How Different is the Core of

The structure of a neutron-rich ^{25}F nucleus is investigated by a quasifree (p,2p) knockout reaction at 270A MeV in inverse kinematics. The sum of spectroscopic factors of π0d_{5/2} orbital is found to be 1.0±0.3. However, the spectroscopic factor with residual ^{24}O nucleus being in the ground state is found to be only 0.36±0.13, while those in the excited state is 0.65±0.25. The result shows that the ^{24}O core of ^{25}F nucleus significantly differs from a free ^{24}O nucleus, and the core consists of ∼35% ^{24}O_{g.s.}. and ∼65% excited ^{24}O. The result may infer that the addition of the 0d_{5/2} proton considerably changes neutron structure in ^{25}F from that in ^{24}O, which could be a possible mechanism responsible for the oxygen dripline anomaly.

Early results of a randomized two-by-two factorial phase II trial comparing neoadjuvant chemotherapy with two and four courses of cisplatin/S-1 and docetaxel/cisplatin/S-1 as neoadjuvant chemotherapy for locally advanced gastric cancer.

BACKGROUND: Neoadjuvant chemotherapy (NAC) is a promising method of improving the survival of resectable gastric cancer. Cisplatin/S-1 (CS) and docetaxel/cisplatin/S-1 (DCS) are both effective against metastatic gastric cancer. This report clarified the impact of these regimens on early endpoints, including the pathological responses, chemotherapy-related toxicities, and surgical results. METHODS: Patients with M0 and either T4 or T3 in case of junctional cancer or scirrhous type received two or four courses of cisplatin (60 mg/m2 at day 8)/S-1 (80 mg/m2 for 21 days with 1 week rest) or docetaxel (40 mg/m2 at day 1)/cisplatin (60 mg/m2 at day 1)/S-1 (80 mg/m2 for 14 days with 2 weeks rest) as NAC. Patients then underwent D2 gastrectomy and adjuvant S-1 chemotherapy for 1 year. The primary endpoint was the 3-year overall survival. RESULTS: Between October 2011 and September 2014, 132 patients were assigned to receive CS (n = 66; 33 in 2 courses and 33 in 4 courses) or DCS (n = 66; 33 in 2 courses and 33 in 4 courses). The respective major grade 3 or 4 hematological toxicities (CS/DCS) were leukocytopenia (14.1%/26.2%), neutropenia (29.7%/47.7%), anemia (14.1%/12.3%), and platelet reduction (3.1%/1.5%). The rate of pathological response, defined as a complete response or < 10% residual cancer remaining, was 19.4% in the CS group and 15.4% in the DCS group, and 15.6% in the two-course group and 19.0% in the 4-course group. The R0 resection rate was 72.7% in the CS group and 81.8% in the DCS group and 80.3% in the two-course group and the 74.2% in the four-course group. No treatment-related deaths were observed. CONCLUSIONS: Our results do not support three-drug therapy with a taxane over two-drug therapy, or any further treatment beyond two cycles as an attractive candidate for the test arm of NAC.

Effect of short-term maximal voluntary co-contraction training on neuromuscular function.

The present study aimed to examine the effect of short-term training utilizing voluntary co-contraction with maximal efforts. 23 healthy young men (training group: TG, n = 13; control group: CG, n = 10) participated in this study. TG conducted a 4-week training program (3 days/week), which consisted of 4 s simultaneous maximal voluntary contractions of elbow flexors and extensors at 90° of the elbow joint, followed by 4 s muscle relaxation (10 repetitions/set, 5 sets/day). Before and after the intervention, maximal voluntary isometric and isokinetic torques and the muscle thicknesses of the elbow flexors and extensors were determined. The electromyograms (EMGs) of the 2 muscle groups during isometric maximal voluntary contraction (MVC) were also recorded. After the intervention, CG did not show any significant changes in all measured variables. In TG, significant increases were found in the agonist EMG activities during MVC, and maximal isometric and isokinetic torques of the elbow flexors and extensors, without significant changes in the muscle thicknesses and involuntary coactivation levels during MVC. The current results indicate that the training mode with maximal voluntary co-contraction is effective for improving the force-generating capabilities of the exercising muscles, without any increases in the level of involuntary coactivation during MVC.

Discussion based on analysis of the suicide rate and the average disposable income per household in Japan.

