Prostate cancer treatment with Irreversible Electroporation (IRE): Safety, efficacy and clinical experience in 471 treatments.

BackgroundIrreversible Electroporation (IRE) is a novel image-guided tissue ablation technology that induces cell death via very short but strong pulsed electric fields. IRE has been shown to have preserving properties towards vessels and nerves and the extracellular matrix. This makes IRE an ideal candidate to treat prostate cancer (PCa) where other treatment modalities frequently unselectively destroy surrounding structures inducing severe side effects like incontinence or impotence. We report the retrospective assessment of 471 IRE treatments in 429 patients of all grades and stages of PCa with 6-year maximum follow-up time.Material and findingsThe patient cohort consisted of low (25), intermediate (88) and high-risk cancers (312). All had multi-parametric magnetic resonance imaging, and 199 men had additional 3D-mapping biopsy for diagnostic work-up prior to IRE. Patients were treated either focally (123), sub-whole-gland (154), whole-gland (134) or for recurrent disease (63) after previous radical prostatectomy, radiation therapy, etc. Adverse effects were mild (19.7%), moderate (3.7%) and severe (1.4%), never life-threatening. Urinary continence was preserved in all cases. IRE-induced erectile dysfunction persisted in 3% of the evaluated cases 12 months post treatment. Mean transient IIEF-5-Score reduction was 33% within 12-month post IRE follow-up and 15% after 12 months. Recurrences within the follow-up period occurred in 10% of the treated men, 23 in or adjacent to the treatment field and 18 outside the treatment field (residuals). Including residuals for worst case analysis, Kaplan Maier estimation on recurrence rate at 5 years resulted in 5.6% (CI95: 1.8-16.93) for Gleason 6, 14.6% (CI95: 8.8-23.7) for Gleason 7 and 39.5% (CI95: 23.5-61.4) for Gleason 8-10.ConclusionThe results indicate comparable efficacy of IRE to standard radical prostatectomy in terms of 5-year recurrence rates and better preservation of urogenital function, proving the safety and suitability of IRE for PCa treatment. The data also shows that IRE, besides focal therapy of early PCa, can also be used for whole-gland ablations, in patients with recurrent PCa, and as a problem-solver for local tumor control in T4-cancers not amenable to surgery and radiation therapy anymore

Realization of an Inductance Scale Traceable to the Quantum Hall Effect Using an Automated Synchronous Sampling System

In this paper, the realization of an inductance scale from 1~$\mu$H to 10~H for frequencies ranging between 50~Hz to 20~kHz is presented. The scale is realized directly from a series of resistance standards using a fully automated synchronous sampling system. A careful systematic characterization of the system shows that the lowest uncertainties, around 12~$\mu$H/H, are obtained for inductances in the range from 10~mH to 100~mH at frequencies in the kHz range. This new measurement system which was successfully evaluated during an international comparison, provides a primary realization of the henry, directly traceable to the quantum Hall effect. An additional key feature of this system is its versatility. In addition to resistance-inductance (R-L) comparison, any kind of impedances can be compared: R-R, R-C, L-L or C-C, giving this sampling system a great potential of use in many laboratories around the world

Numerical modelling of cutting forces in gear skiving

Gear skiving is a high-performance machining process for gear manufacturing. Due to its complex kinematics, the local cutting conditions vary during tool engagement. Particularly, the local rake angle can reach highly negative values, which have a significant effect on the cutting force. In this paper, the Kienzle force model with additional coefficients was implemented in a numerical model to calculate local cutting forces considering the influence of local rake angle. The experimental validation based on total cutting forces shows good results and indicates an increase of model accuracy for a wide parameter range by considering the rake angle variation

Spin Glass and ferromagnetism in disordered Cerium compounds

The competition between spin glass, ferromagnetism and Kondo effect is analysed here in a Kondo lattice model with an inter-site random coupling $J_{ij}$ between the localized magnetic moments given by a generalization of the Mattis model which represents an interpolation between ferromagnetism and a highly disordered spin glass. Functional integral techniques with Grassmann fields have been used to obtain the partition function. The static approximation and the replica symmetric ansatz have also been used. The solution of the problem is presented as a phase diagram giving $T/{J}$ {\it versus} $J_K/J$ where $T$ is the temperature, $J_{K}$ and ${J}$ are the strengths of the intrasite Kondo and the intersite random couplings, respectively. If $J_K/{J}$ is small, when temperature is decreased, there is a second order transition from a paramagnetic to a spin glass phase. For lower $T/{J}$, a first order transition appears between the spin glass phase and a region where there are Mattis states which are thermodynamically equivalent to the ferromagnetism. For very low ${T/{J}}$, the Mattis states become stable. On the other hand, it is found as solution a Kondo state for large $J_{K}/{J}$ values. These results can improve the theoretical description of the well known experimental phase diagram of $CeNi_{1-x}Cu_{x}$.Comment: 17 pages, 5 figures, accepted Phys. Rev.

Thermodynamics of the Spin Luttinger-Liquid in a Model Ladder Material

The phase diagram in temperature and magnetic field of the metal-organic, two-leg, spin-ladder compound (C5H12N)2CuBr4 is studied by measurements of the specific heat and the magnetocaloric effect. We demonstrate the presence of an extended spin Luttinger-liquid phase between two field-induced quantum critical points and over a broad range of temperature. Based on an ideal spin-ladder Hamiltonian, comprehensive numerical modelling of the ladder specific heat yields excellent quantitative agreement with the experimental data across the complete phase diagram.Comment: 4 pages, 4 figures, updated refs and minor changes to the text, version accepted for publication in Phys. Rev. Let

Character of magnetic excitations in a quasi-one-dimensional antiferromagnet near the quantum critical points: Impact on magneto-acoustic properties

We report results of magneto-acoustic studies in the quantum spin-chain magnet NiCl$_2$-4SC(NH$_2$)$_2$ (DTN) having a field-induced ordered antiferromagnetic (AF) phase. In the vicinity of the quantum critical points (QCPs) the acoustic $c_{33}$ mode manifests a pronounced softening accompanied by energy dissipation of the sound wave. The acoustic anomalies are traced up to $T > T_N$, where the thermodynamic properties are determined by fermionic magnetic excitations, the "hallmark" of one-dimensional (1D) spin chains. On the other hand, as established in earlier studies, the AF phase in DTN is governed by bosonic magnetic excitations. Our results suggest the presence of a crossover from a 1D fermionic to a 3D bosonic character of the magnetic excitations in DTN in the vicinity of the QCPs.Comment: 5 pages, 4 figures. Accepted for publication by Phys. Rev

Low temperature specific heat of the heavy fermion superconductor PrOs4_4Sb12_{12}

We report the magnetic field dependence of the low temperature specific heat of single crystals of the first Pr-based heavy fermion superconductor PrOs$_4$Sb$_{12}$. The low temperature specific heat and the magnetic phase diagram inferred from specific heat, resistivity and magnetisation provide compelling evidence of a doublet ground state and hence superconductivity mediated by quadrupolar fluctuations. This establishes PrOs$_4$Sb$_{12}$ as a very strong contender of superconductive pairing that is neither electron-phonon nor magnetically mediated.Comment: 4 pages, 4 figure