Risk factors for oral frailty among community-dwelling pre-frail older adults in Japan: A cross-sectional analysis

OBJECTIVES

Oral frailty is a well-established risk factor for frailty and plays a significant role in progression to frailty. However, the association between oral frailty and pre-frailty in elderly individuals remains unclear. This cross-sectional study aimed to clarify the characteristics and risk factors of pre-frailty in elderly individuals with oral frailty.

METHODS

A total of 377 elderly individuals participated. Oral examinations comprised simple and non-invasive measures of chewing function, self-reported swallowing function, and oral moisture. The frailty screening index was used to assess frailty phenotypes.

RESULTS

The overall prevalence of pre-frailty was 63.1%, after excluding 40 frail and 99 robust individuals. The mean age of the pre-frail participants was 76.6 ± 5.8 years; 70.6% were women. 10.5% of the pre-frail elderly participants had oral frailty. In multivariate analysis diabetes mellitus, history of cancer, denture wearing, and malnutrition were independently associated with oral frailty among pre-frail elderly individuals (adjusted odds ratio (OR) 3.8, 95% confidence interval (CI) 1.06-13.54; OR 4.5, CI 1.32-15.36; OR 8.8, CI 1.76-43.78; and OR 3.6, CI 1.30-9.67; respectively).

CONCLUSIONS

The prevalence of oral frailty was low among community-dwelling pre-frail elderly individuals. Early interventions involving oral, nutritional, and disease management may prevent or improve oral frailty in pre-frail elderly individuals and may prevent progression to frailty. Further studies are required to elucidate the underlying mechanisms.

AB0528 COMPARABLE SAFETY PROFILE OF GUSELKUMAB IN PSORIATIC ARTHRITIS AND PSORIASIS: RESULTS FROM PHASE 3 TRIALS THROUGH 1 YEAR

Background:

DISCOVER 1&2 (PsA) and VOYAGE 1&2 (PsO) are Phase 3 trials of guselkumab (GUS).

Objectives:

Compare safety results through up to 1yr of GUS in PsA and PsO pts.

Methods:

In DISCOVER, 1120 pts with active PsA despite standard therapy were treated. Most pts were biologic-naïve; ~30% in DISCOVER 1 had previous exposure to 1-2 TNFi. Concomitant MTX (57%), oral corticosteroids (17%), and NSAIDs (64%) were permitted. Pts were randomized to SC GUS 100mg at W0, W4, then Q8W; GUS 100mg Q4W; or PBO. At W24, PBO patients were switched to GUS 100mg Q4W. In VOYAGE, in which concomitant MTX use was prohibited, 1245 pts with moderate to severe PsO were treated and randomized to SC GUS 100 mg at W0, W4, W12, then Q8W; or PBO at W0, W4, W12, with crossover to GUS at W16, W20, then Q8W. AEs and laboratory parameters, analyzed by National Cancer Institute-Common Terminology Criteria for AEs [NCI-CTCAE] toxicity grades, were summarized through the PBO-controlled periods and 1yr.

Results:

Safety profiles were generally consistent across the GUS PsO and PsA clinical programs (Table 1). Time-adjusted incidence rates for numbers of AEs, serious AEs, serious infections, malignancy, MACE and AEs leading to d/c were generally similar between PsO and PsA. No cases of anaphylaxis or opportunistic infections were reported. Proportions of pts with decreased neutrophil counts and elevations in hepatic transaminases were slightly higher in PsA vs PsO. These abnormalities were mostly of NCI-CTCAE Grade 1 or 2 (<LLN-1000/mm3 for neutrophils; <5.0 x ULN for AST/ ALT), generally transient, required no medical interventions, resolved spontaneously, and did not lead to interruption or d/c of treatment. Through 1yr, proportions of pts with ALT/AST elevations in PsA trials were slightly higher for GUS Q4W than Q8W and in pts with vs without baseline MTX use.

Conclusion:

The GUS safety profile was generally consistent in PsA and PsO GUS-treated pts through 1yr of the DISCOVER and VOYAGE trials.

Table 1.

