O2 solvation cavity in voids of ionic liquids studied by the solvatochromic red shift of O2(1Δg) phosphorescence.

Phosphorescence spectroscopy of singlet oxygen [=O2(1Δg)] was applied to study the solvation properties of small solute molecule, O2, in ionic liquids. Unlike conventional molecular solvents, the spectral red shift of the O2(1Δg) phosphorescence in ionic liquids from the gas phase was found to depend not only on the refractive index of solvents but also on the vdW volume of anions. This unusual spectral shift of the O2(1Δg) luminescence is interpreted by considering the size of solvation cavities in voids, which is estimated by analyzing the free volume in ionic liquids. These results suggest the potential of the O2(1Δg) phosphorescence spectral shift measurement in the study of molecular-scale voids in ionic liquids.

Effect of jaw clenching on head acceleration during a predictable load impact.

BACKGROUND: Jaw clenching is considered to reduce head acceleration while receiving a strong impact on the body during sport activities. OBJECTIVE: The present study aimed to clarify the effect of jaw clenching on reduction of head acceleration during a predictable load impact to the body. METHODS: Seven healthy participants were exposed to a predictable load impact with and without jaw clenching. We recorded the electromyographic activity of the masseter (MA) and digastricus (DIG) muscles, occlusal pressure and head acceleration throughout the experiment. RESULTS: When participants were not instructed to clench their jaws, they naturally positioned their jaws without occlusal contact at the time of pendulum impact by co-contracting the jaw opener and closer muscles. When participants were instructed to clench their jaws, neither the activity of the jaw opener muscle nor the head acceleration differed at the time of pendulum impact when compared with when participants were not instructed to clench their jaws. CONCLUSIONS: A slightly distanced jaw position (co-contracting the jaw opener and closer muscles without occlusal contact) might serve inherently safety for reduction of head acceleration during predictable body impact, while jaw clenching does not contribute to reduction of head acceleration in response to pendulum impact more than the distanced jaw position does. Notably, DIG activation to minimise the head acceleration in response to pendulum impact was similar in clenching and no clenching positions. This suggests that DIG may play a crucial role in the reduction of head acceleration, regardless of MA muscle activity.

[A Case of Ramucirumab-Related Small Intestinal Perforation in Gastric Cancer].

A 54-year-old man underwent laparoscopic distal gastrectomy with D2 lymph node dissection and ante-colic Roux-en-Y reconstruction for gastric cancer. The histopathological diagnosis was pT2N3aM0, pStage ⅢA, HER2 negative. After 8 courses of S-1 plus oxaliplatin as adjuvant chemotherapy, he was diagnosed as peritoneal dissemination and treated with ramucirumab(RAM)plus paclitaxel(PTX). On the 12th day of course 10, he visited to our hospital with abdominal pain. CT showed free air and massive ascites. Emergent surgery was performed under the diagnosis of gastrointestinal perforation. A small intestinal perforation in front of the jejunal limb near gastric-jejunal anastomosis was identified and there was no peritoneal dissemination. We performed partial resection of remnant stomach and jejunal limb by linear stapler and reconstruction by end to side gastric-jejunal anastomosis. Because the gastric and intestinal wall were quite fragile and RAM impaired wound healing as adverse event, we feared about leakage, but he had no major postoperative complications and discharged on the 33th day after surgery. After 24 courses of nivolumab as third-line chemotherapy, the peritoneal dissemination disappeared. He has been alive without recurrence for about 1 year since then.

[A Case of Metastatic Colorectal Cancer with Hyperammonemic Encephalopathy Induced by mFOLFOX6 and SOX Therapy].

A 77-year-old man was given a diagnosis of pT4aN0M1a(PUL2), stage Ⅳ, RAS mutant type, after the operation for advanced ascending colon cancer. He was administered mFOLFOX6 plus Bmab as first-line chemotherapy. He showed consciousness disturbance on the 2nd day during the 6 cycles. Because of head computed tomography and magnetic resonance imaging showing no abnormal findings, we diagnosed convulsive seizure. His consciousness level gradually improved after intravenous infusion. He showed consciousness disturbance on the 2nd day during the 7 cycles again. Because blood ammonia level were high at 400µg/dL, he was diagnosed as hyperammonemic encephalopathy. His consciousness level rapidly recovered after branched chain amino acid(BCAA)infusion. SOX plus Bmab therapy was started as a post-treatment, he developed hyperammonemia(NH3 288µg/dL)again, on the 4th day during the 3 cycles. After taking of oral administration of BCAA and lactulose, the recurrence of hyperammonemic encephalopathy was not found. Therefore, 3 cycles of SOX plus Bmab therapy and 12 cycles of IRIS plus Bmab therapy were administered.

