Osteonecrosis of the Jaw in Myeloma Patients Receiving Denosumab or Zoledronic Acid. A Commentary of the Pivotal Trial by Raje et al. Published on Lancet Oncology

The recent randomized trial, published by Raje et al., on Lancet Oncology is potentially practice changing. It proposes that denosumab is a valid alternative to zoledronic acid in the treatment of myeloma patients. However, several points need further data and more details, such as information on incidence, diagnosis, and follow-up of osteonecrosis of the jaw (ONJ) cases, observed among treated patients. Adopted definition to adjudicate ONJ cases, type of registration of potential ONJ cases, length of observation are possible causes of potential underestimation of ONJ incidence in their study. Future updated evaluations with longer follow-up, and including actuarial estimation, are required for final judgment on ONJ risk in myeloma patients receiving denosumab, and comparison with ONJ risk by zoledronic acid.

Early mortality in myeloma patients treated with first-generation novel agents thalidomide, lenalidomide, bortezomib at diagnosis: A pooled analysis

INTRODUCTION

Early toxic death (≤60 days of diagnosis) in elderly multiple myeloma (MM) patients is attributable to active disease, age and co-morbidities. Rate of early toxic deaths is 10% with conventional chemotherapy mainly due to infection and renal failure. Novel agents have improved MM outcome at the expense of newer toxicity.

METHODS

We analyzed 1146 individual patient data to assess toxic deaths during induction treatment with first-generation novel agents thalidomide, lenalidomide, bortezomib.

RESULTS

During first-line therapy, 119/1146 patients (10%) died for any cause, and 47/1146 (4%) due to toxicity, including 12/1146 (1%) early deaths. The 24-month cumulative incidence was 4.1% without any difference between bortezomib (18/503 patients, 4%) and lenalidomide (29/643patients, 5%; p = 0.31). Toxic deaths occurred in 34/1039 (3%) patients <80 years and 13/107 (12%) patients ≥80 years. Causes were cardiac events (28%), infections (26%) and vascular complications (15%). In a multivariate analysis, older age and unfavorable ISS stage increased the risk of death.

CONCLUSION

First-generation novel agents significantly reduced toxic deaths compared to conventional chemotherapy. One third of deaths during first-line therapy were due to cumulative drug-related toxicities, thus supportive approaches and prevention strategies should be optimized. The higher mortality rate for toxicity in octogenarians confirms the need for a careful frailty assessment.

Hydrocarbon decomposition kinetics on the Ir(111) surface

The kinetics of the thermal decomposition of hydrocarbons on the Ir(111) surface is determined using kinetic Monte Carlo (kMC) and rate equations simulations, both based on the density functional theory (DFT) calculated energy barriers of the involved reaction processes. This decomposition process is important for understanding the early stages of epitaxial graphene growth where the deposited hydrocarbon acts as a carbon feedstock for graphene formation. The methodology of the kMC simulations and the rate equation approaches is discussed and a comparison between the results obtained from both approaches is made in the case of the temperature programmed decomposition of ethylene for different initial coverages. The theoretical results are verified against experimental data from in situ X-ray photoelectron spectroscopy (XPS) experiments. Both theoretical approaches give reasonable results; however we find that, as expected, rate equations are less reliable at high coverages. We find that the agreement between experiment and theory can be improved in all cases if slight adjustments are made to the energy barriers in order to account for the intrinsic errors in DFT. Finally we extend our approach to the case where hydrocarbon species are dosed onto the substrate continuously, as in the chemical vapour deposition (CVD) graphene growth method. For ethylene and methane the thermal decomposition mechanism is determined, and it is found that in both cases the formation of C monomers is to be expected, which is limited by the presence of hydrogen atoms.

Theoretical and experimental investigation of optical absorption anisotropy in β-Ga2O3

The question of optical bandgap anisotropy in the monoclinic semiconductor β-Ga2O3 was revisited by combining accurate optical absorption measurements with theoretical analysis, performed using different advanced computation methods. As expected, the bandgap edge of bulk β-Ga2O3 was found to be a function of light polarization and crystal orientation, with the lowest onset occurring at polarization in the ac crystal plane around 4.5-4.6 eV; polarization along b unambiguously shifts the onset up by 0.2 eV. The theoretical analysis clearly indicates that the shift in the b onset is due to a suppression of the transition matrix elements of the three top valence bands at Γ point.

