Amplification of ultrashort laser pulses by brillouin backscattering in plasmas

Plasma media, by exciting Raman (electron) or Brillouin (ion) waves, have been used to transfer energy from moderately long, high-energy light pulses to short ones. Using multidimensional kinetic simulations, we define here the optimum window in which a Brillouin scheme can be exploited for amplification and compression of short laser pulses over short distances to very high power. We also show that shaping the plasma allows for increasing the efficiency of the process while minimizing other unwanted plasma processes. Moreover, we show that, contrary to what was traditionally thought (i.e., using Brillouin in gases for nanosecond pulse compression), this scheme is able to amplify pulses of extremely short duration.

Production of large volume, strongly magnetized laser-produced plasmas by use of pulsed external magnetic fields

The production of strongly magnetized laser plasmas, of interest for laboratory astrophysics and inertial confinement fusion studies, is presented. This is achieved by coupling a 16 kV pulse-power system. This is achieved by coupling a 16 kV pulse-power system, which generates a magnetic field by means of a split coil, with the ELFIE laser facility at Ecole Polytechnique. In order to influence the plasma dynamics in a significant manner, the system can generate, repetitively and without debris, high amplitude magnetic fields (40 T) in a manner compatible with a high-energy laser environment. A description of the system and preliminary results demonstrating the possibility to magnetically collimate plasma jets are given.

Charge equilibrium of a laser-generated carbon-ion beam in warm dense matter

Using ion carbon beams generated by high intensity short pulse lasers we perform measurements of single shot mean charge equilibration in cold or isochorically heated solid density aluminum matter. We demonstrate that plasma effects in such matter heated up to 1 eV do not significantly impact the equilibration of carbon ions with energies 0.045-0.5  MeV/nucleon. Furthermore, these measurements allow for a first evaluation of semiempirical formulas or ab initio models that are being used to predict the mean of the equilibrium charge state distribution for light ions passing through warm dense matter.

Generation of laser-driven higher harmonics from grating targets

The first experimental evidence of the higher-order harmonic radiation generated by periodically modulated targets (gratings) irradiated by relativistic, ultrashort (<30 fs), high intensity [Iλ(2)=10(20) (W/cm(2)) μm(2)] laser pulse is presented. The interference effects on the grating surface lead to the emission of high harmonics up to 45th order along the target surface when the laser beam is focused onto a grating target close to normal incidence (5°). By means of numerical simulations we demonstrate the possibility of controlling the composition of the higher harmonic spectrum and we prove the influence of the laser pulse parameters in the interaction area (laser focusing and wavefront curvature) on the emission angle of a certain high harmonic order.

Astrophysics of magnetically collimated jets generated from laser-produced plasmas

The generation of astrophysically relevant jets, from magnetically collimated, laser-produced plasmas, is investigated through three-dimensional, magnetohydrodynamic simulations. We show that for laser intensities I∼10(12)-10(14) W cm(-2), a magnetic field in excess of ∼0.1  MG, can collimate the plasma plume into a prolate cavity bounded by a shock envelope with a standing conical shock at its tip, which recollimates the flow into a supermagnetosonic jet beam. This mechanism is equivalent to astrophysical models of hydrodynamic inertial collimation, where an isotropic wind is focused into a jet by a confining circumstellar toruslike envelope. The results suggest an alternative mechanism for a large-scale magnetic field to produce jets from wide-angle winds.

Effect of sorafenib combined with cytostatic agents on hepatoblastoma cell lines and xenografts

BACKGROUND

Sorafenib has recently been shown to reduce tumour growth in hepatoblastoma (HB) xenografts. The effect of a combined administration with cytostatic agents was now investigated.