Treatment-Emergent AEs During PBO-controlled Period and Through 1Yr: VOYAGE & DISCOVER Trials

Pooled VOYAGE 1&2Pooled DISCOVER 1&2Time PeriodW0-16Through 1YrW0-24bThrough 1Yr(N=)PBO(422)GUS Q8W(823)Combined GUSa(1221)PBOc(372)GUS Q8W(375)GUS Q4W (373)GUS Q8W(375)GUS Q4W (373)Combined GUS† (1100)Total pt-yrs of follow-up128255974173173172384385973Incidence/100 pt-yrs (95% CI)dAEs317 (287,349)330 (308,353)259 (249, 270)219 (198,243)256 (232,281)221 (200, 245)218 (203,233)177 (164,191)191 (182, 199)SAEs5 (2, 10)6 (4, 10)6 (5, 8)9 (5, 15)4 (2, 8)5 (2, 10)6 (4, 9)4 (2, 7)6 (4, 7)AEs leading to study agent d/c3 (0.9, 8)4 (2, 8)2 (2, 4)4 (2, 8)3 (1, 7)7 (4, 12)2 (1, 4)4 (2, 6)3 (2, 5)Infections86 (71, 104)98 (86, 111)98 (92, 104)58 (48, 71)58 (47, 71)63 (51, 76)58 (50, 66)53 (46, 61)55 (50, 60)Serious Infections0. 8 (0, 4)0.4 (0, 2)1 (0.5, 2)4 (2, 8)0.6 (0, 3)2 (0.4, 5)2 (0.6, 3)1 (0, 2)2 (0.9, 3)All Malignancy0 (0, 2)0.4 (0, 2)1 (0.4, 2)0.6 (0, 3)1 (0, 4)0 (0, 2)0.5 (0, 2)0 (0, 0. 8)0 (0, 1)MACE0 (0, 2)0.4 (0, 2)0.4 (0, 1)0.6 (0, 3)0 (0, 2)0.6 (0, 3)0 (0, 0.8)0.3 (0, 1.4)0.1 (0, 0.6)% pts with ≥1 injection site rxn3.14.55.00.31.31.11.62.41.7

aPlacebo crossover pts were included in the combined GUS column after crossover to GUS

bFor all pts who d/c study treatment early with the last dose of PBO/GUS prior to W24 and who did not receive any PBO/GUS at or after Wk24, all data including the final safety follow-up visit collected through 1yr were included

cFor pts in PBO group who switched to GUS due to cross-over or inadvertently, only data prior to first administration of GUS were included.

dCI based on an exact method assuming observed number of events follows a Poisson distribution

Disclosure of Interests:

Alice B Gottlieb Consultant of: Anaptyps Bio, Avotres Therapeutics, Beiersdorf, Boehringer Ingelheim, Bristol-Myers-Squibb, Eli Lilly, Janssen, LEO Pharma, Novartis, Sun Pharmaceuticals, UCB, and Xbiotech, Grant/research support from: Boehringer Ingelheim, Janssen, Novartis, Sun Pharmaceuticals, UCB, and Xbiotech, Joseph F. Merola Consultant of: AbbVie, Arena, Biogen, BMS, Dermavant, Eli Lilly, Janssen, Novartis, Pfizer, Sun Pharma, UCB, April Armstrong Consultant of: AbbVie, Janssen, Lilly, Leo, Novartis, UCB, Ortho Dermatologics, Dermira, KHK, Sanofi, Regeneron, Sun Pharma, BMS, Dermavant, and Modernizing Medicine, Richard Langley Speakers bureau: AbbVie, Amgen, Boehringer Ingelheim, Celgene, Eli Lilly, Janssen, LEO Pharma, Merck, Novartis, Pizer, Sun Pharmaceutical, and UCB Pharma, Consultant of: AbbVie, Amgen, Boehringer Ingelheim, Celgene, Eli Lilly, Janssen, LEO Pharma, Merck, Novartis, Pizer, Sun Pharmaceutical, and UCB Pharma, Mark Lebwohl Consultant of: Aditum Bio, Allergan, Almirall, Arcutis, Inc., Avotres Therapeutics, BirchBioMed Inc., BMD skincare, Boehringer-Ingelheim, Bristol-Myers Squibb, Cara Therapeutics, Castle Biosciences, Corrona, Dermavant Sciences, Evelo, Evommune, Facilitate International Dermatologic Education, Foundation for Research and Education in Dermatology, Inozyme Pharma, Kyowa Kirin, LEO Pharma, Meiji Seika Pharma, Menlo, Mitsubishi, Neuroderm, Pfizer, Promius/Dr. Reddy’s Laboratories, Serono, Theravance, and Verrica., Grant/research support from: Abbvie, Amgen, Arcutis, Boehringer Ingelheim, Dermavant, Eli Lilly, Evommune, Incyte, Janssen, Leo Pharmaceutucals, Ortho Dermatologics, Pfizer, and UCB, Christopher E.M. Griffiths Speakers bureau: AbbVie, Amgen, Almirall, BMS, Boehringer Ingelheim Celgene, Janssen, LEO Pharma, Lilly, Novartis, Pfizer, Sun Pharma, UCB Pharma., Consultant of: AbbVie, Amgen, Almirall, BMS, Boehringer Ingelheim Celgene, Janssen, LEO Pharma, Lilly, Novartis, Pfizer, Sun Pharma, UCB Pharma., Grant/research support from: AbbVie, Amgen, Almirall, BMS, Boehringer Ingelheim Celgene, Janssen, LEO Pharma, Lilly, Novartis, Pfizer, Sun Pharma, UCB Pharma., May Shawi Shareholder of: Johnson & Johnson, Employee of: Janssen Global Services, LLC, Ya-Wen Yang Shareholder of: Johnson & Johnson, Employee of: Janssen Global Services, LLC, Elizabeth C Hsia Shareholder of: Johnson & Johnson, Employee of: Janssen Research & Development, LLC, Alexa Kollmeier Shareholder of: Johnson & Johnson, Employee of: Janssen Research & Development, LLC, Xie L Xu Shareholder of: Johnson & Johnson, Employee of: Janssen Research & Development, LLC, Miwa Izutsu Shareholder of: Johnson & Johnson, Employee of: Janssen Research & Development, LLC, Paraneedharan Ramachandran Shareholder of: Johnson & Johnson, Employee of: Janssen Research & Development, LLC, Shihong Sheng Shareholder of: Johnson & Johnson, Employee of: Janssen Research & Development, LLC, Yin You Shareholder of: Johnson & Johnson, Employee of: Janssen Research & Development, LLC, Megan Miller Shareholder of: Johnson & Johnson, Employee of: Janssen Research & Development, LLC, Christopher T. Ritchlin Consultant of: AbbVie, Amgen, Gilead, Janssen, Lilly, Novartis, Pfizer, and UCB Pharma, Grant/research support from: AbbVie, Amgen, and UCB Pharma, Iain McInnes Consultant of: AbbVie, Bristol-Myers Squibb, Celgene, Eli Lilly and Company, Gilead, and Janssen, Novartis, Pfizer, and UCB, Grant/research support from: Bristol-Myers Squibb, Celgene, Eli Lilly and Company, Janssen, and UCB, Proton Rahman Speakers bureau: AbbVie, Eli Lilly, Janssen, Novartis, Pfizer, and UCB, Consultant of: AbbVie, Amgen, Bristol Myers Squibb, Celgene, Eli Lilly, Janssen, Novartis, Pfizer, Roche, and UCB, Grant/research support from: Janssen and Novartis.

POS1031 LOW INCIDENCE OF GASTROINTESTINAL-RELATED AND OVERALL SERIOUS ADVERSE EVENTS AMONG GUSELKUMAB-TREATED PATIENTS: POOLED ANALYSES OF VOYAGE 1 & 2 AND DISCOVER 1 & 2 THROUGH 1-YEAR

Background:

Guselkumab (GUS), a human monoclonal antibody that specifically binds to the p19-subunit of interleukin (IL)-23, demonstrated efficacy in the Phase 3 VOYAGE 1&2 trials of patients (pts) with moderate to severe plaque psoriasis (PsO)1,2 and in the DISCOVER 1&2 trials of pts with active psoriatic arthritis (PsA).3,4 IL-17 inhibitors used to treat PsO and PsA have been associated with exacerbation or new onset of inflammatory bowel disease (IBD) (e.g., Crohn’s disease or ulcerative colitis).5

Objectives:

Evaluate the incidence of gastrointestinal (GI)-related and overall serious adverse events (SAEs) from pooled safety data through 1-year of GUS 100 mg treatment from the VOYAGE 1&2 and DISCOVER 1&2 trials.

