Our experience with laparoscopic total gastrectomy for gastric cancer: A case series

Background:Though laparoscopic distal gastrectomy has become a standard procedure for treatment of gastric cancer, laparoscopic total gastrectomy has not been widely accepted as it requires more dexterity and lack of evidence about its feasibility and safety.Methods:Here retrospectively we review a series of 12 cases of gastric cancer undergone laparoscopic total gastrectomy with D1 or D2 lymphadenectomy over a period of 10 years at a tertiary care hospital. The patient demographic characteristics were reviewed and the outcomes after surgery was analyzed in terms of extent of lymphadenectomy, mean operative time, mean intraoperative blood loss median number of lymph nodes harvested, median time for postoperative ambulation, median time for postoperative oral feeding, median time of postoperative hospital stay, postoperative complications and mortality.Results:All patients had total gastrectomy entirely through laparoscopic method. Mean operative time was 282 minutes, mean intraoperative blood loss was 120 ml, median time for ambulation and oral feeding was 3 days and 6 days respectively. Median time of hospital stay was 16 days and 2 patients had complications as pancreatic fistula and port site abscess. No mortality was observed.Conclusion:With zero mortality and accepted rate of complications, laparoscopic total gastrectomy appears to be technically feasible and safe for management of gastric cancer. But more studies have to be conducted with comparison to other standard gastrectomies and long term follow up to be done to establish its standardized application

The statistical analysis of the dynamical evolution of the open clusters

We present the dynamical evolution of ten open clusters which were part of our previous studies. These clusters include both young and intermediate-age open clusters with ages ranging from 25$\pm$19 Myr to 1.78$\pm$0.20 Gyr. The total mass of these clusters ranges from 356.18$\pm$142.90 to 1811.75$\pm$901.03 M$_{\odot}$. The Galactocentric distances to the clusters are in the range of 8.91$\pm$0.02 to 11.74$\pm$0.18 kpc. The study is based on the ground-based UBVRI data supplemented by the astrometric data from the Gaia archive. We studied the minimum spanning tree of the member stars for these clusters. The mass segregation in these clusters was quantified by mass segregation ratios calculated from the mean edge length obtained through the minimum spanning tree. The clusters NGC 2360, NGC 1960, IC 1442, King 21, and SAI 35 have ${\Gamma}_{MSR}$ to be 1.65$\pm$0.18, 1.94$\pm$0.22, 2.21$\pm$0.20, 1.84$\pm$0.23, and 1.96$\pm$0.25, respectively which indicate moderate mass segregation in these clusters. The remaining five clusters are found to exhibit weak or no mass segregation. We used the ratio of half mass radius to the tidal radius i.e. R$_{h}$/R$_{t}$ to investigate the effect of the tidal interactions on the cluster structure and dynamics. The ratios of half mass radii to tidal radii are found to be positively correlated with the Galactocentric distances with a linear slope of 0.06$\pm$0.01 having linear regression coefficient r-square = 0.93 for the clusters.Comment: 9 pages, 3 figures, 2 table

ALMA Survey of Orion Planck Galactic Cold Clumps (ALMASOP) : Evidence for a Molecular Jet Launched at an Unprecedented Early Phase of Protostellar Evolution

Protostellar outflows and jets play a vital role in star formation as they carry away excess angular momentum from the inner disk surface, allowing the material to be transferred toward the central protostar. Theoretically, low-velocity and poorly collimated outflows appear from the beginning of the collapse at the first hydrostatic core (FHSC) stage. With growing protostellar core mass, high-density jets are launched, entraininf an outflow from the infalling envelope. Until now, molecular jets have been observed at high velocity (greater than or similar to 100 km s(-1)) in early Class 0 protostars. We, for the first time, detect a dense molecular jet in SiO emission with low velocity (similar to 4.2 km s(-1), deprojected similar to 24 km s(-1)) from source G208.89-20.04Walma (hereafter G208Walma) using ALMA Band 6 observations. This object has some characteristics of FHSCs, such as a small outflow/jet velocity, extended 1.3 mm continuum emission, and N2D+ line emission. Additional characteristics, however, are typical of early protostars: collimated outflow and SiO jet. The full extent of the outflow corresponds to a dynamical timescale of similar to 930(-100)(+200) yr. The spectral energy distribution also suggests a very young source having an upper limit of T-bol similar to 31 K and L-bol similar to 0.8 L-circle dot. We conclude that G208Walma is likely in the transition phase from FHSC to protostar, and the molecular jet has been launched within a few hundred years of initial collapse. Therefore, G208Walma may be the earliest object discovered in the protostellar phase with a molecular jet.Peer reviewe

ALMA Survey of Orion Planck Galactic Cold Clumps (ALMASOP): How Do Dense Core Properties Affect the Multiplicity of Protostars?

