>30 W vortex LG01 or HG10 laser using a mode transforming output coupler.

High-power vortex light generated directly from lasers will help drive their applications in material processing, optical manipulation, levitation, particle acceleration, and communications, but limited power has been achieved to date. In this work, we demonstrate record vortex average power of 31.3 W directly from a laser, to the best of our knowledge, using an interferometric mode transforming output coupler to convert a fundamental mode Nd:YVO4 laser into a LG01 vortex output. The vortex laser was Q-switched with up to 600 kHz pulse rate with a high slope efficiency of 62.5% and an excellent LG01 modal purity of 95.2%. We further demonstrate > 30W laser power in a high quality HG10 mode by simple adjustment of the output coupler. Experimental investigations of varying output coupling transmission are compared with theory. This successful implementation of the interferometric output coupler in a high power system demonstrates the suitability of the mode transforming method for robust turn-key vortex lasers with high efficiency and high modal purity, with scalable power and pulse rate.

Subpolar North Atlantic western boundary density anomalies and the Meridional Overturning Circulation.

Changes in the Atlantic Meridional Overturning Circulation, which have the potential to drive societally-important climate impacts, have traditionally been linked to the strength of deep water formation in the subpolar North Atlantic. Yet there is neither clear observational evidence nor agreement among models about how changes in deep water formation influence overturning. Here, we use data from a trans-basin mooring array (OSNAP-Overturning in the Subpolar North Atlantic Program) to show that winter convection during 2014-2018 in the interior basin had minimal impact on density changes in the deep western boundary currents in the subpolar basins. Contrary to previous modeling studies, we find no discernable relationship between western boundary changes and subpolar overturning variability over the observational time scales. Our results require a reconsideration of the notion of deep western boundary changes representing overturning characteristics, with implications for constraining the source of overturning variability within and downstream of the subpolar region.

Vortex laser by transforming Gaussian mode with an interferometric output coupler.

Generation of vortex beams directly from the laser source can be limited in power and efficiency, or to specific pump sources and gain media. Here, we propose a new high power and high efficiency vortex laser methodology with interferometric mode transformation as output coupling, which uses high power handling and low loss optics that have wavelength versatility. Experimental demonstration is made in a diode-pumped Nd:YVO4 laser using an imbalanced Sagnac interferometer as output coupler producing high quality vortex output beams (M2 = 2.07) with fully selectable control of handedness whilst the intracavity mode is maintained as a fundamental Gaussian. Vortex output power >3W is produced with only small reduction in efficiency compared to the equivalent TEM00 laser. Continuous variation of vortex output coupling transmission and the quality of the vortex is investigated experimentally showing good agreement with theory. This work reveals a new approach to high power structured laser radiation direct from the source through interferometric spatial mode transformations.

A sea change in our view of overturning in the subpolar North Atlantic.

To provide an observational basis for the Intergovernmental Panel on Climate Change projections of a slowing Atlantic meridional overturning circulation (MOC) in the 21st century, the Overturning in the Subpolar North Atlantic Program (OSNAP) observing system was launched in the summer of 2014. The first 21-month record reveals a highly variable overturning circulation responsible for the majority of the heat and freshwater transport across the OSNAP line. In a departure from the prevailing view that changes in deep water formation in the Labrador Sea dominate MOC variability, these results suggest that the conversion of warm, salty, shallow Atlantic waters into colder, fresher, deep waters that move southward in the Irminger and Iceland basins is largely responsible for overturning and its variability in the subpolar basin.

A disintegrin and metalloprotease-12 is type I myofiber specific in Bos taurus and Bos indicus cattle.

A disintegrin and metalloproteinase-12 (ADAM12) is involved in the regulation of myogenesis and adipogenesis and is of interest as a potential target to manipulate skeletal muscle development and intramuscular fat (IMF) deposition in cattle to increase beef yield and improve meat quality. The longissimus thoracis muscle (LM) and semitendinosus muscle (STM) from 5 Bos taurus (Angus) and 5 Bos indicus (Brahman) cattle were collected for histological and ADAM12 gene and protein expression analysis. Myofiber typing was used to determine if ADAM12 expression patterns related to differences in muscling and IMF deposition, which are influenced by proportions of the different myofiber types. The STM was found to contain a higher proportion of glycolytic myofibers than the LM, which contained a greater proportion of oxidative myofibers (myofiber ratio of glycolytic to more oxidative types in LM and STM of 1.1 and 3.5, respectively; P < 0.05). ADAM12 gene expression, fluorescent immunohistochemical staining for ADAM12, and image analysis found ADAM12 to be greater in the LM (P < 0.05). Regression analysis found a strong, positive relationship for the distribution of ADAM12 against the proportion of type I myofibers (P < 0.05, r(2) = 0.86). These findings suggest ADAM12 is upregulated in muscles with more slow-oxidative myofibres, such as the LM, and is linked to type I myofibers in cattle. ADAM12 may be important in the regulation and maintenance slow myofibers in the LM muscle.