Interplay between electronic and structural properties in the Pb/Ag(1 0 0) interface

We report an investigation of the structural and electronic properties of a Pb monolayer (ML) grown on Ag(1 0 0), by combining x-ray photoelectron diffraction (XPD) and angle resolved photoelectron spectroscopy (ARPES). The Pb atoms are found to arrange in a pseudo-hexagonal adlayer commensurate to the underlying square Ag substrate, resulting in a coincidence cell with c([Formula: see text]) periodicity. The electronic structure of the Pb ML in proximity of the Fermi level consists in three p-derived bands, which show different degrees of hybridization with the substrate for their different orbital characters. In particular, we report that the p xy states disperse without forming energy gap, in contrast to previous ARPES studies of the Pb ML on different metallic substrates. We attribute the absence of energy gap to the commensurability between substrate and adlayer, resulting in a higher two-dimensionality of the Pb ML.

Human nail plate modifications induced by onychomycosis: implications for topical therapy

PURPOSE

Through the characterisation of the human onchomycotic nail plate this study aimed to inform the design of new topical ungual formulations.

METHODS

The mechanical properties of the human nail were characterised using a Lloyd tensile strength tester. The nail's density was determined via pycnometry and the nail's ultrastructure by electron microscopy. Raman spectroscopy analysed the keratin disulphide bonds within the nail and its permeability properties were assessed by quantifying water and rhodamine uptake.

RESULTS

Chronic in vivo nail plate infection increased human nailplate thickness (healthy 0.49 ± 0.15 mm; diseased 1.20 ± 0.67 mm), but reduced its tensile strength (healthy 63.7 ± 13.4 MPa; diseased 41.7 ± 5.0 MPa) and density (healthy 1.34 ± 0.01 g/cm(3); diseased 1.29 ± 0.00 g/cm(3)). Onchomycosis caused cell-cell separation, without disrupting the nail disulfide bonds or desmosomes. The diseased and healthy nails showed equivalent water uptake profiles, but the rhodamine penetration was 4-fold higher in the diseased nails using a PBS vehicle and 3 -fold higher in an ethanol/PBS vehicle.

CONCLUSIONS

Onchomycotic nails presented a thicker but more porous barrier, and its eroded intracellular matrix rendered the tissue more permeable to topically applied chemicals when an aqueous vehicle was used.

Surface structure of Pd(111) with less than half a monolayer of Zn

We have characterized the structural properties of submonolayer amounts of Zn on Pd(111) using scanning tunneling microscopy (STM) and spot-profile analysis low energy electron diffraction (SPA-LEED). Following room temperature deposition of ≈0.06 monolayers (ML) Zn onto Pd(111), we observe the substitution of Zn for Pd in the surface layer. At ≈0.20 ML of deposited Zn, STM reveals a locally ordered phase with a (2/√3 × 2/√3)R30° unit cell located near Zn substitutions; SPA-LEED patterns reveal the same periodicity. We attribute this phase to the metastable bonding of atoms or clusters predominantly in hollow sites surrounding Zn substitutions in the surface layer. At ≈0.4 ML, STM images reveal local (√3 × √3)R30° and (2 × 1) ordering on surfaces annealed to 350 K. At coverages near 0.5 ML, both STM and SPA-LEED show the onset of the formation of the (2 × 1) ordering associated with the Zn : Pd 1 : 1 alloy phase. At all coverages, the surface is dominated by island growth; the islands' size and density is shown to depend critically on annealing at temperatures as low as 350 K. These results provide insight into the structural features of a Zn/Pd(111) coverage regime that has been much debated in recent years.

