An Observational Research Study to Evaluate the Impact of Breakthrough Cancer Pain on the Daily Lives and Functional Status of Patients.

Breakthrough cancer pain (BTcP) is common, resulting in significant physical and psychosocial morbidity. We assessed the impact of BTcP on 81 cancer patients attending Irish specialist palliative care services. BTcP occurred up to twice daily in 24 (30%) and 3-4 times daily in 57 (70%) of cases. Median scores for the 'worst' and 'least' pains in the previous 24 hours were 7 and 2/10 respectively. Pain lasted < 15 minutes in 19 (23.5%), 15-30 minutes in 25 (30.8%), 30-60 minutes in 18 (22.2%) and > 60 minutes in 19 (23.5%) of patients. BTcP had a negative impact on general activity, mood, walking ability, work, relations with others, sleep and overall enjoyment of life. BTcP increased anxiety, depression, anger, isolation, financial difficulties and an inability to undergo cancer treatments. Systematic assessment of BTcP should form an integral part of every oncology/palliative medicine assessment. Once identified, BTcP should be managed assiduously.

Generation of high-purity higher-order Laguerre-Gauss beams at high laser power.

We have investigated the generation of highly pure higher-order Laguerre-Gauss (LG) beams at high laser power of order 100 W, the same regime that will be used by second-generation gravitational wave interferometers such as Advanced LIGO. We report on the generation of a helical-type LG33 mode with a purity of order 97% at a power of 83 W, the highest power ever reported in literature for a higher-order LG mode. This is a fundamental step in proving technical readiness for use of LG beams in gravitational wave interferometers of future generations.

Stabilized high-power laser system for the gravitational wave detector advanced LIGO.

An ultra-stable, high-power cw Nd:YAG laser system, developed for the ground-based gravitational wave detector Advanced LIGO (Laser Interferometer Gravitational-Wave Observatory), was comprehensively characterized. Laser power, frequency, beam pointing and beam quality were simultaneously stabilized using different active and passive schemes. The output beam, the performance of the stabilization, and the cross-coupling between different stabilization feedback control loops were characterized and found to fulfill most design requirements. The employed stabilization schemes and the achieved performance are of relevance to many high-precision optical experiments.

Frontal and periventricular brain white matter lesions and cortical deafferentation of cholinergic and other neuromodulatory axonal projections.

White matter fiber bundles form a spatial pattern defined by anatomical and functional architecture. Structural lesions in the white matter may cause clinical symptoms because of disruption of fiber tracts. The clinical significance will depend on the anatomic location of such lesions and whether the functional integrity of specific fiber bundles is affected. Unlike more acute lesions of stroke or multiple sclerosis that may cause sudden sensorimotor deficits, white matter lesions of aging manifest with more subtle and gradual symptoms that are often cognitive in nature. Such cognitive symptoms have been explained by strategically located white matter lesions in the deep forebrain that may disrupt cholinergic projection fibers at their proximal origin. Recent in vivo imaging studies provide supportive evidence that periventricular white matter lesions are associated with cortical cholinergic deafferentation in elderly with leukoaraiosis. White matter lesions at the frontal horns, so-called "capping," are in close proximity to cholinergic axons that originate in the basal forebrain. Therefore, these lesions may result in more significant cortical deafferentation because of the more proximal axonal disruption. A unique anatomic feature common to all cortical projections from subcortical neuromodulator systems (that not only include the cholinergic but also the monoaminergic systems, such as dopamine, serotonin, and norepinephrine) is that the proximal axons largely pass through the deep forebrain before fanning out to the cortex. It is thus plausible that deep frontal white matter lesions may result in not only cholinergic but also variable monoaminergic cortical deafferentation.

cAMP and in vitro inotropic actions of secretin and VIP in rat papillary muscle.

Secretin and VIP stimulate cardiac adenylyl cyclase activity and exert a positive inotropic action in several mammalian species. This study examined positive inotropic activity and cAMP levels in rat papillary muscle. Isoproterenol and secretin increased contractions by 150+/-31% and 129+/-27%, respectively. VIP increased contraction by 30+/-21% only at 10 microM. Isoproterenol significantly increased cAMP levels by 82%, whereas increases by secretin (58%) and VIP (56%) were not significant. These results are consistent with reports that secretin and VIP stimulate cardiac adenylyl cyclase in the rat, but suggest that cAMP tissue levels cannot totally explain the positive inotropic responses to secretin and VIP.