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This review is concerned with a physical cleaning method based on ultrasound superposed water jets that collide with cleaning targets and spread over their surface; this method is called ultrasonic water flow cleaning and can be used in semiconductor manufacturing processes. Visualization of the acoustic wave and cavitation bubbles in ultrasonic water flow is presented to examine the role of bubbles oscillating under ultrasound irradiation in the process of removing small silica particles from glass surfaces. The visualization results suggest that hydrodynamic force from single-phase water flow does not suffice for particle removal and that acoustic cavitation bubbles play a major role in particle removal as in the case of ultrasonic bath immersion cleaning [ABSTRACT FROM AUTHOR]

The vibration mode of bend pipe and the choking prevention effect in dense-phase pneumatic conveying has been investigated experimentally. The vibration mode has been showed that it has four antinodes for longitudinal direction, and eight for pipe cross section as designed, and the vibration amplitude has increased as increasing the input voltage. Therefore, it is possible to adjust the vibration amplitude easily by changing the input voltage. Then, the frictional force between the packed bed and pipe wall has been increased with increasing particle diameter. However, it has been reduced with ultrasonic vibration in spite of kinds of particles and pipe diameter. This means the possibility of choking can be removed with ultrasonic vibration in bend pipe as well as in horizontal pipe. [ABSTRACT FROM AUTHOR]

Ultrasound was irradiated to ultrapure water. Ultrafine bubbles with a diameter of 90 - 100 nm were generated. Number concentration of ultrafine bubbles increased with time and approached asymptotically to an equilibrium value. Ultrafine bubble concentration increased with increasing ultrasonic power and decreasing frequency. For comparison, highly concentrated ultrafine bubble water was prepared by pressurized dissolution method, and ultrasound was also irradiated to the ultrafine bubble water. Reduction of ultrafine bubbles was observed and ultrafine bubble concentration decreased to the equilibrium value. Ultrafine bubble concentration decreased with increasing ultrasonic power and frequency. Generation and reduction of ultrafine bubbles by ultrasound was modeled to analyze experimental data. The results calculated by our model were in good agreement with the experimental data. [ABSTRACT FROM AUTHOR]

As ultrafine bubble (UFB) water becomes widespread in society, it is extremely important to see if the UFB water can be treated like a popular aqueous solution. The most fundamental handling includes storage, transportation, concentration, dilution and removal. Although the number concentration of UFBs gradually decreased even in an environment where it was allowed to stand at room temperature, it maintained about a few hundred million/mL for several months. There was also no significant decrease in number concentration due to the international transportation between Japan and Germany. The UFBs in water could be concentrated by vacuum evaporation method or very slow forward partial freezing method. Furthermore, UFB water could be diluted with ultrapure water. The UFB number concentration distribution hardly changed in these various concentration adjustment operations. The UFBs were removed from UFB water by ultrasonic irradiation in the MHz band. [ABSTRACT FROM AUTHOR]

During surgery for skull base lesions, maximum efforts should be made to improve the removal rate of the lesion while avoiding complications, and it is necessary to expand the surgical field by selecting appropriate surgical instruments and equipment. In both microsurgery and endoscopic surgery, high-speed drills and ultrasonic aspirators contribute significantly to the safe and reliable removal of skull base lesions, and the surgeons need to be familiar with these characteristics. The specific vital points are as follows: (1) Preparation of the appropriate environment for using a high-speed drill or an ultrasonic aspirator with the understanding of the microsurgical anatomy, (2) Bone excision using a high-speed drill with the selection of an appropriate drill attachment or drill bar tip according to the site of use, (3) Internal decompression of lesions using an ultrasonic aspirator with appropriate settings, (4) Additional expansion of the surgical field by using an ultrasonic aspirator in the osteotomy mode, and so on. This section describes details of how to use a high-speed drill and an ultrasonic aspirator during skull base surgery.

In general probe, the focal length in the elevational direction and resolution are fixed by the acoustic lens, so that sufficient resolution cannot be obtained in the region other than the focal point, except for special ultrasonic probes. Therefore, to improve the elevational resolution in the very shallow region, we devised the "narrow aperture method" for attaching a tape slit to an acoustic lens, and verified the method and its effect. The result of the study, for the slit, use Transpore™ tape overlaid on three layers and set the slit width to 1 mm. In addition, as a result of measurement of the slice thickness of the linear probe PLT-1204B manufactured by Canon Medical Systems, it was possible to reduce the slice thickness to a depth of 9 mm by 1 mm slit. The effectiveness of a 1 mm slit was also confirmed by probes from other companies. Moreover, it was found that the beam profile of 1 mm slit has almost the same shape even if the probe is different. The narrow aperture method of the acoustic lens can improve the elevational resolution in a very shallow region of a general ultrasonic probe.

