Endometriosis-Associated Angiogenesis and Anti-angiogenic Therapy for Endometriosis

Endometriosis is a known estrogen-dependent inflammatory disease affecting reproductive-aged women. Common symptoms include pelvic pain, dysmenorrhea, dyspareunia, heavy menstrual bleeding, and infertility. The exact etiology of endometriosis is largely unknown, and, thus, the diagnosis and treatment of endometriosis are challenging. A complex interplay of many molecular mechanisms is thought to aid in the progression of endometriosis, most notably angiogenesis. This mini-review examines our current knowledge of the molecular etiology of endometriosis-associated angiogenesis and discusses anti-angiogenic therapy, in the blockade of endometriosis-associated angiogenesis, as potential non-hormonal therapy for the treatment of endometriosis.

Detection of Local Recurrence in Patients with Head and Neck Squamous Cell Carcinoma Using Voxel-Based Color Maps of Initial and Final Area under the Curve Values Derived from DCE-MRI

BACKGROUND AND PURPOSE

Early detection of local recurrence is important to increase the chance of cure because local recurrence is the main cause of treatment failure in head and neck squamous cell carcinoma. We evaluated the added value of voxel-based color maps of dynamic contrast-enhanced MR imaging compared with conventional MR imaging alone for detecting local recurrence of head and neck squamous cell carcinoma.

MATERIALS AND METHODS

We retrospectively enrolled 63 consecutive patients with head and neck squamous cell carcinoma after definitive treatment and posttreatment surveillance MR imaging studies that demonstrated focal enhancement at the primary site. Three independent readers assessed conventional MR imaging and a pair of color maps of initial and final 90-second time-signal intensity areas under the curve from dynamic contrast-enhanced MR imaging. The sensitivities, specificities, and accuracies of both conventional MR imaging alone and combined interpretation of conventional and dynamic contrast-enhanced MR imaging were assessed using the clinicopathologic diagnosis as the criterion standard. κ statistics were used to evaluate interreader agreement.

RESULTS

There were 28 patients with subsequently documented local recurrence and 35 with posttreatment change. Adding dynamic contrast-enhanced MR imaging to conventional MR imaging significantly increased the diagnostic accuracies for detecting local recurrence (48%-54% versus 87%-91%; P < .05), with excellent interreader agreement (κ = 0.8; 95% CI, 0.67-0.92 to κ = 0.81; 95% CI, 0.69-0.93). By all 3 readers, the specificities were also significantly improved by adding dynamic contrast-enhanced MR imaging to conventional MR imaging (22%-43% versus 87%-91%; P < .001) without sacrificing the sensitivities (68%-82% versus 86%-89%; P > .05).

CONCLUSIONS

Adding voxel-based color maps of initial and final 90-second time-signal intensity areas under the curve from dynamic contrast-enhanced MR imaging to conventional MR imaging increases the diagnostic accuracy to detect local recurrence in head and neck squamous cell carcinoma by improving the specificity without sacrificing the sensitivity.

A Scoring System for Prediction of Cervical Lymph Node Metastasis in Patients with Head and Neck Squamous Cell Carcinoma

BACKGROUND AND PURPOSE

An accurate and comprehensive assessment of lymph node metastasis in patients with head and neck squamous cell cancer is crucial in daily practice. This study constructed a predictive model with a risk scoring system based on CT characteristics of lymph nodes and tumors for patients with head and neck squamous cell carcinoma to stratify the risk of lymph node metastasis.

MATERIALS AND METHODS

Data included 476 cervical lymph nodes from 191 patients with head and neck squamous cell carcinoma from a historical cohort. We analyzed preoperative CT images of lymph nodes, including diameter, ratio of long-to-short axis diameter, necrosis, conglomeration, infiltration to adjacent soft tissue, laterality and T-stage of the primary tumor. The reference standard comprised pathologic results. Multivariable logistic regression analysis was performed to develop the risk scoring system. Internal validation was performed with 1000-iteration bootstrapping.

RESULTS

Shortest axial diameter, ratio of long-to-short axis diameter, necrosis, and T-stage were used to develop a 9-point risk scoring system. The risk of malignancy ranged from 7.3% to 99.8%, which was positively associated with increased scores. Areas under the curve of the risk scoring systems were 0.886 (95% CI, 0.881-0.920) and 0.879 (95% CI, 0.845-0.914) in internal validation. The Hosmer-Lemeshow goodness-of-fit test indicated that the risk scoring system was well-calibrated (P = .160).

CONCLUSIONS

We developed a comprehensive and simple risk scoring system using CT characteristics in patients with head and neck squamous cell carcinoma to stratify the risk of lymph node metastasis. It could facilitate decision-making in daily practice.

Peeled volume models of a whole body to enhance comprehension of anthropological bone landmarks

BACKGROUND

In physical anthropology, bone landmarks are palpated in living humans for the identification of corresponding skin landmarks and exact biometry. The purpose of this study is to help comprehend the locations and depths of representative bone landmarks all over the body.

MATERIALS AND METHODS

The sectioned images of a male cadaver's whole body were used to build a volume model, which was continuously peeled at 1 mm thicknesses to disclose 27 selected landmarks in the anterior, lateral, or posterior views.

RESULTS

The captured views of peeled volume models along with the labels of the bone landmarks were loaded to browsing software that was distributed for free. The browsing software containing the peeled volume models will enhance convenient studying of the bone landmarks.

CONCLUSIONS

With the knowledge of bone landmarks, investigators would be able to attain more accurate measurements between skin landmarks.

MR Imaging-Based Evaluations of Olfactory Bulb Atrophy in Patients with Olfactory Dysfunction

BACKGROUND AND PURPOSE

Although the olfactory bulb volume as assessed with MR imaging is known to reflect olfactory function, it is not always measured during olfactory pathway assessments in clinical settings. We aimed to evaluate the utility of visual olfactory bulb atrophy and neuropathy analyses using MR imaging in patients with olfactory dysfunction.

MATERIALS AND METHODS

Thirty-four patients who presented with subjective olfactory loss between March 2016 and February 2017 were included. Patients underwent a nasal endoscopic examination, olfactory testing with the Korean Version of the Sniffin' Sticks test, and MR imaging. All patients completed the Sino-Nasal Outcome Test and Questionnaire of Olfactory Disorders. Olfactory bulb atrophy and neuropathy were evaluated on MR images by 2 head and neck radiologists.