METHODS

Cell viability after treatment with sorafenib and different cytostatic agents was evaluated in two HB cell lines (HUH6 and HepT1) using MTT assay. ERK signalling was investigated by western blot, NOXA expression by rt-PCR, and formation of DNA adducts using immunocytology. NMRI mice bearing subcutaneous HUH6-derived tumours were treated with sorafenib alone or in combination with cisplatin. Tumour progression, viability, apoptosis, and vascularisation were monitored by tumour volume, AFP levels, TUNEL assay, and CD31 immunostaining, respectively.

RESULTS

The combination of sorafenib and cisplatin led to a remarkable decrease in cell viability. The cisplatin-induced enhanced ERK1/2 activation, but not NOXA expression and the formation of DNA adducts was partly abrogated by sorafenib. In HB xenografts, both, sorafenib and alternated application of sorafenib and cisplatin significantly reduced tumour growth (P<0.05). Levels of AFP were lower in both treated groups (P=0.08). Relative apoptotic areas were increased (P=0.003). Mean vascular density was the lowest in the sorafenib/CDDP group (P=0.02).

CONCLUSION

The combination of sorafenib with cisplatin might be a promising treatment option for high risk or recurrent HB.

Molecular cytogenetics (FISH, GISH) of Coccinia grandis : a ca. 3 myr-old species of cucurbitaceae with the largest Y/autosome divergence in flowering plants

The independent evolution of heteromorphic sex chromosomes in 19 species from 4 families of flowering plants permits studying X/Y divergence after the initial recombination suppression. Here, we document autosome/Y divergence in the tropical Cucurbitaceae Coccinia grandis, which is ca. 3 myr old. Karyotyping and C-value measurements show that the C. grandis Y chromosome has twice the size of any of the other chromosomes, with a male/female C-value difference of 0.094 pg or 10% of the total genome. FISH staining revealed 5S and 45S rDNA sites on autosomes but not on the Y chromosome, making it unlikely that rDNA contributed to the elongation of the Y chromosome; recent end-to-end fusion also seems unlikely given the lack of interstitial telomeric signals. GISH with different concentrations of female blocking DNA detected a possible pseudo-autosomal region on the Y chromosome, and C-banding suggests that the entire Y chromosome in C. grandis is heterochromatic. During meiosis, there is an end-to-end connection between the X and the Y chromosome, but the X does not otherwise differ from the remaining chromosomes. These findings and a review of plants with heteromorphic sex chromosomes reveal no relationship between species age and degree of sex chromosome dimorphism. Its relatively small genome size (0.943 pg/2C in males), large Y chromosome, and phylogenetic proximity to the fully sequenced Cucumis sativus make C. grandis a promising model to study sex chromosome evolution.

Dynamics of self-generated, large amplitude magnetic fields following high-intensity laser matter interaction

The dynamics of magnetic fields with an amplitude of several tens of megagauss, generated at both sides of a solid target irradiated with a high-intensity (~10(19) W/cm(2)) picosecond laser pulse, has been spatially and temporally resolved using a proton imaging technique. The amplitude of the magnetic fields is sufficiently large to have a constraining effect on the radial expansion of the plasma sheath at the target surfaces. These results, supported by numerical simulations and simple analytical modeling, may have implications for ion acceleration driven by the plasma sheath at the rear side of the target as well as for the laboratory study of self-collimated high-energy plasma jets.

Alteration of basic chromosome number by fusion-fission cycles

A complete chromosomal fusion-fission cycle is described for the first time. In the field bean, Vicia faba, this cycle probably started with a reversible fusion of two telocentrics giving rise to the standard metacentric chromosome I. The next step was a recent fission of this chromosome into two stable telocentrics eventually followed by a new fusion reconstituting the metacentric chromosome.

