Probing the Pairing Interaction and Multiple Bardasis-Schrieffer Modes Using Raman Spectroscopy.

In unconventional superconductors, understanding the form of the pairing interaction is the primary goal. In this regard, Raman spectroscopy is a very useful tool, as it identifies the ground state and also the subleading pairing channels by probing collective modes. Here, we propose a general theory for a multiband Raman response and identify new features in the spectrum that can provide a robust test for a pairing theory. We identify multiple Bardasis-Schrieffer type collective modes and connect the weights of these modes to the subleading gap structures within a microscopic pairing theory. While our conclusions are completely general, we apply our approach to interpret the specific case of B_{1g} Raman scattering in hole-doped BaFe_{2}As_{2}.

Raman-scattering detection of nearly degenerate s-wave and d-wave pairing channels in iron-based Ba0.6K0.4Fe2As2 and Rb0.8Fe1.6Se2 superconductors.

We show that electronic Raman scattering affords a window into the essential properties of the pairing potential V(k,k') of iron-based superconductors. In Ba0.6K0.4Fe2As2 we observe band dependent energy gaps along with excitonic Bardasis-Schrieffer modes characterizing, respectively, the dominant and subdominant pairing channel. The d(x(2)-y(2)) symmetry of all excitons allows us to identify the subdominant channel to originate from the interaction between the electron bands. Consequently, the dominant channel driving superconductivity results from the interaction between the electron and hole bands and has the full lattice symmetry. The results in Rb(0.8)Fe(1.6)Se(2) along with earlier ones in Ba(Fe(0.939)Co(0.061))(2)As(2) highlight the influence of the Fermi surface topology on the pairing interactions.

[Combined implantation of monofocal and multifocal intraocular lenses for presbyopia correction in cataract patients]. / Kombinierte Implantation einer Mono- und einer Multifokallinse zur Presbyopiekorrektur bei Kataraktpatienten.

BACKGROUND: The purpose of this study was to assess uncorrected far and near vision after implantation of a multifocal intraocular lens (IOL) in the second eye in patients with a unilateral monofocal IOL. PATIENTS AND METHODS: 13 cataract patients with a monofocal intraocular lens in one eye (SA60AT, Alcon) and postoperative emmetropia received a multifocal lens in the second eye (ReSTOR, Alcon). Two and six months postoperatively the clinical examination, far and near vision, near aniseikonia (AWAYA-New Aniseikonia Test), stereo vision (Lang I test) and the mesopic contrast sensitivity (F. A. C.T) were tested. In addition, the grade of satisfaction without glasses in general, and with far and near vision were noted on a visual analogue scale (0 - 10). Furthermore, independence from glasses and the presence of optical phenomena were assessed. RESULTS: The mean uncorrected far visual acuity 6 months postoperatively was 1.06 +/- 0.28 for the monofocal lens, 0.88 +/- 0.23 for the multifocal lens, and 1.16 +/- 0.24 binocularly. The uncorrected near visual acuity was Nieden 1 binocularly for all patients and ranged from Nieden 1 - 3 for the multifocal lens to Nieden 2 - 11 for the monofocal lens. 77% of the patients received the multifocal lens in their far dominant eye. The mean uncorrected near aniseikonia was < 1%. The mesopic contrast sensitivity showed no significant differences between the two IOL types and compared to binocular values. The satisfaction with the uncorrected visual acuity was in general 8.88 +/- 1.21, with the far visual acuity 9.42 +/- 1.24, and 7.33 +/- 1.72 with the near visual acuity. After 6 months 67% of the patients used glasses only for periods of prolonged reading. Halos and a low degree of glare were noted by 38.5% of patients 2 months postoperatively. At the 6 months visit 33.3% still had halos and only 8% glare. CONCLUSIONS: This first experience with the combined implantation of a monofocal and a multifocal lens revealed a marked improvement of the uncorrected near visual acuity compared to bilateral monofocal IOL implantation along with a high patient satisfaction.

Trochleaplasty for recurrent patellar dislocation in association with trochlear dysplasia. A 4- to 14-year follow-up study.

