The surgical management of sex reassignment surgery and its options

GENDER IDENTITY DISORDER (GID) is a unique human condition that is classified behaviorally and treated medically with hormones and surgery in the severe form. This condition has been and still somewhat remains controversial by religious belief, social institutions and health care delivery systems. We described the surgical management of transsexuals, so called SEX　REASSGINMENT SURGERY (SRS) and showed the team for gender treatment, GENDER CLINIC. A gender treatment team composing staff members from the Psychiatric, Plastic Surgery, Urology, Obstetric/Gynecological Surgery, and the Social Service, was established at the Hospital of Okayama University Medical schools in 1999. Female-to-Male procedures include mastectomy, phalloplasty, Phalloplasty are completion and an appurtenance, something pleasing to others. Male-to-Female program includes the genital surgery. The genital change surgery consists of the penile inversion, orchiectomy, vaginoplasty. Other prodedures include reduction thyroid chondroplasty, hair transplant, voice change, laryngeal surgery, epilation with the laser. SRS is the only effective treatment available today in the management of GID. The aesthetic and functional results achievable from various procedures are generally satisfactory and are acceptable to the patients. On the other hand, we should remember that the numerous steps of information for SRS will be required

Nonlinear propagation effect in x-ray parametric amplification during high harmonic generation

We report the realization and characterization of parametric amplification in high harmonic generation around 100 eV using He gas in a double gas jet arrangement. The delay of the seed extreme ultraviolet (XUV) pulse with respect to the amplifier gas jet was scanned by changing the distance between the gas jets. Experiments and numerical calculations show that parametric amplification occurs within a temporal window of several optical cycles. Strong correlation between the seed and amplifier was observed in a shorter, few optical cycles delay range, which appeared as a modulation of the XUV intensity with an unexpected one optical cycle periodicity instead of half optical cycle. Simulations revealed that the strong correlation and also the unusual periodicity was the consequence of the nonlinear effect produced by plasma dispersion on the parametric amplification process during propagation in the amplifier jet.Japan Society for the Promotion of Science (JP19K15402, JP20H00141, JP21H03750); JKA Foundation (KEIRIN RACE); Ministerio de Economía y Competitividad (FIS2017-85526-R); Horizon 2020 Framework Programme (856415); European Metrology Programme for Innovation and Research (20FUN01 TSCAC); Österreichische Nationalstiftung für Forschung, Technologie und Entwicklung (AQUnet).Peer ReviewedPostprint (author's final draft