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We explored how body movements influence illusory body motion intensity and their association with motion sickness. Twelve individuals who were seated in the back of a passenger car, performed a visual task and were subjected to continuous rotations followed by driving in a straight line. The body movements during and immediately after rotation were categorized as follows: (A) upright posture; (B) leaning the body in the yaw direction towards the rotation center, returning the yaw angle to zero upon transitioning to straight line travel, and tilting in the roll condition and gradually returning to upright; and (C) tilting in roll conditions towards the centripetal direction during rotation and becoming upright upon transitioning to straight line travel. In experiment-1, after spanning half a lap, participants reported the intensity of the illusory motion experienced during straight line travel immediately after rotation. In experiment-2, after travelling up to eight laps, the participants reported the symptom level of motion sickness experienced during two straight sections per lap using the MIsery SCale (MISC). Experiment-1 revealed that condition (C) had significantly larger illusions than Conditions (A) and (B). Experiment-2 revealed that motion sickness progressed significantly more in Condition (C) than in Condition (A). A significant positive correlation was found between the observed MISC and the illusion strength. Our findings suggest that body movements during and immediately after continuous rotation have a significant impact on the illusion strength. Additionally, illusory motion could serve as an indicator of impending motion sickness.
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Ilusões , Percepção de Movimento , Enjoo devido ao Movimento , Humanos , Enjoo devido ao Movimento/fisiopatologia , Masculino , Feminino , Rotação , Adulto , Ilusões/fisiologia , Adulto Jovem , Percepção de Movimento/fisiologia , Movimento/fisiologia , Condução de Veículo , Postura/fisiologiaRESUMO
Automated vehicles could increase the risk of motion sickness because occupants are not involved in driving and do not watch the road. This paper aimed to investigate the influence of motion predictability on motion sickness in automated vehicles, as better motion anticipation is believed to mitigate motion sickness. In a simulator-based study, twenty participants experienced two driving conditions differing only in turn directions. The repetitive condition featured a repeating turn direction pattern. The non-repetitive condition contained pseudo-randomly ordered turn directions. To mimic an 'eyes-off-the-road' setting and prevent visual motion anticipation, road visuals were omitted. No significant differences in sickness or head motion, a metric for motion anticipation, were found between the conditions. No participant recognised the repeating turn pattern. This suggests no increased motion anticipation in the repetitive condition, possibly due to a reduced ability to recognise a repeating motion pattern in one degree of freedom within more complex motion.
Motion anticipation is believed to mitigate motion sickness. However, in this simulator-based study on automated vehicles, no significant differences in motion anticipation or sickness were observed between repetitive and non-repetitive turn directions. Recognition of a repeating motion pattern in one degree of freedom might be diminished when it is part of more complex motion.
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The patient was a 54-year-old male at the time of initial examination. He was aware of numbness and weakness in the left hemisphere of his body and came to see the hospital. He was diagnosed with brain metastasis of lung cancer and started treatment(cT2N0M1[Brain]). He underwent gamma knife for the head lesion and nivolumab for the lung lesion. The patient's lesions shrank with the success of the medical treatment, but recurred with small intestinal metastasis. He underwent a partial resection of the small intestine and was treated again with nivolumab, which resulted in a complete response. He is currently alive without recurrence. We have experienced a very rare case of recurrence-free survival after treatment for brain metastasis and small intestinal metastasis of lung cancer.
