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In recent years, high precision and high resolution road surface orthophotos have been generated using video cameras mounted on surveying vehicles. However, there is a serious issue in generating an orthophoto from this image. The shadows of the surrounding structures and vehicles on the road surface cause a lack of information and decrease in visibility. Therefore, the shadows should be removed from the images for exact road management. On the other hand, the Mobile Mapping System with a laser scanner mounted on vehicles has been receiving more attention because the laser scanner intensity is almost unaffected by shadows. This paper presents shadow extraction and shadow correction for generating road surface orthophotos using the laser scanner intensity.

Competing Interests: Conflict of interestAll authors have no conflicts of interest or financial ties to disclose.

Optical parametric amplification in the range of 1.3-1.8 µm was demonstrated by using a periodically poled LiNbO 3 (PPLN) waveguide as a nonlinear medium by varying the detuning of the pump wavelength. A wide range of detuning was enabled by using a multiple-quasi-phase-matched (M-QPM) LiNbO 3 waveguide for pump generation through second harmonic generation (SHG) and temperature control of the PPLN waveguide. Broadband optical amplification and wavelength conversion through difference frequency generation (DFG) are considered useful for widening the bandwidth of optical communication.

Purpose: Both laparoscopic proximal gastrectomy with lower esophagectomy (extended LPG) and minimally invasive Ivor Lewis esophagectomy (MIILE) are acceptable treatments for adenocarcinoma of the esophagogastric junction (AEG), but the optimal reconstruction technique for mediastinal esophagogastrostomy (one that provides adequate reflux prevention) has not been established. We devised a novel side-overlap esophagogastric-tube (SO-EG) reconstruction., Methods: We performed a retrospective review of patient records after LPG or MIILE. In each patient, we created a 3-cm wide gastric tube, overlapping the esophagus by 5 cm. A linear stapler was inserted into the left side of the esophageal stump and the anterior gastric wall along the greater curvature. The entry hole was closed to make a slit-like anastomosis, and the right side of the esophageal wall was fixed to the anterior gastric wall., Results: Ten consecutive patients underwent this procedure between June 2020 and July 2021. Five patients had Siewert type II AEG: 4 with lower thoracic esophageal cancer and 1 with benign lower esophageal stenosis. A total of 3 patients underwent extended LPG, and 7 underwent MIILE. The median operative time was 352 min (range, 221-556 min). The postoperative course was uneventful in 9 patients; a single patient developed pneumonia. Seven patients underwent follow-up endoscopy at 6 months. One patient with anastomotic stenosis and 2 with mild reflux esophagitis were treated conservatively., Conclusion: Our novel SO-EG reconstruction is simple and feasible, with acceptable results for preventing reflux esophagitis. This technique can be performed with either extended LPG or MIILE., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: We previously reported a novel method of mesenteric excision for esophageal cancer surgery. The esophagus, trachea, recurrent laryngeal nerves (RLNs), and surrounding lymph nodes (LNs) are contained in a common mesenterium, which we termed the "mesotracheoesophagus". In addition, near-infrared (NIR) image-guided lymphatic mapping has recently been used. The purpose of this study was to confirm the feasibility of NIR image-guided lymphatic mapping for upper mediastinal LN dissection, and to confirm the oncological feasibility of our surgical approach., Methods: Fifteen patients with resectable esophageal cancer underwent submucosal injection of indocyanine green (ICG), and underwent robot-assisted esophagectomy. The frequency of ICG positivity in the LN basins along the RLNs, and metastatic frequency were assessed. Regarding the oncological feasibility of our thoracoscopic esophagectomy, the recurrence patterns and survival of 72 consecutive patients who underwent curative resection from 2011 to 2016 were analyzed., Results: ICG-positive LN basins along the right and left RLNs were found in 12 (80% of 15) patients (3 patients positive for metastatic LNs) and 11 (73% of 15) patients (2 positive for metastatic LNs and 1 false-negative), respectively. All ICG-positive LN basins were found within the mesotracheoesophagus. The sensitivity was 5/6 (83%), and the negative predictive value was 6/7 (86%). Among the 72 patients, with a median follow-up period of 1644 days, only 3 (4.2%) patients developed locoregional recurrence., Conclusions: The NIR image-guided lymphatic mapping was feasible. Our results with no ICG-positive basins outside of the '"mesotracheoesophagus", supported our surgical approach. It might become standard, with acceptable locoregional control.

