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Due to vigorous efforts to decontaminate the environment following the accident at Fukushima Daiichi nuclear power plant, the size of the difficult-to-return zone has reduced significantly and people have started returning to their homes. As the population has increased, medical needs have ensued. A marked increase in traffic as well as decontamination and reconstruction projects has led to an increase in the number of road traffic and occupational accidents. Acceleration of population aging has resulted in an increased number of elderly residents with multiple medical problems. Uncontrolled/untreated medical problems among middle-aged to older workers have made them susceptible to deterioration of health conditions. Insufficient social support for elderly people living alone has resulted in delayed access to medical care. Early intervention and the prevention of health deterioration are instrumental. When responding to medical needs, proactive approaches, including home visits for elderly patients and health promotion, have been implemented. Human resource development is crucial to ensure the sustainability of these activities.

The accident at Fukushima Daiichi nuclear power plant occurred following the huge tsunami and earthquake of 11 March 2011. After the accident, there was considerable uncertainty and concern about the health effects of radiation. In this difficult situation, emergency responses, including large-scale evacuation, were implemented. The Fukushima Health Management Survey (FHMS) was initiated 3 months after the accident. The primary purposes of FHMS were to monitor the long-term health of residents, promote their well-being, and monitor any health effects related to long-term, low-dose radiation exposure. Despite the severity of the Fukushima accident and the huge impact of the natural disaster, radiation exposure of the public was very low. However, there were other serious health problems, including deaths during evacuation, increased mortality among displaced elderly people, mental health and lifestyle-related health problems, and social issues after the accident. The Nuclear Emergency Situations – Improvement of Medical and Health Surveillance (SHAMISEN) project, funded by the Open Project For European Radiation Research Area, aimed to develop recommendations for medical and health surveillance of populations affected by previous and future radiation accidents. This paper briefly introduces the points that have been learned from the Fukushima accident from the perspective of SHAMISEN recommendations.

Aims: To develop a quick and accurate PCR-based method to evaluate viable Bifidobacterium breve strain Yakult (BbrY) in human faeces. Methods and Results: The number of BbrY in faeces was detected by using strain-specific quantitative real-time PCR (qPCR) derived from a randomly amplified polymorphic DNA analysis. And using propidium monoazide (PMA) treatment, which combined a DNA-intercalating dye for covalently linking DNA in dead cells and photoactivation, only viable BbrY in the faeces highly and significantly correlated with the number of viable BbrY added to faecal samples within the range of 105–109 cells per g of faeces was enumerated. After 11 healthy subjects ingested 10·7 log CFU of BbrY daily for 10 days, 6·9 (±1·5) log CFU g−1 [mean (±SD)] of BbrY was detected in faeces by using strain-specific transgalactosylated oligosaccharide–carbenicillin (T-CBPC) selective agar medium. Viable BbrY detected by qPCR with PMA treatment was 7·5 (±1·0) log cells per g and the total number (viable and dead) of BbrY detected by qPCR without PMA treatment was 8·1 (±0·8) log cells per g. Conclusions: Strain-specific qPCR with PMA treatment evaluated viable BbrY in faeces quickly and accurately. Significance and Impact of the Study: Combination of strain-specific qPCR and PMA treatment is useful for evaluating viable probiotics and its availability in humans.

Ultra-low-frequency photocurrent (PC) self-oscillation has been investigated in an In 0.15 Ga 0.85 As/Al 0.15 Ga 0.85 As quantum-well (QW) diode in details as a function of temperature, excitation power and wavelength. The PC oscillation frequency increases with increasing temperature and illumination power at excitation wavelengths below the leading n = 1 heavy-hole exciton resonance line under reverse bias conditions. The illumination wavelength dependence shows a clear evidence for beating due to two oscillators when photoexcitation by shorter wavelength below 1050 nm is used. These results suggest that the low-frequency PC self-oscillation with a characteristic frequency of about 0.01-0.1 Hz is caused by oscillating electric fields due to two types of photogenerated charge carriers trapped at deep localized centers within the QW regions.