We investigated the clinical and radiological outcome of trochleaplasty for recurrent patellar dislocation in association with trochlear dysplasia in 38 consecutive patients (45 knees) with a mean follow-up of 8.3 years (4 to 14). None had recurrence of dislocation after trochleaplasty. Post-operatively, patellofemoral pain, present pre-operatively in only 35 knees, became worse in 15 (33.4%), remained unchanged in four (8.8%) and improved in 22 (49%). Four knees which had no pain pre-operatively (8.8%) continued to have no pain. A total of 33 knees were available for radiological assessment. Post-operatively, all but two knees (93.9%) had correction of trochlear dysplasia radiologically but degenerative changes of the patellofemoral joint developed in 30% (10) of the knees. We conclude that recurrent patellar dislocation associated with trochlear dysplasia can be treated successfully by trochleaplasty, but the impact on patellofemoral pain and the development of patellofemoral osteoarthritis is less predictable. Overall, subjective patient satisfaction with restored patellofemoral stability after trochleaplasty appeared to outweigh its possible sequelae.

[Optical quality of the cornea following incisional correction of astigmatism]. / Optische Qualität der Hornhaut nach inzisionaler Astigmatismuskorrektur.

BACKGROUND: Unilateral lamellar keratotomy (LKT) and curved dual lamellar keratotomy (BLK) were compared to evaluate the influence of incisional correction of astigmatism on the optical quality of the cornea. PATIENTS AND METHODS: Forty-six patients with a preoperative astigmatism greater than 1.5 D were studied. LKT was performed on 30 eyes during cataract surgery and 20 eyes were treated with a BLK. Preoperatively and 4 weeks after surgery the corneal topographical data were analyzed with ray tracing in a 3-mm optical zone. The potential visual acuity (PVA) and the optical distortion (OD), which is represented by the width of the point spread in the optical center, were calculated as parameters for the optical quality. RESULTS: The mean surgically induced astigmatism was 2.6+/-1.5 D for the LKT group and 3.5+/-1.4 D for the BLK group. The PVA decreased significantly in the LKT group from 1.2+/-0.2 to 1.0+/-0.3 (p=0.008), whereas in the BLK group the PVA remained unchanged (p=0.916). The OD increased from 6.6+/-0.9 microm to 7.9+/-2.0 microm (p=0.007) in the LKT group. In the BLK group the values were stable (p=0.843). CONCLUSIONS: The optical quality of the cornea decreased after unilateral keratotomy in the early postoperative period. Thus, optical quality values should also be considered in incisional correction of astigmatism.

Characteristics of P2X7 receptors from human B lymphocytes expressed in Xenopus oocytes.

Human B lymphocytes express an ATP-gated ion channel (P2Z receptor), which shares similarities with the recently identified P2X7 receptor. Using gene specific primers, we have now isolated P2X7 cDNA from the total RNA of human B lymphocytes. This hP2X7 receptor subtype was expressed in Xenopus oocytes and electrophysiologically characterized. The hP2X7 receptor is similar to, but does not completely match, P2Z of human B cells. The hP2X7 receptors resemble the P2Z receptors with regard to the ATP concentration of half maximal activation, reproducibility, permeation characteristics and lack of desensitization of the ATP-evoked currents. However, in contrast to the native lymphocytic P2Z receptor, the time course of activation of hP2X7 displayed an additional linearly increasing current component. Furthermore, a second, small and slowly deactivating current component exists only in hP2X7 expressed in oocytes. The activation and deactivation kinetics as well as permeation characteristics of hP2X7 are different from rat P2X7 recently expressed in oocytes. Unlike in mammalian cells, hP2X7 expressed in Xenopus oocytes is not sufficient to induce large non-selective pores.

The effect of ambient pressure on well chamber response: experimental results with empirical correction factors.

For some air-communicating well-type chambers used for low-energy brachytherapy source assay, deviations from expected values of measured air kerma strength were observed at low pressures associated with high altitudes. This effect is consistent with an overcompensation by the air density correction to standard atmospheric temperature and pressure (P(TP)). This work demonstrates that the P(TP) correction does not fully compensate for the high altitude pressure effects that are seen with air-communicating chambers at low photon energies in the range of 20-100 keV. Deviations of up to 18% at a pressure corresponding to an approximate elevation of 8500 ft for photon energies of 20 keV are possible. For high-energy photons and for high-energy beta emitters in air-communicating chambers the P(TP) factor is applicable. As expected, the ambient pressure does not significantly affect the response of pressurized well chambers (within 1%) to either low- or high-energy photons. However, when used with beta emitters, pressurized chambers appear to exhibit a slight dependence on the ambient pressure. Using measured data, the response and correction factors were determined for three models of air-communicating well chambers for low-energy photon sources at various pressures corresponding to elevations above sea level. Monte Carlo calculations were also performed which were correlated with the experimental findings. A more complete study of the Monte Carlo calculations is presented in the accompanying paper, "The effect of ambient pressure on well chamber response: Monte Carlo calculated results for the HDR1000 Plus."

