Robot-assisted laparoscopic surgery with a fluorescent near-infrared ray ureteral catheter for a rectal cancer patient with pelvic kidney: A case report.

An 85-year-old woman presented with a stomachache after a meal and was admitted to the previous clinic. Multi-detector computed tomography (CT) of the abdomen showed wall thickening in the rectum and right ectopic pelvic kidney. Colonoscopy revealed a mass at the rectum, and a biopsy showed adenocarcinoma. CT showed no lymphadenopathy or distant metastasis. Hartmann's procedure with fluorescent near-infrared ray ureteral catheters was used to avoid causing urinary injury. Robotic surgery was performed while checking the route of the ureter in near-infrared mode. The patient was discharged on postoperative day 14 without specific complications. This case appears to be the first of robot-assisted laparoscopic surgery for a rectal cancer patient with pelvic kidney.

Left paraduodenal hernia treated by single-incision laparoscopic surgery: a case report.

BACKGROUND: Paraduodenal hernia is a rare internal hernia which accounts for only 1% of all intestinal hernias. There have been limited reported cases of paraduodenal hernia treated by laparoscopic surgery. We report a case of left paraduodenal hernia that was successfully treated by single-incision laparoscopic surgery (SILS). CASE PRESENTATION: A 17-year-old woman presented with left upper abdominal pain. An abdominal enhanced multi-detector computed tomography demonstrated encapsulated cluster of small bowel loops in the left upper quadrant which passed through the dorsal side of the inferior mesenteric vein, and showed that blood flow of the prolapsed small bowel was preserved. We preoperatively diagnosed left paraduodenal hernia without ischemia or necrosis. We performed elective SILS because she was a young actress training school student and cosmetic benefit was thought to be important. We pulled out the protruded small bowel and closed a defect with a running suture by SILS. The patient was discharged 3 days after the surgery with no complications. CONCLUSIONS: We reported the case of left paraduodenal hernia successfully diagnosed and treated by SILS.

[A Case of Sarcoid‒Like Reaction with Multiple Lymphadenopathy by Rectal Cancer after an Operation].

We are reporting on a case of lymphadenopathy after surgery for rectal cancer. The case was a 66‒year‒old female. Laparoscopic high anterior resection(D3 dissection)was performed for rectal cancer(pT1bpN0M0, pStage Ⅰ)in April 2018, and she was followed up with on an outpatient basis. In July of the same year, a painless mass had formed in the right groin. An abdominal contrast‒enhanced CT showed lymph node swelling around the right groin and external iliac artery, but the tumor markers, CEA 2.3 ng/mL and CA19‒9 <2 U/mL, were within the standard values. An inguinal lymph node biopsy was performed during the same month. Pathological examination revealed no cancer cells and formation of epithelioid granuloma with giant cells. There was no suspicion of systemic sarcoidosis based on the test results and clinical findings. From the above, the patient was diagnosed with sarcoid reaction due to the tumor. Abdominal contrast‒enhanced CT scan 2 months after the biopsy showed lymph node shrinkage and there was no recurrence 2 years after the biopsy.

Absolute response of a Fuji BAS-TR imaging plate to low-energy protons (<0.2 MeV) and carbon ions (<1 MeV).

This paper reports on the absolute response of a Fuji BAS-TR image plate to relatively low-energy protons (<0.2 MeV) and carbon ions (<1 MeV) accelerated by a 10-TW-class compact high-intensity laser system. A Thomson parabola spectrometer was used to discriminate between different ion species while dispersing the ions according to their kinetic energy. Ion parabolic traces were recorded using an image plate detector overlaid with a slotted CR-39 solid-state detector. The obtained response function for the protons was reasonably extrapolated from previously reported higher-ion-energy response functions. Conversely, the obtained response function for carbon ions was one order of magnitude higher than the value extrapolated from previously reported higher-ion-energy response functions. In a previous study, it was determined that if the stopping range of carbon ions is comparable to or smaller than the grain size of the phosphor, then some ions will provide all their energy to the binder resin rather than the phosphor. As a result, it is believed that the imaging plate response will be reduced. Our results show good agreement with the empirical formula of Lelasseux et al., which does not consider photo-stimulated luminescence (PSL) reduction due to the urethane resin. It was shown that the PSL reduction due to the deactivation of the urethane resin is smaller than that previously predicted.

