Vertical mandibular asymmetry and hand measurements in patients in growth: cross-sectional study

Objectives

The aim of this study was to determine the relationship between the vertical mandibular ramus asymmetry and the hand measurements asymmetry in growing patients.

Material and Methods

Panoramic radiographs and comparative radiographs of the right and left hands of 40 patients (14 males and 26 females) between 6 and 16 years old (mean age of 11.35±1.99 years) were evaluated. The total height of the mandibular ramus was measured, and the asymmetry index was calculated. The lengths of the proximal, middle and distal phalanges and the metacarpals of the five digits of both hands were measured and the absolute differences R-L were calculated for each one.

Results

A statistically significant association between the presence of vertical mandibular ramus asymmetry and the presence of phalanges asymmetry FPII (p=0.016), FPIII (p=0.016), FPIV (p=0.033), FMIII (p=0.031) and FMIV (p=0.016) was observed.

Conclusions

Mandibular asymmetry appears not to be isolated but also present in other body districts such as the phalanx bones. The total vertical asymmetry of the mandibular ramus showed an association with the asymmetry of the lengths of the FPIII, FMIII, FPIV, FMIV and FPII in growing individuals, with association between the side of mandibular asymmetry and the side of the phalanx's asymmetry. The asymmetry of this phalanges increases with increasing index of vertical mandibular ramus asymmetry.

The role of personality disorders on drug dependence treatment outcomes following inpatient detoxification

Aims

The present 6 month follow-up study was conducted to investigate the possible influence of comorbid personality disorders on drug treatment, as well as associated psychopathology and HIV-related risk behaviors outcomes.

Subjects and methods

Data were collected initially from a consecutive sample of 74 patients with a diagnosis of opiate abuse or dependence, admitted for inpatient detoxification.

Result

During intake, 80.9% of patients reported at least one HIV-related risk behavior in the previous 6 months. Not using condoms during sexual intercourse was the most common and the only risk behavior that showed a statistically significant reduction over the follow-up period. A total of 58.1% of subjects had at least one personality disorder (PD). Borderline PD was the most prevalent. However, antisocial PD was the only PD that influenced substance use outcomes. The presence of this diagnosis increased the chance of worse opiate use outcomes, but decreased likelihood of not using condoms. Patients with low obsessive–compulsive PD dimensional scores showed a significant increase in the number of risk behaviors. However, these influences were only seen at the 3-month follow-up assessment.

Conclusions

These results suggest that personality disorders need to be considered when planning effective interventions for opiate dependent individuals and when preparing and evaluating HIV risk-reduction interventions, particularly for the more severe substance dependent patients.

Radiofrequency ablation of functioning and non-functioning thyroid nodules: a single institution 12-month survey

PURPOSE

Radiofrequency (RF) treatment has played an increasing role in the management of benign thyroid nodules in recent years. The aim of this retrospective study was to evaluate the efficacy of RF treatment on volume reduction in functioning and non-functioning thyroid nodules.

PATIENTS AND METHODS

We reviewed the medical records of patients who had thyroid nodule RF ablation at our department between August 2017 and May 2018. Patients underwent a periodical follow-up with ultrasound examinations and thyroid function tests at 1, 3, 6 and 12 months from RF. Complications were assessed using the reporting standards of Interventional societies.

RESULTS

43 patients were submitted to thyroid nodule RF ablation treatment. Patients were subdivided into two groups, those with functioning (17 patients) or non-functioning nodules. At baseline (i.e. pre-RF treatment), the two groups of patients were superimposable for gender, age, BMI, nodule volume and maximum nodule diameter. The volume reduction of all 43 nodules was 69.1 ± 17.3% (range 26.0-94.5%) with no difference between functioning and non-functioning lesions (72.9 ± 18.1% vs 66.7 ± 16.7%, p = 0.254). A total energy delivered per nodule was 16.5 ± 6.8 kJ, with no difference between functioning and non-functioning lesions (14.5 ± 7.2 kJ vs. 18.2 ± 6.3 kJ, p = 0.083, respectively). No major complications were observed.