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Neoplasias Encefálicas , Neoplasias Intestinais , Neoplasias Pulmonares , Humanos , Masculino , Neoplasias Pulmonares/secundário , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/terapia , Pessoa de Meia-Idade , Neoplasias Encefálicas/secundário , Neoplasias Encefálicas/terapia , Neoplasias Intestinais/cirurgia , Neoplasias Intestinais/patologia , Neoplasias Intestinais/secundário , Neoplasias Intestinais/terapia , Terapia Combinada , Fatores de Tempo , Recidiva , Radiocirurgia , Nivolumabe/uso terapêutico , Intestino Delgado/patologia , Antineoplásicos Imunológicos/uso terapêuticoRESUMO
A 78-year-old male patient was referred to another hospital for cecal cancer and metastatic liver tumor. After open ileocecal resection, he was referred to our hospital for treatment of liver lesions. CT scan showed a lesion with contrast effect of approximately 60 mm in S8, and the patient was judged to be resectable by right lobe resection. However, considering his age and the possibility of latent disease, it was decided to introduce preoperative chemotherapy. After 4 courses of XELOX, although the ICG worsened from 9% to 18% after chemotherapy, the tumor was reduced to approximately 30 mm. The patient underwent an open anterior segment resection of the liver. Colorectal cancer guidelines recommend that surgical resection is the first-line treatment for resectable liver metastases and that preoperative adjuvant chemotherapy should not be given to patients. In this report, we describe a case in which a liver metastasis was safely resected with chemotherapy.
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Neoplasias do Ceco , Neoplasias Hepáticas , Masculino , Humanos , Idoso , Neoplasias do Ceco/tratamento farmacológico , Neoplasias do Ceco/cirurgia , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Quimioterapia Adjuvante , Hepatectomia , Neoplasias Hepáticas/tratamento farmacológico , Neoplasias Hepáticas/cirurgia , Neoplasias Hepáticas/secundárioRESUMO
There is a liver damage in a serious side effect of regorafenib. Case 1 was a 54-year-old woman, and she had an operation of rectal cancer and metastasized to multiple organs afterwards and started regorafenib as third-line. Erythema exudativum multiform developed on the 8th day after a start and regorafenib was canceled once and reduced on the 21st day when a skin symptom was relieved and restarted. However, because a significant rise of AST, ALT, T -Bil was recognized afterwards, regorafenib was canceled on the 27th day and enforced steroid pulse therapy and was relieved afterwards. Case 2 was a 61-year-old woman, and she had an operation of ascending colon cancer, ovarian metastasis and peritoneum dissemination. Regorafenib was started by frequent occurrence lung metastasis, cancerous pleurisy afterwards as fifth-line. Dissemination erythema developed on the 16th day and a liver damage developed on the 22nd day. Because a rise of AST, ALT went and was prolonged, liver biopsy was enforced in a cause close inspection purpose on the 45th day. A medicamentosus liver damage was diagnosed. The liver enzyme decreased afterwards. It may be easy to make the liver damage by regorafenib serious, and attention is necessary.
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Neoplasias do Colo , Neoplasias Ovarianas , Piridinas , Feminino , Humanos , Pessoa de Meia-Idade , Neoplasias do Colo/patologia , Compostos de Fenilureia/efeitos adversos , Neoplasias Ovarianas/tratamento farmacológico , Eritema/induzido quimicamente , Fígado/patologiaRESUMO
Chalcopyrite CuInSe2 (CISe)-based thin-film photovoltaic solar cells have been attracting attention since the 1970s. The technologies of CISe-based thin-film growth and device fabrication processes have already been put into practical applications and today commercial products are available. Nevertheless, there are numerous poorly understood areas in the physical and chemical aspects of the underlying materials science and interfacial and bulk defect physics in CISe-based thin-films and devices for further developments. In this paper, current issues in physical and chemical studies of CISe-based materials and devices are reviewed. Correlations between Cu-deficient phases and the effects of alkali-metals, applications to lightweight and flexible solar minimodules, single-crystalline epitaxial Cu(In,Ga)Se2 films and devices, differences between Cu(In,Ga)Se2 and Ag(In,Ga)Se2 materials, wide-gap CuGaSe2 films and devices, all-dry processed CISe-based solar cells with high photovoltaic efficiencies, and also fundamental studies on open circuit voltage loss analysis and the energy band structure at the interface are among the main areas of discussion in this review.
