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Abstract Aim There is limited evidence regarding the feasibility of living‐donor liver transplantation (LDLT) for patients aged over 70. The aims of this study were to assess postoperative outcomes in elderly recipients and to ascertain the potential feasibility and acceptability of LDLT. Methods Data were collected from 762 recipients, including 26 in the elderly group (aged ≥70) and 736 in the younger group (aged

HSC 120505.09-000027.9 (J1205–0000) is one of the highest redshift ( z = 6.72) dust-reddened quasars (red quasars) known to date. We present an improved analysis of Atacama Large Millimeter/submillimeter Array data of the [C ii ] 158 μ m line and the underlying rest-frame far-infrared (FIR) continuum emission, previously reported in T. Izumi et al. (2021b), toward J1205–0000. Red quasars are thought to be a transitional phase from an obscured starburst to a luminous blue quasar, in some cases associated with massive outflows driven by the active galactic nucleus (AGN). J1205–0000 has a high FIR luminosity, L _FIR = 2.5 × 10 ^12 L _⊙ and a total IR luminosity of L _TIR = 3.5 × 10 ^12 L _⊙ , corresponding to a star formation rate of ∼528 M _⊙ yr ^−1 . With the [C ii ]-based dynamical mass of ∼1 × 10 ^11 M _⊙ , we conclude that J1205–0000 is hosted by a starburst galaxy. In contradiction to T. Izumi et al., our improved analysis shows no hint of a broad component in the [C ii ] line spectrum. Thus there is no evidence for a host galaxy-scale fast [C ii ] outflow, despite the fact that J1205–0000 has fast nuclear ionized outflows seen in the rest-frame UV. We explore several scenarios for this discrepancy (e.g., the early phase of AGN feedback, reliability of the [C ii ] line as a tracer of outflows), and we claim that it is still too early to conclude that there is no significant negative AGN feedback on star formation in this red quasar.

We present a 19.7–214 μ m imaging atlas of local (4–181 Mpc; median 43 Mpc) active galactic nuclei (AGN) observed with FORCAST and HAWC+ on board the SOFIA telescope with angular resolutions ~3 ″ –20 ″ . This atlas comprises 22 Seyferts (17 Type 2 and five Type 1) with a total of 69 images, 41 of which have not been previously published. The AGN span a range of luminosities of ${\mathrm{log}}_{10}({L}_{\mathrm{bol}}[\mathrm{erg}\,{{\rm{s}}}^{-1}])=[42,46]$ with a median of ${{\rm{log}}}_{10}({L}_{{\rm{bol}}}[{\rm{erg}}{{\rm{s}}}^{-1}])=44.1\pm 1.0$ . We provide the total fluxes of our sample using aperture photometry for point-source objects and a 2D Gaussian fitting for objects with extended host galaxy emission, which was used to estimate the unresolved nuclear component. Most galaxies in our sample are pointlike sources; however, four sources (Centaurus A, Circinus, NGC 1068, and NGC 4388) show extended emission in all wavelengths. The 30–40 μ m extended emission in NGC 4388 is coincident with the narrow-line region at PA ~ 50°, while the dusty extension at longer wavelengths arises from the host galaxy at PA ~ 90°. Our new observations allow us to construct the best-sampled parsec-scales (spectral energy distributions, SEDs) available between 30 and 500 μ m for a sample of nearby AGN. We estimate that the average peak wavelength of the nuclear SEDs is ~40 μ m in νF _ν , which we associate with an unresolved extended dusty region heated by the AGN.

We present an analysis of near-infrared photometry of 59 quasars at 5.83 0.1. We identified five red quasar candidates. The low fraction (8%) of red quasars in our sample suggests that the low luminosity of the SHELLQs quasars is mostly due to the nature of the quasars, not due to extinction by dust. The candidates tend to be found on the low-luminosity side (measured with the rest-ultraviolet absolute magnitude at 1450 Å of M _1450 > −24 mag) of the sample. This luminosity trend may support the idea that red quasars represent an evolutionary stage preceding unobscured quasars, often invoked in the merger-driven galaxy evolution scenario.

Abstract Background Liver transplantation is the definitive therapy for patients with decompensated cirrhosis. Marfan syndrome is a systemic inheritable connective tissue disease associated with fibrillin-1 gene mutations, which cause abnormalities in connective tissue. Vascular changes due to Marfan syndrome occur mostly in the main vessels due to the high amount of connective tissue within the vessel wall and the high pressure and blood flow to which they are exposed. The incidence of changes in visceral arteries is about 0.42% and usually presents with cystic medial necrosis. This report is the first deceased-donor liver transplantation with a donor with Marfan syndrome with a history of abdominal surgery. Case presentation A patient in his 50s underwent liver transplantation for decompensated alcoholic cirrhosis. The donor, a 50s male with Marfan syndrome, was diagnosed with brain-death due to a cerebral hemorrhage caused by a cerebral aneurysm. The donor’s clinical presentation as Marfan syndrome was aortic dissection, with multiple surgical procedures performed from the aortic root to the abdominal aorta. An intraoperative biopsy of the hepatic artery showed no abnormality, so this organ was considered appropriate. The surgery was completed without any problems of the arterial anastomosis. The patient’s postoperative course was uneventful, and he was transferred to a hospital for recuperation on the 18th postoperative day. One year after the surgery, the patient is still alive without any complications from the transplantation or arterial problems. Conclusions Even if the patient had a history of surgery for vascular anomalies extending to the abdominal aorta due to Marfan syndrome, the patient can be a donor for liver transplantation under appropriate judgment, including intraoperative biopsy.

