Nineteen per cent of synchronous cancers were not detected until the initial ESD. The incidence rate of metachronous cancer after ESD was constant. Scheduled endoscopic surveillance showed that almost all recurrent lesions were treatable by endoscopic resection.

Esophageal ESD has become feasible with acceptable complication risks and favorable long term outcomes.

No abstract

BACKGROUND & AIMS: We performed a large, multicenter, randomized controlled trial to determine the efficacy and safety of early colonoscopy on outcomes of patients with acute lower gastrointestinal bleeding (ALGIB). METHODS: We performed an open-label study at 15 hospitals in Japan of 170 patients with ALGIB randomly assigned (1:1) to groups that underwent early colonoscopy (within 24 hours of initial visit to the hospital) or elective colonoscopy (24-96 hours after hospital admission). The primary outcome was identification of stigmata of recent hemorrhage (SRH). Secondary outcomes were rebleeding within 30 days, endoscopic treatment success, need for transfusion, length of stay, thrombotic events within 30 days, death within 30 days, and adverse events. RESULTS: SRH were identified in 17 of 79 patients (21.5%) in the early colonoscopy group vs 17 of 80 patients (21.3%) in the elective

In this large-scale, multicenter cross-sectional study, over 40% of the noninvasive gastric neoplasia specimens were determined to have adenocarcinoma, and the ESD-related complication rate was relatively low. Therefore, ESD was useful and may be a therapeutic option for gastric NIN.

A significant association is suggested between enlarged-fold gastritis and gastric carcinoma.

Recently, it was shown that individual tree heights could be accurately estimated using small-footprint airborne light detection and ranging (LiDAR) remote sensing. Because most of the areas studied previously were limited to flat terrain, we investigated the accuracy of LiDAR-derived individual tree height estimates for different types of topographical features in mountainous forests with a steeper and more complex topography. Several middle-aged (40-50 years old) sugi (Cryptomeria japonica D. Don) plantations are found in the mountainous regions in Japan; hence, we chose 48-year-old sugi plantations to investigate the accuracy of these estimates. The surveyed area was divided into three types of topographical features; steep slope (mean slope Ϯ SD; 37.6° Ϯ 5.8°), gentle slope (15.6° Ϯ 3.7°), and gentle yet rough terrain (16.8° Ϯ 7.8°). Before estimating tree heights, the number of detected trees within each topographical feature was researched. In each of these terrains, the percentage of trees detected correctly was 74%, 86%, and 92%; the average error between LiDAR-derived and field-measured tree heights was 0.227 m, Ϫ0.473 m, and Ϫ0.183 m; and the accuracy of the LiDAR-derived tree height estimates, given as root mean square error (RMSE), was 0.901 m, 0.846 m, and 0.576 m, respectively. Consequently, the procedure presented in this study could detect most canopy trees and estimate individual tree heights with an accuracy better than 1 m, even in a forest with a mean slope angle of approximately 38°; thus, indicating that small-footprint airborne LiDAR will be a useful tool for accurately estimating the heights of individual canopy trees in sugi plantations in mountainous areas.

Background and study aims: Endoscopic submucosal dissection (ESD) has become widely accepted as a minimally invasive treatment for early gastric cancer (EGC), and opportunities to use ESD to treat EGC in elderly patients are increasing. The objective of this study was to elucidate the safety and efficacy of ESD in elderly patients. Patients and methods: Between April 2006 and March 2013, a total of 892 patients with EGC were prospectively recruited to undergo ESD according to definite inclusion criteria. The short-term outcomes and incidence of complications in 345 of these patients who were 75 years of age or older (elderly group) were compared with the short-term outcomes and incidence of complications in the remaining 547 patients (non-elderly group). Factors associated with the occurrence of pneumonia and delirium were also investigated. Results: The R0 resection rate did not differ between the two groups (96.2 % in the elderly group vs. 96.7 % in the non-elderly group; P = 0.65). The incidence of pneumonia (7.5 % vs. 1.8 %; P < 0.01) and incidence of delirium (10.1 % vs. 1.1 %; P < 0.01) were significantly higher in the elderly group. The incidence of post-ESD bleeding and incidence of perforation were similar in the two groups. No emergency surgery was required, but one patient in the non-elderly group died of aspiration pneumonia. On multivariate analysis, age 75 years or older, cerebrovascular disease, chronic obstructive pulmonary disease, delirium, and remnant stomach or gastric tube were independent risk factors for pneumonia, and age 75 years or older, diabetes, dementia, and pneumonia were independent risk factors for delirium. Conclusion: ESD for EGC was feasible for elderly patients in good condition. However, pneumonia and delirium may develop more frequently after ESD in elderly patients with co-morbidities.