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OBJECTIVES: To assess the efficacy of experimental cleaners containing 10-methacryloyloxydecyl dihydrogen phosphate (MDP) on the saliva decontamination of ceramic and their influence in restoring zirconia's adherence to resin cement. MATERIALS AND METHODS: Four hundred sixty alumina-blasted zirconia specimens were categorized into saliva-contaminated and uncontaminated groups which were treated with ceramic primer (P), experimental cleaner 1 (C1), C1 followed by P (C1P), experimental cleaner 2 (C2), and C2 followed by P (C2P). Stainless-steel rods were then attached to the specimens using PanaviaV5 cement (Kuraray Noritake Dental; Tokyo, Japan). Tensile bond strength (TBS) test was performed after 24 h and 5000 thermocycling processes. X-ray photoelectron spectroscopy (XPS) analysis and contact angle measurement of the specimen were performed. The TBS data were analyzed by Weibull analysis and three-way ANOVA. Contact angle data were analyzed by two-way ANOVA (α = 0.05). RESULTS: C2P groups showed the highest TBS in all conditions among tested groups. Saliva contamination led to a significant reduction of TBS in primer- and cleaner-treated groups, with no significant impact on C2P. Adhesive failure was predominant in contaminated groups except with the C1P and C2P groups. XPS revealed that a nitrogen peak was observed on contaminated groups but not in primed groups. The contact angle was significantly affected by saliva contamination, the cleaners, and/or ceramic primer usage (p < 0.001). CONCLUSIONS: The MDP cleaner followed by the MDP primer protocol may overcome the effect of saliva contamination and improve the resin-ceramic bond strength. CLINICAL RELEVANCE: It is recommended to use a combination of MDP-containing cleaner 2 and ceramic primer as a chair-side chemical pretreatment for zirconia substrate with or without saliva contamination.
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Colagem Dentária , Cerâmica , Análise do Estresse Dentário , Teste de Materiais , Metacrilatos , Cimentos de Resina , Saliva , Resistência ao Cisalhamento , Propriedades de Superfície , ZircônioRESUMO
We report a rare case of metastatic small intestine cancer originating from penile cancer triggered by intestinal obstruction, with some review of the literature. The case was a 78-year-old man at the first visit. Partial penile resection was performed for penile cancer. Histopathological findings were squamous cell carcinoma, and the surgical margin was negative. The stage at the time of the first surgery was T2N0M0, Stage â ¡. He came to the hospital with a complaint of abdominal pain 4 years after the operation. He was diagnosed with intestinal obstruction and was treated medically. He underwent medical treatment for 12 days, but did not improve, so he underwent laparoscopic ileus release. Surgical findings showed a neoplastic lesion in the abdominal cavity, and the site was obstructed, and partial resection of the small intestine including the neoplastic lesion was performed. Pathological examination revealed small intestinal metastasis of penile cancer. Postoperative intestinal obstruction improved and he was discharged without complications. After discharge, he underwent systemic chemotherapy at an outpatient clinic, but died of the primary disease 181 days after intestinal obstruction.
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Íleus , Obstrução Intestinal , Laparoscopia , Neoplasias Penianas , Idoso , Humanos , Íleus/etiologia , Íleus/cirurgia , Obstrução Intestinal/etiologia , Obstrução Intestinal/cirurgia , Intestino Delgado/patologia , Intestino Delgado/cirurgia , Laparoscopia/efeitos adversos , Masculino , Neoplasias Penianas/complicações , Neoplasias Penianas/patologia , Neoplasias Penianas/cirurgiaRESUMO
BACKGROUND: Complete mesocolic excision (CME) has been demonstrated to be a useful surgical procedure for advanced colon cancer. We previously reported on laparoscopic (Lap) CME with true central vascular ligation (CVL) for advanced right-sided colon cancer. Lap CME with true CVL is highly plausible from the perspective of surgical oncology. However, true CVL of the middle colic artery (MCA) may require extensive resection of the transverse colon. The Japanese Classification of Colorectal Cancer defines D3 as main lymph node dissection around the superior mesenteric artery (SMA), and true CVL is not listed as a required condition. Our institution has been performing a Lap procedure (Lap D3/modified CME) that consists of the dissection of main lymph nodes around the root of the MCA (#223LNs) while preserving the left branch of the MCA. Two videos of a Lap D3/modified CME are presented, and the short-term outcome is reported. METHODS: Lap D3/modified CME was defined as Lap ligation surgery at the root of the right branch of the MCA that preserves the MCA with #223LNs on the resection side. The present study retrospectively examined 11 cases of Lap D3/modified CME performed at the Tokyo Medical University Hospital between 2015 and 2020. When the SMA is difficult to visualize in Type V/A cases, the SMV is pulled using some silicone string, and the surrounding lymph nodes are dissected while visualizing the SMA. RESULTS: The median operating time was 289 min, and the median blood loss was 57 ml. The median total number of dissected lymph nodes was 38, and the median number of dissected #223LNs was three. No metastasis was found in the dissected #223LNs. CONCLUSION: Although this surgery can be performed safely, we believe that this surgery needs to be performed for suitable cases by a highly experienced and skilled surgical team.
