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Using electron spectroscopy, we have investigated nanoplasma formation from noble gas clusters exposed to high-intensity hard-x-ray pulses at ~5 keV. Our experiment was carried out at the SPring-8 Angstrom Compact free electron LAser (SACLA) facility in Japan. Dedicated theoretical simulations were performed with the molecular dynamics tool XMDYN. We found that in this unprecedented wavelength regime nanoplasma formation is a highly indirect process. In the argon clusters investigated, nanoplasma is mainly formed through secondary electron cascading initiated by slow Auger electrons. Energy is distributed within the sample entirely through Auger processes and secondary electron cascading following photoabsorption, as in the hard x-ray regime there is no direct energy transfer from the field to the plasma. This plasma formation mechanism is specific to the hard-x-ray regime and may, thus, also be important for XFEL-based molecular imaging studies. In xenon clusters, photo- and Auger electrons contribute more significantly to the nanoplasma formation. Good agreement between experiment and simulations validates our modelling approach. This has wide-ranging implications for our ability to quantitatively predict the behavior of complex molecular systems irradiated by high-intensity hard x-rays.

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We have investigated multiphoton multiple ionization dynamics of xenon atoms using a new x-ray free-electron laser facility, SPring-8 Angstrom Compact free electron LAser (SACLA) in Japan, and identified that Xe(n+) with n up to 26 is produced at a photon energy of 5.5 keV. The observed high charge states (n≥24) are produced via five-photon absorption, evidencing the occurrence of multiphoton absorption involving deep inner shells. A newly developed theoretical model, which shows good agreement with the experiment, elucidates the complex pathways of sequential electronic decay cascades accessible in heavy atoms. The present study of heavy-atom ionization dynamics in high-intensity hard-x-ray pulses makes a step forward towards molecular structure determination with x-ray free-electron lasers.

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PURPOSE: To determine the value of color Doppler ultrasonography (CDUS) in the diagnosis of acute scrotum. MATERIALS AND METHODS: 10 patients referred to our hospital with acute scrotal pain were included in this study. All patients were evaluated with CDUS after the initial clinical examinations. Blood flow of the involved testis was compared semiquantitatively to that of the opposite testis. Patients with a diagnosis of testicular torsion by CDUS underwent surgical exploration. Patients with CDUS diagnosis of epididymitis were treated with intravenous antibiotics. RESULTS: Of the 10 patients evaluated, CDUS diagnosed 5 patients with testicular torsion and 5 patients with epididymitis. All cases of torsion were confirmed intraoperatively. 2 cases with no intratesticular blood flow on CDUS had necrotic testes and underwent orchiectomy with orchiopexy of the contralateral testes. A case with absent flow and 2 cases with decreased flow had bilateral orchiopexy. CDUS findings of normal or increased flow were present in all patients with epididymitis. No cases of testicular atrophy were encountered on long-term follow up in patients with epididymitis. CONCLUSION: CDUS is helpful in detecting the perfusion of the testis as well as in getting anatomical information. CDUS is a very useful device which causes a minimal burden to the patient with acute scrotum. In most cases it will rapidly provides us the correct information although it may not be regarded as the definitive adjunct.

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An 88-year-old woman was hospitalized with the chief complaints of lower abdominal pain, miction pain and pollakisuria. Radiographs showed a giant bladder stone shadow, 12.0 x 9.0 cm in size. Cystolithotomy was performed under the diagnosis of bladder stone. The extirpated stone weighed 510 g, and measured 10.0 x 7.5 x 6.0 cm in size. The stone had four compartments of stratified lamellae composed of calcium phosphate and magnesium ammonium phosphate. The postoperative course was uneventful and the bilateral hydronephrosis improved markedly on DIP.

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We reviewed 45 cases of transitional cell carcinoma of the renal pelvis and ureter with reference to the coexistence or subsequent development of bladder cancer. Bladder cancer was associated with an upper urinary tract neoplasm in 26 of the 45 cases. The 5-year survival rate for coexistence of bladder cancer was 56% and that for subsequent bladder cancer was 65.6%. The 5-year survival rate for 19 cases unrelated with bladder cancer was 46.7%. Therefore, there was no significant difference among the three groups. As to degree of the malignancy of the renal pelvis and ureter, the 5-year survival rate was 73.7% for G1 and G2 and 26.2% for G3. As to the depth of invasion, of the renal pelvis and ureter the 5-year survival rate was 71.8% and 31.1% in the patients with stage of T1, T2 and T3, T4. The prognosis of cancer of the upper urinary tract depended on the degree of the malignancy, and the depth of invasion. Ninety two percent of subsequent bladder cancer was detected within 2 years after resection of the primary cancer.

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We have experienced 3 cases of retroperitoneal ganglioneuroma. One case was in a 5-year-old boy with the chief complaint of abdominal mass. The preoperative diagnosis was neuroblastoma due to excessive urinary excretion of vanillylmandelic acid. The other two cases were in adults, 40 and 28 years old, and were found incidentally. All three cases were doing well without any clinical signs of recurrence almost 10 years, 5 years, and 6 months, postoperatively. The literature is reviewed briefly concerning some cases in children under 5 years of age whose ganglioneuromas were sometimes confused with neuroblastoma because of excessive catecholamines.

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A thirteen-year-old girl sought medical advice because of a markedly weakened urinary stream with severe hesitancy. She was referred to the pediatric clinic because of 3 episodes of acute urinary retention during a previous month. Pelvic examination showed a retrovesical tumor. An excretory urogram revealed bilateral ureterectasis and pyelocalicectasis. Two weeks after left nephrostomy, surgical exploration demonstrated a right ovarian mass causing compression of the left ureter and obstruction of the bladder neck. Excision of the tumor was performed without difficulty, following which the patient resumed normal voiding. The resected tumor weighed 815 Gm and pathologic examination showed dysgerminoma. Postoperatively the following two and one half years were uneventful.

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A part of our continuous investigation on the clinical effect of cefaclor against urinary tract infections was reported herein. Cefaclor, a daily dose of 0.75 g t.i.d., has been applied for the treatment of (I) 26 cases with the simple UTI and (II) 41 cases with the complicated. Rates of effectiveness were obtained 100% in (I) and 80% in (II). Side effects were noted in 8 cases (8.4%) out of total 95 cases.

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