Laser resonance frequency analysis of pedicle screw stability: A cadaveric model bone study.

There is no evaluation method currently available to assess intraoperative pedicle screw fixation (PSF) strength. In this study, we established a laser-based resonance frequency analysis (RFA) system with high-speed, noncontact, quantitative measurements of PSF. Clinical investigations in the future can assess surgical failure risk of implants. We investigated the characteristics of the laser RFA and compared them with the conventional methods. We inserted a pedicle screw in the vertebral pedicle of human cadaver or model bone, followed by screw pull-out, peak torque, implant stability quotient (ISQ) value obtained by the magnetic dental RFA system, and fixation force of laser RFA. We compared the outcomes using best-fit linear or logarithmic approximations. For the model bone study, the resonance frequency (RF) versus peak torque/pull-out force (POF) demonstrated strong correlations using logarithmic approximation (vs. peak torque: R = 0.931, p < .001, vs. POF: R = 0.931, p < .001). RF strongly correlated with the ISQ value using linear approximation (R = 0.981, p < .001). For the cadaveric vertebrae study, the correlation coefficients between RF and the peak torque/POF were significant regardless of approximation method (peak torque: logarithmic: R = 0.716 vs. linear: R = 0.811; p < .001) (POF: logarithmic: R = 0.644 vs. linear: R = 0.548; p < .05). Thus, the results of this study revealed a constant correlation between RFA and conventional methods as a measurement validation, predicting favorable support for intraoperative PSF. RFA has the potential to be a new index for evaluating the implant fixation force.

Compact Thomson parabola spectrometer with variability of energy range and measurability of angular distribution for low-energy laser-driven accelerated ions.

This article reports the development of a compact Thomson parabola spectrometer for laser-accelerated ions that can measure angular distribution with a high energy resolution and has a variable measurable energy range. The angular-resolved energy spectra for different ion species can be measured in a single shot, and the sampling angle can be selected from outside the vacuum region. The electric and magnetic fields are applied to the ion dispersion by using a permanent magnetic circuit and annulus sector-shaped electrodes with a wedge configuration. The compact magnetic circuit consists of permanent magnets, fixed yokes, and movable yokes. The magnetic flux is intentionally leaked to the movable yokes, allowing the magnetic field to be adjusted from 53 mT to 259 mT. The annulus sector-shaped electrodes with a wedge configuration provide better trace separation for high-energy ions, retain the lower-energy part of the ion signal, and subject ions passing through all pinholes to an equivalent Lorentz force. The magnetic and electric fields are designed for measuring protons and carbon ions with an energy range of 0.1-5 MeV. The spectrometer allows for the adjustment of the observable energy range afterward according to the parameters of the accelerated ion.

Soft x-ray laser beamline for surface processing and damage studies.

We have developed a soft x-ray laser (SXRL) beamline equipped with an intensity monitor dedicated to ablation study such as surface processing and damage formation. The SXRL beam having a wavelength of 13.9 nm, pulse width of 7 ps, and pulse energy of around 200 nJ is generated from Ag plasma mediums using an oscillator-amplifier configuration. The SXRL beam is focused onto the sample surface by the Mo/Si multilayer coated spherical mirror. To get the correct irradiation energy/fluence, an intensity monitor composed of a Mo/Si multilayer beam splitter and an x-ray charge-coupled device camera has been installed in the beamline. The Mo/Si multilayer beam splitter has a large polarization dependence in the reflectivity around the incident angle of 45°. However, by evaluating the relationship between reflectivity and transmittance of the beam splitter appropriately, the irradiation energy onto the sample surface can be derived from the energy acquired by the intensity monitor. This SXRL beamline is available to not only the ablation phenomena but also the performance evaluation of soft x-ray optics and resists.