Additional value of electrical impedance scanning: experience of 240 histologically-proven breast lesions.

The aim of this study was to quantify the clinical value of using electrical impedance scanning (EIS) as an adjunct to other diagnostic techniques in order to identify cancerous tissue based upon its inherent altered local dielectric properties. 210 consecutive women with 240 sonographically and/or mammographically suspicious findings were examined using EIS. All lesions were histologically-proven. 86/103 malignant and 91/137 benign lesions were correctly identified using EIS (87.8% sensitivity, 66.4% specificity). NPV and PPV of 84.3% and 65.2% were observed, respectively. Excluding cases as defined by a priori criteria, i.e. lesions located deeper than 35 mm, lesions larger than 35 mm, and retroareolar lesions, a sensitivity of 85.5% was observed, and for invasive cancers, 91.7%. The detection rate for ductal carcinoma in situ (DCIS) was poor (57.1%, n=14). By adding EIS to mammography and ultrasound, the sensitivity rose from 86.4 to 95.1%, whereas the accuracy decreased from 82.3 to 75.7%. EIS appears to be of interest as an adjunct to breast diagnostic techniques, performing with a reasonable sensitivity. Further investigations on histomorphological characteristics and the reasons for false-negative findings are essential to gain further knowledge about the bioelectricity of breast lesions, and prove the value of this new technology.

Saline-enhanced radiofrequency ablation of breast tissue: an in vitro feasibility study.

RATIONALE AND OBJECTIVES: The feasibility of radiofrequency (RF) ablation for the treatment of breast tumors was investigated in vitro. The best parameters for ablation of breast tissue were chosen. METHODS: Saline-enhanced RF ablation was performed in human breast tissue specimens and cow udder tissue. Temperature profiles were measured depending on RF power (20, 28, 36 W) and NaCl infusion rate (15, 30, 60 mL/h) using eight thermocouples. Lesion development was monitored by ultrasound. Thermolysis efficiency was measured by tissue weight determinations before and after ablation. RESULTS: After RF ablation of tissue samples, 73.6% turned into a fat/saline emulsion. Ultrasound monitoring showed a cone-shaped hyperechoic area during the first 2 minutes of RF ablation, followed by an irregular expansion of the area. Time-dependent spatial temperature curves were more homogeneous at low infusion rates (15 mL/h). Peak temperatures up to 160 degrees C were measured. CONCLUSIONS: Controlled RF ablation of breast tissue is feasible. The irregular expansion of RF lesions in fatty breast tissue is due to liquefied fat. Low saline interstitial infusion rates result in better control of lesioning.

Risk of bacteremia induced by transesophageal echocardiography: analysis of 100 consecutive procedures.

The incidence of bacteremia induced by transesophageal echocardiography (TEE) and, consequently, the need for an antibiotic prophylaxis before TEE is still controversial. Therefore, we studied the incidence of bacteremia associated with TEE prospectively in 100 consecutive patients without clinical or laboratory signs of bacterial infection. Blood samples were drawn immediately before and at 0, 5, and 15 minutes after TEE. In addition, swabs were taken from the pharyngeal region before TEE and from the distal part of the TEE-probe before and after TEE. All blood cultures taken before TEE remained sterile. After TEE, three positive blood cultures were found in two patients: the first patient had two different species of coagulase-negative staphylococci in cultures taken at 0 minutes (Staphylococcus capitis) and 15 minutes (Staphylococcus cohnii) after TEE, whereas the sample taken after 5 minutes remained sterile. In the second patient, Propionibacterium species appeared after 7 days of processing in a culture taken immediately after TEE, but not in the samples taken after 5 and 15 minutes. None of the three microorganisms found in the blood were simultaneously isolated in pharyngeal specimens or TEE-probe specimens of the same patient. Thus positive blood cultures in both patients were considered contaminated. This study demonstrates that TEE, when performed by an experienced investigator, is not associated with an increased risk of bacteremia. Accordingly, it is justified to perform TEE examinations (also in high-risk patients) without antibiotic prophylaxis.

Dose rate table for a 32P intravascular brachytherapy source from Monte Carlo calculations.

