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Tra le due guerre mondiali il ruolo e le funzioni delle banche italiane si modificarono in modo sostanziale. Il saggio esamina attraverso l'utilizzo di un'ampia letteratura, anche coeva, le evoluzioni del sistema creditizio e in particolare analizza il passaggio dall'autocrazia al controllo politico, quest'ultimo tratto basilare di lungo periodo tale da condizionare in modo sostanziale le vicende economiche dell'Italia repubblicana.

Eosinophilic granulomatosis with polyangitis (EGPA) is an uncommon ANCA-associated systemic small-vessel necrotizing vasculitis. At times, EGPA presenting manifestations can be very different from the usually recognized disease patterns. We report a 52-year-old female patient with 3 years history of itching. During the time occurred a chronic skin lichenification on her legs and gradually developed a full-blown ANCA-MPO positive EGPA in combination with blood hypereosinophilia, eosinophilic vasculitis at skin biopsy, subclinical asthma and chronic rhinosinusitis.

Background Although splenic artery aneurysms (SAAs) are relatively uncommon, they are clinically relevant because of the risk of rupture. Optimal management is a matter of debate and involves the use of percutaneous endovascular stenting, which has limitations, versus the open surgical approach which can lead to significant morbidity. The present study reports the outcomes of robot-assisted surgery for SAA and its role in overcoming many of the limitations of laparoscopy. Methods A total of nine patients with incidentally detected SAAs underwent a surgery between September 2001 and November 2007. Six of these nine patients underwent a robot-assisted splenic aneurysm resection with vascular reconstruction. The remaining three cases included one robotic arterial ligation, one robotic partial splenectomy, and one laparoscopic splenectomy. Results The mean operating time was 212 ± 61 minutes (range: 90-300), mean intraoperative blood loss was 186.6 ± 202.4 mL (range: 0-500), and mean hospital stay was 7.1 ± 3.7 days (range: 3-14). The morbidity rate was 11.1% and no mortality was reported. Doppler-ultrasonography surveillance showed regular organ perfusion in all patients with vascular reconstruction. Conclusion Robot-assisted surgery for SAA represents one of the most advanced developments among minimally invasive procedures and can become an important option for the treatment of this disease.

Introduction Bien que les anevrysmes de l'artere splenique (AAS) soient relativement rares, ils presentent un risque de rupture. La prise en charge optimale est sujet a discussion et comporte l'utilisation de stents endovasculaires percutanes, qui presentent des limites, et l'approche chirurgicale ouverte qui peut mener a une morbidite significative. Cette etude indique les resultats de la chirurgie robot-assistee pour AAS et de son interet face aux limites de la laparoscopie. Methodes Un total de neuf patients avec AAS fortuitement diagnostiques ont subi une chirurgie entre septembre 2001 et novembre 2007. Six de ces neuf patients ont subi une resection splenique robot-assistee de l'anevrisme avec reconstruction vasculaire. Les trois autres ont ete traites par une ligature arterielle robotique, une splenectomie partielle robotique, et une splenectomie laparoscopique. Resultats La duree operatoire moyenne etait de 212 ± 61 minutes (extremes : 90-300), la perte sanguine peroperatoire etait de 186,6 ± 202,4 ml (extremes : 0-500), et la duree moyenne de sejour a l'hopital etait de 7,1 ± 3,7 jours (extremes : 3-14). Le taux de morbidite etait de 11,1% et aucune mortalite n'a ete rapportee. La surveillance par echodoppler a montre une bonne perfusion d'organe chez tous les patients ayant subi une reconstruction vasculaire. Conclusion La chirurgie Robot-assistee pour AAS represente un des progres les plus avances parmi les procedures mini-invasives et peut devenir une option importante pour le traitement de cette maladie.

Roux-en-Y gastric bypass performed laparoscopically remains the gold standard in bariatric surgery. The role of robot-assisted laparoscopic Roux-en-Y gastric bypass has not been clearly defined.We present 80 consecutive cases of robot-assisted laparoscopic Roux-en-Y gastric bypass performed at a single institution. Mechanics, early outcomes, and learning curve are evaluated. Eighty robot-assisted laparoscopic Roux-en-Y gastric bypasses were performed on 71 women and 9 men with a mean age of 39 years, mean preoperative weight of 134 kg, and mean BMI of 48.Total mean operative time was 209 minutes. There was no mortality, leak, stricture, or obstruction.Robot-assisted laparoscopic Roux-en-Y gastric bypass is a safe and feasible option for bariatric surgery. Its role in improving surgical outcomes needs to be defined further.

