Inorder to determine the operative indications of three-field lymph node dissection of esophageal cancer, attempts were made to collect data concerning procedures performed between 1983 and 1989 in major institutions in Japan, and the results from institutions performing three-field or two-field lymph node dissection were compared. The treatment results of three-field lymph node dissection were better than those after two-field dissection, except for early or advanced cancer. The survival rate improved by the three-field as compared with the two-field lymph node dissection; however,, since surgery was invasive, some complications such as recurrent nerve paralysis were frequent. The results show that the indication of three-field lymph node dissection has to be carefully determined for each patient.

The purpose of this paper is to give basic tools for the classification of nonsingular toric Fano varieties by means of the notions of primitive collections and primitive relations due to Batyrev. By using them we can easily deal with equivariant blow-ups and blow-downs, and get an easy criterion to determine whether a given nonsingular toric variety is a Fano variety or not. As applications of these results, we get a toric version of a theorem of Mori, and can classify, in principle, all nonsingular toric Fano varieties obtained from a given nonsingular toric Fano variety by finite successions of equivariant blow-ups and blow-downs through nonsingular toric Fano varieties. Especially, we get a new method for the classification of nonsingular toric Fano varieties of dimension at most four. These methods are extended to the case of Gorenstein toric Fano varieties endowed with natural resolutions of singularities. Especially, we easily get a new method for the classification of Gorenstein toric Fano surfaces. Proposition 2.2 (Batyrev [3])If ∆ ⊂ N R is a reflexive polytope, then T N emb(Σ(∆)) is a Gorenstein toric Fano variety. Conversely, if Σ is a finite complete fan in N such that T N emb(Σ) is a Gorenstein toric Fano variety, then Conv( G (Σ)) ⊂ N R is a reflexive polytope, where Conv( G (Σ)) is the convex hull of G (Σ) ⊂ N R . Moreover, any two Gorenstein toric Fano varieties T N emb(Σ(∆ 1 )) and T N emb(Σ(∆ 2 )) corresponding to two reflexive polytopes ∆ 1 ⊂ N R and ∆ 2 ⊂ N R are isomorphic if and only if ∆ 1 and ∆ 2 are equivalent up to unimodular transformation of the lattice N.Remark 2.3 A reflexive polytope ∆ is called a Fano polytope if Σ(∆) is nonsingular. Primitive collections and primitive relationsPrimitive collections and primitive relations, introduced by Batyrev [4], are very convenient in describing higher-dimensional fans. So in this section, we recall these concepts and characterize toric Fano varieties using them.

No abstract

Since 1986, serogroup B Neisseria meningitidis has caused approximately 80%Yv of the meningococcal disease in Brazil. In 1988, an epidemic caused byN. meningitidis B:4:P1.15 was recognized in the greater Sio Paulo area of Brazil. The Sfio Paulo state government decided to vaccinate children from 3 to 83 months of age with a vaccine consisting of serotype 4 outer membrane protein and group C meningococcal polysaccharide that was produced in Cuba. About 2.7 million children were vaccinated during two immunization campaigns conducted in 1989 and 1990. Because of this, a case-control study was designed to determine vaccine efficacy against group B meningococcal disease. The purpose of our study was to compare the antibody response with the protection from disease estimated from the case-control study. We measured the immune responses of vaccinees by enzyme-linked immunosorbent assay (ELISA), immunoblot, and bactericidal assay. The development of bactericidal antibodies was age dependent and in good agreement with the results of the case-control study. Only 40%o of vaccinees showed fourfold or greater increases in bactericidal antibody titers after vaccination. A poor correlation between antibody levels detected by ELISA and those by bactericidal assay was found. Immunoblot analysis showed that about 50%o of the serum samples with bactericidal titers higher than 1:4 were reactive with class 1 outer membrane protein. We conclude that the bactericidal assay is a good, laboratorybased, functional assay for the study of vaccine immunogenicity and that an effective solution to group B meningococcal disease remains to be demonstrated.

It is shown in [DS] that the Sierpinski gasket ^aR N can be represented as the Martin boundary of a certain Markov chain and hence carries a canonical metric p M induced by the embedding into an associated Martin space M. It is a natural question to compare this metric p M with the Euclidean metric. We show first that the harmonic measure coincides with the normalized //=(log(Af+l)/log2)-dimensional Hausdorff measure with respect to the Euclidean metric. Secondly, we define an intrinsic metric p which is Lipschitz equivalent to p M and then show that p is not Lipschitz equivalent to the Euclidean metric, but the Hausdorff dimension remains unchanged and the Hausdorff measure in p is infinite. Finally, using the metric p, we prove that the harmonic extension of a continuous boundary function converges to the boundary value at every boundary point.

Elevated circulating uremic toxins are associated with a variety of symptoms and organ dysfunction observed in patients with chronic kidney disease (CKD). Indoxyl sulfate (IS) and p-cresyl sulfate (PCS) are representative uremic toxins that exert various harmful effects. We recently showed that IS induces metabolic alteration in skeletal muscle and causes sarcopenia in mice. However, whether organ-specific accumulation of IS and PCS is associated with tissue dysfunction is still unclear. We investigated the accumulation of IS and PCS using liquid chromatography/tandem mass spectrometry in various tissues from mice with adenine-induced CKD. IS and PCS accumulated in all 15 organs analyzed, including kidney, skeletal muscle, and brain. We also visualized the tissue accumulation of IS and PCS with immunohistochemistry and mass spectrometry imaging techniques. The oral adsorbent AST-120 prevented some tissue accumulation of IS and PCS. In skeletal muscle, reduced accumulation following AST-120 treatment resulted in the amelioration of renal failure-associated muscle atrophy. We conclude that uremic toxins can accumulate in various organs and that AST-120 may be useful in treating or preventing organ dysfunction in CKD, possibly by reducing tissue accumulation of uremic toxins.

No abstract

No abstract