During laparoscopic-assisted gastrectomy, it is impossible to identify early gastric cancer (EGC) lesions; therefore, a precise localization technique is needed. In this study, we used laparoscopic ...ultrasonography (LUS) after endoscopic clipping as a method of localizing EGC and evaluated the effectiveness of this method.
A prospective study of 17 patients who had undergone laparoscopic-assisted gastrectomy was performed. Three endoscopic clips were applied just proximal to the tumor during the preoperative endoscopy. The applied clips were detected from the serosal side of the stomach using LUS. The serosal surface of the lesion was marked with dye.
In all patients, endoscopic clips were applied proximal to the lesion without complications, and the applied clips were confirmed by plain abdominal radiography. The clips were successfully detected by LUS in all patients. In the resected specimen, the serosal surface, marked with dye, was always just above the clips in the anterior wall or on the anterior wall opposite the clips applied in the posterior wall. The mean detection time was 4.7 min (range, 2-8). With this procedure, two patients underwent total gastrectomy and 15 patients underwent distal subtotal gastrectomy with gastroduodenostomy or gastrojejunostomy. Histological examination confirmed that the resection margins were tumor free in all patients. There was no operative morbidity related to the LUS procedure.
Using LUS to detect endoscopic clips is an easy, safe, and accurate method to localize EGC lesions in laparoscopic-assisted gastrectomy.
We have performed polarized and unpolarized small angle neutron scattering experiments on single crystals of HoMnO(3) and have found that an increase in magnetic scattering at low momentum transfers ...begins upon cooling through temperatures close to the spin reorientation transition at T(SR) approximately 40 K. We attribute the increase to an uncompensated magnetization arising within antiferromagnetic domain walls. Polarized neutron scattering experiments performed while applying an electric field show that the field suppresses magnetic scattering below T approximately 50 K, indicating that the electric field affects the magnetization via the antiferromagnetic domain walls rather than through a change to the bulk magnetic order.
Inelastic neutron scattering studies in single crystals of TbInO3 and TbIn0.95Mn0.05O3 with nearly triangular antiferromagnetic lattice are reported. At low energies, a broad and apparently gapless ...continuum of magnetic excitations, located at the triangular lattice (TL) Brillouin zone boundary, is observed. The data are well described by the uncorrelated nearest-neighbor valence bonds model. At higher energies, a broad excitation branch dispersing from the TL zone boundary is observed. No signs of static magnetic order are found down to the temperatures two orders of magnitude smaller than the effective interaction energy. The fluctuating magnetic moment exceeds two-thirds of the Tb3+ free-ion value and is confined to the TL plane. These observations are consistent with a TL-based spin liquid state in TbInO3.
When comparing alloy catalysts with different degrees of ordering, it is important to maintain surface facets to understand the effect of different arrangements of surface atoms. This is even more ...important when both metals are involved in the reaction steps, which is the case of Pt3Sn for the methanol oxidation reaction (MOR). We have prepared 95 and 60% ordered Pt3Sn nanocubes with {100} facets for the MOR. We show that the Sn atoms in the 60% ordered Pt3Sn nanocubes can be electrochemically oxidized to Sn4+, whereas the Sn atoms in the 95% ordered Pt3Sn nanocubes are more resistant to oxidation. The Sn4+ in the disordered catalysts makes them more active than the ordered catalysts. At low overpotentials, the electrochemically formed Sn4+ in the 60% ordered Pt3Sn nanocubes bind OH, oxidizing the CO intermediate adsorbed on Pt more efficiently. At high overpotentials, Sn4+ prevents the passivation of the Pt sites due to adsorption of OH. These effects lead to a 5.6 times higher activity of the 60% ordered nanocubes compared to the 95% ordered nanocubes. These results illustrate the importance in catalyst design of controlling the environment and especially the atoms neighboring Pt for intermetallic Pt–M electrocatalysts.
