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Background and Objectives Continuous monitoring of blood use and feedback on transfusions are effective in decreasing inappropriate blood transfusions. However, traditional methods of monitoring have practical challenges, such as the limited availability of experts and funding. Administrative data including a patient classification system may be employed for risk-adjusted assessment of hospital-wide blood use. Materials and Methods We conducted an audit of blood use at two hospitals and determined proportions of appropriate blood use at each hospital. We then used administrative data of 587 045 cases provided by 73 hospitals to develop two mathematical models to calculate risk-adjusted use of blood products. The first model is a logistic regression model to predict the percentage of transfused patients. Patient demographics, surgery and diagnostic groups were utilized as predictors of transfusion. The second model is a case-mix adjusted model which predicts hospital-wide use of units of blood products from the distribution of diagnosis-related groups. For each model, the observed to expected (O/E) ratio of blood use in each hospital was calculated. We compared resultant ratios with proportions of appropriate blood use in two of the hospitals studied. Results Both models showed good prediction abilities. O/E ratios calculated using the two models were relevant to proportions of appropriate transfusions. Conclusions Risk-adjusted assessments of blood product use based on administrative data allow hospital-wide evaluation of transfusion use. Comparing blood use between different hospitals contributes toward establishing appropriate transfusion practices. [ABSTRACT FROM AUTHOR]

Background: We devised a new method incorporating cyber visual training whereby novices in endoscopic surgery are instructed via repetition of a video-recorded procedure. We then conducted a study designed to investigate the impact of this cyber visual training on the mastery of intracorporeal knot-tying as an endoscopic technique.Methods: For the cyber visual training a 10-min video of the same procedure was replayed at normal, slow, and rapid speeds or presented in a series of still images. The training was undertaken by 36 medical students and 1st year trainee doctors who had had no experience of endoscopic surgery. They were divided into three groups, each of all received the same introductory lecture. Group A was only given training with the instructor for 15 min. Group B trained with the instructor for 15 min and was allowed self-training for 10 min. Group C viewed the cyber video beforehand and then underwent training with the instructor for 15 min. For all participants, the time required to complete a knot-tying task was measured and the level of endoscopic skill before and after the training was assessed using a virtual reality system the minimally Invasive Surgical Trainer-Virtual Reality (MIST-VR), in terms of the following three parameters: time, errors, and efficiency of hand movements. The Steel-Dwass test was used to evaluate the differences among the three groups in task performance.Results: Group C completed the knot-tying task faster than group A (p = 0.0375), but there were significant differences between groups A and B and groups B and C. There were no significant differences in the parameters assessed using the MIST-VR.Conclusions: Our new concept of cyber visual training is effective for mastering the knot-tying technique. This type of training should be widely applicable to other procedures, such as dissection, clipping, and hemostasis. [ABSTRACT FROM AUTHOR]

Nicardipine (Nic) or nifedipine (Nif) was given to male and female C57BL/6J mice by a single gavage at doses of 100, 200 and 400μmol kg-1, and changes in the levels of mRNA and apoprotein of hepatic cytochrome P450 (P450) enzymes, including Cyp2b9, Cyp2b10, Cyp3a11 and Cyp3a41, were examined by reverse transcriptase-polymerase chain reaction (RT-PCR) and Western blotting, respectively. Furthermore, hepatic microsomal activities for pentoxyresorufin O-dealkylation (PROD) and nifedipine oxidation, which are mainly mediated by Cyp2b and Cyp3a subfamily enzymes, respectively, were measured. Results from RT-PCR analysis revealed that Nic, but not Nif, showed a capacity for activating the Cyp3a11 gene in either sex of mice and that both chemicals could induce a male-selective activation of Cyp2b10 gene, although they bad no capacity for activating the Cyp2b9 and Cyp3a41 genes in either sex. Increased levels of the mRNAs of Cyp2b10 and Cyp3a11 were closely correlated with those of apoprotein and activity of the corresponding P450 subfamily enzymes. The study demonstrated for the first time that Nic, but not Nif, showed the ability to induce Cyp3a11 in both sexes of mice, although both Nif and Nic led to a male-selective induction of Cyp2b10, and that Nic and Nif bad no ability to induce Cyp2b9 and Cyp3a41 in either sex. [ABSTRACT FROM AUTHOR]

