Plastic deformation of synthetic quartz nanopillars by nanoindentation for multi-scale and multi-level security artefact metrics.

Individual authentication using artefact metrics has received increasing attention, as greater importance has been placed on the security of individual information. These artefact metrics must satisfy the requirements of individuality, measurement stability, durability, and clone resistance, in addition to possessing unique physical features. In this study, we proposed that nanostructures of synthetic quartz (SQ) deposited on an SQ plate may provide sophisticated artefact metrics if morphological changes could be intentionally introduced into the SQ nanostructures at certain positions. We fabricated SQ nanopillars using a mass-production method (ultraviolet nanoimprint lithography) and investigated their mechanical deformation using nanoindentation with a spheroid diamond tip through a loading and unloading cycle. The SQ nanopillars with an aspect ratio of 1 (i.e., diameters D of 100 and 200 nm with corresponding heights H of 100 and 200 nm, respectively) could be plastically deformed without collapsing within a specified pillar-array format at programmed positions. The plastically deformed SQ nanopillar arrays demonstrated multi-scale (sub-millimetre, micrometre, and nanometre) and multi-level (shape, area, diameter, and height) individuality authentication and clone resistance. Because SQ is physically and chemically stable and durable, individuality authentication can be a highly reliable tool on Earth and in space.

[Experience with implanted venous reservoirs in patients with terminal urological cancers].

The medical records of 8 consecutive patients with terminal urological cancers who were treated with implanted venous reservoirs between October 2001 and July 2004 were retrospectively reviewed. All 8 devices were placed safely in the 8 patients, and fluids and drugs were easily administered via the reservoirs. The devices were utilized for a mean of 40.6 days (range, 18 to 98) until the patients died of the cancer, and there were no complications which required removal of the devices such as catheter or reservoir infections, catheter occlusions and catheter thromboses. Seven patients were discharged or stayed at home on weekends and received home parental nutrition (HPN) through implanted venous reservoirs. Although HPN with the implanted venous reservoir is recently becoming common in digestive surgery or gynecological fields, it still remains uncommon in the urological field. Because this device would be useful and safe for patients with terminal urological cancers, we should consider the use of implanted venous reservoirs for patients who desire terminal home care.

Improved accuracy in predicting the presence of Gleason pattern 4/5 prostate cancer by three-dimensional 26-core systematic biopsy.

OBJECTIVES: To evaluate whether three-dimensional 26-core (3D26) prostate biopsy improves the accuracy in predicting the presence of Gleason pattern 4/5 cancer compared with extended transrectal 12-core (TR12) or transperineal 14-core (TP14) biopsy schemes. METHODS: We studied 143 consecutive men in whom prostate cancer was diagnosed by the 3D26 biopsy and who underwent radical prostatectomy (RP) without neoadjuvant treatment. All histologic grading was reevaluated by a single pathologist according to the 2005 International Society of Urological Pathology Consensus Conference on Gleason Grading. Cancer grade was categorized into high grade (Gleason pattern 4/5 cancer present) and non-high grade (absent) in both biopsy and RP specimens. Since TR12 and TP14 biopsy schemes represent subsets of the 3D26 biopsy, we could compare these schemes directly in an identical patient cohort. RESULTS: There was a grade agreement between 3D26 biopsy and RP in 132 (92.3%) cancers. Grade concordance between biopsy and RP was significantly better in 3D26 biopsy than in TR12 (83.5%, p=0.025) biopsy. Risk of underestimation of cancer grade by 3D26 biopsy (26.5%) was significantly lower than that by TP14 (51.4%, p=0.034). Grade concordance between 3D26 biopsy and RP was not according to clinical variables including prostate volume, clinical stage, prostate-specific antigen (PSA), and PSA density. CONCLUSIONS: We demonstrated that the 3D26 biopsy can accurately predict the presence of Gleason pattern 4/5 cancer on RP specimens with a high concordance rate of 92.3%, a value significantly higher than that between extended TR12 biopsy and RP specimens.

Successful management of vesicouterine fistula by luteinizing hormone-releasing hormone analog.

Vesicouterine fistula is a rare complication of cesarean section. Although surgical repair was mandatory for the management of the fistula previously, a recent review showed high efficacy of hormonal manipulation by the induction of amenorrhea. Herein, we report a new case of vesicouterine fistula secondary to cesarean section successfully treated by luteinizing hormone-releasing hormone analog for 6 months. Conservative hormonal treatment for vesicouterine fistula caused by cesarean section should be considered before surgical repair.

[Solitary metastasis to the urinary bladder from renal cell carcinoma: a case report].

A 48-year-old woman was referred to our hospital with a bladder mass which was detected by a general practitioner. Ultrasonography showed a small bladder tumor and right renal mass. Cystoscopy revealed a solitary, non papillary tumor at the right side of the retro-trigone. Computed tomography revealed a large tumor at the right kidney. Transurethral resection of the bladder tumor was performed. The histopathological diagnosis was clear cell carcinoma. There was no other distant metastasis. Sequentially, radical nephrectomy was performed. Histopathologically, the right renal tumor showed clear cell carcinoma. This was considered to be a case of a solitary metastatic bladder tumor from renal cell carcinoma.

[Usefulness of an all-in-one clinical pathway for transurethral resection of prostate].

