Development of Gentle Slope Light Guide Structure in a 3.4 µm Pixel Pitch Global Shutter CMOS Image Sensor with Multiple Accumulation Shutter Technology.

CMOS image sensors (CISs) with global shutter (GS) function are strongly required in order to avoid image degradation. However, CISs with GS function have generally been inferior to the rolling shutter (RS) CIS in performance, because they have more components. This problem is remarkable in small pixel pitch. The newly developed 3.4 µm pitch GS CIS solves this problem by using multiple accumulation shutter technology and the gentle slope light guide structure. As a result, the developed GS pixel achieves 1.8 e- temporal noise and 16,200 e- full well capacity with charge domain memory in 120 fps operation. The sensitivity and parasitic light sensitivity are 28,000 e-/lx·s and -89 dB, respectively. Moreover, the incident light angle dependence of sensitivity and parasitic light sensitivity are improved by the gentle slope light guide structure.

Long non-coding RNA lnc-CHAF1B-3 promotes renal interstitial fibrosis by regulating EMT-related genes in renal proximal tubular cells.

Renal interstitial fibrosis (RIF) is a common pathological manifestation of chronic kidney diseases. Epithelial-mesenchymal transition (EMT) of tubular epithelial cells is considered a major cause of RIF. Although long non-coding RNAs (lncRNAs) are reportedly involved in various pathophysiological processes, the roles and underlying molecular mechanisms of lncRNAs in the progression of RIF are poorly understood. In this study, we investigated the function of lncRNAs in RIF. Microarray assays showed that expression of the lncRNA lnc-CHAF1B-3 (also called claudin 14 antisense RNA 1) was significantly upregulated in human renal proximal tubular cells by both transforming growth factor-ß1 (TGF-ß1) and hypoxic stimulation, accompanied with increased expression of EMT-related genes. Knockdown of lnc-CHAF1B-3 significantly suppressed TGF-ß1-induced upregulated expression of collagen type I alpha 1, cadherin-2, plasminogen activator inhibitor-1, snail family transcriptional repressor I (SNAI1) and SNAI2. Quantitative reverse transcriptase PCR analyses of paraffin-embedded kidney biopsy samples from IgA nephropathy patients revealed lnc-CHAF1B-3 expression was correlated positively with urinary protein levels and correlated negatively with estimated glomerular filtration rate. In situ hybridization demonstrated that lnc-CHAF1B-3 is expressed only in proximal tubules. These findings suggest lnc-CHAF1B-3 affects the progression of RIF by regulating EMT-related signaling. Thus, lnc-CHAF1B-3 is a potential target in the treatment of RIF.

Silicon-based current-injected light emitting diodes with Ge self-assembled quantum dots embedded in photonic crystal nanocavities.

Room temperature light emission from Ge self-assembled quantum dots (QDs) embedded in L3-type photonic crystal (PhC) nanocavity is successfully demonstrated under current injection through a lateral PIN diode structure. The Ge QDs are grown on silicon-on-insulator (SOI) wafer by solid-source molecular beam epitaxy (SS-MBE), and the PIN diode is fabricated by selective ion implantation around the PhC cavity. Under an injected current larger than 0.5 mA, strong resonant electroluminescence (EL) around 1.3-1.5 µm wavelength corresponding to the PhC cavity modes is observed. A sharp peak with a quality factor up to 260 is obtained in the EL spectrum. These results show a possible way to realize practical silicon-based light emitting devices.

Transurethral ureterolithotripsy and extracorporeal shock wave lithotripsy in patients with idiopathic thrombocytopenic purpura.

Idiopathic thrombocytopenic purpura (ITP) is an autoimmune disease defined by a low platelet count secondary to accelerated platelet destruction by anti-platelet antibodies. The resulting bleeding diathesis can present a therapeutic dilemma. We have treated two cases of ITP in which ureteral stones were successfully extracted by transurethral ureterolithotripsy (TUL) and extracorporeal shock wave lithotripsy (ESWL) after high-dose gamma-globulin therapy. The first case was in a 52-year-old woman and the second case was in a 65-year-old woman. Intravenous pyelography revealed a left ureteral stone in the first case and bilateral ureteral stones in the second case. High-dose gamma-globulin therapy and platelet transfusion elevated their platelet counts to safe levels; TUL and ESWL were then performed successfully with no bleeding complications. This is the first case report of ITP being treated by ESWL after high-dose gamma-globulin therapy. High-dose gamma-globulin therapy effectively provides adequate platelet counts for surgical treatment in patients with ITP.

