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Objectives: Amyotrophic lateral sclerosis (ALS) patients may present with cognitive and behavioral abnormalities similar to frontotemporal dementia (FTD). In this multicenter study we examined Japanese ALS patients with and without FTD in order to characterize the full extent of cognitive and behavioral abnormalities, including associations with functional motor status, anxiety and depression. Methods: Patients were evaluated using the Montreal Cognitive Assessment (MoCA), Frontal Assessment Battery (FAB), Hospital Anxiety and Depression Scale, ALS Functional Rating Scale-Revised, spirometry, and verbal fluency tests. Caregivers were asked to complete the ALS-FTD-Questionnaire (ALS-FTD-Q), a behavioral screen. We defined severe cognitive impairment (MoCA < 21 or FAB < 11), mild impairment (11 ≤ MoCA ≤ 25 or 11 ≤ FAB ≤ 15), and normal cognition (MoCA > 25 or FAB > 15). Severe and mild behavioral impairments and normal behavior were defined by the ALS-FTD-Q scores. Results: In 145 ALS patients, better cognitive scores were correlated with earlier age at onset, whereas a worse behavioral score was associated with a longer disease duration and higher level of anxiety and depression. Around seventy percent of all ALS patients showed mild (40–45%) or severe cognitive impairment with cognitive impairment outnumbering behavioral impairment fivefold. Cognitive functions were more impaired in patients with age of onset over 65 years, while behavioral scores were not related to age. Conclusions: Considering the high prevalence of in particular cognitive impairment, and the diversity of impairments, the cognitive and behavioral aspects of Japanese ALS patients should be given more attention clinically.

A permanent magnet (PM) with an accurate magnetization distribution is required for the design of high-quality electrical machines. The nondestructive diagnosis of the magnetization distribution in PM is essential to facilitate the practical design of the synchronous machines. While some methods for magnetization evaluation have been proposed, an optimal method has not been established due to the indefiniteness of the magnetization distribution. Then, the method using nonlinear programming based on the 1-D Fourier series expansion has been proposed by the authors. In this article, the method based on the 2-D Fourier expansion is proposed. The performance of the proposed method was demonstrated in PM, in which orientations were set to parallel and polar isotropic. The performance of the proposed method is compared with the singular value decomposition method.

The promising results of the PACIFIC study led to the approval of consolidation durvalumab for coverage by the National Health Insurance (NHI) in 2018 for patients with locally-advanced unresectable non-small cell lung carcinoma (NSCLC) treated with definitive concurrent chemoradiotherapy (CCRT). However, the effect of NHI coverage on the patterns of care for this population remains unclear. Here, we conducted a questionnaire-based survey to determine the patterns of care for patients with stage II-III NSCLC treated with definitive radiotherapy in 2017 (pre-durvalumab era) or in 2019 (post-durvalumab era). Data were obtained from 11 radiotherapy facilities in Gunma prefecture, which has a population of 1.94 million. We identified 80 and 83 patients with stage II-III NSCLC who received definitive radiotherapy in Gunma in 2017 and 2019, respectively. At a given facility, CCRT was the treatment of choice in a significantly greater proportion of patients in 2019 than in 2017 (66% ± 20% vs 51% ± 29%, P = 0.041). Intensity-modulated radiotherapy (IMRT) was more frequent in 2019 than in 2017 (24% vs 1.2%). Carboplatin plus paclitaxel was used for CCRT at higher rate in 2019 than in 2017 (73% vs 44%). Consolidation durvalumab was performed in 73% (40/55) of CCRT-treated patients in 2019, and the treatment was performed for the planned 12 months in 45% (18/40) of patients. These data indicate that NHI coverage of durvalumab might be a possible reason for choosing CCRT in patients with stage II-III NSCLC in the real-world setting.

To manufacture high-quality electrical machinery, the accurate estimation of magnetization is required before the practical design. The early diagnosis of magnetization distribution with high accuracy decreases the number of inferior electrical machineries. Diagnosis methods to identify the magnetization distribution in a permanent magnet are classified into two types. The first method is based on destructive testing (e.g., electron backscatter diffraction patterns, X-ray diffraction). The second method is based on nondestructive testing using measurement data on magnetic flux density in the surrounding region of the magnet. While destructive testing takes several days, the measurement time for nondestructive testing using outside magnetic flux density is much shorter. However, one drawback of the nondestructive testing is that because the number of combinations of magnetization distribution to reconstruct the outside flux is infinite, the measurement error of the measured flux density in the outside leads to infeasible magnetization distribution. Thus, to overcome this difficulty, a diagnosis method for magnetization distribution based on the Fourier series expansion is proposed. The validity of the proposed method is demonstrated in a permanent magnet with multipole orientation.