Cryogenic spill on Floating LNG (FLNG) is one of the risks which need to be managed to avoid the potential embritllement and subsequent fracture of exposed unprotected steel work, as well as the possibility of large flammable cloud within the facility which may cause fire and explosion. For onshore LNG plants, guidance on spill control has been based on the widely used NFPA59A and EN1473.However, these guidelines are not directly applicable FLNG. With the absence of international rules directly applicable to this new concept, risk-based approach can be considered to determine the design. The challenge is how to control the cryogenic liquid spill in a congested installation when there are no proven robust existing installations for this application. Onshore practice is to collect the cryogenic liquid spill in an impoundment area. However, this practice is not suitable for offshore installation due to limitation in space and congested nature of FLNG facilities. In using risk based approach, the cryogenic spill is presumed to have a large extent due to two-phase jet caused by high pressure systems. Thus, a study and optimization for the cryogenic spill control design on the onset of the project is important. In this paper, there are several options that are considered during the design development on how to control the cryogenic spill in Floating LNG using risk analysis. The risk analysis method is widely used in offshore design but it also has limitations. Designing based on risk analysis with different possible options is also described, recognizing the strengths and weaknesses of each design option in terms of safety and operability. An observation of alternative approach rather than purely relying on risk analysis is also discussed in this paper.

Effective and compact deodorization systems have been required for the measure of small-scale emission sources of offensive odors usually found in urban areas. We have developed a sheet material with titanium dioxide (TiO 2 ) photocatalyst supported on fiber activated carbon (FAC) for a compact deodorization system. In the deodorization system using the TiO 2 /FAC sheet and a ultraviolet lamp, malodorants can be collected on the TiO 2 /FAC sheet by adsorption and then decomposed by photocatalysis with UV-irradiation. In this study, we obtained basic information about the removal and the decomposition of malodorants in the photocatalytic deodorization system using the TiO 2 /FAC sheet. The malodorants used in this study were methyl mercaptan, ammonia, and hydrogen sulfide. In addition, two kinds of light sources, a black light bulb (BLB; dominant wavelength: 365 nm) and an ultraviolet germicidal lamp (UV2; dominant wavelength: 254 nm) were used to analyze the effect on removal and decomposition characteristics by different dominant wavelengths. The removal rates of malodorants from the gas phase were determined in the deodorization system in the presence or absence of the TiO 2 /FAC sheet and UV-irradiation in order to study each removal effect due to adsorption onto the TiO 2 /FAC sheet, direct photolysis by UV-irradiation, and photocatalytic decomposition. The effect of adsorption onto the TiO 2 /FAC sheet was pronounced in this batch-type experiment. The effect of photocatalysis was observed from the removal rates of methyl mercaptan. The percent oxidation of ammonia to nitrate and that of methyl mercaptan to sulfate were examined by determining products, i.e. nitrate and sulfate ions, with purified water after the reaction. The formation of nitrate or sulfate was not observed without UV-irradiation using the BLB, while the reactions progressed in the presence of the TiO 2 /FAC sheet. When the UV2 lamp was used, the oxidation of methyl mercaptan to sulfate occurred without the TiO 2 /FAC sheet. This suggests that the decomposition characteristics of malodorants were dependent on the wavelength of the light source.

Fetal pancreatic islets show a deficiency in insulin secretion in response to glucose, but the underlying mechanism is disputed. By isolating pancreatic islets from 21-day pregnant rats and culturing them with 2.8 or 11.1 mM glucose for 7 days, we attempted to clarify the involvement of low glucokinase activity in the poor glucose response in islets cultured with 2.8 mM glucose relative to the response obtained from those cultured with 11.1 mM glucose. The insulin secretion induced by 10 mM glyceraldehyde or 15 mM leucine, but not that induced by 20 mM glucose, from islets cultured with 2.8 mM glucose was higher than the basal insulin secretion, suggesting that the defect in glucose stimulation in fetal islets may be localized somewhere before the glyceraldehyde 3-phosphate step in the glycolytic pathway. When islets cultured with 11.1 mM glucose as distinct from those cultured with 2.8 mM glucose were incubated with glucose, the glycolytic intermediate contents were increased in a concentration- and time-dependent manner. Utilization of glucose at 20 mM, but not at 5 mM, in islets cultured with 11.1 mM glucose was higher than that in islets cultured with 2.8 mM glucose. The Vmax value of glucokinase, but not that of hexokinase or aldolase, in islets cultured with 11.1 mM glucose was higher by 150% than that in islets cultured with 2.8 mM glucose. The results suggest that the poor secretion of insulin in response to glucose can be explained by insufficient glucose metabolism due to the low glucokinase activity.

