Extraction of Beam-Spin Asymmetries from the Hard Exclusive π

We have measured beam-spin asymmetries to extract the sinϕ moment A_{LU}^{sinϕ} from the hard exclusive e[over →]p→e^{'}nπ^{+} reaction above the resonance region, for the first time with nearly full coverage from forward to backward angles in the center of mass. The A_{LU}^{sinϕ} moment has been measured up to 6.6 GeV^{2} in -t, covering the kinematic regimes of generalized parton distributions (GPD) and baryon-to-meson transition distribution amplitudes (TDA) at the same time. The experimental results in very forward kinematics demonstrate the sensitivity to chiral-odd and chiral-even GPDs. In very backward kinematics where the TDA framework is applicable, we found A_{LU}^{sinϕ} to be negative, while a sign change was observed near 90° in the center of mass. The unique results presented in this Letter will provide critical constraints to establish reaction mechanisms that can help to further develop the GPD and TDA frameworks.

Cirrhotic cardiomyopathy: the liver affects the heart.

Cirrhotic cardiomyopathy historically has been confused as alcoholic cardiomyopathy. The key points for diagnosis of cirrhotic cardiomyopathy have been well explained, however this entity was neglected for a long time. Nowadays the diagnosis of this entity has become important because it is a factor that contributes significantly to morbidity-mortality in cirrhotic patients. Characteristics of cirrhotic cardiomyopathy are a hyperdynamic circulatory state, altered diastolic relaxation, impaired contractility, and electrophysiological abnormalities, particularity QT interval prolongation. The pathogenesis includes impaired function of beta-receptors, altered transmembrane currents and overproduction of cardiodepressant factors, such as nitric oxide, cytokines and endogenous cannabinoids. In addition to physical signs of hyperdynamic state and heart failure under stress conditions, the diagnosis can be done with dosage of serum markers, electrocardiography, echocardiography and magnetic resonance. The treatment is mainly supportive, but orthotopic liver transplantation appears to improve this condition although the prognosis of liver transplantation in patients with cirrhotic cardiomyopathy is uncertain.

Cirrhotic cardiomyopathy: the liver affects the heart

Cirrhotic cardiomyopathy historically has been confused as alcoholic cardiomyopathy. The key points for diagnosis of cirrhotic cardiomyopathy have been well explained, however this entity was neglected for a long time. Nowadays the diagnosis of this entity has become important because it is a factor that contributes significantly to morbidity-mortality in cirrhotic patients. Characteristics of cirrhotic cardiomyopathy are a hyperdynamic circulatory state, altered diastolic relaxation, impaired contractility, and electrophysiological abnormalities, particularity QT interval prolongation. The pathogenesis includes impaired function of beta-receptors, altered transmembrane currents and overproduction of cardiodepressant factors, such as nitric oxide, cytokines and endogenous cannabinoids. In addition to physical signs of hyperdynamic state and heart failure under stress conditions, the diagnosis can be done with dosage of serum markers, electrocardiography, echocardiography and magnetic resonance. The treatment is mainly supportive, but orthotopic liver transplantation appears to improve this condition although the prognosis of liver transplantation in patients with cirrhotic cardiomyopathy is uncertain.

Acute phase proteins disturbances indicate uncompensated obesity declining physical fitness.

OBJECTIVE: The correlation between physical fitness and health indicators still requires a research aimed at improving the knowledge about physical fitness and the impact of obesity on the health status in children and adolescents. The aim of this study is an analysis of the results of the EUROFIT battery tests in relation to routine laboratory parameters and the inflammation markers. PATIENTS AND METHODS: In the group of 123 Polish adolescents the routine parameters of lipid metabolism and acute phase proteins were investigated, and compared with EUROFIT motor fitness tests results, expressed as percentiles of the results achieved by healthy Polish population. RESULTS: Most of the EUROFIT tests battery were performed by overweight adolescent girls on an insufficient level. Children who were described by parameters indicating more advanced obesity performed the EUROFIT tests worse. There was showed a negative correlation between the concentration of HDL cholesterol and the long jump (rho=-0.304) as well as with the speed of limb movement (rho=-0.277). There was a positive correlation between the speed of limb movement and the concentration of triglycerides (rho=0.335), LDL cholesterol (rho=0.305) and the percentage of the A4 (rho=0.239). CONCLUSIONS: Disturbed lipid parameters, as well as altered glycosylation profiles of acute phase proteins, were observed in all overweight children, and the intensity of alterations correlated with worse fitness.

