Management of laryngeal precancerous lesions

Objective: The identification of precancerous lesions is the basis of an early diagnosis, and of a treatment that allows, in the great part of cases, the preservation of organ functions. The aims of this study were: the evaluation of the less invasive treatment for precancerous lesion of the larynx to minimize the recurrences, the estimation of number of further operation required. Methods: A prospective study was clone on patients with clinical diagnosis of laryngeal precancerosis. The patients were treated by a transoral endoscopic approach with direct microlaryngoscopy (DML) doing an excision-biopsy with cold blade, consisting in excision of the whole visible lesion with vocal ligament preservation. Results: A recurrence of a clinically evident precancerous lesion was present in 13.2% of patients that had a laryngeal intraepithelial lesion (LIN) 1 lesion and in 28.95% of patients that had a LIN 2 lesion. Conclusion: In order to achieve a control of a precancerous lesion, we suggest: excisional biopsy/subepithelial cordectomy (type 1 cordectomy) for LIN 1 lesions and subligament cordectomy (type 2 cordectomy) in case of LIN 2 cases. In case of recurrences of LIN 1 lesion we suggest directly a type 2 cordectomy

Numerical Simulation of the Kinetics of Radical Decay in Single-Pulse High-Energy Electron-Irradiated Polymer Aqueous Solutions

A new method for the numerical simulation of the radiation chemistry of aqueous polymer solutions is introduced. The method makes use of a deterministic approach combining the conventional homogeneous radiation chemistry of water with the chemistry of polymer radicals and other macromolecular species. The method is applied on single-pulse irradiations of aqueous polymer solutions. The speciation of macromolecular species accounts for the variations in the number of alkyl radicals per chain, molecular weight, and number of internal loops (as a consequence of an intramolecular radical-radical combination). In the simulations, the initial polymer molecular weight, polymer concentration, and dose per pulse (function of pulse length and dose rate during the pulse) were systematically varied. In total, 54 different conditions were simulated. The results are well in line with the available experimental data for similar systems. At a low polymer concentration and a high dose per pulse, the kinetics of radical decay is quite complex for the competition between intra- and intermolecular radical-radical reactions, whereas at a low dose per pulse the kinetics is purely second-order. The simulations demonstrate the limitations of the polymer in scavenging all the radicals generated by water radiolysis when irradiated at a low polymer concentration and a high dose per pulse. They also show that the radical decay of lower-molecular-weight chains is faster and to a larger extent dominated by intermolecular radical-radical reactions, thus explaining the mechanism behind the experimentally observed narrowing of molecular weight distributions

Inherently fluorescent polyaniline nanoparticles in a dynamic landscape

In this paper we report for the first time on the emissive behavior of two polyaniline (PANI) nanoparticle systems produced via oxidative chemical polymerization in the presence of either poly(vinyl alcohol)(PVA) or chitosan as polymeric stabilizers in water. The emission from PANI nanoparticles is irreversibly quenched by an increase of pH of the suspending medium from acid to neutral (chitosan–PANI) or alkaline (PVA–PANI). Conversely, PANI nanorods synthesized in the same conditions of the above, but in presence of poly(N-vinyl pyrrolidone), is not emissive at any pH. The role of the polymeric surfactant as a soft template is key in controlling the morphology and the properties of the obtained PANI dispersions. FTIR, UV–Vis absorption and photoluminescence excitation (PLE) spectra studies suggest that the emissive properties are related to the establishment of strong, non-covalent interactions between nanoscalar PANI particles and the polymeric surfactant at the pH of synthesis. Morphology examination of the three systems, by both dynamic light scattering (DLS) and Transmission Electron Microscopy (TEM), reveal that photoluminescence is associated to the presence of a genuinely 3D nanoscalar morphology, together with an ordered disposition of PANI chains into aligned crystal planes. Concomitant to the irreversible quenching of the emission signal with increasing pH, there is an evolution of the morphology leading to particle coalescence, coarsening and ultimately phase-separation, with consequent modification of PANI–polymeric surfactant interactions, PANI chains supra-molecular organization and optical properties of the PANI nanoparticles dispersion

Control of end-of-life oxygen-containing groups accumulation in biopolyesters through introduction of crosslinked polysaccharide particles

