Evidence for Coexisting Shapes through Lifetime Measurements in

The lifetimes of the first excited 2^{+}, 4^{+}, and 6^{+} states in ^{98}Zr were measured with the recoil-distance Doppler shift method in an experiment performed at GANIL. Excited states in ^{98}Zr were populated using the fission reaction between a 6.2 MeV/u ^{238}U beam and a ^{9}Be target. The γ rays were detected with the EXOGAM array in correlation with the fission fragments identified by mass and atomic number in the VAMOS++ spectrometer. Our result shows a very small B(E2;2_{1}^{+}→0_{1}^{+}) value in ^{98}Zr, thereby confirming the very sudden onset of collectivity at N=60. The experimental results are compared to large-scale Monte Carlo shell model and beyond-mean-field calculations. The present results indicate the coexistence of two additional deformed shapes in this nucleus along with the spherical ground state.

[ALIF and PLIF interposition in low-grade isthmic spondylolisthesis L5/S1 : Longterm-Comparison of interbody fusion techniques (ALIF - PLIF)]. / ALIF- und PLIF-Interposition bei low-grade isthmischen Spondylolisthesen L5/S1 : Langzeitvergleich der interkorporellen Fusionstechnik (ALIF - PLIF).

INTRODUCTION: For the treatment of isthmic spondylolisthesis two alternative interbody fusion techniques are available, the dorsoventral interposition in ALIF technique and the dorsal access interposition in PLIF technique. Due to the complications of anterior lumbar surgery and in order to avoid a second operation, the dorsoventral fusion technique is becoming uncommon and mainly a pure dorsal supply is performed. The aim of the study was to compare the clinical long-term results of both treatment techniques. MATERIALS AND METHODS: 138 patients were treated surgically between 2003 and 2012 in symptomatic isthmic spondylolysis in L5/S1 with a Meyerding degree of I-III. 72 patients were evaluated finally (ALIF n = 25 and PLIF n = 47). The average follow-up period was 7.9 years for the ALIF group and 5.6 years for the PLIF group. In both groups the average drug consumption, duration of recovery, resumption of work and resumption of sport activities was recorded. RESULTS: The results showed an extended time of surgery and a prolonged hospitalization of 5.4 days for the ALIF group. The ODI had a greater improvement in the PLIF group but this difference was not significant. The VAS was reduced in both groups. 36.8 % of the ALIF group and 44.7 % of the PLIF group reported a reduced pain medication postoperatively. The average recovery was 16 weeks for both groups. 29 % of PLIF and 9 % of ALIF patients had no pain relief. ALIF patients were able to get back to work after 149 days and the PLIF patients after 178 days. 31 % of the PLIF group and 13 % of the ALIF group were not able to return back to work. Revisions of fusion and the rate of wound revisions were increased in the PLIF group, adjacent segment diseases occurred more frequently in the ALIF group. CONCLUSION: Both treatment and fusion techniques (ALIF/PLIF) were able to achieve a significant pain relief and reduced consumption of pain medication postoperatively. The recovery period was similar in both groups, but there were differences regarding the date of return to work, hospitalization, duration of surgery and ODI score. Neither of the two methods could show a definite advantage.

Lifetime measurement of the 2(1)+ state in 20C.

Establishing how and when large N/Z values require modified or new theoretical tools is a major quest in nuclear physics. Here we report the first measurement of the lifetime of the 2(1)+ state in the near-dripline nucleus 20C. The deduced value of τ(2(1)+)=9.8±2.8(stat)(-1.1)(+0.5)(syst) ps gives a reduced transition probability of B(E2; 2(1)+→0(g.s.)+)=7.5(-1.7)(+3.0)(stat)(-0.4)(+1.0)(syst) e2 fm4 in good agreement with a shell model calculation using isospin-dependent effective charges.

Enhanced quadrupole collectivity at N = 40: the case of neutron-rich Fe isotopes.

