Transfer of orbital angular momentum of light to plasmonic excitations in metamaterials

The emergence of the vortex beam with orbital angular momentum (OAM) has provided intriguing possibilities to induce optical transitions beyond the framework of the electric dipole interaction. The uniqueness stems from the OAM transfer from light to material, as demonstrated in electronic transitions in atomic systems. In this study, we report on the OAM transfer to electrons in solid-state systems, which has been elusive to date. Using metamaterials (periodically textured metallic disks), we show that multipolar modes of the surface electromagnetic excitations (so-called spoof localized surface plasmons) are selectively induced by the terahertz vortex beam. Our results reveal selection rules governed by the conservation of the total angular momentum, which is confirmed by numerical simulations. The efficient transfer of light's OAM to elementary excitations in solid-state systems at room temperature opens up new possibilities of OAM manipulation.

Versican is a potential therapeutic target in docetaxel-resistant prostate cancer

In the current study, we investigated a combination of docetaxel and thalidomide (DT therapy) in castration-resistant prostate cancer (CRPC) patients. We identified marker genes that predict the effect of DT therapy. Using an androgen-insensitive PC3 cell line, we established a docetaxel-resistant PC-3 cell line (DR-PC3). In DR-PC3 cells, DT therapy stronger inhibited proliferation/viability than docetaxel alone. Based on gene ontology analysis, we found versican as a selective gene. This result with the findings of cDNA microarray and validated by quantitative RT-PCR. In addition, the effect of DT therapy on cell viability was the same as the effect of docetaxel plus versican siRNA. In other words, silencing of versican can substitute for thalidomide. In the clinical setting, versican expression in prostate biopsy samples (before DT therapy) correlated with PSA reduction after DT therapy (p<0.05). Thus targeting versican is a potential therapeutic strategy in docetaxel-resistant prostate cancer.

Case report of a ureteral obstruction by Candida albicans fungus balls detected by magnetic resonance imaging in kidney transplant recipient

In kidney transplant recipients, acute renal failure resulting from a ureteral obstruction by fungus balls is uncommon. We report a 60-year-old man diagnosed with ureteral obstruction caused by Candida albicans fungus balls early after transplant. Diagnosis was made by a T2-weighted magnetic resonance image, which demonstrated fungus balls as a low-intensity mass in the pelvis and microscopic examination findings in the urine. The patient was treated successfully with an antifungal agent and direct irrigation. It should be noted that fungus balls may cause ureteral obstruction of transplanted kidneys, possibly resulting in graft failure. Imaging of the kidneys and collecting system and aggressive debridement that adds to systemic therapy are necessary for early diagnosis and are central to a successful outcome.

Influence of cycloplegia with topical cyclopentolate on higher-order aberrations in myopic children

PURPOSE

To investigate the influence of cycloplegia with topical cyclopentolate on wavefront aberrations in myopic children.

DESIGN

This is a prospective, comparative study.

METHODS

Twenty-eight myopic children with a mean age of 7.25 ± 2.55 were enrolled in this study. We evaluated refraction and wavefront aberrations before and after cycloplegia with 1% cyclopentolate hydrochloride. Ocular and corneal aberrations were simultaneously measured and compared with each other. Individual Zernike components were also analyzed up to the sixth order. All these parameters were compared before and after cycloplegia.

RESULTS

Ocular higher-order aberrations (HOAs) significantly increased after cycloplegia (P=0.012 for spherical-like and P=0.015 for total HOAs). Corneal HOAs did not change after cycloplegia. When corneal and ocular HOAs were compared, the ocular HOAs were significantly smaller than the corneal HOAs in spherical-like aberrations (P<0.001) and total HOAs (P=0.006). As for individual Zernike components, ocular aberration generally showed smaller or equivalent values in comparison with corneal aberration. In addition, each Zernike component showed a large standard deviation.

CONCLUSIONS

Internal optics compensates for corneal HOAs in myopic children, and paralysis of tonic accommodation with cyclopentolate considerably affects ocular HOAs. However, inter-individual variation in each Zernike component is quite large in myopic children.

