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This study examined the aspect of the regulation of velum movement in the transition from the oral to pharyngeal phases of swallowing in relation to changes in the swallowing volume and viscosity by means of measurment of levator veli palatini muscle activity. The subjects were nine normal adults, ranging in age from 24 to 30 years. The swallowing volume was set at 1/4, 1/2 and 1 volume of the optimum volume of green tea for swallowing determined in each subject, and the viscosity was adjusted to 0, 2·0 and 4·6 Pa·s by mixing with thickener. Nine test foods were prepared in total. The electromyographic activity of the levator veli palatini muscle was monitored using bipolar hooked wire electrodes. The levator veli palatini muscle activity was defined as the integrated electromyographic wave. The mean in swallowing each test food was determined in each subject. The levator veli palatini muscle activity increased with the swallowing volume for all subjects ( P < 0·05) and decreased inversely with the viscosity for six subjects ( P < 0·05), but no change with the increase in the viscosity was noted for three subjects. This study clarified the aspect of the regulation of velar movement with regard to the involvement of the levator veli palatini muscle in swallowing activity with changes in the swallowing volume and viscosity. [ABSTRACT FROM AUTHOR]

The authors performed trials and studies to solve the remaining technical problems for manufacturing the ITER Toroidal Field (TF) coil. Cover plate (CP) welding deformation of a side double pancake may achieve specified tolerances with correction of a long wave distortion through the use of a small load, although complicated welding operations are required. In addition, JAEA developed a new procedure for manufacturing a CP at a reduced cost. Straight and curved CPs are fabricated by hot-rolling and cold-drawing and bending the straight CP with sufficient accuracy. Applying these results, JAEA has started procurement of the TF coil, beginning with qualification trials. Manufacture of a full-scale regular RP, finalization of a manufacturing plan and drawings and design of tooling will be completed by the middle of 2011. [ABSTRACT FROM AUTHOR]

Field resistance is defined as the resistance that allows effective control of a parasite under natural field conditions and is durable when exposed to new races of that parasite. To identify the genes for field resistance to rice blast, quantitative trait loci (QTLs) conferring field resistance to rice blast in Japanese upland rice were detected and mapped using RFLP and SSR markers. QTL analysis was carried out in F4 progeny lines from the cross between Nipponbare (moderately susceptible, lowland) and Owarihatamochi (resistant, upland). Two QTLs were detected on chromosome 4 and one QTL was detected on each of chromosomes 9 and 12. The phenotypic variation explained by each QTL ranged from 7.9 to 45.7% and the four QTLs explained 66.3% of the total phenotypic variation. Backcrossed progeny lines were developed to transfer the QTL with largest effect using the susceptible cultivar Aichiasahi as a recurrent parent. Among 82 F3 lines derived from the backcross, resistance segregated in the expected ratio of resistant 1 : heterozygous 2 : susceptible 1. The average score for blast resistance measured in the field was 4.2 ± 0.67, 7.5 ± 0.51and 8.2 ± 0.66, for resistant, heterozygous and susceptible groups, respectively. The resistance gene, designated pi21, was mapped on chromosome 4 as a single recessive gene between RFLP marker loci G271 and G317 at a distance of 5.0 cM and 8.5 cM, respectively. The relationship to previously reported major genes and QTLs conferring resistance to blasts, and the significance of marker-assisted selection to improve field resistance, are discussed. [ABSTRACT FROM AUTHOR]

Abstract: This is an overview paper of the joint TITAN (Tritium, Irradiation, and Thermofluid for America and Nippon) project of the Japan–USA fusion cooperation program. The objectives, tasks structure, and technical highlights of the TITAN project are presented, as well as the direction of the project toward its end in March 2013. [Copyright &y& Elsevier]

