Management of an Accessory Bile Duct Leak Following Pancreaticoduodenectomy: A Novel Approach Utilizing a Percutaneous and Endoscopic Rendezvous.

Biliary leaks are uncommon but morbid complications of pancreaticoduodenectomies, which have historically been managed with percutaneous drainage, reoperation, or a combination of both. We report a de novo percutaneous-endoscopic hepaticojejunostomy from an anomalous right hepatic duct injured during pancreaticoduodenectomy to the afferent bowel limb. The percutaneous-endoscopic hepaticojejunostomy was stented to allow for tract formation with successful stent removal after 5.5 months. One year after the creation of the percutaneous-endoscopic hepaticojejunostomy, the patient remains clinically well without evidence of biliary leak or obstruction

Replica symmetry breaking transition of the weakly anisotropic Heisenberg spin glass in magnetic fields

The spin and the chirality orderings of the three-dimensional Heisenberg spin glass with the weak random anisotropy are studied under applied magnetic fields by equilibrium Monte Carlo simulations. A replica symmetry breaking transition occurs in the chiral sector accompanied by the simultaneous spin-glass order. The ordering behavior differs significantly from that of the Ising SG, despite the similarity in the global symmetry. Our observation is consistent with the spin-chirality decoupling-recoupling scenario of a spin-glass transition.Comment: 4 pages, 4 figure

Gd-EOB-DTPA-Enhanced MRI for Detection of Liver Metastases from Colorectal Cancer: A Surgeon’s Perspective!

Colorectal cancer affects over one million people worldwide annually, with the liver being the most common site of metastatic spread. Adequate resection of hepatic metastases is the only chance for a cure in a subset of patients, and five-year survival increases to 35% with complete resection. Traditionally, computed tomographic imaging (CT) was utilized for staging and to evaluate metastases in the liver. Recently, the introduction of hepatobiliary contrast-enhanced magnetic resonance imaging (MRI) agents including gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Eovist in the United States, Primovist in Europe, or Gd-EOB-DTPA) has proved to be a sensitive method for detection of hepatic metastases. Accurate detection of liver metastases is critical for staging of colorectal cancer as well as preoperative planning

Ordering of the Heisenberg Spin Glass in High Dimensions

Ordering of the Heisenberg spin glass with the nearest-neighbor Gaussian coupling is investigated by equilibrium Monte Carlo simulations in four and five dimensions. Ordering of the mean-field Heisenberg spin-glass is also studied for comparison. Particular attention is paid to the nature of the spin-glass and the chiral-glass orderings. Our numerical data suggest that, in five dimensions, the model exhibits a single spin-glass transition at a finite temperature, where the spin-glass order accompanying the simultaneous chiral-glass order sets in. In four dimensions, by contrast, the model exhibits a chiral-glass transition at a finite temperature, not accompanying the standard spin-glass order. The critical region associated with the chiral-glass transition, however, is very narrow, suggesting that dimension four is close to the marginal dimensionality.Comment: 18 pages, 12 figure

Ordering of the three-dimensional Heisenberg spin glass in magnetic fields

Spin and chirality orderings of the three-dimensional Heisenberg spin glass are studied under magnetic fields in light of the recently developed spin-chirality decoupling-recoupling scenario. It is found by Monte Carlo simulations that the chiral-glass transition and the chiral-glass ordered state, which are essentially of the same character as their zero-field counterparts, occur under magnetic fields. Implication to experimental phase diagram is discussed.Comment: 5 pages, 3 figure

"Glassy Dynamics" in Ising Spin Glasses -- Experiment and Simulation

The field-cooled magnetization (FCM) processes of Ising spin glasses under relatively small fields are investigated by experiment on Fe_{0.55}Mn_{0.45}TiO_3 and by numerical simulation on the three-dimensional Edwards-Anderson model. Both results are explained in a unified manner by means of the droplet picture. In particular, the cusp-like behavior of the FCM is interpreted as evidence, not for an equilibrium phase transition under a finite magnetic field, but for a dynamical (`blocking') transition frequently observed in glassy systems.Comment: 4 pages, 7 figure