Hybrid procedure using perineal and abdominal approaches for radical prostatocystectomy: initial experience with 16 select cases

OBJECTIVES

To validate the feasibility and implications of a hybrid procedure using perineal and abdominal approaches for a radical prostatocystectomy.

METHODS

Between March 2007 and May 2012, we performed 16 prostatocystectomy and simultaneous urethrectomy under a hybrid procedure using perineal and abdominal approach for advanced bladder cancer. The hybrid procedure was selected in each case, because of prostatic urethra involvement in 13 and prior treatment in 3 (irradiation, radical retropubic prostatectomy, and sigmoidectomy, respectively). Two surgical teams, one responsible for the perineal approach and the other for the abdominal portion, performed the operation.

RESULTS

The median operation time for the prostatocystectomy procedure was 207 minutes and median intraoperative blood loss was 1665 ml. The en bloc removal of the specimen was perfectly performed and no intraoperative difficulties and intraoperative complications such as rectal injury were recognized in all cases. As for postoperative complications associated with the exaggerated lithotomy position, neurologic complications and rhabdomyolysis which could be treated conservately were found in 1 case. Although 5 patients died from distant metastasis, local recurrence was not seen in any of the 16 patients during the follow-up period.

CONCLUSION

The hybrid procedure using perineal and abdominal approach for radical prostatocystectomy is a well-organized procedure that can provide good visualization of the surgical structure around the prostate, leading to a reduction in or prevention of local recurrence and surgical complications even in the selected patient.

Identification of lymphatic pathway involved in the spreading of prostate cancer by fluorescence navigation approach with intraoperatively injected indocyanine green

Objective: The objective of this study was to identify lymphaticvessels draining from the prostate by using a fluorescence navigation(FN) system.Methods: Fourteen subjects were candidates for radical retropubicprostatectomy (RRP) and pelvic lymph node dissection (PLND).After an indocyanine green solution was injected into the prostateduring RRP, lymphatic vessels draining from the prostate were analyzedusing a FN system. After PLND based on lymphatic mappingby the FN system (in vivo probing) was performed in the externaliliac, obturator and internal iliac regions; the fluorescence of theremoved lymph nodes (LNs) was analyzed on the bench (ex vivoprobing).Results: Under in vivo and ex vivo probing, the fluorescence intensityof internal iliac nodes was greater than that of external iliacor obturator nodes.Conclusion: The current study suggests that using a FN systemafter injecting indocyanine green is a safe and rational approachfor detecting the lymphatic channel draining from the prostate.The major lymphatic pathway involved in the spreading of prostatecancer appears to relate to internal iliac LNs, which wouldmean that the standard PLND covering external iliac and obturatorregions would not keep the cancer from spreading.Objectif : L’objectif de l’étude était de repérer les vaisseaux lymphatiquesquittant la prostate à l’aide d’un système d’imagerie parfluorescence (IF).Méthodologie : Quatorze sujets devaient subir une prostatectomieradicale rétropubienne (PRR) et une lymphadénectomie pelvienne.Après injection d’une solution de vert d’indocyanine dansla prostate pendant la PRR, les vaisseaux lymphatiques drainant laprostate ont été analysés par IF. Une lymphadénectomie pelviennefondée sur la cartographie lymphatique par IF (exploration in vivo)a ensuite été réalisée dans les régions de la fosse iliaque externe,de l’obturateur et de la fosse iliaque interne; la fluorescence desganglions lymphatiques retirés a été analysée sans délai (explorationex vivo).Résultats : Lors de l’exploration in vivo et ex vivo, l’intensité dela fluorescence des ganglions iliaques internes était plus forte quecelle des ganglions iliaques externes ou des ganglions obturateurs.Conclusion : Cette étude porte à croire que l’IF après injectionde vert d’indocyanine est une méthode sûre et rationnelle pourrepérer les vaisseaux lymphatiques drainant la prostate. La principalevoie lymphatique de propagation du cancer de la prostatesemble être reliée aux ganglions lymphatiques iliaques internes, cequi signifie que la lymphadénectomie pelvienne standard retirantles ganglions iliaques externes et obturateurs n’empêcherait pasle cancer de se propager.

