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The Divertor Tokamak Test facility (DTT) will be a new experimental facility located at Frascati, Rome, Italy, whose main goal will be to have a better understanding on hot plasma interactions with plasma-facing components (PFCs) and aid in the development of ITER and successively DEMO. The improved conceptual design of the beamline for the DTT neutral beam heating (NBH) system is here overviewed, with a particular focus on the technical solutions adopted to fulfill the requirements and maximize beamline performances. The proposed system features a beamline providing deuterium neutrals ( $D^{0}$ ) with an energy of 510 keV and an injected power of 10 MW. Various design options have been considered, and a comprehensive set of simulations has been carried out using several physics and engineering codes to drive the choice of the most suitable design options and optimize them, aiming at finding a good compromise among different design requirements.

The additive manufacturing capabilities open new frontiers in the design of complex geometries in many different application fields, especially thermal science, in which multi-functional, efficient, compact components with internal cooling or heating channels are becoming more and more requested. Among the possible additive manufacturing technologies, the laser powder bed fusion process has recently been proven to manufacture high-conductivity metals, with good mechanical and thermal properties (i.e. pure copper and copper alloys), attracting the attention of the heat transfer community. However, depending on the material, design, and process parameters, the surface roughness of the components can remarkably change and become a critical issue in cooling applications. Currently, the surface texture characteristics and the final channel size cannot be accurately estimated a priori, and thus the initial hypothesis of the current design methods may lead to unpredictable and undesired results. This work experimentally and numerically explores the effects of the building orientation on the fluid dynamic behaviour in CuCrZr alloy channels, which is considered one of the most promising additive manufacturing materials for thermal applications. By coupling the experimental hydraulic results with surface characterization and X-ray computer tomography dimensional measurements of the channels, a novel simplified methodology to properly correlate the pressure drop to the surface texture of a single wall is proposed and numerically validated.

Using a cellulosic material dating method recently proposed by three of the authors of the present article further applications to real samples are discussed. In the first instance, to wood samples, that is, to a type of sample for which the method was specifically developed but with the samples differing widely in age, and then to textile or paper samples. Of course in the latter two cases the results obtained are still quite preliminary, above all because of the difficulty of procuring certainly dated samples of this type.

The improvement of acne vulgaris (AV) during summer months is a general opinion which is not universally accepted as some patients experience no change or even an aggravation of their AV during hot months. Therapeutic management of AV in summer is often difficult; in fact, most traditional anti-acne treatments are contraindicated or poorly tolerated during summer months. In this study we evaluated the tolerability and effectiveness of a cosmetic anti-acne treatment performed for 12 summer weeks in 347 patients (mean age, 19.4 yrs) with mild AV of the face. The study product (Exfoliac®) contained a mixture of alpha hydroxy acids and substances with moisturizing and/or lenitive effects. In the first 4 weeks, Exfoliac® 10 cream was applied twice a day (b.i.d.). The treatment in the following 8 weeks was decided on the basis of dermatologist's assessment of the clinical response and could consist in Exfoliac® 10 cream or Exfoliac® 15 cream, once daily (o.d.) or b.i.d. During the study period, patients used Exfoliac® cleansing gel. The cumulative results indicate a significant improvement of AV lesions and seborrhoea, irrespectively of sun exposure, and a good tolerability, even in sunbathed patients. Adverse reactions, mostly of mild severity, appeared to be independent of sunbathing or use of sunscreens and were observed in a small proportion of cases (6.8% in the first 4 weeks and 5.6% in the last 8 weeks).Our results suggest that this type of treatment is an effective and safe approach to patients with mild AV who require treatment in the summertime.

