Through magnetization measurement with a SQUID magnetometer the heat treatment optimization of an international thermonuclear experimental reactor (ITER)-type internal-Sn Nb3Sn superconducting wire has been investig...Through magnetization measurement with a SQUID magnetometer the heat treatment optimization of an international thermonuclear experimental reactor (ITER)-type internal-Sn Nb3Sn superconducting wire has been investigated. The irreversibility temperature T^* (H), which is mainly dependent on A15 phase composition, was obtained by a warming and cooling cycle at a fixed field. The hysteresis width △M(H) which reflects the flux pinning situation of the A15 phase is determined by the sweeping of magnetic field at a constant temperature. The results obtained from differently heat-treated samples show that the combination of T^* (H) with AM(H) measurement is very effective for optimizing the heat reaction process. The heat treatment condition of the ITER-type wire is optimized at 675℃/128 h, which results in a composition closer to stoichiometric Nb3Sn and a state with best flux pinning.展开更多
Hydrogen absorption and desorption characteristics for high coercivity NdDyFeCoNbCuB sintered bulk magnets were studied, by differential scanning calorimetry (DSC) measurement and hydrogenation kinetics measurement....Hydrogen absorption and desorption characteristics for high coercivity NdDyFeCoNbCuB sintered bulk magnets were studied, by differential scanning calorimetry (DSC) measurement and hydrogenation kinetics measurement. The DSC measurements showed that hydrogenation of Nd-rich phase occurred in the temperature range of 40-185 ℃, hydrogenation of the tetragonal (Ф) phase in the temperature range of 185-220 ℃, as well as the disproportionation of the Ф phase that occurred in a broad temperature range from around 500 to 800 ℃. The hydrogenation kinetics measurements indicated that hydrogen absorption of the bulk magnets at 50 ℃ absorbed more hydrogen than at 150 ℃, although this procedure was slower at 50 ℃ than at 150℃. This phenomenon was discussed by means of pressure-concentration-temperature (p-c-T) diagrams.展开更多
Anisotropic powder was prepared with precursor (NdDy)-(FeCoNbCu)-B sintered magnets by hydrogen decrepitation, desorption, and subsequent annealing treatment. The hydrogen desorption was performed in magnetic fiel...Anisotropic powder was prepared with precursor (NdDy)-(FeCoNbCu)-B sintered magnets by hydrogen decrepitation, desorption, and subsequent annealing treatment. The hydrogen desorption was performed in magnetic fields of 0, 1, 3, and 5 T. The orientation of tetragonal phase grains of the powder was evaluated from the hysteresis loops measured by extraction magnetometer. Residual hydrogen content of the powder was evaluated by thermal-magnetic analysis. The powder with Hcj, Br, and (BH)max of 1138 kA.m^-1, 1.029 T, and 172.5 kJ.m^-3, respectively, was achieved under the condition of the magnetic field of 3 T. Magnetic properties of the powder, especially, the remanence of the powder, are enhanced upon magnetic fields, which is due to better orientation of powder particles and less residual hydrogen in the powder resulted from the magnetic field during the hydrogen desorption process.展开更多
Greek schools are witnessing widening gaps between traditional definitions and applications of literacy, which include reading, writing and speaking in terms of exercises from school textbooks and contemporary literac...Greek schools are witnessing widening gaps between traditional definitions and applications of literacy, which include reading, writing and speaking in terms of exercises from school textbooks and contemporary literacy practices like digital storytelling, interactive multimedia use and online communications. Language and literacy teachers of primary education are called upon daily to bridge these contradictions through pedagogical and textual choices they make in classroom teaching. This paper reports an experimental study with children of the fifth grade at public Greek schools to apply modernist literacy approaches involving digital storytelling and online communication in improving language skills. The paper analytically presents the didactic examples of a thematic union within the framework of the Greek curriculum and the alternative assessment for the experimental teaching on digital technologies among mother tongue learners. The findings have implications for teacher's and student's education and also for the integration of a pedagogical-technological content of curriculum within the continuing debate of being culturally and equally literate in today's education.展开更多
