Polymorphism and orientation control of copper-dicarboxylate metal-organic framework thin films through vapour- and liquid-phase growth

Precise control over the crystalline phase and crystallographic orientation within thin films of metal-organic frameworks (MOFs) is highly desirable. Here, we report a comparison of the liquid- and vapour-phase film deposition of two copper-dicarboxylate MOFs starting from an oriented metal hydroxide precursor. X-ray diffraction revealed that the vapour- or liquid-phase reaction of the linker with this precursor results in different crystalline phases, morphologies, and orientations. Pole figure analysis showed that solution-based growth of the MOFs follows the axial texture of the metal hydroxide precursor, resulting in heteroepitaxy. In contrast, the vapour-phase method results in non-epitaxial growth with uniplanar texture only.

Effect of moderate hydrostatic pressure on crystallization of palm kernel stearin-sunflower oil model systems

Lipid crystallization under moderate hydrostatic pressure treatments (200 MPa, 20 °C, 1-24 h) was studied in palm kernel stearin (PS 100%) and its blends with sunflower oil (PS 80, 90 % w/w). Hyperbarically-crystallized samples exhibited significantly higher firmness, elastic modulus and critical stress values as compared to those of the samples crystallized at atmospheric pressure. These data indicate that moderate hydrostatic pressure favored the formation of a higher amount of small palm kernel stearin crystals as compared to those formed at atmospheric pressure. Pressurization did not affect fat polymorphism, but was able to enhance nucleation instead of crystal growth. This work clearly demonstrated the efficacy of moderate hydrostatic pressure in steering lipid crystallization, opening interesting possible applications of high-pressure processing technology in the fat manufacturing sector.

Assembly of the Intraskeletal Coral Organic Matrix during Calcium Carbonate Formation

Scleractinia coral skeleton formation occurs by a heterogeneous process of nucleation and growth of aragonite in which intraskeletal soluble organic matrix molecules, usually referred to as SOM, play a key role. Several studies have demonstrated that they influence the shape and polymorphic precipitation of calcium carbonate. However, the structural aspects that occur during the growth of aragonite have received less attention. In this research, we study the deposition of calcium carbonate on a model substrate, silicon, in the presence of SOM extracted from the skeleton of two coral species representative of different living habitats and colonization strategies, which we previously characterized. The study is performed mainly by grazing incidence X-ray diffraction with the support of Raman spectroscopy and electron and optical microscopies. The results show that SOM macromolecules once adsorbed on the substrate self-assembled in a layered structure and induced the oriented growth of calcite, inhibiting the formation of vaterite. Differently, when SOM macromolecules were dispersed in solution, they induced the deposition of amorphous calcium carbonate (ACC), still preserving a layered structure. The entity of these effects was species-dependent, in agreement with previous studies. In conclusion, we observed that in the setup required by the experimental procedure, the SOM from corals appears to present a 2D lamellar structure. This structure is preserved when the SOM interacts with ACC but is lost when the interaction occurs with calcite. This knowledge not only is completely new for coral biomineralization but also has strong relevance in the study of biomineralization on other organisms.

Role of the polyphenol content on the structuring behavior of liposoluble gelators in extra virgin olive oil

The role of polyphenols in affecting the structural and rheological properties of oleogels was investigated. Polyphenols were selectively removed from extra virgin olive oil (EVOO), and the resulting oils at three different polyphenol levels were gelled by using 10% (w/w) of monoglycerides (MG), rice wax (RW), sunflower wax (SW), and a mixture of β-sitosterol/γ-oryzanol (PS). The structural characteristics of oleogels were assessed by visual appearance, rheology, polarized light microscopy, calorimetry, XRD, and FTIR. Polyphenol content differently affected oleogel characteristics depending on network features. While EVOO-polyphenols did not influence PS- and SW-based oleogels, they reinforced MG- and RW-based oleogel network. As polyphenol content increased, the critical stress and melting temperature also increased, concomitantly with changes in crystal morphology. This was attributed to the capacity of polyphenols to form additional junction points in the crystalline network.