Objective The aim of this article is to report our experience in the repair of renal artery aneurysms using robot-assisted surgery. Methods Between December 2002 and March 2009, five women with a mean age of 63.8 years (range, 57-78 years) underwent robot-assisted laparoscopic repair of renal artery aneurysms by the same surgeon at two different institutions, the Department of General Surgery, Misericordia Hospital, Grosseto, Italy (three patients) and the Division of Minimally Invasive and Robotic Surgery at the University of Illinois, Chicago (two patients). The mean size of the lesions was 19.4 mm (range, 9-28 mm). Four of the lesions were complex aneurysms involving the renal artery bifurcation. Two patients were symptomatic and three had hypertension. In situ repair by aneurysmectomy was performed in all cases, followed by revascularization. In complex aneurysms, an autologous saphenous vein graft was used for the reconstruction. Results The mean operative time was 288 minutes (range, 170-360 min) and the estimated surgical blood loss was 100 ml (range, 50-300 ml). Warm ischemia time was 10 minutes in the patient treated by aneurysmectomy, followed by direct reconstruction. The average warm ischemia time was 38.5 minutes (range, 20-60 min) for patients treated with saphenous vein graft interposition. The mean time to resume a regular diet was 1.6 days (range, 1-2 days). The mean postoperative length of hospital stay was 5.6 days (range, 3-7 days). No postoperative morbidity was noted. The mean follow-up time for the entire series was 28 months (range, 6-48 months). Color Doppler ultrasonography examination showed patency in all reconstructed vessels. One patient had stenosis of one of the reconstructed branches, which was treated with percutaneous angioplasty. Conclusions Robot-assisted laparoscopic repair of renal artery aneurysms is feasible, safe and effective. The technical advantages of the robotic system allows for microvascular reconstruction to be performed using a minimally invasive approach, even in complex cases. This approach may also allow for improved postoperative recovery and reduce the morbidity correlated with open repair of renal artery aneurysms. Although more experience and technical refinements are necessary, robot-assisted laparoscopic repair of renal artery aneurysms represents a valid alternative to open surgery.

Middle pancreatectomy has been accepted as a valid surgical alternative to more extensive standard resections for the treatment of benign central pancreatic tumors. In this article, we describe a new minimally invasive approach to this procedure, using a robot-assisted laparoscopic technique.From May 2004 to October 2005, 3 patients (2 female and 1 male), with a mean age of 52 years (range, 44-68), underwent robot-assisted laparoscopic middle pancreatectomies at the Department of General Surgery of Misericordia Hospital in Grosseto, Italy. Two of the patients had symptomatic serous cystadenomas, and 1 patient had a mucinous cystadenoma, which was discovered incidentally. The da Vinci((R)) Surgical System (Intuitive Surgical, Sunnyvale, CA) was used to perform the main steps of the intervention. All patients underwent a pancreaticogastrostomy for pancreaticoenteric reconstruction to the distal stump.The mean operative time was 320 minutes (range, 270-380). Mean blood loss was 233 mL (range, 100-400). There were no mortalities. One patient developed a postoperative pancreatic fistula, which was managed conservatively. The postoperative hospital stay was 9 days for 2 patients and 27 days for the third patient. No endocrine or exocrine deficiencies were observed in the patients during a mean follow-up of 44 months (range, 38-48).Robot-assisted laparoscopic middle pancreatectomy presents an interesting, less-invasive option for resection of benign tumors of the neck and proximal body of the pancreas. In benign disease, it allows for the preservation of functional pancreatic parenchyma and, subsequently, reduced operative trauma.

