Search Results (153)

Background/Objectives: Carbon-ion radiotherapy (CIRT) offers precise dose distribution and enhanced biological effectiveness in localized prostate cancer. However, the safety of CIRT in patients with a history of surgery for benign prostatic hyperplasia (BPH), such as transurethral resection of the prostate (TURP), remains unclear. This study aimed to evaluate the long-term safety and oncological outcomes of CIRT in this population. Methods: A retrospective analysis was conducted in 74 of 3848 patients with prostate cancer and a history of surgery for BPH who underwent CIRT combined with risk-adapted androgen deprivation therapy between 2007 and 2023. Adverse events were assessed using CTCAE v5.0. Biochemical recurrence-free survival was estimated using the Kaplan–Meier method and risk factors for hematuria with multivariate logistic regression and receiver operation characteristic (ROC) analysis. Results: CIRT was generally well-tolerated. Early Grade 2 genitourinary (GU) adverse events occurred in 5.4% of patients, and late-Grade 2 or higher GU events occurred in 8.1%. The cumulative incidence of Grade 2 ≥ GU events remained 10% at 36 months. Compared to holmium laser enucleation of the prostate, a shorter interval between BPH surgery and CIRT initiation and a history of TURP were independently associated with an increased risk of hematuria. Notably, 5-year bRFS was 100% in low- and intermediate-risk groups and 88.6% in the high-risk group. Conclusions: CIRT demonstrates acceptable oncological outcomes and urinary complication rates in patients with prostate cancer and a history of BPH surgery. These findings suggest that CIRT can be a feasible treatment option in this surgically altered population, but careful patient selection, individualized treatment planning, and long-term follow-up are essential. Given the absence of a non-BPH control group, oncological efficacy should be interpreted with caution. Full article

We theoretically studied the control of the extraction of anti-Stokes photoluminescence using photonic crystal (PhC) nanocavities. Our fabricated (erbium,oxygen)-codoped GaAs PhC nanocavity showed a positive feedback gain of heating through the excitation of the GaAs host, which suggests the possibility of higher laser-cooling efficiencies at lower temperatures in such systems. Based on this result, we constructed a theoretical framework of laser cooling in PhC nanocavities. The predicted laser cooling efficiency of a PhC nanocavity is six to eight times higher than that of the corresponding bulk system, and we predict that more than 24% can be achieved at 100 K using holmium-doped materials. Full article

Background and Clinical Significance: Cervical ectopic pregnancy (CEP) is a rare and potentially serious condition, in which the embryo implants within the cervical canal rather than the uterine cavity and is present in less than 1% of all ectopic pregnancies. There are different treatment options depending on the particular situation and the woman’s reproductive desire but conservative approaches as the first line of treatment is preferred in all cases and hysteroscopic resection of the fetus is one of these options. Several types of laser systems are available for use in hysteroscopic surgery, including neodymium:YAG (Nd:YAG) lasers, KTP and Argon lasers, as well as diode lasers. The holmium:YAG (Ho:YAG) laser, although more commonly used in urology due to its ability to cut, coagulate, and vaporize tissue, has gained interest in gynecologic procedures because of its precision and favorable safety profile. Case Presentation: We present the case of a 32-year-old woman, pregnant for the first time, who was diagnosed with CEP and successfully treated using a Ho:YAG laser during an outpatient hysteroscopic procedure. As far as we know, this is the first published case using this approach. Conclusions: The Ho:YAG laser is a proven tool for outpatient hysteroscopic procedures like septum and adhesion removal. Its ability to both cut and coagulate offers a minimally invasive, fertility-sparing option for managing cervical ectopic pregnancy. With the right patient and proper backup plans in place, this approach could be a promising alternative to more aggressive treatments. Full article