Studies of intravascular brachytherapy to prevent restenosis following angioplasty have shown many promising results. Accurate dose rate tables based on detailed models of the brachytherapy sources are necessary for treatment planning. This work will present an away and along dose rate table for a 27 mm long catheter based 32P beta source. MD-55-2 radiochromic film has been exposed at five different depths (0.5 mm-4 mm) in a polystyrene phantom using a 27 mm long Guidant 32P beta source. The total dose to the active region of the film was determined using the absolute detector response of the MD-55-2 radiochromic film. The Monte Carlo code MCNP4B2 was also used to calculate the dose to the active region of the film using a detailed model of the source, encapsulation, and radiochromic film. The dose to film calculations showed good agreement with the measurements presented in this work with an average difference of 7%. The Monte Carlo calculations were also verified against previously published depth dose in water measurements determined using radiochromic film and plastic scintillator. The depth dose calculations in water showed good agreement with the previously published measurements with the calculations being about 2.5% lower than the film measurements and about 2.5% higher than the scintillator measurements. This work then uses the verified Monte Carlo code to present a dose rate table for the 32P intravascular beta source.

Measurements and Monte Carlo calculations to determine the absolute detector response of radiochromic film for brachytherapy dosimetry.

GafChromic (MD-55-2) radiochromic film has become increasingly popular for medical applications and has proven to be useful for brachytherapy dosimetry. To measure the absolute dose near a brachytherapy source, the response of the proposed detector in the measurement conditions relative to the response of the detector in calibration conditions must be known. MD-55-2 radiochromic film has been exposed in four different photon beams, a 30 and 40 kVp tungsten anode x-ray beam, a 75 kVp orthovoltage therapy beam, and a 60Co teletherapy beam to measure the relative detector response. These measurements were combined with coupled photon/electron Monte Carlo transport calculations to determine the absolute detector response. The Los Alamos National Laboratory Monte Carlo transport code MCNP4B2 was used. The measured relative response of this batch of MD-55-2 film varies from 8.79 mOD/Gy, measured for the 60Co beam, by as much as 42% for the low-energy x-ray beams. However, the absolute detector response varies from 4.32 mOD/Gy for the 60Co beam by, at most, only 6.3%. In this work we demonstrate that the absolute detector response of MD-55-2 radiochromic film is a constant and independent of beam quality. Further, this work shows that MCNP4B2 accurately simulates the energy response and geometry artifacts of the radiochromic film.

Monte Carlo calculations to characterize the source for neutron therapy facilities.

Modern radiation treatment planning for photons includes full 3D modeling of the adsorbed dose distribution, accurate inclusion of the patient anatomy, and consideration of significant changes in material density and composition. Such efforts are founded in an accurate description of the radiation source and the beam delivery system. Modern fast neutron therapy facilities employ highly penetrating beams and isocentric beam delivery. Treatment planning is largely based on analytic models adapted from photon codes and interaction cross sections normalized to macroscopic attenuation. However, the recent PEREGRINE initiative at Lawrence Livermore Laboratory offers the possibility of fully stochastic modeling if the neutron source can be adequately described. In this article we report neutron source modeling of three high energy facilities. Neutron production is based on the intra-nuclear cascade model of the LAHET code while neutron transport through the beam delivery system is managed by MCNP using cross section libraries extended to 100 MeV neutron energy. PEREGRINE is then used to transport the neutron beam through typical phantoms. The resulting neutron sources are in excellent agreement with the limited experimental information and the measured phantom data are well described by the PEREGRINE transport using the LAHET/MCNP determined neutron sources.

Reproducibility--an important factor determining the quality of computer-aided detection (CAD) systems.

PURPOSE: To test the reproducibility of markings on mammography films set by a commercial computer aided detection (CAD) system. PATIENTS AND METHODS: One hundred unilateral mammography examinations (each in CC and MLO) of 100 patients with mammographically detected suspicious foci, which were histopathologically proven to be malignant, were scanned three times with the CAD system, retrospectively. Every fifth patient of the institutional tumor case sampler was enrolled in the study. Only cases with one visible lesion were included in the study. Reproducibility and sensitivity (in both the strict and the broader sense) were determined. Strict sensitivity means the correct set of markers in both images, whereas broader sensitivity means the correct set in at least one of the images. Sixteen of 100 malignancies were indicated by focal suspicious microcalcification clusters, 53 tumors by masses and 31 cases by both signs of breast cancer. The CAD evaluation was divided into only two different markers: one for microcalcifications and one for masses. Thus, 47 (16+31) tumor-induced microcalcifications and 84 (53+31) malignancy-related masses were checked using the CAD system. RESULTS: Eighteen of 100 unilateral mammography examinations revealed identical patterns in all three scans (18% reproducibility). Eleven of 47 suspicious focal microcalcification clusters and 43/84 masses were correctly marked on both mammographic views in all three CAD scans (strict and broader sensitivity, 23.4 and 51.1%, respectively). Six of 47 microcalcification clusters and 8/84 masses were totally missed in all images by the system (false negative rate, 12.8 and 9.6%, respectively). CONCLUSION: Reproducibility is essential for CAD systems. Currently, reproducibility of the used CAD system appears to be insufficient for clinical routine. Improvement of the system characteristics would make such systems valuable as a 'second reader' in clinical examination.