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Colectomia/métodos , Neoplasias do Colo/cirurgia , Laparoscopia/métodos , Excisão de Linfonodo/métodos , Artérias Mesentéricas/cirurgia , Colo Transverso/irrigação sanguínea , Colo Transverso/cirurgia , Neoplasias do Colo/patologia , Humanos , Ligadura , Linfonodos/patologia , Linfonodos/cirurgia , Mesocolo/cirurgia , Duração da Cirurgia , Estudos RetrospectivosRESUMO
Teeth clenching during exercise is important for sports performance and health. Recently, several mouth guard (MG)-type wearable devices for exercise were studied because they do not disrupt the exercise. In this study, we developed a wearable MG device with force sensors on both sides of the maxillary first molars to monitor teeth clenching. The force sensor output increased linearly up to 70 N. In four simple occlusion tests, the trends exhibited by the outputs of the MG sensor were consistent with those of an electromyogram (EMG), and the MG device featured sufficient temporal resolution to measure the timing of teeth clenching. When the jaw moved, the MG sensor outputs depended on the sensor position. The MG sensor output from the teeth-grinding test agreed with the video-motion analysis results. It was comparatively difficult to use the EMG because it contained a significant noise level. Finally, the usefulness of the MG sensor was confirmed through an exercise tolerance test. This study indicated that the developed wearable MG device is useful for monitoring clenching timing and duration, and the degree of clenching during exercise, which can contribute to explaining the relationship between teeth clenching and sports performance.
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Bruxismo , Protetores Bucais , Dispositivos Eletrônicos Vestíveis , Força de Mordida , Eletromiografia , Humanos , Contração MuscularRESUMO
79-year-old man underwent laparoscopic distal gastrectomy with early gastric cancer 0-â ¡c lesion on the greater curvature side of the lower body of the gastric body on gastric cancer screening. On the 10th day after the operation, abdominal pain and fever were observed, and CT revealed suture failure and intra-abdominal abscess. Partial gastrectomy and Roux- en-Y reconstruction were performed in emergency surgery, but duodenal stump suture failure was observed on the third day of reoperation. For duodenal stump suture failure, a catheter was placed in the duodenum by applying PTCD technology, and drainage of the bile duct and duodenal contents was performed, and conservative healing was successful. Duodenal stump suture failure after Roux-en-Y reconstruction is intractable and can sometimes result in death with severe infection and intra-abdominal hemorrhage. Here, we report a case in which duodenal stump suture failure was completely cured by percutaneous transhepatic duodenal drainage, with some literary consideration.
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Gastrectomia , Neoplasias Gástricas , Anastomose em-Y de Roux , Drenagem , Duodeno/cirurgia , Humanos , Masculino , Neoplasias Gástricas/cirurgia , SuturasRESUMO
A bent crystal Laue analyser (BCLA) is an X-ray energy analyser used for fluorescence X-ray absorption fine-structure (XAFS) spectroscopy to separate the fluorescence X-ray emission line of a target atom from the elastic scattering X-rays and other fluorescence emission lines. Here, the feasibility of the BCLA for total reflection fluorescence XAFS (TRF-XAFS), which has a long X-ray footprint on the substrate surface owing to grazing incidence, was tested. The focal line of the BCLA was adjusted on the X-ray footprint and the XAFS signal for one monolayer of Pt deposited on a 60â nm Au film with high sensitivity was obtained. Although range-extended XAFS was expected by the rejection of Au fluorescence arising from the Au substrate, a small glitch was found in the Au L3 edge because of the sudden change of the complex refraction index of the Au substrate at the Au edge. This abnormal spectrum feature can be removed by reflectivity correction using Au foil absorption data. BCLA combined with TRF-XAFS spectroscopy (BCLA + TRF-XAFS) is a new technique for the in situ surface analysis of highly dispersed systems even in the presence of a liquid overlayer.
