DOCSLIB.ORG

Revisions of International Consensus Fukuoka Guidelines for the Management of IPMN of the Pancreas

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Revisions of International Consensus Fukuoka Guidelines for the Management of IPMN of the Pancreas Pancreatology xxx (2017) 1e16 Contents lists available at ScienceDirect Pancreatology journal homepage: www.elsevier.com/locate/pan Revisions of international consensus Fukuoka guidelines for the management of IPMN of the pancreas * Masao Tanaka a, , Carlos Fernandez-del Castillo b, Terumi Kamisawa c, Jin Young Jang d, Philippe Levy e, Takao Ohtsuka f, Roberto Salvia g, Yasuhiro Shimizu h, Minoru Tada i, Christopher L. Wolfgang j a Department of Surgery, Shimonoseki City Hospital, Shimonoseki, Japan b Pancreas and Biliary Surgery Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA c Department of Gastroenterology, Komagome Metropolitan Hospital, Tokyo, Japan d Division of Hepatobiliary-Pancreatic Surgery, Department of Surgery, Seoul National University College of Medicine, Seoul, South Korea e Pole^ des Maladies de l'Appareil Digestif, Service de Gastroenterologie-Pancreatologie, Hopital Beaujon, Clichy Cedex, France f Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan g Department of General and Pancreatic Surgery, The Pancreas Institute, University of Verona Hospital Trust, Verona, Italy h Dept. of Gastroenterological Surgery, Aichi Cancer Center, Nagoya, Japan i Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan j Cameron Division of Surgical Oncology and The Sol Goldman Pancreatic Cancer Research Center, Department of Surgery, Johns Hopkins University, Baltimore, MD, USA article info abstract Article history: The management of intraductal papillary mucinous neoplasm (IPMN) continues to evolve. In particular, Received 1 July 2017 the indications for resection of branch duct IPMN have changed from early resection to more deliberate Received in revised form observation as proposed by the international consensus guidelines of 2006 and 2012. Another guideline 12 July 2017 proposed by the American Gastroenterological Association in 2015 restricted indications for surgery Accepted 12 July 2017 more stringently and recommended physicians to stop surveillance if no significant change had occurred Available online xxx in a pancreatic cyst after five years of surveillance, or if a patient underwent resection and a non- malignant IPMN was found. Whether or not it is safe to do so, as well as the method and interval of Keywords: International guidelines surveillance, has generated substantial debate. Based on a consensus symposium held during the Intraductal papillary mucinous neoplasm meeting of the International Association of Pancreatology in Sendai, Japan, in 2016, the working group Pancreatic cancer has revised the guidelines regarding prediction of invasive carcinoma and high-grade dysplasia, sur- Surveillance veillance, and postoperative follow-up of IPMN. As the working group did not recognize the need for major revisions of the guidelines, we made only minor revisions and added most recent articles where appropriate. The present guidelines include updated information and recommendations based on our current understanding, and highlight issues that remain controversial or where further research is required. © 2017 IAP and EPC. Published by Elsevier B.V. All rights reserved. Introduction is unclear what proportion of these incidentally-discovered pancreatic cysts represents IPMN, surgical series have shown that Increased detection of pancreatic cysts due to improvement and most of the larger ones indeed are branch duct IPMN (BD-IPMN). expanded use of computed tomography (CT) and magnetic reso- Early on, the malignant potential of this entity led to surgical nance imaging (MRI) has led to a surge in interest on intraductal resection of most pancreatic cysts, and although in very few centers papillary mucinous neoplasms (IPMN) of the pancreas. Although it this