Mixed 3D-2D Perovskite Flexible Films for the Direct Detection of 5 MeV Protons

This study reports on a novel, flexible, proton beam detector based on mixed 3D-2D perovskite films deposited by solution onto thin plastic foils. The 3D-2D mixture allows to obtain micrometer-thick and highly uniform films that constitute the detector's active layer. The devices demonstrate excellent flexibility with stable electric transport properties down to a bending radius of 3.1 mm. The detector is characterized under a 5 MeV proton beam with fluxes in the range [4.5 × 105 - 1.4 × 109 ] H+ cm-2 s-1 , exhibiting a stable response to repetitive irradiation cycles with sensitivity up to (290 ± 40) nC Gy-1 mm-3 and a limit of detection down to (72±2) µGy s-1 . The detector radiation tolerance is also assessed up to a total of 1.7 × 1012 protons impinging on the beam spot area, with a maximum variation of the detector's response of 14%.

Disentangling Structural and Electronic Properties in V2O3 Thin Films: A Genuine Nonsymmetry Breaking Mott Transition

Phase transitions are key in determining and controlling the quantum properties of correlated materials. Here, by using the combination of material synthesis and photoelectron spectroscopy, we demonstrate a genuine Mott transition undressed of any symmetry breaking side effects in the thin films of V₂O₃. In particular and in contrast with the bulk V₂O₃, we unveil the purely electronic dynamics approaching the metal-insulator transition, disentangled from the structural transformation that is prevented by the residual substrate-induced strain. On approaching the transition, the spectral signal evolves slowly over a wide temperature range, the Fermi wave-vector does not change, and the critical temperature is lower than the one reported for the bulk. Our findings are fundamental in demonstrating the universal benchmarks of a genuine nonsymmetry breaking Mott transition, extendable to a large array of correlated quantum systems, and hold promise of exploiting the metal-insulator transition by implementing V₂O₃ thin films in devices.

Impact of sample misalignment on grazing incidence x-ray diffraction patterns and the resulting unit cell determination

Grazing incidence x-ray diffraction (GIXD) is a frequently used tool for the crystallographic characterization of thin films in terms of polymorph identification and determination of the crystallographic lattice parameters. Even full structure solutions are possible. To obtain highly accurate diffraction patterns, the thin film sample has to be aligned carefully with the center of the goniometer, which allows a defined incidence of the primary x-ray beam relative to the sample surface. This work studies the effect of misalignment of a thin film sample on the acquired diffraction pattern. Three potential types of misalignments are considered: the deviation of the sample surface from the center of the goniometer, an error in the incidence angle of the primary beam, and an inclination of the goniometer rotation axis from the normal of the substrate surface. The consequence of these types of sample misalignments is the shift of diffraction peaks toward specific directions in reciprocal space. Mathematical equations are given that relate the error in positions of Bragg peaks for each type of sample misalignment. Experiments with intentionally misaligned samples confirm the given formulas. In a subsequent step, the errors in the peak positions are translated to systematic errors in the estimation of the unit cell parameters. Depending on the type of misalignment, some alignment errors can be reduced or even corrected; in particular, azimuthal sample rotations prove to be advantageous in these cases. The results in this work improve the quality of GIXD measurements, in general, enabling deeper analysis like the full structure solution from the GIXD pattern on everyday basis.

Highly Stable Thin Films Based on Novel Hybrid 1D (PRSH)PbX3 Pseudo-Perovskites

In this study, the structure and morphology, as well as time, ultraviolet radiation, and humidity stability of thin films based on newly developed 1D (PRSH)PbX₃ (X = Br, I) pseudo-perovskite materials, containing 1D chains of face-sharing haloplumbate octahedra, are investigated. All films are strongly crystalline already at room temperature, and annealing does not promote further crystallization or film reorganization. The film microstructure is found to be strongly influenced by the anion type and, to a lesser extent, by the DMF/DMSO solvent volume ratio used during film deposition by spin-coating. Comparison of specular X-ray diffraction and complementary grazing incidence X-ray diffraction analysis indicates that the use of DMF/DMSO mixed solvents promotes the strengthening of a dominant 100 or 210 texturing, as compared the case of pure DMF, and that the haloplumbate chains always lie in a plane parallel to the substrate. Under specific DMF/DMSO solvent volume ratios, the prepared films are found to be highly stable in time (up to seven months under fluxing N₂ and in the dark) and to highly moist conditions (up to 25 days at 78% relative humidity). Furthermore, for representative (PRSH)PbX₃ films, resistance against ultraviolet exposure (λ = 380 nm) is investigated, showing complete stability after irradiation for up to 15 h at a power density of 600 mW/cm². These results make such thin films interesting for highly stable perovskite-based (opto)electronic devices.