Methods:

Using pooled safety data from the VOYAGE 1&2 PsO trials and DISCOVER 1&2 PsA trials, SAEs related to GI disorders were identified using the Medical Dictionary for Regulatory Activities (MedDRA) system-organ class “GI disorders”. Pts with a previous history of IBD were not excluded in these trials; medical history of IBD was collected at baseline in DISCOVER 1&2. Rates of overall SAEs and GI-related SAEs were calculated as the number of SAEs per 100 pt-years (PY) of follow-up (95% confidence intervals). Data are presented for the placebo (PBO)-controlled period (Weeks 0-16 for VOYAGE 1&2; Weeks 0-24 for DISCOVER 1&2) and through 1-year (defined as through Week 48 for VOYAGE 1&2; through Week 60 for DISCOVER 1, and through Week 52 for DISCOVER 2). Events of uveitis and opportunistic infections were also analyzed.

Results:

Through the PBO-controlled period, the overall rates of GI-related SAEs per 100 PY for pooled VOYAGE 1&2 were: PBO 0.78 (0.02, 4.34), GUS q8w 0; and for pooled DISCOVER 1&2: PBO 0.58 (0.01, 3.23), GUS q8w 0.58 (0.01, 3.21), GUS q4w 0. The GI-related SAEs included: gastrointestinal hemorrhage (PBO; n=1) for pooled VOYAGE 1&2; and inflammatory bowel disease (PBO; n=1) and mechanical ileus (GUS q8w; n=1) for pooled DISCOVER 1&2. Through 1-year, the overall rates of GI-related SAEs for pooled VOYAGE 1&2 were: Combined GUS group (GUS q8w and PBO→GUS groups) 0.51 (0.17, 1.20); and for pooled DISCOVER 1&2: GUS q8w 0.52 (0.06, 1.88), GUS q4w 0, Combined GUS group (GUS q8w, GUS q4w, and PBO→GUS groups) 0.21 (0.02, 0.74). The GI-related SAEs in the Combined GUS group for pooled VOYAGE 1&2 included: gastritis, hemorrhoids, inguinal hernia, pancreatitis, and umbilical hernia (0.10/100PY [0.00, 0.57]; n=1 for each); and in the Combined GUS group for pooled DISCOVER 1&2: mechanical ileus and pancreatitis chronic (0.10/100PY [0.00, 0.57]; n=1 for each). Overall, no cases of exacerbation or new onset of IBD were reported in GUS-treated pts, including 2 pts with a prior history of IBD in DISCOVER 1&2 (total PY of follow-up for the Combined GUS groups in VOYAGE and DISCOVER were 974 and 973, respectively). Through the PBO-controlled period, rates of overall SAEs for GUS-treated pts were comparable to PBO-pts and SAE rates remained low through 1-year of follow-up in the VOYAGE 1&2 and DISCOVER 1&2 trials. There were no reported cases of uveitis, opportunistic infections, or tuberculosis in GUS-treated pts through 1-year.

Conclusion:

Through 1-year of follow-up with GUS treatment in pooled VOYAGE 1&2 and DISCOVER 1&2, GI-related SAE rates were low. There were no reported cases of uveitis, opportunistic infections, or new onset/exacerbation of IBD in GUS-treated pts. No new safety concerns were identified through 1-year.

References:

[1]Blauvelt A., et al. J Am Acad Dermatol. 2017;76:405-17.

[2]Reich K., et al. J Am Acad Dermatol. 2017;76:418-31.

[3]Deodhar A., et al. Lancet. 2020;395:1115-25.

[4]Mease P.J., et al. Lancet. 2020; 395:1126-36.

[5]Hohenberger M., et al. J Dermatolog Treat. 2018;29:13-8.

Disclosure of Interests:

Philip J Mease Consultant of: AbbVie, Amgen, Boehringer Ingelheim, Bristol Myers Squibb, Eli Lilly, Galapagos, Gilead, GlaxoSmithKline, Janssen, Novartis, Pfizer, SUN, and UCB, Grant/research support from: AbbVie, Amgen, Bristol Myers Squibb, Eli Lilly, Galapagos, Gilead, Janssen, Novartis, Pfizer, SUN, and UCB, Peter Foley Speakers bureau: AbbVie, Celgene, Janssen, Lilly, Merck, Novartis, Pfizer, Valeant, Galderma, GSK, Leo Pharma, and Roche, Consultant of: Janssen, Lilly, Novartis, Pfizer, Galderma, AbbVie, Amgen, AstraZeneca, Arcutis, Aslan, Boehringer Ingelheim, Celgene, Hexima, Merck, Sun Pharma, UCB Pharma, Valeant, BMS, Celtaxsys, CSL, Cutanea, Dermira, Genentech, GSK, Leo Pharma, Regeneron Pharmaceuticals Inc, Reistone, Roche, and Sanofi, Grant/research support from: AbbVie, Amgen, Celgene, Janssen, Leo Pharma, Lilly, Merck, Novartis, Pfizer, Sanofi, and Sun Pharma; travel grants from AbbVie, Janssen, Lilly, Merck, Novartis, Pfizer, Galderma, Leo Pharma, Roche, Sun Pharma, and Sanofi

