[102 patients with suspected myocarditis : Clinical presentation, diagnostics, therapy and prognosis]. / 102 Patienten mit Verdacht auf Myokarditis : Klinische Präsentation, Diagnostik, Therapie und Prognose.

INTRODUCTION: Myocarditis is a disease which is difficult to diagnose and which includes a risk of the development of dilated cardiomyopathy and sudden cardiac death. METHODS AND PATIENTS: In this study 102 patients were included from the time period 2003-2013 after diagnosis or suspected diagnosis of myocarditis in the department of internal medicine at the University Hospital Halle (Saale). RESULTS: Of the study participants 77.5% were male and the average age was 35.5 ± 14.1 years. The symptoms reported by the patients were angina in 46.1%, dyspnea in 38.2%, performance deterioration in 29.4%, palpitations in 9.8% and syncope in 8.8%. In 45.1% of patients, symptoms were preceded by a respiratory infection. All patients underwent an echocardiogram and in 36.5% it was possible to demonstrate a regional wall motion abnormality and in 20.4% a pericardial effusion. A myocardial biopsy was performed in 15.6% of the patients. The presence of cardiotropic viruses was investigated in 37.3% of patients but was detected in only 5.9%. Cardiac magnetic resonance imaging (MRI) was performed in 82 patients of whom 33.3% showed a late enhancement and 11.9% a wall movement disorder. In this study four patients, all male, died and three suffered recurrent myocarditis. CONCLUSION: This study showed the wide range of symptoms in myocarditis. Myocarditis is rarely severely manifested and in this study the mortality was 3.9%. For further optimization of the diagnostic and treatment algorithms, prospective, randomized studies would be desirable.

[How Valid is the Performance Diagnostic in Soccer?]. / Wie valide ist die Leistungsdiagnostik im Fußball?

BACKGROUND: Assessments of physical and physiological performance tests in soccer sports are still unspecific yet. There is also a lack of scientific validation using those as a "golden standard". Concerning match performance a large deficit also exist in sports and medical science. OBJECTIVE: The aim and purpose of this multicentric and prospective diagnostic study was to evaluate the validity of current established and recommended diagnostic tests for endurance and match performance (golden standard: real time of playing) in soccer. MATERIALS AND METHODS: In a prospective study protocol two German soccer teams from the fourth (n = 22) and third (n = 24) national league first underwent different tests of performance and diagnostics ahead of the competition season (tapping, drop jump, counter movement jump, speed dribbling, treadmill running test). Afterwards, match performance of each athlete was assessed by real time of playing (as a surrogate parameter) during the half season (14 and 25 matches). We finally compared test parameters with the match performance in a linear regression analysis. RESULTS: Our analysis showed no statistical relevant relationship between test parameters and match performance (r(2) < 0.10). Only the assessment in maximum of relative oxygen uptake during the treadmill test for endurance was associated with a higher amount of variance (12%). CONCLUSIONS: According to the study results there is no relevant and valid correlation between current established diagnostic tests in soccer sport and sport-specific performance. The time of real engagement during a match might be associated with a quality of performance for the single athlete. Therefore, the assessment of this match activity is the most important parameter for improving diagnostic tests in soccer. The existence of a "golden standard" is essential for validation of any tests and parameters and the development of new specific assessments. At the moment, physical performance tests have no scientific evidence in soccer sports.

2,4,6-Triphenylphosphinine and 2,4,6-triphenylposphabarrelene revisited: synthesis, reactivity and coordination chemistry.

The synthesis of 2,4,6-triphenylphosphinine has been revisited and a general protocol for the preparation of such low-coordinate phosphorus compounds in good to excellent yields could be established. This allows to investigate several aspects of the chemistry of 2,4,6-triarylphosphinine, such as the reaction with in situ generated benzyne to give 2,4,6-triphenylphosphabarrelene. The corresponding 2,4,6-triphenylphosphabarrelene-selenide could be characterized crystallographically for the first time and the structural and electronic properties of this cage-compound in comparison to classical triarylphosphines could be evaluated. Moreover, [(L)W(CO)5)] complexes of both 2,4,6-triphenylphosphinine and 2,4,6-triphenylphosphabarrelene were prepared and characterized by means of X-ray crystallography. This allowed for the first time a direct structural comparison of these related phosphorus compounds, coordinated to the same metal fragment.

