Noncollinear electro-optic sampling detection of terahertz pulses in a LiNbO3 crystal while avoiding the effect of intrinsic birefringence.

We propose and experimentally prove efficient high-resolution electro-optic sampling measurement of broadband terahertz waveforms in a LiNbO3 crystal in the configuration with the probe laser beam propagating along the optical axis of the crystal. This configuration allows one to avoid the detrimental effect of strong intrinsic birefringence of LiNbO3 without any additional optical elements. To achieve velocity matching of the terahertz wave and the probe beam, the terahertz wave is introduced into the crystal through a Si prism at the Cherenkov angle to the probe beam. The workability of the scheme at different wavelengths of the probe optical beam (800 and 1550 nm) is demonstrated.

Associations of vertebral deformities and osteoarthritis with back pain among Japanese women: the Hizen-Oshima study.

UNLABELLED: We examined the spinal distribution of the types of vertebral deformities and the associations of vertebral deformities and osteoarthritis with back pain in Japanese women. Midthoracic and upper lumbar vertebrae were more susceptible to deformity. Vertebral deformity and osteoarthritis were frequent and were associated with back pain. INTRODUCTION: Vertebral fractures due to osteoporosis and osteoarthritis are both common and significant health problems in aged people. However, little is known about the descriptive epidemiology of the individual deformity types and the relative clinical impact in women in Japan. METHODS: Lateral radiographs were obtained from 584 Japanese women ages 40 to 89 years old. Deformities were defined as vertebral heights of more than 3 standard deviations (SDs) below the normal mean. Osteoarthritis was defined as Kellgren-Lawrence (KL) grade 2 or higher. Information on upper or low back pain during the previous month was collected by questionnaire. We compared the spinal distribution of the three types of vertebral deformities (wedge, endplate, and crush) typical of fractures and examined the associations of number and type of vertebral deformities and osteoarthritis with back pain. RESULTS: Fifteen percent of women had at least one vertebral deformity and 74% had vertebral osteoarthritis. The prevalence of upper or low back pain was 30.1%. Deformities were most common in the midthoracic and upper lumbar regions and wedge was the frequent type, followed by endplate and crush. Multiple logistic regression analysis showed that the odds of back pain was 3.0 (95% CI 1.5-6.3) times higher for women with a single wedge deformity and 3.2 (95% CI 1.0--0.6) times higher for women with two or more wedge deformities, compared to women with no wedge deformity. Vertebral osteoarthritis was associated with back pain (OR 1.8, 95% CI 1.1-2.9), independent of other covariates including age and deformities. CONCLUSION: Our results in this group of Japanese women are similar to and consistent with results reported previously in other populations of Japanese and Caucasians.

Prolonged lymphocytopenia after bendamustine therapy in patients with relapsed or refractory indolent B-cell and mantle cell lymphoma.

This corrects the article DOI: 10.1038/bcj.2015.86.

Parathyroid carcinoma visualized by gallium-67 citrate scintigraphy.

An abnormal uptake of [67Ga]citrate by a palpable neck tumor was observed in a patient with primary hyperparathyroidism. The pathological diagnosis of the surgically resected specimen was parathyroid carcinoma invading the thyroid. The uptake was negative in nine patients with parathyroid adenoma. These results suggest that 67Ga scintigraphy may be useful to differentiate parathyroid carcinoma from benign parathyroid tumor.

Fluorine-18-fluorodeoxyglucose and carbon-11-methionine evaluation of lymphadenopathy in sarcoidosis.

