Exploring simple ways to avoid collecting highly 137Cs-contaminated Aralia elata buds for the revival of local wild vegetable cultures.

Collection and cooking of wild vegetables have provided seasonal enjoyments for Japanese local people as provisioning and cultural ecosystem services. However, the Fukushima Daiichi Nuclear Power Plant accident in March 2011 caused extensive radiocesium contamination of wild vegetables. Restrictions on commercial shipments of wild vegetables have been in place for the last 10 years. Some species, including buds of Aralia elata, are currently showing radiocesium concentrations both above and below the Japanese reference level for food (100 Bq/kg), implying that there are factors decreasing and increasing the 137Cs concentration. Here, we evaluated easy-to-measure environmental variables (dose rate at the soil surface, organic soil layer thickness, slope steepness, and presence/absence of decontamination practices) and the 137Cs concentrations of 40 A. elata buds at 38 locations in Fukushima Prefecture to provide helpful information on avoiding collecting highly contaminated buds. The 137Cs concentrations in A. elata buds ranged from 1 to 6,280 Bq/kg fresh weight and increased significantly with increases in the dose rate at the soil surface (0.10-6.50 µSv/h). Meanwhile, the 137Cs concentration in A. elata buds were not reduced by decontamination practices. These findings suggest that measuring the latest dose rate at the soil surface at the base of A. elata plants is a helpful way to avoid collecting buds with higher 137Cs concentrations and aid in the management of species in polluted regions.

Immunoglobulin G4-related Dacryoadenitis Successfully Treated with Baricitinib.

A 48-year-old woman visited our hospital because of bilateral lacrimal gland enlargement. Her serum immunoglobulin G4 (IgG4) level was high, and positron emission tomography-computed tomography showed significant positive findings in the bilateral lacrimal gland. A biopsy revealed a considerable increase in IgG4/CD138, leading to a diagnosis of IgG4-related dacryoadenitis. The disease did not respond to steroid therapy, so treatment was started with baricitinib because of exacerbation of the original atopic dermatitis and dacryoadenitis after the second dose of the coronavirus disease 2019 (COVID-19) vaccine. Baricitinib was effective for resolving both dermatitis and dacryoadenitis, and steroids were able to be discontinued. The IgG4 level also improved.

Squamous cell carcinoma of the eyelid.

Eyelid squamous cell carcinoma is a major type of rare eyelid cancer, together with basal cell carcinoma and sebaceous gland carcinoma. It is a painless disease that progresses slowly and is often detected by the appearance of nodules or plaques. Risk factors include exposure to ultraviolet light, fair skin, radiation and human papillomavirus infection. The standard treatment is surgical removal, and in cases of orbital invasion, orbital content removal is required. If sentinel node biopsy reveals a high risk of lymph node metastasis, adjuvant radiotherapy may be considered. Local chemotherapy, such as imiquimod and 5-fluorouracil, may be used for eyelid squamous cell carcinoma in situ. When surgery or radiotherapy is not recommended for distant metastases or locally advanced disease, drug therapy is often according to head and neck squamous cell carcinoma in Japan. The treatment often requires a multidisciplinary team to ensure the preservation of function and cosmetic appearance.

Lessons learnt on the impact of an unprecedented soil decontamination program in Fukushima on contaminant fluxes.

In the context of elevated concerns related to nuclear accidents and warfare, the lessons learnt from the Fukushima Daiichi Nuclear Power Plant accident in 2011 are important. In particular, Japanese authorities implemented an ambitious decontamination program to reduce the air dose rate in order to facilitate the return of the local inhabitants to previously evacuated areas. This approach contrasts the strategy adopted in Chernobyl, where the most contaminated areas remain off limits. Nonetheless, the effectiveness of the Japanese decontamination strategy on the dispersion of radioactive contaminant fluxes across mountainous landscapes exposed to typhoons has not been quantified. Based on the unique combination of river monitoring and modeling in a catchment representative of the most impacted area in Japan, we demonstrate that decontamination of 16% of the catchment area resulted in a decrease of 17% of sediment-bound radioactive fluxes in rivers. Decontamination operations were therefore relatively effective, although they could only be conducted in a small part of the area due to the dominance of steep forested slopes. In fact, 67% of the initial radiocesium contamination was calculated to remain stored in forested landscapes, which may contribute to future downstream radiocesium dispersion during erosive events. Given that only a limited proportion of the initial population had returned in 2019 (~30%), it raises the question as to whether decontaminating a small percentage of the contaminated area was worth the effort, the price, and the amount of waste generated?

