An 80-year-old man was transferred to our institution with lower limb edema and worsening dyspnea following the administration of diuretic medication. Transthoracic echocardiography and computed ...tomography revealed a giant hepatic cyst (176×190 mm) compressing his right atrium and inferior vena cava (IVC). Laparoscopic cyst deroofing combined with omental packing and subsequent tube drainage immediately alleviated all his symptoms. The procedure was uneventful, and he was discharged without any complications on postoperative day 9; he had no recurrent symptoms or hepatic cysts at the postoperative 2-month follow-up. Therefore, a giant hepatic cyst can cause IVC syndrome, and laparoscopic deroofing is a beneficial approach for the treatment of accessible cysts.
Chronic limb-threatening ischemia (CLTI) is a severe peripheral artery disease with rest pain and lower limb ulceration. After revascularization, limb ulceration treatment should be completed quickly ...before restenosis. We aimed to investigate the effect of negative pressure wound therapy with instillation and dwell (NPWTi-d) using an antiseptic solution (AS) versus a saline solution (SS) in CLTI. There is no research limited to CLTI on this topic.
All patients underwent revascularization and surgical debridement. NPWTi-d was applied after surgical debridement. We evaluated wound tissue cultivation from pre- and post-NPWTi-d, length of NPWTi-d, and laboratory data pre- and post-NPWTi-d. All data are presented as the median, interquartile range. For univariate analysis, nonnormally distributed data were examined using the Wilcoxon rank sum test between the two groups of NPWTi-d (AS and SS group). A
value of less than 0.05 was considered statistically significant.
Forty-eight CLTI patients participated. The SS group included 24 patients (19 men, five women, average age 68.8 years) and the AS group included 24 patients (16 men, eight women, average age 67.4 years). The comorbidities included 23 and 19 patients with diabetes mellitus and hemodialysis in the SS group, and 22 and 16 patients in the AS group, respectively. There were no adverse events in either group. Both groups reduced the number of bacteria. The AS group required shorter NPWTi-d time (
= 0.02).
The AS group was able to shorten the treatment duration in CLTI.
During wakefulness, a constant and continuous stream of complex stimuli and self-driven thoughts permeate the human mind. Here, eleven participants were asked to count down numbers and remember ...negative or positive autobiographical episodes of their personal lives, for 32 seconds at a time, during which they could freely engage in the execution of those tasks. We then examined the possibility of determining from a single whole-brain functional magnetic resonance imaging scan which one of the two mental tasks each participant was performing at a given point in time. Linear support-vector machines were used to build within-participant classifiers and across-participants classifiers. The within-participant classifiers could correctly discriminate scans with an average accuracy as high as 82%, when using data from all individual voxels in the brain. These results demonstrate that it is possible to accurately classify self-driven mental tasks from whole-brain activity patterns recorded in a time interval as short as 2 seconds.
•We developed the A-V and the V-V method to determine temporal gait parameters.•The concurrent validity was excellent between both methods and the standard method.•The accuracy in the A-V method was ...better than the V-V method in older adults.•Inertial sensors attached to the heels provide a valid measurement.
The heel is likely a suitable location to which inertial sensors are attached for the detection of gait events. However, there are few studies to detect gait events and determine temporal gait parameters using sensors attached to the heels. We developed two methods to determine temporal gait parameters: detecting heel-contact using acceleration and detecting toe-off using angular velocity data (acceleration-angular velocity method; A-V method), and detecting both heel-contact and toe-off using angular velocity data (angular velocity-angular velocity method; V-V method). The aim of this study was to examine the concurrent validity of the A-V and V-V methods against the standard method, and to compare their accuracy. Temporal gait parameters were measured in 10 younger and 10 older adults. The intra-class correlation coefficients were excellent in both methods compared with the standard method (0.80 to 1.00). The root mean square errors of stance and swing time in the A-V method were smaller than the V-V method in older adults, although there were no significant discrepancies in the other comparisons. Our study suggests that inertial sensors attached to the heels, using the A-V method in particular, provide a valid measurement of temporal gait parameters.
