Thermoelastic wave generation and its longitudinal wave

Laser ultrasonics is a noncontact measurement method that uses a laser-induced elastic wave source in combination with an optical surface displacement-tracking system. This study compared the performances of two optical interferometers with different characteristics when applied to measurement of pulsed thermoelastic waves. The surface displacement-tracking system was designed to measure the center of the microscopic view. A pulsed laser beam irradiated a black ink layer to generate the thermoelastic waves. The out-of-plane displacement on the axially opposite side was then measured using either a Michelson interferometer or a Sagnac interferometer. The objective lens of the system was of a type commonly used in biological observations. The Michelson interferometer estimated a maximum displacement of 0.43 nm and a maximum sound pressure of 24.7 kPa. The signal-to-noise ratios from 16 averages were 14.9 dB (Michelson interferometer) and 19.2 dB (Sagnac interferometer). Furthermore, this paper compares the performance of the numerically estimated Sagnac interferometer outputs calculated from the measured Michelson interferometer outputs with the experimentally obtained Sagnac interferometer outputs. The numerically estimated Sagnac interferometer's output was shown to be identical to the experimentally acquired output. The Michelson interferometer requires a higher average operating frequency (i.e., it needs a longer data acquisition time), although this interferometer does offer superior displacement output linearity. This property enables calculation of the sound pressure from the displacement amplitude. These findings indicated that combination of the measurement points of the Sagnac interferometer with those of the sparsely distributed Michelson interferometer reduced the measurement time when compared with a single use of the Michelson interferometer while also maintaining the data acquisition quality.

Real-time fetal monitoring using photoacoustic measurement of placental oxygen saturation in a rabbit hypoxia model

INTRODUCTION

Ensuring adequate fetal oxygenation is an essential aim of fetal monitoring. The purpose of this study was to establish a basic technique for real-time measurement of blood oxygen saturation of the placenta by photoacoustic (PA) technique as a new fetal monitoring method.

METHODS

The hypoxia model established in our previous study was applied to 7 pregnant rabbits. Three phases were induced: normal phase, hypoxia phase, and recovery phase. Three methods were simultaneously used for real-time fetal monitoring: fetal heat rate (FHR) monitoring, oxygen saturation (SO2) measurement by near-infrared spectroscopy (SNO2), and placenta SO2 measured by PA technique (SplO2). The maternal hypoxia was assessed by skin SO2 measured by PA technique (SsO2), and arterial blood SO2 by blood gas analysis (SaO2).

RESULTS

The average of SplO2 in normal phase was 52.6 ± 13.9 %. The averages of SNO2, SSO2, and SplO2 in the seven rabbits changed in parallel from the normal phase to hypoxia phase. In the recovery phase, the SplO2 rose in parallel with recovery of SaO2. There was lag in increase of the FHR compared to the change in the other values. In the detailed analysis of PA signals from the labyrinth and decidua, a unique change in oxygen saturation was seen in one case.

DISCUSSION

Results of this study showed that sensitivity of our novel PA technique in detecting tissue hypoxia was similar to near-infrared spectroscopy (NIRS). As an advantage, unlike NIRS, monitoring with PA technique was unaffected by ischemia and surface changes in oxygen saturation because of its higher spatial resolution. We conclude that PA technique provides more accurate information about fetal blood placenta than NIRS. Ultrasound imaging, combined with oxygen saturation monitoring by PA technique, would improve fetal monitoring and fetal diagnosis in the future.

COVID-19 Effects on Income and Dental Visits: A Cross-sectional Study

OBJECTIVES

In April 2020, the Japanese government declared a state of emergency owing to the outbreak of the novel coronavirus disease (COVID-19) pandemic, which resulted in reduced workforce and job losses. Furthermore, income is one of the most consistent predictors of dental visits. Therefore, this study examined the association between income changes and dental clinic visits during the COVID-19 state of emergency in Japan.

METHODS

An online, self-reported cross-sectional survey about health activities including dental visits during the first COVID-19 state of emergency was conducted in Osaka, Japan (June 23 to July 12, 2020). Among participants with toothaches, the assessment for the association between "refrained from visiting a dentist despite wanting treatment for toothache during the state of emergency (refrained treatment)" and income changes before and after the state of emergency using a multivariate Poisson regression model adjusted for sex, age, self-rated health, frequency of regular dental visits, and employment status.

RESULTS

Among 27,575 participants, 3,895 (14.1%) had toothaches, and 1,906 (6.9%) reported refrained treatment. Among people with decreased income (n = 8,152, 29.6% of overall participants), the proportions of the refrained treatment group were 8.0% (income decreased by 1%-49%), 9.9% (50%-99% decreased), and 9.1% (100% decreased). Among participants with toothache, after adjusting for all variables, compared with participants with no income change, we observed significantly higher prevalence ratios (PRs) for refrained treatment in those who experienced a decreased income owing to COVID-19 (1%-49% decrease: PR = 1.08; 95% confidence interval [CI], 1.005-1.17; 50%-99% decrease: PR = 1.18; 95% CI, 1.06-1.32; 100% decrease: PR = 1.18; 95% CI, 1.04-1.33).

CONCLUSION

Decreased income was associated with refrained dental treatment during the COVID-19 state of emergency in Osaka, Japan. The economic damage related to the COVID-19 pandemic could lead to oral health inequalities.