Abstract Background and Aim Many recent studies have shown a relationship between various systemic diseases and the gut microbiota (GM), with the gut–liver axis receiving particular attention. In contrast, no report has comprehensively shown the effects of GM on the pathophysiology of patients undergoing living donor liver transplantation (LDLT). Method We enrolled 16 recipients who underwent LDLT for liver cirrhosis, and 17 donors constituted the reference group. We examined the differences in GM between recipients and donors. We also examined the relationships between GM, short‐chain fatty acids, and portal vein pressure (PVP) in recipients. Results There was no significant difference in alpha‐diversity between the recipients and donors, but there was variation in beta‐diversity among the recipients. The abundance of the phylum Bacteroidetes was significantly higher in recipients than in donors (P = 0.016), and it was positively correlated with PVP (r = 0.511, P = 0.043). Propionic acid, which is a component of short‐chain fatty acids, was positively correlated with PVP (r = 0.544, P = 0.0295), the phylum Bacteroidetes (r = 0.677, P = 0.004), and total bilirubin concentration (r = 0.501, P = 0.048). Propionic acid was negatively correlated with serum albumin concentration (r = −0.482, P = 0.043). Conclusion Our findings suggest relationships between fecal Bacteroidetes levels, propionic acid concentrations, and PVP in patients with liver cirrhosis undergoing LDLT.

We report the discovery of two quasars at a redshift of z = 6.05 in the process of merging. They were serendipitously discovered from the deep multiband imaging data collected by the Hyper Suprime-Cam (HSC) Subaru Strategic Program survey. The quasars, HSC J121503.42−014858.7 (C1) and HSC J121503.55−014859.3 (C2), both have luminous (>10 ^43 erg s ^−1 ) Ly α emission with a clear broad component (full width at half maximum >1000 km s ^−1 ). The rest-frame ultraviolet (UV) absolute magnitudes are M _1450 = − 23.106 ± 0.017 (C1) and −22.662 ± 0.024 (C2). Our crude estimates of the black hole masses provide $\mathrm{log}({M}_{\mathrm{BH}}/{M}_{\odot })=8.1\pm 0.3$ in both sources. The two quasars are separated by 12 kpc in projected proper distance, bridged by a structure in the rest-UV light suggesting that they are undergoing a merger. This pair is one of the most distant merging quasars reported to date, providing crucial insight into galaxy and black hole build-up in the hierarchical structure formation scenario. A companion paper will present the gas and dust properties captured by Atacama Large Millimeter/submillimeter Array observations, which provide additional evidence for and detailed measurements of the merger, and also demonstrate that the two sources are not gravitationally lensed images of a single quasar.

We analyze JWST Mid-Infrared Instrument/Medium Resolution Spectrograph integral field unit observations of three Seyferts from the Galactic Activity, Torus, and Outflow Survey (GATOS) and showcase the intriguing polycyclic aromatic hydrocarbon (PAH) and emission-line characteristics in regions of ∼500 pc scales over or around their active galactic nuclei (AGN). Combing the measurements and model predictions, we find that the central regions containing a high fraction of neutral PAHs with small sizes, e.g., those in ESO137-G034, are in highly heated environments, due to collisional shock heating, with hard and moderately intense radiation fields. Such environments are proposed to result in inhibited growth or preferential erosion of PAHs, decreasing their average size and overall abundance. We additionally find that the central regions containing a high fraction of ionized PAHs with large sizes, e.g., those in MCG-05-23-016, are likely experiencing severe photoionization because of the radiative effects from the radiative shock precursor besides the AGN. The severe photoionization can contribute to the ionization and further destruction of PAHs. Overall, different Seyferts, even different regions in the same galaxy, e.g., those in NGC 3081, can contain PAH populations of different properties. Specifically, Seyferts that exhibit similar PAH characteristics to ESO137-G034 and MCG-05-23-016 also tend to have similar emission-line properties to them, suggesting that the explanations for PAH characteristics of ESO137-G034 and MCG-05-23-016 may also apply generally. These results have promising application in the era of JWST, especially in diagnosing different (i.e., radiative and kinetic) AGN feedback modes.

