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Cronkhite-Canada syndrome (CCS) is a non-hereditary disorder characterized by non-neoplastic gastrointestinal polyposis and ectodermal changes. While corticosteroids are considered effective, some cases are refractory. A 48-year-old woman presented with diarrhea, anorexia, and epigastralgia lasting for 3 months. She suffered from alopecia and nail dystrophy. Gastrointestinal endoscopy with histological examination confirmed non-neoplastic polyposis from the stomach to the rectum, confirming the diagnosis of CCS. Linked color imaging (LCI) with magnified endoscopy revealed a ribbon-like proliferation of capillaries surrounding the pits in the colonic mucosa. Histologically, the polyps had dilated glands, edematous stroma with inflammatory cell infiltrates and increased capillaries just beneath the epithelium. Immunohistochemical examination confirmed the expression of vascular endothelial growth factor (VEGF), mainly in the superficial epithelial and crypt cells. Steroid therapy was ineffective, and concomitant infliximab therapy provided symptomatic relief. Although symptoms rapidly improved with combination therapy, capillary hyperplasia and slight inflammation persisted in the colon mucosa after polyp resolution. Withdrawal of steroid treatment resulted in flare-ups of symptoms and polyps. Repeated magnified observations at LCI during post-relapse retreatment clearly captured the resolution process of both neovascularization and inflammation. Once the capillary hyperplasia and inflammation subsided, the steroid could be tapered off without relapse. To our knowledge, this is the first report describing the involvement of VEGF-induced angiogenesis and LCI findings in CCS; LCI observations are useful not only in the active phase of CCS, but also in determining subtle capillary hyperplasia and residual inflammation in remission, which may be an indicator of continued treatment.

The purpose of this study was to evaluate the effectiveness of a wound closure method using a combination of subcuticular sutures and subcutaneous closed-suction drainage (SS closure) for preventing incisional surgical site infection (SSI) in loop ileostomy closure. A total of 178 consecutive patients who underwent loop ileostomy closure at Nara Medical University Hospital between 2004 and 2018 were retrospectively assessed. The patients were divided into 2 groups: the conventional skin closure (CC) group from 2004 to 2009 (75 patients) and the SS closure (SS) group from 2010 to 2018 (103 patients). The incidence of incisional SSI was compared between the two groups, and the factors associated with incisional SSI were examined by univariate and multivariate analyses. Incisional SSI occurred in 7 cases (9.3%) in the CC group but was significantly reduced to only 1 case (0.9%) in the SS group (p = 0.034). In the univariate analysis, the hemoglobin levels, serum creatinine levels, and SS closure were associated with incisional SSI. SS closure was the only independent preventive factor for incisional SSI according to the multivariate analysis (hazard ratio = 0.24, p = 0.011). The combination of subcuticular sutures and subcutaneous closed-suction drainage may be a promising way of preventing incisional SSI in loop ileostomy closure.

Colorectal endoscopic submucosal dissection (ESD) produces exfoliated tumor cells that occasionally cause local recurrence. However, the biological characteristics of these tumor cells have not been clarified. The aim of this study was to clarify the genetic background and viability of exfoliated tumor cells in colorectal ESDs, as well as possible method for their elimination. Post-ESD intraluminal lavage samples from 19 patients who underwent colorectal ESDs were collected. In four patients with adenocarcinoma, gene mutations in the primary tumors and exfoliated cells in lavage samples were analyzed using a next-generation sequencer (NGS). In 15 patients with adenoma or adenocarcinoma, the viability of exfoliated cells and the cell-killing effect of povidone-iodine on exfoliated cells were evaluated. The analysis using a NGS demonstrated that tumors targeted for ESD had already acquired mutations in many genes involved in cell proliferation, angiogenesis, and invasions. Furthermore, gene mutations between the exfoliated tumor cells and tumors resected by ESDs showed a 92 to 100% concordance. The median viable cell counts and the median viability of exfoliated cells in intraluminal lavage samples after ESDs were 4.9 × 105 cells/mL and 24%, respectively. The viability of the exfoliated cells did not decrease even 12 h after ESD. However, contact with 2.0% povidone-iodine solution reduced both viable cell counts and viability, significantly. A large number of tumor cells exfoliated during colorectal ESDs had acquired survival-favorable gene mutations and could survive for some time. Therefore, a lavage using a solution of 2.0% povidone-iodine may be effective against such cells. The prospective study registered 1317, and the retrospective study registered 2729. The prospective study approved on June 20, 2016, and the retrospective study approved on October 6, 2020.