RESULTS

The etiology of olfactory loss was chronic rhinosinusitis with/without nasal polyps in 15 (44.1%) patients, respiratory viral infection in 7 (20.6%), trauma in 2 (5.9%), and idiopathic in 10 (29.4%) patients. Although 10 (29.4%) of the 34 patients were normosmic according to the Sniffin' Sticks test, their scores on the other tests were like those of patients who were hyposmic/anosmic according to the Sniffin' Sticks test. However, the detection rate of olfactory bulb atrophy was significantly higher in patients with hyposmia/anosmia than it was in patients with normosmia (P = .002). No difference in olfactory bulb neuropathy was identified among patients with normosmia and hyposmia/anosmia (P = .395).

CONCLUSIONS

MR imaging evaluations of olfactory bulb atrophy can be used to objectively diagnose olfactory dysfunction in patients with subjective olfactory loss.

Ethanol Ablation of Ranulas: Short-Term Follow-Up Results and Clinicoradiologic Factors for Successful Outcome

BACKGROUND AND PURPOSE

Surgical excision of an affected sublingual gland for treatment of a ranula can carry a potential of a nerve damage or postoperative complications. However, there have been little studies about effective minimally invasive therapeutic method, yet. Our aim was to evaluate the efficacy and safety of ethanol ablation of ranulas and the clinicoradiologic factors that can predict outcome.

MATERIALS AND METHODS

This retrospective study evaluated 23 patients with ranulas treated by percutaneous ethanol ablation. Treatment outcome was assessed in 20 patients followed for at least 6 months. The duration of symptoms before ethanol ablation, pretreatment volume, and parapharyngeal extension on sonography and/or CT were correlated with the outcome. The Mann-Whitney U test and Fisher exact test were used for comparison of the factors according to the outcome.

RESULTS

The study evaluated 14 males and 9 females with a median age of 26 years (range, 3-41 years). Among 20 patients who were followed for at least 6 months (median, 20 months; range, 6-73 months), 9 patients (45%) demonstrated complete disappearance of the ranulas and 11 (55%) showed an incomplete response. When the patients were divided according to the duration of symptoms before ethanol ablation, the complete response rate was significantly higher in patients with ≤12 months of symptoms (73%, 8/11) than that in others (11%, 1/9) (P = .010). Pretreatment volume and parapharyngeal extension were not significantly different between the 2 groups.

CONCLUSIONS

Ethanol ablation is a safe and noninvasive treatment technique for ranulas with a significantly better outcome in patients with ≤12 months of symptoms. Therefore, it could be considered an alternative nonsurgical approach for ranulas with recent onset of symptoms.

Improved Diagnostic Accuracy Using Arterial Phase CT for Lateral Cervical Lymph Node Metastasis from Papillary Thyroid Cancer

BACKGROUND AND PURPOSE

Contrast-enhanced CT protocols for papillary thyroid cancer are yet to be optimized. Our aim was to compare the diagnostic accuracy of arterial phase CT and delayed-phase CT protocols for lateral cervical lymph node metastasis from papillary thyroid carcinoma by using the lymph node tissue attenuation.

MATERIALS AND METHODS

This retrospective study included 327 lateral cervical lymph nodes (177 metastatic and 150 benign) from 131 patients with papillary thyroid carcinoma (107 initially diagnosed and 24 recurrences). Patients underwent CT by using 1 of 3 protocols: a 70-second (A) or a 35-second (B) delay with 100 mL of iodinated IV contrast or a 25-second delay with 75 mL of IV contrast (C). Two readers independently measured and compared lymph node tissue attenuation between metastatic and benign lymph nodes. An area under the receiver operating characteristic curve analysis was performed to differentiate metastatic and benign lymph nodes after multiple comparison correction for clustered data and was compared across the protocols.

RESULTS

The difference in mean lymph node tissue attenuation between metastatic and benign lymph nodes was maximum in protocol C (P < .001 for both readers). Protocol C showed the highest diagnostic performance (area under the receiver operating characteristic curve, 0.88-0.92) compared with protocol A (area under the receiver operating characteristic curve, 0.73-0.74, P < .001 for both readers) and B (area under the receiver operating characteristic curve, .63-0.65, P < .01 for both readers). The sensitivity, specificity, positive predictive value, and negative predictive value of lymph node tissue attenuation by using a 99-HU cutoff value were 83%-87%, 93.7%-97.9%, 95.1%-97.3%, and 81.2%-87%.

CONCLUSIONS

A combination of 25-second delay CT and 75 mL of iodinated IV contrast can improve the diagnostic accuracy for lateral lymph node metastasis from papillary thyroid carcinoma compared with a combination of a 35- or 70-second delay with 100-mL of iodinated IV contrast.

Comparison of High-Resolution MR Imaging and Digital Subtraction Angiography for the Characterization and Diagnosis of Intracranial Artery Disease

BACKGROUND AND PURPOSE

High-resolution MR imaging has recently been introduced as a promising diagnostic modality in intracranial artery disease. Our aim was to compare high-resolution MR imaging with digital subtraction angiography for the characterization and diagnosis of various intracranial artery diseases.

MATERIALS AND METHODS

Thirty-seven patients who had undergone both high-resolution MR imaging and DSA for intracranial artery disease were enrolled in our study (August 2011 to April 2014). The time interval between the high-resolution MR imaging and DSA was within 1 month. The degree of stenosis and the minimal luminal diameter were independently measured by 2 observers in both DSA and high-resolution MR imaging, and the results were compared. Two observers independently diagnosed intracranial artery diseases on DSA and high-resolution MR imaging. The time interval between the diagnoses on DSA and high-resolution MR imaging was 2 weeks. Interobserver diagnostic agreement for each technique and intermodality diagnostic agreement for each observer were acquired.

RESULTS

High-resolution MR imaging showed moderate-to-excellent agreement (interclass correlation coefficient = 0.892-0.949; κ = 0.548-0.614) and significant correlations (R = 0.766-892) with DSA on the degree of stenosis and minimal luminal diameter. The interobserver diagnostic agreement was good for DSA (κ = 0.643) and excellent for high-resolution MR imaging (κ = 0.818). The intermodality diagnostic agreement was good (κ = 0.704) for observer 1 and moderate (κ = 0.579) for observer 2, respectively.

CONCLUSIONS

High-resolution MR imaging may be an imaging method comparable with DSA for the characterization and diagnosis of various intracranial artery diseases.

Isolated Ischemic Contracture of the Mobile Wad: A Report of Two Cases

Two children with isolated ischaemic contractures of the mobile wad (extensor carpi radialis longus, extensor carpi radialis brevis and brachioradialis), which developed after treatment of a supracondylar fracture, are presented. Z-lengthening of the extensor carpi radialis longus and brevis tendons improved wrist flexion.