The development and optimization of an analytical method using enzymatic biosensors able to operate in organic solvents [organic phase enzyme electrodes (OPEEs)] for the determination of the water content in food fats (butter, margarine) or pharmaceutical or cosmetic ointments is described. The method is based on the increase in enzymatic activity which is related to the increase in the percentage water content in the organic phase into which the biosensor is dipped. The enzymes used to assemble the biosensors were tyrosinase or catalase, the substrates were phenol or p-cresol and tert-butyl hydroperoxide, respectively, and the organic solvents were acetonitrile or dioxane. A gas diffusion amperometric electrode for oxygen measurement was used as electrochemical transducer. The results were compared with those obtained applying the Karl Fischer method to the same food or drug matrices. The correlations among the two methods proved satisfactory, as the difference in the computed values of water content was never higher than 7%. Also, the precision of measurements was acceptable (RSD <6%) in all the analyses of real matrices.

The aims of this study were (1) to assess possible variations in the serum levels of epidermal growth factor (EGF), insulin-like growth factor I (IGF I) and somatostatin in patients with pancreatic cancer as compared to other pancreatic or extrapancreatic diseases and (2) to ascertain the role of these substances in tumour growth and spread. 35 patients with pancreatic cancer were compared to 15 patients with chronic pancreatitis, 15 with benign hepatobiliary diseases, 23 with benign or malignant gastro-intestinal diseases and 22 control subjects. Increased EGF and IGF I serum levels were found in 10% of patients with pancreatic cancer. Somatostatin levels were increased in 8/16 (50%) patients with pancreatic cancer. No correlation was found between EGF, IGF I or somatostatin and tumour size or stage. In pancreatic cancer somatostatin serum levels were correlated with total bilirubin (p < 0.04), while EGF and IGF I were inversely correlated with fasting serum glucose levels (p < 0.05). In conclusion, (1) the serum levels of EGF, IGF I and somatostatin were not related to tumour size and clinical stage of pancreatic cancer, (2) the serum levels EGF and IGF I may be related to altered glucose metabolism, and (3) liver impairment can influence somatostatin serum levels.

Summary Elastase 1 and immunoreactive trypsin were assessed by a RIA technique in the sera of 29 control subjects, 24 pancreatic cancer patients, 22 patients with chronic pancreatitis and 31 with extra-pancreatic diseases to ascertain and compare their usefulness in chronic pancreatic disease diagnosis. Increased levels of elastase 1 were detected in 60.9% of pancreatic cancer and in 61.1% of chronic pancreatitis patients; low values were found in only two subjects with pancreatic disease. A close correlation between the two enzymes was found in patients suffering from pancreatic cancer and chronic pancreatitis. These data suggest that serum elastase 1, as well as immunoreactive trypsin, is of limited value in chronic pancreatic disease diagnosis; increased levels of the two enzymes always occur simultaneously; low immunoreactive trypsin values together with normal elastase 1 serum levels are detectable in a number of patients with chronic pancreatitis and severe exocrine insufficiency.

Pancreatic tissue obtained from 26 patients with alcoholic chronic pancreatitis (ACP), nine patients with nonalcoholic idiopathic chronic pancreatitis (NAICP), and seven patients with obstructive chronic pancreatitis (OCP) was studied in an attempt to determine whether clinical or etiologic differences have a morphologic counterpart. Histologically it was easy to distinguish ACP from OCP occurring distal to an obstruction of the pancreatic duct. Nine patients with NAICP showed histological features similar to those found in ACP. Plugs and calcifications were found as frequently in NAICP as in ACP, suggesting that NAICP, whatever the etiology, is truly pancreatolithiasis, which leads to slowly progressive fibrosis and acinar atrophy in the obstructed pancreatic lobule. Nerve fibers were found to be more numerous in all disease categories. Inflammatory foci of lymphocytes associated with nerves were observed in 57 and 35 of cases with OCP and ACP, respectively, but only in one patient with NAICP. These findings may constitute a pathological basis for the existing clinical data showing that NAICP frequently runs a pain-free course.