Overhead-optimization of pilot-based digital signal processing for flexible high spectral efficiency transmission.

We present a low-complexity fully pilot-based digital signal processing (DSP) chain designed for high spectral efficiency optical transmission systems. We study the performance of the individual pilot algorithms in simulations before demonstrating transmission of a 51×24 Gbaud PM-64QAM superchannel over distances reaching 1000 km. We present an overhead optimization technique using the system achievable information rate to find the optimal balance between increased performance and throughput reduction from adding additional DSP pilots. Using the optimal overhead of 2.4%, we report 9.3 (8.3) bits/s/Hz spectral efficiency, or equivalently 11.9 (10.6) Tb/s superchannel throughput, after 480 (960) km of transmission over 80 km spans with EDFA-only amplification. Moreover, we show that the optimum overhead depends only weakly on transmission distance, concluding that back-to-back optimization is sufficient for all studied distances. Our results show that pilot-based DSP combined with overhead optimization can increase the robustness and performance of systems using advanced modulation formats while still maintaining state-of-the-art spectral efficiency and multi-Tb/s throughput.

Improved 68 Ga-labeling method using ethanol addition: Application to the α-helical peptide DOTA-FAMP.

We examined the 68 Ga labeling of the α-helical peptide, DOTA-FAMP, and evaluated conformational changes during radiolabeling. 68 Ga-DOTA-FAMP is a positron emission tomography probe candidate for atherosclerotic plaques. The labeling yield achieved by Zhernosekov's method (using acetone for 68 Ga purification) was compared with that achieved by the original and 2 modified Mueller's methods (using NaCl solution). Modified method I involves desalting the 68 Ga prior to labeling, and modified method II involves the inclusion of ethanol in the labeling solution. The labeling yield using Zhernosekov's method was 62% ± 5.4%. In comparison, Mueller's original method gave 8.9% ± 1.7%. Modified method I gave a slight improvement of 32% ± 2.1%. Modified method II further increased the yield to 66% ± 3.4%. Conformational changes were determined by circular dichroism spectroscopy, revealing that these differences could be attributed to conformational changes. Heat treatment affects peptide conformation, which leads to aggregation and decreases the labeling yield. Mueller's method is simpler, but harsh conditions preclude its application to biomolecules. To suppress aggregation, we included a desalting process and added ethanol in the labeling solution. These changes significantly improved the labeling yield. Before use for imaging, conformational changes of biomolecules during radiolabeling should be evaluated by circular dichroism spectroscopy to ensure the homogeneity of the labeled product.

[A Case of Gallbladder Carcinoma Producing Alpha-Fetoprotein(AFP)with Metastatic Liver Tumor].

Gallbladder carcinoma producing alpha-fetoprotein(AFP)is rare.We report a case of AFP producing carcinoma of the gallbladder with huge metastatic hepatic tumor.A 81-year-old female with a hepatitis B virus(HBV)had a fever and right hypochondralgia.Abdominal CT showed an enlarged gallbladder with gallbladder stones, a huge tumor in the right lobe of liver, and swelling paraaortic lymph nodes.Acute cholecystitis was treated by percutaneous transhepatic gallbladder drainage (PTGBD).The hepatic tumor was diagnosed as hepatocellular carcinoma for HBV carrier and the high level of AFP and PIVKA- II .We performed right lobectomy, cholecystectomy and the resection of paraaortic lymph nodes.In the resected gallbladder, the papillary tumor was detected.Histopathological diagnosis was moderately to poorly differentiated adenocarcinoma of the gallbladder.The liver tumor and paraaortic lymph nodes were metastases of the gallbladder carcinoma.The both of gallbladder and liver tumor immunohistochemically stained positive to AFP.It was difficult to diagnose the hepatic tumor because of HBV carrier, the high level of AFP and the unnoticed gallbladder tumor.Gallbladder carcinoma with the high level of AFP might have relation to liver metastases.

High-dimensional modulation for coherent optical communications systems.

