High-Brightness Continuous-Wave Electron Beams from Superconducting Radio-Frequency Photoemission Gun.

Continuous-wave photoinjectors operating at high accelerating gradients promise to revolutionize many areas of science and applications. They can establish the basis for a new generation of monochromatic x-ray free electron lasers, high-brightness hadron beams, or a new generation of microchip production. In this Letter we report on the record-performing superconducting rf electron gun with CsK_{2}Sb photocathode. The gun is generating high charge electron bunches (up to 10 nC/bunch) and low transverse emittances, while operating for months with a single photocathode. This achievement opens a new era in generating high-power beams with a very high average brightness.

Absolute frequency spectroscopy of CO2 lines at around 2.09 µm by combined use of an Er:fiber comb and a Ho:YLF amplifier.

The low-frequency tail of an octave-spanning supercontinuum (SC) generated by an Er:fiber comb is enhanced by a multipass Ho:YLF amplifier and used in a sum-frequency-generation scheme to obtain absolute referencing of a single-mode Tm-Ho:YAG laser tunable around 2.09 µm. By tuning the comb repetition frequency, the probing laser is scanned across the absorption lines of a CO(2) gas sample and highly accurate absorption profiles are measured. This approach can be readily scaled to any wavelength above ~2 µm.

CW and femtosecond operation of a diode-pumped Yb:BaY(2)F(8) laser.

We report for the first time on laser action of a diode-pumped Yb:BaY(2)F(8) crystal. Both CW and femtosecond operations have been demonstrated at room-temperature conditions. A maximum output power of 0.56 W, a slope efficiency of 34%, and a tunability range from 1013 to 1067 nm have been obtained in CW regime. Transform-limited pulse trains with a minimum duration of 275 fs, an average power of 40 mW, and a repetition rate of 83 MHz have been achieved in a passive mode-locked regime using a semiconductor saturable absorber mirror.

Efficient visible laser emission of GaN laser diode pumped Pr-doped fluoride scheelite crystals.

In the present work we report on the growth, spectroscopy and laser results of diode pumped Pr-doped LiYF(4), LiLuF(4) and LiGdF(4) fluoride, scheelite-type structure crystals. We measured the polarisation dependent absorption and emission properties as well as the decay time of the (3)P(0) level. Exploiting the (3)P(2) absorption around 444 nm, we obtained efficient laser emission under GaN laser diode pumping on several transitions from the green to the near infrared wavelength range.

Diode-pumped passively mode-locked Yb:YLF laser.

We demonstrate passive mode-locking by means of a semiconductor saturable-absorber mirror in a diode-pumped Yb:YLF laser. We present crystal growth process, spectroscopic measurements, and investigation of mode-locking performance. Pulse trains with minimum duration of 196 fs, average power of 54 mW and a repetition rate of 55 MHz were obtained. The optical spectrum, centered at 1028 nm, has a 7.1-nm bandwidth leading to nearly transform-limited pulses.

In-vacuum optical isolation changes by heating in a Faraday isolator.

We describe a model evaluating changes in the optical isolation of a Faraday isolator when passing from air to vacuum in terms of different thermal effects in the crystal. The changes are particularly significant in the crystal thermal lensing (refraction index and thermal expansion) and in its Verdet constant and can be ascribed to the less efficient convection cooling of the magneto-optic crystal of the Faraday isolator. An isolation decrease by a factor of 10 is experimentally observed in a Faraday isolator that is used in a gravitational wave experiment (Virgo) with a 10 W input laser when going from air to vacuum. A finite element model simulation reproduces with a great accuracy the experimental data measured on Virgo and on a test bench. A first set of measurements of the thermal lensing has been used to characterize the losses of the crystal, which depend on the sample. The isolation factor measured on Virgo confirms the simulation model and the absorption losses of 0.0016 +/- 0.0002/cm for the TGG magneto-optic crystal used in the Faraday isolator.

[Prenatal medicine: from the obstetric stethoscope to the computerized telecardiotocography]. / La medicina dell'età prenatale: dallo stetoscopio ostetrico alla telecardiotocografia computerizzata.

The aim of this article is to illustrate the history of fetal auscultation from the 19(th) century, when the fetus was considered as an object and the obstetrician as a ''mechanic of the birth'', to the present age, when the fetus is a subject and the obstetricians have at their disposal all the means they need to confirm his well-being and to early diagnose his pathologies, even using prenatal telemedicine.

