Superabsorbent Polymer Microspheres Prepared with Hypertonic Saline to Reduce Microsphere Expansion.

PURPOSE: To analyze size changes of superabsorbent polymer (SAP) microspheres with the reduced expansion technique, and to evaluate pharmacological advantages of transarterial chemoembolization using cisplatin-loaded SAP microspheres with the reduced expansion technique. MATERIALS AND METHODS: In an in vitro study, diluted contrast materials containing different concentrations of sodium ions were examined to expand SAP microspheres and determined the reduced expansion technique. Size distributions of cisplatin-loaded SAP microspheres were analyzed. In an in vivo study, TACE was performed using cisplatin-loaded SAP microspheres with the reduced expansion and control techniques in 18 VX2 rabbits. RESULTS: The degree of expansion was reduced to the greatest extent by using a mixture of non-ionic contrast material and 10% NaCl at a 4:1 ratio. The mean diameter of the reduced expansion of cisplatin-loaded SAP microspheres was 188.4 µm, while that of the control expansion was 404.9 µm. The plasma platinum concentrations of the reduced expansion group at 5 min after TACE were significantly higher than those of the control expansion group (2.19 ± 0.77 vs. 0.75 ± 0.08 µg/mL, P = .01). The tumor platinum concentrations of the reduced expansion group at 1 h were significantly higher than those of the control expansion group (10.76 ± 2.57 vs. 1.57 ± 0.14 µg/g, P = .044). CONCLUSION: The expanding level of SAP microspheres can be reduced by using hypertonic saline. Cisplatin-loaded SAP microspheres with the reduced expansion technique have the advantages of achieving higher cisplatin tissue concentration in TACE for liver tumors.

Changes in the Width of the Tibiofibular Syndesmosis Related to Lower Extremity Joint Dynamics and Neuromuscular Coordination on Drop Landing During the Menstrual Cycle.

BACKGROUND: Many injuries of the lower extremities, especially the knee and ankle, occur during sports activity, and the incidence rate is higher in women than in men. HYPOTHESIS: The hypothesis was that phases of the menstrual cycle affect the width of the tibiofibular syndesmosis during drop landing in healthy young women and that such changes at the tibiofibular joint also affect the dynamics and neuromuscular coordination of the lower extremities. STUDY DESIGN: Descriptive laboratory study. METHODS: Participants included 28 healthy young women (mean age, 21.0 ± 0.8 years). Blood samples were collected to determine plasma levels of estradiol and progesterone immediately before the performance of the task: drop landing on a single leg from a 30-cm platform. Using ultrasonography, the distance between the tibia and the distal end of the fibula, regarded as the width of the tibiofibular syndesmosis, was measured in an upright position without flexion of the ankle. The peak ground-reaction force (GRF) on landing was measured using a force platform. The time to peak GRF (Tp-GRF) was measured as the time from initial ground contact to the peak GRF. Hip, knee, and ankle joint angles during the single-leg landing were calculated using a 3-dimensional motion analysis system. Muscle activities of the lower extremities were measured using surface electromyography. RESULTS: The width of the tibiofibular syndesmosis was significantly greater in the luteal phase when compared with the menstrual, follicular, and ovulation phases (by 5%-8% of control). Also, during the luteal phase, the Tp-GRF was significantly shorter than in the follicular phase (by 6%); hip internal rotation and knee valgus were significantly greater than in the menstrual phase (by 43% and 34%, respectively); knee flexion was significantly less than in the menstrual and follicular phases (by 7%-9%); ankle dorsiflection was significantly less than in the follicular phase (by 11%); ankle adduction and eversion were significantly greater than in the menstrual and follicular phases (by 26%-46%, and 27%-33%, respectively); and activation of the gluteus maximus before landing was significantly lower than in the menstrual and follicular phases (by 20%-22%). CONCLUSION: The luteal phase appears to be associated with decreased strength and laxity of the ankle as well as lower extremity muscle activity in women. The changes presumably represent a greater risk for sports injuries. CLINICAL RELEVANCE: The results of this study suggest that the luteal phase may be related to the greater incidence of lower extremity injuries in women.

