Neoadjuvant concurrent chemoradiotherapy with and without hyperthermia in retroperitoneal sarcomas: feasibility, efficacy, toxicity, and long-term outcome.

PURPOSE: Retroperitoneal (RPS) sarcomas are associated with poor local and abdominal tumor control. However, the benefit of preoperative radio- or chemotherapy alone for these entities is currently unclear. Moreover, as intermediate- and high-grade sarcomas have a tendency toward early metastasis, exploration of neoadjuvant strategies is of high importance. This analysis reports the results of our 20-year single-institution experience with preoperative neoadjuvant concurrent chemoradiation. METHODS: From 2000-2019, 27 patients with intermediate- or high-grade RPS (12 dedifferentiated liposarcoma, 10 leiomyosarcoma, 5 others) were treated with radiotherapy (median dose: 50.4 Gy; range 45-75 Gy) and two cycles of chemotherapy (doxorubicin 50 mg/m2 BSA/d3 q28 and ifosfamide 1.5 g/m2 BSA/d1­5 q28) in neoadjuvant intent. Chemotherapy consisted of doxorubicin alone in two cases and ifosfamide alone in one case. Fifteen patients (56%) additionally received deep regional hyperthermia. RESULTS: The median follow-up time was 53 months (±56.7 months). 92% of patients received two cycles of chemotherapy as planned and 92% underwent surgery. At 5 and 10 years, abdominal-recurrence-free survival was 74.6% (±10.1%) and 66.3% (±11.9%), distant metastasis-free survival was 67.2% (±9.7%) and 59.7% (±11.1%), and overall survival was 60.3% (±10.5%) and 60.3% (±10.5%), respectively. CTC grade III and IV toxicities were leukocytopenia (85%), thrombocytopenia (33%), and anemia (11%). There were no treatment-related deaths. CONCLUSION: Neoadjuvant chemoradiotherapy with and without hyperthermia for retroperitoneal sarcomas is feasible and provided high local control of intermediate- and high-grade sarcoma.

New design of a multi-jet target for quasi phase matching.

An improved dual-gas quasi-phase matching (QPM) foil target for high harmonic generation (HHG) is presented. The target can be setup with 12 individual gas inlets each feeding multiple nozzles separated by a minimum distance of 10 µm. Three-dimensional gas density profiles of these jets were measured using a Mach-Zehnder Interferometer. These measurements reveal how the jets influence the density of gas in adjacent jets and how this leads to increased local gas densities. The analysis shows that the gas profiles of the jets are well defined up to a distance of about 300 µm from the orifice. This target design offers experimental flexibility, not only for HHG/QPM investigations, but also for a wide range of experiments due to the large number of possible jet configurations. We demonstrate the application to controlled phase tuning in the extreme ultraviolet using a 1 kHz-10 mJ-30 fs-laser system where interference between two jets in the spectral range from 17 to 30 nm was observed.

Coherent spectral enhancement of carrier-envelope-phase stable continua with dual-gas high harmonic generation.

Attosecond science is enabled by the ability to convert femtosecond near-infrared laser light into coherent harmonics in the extreme ultraviolet spectral range. While attosecond sources have been utilized in experiments that have not demanded high intensities, substantially higher photon flux would provide a natural link to the next significant experimental breakthrough. Numerical simulations of dual-gas high harmonic generation indicate that the output in the cutoff spectral region can be selectively enhanced without disturbing the single-atom gating mechanism. Here, we summarize the results of these simulations and present first experimental findings to support these predictions.

Pulsed operation of a high average power Yb:YAG thin-disk multipass amplifier.

An Yb:YAG thin-disk multipass laser amplifier system was developed operating in a 10 Hz burst operation mode with 800 µs burst duration and 100 kHz intra-burst repetition rate. Methods for the suppression of parasitic amplified spontaneous emission are presented. The average output pulse energy is up to 44.5 mJ and 820 fs compressed pulse duration. The average power of 4.45 kW during the burst is the highest reported for this type of amplifier.

Coherent control of high harmonic generation via dual-gas multijet arrays.

High harmonic generation (HHG) is a central driver of the rapidly growing field of ultrafast science. We present a novel quasiphase-matching (QPM) concept with a dual-gas multijet target leading, for the first time, to remarkable phase control between multiple HHG sources (>2) within the Rayleigh range. The alternating jet structure with driving and matching zones shows perfect coherent buildup for up to six QPM periods. Although not in the focus of the proof-of-principle studies presented here, we achieved competitive conversion efficiencies already in this early stage of development.

Yb:YAG Innoslab amplifier: efficient high repetition rate subpicosecond pumping system for optical parametric chirped pulse amplification.