Background: We invented a simple and secure method of intracorporeal gastroduodenostomy, the delta-shaped anastomosis (DA), using endoscopic linear stapler only and standardized the DA procedure by resecting two-thirds of the stomach based on the anatomical landmarks. This study aimed to evaluate the feasibility of the standardized DA as the standard reconstruction procedure after a laparoscopic distal gastrectomy assessing functional outcomes including postoperative complications, body weight loss, nutritional status, and endoscopic findings., Methods: The medical records of 349 patients with gastric cancer who underwent laparoscopic distal gastrectomy from April 2011 to December 2017 at our hospital were retrospectively reviewed. Functional outcomes were assessed according to nutritional status and endoscopic findings., Results: The operation time was shorter and complication rate was lower in the standardized DA than those in Billroth-II (BII) and Roux-en-Y (RY). The body weight loss in DA was 10% 1 year postoperatively and remained stable during the follow-up period, which showed no significant difference. The endoscopic findings showed the ratio of residual food in DA was lower than that in RY (DA:RY = 13.3%:13.6% and 8.4%:33.3% at 1 and 3 years postoperatively, respectively). Severe gastritis was extremely rare in DA (6.7% at 1 year and 15.6% at 3 years postoperatively). Bile reflux was more often found in DA than RY (DA:RY = 19.9%:4.8% and 26.6%:0% at 1 and 3 years postoperatively, respectively). Reflux esophagitis was found 10% of DA only., Conclusions: Functional outcomes of the standardized DA were satisfactory and feasible. Our intracorporeal Billroth-I reconstruction, by resecting two-thirds of the stomach, can be one of the standard reconstruction methods after a laparoscopic distal gastrectomy.

Background: The number of patients who are undergoing laparoscopic gastrectomy for treating gastric cancer is increasing. Although prophylactic drains have been widely employed following the procedure, there are few studies reporting the efficacy of prophylactic drainage. Therefore, this study assessed the efficacy of prophylactic drains following laparoscopic gastrectomy for gastric cancer., Methods: Data of patients who received laparoscopic gastrectomy for treating gastric cancer in our institution between April 2011 and March 2017 were reviewed, and the outcomes of patients with and without a prophylactic drainage were compared. Propensity score matching was used to minimize potential selection bias., Results: A total of 779 patients who underwent surgery for gastric cancer were reviewed; of these, 628 patients who received elective laparoscopic gastrectomy were included in this study. After propensity score matching, data of 145 pairs of patients were extracted. No significant differences were noted in the incidence of postoperative complications between the drain and no-drain groups (19.3% vs 11.0%, P = 0.071). The days after the surgery until the initiation of soft diet (6.3 ± 7.4 vs 4.9 ± 2.9 days, P = 0.036) and the length of postoperative hospital stay (15.7 ± 12.9 vs 13.0 ± 6.3 days, P = 0.023) were greater in the drain group than those in the no-drain group., Conclusions: This study suggests that routinely using prophylactic drainage following laparoscopic gastrectomy for treating gastric cancer is not obligatory.

Background: Effective treatment of esophageal cancer requires dissection of the regional lymph nodes (LNs) from the cervical to the abdominal area. In this study, we hypothesized that adequate no. 101R dissection is achieved through a thoracoscopic approach in the prone position., Methods: The study cohort was limited to 42 patients who underwent thoracoscopic subtotal esophagectomy with bilateral cervical lymphadenectomy for thoracic esophageal cancer between January 2015 and March 2017. The number of LNs and the incidence of metastasis were analyzed. During the proposed thoracoscopic procedure, cervical paraesophageal LNs were dissected continuously, with the LNs surrounding the recurrent laryngeal nerve (RLN; no. 106rec) as an en bloc resection. In this study, LNs that required further picking up via a cervical incision were defined as no. 101. The recurrent sites among the consecutive patients during the 3-year follow-up, for whom bilateral cervical lymphadenectomy was omitted for lower and middle thoracic tumors between 2012 and 2014, were analyzed further., Results: The data of 42 patients were analyzed. The lymphatic tissues dorsal to the right cervical RLN were almost completely dissected via thoracoscopy. A median of 0 (0-6) LNs were ventral to the right RLN (no. 101R) and no LN metastasis was observed. There were no lymph nodes in 27 patients (64%). By contrast, there was a median of 1(0-10) no. 101L nodes, and LN metastasis was observed in two patients (4.7%). The numbers of LNs at no. 106recR and no. 106recL were 3 (0-9) and 2(0-13), respectively, and the corresponding numbers of patients with metastases at these sites were 11(26%) and 5(12%), respectively. Among the 33 patients who completed the 3-year follow-up, 9 patients developed recurrence, but none involved 101R LNs., Conclusions: There were no residual LNs in the area ventral to the right cervical RLN in 64% of the patients who underwent additional cervical lymphadenectomy after the right thoracoscopic approach in the prone position. Further studies with larger patient cohort or randomization are required to confirm our results.

