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The aim of this study was to investigate whether attention may be specifically impaired in Alzheimer's disease from the early stages of the disease. Subgroups of patients with different types of mild cognitive impairment were selected according to standard criteria. Patients and controls were given tasks exploring various subcomponents of attention and executive functions. Only subgroups of mild cognitive impairment characterized by memory disorders obtained lower scores than controls on attention and executive tasks. On the basis of the scores obtained on the Clinical Dementia Rating at the 1-year follow-up, patients were redistributed into 2 groups: those who developed and those who did not develop dementia. Patients who presented evolution to dementia already had, at baseline, lower scores than patients who did not evolve on tasks exploring attention and executive functions. The results suggest that not only memory disorders but also attention/executive deficits may characterize dementia at the onset.

A diode-pumped single-pass amplifier system relying on two grazing-incidence Nd:YVO(4) slabs was developed to increase the energy of low-repetition-rate pulses from a decimated low-power cw mode-locked oscillator. Single-pass unsaturated gain up to 1.3x10(5) was achieved, and amplified pulses of 10-muJ energy and 8.0-ps duration were obtained. Efficient second harmonic generation (SHG) at 532 nm was achieved, as well as traveling-wave parametric conversion in the range 770-1020 nm (signal) and 1110-1720 nm (idler).

Frontal variant-Frontotemporal dementia (fvFTD) and Alzheimer's disease (AD) patients matched for severity of dementia at the Clinical Dementia Rating (CDR) received neuropsychological testing in order to explore if the dysexecutive disorder might characterise fvFTD at early stage, when AD is dominated by the episodic memory defect. We also determined if the behavioural syndrome was more severe in fvFTD than AD, and if specific patterns of behavioural symptoms could differentiate the two types of dementia, using the Neuropsychiatry Inventory (NPI). AD patients performed worse than fvFTD not only in memory but also in executive tasks. Apathy and eating disorders proved to be more severe or frequent in fvFTD even if the two groups did not differ in the total NPI score. CDR score significantly correlated with the NPI score in fvFTD and with the MMSE in AD. Our data confirm that the memory disorders may differentiate the two types of dementia; however, the dysexecutive syndrome is as severe, and even more severe in AD. The severity of the behavioural syndrome is comparable in the two groups but the nature of the behavioural disorders may vary to some extent. We conclude that AD dementia at early stage is a behavioural-cognitive syndrome, while in fvFTD the behavioural disorders appear when the cognitive deficit is still relatively mild.

Cholinesterase inhibitors (ChEIs) are the most established treatment strategy in Alzheimer's disease (AD). However, the responsiveness to these drugs is widely heterogeneous and the majority of AD subjects do not respond to treatment. Paraoxonase-1 (PON-1) is a potent endogenous ChEI and has been widely studied for its ability to hydrolyze environmental neurotoxins. Serum levels and biological activity of PON-1 display wide inter-individual variability and are strongly influenced by a common polymorphism at position 192 of the PON-1 gene. Here, we evaluated whether this gene variation is associated with differences in the ability of AD subjects to respond to therapy with ChEIs. We found that individuals that respond to ChEIs had a significantly higher frequency of the R allele, compared to non-responders (P<0.05). This study indicates that the 192 Q/R polymorphism of the PON-1 gene might influence responsiveness to ChEIs, with potentially important implications for the treatment of AD. Mutations of genes encoding for endogenous modulators of the cholinergic system should merit further investigation as prognostic indicators of individual response to treatment in AD subjects.

We report on a simple design for a multi-GHz tunable-repetition-rate diode-pumped picosecond laser. Using a plano-Brewster Nd:GdVO4 crystal in a V-folded cavity employing only readily available commercial components, we achieved passive mode-locking with 4.4-ps pulses tunable in the range 2.5-2.7 GHz. This laser is meant to be employed in the MIR experiment that aims at the detection of the Schwinger radiation (dynamical Casimir effect).

We report what is to our knowledge the first high repetition rate Q-switched Nd:BaY(2)F(8) (Nd:BaYF) laser pumped with a multiwatt fiber-coupled diode array tuned at 806 nm. As much as 2.42 W of average power and up to 1.05 mJ of pulse energy were obtained with 6.1 W of absorbed pump power, with excellent beam quality (M(2)<1.2) and linear polarization.

Reaction times and movement times were studied in 18 individuals with severe traumatic brain injury (TBI) and 36 matched normal controls. Reaction times depended on the type of task: in the case of simple visual stimuli (Alertness condition) they were similar in individuals with TBI and normal controls. In contrast, individuals with TBI were slower in a Go-no-go test. Regardless of task, movement times depended on movement length and were slower in individuals with TBI. These findings indicate the presence of a residual motor programming deficit in individuals with TBI even in the chronic stage and in the presence of good motor recovery, as assessed clinically.

