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With age, senescence-associated (SA) CD4+ T cells that are refractory to T cell receptor (TCR) stimulation are increased along with spontaneous germinal center (Spt-GC) development prone to autoantibody production. We demonstrate that CD153 and its receptor CD30 are expressed in SA-T and Spt-GC B cells, respectively, and deficiency of either CD153 or CD30 results in the compromised increase of both cell types. CD153 engagement on SA-T cells upon TCR stimulation causes association of CD153 with the TCR/CD3 complex and restores TCR signaling, whereas CD30 engagement on GC B cells induces their expansion. Administration of an anti-CD153 antibody blocking the interaction with CD30 suppresses the increase in both SA-T and Spt-GC B cells with age and ameliorates lupus in lupus-prone mice. These results suggest that the molecular interaction of CD153 and CD30 plays a central role in the reciprocal activation of SA-T and Spt-GC B cells, leading to immunosenescent phenotypes and autoimmunity., 老化T細胞が自己免疫病や慢性炎症疾患を引き起こすメカニズムを解明 --老化関連疾患克服への新しいアプローチ--. 京都大学プレスリリース. 2022-09-22.

Background Although sacrococcygeal teratoma (SCT) is relatively common in children, it is rare in adults. The prognosis for malignant cases is poor, so prompt surgical resection is required. Transabdominal and transsacral approaches are common approaches for tumor resection. In recent years, there have been reports of tumor removal with laparoscopic assistance, but all have applied transabdominal approaches. Case presentation A 27-year-old woman visited our gynecology department because of abdominal pain and genital bleeding. Magnetic resonance imaging (MRI) revealed a 3-cm-sized cystic mass in the left retrorectal area, and she was referred to our department for detailed examinations and treatment. She was diagnosed with a presacral cystic tumor and decided to undergo surgery. We used a transsacral approach to perform tumor excision. Since it was difficult to confirm the deep part of the tumor through direct visualization, we used GelPOINT® Path (a transanal access platform) and AirSEAL® System (insufflation device) to remove the tumor endoscopically. The postoperative course was uneventful with no bladder or rectal dysfunction. Histopathological examination revealed a mature teratoma. Conclusions When the tumor is relatively small and located in the lower sacrum, the endoscopically assisted transsacral approach can establish a stable field of view by expanding the depth of the surgical field. This method is useful considering its ability to perform excision without leaving residual tumor tissue and satisfactory safety and cosmetic results.

PurposeIn surgery for colorectal cancer, dissection of the lymph nodes and fatty tissue around the root of the inferior mesenteric artery is important from an oncologic point of view. However, it is debatable whether it is better to preserve or remove the left colic artery (LCA). This study aimed to compare D3 lymphadenectomy with versus without LCA preservation in single-incision laparoscopic surgery for sigmoid and rectosigmoid cancer.MethodsA total of 1138 patients underwent surgery for colorectal cancer between April 2011 and December 2018 at Fukui Prefectural Hospital. This propensity score-matched retrospective study analysed the data of 163 patients: 42 patients with LCA preservation (group A) and 129 without LCA preservation (group B). Clinical and oncological outcomes were compared between the two groups.ResultsAfter propensity score matching, the mean ASA score was slightly lower in group B than in group A. There were no significant differences between groups A and B in surgical outcomes, including the 5-year overall survival rate (80% vs 80%, hazard ratio (HR) 1.11, 95% confidence interval (CI) 0.43–2.86), 5-year disease-free survival rate (76.6% vs 80%, HR 0.82, 95% CI 0.26–2.48), and 5-year cancer-specific survival rate (90% vs 83.3%, HR 1.29, 95% CI 0.34–5.23).ConclusionThere were no significant differences in the short- and long-term outcomes of patients who underwent single-incision laparoscopic surgery with D3 lymphadenectomy with versus without LCA preservation. This suggests that LCA preservation is safe and feasible in single-incision laparoscopic surgery for sigmoid and rectosigmoid colon cancer.

