Alpha-foetoprotein and carcinoembryonic antigen in germ cell neoplasms.

Serum alpha-foetoprotein (AFP) and serum carcinoembryonic antigen (CEA) levels were measured, serially whenever possible, in 70 patients attending the Institute of Radiotherapy, Rotterdam, on account of testicular (65) or ovarian (4) germ cell tumours or, in one case, an endodermal sinus (yolk sac) tumour in the mediastinum. In 15 patients the disease was active; in the others it was in remission. Patients with active disease had raised serum AFP levels which correlated well with disease activity; no patient without evidence of active disease had raised serum AFP levels. None of the patients with active disease was found to have raised serum CEA levels. There was no correlation between serum AFP and CEA levels in patients with germ cell neoplasms, but good correlation between serum AFP levels and disease activity. Serum CEA levels did not correlate with disease activity, and serial determinations would therefore not be useful in monitoring progress in this group of diseases

Flooding of Regular Phase Space Islands by Chaotic States

We investigate systems with a mixed phase space, where regular and chaotic dynamics coexist. Classically, regions with regular motion, the regular islands, are dynamically not connected to regions with chaotic motion, the chaotic sea. Typically, this is also reflected in the quantum properties, where eigenstates either concentrate on the regular or the chaotic regions. However, it was shown that quantum mechanically, due to the tunneling process, a coupling is induced and flooding of regular islands may occur. This happens when the Heisenberg time, the time needed to resolve the discrete spectrum, is larger than the tunneling time from the regular region to the chaotic sea. In this case the regular eigenstates disappear. We study this effect by the time evolution of wave packets initially started in the chaotic sea and find increasing probability in the regular island. Using random matrix models a quantitative prediction is derived. We find excellent agreement with numerical data obtained for quantum maps and billiards systems. For open systems we investigate the phenomenon of flooding and disappearance of regular states, where the escape time occurs as an additional time scale. We discuss the reappearance of regular states in the case of strongly opened systems. This is demonstrated numerically for quantum maps and experimentally for a mushroom shaped microwave resonator. The reappearance of regular states is explained qualitatively by a matrix model.Untersucht werden Systeme mit gemischtem Phasenraum, in denen sowohl reguläre als auch chaotische Dynamik auftritt. In der klassischen Mechanik sind Gebiete regulärer Bewegung, die sogenannten regulären Inseln, dynamisch nicht mit den Gebieten chaotischer Bewegung, der chaotischen See, verbunden. Dieses Verhalten spiegelt sich typischerweise auch in den quantenmechanischen Eigenschaften wider, so dass Eigenfunktionen entweder auf chaotischen oder regulären Gebieten konzentriert sind. Es wurde jedoch gezeigt, dass aufgrund des Tunneleffektes eine Kopplung auftritt und reguläre Inseln geflutet werden können. Dies geschieht wenn die Heisenbergzeit, das heißt die Zeit die das System benötigt, um das diskrete Spektrum aufzulösen, größer als die Tunnelzeit vom Regulären ins Chaotische ist, wobei reguläre Eigenzustände verschwinden. Dieser Effekt wird über eine Zeitentwicklung von Wellenpaketen, die in der chaotischen See gestartet werden, untersucht. Es kommt zu einer ansteigenden Wahrscheinlichkeit in der regulären Insel. Mithilfe von Zufallsmatrixmodellen wird eine quantitative Vorhersage abgeleitet, welche die numerischen Daten von Quantenabbildungen und Billardsystemen hervorragend beschreibt. Der Effekt des Flutens und das Verschwinden regulärer Zustände wird ebenfalls mit offenen Systemen untersucht. Hier tritt die Fluchtzeit als zusätzliche Zeitskala auf. Das Wiederkehren regulärer Zustände im Falle stark geöffneter Systeme wird qualitativ mithilfe eines Matrixmodells erklärt und numerisch für Quantenabbildungen sowie experimentell für einen pilzförmigen Mikrowellenresonator belegt

Effect of Functional Capacity Evaluation information on the judgment of physicians about physical work ability in the context of disability claims

Purpose To test whether Functional Capacity Evaluation (FCE) information lead insurance physicians (IPs) to change their judgment about the physical work ability of claimants with musculoskeletal disorders (MSDs). Methods Twenty-seven IPs scored twice the physical work ability of two claimants for 12 specified activities, using a visual analogue scale. One claimant performed an FCE, the other served as a control. Outcome measure was the difference between experimental and control group in number of shifts in the physical work ability for the total of 12 specified activities. Results The IPs changed their judgment about the work ability 141 times when using FCE information compared to 102 times when not using this information (P-value = 0.001), both in the direction of more and less ability. Conclusions The IPs change their judgment of the physical work ability of claimants with MSDs in the context of disability claim procedures more often when FCE information is provide