Primary lung metastases in pediatric malignant non-Wilms renal tumors: data from SIOP 93-01/GPOH and SIOP 2001/GPOH

Malignant non-Wilms renal tumors (NWRT) are a small but relevant subgroup of renal neoplasms in children. In this study we analyzed corresponding data from the trials SIOP 93-01/GPOH and SIOP 2001/GPOH of the Society of Pediatric Oncology and Hematology.Data of 22 patients with NWRT and primary lung metastases were retrospectively reviewed. Analyses included epidemiology, tumor characteristics, chemotherapy, local treatment, and outcome.The following diagnoses were registered: Malignant Rhabdoid tumor of the kidney (MRTK, n=15), Renal-cell carcinoma (RCC, n=3), Clear-cell sarcoma of the kidney (CCSK, n=3), and primitive neuro ectodermal tumor (PNET, n=1). Median age of patients at diagnosis was 14 months. Overall survival was 36.36% (8/22). Of the 15 children with MRTK 3 survived, 3/3 patients with RCC, 1/3 patients with CCSK, and 1/1 patient with PNET survived. Lung metastases disappeared in 6 patients after initial chemotherapy, 6/8 patients undergoing local treatment of lung metastases (surgery, irradiation, or both) achieved complete remission. Only patients with complete clearance of lung lesions, either through neoadjuvant chemotherapy or subsequent local treatment, survived. Mean Follow up was 31 months (1-137).Survival of patients with stage IV NWRT is dismal. Complete removal of lung metastases seems mandatory for survival. An aggressive diagnostic and therapeutic approach seems justified in affected children.

Weibel-induced filamentation during an ultrafast laser-driven plasma expansion

The development of current instabilities behind the front of a cylindrically expanding plasma has been investigated experimentally via proton probing techniques. A multitude of tubelike filamentary structures is observed to form behind the front of a plasma created by irradiating solid-density wire targets with a high-intensity (I ~ 10(19) W/cm(2)), picosecond-duration laser pulse. These filaments exhibit a remarkable degree of stability, persisting for several tens of picoseconds, and appear to be magnetized over a filament length corresponding to several filament radii. Particle-in-cell simulations indicate that their formation can be attributed to a Weibel instability driven by a thermal anisotropy of the electron population. We suggest that these results may have implications in astrophysical scenarios, particularly concerning the problem of the generation of strong, spatially extended and sustained magnetic fields in astrophysical jets.

Focusing dynamics of high-energy density, laser-driven ion beams

The dynamics of the focusing of laser-driven ion beams produced from concave solid targets was studied. Most of the ion beam energy is observed to converge at the center of the cylindrical targets with a spot diameter of 30  μm, which can be very beneficial for applications requiring high beam energy densities. Also, unbalanced laser irradiation does not compromise the focusability of the beam. However, significant filamentation occurs during the focusing, potentially limiting the localization of the energy deposition region by these beams at focus. These effects could impact the applicability of such high-energy density beams for applications, e.g., in proton-driven fast ignition.

Dynamic control over mega-ampere electron currents in metals using ionization-driven resistive magnetic fields

The possibility of dynamically shaping mega-ampere electron currents generated in solids by ultraintense laser pulses in various conductor materials has been investigated. By tuning the target ionization dynamics, which depends both on the target material properties and on the input electron beam characteristics, we can control the growth of resistive magnetic fields that feedback on the current transport. As a result, collimation, hollowing, or filamentation of the electron beam can all be obtained. These results are beneficial for applications such as the production of secondary particles and radiation sources and fast ignition of inertial confinement fusion.

Outcome of augmentation cystoplasty and bladder substitution in a pediatric age group

OBJECTIVE

Aim of the study was to evaluate the outcome of augmentation cystoplasty and bladder substitution in a pediatric age group.

METHODS

Patient records of all children who underwent reconstructive bladder surgery between October 1999 and November 2007 were reviewed. Additionally, standardized interviews were performed to evaluate the postoperative outcome.

RESULTS

Augmentation cystoplasty and bladder substitution were performed in 19 and 6 patients, respectively. 21 patients underwent continent catheterizable vesicostomy. Postoperative urodynamics revealed a significant increase in bladder volume (median 400 ml) as well as a significant improvement in bladder compliance (median 13.5 ml/cmH2O). 90% of the patients were reported to be socially continent. Renal function remained stable in 95% and decreased in 5% of the children. Major complications were lower urinary tract calculi (39%), stricture or insufficiency of the continent vesicostomy (28%), and intestinal obstruction (9%). No malignancies associated to bladder augmentation or substitution were detected yet.

