Short-term outcomes of robotic tumor-specific mesorectal resection of rectal cancer: surgical techniques in mesorectal division using rolling division of the mesorectum.

BACKGROUND: This study aims to report our surgical techniques for robot-assisted laparoscopic anterior resection, specifically focusing on mesorectal division using rolling division of the mesorectum, and to elucidate short-term outcomes at a single institution. Tumor-specific mesorectal excision (TSME) is commonly performed for resection of a tumor located in the upper rectum. However, especially in a narrow pelvis, it is difficult to perform appropriate mesorectal division at an adequate distance from the tumor in robot-assisted laparoscopic anterior resection. METHODS: Retrospective case series of patients with rectal cancer who underwent robot-assisted TSME using rolling division of mesorectum. Patient characteristics, perioperative clinical results, surgical and pathological details were recorded. RESULTS: A total of 198 patients underwent robot-assisted TSME for rectal cancer using rolling division of mesorectum between May 2019 and December 2023.The tumor was located in the upper rectum in 45 patients, middle rectum in 115 patients and lower rectum in 38 patients. The types of resections were 40 high anterior resection and 158 low anterior resections. The median operation time was 175 (range 109-310) min, and median mesorectal division time was 24 (range 15-45) min. Median blood loss was 3 (range 0-20) ml; no patients required blood transfusion. The overall complication rate of Clavien-Dindo classification grades I-IV was 7.1%. Anastomotic leakage was observed in two patients (1.0%) with grade III. There was no surgical mortality in this series. CONCLUSION: This robotic technique for anterior resection is a feasible and reliable procedure for achieving sufficient and safe TSME in this cohort.

Global Association between Traditional Japanese Diet Score and All-Cause, Cardiovascular Disease, and Total Cancer Mortality: A Cross-Sectional and Longitudinal Ecological Study.

OBJECTIVE: Studies conducted on Japanese people have suggested that a traditional Japanese diet contributes to good health, longevity, and protection against several non-communicable diseases. However, it is unknown whether traditional Japanese dietary patterns are associated with all-cause mortality, cardiovascular disease, and cancer mortality globally. The purpose of this cross-sectional and longitudinal ecological study is to clarify the global association between the traditional Japanese diet score (TJDS) and all-cause, cardiovascular disease, and total cancer mortality. METHODS: Data on food supply and all-cause mortality, cardiovascular disease mortality, total cancer mortality, and covariables by country were obtained from a relevant internationally available database. TJDS by country was calculated from eight food groups and the total score ranged from -8 to 8, with higher scores indicating greater adherence to a traditional Japanese diet. We evaluated the cross-sectional and 10-year longitudinal association between TJDS and all-cause, cardiovascular disease, and total cancer mortality using 2009 as the baseline in 142 countries with populations of more than one million. A cross-sectional analysis and a longitudinal analysis were performed using three general linear models or three linear mixed models with different covariables. RESULTS: In cross-sectional models controlled for fully-adjusted covariables, TJDS was negatively associated with all-cause mortality (ß ± standard error; -43.819 ± 11.741, p < 0.001), cardiovascular disease mortality (-22.395 ± 4.638, p < 0.001), and total cancer mortality (-3.893 ± 1.048, p < 0.001). In 10-year longitudinal models controlled for fully-adjusted covariables, TJDS was significantly negatively associated with all-cause mortality (-31.563 ± 7.695, p < 0.001), cardiovascular disease mortality (-16.249 ± 4.054, p < 0.001), and total cancer mortality (-3.499 ± 0.867, p < 0.001). CONCLUSIONS: This cross-sectional and longitudinal ecological study suggests that the traditional Japanese diet is associated with lower all-cause mortality, cardiovascular disease mortality, and total cancer mortality, worldwide.

Variational quantum eigensolver simulations with the multireference unitary coupled cluster ansatz: a case study of the C2v quasi-reaction pathway of beryllium insertion into a H2 molecule.