Purpose Lateral lymph node (LLN) metastasis is one of the leading causes of local recurrence in patients with lower rectal cancer. Unfortunately, no diagnostic biomarkers are currently available that can predict LLN metastasis preoperatively. Accordingly, we investigated the relationship between the middle rectal artery (MRA) identified by contrast-enhanced magnetic resonance imaging (ceMRI) and LLN metastases. Methods Data from 102 patients with lower rectal cancer who underwent surgery, and were evaluated by preoperative ceMRI, between 2008 and 2016 were reviewed retrospectively. Two expert radiologists evaluated the MRA findings. The diagnostic performance of MRA for LLN metastasis was evaluated by a multivariate analysis with conventional clinicopathological factors. Results The MRA was detected in 67 patients (65.7%), including 32 (31.4%) with bilateral MRA and 35 (34.3%) with unilateral MRA. The tumor size, presence of the MRA, and clinical LLN status were significantly correlated with LLN metastasis. A multivariate analysis demonstrated that the presence of MRA (P = 0.045) and clinical LLN status (P = 0.001) were independent predictive factors for LLN metastasis. Furthermore, the sensitivity and negative predictive value of MRA for LLN metastasis were 95% and 97.1%, respectively. Conclusion We successfully demonstrated that MRAs could be clearly detected by ceMRI, and the presence of MRA robustly predicted LLN metastasis in patients with lower rectal cancer, highlighting its clinical significance in the selection of more appropriate treatment strategies. Trial registration Trial registration number: retrospectively registered 2126 Trial registration date of registration: August 23, 2019

I am deeply grateful for this opportunity to share with you my reminiscences about the development of ferrite. I am an old man of almost ninety and my English is far from adequate so I have prepared historical notes of my experiments (see Fig. 1).

慢性肝疾患にみられる耐糖能異常の機序を追求する一環として合併する膵内外分泌機能障害の実態を明らかにし,耐糖能との関連性を検討した.慢性肝疾患101例にPancreozymin secretin試験とブドウ糖負荷試験を行い,大多数の例で糖負荷後の血中インスリン反応を,一部の例ではアルギニン静注負荷後の血中インスリン,グルカゴン動態も検討した.膵外分泌機能障害を呈した例は非硬変群の40%,肝硬変群の55%に達したが,その大多数は軽度障害であり,この段階では耐糖能や内分泌機能に対する影響は認められなかった.中等度以上の外分泌機能障害は非硬変の大酒家で多くみられ,耐糖能異常やインスリン低反応,グルカゴン低反応を伴う例が多かった.慢性肝疾患全体としては膵障害は耐糖能異常の発現に著しく関与しているとは言えないが,大酒歴を有する非硬変例で耐糖能低下がみられる時には膵障害の合併も考えて,その検索をすることが大切である.

