Frequency resolution improvement by sub-bins and an inverse matrix in discrete Fourier transform.

We proposed a method to use sub-bins (SBs) and the inverse matrix to reduce the spectral leakage in discrete Fourier transform (DFT) over the conventional spectral resolution. SBs were assigned between two conventional bins. Utilizing the real signal, the process reproducing complex amplitudes at each SB was described and confirmed through simulations with the pseudo-inverse matrix. In experiments, with the 256 number of data, the frequency interval of k=107 and 108 was 4 divided by SBs. The single-peak spectrum at each SB frequency was measured clearly. Using the two signals with frequencies corresponding to two SBs within the conventional bin interval, the spectrum with two peaks was also measured. The linearity was confirmed for the input range from 0.1-5 V. The feasibility of this method to improve the frequency resolution has been shown for various optical applications.

[Stanford Type B Acute Aortic Dissection Complicated by Lower Limb Ischemia Late after Abdominal Aortic Graft Replacement].

Leg ischemia is a serious complication of acute aortic dissection. Few cases of lower extremity ischemia due to dissection late after abdominal aortic graft replacement have been reported. Critical limb ischemia occurs when true lumen blood flow is obstructed by the false lumen at the proximal anastomosis of the abdominal aortic graft. Usually, the inferior mesenteric artery (IMA) is reimplanted to the aortic graft to avoid intestinal ischemia. We therein report a case of Stanford type B acute aortic dissection, in which previously reimplanted IMA prevented bilateral lower extremity ischemia. A 58-years-old male with a history of abdominal aortic replacement experienced sudden onset of epigastralgia and subsequent pain in the back and the right lower limb and was admitted to the authors' hospital. Computed tomography (CT) revealed Stanford type B acute aortic dissection, and occlusion of the abdominal aortic graft, and the right common iliac artery. However, the left common iliac artery was perfused through the reconstructed IMA during previous abdominal aortic replacement. The patient underwent thoracic endovascular aortic repair and thrombectomy, and had an uneventful recovery. For residual arterial thrombi in the abdominal aortic graft, oral warfarin potassium was administered for 16 days until the day of discharge. Since then, the thrombus has dissolved and the patient has been doing well without any lower extremity disorders.

A Practical Grading Scale for Predicting Outcomes of Radiosurgery for Dural Arteriovenous Fistulas: JLGK 1802 Study.

BACKGROUND AND PURPOSE: To assess the long-term outcomes of intracranial dural arteriovenous fistula (DAVF) treated with stereotactic radiosurgery (SRS) alone or embolization and SRS (Emb-SRS) and to develop a grading system for predicting DAVF obliteration. METHODS: This multi-institutional retrospective study included 200 patients with DAVF treated with SRS or Emb-SRS. We investigated the long-term obliteration rate and obliteration-associated factors. We developed a new grading system to estimate the obliteration rate. Additionally, we compared the outcomes of SRS and Emb-SRS by using propensity score matching. RESULTS: The 3- and 4-year obliteration rates were 66.3% and 78.8%, respectively. The post-SRS hemorrhage rate was 2%. In the matched cohort, the SRS and Emb-SRS groups did not differ in the rates of obliteration (P=0.54) or post-SRS hemorrhage (P=0.50). In multivariable analysis, DAVF location and cortical venous reflux (CVR) were independently associated with obliteration. The new grading system assigned 2, 1, and 0 points to DAVFs in the anterior skull base or middle fossa, DAVFs with CVR or DAVFs in the superior sagittal sinus or tentorium, and DAVFs without these factors, respectively. Using the total points, patients were stratified into the highest (0 points), intermediate (1 point), or lowest (≥2 points) obliteration rate groups that exhibited 4-year obliteration rates of 94.4%, 71.3%, and 60.4%, respectively (P<0.01). CONCLUSIONS: SRS-based therapy achieved DAVF obliteration in more than three-quarters of the patients at 4 years of age. Our grading system can stratify the obliteration rate and may guide physicians in treatment selection.