Abstract Background This study aimed to determine which running pattern of the left gastric vein (LGV) is most frequently ligated in subtotal stomach-preserving pancreatoduodenectomy (SSPPD) and how LGV ligation affects delayed gastric emptying (DGE) after SSPPD. Methods We retrospectively analysed 105 patients who underwent SSPPD between January 2016 and September 2021. We classified the running pattern of LGV as follows: type 1 runs dorsal to the common hepatic artery (CHA) or splenic artery (SpA) to join the portal vein (PV), type 2 runs dorsal to the CHA or SpA and joins the splenic vein, type 3 runs ventral to the CHA or SpA and joins the PV, and type 4 runs ventral to the CHA or SpA and joins the SpV. Univariate and multivariate analyses were used to identify differences between patients with and without DGE after SSPPD. Results Type 1 LGV running pattern was observed in 47 cases (44.8%), type 2 in 23 (21.9%), type 3 in 12 (11.4%), and type 4 in 23 (21.9%). The ligation rate was significantly higher in type 3 (75.0%) LGVs (p

The physical quantity that directly controls the feedback of active galactic nuclei (AGNs) in elliptical galaxies remains to be determined. The discovery of molecular gas around the AGNs suggests that the gas is fueling the AGNs. Therefore, we analyze Atacama Large Millimeter/submillimeter Array data for the CO line ( J = 1–0, 2–1, 3–2) emission and estimate the mass of molecular gas within 500 pc of the center of 12 noncentral elliptical galaxies (NCEGs) and 10 of the brightest cluster galaxies. We find that the mass ( M _mol ∼ 10 ^5 –10 ^9 M _☉ ) is correlated with the jet power of their AGNs, which is represented by ${P}_{\mathrm{cav}}\approx 4.1\times {10}^{42}{({M}_{\mathrm{mol}}/{10}^{7}\ {M}_{\odot })}^{1.3}\mathrm{erg}\ {{\rm{s}}}^{-1}$ , although NCEGs alone do not show the correlation. We also find that M _mol is correlated with the AGN continuum luminosities at ∼1.4 GHz ( L _1.4 ) and ∼100–300 GHz ( L _con ). Since P _cav reflects galactic-scale, long-term AGN activity, while the continuum luminosities reflect local (≲500 pc), short-term AGN activity, our results suggest that AGN activity depends on the amount of gas, regardless of its timescale. On the other hand, we cannot find a clear correlation between the mass of the black holes in the AGNs ( M _BH ) and P _cav . This suggests that M _mol , rather than M _BH , is the main factor controlling AGN activity. We confirm that the origin of the continuum emission from the AGNs at ∼1.4–300 GHz is mostly synchrotron radiation.

Recent submillimeter observations have revealed signs of parsec-scale molecular inflow and atomic outflow in the nearest Seyfert 2 galaxy, the Circinus galaxy. To verify the gas kinematics suggested by these observations, we performed molecular and atomic line transfer calculations based on a physics-based 3D radiation-hydrodynamic model, which has been compared with multiwavelength observations in this paper series. The major-axis position–velocity diagram (PVD) of CO(3–2) reproduces the observed faint emission at the systemic velocity, and our calculations confirm that this component originates from failed winds falling back to the disk plane. The minor-axis PVD of [C i ]( ^3 P _1 – ^3 P _0 ), when created using only the gas with positive radial velocities, presents a sign of blueshifted and redshifted offset peaks similar to those in the observation, suggesting that the observed peaks indeed originate from the outflow, but that the model may lack outflows as strong as those in the Circinus galaxy. Similar to the observed HCN(3–2), the similar dense-gas tracer HCO ^+ (3–2) can exhibit nuclear spectra with inverse P-Cygni profiles with ∼0.5 pc beams, but the line shape is azimuthally dependent. The corresponding continuum absorbers are inflowing clumps at 5–10 pc from the center. To detect significant absorption with a high probability, the inclination must be fairly edge-on (≳85°), and the beam size must be small (≲1 pc). These results suggest that HCN or HCO ^+ and [C i ] lines are effective for observing parsec-scale inflows and outflows, respectively.

The evolution of the quasar luminosity function (QLF) is fundamental to understanding the cosmic evolution of black holes (BHs) through their accretion phases. In the era of the James Webb Space Telescope (JWST), Euclid, and Nancy Grace Roman Space Telescope, their unprecedented detection sensitivity and wide survey area can unveil the low-luminosity quasar and low-mass BH population, and provide new insights into quasar host galaxies. We present a theoretical model describing BH growth from initial seeding at z ≳ 20 to ∼ 4, incorporating the duration of accretion episodes, the distribution of Eddington ratios, and the mass dependency of BH accretion rates. By constraining the model parameters with the observed QLFs at 4 ≤ z ≤ 6 across a wide UV luminosity range, we find that the high-redshift BH population grows rapidly at z ≳ 6, and decelerates the pace in subsequent epochs. Toward lower redshifts ( z < 6), mass-dependent accretion inhibits the growth of high-mass BHs with M _• > 10 ^8 M _⊙ , leading to mass saturation at M _• ≳ 10 ^10 M _⊙ . We predict the BH mass function down to M _• ∼ 10 ^6 M _⊙ for both unobscured and obscured quasar populations at 4 ≤ z ≤ 11, offering a benchmark for future observational tests. Our model accounts for the presence of both bright and faint quasars at z > 4, including those discovered by JWST. Furthermore, our findings suggest two distinct pathways for the early assembly of the BH–galaxy mass correlation: the population with a BH-to-stellar-mass ratio near the local value of M _• / M _⋆ ≃ 5 × 10 ^−3 maintains proximity to the relation via moderate growth, while the population that begins to grow above the local relation becomes as overmassive as M _• / M _⋆ ∼ 0.01–0.1 by z ∼ 6 via rapid mass accretion.