The transition rates for the 2(1)+ states in (62,64,66)Fe were studied using the recoil distance Doppler-shift technique applied to projectile Coulomb excitation reactions. The deduced E2 strengths illustrate the enhanced collectivity of the neutron-rich Fe isotopes up to N = 40. The results are interpreted using the generalized concept of valence proton symmetry which describes the evolution of nuclear structure around N = 40 as governed by the number of valence protons with respect to Z ≈ 30. The trend of collectivity suggested by the experimental data is described by state-of-the-art shell-model calculations with a new effective interaction developed for the fpgd valence space.

Low-lying neutron intruder state in 13B and the fading of the N = 8 shell closure.

A lifetime measurement of the excited states in the neutron-rich isotope (13)B has been performed using the (7)Li((7)Li,p)(13)B reaction. An anomalously long mean lifetime of 1.3(3) ps was found for the excited state at 3.53 MeV, giving the upper limits of the transition strengths to the ground state: B(M1) = 7.2 x 10;{-4} Weisskopf unit (W.u.) and B(E2) = 0.81 W.u.. The hindered transition strengths indicate significant intruder configurations for the excited state, coexisting with the normal ground state. The data are well explained by recent shell-model calculations, which suggest J;{pi} = 3/2;{-} for the 3.53-MeV state with the dominant intruder (nu2p2h) configuration.

Shape and structure of N=Z 64Ge: electromagnetic transition rates from the application of the recoil distance method to a knockout reaction.

Transition rate measurements are reported for the 2(1)+ and 2(2)+ states in N=Z 64Ge. The experimental results are in excellent agreement with large-scale shell-model calculations applying the recently developed GXPF1A interactions. The measurement was done using the recoil distance method (RDM) and a unique combination of state-of-the-art instruments at the National Superconducting Cyclotron Laboratory (NSCL). States of interest were populated via an intermediate-energy single-neutron knockout reaction. RDM studies of knockout and fragmentation reaction products hold the promise of reaching far from stability and providing lifetime information for excited states in a wide range of nuclei.

Men with chronic occupational stress benefit from behavioural/psycho-educational group training: a randomized, prospective, controlled trial.

BACKGROUND: Overworking is one of the most frequent stressors. The purpose of this study was to determine the effectiveness of behavioural/psycho-educational group training in men who are chronically stressed from overworking. METHOD: Of 72 male subjects, 36 were randomly assigned to training for 8 weeks and another 36 formed the control group, which received a placebo intervention. Primary outcome measures were systolic blood pressure, salivary cortisol concentration upon awakening, and self-reported changes on the scales of the Trier Inventory for the Assessment of Chronic Stress (TICS), the State-Trait Anger Expression Inventory (STAXI) and the 36-item Short Form Health Survey (SF-36). RESULTS: A significant reduction in mean values was observed in daily systolic blood pressure and salivary cortisol concentration on all the TICS and most of the STAXI and SF-36 scales. CONCLUSIONS: Behavioural/psycho-educational group training appears to be effective in the treatment of men suffering from chronic stress due to overworking.

Cabergoline treatment in men with psychogenic erectile dysfunction: a randomized, double-blind, placebo-controlled study.

The effectiveness of cabergoline in 50 men with psychogenic erectile dysfunction was investigated in a 4-month, randomized, placebo-controlled, double-blind study with validated psychological tests, and prolactin, follicle-stimulating hormone, luteinizing hormone and testosterone serum levels. Cabergoline treatment was well-tolerated and resulted in normalization of hormone levels in most cases. In the cabergoline-treated group, significant interactions between prolactin and testosterone serum concentrations were observed. Erectile function improved significantly. Sexual desire, orgasmic function, and the patient's and his partner's sexual satisfaction were also enhanced. Cabergoline may be an effective and safe alternative agent for men with psychogenic ED.