Laser-induced damage thresholds and mechanism of silica glass induced by ultra-short soft x-ray laser pulse irradiation.

Laser-induced damage thresholds (LIDTs) of silica glasses obtained by the femtosecond soft x-ray free-electron laser (SXFEL, 13.5 nm, 70 fs) and the picosecond soft x-ray laser (SXRL, 13.9 nm, 7 ps) are evaluated. The volume of the hydroxyl group in the silica glasses influenced its LIDTs. The LIDTs obtained in this research by the femtosecond SXFEL and the picosecond SXRL were nearly identical, but were different from that by the nanosecond soft x-ray pulse. The photoionization processes of silica glass in context of the laser-induced damage mechanism (LIDM) are also discussed. In the ultra-short soft x-ray pulse irradiation regime, the LIDM can be speculated to include the spallation process with a scission of bondings.

Laser Resonance Frequency Analysis: A Novel Measurement Approach to Evaluate Acetabular Cup Stability During Surgery.

Artificial joint acetabular cup stability is essential for successful total hip arthroplasty. However, a quantitative evaluation approach for clinical use is lacking. We developed a resonance frequency analysis (RFA) system involving a laser system that is fully contactless. This study aimed to investigate the usefulness of laser RFA for evaluating acetabular cup stability. First, the finite element method was performed to determine the vibration mode for analysis. Second, the acetabular cup was press-fitted into a reamed polyurethane cavity that replicated the human acetabular roof. The implanted acetabular cup was vibrated with pulse laser irradiation and the induced vibration was detected with a laser Doppler vibrometer. The time domain signal from the vibrometer was analyzed by fast Fourier transform to obtain the vibration frequency spectrum. After laser RFA, the pull-down force of the acetabular cup was measured as conventional implant fixation strength. The frequency of the first highest amplitude between 2 kHz and 6 kHz was considered as the resonance peak frequency, and its relationship with the pull-down force was assessed. The peak frequency could predict the pull-down force (R2 = 0.859, p < 0.000). Our findings suggest that laser RFA might be useful to measure acetabular cup stability during surgery.

Enhancement of water-window soft x-ray emission from laser-produced Au plasma under low-pressure nitrogen atmosphere.

To generate bright water-window (WW) soft x rays (2.3-4.4 nm), gold slab targets were irradiated with laser pulses (1064 nm, 7 ns, 1 J). Emission spectroscopy showed that the introduction of low-pressure nitrogen enhanced the soft x-ray yield emitted from the laser-produced Au plasma. The intensity of the WW x-ray transported in a 400-Pa N2 atmosphere from the laser-produced plasma increased by 3.8 times over that in vacuum. Considering a strong x-ray absorption, the x-ray yield emitted directly from the Au plasma in the N2 gas was evaluated to be 13 times higher than that in vacuum. Although similar measurements were made for various gases, only N2 gas causes an increase in a soft x-ray yield. The processes leading to this enhancement mechanism were revealed by using hydrodynamic simulation and atomic structure codes.

A cut-off value of shear wave speed to distinguish nonalcoholic steatohepatitis candidates.