continues to be the case, following the publication of the In- ternational Association of Pancreatology (IAP) Sendai guidelines in 2006 [1] and the subsequent Fukuoka guidelines in 2012 [2], a more conservative attitude is followed. As a consequence, currently the * Corresponding author. Shimonoseki City Hospital, 1-13-1 Koyo-cho, Shimono- seki 750-8520, Japan. majority of newly-diagnosed BD-IPMNs do not undergo surgery. E-mail address: [email protected] (M. Tanaka). However, it is also recognized that a proportion of these evolve over http://dx.doi.org/10.1016/j.pan.2017.07.007 1424-3903/© 2017 IAP and EPC. Published by Elsevier B.V. All rights reserved. Please cite this article in press as: Tanaka M, et al., Revisions of international consensus Fukuoka guidelines for the management of IPMN of the pancreas, Pancreatology (2017), http://dx.doi.org/10.1016/j.pan.2017.07.007 Downloaded for AdminAigo AdminAigo ([email protected]) at Italian Association of Gastroenterology (AIGO) from ClinicalKey.com by Elsevier on August 07, 2017. For personal use only. No other uses without permission. Copyright ©2017. Elsevier Inc. All rights reserved. 2 M. Tanaka et al. / Pancreatology xxx (2017) 1e16 time and can become malignant, and also, that patients with IPMN IPMN, and mixed type, based on imaging studies and/or histology are at an increased risk of developing conventional pancreatic (Fig. 1). MD-IPMN is characterized by segmental or diffuse dilation ductal adenocarcinoma (PDAC) elsewhere in the gland. Because of of the main pancreatic duct (MPD) of >5 mm without other causes this, surveillance is carried out on most of these patients. Deter- of obstruction. A low threshold for MPD dilation (5 mm) was mining which patients are at a higher risk of harboring or devel- adopted in the previous guidelines, increasing the sensitivity for oping invasive carcinoma or high-grade dysplasia (HGD) and radiologic diagnosis of MD-IPMN without losing specificity [4e8]. therefore should undergo resection, and how to follow the However, MPD dilation of 5e9 mm is not an immediate surgical remaining ones is the matter of extensive studies throughout the indication but considered one of “worrisome features” mentioned world, as well as a source of controversy. In 2015, the American later, while an MPD diameter of 10 mm is one of the “high-risk Gastroenterological Association (AGA) published another new stigmata”. Pancreatic cysts of >5 mm in diameter that communi- guideline that has different and more conservative criteria for in- cate with the MPD should be considered as BD-IPMN, with pseu- dications of resection and recommends stopping surveillance after docyst being in the differential diagnosis for patients with a prior 5 years if no significant change is observed or if a cyst is resected history of pancreatitis. Mixed type patients meet the criteria for and found to be benign [3]. Not unexpectedly, the AGA guideline both MD-IPMN and BD-IPMN. has generated intense debate in the field of pancreatology. There are considerable differences in the proportions of each During the 20th meeting of the International Association of type and the risks of invasive carcinoma and HGD [1e19]. The Pancreatology (IAP 2016) in Sendai, Japan, a symposium focused on differences are partly caused by variation in the type definitions, surveillance of BD-IPMN was held. The symposium also addressed since the correlation between the histologic and radiologic criteria the significance of mural nodule size to predict invasive carcinoma is only around 70% [7,20]. For example, a BD-IPMN in the head of and HGD in BD-IPMN. The present revision is aimed particularly at the pancreas can cause MPD dilation throughout the pancreas these controversial items. The other parts of the Fukuoka guidelines because of ductal hypertension related to mucin, protein plugs, and are left unchanged or updated by adding recent literature. focal pancreatitis, and on the other hand there can be main duct Mucinous