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Retroperitoneal cavernous hemangioma, a rare vascular tumor, has only 30 PubMed cases. Preoperative diagnostic criteria are unclear and often present asymptomatically until complications such as rupture or compression arise.We present a 73-year-old with chronic abdominal pain and a giant retroperitoneal tumor. Computed tomography (CT) and magnetic resonance imaging (MRI) revealed an irregular space-occupying mass in the retroperitoneum, suggesting a retroperitoneal chronic expanding hematoma. Total surgical resection confirmed the diagnosis as retroperitoneal cavernous hemangioma.

Objectives It has been hypothesised that smoking intensity may be related to occupational stress. This study aimed to investigate whether stress, including problems with superiors or co-workers, is a driver of smoking.Design Cross-sectional study.Setting and participants 59 355 employees (34 865 men and 24 490 women) across multiple occupations who completed a self-reported questionnaire-based occupational stress survey between April 2016 and March 2017 in Niigata Prefecture.Main outcome measures Stress scores for the Brief Job Stress Questionnaire subscales summed up after assigning high points for high stress and converted to Z-scores based on the mean of all participants. Heavy smokers (HS) smoked ≥15 cigarettes/day and light smokers (LS) smoked

Abstract Background Pancreatic fistula is one of the serious complications for patients undergoing distal pancreatectomy, which leads to significant morbidity. The aim of our study is to compare linear stapling closure plus continuous suture with linear stapling closure alone during laparoscopic distal pancreatectomy (LDP) in terms of clinically relevant postoperative pancreatic fistula (POPF) rate. Methods Twenty-two patients underwent LDP at our institution between 2011 and 2013. Twelve patients had linear stapling closure with peri-firing compression (LSC) alone compared with ten patients who had linear stapling closure, peri-firing compression plus continuous suture (LSC/CS) for stump closure of remnant pancreas in LDP. Biochemical leak and clinically relevant POPF were compared between both groups. Results POPF occurred in 4 of 12 (33.3%) patients with linear stapling closure while no patient developed a clinically relevant POPF in the triple combination of linear stapling, peri-firing compression plus continuous suture group (p = 0.043).1 patient (8.3%) in the LSC group and 5 patients (50%) in the LSC/CS group had evidence of a biochemical leak. There were no significant differences in operative time (188.3 vs 187.0 min) and blood loss (135 vs. 240 g) between both groups but there was a significantly of shorter length of hospital stay (11.9 vs. 19.9 days) in LSC/CS group (p = 0.037). There was no mortality in either group. Conclusions The triple combination of linear stapling, peri-firing compression plus continuous suture in LDP has effectively prevented occurrence of clinically relevant ISGPF POPF. Trial registration The study was retrospectively registered September 30, 2019 at Showa University Ethics Committee as IRB protocol numbers 2943.

Characterizing and controlling the uniformity of nanoparticles is crucial for their application in science and technology because crystalline defects in the nanoparticles strongly affect their unique properties. Recently, ultra-short and ultra-bright X-ray pulses provided by X-ray free-electron lasers (XFELs) opened up the possibility of structure determination of nanometre-scale matter with Å spatial resolution. However, it is often difficult to reconstruct the 3D structural information from single-shot X-ray diffraction patterns owing to the random orientation of the particles. This report proposes an analysis approach for characterizing defects in nanoparticles using wide-angle X-ray scattering (WAXS) data from free-flying single nanoparticles. The analysis method is based on the concept of correlated X-ray scattering, in which correlations of scattered X-ray are used to recover detailed structural information. WAXS experiments of xenon nanoparticles, or clusters, were conducted at an XFEL facility in Japan by using the SPring-8 Ångstrom compact free-electron laser (SACLA). Bragg spots in the recorded single-shot X-ray diffraction patterns showed clear angular correlations, which offered significant structural information on the nanoparticles. The experimental angular correlations were reproduced by numerical simulation in which kinematical theory of diffraction was combined with geometric calculations. We also explain the diffuse scattering intensity as being due to the stacking faults in the xenon clusters.