Influential factors of long-term and seasonal 137Cs change in agricultural and forested rivers: Temperature, water quality and an intense Typhoon Event.

In this study, the effect of temperature, water quality, and the impact of an intense typhoon event on change in 137Cs concentration in the water of agricultural and forested rivers near the Fukushima Daiichi nuclear power plant (Japan) was evaluated using monthly stationary observations obtained under baseflow conditions 2.8-10.6 years after the nuclear accident in 2011. The dissolved 137Cs concentration fluctuated seasonally with water temperature in all rivers, and the increase in dissolved 137Cs concentration for unit increase in temperature was higher in forested rivers than in agricultural rivers. The relationship between water temperature and the apparent distribution coefficient of 137Cs well followed the van 't Hoff equation in the two agricultural rivers, where the enthalpy of reaction was estimated as -15.6 and -19.6 kJ mol-1. The van 't Hoff equation was not well followed for a forested river, where the suspended solids mainly comprised organic matter, suggesting that the dominant process determining dissolved 137Cs concentrations in forested rivers is not only water temperature effect on ion exchange, but rather the input of 137Cs and K+ (competing with 137Cs for exchange sites on mineral particles) into the water phase via litter leaching. Suspended solids concentrations in agricultural rivers correlated negatively with 137Cs concentrations in suspended solids, suggesting an increased proportion of coarse particles or the input of soils with low 137Cs concentration from decontaminated agricultural land. At some sites, 137Cs concentrations in dissolved form and in suspended solids were reduced sharply in association with the passage of Typhoon Hagibis in October 2019, suggesting that Typhoon Hagibis caused large-scale surface erosion that removed the source of 137Cs.

Contrasting seasonality of 137Cs concentrations in two stream animals that share a trophic niche.

Understanding the seasonality of 137Cs concentrations in aquatic animals is crucial for reviving local inland fisheries. The seasonality of 137Cs concentrations in animals is expected to vary, even if focal species consume similarly contaminated foods because the 137Cs excretion rate is species-specific, and 137Cs uptake by foraging autochthonous food resources also vary among seasons. Here, we conducted a seasonal monitoring survey of dissolved 137Cs concentrations as an indicator of the contamination level of food resources and measured 137Cs concentrations in two carnivorous aquatic animals (Palaemon paucidens and Rhinogobius sp.) that share a trophic niche in a stream connected to a dam reservoir. The dissolved 137Cs concentration had clear seasonality-high in summer and low in winter. The 137Cs concentrations in the animals revealed a different seasonal pattern-it peaked in October in P. paucidens and peaked in February in Rhinogobius. Overall, the 137Cs concentration was relatively higher in P. paucidens than in Rhinogobius, suggesting that P. paucidens has a lower excretion rate than Rhinogobius. Consequently, the seasonality of the 137Cs concentration in P. paucidens showed temporal changes similar to those of the dissolved 137Cs concentration, which were likely affected by 137Cs uptake through foraging, whereas that in Rhinogobius was controlled by 137Cs excretion. This study shows that the seasonality of 137Cs concentration can differ between sympatric animals that share a trophic niche. Accumulating knowledge and comparing the seasonality of 137Cs concentrations in fisheries species based on the balance between uptake and excretion will be valuable to determine the appropriate seasons to obtain less-contaminated products.

Radiocesium-bearing microparticles cause a large variation in 137Cs activity concentration in the aquatic insect Stenopsyche marmorata (Tricoptera: Stenopsychidae) in the Ota River, Fukushima, Japan.

