Search

Endoscopic resection (ER) for early gastric cancer (EGC) can preserve the stomach; however, the remaining stomach can develop second gastric cancer. Few reports have prospectively investigated the incidence and treatment outcomes of second gastric cancer.This post-hoc analysis used the dataset of the single-arm confirmatory trial, JCOG0607. The key inclusion criteria for JCOG0607 were solitary differentiated-type EGC and no previous gastrectomy or endoscopic treatment for EGC. Three hundred seventeen patients who underwent curative ER were included in this study. Surveillance endoscopy was performed 1 to 3 months after the initial ER and subsequently annually for at least 5 years. A lesion detected ≤1 year and1 year after the initial ER was defined as overlooked gastric cancer (OGC) and metachronous gastric cancer (MGC), respectively.During a median follow-up period of 6.0 years (interquartile range, 5.1-7.0), 30 OGCs and 61 MGCs were detected in 24 and 48 patients, respectively. The cumulative incidence of OGC at 1 year and MGC at 5 years was 7.6% and 12.7%, respectively. ER and gastrectomy were performed in 85 lesions and 6 lesions, respectively. Pathologic evaluation showed 78 mucosal cancers, 12 submucosal cancers, and 1 advanced cancer. Eventually, 28 OGCs and 52 MGCs fulfilled the pathologic criteria for curative ER.Our study was the first to reveal the actual incidence of second gastric cancer after curative ER for differentiated-type gastric cancer. Most lesions could be treated with ER. Continuous endoscopic surveillance after curative ER is important to detect second gastric cancer.

Purpose To compare clinical success rates and reductions in intraocular pressure (IOP) and IOP-lowering medication use following suture trabeculotomy ab interno (S group) or microhook trabeculotomy (μ group). Methods This retrospective review collected data from S (n = 104, 122 eyes) and μ (n = 42, 47 eyes) groups who underwent treatment between June 1, 2016, and October 31, 2019, and had 12-month follow-up data including IOP, glaucoma medications, complications, and additional IOP-lowering procedures. The Kaplan–Meier survival analysis was used to evaluate treatment success rates defined as normal IOP (> 5 to ≤ 18 mm Hg), ≥ 20% reduction of IOP from baseline at two consecutive visits, and no further glaucoma surgery. Results Schlemm’s canal opening was longer in the S group than in the μ group (P P = 0.230). The Kaplan–Meier survival analysis of eyes with preoperative IOP ≥ 21 mmHg showed cumulative clinical success rates in S and μ groups were 80.4% and 60.0% (P = 0.0192). There were no significant differences in postoperative IOP at 1, 3, and 6 months (S group, 14.9 ± 5.6, 14.6 ± 4.5, 14.6 ± 3.9 mmHg; μ group, 15.8 ± 5.9, 15.2 ± 4.4, 14.7 ± 3.7 mmHg; P = 0.364, 0.443, 0.823), but postoperative IOP was significantly lower in the S group at 12 months (S group, 14.1 ± 3.1 mmHg; μ group, 15.6 ± 4.1 mmHg; P = 0.0361). There were no significant differences in postoperative numbers of glaucoma medications at 1, 3, 6, and 12 months (S group, 1.8 ± 1.6, 1.8 ± 1.5, 2.0 ± 1.6, 1.8 ± 1.5; μ group, 2.0 ± 1.6, 2.0 ± 1.6, 2.1 ± 1.6, 2.2 ± 1.7; P = 0.699, 0.420, 0.737, 0.198). Conclusion S and µ group eyes achieved IOP reduction, but μ group eyes had lower clinical success rates among patients with high preoperative IOP at 12 months.

During the large-area EB irradiation, plasma generation is confirmed by collision of electrons with vaporized workpiece materials above the substrate surface due to its high energy density. This phenomenon would cause the sputtering of target material when it is set near the substrate surface. Thus, there is a possibility for coating a target material on the substrate surface by the large-area EB irradiation. The simultaneous sputter deposition of target material with melting and resolidification of workpiece surface by the large-area EB would improve the adhesion strength between the coated film and the workpiece surface. In this study, a new ceramics coating method with sputtering of target tube by large-area EB irradiation is proposed. Ceramic target tube made of alumina is put on the substrate surface of mold steel, and the large-area EB is irradiated to the substrate surface. The alumina film with thickness of several micro meter can be formed on the substrate surface. Moreover, the film formation mechanism is discussed by changing material property of a jig supporting the alumina target tube. The spectrum of plasma generated on the substrate surface during the EB irradiation is also analyzed. It is made clear that the magnetic property of jig greatly influences on the film formation. Furthermore, main components of plasma generated on workpiece surface during the process are components of steel in the case of low number of EB irradiation, while much more alumina component as a film is detected in the case of high number of EB irradiation.

