Clinical Outcome of Laparoscopic Intersphincteric Resection Combined with Transanal Rectal Dissection for T3 Low Rectal Cancer in Patients with a Narrow Pelvis

Purpose. The purpose of this study was to analyze the safety and feasibility of laparoscopic intersphincteric resection (ISR) combined with transanal rectal dissection (TARD) for T3 low rectal cancer in a narrow pelvis. Methods. We studied 20 patients with a narrow pelvis of median body mass index 25.3 (16.9–31.2). Median observation period was 23.6 months (range 12.2–56.7). Results. Partial, subtotal, and total ISR was performed in 15, 1, and 4 patients, respectively. Median duration of TARD was 83 min (range 43–135). There were no major complications perioperatively or postoperatively. Surgical margins were histologically free of tumor cells in all patients, and there was no local recurrence. Excluding urgency, frequency of bowel movements, and incontinence status improved gradually after stoma closure. Conclusion. Laparoscopic ISR combined with TARD is technically feasible for selective T3 low rectal cancer in patients with a narrow pelvis

Localization and Quantum Hall Effect in Two-Dimensional Systems Under Strong Magnetic Fields(Transport and Fermiology)

Experimental researches of quantum transport properties of semiconductor two-dimensional electron systems in Si-MOSFETs and GaAs/AlGaAs heterostructures in high magnetic fields up to 27 T and at low temperatures down to 20 mK are performed. Analysis of the Hall conductivity of Si-MOSFETs based on a mobility edge model shows that the temperature dependence of the mobility edge can not be explained by existing theory of localization. The fractional quantum Hall effect is observed at the filling factor of 1/7 in heterostructures. Sample size dependence and magnetic field dependence of the breakdown of the integral quantum Hall effect in heterostructures reveal that the Hall current is carried not by the edge states but by the extended states in the localization in the bulk of the two-dimensional systems

Planar-type silicon thermoelectric generator with phononic nanostructures for 100 {\mu}W energy harvesting

Energy harvesting is essential for the internet-of-things networks where a tremendous number of sensors require power. Thermoelectric generators (TEGs), especially those based on silicon (Si), are a promising source of clean and sustainable energy for these sensors. However, the reported performance of planar-type Si TEGs never exceeded power factors of 0.1 ${\mu} Wcm^{-2} K^{-2}$ due to the poor thermoelectric performance of Si and the suboptimal design of the devices. Here, we report a planar-type Si TEG with a power factor of 1.3 ${\mu} Wcm^{-2} K^{-2}$ around room temperature. The increase in thermoelectric performance of Si by nanostructuring based on the phonon-glass electron-crystal concept and optimized three-dimensional heat-guiding structures resulted in a significant power factor. In-field testing demonstrated that our Si TEG functions as a 100-${\mu}W$-class harvester. This result is an essential step toward energy harvesting with a low-environmental load and cost-effective material with high throughput, a necessary condition for energy-autonomous sensor nodes for the trillion sensors universe

Anti-cancer stem cell activity of the Src inhibitor dasatinib in thyroid cancer cells

Although the prognosis of differentiated thyroid cancer (DTC) is good, those of poorly-differentiated and undifferentiated thyroid cancers (PDTC and UDTC) are poor. Recent preclinical studies have suggested that the Src inhibitor dasatinib is active in thyroid cancer cell lines. We conducted the present study in an attempt to clarify the antitumor activity of dasatinib in PDTC and UDTC. The expression levels of c-Src, phosphorylated Srcs (p-SrcY416 and p-SrcY527), focal adhesion kinase (FAK), and phosphorylated FAK (p-FAKY861) were immunohistochemically investigated in a case-control series (15 cases of PDTC or UDTC vs. 29 control cases of DTC). The PDTC cell line KTC-1 and UDTC cell line KTC-2 were used to investigate the anticell growth and anti-cancer stem cell (CSC) activities of dasatinib. The combined effects of dasatinib and the taxane paclitaxel on anti-cell growth and anti-CSC activities were also tested. c-Src and p-FAKY861 expression levels were significantly higher, while those of p-SrcY416 were slightly higher in PDTC and UDTC than in DTC. Dasatinib inhibited cell growth in association with G1-S cell cycle retardation and increased apoptosis in both cell lines. Dasatinib significantly decreased the proportion of CSCs and more than additively enhanced the anti-cell growth activity of paclitaxel. The results of this study suggest that the Src signaling pathway is activated more in PDTC and UDTC than in DTC. The Src inhibitor dasatinib exhibited anti-cell growth and anti-CSC activities. Furthermore, it more than additively enhanced the anti-cell growth activity of paclitaxel