After the Tokyo Electric Power Company Fukushima Daiichi Nuclear Power Plant accident in Japan, freshwater ecosystems near the site remained contaminated by radiocesium (RCs). Clarifying RCs concentrations in aquatic insects is crucial because fishes consume these insects that transfer RCs into freshwater ecosystems. As aquatic insects are usually measured for radioactivity in bulk samples of several tens of insects, variation in RCs concentration among individuals is not captured. In this study, we investigated the variability in 137Cs activity concentration in individual aquatic insects in detritivorous caddisfly (Stenopsyche marmorata) and carnivorous dobsonfly (Protohermes grandis) larvae from the Ota River, Fukushima. Caddisfly larvae showed sporadically higher radioactivity in 4 of the 46 caddisfly larvae, whereas no such outliers were observed in 45 dobsonfly larvae. Autoradiography and scanning electron microscopy analyses confirmed that these caddisfly larvae samples contained radiocesium-bearing microparticles (CsMPs), which are insoluble Cs-bearing silicate glass particles. CsMPs were also found in potential food sources of caddisfly larvae, such as periphyton and drifting particulate organic matter, indicating that larvae may ingest CsMPs along with food particles of similar size. Although CsMP distribution and uptake by organisms in freshwater ecosystems is relatively unknown, our study demonstrates that CsMPs can be taken up by aquatic insects.

Remobilisation of radiocaesium from bottom sediments to water column in reservoirs in Fukushima, Japan.

Reservoir sediments generally act as a sink for radionuclides derived from nuclear accidents, but under anaerobic conditions, several radionuclides remobilise in bioavailable form from sediments to water columns, which may contribute to the long-term contamination of aquatic products. This study systematically investigated the 137Cs activities of sediment-pore water, providing a direct evidence of the remobilisation of bioavailable 137Cs from sediments in two highly contaminated reservoirs affected by the Fukushima Dai-ichi Nuclear Power Plant (FDNPP) accident. We observed that the dissolved 137Cs activity concentration of pore water (3.0-65.8 Bq L-1) was one to two orders of magnitude higher than that of reservoir water. Moreover, the distribution coefficient (Kd) values for the 137Cs of sediment-pore water (2.6-14 × 103 L kg-1) decreased with depth. The Kd values were significantly and negatively correlated with the concentration of the major 137Cs competing cation NH4+. Our results strongly indicate a competitive ion exchange process between 137Cs and NH4+ via a highly selective interaction with the frayed edge sites of phyllosilicate minerals, which is the major reason for the variability of Kd values of sediment-pore water, even in the Fukushima case. Additionally, the sediment accumulation rates were relatively high, and the annual depositional rate of exchangeable 137Cs prevailed over the annual diffusive flux of 137Cs from the sediment to the overlying water. This finding indicates that even after 10 years since the FDNPP accident, the bioavailable 137Cs is still continuously supplied from the catchment covered by mountainous forests, and reservoir sediments are a long-term important source of bioavailable 137Cs in the riverine system. Our findings provide important parameter values for mid- and long-term assessments of the radiation impact of radionuclide discharges to freshwater environments.

More Accurate Diagnosis of Vitreoretinal Lymphoma Using a Combination of Diagnostic Test Results: A Prospective Observational Study.

PURPOSE: To establish diagnostic criteria for vitreoretinal lymphoma (VRL) using cytology and laboratory tests from vitreous samples: interleukin (IL)-10/IL-6 ratio, immunoglobulin (Ig) H gene rearrangement, and clonal B-cells on flow cytometry. METHODS: Fifty-six patients with and 39 without VRL were included. We assessed the sensitivity and specificity of each test and those of diagnostic criteria based on combinations of these tests. RESULTS: The sensitivity values for malignant cytology, IL-10/IL-6 > 1, IgH gene rearrangement, and flow cytometry were 0.554, 0.821, 0.732, and 0.625 with specificity of 1.000, 1.000, 0.846, and 0.974, respectively. When the diagnostic criteria were set at malignant cytology or at two or more of of four tests (atypical cells, IL-10/IL-6 > 1, IgH gene rearrangement, and flow cytometry), the sensitivity and specificity values for accurate diagnosis were 0.929 and 1.00, respectively. CONCLUSION: Malignant cytology or positive results for two or more of four tests may be adequate for VRL diagnosis.

Untangling radiocesium dynamics of forest-stream ecosystems: A review of Fukushima studies in the decade after the accident.