Complications of untreated and ineffectively treated neurogenic bladder dysfunctions in children: our own practical classification.

The neurogenic dysfunctions of the detrusor and the sphincter are caused by either a known congenital defect of the nervous system or by acquired damage to the nervous system. In patients with idiopathic bladder dysfunctions neurological examinations fail to reveal any pathology in the nervous system. The treatment strategy for the patient with detrusor-sphincter dysfunction should be based on a comprehensive functional and morphological evaluation. Clean Intermittent Catheterization is mandatory if voiding is ineffective. Reduced bladder capacity related to detrusor overactivity and decreased bladder walls compliance is successfully managed conservatively with oral anticholinergics. Conservative treatment prevents complications in the majority of patients. However, despite proper conservative treatment, some patients still develop complications. We propose our own practical classification of complications characteristic for the bladder and sphincter dysfunctions: 1. Urinary tract infections; 2. Urolithiasis; 3. Anatomic changes in the lower urinary tract; 4. Anatomic changes in the upper urinary tract; 5. Functional disturbances of kidneys parenchyma; 6. Urinary incontinence. Proposed practical classification of complications of bladder and sphincter dysfunctions is clear and simple. This classification can be used both in children with neurogenic and non-neurogenic dysfunctions. It is helpful in planning follow-up procedures and evaluation of treatment results.

Amorphous Ge quantum dots embedded in crystalline Si: ab initio results.

We study amorphous Ge quantum dots embedded in a crystalline Si matrix through structure modeling and simulation using ab initio density functional theory including spin-orbit interaction and quasiparticle effects. Three models are generated by replacing a spherical region within diamond Si by Ge atoms and creating a disordered bond network with appropriate density inside the Ge quantum dot. After total-energy optimisations of the atomic geometry we compute the electronic and optical properties. We find three major effects: (i) the resulting nanostructures adopt a type-I heterostructure character; (ii) the lowest optical transitions occur only within the Ge quantum dots, and do not involve or cross the Ge-Si interface. (iii) for larger amorphous Ge quantum dots, with diameters of about 2.0 and 2.7 nm, absorption peaks appear in the mid-infrared spectral region. These are promising candidates for intense luminescence at photon energies below the gap energy of bulk Ge.

Human BRCA1-associated breast cancer: no increase in numerical chromosomal instability compared to sporadic tumors.

BRCA1 is a major gatekeeper of genomic stability. Acting in multiple central processes like double-strand break repair, centrosome replication, and checkpoint control, BRCA1 participates in maintaining genomic integrity and protects the cell against genomic instability. Chromosomal instability (CIN) as part of genomic instability is an inherent characteristic of most solid tumors and is also involved in breast cancer development. In this study, we determined the extent of CIN in 32 breast cancer tumors of women with a BRCA1 germline mutation compared to 62 unselected breast cancers. We applied fluorescence in situ hybridization (FISH) with centromere-specific probes for the chromosomes 1, 7, 8, 10, 17, and X and locus-specific probes for 3q27 (BCL6), 5p15.2 (D5S23), 5q31 (EGR1), 10q23.3 (PTEN), and 14q32 (IGH@) on formalin-fixed paraffin-embedded tissue microarray sections. Our hypothesis of an increased level of CIN in BRCA1-associated breast cancer could not be confirmed by this approach. Surprisingly, we detected no significant difference in the extent of CIN in BRCA1-mutated versus sporadic tumors. The only exception was the CIN value for chromosome 1. Here, the extent of CIN was slightly higher in the group of sporadic tumors.

Influence of SiO2 matrix on electronic and optical properties of Si nanocrystals.