Segmentation and surface reconstruction of a cadaver heart on Mimics software

The Visible Korean research team used Mimics software (Materialise, Leuven, Belgium) for the segmentation and subsequent surface reconstruction of heart structures using information obtained from sectioned images of a cadaver. Twenty-six heart components were outlined in advance on Photoshop (Adobe Systems, San Jose, CA, USA). By use of the Mimics, the outlined images were then browsed along with the vertical planes as well as the 3-dimensional surface models, which were immediately built by piling the images. Erroneous delineation was readily detected and revised until satisfactory heart models were acquired. The surface models and the selected sectioned images in horizontal, coronal, and sagittal planes were inputted into a PDF file, where any combinations of reconstructed constituents could be displayed and rotated by the user. Mimics software accelerated the segmentation and surface reconstruction of heart anatomical structures. Similar benefits hopefully result from various serial images of other organs. The PDF file, and plane and stereoscopic image data are being distributed to others, and should prove valuable for medical students and clinicians.

Morphologic features of cardiac sarcoidosis in native hearts of patients having cardiac transplantation

Described herein are 10 patients who underwent cardiac transplantation (CT) for severe chronic systolic heart failure resulting from cardiac sarcoidosis. None had the diagnosis of sarcoidosis established before CT except for the 3 patients who earlier had had a portion of left ventricular wall excised for insertion of a left ventricular assist device and non-caseating granulomas were present in the removed myocardium. Although none of the 10 patients had significant narrowing of any of the epicardial coronary arteries, all had focal scarring of the walls of the left and right ventricles and ventricular septum and all had dilated ventricular cavities. The patients with the most ventricular wall scarring tended to have the fewest sarcoid granulomas in the ventricular walls. Two patients had no sarcoid granulomas in the excised heart although one did have typical sarcoid granulomas in the portion of left ventricular wall excised to insert a left ventricular assist device. Patients with cardiac sarcoidosis severe enough to warrant CT had characteristic cardiac ventricular morphologic findings, and no dysfunction of other non-cardiac organs, making clinical diagnosis of cardiac sarcoidosis rather difficult.

The myth of the Bernheim syndrome

The Bernheim syndrome has been a topic of discussion for over a century. It has been reported to be caused by severe rightward movement of the ventricular septum resulting in compression of the right ventricular cavity leading to right-sided heart failure without pulmonary congestion. Hemodynamic findings have been described in a few patients with the so-called Bernheim syndrome. We describe a patient in whom the ventricular septum dramatically decreased the size of the right ventricular cavity and yet peak systolic pressures in both the right ventricle and pulmonary trunk were identical. Thus, it is difficult to view the Bernheim syndrome as a real entity.

Abstract P2-10-39: Does E-cadherin or N-cadherin or epithelial-mesenchymal transition have a probability of clinical implication of the prognostic marker in invasive ductal carcinoma?

Purpose: Epithelial to mesenchymal transition (EMT) is widely accepted hypothesis of progression and metastasis in carcinoma. EMT can be explained as a loss of epithelial features and gain of mesenchymal properties, and in the same manner, it can be characterized by down-regulation of epithelial cellular markers, such as E-cadherin (EC) and up-regulation of mesenchymal cellular markers, such as N-cadherin (NC). Breast cancer has a diverse clinical spectrum, treatments and prognosis according to clinicopathologic characteristics and immunohistochemical features. Identifying the presence of EMT also would be able to predict the prognosis and design better and customized therapy. Our objective was to evaluate expression of the EC/NC and EMT and correlation between EMT and clinicopathologic, immunohistochemical features and to investigate clinical implication of the EC/NC and EMT as prognostic marker in breast cancer.

Methods: Using the clinicopathologic data of 480 patients who underwent operation for invasive ductal carcinoma (IDC) during February 2001 to December 2008. 282 patients with good quality of paraffin embedded tissue block were selected. The ER and PR immunohistochemistry was scored using the Allred Score. EC and NC expression were classified on the basis of intensity of immunohistochemistry staining. The gain of a mesenchymal marker or loss of an epithelial marker was interpreted as EMT-positive. In this study, breast cancer was classified into four types according to the immunohistochemical expression of ER, PR and HER2 expression on immunohistochemical analysis and/or with HER2 gene by FISH analysis: luminal A, luminal B, HER2-enriched, and triple negative type.

Results: Median follow-up period was 52.6 months (range 1–113) and median age was 49 years (range 27–79). Of total 282 cases, 152 (53.9%) cases were classified as luminal A, 32 (11.3%) classified as luminal B, 43 (15.2%) cases were HER2-enriched and 55 (19.5%) cases were triple negative type. Expression of a mesenchymal marker, NC was observed in 22 (7.8%) patients and loss of an epithelial marker, EC was observed in 57 (20.2%) cases. A total of 75 (26.6%) were interpreted as EMT-positive. NC score was associated with HER2-enriched, and triple negative molecular subtype (P = 0.0234). NC status was associated with HER2 positive status (P = 0.0456) and HER2-enriched, triple negative molecular subtype (P = 0.0029). EMT correlated with ER negative status (P = 0.0199). T stage (P &lt; 0.001), N stage (P &lt; 0.001) and TNM stage (P &lt; 0.001) and ER (P = 0.0403) and PR (P = 0.0041) status significantly influenced disease-free survival (DFS). Age (P = 0.0185) and T stage (P = 0.0017), N stage (P &lt; 0.001) and ER (P = 0.0048), and PR status (P = 0.0072), molecular subtype (P = 0.0372), significantly influenced overall survival (OS). The status of the EC/NC and EMT did not significantly affect DFS or OS.

Conclusion: NC status was associated with HER2 positive status and HER2-enriched, triple negative molecular subtype. And EMT correlated with ER negative status. EC/NC and EMT status have relevance to a specific molecular subtype or a probability of clinical implication of the poor prognostic marker in breast cancer.

Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P2-10-39.

Comparative rapid onset of efficacy between doxazosin gastrointestinal therapeutic system and tamsulosin in patients with lower urinary tract symptoms from benign prostatic hyperplasia: a multicentre, prospective, randomised study

AIMS

To compare the rapidity of improvement in lower urinary tract symptoms (LUTS) for the doxazosin gastrointestinal therapeutic system (GITS) and tamsulosin in benign prostatic hyperplasia (BPH) patients.