BACKGROUND Leukaemias comprise a heterogenous group of haematological malignancies. In CONCORD-3, we analysed data for children (aged 0-14 years) and adults (aged 15-99 years) diagnosed with a haematological malignancy during 2000-14 in 61 countries. Here, we aimed to examine worldwide trends in survival from leukaemia, by age and morphology, in young patients (aged 0-24 years). METHODS We analysed data from 258 population-based cancer registries in 61 countries participating in CONCORD-3 that submitted data on patients diagnosed with leukaemia. We grouped patients by age as children (0-14 years), adolescents (15-19 years), and young adults (20-24 years). We categorised leukaemia subtypes according to the International Classification of Childhood Cancer (ICCC-3), updated with International Classification of Diseases for Oncology, third edition (ICD-O-3) codes. We estimated 5-year net survival by age and morphology, with 95% CIs, using the non-parametric Pohar-Perme estimator. To control for background mortality, we used life tables by country or region, single year of age, single calendar year and sex, and, where possible, by race or ethnicity. All-age survival estimates were standardised to the marginal distribution of young people with leukaemia included in the analysis. FINDINGS 164 563 young people were included in this analysis: 121 328 (73·7%) children, 22 963 (14·0%) adolescents, and 20 272 (12·3%) young adults. In 2010-14, the most common subtypes were lymphoid leukaemia (28 205 [68·2%] patients) and acute myeloid leukaemia (7863 [19·0%] patients). Age-standardised 5-year net survival in children, adolescents, and young adults for all leukaemias combined during 2010-14 varied widely, ranging from 46% in Mexico to more than 85% in Canada, Cyprus, Belgium, Denmark, Finland, and Australia. Individuals with lymphoid leukaemia had better age-standardised survival (from 43% in Ecuador to ≥80% in parts of Europe, North America, Oceania, and Asia) than those with acute myeloid leukaemia (from 32% in Peru to ≥70% in most high-income countries in Europe, North America, and Oceania). Throughout 2000-14, survival from all leukaemias combined remained consistently higher for children than adolescents and young adults, and minimal improvement was seen for adolescents and young adults in most countries. INTERPRETATION This study offers the first worldwide picture of population-based survival from leukaemia in children, adolescents, and young adults. Adolescents and young adults diagnosed with leukaemia continue to have lower survival than children. Trends in survival from leukaemia for adolescents and young adults are important indicators of the quality of cancer management in this age group. FUNDING Children with Cancer UK, the Institut National du Cancer, La Ligue Contre le Cancer, Centers for Disease Control and Prevention, Swiss Re, Swiss Cancer Research foundation, Swiss Cancer League, Rossy Family Foundation, US National Cancer Institute, and the American Cancer Society.

Among several mechanisms for the resistance of human epidermal growth factor receptor 2-overexpressing (HER2 +) cancer cells to trastuzumab, little is known regarding the mechanism underlying the resistance to trastuzumab-mediated antibody-dependent cellular cytotoxicity (ADCC). Cell death due to ADCC is caused by apoptosis of target cells induced by granzymes released from natural killer cells. Because optimal granzyme physiological activity occurs at neutral pH, we assumed that the pH of the intracellular environment influences the cytotoxic effects of granzymes. We established ADCC-resistant cells and compared them with wild-type cells in terms of the expression of intracellular pH-regulating genes. The expression of ATP6V1B1, which encodes a component of vacuolar ATPases, was downregulated in the ADCC-resistant cells. Thus, to functionally characterize ATP6V1B1, we used a CRISPR/Cas9 system to generate ATP6V1B1-knockout SKBR3 and JIMT-1 cells (both HER2 + human breast cancer cell line). The resulting cells exhibited significantly less ADCC than the control SKBR3 and JIMT-1 cells. The intracellular pH of the ATP6V1B1-knockout SKBR3 and JIMT-1 cells was significantly lower than control SKBR3 and JIMT-1cells. An analysis of granzyme dynamics during the ADCC reaction in cancer cells revealed that granzymes degraded intracellularly in the control SKBR3 and JIMT-1 cells and accumulated in ATP6V1B1-knockout cells, but were not cytotoxic. These findings suggest that decreased vacuolar ATPase activity alters the cytoplasmic pH of cancer cells to create an environment that is less suitable for granzyme bioactivity, which adversely affects the induction of apoptosis of cancer cells by NK cells.

Single-incision plus one-port laparoscopic surgery (SILS+1) for rectal cancer reduces technical difficulties of pure single-incision laparoscopic surgery (SILS) keeping good cosmetic results. However, the adequate long-term oncological outcomes of SILS+1 for rectal cancer were not documented in the literature. Data from 136 patients (86 males) who performed an elective surgery with SILS+1 for stage I to III rectal cancer were reviewed, and its 5-year oncologic outcomes were evaluated. The median follow-up period was 57 months. A total of 18 patients (13.3%) experienced recurrence, including two peritoneum and three local recurrences. In these five patients, four patients except one patient with relapse at an anastomotic site were pT4 patients. The 5-year overall survival for stage I, II, and III patients were 98.1, 91.2, and 88.5%, respectively, and the 5-year cancer-specific survival for stage I, II, and III patients was 100, 97.1, and 97.8%, respectively. The long-term oncological safety of SILS+1 for rectal cancer was demonstrated with an excellent 5-year cancer-specific survival.

