Continent urinary tract reconstruction - the Lund experience.

The Department of Urology in Lund, Sweden, has a long association with innovations in reconstructive urology. The authors from that department describe their experience over a long period with orthotopic bladder substitution and continent cutaneous urinary diversion. They conclude that continent urinary tract reconstruction is associated with a high incidence of early and late complications. They also found that for storage and emptying, their Lundiana pouch was superior to the Goldwasser neobladder. OBJECTIVE: To assess the early and late complications and functional results in patients undergoing continent reconstruction of the urinary tract, i.e. orthotopic bladder substitution (OBS) or continent cutaneous diversion (CCD). PATIENTS AND METHODS: The medical records of all patients undergoing OBS (Goldwasser technique) or CCD ('Lundiana' technique) for malignant or benign disease during 1987-1999 and followed to December 2001 were reviewed. There were 67 patients with neobladders, 77 with a Lundiana pouch who had undergone radical cystectomy and 22 with a Lundiana pouch operated for benign disorders. RESULTS: Early complications requiring reoperation occurred in 12% of the cystectomy group, with no difference with type of reconstruction, and in 10% with benign diseases. Four patients (3%) undergoing radical cystectomy died from early cardiovascular complications, two after surgery for intra-abdominal complications. Intestinally related complications and wound dehiscence requiring re-operation occurred in nine and six patients, respectively. The incidence of late complications requiring open surgery was 22% and 23% after cystectomy with OBS and CCD, respectively. The value in patients with benign diseases undergoing CCD was also 23%. Stone formation in the pouch was common, occurring in 12% in patients with OBS and in 10% after CCD. The pouch perforated or ruptured in four patients. The incidence of uretero-intestinal stricture using the Le Duc technique was 2.4% and renal function was well preserved. The incidence of revisional surgery of the Lundiana pouch outlet for incontinence was low and all patients but four were continent. The functional outcome in patients with OBS was less good; some needed pouch augmentation or an artificial urinary sphincter. Most patients used incontinence products and many needed clean intermittent self-catheterization. CONCLUSION: Continent urinary tract reconstruction is associated with a high incidence of early and late complications. For storage and emptying, the CCD Lundiana pouch is superior to the OBS of Goldwasser

Dimensional reduction by pressure in the magnetic framework material CuF2_{2}(D2_{2}O)2_{2}pyz: from spin-wave to spinon excitations

Metal organic magnets have enormous potential to host a variety of electronic and magnetic phases that originate from a strong interplay between the spin, orbital and lattice degrees of freedom. We control this interplay in the quantum magnet CuF$_2$(D$_2$O)$_2$pyz by using high pressure to drive the system through a structural and magnetic phase transition. Using neutron scattering, we show that the low pressure state, which hosts a two-dimensional square lattice with spin-wave excitations and a dominant exchange coupling of 0.89 meV, transforms at high pressure into a one-dimensional spin-chain hallmarked by a spinon continuum and a reduced exchange interaction of 0.43 meV. This direct microscopic observation of a magnetic dimensional crossover as a function of pressure opens up new possibilities for studying the evolution of fractionalised excitations in low dimensional quantum magnets and eventually pressure-controlled metal--insulator transitions

Assessing energy security: An overview of commonly used methodologies

This paper provides an overview of methodologies used for quantitative evaluations of security of supply. The studied material is mainly based on peer-reviewed articles and the methodologies are classified according to which stage in the supply chain their main focus is directed to, as well as their scientific background. Our overview shows that a broad variety of approaches is used, but that there are still some important gaps, especially if the aim is to study energy security in a future-oriented way. First, there is a need to better understand how sources of insecurity can develop over time and how they are affected by the development of the energy system. Second, the current tendency to study the security of supply for each energy carrier separately needs to be complemented by comparisons of different energy carrier's supply chains. Finally, the mainly static perspective on system structure should be complemented with perspectives that to a greater extent take the systems' adaptive capacity and transformability into account, as factors with a potential to reduce the systems vulnerabilities. Furthermore, it may be beneficial to use methodological combinations, conduct more thorough sensitivity analysis and alter the mind-set from securing energy flows to securing energy services