We report on a Yb:YAG Innoslab laser amplifier system for generation of subpicsecond high energy pump pulses for optical parametric chirped pulse amplification (OPCPA) at high repetition rates. Pulse energies of up to 20 mJ (at 12.5 kHz) and repetition rates of up to 100 kHz were attained with pulse durations of 830 fs and average power in excess of 200 W. We further investigate the possibility to use subpicosecond pulses to derive a stable continuum in a YAG crystal for OPCPA seeding.

High harmonic generation by novel fiber amplifier based sources.

Significant progress in high repetition rate ultrashort pulse sources based on fiber technology is presented. These systems enable operation at a high repetition rate of up to 500 kHz and high average power in the extreme ultraviolet wavelength range via high harmonic generation in a gas jet. High average power few-cycle pulses of a fiber amplifier pumped optical parametric chirped pulse amplifier are used to produce µW level average power for the strongest harmonic at 42.9 nm at a repetition rate of 96 kHz.

Higher-order dispersion compensation to enable a 3.6 micros wavelength-maintaining delay of a 100 Gb/s DQPSK signal.

We demonstrate a method for dispersion slope compensation of a conversion/dispersion-based optical delay to enable 100 Gb/s operation based on a spatial light modulator and fiber Bragg gratings. A continuous delay of up to 3.6 micros for 100, 80, and 20 Gb/s differential quadrature phase-shift-keyed (DQSPK) and 50, 40, and 10 Gb/s differential phase-shift-keyed (DPSK) waveforms is shown. A time-delay bit-rate product of approximately 360,000 for 100 Gb/s DQPSK with wavelength-maintaining operation is achieved.

High average and peak power few-cycle laser pulses delivered by fiber pumped OPCPA system.

We report on a high power optical parametric amplifier delivering 8 fs pulses with 6 GW peak power. The system is pumped by a fiber amplifier and operated at 96 kHz repetition rate. The average output power is as high as 6.7 W, which is the highest average power few-cycle pulse laser reported so far. When stabilizing the seed oscillator, the system delivered carrier-envelop phase stable laser pulses. Furthermore, high harmonic generation up to the 33(th) order (21.8 nm) is demonstrated in a Krypton gas jet. In addition, the scalability of the presented laser system is discussed.

Continuously tunable 1.16 micros optical delay of 100 Gbit/s DQPSK and 50 Gbit/s DPSK signals using wavelength conversion and chromatic dispersion.

We demonstrate a variable optical delay element that uses tunable wavelength conversion and phase conjugation in highly nonlinear fiber and uses chromatic dispersion in dispersion-compensating fiber. A continuous delay of up to 1.16mus, equaling a >110,000 time-delay bit-rate product for 100 Gbit/s non-return-to-zero differential quadrature phase-shift-keying (NRZ-DQSPK) and >55,000 for 50 Gbit/s NRZ differential phase-shift-keying (NRZ-DPSK) modulation formats, is demonstrated. Bit error rates <10(-9) are demonstrated for each waveform at various delay settings.

Fiber-amplifier pumped high average power few-cycle pulse non-collinear OPCPA.

We report on the performance of a 60 kHz repetition rate sub-10 fs, optical parametric chirped pulse amplifier system with 2 W average power and 3 GW peak power. This is to our knowledge the highest average power sub-10 fs kHz-amplifier system reported to date. The amplifier is conceived for applications at free electron laser facilities and is designed such to be scalable in energy and repetition rate.

Fine tuning of conversion/dispersion based optical delays with a 1 pm tunable laser using cascaded acousto-optic mixing.

We demonstrate a technique for fine tuning of optical delays using cascaded acousto-optic modulators to improve the delay resolution by 5 orders of magnitude compared to a 1 pm tunable laser. A 256 ns delay with <0.5 ps resolution is shown for 40 Gbits/s return-to-zero on-off keying with no added penalty.

Optical signal-to-noise ratio monitoring of an 80 Gbits/s polarization-multiplexed return-to-zero differential phase-shift keying channel.

We propose and experimentally demonstrate an optical signal-to-noise ratio (OSNR) monitoring technique for an 80 Gbits/s polarization-multiplexed return-to-zero differential phase-shift keying channel utilizing a narrowband optical filter and a low-speed detector. A maximum power increment of 19.7 dB is measured at a radio frequency (rf) of 250 MHz for monitoring of OSNR up to 27 dB, insensitive to chromatic dispersion of 0-300 ps/nm and polarization-mode dispersion (PMD) of 0-50 ps.

Variable rate, multi-format receiver design for 10 to 40 Gb/s DPSK and OOK formats.

