Endoscopic submucosal dissection (ESD) of undifferentiated-type early gastric cancer (UD-EGC) is technically feasible; however, the long-term clinical outcomes of the procedure have not yet been ...fully investigated. The aim of our study was to elucidate long-term outcomes of ESD for UD-EGC.
Between September 2003 and October 2009, a total of 153 patients were diagnosed endoscopically as having UD-EGC fulfilling the expanded criteria for ESD. After informed consent was obtained, 101 patients were selected to undergo ESD and 52 to undergo surgical operation. We assessed the clinical outcomes of ESD in 101 consecutive patients with 103 UD-EGC lesions who were undergoing ESD for the first time. The overall mortality and disease-free survival rates after ESD were evaluated as the long-term outcomes.
The rates of en bloc and curative resection were 99.0% (102/103) and 82.5% (85/103), respectively. We encountered one patient with nodal metastasis detected by computed tomography before diagnostic ESD, although curative resection of the primary lesion was achieved based on routine histological examination. Among the 78 patients without a past history of malignancy within the previous 5 years in whom curative resection of the primary lesion was achieved, no cases of local recurrence or distant metastasis were observed during follow-up; however, 1 synchronous and 2 metachronous lesions were detected in 2 patients (2.6%) after primary ESD. Thus, estimated over a median follow-up period of 40.0 months (range 19-92 months) and 36.0 months (range 9-92 months), the 3-and 5-year overall mortality rates were 1.9% and 3.9%, respectively, and the 3-and 5-year overall disease-free survival rates were both 96.7%.
Although our single-center retrospective study may be considered to be only preliminary, our data indicate that ESD for UD-EGC may yield good long-term outcomes.
Abstract
We report the first search result for the flux of astrophysical electron antineutrinos for energies
(
10
)
MeV
in the gadolinium-loaded Super-Kamiokande (SK) detector. In 2020 June, ...gadolinium was introduced to the ultrapure water of the SK detector in order to detect neutrons more efficiently. In this new experimental phase, SK-Gd, we can search for electron antineutrinos via inverse beta decay with efficient background rejection thanks to the high efficiency of the neutron tagging technique. In this paper, we report the result for the initial stage of SK-Gd, during 2020 August 26, and 2022 June 1 with a 22.5 × 552 kton · day exposure at 0.01% Gd mass concentration. No significant excess over the expected background in the observed events is found for the neutrino energies below 31.3 MeV. Thus, the flux upper limits are placed at the 90% confidence level. The limits and sensitivities are already comparable with the previous SK result with pure water (22.5 × 2970 kton · day) owing to the enhanced neutron tagging. Operation with Gd increased to 0.03% started in 2022 June.
Abstract
In 2020, the Super-Kamiokande (SK) experiment moved to a new stage (SK-Gd) in which gadolinium (Gd) sulfate octahydrate was added to the water in the detector, enhancing the efficiency to ...detect thermal neutrons and consequently improving the sensitivity to low energy electron anti-neutrinos from inverse beta decay (IBD) interactions. SK-Gd has the potential to provide early alerts of incipient core-collapse supernovae through detection of electron anti-neutrinos from thermal and nuclear processes responsible for the cooling of massive stars before the gravitational collapse of their cores. These pre-supernova neutrinos emitted during the silicon burning phase can exceed the energy threshold for IBD reactions. We present the sensitivity of SK-Gd to pre-supernova stars and the techniques used for the development of a pre-supernova alarm based on the detection of these neutrinos in SK, as well as prospects for future SK-Gd phases with higher concentrations of Gd. For the current SK-Gd phase, high-confidence alerts for Betelgeuse could be issued up to 9 hr in advance of the core collapse itself.
Endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) are being used increasingly to treat superficial oropharyngeal and hypopharyngeal carcinomas. The aim of this study was ...to clarify whether ESD provided better results than EMR for en bloc and complete resection of superficial pharyngeal carcinomas.
A total of 76 superficial pharyngeal carcinomas in 59 consecutively treated patients were included. Patients underwent either conventional EMR (using a transparent cap or strip biopsy) (n = 45 lesions) or ESD (n = 31 lesions) between October 2006 and January 2011. The rates of en bloc resection, complete resection (defined as en bloc resection with tumor-free margins), major complications, and local recurrence were evaluated retrospectively as the therapeutic outcomes.
ESD yielded significantly higher rates of both en bloc and complete resection compared with EMR (en bloc 77.4 % 24/31 vs. 37.8 % 17/45, P = 0.0002; complete 54.8 % 17/31 vs. 28.9 % 13/45, P = 0.0379). ESD was more frequently complicated by severe laryngeal edema (4/21 19.0 % vs. 1/31 3.2 %, P = 0.1446) and was also more time-consuming (124.9 ± 65.1 minutes vs. 57.2 ± 69.6 minutes; P = 0.0014). Local recurrence was observed more often after EMR than after ESD (3/45 6.7 % vs. 0/31 0 %), although this difference did not reach statistical significance (P = 0.2658).