Based on ab initio density functional theory we present electronic properties and the optical response for Si nanocrystals embedded in amorphous SiO(2) networks. Quasi-spherical dots with diameters from 0.8 to 1.6 nm are investigated. The results for Si nanocrystals embedded in SiO(2) are compared with corresponding results for hydrogenated Si nanocrystals of the same size. The calculations show the influence of the interface between nanocrystal and matrix on the electronic properties. The results are compared with recent experimental data and discussed in detail. As striking features, strong reductions of the gaps and their diameter variation are predicted due to the oxide presence. Electronic confinement mainly influences the absorption edge while at higher photon energies only broad peaks at almost fixed positions occur.

[Anatomical and functional results after macular hole surgery]. / Anatomische und funktionelle Ergebnisse nach Makulaforamenchirurgie.

BACKGROUND: In a retrospective study we examined the anatomical and functional effects of a combined macular hole surgery with and without the application of indocyanin green (ICG) as well as phacoemulsification. METHODS AND PATIENTS: Out of 91 patients (91 eyes) with idiopatic macular holes 82 eyes were phacic. 25 cases received during the first surgery a combined pars plana vitrectomy with phacoemulsification. In 46 eyes the vitrectomy and consecutive peeling of the inner limiting membrane (ILM) was performed without ICG (Group A), in 45 eyes with ICG-assisted staining of the ILM (Group B). The average follow-up time was 19 months (12 - 24 months). RESULTS: The primary closure rate was 82.4 % and 94.5 % after reoperation. In Group A there were primarily 76 % and at the end 89.1 % closed results compared with 88.9 % and 100 % in group 2 (p = 0.172). Five persisting holes had a preoperative diameter above 600 microm (p = 0.014). Visual acuity improved in Group A preoperatively from 0.17 to postoperatively 0.33 and in Group B from 0.22 to postoperatively 0.38. The difference between both groups was not significant (p = 0.106). From 82 phacic eyes 25 were treated by a combined vitrectomy with phacoemulsification, 23 eyes received later a phacoemulsification while 34 remained phacic. DISCUSSION: Peeling of the ILM was complete after staining with ICG resulting in an increased closure rate. The functional results between both groups did not differ significantly. Phacic eyes may keep their clear lens even after multiple surgeries.

[Advantages and disadvantages of the circumferential retinal cryocoagulation before vitrectomy in proliferative diabetic vitreoretinopathy]. / Adjuvante zirkuläre Netzhautkryokoagulation bei proliferativer diabetischer Vitreoretinopathie--vor oder während der Vitrektomie?

BACKGROUND: It is unclear if a circumferential cryocoagulation 4 weeks before pars plana vitrectomy is useful for reducing the risks of surgery such as retinal detachment, secondary glaucomas or rebleeding. Otherwise it seems possible that this surgery itself, done in local anaesthesia, could be an additional risk. PATIENTS AND METHODS: We retrospectively evaluated the reports of all patients who underwent vitrectomy as primary surgery due to proliferative diabetic vitreoretinopathy between 1997 and 2000. Besides age and sex, all additional surgery (like phacoemulsification, endolaser coagulation, kind of tamponade etc.) and all intra- or postoperative complications were reported after a follow-up of at least 3 months. We created and compared 2 groups of patients, showing in group 1 patients who underwent vitrectomy 4 weeks after cryocoagulation and in group 2 patients undergoing vitrectomy combined with circumferential cryocoagulation. RESULTS: We evaluated the reports of 226 patients (103 men, 123 women, mean age 58.6 +/- 13.0 years). Follow-up was in the mean 16.3 months. Group 1 contained 150 patients (66.4 %), group 2 76 patients (33.6 %). 63.7 % received air as endotamponade, 8.0 % C(2)F(6) gas, 7.1 % silicon oil and 21.2 % BSS, 34.1 % were operated in combination with phakoemulsification. We observed 9 postoperative retinal detachments (4.0 %), with no significant difference between the two groups (6 detachments in group 1, 2 detachments in group 2). For other surgical risks like rebleeding, rubeosis iridis, secondary glaucoma etc. we also found no statistically significant differences. CONCLUSION: Circumferential retinal cryocoagulation is a useful preparation before pars plana vitrectomy, when done due to vitreous haemorrhage, because improved resorption lowers the vitrectomy rate. In all other cases it can be done during vitrectomy. Adjuvant circumferential cryocoagulation seems to decrease the risk of postoperative retinal detachments and rebleedings as documented in literature comparison.

