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Cystadenoma with ovarian type of stroma is a rare liver tumor. Authors discuss diagnostic difficulties and troublesome therapy with potential complications at unfavourable central localization in the liver of 46 years old woman.

We demonstrate the potential of semiconductor quantum dot nanomaterials for solid-state based controllable quantum memories in which losses may be compensated by gain. The dynamic photonic quantum-coherence present in a quantum dot ensemble and generated by a coherent signal pulse is influenced and controlled by disorder, spectral detuning and the power of the pulse. We show that the high coupling of spatial and temporal degrees of freedom is a key requirement for coherence transfer and/or storage.

Objective: We report the results of a prospective multicenter pilot study performed in Germany, Sweden, and Switzerland with a new self-centering device for transcatheter closure of an atrial septal defect (ASD) or a patent foramen ovale (PFO) called the Solysafe Septal Occluder., Interventions: The device was successfully implanted in 44 patients. In 15 patients with a median age of 40 years (range 6-76 years), a Solysafe device was successfully implanted in an ASD. The median size of the stretched defects was 17 mm (range 10-21 mm). Three 15-mm devices, eight 20-mm devices, and four 25-mm devices were used. Procedure time ranged from 40 to 107 min (median 66 min) and fluoroscopic time from 5.3 to 17.5 min (median 12 min). In 29 patients with a median age of 47 years (range 15-78 years), a Solysafe device was implanted in a PFO. The procedure time ranged from 21 to 155 min (median 51 min) and fluoroscopic time from 3.1 to 31.3 min (median 7.6 min)., Results: At discharge, 1 of the 29 patients (3%) had a small shunt. No patient in either the ASD or the PFO group had any major complication. Six months after implantation, the overall closure rate with the Solysafe septal occluder in both groups was 100% (44/44)., Conclusion: With the self-centering Solysafe Septal Occluder, PFOs, and ASDs with a stretched diameter of up to 21 mm can be effectively closed with very high occlusion rates., ((c) 2008 Wiley-Liss, Inc.)

A generalized model for the behavior of the stress tensor in non-Newtonian fluids is investigated for spatially homogeneous plane Couette flow, showing a variety of nonlinear responses and deterministic chaos. Mapping of chaotic solutions is achieved through the largest Lyapunov exponent for the two main parameters: The shear rate and the temperature and/or density. Bifurcation diagrams and stability analysis are used to reveal some of the rich dynamics that can be found. Suggested mechanisms for stability loss in these complex fluids include Hopf, saddle-node, and period-doubling bifurcations.

Light usually propagates inside transparent materials in well known ways. However, recent research has examined the possibility of modifying the way the light travels by taking a normal transparent dielectric and inserting tiny metallic inclusions of various shapes and arrangements. As light passes through these structures, oscillating electric currents are set up that generate electromagnetic field moments; these can lead to dramatic effects on the light propagation, such as negative refraction. Possible applications include lenses that break traditional diffraction limits and 'invisibility cloaks' (refs 5, 6). Significantly less research has focused on the potential of such structures for slowing, trapping and releasing light signals. Here we demonstrate theoretically that an axially varying heterostructure with a metamaterial core of negative refractive index can be used to efficiently and coherently bring light to a complete standstill. In contrast to previous approaches for decelerating and storing light, the present scheme simultaneously allows for high in-coupling efficiencies and broadband, room-temperature operation. Surprisingly, our analysis reveals a critical point at which the effective thickness of the waveguide is reduced to zero, preventing the light wave from propagating further. At this point, the light ray is permanently trapped, its trajectory forming a double light-cone that we call an 'optical clepsydra'. Each frequency component of the wave packet is stopped at a different guide thickness, leading to the spatial separation of its spectrum and the formation of a 'trapped rainbow'. Our results bridge the gap between two important contemporary realms of science-metamaterials and slow light. Combined investigations may lead to applications in optical data processing and storage or the realization of quantum optical memories.