CONCLUSIONS

Radiofrequency ablation is a clinically effective and safe outpatient treatment in patients with benign nodules. In particular, we showed that a single treatment is effective in restoring euthyroidism in patients with autonomously functioning thyroid nodules.

Prevalence of craniomandibular disorders in orthodontic pediatric population and possible interactions with anxiety and stress

AIM

To analyse the presence and prevalence of gnathologic problems in a sample of children, candidate for orthodontic treatment, and evaluate the relationship between psychological factors and gnathological problems. The purpose of this study was also to evaluate a simple protocol with specific psychological test and a questionnaire for the rapid diagnosis of gnathologic problems, useful for possible screening studies on a wider population.

MATERIALS AND METHODS

Study Design: Observational, cross-sectional study. Among the patients coming for a first orthodontic evaluation 106 children, aged between 8 and 16 years, were examined. A complete orthodontic evaluation was performed in all patients; the RCMAS (Revised Children's Manifest Anxiety Scale) was used in the study to test the psychological condition, while the selected test for the diagnosis of gnathologic problems was the Fonseca Test. The prevalence of temporomandibular disorders (TMD) was evaluated with descriptive statistical analysis, and the eventually present correlation with a positive psycological test for anxiety has been evaluated with correlation parameters: c2 test of Pearson, and Cramer's V index.

RESULTS

The mean age of the children was 10.74 years. Females accounted for 55.66% of the total compared to 44.34% males. Signs and symptoms of TMD were present on average in 82% and 32% respectively. A remarkable amount of children also showed signs of psychological problems, mostly represented by anxiety. Positive correlation resulted between TMD (Fonseca scores) and increased overbite. Cross-correlations have been obtained, tested with Pearson c2 test and Cramer's V index, between level of anxiety, muscle pain on palpation, bad habits, and headache. The Class II subdivision molar class and altered canine relationship have been related to the presence of articular noise.

CONCLUSION

The protocol largely respected the need for speed of administration, comprehensiveness and reliability that we set out to achieve. Limited correlations have been assessed between occlusal conditions and positivity to the administrated tests. Further studies are desirable to increase the sample population.

TSH evaluation in hypothyroid patients assuming liquid levothyroxine at breakfast or 30 min before breakfast

PURPOSE

To compare TSH levels of hypothyroid patients treated with liquid LT4 at breakfast or 30 min before breakfast.

PATIENTS AND METHODS

Subjects, aged 18-75 years old, were eligible if they presented hypothyroidism, due to Hashimoto's thyroiditis or after thyroidectomy for proven benign goiter. Seven hundred ninety-eight patients were recruited and enrolled in the study. Thirty-seven subjects withdrew from the trial. A total of 761 patients (mean age 46.2 ± 10.8 years) completed the study. The starting dose of LT4 was determined through clinical judgment, taking into account TSH levels, estimated residual thyroid function, age, body weight and comorbidities. All patients underwent TSH, fT4, and fT3 evaluation to verify achievement of euthyroidism with their initial fasting state assumption of LT4 after 8 weeks of therapy. If euthyroidism was not achieved, an appropriately adjusted LT4 dose was administered for 8 weeks, after which thyroid function parameters were checked again. If euthyroidism was achieved, the patients were asked to take LT4 at breakfast and hormone levels were checked again after 6 months.

RESULTS

At the end of the study period, no significant differences in serum TSH level were observed whether LT4 was ingested at breakfast or 30 min prior in a fasting state: 2.61 ± 1.79 vs. 2.54 ± 1.86 mIU/L, respectively (p = 0.455).

CONCLUSIONS

This study confirms in a large set of patients that a liquid LT4 formulation can be taken directly at breakfast and potentially improve therapeutic compliance.