cystic neoplasm (MCN) has been excluded from the involvement by neoplasm without significant duct dilation [21]. revised guidelines, given that there are very few remaining points However, since the classification is important for clinicians to plan of controversy regarding this entity. the management, it should be based on the preoperative radiologic All the authors contributed equally to the guidelines. M. Tanaka, images, and the pathological classification can be specified a C. Fernandez-del Castillo and T. Kamisawa chaired this working posteriori. group of the IAP and played a pivotal role in the preparation of the manuscript. The remaining authors are listed in alphabetical order. Definition of malignant IPMN Classification IPMNs exhibit a spectrum of neoplastic transformation, not only within each category but also often within the same case, ranging Criteria for distinction of BD-IPMN and main duct IPMN (MD-IPMN) from innocuous lesions that used to be called “hyperplasia” or adenoma (currently classified as “low-grade dysplasia”) to invasive IPMNs can be classified into three types, i.e., MD-IPMN, BD- carcinomas [22,23]. The definition of “malignancy” has been Fig. 1. Magnetic resonance cholangiopancreatograms demonstrating the three morphological types of intraductal papillary mucinous neoplasm. a. Main duct type with a mural nodule (arrow). b. Branch duct type. c. Mixed type. Please cite this article in press as: Tanaka M, et al., Revisions of international consensus Fukuoka guidelines for the management of IPMN of the pancreas, Pancreatology (2017), http://dx.doi.org/10.1016/j.pan.2017.07.007 Downloaded for AdminAigo AdminAigo ([email protected]) at Italian Association of Gastroenterology
Load more

Recommended publications
  • Japan's Friendship Ties Program
    Japan’s Friendship Ties Program (USA) KAKEHASHI Project Tomodachi KAKEHASHI Inouye the 2nd Slot Program Report 1．Program Overview Under the “KAKEHASHI Project” of Japan’s Friendship Ties Program, 25 university students and supervisors from the United States visited Japan from March 24th to March 31st, 2017 to participate in the program aimed at promoting their understanding of Japan with regard to Japanese politics, economy, society, culture, history, and foreign policy. Through visiting local governments, lecture by ministry, school exchange, observation of historical sites and other experiences, the participants enjoyed a wide range of opportunities to improve their understanding of Japan and shared their individual interests and experiences through SNS. Based on their findings and learning in Japan, each group of participants made a presentation in the final session and reported on the action plans to be taken after returning to their home country. 【Participating Countries and Number of Participants】 U.S.A. 25 Participants (University of Hawaii at Manoa) 【Prefectures Visited】 Tokyo, Kanagawa, Fukuoka 2．Program Schedule March 24th (Fri) Arrival at Narita International Airport [Lecture] Ministry of Foreign Affairs, North American Bureau “Japan’s Foreign Policy” [Orientation] March 25th (Sat) [History/Culture] Oversea Immigration Museum [Historical Landmark] Japan Open-Air Folk House Museum [Observation of Commercial Facility] Queen’s Square March 26th (Sun) Move o Fukuoka [Historical Landmark] Dazaifu Tenmangu Shrine [Cultural Experience]Umegae
    [Show full text]
  • CORPORATE DIRECTORY (As of June 28, 2000)
