Quantum circuits with many photons on a programmable nanophotonic chip.

Growing interest in quantum computing for practical applications has led to a surge in the availability of programmable machines for executing quantum algorithms1,2. Present-day photonic quantum computers3-7 have been limited either to non-deterministic operation, low photon numbers and rates, or fixed random gate sequences. Here we introduce a full-stack hardware-software system for executing many-photon quantum circuit operations using integrated nanophotonics: a programmable chip, operating at room temperature and interfaced with a fully automated control system. The system enables remote users to execute quantum algorithms that require up to eight modes of strongly squeezed vacuum initialized as two-mode squeezed states in single temporal modes, a fully general and programmable four-mode interferometer, and photon number-resolving readout on all outputs. Detection of multi-photon events with photon numbers and rates exceeding any previous programmable quantum optical demonstration is made possible by strong squeezing and high sampling rates. We verify the non-classicality of the device output, and use the platform to carry out proof-of-principle demonstrations of three quantum algorithms: Gaussian boson sampling, molecular vibronic spectra and graph similarity8. These demonstrations validate the platform as a launchpad for scaling photonic technologies for quantum information processing.

The superior mesenteric artery and the variations of the colic patterns. A new anatomical and radiological classification of the colic arteries.

The superior mesenteric artery (SMA) supplies irrigation to the small intestine, ascending and a variable area of the transverse colon. Although medical imaging and surgical procedures have been widely developed in the last decades, the anatomy of the SMA using advanced imaging technology remains to be elucidated. Previous studies have used small sample sizes of cadaveric or radiological samples to propose a number of classifications for the SMA. In this study, we aimed to provide a more detailed description and useful classification of the SMA and its main branches [middle colic artery (MCA), right colic artery (RCA), and ileocolic artery (ICA)]. Samples (n = 50, 28 males and 22 females) were obtained from the repository of human cadavers located at the Department of Human Anatomy and Embryology, Complutense University of Madrid. This sample was dissected by preclinical medical students and completed by two of the authors (Gamo and Jiménez). A second set of samples was obtained from a bank of computerized tomography (CT) (560 CTs, 399 males and 161 females) collected by the Radiology Department at the Clínico San Carlos Hospital, Spain. Based on the results obtained from these studies, we propose a new classification of four patterns for the SMA anatomy. Pattern I as the independent origin of the three main branches of the SMA (cadaveric 40 %; CT 73.69 %); Pattern II is subdivided in three sub-patterns based on the common trunks of origin: Pattern IIa, common trunk between RCA and MCA (cadaveric 20 %, CT 4.28 %); Pattern IIb, common trunk between RCA and ICA (cadaveric 32 %, CT 15 %); Pattern IIc, common trunk for the three main branches (cadaveric 0 %, CT 0.35 %); Pattern III, as the absence of RCA (cadaveric 8 %; CT 2.32 %) and Pattern IV, based on presence of accessory arteries (not found in any of the samples). Although the independent origin of the three colic arteries have been classically described as the most frequent, the right colic artery is responsible of major variations.

Anatomical variations of the celiac trunk: cadaveric and radiological study.

PURPOSE: The celiac trunk (CT) is a vascular structure of the upper abdomen which gives off the left gastric artery (LGA), the splenic artery and the common hepatic artery. This study aims to compare the vascular patterns of the CT of two different samples (cadaveric and radiological) and to propose a simple classification of CT variations based on previous studies and our results. MATERIALS AND METHODS: To perform this study we examined 43 adult cadavers, 24 males and 19 females, ages ranged from 69 to 92. In addition, we analysed 596 MDCT (multidetector computed tomographic) angiography examinations of 430 males and 166 females, ages ranged from 42 to 82. RESULTS: According to the classification proposed, results were divided into Type I or complete CT (578/639 cases, 90.5 %), Type II or incomplete CT (61/639 cases, 9.5 %), Type III or absence of CT and Type IV or celiacomesenteric trunk with no cases reported. Type I was divided into Type Ia or bifurcated trunk with LGA arising first (368/639 cases, 57.6 %), Type Ib or trifurcated trunk (205/639 cases, 32.1 %) and Type Ic or tetrafurcated trunk with an extra branch (5/639 cases, 0.8 %). Type II included hepatosplenic (29/639 cases, 4.5 %), gastroplenic (32/639, 5 %) and hepatogastric trunks (0/639, 0 %) which represented Types IIa, IIb and IIc respectively. CONCLUSIONS: No significant differences were found between the cadaveric and radiological samples. Gender did not appear to be related to any variability of the structures either. A new, simple and complete classification of the anatomical variations of the CT is proposed.