METHODS

A total of 207 patients were randomised to one of two groups for a 12-week daily treatment with doxazosin-GITS 4 mg or tamsulosin 0.2 mg. The primary end-point was to compare the early onsets of efficacy between the two drugs. This was assessed by analysing the changes from baseline in the total International Prostate Symptom Score (IPSS) in the early period of treatment. Secondary aims were to compare improvements in obstructive/irritative subscore and quality of life (QoL) score between the two groups, and to evaluate the adverse events (AEs) with the drugs.

RESULTS

After 12 weeks of treatment, both groups showed significant improvements in IPSS scores (total, obstructive and irritative subscores, QoL score) from baseline (p < 0.0001). However, the doxazosin-GITS group showed significantly greater improvements in total IPSS and obstructive subscore than the tamsulosin group in the early period (p < 0.05). Improvements in irritative subscore (within 4 weeks) and QoL score (during 12 weeks) were not significantly different between the groups. The incidences of AEs were similar between the groups.

CONCLUSION

In this study, doxazosin-GITS showed significantly more rapid onset of efficacy and similar AEs compared with tamsulosin in BPH patients with LUTS. We believe this will probably improve patient compliance. Future studies with a larger number of patients and a longer follow-up period will be required to confirm this.

Simulations of infrared and optical rectification by geometrically asymmetric metal-vacuum-metal junctions for applications in energy conversion devices

We use a transfer-matrix methodology to simulate the rectification of infrared and optical radiation by geometrically asymmetric metal-vacuum-metal junctions in which one of the metals is flat while the other is extended by a tip. We determine in particular the power this junction could provide to an external load and the efficiency with which the energy of incident radiations is converted. We consider first situations in which the external radiation is monochromatic, with typical frequencies in the infrared and optical domains. We then consider situations in which the external radiation consists of a full range of frequencies, with amplitudes that are representative of a focused beam of solar radiation. We investigate in particular how the efficiency of the rectification is affected by the aspect ratio of the tip, the work function of the metallic elements and the occurrence of polarization resonances. Our results demonstrate that the rectification of infrared and optical radiation is possible using devices of the type considered in this work. They finally provide a quantitative analysis of the efficiency of this rectification.

Computed tomographic assessment of reduction of the distal radioulnar joint by gradual lengthening of the radius

Congruency of the distal radioulnar joint was assessed by computed tomography after gradual lengthening of the radius in patients with considerable ulnar positive variance of mean 12 (range 10-17) mm and chronic dislocation of the distal radioulnar joint. Six patients of mean age 25 years were treated by radial osteotomy and subsequent gradual lengthening using either a single-rod or a half-ring external fixator, which was applied for a mean of 81 days. The causes of deformity were distal radial epiphyseal injury in four, malunion of a radius shaft fracture in one and Madelung deformity in one. Computed tomography scans taken at 1 year postoperatively demonstrated that all patients had a congruent distal radioulnar joint. All patients achieved symptom and radiographic parameter improvements at a mean follow-up of 40 months. A disadvantage was unattractive scars on a cosmetically important surface of the forearm. Given a relatively intact bony contour of the distal radioulnar joint, congruent reduction of the distal radioulnar joint can be obtained by gradual lengthening of the radius.

Complications of distraction lengthening in the hand

This study examined the features of 16 complications from 51 distraction lengthenings in the hands of 43 patients. From 1996 to 2006, 24 metacarpals and 27 phalanges were lengthened at a rate of 0.5 and 0.25 mm/day, respectively, using a callus distraction technique. The indications were congenital (33 cases in 27 patients) and traumatic (18 cases in 16 patients) deformities. The average percentage lengthening in the phalanges and metacarpals was 62% (16 mm) and 63% (34 mm), respectively. The distraction rates in the phalanges and metacarpals were 69 and 52 days/cm, respectively. The overall complication rate was 31%. Major complications requiring secondary procedures were non-union (one case), fracture (one case), premature union (one case), angulations (two cases) and dislodgment of pins (two cases). The minor complications encountered were delayed callus formation (four cases), joint stiffness (four cases) and soft tissue thinning (one case). Traumatic deformities had more complications than the congenital ones (nine of 18 cases and seven of 33 cases, respectively). The phalanges had a higher rate of complication than the metacarpals (11 of 27 cases and four of 24 cases, respectively). Most patients with complications except for two children with dislodgment were as satisfied with the final results as those without complications. Although callus distraction in the hand requires a long treatment period and has a relatively high rate of complication, it appears to be effective in achieving adequate bone length. A high level of patient compliance and prompt management of complications by an experienced surgeon are essential for achieving good results.

Arthroplasty for advanced Kienböck's disease using a radial bone flap with a vascularised wrapping of pronator quadratus

We have performed a form of lunate replacement arthroplasty, which included excision of the lunate and insertion of a vascularised radial bone flap wrapped in pronator quadratus, for stage IIIB or stage IV Kienböck's disease, in 41 patients who have been followed up for more than three years. All patients reported an improvement in their symptoms, and 20 of the 41 became free of pain after the operation. Extension and flexion of the wrist were increased by a mean of 9 degrees and 6 degrees , respectively (p < 0.05). The radioscaphoid angle and the carpal height ratio were not significantly changed and only minimal deterioration was observed due to degenerative change. The size, density or location of the inserted bone did not change with time. A vascularised radial bone flap wrapped in pronator quadratus can be a reliable treatment option for advanced Kienböck's disease, when the pedicled bone and muscle envelope acts as a stable spacer for the excised lunate.

Multiple congenital brachymetatarsia

We performed nine metatarsal and three proximal phalangeal lengthenings in five patients with congenital brachymetatarsia of the first and one or two other metatarsal bones, by a one-stage combined shortening and lengthening procedure using intercalcary autogenous bone grafts from adjacent shortened metatarsal bones. Instead of the isolated lengthening of the first and the other metatarsal bones, we shortened the adjacent normal metatarsal and used the excised bone to lengthen the short toes, except for the great toe, to restore the normal parabola. One skin incision was used. All the operations were performed bilaterally and the patients were followed up for a mean period of 69.5 months (29 to 107). They all regained a nearly normal parabola and were satisfied with the cosmetic results.

Our technique is straightforward and produces good cosmetic results. Satisfactory, bony union is achieved, morbidity is low, and no additional surgery is required for the removal of metal implants.

Chemotherapeutic efficacy of praziquantel in rats with protective immunity to Clonorchis sinensis infection

OBJECTIVE

To study the synergic effect of praziquantel (PZQ) and host acquired immunity on Clonorchis sinensis.