In this paper, we examine the performance of several modulation formats in more than four dimensions for coherent optical communications systems. We compare two high-dimensional modulation design methodologies based on spherical cutting of lattices and block coding of a 'base constellation' of binary phase shift keying (BPSK) on each dimension. The performances of modulation formats generated with these methodologies is analyzed in the asymptotic signal-to-noise ratio regime and for an additive white Gaussian noise (AWGN) channel. We then study the application of both types of high-dimensional modulation formats to standard single-mode fiber (SSMF) transmission systems. For modulation with spectral efficiencies comparable to dual-polarization (DP-) BPSK, polarization-switched quaternary phase shift keying (PS-QPSK) and DP-QPSK, we demonstrate SNR gains of up to 3 dB, 0.9 dB and 1 dB respectively, at a BER of 10(-3).

[A case of hepatic metastases from colorectal cancer in a long-term survivor undergoing local combined modality therapy for repeated local recurrences].

Herein, we report of a long-term survivor who underwent local combined modality therapy for local hepatic recurrences detected 10 years after initial surgery for colorectal cancer and 7 years after metachronous liver metastasis. In the third year after surgery for colorectal cancer, a solitary liver metastasis was detected, and curative surgical resection was performed. However, because local recurrence developed 3 years later, curative resection was repeated. When local recurrence developed again 1.5 years later, the patient declined surgery and systemic chemotherapy, and radiofrequency ablation was performed. However, because of the development of another local recurrence 6 months later, hepatic arterial infusion chemotherapy was initiated. This therapy has been continued for 1.5 years to date, with successful local disease control and no adverse events. Although surgical resection is the first choice for resectable liver metastases of colorectal cancer, thermocoagulation and hepatic arterial infusion chemotherapy can also be valid options for patients who are inoperable or refuse surgery as well as for those who are not suitable for or refuse systemic chemotherapy. Notwithstanding, the guidelines for the treatment of colorectal cancer (2014 edition) now include the following statement: thermocoagulation is not recommended as an alternative to surgical resection. Hepatic arterial infusion chemotherapy appears to be a promising treatment strategy associated with antitumor effects with few adverse events. It is also relatively less expensive than systemic chemotherapy.

[A case of locally advanced breast cancer that responded to preoperative chemotherapy].

A 51-year-old woman presented with a huge tumor in the left breast. The tumor occupied the whole breast, accompanied with a 10-cm wide red discoloration of the skin, subsequently followed by a massive axillary lymph node metastasis. The patient was diagnosed with locally advanced breast cancer, graded as T4cN2aM0, StageIIIB. After preoperative chemotherapy, even though the tumor could not be observed on a CT scan, it was assumed to persist in the skin as discoloration was observed. Bt+Ax+Mj+Mi(level 1+2) and a full-thickness skin graft transplantation were performed. Pathological findings revealed a benign remnant of the active cancer in the skin. Four months after the operation, local recurrence was observed in the skin of the chest wall. Therefore, radiotherapy was performed.

An energy-efficient and elastic optical multiple access system based on coherent interleaved frequency division multiple access.

This paper proposes a novel bandwidth-elastic and energy-efficient passive optical network (PON) based on the coherent interleaved frequency division multiple access (IFDMA) scheme. We experimentally demonstrate the coherent IFDMA-PON uplink transmission up-to 30 Gbps over a 30 km standard single-mode fiber with 2 × optical network units (ONUs). A low-complexity digital carrier synchronization technique enables multiple access of the ONUs on the basis of 78.1 MHz narrow band orthogonal subcarriers without any guard-bands.

[A case of chest wall recurrence after mastectomy for breast cancer that showed response to chemotherapy].

We report a case of a 55-year-old woman who underwent mastectomy and axillary lymph node dissection for right breast cancer( T2N1cM0) 7 years previously. She had been experiencing chest pain for 1 year. Ultrasonography( US) showed a low echoic mass, 1 cm in diameter, near the rib in the right breast (class 5).Magnetic resonance imaging (MRI) and positron emission tomography( PET)-computed tomography( CT) scans revealed an 8-cm wide, segmentally enhancing soft tissue lesion and enhanced lymph nodes at the right edge of the sternum. Under the diagnosis of local recurrence, the patient received chemotherapy consisting of adriamycin and cyclophosphamide( AC) and docetaxel. Definite improvement in chest wall metastasis was observed following this treatment. By changing the treatment to endocrine therapy, the disease has been effectively controlled.

[A case of intrahepatic hematoma from hepatocellular carcinoma].