UNLABELLED: Uptake of 18F-fluorodeoxyglucose (FDG) and 11C-methionine (Met) in mediastinum and hilar lymph nodes was studied using PET in 31 patients with sarcoidosis. The aim of our study was to examine whether these different tracers play a differential role in clinical assessment of pulmonary involvement. METHODS: Fluorine-18-fluorodeoxyglucose and 11C-Met PET were administered on different days. The differential absorption ratio of these tracers was calculated for the region of interest with the highest level of activity. Clinical reassessment of sarcoidosis was made at least 1 yr after the first PET examination. In seven patients whose lymph nodes still remained visible by other imagings at the time of reevaluation, the same PET study was performed again. RESULTS: Both FDG and Met were accumulated in the lymph nodes in all but one patient. The FDG and Met uptake ratios in all patients were not correlated, but they could be divided into the FDG-dominant group (FDG/Met uptake ratio > or = 2) and the Met-dominant group (FDG/Met uptake ratio < 2). Within each group, the FDG and Met uptake values were correlated. The rate of improvement assessed by clinical status and chest radiographs was considerably higher in the FDG- (78%) than in the Met-dominant group (33%). In the seven patients of the repeated PET examination, their FDG/Met uptake ratios were generally unchanged after 1 yr. CONCLUSION: The results suggest that the FDG/Met uptake ratio using PET may reflect the differential granulomatous status in sarcoidosis and be a useful tool for pretreatment evaluation.

Advanced nasopharyngeal carcinoma treated with chemotherapy and radiotherapy: distant metastasis and local recurrence.

One hundred and twenty-nine patients with NPC treated at the Department of Radiology, Chiba University Hospital and Keio University Hospital from 1980 through 1993 were selected for this study. Forty-four patients received cisplatin (CDDP)- or carboplatin-based chemotherapy, and 58 patients received adriamycin (ADM)- and/or 5-FU-based chemotherapy. The remaining 27 patients were treated with radiotherapy alone. The median radiation dose to the nasopharyngeal region was 64 Gy, and to the initially involved cervical node, 60 Gy. The 5 year survival rates for the CDDP, the ADM/5-FU and the radiation alone groups were 61%, 47% and 42%, respectively. The cumulative incidences of local control in the CDDP, the ADM/5-FU and the radiation alone groups were 77%, 49% and 53% respectively. The CDDP group achieved the significantly better local control (CDDP vs ADM: p=0.001). The overall incidence of distant metastases was 54% in the CDDP group. On the other hand, it was 24% in the ADM/5-FU group and 22% in the radiation alone group (CDDP vs ADM: p=0.048). While the locoregional control rate was significantly better in the CDDP given group, more distant metastases were seen in this group.

Expression of vascular endothelial growth factor and angiogenesis in cardiac myxoma: a study of fifteen patients.

OBJECTIVE: To clarify the association between angiogenesis and the clinicopathologic features in cardiac myxoma, vascular endothelial growth factor expression in the myxoma was examined by using reverse transcriptase polymerase chain reaction and immunohistochemistry, and the microvessel density was determined by counting microvessels in the myxoma by using immunostaining for platelet endothelial cell adhesion molecule 1. METHODS: Seven fresh-frozen and 15 formalin-embedded tissues were analyzed by means of reverse transcriptase polymerase chain reaction and immunostaining for vascular endothelial growth factor, respectively. The microvessel density was measured in the 15 formalin-embedded tissues. Furthermore, immunostaining for proliferating cell nuclear antigen was performed, and the proliferating cell nuclear antigen-labeling index was calculated. RESULTS: All of the 7 analyzed myxomas were positive for vascular endothelial growth factor messenger RNA, as determined by means of reverse transcriptase polymerase chain reaction, whereas atrial septum and atrium tissues were negative. Positive immunohistochemical reaction for vascular endothelial growth factor was observed in the cells of all 15 myxomas. The size of myxomas with high vascular endothelial growth factor expression was smaller than that of myxomas with low vascular endothelial growth factor expression. The microvessel density in myxomas with high vascular endothelial growth factor expression was higher than that in myxomas with low vascular endothelial growth factor expression. There was an inverse correlation between the tumor size and the ratio of the microvessel density in the central part to the microvessel density in the peripheral part of myxomas. Furthermore, there was an inverse correlation between the proliferating cell nuclear antigen-labeling index and the tumor size, and the prolferating cell nuclear antigen-labeling index in myxomas with high vascular endothelial growth factor expression was higher than that in myxomas with low vascular endothelial growth factor expression. CONCLUSIONS: Cardiac myxomas produce vascular endothelial growth factor, which probably induces angiogenesis for tumor growth.

Eosinophil cationic protein in the sera of patients with Mycoplasma pneumonia.