KNOWLEDGE TRANSFER STATEMENT

Our study found that individuals with decreased income owing to COVID-19 before and after the state of emergency showed significantly higher prevalence ratios for refraining from visiting a dentist despite wanting treatment for toothache. We believe that our study makes a significant contribution because it provides novel, basic data that economic damages related to the COVID-19 pandemic might expand to oral health inequalities.

Spectroscopic photoacoustic microscopic imaging during single spatial scan using broadband excitation light pulses with wavelength-dependent time delay

In most multispectral optical-resolution photoacoustic microscopy (OR-PAM), spatial scanning is repeated for each excitation wavelength, which decreases throughput and causes motion artifacts during spectral processing. This study proposes a new spectroscopic OR-PAM technique to acquire information on the photoacoustic signal intensity and excitation wavelength from single spatial scans. The technique involves irradiating an imaging target with two broadband optical pulses with and without wavelength-dependent time delays. The excitation wavelength of the sample is then calculated by measuring the time delay between the photoacoustic signals generated by the two optical pulses. This technique is validated by measuring the excitation wavelengths of dyes in tubes. Furthermore, we demonstrate the three-dimensional spectroscopic OR-PAM of cells stained with suitable dyes. Although the tradeoff between excitation efficiency and excitation bandwidth must be adjusted based on the application, combining the proposed technique with fast spatial scanning methods can significantly contribute to recent OR-PAM applications, such as monitoring quick biological events and microscale tracking of moving materials.

Photoacoustic imaging of fresh human surgically and endoscopically resected gastrointestinal specimens

Objective

Photoacoustic (PA) imaging is a novel noninvasive technique that offers high‐contrast tomographic imaging with ultrasound‐like resolution at depths of centimeters, enabling visualization of deep small vessels. The aim of this pilot study was to survey the characteristics of deep vessel networks in the mucosa of neoplastic gastrointestinal (GI) lesions using PA imaging.

Methods

Specimens of patients who had undergone surgical and endoscopic resection for GI lesions were included in this study. The PA/ultrasound imaging system for clinical research is characterized by a technology that can superimpose a PA image over an ultrasound image. Three‐dimensional PA images were acquired for the resected specimen before fixation. The stomach and colon of live pigs were incised, and the walls were scanned from the mucosa.

Results

A total of 32 specimens (nine esophageal, 12 gastric, 11 colorectal) were scanned. The pathological diagnoses were adenomas (n = 2), intramucosal cancers (n = 14), and invasive cancers (n = 16). The deep vessel networks of all lesions could be visualized. In the intramucosal lesions, the deep vessel network was similar to that of a normal tissue. In invasive cancers, the thick and prominent vessel network was visible in the surface layer of esophageal cancers, infiltrated area of gastric cancers, and surface layer and infiltrated area of colorectal cancers. In the images of living pigs, visualizing the vascular network deeper than the submucosa in both the stomach and large intestine was possible.

Conclusion

Our study confirmed that the deep vessel networks of neoplastic GI lesions were visible by PA imaging.

Chromatic-aberration-free multispectral optical-resolution photoacoustic microscopy using reflective optics and a supercontinuum light source

A supercontinuum (SC) light source enables multispectral photoacoustic imaging at excitation wavelengths in the visible-to-near-infrared range. However, for such a broad optical wavelength range, chromatic aberration is non-negligible. We developed a multispectral optical-resolution photoacoustic microscopy (MS-OR-PAM) setup with a nanosecond pulsed SC light source and a reflective objective lens to avoid chromatic aberration. Chromatic aberrations generated by reflective and conventional objective lenses were compared, and the images acquired using the reflective objective were not affected by chromatic aberration. Hence, MS-OR-PAM with the reflective objective was used to distinguish red blood cells from melanoma cells via spectral subtraction processing.

Hospital volume and five-year survival after cancer surgery in 2007-2011 in Osaka, Japan

Background

The relationship between hospital volume (HV) and patient outcome is well-known evidence, and hospital volume is widely used as a quality indicator. In Japan, however, few studies are available on the associations between HV and survival after cancer surgery. This study aimed at examining the association between HV and longitudinal survival after surgeries of major cancer sites.

Methods

This is a retrospective observational study. Using the Osaka Cancer Registry database, we identified patients who were diagnosed as major sites of cancer (esophageal, gastric, colorectal, pancreatic, lung, breast, and uterus cancer) between 2007 and 2011, and undergone surgeries in Osaka. To define the quartiles of HV (high, medium, low, and very low-volume hospitals), we ranked hospitals by annual surgical volume, sorted patients in descending order of HV, and assigned them into four equal-sized groups. The study outcome was five-year survival from the diagnosis. We analyzed the associations between hospital volume and survival among eligible patients aged between 15 and 84 years old, using Cox proportional hazard models. In the models, we adjusted for characteristics of patient and treatment received by the patients.

Results

A sample of 86,867 patients were analyzed. The mortality hazards of patients treated at very low-volume hospitals were 1.4 - 2.1 times higher than that of patients treated at high-volume hospital in all selected cancers. However, absolute differences (percent points) in adjusted survival rates between high- and very low-volume hospitals were varied by cancer site: esophagus (24.2), stomach (14.9), colorectum (11.5), pancreas (9.2), lung (10.8), breast (2.4), and uterus (3.3).

Conclusions

Very low-volume hospitals showed the poorest patient survival after cancer resections. Healthcare quality assessment at lower-volume hospitals and referrals to higher-volume hospitals are potential measures to improve survival of cancer patients.

