Search

Background: Body weight, especially lean body mass, significantly decreases after gastrectomy for gastric cancer due to surgical invasion, reduced food intake, and reduced mobility, which can reduce the quality of life and induce associated toxicity or reduce compliance with adjuvant chemotherapy. Such risks can be particularly high in elderly patients with gastric cancer. However, whether or not changes in the weight and body composition differ between elderly and non-elderly patients remains unclear. Patients and Methods: This retrospective study examined patients who underwent curative surgery for gastric cancer between May 2010 and February 2017. Body weight and composition were evaluated by a bioelectrical impedance analyzer within 1 week before surgery, at 1 week after surgery, and at 1 and at 3 months after surgery. Patients were classified as elderly (≥80 years) or non-elderly (

Zeolite, used to remove Cs from a contaminated water, would be solidified for the safety disposal. Recently, geopolymer is considered as a new binder for disposal. Geopolymer has an advantage that primary phases such as potassium almino silicate hydrate (K-A-S-H) may sorb radioactive nuclides. In this study, Cs adsorption, co-precipitation and desorption experiment were conducted, and C-S-H, which is primary phases of cement, were also employed for experiments for comparison. From these experiments, it is obtained that K-A-S-H has higher adsorption capacity of Cs than C-S-H. Cs adsorption ratio and co-precipitation ratio by C-S-H were almost same. Cs is likely sorbed by C-S-H thoroughly via ion exchanging. The desorption experiment demonstrated that most Cs was desorbed from C-S-H while 90% of Cs remained in K-A-S-H. Therefore, K-A-S-H has a higher retention capacity than that of C-S-H. Consequently, geopolymer is considered to be a better material in terms of Cs storage.

Kabwe area in Zambia has been affected by heavy metal contaminations which derived from past mining activities. Particularly, Pb is one of the most concerned elements for human health in Kabwe. In this context, treatment by phosphoric fertilizer was conducted to reduce Pb solubility in soil and slag, limiting their bioavailability. Because leach plant residue in Kabwe contains metal sulfate minerals with high solubility, concentration of heavy metals in groundwater is high. We clarified the geochemical behavior of heavy metals (Pb, Cd, Zn and Cu) after the addition of phosphoric fertilizer (Triple Super Phosphate: TSP) in column experiment. Immobilization of Pb and Cd lowers concentration of the metals in ground below WHO environmental standard.

Nowadays, the globalization is rapidly increasing and many Japanese employees are going overseas. The first author has experienced assignment in the Philippines for globalization, but the first author had a stumbling block in work-related communication with the local workers and felt difficulty to adopt globalization. Our interviews confirmed that most Japanese IT workers assigned to the Philippines had similar experiences that the problem was difficult to take measures in advance. A sense of unease was revealed in surveys conducted in 2002 by Nishida on intercultural communication frictions in Japanese companies in the Philippines entitled “Japanese Cultural Differences Felt by Filipinos” and “Roles Sought From Japanese Bosses and Leaders by Filipinos”. Although many studies have been done on communication and interpersonal relations and it is often stated that conscious communication from the initial stages is vital to building interpersonal relationships, there are still few practical studies on the matter. Instead of initial stage communication, we focused on the first meeting conversation, conducted questionnaires on topics selection among Japanese and Filipino IT workers, verified differences in topic selection mutually using quantitative evaluation, and reported investigative results on possible reason why smooth interpersonal relationships could not be built from the initial stages.

The increasing need to treat wastewater from mine effluents has drawn attention to passive treatment systems. Colloids are common in mine waters and are highly reactive, so their formation, characteristics, behavior, and the critical factors that affect them need to be understood for designing efficient treatment systems. An investigation was conducted at the abandoned Ainai mine drainage, Japan, where aeration is utilized to remove Fe, As, and Zn from circumneutral wastewater drainage, during rainy and dry seasons of 2016 and 2018 respectively, based on observations of physiochemical characteristics, elemental concentrations in dissolved and colloidal fractions, transmission electron microscopy, and synthetic experiments. In this circumneutral Fe-rich mine drainage, Fe2+ is oxidized to Fe3+, resulting in the formation of Fe colloids that incorporate As during their formation. Colloid formation increases turbidity, and, in the rainy season, increased colloidal interaction enhances their aggregation and higher flow rates lead to greater mobilization of the colloids. Zn-bearing colloids are rare in Ainai mine drainage because the Zn concentrations are low. However, Zn-Fe layered double hydroxide (LDH) was identified and confirmed by geochemical modelling and experiments. The Zn-Fe LDH was formed by isomorphous substitution of Zn into an Fe2+–Fe3+–CO32–LDH, at pH greater than 7.5, thereby achieving efficient natural remediation of Zn and As in the drainage.

Overall survival remains unsatisfactory in stage II/III gastric cancer, even after curative surgery and adjuvant chemotherapy. Platelet-derived growth factor receptor-β (PDGFR-β) is associated with the proliferation of cancer cells. The present study therefore investigated the association of PDGFR-β gene expression with patient outcome in 134 stage II/III gastric cancer patients who received adjuvant chemotherapy with S-1. Relative PDGFR-β gene expression was measured in surgical cancer tissue and adjacent normal mucosa specimens by reverse transcription-quantitative polymerase chain reaction. The PDGFR-β gene expression levels were found to be significantly higher in the cancer tissues compared with the adjacent normal mucosa. A high level of PDGFR-β gene expression was associated with a significantly poorer 5-year overall survival rate compared with a low level of PDGFR-β expression. Upon multivariate analysis, PDGFR-β gene expression was found to be an independent predictor of survival. Overall, the study indicates that PDGFR-β overexpression in gastric cancer tissues is a useful independent predictor of outcome in patients with stage II/III gastric cancer who receive adjuvant chemotherapy with S-1.

This study evaluated the feasibility and safety of laparoscopy-assisted subtotal gastrectomy preserving a minimal remnant stomach for clinical T1 gastric cancer invading the upper stomach. Forty-three consecutive patients who underwent laparoscopy-assisted subtotal gastrectomy preserving a minimal remnant stomach were examined. In addition to the conventional laparoscopy-assisted distal gastrectomy, some short and posterior gastric arteries were resected. A minimal remnant stomach-jejunum anastomosis was made by using a circular stapler with regular anvil or transoral anvil. Transoral anvil was selected in 19 patients, and regular anvil was used in 24 patients. The median operation time was 288 minutes, and the median blood loss was 50 mL. Conversion to open surgery was required in 2 patients due to bleeding. No patient required conversion to open surgery due to the difficulty of the anastomosis. Nine patients developed postoperative complications, including grade 3 duodenal stump leakage in 1 patient and grade 2 anastomotic bleeding in another patient. No mortality was observed. Laparoscopy-assisted subtotal gastrectomy preserving a minimal remnant stomach is safe and feasible for early gastric cancer invading the upper stomach.