A spin- and angle-resolving photoelectron spectrometer

A new type of hemispherical electron energy analyzer that permits angle and spin resolved photoelectron spectroscopy has been developed. The analyzer permits standard angle resolved spectra to be recorded with a two-dimensional detector in parallel with spin detection using a mini-Mott polarimeter. General design considerations as well as technical solutions are discussed and test results from the Au(111) surface state are presented

QCD Signatures of Narrow Graviton Resonances in Hadron Colliders

We show that the characteristic p_\perp spectrum yields valuable information for the test of models for the production of narrow graviton resonances in the TeV range at LHC. Furthermore, it is demonstrated that in those scenarios the parton showering formalism agrees with the prediction of NLO matrix element calculations.Comment: 6 pages, 9 figures, LaTe

"I see myself": Craving imagery among individuals with addictive disorders.

Craving has been put forward as a core feature of addictive disorders. The present qualitative study investigated the experience of craving among individuals with addictive disorders and recent experiences of cravings. Eleven individuals with Gambling Disorder and ten with Alcohol Use Disorder (n = 21) were recruited. A semi-structured interview explored: (1) modes of thought during craving (mental imagery or verbal thoughts), (2) craving content, (3) coping strategies and (4) craving context. The thematic analysis showed that cravings were initially dominated by imagery, with a subsequent conflict between imagery and verbal thoughts. Craving content included imagery of preparative rituals, anticipation, and sensory activation, imagery of the addictive behavior "me, there and then imagery" and anticipating that "something good will come out of it." Some participants related to craving as a symptom of sickness, and coping with craving were through distraction, reminding oneself of negative consequences, or via sensory control: avoiding stimuli associated with the addiction. Craving contexts included typical settings of drinking or gambling and engagement of both positive and negative emotions. Alcohol craving was described as an expected relief from internal stimuli, such as anxiety or stress, whereas gambling craving was more often described as an expectancy of financial reward. Craving was experienced mainly through imagery containing the preparative routines and expected outcomes. Future research and clinical practice should incorporate mode of thought in cravings to better understand its role in the maintenance of the disorders and their treatment

Sulfatide in health and disease. The evaluation of sulfatide in cerebrospinal fluid as a possible biomarker for neurodegeneration

Sulfatide (3-O-sulfogalactosylceramide, SM4) is a glycosphingolipid, highly multifunctional and particularly enriched in the myelin sheath of neurons. The role of sulfatide has been implicated in various biological fields such as the nervous system, immune system, host-pathogen recognition and infection, beta cell function and haemostasis/thrombosis. Thus, alterations in sulfatide metabolism and production are associated with several human diseases such as neurological and immunological disorders and cancers. The unique lipid-rich composition of myelin reflects the importance of lipids in this specific membrane structure. Sulfatide has been shown to be involved in the regulation of oligodendrocyte differentiation and in the maintenance of the myelin sheath by influencing membrane dynamics involving sorting and lateral assembly of myelin proteins as well as ion channels. Sulfatide is furthermore essential for proper formation of the axo-glial junctions at the paranode together with axonal glycosphingolipids. Alterations in sulfatide metabolism are suggested to contribute to myelin deterioration as well as synaptic dysfunction, neurological decline and inflammation observed in different conditions associated with myelin pathology (mouse models and human disorders). Body fluid biomarkers are of importance for clinical diagnostics as well as for patient stratification in clinical trials and treatment monitoring. Cerebrospinal fluid (CSF) is commonly used as an indirect measure of brain metabolism and analysis of CSF sulfatide might provide information regarding whether the lipid disruption observed in neurodegenerative disorders is reflected in this body fluid. In this review, we evaluate the diagnostic utility of CSF sulfatide as a biomarker for neurodegenerative disorders associated with dysmyelination/demyelination by summarising the current literature on this topic. We can conclude that neither CSF sulfatide levels nor individual sulfatide species consistently reflect the lipid disruption observed in many of the demyelinating disorders. One exception is the lysosomal storage disorder metachromatic leukodystrophy, possibly due to the genetically determined accumulation of non-metabolised sulfatide. We also discuss possible explanations as to why myelin pathology in brain tissue is poorly reflected by the CSF sulfatide concentration. The previous suggestion that CSF sulfatide is a marker of myelin damage has thereby been challenged by more recent studies using more sophisticated laboratory techniques for sulfatide analysis as well as improved sample selection criteria due to increased knowledge on disease pathology