Benefits of early postoperative jejunal feeding in patients undergoing duodenohemipancreatectomy

瞄准：学习早手术后的肠内的营养是否减少复杂并发症的发生或改进营养的地位追随者 duodenohemipancreatectomy (DHP ) 。方法：我们学习了为一个 peri-ampullary 团经历了 DHP 的 39 个病人。23 个病人收到了全部的父母营养然后开始有在手术后的白天(邮政部门) 之间的营养的口头的吸入 7 和 14 [晚手术后的肠内的营养(LPEN ) 组] 。十六个病人开始有肠内的在手术以后整个空肠造口术导管日子喂[早手术后的肠内的营养(EPEN ) 组] 。在早手术后的阶段的复杂并发症和实验室数据的发生在在 LPEN 和 EPEN 组之间的比较被学习。结果：在 EPEN 组的白朊和全部的蛋白质的浆液层次比在 LPEN 组的那些显著地高。身体团索引的损失显著地作为与 LPEN 组相比在 EPEN 组被压制。在操作比在 LPEN 组在 EPEN 组更快显著地被恢复以后，淋巴细胞计数立即减少了。EPEN 组显著地比 LPEN 组显示出手术后的胰腺的管，以及住院的显著地更短的长度的更少发生。在在二个组之间的另外的手术后的复杂并发症的发生没有有效差量，例如推迟的胃的倒空，外科的地点感染，胆管炎，和小肠阻塞。结论：EPEN 是为为一个 peri-ampullary 团经历了 DHP 的病人的一个安全、有益的机会。

Pharmacokinetic study of paclitaxel in malignant ascites from advanced gastric cancer patients

瞄准：由于源于先进胃的癌症的腹膜炎 carcinomatosa 与腹水在病人在它的静脉内的管理以后在血浆和腹水检验 paclitaxel 集中。方法：有腹水的二个病人在这研究由于源于胃的癌症的腹膜炎 carcinomatosa 被包括。在血浆和腹水的 paclitaxel 集中为 72 h 被调查以防 1 和 168 h 以防 2 在静脉内的管理以后。结果：在血浆的 paclitaxel 集中在管理以后立即达到顶点，在 24 h 以内在 0.1 微摩尔(85 ng/mL ) 的阀值价值下面由快速的减少列在后面。相反，在腹水的 paclitaxel 集中在管理以后为 24 h 逐渐地增加了到与在血浆发现的水平一致的水平。在 24 h 以后，在腹水和血浆的 paclitaxel 的水平变得类似，与被维持直到 72 h 追随者管理的最佳的水平。结论：在腹水的 paclitaxel 的集中在静脉内的管理以后为多达 72 h 为癌症房间的治疗在最佳的水平以内被维持。Paclitaxel 是为胃的癌症的恶意的腹水的治疗的有希望的药。

Cetuximab and panitumumab in a patient with colon cancer and concomitant chronic skin disease:A potential beneficial effect on psoriasis vulgaris

Monoclonal antibodies against epidermal growth factor receptor(EGFR) are used in the treatment of advanced colorectal cancer. However, these agents can induce severe dermatological side effects that discourage their administration in patients with chronic dermatological disease. EGFR plays a key role in normal skin development and immunological function, and is expressed in various tissues and organs, although contrarily, it is overexpressed in psoriasis-related skin lesions. Thus, discussion is ongoing regarding the putative pathological role and therapeutic potential of this protein. We herein report on a patient with advanced colon cancer and concomitant long-standing psoriasis vulgaris who received antiEGFR antibody monotherapy as a third-line treatment for metastatic disease. One week after the initiation of treatment, the patient's skin lesions dramatically subsided and the improvement was sustained during therapy. Based on this case, we propose that anti-EGFR antibody therapy is not necessarily contraindicated in patients with psoriasis vulgaris. Moreover, the findings reaffirmed that EGFR is an important molecule in the pathology of psoriasis.