Peripheral loss of regulatory T cells and polyautoimmunity in an HIV-infected patient

We report a case of a human immunodeficiency virus (HIV)/hepatitis C virus-co-infected patient with an optimal virological status but with a poor CD4+ cell profile, followed up in the University Department of Infectious and Tropical Diseases of Brescia, Italy. He presented several autoimmune diseases (ADs) over the years concomitant with CD4+ cell increase episodes following severe immune depression of unknown cause. We studied T- and B-cell subsets and found low levels of K-deleting Recombination Excision Circles, T-cell Receptor Excision Circles and B and T memory subpopulations, which indicated that the bone marrow and thymic outputs were lower than in healthy controls. The most relevant phenotypic alteration was in the regulatory T-cell (Treg) population, because total Tregs as well as naïve, central memory and effector memory cells were detected at very low levels. This was the first case of polyautoimmunity defined as the presence of more than one AD in the same individual, occurring in an HIV patient. Several factors may be implicated, including genetic susceptibility, environmental factors, concomitant therapies and dysregulation of immune system cells. The extremely low number of Tregs found in our patient may play a major role in the regulation of the immune response and the development of all ADs.

Zemax simulations describing collective effects in transition and diffraction radiation

Transition and diffraction radiation from charged particles is commonly used for diagnostics purposes in accelerator facilities as well as THz sources for spectroscopy applications. Therefore, an accurate analysis of the emission process and the transport optics is crucial to properly characterize the source and precisely retrieve beam parameters. In this regard, we have developed a new algorithm, based on Zemax, to simulate both transition and diffraction radiation as generated by relativistic electron bunches, therefore considering collective effects. In particular, unlike other previous works, we take into account electron beam physical size and transverse momentum, reproducing some effects visible on the produced radiation, not observable in a single electron analysis. The simulation results have been compared with two experiments showing an excellent agreement.

Alginate-polymethacrylate hybrid hydrogels for potential osteochondral tissue regeneration

Porous scaffolds based on alginate-polymethacrylate hybrid hydrogels intended for bone and cartilage regeneration were prepared through controlled calcium ions diffusion from an agar mould. The double interconnected network of such materials combines into a single porous structure maintained by both noncovalent crosslinks (calcium ions for alginate) and covalent crosslinks (polymethacrylate crosslinked by the addition of mixtures of mono and bifunctional monomers). The alginate component ensures the appropriate micro-environment to mimic the extra-cellular matrix, whereas the polymethacrylate improves the mechanical performances of the hybrid hydrogels, helping to overcome the mechanical limitations of the alginate component. Morphological characterization and porosity analysis of the hybrid scaffolds were assessed by scanning electron microscopy and micro-computed tomography. Relative concentration and distribution of calcium ions were evaluated by atomic absorption and dispersive X-ray analysis, respectively. Uniaxial compressive mechanical tests were conducted to evaluate the compressive elastic modulus of the hybrid hydrogels that was correlated with their swelling ratio and crosslinking degree. As was envisaged a much higher modulus (about seven times) was obtained for the hybrid Alg/HE hydrogel than with alginate alone.

Sub-picosecond snapshots of fast electrons from high intensity laser-matter interactions

The interaction of a high-intensity short-pulse laser with thin solid targets produces electron jets that escape the target and positively charge it, leading to the formation of the electrostatic potential that in turn governs the ion acceleration. The typical timescale of such phenomena is on the sub-picosecond level. Here we show, for the first time, temporally-resolved measurements of the first released electrons that escaped from the target, so-called fast electrons. Their total charge, energy and temporal profile are provided by means of a diagnostics based on Electro-Optical Sampling with temporal resolution below 100 fs.

Femtosecond dynamics of energetic electrons in high intensity laser-matter interactions

Highly energetic electrons are generated at the early phases of the interaction of short-pulse high-intensity lasers with solid targets. These escaping particles are identified as the essential core of picosecond-scale phenomena such as laser-based acceleration, surface manipulation, generation of intense magnetic fields and electromagnetic pulses. Increasing the number of the escaping electrons facilitate the late time processes in all cases. Up to now only indirect evidences of these important forerunners have been recorded, thus no detailed study of the governing mechanisms was possible. Here we report, for the first time, direct time-dependent measurements of energetic electrons ejected from solid targets by the interaction with a short-pulse high-intensity laser. We measured electron bunches up to 7 nanocoulombs charge, picosecond duration and 12 megaelectronvolts energy. Our ’snapshots’ capture their evolution with an unprecedented temporal resolution, demonstrat- ing a significant boost in charge and energy of escaping electrons when increasing the geometrical target curvature. These results pave the way toward significant improvement in laser acceleration of ions using shaped targets allowing the future development of small scale laser-ion accelerators.