Key messages

Patients treated at lower-volume hospitals had a higher mortality risk than those treated at higher-volume hospitals. Healthcare quality assessments and effective referrals of high-risk patients are potential interventions to improve patient survival.

Spectral-differential-based unmixing for multispectral photoacoustic imaging

We propose the use of a spectral differential method (SDM) to emphasize the spectral peaks of multispectral photoacoustic images. Because contrast agent signals have spectral peaks at the contrast agent absorption peak, the SDM can selectively emphasize contrast agent signals. Unlike the conventional spectral fitting method (SFM), the SDM does not require reference background spectra and, consequently, does not suffer from separation error caused by the deviation of reference spectra from the measured spectra. We performed multispectral photoacoustic imaging of tissue-mimicking phantoms and subcutaneous tumors of mice injected with small organic molecule-based contrast agents. Contrast agent images obtained by the SDM were clearer than those obtained by SFM.

Image reconstruction of the absorption coefficients with l 1-norm minimization from photoacoustic measurements

BACKGROUND

The photoacoustic (PA) imaging by considering light propagation into image reconstruction process can provide quantitative information of photon absorbers, such as hemoglobin and exogenous dyes, and to improve their imaging contrasts.

METHODS

A 2D image reconstruction of the distribution of the light absorption coefficient from the PA measurements with light source and ultrasound transducer placed at the identical position was tested. The PA pressures were formulated with the PA wave equation and the photon diffusion equation. The relation between the PA pressure and the absorption coefficient was linearized. The image reconstruction was carried out by minimizing the squared error between the measured and calculated PA signals. The l 1-norm of the reconstructed image was simultaneously minimized to improve the localization of the reconstructed target in the image. The image reconstruction with the l 1-norm minimization was compared to that with the Tikhonov regularization by numerical simulation and phantom experiment. In phantom experiment, an aqueous solution of the intralipid and the indocyanine green was used as the measured object. The PA probe had optical fiber for illumination and piezoelectric film for detection placed at the identical position.

RESULTS

The l 1-norm minimization reconstructed more localized target than the Tikhonov regularization.

CONCLUSIONS

The l 1-norm minimization is useful for the sparse PA image reconstruction.

Reconstruction of localized fluorescent target from multi-view continuous-wave surface images of small animal with lp sparsity regularization

Fluorescence diffuse optical tomography using a multi-view continuous-wave and non-contact measurement system and an algorithm incorporating the lp (0 < p ≤ 1) sparsity regularization reconstructs a localized fluorescent target in a small animal. The measurement system provides a total of 25 fluorescence surface 2D-images of an object, which are acquired by a CCD camera from five different angles of view with excitation from five different angles. Fluorescence surface emissions from five different angles of view are simultaneously imaged on the CCD sensor, thus leading to fast acquisition of the 25 images within three minutes. The distributions of the fluorophore are reconstructed by solving the inverse problem based on the photon diffusion equations. In the reconstruction process incorporating the lp sparsity regularization, the regularization term is reformulated as a differentiable function for gradient-based non-linear optimization. Numerical simulations and phantom experiments show that the use of the lp sparsity regularization improves the localization of the target and quantitativeness of the fluorophore concentration. A mouse experiment demonstrates that a localized fluorescent target in a mouse is successfully reconstructed.

Quantification of effective attenuation coefficients using continuous wavelet transform of photoacoustic signals

A method for quantifying the effective attenuation coefficients of optical absorbers by using the continuous wavelet transform (CWT) to calculate the time-resolved frequency spectra of photoacoustic signals is proposed. Because the coefficients can be quantified according to the relative intensity of the frequency content of the signals, it is unnecessary to determine the fluences. A computational simulation reveals that the time-resolved frequency spectra exhibit better correlation with the coefficients than do power spectra calculated using a Fourier transformation. The CWT-based method was experimentally verified, and the coefficients were quantified with mean square error of 2.0  cm(-1).

Regulation of miRNA expression by low-level laser therapy (LLLT) and photodynamic therapy (PDT)

Applications of laser therapy, including low-level laser therapy (LLLT), phototherapy and photodynamic therapy (PDT), have been proven to be beneficial and relatively less invasive therapeutic modalities for numerous diseases and disease conditions. Using specific types of laser irradiation, specific cellular activities can be induced. Because multiple cellular signaling cascades are simultaneously activated in cells exposed to lasers, understanding the molecular responses within cells will aid in the development of laser therapies. In order to understand in detail the molecular mechanisms of LLLT and PDT-related responses, it will be useful to characterize the specific expression of miRNAs and proteins. Such analyses will provide an important source for new applications of laser therapy, as well as for the development of individualized treatments. Although several miRNAs should be up- or down-regulated upon stimulation by LLLT, phototherapy and PDT, very few published studies address the effect of laser therapy on miRNA expression. In this review, we focus on LLLT, phototherapy and PDT as representative laser therapies and discuss the effects of these therapies on miRNA expression.

Phantom and mouse experiments of time-domain fluorescence tomography using total light approach

Phantom and mouse experiments of time-domain fluorescence tomography were conducted to demonstrate the total light approach which was previously proposed by authors. The total light approach reduces the computation time to solve the forward model for light propagation. Time-resolved temporal profiles were acquired for cylindrical phantoms having single or double targets containing indocyanine green (ICG) solutions. The reconstructed images of ICG concentration reflected the true distributions of ICG concentration with a spatial resolution of about 10 mm. In vivo experiments were conducted using a mouse in which an ICG capsule was embedded beneath the skin in the abdomen. The reconstructed image of the ICG concentration again reflected the true distribution of ICG although artifacts due to autofluorescence appeared in the vicinity of the skin. The effectiveness of the total light approach was demonstrated by the phantom and mouse experiments.

