Raman Studies of Structural Changes in Diamond-like Carbon Films on Si Induced by Ultrafast Laser Ablation

In this study, the diamond-like carbon (DLC), a tetrahedral amorphous carbon sample deposited on Si, was irradiated using a picosecond laser. We evaluated the picosecond-laser-induced structural and morphological changes in DLC using micro-Raman spectroscopy via line measurements. We obtained the spatial distribution of the structure and morphology of DLC on Si by regression analysis of the Raman spectra. The photo-induced crater could be categorized into four regions: peripheral, morphological-change, structural-changes, and ablated regions. The structure and morphology of the peripheral region were similar to those of the as-received DLC. In the morphological-change region, which is inside the periphery region, the thickness of the DLC decreased without any structural changes. At the center of the crater, which is shown in black in the optical image, two regions were identified by Raman spectroscopy. On the outer side, there is a structural-change region where the graphitization of DLC materialized with a reduction in the film thickness. Inside the structural-change region, there is an ablated region where the DLC was degraded by laser ablation

Pulse Duration Dependence of Novel Metal Alloying on Fe/Cr/Ni Thin Films by Ultra-Short Pulsed Laser Irradiation

We examined the possibility of suppressing elemental segregation of high-entropy alloys (HEAs) using femtosecond laser irradiation. Thin films of iron (Fe), chromium (Cr), and nickel (Ni) were deposited on the surfaces of n-type SiC and p-type GaN substrates. The thicknesses of the Fe, Cr, and Ni films were 12, 7, and 11 nm, respectively. Laser irradiation was performed from the substrate side by focusing on the interface between the Fe film and substrate. Scanning transmission electron microscopy (STEM) bright-field images superimposed on the elemental maps of Fe, Cr, and Ni showed a more homogenous mixing of Fe, Cr, and Ni in the femtosecond-laser-modified region than in the picosecond-laser-modified region. In particular, the Ni distribution showed a significant improvement in homogeneity. In other words, the Ni mixture was more homogeneous in the femtosecond laser-modified region than in the picosecond laser-modified region. Although the duration of the picosecond laser pulse was sufficiently long for atomic diffusion, segregation still occurred during the cooling process following laser irradiation

Relationship between nerve fiber layer defect and the presence of epiretinal membrane in a Japanese population: The JPHC-NEXT Eye Study

The study subjects were residents of Chikusei city, Japan, aged 40 years or older who attended annual health check-up programs and participated in the JPHC-NEXT Eye Study which performed non-mydriatic fundus photography of both eyes. The relationship of glaucomatous fundus changes such as optic disc cupping (cup to disc ratio ≥ 0.7) and retinal nerve fiber layer defect (NFLD) with the presence of epiretinal membrane (ERM) were examined cross-sectionally. A total of 1990 persons gave consent to participate in this study in 2013. The overall prevalence of ERM was 12.9%. Of these, 1755 had fundus photographs of sufficient quality and no history of intraocular surgery (mean age: 62.3 ± 10.0 years). After adjusting for age, sex and refractive error, NFLD was positively associated with the presence of ERM (odds ratio [OR]: 2.48; 95% confidence interval [CI]: 1.24, 4.96; P = 0.010), but optic disc cupping was not (OR: 1.33; CI: 0.71, 2.48; P = 0.37). The results did not necessarily suggest an association between glaucoma and ERM, but indicated an association between NFLD and ERM

Two cases of multiple infarctions due to vertebral arterial occlusion associated with atlantoaxial subluxation caused by rheumatoid arthritis

Case 1: A 58-year-old woman with rheumatoid arthritis (RA) suffered from pontine and cerebellar infarctions and underwent three-dimensional computed tomography angiography (3D-CTA) of the vertebral artery (VA) with left-sided rotation of the head. This revealed a destroyed right atlantoaxial (AA) joint and right VA occlusion, which had caused the infarction. No recurrent infarctions have been observed after transarticular screw fixation (Magerl technique) was performed. Case 2: A 68-yearold woman with RA also suffered from pontine and cerebellar infarctions and underwent 3D-CTA of the VA with right-sided rotation of the head. This revealed a destroyed left AA joint and left VA occlusion, which had caused the infarction. No recurrentinfarctions have been observed after posterior fusion between the occiput and 3rd cervical vertebra was performed. In both cases of RA, who had multiple infarctions due to VA occlusion and a temporary thrombus formation, 3D-CTA in a rotated position helped to diagnose arterial occlusion. In addition, posterior fusion of the AA joint was a useful surgical technique

Development of D-to-D-to-P telemedicine at a remote island hospital using smart glasses

Background: Medical resources on remote islands are limited, which makes it difficult for patients to receive specialized medical care.Purpose: This study aimed to develop and evaluate a method to perform doctor-to-doctor-to-patient (D-to-D-to-P) telemedicine.Methods: The-D-to-D-to-P telemedicine was implemented to provide specialized medical support from a neurologist at Nagasaki University Hospital to a rural physician wearing camera-equipped smart glasses at Goto Chuoh Hospital on a remote island, which was called a virtual neurological outpatient (VNO). For the first six months, the rural physician independently saw patients with Parkinson’s disease (PD), and then for the next six months, VNO was implemented. Comparisons were made before and after the implementation of the VNO. Next, by adding a 4 K overhead camera, in-person examinations of a single outpatient were compared between the rural physician with VNO and another neurologist unrelated to the VNO.Results: The clinical efficacy of VNO was not superior to no VNO, but had a learning effect on rural physicians and was satisfactory for patients. By adding a 4 K overhead camera to the VNO, the accuracy of the in-person examination by the rural physician was shown to be equivalent to that of an in-person neurologist.Conclusion: VNO using smart glasses could be applied for D-to-D-to-P telemedicine in neurology. However, to promote telemedicine on remote islands, it will be necessary to improve the system to make it more accessible to rural physicians

Hepatocellular Carcinoma with Direct Invasion to the Duodenal Bulb, Presenting with Gastrointestinal Bleeding

Hemorrhage from hepatocellular carcinoma (HCC) directly invading the gastrointestinal tract is very rare. A 71-yearold man, who had been treated with transcatheter arterial embolization and percutaneous ethanol injection for HCC in the right hepatic lobe, presented with melena. Endoscopic examination showed a crater-like ulceration coated with blood clot in the duodenal bulb, and microscopic examination of a biopsy specimen from the duodenal lesion confirmed HCC. Abdominal computed tomography (CT) revealed that the HCC mass containing air-density invaded the duodenum. Recurrent bleeding continued from the lesion and the patient died of liver failure. Postmortem examination revealed massive HCC with hepatoduodenal fistula caused by direct tumor invasion into the duodenum