Epstein-Barr virus reactivation in allogeneic stem cell transplantation is highly related to cytomegalovirus reactivation

Monitoring of Epstein-Barr virus (EBV) load and pre-emptive rituximab is an appropriate approach to prevent post-transplant lymphoproliferative disease (PTLD) occurring after hematopoietic stem cell transplantation (HSCT). This pre-emptive approach, based on EBV-DNA monitoring through a quantitative polymerase chain reaction, was applied to 101 consecutive patients who underwent allo HSCT at our Institute (median age 50). A single infusion of rituximab was administered to 11 of 16 patients who were at high risk for progression to PTLD, defined as a DNA value >10 000 copies/mL. All patients cleared EBV DNAemia, without any recurrences. Main factors significantly associated with high risk for PTLD were as follows: (i) unrelated vs. sibling (26% vs. 7%; p = 0.011); (ii) T-cell depletion (29% vs. 6%; p = 0.001); (iii) graft versus host disease (GVHD; 30% vs. 7%; p = 0.002); and (iv) cytomegalovirus (CMV) reactivation (29% vs. 4%; p = 0.001). Multivariate analysis showed that CMV reactivation was the only independent variable associated with EBV reactivation. We conclude that: (i) a single infusion of rituximab is able to prevent the risk of progression into EBV-related PTLD; and (ii) CMV reactivation is strongly associated with EBV reactivation; therefore, an intensive EBV monitoring strategy could be advisable only in case of CMV reactivation.

Fine tuning of graphene-metal adhesion by surface alloying

We show that bimetallic surface alloying provides a viable route for governing the interaction between graphene and metal through the selective choice of the elemental composition of the surface alloy. This concept is illustrated by an experimental and theoretical characterization of the properties of graphene on a model PtRu surface alloy on Ru(0001), with a concentration of Pt atoms in the first layer between 0 and 50%. The progressive increase of the Pt content determines the gradual detachment of graphene from the substrate, which results from the modification of the carbon orbital hybridization promoted by Pt. Alloying is also found to affect the morphology of graphene, which is strongly corrugated on bare Ru, but becomes flat at a Pt coverage of 50%. The method here proposed can be readily extended to several supports, thus opening the way to the conformal growth of graphene on metals and to a full tunability of the graphene-substrate interaction.

A survey of fuzzy clustering algorithms for pattern recognition. II

For pt.I see ibid., p.775-85. In part I an equivalence between the concepts of fuzzy clustering and soft competitive learning in clustering algorithms is proposed on the basis of the existing literature. Moreover, a set of functional attributes is selected for use as dictionary entries in the comparison of clustering algorithms. In this paper, five clustering algorithms taken from the literature are reviewed, assessed and compared on the basis of the selected properties of interest. These clustering models are (1) self-organizing map (SOM); (2) fuzzy learning vector quantization (FLVQ); (3) fuzzy adaptive resonance theory (fuzzy ART); (4) growing neural gas (GNG); (5) fully self-organizing simplified adaptive resonance theory (FOSART). Although our theoretical comparison is fairly simple, it yields observations that may appear parodoxical. First, only FLVQ, fuzzy ART, and FOSART exploit concepts derived from fuzzy set theory (e.g., relative and/or absolute fuzzy membership functions). Secondly, only SOM, FLVQ, GNG, and FOSART employ soft competitive learning mechanisms, which are affected by asymptotic misbehaviors in the case of FLVQ, i.e., only SOM, GNG, and FOSART are considered effective fuzzy clustering algorithms.

Hyperfine structure of Ho3+ levels and electron-phonon coupling in YPO4 single crystals

High resolution spectroscopy (the finest being 0.01 cm(-1)) was applied in the 75-25,000 cm(-1) and 9-300 K ranges to a 1 mol% holmium doped Y PO(4) single crystal with two purposes: (1) to study the hyperfine splitting of Ho(3+) energy levels of interest for possible quantum manipulation media and (2) to analyze the electron-phonon interaction. The hyperfine structure was clearly revealed for a high number of lines in a wide wavenumber range (up to ~21,500 cm(-1)) and for a large number of multiplets. Several hyperfine patterns were monitored, differing in the number of components (a maximum of 16 could be easily distinguished in a single beautiful pattern), in their separation, and in their relative statistical weight. These features were all understood in terms of a crystal-field model, whose results are in good agreement with experiments and account for the involved level symmetry, the type of transitions (electric and magnetic dipole allowed), and the contribution of a second-order (pseudoquadrupolar) hyperfine coupling between close levels. The electron-phonon interaction, investigated through the thermally induced line shift, was critically discussed in the framework of single phonon coupling and of two phonon Raman scattering models.