Impact of the Electron Acceptor Nature on the Durability and Nanomorphological Stability of Bulk Heterojunction Active Layers for Organic Solar Cells

A systematic study is conducted to compare the performances and stability of active layers employing a high performance electron donor (PBDB-T) combined with state-of-the-art fullerene (PC₇₁ BM), nonfullerene (ITIC), and polymer (N2200) electron acceptors. The impact of the chemical nature of the acceptor on the durability of organic solar cells (OSCs) is elucidated by monitoring their photovoltaic performances under light exposure or dark conditions in the presence of oxygen. PC₇₁ BM molecules exhibit a higher resistance toward oxidation compared to nonfullerene acceptors. Unencapsulated PBDB-T:PC₇₁ BM OSCs display relatively stable performances at room temperature when stored in air for 3 months. However, when exposed to temperatures above 80 °C, their active materials demix causing notable reductions in the short-circuit densities. Such detrimental demixing can also be seen for PBDB-T:ITIC active layers above 120 °C. Although N2200 chains irreversibly degrade when exposed to air, thermally induced demixing does not occur in PBDB-T:N2200 active layers annealed up to 200 °C. In summary, fullerene OSCs may be the best currently available choice for unencapsulated room temperature applications but if oxidation of the polymer acceptors can be avoided, all polymer active layers should enable the fabrication of highly durable OSCs with lifetimes matching the requirements for OSC commercialization.

A novel water-resistant and thermally stable black lead halide perovskite, phenyl viologen lead iodide C22H18N2(PbI3)2

A novel black organoammonium iodoplumbate semiconductor, namely phenyl viologen lead iodide C22H18N2(PbI3)2 (PhVPI), was successfully synthesized and characterized. This material showed physical and chemical properties suitable for photovoltaic applications. Indeed, low direct allowed band gap energy (Eg = 1.32 eV) and high thermal stability (up to at least 300 °C) compared to methylammonium lead iodide CH3NH3PbI3 (MAPI, Eg = 1.5 eV) render PhVPI potentially attractive for solar cell fabrication. The compound was extensively characterized by means of X-ray diffraction (performed on both powder and single crystals), UV-Vis diffuse reflectance spectroscopy (UV-Vis DRS), UV-photoelectron spectroscopy (UPS), FT-IR spectroscopy, TG-DTA, and CHNS analysis. Reactivity towards water was monitored through X-ray powder diffraction carried out after prolonged immersion of the material in water at room temperature. Unlike its methyl ammonium counterpart, PhVPI proved to be unaffected by water exposure. The lack of reactivity towards water is to be attributed to the quaternary nature of the nitrogen atoms of the phenyl viologen units that prevents the formation of acid-base equilibria when in contact with water. On the other hand, PhVPI's thermal stability was evaluated by temperature-controlled powder XRD measurements following an hour-long isothermal treatment at 250 and 300 °C. In both cases no signs of decomposition could be detected. However, the compound melted incongruently at 332 °C producing, upon cooling, a mostly amorphous material. PhVPI was found to be slightly soluble in DMF (∼5 mM) and highly soluble in DMSO. Nevertheless, its solubility in DMF can be dramatically increased by adding an equimolar amount of DMSO. Therefore, phenyl viologen lead iodide can be amenable for the fabrication of solar devices by spin coating as actually done for MAPI-based cells. The crystal structure, determined by means of single crystal X-ray diffraction using synchrotron radiation, turned out to be triclinic and consequently differs from the prototypal perovskite structure. In fact, it comprises infinite double chains of corner-sharing PbI6 octahedra along the a-axis direction with phenyl viologen cations positioned between the columns. Finally, the present determination of PhVPI's electronic band structure achieved through UPS and UV-Vis DRS is instrumental in using the material for solar cells.

The effect of long-range order on intermolecular interactions in organic semiconductors: zinc octaethyl porphyrin molecular thin film model systems

In order to optimize the performance of devices based on porphyrin thin films it is of great importance to gain a physical understanding of the various factors which affect their charge transport and light-harvesting properties. In this work, we have employed a multi-technique approach to study vacuum deposited zinc octaethyl porphyrin (ZnOEP) thin films with different degrees of long-range order as model systems. An asymmetrical stretching of the skeletal carbon atoms of the porphyrin conformer has been observed and attributed to ordered molecular stacking and intermolecular interactions. For ordered films, a detailed fitting analysis of the X-ray absorption near edge structure (XANES) using the MXAN code establishes a symmetry reduction in the molecular conformer involving the skeletal carbon atoms of the porphyrin ring; this highlights the consequences of increased π-π stacking of ZnOEP molecules adopting the triclinic structure. The observed asymmetrical stretching of the π conjugation network of the porphyrin structure can have significant implications for charge transport and light harvesting, significantly influencing the performance of porphyrin based devices.