Determination of Heavy Metals in Human Liver

The levels of Cr (2.49±0.89 ppm), Mn (5.08 ± 1.60 ppm), Ni (1.81±0.95 ppm) and Pb (4.43 ± 3.12 ppm) were measured in dessicated liver from 44 cases of sudden traumatic death considered as representative of the general population in our area, after ruling out the presence of any underlying disease.

Atomic absorption spectrophotometry and electrothermal atomitazion was carried out after hot, acid digestion, of the dessicated samples.

After cancelling the influence of age and cause of death, a significant, positive correlation between Cr/Mn (P = 0.0009; R = 0.493) and Cr/Ni ( P = 0.0245; R = 0.347) levels was found.

Recreational Boating in Ligurian Marine Protected Areas (Italy): A Quantitative Evaluation for a Sustainable Management

Recreational boating is an important economic activity that can also represent a powerful source of interference for biological communities. The monitoring of the recreational boating in all Marine Protected Areas (MPAs) within the Liguria region was conducted in the 2010 summer season and it allowed to obtain information not provided by any official institution. The collaboration of geographically different MPAs in Liguria has led to the implementation of a monitoring framework of recreational boating, and this has made it possible to develop uniform management strategies for all the Ligurian marine parks. This study identifies the optimal number of boats for each MPAs, the number of boats that can anchor in the various parks without creating any impact on the biocenosis of merit, providing a first characterization of recreational boating in Liguria during the high touristic season and providing management recommendation to each MPAs. Generally, the Ligurian MPAs do not present critical situations, the number of boats in each MPA being below the optimal number, with the exception of Portofino MPA, where in the 12.5 % of monitored days more than 220 boats were counted and the mean density for weekend is 1.19 no boats/ha (4 times higher than weekday). The results confirm the dependence of the boats peaking from the holidays and the months of the summer, but also it highlights other factors that can contribute in the choice of the boaters.

Evaluation of the boundary condition influence on PAH concentrations in the water column during the sediment dredging of a port

The mobilisation of sediments and related contaminants connected to dredging activities is one of the most critical issues to the environmental risk and exposure assessment of a dredging project. The aim of this paper was an investigation of the mobilisation of polycyclic aromatic hydrocarbons (PAHs) due to the dredging of the Port of Genoa (Italy) to identify the temporal and spatial extent of the contaminant transport, and the influence of the dredging and the boundary conditions on it. The results showed relatively low background PAH concentrations in the water column and confirmed the dredging as the primary rising factor of concentrations in the water column, but also showed a complex scenario in which the different environmental and dredging factors forced the concentrations at different levels and moments. The post dredging phase showed PAH values close to the background conditions and the concentrations remained relatively high only for a few PAHs.

Craniofacial asymmetry in non-syndromic orthodontic subjects: clinical and postural evaluation

OBJECTIVE

The aim of this study was to evaluate the possible influence of a malocclusion pattern on a patient's posture.

METHODS

Patients affected by symmetric malocclusion or malocclusion with mild to moderate non-syndromic craniofacial asymmetry were submitted to a clinical and X-ray evaluation. Subjects with symmetric skeletal class I were used as the control group. Evaluation of differences in postural pattern was performed using rasterstereography.

RESULTS

Statistical analysis (t-test) was performed on 61 patients divided in homogeneous subgroups. The results show a pelvic torsion angle of 1.08° + 3.00° (P = 0.0023) (normal value (NV) = 0.0-1.9°) in subjects presenting skeletal class II z asymmetry (control group: 1.17° ± 1.25°, not significant (NS)).

