鈍的腎損傷の画像診断

18名の鈍的腎損傷の患者における画像診断法の臨床的意義を検討した.患者は11名がminor injuryで, 7名がmajor injuryであった.このうち14名が保存的治療を, 4名が手術的治療を受けた.静脈性腎盂造影は健側腎の存在が把握できるために有用であるが, しばしば損傷の範囲が不確かなことが多く, これは過大評価が多く, 過小評価が稀な傾向を示した.CTエックス線検査は損傷の範囲, 腎周囲血腫および併発する後腹膜や腹部外傷が, 静脈性腎盂造影に比べ明らかに正確に診断された.血管造影は動脈性出血の部位を同定するのに有用であったRadiographic evaluation was performed on 18 patients with blunt renal trauma. Of 18 patients 11 had minor injury. Four of 11 patients with minor injury had a normal intravenous pyelogram (IVP), and other 7 were confirmed to have minor renal injury by computed tomographic (CT) scan. Seven patients had major injury. Six patients were diagnosed by both IVP and CT, and five by angiography. CT scan was reliable in major injury and had the high staging accuracy. Angiography was useful in specific patients. Therefore, we conclude that IVP or CT scan should be performed as the initial evaluation, and CT scan or angiography might be used as the second examination in selected patients

Tumour architecture is an independent predictor of outcomes after nephroureterectomy: a multi-institutional analysis of 1363 patients

To assess whether tumour architecture can help to refine the prognosis of patients treated with nephroureterectomy (NU) for urothelial carcinoma (UC) of the upper urinary tract (UT), as the prognostic value of tumour architecture (papillary vs sessile) in UTUC remains elusive. PATIENTS AND METHODS The study included 1363 patients with UTUC and treated with radical NU at 12 centres worldwide. All slides were re-reviewed according to strict criteria by genitourinary pathologists who were unaware of the findings of the original pathology slides and clinical outcomes. Gross tumour architecture was categorized as sessile vs papillary. RESULTS Papillary growth was identified in 983 patients (72.2%) and sessile growth in 380 (27.8%). The sessile growth pattern was associated with higher tumour grade, more advanced stage, lymphovascular invasion, and metastasis to lymph nodes (all P  < 0.001). In multivariable Cox regression analyses that adjusted for the effects of pathological stage, grade and lymph node status, tumour architecture (sessile or papillary) was an independent predictor of cancer recurrence (hazard ratio 1.5, P  = 0.002) and cancer-specific mortality (1.6, P  = 0.001). Adding tumour architecture increased the predictive accuracy of a model that comprised pathological stage, grade and lymph node status for predicting cancer recurrence and cancer-specific death by a minimal but statistically significant margin (gain in predictive accuracy 1% and 0.5%, both P  < 0.001). CONCLUSION The tumour architecture of UTUC is associated with established features of biologically aggressive disease, and more importantly, with prognosis after radical NU. Including tumour architecture in predictive models for disease progression should be considered, aiming to identify patients who might benefit from early systemic therapeutic intervention.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/72257/1/j.1464-410X.2008.08003.x.pd

Enhanced photoluminescence and directional white-light generation by plasmonic array

次世代の指向性白色光源の開発に成功 --ナノアンテナで明日を照らす--. 京都大学プレスリリース. 2018-12-06.White light-emitting diodes (LEDs), light sources that combine blue LEDs and yellow phosphors, are equipped with bulky optics such as lenses, mirrors, and/or reflectors to shape the light into the required directions. The presence of bulky optics causes optical loss and limits the design. Here, a periodic array of metallic nanocylinders, which exhibits a high scattering efficiency owing to the excitation of localized surface plasmon resonance, is proposed as an alternative means of achieving a directional output without the limitations of bulky optics. A prototype of a directional light emitter is fabricated consisting of an Al nanocylinder array on a yellow phosphor plate and a blue laser. The array shapes the yellow luminescence into the forward direction and generates directional quasi-white light (correlated color temperature of 4900 K). The intensity enhancement reaches a factor of five in the forward direction and is further improved up to a factor of seven by the deposition of a multilayer dichroic mirror on the back side of the phosphor plate, resulting in conversion efficiencies as high as 90 lm/W. Our results pave the way toward the development of efficient and compact directional white-light-source devices without any bulky optics

Microscopic Structure and Binding Mechanism of the Corrosion-Protective Film of Oleylpropanediamine on Copper in Hot Water

The structure of the film formed by oleylpropanediamine (OLDA) on the copper (Cu) metal surface in water at 150 °C was investigated by combining quantitative NMR and surface characterization methods. We succeeded in quantifying the amount of film formation by precisely determining all mass balances in the systems examined. 2D IR microscopic mapping showed that the film thickness is uneven in the horizontal direction with a length scale of ~100 μm and hundreds of OLDA layers. This film thickness was also confirmed by AFM. The analysis of the C–H stretching vibrational frequency disclosed that the alkyl chains are highly ordered in the layers close to the Cu surface and are conformationally disordered in the layers distant from the Cu surface in the thicker portion of the film. Combining XPS measurements using argon gas cluster ion beam etching with the ICP-AES analysis, we revealed that the key to multiple layering is the formation of a coordination complex of the unprotonated amino groups of OLDA with Cu that presumably results in polymer chain-like network structures. Contact angle measurements at different OLDA concentrations and treatment times showed that the water repellency of the film originated from the thick layering of OLDA molecules with disordered hydrophobic chains