A case of an intramesenteric GIST accurately diagnosed and completely resected by PET-CT and laparoscopy after gastrectomy for gastric cancer.

We performed the accurate diagnosis and complete surgical resection of a gastrointestinal stromal tumor at the mesentery of the small bowel. Computed tomography (CT) in a 62-year-old man at 2 years after gastrectomy for gastric cancer showed a mesenteric tumor, with no other tumors noted. Positron emission tomography-computed tomography (PET-CT) showed a maximum standardized uptake value (SUV max) of 2.9 at the tumor. The presence of a single and low SUV max tumor allowed us to perform laparoscopic surgery. Partial resection of the tumor with an adequate margin was performed. The pathological findings showed c-kit positivity and a low Ki-67 proliferation index (<5%). In the present case, PET-CT and laparoscopic assessments were useful for accurately evaluating the surgical resectability of the mesenteric tumor after distal gastrectomy for gastric cancer. The low SUV max and laparoscopic findings led to complete surgical resection of a mesenteric tumor.

[Successful Surgical Correction of Partial Atrioventricular Septal Defect in an Elderly Patient:Report of a Case].

There are only few reports on surgery for partial atrioventricular septal defect( pAVSD) in patients aged over 70 years. This report is about successful surgical correction of pAVSD in a 79-year-old women. Echocardiography showed left-sided atrioventricular valve regurgitation with cleft and ostium primum atrial septal defect, but without ventricular septal defect. Accordingly, she was diagnosed with pAVSD. Treatment plan included direct cleft closure, patch closure for the ostium primum atrial septal defect, and right atrioventricular annuloplasty. The postoperative course was uneventful. She was followed up without complications for four years. To the best of our knowledge, our patient is the oldest to undergo such surgical techniques in Japan to date.

Improvement of frequency resolution using a sub-bin structure in the discrete Fourier transform.

To improve frequency resolution, assignments of sub-bins within the bin interval of the conventional discrete Fourier transform are proposed by decreasing the number of sampled data. The simulated and experimental results of the basic sub-bin spectrum characteristics are presented. Using a signal oscillator, digital oscilloscope, and PC, the sub-bin line spectrum between two conventional bins is measured, and nine line spectra of sub-bins corresponding to the simulated results are measured. The linearity of the sub-bin spectrum intensity for amplitudes of 0.001-10 V of the input signal is also measured. The Doppler signals from the optical interferometer using a He-Ne laser are measured using a mixer to tune the frequency. A sub-bin spectrum of 104.89 kHz between two bin frequencies of 104.49 and 105.47 kHz is measured using 256 data points at a sampling frequency of 250 kHz and an acquisition time of 1.024 ms. The precision of displacement for the acquisition time is improved by one order to 32 nm for a full displacement of 2.342 µm. The sub-bins, as a composition of bin structure, are applicable to various fields.

A case of successful conversion surgery for gastric cancer with direct invasion to pancreatic head.

We experienced the case of successful conversion to distal gastrectomy for gastric cancer with direct invasion to the pancreatic head after the pre-operative chemotherapy. Esophagogastroduodenoscopy in a 66-year-old man revealed a tumor at the gastric antrum. Abdominal computed tomography (CT) showed that the tumor of the antrum was in contact with the pancreatic head. A biopsy of the tumor confirmed an adenocarcinoma and an overexpression of HER2 (3+). Staging laparoscopy showed the direct invasion of the gastric tumor to the pancreatic head. The patient received S-1, oxaliplatin and trastuzumab. After the pre-operative chemotherapy, CT showed a significantly shrinking tumor detached from the pancreatic head. Subsequently, distal gastrectomy was performed. Intra-operative exploration showed that the gastric tumor separated from the pancreatic head. The accumulation of trials for pre-operative chemotherapy for local advanced gastric cancer is expected.