    CORPORATE DIRECTORY (as of June 28, 2000) JAPAN TOKYO ELECTRON KYUSHU LIMITED TOKYO ELECTRON FE LIMITED Saga Plant 30-7 Sumiyoshi-cho 2-chome TOKYO ELECTRON LIMITED 1375-41 Nishi-Shinmachi Fuchu City, Tokyo 183-8705 World Headquarters Tosu City, Saga 841-0074 Tel: 042-333-8411 TBS Broadcast Center Tel: 0942-81-1800 District Offices 3-6 Akasaka 5-chome, Minato-ku, Tokyo 107-8481 Kumamoto Plant Osaka, Kumamoto, Iwate, Tsuruoka, Sendai, Tel: 03-5561-7000 2655 Tsukure, Kikuyo-machi Aizuwakamatsu, Takasaki, Mito, Nirasaki, Toyama, Fax: 03-5561-7400 Kikuchi-gun, Kumamoto 869-1197 Kuwana, Fukuyama, Higashi-Hiroshima, Saijo, Oita, URL: http://www.tel.co.jp/tel-e/ Tel: 096-292-3111 Nagasaki, Kikuyo, Kagoshima Regional Offices Ozu Plant Fuchu Technology Center, Osaka Branch Office, 272-4 Takaono, Ozu-machi TOKYO ELECTRON DEVICE LIMITED Kyushu Branch Office, Tohoku Regional Office, Kikuchi-gun, Kumamoto 869-1232 1 Higashikata-cho, Tsuzuki-ku Yamanashi Regional Office, Central Research Tel: 096-292-1600 Yokohama City, Kanagawa 224-0045 Laboratory/Process Technology Center Koshi Plant Tel: 045-474-7000 Sales Offices 1-1 Fukuhara, Koshi-machi Sales Offices Sendai, Nagoya Kikuchi-gun, Kumamoto 861-1116 Utsunomiya, Mito, Kumagaya, Kanda, Tachikawa, Tel: 096-349-5500 Yamanashi, Matsumoto, Nagoya, Osaka, Fukuoka TOKYO ELECTRON TOHOKU LIMITED Tohoku Plant TOKYO ELECTRON MIYAGI LIMITED TOKYO ELECTRON LEASING CO., LTD. 52 Matsunagane, Iwayado 1-1 Nekohazama, Nemawari, Matsushima-machi 30-7 Sumiyoshi-cho 2-chome Esashi City, Iwate 023-1101 Miyagi-gun, Miyagi
    [Show full text]
  • Utility of the 2006 Sendai and 2012 Fukuoka Guidelines for The
    ® Observational Study Medicine OPEN Utility of the 2006 Sendai and 2012 Fukuoka guidelines for the management of intraductal papillary mucinous neoplasm of the pancreas A single-center experience with 138 surgically treated patients Chih-Yang Hsiao, MD, Ching-Yao Yang, MD, PhD, Jin-Ming Wu, MD, Ting-Chun Kuo, MD, ∗ Yu-Wen Tien, MD, PhD Abstract This study aimed to evaluate the utility of the 2006 Sendai and 2012 Fukuoka guidelines for differentiating malignant intraductal papillary mucinous neoplasm (IPMN) of the pancreas from benign IPMN. Between January 2000 and March 2015, a total of 138 patients underwent surgery and had a pathologically confirmed pancreatic IPMN. Clinicopathological parameters were reviewed, and all patients were classified according to both the 2006 Sendai and 2012 Fukuoka guidelines. Univariate and multivariate analyses were used for identifying significant factors associated with malignancy in IPMN. There were 9 high-grade dysplasia (HGD) and 37 invasive cancers (ICs) in the 138 patients. The positive predictive value (PPV) and negative predictive value (NPV) of the Sendai and Fukuoka guidelines for HGD/IC was 35.1%, 43.3%, 100%, and 85.4%, respectively. Of the 36 patients with worrisome features using the Fukuoka guideline, 7 patients had HGD/IC in their IPMNs. According to the multivariate analysis, jaundice, tumors of ≥3cm, presence of mural nodule on imaging, and aged <65 years were associated with HGD/IC in patients with IPMN. The Sendai guideline had a better NPV, but the Fukuoka guideline had a better PPV. We suggest that patients with worrisome features based on the Fukuoka guideline be aggressively managed.
    [Show full text]
  • Learn from Japan's Earthquake and Tsunami Crisis
    Learn from Japan’s Earthquake and Tsunami Crisis International Field Experience Spring 2018 TOHOKU TRIP BOOKLET Center for Public Service, Portland State University Contents What to pack? --------------------------------------- 2 Transportation --------------------------------------- 2-7 Cell phone -------------------------------------------- 7 WiFi ---------------------------------------------------- 7 Smartphone Apps ---------------------------------- 8 Restrooms -------------------------------------------- 8 Laundry ----------------------------------------------- 8 Tips ---------------------------------------------------- 8 Smoking and Alcohol ------------------------------ 9 Sales Tax --------------------------------------------- 9 Credit Cards ------------------------------------------ 9 Currency ---------------------------------------------- 10-11 Safety -------------------------------------------------- 11 In case of Emergency ------------------------------ 11 Phrases and Vocabulary -------------------------- 12-14 2 What to pack? While Japan offers most items found in the U.S., consider preparing the following items as listed below: ● Clothing: ○ Prepare for hot & humid weather Average temperature in the Tohoku region is ~72 with humidity. Bringing cotton or other lightweight clothing items for the trip is recommended. ℉ However, please remember to dress appropriately. Avoid open-toed shoes, exposing shoulders/chest, or anything above the knee when visiting shrines/memorial sites. Occasionally you will need to remove your shoes,