Background: The main dermatology textbooks describe only in passing pruritus in psoriasis and rarely mention other symptoms. A quantification of the presence of symptoms is not available for clinical subgroups of psor...Background: The main dermatology textbooks describe only in passing pruritus in psoriasis and rarely mention other symptoms. A quantification of the presence of symptoms is not available for clinical subgroups of psoriasis. Objectives: T o investigate the prevalence of symptoms experienced by patients with different clinical types of psoriasis. Methods: The study was carried out in patients hosp italized for psoriasis between February 2000 and February 2002 at the inpatient wards of the Istituto Dermopatico dell’Immacolata, Rome, Italy. Symptoms were evaluated using the symptoms scale of Skindex- 29. Clinical severity was assess ed by the dermatologists using the Psoriasis Area and Severity Index (PASI), and by the patients completing the self-administered PASI. Psychiatric morbidity was evaluated using the 12- item General Health Questionnaire. Results: In tota l, 936 eligible patients were analysed. The proportions of patients experiencing symptoms often or always in the 4 weeks before hospitalization were: 63.8% it ching, 59.7% irritation, 46.1% burning/stinging, 39% sensitivity, 26% pa in (from 10% in guttate psoriasis to 50% in arthropathic)- , 25.4% bleedi ng (17% pustular, 19% localized plaque, 36% palmoplantar), and 23.9% bot hered by water (from 8.5% in the guttate form to 68% in palmoplantar). The p revalence of all symptoms was significantly higher in women and tended to increa se with clinical severity. Conclusions: Our study provides evidence of the high frequency of a number of symptoms in different subgroups of psoriasis patients d etermined by their sociodemographic characteristics, clinical type and disease s everity. Symptoms represent a serious disabling factor in patients affected by p soriasis, including those with low levels of psychological distress. Dermatologi sts should include symptoms in the evaluation of disease severity both in clinic al practice and in clinical trials.展开更多
Melkersson-Rosenthal syndrome (MRS) is a complex neuromucocutaneous disorder characterized by localized orofacial oedema and cranial nerve dysfunction, frequently associated with minor signs, including furrowed tongue...Melkersson-Rosenthal syndrome (MRS) is a complex neuromucocutaneous disorder characterized by localized orofacial oedema and cranial nerve dysfunction, frequently associated with minor signs, including furrowed tongue. Complete forms are rare where a smono-and oligosymptomatic variants are more common. A 71-year-old man presented with a 2-year history of relapsing and progressively persistent oedema of the right eyelids and periorbital region. A fissured tongue and telangiectatic rosacea had been present since the age of 50 and 60 years, respectively. The patient was also affected by essential hypertension and diabetes mellitus. A skin biopsy showed a marked upper dermal oedema, and small epithelioid cell granulomas arranged in perivascular and perilymphatic location. Collections of small epithelioid cells were occasionally observed within lymphatic spaces. No acid-fast bacteria, fungi or foreign bodies were detected. Intralesional corticosteroids induced transient improvement, whereas minocycline, clofazimine and dapsone have been ineffective. MRS may present with unilateral eyelid and periorbital swelling. Differential diagnoses of such cases may include a variety of cutaneous, ophthalmic and systemic diseases.展开更多
Background: There is a need for reliable, easily measurable laboratory markers that may help dermatologists to predict the course of mycosis fungoides (MF) when they first evaluate their patients. Objectives: Our obje...Background: There is a need for reliable, easily measurable laboratory markers that may help dermatologists to predict the course of mycosis fungoides (MF) when they first evaluate their patients. Objectives: Our objective was to identify clinical, haematological or immunological parameters as predictors of mortality in patients with MF. Methods: We conducted a retrospective study on a prevalent cohort of 124 patients with MF hospitalized at IDI-IRCCS, Rome, Italy, from 1983 to 2001. We calculated the proportion of patients surviving (Kaplan-Meier product-limit estimates) 5 and 10 years after first hospital admission, and hazard ratios (HR) from the Cox proportional hazards model. Results: Patients’survival was linked to age and staging (lower survival in older patients and in patients with staging IIB-IV). Higher numbers of white blood cells (WBC) and neutrophils, lower numbers of CD8+lymphocytes, low haematocrit and lower levels of albumin were significantly associated with a lower survival probability. When simultaneously accounting for age and staging, CD8+[HR = 3.02, 95%confidence interval (CI) 1.01-9.07 for CD8+< 250 vs. ≥600 cells μL-1] and WBC (HR = 2.59, 95%CI 0.96-6.96 for WBC ≥9000 vs. < 6000 cells μL-1) were associated with survival. In addition, we observed an exceedingly high risk of death (HR = 12.40, 95%CI 3.11-49.43) for patients with a combination of WBC ≥9000 and CD8+< 600 cells μL-1 vs. WBC < 9000 and CD8+≥600 cells μL-1). Conclusions: The measurement of CD8+cells and WBC in MF seems to be a promising criterion to predict survival, and possibly to support treatment decisions and inclusion of patients in randomized controlled trials.展开更多