This work examines the possibility of using a PbO₂-based electrode doped with the rare-earth metal holmium in the field of oxygen evolution and the development of an efficient method for the degradation of acetamiprid. Acetamiprid is a widely used insecticide and, as such, it very often reaches waterways, where it can cause many problems for wildlife and the environment. X-ray powder diffraction analysis, Raman spectroscopy, and energy-dispersive X-ray spectroscopy results confirmed the structure of Ti/SnO₂-Sb₂O₃/Ho-PbO₂, while the morphology of its surface was investigated by scanning electron microscopy with energy-dispersive X-ray spectroscopy. Ti/SnO₂-Sb₂O₃/Ho-PbO₂ showed good OER activity in alkaline media with a Tafel slope of 138 mV dec⁻¹. The Ti/SnO₂-Sb₂O₃/Ho-PbO₂ electrode shows very good efficiency in removing acetamiprid. By optimizing the degradation procedure, the following operating conditions were obtained: a current density of 20 mA cm⁻², a pH value of the supporting electrolyte (sodium sulfate) of 2, and a concentration of the supporting electrolyte of 0.035 M. After optimization, the maximum efficiency of removing acetamiprid (10 mg L⁻¹, 4.5 × 10⁻⁵ mol) from water was achieved, 96.8%, after only 90 min of treatment, which represents an efficiency of 1.125 mol cm⁻² of the electrode. Additionally, it was shown that the degradation efficiency is strictly related to the concentration of the treated substance. Full article

Plugs of lignite coal from multiple formations were subjected to a series of tests to determine the amount of rare-earth elements (REEs) to be extracted from coal in an in situ mining operation. These tests were used to determine if extraction of REEs and other critical minerals in an in situ environment would be possible for future attempts as an alternative to extraction mining. The tests involved subjecting whole lignite coal plugs from the Twin Butte coal seams in North Dakota to flow-through tests of water, and concentrations of 1.0 M ammonium nitrate, 1.0 M and 1.5 M sulfuric acid, and 1.0 M and 1.5 M hydrochloric acid (HCl) solvents at different concentrations and combinations. The flow-through testing was conducted by alternating the solvent and water flow-through to simulate an in situ mining scenario. The samples were analyzed for their concentrations of REEs (lanthanum [La], cerium [Ce], praseodymium [Pr], neodymium [Nd], samarium [Sm], europium [Eu], gadolinium [Gd], terbium [Tb], dysprosium [Dy], holmium [Ho], erbium [Er], thulium [Tm], ytterbium [Yb], lutetium [Lu], yttrium [Y], and scandium [Sc], as well as germanium [Ge] and cobalt [Co], manganese [Mn], nickel [Ni], and barium [Ba]). Results from the testing showed that REEs were extracted in concentrations that were on average higher using sulfuric acid (8.9%) than with HCl (5.8%), which had a higher recovery than ammonium nitrate. Tests were performed over a standard time interval for comparison between solvents, while a second set of testing was done to determine recovery rates of REEs and critical minerals under certain static and constant flow-through times to determine extraction in relation to time. Critical minerals had a higher recovery rate than the REEs across all tests, with a slightly higher recovery of light REEs over heavy REEs. Full article

Background and Objectives: The aim of our study was to evaluate in an ex vivo setting the impact of the holmium laser lithotripsy over the temperature of the irrigation fluid. Materials and Methods: We recorded temperature changes in an ex vivo porcine model during laser activation using dusting (18 Hz, 0.6 J, 10.8 W) and fragmenting settings (8 Hz, 2 J, 16 W). The temperature was recorded for each of these modes in three settings: without irrigation or access sheath, with irrigation but no access sheath, and with irrigation and a 10/12 F access sheath in place. Results: Using dusting settings, the maximum recorded temperatures were 42.3 degrees Celsius (no irrigation, no sheath), 37.3 degrees Celsius (with irrigation but no access sheath) and 36.2 degrees Celsius (with irrigation and access sheath). In fragmenting mode, the maximum recorded temperatures were 52 degrees Celsius (no irrigation, no sheath), 43.1 degrees Celsius (with irrigation but no access sheath), and 42.9 degrees Celsius (with irrigation and access sheath). Conclusions: In certain conditions (no irrigation, more watts) the temperature may rise to dangerous levels. However, in closer to real-life settings (with irrigation and especially when ureteral access sheaths are employed) the magnitude of this effect is limited, making flexible intrarenal laser lithotripsy a reasonably safe procedure. Full article

The development of a high-power 7 × 1 triple-clad fiber combiner aimed at resonantly clad-pump holmium-doped fiber lasers is presented. Thanks to the implementation in the combiner of a low refractive index glass capillary, we show that the developed combiner is compatible with power scaling. Due to the hexagonal arrangement of its seven single-mode input fibers, the presented combiner can also be used in a 6 + 1 × 1 configuration. This characteristic of the fiber component allows for holmium-doped fiber lasers to be studied and developed with both single-oscillator and master-oscillator power amplifier architectures. Full article