Forest-stream ecosystems are widespread and biodiverse terrestrial landscapes with physical and social connections to downstream human activities. After radiocesium is introduced into these ecosystems, various material flows cause its accumulation or dispersal. We review studies conducted in the decade after the Fukushima nuclear accident to clarify the mechanisms of radiocesium transfer within ecosystems and to downstream areas through biological, hydrological, and geomorphological processes. After its introduction, radiocesium is heavily deposited in the organic soil layer, leading to persistent circulation due to biological activities in soils. Some radiocesium in soils, litter, and organisms is transported to stream ecosystems, forming contamination spots in depositional habitats. While reservoir dams function as effective traps, radiocesium leaching from sediments is a continual phenomenon causing re-contamination downstream. Integration of data regarding radiocesium dynamics and contamination sites, as proposed here, is essential for contamination management in societies depending on nuclear power to address the climate crisis.

Prolonged pain in patients with fragility fractures of the pelvis may be due to fracture progression.

PURPOSE: Most fragility fractures of the pelvis (FFPs) are conservatively treated in the early phase. However, the definition of conservative treatment failure and the subsequent treatment protocol is controversial. Fracture progression (FP) sometimes occurs during conservative treatment of FFPs. This study aimed to assess the association between FP and prolonged pain in patients with FFPs receiving conservative treatment. METHODS: Retrospective case series in a single institution in Japan. A total of 192 consecutive FFP patients were identified during study period. Seventy-nine patients met the inclusion and exclusion criteria. FFPs were diagnosed using both CT and MRI and FP was diagnosed with CT. Patients met criteria for prolonged pain if they had persisting pain after 2 weeks of conservative treatment and had lack of improvement in mobility. The relationship between FP and prolonged pain was analyzed using Fisher's exact test. RESULTS: Of the 79 patients, 18 developed FP. Four of the 18 patients with FP met criteria for prolonged pain. Two of 61 patients without FP had prolonged pain (p = 0.022; odds ratio 8.12). In the entire study cohort, six patients (7.6%) met criteria prolonged pain and underwent elective surgery. CONCLUSION: In patients with FFPs, prolonged pain was associated with FP (p = 0.022, OR 8.12). The presence of prolonged pain might help identify FP. If FP is identified, surgical treatment may be required with cautious follow-up particularly in cases, where FFP progresses to type III or IV fracture.

Volar Dislocation of the Fourth and Fifth Carpometacarpal Joint Associated with Hamate Hook Fracture: A Case Report and Literature Review.

We report a case of volar fourth and fifth carpometacarpal (CMC) joint dislocation complicated by a hamate hook fracture. The CMC joint was reduced in a closed fashion and temporally fixed with Kirschner wires. Using intraoperative computed tomography, the displaced fracture of the hamate hook was reduced by open reduction and internal fixation and fixed with a screw. We suggest that this rare injury was caused by the over contraction of the flexor carpi ulnaris and avulsion force from the ligamentous structure around the pisiform, hamate, and metacarpal bones.

Therapeutic Changes in Bilateral Choroidal Metastasis from Non-Small Cell Lung Cancer with Response to Afatinib: A Case Report.

A 49-year-old male presented with a three-day onset of blurred vision and metamorphopsia in the left eye. Fundoscopy and OCT images identified multiple subretinal masses with associating serous retinal detachment in both eyes. Bilateral choroidal metastasis was suspected, and further evaluation revealed a mass in the lower left lobe of the lung with multiple metastatic loci. Ultimately, the patient was diagnosed with Stage IVB (T2aN2M1c) adenocarcinoma of the lung. Genetic analysis revealed an exon 19 deletion mutation in the epidermal growth factor receptor (EGFR) gene. The patient was started on afatinib, a second-generation tyrosine kinase inhibitor. Drastic improvement in both tumor volume and visual acuity was observed after 1.5 months. The primary site and other metastatic loci also improved significantly during the observed period. Our report demonstrated the effectiveness of afatinib alone for the treatment of bilateral choroidal metastasis in a non-small cell lung cancer patient exhibiting EGFR mutation.

Factors controlling dissolved 137Cs concentrations in east Japanese Rivers.