In vivo time-resolved DOT measurement and image reconstruction of human forearm under exercises

In vivo measurement of time-resolved diffuse optical tomography (TR-DOT) were performed for human forearms under the exercises. The DOT images of oxygenation state were reconstructed, and the activities of the inner muscles were assessed.

3D analysis of intracortical microvasculature during chronic hypoxia in mouse brains

The purpose of this study is to determine when and where the brain microvasculature changes its network in response to chronic hypoxia. To identify the hypoxia-induced structural adaptation, we longitudinally imaged cortical microvasculature at the same location within a mouse somatosensory cortex with two-photon microscopy repeatedly for up to 1 month during continuous exposure to hypoxia (either 8 or 10% oxygen conditions). The two-photon microscopy approach made it possible to track a 3D pathway from a cortical surface arteriole to a venule up to a depth of 0.8 mm from the cortical surface. The network pathway was then divided into individual vessel segments at the branches, and their diameters and lengths were measured. We observed 3-11 vessel segments between the penetrating arteriole and the emerging vein over the depths of 20-460 μm within the 3D reconstructed image (0.46 × 0.46 × 0.80 mm(3)). The average length of the individual capillaries (<7 μm in diameter) was 67 ± 46 μm, which was not influenced by hypoxia. In contrast, 1.4 ± 0.3 and 1.2 ± 0.2 fold increases of the capillary diameter were observed 1 week after exposure to 8 % and 10% hypoxia, respectively. At 3 weeks from the exposure, the capillary diameter reached 8.5 ± 1.9 and 6.7 ± 1.8 μm in 8% and 10 % hypoxic conditions, respectively, which accounted for the 1.8 ± 0.5 and 1.4 ± 0.3 fold increases relative to those of the prehypoxic condition. The vasodilation of penetrating arterioles (1.4 ± 0.2 and 1.2 ± 0.2 fold increases) and emerging veins (1.3 ± 0.2 and 1.3 ± 0.2 fold increases) showed relatively small diameter changes compared with the parenchymal capillaries. These findings indicate that parenchymal capillaries are the major site responding to the oxygen environment during chronic hypoxia.

Improvement of image quality of time-domain diffuse optical tomography with l sparsity regularization

An l(p) (0 < p ≤ 1) sparsity regularization is applied to time-domain diffuse optical tomography with a gradient-based nonlinear optimization scheme to improve the spatial resolution and the robustness to noise. The expression of the l(p) sparsity regularization is reformulated as a differentiable function of a parameter to avoid the difficulty in calculating its gradient in the optimization process. The regularization parameter is selected by the L-curve method. Numerical experiments show that the l(p) sparsity regularization improves the spatial resolution and recovers the difference in the absorption coefficients between two targets, although a target with a small absorption coefficient may disappear due to the strong effect of the l(p) sparsity regularization when the value of p is too small. The l(p) sparsity regularization with small p values strongly localizes the target, and the reconstructed region of the target becomes smaller as the value of p decreases. A phantom experiment validates the numerical simulations.

Reduction of image artifacts induced by change in the optode coupling in time-resolved diffuse optical tomography

Tomographic images of the optical properties can be reconstructed using inversion algorithms for diffuse optical tomography (DOT); however, changes in the optode coupling that occurs while obtaining an object's measurements may often lead to the presence of artifacts in the reconstructed images. To reduce the number of artifacts induced by optode coupling, previous studies have introduced (unknown) coupling coefficients in reconstruction algorithms, which were found to be effective for continuous wave- and frequency-domain DOT. This study aims to investigate the effects of optode calibration on the reconstructed images of time-domain DOT. Here, coupling coefficients are incorporated into the time-domain DOT algorithm based on a modified generalized pulse spectrum technique. The images of the absorption coefficient are reconstructed in various numerical simulations, phantom experiments, and in vivo experiments of time-domain DOT. As a result, the artifacts resulting from changes in optode coupling are reduced in the reconstructed images of the absorption coefficient, thereby demonstrating that introduction of coupling coefficients is effective in time-domain DOT. Moreover, numerical simulations, phantom experiments, and in vivo studies have validated this algorithm.

Reconstruction of fluorescence/bioluminescence sources in biological medium with spatial filter

We propose a new method for reconstruction of emitting source distributions by use of a spatial filter and a successive updating process of the forward model for fluorescence/bioluminescence diffuse optical tomography. The spatial filter transforms a set of the measurement data to a single source strength at a position of interest, and the forward model is updated by use of the estimated source strengths. This updating process ignores the dispensable source positions from reconstruction according to the reconstructed source distribution, and the spatial resolution of the reconstructed image is improved. The estimated sources are also used for the reduction of artifacts induced by noises based on the singular value decomposition. Some numerical experiments show the advantages of the proposed method by comparing the present results with those obtained by the conventional methods of the least squares method nd Algebraic Reconstruction Technique. Finally the criteria for practical use of the method are quantitatively presented by the simulations for 2D and 3D geometries.