Particulate $^{137}$Cs in stream water was collected continuously for two years in order to assess the long-term trend of the $^{137}$Cs discharge from the forest environment. Sampling was conducted from December 2011 to December 2013 in a mountainous stream, which received the $^{137}$Cs from the Fukushima Daiichi Nuclear Power Plant accident. A seasonal increase in fluvial transport load of particulate $^{137}$Cs associated with suspended solids (SS) was observed in August and September when rainfall was abundant. The particulate $^{137}$Cs concentration decreased at a faster rate than the rate due to radioactive decay. This decrease might be resulted from redistribution of the easily eroded and polluted soil surface due to heavy rain events such as typhoons. These findings indicate that the particulate $^{137}$Cs load was subject to the inter-annual variations in rainfalls, and decreased gradually over a long period of time due to a decrease in $^{137}$Cs concentration in SS., 福島第一原子力発電所事故に由来する放射性Csの森林集水域からの流出挙動とその変動要因を解明するために、渓流水中の懸濁態放射性Csの流出量を2012年から2年間連続して測定した。懸濁態$^{137}$Csの流出は、流域からの懸濁物質の流出と密接な関係があり、降雨量の多い8-9月に増加した。$^{137}$Csは懸濁物質中の粘土鉱物に強く結びついており、流下中に水中に溶存しないことが、鉱物同定及び抽出実験の結果より示唆された。また、単位懸濁物質量あたりの$^{137}$Cs濃度は、2012年から徐々に低下していた。これらの結果より、懸濁態$^{137}$Csの流出量は、降雨量に関連した懸濁物質量の変動と、懸濁物質中の$^{137}$Cs濃度の経年変化の両方の影響を受けて変化していることが明らかとなった。

BACKGROUND Stereotactic body radiation therapy (SBRT) is a viable treatment option for stage I non-small cell lung carcinoma (NSCLC) in non-surgical candidates. Although treatment with a 100 Gy biological effective dose is considered to carry a low risk of local recurrence, only a few reports have focused on changes in tumors or surrounding intact portions of the lung after SBRT. Such changes are assessed using diagnostic imaging specifically for radiation pneumonitis, which can be difficult to distinguish from local tumor recurrence. Cavity changes after SBRT observed around the tumor within the irradiated field resemble an egg, fried with the yolk facing upward, and are thus referred to as 'sunny-side-up egg-like' changes. They have the appearance of a residual tumor in the center. This study aimed to evaluate patients with post-treatment cavity changes after SBRT for stage I NSCLC. PATIENTS AND METHODS Cavity changes were observed in four cases. Tumors were irradiated with a 6-MV X-ray using 10 fixed ports. The single dose was 12 Gy, the total dose 48 Gy. RESULTS The time until the appearance of cavity changes ranged from 4 to 9 months (median=6 months). The cavity changes disappeared in 12-20 months (median=16 months). CONCLUSION Cavity changes (sunny-side-up egg-like) in the lungs may develop after SBRT for stage I NSCLC.

Deregulated iron metabolism underlies the pathogenesis of many human cancers. Recently, low expression of ferroportin, which is the only identified non-heme iron exporter, has been associated with significantly reduced overall survival in multiple myeloma (MM); however, the altered iron metabolism in MM biology remains unclear. In this study we demonstrated, by live cell imaging, that MM cells have increased intracellular iron levels as compared with normal cells. In experiments to test the effect of iron chelation on the growth of MM cells, we found that deferasirox (DFX), an oral iron chelator used to treat iron overload in clinical practice, inhibits MM cell growth both in vivo and in vitro. Mechanistically, DFX was found to induce apoptosis of MM cells via the inhibition of proline-rich tyrosine kinase 2 (Pyk2), which is known to promote tumor growth in MM. Inhibition of Pyk2 is caused by the suppression of reactive oxygen species, and leads to downregulation of the Wnt/β-catenin signaling pathway. Taken together, our findings indicate that high levels of intracellular iron, which might be due to low ferroportin expression, play a role in MM pathophysiology. Therefore, DFX may provide a therapeutic option for MM that is driven by deregulated iron homeostasis and/or Pyk2/Wnt signaling.

Fe 3+ minerals are ubiquitous in diverse near-surface environments, where they exert important controls on trace species transport. In alkaline environments such as the glass-steel interface in geological high-level radioactive waste disposal sites that use cement for plugging and grouting, Fe minerals are closely associated with Si that may affect their crystallization behavior as well as their capacities to regulate hazardous element cycling. While it is well known that Si retards Fe mineral crystallization, there is currently an overall lack of quantitative information on the rates of crystallization of stable Fe minerals in the presence of Si at alkaline conditions. Crystallization of Fe 3+ minerals goethite and hematite from ferrihydrite co-precipitated with different amounts of Si was studied at pH 10 and at temperatures ranging from 50 to 80 °C using powder X-ray diffraction (XRD) and transmission electron microscopy (TEM). Mineral abundances evaluated from Rietveld refinement of XRD data show that the proportion of goethite in the final assemblage decreases relative to hematite with increasing Si. TEM observation of goethite and hematite crystals formed in the presence of Si show significant morphological differences compared to those formed in the absence of Si. Rate constants for crystallization derived from fitting of time-dependent changes in mineral abundances with the Avrami equation show a decreasing trend with increasing Si for both goethite and hematite. Apparent activation energies for crystallization for both minerals increase with increasing Si, with that of goethite increasing more drastically compared to hematite, indicating the inhibitive effect of Si on the crystallization of both minerals. The overall inhibition of crystallization may be explained in terms of the effects of Si on the surface properties of the ferrihydrite precursor. The rate constants and apparent activation energies reported in this study may be useful in estimating the crystallization behavior and timescales of Fe minerals in both natural and engineered environments. This information may eventually be helpful in predicting the fate of hazardous elements in such environments.