Dynamical Critical Phenomena in three-dimensional Heisenberg Spin Glasses

Spin-glass (SG) and chiral-glass (CG) orderings in three dimensional (3D) Heisenberg spin glass with and without magnetic anisotropy are studied by using large-scale off-equilibrium Monte Carlo simulations. A characteristic time of relaxation, which diverges at a transition temperature in the thermodynamic limit, is obtained as a function of the temperature and the system size. Based on the finite-size scaling analysis for the relaxation time, it is found that in the isotropic Heisenberg spin glass, the CG phase transition occurs at a finite temperature, while the SG transition occurs at a lower temperature, which is compatible with zero. Our results of the anisotropic case support the chirality scenario for the phase transitions in the 3D Heisenberg spin glasses.Comment: 9 pages, 19 figure

Monte Carlo studies of the ordering of the one-dimensional Heisenberg spin glass with long-range power-law interactions

The nature of the ordering of the one-dimensional Heisenberg spin-glass model with a long-range power-law interaction is studied by extensive Monte Carlo simulations, with particular attention to the issue of the spin-chirality decoupling/coupling. Large system sizes up to $L=4096$ are studied. With varying the exponent $\sigma$ describing the power-law interaction, we observe three distinct types of ordering regimes. For smaller $\sigma$, the spin and the chirality order at a common finite temperature with a common correlation-length exponent, exhibiting the standard spin-chirality coupling behavior. For intermediate $\sigma$, the chirality orders at a temperature higher than the spin, exhibiting the spin-chirality decoupling behavior. For larger $\sigma$, both the spin and the chirality order at zero temperature. We construct a phase diagram in the $\sigma$ versus the temperature plane, and discuss implications of the results. Critical properties associated with both the chiral-glass and the spin-glass transitions are also determined.Comment: 28 pages, 26 figures, to appear in J. Phys. Soc. Jp

Improved detectability of small-bowel lesions via capsule endoscopy with computed virtual chromoendoscopy: A pilot study

Objective. Real-time video capsule endoscopy (CE) with flexible spectral imaging color enhancement (FICE) improves visibility of small-bowel lesions. This article aims to clarify whether CE-FICE also improves detectability of small-bowel lesions. Patients and methods. A total of 55 patients who underwent CE at Hiroshima University Hospital during the period November 2009 through March 2010 were enrolled in the study. Five patients were excluded from the study because residues and transit delays prevented sufficient evaluation. Thus, 50 patients participated. Two experienced endoscopists (each having interpreted more than 50 capsule videos) analyzed the images. One interpreted conventional capsule videos; the other, blinded to interpretation of the conventional images, interpreted CE-FICE images obtained at settings 1-3 (setting 1: red 595 nm, green 540 nm, blue 535 nm; setting 2: red 420 nm, green 520 nm, blue 530 nm; setting 3: red 595 nm, green 570 nm, blue 415 nm). Lesions were classified as angioectasia, erosion, ulceration, or tumor. Detectability was compared between the two modalities. Time taken to interpret the capsule videos was also determined. Results. Seventeen angioectasias were identified by conventional CE; 48 were detected by CE-FICE at setting 1, 45 at setting 2, and 24 at setting 3, with significant differences at settings 1 and 2 (p = 0.0003, p < 0.0001, respectively). Detection of erosion, ulceration, and tumor did not differ statistically between conventional CE and CE-FICE, nor did interpretation time (conventional CE 36 ± 6.9 min; CE-FICE setting 1, 36 ± 6.4 min; setting 2, 38 ± 5.8 min; setting 3, 35 ± 6.7 min). Conclusions. CE-FICE is superior in the lesion detection in comparison with conventional CE and improves detection of angioectasia