Background/Objectives: This systematic review and meta-analysis evaluated the effectiveness and the safety of transarterial radioembolization using Holmium-166 microspheres (Ho-166-TARE) for the treatment of primary and secondary liver tumors. The aim of the study was to offer a detailed analysis of clinical outcomes and the potential benefits of this innovative therapy. Methods: The study was conducted according to the PRISMA 2020 guidelines. The systematic search was performed in five databases in November 2023 and updated in June 2024. All 16 eligible studies were original research that evaluated Ho-166-TARE. The endpoints analyzed were disease control rate (DCR), overall survival (OS), progression-free survival (PFS), clinical and laboratory adverse events, healthy-liver- and tumor-liver-absorbed doses. The risk of bias was assessed using the MINORS checklist. Results: The pooled overall disease control rate (DCR) was 72% (95% CI, 46–89%); by mRECIST, it was 93% (95% CI, 71–99%); and by RECIST 1.1, it was 54% (95% CI, 22–83%) at 3-month follow-up. Overall survival (OS) at 3, 6, 12, and 30 months was 98%, 89%, 74%, and 39%, respectively. Severe clinical adverse events were minimal, although some patients showed elevated GGT levels and lymphocytopenia. Tumor-absorbed doses were nearly three times higher than those in healthy liver tissue. Conclusions: These findings suggest that Ho-166-TARE is a safe and effective locoregional treatment option for liver tumors, especially in cases where systemic therapy alone is insufficient or surgical resection is not feasible. Further studies are needed to investigate tumor-specific response, optimize dosimetry strategies, and establish standardized protocols for long-term outcome assessment. Full article

Background/Objectives: The aim of this research was to compare perioperative outcomes, functional results, quality of life, and complications between robot-assisted simple prostatectomy (RASP) and holmium laser prostate enucleation (HoLEP) as minimally invasive techniques for treating benign prostatic hyperplasia (BPH) in large prostates (>150 cm³). Methods: This retrospective, multicenter, observational study (2007–2023) included patients with >150 cm³ prostate volumes who underwent either HoLEP or robot-assisted prostatectomy. Primary outcomes: success rate (complete enucleation, without transfusion or reintervention), good postoperative quality of life (IPSS 8th question score: 0–2), and continence at 6 months (no pads). Secondary outcomes: operative and catheterization time, hospital stay, enucleated gland weight, PSA reduction, Qmax improvement, and perioperative complications. Results: We included 95 HoLEP and 50 RASP patients with similar demographics and prostate volume (HoLEP: 187.72 cm³; RASP: 203.38 cm³). The success rate (HOLEP: 83.2%; RASP: 74%), continence rate (HoLEP: 85.1%; RASP: 86%), and quality of life (HoLEP: 83.2%; RASP 94%) were similar (p = 0.275, p = 1, and p = 0.075, respectively). HoLEP had a shorter operative time (97.58 vs. 122.4 min) and catheterization duration, with similar hospitalization duration (HoLEP: 3.46 days; RASP: 4.22 days). Although there was no significant difference in enucleated gland weight, HoLEP was more efficient (1.28 g/min vs. 1.06 g/min). Complication rates were similar (HOLEP: 15.5%; RASP: 26%; p = 0.12). Conclusions: Both RASP and HoLEP are safe for treating BPH in prostates >150 cm³, reporting similar success and continence rates and good quality of life after surgery. However, HoLEP achieved results with shorter operative time and catheterization duration. Full article

Frustrated magnetic systems arising in geometrically constrained lattices represent rich platforms for exploring unconventional phases of matter, including fractional magnetization plateaus, incommensurate orders and complex domain dynamics. However, determining the microscopic spin configurations that stabilize such phases is a key challenge, especially when in-plane and out-of-plane spin components coexist and compete. Here, we combine neutron scattering and magnetic susceptibility experiments with simulations to investigate the emergence of field-induced fractional plateaus and the related criticality in a frustrated magnet holmium tetraboride (HoB₄) that represents the family of rare earth tetraborides that crystalize in a Shastry–Sutherland lattice in the $ab$ plane. We focus on the interplay between classical and quantum criticality near phase boundaries, as well as the role of material defects in the stabilization of the ordered phases. We find that simulations using classical annealing can explain certain observed features in the experimental Laue diffraction and the origin of multiple magnetization plateaus. Our results show that defects and out-of-plane interactions play an important role and can guide the route towards resolving microscopic spin textures in highly frustrated magnets. Full article