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BACKGROUND: A large number of patients suffer recurrence after curative resection, and mortality from colon cancer remains high. The role of systemic inflammatory response, as reflected by neutrophil-to-lymphocyte ratio (NLR), in cancer recurrence and death has been increasingly recognized. This study aimed to analyze long-term oncologic outcomes of Stage II-III colon cancer to examine the prognostic value of NLR using a propensity score analysis. METHODS: A total of 375 patients with colon cancer underwent radical surgery between 2000 and 2014 at Tokyo Medical University Hospital. Long-term oncologic outcomes of these patients were evaluated according to NLR values. A cut-off NLR of 3.0 was used based on receiver operating characteristic curve analysis. Primary outcomes were overall survival (OS) and relapse-free survival (RFS). An analysis of outcomes according to tumor sidedness was also performed. RESULTS: Patients with lower NLR values ("lower NLR group") were more likely to have lymph node metastasis compared to those with higher NLR values ("higher NLR group") before case matching. After case matching, clinical outcomes were similar between the two groups. There were no significant differences in 5-year OS and 5-year RFS rates between the two groups before case matching based on propensity scores. After case matching, 5-year OS rates were 94.5% in the lower NLR group (n = 135) and 87.0% in the higher NLR group (n = 135), showing a significant difference (p = 0.042). Five-year RFS rates were 87.8% in the lower NLR group and 77.9% in the higher NLR group, also showing a significant difference (p = 0.032). Among patients with left-sided colon cancer in the matched cohort, 5-year OS and 5-year RFS rates were 95.2 and 87.3% in the lower NLR group (n = 88), respectively, and 86.4 and 79.2% in the higher NLR group (n = 71), respectively, showing significant differences (p = 0.014 and p = 0.047, respectively). CONCLUSIONS: The NLR is an important prognostic factor for advanced colon cancer, especially for left-sided colon cancer.
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Neoplasias do Colo/sangue , Linfócitos/metabolismo , Neutrófilos/metabolismo , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Pontuação de PropensãoRESUMO
BACKGROUND: Complete mesocolic excision (CME) is known to be effective for colon cancer. However, in right-sided colon cancer, central vascular ligation (CVL) is not easy to perform. In particular, in patients in whom the superior mesenteric vein (SMV) runs on the ventral side of the superior mesenteric artery (SMA) (Type V/A), laparoscopic ligation of the artery at its root is extremely difficult compared with this procedure in patients in whom the SMA runs on the ventral side of the SMV (Type A/V). METHODS: We started performing laparoscopic CME with true CVL for right-sided colon cancer using the SMA as a landmark in 2015, and by 2019, we had completed it for 60 patients. To start, the mesocolon is opened well to the caudal side of the ileocolic vessels. The mesentery is then fully detached from the retroperitoneal tissue, after which the ileocolic vessels are ligated at their roots. D3 lymph node dissection of the lymph nodes around the SMA and SMV on the resection side is also performed using the SMA as a landmark, and depending on the location of the tumor, the roots of the right and middle colic vessels are ligated and divided. This study was conducted with the approval of the Tokyo Medical University Ethics Committee. All patients provided informed consent. RESULTS: The tumor was located in the cecum in 21 cases, the ascending colon in 33, and the transverse colon in 6. The mean operating time was 229 min and the mean volume of hemorrhage was 67 ml. There was one Clavien-Dindo Grade 3 or worse postoperative complication (ileus). There were no surgery-related or in-hospital deaths. CONCLUSION: This procedure can be performed comparatively safely. However, since it requires some skill, we consider that it should only be performed in suitable cases by teams with sufficient experience.