Context: G to A transition at position 6,664 (G6664A) in human GH-1 results in the substitution of arginine by histidine at position 183 (R183H) of the GH molecule and causes familial isolated GH deficiency type II (IGHD II)., Objectives: The objective of the study was to assess the phenotype-genotype correlation of subjects affected with IGHD II caused by a G6664A mutation in 34 affected members of two large families., Design and Patients: Sixty-six subjects from two core families were included. The G6664A mutation among family members was determined by restriction fragment length polymorphism., Results: Twenty-four of the 52 members from family 1 and 10 of 14 from family 2 carried the same G6664A mutation in a heterozygous state. The affected subjects in family 1 were significantly shorter [-2.6 vs. -0.1 sd score (SDS), P < 0.0001] and had significantly lower IGF-I serum levels (-1.9 vs. -0.5 SDS, P < 0.0001), compared with normal-genotype family members. The affected adults exhibited great variability in their stature, ranging from -4.5 to -1.0 (mean -2.8 SDS), with five members being of normal height (>-2 SDS). Twelve children were diagnosed with IGHD. Two affected children had normal peak GH levels, although one of these subsequently demonstrated GH insufficiency (6.5 and 3.7 ng/ml). The affected children from both families exhibited large variability in their height, growth velocity, delay in bone age (chronological age - bone age), age at diagnosis, peak GH response, and IGF-I levels., Conclusions: These detailed phenotypic analyses show the variable expressivity of patients bearing a G6664A mutation, reflecting the spectrum of GH deficiency in affected patients, even within families, and the presence of additional genes modifying height determination. Our findings raise a new dilemma in the guidelines for the diagnosis of GH deficiency and the indications for GH therapy.

Background: Activation of the cytokine and the complement system is associated with disease progression in severe congestive heart failure (CHF). Magnitude and prognostic relevance of cytokine and complement activation remain uncertain in patients with moderate CHF., Objectives: Measurement of cytokine and complement activation in patients with moderate CHF and testing whether C-reactive protein (CRP) can serve as a surrogate marker of their activation, adding independent prognostic information when co-measured with B-type natriuretic peptide (BNP)., Methods: The 118 study participants were separated into three groups based on pre-determined CRP and BNP levels: Group I (n = 27; CRP > 5 mg/liter, BNP > or = 200 pg/ml); Group II (n = 46; CRP < or = 5 mg/liter, BNP > or = 200 pg/ml); and Group III (n = 45; CRP < or = 5 mg/liter, BNP < 200 pg/ml)., Results: Mortality was high in Group I (30%; log-rank p < 0.001) but low in Groups II and III (2% and 4%, respectively; log rank, p = 0.7). No differences were observed for left ventricular ejection fraction (LVEF) and left ventricular end-diastolic diameter (LVEDD) between Groups I and II (31 +/- 16 vs 32 +/- 14% and 66 +/- 16 vs 65 +/- 11 mm, respectively), whereas in Group III LVEF was higher (42 +/- 17%, p = 0.002) with smaller LVEDD (57 +/- 13 mm, p = 0.012). Cytokine sCD14 and tumor necrosis factor (TNF)-alpha levels were not different between the three groups. However, interleukin-6 levels (9.75 +/- 8.17 pg/ml, p = 0.001) and the terminal complement complex C5b-9 (109.9 +/- 68 ng/ml; p = 0.04) were elevated in Group I, both correlating with CRP (interleukin-6: r = 0.5, p < 0.001; C5b-9: r = 0.41, p = 0.001)., Conclusions: CRP may be used as a surrogate parameter for interleukin-6 and complement activation in moderate CHF. CRP in combination with BNP identifies a high-risk group with a tendency for poor outcome not discriminated by cardiac function.