Chemical and isotopic studies including analyses of noble gases were comprehensively conducted on the groundwater of the entire Kii Peninsula, which is located in the fore-arc region of southwest Japan. Groundwater of Na–Cl–HCO3, Na–HCO3–Cl, and Na–Cl types was shown to be distributed across the whole area. Groundwater in the inland central part of the peninsula shows relatively low salinity, whereas groundwater from the area along the ENE-trending Median Tectonic Line (MTL), on the north side of the peninsula, shows high salinity (up to 18,800 mg/L of Cl−) and the presence of unusual heavy oxygen isotopes. This trend is similar to that documented in saline waters from the Arima region (the so-called “Arima-type thermal water”). High 3He/4He ratios relative to the atmospheric value (up to 6.7 Ra) were recorded throughout the Kii Peninsula, covering a wider area than documented previously. The saline groundwater is also strongly depleted in 20Ne and heavy noble gases. From the wide distribution of high 3He/4He values and the associated 20Ne and Cl− concentrations, we infer that aqueous fluids derived from dehydration of the subducting slab are present at depth beneath almost the entire Kii Peninsula. These aqueous fluids may ascend along the major north-dipping boundary faults. The isotopic composition of groundwater from the southern part of the peninsula suggests that the contribution from these dehydration-derived fluids is relatively small in this region. However, volatile components (e.g., noble gases and CO2) in the groundwater of this area may originate from the dehydration-derived fluids. Upwelling of Arima-type thermal water of the Na–Cl–HCO3 type is expected to undergo a phase separation of volatile species due to decompression as the fluid ascends. The variety of water types documented may be due to this water–gas separation and the subsequent incorporation of gaseous species into shallow meteoric groundwater. The observed high 3He/4He ratios in the absence of a mantle wedge below the southern part of the Kii Peninsula may reflect the oblique ascent of these fluids along north-dipping boundary faults.

Lead (Pb) is one of common heavy metal that has been shown to be very useful tracers of environmental pollution. The consequences of urbanization process can cause not only economic growth but also negatively impact on the quality of water and soil. Therefore the objective of this research is to know the potential contamination of lead in soil of urban area. The soil samples were conducted by batch leaching experiment. In surface soil, lead in soil of Pakem area varies from 2.01ppm to 5.13 ppm with average value of 3.02 ppm and Merapi area ranges from 1.84 ppm to 3.41ppm with average value of 2.42 ppm. In urban area, lead varies from 4.18 to 14.88 ppm with average of 9.93 ppm. Lead in urban soil is higher than Pakem and Merapi soil. The potential contamination of lead in urban soil is occurred with respect to urbanization and human activities. The value of lead is shown with the average of 3 ppm for Caturtunggal, Depok District, 6.53 ppm in Mantrijeron District and 9.82 ppm for Kotagede District in Yogyakarta city. The result of lead distribution in Kotagede District is the highest concentrated and it is followed by Mantrijeron District and Caturtunggal, Depok District.

Complete remission by induction therapy in acute myelogenous leukemia (AML) can be achieved due to improvements in supportive and optimized therapy. However, more than 20% of patients will still need to undergo salvage therapy, and most will have a poor prognosis. Determining the specificity of drugs to leukemia cells is important since this will maximize the dose of chemotherapeutic agents that can be administered to AML patients. In turn, this would be expected to lead to reduced drug toxicity and its increased efficacy. We targeted Notch-1 positive AML cells utilizing fucose-bound liposomes, since activation of Notch-1 is required for O-fucosylation. Herein, we report that intravenously injected, L-fucose-bound liposomes containing daunorubicin can be successfully delivered to AML cells that express fucosylated antigens. This resulted in efficient tumor growth inhibition in tumor-bearing mice and decreased proliferation of AML patient-derived leukemia cells. Thus, biological targeting by fucose-bound liposomes that takes advantage of the intrinsic characteristics of AML cells could be a promising new strategy for Notch-1 positive-AML treatment.

This study examines the possible immobilization of Se(VI) by Mg-bearing hydrotalcite and serpentine-like minerals. Selenate immobilization was carried out via adsorption and coprecipitation reactions under alkaline conditions. The effects of Mg/Al ratios, temperature and initial Se concentration on the adsorption and/or coprecipitation of Se 6 + onto these Mg-bearing minerals were examined. The sorption mechanism of Se(VI) was examined by XAFS analysis to give account of its local coordination environment. The results showed that Se(VI) sorption behavior by hydrotalcite and serpentine-like minerals was mainly influenced by their Mg/Al ratio. Higher removal efficiency of Se(VI) (> 60 and 90% at 100 and 10 ppm initial Se concentration) was observed during coprecipitation onto hydrotalcite and serpentine-like phases with Mg/Al ratios of 2 and 1.25, respectively. The formation of Mg-bearing minerals was enhanced at higher temperature (at 75 °C) but the effect of temperature in Se(VI) immobilization was very minimal. Selenate was mainly retained via outer-sphere complexation but an irreversible fraction of sorbed selenate (about 20%) was observed in these mineral phases. In overall, this study has several important implications in the possible application of hydrotalcite and aluminian serpentine in Se(VI) immobilization.

The syntheses of Mg–Fe(III) layered double hydroxides with different compositions at varied temperature through a co-precipitation method were attempted. The well-crystallized and white colored layered double hydroxides with chloride anions were obtained from the samples adjusted to the composition of Mg/Fe = 4 and aged at higher temperature. The Fe species in the white colored Mg–Fe layered double hydroxides were evaluated as all Fe(III) species by a Mossbauer measurement. The synthesized Mg–Fe(III) layered double hydroxide was treated with a sugar alcohol at temperature above its melting point in order to reduce Fe(III) incorporated into the hydroxide layers. The Mg–Fe layered double hydroxide resulting from a sugar alcohol treatment showed the reduction property in an aqueous solution.

An efficient and scalable synthesis of an antidiabetic drug, tofogliflozin (1), which was identified as a highly selective sodium glucose cotransporter 2 (SGLT2) inhibitor, is described. A key factor in the synthesis of 1 was the selection of the purpose-designed protecting group, which plays a strategic role in protection, chemoselective activation, and crystalline purification. The developed and optimized method made it possible to prepare 1 on a multidecagram scale without any column chromatography.

Lean body mass loss after surgery, which decreases the compliance of adjuvant chemotherapy, is frequently observed in gastric cancer patients who undergo gastrectomy for gastric cancer. However, the risk factors for loss of lean body mass remain unclear. The current study retrospectively examined the patients who underwent curative gastrectomy for gastric cancer between June 2010 and March 2014 at Kanagawa Cancer Center. All the patients received perioperative care for enhanced recovery after surgery. The percentage of lean body mass loss was calculated by the percentile of lean body mass 1 month after surgery to preoperative lean body mass. Severe lean body mass loss was defined as a lean body mass loss greater than 5 %. Risk factors for severe lean body mass loss were determined by both uni- and multivariate logistic regression analyses. This study examined 485 patients. The median loss of lean body mass was 4.7 %. A lean body mass loss of 5 % or more occurred for 225 patients (46.4 %). Both uni- and multivariate logistic analyses demonstrated that the significant independent risk factors for severe lean body mass loss were surgical complications with infection or fasting (odds ratio [OR] 3.576; p = 0.001), total gastrectomy (OR 2.522; p = 0.0001), and gender (OR 1.928; p = 0.001). Nutritional intervention or control of surgical invasion should be tested in future clinical trials for gastric cancer patients with these risk factors to maintain lean body mass after gastrectomy.