Novel hexagonal structure and ultrahigh strength of magnesium solid solution in the Mg-Zn-Y system

A magnesium (Mg) solid solution with a long periodic hexagonal structure was found in a Mg97Zn1Y2 (at.%) alloy in a bulk form prepared by warm extrusion of atomized powders at 573 K. The novel structure has an ABACAB-type six layered packing with lattice parameters of a = 0.322 nm and c = 3 ~ 0.521 nm. The Mg solid solution has fine grain sizes of 100 to 150 nm and contains 0.78 at.% Zn and 1.82 at.% Y. In addition, cubic Mg24Y5 particles with a size of about 7 nm are dispersed at small volume fractions of less than 10% in the Mg matrix. The specific density (ƒÏ) of the extruded bulk Mg-Zn-Y alloy was 1.84 Mg/m3. The tensile yield strength (ƒÐy) and elongation (ƒÂ) are 610 MPa and 5%, respectively, at room temperature, and the specific yield strength defined by the ratio of ƒÐy to ƒÏ is as high as 3.3 ~ 105 Nm/kg. High ƒÐy values exceeding 400 MPa are also maintained at temperatures up to 473 K. It is noticed that the ƒÐy levels are 2.5 to 5 times higher than those for conventional high-strength type Mg-based alloys. The Mg-based alloy also exhibits a high-strain-rate superplasticity with large ƒÂ of 700 to 800% at high strain rates of 0.1 to 0.2 s-1 and 623 K. The excellent mechanical properties are due to the combination of the fine grain size, new long periodic hexagonal solid solution containing Y and Zn, and dispersion of fine Mg24Y5 particles. The new Mg-based alloy is expected to be used in many fields

A rare case of repeated anastomotic recurrence due to tumor implantation after curative surgery for sigmoid colon cancer

<p>Abstract</p> <p>Background</p> <p>Anastomotic recurrence is often experienced at colocolic or colorectal anastomoses. Tumor cell implantation has been reported as the mechanism of anastomotic recurrence. However, anastomotic recurrence occurring repeatedly after curative surgery is rare. We herein report a rare case of repeated anastomotic recurrence after curative surgery for sigmoid colon cancer.</p> <p>Case presentation</p> <p>A 51-year-old man underwent radical surgery for sigmoid colon cancer. However, anastomotic recurrence developed three times during three years and six months after the initial operation in spite of irrigation with 5% povidone-iodine before anastomosis. The serum carcinoembryonic antigen (CEA) level had been within normal limits after sigmoidectomy. Finally, the patient underwent abdominoperineal resection. The clinico-pathological findings revealed that possible tumor cell implantation caused these anastomotic recurrences. The patients survived without recurrence during the follow-up period of seven years and nine months.</p> <p>Conclusion</p> <p>We experienced a rare case of repeated anastomotic recurrence due to possible tumor implantation after curative surgery for sigmoid colon cancer; however the prognosis was ultimately very good. CEA monitoring was insensitive for detection of anastomotic recurrence in this case.</p