In 1985 we reported that eosinophilia was found in many children with Mycoplasma pneumonia. We measured the serum concentrations of eosinophil cationic protein (ECP) produced by eosinophils in 25 children with Mycoplasma pneumonia, 25 with asthma and 11 with no disease (normal controls). The mean concentrations (+/- SD) of serum ECP in children with Mycoplasma pneumonia, with asthma and the normal controls were 18.7 +/- 12.6, 23.7 +/- 12.2 and 6.5 +/- 1.4 micrograms/ml, respectively. When compared with those of normal controls, these higher serum concentrations of ECP in children with Mycoplasma pneumonia and asthma were statistically significant (P < 0.001). The data were directly correlated with the presence of eosinophilia (r = 0.349). There was no relationship between the amount of ECP and the age of children with Mycoplasma pneumonia. These results suggest that ECP may work as a factor causing a persistent cough similar to asthma in children with Mycoplasma pneumonia.

Operative results after the Cox/maze procedure combined with a mitral valve operation.

BACKGROUND: There have been few reports on postoperative morbidity and mortality analyses after concomitant mitral valve operation and the Cox/maze procedure. METHODS: Between April 1993 and August 1995, 87 consecutive patients with chronic atrial fibrillation underwent a mitral valve operation and concomitant Cox/maze procedure at Iwate Medical University. The patients were divided into the replacement group (n = 31) and repair group (n = 56) according to the method of mitral valve replacement. Our initial experience with the combined operative procedures is presented along with the operative mortality and morbidity rates. Univariate analysis on preoperative and intraoperative variables affecting early mortality and morbidity is carried out retrospectively. RESULTS: Total cardiopulmonary bypass time in all patients was 177.2 +/- 70.1 minutes. Total aortic cross-clamp time was 121.7 +/- 30.8 minutes. Total intensive care unit stay was 5.3 +/- 7.9 days. The average intubation period was 55.5 +/- 187.6 hours. The intensive care unit stay and the intubation period of the replacement group were longer than those of the repair group. There were four operative deaths among the 87 patients (4.6%). All repair group patients survived operation, whereas 4 replacement group patients died after operation. In all patients, the New York Heart Association functional class was higher (p = 0.028) in those who died than in those who survived. The overall restoration rate from atrial fibrillation was 79.5% (66 of 83 survivors). Seventeen patients (20.5%) had persistent atrial fibrillation postoperatively. Sick sinus syndrome occurred in 7 patients (8.4%). In the repair group, the restoration rate was 76.8%, whereas in the replacement group it was 85.2% for the survivors. CONCLUSIONS: The Cox/maze procedure can be combined with a mitral valve operation with acceptably low operative risk. Analysis of risk factors of early mortality revealed that the type of mitral valve operation (replacement versus repair) and higher preoperative New York Heart Association functional class were associated with mortality. Long-term results from this combined procedure should be clearly demonstrated before its universal acceptance.

Predictors of sinus rhythm restoration after Cox maze procedure concomitant with other cardiac operations.

BACKGROUND: There have been sporadic cases of persistent atrial fibrillation and sick sinus syndrome after the maze procedure. The purpose of this study was to identify the predictors of sinus rhythm restoration after operation. METHODS: Between March 1993 and June 1995, we evaluated retrospectively 96 consecutive patients who underwent the maze procedure (maze III) in combination with another type of cardiac operation. Four patients who died and 6 patients who required permanent pacemaker implantation because of sick sinus syndrome were excluded. Ambulatory electrocardiographic monitoring was evaluated 1 year after operation. Multiple logistic regression analysis was applied to identify the predictors of sinus rhythm restoration. RESULTS: The final population comprised 86 patients (mean age, 59.8 years; 67 patients with mitral valve disease). Overall, sinus rhythm was restored in 68 of 86 patients (79.1%). The magnitude of the atrial fibrillatory wave positively predicted postoperative sinus rhythm restoration. Conversely, left atrial diameter was inversely related to postoperative sinus rhythm restoration. The odds ratio of having both a fine atrial fibrillatory wave (< 1.0 mm) and enlarged left atrial diameter (> or = 65 mm) for patients with sinus rhythm restoration was 0.04 (95% confidence interval, 0.01 to 0.28). CONCLUSIONS: Atrial fibrillatory wave and left atrial diameter were independent predictors of sinus rhythm restoration after the maze procedure in patients with chronic atrial fibrillation and organic heart disease.

