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Preoperative chemoradiation and extended pelvic lymphadenectomy for rectal cancer:Two distinct principles

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World Journal of Gastrointestinal Surgery 2010年第4期2卷 95-100页

作者： Tsuyoshi Konishi Toshiaki Watanabe Hirokazu Nagawa Masatoshi Oya masashi ueno Hiroya Kuroyanagi Yoshiya Fujimoto Takashi Akiyoshi Toshiharu Yamaguchi Tetsuichiro Muto Department of Gastroenterological Surgery Cancer Institute HospitalTokyo135-8550Japan Department of Surgical Oncology University of TokyoTokyo113-8655Japan Department of Surgery Teikyo University School of MedicineTokyo173-8605Japan

Extended pelvic lymphadenectomy(EPL) with total mesorectal excision(TME) has been reported to provide oncological benefit in lower rectal cancer in Japan.In Western countries EPL is not widely accepted because of frequent morbidity but instead preoperative chemoradiation(CRT) followed by TME has been established as a standard treatment for decreasing local recurrence.Recently,several studies have focused on the comparison between these two distinct therapeutic approaches in Western countries and Japan.A study comparing Dutch trial data and Japanese data revealed that EPL and RT are almost equivalent in decreasing local recurrence in lower rectal cancer as compared with TME alone.Considering that almost 45 survival can be achieved by EPL even in the presence of metastatic lateral lymph nodes(LLNs),EPL performed by experienced surgeons definitely contributes to decrease local recurrence.On the other hand,a randomized controlled trial in Japan that compared EPL with conventional TME following preoperative RT revealed that EPL is associated with a higher frequency of sexual and urinary dysfunction without oncological benefits in the presence of preoperative RT.On this point,preoperative CRT followed by conventional TME without EPL would be a better therapeutic approach in patients without evident metastatic LLNs.For future treatment,it would be desirable to have a narrower indication for EPL using full advantage of recent improvement in image diagnosis.Although objective comparison of these two principles between Japan and the West is difficult due to differences in patient groups,further studies would lead to the next great step towards future improvement in treating lower rectal cancer.

关键词： Rectal cancer Extended lymphadenectomy Chemoradiation Pelvic lymph node Lateral lymph node

Recurrent colorectal cancer after endoscopic resectionwhen additional surgery was recommended

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World Journal of Gastroenterology 2016年第7期22卷 2336-2341页

作者： Yukiko Takatsu Yosuke Fukunaga Shunsuke Hamasaki Atsushi Ogura Jun Nagata Toshiya Nagasaki,Takashi Akiyoshi Tsuyoshi Konishi Yoshiya Fujimoto Satoshi Nagayama masashi ueno Department of Gastroenterological Surgery Cancer Institute HospitalJapanese Foundation for Cancer ResearchTokyo 135-8550Japan

AIM: To evaluate the type of recurrence after endoscopic resection in colorectal cancer patients and whether rescue was possible by salvage operation.METHODS: Among 4972 patients who underwent surgical resection at our institution for primary or recurrent colorectal cancers from January 2005 to February 2015, we experienced eight recurrent colorectal cancers after endoscopic resection when additional surgical resection was recommended.RESULTS: The recurrence patterns were: intramural local recurrence(five cases), regional lymph node recurrence(three cases), and associated with simultaneous distant metastasis(three cases). Among five cases with lymphatic invasion observed histologically in endoscopic resected specimens, four cases recurred with lymph node metastasis or distant metastasis. All cases were treated laparoscopically and curative surgery was achieved in six cases. Among four cases located in the rectum, three cases achieved preservation of the anus. Postoperative complications occurred in two cases(enteritis).CONCLUSION: For high-risk submucosal invasive colorectal cancers after endoscopic resection, additional surgical resection with lymphadenectomy is recommended, particularly in cases with lymphovascular invasion.

关键词： Colorectal neoplasms Colorectal surgery Laparoscopy Endoscopy Recurrence

Colonic J-pouch Anal Anastomosis with Autonomic Nerve Preservation for Low-lying Rectal Cancer

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Colonic J-pouch Anal Anastomosis with Autonomic Nerve Preser...

Genetic diagnosis of lymph-node metastasis in colorectal cancer

第六次全国大肠癌会议暨中日韩大肠癌会议

作者： Takashi Takahashi Hirotosi Ohta Kaoru Azekura masashi ueno Surgical Department Caneer Institute Hospital Tokyo Surgical Department Caneer Institute Hospital Tokyo Surgical Department Caneer Institute Hospital Tokyo Surgical Department Caneer Institute Hospital Tokyo

＜正＞In order to carry out a complete lymph node dissection for an advanced rectal cancer on the lower rectum, we have to realized three spaces around the rectum which are clearly limited by anatomical elements in the pelvis. The inner space is located within the autonomic nerve system which is correspond with TME （total mesorectal excision） space after Mr. Heald. The intermediate space are between the nerve elements and internal iliac vessels and the outer one is identified the space outside the iliac vessels. Since the lymphatic spread of lower rectal cancer proceeds through these spaces, the clearance of lymph nodes in three spaces is inevitable for curing cancer.

