An isolated mass in the palm, starting manifestation of sarcoidosis

Sarcoidosis is a systemic disease that is characterized with noncaseating granulomatous nodules which present in multiple organs specially lungs (90). Incidence of masses due to Sarcoidosis in upper extremity is low and most cases present in association with involvement of pulmonary hilary lymph nodes. In this article we present a rare case of Sarcoidosis which presented as a single soft tissue mass in hand without osseous or pulmonary hillary lymph node involvement. Incidence of involvement of musculoskeletal system is 1-5 , mostly it occurs in small bones in hands and feet. In most cases involvement of soft tissue in extremities is accompanied with bone lesions. Those cases of soft tissue involvement are generally coincide with pulmonary lymph nodules. To the authors' knowledge, this is the first case of Sarcoidosis that presents without spreading in bones or pulmonary hilar lymph nodes. © 2016 BY THE ARCHIVES OF BONE AND JOINT SURGERY

Nonlinear Optics Quantum Computing with Circuit-QED

One approach to quantum information processing is to use photons as quantum bits and rely on linear optical elements for most operations. However, some optical nonlinearity is necessary to enable universal quantum computing. Here, we suggest a circuit-QED approach to nonlinear optics quantum computing in the microwave regime, including a deterministic two-photon phase gate. Our specific example uses a hybrid quantum system comprising a LC resonator coupled to a superconducting flux qubit to implement a nonlinear coupling. Compared to the self-Kerr nonlinearity, we find that our approach has improved tolerance to noise in the qubit while maintaining fast operation.Comment: 5 pages, 3 figure

Quantum transport of strongly interacting photons in a one-dimensional nonlinear waveguide

We present a theoretical technique for solving the quantum transport problem of a few photons through a one-dimensional, strongly nonlinear waveguide. We specifically consider the situation where the evolution of the optical field is governed by the quantum nonlinear Schr\"odinger equation (NLSE). Although this kind of nonlinearity is quite general, we focus on a realistic implementation involving cold atoms loaded in a hollow-core optical fiber, where the atomic system provides a tunable nonlinearity that can be large even at a single-photon level. In particular, we show that when the interaction between photons is effectively repulsive, the transmission of multi-photon components of the field is suppressed. This leads to anti-bunching of the transmitted light and indicates that the system acts as a single-photon switch. On the other hand, in the case of attractive interaction, the system can exhibit either anti-bunching or bunching, which is in stark contrast to semiclassical calculations. We show that the bunching behavior is related to the resonant excitation of bound states of photons inside the system.Comment: 22 pages, 24 figure

A compact noise covariance matrix model for MVDR beamforming

Acoustic beamforming is routinely used to improve the SNR of the received signal in applications such as hearing aids, robot audition, augmented reality, teleconferencing, source localisation and source tracking. The beamformer can be made adaptive by using an estimate of the time-varying noise covariance matrix in the spectral domain to determine an optimised beam pattern in each frequency bin that is specific to the acoustic environment and that can respond to temporal changes in it. However, robust estimation of the noise covariance matrix remains a challenging task especially in non-stationary acoustic environments. This paper presents a compact model of the signal covariance matrix that is defined by a small number of parameters whose values can be reliably estimated. The model leads to a robust estimate of the noise covariance matrix which can, in turn, be used to construct a beamformer. The performance of beamformers designed using this approach is evaluated for a spherical microphone array under a range of conditions using both simulated and measured room impulse responses. The proposed approach demonstrates consistent gains in intelligibility and perceptual quality metrics compared to the static and adaptive beamformers used as baselines

Aesthetic septorhinoplasty in the burned nose

Patients who have survived thermal injuries to the face suffer severe disfigurement from the devastating deformities of full-thickness facial burns. The nose is the prominent central organ of the face, which has crucial effect on Aesthetic appearance. The plastic surgeon's role to deal with such cases is to undertake procedures to produce a more pleasant look although the target organ could be the non-burned areas of the face. It is a common belief that surgical intervention under the scarred or grafted nose is risky and may result in skin or covering graft necrosis. For this reason, plastic surgeons are cautious and hesitate to perform Aesthetic surgery on burn scarred tissue. We present 13 cases, 10 women and three men with complete or subtotal nasal burn. Classic Aesthetic Rhinoplasty operations were performed to create a better appearance and correct any internal or external deviations. These procedures are carried out under severely burned skins, or previously grafted and reconstructed noses. Cases were followed for about a one-year period. There was no necrosis in any part of skin after surgery. We believe that Aesthetic rhinoplasty can be done safely in these victims with pleasing outcome. The problems that we encountered in these cases were irregularities of burned alar margins, multiple operations and intractable nasal deviation in severe cases. © 2004 Elsevier Ltd and ISBI. All rights reserved

