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Identifying malignant transformation in pancreatic branch-duct intraductal papillary mucinous neoplasms (BD-IPMNs) remains challenging, but the standardized uptake value (SUV) obtained from 18F-fluorodeoxyglucose-positron emission tomography (FDG-PET)/CT has the potential to become a valuable parameter for differentiation. This study aimed to assess the effectiveness of SUV of FDG-PET/CT in distinguishing low-grade dysplasia (LGD), high-grade dysplasia (HGD), and intraductal papillary mucinous carcinoma (IPMC) within BD-IPMNs. We assessed 58 patients with confirmed BD-IPMN undergoing surgery between 2008 and 2022. Receiver operating characteristic curves were plotted using the tumor-to-blood pool ratio (TBR) of FDG-PET/CT in two scenarios: one considering HGD + IPMC as positive and the other considering only IPMC as positive. In the cohort of 58 cases, there were 39 females, and the median age was 71 years. The median TBR value was 1.45 (range, 0.35–25.44). The TBRs exhibited a significant correlation with each histopathology (p < 0.001). Furthermore, in the multivariate analysis, TBR was independently significant in both scenarios, with HGD + IPMC defined as malignant (p = 0.001) and with only IPMC defined as malignant (p = 0.024). TBR might have the potential to serve as a valuable parameter for indicating malignant transformation in pancreatic BD-IPMNs. [ABSTRACT FROM AUTHOR]

In order to elucidate the friction characteristics of different types of periodic surface patterns, friction tests were performed on nanostripe surfaces fabricated on cylindrical surfaces with a curvature radius of 150 mm at sliding speeds of 0.7 μm/s–0.7 mm/s. On the nanostripe surfaces, microgrooves were arrayed at a pitch of 6 μm, while nanogrooves were formed on the ridges between neighboring microgrooves at a pitch of approximately 500 nm. The friction coefficient was the lowest at 0.06 when a nanostripe surface was rubbed against a smooth silicon surface at a speed of 0.7 μm/s and the sliding direction was parallel to the grooves. For combinations consisting of two nanostripe surfaces, the maximum friction coefficient was measured for the configuration wherein the grooves of the nanostripes on the two surfaces were perpendicular to the sliding direction, and for the configuration wherein the grooves of the nanostripes on the two surfaces were orthogonal to each other. In the case of the former configuration, the sticking force generated by the slopes of the microgrooves had a determining effect on the measured friction force. • Cross-cylinder contact configuration enabled a contact area larger than pattern size. • Micro-patterned surfaces were fabricated by photolithography with thin Si wafers. • Constant friction coefficients were obtained by microgrooves under lubricated condition. • Nanogrooves persisted in wear traces due to varying wear rates of constituent metals. [ABSTRACT FROM AUTHOR]

Highlights • This is the first case of brachial plexus injury during thoracoscopic esophagectomy in the prone position. • This paralysis is due to excessive abduction and external rotation associated with the intraoperative position. • To avoid intraoperative brachial plexus injury in the prone position, thoughtful orientation of the head and right arm in a less loaded position is important. Abstract Introduction During prone esophagectomy, placement of a port in the third intercostal space for upper mediastinal dissection requires adequate axillary expansion. To facilitate this, the right arm is elevated cranially and simultaneously turned outward. Brachial plexus paralysis associated with esophagectomy in the prone position has not been documented. Presentation of case A 58-year-old man diagnosed with middle intrathoracic esophageal cancer was referred to our department. Thoracoscopic esophagectomy in the prone position was performed following neoadjuvant chemotherapy. After surgery, he complained of difficulty moving his right arm. Physical examination revealed perceptual dysfunction and movement disorder in the territory of cervical spinal nerve 6. Magnetic resonance imaging indicated the injury in the right posterior cord of the brachial plexus at the costoclavicular space. Therefore, we diagnosed the patient with right brachial plexus injury caused by the intraoperative position. The postoperative course was uneventful other than the brachial plexus paralysis, and he was discharged on postoperative day 23. He underwent continuous rehabilitation as an outpatient, and the right brachial plexus paralysis had completely disappeared by 2 months after surgery. Discussion This is the first case of brachial plexus injury during thoracoscopic esophagectomy in the prone position. In prone esophagectomy, managing the patient's position, especially the head and arm positions, is so important to avoid brachial plexus injury due to intraoperative positioning. Conclusion The clinicians should consider managing the patient's position with anatomical familiarity to avoid brachial plexus injury due to intraoperative positioning. [ABSTRACT FROM AUTHOR]

The benefit of preoperative treatment followed by pancreatic resection in older patients with pancreatic ductal adenocarcinoma (PDAC) remains unclear. In this retrospective analysis of prospectively collected data, we evaluated the significance and safety of preoperative treatment followed by curative resection for older PDAC patients. We evaluated 122 patients with resectable and borderline resectable PDAC who received neoadjuvant chemoradiotherapy (NACRT) followed by curative resection between 2009 and 2019. Changes in the prognostic nutritional indices during NACRT, surgical outcomes, and prognosis were compared between older (≥75 years, n = 44) and younger patients (<75 years, n = 78). The completion rate, adverse event rate, changes in prognostic nutritional indices during NACRT, and prognosis were similar between the groups. In multivariate analysis, an elevated C-reactive protein/albumin ratio (CRP/Alb) ≥ 33.1% during NACRT (p = 0.035) and no postoperative adjuvant chemotherapy (p = 0.041) were identified as significant predictors of overall survival. NACRT followed by pancreatic resection could be safely performed in older patients, with a similar prognosis as that of younger patients, despite an increased frequency of postoperative complications. Elevated CRP/Alb during NACRT and no postoperative adjuvant chemotherapy were poor prognostic factors for older patients. [ABSTRACT FROM AUTHOR]

Tribological properties can be improved by surface texturing; however, most of the conducted studies used microscale patterns. This study evaluated the lubrication properties of four different micro/nanogroove layouts (i.e., one straight layout and three different types of V-shaped layouts) created using the nanostripe fabrication technology. For each layout, microgrooves were arrayed at a pitch of 4 μm or 6 μm, and nanogrooves were formed on the ridge between these microgrooves. Friction tests were conducted at different loads and speeds using a single-crystal SiC disk as the counter specimen. We showed that patterns with 6 μm pitch microgrooves had a lower friction coefficient than those with 4 μm pitch microgrooves. The layouts with a higher ratio of nanogrooved area obtained a lower friction coefficient in high load and low speed conditions that are considered as boundary or mixed lubrication regimes. • V-shaped micro/nanogroove layouts were created on Si substrateby top-down fabrication. • Microgrooves reduced friction coefficient at higher sliding speed and lower load. • Higher ratios of nanogrooved area obtained lower friction coefficients. • Friction coefficient was lowest for a V-shaped layout with deeper microgrooves. [ABSTRACT FROM AUTHOR]