The Dermatology Life Quality Index (DLQI) is one of the most frequently used questionnaires to evaluate the impact of dermatological diseases on patients’ lives. This study aimed to assess the reliability and validit...The Dermatology Life Quality Index (DLQI) is one of the most frequently used questionnaires to evaluate the impact of dermatological diseases on patients’ lives. This study aimed to assess the reliability and validity of the instrument and to test its unidimensionality in a large sample of patients with psoriasis (n=976) hospitalized at IDI- IRCCS, Rome, Italy. Nine hundred patients completed the DLQI, the Psoriasis Disability Index (PDI) and the Skindex- 29 (response rate 92% ). The internal consistency of the DLQI was high (Cronbach’ s alpha= 0.83). Evidence of convergent validity was provided by high (r=0.64- 0.81) correlations between the DLQI, the PDI, and the functioning and emotions scales of Skindex- 29. Exploratory factor analysis indicated the presence of four different principal common factors. Confirmatory factor analysis showed a clear second- order factor structure, with a homogeneous second- order factor underlying the four primary- surface factors. This study confirms that the DLQI is a reliable and valid instrument to assess patient- perceived impact of skin disease. Also, it supports the unidimensionality of the DLQI and hence corroborates the common practice of using the total score.展开更多
Background: The NC16A immunodominant region of the bullous pemphigoid (BP) antigen BP180 has been used to develop several enzyme-linked immunosorbent assays (ELISAs) as diagnostic tools for BP autoantibody detection. ...Background: The NC16A immunodominant region of the bullous pemphigoid (BP) antigen BP180 has been used to develop several enzyme-linked immunosorbent assays (ELISAs) as diagnostic tools for BP autoantibody detection. Objectives: Because BP180 autoantibody reactivity is not restricted toNC16A, we have investigated the possibility of developing an ELISA based on selected epitopes additional to this immunodominant region. Methods: Initially 78 BP sera were tested using an NC16A ELISA and IgG reactivity was detected in 64 BP sera (82%). The 14 NC16A-negative BP sera were then analysed by immunological screening against seven BP180-specific epitopes. Recombinant phages displaying BP180 epitopes were grown as plaques, blotted onto a nitrocellulose filter and incubated with BP sera. Results: Three and five NC16A-negative BP sera reacted with epitopes AA 1080-1107 and AA 1331-1404 of the BP180 ectodomain, respectively. Thus, a novel ELISA with GST-1080 and GST-1331 (GST-1080/1331) was developed: 32 of 78 BP sera (41%) proved positive by this assay. The combined use of ELISAs with GST-NC16A and GST-1080/1331 detected IgG reactivity in 72 of 78 BP sera, increasing the sensitivity from 82%to 92%. In addition, autoreactivity against the three extracellular epitopes appeared to be related to the presence of both skin and mucosal involvement as assessed by Fisher‘s exact probability test. Conclusions: Our findings further characterize the autoimmune response in BP by identifying a subgroup of NC16A-negative patients who react with different BP180 extracellular epitopes. The developed ELISA system appearsmore sensitive than the ELISA based on NC16A alone and also informative about the epitope profile of BP patients.展开更多
Objective141: To evaluate the association between different components of smoking history and the clinical severity of psoriasis. Design: A hospital-based cross-sectional study. Setting: Inpatient wards of a hospital ...Objective141: To evaluate the association between different components of smoking history and the clinical severity of psoriasis. Design: A hospital-based cross-sectional study. Setting: Inpatient wards of a hospital for skin diseases in Rome, Italy.Patients: A total of 818 adults with psoriasis. Main Outcome Measure: The Psoriasis Area and Severity Index was used to assess the clinical severity of psoriasis between February 21, 2000, and February 19, 2002. Results: After adjustment for potential confounders (sex, age, body mass index, psychological distress, family history of psoriasis, duration of psoriasis disease, and alcohol consumption), high intensity of smoking (>20 cigarettes daily) vs a lower level of consumption (≤ 10 cigarettes daily) was associated with a more than 2-fold increased risk of clinically more severe psoriasis (odds ratio [OR], 2.2;95% confidence interval [CI], 1.2- 4.1). Cigarette-years, measured as the product of the intensity and duration (years) of smoking, significantly increased the risk of clinically more severe psoriasis after adjustment for confounding factors (OR,1.3; 95% CI, 1.0- 1.6, for a 600-U increase in cigarette-years).Separate analyses for men and women showed that the effect of cigarette-years was stronger for women (OR, 1.8; 95% CI, 1.2- 2.6, for a 400-U increase in cigarette-years) than for men (OR,1.2; 95% CI, 0.9- 1.6, for a 700-U increase in cigarette-years).Conclusion: Smoking is associated with the clinical severity of psoriasis and highlights the importance of smoking cessation in patients with psoriasis.展开更多
CD30+anaplastic large cell lymphoma is a primary cutaneous lymphoproliferative disorder with a high rate of spontaneous regression (almost 25%). The suggested therapies are radiation, surgery and methotrexate. We desc...CD30+anaplastic large cell lymphoma is a primary cutaneous lymphoproliferative disorder with a high rate of spontaneous regression (almost 25%). The suggested therapies are radiation, surgery and methotrexate. We describe two patients with nonregressing primary cutaneousCD30+T cell lymphoma that was successfully treated with topical imiquimod 5%cream (Aldara., 3M) three times weekly for 6 weeks. In both cases we obtained complete clinical remission, confirmed by histology. No recurrences were observed during the following 8 months. We consider that topical application of an immune response modifier, such as imiquimod, could be a good alternative to other potentially more dangerous or aggressive treatments.展开更多
