BACKGROUND During pancreaticoduodenectomy in patients with celiac axis(CA)stenosis due to compression by the median arcuate ligament(MAL),the MAL has to be divided to maintain hepatic blood flow in many cases.However,...BACKGROUND During pancreaticoduodenectomy in patients with celiac axis(CA)stenosis due to compression by the median arcuate ligament(MAL),the MAL has to be divided to maintain hepatic blood flow in many cases.However,MAL division often fails,and success can only be determined intraoperatively.To overcome this problem,we performed endovascular CA stenting preoperatively,and thereafter safely performed pancreaticoduodenectomy.We present this case as a new preoperative treatment strategy that was successful.CASE SUMMARY A 77-year-old man with a diagnosis of pancreatic head cancer presented to our department for surgery.Preoperative assessment revealed CA stenosis caused by MAL.We performed endovascular stenting in the CA preoperatively because we knew that going into the operation without a strategy could lead to ischemic complications.Double-antiplatelet therapy(DAPT)–which is needed when a stent is inserted–was then administered in parallel with neoadjuvant chemotherapy(NAC).This allowed us to administer DAPT for a sufficient period before the main pancreaticoduodenectomy procedure while obtaining therapeutic effects from NAC.Subtotal stomach-preserving pancreaticoduodenectomy was thenperformed.The operation did not require any unusual techniques and was performed safely.Postoperatively,the patient progressed well,without any ischemic complications.Histopathologically,curative resection was confirmed,and the patient had no recurrence or complications due to ischemia up to six months postoperatively.CONCLUSION Preoperative endovascular stenting,with NAC and DAPT,is effective and safe prior to pancreaticoduodenectomy in potentially resectable pancreatic cancer.展开更多
Lattice-strained Si thin films grown onto SiGe(110)/Si(110) are attracting because of their potential to realize high-speed transistors. In this study we observe surface morphology of Si/SiGe/Si(110) using scanning el...Lattice-strained Si thin films grown onto SiGe(110)/Si(110) are attracting because of their potential to realize high-speed transistors. In this study we observe surface morphology of Si/SiGe/Si(110) using scanning electron microscopy and we also observe microstructure of the identical position using cross-sectional transmission electron microscopy. These results reveal that crossing of stress-induced twins causes remarkable surface roughness. We propose using vicinal substrate to avoid this phenomenon and our successive experimental results are shown in this paper.展开更多
A moiré between crystal lattice planes and scanning electron beam-lines formed in a scanning transmission electron microscope includes the information of the lattice spacing. We apply these phenomena to a composi...A moiré between crystal lattice planes and scanning electron beam-lines formed in a scanning transmission electron microscope includes the information of the lattice spacing. We apply these phenomena to a compositionally graded SiGe thin film deposited onto a Si substrate by molecular beam epitaxy method. The results of the experiments and image analysis show the potential of this technique to analyze a slight change of the lattice spacing according to a compositional change.展开更多
文摘BACKGROUND During pancreaticoduodenectomy in patients with celiac axis(CA)stenosis due to compression by the median arcuate ligament(MAL),the MAL has to be divided to maintain hepatic blood flow in many cases.However,MAL division often fails,and success can only be determined intraoperatively.To overcome this problem,we performed endovascular CA stenting preoperatively,and thereafter safely performed pancreaticoduodenectomy.We present this case as a new preoperative treatment strategy that was successful.CASE SUMMARY A 77-year-old man with a diagnosis of pancreatic head cancer presented to our department for surgery.Preoperative assessment revealed CA stenosis caused by MAL.We performed endovascular stenting in the CA preoperatively because we knew that going into the operation without a strategy could lead to ischemic complications.Double-antiplatelet therapy(DAPT)–which is needed when a stent is inserted–was then administered in parallel with neoadjuvant chemotherapy(NAC).This allowed us to administer DAPT for a sufficient period before the main pancreaticoduodenectomy procedure while obtaining therapeutic effects from NAC.Subtotal stomach-preserving pancreaticoduodenectomy was thenperformed.The operation did not require any unusual techniques and was performed safely.Postoperatively,the patient progressed well,without any ischemic complications.Histopathologically,curative resection was confirmed,and the patient had no recurrence or complications due to ischemia up to six months postoperatively.CONCLUSION Preoperative endovascular stenting,with NAC and DAPT,is effective and safe prior to pancreaticoduodenectomy in potentially resectable pancreatic cancer.
文摘Lattice-strained Si thin films grown onto SiGe(110)/Si(110) are attracting because of their potential to realize high-speed transistors. In this study we observe surface morphology of Si/SiGe/Si(110) using scanning electron microscopy and we also observe microstructure of the identical position using cross-sectional transmission electron microscopy. These results reveal that crossing of stress-induced twins causes remarkable surface roughness. We propose using vicinal substrate to avoid this phenomenon and our successive experimental results are shown in this paper.
文摘A moiré between crystal lattice planes and scanning electron beam-lines formed in a scanning transmission electron microscope includes the information of the lattice spacing. We apply these phenomena to a compositionally graded SiGe thin film deposited onto a Si substrate by molecular beam epitaxy method. The results of the experiments and image analysis show the potential of this technique to analyze a slight change of the lattice spacing according to a compositional change.