    [Show full text]
  • Japan Earthquake and Tsunami Update Saturday, March 12, 2011
    Japan Earthquake and Tsunami Update Saturday, March 12, 2011 Note: New content has been inserted in red, italicized, bold font. Overview A powerful 8.9-magnitude earthquake hit Japan on Friday (March 11) at 1446 local time (0546 GMT), unleashing massive tsunami waves that crashed into Japan’s eastern coast of Honshu, the largest and main island of Japan, resulting in widespread damage and destruction. According to the Government of Japan (GoJ) as of Saturday (March 12), at least 464 1 people have been reported dead and some 725 people are reported to be missing, the UN’s Office for the Coordination of Humanitarian Affairs (OCHA) reported. The GoJ’s chief spokesperson said the death toll could exceed 1,000. Local media put the death toll closer to 1,300 people. As initial assessments come in it is expected that the death toll will rise due to the extensive devastation along the coastline and majority of the casualties are likely to be the result of the tsunami. The earthquake sparked widespread tsunami warnings across the Pacific that stretched from Japan to North and South America. According to the US Geological Survey (USGS), the shallow quake struck at a depth of six miles (10 km) (20 km deep according to Japan’s Meteorological Agency), around 80 miles (125 km) off the eastern coast of Japan, and 240 miles (380 km) northeast of Tokyo. It was reportedly the largest recorded quake in Japan’s history and the fifth largest in the world since 1900. The quake was also felt in Japan’s capital city, Tokyo, located hundreds of miles from the epicenter and was also felt as far away as the Chinese capital Beijing, some 1,500 miles away.
    [Show full text]
  • Explore Shizuoka Explore the Spectacular Natural Environment, Authentic Japanese Culture, Unique History and Renowned Cuisine Of
    Explore the spectacular natural environment, authentic Japanese culture, unique history and renowned cuisine of the majestic home of Mount Fuji. Exploreshizuoka.com NATURAL BEAUTY, ON LAND AND SEA From the iconic Mount Fuji in the north to 500km of spectacular Pacific coastline in the south, Shizuoka is a region of outstanding natural beauty, with highlands, rivers and lakes giving way to the white sand beaches and volcanic landscapes of the Izu Peninsula. And all this just one hour from Tokyo by shinkansen (bullet train). Okuoikojo Station MOUNTAINS, FORESTS AND FALLS At 3,776m high, the majestic “Fuji-san” is Japan’s best-known symbol with shrines paying homage to the mountain and paintings illustrating its beauty. Designated a UNESCO World Cultural Heritage Site in 2013, the climbing season runs from July to early September. Shizuoka’s central area is dominated by deeply forested mountains that stand over 800 m in height, tea plantations and beautiful waterfalls, such as the Shiraito Falls which, along with the 25m Joren Falls on the Izu Peninsula, is ranked among the 100 most beautiful waterfalls in Japan. The Seven Waterfalls of Kawazu are surrounded by a thick forest of pines, cedars and bamboo with a walking path taking you to all seven in roughly one hour. For a unique and unforgettable experience, visitors can take the historic Oigawa steam railway to visit the beautiful “Dream Suspension Bridge” across the Sumatakyo Gorge. THE IZU PENINSULA Surrounded by ocean on three sides, the Izu Peninsula was designated a UNESCO Global Geopark in 2018. Twenty million years of shifting undersea volcanoes created its dramatic landscapes and natural hot springs.
