G. Li Destri

Polymer/metal hybrid multilayers modified Schottky devices

Insulating, polymethylmethacrylate (PMMA), and semiconducting, poly(3-hexylthiophene) (P3HT), nanometer thick polymers/Au nanoparticles based hybrid multilayers (HyMLs) were fabricated on p-Si single-crystal substrate. An iterative method, which involves, respectively, spin-coating (PMMA and P3HT deposition) and sputtering (Au nanoparticles deposition) techniques to prepare Au/HyMLs/p-Si Schottky device, was used. The barrier height and the ideality factor of the Au/HyMLs/p-Si Schottky devices were investigated by current-voltage measurements in the thickness range of 1–5 bilayers. It was observed that the barrier height of such hybrid layered systems can be tuned as a function of bilayers number and its evolution was quantified and analyzed.

FEASIBILITY OF A PORTO-INTRACAVAL SHUNT FOR LIVER TOTAL VASCULAR EXCLUSION IN THE RABBIT: PRELIMINARY REPORT

The animals do not tolerate prolonged caval and/or portal clamping which induces negative pathophysiological events such as release of chinines, damage of the intestinal mucosa, and bacterial translocation. In human liver surgery, these problems have been solved by bio‐pump for veno‐venous bypass. In order to find a simple method to reproduce a veno‐venous bypass, we developed the porto‐intracaval shunt and used it in six adult rabbits. The shunt tested was a self constructed 7‐french polyurethane shunt modeled as an inverted Y. The inferior vena cava vein below the diaphragm and below the liver and the portal vein were gently dissected. The two longer branches of the shunt were inserted in the cava vein, while the remaining branch of the Y shunt was inserted in the portal vein. After clamping the hepatic artery, the liver was partially resected in three animals and after 60 min the shunt was removed. The insertion of the shunt was always easy and the animals tolerated well the procedure and the anhepatic phase. Our study has been performed in order to test especially the technical feasiblity of this shunt in an effort to reduce portal and caval stasis during the anhepatic phase of the surgical procedures that require caval and portal clamping. The technical feasibility has been obtained but we believe that the materials and dimensions of the shunt have to be perfected and adapted depending on the size of the cava and portal veins.

Controlling length-scales of the phase separation to optimize organic semiconductor blends

The length-scale of phase separation in organic semiconductor donor-acceptor mixtures, while being crucially important for applications, is a non-trivial parameter to control in non-equilibrium thin film growth. We present a comprehensive study of all the important parameters that can be used to tailor the length-scale of phase separation in organic semiconductor mixtures. We employed different substrate temperatures, different growth rates, time-dependent deposition rates, and surface functionalization layers. We found not only that the substrate temperature is most prominent in influencing the length-scale of phase separation in the studied parameter range, but also that other routes can be used to tailor this length-scale.

Management of colorectal cancer follow-up in elderly patients

Background Follow-up of surgically treated colorectal cancer patients is not supported by objectively certain data. Despite the thousands of investigations reported in the literature, only six randomized prospective studies and two meta-analysis of randomized studies provide data suggesting clear conclusions until today. The main goal of colorectal follow-up is to improve patient survival by early diagnosis of recurrence during the asymptomatic stage when radical surgical treatment is more viable [1]. However the reduction of global mortality from colorectal cancer achieved by follow-up, radical second-surgery and therefore new and definite patient recovery calculated in our patients in follow-up on 5 years disease free interval was only 2.6 % according to the findings of other authors [2,3]. In our recent study carried out on a group of 280 patients in our follow-up the average age was 69.5 demonstrating that the age must be carefully considered in order to establish the follow-up timing and modality and to calculate the cost-benefit ratio. In our experience the far from brilliant results obtained led us to change our follow-up in 2006 and make it less intensive, tailoring it to the stage of the disease, the reliability of the diagnostic methods, times of recurrences and no less important, the age of patients. In the aged obviously the surgical and/or adjuvant and neoadjuvant treatments are to be considered with caution and local and general controindications to every type of therapy carefully evaluated. The age is a fundamental part of ASA, POSSUM and PST and could condition the therapeutical strategies. On the other hand many reports confirm the possibility of performing safe operation for liver and lung metastases or local recurrences in the elderly without a statistical higher rate of morbidity and mortality compounding with younger adults. Lastly, in our policy we have considered the agreement of elderly patients to modality and timing of follow-up on the basis of a study carried out with the collaboration of a psychological team. On the basis of those experiences we also believe that in some patients and circumstances a major involvement of family doctors substituting the institutional follow-up staff is necessary.

Late cutaneous fistula after inguinal hernia repair without prosthesis.

Abstract Late onset of cutaneous fistulas associated with inguinal hernia repair represents an extremely rare complication that occurs especially after affixing a prosthesis. The authors report a case of a patient developing this complication after a hernia repair (Shouldice’s technique), emphasize that the fistula appeared after more than 12 years (the longest interval reported in the literature), and explain how it resolved only with the surgical removal of the suture used for hernia repair. The authors emphasize the aetiology of this complication and stress that it can occur even after a hernia repair without prosthesis.

Misplacement of a jugular line in a facial vein

We report an exceptional misplacement of a central venous catheter, from the right jugular vein where it was introduced, into the right thyro-lingual-facial trunk. A brief description of the clinical course and a literature review on catheter misplacement is presented. This case illustrates the importance of routine use of a chest X-ray, and when necessary contrast medium, to verify the correct location of the catheter tip.