[Double Patch Closure for Ruptured Sinus of Valsalva Aneurysm:Report of a Case].

A 53-year-old man visited a previous hospital because of dyspnea. He was transferred to our hospital with a diagnosis of a ruptured Valsalva aneurysm. At surgery, the tip of aneurysm originated from the right sinus of Valsalva had ruptured into the right ventricular outflow tract. A longitudinal incision was made in the main pulmonary artery, and the rupture site was closed with continuous suture. The first Hemashield patch was sewn to the tissue around the aneurysm in the right ventricular outlet septum. After that, the second Hemashield patch was fixed to the patch of the right ventricular outlet septum by horizontal mattress suture from the aorta. There has been no problem for more than five years after surgery.

Differential phase imaging in full-field optical coherence microscopy using a short multimode fiber probe.

We demonstrate phase imaging that reduces the common phase noise in full-field optical coherence microscopy using a short multimode fiber (SMMF) probe. Using a cover glass, phase images of the SMMF and sample surfaces were measured simultaneously. Subtracting the phase of the SMMF surface as a reference, the phase drifts in the sample region are reduced. The axial and lateral resolutions were 2.3 µm and <4.4µm, respectively. The standard deviation of the time variation in the phase decreased from 14.3 deg to 9.2 deg and was reduced by 64% when in contact with the polymer film at the SMMF. In quantitative evaluations, the measured phases closely correspond to the phases changed by a piezoelectric device.

Risk Factors of Postoperative Complications in Laparoscopic Cholecystectomy for Acute Cholecystitis.

INTRODUCTION: There are often cases with postoperative complications after laparoscopic cholecystectomy (LC), resulting in severe consequences. This study aimed to identify potential risk factors of postoperative complications in cases of LC for acute cholecystitis. MATERIALS AND METHODS: A total of 423 patients with cholecystitis underwent LC. We divided the patients into two groups: group without postoperative complications (Group A) and group with postoperative complications (Group B). Pre-operative findings, surgical findings, and the methods for evaluating the risk of peri-operative complications were compared between the two groups with a univariate analysis. Independent risk factors of postoperative complications were then evaluated in a multivariate analysis with the factors shown to be statistically significant in the univariate analysis. RESULTS: A Physiological and Operative severity Score for enUmeration of Mortality and morbidity (POSSUM) of ≥ 48.3 and moderate or severe cholecystitis were independent risk factors of postoperative complications in LC. CONCLUSIONS: This study indicated that POSSUM morbidity and moderate or severe cholecystitis were potential risk factors of postoperative complications. The pre-operative management of the general condition and cholecystitis using antibiotics, infusion, percutaneous transhepatic gallbladder drainage, and other approaches may be significant for the prevention of postoperative complications. Once the POSSUM morbidity reaches the threshold after LC, postoperative management becomes difficult, so strict control of the general condition should be performed.

Cyclic Sulfamidite as Simultaneous Protecting Group for Amino Alcohols: Development of a Mild Deprotection Protocol Using Thiophenol.

This study describes the novel utility of cyclic sulfamidite as a simultaneous protecting group for 1,2- or 1,3-amino alcohols. An exceptionally mild and neutral condition for the removal of the cyclic sulfamidite was developed. The deprotection condition demonstrated a broad range of functional-group compatibility, including a substrate bearing a Z-enyne structure without any loss of double-bond stereochemistry.

Time-Enhancement Curve of Four-Dimensional Computed Tomography Predicts Aneurysm Enlargement with Type-II Endoleak after Endovascular Aneurysm Repair.