, Kristian Reich Consultant of: AbbVie, Amgen, Gilead, Janssen, Lilly, Novartis, Pfizer, and UCB Pharma, Grant/research support from: AbbVie, Amgen, and UCB Pharma, Jerry Bagel Speakers bureau: AbbVie, Celgene Corporation, Eli Lilly, Janssen Biotech, and Novartis, Consultant of: AbbVie, Amgen, Celgene Corporation, Eli Lilly and Company, Janssen Biotech, Leo Pharma, Novartis, Sun Pharmaceutical Industries Ltd, and Valeant Pharmaceuticals, Grant/research support from: AbbVie, Amgen, Arcutis Biotherapeutics, Boehringer Ingelheim, Bristol Myers Squibb, Celgene Corporation, Corrona, LLC, Dermavant Sciences, LTD, Dermira/UCB, Eli Lilly and Company, Glenmark Pharmaceuticals Ltd, Janssen Biotech, Kadmon Corporation, Leo Pharma, Lycera Corp, Menlo Therapeutics, Novartis, Pfizer, Regeneron Pharmaceuticals, Sun Pharma, Taro Pharmaceutical Industries Ltd, and Valeant Pharmaceuticals, Mark Lebwohl Consultant of: Aditum Bio, Allergan, Almirall, Arcutis, Inc., Avotres Therapeutics, BirchBioMed Inc., BMD skincare, Boehringer-Ingelheim, Bristol-Myers Squibb, Cara Therapeutics, Castle Biosciences, Corrona, Dermavant Sciences, Evelo, Evommune, Facilitate International Dermatologic Education, Foundation for Research and Education in Dermatology, Inozyme Pharma, Kyowa Kirin, LEO Pharma, Meiji Seika Pharma, Menlo, Mitsubishi, Neuroderm, Pfizer, Promius/Dr. Reddy’s Laboratories, Serono, Theravance, and Verrica, Grant/research support from: Abbvie, Amgen, Arcutis, Boehringer Ingelheim, Dermavant, Eli Lilly, Evommune, Incyte, Janssen, Leo Pharmaceutucals, Ortho Dermatologics, Pfizer, and UCB, Ya-Wen Yang Shareholder of: Johnson & Johnson, Employee of: Janssen Global Services, LLC, May Shawi Shareholder of: Johnson & Johnson, Employee of: Janssen Global Services, LLC, Megan Miller Shareholder of: Johnson & Johnson, Employee of: Janssen Research & Development, LLC, Alexa Kollmeier Shareholder of: Johnson & Johnson, Employee of: Janssen Research & Development, LLC, Elizabeth C Hsia Shareholder of: Johnson & Johnson, Employee of: Janssen Research & Development, LLC, Xie L Xu Shareholder of: Johnson & Johnson, Employee of: Janssen Research & Development, LLC, Miwa Izutsu Shareholder of: Johnson & Johnson, Employee of: Janssen Research & Development, LLC, Paraneedharan Ramachandran Shareholder of: Johnson & Johnson, Employee of: Janssen Research & Development, LLC, Shihong Sheng Shareholder of: Johnson & Johnson, Employee of: Janssen Research & Development, LLC, Yin You Shareholder of: Johnson & Johnson, Employee of: Janssen Research & Development, LLC, Philip Helliwell Consultant of: Galapagos, Janssen, Novartis, Grant/research support from: Abbvie, Janssen, Pfizer, Wolf-Henning Boehncke Speakers bureau: AbbVie, Almirall, Celgene, Janssen, Leo, Lilly, Novartis, and UCB Pharma, Consultant of: AbbVie, Almirall, Celgene, Janssen, Leo, Lilly, Novartis, and UCB Pharma, Grant/research support from: Pfizer

Coaxial periodic optical waveguide

Guided modes in a dielectric waveguide structure with a coaxial periodic multi-layer are investigated by using a matrix formula with Bessel functions. We show that guided modes exist in the structure, and that the field is confined in the core which consists of the optically thinner medium. The dispersion curves are discontinuous, so that the modes can exist only in particular wavelength bands corresponding to the stop bands of the periodic structure of the clad. It is possible that the waveguide structure can be applied to filters or optical fibers to reduce nonlinear effects.