Electrocardiographic nature of restored sinus rhythm after Cox maze procedure in patients with chronic atrial fibrillation who also had other cardiac surgery.

OBJECTIVE: To characterise heart rate variability and high frequency components of restored sinus rhythm after the maze procedure. The maze procedure for chronic atrial fibrillation may prevent thrombotic events and improve the quality of life. However, the electrocardiographic nature of restored sinus rhythm after the maze procedure has not been fully elucidated. PATIENTS AND METHODS: Between March 1993 and August 1995, 104 consecutive patients undergoing the maze procedure in combination with other cardiac surgery were studied. There were 100 long-term survivors (78 with mitral valve disease, 9 with aortic valve disease, 8 with congenital heart disease, and 5 others). Twenty age-matched patients with mitral valve disease who were in normal sinus rhythm preoperatively were enrolled as a control group. 30 days after surgery, the presence of arrhythmias and the circadian changes of heart rate variability were estimated by ambulatory electrocardiographic monitoring and the filtered P duration was evaluated by signal-averaged electrocardiogram. RESULTS: Restoration of sinus rhythm was observed in 73 of 100 cases. Subjects were classified into three groups according to their postoperative ambulatory electro-cardiographic monitoring findings: patients in group 1 (n = 73) (1a: 58 regular sinus rhythm; 1b: 15 sinus rhythm with frequent premature atrial contractions (> 1000/day); patients in group 2 (n = 21) still had persistent atrial fibrillation; and patients in group 3 (n = 6) required permanent pacemaker implantation because of sick sinus syndrome. The success rate of restoration of sinus rhythm was 88.3% if left atrial diameter was small (< 65 mm). Circadian changes in the low frequency to high frequency power ratio in group 1a were significantly diminished compared with control group (P < 0.01). Furthermore, the filtered P duration in group 1a (150 (20) ms) and group 1b (158 (23) ms) were longer than in the control group (122 (11) ms) (P < 0.01). CONCLUSIONS: The maze procedure may result in a decreased sinus response and non-uniform transmission of impulses in the atrium.

Determination of the photochemical efficiency of o-quinodimethane ring closure in room-temperature solutions by using time-delayed, two-color photolysis technique

Photochemical efficiency of o-quinodimethane (3) ring closure at room temperature was determined by using a time-delayed, two-color photolysis technique. o-Quinodimethane (3) was generated by the photolysis of 1,2-bis[(phenylseleno)methyl]benzene (1) by a KrF (248 nm) laser pulse and thus-generated 3 was photolyzed by a subsequent XeCl (308 nm)/XeF (351 nm) laser pulse with varying delay time of 0 to 3 s. The time profile of 3 was monitored by the chemical analyses of benzocyclobutene (5) (a photochemical product of 3), which was formed by a one-photon process, and the spiro dimer of 3 (4) (a thermal product of 3) in the two-color photolysis experiments. The time profile of 3 followed a second-order decay kinetics. The photochemical efficiency was obtained by the analysis of the delay-time dependence of the product yields; those of the consumption of 3 and the conversion 3-->5 by a single pulse of the excimer laser were 81% and 5.7% for the XeCl laser, and 73% and 2.3% for the XeF laser. This difference was attributed to the different excited states involved in the photolysis. In contrast to the photolysis of 3 in argon or rigid organic matrixes, it was revealed that photochemical conversion 3-->5 was not the main path in the solutions, and intermolecular reactions predominated.

Enhanced reactivity of electron-deficient enynes in the palladium-catalyzed homo-benzannulation of conjugated enynes

We report the high reactivity of electron-deficient enynes in the homo-benzannulation of conjugated enynes in the presence of Pd(PPh3)4. The introduction of electron-withdrawing groups enabled us to carry out the benzannulation of 1-substituted enynes as well as 1,2- and 2,4-disubstituted enynes. Polysubstituted benzenes were prepared in a highly regioselective manner in good to excellent yields.

Clinical role of Tc-99m-MIBI scintigraphy in non-Hodgkin's lymphoma.