To ascertain whether aging and/or cholelithiasis can influence oro- cecal transit time (OCTT), we studied a total of 70 subjects, i.e., 10 healthy young adult controls, 22 healthy elderly controls, 18 elderly cholelithiasis patients and 20 elderly subjects with a history of cholecystectomy for gallstones. OCTT was measured by means of the hydrogen breath test after administering a liquid meal of 10 g of lactulose in 200 mL of water, and collecting exhaled breath samples every 10 minutes for 200 minutes. Of all subjects in the group of patients with a history of cholecystectomy, 6/20 were non- hydrogen producers, and therefore were not included in the study. The OCTT was found to be significantly longer in healthy elderly controls, than in healthy young adult controls; the elderly subjects who had undergone cholecystectomy had a longer OCTT than the healthy elderly controls, while no difference was detected when compared to elderly patients with gallstones. In conclusion, OCTT seems to increase in healthy aging. Cholecystectomy also increases OCTT in the elderly, suggesting a link between intestinal motility and the biliary tract which may be of pathophysiological significance. (Aging Clin. Exp. Res. 7: 234–237, 1995)

This study was performed to investigate modifications in the serum bilirubin forms, hepatobiliary enzymes, and some glycoproteic substances in patients during the course of extrahepatic cholestasis (stage A) and following its clinical resolution (stage B). The series consisted of 16 patients 11 had main bile duct stones; two, benign stenosis of the main bile duct; and three, main bile duct cancer. Cholestasis resolved spontaneously in one case, under endoscopy in two, and following surgery in 13. Five patients with liver cirrhosis and a picture of intrahepatic cholestasis following anesthesia were also investigated. Serum bilirubin forms were measured using van den Bergh's method and the alkaline methanolysis-HPLC procedure; the mono- and di-conjugated forms were considered together in the overall evaluation of the results. The hepatobiliary enzymes (ALP, GGT, and AST) were increased at stage A and significantly decreased at stage B. Similar patterns were observed in total (TB), unconjugated (UB), and conjugated bilirubin (CB) and in the percentage of CB out of TB (% CB). In the majority of patients, % CB at stage B was lower than at stage, whereas in subjects with a high initial UB value, a different % CB pattern was observed. The direct bilirubin percentage (% DB), on the other hand, had a different pattern, and the variations between stages A and B were not significant. The pathophysiological bilirubin pattern was similar in patients with intrahepatic cholestasis. At stage A, in a number of patients the levels of glycoproteic substances (CA 19-9, TPA and ferritin) were raised, but at stage B they tended to decrease towards the normal range. Correlations were found between CA 19-9 or TPA variations and cholestasis indicators. It may be concluded that our HPLC technique may reveal differences in the behavior of the bilirubin pigments that cannot be detected with van den Bergh's method, even in the presence of similar TB variations. The increase in the glycoproteic substances considered may express an impairment in their metabolic (largely hepatic) clearance, as occurs in the cholestatic setting.

Summary: We evaluated levels of insulin-like growth factor-I and interleukin-1 α and β in patients with pancreatic cancer; the role of these substances in tumor spread and in hyperglycemia was also investigated. Thirty pancreatic cancer patients (21 with hyperglycemia) were compared with others with diseases causing hyperglycemia [liver cirrhosis (14 cases, 12 with hyperglycemia), chronic pancreatitis (20 cases, 12 with hyperglycemia), type I diabetes mellitus (13 cases, all hyperglycemic)]. Insulin-like growth factor-I was significantly reduced in patients with liver cirrhosis, probably due to a reduced hepatic capacity for synthesis. It was increased in 6 of 30 pancreatic cancer patients; in these subjects it was correlated with alanine aminotransferase and C-peptide, but not with tumor diameter or the presence of metastases. Interleukin-1α and β were both elevated in pancreatic cancer patients. The former was high, while the latter was low when liver metastases were present. Neither was related to glucose or C-peptide levels. In summary, insulin-like growth factor-I levels are increased in some pancreatic cancer patients but this does not seem to favor tumor spread; however IGF-I could be involved influencing glucose homeostasis. Interleukin-1 α increased, while interleukin-1β decreased in pancreatic cancer patients with metastases, suggesting a different involvement of these two substances in pancreatic cancer spread.