Background and Aims: Endoscopic submucosal dissection (ESD) seems to be a reasonable option for gastrointestinal subepithelial lesions (SELs) localized within the submucosa. Indications for ESD include small neuroendocrine tumors (NETs) and indeterminate SELs. However, the prospective data regarding ESD and surveillance remain unclear. This study was performed to prospectively investigate the outcomes of ESD, including organ-specific outcomes and the mid-term prognosis. Methods: This prospective multicenter study included 57 patients who underwent ESD for SELs localized within the submucosa [definite NETs (n = 42) and indeterminate SELs (n = 15)]. The efficacy and safety of ESD were evaluated in the whole cohort and in subgroups (NETs and indeterminate SELs). All patients were followed up. Results: The rates of en bloc resection, curative resection, and complications were 98.2%, 66.7%, and 7.7% for the overall population (n=57); 100%, 61.9%, and 2.4% for NETs (n=42); and 93.3%, 80.0%, and 20.0% for indeterminate SELs (n=15), respectively. The rates of curative resection for NETs were poorer in the stomach (20%, n=5) and duodenum (33%, n=3) than in the rectum (71%, n=34). Including 11 of 16 patients with NETs who underwent a conservative approach resulting in non-curative resection, no patients developed tumor recurrence during the follow-up period (median, 24.5 months; range, 1–60 months). ESD followed by surveillance demonstrated acceptable mid-term outcomes for non-curative NETs. Conclusions: ESD can be an efficient therapy for SELs localized within the submucosa. However, gastric and duodenal ESD for NETs may be limited in terms of its curative and technical aspects. Clinicians should be aware of the potential complications of ESD for indeterminate SELs.

The Over-The-Scope Clip (OTSC) can effectively treat refractory gastrointestinal diseases. However, most reports have focused on short-term effectiveness. We examined clinical outcomes of the deployed clips and long-term characteristics.Of 47 patients with OTSC treatment, 35 with follow-up periods of ≥3 months were retrospectively examined. The indications were 11 bleedings, 17 perforations, and seven fistulas. The observation period was defined as medium-term (3 to12 months) or long-term (≥12 months). The primary outcome was the clinical success rate without disease recurrence. The secondary outcomes were the complication rate, survival duration, and clip retention rate.The medium- and long-term clinical success rates were 100% during the observation period (median, 44 months; range, 3-78 months). The complication rate was 2.9% (Regardless of clip detachment, the OTSC can be effective in long-term.

Background: Conventional trabeculotomy (CT) is performed in an ab-externo manner with at most 120 degrees of incision area of Schlemm’s canal (SC). Recently, gonioscopy-assisted transluminal trabeculotomy (GATT), which makes possible a 360-degree incision area of SC in an ab-interno manner, is introduced. The purpose of this study was to compare surgical outcomes for CT and GATT with and without simultaneous phacoemulsification over 24 months and to identify factors associated with surgical success. Results: Patients’ baseline characteristics were not significantly different between two groups. The surgical success rate in CT and GATT with phacoemulsification groups were 40.4% and 96.6% and were significantly higher in the GATT group than in the CT group (p < 0.001). However, the surgical success rate in CT and GATT without phacoemulsification groups were 40.8% and 54.2%, and there were no significant differences between two groups without phacoemulsification (p = 0.55). Similarly, the postoperative IOP was significantly lower in the GATT group than in the CT group only in eyes with simultaneous phacoemulsification. There were no significant differences in the numbers of glaucoma medications between the two groups. Additional glaucoma surgery was needed in 13.2% and 25.9% of patients in the GATT and CT groups, respectively (p = 0.157). The multivariate logistic regression analysis revealed that the surgical success of trabeculotomy was significantly associated with combined phacoemulsification and the type of glaucoma surgery (GATT). Conclusion: Although both groups without phacoemulsification had a similar surgical success and IOP-lowering effect, GATT combined with phacoemulsification had a higher surgical success rate and a greater IOP-lowering effect compared with combined CT and phacoemulsification. Multivariate logistic regression analysis showed that the factors associated with higher surgical success at one year and two years postoperatively were the combined phacoemulsification procedure and the GATT.