Angular and magnetic field dependences of the magnetization in the mixed state have been measured on Nd1.858 Ce0.142 CuO4 single crystal. The angular dependence of the magnetization due to the superconductivity in the mixed state shows an anomalous peak just around H‖a-axis above 2 kOe in ZFC and the peak becomes sharp with increasing magnetic fields. The magnetization curve for H‖a-axis shows negligibly small hysteresis in the mixed state between the increase and the decrease of the magnetic fields above 5 kOe. These behaviors were discussed on the basis of the vortex configuration and the superconducting anisotropy of this crystal. If the vortex would be pancake-like and could not exist in the sample for H‖a-axis, the anomalous behaviors could be understood qualitatively. It was concluded that the dimensional crossover from 3-D to 2-D in the vortex system began to occur in H>5 kOe and the pancake-like vortex appeared at higher magnetic fields.

Hepatocyte growth factor (HGF) and transforming growth factor alpha (TGF-alpha) stimulate liver regeneration, whereas transforming growth factor beta 1 (TGF-beta 1) inhibits it in rats. However their significance in human liver diseases, especially in severe acute liver injury, remains unclear. We studied HGF, TGF-alpha, and TGF-beta 1 messenger RNA (mRNA) expression in the livers of patients with live diseases using a competitive reverse transcriptase polymerase chain reaction. As little as a twofold difference in mRNA expression could be detected from minute liver biopsy samples. We then examined cell proliferation using proliferating cell nuclear antigen (PCNA) staining. HGF mRNA levels were significantly higher (approximately threefold) in acute hepatitis (AH) than in exacerbation of chronic liver disease (EX) (P.05). TGF-alpha mRNA levels were significantly greater in AH (approximately twofold) than EX (P.05), and the levels were significantly higher (approximately threefold) in chronic hepatitis (CH) than in EX (P.05). The TGF-beta 1 mRNA levels in all the groups were not significantly different. In acute liver injury (AH and EX), there was a significant correlation between HGF mRNA expression and the PCNA labeling index (LI) in the liver (r = .87, P.005). TGF-alpha mRNA expression also correlated with the PCNA LI (r = .92,P.0001). There was no significant correlation between the serum HGF and the PCNA LI in the liver. In conclusion, HGF and TGF-alpha produced in the liver stimulate hepatocyte proliferation in response to acute liver injury in humans.

We report an observation of ultra-low-frequency self-oscillation of photocurrent in InxGa1–xAs/Al0.15Ga0.85As multiple-quantum-well p–i–n diodes. The photocurrent intensity shows self-oscillations with a characteristic frequency of ~0.1 Hz at low temperatures under reverse bias voltages. The photocurrent self-oscillation depends on applied bias voltage, temperature, illumination power, and indium content of quantum-well layers. These dependences indicate that the photocurrent self-oscillation is attributed to photogenerated carriers trapped in localized centers within InxGa1–xAs quantum-well regions.

A major thrust in the application of gene transfer technology for cancer therapy has been the modulation of the immune response. There has been a veritable explosion of information regarding the components of the immune response that are required to generate a meaningful cellular response to tumorassociated antigens (TAAs) capable of eliciting rejection of established tumor. Many of the preclinical and clinical immunogenetic studies have focused on melanoma. Historically, melanoma has been an immunoresponsive tumor for which several melanoma TAAs have been identified.

The effect of maternal hypoglycemia on early organogenesis was studied in normal and diabetic rats. Female Wistar rats were made diabetic by an intravenous injection of streptozotocin (45 mg/kg) 2-3 weeks before conception. On day 9.5 or 10.5 of embryo development, both control and diabetic dams received saline or Actrapid human insulin (400 mU/rat) intraperitoneally after 19-h starvation. The fasting plasma glucose levels in diabetic dams decreased from approximately 23 to 8 mM. Hypoglycemia as low as 3.5 mM was maintained for 60 min in insulin-treated mother rats. Pregnancy was terminated on day 11.6 of embryo development. A significant growth retardation was found in diabetic embryos as compared with normal embryos. Maternal hypoglycemia lowered the DNA content in normal but not diabetic embryos, while the teratogenic effect of maternal hypoglycemia was not pronounced in either normal or diabetic embryos. These data may suggest that maternal hypoglycemia in vivo in early pregnancy influences the embryogenesis but not teratogenesis of rat embryos.