Abstract: The effect of neutron-irradiation damage has been mainly simulated using high-energy ion bombardment. A recent MIT report (PSFC/RR-10-4, An assessment of the current data affecting tritium retention and its use to project towards T retention in ITER, Lipschultz et al., 2010) summarizes the observations from high-energy ion bombardment studies and illustrates the saturation trend in deuterium concentration due to damage from ion irradiation in tungsten and molybdenum above 1 displacement per atom (dpa). While this prior database of results is quite valuable for understanding the behavior of hydrogen isotopes in plasma facing components (PFCs), it does not encompass the full range of effects that must be considered in a practical fusion environment due to short penetration depth, damage gradient, high damage rate, and high primary knock-on atom (PKA) energy spectrum of the ion bombardment. In addition, neutrons change the elemental composition via transmutations, and create a high radiation environment inside PFCs, which influences the behavior of hydrogen isotope in PFCs, suggesting the utilization of fission reactors is necessary for neutron-irradiation. Under the framework of the US–Japan TITAN program, tungsten samples (99.99at.% purity from A.L.M.T. Co.) were irradiated by fission neutrons in the High Flux Isotope Reactor (HFIR), Oak Ridge National Laboratory (ORNL), at 50 and 300°C to 0.025, 0.3, and 2.4dpa, and the investigation of deuterium retention in neutron-irradiated tungsten was performed in the Tritium Plasma Experiment (TPE), the unique high-flux linear plasma facility that can handle tritium, beryllium and activated materials. This paper reports the recent results from the comparison of ion-damaged tungsten via various ion species (2.8MeV Fe2+, 20MeV W2+, and 700keV H−) with that from neutron-irradiated tungsten to identify the similarities and differences among them. [Copyright &y& Elsevier]

Abstract: Japan Atomic Energy Agency has manufactured JJ1, strengthened 316LN (ST316LN) forgings, ST316LN hot rolled plates to demonstrate for mass production of the materials for ITER Toroidal Field (TF) coil structure. Tensile, fracture toughness and fatigue test samples were taken from the products and tested to demonstrate mechanical properties of mass production material. Averaged value of 0.2% yield strength for the JJ1, ST316LN forgings and the ST316LN hot rolled plate are 1126MPa, 1078MPa and 1066MPa, respectively. The JJ1 and ST316LN forgings showed uniform ultimate tensile strength (UTS) distribution along the thickness direction. In the ST316LN hot rolled plate with thickness of 200mm, UTS showed some scattering caused by coarse gains which was locally observed at one quarter thickness. However, the mixed grain condition would be solved by modification of forging process, followed by a hot roll process. Measured fracture toughness K IC(J) was more than for all products. A fatigue characteristics (S–N) of ST316LN have been measured at 4.2K and design S–N curve were determined. It was confirmed that ST316LN has enough margins for a cyclic operation of 384MPa with 3×104 cycles on the TF coil case. Therefore, the ITER mechanical requirements for TF coil structure material will be achievable in actual JJ1 and ST316LN manufacturing. [Copyright &y& Elsevier]

Abstract: Japan National Centralized Tokamak (NCT) is a superconducting tokamak proposed as a modification to JT-60U. As part of the R&D for the National Centralized Tokamak, a two-turn, approximately 2m tall, D-shaped Nb3Al coil was wound and tested using a full-size cable-in-conduit conductor (CICC). The Nb3Al cable-in-conductor was bent following the heat treatment reaction with a maximum bending strain of 0.4% to simulate the react-and-wind fabrication. The comparison of the coil performance to the measured strand data shows that the effective axial strain of the conductor strands is essentially zero despite the 0.4% bending strain of the conductor. This suggests that the strands in the cable slipped relatively to each other during bending of the conduit, thus reducing the effective strain transmitted to the strands. This result is very encouraging for the low-cost fabrication of high-current-density fusion coils using the react-and-wind method. [Copyright &y& Elsevier]

The cooperative research program between JAERI and universities using the first wall tiles was initiated in 2001 to elucidate the plasma–wall interactions in JT-60U. Various studies have been intensively performed from 2001 to 2002. Major research results obtained in these years were reviewed. Main topics are as follows: (1) Tritium areal distribution on plasma facing graphite tiles was measured by using tritium imaging plate technique and a combustion method. the results were compared to the simulation results for triton orbits, (2) erosion depth and deposition thickness were measured poloidally by using dial gauge and SEM on a set of W-shaped divertor tiles, (3) distribution of hydrogen isotopes and the chemical status of carbon in the divertor region were evaluated by SIMS and XPS, (4) release behavior of tritium from graphite tile samples was studied using thermal desorption, and (5) tritium degassing characteristics in tokamak exhaust were investigated by cleaning discharges. [Copyright &y& Elsevier]

A round-robin study of arsenic depth profiling was conducted by Japanese SIMS users using arsenic-implanted silicon specimens with doses of 3×1014 to 3×1016 ions/cm2. The peak concentration of the implanted arsenic was about 11 at.% for the specimen with the dose of 3×1016 ions/cm2. The shape of arsenic ion (AsSi− and As−) profiles was not affected by the incident angle of Cs+ primary ion. The RSFs calculated from AsSi−/Si2− and As−/Si− by point-by-point normalization were constant against arsenic doses. No dependence of RSFs on the angle of primary ion incidence was observed. Using an AsSi−/Si2− or As−/Si− point-by-point calibration method, arsenic with high concentration (11 at.%) in silicon can be quantitatively evaluated without being interfered by its matrix effect. [Copyright &y& Elsevier]

