SUMMARY Disregarding the widely used division of skull base into anterior and lateral, since the skull base should be conceived as a single anatomic structure, it was to our convenience to group all those approaches that run from the antero-lateral, pure lateral and postero-lateral side of the skull base as “Surgery of the lateral skull base”. “50 years of endeavour” points to the great effort which has been made over the last decades, when more and more difficult surgeries were performed by reducing morbidity. The principle of lateral skull base surgery, “remove skull base bone to approach the base itself and the adjacent sites of the endo-esocranium”, was then combined with function preservation and with tailoring surgery to the pathology. The concept that histology dictates the extent of resection, balancing the intrinsic morbidity of each approach was the object of the first section of the present report. The main surgical approaches were described in the second section and were conceived not as a step-by-step description of technique, but as the highlighthening of the surgical principles. The third section was centered on open issues related to the tumor and its treatment. The topic of vestibular schwannoma was investigated with the current debate on observation, hearing preservation surgery, hearing rehabilitation, radiotherapy and the recent efforts to detect biological markers able to predict tumor growth. Jugular foramen paragangliomas were treated in the frame of radical or partial surgery, radiotherapy, partial “tailored” surgery and observation. Surgery on meningioma was debated from the point of view of the neurosurgeon and of the otologist. Endolymphatic sac tumors and malignant tumors of the external auditory canal were also treated, as well as chordomas, chondrosarcomas and petrous bone cholesteatomas. Finally, the fourth section focused on free-choice topics which were assigned to aknowledged experts. The aim of this work was attempting to report the state of the art of the lateral skull base surgery after 50 years of hard work and, above all, to raise questions on those issues which still need an answer, as to allow progress in knowledge through sharing of various experiences. At the end of the reading, if more doubts remain rather than certainties, the aim of this work will probably be achieved.
Size-tunable platinum nanoparticles (PtNPs) prepared by a facile method in an aqueous environment without the use of catalyst-poisoning reagents are used here in the electrocatalytic detection of hydrogen peroxide. Spherical nanoparticles with sizes as small as 4 and 20 nm are obtained as shown by transmission electron microscopy (TEM) analysis only using small easy-to-remove molecules such as sodium citrate. PtNPs are freed from the citrate capping agent at the surface by changing the pH to basic values and then deposited on a glassy carbon electrode by a very simple and rapid drop-casting method, achieving high cleanliness of the nanoparticle surface without the need for further treatments. The superior quality of nanoparticles on the glassy carbon is further investigated by scanning electron microscopy (SEM) analysis, which shows a highly homogeneous distribution of well-dispersed nanoparticles on the electrode surface, as well as by X-ray photoelectron spectroscopy (XPS) analysis, which confirms a drastic decrease of the citrate content, providing useful information about the citrate–platinum interaction, and evidences a related remarkable increase of conductivity of capping-free washed nanoparticles. Due to such key features, PtNPs possess excellent electrocatalytic properties, which have been tested in hydrogen peroxide electroreduction, a well-known catalytic reaction of nanostructured platinum materials. The size effect on PtNPs electrocatalytic properties is demonstrated, achieving higher performances with smaller NPs in the amperometric detection of hydrogen peroxide at −0.1 V in the concentration range of 25–750 μM, with a detection limit of 10 μM. Good sensing results toward hydrogen peroxide have also been obtained in terms of sensitivity, selectivity, repeatability, stability, and in tests performed in tap water samples. In addition, the strong adhesion of nanoparticles to the electrode surface has been verified and ascribed to their coating-free surface.
