Observation of Interactions between Trapped Ions and Ultracold Rydberg Atoms.

We report on the observation of interactions between ultracold Rydberg atoms and ions in a Paul trap. The rate of observed inelastic collisions, which manifest themselves as charge transfer between the Rydberg atoms and ions, exceeds that of Langevin collisions for ground state atoms by about 3 orders of magnitude. This indicates a huge increase in interaction strength. We study the effect of the vacant Paul trap's electric fields on the Rydberg excitation spectra. To quantitatively describe the exhibited shape of the ion loss spectra, we need to include the ion-induced Stark shift on the Rydberg atoms. Furthermore, we demonstrate Rydberg excitation on a dipole-forbidden transition with the aid of the electric field of a single trapped ion. Our results confirm that interactions between ultracold atoms and trapped ions can be controlled by laser coupling to Rydberg states. Adding dynamic Rydberg dressing may allow for the creation of spin-spin interactions between atoms and ions, and the elimination of collisional heating due to ionic micromotion in atom-ion mixtures.

Trapped Ions in Rydberg-Dressed Atomic Gases.

We theoretically study trapped ions that are immersed in an ultracold gas of Rydberg-dressed atoms. By off-resonant coupling on a dipole-forbidden transition, the adiabatic atom-ion potential can be made repulsive. We study the energy exchange between the atoms and a single trapped ion and find that Langevin collisions are inhibited in the ultracold regime for these repulsive interactions. Therefore, the proposed system avoids recently observed ion heating in hybrid atom-ion systems caused by coupling to the ion's radio frequency trapping field and retains ultracold temperatures even in the presence of excess micromotion.

The nutritional management of type 3c (pancreatogenic) diabetes in chronic pancreatitis.

Type 3c diabetes mellitus (T3cDM), also known as pancreatogenic diabetes, refers to diabetes caused by disease of the exocrine pancreas. T3cDM is not commonly recognised by clinicians and frequently it is misclassified as T1DM, or more commonly, T2DM. T3cDM can be difficult to distinguish from T1DM and T2DM, and it often co-exists with the latter. The aim of this review is to describe T3cDM, along with its complications, diagnosis and management. We focus on the nutritional implications of T3cDM for those with chronic pancreatitis, and provide a practical guide to the nutritional management of this condition.

Prevalence of diabetes mellitus secondary to pancreatic diseases (type 3c).

BACKGROUND: Diabetes mellitus secondary to pancreatic diseases is a condition seldom thought of in clinical practice. Yet, a high percentage of exocrine pancreatic insufficiency has been reported for the general population and especially for diabetic subjects. Thus, we investigated the prevalence of diabetes mellitus due to pancreatic diseases. METHODS: In this study, we investigated 1868 patients diagnosed with diabetes mellitus who had been admitted to our hospital during the last 24 months. Patient data were diligently studied, and patients were reclassified according to the diabetes classification as proposed by the American Diabetes Association. RESULTS: Among 1868 subjects, 172 patients could be classified as type 3c diabetes mellitus (9.2%). Among these were 135 diagnosed with chronic pancreatitis (78.5%), 12 with hereditary haemochromatosis, 14 with pancreatic cancer and 7 with cystic fibrosis. Thus, diabetes mellitus due to chronic pancreatitis occurred in this collective in 7.2% of all diabetic subjects. Misclassification of these patients was very common. Only 51.2% (88/172) were initially classified correctly. Most type 3 diabetes patients were initially misclassified as type 2 diabetes (69/84). CONCLUSIONS: Diabetes mellitus secondary to pancreatic diseases (especially chronic pancreatitis) seems more common than generally believed with a prevalence of 9.2% among the subjects studied here. Because the awareness of this diabetes type is poor, misclassification is quite frequent. A common problem seems to be the differentiation between type 2 and type 3. Yet, the right classification of diabetes mellitus is important, because there are special therapeutic options and problems in patients with diabetes secondary to pancreatic diseases.