A spectrometer was constructed to measure the invariant mass spectra of ρ, ω and φ mesons through their e+e− or K+K− decays. The KEK experiment E325 was successfully carried out using the new spectrometer, and observed the signature of an in-medium mass modification of the ρ and/or ω mesons for the first time. The details of the spectrometer are described. [Copyright &y& Elsevier]

Several reports have been published which describe the technique of using an Endo GIA to resect submucosal tumors on the anterior wall of the stomach. Lesions on the posterior wall, however, especially near the esophagocardiac junction (ECJ), are difficult to resect using these reported techniques. This is because the surgeon must divide the omentum and enter the omental bursa in order to use a similar extraluminal technique. Furthermore, special care must be taken to ensure that resections do not involve the ECJ and narrow the esophagus. In order to overcome these difficulties, we have proposed a new technique for the laparoscopic excision of a submucosal tumor located on the posterior wall of the gastric fundus. The principle of this procedure involves the intraluminal resection of the submucosal tumor, including the surrounding stomach wall, using the Endo GIA. This technique is safe, simple, and effective. We believe that we are the first to address the excision of a submucosal lesion by resecting the full thickness of the posterior gastric wall lesion intraluminally. [ABSTRACT FROM AUTHOR]

Abstract: We constructed a Gas Electron Multiplier (GEM) chamber using a new type of GEM foils with holes etched into a flexible printed circuit board using LASER and then plasma. The effective gas gain in a chamber containing three of the foils was similar to that obtainable using three standard CERN GEM foils. The new etching method allows holes to be made in thicker foils. New GEM foils thick were produced to achieve higher gas gains with a single GEM configuration. The effective gas gain was higher than obtained with a chamber with three standard -thick GEM foils in the same electric fields. Using the new thicker GEM foils allows the chamber to be simpler and, in the near future, cylindrical. [Copyright &y& Elsevier]

Background: Bile duct injuries during laparoscopic cholecystectomy (LC) are thought to occur because surgeons tend to confuse the common bile duct (CBD) with the cystic duct. Among reasons for this misidentification, the difference in the way the operating field is exposed in LC compared to open cholecystectomy should be noticed. Using Dr. Reddick's technique, which is commonly practiced, the upward and the lateral traction of the gallbladder results in a narrower Calot's triangle and angulation of the CBD. These anatomical distortions are thought to contribute to ductal injuries during LC.Methods: We propose a new method to expose Calot's triangle during LC. The principle of this technique is to expose the hepatic hilus by retracting the caudal surfaces of the quadrate and lateral lobes of the liver using an atraumatic curved instrument.Results: The advantages of this technique are that one gains wide exposure of the hepatic hilus, leaves Calot's triangle undistorted, and avoids tenting the CBD.Conclusions: This new technique may make LC safer and decrease the number of bile duct injuries associated with the misidentification of the anatomy. [ABSTRACT FROM AUTHOR]

Introduction Some of the most feared complications of falls are hip fractures. Of those who sustain hip fractures, up to 20% become non-ambulatory, and only 14-21% recover their ability to carry out instrumental activities of daily living. In Japan, the incidence of hip fracture is estimated as 120,000 persons per year, and the number of elderly patients with hip fractures is increasing. The LOS (length of hospital stay) in elderly patients with hip fractures is generally long. While many studies have revealed that patient characteristics are closely associated with longer hospitalization, little is known about hospital structures and processes of care associated with LOS. The objective of this study is to identify institutional factors and processes of care associated with LOS in elderly patients with hip fractures. Methods We analyzed administrative data provided by 67 hospitals participating in the Quality Indicator/Improvement Project (QIP). The study included 2,134 patients with hip fractures who were 60 years of age or older, underwent surgical treatment, and were discharged from the hospitals between April 2007 and March 2008. We excluded patients whose lengths of stay were longer than 150 days. First, we conducted a patient-level multiple linear regression analysis to identify patient-risk factors associated with LOS. Using this model, we calculated the risk-adjusted mean LOS for each hospital. Secondly, we categorized patients into two groups according to discharge destination: home or other facilities. We conducted a multiple linear regression analysis to identify institutional factors and processes of care associated with risk-adjusted mean LOS in each subgroup (discharge to home or discharge to other facilities). In this analysis, the dependent variable was the risk-adjusted mean LOS of hip fracture in each hospital. Explanatory variables included the following: • Surgical procedure (hip replacement or internal fixation) • Timing of operation (within 48 hours or later) • Timing of rehabilitation (within two days after operation or later) • Frequency of rehabilitation (rehabilitation was provided for more than 80% of total LOS or less than 80%) • Number of acute care beds >400 or ≦400) • Inpatient volume per physician per year (>150 or ≦150) • Case volume of physical therapist (PT) per year (>2000 or ≦2000) • Number of medical social workers (MSW) per bed (>1 or ≦1) • Hospital ownership (a local government hospital, private hospital, or public hospital) • Presence of sub-acute care beds in the hospital Results In the patient-level analysis, we found that age, complication, and previous hospitalization were significantly associated with LOS. We also took into account the results of a hospital-level regression analysis. In both groups (discharge to home and discharge to other facilities), timing of rehabilitation was significantly associated with LOS. However, timing of operation, and frequency of rehabilitation, were significant predictors of longer LOS only among patients discharged to home. The number of beds, case volume per physician and PT, hospital ownership, and the presence of sub-acute care beds in the hospital were significantly associated with LOS in both groups. The number of MSW per bed was a significant predictor of shorter LOS only among patients discharged to other facilities. Conclusion In this study, we examined institutional structures and processes of care associated with LOS in elderly patients with hip fractures. Our results suggest that early and intensive rehabilitation can decrease LOS of patients who were discharged to their homes through a rapid recovery of activity of daily life (ADL). Institutional structures such as hospital bed size, case volume per physician and PT, and number of MSW were strong predictors of shorter LOS.… [ABSTRACT FROM AUTHOR]