Time course of changes in ocular wavefront aberration after administration of eye ointment

PURPOSE

To investigate the influence of an eye ointment on ocular aberration.

DESIGN

Prospective, comparative study.

METHODS

In 10 normal volunteers, ocular aberration was assessed before and 5, 30 min, 1, 2, 3, 6, and 12 h after administration of ofloxacin eye ointment. Ocular aberration was sequentially measured over a period of 10 s, and the root mean square (RMS) of the second-, third-, fourth-, and total higher-order aberrations (HOAs) were determined. From the sequential changes in total HOAs during 10 s, the fluctuation index (FI) and stability index (SI) were calculated. The obtained data were compared with those of another 17 normal volunteers who received timolol maleate gel-forming ophthalmic solution.

RESULTS

No significant changes in second-order RMS were observed after administration of the ointment. HOAs such as third-, fourth-, and total higher-order RMS significantly changed during the study period (P<0.05, repeated-measures analysis of variance). The RMS of each HOA component significantly increased 5 min after administration compared with the baseline values (P<0.05, Dunnett test). FI also increased significantly 5 min after administration (P<0.05), but SI did not change significantly. When compared with the results of the gel-forming solution group, HOAs and FI showed significantly higher values at several time points during 6 h after application (P<0.05, Mann-Whitney U-test).

CONCLUSIONS

Administration of eye ointment significantly degrades optical quality of the eye by increasing and oscillating HOAs. These changes were more pronounced than those after instillation of gel-forming ophthalmic solution for at least several hours.

Indocyanine green (ICG)-based fluorescence navigation system for discrimination of kidney cancer from normal parenchyma: application during partial nephrectomy

PURPOSE

To determine the definite border between normal and tumor kidney tissues during partial nephrectomy (PN) procedures using intraoperative indocyanine green (ICG)-based fluorescence imaging.

METHODS

Sixteen potential candidates for PN with organ-confined, small renal masses treated between July 2008 and June 2011 at Shimane University Hospital were enrolled. An ICG-based fluorescence navigation (FN) system was used to evaluate the border between the tumor and normal kidney parenchyma (step 1), the cavity following tumor excision (step 2), and the negative surgical margin of resected tissues (step 3). The R.E.N.A.L nephrometry score (RNS) was applied to evaluate the correlation between tumor anatomy and ICG-based fluorescence imaging.

RESULTS

In step 1, in vivo probing revealed 14 tumors with a mean RNS of 7 points that showed quite low ICG fluorescence signals in the tumor mass as compared with normal kidney parenchyma. In step 2, in vivo probing around the bed revealed highly fluorescent signals with no remnant tumor residing in 10 cases with a mean RNS of 6 points. In step 3, ex vivo probing revealed cancer tissues involving normal parenchyma that were completely excised with minimum amounts of normal parenchyma in all 16 resected specimens.

CONCLUSIONS

ICG-based FN system was very helpful for confirming negative margin status in even the most complex cases. Further evaluations may open the door for widespread use of this ICG-based FN system as a feasible and attractive alternative during a PN procedure.

Identification of lymphatic pathway involved in the spreading of prostate cancer by fluorescence navigation approach with intraoperatively injected indocyanine green

OBJECTIVE

: The objective of this study was to identify lymphatic vessels draining from the prostate by using a fluorescence navigation (FN) system.

METHODS

: Fourteen subjects were candidates for radical retropubic prostatectomy (RRP) and pelvic lymph node dissection (PLND). After an indocyanine green solution was injected into the prostate during RRP, lymphatic vessels draining from the prostate were analyzed using a FN system. After PLND based on lymphatic mapping by the FN system (in vivo probing) was performed in the external iliac, obturator and internal iliac regions; the fluorescence of the removed lymph nodes (LNs) was analyzed on the bench (ex vivo probing).

RESULTS

: Under in vivo and ex vivo probing, the fluorescence intensity of internal iliac nodes was greater than that of external iliac or obturator nodes.

CONCLUSION

: The current study suggests that using a FN system after injecting indocyanine green is a safe and rational approach for detecting the lymphatic channel draining from the prostate. The major lymphatic pathway involved in the spreading of prostate cancer appears to relate to internal iliac LNs, which would mean that the standard PLND covering external iliac and obturator regions would not keep the cancer from spreading.