[Pyruvate kinase M2 (tumor M2-PK) as a screening tool for colorectal cancer (CRC). A review of current published data]. / Pyruvatkinase M2 (Tumor M2-PK) im Stuhl als Screeningparameter für kolorektale Neoplasien. Eine Ubersicht über bisher publizierte Daten.

INTRODUCTION: Colonoscopy is currently supposed to be the best screening tool for colorectal cancer. However, the acceptance of the population is very poor although it has been included in screening programs in the German health system since 2002. Therefore, evaluation of additional screening tools seems to be of great interest. Recently testing for fecal occult blood (FOBT), genetic alterations or alterations in tumor metabolism (e.g., tumor M2-PK) are under investigation. METHODS: The use of M2-PK measurement in the feces has been reported in 6 studies until today. The data of these studies were analyzed and critically reviewed. RESULTS: The overall sensitivity of M2-PK is 77.9% concerning CRC. Specificity ranges from 74.3-83.3%. Overall sensitivity for adenomas is 45.9%, increasing to 61.1% for adenomas > 1 cm. A high percentage of positive results (90.4%) was also observed in patients with chronic inflammatory bowel disease. CONCLUSIONS: Compared to FOBT or genetic testing the M2-PK test seems to be superior for CRC screening. Concerning handling, effectiveness and analysis, M2-PK seems to be a good possibility for large scale-screening of colorectal carcinoma. It might even be used to detect larger adenomas. Elevated levels of M2-PK in patients with acute and/or chronic inflammatory bowel diseases are probably due to proliferation of epithelial cells and leucocytes in the inflammatory area.

Role of redox signaling in the autonomous proliferative response of endothelial cells to hypoxia.

Endothelial cells exhibit an autonomous proliferative response to hypoxia, independent of paracrine effectors. In cultured endothelial cells of porcine aorta, we analyzed the signaling of this response, with a focus on the roles of redox signaling and the MEK/ERK pathway. Transient hypoxia (1 hour) stimulated proliferation by 61+/-4% (n=16; P<0.05 versus control), quantified after 24 hours normoxic postincubation. Hypoxia induced an activation of ERK2 and of NAD(P)H oxidase and a burst of reactive oxygen species (ROS), determined by DCF fluorescence. To inhibit the MEK/ERK pathway, we used PD 98059 (PD, 20 micromol/L); to downregulate NAD(P)H oxidase, we applied p22phox antisense oligonucleotides; and to inhibit mitochondrial ROS generation, we used the ubiquinone derivate mitoQ (MQ, 10 micromol/L). All three inhibitions suppressed the proliferative response: PD inhibited NAD(P)H oxidase activation; p22phox antisense transfection did not inhibit ERK2 activation, but suppressed ROS production; and MQ inhibited ERK2 activation and ROS production. The autonomous proliferative response depends on the MEK/ERK pathway and redox signaling steps upstream and downstream of ERK. Located upstream is ROS generation by mitochondria, downstream is NAD(P)H oxidase.

Signaling of hypoxia-induced autonomous proliferation of endothelial cells.

Endothelial cells exhibit an autonomous proliferative response to hypoxia, independent of paracrine effectors. In cultured endothelial cells of porcine aorta, we analyzed the signaling and compared hypoxia with mitochondrial inhibition by rotenone. Particularly, roles of the mitogen-activated protein kinase (MAPK) kinase (MEK)/MAPK pathway and cytosolic Ca2+ were studied. Hypoxia resulted in increased proliferation by 65+/-2%. Hypoxia induced transient activation of p42 MAPK (phosphorylation rose from 11+/-5 to 51+/-7%), followed by translocation of p42 MAPK into the nucleus. The proliferative response was diminished after inhibition of the MEK/MAPK pathway by PD 98059 (20 microM) or UO 126 (10 microM) but not sensitive to 8-phenyl-theophillin (10 microM), an adenosine receptor blocker, nor to a neutralizing antibody for vascular endothelial growth factor (VEGF). Inhibition of intracellular Ca2+ release, capacitive Ca2+ influx, or removal of extracellular Ca2+ prevented hypoxic Ca2+ overload and the proliferative response. Suppression of cytosolic Ca2+ rise did not interfere with activation of p42 MAPK but abolished its nuclear translocation. Effects of hypoxia were mimicked by rotenone (10 microM. Transient hypoxic inhibition of mitochondria induces a proliferative endothelial response mediated through Ca2+-independent activation and Ca2+-dependent nuclear translocation of p42 MAPK. This proliferative response is independent of adenosine or VEGF.

