Tracing electron-ion recombination in nanoplasmas produced by extreme-ultraviolet irradiation of rare-gas clusters.

We investigate electron-ion recombination in nanoplasmas produced by the ionization of rare-gas clusters with intense femtosecond extreme-ultraviolet (XUV) pulses. The relaxation dynamics following XUV irradiation is studied using time-delayed 790-nm pulses, revealing the generation of a large number of excited atoms resulting from electron-ion recombination. In medium-sized Ar-Xe clusters, these atoms are preferentially created in the Xe core within 10 ps after the cluster ionization. The ionization of excited atoms serves as a sensitive probe for monitoring the cluster expansion dynamics up to the ns time scale.

Use of 2% taurolidine lock solution for treatment and prevention of catheter-related bloodstream infections in neonates: a feasibility study.

BACKGROUND: Taurolidine lock, a technique used to prevent or treat catheter-related bloodstream infection (CRBSI), is effective in adult and paediatric patients but has been described rarely in neonates. The aim of this descriptive retrospective study, was to determine the feasibility and direct outcomes of prophylactic and therapeutic taurolidine locks in term and preterm neonates. METHODS: We implemented the use of therapeutic taurolidine lock in addition to antibiotic treatment with the aim of catheter salvage in critical neonates with difficult vascular access (group 1). In addition, we introduced taurolidine lock as a preventive measure in neonates with a central venous catheter (CVC) at high risk of developing CRBSI (group 2). Every 24 h (in the treatment group) a 2% taurolidine solution was injected and the catheter locked for at least 120 min, until infection clearance (group 1). In the preventive group, the catheter was locked for 30 min every 48 h until CVC removal (group 2). FINDINGS: Thirty-seven neonates who received taurolidine were included in this study. We did not observe any major adverse events. In group 1 (21 cases), clinical symptom disappearance and bacteraemia clearance were achieved without catheter removal in 18 cases (85.7%); in the other three neonates the catheter was removed shortly after the start of the locks as it was possible to replace the CVC. In group 2 (16 neonates), no CRBSI was observed during the duration of the catheter placement. CONCLUSIONS: In this retrospective study, taurolidine was successfully used in neonates both for prevention and treatment of CRBSI, without major undesired effects. A larger cohort and a randomized clinical trial is warranted in order to establish its efficacy and safety in neonates.

Surgical approach to acute pectoralis major tendon rupture.

Pectoralis major rupture is a very uncommon injury first time described by Patissier in 1822. Tears are classified on the type (partial and complete) or on the site (tendinous, myotendinous junction, intramuscular). Ruptures are reported in young high-performance athletes as results of eccentric contractions of the musculotendinous unit. The most probable mechanism in elderly patients is a brisk tearing movement applied to stiff atrophic muscle. Injuries generally involve the sternal portion; the localization to the clavicular portion is rare and can be misdiagnosed as muscle sprain. Preoperative planning include MRI as gold standard regarding operative versus non operative treatment decisions. Surgical repair is recommended in cases of complete tears because of loss of strenght in adduction, flexion and internal rotation. Aim of the current study is to describe the surgical repair of acute pectoralis major tendon rupture in 5 patients. Surgery was performed through a modified delto-pectoral approach; pectoralis major tendon was attached at its anatomic insertion using two metallic anchors. The patient as been immobilized in a sling for 30 days and then assisted physiotherapy begun; strenght exercises were allowed at 90 days. At a mean follow-up of 24 months results were excellent in all cases with restoration of strenght and coming back to previously sports activity.

EXPERIMENTAL VALIDATION OF ALGORITHMS USED TO ESTIMATE EFFECTIVE DOSE DURING INTERVENTIONAL RADIOLOGY PROCEDURES.

In IR procedures, in order to evaluate the effective dose, the importance of the double dosemeter has been recognised, one worn above and one under the apron. Over the last few decades several algorithms have been developed to combine the readings of the dosemeters, however currently there is no international consensus on which is the best one. In this work, eight irradiations, corresponding to typical interventional radiology procedures, were carried out in order to experimentally verify the accuracy of the algorithms. The patient was substituted by solid water-equivalent (RW3) layers, while effective dose to personnel was calculated by TLDs inside the Alderson Rando phantom. The results show that most of the algorithms, with a few exceptions, are too conservative, however there are many factors which can affect their accuracy, so it is impossible to achieve a high level of precision in the evaluation of the effective dose.

Topsoil radiological characterisation of L-54M reactor surroundings preliminary to decommissioning operations.