This study was designed to investigate the relationship between Tc-99m-hexakis-2-methoxyisobutylisonitrile (MIBI) scintigraphy and outcome of treatment in patients with non-Hodgkin's lymphoma (NHL). Forty-five patients with NHL were studied with Tc-99m-MIBI before any treatment. Images of the lesions were obtained at 20 min and 2 h after radionuclide administration. Visual semi-quantitative interpretation was performed for Tc-99m-MIBI (grade 0-4) scintigraphy. Patients underwent 3-5 cycles of CHOP chemotherapy with/without involved field radiotherapy for large tumors. Their responses to treatment were evaluated at the end of chemotherapy and during the follow-up period. Forty of 45 patients (89%) showed abnormal uptake of Tc-99m-MIBI. There was no correlation between intensity of MIBI accumulation and response to chemotherapy. However, patients with negative or decreased MIBI activity 2 h after radionuclide administration showed worse response to chemotherapy compared to those with continued MIBI activity. MIBI activity could not predict the development of relapse in the follow-up study. In this study, the number of patients was small and we could not reach definite conclusions. However, we think that MIBI scintigraphy is not valuable for predicting the chemotherapy outcome in patients with NHL.

The change in color matches with retinal angle of incidence of the colorimeter beams.

Differences between W.D.W. chromaticities of monochromatic lights obtained with all colorimeter beams incident on the retina "off-axis" and those found for lights striking the retina normally have been studied throughout the visible spectrum on 4 normal trichromats. The results are inconsistent with: (i) the assumption in Weale's theories of the Stiles-Crawford hue shift that the sets of absorption spectra of the visual pigments catching normally and obliquely incident photons are identical, and (ii) "self-screening" explanations for the change in color with angle of incidence on the retina. The color matching functions of a protanomalous trichromat are inconsistent with the hypothesis that the absorption spectra of the visual pigments catching normally incident photons in his retina are those catching obliquely incident photons in the normal retina.

Enantiomer separation by gas and high-performance liquid chromatography with tripeptide derivatives as chiral stationary phases.

Excellent enantiomer separation of a variety of racemic compounds, including alcohols, amines, amino alcohols, carboxylic acids, hydroxy acids and amino acids, was achieved by GC and HPLC with tripeptide derivatives, containing L-valyl-L-valyl-L-valine isopropyl ester as a chiral selector, bonded to amino silicone oil (CSP-3) and N-(2-aminoethyl)-3-aminopropyl silica gel (CSP-4) via a triazine ring, respectively. These results show that the hydrogen bonding association between solutes and chiral stationary phases (CSPs) can play an important role in chiral recognition in both GC and HPLC. The joint use of two CSPs is promising for the direct separation of racemic compounds.

Can the maze procedure be combined safely with mitral valve repair?

BACKGROUND AND AIMS OF THE STUDY: The safety of combining mitral valve repair with the maze procedure for chronic atrial fibrillation in the surgical management of patients with mitral valve disease is not well elucidated. We present our operative results regarding mortality and morbidity after such combined surgery. As a comparison, our operative results after mitral valve repair in patients without chronic atrial fibrillation are presented. METHODS: Between April 1993 and December 1994, 39 patients with chronic atrial fibrillation underwent mitral valve repair and concomitant maze procedure (group 1) at the Iwate Medical University. During the same period, 36 patients with sinus rhythm and one patient with DDD pacemaker underwent mitral valve repair (group 2). In order to evaluate the operative risk, morbidity, and mortality of adding the maze procedure to mitral valve repair, total cardiopulmonary bypass time, aortic cross-clamp time, intraoperative blood loss, intubation period, and duration of ICU stay were compared between the groups. RESULTS: Total cardiopulmonary bypass time and aortic cross-clamp time in group 1 were longer than in group 2 (174.0 +/- 38.8 min versus 150.1 +/- 54.4 min; p = 0.032, 122.5 +/- 30.7 min versus 95.8 +/- 38.2 min; p = 0.0012). However, the duration of ICU stay, intubation period, and intraoperative blood loss were not different between the groups. There were no hospital deaths in either group. Four patients in group 1, and two patients in group 2 required re-exploration for bleeding (p = NS). Two patients in group 1, and none in group 2 required pacemaker implantation postoperatively (p = NS). Two patients in group 2, and none in group 2 had minor cerebral infarction (p = NS). At hospital discharge, 28 patients in group 1 (72%) and 35 patients (97%) in group 2 were in sinus rhythm. CONCLUSIONS: The maze procedure can be combined with mitral valve repair without adding undue operative risk to patients. Those patients with chronic atrial fibrillation undergoing mitral valve repair may be advised for the possibility of concomitant maze procedure.