    [Show full text]
  • By Municipality) (As of March 31, 2020)
    The fiber optic broadband service coverage rate in Japan as of March 2020 (by municipality) (As of March 31, 2020) Municipal Coverage rate of fiber optic Prefecture Municipality broadband service code for households (%) 11011 Hokkaido Chuo Ward, Sapporo City 100.00 11029 Hokkaido Kita Ward, Sapporo City 100.00 11037 Hokkaido Higashi Ward, Sapporo City 100.00 11045 Hokkaido Shiraishi Ward, Sapporo City 100.00 11053 Hokkaido Toyohira Ward, Sapporo City 100.00 11061 Hokkaido Minami Ward, Sapporo City 99.94 11070 Hokkaido Nishi Ward, Sapporo City 100.00 11088 Hokkaido Atsubetsu Ward, Sapporo City 100.00 11096 Hokkaido Teine Ward, Sapporo City 100.00 11100 Hokkaido Kiyota Ward, Sapporo City 100.00 12025 Hokkaido Hakodate City 99.62 12033 Hokkaido Otaru City 100.00 12041 Hokkaido Asahikawa City 99.96 12050 Hokkaido Muroran City 100.00 12068 Hokkaido Kushiro City 99.31 12076 Hokkaido Obihiro City 99.47 12084 Hokkaido Kitami City 98.84 12092 Hokkaido Yubari City 90.24 12106 Hokkaido Iwamizawa City 93.24 12114 Hokkaido Abashiri City 97.29 12122 Hokkaido Rumoi City 97.57 12131 Hokkaido Tomakomai City 100.00 12149 Hokkaido Wakkanai City 99.99 12157 Hokkaido Bibai City 97.86 12165 Hokkaido Ashibetsu City 91.41 12173 Hokkaido Ebetsu City 100.00 12181 Hokkaido Akabira City 97.97 12190 Hokkaido Monbetsu City 94.60 12203 Hokkaido Shibetsu City 90.22 12211 Hokkaido Nayoro City 95.76 12220 Hokkaido Mikasa City 97.08 12238 Hokkaido Nemuro City 100.00 12246 Hokkaido Chitose City 99.32 12254 Hokkaido Takikawa City 100.00 12262 Hokkaido Sunagawa City 99.13
    [Show full text]
  • Bibliography for Japan Envisions the West: 16Th-19Th Century Japanese Art from Kobe City Museum Prepared by Jie Pan, Assistant Librarian
    Bibliography for Japan Envisions the West: 16th-19th Century Japanese Art from Kobe City Museum Prepared by Jie Pan, Assistant Librarian A Collection of Nagasaki Colour Prints and Paintings; Showing the Influence of Chinese and European Art on that of Japan. N. H. N Mody. Rutland, Vt., C.E. Tuttle Co., 1969. NE 1310 M8 The History of Cultural Exchange between East and West in the 16th and 17th century.../Koro Ajia e! Sakoku Zenya no Tiozai Koryu--the Galleon Trade & the V.O.C.: a Special Exhibition. Tabako to Shio no Hakubutsukan (Tokyo, Japan). [Tokyo]: Tabako to Shio no Hakubutsukan, 1998. HF 3128 T2 Japan Envisions the West: 16th-19th century Japanese Art from Kobe City Museum. Yukiko Shirahara et al. Seattle: Seattle Art Museum, 2007. Exhibition catalogue. N 7353.4 S34 Meiji Western Painting. Minoru Harada. New York: Weatherhill, 1974. ND 1054 H3 Nihon Bijutsu no Naka no Seiyo: Azuchi Momoyama, Edo no Nyu Ato: Yunibashiado Fukuoka Taikai Kaisai Kinen Tokubetsuten = Western influence on Japanese art--16th century-19th century. Fukuoka-shi Bijutsukan et al. Fukuoka-shi: Fukuoka-shi Bijutsukan, 1995. ND 1053 F85 Paris in Japan: the Japanese Encounter with European Painting. Shuji Takashina et al. Tokyo: Japan Foundation; St. Louis: Washington University, 1987. ND 1055 W28 The Southern Barbarians; the First Europeans in Japan. Michael Cooper. Tokyo, Palo Alto, Calif.: Kodansha International in cooperation with Sophia University, 1971. DS 836 C6 The Western Scientific Gaze and Popular Imagery in Later Edo Japan: the Lens within the Heart. Timon Screech. Cambridge; New York: Cambridge University Press, 1996.