Determination of arsenic in pure aluminum by inductively coupled plasma atomic emission spectrometry was interfered by aluminum matrix. The experiment showed that when the mass concentration of Al was greater than or equal to 5 000 times the As in the test solution, the measurement error was greater than 5%. In order to eliminate the interference, strong acid cation exchange fiber (SACEF) was used as solid phase extraction agent to adsorb Al(3+). The extraction conditions included amount of SACEF, extraction time, temperature and pH were investigated. The optimal extraction conditions were that 0.9000 g SACEF was used to extract the aluminum from the sample solution of pH 2.0 at 55 °C for 5 min with the ultrasonic assist, and in this case, the arsenic in the form of arsenic acid was not extracted and left in the solution for the determination. The results showed that after treating 10. 00 mL test solution containing 1.00 µg arsenic and 20.0 mg aluminum, arsenic did not lose. The mass concentration of residual aluminum in the raffinate was about 2,000 times the As, which had not interfered the determination of arsenic. The detection limit (3 s) was 0.027 µg · mL(-1) and quantification limit (10 s) was 0.0091 µg · mL(-1). The proposed method was successfully applied to the separation and determination of arsenic in the synthetic samples, the aluminum cans and the barbecue aluminum foil. Recovery was in the range of 98.3%-105% and RSD (n = 3) was in the range of 0.1%-4.3%. The results showed that the content of arsenic in the aluminum cans and the aluminum barbecue foil was below the limited value of national standard (GB/T 3190-2008).

To assess the usefulness of ultrasound-guided sciatic nerve block in the popliteal fossa in the postoperative pain management after Achilles' tendon repair, we compared 15 patients managed by general anesthesia and sciatic nerve block (Group B) with 17 patients managed by general anesthesia alone (Group G). The time required for the nerve block was about 20 minutes on the average, and the success rate was 100%. No significant complication associated with the nerve block was observed. Fentanyl dosing for the postoperative analgesia was significantly smaller in the Group B. Although the postoperative analgesic requirement was comparable, the time to the first postoperative analgesic administration was significantly longer in the Group B. This retrospective study suggests that ultrasound-guided sciatic nerve block in the popliteal fossa provides safe and effective postoperative pain relief after Achilles' tendon repair.

In the post-genome era, the analysis of disease-related genes has rapidly advanced, and the medical application of the information obtained from gene analysis is being put into practice. In particular, the development of a novel system to transfect the gene of interest selectively and efficiently into targeted cells is essential for the gene therapy of refractory diseases, in vivo functional analysis of genes, and establishment of animal models for diseases. However, a suitable carrier for selective gene delivery to targeted cells remains to be developed. The sonoporation method using microbubbles and ultrasound (US) exposure is one of the most promising approaches for effective gene transfection. However, it is difficult to transfect the therapeutic gene into the targeted organs/cells selectively by the conventional sonoporation method. Recently, our group has developed mannose-modified and US-responsive carriers/nucleic acid complexes (Man-PEG(2000) bubble lipoplexes), and succeeded in obtaining the enhanced and selective gene expression in mannose receptor-expressing cells by combination with US exposure. In this review, I described our gene transfection methods using Man-PEG(2000) bubble lipoplexes and external US exposure. Additionally, I also reviewed the enhancing mechanism of gene expression focusing on the intracellular transporting processes, in vivo distribution, and the activation of transcriptional factors. I believe that these findings help in the development of an effective gene transfection system using US-exposing system.