This study aimed to compare lower limb events associated with preplanned and finally selected treatment strategies-the validity and usefulness of the physician-chosen strategy were verified.We ...examined the data of 1003 patients in the registry of multicenter endovascular treatment for superficial femoral and popliteal artery disease study and prospectively enrolled patients who underwent endovascular treatment (EVT) of the femoropopliteal (FP) artery between February 2017 and June 2018 from 67 Japanese institutes. The outcome measures were major adverse limb events (MALE) and target vessel revascularization.The EVT strategies were classified into balloon angioplasty-alone (37.3%), primary stenting (26.7%), and provisional stenting (36.0%) groups. In the initial strategy analysis for the balloon angioplasty-alone, primary stenting, and provisional stenting groups, two-year rates of freedom from MALE (95% confidence interval) were 0.680 (0.620-0.732), 0.754 (0.688-0.808), and 0.798 (0.746-0.840), respectively. Additionally, the rate of MALE was significantly higher among patients in the balloon angioplasty-alone group than among those in the primary or provisional stenting groups in the initial strategy analysis (P = 0.007). Changes in treatment strategy were more frequent in the primary stenting group than in the other groups. Furthermore, the rate of MALE did not significantly differ among the three groups in the final strategy analysis (P = 0.56).Limb outcomes for the final applied strategy did not differ among the three strategies. Additionally, the physician's selection bias was mostly appropriate in the EVT of the FP artery.
Let Γ be a countable discrete group, and let
be a representation of Γ by invertible operators on a separable Hilbert space
.
We show that the semidirect product group
is SIN (
admits a two-sided ...invariant metric compatible with its topology) and unitarily representable (
embeds into the unitary group
) if and only if π is uniformly bounded, and that π is unitarizable if and only if
is of finite type, that is,
embeds into the unitary group of a
-factor. Consequently, we show that a unitarily representable Polish SIN group need not be of finite type, answering a question of Sorin Popa.
The key point in our argument is an equivariant version of the Maurey–Nikishin factorization theorem for continuous maps from a Hilbert space to the space
of all measurable maps on a probability space.
The present study aimed to clarify the current status, therapeutic strategy, and 1-year outcome in acute limb ischemia (ALI) patients in Japan. The EnDOvascular treatment (Edo) registry database ...includes 324 patients from 10 institutes who were registered between November 2011 and October 2013. A total of 70 ALI patients (mean age 74.0 years) from the Edo registry database were enrolled in this study. Of the 70 included patients, 72.9% were male and 35.7% had embolism. Of patients, 38.6%, 42.9%, and 18.6% underwent EVT, surgery, and hybrid thrombectomy, respectively, in primary revascularization strategy. Limb ischemia was categorized into four classes at initial evaluation: SVS/ISCVS class I (
n
= 13, 18.6%), SVS/ISCVS class IIa (
n
= 36, 51.4%), SVS/ISCVS class IIb (
n
= 21, 30%), and SVS/ISCVS class III (
n
= 0, 0%). Three patients with SVS/ISCVS class IIb limb ischemia developed myonephropathic metabolic syndrome. No catheter-directed thrombolysis was employed as a primary revascularization strategy. The 1-year rates of all-cause death, major amputation, and a composite of perioperative death or major adverse limb event were 28.6%, 5.7%, and 40.0%, respectively. Lower age, male sex, dyslipidemia, high estimated glomerular filtration rate, high albumin level, and low C-reactive protein level were independent positive predictors of all-cause death. In this registry, SVS/ISCVS class IIa ALI was predominant. Approximately 40% of primary revascularization strategy was surgery and EVT, followed by hybrid therapy. All-cause death and major amputation rates at 1 year were less than 30% and 6%, respectively.
We developed a compact system for the spectroscopic mapping of a microstructure with a nano-focused beam at a soft X-ray beamline of synchrotron radiation. The experimental setup comprises a Wolter ...mirror and sample that are arranged with two mounting stages. The Wolter mirror is aligned with three degrees of freedom, and the sample with two degrees. The system generates a beam with an 800-nm spot and maps out a chemical distribution of non-uniform material through near-edge X-ray fine structure spectroscopy. The design and actual system are suited to experiments conducted with a nano-focused X-ray beam at beamlines of synchrotron radiation or an X-ray free-electron laser. Additionally, this technical note presents guidelines for actual experiments.
The Weyl–von Neumann theorem asserts that two bounded self-adjoint operators A, B on a Hilbert space H are unitarily equivalent modulo compacts, i.e.uAu* + K = B for some unitary u u(H) and compact ...self-adjoint operator K, if and only if A and B have the same essential spectrum: σess (A) = σess (B). We study, using methods from descriptive set theory, the problem of whether the above Weyl–von Neumann result can be extended to unbounded operators. We show that if H is separable infinite dimensional, the relation of unitary equivalence modulo compacts for bounded self-adjoint operators is smooth, while the same equivalence relation for general self-adjoint operators contains a dense Gδ-orbit but does not admit classification by countable structures. On the other hand, the apparently related equivalence relation A ~ B ⇔ ∃u U(H) u(A-i)–1u* - (B-i)–1 is compact is shown to be smooth.
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