Background: Psoriasis has a great impact on the quality of life of patients, and the ageing population is an important public health issue. Objectives: To investigate whether older patients with psoriasis have a diffe...Background: Psoriasis has a great impact on the quality of life of patients, and the ageing population is an important public health issue. Objectives: To investigate whether older patients with psoriasis have a different impairment in quality of life compared with younger patients, considering level of severity, duration of disease, gender and psychological distress. Methods: The study was performed between February 2000 and February 2002 at the inpatient wards of the Dermatological Institute IDI-IRCCS, Rome, Italy, in the framework of a large project on clinical, epidemiological, emotional and quality of life aspects of psoriasis (IMPROVE study). This is a hospital-based cross-sectional study, with measures of quality of life (Skindex-29, Dermatology Life Quality Index and Psoriasis Disability Index) and of psychological distress, generic (12-item General Health Questionnaire) and psoriasis-related (Psoriasis Life Stress Inventory), all self-asses- sed by patients. We compared the mean scores of each quality of life instrument in patients aged < 65 years and ≥65 years, in subsets of patients based on clinical and sociodemographic characteristics. Results: We analysed 936 patients hospitalized at IDI-IRCCS with a diagnosis of psoriasis. Quality of life was significantly more impaired in the older group for all the Skindex-29 scales, and psychological distress was higher in older patients. In particular, older women suffering from anxiety or depression had the greatest impairment in quality of life. The results were somewhat different using the other quality of life instruments. Conclusions: These results should alert dermatologists that similar levels of clinical severity in psoriasis may be associated with different levels of quality of life and psychological distress of patients. Particular attention should be devoted to older patients, and especially to older women.展开更多
Background: Concerns have been raised about the potential of deliberate self- harm and suicide among patients with dermatologic conditions. Objective: We sought to estimate the prevalence of suicidal ideation among pa...Background: Concerns have been raised about the potential of deliberate self- harm and suicide among patients with dermatologic conditions. Objective: We sought to estimate the prevalence of suicidal ideation among patients with dermatologic conditions, and to identify demographic, clinical, and psychosocial correlates. Methods: Two samples of outpatients with dermatologic conditions (N = 294) and inpatients (N=172) completed the 12- item General Health Questionnaire, the Skindex- 29, and the Patient Health Questionnaire. Results: Forty patients (8.6% ) reported suicidal ideation during the previous 2 weeks. In univariate analysis, the presence of suicidal ideation was associated with female sex, inpatient status, presence of a depressive or anxiety disorder, and higher 12- item General Health Questionnaire and Skindex- 29 scores. The size of the diagnostic groups allowed reasonable prevalence estimates only for psoriasis (10% ) and acne (7.1% ). In multivariate analysis, only emotional distress (12- item General Health Questionnaire) and impaired social functioning (Skindex- 29) were independently associated with suicidal ideation. Limitations: We lacked an observer- rated evaluation of skin condition and could rely only on the Skindex- 29 symptoms subscale as a measure of disease severity. In addition, the measurement of suicidal ideation was limited as a result of the use of only one question to assess it. Furthermore, the crosssectional design prevented causal inferences. Conclusion: Suicidal ideation is not rare among patients with dermatologic conditions. Assessing suicidality would be warranted in dermatologic practice among patients at particular risk such as women with high psychologic distress and impaired social functioning. The development of psychiatric consultation- liaison services is mandatory to provide effective treatment and careful follow- up of patients who are suicidal.展开更多
The recalescence behavior of undercooled Co-Sn alloys under static magnetic fields was investigated using glass slag fluxing technique in a 12T superconducting magnet.Results indicated that the nucleation temperature ...The recalescence behavior of undercooled Co-Sn alloys under static magnetic fields was investigated using glass slag fluxing technique in a 12T superconducting magnet.Results indicated that the nucleation temperature and the highest temperature after recalescence of undercooled melt can be affected by the static magnetic field.The undercooling for Co-Sn alloys keep unchanged when a strong magnetic field was applied while the recalescence extent was reduced. With the increasing Co content for Co-Sn eutectic systems,the effect of the magnetic field on the recalescence was strengthened.We find that the magnetic field has very limited effect on the nucleation temperature on alloys while the highest temperature after recalescence is affected by the field depending on the magnetization difference of the undercooled melt before and after solidification.展开更多
