Die Transurethrale Laservaporisation der Prostata

Die Trans-urethralen Laser-Ablation der Prostata stellt ein neues minimal invasives Verfahren in der alternativen Therapie der benignen Prostatahyperplasie dar. Das adenomatös veränderte Gewebe der Drüse wird mit einem Quarzlichtleiter bei axialem Strahlengang verdampft. Die Bestrahlung erfolgt mit einem Nd:YAG-Laser mit 60 Watt Dauerleistung. Es bilden sich in antegrader Richtung zylinderförmige Hohlräume im Gewebe, die zu einer Volumenreduktion und damit zu Abnahme der Obstruktion führen. Es wurden 242 Männer mit benigner Prostatahyperplasie mit der TULAP-Methode behandelt. Als Ausschlusskriterien galten lediglich floride Infektionen und Malignome der Blase oder Prostata, ebenso wie neurogene Blasenentleerungsstörungen. Der mittlere IPSS-Wert sank im Verlauf von 12 Monaten von 21,4 auf 20ml/s. Schwerwiegende Komplikationen ergaben sich nicht. Die Anzahl von Zweiteingriffen lag bei 10,3%. In keinem Fall wurde ein Einschwemmsyndrom beobachtet, lediglich bei einem Patient war weitgehend unabhängig des Eingriffs eine Bluttransfusion notwendig. Die subjektive Akzeptanz der Patienten war gut, 98% der Befragten würde den Eingriff in dieser Form erneut durchführen lassen. Die TULAP stellt somit eine effektive Methode zur Behandlung der hyperplastischen Prostata dar. Die infravesikale Obstruktion kann wirksam behoben werden. Die komplikations- und nebenwirkungsarme Technik empfiehlt sich damit nicht zuletzt auch aufgrund der ökonomischen Gesichtspunkte eines begrenzten apparativen Aufwandes als therapeutische Alternative zu den bekannten Standardverfahren in der operativen Behandlung des Prostataadenoms

A leed analysis of the (2×1)H-Ni(110) structure

A monolayer of H atoms adsorbed on Ni(110) below 180 K forms a (2×1) structure. The unit cell exhibits a glide symmetry plane and contains two adsorbed atoms. Based on a quantitative comparison between experimental and calculated LEED I/V spectra using standard R-factors the following structure was derived: On the clean Ni(110) surface the separation between the first two atomic layers, d12, is contracted by 8.5%±1.5% with respect to the bulk value; those between the second and third and the third and fourth layer, d23 and d34, are expanded by 3.5%±1.5% and 1%±1.5%, respectively—in agreement with recent other results. In the presence of the H adlayer the contraction of d12 is reduced to 4.5%±1.5%, while the expansion of d23 is not affected within the limits of accuracy. The third interlayer spacing d34 returns to its bulk value. The H atoms occupy threefold-coordinated sites formed by two Ni atoms from the first layer and one Ni atom from the second layer which confirms previous more qualitative conclusions based on He diffraction and vibrational spectroscopy. The bond lengths between H and its neighbouring Ni atoms were determined to be equal, namely 1.72±0.1 Å

Antiskyrmions and their electrical footprint in crystalline mesoscale structures of Mn1.4PtSn

Skyrmionic materials hold the potential for future information technologies, such as racetrack memories. Key to that advancement are systems that exhibit high tunability and scalability, with stored information being easy to read and write by means of all-electrical techniques. Topological magnetic excitations such as skyrmions and antiskyrmions, give rise to a characteristic topological Hall effect. However, the electrical detection of antiskyrmions, in both thin films and bulk samples has been challenging to date. Here, we apply magneto-optical microscopy combined with electrical transport to explore the antiskyrmion phase as it emerges in crystalline mesoscale structures of the Heusler magnet Mn1.4PtSn. We reveal the Hall signature of antiskyrmions in line with our theoretical model, comprising anomalous and topological components. We examine its dependence on the vertical device thickness, field orientation, and temperature. Our atomistic simulations and experimental anisotropy studies demonstrate the link between antiskyrmions and a complex magnetism that consists of competing ferromagnetic, antiferromagnetic, and chiral exchange interactions, not captured by micromagnetic simulations

COI1-dependent jasmonate signalling affects growth, metabolites production and cell wall protein composition in Arabidopsis

Background and Aims: Cultured cell suspensions have been the preferred model to study the apoplast as well as to monitor metabolic and cell cycle-related changes. Previous work showed that methyl jasmonate (MeJA) inhibits leaf growth in a CORONATINE INSENSITIVE 1 (COI1)-dependent manner, with COI1 being the jasmonate (JA) receptor. Here, the effect of COI1 overexpression on the growth of stably transformed arabidopsis cell cultures is described. Methods: Time-course experiments were carried out to analyse gene expression, and protein and metabolite levels. Key Results: Both MeJA treatment and the overexpression of COI1 modify growth, by altering cell proliferation and expansion. DNA content as well as transcript patterns of cell cycle and cell wall remodelling markers were altered. COI1 overexpression also increases the protein levels of OLIGOGALACTURONIDE OXIDASE 1, BETA-GLUCOSIDASE/ENDOGLUCANASES and POLYGALACTURONASE INHIBITING PROTEIN2, reinforcing the role of COI1 in mediating defence responses and highlighting a link between cell wall loosening and growth regulation. Moreover, changes in the levels of the primary metabolites alanine, serine and succinic acid of MeJA-treated Arabidopsis cell cultures were observed. In addition, COI1 overexpression positively affects the availability of metabolites such as β-alanine, threonic acid, putrescine, glucose and myo-inositol, thereby providing a connection between JA-inhibited growth and stress responses. Conclusions: This study contributes to the understanding of the regulation of growth and the production of metabolic resources by JAs and COI1. This will have important implications in dissecting the complex relationships between hormonal and cell wall signalling in plants. The work also provides tools to uncover novel mechanisms co-ordinating cell division and post-mitotic cell expansion in the absence of organ developmental control