CONCLUSION

Augmentation cystoplasty and bladder substitution preserve renal function and provide urinary continence in most children with intractable lower urinary tract disease. However, the procedures remain associated with numerous complications.

Transition From Single-Layer to Double-Layer Steps on GaAs(110) Prepared by Molecular Beam Epitaxy

Even though GaAs (110) is the only semiconductor whose surface structure is known with confidence, little is known about its microscopic growth mechanisms. We have used RHEED to study the role of steps in the MBE growth of GaAs on vicinal GaAs(11O) surfaces which were misoriented by less than 2 mrad. After thermally desorbing the initial oxide, 20 layers of GaAs deposited at 700K produced a surface with single atomic-layer steps having an average terrace length of a few hundred Angstroms. Upon annealing to 8OOK, a slow mass migration occurred producing a surface with one thousand Angstrom average terrace lengths and predominantly double layer step heights. The RHEED pattern was nearly instrument limited at in-phase angles of incidence, with little background intensity and bright Kikuchi lines. Subsequent deposition showed only weak oscillations in the RHEED intensity, in contrast to growth on the (001) surface. The period of the observed oscillations indicates that the layer-by-layer growth involves single-layer steps. Growth of as little as 5 atomic layers on a surface with double steps could not be annealed to give a RHEED intensity as great as the first annealed surface. These measurements reconcile previous LEED results with the oxygen adsorption measurements of Ranke. The results clearly show the dominance of steps in the formation of RHEED streaks.

Kava hepatotoxicity: comparative study of two structured quantitative methods for causality assessment

BACKGROUND AND OBJECTIVE

Ingestion of the medicinal herb kava has been associated with hepatotoxicity. We aimed to compare two different quantitative methods of causality assessment of patients with assumed hepatotoxicity by the herb.

METHODS

We assessed causality in 26 patients from Germany and Switzerland, using two structured quantitative analytical methods: the system of Maria and Victorino (MV) and that of the Council for International Organizations of Medical Sciences (CIOMS). In all 26 patients, regulatory ad hoc evaluation had suggested a causal relationship between liver disease and kava use.

RESULTS AND DISCUSSION

Assessment with the MV scale resulted in no or low graded causality for kava in the 26 patients with liver disease. Causality was probable (n=1), possible (n=2), unlikely (n=7), and excluded (n=16). Causality for kava was more evident with the CIOMS scale: highly probable (n=1), probable (n=2), possible (n=6), unlikely (n=2) and excluded (n=15). However, the results of both quantitative causality assessments are not supportive for most of the regulatory ad hoc causality assessments of the 26 patients.

CONCLUSION

Grades of causality for suspected hepatotoxicity by kava were much lower when evaluated by structured quantitative causality assessment scales than by regulatory ad hoc judgements. The quantitative CIOMS scale is the preferable tool for causality assessment of spontaneous reports of hepatotoxcity involving kava.

Characterization of Eu- and heterochromatin of citrus with a focus on the condensation behavior of 45S rDNA chromatin