Acquired immune function shows recognizable changes over time with organismal aging. These changes include T-cell dysfunction, which may underlie diminished resistance to infection and possibly various chronic age-associated diseases in the elderly. T-cell dysfunction may occur at distinct stages, from naive cells to the end stages of differentiation during immune responses. The thymus, which generates naive T cells, shows unusually early involution resulting in progressive reduction of T-cell output after adolescence, but peripheral T-cell numbers are maintained through antigen-independent homeostatic proliferation of naive T cells driven by the major histocompatibility complex associated with self-peptides and homeostatic cytokines, retaining the diverse repertoire. However, extensive homeostatic proliferation may lead to the emergence of dysfunctional CD4+ T cells with features resembling senescent cells, termed senescence-associated T (SA-T) cells, which increase and accumulate with age. In situations such as chronic viral infection, T-cell dysfunction may also develop via persistent antigen stimulation, termed exhaustion, preventing possible immunopathology due to excessive immune responses. Exhausted T cells are developed through the effects of checkpoint receptors such as PD-1 and may be reversed with the receptor blockade. Of note, although defective in their regular T-cell antigen-receptor-mediated proliferation, SA-T cells secrete abundant pro-inflammatory factors such as osteopontin, reminiscent of an SA-secretory phenotype. A series of experiments in mouse models indicated that SA-T cells are involved in systemic autoimmunity as well as chronic tissue inflammation following tissue stresses. In this review, we discuss the physiological aspects of T-cell dysfunction associated with aging and its potential pathological involvement in age-associated diseases and possibly cancer., The cellular basis of T-cell senescence

Highlights • Enema examination is considered safe, but in rare cases, complications may result. • Iatrogenic bowel perforation can occur without leakage of contrast agent during enema examination through a colostomy. • In the case of an enema examination through a colostomy, clinicians must be aware of the possibility of bowel perforation even if leakage of contrast agent is not observed., Introduction Enema examination is considered safe, but in rare cases, complications may result. Here, we report a rare case of iatrogenic bowel perforation during enema examination through a colostomy without leakage of contrast agent. Presentation of case A 36-year-old man who had undergone a sigmoid loop colostomy was diagnosed with ulcerative colitis. A bowel enema through a colostomy was performed by nurses and radiological technologists. During the procedure, a balloon catheter was inserted into the proximal lumen of the colostomy, and the balloon was inflated. The patient developed severe abdominal pain a few minutes following withdrawal of the catheter. Computed tomography showed intraperitoneal free air, although contrast agent leakage into the intraperitoneal cavity was not observed. The patient underwent emergency laparotomy. Intraoperatively, there was a 3-cm bowel perforation just inside the colostomy where the inflated balloon was pressing. Discussion The perforation site may have been sealed by the inflated balloon during the enema examination. In addition, the patient maintained a supine position during and after the examination. This led to contrast agent accumulating on the dorsal side and not leaking out from the perforation site after the balloon was deflated. Conclusion Iatrogenic bowel perforation can occur without leakage of contrast agent during enema examination through a colostomy, and the examination should be performed under the supervision of an attending doctor. In the case of an enema examination through a colostomy, clinicians must be aware of the possibility of bowel perforation even if leakage of contrast agent is not observed.

Background Portal venous gas has traditionally been considered an inevitable harbinger of death due to its association with bowel necrosis. Recently, an increasing number of cases of portal venous gas have been reported in patients with various clinical conditions and without bowel necrosis. We herein report the case of a patient in whom portal venous gas developed after transverse colon cancer surgery. Case presentation A 69-year-old man who had transverse colon cancer underwent insertion of a transanal ileus tube for decompression. Transverse colon resection was performed on the 11th day after the insertion of the transanal ileus tube. The patient had a high fever on the 6th day after the operation. Computed tomography showed portal venous gas over the entire area of the liver and pneumatosis intestinalis in the wall of the ascending colon. There were no signs of anastomotic leakage or bowel necrosis, so we decided to use conservative therapy with fasting and antibiotics. The portal venous gas disappeared on the 19th day after the operation. The patient was discharged in good condition on the 29th day after the operation. Conclusions Conservative treatment for portal venous gas is reasonable for patients without signs of anastomotic leakage or bowel necrosis. However, it is important to carefully observe patients with portal venous gas during conservative treatment because portal venous gas may be life-threatening.