A 77-year-old man with chronic hepatitis C underwent transcatheter arterial chemoembolization (TACE) and radiofrequency ablation (RFA) for early-stage hepatocellular carcinoma (HCC) in segment 8 of the liver. Necrosis was confirmed radiologically. After 19 months, recurrent HCC in segment 6 was treated with TACE and RFA. There was no recurrence. Direct-acting antiviral (DAA) therapy 24 months after the initial procedure led to a sustained virologic response. AFP-L3 markedly increased 11 months after DAA therapy, and MRI 6 months after that showed a solitary lymph node near the common bile duct. Because no intrahepatic recurrence or other lymph nodes were seen, the solitary node was excised. Histopathology showed metastatic HCC. There has been no subsequent recurrence over 13 months of follow-up.

Automobiles are designed to provide safe and comfortable movement to people all over the world. In order to accomplish this mission, car makers have focused on functional development including safety performance, environmental performance, driving performance, and provision of comfortable space. A wide variety of material technologies related to magnetic circuits is applied in the automobiles. These technologies have supported the development of the automobile industry and have become indispensable for high functionality and performance of the automobiles. This section will describe the relation between the basic functions of automobiles, namely, “run,” “turn,” and “stop,” discuss the application of magnetism from the historical point of view, and explain the latest technologies and future prospects.

It is important to screen for alcohol consumption and drinking customs by using a stan- dardized method. The aim of this study was to investigate whether standardized questionnaire was useful for predicting alcohol consumption. A cross-sectional study using the Alcohol Use Disorders Identification Test (AUDIT) was conducted in 334 outpatients who consulted the Internal Medicine Department of Osaka City Juso Hospital. The patients completed self-reported questionnaires and underwent a diagnostic interview, physical examination, and laboratory testing. Forty (23%) male patients reported daily alcohol consumption 40 g, and 16 (10%) female patients reported consumption 20 g. The optimal cutoff values of hazardous drinking (all patients)/ drinker (male)/ drinker (female) were calculated using a 10-fold cross validation, resulting in an optimal AUDIT score cutoff of 8.2/ 7.2/ 6.1, with sensitivity of 95.5%/ 96.3%/ 88.9%, specificity of 87.0%/ 96.3%/ 88.9%, false positive rate of 13.0%/ 9.4%/6.6%, false negative rate of 4.5%/ 3.'%/ 11.1%, and area under the receiver operating characteristic curve of 0.97/ 0.98/ 0.99. In conclusion, this study showed that the AUDIT score was useful for predicting alcohol consumption.

In previous studies on precise computation methods of iron loss, it has been shown that the 1-D dynamic magnetic field analysis with hysteresis in post-processing is effective. However, there is a problem in that the hysteresis makes the convergence of nonlinear iterations unstable. This paper proposes a stabilization method for the 1-D dynamic magnetic field analysis with hysteresis. The proposed method is characterized as an approach for improving the initial value and the step size in the Newton–Raphson method. The results of this paper showed that the convergence characteristic of the nonlinear 1-D magnetic field analysis for variety flux density waveforms of each part in an electric motor is improved using the proposed method.

Item does not contain fulltext Amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD) share common clinical, genetic and neuropathological features. Some ALS patients have behavioral/personality changes, which could result in significant obstacles in the care provided by family members and caregivers. An easy screening tool would contribute greatly to the evaluation of these symptoms. We translated the ALS-FTD-Questionnaire, developed in the Netherlands, into Japanese (ALS-FTD-Q-J) and examined the clinimetric properties (internal consistency, construct and clinical validity). Patients with ALS and/or behavioral variant FTD (bvFTD) were evaluated alongside healthy controls in this multicenter study. All ALS patients, regardless of bvFTD status, were further evaluated by the frontal behavioral inventory (FBI) and for frontal/executive function, cognition, anxiety/depression, and motor functions. Data from 146 subjects were analyzed: ALS (92), ALS-bvFTD (6), bvFTD (16), and healthy controls (32). The internal consistency of the ALS-FTD-Q-J was good (Cronbach alpha=0.92). The ALS-FTD-Q-J showed construct validity as it exhibited a high correlation with the FBI (r=0.79). However, correlations were moderate with anxiety/depression and low with cognitive scales, in contrast to the original report, i.e. a moderate correlation with cognition and a low correlation with anxiety/depression. The ALS-FTD-Q-J discriminated ALS patients from (ALS-)bvFTD patients and controls. Thus, the ALS-FTD-Q-J is useful for evaluating Japanese ALS/FTD patients.

Dissection of the splanchnic artery unrelated to an aortic lesion is extremely rare. We describe a patient with dissection of the celiac and splenic arteries causing splenic circulatory impairment. A 55-year-old Japanese man was referred to our hospital for left back pain that suddenly occurred 3 days previously and spread to the left flank. He had complicated sleep apnea syndrome well controlled with continuous positive airway pressure, and had been prophylactically taking aspirin (100 mg/day) because of asymptomatic cerebral lacunar infarcts. Contrast-enhanced computed tomography (CT) in the arterial phase revealed dissection from the celiac root extending to the entire splenic artery, the caliber of which was irregularly narrowed, causing malperfusion in the spleen. Because of hemodynamic stability and lack of impending sequelae, the patient was carefully observed with rest, strict blood pressure control, and aspirin administration. One month later, CT revealed restoration of the caliber of the dissected arteries and regression of the organizing false lumen, which confirmed the patient's recovery. Despite the extreme rarity or nonspecific symptoms, splanchnic artery dissection should be considered a potentially life-threatening emergency. This case supports the possible benefit of starting antithrombotic treatment early to prevent thrombotic sequelae such as organ infarction and aneurysmal formation.