We demonstrate a continuously-variable bit-rate receiver from 10 to 40 Gbit/s for DPSK demodulation. Unlike previous DPSK demodulators, this receiver is also capable of passing intensity modulated waveforms without distortion. Degradations imposed by receiver imperfections are presented and compared with a traditional DPSK delay-line interferometer.

All-optic scheme for automatic polarization division demultiplexing.

We describe a cost effective scheme to automatically separate two polarization channels in a polarization division multiplexing (PDM) system, without having to modify the existing transmitter or receiver electronics or software. We experimentally validate the concept by achieving an extinction ratio of more than 28-dB between two demultiplexed channels. Finally, we successfully demonstrate the PDM scheme in a 1.12-Tb/s (14x2x40-Gb/s) system over 62-km of transmission fiber.

Continuously-tunable, bit-rate variable OTDM using broadband SBS slow-light delay line.

We conceptually compare the advantages of the proposed slow-light-based tunable OTDM to conventional fiber-based fixed OTDM multiplexer. We experimentally demonstrate continuously-controllable OTDM of two 2.5-Gb/s return-to-zero (RZ) signals using broadband SBS-based slow-light as the tunable optical delay line. We show that the time slot of one signal path can be manipulated relative to the other by as much as 75-ps. This continuous slow light tunability dramatically enhances the OTDM system performance which results in a power penalty reduction of 9-dB for the multiplexed data stream. We also demonstrate variable-bit-rate OTDM by dynamically adjusting the tunable slow-light delay according to the input bit-rates. We show efficient two-by-one optical time multiplexing of three different input data streams at 2.5-Gb/s, 2.67-Gb/s and 5-Gb/s.

A 10-Gbit/s EML link using detuned narrowband optical filtering.

In this paper, the effects of asymmetric narrowband optical filtering are investigated in a 10-Gbit/s optical communication link using integrated electro-absorption modulated lasers (EML). We investigate the effect of EML chirp on link performance as well as the optimal filter bandwidth and wavelength detuning. We show that both the phase response and the spectral narrowing of the filter will enable a longer distance transmission by interacting with the EML transient chirp and compensating for the fiber chromatic dispersion. Experimentally, an 8.75-GHz filter is shown to improve the link distance by 40 km from 65 to 105 km, when transmitting over standard single mode fiber.

Reach extension in 10-Gb/s directly modulated transmission systems using asymmetric and narrowband optical filtering.

Optical filtering has been used to extend the reach of directly modulated laser in 10Gb/s WDM systems via two separate mechanisms: narrowing the broadened spectrum, and converting frequency modulation into useful amplitude modulation. We investigate in detail, the impact of asymmetric and narrowband optical filtering at the transmitter or receiver. Experimental demonstrations for both shorter distance and long-haul like transmission using optical filtering are performed. The transmission reach is nearly doubled from <25-km to >45-km without dispersion compensation. 1400-km error-free transmission (Q > 15.6-dB) is further achieved over dispersion-managed link for a directly modulated DFB laser within an 8x10-Gb/s WDM system.

Tracheal stenosis and congenital heart disease in patients with Down syndrome: diagnostic approach and surgical options.

Upper airway obstruction is a prevalent feature in patients with Down syndrome. However, these patients may be completely asymptomatic in the early months of life. The recognition of a problem within the airway quite often occurs when these children present for cardiac surgery, diagnostic radiography with sedation, or during the induction and intubation for anesthesia. Tracheal stenosis is rare in the general population, but is seen somewhat more frequently in patients with Down syndrome. The incidence of tracheal stenosis in children with congenital heart disease, which is seen in 40% of patients with Down syndrome, has been reported to be 1.2%. Patients with Down syndrome also tend to have other upper airway obstructive pathology such as nasopharyngeal, oropharyngeal, and subglottic compromise. These entities, combined with the high incidence of cardiac disease, put these children at risk for acute and chronic cardiopulmonary compromise. We present two patients with Down syndrome and congenital heart disease who were found to have significant tracheal stenosis at the time of their cardiac surgery. The perioperative management of their airway defects including diagnostic evaluation and treatment modalities are discussed.

Loop-mirror filters based on saturable-gain or-absorber gratings.

We present a novel all-fiber narrow-band filter based on pump-induced saturable-gain or-absorber gratings in a loop mirror. Our design provides built-in interferometric phase alignment of the signal to the grating for optimal filtering. Notch or bandpass functionality is determined by the choice of gain or absorption and the input ports selected for the pump and signal. The loop-mirror filter has potential bandwidths from the submegahertz to beyond the gigahertz regimes, and one can tune it optically by changing the wavelength of the pump light that establishes the grating. Such filters have potential applications to wavelength-division-multiplexed optical networks and optical rf signal processing.