Background: Stent thrombosis may occur late after drug-eluting stent (DES) implantation, and its cause remains unknown. The present study investigated differences of the stented segment between patients with and without very late stent thrombosis with the use of intravascular ultrasound., Methods and Results: Since January 2004, patients presenting with very late stent thrombosis (> 1 year) after DES implantation underwent intravascular ultrasound. Findings in patients with very late stent thrombosis were compared with intravascular ultrasound routinely obtained 8 months after DES implantation in 144 control patients, who did not experience stent thrombosis for > or = 2 years. Very late stent thrombosis was encountered in 13 patients at a mean of 630+/-166 days after DES implantation. Compared with DES controls, patients with very late stent thrombosis had longer lesions (23.9+/-16.0 versus 13.3+/-7.9 mm; P<0.001) and stents (34.6+/-22.4 versus 18.6+/-9.5 mm; P<0.001), more stents per lesion (1.6+/-0.9 versus 1.1+/-0.4; P<0.001), and stent overlap (39% versus 8%; P<0.001). Vessel cross-sectional area was similar for the reference segment (cross-sectional area of the external elastic membrane: 18.9+/-6.9 versus 20.4+/-7.2 mm2; P=0.46) but significantly larger for the in-stent segment (28.6+/-11.9 versus 20.1+/-6.7 mm2; P=0.03) in very late stent thrombosis patients compared with DES controls. Incomplete stent apposition was more frequent (77% versus 12%; P<0.001) and maximal incomplete stent apposition area was larger (8.3+/-7.5 versus 4.0+/-3.8 mm2; P=0.03) in patients with very late stent thrombosis compared with controls., Conclusions: Incomplete stent apposition is highly prevalent in patients with very late stent thrombosis after DES implantation, suggesting a role in the pathogenesis of this adverse event.

The trend in silicon photonics, in the last few years has been to reduce waveguide size to obtain maximum gain in the real estate of devices as well as to increase the performance of active devices. Using different methods for the modulation, optical modulators in silicon have seen their bandwidth increased to reach multi GHz frequencies. In order to simplify fabrication, one requirement for a waveguide, as well as for a modulator, is to retain polarisation independence in any state of operation and to be as small as possible. In this paper we provide a way to obtain polarization independence and improve the efficiency of an optical modulator using a V-shaped pn junction base on the natural etch angle of silicon, 54.7 deg. This modulator is compared to a flat junction depletion type modulator of the same size and doping concentration.

A 20-year-old female horse showed a nodular, firm, focal ulcerated mast cell tumor at the right dorsobuccal face of the tongue. Histologically, the nonencapsulated tumor consisted of dense, infiltrating aggregates of well-differentiated, Cresyl violet-positive mast cells accompanied by numerous eosinophils. Furthermore, they exhibited a strong, diffuse, intracytoplasmatic immunohistochemical signal for tryptase and a faint membrane-associated and perinuclear signal for tyrosine kinase receptor KIT. Confocal laser scanning microscopy confirmed an aberrant spatial colocalization of KIT in the Golgi apparatus, which may be the result of a defective protein processing within the tumor cells. The tumor was not associated with a poor prognosis.

Optical pulse amplification in doped fibers is studied using an extended power transport equation for the coupled pulse spectral components. This equation includes the effects of gain saturation, gain dispersion, fiber dispersion, fiber nonlinearity, and amplified spontaneous emission. The new model is employed to study nonlinear gain-induced effects on the spectrotemporal characteristics of amplified subpicosecond pulses, in both the anomalous and the normal dispersion regimes.

The coupled nonlinear dynamics of rotary motor ensembles and an embedding fluid medium are simulated on the basis of Navier-Stokes equations. The model description considers space-dependent rotation of motors and a spatially inhomogeneous motor distribution as well as spatial fluctuations in molecular properties. The mutual influence of motor rotations and fluid dynamics as well as spatial inhomogeneities of their molecular properties are self-consistently included. Space-time simulations visualize the complex interplay between the fluid dynamics and motor rotation and show that the dynamic coupling to the environment via the velocity field as well as the spatial inhomogeneity and distribution of rotors determines the overall behavior of the motor complex. Depending on the initial molecular distribution, rotation frequency, and fluid dynamics a spatial self-organization or a chaotic behavior may arise.

We explore the ultrafast spatio-temporal dynamics of whispering-gallery micro-cavity lasers. To model the dynamics of the nonlinear whispering-gallery modes we develop a three-dimensional Finite-Difference Time-Domain modelling framework based on the spin and therefore optical polarisation resolved Maxwell-Bloch equations. The numerical algorithm brings together a real value form of the optical Bloch equations with the curl part of Maxwell's equations. The Hamiltonian of the two-level system contains either linear or circular polarised transitions. In cylindrical micro-cavity lasers the coherent, nonlinear emission process leads to ultrafast fan-like rotational phase dynamics of the degenerate whispering-gallery modes. This rotation is shown to be arrested in gear-shaped micro-cavity lasers followed by an over-damped relaxation oscillation.