パルボシクリブ併用内分泌治療が著効した閉経前再発乳癌の１例

　パルボシクリブ併用内分泌療法が著効した閉経前再発乳癌の１例を報告する．８年前に乳房温存手術を受け，残存乳房への放射線治療後に化学内分泌補助療法（シクロフォスファミド＋エピルビシン（CE 90）を４サイクル後に毎週パクリタキセルを４サイクル施行．化学療法終了後からLH-RH アゴニスト２年間とタモキシフェン５年間）を行った．治療継続中も含め定期で外来受診を継続しており，年１回の画像検査（肺，肝，骨を標的）と３か月ごとの腫瘍マーカー測定では再発の兆候はなく経過していた．しかし，補助治療終了後約３年で発熱と肝機能障害をきっかけに多発遠隔再発（肺・骨・肝・子宮体部）を発見した．ホルモン感受性は残存している可能性はあったが，急速な再発であるために，再発後初回治療としてドセタキセルおよびデノスマブの投与を開始した．有効ではあったが投与後約半年でマーカーの再上昇と体動時呼吸困難（在宅酸素療法導入）および疲労・倦怠感の増強が出現した．有害事象と病勢進行のため再発後の二次治療としてパルボシクリブ，フルベストラント，LH-RH アゴニストを導入した．導入後１か月で体動時呼吸困難が消失し，３か月で在宅酸素療法が中止できた．半年後のPET/CT で集積が消失しており画像上は著効と判断できた．有害事象は白血球・好中球減少が出現した以外に認めなかった．再発治療としてパルボシクリブ併用内分泌治療が有用であった．　We have a case of pre-menopausal patient with recurrent breast cancer showing an excellent response to endocrine therapy with palbociclib. Eight years ago, she underwent breast conserving operation followed by adjuvant chemo-endocrine therapy (4 cycles of cyclophosphamide and doxorubicin, 4 cycles of paclitaxel and tamoxifen adding LHRH agonist). The administration of tamoxifen continued for 5 years as an adjuvant therapy. After 3 years of discontinuation of adjuvant medication, fever and liver dysfunction led to find the recurrence of breast cancer in lung, bone, liver and uterus. We chose to treat with chemotherapy as the first line, because the recurrence was rash and multiple. After 6 months of treatment of docetaxel and denosumab, serum decreased tumor markers elevated gradually and dyspnea and general fatigue worsened. She recieved palbociclib, fluvestrant and LH-RH agonist as a second endocrine therapy. Six months after the treatment, PET/CT revealed an excellent effect on each metastatic lesion. Adverse event was only seen in neutropenia to make one-level reduction of dose. Palbociclib and endocrine therapy appeared to be useful as a second-line treatment for recurrent breast patient

プールの健康教室に参加することによる心身への影響―低身体活動高齢女性の実態調査―

目的：群馬県内のAプールが実施している健康教室に参加することが心身に及ぼす影響を明らかにすることを目的とした． 方法：研究参加に同意した65歳以上の低身体活動の女性11名を対象者とした．教室参加前に年齢，健康状態，気分を，教室当日に運動前，中，後の血圧・脈拍，主観的運動強度を，教室終了後に気分を調査した．任意で体力測定を行った． 結果：体力測定の結果は，握力，上体起こし，長座体前屈，開眼片足立ち，10m障害物歩行の全てで全国平均よりも低かった．気分は，教室参加後に緊張・不安が有意に低下した．収縮期血圧は運動後では運動前よりも有意に上昇し，脈拍は運動前よりも有意に低下した．主観的運動強度は運動前よりも有意に上昇した． 結論：対象者は，肥満，筋力低下傾向にあるが，集団で実施する水中運動の強度は適度であった．健康教室により，緊張・不安が改善し，適度な運動強度においても血圧や脈拍の有意な変動が認められた．Objectives: The purpose of this study was to investigate the effects of a health class offered at a swimming pool. Methods: The subjects were 11 women aged 65 years or older who had low active mass. We investigated age, health condition, and mood before the health class. On the day of the health class, we measured blood pressure, pulse, and perceived exertion before, during, and after aquatic exercise. We then investigated mood after the health class. We also offered an optional physical fitness test to the subjects. Results: Scores for grip strength, sit-ups, toe touching, one-leg standing with eyes open, and 10-m obstacle walking test results were below healthy levels. The mood test showed that tension and anxiety were improved. Systolic blood pressure was significantly higher, pulse was significantly lower, and the rate of perceived exertion was significantly higher after exercise than before. Conclusions: The subjects were obese and had muscle weakness, but the exercise was of moderate intensity. Tension and anxiety improved after the health class. Significant changes in blood pressure and pulse were found after exercise.原