Background: Intra-articular platelet-rich plasma (PRP) injections have been proposed for the treatment of knee osteoarthritis (OA); however, their effectiveness in Japanese patients remains unclear., Purpose: To investigate whether 3 intra-articular injections of leukocyte-poor PRP (LP-PRP) improve symptoms and joint function in symptomatic Japanese patients with mild to moderate knee OA., Study Design: Randomized controlled trial; Level of evidence, 1., Methods: Of 72 patients screened, 30 were included and randomized to receive LP-PRP (n = 15) or saline (placebo; n = 15) injections between March 2019 and February 2023. Patients attended a screening visit and 3 treatment visits at 1 week apart, followed by 3 follow-up visits (at 4, 12, and 24 weeks) after the initial treatment visit. The primary efficacy outcome measure was the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, whereas the secondary efficacy outcome measures were the proportion of patients showing a visual analog scale (VAS) improvement of ≥50%. Magnetic resonance imaging was performed to evaluate joint effusion and bone marrow lesions using the Whole-Organ Magnetic Resonance Imaging Score. Patients were followed for 24 weeks., Results: Patients in the PRP group (mean age, 65.9 years) had a mean hip-knee-ankle angle of 5.1°, with 7 and 8 patients demonstrating Kellgren-Lawrence grade 2 and 3 knee OA, respectively. Patients in the placebo group (mean age, 67.9 years) had a mean hip-knee-ankle angle of 3.8°, with 6 and 9 patients showing Kellgren-Lawrence grade 2 and 3 knee OA, respectively. No significant differences were identified in any baseline factors. The percentage change in Western Ontario and McMaster Universities Osteoarthritis Index scores from baseline to 24 weeks was significantly different (P= .032) between the PRP (median, 75.9%; quantile 1 [Q1], 49.6; quantile 3 [Q3], 94.1]) and placebo (median, 27.7%; Q1, -9.4; Q3, 80.9]) groups. Overall, 73.3% and 28.6% of the PRP group and placebo group, respectively, exhibited an improvement in visual analog scale scores of ≥50%, with a significant improvement observed in the PRP group ( P = .027). Changes in bone marrow lesions from baseline to 24 weeks, as assessed on magnetic resonance imaging, significantly differed between groups ( P = .017), with no significant differences in other secondary endpoints., Conclusion: In Japanese patients with knee OA, 3 intra-articular LP-PRP injections led to clinical improvements at 24-week follow-up and significant functional improvements and pain relief after 24 weeks., Competing Interests: One or more of the authors has declared the following potential conflict of interest or source of funding: This study was funded by a grant for the implementation of advanced medicine from the University of Tsukuba Hospital (No. TRM2019-06). AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.

We conducted a multicenter survey for oral appliance (OA) therapy to grasp and analyze the current situation of OA therapy, including efficacy, side effects, and follow-up, in Japan. The Japanese cross-sectional multicenter survey (JAMS) for obstructive sleep apnea (OSA) was undertaken by patients in 10 institutions associated with oral appliance therapy during two years, from 2014 to 2015, retrospectively. Age, sex, body mass index (BMI), baseline apnea-hypopnea index (AHI), OA type, adjustment, adverse reactions with OA, and AHI with OA were elicited from the patient clinical record. The number of included OSA patients was 3217. The number of patients with OA therapy was 2947. We evaluated 1600 patients for the OA treatment. The patients treated with OA, both male and female, were most commonly in their 50s. In terms of OSA severity, snoring was 2.3%, mild was 38.5%, moderate was 39.9%, and severe was 19.3%. The use of mono bloc appliance was 91.8%, bi bloc appliance was 7.9%, and tongue-retaining device (TRD) was 0.3%. After OA treatment, AHI decreased from 22.4/h to 9.3/h. The AHI reduction rate with OA was 52.0%. The rate of AHI <5 with OA was 35.6%. Adverse reactions developed in 14.7% of the subjects. OA reassessment was conducted for 54.3%. This study revealed the current situation of efficacy and side effects of OA therapy, and the problem that the reassessment rate of OA was low in Japan., Competing Interests: The authors declare no conflict of interest.