The present study investigated biosorption of Pb (II) and Zn (II) using a heavy metal tolerant bacterium Oceanobacillus profundus KBZ 3-2 isolated from a contaminated site. The effects of process parameters such as effect on bacterial growth, pH and initial lead ion concentration were studied. The results showed that the maximum removal percentage for Pb (II) was 97% at an initial concentration of 50 mg/L whereas maximum removal percentage for Zn (II) was at 54% at an initial concentration of 2 mg/L obtained at pH 6 and 30 °C. The isolated bacteria were found to sequester both Pb (II) and Zn (II) in the extracellular polymeric substance (EPS). The EPS facilitates ion exchange and metal chelation-complexation by virtue of the existence of ionizable functional groups such as carboxyl, sulfate, and phosphate present in the protein and polysaccharides. Therefore, the use of indigenous bacteria in the remediation of contaminated water is an eco-friendly way of solving anthropogenic contamination.

Massive amount of highly contaminated mining residual materials (MRM) has been left unattended and has leached heavy metals, particularly lead (Pb) and zinc (Zn) to the surrounding environments. Thus, the performance of three immobilizers, raw dolomite (RD), calcined dolomite (CD), and magnesium oxide (MO), was evaluated using batch experiments to determine their ability to immobilize Pb and Zn, leached from MRM. The addition of immobilizers increased the leachate pH and decreased the amounts of dissolved Pb and Zn to different extents. The performance of immobilizers to immobilize Pb and Zn followed the following trend: MO &gt, CD &gt, RD. pH played an important role in immobilizing Pb and Zn. Dolomite in RD could slightly raise the pH of the MRM leachate. Therefore, the addition of RD immobilized Pb and Zn via adsorption and co-precipitation, and up to 10% of RD addition did not reduce the concentrations of Pb and Zn to be lower than the effluent standards in Zambia. In contrast, the presence of magnesia in CD and MO significantly contributed to the rise of leachate pH to the value where it was sufficient to precipitate hydroxides of Pb and Zn and decrease their leaching concentrations below the regulated values. Even though MO outperformed CD, by considering the local availability of RD to produce CD, CD could be a potential immobilizer to be implemented in Zambia.

Zinc plant leach residues (ZPLRs) are hazardous solid wastes generated from zinc metal production owing to their substantial contents of lead (Pb), a toxic heavy metal. This study investigated the detoxification of historic ZPLRs from Kabwe, Zambia by removing Pb using a coupled extraction-cementation method in chloride media. For the coupled extraction-cementation method, micro-scale zero-valent iron (mZVI) was added during ZPLRs leaching in acidified chloride solution. Cemented Pb on the surface of mZVI was recovered easily from the leaching pulp by magnetic separation. Pb removal was evaluated in different solution compositions (NaCl:1–5.13 M, HCl: 0–0.1 M) with and without the addition of mZVI. The addition of mZVI during ZPLRs leaching (i.e., coupled extraction-cementation) increased Pb removal from 3% to 24%, 1.3% to 27.5%, 5.2% to 34.9%, and 6.5% to 55.8% when NaCl concentration was fixed at 0.86 M and HCl concentrations were 0 M, 0.01 M, 0.05 M and 0.1 M, respectively. When NaCl concentration was increased above 3.42 M and HCl maintained at 0.1 M HCl, Pb removal increased to 80%. Analysis of the Pb-loaded mZVI (magnetic fraction) by scanning electron microscopy with energy dispersive X-ray spectroscopy (SEM-EDX) and X-ray photoelectron spectroscopy (XPS) revealed that Pb was recovered during leaching via cementation as Pb°. The toxicity characteristic leaching procedure (TCLP) and in vitro solubility and bioavailability research consortium gastric phase (SBRC-G) tests for Pb of ZPLRs before and after treatment decreased drastically from 11.3 to 3.5 mg/L (below 5 mg/L threshold) and 12 300 to 2 840 mg/Kg, respectively.

This study examined radon concentrations in springs in Kumamoto and Aso regions following the 2016 Kumamoto earthquake, in addition to monitoring springs near the Futagawa-Hinagu fault zone for more than two years following the earthquake to investigate the relationship between crustal deformation and the radon concentration variation. We compared these radon concentrations with those obtained prior to the earthquake. The springs that showed elevated radon concentrations were located within the compressive strain quadrant of the earthquake. The post-seismic concentration variations of the monitored springs can be explained by rock porosity changes. These results suggest that the radon concentration in spring water is affected by porosity changes caused by stress changes derived from earthquake deformation and subsequent post-seismic relaxation. Our results are consistent with the previously inferred permeability enhancement model. Mass conservation calculations for radon release yielded porosity changes ranging from 30% to 70% for some aquifer systems. This study explores the possibility of radon monitoring as a tool to investigate not only seismic precursors but also post-seismic crustal deformation and aquifer property changes due to large earthquakes on a regional scale.

Zinc plant leach residues (ZPLRs) contain significant amounts of metal compounds of lead (Pb), zinc (Zn), iron (Fe), etc., hence, they are considered as a secondary source of metals. On the other hand, ZPLRs are regarded as hazardous materials because they contain heavy metals that pollute the environment. Resources and environmental concerns of ZPLRs were addressed in this study by removing/recovering Pb and Zn using a concurrent dissolution and cementation technique. To cement the dissolved Pb and Zn in leaching pulp, zero-valent aluminum (ZVAl) was added during ZPLRs leaching in the hydrochloric (HCl)&ndash, sodium chloride (NaCl) solution. The resulting cemented metals were agglomerated and separated by sieving. Lead removal increased with increasing both NaCl and HCl concentrations. However, when ZVAl was added, significant Pb removal was achieved at a low concentration. Zinc was not cemented out of the pulp using ZVAl and its recovery from ZPLRs was dependent on the HCl concentration only. By applying a concurrent dissolution and cementation technique, both Pb and Zn were removed using a low concentration of NaCl, and most importantly Pb&mdash, the most toxic metal in ZPLRs&mdash, was captured and separated before the solid-liquid separation, hence, eliminating the need for extensive washing of the generated residues to remove the inherent residual solution.