Spontaneous intrahepatic hematoma caused by hepatocellular carcinoma is a rare condition since usually the circumference shows liver cirrhosis. We report a case of hepatocellular carcinoma with an intrahepatic hematoma. A 79-year-old man was admitted to our hospital with sudden onset upper abdominal pain and high fever. Laboratory data showed that the patient had liver dysfunction but was not anemic. Abdominal computed tomography( CT) revealed an intrahepatic tumor with a hematoma measuring 8.5 cm in diameter in the right lobe of the liver. An enhancing lesion and pooling of contrast media inside the tumor was observed. Angiography also revealed a microaneurysm in the tumor. The patient underwent right hepatic lobectomy, and histopathological examination showed hepatocellular carcinoma.

[A case in which XELOX plus bevacizumab chemotherapy was effective in an elderly patient with heart failure and multiple liver metastases after sigmoidectomy].

A 75-year-old woman with a chief complain of anal pain visited the emergency department. She was diagnosed as having S-colon cancer perforation accompanied by an intra-abdominal abscess. Computed tomography (CT)-guided drainage was applied to the intra-abdominal abscess. Six days after drainage, the patient's condition progressed to acute respiratory failure due to heart failure, and ventilator support was provided temporarily. The patient's cardiopulmonary function improved with conservative management. S-colon cancer was detected during colonoscopy examination, and biopsy indicated a tub2 tumor. Next, S-colon resection with D3 lymph node dissection was performed. The postoperative course was uncomplicated. Two months after surgery, liver metastases were detected on CT. Since the patient's performance status (PS) was 3, it was impossible for her to undergo chemotherapy. Four months after surgery, her PS was restored to 2 and the liver metastases were exacerbated, as seen on CT. The patient began chemotherapy (XELOX plus bevacizumab, 30% reduced dose). Eight months after the start of chemotherapy, 9 courses had been administered, the carcinoembryonic antigen (CEA)/carbohydrate antigen (CA) 19-9 level had decreased to the reference value, and the decrease in size of the liver metastases indicated a partial response (PR), as assessed by CT.

[An effective treatment by chemotherapy with CDDP+CPT-11 for recurrent gastric cancer which S-1 cannot be used owing to adverse effects].

We report a case of a 64-year-old man with multiple lung metastases after gastric cancer surgery. This patient was initially treated with S-1. However, he experienced adverse effects, and subsequently, he was effectively treated with cisplatin (CDDP) and irinotecan (CPT-11). In July 2010, the patient experienced a decrease in appetite and underwent a detailed examination. He also underwent distal gastrectomy in the same month. The postoperative diagnosis was T4a( SE), N2, M0, Stage IIIB. In November 2010, adjuvant chemotherapy with S-1 was initiated. In February 2011, the patient developed a skin disorder( grade 3) and generalized edema along with walking difficulty, which were identified as adverse effects of S-1. Evidently, S-1 was contraindicated for this patient, and adjuvant therapy was discontinued. In September 2011, contrast -enhanced thoracoabdominal computed tomography( CT) was performed and para-aortic lymph node metastasis and multiple lung metastases were detected. CDDP+CPT-11 therapy was initiated. By June 2012, 8 courses had been administered, and the patient had a good partial response. With regard to chemotherapy for advanced or recurrent gastric cancer, there is no consensus on a treatment policy for cases in which S-1 cannot be used owing to adverse effects. CDDP+CPT-11 therapy is considered a safe and effective choice.

[A case of iatrogenic immunodeficiency-associated lymphoproliferative disease in a patient treated with methotrexate for rheumatoid arthritis for 9 consecutive years, which Showed natural remission after discontinuation of MTX therapy].

We report our experience with a case of iatrogenic immunodeficiency-associated lymphoproliferative disease in a patient who had been treated with methotrexate (MTX) for rheumatoid arthritis for 9 consecutive years, which showed natural remission after discontinuation of the MTX therapy. The patient was a 64-year-old woman who was admitted emergently to our hospital with hematemesis and melena. She presented with multiple gastric ulcers and bilateral tonsillitis with a central ulcer. Biopsy of these lesions raised the suspicion of diffuse large B-cell lymphoma. Positron emission tomography (PET)- computed tomography( CT) showed increased fluorodeoxyglucose( FDG) accumulation in the pharynx, cervical lymph nodes, liver, spleen, stomach, distal part of the ileum, and para-aortic lymph nodes, with a maximum standard uptake value of 26.85. Blood test showed elevated lactate dehydrogenase( LDH)( 321 U/L) and interleukin( IL)-2R( 3,531 U/mL) levels. After discontinuation of MTX, the sore throat subsided, and the tonsillitis, lymph node enlargement, and ulcers were resolved. The levels of LDH and IL-2R returned to within the normal range. The patient could be categorized into a regressive disease group with relatively favorable prognosis among patients with MTX-induced lymphoproliferative disease. However, she should continue to be followed up regularly because there remains a possibility that lymphoproliferative disease may relapse after the discontinuation of MTX.