Multifunction optical filter with a Michelson-Gires-Tournois interferometer for wavelength-division-multiplexed network system applications

We propose using a novel multifunction optical filter with a Michelson-Gires-Tournois interferometer (MGTI) for future smart wavelength-division-multiplexed network system applications. The MGTI filter is a typical Michelson interferometer in which one of its reflecting mirrors is replaced with a Gires-Tournois resonator. One unique feature of this device is that it can function as a channel-passing (CP), a channel-dropping (CD), or a wide-bandpass (BP) filter, depending on the interferometer arm-length difference. Other interesting features are that (1) the linewidths of both the CP and the CD filter are twice as narrow as that of a typical Fabry-Perot filter with similar parameters, (2) theoretical visibility is always unity regardless of the mirror reflectance value, and (3) the BP filter has an excellent boxlike response function. Numerical results showing these characteristics are presented.

Optical wave-front transformer using the multiple-reflection interference effect inside a resonator

We propose a new class of optical wave-front transformer based on a different mechanism that uses the multiple-reflection interference effect in a Gires-Tournois resonator (GTR) as the physical mechanism for phase modification. By coating the front surface of a GTR with a predefined graded reflectivity profile, one can synthesize various optical elements. We present the basic concept of our proposal by synthesizing a lenslike element as a proof-of-principle example. One unique feature of this element is that it can function as a reflecting mirror, a converging lens, or a diverging lens, depending on the resonator length. Other applications are briefly discussed.

[CT anatomy of the caudate lobe of the liver]

The anatomy of the portal vein branches in the caudate lobe of the liver was studied in 20 patients by double-phase CT arterial portography (DP-CTAP). DP-CTAP provided excellent images of the portal venous system in the first phase and the perfusion defects of intrahepatic tumors in the second phase. From DP-CTAP images of the first phase, a sufficient number of interpolated images were created for a smooth paging display. The ramifying structures of the portal system were traced on the monitor using the tracking ball. This method was found to be very effective and reliable for the anatomical assessment of the caudate lobe. The number and origins of the caudal portal branches were investigated in each case, and the caudate lobe of the liver could be divided into right and left segments.

[CT angiography of the liver]

The diagnostic efficacy of CT arterial portography (CTAP) for the hepatic tumors has been established. We developed the double-phase incremental CTAP (DP-CTAP) using a fast CT scanner, by which the double-phase scanning of the whole liver was made during a single contrast administration. The DP-CTAP was performed in 9 cases of hepatic diseases, and was useful for the lesion detection and improvement of the visualization of the liver vasculatures. The maximum density projection angiogram of the portal and hepatic veins was easily made by DP-CTAP images, and useful for three dimensional understanding of the liver vasculatures and the detection of the vascular abnormalities.

Bladder tumor staging: comparison of conventional and gadolinium-enhanced dynamic MR imaging and CT

With computed tomography (CT) and unenhanced magnetic resonance (MR) imaging, stage pT3b extravesical extension and beyond can be diagnosed, but tumors confined to the bladder wall (stages pT1-pT3a) are poorly delineated. To determine whether visualization of such tumors could be improved with gadolinium-enhanced MR imaging, dynamic breath-hold T1-weighted MR images were obtained after intravenous infusion of 0.1 mmol/kg gadopentetate dimeglumine in 79 patients (86 tumors). Conventional MR images, CT scans, and histologic correlation were available in all cases. With dynamic gadolinium-enhanced MR imaging, the mucosa could be distinguished from the muscular layers of the bladder wall. Staging accuracy with this technique was 85% (73 of 86), which was significantly better than with CT (55%; 47 of 86) (P < .005) or conventional MR imaging (58%; 50 of 86) (P < .05). The accuracy of staging the intramural extent (pT1-pT3a) of bladder tumors was thus improved with gadolinium-enhanced dynamic MR imaging.