[Urinary diversions and intestinal grafts in renal transplantation in children. Report of 8 cases]. / Dérivations urinaires et greffons intestinaux en transplantation rénale chez l'enfant. Rapport de huit cas.

In a series of 400 transplantations, 8 children presented a severe lesion of the lower urinary tract requiring an intestinal graft to divert the urine or to replace the useless bladder: 4 cases of posterior urethral valves and 4 cases of neurogenic bladder. Four permanent urinary diversions and 4 bladder enlargements, including 3 temporary diversions, were performed. The sigmoid colon was used in 5 cases and the ileum was used in 3 cases. The preparation of the intestinal graft was always performed prior to the transplantation. The uretero-intestinal anastomosis included an antireflux device in 3 of the 8 cases. There were no deaths in this series. Three occlusions and 2 lymphoceles occurred in the immediate post-transplantation period, but were corrected by re-operation. Two cases of calculi occurred in the long term, one of which required operation. Moderate stenosis of the renal artery in one case resulted in systemic hypertension which was well controlled by medical treatment. An episode of acute pyelonephritis resolved rapidly with antibiotic treatment. Two cases of acidosis were corrected by salt supplementation. There was one case of early graft rejection on the 15th day and a delayed rejection after 18 months, leading to removal of the transplant. At the present time, 6 renal grafts function normally (75%) with a follow-up of 1 to 8 years.

[Surgical complications of renal transplantation in children. Retrospective study of 372 cases]. / Complications chirurgicales de la transplantation rénale chez l'enfant. Etude rétrospective de 372 cas.

On the basis of a personal series of 372 cases of renal transplantation performed in children, half of whom presented congenital urinary tract malformations, the authors report 110 complications (29.6%). The most frequent complications were urological (14.2%), consisting essentially of fistulae (8.9%) and stenoses (3%). These were followed by vascular complications (6.4%) generally in the form of stenoses (4.8%) and rarely thromboses (1.1%). The authors also report the various local complications which were infectious (wall abscess, suppuration of the renal compartment), haemorrhagic (haematomas) or stones (stones forming on non-resorbable sutures) as well as 5 cases of lymphocele. The prophylaxis of these complications depends on the care taken in collection of the graft (en bloc removal of both kidneys), the restoration of the continuity of the urinary tract (as much as possible Lich-Gregoire extravesical uretero-vesical reimplantation), the vascular anastomoses (vascular dissection limited to a strict minimum), the choice of suture material (resorbable synthetic suture material) and the prevention of infection by systematic pre-, intra- and post-operative antibiotic therapy.

[Use of the intestinal graft in renal transplantation in children and adults]. / L'utilisation du greffon intestinal dans la transplantation rénale chez l'enfant et l'adulte.

Intestinal grafts as a means to external shunting of urine during renal transplant operation were described by W.D. Kelly as early as 1966. Since then 80 cases have been reported in the Anglo-Saxon literature. A total of 68 well-documented cases showed functional kidneys in 52%, complications in 42% and a 13% mortality rate. Between 1973 and 1985, of 400 renal transplant operations in children, an intestinal graft was used in 8 cases (2%) to provide 4 definitive external diversions and 4 enlargements or replacements of bladder. Indications for use were neurological bladder and posterior urethra valves. In all cases the graft was prepared before transplant operation. Enlargement of bladder requires good cervico-urethral function determined by previous study of a generally nonfunctioning bladder distal to an cutaneous ureterostomy. To avoid post-transplant urological effects the graft for enlargement or replacement is opened temporarily on to skin and closed several months after grafting. Follow up for 2 to 8 years showed 6 kidneys functioning normally, and 3 enlarged or replaced bladders out of 4 currently closed functioning satisfactorily. The 2 lost kidneys were rejected 2 weeks and 2 years respectively after the graft operation. There was no mortality or urological complication. The only surgical complications related to the intestinal graft were 3 early-onset occlusions treated successfully. Calculi formed in 2 cases, one being eliminated spontaneously at an early stage and the other, of late onset, requiring two operations. Metabolic or infectious complications were benign.(ABSTRACT TRUNCATED AT 250 WORDS)

