Abstract Purpose Previously, we reported a nomogram for the prediction of positive resection margin (RM) after breast conserving surgery (BCS). This study was conducted to evaluate the clinical ...usefulness of the nomogram. Methods Prospective patients who underwent operations using the nomogram between July 2012 and August 2013(nomogram group; N=260) were compared with past control patients who underwent operations between July 2010 and October 2011 and underwent frozen section biopsy(FSB) without use of the nomogram(N=266). In the nomogram group, an intraoperative assessment of RM using FSB was only performed when the nomogram score was higher than predefined cut-off(>80). In addition, we conducted retrospective analysis of additional 181 patients who received BCS in another institute (Kyoto University Hospital). These patients did not undergo FSBs for RMs. Results Of 260 patients, 161(61.9%) presented low nomogram scores and avoided FSB. The surgical decision to use the nomogram did not significantly increase reoperation rate due to positive RM compared with the control FSB group (4.6% vs. 3.8%, p=0.47). The surgery time was significantly reduced by 18.1% (mean 14.7 minutes) in nomogram group (p<0.001). Of 99 nomogram high-score patients, 14 presented with positive RM on FSB and 11 of them avoided reoperation. In the Kyoto cohort, the reoperation rate was significantly lower in low-score patients than in high-score patients (2.7% vs. 11.4%, p<0.001). Conclusions We showed that our nomogram is useful to reduce FSBs without increasing reoperation rate for surgeons who perform routine FSBs. For most surgeons, it can give useful information about the possibility of tumor-positive RMs.
A computer-aided diagnosis (CAD) algorithm identifying breast nodule malignancy using multiple ultrasonography (US) features and artificial neural network (ANN) classifier was developed from a ...database of 584 histologically confirmed cases containing 300 benign and 284 malignant breast nodules. The features determining whether a breast nodule is benign or malignant were extracted from US images through digital image processing with a relatively simple segmentation algorithm applied to the manually preselected region of interest. An ANN then distinguished malignant nodules in US images based on five morphological features representing the shape, edge characteristics, and darkness of a nodule. The structure of ANN was selected using k-fold cross-validation method with k=10. The ANN trained with randomly selected half of breast nodule images showed the normalized area under the receiver operating characteristic curve of 0.95. With the trained ANN, 53.3% of biopsies on benign nodules can be avoided with 99.3% sensitivity. Performance of the developed classifier was reexamined with new US mass images in the generalized patient population of total 266 (167 benign and 99 malignant) cases. The developed CAD algorithm has the potential to increase the specificity of US for characterization of breast lesions.
The charge storage and program/erase mechanisms in polysilicon-oxide-nitride-oxide-silicon (SONOS) memory structures with charge-storage layers of different materials are investigated in this paper. ...In particular, the use of a HfAlO charge-storage layer in a SONOS-type memory structure is proposed. Compared to other high-/spl kappa/ charge-storage layers, HfAlO has the advantage of high-speed program/erase of HfO/sub 2/ as well as the good charge-retention time of Al/sub 2/O/sub 3/, which makes HfAlO a promising candidate for the charge-storage layer in a SONOS-type memory. The use of HfAlO with different HfO/sub 2/ and Al/sub 2/O/sub 3/ compositions as a blocking-oxide layer in SONOS-type structures is also investigated.
Polylactic acid (PLA) fillers are widely used for cosmetic volume augmentation. But, no study has evaluated the use of PLA filler in penile augmentation (PA No. 4). We evaluated the efficacy and ...safety of a newly developed PLA filler for PA during a 18-month follow-up period. A total of 23 healthy adult men were prospectively enrolled between June and November 2012. Penile girth was measured at proximal-, mid- and distal-shaft at baseline, 3, 6, 12 and 18 months following injection. Subjects' satisfaction was assessed with visual analogue scale (VAS). Adverse events (AEs) were also reported. Mean injected volume was 20 ml. The circumference of proximal-, mid-, and distal-shaft increased by a mean of 2.2±0.2, 2.7±1.0 and 2.7±1.0 cm at 3 months, respectively (each P<0.001). No significant differences were noted in girth circumference between 3 and 18 months post-injection (each P>0.05). VAS score increased from 51.6±14.7 at baseline to 64.8±19.3 and 74.3±14.6 at 3 and 6 months, respectively (each P<0.05). Six cases of mild, transient treatment-emergent AEs were reported in 5 subjects. Serious AEs were not reported. In conclusion, penile injection of a newly developed PLA filler led to significant penile augmentative effects for up to 18 months and was well tolerated without serious AEs.
Summary
This study investigated the protective effects of melatonin (MT) against gentamicin (GM)‐induced testicular toxicity and oxidative damage in rats. GM (100 mg kg−1) was injected ...intraperitoneally (i.p.) to rats for 6 days. MT (15 mg kg−1) was administered i.p. to rats for 6 days at 1 hr after the GM treatment. GM caused a decrease in prostate and seminal vesicle weights, sperm count and sperm motility. Histopathological examination showed various morphological alterations in the testis, characterised by degeneration of spermatogonia/spermatocytes, decrease in the number of early spermatogenic cells and vacuolisation. In addition, an increased malondialdehyde concentration and decreased glutathione content and glutathione reductase, catalase and glutathione‐S‐transferase activities were found in the testis. In contrast, MT treatment significantly attenuated the testicular toxicity of GM, including decreased reproductive organ weights, sperm count, and sperm motility and increased histopathological alterations. MT also had an antioxidant benefit by decreasing the lipid peroxidative product malondialdehyde and increasing the level of the antioxidant glutathione and the activities of antioxidant enzymes in the testis. These results indicate that MT prevents testicular toxicity induced by GM in rats, presumably due to its potent antioxidant activity, and its ability to inhibit lipid peroxidation, and restore antioxidant enzyme activity.