We report on a diode-pumped 1.3-microm Nd:GdVO4 cw laser, intracavity doubled for highly efficient generation of red light. We obtained as much as 2.4 W of power at 670 nm (corresponding to 26% optical-to-optical efficiency) in a nearly TEM00 mode and with small amplitude noise. To the best of our knowledge, these results represent the highest performance at this wavelength for cw solid-state lasers.

Peripheral blood stem cells (PBSCs) collected following stimulation with cytokines are commonly used for autologous haematopoietic transplants. Currently, PBSCs are being used for syngeneic or allogeneic transplants from matched or haploidentical donors. However, many issues are still unanswered regarding the early or late side-effects cytokines have on recipients and on healthy donors. The aims of this paper were to evaluate the experience acquired worldwide in this field, to define the acceptability of stem cell donation by G-CSF-stimulated apheresis from unrelated donors after the failure of a first donation, and to assess side-effects of G-CSF on unrelated donors. The use of PBSCs has increased tremendously over the last few years and in the near future PBSCs will probably become the most relevant source of stem cells. Studies conducted so far have definitely concluded that G-CSF is safe and well tolerated. Results observed in transplants utilizing marrow stem cells compared with results obtained in transplants utilizing PBSCs have shown that patients undergoing this latter procedure recover earlier, require a lower number of transfusions and spend fewer days in hospital with a consequent decrease in costs. We concluded that a second transplant by G-CSF-stimulated apheresis from an unrelated donor is definitely acceptable and we designed a prospective study to better define all controversial aspects. Donors will be given 10 microg/kg/day of G-CSF subcutaneously for 5 days. One or two PBSC collection procedures will be performed: the first on day 5 and the second, if necessary, on day 6. Donors will be surveyed and blood counts monitored in a standardized manner during the process.

A diode-pumped Q-switched Nd:YAG laser that operates at the eye-safe 1444 nm wavelength has been developed. When pumped by a 10-W fiber-coupled array at 808 nm, it generated 1 W in cw operation and 560 mW at 20-kHz repetition rate with active Q-switching. Design issues such as thermal lensing characterization and beam quality are discussed.

A diode-pumped Nd(3+):YVO(4) laser passively mode locked by a nonlinear mirror based on second-harmonic generation has been developed. Pumping with a fiber-coupled 10-W diode array, we generated nearly diffraction limited, linearly polarized 11-ps pulses at 1064nm, with average power of 2.7 W at a 150-MHz repetition rate. Pulses as short as 7.9 ps were measured with reduced output power (1.35 W) by optimal focusing in the nonlinear crystal.

A quasi-cw diode-pumped Nd:YAG laser, mode locked by a nonlinear mirror and stabilized by an acousto-optic modulator, has been developed that generates 31-ps, 23-microJ pulses. Employing this source with a periodically poled lithium niobate crystal in a traveling-wave geometry, we obtained extracavity frequency conversion with pump depletion of as much as 62% in the near infrared (1.46- 1.56 microm) with a pulse spectral width of 1.5nm and a beam quality M(2)=1.7.

We report on the experimental results of a diode-pumped, intracavity-doubled cw Nd:YAG laser, pumped by a 10-W fiber-coupled semiconductor laser at 808 nm and emitting as much as 600 mW in a stable single longitudinal mode and TEM(00) spatial mode. We discuss the main issues of the resonator design and the optimization of the intracavity second harmonic conversion by interpreting our results using simple models. Improvements for the current project are also discussed.

The study analyzes the results obtained when Bankart-Delitala surgery was used to treat recurrent anterior dislocation of the shoulder. A group of 30 patients were submitted to clinical and functional follow-up based on the Rowe system; 15 of the patients also underwent isokinetic testing. The data obtained were interpreted based on the Rowe system, but also analytically and statistically. The authors conclude that Bankart-Delitala surgery constitutes an effective surgical option in the treatment of recurrent anterior dislocation of the shoulder.

There is a growing interest in the use of peripheral blood stem cells (PBSC) for allogeneic transplantation. This is due in part to the idea that, as with autologous transplantation, increasing the number of allogeneic hemopoietic progenitors infused may lead to reduced complications. However, introducing the PBSC technique into allogeneic transplants implies theoretical as well as ethical problems involving both patient and donor. We are still uncertain whether the PBSC technique will result in an increase of GVHD or (better) of GVL. G-CSF, necessary for effective PBSC mobilization, is safe but its use in normal subjects should be regarded with caution. For this reason, a Study Committee promoted by the GITMO (Gruppo Italiano Trapianto di Midollo Osseo) evaluated the key aspects of allogeneic PBSC collection and transplantation. The present paper summarizes the scientific data and suggests some guidelines for the introduction of allogeneic PBSC transplantation into clinical practice. The procedure should be considered experimental and the Committee strongly recommends the use of allogeneic PBSC in experienced centers, initially in patients with advanced disease. The donor should be given a complete explanation of the advantages and risks of G-CSF therapy, leukapheresis and general anesthesia. A careful monitoring of both patient and donor should also be included to watch for short-term and long-term side effects.