During the transition phase from a prestellar to a protostellar cloud core, one or several protostars can form within a single gas core. The detailed physical processes of this transition, however, remain unclear. We present 1.3 mm dust continuum and molecular line observations with the Atacama Large Millimeter/submillimeter Array toward 43 protostellar cores in the Orion molecular cloud complex (λ Orionis, Orion B, and Orion A) with an angular resolution of ∼0.″35 (∼140 au). In total, we detect 13 binary/multiple systems. We derive an overall multiplicity frequency (MF) of 28% ± 4% and a companion star fraction (CSF) of 51% ± 6%, over a separation range of 300-8900 au. The median separation of companions is about 2100 au. The occurrence of stellar multiplicity may depend on the physical characteristics of the dense cores. Notably, those containing binary/multiple systems tend to show a higher gas density and Mach number than cores forming single stars. The integral-shaped filament of the Orion A giant molecular cloud (GMC), which has the highest gas density and hosts high-mass star formation in its central region (the Orion Nebula cluster), shows the highest MF and CSF among the Orion GMCs. In contrast, the λ Orionis GMC has a lower MF and CSF than the Orion B and Orion A GMCs, indicating that feedback from H ii regions may suppress the formation of multiple systems. We also find that the protostars comprising a binary/multiple system are usually at different evolutionary stages.T.L. acknowledges support from the National Natural Science Foundation of China (NSFC) through grants No. 12073061 and No. 12122307, the International Partnership Program of the Chinese Academy of Sciences (CAS) through grant No. 114231KYSB20200009, the Shanghai Pujiang Program (20PJ1415500), and science research grants from the China Manned Space Project with no. CMS-CSST-2021-B06. K.T. was supported by Japan Society for the Promotion of Science (JSPS) KAKENHI (grant No. 20H05645). D.J. and J.d.F. are supported by NRC Canada and by NSERC Discovery Grants. C.-F.L. acknowledge grants from the Ministry of Science and Technology of Taiwan (MoST 107-2119-M-001-040-MY3 and 110-2112-M-001-021-MY3) and Academia Sinica (Investigator Award AS-IA-108-M01). This research was carried out in part at the Jet Propulsion Laboratory, which is operated by the California Institute of Technology under a contract with the National Aeronautics and Space Administration (80NM0018D0004). J.-E.L. was supported by a National Research Foundation of Korea grant funded by the Korean government (MSIT) (grant No. 2021R1A2C1011718). J.H. acknowledges the support of NSFC projects 11873086 and U1631237. This work is sponsored (in part) by the CAS, through a grant to the CAS South America Center for Astronomy in Santiago, Chile. S.-L.Q. is supported by the NSFC with grant No. 12033005. S.Z. acknowledges the support of the China Postdoctoral Science Foundation through grant No. 2021M700248. L.B. gratefully acknowledges support by the ANID BASAL projects ACE210002 and FB210003. P.S. was supported by a Grant-in-Aid for Scientific Research (KAKENHI No. 18H01259) of JSPS. V.-M.P. acknowledges support by the grant PID2020-115892GB-I00 funded by MCIN/AEI/10.13039/501100011033

ALMA Survey of Orion Planck Galactic Cold Clumps (ALMASOP): Evidence for a Molecular Jet Launched at an Unprecedented Early Phase of Protostellar Evolution

Protostellar outflows and jets play a vital role in star formation as they carry away excess angular momentum from the inner disk surface, allowing the material to be transferred toward the central protostar. Theoretically, low-velocity and poorly collimated outflows appear from the beginning of the collapse at the first hydrostatic core (FHSC) stage. With growing protostellar core mass, high-density jets are launched, entraininf an outflow from the infalling envelope. Until now, molecular jets have been observed at high velocity (greater than or similar to 100 km s(-1)) in early Class 0 protostars. We, for the first time, detect a dense molecular jet in SiO emission with low velocity (similar to 4.2 km s(-1), deprojected similar to 24 km s(-1)) from source G208.89-20.04Walma (hereafter G208Walma) using ALMA Band 6 observations. This object has some characteristics of FHSCs, such as a small outflow/jet velocity, extended 1.3 mm continuum emission, and N2D+ line emission. Additional characteristics, however, are typical of early protostars: collimated outflow and SiO jet. The full extent of the outflow corresponds to a dynamical timescale of similar to 930(-100)(+200) yr. The spectral energy distribution also suggests a very young source having an upper limit of T-bol similar to 31 K and L-bol similar to 0.8 L-circle dot. We conclude that G208Walma is likely in the transition phase from FHSC to protostar, and the molecular jet has been launched within a few hundred years of initial collapse. Therefore, G208Walma may be the earliest object discovered in the protostellar phase with a molecular jet.N