The radiological characterization of the topsoil of the L-54M reactor surroundings carried out in this work aims at obtaining the reference blank point for the forthcoming decommissioning operations and ascertain if unexpected radionuclide release occurred during the operational life of the plant. Standardised methods have been employed in order to collect representative samples and reliable results. Suitable sample pre-treatment procedures were applied. Gamma and beta spectrometric analyses were carried out to measure the activity concentrations of 60Co 137Cs, 152Eu, 241Am and 90Sr. These have been considered as representative radionuclides that could have been originated from reactor operations and that could still be present at four decades post reactor shutdown.

Endoscopic approach to cubital tunnel syndrome.

The cubital tunnel syndrome is one of the most common entrapment neuropathy of the upper limb. The ulnar nerve can be compressed in the oteofibrous tunnel by the bone structures, the Osborne's ligament, the fascia of the ulnar flexor muscle of the carpus or of the aponeurosis of the deep flexor of the fingers. Pressure values in the cubital tunnel >50 mm Hg induce blocking of intraneural circulation with electrodiagnostic modifications, clinical signs and histological changes including demyelinazion of the nerve proximal to the cubital tunnel. Surgery becomes essential in case of failure of conservative and physical therapy. Various surgical techniques have been described in the literature for the treatment of the ulnar neuropathy at the elbow. In this paper the authors report a new endoscopic technique for the treatment of ulnar nerve entrapment at the elbow which requires respect of specific electrodiagnostic and clinical criteria of inclusion. The restored joint active motion following elbow arthroscopy in osteoarthritis can induce or get worse a ulnar nerve neuropathy; endoscopy neurolysis is essential to remove perineural adherences and reduces the nerve stress. Immediate well-being of the patient, lesser invasiveness and minimum vascular complications are clear advantages of the endoscopic approach, while the treatment of the pathologies proximal and distal to the Struther's arcade is a limit of the technique.

Sensitivity study of CR39 track detector in an extended range Bonner sphere spectrometer.

Bonner sphere spectrometers (BSS) are being used widely in neutron spectrometry since 1960. The response to neutrons of these moderating detectors spans over a broad energy range. This work discusses the measurement of the sensitivity of an extended range BSS hosting a CR39 nuclear track detector coupled to a boron converter. Two kinds of boron converters were tested, the first made by natural boron and a second one enriched in (10)B. The BSS response functions were calculated with Monte Carlo simulation using the MCNPX 2.4.0. and the FLUKA codes.

Design and test of a broadband split-and-delay unit for attosecond XUV-XUV pump-probe experiments.

We present the design of a split-and-delay unit for the production of two delayed replicas of an incident extreme ultraviolet (XUV) pulse. The device features a single grazing incidence reflection in combination with attenuation of remaining infrared light co-propagating with the XUV beam, offering a high throughput without the need of introducing additional optics that would further decrease the XUV flux. To achieve the required spatial and temporal stabilities, the device is controlled by two PID-controllers monitoring the delay and the beam pointing using an optical reference laser beam, making collimation of the beam by additional optics unnecessary. Finally, we demonstrate the stability of the split-and-delay unit by performing all-reflective autocorrelation measurements on broadband few-cycle laser pulses.

Beam dumps design and local radiation protection at TERA synchrotron.

The realisation of the National Center of Hadrontherapy was funded by the Italian Government in 2002. The Centre will be built in the area of Pavia (Italy). The synchrotron designed in the framework of this programme will accelerate protons and carbon ions up to 250 MeV and 400 MeV u(-1), respectively. Some of the main aspects which were taken into account in the design of the acceleration system are the patient's safety and the beam control. From this point of view an important role is played by the beam dumps in the synchrotron ring and upstream of the extraction system. In particular, an horizontal and a vertical beam dump will be installed in the synchrotron ring: the former will be used for lowering the beam intensity and the latter for beam abortion. The dump at the extraction will absorb the particles during the mounting and the falling ramps of the synchrotron magnetic cycle, thus extracting only the flat top of the ion spill. Beam dumps can produce intense fields of secondary radiation (neutrons, charged light-hadrons and photons) and high rates of induced activity, since they can absorb the beam completely. Usually they have to be shielded to protect the electronics during machine operation and to attenuate the radiation dose below the limits imposed by the law when the personnel access to the synchrotron hall. The part of the shielding design of the beam dumps concerning with the acceleration of protons was made using Monte Carlo simulations with the FLUKA code. Both induced activity and secondary radiation were taken into account. The shields against secondary radiation produced by carbon ions were designed, referring only to secondary neutrons, taking double-differential distributions from the literature as sources for the FLUKA simulations. The induced activity from carbon ions interactions was estimated analytically, using the data generated by the EPAX 2 code. The dose-equivalent rates from the induced radionuclides were calculated at 1 m from the shielded dumps, taking into account the contribution of activated components of the synchrotron ring.