Synthesis, physico-chemical characterization and structure of the elusive hydroxylammonium lead iodide perovskite NH3OHPbI3

The elusive hydroxylammonium lead iodide NH₃OHPbI₃ has been successfully synthesized and characterized for the first time.

Evidence for a Strong Topological Insulator Phase in ZrTe_{5}

The complex electronic properties of ZrTe_{5} have recently stimulated in-depth investigations that assigned this material to either a topological insulator or a 3D Dirac semimetal phase. Here we report a comprehensive experimental and theoretical study of both electronic and structural properties of ZrTe_{5}, revealing that the bulk material is a strong topological insulator (STI). By means of angle-resolved photoelectron spectroscopy, we identify at the top of the valence band both a surface and a bulk state. The dispersion of these bands is well captured by ab initio calculations for the STI case, for the specific interlayer distance measured in our x-ray diffraction study. Furthermore, these findings are supported by scanning tunneling spectroscopy revealing the metallic character of the sample surface, thus confirming the strong topological nature of ZrTe_{5}.

Transfer-printing of active layers to achieve high quality interfaces in sequentially deposited multilayer inverted polymer solar cells fabricated in air

Polymer solar cells (PSCs) are greatly influenced by both the vertical concentration gradient in the active layer and the quality of the various interfaces. To achieve vertical concentration gradients in inverted PSCs, a sequential deposition approach is necessary. However, a direct approach to sequential deposition by spin-coating results in partial dissolution of the underlying layers which decreases the control over the process and results in not well-defined interfaces. Here, we demonstrate that by using a transfer-printing process based on polydimethylsiloxane (PDMS) stamps we can obtain increased control over the thickness of the various layers while at the same time increasing the quality of the interfaces and the overall concentration gradient within the active layer of PSCs prepared in air. To optimize the process and understand the influence of various interlayers, our approach is based on surface free energy, spreading parameters and work of adhesion calculations. The key parameter presented here is the insertion of high quality hole transporting and electron transporting layers, respectively above and underneath the active layer of the inverted structure PSC which not only facilitates the transfer process but also induces the adequate vertical concentration gradient in the device to facilitate charge extraction. The resulting non-encapsulated devices (active layer prepared in air) demonstrate over 40% increase in power conversion efficiency with respect to the reference spin-coated inverted PSCs.

Structural and viscoelastic characterization of ternary mixtures of sunflower oil, saturated monoglycerides and aqueous phases containing different bases

The structure at different length scales and the viscoelastic properties of ternary mixtures composed of saturated monoglycerides, sunflower oil and aqueous solutions of weak bases (KHCO₃, NaHCO₃, and NH₄HCO₃) or strong bases (NaOH and KOH) were investigated. The characteristics of ternary mixtures were studied systematically by using polarized light microscopy, differential scanning calorimetry (DSC), synchrotron X-ray diffraction (XRD) and rheological analysis. Results showed that the base type and concentration greatly affected the structure of the mixtures. The use of strong bases allowed gelled systems to be obtained only at low concentrations (<10mM). On the contrary, the presence of weak bases induced gelling at all concentrations considered (from 1 to 1000mM). The increase of base concentration led to a reduction of the mean droplet diameter and melting temperature. At the same time, the viscoelastic characteristics as a function of base concentration followed a more complex behavior: G' and G″ progressively decreased as the salt concentration increased in a concentration range from 1 to 100mM, while the rheological parameters increased when salt concentration increased from 100 to 1000mM. The structural and viscoelastic behavior of systems prepared with different salts were commonly independent of the cation present in the medium. Results highlight that it is possible to tailor the structure of these gels by using specific bases.

Poly(styrene)/oligo(fluorene)-intercalated fluoromica hybrids: synthesis, characterization and self-assembly

We report on the intercalation of a cationic fluorescent oligo(fluorene) in between the 2D interlayer region of a fluoromica type silicate. The formation of intercalated structures with different fluorophore contents is observed in powders by synchrotron radiation XRD. Successively, the hybrids are dispersed in poly(styrene) through in situ polymerization. Such a procedure allows us to synthesize the materials from solution, to achieve solid films, and to characterize them by optical and morphologic techniques. The polymeric films with homogeneous distribution of the hybrids exhibit ultraviolet-blue photoluminescence with a significantly enhanced photostability compared to the bare oligo(fluorene)s. Finally, under specific conditions, the polymer hybrid with higher oligo(fluorene) content spontaneously assembles into highly ordered microporous films.