The copper (II) acrylic monomer Cu(aaem)2 (aaem = 2-acetoacetoxyethyl methacrylate) undergoes high-yield γ-ray copolymerization with dimethylacrylamide, styrene, and hydroxoethyl methacrylate in the presence of methylene bisacrylamide as crosslinking agent in dimethylformamide. The metalloorganic copolymers are fully characterized. Polymer-protected Cu(II) results in being extremely stable toward a number of reducing agents in different media. © 1997 John Wiley & Sons, Inc. J Appl Polym Sci 65: 2201–2207, 1997

To evaluate β-cell function in patients with pancreatic cancer, the glucagon stimulation test was performed in seven patients with pancreatic adenocarcinoma, seven patients with type I diabetes mellitus, seven patients with type II diabetes mellitus, and in seven healthy controls. C-peptide serum levels were determined before and after a 1-mg i.v. glucagon injection. Basal C-peptide values were normal or slightly increased in pancreatic cancer and type II diabetic patients and low in type I diabetic patients. Following glucagon stimulation, no significant increase was observed in C-peptide values of type I diabetics and pancreatic cancer patients, whereas significant increases occurred in controls and type II diabetics. It is concluded that the altered p-cell function found in pancreatic cancer patients may lead to hyperglycemia, which is frequently associated with this tumor type.

The diagnostic value of the tumor-associated antigens Ca 19–9 and Ca 12–5 was tested in 130 subjects (38 healthy controls, 37 carcinomas of the pancreas, 23 chronic pancreatitis, 23 extrapancreatic gastrointestinal cancers, 9 endocrine pancreatic tumors). Ca 19–9 levels above 37 U/ml were obtained in 67.6 and Ca 12–5 levels above 39 U/ml in 45.9 of carcinomas of the pancreas, 4.3 and 8.796, respectively, of chronic pancreatis, 21.7 and 17.4 of extrapancreatic gastrointestinal tumors, and 0 and 11.1 of endocrine pancreatic tumors and in none of the healthy controls. Results of preoperative determination of Ca 19–9 and Ca 12–5 gave a sensitivity of 67.6 and 45.9, a specificity of 91.8 and 90.9, a predictive value of a positive test of 80.6 and 70.8. When elevation of both antigens was required, sensitivity decreased to 32.4 but specificity rose to 97.3. All but one of the pancreatic cancer patients were at stage 3 and 4. The only patient with pancreatic cancer in stage 1 had normal levels of both markers. Ca 19–9 and Ca 12–5, whether alone or associated, represent a good diagnostic test for differentiating pancreatic cancer from chronic pancreatitis. Due to the low sensitivity of both markers, the tests are of limited value when any other diagnostic evidence of pancreatic cancer is absent.

This study was performed to investigate the behavior of phospholipase A2 (PLA2) in serum and urine of patients with chronic pancreatic diseases and to ascertain whether any factors influenced the results. In 30 controls, 45 patients with pancreatic cancer, 54 with chronic pancreatitis, and 64 with extrapancreatic diseases, serum and urinary PLA2, pancreatic isoamylase and RNase, and urinary N-acetylglucosaminidase (NAG) were measured. Serum PLA2 levels were higher in patients with chronic pancreatitis than in all the other groups. In our patients, only occasionally was urinary PLA2 elevated, the increase occurring almost exclusively in the presence of an acute inflammatory disease, e.g., relapsed chronic pancreatitis or active inflammatory bowel disease. A correlation was found between serum PLA2 and serum RNase, an indicator of tissue damage, but not between serum PLA2 and pancreatic isoamylase. Urinary PLA2 output was correlated with its renal input and with RNase output. No correlation was found between PLA2 output and pancreatic isoamylase or NAG urinary excretion. In conclusion, (7) the determination of serum PLA2 activity may be an aspecific test of pancreatic disease; (2) PLA2 urinary excretion occasionally increases, especially in the presence of severe phlogosis, which occurs in chronic pancreatitis, in particular during relapse; and (3) irrespective of the tissue origin of urinary PLA2, its increased excretion may be accounted for in part by its increased circulating levels. It is, however, more likely the consequence of a renal tubular dysfunction, which is sometimes found in patients with pancreatic diseases.