Preoperative assessment of relative pulmonary lobar perfusion fraction in lung cancer patients. A rather simple three-dimensional CT-based vs. planar image-derived quantification.

UNLABELLED: Preoperative quantification of (relative) pulmonary lobar perfusion fraction using scintigraphy is established in predicting lung function after pulmonary surgery. Aim was to develop an easy and truly anatomical method for relative pulmonary lobar perfusion fraction quantification using SPECT/CT and to compare results with those from planar analyses in lung cancer patients. PATIENTS, METHODS: 36 patients with operable lung cancer, borderline lung function referred to pre-operative quantification. Perfusion SPECT-data were acquired p.i. of 163±9 MBq 99mTc-MAA, subsequent low-dose-CT (SymbiaT, Siemens). Iterative Flash3D-reconstruction, manual 3D segmentation of all lobes using PMOD. VOI transfer to coregistered perfusion SPECT-data, calculation of lobar fractions. Model-based calculation of relative lobar fractions based on planar data, analysis of planar vs. 3D results using t-test. RESULTS: Significant differences (p<0.05) between the results from 3D method and planar imaging were found for right upper and middle lobe and both lower lobes. Maximum differences ranged from 10.9% (left upper lobe) to 22.9% (right upper lobe). CONCLUSIONS: Relative pulmonary lobar perfusion fraction can easily be obtained by an anatomically driven 3D quantification. Results yielded by this method and the traditional planar approach differed greatly, possibly affecting eligibility for lung surgery in individual patients. Considering these results a 3D approach should be used whenever possible.

Niveles de ansiedad de médicos residentes / Anxiety levels in medical residents

Introducción: La residencia médica es un período de riesgo para el desarrollo de problemas de salud mental. Los estudios de ansiedad en residentesson contrastantes; sin embargo, se cree que los niveles de ansiedad son altos ya que los programas se desarrollan en hospitales nacionales que carecende recursos fsicos, materiales y humanos. El objetvo del presente estudio es determinar los niveles de ansiedad en médicos residentes en diferentesespecialidades empleando el cuestonario inventario de la ansiedad rasgo-estado (IDARE).Métodos: Se administró una encuesta electrónica para determinar el nivel de ansiedad en médicos residentes en diferentes especialidades del HospitalGeneral San Juan de Dios.Resultados: Se obtuvieron 132 encuestas para el análisis. La mayoría de los médicos encuestados son hombres (59%), solteros (83%) que no tenendependientes (79%), cursan residencia de cirugía o medicina interna (54%), trabajan más de 80 horas por semana (85%) y viajan menos de una horapara llegar al lugar de residencia (67%). El promedio del nivel de ansiedad-estado de los médicos residentes fue 46.94 puntos, mientras que el nivelpromedio de ansiedad-rasgo fue de 42.77 puntos. El 35% de los residentes poseen niveles de ansiedad medio y 59% altos en el momento de responderla encuesta; y el 56% posee niveles de ansiedad medio y 37% alto generalmente. No se encontró diferencia estadístcamente signifcatva en los nivelesde ansiedad en base a género, estado civil, tpo de residencia, dependientes y horas de tráfco. La única variable asociada con ansiedad fue la cantdadde horas de trabajo por semana.Conclusiones: La mayoría de los residentes encuestados poseen niveles de ansiedad medio-altos, la única variable asociada con niveles de ansiedadfue la cantdad de horas de trabajo por semana.

Background: Medical residency is a risky period for the development of mental health problems. Although anxiety studies in medical residents areinconclusive; we hypothesize anxiety levels in residents are high, since residency programs are developed in community hospitals that lack material andhuman resources. The aim of this study is to determine the levels of anxiety in medical residents of diferent specialtes using the State Trait-AnxietyInventary (STAI).Methods: An electronic poll with STAI was administered to medical residents of diferent specialtes of a tertary referral hospital.Results: We received 132 questonnaires for analysis. Most of the respondents are men (59%), single (83%), without dependents (79%), belong tosurgical or internal medicine residency (54%), work more than 80 hours per week (85%) and travel less than an hour to get to the hospital (67%). Theaverage level of state anxiety of the residents was 46.94 points, while the average level of trait anxiety was 42.77 points. Thirty fve percent of theresidents have medium anxiety levels and 59% high anxiety levels at the tme they answered the inventory; and 56% have medium anxiety levels and37% have high anxiety levels as a trait. We did not found a statstcal diference in anxiety levels based on gender, marital status, and type of residency,number of dependents or number of hours spent in trafc. The only variable that was associated with anxiety was the amount of work hours per week.Conclusions: Most of the residents have medium-high levels of anxiety; the only variable associated with anxiety levels was the amount of work hoursper week