Abstract Background There are no established standard criteria for choosing the most appropriate procedure of splenic artery dissection during laparoscopic distal pancreatectomy (LDP). The aim of this study was to evaluate the clinical benefits of individualized procedures for splenic artery dissection during LDP based on the variations in arterial structure visualized on preoperative three-dimensional computed tomography (3D-CT). Methods Patients who underwent LDP following 3D-CT at a single center were retrospectively evaluated. 3D-CT images were used to construct virtual 3D laparoscopic images for surgical planning. The splenic artery was classified into two major anatomic types: type S that curves and runs suprapancreatic and type D that runs straight and dorsal to the pancreas. Splenic artery dissection was planned according to these two variations, with type S dissected using an suprapancreatic approach and type D using a dorsal approach. Results Type-specific dissection was applied for 30 patients: 25 (83%) with type S and 5 (17%) with type D splenic artery anatomies. In 25 (83%) patients, the splenic artery was successfully dissected using the planned surgical procedure, whereas the surgical plan had to be altered in 5 cases (17%) due to difficulty in dissecting the splenic artery. Conclusion The individualized procedures for splenic artery dissection according to anatomic variations visualized on 3D-CT images can help improve the success and safety of LDP.

With the emergence of X-ray free-electron lasers, it is possible to investigate the structure of nanoscale samples by employing coherent diffractive imaging in the X-ray spectral regime. In this work, we developed a refinement method for structure reconstruction applicable to low-quality coherent diffraction data. The method is based on the gradient search method and considers the missing region of a diffraction pattern and the small number of detected photons. We introduced an initial estimate of the structure in the method to improve the convergence. The present method is applied to an experimental diffraction pattern of an Xe cluster obtained in an X-ray scattering experiment at the SPring-8 Angstrom Compact free-electron LAser (SACLA) facility. It is found that the electron density is successfully reconstructed from the diffraction pattern with a large missing region, with a good initial estimate of the structure. The diffraction pattern calculated from the reconstructed electron density reproduced the observed diffraction pattern well, including the characteristic intensity modulation in each ring. Our refinement method enables structure reconstruction from diffraction patterns under difficulties such as missing areas and low diffraction intensity, and it is potentially applicable to the structure determination of samples that have low scattering power.

We report an experimental observation of mesoscopic fluctuations underlying the thermodynamic anomalies of ambient liquid water. The combination of two sound-velocity-measurement methods with largely different frequencies, namely inelastic x-ray scattering (IXS) in the terahertz band and ultrasonic (US) in the megahertz band, allows us to investigate a relaxation phenomenon that has a characteristic frequency between the two aforementioned frequencies. We performed IXS measurements to obtain the IXS sound velocity of liquid water from the ambient conditions to the supercritical region of liquid–gas phase transition (LGT) and compared the results with the US sound velocity reported in the literature. We found that the ratio of the sound velocities, S_{f}, which corresponds to the relaxation strength, obtained using these two methods exhibits a simple but significant change. Two distinct rises were observed in the high- and low-temperature regions, implying that two relaxation phenomena exist. In the high-temperature region, a peak was observed near the LGT critical ridge line, which was linked to changes in the magnitude of density fluctuation and isochoric and isobaric-specific heat capacities. This result indicates that the high-temperature relaxation originates from the LGT critical fluctuation, proving that this method is effective for observing such mesoscopic fluctuations. Meanwhile, in the low-temperature region, S_{f} increased from 550 K toward the low-temperature region and reached a high value, attaining the “fast sound” state under ambient conditions. This result indicates that another mechanism of relaxation exists, which causes the sound velocity anomaly, including the “fast sound” phenomenon of liquid water under ambient conditions. The change in S_{f} in the low-temperature region is linked to the change in the isochoric heat capacity, which identified that this relaxation causes the well-known heat capacity anomaly of liquid water. This low-temperature relaxation corresponds to the critical fluctuation of the liquid–liquid phase transition (LLT) that is speculated to exist in the supercooled region. In this study, both LGT and LLT critical fluctuations were observed, and the relationship between thermodynamics and the critical fluctuations was comprehensively discussed by analyzing the similarities and differences between the two phase transitions.