To develop a quick and accurate PCR-based method to evaluate viable Bifidobacterium breve strain Yakult (BbrY) in human faeces.The number of BbrY in faeces was detected by using strain-specific quantitative real-time PCR (qPCR) derived from a randomly amplified polymorphic DNA analysis. And using propidium monoazide (PMA) treatment, which combined a DNA-intercalating dye for covalently linking DNA in dead cells and photoactivation, only viable BbrY in the faeces highly and significantly correlated with the number of viable BbrY added to faecal samples within the range of 10(5) -10(9) cells per g of faeces was enumerated. After 11 healthy subjects ingested 10·7 log CFU of BbrY daily for 10 days, 6·9 (± 1·5) log CFU g(-1) [mean (± SD)] of BbrY was detected in faeces by using strain-specific transgalactosylated oligosaccharide-carbenicillin (T-CBPC) selective agar medium. Viable BbrY detected by qPCR with PMA treatment was 7·5 (± 1·0) log cells per g and the total number (viable and dead) of BbrY detected by qPCR without PMA treatment was 8·1 (± 0·8) log cells per g.Strain-specific qPCR with PMA treatment evaluated viable BbrY in faeces quickly and accurately.Combination of strain-specific qPCR and PMA treatment is useful for evaluating viable probiotics and its availability in humans.

Temperature dependence of the photocurrent (PC) intensity has been experimentally investigated as a function of reverse bias in high quality In 0.1 Ga 0.9 As/A 0.15 Ga 0.85 As multiple quantum wells (MQW) in a p-i-n diode configuration. PC features show unusual behaviors at low temperatures, especially at 15 K, such as (1) the PC intensity increase with the electric field under low field conditions at 15 K and (2) a reduction up to 60 K and a rise above 60 K, while the PC intensity under high field conditions decreases with temperature. These unusual PC features under low field conditions at low temperatures are explained by considering exciton ionization, the thermal population and the tunneling probability.

The proposed register access queues are used as part of a scheduler which avoids possible access conflicts for a multi-bank register file in the highly parallelized processor. From the design and implementation in 180 nm CMOS technology, a multi-bank register file with the access queue realizes 65 % smaller area and 64 % higher clock frequency when compared with a conventional multi-port-cell register file. Since the cycle-based execution performance of the processor remains practically unchanged, the higher clock frequency translates directly into higher processor performance

It seems that mitral valve surgery in patients older than 80 years increase against the background of the aging society. Basically, there are not particular differences between elderly patients and younger patients in procedures for diagnosis and operative indication in mitral valve diseases. However, cardiac surgery for patients older than 80 years has been reported to have high mortality rate. Therefore, it is necessary that we should evaluate and treat complications of important organs such as brain/coronary artery/lungs/liver/kidney, adequately. Our mortality rate of the whole mitral valve operations was 2.4% and that of patients older than 75 years was 7.9%. This result compares favorably with those reported from other institutions. However, when we perform mitral valve operations for patients older than 80 years, it is necessary to investigate activities of daily living and quality of life before and after the operation.

Photocurrent (PC) response properties have been investigated of In/sub x/Ga/sub 1-x/As/Al/sub 0.15/Ga/sub 0.85/As quantum wells (QWs) embedded in an intrinsic region of a p-i-n diode as a function of temperature and bias voltage. It is found that the PC signal intensity shows self-oscillations with a characteristic frequency of about 0.1 Hz at low temperatures below 60 K under the reverse bias conditions by illumination at wavelengths near the leading n = 1 heavy-hole exciton resonance. The frequency of the self-oscillation depends on the illumination power. The self-oscillations are only observed for QWs with higher In fractions (with x = 0.10 and 0.15) with delayed PC rises. These results suggest that the low-frequency PC self-oscillation is caused by oscillating electric fields due to photogenerated charge carriers trapped at deep localized centers within the In/sub x/Ga/sub 1-x/As QW regions.

IP telephony systems are expected to be deployed worldwide in the near future because of their potential for integrating the multimedia communication infrastructure over IP networks. Phone-to-phone connection over an IP network via IP telephony gateways (IP-GWs) is a key feature of the system. In an IP telephony system, a low-bit-rate voice codec is used to improve bandwidth efficiency. However, due to the packet transfer method over the IP network, it is necessary to add packet headers, including IP, UDP, and RTP headers, which increases the header overhead and thus decreases transfer efficiency. Moreover, because there will be large numbers of short voice packets flowing into the IP network, the load on the Internet will increase. We propose voice stream multiplexing between IP-GWs to solve these problems. In this scheme, multiple voice streams are connected between a pair of IPCWs, enabling multiplexed voice stream transfer. The voice stream multiplexing mechanism can reduce the header overhead as well as decrease the number of voice packets. The voice stream multiplexing we propose is to concatenate RTP packets destined for the same IP-GW at a multiplexing interval period into a single UDP packet. The advantage of this method is that no new additional header is required and the current well-defined H.323 and RTP standards can be applied with minimum changes. We implemented and tested the system.