Evidence-based therapy of diabetic retinopathy.

INTRODUCTION: Evidence-based medicine is often misunderstood as 'cookbook medicine with standard recipes' that does not take clinical experience into account. It is, however, supposed to be a basis for decision making in caring for individual patients under consideration of patients' preferences. This seems to be very important, since diabetic retinopathy continues to be the most frequent cause of vision loss in working age adults with negative consequences for patients' quality of life and for health economics. MATERIALS AND METHODS: The most important evidence-based therapy for diabetic retinopathy and maculopathy is laser coagulation. Vitrectomy for proliferative stages has also been proven effective by clinical studies. For more recent treatment options like triamcinolone injection and vitrectomy for diabetic macular edema there is a lower level of evidence so far. RESULTS: The Diabetic Retinopathy Study was the first to show the effectiveness of panfundus laser coagulation for a larger group of patients. The Early Treatment Diabetic Retinopathy Study in turn serves as a basis for laser coagulation of retinopathy and maculopathy. The Diabetic Retinopathy Vitrectomy Study could show the advantages of timely vitrectomy. Both the Diabetes Control and Complications Trial and the United Kingdom Prospective Diabetes Study could show the value of intensive blood glucose control. DISCUSSION: Evidence-based medicine on the basis of the studies mentioned above is practiced quite self-evidently in ophthalmo-diabetology. It should be regarded as a helpful tool for special therapeutic situations which still leaves room for one's personal clinical experience to be included. It is somewhat problematic that the term evidence-based medicine seems to be restricted to the results of large randomized studies, because even special problems and very individual, difficult therapeutic questions can be placed on an evidence-based foundation, although at a lower level of evidence, using today's modern means of literature research.

[Influence of vital dyes on the function of the outer blood-retinal barrier in vitro]. / Einfluss von Vitalfarbstoffen auf die Funktion der äusseren Blut-Retina-Schranke in vitro.

BACKGROUND: The use of vital dyes in "chromovitrectomy" allows the easier removal of less recognizable structures like epiretinal membranes (EM) or the inner limiting membrane (ILM). In recent years numerous studies demonstrated the use of indocyanine green (ICG), trypan blue (TB) and patent blue (PB) for this indication. Reports of the possible risk of these dyes, i. e. especially ICG, in respect of reduced visual acuity results, possible visual field defects or alterations of the retinal pigment epithelium (RPE) resulted in limitations in their application. MATERIAL AND METHODS: Human RPE cells and choroidal endothelial cells were cultured in monolayers on semipermeable membranes representing an in vitro model of the outer blood-retinal barrier. By measurement of the transepithelial electrical resistance (TER) the stable barrier function was determined. Two different models representing an air-filled and a fluid-filled eye were tested on the one hand by addition of the dye to the culture medium and, on the other, by direct application on the cell monolayer. In these two models ICG (5 mg/ml, 0.5 mg/ml, 0.125 mg/ml), TB (1.5 mg/ml, 0.15 mg/ml) and PB (2.4 mg/ml, 0.24 mg/ml) were applied for three minutes and the influence on the barrier function was determined. RPE cell growth was also tested in these two models after the application of ICG, TB and PB. Finally, monolayers of RPE cells were evaluated by transmission electron microscopy (TEM). RESULTS: After application of TB, PB and the lowest concentration of ICG of 0.125 mg/ml, the TER remained stable in both models. In contrast, ICG in a concentration of 5 mg/ml and 0.5 mg/ml caused a significant TER decrease in the model of the air-filled eye, whereas no influence on the function of the outer blood-retinal barrier was noted in the model of the fluid-filled eye. RPE cell growth rates were not influenced by the addition of the vital dyes, with the exception of ICG in a concentration of 5 mg/ml in the model of the air-filled eye, resulting in a temporary reduction of the cell count. In good correspondence to these results also in TEM intercellular blisters were noted after application of 5 mg/mL ICG for 3 minutes in the model of the air-filled eye. However, damage to the RPE cells themselves was not obvious. No pathological changes in the TEM were noted after application of TB and PB. CONCLUSIONS: The use of PB and TB at the posterior eye segment seems to be safe concerning damage to the PRE and its barrier function. In contrast, ICG in higher concentrations and with longer application times may cause a toxic effect on RPE morphology and function.