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Neoplasias do Colo/cirurgia , Laparoscopia , Ligadura , Mesocolo/cirurgia , Idoso , Feminino , Humanos , Laparoscopia/efeitos adversos , Linfonodos/patologia , Masculino , Veias Mesentéricas/cirurgia , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologiaRESUMO
A 56-year-old man presented to our hospital with melena, and was diagnosed as having locally advanced sigmoid colon cancer invading the trigone of the bladder(cT4bN0M0). mFOLFOX6 plus panitumumab was administered as a preoperative chemotherapy. After 6 courses of administration, the main tumor shrunk but the bladder invasion remained. We explained to the patient that resection of the bladder was necessary for radical treatment of the tumor. As he refused a urostomy for urinary reconstruction, we chose ileal neobladder reconstruction and performed lower anterior resection plus total cystectomy, which resulted in pathologically curative resection. No recurrence and almost no urinary incontinence occurred during the 8 months after the operation. Although further follow-up is required, our present case indicates that ileal neobladder may be a useful reconstruction option for patients with locally advanced colorectal cancer who undergo total cystectomy.
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Neoplasias Colorretais , Neoplasias da Bexiga Urinária , Derivação Urinária , Cistectomia , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Neoplasias da Bexiga Urinária/tratamento farmacológico , Neoplasias da Bexiga Urinária/cirurgiaRESUMO
In September 2015, a 90-year-old woman presented with abdominal pain and emesis as the chief complaints. Except for WBC counts of 10,420/mL, CRP levels of 5.69mg/dL, and ALP levels of 359 IU/L, no other abnormal values were noted, and CEA and CA19-9 tumor marker levels were normal at 3.9 ng/mL and 5.7 U/mL, respectively. Abdominal CT showed intussusception of the right colon and a solid tumor at the presenting portion. Surgery for suspected intussusception caused by colon cancer was performed. Surgical findings revealed a protruding lesion at the ascending colon that extended to the transverse colon, and the intussusception was intrusive up to the ascending colon at the end of the intestinal ileum. Thus, resection of the right half colon and dissection of lymph nodes were performed. Resected specimens revealed a type 1 tumor measuring 65×50×30mm in diameter at the ascending colon. Histopathologic findings revealed tub1>tub2, SS, ly0, v0, PM0, DM0, N0 (0/27)Stage â ¡a tumor. The postoperative course was favorable, and the patient was discharged on postoperative day 12. We report about a rare case of intussusception caused by ascending colon cancer.
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Colo Transverso , Neoplasias do Colo , Intussuscepção , Idoso de 80 Anos ou mais , Colo Ascendente , Neoplasias do Colo/complicações , Feminino , Humanos , Íleo , Intussuscepção/etiologiaRESUMO
A 49-year-old man was preoperatively diagnosed with rectosigmoid carcinoma, c-T4a, N3, M1b, Stage â £b. On CT, lymph node swelling outside that area, including lesser-curvature lymph nodes(LNS), and liver metastases were seen. Laparoscopic high anterior resection was performed with the aim of local control. Additionally, D3 dissection and LNS sampling were performed. The tumor had invaded the bladder wall, and removed LNS were positive for metastasis. The final diagnosis was f-T4b, N3, M1b, Stage â £b. One month after surgery, a CV port was implanted, and chemotherapy was initiated for unresectable cancer. The regimen was capecitabine and oxaliplatin(CAPOX)plus bevacizumab(BEV). After 5 courses, the patient was hospitalized for a CV thrombus that had occurred, and his chemotherapy was withdrawn for approximately 1 month while he was receiving antithrombotic therapy. After discharge, BEV was discontinued, and he received CAPOX alone. Bleeding from a pituitary adenoma was seen after a total of 19 courses. He was hospitalized for 2 months for the treatment, including surgery. A clinical complete response was determined based on CT and PET-CT performed after chemotherapy had been withdrawn for approximately 3 months. For approximately 1 year since the chemotherapy was discontinued, progression-free survival has been maintained.