Background Currently, no system for appropriate intra-hospital collaboration regarding hepatitis virus positive individuals exists, even in medical institutions with hepatologists among their staff. The main objective of this study was to explore a simple alert system to promote the referral of patients with hepatitis B surface antigen (HBsAg)- or anti-hepatitis C virus (HCV) antibodies positivity to hepatologists through electronic medical records. Methods Since April 2014 at Osaka City Juso Hospital, “sticky notes” have been put on the electronic medical records of patients newly diagnosed with HBsAg- or anti-HCV- antibodies positivity to recommend intra-hospital referral of those patients to specialists. In this study, we investigated the number of referrals to hepatologists before vs. after the introduction of this system (that is, in fiscal years 2013 [Period 1] and 2014 [Period 2], respectively), and the subsequent clinical courses of the patients. Results The proportions of patients with HBsAg and anti-HCV antibody positivity did not show statistically significant differences between Period 1 and Period 2 (1.6 % [43/2,757] vs. 1.3 % [39/2,891], p = 0.58; and 5.8 % [156/2,674] vs. 5.3 % [147/2,790], p = 0.39, respectively). However, the referral proportions for patients with HBsAg- and anti-HCV antibody positivity were significantly higher in Period 2 (73 % [11/15] and 65 % [41/63], respectively) than in Period 1 (28 % [5/18] and 17 % [9/54]) (p = 0.009 and p

症例は43歳女性．17年前に前置胎盤で帝王切開術を受けている．某年7月から下痢と血便があり，前医を受診した．翌月に大腸内視鏡検査（CS）を施行し，直腸に隆起性病変をみとめたため，精査目的で当科を受診した．CSでは，横行結腸中央部に狭窄を伴う表面顆粒状隆起性病変，S状結腸に粘膜下腫瘍様隆起，下部直腸に表面顆粒状の隆起性病変がみられた．腹部造影CT検査では，横行結腸に壁肥厚と壁内部に低吸収域がみられた．子宮は肥大し内部に低吸収域が多発し，子宮背側周囲に多胞性嚢胞がみられたため，子宮内膜症が疑われた．注腸検査では，横行結腸中央部に約6cmにわたる狭窄と鋸歯状の陰影欠損，S状結腸に壁の伸展不良，直腸に壁のひきつれと隆起を認めた．2ヵ月後CSを行い，横行結腸中央部，下部直腸からの生検で腸管子宮内膜症と診断した．横行結腸に病変をみとめた腸管子宮内膜症は，本邦では2例目で非常に稀であり，文献的考察を加えて報告する．

Purpose: Breathing control is crucial to ensuring the accuracy of stereotactic irradiation for lungcancer. This study monitored respiration in patients with inoperable nonsmall-cell lungcancer using a respiration-monitoring apparatus, Abches, and investigated the reproducibility of tumor position in these patients.Methods: Subjects comprised 32 patients with nonsmall-cell lungcancer who were administered stereotactic radiotherapy under breath-holding conditions monitored by Abches. Computed tomography(CT) was performed under breath-holding conditions using Abches (Abches scan) for treatment planning. A free-breathing scan was performed to determine the range of tumor motions in a given position. After the free-breathing scan, Abches scan was repeated and the tumor position thus defined was taken as the intrafraction tumor position. Abches scan was also performed just before treatment, and the tumor position thus defined was taken as the interfraction tumor position. To calculate the errors, tumor positions were compared based on Abches scan for the initial treatment plan. The error in tumor position was measured using the BrainSCAN treatment-planning device, then compared for each lung lobe.Results: Displacements in tumor position were calculated in three dimensions (i.e., superior–inferior (S–I), left–right (L–R), and anterior–posterior (A–P) dimensions) and recorded as absolute values. For the whole lung, average intrafraction tumor displacement was 1.1 mm (L–R), 1.9 mm (A–P), and 2.0 mm (S–I); the average interfraction tumor displacement was 1.1 mm (L–R), 2.1 mm (A–P), and 2.0 mm (S–I); and the average free-breathing tumor displacement was 2.3 mm (L–R), 3.5 mm (A–P), and 7.9 mm (S–I). The difference between using Abches and free breathing could be reduced from approximately 20 mm at the maximum to approximately 3 mm in the S–I direction for both intrafraction and interfraction positions in the lower lobe. In addition, maximum intrafraction tumor displacement with the use of Abches was 4.5 mm (S–I) in the lingular segment. These results suggest that use of the Abches system can reduce deviations in tumor position to levels below those achieved under free breathing, irrespective of the tumor location.Conclusions: Respiratory control with high accuracy and reproducibility is required for high-precision radiotherapy of inoperable nonsmall-cell lungcancer and was achieved using Abches in this study.

