Background and Aim Colorectal endoscopic submucosal dissection ( ESD ) is widely carried out, but is still considered difficult. In 2010, a tumor size of ≥50 mm and less experience in colorectal ESD were reported as independent risk factors for complications such as perforation, delayed perforation and postoperative bleeding. In order to overcome such difficulties, we developed a scissors‐type grasping device and reported the treatment results of a multicenter study. The aim of the present study was to investigate therapeutic outcomes of colorectal ESD of different tumor sizes. Methods G roup A (134 tumors): tumor size <50 mm, and G roup B (16 tumors): tumors ≥50 mm. All tumors were removed by ESD . We retrospectively evaluated the clinicopathological features of the tumors and the treatment results. Results Age, sex, tumor location and histopathological diagnosis were not different between the two groups. Laterally spreading tumor non‐granular type was more often observed in G roup A (64/134, 47.8%) than in G roup B (0/16, 0%). Procedure time was significantly longer in G roup B ( G roup A : 38 min; G roup B : 86 min, P < 0.01). However, procedure speed was significantly faster in G roup B ( G roup A : 0.21 cm 2 /min; G roup B : 0.37 cm 2 /min, P < 0.01). No complications were observed in either group. The en bloc resection rate, en bloc R 0 resection rate, and en bloc curative resection rate were similar between the groups with no significant differences. Conclusions Procedure speed for G roup B was faster than that for G roup A . G roup B was treated as safely as G roup A .
Abstract Aim: Because of less frequent lymph node metastasis and parametrial involvement, patients with stage Ib1 cervical cancer may benefit from a curtailment of surgery. We retrospectively investigated the distribution of lymph node metastasis in stage Ib1 patients. After comparing the data with that of higher stages and sentinel lymph node navigation (SLNN), the appropriate extent of lymphadenectomy (LA) in stage Ib1 disease was newly suggested. Method: A total of 303 patients underwent a radical hysterectomy with LA and the region‐specific rate of node metastasis was obtained. SLNN was performed for 50 patients using 99m Tc phytate injection into the cervix and intra‐operative detection by a gamma‐probe. Results: The rate of node metastasis and the average number of nodes removed, respectively, were: 23/189 (12.2%), 65.2 in stage Ib1; 14/47 (29.8%), 70.1 in stage Ib2; 7/20 (35.0%), 78.2 in stage IIa; and 26/47 (55.3%), 69.1 in stage IIb. Lymph node metastasis in stage Ib1 was prevalent in the obturator (Ob) (9.5%), inter‐iliac (Ii) (4.9%), superficial common iliac (Sc) (2.3%), cardinal (Cd) (2.2%) and external iliac (Ei) (1.7%) nodes. In patients with upper stage disease, lymph node metastasis could occur in all lymph nodes. In stage Ib1 patients, the sentinel nodes were assigned only to the Ob, Ii, Sc and Ei nodes, being identical with frequent metastatic sites in stage Ib1 (excluding Cd). Conclusion: The extent of LA can be routinely completed with the removal of Ob, Ii, Ei, Sc and Cd nodes, which may provide a higher quality of life, including the reduction of lymphedema by preventing the removal of the inguinal nodes.
Using milk casein and several kinds of surfactants as chemical agents, removal of suspended solids by coagulation and foam separation with dispersed air was examined. Casein functioned both as a collector and a frother, and coagulating flocs were almost perfectly recovered in foam generated from the liquid. Although oleic acid of anionic surfactant functioned as a collector, the removal efficiency of suspended solids was lower than that of casein. In contrast, cationic, amphoteric, and nonionic surfactants did not function act as collectors. It was clarified that casein had a much greater capacity for producing the hydrophobic interface of flocs than the surfactants used. However, all of the surfactants could also be utilized as frothers for recovering the hydrophobic flocs with casein.For municipal wastewater treatment, a very high removal efficiency was obtained with a small amount of casein (3mg·l-1), because detergent contained in the wastewater functioned as a frother. In this method using casein, detergent is one of the object substances in wastewater. It is utilized as a foaming agent and is removed with foam.
Magnetic properties of Permalloy films consisting of nickel and iron are influenced significantly by their compositions. It is necessary, therefore, to understand the relationship between the plating conditions and the resulting compositions. The conditions for obtaining Permalloy films of regular compositions from sulfamate solutions are discussed. It is concluded that the electroplating at relatively low ferrous ion concentrations and low current densities is most favorable.
Objective: Many studies have confirmed the benefits of wearing Mouth-Guards (MG) on the prevention or reduction of sport-related stomatognathic system trauma. However, custom made MG with high adaptability can be retained in a dentition even when the mouth is open; this situation thought to increase jaw fragility and the possibility of trauma. This study investigated the effects of the clenching with MG, and occlusal support area difference on mandibular distortions related to injury caused by direct lateral impact.
Materials and Method: A pendulum-type device was used to apply an impact on the lower-left region of the mandibular body of a skull model. MGs with different occlusal support areas were fabricated for various conditions. A pseudo-occlusal force of approximately 30 N was applied in the submental region for the model except for mouth open of control condition during impact. Evaluation criteria included the degree of mandibular distortion.
Results and Discussion: Large distortion was indicated during the impact when the mouth was open (p<0.01). In contrast, distortion was lowest when the mouth was clenched with fully supported MG (p<0.01); however, distortion increased when the occlusal support area of MG was reduced. Results indicated that clenching with appropriately designed MG is useful for the prevention and reduction of mandibular injuries.
Studies on the conditions and pollution routes of antibiotic-resistant bacteria (ARB) in rivers can help provide countermeasures against the spread of ARB. This study focused on the pristine uppermost stream of a river, where Escherichia coli ( E. coli ) and enterococci were detected, although the stream flows through a pristine forest catchment. Antibiotic resistance of E. coli and enterococci isolated from the river water, riverbed sediment, and feces of waterside animals, such as birds and Mustelidae, were investigated throughout the year in the pristine uppermost sites. Antibiotic resistance was present in 1.4% (7/494) of the E. coli strains and 3.0% (24/812) of the enterococcal strains, and was low throughout the year. Although antibiotic resistance of bacteria isolated from feces was not detected in this watershed, the prevalence of multidrug-resistant E. coli was 0.4% (1/246) and 0.6% (1/172) in river water and riverbed sediment samples, respectively were observed. The presence of extended-spectrum β-lactamase (ESBL)-producing E. coli was confirmed in river water samples, and genomic analysis revealed that the samples possessed the CTX-M-15 group. Multidrug-resistant strains and ESBL-producing strains were classified as phylogroups B1 and A, respectively, which are E. coli phenotypes isolated from wild animals. Pulsed-field gel electrophoresis revealed analysis targeting enterococci that strains isolated from river water and bird feces were in the same cluster with 100% similarity. Therefore, bird feces are a source of enterococci in the uppermost stream of the river. Because multidrug-resistant bacteria and ESBL-producing bacteria were present in the pristine uppermost stream of the pristine river, urgent elucidation of the spreading routes of ARB is important.
