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Dai Sonoda,1,2 Yosuke Matsuura,1 Junji Ichinose,1 Masayuki Nakao,1 Hironori Ninomiya,3 Mingyon Mun,1 Yuichi Ishikawa,3 Ken Nakagawa,1 Yukitoshi Satoh,2 Sakae Okumura11Department of Thoracic Surgical Oncology, The Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo 135-8550, Japan; 2Department of Thoracic Surgery, Kitasato University School of Medicine, Sagamihara, Kanagawa 252-0374, Japan; 3Department of Pathology, The Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo 135-8550, JapanPurpose: Most postoperative recurrences of non-small cell lung cancer (NSCLC) develop within 5 years after curative resection, with ultra-late recurrences developing over 10 years after the resection being rare. This study aimed to analyze the features of ultra-late recurrence in cases with NSCLC who had undergone curative resection.Patients and methods: Among 1458 consecutive cases with NSCLC who underwent curative resection with systematic lymph node dissection during 1990–2006, 12 cases developed recurrence over 10 years after the resection. We defined the recurrence developing over 10 years after the resection as ultra-late recurrence and analyzed the factors related to it.Results: Among the 1458 cases, recurrence developed in 476 (32.6%) cases. Of them, ultra-late recurrence developed in 12 (2.5%) cases. The ultra-late recurrence was histopathologically classified as adenocarcinoma in 11 cases and atypical carcinoid in 1 case. All cases were of invasive carcinoma. We compared ultra-late recurrence cases with non-recurrence cases and showed that none of the examined factors significantly influenced ultra-late recurrence; however, lymphatic invasion was close to significantly influencing it. There were two cases in which recurrence developed over 15 years after the resection; both cases were of adenocarcinoma with anaplastic lymphoma kinase (ALK) rearrangement.Conclusion: There is a possibility of ultra-late recurrence developing over 10 years after the resection of any invasive NSCLC. Lymphatic invasion is close to significantly influencing ultra-late recurrence. Furthermore, a long follow-up period may be required in cases with adenocarcinoma with ALK rearrangement because it has the possibility of recurrence over 15 years after the resection.Keywords: lung cancer, recurrence, resection, ALK rearrangement

Yuhei Hatakenaka,1,2 Hitoshi Ninomiya,3 Eva Billstedt,2 Elisabeth Fernell,2 Christopher Gillberg2 1Kochi Gillberg Neuropsychiatry Centre, Kochi Prefectural Medical and Welfare Center, Kochi, Japan; 2Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; 3Integrated Centre for Advanced Medical Technologies, Kochi University Medical School, Kochi, Japan Background: Screening for developmental disorders is an important task for Child Health Care. The concept of ESSENCE (early symptomatic syndromes eliciting neurodevelopmental clinical examinations) was created to cover all types of early developmental disorders and the ESSENCE-Questionnaire (ESSENCE-Q containing 12 questions with possible total scores ranging from 0 to 22) was developed as a tool for early detection of these disorders. The aim of this study was to perform a validation study in a public health situation in Japan.Methods: The psychometric properties of the ESSENCE-Q, completed by mothers, public health nurses (PHNs), and psychologists at 18-month (n=143 children) and 36-month (n=149 children) checkups were evaluated in a small city of Japan. Results were validated against clinical ESSENCE diagnoses. Receiver operating characteristic curves were generated and compared by using the area under the curve (AUC). Optimal cutoff values were explored.Results: At the 18-month checkup, AUC by mothers was 0.72, by PHNs 0.86, and by psychologists 0.82. An optimal cutoff was 3 with a high negative predictive value (NPV). At the 36-month checkup, AUC by mothers was 0.57, by PHNs 0.82, and by psychologists 0.87. Optimal cutoff was 2 with high NPV.Conclusion: The ESSENCE-Q completed by PHNs and psychologists had good diagnostic validity. The results suggested that almost all children scoring under cutoff would not have any ESSENCE problems/diagnoses. Keywords: ESSENCE, questionnaire, public health nurse, receiver operating characteristic, ROC, area under the curve, AUC, optimal cutoff, negative predictive value, NPV