Manganese bearing wustite containing MnO up to 16 mol % were prepared by powder metallurgical method as was previously reported, and their semiconductive properties were pursued.The Neel point decreased and thermoelectric power increased with the increase of MnO content. Within the temperature range under survey, all specimens were p-type semiconductors and the activation energy for electric conduction was calculated to be 1.1-1.3×10 -1 eV below the Neel point and that of upper to be 0.6-0.8×10-1eV.From the thermomagnetic measurements it was found that the temperature at which thermal decomposition of the quenched specimen took place in reheating decreased as the content of MnO increased. The Curie point of the decomopsed spinel phase was also decreased as the increase of MnO content.From these results, in addition to the results described in the first paper, some points were noticed about the distribution of iron and manganese ions in the wustite phase. That is, spinel like skeleton having n-type behavior were presumed to exist superposed on the wustite lattice locally, especially near grain boundary, and this skeleton was seemed to accelerate the thermal disintegration.

Effects of various factors on the formation, structure and state of the diffusion layer obtained by heating Aluminium-sprayed iron and steel, were studied by microscopic observations. There are a number of factors responsible for the formation of the diffusion layer, among which were discussed the temperature and time of annealing, thickness, porosity and adhesiveness of the sprayed layer, and the carbon content and pre-treatment of the base metal.Some preliminary experiments were made on the usefulness of sealers, together with alternative availability of differently processed sprayed layers. From these results, some fundamental surveys on high temperature behaviors of the diffusion layer are given; hence, conditions for high temperature services of the diffusion-annealed coatings were discussed.Results are summarized as follows:1) Structure and state of the diffusion layer are essentially dependent on the temperature and time of annealing and thickness of the sprayed layer, although other factors have to do with the diffusion-anneal to some extent.2) Porosity and poor adhesion of the sprayed layer are the fatal defects for the production of highly resistant coatings, since they affect the uniformity of the diffusion layer, resulting in partial exposure of the base metal.3) Optimum conditions for the diffusion-anneal were determined from the practical point of view. The most satisfactory diffusion layer is obtained when 0.3mm thick Aluminium-sprayed layer is heated at 900°C for 30min.4) Use of sealar is advantageous when the thickness of the Aluminium-sprayed layer is less than 0.2mm.

Most of the soft ferromagnetic ferrites are manufactured by sintering the prefired powder of mixed oxides. As the particle size of the powder have a marked influence on the properties of the sintered ferrite, the authors measured the size and its distribution of the powder and found the relation between the particle size and ball milling time of the prefired ferrite as shown in Fig. 1Density of the sintered ferrite was also measured and it was found that it increases noticeably as the ball milling time of the prefired ferrite increases in the case of low temperature sintering. Whereas, the change of the density is small and not regular-in some case it decreases-in the case of high temperature sintering as shown in Fig. 2 and Fig. 3.Shrinkage in sintering was also measured. In most cases, it increases a little as the ball milling time increases as shown in Fig. 4. The reasons of these changes were discussed.

The protective value of the flame sprayed plastic coating is studied. Tests were made during one month at room temperature. For epoxy resin, high temperature test was also made at 70-80°C. The coatings of polyethylen, polyvinyl-buttylal and epoxy resin were found to be anti-corrosive for strong acids, alkalies and a few organic chemicals.An excellent curing agent for epoxy resin spraying was found and the mixing ratio was also determined.

Simple method for the determination of zinc oxide in the sprayed zinc coating is not yet provided, though it is quite important in the inspection of quality of coating. The authors' effort is, therefore, mainly focussed to obtain methods for practical use.First, we tried to estimate the oxide content from the volume of hydrogen gas evolved when the coating was dipped in acid solution. The volume changed sensibly as was expected, with the change of oxide content. After many tests, it was found that, this method could be used for practice if the temperature of the gas was regularly controlled by proper apparatus.Second, the coating was tried to dissolve in the potassium iodide solution containing iodine. By this treatment, not only the metal, but also a small amount of oxide are dissolved, which makes the determination not simple. Thus, it seems that, for practice, the first method is better than the second with respect to operation, accuracy and cost of analysis.