This study was undertaken in order to compare the reliability of two acute reflux pancreatitis models in rats, one performed by positioning a silicon tube in the duodenum and the other by creating a gastro-jejunal anastomosis. In two groups (A= 10 and B= 10 rats) a silicon tube was positioned in the duodenum; in the remaining two groups (C=12 and D=6 rats) a latero-lateral antecolic anisoperistaltic gastrojejunal anastomosis was performed 30 days before surgery. A closed duodenal loop was created for 12 hours in groups A and C but not in B and D. Rats in both groups A and C developed acute pancreatic inflammation of a mild degree. Sham operated rats with silicon tube placement had higher histological damage scores than those with gastro-jejunal anastomosis. The difference found between the two groups of rats which under-went gastro-jejunal anastomosis was more marked than that between the two groups which had silicon tube placement. It was concluded that the creation of a gastro-jejunal anastomosis is probably the safer procedure to allow gastro-intestinal flow in acute reflux pancreatitis in rats.

The present review focuses on the utility of serum tumor markers in screening, diagnosis, prognosis and monitoring of pancreatic cancer. Serum determination of all tumor markers studied offers no help in screening or early diagnosis of pancreatic cancer. For diagnosis, blood group-related antigens, in particular CA 19-9, are considered the best indicators of this neoplasm. However, as occurs with other glycoproteic tumor markers, the circulating levels of CA 19-9 are significantly influenced by jaundice, probably because its liver metabolism is reduced. Therefore, the finding of elevated CA 19-9 levels in jaundiced patients has to be evaluated with caution. Since pancreatic cancer recurrences are not susceptible to treatment, the clinical role of widespread use of tumor marker determination in follow-up programs is limited and calls for a critical evaluation.

As referred to in the literature, patients complaining of constipation may have a spastic or, in the case of chronic straining, weak pelvic floor. Twenty-two severely constipated patients who did not improve after a high fiber diet were submitted to whole gut transit time (TT), proctographic, and anorectal manometric studies. A control group consisting of five subjects for TT, five subjects for proctogram, and ten subjects for manometry was also studied. Transit time was delayed (P< 0.001) in all patients. Manometry in the constipated group showed a high rectal threshold (64.1vs.17.1 ml of air,P< 0.01), but no other significant difference. Proctograms in 10 of 22 patients (Group A) showed no differences in the anorectal angle (ARA) and in its distance from the pubococcygeal line (DLPC) in respect to the control group; 12 of 22 patients (Group B) had a paradoxical closure of the ARA at straining in respect to resting position (101.2†vs.120.1†), and a higher DLPC than Group A and the control group in all positions studied. There was no difference in TT for rectal stasis of radiopaque markers between the two pathologic groups. Patients in Group B were older than patients in Group A (55.3vs.42.9 years,P<0.05). In conclusion, proctograms showed alterations of the pelvic floor, but there was no correlation between proctographic data and rectal or colonic stasis of the radiopaque markers, or clinic severity of constipation, but a correlation between ages did exist.

Summary Serum TATI (tumor-associated trypsin inhibitor) was measured in 41 control subjects, 30 patients with pancreatic cancer, 53 with chronic pancreatitis, and 47 with extrapancreatic diseases, mainly of gastrointestinal origin. TATI was found to be elevated in some subjects in all groups of patients; patients with chronic pancreatitis studied during an acute exacerbation of the disease had the highest percentage (68%) of pathological values. TATI was found to be correlated with elastase 1, tissue polypeptide antigen, and total and pancreatic isoamylase. A significant relationship was also found between TATI and serum creatinine levels.