[Intraobserver reliability of the Handball-specific complex test (HBKT)]. / Intraobserverreliabilität des handballspezifischen Komplextests (HBKT).

BACKGROUND: There are clearly no complex and sports-specific tests in handball. So far, no specific complex test has been developed and verified for its intraobserver reliability (IR). OBJECTIVE: The aim of this study was to determine the IR of the Handball-specific complex test (HBKT). METHODS: The HBKT was applied twice at an interval of two days to two teams of the German Third League (n = 30; age 25.7 ±â€Š3.9 years, range: 19 - 33 years). Within the HBKT, the stress parameters lactate and heart rate as well as the loading parameters time, throwing velocity and number of errors were collected. RESULTS: Overall, 23 % (3/13) of the stress parameters showed a high relative [intraclass correlation coefficient (ICC) > 0.75] and absolute [coefficient of variation (CV) ≤ 5 %] IR. On average, a sufficient absolute (∅CV = 11.3 %) and relative (∅ICC = 0.67) IR was observed. Without the parameters "missed throws" and "technical errors" in both rounds, the IR increased significantly (∅ICC: from 0.67 to 0.72 & ∅CV from 11.3 to 6.3 %). The heart rate was comparatively more reliable than lactate (∅ICC = 0.71 & ∅CV = 4.23 % vs. ∅ICC = 0.65 & ∅CV = 15.1 %). With respect to load parameters in round one, 50 % (5/10) showed a high IR; in round two, these values decreased to 40 % (4/10). The mean IR of the parameters in round one was higher than in round two (∅ICC = 0.71 & ∅CV = 12.2 % vs. ∅ICC = 0.60 & ∅CV = 14.3 %). Overall, there was an improvement of the athletes in most stress and load parameters from session one to session two. CONCLUSIONS: The HBKT can be attested with a sufficient intraobserver reliability. When the parameters "missed throws" and "technical errors" were excluded, the IR further increased significantly. Therefore, these parameters should be recorded in order to standardized the HBKT, but not be included in the statistical analysis. There are discrete adaptation and learning effects. For this reason, it is essential to familiarise trainers and players with the HBKT test procedure before the first measurement. Otherwise training effects can be easily overrated. Moreover, the test concept of HBKT can be used as a blueprint for the development of sport-specific tests in other team sports (e. g., soccer, basketball). For example, we generated a complex soccer-specific field test 1 based on the HBKT.

Fibroblast growth factor 2 is of prognostic value for patients with locally advanced squamous cell carcinoma of the head and neck.

BACKGROUND AND PURPOSE: Patients with locally advanced SCCHN have a poor prognosis. This study investigated the prognostic value of the tumor cell expression of the fibroblast growth factor 2 (FGF-2) in patients treated with surgery followed by radiotherapy. PATIENTS AND METHODS: The impact of FGF-2-expression and 11 additional potential prognostic factors on loco-regional control (LRC), metastases-free survival (MFS), and overall survival (OS) was retrospectively evaluated in 146 patients. Additional factors included age, gender, performance status, pre-radiotherapy hemoglobin levels, tumor site, histologic grade, T-category, N-category, human papilloma virus (HPV) status, extent of resection, and chemotherapy. Univariate analyses were performed with the Kaplan-Meier method and the log-rank test, multivariate analyses with the Cox proportional hazard model. RESULTS: On multivariate analysis, improved LRC was significantly associated with FGF-2-negativity [risk ratio (RR): 7.33; 95%-confidence interval (CI): 2.88-19.05; p<0.001], lower T-category (RR: 2.42; 95%-CI: 1.47-4.33; p<0.001), lower N-category (RR: 12.36; 95%-CI: 3.48-78.91; p<0.001), and pre-radiotherapy hemoglobin levels ≥ 12 g/dl (RR: 4.18; 95%-CI: 1.73-10.53; p=0.002). No factor was significantly associated with improved MFS. Lower T-category showed a trend (RR: 1.59; 95%-CI: 0.97-2.82; p=0.069). Better OS was significantly associated with FGF-2-negativity (RR: 5.10; 2.22-11.80; p<0.001), lower T-category (RR: 2.17; 95%-CI: 1.38-3.68; p < 0.001), lower N-category (RR: 3.86; 95%-CI: 1.60-10.85; p=0.002), and pre-radiotherapy hemoglobin levels ≥ 12 g/dl (RR: 3.20; 95%-CI: 1.46-7.30; p=0.004). HPV-positivity showed a trend (RR: 2.36; 95%-CI: n.a.; p=0.054). CONCLUSIONS: Tumor cell expression of FGF-2 proved to be an independent prognostic factor for LRC and OS. This factor can help personalize treatment and stratify patients in future trials.