OBJECTIVE: Suicide is one of the major social issues in Japan. According to a report of the National Policy Agency, there were approximately 22 000 to 24 000 annual suicides between 1994 and 1997 and there have been over 30 000 annual suicides in Japan since 1998. For these reasons, we think it is important to discuss the economic factor related to suicides in recent years. METHOD: In this study, we examined suicide rates and the average disposable income per household in Japan in the last 15 years (ie 1994-2008) and discuss the statistical analysis of the average disposable income per household and the associated suicide rates. RESULTS AND DISCUSSION: During the research period, annual suicide rates per 100 000 population in Japan ranged from 16.9 to 25.5 among the total population, from 23.1 to 38.0 among men, and from 10.9 to 14.7 among women. The annual average disposable income per household (ten thousand yen) ranged from 424.0 to 549.9. The average disposable income per household was related to the suicide rate among the total population and among men. The average disposable income per household was not related to the suicide rate among women. CONCLUSION: We believe that this discussion will be useful in developing specific suicide preventive measures.

The relationship between suicide and five climate issues in a large-scale and long-term study in Japan.

OBJECTIVE: Suicide rates in Japan were high in 1998 and have remained high since then. Many researchers have discussed the current state of suicide in Japan and the world; however, there are various opinions about the relationship between suicide and climate. SUBJECTS AND METHOD: In the present study, we report on long-term data of suicide and examine five climatic issues in Japan as a whole and in 10 selected prefectures: the five with the highest suicide rates in 2006 (Akita, Iwate, Shimane, Yamagata and Miyazaki Prefectures) and the five with the lowest (Nara, Tokushima, Okayama, Kanagawa and Kyoto Prefectures). RESULTS: Annual age-adjusted suicide rates were found to have a significant inverse correlation with annual mean air temperature in the five prefectures with the highest suicide rates and in the three prefectures with the lowest suicide rates among women. Annual age-adjusted suicide rates were significantly correlated with annual mean relative humidity in the three prefectures with the highest suicide rates among women and with the annual total sunshine duration in the three prefectures with the highest suicide rates among women. CONCLUSION: It is important that these associations between suicide and climatic factors be discussed further from various viewpoints, including those of many researchers and relevant organizations.

Effect of individual fat areas on early surgical outcomes after open gastrectomy for gastric cancer.

BACKGROUND: Obesity is generally considered a risk factor for postoperative morbidity following open gastrectomy. Body mass index (BMI) is widely accepted as an indicator of obesity, but does not necessarily reflect the distribution of fat. It is unclear how different types of fat may affect the operative procedure and outcome. METHODS: The relationship between fat area (total, visceral and subcutaneous fat, and BMI) and early surgical outcomes (bleeding, operating time, morbidity, hospital death and hospital stay) was investigated in 135 patients who had a curative gastrectomy at the Cancer Institute Hospital, Tokyo, in 2006. RESULTS: Postoperative intra-abdominal infection, which occurred in 13 patients (9.6 per cent), correlated strongly with visceral (P = 0.023) and total (P = 0.037) fat area. Visceral fat area also correlated with hospital death (P = 0.041) and a longer hospital stay (P = 0.001). Subcutaneous fat area and BMI did not correlate with these early surgical outcomes. CONCLUSION: Patients with a high visceral fat area are more likely to develop an intra-abdominal infection after gastrectomy. Assessment of fat area, in particular visceral fat area, should alert surgeons to increased postoperative risks.

Stroke power consistency and 2000 m rowing performance in varsity rowers.

We studied the relationship between stroke power consistency and 2000 m rowing time besides determining maximal oxygen uptake (VO(2max)) and leg extension power. The subjects (n=16, male varsity rowers) carried out an incremental test to volitional exhaustion on a rowing ergometer, and the VO(2) at each stage was determined. The stroke power consistency was assessed by the coefficient of variation of power (CVP(high)) at the highest workload at which each subject could maintain power. Besides the incremental test, 2000 m all-out rowing was performed on the ergometer and leg extension power was measured. Stepwise multiple regression analysis indicated that the 2000 m rowing time could be predicted by VO(2max), leg extension power and CVP(high) in order of strength of standardized partial correlation coefficients as explanatory variables. The CVP(high) correlated with the residual of the regression between 2000 m rowing time and VO(2max). The findings suggest that the stroke power consistency contributes to maintenance of the power during ergometer rowing.

Laparoscopic and endoscopic cooperative surgery for gastrointestinal stromal tumor dissection.

