We report a case of infected iliac artery aneurysm concomitant with liver abscesses caused by Fusobacterium nucleatum. A 58-year-old man developed an aneurysm of the right common iliac artery and liver abscesses. The ...We report a case of infected iliac artery aneurysm concomitant with liver abscesses caused by Fusobacterium nucleatum. A 58-year-old man developed an aneurysm of the right common iliac artery and liver abscesses. The aneurysm was resected and a femoro-femoral crossover bypass with a knitted Dacron graft was performed for impending rupture. Anaerobic cultures obtained from blood and intramural thrombus were positive for Fusobacterium nucleatum. With antibiotics, the liver abscesses disappeared without drainage. Iliopsoas abscesses developed after surgery, but it was controlled with antibiotics. The patient was free of infection 1 year after the surgery. The causative bacterium was suspected to originate in the oral cavity, because the patient had a notable history of poor chronic periodontal conditions. Clinically, infected aortoiliac aneurysm complicated by Fusobacterium is extremely rare relative to the prevalence of the pathogenic bacterium. However, it is noteworthy that Fusobacterium can cause this condition.展开更多
To evaluate risk factors of biliary anastomotic complications （BACs） and outcomes according to type of biliary reconstruction. METHODS： A total of 33 consecutive adult living donor liver transplantation （LDLT） we...To evaluate risk factors of biliary anastomotic complications （BACs） and outcomes according to type of biliary reconstruction. METHODS： A total of 33 consecutive adult living donor liver transplantation （LDLT） were reviewed, 17 of which had undergone Duct-to-Duct anastomosis （D-D）. The remaining 16 patients received Roux-en-Y anastomosis （R-Y）. The perioperative factors, such as the type of graft and the number of graft bile ducts, were analyzed retrospectively. RESULTS： The overall incidence of BACs was 39.4%. The incidence of BACs was significantly higher in the patients with than without neoadjuvant chemotherapy （71.4% vs 10%, P = 0.050）. There was no significant difference in the incidence of biliary leakage in patients with D-D vs. those with R-Y. The incidence of biliary strictures following the healing of biliary leakage was significantly higher in D-D （60%） than in R-Y （0%） （P = 0.026）. However, the incidence of BACs related bacteremia was significantly higher in R-Y than in D-D （71.4% vs 0%, P = 0.008）. In D-D, use of T-tube stent remarkably reduced the incidence of 8ACs, compared with straight tube stent （0% vs 50%, P = 0.049）. CONCLUSION： Our experience showed an increase of BACs related bacteremia in the patients with R-Y. Therefore, D-D might be a preferred biliary reconstruction. However, the surgical refinement of D-D should be required because of the high incidence of biliary strictures. Use of the T-tube stent might lead to a significant reduction of BACs in D-D.展开更多
Primary histiocytic sarcoma of the spleen is a rare but potentially lethal condition. It can remain asymptomatic or only mildly symptomatic for a long time. An 81-year-old woman presented with an extremely enlarged sp...Primary histiocytic sarcoma of the spleen is a rare but potentially lethal condition. It can remain asymptomatic or only mildly symptomatic for a long time. An 81-year-old woman presented with an extremely enlarged spleen. She suffered from progressive anemia and required a red blood cell transfusion once a month. Although computed tomography, ultrasonography, and magnetic resonance imaging were performed for diagnosis, a confirmed diagnosis was not obtained. Her enlarged spleen compressed her stomach, and she suffered from gastritis and a sense of gastric fullness just after meals. She underwent laparoscopic splenectomy for therapeutic and diagnostic purposes. Her postoperative course was uneventful. After surgery, her red blood cell and platelet counts increased markedly. The tumor was diagnosed as splenic histiocytic sarcoma. Post-surgical chemotherapy was not performed, and the patient died of liver failure due to liver metastasis 5 mo after surgery. Laparoscopic splenectomy is minimally invasive and useful for the relief of symptoms related to hematological disorders. However, in cases of an enlarged spleen, optimal views and working space are limited. In such cases, splenic artery ligation can markedly reduce the size of the spleen, thus facilitating the procedure. The case reported herein suggests that laparoscopic splenectomy may be useful for the treatment of splenic malignancy.展开更多
Recent progress in plasma control studies on the improvement of plasma performance in Heliotron J is reviewed. The supersonic molecular beam injection （SMBI） fueling is successfully applied to Heliotron J plasma. A ...Recent progress in plasma control studies on the improvement of plasma performance in Heliotron J is reviewed. The supersonic molecular beam injection （SMBI） fueling is successfully applied to Heliotron J plasma. A supersonic H2-beam is effectively injected to increase fueling efficiency and generate a peaked density profile. Local fueling with a short-pulsed SMBI can increase the core plasma density and avoid the degradation arising from edge cooling. Second harmonic electron cyclotron current drive （ECCD） experiments were conducted by launching a focused Gaussian beam with a parallel refractive index of -0.05 ≤ Nil 〈 0.6. Results show that the electron cyclotron （EC） driven current is determined not only by Nil but also by local magnetic field （B） structure where the EC power is deposited. Detailed analysis of the observed NI and B dependences is in progress with a ray-tracing simulation using the TRAVIS code. Fast ion velocity distribution was investigated using fast protons generated by ion cyclotron resonant frequency （ICRF） minority heating. For the standard configuration in Heliotron J, charge ex- change neutral particle analysis （CX-NPA） measurements show higher effective temperature of fast minority protons in the on-axis resonance case compared to that in the HFS （high field side） off-axis resonance case. However, the increase in bulk ion temperature in the HFS resonance case is larger than that in the on-axis resonance.展开更多