When a nanoparticle is irradiated by an intense laser pulse, it turns into a nanoplasma, a transition that is accompanied by many interesting nonequilibrium dynamics. So far, most experiments on nanoplasmas use ion measurements, reflecting the outside dynamics in the nanoparticle. Recently, the direct observation of the ultrafast structural dynamics on the inside of the nanoparticle also became possible with the advent of x-ray free electron lasers (XFELs). Here, we report on combined measurements of structural dynamics and speeds of ions ejected from nanoplasmas produced by intense near-infrared laser irradiations, with the control of the initial plasma conditions accomplished by widely varying the laser intensity (9×10^{14} W/cm^{2} to 3×10^{16} W/cm^{2}). The structural change of nanoplasmas is examined by time-resolved x-ray diffraction using an XFEL, while the kinetic energies of ejected ions are measured by an ion time-of-fight method under the same experimental conditions. We find that the timescale of crystalline disordering in nanoplasmas strongly depends on the laser intensity and scales with the inverse of the average speed of ions ejected from the nanoplasma. The observations support a recently suggested scenario for nanoplasma dynamics in the wide intensity range, in which crystalline disorder in nanoplasmas is caused by a rarefaction wave propagating at a speed comparable with the average ion speed from the surface toward the inner crystalline core. We demonstrate that the scenario is also applicable to nanoplasma dynamics in the hard x-ray regime. Our results connect the outside nanoplasma dynamics to the loss of structure inside the sample on the femtosecond timescale.

Inelastic x-ray scattering measurements using high-pressure apparatus were carried out for liquid Te up to 1673 K above the boiling point at the normal pressure. We could obtain the dynamic structure factor S(Q,E) of good quality at 1.8 ≤ Q ≤ 22 nm−1. Although the excitation energies of the acoustic mode are fluctuating more at lower temperatures, we found that the dynamical sound speed at 1.8 and 2.1 nm−1 becomes fast with increasing temperature from 773 to 923 K, similarly to the temperature dependence of ultrasonic sound speed in liquid Te. Despite this unusual temperature dependence at the lowest Q, the sound speed at higher Q is consistent with those obtained by the previous inelastic neutron and x-ray scattering studies, in which the dynamical sound just slows down with increasing temperature. The present results may be correlated with the temperature-driven semiconductor-metal transition in liquid Te, and if so, it is inferred that a domain size of inhomogeneity induced with the transition is comparable to the wave length corresponding to the lowest Q. Keywords: Inelastic x-ray scattering, Atomic dynamics, Collective mode, Semiconductor-metal transition, Liquid chalcogen

X-ray free-electron lasers (XFELs) deliver ultrashort coherent laser pulses in the X-ray spectral regime, enabling novel investigations into the structure of individual nanoscale samples. In this work, we demonstrate how single-shot small-angle X-ray scattering (SAXS) measurements combined with fluorescence and ion time-of-flight (TOF) spectroscopy can be used to obtain size- and structure-selective evaluation of the light-matter interaction processes on the nanoscale. We recorded the SAXS images of single xenon clusters using XFEL pulses provided by the SPring-8 Angstrom compact free-electron laser (SACLA). The XFEL fluences and the radii of the clusters at the reaction point were evaluated and the ion TOF spectra and fluorescence spectra were sorted accordingly. We found that the XFEL fluence and cluster size extracted from the diffraction patterns showed a clear correlation with the fluorescence and ion TOF spectra. Our results demonstrate the effectiveness of the multispectroscopic approach for exploring laser−matter interaction in the X-ray regime without the influence of the size distribution of samples and the fluence distribution of the incident XFEL pulses.

Mycoplasma fermentans possesses unique α-glycolipid antigens (GGPL-I and GGPL-III) at the cytoplasm membrane, which carry a phosphocholine group at the sugar primary (6-OH) position. This paper describes a practical synthetic pathway to a GGPL-I homologue (C16:0) and its diastereomer, in which our one-pot α-glycosylation method was effectively applied. The synthetic GGPL-I isomers were characterized with 1H NMR spectroscopy to determine the equilibrium among the three conformers (gg, gt, tg) at the acyclic glycerol moiety. The natural GGPL-I isomer was found to prefer gt (54%) and gg (39%) conformers around the lipid tail, while adopting all of the three conformers with equal probability around the sugar position. This property was very close to what we have observed with respect to the conformation of phosphatidylcholine (DPPC), suggesting that the Mycoplasma glycolipids GGPLs may constitute the cytoplasm fluid membrane together with ubiquitous phospholipids, without inducing stereochemical stress.

Tenryocha, rooibos, and guava teas are widely consumed as herbal beverages, especially as a therapy against pollen allergy. To investigate the possible herbal tea-drug interaction the effect of continuous ingestion of these teas on cytochrome P450 (CYP) 3A were studied. Rats (n = 6) were allowed free access to either tea (experimental groups) or water (control) for two weeks. Midazolam (MDZ) (20 mg/kg) was orally administered and the serum concentration was determined. The area under the serum concentration-time curve (AUC0–∞) and the maximum serum concentrations (Cmax) of MDZ were reduced by more than 60% after the treatment of tenryocha and rooibos tea (P