Androgen receptor expression: prognostic value in locally advanced squamous cell carcinoma of the head and neck.

BACKGROUND AND PURPOSE: This study investigated the prognostic value of androgen receptor (AR) expression of tumor cells in patients treated with surgery and subsequent radio(chemo)therapy for locally advanced squamous cell carcinoma of the head and neck (SCCHN). MATERIAL AND METHODS: The impact of AR and 11 additional factors on locoregional control (LRC), metastases-free survival (MFS), and overall survival (OS) was retrospectively studied in 163 patients with nonmetastatic stage III/IV SCCHN. Additional factors included age, gender, ECOG performance status, pre-radiotherapy (pre-RT) hemoglobin levels, tumor site, histologic grade, T category, N category, HPV status, extent of resection, and concurrent chemotherapy. RESULTS: On multivariate analysis, improved LRC was significantly associated with pre-RT hemoglobin levels≥12 g/dl (risk ratio [RR] 2.22; 95% confidence interval [CI] 1.19­4.13; p=0.013), tumor site (RR 1.39; 95% CI 1.14­1.70; p=0.001), lower T category (RR 1.67; 95% CI 1.18­2.44; p=0.003), and lower N category (RR 4.18; 95% CI 1.90­10.55; p<0.001). Improved MFS was associated with AR expression (RR 2.21; 95% CI 1.01­5.41; p=0.048), better ECOG performance status (RR 3.19; 95% CI 1.50­7.14; p=0.003), lower T category (RR 2.24; 95% CI 1.47­3.65; p<0.001), and lower N category (RR 5.33; 95% CI 2.07­16.63; p<0.001). OS was positively associated with AR expression (RR 1.99; 95% CI 1.06­4.00; p=0.032), better ECOG performance status (RR 2.20; 95% CI 1.20­4.09; p=0.010), pre-RT hemoglobin levels≥12 g/dl (RR 2.13; 95% CI 1.19­3.82; p=0.012), lower T category (RR 1.81; 95% CI 1.30­2.62; p<0.001), and lower N category (RR 3.41; 95% CI: 1.65­7.80; p<0.001). CONCLUSION: Tumor cell expression of AR was an independent prognostic factor for MFS and OS and should be considered in future prospective trials.

Impact of the HPV-positivity definition on the prognostic value of HPV status in patients with locally advanced squamous cell carcinoma of the head and neck.

BACKGROUND AND PURPOSE: This study re-evaluated the prognostic value of HPV status for loco-regional control (LRC), metastases-free survival (MFS), and survival (OS) in patients with locally advanced squamous cell carcinoma of the head and neck (SCCHN). A modified definition of HPV positivity was used in the current study compared to the authors' previous study. PATIENTS AND METHODS: In the previous study of the same 170 patients, a tumor was defined as HPV-positive if it showed a positive in situ hybridization result in ≥10% of tumor cells and/or positive p16 immunostaining. In the current analysis, tumors were considered HPV-positive only if they showed positive results for both in situ hybridization and p16 immunostaining. In addition to HPV status, the same 11 potential prognostic factors were investigated for treatment outcomes as in the preceding study. RESULTS: In the multivariate analysis of the current study, HPV positivity was significantly associated with improved LRC [risk ratio (RR) 9.78; p<0.001], MFS (RR 7.17; p=0.008), and OS (RR 6.61; p<0.001). In the previous study, HPV positivity was associated with LRC (RR 2.34; p=0.014) and OS (RR 2.19; p=0.019), but not with MFS (RR 2.04; p=0.11). CONCLUSIONS: Applying the new definition of HPV positivity, the impact of HPV status on the prognosis of patients irradiated for locally advanced SCCHN was more prominent than in our previous study and associated with all three investigated endpoints.

