Real-time spectral interferometry probes the internal dynamics of femtosecond soliton molecules.

Solitons, particle-like excitations ubiquitous in many fields of physics, have been shown to exhibit bound states akin to molecules. The formation of such temporal soliton bound states and their internal dynamics have escaped direct experimental observation. By means of an emerging time-stretch technique, we resolve the evolution of femtosecond soliton molecules in the cavity of a few-cycle mode-locked laser. We track two- and three-soliton bound states over hundreds of thousands of consecutive cavity roundtrips, identifying fixed points and periodic and aperiodic molecular orbits. A class of trajectories acquires a path-dependent geometrical phase, implying that its dynamics may be topologically protected. These findings highlight the importance of real-time detection in resolving interactions in complex nonlinear systems, including the dynamics of soliton bound states, breathers, and rogue waves.

[Intravesical radioimmunotherapy of carcinoma in situ of the urinary bladder after BCG failure]. / Intravesikale Radioimmuntherapie des Carcinoma in situ der Harnblase nach BCG-Versagen.

BACKGROUND: In failure to respond to bacillus Calmette-Guérin (BCG) in patients with carcinoma in situ (CIS) of the urinary bladder, radical cystectomy remains the mainstay after BCG failure. OBJECTIVES: The aim of this pilot study was to evaluate tolerability and safety of the α­emitter radioimmunoconjugate instillation in patients after BCG failure. MATERIALS AND METHODS: Nine patients were included. After emptying the bladder via a transurethral catheter, Bi-213-anti-EGFR-mAb was instilled. Treatment was terminated by emptying of the radioimmunoconjugate from the bladder 120 min after instillation. Efficacy was evaluated via endoscopy and histology 6 weeks after instillation. RESULTS: All patients showed excellent toleration of the treatment without any side effects. Treatment resulted in complete eradication of tumor cells in 3 patients and persistent tumor detection in the other 6 patients. CONCLUSIONS: Intravesical instillation of Bi-213-anti-EGFR-mAb is a promising therapeutic option for treatment of in situ bladder cancer after BCG failure for patients who wish to preserve the bladder.

[The most important current guideline recommendations on the topic urolithiasis : A brief comparison]. / Die wichtigsten aktuellen Leitlinienempfehlungen zum Thema Urolithiasis : Ein kurzer Vergleich.

For the development of patient-specific therapies the guidelines offer the physician a valuable catalogue of possible treatment options. They are based on the current level of knowledge and urological research, but also let some space for individual treatment at the same time. In this article, the current guidelines of several urological associations on the topic of urolithiasis regarding recommendations are described and the differences are highlighted.

[Diagnostic imaging of urolithiais. Current recommendations and new developments]. / Bildgebende Diagnostik bei Harnsteinen. Aktueller Stand und neue Trends.

BACKGROUND AND METHOD: Prevalence of urolithiasis is increasing in industrialized countries--in both adults and children, representing a unique diagnostic and therapeutic challenge. Risk-adapted diagnostic imaging currently means assessment with maximized sensitivity and specificity together with minimal radiation exposure. In clinical routine, imaging is performed by sonography, unenhanced computed tomography (NCCT) or intravenous urography (IVU) as well as plain kidney-ureter-bladder (KUB) radiographs. AIM: The aim of the present review is a critical guideline-based and therapy-aligned presentation of diagnostic imaging procedures for optimized treatment of urolithiasis considering the specifics in children and pregnant women.

Undervirilization in XY newborns may hide a 5α-reductase deficiency: report of three new SRD5A2 gene mutations.

The observation of ambiguous genitalia in the newborn signals a medical, surgical and psychological emergency. The most crucial decision will be the choice of sex assignment. Rapid and precise diagnosis is thus essential. In XY newborns with normal/high plasma testosterone (T), partial androgen insensitivity syndrome (PAIS) is usually the first diagnosis evoked, which implies an androgen receptor (AR) defect. The diagnosis of steroid-5-alpha-reductase deficiency is rarely considered by the paediatrician. We report three new SRD5A2 gene mutations in four newborns from France, Morocco and Turkey. The newborns presented with ambiguous genitalia and normal plasma T values and the initial diagnosis\PAIS. In all four cases, normal sequences of the complete AR gene excluded this diagnosis and raised the hypothesis of 5α-reductase deficiency. The entire coding region (5 exons) of the SRD5A2 gene was assessed by PCR and direct sequencing analysis. For patient 1, we identified a new homozygous 2bp deletion in exon 1 (c.122_123delAG). Patient 2 had a known homozygous mutation, p.G115D, in exon 2. New compound heterozygous mutations in exon 4 (p.A215V) and exon 5 (p.X255Q) were found in patient 3. Patient 4 presented a new substitution in exon 1 (p.S14R) associated with a known polymorphism (p.V89L). Our data confirm our previous experience and clearly demonstrate that a 5-α reductase defect should be considered in all XY newborns with ambiguous genitalia and normal plasma T secretion, whatever their geographic area or ethnic group; moreover, this defect was not linked to specific phenotype. Early molecular diagnosis is indispensable for the crucial decision of the newborn's sex of rearing.

[The influence of the T stage on the risk of metastasis of penis cancer: T1 vs. T2]. / Der Einfluss des T-Stadiums auf das Metastasierungsrisiko des Peniskarzinoms: T1 vs. T2.