Use of robotic surgery has gained increasing acceptance over the last few years. There are few reports, however, on advanced pancreatic robotic surgery. In fact, the indication for robotic surgery in pancreatic disease has been controversial. This paper retrospectively reviews one surgeon’s experience with robotic surgery to treat pancreatic disease, and analyzes its indications and outcomes, as well as the controversy that exists. A retrospective review of the charts of all patients who underwent robotic surgery for pancreatic disease by a single surgeon at two different institutions was carried out. From October 2000 to January 2009, 134 patients underwent robotic-assisted surgery for different pancreatic pathologies. All procedures were performed using the da Vinci robotic system. Of the 134 patients, 83 were female. The average age of all patients was 57 years (range 24–86 years). Mean operating room (OR) time was 331 min (75–660 min). There were 14 conversions to open surgery. Mean length of stay was 9.3 days (3–85 days). Length of stay for patients with no complications was 7.9 days (3–15 days). The postoperative morbidity rate was 26% and the mortality rate was 2.23% (three patients). Among the procedures performed were 60 pancreaticoduodenectomies, 23 spleen-preserving distal pancreatectomies, 23 splenopancreatectomies, 3 middle pancreatectomies, 1 total pancreatectomy, and 3 enucleations. Another 21 patients underwent different surgical procedures for treatment of acute and chronic pancreatitis. Two cases of pancreaticoduodenectomy were performed in outside institutions and are not included in this series. This is the largest series of robotic pancreatic surgery presented to date. Robotic surgery enables difficult technical maneuvers to be performed that facilitate the success of pancreatic minimally invasive surgery. The results in this series demonstrate that it is feasible and safe. Complication and mortality rates are comparable to those of open surgery but with the advantages of minimally invasive surgery.

In this paper we report on Force Modulation Microscopy (FMM) study and force-distance curve analysis of porous silicon layers grown on silicon. The characterization has been carried out on the cross section of porous silicon. The FMM images allowed us to investigate the morphological thickness of the layers through local elasticity differences resolving both between porous silicon layers of different porosities and between porous silicon and silicon itself. Force-distance curves showed different adhesion behaviour: porous silicon is more hydrophobic than bulk silicon in cross sectional view.

A new structure is proposed to improve the external quantum efficiency of porous silicon (PS) light emitting diodes (LED). It is based on a heterojunction between n-type doped silicon and PS. The heterojunction is formed due to the doping selectivity of the etching process used to form PS. The improvement of the proposed LED structure with respect to usual metal/PS LED is demonstrated. This is thought to be due to a different injection mechanism for which carriers are injected directly into conduction band states. Anodic oxidation experiments show further improvements in the LED efficiency.

Objective To analyze the preliminary experience with the new da Vinci single-site technology for cholecystectomy. Hypothesis Single-incision laparoscopic cholecystectomy is technically challenging and a related learning curve clearly exists. A novel approved robotic single-port platform has recently been introduced. This technology may help overcome some of the limitations of manual single-incision surgery relating to triangulation of instruments, ergonomics, and surgical exposure. Design A prospective longitudinal observational study was conducted on 100 consecutive da Vinci single-site cholecystectomies. Setting Five Italian centers of robotic general surgery. Main Outcome Measures Primary end points were feasibility without conversion and the absence of major complications. Operative times were analyzed to define the learning curve using a mixed regression model. A questionnaire collected the opinions of the surgeons involved in using the new technique. Results Two patients underwent conversion. No major intraoperative complications occurred, but there were 12 minor incidents (7 ruptures of the gallbladder and 5 cases of minor bleeding from the gallbladder bed). Mean (SD) total operative time was 71 (19) minutes, with a mean (SD) console time of 32 (13) minutes. No significant reduction in the operative times was observed with the increasing of each surgeon's experience. The technique was judged more complex than standard 4-port laparoscopy but easier than single-incision laparoscopy. Conclusions Da Vinci single-site cholecystectomy is an easy and safe procedure for expert robotic surgeons. It allows the quick overcoming of the learning curve typical of single-incision laparoscopic surgery and may potentially increase the safety of this approach.

Near-field optical spectroscopy has been used to investigate photoluminescence features of porous silicon microcavity samples with a subwavelength space resolution. The emission is found to be markedly dependent on the lateral position, with the presence of relatively narrow spectral features peaked at different wavelengths in the range 610–690 nm. Furthermore, the spectrum obtained by summing up spectra taken at different sampling points (relative displacement ∼100 nm) recovers the standard (macroscopic) photoluminescence spectrum of porous silicon, except for the presence of a dip around the resonance wavelength of the microcavity resonator.