Total light approach of time-domain fluorescence diffuse optical tomography

In this study, time-domain fluorescence diffuse optical tomography in biological tissue is numerically investigated using a total light approach. Total light is a summation of excitation light and zero-lifetime emission light divided by quantum yield. The zero-lifetime emission light is an emitted fluorescence light calculated by assuming that the fluorescence lifetime is zero. The zero-lifetime emission light is calculated by deconvolving the actually measured emission light with a lifetime function, an exponential function for fluorescence decay. The object for numerical simulation is a 2-D 10 mm-radius circle with the optical properties simulating biological tissues for near infrared light, and contains regions with fluorophore. The inverse problem of fluorescence diffuse optical tomography is solved using time-resolved simulated measurement data of the excitation and total lights for reconstructing the bsorption coefficient and fluorophore concentration simultaneously. The mean time of flight is used as the featured data-type extracted from the time-resolved data. The reconstructed images of fluorophore concentration show good quantitativeness and spatial reproducibility. By use of the total light approach, computation is performed much faster than the conventional ones.

Reduction of noise from magnetoencephalography data

A noise reduction method for magnetoencephalography (MEG) data is proposed. The method is a combination of Kalman filtering and factor analysis. A state-space model for a Kalman filter was constructed using the forward problem in MEG measurement. Factor analysis provide estimations of noise covariances required by the Kalman filter to eliminate independent additive sensor noise. The proposed method supports independent component analysis (ICA), which is difficult to use in MEG analysis owing to the sensor noise. Numerical experiments were conducted to investigate the performance of the proposed method. In a single dipole case where the maximum signal-to-noise ratio (SNR) was -10 dB, approximately equivalent to raw MEG data, noise-free signals were successfully estimated from noisy data; a 0.02 s delay of the peak latency and 15-40% of attenuation of the peak amplitude were observed. Moreover, in a multiple dipole case, independent components preprocessed with the proposed method had high correlation, 0.88 at the lowest, with correlation of 0.69 and 0.52 for those preprocessed with conventional bandpass filters. The results show that the noise reduction method reduces sensor noise effectively. High SNR-independent components are obtained by the proposed method. Real MEG data analysis was also demonstrated. The proposed method extracted auditory evoked responses from unaveraged single-trial data.

Coronary risks after high-dose gamma-globulin in children with Kawasaki disease

OBJECTIVES

The goals of the present study were to develop a predictive coronary risk scoring system after intravenous gamma-globulin (IVGG) therapy of any dose for the different preparations currently used in the treatment of children with Kawasaki disease and to determine the predictive value of the system. The previously reported scoring systems were based on treatment with high-dose IVGG therapy at limited doses and were determined using investigative methods.

METHODS

Four hundred and fifty-one patients were randomized into one of three groups and received either i.v. polyethylene glycol-treated human immunoglobulin at a dose of either 200 (n = 147) or 400 mg/kg per day (n = 152) or freeze-dried sulfonated human immunoglobulin at 200 mg/kg per day (n = 152) for 5 consecutive days. We documented 31 cases of coronary abnormalities (CA). Univariate and multivariate logistic regression was performed using 49 clinical variables and the resulting predictive model was validated.

RESULTS

The duration of fever (odds (I day)/odds (- 5 days)= 0.158; 95% confidence interval (CI) 0.0385-0.648), hemoglobin (odds (Q1 = 10.3)/odds (Q3 = 11.6) = 3.97; 95% CI 1.92-8.20), IgG (odds (Q1 = 1,900)/odds (Q3=2,658)=2.72, 95% CI 1.18-6.25) and IgA (odds (Q1 =72)/odds (Q3= 160) = 0.415; 95% CI 0.253-0.680) levels after completion of gamma-globulin infusion were independent predictors. The model is quasi-cross validated and has acceptable sensitivity and selectivity. The estimated risk and observed occurrence of CA coincide.

CONCLUSIONS

Determinants of the risk of CA after IVGG therapy are a longer duration of fever, a lower IgG level, a higher IgA level and a lower hemoglobin level after IVGG infusion. This model is applicable for IVGG doses from 1 to 2 g/kg and for at least two different gamma-globulin preparations.

New partition technique for two-chamber pressure casting unit for titanium

Although titanium has been widely used in prosthetic appliances, such as cast removable partial denture frameworks, high quality castings are still difficult to obtain. This study proposes a new partition technique using a metal foil for improving castability of a two-chamber pressure casting unit. The metal foil was formed beforehand to bring it in contact with the mold crucible wall so that no clearance was left behind it. Using this formed foil, the mold cavity can be completely isolated from the upper chamber and can be maintained in a vacuum even after the rupture of the foil. Accordingly, a large casting force is generated very quickly, and as a result, castability is expected to be significantly improved. This expectation was confirmed by the experiments using wax patterns including thin plate and mesh plate.

Massive accumulation of M and H subunits of neurofilament proteins in spinal motor neurons of neurofilament deficient Japanese quail, Quv

Quiver (Quv) is a non-sense mutation of neurofilament protein L subunit (NF-L) that causes neurofilament deficiency with preserved microtubules in Japanese quail. Anti-NF-M and anti-NF-H mAbs stained cell bodies of motor neurons in Quv embryo spinal cords much more intense than those in control spinal cords. Volume of motor neurons in Quv spinal cords increased to 2.3 times of control motor neurons. Immunoblot of Quv spinal cords revealed a relative increase in non- and hypo-phosphorylated NF-M and NF-H, and a decrease in the total amount of NFs. Quv sciatic nerves showed faintly reacted phosphorylated NF-M and NF-H. These results suggest that deficiency of assembled neurofilament results in decreased axonal transport of NFs and accumulation of NFs in cell bodies of spinal motor neurons.