The formulation of bio-based materials with good performance in service and controlled end-of-life is imperative for an effective circular economy. In this work, an innovative approach to induce and control the end-of-life of biodegradable polyesters through introduction of crosslinked polysaccharide particles is proposed. Chitosan (Ch) has been subjected to ionotropically crosslinking and then added to polylactic acid (PLA) at different amounts (1.0–4.0%w) by melt mixing. All obtained results suggest that the addition of crosslinked Ch (cCh) particles does not modify significantly the investigated biopolyester properties. Specifically, the thermal analysis of the composites reveals that the addition of unmodified Ch alters the PLA thermal behavior, while the addition of cCh particles does not change the PLA glass transition, cold crystallization and fusion phenomena. The infrared and UV–visible spectroscopic analyses suggest no significant changes in PLA structure. PLA/cCh films show a good optical transparency, which is a desirable property for food packaging applications. In addition, thin PLA-based films have been subjected to UVB exposure and the accumulation of oxygen-containing groups has been monitored in time through spectroscopic analysis. Interestingly, at low exposure time, the presence of chitosan slows down the accumulation of these groups, while at long exposure time, chitosan induces accelerated oxygen-groups formation, supporting its beneficial effect as end-of-life accelerant

A new route for the preparation of flexible skin\u2013core poly(ethylene-co-acrylic acid)/polyaniline functional hybrids

Surface modification of polymeric films is a way to obtain final products with high performance for many specific and ad hoc tailored applications, e.g. in functional packaging, tissue engineering or (bio)sensing. The present work reports, for the first time, on the design and development of surface modified ethylene\u2013 acrylic acid copolymer (EAA) films with polyaniline (PANI), with the aim of inducing electrical conductivity and potentially enable the electronic control of a range of physical and chemical properties of the film surface, via a new \u2018\u2018grafting from\u2019\u2019 approach. In particular, we demonstrate that PANI was successfully polymerized and covalently grafted onto flexible EAA substrates, previously activated. The final hybrid materials and the corresponding intermediates were fully characterized via FTIR, XPS, SEM\u2013EDAX, mechanical and electrical tests. The mechanical properties of the films are not detrimentally affected by each treatment step, while a significant increase in electrical conductivity was achieved for the new hybrid materials

Use of biochar as peat substitute for growing substrates of Euphorbia × lomi potted plants

Biochar from conifers wood was used in soilless culture as growing substrate alternative to peat for ornamental crops. Potted plants of Euphorbia × lomi Rauh cv. 'Ilaria' were grown with different mixtures (v:v) of brown peat and biochar in order to evaluate main physical and chemical characteristics of this biomaterial as well as its effect on plant growth, ornamental characteristics and nutrients uptake. Biochar addition to peat increased pH, EC and K content of the growing substrates, as well as air content and bulk density. Biochar content of substrates significantly affected plant growth and biomass partitioning: higher number of shoots and leaves, leaf area and leaf dry weight were recorded in plants grown in 40% peat-60% biochar, with respect to plants grown in 100% peat and secondarily in 100% biochar. Leaf chlorophyll content was higher in plants grown in 60% and 80% biochar, while biomass water use efficiency was higher with 60% biochar. Plant uptake of K and Ca increased as biochar content of the substrates increased. Hence, a growing substrate containing 40% brown peat and 60% conifers wood biochar was identified as the more suitable mixture allowing to have a high-quality production of Euphorbia × lomi potted plants

Development and characterization of an amorphous solid dispersion of furosemide in the form of a sublingual bioadhesive film to enhance bioavailability

Administered by an oral route, Furosemide (FUR), a diuretic used in several edematous states and hypertension, presents bioavailability problems, reported as a consequence of an erratic gastrointestinal absorption due to various existing polymorphic forms and low and pH-dependent solubility. A mucoadhesive sublingual fast-dissolving FUR based film has been developed and evaluated in order to optimize the bioavailability of FUR by increasing solubility and guaranteeing a good dissolution reproducibility. The Differential Scanning Calorimetry (DSC) analyses confirmed that the film prepared using the solvent casting method entrapped FUR in the amorphous state. As a solid dispersion, FUR increases its solubility up to 28.36 mg/mL. Drug content, thickness, and weight uniformity of film were also evaluated. The measured Young\ue2\u80\u99s Modulus, yield strength, and relative elongation of break percentage (EB%) allowed for the classification of the drug-loaded film as an elastomer. Mucoadhesive strength tests showed that the force to detach film from mucosa grew exponentially with increasing contact time up to 7667 N/m2. FUR was quickly discharged from the film following a trend well fitted with the Weibull kinetic model. When applied on sublingual mucosa, the new formulation produced a massive drug flux in the systemic compartment. Overall, the proposed sublingual film enhances drug solubility and absorption, allowing for the prediction of a rapid onset of action and reproducible bioavailability in its clinical application

Fat plug myringoplasty: Analysis of a safe procedure for small tympanic perforations

Objective: Assessment of value of fat plug myringoplasty as office-based procedure in small tympanic membrane perforations. Material and Methods: Prospective study of consecutive patients undergoing fat plug myringoplasty under local anesthesia. Minimum follow-up considered was 6 months, which included several microscopic examinations. All data were recorded and analyzed statistically. Results: 33 patients matched the inclusion criteria; the mean perforation size was 2.8 mm. No change in PTA was noted after surgery in the whole series. Recurrence of perforation was detected in 7 cases (21%), which was statistically related with the cause of perforation rather than location or size (p-value <0.01). Conclusions: Fat plug myringoplasty is a safe procedure with very low rate of complications, and it is an office-based procedure well tolerate by all patients. Results in case of primary surgery are excellent, with a high success rate (90%). In case of recurrent perforation after traditional surgery, success rate get decreased