Various types of planar inductors have been proposed for reducing the volume of switching converters. Planar inductors using amorphous alloy ribbons as magnetic layers are also studied. The purpose of this study is to clarify the relation between the electrical performance of the inductor, and the properties and composition of amorphous ribbon. The experimental results show that superimposed dc current, I80, increases linearly with the product of Bm and ribbon thickness t, where I80 is defined as the dc current corresponding to an inductance which decreases to 80% of an initial value. In the case of stacking amorphous alloy ribbons, I80 increases with gradual approach to saturation, as the stack thickness increases regardless of ribbon thickness. However, the saturation value of I80 depends on ribbon thickness. The saturation value increases with increasing ribbon thickness. The above results suggest that from a practical viewpoint the use of thick ribbons is preferable. With respect to alloy composition,...

In the last few years, software tools such as electronic mail and World Wide Web browsers have greatly increased productivity. The demand to take these tools out of the office through small, lightweight hand-held devices called personal digital assistants (PDAs) has been especially fervent. Manufacturers have had to scramble to supply this demand, but have run into problems with size, weight, batteries and operating systems (OSs). In order to solve these problems, the BTRON OS was singled out because it operates on very few resources, which makes it perfect for use in PDAs, and through the addition of power management functions, Seiko Instruments Inc. (SII) was able to create the BTRON-Brain Pad, the world's first PDA to run on the BTRON OS with long-life, small batteries for lightweight portability. This paper introduces the technical specifications of the BTRON-BrainPad, as well as how power management functions were added to the newest BTRON OS (BTRON3), to enable the realization of this small-sized, lightweight and easy-to-use PDA.

Effective and compact deodorization systems have been required for the measure of small-scale emission sources of offensive odors usually found in urban areas. We have developed a sheet material with titanium dioxide (TiO2) photocatalyst supported on fiber activated carbon (FAC) for a compact deodorization system. In the deodorization system using the TiO2/FAC sheet and a ultraviolet lamp, malodorants can be collected on the TiO2/FAC sheet by adsorption and then decomposed by photocatalysis with UV-irradiation. In this study, we obtained basic information about the removal and the decomposition of malodorants in the photocatalytic deodorization system using the TiO2/FAC sheet. The malodorants used in this study were methyl mercaptan, ammonia, and hydrogen sulfide. In addition, two kinds of light sources, a black light bulb (BLB; dominant wavelength: 365 nm) and an ultraviolet germicidal lamp (UV2; dominant wavelength: 254 nm) were used to analyze the effect on removal and decomposition characteristics by different dominant wavelengths. The removal rates of malodorants from the gas phase were determined in the deodorization system in the presence or absence of the TiO2/FAC sheet and UV-irradiation in order to study each removal effect due to adsorption onto the TiO2/FAC sheet, direct photolysis by UV-irradiation, and photocatalytic decomposition. The effect of adsorption onto the TiO2 /FAC sheet was pronounced in this batch-type experiment. The effect of photocatalysis was observed from the removal rates of methyl mercaptan. The percent oxidation of ammonia to nitrate and that of methyl mercaptan to sulfate were examined by determining products, i.e. nitrate and sulfate ions, with purified water after the reaction. The formation of nitrate or sulfate was not observed without UV-irradiation using the BLB, while the reactions progressed in the presence of the TiO2/FAC sheet. When the UV2 lamp was used, the oxidation of methyl mercaptan to sulfate occurred without the TiO2/FAC sheet. This suggests that the decomposition characteristics of malodorants were dependent on the wavelength of the light source.

To determine how the education of basic life support (BLS)/advanced cardiac life support (ACLS) and emergency medicine for anesthesiologists is conducted, we performed a survey of chairpersons at university departments and newly board certified anesthesiologists in 1999. Basic and advanced life support courses for residents were provided in more than half of the anesthesiology departments that responded to this survey. However, approximately only 10% of the respondents had regular BLS/ACLS courses for residents. On the other hand, more than 80% of respondents considered a rotation in emergency medicine desirable as a part of anesthesia training. To improve the resuscitation skills of anesthesiologists, an urgent need to establish regular BLS/ALS courses and educational programs in emergency medicine in anesthesia training does exist.