Aims: This study was designed in an attempt to improve the sensitivity of cytologic examination of fineneedle aspiration biopsies., Methods and Results: A prospective study was carried out on 79 patients with breast lesions less than 1 cm in diameter and clinically impalpable who were referred to the Radiodiagnostics Section of the Ca' Granda Hospital of Milan in 1990 and 1991 for mammographic and ultrasound verification. The examination was carried out using a high frequency (10 MHz) ultrasound probe to which an aspiration needle had been soldered. This made it possible to quickly and accurately reach the target nodule and thus gave a high sensitivity of the examination (93%). However, attachment of the needle to the probe prevented sampling from other points of the nodule and was responsible for the slight increase in number of inadequate samplesfi which in turn worsened the specificity of the test (86%). To check the gold standard of the examination, all the patients with positive or doubtful aspirations underwent surgical biopsy, whereas strict radiologic controls were performed in the negative cases., Conclusions: Ultrasound-guided fineneedle aspiration may have advantages over needle aspiration performed with the stereotactic radiologic technique. The needle can be monitored even if the patient moves; even deep, peripheral nodules as well as those near a prosthesis can be reached; repeated samples can be taken, and costs are limited.

It has been speculated that changes in intrinsic blood flow properties may contribute to the evolution of vascular complications in diabetes mellitus. To verify this hypothesis we measured hematocrit, fibrinogen, plasma and blood viscosity in 30 diabetic patients and in 25 healthy volunteers. Diabetics showed blood and plasma viscosity and fibrinogenemia higher than healthy subjects, although only plasma viscosity and fibrinogenemia were statistically significant (p less than 0.001). Moreover the diabetic patients with the highest HbAlc values had a significant increase in plasma viscosity compared with the patients with lower HbAlc values (p less than 0.001), despite a similar fibrinogenemia. This study confirms the presence of hemorheological changes in diabetes mellitus and shows a correlation between plasma viscosity and metabolic control.

Fifty patients with severe aplastic anemia (SAA) were treated with immunosuppressive regimens consisting of high-dose 6-methylprednisolone (HD-6MPr) followed by or given in combination with anti-lymphocyte globulin (ALG). Eighteen of 50 patients given one course of immunosuppression (IS) showed a response, as defined by self-sustaining peripheral blood counts, with no further need for transfusions; 8 of 27 and 2 of 7 patients given, respectively, two or three courses of IS responded. The overall response rate was 28 of 50 (56%). Seventeen patients died, 5 are alive but pancytopenic. The actuarial six-year survival is currently 65%. The following prognostic factors on admission were significantly associated with response to IS: 1) age over 30 years (P = .005), 2) a short interval from diagnosis to treatment (P = .03), 3) a small number of transfusions before treatment (P = .004). The sex of the patient, the number of transfusions before treatment, and the number of CFU-c from unfractionated as well as from T-depleted bone marrow had no significant influence on response to IS. After one month from IS, however, patients responding to IS had a significantly (P = .01) higher number of CFU-c on T-depleted marrow cells, compared with nonresponders. The present study confirms that over 50% of patients with SAA can be successfully treated with IS. Older patients, with a short interval from diagnosis to treatment and with rapid recovery of CFU-c growth on T-depleted marrow, have the best chance for autologous hematopoietic reconstitution.

A mode-locked Nd:YAG oscillator is described that operates at 1.052 microm. It is shown that a birefringent filter efficiently discriminates and selects each one of the fundamental Nd:YAG transitions.

A wide data collection on blood group gene frequencies in Italian regions and provinces is presented. This report is the result of a joint collaboration of human geneticists and forensic haematologists started in 1979 and updates a previous work by the same group. The following genetic polymorphisms have been examined: red-cell antigens (ABO, FY, Kell, Kidd, Lewis, Lutheran, MNSs, P, Rhesus), red-cell enzymes (ACP1, ADA, AK1, ESD, GLO1, GPT, PGD, PGM1), plasma proteins (BF, C3, GC, HP, IGK, PI, TF). Data have been classified according to genetic systems, Italian regions and provinces. Gene frequencies were estimated by the maximum likelihood method. The goodness of fit to Hardy-Weinberg proportions has been evaluated by the likelihood ratio statistics. Genetic heterogeneity of provinces and regions is reported.

We have measured the nonlinear refractive index, n(2), of CS(2) at 10.6 microm by observing the onset of whole-beam selffocusing. We find that n(2) is (2.2 +/- 0.7) x 10(-10) esu, which is over an order of magnitude larger than n(2) in the visible.

We reported the main rheological and coagulative features in seven patients affected with monoclonal gammapathy: four of them presented IgA class paraprotein, two IgM class paraprotein and one IgG class paraprotein. All presented increased plasma and serum viscosity. The four patients affected with IgA monoclonal paraproteinaemia underwent one plasma volume plasmapheresis. This procedure has been demonstrated to be useful and effective in reducing both plasma and serum viscosity.