Recently, Additive Manufacturing (AM) of metal components has opened new frontiers in heat transfer applications, going beyond the capabilities of conventional technologies. Despite the great design freedom offered by AM, when dealing with metals, there are a few issues that should be considered to exploit the great capabilities of this manufacturing technology. In fact, the surface roughness of the components is expected to affect the performance of the devices, which can be remarkably different from the ones simulated with computer codes. This paper presents a critical analysis of the accuracy of the numerical tools to simulate the fluid flow behaviour inside channels obtained via AM, showing the major limitations of the standard approaches to accurately predict the pressure drops in straight and complex channels. Three different copper channels of growing complexity were built via SLM (Selective Laser Melting) and then they were experimentally tested to evaluate the predictive abilities of the numerical model. The results revealed that the surface roughness deeply affects the fluid flow, thus the numerical models need to be calibrated to become reliable design tools. The proposed procedure can be considered the first attempt in this direction and allows for a proper integration of the AM with the numerical simulation tools to boost the design capabilities of SLM technology.

The usefulness of serum DU-PAN-2 in diagnosing pancreatic cancer and in distinguishing between this cancer and other benign and malignant diseases, and to assess the role of liver dysfunction in altering the serum levels of this marker were investigated. DU-PAN-2 was measured in the sera of 31 patients with pancreatic cancer, 32 with chronic pancreatitis, 20 with benign and 21 with malignant extra-pancreatic diseases. DU-PAN-2 was found to be above 300 U ml-1 in 21/31 patients with pancreatic cancer (sensitivity 68%). Only 3/32 patients with chronic pancreatitis had abnormal values. A substantial number of patients with both benign and malignant extra-pancreatic diseases had an elevated serum DU-PAN-2 (9/20 and 15/21, respectively). Correlations were found between DU-PAN-2 and (1) total bilirubin, (2) alanine-amino-transferase and (3) alkaline phosphatase. Of the patients with high DU-PAN-2 values, jaundice was found in: 2/3 with chronic pancreatitis, 9/10 with benign and 12/14 with malignant extra-pancreatic diseases. In conclusion, the serum DU-PAN-2 test for pancreatic malignancy is not completely satisfactory, because it is not sensitive enough. While the test for chronic pancreatitis has an acceptable specificity, the assay cannot distinguish between pancreatic cancer and other extra-pancreatic diseases, mainly of the liver and biliary tract. Liver dysfunction as well as jaundice seem to considerable affect the levels of this marker, as reported elsewhere for CA 19-9.

This study was undertaken in order to compare the usefulness of three indices of tumour proliferation in detecting primary hepatocellular carcinoma (HCC) and in differentiating this neoplasm from liver cirrhosis. In 10 patients with HCC and in 63 with liver cirrhosis serum a-fetoprotein (AFP), tissue polypeptide antigen (TPA) and ferritin were assayed. Increased levels of AFP but not of TPA and ferritin were observed in HCC as compared to liver cirrhosis. The receiver-operating characteristic curves demonstrated that AFP is more discriminating between HCC and liver cirrhosis than the other two markers. Correlations between liver function tests and serum markers were observed in liver cirrhosis but not in HCC. We can conclude that AFP is more useful than TPA and ferritin in detecting HCC in patients with liver cirrhosis, owing to the high frequency of false positive results of the latter two indices in liver cirrhosis. Liver dysfunction is probably involved in increasing all these markers of malignancy, thus reducing the specificity of these tests.

Serum RBP, prealbumin, and zinc were evaluated in normal subjects and patients with pancreatic cancer and chronic pancreatitis. A significant decrease of RPB was found in pancreatic cancer patients compared with controls. A concomitant reduction of prealbumin and zinc was also observed. Multiple regression analysis suggested that the modification of RBP serum levels might be accounted for mainly by diminished prealbumin levels, while the direct role of zinc is negligible.