A case of primary retroperitoneal serous adenocarcinoma

Primary retroperitoneal serous adenocarcinoma (PRSA) is an extremely rare malignancy, of which only six cases have been reported in the literature. Here, we describe a PRSA in a 75-year-old woman treated with surgical excision and adjuvant chemotherapy. The pathological features of PRSA resemble those of ovarian serous carcinoma, which suggests that a combination of surgical excision with adjuvant chemotherapy may be the best option.

Rare complication of a sigmoid colon perforation after a kidney transplant with an artificial vascular graft

A 65-year-old man (blood type O) came to our hospital for transplant of an unrelated kidney (6/6 mismatch of HLA genotype) donated by his living 60-year-old wife (blood type B). The planned right donor nephrectomy was uneventful, with a warm ischemic time of 5 minutes, but her right renal vein was too fragile and weak to be repaired for vascular anastomosis. Therefore, we used an artificial vascular graft (polytetrafluoroethylene) interposed between the donor renal vein and the recipient's left external iliac vein. On the 11th day after surgery, infraphrenic free air (identified by a chest radiograph) made us do an emergent laparoscopic examination that showed a perforation of his sigmoid colon. A transient transverse colostomy was therefore prepared. The transient transverse colostomy was closed 8 months after the kidney transplant. Twelve months after the transplant, the patient is doing well with a serum creatinine level of 150.44 micromol/L (1.7 mg/dL).

Investigation of new cytogenetic biomarkers specific to high-LET radiation usingin vivoandin vitroexposed human lymphocytes

PURPOSE

To find detectable cytogenetic biomarkers that can offer information about the radiation quality of in vivo exposure retrospectively.

MATERIALS AND METHODS

Chromosome-type aberrations of peripheral lymphocytes of uterine cancer patients that received internal gamma- and external X-ray therapy or carbon beam therapy and of victims severely exposed to neutrons and gamma-rays in a criticality accident that occurred in Tokai-mura, Japan were analysed. Data obtained from in vitro irradiation experiments using 60Co gamma-rays and 10 MeV neutrons were compared with the in vivo exposure data.

RESULTS

The ratio of acentric rings to dicentric chromosomes (termed RaD ratio) and that of excess fragments to dicentrics (termed EfD ratio) showed significant (p < 0.05) differences between the two groups of cancer patients, and these ratios for accidental victims were in between the values of the two groups of cancer patients. The in vitro studies using doses equivalent to 1 - 3 Gy of gamma-rays have confirmed that the EfD ratios were increased with the high LET (linear energy transfer) and RaD ratios decreased.

CONCLUSION

The present data show that the RaD and EfD ratios can be used as cytogenetic biomarkers of exposure to high-LET radiation at least within a few years of exposure.

Five-year longitudinal effect of radical perineal prostatectomy on health-related quality of life in Japanese men, using general and disease-specific measures

OBJECTIVE

To investigate the longitudinal alteration of health-related quality of life (HRQL) up to 5 years after radical perineal prostatectomy (RPP) among Japanese patients with localized prostate cancer.

PATIENTS AND METHODS

In all, 194 patients who had RPP were included in this longitudinal survey. The validated RAND 36-Item Health Survey (SF-36) and the University of California, Los Angeles Prostate Cancer Index (UCLA-PCI) were used to evaluate the HRQL.

RESULTS

Among the UCLA-PCI urinary domains, urinary function scores decreased at 3 months after RPP, but they increased 6 months after RPP. Likewise, urinary bother showed a transient decrease at 3 months, but had returned to the baseline level 6 months after RPP. Sexual function (SF) was drastically decreased at 3 months after RPP, but had slightly increased 1 year after RPP. Patients who had a nerve-sparing (NS) RPP showed better SF-related HRQL than those who did not at 6 months after RPP. This favourable alteration involving SF-related HRQL was closely associated with the NS procedure, but not with the patient age. Multivariate analysis showed that later recovery of SF was essentially related to the use of NS RPP, while early recovery of sexual bother was closely related to the patient age.