Background: The aim of this study was to assess the efficacy and safety of Holmium Laser Enucleation of the Prostate (HoLEP) in the treatment of symptomatic benign prostatic hyperplasia (BPH) in elderly patients using the Trifecta Score, based on a 1-year follow-up. Methods: We conducted a retrospective analysis of patients with BPH who underwent HoLEP at our institution between January 2016 and December 2022. The patients were divided into two groups: Group 1: patients aged ≥75 years, Group 2: patients aged below 74 years. The Trifecta Score achievement rates were then evaluated. Logistic regression analyses were performed to examine the impact of age on Trifecta parameters and to assess factors associated with urinary incontinence. Results: Overall, 981 participants were enrolled, with 490 in Group 1 and 491 in Group 2. Operative characteristics were similar between groups, though Group 1 had a longer time to catheter removal. At the 3-month follow-up, Group 1 had a higher IPSS and lower Qmax compared to Group 2, while there were no significant differences in functional outcomes by one year. In terms of postoperative morbidities, Group 1 exhibited a higher rate of blood transfusion. The Trifecta Score was similar between Groups 1 and 2 (63.5% vs. 68.8%, respectively, p = 0.08), and no parameter of that score exhibited a negative correlation with age. Conclusions: HoLEP demonstrates comparable functional outcomes to those observed in younger cohorts after one year. Overall, the Trifecta Score appears to be a valuable tool for this assessment. Nevertheless, incorporating an assessment of postoperative urinary continence and 1-year postoperative Qmax could enhance the system’s validity. Full article

Background: Holmium Laser Enucleation of the Prostate (HoLEP) is an established treatment for benign prostatic hyperplasia (BPH). Pulse-modulated lasers, like MOSES technology (MoLEP), may enhance the procedure’s efficiency and safety. Methods: A 3-year single-center retrospective comparative study was conducted on 1368 patients treated with HoLEP/MoLEP at MITERA Hospital. Results: A total of 688 patients were treated with HoLEP and 680 with MoLEP. Compared to HoLEP, MoLEP demonstrated shorter surgical (50.5 min [IQR 33–60] vs. 58 min [IQR 46–69], p < 0.01) and enucleation times (34 min [IQR 23–43] vs. 43 min [IQR 34–51], p < 0.001) and shorter hospital stay (8 h [IQR 6–19] vs. 12 h [IQR 9–24], p = 0.027), catheterization time (19 h [IQR 12–48] vs. 24 h [IQR 24–48], p < 0.001), and irrigation duration (5 h [IQR 2–8] vs. 7 h [IQR 3–10], p < 0.001), with similar morcellated tissue weight and morcellation time. At 1 month, MoLEP showed higher Qmax (27.3 mL/s [IQR 23.9–30.3] vs. 20 mL/s [IQR 17–23.6], p < 0.001), lower PVR (11.4 mL [IQR 7.7–15] vs. 12.5 mL [IQR 7–18], p = 0.005), better IPSS (4 [IQR 3–6] vs. 7 [IQR 5–11], p < 0.005), QoL (1 [IQR 1–2] vs. 2 [IQR 1–2], p < 0.001), lower PSA (1.8 ng/mL [IQR 1.1–2.6] vs. 2.4 ng/mL [IQR 1.3–3.5], p < 0.001), which were maintained at 6 months, and fewer Clavien-Dindo I (2.5% vs. 7.5%, p < 0.001) and II (16% vs. 25.7%, p < 0.001) complications. Conclusions: MoLEP offered significant advantages over HoLEP in this study. Full article