Muscular dystrophies are a group of heterogeneous diseases that are characterized by progressive muscle weakness, wasting and degeneration. These muscular deficiencies are often caused by the loss of the protein dystrophin, a crucial element of the dystrophin-glycoprotein complex of muscle fibers. Duchenne muscular dystrophy (DMD) is a fatal, X-linked muscular disease that occurs in 1 out of every 3500 males. Therefore, feasible strategies for replacing or repairing the defective gene are required; however, to date, no effective therapeutic strategies for muscular dystrophies have been established. In this review, we first introduce gene therapies mediated by adeno-associated viruses (AAVs) including a functional dystrophin cDNA or antisense oligonucleotide (AO)-induced exon-skipping therapies, which are designed to exclude the mutated or additional exon(s) in the defective gene and thereby correct the translational reading frame. Recently, we developed "Bubble liposomes" (BLs), which are polyethylene glycol (PEG)-modified liposomes entrapping echo-contrast gas that is known as ultrasound (US) imaging gas. BL application combined with US exposure can function as a novel gene delivery tool, and we demonstrate that the US-mediated eruption of BLs is a feasible and efficient technique to deliver plasmid DNA or AOs for the treatment of muscular dystrophies.

A total of 121 Japanese patients scheduled for prostate biopsy were randomly and double-blindly assigned to be given a single oral dose of 100 mg Tramadol mixed with 20 ml of sugar syrup or placebo, 30 minutes before the procedure. Pain severity was measured by verbal rating scale (VRS) and visual analog scales (VAS). We also analyzed cardio-respiratory parameters and complications. Of 121 patients, 117 replied validly to VRS and VAS ; and 91 of 117 patients replied to the cohort questionnaire for analysis of the late disorder, patient's impression, prolonged pain and past history of hemorrhoid treatment. Tramadol showed no significant effect on pain severity indicated by VRS and VAS, and no change in cardiorespiratory parameters. Furthermore, 70 patients without a history of hemorrhoid treatment, showed no significant analgesic benefits of Tramadol during the biopsy. In total, 3 patients had side effects of vomiting (CTCAE : grade 1)6), which subsided spontaneously. The oral administration of a single dose of 100 mg Tramadol 30 minutes before a transrectal needle biopsy of the prostate was safe, but was not effective to calm down the pain severity.

Human norovirus is the most important foodborne virus in Japan. According to the statistics of food poisoning by the Ministry of Health, Labour, and Welfare (MHLW), the number of patients infected with norovirus has accounted for half of all the patients with food poisoning in recent years. One of the most important measures for the control of infectious diseases is establishing of techniques for inactivating pathogens. For the prevention of food poisoning caused by norovirus, MHLW recommends that foods be subjected to heat treatment at 85 degrees C for 1 min or more; moreover, it recommends the use of sodium hypochlorite to inactivate (disinfect) this virus. However, application of these treatments is not always feasible because heat results in denaturation and sodium hypochlorite can be toxic to the human body and can cause discoloration. Therefore, it is necessary to develop and improve the efficacy of disinfectants and physiochemical treatments against the virus. Human norovirus cannot be propagated in cell culture or in a small animal. This matter is the greatest hindrance for testing the stability of this virus in environments or for evaluating the efficacy of disinfectants, heat treatment, pH treatment, ultraviolet or gamma irradiation, high hydrostatic pressure treatment, and other methods for the inactivation of the virus. Hence, some viruses such as human enterovirus, feline calicivirus, or mouse norovirus have been used as surrogates of human norovirus. The data on inactivation and stability of surrogate viruses are exclusively used as the data of human noroviruses. In recent years, some attempts to distinguish between infectious and noninfectious virus particles by genetic methods such as polymerase chain reaction have been made. These methods include pretreatments by RNase for digesting viral RNAs from non-intact or destroyed virus particles, or addition of a reagent such as ethidium monoazide for inhibiting PCR amplification of viral RNAs from them, before RNA extraction. Non-intact virus particles, which may represent virus particles with some damage (s) in the structural protein(s), are not necessarily synonymous with non-infectious virus particles. However, the results of methods using these treatments, compared to the results of traditional methods without these treatments, seem to be more correlated to the amount of the infectious virus particles. Although many disinfectants or physiochemical treatments have been reported, traditional techniques such as removal of virus particles by washing in running water, heat treatment, or disinfection by sodium hypochlorite are still important control measures. Establishment of control measures for human norovirus and successful propagation of the virus in cell culture are strongly desired.