Thermal stability of corrugated epitaxial graphene grown on Re(0001)

We report on a novel approach to determine the relationship between the corrugation and the thermal stability of epitaxial graphene grown on a strongly interacting substrate. According to our density functional theory calculations, the C single layer grown on Re(0001) is strongly corrugated, with a buckling of 1.6 Å, yielding a simulated C 1s core level spectrum which is in excellent agreement with the experimental one. We found that corrugation is closely knit with the thermal stability of the C network: C-C bond breaking is favored in the strongly buckled regions of the moiré cell, though it requires the presence of diffusing graphene layer vacancies.

O- and H-induced surface core level shifts on Ru(0001): prevalence of the additivity rule

In previous work on adsorbate-induced surface core level shifts (SCLSs), the effects caused by O atom adsorption on Rh(111) and Ru(0001) were found to be additive: the measured shifts for first-layer Ru atoms depended linearly on the number of directly coordinated O atoms. Density-functional theory calculations quantitatively reproduced this effect, allowed separation of initial- and final-state contributions, and provided an explanation in terms of a roughly constant charge transfer per O atom. We have now conducted similar measurements and calculations for three well-defined adsorbate and coadsorbate layers containing O and H atoms: (1 × 1)-H, (2 × 2)-(O+H) and (2 × 2)-(O+3H) on Ru(0001). As H is stabilized in fcc sites in the prior two structures and in hcp sites in the latter, this enables us to not only study coverage and coadsorption effects on the adsorbate-induced SCLSs, but also the sensitivity to similar adsorption sites. Remarkably good agreement is obtained between experiment and calculations for the energies and geometries of the layers, as well as for all aspects of the SCLS values. The additivity of the next-neighbor adsorbate-induced SCLSs is found to prevail even for the coadsorbate structures. While this confirms the suggested use of SCLSs as fingerprints of the adsorbate configuration, their sensitivity is further demonstrated by the slightly different shifts unambiguously determined for H adsorption in either fcc or hcp hollow sites.

Model transitions in descending FLVQ

Fuzzy learning vector quantization (FLVQ), also known as the fuzzy Kohonen clustering network, was developed to improve performance and usability of on-line hard-competitive Kohnen's vector quantization and soft-competitive self organizing map (SOM) algorithms. The FLVQ effectiveness seems to depend on the range of change of the weighting exponent m(t). In the first part of this work, extreme m(t) values (1 and 1, respectively) are employed to investigate FLVQ asymptotic behaviors. This analysis shows that when m(t) tends to either one of its extremes, FLVQ is affected by trivial vector quantization, which causes centroids collapse in the grand mean of the input data set. No analytical criterion has been found to improve the heuristic choice of the range of m(t) change. In the second part of this paper, two FLVQ and SOM classification experiments of remote sensed data are presented. In these experiments the two nets are connected in cascade to a supervised second stage, based on the delta rule. Experimental results confirm that FLVQ performance can be greatly affected by the user's definition of the range of change of the weighting exponent. Moreover, FLVQ shows instability when its traditional termination criterion is applied. Empirical recommendations are proposed for the enhancement of FLVQ robustness. Both the analytical and the experimental data reported seem to indicate that the choice of the range of m(t) change is still open to discussion and that alternative clustering neural-network approaches should be developed to pursue during training: 1) monotone reduction of the neurons' learning rate and 2) monotone reduction of the overlap among neuron receptive fields.

Self-organised synthesis of Rh nanostructures with tunable chemical reactivity

Nonequilibrium periodic nanostructures such as nanoscale ripples, mounds and rhomboidal pyramids formed on Rh(110) are particularly interesting as candidate model systems with enhanced catalytic reactivity, since they are endowed with steep facets running along nonequilibrium low-symmetry directions, exposing a high density of undercoordinated atoms. In this review we report on the formation of these novel nanostructured surfaces, a kinetic process which can be controlled by changing parameters such as temperature, sputtering ion flux and energy. The role of surface morphology with respect to chemical reactivity is investigated by analysing the carbon monoxide dissociation probability on the different nanostructured surfaces.