Prognostic impact of VEGF and FLT-1 receptor expression in patients with locally advanced squamous cell carcinoma of the head and neck.

BACKGROUND AND PURPOSE: This study investigated the prognostic value of tumor cell expression of vascular endothelial growth factor (VEGF) and its receptor fms-related tyrosine kinase 1 (FLT-1) in patients with locally advanced squamous cell carcinoma of the head and neck (SCCHN) who had been treated with adjuvant radiotherapy or radiochemotherapy. MATERIAL AND METHODS: The impact of tumor cell VEGF and FLT-1 expression plus 11 additional factors on loco-regional control (LRC), metastases-free survival (MFS) and overall survival (OS) was retrospectively evaluated in 157 patients. The additional factors were age, gender, performance status, pre-radiotherapy (pre-RT) hemoglobin levels, tumor site, histologic grade, T-category, N-category, human papillomavirus (HPV) status, extent of resection and chemotherapy. RESULTS: On multivariate analysis, improved LRC was significantly associated with an absence of VEGF expression (risk ratio, RR: 5.02; p = 0.009), lower T-category (RR: 2.00; p < 0.001), lower N-category (RR: 3.75; p < 0.001) and pre-RT hemoglobin levels ≥ 12 g/dl (RR: 2.20; p = 0.029). Improved MFS was significantly associated with an absence of VEGF expression (RR: 7.46; p = 0.002), lower T-category (RR: 1.97; p = 0.002), lower N-category (RR: 3.29; p = 0.005) and a favorable tumor location (RR: 1.34; p = 0.033); HPV positivity showed a trend towards improved MFS (RR: 1.43; p = 0.09). Improved OS was significantly associated with an absence of VEFG expression (RR: 3.22; p = 0.041), pre-RT hemoglobin levels ≥ 12 g/dl (RR: 2.47; p = 0.009), lower T-category (RR: 1.92; p < 0.001) and lower N-category (RR: 3.39; p < 0.001). FLT-1 expression was significantly associated with LRC and OS in the univariate but not in the multivariate analysis. CONCLUSION: VEGF expression proved to be an independent negative predictor for LRC, MFS and OS in patients treated for locally advanced SCCHN with adjuvant radiotherapy or radiochemotherapy. FLT-1 expression was not significant in multivariate analyses.

Prognosis of patients with locally advanced squamous cell carcinoma of the head and neck. Impact of tumor cell expression of EPO and EPO-R.

BACKGROUND AND PURPOSE: This study investigated the prognostic role of tumor cell expression of erythropoietin (EPO) and its receptor (EPO-R) in patients with locally advanced squamous cell carcinoma of the head and neck (SCCHN) treated with surgery plus radiotherapy. PATIENTS AND METHODS: The impact of EPO, EPO-R, and 11 additional factors on locoregional control (LRC), metastases-free survival (MFS), and overall survival (OS) was retrospectively evaluated in 144 patients. Additional factors were age, gender, performance status, preradiotherapy (pre-RT) hemoglobin levels, tumor site, histologic grade, T category, N category, human papillomavirus (HPV) status, extent of resection, and chemotherapy. Univariate analyses were performed with the Kaplan-Meier method and the log-rank test, multivariate analyses with the Cox proportional hazard model. RESULTS: On multivariate analysis, improved LRC was significantly associated with no EPO expression (risk ratio [RR] 3.72; 95 % confidence interval [CI] 1.35-15.42; p = 0.008), lower T category (RR 1.60; 95 %CI 1.14-2.32; p = 0.005), and oropharynx or larynx cancer (RR 1.23; 95 %CI 1.02-1.49; p = 0.033). Improved MFS was significantly associated with no EPO expression (RR 5.45; 95 %CI 1.13-97.81; p = 0.031), lower T category (RR 1.66; 95 %CI 1.11-2.65; p = 0.013), lower N category (RR 2.44; 95 %CI 1.04-6.66; p = 0.039), HPV positivity (RR 3.14; 95 %CI not available; p = 0.034), and oropharynx or larynx cancer (RR 1.28; 95 %CI 1.01-1.61; p = 0.041). Improved OS was significantly associated with no EPO expression (RR 4.77; 95 %CI 1.63-20.68; p = 0.003), no EPO-R expression (RR 2.36; 95 %CI 1.22-4.92; p = 0.010), lower T category (RR 1.44; 95 %CI 1.04-2.04; p = 0.027), oropharynx or larynx cancer (RR 1.30; 95 %CI 1.08-1.57; p = 0.007), and pre-RT hemoglobin ≥ 12 g/dl (RR 1.94; 95 %CI 1.03-3.65; p = 0.042). CONCLUSION: EPO expression of tumor cells was an independent prognostic factor for LRC, MFS, and OS. EPO-R expression was an independent prognostic factor for OS.