Subendocardial Infarction in Severe Bicuspid Aortic Stenosis without Coronary Stenosis Confirmed by Contrast-enhanced Computed Tomography and Autopsy.

A 59-year-old man with aortic stenosis (AS) showed cardiopulmonary arrest requiring extracorporeal circulation. Although coronary angiography did not show coronary artery stenosis, he had an elevated creatine kinase-myocardial band value of 1,298 U/L. Echocardiography revealed severe AS and global hypokinesia of the thickened myocardium. Contrast-enhanced computed tomography (CT) detected a circumferential subendocardial perfusion defect of the left ventricular myocardium. Eventually, the patient died from brain anoxia. Autopsy revealed circumferential subendocardial infarction of the left ventricular myocardium. This is the first case of circumferential subendocardial defect on CT corresponding to circumferential subendocardial infarction on autopsy in severe AS without coronary stenosis.

High-order statistical equalizer for nonlinearity compensation in dispersion-managed coherent optical communications.

Fiber nonlinearity has become a major limiting factor to realize ultra-high-speed optical communications. We propose a fractionally-spaced equalizer which exploits a trained high-order statistics to deal with data-pattern dependent nonlinear impairments in fiber-optic communications. The computer simulation reveals that the proposed 3-tap equalizer improves Q-factor by more than 2 dB for long-haul transmissions of 5,230 km distance and 40 Gbps data rate. We also demonstrate that the joint use of a digital backpropagation (DBP) and the proposed equalizer offers an additional 1-2 dB performance improvement due to the channel shortening gain. A performance in high-speed transmissions of 100 Gbps and beyond is evaluated as well.

Analysis of J waves during myocardial ischaemia.

AIMS: The aim of this study was to investigate the relationship between J-wave dynamics and arrhythmias during myocardial ischaemia in patients with vasospastic angina (VSA). METHODS AND RESULTS: Sixty-seven consecutive patients diagnosed with VSA by a provocation test for coronary spasm were grouped according to whether they had a J wave in the baseline electrocardiograms or not (VSA-JW group, n = 14; VSA-non-JW group: n = 53). We retrospectively studied the associations between J-wave and ST-segment dynamics and induced ventricular fibrillations (VFs) during coronary spasm.  In the VSA-JW group, 7 of the 14 patients showed changes in J-wave morphology and/or gains in J-wave voltage, followed by VF in 4 patients. Compared with patients without VF, the four patients with VF showed similar maximal voltage in the baseline J waves but a higher voltage during induced coronary spasms (0.57 ± 0.49 vs. 0.30 ± 0.11 mV; P = 0.011). In three patients with VF, J waves progressively increased and were accompanied by the characteristic coved-type or lambda-shaped ST-segment elevations. In the VSA-non-JW group, only four patients showed new appearances of J waves during coronary spasms and another patient without a distinct J wave developed VF. Ventricular fibrillations were induced more frequently in the VSA-JW group than in the VSA-non-JW group [4/14 (29%) vs. 1/53 (2%); P = 0.012]. CONCLUSION: J-wave augmentations were caused by myocardial ischaemia during coronary spasms. The presence and augmentation of J waves, especially prominent J waves with the characteristic ST-elevation patterns, were associated with VF.

[Long-surviving patient with hilar cholangiocarcinoma by gemcitabine monotherapy].

An 80-year-old woman visited our department with the complaint of icterus and brown urine. After detailed examination, she was diagnosed with cT4N0M (-), cStage IVa, hilar cholangiocarcinoma. We believed that she could be cured with surgery, but she and her family did not agree to the surgical procedure. Chemotherapy was scheduled, and gemcitabine (GEM) therapy was started in April 2011. GEM therapy reduced significantly the level of the CA 19-9 tumor marker, and diagnostic imaging allowed a judgment of partial response or stable disease after 18 months. In the present report, we describe a case of a patient with hilar cholangiocarcinoma who achieved long-term survival with GEM therapy. We also include a brief literature review.