The rationale for surgery in achalasia is to reduce lower esophageal sphincter (LES) pressure and recontruct an antireflux mechanism. Fundopexy as an antireflux procedure after LES myotomy (modified Heller myotomy), called the Jekler and Lhotka method or the Heller and Dor operation, is commonly performed as standard surgery. In our institution, this method has been used since 1982. We have performed the modified Jekler and Lhotha method including long myotomy to confirm complete reduction of LES pressure as measured by intraoperative manometry and fundopexy plus posterior wall fixation to contract the long abdominal esophagus since 1986. Satisfactory results with this procedure have been obtained and reported. Furthermore, we have recently performed this procedure with minilaparotomy. In this review, we describe the modified Jekler and Lhotha method in minimized laparotomy and evaluate this procedure using intraoperative manometry.

Interferon-gamma-inducing factor (IGIF) is a novel cytokine that stimulates T-cell proliferation, augments natural killer (NK) cell lytic activity, and induces interferon-gamma (IFN-gamma) production in established type 1 T-helper (Th1) cells in the presence of anti-CD3 antibody. The in vitro induction of IFN-gamma by recombinant murine IGIF in these cells was more potent than that induced by murine interleukin-12 (IL-12) and occurred apparently independent of murine IL-12. Here we report that subcutaneous injection into mice of tumor cells transfected with murine IGIF complementary DNA (cDNA) resulted inor = 10-fold increase of mitogen-stimulated IFN-gamma production in cultured splenocytes. In addition, IGIF-transfected Renca and K1735 tumor cells can be rejected in vivo. The IGIF antitumor effect was abrogated in mice that were sublethally irradiated or depleted of both CD4+ and CD8+ T cells but not in mice depleted of either subpopulation alone. The antitumor effect mediated by IGIF appears to be dependent on IFN-gamma production, because in vivo neutralization of IFN-gamma was accompanied by growth of IGIF-transfected tumors in 100% of the animals. Taken together, our results show that murine IGIF can elicit T-cell-dependent antitumor immunity associated with IFN-gamma induction.

We have previously reported that CD8+ tumor-draining lymph node (TDLN) cells activated with anti-CD3 and IL-2-mediated tumor regression in adoptive immunotherapy. In this study, we examined the TCR Vbeta repertoire usage of TDLN cells with respect to cytokine release profiles and therapeutic efficacy in vivo. The majority of the whole population of TDLN cells after activation with anti-CD3 were composed of Vbeta3+, -5+, -7+, -8+, and -11+ cells. Enrichment of Vbeta subsets of TDLN cells by in vitro activation with anti-Vbeta mAb revealed Vbeta8+ cells released high amounts of IFN-gamma and granulocyte/macrophage-CSF (GM-CSF) with minimal amounts of IL-10 in response to tumor and mediated tumor regression in vivo. In contrast, enriched populations of Vbeta5+, Vbeta7+, and Vbeta11+ cells released low amounts of IFN-gamma and GM-CSF with high levels of IL-10 and had no in vivo antitumor reactivity. In vitro depletion of specific Vbeta subsets from the whole TDLN pool confirmed that the profile of cytokines released correlated with in vivo antitumor function. Therapeutic efficacy mediated by TDLN cells required the release of IFN-gamma and GM-CSF since in vivo neutralization of both cytokines inhibited tumor regression. The administration of anti-IL-10 mAb abrogated the suppressed antitumor response manifested by adoptively transferred TDLN cells, which elaborated increased levels of IL-10. Our study documents that type 1 cytokine release (i.e., IFN-gamma and GM-CSF) promotes in vivo tumor Ag recognition, in contrast to type 2 release (i.e., IL-10), which suppresses this interaction, and discriminates the functional activity of Vbeta subpopulations of effector cells.

The points of the postoperative care in radical operation of esophageal cancer are followings. 1) Postoperative nutritional management: In the reconstruction using gastric tube, we make Witzel's gastrostomy in antrum of regardless of the reconstructive routes and transfer to enteral tube-feeding to assist the oral food-taking amount. These management is not only attributing to assist early return to working but also effective to prevent the loss of postoperative physical strength in older patients. 2) Postoperative adjuvant therapy: The esophageal cancer is the diseases that react chemo- and radio-therapy, so most of advanced cases were treated with adjuvant therapy. Nowadays, it is essential for patients to explain the real diagnosis, treatment regimen, then to agree to the informed concent. After informed, the tender mental consult during treatment and outpatient service is required for mental burden. 3) Postoperative follow-up: The recognition of postoperative QOL, early detection of recurrence are mostly emphasized during 2 years after operation. The occurrence of secondary cancer (gastric cancer, cervico-pharyngeal cancer, colorectal cancer etc.) are seen in even 5-10 years after operation. Then the long-term periodical examination and life care are needed.