Surface composition and structure of titanium polished with aqueous slurry of ferric oxide

Cast plates were prepared from commercial titanium. The plates were polished with a slurry of fine ferric oxide powder. The surface composition and structure were investigated by electron probe microanalysis (EPMA) and X-ray photoelectron spectroscopy (XPS). In the high pressure-polished surface, iron was non-uniformly distributed but oxygen was mostly uniformly distributed, while in a light pressure-polished surface, iron and oxygen were uniformly distributed though at lower and higher concentrations, respectively. EPMA state analysis and XPS suggested that the iron might exist as Fe2+ in the outermost surface, while it might be in a metallic state in the inner surface layer.

Possible segregation caused by centrifugal titanium casting

The possibility of the segregation under solidification process using a centrifugal casting machine was investigated using an electron probe microanalyzer with elemental distribution map, line analysis and quantitative analysis. When a very small quantity of platinum was added to local molten titanium during the casting process, macroscopic segregation was observed under conditions of density difference of 0.1 g/cm3 at the most, confirming that the centrifugal force of the casting machine is extremely strong. When a Ti-6Al-4V alloy was cast, however, no macroscopic segregation was observed. The centrifugal force of the casting machine examined in the present study hardly results in the body-force segregation in this titanium alloy.

Surface contamination of titanium by abrading treatment

This study investigated the contamination of abraded Ti surfaces. Using a polishing machine, specimens were abraded with waterproof SiC grit papers under water cooling. The abraded surfaces were examined using element analysis, X-ray diffraction, and hardness tests. Contaminant deposits with dimensions reaching about 30 microns were observed throughout the surface. In these deposits, Ti was apparently reduced by about 10% and replaced by Si and O. The chemical bond state of the Si was similar to that of SiC or a titanium silicide. The O was solute in Ti, which increased the surface hardness. The contaminant deposits were amorphous or very thin. The contamination of Ti, the extent of which was related to hardness, resulted from a reaction with abrasives.

[Effects of lactitol on fecal bacterial flora in patients with liver cirrhosis and hepatic encephalopathy]

Lactitol, a non-absorbable synthetic disaccharide, was administered at a dose of 36g/day for 3-4 weeks to 8 patients with liver cirrhosis and hepatic encephalopathy in order to investigate its effects on fecal bacterial flora and clinical symptoms of hepatic encephalopathy. Lactitol significantly increased occupation ratio (ratio to total bacterial number) of anaerobic Bifidobacterium (before administration 7.1% --> after 4 weeks 46.0% (p < 0.05) as well as bacterial count of Lactobacillus. On the other hand, bacterial counts of Bacteroides and Clostridium, which are considered to be NH3-producing bacteria, and that of total aerobic bacteria were not markedly changed, but their occupation ratio were decreased after the administration. Further, tendencies toward decreased fecal pH, increased frequency of defecation and soft stools were observed. As for clinical efficacy, a decrease in blood ammonia concentration, improvement in mental state and flapping tremor were also observed.

A multicenter, randomized, controlled trial of intravenous gamma globulin therapy in children with acute Kawasaki disease

We studied the effect of intravenous, polyethyleneglycol-treated, human immunoglobulin, administered at 200 mg/kg per day (group A: n = 147; male 86, female 61; age < 1 year, 50) or 400 mg/kg per day (group B: n = 152; male 87, female 65; age < 1 year, 52) for five consecutive days and compared it with freeze-dried, sulfonated human immunoglobulin [group C: n = 152; male 87, female 65; age < 1 year, 51), administered at 200 mg/kg per day for five consecutive days, on the prevention of coronary artery abnormalities in Kawasaki disease. Echocardiograms were interpreted blindly and independently. Proportions of 87.1%, 95.4%, and 82.3% in groups A, B, and C, respectively, had no coronary artery abnormalities. The confidence limits of difference between the proportions of groups A and C, groups B and C, and groups B and A were -4.4% and 10.4%, 7.8% and 15.9%, and 4.0% and 10.8%, respectively. Duration of fever and serum immunoglobulin G (IgG) levels were correlated with the prevalence of coronary artery abnormalities. We concluded that intravenous, polyethyleneglycol-treated, human immunoglobulin and freeze-dried, sulfonated human immunoglobulin had clinically equivalent effects on coronary artery abnormalities, and that five daily doses of 400 mg/kg of intravenous, polyethyleneglycol-treated, human immunoglobulin is more effective than that of 200 mg/kg gamma globulin.

Skin holes of titanium casting

The present study describes refractories which contribute to formation of skin holes of Ti casting. Plates consisting of quartz (Qu) and cristobalite (Cr) powders and Qu- and Cr-MgO mixtures were fired at high temperatures and used as phosphate-free molds. The cross-section of the castings was investigated using an optical microscope and an electron probe microanalyzer. Whereas the castings into the Qu molds were almost complete, those into the Cr molds were incomplete. The surface reaction zone of the Qu molds formed a typical layered structure with fewer skin holes. That of the latter extended deeply into the interior with a net-shaped Ti-Si phase, cracks, and holes. Addition of MgO to Cr effectively improved the castability and changed the reaction zone to the typical layered structure. However, slender holes occurred along the mold wall. The overall area around the holes was contaminated by Si and Mg. Probably, this resulted from a reaction of forsterite with Ti. The reactivity difference between Qu and Cr was not related to the fired strength of mold.