Background: Lung cancers are classified into small-cell lung cancer (SCLC) and non-small-cell lung cancer due to their different treatment and prognosis. Although many studies have reported the specific survival of SCLC patients treated at cancer hospitals, survival from population-based data has rarely been reported. Methods: We analyzed survival of SCLC cases diagnosed from 1993 through 2006 from a population-based cancer registry of six prefectures. To assess trends in SCLC survival, we defined three periods that mirrored developments in SCLC treatment: period 1, 1993–1998; period 2, 1999–2001; and period 3, 2002–2006. Assessments were based on relative survival (RS), excess hazard, and conditional survival. Results: A total of 10,911 SCLC patients were analyzed. Five-year RS among limited disease SCLC (LD-SCLC) in periods 1 to 3 was 16.8%, 21.1%, and 21.4%, respectively. Five-year RS among extensive disease SCLC (ED-SCLC) in periods 1 to 3 was 2.3%, 2.8%, and 2.7%, respectively. Improvement in 5-year RS in periods 2 and 3 compared with period 1 was significant among both LD- and ED-SCLC patients (all P < 0.001). Conditional 5-year RS of LD-SCLC increased from 21% at year 0 to 73% at year 5, while that of ED-SCLC was 3% at year 0 and 53% at year 5. Conclusions: The prognosis of SCLC patients improved from 1999–2001 but plateaued in 2002–2006, after which no further significant improvement was seen. Continuous survey based on population-based data is helpful in monitoring the impact of developments in treatment.

Background We retrospectively reviewed our consecutive experience from the introduction of single-port laparoscopic surgery (SPS) for colon cancer, and its 5-year oncological outcomes are evaluated. Methods A total of 288 patients (140 males) with a mean age of 71.5 years were treated with the single-port laparoscopic colectomy for stage I, II and III colon cancers. Exclusion criteria of SPS were patients with unresolved bowel obstruction, T4b tumour, tumour perforation and severe medical illness. Results In 20 patients (6.9%), we inserted an extra port mainly to transect the rectum. The median follow-up period was 52 months. The 5-year relapse-free survival rates in stage I, II and III patients were 95.8%, 80.2% and 61.6%, respectively. The 5-year overall survival rates for stage I, II and III patients were 97.4%, 85.3% and 72.9%, respectively. The 5-year cancer-specific survival rates in patients diagnosed pathologically T1, T2, T3 and T4 were 100%, 100%, 92.1% and 73.9%, respectively. Conclusions SPS colectomy can be applied to the treatment of colon cancer with good long-term oncological outcomes. However, we should pay more attention when we treat the pathologically diagnosed T4 tumours.

The use of 2‑octyl cyanoacrylate (CA) for the umbilical wound after single-incision laparoscopic surgery (SILS) for colorectal cancer has not been described. A consecutive experience of SILS for colorectal cancer is presented. Three hundred sixty-four patients (172 women) were treated with SILS for colorectal cancer between December 2010 and December 2015. Our institution introduced CA in September 2012. The data of patients treated with CA were compared to a historical group who underwent standard sutured skin closure with thin adhesive strips (AS) at our institution. The Centers for Disease Control and Prevention criteria were used for the diagnosis of superficial surgical site infection (SSI). Of these 364 patients, 20 patients (5.5%) were converted to laparotomy including the extension of the skin incision longer than 3 cm. In 344 patients completed with SILS, CA was used in 247 patients. Superficial SSI occurred in two patients (0.81%) with CA and one (1.03%) with AS. No patients completed with SILS suffered wound dehiscence in this series. There were no significant differences in wound-related complication rate between the two groups. CA provides sufficient wound closure in SILS for colorectal cancer. SILS with CA has the possibility to provide a lower superficial SSI rate in patients with colorectal cancer.

Background Douche injury is a rare consequence of water recreation activities. Generally, this type of trauma occurs when people fall into the water in a sitting position during high-speed activities such as using a personal watercraft (PWC). Here, we report a rare case of anorectal injury caused by water jets from a PWC during sudden acceleration from rest. Case presentation A 21-year-old male passenger on a PWC fell off backward from the rear seat when the craft suddenly accelerated. He fell into the water in a supine position with his legs open, and the water jets of the PWC struck his perineum directly. Thereafter, bleeding from the anus was seen, and he was transferred to our hospital. On physical examination, there was a deep laceration interrupting the external anal sphincter in the posterior rectal wall. Abdominal computed tomography revealed a full-layer perforation of the posterior rectal wall and leakage of feces into the extraperitoneal space, but intraperitoneal free air was not seen. Laparoscopic sigmoid loop colostomy and primary suturing of the sphincter and mucosa were performed. He did not have any complications and was discharged from our hospital 16 days after the surgery. His anal function was almost perfectly preserved, and his diverting colostomy was closed 4 months later. Conclusion Anorectal injuries related to PWCs can occur not only while traveling at high speeds, but also when suddenly accelerating from rest. A diverting colostomy should be performed for this type of trauma. In these trauma cases, clinicians must suspect complex and life-threatening anorectal injuries early.