Experience in retake analysis for digital mammography at a university hospital.

Data from one digital mammograph (flat detector active area of 19.2 × 23 cm(2)) were collected over a 1-year period using locally developed software in order to evaluate retakes, their rates, their causes and the possible measures to reduce their occurrence. Among them, 7.1 % of the images were marked as repetitions, and in 16 % of the studies, at least one image was repeated. When evaluating causes of retakes, the primary cause was incorrect positioning (49 %), closely followed by additional retakes in cases of large breasts (44 %). When dealing with large breasts and using a small flat panel, additional images were necessary to fully visualise the breast, and as a consequence, some breast regions received repeated radiation exposure. Moreover, a small detector increases retakes in breasts slightly wrongly positioned. To try and reduce the retake rate, it is important to plan training sessions based on images selected from the retake analysis.

Utility and interobserver agreement of ultrasound elastography in the detection of malignant thyroid nodules in clinical care.

BACKGROUND AND PURPOSE: Malignancy correlates with hardness of tissues and US elastography can potentially analyze the stiffness of lesions. Our aim was to evaluate the utility of US elastography in the detection of malignant nodules and to investigate interobserver agreement with this technique. MATERIALS AND METHODS: One-hundred three consecutive patients with 106 thyroid nodules were examined prospectively with conventional B-mode sonography and real-time US elastography. All patients were referred for FNAB. Conventional B-mode sonography and US elastographic examinations were performed, and images were separated and independently interpreted by 2 radiologists blinded to pathologic results. US elastogram evaluation was based on a simplified classification of stiffness based on gray-scale patterns, tumor size compared with B-mode, and margins. Interobserver agreement was studied. FNAB was used as the reference standard for the diagnosis of benign nodules, but histopathologic evaluations were performed when results suspicious for malignancy or malignant results were obtained on FNAB as well as in indeterminate lesions. RESULTS: In our study, pattern of stiffness based on gray-scale and classification proposed were statistically significant and predicted malignancy with 100% sensitivity and 40.6% specificity. Tumor size when compared with B-mode images or margins was not statistically significant in our study. No false-negatives were found, and an NPV of 100% was seen. Interobserver agreement for US elastography was excellent in our study, with a κ index of 0.82 (95% CI). CONCLUSIONS: We believe that US elastography is a promising technique that can assist in the evaluation of thyroid nodules and can potentially diminish the number of FNAB procedures needed. We believe that it may be useful to introduce US elastography into routine clinical practice.

Estenosis congénita de la apertura piriforme nasal / Congenital nasal pyriform aperture stenosis

La obstrucción de la vía aérea nasal es una situación potencialmente letal en los neonatos, puesto que son respiradores nasales obligados. La etiología más habitual es la atresia de coanas, pero hay otras entidades, como la estenosis congénita de la apertura piriforme nasal que, a pesar de su rareza, deben considerarse en el diagnóstico diferencial de un neonato que muestra signos y síntomas de compromiso de la vía aérea superior. A propósito de 2 casos de estenosis de la apertura piriforme nasal en nuestro centro se describen sus principales características y se presenta una revisión de la bibliografía (AU)

Obstruction of the nasal airway is potentially lethal in newborns because they are forced to breathe through their noses. The most common cause of obstruction is atresia of the choanae; however, other entities such as congenital nasal pyriform aperture stenosis, although rare, must be considered in the differential diagnosis of a newborn that shows signs and symptoms of upper airway compromise. We report two cases of nasal pyriform aperture stenosis seen at our center; we describe the main characteristics of the condition and review the relevant literature (AU)

[Congenital nasal pyriform aperture stenosis]. / Estenosis congénita de la apertura piriforme nasal.

Obstruction of the nasal airway is potentially lethal in newborns because they are forced to breathe through their noses. The most common cause of obstruction is atresia of the choanae; however, other entities such as congenital nasal pyriform aperture stenosis, although rare, must be considered in the differential diagnosis of a newborn that shows signs and symptoms of upper airway compromise. We report two cases of nasal pyriform aperture stenosis seen at our center; we describe the main characteristics of the condition and review the relevant literature.