Two pairs of high-frequency magnetic probes were installed in the Large Helical Device （LHD）. During the injection of a perpendicular neutral beam, ion cyclotron emissions （ICEs） with the fundamental frequency cor...Two pairs of high-frequency magnetic probes were installed in the Large Helical Device （LHD）. During the injection of a perpendicular neutral beam, ion cyclotron emissions （ICEs） with the fundamental frequency corresponding to the ion cyclotron frequency at the plasma edge were detected, which are the same type of ICE as measured with the former spare ion cyclotron range of frequencies （ICRF） heating antennas. This type of ICE was further investigated with regard to the phase and intensity of signals. Another type of ICE was found in the LHD, and these ICEs were synchronized with bursts of toroidicity induced Alfv^n eigenmodes （TAE） and the rise of intensity of lost ion flux. Therefore the source of these ICEs was thought to be the particles transferred from the core to the outer region of plasma by the TAE bursts. The frequency of ICEs induced by the TAE bursts increases linearly with the magnetic field strength, since the ion cyclotron frequency increases with the magnetic field strength.展开更多
This letter proposes a new tomographic reconstruction procedure based on the Laplacian eigenfunction(LEF) patterns, which are independent of the plasma cross-section and do not require the flux surface information. Th...This letter proposes a new tomographic reconstruction procedure based on the Laplacian eigenfunction(LEF) patterns, which are independent of the plasma cross-section and do not require the flux surface information. The process is benchmarked for the experimental data of Heliotron J plasma and the results are compared with the least-squares approximation by a Phillips–Tikhonov(PT)-type regularization, which is widely used as the standard technique for tomographic reconstruction. The reconstruction based on the LEF is found to be capable of determining the magnetic axis at different time locations efficiently in comparison with the PT-type regularization.展开更多
A new high repetition rate Nd：YAG Thomson scattering system is developed for the Heliotron J helical device. A main purpose of installing the new system is the temporal evolution measurement of a plasma profile for i...A new high repetition rate Nd：YAG Thomson scattering system is developed for the Heliotron J helical device. A main purpose of installing the new system is the temporal evolution measurement of a plasma profile for improved confinement physics such as the edge transport barrier （H-mode） or the internal transport barrier of the helical plasma. The system has 25 spatial points with -10 mm resolution. Two high repetition Nd：YAG lasers （〉 550 m J@ 50 Hz） realize the measurement of the time evolution of the plasma profile with ~10 ms time intervals. Scattered light is collected by a large concave mirror （D----800 mm, f/2.25） with a solid angle of -100 mstr and transferred to interference filter polychromators by optical fiber bundles in a staircase form. The signal is amplified by newly designed fast preamplifiers with DC and AC output, which reduces the low frequency background noise. The signals are digitized with a multi-event QDC, fast gated integrators. The data acquisition is performed by a VME-based system operated by the CINOS.展开更多
Introduction In contrast to familiar developmental anomalies,such as pancreatobiliary maljunction and pancreas divisum,a double orifice of the ampulla of Vater is a much more rare congenital malformation.We encountere...Introduction In contrast to familiar developmental anomalies,such as pancreatobiliary maljunction and pancreas divisum,a double orifice of the ampulla of Vater is a much more rare congenital malformation.We encountered a patient with pancreatolithiasis associated with anatomic variation of Wirsung duct showing a single major duodenal papilla with a double orifice and no minor papilla.展开更多
文摘We report a case of infected iliac artery aneurysm concomitant with liver abscesses caused by Fusobacterium nucleatum. A 58-year-old man developed an aneurysm of the right common iliac artery and liver abscesses. The aneurysm was resected and a femoro-femoral crossover bypass with a knitted Dacron graft was performed for impending rupture. Anaerobic cultures obtained from blood and intramural thrombus were positive for Fusobacterium nucleatum. With antibiotics, the liver abscesses disappeared without drainage. Iliopsoas abscesses developed after surgery, but it was controlled with antibiotics. The patient was free of infection 1 year after the surgery. The causative bacterium was suspected to originate in the oral cavity, because the patient had a notable history of poor chronic periodontal conditions. Clinically, infected aortoiliac aneurysm complicated by Fusobacterium is extremely rare relative to the prevalence of the pathogenic bacterium. However, it is noteworthy that Fusobacterium can cause this condition.