285 Background: A complete resection of the omentum has been believed as a standard procedure for advanced gastric cancer. However, there was no evidence for survival significance of omentectomy. Therefore, we conduct the Phase II trial (TOP-G trial) comparing gastrectomy with omentectomy and omentum preserving gastrectomy. Here, we present the short-term outcomes which was a secondary endpoint of TOP-G trial. Methods: Enrollment criteria included histologically confirmed cT2-4a and N0-2 gastric adenocarcinoma. The extent of nodal dissection was performed based on the Gastric Cancer Treatment Guidelines in Japan. All procedure was performed through laparotomy. Laparoscopic approach was not accepted. Surgical outcomes morbidity, and mortality were compared between gastrectomy with omentectomy group (group A) and omentum preserving gastrectomy group (group B). Postoperative complication was evaluated with Clavien-Dindo classification. Results: A total of 251 patients were randomly assigned to group A (n = 125) or group B (n = 126) between April 2011 and October 2018. After excluding patients who received bypass or no surgery, 246 patients were analyzed as actual treatment group. There was no difference between two groups in patient characteristics and pathological findings. There was no difference in operation time (median 244 vs 204 min, p = 0.156) and in blood loss (median 260 vs. 210 ml, p = 0.371). Median number of totally retrieved lymph nodes was similar (median 36 vs. 37, p = 0.758). There was no difference in the incidence of any postoperative complication (28.9% vs. 25.8%, p = 0.584). There was no mortality in both groups. Conclusions: Omentum preserving gastrectomy for advanced gastric cancer was similar short-term outcomes with gastrectomy with omentectomy. Clinical trial information: UMIN000005421.

338 Background: Postgastrectomy vitamin B12 deficiency is common metabolic sequel and worsens the quality of life of gastric cancer survivors. Recently, oral vitamin B12 replacement is reported. Therefore, we investigated retrospectively the efficacy of oral vitamin B12 replacement for gastric cancer patients with vitamin B12 deficiency after total gastrectomy. Methods: We reviewed 73 patients with gastric cancer who underwent total gastrectomy and were treated vitamin B12 replacement. Patients were consisted of 56 males and 17 females and median age was 70 y/o. We investigated initial treatment of vitamin B12 replacement and improvement of vitamin B12 deficiency. Results: Initial treatment of vitamin B12 replacements were intramuscular injection for 42 patients, per oral replacement for 28 patients and intravenous injection for 3 patients. Finally, all patients were treated with per oral replacement and the serum vitamin B12 levels became within normal range. Final vitamin B12 doses of replacement therapy were 500 µg of 20 out of 73 pts, respectively. Conclusions: Vitamin B12 replacement therapy should be necessary and continued. According to our results, one vitamin B12 tablet a day is enough. The vitamin B12 deficiency symptoms could be prevented. 500 micrograms vitamin B12 replacement orally is maybe effective and necessary. Our prospective clinical protocol (UMIN000030727): In this study, an oral vitamin B12 preparation (1500 μg/day, administered daily) was set as the control treatment, and a specific clinical trial was started to determine whether 500 μg/day daily administration would be sufficient for replacement therapy. Clinical trial information: UMIN000030727.

370 Background: We examined the association between postoperative pneumonia and prognosis of patients with esophageal cancer after curative surgery. Methods: We enrolled 122 patients who underwent curative resection for esophageal cancer between 2008 and 2018. The patients who had postoperative pneumonia were categorized into the pneumonia group, while those without postoperative pneumonia were classified into the non-pneumonia group. We identified the risk factors for the recurrence-free survival (RFS) and the overall survival (OS). Postoperative pneumonia was defined using the revised Uniform Pneumonia Score. Results: Thirty-four of the 122 patients (27.9%) had postoperative pneumonia. The 5-year OS rate after surgery in the pneumonia group was significantly lower than that in the non-pneumonia group (28.2% versus 55.1%, p = 0.006). Although not significant, the 5-year RFS rate after surgery in the pneumonia group tended to be lower than that in the non-pneumonia group (18.9% versus 49.2%, p = 0.061). A multivariate analysis identified postoperative pneumonia as a significant independent risk factor for the OS (hazard ratio = 2.15; 95% confidence interval, 1.25 to 3.68; P = 0.006). Conclusions: Our analysis showed postoperative pneumonia was an independent risk factor for worse overall survival in patients who underwent curative resection for esophageal cancer. This finding suggests that we should plan the surgical procedure, perioperative care and surgical strategy to prevent postoperative pneumonia.

Summary Site-specific recombination (SSR) systems are employed for transfer of mobile genetic elements (MGEs), such as lysogenic phages and integrative conjugative elements (ICEs). SSR between attP/I and attB sites is mediated by an integrase (Int) and a recombination directionality factor (RDF). The genome of Bacillus subtilis 168 contains SPβ, an active prophage, skin, a defective prophage, and ICEBs1, an integrative conjugative element. Each of these MGEs harbors the classic SSR unit attL-int-rdf-attR. Here, we demonstrate that these SSR units are all compatible and can substitute for one another. Specifically, when SPβ is turned into a defective prophage by deletion of its SSR unit, introduction of the SSR unit of skin or ICE converts it back to an active prophage. We also identified closely related prophages with distinct SSR units that control developmentally regulated gene rearrangements of kamA (L-lysine 2,3-aminomutase). These results suggest that SSR units are interchangeable components of MGEs., Graphical Abstract, Highlights • Lysogenic phage-derived SSR unit is sufficient to drive SSR of ICE and vice versa • Defective prophage-derived SSR unit can drive the excision of the active lysogenic phage • Closely related prophages with distinct SSR units control each gene rearrangements • Correspondence between MGEs and their cognate SSR units is not absolute, Genetics; Molecular Genetics; Microbiology; Microbial Genetics

The favorable oncological impact of D3 lymph node dissection after colon cancer surgery has been described previously. However, D3 lymph node dissection is potentially more invasive than conventional D2 lymph node dissection. The oncological merit of D3 lymph node dissection in elderly patients with colon cancer remains unclear. This study aimed to clarify the oncological outcome after D3 lymph node dissection in patients with colon cancer aged > 75 years. This is a retrospective cohort analysis using propensity matching method. The study was conducted at a university hospital and two community teaching hospitals in a large urban city. A total of 378 consecutive patients with pathological stage II and stage III colon cancer who underwent primary resection with either D2 or D3 lymph node dissection were retrospectively identified on a prospective database between 2000 and 2015. The primary and secondary outcomes of interests were recurrence-free survival and postoperative complication rate, respectively. After propensity matching, 232 patients were analyzed. The long-term findings showed that the elderly who underwent D3 lymph node dissection had significantly better recurrence-free survival than those who underwent D2 lymph node dissection (p = 0.01). The incidence of postoperative complication was almost similar between the two groups. D3 lymph node dissection provides better recurrence-free survival than D2 lymph node dissection after primary resection for elderly patients with pathological stage II and stage III colon cancer.