Background/aims: In children with short stature, in whom growth hormone deficiency has been excluded, the presence of a normal or elevated growth hormone concentration concomitant with low insulin-like growth factor I suggests growth hormone insensitivity (GHI). Previous reports suggest that heterozygous mutations in the growth hormone receptor gene (GHR) may account for about 5% of children with idiopathic short stature (ISS). In the present study we have attempted to determine whether mutations in the GHR explain the short stature and growth retardation in a cohort of children with ISS and characteristics suggesting GHI., Methods: For the present study 33 children with clinical and biochemical characteristics of GHI were selected from a cohort of 150 children of short stature. Molecular analysis of the GHR was performed using a single-strand conformation polymorphism technique and sequencing. Ten different sequence changes in 19 (58%) out of 33 children were identified, 9 of them novel and 1 that had been described previously., Results: Two changes were found in exons 2 and 6. The known polymorphism of exon 6 (G168) was significantly more common in the control subjects than in our study group (63.5 vs. 30%; p < 0.0001). In the intronic sequences 8 previously undescribed DNA changes were found. The screening of the affected children's family members revealed that both normal and short stature members carried the same variants. The study group did not significantly differ from the controls in retention (GHRfl) or exclusion (GHRd3) of exon 3., Conclusion: Our study suggests that sequence changes of the GHR are common in children with ISS. The presence of these sequence changes in the control subjects as well as in normal stature family members indicates that these changes represent a simple polymorphism of the GHR. Such DNA changes are more prevalent than previously recognized, and they do not seem to play a contributory role in the etiology of short stature., (Copyright (c) 2006 S. Karger AG, Basel.)

Phospholipid-binding proteins in the male genital tract are characterized by differing numbers Fn-2 modules (B-domain) carrying N-terminal extensions (A-domain) of variable length. In the stallion, three different proteins were identified, SP-1, SP-2, and EQ-12. SP-1 and SP-2 of the AA'BB'- and ABB'-type, respectively, are major proteins of the seminal plasma. Here we report the cDNA sequences of SP-1, and of a new member of the SP-2 family (SPnew) and the partial characterization of their iso- and glycoforms. The phosphorylcholine (PC)-binding ability of the long Fn-2 protein, EQ-12, with four tandemly arranged Fn-2 modules was determined by PC-affinity chromatography. Expression patterns of EQ-12, and the SP-proteins were studied by means of RT-PCR, Northern blot analysis and immunological approaches indicating differential expression along the male reproductive tract. The vast majority of the short SP-1 and SP-2 proteins are produced by the ampulla whereas EQ-12 originates from the epididymis. Indirect immunofluorescence microscopy of sperm isolated from different regions of the epididymis and Western blot analysis indicate that both, the long and the short Fn-2 proteins associate to the sperm surface during post-testicular maturation. Sperm binding of Fn-2 proteins at the post-acrosome and midpiece was at first detected in the corpus epididymis. Enhanced fluorescence intensity after ejaculation point to an increased number of molecules bound to the sperm surface. The function of these proteins is discussed in regard to their structure-function relationships., ((c) 2004 Wiley-Liss, Inc.)

Electronic data transfer by capacitive and galvanic coupling through the human body has been proposed by research and industry as a novel but highly promising technology for ultra low power wireless body LANs. Investigation on the most challenging questions considering data communication becomes enabled with a highly versatile measurement system for frequencies in the range of 10 kHz to 1 MHz. The human body is characterized as a transmission medium for electrical current by means of measurements and is investigated as communication channel for biomedical parameter monitoring by using different modulation schemes at low frequency. Excellent transmission was achieved on the thorax while the attenuation increases along the extremities. The injected current is 10 times below the maximum allowed contact current and more than 25 times below nerve stimulation. The new technology has shown its feasibility in clinical trials.

We consider a quantum system consisting of a regular chain of elementary subsystems with nearest neighbor interactions and assume that the total system is in a canonical state with temperature T . We analyze under what condition the state factors into a product of canonical density matrices with respect to groups of n subsystems each, and when these groups have the same temperature T. While in classical mechanics the validity of this procedure only depends on the size of the groups n, in quantum mechanics the minimum group size n(min) also depends on the temperature T! As examples, we apply our analysis to a harmonic chain and different types of Ising spin chains. We discuss various features that show up due to the characteristics of the models considered. For the harmonic chain, which successfully describes thermal properties of insulating solids, our approach gives a quantitative estimate of the minimal length scale on which temperature can exist: This length scale is found to be constant for temperatures above the Debye temperature and proportional to T-3 below.