文摘To evaluate risk factors of biliary anastomotic complications （BACs） and outcomes according to type of biliary reconstruction. METHODS： A total of 33 consecutive adult living donor liver transplantation （LDLT） were reviewed, 17 of which had undergone Duct-to-Duct anastomosis （D-D）. The remaining 16 patients received Roux-en-Y anastomosis （R-Y）. The perioperative factors, such as the type of graft and the number of graft bile ducts, were analyzed retrospectively. RESULTS： The overall incidence of BACs was 39.4%. The incidence of BACs was significantly higher in the patients with than without neoadjuvant chemotherapy （71.4% vs 10%, P = 0.050）. There was no significant difference in the incidence of biliary leakage in patients with D-D vs. those with R-Y. The incidence of biliary strictures following the healing of biliary leakage was significantly higher in D-D （60%） than in R-Y （0%） （P = 0.026）. However, the incidence of BACs related bacteremia was significantly higher in R-Y than in D-D （71.4% vs 0%, P = 0.008）. In D-D, use of T-tube stent remarkably reduced the incidence of 8ACs, compared with straight tube stent （0% vs 50%, P = 0.049）. CONCLUSION： Our experience showed an increase of BACs related bacteremia in the patients with R-Y. Therefore, D-D might be a preferred biliary reconstruction. However, the surgical refinement of D-D should be required because of the high incidence of biliary strictures. Use of the T-tube stent might lead to a significant reduction of BACs in D-D.
文摘Primary histiocytic sarcoma of the spleen is a rare but potentially lethal condition. It can remain asymptomatic or only mildly symptomatic for a long time. An 81-year-old woman presented with an extremely enlarged spleen. She suffered from progressive anemia and required a red blood cell transfusion once a month. Although computed tomography, ultrasonography, and magnetic resonance imaging were performed for diagnosis, a confirmed diagnosis was not obtained. Her enlarged spleen compressed her stomach, and she suffered from gastritis and a sense of gastric fullness just after meals. She underwent laparoscopic splenectomy for therapeutic and diagnostic purposes. Her postoperative course was uneventful. After surgery, her red blood cell and platelet counts increased markedly. The tumor was diagnosed as splenic histiocytic sarcoma. Post-surgical chemotherapy was not performed, and the patient died of liver failure due to liver metastasis 5 mo after surgery. Laparoscopic splenectomy is minimally invasive and useful for the relief of symptoms related to hematological disorders. However, in cases of an enlarged spleen, optimal views and working space are limited. In such cases, splenic artery ligation can markedly reduce the size of the spleen, thus facilitating the procedure. The case reported herein suggests that laparoscopic splenectomy may be useful for the treatment of splenic malignancy.