We present Atacama Large Millimeter/submillimeter Array observations of the [C ii ] 158 μ m line and the underlying continuum emission of TN J0924−2201, which is one of the most distant known radio galaxies at z > 5. The [C ii ] line and 1 mm continuum emission are detected at the host galaxy. The systemic redshift derived from the [C ii ] line is z _[C _II _] = 5.1736 ± 0.0002, indicating that the Ly α line is redshifted by a velocity of 1035 ± 10 km s ^−1 , marking the largest velocity offset between the [C ii ] and Ly α lines recorded at z > 5 to date. In the central region of the host galaxy, we identify a redshifted substructure of [C ii ] with a velocity of 702 ± 17 km s ^−1 , which is close to the C iv line with a velocity of 500 ± 10 km s ^−1 . The position and the velocity offsets align with a model of an outflowing shell structure, consistent with the large velocity offset of Ly α . The nondetection of [C ii ] and dust emission from the three CO(1–0)-detected companions indicates their different nature compared to dwarf galaxies, based on the photodissociation region model. Given their large velocity of ∼1500 km s ^−1 , outflowing molecular clouds induced by the active galactic nucleus are the most plausible interpretation, and they may exceed the escape velocity of a 10 ^13 M _⊙ halo. These results suggest that TN J0924−2201, with ongoing and fossil large-scale outflows, is in a distinctive phase of removing molecular gas from a central massive galaxy in an overdense region in the early Universe. A dusty H i absorber at the host galaxy is an alternative interpretation.

We present Atacama Large Millimeter/submillimeter Array [C ii ] 158 μ m line and underlying far-IR continuum emission observations (0.″57 × 0.″46 resolution) toward a quasar–quasar pair system recently discovered at z = 6.05. The quasar nuclei (C1 and C2) are faint ( M _1450 ≳ −23 mag), but we detect very bright [C ii ] emission bridging the 12 kpc between the two objects and extending beyond them (total luminosity L _[C _ii _] ≃ 6 × 10 ^9 L _⊙ ). The [C ii ]-based total star formation rate of the system is ∼550 M _⊙ yr ^−1 (the IR-based dust-obscured star formation is ∼100 M _⊙ yr ^−1 ), with a [C ii ]-based total gas mass of ∼10 ^11 M _⊙ . The dynamical masses of the two galaxies are large (∼9 × 10 ^10 M _⊙ for C1 and ∼5 × 10 ^10 M _⊙ for C2). There is a smooth velocity gradient in [C ii ], indicating that these quasars are a tidally interacting system. We identified a dynamically distinct, fast-[C ii ] component around C1: detailed inspection of the line spectrum there reveals the presence of a broad-wing component, which we interpret as the indication of fast outflows with a velocity of ∼600 km s ^−1 . The expected mass-loading factor of the outflows, after accounting for multiphase gas, is ≳2 − 3, which is intermediate between AGN-driven and starburst-driven outflows. Hydrodynamic simulations in the literature predict that this pair will evolve to a luminous ( M _1450 ≲ −26 mag), starbursting (≳1000 M _⊙ yr ^−1 ) quasar after coalescence, one of the most extreme populations in the early Universe.

Utilizing JWST MIRI/Medium Resolution Spectrograph integral field unit observations of the kiloparsec-scale central regions, we showcase the diversity of ionized gas distributions and kinematics in six nearby Seyfert galaxies included in the GATOS survey. Specifically, we present spatially resolved flux distribution and velocity field maps of six ionized emission lines covering a large range of ionization potentials (15.8–97.1 eV). Based on these maps, we showcase the evidence of ionized gas outflows in the six targets, and find some highly disturbed regions in NGC 5728, NGC 5506, and ESO137-G034. We propose active galactic nucleus (AGN)-driven radio jets plausibly play an important role in triggering these highly disturbed regions. With the outflow rates estimated based on [Ne V ] emission, we find the six targets tend to have ionized outflow rates converged to a narrower range than the previous finding. These results have an important implication for the outflow properties in AGN of comparable luminosity.

Abstract Background Gastric cancer rarely metastasizes to the gallbladder. Furthermore, there has never been a case report of simultaneous gallbladder metastasis from residual gastric cancer. Here, we report a case of synchronous gallbladder metastasis originating from a residual gastric cancer. Case presentation A 67-year-old man underwent a follow-up upper endoscopy 18 months after a partial gastrectomy for gastric cancer; an ulcerative lesion was found in the remnant stomach at the gastrojejunal anastomosis. A biopsy revealed gastric signet-ring cell carcinoma (SRCC). A full-body examination revealed no abnormalities other than gallstones in the gallbladder. With a diagnosis of residual gastric cancer (cT2N0M0 cStage I), the patient underwent open total gastrectomy and cholecystectomy. Macroscopic findings of the resected specimen revealed thickening of the gallbladder wall; however, no obvious neoplastic lesions were found on the mucosal surface of the gallbladder. The pathological findings showed that the SRCC had invaded the submucosa of the gastrojejunostomy site with a high degree of lymphatic invasion and lymph node metastases. SRCCs were also found in the lymphatic vessels of the gallbladder wall. These findings suggested the possibility of gallbladder metastasis through lymphatic vessels. The patient and his family members refused postoperative chemotherapy. Ten months after the operation, the patient experienced respiratory failure due to lymphangitis carcinomatosa and died. Conclusions At present, it is difficult to determine whether resection of the gallbladder contributes to an improved prognosis of gastric cancer patients. However, reports in such cases demonstrate that gallbladder metastasis could be a poor predictor of prognosis for gastric cancer.