The necessity and efficacy of biliary drainage prior to major surgery in patients with obstructive jaundice have been reported in various clinical and experimental studies in Japan. However, it is not enough that Western countries understand the advantage of preoperative drainage. In this study, therefore, cytoprotective effect of preoperative biliary drainage drainage was evaluated using the cell biological technique.Ten jaundiced dogs and 10 with drainage (after induction of jaundice) were each divided into two groups: those with and those without 40% hepatectomy. Using these four groups, the advantage of biliary drainage before hepatectomy in obstructive jaundice was studied, using isolated hepatocytes and Kupffer cells.In jaundiced dogs, isolated hepatocyte viability and intracellular cyclic AMP concentration were considerably reduced. The bleb formation rate, culture supernatant lipid peroxide and lactate dehydrogenase contents, and plasma thromboxane B2 and 6-keto-PGF1 alpha levels all markedly increased. These changes were more exaggerated in those after hepatectomy. In the dogs with drainage, all of these values were approximated to those in normal animals. The changes following hepatectomy in dogs with drainage were also less pronounced in comparison with jaundiced animals.These findings suggest that biliary drainage prior to hepatectomy in obstructive jaundice mitigates liver impairment, both at the cellular level and in terms of prostanoid metabolism. It was concluded that preoperative biliary drainage prior to hepatectomy ensures better results for obstructive jaundice.

Congenital erythropoietic porphyria (CEP, Günther's disease) is an extremely rare autosomal recessive disease (There have been only 33 case reports in Japan to date.), characterized by mutilating cutaneous photosensitivity and abnormal haem synthesis in the bone marrow. Reduced activity of uroporphyrinogen III synthase (UROIIIS), the fourth enzyme of haem biosynthetic pathway causes this disease. Recent progresses of molecular biology enable us to analyze genetic defect at the molecular level of porphyrias. Also in CEP, it has been reported several reports of mutations of the UROIIIS gene since isolation of a full-length human cDNA encoding UROIIIS by Desnick et al. Here we report about epidemiology, signs and symptoms, laboratory findings and therapies of CEP.

Clinical features, diagnostic accuracy of imaging study, and the outcome of surgical treatment for endocrine tumors of the pancreas were analyzed in 12 patients who underwent surgery for the past 16 years and 11 months. The 12 cases were classified into two groups: functioning tumors in 8 (insulinoma in 7 including one malignant case, and malignant glucagonoma in one), and nonfunctioning tumors in 4 including 3 malignant cases. In functioning tumors, tumor size was 2 cm or less in 6 benign cases, but 5 cm or more in 2 malignant cases. In nonfunctioning tumors, tumor size was larger, ranging from 3.5 to 8.0 cm. Diagnostic accuracy for localization of functioning tumors was 66.7% for US, 75.0% for CT, 66.7% for endoscopic retrograde pancreatography (ERP), and 50.0% for selective angiography, while all nonfunctioning tumors could be detected by any diagnostic imagings. Percutaneous transhepatic portal venous sampling for immunoreactive insulin was very helpful to localize insulinoma. Stenosis or obstruction of the main pancreatic duct on ERP and arterial encasement on angiography highly suggested a malignant tumor. Even for malignant cases with liver metastasis, resection of the primary tumor with debulking of metastatic disease or intraarterial infusion chemotherapy was considered to prolong patient prognosis.

We compared insulin secretory activity from rat pancreatic islets with that from a hamster beta-cell line (HIT-T). Insulin release from HIT cells was maximally stimulated with glucose at a concentration of 11.1 mM, and rather inhibited by higher concentrations of glucose. Blunted insulin release induced by glucose was shown in the isolated rat islets exposed to either streptozotocin (2.2 mM) for 30 min or alloxan (2 mM) for 5 min, whereas glucose-induced insulin release from HIT cells was not affected by pre-treatment with such beta-cell toxin. When pancreatic islets and HIT cells were cultured for 7 days with 10 mM nicotinamide, an inhibitor of poly (ADP-ribose) synthetase, glucose-induced insulin release from the islets was inhibited, whereas insulin release from HIT cells was rather enhanced. Insulin release induced by either arginine or leucine was also enhanced in HIT cells cultured with nicotinamide. These findings indicate that the multiple components of insulin stimulus-secretion coupling in HIT cells are considerably different from those in rat pancreatic islets.