We consider a regular chain of quantum particles with nearest neighbor interactions in a canonical state with temperature T. We analyze the conditions under which the state factors into a product of canonical density matrices with respect to groups of n particles each and under which these groups have the same temperature T. In quantum mechanics the minimum group size n(min) depends on the temperature T, contrary to the classical case. We apply our analysis to a harmonic chain and find that n(min)=const for temperatures above the Debye temperature and n(min) proportional to T(-3) below.

Integrin alpha2beta1 is the principal adhesive receptor for collagen but platelets also adhere through glycoprotein VI (GPVI). Integrin alphaIIbbeta3 may augment platelet adhesion. We have shown that disulfide exchange is necessary for platelet adhesion to fibrinogen, fibronectin, and collagen. However 2 questions remained: (1) Can activated alphaIIbbeta3 explain the observed role of disulfide exchange in adhesion to collagen, or is this role common to other integrins? (2) Is disulfide dependence specific to the integrin receptors or shared with GPVI? To discriminate adhesive functions of alpha2beta1 from those of alphaIIbbeta3 we used Glanzmann platelets and alphaIIbbeta3-specific antibodies applied to normal platelets. To resolve adhesive events mediated by alpha2beta1 from those of GPVI we used synthetic peptides specific to each receptor. We addressed direct integrin ligation using purified alpha2beta1 and recombinant I domain. We observed the following: adhesion to the alpha2beta1-specific peptide was disulfide-exchange dependent and protein disulfide isomerase (PDI) mediated; membrane-impermeant thiol blockers inhibited alpha2beta1, but not GPVI mediated, adhesion; direct blockade of PDI revealed that it is involved in adhesion through alpha2beta1 but not GPVI; and purified alpha2beta1, but not recombinant I domain, depended on free thiols for ligation. These data suggest that the enzymatically catalyzed adhesion-associated reorganization of disulfide bonds is common to members of the integrin family and specific to this family.

The spatiotemporal dynamics of optical molecular motors is simulated on the basis of a spatially resolved model. A spatially dependent Fokker-Planck model for the molecular motors is linked with Maxwell's wave equation describing the external excitation via a spatially inhomogeneous light field. Simulations show that strong diffusion of the embedding fluent leads to increased motor dynamics while in inhomogeneous ensembles motor clustering may occur. Spatially inhomogeneous optical excitation may provide a means of movement control of the molecular motors.

Studies have suggested a pivotal role for free sulfhydryls in platelet integrin function, and enzyme-mediated reduction of disulfide bonds on platelets has been implicated. The platelet fibrinogen receptor alpha(IIb)beta(3) is the best-studied platelet integrin and serves as a model system for studying the structure-function relation in this family of adhesion receptors. The demonstration of free sulfhydryls on the exofacial domain of purified alpha(IIb)beta(3), specifically in its activated conformation, prompted us to explore the potential for activation-dependent, enzymatically catalyzed thiol expression on intact platelets and the possible role of surface-associated protein disulfide isomerase (PDI) in alpha(IIb)beta(3) ligation. Using the membrane-impermeant sulfhydryl blocker para-chloromercuriphenyl sulfonate, the inhibitor of disulfide exchange bacitracin, and the monoclonal anti-PDI antibody RL90, we examined fibrinogen binding to alpha(IIb)beta(3) as well as ligation-induced allosteric changes in the conformation of alpha(IIb)beta(3). We sought to distinguish the possible involvement of disulfide exchange in agonist-induced platelet stimulation from its role in integrin ligation. Analysis of the role of free thiols in platelet aggregation suggested a thiol-independent initial ligation followed by a thiol-dependent stabilization of binding. Flow cytometric analysis showed that sustained binding of fibrinogen, as well as expression of ligand-induced binding site epitopes and ligand-bound conformation, depended on free thiols and disulfide exchange. Expression of P-selectin was minimally affected, even with complete inhibition of alpha(IIb)beta(3) function. These data indicate that although agonist-induced platelet stimulation is independent of ecto-sulfhydryls, engagement of integrin alpha(IIb)beta(3) on the intact platelet depends totally on their enzymatically catalyzed surface expression.