[Treatment results from inpatient psychosomatic rehabilitation of Turkish migrants: a prospective study]. / Behandlungsergebnisse stationärer psychosomatischer Rehabilitation bei türkischen Migranten: Eine prospektive Studie.

Psychosomatic rehabilitation and the concluding social-medical assessment constitute a particular challenge. The aim of this study was to examine whether inpatient psychosomatic rehabilitation in the context of an integrated treatment concept, conducted in Turkish and German, is effective in the rehabilitation of Turkish migrant laborers, and what concluding socio-medical assessment results from this treatment. 195 Turkish patients--44 male and 151 female--received inpatient psychosomatic treatment for approximately 40 days. Sociodemographic, psychiatric and social-medical data were recorded, as well as Symptom Checklist (SCL-90-R) testing upon admission and discharge. A predominant number of patients were laborers, with a low level of primary education, who were afflicted with psychosocial problems and dissatisfaction with their workplace and who first came into psychosomatic treatment many years following the onset of their illness. Many of them had a clearly defined desire to retire. At the end of their admission, a significant improvement in almost all the scales of the SCL-R-90 was ascertained on the one hand, but on the other, adequate socio-medical results were hardly observed. The symptoms' improvement would confirm that the combination of service offerings in Turkish and German proved themselves. A portion of the patients (approx. 40 %) were classified subsequent to treatment as capable of working for 6 hours or more. Nevertheless, approximately approx. 75 % still sought to retire. Timely psychosomatic treatment could counteract chronification of the illness and the establishment of a steadfast desire to enter retirement, and consequently represent an improvement in the prognosis. Likewise, consistent psychosomatic training of physicians, as well as systematic prophylactic measures with the migrant laborers, should be considered.

[Treatment motivation and results of inpatient psychotherapy for women with depressive disorders: a prospective study]. / Behandlungsmotivation und Ergebnisse der stationären Psychotherapie bei Frauen mit depressiven Erkrankungen: eine prospektive Studie.

Whether the treatment results in inpatient psychotherapy are significantly influenced by the patient's motivation is a subject of discussion. The goal of this study was to assess whether the primary motivation for therapy in depressive women influences the results of psychotherapeutic treatment. In a prospective study, the monitored results from 64 female inpatients (32 who were highly motivated to enter therapy, and 32 who were minimally motivated) were compared to each other. The period of observation was six weeks. As instruments of assessment, the Fragebogen zur Therapiemotivation (FMP) (Questonnaire on Motivation for Entering Therapy) and the Beck Depression Inventory (BDI) were aministered upon admission; after the fourth and sixth weeks of therapy, the Veränderungsfragebogen des Erlebens und Verhaltens (VEV) (Questionnaire of Changes in Experience and Behavior) was administered as well. All patients who had applied for a pension were found in the group of less motivated patients and consolidated into a subgroup. The analysis was carried out according to the intent-to-treat principle. The variance analysis for the repeat measurements showed significant differences on all the FMP scales and on the BDI (all P< 0.001). The measurements with VEV likewise resulted in a significant difference (P< 0.01). The subgroup of "pension patients" showed significantly less change in all three of the above measurements. Patients with depressive symptomology who essentially are relatively highly motivated for therapy could profit significantly more from inpatient psychosomatic treatment than those who are less motivated. Establishing and developing motivation prior to inpatient hospitalization could possibly contribute to more efficient and cost-effective clinical treatment. Where legal proceedings pertaining to a pension are pending, relatively less motivated patients fare significantly worse not only in their motivational development for therapy, but also in their final treatment results. It should be noted, however, that the relatively small random sample, the restricted blinding, which was only partially possible, could have led to possible distortions.

Patients with extreme obesity: change in mental symptoms three years after gastric banding.

