Endoscopic Mucosal Resection of Primary Anorectal Malignant Melanoma:A Case Report

Anorectal melanoma is a rare malignant tumor with a poor prognosis. However, several studies have reported cases of long-term survival. In this report, we present a patient with anorectal melanoma who has survived for 9 years after endoscopic mucosal resection. An 85-year-old man was referred to our hospital for further examination and treatment of an anal tumor 2cm in size. Endoscopic ultrasonography revealed that the depth of tumor invasion was confined to the submucosal layer. Endoscopic mucosal resection was performed, and the tumor was diagnosed as a malignant melanoma. The patient was followed without any additional treatment, which was per his wishes. Although melanoma recurred 4 times thereafter, endoscopic mucosal resection was performed for each recurrent lesion. Thus, he has been alive for 9 years since the first endoscopic mucosal resection without distant metastases. If the depth of tumor invasion is shallow, endoscopic mucosal resection is a useful option among other therapeutic modalities.</p

日本における潰瘍性大腸炎の臨床的特徴の変化；1981年から2000年までの病院通院患者844名の解析

Although the number of ulcerative colitis patients has increased rapidly in Japan, few reports have been published regarding their clinical aspects. We investigated the clinical characteristics and chronological change of ulcerative colitis in Japanese patients. METHODS: Patients diagnosed with ulcerative colitis during the period from 1981 to 2000 were registered and their clinical profiles were analyzed. The chronological changes in clinical aspects, such as onset age, sex distribution, severity, extent of disease, clinical course, and corticosteroid use, were also determined. RESULTS: A total of 844 patients were registered, composed of 431 men and 413 women, with a median onset age of 34 years. The proportion of mild colitis and proctitis was significantly larger in patients with an onset at over 60 years of age, relative to those with an onset at less than 30 years (P<0.016). The proportion of ulcerative colitis patients with old age onset (P=0.09), male sex (P<0.01), mild colitis (P<0.01), proctitis (P<0.01), one-attack-only type (P<0.01), and not-treated-with-corticosteroid (P<0.01) demonstrated a chronological increase from 1981 to 2000. CONCLUSIONS: The distinctive clinical features and chronological change were seen in Japanese ulcerative colitis patients in recent years. Our data can help understand clinical aspects of ulcerative colitis patients in Asia, where the incidence of ulcerative colitis is still increasing

Chapter 7 Organizational Stress in Contemporary Japan

Stress is defined as a feeling experienced when a person perceives that demands exceed the personal and social resources the individual is able to mobilize. It can occur due to environmental issues, such as a looming work deadline, or psychological, for example, persistent worry about familial problems. While the acute response to life-threatening circumstances can be life-saving, research reveals that the body’s stress response is largely similar when it reacts to less threatening but chronically present stressors such as work overload, deadline pressures and family conflicts. It is proffered that chronic activation of stress response in the body can lead to several pathological changes such as elevated blood pressure, clogging of blood vessels, anxiety, depression, and addiction. Organizational Stress Around the World: Research and Practice aims to present a sound theoretical and empirical basis for understanding the evolving and changing nature of stress in contemporary organizations. It presents research that expands theory and practice by addressing real-world issues, across cultures and by providing multiple perspectives on organizational stress and research relevant to different occupational settings and cultures. Personal, occupational, organizational, and societal issues relevant to stress identification along with management techniques/approach to confront stress and its associated problems at individual and organizational level are also explored. It will be of value to researchers, academics, practitioners, and students interested in stress management research

Construction of Mass Concrete Structure Utilizing Ground Settlement from Underpass Construction in the 2nd Phase Kansai International Airport Project

The man-made island of Kansai International Airport is located 5 km offshore in Osaka bay and the water depth at the point is about 20 m. Thickness of the sediments beneath the island is several hundred meters, including 20 m of very soft Holocene clay layer. Huge amount of soil had been reclaimed layer over layer and the total thickness is up to 34 to 45 m. Therefore, large amount of settlement is inevitable and the average settlement forecast in the 2nd phase island over the 60 years period from the start of reclamation work is 18 m. In this paper, design and construction of 2nd phase underpass structure is discussed. The overview of construction of the airport island and settlement prediction is described first, then the idea of constructing the under water level structure while it was still above water level is introduced. The design concept of following the large displacement and method of displacement prediction is described next and verification with survey and evaluation is concluded at last