Evaluation of etching correction factor for LR115 cellulose nitrate films from track parameters.

LR115 cellulose nitrate films efficiency is strongly dependent on the conditions of etching. In this paper a new method to evaluate a correction factor for this effect is given. The film is scanned with an high-resolution scanner, the diameter of the tracks is measured, and the correction factor is calculated from the average diameter of the tracks. The sensitivity of the film is found to have a linear dependence on the average diameter, and the classical correction, based on the residual thickness, can be substituted by a method based on average track diameter.

Uncertainties evaluation for electrets based devices used in radon detection.

In recent years uncertainty evaluation in measurements has achieved great importance. National and international standards offer guidelines to evaluate uncertainties, but these procedures are, until now, not well understood by the operators. This is because of the fact that a detailed uncertainty evaluation is not an easy operation and a standard rule to apply in all cases is not available. Every measurement procedure has its own uncertainty evaluation. In this work, attention is focused upon the electret ion chambers (EIC), widely used in radon concentration measurements. Measurements of gamma radiation sensitivity are performed in a secondary standard calibration laboratory and measurement of radon concentration sensitivity is performed in a radon chamber 0.8 m3 in volume. Raw data are analysed to evaluate the calibration factors and the combined uncertainties are determined. The aim of the work is to give a practical method to assess the uncertainty of a radon measurement.

Comparison between arthroscopy and arthrotomy in the treatment of shoulder instability.

Anterior post-traumatic shoulder instability represents a common finding in orthopaedic surgery. The surgical treatment of this lesion is often indispensable for the normal social life of the patient and for the sports activity of the young. The Bankart procedure with capsular retensioning by arthrotomic access has for years been the gold standard. In the last 10 years arthroscopic accesses have gained more and more consent for the surgical treatment of such lesions, with results that have considerably improved in time. It is the purpose of this study to compare the results obtained in patients affected with anterior-inferior post-traumatic shoulder instability treated by Bankart surgery, arthrotomic and arthroscopic, with a minimum follow-up of 4 years.

Arthroscopic neurolysis of the ulnar nerve at the elbow.

Cubital tunnel syndrome is a frequent form of neuropathy caused by entrapment of the upper limb. Conservative treatment and physical therapy are the treatment of choice for at least 6 months prior to any type of surgery. The surgical techniques proposed for treatment of this syndrome include simple decompression, transposition and neurolysis. It is the purpose of this study to demonstrate the advantages of arthroscopy for neurolysis of the ulnar nerve at the elbow in a specific cohort of patients. The patients were evaluated preoperatively and postoperatively based on subjective (VAS) and objective (Bishop and Dellon) scales. The degree of patient satisfaction on the average was more than 60%. The mean increase in Bishop score was 5 points (minimum 3, maximum 7). Results appeared to be good and stable at 6 and 12-month follow-up evaluation.

The Bristow-Latarjet method in the treatment of shoulder instability that cannot be resolved by arthroscopy. A review of the literature and technical-surgical aspects.

Arthroscopy has surpassed traditional types of open surgery in the treatment of shoulder instability because of its mini-invasiveness and shorter rehabilitation time. Despite this, in some cases, such as those involving significant glenoid erosions and extensive capsular lesions, arthroscopic methods fail the objectives, and methods that were believed to have been surpassed are again used, such as the Bristow-Laterjet procedure. It is the purpose of this article to describe use of the method in light of the possibilities offered by arthroscopy.

Thermodynamically distinct high and low affinity states of the A(1) adenosine receptor induced by G protein coupling and guanine nucleotide ligation states of G proteins.

The influence of the receptor-G protein coupling state and the guanine nucleotide ligation state of the G protein on the binding mechanism of A(1) adenosine receptor ligands has been investigated in [(3)H]-1,3-dipropyl-8-cyclopentylxanthine ([(3)H]-DPCPX) binding studies in rat brain membranes. Thermodynamic parameters of binding of A(1) adenosine receptor ligands of different intrinsic activities were determined in the absence or presence of GDP and compared to the binding mechanism after receptor-G protein uncoupling. In agreement with previous studies, it was found that xanthine and non-xanthine antagonists showed an enthalpy- or enthalpy- and entropy-driven binding mechanism under all conditions. In contrast to antagonists, the binding mechanism of agonists was strongly affected by the G protein coupling state or the absence or presence of guanine nucleotides. Binding of full and partial agonists to the high-affinity state of the A(1) receptor was entropy-driven in the absence of GDP, and a good correlation between intrinsic activities and the contribution of entropy was observed. In the absence of GDP, binding of full and partial agonists and antagonists to the high affinity state of the receptor was thermodynamically discriminated. In contrast, no such discrimination was found in the presence of GDP. The binding mechanism of agonists to the low-affinity state of the receptor was identical to that of antagonists only after uncoupling of the receptor from G proteins by pretreatment with N-ethylmaleimide or guanosine-5'-(gamma-thio)-triphosphate (GTPgammaS). These results indicate the existence of two thermodynamically distinct high- and low-affinity states of the A(1) adenosine receptor.

