[A Case of Distal Gastrectomy and Left Segmentectomy for Hepatic Invasion of Gastric Cancer].

A 66-year-old male came to our hospital because of occult blood in stool and anemia. The patient was diagnosed as unresectable advanced gastric cancer,( ML/Less, type 2, tub2, cT4b[liver], cN+, cM0, cStage Ⅳ, HER2 negative). He was given oxaliplatin plus S-1 therapy. In the 3rd course of chemotherapy, he had severe anemia, and active bleeding from the tumor. To control the bleeding he underwent distal gastrectomy, lateral segmentectomy of the liver, and S4 partial hepatectomy. The patient underwent adjuvant chemotherapy with docetaxel plus S-1. Three months after surgery, lymph nodes recurrence was observed. He underwent second-line therapy with paclitaxel and ramucirumab. Seven months after surgery, lymph nodes recurrence was increased. He was switched to third-line therapy with nivolumab. He is currently arrive 12 months after surgery.

[A Case of Colon Metastasis after Surgery for Left Renal Pelvis Cancer].

The patient was a 73-year-old man. He was diagnosed with left renal pelvic carcinoma(papillary urothelial carcinoma, pT3aN0M0, Stage Ⅱ)at the age of 69. Left nephroureterectomy and partial cystectomy were performed at our hospital. At the age of 71, he was diagnosed with a recurrent bladder tumor and underwent radical cystectomy and ureteroenterostomy at a different hospital. At the age of 73, he visited our hospital with abdominal pain. Computed tomography(CT)revealed wall thickening of the descending colon and dilation of the oral tract. Emergency colonoscopy was performed. He was diagnosed with intestinal obstruction due to descending colon cancer. Colonoscopy revealed a circumferential type 2 lesion in the descending colon that was completely stenosed. Colonic stent placement was performed. A tumor biopsy confirmed the diagnosis of micropapillary adenocarcinoma. The preoperative diagnosis was descending colon cancer cT4aN2aM0, cStage Ⅲc. One month after stent placement, an open segmental resection of the descending colon with D2 dissection was performed. Immunostaining of the specimen showed CK7(+)and CK20(-), and the postoperative diagnosis was a recurrence of left renal pelvic carcinoma in the descending colon. We report a rare case of renal pelvic carcinoma that recurred in the descending colon 4 years after initial surgery.

Rugged bialkali photocathodes encapsulated with graphene and thin metal film.

Protection of free-electron sources has been technically challenging due to lack of materials that transmit electrons while preventing corrosive gas molecules. Two-dimensional materials uniquely possess both of required properties. Here, we report three orders of magnitude increase in active pressure and factor of two enhancement in the lifetime of high quantum efficiency (QE) bialkali photocathodes (cesium potassium antimonide (CsK2Sb)) by encapsulating them in graphene and thin nickel (Ni) film. The photoelectrons were extracted through the graphene protection layer in a reflection mode, and we achieved QE of ~ 0.17% at ~ 3.4 eV, 1/e lifetime of 188 h with average current of 8.6 nA under continuous illumination, and no decrease of QE at the pressure of as high as ~ 1 × 10-3 Pa. In comparison, the QE decreased drastically at 10-6 Pa for bare, non-protected CsK2Sb photocathodes and their 1/e lifetime under continuous illumination was ~ 48 h. We attributed the improvements to the gas impermeability and photoelectron transparency of graphene.