OBJECTIVE: Extreme obesity causes grave psychosocial and psychopathological problems in addition to somatic morbidity. One possible treatment is gastric banding, a surgical reduction of stomach volume. The aim of this study was to investigate whether gastric banding leads to lasting change in: 1) the Body Mass Index (BMI); 2) social factors such as work and partnerships, eating behavior, anxiety and depression symptoms; and 3) health related quality of life. METHOD: We surveyed a sample of 50 adipose women (BMI > 40 kg/m2). Primary outcome measures were self-reported changes on the scales of the Three-Factor Eating Questionnaire (TFEQ), the Hospital Anxiety and Depression Scale (HADS-D), and the Health Survey (SF-36). RESULTS: In comparison with the control group, we observed significant changes in BMI (p < 0.01) and the existence of a partnership (p < 0.01), on all three scales of the TFEQ (p < 0.01), on both scales of the HADS-D (anxiety: p < 0.05; depression:p < 0.01), and on all scales of the SF-36 Health Survey (p between < 0.05 and < 0.01 in every case). The most marked changes in all the qualities investigated occurred within the first 12 months of surgery. CONCLUSIONS: Three years after gastric banding, positive changes in BMI reduction, partnership, eating behavior, anxiety, depressive symptomatology, and health related quality of life could be observed. There was also a significant correlation between BMI reduction and reduction firstly on the depression scale (HADS-D) and secondly on the SF-36 scales for physical functioning (PHFU), role physical (ROPH), mental health (PSYC), and vitality (VITA).

[A concept for the psychosomatic clinic in Bad Aussee]. / Konzept der Klinik für Psychosomatik in Bad Aussee.

For the first time in Austria a large psychosomatic hospital with 120 beds is in planning. It shall be closely connected to the newly constructed general hospital Bad Aussee. By applying a cooperative approach multiple economic, financial and technical-medical synergies are intended. Also middle- and long-term savings for the social insurance system are expected by specialised psychosomatic treatment programmes that should help reduce disease chronification as well as related health care costs. Such a treatment approach needs to take into account the patient's personal history, his value system, his various resources and intentions, psychodynamic factors and the course and severity of the disease. With this new hospital we strive for a psychosomatic department that is adequately equipped and adequately large to offer indication-specific treatment programmes for a broad range of psychosomatic disorders.

Thermal damage of the inner vein wall during endovenous laser treatment: key role of energy absorption by intravascular blood.

BACKGROUND: Despite the clinical efficacy of endovenous laser treatment (EVLT), its mode of action is incompletely understood. OBJECTIVE: To evaluate the role of intravascular blood for the effective transfer of thermal damage to the vein wall through absorption of laser energy. METHODS: Laser energy (15 J/pulse, 940 nm) was endovenously administered to explanted greater saphenous vein (GSV) segments filled with blood (n = 5) or normal saline (n = 5) in addition to GSVs under in vivo conditions immediately prior to stripping. Histopathology was performed on serial sections to examine specific patterns of damage. Furthermore, in vitro generation of steam bubbles by different diode lasers (810, 940, and 980 nm) was examined in saline, plasma, and hemolytic blood. RESULTS: In saline-filled veins, EVLT-induced vessel wall injury was confined to the site of direct laser impact. In contrast, blood-filled veins exhibited thermal damage in more remote areas including the vein wall opposite to the laser impact. Steam bubbles were generated in hemolytic blood by all three lasers, while no bubbles could be produced in normal saline or plasma. CONCLUSION: Intravascular blood plays a key role for homogeneously distributed thermal damage of the inner vein wall during EVLT.

Endovenous treatment of the greater saphenous vein with a 940-nm diode laser: thrombotic occlusion after endoluminal thermal damage by laser-generated steam bubbles.