We present the quasar luminosity function (LF) at z = 7, measured with 35 spectroscopically confirmed quasars at 6.55 < z < 7.15. The sample of 22 quasars from the Subaru High- z Exploration of Low-Luminosity Quasars (SHELLQs) project, combined with 13 brighter quasars in the literature, covers an unprecedentedly wide range of rest-frame ultraviolet magnitudes over −28 < M _1450 < −23. We found that the binned LF flattens significantly toward the faint end populated by the SHELLQs quasars. A maximum likelihood fit to a double power-law model has a break magnitude ${M}_{1450}^{* }=-{25.60}_{-0.30}^{+0.40}$ , a characteristic density ${{\rm{\Phi }}}^{* }={1.35}_{-0.30}^{+0.47}$ Gpc ^−3 mag ^−1 , and a bright-end slope $\beta =-{3.34}_{-0.57}^{+0.49}$ , when the faint-end slope is fixed to α = −1.2 as observed at z ≤ 6. The overall LF shape remains remarkably similar from z = 4 to 7, while the amplitude decreases substantially toward higher redshifts, with a clear indication of an accelerating decline at z ≥ 6. The estimated ionizing photon density, 10 ^48.2±0.1 s ^−1 Mpc ^−3 , is less than 1% of the critical rate to keep the intergalactic medium ionized at z = 7, and thus indicates that quasars are not a major contributor to cosmic reionization.

Abstract Background Intraductal papillary neoplasm of the bile duct (IPNB) is a subtype of biliary tumor. The 5-year survival rate of patients with IPNB who underwent curative resection is 81%. However, IPNB is known to often recur in other parts of the bile duct. Nevertheless, its mechanism remains poorly understood. Herein, we report the case of a patient with recurrent IPNB, which was considered to be attributed to intraductal dissemination in the common bile duct at 12 months after curative resection. We also made a review of the existing literature. Case presentation A 69-year-old man was referred to our hospital for the evaluation and dilation of an intrahepatic bile duct (IHBD) mass. Computed tomography (CT) findings confirmed a mass in the left hepatic duct. Left trisectionectomy, extrahepatic bile duct resection with biliary reconstruction, and regional lymph node dissection were performed. Intraoperative examination of the resection margin at the common bile duct and posterior segmental branch of the hepatic duct was negative for the presence of malignant cells. Histologically, the tumor showed intraductal papillary growth of the mucinous epithelium and was diagnosed as non-invasive IPNB. It had a papillary structure with atypical epithelial cells lined up along the neoplastic fibrovascular stalks. Immunohistochemically, this was as a gastric-type lesion. At 12 postoperative months, CT revealed a 1.5-cm mass in the lower remnant common bile duct. We performed subtotal stomach-preserving pancreaticoduodenectomy. The tumor exhibited papillary growth and was microscopically and immunohistochemically similar to the first tumor. At approximately 16 months after the patient’s second discharge, CT showed an abdominal mass at the superior mesenteric plexus, which was diagnosed as recurrent IPNB. Chemotherapy is ongoing, and the patient is still alive. In this case, as described in many previous reports, IPNB recurred below the primary lesion in the bile duct. Conclusion Based on our review of previous reports on IPNB recurrence, intraductal dissemination was considered one of the mechanisms underlying recurrence after multicentric development. Considering the high frequency and oncological conversion of recurrence in IPNB, regular follow-up examination is essential to achieve better prognosis in patients with recurrent IPNB.

Abstract Background Acute mediastinitis is a rare disease that rapidly progresses with a high mortality rate. Its most common cause is direct injury of the mediastinum, including iatrogenic causes such as cardiac surgery or upper endoscopy. Enzymatic mediastinitis is a rare complication of a pancreatic fistula caused by the inflammatory digestion of the parietal peritoneum spreading to the mediastinum. Here, we present two cases of enzymatic mediastinitis caused by total gastrectomy with splenectomy. One of them was successfully treated and cured after early diagnosis and transabdominal drainage. Case presentation Case 1 was that of a 60-year-old man (body mass index [BMI] 27) with a medical history of diabetes and hypertension who was diagnosed with advanced gastric cancer in the upper body of the stomach. A total gastrectomy with splenectomy was performed. The patient experienced acute respiratory failure 24 h after surgery. Pulmonary embolism was suspected, so a computed tomography (CT) scan was performed; however, no relevant causes were found. Although he was immediately intubated and treated with catecholamine, he died in the intensive care unit (ICU) 40 h after surgery. Post-mortem findings revealed retroperitonitis caused by a pancreatic fistula spreading towards the mediastinum, causing severe mediastinitis; a review of the CT scan revealed pneumomediastinum. We concluded that the cause of death was enzymatic mediastinitis due to post-gastrectomy pancreatic fistula. Case 2 involved a 61-year-old man (BMI 25) with a medical history of appendicitis who was diagnosed with advanced gastric cancer at the gastric angle between the lesser curvature and the pylorus, spreading to the upper body of the stomach. A total gastrectomy with splenectomy was also performed. The patient had a high fever 3 days after the surgery, and a CT scan revealed pneumomediastinum, indicating mediastinitis. As the inflammation was below the bronchial bifurcation, we chose a transabdominal approach for drainage. The patient was successfully treated and discharged. Conclusion Acute mediastinitis caused by gastrectomy is rare. The acknowledgment of abdominal surgery as a cause of mediastinitis is important. In treating mediastinitis caused by abdominal surgery, transabdominal drainage may be a minimally invasive yet effective method if the inflammation is mainly located below the bifurcation of the trachea.