We describe that case of a 61-year-old woman who developed high spiking fever, sore throat, polyarthralgia, and salmon pink evanescent rash following influenza vaccination. A diagnosis of adult-onset Still's disease (AOSD) was made based on clinical and laboratory findings. Methylprednisolone pulse therapy followed by oral prednisolone resulted in a favorable outcome. This is the second published case in which a causal relationship between vaccination and onset of AOSD is suggested. Bystander activation would appear to play an important role in inducing the immune reaction.

To investigate the effects of ulinastatin, a urinary trypsin inhibitor (UTI), on jugular venous superoxide radical (O₂⁻·) generation, oxidative stress, early inflammation, and endothelial activation in forebrain ischemia/reperfusion (FBI/R) rats.Fourteen Wistar rats were allocated to a control group (n = 7) and a UTI group (n = 7). Throughout the experiments, O₂⁻· in the jugular vein was measured by the produced current using a novel electrochemical O₂⁻· sensor. Forebrain ischemia was induced by occlusion of the bilateral common caroti darteries with hemorrhagic hypotension for 20 min, followed by reperfusion. In the UTI group, UTI (5 U/g) was administered intravenously immediately after reperfusion. At 60 min after reperfusion, plasma and brain were harvested, and malondialdehyde, high-mobility group box 1 (HMGB1) protein, and intercellular adhesion molecule-1 (ICAM-1) were measured.O₂⁻· current increased gradually during forebrain ischemia in both groups. The current increased markedly in the control group immediately after reperfusion but was significantly attenuated in the UTI group after reperfusion. Brain and plasma malondialdehyde, HMGB1, and ICAM-1 were significantly attenuated in the UTI group compared with those in the control group, except for brain HMGB1, which was associated with the amount of O₂⁻· generated during FBI/R.UTI suppressed jugular venous O₂⁻· generation, oxidative stress, early inflammation, and endothelial activation in FBI/R rats. Therefore, UTI might be a useful agent for the therapy of the cerebral ischemia/reperfusion pathophysiology.

This study used an electrochemical O2. sensor to investigate the effects of hyperoxia on generation of the superoxide radical (O2.) in the jugular vein during forebrain I/R in rats. Twenty-eight male Wistar rats were allocated to a sham group (n = 7; sham-treated rats with inspired oxygen fraction [FiO2] of 0.4), a hemorrhagic shock and reperfusion (HS/R) group (n = 7; HS without carotid artery occlusion and reperfusion with FiO2 of 0.4), a normoxia group (n = 7; forebrain ischemia produced by bilateral carotid arteries occlusion with HS and reperfusion with FiO2 of 0.4), and a hyperoxia group (n = 7; forebrain ischemia with FiO2 of 0.4 and reperfusion with FiO2 of 1.0). The jugular venous O2. current was measured for 10 min during forebrain ischemia and for 120 min after reperfusion. The O2. current increased gradually during forebrain ischemia in the three groups other than the sham group. Immediately after reperfusion, the current showed a marked increase in the normoxia group and a pronounced decrease in the hyperoxia group. Levels of brain and plasma malondialdehyde, high-mobility group box 1 protein, and intercellular adhesion molecule 1 were significantly attenuated in the hyperoxia group relative to those in the normoxia group. In conclusion, hyperoxia suppressed jugular venous O2. generation and malondialdehyde, high-mobility group box 1, and intercellular adhesion molecule 1 in the brain and plasma in the acute phase of cerebral I/R. Thus, the administration of 100% oxygen immediately after reperfusion suppresses oxidative stress and early inflammation in cerebral I/R.

We conducted a meta-analysis to evaluate and compare the advantages of laparoscopy-assisted distal gastrectomy (LADG) over open distal gastrectomy (ODG) for treating early gastric cancer (EGC). We searched MEDLINE, EMBASE, Science Citation Index, and Cochrane Controlled Trial Register for relevant papers published between January 1990 and January 2010 by using the following search terms: laparoscopy-assisted gastrectomy, laparoscopic gastrectomy, and early gastric cancer. The following data were analyzed: operative time, estimated blood loss, number of harvested lymph nodes, time required for resumption of oral intake, duration of hospital stay, frequency of analgesic administration, complications, tumor recurrence, and mortality. We selected four papers reporting randomized control studies (RCTs) that compared LADG with ODG for EGC. Our meta-analysis included 267 patients with EGC; of these, 134 and 133 had undergone LADG and ODG, respectively. The volume of intraoperative blood loss, frequency of analgesic administration, and rate of complications were significantly lesser for LADG than for ODG. However, the time required for resumption of oral intake and duration of hospital stay did not significantly differ between LADG and ODG. The operative time for LADG was significantly longer than that for ODG; further, the number of harvested lymph nodes was significantly lesser in the LADG group than in the ODG group. LADG is advantageous over ODG because it results in lesser blood loss, is less painful, and is associated with a low risk of complications. Additional RCTs that compare LADG and ODG and investigate the long-term oncological outcomes of LADG are required to determine the advantages of LADG over ODG.