Gender difference in distance of tibiofibular syndesmosis to joint dynamics of lower extremities during squat.

The incidence of lower extremity injury is greater in women than men, indicating gender difference in lower extremity function. Here we investigate the role of the ankle during squatting in young men and women by measuring the tibiofibular syndesmosis (TFS) distance and the angles of hip, ankle and knee joints. TFS distance was positively correlated to body mass in men, but not in women, suggesting some factor(s) affecting TSF distance in women. When divided into two groups with wide and narrow TFS distances, men apparently used ankle and hip joints evenly during squatting, but women, specifically those with a narrow TFS distance, used the hip joint more effectively than ankle. Estimated knee moment was positively correlated to TFS distance in women, but not in men. These results suggest that the women possessing a wider TFS distance use ankle function rather than hip junction when performing lower-extremity exercises (i.e. squatting), presumably accounting for the higher incidence of ankle injury in women during such activities.

Association between Femoral Anteversion and Lower Extremity Posture upon Single-leg Landing: Implications for Anterior Cruciate Ligament Injury.

[Purpose] Increased femoral anteversion may occur with hip internal rotation and valgus knee alignment upon landing and is considered a risk factor for anterior cruciate ligament injury. We examined the relationship between femoral anteversion and joint motion and muscle activity of the lower extremity in terms of the risk factors for anterior cruciate ligament injury. [Subjects] Sixteen healthy females were divided on the basis of femoral anteversion into low and high groups. [Methods] Femoral anteversion was assessed using Craig's test. We performed kinematic analysis and measured the electromyography activity of the lower extremity upon left single-leg landing. [Results] The high group had a significantly lower hip flexion angle and higher knee flexion and valgus angles than the low group. The rectus femoris showed significantly greater electromyography activities in the high group than in the low group. [Conclusion] These results suggest that increased femoral anteversion results in lower hip flexion angle, higher knee valgus alignment, and greater rectus femoris muscle activity, leading to anterior tibial displacement upon single-leg landing. Increased femoral anteversion may be a potential risk factor for anterior cruciate ligament injury.

Influence of ion assistance on LaF3 films deposited by molybdenum boat evaporation.

LaF3 thin films at 193 nm were deposited by the molybdenum boat evaporation with ion-assisted deposition (IAD). Various optical characteristics, stress, and microstructures that formed under different ion-beam voltages of IAD deposition were investigated. The relation between these properties is also discussed. LaF3 films deposited with IAD exhibited small rough surfaces and large optical loss at 193 nm. The largest value of optical loss for films at 193 nm, which were prepared at an ion-beam voltage of 400 V, was 1.55% and the extinction coefficient was smaller than 0.0015. Microstructures and crystalline structures of films were influenced and changed by the ion-assisted deposition process. Tensile stress value of films increased as the ion-beam voltage rose. Refractive index, related to the packing density and microstructures, also increased as the ion-beam voltage rose.

A method to improve a job process at a hospital using the "unit process flow chart".

The development of methods to improve the quality of services provided at hospitals has been essential owing to the inadequacy of arrangements for standard procedures and the inadequacy of work instructions based on such procedures. In this paper, we propose a method that involves the following steps: description of the job process, analysis of the causes of incidents, and the planning of improvements for the relevant job process. This method describes a healthcare process using a set of unit process flow charts (UPFCs), which are structured and standardized modules represented in the form of flow charts that elucidate the elements of jobs. Describing a job in this manner allows for an appropriate and in-depth analysis of the causes of incidents that occur during a job process, owing to the fact that the structure and description of the characteristics of relevant unit processes are properly designed. In this paper, we provide a detailed explanation of how this method was developed. Lastly, we apply the method to actual cases at a hospital to illustrate its effectiveness in comparison with the systems that are currently in place.

Oncological results, functional outcomes and health-related quality-of-life in men who received a radical prostatectomy or external beam radiation therapy for localized prostate cancer: a study on long-term patient outcome with risk stratification.