Regional Management Units for Marine Turtles: A Novel Framework for Prioritizing Conservation and Research across Multiple Scales

Background: Resolving threats to widely distributed marine megafauna requires definition of the geographic distributions of both the threats as well as the population unit(s) of interest. In turn, because individual threats can operate on varying spatial scales, their impacts can affect different segments of a population of the same species. Therefore, integration of multiple tools and techniques - including site-based monitoring, genetic analyses, mark-recapture studies and telemetry - can facilitate robust definitions of population segments at multiple biological and spatial scales to address different management and research challenges. Methodology/Principal Findings: To address these issues for marine turtles, we collated all available studies on marine turtle biogeography, including nesting sites, population abundances and trends, population genetics, and satellite telemetry. We georeferenced this information to generate separate layers for nesting sites, genetic stocks, and core distributions of population segments of all marine turtle species. We then spatially integrated this information from fine-to coarse-spatial scales to develop nested envelope models, or Regional Management Units (RMUs), for marine turtles globally. Conclusions/Significance: The RMU framework is a solution to the challenge of how to organize marine turtles into units of protection above the level of nesting populations, but below the level of species, within regional entities that might be on independent evolutionary trajectories. Among many potential applications, RMUs provide a framework for identifying data gaps, assessing high diversity areas for multiple species and genetic stocks, and evaluating conservation status of marine turtles. Furthermore, RMUs allow for identification of geographic barriers to gene flow, and can provide valuable guidance to marine spatial planning initiatives that integrate spatial distributions of protected species and human activities. In addition, the RMU framework - including maps and supporting metadata - will be an iterative, user-driven tool made publicly available in an online application for comments, improvements, download and analysis

Psychological approaches to understanding and promoting recovery in psychosis and bipolar disorder:a mixed-methods approach

BackgroundRecovery in mental health is a relatively new concept, but it is becoming more accepted that people can recover from psychosis. Recovery-orientated services are recommended for adult mental health, but with little evidence base to support this. ObjectivesTo facilitate understanding and promotion of recovery in psychosis and bipolar disorder (BD), in a manner that is empowering and acceptable to service users. MethodThere were six linked projects using qualitative and quantitative methodologies: (1) developing and piloting a service user-defined measure of recovery; (2) a Delphi study to determine levels of consensus around the concept of recovery; (3) examination of the psychological factors associated with recovery and how these fluctuate over time; (4) development and evaluation of cognitive–behavioural approaches to guided self-help including a patient preference trial (PPT); (5) development and evaluation of cognitive–behavioural therapy (CBT) for understanding and preventing suicide in psychosis including a randomised controlled trial (RCT); and (6) development and evaluation of a cognitive–behavioural approach to recovery in recent onset BD, including a RCT of recovery-focused cognitive–behavioural therapy (RfCBT). Service user involvement was central to the programme. ResultsMeasurement of service user-defined recovery from psychosis (using the Subjective Experience of Psychosis Scale) and BD (using the Bipolar Recovery Questionnaire) was shown to be feasible and valid. The consensus study revealed a high level of agreement among service users for defining recovery, factors that help or hinder recovery and items which demonstrate recovery. Negative emotions, self-esteem and hope predicted recovery judgements, both cross-sectionally and longitudinally, whereas positive symptoms had an indirect effect. In the PPT, 89 participants entered the study, three were randomised, 57 were retained in the trial until 15-month follow-up (64%). At follow-up there was no overall treatment effect on the primary outcome (Questionnaire about the Process of Recovery total; p = 0.82). In the suicide prevention RCT, 49 were randomised and 35 were retained at 6-month follow-up (71%). There were significant improvements in suicidal ideation [Adult Suicidal Ideation Questionnaire; treatment effect = –12.3, 95% confidence interval (CI) –24.3 to –0.14], Suicide Probability Scale (SPS; treatment effect = –7.0, 95% CI –15.5 to 0) and hopelessness (subscale of the SPS; treatment effect = –3.8, 95% CI –7.3 to –0.5) at follow-up. In the RCT for BD, 67 participants were randomised and 45 were retained at the 12-month follow-up (67%). Recovery score significantly improved in comparison with treatment as usual (TAU) at follow-up (310.87, 95% CI 75.00 to 546.74). At 15-month follow-up, 32 participants had experienced a relapse of either depression or mania (20 TAU vs. 12 RfCBT). The difference in time to recurrence was significant (estimated hazard ratio 0.38, 95% CI 0.18 to 0.78; p < 0.006). ConclusionsThis research programme has improved our understanding of recovery in psychosis and BD. Key findings indicate that measurement of recovery is feasible and valid. It would be feasible to scale up the RCTs to assess effectiveness of our therapeutic approaches in larger full trials, and two of the studies (CBT for suicide prevention in psychosis and recovery in BD) found significant benefits on their primary outcomes despite limited statistical power, suggesting definitive trials are warranted. FundingThe National Institute for Health Research Programme Grants for Applied Research programme