Cell adhesion is mediated by the integrin adhesion receptors. Receptor-ligand interaction involves conformational changes in the receptor, but the underlying mechanism remains unclear. Our earlier work implied a role for sulfhydryls in integrin response to ligand binding in the intact blood platelet. We now show that non-penetrating blockers of free sulfhydryls inhibit beta(1) and beta(3) integrin-mediated platelet adhesion regardless of the affinity state of the integrin. Removal of the inhibitors prior to adhesion fully restores adhesion despite the irreversible nature of inhibitor-thiol interaction, indicating sulfhydryl exposure in response to adhesion. We further show that blocking protein disulfide isomerase (PDI) inhibits adhesion. These data indicate that: (a) ecto-sulfhydryls are necessary for integrin-mediated platelet adhesion; (b) disulfide exchange takes place during this process; (c) surface PDI is involved in integrin-mediated adhesion.

The use of quantitative coronary angiography, combined with Doppler and PET, has recently been directed at the study of alpha-adrenergic coronary vasomotion in humans. Confirming prior animal experiments, there is no evidence of alpha-adrenergic coronary constrictor tone at rest. Again confirming prior experiments, responses to alpha-adrenoceptor activation are augmented in the presence of coronary endothelial dysfunction and atherosclerosis, involving both alpha(1)- and alpha(2)-adrenoceptors in epicardial conduit arteries and microvessels. Such augmented alpha-adrenergic coronary constriction is observed during exercise and coronary interventions, and it is powerful enough to induce myocardial ischemia and limit myocardial function. Recent studies indicate a genetic determination of alpha(2)-adrenergic coronary constriction.

Objectives: Magnetic resonance (MRI) velocity mapping was used to evaluate non-invasively the flow profiles of the ascending aorta in normal volunteers and in patients with an aortic (mechanical) valve prosthesis., Background: In patients with artificial aortic valves the flow profile in the ascending aorta is severely altered. These changes have been associated with an increased risk of thrombus formation and mechanical hemolysis., Methods: Velocity profiles were determined 30 mm distal to the aortic valve in six healthy volunteers and seven patients with aortic valve replacement (replacement within the last 2 years) using ECG triggered phase contrast MRI. Peak flow, mean flow and mean reverse flow were measured in intervals of 25 ms during the entire heart cycle. Systolic reverse flow, end-systolic closing and diastolic leakage volume were calculated for all subjects., Results: Peak flow velocity during mid-systole was significantly higher in patients with valvular prosthesis than in normals (mean + SD, 1.9 +/- 0.4 m/s vs. 1.2 +/- 0.03 m/s, P < 0.001) with a double peak and a zone of reversed flow close to the inner (left lateral) wall of the ascending aorta of the patients. Closing volume was significantly larger in patients than in controls (-3.3 +/- 1.2 ml/beat vs. -0.9 +/- 0.5 ml/beat; P < 0.001). There was reverse flow during systole in valvular patients amounting to 15.7 +/- 6.7% of total cardiac output compared to 2.3 +/- 1.2% in controls (P < 0.001). Diastolic mean flow was negative in patients after valve replacement but not in controls (-11.0 +/- 15.2 ml/beat vs. 6.8 +/- 3.2 ml/beat; P < 0.01)., Conclusions: The following three major quantitative observations have been made in the present study: (1) Mechanical valve prostheses have an increased peak flow velocity with a systolic reverse flow at the inner (left lateral) wall of the ascending aorta. (2) A double peak flow velocity pattern can be observed in patients with bileaflet (mechanical) prosthesis. (3) The blood volume required for leaflet closure and the diastolic leakage blood volume are significantly higher for the examined bileaflet valve than for native heart valves.

In large high-power broad-area lasers the spatiotemporal filamentation processes and instabilities occur macroscopic as well as on microscopic scales. Numerical simulations on the basis of Maxwell- Bloch equations for large longitudinally and transversely extended semiconductor lasers reveal the internal spatial and temporal processes, providing the relevant scales on which control for stabilization consequently has to occur. It is demonstrated that the combined longitudinal instabilities, filamentation, and propagation effects may be controlled by suitable spatially structured delayed optical feedback allowing, in particular, the control of coherent regimes in originally temporally and spatially chaotic states.