[GnRH agonists and antagonists in the preoperative therapy of uterine fibroids: literature review]. / Agonisti e antagonisti del GnRH nella terapia pre-chirurgica della fibromiomatosi uterina.

Uterine leiomyomas are the most frequent gynecological benign tumors. Their growth is regulated by ovarian steroids, therefore a hypoestrogenic state, like menopause or pharmacologically induced pseudo-menopause by GnRH-agonists or GnRH-antagonists, is associated with the decrease of their volume. This volume reduction allows a less invasive surgical procedure and may reduce the amount of blood loss during surgery. Therefore, GnRH-agonists and antagonists are used in presurgical treatment of uterine fibromatosis. This review analyses the effects of GnRH-agonists and GnRH-antagonists therapies. GnRH-agonists produce a down-regulation of GnRH receptor, while GnRH-antagonists compete with endogenous GnRH for pituitary binding sites. Due to the lack of any intrinsic activity of GnRH-antagonists, the characteristic initial flare-up observed with GnRH-agonist treatment is absent. So, GnRH-antagonists rapidly suppress gonadotropin release within 4-8 h, while GnRH-agonists show clinical effects after 2 or 3 weeks of treatment. GnRH-antagonist activity is dose-dependent so it is possible to adjust the dose to obtain the proper levels of inhibition. The GnRH-agonist presurgical treatment usually is a short-term therapy (3-6 months), because it causes side-effects like menopause symptoms. GnRH-antagonist clinical effects can be achieved with a short-time therapy too. Their side-effects include flushes and head-ache. After stopping therapy with both drugs, leiomyomas rapidly achieve their original size while side-effects disappear. Further studies are necessary to establish the use of GnRH-antagonists in leiomyomas therapy, but in Italy this is not possible because their use is not approved.

Nutritional intervention in a hemodialysis pregnant woman: a case report.

Pregnancy in dialysis patients is a rare occurrence. When pregnancy does occur, the risk of spontaneous abortion, stillbirth and neonatal complications, such as prematurity and growth retardation, are fairly high. The authors describe their experience in the follow-up of a patient with chronic renal failure who became pregnant during regular dialysis treatment and followed nutritional care. The outcomes were successful and she gave birth to a healthy baby. It is emphasized that special dedication to the nutritional control enabled a good outcome of the pregnancy. The importance of the nutritionist intervention in the follow-up of dialysis patients with the integration of a multidisciplinary staff is stressed.

Circulating leptin in patients with anorexia nervosa, bulimia nervosa or binge-eating disorder: relationship to body weight, eating patterns, psychopathology and endocrine changes.

A decreased production of leptin has been reported in women with anorexia nervosa (AN) and has been attributed merely to the patients' reduced body fat mass. The extent to which eating patterns, purging behaviors, psychopathology and endocrine changes may contribute to the genesis of leptin alterations has not been deeply investigated. Therefore, we measured plasma levels of leptin, glucose and other hormones in three groups of eating disorder patients with different body weight (BW), eating patterns and purging behaviors. Sixty-seven women, 21 with AN, 32 with bulimia nervosa (BN), 14 with binge-eating disorder (BED) and 25 healthy females volunteered for the study. We found that circulating leptin was significantly reduced in AN and BN patients, but significantly enhanced in women with BED. In anorexics, plasma glucose was decreased, whereas plasma cortisol was enhanced; blood concentrations of 17beta-estradiol and prolactin (PRL) were reduced in both AN, BN and BED patients. In all subject groups, a strong positive correlation emerged between plasma levels of leptin and the subjects' BW or body mass index, but not between leptin and psychopathological measures, plasma glucose, cortisol, PRL and 17beta-estradiol. Since leptin was reduced in both underweight anorexics and normal weight bulimics, but increased in overweight BED women, who compulsively binge without engaging in compensatory behaviors, we suggest that factors other than BW may play a role in the determination of leptin changes in eating disorders.

Desogestrel versus gestodene in oral contraceptives: influence on the clinical and histomorphological features of benign breast disease.