[Anaphylactoid purpura after intravesical therapy using bacillus Calmette-Guerin for superficial bladder cancer].

We report a very rare side effect, anaphylactoid purpula, after intravesical administration of bacillus Calmette-Guerin (BCG). A 83-year-old man presented with purpura located on his bilateral lower legs. He had received transurethral resections four times for superficial bladder tumors. Intravesical therapy using BCG was performed. During the treatment course, asymptomatic purpura was suddenly seen in the lower legs after the third administration. Lymphocyte stimulation test was highly positive for BCG. He was diagnosed with anaphylactoid purpura caused by BCG. Conservative treatment was selected because there were no concomitant diseases in other organs. There have been no signs of recurrence of tumors or purpura during the one-year follow-up. However, physicians need to be cautious of anaphylactoid purpura which could lead to severe diseases, such as renal failure, gastrointestinal dysfunction and systematic arthritis.

[Incidental inverted papilloma during the clinical follow-up of superficial transitional cell carcinoma in the urinary bladder].

A 76-year-old woman presented with gross hematuria. She had received transurethral resections (TURBT) twice for superficial bladder tumors near the right orifice. All pathologic findings demonstrated low grade superficial transitional cell carcinoma (TCC). Cystoscopy showed the tumor lesions during the follow-up. Bladder tumors were completely harvested and pathologic examination revealed inverted papilloma. However, recurrent tumors were detected at the same location after 4 months' follow up. Although she came to our hospital for the purpose of TURBT, she complained of severe neck pain and was suddenly dead. Autopsy findings showed that dissecting aortic aneurism was the cause of death and the bladder tumor was low grade superficial TCC. The case reported here had a very rare pathologic finding with a history of superficial tumors located in the same areas in the urinary bladder.

[Clinical significance of risedronate for patients with prostate cancer receiving androgen deprivation therapy].

PURPOSE: Androgen deprivation therapy (ADT) in patients with prostate cancer is associated with bone loss. We investigated the effectiveness of risedronate about a decreasing bone mineral density in patients with prostate cancer on ADT. MATERIAL AND METHOD: A prospective study was conducted in Kitasato University Hospital from April 2004 to October 2006. A total of 69 men with prostate cancer were assigned to receive either oral risedronate or none during ADT (hormone naïve). The treatment group was 58 men and taking 2.5 mg risedronate per day. The control group was 11 men. At baseline, we assessed BMD (bone mineral density) by DEXA and urinary NTX, and measured for these changes every 6 months. RESULT: At baseline, each BMDs had no significant difference at the lumber and total hip. At the first 6-month stage, the change in BMD percentage between the 2 groups was statistically significantly different at lumber (p = 0.002) and total hip (p = 0.038). At the 12-month stage, the change in the BMD percentage between the 2 groups was statistically significantly different at the lumber (p = 0.038). And each difference made out that the risedronate group was preserving BMD. In urinary NTX, bone turn over was statistically significantly decreased with the risedronate group compared with the control group at the 12-month stage (p = 0.017). CONCLUSION: We assure the beginning of bone loss at an early date (6 months) with ADT. Daily oral risedronate in patients with receiving ADT reduces bone mineral loss and maintain BMD.

[A case report: Bilharzial schistosomiasis in the urinary bladder presented with gross hematuria].

A 31-year-old Japanese man who had been in Africa for two years presented with gross hematuria. He had been swimming in Lake Malawi during this period. Urinary specimen consisted of hematuria and pyuria. Cystoscopy showed tumors resembling Bilharzial tubercles located in the trigone, left lateral and posterior wall and dome. Further urine examination demonstrated eggs of schistosome haematobium. The patient was highly suspected of having Bilharzial schistosomiasis in the urinary bladder. Transurethral resection of bladder tumors was performed for diagnosis. Pathological examination revealed granuloma with many eggs of schistosome haematobium. He was diagnosed with Bilharzial schistosomiasis and was treated with 3,600 mg of praziquantel daily for two days. There have been no signs of recurrence during the one-year follow up except for excretion of degenerated eggs of schistosome haematobium in the urine specimens.