Bone marrow biopsy and bone scan to detect skeletal metastases.

This study correlates the findings of bone marrow biopsy with those of bone scan in patients with common cancers and highlights the comparable sensitivities of the two methods at the authors' institution. The results show that bone scintigraphy may be slightly more sensitive than bone marrow examination for the detection of carcinomatous metastases. This experience suggests that institutions should devise clinical pathways based on their testing sensitivities and patient characteristics. These considerations will ultimately result in better and more cost-effective treatment of these patients.

Various presentations of postcholecystectomy bile leak diagnosed by scintigraphy.

Hepatobiliary scintigraphy is an established method for the diagnosis of a bile leak from the biliary system. A bile leak should be considered in any patient after cholecystectomy who has unexplained abdominal pain after operation. Three patients with bile leak diagnosed by scintigraphy are described, one of whom had an unusual pattern of hepatic subcapsular collection of the bile. The second patient had a bile leak through the postsurgical drainage tube, whereas the third patient had a more typical pattern of leakage into the peritoneal cavity.

Scintigraphic evaluation of colonic transit in two patients with idiopathic chronic constipation.

Bowel transit in two women with protracted constipation was evaluated after oral administration of In-111 DTPA in water. Serial abdominal images were obtained for as long as 96 hours to assess transit through the stomach, small bowel, and colon. In both patients, large bowel transit was delayed. A pattern of colonic inertia was observed in one patient, whereas retention in the distal colon was seen in the other patient. Both patients underwent total colectomy with marked symptomatic relief. Colonic transit studies of these patients are presented, and the literature is reviewed.

Scintigraphic detection of a disseminated synovial lymphoma in a postrenal transplant patient.

Post-transplant lymphoproliferative disease is a recognized complication of immunosuppressive therapy, however, articular lymphomas involving the synovlum are very rare. Disseminated synovial lymphoma of the knee with hepatic involvement in a patient after renal transplant was suggested on bone/gallium scintigraphy and confirmed by synovial biopsy. Gallium scanning thus was instrumental in the evaluation, staging, and proper treatment of this rare condition.

Scintigraphic localization of recurrent anastomotic site bleeding in the gastrointestinal tract.

Scanning with Tc-99m labeled RBC was performed in two patients with recurrent postoperative gastrointestinal bleeding after partial colonic resection. Imaging correctly identified the source of bleeding at the anastomotic site in the large bowel, effectively contributing in the patient's treatment planning. Radionuclide scintigraphy provides a simple, noninvasive modality to diagnose and manage difficult clinical situations such as postoperative bleeding.

Scintigraphic evaluation of multifocal hemangioendothelioma of bone.

Multifocal bone involvement was seen on bone scintigraphy in a young woman being examined for a suspected bone lesion noted on pelvic radiographs. Biopsy of the third lumbar vertebral body demonstrated a vascular lesion. The tumor was resected and a bone graft was performed. The patient was followed with serial scans to assess the viability of the bone graft and course of the disease. This report analyzes the scintigraphic characteristics of this rare tumor and emphasizes the importance of bone scintigraphy in the diagnosis, treatment, and follow up of this condition.

Tamizaje de la anemia en atención primaria de salud mediante hemoglobinometría en una comunidad tropical / Primary health screening by haemoglobinometry in tropical community

En una encuesta sobre la anemia en varias comunidades indígenas aisladas que viven en la selva del norte del Perú, se evaluó la utilidad que tiene para la atención primaria de salud un hemoglobinómetro portatil diseñado recientemente. Para su funcionamiento solo se requiere una gota de sangre, que se coloca en una cubeta desechable sin necesidad de diluirla previamente. Se describen otras ventajas y limitaciones del método. En el estudio se observó una alta incidencia de anemia en los hombres, mujeres y niños. Si bien fueron frecuentes las infecciones parasitarias intestinales, incluida la uncinariasis, estas enfermedades no se relacionaron directamente con la anemia. Estas observaciones indican la necesidad de efectuar una investigación epidemiológica más amplia con el fin de identificar los factores etiológicos. Teniéndo en cuenta la importancia de disponer de mediciones confiables de la concentración de hemoglobina que proporcionen información de base, en el estudio se comprobó la utilidad de este hemoglobinómetro portátil de fácil manejo en zonas geográficas alejadas con escasos o sin recursos de laboratorio. Una ventaja importante del instrumento fue que, después de una breve sesión de adiestramiento, los trabajadores contratados en el lugar pudeiron medir fácil y correctamente la concentración de hemoglobina