Forty-four female volunteers asking for oral contraception, affected by symptomatic benign breast disease (BBD) were evaluated to compare the effects on mastalgia and breast nodularity of two different low dose oral contraceptives (OCs), containing 20 micrograms [corrected] ethinylestradiol + 150 micrograms desogestrel (EE+D) and 30 micrograms ethinylestradiol + 75 micrograms gestodene (EE+G), respectively. Physical examination, bilateral thermography, X-ray and/or ultrasonography of breast, and needle and screw-needle biopsies of mammary tissue were performed in all patients before OCs administration and after six cycles of treatment. OCs administration caused an overall improvement of mastalgia in 53%. Breast nodularity improved only in 8% of patients in both groups. Epithelial tissue modifications in mammary biopsies were observed, with involutive and/or secretory histomorphological and ultrastructural changes, frequently coexisting in different areas of the same breast.

PIP: In Italy, researchers compared data on 22 women who used the low-dose oral contraceptive (OC) containing 20 mcg ethinyl estradiol and 150 mcg desogestrel (EE+D) with data on 22 other women who used the low-dose OC containing 30 mcg ethinyl estradiol and 75 mcg gestodene (EE+G) to determine the pharmacological effects of the 2 OCs on women affected by mastalgia and breast nodularity. Clinicians performed physical exams, bilateral thermography, X-ray and/or ultrasonography of breast and needle and screw-needle biopsies of mammary tissue before OC administration and after 6 cycles of OC treatment. An overall improvement of mastalgia and breast nodularity occurred in 53% and 8% of all patients, respectively. There were no significant differences between groups. Among EE+D treated women, a marked secretory attitude in breast epithelial cells occurred, probably due to a prominent progestin effect. Both OCs increased the number of cytoplasmatic organules and intraluminal secretory material without any apparent increase of cell proliferation. The observed involutive and/or secretory histomorphological and ultrastructural changes often occurred in different areas of the same breast. These results suggest that low dose OC use by women affected by benign breast disease improves mastalgia but not breast nodularity.

Atrial natriuretic factor in amniotic fluid and in maternal venous blood of pregnancies with fetal cardiac malformations and chromosomal abnormalities.

OBJECTIVE: We evaluated the levels of atrial natriuretic factor (ANF) in amniotic fluid and in maternal venous blood in pregnancies with fetal cardiac malformations and chromosomal abnormalities. METHOD: Between the 16th and 18th week of pregnancy, 151 women were divided into three groups. Group A included patients at lowest risk, carrying a fetus with a normally developing heart and normal karyotype (control group). Group B included women with a fetus suffering from cardiac malformations, with or without associated chromosomal abnormalities. Group C included women carrying a fetus affected with chromosomal abnormalities without congenital cardiopathies. ANF was evaluated by radioimmunoassay. RESULTS: In maternal venous blood, the mean levels of ANF were 42.1, 53.1 and 38.7 pg/ml in groups A, B and C, respectively. In amniotic fluid, the mean levels of ANF were 34.2, 101.8 and 35.8 pg/ml in groups A, B and C, respectively. In group A (control group) there was no statistical difference in ANF levels across the gestational age range of 16-18 weeks, either in amniotic fluid or in maternal venous blood. A significant difference of ANF content in maternal venous blood was revealed in comparing group A with group B (p < 0.01), and group C with group B (p < 0.01). A statistically significant difference in ANF levels was also found in amniotic fluid between group A and group B (p < 0.01), and between group C and group B (p < 0.01). No statistically significant differences were found between group C and group A in comparing ANF levels in maternal venous blood and amniotic fluid. CONCLUSION: ANF levels in amniotic fluid and in maternal venous blood are increased early in the case of fetuses with cardiac malformations, with or without associated karyotype alteration. Chromosomally abnormal fetuses without heart malformations have normal ANF levels. These results could be useful for elucidating fetal pathophysiology mechanisms.

[Ultrasonic criteria for the evaluation of placentation in twin pregnancies]. / Criteri ultrasonografici per la valutazione della placentazione nelle gravidanze gemellari.

Ultrasound assessment of septum thickness is useful in twin pregnancies for predicting the type of placentation. In fact, its greater or lesser acoustic resonance distinguishes monochorionic or dichorionic pregnancies. This makes adoption of therapeutic measures more secure in the event of pathology involving only one of the two fetuses.