Skeletal muscle is a promising target tissue for the gene therapy of both muscle and non-muscle disorders. Gene transfer into muscle tissue can produce a variety of physiologically active proteins and may ultimately be applied to treatment of many diseases. A variety of methods have been studied to transfer genes into skeletal muscle, including viral and non-viral vectors. Recently, we have developed the polyethyleneglycol (PEG)-modified liposomes entrapping echo-contrast gas known as ultrasound (US) imaging gas. We have called the liposomes "Bubble liposomes" (BLs). We have further demonstrated that US-mediated eruption of BLs loaded with naked plasmid-DNA is a feasible and efficient technique for gene delivery. In this study, to assess the feasibility and the effectiveness of BLs for the gene therapy of disorders, we tried to deliver therapeutic genes (anti-inflammatory cytokine; IL-10 or anti-angiogenic factor; hK1-5) into skeletal muscles of arthritis or tumor model mice by the gene delivery system with BLs and US exposure. As a result, their disease symptom was efficiently improved by the systemic secretion of therapeutic proteins. Thus, this US-mediated BLs technique for muscle gene transfer may provide an effective noninvasive method for arthritis or cancer gene therapy in clinical use. In addition, it may be applicable for the gene therapy of other non-muscle and muscle disorders.

Background: The aim of this study is to compare the efficacy of stellate ganglion block, performed by ultrasound guided technique and blind technique, and ultrasound guided T2 intercostal nerve block., Methods: In the present study, we evaluated the changes in upper arm skin temperature, and the development of Horner syndrome after stellate ganglion block (blind technique and ultrasound guided technique) and ultrasound guided T2 intercostal nerve block in 12, 11 and 10 patients scheduled for each block. Stellate ganglion blocks (blind technique) were performed via an anterior paratracheal approach at C6 using 1% mepivacaine 5 ml. Ultrasound guided stellate ganglion blocks were performed using 8-5 MHz, curved array transducer, and 1% mepivacaine 5 ml is injected to the longus colli muscle at C6 by the out of plane technique. Ultrasound guided intercostal nerve blocks were performed using 13-6 MHz, linear array transducer, and 0.75% ropivacaine 5 ml at T2. Patients were examined before and after the procedure., Results: There were no significant differences in the increase of skin temperature and the development of Horner syndrome between the groups., Conclusions: Compared to stellate ganglion block (blind technique), ultrasound guided stellate ganglion block and T2 ultrasound-guided intercostal nerve block provided a similar efficacy.

Evidence has accumulated that collagen cross-links also play important roles in bone strength and the proper biological functions of bone. Thus, collagen cross-links may be a factor in determining the material properties of bone. Collagen cross-linking is affected by some growth factors, and tissue age. Collagen cross-links can be roughly divided into two types : lysyl oxidase mediated cross-links (enzymatic immature, divalent and mature, trivalent cross-links) and advanced glycation end-products (AGE ; non-enzymatic, pentosidine cross-links). These two types vary by both the mechanism of formation and by functional differences. Hyper- and micro-gravity, weight-bearing, and low intensity pulsed ultrasound (LIPUS) have distinct biological effects on bone collagen cross-link formation in vitro and in vivo (Saito M, J Bone Miner Res 2003, Bone 2004, Calcif Tissue Int 2004) . We demonstrated in previous studies that physiologic levels of mechanical strain such as hypergravity, weight-bearing, and LIPUS induce the formation of bone-type collagenous matrix into a specific molecular packing arrangement through the formation of characteristic types of cross-links as mineralization begins. Collagen cross-links play important roles in the expression of bone strength and the proper biological function of bone. Thus, collagen cross-links are thought to be a determinant of bone quality. While LIPUS have beneficial effects on collagen enzymatic cross-link formation, mechanical stress may improve bone quality (Saito M, Osteoporos Int, REVIEW, 2010) .

In gene therapy, it is important to develop an effective and safe gene delivery system. Especially, from the viewpoint of reducing side effects, gene delivery into a specific site is essential. We previously, developed liposomal bubbles (Bubble liposomes) containing perfluoropropane. Bubble liposomes were useful as ultrasound enhanced gene delivery tools in vitro and in vivo. In this review, we introduced the characteristics of Bubble liposomes as ultrasound imaging agents and ultrasound enhanced gene delivery tools. Bubble liposomes worked as ultrasound imaging agents in cardiosonography. In addition, their combination with ultrasound exposure was able to deliver plasmid DNA in the femoral artery. The gene expression was only observed at the site of ultrasound exposure. Moreover, the gene delivery by Bubble liposomes and ultrasound exposure was more efficient than that by conventional lipofection method using Lipofectamine 2000. Therefore, it was suggested that Bubble liposomes might be a new class of tools for site specific gene delivery.

