大腸腫瘍性病変の拾い上げ診断における透明フードを併用した自家蛍光内視鏡の有用性:前向き無作為化比較試験

BACKGROUND: Colonoscopy is one of the most reliable methods for detection of colorectal neoplasms, but conventional colonoscopy can miss some lesions. OBJECTIVE: To evaluate the efficacy of autofluorescence imaging (AFI) with a transparent hood (TH) for detection of colorectal neoplasms. DESIGN: A 2 × 2 factorial designed, prospective, randomized, controlled trial. SETTING: This study was conducted at the Osaka Medical Center for Cancer and Cardiovascular Diseases, a tertiary cancer center. PATIENTS: A total of 561 patients. INTERVENTIONS: Patients were allocated to 1 of 4 groups: (1) white light imaging (WLI) alone--colonoscopy using WLI without a TH; (2) WLI+TH--colonoscopy using WLI with a TH; (3) AFI alone--colonoscopy using AFI without a TH; and (4) AFI+TH--colonoscopy using AFI with a TH. Eight colonoscopists used each allocated method. MAIN OUTCOME MEASUREMENT: The difference in neoplasm detection rate (number of detected neoplasms per patient) between the WLI alone and AFI+TH groups. RESULTS: Neoplasm detection rate (95% confidence interval) in the AFI+TH group was significantly higher than in the WLI alone group (1.96 [1.50-2.43] vs 1.19 [0.93-1.44]; P = .023, Tukey-Kramer multiple comparison test). Relative detection ratios (95% confidence interval) for polypoid neoplasms based on Poisson regression model were significantly increased by mounting a TH (1.69 [1.34-2.12], P < .001), and relative detection ratios for flat neoplasms were significantly increased by AFI observation (1.83 [1.24-2.71], P = .002). LIMITATIONS: Open trial performed in single cancer referral center. CONCLUSION: AFI colonoscopy with a TH detected significantly more colorectal neoplasms than did conventional WLI colonoscopy without a TH.博士（医学）・乙1327号・平成26年3月17

Usefulness of medium-Energy Collimator for Sentinel Node Lymphoscintigraphy Imaging in Breast Cancer Patients

金沢大学大学院医学系研究科小野口, 昌久This study was performed to investigate the usefulness of a general-purpose medium-energy (ME) collimator for the accurate localization of the sentinel lymph node (SLN) in breast cancer patients. Methods: We compared phantom images and lymphoscintigraphy images obtained under different conditions for a patient with breast cancer. Comparisons were performed between 2 cameras, between a low-energy high-resolution (LEHR) collimator and a general-purpose ME collimator, and between energy windows centered at 141 keV and at 146 keV. Profile curves and image contrast were evaluated along with the visual interpretation of images. The most suitable imaging time was selected from the relationship between contrast and the data acquisition time. Results: The images obtained with the general-purpose ME collimator and the energy window centered at 141 keV were of poorer quality than those obtained with the LEHR collimator and the same energy window. However, the quality of the images obtained with the general-purpose ME collimator improved when the energy window was centered at 146 keV. The method involving the general-purpose ME collimator and the energy window centered at 146 keV showed excellent image quality similar to that obtained with the LEHR collimator. The enhancement of contrast was confirmed at more than 3 cm away from the center of the injection site. Stable contrast was obtained with a data acquisition time of 5 min, with the general-purpose ME collimator, and with the energy window centered at 146 keV. Conclusion: The method involving the general-purpose ME collimator and the energy window centered at 146 keV has the merit of the lymph node not being concealed by a lead shield. This new method is expected to improve the rate of detection of SLN and has the potential for shortening the acquisition time

Advantages of upright position imaging with medium-energy collimator for sentinel node lymphoscintigraphy in breast cancer patients

金沢大学大学院医学系研究科先端医療技術学Objective: To evaluate the advantage of upright position imaging with a medium-energy collimator for the detection of sentinel lymph node (SLN). Methods: Thirty-four patients with operable breast cancer underwent sentinel node lymphoscintigraphy with 99mTc-tin colloid. Images were obtained in 5 different positions and paired images from the same patient were compared using side-by-side interpretation. Images were compared in 3 groups: group 1 (anterior view); supine (SAV) vs. upright (UAV), group 2 (oblique view); supine (SOV) vs. upright (UOV), and group 3 (oblique view); modified supine (MOV) vs. UOV. Image quality was evaluated using a 3-grade scale of clear, faint, and equivocal depiction, and correlated to 3 parameters: distance from injection site to lymph node (hot node), counts in hot node, and image contrast. Parameters in group 1 were compared by classifying the primary tumor site into 4 subregions. Results: Image quality in all 3 groups was more enhanced on the image obtained in the upright position than that in the supine position. Obtaining images in an upright position increased the mean distances by 1.5-3.2 cm, and mean contrasts were significantly increased by 0.13-0.31 (p < 0.05). It was shown that image quality was more greatly affected by image contrast than by counts in the hot node. Image contrast of 0.5 seemed an appropriate threshold level for detection of the hot node. On comparison of tumor sites, the upper outer quadrant (C) region of the 4 subregions demonstrated greater contrast enhancement on upright position images. Conclusion: Clinical images obtained in an upright position with a medium-energy collimator were superior to those obtained in a supine position. Use of this procedure is recommended to enhance lymph node detection on sentinel node lymphoscintigraphy