CONCLUSIONS

Our results confirmed the positive effect of RPP on the long-term HRQL in Japanese patients. Although NS surgery conferred the benefit of the recovery of SF, older Japanese patients were not greatly concerned about their decreased SF-related HRQL. The current results provide primary evidence for predicting the alteration of HRQL and understanding the effect of patient age and NS surgery on HRQL after RPP.

Recovery of corneal irregular astigmatism, ocular higher-order aberrations, and contrast sensitivity after discontinuation of overnight orthokeratology

AIMS

To examine prospectively the recovery of various parameters after discontinuation of overnight orthokeratology.

METHODS

Seventeen subjects undergoing orthokeratology for 12 months were examined. Refraction, corneal topography, wavefront aberrometry, a visual acuity test and a contrast sensitivity test were performed at baseline, 12 months after commencement of the procedure, and 1 week and 1 month after discontinuation of the treatment. Asymmetry and higher-order irregularity components were calculated using a Fourier analysis of the corneal topography data. Contrast sensitivity was assessed at four spatial frequencies, and the area under the log contrast sensitivity function (AULCSF) was calculated.

RESULTS

Orthokeratology significantly reduced manifest refraction (p<0.0001, Dunnett test) and significantly improved uncorrected visual acuity (UCVA) at 12 months after commencement of the procedure (p<0.0001). Asymmetry and higher-order irregularity components increased significantly (p<0.0001, p = 0.0032, respectively), and third- and fourth-order aberrations also increased significantly (p<0.0001). The treatment resulted in significant decreases in AULCSF (p = 0.0004). After discontinuing lens wear, all parameters, such as refraction, UCVA, asymmetry, higher-order irregularity, third-order aberration, fourth-order aberration and AULCSF, returned to the baseline level at 1 week.

CONCLUSION

This study confirmed that the effect of orthokeratology is completely reversible in light of optical quality of the eye and quality of vision as well as refraction and visual acuity.

Neural correlates of regional EEG power change

To clarify the physiological significance of task-related change of the regional electroencephalogram (EEG) rhythm, we quantitatively evaluated the correlation between regional cerebral blood flow (rCBF) and EEG power. Eight subjects underwent H2 15O positron emission tomography scans simultaneously with EEG recording during the following tasks: rest condition with eyes closed and open, self-paced movements of the right and left thumb and right ankle. EEG signals were recorded from the occipital and bilateral sensorimotor areas. Cortical activation associated with EEG rhythm generation was studied by the correlation between rCBF and EEG power. There were significant negative correlations between the sensorimotor EEG rhythm at 10-20 Hz on each side and the ipsilateral sensorimotor rCBF and between the occipital EEG rhythm at 10-20 Hz and the occipital rCBF. The occipital EEG rhythm showed a positive correlation with the bilateral medial prefrontal rCBF, while the right sensorimotor EEG rhythm showed a positive correlation with the left prefrontal rCBF. In conclusion, decrease in the regional EEG rhythm at 10-20 Hz might represent the neuronal activation of the cortex underlying the electrodes, at least for the visual and sensorimotor areas. The neural network including the prefrontal cortex could play an important role to generate the EEG rhythm.

Phase-II study of docetaxel, estramustine phosphate, and carboplatin in patients with hormone-refractory prostate cancer

OBJECTIVES

To determine the safety and efficacy of combination chemotherapy with docetaxel (DTX), estramustine phosphate (EMP), and carboplatin (CBDCA) in patients with hormone-refractory prostate cancer (HRPC).

METHODS

This study included a total of 40 HRPC patients. We evaluated the activity of the following schedule: weekly DTX 30 mg/m(2) iv, daily EMP 10mg/kg po, and CBDCA AUC=6 iv on day 1 of a every 4-wk cycle. Treatment was continued until disease progression or excessive toxicity.