Prevention of bisphosphonates-induced osteonecrosis

The osteonecrosis of the jaw is a new emergent disease, secondary to prolonged use of bisphosphonates. Bisphosphonates are a class of drug used in prevention and cure of bone diseases such as malignancy or bone metabolic diseases. In this article, we have tried to summarize, for patients taking IV or oral bisphosphonates-therapy, the most important informations on the pathogenesis and the risk factors in osteonecrosis of the jaw with particular attention about the preventive policies.

Growth of SnO(2) nanocrystals controlled by erbium doping in silica

We investigate the effects of erbium doping on SnO(2) nanoclustering in Sn-doped silica. Vibrational spectroscopy data from Raman and infrared absorption measurements show nanostructuring effects on the SnO(2) nanophase. Ultraviolet absorption spectra evidence a gap shift ascribable to size-dependent quantum confinement, also suggesting a role of erbium doping in determining cluster sizes and the amount of localized states on the nanophase boundary. Transmission electron microscopy confirms and details the spectroscopic data. As a result of these measurements, we find that the nanocrystal size distribution becomes narrower, increasing the erbium concentration, while the density of localized states at the nanocrystal surface decreases. The distribution of erbium ions among the possible environments is then examined through simultaneous spectroscopy of luminescence excited by nanocrystal-to-erbium energy transfer and the absorption of nanocrystal luminescence by erbium ions. This analysis shows that erbium behaves as an extrinsic nucleation centre of the SnO(2) nanophase at low doping levels, whereas at high concentrations it modifies the matrix, hindering the growth of SnO(2) crystals and passivating the interface.

Carbon monoxide dissociation on Rh nanopyramids

CO dissociation on rhomboidal faceted nanopyramids, produced on Rh(110) by fine-tuning of ion irradiation conditions, has been studied by high resolution core-level spectroscopy. We find that this morphology presents a large efficiency towards CO dissociation, a process which is inhibited on flat (110) terraces. We also measured the reactivity of nanostructures bound by different artificial step distributions identifying the sites responsible for the molecular bond disruption in the undercoordinated (n=6) edges running along the [11[over ]2] equivalent directions, with CO sitting in on-top configuration.

Bisphosphonates (BP)-related osteonecrosis of the jaw (ONJ): Clinical experience of the “Rete Oncologica di Piemonte e Valle d’Aosta” network

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Background: ONJ have been recently reported in patients (pts) treated with BP, especially Pamidronate (P) and Zoledronic Acid (Z). Measures of screening, treatment, and prevention have been planned in our regional oncology network. Methods: We evaluated dental history of pts previously treated with BP and/or under treatment in 2005, finding 60 cases of ONJ, but a large number of suspected cases are under investigation/observation. Full details of oncologic and dental history have been collected so far of 43 pts. Results: Pts characteristics: sex: 14/29 M/F; median age 66 years (range 45–81); tumour: 24 breast cancer, 7 prostate cancer; 12 myeloma. BP treatment: 5 P, 14 P changed to Z, 24 Z; median number of infusions: 22 of P (range 12–52), 18 of Z (range 7–43). Site of ONJ: 33 (77%) in mandible, 9 (21%) in maxilla, 1 (2%) in both. Presenting findings included exposed bone or infections (95%), pain, mobile teeth, soft-tissue swelling, nonhealing fistulas . Dental comorbidities were present in all pts and 92 % had precipitating events, as teeth extraction, periodontal surgery, dental implants, or traumatic use of dentures. Conclusions: Our oncology network planned: a) review of all pts treated with BP since 2000, to obtain real estimates of frequency and of possible risk factors; b) screening of all pts under treatment with BP, with panoramic X-rays and maxillofacial surgeon visit (w/o CT or MR scan in selected cases); c) careful evaluation of pts candidate to be treated with BP (as above), with pretherapy dental care if necessary; d) prospective evaluation of incidence in future, after pretherapy dental care policy and avoiding (as possible) surgical dental procedures during BP treatment; e) prospective trials of evaluation of palliative treatment of ONJ and related complications in affected pts (chlorohexidine mouthwashes, antibiotics, metronidazole, hyperbaric oxygen, etc.).