To distinguish and characterize nonalcoholic steatohepatitis (NASH) candidates from among medical checkup visitor diagnosed with nonalcoholic fatty liver diseases (mcNAFLDs).A cut-off value has not been established to differentiate NASH at the earliest stage in NAFLD.Shear wave speed (SWS) was measured in the livers of 480 mcNAFLDs. NASH candidates were screened out by adopting a statistically defined cut-off value of SWS and were characterized in terms of food preference.SWS ranged between 1.11 and 2.18 m/s and fit a Gaussian distribution (r = 0.98) with an average and SD of 1.324 and 0.0847 m/s, respectively, in 320/160 males/females 64.4 (interquartile range 57.3-69.4) years old. The average plus SD (1.41 m/s) screened out 82 (17.1%) NASH candidates, who were significantly older (66.8 vs. 64.1 years old, P = 0.001) and had higher fibrosis 4 index values (1.58 vs. 1.33, P < 0.0001) than the remaining mcNAFLDs. The number of patients with a BMI greater than 25 kg/m was 118 (29.6%) mcNAFLDs and 34 (41.5%) NASH candidates, with a significantly higher frequency in NASH candidates (P = 0.05). Obese patients preferentially ate fatty acids in general, while NASH candidates preferred to consume several long-chain unsaturated fatty acids irrespective of their BMI.These results suggest that NASH candidates who have a longer disease duration and pathological progression can be distinguished from mcNAFLDs by a statistically defined cut-off value of SWS. The defined value indicates that there are different food habitats associated with obesity and NAFLD progression.

Pycnogenol ameliorates depression-like behavior in repeated corticosterone-induced depression mice model.

Oxidative stress is considered to be a mechanism of major depression. Pycnogenol (PYC) is a natural plant extract from the bark of Pinus pinaster Aiton and has potent antioxidant activities. We studied the ameliorative effect of PYC on depression-like behavior in chronic corticosterone- (CORT-) treated mice for 20 days. After the end of the CORT treatment period, PYC (0.2 mg/mL) was orally administered in normal drinking water. Depression-like behavior was investigated by the forced swimming test. Immobility time was significantly longer by CORT exposure. When the CORT-treated mice were supplemented with PYC, immobility time was significantly shortened. Our results indicate that orally administered PYC may serve to reduce CORT-induced stress by radical scavenging activity.

A new grating X-ray spectrometer for 2-4 keV enabling a separate observation of In-Lß and Sn-Lα emissions of indium tin oxide.

A new multilayer-coated varied line-spaced grating, JS4000, was fabricated and tested for extending the upper limit of a grating X-ray spectrometer for electron microscopy. This grating was designed for 2-3.8 keV at a grazing incidence angle of 1.35°. It was revealed that this new multilayer structure enables us to take soft-X-ray emission spectra continuously from 1.5 to 4.3 keV at the same optical setting. The full-width at half maximum of Te-L(α1,2) (3.8 keV) emission peak was 27 eV. This spectrometer was applied to indium tin oxide particles and clearly resolved Sn-L(α) (3444 eV) and In-L(ß1) (3487 eV) peaks, which could not be resolved by a widely used energy-dispersive X-ray spectrometer.

Laminar and blazed type holographic gratings for a versatile soft x-ray spectrograph attached to an electron microscope and their evaluation in the 50-200 eV range.

Laminar and blazed type holographic varied-line-spacing spherical gratings for use in a versatile soft x-ray flat-field spectrograph attached to an electron microscope are designed, fabricated, and evaluated. The absolute diffraction efficiencies of laminar (or blazed) master and replica gratings at 86.00° incidence evaluated by synchrotron radiation show over 5% (or 8%) in the 50-200 eV range with the maxima of 22% (or 26%-27%). Also the resolving power evaluated by a laser produced plasma source is in excess of 700 at the energy near the K emission spectrum of lithium (~55 eV) for all gratings. Moreover, the K emission spectrum of metallic Li with high spectral resolution is successfully observed with the spectrograph attached to a transmission electron microscope.

Hepatoprotective effects of pycnogenol in a rat model of non-alcoholic steatohepatitis.

