Search

Gastric cancer occurring after bariatric and metabolic surgeries is rare. We report a case of gastric cancer that developed at 14 years after laparoscopic adjustable gastric banding. The patient was an obese 81-year-old woman who underwent LAGB at 14 years prior when her body mass index was 35.3 kg/m2. Anemia was noted during a visit to her family clinic. Subsequent esophagogastroduodenoscopy revealed a type 5 lesion (Macroscopic Classification of the Gastric Cancer in Japanese Classification of Gastric Carcinoma, The 15th Edition) near the greater curvature of the posterior wall of the gastric antrum. A biopsy indicated a poorly differentiated adenocarcinoma. Computed tomography showed no evidence of invasion of other organs, lymph node metastasis, or distant metastasis. The patient underwent laparoscopy-assisted distal gastrectomy, banding removal, Roux-en-Y reconstruction. The histopathological diagnosis was pT3N2M0 and pStage IIIA. The patient exhibited an uneventful postoperative course and was discharged on postoperative day 8. The patient has remained recurrence-free up to 12 months postoperatively. While metabolic surgeries have been shown to reduce the risk of developing malignant diseases, including gastric cancer, the present patient developed gastric cancer at 14 years after laparoscopic adjustable gastric banding. The patient developed gastric cancer during a long-term course, indicating the importance of periodic examinations after metabolic surgery. Previous studies showed metabolic surgeries for obesity reduce the risk of developing malignancies, including gastric cancer; however, the present case suggests that gastric cancer may develop over a long-term course. • Gastric cancer following laparoscopic adjustable gastric banding is rare. • Gastric cancer following laparoscopic adjustable gastric banding can be safely treated laparoscopically. • For patients at high risk of developing gastric cancer, consider periodic evaluation even after metabolic surgery. [ABSTRACT FROM AUTHOR]

Accurately predicting nipple-areola complex (NAC) involvement in breast cancer is necessary for identifying patients who may be candidates for a nipple-sparing mastectomy. Although multiple risk factors are indicated in the guidelines, it is difficult to predict NAC involvement (NAC-i) preoperatively even if these factors are evaluated individually. This study aimed to develop a more accurate and practical preoperative NAC-i prediction model using magnetic resonance imaging (MRI). All tumors in 252 patients were evaluated using postcontrast T1-weighted subtraction on MRI. The receiver operating characteristic curves identified cut-off values for tumor size and tumor-to-nipple distance (TND) as 4 cm and 1.2 cm, respectively. Multivariate analysis demonstrated that TND (p < 0.001), ductal enhancement extending to the nipple (DEEN) (p < 0.001), and nipple enhancement (NE) (p = 0.005) were independent clinical risk factors for pathological NAC-i. A formula was constructed using odds ratios for these three independent preoperative risk factors in multivariate analysis: the MRI-based NAC-i predictive index (mNACPI) = TND × 4 + DEEN × 3 + NE × 1. A total score of ≤4 points was defined as low risk and ≥5 points as high risk. NAC-i rates were 2.4% in the low-risk group and 89.4% in the high-risk group; a significant correlation was observed between the risk group and permanent pathological NAC-i (p < 0.001). Assuming that the NAC was preserved in low-risk patients and resected in high-risk patients, NAC-i was verified using the mNACPI. mNACPI may contribute greatly to the improvement of selecting suitable patients for NAC preservation in breast reconstructive surgery while maintaining oncological safety. [ABSTRACT FROM AUTHOR]

The laser-induced crystallization method is applied to an oxyfluoride glass with the composition of 41.5SiO2–21.3Al2O3–4.8CaO–12.6NaF–16.4CaF2–2.9NiO–0.5ErF3 (mol%), and the lines consisting of CaF2 nanocrystals (diameter: ∼20 nm) are patterned on the glass surface. It is found from micro-photoluminescence (PL) spectra of Er3+ ions that Er3+ ions are incorporated into CaF2 nanocrystals formed by laser (continuous-wave Yb:YVO4 fiber laser with a wavelength of 1080 nm) irradiations. Two-dimensional mappings of the PL intensity for the 4S3/2→4I15/2 transition of Er3+ ions are measured for the surface and cross section of the patterned lines. It is found that two phases giving different PL intensities are formed in the laser-irradiated region, suggesting that the center part of the laser-irradiated region consists of Er3+-doped CaF2 nanocrystals and the surrounding of the center part gives the fluoride ion rich coordination state for Er3+ ions. The formation mechanism of Er3+-doped CaF2 nanocrystals is related to the temperature distribution of the laser-irradiated region. [ABSTRACT FROM AUTHOR]