The band electrode: Ongoing experience with a novel turp loop to improve hemostasis in 265 patients

Introduction: Intraoperative bleeding, one of the major complications of conventional transurethral resection of the prostate ( TURP), has led to a search for various alternative methods of tissue ablation in patients with benign prostatic hyperplasia. In 1996, we introduced the newly designed Band Electrode, which combines a high degree of resection efficiency with a better hemostasis. Material and Methods: 265 consecutive patients with prostatism underwent TURP with the Band Electrode. This modified loop electrode does not consist of a thin wire but is rather a flat metal band with a width of 1.2 mm. International prostate symptom score (IPSS), Life Quality Index ( L), peak urine flow and postvoid residual urine were evaluated pre- and postoperatively. Additionally, electrical parameters have been recorded with a specially designed high-frequency generator. Results: Median IPSS decreased from 23 preoperatively to 8 and 9 at 12 (n = 194) and 24 months ( n = 172), respectively (p < 0.001). Life Quality Index ( L) dropped from 4 to 2 and 2, respectively (p < 0.001). Peak urine flow increased from 8.2 ml/s to 18.2 (at postoperative day 3), 17.8 and 17.4 ml/s, respectively (p < 0.001). Median postvoid residual urine decreased from 77 to 15, 22 and 21 ml, respectively (p < 0.001). Resected tissue mass averaged 25 (8 - 102) g, resection time was 36.5 ( 18 - 82) min. Indwelling catheters were removed 32 ( 24 - 72) h postoperatively. None of the patients required blood transfusions or showed signs of a TUR syndrome. Despite a 1.3 times higher power need, the total energy application in vivo was comparable to conventional TURP. Conclusions: This simple exchange of active electrodes leads to a superior hemostasis and thus safety in TURP. Resection speed, tissue ablation and total energy need remain identical. Copyright (C) 2004 S. Karger AG, Basel

Simultaneous microsurgical spermatic vein ligation and sclerotherapy - A combined procedure for the treatment of recurrent or persistent varicocele

Objectives: Microsurgical ligation as well as antegrade sclerotherapy have been established in varicocele treatment. The aim of this study was to evaluate whether a combination of microsurgery. and sclerotherapy can: provide a safe and effective treatment of varicocele recurrence or persistence. Methods. Nine patients with, recurrent or persistent varicoceles were operated by means of the combination method. Under microscopic control varix veins were ligated selectively preserving: lymphatics and arteries. Ectopic veins as a possible source for varicocele persistence or recurrence were also ligated. Finally, an intraoperative venography with subsequent sclerotherapy was, performed through one of the dissected veins. Results. Despite: difficult anatomical situations after previous surgical interventions, the operations were perform, ed successfully without any complications. Clinical controls showed varicocele disappearance without damage of the testis. No varicocele recurrence or persistence was observed. Conclusions. This method combines the advantages of both methods. Precision of the microsurgical technique is combined with velocity of sclerotherapy. Thus, it may represent an Interesting alternative to conventional operation methods especially in the treatment of recurrent or persistent varicoceles. Copyright (C) 2001 S. Karger AG, Basel

Quantum Criticality in an Organic Magnet

Exchange interactions between $S=\frac{1}{2}$ sites in piperazinium hexachlorodicuprate produce a frustrated bilayer magnet with a singlet ground state. We have determined the field-temperature phase diagram by high field magnetization and neutron scattering experiments. There are two quantum critical points: $H_{c1}=7.5$ T separates a quantum paramagnet phase from a three dimensional, antiferromagnetically-ordered state while $H_{c2}=37$ T marks the onset of a fully polarized state. The ordered phase, which we describe as a magnon Bose-Einstein condensate (BEC), is embedded in a quantum critical regime with short range correlations. A low temperature anomaly in the BEC phase boundary indicates that additional low energy features of the material become important near $H_{c1}$.Comment: 4 pages, 4 figures, submitted to Phys. Rev. Lett. Replaced original text with additional conten

Phase diagram of a surface superconductor in parallel magnetic field

Detailed theory of phase diagram of clean 2D surface superconductor in a parallel magnetic field is presented. Regular spin-orbital interaction of the Rashba type is known to produce inhomogeneous superconductive state similar to the Larkin-Ovchinnikov-Fulde-Ferrel (LOFF) state with $\Delta({\bf r})\propto \cos({\bf Qr})$ at high magnetic fields, with $Q \sim g\mu_B h/v_F$. We consider the case of relatively strong Rashba interaction and show that at low temperatures $T\leq 0.4 T_{c0}$ the LOFF-type state is separated from the usual homogeneous state by the first-order phase transition line. At higher temperatures new "helical" state with $\Delta({\bf r}) \propto \exp(i{\bf Qr})$ intervene between uniform BCS state and LOFF-like state. One component of superfluid density tensor $n_s$ vanishes on the second-order transition line between BCS state and helical state. Nonmagnetic impurities suppresses both inhomogeneous states, and eliminate them completely at $T_{c0}\tau \leq 0.11$.Comment: 5 pages, 1 figure; v2: as published, minor correction