To characterize the properties of eu- and heterochromatic regions in Citrus species, the chromosomal distribution of different histone H3 marks, DNA methylation sites (5mC) and 45S ribosomal DNA sites were determined for C. clementina, C. paradisi, C. sinensis, and for the hybrid Ortanique C. reticulata × C. sinensis. Our data show that in the relatively small genomes of investigated Citrus species (genome size ranges from 378-400 Mbp) the euchromatin is characterized by histone H3 lysine 4 mono-, di- and trimethylation (H3K4me1/ 2/3) and histone H3 lysine 9 trimethylation (H3K9me3). In contrast, histone H3 lysine 9 mono- and dimethylation (H3K9me1/2), histone H3 lysine 27 mono-, di- and trimethylation (H3K27me1/2/3) as well as 5-methylcytosine (5mC) were enriched at certain heterochromatin fractions. Whereas H3K9me1/2 and H3K27me1 were preferentially enriched at the chromomycin A(3)-bright (CMA(+)) heterochromatin, H3K27me2/3 showed a higher accumulation at the DAPI brightly-stained heterochromatin. 5mC signals were associated with most of the CMA(+) areas as well as with the DAPI strongly-stained heterochromatin fraction. Therefore, extensive methylation of DNA as well as of H3K9me1/2 and H3K27me1/2/3, and depletion of H3K4me1/2/3 and H3K9me3 appear to be specific features of heterochromatin in Citrus. Transcriptionally active decondensed 45S rDNA sites were found DNA hypomethylated, while the silenced condensed sites were strongly 5mC methylated. Although the number of chromosomal 45S rDNA sites differed between the species, the number of transcriptionally active rDNA sites remains constant.

Shrinking genomes? Evidence from genome size variation in Crepis (Compositae)

Large-scale surveys of genome size evolution in angiosperms show that the ancestral genome was most likely small, with a tendency towards an increase in DNA content during evolution. Due to polyploidisation and self-replicating DNA elements, angiosperm genomes were considered to have a 'one-way ticket to obesity' (Bennetzen & Kellogg 1997). New findings on how organisms can lose DNA challenged the hypotheses of unidirectional evolution of genome size. The present study is based on the classical work of Babcock (1947a) on karyotype evolution within Crepis and analyses karyotypic diversification within the genus in a phylogenetic context. Genome size of 21 Crepis species was estimated using flow cytometry. Additional data of 17 further species were taken from the literature. Within 30 diploid Crepis species there is a striking trend towards genome contraction. The direction of genome size evolution was analysed by reconstructing ancestral character states on a molecular phylogeny based on ITS sequence data. DNA content is correlated to distributional aspects as well as life form. Genome size is significantly higher in perennials than in annuals. Within sampled species, very small genomes are only present in Mediterranean or European species, whereas their Central and East Asian relatives have larger 1C values.

Enhanced propagation for relativistic laser pulses in inhomogeneous plasmas using hollow channels

The influence of long (several millimeters) and hollow channels, bored in inhomogeneous ionized plasma by using a long pulse laser beam, on the propagation of short, ultraintense laser pulses has been studied. Compared to the case without a channel, propagation in channels significantly improves beam transmission and maintains a beam quality close to propagation in vacuum. In addition, the growth of the forward-Raman instability is strongly reduced. These results are beneficial for the direct scheme of the fast ignitor concept of inertial confinement fusion as we demonstrate, in fast-ignition-relevant conditions, that with such channels laser energy can be carried through increasingly dense plasmas close to the fuel core with minimal losses.

Time and space resolved interferometry for laser-generated fast electron measurements

A technique developed to measure in time and space the dynamics of the electron populations resulting from the irradiation of thin solids by ultraintense lasers is presented. It is a phase reflectometry technique that uses an optical probe beam reflecting off the target rear surface. The phase of the probe beam is sensitive to both laser-produced fast electrons of low-density streaming into vacuum and warm solid density electrons that are heated by the fast electrons. A time and space resolved interferometer allows to recover the phase of the probe beam sampling the target. The entire diagnostic is computationally modeled by calculating the probe beam phase when propagating through plasma density profiles originating from numerical calculations of plasma expansion. Matching the modeling to the experimental measurements allows retrieving the initial electron density and temperature of both populations locally at the target surface with very high temporal and spatial resolution (~4 ps, 6 μm). Limitations and approximations of the diagnostic are discussed and analyzed.