Health-related quality-of-life (HRQOL) after a radical prostatectomy (RP) or external beam radiation therapy (EBRT) has not been studied in conjunction with oncological outcomes in relation to disease risk stratification. Moreover, the long-term outcomes of these treatment approaches have not been studied. We retrospectively analyzed oncological outcomes between consecutive patients receiving RP (n=86) and EBRT (n=76) for localized prostate cancer. HRQOL and functional outcomes could be assessed in 62 RP (79%) and 54 EBRT (79%) patients over a 3-year follow-up period (median: 41 months) using the Medical Outcomes Study Short Form-36 (SF-36) and the University of California Los Angeles Prostate Cancer Index (UCLA PCI). The 5-year biochemical progression-free survival did not differ between the RP and EBRT groups for low-risk (74.6% vs. 75.0%, P=0.931) and intermediate-risk (61.3% vs. 71.1%, P=0.691) patients. For high-risk patients, progression-free survival was lower in the RP group (45.1%) than in the EBRT group (79.7%) (P=0.002). The general HRQOL was comparable between the two groups. Regarding functional outcomes, the RP group reported lower scores on urinary function and less urinary bother and sexual bother than the EBRT group (P<0.001, P<0.05 and P<0.001, respectively). With risk stratification, the low- and intermediate-risk patients in the RP group reported poorer urinary function than patients in the EBRT group (P<0.001 for each). The sexual function of the high-risk patients in the EBRT group was better than that of the same risk RP patients (P<0.001). Biochemical recurrence was not associated with the UCLA PCI score in either group. In conclusion, low- to intermediate-risk patients treated with an RP may report relatively decreased urinary function during long-term follow-up. The patient's HRQOL after treatment did not depend on biochemical recurrence.

Fluoride antireflection coatings deposited at 193 nm.

Antireflection coatings for 193 nm composed of low-index (MgF(2) and AlF(3)) and high-index (LaF(3) and GdF(3)) materials are deposited by the resistive heating boat method at a substrate temperature of 300 degrees C. The optical characteristics (reflectance and optical loss), microstructure (morphology and surface roughness), stress, and laser-induced damage threshold (LIDT) of the coatings are investigated and discussed. The related reflection at 193 nm of the four kinds of antireflection coatings is smaller than 0.2% and the optical loss is less than 0.15%. Of the fluoride antireflection coatings, AlF(3)/GdF(3) had the lowest stress value. Antireflection coatings with AlF(3) as the low-index material had higher LIDT values than when MgF(2) was used.

Evaluation of magnetic resonance imaging-based prostate-specific antigen density of the prostate in the diagnosis of prostate cancer.

OBJECTIVES: We evaluated prostate-specific antigen (PSA) density of the prostatic volume (PSAD) estimated using transrectal ultrasonography (TRUS; TRUS-based PSAD), magnetic resonance imaging (MRI; MRI-based PSAD), and PSA density of the transition zone (TZ) volume (PSATZD) estimated using MRI (MRI-based PSATZD) in the diagnosis of prostate cancer (PCa). METHODS: One hundred and twenty patients, who were suspected to have PCa based on PSA, ranged between 4.1 and 20.0 ng/mL were enrolled in this study. RESULTS: The prostatic volume estimated using TRUS was smaller than the volume estimated using MRI by 11.4% in the patients with PSA levels ranging 4.1-20.0 ng/mL, 7.2% in those 4.1-10.0 ng/mL, and 15.7% in those 10.1-20.0 ng/mL, respectively. PSA levels were correlated with the prostatic volume estimated using TRUS and MRI, and TZ volume estimated using MRI in the patients without PCa; however, the level was not correlated with them in the patients with PCa. The area under the receiver operating characteristic curve of MRI-based PSAD was higher than that of TRUS-based PSAD; however, there was no statistical difference. Stepwise logistic regression analysis for the prediction of PCa by using PSA-related parameters confirmed that MRI-based PSATZD was the most significant predictor in patients with PSA levels in the range of 4.1-20.0 ng/mL (P < 0.001), the range of 4.1-10.0 ng/mL (P = 0.002), and the range of 10.1-20.0 ng/mL (P < 0.001), respectively. CONCLUSIONS: The prostatic volume estimated using TRUS was smaller than the volume estimated using MRI. MRI-based PSATZD is the most significant predictor in the four parameters.