The aim of this study was to assess the effect of moderate hypothermia (MH) on generation of jugular venous superoxide radical (O2-.), oxidative stress, early inflammation, and endothelial injury in forebrain ischemia/reperfusion (FBI/R) rats. Twenty-one Wistar rats were allocated to a control group (n=7, 37 degrees C), a pre-MH group (n=7, 32 degrees C before ischemia), and a post-MH group (n=7, 32 degrees C after reperfusion). MH was induced before induction of ischemia in the pre-MH group and just after reperfusion in the post-MH group. Forebrain ischemia was induced by occlusion of bilateral common carotid arteries with hemorrhagic hypotension for 10 min, followed by reperfusion. O(2)(-)(.) in the jugular vein was measured from the produced current using a novel O2-. sensor. The O2-. current showed a gradual increase during forebrain ischemia in the control and post-MH groups but was attenuated in the pre-MH group. Following reperfusion, the current showed a marked increase in the control group but was strongly attenuated in the pre- and post-MH groups. Concentrations of malondialdehyde, high-mobility group box 1 (HMGB1) protein, and intercellular adhesion molecule-1 (ICAM-1) in the brain and plasma 120 min after reperfusion in the pre- and post-MH groups were significantly lower than those in the control group, except for plasma HMGB1 in the post-MH group. In conclusion, MH suppressed O2-. measured in the jugular vein, oxidative stress, early inflammation, and endothelial injury in FBI/R rats.

A novel electrochemical sensor was used in this study to determine the correlations between jugular venous O(2)(-) and HMGB1, malondialdehyde (MDA), and intercellular adhesion molecule-1 (ICAM-1) in rats with forebrain ischemia/reperfusion (FBI/R). Twenty-one male rats were divided into a Sham group, a hemorrhagic shock/reperfusion (HS/R) group, and a forebrain ischemia/reperfusion (FBI/R) group. The O(2)(-) sensor in the jugular vein detected the current derived from O(2)(-) generation (abbreviated as "O(2)(-) current"), which was integrated as the partial value of quantified electricity during ischemia (Q(I)) and after reperfusion (Q(R)). The plasma O(2)(-) current showed a gradual increase during forebrain ischemia in the HS/R and the FBI/R groups. The current showed a marked increase immediately after reperfusion and continued for more than 60 min in the FBI/R group. In the HS/R group, the current was gradually attenuated to the baseline level. Brain and plasma HMGB1 increased significantly in the FBI/R group compared with those in the Sham and the HS/R groups, and both brain and plasma HMGB1 correlated significantly with the sum of Q(I) and Q(R) (total Q). Brain and plasma MDA and plasma soluble ICAM-1 also correlated significantly with total Q. Here, we report the correlation between O(2)(-) and HMGB1, MDA, and sICAM-1 in rats with cerebral ischemia-reperfusion, using a novel electrochemical sensor. These data indicated that excessive production of O(2)(-) after ischemia-reperfusion was associated with early inflammation, oxidative stress, and endothelial activation in the brain and plasma, which might enhance the ischemia-reperfusion injury.

Iron porphyrin complexes were applied for the electrochemical detection of superoxide anion radical (O2−•). An electropolymerizable axial ligand, 1-(4-(3-thienyl)benzyl)imidazole was designed and synthesized for the application to a sensor for O2−•. The axial ligand was electropolymerized onto a grassy carbon (GC) electrode. This electrode was immersed into the solution of iron porphyrin complexes. UV-visible absorption spectrum showed that iron porphyrin complexes were successfully bound to the axial ligand, and differential pulse voltammograms showed redox responses near 0 to −0.3 V vs. Ag/AgCl due to Fe2+/3+. These electrodes were applied to detect O2−• produced by the xanthine oxidase (XOD)-catalyzed xanthine oxidation. These electrodes showed a linear relationship between the current and the O2−• concentration.

The outcomes of hepatocellular carcinoma treated with percutaneous ethanol injection therapy (PEIT), percutaneous microwave coagulation therapy (PMCT) and percutaneous radiofrequency wave ablation (PRFA) were compared. The cumulative 5-year survival rate was most favorable, at 92%, with PRFA, followed by PMCT, PEIT, and concomitant percutaneous ablation therapy in this order, at 61%, 50% and 30% respectively. However, as determined by modified Japan Integrated Staging score (mJIS), the outcome following PEIT was equivalent to that following PMCT. Due to the short observation period and small number of cases, it was not possible to accurately compare these therapies based on mJIS, but, the outcome with PRFA appeared similarly favorable.