Applications of lanthanide chemistry have been successful in metallics and the petroleum industry. In the medical realm, lanthanides have shown utility in radiotherapy agents, photodynamic therapy agents, and magnetic resonance imaging (MRI) contrast agents. The lanthanide group elements have a few known biological roles, notably among some bacteria and the yeast Saccharomyces cerevisiae, which have been used as models for changes in gene expression. However, the systematic effects of lanthanide nitrates on eukaryotic cell model systems have not yet been reported. This study presents the first documented effects on cell viability, after acute incubations of various lanthanide nitrate salts, using axenic C6 glial or PC12 neuronal cells in vitro. Cultures were exposed to a 1 mM concentration of lanthanide nitrate salts for 24 h. In comparison to the saline control, several cultures demonstrated significantly lower cell viability, as measured by the MTT viability assay. Data were analyzed as an average absorbance of n = 4 replicate samples, corrected for the average absorbance of cell-free blanks. The reported results were normalized to the average of the saline control cells. Among the 13 lanthanides tested, Praseodymium, Holmium, Erbium, Thulium, and Ytterbium nitrates exhibited the most pronounced inhibitory effects, resulting in over 40% reduction in cell viability at 1 mM for either or both cell types. Recovery after lanthanide exposure also was cell-type-dependent as well as lanthanide-type-dependent, with Lutetium having the greatest effect on both cell types. PC12 cells displayed greater sensitivity for inhibition than the C6 cells with some of the lanthanides but not all. Furthermore, the controls of sodium nitrate and calcium nitrate showed only modest discernible impacts on cell viability for PC12 and C6 cells, highlighting the role of the lanthanides in influencing cell viability. Full article

Background/Objectives: Patients diagnosed with pancreatic ductal adenocarcinoma (PDAC) have a poor prognosis. Local therapy may enhance tumor control and increase resectability. Intratumoral injection of radioactive holmium-166 microspheres presents a promising and minimally invasive treatment with multimodality imaging capabilities (SPECT, CT, MRI). However, holmium-166 microspheres are not commonly used for intratumoral injections, and PDAC is notorious for its high intratumoral pressure. This study developed an intratumoral injection method with nonradioactive holmium-165 microspheres in ex vivo human PDAC specimens using a novel injection system for suspension homogenization. Methods: An injection system was developed and validated in a laboratory setting. Thereafter, intratumoral injections in surgically removed ex vivo PDACs were performed, and parameters were established to optimize feasibility, defined by the ability to inject and control the microsphere distribution. Also, injection limitations and cutoff values were determined. The distribution was assessed by visual confirmation, CT, MRI, ultrasound, and histopathology. Results: With a validated injection system, intratumoral injections were performed in ten ex vivo PDAC samples. Feasible injection guidelines include but are not limited to ultrasound or CT needle guidance, a maximum injection volume of <20.0% from the tumor volume, ≤3 needle positions, and an injection volume of 0.3–1.0 mL per needle position. Conclusions: Intratumoral injection of holmium-165 microspheres in ex vivo pancreatic ductal adenocarcinoma was feasible with adherence to injection parameters necessary for effective intratumoral deposition and minimal leakage. The injection system and parameters developed here provide a foundation for future studies on holmium-166 microsphere injections in pancreatic cancer patients, with the aim to improve local tumor control as a part of a multimodal therapy. Full article

Background: Bouveret syndrome is a complication of cholelithiasis, characterized by the migration of a large gallstone from the gallbladder to a part of the stomach or intestine through a bilio-enteric fistula. This condition results in a rare form of gallstone ileus, presenting signs and symptoms of gastric outlet obstruction. Methods: This case report aims to present a rare instance of Bouveret syndrome in a 64-year-old woman who presented to our emergency department with recurrent epigastric pain and vomiting for over 2 months. After a CT scan, an esophagogastroscopy was performed following a multidisciplinary discussion. An endoscopic evaluation revealed a large (4 cm) gallstone found in the proximal duodenum using an endoscope. We then inserted the holmium laser fiber system through a standard ERCP catheter, passing it through the endoscope’s working channel. By positioning the holmium laser fiber within the catheter, we stabilized the energy on the gallstone, which was then fragmented into smaller pieces after administering pulse energy. Results: In this case report, we successfully treated Bouveret syndrome using endoscopic laser lithotripsy combined with mechanical lithotripsy, avoiding traditional surgery. Conclusions: The endoscopic approach that combines laser and mechanical lithotripsy appears effective in fragmenting large gallstones into smaller pieces, facilitating their passage through the digestive tract and resolving the obstruction. Full article