Angiotensin-converting enzyme (ACE) exists in the kidney, lung and small intestine of the NOD mouse (autoimmune type 1 diabetes animal model). ACE changes Angiotensin I to Angiotensin II. ACE exists in the small intestinal epithelial cells and villi, and digests the protein antigen molecules in the small intestine. ACE plays an important role in the antigen presenting process in the mucosal immune system of the duodenum and jejunum. To examine if ACE has a role in the development of type 1 diabetes of the NOD mouse, ACE Inhibitors, enalapril maleate (EM) or captopril (CA) was dissolved in a drinking water at the concentration of 12.5μg/ml and given daily to 28-day-old NOD mice ad libitum (89 females and 70 males in CA, 72 and 52 in EM, 120 and 87 in water control group, respectively). The animals were screened for the development of diabetes twice a week for 7 months and subjected to the Life Table analysis. The incidence of diabetes in our NOD/Kmc colony is 83% in females and 40% in males at 210 days of age. The EM-treated NOD mice showed a significant delay of the onset of diabetes at 120 days of age in comparison with the controls (25% vs. 45% in females, P=0.002; 0% vs. 8% in males, P=0.037). The CA treatment was ineffective to delay the onset of diabetes. The histological examination of the pancreata showed that the EM-treated females had more islets without lymphocytic infiltration than the water-control females (mean number of undamaged islets±SD: 11.1±8.5 in EM vs. 1.9±2.5 in Control, P=0.009). The undamaged islets weighed 0.772±0.383 in EM and 0.441±0.386 in water-control (mg: mean±SE). The mRNA expression of MHC K and A genes was suppressed in the duodenum and jejunum of the NOD mice by EM- or CA-water for 14 days. Flow cytometric analysis showed suppression of the MHC K and I-A expression in the pancreatic lymphocytes of the EM- and CA-treated mice in comparison with the control mice. Disclosure M. Hattori: None. A. Ueda: None. R. Katoh: None. M. Hirai: None. A. Noda: None. K. Mayanagi: None. Y. Furuichi: None. K. Hattori: None. T. Lund: None. K. Kobayashi: None. Y. Nakamura: None.

In modern semiconductor lithography world, doubtlessly, scanners using DUV as light source still be main work horses to push physical limits of semiconductor devices to a new level. Meanwhile, as the semiconductor devices diversified to many different types, for example, logic, DRAM, NAND ash, CMOS Image Sensor (CIS), etc., lithography performances needed are also diversified. For example, CH/VIA layers in the-state-of-the-art logic processes require improved lithography Process Window (PW) due to their shallow Depth of Focus (DOF). On the other hand, engineers working in the field of modern 3D-NAND ash memory and CIS lithography are needed to deal with problems induced by thick resists. Efforts by chip makers, scanner vendors solved the problems in some degree. For example, focus drilling multi-exposure, has improved DOF of some specific layers substantially. But all these approaches have some kinds of issues, such as, throughput losses, etc. As a light source maker, we believe we can make unique contributions to solve the issues. In this report, we are going to show that our advanced Spectral Engineering (SE), a cost-effective way, can provide chip makers with an alternative to cope with the challenges stated above.

Single-incision laparoscopic surgery (SILS) and single-incision plus one-port laparoscopic surgery (SILS+1) for colorectal cancer are considered to require long operative times, experienced surgeons, and advanced surgical techniques. However, these procedures are advantageous because they require both fewer ports and fewer surgeons.In the SILS procedure for colon cancer, a Lap Protector™ (LP; Hakkou Shoji, Japan) is inserted through a 2.5 cm transumbilical incision. Next, an EZ-Access (Hakkou Shoji, Japan) is mounted onto the LP, and three ports are made in the EZ-Access. In SILS+1 for rectal cancer, we use an extra incision in the lower quadrant for drainage from the beginning of the operation. Data from 849 patients who underwent elective surgery with SILS or SILS+1 for colorectal cancer were reviewed.In 808 patients who underwent a reduced-port procedure for colorectal cancer, the mean incision length was 2.91 cm. The average operative time was 198.2 minutes, and average intra-operative blood loss was 25.6 mL. Complications with a Clavien-Dindo classification of II or greater occurred in 63 patients (7.2%). Among 654 stage I-III colorectal cancer patients, 69 (10.6%) experienced postoperative relapse during the follow-up period of 42 months.Our cumulative findings support the use of SILS or SILS+1 in patients with colorectal cancer. The long-term oncologic outcomes make them acceptable technical alternatives to conventional multiport laparoscopic colectomy. Further trials are still needed to fully document the non-cosmetic benefits.

Polymer-based, high thermal conductivity composite materials are commonly used for transferring heat from heat source to ambient in electronics and electrical systems. Thermal conductivity is a critical property of thermally conductive composite materials. Thermal conductivity is dependent on the volume fraction of the thermally conductive fillers. Although the thermal conductivity is an intrinsic specific value, different values can be reported depending on the thermal conductivity test method used. In this study, samples are prepared with four levels of volume fraction of alumina and silicone polymer. Composite materials are measured for thermal conductivity using transient method (hot disk method, laser flash method) and steady-state method. Moreover, Finite element analysis was conducted on the heat conduction characteristic using the representative volume element (RVE) model. The Digimat software was used to create two and three-dimensional RVE containing randomly distributed thermally conductive fillers. The RVE was modeled to show transient response during laser flash testing using the ANSYS finite element program. Comparison of actual test values are compared to the finite element analysis results.