Gastrointestinal pathologistsâ perspective on managing risk in the distal esophagus: convergence on a pragmatic approach

Here, we discuss recent updates and a continuing controversy in the diagnosis and management of Barrett’s esophagus, specifically the recommendation that the irregular Zâ line not be biopsied, the diminished status of ultrashortâ segment Barrett’s esophagus, the evidence basis for excluding and including the requirement of goblet cells for the diagnosis of Barrett’s esophagus, and the conclusion that histologically confirmed lowâ grade dysplasia is best managed with endoscopic ablation rather than surveillance. We reference the American Gastroenterological Association and College of Gastroenterology and the British Society of Gastroenterology guidelines throughout, with the thesis that the field is converging on the concept of applying scarce medical resources to the diagnosis, surveillance, and therapy of patients most likely to derive benefit.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/146991/1/nyas13680.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/146991/2/nyas13680_am.pd

5-year efficacy of all surface laser ablation with cross-linking (ASLA-XTRA) for the treatment of myopia.

The purpose of our study is to examine the long (5-year) efficacy of the all surface laser ablation (ASLA) combined with accelerated cross-linking (CXL) for the treatment of myopia without the use of mitomycin-C (MMC). This retrospective study consisted of 202 eyes of 118 myopic (SD: 2.41, range: - 1.50 to - 12.75 D) patients (44 males, 74 females). Mean age was 28.50 years (SD: 6.45, range: 18 to 51 years) that underwent ASLA with accelerated CXL for the treatment of their myopia. The patients underwent routine postoperative assessment on the 1st, 3rd, 7th day and in the 1st, 3rd, 6th and 12th month, 30th month (±6 months), 4th and 5th year. The mean spherical equivalent (SEq) refractive error changed from - 6.41 ± 2.41 D preoperatively to - 0.02 ± 0.53 D at 5 years postoperatively. The haze score was 0.18, 0.25 and 0.28 at 1, 3 and 6 months postoperatively. At 12 months after the treatment, no eyes had significant corneal haze and in all the following postoperative time intervals the haze traces were gone. ASLA combined with accelerated CXL (ASLA-XTRA) appears to be safe, efficacious and offering very good refractive results. The potential additional benefits of this modality are the stabilizing effect of the refraction and its sterilization effect on the treated cornea without the potential side effects of MMC

Regulatory t-cells and their impacts on cytokine profile of end-stage renal disease patients suffering from systemic lupus erythematosus

Autoimmunity is an identified factor for development of end-stage renal disease (ESRD). Regulatory T-cells (Tregs) play a fundamental role in preventing autoimmunity. This study aimed to determine Treg frequency and its effects on cytokine profile of ESRD patients with and without systemic lupus erythematosus (SLE). Moreover, this study also determines how Treg number is affected by blood transfusion and gender. Peripheral blood mononuclear cells were isolated from 26 ESRD and 10 healthy subjects and stained with anti-CD4, anti-CD25, and anti-FoxP3 antibodies. Treg frequencies in ESRD patients with and without blood transfusion were determined by flow cytometry. Antibodies against human leukocyte antigens (HLAs) were investigated by panel-reactive antibodies screening. Tumor growth factor (TGF)-β1, interleukin (IL)-4, IL-10, TNF-α, IL-17A, and interferon (IFN)-γ serum levels in participants were measured by enzyme-linked immunoasorbent assay (ELISA). ESRD patients with SLE, unlike the patients without SLE, showed a significant reduction in Treg percentage compared to healthy subjects (P < 0.01). All women had a reduced number of Tregs compared to men. Treg number was significantly decreased in ESRD patients with HLA antibodies (P < 0.05). Blood transfusion enhanced Treg development in ESRD patients without SLE, unlike the patients with SLE (P < 0.05). ESRD patients with low Treg showed a reduction in TGF-β1 and IL-4 and an increase in TNF-α and IL-17A levels compared to control groups (P < 0.05�0.0001). However, no change was observed in IL-10 and IFN-γ levels. Treg frequency was negatively associated with the age of patients (P < 0.01), while this association was not observed in healthy subjects. Based on these findings, it can be observed that reduction in Treg number may contribute to ESRD development in patients with SLE. © The Author(s) 2019

Topological Photonics

Topology is revolutionizing photonics, bringing with it new theoretical discoveries and a wealth of potential applications. This field was inspired by the discovery of topological insulators, in which interfacial electrons transport without dissipation even in the presence of impurities. Similarly, new optical mirrors of different wave-vector space topologies have been constructed to support new states of light propagating at their interfaces. These novel waveguides allow light to flow around large imperfections without back-reflection. The present review explains the underlying principles and highlights the major findings in photonic crystals, coupled resonators, metamaterials and quasicrystals.Comment: progress and review of an emerging field, 12 pages, 6 figures and 1 tabl