Beam imaging in the injection line of the INFN-LNS superconducting cyclotron.

A cheap and efficient diagnostic system for beam monitoring has been recently developed at INFN-LNS in Catania. It consists of a high sensitivity CCD camera detecting the light produced by an ion beam hitting the surface of a scintillating screen and a frame grabber for image acquisition. A scintillating screen, developed at INFN-LNS and consisting of a 2 µm BaF2 layer evaporated on an aluminium plate, has been tested by using (20)Ne and (40)Ar beams in the keV energy range. The CAESAR ECR ion source has been used for investigating the influence of the frequency and magnetic field tuning effects, the impact of the microwave injected power, and of the focusing solenoids along the low energy beam transport on the beam shape and current. These tests will allow to better understand the interplay between the plasma and beam dynamics and, moreover, to improve the transport efficiency along the low energy beam line and the matching with the superconducting cyclotron, particularly relevant in view of the expected upgrade of the machine.

Ureteroscopic laser endopyelotomy in secondary UPJ obstruction after pyeloplasty failure.

OBJECTIVES: Secondary ureteropelvic junction (UPJ) obstruction after failure of open and laparoscopic repair may be challenging to resolve due to possible extensive fibrosis and the increased invasiveness of this procedure. Alternatively, ureteroscopic laser endopyelotomy may be a more acceptable procedure for patients and surgeons. We report our preliminary experience with ureteroscopic holmium laser endopyelotomy after open pyeloplasty failure and define the complications that arose and the results. MATERIALS AND METHODS: We performed 6 retrograde endopyelotomies with a holmium laser for failed UPJ repairs following the Anderson-Hynes procedures. Patient follow-up was carried out every 3 months using sonography and renal scan, and again after 1 year using renal scan and urography. RESULTS: Mean hospitalization was 2.1 days. Ureteroscopic laser endopyelotomy was successful in 4 cases (66.6%). In 2 patients, failure occurred at the third month of follow-up. Complications included 1 case of slight bleeding, which was resolved conservatively without the need for blood transfusion, and 2 cases of guidewire rupture. CONCLUSIONS: Secondary UPJ obstruction is more challenging to resolve by open or laparoscopic approach. Retrograde endopyelotomy gives a valid alternative thanks to its success rate and its better acceptance by patients. We consider retrograde laser endopyelotomy the approach to choose when faced with secondary UPJ obstruction after open or laparoscopic failures.

Detrusor pressure uroflowmetry studies in women: effect of 4 Fr transurethral.

PURPOSE: Pressure flow technique on males is considered a standard diagnostic procedure to investigate the voiding process, while on female this is still under investigation. Many studies have been conducted in order to establish a female bladder outlet obstruction nomograms using a 7 Fr catheter, but recently a report showed that 7 Fr catheter may adversely affect the voiding process on women. We studied the effect of 4 Fr urethral catheter in women undergoing pressure flow evaluation in order to assess any detrimental effect in the voiding process. MATERIALS: We evaluated a database of 85 patients referred for lower urinary tract symptoms. First, all patients had free uroflowmetry and then underwent pressure flow studies utilizing two catheters: a 12 Fr for filling and a 4 Fr mono J for measuring detrusor pressure. After filling we removed the 12 Fr catheter and pressure flow was performed leaving the 4 Fr only in the urethra. As positive correlation of flow rate with voided volume is well established, we selected only 33 patients who had similar prevoided volumes varying by less than 30% and free and intubated flow parameters were compared according to volume categories in order to strengthen the statistic analysis. RESULTS: In each group all the free and pressure flow parameters were not statistically different. Only in the group who voided within 250 and 500 ml we found the pressure flow voiding time to be almost longer than the free flow equivalent, but not statistically different (31.1 +/- 15 versus 56.7 +/- 49.3; p = 0.05). Furthermore we did not find any difference in free and intubated morphology of curves. CONCLUSIONS: A 4 Fr transurethral catheter does not affect adversely the voiding process in women undergoing pressure flow studies for lower urinary tract symptoms. This finding has very important clinical implications for interpreting female voiding patterns and may be considered the best tool to define bladder outlet obstruction on women.