Grazing-incidence X-ray diffraction study of rubrene epitaxial thin films

The growth of organic semiconductors as thin films with good and controlled electrical performances is nowadays one of the main tasks in the field of organic semiconductor-based electronic devices. In particular it is often required to grow highly crystalline and precisely oriented thin films. Here, thanks to grazing-incidence X-ray diffraction measurements carried out at the ELETTRA synchrotron facility, it is shown that rubrene thin films deposited by organic molecular beam epitaxy on the surface of tetracene single crystals have the structure of the known orthorhombic polymorph, with the (2 0 0) plane parallel to the substrate surface. Moreover, the exact epitaxial relationship between the film and the substrate crystalline structures is determined, demonstrating the presence of a unique in-plane orientation of the overlayer.

Enhanced Vertical Concentration Gradient in Rubbed P3HT:PCBM Graded Bilayer Solar Cells

Graded bilayer solar cells have proven to be at least as efficient as the bulk heterojunctions when it comes to the Poly(3-hexylthiophene) (P3HT) - [6,6]-phenyl-C61-butyric acid methyl ester (PCBM) donor-acceptor system. However, control of the vertical concentration gradient using simple techniques has never been reported. We demonstrate that rubbing the P3HT layer prior to PCBM deposition induces major morphological changes in the active layer. Using the newly introduced energy-dispersive X-ray spectroscopy element mapping technique, we found that rubbing P3HT induces the formation of an ideal vertical donor-acceptor concentration gradient. Furthermore, the P3HT crystallites undergo a molecular reorientation from edge-on to face-on configuration inducing a better charge transport in the vertical direction. The combination of these two major morphological changes leads to the fabrication of high-performance solar cells that exhibit, to date, the record efficiencies for spin-coated graded bilayers solar cells.

Evolution and control of oxygen order in a cuprate superconductor

The disposition of defects in metal oxides is a key attribute exploited for applications from fuel cells and catalysts to superconducting devices and memristors. The most typical defects are mobile excess oxygens and oxygen vacancies, which can be manipulated by a variety of thermal protocols as well as optical and d.c. electric fields. Here we report the X-ray writing of high-quality superconducting regions, derived from defect ordering, in the superoxygenated layered cuprate, La₂CuO(4+y). Irradiation of a poor superconductor prepared by rapid thermal quenching results first in the growth of ordered regions, with an enhancement of superconductivity becoming visible only after a waiting time, as is characteristic of other systems such as ferroelectrics, where strain must be accommodated for order to become extended. However, in La₂CuO(4+y), we are able to resolve all aspects of the growth of (oxygen) intercalant order, including an extraordinary excursion from low to high and back to low anisotropy of the ordered regions. We can also clearly associate the onset of high-quality superconductivity with defect ordering in two dimensions. Additional experiments with small beams demonstrate a photoresist-free, single-step strategy for writing functional materials.

Recurrent and de novo diabetic nephropathy in renal allografts

BACKGROUND

Histologic findings of diabetic nephropathy (DN) are observed in allografts of patients with pretransplant (PreTx) diabetes mellitus (DM) and in patients who develop DM posttransplant (PostTx). Patients with allograft biopsies (Bx) were retrospectively studied to determine the incidence of recurrent and de novo DN and to ascertain what, if any, risk factors predispose to histologic DN in either patient population.

METHODS

From the renal transplant services at four hospitals from 1992 to 2000, the authors identified all patients with PreTxDM and PostTxDM (n=81). Those with renal biopsies performed >/=18 months PostTx were classified according to the presence or absence of histologic DN (Bx-positive, n=23; Bx-negative, n=35). Patients were then subdivided into four categories-recurrent DN (n=16), de novo DN (n=7), no recurrent DN (n=27), and no de novo DN (n=8)-for analyses.

RESULTS

Among these 58 patients, 74.1% had PreTx and 25.9% had PostTx diabetes. Of those with histologic DN, 69.6% were recurrent DN and 30.4% were de novo DN, making de novo DN at least as likely to develop as recurrent DN. After the onset of diabetes in the de novo population, the time to development of histologic DN was similar in the recurrent and the de novo patients (6.68+/-3.86 years vs. 5.90+/-3.13 years, P=0.66) and more rapid than previously reported. Apart from a more frequent family history of hypertension in patients with allograft DN compared with those without allograft DN, known risk factors for the development of native DN did not significantly differ among patients in the four cohorts. Proposed risk factors related to transplantation did not correlate with the development of recurrent or de novo DN.