Background Body weight, especially lean body mass, significantly decreases after gastrectomy. Postoperative surgical complications are a major risk factor for changes in body weight and body composition after gastrectomy. However, the influence of postoperative surgical complications after gastrectomy on body weight and body composition changes remains unclear. Patients and methods This retrospective study examined patients who underwent curative surgery for gastric cancer between May 2010 and February 2017. Their body weight and composition were evaluated by a bioelectrical impedance analyzer within 1 week before surgery, and at 1 week, 1 month and 3 months after surgery. Patients were classified as those with surgical complications and those without. Results Eight hundred and eighty-eight patients (156 in the group with complications and 732 in the group without) were entered in the present study. When comparing the two groups, the patients' background and surgical factors significantly differed, while the pathological findings were similar. The body weight losses at 1 week, 1 month, and 3 months after surgery were 3.8%, 7.0%, and 10.4%, respectively, in those with complications, and 3.3%, 5.6%, and 6.8%, respectively, in the group without, with p-values of 0.001, 0.002, and 0.001, respectively. The corresponding lean body mass losses were 3.7%, 6.5%, and 6.8%, and 3.2%, 4.2%, and 3.5%, respectively, with p-values of 0.001, 0.001, and 0.001, respectively. Conclusion Decreases in body weight and lean body mass after gastrectomy were more serious in the patients with surgical complications than in those without. To maintain body weight and lean body mass in patients with surgical complications, additional care or treatments are needed.

The method of improving thickness uniformity of sputter-deposited film by using magnet rotation speed control technique as an advanced process control (APC) is discussed. It is demonstrated that magnet rotation speed control technique can improve both film thickness uniformity and its variation.

Background/aim Laparoscopy-assisted total gastrectomy (LATG) for gastric cancer may prevent the loss of body weight or lean body mass after surgery due to its reduced surgical stress compared with open total gastrectomy (OTG). Patients and methods A total of 303 patients were examined in this study. All patients received the same perioperative care via fast-track surgery. The body weight and composition were evaluated using a bioelectrical impedance analyzer within 1 week before and at 1 week, 1 month, and 3 months after surgery. Results Two hundred and eight patients received OTG, and 95 received LATG. Although the clinical T factor and N factor were significantly different between these two groups, other clinical factors were similar. The respective body weight loss (1 week/1 month/3 months) was -4.7%/-8.0%/-11.9% in the OTG group and -4.7%/-8.2%/-11.6% in the LATG group, that were not significantly different between the two groups at any time point of measurement (p=0.698/0.528/0.534, respectively). The respective lean body mass loss (1 week/1 month/3 months) was -4.2%/-6.4%/-7.4% in the OTG group and -4.0%/-5.8%/-6.2% in the LATG group, that were not significantly different between the groups (p=0.503/0.588/0.946, respectively). Conclusion The body composition changes were similar between the OTG and LATG groups using the same perioperative care of fast-track surgery. Adopting a laparoscopic approach would not help in reducing loss of body weight or lean body mass after gastric cancer surgery.

A 32-year-old woman with a history of undergoing upper gastrointestinal surgery was administered prednisolone for abortive Behçet's disease since 2015. In March 2017, upper gastrointestinal endoscopy revealed a 0-IIc type early stage gastric carcinoma at the posterior wall of the gastric antrum. The pathological diagnosis was signet-ring cell carcinoma. This gastric carcinoma was classified as cT1aN0M0; therefore, endoscopic submucosal dissection(ESD)was performed for the expanded indication lesion in April 2017. The pathological diagnosis after ESD indicated the need for non-curative resection; thus, laparoscopy-assisted distal gastrectomy and Billroth I anastomosis were performed in July 2017. A transient anastomotic structure was admitted after this surgery, but she was discharged from the hospital lighthearted. A preoperative important aspect was the careful examination of all intestinal tracts for ulcer lesions, and an intraoperative important aspect was hand-sewn anastomosis because using a metallic stapler conferred a high risk of ulcer lesions and suture failure. We encountered a case wherein laparoscopy-assisted distal gastrectomy was performed in a patient with abortive Behçet's disease, early stage gastric carcinoma, and a history of undergoing upper gastrointestinal surgery.

A 59-year-old woman was diagnosed with advanced gastric cancer with para-aortic and Virchow's lymph node metastases (L, Less, type 2, tub1, cT3N2H0P0M1[LYM: #16, Virchow's]). Four courses of S-1(80mg/m / 2, days 1-21)and CDDP(60mg/ m2, day 8)were administered. After the chemotherapy, CT showed that the primary tumor and para-aortic and Virchow's lymph nodes had reduced in size. The clinical stage was ycT3N1H0P0M0, stage III A. The patient underwent distalgastrectomy, D2 dissection, and sampling of the para-aortic lymph nodes(#16b1lat, #16a2int). The pathological diagnosis was L, less, type 1, por1/2, pT2N2H0P0M0CY0, pStage III B. The patient was treated with S-1(80mg/m2, days 1-28)as adjuvant chemotherapy. After 3 courses had been administered(6 months after the resection), swelling of a para-aortic lymph node (#16b1int)was detected using CT. Based on the diagnosis of recurrence in the lymph node, weekly paclitaxel(80mg/m2, days 1, 8, and 15)was administered. After receiving 9 courses of weekly paclitaxel, the swelling of the lymph node disappeared, and the response evaluation was complete response. She discontinued the chemotherapy 5 years and 9 months after the surgery. To date, she has survived more than 6 years after surgery without recurrence. We report a long-surviving patient with advanced gastric cancer with para-aortic lymph node metastasis who received combined modality therapy.

A 74-year-old woman was found to have a hepatic mass based on CT findings. She was diagnosed as having cecum cancer, and it was difficult to distinguish whether the hepatic mass was liver metastasis or biliary cystadenocarcinoma. We proceeded with the surgery for cecum cancer, and laparoscopic ileocecal resection with D3 lymph node dissection was performed. The histopathological diagnosis was mucinous adenocarcinoma, and the pathological stage was T3N2H1P0M1a, Stage IV. After the surgery, her CEA level was elevated, and we diagnosed the hepatic mass as a liver metastasis. A CapeOX plus bevacizumab regimen was administered but was discontinued for 2 courses due to the development of adverse effects and her decision. Gd-EOB-DTPA-enhanced MRI revealed a multilocular and lobulated mass, which was a low-intensity area in T1WI and high-intensity area in T2WI, and the mass had no significant contrast effects. These images were unspecific for liver metastasis of colorectal cancer, and we performed segmental 6 hepatectomy for diagnosis and curative surgery. A histopathological diagnosis of liver metastasis of cecum cancer was made. Here, we report a case of liver metastasis of colorectal cancer that was undifferentiated from biliary cystadenocarcinoma.