Variational quantum eigensolver (VQE)-based quantum chemical calculations have been extensively studied as a computational model using noisy intermediate-scale quantum devices. The VQE uses a parametrized quantum circuit defined through an "ansatz" to generate approximated wave functions, and the appropriate choice of an ansatz is the most important step. Because most chemistry problems focus on the energy difference between two electronic states or structures, calculating the total energies in different molecular structures with the same accuracy is essential to correctly understand chemistry and chemical processes. In this context, the development of ansatzes that are capable of describing electronic structures of strongly correlated systems accurately is an important task. Here we applied a conventional unitary coupled cluster (UCC) and a newly developed multireference unitary coupled cluster with partially generalized singles and doubles (MR-UCCpGSD) ansatzes to the quasi-reaction pathway of Be insertion into H2, LiH molecule under covalent bond dissociation, and a rectangular tetra-hydrogen cluster known as a P4 cluster; these are representative systems in which the static electron correlation effect is prominent. Our numerical simulations revealed that the UCCSD ansatz exhibits extremely slow convergence behaviour around the point where an avoided crossing occurs in the Be + H2 → BeH2 reaction pathway, resulting in a large discrepancy of the simulated VQE energy from the full-configuration interaction (full-CI) value. By contrast, the MR-UCCpGSD ansatz can give more reliable results with respect to total energy and the overlap with the full-CI solution, insisting the importance of multiconfigurational treatments in the calculations of strongly correlated systems. The MR-UCCpGSD ansatz allows us to compute the energy with the same accuracy regardless of the strength of multiconfigurational character, which is an essential property to discuss energy differences of various molecular systems.

Global relationship between Mediterranean diet and the incidence and mortality of ischaemic heart disease.

BACKGROUND: The purpose of this study was to clarify the global relationship between the Mediterranean diet score (MDS) and country-wise incidence and mortality of ischaemic heart disease (IHD) using an international database. METHODS: We used population data from a global longitudinal database covering 137 countries with a population of over one million. MDS were evaluated based on the total score of the nine foods that comprise the Mediterranean diet. The incidence and mortality of IHD by country was derived from the Global Burden of Disease (GBD) database. Average food (g/day/capita) and energy supply (kcal/day/capita) by country, excluding loss between production and household, were obtained from the Food and Agriculture Organization of the United Nations Statistics Division database. Data from the GBD database were used for body mass index, current smoking rates, physical activity, years of education and percentage of the Muslim population. We identified the percentage of the population over 65 years of age (aging rate) and gross domestic product per capita (US$/capita) using the World Bank database. A linear mixed-effect model was used for evaluating the effects of MDS on incidence and mortality of IHD controlled for socioeconomic and lifestyle variables. RESULTS: Analysis showed that MDS was significantly associated with IHD incidence after controlling for covariates (-1.01 ± 0.27, P < 0.001). Similarly, there was a significant association between MDS and IHD-related mortality after controlling for covariates (-0.73 ± 0.34, P < 0.05). CONCLUSION: Analysis of 27 years of data suggests that a Mediterranean diet might have a preventive effect on IHD.

A longitudinal association between the traditional Japanese diet score and incidence and mortality of breast cancer-an ecological study.

BACKGROUND: The traditional Japanese diet is considered one of the important factors of health and longevity in Japanese people. Breast cancer is the most common cancer among women in the world. However, the association between the traditional Japanese diet and breast cancer is unclear. The purpose of this study was to investigate the longitudinal association between the traditional Japanese diet score (TJDS) with the incidence and mortality of breast cancer in an ecological study. METHODS: Food supply and breast cancer incidence and mortality by country were obtained from an international database. TJDS by country was calculated from nine food groups and the total score ranged from -9 to 9, with higher scores indicating greater adherence to a traditional Japanese diet. Longitudinal associations of interaction between TJDS and fiscal year on breast cancer incidence and mortality were investigated in 139 countries with populations of 1 million or greater. The longitudinal analysis was evaluated using four linear mixed-effect models with different adjustment covariables. RESULTS: Many countries with high scores on TJDS had lower distributions of breast cancer incidence and mortality in 1990-2017. Longitudinal analysis using a linear mixed-effect model controlled for socio-economic and lifestyle covariables showed that the interaction between TJDS and fiscal year was significantly associated with incidence of breast cancer (-0.453 ± 0.138, p < 0.01) and mortality of breast cancer (-0.455 ± 0.135, p < 0.001). CONCLUSIONS: This longitudinal analysis suggested that a traditional Japanese diet has been associated with lower breast cancer incidence and mortality worldwide in recent years.

Oxidation suppression of Cu in alkaline aluminophosphate glass and the effects for radiation-induced luminescence characteristics.