To investigate the main factors that control the dissolved radiocesium concentration in river water in the area affected by the Fukushima Daiichi nuclear power plant accident, the correlations between the dissolved 137Cs concentrations at 66 sites normalized to the average 137Cs inventories for the watersheds with the land use, soil components, topography, and water quality factors were assessed. We found that the topographic wetness index is significantly and positively correlated with the normalized dissolved 137Cs concentration. Similar positive correlations have been found for European rivers because wetland areas with boggy organic soils that weakly retain 137Cs are mainly found on plains. However, for small Japanese river watersheds, the building area ratio in the watershed strongly affected the dissolved 137Cs concentration. One reason for this would be because the high concentrations of solutes, such as K+ and dissolved organic carbon, discharged in urban areas would inhibit 137Cs absorption to soil particles. A multiple regression equation was constructed to predict the normalized dissolved 137Cs concentration with the topography, land use, soil component, and water quality data as explanatory variables. The best model had the building land use as the primary predictor. When comparing two multiple regression models in which the explanatory variables were limited to (1) the land use and soil composition and (2) the water quality, the water quality model underestimated the high normalized dissolve 137Cs concentration in urban areas. This poor reproducibility indicates that the dissolved 137Cs concentration value in urban areas cannot be solely explained by the solid-liquid distribution of 137Cs owing to the influence of the water quality, but some specific 137Cs sources in urban areas would control the dissolved 137Cs concentration.

Reconstruction of uranium and plutonium isotopic signatures in sediment accumulated in the Mano Dam reservoir, Japan, before and after the Fukushima nuclear accident.

The Fukushima Dai-ichi Nuclear Power Plant (FDNPP) accident in Japan resulted in a major release of radionuclides into the environment. Compared to other radionuclides, few studies have investigated the fate of actinides in the environment. Accordingly, this research investigates the Pu composition in soil samples collected in paddy fields before and after the accident. Furthermore, the vertical distributions of Pu and U isotopic signatures, along with 137Cs activities, were measured in a sediment core collected in the Mano Dam reservoir, in the Fukushima Prefecture. Changes in the relative contributions of the major actinide sources (global fallout or FDNPP derived fallout) were investigated in sediment deposited in the reservoir. The distinct peak observed for all Pu isotope ratios (240Pu/239Pu, 241Pu/239Pu and 242Pu/239Pu) and for 137Cs concentrations in the sediment core was attributed to the Fukushima fallout, and coincided with the maximum atomic contribution of only 4.8 ±â€¯1.0% of Pu from the FDNPP. Furthermore, 236U/238U ratios measured in the sediment core remained close to the global fallout signature indicating there was likely no U from the FDNPP accident detected in the sediment core. More research is required on the environmental dynamics of trace actinides in landscapes closer to the FDNPP where there are likely to be greater abundances of FDNPP-derived Pu and U.

[A Postoperative Case of Rectal Cancer with Anal Pain Caused by Side Effects of Oxaliplatin].

This case involved a 28-year-old female with rectal cancer in the inner pelvis. Two courses of SOX plus Cmab therapy, and 4 courses of FOLFOX-Cmab therapy were administered as preoperative chemotherapies, which resulted in a reduction in the major lesion. Subsequently, laparoscopic low anterior resection and dissection of the bilateral lymph nodes were performed. After the surgery, adjuvant chemotherapy with FOLFOX was administered. Afterwards, the patient developed severe anal pain and visited us for treatment. The severe anal pain continued even after FOLFOX treatment and increased with defecation. A side effect of oxaliplatin was suspected, and sLV5FU chemotherapy was administered. As a result, the anal pain disappeared. Thus, the pain was considered to be induced by oxaliplatin. While peripheral neuropathy is a widely known side effect of oxaliplatin, this case was considered to be unique because anal pain occurs very rarely with oxaliplatin treatment.

Vertical/spatial movement and accumulation of 137Cs in a shallow lake in the initial phase after the Fukushima Daiichi nuclear power plant accident.

Movement of 137Cs in the bottom sediment of a shallow lake was investigated by collecting columnar sediment cores from the entire area once a year, and also from three representative points every 3 months over 3 years from the 137Cs fallout in March 2011. The 137Cs inventory in the sediment increased remarkably near the mouths of urban rivers; however, the distribution of the 137Cs inventory did not change remarkably in most areas, and horizontally slow downstream movement of 137Cs was observed.