Introduction Due to rising health costs, hospitals are making efforts to assess and improve management efficiency. However, at present, Japanese hospitals rely on individual assessment methods. Due to the lack of a common method of assessment - based on standardized data available from all hospitals - meaningful comparisons cannot be conducted. The objectives of this study were to develop a method of assessing OR management based on standardized administrative data, and to apply this method in assessing and comparing OR efficiencies in a multi-institutional setting. Methods DPC (Diagnosis Procedure Combination) is a patient classification system in Japan. DPC data E and F files contain detailed information such as general anesthesia duration, and dosages for all medication prescribed. We obtained patient data from 133 hospitals, between April 2006 and March 2008, from the specific components of the DPC database known as the E and F files. As possible indicators for assessing operation management, we offer the following variables. Using data from the E and F files of the DPC database, we calculated: • x) Procedural fee per OR per month • a) Number of operations per OR per month • b) Procedural fee per operation • c) Total utilization times of each OR per month • d) Procedural fee per OR per hour In order to take into account hospital variations while analyzing reimbursement, we carried out a multiple linear regression analysis at the hospital level. The dependent variable was the procedural fee per OR per month, and the independent variables were the number of surgeons per OR and the total number of beds. Next, for surgery volume, another multiple linear regression analysis was conducted. The dependent variable was the number of operations per OR per month, and the independent variables were the number of surgeons per OR, and the total number of beds. Finally, we conducted a multi-institutional comparison of expected and observed values for the dependent variables from both regression models in 133 hospitals. Results We show the results of descriptive statistics for the following: • Procedural fee per OR per month • Number of operations per OR per month • Procedural fee per operation • Total utilization time of each OR per month • Procedural fee per OR per hour There were large inter-hospital variations seen in all five of these indicators. The mean procedural fee per OR per month was found to be US $76,516 (SD: US $31,145; Range: US $11,857-US $195,546). There was an observed mean of 46 operations per OR per month (SD: 16 operations; Range: 10-107 operations). According to the results of our regression analyses, we found that the number of surgeons per OR, as well as the total number of beds in each hospital, was significantly and positively associated with our operation management assessment indicators of procedural fee per OR per month, and the number of operations per OR per month. Using the expected values of the dependent variables from the regression models, we conducted a comparison of the observed/expected (O/E) ratios of each hospital, as well as their respective residual values relative to an O/E ratio of 1. This allowed for the assessment of the relative performance of each hospital. Conclusion The OR management assessment method, which is based on standardized DPC data, allows for meaningful multiinstitutional comparisons. Comparisons of the expected and observed values of the indicators, based on these data, may provide a greater insight into the target of the fee, as well as the number of surgical operations occurring at each hospital (after taking into account inter-hospital variations). Therefore these comparisons may be useful as a tool in target management. [ABSTRACT FROM AUTHOR]