Genetic Classification of Populations using Supervised Learning

There are many instances in genetics in which we wish to determine whether two candidate populations are distinguishable on the basis of their genetic structure. Examples include populations which are geographically separated, case--control studies and quality control (when participants in a study have been genotyped at different laboratories). This latter application is of particular importance in the era of large scale genome wide association studies, when collections of individuals genotyped at different locations are being merged to provide increased power. The traditional method for detecting structure within a population is some form of exploratory technique such as principal components analysis. Such methods, which do not utilise our prior knowledge of the membership of the candidate populations. are termed \emph{unsupervised}. Supervised methods, on the other hand are able to utilise this prior knowledge when it is available. In this paper we demonstrate that in such cases modern supervised approaches are a more appropriate tool for detecting genetic differences between populations. We apply two such methods, (neural networks and support vector machines) to the classification of three populations (two from Scotland and one from Bulgaria). The sensitivity exhibited by both these methods is considerably higher than that attained by principal components analysis and in fact comfortably exceeds a recently conjectured theoretical limit on the sensitivity of unsupervised methods. In particular, our methods can distinguish between the two Scottish populations, where principal components analysis cannot. We suggest, on the basis of our results that a supervised learning approach should be the method of choice when classifying individuals into pre-defined populations, particularly in quality control for large scale genome wide association studies.Comment: Accepted PLOS On

Evidenzbasierte Therapie des Raynaud-Syndroms

Zusammenfassung: Das Raynaud-Syndrom ist mit einer Prävalenz von 3-5% ein häufiges klinisches Problem. Dennoch ist die Wirkung der meisten Therapiemöglichkeiten nur unzureichend durch kontrollierte Studien belegt. Zu den Therapien mit höherem Evidenzgrad gehört der Kalziumantagonist Nifedipin, für den in Metaanalysen sowohl bei primärem als auch bei sekundärem Raynaud-Syndrom eine verbesserte periphere Durchblutung sowie eine Abnahme der Frequenz und des Schweregrades der Raynaud-Attacken nachgewiesen werden konnte. Ähnliches gilt für intravenös appliziertes Iloprost in der Therapie des sekundären Raynaud-Syndroms bei systemischer Sklerose. Intravenös verabreichtes Iloprost verbessert darüber hinaus das Abheilen von Fingerkuppenulzera bei Patienten mit systemischer Sklerose. Vielversprechende Therapieansätze stellen Angiotensin-II-Rezeptor-1-Antagonisten (Losartan), die Kalziumantagonisten Felodipin und Amlodipin, Serotonin-Reuptake-Hemmer (Fluoxetin) und Phosphodiesterase-V-Hemmer (Sildenafil, Vardenafil) dar, die sich in kontrollierten Einzelstudien als wirksam erwiesen haben. Jedoch fehlen Erfahrungen mit größeren Patientenzahlen und längeren Anwendungszeiten, um diese Therapiemöglichkeiten abschließend zu beurteile

Rotation Measure Synthesis of Galactic Polarized Emission with the DRAO 26-m Telescope

Radio polarimetry at decimetre wavelengths is the principal source of information on the Galactic magnetic field. The diffuse polarized emission is strongly influenced by Faraday rotation in the magneto-ionic medium and rotation measure is the prime quantity of interest, implying that all Stokes parameters must be measured over wide frequency bands with many frequency channels. The DRAO 26-m Telescope has been equipped with a wideband feed, a polarization transducer to deliver both hands of circular polarization, and a receiver, all operating from 1277 to 1762 MHz. Half-power beamwidth is between 40 and 30 arcminutes. A digital FPGA spectrometer, based on commercially available components, produces all Stokes parameters in 2048 frequency channels over a 485-MHz bandwidth. Signals are digitized to 8 bits and a Fast Fourier Transform is applied to each data stream. Stokes parameters are then generated in each frequency channel. This instrument is in use at DRAO for a Northern sky polarization survey. Observations consist of scans up and down the Meridian at a drive rate of 0.9 degree per minute to give complete coverage of the sky between declinations -30 degree and 90 degree. This paper presents a complete description of the receiver and data acquisition system. Only a small fraction of the frequency band of operation is allocated for radio astronomy, and about 20 percent of the data are lost to interference. The first 8 percent of data from the survey are used for a proof-of-concept study, which has led to the first application of Rotation Measure Synthesis to the diffuse Galactic emission obtained with a single-antenna telescope. We find rotation measure values for the diffuse emission as high as approximately 100 rad per square metre, much higher than recorded in earlier work.Comment: Accepted for publication in The Astronomical Journa

Geometric Integration of Hamiltonian Systems Perturbed by Rayleigh Damping

Explicit and semi-explicit geometric integration schemes for dissipative perturbations of Hamiltonian systems are analyzed. The dissipation is characterized by a small parameter $\epsilon$, and the schemes under study preserve the symplectic structure in the case $\epsilon=0$. In the case $0<\epsilon\ll 1$ the energy dissipation rate is shown to be asymptotically correct by backward error analysis. Theoretical results on monotone decrease of the modified Hamiltonian function for small enough step sizes are given. Further, an analysis proving near conservation of relative equilibria for small enough step sizes is conducted. Numerical examples, verifying the analyses, are given for a planar pendulum and an elastic 3--D pendulum. The results are superior in comparison with a conventional explicit Runge-Kutta method of the same order