Risultati del trattamento chirurgico del varicocele nella infertilità maschile

To evaluate the results of surgical treatment of varicocele on infertile men, especially regarding sperm count, 245 patients, surgically treated from 1993 to 2003, were evaluated. Patients underwent to ligature and section of the pampiniform plexus, throught the subinguinal approach and local anaesthesia. At the follow-up (3-6-12 months) an improvement of sperm count was relieved in 79.5% of patients and the incidence of complications and relapses was of 3.7% and 1.2%, respectively. The Authors stress the efficacy of surgical treatment of varicocele in male infertility and hold the subinguinal approach as an effective treatment, minimally invasive and low cost

Chemical ear peeling: a simple technique for the treatment of chronic external otitis: how we do it

[NFew conditions encountered by otolaryngologists are as frustrating as chronic otitis externa and recurrent exacerbation presents a special challenge for the attending physician. The disease may be extremely therapy-resistant: a great many patients report chronic suffering from otitis externa with inadequate and inefficacious treatment attempts.1 Current medical treatment is based on topical application of steroids, antibiotics and external auditory canal cleansing.2 Moreover, there are no long-term outcome data on medical management.3 In this study we present, showing the short- and longterm clinical outcomes, a new, safe and simple therapeutic technique for the management of chronic otitis externa: chemical ear peeling (CEP).o abstract available

Quantification of fibrosis by collagen proportionate area predicts hepatic decompensation in hepatitis C cirrhosis

Background It is unclear whether the course of cirrhosis and its prognosis are related to the amount of collagen in the liver. Aim To determine whether fibrosis, assessed by collagen proportionate area (CPA) in patients with compensated cirrhosis, is associated with the presence of oesophageal varices, and predict disease decompensation during the follow-up period. Methods We prospectively evaluated 118 consecutive patients with compensated cirrhosis to correlate fibrosis, assessed by CPA in liver biopsies, with the presence of oesophageal varices (OV) and with the rate of liver decompensation (LD) development during a median follow-up of 72 months. Results At baseline 38 (32.2%) patients had OV and during the follow-up (median 72 months, IQR 47–91), 17 patients (14.4%) developed LD. The mean CPA value was different in patients with and without OV (14.8 5.9% vs. 21.6 9.5%, P < 0.001). The best CPA cut-off for OV by area under the receiver operating characteristic (AUROC) was ≥14% and with multivariate logistic analysis CPA was the only variable associated with OV (OR: 28.32, 95% CI: 6.30–127.28; P < 0.001). By AUROC analysis the best CPA cut-off to predict LD was 18.0%. By Cox regression multivariate analysis CPA ≥18% (HR: 3.99, 95% CI: 1.04–11.45; P = 0.036), albumin (HR: 0.12, 95% CI: 0.04–0.43; P = 0.001) and presence of OV (HR: 8.15, 95% CI: 2.31– 28.78; P = 0.001) were independently associated with LD. Conclusion Quantification of fibrosis by collagen proportionate area allows identification of patients with compensated HCV cirrhosis with a higher likelihood of clinically relevant portal hypertension and a higher risk of decompensation

Comparison of MLT Momentum Fluxes Over the Andes at Four Different Latitudinal Sectors Using Multistatic Radar Configurations

The middle atmosphere over South America, particularly above the Andes mountain range, is known as one of the most dynamically active regions in the world. Previous studies have investigated wave dynamics at mesosphere and lower thermosphere (MLT) altitudes within this region, but only a handful of them have made use of continuous measurements provided by specular meteor radars (SMRs). Furthermore, it was only until recently that MLT horizontal wind gradients were estimated for the first time using Spread Spectrum Interferometric Multistatic meteor radar Observing Network (SIMONe) Argentina, a multistatic SMR network located in southern Patagonia. By observing larger amounts of meteors from different viewing angles, multistatic SMRs allow, among others, for more reliable momentum flux estimates. In this work, we explore and compare the summer and winter MLT momentum flux dynamics at low and middle latitude sectors over the Andes mountain range. We also investigate the intermittency of the total momentum flux over these sectors. For this purpose, we analyze measurements provided by four multistatic SMR networks: SIMONe Peru (12°S), CONDOR (30°S), SIMONe Argentina (49°S) and MMARIA-SAAMER (54°S). We find that the momentum flux dynamics can change considerably over distances of only a few hundred km (e.g., southern Argentina). On the other hand, the contributions of large momentum fluxes to the total flux can be similar between regions separated by thousands of km (e.g., between Peru and southern Argentina)

Mechanism of Hydrogen-Bonded Complex Formation between Ibuprofen and Nanocrystalline Hydroxyapatite.