CONCLUSION

Among patients with histologic DN, de novo DN occurred at least as frequently as recurrent DN, and the time to onset of histologically apparent DN was more rapid than previously reported. Neither the usual clinical predictors of DN nor clinical variables related to transplantation clearly distinguished the group with DN from the group without it, potentially implicating novel mechanisms in its pathogenesis.

Analysis and toxicity of methomyl and ametryn after biodegradation

The controlled biodegradation of ametryn and methomyl has been performed, in accordance with the OECD Zahn-Wellens/EMPA procedure, by use of an enriched mixture of activated sludge collected from three domestic waste-water-treatment plants (WWTP). During the process concentrations of ametryn and methomyl in the water samples were isolated by solid-phase extraction (SPE); recovery rates were 98.9 and 93.2 for methomyl and ametryn, respectively. Liquid chromatography-mass spectrometry (LC-MS) was used to determine final pesticide concentrations and for metabolite identification. The efficiency of aerobic biodegradation of ametryn and methomyl was evaluated by measuring both the decrease in the concentration of the pesticides and global properties such as the chemical oxygen demand (COD). The acute toxicity of ametryn and methomyl was evaluated by use of the ToxAlert100 biological test, which is based on inhibition of the bioluminescence of Vibrio fischeri. There was significant correlation between results from primary and ultimate biodegradation and those from determination of toxicity. Pesticide concentrations were always reduced to below the limit of detection in less than 17 days. High COD removal (90-96%) was achieved in 28 and 18 days for methomyl and ametryn, respectively.

Glomerular mRNAs in human type 1 diabetes: biochemical evidence for microalbuminuria as a manifestation of diabetic nephropathy

BACKGROUND

In patients with type 1 diabetes, some consider microalbuminuria to be a predictor of diabetic nephropathy while others believe it is an early feature of diabetic nephropathy.

METHODS

Levels of mRNAs that are of pathogenetic relevance in diabetic nephropathy were compared in glomeruli isolated from microalbuminuric and overtly proteinuric subjects and in control normoalbuminuric diabetic subjects and living renal transplant donors.

RESULTS

In subjects with microalbuminuria and overt proteinuria, glomerular mRNAs were virtually identical and approximately twofold higher for connective tissue growth factor (CTGF; P < 0.01) and collagen alpha2(IV) (P < 0.03) compared to living renal donors and normoalbuminuric patients. Glomerular glyceraldehyde-3-phosphate dehydrogenase (GAPDH) levels were not significantly different among the groups (P = 0.4). Weak but statistically significant correlations were noted between CTGF mRNA and albuminuria (assessed by rank), fractional mesangial surface area, and a composite renal biopsy index. Glomerular CTGF mRNA correlated inversely with creatinine clearance. Glomerular collagen alpha2(IV) mRNA levels correlated with albuminuria (by rank) and less strongly with fractional mesangial area.

CONCLUSION

To our knowledge, these data provide the first biochemical evidence demonstrating that the glomeruli of microalbuminuric patients and those with overt proteinuria do not differ significantly. The data support the concept that microalbuminuria is not "predictive" of diabetic nephropathy, but rather is an earlier point in the spectrum of diabetic nephropathy.

[Single-compartment knee arthroplasty prosthesis and idiopathic necrosis of the medial tibia surface]

PURPOSE OF THE STUDY

Idiopathic necrosis of the medial articular surface of the tibia is exceptional. Diagnosis is quite difficult and often made late. Among the different treatments proposed, we preferred single-compartment arthroplasty.

MATERIAL AND METHODS

We report 8 cases in women with a mean age of 71.1 years. Diagnosis was suspected due to drug-resistant knee pain, particularly frequent at night, initially with radiographically normal knees. The first radiographic signs, seen 3 months after the onset of pain, were pathognomonic for osteonecrosis evidencing subchondral defects of the tibial surface with a dense peripheral rim and apparently "sequestered" in a notch. Bone scintigraphy evidenced intense uptake in the medial compartment. MRI confirmed the diagnosis evidencing a band of low intensity signals completely surrounding a sequestered zone reaching the cortical. This band was stable and irreversible. In 5 cases CT scan and in 3 cases tomography identified the width and height of the necrotic area that was limited to the medial compartment in all cases. All patients were treated with a single compartment implant. The diagnosis of necrosis was confirmed at pathology.

