Revealing extraordinary intrinsic tensile plasticity in gradient nano-grained copper.

Nano-grained (NG) metals are believed to be strong but intrinsically brittle: Free-standing NG metals usually exhibit a tensile uniform elongation of a few percent. When a NG copper film is confined by a coarse-grained (CG) copper substrate with a gradient grain-size transition, tensile plasticity can be achieved in the NG film where strain localization is suppressed. The gradient NG film exhibits a 10 times higher yield strength and a tensile plasticity comparable to that of the CG substrate and can sustain a tensile true strain exceeding 100% without cracking. A mechanically driven grain boundary migration process with a substantial concomitant grain growth dominates plastic deformation of the gradient NG structure. The extraordinary intrinsic plasticity of gradient NG structures offers their potential for use as advanced coatings of bulk materials.

Erratum: ZnO-based MIS photodetectors.

[This corrects the article DOI: 10.1016/j.sna.2007.06.006.].

Gastrectomy for advanced gastric carcinoma with invasion to the serosa.

A review of gastrectomy for 332 patients who had advanced gastric cancer with serosal exposed (S2) or adjacent organs invaded (S3) was made. Simple gastrectomy (SG) was carried out in 144 patients while radical gastrectomy (RG), which consisted of systemic lymphadenectomy in addition to SG, was used for the other 188 patients. The type of gastrectomy was chosen arbitrarily by the surgeons except that SG was usually selected when some non-curable factors were present. The operative mortality of SG was 2.7% and that of RG was 3.2%. More lymphnodes could be obtained by RG. Of the 152 patients with S2 who received RG, 46.7% of metastatic lymphnodes could not be identified by SG, while of the 36 patients with S3, 75% of metastatic nodes would be misjudged if SG was carried out. The 5-year-survival rate of RG for stage 3 patients was 42.4% and that for stage 4 patients was 28.2%. Better postoperative long-term-survival was achieved by RG than SG in both stage 3 and 4 patients. When considering the curability of the gastrectomy, the best outcome in stage 3 patients was found in those who underwent an absolute curative resection. Of the stage 4 patients those who received an absolute non-curative resection had the worst result. We recommend that RG be the procedure of choice in treatment of serosal gastric cancer in the absence of non-curable factors. Other adjuvant therapies may be considered after an absolute non-curative gastrectomy in stage 4 serosal cancer patients when multiple non-curable factors were present.

[Gastrectomy for advanced gastric carcinoma with serosal involvement].

Four hundred and eighty five gastric cancer patients underwent gastrectomy in the past 6 years and of those 332 patients (68.2%) were found to have only serosal involvement (se) or adjacent organ invasion (sei). Simple gastrectomy (SG) was carried out in 144 cases while radical gastrectomy (RG), which included systemic lymphadenectomy, was performed in 188 cases. This type of operation was chosen by the operators arbitrarily except in the presence of non-curative factors such as multiple liver metastasis, peritoneal seeding and distant metastasis, in which case SG was always used to relieve gastrointestinal obstruction or bleeding. The operative mortality of SG was 2.7% and that of RG was 3.2%. On average, 15.8 lymph nodes were taken out per patient in SG and 33.6 lymph nodes in RG. The chance of nodal metastasis was higher in sei than in se. According to the Japanese General Rules of Gastric Cancer Study, we found that for gastric cancer with serosal involvement: (1) the long term result of RG was superior to SG in both stage 3 and 4 patients, (2) when absolute curative resection was achieved, the result was the best in stage 3 patients, (3) no patient in stage 4 who underwent absolute non-curative resection survived for more than 42 months, therefore this result was the worst. RG is recommended for advanced gastric cancer patients with serosal involvement whenever the patient's condition permits and in absence of the unresectable non-curative factors.

[Retrograde jejuno-jejunal intussusception. A rare complication following total gastric resection].

Jejunogastric intussusception is an infrequent complication following simple gastrojejunostomy or Billroth II anastomosis. Jejunojejunal intussusception through enteroenteric anastomosis following total gastrectomy, however, was reported in 2 cases. Here we present a case of a 59-year-old male patient with gastric ulcer who received a total gastrectomy with loop esophagojejunostomy and Braun's anastomosis 10 years previously, then developed retrograde jejunojejunal intussusception through Braun's anastomosis. The patient presented after a day of acute attacks of left upper quadrant pain with bilious vomiting. In-time, an operation was performed with successful results. This complication of retrograde jejunojejunal intussusception has never been reported. Clinical history, diagnosis, and treatment are discussed.