Hypothesis Robotic surgery for performance of right hepatectomy is safe and effective. Design Case series from 2 medical institutions. Setting University of Illinois at Chicago and Misericordia Hospital, Grosseto, Italy. Patients Twenty-four patients underwent right hepatectomy between March 1, 2005, and January 31, 2010, using a robotic surgical system. Main Outcome Measures Intraoperative blood loss, operative time, morbidity, mortality, and long-term oncologic follow-up. Results The procedure was converted to open surgery in 1 patient (4.2%). The overall mean (SD) operative time was 337 (65) minutes (range, 240-480 minutes), and the mean (SD) intraoperative blood loss was 457 (401) mL (range, 100-2000 mL). Three patients (12.5%) underwent blood transfusion. There were no perioperative deaths and no reoperations. Six patients (25.0%) experienced postoperative morbidity, including transitory liver failure in 2 patients and pleural effusion, bile leak, fluid collection, and deep venous thrombosis in 1 patient each. The patients' diagnoses included colorectal liver metastases (n = 11), noncolorectal liver metastases (n = 4), hemangioma (n = 4), adenoma (n = 2), hepatocellular carcinoma (n = 1), hepatoblastoma (n = 1), and biliary amartoma (n = 1). At a mean follow-up duration of 34 months, no port site metastases were observed in patients with malignant pathologic findings. Conclusions The zero mortality and acceptable morbidity of our series indicate that in experienced hands, robotic right hepatectomy is feasible and safe. Robotic surgery offers a new technical option for minimally invasive major hepatic resections. Long-term results seem to confirm oncologic effectiveness of the procedure.

Kidney transplantation in morbidly obese patients can be technically demanding. Furthermore, morbidly obese patients experience a high rate of wound infections and related complications, which mostly result from the longer length and extent of the incision. These complications can be avoided through minimally invasive surgery; however, conventional laparoscopic instruments are unsuitable for the safe performance of a kidney transplant in morbidly obese patients. Herein, we report the first minimally invasive, total robotic kidney transplant in a morbidly obese patient. A left, deceased donor kidney was transplanted into a 29-year-old woman with a body mass index (BMI) of 41 kg/m(2) who had been on hemodialysis for 5 years. The operation was performed intraabdominally using the DaVinci Robotic Surgical System with 4 trocars and a 7 cm midline incision. The operative time was 223 min, and the blood loss was less than 50 cc. The kidney had immediate graft function. No perioperative complications were observed, and the patient was discharged on postoperative day 5 with normal kidney function. Minimally invasive access and robotic technology facilitated the safe performance of a successful kidney transplant in a morbidly obese patient.

Robotic surgery represents one of the most advanced developments in the field of minimally invasive surgery. In this article, we describe the case of an extended right hepatectomy with a left hepaticojejunostomy performed for radical resection of a hilar cholangiocarcinoma. This operation was performed by using the da Vinci Robotic Surgical System (Intuitive Surgical, Sunnyvale, CA). In this case, the operative time was 540 minutes, with an intraoperative blood loss of 800 mL. The postoperative course was uneventful, and the patient was discharged at postoperative day 11. This report confirms the technical feasibility and safety of robot-assisted extended hepatic resections with biliary reconstruction. Further experience and a long follow-up are required to validate this initial report.

Background Robotic surgery is gaining popularity for digestive surgery; however, its use for liver surgery is reported scarcely. This article reviews a surgeon's experience with the use of robotic surgery for liver resections. Methods From March 2002 to March 2009, 70 robotic liver resections were performed at 2 different centers by a single surgeon. The surgical procedure and postoperative outcome data were reviewed retrospectively. Results Malignant tumors were indications for resections in 42 (60%) patients, whereas benign tumors were indications in 28 (40%) patients. The median age was 60 years (range, 21–84) and 57% of patients were female. Major liver resections (≥3 liver segments) were performed in 27 (38.5%) patients. There were 4 conversions to open surgery (5.7%). The median operative time for a major resection was 313 min (range, 220–480) and 198 min (range, 90–459) for minor resection. The median blood loss was 150 mL (range, 20–1,800) for minor resection and 300 mL (range, 100–2,000) for major resection. The mortality rate was 0%, and the overall rate of complications was 21%. Major morbidity occurred in 4 patients in the major hepatectomies group (14.8%) and in 4 patients in the minor hepatectomies group (9.3%). All complications were managed conservatively and none required reoperation. Conclusion This preliminary experience shows that robotic surgery can be used safely for liver resections with a limited conversion rate, blood loss, and postoperative morbidity. Robotics offers a new technical option for minimally invasive liver surgery.