Successful aggressive treatment against multiple intra-abdominal metastases from renal cell carcinoma 18 years after nephrectomy

The management of late metastases from renal cell carcinoma is often difficult because of multiple organ involvement. We report a case of multiple metastases from renal cell carcinoma in the duodenum, pancreas, intestine, falciform ligament and liver, 18 years after nephrectomy. The patient underwent a total pancreatectomy following a gastroduodenal arterial embolization to control duodenal bleeding, a resection of the ileum and falciform ligament at a second laparotomy and repeated hepatic arterial embolizations to control the growth of liver metastases. Aggressive treatment should be undertaken in cases of late recurrence of renal cell carcinoma after nephrectomy because of the possibly slow-growing biological character of the tumor.

Involvement of calmodulin- and protein kinase C-related mechanism in an induction process of peroxisomal fatty acid oxidation-related enzymes by hypolipidemic peroxisome proliferators

Trifluoperazine, a calmodulin antagonist, suppressed the clofibric acid-evoked induction of the peroxisomal cyanide-insensitive fatty acyl-CoA oxidizing system and carnitine acetyltransferase in rat liver and also in cultured rat hepatocytes. H-7, a potent inhibitor of protein kinase C, also suppressed the induction of these enzymes by clofibric acid, bezafibrate, Wyl4,643 or mono(2-ethylhexyl)phthalate in cultured rat hepatocytes. This suppressive effect was also confirmed by the protein composition of hepatocytes treated with clofibric acid and these antagonists, where the increase in the amount of peroxisomal bifunctional enzyme by peroxisome proliferator was markedly suppressed by above two antagonists. Profile of the time-dependent changes in the activities of the two enzymes after clofibric acid treatment showed that there might be two phases in the induction process. The initial phase (0-3 days after the treatment) showed a relative low inducing rate and subsequent phase (3-5 days after the treatment) showed an abrupt induction. The suppressive effect of the above two antagonists was significant in the later phase. In a time course study of the induction process of peroxisomal catalase, bifunctional enzyme or 69 kDa integral membrane protein using immunochemical detection, the induction of the membrane protein by clofibric acid was delayed compared with that of the bifunctional enzyme, where the induction was inhibited almost completely by nicardipine. These experimental results suggest that calmodulin- and protein kinase C-dependent processes play an important role in the process of marked induction of peroxisomal enzymes and membrane protein by drugs in rat liver.

[Effect of antiplatelet and anticoagulant therapy on secondary prevention and long-term prognosis after acute myocardial infarction in aged patients]

The long-term efficacy and side effects of antiplatelet and anticoagulant therapy for secondary prevention after the first acute myocardial infarction (AMI) were retrospectively assessed in 133 patients over 60 years of age during a mean follow-up period of 36.6 months. Seventy five patients received antiplatelet and anticoagulant therapy (group 1) and 58 patients did not (group 2). In group 1 patients, 54, 12 and 9 patients received ticlopidine, aspirin and warfarin, respectively. Mean age, sex ratio, site of AMI, max CPK value and left ventricular ejection fraction in the convalescent phase did not differ between the two groups. There were no differences between the two groups in terms of the number and kind of combination drugs such as nitrate, beta-blocker and Ca antagonist. During the follow-up period 40 patients died; 18 patients (45%) suffered cardiac death and 22 patients (55%) experienced non-cardiac death. Nineteen patients had recurrent MI and 37 patients had cardiac events which were defined in total as cardiac death, recurrent MI and unstable angina pectoris. The total mortality rate and rate of recurrent MI based on the life time table method were significantly lower in group 1 than in group 2 by the generalized Wilcoxon test. The cumulative total mortality rate in the fifth year was 24.2% in group 1 and 49% in group 2. The cumulative rate for recurrent MI in the fifth year was 7.4% in group 1 and 27.5% in group 2 (p less than 0.05). However, the rate of cardiac events did not differ between the two groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Molten titanium flow in a mesh cavity by the flow visualization technique

The tracer element molten (TEM) method, which provides titanium flow visualization in a mold cavity, was applied to investigate the flow in a mesh pattern. When a pressure casting machine was used, most of the mesh rods were composed of many solidification layers, which implied that the flow was laminar and almost steady. When a centrifugal casting machine was used, the flow was almost irregular and a stack of solidification layers was observed in only a few segments. These results indicate that the flow was turbulent. In a complicated cavity, such as a mesh pattern, pressure rather than centrifugal force acts as an effective casting force. Therefore, in such a cavity, favorable castability can be achieved with high pressure and laminar flow.

Cardiac sequelae of Kawasaki disease in Japan: statistical analysis

The proportions of Kawasaki disease patients with cardiac sequelae in Japan were analyzed using nationwide survey data from the 6 1/2-year period July 1982 through December 1988. Of 46,864 cases of Kawasaki disease reported in the surveys, 7637 or 16.3% had cardiac sequelae such as dilation or stenosis of coronary arteries, myocardial infarction, and valvar lesions 1 month or more after onset. The prevalence of cardiac sequelae was particularly high in males, infants younger than 1 year, and children older than 5 years of age. In sequential observation, there was no correlation between the prevalence of cardiac sequelae and periods of high or low incidence of the disease. The prevalence of cardiac sequelae overall declined steadily over the observation period, perhaps as a consequence of increasing use of intravenous gamma globulin. However, children older than the age of 5 years manifested increasing prevalence of cardiac sequelae over the observation period, probably as a result of lower rates of intravenous gamma globulin administration.