CONCLUSIONS

The present study shows evidence of a relationship between malocclusion and spinal posture. A better understanding of the relationship between malocclusion and posture may help in planning a multidisciplinary approach that could involve other specialists.

Comparison between liquid and tablet levothyroxine formulations in patients treated through enteral feeding tube

BACKGROUND

The majority of clinicians suggest that enteral feedings should be held 1-2 h prior to and after L-T4 administration despite lack of data for continuous enteral nutrition.

AIM

The aim of this study was to: (1) compare the thyroid hormonal profile in patients submitted to L-T4 treatment in tablets or liquid formulation with an enteral feeding tube; (2) evaluate the nursing compliance with the two different formulations.

SUBJECTS AND METHODS

20 euthyroid patients submitted to total laryngectomy and thyroidectomy consecutively started L-T4 treatment in tablets (Group T) or in liquid formulation (Group L) with enteral feeding tube the day after surgery. Tablets were crushed before administration and enteral feeding was stopped for 30 min before and after L-T4 treatment, whereas liquid formulation was placed into the nasoenteric tube immediately. A questionnaire about the preparation and administration of thyroxine replacement therapy was given to the nurses.

RESULTS

No difference of TSH, fT4 and fT3 before and after L-T4 treatment was observed among patients of Group L. A slightly serum TSH increase was observed in Group T, but not reaching statistical significance (2.50 ± 1.18 vs 2.94 ± 1.22 mUI/L), whereas no difference in fT4 and fT3 levels was found. Preparation and administration of liquid L-T4 was considered excellent by 12/13 nurses, whereas tablet formulation was considered poor by 10/13.

CONCLUSIONS

Our data showed that liquid L-T4 formulation can be administered directly through feeding tube with no need for an empty stomach, with a significant improvement in therapy preparation and administration by nurses.

Ultrasound findings of subacute thyroiditis: a single institution retrospective review

BACKGROUND

High resolution ultrasonography features have also been described as having a useful supporting role in the diagnosis of subacute granulomatous thyroiditis (ST), and images are generally characterized by heterogeneous hypoechoic areas of the affected tissue with lack of flow on color Doppler US.

PURPOSE

To determine the sonographic features of subacute granulomatous thyroiditis.

MATERIAL AND METHODS

We reviewed the medical records of patients referred at the Endocrine and Metabolic Unit of our Institution between January 2010 and December 2011.

RESULTS

A total of 7520 patients were evaluated in our department between January 2010 and December 2011. Among them, 22 (0.3%) patients had a diagnosis of ST (19 women and 3 men, 45.4 ± 9.7 year; range, 33-62 years). Ultrasound examination showed bilateral ST in 64% of patients. Thyroid volume was 13.2 ± 7.7 mL, without difference if ST was unilateral (13.2 ± 7.1 mL) or bilateral (13.9 ± 8.3 mL). On grayscale US, heterogeneous diffusely or focally marked hypoechoic areas, like "lava flow", were found in all the lesions.

CONCLUSION

Our data confirm the high sensitivity of US in the diagnosis of ST: diffuse hypoechoic and confluent areas with the characteristic features like "lava flow".

Simulations of dredged sediment spreading on a Posidonia oceanica meadow off the Ligurian coast, Northwestern Mediterranean

The sandy deposits from dredging can have negative effects on the environment such as increase in suspended solids in the water column and their consequent transport. An experimental study was conducted to characterize water masses, dynamics, and sedimentation rates on the Ligurian continental shelf (Italy), where both a sand deposit, that could be used for beach nourishment, and a nearby Posidonia oceanica meadow coexist. The environmental plan provides a mathematical simulation of the sediment-dispersion to evaluate the possible impact on the meadow. It has been calculated that the dredging could double the concentration of suspended particles, but its scheduling will preclude a sediment accumulation. All the information obtained from this work will be used to study the environmental feasibility of the sand deposit exploitation and as starting point for drawing up the monitoring plan in case of dredging.