Background It is important to screen for alcohol consumption and drinking customs in a standardized manner. The aim of this study was 1) to investigate whether the AUDIT score is useful for predicting hazardous drinking using optimal cutoff scores and 2) to use multivariate analysis to evaluate whether the AUDIT score was more useful than pre-existing laboratory tests for predicting hazardous drinking. Methods A cross-sectional study using the Alcohol Use Disorders Identification Test (AUDIT) was conducted in 334 outpatients who consulted our internal medicine department. The patients completed self-reported questionnaires and underwent a diagnostic interview, physical examination, and laboratory testing. Results Forty (23 %) male patients reported daily alcohol consumption ≥ 40 g, and 16 (10 %) female patients reported consumption ≥ 20 g. The optimal cutoff values of hazardous drinking were calculated using a 10-fold cross validation, resulting in an optimal AUDIT score cutoff of 8.2, with a sensitivity of 95.5 %, specificity of 87.0 %, false positive rate of 13.0 %, false negative rate of 4.5 %, and area under the receiver operating characteristic curve of 0.97. Multivariate analysis revealed that the most popular short version of the AUDIT consisting solely of its three consumption items (AUDIT-C) and patient sex were significantly associated with hazardous drinking. The aspartate transaminase (AST)/alanine transaminase (ALT) ratio and mean corpuscular volume (MCV) were weakly significant. Conclusions This study showed that the AUDIT score and particularly the AUDIT-C score were more useful than the AST/ALT ratio and MCV for predicting hazardous drinking. Electronic supplementary material The online version of this article (doi:10.1186/s12889-016-3053-6) contains supplementary material, which is available to authorized users.

Spherically contoured AT-cut rectangular quartz crystal resonators have been fabricated by electro-magnetically enforced rotary barrel finishing system. Shape and frequency responses of the fabricated blanks have also been measured and compared with those of the blanks fabricated without using the electro-magnets. In previous work by the authors, the fixed abrasive method, in which abrasive papers are used instead of powder abrasives, was introduced as a new rotary barrel finishing method for fabricating the spherically contoured rectangular quartz crystal blanks. By adopting the fixed abrasive method, accurate shape transferring, dustless clean working environment, and short turnaround time has been realized. In this paper, in order to further shorten the process time, electro-magnets are used for generating additional machining pressure. As a result, the process time required for complete shape transferring has been decreased to 67% of the turnaround time obtained by previous work.

We constructed a novel database of the proteome of DLD-1 colon cancer cells by two-dimensional polyacrylamide gel electrophoresis (2D-PAGE) of fluorescence-labeled proteins followed by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF) analysis. The database consists of 258 functionally categorized proteins corresponding to 314 protein spots. The majority of the proteins are oxidoreductases, cytoskeletal proteins and nucleic acid binding proteins. Phosphatase treatment showed that 28% of the protein spots on the gel are phosphorylated, and mass spectrometric analysis identified 21 of them. Proteins of DLD-1 cells and of laser-microdissected colon cancer tissues showed similar distribution on 2D gels, suggesting the utility of our database for clinical proteomics.

Purpose: To analyze the stereotactic radiotherapy (SRT) plans in terms of internal target volume (ITV) and organs at risk (OARs). Methods and Materials: Treatment planning and dose distributions were analyzed using dose-volume histograms (DVHs) of ITV and OARs in 37 patients, who were treated for a solitary lung tumor with SRT. The stereotactic body frame (SBF) was used for immobilization and accurate setup. Prescription dose was 48 Gy in four fractions at the isocenter. Results: Use of SBF limits the extent of the noncoplanar beam directions to prevent a collision with the Linac gantry. DVH analyses showed that the homogeneity index, defined as the ratio of maximum and minimum dose to ITV, ranged from 1.03 to 1.25 (mean, 1.12). The volume irradiated with 20 Gy or more (V 20 ) of the lung ranged from 0.3 to 11.6% (mean, 4.4%) of the whole lung volume. The maximum dose to the other OARs ranged from 0 to 11.8 Gy (mean, 0.5–2.7) per fraction. No clinically significant complications were encountered. Conclusions: Despite the limitation of the beam arrangement, a homogeneous target dose distribution, while avoiding high doses to normal tissues, was obtained.

This study was performed to investigate the feasibility of FDG- and L-[methyl-11C]methionine (Met)-PET for the follow up of lung cancer after stereotactic radiotherapy (SRT). Nine patients (pt) with solitary lung cancer underwent SRT. Met- and FDG-PET studies were performed one week before SRT and from one week to 8 months after SRT. Responses to SRT were complete in 2 pt and partial in 7 pt. Met- and FDG-PET scan showed high tracer uptake in all tumors before SRT. After SRT, standardized uptake values (SUV) of FDG and Met changed concordantly. Both decreased with time in 5 pt but did not decrease steadily in 4 pt, where 2 pt showed an increase at 1 to 2 weeks after SRT and 2 pt showed an increase at more than 3 months after SRT. The former appears to reflect the acute reaction to SRT and the latter radiation-induced pneumonitis. Although the addition of Met-PET did not provide additional information over FDG-PET, FDG- and Met-PET could be used to evaluate the treatment effect of SRT.

Frequency responses of spherically contoured rectangular AT-cut quartz crystal resonators fabricated by fixed abrasive method have been analyzed experimentally. Not only the required mode, but also many spurious modes can exist on rectangular AT-cut plates. Empirically, in order to eliminate the spurious modes and to achieve high stable and reliable quartz crystal resonators, quartz crystal blanks have been polished into lens-like shape (spherically contoured shape). The spherically contoured blanks have a drastic effect on the decoupling of modes by restricting the vibrating area of the plate within its central region (energy trapping effect). However, a long process time is necessary to fabricate the quartz blanks into spherically contoured shape. In our previous works, a fixed abrasive method has been introduced as a new rotary barrel finishing method for finishing the spherically contoured blanks. In this paper, the frequency responses and the shape of the spherically contoured resonators fabricated with different process times have been presented and discussed. As a result, resonators with very little spurious at 15 MHz within 2 MHz bandwidth have been successfully fabricated.