Microstructure of magnesium fluoride films deposited by boat evaporation at 193 nm.

Single layer magnesium fluoride (MgF2) was deposited on fused-silica substrates by a molybdenum boat evaporation process at 193 nm. The formation of various microstructures in relation to the different substrate temperatures and deposition rates were investigated. The relation between these microstructures (including cross-sectional morphology, surface roughness, and crystalline structures), the optical properties (including refractive index and optical loss) and stress, were all investigated. It was found that the laser-induced damage threshold (LIDT) would be affected by the microstructure, optical loss, and stress of the thin film. To obtain a larger LIDT value and better optical characteristics, MgF2 films should be deposited at a high substrate temperature (300 degrees C) and at a low deposition rate (0.05 nm s(-1)).

Microstructure-related properties at 193 nm of MgF2 and GdF3 films deposited by a resistive-heating boat.

MgF2 and GdF3 materials, used for a single-layer coating at 193 nm, are deposited by a resistive-heating boat at specific substrate temperatures. Optical characteristics (transmittance, refractive index, extinction coefficient, and optical loss) and microstructures (morphology and crystalline structure) are investigated and discussed. Furthermore, MgF2 is used as a low-index material, and GdF3 is used as a high-index material for multilayer coatings. Reflectance, stress, and the laser-induced damage threshold (LIDT) are studied. It is shown that MgF2 and GdF3 thin films, deposited on the substrate at a temperature of 300 degrees C, obtain good quality thin films with high transmittance and little optical loss at 193 nm. For multilayer coatings, the stress mainly comes from MgF2, and the absorption comes from GdF3. Among those coatings, the sixteen-layer design, sub/(1.4L 0.6H)8/air, shows the largest LIDT.

Characterization of AlF3 thin films at 193 nm by thermal evaporation.

Aluminum fluoride (AlF3) was deposited by a resistive heating boat. To obtain a low optical loss and high laser-induced damage threshold (LIDT) at 193 nm, the films were investigated under different substrate temperatures, deposition rates, and annealing after coating. The optical property (the transmittance, refractive index, extinction coefficient, and optical loss) at 193 nm, microstructure (the cross-sectional morphology, surface roughness, and crystalline structure), mechanical property (stress), and LIDT of AlF3 thin films have been studied. AlF3 thin films deposited at a high substrate temperature and low deposition rate showed a lower optical loss. The highest LIDT occurred at the substrate temperature of 150 degrees C. The LIDT of the films prepared at a deposition rate of 2 A/s was higher than that at other deposition rates. The annealing process did not influence the optical properties too much, but it did increase the LIDT and stress.

Influence of thermal annealing and ultraviolet light irradiation on LaF3 thin films at 193 nm.

Lanthanum fluoride (LaF3) thin films were prepared by resistive heating evaporation and electron-beam gun evaporation under the same deposition rate, deposition substrate temperature, and vacuum pressure. The coated LaF3 films were then treated by heat annealing and UV light irradiation. The optical properties, microstructures, stress, and laser-induced damage threshold (LIDT) at a wavelength of 193 nm were investigated. The surface roughness, optical loss, stress, and LIDT of the films were improved after the annealing. The films had better properties when irradiated by UV light as compared with heat annealing.

[A case of lipoleiomyosarcoma of the spermatic cord].

A 54-year-old male was referred to our hospital with the chief complaint of a painless inguinal mass. A hard mass was palpable beside the left spermatic cord, which was covered with a soft tissue mass. Computed tomographic scan showed an inguinal mass, which was well enhanced to vascular density. The operative appearance indicated a tumor in the left spermatic cord, so we performed a radical orchiectomy. Histopathological diagnosis was lipoleiomyosarcoma. Lipoleiomyosarcoma of the spermatic cord is quite rare, and our case was considered as the first report in Japan.