High prevalence of anemia in heart failure with preserved left ventricular ejection fraction (HFpEF) has been reported. However, little is known about the association of anemia and gender with prognosis in HFpEF patients. In addition, effective blood hemoglobin (Hb) level for prognosis in HFpEF patients remains largely unknown. In this study, we investigated the association between anemia, gender, and prognosis in 535 HFpEF patients enrolled in Japanese heart failure syndrome with preserved ejection fraction registry. Furthermore, we assessed effective blood Hb level to predict prognosis in HFpEF patients. According to the World Health Organization criteria, the prevalence rate of anemia on admission was about 70% in both male and female HFpEF patients. Kaplan-Meier analysis for all-cause mortality demonstrated that anemic patients had poor prognosis compared with non-anemic patients in both male and female HFpEF patients. Interestingly, multivariate analysis revealed that blood Hb level at discharge was an independent predictor of all-cause mortality in both male and female HFpEF patients. According to survival classification and regression tree analysis, blood Hb level at discharge of 9.4 g/dL for male and 12.3 g/dL for female was more accurate cutoff value to predict all-cause mortality in HFpEF patients. Anemia was implicated in poor prognosis in both male and female HFpEF patients. In particular, blood Hb level at discharge was an independent predictor of all-cause mortality in both male and female HFpEF patients. Effective cutoff value of blood Hb level at discharge to predict all-cause mortality was lower in male than in female HFpEF patients.

Background: Only a few reports discuss long-term functional outcomes and changes observed in patients over several years following a distal gastrectomy. We investigated long-term functional outcomes and changes after laparoscopic distal gastrectomy based on the analysis of postoperative conditions and endoscopic findings observed in patients., Methods: The study group comprised 159 patients who underwent Roux-en-Y reconstruction following laparoscopic distal gastrectomy (R-Y group) between December 2008 and November 2012 and 78 patients who underwent Billroth I reconstruction (B-I group) between January 2002 and November 2012. To minimize bias between the two groups, propensity scores were calculated using a logistic regression model. The groups were compared with respect to postoperative conditions and endoscopic findings at 1, 3, and 5 years postoperatively., Results: The B-I group demonstrated more frequent heartburn than the R-Y group at 3 and 5 years postoperatively. No significant differences were found in terms of loss of body weight and food intake. Endoscopic findings showed significantly lesser residual food and remnant gastritis in the R-Y group at each annual postoperative follow-up. The incidence of bile reflux and reflux esophagitis in the B-I group gradually increased over the years and showed a significant difference at the culmination of the 5-year postoperative follow-up, compared to the R-Y group., Conclusions: Roux-en-Y reconstruction was superior to Billroth I reconstruction in terms of frequency of occurrence of residual food, bile reflux, remnant gastritis, and reflux esophagitis in the long term. Differences between the two methods became more evident as the follow-up period lengthened.

The purpose of this study was to investigate the prevalence of extended-spectrum β-lactamase (ESBL)-producing Escherichia coli (ESBL-Ec) in retail chicken meats in Japan. Fifty-six domestic and 50 imported (Brazil, n=36; United States, n=8; Thailand, n=6) chicken meat samples were analyzed. The 162 ESBL-Ec included 111 from 43 (77%) domestic samples and 51 from 26 (52%) Brazilian samples. Fifty-three and 30 of 111 and 51 ESBL-Ec from domestic and Brazilian chickens, respectively, were selected for ESBL genotyping. The bla CTX-M (91%), bla TEM (36%) and bla SHV (15%) genes were detected in ESBL-Ec isolated from domestic chickens, whereas bla CTX-M (100%) and bla TEM (20%) were detected in ESBL-Ec isolated from imported chickens. Among the bla CTX-M group, bla CTX-M-2 (45%) and bla CTX-M-1 (34%) were prevalent in domestic chicken isolates, whereas bla CTX-M-2 (53%) and bla CTX-M-8 (43%) were prevalent in imported chicken isolates. Domestic chicken isolates were mostly resistant to tetracycline (83%), followed by streptomycin (70%) and nalidixic acid (62%). Imported chicken isolates were resistant to streptomycin (77%), followed by nalidixic acid (63%) and tetracycline (57%). Notably, extensive multidrug resistance was detected in 60% (32/53) and 70% (21/30) ESBL-Ec from domestic and imported chickens, respectively. Virulence genes associated with diarrheagenic and extra-intestinal pathogenic E. coli were detected in ESBL-Ec isolated from domestic and imported chickens. These data suggest that ESBL-Ec in retail chicken meats could be a potential reservoir for antimicrobial resistance determinants and that some are potentially harmful to humans.

