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Objective:The number of patients with foot gangrene caused by critical ischaemia and severe infection is increasing significantly in developed countries. The measurement of perilesional skin blood flow by skin perfusion pressure (SPP) is useful to select the appropriate treatment of gangrenous lesions, in that it is not affected by calcifications of blood vessels. However, the prognosis of a foot ulcer may also be affected by the level of blood sugar and infections. This study aimed to validate the use of SPP in cases of foot gangrene and ulcers in patients with and without diabetes mellitus (DM) and infection.Method:Clinical symptoms, ankle-brachial pressure index (ABPI) and SPP were assessed to evaluate the condition of each foot ulcer. Every foot ulcer was treated as independent, even if a participant had multiple ulcers. All ulcers for which we measured SPP were subject to the analysis. All ulcers were purely ischaemic in nature and were exclusively located on the foot or toes.Results:Data were collected from 117 foot ulcers on 91 toes and feet from 65 patients. Almost all SPP values in healed cases were > 27 mmHg. There were three patients whose ulcers failed to heal by conservative treatments were complicated with severe infection. However, no effect of DM on the relationship between SPP values and prognosis was observed. Logistic regression analysis of all ulcers except for the 5 cases complicated with infection revealed that those with 30 mmHg or lower SPP values are likely to heal by conservative treatment with 23% or lower probability, whereas any ulcer with more than 50 mmHg SPP value and without severe infection may heal without the need for further operations with 80% or higher probability.Conclusion:The combination of SPP and careful evaluation of infection may be a good parameter to decide the appropriate treatment for ischaemic skin ulcers, regardless of the complication of DM.

Micromolding with microscale surface features and thin-wall plates of polycarbonate polymer was performed with heat insulator molds using zirconia ceramic. Effects of process parameters on processability and surface replication of the molded optical parts such as anti-reflective plates were evaluated. Calculation results show the interfacial layer of molded parts with a heat insulator mold shows 20 K higher than a conventional mold. The state of replication and higher-order structure of molded parts were analyzed using a scanning electron microscope and a polarizing optical microscope. Using a heat insulator mold, the flow length is increased, and the state of surface replication of molded parts is better. Due to the better surface replication, plates using the insulator mold show higher light transmission due to the less light reflection at the surface of plates. The molecular orientation of molded parts decreased using this mold, as it did in molding conditions of higher mold temperatures and injection temperatures.