We present a numerical study of a two dimensional all- optical switching device which consists of two crossed waveguides and a nonlinear photonic band{gap structure in the center. The switching mechanism is based on a dynamic shift of the photonic band edge by means of a strong pump pulse and is modeled on the basis of a two dimensional finite volume time domain method. With our arrangement we find a pronounced optical switching effect in which due to the cross-waveguide geometry the overlay of the probe beam by a pump pulse is significantly reduced.

Microscopic simulations on the basis of semiconductor Maxwell-Bloch equations show that in the short-time spatio-temporal dynamics of large aspect vertical cavity surface emitting lasers (VCSEL) and coupled VCSEL-arrays microscopic and macroscopic effects are intrinsically coupled. The combination of microscopic spatial and spectral dynamics of the carrier distribution functions and the nonlinear polarization of the active semiconductor medium reveal spatio-spectral hole-burning effects as the origin of ultra-fast mode-switching effects. In coupled VCSEL-arrays the simulations predict the emergence of spontaneous ultra-fast spatial switching.

Unlabelled: We hypothesized that pacing at two ventricular sites simultaneously would activate the myocardium more rapidly and improve ventricular function. We studied the effect of pacing at the right ventricular outflow tract (RVOT) and the RV apex (RVA) on systolic and diastolic function. In 14 patients with a reduced systolic ejection fraction < 40% (mean EF 32% +/- 4%) we measured RV pressures, left ventricular pressures, EF, cardiac output, peak dP/dt, peak negative dP/dt, and the time constant of relaxation, Tau, during intrinsic rhythm, atrial pacing and DVI pacing at the RVA, the RVOT, and both RV sites combined in random order. Repeated measures analysis of variance showed no significant differences in any of these parameters. The highest absolute values of dP/dt were observed during sinus rhythm and the lowest with RVA pacing. This parameter tended to improve progressively with pacing in the RVOT and at both sites. Peak negative dP/dt showed a similar nonsignificant trend., Conclusion: These data suggest that in patients with poor LV function, there may be subtle improvements in diastolic and systolic function with pacing in the RVOT and at combined sites in the RV compared to traditional RVA pacing.

We show that the influence of quantum fluctuations in the electromagnetic field vacuum on a two level atom can be measured and consequently compensated by balanced homodyne detection and a coherent feedback field. This compensation suppresses the decoherence associated with spontaneous emissions for a specific state of the atomic system allowing complete control of the coherent state of the system.

It is shown that the interference between amplified spontaneous emission into the nonlasing supermode and the laser field of a semiconductor laser array causes spatial hole burning, which couples the dynamics of the amplified spontaneous emission with the laser field. In particular, phase locking between the amplified spontaneous emission and the lasing mode leads to the formation of a spectral triplet composed of in-phase relaxation oscillation sidebands and an out-of-phase line at the lasing frequency.

Cysteine rich secretory proteins (CRISPs) have been detected immunochemically in the equine male genital tract. CRISPs are secretory products of the epididymis, the ampulla and the seminal vesicle. A particular feature of the horse is the abundance of CRISPs in seminal plasma. CRISPs can also be detected in extracts of testicular, epididymal and ejaculated spermatozoa in increasing amounts. Unlike other seminal plasma proteins, they cannot be removed completely from spermatozoa by high salt treatment. The remaining CRISP antigens are localized on the midpiece, and the postacrosomal and equatorial region of the sperm head. Tissue distribution and localization of CRISPs on equine spermatozoa point to a role of these proteins in epididymal sperm maturation and equine reproduction.

This study was conducted to determine the impact of maternal exercise on fetal breathing and fetal body movement, which are commonly used for assessing fetal well-being. Twelve healthy patients with a range of gestational ages of 26 to 36 weeks, who actively exercised throughout pregnancy, participated in the study. The patients walked on a motorized treadmill using a modified Bruce protocol until the maternal heart rate reached 75% of the age-predicted maximal heart rate. Fetal activities (fetal breathing and fetal body movement) were continuously monitored with real-time ultrasonography for 20 minutes before and after the standardized exercise test. Our results demonstrate that there is a significant increase in maternal heart rate and blood pressure associated with exercise. In addition, there is a significant decrease in the total duration and frequency of fetal breathing and fetal body movements following acute maternal exercise.