Oxidative stress is considered as a mechanism of hepatocellular injury in non-alcoholic steatohepatitis (NASH). Pycnogenol (PYC) is the natural plant extract from the bark of Pinus pinaster Aiton. and has potent antioxidant activities. We studied the protective effect of PYC on excessive fat accumulation in the liver fed a methionine-choline deficient (MCD) high-fat diet for 6 weeks. Pycnogenol (10 mg/kg body weight) was orally administered for 5 weeks. At the end of the experiment, blood and liver samples were collected and assessed for effects of PYC by histopathological and biochemical analyses. Histopathological analyses of liver tissues stained with Azan-Mallory showed hepatic macrovesicular steatosis and fibrosis in MCD-fed rats. Supplementation of PYC prevented this effect. Pycnogenol treatment significantly decreased the liver triglyceride and serum alanine amino transferase levels. Our results indicated that orally administered PYC may serve to prevent NASH-induced liver damage.

Protective effect of Pycnogenol® on ovariectomy-induced bone loss in rats.

Pycnogenol® (PYC) is a natural plant extract from the bark of Pinus pinaster and has potent antioxidant activities. The protective effect of PYC on bone loss was studied in multiparous ovariectomized (OVX) female rats. Pycnogenol® (30 or 15 mg/kg body weight/day) was administered orally to 8-month-old OVX rats for 3 months. At the end of the experiment, bone strength was measured by a three-point bending test and bone mineral density was estimated by peripheral quantitative computed tomography. Ovariectomy significantly decreased femur bone strength and bone density. Supplementation with PYC suppressed the bone loss induced by OVX. The OVX treatment significantly increased serum osteocalcin (OC) and C-terminal telopeptide of type I collagen (CTx). Supplementation with PYC reduced the serum OC and CTx in OVX rats to a level similar to that of the sham-operated group. The results indicated that orally administered PYC can decrease the bone turnover rate in OVX rats, resulting in positive effects on the biomechanical strength of bone and bone mineral density.

Experimental verification of femtosecond laser ablation schemes by time-resolved soft x-ray reflective imaging.

Pump and probe reflective imaging using a soft x-ray laser probe was applied to the observation of the early stage of femtosecond laser ablation process on platinum. In strongly excited area, drastic and fast reflectivity drop was observed. In moderately excited area, the decay of the reflectivity is slower than that in the strongly excited area, and the reflectivity reaches its minimum at t = 160 ps. In weakly excited area, laser-induced reflectivity change was not observed. In addition, the point where the reflectivity dip was observed at t = 10 ps and t = 40 ps, coincides with the position of the edge of reflectivity drop at t = 160 ps. These results give the critical information about the femtosecond laser ablation.

γ-H2AX and phosphorylated ATM focus formation in cancer cells after laser plasma X irradiation.

The usefulness of laser plasma X-ray pulses for medical and radiation biological studies was investigated, and the effects of laser plasma X rays were compared with those of conventional sources such as a linear accelerator. A cell irradiation system was developed that used copper-Kα (8 keV) lines from an ultrashort high-intensity laser to produce plasma. The absorbed dose of the 8 keV laser plasma X-ray pulse was estimated accurately with Gafchromic® EBT film. When the cells were irradiated with approximately 2 Gy of laser plasma X rays, the circular regions on γ-H2AX-positive cells could be clearly identified. Moreover, the numbers of γ-H2AX and phosphorylated ataxia telangiectasia mutated (ATM) foci induced by 8 keV laser plasma X rays were comparable to those induced by 4 MV X rays. These results indicate that the laser plasma X ray source may be useful for radiation biology studies.

Single-shot picosecond interferometry with one-nanometer resolution for dynamical surface morphology using a soft X-ray laser.

Using highly coherent radiation at a wavelength of 13.9 nm from a Ag-plasma soft X-ray laser, we constructed a pump-and-probe interferometer based on a double Lloyd's mirror system. The spatial resolutions are evaluated with a test pattern, showing 1.8-mum lateral resolution, and 1-nm depth sensitivity. This instrument enables a single-shot observation of the surface morphology with a 7-ps time-resolution. We succeeded in observing a nanometer scale surface dilation of Pt films at the early stage of the ablation process initiated by a 70 fs near infrared pump pulse.