Polymerization reactions and modifications of polymers by ionizing radiation

Ionizing radiation has become the most effective way to modify natural and synthetic polymers through crosslinking, degradation, and graft polymerization. This review will include an in-depth analysis of radiation chemistry mechanisms and the kinetics of the radiation-induced C-centered free radical, anion, and cation polymerization, and grafting. It also presents sections on radiation modifications of synthetic and natural polymers. For decades, low linear energy transfer (LLET) ionizing radiation, such as gamma rays, X-rays, and up to 10 MeV electron beams, has been the primary tool to produce many products through polymerization reactions. Photons and electrons interaction with polymers display various mechanisms. While the interactions of gamma ray and X-ray photons are mainly through the photoelectric effect, Compton scattering, and pair-production, the interactions of the high-energy electrons take place through coulombic interactions. Despite the type of radiation used on materials, photons or high energy electrons, in both cases ions and electrons are produced. The interactions between electrons and monomers takes place within less than a nanosecond. Depending on the dose rate (dose is defined as the absorbed radiation energy per unit mass), the kinetic chain length of the propagation can be controlled, hence allowing for some control over the degree of polymerization. When polymers are submitted to high-energy radiation in the bulk, contrasting behaviors are observed with a dominant effect of cross-linking or chain scission, depending on the chemical nature and physical characteristics of the material. Polymers in solution are subject to indirect effects resulting from the radiolysis of the medium. Likewise, for radiation-induced polymerization, depending on the dose rate, the free radicals generated on polymer chains can undergo various reactions, such as inter/intramolecular combination or inter/intramolecular disproportionation, b-scission. These reactions lead to structural or functional polymer modifications. In the presence of oxygen, playing on irradiation dose-rates, one can favor crosslinking reactions or promotes degradations through oxidations. The competition between the crosslinking reactions of C-centered free radicals and their reactions with oxygen is described through fundamental mechanism formalisms. The fundamentals of polymerization reactions are herein presented to meet industrial needs for various polymer materials produced or degraded by irradiation. Notably, the medical and industrial applications of polymers are endless and thus it is vital to investigate the effects of sterilization dose and dose rate on various polymers and copolymers with different molecular structures and morphologies. The presence or absence of various functional groups, degree of crystallinity, irradiation temperature, etc. all greatly affect the radiation chemistry of the irradiated polymers. Over the past decade, grafting new chemical functionalities on solid polymers by radiation-induced polymerization (also called RIG for Radiation-Induced Grafting) has been widely exploited to develop innovative materials in coherence with actual societal expectations. These novel materials respond not only to health emergencies but also to carbon-free energy needs (e.g., hydrogen fuel cells, piezoelectricity, etc.) and environmental concerns with the development of numerous specific adsorbents of chemical hazards and pollutants. The modification of polymers through RIG is durable as it covalently bonds the functional monomers. As radiation penetration depths can be varied, this technique can be used to modify polymer surface or bulk. The many parameters influencing RIG that control the yield of the grafting process are discussed in this review. These include monomer reactivity, irradiation dose, solvent, presence of inhibitor of homopolymerization, grafting temperature, etc. Today, the general knowledge of RIG can be applied to any solid polymer and may predict, to some extent, the grafting location. A special focus is on how ionizing radiation sources (ion and electron beams, UVs) may be chosen or mixed to combine both solid polymer nanostructuration and RIG. LLET ionizing radiation has also been extensively used to synthesize hydrogel and nanogel for drug delivery systems and other advanced applications. In particular, nanogels can either be produced by radiation-induced polymerization and simultaneous crosslinking of hydrophilic monomers in “nanocompartments”, i.e., within the aqueous phase of inverse micelles, or by intramolecular crosslinking of suitable water-soluble polymers. The radiolytically produced oxidizing species from water, •OH radicals, can easily abstract H-atoms from the backbone of the dissolved polymers (or can add to the unsaturated bonds) leading to the formation of C-centered radicals. These C-centered free radicals can undergo two main competitive reactions; intramolecular and intermolecular crosslinking. When produced by electron beam irradiation, higher temperatures, dose rates within the pulse, and pulse repetition rates favour intramolecular crosslinking over intermolecular crosslinking, thus enabling a better control of particle size and size distribution. For other water-soluble biopolymers such as polysaccharides, proteins, DNA and RNA, the abstraction of H atoms or the addition to the unsaturation by •OH can lead to the direct scission of the backbone, double, or single strand breaks of these polymers