Totally Laparoscopic Gastrectomy for Gastric Cancer Associated with Recklinghausen's Disease

This paper documents the first case of gastric cancer associated with Recklinghausen's disease, which was successfully treated by a totally laparoscopic operation. A 67-year-old woman with Recklinghausen's disease was referred to this department to undergo surgical treatment for early gastric cancer. The physical examination showed multiple cutaneous neurofibromas throughout the body surface, which made an upper abdominal incision impossible. Laparoscopic surgery requiring only small incisions was well indicated, and a totally laparoscopic distal gastrectomy with lymph node dissection was performed. Billroth I reconstruction was done intra-abdominally using a delta-shaped anastomosis. The patient followed a satisfactory postoperative course with no complications. Since the totally laparoscopic gastrectomy has many advantages over open surgery, it should therefore be preferentially used as a less invasive treatment in the field of gastric cancer

Optical transmittance investigation of 1-keV ion-irradiated sapphire crystals as potential VUV to NIR window materials of fusion reactors

We investigate the optical transmittances of ion-irradiated sapphire crystals as potential vacuum ultraviolet (VUV) to near-infrared (NIR) window materials of fusion reactors. Under potential conditions in fusion reactors, sapphire crystals are irradiated with hydrogen (H), deuterium (D), and helium (He) ions with 1-keV energy and ∼ 1020-m-2 s-1 flux. Ion irradiation decreases the transmittances from 140 to 260 nm but hardly affects the transmittances from 300 to 1500 nm. H-ion and D-ion irradiation causes optical absorptions near 210 and 260 nm associated with an F-center and an F+-center, respectively. These F-type centers are classified as Schottky defects that can be removed through annealing above 1000 K. In contrast, He-ion irradiation does not cause optical absorptions above 200 nm because He-ions cannot be incorporated in the crystal lattice due to the large ionic radius of He-ions. Moreover, the significant decrease in transmittance of the ion-irradiated sapphire crystals from 140 to 180 nm is related to the light scattering on the crystal surface. Similar to diamond polishing, ion irradiation modifies the crystal surface thereby affecting the optical properties especially at shorter wavelengths. Although the transmittances in the VUV wavelengths decrease after ion irradiation, the transmittances can be improved through annealing above 1000 K. With an optical transmittance in the VUV region that can recover through simple annealing and with a high transparency from the ultraviolet (UV) to the NIR region, sapphire crystals can therefore be used as good optical windows inside modern fusion power reactors in terms of light particle loadings of hydrogen isotopes and helium.Iwano K., Yamanoi K., Iwasa Y., et al. Optical transmittance investigation of 1-keV ion-irradiated sapphire crystals as potential VUV to NIR window materials of fusion reactors. AIP Advances 6, 105108 (2016); https://doi.org/10.1063/1.4965927

Novel case of laparoscopically resected gastric adenocarcinoma concurrent with lanthanum deposition

Abstract A 73‐year‐old man taking lanthanum carbonate for hemodialysis showed progressing gastric mucosal changes with lanthanum deposition. Regular examination revealed concurrent gastric carcinoma. The extent and depth of its invasion were ambiguous because of the surrounding lanthanum deposition. Furthermore, there could be other potent carcinomas, and curative laparoscopic gastrectomy was performed

Neuroendocrine carcinoma of the esophagus: Clinicopathological and immunohistochemical features of 14 cases.

BACKGROUND:Neuroendocrine carcinoma (NEC) of the esophagus is a rare and highly aggressive disease but the biological features are poorly understood. The objective of this study was to analyze the clinicopathological and immunohistochemical features of NEC of the esophagus. METHODS:Fourteen patients diagnosed with NEC of the esophagus from 1998 to 2013 were included in this study. Clinicopathologic features, therapeutic outcomes and immunohistochemical results were analyzed. RESULTS:Eleven out of 14 cases showed protruding or localized type with or without ulceration. Only three patients were negative for both lymph node and organ metastasis and seven cases were positive for metastases to distant organs and/or distant lymph nodes. Of the six patients with limited disease (LD), three patients were treated by surgery. Three patients with LD and seven patients with extensive disease (ED) were initially treated with chemotherapy, except for one who underwent concurrent chemo-radiotherapy due to passage disturbance. The median survival of patients with LD was 8.5 months, whereas that of patients with LD was 17 months. Among the 14 cases, 12 cases (83.3%), 13 cases (91.7%) and 12 cases (83.3%) showed positive immunostaining for choromogranin A, synaptophysin and CD56, respectively. Nine of 14 cases (64.2%) presented positive staining for c-kit and most (8/9, 88%) simultaneously showed p53 protein abnormality. Two cases were negative for c-kit and p53, and positive for CK20. CONCLUSION:Consistent with previous reports, the prognosis of NEC of esophagus is dismal. From the results of immunohistochemical study, NEC of esophagus might be divided into two categories due to the staining positivity of c-kit and p53. This study provides new insight into the biology of NEC of the esophagus

Mutated KIT Tyrosine Kinase as a Novel Molecular Target in Acute Myeloid Leukemia

KIT is a type-III receptor tyrosine kinase that contributes to cell signaling in various cells. Since KIT is activated by overexpression or mutation and plays an important role in the development of some cancers, such as gastrointestinal stromal tumors and mast cell disease, molecular therapies targeting KIT mutations are being developed. In acute myeloid leukemia (AML), genome profiling via next-generation sequencing has shown that several genes that are mutated in patients with AML impact patients’ prognosis. Moreover, it was suggested that precision-medicine-based treatment using genomic data will improve treatment outcomes for AML patients. This paper presents (1) previous studies regarding the role of KIT mutations in AML, (2) the data in AML with KIT mutations from the HM-SCREEN-Japan-01 study, a genome profiling study for patients newly diagnosed with AML who are unsuitable for the standard first-line treatment (unfit) or have relapsed/refractory AML, and (3) new therapies targeting KIT mutations, such as tyrosine kinase inhibitors and heat shock protein 90 inhibitors. In this era when genome profiling via next-generation sequencing is becoming more common, KIT mutations are attractive novel molecular targets in AML