Early changes in adenosine A1 receptors in cerebral cortex slices submitted to in vitro ischemia.

The effects of brain ischemia on the maximum binding capacity (Bmax) and affinity (Kd) of A1 receptors were studied in the rat cerebral cortex, with an in vitro approach. The results were correlated with changes in 3H-adenosine release, studied under identical experimental conditions. Fifteen minutes of in vitro 'ischemia' (hypoxic, glucose-free medium) induced a significant increase in both Bmax (2398+/-132 fmol/mg protein, 151% of the control, P < 0.05) and in Kd (2.43+/-0.12 nM, 161% of the control, P < 0.01). At the same time, an increase in tritium efflux from [3H]-adenosine labeled cerebral cortex slices to 324% of the control was observed. A trend toward normalization was evident 5-15 min after 'reoxygenation' (restoring normal medium), but the binding parameters were still altered after 60 min (Bmax 2110+/-82 fmol/mg protein, Kd 2.26+/-0.14 nM, P < 0.01 vs the corresponding control) as was adenosine release (196% of the control). These findings suggest that the increased availability of adenosine and its receptors may be a defense mechanism against ischemic injury, while the reduced affinity of A1 receptors, possibly due to desensitization, may be a sign of ischemia-induced cellular damage.

Inhibition of endosomal acidification in normal cells mimics the derangements of cellular insulin and insulin-receptor metabolism observed in non-insulin-dependent diabetes mellitus.

Dissociation of the insulin-insulin receptor complex plays a crucial role in the processing of both insulin and the insulin receptor, and the acidification of endocytic vesicles may be the mechanism by which internalized insulin is dissociated from its receptor and properly sorted and processed. Internalized insulin-insulin receptor complexes are abnormally processed in cells from patients with non-insulin-dependent diabetes mellitus (NIDDM). Accordingly, to further investigate the mechanisms of the derangements observed in NIDDM cells, we examined the effects of the ionophore monensin, which inhibits endosomal acidification, on the cellular processing of insulin and insulin receptor in monocytes from control subjects (n = 12) and NIDDM patients (n = 14). This study confirms that monocytes from NIDDM patients, compared with cells from normal controls, had reduced binding (P < .01), internalization (P < .01), and degradation (P < .01) of insulin. In addition, the release of intracellular radioactivity was slower (P < .01), and recycling of the insulin receptor was inhibited (P < .01). Moreover, these defects were associated with a significant (P < .01) decrease of dissociation of the internalized insulin-insulin receptor complex. In cells from normal controls, incubation with monensin decreased insulin binding (P < .01), but not insulin internalization. High-performance liquid chromatography (HPLC) analysis of intracellular radioactivity showed that after monensin intracellular intact insulin significantly increased (P < .01), thus suggesting a decrease of intracellular insulin degradation. Moreover, insulin receptor recycling was completely disrupted. All of these derangements were associated with a significant decrease (P < .01) of dissociation of insulin-insulin receptor complexes. On the contrary, in diabetic monocytes, monensin had no significant additional effect on NIDDM-linked alterations. Comparison of the results obtained in cells from NIDDM patients to those found in monensin-treated normal cells demonstrates that NIDDM and monensin gave rise to a superimposable impairment of dissociation of the intracellular insulin-insulin receptor complex, associated with similar abnormal sorting and processing of insulin and its receptor. The only defect present in NIDDM cells but not in monensin-treated cells is the decrease of insulin internalization, which thus seems independent of the action of monensin on the processing of internalized insulin-insulin receptor complex. These results suggest that the impairment of dissociation of the insulin-insulin receptor complex may play a crucial role in the subsequent altered processing of insulin and insulin receptor. Moreover, they raise the question as to a possible similar alteration of the same intracellular mechanism by NIDDM and monensin, and point out that the derangements found in cells from NIDDM patients could be localized within the endosomal apparatus and consist mainly of a defective acidification of its interior.