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Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Neoplasias Retais , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Capecitabina/uso terapêutico , Humanos , Linfonodos , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Neoplasias Retais/tratamento farmacológico , Neoplasias Retais/cirurgiaRESUMO
BACKGROUND: The standard treatment in Japan for advanced lower rectal cancer is total mesorectal excision(TME)plus lateral lymph node dissection(LLND). However, the standard treatment in Western countries is preoperative treatment plus TME. There have been some discussions on preoperative chemotherapy and chemoradiation therapy. This study was aimed at identifying the prognostic factors of recurrence after curative surgery for advanced lower rectal cancer. METHODS: A total of 54 patients with advanced lower rectal cancer who had undergone curative operation at our department from 2010 to 2015 were retrospectively analyzed, excluding patients with both LLND and preoperative therapy. The primary endpoint of this study was the 5-year recurrence-free survival(5RFS). RESULTS: The overall 5RFS was 57.6%. The univariate analysis demonstrated that lymph node metastasis(p=0.038)and radial margin(RM, p=0.015)were significant risk factors, with a 5RFS of 39.7% and 0%, respectively. The multivariate analysis revealed that only RM significantly affected 5RFS(p= 0.009). CONCLUSION: Our results suggest that securing an adequate circumferential resection margin together with proper surgical technique and preoperative therapy are important for decreasing postoperative recurrence rates of advanced lower rectal cancer.
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Recidiva Local de Neoplasia , Neoplasias Retais , Humanos , Japão , Excisão de Linfonodo , Estadiamento de Neoplasias , Neoplasias Retais/patologia , Neoplasias Retais/cirurgia , Estudos Retrospectivos , Fatores de RiscoRESUMO
PURPOSE: This study was aimed at evaluating the oncologic outcomes of our preoperative treatment strategies for cStage â ¡/â ¢ lower rectal cancer. At our hospital, neoadjuvant chemotherapy is administered for patients with bulky mesenteric lymph nodes on pretreatment imaging, and neoadjuvant chemoradiotherapy is administered for patients whose circumferential radial or distal margin cannot be secured because of strong local extension. METHODS: Thirty patients who underwent preoperative therapy followed by total mesorectal excision for cStage â ¡/â ¢ lower rectal cancer were retrospectively analyzed from October 2010 to October 2015. RESULTS: Twenty-five patients underwent neoadjuvant chemotherapy, and 5 patients underwent neoadjuvant chemotherapy. Tumor recurrence occurred in 10 patients at local(5 patients)and distant(5 patients)sites. The 5-year recurrence-free survival(5RFS)was 63.9%. CONCLUSION: We performed preoperative therapy in poor-risk locally advanced lower rectal cancer and obtained good results.
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Terapia Neoadjuvante , Neoplasias Retais , Quimiorradioterapia , Intervalo Livre de Doença , Humanos , Recidiva Local de Neoplasia/patologia , Estadiamento de Neoplasias , Neoplasias Retais/tratamento farmacológico , Neoplasias Retais/cirurgia , Estudos Retrospectivos , Resultado do TratamentoRESUMO
Surface fluorescence X-ray absorption fine structure (XAFS) spectroscopy using a Laue-type monochromator has been developed to acquire structural information about metals with a very low concentrate on a flat highly oriented pyrolytic graphite (HOPG) surface in the presence of electrolytes. Generally, surface fluorescence XAFS spectroscopy is hindered by strong scattering from the bulk, which often chokes the pulse counting detector. In this work, we show that a bent crystal Laue analyzer (BCLA) can efficiently remove the scattered X-rays from the bulk even in the presence of solution. We applied the technique to submonolayer (â¼1014 â atoms cm-2 ) Pt on HOPG and successfully obtained high signal/noise inâ situ XAFS data in combination with back-illuminated fluorescence XAFS (BI-FXAFS) spectroscopy. This technique allows inâ situ XAFS measurements of flat electrode surfaces to be performed in the presence of electrolytes.