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Abstract: JT-60SA is a fully superconducting coil tokamak to be built under the framework of the EU-JA Broader Approach Agreement, and it aims to contribute to the complement of the ITER experiments and to the DEMO reactor design by the study of steady-state high-beta plasma experiments. The conceptual design of the JT-60SA tokamak and the peripheral systems has been carried out in close collaboration of EU and Japan from middle of 2006, and the JT-60SA Conceptual Design Report which involves an analysis of plasma physics and engineering design is summarized in May 2007. This paper intends to present an overall view of the JT-60SA project, and the latest design status of the key engineering issues such as superconducting magnets, divertor target, plasma heating devices, and magnet power supplies. [Copyright &y& Elsevier]

Objective: To survey the results of mass screening for cancer of the endometrium performed over a six-year period in Miyagi Prefecture, Japan., Study Design: Materials were cytodiagnostic samples of the endometrium examined by the Miyagi Cancer Society. The samples were classified into two groups: The mass screening group, from whom samples were collected according to the Health and Medical Service Law for the Aged, and the outpatient group, consisting of samples from other patients. The rates of subjects judged to require close examination and the detection rate of cancer of the endometrium in the two groups were compared., Results: In the mass screening group, the rate of subjects judged to require close examination and the detection rate of cancer of the endometrium were 2.3% and 0.11%, respectively, while they were 5.9% and 0.39%, respectively, in the outpatient group; the differences between the two groups were significant., Conclusion: To improve the detection rate in mass screening for endometrial cancer according to the Health and Medical Service Law for the Aged, it is necessary to establish a new criterion for selecting subjects.

Cost-effectiveness analysis for cervical cancer screening in Japan was performed to estimate the cost per life-year saved by the screening; cost-effectiveness ratio (CER). The analysis was made using a simulation model to estimate long-term cost and effectiveness of the screening programs. CER of cervical cancer screening was estimated to be US$ 40,604 which was 2.4 times more expensive than that for gastric cancer screening but was about the same as that for colorectal cancer screening. It was within the range of cost-effectiveness of other cancer screening programs financed under the Health and Medical Services Law for the Aged in Japan. We performed sensitivity analysis on the following seven estimates, the screening charge, the sensitivity and the specificity of the screening test, the frequency of carcinoma in situ (CIS) among cases detected in the screening program, the initial cost and the terminal cost for patients with invasive cancer, and the incidence rate of cervical cancer. The sensitivity analysis demonstrated that the screening charge was the most influential factor on CER. CER was fairly stable under various assumptions on the accuracy of the screening test, the frequency of carcinoma in situ (CIS), the treatment cost for patient, and the incidence of cervical cancer. CER was less sensitive to the changes in incidence, even to as low as a 50% decrease of the current figure. Then if the incidence rate becomes 85% of the current figure in 2015, CER would be US$ 48,176 and it was suggested that the cervical cancer screening would remain reasonably cost-effective until the year 2015.

Cervical cancer is about 6 times more frequent in Ecuador than in Japan. We investigated the association between infection by the human papillomavirus (HPV) and the genesis of cervical cancer in specimens of lesions of the cervical epithelium obtained from patients in Ecuador and Japan. We also examined the results of HPV DNA detection and typing by the polymerase chain reaction (PCR) performed under the same technical conditions in areas with differing rates of cervical cancer. Purified tissue DNA from paraffin-embedded samples was amplified by PCR with universal and type-specific primers. HPV DNA was detected in 8 (20%) of 40 normal cervical epithelial samples from Ecuadorian patients, 19 (45%) of 42 low-grade squamous intraepithelial lesions (LSIL), 16 (50%) of 32 high-grade squamous intraepithelial lesions (HSIL), and 38 (81%) of 47 invasive squamous cell carcinomas (SCC) compared with 3 (10%) of 30 normal cervical specimens from Japanese patients, 107 (51%) of 210 HSILs, and 45 (71%) of 63 SCCs. The prevalence of HPV types 16 and 18 rose significantly with increasing histological grade (p < 0.05). The prevalence of HPV DNA decreased with increasing age in both Ecuadorian and Japanese patients. The detection rate and type-specific distribution of HPV DNA were not correlated with geographic location. Findings suggest that risk factors associated with poverty and underdevelopment may influence the prevalence of HPV infection and the sequence of events after HPV infection culminating in cervical cancer. These factors may help to explain the differing geographic distribution of this disease.