Co-suppression by nicardipine, a calcium antagonist, of induction of microsomal lauric acid hydroxylation with peroxisome proliferation in clofibrate-treated rat liver

The in vivo effect of nicardipine, a well-known calcium antagonist, on microsomal omega-oxidation of laurate in clofibrate-treated rat liver was studied. The 15.3-fold induction of the activity by 2 weeks administration of 0.25% clofibrate in the diet was markedly suppressed to about 6-fold by co-administration of nicardipine at 100 mg/kg body weight. Similarly, the induction of peroxisomal beta-oxidation and carnitine acetyltransferase activities were also suppressed by this simultaneous administration by more than 50%. Although clofibrate also induced the activity of reduced nicotineamide adenine dinucleotide phosphate (NADPH)-cytochrome c reductase and increased the hepatic content of cytochrome P-450, no suppressive effect of nicardipine was observed. Contrarily, nicardipine induced the reductase activity and increased the hepatic content of cytochromes P-450 and b5. These results provide the first demonstration of a calcium antagonist, e.g. nicardipine acting as inhibitor of the induction of microsomal omega-oxidation, in association with the inhibition of peroxisome proliferation in animals. The suppression of drug-induced peroxisome proliferation and microsomal omega-oxidation by the calcium antagonist may help in elucidating the causal relationship of the induction mechanisms between peroxisomal and microsomal enzymes.

[Determination of titanium flow by the tracer element molten method in the dental precision casting. 1. The principle of flow visualization and application to simple castings]

The tracer element molten (TEM) method has been developed for flow visualization of molten Titanium in dental precision casting. The principle of this technique is as follows. When Titanium is cast, the tracer element wire inserted previously into the selective point of the sprue is molten little by little and distributed according to the molten Titanium flow in the mold cavity. After solidification, to observe the flow pattern, the tracer element needs to be analyzed on a section of the casting by EPMA equipped with the stage scan mapping system. This technique using Ag, Au, Pd or Pt as a tracer has been applied to some simple castings in shape and has been confirmed to be a very powerful technique for Titanium flow visualization in dental castings.

[Reactions at the nonprecious metal-ceramic interface during porcelain firing. (3) A commercial alloy forming much Cr oxide during firing]

To examine the interface reaction between porcelain and a commercial Ni-Cr dental alloy (containing higher Cr and Mo) during porcelain firing, electron probe microanalyzer (EPMA) and X-ray diffraction have been used to characterize the interface which has emerged by means of selective dissolution of the alloy caused by a bromine-methanol solution. Much Cr oxide was formed at the early stage of firing, and remained in the reaction layer even if the holding time at 960 degrees C was up to 8 minutes. As a result, many Cr atoms diffused into the porcelain layer, most of which was found to form oxides through X-ray diffraction. Moreover, the porcelain layer nearest to the oxide layer was deduced to be modified seriously.

[Grinding of titanium. 2. Commercial vitrified wheels made of alumina abrasives]

Cast titanium was ground with commercial vitrified wheels made of alumina abrasives, and their grinding performance was investigated. For cutting, the appropriate circumferential speed of the alumina wheels was about 700 m/min. A speed lower or higher than this yielded unfavorable grinding results, which were attributed to wheel loading or chemical attrition of the abrasive, respectively. The hard wheel made of the A abrasive was suitable for grinding of titanium, and moreover, the wheel of the WA abrasive was more suitable than that made of the A abrasive. Generally, the cutting rate of the alumina wheels was inferior to that of the silicon carbide ones investigated previously. Depression of the wheel against the work yielded unfavorable grinding results; the manner in which the wheel was moved over the work during grinding was very important, compared with the silicon carbide wheels. Although the wheel was moved over the work, the high circumferential speed of the wheel resulted in chemical attrition of the abrasive and discoloration of the work surface, or grinding burn. The grinding burn layer mainly consisted of a few microns-thick titanium oxide.

[Grinding of titanium. 1. Commercial and experimental wheels made of silicon carbide abrasives]

Cast titanium was ground with commercial and experimental wheels made of silicon carbide abrasives, and their grinding performance was investigated. With the vitrified wheels made of the GC abrasive, at a higher the wheel circumferential speed and heavier the grinding pressure, the cutting rate was greater, accompanied by violent wear of the wheel. Being independent of the wheel speed, the grinding ratio reached about 1 under pressure heavier than 100 gf. The MgO-MgCl2-bonded wheels of the C abrasive exhibited a similar tendency. The manner in which the wheel was moved over the work during grinding proved to be very important, compared with the Ni-Cr alloy as reported previously. Only depression of the wheel against the work resulted in chemical attrition of the abrasive and discoloration of the work surface, or grinding burn, due to oxidation of titanium. Even when the wheel was moved over the work, chip-formation process of the cutting edge was far from ideal, and the work surface was contaminated due to reaction of titanium with the abrasive. At a higher wheel circumferential speed, more chips were loaded or built-up in the wheel and strongly rubbed the work surface, resulting in violent wear of the wheel; loading and dislodging of such chips were repeated.