In this paper, we focus on Kendo, which is a traditional sport in Japan, and propose a strikes-thrusts activity recognition method using a wrist sensor towards a pervasive Kendo support system. We collected the inertial sensor data set from 6 subjects. We attached 3 inertial sensor units (IMUs) on the subjects body, and 2 IMUs on the Shinai (bamboo sword used for Kendo). On the body, IMUs were placed on the Right Wrist, Waist and Right Ankle. On the Shinai, they were placed on the Tsuba and Saki-Gawa. We first classified strikes-thrusts activities consisting of 4 general types, Men, Tsuki, Do, and Kote, followed by further classification into 8 detailed types. We achieved 90.0% of F-measure in the case of 4-type classification and 82.6% of F-measure in the case of 8-type classification when learning and testing the same subjects data for only Right Wrist. Further, when adding data of sensors attached to the Waist and Right Ankle, we achieved 97.5% of F-measure for 4-type classification and 91.4% of F-measure for 8-type classification. As a result of leave-one-person-out cross-validation from 6 subjects to confirm generalized performance, in the case of 4-type classification, we achieved 77.5% of F-measure by using only 2 IMUs (Right Wrist and Shinai Tsuba).

The organic LED (OLED) performance of standard bilayer OLEDs with three different cathode materials has been studied. The device structure was indium tin oxide/1,4,5,8,9,11-hexaazatriphenylene-hexacarbonitrile/N,N'-di(1-naphthyl)-N,N'-diphenylbenzidine/tris-(8-hydroxyquinolate) aluminum/cathode of aluminum, silver-doped magnesium or lithium fluoride/aluminum. Negative capacitance is observed in the OLEDs with the three different cathodes, and the value of the negative capacitance is closely correlated to the current efficiency of the OLEDs and to the device lifetime. The experimental results are examined with the aid of device simulation. It is shown that measurements of negative capacitance in the bilayer OLEDs can offer useful information concerning device operation and degradation.

We report a case of a corneal disorder after breast cancer treatment with a microtubule inhibitor, nab-paclitaxel (Abraxane).A 55-year-old woman, who was referred to our clinic, presented with blurred vision. 2 weeks previously, she had been undergoing treatment with nab-paclitaxel, trastuzumab and pertuzumab. Visual acuity was 20/60 in right eye and 20/40 in left eye. Slit-lamp examination showed an atypical epithelium invasion of the cornea in both eyes and small epithelial defect in left eye. After the nab-paclitaxel treatment was discontinued the corneal findings improved. 4 months later, visual acuity was 20/15 in right eye and 20/20 in left eye.Nab-paclitaxel can cause severe corneal disorders, but the possibility that trastuzumab and pertuzumab combination therapy is associated with these disorders cannot be denied. Clinicians should consider the possibility of the side effects caused by systemic administration in cases of corneal disorders of uncertain etiology.

The degradation of bilayer organic light-emitting diodes (OLEDs) with a device structure of N, N′-di(1-naphthyl)-N, N′-diphenylbenzidine (α-NPD) (hole transport layer) and tris-(8-hydroxyquinolate)aluminum (Alq3) (emissive layer and electron transport layer) has been studied by impedance spectroscopy and device simulation. Two modulus peaks are found in the modulus spectra of the OLEDs below the electroluminescence threshold. After aging of the OLEDs, the intensity of electroluminescence is degraded and the modulus peak due to the Alq3 layer is shifted to lower frequency, indicating that the resistance of the Alq3 layer is increased. Device simulation reveals that the increase in the resistance of the Alq3 layer is due to the decrease in the electron mobility in the Alq3 layer.

An analytical expression for impedance spectra in the case of double injection (both electrons and holes are injected into an organic semiconductor thin film) has been derived from the basic transport equations (the current density equation, the continuity equation and the Possion’s equation). Capacitance-frequency characteristics calculated from the analytical expression have been examined at different recombination constants and different values of mobility balance defined by a ratio of electron mobility to hole mobility. Negative capacitance appears when the recombination constant is lower than the Langevin recombination constant and when the value of the mobility balance approaches unity. These results are consistent with the numerical results obtained by a device simulator (Atlas, Silvaco).