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Genetic diagnosis of lymph-node metastasis in colorectal can...

Treatment of colorectal carcinoids:A new paradigm

第六次全国大肠癌会议暨中日韩大肠癌会议

作者： Sachiko Sugai Yoshio Miki Hirotoshi Ohta masashi ueno Makoto Seki Takashi Takahashi Dept. of Clinical Laboratory The Cancer Institutehospital Surgery The Cancer Institutehospital Dept. of Clinical Laboratory The Cancer Institutehospital

The presence of metatatic tumor in regional lymph nodes at the time of colorectal surgery is of major significance for tumor recurrence and prognosis in patients with colorectal cancer. However, conventional staining may not be sensitive enough. Mutant allele-specific amplification(MASA) is a method to be able to detect micrometastasis to lymph nodes that are histologically diagnosed as negative.

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World Journal of Gastrointestinal Surgery 2010年第5期2卷 153-156页

作者： Tsuyoshi Konishi Toshiaki Watanabe Hirokazu Nagawa Masatoshi Oya masashi ueno Hiroya Kuroyanagi Yoshiya Fujimoto Takashi Akiyoshi Toshiharu Yamaguchi Tetsuichiro Muto Department of Gastroenterological Surgery Cancer Institute Hospital Department of Surgical Oncology University of Tokyo Department of Surgery Teikyo University School of Medicine

It is often difficult to evaluate the grade of malignancy and choose an appropriate treatment for colorectal carcinoids in clinical settings. Although tumor size and depth of invasion are evidently not enough to stratify the risk of this rare tumor, the present guidelines or staging systems do not mention other clinicopathological variables. Recent studies, however, have shed light on the impact of lymphovascular invasion on the outcome of colorectal carcinoids. It has been revealed that the presence of lymphovascular invasion was among the strongest risk factors for metastasis along with tumor size and depth of invasion. Furthermore, tumors smaller than 1 cm, within submucosal invasion and without lymphovascular invasion, carry minimal risk for metastasis with 100% 5-year survival in the studies from Japan as well as from the USA. This would suggest that these tumors could be curatively treated by endoscopic resection or transanal local excision. On the other hand, colorectal carcinoids with either lymphovascular invasion or tumor size larger than 1 cm carry the risk for metastasis equivalent to adenocarcinomas. Therefore, it should be emphasized that histological examination of lymphovascular invasion is mandatory in the specimens obtained by endoscopic resection or transanal local excision, as this would provide useful information for determining the need for additional radical surgery with regional lymph node dissection. Although the present guidelines or TNM staging system do not mention the impact of lymphovascular invasion, this would be among the next promising targets in order to establish better guidelines and staging systems, particularly in early-stage colorectal carcinoids.

关键词： Lymphovascular invasion Neuroendocrine tumor Carcinoid Colorectal cancer

A new electric field mill array with each of the mill’s rotor controlled precisely by a GPS module:Equipment and initial results

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Earth and Planetary Physics 2024年第2期8卷 423-435页

作者： Kozo Yamashita Hironobu Fujisaka DaoHong Wang Hiroyuki Iwasaki Kazuo Yamamoto Koichiro Michimoto masashi Hayakawa Department of Production Systems Engineering and Sciences Komatsu UniversityNu 1-3 Shicho-machiKomatsuIshikawa 923-8511Japan Fujisaka Technology Office 1058-5 Yoshizawa-choOhta-shiGunma 373-0019Japan Department of Electrical Electronic and Computer EngineeringGifu University1-1 YanagidoGifu CityGifu 501-1193Japan Cooperative Faculty of Education Gunma University4-2-Aramaki-machiMaebashiGunma 371-8510Japan Department of Electrical and Electronic Engineering Chubu University1200 Matsumoto-choKasugaiAichi 487-8501Japan Independent Researcher Kosenba Town 2-44-11-406Kawagoe CitySaitama350-0036Japan Advanced Wireless&Communications Research Center The University of Electro-Communications1-5-1 ChofugaokaChofuTokyo 182-8585Japan

We have newly designed an electrostatic sensor,called an electric field mill(EFM),to simplify the estimation of the charge position and charge amount transferred by lightning discharges.It is necessary for this remote estimation of the transferred charge to measure electric field changes caused by charge loss at the time of a lightning strike at multiple locations.For multiple-station measurement of electric field changes,not only speed but also phase for exposure and shielding of the sensing plates inside each EFM of the array should be synchronized to maintain the sensitivities of the deployed instruments.Currently,there is no such EFM with specified speed and phase control performance of the rotary part.Thus,we developed a new EFM in which the rotary mechanism was controlled consistently to within 3%error by a GPS module.Five EFMs had been distributed in the Hokuriku area of Japan during the winter season of 2022-2023 for a test observation.Here we describe the design and a simple calibration method for our new EFM array.Data analysis method based on the assumption of a simple monopole charge structure is also summarized.For validation,locations of assumed point charges were compared with three-dimensional lightning mapping data estimated by radio observations in the MF-HF bands.Initial results indicated the validity to estimate transferred charge amounts and positions of winter cloud-to-ground lightning discharges with our new EFM array.