An outbreak of post-acupuncture cutaneous infections due to Mycobacterium abscessus occurred in Ansan, Korea, from November 2007 through to May 2008. During this time a prospective, observational, ...non-randomized study was conducted involving 52 patients that were diagnosed with cutaneous M. abscessus infection. We compared the clinical response between patients treated with clarithromycin plus amikacin regimen and those treated with clarithromycin plus moxifloxacin regimens with regard to time to resolution of the cutaneous lesions. Among the 52 study patients, 33 were treated with clarithromycin plus amikacin, and 19 were treated with clarithromycin plus moxifloxacin. The baseline characteristics for the treatment groups were not significantly different, except for initial surgical excision (n = 27 vs. 6, respectively, p = 0.001). The median time (weeks) to resolution of the lesions in the clarithromycin plus moxifloxacin-treated subjects was significantly shorter than that in the clarithromycin plus amikacin-treated subjects (17 ± 1.1 vs. 20 ± 0.9, respectively, p = 0.017). With adjustments for age, location of lesions, prior incision and drainage, and excision during medical therapy, clarithromycin plus moxifloxacin-treated subjects were more likely to have resolved lesions (hazard ratio, 0.387; 95% confidence interval, 0.165–0.907; p = 0.029). The frequency of drug-related adverse events in the two treatment groups was not significantly different (n = 18 vs. 14, respectively; p = 0.240). The most common adverse event was gastrointestinal discomfort. The results of our study showed that the combination regimen of clarithromycin and moxifloxacin resulted in a better clinical response than a regimen of clarithromycin plus amikacin when used for treatment of cutaneous M. abscessus infection.
Historically, open oesophagectomy was the gold standard for oesophageal cancer surgery. This was associated with a relatively higher morbidity. In the last two decades, we have seen significant ...improvements in short and long term outcomes due to centralisation of oesophagectomy, multidisciplinary approach, enhanced recovery after surgery programmes, neoadjuvant treatments and advances in minimally invasive oesophagectomy (MIO) techniques. MIO has significantly reduced postoperative morbidity and improved functional recovery, while maintaining comparable long-term oncological outcomes. MIO is technically demanding, and requires a long learning curve. However, it has been proven to be safe and successful in expert centres. This is a review on the current role of MIO in the management of oesophageal cancer.
This paper presents a study of local thermal sensation (LTS) and comfort in a field environmental chamber (FEC) served by displacement ventilation (DV) system. The FEC, 11.12
m (
L)×7.53
m (
W)×2.60
...m (
H), simulates a typical office layout. A total of 60 tropically acclimatized subjects, 30 male and 30 female, were engaged in sedentary office work for 3
h. Subjects were exposed to three vertical air temperature gradients, nominally 1, 3 and 5
K/m, between 0.1 and 1.1
m heights and three room air temperatures of 20, 23 and 26
°C at 0.6
m height. The objective of this study is to investigate the mutual effect of local and overall thermal sensation (OTS) and comfort in DV environment. The results show that in a space served by DV system, at OTS close to neutral, local thermal discomfort decreased with the increase of room air temperature. The OTS of occupants was mainly affected by LTS at the arm, calf, foot, back and hand. Local thermal discomfort was affected by both LTS and OTS. At overall cold thermal sensation, all body segments prefer slightly warm sensation. At overall slightly warm thermal sensation, all body segments prefer slightly cool sensation.
The detection of gravitational waves by Advanced LIGO and Advanced Virgo provides an opportunity to test general relativity in a regime that is inaccessible to traditional astronomical observations ...and laboratory tests. We present four tests of the consistency of the data with binary black hole gravitational waveforms predicted by general relativity. One test subtracts the best-fit waveform from the data and checks the consistency of the residual with detector noise. The second test checks the consistency of the low- and high-frequency parts of the observed signals. The third test checks that phenomenological deviations introduced in the waveform model (including in the post-Newtonian coefficients) are consistent with 0. The fourth test constrains modifications to the propagation of gravitational waves due to a modified dispersion relation, including that from a massive graviton. We present results both for individual events and also results obtained by combining together particularly strong events from the first and second observing runs of Advanced LIGO and Advanced Virgo, as collected in the catalog GWTC-1. We do not find any inconsistency of the data with the predictions of general relativity and improve our previously presented combined constraints by factors of 1.1 to 2.5. In particular, we bound the mass of the graviton to be mg≤4.7×10−23 eV/c2 (90% credible level), an improvement of a factor of 1.6 over our previously presented results. Additionally, we check that the four gravitational-wave events published for the first time in GWTC-1 do not lead to stronger constraints on alternative polarizations than those published previously.
Magnetic resonance is considered to be a necessary condition for metamaterial perfect absorbers, and dual-band absorbers can be composed of a pair of metallic layers with anti-parallel surface ...currents. We designed and fabricated a tunable dual-band perfect absorber based on extraordinary-optical-transmission (EOT) effect and Fabry-Perot cavity resonance. The idea and the mechanism are completely different from the absorber based on the near-field interaction. The important advantage of our structure is that we can switch a single-band absorber to a dual-band absorber by changing the distance between two metallic layers and/or incident angle. The peak originating from the EOT effect becomes significantly narrower, resulting in an increase of the Q-factor from 16.88 to 49. The dual-band absorber can be optimized to be insensitive to the polarization of the incident electromagnetic wave by slightly modifying the absorber structure.
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