[Fallopian tube recanalization with a catheter system--experience in the use of a balloon catheter]

Fallopian tube obstruction is one of the most difficult problems in the treatment of infertility. This report gives the results of a pilot study on the transcervical recanalization of the occlusive fallopian tube. Selective catheterization of the uterine cornu was applied through a balloon catheter, which was wedged at the internal uterine os. In 16 occlusive fallopian tubes of 11 cases, the catheterization procedure was attempted and accomplished with a 87.5% success rate. Recanalization was successful in 75.0% of the affected tubes. Subsequent pregnancy was confirmed in three cases. This convenient technique is safe and effective and it will be accepted as the first choice in the diagnosis and treatment of fallopian tube obstruction.

Beam propagation method analysis of optical waveguide lenses

Focusing characteristics of optical waveguide lenses are analyzed by the beam propagation method (BPM) instead of the ray tracing method. By use of the BPM, we can observe field distributions of a converging or diverging light beam after it passes through a waveguide lens. Variations of the spot width and magnitude of diffraction can immediately be evaluated with this calculation. The BPM calculations are used for a mode-index, Luneburg, and geodesic lenses. For the application of the method to the geodesic lens, the surface deformation is converted into an equivalent index.

[A case of multiple intrahepatic portosystemic venous shunts associated with multiple hemangioma-like lesions of the liver]

Intrahepatic portosystemic venous shunts (IPVS) are rare, except for the minute ones observed in cirrhotic liver. This report concerns a case with frequent episodes of consciousness loss, diagnosed as IPVS and multiple hemangioma-like lesions of the liver by US, CT and angiography. To our knowledge, this is the first report of association of IPVS and such angiographically evident hemangioma-like lesions of the liver. The etiology of IPVS is mostly considered to be congenital though, there are still many arguments about it. The relation between IPVS and the hemangioma-like lesions of the liver is discussed.

Integrated optic pressure sensor on silicon substrate

A novel integrated optic pressure sensor was constructed with the Mach-Zehnder interferometer structure of glass waveguides on a silicon substrate. Pressure is sensed by detecting the deformation of a thin diaphragm fabricated by using the anisotropic etching of a silicon substrate. The basic design concept of the present sensor was provided by analyzing its operation. The measurable pressure range and the sensitivity can be set by the proper selection of the diaphragm structure. A device was built and its operation performances were tested at 633 nm. For the fabricated device, the measured halfwave pressure was 0.8 x 10(5) Pa and the extinction ratio was 10 dB.

Development and evaluation of a radiological reporting system for use with a personal computer

A computer-assisted radiological reporting system (CRRS) was developed for the efficient management and effective use of a database of radiological information. The system consists of a computer terminal linked to an HIS, a reporting console and a personal computer in the local area network of the radiology department, and a radiography care reader which transfers basic data on the patient from the HIS to the CRRS. The patient's name, hospital ID number, sex and date of birth, the department from which the patient has been referred, in-patient/out-patient status and the procedure needed are recorded on magnetic cards (radiography cards) issued to radiology patients. The system has been successfully used in all diagnostic procedures for 8 months: 16,300 reports have been printed out and stored. The system has made it possible to implement the complete radiological reporting procedure for clinical applications, and the required data can easily be retrieved and used. It has proved to be quite easy to use CRRS to obtain diagnostic histories, and the improved efficiency of the reporting procedure has enabled the cost of a clerk typist to be eliminated.

CT and ultrasound findings of surgically retained sponges and towels

The CT and ultrasound features of retained sponges (gossypibomas) are described in six patients. They are well-circumscribed cystic masses without surrounding edema. The retained sponges or towels were correctly identified in only three cases. In the other three cases retained sponges were organized and lost their original configuration. Gas was seen in one case and calcification in two cases. Gossypibomas should be included in the differential diagnosis in all patients with a well-circumscribed cystic mass in the abdomen and with a history of previous laparotomy.

Optical-waveguide hybrid coupler

As a novel guided-wave passive device, the optical-waveguide hybrid coupler is proposed and its first known demonstration is reported. The proposed device consists of symmetric and nonsymmetric branching forks connected at a junction. An explanation of the working mechanism is presented. The feasibility of the device is confirmed by constructing and testing the hybrid coupler with an integrated Mach-Zehnder interferometer composed of a Y junction and phase shifters using a Ti-diffused LiNbO(3) waveguide.

Operation mechanism of the single-mode optical-waveguide Y junction

An explanation of the working mechanism of single-mode optical-waveguide Y junction is presented. Taking into account the contribution of radiation mode, the power conservation at the junction is clearly verified. Also, the analogy between the behavior of the single-mode Y junction and that of a beam splitter is discussed.