Failure to treat alopecia areata with photodynamic therapy.

We treated six patients with static alopecia areata (AA) with photodynamic therapy (PDT). All patients had received other treatment before starting PDT, but with no benefit. All previous treatments were stopped at least 3 months before beginning PDT, and no other treatment was given during the study period. PDT was used on only one of the affected areas, or if there was only one affected area, to only part of that area; untreated areas served as controls. For all patients methylaminolaevulinic acid was applied under occulsion 3 h after irradiation with red light at 630 nm (37 J/cm(2), 7.5 min). One session was carried out each month. Clinical and fluorescence photographs were taken with a digital camera connected to ultraviolet flashes, both before and after each treatment. None of the patients with AA of the scalp achieved complete hair regrowth, either in the treated or the untreated areas. Two of the patients showed growth of some thin hair over < 10 of the treated area. The remaining patients had no change. However, the patient with AA of the beard experienced complete regrowth after four sessions. To our knowledge, this is the first case of AA treated with PDT in this location. It may be that AA of beard hair responds better to PDT, but further studies are necessary.

Therapeutic response of rosacea to dobesilate.

Despite an incomplete understanding of the pathogenesis of rosacea, therapeutic modalities continue to expand. The principal subtype of rosacea includes erythematotelangiestatic rosacea, which is characterized by uncontrolled angiogenesis. Angiogenic growth factors such as fibroblast growth factors (FGF) and vascular endothelial growth factor (VEGF) are currently targets of intense effort to inhibit deregulated blood vessel formation in diseases such as cancer. Here we report a 33-years-old woman with erythematotelangestatic rosacea who responds to a daily treatment of topically applied dobesilate, an inhibitor of FGF, with an improvement in erythema and telangectasia after two weeks. Thus, dobesilate might be useful in the treatment of rosacea and other diseases that depend on pathologic angiogenesis.

Topical treatment of basal cell carcinoma with neomycin.

Basal cell carcinoma (BCC) is the most common skin cancer, occurring more frequently than malignancies of any other tissue or organ, either individually or in total. Medical treatment modalities of BCC offer cost reduction and clinical advantages in selected cases. Neomycin has been reported to have an important role on proliferation of endothelial cells and neoplastic cells. This finding may lead to new strategies for the therapeutic use of agents which block FGF activities in disease states associated with enhanced keratinocyte proliferation. We report here a case of BCC treated with neomycin 5% cream that induced a regression of BCC.

[Neurilemmoma of the larynx: a case report]. / Neurinoma laríngeo: a propósito de un caso.

Neuromas or Schwannomas are extremely rare among tumors of the larynx. They are Schwann cell tumors that can be difficult to distinguish from neurofibromas. They present usually as supraglottic masses, since they may arise from the internal branch of the superior laryngeal nerve. Nuclear magnetic resonance imaging is the best diagnostic technique, conferring a high degree of suspicion. We present an exceptional case of a laryngeal neuroma, with a very long evolution, a large tumor volume, dyspnea and vocal cord fixation, with complete resolution through an external approach following surgical removal. The difficulties encountered with its pathological and clinical diagnosis are discussed as well as a review of the literature.

Neurinoma laríngeo: a propósito de un caso / Neurilemmoma of the larynx: a case report

El neurinoma laríngeo es un tumor benigno extremadamente raro que deriva de las células de Schwann y se puede confundir con un neurofibroma. La forma de presentación más frecuente es una masa supraglótica que deriva de la rama interna del nervio laríngeo superior y es la RMN el método que mejor establece el diagnóstico de sospecha. Presentamos un caso tratado en nuestro servicio, cuya excepcionalidad radica en el largo tiempo de evolución, volumen elevado que conlleva disnea e inmovilidad de la hemilaringe afecta, que se recupera tras cirugía con abordaje externo. Se discuten las dificultades planteadas por su diagnóstico clínico y anátomo-patológico, al tiempo que se hace una revisión de la bibliografía pertinente (AU)

Neuromas or Schwannomas are extremely rare among tumors of the larynx. They are Schwann cell tumors that can be difficult to distinguish from neurofibromas. They present usually as supraglottic masses, since they may arise from the internal branch of the superior laryngeal nerve. Nuclear magnetic resonance imaging is the best diagnostic technique, conferring a high degree of suspicion. We present an exceptional case of a laryngeal neuroma, with a very long evolution, a large tumor volume, dyspnea and vocal cord fixation, with complete resolution through an external approach following surgical removal. The difficulties encountered with its pathological and clinical diagnosis are discussed as well as a review of the literature (AU)

Do cognitive patterns of brain magnetic activity correlate with hippocampal atrophy in Alzheimer's disease?