OBJECTIVE: We investigated the hemodynamic features of Type-II endoleaks after endovascular aneurysm repair (EVAR) using four-dimensional (4D) computed tomography (CT) to identify patients with aneurysm enlargement. METHODS: During a 13-month period (January 2017-January 2018) at our institution, we performed 4D-CT examinations in 13 patients after EVAR because of suspected Type-II endoleaks. Three patients were excluded from the study because of other endoleaks or absence of detectable endoleaks. The ramaining 10 patients were divided into two groups: enlargement group (n = 4), in which the aneurysm volume increased, and stable group (n = 6), in which the aneurysm remained stable or shrank. A CT scanner and three-dimensional workstation were used. All images were obtained using a consistent protocol (22 phase scans using the test bolus tracking method). We analyzed the hemodynamics of the endoleak cavity (EC) relative to those of the aorta and evaluated the time-enhancement curves (TECs) using measurement protocols. The strengths of correlations between these factors in the two groups were analyzed statistically. RESULTS: TECs in the enlargement group showed a more gradual curve, and the upslope, the gradient of TEC in the ascending phase and the upslope index were significantly more gradual than those in the stable group (p = 0.0247, 0.0243). The EC washout and the EC washout index were also more gradual than in the stable group's (p = 0.019, 0.019). The enhancement duration was longer in the former than in the latter (80%, p = 0.0195; 70%, p = 0.0159; 60%, p = 0.0159). The CT number in the equilibrium phase was larger in the enlargement group than in the stable group (p = 0.019). CONCLUSION: The 4D-CT is useful for predicting aneurysm enlargement with Type-II endoleaks after EVAR.

[Analysis of Dieldrin and DTTB in Textiles].

Standard analytical methods for the detection of dieldrin and 4,6-dichloro-7-(2,4,5-trichlorophenoxy)-2-trifluoromethylbenzimidazole (DTTB) in textiles, which are regulated by Japanese law ("Act on the Control of Household Products Containing Harmful Substances"), have been in place for more than 30 years. In this study, we developed an improved analytical method, based on GC-MS, that uses safe reagents and can simultaneously detect dieldrin and DTTB analytes. In the standard (existing) analytical method, dimethyl sulfate, which is a potential carcinogen, is used to derivatize DTTB. In the developed method, phenyltrimethylammonium hydroxide, as an alternative reagent, was used to derivatize DTTB in good results. Dieldrin and the derivatized DTTBs gave highly linear calibration curves when analyzed by GC-MS. Moreover, we found that both analytes are adequately extracted from textiles by refluxing in hydrochloric acid and methanol. Furthermore, we established a purification method using the Bond Elut PRS column that effectively removed interfering substances in woolen products. Finally, we developed an improved analysis method by combining the above-mentioned techniques; the developed method exhibited a recovery rate of 94-104% and a relative standard deviation of less than 7% for both analytes. In addition, the limits of quantitation (dieldrin: 1.3 µg/g, DTTB: 0.72 µg/g) were sufficiently lower than the Japanese regulatory value of 30 µg/g.

Effect of Noncompacted Myocardial Resection on Isolated Left Ventricular Noncompaction.

Isolated left ventricular noncompaction, where broad trabeculae and deep intertrabecular recesses are observed in the left ventricular myocardium resulting from an arrest in normal embryogenesis, is a rare cardiomyopathy. We present a report on isolated trabeculectomy and postoperative echocardiographic follow-up showing recovery of cardiac function for isolated left ventricular noncompaction.

Total Synthesis of (-)-Lepadiformine A via Radical Translocation-Cyclization Reaction.

Total synthesis of (-)-lepadiformine A featuring construction of the 1-azaspiro[4.5]decane skeleton by a highly diastereoselective radical translocation-cyclization reaction of a γ-lactam derivative bearing a chiral butenolide moiety is described. The enantioselective construction of butenolide is conducted via Krische's catalytic asymmetric allylation protocol. After the radical translocation-cyclization reaction, a hydroxymethyl group at the C-13 position was stereoselectively introduced by a one-pot partial reduction-allylation protocol of the unprotected lactam derivative. Finally, the total synthesis is completed by formation of a C ring.

Gamma Knife Surgery for Residual or Recurrent Craniopharyngioma After Surgical Resection: A Multi-institutional Retrospective Study in Japan.