Background The nasal mucosa plays a key role in conditioning the inhaled air and in regulating the immune response. These functions led many authors to recommend mucosal sparing techniques for the surgical management of inferior turbinate hypertrophy. However, the histological modifications of chronic diseases retain the inflammatory activity and prevent the nasal physiology restoration. It has been proved that the basal cells of the nasal mucosa are able to proliferate and to repair after cold-knife incision. The aim of this study was to demonstrate that the healing process after removal of the inferior turbinate mucosa with cold techniques results in a complete structural restoration.MethodsA prospective study was performed in 18 patients who underwent Microdebrider inferior turbinoplasty (cold technique). Subjective and objective improvement of nasal patency was evaluated with visual analogue scale, rhinomanometry, videoendoscopy and mucociliary transport test. Pre- and post-operative biopsy specimens were taken from 7 patients to evaluate the healing process. Two samples were taken from two healthy patients as control. The specimens were processed for transmission electron microscopy analysis.ResultsVideoendoscopy showed reduction of lower turbinate after surgery. Nasal patency augmented and no adverse consequences were observed. After 4 months the nasal mucosa showed normal appearance, with restoration of the pseudostratified ciliated pattern, intercellular connections and normal cellular morphology. Fibrosis and submucosal edema disappeared. At longer time after operation (4 years) clinical improvement was confirmed.ConclusionsThe total removal of the nasal mucosa with cold techniques results in a complete restoration of the normal structure and permanent resolution of the chronic inflammation typical of hypertrophic rhinopathy.
Shape-selective, sub-10 nm-sized metal nanoparticles are of high fundamental and practical interest in catalysis and electrocatalysis, where the surface structure dictates the kinetic properties of the nanomaterials. Unlike their bimetallic analogues, the synthesis of size-controlled, pure Pt octahedral nanocatalysts has remained a formidable chemical challenge. In bimetallic shaped systems, however, the benefit of shape is often convoluted with surface composition in complex ways. In the present work, a seed-templated approach is presented for the preparation of ultrasmall octahedral platinum nanoparticles (Pt NPs), harnessing the effect of monocrystalline anisotropic seeds and strict control of the reduction rate and other physicochemical parameters while avoiding polymers, surfactants, and organic solvents. The procedure yields previously elusive 6.7 nm, strictly single-crystal, Pt NPs with partially truncated octahedral shape and prevalent extended {111} surface facets. Electrochemical measurements using rotating disk electrodes in an acid electrolyte revealed a much higher electrochemical active surface area (ECSA) over the state-of-the-art octahedral Pt NPs, which is ascribed to small-sized, poison-free, and preferentially {111} orientated facets. The dramatic kinetic benefit for the oxygen reduction reaction (ORR) of the octahedral shape over spherical particle shapes of same size is convincingly demonstrated. More important for practical applications is the fact that the intrinsic specific ORR activity is about 2.4-fold higher than commercial optimized spherical Pt NPs deployed in fuel cell cathodes at comparable ORR stability. In doing this analysis, we validate the voltammetric correspondence between Pt single crystals and Pt nanoparticulate materials and highlight the kinetic benefits of limiting the proportion of {100} facets. Prolonged suppression of {100} facet growth in octahedral Pt catalysts is the reason for the unusually high specific activity and fair stability and calls for their integration and testing as cathode catalysts in fuel cell membrane electrode assemblies.
Oxidative stress is known to be the cause of several neurovascular diseases, including neurodegenerative disorders, since the increase of reactive oxygen species (ROS) levels can lead to cellular damage, blood–brain barrier leaking, and inflammatory pathways. Herein, we demonstrate the therapeutic potential of 5 nm platinum nanoparticles (PtNPs) to effectively scavenge ROS in different cellular models of the neurovascular unit. We investigated the mechanism underlying the PtNP biological activities, analyzing the influence of the evolving biological environment during particle trafficking and disclosing a key role of the protein corona, which elicited an effective switch-off of the PtNP catalytic properties, promoting their selective in situ activity. Upon cellular internalization, the lysosomal environment switches on and boosts the enzyme-like activity of the PtNPs, acting as an intracellular “catalytic microreactor” exerting strong antioxidant functionalities. Significant ROS scavenging was observed in the neurovascular cellular models, with an interesting protective mechanism of the Pt-nanozymes along lysosomal–mitochondrial axes.
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