[Teratoma of the renal sinus. Apropos of a Case]. / Tératome de la loge rénale. A propos d'un cas.

The authors report a new case of teratoma of the renal fossa. Such tumours are rare. The case reported is unusual since it involved an older child and because the small lesion was located in the renal sinus and not in the parenchyma.

[Diagnosis, prevalence, prognosis and treatment of the trophoblastic component in germinal tumours of the testis in the adult]. / Diagnostic, incidence, pronostique et thérapeutique de la composante trophoblastique dans les tumeurs germinales du testicule chez l'adulte.

The authors report a series of 97 germinal tumours of the testis in the adult, studied first in terms of conventional histological data. Of 33 seminomas, 2 secreted HCG. The 5-year actuarial survival at stage I was 93%, and at stage II 75%. Stage II deaths revealed the existence of not purely seminomatous tumours. Amongst dysembryomas, half secreted HCG, with 3 histological groups: predominant choriocarcinomas, tumours with a trophoblastic component and "apparently pure" dysembryomas. The 3-year actuarial survival for dysembryomas was 90% at stage I and 58% at stage II. 51 patients of the series were studied retrospectively by sections with HCG peroxidase, a technique which reveals the intracytoplasmic synthesis of the hormone. Two types of cells have proved capable of such synthesis: syncytial cells, of syncytial-trophoblastic type, and small mononuclear cells. One third of seminomas and 90% of dysembryomas proved to have a trophoblastic component as demonstrated by HCG immunoperoxidases. All patients secreting HCG were HCG peroxidase positive. This equally applied to all patients with syncytial cells. Furthermore, all the indications are that HCG secretion is above all by the syncytial cells. From a diagnostic standpoint, any rise in beta HCG is synonymous with an HCG immunoperoxidase trophoblastic component. Detection of such a component using immunoperoxidase would seem to be essential for non-secreting tumours. From a prognostic standpoint, seminomas with a trophoblastic component are in fact dysembryomas and lymph node dissection should be performed, this being the only way of not missing a non-seminomatous metastasis. Therapeutically, pure seminomas are distinguished by the possibility of cure by radiotherapy. For all other tumours, orchidectomy must be followed by lymph node dissection. Subsequent treatment is decided on the basis of the results of the latter, with the exception of tumours with visceral metastases where chemotherapy must come first.

[Intraperitoneal bladder rupture (author's transl)]. / Rupture intra-péritonéale de vessie.

On-duty radiologists should keep in mind some peculiar circumstances leading to intraperitoneale bladder rupture without fracture of pelvic bones. It is thus possible to identify the classical pattern of dog's ears topping the bladder, on the abdomen plain film, and the diagnosis may be confirmed by intravenous urography. An illustration is given by the reported case: a young man, after drinking too much, received a kick into the lap, followed by a severe pain and total urinary retention with a flat bladder.

[The treatment of abdominal evisceration using the wire technique (author's transl)]. / Traitement des éviscérations par la technique des broches.

The insertion of wires in the preventive and curative treatment of abdominal evisceration is a variety of atraumatic open full-thickness sutures which are easy to carry out and particularly effective. In preventive treatment, they facilitate abdominal closure and avoid the risk of evisceration when large areas of skin are involved. In curative treatment, they form an abdominal "buckle" with the equal distribution of increased pressure over a large area, avoiding pulling on the sutures.