Bi-convex quartz crystal resonators have been fabricated by rotary barrel finishing. By rotating a pipe, which is generally used as a barrel, with abrasives and quartz crystal blanks (loose abrasive method), inner curve of the pipe is transferred to the quartz crystal blanks. The curve transfer depends on the machining pressure caused by blanks’ weight and the relative movement between the abrasives and the blanks. However, as the abrasives are sandwiched and work between the pipe and the blanks, subsequently, it is difficult to transfer the curve to the blanks accurately. Moreover, the polishing process makes dust, because of using the abrasives and the abrasion of the abrasives. This paper reports a new method of transferring the curve to the blanks accurately by using abrasive paper (fixed abrasive method) without using abrasives. It is also prospective that the dustless clean working environment is realized, because the abrasives are not necessary for the fixed abrasive method any more.

Electro-magnetically enforced rotary barrel finishing system has been developed for finishing rectangular quartz crystal blanks into lens-like shape (bi-convex). In our previous works, the fixed abrasive method, in which abrasive papers are used instead of powder abrasives, has been introduced as a new finishing method for fabricating the bi-convex type rectangular quartz crystal blanks. Our previous works also have shown that, the use of the fixed abrasive method make possible to realize accurate shape transferring, dustless clean working environment, and shortening process time (20 hours for complete shape transferring). In this paper, we have developed an electro-magnetically enforced rotary barrel finishing system for finishing the rectangular quartz blanks into bi-convex within a shorter process time. It can be reasonably expected that the use of electro-magnets generate additional machining pressure, and enable to further shorten the process time. As a result, almost complete shape transferring has been realized by 9 hours processing, which corresponds 45% of previous process time. Shape and frequency responses of the fabricated resonators have also been measured and discussed.

Purpose : This study was performed to evaluate the efficacy and safety of dynamic arc conformal radiotherapy, a simple intensity modulated radiation therapy (IMRT), for the treatment of paraaortic lymph node metastases. Materials and methods : Twenty-nine patients with paraaortic lymph node metastases were enrolled in this study. The total planned dose was 55–60 Gy. A computed tomography (CT) simulator was used in the treatment planning. Results : The total radiation dose delivered was 50–63.4 Gy (median 60 Gy). Sixteen of 29 patients showed local tumor shrinkage on CT, and the 2 year in-field recurrence free survival rate was 58%. Acute Grade 1 and Grade 2 gastrointestinal disorders occurred in 31% and 17%, respectively, and acute Grade 2 liver dysfunction occurred in 7%. As a late complication, Grade 1 and Grade 2 liver dysfunction occurred in six patients (21%) and five patients (17%), respectively. There was no renal dysfunction or myelopathy detected. Conclusion : Dynamic arc conformal radiotherapy, a simple IMRT, is a safe and effective treatment method for paraaortic lymph node metastasis.

一卵性双生児の姉妹双方に発症したクローン病症例を経験した.症例1は19歳,女性.右下腹部痛,発熱を主訴として当院受診,内視鏡検査で回腸末端に縦走潰瘍を認め,クローン病と診断した.症例2は症例1の双生児の姉.右下腹部痛の訴えにて当院受診,注腸造影で上行結腸の部分狭窄と全大腸にアフタの多発を認め,クローン病と診断した.両症例とも,内科的治療にて一時軽快したが,その後,症状の再燃がみられたため,回盲部切除を施行した.術後,再発はなく,経過良好である.同様の症例は,欧米では比較的多くみられ,その検討より,クローン病の発症に遺伝的因子の関与が強く疑われる.本邦では,同様の症例報告は過去に一組のみであり,双生児双方に発症したクローン病症例は非常に稀である.

The pathogenesis of cap polyposis remains unknown. Here, we report a patient with cap polyposis that developed simultaneously in the colon and stomach, and which regressed after Helicobacter pylori eradication. A 63-year-old man was diagnosed as having cap polyposis with mucoid stool, diarrhea, and bleeding on defecation. Following 5 weeks of total parenteral nutrition, his symptoms and hypoproteinemia improved and he was discharged, although follow-up colonoscopic findings revealed no improvement. Subsequent gastroscopy revealed diffusely erosive polyps with cap-like "fur" from the angle to the antrum of the stomach, similar to the lesions observed in the colon. Because H. pylori infection was demonstrated in the stomach, eradication therapy was administered. After this treatment, his symptoms immediately disappeared, and the polypoid lesions in the colon and stomach had completely disappeared 8 months later. Because there have been no previous reports of a relationship between H. pylori and cap polyposis, this case is of great interest.