A glass phosphor is an attractive material for applications in radiation detections because of its high workability and availability with a wide range of chemical compositions. Recently, X-ray-induced luminescence of glasses containing various luminescent activators are actively investigated worldwide. In applications as phosphor, tailoring valence state of activators, which can take multiple valence states in glass, is very important. In this research, we studied effects of glass melting atmosphere on the valence state of copper-activator ion in alkaline aluminophosphate glasses and the radiation-induced luminescence characteristics. Optical absorption and X-ray absorption near edge structure spectra of Cu-doped glasses showed that the glass fused in Ar atmosphere contains higher concentration of Cu+ than those prepared in air. In addition, the presence of Cu+ enhances the photoluminescence (PL) quantum yield and PL kinetic constant. Furthermore, the increase of Cu+ concentration resulted an improvement of the X-ray-induced scintillation and thermally-stimulated luminescence intensity.

The mechanism of action of Spi-B in the transcriptional activation of the interferon-α4 gene.

Plasmacytoid dendritic cells (pDCs) are characterized by an exclusive expression of nucleic acid sensing Toll-like receptor 7 (TLR7) and TLR9, and production of high amounts of type I interferon (IFN) in response to TLR7/9 signaling. This function is crucial for both antiviral immunity and the pathogenesis of autoimmune diseases. An Ets family transcription factor, i.e., Spi-B (which is highly expressed in pDCs) is required for TLR7/9 signal-induced type I IFN production and can transactivate IFN-α promoter in synergy with IFN regulatory factor-7 (IRF-7). Herein, we analyzed how Spi-B contributes to the transactivation of the Ifna4 promoter. We performed deletion and/or mutational analyses of the Ifna4 promoter and an electrophoretic mobility shift assay (EMSA) and observed an Spi-B binding site in close proximity to the IRF-7 binding site. The EMSA results also showed that the binding of Spi-B to the double-stranded DNA probe potentiated the recruitment of IRF-7 to its binding site. We also observed that the association of Spi-B with transcriptional coactivator p300 was required for the Spi-B-induced synergistic enhancement of the Ifna4 promoter activity by Spi-B. These results clarify the molecular mechanism of action of Spi-B in the transcriptional activation of the Ifna4 promoter.

Involvement of transcription factor Ets-1 in the expression of the α3 integrin subunit gene.

The α3ß1 integrin is an adhesion receptor for extracellular matrix proteins, and plays crucial roles in cell motility, proliferation, and differentiation. The aberrant expression of this adhesion molecule on tumor cells is frequently associated with their malignant behaviors. We previously reported that the Ets transcription factor-binding consensus sequence 133 bp upstream of the mouse α3 integrin gene is an important element for its expression in various tumor cell lines. In the present study, we attempted to identify a transcription factor bound to the Ets-consensus sequence, and found that Ets-1 bound to this sequence in an electrophoretic mobility shift assay, chromatin immunoprecipitation assay, and pull-down assay with a tandem repeat of the sequence as adsorbent. We next examined the role of Ets-1 in α3 integrin gene expression by use of a luciferase assay with a reporter plasmid containing the 5'-flanking region of the α3 integrin gene. Cotransfection of HEK293T cells with an Ets-1 expression construct and the reporter plasmid increased luciferase activity. By contrast, transfection of HT1080 cells (high α3 integrin expresser) with a dominant-negative mutant of Ets-1 decreased luciferase activity. Overexpression of Ets-1 in HepG2 hepatocellular carcinoma cells (low α3 integrin expresser) upregulated α3 integrin expression as assessed by immunoprecipitation. Finally, the induction of α3 integrin gene expression in HepG2 cells after transforming growth factor-ß1 treatment was abrogated by the dominant-negative mutant of Ets-1. These results suggest that Ets-1 is involved in transcriptional activation of the α3 integrin gene through its binding to the Ets-consensus sequence at -133 bp.

Clinical characteristics of young-onset and medical treatment-requiring hypertension identified by targeted screening in university health check-up.

Based on targeted screening for hypertension at a university health check-up, we previously reported a high incidence of white-coat hypertension and estimated prevalence of hypertension requiring medical treatments (HT) as around 0.1% in young population aged less than 30. In spite of such low prevalence, continuous screening for seven consecutive years (2003-2009) increased the number of HT students to 20 (19 males and 1 female). We presently assessed the clinical characteristics of these HTs. Renovascular hypertension was found in the only female HT and aortic valve regurgitation in two HTs. Resting 17 HTs were diagnosed as having essential hypertension (EH). A father and/or a mother had EH in 16 out of 17 EHs, and blood pressure (BP) at home was slightly elevated (135-145 mm Hg in systolic) except three obese EHs (body mass index more than 30) who demonstrated more than 160 mm Hg in systolic. Plasma aldosterone-renin ratio (ARR) of EHs did not differ from that of normal controls, and Pearson correlation coefficient (R) between ARR and systolic BP (SBP) was -0.2. Its partial correlation coefficient, however, was statistically significant (R = -0.55, P = .026) after correcting for body mass index, which was significantly correlated with both SBP (P = .006, after correcting for ARR) and ARR (P = .004, after correcting for SBP). In conclusion, most of young-onset HTs are male EHs, and aortic valve regurgitation should be carefully checked. Excess plasma renin activity would be one of additional characteristics of young-onset EH to male gender, genetic background, and increased body mass.