RESULTS

All patients were assessable for response. A median of six consecutive cycles was administered per patient. Levels of prostate-specific antigen decreased by more than 50% in 95.0% of the patients. Consumption of medication for cancer-induced pain was reduced in 84.6%. Partial response was attained in 66.7% of measurable lesions. Of patients with bone metastasis, 8.3% demonstrated partial response. With a median follow-up of 11.4 mo, the median time to progression was 12.0 mo, and the median overall survival time was 26.6 mo. The predominant toxicities were grade-3 or -4 anemia in 32.5% of the patients, leukopenia in 20.0%, and thrombocytopenia in 17.5%. However, all toxicity was temporary and reversible with dose reduction or temporary cessation of chemotherapeutic agents. There were no therapy-related deaths.

CONCLUSIONS

Combination chemotherapy with DTX/EMP/CBDCA was found to have significant clinical activity with an acceptable toxicity profile in HRPC patients. More suitable selection of patients may be beneficial in terms of improved overall survival in the future.

Retention and removal of a new viscous dispersive ophthalmic viscosurgical device during cataract surgery in animal eyes

AIMS

To assess the retention and removal properties of a new viscous dispersive ophthalmic viscosurgical device (OVD), DisCoVisc, in comparison with those of cohesive (Provisc), dispersive (Viscoat), and viscoadaptive (Healon5) OVDs.

METHODS

In 20 porcine eyes, cataract surgery was simulated using one of the four OVDs which were stained with fluorescein for better visualisation. Three parameters were measured. Firstly, the presence/absence of OVDs in the chamber at the completion of phacoemulsification was recorded. Secondly, the time until the OVDs were completely removed from the anterior chamber using the phaco needle was measured. Thirdly, after intraocular lens (IOL) implantation, the time needed to completely remove the OVDs from the chamber with irrigation/aspiration tip was recorded.

RESULTS

At the completion of phacoemulsification, the OVDs retained in 0% (0/5) for Provisc, 80% (4/5) for Healon5, 100% (5/5) for DisCoVisc, and 100% (5/5) for Viscoat. The retention of OVDs during phacoemulsification was greatest with Viscoat followed by, in descending order, DisCoVisc, Healon5, and Provisc. The removal of OVDs after IOL implantation took longest with Viscoat followed by Healon5, DisCoVisc, and Provisc.

CONCLUSION

The viscous dispersive DisCoVisc showed excellent retention during phacoemulsification, while its removal after IOL implantation was very easy. When compared with the viscoadaptive Healon5, DisCoVisc was retained better in the chamber and was easier to remove. These features of DisCoVisc should be highly advantageous when considering covering the entire cataract surgery procedure with a single OVD.

A new method using F-waves to measure muscle fiber conduction velocity (MFCV)

OBJECTIVE

First, to propose a new technique for measuring muscle fiber conduction velocity (MFCV). Second, to ascertain the validation of the new method that uses F-waves (F-MFCV) in healthy volunteers. Third, to examine the relationship between F-MFCV and motor nerve conduction velocity (MCV) in the same subjects.

SUBJECTS AND METHODS

F-waves reflecting single motor units were recorded with a multi-channel surface electrode array and weak electrical stimulation to the median or ulnar nerves in 21 healthy volunteers. F-MFCVs of the abductor pollicis brevis (APB) and abductor digiti minimi (ADM) were calculated from the F-wave peak latency in each channel. MFCV during minimal voluntary contraction (V-MFVC) was measured in the same muscles.

RESULTS

There was no significant difference between F-MFCV and V-MFCV in the muscles tested The mean F-MFCV value was similar to recently reported MFCV values generated by minimal voluntary contraction. No significant differences were found between the APB and ADM F-MFCVs, whereas the MCV of the ulnar nerve was faster than that of the median nerve.

CONCLUSION

The MFCV in a single motor unit could be measured with a multi-channel surface electrode array by recording F-waves induced by weak stimulation. Since V-MFCV generated by minimal voluntary contraction is explained by the size principle, V-MFCV reflects small and slow conducting motor unit. There was no significant difference between F-MFCV and V-MFCV. It seemed that F-MFCV also reflected small motor unit. The reason for the lack of difference in the F-MFCVs of the ADM and APB is considered to be a relatively slow F-MFCV. Moreover, MCV reflected the speed of the fastest nerve fiber, whereas F-MFCV did not.