Mixtures of accurately weighed Mn, Fe, Fe2O4 powder were pressed into discs and were sealed in evacuated quartz tube. They were heated at 1000°C for 9 hrs, and then were quenched into water. The composition was chosen so as to enhance the following reaction quantitatively, 4yMn+{1-4(x+y)}Fe+Fe2O4→4Mn yFe 1-(x+y)OAfter the accurate composition was determined by chemical analysis, the quenched specimens were again heated at various temperatures for different durations in order to observe the thermal disintegration.From the results of microscopic observations, it was found that manganese played as an accelerater of grain glowth in the wustite and showed a little influence on the known features of the disintegration.During the heat treatments, lattice constants of manganese-bearing wustite increased over the stable limits, and those of deposited spinel increased with the increase of manganese conntent. On the other hand, those of metal phase remained unchanged.From the results above mentioned, it was found that manganese distributed both in the disintegrated wustite and the deposited spinel and was not included in the metal phase. It was also possible to discuss the mechanism of disintegration.

The crystal size of the ferrites formed hydrothermally from the mixtures of 2α-FeOOH +Zn(OH)2, 2α-FeOOH+NiO or 2α-FeOOH+Co(OH)2, was found to depend on the pH of the medium, and large cubic crystals were observable in alkaline medium, in which complex ions bearing Zn++, Ni++ or Co++ were stable.In case of the synthesis of these ferrites from coprecipitates, the sizes were very small and nearly independent of the pH.Copper ferrites were formed only from the coprecipitates or wet mixtures.Grain growth of the ferrites was scarcely observable during the treatments within 10 hours.Based on these observations, brief discussions were given on the mechanism of the formation.

Heat-resisting characteristics at temperatures between 900-1000°C, of the steel plate coated with ceramics by flame spraying were studied, and the following result was obtained. Flame spraying was carried out by powder method or rod method.1. Steel plate coated with fused Al2O3 is nearly 3 times more resistant to oxidation than bare steel. But the coating technique in this case is not easy and the film is liable to strip out.2. When metallic Cr is added to Al2O3, the porosity of the film is reduced and the oxidation resistivity is increased. The maximum of the porosity was found between the Cr content of 20-50%.3. The film is more closely adhered if the steel surface is at first covered with Fe-Al alloy and the flame spray is carried out on the alloy. Covering with Co metal with electroplating gives nearly the same effect.4. When the fused Al2O3 tube connected through hole with metal wire is used as spraying rod, very resistant coating is obtained as in the case of (2).

By heating under water vapor, ferrite was formed from coprecipitate made from constituent sulfate solution or wet mixture of component hydroxides, similar to the case of hydrothermal synthesis. Temperature (100°C-300°C) had a marked effect on the velocity of the formation.In the case of Ni ferrite, pressure of water vapor played an important role on the formation, while in the case of Zn ferrite, it appears that only a small amount of water vapor was enough for the formation.Even from the dry mixture of component hydroxides, ferrite of normal structure was formed. The formation by this process from the coprecipitate or wet mixture heated in air up to 250°C was also evident.From these results, some discussions were made on the mechanism of the formation.

In the case of epoxy resin Spraying, it is essentially important to complete the curing after spraying in order to obtain chemically and physically superior film.Therefore the authors tried to get a method “how to complete the curing” and could catch the condition of it by the following experiment.i) Determination of free phthalic unhydride, accelerator of condensation, in each step of material preparation, spraying and curing.ii) Measurement of corrosion resistivity in the course of curing.iii) Measurement of hardness in the course of curing.

SummaryThe authors have shown that special formulations are required to give complete covering of steel surface (with no swelling, break away, cracks, etc) with flame sprayed film coating of epoxy resin. For this purpose, there should be minimum stress in the film, and it was concluded that treatments effective for this purpose involve adding adequate filler to reduce the thermal expansion coefficient, controlling the degree of cure, holding small closed pores in the film and semi-curing immediately after spray to keep the required tensile strength.

A brief outline of the status of the electrochemical and electrometallurgical industry in Japan, including some figures on the production of various materials which have been obtained in recent years, is given here.