Diffusion couple experiments between various Co-rich face centered cubic (FCC) alloys in the Co-W-Al ternary system have been conducted at 900 and 1000 °C. Diffusion coefficients have been extracted ...for the Co-W binary and for ternary alloys at compositions where the diffusion paths cross. In addition, a least squares method has been utilized to optimize diffusion mobility parameters using DICTRA simulations to best fit the experimental concentration versus distance curves. Predictions of the diffusion matrix using the refined mobility database are in good agreement with the values obtained at the diffusion path crossing points.
The use of expanded-criteria deceased-donor (ECD) kidneys must be evaluated within the objective perspective of critical organ shortage and graft function and survival. In this study, we aimed to ...compare the clinical outcomes of ECD reliance with concurrent use of ideal-criteria deceased donors (IDDs) and non-ECDs in adult renal transplantation.
Between February 2000 and December 2015, we analyzed 405 deceased-donor renal transplants, specifically 129 grafts (31.9%) from ECDs, 233 grafts (57.5%) from non-ECDs, and 43 grafts (10.6%) from IDDs. ECDs were classified according to the United Network for Organ Sharing guidelines, while an IDD was defined as a younger person (10–39 years of age) with no medical risk factors who died from a traumatic head injury. Donor and recipient risk factors were separately analyzed and correlated with recipient graft function, and survival was evaluated.
ECDs were older (56.8 ± 6.3 years); showed increased incidence of hypertension, diabetes, and cerebrovascular brain death; and had a higher pre-retrieval serum creatinine level than the other groups. ECD kidney recipients were also older (50.6 ± 9.8 years), had a shorter waiting time (P = .031), and demonstrated a low frequency of re-transplantation (P = .028). Long-term renal function followed longitudinally was lower in ECD kidney recipients until five years after transplantation, while the glomerular filtration rate (GFR) level at 7 and 10 years did not differ significantly among the groups (P = .074 and .262, respectively). There were no significant differences in terms of graft survival (P = .394) or patient survival (P = .737) among the groups.
Although the long-term renal function followed longitudinally was lower in ECD kidney recipients, the use of renal grafts from ECDs is an acceptable method to resolve the disparity of critical organ shortage. However, the classification of the high-risk group should be updated with consideration given to differences in regional characteristics.
•The use of expanded-criteria deceased-donor (ECD) kidneys must be evaluated.•The clinical outcomes of ECDs were compared with ideal deceased donors and non-ECDs.•No significant differences were found in survival rates among the groups.•The use of renal grafts from ECDs is an acceptable method.•A proper classification of the high-risk group should be updated.
Two experiments were conducted to evaluate the efficacy of β-glucan on growth performance, nutrient digestibility, and immunity in weanling pigs. In Exp. 1, 210 weanling pigs (6.38 ± 0.92 kg of BW) ...were fed dietary β-glucan (0, 0.01, 0.02, 0.03, or 0.04%) for 5 wk. In Exp. 2, 168 pigs (6.18 ± 1.31 kg of BW) were fed no β-glucan or antibiotics (T1), 0.02% β-glucan (T2), only antibiotics (T3), or 0.02% β-glucan with antibiotics (T4) for 8 wk. In Exp. 2, the antibiotics fed were apramycin and carbadox in phase I (0 to 2 wk) and carbadox and chlortetracycline in phase II (3 to 8 wk). During Exp. 2, the performance study was conducted for 5 wk, and the immune response was tested until 8 wk. In Exp. 1, there was a trend for a linear increase (P = 0.068) in ADG as the dietary β-glucan concentration increased in the diet. The digestibilities of DM, GE, CP, ether extract, Ca, and P increased linearly (P < 0.05) in the β-glucan-supplemented pigs. In Exp. 2, the overall ADG was greater (P < 0.05) in treatment T4 compared with the control group (T1). Also, except for P, this group showed greater (P < 0.05) nutrient digestibilities than the control group. In Exp. 2, at d 15, 24, and 46 antibody titers were measured by ELISA against Pasteurella multocida type A and D after vaccination with atrophic rhinitis, and they differed significantly (P < 0.05) with no particular trend. Flow cytometry was used to determine porcine lymphocyte subpopulations at 4 and 8 wk of Exp. 2. There was an increase in CD4 cells (P < 0.05) and a trend for an increase in CD8 cells (P < 0.10) at 8 wk in pigs fed the T2 diet compared with the other groups. Overall, increasing the dietary concentrations of β-glucan did not improve ADG without antibiotic, and in weanling pigs antibiotics seem to be more effective in improving nutrient digestibilities and growth performance than β-glucan.
The temperature (T) dependence of the optical conductivity spectra σ(ω) of a single crystal SrRuO(3) thin film is studied over a T range from 5 to 450 K. We observed significant T dependence of the ...spectral weights of the charge transfer and interband d-d transitions across the ferromagnetic Curie temperature (T(c) ∼ 150 K). Such T dependence was attributed to the increase in the Ru spin moment, which is consistent with the results of density functional theory calculations. T scans of σ(Ω,T) at fixed frequencies Ω reveal a clear T(2) dependence below T(c), demonstrating that the Stoner mechanism is involved in the evolution of the electronic structure. In addition, σ(Ω,T) continues to evolve at temperatures above T(c), indicating that the local spin moment persists in the paramagnetic state. This suggests that SrRuO(3) is an intriguing oxide system with itinerant ferromagnetism.
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