Tamizaje de la anemia en atención primaria de salud mediante hemoglobinometría en una comunidad tropical / Primary health screening by haemoglobinometry in tropical community

En una encuesta sobre la anemia en varias comunidades indígenas aisladas que viven en la selva del norte del Perú, se evaluó la utilidad que tiene para la atención primaria de salud un hemoglobinómetro portatil diseñado recientemente. Para su funcionamiento solo se requiere una gota de sangre, que se coloca en una cubeta desechable sin necesidad de diluirla previamente. Se describen otras ventajas y limitaciones del método. En el estudio se observó una alta incidencia de anemia en los hombres, mujeres y niños. Si bien fueron frecuentes las infecciones parasitarias intestinales, incluida la uncinariasis, estas enfermedades no se relacionaron directamente con la anemia. Estas observaciones indican la necesidad de efectuar una investigación epidemiológica más amplia con el fin de identificar los factores etiológicos. Teniéndo en cuenta la importancia de disponer de mediciones confiables de la concentración de hemoglobina que proporcionen información de base, en el estudio se comprobó la utilidad de este hemoglobinómetro portátil de fácil manejo en zonas geográficas alejadas con escasos o sin recursos de laboratorio. Una ventaja importante del instrumento fue que, después de una breve sesión de adiestramiento, los trabajadores contratados en el lugar pudeiron medir fácil y correctamente la concentración de hemoglobina

Disponible en inglés en Bull. WHO 67(6), 1989

Leuprolide therapy for prostate cancer. An association with scintigraphic "flare" on bone scan.

The scintigraphic "flare" phenomenon on bone imaging refers to an increase in intensity of tracer uptake in sites of bone metastases and/or the appearance of "new" lesions, which occur shortly after commencement of hormonal therapy or chemotherapy for breast, prostate, or lung cancer. In this study, we observed that scintigraphic flare can occur in patients with prostate cancer following treatment with the "hormone-like" luteinizing hormone releasing hormone analog, leuprolide acetate. Twenty-six patients with prostate cancer being treated with leuprolide acetate underwent serial bone scans at three-month intervals. Five (19.2%) of the 26 patients had findings consistent with a scintigraphic flare on bone scans obtained between three and six months after initiation of therapy. These scan findings should not be confused with progression of skeletal metastases.

Measurement of joint inflammation in rheumatoid arthritis with indium-111 chloride.

Studies in the collagen and rabbit models of arthritis have indicated that indium-111 chloride (111InCl3) scintigraphy objectively measures synovial inflammation. Indium-111 chloride scans, with imaging three days after 19 MBq intravenous injection, were performed on 21 patients with definite or classical rheumatoid arthritis (RA), all of whom were functional class II. Standard clinical indices of disease activity were recorded at the time of imaging by the same investigator, who was unaware of the results of joint scans. In addition, eight patients with severe osteoarthritis, four of whom were considered to need hip or knee joint replacement, were similarly scanned. In each patient 16 joints were graded as 0 to 5, based on increasing degrees of 111InCl3 uptake, by a single investigator blinded to the patient's diagnosis and clinical status. In the group with RA significant correlations were observed between individual joint uptake on scan and peripheral joints with swelling, joints reported to be painful, and joints with any abnormality on physical examination. In the group with osteoarthritis joints positive on scan correlated with the presence of pain. A total scan score (sum of individual joint scores) was calculated for each patient. In the patients with RA values ranged from 0 to 42 with a mean (SEM) of 20.7 (2.7) and correlated with the number of swollen joints and decreasing grip strength. In the group with osteoarthritis the mean total scan score (9.2 (1.5), range 3-14) was significantly lower than in the patients with RA. These data show that 111InCl3 scanning can measure joint involvement by RA.

Breast carcinoma metastatic to a meningioma. Case report and review of the literature.

We describe a patient who developed an intracranial mass that consisted of a meningioma and metastatic breast cancer. A literature review revealed 12 similar cases. In epidemiologic studies, the incidence of meningioma in patients with breast cancer is higher than expected. Both tumors are more common in women, have been reported to flare during pregnancy, and express hormone receptors. In a patient with breast cancer, an intracranial mass with radiographic features suggestive, but atypical, of a meningioma should be evaluated surgically. The lesion may represent a metastasis, a meningioma, or both.