Purpose: The objective of this study was to optimize least invasive techniques, like microwave tissue coagulation (MCT), radiofrequency ablation (RFA) or ultrasonically-activated scalpel (USS) for the electric and thermal conduction in kidney., Materials and Methods: Needle electrode of MCT, RFA or USS were inserted into pig's kidney, under general anesthesia. We examined if the interruption of renal artery or cooling of renal parenchyma by irrigation in the renal pelvis had an effect on the tissue temperature distribution and area of tissue degeneration. The tissue parenchyma temperatures were measured at regular intervals of area (each 2.5-5.0 mm) from needle electrode or hook probe and of time (each 10 sec) using by needle temperature sensor, and pathological investigations on the tissue degeneration of the renal parenchyma were done., Results: By MCT, interruption of renal artery had no effect on the distribution of tissue temperature and the area of tissue degeneration. Cooling of renal parenchyma by irrigation in the renal pelvis did not affect the area of tissue degeneration but the tissue temperature was elevated significantly. By RFA, particular interest, interruption of renal artery and cooling of renal parenchyma enhanced to increase both the tissue temperature and the area of tissue degeneration. By USS, interruption of renal artery enhanced to increase both the tissue temperature and the area of tissue degeneration. Cooling of renal parenchyma by irrigation in the renal pelvis had no effect on the distribution of temperature and the area of tissue degeneration. We also examined weather cooling of renal parenchyma by several irrigation solutions which have different electric conductivity (EC) such as normal saline solution (EC: 15,800 microS/cm), tap water (EC: 133 microS/cm) and glucose solution (EC: 8.6 microS/cm) in the renal pelvis using ureteral catheter would effect on the distribution of temperature and the area of tissue degeneration. In MCT and USS, these solutions did not have any effect, but in RFA the degree of tissue temperature elevation by normal saline, tap water and glucose solution were high, intermediate and low, respectively., Conclusion: As RFA and USS tend to be affected by the surrounding environment, electric and thermal conductivity should be applied with caution, while using these techniques.

The potential of transdermal drug delivery systems has been demonstrated in recent years with the approval of several medicines for use by patients who are unable to use conventional dosage routes, like oral administration or injection. To enhance the TDDS (Transdermal Drug Delivery System) potential to include other drug candidates, many researchers have been exploring enhancement approaches to increase the permeability of various drugs through the skin. Recently, physical enhancement systems are being reported as having big potential by many researchers. In particular, iontophoresis is a very attractive way of delivering ionized drugs by the application of an electric field to the skin. This has been marketed with some topical and systemic drugs (lidocaine and fentanyl). Sonophoresis is also an attractive method to deliver a drug through the skin using ultrasound. Besides these technologies, various physical approaches are under study. Such technologies can be expected to deliver not only small MW compounds but also macromolecules like peptides. In this article, after looking back through the history of TDDS development, I would like to summarize with new physical and chemical approaches and outline of the new trend of TDDS development with those enhancement system.

We evaluated the reliability and efficacy of the ultrasonically activated scalpel (Harmonic Scalpel) for pulmonary resection in video-assisted thoracoscopic surgery (VATS). Fifty-six cases of primary or metastatic lung cancer with history of lobectomy or segmentectomy from July 2003 to June 2006 were investigated. The ultrasonically activated scalpel was used to separate aborted lobulation and segment in the surgery. The outcome of the operation using the ultrasonically activated scalpel revealed the mean operation time of 224.5 minutes and mean blood loss volume of 116.7 ml. The chest drainage catheter was removed at the postoperative day 3.4 and hospitalization lasted 10.4 days on average. By means of statistical analysis, no significant differences were noted when compared with the cases using surgical stapler to separate the lobules or segments of the lungs. Histopathological results showed destruction of alveolar structures and denaturation of cells at the cut surface of the resected lung through the use of the ultrasonically activated scalpel. This method resulted in good lung expansion and preservation of the residual lung volume. Furthermore, it prevented postoperative air leakage by appropriate treatment to the cut surfaces of the residual lung. Indeed, the method appears to be useful in the separation of lung tissues in severe aborted lobulation and segmentectomy by VATS.