The behavior of YBCO/metal bilayers under transport currents was explored in the framework of fault current limitation (FCL). Properties of the superconducting-normal transition were first studied phenomenologically d...The behavior of YBCO/metal bilayers under transport currents was explored in the framework of fault current limitation (FCL). Properties of the superconducting-normal transition were first studied phenomenologically during sweep current experiments. For current rates higher than 500 A/s, the transition into the normal state was based on non-thermal phenomena and was characterized by a flux creep regime ended by a jump into the normal state. At lower sweep rates, a total diversion of the current in the metallic shunt was observed for temperatures higher than 85K. In this regime, a partial recovery of the superconducting state took place due to a finite thermal resistance between the superconducting and the metallic films. These two properties of partial diversion into the shunt and of fast switching for a quick rise of the current during a default were exploited for current limitation at 77 K. FCL experiments at 50 Hz show that YBCO/Au bilayers limit the current in about 1ms at a value of 2. 5/c by developing electrical fields as high as 3kV/m. Moreover, a recovery of the zero resistance state could occur under rated mode. A straightforward application of this property would be the transformer connection. Finally, results on DC current limitation and recovery under nominal mode were presented for the first time.展开更多
文摘Through magnetization measurement with a SQUID magnetometer the heat treatment optimization of an international thermonuclear experimental reactor (ITER)-type internal-Sn Nb3Sn superconducting wire has been investigated. The irreversibility temperature T^* (H), which is mainly dependent on A15 phase composition, was obtained by a warming and cooling cycle at a fixed field. The hysteresis width △M(H) which reflects the flux pinning situation of the A15 phase is determined by the sweeping of magnetic field at a constant temperature. The results obtained from differently heat-treated samples show that the combination of T^* (H) with AM(H) measurement is very effective for optimizing the heat reaction process. The heat treatment condition of the ITER-type wire is optimized at 675℃/128 h, which results in a composition closer to stoichiometric Nb3Sn and a state with best flux pinning.
文摘Hydrogen absorption and desorption characteristics for high coercivity NdDyFeCoNbCuB sintered bulk magnets were studied, by differential scanning calorimetry (DSC) measurement and hydrogenation kinetics measurement. The DSC measurements showed that hydrogenation of Nd-rich phase occurred in the temperature range of 40-185 ℃, hydrogenation of the tetragonal (Ф) phase in the temperature range of 185-220 ℃, as well as the disproportionation of the Ф phase that occurred in a broad temperature range from around 500 to 800 ℃. The hydrogenation kinetics measurements indicated that hydrogen absorption of the bulk magnets at 50 ℃ absorbed more hydrogen than at 150 ℃, although this procedure was slower at 50 ℃ than at 150℃. This phenomenon was discussed by means of pressure-concentration-temperature (p-c-T) diagrams.
基金the French Embassy in Beijing for provision of a collaborative research grant as part of a co-research program under the frame of LIA-LAS2M between Northwestern Polytechnic University-Xi'an,China and CNRS-Grenoble,France
文摘Anisotropic powder was prepared with precursor (NdDy)-(FeCoNbCu)-B sintered magnets by hydrogen decrepitation, desorption, and subsequent annealing treatment. The hydrogen desorption was performed in magnetic fields of 0, 1, 3, and 5 T. The orientation of tetragonal phase grains of the powder was evaluated from the hysteresis loops measured by extraction magnetometer. Residual hydrogen content of the powder was evaluated by thermal-magnetic analysis. The powder with Hcj, Br, and (BH)max of 1138 kA.m^-1, 1.029 T, and 172.5 kJ.m^-3, respectively, was achieved under the condition of the magnetic field of 3 T. Magnetic properties of the powder, especially, the remanence of the powder, are enhanced upon magnetic fields, which is due to better orientation of powder particles and less residual hydrogen in the powder resulted from the magnetic field during the hydrogen desorption process.
文摘Greek schools are witnessing widening gaps between traditional definitions and applications of literacy, which include reading, writing and speaking in terms of exercises from school textbooks and contemporary literacy practices like digital storytelling, interactive multimedia use and online communications. Language and literacy teachers of primary education are called upon daily to bridge these contradictions through pedagogical and textual choices they make in classroom teaching. This paper reports an experimental study with children of the fifth grade at public Greek schools to apply modernist literacy approaches involving digital storytelling and online communication in improving language skills. The paper analytically presents the didactic examples of a thematic union within the framework of the Greek curriculum and the alternative assessment for the experimental teaching on digital technologies among mother tongue learners. The findings have implications for teacher's and student's education and also for the integration of a pedagogical-technological content of curriculum within the continuing debate of being culturally and equally literate in today's education.