BACKGROUND: Laparoscopic wedge resections are increasingly applied for gastric submucosal tumors such as gastrointestinal stromal tumor (GIST). Despite this, no defined strategy exists to guide the surgeon in choosing the appropriate laparoscopic technique for an individual case on the basis of tumor characteristics such as location or size. This study aimed to introduce a laparoscopic and endoscopic cooperative surgery (LECS) for gastric wedge resection that is applicable for submucosal tumor resection independent of tumor location and size. METHODS: Seven patients underwent LECS for the resection of gastric submucosal tumors. Both mucosal and submucosal layers around the tumor were circumferentially dissected using endoscopic submucosal dissection via intraluminal endoscopy. Subsequently, the seromusclar layer was laparoscopically dissected on the exact three-fourths cut line around the tumor. The submucosal tumor then was exteriorized to the abdominal cavity and dissected with a standard endoscopic stapling device. RESULTS: In all cases, the LECS procedure was successful for dissecting out the gastric submucosal tumor. In four of seven cases, the tumor was located in the upper gastric portion near the esophagogastric junction. The remaining three tumors were in the posterior gastric wall. In two cases, the tumors were more than 5 cm in diameter, and one was a GIST of the remnant stomach. The mean operation time was 169 +/- 17 min, and the estimated blood loss was 7 +/- 2 ml. The postoperative course was uneventful in all cases. CONCLUSIONS: The LECS procedure for dissection of gastric submucosal tumors such as GIST may be performed safely with reasonable operation times, less bleeding, and adequate cut lines. In addition, the success of the procedure does not depend on the tumor location such as the vicinity of the esophagogastric junction or pyloric ring.

Can immune-enhancing nutrients reduce postoperative complications in patients undergoing esophageal surgery?

Postoperative infection of esophageal neoplasm surgery is the major cause of prolonged postoperative hospitalization, as well as morbidity. The clinical benefits of administering immune-enhancing nutrients (IEN) to critically ill patients and those undergoing elective surgery were clarified. However, the benefits of preoperative administration of IEN for patients with esophageal cancer remain unclear. The present study was designed to clarify the clinical efficacy of administration of IEN prior to esophageal surgery. A total of 123 patients undergoing esophagectomy in single institute were retrospectively investigated. All patients received postoperative enteral nutrition by use of ordinal nutrients. Preoperative IEN were also given to 84 patients (IEN group), while the other 39 received an ordinary diet (control). Postoperative courses and laboratory data were compared between the two groups. The incidences of infectious complications in the IEN and control groups were 18% and 38%, respectively (P < 0.05). Pneumonia developed in 5 (6%) IEN and 7 (18%) control patients (P < 0.05). Postoperative hospitalization was shorter in the IEN group (P < 0.01). Prealbumin levels, retinal binding protein levels and the lymphocyte count were significantly higher in the IEN group on postoperative day 3. These results suggest that preoperative administration of IEN in patients undergoing esophagectomy reduces infectious complications, mainly pneumonia, and shortens postoperative hospitalization.

Celiac lymph nodes: distant or regional for thoracic esophageal carcinoma?

Involvement of celiac nodes is defined as distant metastasis in the TNM classification for thoracic esophageal carcinoma. Some textbooks, however, describe dissection of these nodes as a standard technique. The present study was, therefore, undertaken to clarify which celiac nodes are regional for thoracic esophageal carcinoma and whether or not celiac node dissection would provide a survival benefit. Eight hundred and five patients who underwent R0 resection (no residual tumor) with systematic lymphadenectomy including the celiac axis area for thoracic esophageal carcinoma were retrospectively investigated. The frequency of metastasis and the therapeutic value of dissecting celiac nodes were compared to those associated with the left gastric artery area. The frequencies of left gastric and celiac nodal involvement were 15.4% and 9.6%, respectively, for thoracic esophageal carcinoma. As for tumor location, the incidences of metastasis around left gastric artery and celiac axis from the upper, middle and lower portion were 6.7% and 1.0%; 12.3% and 7.7%; and 25.7% and 17.4%, respectively. The 5-year survivals of patients with celiac but not left gastric metastasis were 36.3% and 41.8% for the middle and lower portions, respectively, while the corresponding values with left gastric involvement but no celiac metastasis were 24.1% and 27.9%. These differences were not significant. The frequency of celiac node involvement was not low. And, their dissection has equivalent therapeutic value to that of left gastric nodes. Revision of the TNM classification to account for celiac node involvement in thoracic esophageal carcinoma, especially of the middle and lower portions, is needed.

Suicide in Mie Prefecture, Japan, since 1990.

The number of suicides in Japan has increased to over 30,000 per year since 1998. Similarly, the number of suicides has been increasing in Mie Prefecture. In the present study, we examined the incidence and the circumstances of all suicidal cases that were reported to the Mie Prefectural Police Headquarters during the thirteen-year period 1990-2002. In Mie Prefecture, the number of suicides per year averaged 363.1. The largest numbers occurred in the spring and early summer months. For men, suicides were most common in the 50-59-year age group; for women, they were most common in the 70-79-year age group. As for the methods of suicide, hanging was the most frequent for both genders. The major causative factors of suicide were described as "suffering from physical illness", "psychiatric disorders" and "economic difficulties". Of these, "psychiatric disorders" was the most important causative factor for the younger groups of both genders. For the middle-aged group of men, the most important causative factor was "economic difficulties". "Suffering from physical illness" was the most serious causative factor for the elderly group of both genders. In order to prevent suicide, urgent strategies for effective medical treatment and social cooperation are required.