[Longitudinal and specific analyses of physical performance in handball]. / Longitudinale, sportartspezifische Leistungsdiagnostik im Handball.

BACKGROUND: Sports-specific, biomechanical measuring stations and measuring-station trainings have become common practice in many forms of sports and are an essential element of the complex assessment of physical performance. In handball, however, there is still considerable research potential in this respect as well as in the systematic generation and acquisition of the requirements profile and progress of strain. OBJECTIVE: The prime objective of the longitudinal study was to determine the potential performance and development of handball players (3 rd league) in general and in terms of handball sport in particular. Another objective was to establish correlations between tests and indicators of performance in competitions. MATERIALS AND METHODS: 13 handball players (age: 26.5 ± 3.6 years) were tested three times (before and after the pre-season preparation phase and at the end of the first half of the season) on two test days each. The examination was composed of sprint test (ST, day 1), handball-specific complex test (HBKT, day 1) and assessment of treadmill diagnostics (LD, day 2). The surveyed parameters were lactate and heart rate (LD/HBKT) as well as time (ST, HBKT) and the number of errors (HBKT). RESULTS: The cardiac (Hfmax = 201 min-1) and metabolic strain (lactate = 17.8 mmol/L) in the HBKT were very high. In the preparatory phase, the average magnitudes of effect registered were at d = 0.31 (ST parameter), d = 0.68 (HBKT parameter) and d = 0.98 (LD parameter). The most significant improvements throughout the entire period of time were registered in the parameters v2 (LD; η2 = 0.371), total goal-throwing time (HBKT; η2 = 0.250), total penalty time (HBKT; η2 = 0.236) and total round 2 (HBKT; η2 = 0.227). In HBKT and LD, the performance level was stabilised by the end of the first half of the season. In terms of speed, however, there was a decline in performance abilities. The competition performance has its highest degree of correlation with cardial (defense: r = -0.656) and metabolic (offensive: r = -0.655) recuperativeness in HBKT. CONCLUSIONS: The findings of this longitudinal survey are on the one hand intended to make assessments of physical performance more efficient (isolated sprint test no longer required) and to improve data output (HBKT: throwing velocity; reference database). In this context, a more extensive consideration of indicators for competition performance and their correlation to specific parameters is recommendable. On the other hand, the applied training contents must be further optimised in terms of their severity and chronology.

Ultrafast photo-excitation dynamics in isolated, neutral water clusters.

Using the efficient nonlinear conversion scheme which was recently developed in our group [M. Beutler, M. Ghotbi, F. Noack, and I. V. Hertel, Opt. Lett. 134, 1491 (2010); M. Ghotbi, M. Beutler, and F. Noack, ibid 35, 3492 (2010)] to provide intense sub-50 fs vacuum ultraviolet laser pulses we have performed the first real time study of ultrafast, photo-induced dynamics in the electronically excited Ã-state of water clusters (H(2)O)(n) and (D(2)O)(n) , n=2-10. Three relevant time scales, 1.8-2.5, 10-30, and 50-150 fs, can be distinguished which-guided by the available theoretical results-are attributed to H (D)-ejection, OH (OD) dissociation, and a nonadiabatic transition through a conical intersection, respectively. While a direct quantitative comparison is only very preliminary, the present results provide a crucial test for future modeling of excited state dynamics in water clusters, and should help to unravel some of the many still unresolved puzzles about water.