文摘Background: The main dermatology textbooks describe only in passing pruritus in psoriasis and rarely mention other symptoms. A quantification of the presence of symptoms is not available for clinical subgroups of psoriasis. Objectives: T o investigate the prevalence of symptoms experienced by patients with different clinical types of psoriasis. Methods: The study was carried out in patients hosp italized for psoriasis between February 2000 and February 2002 at the inpatient wards of the Istituto Dermopatico dell’Immacolata, Rome, Italy. Symptoms were evaluated using the symptoms scale of Skindex- 29. Clinical severity was assess ed by the dermatologists using the Psoriasis Area and Severity Index (PASI), and by the patients completing the self-administered PASI. Psychiatric morbidity was evaluated using the 12- item General Health Questionnaire. Results: In tota l, 936 eligible patients were analysed. The proportions of patients experiencing symptoms often or always in the 4 weeks before hospitalization were: 63.8% it ching, 59.7% irritation, 46.1% burning/stinging, 39% sensitivity, 26% pa in (from 10% in guttate psoriasis to 50% in arthropathic)- , 25.4% bleedi ng (17% pustular, 19% localized plaque, 36% palmoplantar), and 23.9% bot hered by water (from 8.5% in the guttate form to 68% in palmoplantar). The p revalence of all symptoms was significantly higher in women and tended to increa se with clinical severity. Conclusions: Our study provides evidence of the high frequency of a number of symptoms in different subgroups of psoriasis patients d etermined by their sociodemographic characteristics, clinical type and disease s everity. Symptoms represent a serious disabling factor in patients affected by p soriasis, including those with low levels of psychological distress. Dermatologi sts should include symptoms in the evaluation of disease severity both in clinic al practice and in clinical trials.
文摘Melkersson-Rosenthal syndrome (MRS) is a complex neuromucocutaneous disorder characterized by localized orofacial oedema and cranial nerve dysfunction, frequently associated with minor signs, including furrowed tongue. Complete forms are rare where a smono-and oligosymptomatic variants are more common. A 71-year-old man presented with a 2-year history of relapsing and progressively persistent oedema of the right eyelids and periorbital region. A fissured tongue and telangiectatic rosacea had been present since the age of 50 and 60 years, respectively. The patient was also affected by essential hypertension and diabetes mellitus. A skin biopsy showed a marked upper dermal oedema, and small epithelioid cell granulomas arranged in perivascular and perilymphatic location. Collections of small epithelioid cells were occasionally observed within lymphatic spaces. No acid-fast bacteria, fungi or foreign bodies were detected. Intralesional corticosteroids induced transient improvement, whereas minocycline, clofazimine and dapsone have been ineffective. MRS may present with unilateral eyelid and periorbital swelling. Differential diagnoses of such cases may include a variety of cutaneous, ophthalmic and systemic diseases.
文摘Background: There is a need for reliable, easily measurable laboratory markers that may help dermatologists to predict the course of mycosis fungoides (MF) when they first evaluate their patients. Objectives: Our objective was to identify clinical, haematological or immunological parameters as predictors of mortality in patients with MF. Methods: We conducted a retrospective study on a prevalent cohort of 124 patients with MF hospitalized at IDI-IRCCS, Rome, Italy, from 1983 to 2001. We calculated the proportion of patients surviving (Kaplan-Meier product-limit estimates) 5 and 10 years after first hospital admission, and hazard ratios (HR) from the Cox proportional hazards model. Results: Patients’survival was linked to age and staging (lower survival in older patients and in patients with staging IIB-IV). Higher numbers of white blood cells (WBC) and neutrophils, lower numbers of CD8+lymphocytes, low haematocrit and lower levels of albumin were significantly associated with a lower survival probability. When simultaneously accounting for age and staging, CD8+[HR = 3.02, 95%confidence interval (CI) 1.01-9.07 for CD8+< 250 vs. ≥600 cells μL-1] and WBC (HR = 2.59, 95%CI 0.96-6.96 for WBC ≥9000 vs. < 6000 cells μL-1) were associated with survival. In addition, we observed an exceedingly high risk of death (HR = 12.40, 95%CI 3.11-49.43) for patients with a combination of WBC ≥9000 and CD8+< 600 cells μL-1 vs. WBC < 9000 and CD8+≥600 cells μL-1). Conclusions: The measurement of CD8+cells and WBC in MF seems to be a promising criterion to predict survival, and possibly to support treatment decisions and inclusion of patients in randomized controlled trials.