METHODS

Acquired immunity to C. sinensis was induced by immunization with crude adult worm antigen (AW Ag) and excretory-secretory antigen (ES Ag) or infection with C. sinensis metacercariae. The effect was assessed by the worm reduction rate compared with the control groups after challenge infection with 50 metacercariae and treated orally with a subcurative dose of praziquantel (50 mg/kg). Significant test was performed by analysis of variance (ANOVA) and Npar1 way Kruskal-Wallis test. All calculations were performed by PC-SAS system.

RESULTS

1. PZQ was more effective against C. sinensis larvae than against adult worms in the control (P < 0.001), ES Ag (P < 0.01) or crude AW Ag immunization group (P < 0.001). 2. As compared with the control, the worm reduction rate after challenge infection was significantly higher (P < 0.001) in ES Ag immunized group (35.6%) and metacercaria infection group (97.5%) and less in crude AW Ag group (23.4%). The PZQ efficacy was significantly enhanced in ES Ag immunized group.

CONCLUSION

The efficacy of PZQ against C. sinensis could be synergically enhanced in rats by inducing host acquired immunity.

Intramuscular neurilemoma

In this retrospective study, we analysed the clinical features of neurilemoma when it is located in muscle. Twelve patients had an intramuscular neurilemoma as shown on magnetic resonance (MR) scans and confirmed at operation. In six it was located in the upper limb, in five in the lower limb, and in one in the back. The mean age of the patients was 41 years (12 to 58). Nine complained only of a palpable mass and the other three of a mass with slight tenderness. None had neurological symptoms or signs, such as radicular pain, a positive Tinel sign, or motor weakness. There were no postoperative complications or recurrence of the tumour after a mean follow-up of two years (1 to 10).

Flow measurements via two-particle azimuthal correlations in Au + Au collisions at sqrt [s(NN)]=130 GeV

Two-particle azimuthal correlation functions are presented for charged hadrons produced in Au+Au collisions at the Relativistic Heavy Ion Collider (sqrt [s(NN)]=130 GeV). The measurements permit determination of elliptic flow without event-by-event estimation of the reaction plane. The extracted elliptic flow values (v2) show significant sensitivity to both the collision centrality and the transverse momenta of emitted hadrons, suggesting rapid thermalization and relatively strong velocity fields. When scaled by the eccentricity of the collision zone epsilon, the scaled elliptic flow shows little or no dependence on centrality for charged hadrons with relatively low p(T). A breakdown of this epsilon scaling is observed for charged hadrons with pT >1.0 GeV/c.

Measurement of Lambda and Lambda(macro) particles in Au+Au collisions at the square root of S(NN) = 130 GeV

We present results on the measurement of Lambda and Lambda(macro) production in Au+Au collisions at square root of (S (NN) = 130 GeV with the PHENIX detector at the Relativistic Heavy Ion Collider. The transverse momentum spectra were measured for minimum bias and for the 5% most central events. The Lambda;/Lambda ratios are constant as a function of p(T) and the number of participants. The measured net Lambda density is significantly larger than predicted by models based on hadronic strings (e.g., HIJING) but in approximate agreement with models which include the gluon-junction mechanism.

Net charge fluctuations in Au + Au interactions at sqrt[s(NN)]=130 GeV

Data from Au + Au interactions at sqrt[s(NN)]=130 GeV, obtained with the PHENIX detector at the Relativistic Heavy-Ion Collider, are used to investigate local net charge fluctuations among particles produced near midrapidity. According to recent suggestions, such fluctuations may carry information from the quark-gluon plasma. This analysis shows that the fluctuations are dominated by a stochastic distribution of particles, but are also sensitive to other effects, like global charge conservation and resonance decays.

Centrality dependence of pi(+/-), K(+/-), p, and (-)p production from sqrt[s(NN)] = 130 GeV Au + Au collisions at RHIC

Identified pi(+/-), K(+/-), p, and (-)p transverse momentum spectra at midrapidity in sqrt[s(NN)] = 130 GeV Au+Au collisions were measured by the PHENIX experiment at RHIC as a function of collision centrality. Average transverse momenta increase with the number of participating nucleons in a similar way for all particle species. Within errors, all midrapidity particle yields per participant are found to be increasing with the number of participating nucleons. There is an indication that K(+/-), p, and (-)p yields per participant increase faster than the pi(+/-) yields. In central collisions at high transverse momenta (p(T) > or =2 GeV/c), (-)p and p yields are comparable to the pi(+/-) yields.

Transverse-mass dependence of two-pion correlations in Au+Au collisions at square root[s(NN)] = 130 GeV

Two-pion correlations in square root[s(NN)] = 130 GeV Au+Au collisions at RHIC have been measured over a broad range of pair transverse momentum k(T) by the PHENIX experiment at RHIC. The k(T) dependent transverse radii are similar to results from heavy-ion collisions at square root[s(NN)] = 4.1, 4.9, and 17.3 GeV, whereas the longitudinal radius increases monotonically with beam energy. The ratio of the outwards to sidewards transverse radii (R(out)/R(side)) is consistent with unity and independent of k(T).

Measurement of single electrons and implications for charm production in Au+Au collisions at square root[s(NN)] = 130 GeV

Transverse momentum spectra of electrons from Au+Au collisions at square root[s(NN)] = 130 GeV have been measured at midrapidity by the PHENIX experiment at the Relativistic Heavy Ion Collider. The spectra show an excess above the background from photon conversions and light hadron decays. The electron signal is consistent with that expected from semileptonic decays of charm. The yield of the electron signal dN(e)/dy for p(T) > 0.8 GeV/c is 0.025+/-0.004(stat)+/-0.010(syst) in central collisions, and the corresponding charm cross section is 380+/-60(stat)+/-200(syst) microb per binary nucleon-nucleon collision.

Suppression of hadrons with large transverse momentum in central Au+Au collisions at root square[s(NN)] = 130 GeV

Transverse momentum spectra for charged hadrons and for neutral pions in the range 1 GeV/c<p(T)<5 GeV/c have been measured by the PHENIX experiment at RHIC in Au+Au collisions at root square[s(NN)] = 130 GeV. At high p(T) the spectra from peripheral nuclear collisions are consistent with scaling the spectra from p+p collisions by the average number of binary nucleon-nucleon collisions. The spectra from central collisions are significantly suppressed when compared to the binary-scaled p+p expectation, and also when compared to similarly binary-scaled peripheral collisions, indicating a novel nuclear-medium effect in central nuclear collisions at RHIC energies.

