Quantum Correlations beyond Entanglement and Discord.

Dissimilar notions of quantum correlations have been established, each being motivated through particular applications in quantum information science and each competing for being recognized as the most relevant measure of quantumness. In this contribution, we experimentally realize a form of quantum correlation that exists even in the absence of entanglement and discord. We certify the presence of such quantum correlations via negativities in the regularized two-mode Glauber-Sudarshan function. Our data show compatibility with an incoherent mixture of orthonormal photon-number states, ruling out quantum coherence and other kinds of quantum resources. By construction, the quantumness of our state is robust against dephasing, thus requiring fewer experimental resources to ensure stability. In addition, we theoretically show how multimode entanglement can be activated based on the generated, nonentangled state. Therefore, we implement a robust kind of nonclassical photon-photon correlated state with useful applications in quantum information processing.

[Individualized use of levosimendan in cardiac surgery]. / Individualisierter Einsatz von Levosimendan in der Herzchirurgie.

BACKGROUND: Levosimendan is a cardiac inotrope that augments myocardial contractility without increasing myocyte oxygen consumption. Additionally, levosimendan has been shown to exhibit anti-inflammatory, antioxidative, and other cardioprotective properties and is approved for treatment of heart failure. Recent studies indicated that these beneficial effects can be achieved with doses lower than the standard dose of 12.5 mg. Patients with preoperatively diagnosed left ventricular ejection fraction (LVEF) ≤40% received 1.25 mg levosimendan after induction of anesthesia. After surgery, administration of low-dose levosimendan was repeated until cardiovascular stability was achieved. OBJECTIVE: This study aimed to evaluate if pharmacological preconditioning with 1.25 mg levosimendan in patients with LVEF ≤40% altered the postoperative need for inotropic agents, the incidence of newly occurring atrial fibrillation, renal replacement therapy, mechanical circulatory support and 30-day mortality. The cumulative dosage of levosimendan was recorded to assess the required dosage in the context of individualized treatment. MATERIAL AND METHODS: This retrospective study included patients with preoperatively diagnosed LVEF ≤40% who underwent cardiac surgery at this institution between January 2015 and December 2018 and who received 1.25 mg levosimendan after induction of anesthesia to prevent postoperative low cardiac output syndrome. Based on echocardiography results, invasive hemodynamic monitoring, and central venous or mixed venous oxygen saturation and lactate clearance, repetitive doses of levosimendan in 1.25 mg increments could be postoperatively administered until cardiovascular stability was achieved. The results were compared to the current literature. RESULTS: We identified 183 patients with LVEF <40% who received pharmacological preconditioning with 1.25 mg levosimendan. Maximum doses of epinephrine, incidence of atrial fibrillation, need for renal replacement therapy and 30-day mortality were found to be below the published rates of comparable patient collectives. In 73.2% of patients, a cumulative dosage of 5 mg levosimendan or less was considered sufficient. CONCLUSION: The presented concept of pharmacological preconditioning with 1.25 mg levosimendan followed by individualized additional dosing in cardiac surgery patients with preoperative LVEF ≤40% suggests that this concept is safe, with possible advantages regarding the need of inotropic agents, renal replacement therapy, and 30-day mortality, compared to the current literature. Individualized treatment with levosimendan to support hemodynamics and a timely reduction of inotropic agents needs further confirmation in randomized trials.

[A 61-year-old man with jaundice following stomach cancer]. / 61-jähriger Patient mit Ikterus bei Zustand nach Magenkarzinom.

A 61-year-old man with occlusion of the common bile duct due to metachronous metastases after surgery for adenocarcinoma of the stomach underwent a bile drainage intervention using endoscopic ultrasound (EUS). A self-expanding metal stent was inserted into the common bile duct of the liver via the esophagus. Successful drainage of the bile fluid into the duodenum was achieved for 14 months until the death of the patient. EUS interventions are becoming increasingly common. Although many questions such as the methodological details still remain, EUS interventions have the potential to become standard procedures especially in the situation of malignant stenoses of the bile or pancreatic duct.

[Vulval hypoplasia in an alpaca cria - first case report in Germany]. / Vulvahypoplasie bei einem Alpakacria - Erstbeschreibung eines Falls in Deutschland.

This is the first German case report of an alpaca cria suffering from a congenital vulvahypoplasia. Symptoms, diagnostics and therapy are described. The 24-hours-old cria was referred to the hospital due to reduced general condition and colic. The existent vulvahypoplasia led to impaired urination, causing further complications such as urovagina and urinary stasis up to the renal pelvis. Surgical construction of the rima vulvae cured the cria. As indicated by several cases published on the clinical picture of vulvahypoplasia during recent years, this congenital deformation could become an increasing problem in the alpaca population.

[Improvement of tomographic reconstruction in bone SPECT]. / Optimierung der tomographischen Rekonstruktion in der Skelett-SPECT.

AIM: The comparison between iterative reconstruction and filtered backprojection in the reconstruction of bone SPECT in the diagnosis of skeletal metastases. PATIENTS, METHODS: 47 consecutive patients (vertebral segments: n = 435), with suspected malignancy of the vertebral column, were examined by bone scintigraphy and MRI (maximal interval between the two procedures +/- 5 weeks). The SPECT-data were reconstructed with an iterative algorithm (ISA) and with filtered backprojection. We defined semiquantitative criteria in order to assess the quality of the tomograms. Conventional reconstruction was performed both by a Wiener-filter and a low-pass-filter. Iterative reconstruction was performed by the ISA algorithm. The clinical evaluation of the different reconstruction algorithms was performed by MRI as the gold-standard. RESULTS: Sensitivity (%): 87.3 (ISA), 86.4 (low-pass), 79.7 (Wiener); specificity (%): 95.3 (ISA), 95 (low-pass), 85.4 (Wiener). The sensitivity of iterative reconstructed SPECT and low-pass reconstructed SPECT was significantly higher (p < 0.05) compared with the sensitivity of SPECT reconstructed by the Wiener-filter. The specificity of iterative reconstruction ISA and low-pass-filter reconstructed SPECT were significantly higher compared with the SPECT data reconstructed by the Wiener-filter. ISA was significantly superior to the Wiener-SPECT relating to all criteria of quality. Iterative reconstruction was significantly superior to the low-pass-SPECT relating to 2 of 3 criteria. In addition the Wiener-SPECT was significantly inferior to the low-pass-SPECT regarding to 2 of 3 criteria. CONCLUSION: In our series the iterative algorithm ISA was the method of choice in the reconstruction of bone SPECT data. In comparison with conventional algorithms ISA offers a significantly higher quality of the tomograms and yields a high diagnostic accuracy.

[The phenylalanine stress test in the classification of patients with phenylketonuria]. / Der Phenylalanin-Belastungstest in der Klassifikation der Phenylketonurie-Patienten.

Classification of defects of phenylalanine hydroxylase is usually performed by a phenylalanine loading test according to Blaskovics. This loading test has some drawbacks, especially negative side effects for the patients. We found a correlation between the result of the loading test and the dietetic phenylalanine tolerance. Therefore the trouble of undergoing the loading rest may be spared many patients.