Characterization of the THz radiation source at the Frascati linear accelerator

The linac driven coherent THz radiation source at the SPARC-LAB test facility is able to deliver broadband THz pulses with femtosecond shaping. In addition, high peak power, narrow spectral bandwidth THz radiation can be also generated, taking advantage of advanced electron beam manipulation techniques, able to generate an adjustable train of electron bunches with a sub-picosecond length and with sub-picosecond spacing. The paper reports on the manipulation, characterization, and transport of the electron beam in the bending line transporting the beam down to the THz station, where different coherent transition radiation spectra have been measured and studied with the aim to optimize the THz radiation performances.

Usefulness of repeated recombinant human thyrotropin-stimulated thyroglobulin test in the post-surgical follow-up of very low-risk patients with differentiated thyroid carcinoma

BACKGROUND

The European Thyroid Association (ETA) and the American Thyroid Association (ATA) guidelines identify subgroups of patients affected by thyroid carcinoma in whom, due to a low risk of recurrence, radioiodine ablation is not indicated. These patients are referred to as "very low-risk" according to the ETA consensus and "low-risk" patients according to the ATA guidelines. The recommended post-surgical follow-up of these patients is based upon periodical measurements of serum thyroglobulin (Tg) on levothyroxine therapy and neck ultrasound (US).

AIM

To evaluate the usefulness of recombinant human (rh)-TSH Tg test and its repetition 2-3 yr afterwards in very low-risk patients.

MATERIALS AND METHODS

We consecutively enrolled 32 patients with undetectable anti-Tg antibodies. Basal serum Tg levels was undetectable in all patients.

RESULTS

Following rhTSH serum Tg remained undetectable in 23 (71.9%) patients (UP) and was >1.0 ng/ml in 9 (DP). US and whole body scan, revealed lymph node metastasis in 4/9 DP patients. A second rhTSH stimulation test (36.9±3.5 months later) was performed in all UP and in 5 DP patients without proven recurrences. All the UP and 4/5 formerly DP patients showed undetectable Tg stimulation.

CONCLUSIONS

Our results suggest that rhTSH Tg test may be helpful in very low-risk patients, given its ability to differentiate those who may be considered "free of disease" from those who require further investigation and treatment. Repeated rhTSH Tg tests may be indicated only in patients with detectable serum Tg at prior stimulation testing.

A novel menin gene deletional mutation in a little series of Italian patients affected by apparently sporadic multiple endocrine neoplasia type 1 syndrome

AIM

To perform a genetic screening for the multiple endocrine neoplasia type 1 (MEN1) gene mutations in patients affected by an apparently sporadic form of the disease, referred to an internal medicine unit of a large general hospital.

SUBJECTS AND METHODS

In a group of 12 consecutive patients presenting clinical features of MEN type 1 syndrome, we performed a genetic screening for germline MEN1 gene mutations, including complete sequencing of the coding region (exons 2 to 10) and multiplex ligation-dependent probe amplification analysis for large deletion detection.

RESULTS

Among these patients affected by apparently sporadic MEN type 1 syndrome, a targeted clinical history could detect indirect support for a diagnosis of familial condition only in 2 cases. The genetic screening identified pathogenic germline MEN1 gene mutations in 3 patients (25%). A previously unknown 18 base-pair deletion within exon 3, c.564_581delCAATGGGGAGCAGACAGC, resulting in loss of 6 amino acids (pAsp189_Ala194del), was found in heterozygosis in a woman affected by primary hyperparathyroidism and multifocal pancreatic neoplasia.

CONCLUSIONS

Our results underscore the importance of performing genetic testing also in apparently sporadic MEN1 patients and extend the list of molecular variants leading to inactivation of the MEN1 gene.

Decreased number of circulating endothelial progenitor cells in patients with Graves' hyperthyroidism

OBJECTIVE

A relevant biological role of circulating endothelial progenitor cells (EPC) was recently demonstrated. EPC are generated in the bone marrow, and interact with damaged endothelium, restoring the integrity of the monolayer. Therefore, aim of the present study was to evaluate EPC in the blood of patients with untreated Graves' hyperthyroidism (GD), in whom an increased oxidative stress was observed.