As a result of the recent improvement of the prognosis of esophageal cancer, the reporting frequency of gastric tube cancer following esophageal cancer has increased. Gastric tube total resection following median sternotomy, a highly invasive surgical procedure, is applied to the cases of advanced gastric tube cancer, whereas endoscopic mucosal resection is selected for the cases of early gastric tube cancer. If endoscopic mucosal resection is not applicable for some reason, partial or total resection of the gastric tube following median sternotomy has been selected. We applied laparoscopic intragastric surgery to such a case: The patient, a 59-year-old man with esophageal cancer, had undergone subtotal esophagectomy followed by gastric tube reconstruction through the retrosternal route 6 years before. Since endoscopy revealed early gastric cancer in the body of the stomach, we tried to perform mucosal resection but failed because of anastomotic stenosis. However, we successfully performed intragastric surgery, in which a camera and forceps were inserted directly into the gastric tube. Thus, laparoscopic intragastric surgery is a useful technique in cases to which endoscopic mucosal resection is not applicable. [ABSTRACT FROM AUTHOR]

Background: Transumbilical single-incision laparoscopic surgery is an emerging concept that could offer excellent cosmetic results [1]. The authors describe an index case of curatively intended resection of early-stage sigmoid colon cancer using this technique [2, 3].Methods: A 75-year-old woman with a body mass index of 24 underwent surgery by two colorectal surgeons who had hundreds of experiences with laparoscopic colorectal surgery. Three 5-mm ports were placed linearly in the vertical 2-cm skin incision in the umbilicus. Almost all the procedures were performed with usual laparoscopic instruments such as a 5-mm flexible laparoscope and the Harmonic ACE (Ethicon Endo-Surgery, Cincinnati, OH, USA). Also, the operative procedures were much the same as in usual laparoscopic surgery. The sigmoid colon was mobilized using a medial approach. Then the root of the superior rectal artery and inferior mesenteric vein were divided using the EnSeal tissue sealing and hemostasis system (SurgRx, Inc. Redwood City, CA, USA). Low-profile trocars were mandatory to minimize interferences among instruments. The rectum was divided 5 cm distal to the lesion with one firing of an endoscopic stapler. The specimen was extracted through a 2-cm transumbilical laparotomy. End-to-side anastomosis using a circular stapler was performed intraabdominally, and air tightness was confirmed by the anastomotic leak test.Results: The operative time was 192 min. There was no intra- or postoperative morbidity. Altogether, 20 cm of sigmoid was resected with negative tumor margins, and 14 lymph nodes were harvested. The patient started receiving meals and was discharged on postoperative days 2 and 7, respectively. The final pathology showed Tis, N0, M0, stage 0. The scar was invisible at 1 month.Conclusion: Single-incision laparoscopic colectomy is feasible and safe for selected patients and gives a favorable cosmetic result. By well-trained surgeons, this technique could be a realistic option for colorectal cancer surgery. [ABSTRACT FROM AUTHOR]

Background: In general, visceral fat and adhesion greatly influence the technical difficulty in performing abdominal surgery. Body mass index (BMI) has been widely used to express the degree of obesity, but it does not always properly reflect the degree of visceral fat. This retrospective study investigated the impact of visceral fat on the operation time to examine whether a quantified visceral fat area (VFA) could be used as a sensitive predictor of technical difficulty in performing a laparoscopic resection of rectosigmoid carcinoma.Methods: Between February 1999 and April 2004, 58 consecutive patients underwent a laparoscopically assisted sigmoidectomy or anterior resection. After a review of the medical charts, the relationship between the operation time and the following variables was analyzed: sex, depth of invasion, approach (medial-to-lateral, lateral-to-medial), subjectively graded degree of visceral fat and adhesion, history of previous abdominal surgery, and BMI. The correlations between VFA, VFA/body surface area (BSA) measured by the "FatScan," software package for quantifying the VFA from the preoperative CT images, and operation time were investigated. Next, the impact of the VFA amount on the early surgical outcome was examined.Results: According to the intraoperative findings, two patients with a severe adhesion required a significantly longer operation time. A history of previous abdominal surgery was not a significant factor in the operation time. Instead, the VFA/BSA had a stronger correlation with the operation time than the BMI. A significantly longer operation time (209 +/- 42 vs 179 +/- 37 min; p = 0.031) was observed for the patients in the high VFA/BSA group (> or =85 cm(2)/m(2)) group than in the normal VFA/BSA group (<85 cm(2)/m(2)).Conclusion: For predicting the technical difficulty of performing a laparoscopic resection of rectosigmoid carcinoma, VFA/BSA may be a more useful index than BMI. [ABSTRACT FROM AUTHOR]

The article examines the incidence of micrometastases in the region of the pelvic plexus by reverse transcriptase-polymerase chain reaction analysis, which is more sensitive than conventional histological diagnosis. The results of the study are summarized. It was concluded that autonomic nerve-preserving surgery may be feasible for advanced rectal cancer, but study of more patients positive for micrometastases is required.

