BACKGROUNDEndoscopic papillectomy (EP) for benign ampullary neoplasms could be a less-invasive alternative to pancreatoduodenectomy (PD). There are some problems and limitations with EP. The post-EP resection margins of ampullary tumors are often positive or uncertain because of the burning effect of EP. The clinical outcomes of resected margin positive or uncertain cases after EP remain unknown.AIMTo investigate the clinical outcomes of resected margin positive or uncertain cases after EP.METHODSBetween January 2007 and October 2018, all patients with ampullary tumors who underwent EP at Kobe University Hospital were included in this study. The indications for EP were as follows: adenoma, as determined by preoperative endoscopic biopsy, without bile/pancreatic duct extension, according to endoscopic ultrasound or intraductal ultrasound. The clinical outcomes of resected margin positive or uncertain cases after EP were retrospectively investigated.RESULTSOf the 45 patients, 29 were male, and 16 were female. The mean age of the patients was 65 years old. Forty-one patients (89.5%) underwent en bloc resection, and 4 patients (10.5%) underwent piecemeal resection. After EP, 33 tumors were histopathologically diagnosed as adenoma, and 12 were diagnosed as adenocarcinoma. The resected margins were positive or uncertain in 24 patients (53.3%). Of these cases, 15 and 9 were diagnosed as adenoma and adenocarcinoma, respectively. Follow-up observation was selected for all adenomas and 5 adenocarcinomas. In the remaining 4 adenocarcinoma cases, additional PD was performed. Additional PD was performed in 4 cases, and residual carcinoma was found after the additional PD in 1 of these cases. In the follow-up period, local tumor recurrence was detected in 3 cases. Two of these cases involved primary EP-diagnosed adenoma. The recurrent tumors were also adenomas detected by biopsy. The remaining case involved primary EP-diagnosed adenocarcinoma. The recurrent tumor was also an adenocarcinoma. All of the recurrent tumors were successfully treated with argon plasma coagulation (APC). There was no local or lymph node recurrence after the APC. The post-APC follow-up periods lasted for 57.1 to 133.8 mo. No ampullary tumor-related deaths occurred in all patients.CONCLUSIONResected margin positive or uncertain cases after EP could be managed by endoscopic treatment including APC, even in cases of adenocarcinoma. EP could become an effective less-invasive first-line treatment for early stage ampullary tumors.

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Cutaneous angiosarcomas is a rare cancer with poor prognoses. The common radiotherapy techniques that have been reported so far are two pairs of lateral X-ray and electron fields. However, it is quite difficult to irradiate scalp angiosarcomas (SAs) homogeneously with this technique. In this study, safety, effectiveness, and risk factors were assessed for localized SAs ≥ 5 cm treated with intensity-modulated radiotherapy (IMRT) or volumetric modulated arc therapy (VMAT) with boluses. Sixty-eight angiosarcoma patients who had received radiotherapy in our institution between January 2007 and November 2020 were retrieved from our radiotherapy database. Of these patients, 27 localized SA patients were included in the retrospective analysis. The 2-year overall survival, local progression-free rate, and distant metastases-free survival were 41.8%, 48.4%, and 33.1%. All the patients experienced acute radiation dermatitis ≥ grade 2, with18 (66.7%) ≥ grade 3. No nodule lesion was a significant unfavorable predictive factor of acute radiation dermatitis ≥ grade 3. Tumor bleeding at the initiation of radiotherapy and tumor invasion to the face were significant predictive factors of overall survival, and tumor bleeding at the initiation of radiotherapy was also a significant predictive factor of local progression-free rate.

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Fe–Co and Fe–Co–Al–O films were prepared by rf magnetron sputtering in an Ar-gas atmosphere. The coercivity (Hc) of the Fe–Co films was greatly decreased by a small amount of Al2O3 addition. However, a film thickness of more than 500 nm is necessary to obtain minimum the Hch (Hc in the hard-axis direction) of 5 Oe. Hch was greatly decreased by using a Ni–Fe underlayer of 0.5–12 nm, and was less than 1 Oe with film thicknesses ranging from 50 to 600 nm for Fe–Co–Al–O films. An amorphous Co–Zr–Nb soft magnetic underlayer was also examined to investigate influence of underlayer crystal structure. A Hch less than 1 Oe was realized for the samples with Co–Zr–Nb underlayer thickness of about 2 nm. Amorphous underlayer films were also effective in improving the soft magnetic properties of Fe–Co–Al–O films. It is finally concluded that combination of a small amount of Al2O3 addition and a soft magnetic underlayer film is essential to obtain small Hch with high saturation magnetic flux density of 2.4 T in a wide range of film thicknesses.

A new design for a high writing-sensitivity single-pole head is proposed. The head is driven with regular pancake structure dual coils, which sandwiches the main-pole. The outer parts of both coils are exposed to the air bearing surface. These coils can generate a cusp field with bifilar connection. A high recording sensitivity of this new head has been clarified by the fact that a small magneto-motive force of less than 0.1 AT 0 P can saturate a medium with a high-coercivity of 3.5 kOe.Index Terms-Inductive head, perpendicular magnetic recording, single-pole head.

BackgroundCronkhite-Canada syndrome (CCS) is a rare non-inherited disorder, characterized by gastrointestinal polyposis and ectodermal changes. The pathophysiology remains unclear. Treatment with corticosteroids is considered the mainstay treatment because of its high efficacy. However, some patients have steroid-resistant CCS. The therapeutic strategy for steroid-resistant CCS is not yet established. We report two cases with steroid-resistant CCS that were effectively treated with cyclosporine (CyA). We evaluated the therapeutic strategy for steroid-resistant CCS based on reviews of previous reports.Case presentationOur patients with CCS were first treated with prednisolone. No clinical response was noted, and treatment with CyA was initiated. After beginning CyA treatment, both clinical symptoms and polyposis markedly improved. Up to the present, 55 cases of CCS treated with corticosteroids and their response were reported. Out of the 57 patients, including our 2 cases, 9 (16 %) did not respond clinically to corticosteroids. In 7 of the 9 steroid-resistant cases, the prognosis after corticosteroids treatment was described. In 5 of the 7 steroid-resistant cases, immunosuppressive treatments induced remission. In 4 of these 5 cases, moreover, the key drug of treatments was calcineurin inhibitor.ConclusionsTreatment with calcineurin inhibitor, such as CyA, could be a potential option for steroid-resistant CCS.Electronic supplementary materialThe online version of this article (doi:10.1186/s12876-016-0541-1) contains supplementary material, which is available to authorized users.