False aneurysms of the left ventricle after myocardial infarction arae the result of perforation, which usually require early surgical treatment. The clinical features are not characteristic. The chest x-ray may provide important evidence for the diagnosis. Non-invasive diagnosis is possible by means of echocardiography and computer tomography; it is confirmed by angiocardiography. The authors experience with nine cases is described.

The fate of patients with aortic valve disease of varying degrees of severity and the relationship between symptoms and haemodynamic status have been studied in 190 adults undergoing cardiac catheterization during the last two decades. During the follow-up period, 41 patients died and 86 underwent aortic valve replacement; these two events were the endpoints for the calculation of 'event-free' cumulative survival. First-year survival in haemodynamically severe disease was 60% in aortic stenosis and 96% in aortic regurgitation; in moderate and mild disease (in the absence of coronary artery disease) first-year survival was 100% in both groups. After 10 years, 9% of those with haemodynamically severe aortic stenosis and 17% of those with severe regurgitation were event-free, in contrast to 35% and 22%, respectively, of those with moderate changes and 85% and 75%, respectively, of those with mild abnormalities. In the presence of haemodynamically severe disease, 66% of the patients with stenosis and 14% of those with regurgitation were severely symptomatic (history of heart failure, syncope or New York Heart Association class III and IV); 23% of patients with moderate stenosis and 14% with moderate regurgitation were also severely symptomatic. Only 40% of those with disease that was severe both haemodynamically and symptomatically with either stenosis or regurgitation survived the first two years; only 12% in the stenosis group and none in the regurgitation group were event-free at 5 years. Patients with haemodynamically severe aortic stenosis who had few or no symptoms had a 100% survival at 2 years; the comparable figure for the aortic regurgitation group was 94%; 75% of the patients in the stenosis group and 65% in the regurgitation group were event-free at 5 years. In the moderate or mild stenosis and regurgitation groups there was no mortality within the first 2 years in the absence of coronary artery disease, regardless of symptomatic status. Haemodynamically and symptomatically severe aortic stenosis and regurgitation have a very poor prognosis and require immediate valve surgery. Asymptomatic and mildly symptomatic patients with haemodynamically severe aortic stenosis are at low risk and surgical treatment can be postponed until marked symptoms appear without a significant risk of sudden death. In severe aortic regurgitation, the decision for surgery should depend not only on symptoms but should be considered in patients with few or no symptoms because of risk of sudden death. In the absence of coronary artery disease, moderate aortic valve disease does not require valve operation for prognostic reasons.

The ultrasonic beam used for quantitative assessment of left ventricular (LV) function traverses the heart in a projection similar to the familiar angiographic left anterior oblique projection. It crosses the anterior wall of the right ventricle, the right ventricular cavity, the interventricular septum, the LV cavity and the posterior wall of the left ventricle. Whereas the cyclic changes of the right ventricular diameter are rarely clearly determined by echocardiography, the easily assessed cyclic changes of the LV endocardial transverse diameter are useful measure of LV FUNCTION. Of practical importance are the percentage of systolic shortening of the LV diameter (%Sh) and the mean velocity of circumferential fiber shortening (VCF). There are several factors, such as placing of the ultrasonic transducer, the shape and size of the LV cavity and rotational movements of the heart as a whole, that influence echocardiographic determination of the transverse LV diameter. In patients with asynergic contraction, %Sh and VCF cannot be used as measures of overall LV performance, but localized contraction disturbances of the septum and the posterior wall may be detected from the reduced extent of wall motion in a given LV segment during a full sweep from the base to the apex. The most important indications for echocardiographic assessment of LV function are valvar diseases with chronic LV pressure or volume overload, and congestive cardiomyopathy. Echocardiography has proved useful in serial evaluation of LV function in patients undergoing valvar heart surgery. Assessment of LV volume by standard echocardiography using the cubic formula is not satisfactory. More accurate determination of volumes is provided by formulas that include the actual ratio of the LV long axis to the minor axis.