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We aimed to clarify the prognostic factors for patients with esophageal squamous cell carcinoma (ESCC) invading into the muscularis mucosa (pT1a-MM) or submucosa (pT1b-SM) after endoscopic submucosal dissection (ESD).This retrospective study enrolled such patients at 21 institutions in Japan between 2006 and 2017. We evaluated 15 factors, including pathological risk categories for ESCC-specific mortality, six non-cancer-related indices, and treatment strategies.In the analysis of 593 patients, the 5-year overall and disease-specific survival rates were 83.0% and 97.6%, respectively. In a multivariate Cox analysis, male sex (hazard ratio [HR] 3.56), Charlson comorbidity index (CCI) ≥3 (HR 2.53), ages of 75-79 (HR 1.61) and ≥80 years (HR 2.04), prognostic nutrition index (PNI)45 (HR 1.69), and pathological intermediate-risk (HR 1.63) and high-risk (HR 1.89) were prognostic factors. Subsequently, we developed a clinical risk classification for non-ESCC-related mortality based on the number of prognostic factors (age ≥75 years, male sex, CCI ≥3, PNI45): low-risk, 0; intermediate-risk, 1-2; and high-risk, 3-4. The 5-year non-ESCC-related mortality rates for patients without additional treatment were 0.0%, 10.2%, and 45.8% in the low-, intermediate-, and high-risk groups, respectively. Meanwhile, the 5-year ESCC-specific mortality rates for the pathological low-, intermediate-, and high-risk groups were 0.3%, 5.3%, and 18.2%, respectively.We clarified prognostic factors for patients with pT1a-MM/pT1b-SM ESCC after ESD. The combined assessment of non-ESCC- and ESCC-related mortalities by the two risk classifications might help clinicians in deciding treatment strategies for such patients.

Objects Although a recent study showed the cancer incidence of Barrett's esophagus (BE) to be 1.2%/year in 251 patient-years in Japan, the long-term outcomes remain unclear. The present study estimated the cancer risk of BE in Japan using our original prospective multicenter cohort. Methods A total of 98 patients with BE of maximum length of ≥2 cm were enrolled during the period of 2010 to 2012 and received at least 1 follow-up endoscopy over 5 years thereafter. Cancer incidence rates with 95% confidence interval for occurrence of esophageal adenocarcinoma were calculated as the number of events divided by patient-years of follow-up and were expressed as %/year. Results Overall, the median endoscopic follow-up period was 59.9 (first and third quartiles: 48.5-60.8) months, constituting a total of 427 patient-years of observation. Since 2 esophageal adenocarcinoma cases developed, the cancer incidence was 0.47% (0.01%-1.81%)/year. The cancer incidence was 0.39% (-0.16%-2.44%) in 232 patient-years and 0.31% (-0.13%-1.95%)/year in 318 patient-years for 55 cases with specialized intestinal metaplasia and 70 with BE ≥3 cm (maximum), respectively. At the end of follow-up, 12 of 92 patients (13.0%) died, but none died from esophageal adenocarcinoma. Conclusion This is the largest prospective follow-up study with endoscopy to investigate the incidence of esophageal adenocarcinoma in unequivocal BE with the maximum length of ≥2 cm in Japan. Although a further large-scale study will be required to validate our results, the cancer risk of BE in Japan would be lower than previously reported (0.47% vs. 1.2%/year).

Background and Aim Helicobacter pylori-negative and non-steroidal anti-inflammatory drugs (NSAIDs)-negative idiopathic peptic ulcers (IPU) have attracted attention in Japan and other developed countries. The aim of the present study was to clarify the healing rate of IPU and the risk of recurrence. Methods We conducted a retrospective follow-up study of patients with peptic ulcer disease (PUD) who were diagnosed in our previous multicenter-prospective study. Three hundred and eighty-two patients from four institutions in the Tohoku district were enrolled. Enrolled subjects were divided into four groups according to H. pylori infection and intake of NSAIDs. In these patients, we checked treatment course, healing rate during 3 months, and recurrence rate. Results Healing rates in the: (i) simple H. pylori group; (ii) H. pylori (+)/ NSAIDs (+) group, (iii) simple NSAIDs group; and (iv) IPU group, were 95.0%, 94.9%, 73.3%, and 77.4%, respectively. The healing rate of the IPU group was significantly lower than that of both the simple H. pylori group and the H. pylori (+)/ NSAIDs (+) group (P