RESULTS

At 4,6 years of mean follow up all patients had an excellent outcome, "forgetting" their knee. No lucent lines developed along the femoral or tibial implants.

DISCUSSION

Necrosis of the medial articular surface of the tibia is exceptional and often diagnosed late by bone scintigraphy or MRI. Surgical treatment is usually based on tibial osteotomy for valgisation or a single or three-compartment prosthesis. In our 8 cases, the necrosis was limited to the medial compartment, warranting our therapeutic option.

Glomerular type IV collagen in patients with diabetic nephropathy with and without additional glomerular disease

BACKGROUND

Type IV collagen is a constituent of mesangial matrix and is increased in amount in many forms of glomerular injury.

METHODS

We performed renal biopsies in patients who (1) were donating a kidney to a relative (LRD, N = 6), (2) had diabetic glomerulopathy with or without nephrosclerosis (DM, N = 6), or (3) had diabetic glomerulopathy with a superimposed glomerular lesion (DM+, N = 5). Glomerular collagen alpha2(IV) and control glyceraldehyde-3-phosphate dehydrogenase (GAPDH) mRNAs were measured, and the former correlated with clinical and morphological data to assess its usefulness in reflecting glomerular injury.

RESULTS

Collagen alpha2(IV) mRNA levels were lowest in LRD (2.9 +/- 0.6 attomol/glomerulus), higher in DM (5.9 +/- 1.6, P = 0.05), and highest in DM+ (12.7 +/- 2.8 attm/glomerulus, P < 0.05 vs. LRD and vs. DM). Control GAPDH mRNA levels were not significantly different (P > 0.05). Levels of proteinuria, serum creatinine, and glomerular size did not correlate with collagen alpha2(IV) mRNA levels. The fractional mesangial area and the fractional mesangial area occupied by type IV collagen were higher in both diabetic groups than in LRD (P < 10-6), but the intensity of type IV collagen staining in the diabetic patients was significantly less than that seen in the LRD (P < 0.01). In DM+ patients, extramesangial type IV collagen was present. Fractional mesangial area and glomerular collagen alpha2(IV) mRNA levels correlated (r = 0.45, P < 0.05).

CONCLUSION

These data are consistent with a view of diabetic nephropathy as a lesion of increased alpha2 type IV collagen transcription, increased total amount of collagen present, but decreased mesangial density relative to other matrix molecules. These data further demonstrate that glomerular injury superimposed on diabetic nephropathy contributes to additional structural damage by inducing increased synthesis of type IV collagen at extramesangial sites.

[Osteolysis after total knee prosthesis]

PURPOSE OF THE STUDY

The aim of our work was to study X-rays showing osteolysis after 5 years and more in 122 prosthesis and to try and assess such complication, often described in the United States but seldom in Europ.

MATERIAL

We are dealing here with 122 retaining posterior cruciate ligament, mostly cementless prothesis implanted between 1985 and 1992 84 chromium-cobalt prosthesis (PCA and Themis) implanted in 34 males and 88 females with an average age of 67 (45-81), 87,7 p. 100 had femoral cementless components and 70 p. 100 tibial cementless components.

METHODS

All patients were examined and had X-rays at an average of 6,9 years. Specially considered were X-rays showing a possible osteolysis. We looked for possible complication (external laxity, anterior femoral dislocation and polyethylene wear), assessment of the mechanical axis and for clinical results (Hungerford score)

RESULTS

Revisions: 19 arthroplasties were revised for PE wear tibial loosening metallosis or patella problems The postoperative score according to Hungerford was 84,5 p. 100 for PCA prosthese and 87 p.100 for the Themis. On the X-rays were only few osteolysis to be found: 9 cases (7,3 p. 100). For the PCA series: 3 femoral osteolysis, 1 tibial at 12 years, and one patellar osteolysis. For the Themis series: no femoral osteolysis, 3 tibial and one patellar osteolysis. Osteolysis are apparent on X-rays in profile for the femur and the patella, and in both profile and frontal X-rays for the tibia. Clinicaly 4 osteolysis really asymptomatic were not re-operated. 5 were revised: one 11 years later for femoral and tibial loosening, two for a patellar loosening, the other two patients had to be reoperated on for metallism (titanium's femoral component) and for those two instances osteolysis were discovered during the complication.

