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BACKGROUND: It remains controversial as to whether active stone removal should be performed in patients with poor performance status because of their short life expectancy and perioperative risks. Our objectives were to evaluate treatment outcomes of active stone removal in patients with poor performance status and to compare life prognosis with those managed conservatively. METHODS: We retrospectively reviewed 74 patients with Eastern Cooperative Oncology Group performance status 3 or 4 treated for upper urinary tract calculi at our four hospitals between January 2009 and March 2016. Patients were classified into either surgical treatment group or conservative management group based on the presence of active stone removal. Stone-free rate and perioperative complications in surgical treatment group were reviewed. In addition, we compared overall survival and stone-specific survival between the two groups. Cox proportional hazards analysis was performed to investigate predictors of overall survival and stone-specific survival. RESULTS: Fifty-two patients (70.3%) underwent active stone removal (surgical treatment group) by extracorporeal shock wave lithotripsy (n = 6), ureteroscopy (n = 39), percutaneous nephrolithotomy (n = 6) or nephrectomy (n = 1). The overall stone-free rate was 78.8% and perioperative complication was observed in nine patients (17.3%). Conservative treatment was undergone by 22 patients (29.7%) (conservative management group). Two-year overall survival rates in surgical treatment and conservative management groups were 88.0% and 38.4%, respectively (p < 0.01) and two-year stone-specific survival rates in the two groups were 100.0% and 61.3%, respectively (p < 0.01). On multivariate analysis, stone removal was not significant, but was considered a possible favorable predictor for overall survival (p = 0.07). Moreover, stone removal was the only independent predictor of stone-specific survival (p < 0.01). CONCLUSIONS: Active stone removal for patients with poor performance status could be performed safely and effectively. Compared to conservative management, surgical stone treatment achieved longer overall survival and stone-specific survival.
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Tratamiento Conservador , Cálculos Renales/cirugía , Cálculos Ureterales/cirugía , Adulto , Anciano , Anciano de 80 o más Años , Análisis de Varianza , Femenino , Estado de Salud , Humanos , Cálculos Renales/mortalidad , Cálculos Renales/terapia , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Tasa de Supervivencia , Cálculos Ureterales/mortalidad , Cálculos Ureterales/terapiaRESUMEN
We propose novel electrodes with platinum nanoparticles dispersed on a glassy carbon (Pt-NPs/GC) prepared using a pulsed arc plasma deposition (APD) method. The method could coat Pt-NPs on a base material directly with a single-step process in a very short deposition time. The characteristics of the electrodes were discussed in detail. The detection of hydrogen peroxide was performed as an example for application of the electrodes. The distribution of nanoparticles was controlled easily by the number of pulse. The surface morphology changed with the pulse number and the annealing except for the sample prepared by 5 pulses deposition (APD(5)), implying that the APD(5) remained as NPs after the annealing. Average particle size was 2.7 nm on the Pt-NPs/GC. Catalyst activity for oxidizing hydrogen peroxide per Pt loading was excellent on the Pt-NPs/GC. When the Pt-NPs/GC was used as a detector for hydrogen peroxide on a flow injection analysis, the Pt-NPs/GC showed high sensitivity without deterioration. Oxidation current increased linearly with the concentration of hydrogen peroxide from 10nM to 100 µM. This fast and easily prepared electrode showed the capability to replace a conventional bulk metal electrode.
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Carbono/química , Electroquímica/métodos , Peróxido de Hidrógeno/análisis , Nanopartículas del Metal/química , Gases em Plasma/química , Platino (Metal)/química , Electroquímica/instrumentación , Electrodos , Vidrio/química , Peróxido de Hidrógeno/químicaRESUMEN
Nano-cube MgO particles were formed on Si substrates by deposition of an MgO target using pulsed laser deposition method. An epitaxial film grows on Si(001) substrate with its contraction of lattice constants. In this study, expecting high quality MgO film, the MgO film prepared in the oxygen pressure ranging from 75-400 mTorr at the high temperature of -750 degrees C. The deposited MgO showed the growth of (001) preferred orientation on the Si(001) substrate. However, X-ray Photoelectron Spectroscopy (XPS) indicated the MgO film did not form a continuous film on the Si surface. Interestingly, the surface morphology observed by an Atomic Force Microscopy (AFM) showed nano-cube MgO particles scattered on the smooth surface of Si substrate. After annealing the nano-cube MgO, the shape of MgO particles were changed from nano-cube to round shaped particles. The AFM image of the surface showed round shaped MgO nanoparticles scattered on rough surface. X-ray Diffraction (XRD) revealed the epitaxial growth of MgO(001) with cubic on cubic arrangement on the Si(001) substrate (MgO[100] parallel to Si[100]).
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Metal oxide nanoparticles prepared by pulsed laser deposition (PLD) were applied to nonenzymatic glucose detection. NiO nanoparticles with size of 3 nm were deposited on glassy carbon (GC) and silicon substrates at room temperature in an oxygen atmosphere. Transmission electron microscope (TEM) image showed nanoparticles with the size of 3 nm uniformly scattered on the Si(001) substrate. Unlike co-sputtering nanoparticle and carbon simultaneously, the PLD method can easily control the surface coverage of nanoparticles on the surface of substrate by deposition time. Cyclic voltammetry was performed on the samples deposited on the GC substrates for electrochemical detection of glucose. The differences between peak currents with and without glucose was used to optimize the coverage of nanoparticles on carbon electrode. The results indicated that optimal coverage of nanoparticles on carbon electrode.
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After a laser annealing experiment on Si wafer, we found an asymmetric sheet resistance on the surface of the wafer. Periodic nano-strip grating lines (nano-SGLs) were self-organized along the trace of one-time scanning of the continuous wave (CW) laser. Depending on laser power, the nano-trench formed with a period ranging from 500 to 800 nm with a flat trough between trench structures. This simple method of combining the scanning laser with high scanning speed of 300 m min(-1) promises a large area of nanostructure fabrication with a high output. As a demonstration of the versatile method, concentric circles were drawn on silicon substrate rotated by a personal computer (PC) cooling fan. Even with such a simple system, the nano-SGL showed iridescence from the concentric circles.