    [Show full text]
  • List of UNITI-1 Investigators in Japan List of UNITI-2 Investigators in Japan List of IM-UNITI Investigators in Japan Dose Adjus
    See “Efficacy and safety of ustekinumab in Japanese patients with moderately to severely active Crohn’s disease: a subpopu- lation analysis of phase 3 induction and maintenance studies” on page 475-486. Supplementary Information List of UNITI-1 investigators in Japan A Ando, Shiga University of Medical Science Hospital, Otsu, Shiga; T Ashida, Sapporo Higashi Tokushukai Hospital, Sapporo, Hokkaido; H Hanai, Hamamatsu South Hospital, Minamiku, Hamamatsu; T Ishida, Oita Red Cross Hospital, Oita City, Oita; H Ito, Kinshu-kai Infusion Clinic, Osaka City, Osaka; T Matsumoto, Kyushu University Hospital, Fukuoka city, Fukuoka; S Motoya, Hokkaido P.W.F.A.C. Sapporo-Kosei General Hospital, Sapporo-shi, Hokkaido; S Nakamura, Hyogo College of Medicine, Nishi- nomiya, Hyogo; Y Sameshima, Sameshima Hospital, Kagoshima-city, Kagoshima; Y Suzuki, Toho University, Sakura Medical Center, Sakura-shi, Chiba; K Watanabe, Osaka City University Hospital, Osaka City, Osaka; H Yamagami, Osaka City University Hospital, Osaka City, Osaka; T Yamamoto, Yokkaichi Social Insurance Hospital, Department of Surgery, Yokkaichi, Mie; K Yao, Fukuoka University Chikushi Hospital, Chikushi, Fukuoka. List of UNITI-2 Investigators in Japan T Ashida, Sapporo Higashi Tokushukai Hospital, Sapporo, Hokkaido; H Hanai, Hamamatsu South Hospital, Minamiku, Ham- amatsu; N Horiki, Mie University Hospital, Mie Prefecture, Tsu; H Iijima, Osaka University Hospital Department of Medicine, Gastroenterology and Hepatology, Suita; T Ishida, Oita Red Cross Hospital, Oita City, Oita; H Ito, Kinshu-kai Infusion Clinic, Osaka City, Osaka; M Iwabuchi, National Hospital Organization Sendai Medical Center, Miyagi Prefecture, Sendai; T Kanai, Keio University Hospital, Shinjuku-ku, Tokyo; R Kunisaki, Yokohama City University Medical Center, Kanagawa, Minami-ku, Yo- kohama; A Maemoto, Sapporo Higashi Tokushukai Hospital, Sapporo, Hokkaido; K Matsuoka, Keio University Hospital, Shin- juku-ku, Tokyo; S Motoya, Hokkaido P.W.F.A.C.
    [Show full text]
  • The Korean War and Japanese Ports: Support for the UN Forces and Its Influences
    The Korean War and Japanese Ports: Support for the UN Forces and Its Influences ISHIMARU Yasuzo Introduction When the Korean War broke out on June 25, 1950, Japan had been under the occupation of the Allied Forces. Nevertheless, Japan achieved its role as a rear base for the supply and transit of soldiers and materials. What linked the Korean Peninsula—the battlefield—and Japan—the rear base—were the sea and air transport routes, and what supported the sea transport routes were the Japanese ports. These ports in fact constituted important hubs connecting the battlefield and the rear base. During the same period, new laws pertaining to ports were established. These were the Port and Harbor Law (Law No. 218 of 1950) and the Old Naval Base City Conversion Law (Law No. 220 of 1950). The Port and Harbor Law established on the principle that the ports should be managed by local administration.1 Meanwhile, the aim of the Old Naval Base City Conversion Law was to establish a peaceful Japan by converting the former naval bases2 into industrial port cities. Therefore, right when Japanese ports were changing to new ports, the nation was thrown into the Korean War, which set back their efforts. The Korean War had a decisive influence on the path of post-war Japan,3 which prompted studies on its political and economic influences, its history, and on the rearmament of Japan. However, although some literature exists on Japan’s support to the Korean War,4 no studies have ever tried to focus on ports. This article discusses the role Japanese ports played during the Korean War and how they were affected by the war.