Study Objectives: The aim of this study was to investigate the predictors of dental changes associated with long-term treatment with oral appliances (OAs) in patients with obstructive sleep apnea (OSA)., Methods: This was a retrospective study to investigate Japanese patients with OSA receiving long-term treatment with OAs. Comparisons of cephalometric analysis were carried out between the initial and follow-up assessments of dental and skeletal changes. Based on dental changes, predictors that may cause side effects were investigated., Results: A total of 64 patients (average age at start of treatment: 57.7 ± 14.2 years, 44 males) were included in this study. The average duration of treatment was 4.3 ± 2.1 years. Over the total treatment period, there was a significant reduction in overjet (OJ) (1.5 ± 1.3 mm) and overbite (0.90 ± 1.5 mm), and an increase in the lower incisor line to the mandibular plane (3.1 ± 5.4°). A larger reduction in OJ of ≥ 1 mm was associated with treatment duration, use frequency, and mandibular advancement of the OAs. In addition to these predictive factors, the number of teeth was correlated with the amount of OJ reduction., Conclusions: For long-term treatment with OAs, the risk of dental side effects should be considered, such as a reduction in OJ. A small number of maxillary teeth, as well as the factors associated with OAs, including treatment duration, use frequency, and mandibular advancement of the OAs, was correlated with an increased rate of OJ reduction., Commentary: A commentary on this article appears in this issue on page 7., (© 2018 American Academy of Sleep Medicine)

Purpose: Our aim was to determine the recurrence rate of inflammation in Vogt-Koyanagi-Harada (VKH) disease and to describe its clinical features., Methods: We retrospectively evaluated patients diagnosed as having VKH disease with exudative retinal detachment at the Osaka University Hospital or the Japanese Community Healthcare Organization, Osaka Hospital, between 1998 and 2012. All patients received high-dose corticosteroid therapy as the initial treatment and were followed for at least 6 months. Demographic data, including age, sex, visual acuity (VA) levels at initial presentation and at 1 year after initial therapy, treatment received, and recurrent episodes were reviewed., Results: Fifty-five consecutive patients with VKH disease were identified (36 women; mean age 38.6 ± 10.4 years). Fourteen patients (25.5 %) had recurrent inflammation, which manifested as posterior uveitis in eight and as anterior uveitis in six of the patients. Recurrent posterior segment inflammation was more likely to develop in patients whose VA at initial presentation was poor (P = 0.039) and in whom orally administered corticosteroid was tapered rapidly (to 30 mg within 3 weeks or less, to 20 mg within 2 months or less, and to 10 mg within 3 months or less) (P = 0.006, P = 0.066, and P = 0.041, respectively)., Conclusions: About 25 % of patients with VKH disease had recurrent inflammation. Poor initial VA and rapid tapering of the corticosteroid were associated with posterior recurrence.

Purpose: In treatment for obstructive sleep apnea (OSA), oral appliance (OA) therapy is indicated in patients with mild-moderate OSA. However, since patients with severe OSA in whom OA therapy was effective have also been reported, it may not be possible to determine indications for OA therapy based on the severity alone. The purpose of this study was to determine indications for OA therapy using endoscopy during wakefulness in patients with severe OSA., Methods: The subjects consisted of 36 patients (27 males and 9 females) diagnosed with severe OSA using all-night polysomnography. In each patient, a nasoendoscope was inserted in a horizontal position during nasal breathing, and morphological changes in the airway of the velopharynx and oro-hypopharynx with mandibular advancement were evaluated., Results: With mandibular advancement, the oro-hypopharynx was widened in all patients while the velopharynx was widened in 29 patients, but not in 7. The apnea hypopnea index (AHI) reduction rate after OA application was 79.8% (SD, 13.0%) in the group with and 40.6% (SD, 27.0%) in the group without velopharyngeal widening, being significantly different between the two groups. In the group showing velopharyngeal widening, evaluation of the direction of widening revealed two types: the "all-round type", which is circumferential widening in the anteroposterior-lateral directions, and the "lateral dominant type", which is widening mainly in the lateral direction. The AHI reduction rate was 80.1% (SD, 15.0%) for the all-round type and 79.3% (SD, 10.6%) for the lateral dominant type showing no significant difference., Discussion: (1) Concerning indications for OA therapy, findings in the velopharynx rather than those in the hypopharynx may be important. (2) The effects of OA therapy can be expected in the presence of velopharyngeal widening irrespective of its direction. Thus, to determine whether OA therapy is indicated, endoscopic evaluation of morphological changes in the velopharynx with mandibular advancement may be important.