Over the past 30 years, drastic changes in molecular biology have accelerated technical advancements in pathological practice. Microwave irradiation was first applied to pathology archival samples for improved of tissue fixation, immunoreactions, in situ hybridizations, PCR reactions and other molecular assays. Compared to microwave irradiation, ultrasound processing allows rapid cross-linking of formalin-fixed tissue and uniformity of chemical reactions in tissues. In addition, temperature control is easier and tissue damage is minimized. Ultrasound was first applied to fixation solutions to improve the efficiency of tissue fixation. Many phenomena, including cavitation, and thermal and mechanical effects, are believed to play an important role in the ultrasound-mediated enhancement of fixation, dehydration, paraffin penetration, immunological reactions, hybridization, and clearing and impregnating tissue in an extremely short time. We found that to use ultrasound successfully for rapid tissue fixation and processing without tissue damage, it was critical to maintain ultrasound at low frequency and high intensity (40 KHz, 200 W/cm2). This ultrasound-mediated high-speed biological reaction and tissue processing also allows antigen-antibody reactions or nucleic acid hybridizations to occur rapidly with high specificity and with a very low or no background noise. Furthermore, we applied this ultrasound-assisted technique to decalcify and remove fat from tissue for rapid diagnosis, and compared the results to those obtained using conventional methods. In this study, we describe and highlight the advantages of ultrasound-mediated rapid tissue processing for routine pathological work and current molecular pathological applications.

Gene therapy based on ultrasound with microbubbles offers a novel approach for the prevention and treatment of variety of diseases. The major development of gene transfer has importantly contributed to intense investigation of the potential of gene therapy in cancer or cardiovascular medicine. The amazing advances in molecular biology have provided a dramatic improvement of the technology that is necessary to transfer target genes into somatic cells. Gene transfer methods have been surprisingly improved. In fact, some of them (retroviral vectors, adenoviral vectors or liposome based vectors, etc.) have been used in the clinical trials already. But some severe side effects were reported in clinical gene therapy using such viral, so people desire safe and efficient clinical gene therapy. Recently, ultrasound-mediated gene transfer has been reported to augment the transfection efficiency and facilitate local gene expression. Interestingly, gene transfer into the fetal central nervous system was successfully achieved by intrauterine injection with microbubble-enhanced ultrasound. Compared to other viral vectors, there are some theoretical advantages including safety, simplicity of preparation, and local gene transfer. Thus, we focused on the development of gene transfer using naked plasmid DNA with an ultrasound or microbubble-enhanced ultrasound method.

The right gastroepiploic artery (RGEA) could be harvested easily and safely by using an ultrasonic scalpel. It is easier and faster not to remove a satellite vein from RGEA than to skeletonize it fully. And blood flow of the vein is important, because it is the flow of vasa vasorum of RGEA. Among 70 patients who have bypassed to right coronary arteries (RCA), 25 patients were treated with semi-skeletonized RGEA (SSK-RGEA), the other 45 patients were operated with pedicled RGEA or (if pedicled RGEA was short and small) with the other grafts. An availability of SSK-RGEA for RCA was 100%. And that of pedicled RGEA was 47% (p < 0.001). Twenty-eight patients were operated without a pump. Twenty-three of them (82%) were bypassed with RGEA. In the on-pump cases (42 patients), RGEA were used for 13 (31%) cases (p < 0.05). Early post-operative angiographies revealed 1 occlusion. But the site of occlusion was the origin of RGEA branch from a gastro-duodenal artery, and the anastomotic site was patent. This graft was supposed to be occluded post-operatively by arteriosclerosis. Flow competition occurred in two grafts. In conclusion, the SSK-RGEA was useful for RCA bypass grafting. The reliability of RGEA should increase the indication of off-pump coronary artery bypass grafting.

We report our experience of using the ultrasonic coagulating and cutting device, AutoSonix System, which began in January 2000 to reduce the amount of bleeding in radical retropubic prostatectomy. The mean age of the 24 prostate cancer patients operated on was 68.2 years old. The operation results were excellent; the mean operation time was 227 +/- 29 minutes (mean +/- standard deviation), and the mean amount of blood loss during the operation was 215 +/- 114 ml. There were no major complications. After three months or more of follow-up, no patients needed any pads for urinary incontinence. Only one case showed a stricture at cystourethral anastomosis. AutoSonix System was useful to reduce the blood loss from the venous plexus in the pelvic cavity. We believe that radical prostatectomy would be safer if this device would be used by the urologist.