Polarized phonons carry angular momentum in ultrafast demagnetization.

Magnetic phenomena are ubiquitous in nature and indispensable for modern science and technology, but it is notoriously difficult to change the magnetic order of a material in a rapid way. However, if a thin nickel film is subjected to ultrashort laser pulses, it loses its magnetic order almost completely within femtosecond timescales1. This phenomenon is widespread2-7 and offers opportunities for rapid information processing8-11 or ultrafast spintronics at frequencies approaching those of light8,9,12. Consequently, the physics of ultrafast demagnetization is central to modern materials research1-7,13-28, but a crucial question has remained elusive: if a material loses its magnetization within mere femtoseconds, where is the missing angular momentum in such a short time? Here we use ultrafast electron diffraction to reveal in nickel an almost instantaneous, long-lasting, non-equilibrium population of anisotropic high-frequency phonons that appear within 150-750 fs. The anisotropy plane is perpendicular to the direction of the initial magnetization and the atomic oscillation amplitude is 2 pm. We explain these observations by means of circularly polarized phonons that quickly absorb the angular momentum of the spin system before macroscopic sample rotation. The time that is needed for demagnetization is related to the time it takes to accelerate the atoms. These results provide an atomistic picture of the Einstein-de Haas effect and signify the general importance of polarized phonons for non-equilibrium dynamics and phase transitions.

Clinicopathological differences between breast cancer in patients with primary metastatic disease and those without: a multicentre study.

OBJECTIVE: Approximately 6% of breast cancer (BC) patients present with primary metastatic disease (pmBC) at first diagnosis. The clinicopathological differences between tumours from patients who have metastatic disease and those who do not are unclear. METHODS: This study was an exploratory analysis of patients with pmBC treated in 8 German breast cancer centres between 1998 and 2010. Phenotypes were defined using the following immunohistochemical markers: oestrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (Her2). The control arm included the group of patients who had neither local recurrence nor distant metastases at a follow-up of at least 30 months after initial diagnosis. RESULTS: A total of 2214 patients were included. Of these, 1642 had non metastatic BC, and 572 had pmBC. Eighty-five patients (15%) with pmBC were diagnosed at stage T1. On multivariate analysis, factors associated with pmBC were as follows: positive lymph node status, grade 3, lobular histology and Luminal B phenotype (Her 2 positive). Of the sample, 197 patients (34%) with pmBC were diagnosed as stage T2, 90 patients (16%) were diagnosed as stage T3, and 200 patients (35%) were diagnosed as stage T4. Only positive lymph node status and grade 3 were reported as risk factors for distant metastases in patients with stage T3 and T4 cancer. CONCLUSION: There are differences in the clinicopathological features among breast cancer patients with primary metastases and those without. Receptor expression and histological type play a minor role in the risk for metastasis in patients with stage T3 and T4 disease when compared to patients with T1 pmBC tumours. On initial diagnosis, lobular histology and Luminal B positivity (Her 2 positive) in T1 pmBC were determined to be risk factors for primary metastatic disease.

Oral contraception enhances growth hormone responsiveness to hyper- and hypoglycaemia.

AIMS: Plasma glucose levels influence growth hormone concentrations. Oral contraceptives are known to affect circulating growth hormone levels and glucose metabolism. While growth hormone plays an important role in hypoglycaemia counter-regulation, it has been shown that oral contraceptives increase growth hormone concentrations. In this context, we tested if serum growth hormone concentrations display a differential response on glycaemic variations in healthy women using oral contraceptives and those not using contraceptives. METHODS: Fifteen healthy women with oral contraceptive treatment and 10 without participated in a stepwise hyper- and hypoglycaemic glucose clamp procedure. Serum growth hormone concentrations were measured at euglycaemic baseline and subsequently at plasma glucose plateaus of 8.8, 6.8, 4.8 and 2.8 mmol/l. RESULTS: Growth hormone values were significantly higher in women using oral contraceptives throughout the experiments (P = 0.001). Hyperglycaemia decreased growth hormone concentrations in women using oral contraceptives (P = 0.009), but not in those who were not using oral contraceptives (P = 0.241). Hypoglycaemia significantly elevated growth hormone concentrations in women using oral contraceptives (P = 0.009), but not in those not using oral contraceptives (P = 0.094). Maximum growth hormone values were reached at the end of the hypoglycaemic plateau, with significantly higher concentrations in the group using oral contraceptives than in the group not using oral contraceptives (P = 0.016). CONCLUSION: Healthy women on oral contraceptive treatment display an increased responsiveness of growth hormone to hypoglycaemic, as well as hyperglycaemic conditions and generally higher serum growth hormone concentrations than women without oral contraceptives. Given the known boosting effects of growth hormone on hypoglycaemic hormonal counter-regulation, oral contraceptives may thus be a pharmacological candidate contributing to combat hypoglycaemia unawareness in women with diabetes in the future.

Tartrate-resistant acid phosphatase (TRAP) as a serum marker for bone resorption in breast cancer patients with bone metastases.