Although chemotherapy is the standard treatment for unresectable advanced gastric cancer, its prognosis is poor and the median survival time is only around 10 months. With some literature consideration, we report that ovarian metastasis triggered the diagnosis of unresectable advanced gastric cancer with long-term survival through multidisciplinary treatment. This is the case of a 69-year-old woman, who was diagnosed with ovarian tumor and underwent right extracorporectomy and omentum resection in 2011. Pathological diagnosis suspected adenocarcinoma. In February 2012, EGD found a type 4 tumor in the upper portion of the pyloric area of the stomach. She was diagnosed with gastric cancer with Stage IV(T4aN0M1 [ovary])ovarian metastasis. Because the primary tumor was HER2 positive, XP plus HER therapy(capecitabine 1,000mg/m2 twice a day for 14 days, CDDP 80mg/m2 every 3 weeks on the first day, and trastuzumab 8 mg/kg every 3 weeks on the first day)was administered since March 2012. No metastasis was found in the imaging examination after 8 courses of chemotherapy, and we also confirmed the reduction of the primary tumor in the EGD. Based on the images, primary resection was already possible. In December 2012, after a diagnostic laparoscopy, total gastrectomy with D2 lymph node dissection was performed. Postoperative pathology was diagnosed as Stage IV(pT4aN0M1). To control postoperative micrometastasis, capecitabine therapy(1,000mg/m2 twice a day for 14 days)was administered for 12 months starting from February 2013. Then, recurrence and metastasis were not observed during follow-up. However, in January 2017, a circumstellar stenotic tumor was found in the rectum and was diagnosed as recurrence of peritoneal dissemination through images. In February 2017, artificial ostomy(in the sigmoid colon, double-mouth type)was made. Then, the patient underwent an outpatient chemotherapy, with hospital visits, and she survives.

The affiliation of the last author, Kenshi Suzuki has been incorrectly published in the original publication of the article. The correct affiliation is provided in this correction.

Laparoscopy-assisted distal gastrectomy (LADG) has an advantage of earlier recovery after surgery due to having lower invasiveness and wound pain than open distal gastrectomy (ODG). However, whether the same enhanced recovery after surgery (ERAS) program for LADG is equally feasible and safe for ODG remains unclear. We retrospectively extracted the clinical data of the patients enrolled in JCOG0912 from the medical record system of our hospital and compared the treatment process and short-term surgical outcomes between LADG and ODG. Our ERAS program consisted of 13 elements (4 preoperative, 4 intraoperative, and 5 postoperative elements). The morbidity was defined as complications of grade 2 or more. One hundred and sixty-three patients were entered from our hospital and randomized to undergo ODG (82 patients) or LADG (81 patients). The patient’s backgrounds, surgical outcomes, and pathological outcomes were similar between the ODG and LADG groups. The rate of completing the clinical pathway was 95.1% in both groups, and the rates of completing each ERAS element were similar. However, the additional use of acetaminophen was significantly more frequent in the ODG group than in the LADG group (18.3% vs. 6.2%, p = 0.03). The median hospital stay after surgery was 9 days in both groups. Morbidity, defined as Clavien–Dindo classification > grade 2, was observed in 6.1% of the ODG group and 11.1% of the LADG group. No mortality occurred in either group. This study showed that the regimen of perioperative care performed by the ERAS program for LADG was equally feasible and safe for ODG with additional pain control. Less pain observed in LADG was not so apparent advantage for completion and safety of ERAS care.

The acyclic molecule squalene (1) is cyclized into 6,6,6,6,5-fused pentacyclic hopene (2) and hopanol (3; ca. 5:1) through the action of Alicyclobacillus acidocaldarius squalene-hopene cyclase (AaSHC). The polycyclization reaction proceeds with regio- and stereochemical specificity under precise enzymatic control. This pentacyclic hopane skeleton is generated by folding 1 into an all-chair conformation. The Ala306 residue in AaSHC is conserved in known squalene-hopene cyclases (SHCs); however, increasing the steric bulk (A306T and A306V) led to the accumulation of 6,6,6,5-fused tetracyclic scaffolds possessing 20R stereochemistry in high yield (94 % for A306V). The production of the 20R configuration indicated that 1 had been folded in a chair-chair-chair-boat conformation; in contrast, the normal chair-chair-chair-chair conformation affords the tetracycle with 20S stereochemistry, but the yield produced by the A306V mutant was very low (6 %). Consequently, bulk at position 306 significantly affects the stereochemical fate during the polycyclization reaction. The SHC also accepts (3R) and (3S)-2,3-oxidosqualenes (OXSQs) to generate 3α,β-hydroxyhopenes and 3α,β-hydroxyhopanols through polycyclization initiated at the epoxide ring. However, the Val and Thr mutants generated epoxydammarane scaffolds from (3R)-OXSQ; this indicated that the polycyclization cascade started in these instances at the terminal double bond position. This work is the first to report the polycyclization of oxidosqualene starting at the terminal double bond.

The goal of this research was to create the most appropriate index dose for the optimization of protection in medical exposure in general radiography in Kanagawa prefecture. We distributed questionnaires to 272 medical institutions in Kanagawa prefecture. The investigation period was from October 2015 to February 2016. Entrance surface dose (ESD) was used as the index dose. Investigated regions in general radiography were the adult chest, adult abdomen, and infant chest (anterior-posterior projections for all regions). The effective response rate was 35%. ESD was significantly lower with a flat panel detector (FPD) than with computed radiography (CR) in all regions (adult chest and abdomen: p

The prevalence of colorectal cancer in the elderly population is increasing; therefore, surgical interventions with a risk of potential complications are more frequently performed. The aim of the present study was to elucidate whether sarcopenia has a clinical impact on short-term outcomes, such as morbidity and hospital stay after surgery, in elderly patients with colorectal cancer. A total of 82 elderly patients undergoing colectomy for colorectal cancer between January 2011 and December 2015 in our institute were included in the study, and skeletal muscle mass was measured as total psoas area at the level of the third lumbar vertebra (L3) using enhanced computed tomography scans. The patients were divided into two subgroups, namely those with and those without sarcopenia, based on median skeletal muscle mass in men and women, and the association with complications was analyzed. A total of 40 patients (48.8%) were diagnosed with sarcopenia. The patients with sarcopenia exhibited a significantly higher incidence of total complications (55 vs. 31.0%, P=0.028) and longer hospital stay (25.9±21.2 vs. 18.2±8.5 days, P=0.039). The multivariate logistic analysis revealed that sarcopenia was an independent risk factor for postoperative surgical complications. The short-term outcomes, such as postoperative surgical complications and hospital stay, were affected by preoperative sarcopenia in elderly colorectal cancer patients. To improve the short-term outcomes of such patients, it is necessary to carefully plan the surgical procedure, perioperative care and the surgical strategy using preoperative sarcopenia assessment.