Increasing evidences show that immune response affects the reparative mechanisms in injured brain. Recently, we have demonstrated that CD4(+)T cells serve as negative modulators in neurogenesis after stroke, but the mechanistic detail remains unclear. Glucocorticoid-induced tumor necrosis factor (TNF) receptor (GITR), a multifaceted regulator of immunity belonging to the TNF receptor superfamily, is expressed on activated CD4(+)T cells. Herein, we show, by using a murine model of cortical infarction, that GITR triggering on CD4(+)T cells increases poststroke inflammation and decreases the number of neural stem/progenitor cells induced by ischemia (iNSPCs). CD4(+)GITR(+)T cells were preferentially accumulated at the postischemic cortex, and mice treated with GITR-stimulating antibody augmented poststroke inflammatory responses with enhanced apoptosis of iNSPCs. In contrast, blocking the GITR-GITR ligand (GITRL) interaction by GITR-Fc fusion protein abrogated inflammation and suppressed apoptosis of iNSPCs. Moreover, GITR-stimulated T cells caused apoptosis of the iNSPCs, and administration of GITR-stimulated T cells to poststroke severe combined immunodeficient mice significantly reduced iNSPC number compared with that of non-stimulated T cells. These observations indicate that among the CD4(+)T cells, GITR(+)CD4(+)T cells are major deteriorating modulators of poststroke neurogenesis. This suggests that blockade of the GITR-GITRL interaction may be a novel immune-based therapy in stroke.

Transplantation of neural stem cells (NSCs) has been proposed as a therapy for a range of neurological disorders. To realize the potential of this approach, it is essential to control survival, proliferation, migration, and differentiation of NSCs after transplantation. NSCs are regulated in vivo, at least in part, by their specialized microenvironment or “niche.” In the adult central nervous system, neurogenic regions, such as the subventricular and subgranular zones, include NSCs residing in a vascular niche with endothelial cells. Although there is accumulating evidence that endothelial cells promote proliferation of NSCs in vitro, there is no description of their impact on transplanted NSCs. In this study, we grafted cortex-derived stroke-induced neural stem/progenitor cells, obtained from adult mice, onto poststroke cortex in the presence or absence of endothelial cells, and compared survival, proliferation, and neuronal differentiation of the neural precursors in vivo. Cotransplantation of endothelial cells and neural stem/progenitor cells increased survival and proliferation of ischemia-induced neural stem/progenitor cells and also accelerated neuronal differentiation compared with transplantation of neural precursors alone. These data indicate that reconstitution of elements in the vascular niche enhances transplantation of adult neural progenitor cells. Disclosure of potential conflicts of interest is found at the end of this article.

S状結腸癌の手術前検索にて偶然発見されたvon Meyenburg complexの1例を経験したので,これを報告する.症例は70歳男性. S状結腸癌手術前検索で肝臓の両葉にわたり多発する小さな腫瘤性病変を認めた. MRIにて嚢胞性疾患が疑われたが,腹部超音波検査では多彩なエコーレベルを呈する小結節性陰影として描出された.病理組織学的には嚢胞状に拡張した胆管を認め,これらは既存の胆管との交通を認めずvon Meyenburg complexと診断された.von Meyenburg complexは胆管過誤腫性病変といわれている.臨床症状は特に無いので,日常診療で経験されることは稀であるが,今後画像診断の向上とともに遭遇する機会が増えてくるものと思われる.転移性肝腫瘍との鑑別診断にはMRIが有用であると思われた.

宮崎県佐土原町の圃場において, キャベツを定植した灰色低地土の緩斜面圃場 (A1: 1.7°, 5a) で1997年5～7月の梅雨期に地表水の流出が計13回観察された. この圃場にダイアジノン粒剤の定植時処理 (a. i. 300g/10a), その55日後にTPN (400mg/l) とジメトエート (430mg/l) の混用液 (239 1/10a), その8日後にTPN, ダイアジノン (400mg/l) とジメトエートの混用液 (224 1/10a) を散布した. 表流水によって流出したTPNの96% (流出直後) から47% (終了直前) は, 浮遊物質 (SS) とともに流出した. 一方, ダイアジノンとジメトエートはそれぞれ33～44%および1%とほぼ一定の割合でSSとともに流出した. また, 同年9～10月の台風時期にはA1圃場の傾斜を1.15°に調整した圃場 (A2) と黒ボク土の圃場 (B, 5a, 傾斜1.15°) にダイコンを播種して地表水の流出頻度を比較した. その結果, 灰色低地土では4回, 黒ボク土では台風時の降雨によって2回の地表流出が認められた. 灰色低地土のA1圃場では平均降雨強度5mm/hr前後以上で, A2圃場では10mm/hr以上の降雨によって, また黒ボク土のB圃場では20mm/hr以上の降雨によって地表水の流出が生じた. さらに, 人工降雨装置を用いた屋内小規模地表流出試験系でも灰色低地土からは黒ボク土よりも容易に表流水が発生した.