Objective The optimal treatment for a craniopharyngioma has been controversial. Complete resection is ideal, but it has been difficult to obtain total resection in many cases because of intimate proximity to critical structures such as the optic pathway, hypothalamus, and pituitary gland. A growing number of studies have demonstrated the utility of radiosurgery in controlling residual or recurrent craniopharyngioma. However, most of them are small series. The aim of this multi-institutional study was to clarify the efficacy and safety of Gamma Knife (Elekta, Stockholm, Sweden) surgery for patients with a craniopharyngioma. Methods This was a multi-institutional retrospective study by 16 medical centers of the Japan Leksell Gamma Knife Society. Data on patients with craniopharyngiomas treated with Gamma Knife Surgery (GKS) between 1991 and 2013 were obtained from individual institutional review board-approved databases at each center. A total of 242 patients with craniopharyngioma were included in this study. The mean age of the patients was 41 (range, 3 to 86) years. The median follow-up time was 61.4 months (range, 3 to 180 months). The mean radiosurgery target volume was 3.1 ml (range, 0.03-22.3 ml), and the mean marginal dose was 11.4 Gy (range, 8-20.4 Gy). Results Two-hundred twenty patients were alive at the time of the last follow-up visit. The three-, five-, and 10-year overall survival rates after GKS were 95.4%, 92.5%, and 82.0%, respectively. The three-, five-, and 10-year progression-free survival rates after GKS were 73.1%, 62.2%, and 42.6% respectively. The rate of radiation-induced complications was 6.2%. Conclusion GKS is effective for controlling the tumor growth of craniopharyngiomas with an acceptable complication rate.

Frequency-agile injection-seeded terahertz-wave parametric generation: publisher's note.

This publisher's note contains corrections to Opt. Lett.45, 77 (2020)OPLEDP0146-959210.1364/OL.45.000077.

[Mycotic Aneurysm of the Ulnar Artery Associated with Infective Endocarditis;Report of a Case].

A 19-year-old man, with a history of hospitalization for infective endocarditis associated with Streptococcus mitis/oralis 2 months before, was admitted to our hospital because of stomach ache and pulsatile mass on the left forearm. Computed tomography(CT) and ultrasonography revealed a thrombus in the superior mesenteric artery and an aneurysm of the left ulnar artery. As vegetation was noted on the anterior leaflet of the mitral valve, mitral valve replacement and ulnar artery aneurysmorrhaphy were performed. He was discharged 24 days after surgery without any complications. Although mycotic aneurysm is one of the complications of infective endocarditis, it is rarely formed in the ulnar artery. Moreover, mycotic aneurysm may develop even after inflammatory reaction has subsided. Thus, longterm observation of patients with infective endocarditis is necessary.

The timing of cumulus cell removal for intracytoplasmic sperm injection influences the capability of embryonic development.

PURPOSE: To determine whether the presence of intact cumulus cells during the preincubation period for ICSI should be considered as a critical factor in fertilization and embryonic development. METHODS: The cohort of this prospective randomized study was limited to infertile women younger than 39 years of age who underwent controlled ovarian stimulation for ICSI between October 2013 and May 2015 and whose embryos were to be incubated until day 5. Women with estradiol levels of <2000 pmol/L on the day of HCG injection were excluded. Cumulus cells were removed immediately after OPU in Group A and at 120 minutes after OPU in Group B. ICSI was performed with all mature oocytes, and fertilized oocytes were cultured to the blastocyst stage. Maturation, fertilization, blastocyst, good quality blastocyst, pregnancy, live birth, and miscarriage rates were compared. RESULTS: There were no significant differences in maturation, fertilization, blastocyst, pregnancy, live birth, or miscarriage rates between Groups A and B. However, the percentage of good quality blastocysts was significantly higher in Group B than Group A (52.0% vs 33.1%). CONCLUSIONS: Intact cumulus cells should be maintained during the preincubation period, as they are important to embryonic development after fertilization.