Reconstructive challenge of dermatofibrosarcoma protuberans in the female breast

Dermatofibrosarcoma protuberans is an uncommon locally aggressive malignant neoplasm that most frequently appears in the trunk, followed by the extremities, head, and neck. But occurrence in the breast is extremely rare. We present a case of a 28-year-old woman, who had a history of trauma 5 years previously and excision 1 year before presentation at our clinic. We performed wide excision, together with microscopic and immunohistochemical analysis. No postoperative oncologic treatment was used and she remains disease-free 1 year after the surgery without any tumor recurrence. Here, we report a case of dermatofibrosarcoma protuberans in the female breast and present a detailed discussion of the diagnosis and treatment with reference to available literatures

Microscopic Theory of Rashba Interaction in Magnetic Metal

Theory of Rashba spin-orbit coupling in magnetic metals is worked out from microscopic Hamiltonian describing d-orbitals. When structural inversion symmetry is broken, electron hopping between $d$-orbitals generates chiral ordering of orbital angular momentum, which combines with atomic spin-orbit coupling to result in the Rashba interaction. Rashba parameter characterizing the interaction is band-specific, even reversing its sign from band to band. Large enhancement of the Rashba parameter found in recent experiments is attributed to the orbital mixing of 3d magnetic atoms with non-magnetic heavy elements as we demonstrate by first-principles and tight-binding calculations.Comment: 5 pages, 2 figure

Orbital-selective confinement effect of Ru 4d4d orbitals in SrRuO3_3 ultrathin film

The electronic structure of SrRuO$_3$ thin film with thickness from 50 to 1 unit cell (u.c.) is investigated via the resonant inelastic x-ray scattering (RIXS) technique at the O K-edge to unravel the intriguing interplay of orbital and charge degrees of freedom. We found that orbital-selective quantum confinement effect (QCE) induces the splitting of Ru $4d$ orbitals. At the same time, we observed a clear suppression of the electron-hole continuum across the metal-to-insulator transition (MIT) occurring at the 4 u.c. sample. From these two clear observations we conclude that QCE gives rise to a Mott insulating phase in ultrathin SrRuO$_3$ films. Our interpretation of the RIXS spectra is supported by the configuration interaction calculations of RuO$_6$ clusters.Comment: 7 pages, 7 figure

Evaluation of the internal stability of well-graded silty sand through the long-term seepage test

Suffusion is the phenomenon responsible for internal erosion, and is the process by which finer soil particles are moved through the constrictions between the larger soil particles by seepage forces. Generally, gap-graded soil is known to be susceptible to suffusion. Meanwhile, suffusion of well-graded silty sand and the resulting soil behavior are not well understood. Moreover, the previous researches on laboratory suffusion tests focused on the study of the critical hydraulic gradient, which triggers the internal instability of the soils within a short period of time. Therefore, in this study, long-term suffusion tests were conducted on well-graded silty sand under a hydraulic gradient lower than the critical value. As a result, abrupt increases in permeability and amount of soil discharged were observed due to the progressive migration of the soil particles, resulting in suffusion even at a relatively low hydraulic gradient

Reperfusion Injury after Autologous Cranioplasty in a Patient with Sinking Skin Flap Syndrome

The sinking skin flap syndrome is a rare complication after a large craniectomy. It consists of a sunken skin above the bone defect with neurological symptoms such as severe headache, mental changes, focal deficits, or seizures. In patient with sinking skin flap syndrome, cerebral blood flow and cerebral metabolism are decreased by sinking skin flap syndrome, and it may cause the deterioration of autoregulation of brain. We report a case of a patient with sinking skin flap syndrome who suffered from reperfusion injury after cranioplasty with review of pertinent literature

Volumetric analysis and indocyanine green retention rate at 15 min as predictors of post‐hepatectomy liver failure

AbstractObjectivesThe actual future liver remnant (aFLR) is calculated as the ratio of remnant liver volume (RLV) to total functional liver volume (TFLV). The standardized future liver remnant (sFLR) is calculated as the ratio of RLV to standard liver volume (SLV). The aims of this study were to compare the aFLR with the sFLR and to determine criteria for safe hepatectomy using computed tomography volumetry and indocyanine green retention rate at 15 min (ICG R15).MethodsMedical records and volumetric measurements were obtained retrospectively for 81 patients who underwent right hemi‐hepatectomy for malignant hepatic tumours from January 2010 to November 2013. The sFLR was compared with the aFLR, and a ratio of sFLR to ICG R15 as a predictor of postoperative hepatic function was established.ResultsIn patients without cirrhosis, the sFLR showed a stronger correlation with the total serum bilirubin level than the aFLR (R2 = 0.499 versus R2 = 0.239). Post‐hepatectomy liver failure developed only in the group with an sFLR of <25%, regardless of ICG R15. In patients with cirrhosis, the aFLR and sFLR had no correlation with postoperative total serum bilirubin. An sFLR : ICG R15 ratio of >1.9 showed 66.7% sensitivity and 100% specificity.ConclusionsRegardless of ICG R15, an sFLR of ≥25% in patients without cirrhosis, and an sFLR of ≥25% with an sFLR : ICG R15 ratio of >1.9 in patients with cirrhosis indicate acceptable levels of safety in major hepatectomy