エアロゾルゾンデ ニヨル ナンキョク ショウワキチ ジョウクウ ノ セイソウケン タイリュウケン エアロゾル ノウド ノ キセツ ケイネン ヘンカ ノ カンソク

昭和基地(69゜00′S 39゜35′E)において,1997年4月～ 2008年1月まで,気球搭載光散乱式粒子計数装置(エアロゾルゾンデ)による75回の観測を実施し,地上から高度約30 kmまでの半径0.15-3.5 μmの領域の粒径分布の経年変化,季節変化等のデータを得た. 成層圏エアロゾルには,バックグランドエアロゾル層の秋から冬にかけての沈降,冬の極成層圏雲の活動,夏の極渦の崩壊に伴う成層圏エアロゾル層の復帰という季節変化などが見られ,経年変化の解析からは1991年のピナツボ火山噴火の影響が南極においても1999年頃まで残っていたことが示唆された. また,自由対流圏のエアロゾル濃度は,1-6月に比べて7-12月の濃度が有意に高いという季節変化を示した.This report summarizes observations of tropospheric and stratospheric aerosols by a balloon-borne optical particle counter (Aerosol sonde) performed at Syowa Station from April 1997 to January 2008. Typical seasonal changes in the stratospheric aerosol layer were characterized by sedimentations of the stratospheric aerosol layer in autumn, PSCs activity in winter, and sudden increase in aerosol concentration at the end of spring. The annual change shows that the perturbations of stratospheric aerosol caused by the eruption of Mt. Pinatubo in 1991 remained until 1999. Additionally, seasonal variation of tropospheric aerosol shows clear differences between concentrations from January to June and those from July to December

Conductor and joint test results of JT-60SA CS and EF coils using the NIFS test facility

In 2007, JAEA and NIFS launched the test project to evaluate the performance of cable-in-conduit (CIC) conductors and conductor joints for the JT-60SA CS and EF coils. In this project, conductor tests for four types of coil conductor and joint tests for seven types of conductor joint have been conducted for the past eight years using the NIFS test facility. As a result, the test project indicated that the CIC conductors and conductor joints fulfill the design requirement for the CS and EF coils. In addition, the NIFS test facility is expected to be utilized as the test facility for the development of a conductor and conductor joint for the purpose of the DEMO nuclear fusion power plant, provided that the required magnetic field strength is within 9 T

Independence from the Sequence of Single-Electron Transfer of Photoredox Process in Redox-Neutral Asymmetric Bond-Forming Reaction

A catalytic cycle initiated by the oxidative quenching of the excited photosensitizer (Ir*­(ppy)₃) is established for the enantioselective coupling between (<i>N</i>-arylamino)­methanes and (<i>N</i>-methanesulfonyl)­aldimines catalyzed by Ir-based photosensitizer and a chiral (arylamino)­phosphonium tetrakis­[3,5-bis­(trifluoromethyl)­phenyl]­borate under visible light irradiation. This achievement clearly demonstrates the insensitivity of this redox-neutral asymmetric reaction to the sequence of the key redox events involved in the synergistic catalysis

Seasonal and annual variations of aerosol concentrations in the troposphere and stratosphere over Syowa Station observed by a balloon-borne optical particle counter

This report summarizes observations of tropospheric and stratospheric aerosols by a balloon-borne optical particle counter (Aerosol sonde) performed at Syowa Station from April 1997 to January 2008. Typical seasonal changes in the stratospheric aerosol layer were characterized by sedimentations of the stratospheric aerosol layer in autumn, PSCs activity in winter, and sudden increase in aerosol concentration at the end of spring. The annual change shows that the perturbations of stratospheric aerosol caused by the eruption of Mt. Pinatubo in 1991 remained until 1999. Additionally, seasonal variation of tropospheric aerosol shows clear differences between concentrations from January to June and those from July to December

A Structurally Robust Chiral Borate Ion: Molecular Design, Synthesis, and Asymmetric Catalysis

Catalysis by chiral weakly-coordinating anions (WCAs) remains underdeveloped due to the lack of a molecular design strategy for exploiting their characteristics, such as the non-nucleophilic nature. Here, we report the development of a chiral borate ion comprising an O,N,N,O-tetradentate backbone, which ensures hitherto unattainable structural robustness. Upon pairing with a proton, the hydrogen borate acts as an effective catalyst for the asymmetric Prins-type cyclization of vinyl ethers, providing access to structurally and stereochemically defined dihydropyrans. The key to selectivity control is the distinct ability of the borate ion to discriminate the prochiral faces of the acyclic oxonium ion intermediate and dictate the regiochemical outcome. We anticipate that this study paves the way for exploring the untapped potential of WCA catalysis for selective chemical synthesis.<br /

Synergistic Catalysis of Ionic Brønsted Acid and Photosensitizer for a Redox Neutral Asymmetric α‑Coupling of <i>N</i>‑Arylaminomethanes with Aldimines

A redox neutral, highly enantioselective coupling between <i>N</i>-arylaminomethanes and <i>N</i>-sulfonyl aldimines was developed by harnessing the efficient catalysis of <i>P</i>-spiro chiral arylaminophosphonium barfate and a transition-metal photosensitizer under visible light irradiation. This mode of synergistic catalysis provides a powerful strategy for controlling the bond-forming processes of reactive radical intermediates