BACKGROUND: Many reports support the clinical validity of volumetric MRI measurements in Alzheimer's disease. OBJECTIVE: To integrate functional brain imaging data derived from magnetoencephalography (MEG) and volumetric data in patients with Alzheimer's disease and in age matched controls. METHODS: MEG data were obtained in the context of a probe-letter memory task. Volumetric measurements were obtained for lateral and mesial temporal lobe regions. RESULTS: As expected, Alzheimer's disease patients showed greater hippocampal atrophy than controls bilaterally. MEG derived indices of the degree of activation in left parietal and temporal lobe areas, occurring after 400 ms from stimulus onset, correlated significantly with the relative volume of lateral and mesial temporal regions. In addition, the size of the right hippocampus accounted for a significant portion of the variance in cognitive scores independently of brain activity measures. CONCLUSIONS: These data support the view that there is a relation between hippocampal atrophy and the degree of neurophysiological activity in the left temporal lobe.

Spatio-temporal patterns of brain magnetic activity during a memory task in Alzheimer's disease.

The brain magnetic activity patterns in a high load probe-letter (targets and distractors) memory task were examined in patients with Alzheimers's disease (AD) and elderly controls. Control subjects showed a higher number of activity sources over the temporal and parietal cortex between 400 and 700 ms after stimulus onset. However, AD patients showed a higher number of sources over the frontal motor areas, including Broca's and the insula. The number of activity sources on the left parietal areas in response to the target stimuli predicted the AD score oncognitive (MMSE, CAMCOG) and functional staging (FAST) scales. These results suggest that a high information load reveals a deficient functioning of phonological store and reduced task-related activity in temporal and parietal areas, manifesting in a rapid information trace decay. The increased levels of activity in motor areas may reflect a compensatory strategy in an attempt to facilitate rehearsal speed.

[Atrophy of the amygdala complex and neuropsychiatric expression of Alzheimer s disease]. / Atrofia del complejo amigdalino y expresión neuropsiquiátrica de la enfermedad de Alzheimer.

INTRODUCTION: In Alzheimer s disease, together with cognitive changes (loss of memory, lack of orientation in time and space, difficulty in carrying things out, etc.) non cognitive disorders also occur, seriously disturbing the patient s behavioral and emotional balance. Depression, delirious ideas, hallucinations and behavior changes (habits regarding sex, feeding and movement) are amongst the commonest features of this disease from its earliest stages. Several studies have described how initially the histopathological changes selectively involve different structures of the medial temporal lobe ( entorinal cortex, hippocampal formation, amygdala) and gradually includes neocortical association areas. Thus, the amygdala complex, a structure related to processes of memory and emotional control, is severely affected in this disease from the initial stages. PATIENTS AND METHODS: Therefore, to find any possible relationship between involvement of the amygdala and the psychiatric expression of Alzheimer s type dementia, we did a radiological study, using magnetic resonance, together with a neuropsychological study of a group of 24 persons with Alzheimer s disease who had mild moderate deterioration. Analysis of the amygdala area and the scores on the subtest Alzheimer s Disease Assessment Scale Non cognitive (ADAS NC) were the variables chosen for measurement of the anatomical and psychiatric aspects of the subjects under investigation. RESULTS AND CONCLUSIONS: The results of our study show a close relation between involvement of the amygdala (atrophy) and the presence of neuropsychiatric changes in persons with Alzheimer s disease.