Abstract Background Amoebiasis caused by the protozoan species Entamoeba histolytica rarely develops into fulminant amoebic colitis (FAC), but when it does, it shows an aggressive clinical course including colonic perforation, necrotizing colitis, and high mortality. Surgical treatment for FAC patients should be carried out urgently. However, even after surgery, the mortality rate can be 40–50%. Although FAC is one of the most unfavorable surgical diseases with a poor prognosis, there are a few reports on the perioperative diagnosis and management of FAC based on autopsy findings. We herein report the surgical case of a 64-year-old man who developed multiple colon necrosis and perforation due to FAC. A detailed autopsy revealed FAC as the cause of death. Additionally, we reviewed the existing literature on FAC patients who underwent surgery and followed their perioperative diagnosis and management. Case presentation A 64-year-old man presented with anorexia, diarrhea, and altered consciousness on arrival to our hospital. Computed tomography revealed a large mass in the upper right lobe of his lung, and the patient was admitted for close investigation. Bloody diarrhea, lower abdominal pain, and hypotension were observed soon after admission. Urgent abdominal contrast-enhanced computed tomography scan revealed extensive intestinal ischemia, intestinal pneumatosis, and free intra-abdominal gas. The preoperative diagnosis was bowel necrosis and perforation with intussusception of the small intestinal tumor. Emergency subtotal colectomy and enterectomy were performed soon after the contrast-enhanced computed tomography. He was taken to an intensive care unit after surgery. However, he could not recover from sepsis and died with disseminated intravascular coagulation and multiple organ failure on the 10th-day post-surgery. A histopathological examination of the resected colon showed transmural necrosis and massive amoebae invasion. He was diagnosed with FAC. An autopsy revealed that he had developed pulmonary large cell carcinoma with small intestinal metastasis. The death was caused by intestinal ischemia, necrosis and the perforation of the residual bowel caused by amoebae invasion. Conclusions Since FAC is a lethal disease with a high mortality rate and antibiotic therapies except metronidazole are ineffective, preoperative serological testing and perioperative metronidazole therapy in FAC patients can dramatically improve their survival rates.

We present the results of our ALMA ≲0.5 kpc resolution dense molecular line (HCN and HCO ^+ J = 2–1, J = 3–2, and J = 4–3) observations of 12 nearby (ultra)luminous infrared galaxies ([U]LIRGs). After matching beam sizes of all molecular line data to the same values in all (U)LIRGs, we derive molecular line flux ratios by extracting spectra in the central 0.5, 1, and 2 kpc circular regions and in 0.5–1 and 1–2 kpc annular regions. Based on non–local thermal equilibrium model calculations, we quantitatively confirm that the innermost (≲0.5 kpc) molecular gas is very dense (≳10 ^5 cm ^−3 ) and warm (≳300 K) in ULIRGs, and that in one LIRG, it is also modestly dense (10 ^4–5 cm ^−3 ) and warm (∼100 K). We then investigate the spatial variation of the HCN-to-HCO ^+ flux ratios and high- J to low- J flux ratios of HCN and HCO ^+ . A subtle sign of a decreasing trend in these ratios from the innermost (≲0.5 kpc) to the outer nuclear (0.5–2 kpc) region is discernible in a significant fraction of the observed ULIRGs. For two ULIRGS hosting an active galactic nucleus (AGN), which display the trend most clearly, we find based on a Bayesian approach that the HCN-to-HCO ^+ abundance ratio and gas kinetic temperature systematically increase from the outer nuclear to the innermost region. We suggest that this trend comes from potential AGN effects because no such spatial variation is found in a starburst-dominated LIRG.