文摘The Dermatology Life Quality Index (DLQI) is one of the most frequently used questionnaires to evaluate the impact of dermatological diseases on patients’ lives. This study aimed to assess the reliability and validity of the instrument and to test its unidimensionality in a large sample of patients with psoriasis (n=976) hospitalized at IDI- IRCCS, Rome, Italy. Nine hundred patients completed the DLQI, the Psoriasis Disability Index (PDI) and the Skindex- 29 (response rate 92% ). The internal consistency of the DLQI was high (Cronbach’ s alpha= 0.83). Evidence of convergent validity was provided by high (r=0.64- 0.81) correlations between the DLQI, the PDI, and the functioning and emotions scales of Skindex- 29. Exploratory factor analysis indicated the presence of four different principal common factors. Confirmatory factor analysis showed a clear second- order factor structure, with a homogeneous second- order factor underlying the four primary- surface factors. This study confirms that the DLQI is a reliable and valid instrument to assess patient- perceived impact of skin disease. Also, it supports the unidimensionality of the DLQI and hence corroborates the common practice of using the total score.
文摘Background: The NC16A immunodominant region of the bullous pemphigoid (BP) antigen BP180 has been used to develop several enzyme-linked immunosorbent assays (ELISAs) as diagnostic tools for BP autoantibody detection. Objectives: Because BP180 autoantibody reactivity is not restricted toNC16A, we have investigated the possibility of developing an ELISA based on selected epitopes additional to this immunodominant region. Methods: Initially 78 BP sera were tested using an NC16A ELISA and IgG reactivity was detected in 64 BP sera (82%). The 14 NC16A-negative BP sera were then analysed by immunological screening against seven BP180-specific epitopes. Recombinant phages displaying BP180 epitopes were grown as plaques, blotted onto a nitrocellulose filter and incubated with BP sera. Results: Three and five NC16A-negative BP sera reacted with epitopes AA 1080-1107 and AA 1331-1404 of the BP180 ectodomain, respectively. Thus, a novel ELISA with GST-1080 and GST-1331 (GST-1080/1331) was developed: 32 of 78 BP sera (41%) proved positive by this assay. The combined use of ELISAs with GST-NC16A and GST-1080/1331 detected IgG reactivity in 72 of 78 BP sera, increasing the sensitivity from 82%to 92%. In addition, autoreactivity against the three extracellular epitopes appeared to be related to the presence of both skin and mucosal involvement as assessed by Fisher‘s exact probability test. Conclusions: Our findings further characterize the autoimmune response in BP by identifying a subgroup of NC16A-negative patients who react with different BP180 extracellular epitopes. The developed ELISA system appearsmore sensitive than the ELISA based on NC16A alone and also informative about the epitope profile of BP patients.
文摘Objective141: To evaluate the association between different components of smoking history and the clinical severity of psoriasis. Design: A hospital-based cross-sectional study. Setting: Inpatient wards of a hospital for skin diseases in Rome, Italy.Patients: A total of 818 adults with psoriasis. Main Outcome Measure: The Psoriasis Area and Severity Index was used to assess the clinical severity of psoriasis between February 21, 2000, and February 19, 2002. Results: After adjustment for potential confounders (sex, age, body mass index, psychological distress, family history of psoriasis, duration of psoriasis disease, and alcohol consumption), high intensity of smoking (>20 cigarettes daily) vs a lower level of consumption (≤ 10 cigarettes daily) was associated with a more than 2-fold increased risk of clinically more severe psoriasis (odds ratio [OR], 2.2;95% confidence interval [CI], 1.2- 4.1). Cigarette-years, measured as the product of the intensity and duration (years) of smoking, significantly increased the risk of clinically more severe psoriasis after adjustment for confounding factors (OR,1.3; 95% CI, 1.0- 1.6, for a 600-U increase in cigarette-years).Separate analyses for men and women showed that the effect of cigarette-years was stronger for women (OR, 1.8; 95% CI, 1.2- 2.6, for a 400-U increase in cigarette-years) than for men (OR,1.2; 95% CI, 0.9- 1.6, for a 700-U increase in cigarette-years).Conclusion: Smoking is associated with the clinical severity of psoriasis and highlights the importance of smoking cessation in patients with psoriasis.
文摘CD30+anaplastic large cell lymphoma is a primary cutaneous lymphoproliferative disorder with a high rate of spontaneous regression (almost 25%). The suggested therapies are radiation, surgery and methotrexate. We describe two patients with nonregressing primary cutaneousCD30+T cell lymphoma that was successfully treated with topical imiquimod 5%cream (Aldara., 3M) three times weekly for 6 weeks. In both cases we obtained complete clinical remission, confirmed by histology. No recurrences were observed during the following 8 months. We consider that topical application of an immune response modifier, such as imiquimod, could be a good alternative to other potentially more dangerous or aggressive treatments.