An Andean radiation: polyploidy in the tree genus Polylepis (Rosaceae, Sanguisorbeae)

The Andean tree genus Polylepis (Rosaceae) is notorious for the high morphological plasticity of its species and the difficulty in their circumscription. The evolutionary mechanisms that have driven diversification of the genus are still poorly understood, with factors as diverse as ecological specialisation, reticulate evolution, polyploidisation and apomixis being proposed to contribute. In the present study, chromosome counts, flow cytometry and stomata guard cell size measurements were employed to document for the first time the presence of polyploidy in the genus and to infer ploidy levels for most species. Inferred ploidy levels show a clear progression from diploidy in cloud forest species to polyploidy (tetra- to octoploidy) in the morphologically and ecologically specialised incana group, indicating that polyploidisation may have played a major role in speciation processes and the colonisation of novel habitats during the Andean uplift. At least two species of Polylepis comprise populations with varying degrees of ploidy. More extensive studies are needed to obtain a better understanding of the prevalence and effects of intraspecific polyploidy in the genus.

An imaging proton spectrometer for short-pulse laser plasma experiments

The ultraintense short pulse laser pulses incident on solid targets can generate energetic protons. In addition to their potentially important applications such as in cancer treatments and proton fast ignition, these protons are essential to understand the complex physics of intense laser plasma interaction. To better characterize these laser-produced protons, we designed and constructed a novel spectrometer that will not only measure proton energy distribution with high resolution but also provide its angular characteristics. The information obtained from this spectrometer compliments those from commonly used diagnostics including radiochromic film packs, CR39 nuclear track detectors, and nonimaging magnetic spectrometers. The basic characterizations and sample data from this instrument are presented.

HIV vaccine efficacy trial participation: men who have sex with men's experiences of risk reduction counselling and perceptions of risk behaviour change

Qualitative interviews were conducted with 35 men who have sex with men, enrolled in the world's first phase III HIV vaccine efficacy trial at five US sites, regarding their risk reduction counselling experiences and their perceptions of its impact on risk behaviour. Respondents ranged in age from 20 to 58 years and were predominately white (71.4%) in racial/ethnic origin. Systematic qualitative analysis revealed that a positive counselling experience meant having good rapport with clinic staff. Differences in attitudes toward counselling were related to either a personal approach of balancing an enjoyable sex life with safe sex behaviours (balancing risks) or accepting the consequences of risky sexual behaviour rather than making changes (risk homeostasis). Respondents seeking to balance risks indicated that they saw themselves engaging in safer sexual behaviour almost twice as often as in riskier behaviours. They perceived counselling and behavioural risk assessments to help increase their awareness of personal risk-taking behaviours. Conversely, those with a risk homeostasis approach reported that they had established sexual boundaries prior to trial participation that had thus far proven to be effective in avoiding HIV infection, and that they were comfortable with the level of risk taken. Thus, risk reduction counselling had little to no influence on their sexual practices. Some of these men also indicated that while they had not found the risk reduction information imparted to them by clinic staff to be novel, counselling was beneficial in reinforcing their HIV/AIDS and safe sex knowledge base.

Hot electrons transverse refluxing in ultraintense laser-solid interactions

We have analyzed the coupling of ultraintense lasers (at ∼2×10{19}  W/cm{2}) with solid foils of limited transverse extent (∼10  s of μm) by monitoring the electrons and ions emitted from the target. We observe that reducing the target surface area allows electrons at the target surface to be reflected from the target edges during or shortly after the laser pulse. This transverse refluxing can maintain a hotter, denser and more homogeneous electron sheath around the target for a longer time. Consequently, when transverse refluxing takes places within the acceleration time of associated ions, we observe increased maximum proton energies (up to threefold), increased laser-to-ion conversion efficiency (up to a factor 30), and reduced divergence which bodes well for a number of applications.