We present Karl G. Jansky Very Large Array K -band (19 GHz) observations of the redshifted CO(1–0) line emission toward the radio galaxy TN J0924−2201 at z = 5.2, which is one of the most distant radio galaxies with CO detected. With an angular resolution of ∼2″, the CO(1–0) line emission is resolved into three clumps, within ±500 km s ^−1 relative to its redshift, which is determined by Ly α . We find that the clumps are located off-center and 12–33 kpc away from the center of the host galaxy, which has counterparts in the Hubble Space Telescope i band, Spitzer/IRAC, and the Atacama Large Millimeter/submillimeter Array (ALMA) band 6 (230 GHz; 1.3 mm). With the ALMA detection, we estimate the infrared luminosity L _IR and the star formation rate (SFR) of the host galaxy to be (9.3 ± 1.7) × 10 ^11 L _⊙ and 110 ± 20 M _⊙ yr ^−1 , respectively. We also derive the 3 σ upper limit of ${M}_{{{\rm{H}}}_{2}}\lt 1.3\times {10}^{10}$ M _⊙ at the host galaxy. The detected CO(1–0) line luminosities of the three clumps, $L{{\prime} }_{\mathrm{CO}(1-0)}$ = (3.2–4.7) × 10 ^10 K km s ^−1 pc ^2 , indicate the presence of three massive molecular gas reservoirs, with ${M}_{{{\rm{H}}}_{2}}$ = (2.5–3.7) × 10 ^10 M _⊙ , assuming a CO-to-H _2 conversion factor of α _CO = 0.8 ${M}_{\odot }{({\rm{K}}\,\mathrm{km}\,{{\rm{s}}}^{-1}\,{\mathrm{pc}}^{2})}^{-1}$ , although the SFR is not elevated due to the nondetection of the ALMA 1.3 mm continuum (SFR < 40 M _⊙ yr ^−1 ). From the host galaxy, the nearest molecular gas clump, labeled “clump A,” is apparently in alignment with the radio jet axis, showing radio–CO alignment. The origins of these three clumps around TN J0924–2201 can possibly be interpreted as outflows, mergers, or jet-induced metal enrichment.

We report the results of Atacama Large Millimeter/submillimeter Array (ALMA) 1–2 kpc resolution, three rotational transition-line ( J = 2–1, J = 3–2, and J = 4–3) observations of multiple dense molecular gas tracers (HCN, HCO ^+ , and HNC) for 10 nearby (ultra)luminous infrared galaxies ((U)LIRGs). Following the matching of beam sizes to 1–2 kpc for each (U)LIRG, the high- J -to-low- J transition-line flux ratios of each molecule and the emission-line flux ratios of different molecules at each J transition are derived. We conduct RADEX non-LTE model calculations and find that, under a wide range of gas density and kinetic temperature, the observed HCN-to-HCO ^+ flux ratios in the overall (U)LIRGs are naturally reproduced with enhanced HCN abundance compared to HCO ^+ . Thereafter, molecular gas properties are constrained primarily through the use of HCN and HCO ^+ data and the adoption of fiducial values for the HCO ^+ column density and HCN-to-HCO ^+ abundance ratio. We quantitatively confirm the following: (i) molecular gas at the (U)LIRGs’ nuclei is dense (≳10 ^3–4 cm ^−3 ) and warm (≳100 K), (ii) the molecular gas density and temperature in nine ULIRGs’ nuclei are significantly higher than those of one LIRG’s nucleus, (iii) molecular gas in starburst-dominated sources tends to be less dense and cooler than ULIRGs with luminous AGN signatures. For six selected sources, we also apply a Bayesian approach by freeing all parameters and support the above main results. Our ALMA 1–2 kpc resolution, multiple transition-line data of multiple molecules are a very powerful tool for scrutinizing the properties of molecular gas concentrated around luminous energy sources in nearby (U)LIRGs’ nuclei.

We present an imaging molecular line survey in the 3 mm band (85–114 GHz) focused on one of the nearest galaxies with an active galactic nucleus (AGN), NGC 1068, based on observations taken with the Atacama Large Millimeter/submillimeter Array. Distributions of 23 molecular transitions are obtained in the central ∼3 kpc region, including both the circumnuclear disk (CND) and starburst ring (SBR) with 60 and 350 pc resolution. The column densities and relative abundances of all the detected molecules are estimated under the assumption of local thermodynamic equilibrium in the CND and SBR. Then, we discuss the physical and chemical effects of the AGN on molecular abundance corresponding to the observation scale. We found that H ^13 CN, SiO, HCN, and H ^13 CO ^+ are abundant in the CND relative to the SBR. In contrast, ^13 CO is more abundant in the SBR. Based on the calculated column density ratios of N (HCN)/ N (HCO ^+ ), N (HCN)/ N (CN), and other molecular distributions, we conclude that the enhancement of HCN in the CND may be due to high-temperature environments resulting from strong shocks, which are traced by the SiO emission. Moreover, the abundance of CN in the CND is significantly lower than the expected value of the model calculations in the region affected by strong radiation. The expected strong X-ray irradiation from the AGN has a relatively lower impact on the molecular abundance in the CND than mechanical feedback.

