Clinical backgrounds and outcomes of patients with Barrett's esophageal adenocarcinoma treated via endoscopic submucosal dissection in Kyushu, Japan: A retrospective multicenter cohort study

Objectives Most esophageal cancers in Japan are squamous cell carcinomas; however, there has been some concern regarding a recent increase in Barrett's esophageal adenocarcinoma (BEA). This study aimed to clarify the clinical characteristics and outcomes of patients treated via endoscopic submucosal dissection (ESD) in Kyushu, including changes over time. Methods This multicenter, retrospective, observational study was conducted among 21 institutes situated in Kyushu. Data from patients who underwent ESD for BEA or esophageal squamous cell carcinoma between January 2010 and December 2023 were extracted from the pathology database and reviewed. Results The total number of esophageal ESD cases increased from 2299 over the first 7 years to 4009 over the second seven. The incidence of BEA increased from 3.6% (86/2299) over the earlier period to 4.7% (197/4009; p = 0.034) over the latter. We analyzed data from 283 patients (287 lesions). Smaller tumor-sized lesions were detected over the latter period (14.2 ± 11.6 vs. 11.2 ± 9.5 cm2, p = 0.022), significantly reducing treatment times (122.1 ± 81.2 vs. 93.2 ± 53.3 min p < 0.001). The procedure was safe, with low incidence rates, over both the earlier and later periods (respectively), of perforation (0% vs. 1.0%), delayed bleeding (1.2% vs. 2.0%), and pneumonia (4.7% vs. 4.6%). Conclusion The proportion of esophageal ESD procedures to treat BEA has increased in Japan's Kyushu region. This procedure has a comparable safety profile to similar ESD procedures used to treat other conditions

Emphysematous rumenitis in a Japanese black calf caused by Clostridium perfringens with secondary Balantidium coli infection

A 4-month-old Japanese black calf exhibited anorexia and respiratory distress. Necropsy revealed a spongiform appearance of the rumen wall and histologically diagnosed as emphysematous rumenitis. The ruminal mucosa exhibited characteristic lesions of chemical rumenitis, so ruminal acidosis is suspected. Gram-positive bacilli were discernible on the degenerated ruminal mucosal surface and reacted with Clostridium species antibodies. Anaerobic cultures yielded Clostridium perfringens (C. perfringens), identified by multiplex polymerase chain reaction (PCR) as C. perfringens type A. The lumen and submucosa of the rumen showed a large ciliated trophozoite confirmed by PCR as Balantidium coli (B. coli). These findings suggest that ruminal acidosis leads to dysbiosis and allows C. perfringens type A to grow, causing emphysematous rumenitis and facilitating secondary B. coli infection

PDD 構造を有するＸ線 SOI-CMOS 検出器の開発

宮崎大学博士（工学）doctoral thesi

Ophthalmic Artery Feeders in Meningioma Reduce the Effectiveness of Transarterial Embolization With n-Butyl Cyanoacrylate

Background N-butyl cyanoacrylate (n-BCA) is often used for preoperative transarterial embolization (TAE) of meningiomas. However, factors affecting the embolization effect with n-BCA remain unclear. This study aimed to clarify the factors associated with the embolization rate after TAE using n-BCA in meningioma, from the aspect of feeder architecture. Methods We retrospectively analyzed 62 patients with meningioma who underwent preoperative TAE with n-BCA between 2016 and 2021. Patient variables, including characteristics, intraoperative findings, and outcomes, were collected. Feeder architecture was classified into 7 groups: 1) internal maxillary artery, 2) occipital artery, 3) ascending pharyngeal artery, 4) posterior meningeal artery, 5) infraclinoidal internal carotid artery, 6) ophthalmic artery (OphA), and 7) pial feeder group, based on preoperative angiography. We set primary outcome as the embolization rate, representing the reduction rate of the gadolinium-enhanced lesion volume observed on contrast-enhanced magnetic resonance imaging. Angiographic findings following n-BCA injection were classified as feeder occlusion or intratumoral embolization. We analyzed the factors associated with the embolization rate. Results The OphA feeder group showed a decrease in the embolization rate (P = 0.008). The number of feeder groups with intratumoral embolization showed a robust positive correlation (r = 0.557). The OphA feeder group showed an increase in the number of feeder groups (P < 0.001) and larger tumor volume (P = 0.005). Conclusions The OphA feeder group was associated with a lower embolization rate. Our study suggested that the vascular architecture in meningioma affected the efficacy of TAE with n-BCA

Allogeneic Hematopoietic Stem Cell Transplantation for Older Patients With Adult T-Cell Leukemia/Lymphoma: A Nationwide Retrospective Study