We investigate shell emission associated with dying radio loud AGNs. First, based on our recent work by Ito et al. (2015), we describe the dynamical and spectral evolution of shells after stopping the jet energy injection. We find that the shell emission overwhelms that of the radio lobes soon after stopping the jet energy injection because fresh electrons are continuously supplied into the shell via the forward shock, while the radio lobes rapidly fade out without jet energy injection. We find that such fossil shells can be a new class of target sources for SKA telescope. Next, we apply the model to the nearby radio source 3C84. Then, we find that the fossil shell emission in 3C84 is less luminous in the radio band while it is bright in the TeV γ -ray band and can be detectable by CTA. (© 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim)

Background and Aim The prevalence of Helicobacter pylori-negative and nonsteroidal anti-inflammatory drug-negative peptic ulcers, commonly known as idiopathic peptic ulcers (IPUs), has been reported to be very low (0.9–2.6%) in Japan based on data from the 1990s. However, recent trends have yet to be been reported. Herein, we present a multicenter prospective analysis between 2012 and 2013 investigating current trends in the prevalence and characteristics of IPUs in Japan. Methods Clinical data of all peptic ulcer subjects detected via endoscopy at four participating hospitals were prospectively collected between April 2012 and March 2013. Enrolled subjects were classified according to H. pylori infection status and intake of nonsteroidal anti-inflammatory drugs. Multiple logistic regression analyses were used to determine the risk factors for IPUs. Results Of 382 enrolled patients with peptic ulcers, 46 (12%) were judged to have IPUs. Compared with those with simple H. pylori-positive ulcers, patients with IPUs were significantly older (P

Aim. The aim of this study was to examine the awareness of work–life balance (WLB) among the nursing personnel at a university hospital in Japan. Design. Survey. Methods. A questionnaire was sent to 1236 nursing personnel working at a university hospital and 1081 (87·5%) responses received. The questions concerned the following: (1) respondent demographical characteristics, (2) living background, (3) wishes for working environments and (4) motivation to work and health condition. The data were analysed by simple and cross-tabulations. Results. The results can be summarised as follows: (1) the concept and significance of WLB has not yet been established among nurses in Japan, (2) three factors were found, which nurses need as working environment, 1st quality-of-life benefits, 2nd flexible working style, 3rd lifelong learning and (3) nurses who reported good WLB also reported higher job satisfaction and job motivation. Conclusion. The concept and significance of WLB has not yet been established among nurses. Thus, it is needed to enlighten nurses on the concept and significance of WLB as well as how they should practise WLB. Approximately half of the nurses gave their jobs first priority in reality, although they had various needs for their private lives and household affairs, as well as jobs. WLB cannot be achieved only by individual attitudes; thus, organisational efforts are necessary. In the correlation between WLB and ‘job satisfaction’ and ‘job motivation,’ nurses who were satisfied with their job and those who were highly motivated showed higher WLB. There was a significant correlation between satisfaction and motivation. Relevance to clinical practice. It is necessary that nurses understand and have any information about working policy to improve working conditions to get better conditions which they need.

Gamma-ray emission from cocoons of young radio galaxies is predicted. Considering the process of adiabatic injection of the shock dissipation energy and mass of the relativistic jet into the cocoon, we find that the thermal electron temperature of the cocoon is typically predicted to be of the order of $\sim$ MeV, and is determined only by the bulk Lorentz factor of the jet. Together with the time-dependent dynamics of the cocoon expansion, we find that young cocoons can yield thermal Bremsstrahlung emissions at energies $\sim$MeV. Hotter cocoons (i.e., GeV) for younger sources are also discussed., 5 pages and 3 figures, accepted for publication in Astronomische Nachrichten (issue dedicated to the Proceedings of "The 4th Workshop on Compact Steep Spectrum and GHz-Peaked Spectrum Radio Sources" held at Riccione, Italy, 26-29 May 2008)

The RIN gene encodes a putative MADS box transcription factor that controls tomato fruit ripening, and its ripening inhibitor (rin) mutation yields non-ripening fruit. In this study, the molecular properties of RIN and the rin mutant protein were clarified. The results revealed that the RIN protein accumulates in ripening fruit specifically and is localized in the nucleus of the cell. In vitro studies revealed that RIN forms a stable homodimer that binds to MADS domain-specific DNA sites. Analysis of binding site selection experiments revealed that the consensus binding sites of RIN highly resemble those of the SEPALLATA (SEP) proteins, which are Arabidopsis MADS box proteins that control the identity of floral organs. RIN exhibited a transcription-activating function similar to that exhibited by the SEP proteins. These results indicate that RIN exhibits similar molecular functions to SEP proteins although they play distinctly different biological roles. In vivo assays revealed that RIN binds to the cis-element of LeACS2. Our results also revealed that the rin mutant protein accumulates in the mutant fruit and exhibits a DNA-binding activity similar to that exhibited by the wild-type protein, but has lost its transcription-activating function, which in turn would inhibit ripening in mutant fruit.

