Robotic Partial Nephrectomy for a Peripheral Renal Tumor

Partial nephrectomy (PN) is the preferred surgical treatment for T1 renal tumors whenever technically feasible. When properly performed, it allows preservation of nephron mass without compromising oncologic outcomes. This reduces the postoperative risk of renal insufficiency, which translates into better overall survival for the patients. PN can be technically challenging, because it requires the surgeon to complete the tasks of tumor excision, hemostasis and renorrhaphy, all within an ischemic time of preferably below 30 minutes. The surgeon needs to avoid violating the tumor margins while leaving behind the maximal parenchymal volume at the same time. Variations such as zero ischemia, early unclamping, and selective clamping have been developed in an attempt to reduce the negative impact of renal ischemia, but inevitably add to the steep learning curves for any surgeon. Being able to appreciate the fine details of each surgical step in PN is the fundamental basis to the success of this surgery. The use of the robotic assistance allows a good combination of the minimally invasive nature of laparoscopic surgery and the surgical exposure and dexterity of open surgery. It also allows the use of adjuncts such as concurrent ultrasound assessment of the renal mass and intraoperative fluorescence to aid the identification of tumor margins, all with a simple hand switch at the console. Robot-assisted laparoscopic PN is now the most commonly performed type of PN in the United States and is gaining acceptance on the global scale. In this video, we illustrate the steps of robot-assisted laparoscopic PN and highlight the technical key points for success

Meson-Meson Scattering in Relativistic Constraint Dynamics

Dirac's relativistic constraint dynamics have been successfully applied to obtain a covariant nonperturbative description of QED and QCD bound states. We use this formalism to describe a microscopic theory of meson-meson scattering as a relativistic generalization of the nonrelativistic quark-interchange model developed by Barnes and Swanson.Comment: 5 pages, 1 figure in LaTex, talk present at the First Meeting of the APS Topical Group on Hadronic Physics (Fermilab, October 24-26, 2004

Spin-Injection Spectroscopy of a Spin-Orbit Coupled Fermi Gas

The coupling of the spin of electrons to their motional state lies at the heart of recently discovered topological phases of matter. Here we create and detect spin-orbit coupling in an atomic Fermi gas, a highly controllable form of quantum degenerate matter. We reveal the spin-orbit gap via spin-injection spectroscopy, which characterizes the energy-momentum dispersion and spin composition of the quantum states. For energies within the spin-orbit gap, the system acts as a spin diode. To fully inhibit transport, we open an additional spin gap, thereby creating a spin-orbit coupled lattice whose spinful band structure we probe. In the presence of s-wave interactions, such systems should display induced p-wave pairing, topological superfluidity, and Majorana edge states

Impact of positive surgical margins on overall survival after partial nephrectomy—A matched comparison based on the National Cancer Database

Introduction The impact of positive surgical margins (PSM) in partial nephrectomy (PN) has been a controversy. Previous studies on the relationship between PSM and overall survival (OS) were either underpowered or had highly dissimilar groups. We used the National Cancer Database with propensity score matching to determine the association between PSM and OS after PN. Materials and methods We identified patients with T1/T2 N0M0 renal cancer treated with PN between 2004 and 2009, and divided them into 2 groups based on their margin status. We used propensity score matching to ensure similarities in age, comorbidity score (CCI), tumor size, histology, and grade between groups. Covariates were compared by χ2 test. Cox multiple regression was used to estimate the hazard ratios (HR) for all-cause mortality. OS between matched groups were compared by log-rank, Breslow and Tarone-Ware tests. Results After excluding those with missing data on margin or survival status, 20,762 patients were eligible for matching. Each matched group had 1,265 patients, similar in age, sex, race, CCI, tumor size, histology, and grade. There were 386 recorded all-cause mortalities over a median follow-up duration of 72.6 months. Cox multiple regression showed a higher risk of all-cause mortality among cases with PSM (HR: 1.393, P = 0.001). Old age, high CCI, and large tumors had higher risks, while papillary and chromophore histologic subtypes had lower risks. PSM was associated with significantly worse OS by log-rank, Breslow, and Tarone-Ware tests. Conclusion PSM is associated with significantly worse OS after PN