ESD appears to be a superior method of endoscopic resection of superficial pharyngeal carcinomas for achieving both en bloc and complete resection, although these benefits were also associated with a higher incidence of complications and a significantly longer procedure time. Large prospective studies are needed to compare ESD with conventional EMR for superficial pharyngeal carcinomas.
It was shown both theoretically and experimentally that nanosecond order laser pulses at 10.6 micron wavelength were superior for driving the Sn plasma extreme ultraviolet (EUV) source for ...nano-lithography for the reasons of higher conversion efficiency, lower production of debris and higher average power levels obtainable in CO
2
media without serious problems of beam distortions and nonlinear effects occurring in competing solid-state lasers at high intensities. The renewed interest in such pulse format, wavelength, repetition rates in excess of 50 kHz and average power levels in excess of 18 kiloWatt has sparked new opportunities for a matured multi-kiloWatt CO
2
laser technology. The power demand of EUV source could be only satisfied by a Master-Oscillator-Power-Amplifier system configuration, leading to a development of a new type of hybrid pulsed CO
2
laser employing a whole spectrum of CO
2
technology, such as fast flow systems and diffusion-cooled planar waveguide lasers, and relatively recent quantum cascade lasers. In this paper we review briefly the history of relevant pulsed CO
2
laser technology and the requirements for multi-kiloWatt CO
2
laser, intended for the laser-produced plasma EUV source, and present our recent advances, such as novel solid-state seeded master oscillator and efficient multi-pass amplifiers built on planar waveguide CO
2
lasers.
Alterations of chromatin structure have been shown to be crucial for response to cell signaling and for programmed gene expression in development. Posttranslational histone modifications influence ...changes in chromatin structure both directly and by targeting or activating chromatin-remodeling complexes. Histone modifications intersect with cell signaling pathways to control gene expression and can act combinatorially to enforce or reverse epigenetic marks in chromatin. Through their recognition by protein complexes with enzymatic activities cross talk is established between different modifications and with other epigenetic pathways, including noncoding RNAs (ncRNAs) and DNA methylation. Here, we review the functions of histone modifications and their exploitation in the programming of gene expression during several events in development.
Hemorrhagic radiation cystitis is an example of a typical radiotherapy-induced adverse event. However, the optimal treatment for hemorrhagic radiation cystitis is not known. There are limited data ...regarding the use of argon plasma coagulation for hemorrhagic radiation cystitis. Here, we present the use of argon plasma coagulation using a gastrointestinal endoscope to treat hemorrhagic radiation cystitis. The patient was a 75-year-old male patient with hemorrhagic radiation cystitis due to external beam irradiation for prostate adenocarcinoma. Six years after radiotherapy, the patient presented with macroscopic hematuria over the preceding 4 months, and laboratory investigations revealed a low hemoglobin level. The hematuria was not controlled with 2 days of bladder irrigation using normal saline. Thus, argon plasma coagulation using an upper gastrointestinal endoscope was considered for treatment of the hemorrhagic radiation cystitis. The cystoscopic examination revealed diffuse radiation cystitis with oozing telangiectasia and coagula. All of the bleeding sites and telangiectasia were coagulated using argon plasma coagulation. Following treatment, the patient's clinical symptoms improved and did not recur. The hemoglobin level also recovered. No complications associated with the treatment were observed during the 6-month follow-up period. Thus, argon plasma coagulation using a gastrointestinal endoscope is a safe and effective treatment for hemorrhagic radiation cystitis.
We have investigated laser-induced reactions between laser-cooled crystallized Ca+ ions and polar molecule NH3 at room temperature. Reaction rates of Ca+* (3d 2D3/2, 4p 2P1/2) + NH3 → products have ...been determined from time variation of the size of fluorescence images of Ca+ Coulomb crystals. From the pressure dependence of the reaction rates we determined a lower limit of the reaction rate coefficients.
The goal of specimen preparation for transmission electron microscopy is to obtain high-quality ultra-thin sections with which we can correlate cellular structure to physiological function. In this ...study, we newly developed a capsule-supporting ring that can be useful for resin embedding of glass-mounted specimens. The present device allowed us to re-embed a semi-thin section on a microscope slide into a resin block not only for efficient ultra-thin sectioning but also for a correlative light and electron microscopy. Similar to epoxy resins for morphological observations, semi-thin sections of low-viscosity hydrophilic resins, such as Lowicryl series, can be re-embedded into the resin, which can be useful for cytochemical gold labelling. A further application of the present device improved flat embedding of cultured cells on glass cover slips for electron microscopy, preserving in situ sub-cellular structures close to their native state. We practically describe the use of capsule-supporting ring and demonstrate representative micrographs as results.
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