A retrospective study of early gastric cancer (60 patients) was performed to evaluate its diagnosis and treatment. Ninety-five per cent of patients presented with nonspecific gastrointestinal symptoms and 53.3% had been treated for presumed benign disease for up to 48 months before diagnosis. Fiberoptic endoscopy detected these lesions more accurately than radiologic examination. The disease-free 5-year survival rate after resection was 76.4%. Survival showed no significant correlation with sex, tumor site, macroscopic appearance, extent of gastric resection, or histopathologic type. Tumors larger than 1.5 cm in diameter, invasion of submucosa, or lymph node metastasis resulted in significantly lower survival rates. Three of eight patients with nodal metastasis survived 5 or more years, including one who had second-echelon deposits. A high index of suspicion may permit more frequent detection. Extended lymphadenectomy (R2) is recommended to achieve the highest possible cure rate.

Background Breast Implant Illness (BII) is a term used to describe a variety of symptoms by patients with breast implants for which there are no abnormal physical or laboratory findings to explain their symptoms. There currently exists a difference of opinion among clinicians and patients concerning the diagnosis and treatment of patients self-reporting BII. Objectives The first aim of this study was to determine if there is a valid indication for "en bloc" capsulectomy in patients self-reporting BII and if the type of capsulectomy performed alters long-term symptom improvement. The second goal was to identify any clinical laboratory differences between the cohorts. This study was funded by the Aesthetic Surgery Education and Research Foundation (ASERF). Methods A prospective blinded study enrolled 150 consecutive subjects divided equally into three cohorts: (A) women with systemic symptoms they attribute to their implants who requested implant removal, (B) women with breast implants requesting removal or exchange who do not have symptoms they attribute to their implants, and (C) women undergoing cosmetic mastopexy who have never had any implanted medical device. The subject's baseline demographic data and a systemic symptoms survey, including PROMIS ® validated questionnaires, was obtained before surgery and at 3-6 weeks, 6 months, and one year. Blood was collected from all three cohorts and implant capsules were collected from Cohorts A and B. Results 150 patients were enrolled between 2019- 2021. Follow-up at 3-6 weeks for all three cohorts was between 98-100%, 78-98% at 6-months, and one year data is currently at 80%. The type of capsulectomy; intact total, total, or partial all showed similar symptom improvement with no statistical difference in the reduction of symptoms based on the type of capsulectomy. Conclusions This study addresses one of the most discussed questions by plastic surgeons, patients, their advocates, and social media. The findings show that patients who self-report BII demonstrate a statistically significant improvement in their symptoms after explantation and that this improvement persists for at least 6 months. This improvement in self-reported systemic was seen regardless of the type of capsulectomy performed.

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Background Breast Implant Illness (BII), as described in recent medical literature and by social media, describes a range of symptoms in patients with breast implants for which there are no physical findings or laboratory results that explain their symptoms. The Aesthetic Surgery Education and Research Foundation (ASERF) Biospecimen study utilized a convergent design to prospectively study both qualitative systemic symptom data and quantitative heavy metals analysis of tissue obtained in surgery. Objectives Part two of this study aims to determine whether heavy metals are present in the capsules around both saline and silicone implants and if there is a statistical difference in the type or level of these metals between women with or without symptoms. Further, data was collected to understand whether the potential source of metals might be from breast implants or from alternate sources such as smoking, diet, nutritional supplements, tattoos, or environmental exposure. This study was entirely funded by ASERF. Methods As previously described, a prospective, blinded study enrolled 150 consecutive subjects divided equally into three cohorts: (A) women with systemic symptoms they attribute to their implants who requested implant removal, (B) women with breast implants requesting removal or exchange who do not have symptoms they attribute to their implants, and (C) women undergoing cosmetic mastopexy who have never had any implanted medical device. Capsule tissue was removed from Cohort A and B and sent to Eurofins for analysis of 22 heavy metals. Additionally, breast tissue was obtained from a control group with no previous exposure to any implanted medical device. Results 150 patients were enrolled between 2019-2021. Follow-up at 3-6 weeks for all three cohorts was between 98-100%, at 6-months was 84-98%, and at one year is currently at 66-90%. Heavy metal content was compared between the capsule tissue from Cohort A and B. The only statistically significant differences identified in Cohort A were higher levels of arsenic and zinc, and lower levels of cobalt, manganese, silver, and tin. There was no detectable beryllium, thallium, or uranium detected in any capsule tissue. There were no statistically significant differences in aluminum, antimony, barium, cadmium, chromium, copper, iron, lead, lithium, mercury, molybdenum, nickel, platinum, selenium, titanium, or vanadium in Cohort A. Platinum was detected in only one of 50 patients in Cohort A and one of 50 patients in Cohort B. Conclusions This study provides an in-depth analysis of the metal content in breast implant capsules surrounding both saline and silicone breast implants. The data reveal patients in Cohort A had a statistically significant increase in only two of the twenty-two metals tested, arsenic and zinc. Heavy metals were also detected in the non-implant control group breast tissue, with some metals (arsenic, lithium, molybdenum) at numerically higher levels than either breast implant cohort. Confounding variables such as cigarette smoking, gluten free diets, dietary supplements, and the presence of tattoos were all identified as statistically significant potential contributory sources of arsenic and zinc in Cohort A.

Background There has been an increasing need to acquire rigorous scientific data to answer the concerns of physicians, patients, and the FDA regarding the self-reported illness identified as Breast Implant Illness (BII). There are no diagnostic tests or specific laboratory values to explain the reported systemic symptoms described by these patients. Objectives This study aims to determine if there are quantifiable laboratory findings that can be identified in the blood, capsule tissue pathology, or microbes that differentiate women with systemic symptoms they attribute to their implants from two control groups. Methods A prospective blinded study enrolled 150 subjects into three cohorts: (A) women with systemic symptoms they attribute to implants who requested implant removal, (B) women with breast implants requesting removal or exchange who did not have symptoms attributed to implants, and (C) women undergoing cosmetic mastopexy who have never had any implanted medical device. Capsule tissue underwent detailed analysis and blood was sent from all three cohorts to evaluate for markers of inflammation. Results No significant histologic differences were identified between the cohorts except there were more capsules with synovial metaplasia in the Non-BII Cohort. There was no statistical difference in TSH, Vitamin D levels, or CBC with differential between the cohorts. Next Generation Sequencing (NGS) revealed no statistically significant difference in positivity between Cohort A and B. Of the 12 cytokines measured, 3 cytokines, IL-17A, IL-13 and IL-22 were found to be significantly more often elevated in sera of subjects in Cohort A than in Cohorts B or C. The enterotoxins data demonstrated an elevation in IgG a-SEA in Cohort A. There was no correlation between the presence of IgE or IgG anti Staph antibody and a positive NGS result. Conclusions This study adds to the current literature by demonstrating few identifiable biomedical markers to explain the systemic symptoms self-reported by patients with BII.