Thoracic duct visualization: combined use of multidetector-row computed tomography and magnetic resonance imaging.

PURPOSE: The objective of the study was to assess the ability of magnetic resonance imaging (MRI) and helical multidetector-row computed tomography (MDCT) to visualize the thoracic duct in esophageal cancer patients. METHODS: Sixty esophageal cancer patients underwent preoperative MDCT and MRI using 3-dimensional balanced turbo-field-echo sequence. The visualization grades by MDCT, MRI, and a combination of MDCT and MRI were scored in 4 segments of the thoracic duct (cervical, upper, middle, and lower). RESULTS: In the cervical, middle, and lower segments, MRI provided significantly higher visualization grades than MDCT. In all segments, combined MDCT and MRI resulted in higher grades than MDCT alone. In addition, combined MDCT and MRI successfully allowed visualization of the cervical, upper, middle, and lower segments of the thoracic duct in 46 (76.7%), 50 (83.3%), 58 (96.7%), and 60 (100%) patients, respectively. CONCLUSIONS: Combination of MDCT and MRI allows noninvasive thoracic duct visualization, providing 3-dimensional information on other thoracic structures.

Demonstration of the anatomy of the esophageal artery using multidetector-row helical computed tomography.

OBJECTIVE: To assess the ability of multidetector-row helical computed tomography to depict the esophageal artery. METHODS: Patients with esophageal cancer (n = 88) underwent multidetector-row helical computed tomography. Degree of visualization, branching level, angle, and length of the esophageal artery were investigated. RESULTS: In 79 (89.8%) of 88 patients, a total of 146 esophageal arteries were delineated from the origin to the insertion into the esophagus. Of the 146 arteries, 112 (76.7%) originated from the descending aorta and 34 (23.3%) from the right intercostal artery. Of the 112 aorta-originated arteries, 110 (98.2%) originated at a level between T6 and T11 from the left side of the descending aorta to go into the left wall of the esophagus. Of the 34 intercostal-originated arteries, 27 (79.4%) originated from right intercostal arteries between T5 and T7 to go into the esophagus. CONCLUSIONS: Multi-detector-row helical computed tomography depicted the esophageal artery in a high percentage of the patients.

Access to the maxillary sinus using a bone flap with sinus mucosal and mucoperiosteal pedicles.

We describe a procedure for removing lesions in the maxillary sinus using bone flaps with the sinus mucosa and mucoperiosteum. The surgical design is to construct a rectangular trapdoor using 3 consecutive bur-cuts, fracture the upper margin, and lift the bone lid upward. The osteotomy site on the inferior, medial, and lateral sides of the bone lid was exposed subperiosteally, but the mucoperiosteal and sinus mucosal attachments on the superior and central areas of the lid were maintained. Then, following fracture of the upper bone margin, the lid was lifted upward. In this way, the integrity of the mucoperiosteum and sinus mucosa was maintained. Advantages of the bone flap with soft tissue pedicles technique may be quick recovery and restored integrity of the sinus wall, with a low probability of infection because of vascularization of the bone lid. To realize this, a bone flap with both sinus mucosal and mucoperiosteal pedicles is more suitable.

Oral tumor resection and salivary duct relocation with an ultrasonic surgical aspirator.

We describe a procedure of oral tumor resection and salivary duct relocation with an ultrasonic surgical aspirator. After mucosal incision, resection of the underlying musculature was performed using an ultrasonic surgical aspirator. Using the apparatus, the salivary duct was easily exposed without damaging or cutting the duct. After identification of the salivary duct, salivary duct relocation was performed. After resection of the tumor, the artificial dermis was trimmed and sutured to the mucosal edges of the surgical defect. This method is a reliable and simple procedure that can be used to avoid postoperative complications such as salivary fistula or swelling of the gland.

Synthesis and properties of a novel molecular beacon containing a benzene-phosphate backbone at its stem moiety.

