Indirect energy transfer channel between fast ions via nuclear elastic scattering observed on the large helical device

An energy transfer phenomenon between energetic ions, which cannot be explained only considering the Coulomb scattering process, was observed on a large helical device (LHD). This phenomenon often occurs in fusion reactivity enhancement and fast-ion slowing-down process that can be observed as a delay in the decay time of the D(d,n)3He neutron generation rate. The transferred energy required to induce such a reactivity enhancement or delay in the fast-ion slowing-down time (neutron decay time) was examined based on the Boltzmann−Fokker−Planck analysis in which a discrete energy transfer process, called nuclear elastic scattering (NES), is included. It was shown that even though the cross section of the NES is smaller than that of the Coulomb scattering, enough knock-on population appears in the energetic region in ion distribution function to induce the observable NES effects; thus, enough energy is transferred from beam ions to fast component of bulk ion distribution function indirectly and the transferred energy per unit time via NES is comparable to the Coulomb scattering rate. This study analytically demonstrates that the observed phenomena on LHD can be explained smoothly by considering the alternative indirect energy transfer channel between energetic ions, which can be comparable with the one via Coulomb scattering

Thoracic wall muscle metastasis from pancreatic cancer

Abstract Skeletal muscle metastasis from pancreatic cancer is rare. We present a 72-year-old female patient with unresectable pancreatic tail cancer. Fifteen months after the introduction of the chemoradiotherapy, an 18-mm elastic hard tumor was found in her right chest wall and resected after confirmation of no other metastatic lesions. Postoperative pathological examination diagnosed it as a muscle metastasis from the pancreatic cancer, and the patient has since been continuing chemotherapy for 10 months. A review of the literature regarding skeletal muscle metastasis from pancreatic cancer is also presented

Cystic gastric metastasis from pancreatic cancer

Abstract Gastrointestinal tract metastasis from pancreatic cancer is quite rare. We present the case of a 58-year-old male patient who underwent distal pancreatectomy for pancreatic body cancer 5 years prior. Four years after the initial operation, a 15-mm cystic submucosal tumor was found in the antrum of the stomach. Because the tumor had grown to 25 mm and the level of carcinoembryonic antigen in the cystic fluid derived by ultrasound-guided fine-needle aspiration biopsy was high, partial resection of the stomach was performed 5 years after the distal pancreatectomy. Pathological diagnosis was gastric metastasis of pancreatic cancer. The patient has been alive without recurrence for 13 months after the resection of the cystic tumor. We are not aware of any similar cases of cystic gastric metastasis from pancreatic cancer published in the English literature

A long-term survivor of hilar cholangiocarcinoma with resection of recurrent peritoneal dissemination after R0 surgery: a case report

Abstract Background Although hilar cholangiocarcinoma (HCCA) has a very poor prognosis, there are cases in which long-term survival is rarely obtained by multidisciplinary treatment. Case presentation A 61-year-old man diagnosed with HCCA was referred to our hospital. We performed an extended left hemi-hepatectomy and caudate lobectomy with extrahepatic bile duct resection. The tumor stage was T2aN0M0, stage II, based on the TNM classification, seventh edition. R0 resection was successfully performed. Adjuvant chemotherapy was not administered. After 38 months, computed tomography revealed peritoneal dissemination. The patient received chemotherapy with tegafur-gimeracil-oteracil-potassium (S-1) and gemcitabine. The peritoneal dissemination was successfully controlled for more than 50 months. During the treatment, levels of CEA and CA19-9 kept rising slowly, which was followed by bowel obstruction due to peritoneal dissemination of HCCA. The patient underwent resection of transverse colon with tumor nodules, and the tumor was pathologically diagnosed as metastasis of HCCA. Tumor markers decreased to normal levels, and the patient has been free from tumor relapse for 6 months. Conclusions We here report a rare case of HCCA patient with recurrent peritoneal dissemination 3 years after R0 surgery which was sensitive to chemotherapy. The patient successfully received resection of peritoneal dissemination 50 months after the induction of chemotherapy and survived for 10 years

Carcinosarcoma of Vater’s papilla: case report of a rare neoplasm and review of the literature

Abstract Background Carcinosarcoma is a rare tumor that includes both carcinoma and sarcoma components. It develops commonly in the female reproductive tract, most often in the uterus. However, as there are a small number of similar cases in the English literature, we would like to present a rare case of a carcinosarcoma in Vater’s papilla. Case presentation A 76-year-old female patient was preoperatively diagnosed with a papillary adenocarcinoma in Vater’s papilla by endoscopic biopsy. The patient underwent subtotal stomach-preserving pancreaticoduodenectomy, and postoperative pathological examination diagnosed the carcinosarcoma. The patient received adjuvant chemotherapy with gemcitabine, but multiple liver metastases were found 3 months after the operation. Though chemotherapy with gemcitabine and cisplatin was introduced, she died owing to tumor progression 7 months after the operation. Conclusion Because carcinosarcoma of Vater’s papilla is a rare disease, a suitable treatment strategy has been unclear. We also present a review of the English literature regarding carcinosarcoma of Vater’s papilla

Experiences of Teasing and Bullying in Children Who Stutter

Purpose: This study explores the experiences of children who stutter (CWS) in terms of others imitating or questioning them, or laughing at their speech patterns. / Methods: Participants were 120 CWS, aged 3-12 years, who were patients at our hospital. Each child was asked the following three questions: Has anyone asked you why you speak in that way? (questioned); has anyone imitated the way you speak? (imitated); and has anyone laughed at your speech? (laughed). We also asked if the CWS felt unhappy or happy about these responses. / Results: The total proportion of children who were questioned, imitated, and laughed at was 66.6%. Most of the CWS in the study over 4-years-old felt unhappy with any of these responses to stuttering. / Conclusions: We found that even at age 4, CWS remembered non-friendly exchanges with their peers. It is important to take action against teasing and bullying through asking CWS about their experiences of being questioned, imitated, or laughed at

Evaluation of Vocal Fold Motion During Blocks in Adults Who Stutter

Background: Stuttering is a speech disorder; the primary symptom in adults who stutter (AWS) is blocks, which halt both speech and breathing. This study aimed to evaluate vocal fold motion during blocks in AWS, in order to better understand this condition. / Methods: We used data obtained through flexible fiberoptic endoscopy and measurements of airflow and voice obtained from speech phonogram waveforms for 58 blocks in 12 AWS who were asked to read a set text for measurements. We compared the number of blocks with glottal closure and glottal opening during stuttering. / Results: In most AWS, blocks were accompanied by both glottal closure and glottal opening. The proportions of blocks with glottal closure and glottal opening were 46.6% and 53.4%, respectively. Thus, vocal fold positions during stuttering blocks varied among individuals. / Conclusion: Our study shows that stuttering with cessation of voice can occur both when vocal fold is open and when it is closed