基金supported by the JSPS-CAS Core University Program in the field of "'Plasma and Nuclear Fusion"the Collaboration Program of the Laboratory for Complex Energy Processes. IAE. Kyoto University. the NIFS Collaborative flesearch Program (NIFS10KUHL030. etc.)+1 种基金the NIFS/NINS project of Formation of International Network for Scientific Collaborationsthe Grant-in-Aid for Sci.Research. MEXT
文摘Recent progress in plasma control studies on the improvement of plasma performance in Heliotron J is reviewed. The supersonic molecular beam injection （SMBI） fueling is successfully applied to Heliotron J plasma. A supersonic H2-beam is effectively injected to increase fueling efficiency and generate a peaked density profile. Local fueling with a short-pulsed SMBI can increase the core plasma density and avoid the degradation arising from edge cooling. Second harmonic electron cyclotron current drive （ECCD） experiments were conducted by launching a focused Gaussian beam with a parallel refractive index of -0.05 ≤ Nil 〈 0.6. Results show that the electron cyclotron （EC） driven current is determined not only by Nil but also by local magnetic field （B） structure where the EC power is deposited. Detailed analysis of the observed NI and B dependences is in progress with a ray-tracing simulation using the TRAVIS code. Fast ion velocity distribution was investigated using fast protons generated by ion cyclotron resonant frequency （ICRF） minority heating. For the standard configuration in Heliotron J, charge ex- change neutral particle analysis （CX-NPA） measurements show higher effective temperature of fast minority protons in the on-axis resonance case compared to that in the HFS （high field side） off-axis resonance case. However, the increase in bulk ion temperature in the HFS resonance case is larger than that in the on-axis resonance.
基金supported by NIFS budgets NIFS10ULRR003,NIFS11ULRR703,and NIFS11PLRR302
文摘Two pairs of high-frequency magnetic probes were installed in the Large Helical Device （LHD）. During the injection of a perpendicular neutral beam, ion cyclotron emissions （ICEs） with the fundamental frequency corresponding to the ion cyclotron frequency at the plasma edge were detected, which are the same type of ICE as measured with the former spare ion cyclotron range of frequencies （ICRF） heating antennas. This type of ICE was further investigated with regard to the phase and intensity of signals. Another type of ICE was found in the LHD, and these ICEs were synchronized with bursts of toroidicity induced Alfv^n eigenmodes （TAE） and the rise of intensity of lost ion flux. Therefore the source of these ICEs was thought to be the particles transferred from the core to the outer region of plasma by the TAE bursts. The frequency of ICEs induced by the TAE bursts increases linearly with the magnetic field strength, since the ion cyclotron frequency increases with the magnetic field strength.
基金performed under the auspices of the NIFS Bilateral Collaboration Research Program (NIFS10KUHL037)partly supported by Grant-in-aid for Scientific Research (B) 18H01202 from the Japan Society for the Promotion of Science (JSPS) and JSPS-CAS Joint Research Program, Grant number JPJSBP120197202supported by JSPS Core-to-Core Program A. Advanced Research Networks,'PLADyS'。
文摘This letter proposes a new tomographic reconstruction procedure based on the Laplacian eigenfunction(LEF) patterns, which are independent of the plasma cross-section and do not require the flux surface information. The process is benchmarked for the experimental data of Heliotron J plasma and the results are compared with the least-squares approximation by a Phillips–Tikhonov(PT)-type regularization, which is widely used as the standard technique for tomographic reconstruction. The reconstruction based on the LEF is found to be capable of determining the magnetic axis at different time locations efficiently in comparison with the PT-type regularization.
基金supported by the Collaboration Program of the Laboratory for Complex Energy Processes,IAE,Kyoto Universitythe NIFS Collaborative Research Program (NIFS10KUHL030,NIFS09KUHL028,NIFS10KUHL033)
文摘A new high repetition rate Nd：YAG Thomson scattering system is developed for the Heliotron J helical device. A main purpose of installing the new system is the temporal evolution measurement of a plasma profile for improved confinement physics such as the edge transport barrier （H-mode） or the internal transport barrier of the helical plasma. The system has 25 spatial points with -10 mm resolution. Two high repetition Nd：YAG lasers （〉 550 m J@ 50 Hz） realize the measurement of the time evolution of the plasma profile with ~10 ms time intervals. Scattered light is collected by a large concave mirror （D----800 mm, f/2.25） with a solid angle of -100 mstr and transferred to interference filter polychromators by optical fiber bundles in a staircase form. The signal is amplified by newly designed fast preamplifiers with DC and AC output, which reduces the low frequency background noise. The signals are digitized with a multi-event QDC, fast gated integrators. The data acquisition is performed by a VME-based system operated by the CINOS.
文摘Introduction In contrast to familiar developmental anomalies,such as pancreatobiliary maljunction and pancreas divisum,a double orifice of the ampulla of Vater is a much more rare congenital malformation.We encountered a patient with pancreatolithiasis associated with anatomic variation of Wirsung duct showing a single major duodenal papilla with a double orifice and no minor papilla.