BACKGROUND: Controversies persist over the therapeutic approach to T1 penile carcinoma, particularly in patients with negative inguinal lymph nodes. Available data on lymph nodes metastases (LNM) in T1 carcinoma are contradictory. The aim of this study was to evaluate the metastatic risk of T1 carcinoma and to compare it with that of T2 carcinoma. MATERIAL AND METHODS: A total of 37 patients (pts) with T1 or T2 tumors were reviewed. Assessment of the inguinal lymph node condition was based on node dissection in 29 pts and surveillance in eight pts (mean 62 months, range 22-162). RESULTS: Grading was classified as good (G1), moderate (G2) and poor (G3) in seven, 26 and four pts, respectively. Tumor stage was T1 in 21 and T2 in 16 pts. LNM were observed in eight of 21 T1 (38%) and six of 16 T2 tumors (38%). No G1 and all G3 tumors developed LNM independently of tumor stage. Ten of the 26 G2 carcinomas (38%) harboured LNM and seven of these pts (70%) had a T1 tumor. CONCLUSIONS: According to our data, the metastatic potential of T1 penile carcinoma has been underestimated in the recent literature. Tumor grading has a substantially stronger impact on the metastatic risk in T1 and T2 penile carcinoma than tumor stage, indicating a surgical lymph node staging starting at the pT1G2 stage.

Oral L-arginine supplementation in cystic fibrosis patients: a placebo-controlled study.

Exhaled nitric oxide (eNO) is decreased in cystic fibrosis (CF). The effect of oral L-arginine, the precursor of enzymatic nitric oxide (NO) formation, on airway NO in patients with CF was studied. In a pilot study, oral L-arginine was given in a single dose of 200 mg x kg(-1) body weight to eight healthy controls and eight CF patients. Subsequently, the same L-arginine dose was given to 10 patients with CF (five females) t.i.d. for 6 weeks in a randomised double-blind placebo-controlled crossover study. A single dose of oral L-arginine resulted in a 5.5-fold increase of L-arginine in plasma and a 1.3-fold increase of L-arginine in sputum after 2 h. Maximum eNO, within 3 h of L-arginine intake, increased significantly in both CF patients (5.4+/-2.1 ppb versus 8.3+/-3.5 ppb) and controls (18.0+/-8.1 ppb versus 26.4+/-12.3 ppb). Supplementation of L-arginine for 6 weeks resulted in a sustained increase in eNO compared to placebo (9.7+/-5.7 ppb versus 6.3+/-3.1 ppb). An effect of L-arginine supplementation on forced expiratory volume in one second was not observed. These data indicate that airway nitric oxide formation in cystic fibrosis patients can be augmented with oral L-arginine supplementation.

[Study of salivary cortisol using radioimmunological assay. Diagnostic value]. / Etude du cortisol salivaire par dosage radio-immunologique. Intérêt diagnostique.

Salivary cortisol levels reflect the biologically active "free" fraction of blood cortisol. The authors describe the results obtained with the aim of a radio-immunoassay commercial serum cortisol kit, without prealable extraction in different physiological and pathological situations. Salivary cortisol determination appears performant both in nycthemeral studies and in stimulation or freination tests.

[Recklinghausen's disease and pseudohermaphrodism]. / Maladie de Recklinghausen et pseudo-ambiguïté sexuelle.

A clitoral hypertrophy in a girl presenting with Recklinghausen's disease should suggest the possibility of a local neurofibromatosis without any endocrine etiology. Thirteen cases collected in the literature and a new one reported here, give the opportunity to discuss such a possibility. Better knowledge of this unusual localization should, in each case, allow to discuss the extent of hormonal investigations needed.

[Treatment with hGH. Factors influencing response in children with somatotrophic insufficiency (author's transl)]. / Le traitement par l'hormone de croissance humaine. Facteurs influençant la réponse des enfants atteints d'insuffisance somatotrophique.

The present study was designated to investigate causes of hGH treatment failure in 59 prepubertal children, with idiopathic or organic GH deficiency. Children with height gain of less than 6 cm during the first year of treatment were the oldest, those with tallest stature, and had a lower growth rate prior to treatment. Increase of growth rate was negatively correlated with pre-treatment growth rate. Poor results were chiefly observed in children with tumoral organic hypopituitarism or after irradiation of the brain. Finally hGH doses appeared to be similar when two groups with respectively poor and good results were compared, indicating a major role of endogenous factors.

[Linkage between the gene responsible for adrenal hyperplasia caused by 21-hydroxylase deficiency and chromosome-6 short-arm markers]. / Liaison entre le gène responsable de l'hyperplasie surrénalienne par déficit en 21 hydroxlase et les marqueurs de bras court du chromosome 6.

In six patients from four different families, the study of the genetic markers of te short arm of chromosome 6 allows to confirm the situation of the gene responsible for congenital adrenal hyperplasia by deficiency of 21 hydroxylase. Thanks to the discovery of a recombination of the maternal haplotype in an affected girl. we consider the situation of the pathological gene with regard to that of the glyoxalase I gene. In the families including at least one patient, these studies permit to tract the heterozygotes and to make a very early or even antenatal diagnosis.