[A case of unresectable rectal cancer with severe pelvic infiltration responding to FOLFOX].

The patient was a 54-year-old male with a huge advanced rectal cancer tumor. Abdominal CT showed liver metastasis and local progressive cancer of the rectum measuring 13 × 9 × 7 cm in diameter, which invaded the urinary bladder and sacrum. We established a diagnosis of unresectable rectal cancer and then performed sigmoid colostomy.

A collision tumor composed of cancers of the bile duct and ampulla of Vater--immunohistochemical analysis of a rare entity of double cancer.

Collision cancer of the bile duct and the papilla of Vater is an extremely rare entity. This is the first report of a case of bile duct collision cancer. A 75-year-old man presented with jaundice.

Clinical significance of drainage tube insertion in laparoscopic cholecystectomy: a prospective randomized controlled trial.

Background/purpose: We aimed to investigate the appropriateness of inserting an intraperitoneal drainage tube after laparoscopic cholecystectomy (LC), based on postoperative pain and clinical courses, in a randomized comparative study.

Methods: One hundred and twenty patients who were to have LC were enrolled in this prospective randomized study. An 8-mm Penrose drain was retained below the liver bed for 42 h in each of 60 patients (group A), and no drain was retained in the remaining 60 patients (group B).

Prognostic factors for long-term survival in patients with locally invasive pancreatic cancer.

Background/purpose: We aimed to investigate predictors of survival in patients with resectable locally invasive pancreatic cancer.

Methods: The patient cohort consisted of 55 patients with locally invasive pancreatic cancer (International Union Against Cancer [UICC] stage III in 36 patients and stage IV in 19) who had undergone resection. The patients were informed about the advantages and the adverse effects of postoperative chemotherapy, and prospectively selected either observation alone or postoperative chemotherapy.

Pathogenesis of hepatolithiasis based on the analysis of components of intrahepatic stones.

Background/aims: It has been thought that intrahepatic stones are brown pigment stones (bilirubin carbonate stones) but we analyzed a chemical compound to reveal that intrahepatic stones have unique components, and studied their pathogenesis.

Methodology: A total of 45 gallbladder stones (15 cholesterol stones, 15 black pigment stones, and 15 brown pigment stones) and 15 intrahepatic stones were analyzed about amounts of fatty acids, bile acids and trace elements in the gallstones. Thus we established the characteristic components of the intrahepatic stones and studied their pathogenesis.

Early removal of prophylactic drains reduces the risk of intra-abdominal infections in patients with pancreatic head resection: prospective study for 104 consecutive patients.

Objective: The aim of this study was designed to determine whether the period of drain insertion influences the incidence of postoperative complications.

Background Data: The significance of prophylactic drains after pancreatic head resection is still controversial. No report discusses the association of the period of drain insertion and postoperative complications.

Impact of lymph node metastasis on survival in patients with pathological T1 carcinoma of the ampulla of Vater.

To determine the prognostic factors for patients with pathological T1 (pT1) carcinoma of the ampulla of Vater, 36 consecutive patients with carcinoma of the ampulla of Vater who underwent surgery were retrospectively analyzed in terms of clinicopathological features. The overall 5-year Kaplan-Meier survival in all patients was 50.2%, and the median survival of all patients was 64.

Does postoperative chemotherapy have a survival benefit for patients with pancreatic cancer?

In our study, we investigated whether postoperative chemotherapy improved survival in patients with invasive ductal carcinoma of the pancreas. Between 1987 and 2004, 111 patients underwent pancreatic resection against invasive ductal carcinoma of the pancreas in Wakayama Medical University Hospital. Median survival time (MST) was 19.

Improvement of delayed gastric emptying in pylorus-preserving pancreaticoduodenectomy: results of a prospective, randomized, controlled trial.

Objective: To determine if an antecolic or a retrocolic duodenojejunostomy during pylorus-preserving pancreaticoduodenectomy (PpPD) was associated with the least incidence of delayed gastric emptying (DGE), in a prospective, randomized, controlled trial.

Summary Background Data: The pathogenesis of DGE after PpPD has been speculated to be related to factors such as inflammation, ischemia, gastric atony, motilin levels, and type of surgical procedure. Previous retrospective studies have shown a lower incidence of DGE after antecolic duodenojejunostomy.

Complications with reconstruction procedures in pylorus-preserving pancreaticoduodenectomy.

This study was conducted retrospectively to examine the efficacy of Traverso reconstruction compared with Billroth I reconstruction after pylorus-preserving pancreaticoduodenectomy, in the prevention of several complications. Pylorus-preserving pancreaticoduodenectomy is an aggressive surgery, and insufficiency of the pancreaticoenterostomy plays an important role in the postoperative progression. However, reports examining the correlation between pancreatic fistula and the type of reconstruction after pylorus-preserving pancreaticoduodenectomy have been limited.

Recurrence of primary hepatocellular carcinoma after hepatectomy--differences related to underlying hepatitis virus species.

Background/aims: Studies on post-hepatectomy prognoses by infecting viral species have only been rarely reported.

Methodology: The patients who had undergone hepatectomy for primary hepatocellular carcinoma (HCC) over the past 10 years at our hospital were divided into three groups based on their underlying causal diseases: hepatitis B (B type), hepatitis C (C type), and non-viral hepatitis including alcoholic hepatitis, and their backgrounds and long-term results after hepatectomy were comparatively investigated.

Results: As for tumor factors, the tumor diameter was 3.

Dose of adenoviral vectors expressing interleukin-2 plays an important role in combined gene therapy with cytosine deaminase/5-fluorocytosine: preclinical consideration.

Using a syngeneic murine model, we investigated the therapeutic efficacy of combined gene therapy using adenoviral vectors expressing murine interleukin-2 (AdmIL-2) and Escherichia coli cytosine deaminase (AdCD). In a subcutaneous tumor model, tumor-bearing mice were treated with an intratumoral injection of adenoviral vectors and received an intraperitoneal administration of 5-fluorocytosine (5-FC). Only the mice treated with AdCD (2 x 10(8) pfu) and an intermediate dose of AdmIL-2 (1 x 10(6) pfu) survived significantly longer than mice treated with AdCD alone (P < 0.

Identification and characterization of a human agonist cytotoxic T-lymphocyte epitope of human prostate-specific antigen.

One potential target of vaccine therapy for human prostate cancer is the prostate-specific antigen (PSA). One strategy to enhance the immunogenicity of a self-antigen such as PSA is to develop agonist epitopes that are potentially more immunogenic. The studies described here report the design and analysis of an agonist epitope designated PSA-3A ("A" for agonist) of the PSA-3 CTL epitope.