    [Show full text]
  • Hilton Fukuoka Sea Hawk Your First Choice Destination Contents Contents
    HILTON FUKUOKA SEA HAWK YOUR FIRST CHOICE DESTINATION CONTENTS CONTENTS 1. Why Fukuoka ? 1. WHY FUKUOKA? 2. Why Hilton Fukuoka Sea Hawk 3. Meeting Rooms 2. WHY HILTON FUKUOKA SEA HAWK? 4. Catering to your every need 5. Dining options 3. MEETING ROOMS 6. Accommodation 4. CATERING TO YOUR EVERY NEED 7. Relaxation in your spare time 5. DINING OPTIONS 6. ACCOMMODATION 7. RELAXATION IN YOUR SPARE TIME TOUCH TO NEXT WHY FUKUOKA? 1. ACCESSIBILITY EASY ACCESS FROM OVERSEAS • Fukuoka is situated on the northern shore of the island of Kyushu in Japan. • Ranked 10th of the world’s most livable cities in the magazine Monocle in 2014, Fukuoka was praised for its green spaces in a metropolitan setting. • Direct flights to 20 major cities overseas. EASY ACCESS WITHIN JAPAN • Direct access from major cities in Asia • Hong Kong : 3hr 15min | Singapore : 5hr 55mins | Shanghai : 1hr 40mins • Seoul : 1hr 20mins | Seoul : 1hrs | Taipei : 2hrs EASY ACCESS WITHIN JAPAN To/from Tokyo • Number of flights departing from Fukuoka: 378 flights a day • Approximately 2hrs from Narita airport or from Haneda airport in Tokyo To/from Osaka (Kansai) • Over an hour from Kansai International Airport (KIX) and Itami domestic airport. 176 • Number of bullet trains departing from bullet Fukuoka: 176 trains a day trains a day • 2.5 hours to and from Osaka on bullet train. 378 flights a day OSAKA To/from hotel FUKUOKA TOKYO • 20 mins to the International and Domestic ● ● airport by car. Public transportation is also ● available. • 15 mins to the Hakata Station for the bullet KYOTO train access.
    [Show full text]
  • FIFTY YEARS AFTER HIROSHIMA and NAGASAKI Y. Nishiwaki
    XA05C0005 INVITED PRESENTATIONS PROCEEDINGS FIFTY YEARS AFTER HIROSHIMA AND NAGASAKI Y. Nishiwaki Prof. Emeritus, Tokyo Institute of Technology, Tokio, Japan Hon.Prof. der Universität Wien, Institut fir Medizinische Physik, Universität Wien, Wien, Austria Fifty years ago, in 1945, the first three atomic bombs in human history were produced by the United States; one of these bombs was exploded experimentally at the testing ground in the desert 80 km from Alamogordo, New Mexico, on 16 July. The remaining two were used against Japan; the one called "Little Boy", using Uranium 235 was dropped on Hiroshima on 6 August, the other "Fat Man", using Plutonium 239 on Nagasaki on 9 August, 1945. In the early morning, at 1:30 a.m. of 6 August 1945, a United States Army weather observation plane took off from the Tinian air base in one of the Mariana Islands in the Pacific towards Japan. As the plane approached Hiroshima, at an altitude of about 10,000 metres, it sent a message to the B-29 "Enola Gay" loaded with an atomic bomb, which was following it, "fair weather, ready for air raid." The "Enola Gay" took off from Tinian Island at 2:45 a.m. together with two observation planes on both sides, and invaded Hiroshima from the northeast and dropped the atomic bomb at 8:15:17 a.m., (Tinian time 9:15:17 a.m.), at an altitude of 9,600 metres. Records on the time of explosion range from 8:15 to 8:18 a.m., depending on the source of information. However, according to the Hiroshima City, the official time of explosion was announced to have been 8:15 a.m.
    [Show full text]