We present a catalog of the millimeter-wave (mm-wave) continuum properties of 98 nearby ( z < 0.05) active galactic nuclei (AGNs) selected from the 70 month Swift/BAT hard-X-ray catalog that have precisely determined X-ray spectral properties and subarcsecond-resolution Atacama Large Millimeter/submillimeter Array Band 6 (211–275 GHz) observations as of 2021 April. Due to the hard-X-ray (>10 keV) selection, the sample is nearly unbiased for obscured systems at least up to Compton-thick-level obscuration, and provides the largest number of AGNs with high-physical-resolution mm-wave data (≲100–200 pc). Our catalog reports emission peak coordinates, spectral indices, and peak fluxes and luminosities at 1.3 mm (230 GHz). Additionally, high-resolution mm-wave images are provided. Using the images and creating radial surface brightness profiles of mm-wave emission, we identify emission extending from the central sources and isolated blob-like emission. Flags indicating the presence of these emission features are tabulated. Among 90 AGNs with significant detections of nuclear emission, 37 AGNs (≈41%) appear to have both or one of extended or blob-like components. We, in particular, investigate AGNs that show well-resolved mm-wave components and find that these seem to have a variety of origins (i.e., a jet, radio lobes, a secondary AGN, stellar clusters, a narrow-line region, galaxy disk, active star formation regions, or AGN-driven outflows), and some components have currently unclear origins.

One of the determinants for tissue tropism of hepatitis C virus (HCV) is miR-122, a liver-specific microRNA. Recently, it has been reported that interaction of miR-122 to HCV RNA induces a conformational change of the 5'UTR internal ribosome entry site (IRES) structure to form stem-loop II structure (SLII) and hijack of translating 80S ribosome through the binding of SLIII to 40S subunit, which leads to efficient translation. On the other hand, low levels of HCV-RNA replication have also been detected in some non-hepatic cells; however, the details of extrahepatic replication remain unknown. These observations suggest the possibility that miRNAs other than miR-122 can support efficient replication of HCV-RNA in non-hepatic cells. Here, we identified a number of such miRNAs and show that they could be divided into two groups: those that bind HCV-RNA at two locations (miR-122 binding sites I and II), in a manner similar to miR-122 (miR-122-like), and those that target a single site that bridges sites I and II and masking both G28 and C29 in the 5'UTR (non-miR-122-like). Although the enhancing activity of these non-hepatic miRNAs were lower than those of miR-122, substantial expression was detected in various normal tissues. Furthermore, structural modeling indicated that both miR-122-like and non-miR-122-like miRNAs not only can facilitate the formation of an HCV IRES SLII but also can stabilize IRES 3D structure in order to facilitate binding of SLIII to the ribosome. Together, these results suggest that HCV facilitates miR-122-independent replication in non-hepatic cells through recruitment of miRNAs other than miR-122. And our findings can provide a more detailed mechanism of miR-122-dependent enhancement of HCV-RNA translation by focusing on IRES tertiary structure.

Although viruses infect various organs and are associated with diseases, there may be many unidentified pathogenic viruses. The recent development of next-generation sequencing technologies has facilitated the establishment of an environmental viral metagenomic approach targeting the intracellular viral genome. However, an efficient method for the detection of a viral genome derived from an RNA virus in animal or human samples has not been established. Here, we established a method for the efficient detection of RNA viruses in human clinical samples. We then tested the efficiency of the method compared to other conventional methods by using tissue samples collected from 57 recipients of living donor liver transplantations performed between June 2017 and February 2019 at Kyushu University Hospital. The viral read ratio in human clinical samples was higher by the new method than by the other conventional methods. In addition, the new method correctly identified viral RNA from liver tissues infected with hepatitis C virus. This new technique will be an effective tool for intracellular RNA virus surveillance in human clinical samples and may be useful for the detection of new RNA viruses associated with diseases.

Background/Aim: Transileocolic portal vein embolization (TIPE) may reduce the risk of liver failure after massive hepatectomy. However, convincing evidence of its usefulness in this regard is yet to be reported. Therefore, this study aimed to investigate the use of TIPE after massive hepatectomy. Patients and Methods: Twelve patients who underwent TIPE were included. Pre- and postoperative liver volumetry was determined using a 3D simulator with computed tomography. Results: After TIPE, the percent change in total liver volume was 104.0%±13.1% (p=0.08). Conversely, the percent increase in remnant liver volume (ml)/total liver volume (ml) and remnant liver volume (ml)/standard liver volume (ml) was 122.9%±18.6% (p<0.001) and 132.2%±19.6% (p<0.001), respectively. TIPE operation time was 125±84.6 min, with minimal blood loss in all cases. Postoperative hospitalization duration during TIPE was 4.5±2.6 days. No TIPE-related complications occurred in any patient. Conclusion: TIPE is beneficial and safe when preoperative volumetry indicates that the remaining liver volume is inadequate and inoperable. [ABSTRACT FROM AUTHOR]

Active galaxies contain a supermassive black hole at their center that grows by accreting matter from the surrounding galaxy. The accretion process in about the central 10 parsecs has not been directly resolved in previous observations because of the small apparent angular sizes involved. We observed the active nucleus of the Circinus galaxy using submillimeter interferometry. A dense inflow of molecular gas was evident on subparsec scales. We calculated that less than 3% of this inflow is accreted by the black hole, with the rest being ejected by multiphase outflows, providing feedback to the host galaxy. Our observations also reveal a dense gas disk surrounding the inflow that is gravitationally unstable, which drives the accretion into about the central 1 parsec. [ABSTRACT FROM AUTHOR]