Potential Models and Lattice Gauge Current-Current Correlators

We compare current-current correlators in lattice gauge calculations with correlators in different potential models, for a pseudoscalar charmonium in the quark-gluon plasma. An important ingredient in the evaluation of the current-current correlator in the potential model is the basic principle that out of the set of continuum states, only resonance states and Gamow states with lifetimes of sufficient magnitudes can propagate as composite objects and can contribute to the current-current correlator. When the contributions from the bound states and continuum states are properly treated, the potential model current-current correlators obtained with the potential proposed in Ref. [11] are consistent with the lattice gauge correlators. The proposed potential model thus gains support to be a useful tool to complement lattice gauge calculations for the study of $Q\bar Q$ states at high temperatures.Comment: 18 pages, 4 figures, to be published in Physcial Review

Surgery for scoliosis in Duchenne muscular dystrophy

published_or_final_versio

Surgery for scoliosis in Duchenne muscular dystrophy

Reviewpublished_or_final_versio

Quarkonia and Quark Drip Lines in Quark-Gluon Plasma

We extract the $Q$-$\bar Q$ potential by using the thermodynamic quantities obtained in lattice gauge calculations. The potential is tested and found to give dissociation temperatures that agree well with those from lattice gauge spectral function analysis. Using such a $Q$-$\bar Q$ potential, we examine the quarkonium states in a quark-gluon plasma and determine the `quark drip lines' which separate the region of bound color-singlet $Q\bar Q$ states from the unbound region. The characteristics of the quark drip lines severely limit the region of possible bound $Q\bar Q$ states with light quarks to temperatures close to the phase transition temperature. Bound quarkonia with light quarks may exist very near the phase transition temperature if their effective quark mass is of the order of 300-400 MeV and higher.Comment: 24 pages, 13 figures, in LaTe

Singularity Structures in Coulomb-Type Potentials in Two Body Dirac Equations of Constraint Dynamics

Two Body Dirac Equations (TBDE) of Dirac's relativistic constraint dynamics have been successfully applied to obtain a covariant nonperturbative description of QED and QCD bound states. Coulomb-type potentials in these applications lead naively in other approaches to singular relativistic corrections at short distances that require the introduction of either perturbative treatments or smoothing parameters. We examine the corresponding singular structures in the effective potentials of the relativistic Schroedinger equation obtained from the Pauli reduction of the TBDE. We find that the relativistic Schroedinger equation lead in fact to well-behaved wave function solutions when the full potential and couplings of the system are taken into account. The most unusual case is the coupled triplet system with S=1 and L={(J-1),(J+1)}. Without the inclusion of the tensor coupling, the effective S-state potential would become attractively singular. We show how including the tensor coupling is essential in order that the wave functions be well-behaved at short distances. For example, the S-state wave function becomes simply proportional to the D-state wave function and dips sharply to zero at the origin, unlike the usual S-state wave functions. Furthermore, this behavior is similar in both QED and QCD, independent of the asymptotic freedom behavior of the assumed QCD vector potential. Light- and heavy-quark meson states can be described well by using a simplified linear-plus-Coulomb-type QCD potential apportioned appropriately between world scalar and vector potentials. We use this potential to exhibit explicitly the origin of the large pi-rho splitting and effective chiral symmetry breaking. The TBDE formalism developed here may be used to study quarkonia in quark-gluon plasma environments.Comment: 23 pages, 4 figure

Explicit Solution of the Time Evolution of the Wigner Function

Previously, an explicit solution for the time evolution of the Wigner function was presented in terms of auxiliary phase space coordinates which obey simple equations that are analogous with, but not identical to, the classical equations of motion. They can be solved easily and their solutions can be utilized to construct the time evolution of the Wigner function. In this paper, the usefulness of this explicit solution is demonstrated by solving a numerical example in which the Wigner function has strong spatial and temporal variations as well as regions with negative values. It is found that the explicit solution gives a correct description of the time evolution of the Wigner function. We examine next the pseudoparticle approximation which uses classical trajectories to evolve the Wigner function. We find that the pseudoparticle approximation reproduces the general features of the time evolution, but there are deviations. We show how these deviations can be systematically reduced by including higher-order correction terms in powers of $\hbar^2$.Comment: 16 pages, in LaTex, invited talk presented at the Wigner Centennial Conference, Pecs, Hungary, July 8-12, 2002, to be published in the Journal of Optics B: Quantum and Classical Optics, June 200