Observation of a (6)(LambdaLambda)He double hypernucleus

A double-hyperfragment event has been found in a hybrid-emulsion experiment. It is identified uniquely as the sequential decay of ( 6)(LambdaLambda)He emitted from a Xi(-) hyperon nuclear capture at rest. The mass of ( 6)(LambdaLambda)He and the Lambda-Lambda interaction energy DeltaB(LambdaLambda) have been measured for the first time devoid of the ambiguities due to the possibilities of excited states. The value of DeltaB(LambdaLambda) is 1.01+/-0.20(+0.18)(-0.11) MeV. This demonstrates that the Lambda-Lambda interaction is weakly attractive.

Ventral margin of the paracaval portion of human caudate lobe

The topographic anatomy of the ventral margin of the caudate lobe of the human liver is still obscure. We hypothesized the existence of a "precaudate plane", as a flat or slightly curved plane defined by the ventral margins of both the ligamentum venosum and hilar plate. Using 61 cadaveric liver specimens, without great differences in external shape or significant variations in the hilar bifurcation, we examined whether the paracaval caudate branches (PCs) ran through the plane to the ventral side. In 22 of the 61 specimens (36.1%), the PC extended over the plane for less than 10 mm (10 specimens), for 10-20 mm (7 specimens), or for more than 20 mm (5 specimens). The ventral extension consistently included the dome-like area under the terminals of the middle and right hepatic veins. Therefore, the ventrally extended PCs often interdigitated with these veins and their tributaries. The ventral extension often reached the upper, diaphragmatic surface. However, several branches were too difficult to discriminate from the PC, especially those with morphologies intermediate between the PC and segmental portal branches to S4 or S2. We discuss how to identify and manage the ventrally extended PCs before and during surgery.

Monitoring of microbial hazards at farms, slaughterhouses, and processing lines of swine in Korea

This study was executed to investigate microbiological hazards at swine farms, slaughterhouses, dressing operations, and local markets for the application of the hazard analysis critical control point system in Korea by analyzing total aerobic plate count (APC) and presence of pathogens. Six integrated pig farms and meat packers were selected from six different provinces, and samples were collected from pig carcasses by swabbing and excision methods at the slaughterhouses, processing rooms, and local markets, respectively. APCs of water in water tanks were relatively low, 1.9 to 3.1 log10 CFU/ml; however, they were increased to 4.6 to 6.9 log10 CFU/ml when sampled from water nipples in the pigpen. APCs of feeds in the feed bins and in the pigpens were 4.4 to 5.4 and 5.2 to 6.7 log10 CFU/g, respectively. Salmonella spp., Staphylococcus aureus, and Clostridium perfringens were detected from water and feed sampled in pigpens and pigpen floors. S. aureus was the most frequently detected pathogenic bacteria in slaughterhouses and processing rooms. Listeria monocytogenes and Yersinia enterocolitica were also detected from the processing rooms of the Kyonggi, Kyongsang, and Cheju provinces. Even though APCs were maintained at the low level of 3.0 log10 CFU/g during slaughtering and processing steps, those of final pork products produced by the same companies showed relatively high numbers when purchased from the local market. These results indicated that the cold chain system for transporting and merchandising of pork products was deficient in Korea. Water supply and feed bins in swine farms and individual operations can be identified as critical control points to reduce microbiological hazards in swine farms, slaughterhouses, and processing plants.

Changes in ulnar variance in relation to forearm rotation and grip

We studied radiographs of the wrists of 120 healthy volunteers in order to determine the normal range of ulnar variance. They had been taken in various positions under both unloaded (static) and loaded (dynamic) conditions. Pronation posteroanterior, supination anteroposterior and neutral posteroanterior views were taken of each wrist before and during a maximum grip under identical conditions. The mean normal ulnar variance in neutral rotation was +0.74+/-1.46 mm, a value which was significantly lower in males than in females. We found negative variance in 26% of cases. We measured maximum ulnar variance (UVmax +1.52+/-1.56 mm) when gripping in pronation and minimum ulnar variance (UVmin +0.19+/-1.43 mm) when relaxed in supination. We subtracted UVmin from UVmax to calculate a mean maximum dynamic change in ulnar variance of 1.34+/-0.53 mm. We consider this database of normal values to be useful for both the diagnosis and treatment of conditions related to discrepancy in radio-ulnar length and for clinical research.

Management of the corneal flap in laser in situ keratomileusis after previous radial keratotomy

PURPOSE

To report a method of managing the corneal flap in patients having laser in situ keratomileusis for the treatment of residual refractive errors after radial keratotomy.

DESIGN

Retrospective case series.

METHODS

Intraoperative dehiscence of radial keratotomy wounds occurred in 7 eyes of 6 patients treated with laser in situ keratomileusis for residual myopia or astigmatism or hyperopia 5 to 15 years after radial keratotomy. To minimize extension of these tears, the flap was initially rolled like a carpet toward the hinge before the ablation and then rolled away from the hinge to its original position after the ablation.

RESULTS

Using this method of managing the laser in situ keratomileusis flap in patients with previous radial keratotomy, all eyes had successful laser in situ keratomileusis, with 1-year postoperative uncorrected visual acuity ranging between 20/16 and 20/25. No eye had loss of spectacle-corrected vision or interface epithelial ingrowth.

CONCLUSIONS

Laser in situ keratomileusis has proved to be an effective treatment for correction of residual refractive errors after radial keratotomy. The surgical technique used in these cases was targeted at minimizing shearing forces in lifting the corneal flap to avoid extension of radial keratotomy wound dehiscence, which could lead to epithelial ingrowth and loss of best-corrected vision.

Effects of alkalinity of household dishwashing liquids on hand skin

The objective of this research was to investigate the effects of alkaline pH conditions of dishwashing liquids on hand skin of Korean panelists after repeated exposure. A group of 30 persons with normal hands immersed their hands, for a total of 15 min a day for 4 days, into household cleansing solutions adjusted to pH 7.4, 10.0 and 10.8, respectively. The effects of alkalinity of household cleansing solutions on hand skin were evaluated by measuring overall and dry hand-skin grades, as well as the degrees of hand-skin hydration estimated before and after the repeated immersion exposures to the 3 test products. No statistically-significant difference (p>0.05) was found among the parameters from the repeated immersion exposures to the test products. These findings indicate that increases of pH up to 10.8 of household cleansing solutions did not worsen either overall, dry hand-skin conditions or the level of hand-skin hydration.