The difficult freedom from a plan.

The author attempts to describe a tendency among analysts in connection with presenting clinical material to become either too dogmatic or too insecure, either idealising knowledge or uncertainty. Both extremes may also mean idealising intellectualisation. Instead, the author suggests that these tendencies arise as a reaction towards complex psychological strategies from the patient, and that these strategies need to become clarified, instead of the analyst intervening prematurely with the mentioned extreme tendencies. In order to do so, the analyst needs to be free from inner automatic programmes. Two clinical vignettes are described where the analyst's own repression plays a part in his interventions. Freud's technical papers are analysed concerning frame factors and technical recommendations and the author shows how Freud's classical technique is modern in its emphasis on freedom and preliminary truth in interpretations. Freud's papers also seem to agree with Bion's motto 'without memory or desire', which the author discusses as the freedom from a programme. He recommends three governing mottoes for the area of interventions, in order not to idealise the image of psychoanalysis and psychoanalysts. He concludes with a third clinical vignette that underlines the connection between classical analysis and modern analysts who emphasise the freedom from idealised programmes within the psychoanalytic frame.

Turning points and change in psychoanalysis.

The turning point is defined as the sudden change of quality that plays the part of a forerunner or prerequisite to the slow structural change in psychoanalytic treatment. Turning points have two common elements, confrontation and surprise, that lead to the centre of the turning point experience -- the feeling of having an inner life--which leads up to the interpretive working through process that corresponds to structural change. To restore or create the feeling of having an inner life runs parallel to restoring the psychoanalytic process from acting-out temptations. Harold Stewart's agents of change are discussed as having the characteristics of turning points and clinical vignettes are described to show the main points. Finally, the countertransference aspect of allowing turning points to happen is discussed.

[Calcium antagonists and ischemic heart disease]. / Kalcium-antagonisták és ischaemiás szívbetegség.

The authors give a short account about the significance, basic rules in regulation of intracellular (cytosolic) calcium homeostasis, distribution of calcium channels in different organs and characteristics of L channels in cardiovascular system. The different types of calcium channel blockers (dihydropyridines, phenylalkilamines, benzothiazepines), their similarities, dissimilarities (cardio, -vascular selectivity) are discussed. Differences in calcium homeostasis, in sympathetic innervation between vascular smooth- and heart muscle in briefly disputed. The basic role of endothel cell dysfunction in development of ischemic heart disease, the possible mechanisms (potential anti-remodeling, antifissuring, antiischemic, cardioprotective, sympaticolytic effects) of different calcium antagonists in the treatment of patients with ischemic heart disease are reviewed. Potential adverse effects of calcium channel blockers (proischemic, proarrhythmic, procongestive, prohaemorrhagic effects) are also mentioned. Finally the up-date preventive and therapeutic indications of different calcium channel blockers in the clinical management of patients with stable, unstable angina pectoris, silent myocardial ischemia, vasospastic angina, acute myocardial infarction is shortly reported.

Event-related potential correlates of sound organization: early sensory and late cognitive effects.

We tested whether incoming sounds are processed differently depending on how the preceding sound sequence has been interpreted by the brain. Sequences of a regularly repeating three-tone pattern, the perceived organization of which spontaneously switched back and forth between two alternative interpretations, were delivered to listeners. Occasionally, a regular tone was exchanged for a slightly or moderately lower one (deviants). The electroencephalogram (EEG) was recorded while listeners continuously marked their perception of the sound sequence. We found that for both the regular and the deviant tones, the early exogenous P1 and N1 amplitudes varied together with the perceived sound organization. Percept-dependent effects on the late endogenous N2 and P3a amplitudes were only found for deviant tones. These results suggest that the perceived sound organization affects sound processing both by modulating what information is extracted from incoming sounds as well as by influencing how deviant sound events are evaluated for further processing.