No significant financial relationships to disclose.

Monitoring Super- and Subsurface Oxygen on Ag(210) by High Energy Resolution X-ray Photoelectron Spectroscopy: Subsurface Diffusion and Segregation

We report on a high energy resolution X-ray photoelectron spectroscopy plus supersonic molecular beam investigation of O/Ag(210). Two components are detected in the O1s spectra upon O2 adsorption, at binding energies EB=527.7 and 529.6 eV. The former peak persists up to 470 K, while the latter one decreases abruptly above 280 K. Comparison with a previous vibrational spectroscopy investigation on the same system (L. Vattuone, et al. Phys. Rev. Lett. 2003, 90, 228302) allows to assign both features to atomic oxygen. The low-energy peak is identified with adatoms, while the other is correlated to O atoms in subsurface sites. A minor contribution at the same binding energy, due to carbonates, is quantified by inspection of the C1s region and shows a different temperature behavior with respect to oxygen. Oxygen segregation into the subsurface region is observed when heating the crystal in the presence of supersurface oxygen.

NH3 adsorption and decomposition on Ir(110): A combined temperature programmed desorption and high resolution fast x-ray photoelectron spectroscopy study

The adsorption and decomposition of NH3 on Ir(110) has been studied in the temperature range from 80 K to 700 K. By using high-energy resolution x-ray photoelectron spectroscopy it is possible to distinguish chemically different surface species. At low temperature a NH3 multilayer, which desorbs at approximately 110 K, was observed. The second layer of NH3 molecules desorbs around 140 K, in a separate desorption peak. Chemisorbed NH3 desorbs in steps from the surface and several desorption peaks are observed between 200 and 400 K. A part of the NH3ad decomposes into NH(ad) between 225 and 300 K. NH(ad) decomposes into N(ad) between 400 K and 500 K and the hydrogen released in this process immediately desorbs. N2 desorption takes place between 500 and 700 K via N(ad) combination. The steady state decomposition reaction of NH3 starts at 500 K. The maximum reaction rate is observed between 540 K and 610 K. A model is presented to explain the occurrence of a maximum in the reaction rate. Hydrogenation of N(ad) below 400 K results in NH(ad). No NH2ad or NH3ad/NH3 were observed. The hydrogenation of NH(ad) only takes place above 400 K. On the basis of the experimental findings an energy scheme is presented to account for the observations.

Structural and kinetic effects on a simple catalytic reaction: Oxygen reduction on Ni(110)

Oxygen hydrogenation at 100 K by gas phase atomic hydrogen on Ni(110) has been studied under ultrahigh vacuum conditions by temperature programmed desorption (TPD) and x-ray photoelectron spectroscopy (XPS). Formation of adsorbed water and hydroxyl species was observed and characterized. The coverage of the reaction products was monitored as a function of both temperature and initial oxygen precoverage. On the contrary, when high coverage oxygen overlayers were exposed to gas phase molecular hydrogen, no hydrogenation reaction took place. The results are compared to the inverse process, exposing the hydrogen covered surface to molecular oxygen. In this case, at 100 K, simple Langmuir-Hinshelwood modeling yields an initial sticking coefficient for oxygen adsorption equal to 0.26, considerably lower than for the clean surface. Moreover, formation of hydroxyl groups is found to be twice as fast as the final hydrogenation of OH groups to water. Assuming a preexponential factor of 10(13) s(-1), an activation barrier of 6.7 kcal/mol is obtained for OH formation, thus confirming the high hydrogenating activity of nickel with respect to other transition metals, for which higher activation energies are reported. However, oxygen is hardly removed by hydrogen on nickel: this is explained on the basis of the strong Ni-O chemical bond. The hydrogen residual coverage is well described including a contribution from the adsorption-induced H desorption process which takes place during the oxygen uptake and which is clearly visible from the TPD data.