Measurement of the midrapidity transverse energy distribution from square root of [(s)NN] = 130 GeV Au + Au collisions at RHIC

The first measurement of energy produced transverse to the beam direction at the Relativistic Heavy-Ion Collider at Brookhaven National Laboratory is presented. The midrapidity transverse energy density per participating nucleon rises steadily with the number of participants, closely paralleling the rise in charged-particle density, such that <E(T)>/<N(ch)> remains relatively constant as a function of centrality. The energy density calculated via Bjorken's prescription for the 2% most central Au+Au collisions at square root[s(NN)] = 130 GeV is at least epsilon(Bj) = 4.6 GeV/fm(3), which is a factor of 1.6 larger than found at sqrt[s(NN)] = 17.2 GeV ( Pb+Pb at CERN).

Efficacy of flubendazole and albendazole against Trichinella spiralis in mice

Efficacy of flubendazole and albendazole against Trichinella spiralis in mice were studied. ICR mice were experimentally infected with Trichinella spiralis and treated with either flubendazole (FBZ) or albendazole (ABZ) at four different stages of the parasite life-cycle. Oral administration of either FBZ or ABZ at 20 mg/kg and 50 mg/kg on 2 h, 8 h and 24 h (pre-adult stage) after infection eliminated 94.7-100% of adults as determined at necropsy on day 7 post infection (p.i.) and 96.9-100% of larvae on day 45 p.i. FBZ was more effective than ABZ against adult T. spiralis (at 2 to 6 days p.i.), when treated with a dosage of 20 mg/kg for 5 consecutive days (99.4% and 46.0% reduction with respect to the control group). Against migrating larval T. spiralis, FBZ was more effective than ABZ at 20 mg/kg for five consecutive days (on days 11-15 p.i.), and the reduction rate of recovered larvae were 99.6% (FBZ) and 80.8% (ABZ) respectively. FBZ was more effective against early encapsulated larval T. spiralis (at 21 to 25 days p.i.), than ABZ when both were given at 20 mg/kg for five consecutive days (99.8% and 45.4% reduction, respectively). In conclusion, flubendazole was more effective than albendazole against adult and parenteral stages of Trichinella spiralis in mice.

Centrality dependence of charged particle multiplicity in Au-Au collisions at square root of (s)NN = 130 GeV

We present results for the charged-particle multiplicity distribution at midrapidity in Au-Au collisions at square root of [s(NN)] = 130 GeV measured with the PHENIX detector at RHIC. For the 5% most central collisions we find dN(ch)/d eta(vertical line eta = 0) = 622+/-1(stat)+/-41(syst). The results, analyzed as a function of centrality, show a steady rise of the particle density per participating nucleon with centrality.

PCR-RFLP patterns of four isolates of Trichinella for rDNA ITS1 region

We have studied the genetic differences among four isolates of Trichinella including a new strain of Trichinella spiralis (ISS 623) recently found from a human case who took a badger in Korea. Because they have a different host origin and came from geographically separated regions, we supposed the genetic pattern of the isolates might be different as had been previously reported. It was analysed by PCR-RFLP analysis of the rDNA repeat that can readily distinguish a species or strain from others. Isolated genomic DNA of each isolate of Trichinella larvae was amplified with ITS1 specific primers and digested with restriction endonucleases. The PCR product of ITS1 was confirmed using Southern blot analysis to be a 910 bp fragment. The restriction fragments of each isolate had variable patterns when it was digested with Rsa 1 only. According to the RFLP patterns, the estimated genetic divergence between each isolate was different. In conclusion, four isolates of Trichinella including a new strain of T. spiralis obtained from a Korean patient may have genetic differences in the ITS1 region and the Shanghai isolate was genetically more similar to the Japanese unknown isolate than others in the ITS1 region.

Raynaud's phenomenon in idiopathic carpal tunnel syndrome: postoperative alteration in its prevalence

In a previous study the prevalence of Raynaud's phenomenon (RP) in patients with idiopathic carpal tunnel syndrome (CTS) was found to be 60% which is much higher than that in the general population. We undertook a further study of the same cohort of patients have both CTS and RP and who had an open release of the carpal tunnel, to observe the effects of the operation on RP. We observed whether the symptoms of RP improved, and repeated the cold provocation tests to see if the arterial pulse which was decreased before operation would recover. We rated the outcome as good when the patients showed both an improvement of the symptoms of RP and a normal pulse amplitude after exposure to cold, fair when the pulse amplitude recovered to more than two-thirds of that before exposure, and poor when cold hypersensitivity was persistent or showed the same degree of decreased pulse amplitude as observed before operation. Of the 18 patients with both conditions, ten (56%) had good and four (22%) fair results, with a mean recovery time of 4.2 months (6 weeks to 1 year) after operation. If the vasospasm seen in RP is an expression of vasomotor irritation in the carpal tunnel, these findings suggest that local compression of vasomotor fibres in the carpal tunnel can also be relieved by the release of this structure. Careful consideration, however, is still required in treating patients with both conditions since in some cases. RP may be superimposed or it may have other origins.

Three-dimensional image and virtual dissection program of the brain made of Korean cadaver

The three-dimensional (3D) structure of the brain needs to be understood for accurate diagnosis and treatment of brain diseases. The brain of a cadaver may not always be available for dissection when it is needed. To overcome this problem, we attempted to create a 3D image and virtual dissection program of the brain using a Korean cadaver. The brain extracted from a Korean male cadaver was embedded in gelatin solution. 130 MRI of the brain were taken and 130 serially-sectioned specimens were made. All of MRI and specimens were inputted into the computer, and 10 brain components were manually segmented. A 3D image and virtual dissection program of the brain was made. Various virtual dissection functions were established, such as 1) sectioning the 3D image of the brain at free angles to represent its plane as a real image, segmented image, and MRI, 2) identifying the brain components represented in the sectioned plane, and 3) rotating the 3D image of the whole brain or the selected brain components at free angles. The resulting virtual dissection program of the brain is helpful in better understanding the 3D location and shape of the brain components and it is expected to be used as a CD-title or through Internet as an educational tool for medical students and doctors.

Fungal keratitis after laser in situ keratomileusis: a case report

PURPOSE

To report a case of fungal keratitis resulting after laser in situ keratomileusis (LASIK).

METHODS

A 38-year-old white man in good health developed a corneal infiltrate with laboratory confirmation of fungal keratitis after LASIK. Corneal scrapings were taken. Silver stain was positive for hyphae. Culture was positive for Curvularia sp. The patient was started on intensive natamycin 5% and amphotericin 0.15% topical therapy.