Background: Intraperitoneal chemotherapy using paclitaxel is considered an experimental approach for treating peritoneal carcinomatosis. This study aimed to determine the recommended dose, and to evaluate the clinical efficacy and safety, of the combination of intravenous gemcitabine, intravenous nab‐paclitaxel and intraperitoneal paclitaxel in patients with pancreatic cancer and peritoneal metastasis. Methods: The frequencies of dose‐limiting toxicities were evaluated, and the recommended dose was determined in phase I. The primary endpoint of the phase II analysis was overall survival rate at 1 year. Secondary endpoints were antitumour effects, symptom‐relieving effects, safety and overall survival. Results: The recommended doses of intravenous gemcitabine, intravenous nab‐paclitaxel and intraperitoneal paclitaxel were 800, 75 and 20 mg/m2 respectively. Among 46 patients enrolled in phase II, the median time to treatment failure was 6·0 (range 0–22·6) months. The response and disease control rates were 21 of 43 and 41 of 43 respectively. Ascites disappeared in 12 of 30 patients, and cytology became negative in 18 of 46. The median survival time was 14·5 months, and the 1‐year overall survival rate was 61 per cent. Conversion surgery was performed in eight of 46 patients, and those who underwent resection survived significantly longer than those who were not treated surgically (median survival not reached versus 12·4 months). Grade 3–4 haematological toxicities developed in 35 of 46 patients, whereas non‐haematological adverse events occurred in seven patients. Conclusion: Adding intraperitoneal paclitaxel had clinical efficacy with acceptable tolerability. [ABSTRACT FROM AUTHOR]

The gas electron multiplier tracker (GTR) was developed and constructed for the J-PARC E16 experiment. The GTR is capable of operating in a high-counting environment of up to 5 kHz/mm 2 . Additionally, its design is optimized to minimize the material budget and maximize acceptance. With high-quality Gas Electron Multiplier (GEM) foils, eight modules composed of 24 chambers were constructed. The gain of each chamber was measured to be over 6000, satisfying the experimental specification. This study provides a comprehensive description of the detector, including its design, assembly procedure, and construction process. [ABSTRACT FROM AUTHOR]

Purpose: Recent advances in laparoscopic surgical technology have made it possible to perform advanced high-level surgery, such as lymph node dissection for malignancy. Grasping the anatomy during such procedures is important for a safe operation. We have developed a new image information system that provides three-dimensional (3D) reconstructed CT images synchronized with the motion of the laparoscope. This study assesses this new navigation system. Methods: Enhanced CT using a custom-made software program can provide 3D angiography images reconstructed as a laparoscopic view. A motion sensor mounted on the laparoscope can detect the direction angle of the laparoscope. The real-time rendered 3D CT images are synchronized with the laparoscopic video images according to the motion of the scope. These 3D CT images are projected on another monitor close to the laparoscopic video monitor. Lymph node dissection can be performed with the help of the real-time navigation system that provides a detailed 3D view of the vasculature. Results: Ten laparoscopic gastrectomies were performed using this navigation system. Real-time intraoperative navigation of the vasculature was available, allowing for an excellent surgical outcome. No complications occurred in this series. Conclusion: Our intraoperative navigation system allows for safe laparoscopic gastric lymph node dissection. [ABSTRACT FROM AUTHOR]

The HypHI experiment for precise hypernuclear spectroscopy with induced reactions of stable heavy ion beams and rare isotope beams is currently under preparation at GSI. The main goal of the HypHI project is to study neutron and proton rich hypernuclei and to measure directly hypernuclear magnetic moments at GSI and FAIR. In the first HypHI experiment (Phase 0) planned in 2009, the feasibility of precise hypernuclear spectroscopy with heavy ion beams will be demonstrated by observing π- decay channels of $_\Lambda ^3 {\rm{H}}$, $_\Lambda ^4 {\rm{H}}$ and $_\Lambda ^5 {\rm{He}}$ with 6Li projectiles at 2 A GeV impinging on a 12C target. An overview of the HypHI project and the details of the Phase 0 experiment will be discussed. [ABSTRACT FROM AUTHOR]