Clinicopathological study of cardiac tamponade due to pericardial metastasis originating from gastric cancer

AIM: To review the cases reported in the literature,examined their clinicopathological features, and evaluated the efficacy of different therapeutic modalities for this rare condition.METHODS: A search of the MEDLINE database revealed 16 cases of pericarditis carcinomatosa (PC)originating from GC reported in the literature between1982 and 2005. Additional detailed data were obtained from the authors of these studies for subsequent clinicopathological investigation. We have also described about a case study from our own clinic.RESULTS: The mean age of cases with pericarditis carcinomatosa originating from GC was 54 years.Females were diagnosed at a younger age (46.3 years)compared to males (58 years). The mean survival period after diagnosis was 4.5 mo. No statistical differences in the length of survival time were found between different therapeutic modalities, such as drainage, and local and/or systemic chemotherapy after drainage. However,three cases who underwent systemic chemotherapy survived for more than 10 mo. Cases that developed metachronous cardiac tamponade for more than 2years after the diagnosis of GC generally survived for a longer period of time, although this was not statistically significant. Multivariate analysis revealed that low levels of carcinoembryonic antigen (CEA), and CEA and/or cancer antigen 19-9 (CA 19-9) were associated with longer survival.CONCLUSION: Cases with low levels of CEA, and CEA and/or CA 19-9 should undergo systemic chemotherapy with or without local chemotherapy after drainage.

Is there diversity among UGT1A1 polymorphism in Japan?

AIM: To investigate into the diversity of UGT1A1 polymorphism across three different districts in Japan and highlight genetic differences among the population in Japan. METHODS: We enrolled 50 healthy volunteers from each of the Yamaguchi (western part of Japan), Kochi(southern part of Japan) and Akita (northern part of Japan) prefectures. Blood samples (7 mL) were collected from each participant and stored in EDTA for subsequent genotyping by fragment size analysis, direct sequencing and TaqMan assay of UGT1A1*28, UGT1A7*3/UGT1A9*22 and UGT1A1*93/UGT1A1*6/ UGT1A1*27/UGT1A1*60/UGT1A7 (-57), respectively. RESULTS: The only statistically significant differences in allele polymorphisms among the group examined were for UGT1A1*6. The Akita population showed more UGT1A1*6 heterozygosity (P = 0.0496). CONCLUSION: Our study revealed no regional diversity among UGT1A1, UGT1A7 or UGT1A9 polymorphisms in Japan.

Nodular fasciitis in the mesentery, a differential diagnosis of peritoneal carcinomatosis

Nodular fasciitis is a benign proliferative lesion composed of fibroblast-like cells that affects various sites in the body.We describe a patient with nodular fasciitis in the mesentery,encountered during laparotomy for the treatment of ascending colon cancer.The nodular fasciitis in our patient resembled peritoneal dissemination of malignancy on macroscopic observation.Because the treatment options change with concomitant peritoneal dissemination of gastrointestinal tract malignancy,recognition of this rare condition and preparation for unexpected nodular lesions are crucial.

Adult intussusception with cecal adenocarcinoma:Successful treatment by laparoscopy-assisted surgery following preoperative reduction

We report a case of adult intussusception caused by cecal adenocarcinoma that was treated by laparoscopyassisted ileocecal resection following reduction by contrast enema and preoperative colonoscopy.A 68-yearold male with cecal cancer was admitted to our hospital because of colicky abdominal pain after taking a laxative.His abdomen was distended,and a mass was palpable in the right upper quadrant,which appeared as a target-or sausage-shaped lesion by ultrasonograhpy and computed tomography.A contrast enema using water-soluble material showed a cup-shaped filling defect characterized by intussusception in the ascending colon.This round defect with a clear margin was pushed gradually back into the cecum by the enema pressure.Re-occurrence of the intussusception is easilyreleased by colonoscopy.We performed laparoscopyassisted ileocecal resection of a protruding tumor measuring 6.5 cm × 5.0 cm × 3.5 cm from the cecum,with D3 lymph node dissection.Histological examination revealed a well-differentiated adenocarcinoma that had invaded the serosa without permeating the lymphatic or venous capillaries,as well as lymph node metastasis.The postoperative course was uneventful,and the patient has been well without evidence of disease recurrence for 5 years following the operation.Preliminary reduction of adult colonic intussusception before surgical resection is therefore an option in cases of an early and correct diagnosis of intussusception.