Takuji Kurimoto1, Shinichirou Oono1, Hidehiro Oku2, Yuichi Tagami1, Ryousuke Kashimoto1, Masashi Takata1, Norio Okamoto1, Tsunehiko Ikeda2, Osamu Mimura11Department of Ophthalmology, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan; 2Department of Ophthalmology, Osaka Medical College, Takatsuki, Osaka, Japan Purpose: The aim of this article is to investigate the effect of transcorneal electrical stimulation (TES) on chorioretinal blood flow in healthy human subjects.Methods: The chorioretinal blood flow of 10 healthy subjects was measured before and after TES by laser speckle flowgraphy and expressed as the square blur rate (SBR). The chorioretinal blood flow was determined before and immediately after TES and 0.5, 1, 1.5, 2, 2.5, 3, 24, and 40 h after TES in three different areas: the margin of the optic disc, a point located midway between the optic disc and macula, and the macula area. The SBR of the stimulated eye is expressed relative to the value of the fellow eye. The mean standardized blur ratio was calculated as the ratio of the standardized SBR to the baseline SBR. The changes of intraocular pressure (IOP), blood pressure (BP), and pulse rate (PR) were determined after each measurement of the SBR. The ocular perfusion pressure (OPP) was calculated from BP and IOP.Results: The mean standardized blur ratio at the optic disc did not change significantly throughout the course of the experiment. However, the mean standardized blur ratio midway between the optic disc and macula and at the macula area were significantly higher after TES than that after sham stimulation at 3 and 24 h (P < 0.05, P < 0.01, respectively). At all times, the mean BP, PR, IOP, and OPP were not significantly different from the prestimulation values.Conclusions: TES increases the chorioretinal blood flow in normal subjects with minimal effects on the systemic blood circulation and the IOP. The increase in chorioretinal blood flow may be one of the beneficial effects that TES has on ischemic retinal diseases.Keywords: transcorneal electrical stimulation, chorioretinal blood flow, laser speckle flowgraphy, healthy human subjects

Hepatectomy and intraarterial chemotherapy for liver metastasis from colorectal cancer have been performed in our department. Intraarterial infusion chemotherapy has also been performed for unresectable liver metastasis. One hundred twenty-seven cases of liver metastasis from colorectal cancer were studied. The cases were divided into groups according to radicability of the original colorectal cancer, whether or not hepatectomy was performed, and whether or not they received intraarterial chemotherapy. Group I is cur C of origin. Group II is cur A or B without hepatectomy. Group III is cur A or B with hepatectomy. Each group was divided into a group without intraarterial chemotherapy (A) and a group with it (B). IA 23 cases, IB 13 cases, IIA 14 cases, IIB 21 cases, IIIA 28 cases, and IIIB 28 cases. The survival rate of group III was better than that of group II. The survival rate of group II was better than that of group I. There was no significant difference in survival rates between IA and IB. The survival rate of group IIB was significantly better than that of group IIA. The survival rate of group IIIB was significantly better than that of group III A. Hepatectomy and intraarterial chemotherapy after hepatectomy for liver metastasis from colorectal cancer were effective.

We propose a novel architecture (phase change nonvolatile SRAM: PNSRAM) combining SRAM with PRAM. This architecture is possible solution to reduce the program cycle at the nonvolatile material to be divided a program sequence into volatile and nonvolatile. In this paper, we describe the PNSRAM architecture and a circuit simulation results of the volatile and nonvolatile operation

The effect of contact resistance on the determination of charge carrier mobility in single-injection space-charge-limited (SCL) diodes is numerically examined. Contact resistance is inevitably involved in the equivalent circuit of the SCL diodes. It is found that the mobility is accurately determined when it is less than or equal to 1.0 × 10−5 cm2 V−1 s−1 even in the presence of contact resistance at a semiconducting layer thickness of 100 nm, which is comparable to the active layer thickness of organic electronic devices, such as organic light-emitting diodes and organic photovoltaic devices. In contrast, when the input mobility is greater than 1.0 × 10−4 cm2 V−1 s−1 for the numerical calculation, the calculated mobility decreases with increasing contact resistance. Such information is an important guideline for the accurate measurements of mobility in single-injection SCL diodes.