BACKGROUND: A novel immunoassay specific for the osteoclast-produced tartrate-resistant acid phosphatase TRAP isoform 5b was developed some years ago. By means of this assay, the usefulness of serum TRAP in monitoring the response to palliative treatment with clodronate in breast cancer patients with bone metastases was studied. Serum TRAP was examined for correlation with the activity of bone osteoclasts in these patients. MATERIALS AND METHODS: Seventeen patients took part in this study taking 1600 mg clodronate daily as a tablet for five months. Eleven of these patients were evaluated. RESULTS: TRAP activity correlated well with the grade of bone metastases and with the number of locations in the body. During the therapy with clodronate, TRAP activity in serum decreased. CONCLUSIONS: We conclude that the measurement of TRAP is useful in monitoring treatment with bisphosphonate clodronate in patients with bone metastatic breast cancer.

Influence of hypo- and hyperglycaemia on plasma leptin concentrations in healthy women and in women with polycystic ovary syndrome.

BACKGROUND: Insulin resistance and obesity play an important role in the pathogenesis of polycystic ovary syndrome (PCOS). It is known that experimentally induced insulin resistance diminishes the stimulatory effect of insulin on leptin secretion. It is not yet known whether the long-term insulin resistance as found in PCOS patients alters the leptin response to hypo- and hyperglycaemia. METHODS: We induced hyper- and hypoglycaemia by glucose clamp technique in 7 patients with PCOS and 20 healthy controls. After a plasma glucose level of 8.8 mmol/l was reached, the plasma glucose level was reduced stepwise to 6.8, 4.8 and 2.8 mmol/l. RESULTS: The PCOS patients required lower glucose infusion rates to reach the glycaemic targets (P < 0.05). Serum insulin and C-peptide concentrations increased significantly during the clamp compared with the baseline in both groups (P < 0.001 for insulin, and P < 0.001, P < 0.005 for C-peptide control and PCOS, respectively) and increased significantly more in PCOS patients compared with the control group (both P < 0.05). Basal leptin levels were significantly higher in the PCOS group than in the control group (P = 0.005). In the controls, the leptin concentration increased significantly during the clamp (P < 0.001 for each glycaemic target), whereas in the PCOS group, leptin secretion increased only during hypoglycaemia (P = 0.04). CONCLUSIONS: Compared with the healthy controls, the response of leptin secretion to hyper- and hypoglycaemia was diminished in PCOS patients. Changes in leptin secretion seem not to be caused by hyper- and hypoglycaemia, but rather by hyperinsulinaemia. Reduced insulin sensitivity seems to be responsible for the diminished leptin response, which might contribute to the obesity found in PCOS patients.

[Induction of labour at term with misoprostol: an effective, safe and inexpensive alternative]. / Geburtseinleitung mit Misoprostol: eine effektive, sichere und kostengünstige Alternative.

Misoprostol is a prostaglandin E1 analogue marketed for use in the prevention of peptic ulcer disease. It is inexpensive and has few side-effects. Although not registered misoprostol has been widely used for obstetric and gynaecologic indications, such as induction of labour at term. In our clinic misoprostol has been use since April 15, 2003. The data of 70 women, who had been treated with misoprostol for induction of labour at term form April 15 to August 15, 2003, were analysed retrospectively and compared with the data of those women treated with dinoprostin in the same period 2002. The time to active labour was longer with dinoprostin compared to misoprostol (19.2 h vs. 15.5 h). Parity did not influence the time to active labour. The rate of cesarean sections was lower with misoprostol (17.2 vs. 25.8 %). The induction of labour with Misoprostol caused costs of 58.80 euro. If dinoprostin had been used, it would have cost 4 368.00 euro. Although not registered, misoprostol is a safe, effective and inexpensive alternative for induction of labour with few side-effects. However, patients accept the off-label use.

[The use of oral antidiabetic drugs in the treatment of polycystic ovary syndrome]. / Der Einsatz oraler Antidiabetika in der Behandlung des Polyzystischen Ovarsyndroms.

The polycystic ovary syndrome (PCOS) is the most common endocrinopathy in women of reproductive age. It is a complex metabolic-endocrine disorder with severe long-term health consequences like type 2 diabetes. The increased risk for cardiovascular diseases in women with PCOS is due to diabetes, adipositas and dyslipidemia. Insulin resistance plays a key role in the pathophysiology of this syndrome. This makes the use of oral antidiabetic drugs most compelling. The majority of studies have shown amelioration of the typical symptoms like hyperandrogenism and cycle irregularities. Ovulation and pregnancy rates increased. Furthermore these drugs might be cardioprotective by improving insulin sensitivity and reduce the risk for type 2 diabetes. This article reviews the use of different oral antidiabetic drugs in the treatment of PCOS and their influence on fertility, the risk for type 2 diabetes and cardiovascular diseases.

[Pulmonary function parameters of shock lung patients--results of a follow-up study]. / Pulmonale Funktionsparameter von Schocklungenpatienten--Ergebnisse einer Spätuntersuchung.

In seventeen patients out of a total of 219 survivors who had received long-term ventilation for pulmonary failure, an examination was carried out to clarify the question as to late pulmonary sequelae. The following sequelae were detected: 1. a diffusion disturbance in five cases, 2. load-dependent pulmonary hypertension in four cases, and 3. a considerable reduction in compliance.