This study aimed to analyse the sarcolemma of Col6a1−/−fibers in comparison with wild type and mdx fibers, taken as positive control in view of the known structural and functional alterations of their membranes. Structural and mechanical properties were studied in single muscle fibers prepared from FDB muscle using atomic force microscopy (AFM) and conventional electrophysiological techniques to measure ionic conductance and capacitance. While the sarcolemma topography was preserved in both types of dystrophic fibers, membrane elasticity was significantly reduced in Col6a1−/−and increased in mdx fibers. In the membrane of Col6a1−/−fibers ionic conductance was increased likely due to an increased leakage, whereas capacitance was reduced, and the action potential (ap) depolarization rate was reduced. The picture emerging from experiments on fibers in culture was consistent with that obtained on intact freshly dissected muscle. Mdx fibers in culture showed a reduction of both membrane conductance and capacitance. In contrast, in mdx intact FDB muscle resting conductance was increased while resting potential and ap depolarization rate were reduced, likely indicating the presence of a consistent population of severely altered fibers which disappear during the culture preparation.

Polyamines self-assemble in vitro with phosphate ions generating three different supra-molecular aggregates named in vitro Nuclear Aggregates of Polyamines (iv-NAPs). These compounds share structure and functions with the naturally occurring homologues NAPs. They interacts with DNA phosphate groups and influence, more efficaciously than single polyamines, both the conformation and the protection of the DNA, thus playing crucial functions. We report on the morphological AFM characterization of the iv-NAPs and their interactions with the genomic DNA. A hierarchical multi-step process of supra-molecular assembly for each one of the three iv-NAPs in cyclic like structures was highlighted. Moreover, the track of the iv-NAPs coating the DNA was visualized by phase imaging, highly sensitive to the height changes of the samples. We show that iv-NAPs interact with genomic DNA disposing around its longitudinal axis and wrapping it in a helical tunnel like structure. Our images prove that such a molecular organization represents the sole strategy by which polyamines efficiently protect genomic DNA while maintaining its dynamic structure.

Si3N4∕SiO2 waveguides have been fabricated by low pressure chemical vapor deposition within a complementary metal–oxide–semiconductor fabrication pilot line. Propagation losses for different waveguide geometries (channel and rib loaded) have been measured in the near infrared as a function of polarization, waveguide width, and light wavelength. A maximum thickness of single Si3N4 of 250 nm is allowed by the large stress between Si3N4 and SiO2. This small thickness turns into significant propagation losses at 1544 nm of about 4.5dB∕cm because of the poor optical mode confinement factor. Strain release and control is possible by using multilayer waveguides by alternating Si3N4 and SiO2 layers. In this way, propagation losses of about 1.5dB∕cm have been demonstrated thanks to an improved optical mode confinement factor and the good quality of the interfaces in the waveguide.

In view of the integration within Si-based optical devices, LPCVD (low-pressure chemical vapor deposition) thin-film Si3N4 waveguides have been fabricated on a Si substrate within a CMOS fabrication pilot-line. Different structures (channel, rib and strip-loaded) were designed, fabricated and characterized both optically and structurally to optimize waveguide performances. Geometry, sidewall as well as layer roughness of the waveguides have been investigated by scanning electron microscopy and atomic force microscopy. Optical guided modes have been observed and propagation loss measurements at 632.8 and 780 nm have been performed by using the cut-back technique, the insertion loss technique and scattered light collection. The channel waveguides have shown propagation losses of about 0.1–0.2 dB/cm. Differences between geometries and lithographic processes have been discussed. Polarization dependence of propagation losses has been investigated too. Optical guided modes have also been measured in the near-infrared range (at 1544 nm), where propagation losses are about 4.5–5 dB/cm, quite larger with respect to the visible, because of the poorer confinement factor of the optical modes.

The reaction of the Pt(I)Pt(I)Pt(II) triangulo cluster Pt(3)(micro-PBu(t)()(2))(3)(H)(CO)(2) (1) with TfOH (Tf = CF(3)SO(2)) affords the hydride-bridged cationic derivative [Pt(3)(mu-PBu(t)()(2))(2)(mu-H)(PBu(t)()(2)H)(CO)(2)]OTf (2). With TfOD the reaction gives selectively [Pt(3)(mu-PBu(t)(2))(2)(mu-D)(PBu(t)(2)H)(CO)(2)]OTf (2-D(1)), implying that the proton is transferred to a metal center while a P-H bond is formed by the reductive coupling of one of the bridging phosphides and the terminal hydride ligand of the reagent. The reaction proceeds through the formation of a thermally unstable kinetic intermediate which was characterized at low temperatures, and was suggested to be the CO-hydrogen-bonded (or protonated) [Pt(3)(mu-PBu(t)(2))(3)(H)(CO)(2)].HOTf (3). An ab initio theoretical study predicts a hydrogen-bonded complex or a proton-transfer tight ion pair as a possible candidate for the structure of the kinetic intermediate.