[Side effects of extra-amniotic PGF2 alpha in the induction of labor in retained abortion and in the intrauterine death of the fetus]. / Effetti collaterali della PGF2 alfa per via extra-amniotica nell'induzione del travaglio, nell'aborto ritenuto e nella morte endouterina del feto.

PIP: The tolerance of (PGF2alpha) prostaglandin F2alpha used for the induction of abortive labor has been studied in a group of 40 patients. The drug was administered in the extraamniotic intracavitary space. Apart from minor gastrointestinal and peripheral vascular side effects which were well-tolerated, a severe bronchospastic reaction with arterial hypotension and bradycardia was observed in a case of retained abortion at the 22nd week. This was treated with PGF2alpha delivered extraamniotically according to Csapo's double impact technique. In this patient, certain signs such a bradycardia cleared up just a few minutes after resuscitation, while the bronchospasm and peripheral cyanosis only ceased after 2 hours. It is considered that this reaction was determined by the rapid absorption of a large quantity of drug in the general circulation or by a condition of hypersensitivity to PGF2alpha. (author's)^ieng

[Retrospective study of postoperative infectious morbidity following cesarean section]. / Studio retrospettivo della morbilità infettiva postoperatoria nel taglio cesareo.

The increase of cesarean sections produced more postoperative infections. Several authors assessed the effectiveness of chemioantibiotic prophylaxis to reduce the postoperative infective morbidity. Although the family of antibiotics more frequently used is that of cephalosporin, the best single agent has not been found yet. The aim of our study, made in the Department of Obstetrics and Gynecology of University of Naples "Federico II", is to propose a retrospective analysis concerning the incidence of cesarean section (CS), the postoperative infective morbidity and the employment of antibiotic prophylaxis. Our sample is a group of 13285 pregnant women, 3171 (23.9%) of these patients underwent to CS from 1st January 1985 to 31st December 1994. The group of 3171 women was divided in two subgroups, the first of 2748 patients un-derwent to antibiotic prophylaxis, the second of 423 was untreated due to their previous experience of allergy towards antibiotics or because there was no evidence of risk factors. The women we treated with antibiotics underwent a three days prophylactic therapy with cefazolin or ampicillin soon after the CS. The incidence of infective complications had a 21.2% rate over a total of 3171 women. Endometritis was the most common infectious complication following cesarean delivery. The rate was 53.3% in the case of primary cesarean section and 52.3% in the case of iterative cesarean section. The use of antibiotic prophylaxis gave us the opportunity to reduce the postoperative morbidity in the primary CS (23.4%) as well in the iterative CS (16.6%). On the contrary the untreated group had an infective incidence with a 33.8% rate in the case of primary CS and with a 27.4% rate in the case of iterative CS. Our opinion is that the administration of antibiotics as cefazolin and ampicillin is able to reduce in a significant way the incidence of postoperative infective morbidity as well the period of hospitalization.

[Induction of labor in missed abortion, fetal death and vesicular mole, using PGF2 alpha by extra-amniotic intracavitary administration]. / Induzione del travaglio nell'aborto ritenuto, nella morte fetale e nella mola vescicolare con PGF2alpha per via intracavitaria extramniotica.

PIP: It has been known for years that prostaglandins can be used to bring on labor. The authors experienced with alpha PGF2 by extraamiotic, intracavitary infusion. The group of 23 patients included 20 cases of incomplete abortion in the second trimester, 9 cases of intrauterine fetal death in the third trimester, and 1 case of vesicular mole. This method proved 82.6% successful: in 56.9% of cases the product of conception was expelled within 12 hours; in 26.5% of cases within 24 hours. Only in 4 cases, 17.4%, this method proved unsuccessful; oxytocin was used in 3 of these 4 cases. Hypertonia was evident immediately after infusion; uterine contractions, measured and registered with a tocograph, were frequent and increasingly intense. Nausea, vomiting and diarrhea were observed in 26.5% of cases; 1 patient had facial flush. These side effects were probably due to the low absorption of the drug into the circulation. Results obtained confirm others described in the literature on the subject.^ieng

[Prenatal telemedicine and teledidactic networking. A report on the TOCOMAT project]. / Telemedicina prenatale e teledidattica. Esperienza nel progetto TOCOMAT.