Background: TRIB3 is a human homologue of Drosophila tribbles. Previous studies have shown that TRIB3 controls the cell growth through ubiquitination-dependent degradation of other proteins, whereas its significance in the prognosis of colorectal cancer (CRC) is not yet fully understood.Materials: This study comprised 202 patients who underwent surgery for CRC, as well as 22 cell lines derived from human gastrointestinal cancer. The correlation of gene expression with clinical parameters in patients was assessed. The biological significance was evaluated by knockdown experiments in seven colorectal cancer cell lines.Results: A total of 20 cancer cell lines (90.9%) expressed the TRIB3 gene. The assessment in surgical specimens indicated that the gene expression was significantly higher in the cancerous region than in the marginal non-cancerous region. Patients with high TRIB3 expression were statistically susceptible to a recurrence of the disease, and showed poorer overall survival than those with low expression. The assessment of TRIB3 knockdown in five cell lines showed that small interfering RNA (siRNA) inhibition resulted in a statistically significant reduction in cell growth.Conclusion: These data strongly suggest the usefulness of TRIB3 as a marker for predicting the prognosis of CRC patients, showing a basis for the development of effective treatments for CRC. [ABSTRACT FROM AUTHOR]

Abstract: The silicon vertex tracker (VTX) will be installed in the summer of 2010 to enhance the physics capabilities of the Pioneering High Energy Nuclear Interaction eXperiment (PHENIX) experiment at Brookhaven National Laboratory. The VTX consists of two types of silicon detectors: a pixel detector and a strip detector. The pixel detector consists of 30 pixel ladders placed on the two inner cylindrical layers of the VTX. The ladders are required to be assembled with high precision, however, they should be assembled in both cost and time efficient manner. We have developed an assembly bench for the ladder with several assembly fixtures and a quality assurance (Q/A) system using a 3D measurement machine. We have also developed an assembly procedure for the ladder, including a method for dispensing adhesive uniformly and encapsulation of bonding wires. The developed procedures were adopted in the assembly of the first pixel ladder and satisfy the requirements. [Copyright &y& Elsevier]

The experiment KEK-PS E325 measured e+e− and K+K− pairs produced in 12 GeV p + A reactions, in order to search for in-medium modification of vector mesons. In the e+e− spectra, a significant excess on the low-mass side of the ϕ-meson peak is observed in the very low βγ (= p/m) region of the copper target data. On the other hand when the velocity of ϕ mesons is higher or a smaller target, carbon, is employed, the observed ϕ-meson shapes are consistent with the expected shape in vacuum, both in the e+e− and K+K− spectra. We have also compared the nuclear mass number dependence of ϕ-meson production between the e+e− and K+K− decay channels. Using these results, the first experimental limits are obtained for in-medium broadening of the partial decay widths. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine the efficacy of a combination treatment of sequential irinotecan and doxifluridine, an intermediate of capecitabine, evaluated by the response rate and safety in patients with metastatic colorectal cancer. In all, 60 metastatic colorectal cancer patients with measurable disease were enrolled. The schedule of the treatment consisted of a 90 min intravenous (IV) infusion of irinotecan 150 mg/m2 for on days 1 and 15, and 600-1,000 mg/body of oral doxifluridine on days 3-14 and 17-28. Cycles were repeated every 35 days. A median of three cycles of the combination therapy (range 1-14 cycles) was administered. A total of 57 patients (95%) completed at least two cycles of the therapy without any dose reductions. There was one complete response and 23 partial responses with an overall response rate of 40% [95% confidence interval (CI): 28-53%]. A total of 19 patients had stable disease, 43(72%) achieved disease control. The median time to progression was 5.9 months and the median overall survival was 20.5 months. Ten (17%) and 17 (28%) patients developed Grade 3-4 leukopenia and neutropenia, respectively. Grade 3-4 fatigue was observed in 7(12%) patients, nausea in five (8%), vomiting in four (7%), and diarrhea,in three (5%) patients. No treatment-related deaths were noted during the study. From these results, the combination of sequential irinotecan and doxifluridine is considered to be an effective, easy-to-administer regimen with acceptable tolerability. [ABSTRACT FROM AUTHOR]