Mucins are secreted or transmembrane glycoproteins that are expressed mainly in the digestive tract. This family of proteins has been the focus of much gastric cancer research as some transmembrane mucins are implicated in tumorigenesis and make attractive targets for cancer diagnosis and therapeutics. Mucins have also been utilized to classify gastric cancer by differentiating between gastric and intestinal phenotypes. Here we show that transmembrane mucin MUC13 is upregulated in gastric cancer. By quantitative real-time reverse transcription-polymerase chain reaction and immunoblot analysis, overexpression of MUC13 was verified in more than half of the samples examined. In immunohistochemical analysis, MUC13 staining was observed in 74 of 114 cases of gastric cancer (64.9%), predominantly in intestinal type (P < 0.001), and in 9 of 10 cases of intestinal metaplasia, precancerous lesions of intestinal-type gastric cancer, but not observed in normal gastric mucosa. Moreover, MUC13 staining patterns characteristic of histological type were identified: staining was on the apical side of tubular glands in intestinal type and on the cytoplasm in diffuse type. These results suggest that MUC13 is a good differentiation marker for gastrointestinal mucosa and that it may have a causal role that correlates with two distinct gastric tumorigenesis pathways.

The ripening inhibitor (rin) mutation of tomato yields non-ripening fruit, and the gene corresponding to RIN, LeMADS-RIN, is known to encode a transcriptional factor that controls ripening-related genes. In this study, to evaluate the hetero-zygosity effect of rin on fruit ripening, we developed eight F 1 hybrid lines of the rin mutant from various crosses between the lines of the rin mutant and wild type. In the fruit of these F 1 hybrid lines, the shelf-life was improved, but both the shelf-life and colouring varied between the lines. We then chose one line of the F 1 hybrids and investigated the physiological and transcriptional properties of the fruit. Compared with the wild-type parent, this F 1 line showed about half the lycopene content, lower fruit softening and lower mRNA accumulation of the genes that encode phytoene synthase (Psy), poly-galacturonase (PG), β-galactosidase (TBG4) and expansin (LeEXP1). The characteristic climacteric rise in ethylene production typically observed in the wild-type parent during fruit maturation was not observed in the fruit of this F 1 line. The genes that encode ethylene biosynthetic enzymes, namely 1-aminocyclopropane-1-carboxylic acid (ACC) synthase (ACS2 and ACS4) and ACC oxidase (ACO1), were, however, significantly expressed in the F 1 hybrid, suggesting that the post-transcriptional regulator for activating these enzymes is affected by LeMADS-RIN. These results suggest that the heterologous effect of LeMADS-RIN in F 1 hybrids affects the gene transcription and activation of ripening-related factors, resulting in changes in fruit properties, including the extension of the shelf-life.

Twenty patients with palmoplantar pustulosis (PPP) were treated with topical PUVA, oral etretinate (Re), or combined PUVA and etretinate (Re-PUVA). Re and Re-PUVA treated sites improved and/or cleared more rapidly than PUVA treated sites. Complete clearance was observed in six of ten sites treated with Re-PUVA, two of ten with Re, and one of ten sites with PUVA within 12 weeks. UVA-control sites failed to be cleared within 12 weeks. Remission periods after stopping the treatment were 1.5 +/- 0.5 weeks (n = 2) with Re, 10.5 +/- 11.4 weeks (n = 6) with Re-PUVA, and one year (n = 1) with PUVA. These results overall suggested that Re-PUVA is the most effective treatment for PPP. Tonsillar focal infection (TFI) and dental focal infection (DFI) were found in 6/20 and 17/20 patients, respectively. However, the presence of focal infection (FI), TFI and/or DFI, did not appear to interfere with the therapeutic activities of Re and/or PUVA, because the complete clearance rates and remission periods in FI(+) patients were comparable with those in FI(-) patients.