Telemedicine originates with the combined use of electromedical equipment, information technologies and telecommunication systems designed to improve healthcare by overcoming the limitations of time and space. Moreover, telemedicine also possesses greater didactic potential than instruction by traditional means. Teledidactic networking, both as e-learning and e-teaching, represents a new integrated system of computer-aided education for the development and management of distance learning programs. Our study evaluated the effectiveness of teledidactic applications in the first Italian project in conventional and computerized telecardiotocography (TOCOMAT). Five cardiotocography outpatient monitoring facilities were linked telematically to a university central operating unit to obtain computerized analysis of telecardiotocographic (CTG) tracings and specialist consulting. The peripheral site operators received theoretical-practical training in the function and use of the system, the guidelines for CTG tracing interpretation and the diagnostic-therapeutic protocols. Improvement in learning progress was observed in the reduction of technical errors in CTG recording and in the increased ability of the outpatient clinic staff to select, analyze and interpret test RESULTS. Results from the feedback questionnaires on the didactic impact of the project indicated objective improvement in the specific skills acquired by the physicians at these facilities. The findings also show that a well-structured distance learning course can improve clinical, technical and managerial skills and behavior of healthcare operators by promoting the kind of professional continuing education a modern medical school should provide.

Action of a prostaglandin synthetase inhibitor on IUD associated uterine bleeding.

The Authors treated twenty-eight women using IUD, who suffered from increased menstrual blood loss and pelvic pain, with a prostaglandin synthetase inhibitor, Suprofen, in an attempt to reduce their symptomatology, in a double blind crossover study. The drug produced an important reduction of the menstrual blood loss and pains. These observations suggest that prostaglandins are involved in the etiology of excessive menstrual blood loss and pains, and that prostaglandin inhibitors may be useful for reducing these symptoms.

PIP: Suprofen (Suprol-Cilag S.p.A.), a prostaglandin synthetase inhibitor, was tested in a double-blind crossover design on 28 women whose IUDs caused them pain or increased menstrual bleeding. The subjects had worn either a Gravigard (18 women) or a Copper T (10) for 6 to 10 months. Each subject was observed for the first month, and took either placebo or Suprofen during the next menses, followed by the alternative for the third cycle. They took 20 mg Suprofen 4 times daily, at the first sign of bleeding and or pain, then 3 times daily thereafter, for the duration of symptoms or up to 7 days. Before treatment, 71% had severe bleeding, 18% had moderate bleeding and 11% had slightly increased bleeding. During Suprofen, 43% obtained a strong decrease in menstrual blood loss, 36% had a moderate decrease and 7% had a slight decrease. Placebo decreased bleeding moderately in 2. Pain was moderate to intense in 26 women and slight or none in 2 before treatment. With Suprofen, pain decreased moderately or greatly in 23 and slightly or not at all in 5 women. Placebo improved pain moderately in 1 subject. Reported side effects of the drug were stomach cramps in 1 and nausea and headaches in 2 women. In this study, when the subjects were categorized by degree of symptoms, the prostaglandin antagonist was more effective in those complaining of more severe bleeding and pain.

Changes in the Bishop score induced by manual nipple stimulation. A cross-over randomized study.

Bishop score changes, by a cross-over, randomized study, were evaluated in 60 primigravidas at term, not yet in labour, who performed nipple stimulation for 45 minutes three times a day for three days. Results showed that changes of Bishop score in the treated groups were statistically highly significant, in comparison to control groups. A greater frequency in the onset of labour was also remarked.

An unusual case of intermittent atrial parasystole in the fetus during labor.

An unusual fetal arrhythmia, detected during labor by continuous monitoring of fetal heart rate, is here described. This event was characterized by a double rhythm, one at high rate (137 bpm) and the other at low rate (127 bpm). An ECG simultaneously recorded, allowed the measurement of the P-P intervals, which were 438 and 424 msec, alternatively. Meanwhile, the P-Q intervals were of 84 and 75 msec, respectively. On the basis of the ECG waves morphology as well as of the different P-Q intervals, the diagnosis of intermittent atrial parasystole was posed. While the high rate rhythm seems to originate from the sinus node, the low rate rhythm seems to be parasystolic and to arise from an ectopic pace-maker, situated in the atrium in an intermediate location between sinus node and the A-V node.