Purpose: To evaluate the histologic distribution of nonradioactive microspheres when intra-arterially infused into normal kidneys, and to evaluate the histologic changes after the infusion. Materials and Methods: The glass microspheres were SiO 2 microspheres with a smooth spherical shape measuring 20–30 micrometers in diameter with a specific gravity of 2.2 g/cm 3 . After the microspheres were mixed with contrast medium, they were infused into the renal artery. Twelve rabbits were sacrificed at 1 day, 3 days, 1 week, and 8 weeks after the treatment, respectively. The specimen was fixed with 10% buffered formalin, specially embedded in methyl methacrylate (MMA) resin and was stained by hematoxylin-eosin. The distribution of the microspheres in the kidney was analyzed microscopically, and histologic changes were also evaluated. Results: The microspheres were found in arterioles whose diameters were about 20–30 micrometers, within normal kidneys. All vessels containing microspheres were confined to arterioles or arteries. No migration of microspheres was detected in the normal lung or the contralateral kidney. Severe ischemic changes were observed in kidneys, developing within 8 weeks of the infusion. Conclusion: Glass microspheres seemed to be a useful embolic material for intra-arterial radiation therapy.

We investigated the rates of the treatments and their prognoses in 450 patients with hepatocellular carcinoma (HCC), in order to determine the usefulness of percutaneous microwave coagulation therapy (PMCT) given the present situation of treatment for HCC. Rates of initial treatments were hepatectomy in 31%, percutaneous ethanol injection therapy (PEIT) in 19%, transarterial embolization (TAE) and PEIT in 16%, TAE in 14%, hepatic arterial chemotherapy (HAC) in 7%, PMCT in 7% and others in 6% of cases. The prognosis of PMCT in patients with a single tumor 3 cm in size or less was comparable to that with hepatectomy. Recurrence was found in about 59% of 387 patients who underwent radical treatment initially, and about 96% of these were intrahepatic recurrences. Rates of treatment for intrahepatic recurrence were TAE in 59%, PEIT in 33%, HAC in 31%, PMCT in 24% and hepatectomy in 4% of cases. Indications for use of PMCT were more restricted than for PEIT for reasons of safety. Therefore, the rate of use of PMCT as initial treatment was lower than that of PEIT. On the other hand, the rate of use of PMCT in treatment of recurrence was similar to that of PEIT. PMCT should be used not only as initial treatment but also in the treatment of recurrence, in which HCC is often found at a size 3 cm or less, considering the high incidence of intrahepatic recurrence of HCC as well as reliability of the therapeutic effect and low invasiveness attached to PMCT.

Purpose. Local control for pituitary adenomas treated with external beam radiation therapy was retrospectively analyzed to evaluate the efficacy of radiation.

患者は20歳男性で,元来便秘気味であり,8歳頃より過敏性腸症候群に合致する症状があった.午後5時頃に強い腹痛があり,その後大量に排便があり,続いて朝まで7～8回の血性下痢がみられた。当院を受診しすぐに内視鏡検査を施行したところ、下行結腸から横行結腸にかけて全周性と縦走性の潰瘍があり虚血性大腸炎と診断し入院となった.虚血性大腸炎を合併した過敏性腸症候群は世界で3例目であり,稀と考え報告する.

潰瘍性大腸炎にて緊急手術を行ったのは6例であり手術群とした.手術理由は中毒性巨大結腸(TMC)3例,大量出血2例,内科治療無効1例であった.内科的に治療し得たTMC3例と大量出血にて一時的に手術を考えたが内科的に治癒した大量出血例3例の計6例を非手術群とした.2群を比較した結果,手術群は経過中に輸血を必要とする症例,経過中に肝機能障害が出現する症例が多かった.TMCにおいて小腸の拡張がみられ,多量の小腸ガスがみられる症例は緊急手術の適応と考えられた.下部内視鏡にてS状結腸に広範な粘膜脱落がみられる場合も速やかに手術すべきと考えられた.したがって,緊急手術の決定のためにはS状結腸までの内視鏡を積極的に行うことが有用であると考えられた.重症例の診断目的の内視鏡でもS状結腸までの観察が推奨される.また輸血量,腹部単純X線での小腸ガス像,肝機能値異常が手術を必要とするパラメーターとなりうると考えられた.

Objective: We examined the clinical characteristics of ulcerative colitis patients who demonstrated endoscopically discontinuous lesions at the mouth of the appendix. Methods: Of patients with initial or recurrent active ulcerative colitis who underwent total colonoscopy during the past 3 yr at Osaka City General Hospital, we selected those who had skip lesions in the mouth of the appendix before treatment, and examined their gender, age, disease type, sites of lesions, inflammatory reaction, severity of disease, effects of treatment, and posttreatment course. Results: Discontinuous lesions at the mouth of the appendix were found in 10 patients, who had the following common clinical features: the major lesion was usually present in the lower part of the large bowel including the rectum, many of the patients had suffered an initial attack only, all patients had mild disease, and many of the patients responded quite satisfactorily to treatment with salicylazosulfapyridine. Conclusion: Numerous patients with ulcerative colitis with discontinuous lesions at the mouth of the appendix were observed and their clinical characteristics were examined. Determination of the clinical significance of skip lesions in the appendix will contribute to elucidation of the pathogenesis of ulcerative colitis.