The formation of Fe- and Mg-rich smectite and zeolite under alkaline conditions, as secondary minerals after the alkaline alteration of bentonite in repositories for radioactive waste, is of major concern. It is crucial for safety assessments to know whether smectite is formed as a secondary mineral after the alkaline alteration of bentonite. In the present paper, Fe- and Mg-rich smectite, which interacted with the hyperalkaline groundwater at Narra in Palawan, Philippines, was used. Mineralogical and geochemical investigation was conducted to understand the formation process of the smectite and the factors determining the formation of secondary mineral species. The results suggest that a certain amount of smectite may be generated under hyperalkaline conditions, by alteration from amorphous or poorly crystalline components such as M-S-H and F-S-H. Therefore, the controlling factor determining whether smectite or zeolite will be generated as secondary minerals after alkaline alteration of bentonite could be whether nuclei of M-S-H and/or F-S-H are formed. Whether such formation takes place may be determined by the presence of dissolved Mg2+ and Fe2+ in the environment. The formation process of smectite under alkaline conditions, suggested by the results here, is analogous to the generally accepted model of smectite formation as it may have occurred on early Mars.

Elevated antimony concentrations in aqueous environments from anthropogenic sources is becoming of global concern, here iron oxides are known to strongly adsorb aqueous antimony species with different oxidation states, but the effect of silica on the removal characteristics is not well understood despite being a common component in the environment. In this study, ferrihydrite was synthesized at various Si/Fe molar ratios to investigate its adsorption and co-precipitation behaviors with aqueous antimony anionic species, Sb(III) and Sb(V). The XRD analyses of the precipitates showed two broad diffraction features at approximately 35° and 62° 2θ, which are characteristic of 2-line ferrihydrite, no significant shifts in peak positions in the ferrihydrite regardless of the Si/Fe ratios. The infrared spectra showed a sharp band at ~990 cm−1, corresponding to asymmetric stretching vibrations of Si-O-Fe bonds which increased in intensity with increasing Si/Fe molar ratios. Further, the surface charge on the precipitates became more negative with increasing Si/Fe molar ratios. The adsorption experiments indicated that Sb(V) was preferentially adsorbed at acidic conditions and decreased dramatically with increasing pH while the adsorption rate of Sb(III) ions was independent of pH, however, the presence of silica suppressed the adsorption of both Sb(III) and Sb(V) ions. The results showed that Sb(III) and Sb(V) ions were significantly inhibited by co-precipitation with ferrihydrite even in the presence of silica by isomorphous substitution in the ferrihydrite crystal structure.

The standard therapy for Stage IV gastric cancer is chemotherapy. It is not certain, but conversion surgery is expected to be effective. We report the cases of 3 patients who achieved long-term survival after conversion surgery. Case 1 was of a 59- year-old woman. The tumor was classified as L-Less Post, Type 2, tub1, cT3N2M1(#16a2lat), Stage IV. Then, we initiated S-1 plus cisplatin and the LN achieved PRafter 4 courses. We performed distal gastrectomy with D2 lymph node dissection in February 2011. It was classified as ypT2N2 and the primary lesion was histologically classified as Grade 1a. Case 2 was of a 74- year-old man. The tumor was classified as UM-Less Ant, Type 3, por1, cT3N2H0P1CY1, Stage IV. Then, we initiated docetaxel plus cisplatin plus S-1 and the primary tumor achieved PRafter 6 courses. There were no new tumors and we conducted a laparoscopic examination. After the decision of P0CY0, we performed total gastrectomy with D2 lymph node dissection in April 2012. It was classified as ypT3N1 and the primary lesion was histologically classified as Grade 2. Case 3 was of a 64-yearold woman. The tumor was classified as UM-Less, Type 3, por1, cT3N2H1M0(liver), Stage IV. Then, we initiated capecitabin plus cisplatin and liver metastasis achieved PRafter 6 courses. We performed total gastrectomy with D2 lymph node dissection in July 2012. It was classified as ypT3N1 and the primary lesion was histologically classified as Grade 1b. All postoperative chemotherapy courses were of only S-1. In case 1, the para aortic LN exhibited recurrence 6 months postoperatively. We initiated weekly paclitaxel as second-line therapy. It achieved CRafter 6 courses, and the same trend was maintained. In cases 2 and 3, no therapy was administered after 8 S-1 courses, but no recurrences occurred. All patients survived after 62-77 months postoperatively. A new clinical trial is needed to prove the improvement in prognosis for Stage IV gastric cancer after conversion surgery.

The effect of silica on the immobilization reaction of boron by magnesium oxide was investigated by laboratory experiments. In the absence of silica, due to dissolution of the magnesium oxide, boron was removed from solutions by the precipitation of multiple magnesium borates. In the presence of silica, magnesium silica hydrate (M-S-H) was formed as a secondary mineral, which takes up boron. Here B-11 magic-angle spinning nuclear magnetic resonance (MAS-NMR) and Fourier transform infrared spectrometer (FT-IR) data show that a part of the boron would be incorporated into M-S-H structures by isomorphic substitution of silicon. Another experiment where magnesium oxide and amorphous silica were reacted beforehand and boron was added later showed that the shorter the reaction time of the preceding reaction, the higher the sorption ratio of boron. That is, boron was incorporated into the M-S-H mainly by coprecipitation. The experiments in the study here show that the sorption of boron in the presence of silica is mainly due to the incorporation of boron during the formation of the M-S-H structure, which suggests that boron would not readily leach out, and that stable immobilization of boron can be expected.

Formation of Fe- and Mg-rich smectite and zeolite under alkaline conditions is concerned as secondary minerals after alkaline alteration of bentonite in a repository of radioactive wastes. It might be crucial for safety assessment whether smectite will be formed or not as secondary minerals after alkaline alteration of bentonite. In present paper, Fe- and Mg-rich smectite which are currently interacting with hyperalkaline groundwater was found at Narra in Palawan, Philippines. Mineralogical and geochemical investigation was conducted to understand formation process of smectite and factors determined secondary mineral species. Our study revealed a certain amount of smectite may have been produced under hyperalkaline conditions, altered from amorphous or poorly crystalline material such as M-S-H and F-S-H. Key factor which decides smectite or zeolite as secondary minerals after alkaline alteration of bentonite might be whether nuclei of M-S-H and/or F-S-H will be formed or not. This might be decided by the presence of dissolved Mg2+ and Fe2+ in the system. Our suggested formation process of smectite under alkaline conditions is analogue with generally-accepted model of smectite formation that might have been occurred on early Mars.

A 63-year-old man underwent a laparoscopic partial gastrectomy for GIST on September, 2001. Three years and 2 months after the gastrectomy, an abdominal CT showed multiple recurrences in S5 and S6 in the liver and peritoneum. After 4 months from the start of imatinib treatment(400mg/day), peritoneal tumors disappeared and the patient maintained stable disease by imatinib treatment for 8 years. However, on December, 2012, an abdominal CT scan revealed the regrowth of the tumor in S6 in the liver, and PET-CT showed focal progression of only the S6 lesion. Although the lesion was resectable, the patient did not request surgical intervention. So, we initiated sunitinib treatment(50mg/day), and the residual liver metastasis has been well controlled with favorable response of sunitinib for 4 years without severe side effects.