DESIGN AND METHODS

Twenty-three patients with untreated active GD and 18 matched normal controls (NC) were included in the study. Circulating EPC were isolated from peripheral blood. Mononuclear cells were cultured with endothelial basal medium supplemented with EGM SingleQuots, and were identified by positive double staining after 7 days in culture. Circulating levels of C reactive protein, total antioxidant power, interleukin (IL)-6, IL- 18, monocyte chemoattractant protein-1, tumor necrosis facotr- α, soluble vascular cell adhesion molecule (VCAM) and intracellular adhesion molecule were evaluated by enzymelinked immunosorbent assay kit. EPC number was also evaluated in a subgroup of GD patients after restoration of euthyroidism.

RESULTS

Systolic blood pressure resulted increased in GD patients compared with control subjects whereas diastolic blood pressure was not significantly different. Patients with GD showed an increase in circulating levels of IL-18 and VCAM-1 and a reduction of total antioxidant power (p<0.05) compared to NC. Moreover, a reduced number of EPC was observed in patients with GD compared to NC (p<0.05) which turned to NC values after restoring euthyroidism.

CONCLUSION

Patients with GD showed a reduction in the physiological protective mechanisms against endothelial damage, probably induced by increased inflammation and oxidative stress.

Self-amplified spontaneous emission free-electron laser with an energy-chirped electron beam and undulator tapering

We report the first experimental implementation of a method based on simultaneous use of an energy chirp in the electron beam and a tapered undulator, for the generation of ultrashort pulses in a self-amplified spontaneous emission mode free-electron laser (SASE FEL). The experiment, performed at the SPARC FEL test facility, demonstrates the possibility of compensating the nominally detrimental effect of the chirp by a proper taper of the undulator gaps. An increase of more than 1 order of magnitude in the pulse energy is observed in comparison to the untapered case, accompanied by FEL spectra where the typical SASE spiking is suppressed.

Seasonal and spatial variability of water quality parameters in the Port of Genoa, Italy, from 2000 to 2007

This paper presents the results of the statistical analysis of a set of physico-chemical and biological water quality parameters, monthly collected from 2000 to 2007 in the Genoa Harbour area (Ligurian Sea). We applied multivariate methods, such as principal component analysis (PCA) and dynamic factor analysis (DFA) for investigating the spatial and temporal variability and for providing important background information on pollution problems in the region. PCA evidenced the role of the sewage and river discharges and of the exchanges with the open sea in determining the harbour water quality. DFA was used to estimate underlying common trends in the time series. The DFA results partly show a general improvement of water quality over the 8-years period. However, in other areas, we found inter-annual variations but no significant multi-annual trend. Furthermore, we included meteorological variables in our statistical analyses because of their potential influence on the water quality parameters. These natural forcings explain part of the variability in water quality parameters that are superimposed on the dominating anthropogenic pollution factors.

Prevalence of double pituitary adenomas in a surgical series: Clinical, histological and genetic features

BACKGROUND

The term double pituitary adenomas (DPA) is usually referred to those rare lesions showing two distinct cellular components. Genetic background may sustain the proliferation of more than one cell at the same time but no information is available on the presence of aip mutations in these patients.

AIM

We report the prevalence and the endocrinological, neuroradiological, histopathological and genetic features of DPA detected in a large surgical series. The contribution of pituitary transcription factor immunostains in DPA was also evaluated.

SUBJECTS AND METHODS

One-hundred-forty-four patients undergoing surgery for tumors of the sellar region were evaluated. Histopathology, immunohistochemistry and the mutational analysis for the entire coding region of the AIP and MEN1 genes were performed.

RESULTS

One-hundred-seventeen patients out of 144 had a pituitary adenoma. DPA was found in 3 (2.6%) out of 117 patients with pituitary adenoma. Immunohistochemistry and transcription factors analysis demonstrated two not yet described histotype associations in DPA. The coexistence of somatotroph-lactotroph and silent mammosomatotroph histotype in 1 case and the coexistence of sparsely granulated lactotroph and null cell adenomas in the remaining two cases were first identified. Sequencing data for the coding region of the aip and the menin gene resulted in wild type sequences in all patients with DPA.