Sphingolipids are putative intracellular signal mediators in cell differentiation, growth inhibition, and apoptosis. Especially, sphingoid base-backbones of sphingolipids (sphingosine, sphinganine, and phytosphingosine) and their metabolites N-acyl-sphingoid bases (ceramides) are highly bioactive. In skin, one of the caspases, caspase-14, is expressed predominantly in cornifying epithelia, and caspase-14 plays an important role in keratinocyte differentiation. As ceramides were surrounding lipids in the keratinocytes and ceramides stimulate keratinocyte differentiation, we therefore examined the upregulation of caspase-14 by various sphingoid bases and ceramide. Sphingosine, sphinganine, phytosphingosine, and C2-ceramide treatment at the doses not damaging cells significantly increased caspase-14 mRNA and protein expression in dose-dependent manner on human keratinocyte HaCaT cells. These results indicated that sphingoid bases and ceramide upregulated caspase-14 mRNA to increase intracellular caspase-14 protein level. We next examined the caspase-14 upregulation mechanism by sphingoid bases. We used the most effective sphingoid base, phytosphingosine, and revealed that specific inhibitors of the mitogen-activated protein kinase, p38 and c-jun N-terminal protein kinase (JNK), blocked caspase-14 expression. This indicates that phytosphingosine upregulation of caspase-14 is involved of p38 and JNK activation. Moreover, phytosphingosine induced caspase-14 upregulation in vivo, suggesting that sphingoid bases were involved in keratinocyte differentiation by affecting caspase-14.

Malrotation of the midgut is a congenital anomaly of the gastrointestinal tract that usually presents in neonates. Moreover, synchronous colon cancer has rarely been reported. In the present article, we report a preliminary experience with laparoscopic approach for intestinal malrotation with early colon cancer in a 68-year-old woman who presented with bloody stools. Colonoscopy revealed a lateral spreading tumor of the ascending colon. An air-barium contrast enema showed that the entire colon lay within the left hemiabdomen. A computed tomography revealed the superior mesenteric vein rotation sign. At surgery, a condition of malrotation of the midgut was observed: the third and the fourth part of the duodenum descended vertically without Treitz's ligament, and the small bowel and colon were located in the right and left side of the abdominal cavity, respectively. We mobilized the terminal ileum and the right colon with laparoscopic approach. A 3-cm abdominal incision was made via the umbilicus. Right colectomy with lymph node dissection was achieved following extracorporealization. Pathological examination revealed well-differentiated tubular adenocarcinoma without nodal involvement. The patient had an uneventful postoperative course. Laparoscopic surgery for colon cancer associated with malrotation of the midgut is feasible and a promising method because of its less invasiveness and its adaptability to the malrotation without extending the skin incision.

To perform single-incision laparoscopic colectomy (SILC) safely while maintaining the minimal invasiveness of SILC and the quality of the lymph node dissection, we have used hybrid single-incision laparoscopic colectomy (H-SILC). Preliminary experience with H-SILC in advanced colon cancer is reported. First, a multi-flap gate was inserted through a 4.0 cm transumbilical incision, and three 5 mm ports were placed in the converter sheet. The procedures were much the same as in usual laparoscopic colectomy excluding a lateral to medial approach. The initial identification or exposure of the ileocolic vessels was performed through a small incision, and lymphadenectomy was mainly achieved using laparoscopic technique. In the course of laparoscopic procedures, whenever we felt stress, we used the techniques of open surgery through the small incision. The procedure was completed successfully without any perioperative complication and no need to extend the skin incision. The operative time was 191 min. Postoperative follow-up did not reveal any umbilical wound complication or any recurrence. Our experience indicates H-SILC is safe and feasible for selected patients with colon cancer with improved cosmesis.

We report our experience with a case of colorectal cancer treated with chemotherapy for a liver metastasis patient on hemodialysis. The patient was a 67-year-old man with a history of chronic renal failure, who was on hemodialysis since 2005. High anterior resection was performed for sigmoid colon and rectal cancer in January, 2010. After starting chemotherapy while planning to use FOLFOX6+bevacizumab(BV)as a postoperative standard chemotherapy, in combination with hemodialysis three times a week while performing dose escalation, administration postponement was continued for myelosuppression that was considered to be the effect of oxaliplatin. Oxaliplatin was administered for only 2 courses, and was then changed to BV+sLV5FU2 therapy. We continued treating the metastases approximately on schedule. Imaging revealed, the liver metastases were CR because they had disappeared. The BV use case of the dialysis case had few reports, but was thought to be able to use it by careful administration safely.

A 75-year-old man with type 4 advanced gastric cancer was referred to our hospital. We diagnosed the tumor as cStage III B(cT4a, cN2, cM0)gastric cancer. We selected neoadjuvant S-1 combined with CDDP therapy for him. After 2 courses of chemotherapy, the extension of the gastric wall improved. After an additional 2 courses of chemotherapy, the primary tumor revealed a partial response(PR), judged from a barium meal study and upper GI endoscopic findings, and a total gastrectomy with lymph node dissection was performed. The pathological specimens showed no cancer cells in the gastric wall and lymph nodes, so the histological effect was judged as Grade 3.