Generation of 2.5 µJ vacuum ultraviolet pulses with sub-50 fs duration by noncollinear four-wave mixing in argon.

Generation of sub-50fs vacuum UV pulses with more than 2.5µJ energy at a 1kHz repetition rate is reported. The pulses at 160nm are produced using noncollinear difference-frequency four-wave mixing between the fundamental and third harmonics of an amplified Ti:sapphire laser in argon. While the pulse duration is maintained by increasing the phase-matching pressure, noncollinear interaction improves the conversion efficiency by 1 order of magnitude in comparison with the previous results in collinear geometry.

[Foetal rhabdomyosarcoma with massive cardiac and placental infiltration associated with intrauterine foetal death]. / Zum intrauterinen Fruchttod führendes fetales Rhabdomyosarkom mit ausgeprägter cardialer und placentarer Infiltration.

Rhabdomyosarcoma is a common malignant soft-tissue tumour in children, accounting for 6-7% of all malignant tumours in childhood. Congenital neoplasms are very rare in childhood and represent 2.5% of all paediatric tumours; the intrauterine or congenital diagnosis of rhabdomyosarcomas is extremely seldom. The most frequent locations of rhabdomyosarcomas are the head and neck regions. There are a number of ultrasonographic differential diagnoses. In cases of foetal rhabdomyosarcomas in utero, not only distant metastases but also the possibility of placental infiltration and thus of hypothetical distant metastases in the mother must be taken into consideration because of their metastatic potential. Only very few cases of transplacental penetration of tumour cells and especially of foeto-maternal metastatic invasion, in contrast to materno-foetal tumour cell transfer in the case of maternal cancer disease, have been reported in the literature. We report on a foetal rhabdomyosarcoma of the head and neck area with massive cardiac and placental infiltration associated with intrauterine foetal death in the second trimester. Sonographic features and necropsy findings are described and the differential diagnosis is discussed. Furthermore, diagnostic approaches to rule out a pattern of transplacental metastases are presented.

Broadly tunable, sub-30 fs near-infrared pulses from an optical parametric amplifier based on BiB3O6.

We report the generation of tunable femtosecond pulses in the near-IR using a two-stage, white-light seeded, collinear, femtosecond optical parametric amplifier (OPA). The OPA, based on BiB(3)O(6) crystal in both stages and pumped at 800 nm by a 1 kHz Ti:sapphire laser amplifier, provides sub-30 fs signal pulses across the whole tuning range of 1.15-1.6 microm with minimum duration of 22 fs and maximum signal energy of 80 microJ.

Two-octave supercontinuum generation in a water-filled photonic crystal fiber.

Supercontinuum generation in a water-filled photonic crystal fiber is reported. By only filling the central hollow core of this fiber with water, the fiber properties are changed such that the air cladding provides broadband guiding. Using a pump wavelength of 1200 nm and few-microjoule pump pulses, the generation of supercontinua with two-octave spectral coverage from 410 to 1640 nm is experimentally demonstrated. Numerical simulations confirm these results, revealing a transition from a soliton-induced mechanism to self-phase modulation dominated spectral broadening with increasing pump power. Compared to supercontinua generated in glass core photonic fibers, the liquid core supercontinua show a higher degree of coherence, and the larger mode field area and the higher damage threshold of the water core enable significantly higher pulse energies of the white light pulses, ranging up to 0.39microJ.

[Atypical metastasis of renal cell carcinoma. Contribution of comparative genomic hybridisation to diagnosis]. / Atypische Metastasierung eines Nierenzellkarzinoms. Beitrag der komparativen genomischen Hybridisierung zur Diagnosefindung.

In patients younger than 40 years, renal cell carcinoma and metastases to the bladder are rare. Comparative genomic hybridisation (CGH) may be useful to differentiate between metastatic renal cell carcinoma and secondary malignancies of the genitourinary tract, which can occur in all histologic types. We report the case of a 35-year-old patient with renal cell carcinoma in whom only CGH could help differentiate between a second primary malignancy in the bladder and an atypical bladder metastasis.