Recent studies have identified vimentin, a type III intermediate filament, among genes differentially expressed in tumours with more invasive features, suggesting an association between vimentin and tumour progression. The aim of this study, was to investigate whether vimentin expression in colon cancer tissue is of clinical relevance. We performed immunostaining in 142 colorectal cancer (CRC) samples and quantified the amount of vimentin expression using computer-assisted image analysis. Vimentin expression in the tumour stroma of CRC was associated with shorter survival. Overall survival in the high vimentin expression group was 71.2% compared with 90.4% in the low-expression group (P=0.002), whereas disease-free survival for the high-expression group was 62.7% compared with 86.7% for the low-expression group (P=0.001). Furthermore, the prognostic power of vimentin for disease recurrence was maintained in both stage II and III CRC. Multivariate analysis suggested that vimentin was a better prognostic indicator for disease recurrence (risk ratio=3.5) than the widely used lymph node status (risk ratio=2.2). Vimentin expression in the tumour stroma may reflect a higher malignant potential of the tumour and may be a useful predictive marker for disease recurrence in CRC patients. [ABSTRACT FROM AUTHOR]

Invariant mass spectra of low-mass vector mesons in the e+e- channel are measured in 12 GeV p + C and p + Cu reactions $(\sqrt{s}=5.1~{\rm GeV})$ at the KEK Proton Synchrotron. Significant excess is observed at the low-mass side of ω meson peak over the known hadronic sources both in the C and Cu target data. Also below the ϕ meson peak, an excess is found in the Cu target data for slowly moving mesons whose βγ is less than 1.25. They can be interpreted as signatures of the spectral modification of vector mesons in cold nuclear matter. [ABSTRACT FROM AUTHOR]

Whether peroxisome proliferator-activated receptor (PPAR) delta is a good target for the chemoprevention and/or treatment of colorectal cancer (CRC) remains controversial. Our goal was to examine PPARdelta expression in multistage carcinogenesis of the colorectum and to assess the relevance of PPARdelta in CRC. Immunohistochemical analysis indicated that PPARdelta expression increased from normal mucosa to adenomatous polyps to CRC. In cancer tissues, the PPARdelta protein was accumulated only in those cancer cells with highly malignant morphology, as represented by a large-sized nucleus, round-shaped nucleus, and presence of clear nucleoli. Interestingly, the cancer tissue often contained both PPARdelta-positive and -negative areas, each retaining their respective specific morphological features. Moreover, this pattern persisted even when PPARdelta-positive and -negative cells were aligned next to each other within a single cancer nest or gland and was present in the majority of CRC cases. Immunohistochemistry for Ki-67 proliferation marker showed no significant correlation between Ki-67 and PPARdelta in CRC samples. Based on Western blot analysis and quantitative RT-PCR, high PPARdelta protein expression correlated with high PPARdelta mRNA levels. Peroxisome proliferator-activated receptor delta may have a supporting role in tumorigenesis, and the close association between PPARdelta expression and malignant morphology of CRC cells suggests a pivotal role in cancer tissue. [ABSTRACT FROM AUTHOR]

This open label pilot study evaluated the safety and efficacy of the oral 5-HT3 receptor antagonist granisetron for prophylaxis of delayed chemotherapy-induced nausea and vomiting (CINV) in 30 patients with advanced or recurrent colorectal cancer. Patients were studied during two cycles of a 5-week regimen with irinotecan (CPT-11) and UFT. Patients received prophylactic anti-emetic therapy that included intravenous granisetron. If Grade 1 or higher severity gastrointestinal symptoms occurred during 6 days after CPT-11 administration in Cycle 1, then oral granisetron was administered daily for the following 5 days of CPT-11 in Cycle 2. Sixteen patients (53.3%) experienced delayed CINV in Cycle 1. The incidence of Grade 2 or higher vomiting was 32.1% and 27.7% in Cycles 1 and 2 in males ( P = 0.554) respectively, and 54.6% and 32.4% in females ( P = 0.001) respectively. Granisetron is effective against delayed Grade 2 or higher vomiting induced by CPT-11/UFT in female patients, although granisetron alone may not sufficiently control nausea induced by this regimen. [ABSTRACT FROM AUTHOR]