The applicability of single-incision laparoscopic colectomy (SILC) for descending colon cancer is poorly understood. In the present study, consecutive experiences with SILC for descending colon cancer are reviewed, and its long-term clinical and oncological outcomes are evaluated. A single institutional experience of SILC for descending colon cancer is presented. Thirty patients (13 women) with a median age of 68.7 years and a median body mass index of 23.0 kg/m2 were treated with SILC for clinically diagnosed colon cancer between January 2011 and December 2015. We performed left hemicolectomy in patients whose tumor located at the splenic flexure, and selected descending colectomy in the other patients. There were no conversions and additional port insertion. The mean skin incision length was 2.89 cm. The mean operative time and blood loss were 184.7 min and 72.5 mL, respectively. The mean number of harvested lymph nodes was 18.8. The 5-year relapse-free survival for stage I, stage II, and stage III disease was 100%, 70.0%, and 67.3%, respectively. The 5-year overall survival for stage I, stage II, and stage III disease was 100%, 72.0%, and 67.3%, respectively. Our initial experiences showed that SILC can be applied to the treatment of descending colon cancer with good long-term clinical and oncological outcomes.

Background We investigated whether serum uric acid (SUA) levels before kidney transplantation predict new-onset diabetes after kidney transplantation (NODAT) and compared SUA levels with known risk factors for NODAT by prospective cohort study. Methods A total of 151 adult kidney recipients without diabetes (84 men, 67 women) who underwent living-donor kidney transplantation between 2001 and 2011 were followed in this study. The Cox proportional hazards model was used to analyse the risk of NODAT. Results During the follow-up period (median 3.3 years, range 0–10 years), 32 (21.2%) adult kidney recipients without diabetes developed NODAT, and an incidence rate was 5.6 per 100 person-years and a 10-year cumulative incidence of 26.9%. When subjects were stratified by SUA levels into tertiles, the patients in the highest tertile (> 8.6 mg/dl for men, > 7.7 mg/dl for women) had a significantly higher risk of NODAT than the patients in the lower 2 tertiles (log-rank test, P = 0.03). In the univariate analysis, increased level of SUA was associated with NODAT (hazard ratio 1.27 [95% CI 1.04–1.55], P = 0.01). In the multivariate analysis, increased level of SUA was significantly associated with NODAT after correction by any factors, e.g. (age, sex, family history of diabetes, BMI, HbA1c, serum creatinine, tacrolimus, HCV) factors directly affecting the SUA value (1.26 [1.02–1.56], P = 0.03), risk factors for T2DM onset (1.34 [1.10–1.64], P = 0.03), and factors previously reported risk factors for NODAT (1.36 [1.11–1.66], P = 0.003). Conclusion SUA independently predicts NODAT in living-donor kidney transplantation patients.

Aim: In the past, we developed and reported single-incision plus one port laparoscopic anterior resection (SILS + 1-AR) of the rectum. In this study, we reviewed our experiences with 141 consecutive patients admitted in a community hospital for undergoing SILS + 1-AR for rectal cancer and evaluated the short-term clinical and oncological outcomes. Methods: A lap protector (LP) was inserted through a 2.5 cm transumbilical incision; an EZ-access was mounted to the LP and three 5-mm ports were placed. A 12-mm port was inserted in the right lower quadrant. Results: One hundred thirty-six patients (96.5%) completed their treatment with SILA+1-AR. The number of tumor locations in the rectosigmoid, rectum area above the peritoneal reflection (Ra), and rectum area below the peritoneal reflection (Rb) were 44, 63, and 29 respectively. Six (5.6%) tumor recurrences or metastasis occurred in 107 patients with stages I-III disease with a median follow-up of 30 months. One patient with a positive surgical margin rejected additional resection of the positive margin and died of recurrent disease. Conclusion: Our initial experiences suggested that SILS + 1-AR is a feasible and a safe treatment option for rectal cancer patients treated by experienced surgeons specialized in SILS. However, further studies are needed to demonstrate the advantages of this procedure compared to the benefits of conventional laparoscopic AR.