A 50-year-old man with advanced gastric cancer and a tumor embolus in the portal vein was referred to our hospital. We diagnosed the tumor as cStage III B (cT3, cN2, cH0, P0, M0) gastric cancer, and selected neoadjuvant S-1 (80 mg/m2) and CDDP (60 mg/m2) therapy for him. After 2 courses of chemotherapy, the embolus in the portal vein disappeared. After additional chemotherapy, the primary tumor and regional lymph node revealed a partial response (PR), and judging from the results from the barium meal study, upper GI endoscopic findings and CT scan, a total gastrectomy with lymph node dissection was performed.

We report the frequency of lacrimal passage disorder and the outcomes of treatment. This retrospective study was performed on 55 cases that were treated with S-1 for at least 1 month. We asked patients about ocular symptoms. An ophthalmic surgeon examined all patients and diagnosed lacrimal passage disorder in 6 of 55 patients (12. 5%). The mean dose of S- 1 was 10, 300 mg, and the average period to onset of lacrimal passage disorder was 5. 7 months. The causes of epiphora included occlusion/stenosis of lacrimal canaliculus, occlusion of lacrimal puncta and stenosis of nasolacrimal duct. Lacrimal surgery was performed in all 6 patients and epiphora improved. Lacrimal passage disorder may result from systemic treatment of patients with S-1. Symptoms of lacrimal passage disorder improved with early detection and treatment by insertion of a silicone tube.

A neutron crystallographic analysis of phosphate-free bovine pancreatic RNase A has been carried out at 1.7 A resolution using the BIX-4 single-crystal diffractometer at the JRR-3 reactor of the Japan Atomic Energy Agency. The high-resolution structural model allowed us to determine that His12 acts mainly as a general base in the catalytic process of RNase A. Numerous other distinctive structural features such as the hydrogen positions of methyl groups, hydroxyl groups, prolines, asparagines and glutamines were also determined at 1.7 A resolution. The protonation and deprotonation states of all of the charged amino-acid residues allowed us to provide a definitive description of the hydrogen-bonding network around the active site and the H atoms of the key His48 residue. Differences in hydrogen-bond strengths for the alpha-helices and beta-sheets were inferred from determination of the hydrogen-bond lengths and the H/D-exchange ratios of the backbone amide H atoms. The correlation between the B factors and hydrogen-bond lengths of the hydration water molecules was also determined.

To observe the ionized status of the amino acid residues in proteins at different pH (protein pH titration in the crystalline state) by neutron diffraction, hen egg-white lysozyme was crystallized over a wide pH range (2.5-8.0). Crystallization phase diagrams at pH 2.5, 6.0 and 7.5 were determined. At pH < 4.5 the border between the metastable region and the nucleation region shifted to the left (lower precipitant concentration) in the phase diagram, and at pH > 4.5 the border shifted to the right (higher precipitant concentration). The qualities of these crystals were characterized using the Wilson plot method. The qualities of all crystals at different pH were more or less equivalent (B-factor values within 25-40). It is expected that neutron diffraction analysis of these crystals of different pH provides equivalent data in quality for discussions of protein pH titration in the crystalline state of hen egg-white lysozyme.

We report computed tomography of the retropancreatic peritoneal recess in a case in which gastric leiomyosarcoma developed. Because of its location behind the pancreas, an abnormal finding in the retropancreatic peritoneal recess may be radiologically mistaken for a retroperitoneal abnormality. Knowledge of anatomy of posterior peritoneal recesses and understanding of fetal development are important in the radiological diagnosis of the lesions behind the pancreas.

Although dual energy X-ray absorptiometry (DXA) of the anterior-posterior lumbar spine (AP L2-3-4 spine) has been established as a standard procedure by which to assess bone mineral content (BMC), in some cases it does not reflect the true value because of focal sclerosis or other pathological conditions. The purpose of this investigation was to determine the most reliable index of BMC for assessing osteopenia. Bone mineral densitometry was performed at various sites (whole body, AP L2-3-4 spine, lateral L3 spine, femur, and distal radius) in 340 Japanese women. Vertebral fracture, a reliable indicator of osteopenia, was disclosed in 37 subjects. DXA measurements of various sites were obtained, and the bone mineral information was evaluated by comparing the procedure's discriminative ability between women with and without fractures. In addition to conventional whole body BMC (WBBMC) and whole body BMD (WBBMD), the total bone index (TBI), which was defined as WBBMC divided by the BMI (body mass index), was also evaluated. Of all the bone mineral information, TBI showed the best discriminative ability. Whole body bone mineral densitometry was useful.