A new single-sided silicon strip detector has been developed for the silicon vertex tracker of the PHENIX detector at the Relativistic Heavy Ion Collider in Brookhaven National Laboratory (RNL). The novel "stripixel" detector concept developed by the BNL Instrumentation Division was applied to the first prototype silicon sensor. The novel feature of the stripixel concept is two-dimensional (2-D) position sensitivity with single-sided processing achieved by charge sharing between two interleaved electrodes in one pixel. Signals are read out projectively by double layers of aluminum strips. The first prototype stripixel sensors with the size of 343 × 64.6 mm and thickness of 250 and 400 μm were fabricated. the detector with readout electronics was constructed to evaluate the prototype sensor performance by using an analog multiplexer chip with charge sensitive preamplifier-shaper circuits (VA2 chip of IDEAS). The sensor performance on charge sharing, detection efficiency, signal-to-noise ratio, and position resolution has been tested with a radioactive source and a GeV particle beam at KEK-PS. The stripixel detector concept, the specification of the first prototype stripixel sensor, and the test results are presented. [ABSTRACT FROM AUTHOR]

Background: CO2 pneumoperitoneum provides a new surgical environment to treat malignant disease. The purpose of this study was to investigate the influence of CO2 pneumoperitoneum during laparoscopic surgery on cancer cell growth.Methods: WiDr human colon cancer cells were incubated for 3 h under the following two conditions: 100% CO2 at 10 mmHg, and 95% air/5% CO2 (control). Cell proliferation was assessed by the WST-1 assay and BrdU assay. Tumor growth was assessed by subcutaneous injection into 20 nude mice. Cellular damage was measured by lactate dehydrogenase (LDH) assay.Results: The number of WiDr cells under pneumoperitoneal conditions decreased in the first 24 h. However, no significant difference was observed in the proliferation rate and tumor growth of the viable cells. LDH release of the CO2 pneumoperitoneal group was higher than that of the controls.Conclusions: Our data indicate that CO2 pneumoperitoneum does not promote cancer cell proliferation but instead has a toxic effect on cancer cells. [ABSTRACT FROM AUTHOR]

Abstract: We are developing a neutron beam monitor with a gas electron multiplier (GEM) for the high-intensity total diffractometer at J-PARC. In order to analyze the basic characteristics of the GEM-based detector, a neutron irradiation test was carried out at J-PARC. The wavelength-spectrum distribution obtained from the test is consistent with the calculations, and the beam profiles agree with the simple Monte Carlo (MC) simulation. The position resolution of the GEM-based detector is estimated to be approximately 1.2mm. Therefore we found that as a neutron beam monitor, the GEM-based detector has good two-dimensional imaging ability. [ABSTRACT FROM AUTHOR]

Background Brain metastases (BM) from esophageal cancer (EC) are rare. Despite of an advance of treatments for the patients with BM from EC, life expectancy and quality of life of these patients are still poor. We present an overview of the patients with BM from EC at a single institute. Methods We retrospectively identified 10 patients with BM from EC treated with surgery, radiation, or a combination of multidisciplinary therapies at Osaka National Hospital between 2003 and 2017 for stages IIb through IV of primary EC (follow-up, > 157 days). Medical records were reviewed to collect demographic and clinical information. Results Median age at diagnosis of BM was 63.5 years (range, 53–79 years). 9 patients were male, and 7 patients had squamous cell carcinoma of EC at the primary esophageal resection. Median overall survival from the commencements of therapy for BM was 156 days (range, 17–5404 days). The interval between the primary esophagectomy and the start of therapy for BM from EC was 298 days (range, 64–860 days). The average score of Karnofsky performance status (KPS) just before a diagnosis of BM was 75 (range, 50–90). On univariate analysis, the patients with the lower score of KPS (P  = 0.01) or the shorter interval between the primary esophageal surgery and the start of therapy for BM (P  = 0.06) were found to have worsened survival after the therapy for BM from EC. Conclusion The patients who had a poor KPS just before a diagnosis of BM, or the shorter interval between the esophagectomy for the primary EC and the start of therapy for BM, had poor prognosis. Disclosure All authors have declared no conflicts of interest. [ABSTRACT FROM AUTHOR]

Abstract: We studied the -nucleus interaction by the reactions on 12C and 16O. An appreciable strength observed in a bound region indicates that the -nuclear potential is strongly attractive. Potential depth was derived by comparing with the theoretical calculations. It is −190 MeV for the −160 MeV for the , and −180 MeV for the reaction and −160 MeV for the respectively. Our data suggest that the -nucleus potential is sufficiently deep to realize kaon condensation in the core of neutron stars. [Copyright &y& Elsevier]