We evaluated the usefulness of our original all-in-one clinical pathway for transurethral resection of the prostate (TUR-P) on 86 consecutive patients. There were 27 consecutive patients treated before introduction of the clinical pathway (group 1). Twenty-nine consecutive patients were treated just after the introduction of the clinical pathway (group 2) and 30 consecutive patients were treated one year after the introduction of the clinical pathway (group 3). Our pathway includes all items such as vital sign charts and events charts. Although the hospitalization ranged from 5 days to 12 days after introduction of the clinical pathway, the average length of hospital stay was shortened by 2.6 days in group 3. Although the duration of the postoperative indwelling urethral catheter ranged from 2 days to 7 days in the groups 2 and 3, the average duration was approximately 4 days in group 3. Postoperative complications did not differ among the three groups. The medical insurance claims decreased with the introduction of the clinical pathway. Our all-in-one clinical pathway is considered to be a good tool for not only reduction of health care costs but also giving higher quality and better service to patients.

Dynamic analysis of the resultant force acting on the hip joint during level walking.

The present study was designed to determine the resultant force acting on the hip joint during walking using a new dynamic analysis method. Our model utilized joint motion, ground reaction force, and muscle strength data from 18 women (6 normal women aged 20-24 years, 6 normal women aged 50-57 years, and 6 female patients with osteoarthritis, aged 50-66 years). We analyzed the resultant force using the multibody dynamic analysis system. To determine the factors that influence the force acting on the hip, we examined the effect of age and total hip arthroplasty. The maximum resultant force acting on the femoral head was dependent on the subject body weight and correlated with muscle strength and walking speed. The results of this study highlight the agreement between computer simulation analysis and actual measurement of the resultant force acting on the hip. Our results suggest that muscle strength and walking speed are significant determinants of the resultant force acting on the hip.

Relation between vertical orientation and stability of acetabular component in the dysplastic hip simulated by nonlinear three-dimensional finite element method.

In acetabular dysplasia, more vertical orientation of the acetabular component is often used to minimize the superolateral bone grafting. This study was designed to determine the effects of vertical orientation of the cup on the stability and polyethylene wear of the acetabular component in uncemented total hip arthroplasty (THA). Three-dimensional finite element models of the hemipelvis with dysplastic acetabulum were developed. Metal-backed hemispherical cups were placed in the true acetabulum with abduction angles of 35, 45, 55, and 65 degrees. It was found that more vertical orientation of the cup was associated with larger relative motion of the metal shell between the acetabulum and metal shell. Furthermore, tilting and torsional shear stresses in the model of the cup abduction angle of 65 degrees were found to be 1.7 times larger than that in the model with 35 degrees at the bone-metal shell interface. More vertically oriented cups caused larger contact stresses at the articulating surfaces of the polyethylene liners. The results suggest that the abduction angle of the acetabular component significantly influences cup loosening and polyethylene wear in THA.

[A case of idiopathic adrenal hemorrhage].

A 67-year-old woman underwent abdominal ultrasonography as part of a general health examination and was incidentally found to have a mass 5 cm in diameter in the left adrenal gland. She had no experience of abdominal trauma. Computerized tomography (CT) revealed a 5.5 x 5.0 cm mass in the left adrenal gland, which was heterogeneously enhanced by the contrast medium. Hormanal data for adrenal function were all within the normal range. For the suspected non-functioning adrenal tumor, the patient underwent adrenalectomy. Histopathological examination demonstrated only hematoma without tumor cells.

Video urodynamics using transrectal ultrasonography for lower urinary tract symptoms in women.

AIMS: To understand the properties of lower urinary tract disorders in women, we evaluated 60 female patients with lower urinary tract disorders or symptoms of recurrent cystitis by free uroflowmetry and video urodynamics using transrectal ultrasonography (VU-TRUS). METHODS: Results of urodynamic studies or symptoms of stress incontinence were used to divide 60 women into 7 normal controls and 53 with voiding dysfunctions. RESULTS: In normal controls, VU-TRUS showed that the mean posterior urethrovesical angle and anteroposterior diameter of the proximal urethra at maximum flow was 151.4 degrees and 4.9 mm, respectively. In patients with voiding dysfunction, VU-TRUS during voiding revealed various urethral abnormalities, including 16 detrusor sphincter dyssynergia, 4 detrusor bladder neck dyssynergia, and 13 insufficient opening of the entire urethra. VU-TRUS also showed pelvic floor abnormalities, including 24 urethral hypermobilities (group 1) and 11 cystoceles (group 2). Eighteen patients had neither urethral hypermobility nor cystocele (group 3). Major pressure-flow abnormalities in the 53 patients with voiding dysfunctions were weak detrusor (72%) and/or bladder outlet obstruction (25%). There were no significant differences in the distribution of the pressure-flow abnormalities among the three groups. However, the mean values of abdominal pressure at maximum flow of group 1 (20.9 cm H(2)O) and group 2 (17.9 cm H(2)O) were significantly higher than that of group 3 (6.3 cm H(2)O; each P < 0.05). The mean values of residual urine volume of group 2 (60.8 mL) and group 3 (77.6 mL) were significantly higher than that of group 1 (23.5 mL; each P < 0.05). CONCLUSIONS: The symptoms of women with lower urinary tract disorders were frequently accompanied by urethral and/or pelvic floor abnormalities during voiding that were clearly detected by VU-TRUS. VU-TRUS is useful for objective evaluation of female lower urinary tract symptoms.