PURPOSE: Despite a rapid spread of the technique, very little is known about the laser-tissue interaction in endovenous laser treatment (EVLT). We evaluated EVLT of the incompetent greater saphenous vein (GSV) for efficacy, treatment-related adverse effects, and putative mechanisms of action. METHODS: Twenty-six patients with 31 limbs of clinical stages C(2-6), E(P), A(S,P), P(R) with incompetent GSV proven by means of duplex scanning were selected for EVLT in an outpatient setting. A 600-microm fiber was entered into the GSV via an 18-gauge needle below the knee and proceeded to the saphenofemoral junction (SFJ). After infiltration of tumescent local anesthesia, multiple laser pulses of 15 J energy and a wavelength of 940 nm were administered along the vein in a standardized fashion. D-dimers were determined in peripheral blood samples 30 minutes after completion of EVLT in 16 patients and on postoperative day 1 in 20 patients. One GSV that was surgically removed after EVLT was examined by means of histopathology. Additionally, an experimental in vitro set-up was constructed as a means of investigating the mechanism of laser action within a blood-filled tube. RESULTS: A median of 80 laser pulses (range, 22-116 laser pulses) were applied along the treated veins. On days 1, 7, and 28, all limbs except one (97%) showed a thrombotically occluded GSV. In one patient, the vessel showed incomplete occlusion. The distance of the proximal end of the thrombus to the SFJ was a median 1.1 cm (range, 0.2-5.9 cm) in the remaining patients. Adverse effects in all 26 patients were ecchymoses and palpable induration along the thrombotically occluded GSV that lasted for 2 to 3 weeks. In two limbs (6%), thrombophlebitis of a varicose tributary required oral treatment with diclofenac. D-dimers in peripheral blood were tested with normal results in 14 of 16 patients 30 minutes after completion of the procedure and elevated results in 7 of 20 patients at day 1 after EVLT. However, an increase of D-dimers from day 0 to day 1 was observed in 15 of the 16 patients undergoing tests 30 minutes after EVLT and on day 1. The 940-nm laser was demonstrated by means of in vitro experiments and the histopathological examination of one explanted GSV to act by means of indirect heat damage of the inner vein wall. CONCLUSION: EVLT of the GSV with a 940-nm diode laser is effective in inducing thrombotic vessel occlusion and is associated with only minor adverse effects. Laser-induced indirect local heat injury of the inner vein wall by steam bubbles originating from boiling blood is proposed as the pathophysiological mechanism of action of EVLT.

Effective treatment of leg vein telangiectasia with a new 940 nm diode laser.

BACKGROUND: A variety of lasers have been used in an attempt to treat leg vein telangiectasia OBJECTIVE: To evaluate the feasibility of a new 940 nm diode laser for the treatment of leg vein telangiectasia. METHODS: Thirty-one patients with leg vein telangiectasia were treated with a diode laser; 26 of these with 940 nm, 300-350 J/cm2, 40-70 msec, 1.0 mm handpiece, one pass, and 5 of these with 940 nm, 815 J/cm2, 50 msec, 0.5 mm handpiece, one pass. Each subject had three treatments of the same site at 4-week intervals. Photographs taken before and 4 weeks after the last treatment were evaluated by two independent observers for vessel clearance. RESULTS: In those 26 patients treated with a fluence of 300-350 J/cm2, a vessel clearance of greater than 50% was achieved in 20 patients (76%), 12 of these patients had clearance rates greater than 75%. A clearance rate of less than 50% was obtained in six patients, with three of these patients showing responses of less than 25%. In five patients treated with a fluence of 815 J/cm2 a clearance rate of more than 75% was observed. CONCLUSIONS: In this preliminary study a 940 nm diode laser was shown to be safe and effective for the treatment of leg vein telangiectasia.

[Endoscopic laser therapy of bladder tumors in man]. / Endoskopische Laser-Bestrahlung von Blasentumoren des Menschen

15 patients with papillary bladder tumors were radiated with a Neodym-YAG laser beam since summer 1976. The seize of the tumors ranged from 5 to 10 mm in diameter. Neither complications nor tumor recurrency in the former tumor area could be observed. A final statement about the value of laser radiation in malignant tumors is not yet possible because of the small number of patients and the short control period. However, our preliminary experiences might be a beginning of a successful improvement of bladder tumor therapy by use of endoscopic laser radiation.