Near-field optical spectroscopy has been used to study the photoluminescence features of a porous silicon device at room temperature, with a subwavelength space resolution of about 50-100nm. In particular, a prototype of a porous silicon-based light-emitting diode has been characterized by imaging morphology, near-field scattering intensity and emission maps of the same portion of the sample with a space resolution of better than 60 nm. Structured emitting centres are found on the porous regions with size ranging from 200 nm to 1 μm. Emission features, acquired as near-field spectra as well as emission maps at fixed wavelengths, provide crucial information on the prototype structure at the nanometric level, exploitable for improvement in production steps as well as for the study of the dominant working mechanisms of the device.

Background. This study compared long-term survival in pancreatic or periampullary cancer treated with Whipple pancreatoduodenectomy (PD) and pylorus-preserving pancreatoduodenectomy (PPPD). Methods. Two hundred twenty-one patients with pancreatic head or periampullary cancer were treated. Prognostic variables included age, gender, type and period of operation, and tumor stage. In the ductal adenocarcinomas variables also included tumor and node status, type of lymphadenectomy, pathologic grade, and presence of microscopic residual tumor. The end point was death as a result of neoplastic recurrence. Survival curves were estimated by using the Kaplan-Meier method, and multifactorial analysis was also performed on the data from the ductal adenocarcinoma group. Results. The mortality rate was 8.2% in the PD group versus 7.0% in the PPPD group. Morbidity rates were 34.4% for PD and 45.8% for PPPD. Five-year survival was 9.6% in the ductal adenocarcinoma and 63.8% in the periampullary carcinoma groups. Univariate analysis failed to show statistically significant differences in survival curves between the two treatments in either patient group. Correcting for multiple variables in the ductal adenocarcinoma group did not reveal any significant differences in survival rates between the two treatments. Conclusions. PPPD was as successful as classic PD in the treatment of ductal adenocarcinoma and periampullary cancer of the pancreas. Long-term survival was not influenced by the type of resection.

3646 Background: Preoperative chemoradiotherapy has proven to improve resectability and local control in LARC. The aim of the present study is to evaluate activity and toxicity of oral capecitabine and oxaliplatin administered concurrently with high dose pelvic conformal radiotherapy as neo-adjuvant treatment of LARC. Methods: Capecitabine 825 mg/sqm bid (days 1 to 40) and oxaliplatin 60 mg/sqm iv every 2 weeks (3 administrations) were given concomitantly with pelvic conformal radiotherapy 1.8 Gy daily up to 45 Gy followed by a 5-fraction boost up to 54 Gy in 6 weeks. From February to November 2003, 16 patients (pts) entered the study: 11 males, 5 females, median age 70 years (range 61–78). Clinical stage, determined by CT, was T3N0–1 in 13, T4N1 in 3 pts. Results: To date 14 pts are fully evaluable (2 too early): a clinical response was observed in 11/14. All pts underwent a R0 surgical resection. Pathological complete response was verified in 4 pts, a minimal microscopic residuum was found in 2 pts. Tum...

Hypothesis Robotic technology is the most advanced development of minimally invasive surgery, but there are still some unresolved issues concerning its use in a clinical setting. Design The study describes the clinical experience of the Department of General Surgery, Misericordia Hospital, Grosseto, Italy, in robot-assisted surgery using the da Vinci Surgical System. Results Between October 2000 and November 2002, 193 patients underwent a minimally invasive robotic procedure (74 men and 119 women; mean age, 55.9 years [range, 16-91 years]). A total of 207 robotic surgical operations, including abdominal, thoracic and vascular procedures, were performed; 179 were single procedures, and 14 were double (2 operations on the same patient). There were 4 conversions to open surgery and 3 to conventional laparoscopy (conversion rate, 3.6%; 7 of 193 patients). The perioperative morbidity rate was 9.3% (18 of 193 patients), and 6 patients (3.1%) required a reoperation. The postoperative mortality rate was 1.5% (3 of 193 patients). Conclusions Our preliminary experience at a large community hospital suggests that robotic surgery is feasible in a clinical setting. Its daily use is safe and easily managed, and it expands the applications of minimally invasive surgery. However, the best indications still have to be defined, and the cost-benefit ratio must be evaluated. This report could serve as a basis for a future prospective, randomized trial.