关键词： lightning electrostatic field electric field mill electric field change

Analysis of Commuting Modal Shift in Consideration of Social Interaction of Consciousness for Environment

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Journal of Traffic and Transportation Engineering 2024年第2期12卷 63-80页

作者： masashi Okushima Institute of Technology and Science The University of TokushimaTokushima 770-8506Japan

It is the matter for achievement of the low carbon transport system that the excessive use of private vehicles can be controlled appropriately.Not only improvement of service level of modes except private vehicle,but also consciousness for environmental problem of individual trip maker is important for eco-commuting promotion.On the other hand,consciousness for environment would be changed by influence of other person.Accordingly,it is aimed in the study that the structure of decision-making process for modal shift to the eco-commuting mode in the local city is described considering environmental consciousness and social interaction.For the purpose,the consciousness for the environment problem and the travel behavior of the commuter at the suburban area in the local city are investigated by the questionnaire survey.The covariance structure about the eco-consciousness is analyzed with the database of the questionnaire survey by structural equation modeling.As the result,it can be confirmed with the structural equation model that the individual environmental consciousness is strongly related with the intention of self-sacrifice and is influenced with the local interaction of the individual connections.On the other hand,the intention of modal shift for the commuting mode is analyzed with the database of the questionnaire survey.It can be found out that the environmental consciousness is not statistically significant for commuting mode choice with the present poor level of service of public transport.However,the intention of self-sacrifice for the prevention of the global warming is statistically confirmed as the factor of modal shift with the operation of eco-commuting bus service with the RP/SP integrated estimation method.As the result,the multi-agent simulation system with social interaction model for eco consciousness is developed to measure the effect of the eco-commuting promotion.For the purpose,the carbon dioxide emission is estimated based on traffic demand and road network condition in the traffic environm

关键词： Greenhouse gas emission modal shift structural equation model RP/SP combined estimation multi-agent simulation local interaction small world network consciousness for environment commuting shuttle bus local city

Regeneration mechanisms and therapeutic strategies for neuromuscular junctions in aging and diseases

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Neural Regeneration Research 2025年第1期20卷 193-194页

作者： masashi Fujitani Abu Md Mamun Tarif Yoshinori Otani Department of Anatomy and Neuroscience Faculty of MedicineShimane UniversityShimaneJapan

The neuromuscular junction(NMJ)is an essential synaptic structure composed of motor neurons,skeletal muscles,and glial cells that orchestrate the critical process of muscle contraction(Li et al.,2018).The typical NMJ structure is classically described as having a“pretzel-like”shape in mice(Figure 1),whereas human NMJs have a smaller,fragmented structure throughout adulthood.Degenerated NMJs exhibit smaller or fragmented endplates,partial denervation,reduced numbers of synaptic vesicles,abnormal presynaptic mitochondria,and dysfunctional perisynaptic Schwann cells(Alhindi et al.,2022).

关键词： aging structure Figure

Variations of Atmospheric ELF/VLF Radio Noise Due to Seismogenic Modifications in Tropospheric Conductivity

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Open Journal of Earthquake Research 2024年第2期13卷 113-132页

作者： masashi Hayakawa Alexander P. Nickolaenko Hayakawa Institute of Seismo Electromagnetics Co. Ltd. (Hi-SEM) UEC Alliance Center #521 Tokyo Japan The University of Electro-Communications (UEC) Advanced Wireless & Communications Research Center (AWCC) Chofu-shi Tokyo O.Ya. Usikov Institute for Radiophysics and Electronics National Academy of Sciences of the Ukraine Kharkov Ukraine

We suggest a possible explanation of the influence of pre-seismic activity on the registration rate of natural ELF(extremely low frequency)/VLF(very low frequency) pulses and the changes of their characteristics. The main idea is as follows. The distribution of the electric field around a thundercloud depends on the conductivity profile of the atmosphere. Quasi-static electric fields of a thundercloud decrease in those tropospheric regions where an increase of air conductivity is generated by pre-seismic activities due to emanation of radioactive gas and water into the lower atmosphere. The electric field becomes reduced in the lower troposphere, and the probability decreases of the cloud-to-ground (CG) strokes in such “contaminated” areas. Simultaneously, the electric field grows inside and above the thunderclouds, and hence, we anticipate a growth in the number of horizontal and tilted inter-cloud (or intra-cloud) (both termed as IC discharges) strokes. Spatial orientation of lightning strokes reduces vertical projection of their individual amplitudes, while the rate (median number strokes per a unit time) of discharges grows. We demonstrate that channel tilt of strokes modifies the spectral content of ELF/VLF radio noise and changes the rate of detected pulses during the earthquake preparation phase.

关键词： ELF/VLF Radio Noise Earthquake Precursor Pre-Seismic Modification Conductivity Anomaly in the Lower Atmosphere Radioactive Radon Gases CG Lightning Discharges IC Discharges Cloud-to-Ionosphere Discharge