文摘Background: Psoriasis has a great impact on the quality of life of patients, and the ageing population is an important public health issue. Objectives: To investigate whether older patients with psoriasis have a different impairment in quality of life compared with younger patients, considering level of severity, duration of disease, gender and psychological distress. Methods: The study was performed between February 2000 and February 2002 at the inpatient wards of the Dermatological Institute IDI-IRCCS, Rome, Italy, in the framework of a large project on clinical, epidemiological, emotional and quality of life aspects of psoriasis (IMPROVE study). This is a hospital-based cross-sectional study, with measures of quality of life (Skindex-29, Dermatology Life Quality Index and Psoriasis Disability Index) and of psychological distress, generic (12-item General Health Questionnaire) and psoriasis-related (Psoriasis Life Stress Inventory), all self-asses- sed by patients. We compared the mean scores of each quality of life instrument in patients aged < 65 years and ≥65 years, in subsets of patients based on clinical and sociodemographic characteristics. Results: We analysed 936 patients hospitalized at IDI-IRCCS with a diagnosis of psoriasis. Quality of life was significantly more impaired in the older group for all the Skindex-29 scales, and psychological distress was higher in older patients. In particular, older women suffering from anxiety or depression had the greatest impairment in quality of life. The results were somewhat different using the other quality of life instruments. Conclusions: These results should alert dermatologists that similar levels of clinical severity in psoriasis may be associated with different levels of quality of life and psychological distress of patients. Particular attention should be devoted to older patients, and especially to older women.
文摘Background: Concerns have been raised about the potential of deliberate self- harm and suicide among patients with dermatologic conditions. Objective: We sought to estimate the prevalence of suicidal ideation among patients with dermatologic conditions, and to identify demographic, clinical, and psychosocial correlates. Methods: Two samples of outpatients with dermatologic conditions (N = 294) and inpatients (N=172) completed the 12- item General Health Questionnaire, the Skindex- 29, and the Patient Health Questionnaire. Results: Forty patients (8.6% ) reported suicidal ideation during the previous 2 weeks. In univariate analysis, the presence of suicidal ideation was associated with female sex, inpatient status, presence of a depressive or anxiety disorder, and higher 12- item General Health Questionnaire and Skindex- 29 scores. The size of the diagnostic groups allowed reasonable prevalence estimates only for psoriasis (10% ) and acne (7.1% ). In multivariate analysis, only emotional distress (12- item General Health Questionnaire) and impaired social functioning (Skindex- 29) were independently associated with suicidal ideation. Limitations: We lacked an observer- rated evaluation of skin condition and could rely only on the Skindex- 29 symptoms subscale as a measure of disease severity. In addition, the measurement of suicidal ideation was limited as a result of the use of only one question to assess it. Furthermore, the crosssectional design prevented causal inferences. Conclusion: Suicidal ideation is not rare among patients with dermatologic conditions. Assessing suicidality would be warranted in dermatologic practice among patients at particular risk such as women with high psychologic distress and impaired social functioning. The development of psychiatric consultation- liaison services is mandatory to provide effective treatment and careful follow- up of patients who are suicidal.
基金Item Sponsored by European project "MAGPRO"(RFSR-CT-2006-00019)National Basic Research Program of China(Grant No.2011CB610404)
文摘The recalescence behavior of undercooled Co-Sn alloys under static magnetic fields was investigated using glass slag fluxing technique in a 12T superconducting magnet.Results indicated that the nucleation temperature and the highest temperature after recalescence of undercooled melt can be affected by the static magnetic field.The undercooling for Co-Sn alloys keep unchanged when a strong magnetic field was applied while the recalescence extent was reduced. With the increasing Co content for Co-Sn eutectic systems,the effect of the magnetic field on the recalescence was strengthened.We find that the magnetic field has very limited effect on the nucleation temperature on alloys while the highest temperature after recalescence is affected by the field depending on the magnetization difference of the undercooled melt before and after solidification.
文摘The behavior of YBCO/metal bilayers under transport currents was explored in the framework of fault current limitation (FCL). Properties of the superconducting-normal transition were first studied phenomenologically during sweep current experiments. For current rates higher than 500 A/s, the transition into the normal state was based on non-thermal phenomena and was characterized by a flux creep regime ended by a jump into the normal state. At lower sweep rates, a total diversion of the current in the metallic shunt was observed for temperatures higher than 85K. In this regime, a partial recovery of the superconducting state took place due to a finite thermal resistance between the superconducting and the metallic films. These two properties of partial diversion into the shunt and of fast switching for a quick rise of the current during a default were exploited for current limitation at 77 K. FCL experiments at 50 Hz show that YBCO/Au bilayers limit the current in about 1ms at a value of 2. 5/c by developing electrical fields as high as 3kV/m. Moreover, a recovery of the zero resistance state could occur under rated mode. A straightforward application of this property would be the transformer connection. Finally, results on DC current limitation and recovery under nominal mode were presented for the first time.