[Subjective decrease of visual acuity after photodynamic therapy: documentation by optical coherence tomography and its correlation with visual acuity]. / Disminución de la agudeza visual tras terapia fotodinámica: estudio mediante tomografía de coherencia óptica y su correlación con la agudeza visual.

CASE REPORT: A 68-year-old patient complained of decreased visual acuity (VA) two days after photodynamic therapy (PDT) had been performed. VA decreased from the pre-operative value of 0.4 to 0.1 on the second postoperative day. With additional + 1.75 diopters, VA was 0.32. Optical coherence tomography (OCT) disclosed a subneuroretinal fluid accumulation causing a serous retinal detachment 600 microm in height. One week postoperatively, neither decreased vision nor retinal elevation were noted. DISCUSSION: The temporary subjective decreased VA could be predominantly reduced by adequate refraction. OCT and VA measurements excluded ischemia of the neuroretina or the choroid as a causative factor.

Disminución de la agudeza visual tras terapia fotodinámica: estudio mediante tomografía de coherencia óptica y su correlación con la agudeza visual / Subjective decrease of visual acuity after photodynamic therapy: documentation by optical coherence tomography and its correlation with visual acuity

Caso clínico: Paciente de 68 años con disminución de la agudeza visual (AV) dos días tras terapia fotodinámica. La refracción preoperatoria era de 0,4 y descendió a 0,1 al segundo día después del tratamiento. No obstante, con una adición de +1,75 dioptrías, la visión alcanzó 0,32. El examen mediante tomografía de coherencia óptica (OCT) reveló una acumulación de fluido subretiniano que originaba un desprendimiento seroso de la retina de 600 µm de grosor. Transcurridos 7 días se restablecieron la AV y el grosor retiniano.Discusión: La disminución temporal de la AV pudo ser corregida por medio de una adecuada refracción. Los hallazgos del OCT y la AV sirvieron para excluir una isquemia retiniana o coroidea como factores causales

Case report: A 68-year-old patient complained of decreased visual acuity (VA) two days after photodynamic therapy (PDT) had been performed. VA decreased from the pre-operative value of 0.4 to 0.1 on the second postoperative day. With additional + 1.75 diopters, VA was 0.32. Optical coherence tomography (OCT) disclosed a subneuroretinal fluid accumulation causing a serous retinal detachment 600 µm in height. One week postoperatively, neither decreased vision nor retinal elevation were noted. Discussion: The temporary subjective decreased VA could be predominantly reduced by adequate refraction. OCT and VA measurements excluded ischemia of the neuroretina or the choroid as a causative factor

[Autologous serum versus hyaluronic acid eye drops for the treatment of corneal erosions after vitrectomy in diabetic patients. A prospective randomized study]. / Vergleich von Eigenserum und Hyaluronsäure zur Behandlung kornealer Erosiones nach Vitrektomie bei Diabetikern. Eine prospektive, randomisierte Studie.

PURPOSE: The purpose of this study was to evaluate whether treatment with autologous serum exhibits better epitheliotropic properties than hyaluronic acid in patients with reduced wound healing (diabetics). PATIENTS AND METHOD: This prospective randomized study included all diabetic patients undergoing pars plana vitrectomy with abrasion of the corneal epithelium. In addition to the usual topical therapy one group was treated with hourly application of autologous serum, the other group with hyaluronic acid drops. We evaluated the time needed for closure of the corneal epithelium as well as other parameters such as patient's age, sex, duration of surgery, history of diabetes, and the current HbA1C. RESULTS: There were 23 patients enrolled in the study. The epithelium healed a mean of 2 days earlier in the autologous serum group. Based on the statistically significant difference in favor of autologous serum, the study was terminated after treatment of 23 patients. CONCLUSIONS: Autologous serum eye drops lead to earlier closure of the corneal epithelium after intraoperative abrasion in diabetic patients when compared with artificial tears.