DISCUSSION

Osteolysis after TKA appears unusual in our experience without bearing on frequency finded by american authors with a lesser follow-up (Engh 11,1 p. 100 after 4,5y, Peters 16 p. 100 after 2,9 y, Robinson 9,18 p. 100 after 4,6 y). American litteratur analysis shows that the important number of osteolysis is due to: - either to dual-metal using (Co-Cr component with Titanium screws for exemple), - or bad quality of polyethylene (compressed), - or a bad design of former prosthesis.

CONCLUSION

Interface illness, linked to the production of wear debris, osteolysis after total knee arthroplasty is rarer than after a hip one, probably because size of debris is different, larger in knee than in hip. It is likely that the improvement of PE quality, design of prosthesis, as well as a better knowledge of osteolysis mechanism will allow to delay this complication wich is in a long term ineluctable.

Structure of sulfur-substituted rhodanese at 1.36 A resolution

1.36 A resolution X-ray diffraction data have been recorded at 100 K for bovine liver sulfur-substituted rhodanese, using synchrotron radiation. The crystal structure has been refined anisotropically to a final R factor of 0.159 (Rfree = 0.229) for 53034 unique reflections. The model contains 2327 protein atoms and 407 solvent molecules, with a good geometry. The high resolution allows full details for helices, beta-sheets, tight turns and of all inter- and intramolecular interactions stabilizing the enzyme molecule to be given. The situation at the active site is described, particularly in regard to the network of hydrogen bonds made by Sgamma and Sdelta of the sulfur-substituted catalytic Cys247 and surrounding groups and solvent molecules. The replacement of the precipitant ammonium sulfate with cryoprotectants in the crystal-suspending medium led to the removal of the sulfate ion from the enzyme active site. Only limited changes of the enzyme structure have been found as a result of the drastic change in the crystal medium.

Patient death or renal graft loss within 3 yr of transplantation in a county hospital: importance of poor initial graft function

Our purpose was to study the factors predictive of graft loss or patient death within 3 yr of renal transplant in a county population. 363 renal transplants performed between 1984 and 1991 at the Harbor-UCLA Medical Center were reviewed. There were 16 recipients (4%) who died and 76 (21%) who lost their grafts within 3 yr. Known causes of death were cardiac (44%), infection (38%) and malignancy (6%). There was a higher proportion of diabetics (44%), hypertensives (69%) and those with a past cardiac history (38%). There was also a high delayed graft function rate (56%). Of the 76 grafts that failed in the first 3 yr, 14% were due to noncompliance, 20% to grafts that never functioned, 9% to technical problems, 21% to acute rejection, 9% to recurrent disease and 26% to chronic rejection. The noncompliance group were younger (mean 34 yr), and more likely to be a first transplant (90%) and be non-white (82%). The rejection group was significant for high delayed graft function rate (84%) and frequent and early rejection (76% at least one rejection). We conclude that fair organ allocation requires a balance between equity and utility, but patient death or graft loss within 3 yr benefits neither the patient or society. Patient survival may be improved with diligent cardiac evaluation, particularly in older patients and diabetics. Patient education and monitoring for noncompliance is essential, particularly in young first-time recipients. Maneuvers to decrease delayed graft function are essential to improve long-term results.

Improved survival of en bloc renal allografts from pediatric donors

PURPOSE

We developed a technical and immunological protocol to increase survival of renal transplants from pediatric donors.

MATERIALS AND METHODS

En bloc kidneys (22) were procured from donors weighing 2 to 14 kg. (1 to 60 months old) and transplanted into adult recipients. In group 1 (12 patients) sequential therapy was used for kidneys with more than 35 hours of cold storage and immediate triple therapy (cyclosporine, azathioprine and prednisone) was used for those with less than 35 hours of cold storage. In group 2 (10 patients) OKT3 induction therapy was used. Mean followup was 4.7 years.

RESULTS

Mean blood pressure at 1 and 4 years was not significantly different between the groups. Mean serum creatinine was not significantly different between the groups at 1 year but it was significantly less in group 2 at 4 years (1.9 +/- 1.0 versus 1.2 +/- 0.24 mg./dl., p <0.05). At 1 year of followup the complication rate was 75% in 9 of 12 patients in group 1, including 4 infections or leaks (2 lost), 6 rejections (3 lost) and 3 cases of thrombosis or hemorrhage, and 20% (p <0.01) in group 2 (1 patient had the hemolytic uremic syndrome leading to graft loss). Graft survival was significantly greater in group 2 at all 4 years of followup (p = 0.05).

CONCLUSIONS

The success of pediatric en bloc renal transplantation can be enhanced by induction therapy in healthy recipients.