Optically controlled magnetic-field etching on the nano-scale.

Electric and magnetic fields play an important role in both chemical and physical reactions. However, since the coupling efficiency between magnetic fields and electrons is low in comparison with that between electric fields and electrons in the visible wavelength region, the magnetic field is negligible in photo-induced reactions. Here, we performed photo-etching of ZrO2 nano-stripe structures, and identified an etching-property polarisation dependence. Specifically, the etching rate and etched profiles depend on the structure width. To evaluate this polarisation-dependent etching, we performed numerical calculations using a finite-difference time-domain method. Remarkably, the numerical results revealed that the polarisation-dependent etching properties were determined by the magnetic field distributions, rather than the electric field distributions. As nano-scale structures induce a localised magnetic field, the discovery of this etching dependence on the magnetic field is expected to introduce a new perspective on advanced nano-scale structure fabrication.

A case of acute renal failure of multiple myeloma due to monoclonal type I cryoglobulinemia with thrombotic microangiopathy.

The term cryoglobulinemia (CG) is used to refer to vasculitis due to so-called mixed cryoglobulins containing immune complexes. Although most cases of monoclonal CG, called type I CG, are asymptomatic, purpura, skin ulcers, and renal failure develop in some cases. Hematological disorders are the underlying diseases in most cases, on which the therapeutic strategies available and the prognosis of patients depends. We here report a case of a 47-year-old man who had pain in both his ankles, with palpable purpura and epistaxis, and presented with acute renal failure. Monoclonal immunoglobulin (Ig) G-κ protein was detected and cryoglobulin was also positive. Renal biopsy revealed emboli with a fibrillar structure in the glomeruli and renal tubule lumina. The complication of thrombotic microangiopathy (TMA) occurred during the course. Therefore, plasma exchange and hemodialysis were added to methylprednisolone pulse therapy. The treatment was successful, dissipating the purpura. However, the purpura relapsed and renal dysfunction progressed when the administration of oral steroids was tapered. Bone marrow biopsy was performed again, which indicated an increase in abnormal plasma cells. The patient was finally diagnosed as multiple myeloma. Then, bortezomib-dexamethasone therapy was initiated. This is the first case of type I CG with monoclonal IgG complicated by TMA during the course; it provides insight into the pathogenesis of renal dysfunction associated with type I CG.

Prostatic stromal sarcoma with neuroectodermal differentiation.

Prostatic stromal sarcoma is a fairly rare tumor that constitutes approximately 0.1-0.2% of all prostatic cancers. Detailed characteristics of the tumor are still unclear due to its rarity.We describe a case of prostatic stromal sarcoma in a 63 year-old man who suffered from urinary obstructive symptoms. Palliative transuterine resection was performed and the preliminary histopathological diagnosis was neuroendocrine carcinoma. After chemotherapy, total pelvic exenteration was performed. Histopathologically, the tumor was composed of monotonously proliferating small to medium-sized round cells, which existed in compact islands with loose or dense fibrovascular networks. Immunohistochemically, the tumor cells were widely positive for vimentin, CD56, CD99 and focally positive for synaptophysin, CD10, progesterone receptor, desmin and CD34, but negative for EMA, cytokeratin, estrogen receptor, S-100 and myoglobin. Most of the previously reported tumors exhibited positive stainability for CD10 and progesterone receptor. In addition to these markers, expressions of CD56, CD99 and synaptophysin were characteristically detected in our case. To the best of our knowledge, we present the first case of prostatic stromal sarcoma with characteristic immunohistochemical staining properties. Although the biological characteristics of this rare tumor have not yet been elucidated, these findings suggest prostatic stromal sarcoma can potentially show neuroectodermal differentiation. VIRTUAL SLIDE: The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/7291874028051262.

Significance of the craniocaudal distribution of cancer in radical prostatectomy specimens.