CONCLUSIONS

The prevalence of DPA observed in our unselected surgical series is not negligible (2.6%). Furthermore, the evaluation of the treatment outcome would suggest that the clinical management of DPAs requires a careful diagnostic approach and follow- up.

Experimental demonstration of emittance compensation with velocity bunching

In this Letter we report the first experiments aimed at the simultaneous demonstration of the emittance compensation process and velocity bunching in a high brightness electron source, the SPARC photoinjector in INFN-LNF. While a maximum compression ratio up to a factor 14 has been observed, in a particular case of interest a compression factor of 3, yielding a slice current of 120 A with less than 2 microm slice emittance, has been measured. This technique may be crucial in achieving high brightness beams in photoinjectors aiming at optimized performance of short wavelength single-pass free electron lasers or other advanced applications in laser-plasma accelerators.

Prevalence of parathyroid cysts by neck ultrasound scan in unselected patients

BACKGROUND

Parathyroid cysts (PC) are a rare entity, representing only 0.5-1% of all parathyroid lesions and <1% of neck masses. Since its first description, in the second half of the 19th century, fewer than 300 cases have been reported. By reviewing the literature, it appears that the data available arose from surgical series, and the precise incidence of PC as detected by ultrasound (US) has not been described. The aim of this study was to review 5 yr of routine neck US, mainly performed for thyroid diseases, in order to estimate the prevalence of PC in a large series of patients.

METHODS

We reviewed our database of neck US investigations performed from 2003 to 2007: all data regarding patient's clinical history, US images, and fine needle aspiration cytology were retrospectively collected.

RESULTS

Among 6621 patients submitted to neck US investigation, a PC (mean diameter 36.4+/-14.2 mm; range 25-61 mm) was diagnosed in 5 cases. Serum PTH levels were high in all the patients (221+/-140.7 pg/ml; range 111-456 pg/ml), whereas serum calcium levels only in 3 subjects (10.8+/-1.4 mg/dl; range 9.2-12.9 mg/ml).

CONCLUSION

This is the first study evaluating the prevalence of PC in a large series of unselected patients by US. Our results demonstrate a much lower incidence (0.075%) of incidentally detected PC than previously reported.

Selection of variables for on-line monitoring, diagnosis, and control of anaerobic digestion processes

This work aims to systematize the study of indicators for two types of wastewaters: carbohydrate-based and protein-based synthetic wastewaters. Characterization of steady states and dynamic response analysis against disturbances were carried out using both a factorial discriminant analysis (FDA) and a phenomenological analysis, respectively. This research seeks reconciling both sets of indicators in order to optimize resources and provide a minimal cost in instrumentation for its implementation at industrial scale. According to the results of this research, the best indicators for the two types of wastewaters, considering both process steady states and organic load perturbations are: Biogas flow rate or Methane flow rate, and Hydrogen concentration in the biogas; Volatile fatty acids and Partial alkalinity in the liquid phase.

Modified percutaneous ethanol injection of parathyroid adenoma in primary hyperparathyroidism

Surgery is the treatment of choice for symptomatic primary hyperparathyroidism; unlikely few patients do not meet established surgical criteria or have comorbid conditions that prohibit surgery. In these subjects, medical therapy alone offers little hope for a sustained long normocalcemic period. However percutaneous ethanol injection (PEI) may represent an alternative therapeutic procedure. It is currently in use for the treatment of secondary or tertiary hyperparathyroidism, however, few studies or case reports suggest it for the treatment of primary hyperparathyroidism. Moreover, little information is available about the long-term follow-up, where incomplete necrosis or the spreading of ethanol in the surrounding tissues is often reported. We believe that many of the side effects could be correlated to procedure itself. Taking these experiences into account, we have reasoned that in order to limit these side effects, we had to modify the standard PEI procedure. We reported this preliminary experience describing our modified PEI procedure.