Clinical usefulness of the effective regurgitant orifice area determined by transesophageal echocardiography in patients with eccentric aortic regurgitation.

BACKGROUND AND AIMS OF THE STUDY: The aortic regurgitant jet is frequently eccentric, and Doppler color flow mapping techniques of the distal jet is influenced by this eccentricity. The aim of the present study was to determine whether the effective regurgitant orifice area (EROA), determined by the proximal isovelocity surface area (PISA) method using multiplane transesophageal echocardiography (m-TEE), could be used to evaluate the severity of aortic regurgitation (AR) in patients with an eccentric jet. METHODS: Forty-eight patients with eccentric AR were studied. Values of EROA determined by the PISA method were compared with results from cross-sectional area (CSA), vena contracta (VC) width, aortic angiography, and regurgitant fraction. RESULTS: Values of EROA correlated well with results from CSA (r = 0.73, p < 0.001), VC (r = 0.74, p < 0.001), angiographic grade (rs = 0.90 p < 0.001), and regurgitant fraction (r = 0.84, p < 0.001) in patients with eccentric aortic regurgitation. Values of EROA > 0.27 cm2 were always associated with a regurgitant fraction > 0.4, while EROA values < 0.27 cm2 were always associated with a regurgitant fraction < 0.4. CONCLUSIONS: We conclude that, in patients with an eccentric jet, measurement of EROA values by the PISA method using m-TEE is a reliable method of assessing the severity of AR.

Comparative study of bioavailabilities of different phenytoin preparations.

A comparative study of the serum phenytoin (PHT) concentration levels during the treatment with different PHT preparations (powders or tablets) manufactured by two Japanese pharmaceutical companies gave the following results: 1) The serum PHT concentration levels (S in microgram/ml) of children (aged 7-11) who were taking Company A's powder and phenobarbital were less than 2.0 microgram/ml in 21 out of 24 (87.5%) cases without correlation with the dosage (D in mg/kg). The levels in 19 children of the same ages taking Company A's tablets showed significant correlation with the dosage, and the regression line was S = 1.9D - 2.65 (r = 0.86). 2) In 33 cases, previously administered Company A's powder was substituted with different PHT preparations of the same or a lesser dosage; Company A's tablet in group I; powderized Company A's tablet in group II: Company B's powder in group III; and Company B's tablet (solid or powderized) in group IV. In all cases, the PHT S/D ratio increased after the substitution and the mean increase +/- SD was 1.3 +/- 1.2 (p less than 0.001) for group I, 1.0 +/- 0.1 (p less than 0.001) for group II, 0.45 +/- 0.1 (p less than 0.005) for group III, and 1.6 +/- 0.4 (p less than 0.015) for group IV. 3) Tested in five patients using three specially prepared phenytoin powders with different particle sizes clearly demonstrated the fact that the smaller the PHT particle, the higher the PHT S/D ratio. 4) It was suggested that the factors other than particle size of the drug should be taken into consideration in the interpretation of different bioavailabilities of different PHT preparations.

Nonspecific congenital myopathy (minimal change myopathy): a case report.

A 28-month-old male with generalized hypotonia and muscle weakness, a myopathic face, skeletal dysmorphism and delayed motor milestones from birth is reported. He gradually developed the ability of sitting and rolling over, but could not stand without support until 28 months. There was no intellectual impairment or seizures. Deep tendon reflexes were absent. The serum CK value, peripheral nerve conduction velocity and EMG were within normal limits. A muscle biopsy specimen showed mild variation in fiber size, and an increased number of type 2C fibers on histochemical examination, but no apparent abnormalities on electron microscopy. The baby was tentatively diagnosed as having minimal change myopathy or nonspecific congenital myopathy which is thought to be one of the congenital nonprogressive myopathies.