Adult T-cell leukemia/lymphoma (ATL) is a peripheral T-cell lymphoma with a dismal prognosis. Although allogeneic hematopoietic stem cell transplantation (allo-HSCT) remains the only potentially curative treatment, its application in older patients is limited by treatment-related toxicity. Given the aging ATL population and the emergence of novel therapeutic agents, the role of allo-HSCT in elderly patients warrants reevaluation. We retrospectively analyzed 619 patients aged ≥60 years who underwent first allo-HSCT between 2010 and 2017. Patients were stratified into Group 1 (60-64 years, n = 385) and Group 2 (≥65 years, n = 234). The 3-year overall survival (OS) rate was significantly lower in Group 2 compared with Group 1 (23.5% vs. 32.8%, p < 0.001). Among patients transplanted in complete remission (CR), OS was lower in Group 2 than in Group 1 (32.2% vs. 40.2%), although this difference did not reach statistical significance (p = 0.091). In contrast, among non-CR patients, OS was significantly lower in Group 2 (17.3% vs. 26.5%, p = 0.007). Multivariable analysis identified age ≥65 years, HCT-CI ≥4, non-CR status, cord blood transplantation, and female-to-male donor-recipient mismatch as adverse prognostic factors. Notably, patients aged ≥70 years (n = 26) experienced particularly poor outcomes, with a 3-year OS of 11.5% and significantly higher non-relapse mortality, suggesting limited benefit of allo-HSCT in this subgroup. In summary, allo-HSCT is feasible for selected ATL patients aged ≥65 years, particularly those in CR. However, outcomes are substantially worse in older patients not in remission. The extremely poor prognosis among patients aged ≥70 years highlights the need for cautious decision-making and consideration of non-transplant alternatives in this population. These findings underscore the importance of individualized treatment planning for elderly ATL patients

Regional Development of Traditional Sea Food Dishes in Japan, Part8 ー Dishes Listed in ‘The Series of Japanese Foods’ by the Rural Culture Association of Japan（Nousangyosonbunkakyoukai）ー

departmental bulletin pape

Study on the Process of Behavioral Change of Local Residents in Preparation for a Large-Scale Eruption of Sakurajima

We have been working for about three years on collaborative activities between experts and residents aimed at enhancing disaster preparedness against the risk event of the massive fall of pumice and volcanic ash due to a large-scale eruption in Kagoshima City, which is expected to occur within the next few decades due to a major eruption of Sakurajima Volcano. In this study, we identified the behavioral changes of residents observed through collaborative activities undertaken by experts and residents over a long period, using ethnography and individual interviews, and discussed the mechanisms of these changes based on the framework of the theory of planned behavior. As a result, while the specific behaviors arising from collaborative activities were diverse, the behavioral changes could be broadly categorized into two types: “preparing” behaviors that are self-contained and “speaking” behaviors that involve engaging with others. Furthermore, among the survey participants who experienced changes in both “preparing” and “speaking” behaviors, a higher proportion reflected on experiences that stirred emotions such as “gratitude” and “anxiety” as turning points

Perls' Prussian blue staining and chemistry of Prussian blue and Turnbull blue

Perls’ Prussian blue staining or reaction is used to detect haemosiderin, which is stored or sequestrated non-haeme iron. Methodologically, the iron in haemosiderin is released as Fe3+ (FeIII) by hydrochloric acid (HCl), and FeIII reacts with potassium ferrocyanide (K4[FeII(CN)6]) to form Prussian blue. Iron released from ferritin, another stored non-haeme iron, is too scarce to be detected. Haeme iron, including haemoglobin and cytochromes, is not released by HCl. Thus, haemosiderin can easily be detected under the microscope as distinct blue deposits with minimal background staining. The chemistry of cyanide-bridged iron complexes, including Prussian blue and Turnbull blue, is the basis for understanding Perls' staining. Prussian blue is a cubic lattice with FeII or FeIII ions alternately aligned at the corners to give FeII–CN–FeIII formations at the edges. Physicochemically, Prussian blue is soluble in water (dispersible as a colloid) or insoluble depending on how it is formed. As with Perls' staining, Prussian blue is expected to take a soluble form because of excess K4[FeII(CN)6] compared to Fe3+ released from tissues. Notably, Prussian blue used in Perls' staining does not in fact dissipate into the staining solution but remains on the tissue, rendering this a practical method for histological detection of haemosiderin and also exogenous iron of forensic significance. However, further examinations of its mechanisms are needed to evaluate the applicability of this method on various forensics cases