In the semiconductor industry, optical projection lithography is employed for the production of microchips. In this process ultraviolet radiation has been used to exposure of photoresists on silicon wafers. Light sources with shorter wavelength are needed to shrink the chip size due to the diffraction limit. Pulsed excimer lasers have been used since the middle of 1990s instead of mercury lamps. At first KrF lasers (248-nm) were adopted, then ArF lasers (193-nm) have been applied to satisfy tighter leading edge device requirements. Now almost 5,000 excimer lasers for lithography tools are being operated at the world-wide semiconductor fab with stable, its availability up to 99.8%. The latest ArF excimer laser can pulse 15mJ to 20mJ energy with 6-kHz repetition rate, its typical module lifetime which can be replaced is several dozen Billion pulses. The module lifetime are expected to expand to reduce the downtime to replace. Also for precise micromachining applications, ArF hybrid laser consists of all-solid-state DUV light source as a seed laser and excimer laser as amplifier is been developed. The pulse width of this laser is typically sub-nanosecond and its high peak power is another concern for laser optics. Generally, the lifespan of optical elements has been growing to reach 100 Bpls, and its evaluation takes a very long time, typically several years. Comprehensive durability evaluation becomes more efficient by creating accelerated element tests [1]. As an alternative, accelerated lifetime testing with high fluence are helpful approach to screen and select the optics to satisfy the lifetime requirement. We have been developing the accelerated test system to determinate the laser-induced damage threshold of optical surfaces. In this paper, the test system and some results of field-approved optics with 20ns pulse duration will be explained.

Introduction This study aims to evaluate the safety and feasibility of single-port laparoscopic colectomy (SPLC) in elderly patients with colon cancer. Methods During the study period, 344 patients underwent SPLC in our hospital. Among them, 87 patients were aged 80 years and older, and 257 patients were younger than 80 years. After 1:1 propensity-score matching, 87 elderly patients were compared with 87 young patients. Results Short-term clinical outcomes after SPLC were equivalent between the two groups, although the elderly group had a higher ASA score and more postoperative complications. The 5-year overall survival rates were 64.6% in the elderly group and 66.8% in control group. The 5-year cancer-specific survival rates were 78.0% in the elderly group and 70.9% in control group. There were no significant differences between the groups. Conclusion Our results indicated that SPLC is technically feasible for operative teams that have adequately standardized the procedure, and it is oncologically safe in elderly patients with colon cancer.

In recent years, DUV light source used in lithography process is enabling to shrink the feature size as a driver for Moore's law, in order to push the physical limits of semiconductor device. E95, also known as spectral bandwidth, is one of the most important parameters in the semiconductor lithography process. Light source is required to push E95 to be tighter in order to improve image contrast, and also required to improve E95 control technology to contribute to OPE (Optical Proximity Effect) error reduction. Therefore, measurement accuracy is crucial important to measure spectral bandwidth. Current measurement error is 5.6 fm (femtometers) when E95 is 300 fm, under a standard spectral metrology tool as ELIAS (Echelle Based Spectrometers produced by LASERTECHNIK BERLIN GmbH). Gigaphoton's recent technology successfully reduced the E95 target value from the existing 300 fm to 200 fm by decreasing the optical thermal load for the LNM (Line-Narrowing Module) [1]. Under current measurement method, the error will be increased, when E95 is set at 200 fm. In order to resolve this problem, Gigaphoton uses a grating base spectral measurement, to reduce the error, by optical engineering improvement and high-resolution spectrum measurement. This ultra-high-resolution measurement impact to OPE error reduction.

Objective The incidence of breast cancer has progressively increased, making it the leading cause of cancer deaths in Japan. Breast cancer accounts for 20.4% of all new cancers with a reported age-standardized rate of 63.6 per 100 000 women. Methods The Japanese guidelines for breast cancer screening were developed based on a previously established method. The efficacies of mammography with and without clinical breast examination, clinical breast examination and ultrasonography with and without mammography were evaluated. Based on the balance of the benefits and harms, recommendations for population-based and opportunistic screenings were formulated. Results Five randomized controlled trials of mammographic screening without clinical breast examination were identified for mortality reduction from breast cancer. The overall relative risk for women aged 40-74 years was 0.75 (95% CI: 0.67-0.83). Three randomized controlled trials of mammographic screening with clinical breast examination served as eligible evidence for mortality reduction from breast cancer. The overall relative risk for women aged 40-64 years was 0.87 (95% confidence interval: 0.77-0.98). The major harms of mammographic screening were radiation exposure, false-positive cases and overdiagnosis. Although two case-control studies evaluating mortality reduction from breast cancer were found for clinical breast examination, there was no study assessing the effectiveness of ultrasonography for breast cancer screening. Conclusions Mammographic screening without clinical breast examination for women aged 40-74 years and with clinical breast examination for women aged 40-64 years is recommended for population-based and opportunistic screenings. Clinical breast examination and ultrasonography are not recommended for population-based screening because of insufficient evidence regarding their effectiveness.