Yuhei Hatakenaka,1,2 Elisabeth Fernell,2 Masahiko Sakaguchi,3 Hitoshi Ninomiya,3 Ichiro Fukunaga,1 Christopher Gillberg2 1Kochi Gillberg Neuropsychiatry Centre, Kochi Prefectural Medical and Welfare Centre, Kochi, Japan; 2Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; 3Integrated Centre for Advanced Medical Technologies, Kochi University Medical School, Kochi, Japan Background: Early identification of autism spectrum disorder, intellectual developmental disorder, attention-deficit/hyperactivity disorder, and other neurodevelopmental disorders/problems is crucial, yet diagnosis is often delayed for years under the often misguided “wait-and-see” paradigm. The early symptomatic syndromes eliciting neurodevelopmental clinical examinations-questionnaire (ESSENCE-Q) is a brief (12-item) screening questionnaire developed specifically for the purpose of speeding up the identification process of a wide variety of neurodevelopmental problems. The aims were to 1) estimate the reliability of the ESSENCE-Q, 2) evaluate the clinical cutoff levels suggested by the author of the ESSENCE-Q, and 3) propose optimal cutoff levels based on receiver operating characteristic analysis.Methods: The ESSENCE-Q was used for 1 year by a psychiatrist in Kochi, Japan, assessing children under the age of 6 years referred for developmental problems. The children were also clinically assessed with regard to whether or not they met criteria for a developmental disorder (diagnosis positive and diagnosis negative groups). We contrasted the results of the ESSENCE-Q and those of clinical diagnostic assessments in 130 cases.Results: Cronbach’s alpha was 0.82, sensitivity was 0.94 (95% confidence interval [CI]: [0.88, 0.98]), and specificity 0.53 (95% CI: [0.28, 0.77]), which are reasonable psychometrics for a first-step screening tool. Based on receiver operating characteristic analysis, we recommended an optimal cutoff level of yes ≥2 or maybe/a little ≥3 on the ESSENCE-Q (0.87 (95% CI: [0.79, 0.92]) sensitivity and 0.77 (95% CI: [0.50, 0.93]) specificity).Conclusion and implication: The ESSENCE-Q can be a good instrument for use as a screening tool for aiding in the process of early identification of neurodevelopmental disorders in clinical settings. To establish the broader validity and reliability of the ESSENCE-Q, case–control studies and general population studies of children in different age groups are needed. Keywords: ESSENCE, ESSENCE-Q, cutoff levels, receiver operating characteristic analysis

Substituting fossil fuel with woody biomass for bioelectricity production has great potentials for carbon emission reductions while increasing forest productivity to increase carbon sequestration and improve ecological functionalities. Until recently, study on such potentials was very limited. Beginning in 2007, Japan’s special budgets were allocated for a 6-year intensive thinning on about 3.3 million ha of young stands for increasing carbon sinks in Japanese forests to meet the capped amount of 47.7 Tg CO2 year-1 allowed under the Marrakesh Accord. Because of only 30% of the thinned wood were used for sawntimber, CO2 and CH4 must have been emitted from the disposed thinned wood and wood waste. Such emissions and reduction potentials need to be assessed to provide future alternatives for climate change mitigation. We assessed carbon emission reduction potentials when woody biomass from thinned wood is fully utilized for bioelectricity production as compared with the generation of the same amount of energy produced under coal, oil, and natural gas scenarios. Our analytical results show that if all disposed thinned wood and wood waste are utilized to generate energy, about 62.6, 58.3, and 37.8 Tg CO2 year-1 could be prevented from emitting depending on emission scenarios or about 33.2, 30.9, and 20.0% of Japan’s reduction commitment to the Kyoto Protocol. On the other hand, if thinned wood and wood waste are not utilized, about 13.4 Tg CO2 year-1 would be released due to thinning. Our results suggest that incentives to reducing emission reductions in forest sector in the future climate change mitigation agreements will likely lead to large emission reductions, otherwise leakages due to thinning are unavoidable.

J Neurol Neurosurg Psychiatry 2004;75:466-471. doi: 10.1136/jnnp.2002.01834 Objective: Application of spatially filtered magnetoencephalography (MEG) to investigate changes in the mechanism of cerebral motor control in patients with tumours around the [...]

Experimental testing was used to measure the time variationof population densities of V atoms in absorption levels pertinent to an optically pumped atomic V vapor laser. The results showed that irradiation of aV metal by a pumped laser produces V vapor. Population densities of the ground-state and excited-state V atoms allow the vapor temperature to be estimated, and the temperature in the vapor exhibited an increase from 1800 to 4000 K during laser irradiation.