The role of Oad in the decomposition of NH3 adsorbed on Ir(110): a combined TPD and high-energy resolution fast XPS study

High energy resolution fast XPS combined with TPD experiments were used to study the effect of chemisorbed oxygen on the adsorption and dissociation of NH(3) on Ir(110). Below 250 K the presence of O(ad) does not influence NH(3) decomposition. Above 250 K O(ad) enhances NH(3) dissociation, which results in three times as much N(2) formation and less molecular NH(3) desorption compared to the experiments without O(ad). The effect of O(ad) can be attributed to destabilization of NH(ad) on the surface, resulting in a further dehydrogenation towards N(ad). The presence of O(ad) on the surface lowers the temperature at which the N(ad) combination reaction takes place by as much as 200 K, due to repulsive interaction between N(ad) and O(ad). NO is formed above 450 K if both N(ad) and O(ad) are present on the surface.

Calorimetry at surfaces using high-resolution core-level photoemission

We have developed a method to measure simultaneously the internal energy of bulk and the first layer atoms of a crystal. The internal energy of bulk and the surface atoms of lithium (110) have been evaluated from 22 K up to above the melting transition, applying the Debye model to the thermal broadening of the respective 1s photoemission lines. Our measurements clearly reveal two phase changes: the known liquid to solid transition and the surface melting, occurring 50 K below the bulk melting point.

Spectroscopic link between adsorption site occupation and local surface chemical reactivity

In this Letter we show that sequences of adsorbate-induced shifts of surface core level (SCL) x-ray photoelectron spectra contain profound information on surface changes of electronic structure and reactivity. Energy shifts and intensity changes of time-lapsed spectral components follow simple rules, from which adsorption sites are directly determined. Theoretical calculations rationalize the results for transition metal surfaces in terms of the energy shift of the d-band center of mass and this proves that adsorbate-induced SCL shifts provide a spectroscopic measure of local surface reactivity.

Distinct reaction mechanisms in the catalytic oxidation of carbon monoxide on Rh(110): scanning tunneling microscopy and density functional theory studies

By means of scanning tunneling microscopy measurements and density functional theory calculations, we identify the reaction mechanism for the oxidation of carbon monoxide to carbon dioxide on the Rh(110) surface at 160 K, which appears to be completely different than the one active at room temperature. The reasons for these different behaviors are determined. Our results demonstrate that even for a very simple catalytic reaction, the microscopic mechanism can dramatically change with temperature, following pathways that differ for nucleation sites and surface propagation and involve different surface moieties.

Liver and kidney foreign bodies granulomatosis in a patient with malocclusion, bruxism, and worn dental prostheses

Granulomatous reactions caused by foreign bodies have been described in drug abusers, in subjects exposed to occupational pollutants, and more rarely, in association with the use of prosthetic devices. We describe a 62-year-old patient with multiorgan parenchymal granulomatosis caused by inorganic debris of unknown origin. The patient presented with fever, hepatosplenomegaly, progressive cholestasis, and acute renal failure. Liver and kidney biopsies showed the presence of noncaseating epithelioid giant-cell granulomas containing scattered polarizable particles. Similar particles were also present in stools. Studies by innovative scanning electron microscopy and energy-dispersive microanalytical techniques showed that the particles isolated in liver, kidney, and stools were made by feldspars, the main component of porcelain. No occupational or environmental exposure to these materials could be identified in this patient and the only reliable source of the porcelain debris turned out to be constituted by 2 dental bridges evidently worn because of a possible inappropriate construction, malocclusion, and bruxism. The porcelain of the dental prostheses had the same elemental spectrum of the particles isolated from stool specimens and liver-kidney granuloma. After identification of the dental prostheses as the most likely source of ceramic debris, and after their removal, the particles from stool specimens disappeared. The patient was then treated with steroids leading to a remission of the clinical symptoms and a decrease in granulomatous inflammatory reaction in both liver and kidney. This is the first report suggesting that a foreign body systemic granulomatosis can be associated with worn dental prostheses.

Unsuccessful treatment of resistant thrombotic thrombocytopenic purpura with prostacyclin

Prostacyclin has been suggested as a useful agent for patients with thromobotic thrombocytopenic pupura (TTP) refractory to plasma-exchange. We report our unsuccessful experience with iloprost in a patient with TTP resistant to plasma-exghange, vincristine and high dose immunoglobulins.