Fast focusing of short-pulse lasers by innovative plasma optics toward extreme intensity

We developed a compact plasma-based focusing optic that, in one step, increases the peak intensity of ultrahigh-intensity lasers without modifying the laser system itself. By using a plasma-based focusing optic with extremely small f-number (f/0.4), we have experimentally demonstrated a fivefold reduction of the focal spot size (from 4.4 to 0.9 microm), thus producing an at least eightfold enhancement of the laser light intensity. This innovative plasma-based optic opens the way for the study of high-energy-density and high-field science at intensities greater than presently available.

Interspecific hybrids of Hordeum marinum ssp. marinum x H. bulbosum are mitotically stable and reveal no gross alterations in chromatin properties

Interspecific hybrids between the related wild barley species Hordeum marinum and H. bulbosum were generated and tested regarding their chromosomal stability and chromatin properties. Unlike in H. vulgare x H. bulbosum hybrid embryos, there was no effect of temperature on uniparental chromosome elimination or retention during hybrid seed development and 7 chromosomes from each parent were detected according to genomic in situ hybridization analyses. The centromere-specific histone H3 gene (CENH3) of both parental genomes is active in hybrid plants. Indirect immunostaining of flow-sorted 2C nuclei indicated that no major reorganization of histone H3 methylation (K4, K9 and K27), H3K9 acetylation and histone H2A ubiquitination marks or location of active RNA polymerase II sites occurred after interspecific hybridization.

Picosecond short-range disordering in isochorically heated aluminum at solid density

Using ultrafast x-ray probing, we experimentally observed a progressive loss of ordering within solid-density aluminum as the temperature raises from 300 K to >10{4} K. The Al sample was isochorically heated by a short ( approximately ps), laser-accelerated proton beam and probed by a short broadband x-ray source around the Al K edge. The loss of short-range ordering is detected through the progressive smoothing of the time-resolved x-ray absorption near-edge spectroscopy (XANES) structure. The results are compared with two different theoretical models of warm dense matter and allow us to put an upper bound on the onset of ion lattice disorder within the heated solid-density medium of approximately 10 ps.

Experimental evidence of short light pulse amplification using strong-coupling stimulated brillouin scattering in the pump depletion regime

The energy transfer from a long (3.5 ps) pump pulse to a short (400 fs) seed pulse due to stimulated Brillouin backscattering in the strong-coupling regime is investigated. The two pulses, both at the same wavelength of 1.057 microm are quasicounterpropagating in a preformed underdense plasma. Relative amplification factors for the seed pulse of up to 32 are obtained. The maximum obtained amplified energy is 60 mJ. Simulations are in agreement with the experimental results and suggest paths for further improvement of the amplification scheme.

[Functional outcome in children with Hirschsprung's disease or imperforate anus]

Various outcomes following operative therapy for Hirschsprung's disease and anorectal malformations have been reported. Operative techniques for anorectal reconstruction have been modified several times in the past. Repair of anorectal -malformations have been performed through a posterior sagittal approach since the 1980s. This -allows an anatomically correct reconstruction of the anorectal canal. Abdominoperineal or sacro-abdominoperineal pull-through procedures, as the classical operative techniques, have been abandoned by most surgeons. Rectosigmoid-ectomy with colo-anal anastomosis, as described by Swenson and Bill in 1948, as well as the retro-rectal pull-through (Duhamel) and the endorectal pull-through (Soave) are still frequently used in surgery for Hirschsprung's disease. The development of the transanal endorectal pull-through with (Georgeson) or without (de la Torre) laparoscopic assistance has eliminated the necessity of laparotomy in selected cases. Despite significant progress in the understanding of the pathophysiology of and therapy for Hirschsprung's dis-ease and anorectal malformations, the functional results remain unsatisfactory. Functional problems occur already in early childhood and de-crease the quality of life significantly. Although complications resolve with time and the quality of life normalises in adolescence and adulthood, this might be mainly due to an adaptation strategy by the patients. For the future, a standardised and prospective study design is necessary to compare different procedures and to provide a basis for the further development of therapeutic strategies.