This paper describes the synthesis and properties of a novel molecular beacon (MB) containing a benzene-phosphate backbone at its stem moiety. The fluorescence intensity of MBs was found to stabilize by the introduction of the benzene-phosphate backbone at its stem moiety. Furthermore, an MB containing the benzene-phosphate backbone was more resistant to DNase I (endonuclease) than an MB comprising natural DNA and 2'-O-methyl-RNA. These results indicate that the MB with the benzene-phosphate backbone is superior as a molecular beacon as compared to the MB composed of natural DNA and 2'-O-methyl-RNA.

Three minimally invasive procedures for removing lesions in the maxillary sinus.

We describe here 3 minimally invasive procedures for removing lesions from the maxillary sinus using an ultrathin endoscope, microscope, and otoscope.Preoperatively, a lesion in the maxillary sinus was identified by radiographic examination. Then the access hole position and advance direction of the endoscope and forceps were planned. Under local anesthesia, a small incision on the buccal mucosa was made in the planned position. The anterior bony wall of the sinus was exposed subperiosteally, and a small access hole for the insertion of an endoscope was made in the planned position and angled with a fissure bur. After identification of the lesion endoscopically, microscopically, or otoscopically, a forceps was inserted into the sinus cavity through the hole, and the lesion was seized and withdrawn from the sinus.The surgical procedures are suggested to be reliable, easy, and minimally invasive that provide a limited incision and bone removal and respect the integrity of the sinus.

A combination of three minimally invasive surgical procedures for implant placement in the posterior maxilla with insufficient bone quantity.

We describe a combination of 3 surgical procedures for implant placement in the posterior maxilla with insufficient bone quantity and quality. In these situations, we have performed 3 minimally invasive, safe, and reliable surgical procedures: buccal bone graft with bone harvested from the mandibular molar region, submucous vestibuloplasty using artificial dermis, and bone-added osteotome sinus floor elevation under endoscopic control. These modified procedures can be performed in the office setting under outpatient local anesthesia and may minimize patient discomfort and reduce postoperative complications.

Synthesis and properties of a novel molecular beacon containing a benzene-phosphate backbone at a stem moiety.

This paper describes the synthesis and properties of a novel molecular beacon (MB) containing a benzene-phosphate backbone at the stem moieties. Fluorescent intensity of MBs was found to be stabilized by introducing a benzene-phosphate backbone at stem moieties.

[A case of maxillary sinus carcinoma showing long time survival after lung metastasis with administration of S-1 as tumor dormancy therapy].

The patient is a 65-year-old man, who underwent curative resection for maxillary sinus carcinoma after chemoradiation. Lung metastases were observed two months following resection, and were treated with S-1 at a dose of 120 mg/day. One course of the S-1 administration regimen consisted of 2 weeks and a 1-week interval. The patient achieved long survival for 527 days with no adverse reaction. Therefore, this treatment on an outpatient basis greatly contributed to his quality of life. We consider S-1 as a first-line anti-cancer drug for tumor dormancy therapy.

Characterization of the promoter for the alpha3 integrin gene in various tumor cell lines: roles of the Ets- and Sp-family of transcription factors.

The alpha3beta1 integrin is an adhesion receptor for extracellular matrix proteins, including laminin isoforms, and plays crucial roles in the organization of epithelial and endothelial tissues. The aberrant expression of this adhesion molecule on tumor cells is associated with their invasive and metastatic potentials. In the present study, we analyzed the elements essential for alpha3 integrin gene expression in various tumor cell lines with different tissue origins by luciferase assay. An approximately 0.3 kb fragment of the 5'-flanking region of the mouse alpha3 integrin gene (-260/+84, relative to the major transcription start site) showed strong promoter activity in all six examined tumor cell lines. However, we found that these cell lines could be divided into two groups according to the level of dependency on the putative Ets-transcription factor binding motif located at -133. This motif was previously shown to be crucial for alpha3 integrin expression in MKN1 gastric carcinoma cells. The gene expression in one group of cell lines was upregulated mainly by the Ets motif, whereas that in the other group was less dependent on the Ets motif. We then postulated that additional regulatory elements were responsible for the expression of alpha3 integrin, and found that a GC-rich motif at -69 was another important element. An electrophoretic mobility shift assay using specific antibodies and a Western blot analysis of nuclear proteins revealed that the Sp3-transcription factor bound to this GC-rich motif. These results suggest that the Sp3 and Ets transcription factors cooperatively regulate alpha3 integrin gene expression and that the contribution of each element depends on the type of tumor cells.