Background: The histogenesis of the pattern of cancer spread along Auerbach's plexus (myenteric spread: MS) remains unclear and its prognostic value in colorectal cancer (CRC) has not been thoroughly investigated., Methods: Pathology slides of 2845 pT2/pT3/pT4 CRCs stained with hematoxylin-eosin (H&E) were reviewed at 10 institutions. MS was classified into 2 groups depending on whether it was accompanied by the finding of perineural invasion (PN) within the lesion. In addition, immunohistochemical staining (D2-40, S100, CD56, synaptophysin) was performed for serially sectioned specimens from 50 CRCs diagnosed as having PN-negative MS., Results: MS was observed in 504 patients (17.7 %); 360 patients were classified as having PN-positive MS and 144 as having PN-negative MS. The 5-year disease-free survival rate of patients with MS was lower than that of patients without MS (63.3 vs 82.7 %, P < 0.0001); however, there was no significant difference in survival outcome according to the presence or absence of intralesion PN in MS. Multivariate analysis showed that the prognostic impact of MS was independent of conventional prognosticators including T and N stages, vascular invasion and extramural PN. In all the tumors having PN-negative MS, remnants of neural tissue were identified within or around cancer nests located at the leading edge of MS., Conclusions: MS is an important prognostic factor for CRC. This feature is the result of cancer development with replacement of Auerbach's plexus and can be classified as intramural PN. The clinical significance of "Pn1" in the UICC/AJCC TNM classification could be enhanced by individual assessment both intramurally and extramurally.

Background/aims: Postoperative complications associated with gastrointestinal (GI) perforation may lead to a poor prognosis. The goal of the study was to identify factors required for the establishment of appropriate perioperative procedures in such cases., Methodology: The subjects were 51 patients with GI perforation treated from July 2007 to June 2008 in six hospitals in the Minamikawachi district., Results: The perforation sites were the large intestine in 22 cases, small intestine in 15, stomach in 7 and duodenum in 7. Postoperative complications developed in 25 cases (49%), including infection in 20 and respiratory dysfunction in 13. Hospital mortality was 25% and the major causes of death were infection and respiratory dysfunction. The mortality was 52% and 0% in patients with and without postoperative complications, respectively. The mortality was 69% in the 13 patients with postoperative respiratory dysfunction compared to 11% for patients without respiratory dysfunction. Of the 7 patients with large intestine perforation, 4 were treated with sivelestat sodium. These 4 patients had a high mean SOFA score (11.5±1.3), but 2 out of 4 survived., Conclusions: Postoperative complications occurred in approximately half of the patients with GI perforation and were associated with a poor prognosis. Prevention of respiratory dysfunction is particularly important for an improvement of outcome.

As interprofessional work in cancer treatment becomes increasingly important, medical technologists are required to play active roles as part of the team. The cancer center of our hospital organized a lecture meeting, "The 6th Lecture Meeting: Living Together," for cancer patients and their families, and a medical technologist presented a lecture entitled: "Cancer treatment and clinical examinations." According to the results of a questionnaire survey conducted following the meeting, most participants were able to understand the lecture and were satisfied with it. Based on the opinions expressed by meeting participants and the questionnaire results, medical technologists initiate the following services and activities: 1. They explain the results of white blood cell and neutrophil counts of patients on chemotherapy and/or radiation therapy; and 2. provide medical examinations and consultation at outpatient chemotherapy centers. We believe that these efforts will help improve cancer treatment and further contribute to interprofessional health care.

Background/aims: The incidence of delayed gastric emptying after pylorus-preserving pancreaticoduodenectomy has been reported to be 30% to 70%., Methodology: Between January 1996 and December 2002, 43 patients underwent pylorus-preserving pancreaticoduodenectomy, involving pylorotomy, in the First Department of Surgery, Kinki University School of Medicine. The first step in pylorotomy is to cut the duodenal stump obliquely. The next is incision of the pyloric sphincter along its inferior aspect. The incidences of postoperative complications and changes in body weight were collated retrospectively., Results: Delayed gastric emptying was observed in 4 patients (9.3%). However, this complication did not last more than 1 month in any patients. Two patients (4.7%) developed reflux esophagitis 1 month after surgery, but this complication had resolved by 6 months. Weight gain was noted beginning 3 months after surgery., Conclusions: Pylorus-preserving pancreaticoduodenectomy involving pylorotomy may reduce the incidence of delayed gastric emptying and preserve the long-term quality of life more than similar procedures.