Angiotensin-converting enzyme (ACE) exists in the kidney, lung and small intestine of the NOD mouse (autoimmune type 1 diabetes animal model). ACE changes Angiotensin I to Angiotensin II. ACE exists in the small intestinal epithelial cells and villi, and digests the protein antigen molecules in the small intestine. ACE plays an important role in the antigen presenting process in the mucosal immune system of the duodenum and jejunum. To examine the role of ACE in the development of type 1 diabetes of the NOD mouse, ACE-Inhibitors (ACEI): captopril (CA) or enalapril maleate (EM) was dissolved in a drinking water at the concentration of 12.5mg/ml and given daily to 28-day-old NOD females and males ad libitum (89 females and 70 males in CA, 72 and 52 in EM, 120 and 87 in water control group, respectively). The animals were screened for the development of diabetes twice a week for 7 months and subjected to the Life Table analysis. The incidence of diabetes in our NOD/Kmc colony is 83% in females and 40% in males at 210 days of age. The EM-treated NOD mice showed a significant delay of the onset of diabetes at 120 days of age in comparison with the controls (25% vs. 45% in females, p=0.002; 0% vs. 8% in males, p=0.037). The CA treatment was ineffective to delay the onset of diabetes. The histopathological examination of the pancreata showed that the EM-treated females had more islets without lymphocytic infiltration than the CA-treated or the water-control females. The mRNA expression of MHC K and A genes was suppressed in the duodenum and jejunum of the NOD mice by EM- or CA-water for 14 days. Flow cytometric analysis showed suppression of the MHC K and I-A expression in the pancreatic lymphocytes of the EM- and CA-treated mice in comparison with the control mice.

The lifetime of optics, especially windows, has grown to reach 100 Bpls, and its evaluation lasts for several years at least. In elementary testing (short term), focusing on each damage phenomenon must be established. The degradation of calcium fluoride windows used as laser chamber windows in ArF excimer lasers (193-nm wavelength, 30-ns pulse width, 10-mJ output energy, ~80-mJ/cm2, 6-kHz and several dozen billion pulses) is analyzed. The results of analysis such as TEM-EDX, Nomarski-type differential interference contrast (DIC) microscope, AFM, etc. is shown. The damage mechanism can be estimated from these results. Comprehensive durability evaluation becomes more efficient by creating accelerated element tests (short term).

Single-incision laparoscopic surgery (SILS) has been developed with the aim to further reduce the invasiveness of conventional laparoscopy. Our experiences with more than 300 consecutive patients with SILS for colon cancer are reviewed, and its outcomes are evaluated to determine the midterm clinical and oncologic safety of SILS for colon cancer in a community hospital. A single surgeon's consecutive experience of SILS for colon cancer is presented. Three hundred and eight patients were treated with the SILS procedure for colon cancer between December 2010 and March 2015. Data were analyzed according to intention to treat. Of these 308 patients, 19 (6.2%) were converted to laparotomy. Intraoperative injury occurred in five patients. Postoperative complications occurred in 19 patients (6.2%). The 2-year relapse-free survival rates of patients with Stage I, Stage II, and Stage III were 97.8, 92.2, and 80.4 per cent, respectively, and the 2-year overall survival rates of patients with Stage I, Stage II, Stage III, and Stage IV were 100, 95.7, 93.0, and 74.4 per cent, respectively. Our initial experiences showed that SILS colectomy for cancer can be performed safely and with good short-term oncologic outcomes by a skilled surgeon.

Background: Recent improvements in 5-year survival of breast cancer have been reported in Japan and other countries. Though the number of long-term breast cancer survivors has been increasing, recent improvements in 10-year survival have not been reported. Moreover, the degree of improvement according to age and disease stage remains unclear. Methods: We calculated long-term survival using data on breast cancer diagnosed from 1993 through 2006 from six prefectural population-based cancer registries in Japan. The recent increase in 10-year relative survival was assessed by comparing the results of period analysis in 2002–2006 with the results of cohort analysis in 1993–1997. We also conducted stratified analyses by age group (15–34, 35–49, 50–69, and 70–99 years) and disease stage (localized, regional, and distant). Results: A total of 63,348 patients were analysed. Ten-year relative survival improved by 2.4% (76.9% vs 79.3%) from 1993 through 2006. By age and stage, 10-year relative survival clearly improved in the age 35–49 years (+2.9%; 78.1% vs 81.0%), 50–69 years (+2.8%; 75.2% vs 78.0%) and regional disease (+3.4%; 64.9% vs 68.3%). In contrast, the degree of improvement was small in the age 15–34 years (+0.1%; 68.2% vs 68.3%), 70–99 years (+1.0%; 87.6% vs 88.6%), localized disease (+1.1%; 92.6% vs 93.7%) and distant metastasis (+0.9%; 13.8% vs 14.7%). Conclusions: These population-based cancer registry data show that 10-year relative survival improved 2.4% over this period in Japan. By age and stage, improvement in the age 15–34 years and distant metastasis was very small, which suggests the need for new therapeutic strategies in these patients.