We examined the effect of alcohol ingestion on rat hepatocarcinogenesis induced by oral administration of synthetic female hormones, 0.075 mg of ethynylestradiol (EE) and 6.0 mg of norethindrone acetate (NA), everyday for 12 months to Wistar rats. Concomitant administration of 10% ethanol in drinking water resulted in the development of hepatocellular carcinoma (HCC) in 40.8% in female rats and 11.8% in male rats at 12 months, although the incidences of HCC following hormones administration alone were 8.0% in female rats and 0% in male rats. The incidence and the number of hyperplastic nodules in rats with concomitant alcohol treatment were significantly higher than that in rats with hormone treatment alone. The additional alcohol administration significantly increased the values of nuclear and cytosol estrogen receptors at 4 months. Synthetic female hormones and/or alcohol treatment also significantly increased the value of cytosol progesterone receptor at 4 months. 32P-postlabeling analysis of liver DNA revealed that alcohol enhanced the DNA adduct formation induced by hormones. Consequently, alcohol may affect rat hepatocarcinogenesis caused by synthetic female hormones in enhancing cell-proliferating activity via estrogen and progesterone receptors, and DNA adduct formation induced by synthetic female hormones.

Although foreign bodies of the gastrointestinal tract are common in children, they are rare in the adult. Complications of the foreign bodies are well recognized to be a cause of obstruction, bleeding and perforation of the intestine, or furthermore, they sometimes lead to death unfortunately. On the other hand, it is very difficult to diagnose and treat foreign bodies in the handicapped because of disability of complaining the symptoms. This paper reports a 31-year-old severe handicapped man suffering from foreign bodies in the esophagus and the small intestine, and was successful removed by endoscope.

We describe a case of heterotopic pancreatic tissue of the ileum causing acute gastrointestinal tract bleeding. It was initially clearly demonstrated as an ileal polyp preoperatively by radiologic means. Exploratory surgery was performed, and the segment of ileum containing the mass was resected. Histopathologic examination of the lesion revealed heterotopic pancreatic tissue of Heinrich type II. There was no histological evidence of acute or chronic pancreatitis, but erosion was confirmed at the tip of the mass. Even symptomatic heterotopic pancreatic tissue of the ileum may give difficult diagnostic problems. The present case is reported to show the possibility of diagnosing rare abnormalities of the ileum.

The purpose of this study was to find appropriate adjuvant therapy following resection of pancreatic head carcinoma according to the histopathological and biological features. There was a significant correlation between histological tumor spread and biological factors. When all three biological factors, proliferating cell nuclear antigen (PCNA), epidermal growth factor (EGF), and tenascin (TN) were positive, the incidence of liver metastases was 78.6%, while it was only 7.1% when all three were negative. With the results of these factors surgical margin of the resected tumor (ew) we have proposed a protocol for adjuvant therapy following resection of the pancreatic head carcinoma.

Decompensated diabetes mellitus (DM) is associated with abnormalities in fluid and electrolyte balance (1,2,3). Alterations in the renin-angiotensin- aldosterone system and vasopressin have been observed both in human with DM (4,5) and in rats treated with the diabetogenic agent, streptozotocin (STZ) (6,7,8).

Radionuclide ventriculographic studies were performed at rest and during exercise in 15 middle-aged asymptomatic patients with non-insulin-dependent diabetes mellitus (NIDDM) whose mean age was 58.7 +/- 10.5 years (mean +/- SD), and in 10 age- and sex-matched normal control subjects. The patients had neither clinical evidence of cardiovascular diseases nor obvious perfusion defects during maximal exercise testing with thallium-201 myocardial scintigraphy. The average left ventricular ejection fraction (LVEF) at rest was 69.1 +/- 5.3% in the diabetic patients and 65.6 +/- 4.2% in the control subjects, and during exercise, the average LVEFs were 68.3 +/- 6.9% and 72.1 +/- 5.0%, respectively. The changes in LVEF during exercise were -0.7 +/- 7.6% in the diabetic group and +6.5 +/- 2.6% in the control group (p0.01). However, the filling fraction during the first third of diastole at rest was significantly less in the diabetic group than in the control group (p0.05), the time to peak filling rate (TPF) was longer, and the TPF/R-R, normalized by the R-R interval and expressed as a percentage, was greater in the NIDDM patients than in the control subjects. There was close correlation between the abnormal response of LVEF to exercise and the reduced early diastolic filling in the diabetic patients. We concluded that 1) not only the response of LVEF to exercise but also the early left ventricular diastolic filling at rest are impaired in middle-aged asymptomatic NIDDM patients, and 2) some common factors could cause dysfunction of both the systolic and diastolic left ventricles in NIDDM patients, possibly latent global myocardial ischemia or metabolic myocardial disturbances.