Objectives: To investigate the clinical characteristics of contralateral intracranial hematoma (ICH) after traumatic brain injury., Methods: The subjects included 149 patients with traumatic ICH treated by hematoma evacuation. The patients were retrospectively divided into a bilateral ICH (B-ICH) group and unilateral ICH (U-ICH) group after craniotomy using brain CT scans for comparison of the following parameters: complicated expanded brain bulk from the cranial window, hypotension during craniotomy, and outcome., Results: Post-craniotomy brain CT scans revealed U-ICH in 106 patients and B-ICH in 43 patients. Average Glasgow Coma Scale on arrival did not differ between the groups, but a higher proportion of patients in the B-ICH group deteriorated after admission (p = 0.02). The B-ICH patients also exhibited a significantly higher rate of expanded brain bulk from the cranial window (p < 0.05). No significant difference was observed between the groups with hypotension during craniotomy. The B-ICH group exhibited a lower rate of favorable outcome (p < 0.05) and higher mortality (p < 0.05)., Conclusion: The B-ICH patients had a worse outcome than the U-ICH patients. Contralateral ICH was difficult to forecast based on pre- and intraoperative clinical conditions. Subdural hematoma or contusional ICH was frequently observed as a contralateral ICH.

Background: Metastasis to regional lymph nodes from colon cancer is an important prognostic factor. In the TNM classification, node metastases are classified into three grades based on the number of metastatic nodes. In the Japanese General Rules for Clinical and Pathologic Studies on Cancer of the Colon, Rectum, and Anus (JGR), node metastases are classified into four grades based on the distribution of metastatic nodes., Study Design: Based on the findings of node metastases in 164 patients with colon cancer obtained by the clearing method, node classifications by the JGR and TNM classifications were compared., Results: The case distribution by the JGR grading was 41.5% in n (-), 29.3% in n1 (+), 18.3% in n2 (+), and 11.0% in n3 (+) disease. In the TNM classification, the distribution was 23.8% in pN1 and 34.8% in pN2 disease. The 5-year survival rate by the JGR was 98.4% in n (-), 74.3% in n1 (+), 51.2% in n2 (+), and 30.0% in n3 (+) disease; in TNM classification, this rate was 76.0% in pN1 and 45.0% in pN2 disease., Conclusions: In the classification of regional node metastases from colon cancer, the JGR classification showed a wider range in distribution and 5-year survival rate compared with the TNM system.

This prospective study was undertaken to evaluate the efficacy and safety of midazolam as a sedative agent in 14 critically ill patients without coma admitted to the intensive care unit at Nihon University Itabashi Hospital, Japan. Adequate sedation (sedation score [SS] 4-6) was induced with 0.058- 0.372 mg/ kg midazolam and maintained with a dose range of 0.03-0.4 mg/kg per h. Most burn or trauma patients required higher midazolam doses than patients with cardiovascular disease. The most frequent adverse events observed were hypotension, heart-rate fluctuation and electrocardiogram abnormalities. Pharmacokinetic analysis of the population suggested that lower drug clearance rates correlated with presence of complications. Plasma concentrations (EC50) of SS 5, estimated by logistic regression analysis, varied among patients (mean 194 ng/ml). Midazolam infusion achieved successful sedation in this critical care setting, but the optimum dose differed by patient and was influenced by the presence of complications.

We report two cases of early gastric cancer with distant metastases (stage IV). At our institute 1428 cases of primary gastric cancer were resected between 1980 and 1997; 536 were diagnosed as early gastric cancer based on the resected specimens (304 cases of mucosal cancer, Tis--TNM classification--and 232 of submucosal cancer, T1). 528 of these 536 cases were classified as histological stage I, six as stage II, none as stage III and two as stage IV. The incidence of stage IV early gastric cancer was 0.14% of all gastric cancers and 0.37% of the early gastric cancers. The two patients with stage IV early gastric cancer were women. Both tumors were defined as early cancer because they were confined to the submucosa. One was a type 0 IIc + III early cancer, histologically classifiable as a small, moderately differentiated adenocarcinoma (tub2 according to the Japanese Classification of Gastric Carcinoma, G2; TNM classification: ICD-O C16), size 10 x 8 mm; the other was a surface spreading type 0 IIc, classifiable as a signet-ring cell carcinoma (sig, G3), size 50 x 35 mm. Stage IV factors were N3 in the first and ovarian metastasis (Krukenberg tumor) in the second case.