Atrofia del complejo amigdalino y expresión neuropsiquiátricade la enfermedad de Alzheimer / Atrophy pf the amygdala complex and neuropsychiatric expression of Alzheimer´s disease

Introducción. En la enfermedad de Alzheimer, junto con las alteraciones cognitivas (pérdida de memoria, desorientación temporo-espacial, disejecución, etc.), aparecen una serie de manifestaciones `no cognitivas' que afectan gravemente al ajuste conductual y emocional del paciente. Depresión, ideas delirantes, alucinaciones o cambios conductuales (hábitos sexuales, alimenticios, motrices) son algunas de las manifestaciones más frecuentes en esta enfermedad ya desde sus primeros estadios. Diversos estudios han descrito cómo, inicialmente, las alteraciones histopatológicas involucran de forma selectiva a diversas estructuras del lóbulo temporal medial (corteza entorrinal, formación del hipocampo, amígdala) y su acción se amplía paulatinamente hasta áreas asociativas neocorticales. Así, el complejo amigdalino, una estructura relacionada con los procesos mnésicos y de control emocional, se encuentra gravemente afectado en esta enfermedad desde sus fases iniciales. Pacientes y métodos. A fin de contrastar las posibles relaciones entre la afectación de la amígdala y la expresión psiquiátrica de la enfermedad de Alzheimer, se realizó un estudio radiológico, mediante resonancia magnética, y neuropsicológico en un grupo de 24 sujetos con demencia de tipo Alzheimer y deterioro leve-moderado. El análisis del área de la amígdala y las puntuaciones en el subtest Alzheimer's Disease Assessment Scale-Non Cognitive fueron las variables que se seleccionaron para medir los aspectos anatómicos y psiquiátricos en los sujetos a estudio. Resultados y conclusiones. Los resultados procedentes de nuestro trabajo evidencian la existencia de una fuerte relación entre la afectación de la amígdala (atrofia) y la presencia de alteraciones neuropsiquiátricas en sujetos con enfermedad de Alzheimer (AU)

Unusual changing CT and MR appearance of an epithelial intracranial cyst.

INTRODUCTION: Epithelial cysts are infrequent intracranial lesions and may content cilia and mucosecretant cells that may be responsible for the protein concentration within the contents and the variable radiological appearance on CT and MRI. METHODS AND PATIENTS: We present a case of an extraaxial epithelial cyst with changing CT and MR characteristics. RESULTS: The appearance of our cyst on CT or MRI changed with size and morphology. When CT studies showed an hypodense cyst, the lesion was large but when an hyperdense mass was present, the lesion was smaller. In the later situation MRI showed hyperintensity on T1-weighted images and hypointensity on T2-weighted images and the protein concentration of the cystic contents was high. CONCLUSIONS: We believe that a relatively high protein concentration in our cyst was the major factor for the high attenuation on CT and the hyperintensity or hypointensity on T1- and T2-weighted images, respectively. We believe than these atypical imaging findings were caused by changes in the protein concentration within the cyst.

Hydatid disease: radiologic and pathologic features and complications.

Hydatid disease primarily affects the liver and typically demonstrates characteristic imaging findings. However, there are many potential local complications (eg, intrahepatic complications, exophytic growth, transdiaphragmatic thoracic involvement, perforation into hollow viscera, peritoneal seeding, biliary communication, portal vein involvement, abdominal wall invasion). Furthermore, secondary involvement due to hematogenous dissemination may be seen in almost any anatomic location (eg, lung, kidney, spleen, bone, brain). Ultrasonography (US) is particularly useful for the detection of cystic membranes, septa, and hydatid sand. Computed tomography (CT) best demonstrates cyst wall calcification and cyst infection. CT and magnetic resonance (MR) imaging may demonstrate cyst wall defects as well as the passage of contents through a defect. Chest radiography, US, CT, and MR imaging are all useful in depicting transdiaphragmatic migration of hydatid disease. CT is the modality of choice in peritoneal seeding. US and CT demonstrate rupture in most cases that involve wide communication. Indirect signs of biliary communication include increased echogenicity at US and fluid levels and signal intensity changes at MR imaging. CT allows precise assessment of osseous lesions, whereas MR imaging is superior in demonstrating neural involvement. Familiarity with atypical manifestations of hydatid disease may be helpful in making a prompt, accurate diagnosis.

Primary malignant rhabdoid tumour of the brain in an adult.

We report a mass in the left cerebral hemisphere of a 20-year-old man. Histological, ultrastructural and immunohistochemical features of the tumour were consistent with primary malignant rhabdoid tumour. The age of presentation, imaging features prior to histological examination, and prognosis in this case were unusual.

Post-Paget telangiectatic osteosarcoma of the skull.

Sarcomatous transformation is the most dreaded complication of Paget's disease. We report on a case of post-Paget telangiectatic osteosarcoma of the skull, a variant of osteogenic osteosarcoma, in a 79-year-old woman. We discuss the radiological pattern in relationship to the differential diagnosis.