RESULTS

The patient's keratitis was successfully treated with intensive antifungal therapy.

CONCLUSIONS

Infectious keratitis is a rare but a serious potential complication after LASIK. To our knowledge, no previous case of fungal keratitis after LASIK has been reported. This case emphasizes the importance of surveillance for infection after LASIK.

Mycobacterium chelonae keratitis after laser in situ keratomileusis successfully treated with medical therapy and flap removal

PURPOSE

To report a case of Mycobacterium chelonae keratitis after laser in situ keratomileusis successfully treated with medical therapy and flap removal.

METHODS

Case report. A 36-year-old white woman in good health developed a paracentral keratitis in her right eye 1 month after bilateral laser in situ keratomileusis. Initial treatment included topical steroids and then intensive Ocuflox (ofloxacin ophthalmic solution; Allergan, Inc, Irvine, California) without success. Cultures were negative. The keratitis worsened, and she was referred to our institution. Interface infiltration was noted, and the flap was lifted to obtain adequate laboratory studies. Cultures were positive for M chelonae.

RESULTS

The keratitis was treated with intensive topical amikacin sulfate 1%, topical clarithromycin 1%, and Ciloxan (ciprofloxacin HCL; Alcon Laboratories, Inc, Fort Worth, Texas) with minimal improvement in her clinical condition. She developed a toxic reaction to amikacin 1%. In order to improve antibiotic penetration, the hazy, ulcerated corneal flap was removed. The keratitis then resolved with intensive topical clarithromycin 1% and Ocuflox over 5 weeks. The patient now has visual acuity without correction of 20/50, despite superficial corneal haze.

CONCLUSION

M chelonae is a rare and insidious cause of infection after laser in situ keratomileusis. Diagnosis can be difficult and is often delayed. Aggressive medical management, with flap removal, if needed, may lead to resolution of infection.

Survival of Pseudomonas fluorescens and Salmonella typhimurium after electron beam and gamma irradiation of refrigerated beef

The radurization effects of gamma ray and electron beam irradiation at 1.5 and 3.0 kGy on beef steaks inoculated with Salmonella Typhimurium and Pseudomonas fluorescens were investigated during 8 days of storage at 5 degrees C. Total bacterial counts and numbers of Salmonella Typhimurium and P. fluorescens were analyzed at 2-day intervals. Total bacterial counts of samples irradiated by both gamma rays and electron beam were significantly (P < 0.05) reduced by 3.8 to 5.3 log CFU/g. Salmonella Typhimurium was not detectable during the experimental period. P. fluorescens counts of beef samples irradiated by gamma rays at both 1.5 and 3.0 kGy were not detected; however, P. fluorescens in samples irradiated by electron beam at 1.5 and 3.0 kGy was recovered after 2 days, and bacterial counts reached 7.8 and 6.9 log CFU/g, respectively. Both gamma ray and electron beam irradiation reduced total bacterial counts initially, possibly extending shelf life. Irradiation was very effective in destroying Salmonella Typhimurium; however, P. fluorescens was not completely eliminated by electron beam irradiation. Consequently, gamma ray irradiation was more effective than electron beam irradiation in the destruction of P. fluorescens.

Prevalence of Raynaud's phenomenon in patients with idiopathic carpal tunnel syndrome

Both idiopathic carpal tunnel syndrome (CTS) and Raynaud's phenomenon (RP) are common, and may have similar clinical symptoms. The degree of their coexistence is uncertain. We have examined 30 patients, who were diagnosed clinically and electromyographically as having idiopathic CTS, for the presence of RP using a cold provocation test with photoplethysmography. The patients' hands were exposed in water at 10 degrees C for five minutes. A total of 18 patients (60%) was found to have RP; this is much greater than would be expected from the prevalence in the general population. Raynaud's phenomenon should be considered when treating patients with CTS because of the possibility of coexistence and the similar symptoms of these two disorders.

Patient with lichen planus and conjunctival immunopathologic features of lupus erythematosus

PURPOSE

To report a case of severe cicatricial conjunctivitis in a patient with lichen planus, which is known to affect the skin and mucous membranes. The conjunctival immunopathologic features were consistent with lupus erythematosus rather than with lichen planus.

METHOD

Oral mucosal and skin biopsies were performed with histopathologic and immunofluorescent studies consistent with lichen planus. The patient later had a biopsy of cicatrized conjunctiva with histopathologic and immunofluorescent findings consistent with lupus erythematosus. Evaluation by rheumatology and dermatology consultants demonstrated no evidence of active systemic lupus erythematosus or discoid lupus erythematosus.

RESULTS

The patient was treated with topical and systemic immunosuppressives and her disease eventually stabilized.

CONCLUSION

The case demonstrates two coexisting autoimmune disease entities: lichen planus of the skin and oral mucosa and a cicatricial conjunctivitis consistent with lupus erythematosus.

Metatarsal lengthening in congenital brachymetatarsia: one-stage lengthening versus lengthening by callotasis

We retrospectively reviewed and compared the outcomes of 15 one-stage metatarsal lengthenings with intercalary bone graftings in 10 patients with those of nine metatarsal lengthenings by callotasis in five patients younger than 15 years. In the one-stage lengthening group, the diaphyseal osteotomy site was gradually distracted intraoperatively for 20-30 min to relax the surrounding soft tissues. In the callotasis group, lengthening was achieved with mini-Orthofix M-100. There was little difference in the outcomes between the two groups in terms of length gain, percentage increase, and complications. However, the period to achieve bony consolidation was longer in the callotasis group (2.7 months/cm) than in the one-stage lengthening group (1.5 months/cm). No case of neurovascular impairment was found in both groups.

Unidirectional single-mode Nd:YAG laser with a planar semimonolithic ring cavity

Unidirectional single-mode operation of a diode-pumped Nd:YAG laser with a planar semimonolithic ring cavity has been demonstrated at 1064 nm. The semimonolithic cavity consists of a laser active medium placed in a magnetic field, a crystal quartz plate, and an output coupling mirror, which form an optical diode by acting as a Faraday rotator, a reciprocal polarization rotator, and a partial polarizer, respectively. A single-mode output power of 155 mW and a slope efficiency of 17% were obtained with a 1.2-W diode laser at 809 nm. A laser linewidth of less than 100 kHz is inferred from a beat note frequency spectrum between two identical laser systems and continuous tuning to greater than 2 GHz was observed.