OBJECTIVES: To examine the differences in the distribution of prostate cancer (PCa) in the craniocaudal dimension and their potential significance. METHODS: We studied 1253 patients with clinically localized PCa treated with radical prostatectomy (RP) from 1983 to 2000. We analyzed the clinicopathological features according to the craniocaudal distribution (apex, mid, base) of the largest cancer focus. RESULTS: Of these patients, 456 (36%) had the largest cancer focus in the apex, 728 (58%) in the mid, and 69 (6%) in the base. The cancers in the apex were less invasive than those in the mid or base, as evidenced by the lower frequency of extracapsular extension (27% vs 43%, 52%, respectively) and/or seminal vesicle involvement (5% vs 13%, 20%, respectively). The frequency of the largest cancer focus in the apex has increased significantly over time, from 26% before 1995 to 46% after 1995 (P < 0.001). Serum prostate specific antigen non-progression rate at 10 years for patients with a cancer at the apex was 83%, which was better than 76% and 77% of patients with a cancer at the mid or base (P = 0.029, P = 0.14, respectively). CONCLUSION: The cancers dominant at the apex are increasing over time and represent half of the patients treated by RP in recent years. These cancers tend to be less aggressive compared to those in the mid or base of the prostate. This knowledge may be useful in understanding the biology of and maximizing the detection of PCa.

Is intraoperative frozen section analysis an efficient way to reduce positive surgical margins?

OBJECTIVES: To assess the accuracy and efficiency of frozen section analysis to detect positive surgical margins (+SMs) during radical prostatectomy. METHODS: In a consecutive series of 760 patients treated with radical prostatectomy from 1998 to 2002, areas suspicious for +SMs on the surface of the removed prostate were examined by frozen section analysis. In a subset of 520 patients, the surgeon's level of suspicion for +SMs was scored and recorded during radical prostatectomy. RESULTS: Overall, 259 patients underwent frozen section examination. Of these, 55 patients (21%) had +SMs on permanent section examination compared with 50 (10%) of 501 patients with no frozen section analysis (P <0.005). Cancer was present in 23 (8.9%) frozen section specimens, all of which were confirmed on permanent section analysis. Frozen section examination missed 32 +SMs in 236 patients with negative frozen section results. The sensitivity, specificity, and positive and negative predictive value of frozen section analysis to identify +SMs was 42%, 100%, 100%, and 86%, respectively. However, the sensitivity of frozen section analysis was much lower (23 of 105, 22%) when analyzed for the entire population, including those who did not have frozen section analysis. Among the subset of 520 patients with the level of suspicion recorded, 79 had a +SM on permanent section examination. However, 51 (64%) of these were in patients with no suspicious area in the prostatectomy specimen. CONCLUSIONS: Although the positive predictive value of frozen section analysis for +SMs is high, the sensitivity is too low to expect that a policy of routine frozen section analysis of suspicious areas will reduce the rate of +SMs substantially.

Cancer core distribution in patients diagnosed by extended transperineal prostate biopsy.

OBJECTIVES: To perform systemic 22-core transperineal ultrasound-guided template prostate biopsies in patients with previous negative transrectal ultrasound-guided prostate biopsy findings and evaluate the cancer core distribution. METHODS: Between April 2001 and December 2003, 128 men underwent systemic ultrasound-guided biopsy using the transperineal template technique. All patients had undergone at least one previous set of biopsies. Prostate biopsy was performed transperineally using an 18-gauge biopsy needle driven by a spring-loaded device. Four biopsies were obtained anterior to posterior from each of four coronal planes in the mid-region, and three biopsies were obtained anterior to posterior from each of two coronal planes in the apical region. RESULTS: Of the 128 patients, 29 (22.7%) had cancer according to an extended transperineal biopsy. Patients with prostate cancer had significantly greater prostate-specific antigen (PSA) levels (11.4 versus 7.6 ng/mL, P = 0.0125), smaller transition zone volumes (12.7 versus 21.2 cm3, P = 0.0012), smaller prostate glands (31.5 versus 44.0 cm3, P = 0.0015), and greater PSA density (0.36 versus 0.19 ng/mL/cm3, P < 0.0001). The cancer core rates in the mid and apical parts of the anterior region (5.3% and 8.0%) were significantly greater than in the mid and apical parts of the posterior region (3.3% and 3.6%, P = 0.0297 and P = 0.0132, respectively). CONCLUSIONS: The results of our study have shown that transperineal approaches are appropriate for sampling from the anterior half of the prostate gland. In patients in whom the diagnosis of prostate cancer is suspected, we believe that systemic 22-core transperineal ultrasound-guided template prostate biopsy might be the next optional diagnostic step after an initial negative prostate biopsy.