We present an experimental work on porous silicon-based optical devices. Notch filters and planar waveguides are fabricated and characterized. Three different types of filters are shown, the first one is a stop band filter in the 1.5 micron region, where improvements have been performed (smoothing of the index profile, apodization and index matching). The second is a double Notch filter in the IR range, which blocks two different frequencies. Finally Notch filters in the visible range are shown, where porous silicon has been completely oxidized. Double layer waveguides are fabricated and characterized by atomic force microscopy, luminescence and prism coupling techniques. All the results shown are compared with numerical calculations. The photoluminescence changes and the refractive index variations for different annealing times are modeled in terms of oxidation of silicon and slow condensation of the porous structure.

Rib-loaded silica waveguides containing Si nanocrystals were grown by quadruple implantation of Si ions into a 2 μm-thick thermally-grown SiO2 layer. The thickness of the resulting flat-profile active region was about 300 nm, with a 9.5% Si excess (determined by X-ray photoelectron spectroscopy). Complete phase separation and nanocrystal formation was assured by annealing at 1100 °C, and studied by means of optical tools such as Raman and luminescence. The rib-loaded structure of the waveguides was fabricated by photolithographic and reactive ion etching processes, with patterned rib widths ranging from 1 to 8 μm. Efficient light propagation was observed when end-fire coupling a probe signal both at 633 nm and 780 nm into the waveguides, with attenuation losses as low as 11 dB/cm. Signal amplification experiments, with pulsed and continuous wave (CW) top pumping, have shown increased signal absorption when the pump power is raised. This couples with the lack of any fast component in the time decay of the amplified spontaneous emissions as measured by ns pulsed pumping Variable Stripe Length (VSL) experiments. These two phenomena are interpreted as due to the lack of stimulated emission in these nanocrystalline systems.

Background: Radium 223 (RA223) is currently administered as part of a therapeutic sequence with the other life-prolonging agents (LPAs) for metastatic castration-resistant prostate cancer (mCRPC). Patients & methods: We retrospectively reviewed the clinical records of patients who had received at least three LPAs including RA223. Results: Median overall survival (OS) from the start of first-line treatment was 39.8 months, with the patients who completed all six planned courses of RA223 having a longer OS than those who did not (53.2 vs 29.5 months; p

Ostreopsis cf. ovata is a harmful benthic dinoflagellate, widespread along most of the Mediterranean coasts. It produces a wide range of palytoxin-like compounds and variable amounts of mucus that may totally cover substrates, especially during the stationary phase of blooms. Studies on different aspects of the biology and ecology of Ostreopsis spp. are increasing, yet knowledge on toxicity mechanism is still limited. In particular, the potential active role of the mucilaginous matrix has not yet been proven, although when mass mortalities have occurred, organisms have been reported to be covered by the typical brownish mucilage. In order to better elucidate toxicity dependence on direct/indirect contact, the role of the mucilaginous matrix and the potential differences in toxicity along the growth curve of O. cf. ovata, we carried out a toxic bioassay during exponential, stationary and late stationary phases. Simultaneously, a molecular assay was performed to quantify intact cells or to exclude cells presence. A liquid chromatography - high resolution mass spectrometry (LC-HRMS) analysis was also carried out to evaluate toxin profile and content in the different treatments. Our results report higher mortality of model organism, especially during the late stationary phase, when a direct contact between model organism and intact microalgal cells occurs (LC50-48h < 4 cells/ml on A. salina), although also growth medium devoid of microalgal cells but containing O. cf. ovata mucilage cause significant toxic effects. This finding is also supported by chemical analysis which shows the highest toxin content in pellet extract (95%) and around to 5% of toxins in the growth medium holding mucus, while the treatment deprived of both cells and mucilage didn’t contain any detectable toxins. Additionally, the connection between mucilaginous matrix and thecal plates, pores and trychocysts was explored by way of atomic force microscopy (AFM) to investigate cell surface at a sub-nanometer resolution, providing a pioneering description of cellular features.