This investigation presents a new approach in the measurement of the mechanical properties of the ligament substance from tensile testing of a bone-ligament-bone complex. Such basic information should be one of the necessary prerequisites in the evaluation of ligament repair as well as reconstruction by autogenous tissue grafts or artificial ligament implants. The use of a video system permits the determination of tensile strains of the mid-medial collateral ligaments from the canine, swine, and rabbit without mechanically interfering with the ligament deformation during testing. This methodology further eliminates the difficulties of measuring the initial length of the entire medial collateral ligament, as its insertions to bones are ambiguous and cover a large area. It was found that the strain of the ligament substance is consistently and considerably less than specific deformation of the bone-ligament-bone complex. These data suggest that the ligament-bone structure stretches nonuniformly with the highest deformation occurring near or at the ligament insertion sites to bone. Other interesting findings include the variation of tensile strains along the ligament substance for all animal species studied.

Objective: A needs assessment can be used as a direct index of what patients perceive they need help with. The purposes of this study were to investigate the association between patients' perceived needs and psychological distress and/or quality of life (QOL) and to clarify the characteristics of patients with a high degree of unmet needs.Methods: Randomly selected ambulatory female patients with breast cancer participated in this study. The patients were asked to complete the Short-form Supportive Care Needs Survey questionnaire, which covers five domains of need (health system and information, psychological, physical, care and support, and sexuality needs); the Hospital Anxiety and Depression Scale; and the European Organization for Research and Treatment of Cancer QLQ-C 30.Results: Complete data were available for 408 patients. The patients' needs were significantly associated with both psychological distress (r 5 0.63, po0.001) and QOL (r 5 À0.52, po0.001). A multiple regression analysis revealed that employment status (without full-time /part-time job), duration since diagnosis (less than 6 months), advanced stage, and a lower performance status were significantly associated with higher total needs. Only sexuality needs were significantly associated with a younger age, while the other domains were significantly associated with duration since diagnosis, advanced stage, and a lower performance status.Conclusions: Moderate to strong associations exist between patients' needs and psychological distress and/or QOL. The characteristics associated with patients' needs are multi-factorial, and interventions to respond to patients' needs may be one possible strategy for ameliorating psychological distress and enhancing QOL.

Psychosocial needs were strongly associated with psychological distress and quality of life. Quality of life and psychological distress may be improved if interventions for unmet needs, especially psychological and information needs, are made.

The results indicated that SCNS-SF34-J is a valid and reliable tool for assessing the supportive care needs of Japanese cancer patients.

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