Allelic variation at the two prolamin loci (Pro1 and Pro2) and its geographical distribution in 560 local cultivars of foxtail millet (Setaria italica) mainly from Eurasia were studied using SDS-polyacrylamide gel electrophoresis (SDS-PAGE). Genetic analysis of a newly detected polymorphic band, band 6, indicated that it is controlled by an allele at the Pro2 locus, which was designated as Pro2f. Two alleles (Pro1a and Pro1null) at the Pro1 locus and six alleles (Pro2a, Pro2b, Pro2c, Pro2d, Pro2e and Pro2f) at the Pro2 locus were detected among the cultivars examined. Although the frequency of the Pro1a allele varied from 0% in the Nansei islands of Japan and Africa to 66% in Afghanistan, no apparent trend was observed in geographical distribution. In contrast, two common alleles at the Pro2 locus, Pro2b and Pro2f, had clear differential geographical distribution. The Pro2b allele was most frequent in Europe and decreased in frequency eastwards. The Pro2f allele occurred frequently in subtropical and tropical regions including the Nansei islands of Japan, the Philippines, Nepal, India, Pakistan and Africa. All eight alleles at the Pro1 and Pro2 loci occurred in China, suggesting China is a center of diversity. The origin of geographical differentiation of local cultivars into a "tropical group" characterized by the Pro2f allele and other genes was discussed.

N-terminal amino acid sequences of six prolamins encoded by seven alleles at two loci, Pro1 and Pro2, of foxtail millet (Setaria italica (L.) P. Beauv.) were analyzed and compared with other prolamins of subfamily Panicoideae. Based on the N-terminal amino acid sequences, band 3 (the prolamin purified from band 3) which is controlled by an allele at the Pro1 locus and bands 1, 2, 4, 5 and 6 which are controlled by alleles at the Pro2 locus could be classified into three groups. Band 3 was found to be homologous to the prolamin of pearl millet (Pennisetum americanum) and is designated as the "pennisetin-like prolamin". Bands 2 and 4, and bands 1, 5 and 6 were subdivided into "x-type prolamin" and "y-type prolamin". Both of the x-type and y-type prolamins showed homology with prolamin of Echinochloa crus-galli and alpha-zein-like prolamins of maize, sorghum and Job's tears. Therefore, these prolamins were designated as "alpha-zein-like prolamin". These results suggest that alleles at the Pro1 locus and those at the Pro2 locus have not arisen from an identical ancestral gene, and that the Pro2 locus comprise two tightly linked genes, which encode similar prolamins. Hypotheses on the diversification of alleles at the Pro2 locus are discussed based on the N-terminal amino acid sequences of the respective bands, combinations of bands controlled by the alleles, and frequencies of the alleles.

Rice has been grown in Japan for about 3000 years. Although both japonica and indica varieties have been grown in Japan, now japonica rices are grown. Japanese rice breeding has used an ecological breeding approach. While emphasis in rice breeding in the 1940's and 1950's focussed on yield in recent decades quality has been of major importance. Consumer preference and name recognition of high quality varieties, such as Koshihikari, has resulted in slow acceptance of new varieties. Rice germplasm was systematically collected throughout Japan between 1962 and 1963. Subsequent acquisition and collecting, in Japan and other countries, has resulted in 28,000 accessions being conserved in the National Genebank, based at the National institute of Agrobiological Resources (NIAR). Research on genetic diversity of rice using a range of techniques, for example esterase isozymes, has revealed clinal variation in rice radiating from the center of diversity of rice in and around southwest China. Newly found genes in traditional rice germplasm, such as genes for non-elongating mesocotyl, are now routinely identified on the rice genome. Pioneering studies on eco-genetic differentiation of species in the genus Oryza in Japan has revealed much about the complex genepool for which rice evolved. Pest and disease resistance sources, particularly to blast, bacterial blight and brown plant hopper, from many countries have been incorporated into Japanese varieties. Cold tolerance at the booting stage was found in the Indonesian variety Silewah. In the future in characterisation of rice germplasm and interaction between rice germplasm specialists and rice molecular scientists, both in Japan and internationally, will be corner stones to securing rice genetic diversity and rice improvement in the next century.