Nanocrystalline hydroxyapatite (nanoHA) is the main hard component of bone and has the potential to be used to promote osseointegration of implants and to treat bone defects. Here, using active pharmaceutical ingredients (APIs) such as ibuprofen, we report on the prospects of combining nanoHA with biologically active compounds to improve the clinical performance of these treatments. In this study, we designed and investigated the possibility of API attachment to the surface of nanoHA crystals via the formation of a hydrogen-bonded complex. The mechanistic studies of an ibuprofen/nanoHA complex formation have been performed using a holistic approach encompassing spectroscopic (Fourier transform infrared (FTIR) and Raman) and X-ray diffraction techniques, as well as quantum chemistry calculations, while comparing the behavior of the ibuprofen/nanoHA complex with that of a physical mixture of the two components. Whereas ibuprofen exists in dimeric form both in solid and liquid state, our study showed that the formation of the ibuprofen/nanoHA complex most likely occurs via the dissociation of the ibuprofen dimer into monomeric species promoted by ethanol, with subsequent attachment of a monomer to the HA surface. An adsorption mode for this process is proposed; this includes hydrogen bonding of the hydroxyl group of ibuprofen to the hydroxyl group of the apatite, together with the interaction of the ibuprofen carbonyl group to an HA Ca center. Overall, this mechanistic study provides new insights into the molecular interactions between APIs and the surfaces of bioactive inorganic solids and sheds light on the relationship between the noncovalent bonding and drug release properties

Tunable broadband light emission from graphene

Graphene is an ideal material for integrated nonlinear optics thanks to its strong light-matter interaction and large nonlinear optical susceptibility. Graphene has been used in optical modulators, saturable absorbers, nonlinear frequency converters, and broadband light emitters. For the latter application, a key requirement is the ability to control and engineer the emission wavelength and bandwidth, as well as the electronic temperature of graphene. Here, we demonstrate that the emission wavelength of graphene$'$ s broadband hot carrier photoluminescence can be tuned by integration on photonic cavities, while thermal management can be achieved by out-of-plane heat transfer to hexagonal boron nitride. Our results pave the way to graphene-based ultrafast broadband light emitters with tunable emission.Comment: 22 pages, 5 Figure

Video-assisted parathyroidectomy: a series of 85 cases

Abstract AIM OF THE STUDY: To verify the feasibility of video-assisted parathyroidectomy, set up the indications and report the results in a series of 85 patients. MATERIAL AND METHODS: From 1997 to 1999, 85 patients affected by primary hyperparathyroidism due to single gland disease, with an adenoma smaller than 35 mm as demonstrated by preoperative imaging, were referred for video-assisted parathyroidectomy. There were 62 females and 23 males. Mean age was 53 years, (range 23-82). Video-assisted parathyroidectomy was associated with intra-operative PTH quick-assay. Calcium testing was controlled before leaving the hospital, 1 month and 3 months later, and postoperative laryngoscopy was performed in all patients. RESULTS: There were five conversions to open cervicotomy: three due to a contra-lateral second adenoma, two because of an intrathyroidal adenoma. The mean operative time for video-assisted procedure was 59 minutes (range: 25-180). Circulating PTH levels 10 minutes after the removal of the affected gland(s) always dropped significantly, and pathological report confirmed the parathyroid nature of the specimens (mean diameter 13 mm, range 7-35). Morbidity consisted of five cases of transient hypocalcemia and one permanent laryngeal nerve paralysis. We registered no persistent or recurrent disease (mean follow-up 12.8 months, range 1-28). CONCLUSIONS: Video-assisted parathyroidectomy is feasible, and its results are similar to those of traditional procedure, while it seems superior as regards postoperative course and aesthetic results. It also allows different strategical decisions even during operation (i.e. bilateral exploration or thyroid lobectomy) by the same approach

Hydrochlorination of acetylene using supported bimetallic Au-based catalysts

A detailed study of the hydrochlorination of acetylene and higher alkynes using a supported gold catalyst is described and discussed. A series of reactions using sequential exposure of the catalysts to C2H2 and HCl demonstrate that exposure to HCl prior to reaction of C2H2/HCl leads to enhanced activity whereas exposure to C2H2 leads to deactivation. The reaction of higher alkynes is affected by steric factors with the trend in activity being: acetylene (ca. 40 % conversion)>> hex-1-yne (10%)>phenylacetylene (7 %) > hex-2-yne (2 %) under standard reaction conditions. Using 1H-NMR spectroscopy we have found that for hex-1-yne and phenyl acetylene the anti-Markovnikov product is formed by anti addition of HCl. However, the Markovnikov products are equivalent for syn- and antiaddition of HCl, and hence we investigated the reaction using deuterated substrates and confirmed the products are formed by the anti addition of HCl. The reaction mechanism is discussed in detail