Effects of intermittent 5-fluorouracil and low-dose cisplatin therapy on advanced and recurrent gastric cancer.

Background: Although combination therapy consisting of 5-fluorouracil (5-FU) and cisplatin for the treatment of gastric cancer has been reported, no consistent regimen has been established. Our aim was to determine the optimal treatment schedule of this therapy, for patients with advanced or recurrent gastric cancer.

Patients And Methods: We conducted a phase II study to evaluate the efficacy and safety of combination therapy consisting of intermittent 5-FU and low-dose cisplatin in 26 patients with advanced or recurrent gastric cancer.

Simultaneous laparoscopic hand-assisted hepatectomy and splenectomy for liver cancer with hypersplenism: report of a case.

Hepatocellular carcinoma accompanied by portal hypertension and hypersplenism is difficult to treat medically and surgically due to pancytopenia and the development of collateral circulation. In this study, we were able to safely and simultaneously perform a laparoscopically-assisted splenectomy and partial hepatectomy. The characteristics of this procedure include: (1) the shared use of a medial wound made through laparoscopically-assisted surgery; (2) improved safety for manipulating areas that were difficult to observe with a camera in a case of splenomegaly; (3) a preventive ligation of the splenic artery; (4) improved hemostatic function using LigaSure Impact; and (5) hemorrhage control through manual manipulations and the Pringle maneuver during liver parenchymal transection.

Prognostic significance of the serum thymidine phosphorylase levels in venous blood drainage specimens in patients with colorectal cancer.

Background/aims: We investigated whether the serum Thymidine phosphorylase (TP) levels in venous blood drainage specimens were associated with the prognosis and risk of liver metastasis in patients with resectable colorectal cancer.

Methodology: From 88 patients with colorectal cancer, specimens of venous blood drainage were obtained during operation. The serum TP levels were measured by a highly sensitive Enzyme-Linked Immunosorbent Assay (ELISA) method.

Gastric wall-covering method for the prevention of pancreatic fistula after pancreatic resection.

A pancreatic fistula is one of the most frequent complications and is still responsible for most mortality after pancreatic surgery. We propose a gastric wall-covering method, a new and novel surgical technique in pancreatic surgery for the prevention of pancreatic fistula, in which the pancreatic cutting surface is covered completely with the gastric wall. Ten patients underwent our new surgical technique, gastric wall-covering method, in 7 patients with distal pancreatectomy and in 3 with partial resection of the head of the pancreas.

Multiple rectal carcinoids with diffuse ganglioneuromatosis.

Background: Rectal carcinoids comprise only about 1% of all anorectal neoplasms. In addition, ganglioneuroma of the gastrointestinal tract is a rare tumor composed ganglion cells, nerve fibers, and supporting cells. Multiple carcinoid tumors with diffuse ganglioneuromatosis limited to the rectum are quite unusual.

Destructive granuloma derived from a liver cyst: a case report.

We herein report the case of an idiopathic liver cystic mass which aggressively infiltrated the thoraco-abdominal wall. A 74-year-old woman who had a huge cystic lesion in her right hepatic lobe was transferred to our hospital for further examinations. Imaging studies revealed a simple liver cyst, and the cytological findings of intracystic fluid were negative.

Management of chylous leakage after axillary lymph node dissection in a patient undergoing breast surgery.

A 71-year old woman who underwent a modified radical mastectomy for invasive ductal carcinoma of the left breast, developed postoperative chylous leakage. Though conservative management was uneffective, a direct surgical repair led to good results. Because the morbidity of a reoperation to the superficial chest wall is low, timely surgical treatment is therefore strongly recommended in cases of high output chylous leakage following a mastectomy.

Measurement of portal venous pressure is useful for selecting the optimal type of resection in cirrhotic patients with hepatocellular carcinoma.

Background/aims: In the present study the importance of measurement of portal venous pressure was focused on to predict the postoperative liver function before liver surgery, particularly in cirrhotic patients.

Methodology: Ninety-two patients who underwent a hepatic resection for hepatocellular carcinoma (HCC) were retrospectively evaluated to predict their postoperative liver function by measuring the portal venous pressure.

Results: The portal venous pressure was not significantly correlated with the preoperative value of the indocyanine green (ICG) retention test.

Parapapillary choledochoduodenal fistula associated with cholangiocarcinoma.

Parapapillary choledochoduodenal fistula is a rare disorder. We herein report a case of parapapillary choledochoduodenal fistula associated with cholangiocarcinoma. A 61-year-old woman was admitted to our hospital for further examination of a liver tumor.

Colostomy with vancomycin administration as an effective treatment for toxic megacolon associated with fulminant pseudomembranous colitis: a case report.

We report a case of toxic megacolon associated with fulminant pseudomembranous colitis. A 72-year-old woman was admitted with severe dehydration and shock. Computed tomography showed evidence of diffuse thickening of the colonic wall, colonic dilatation and ascites.

Hilar bile duct cancer associated with preoperatively undetectable von Meyenburg complex--report of a case.

A 56-year-old man was admitted to our hospital with a diagnosis of hilar bile duct cancer. Abdominal ultrasonography, computed tomography and endoscopic retrograde cholangiopancreatography showed no other concomitant disease. Biochemical data showed 0.

Treatment strategy when using intraoperative peritoneal lavage for perforated appendicitis in children: a preliminary report.

We attempt to quantify the amount of peritoneal irrigation required to significantly decrease the intraperitoneal bacteria in children with perforated appendicitis, as no ideal volume of peritoneal lavage has yet been determined. A series of 11 children who were operated on for peritonitis caused by perforated appendicitis were reviewed retrospectively. All children were treated with our treatment protocol that included intraoperative peritoneal lavage using a large volume of saline.

Toward therapeutic guidelines for patients with acute right colonic diverticulitis.

Background: At present, little information is available on the outcome of medical therapy for patients with acute right colonic diverticulitis, and this has meant a gap in constructing guidelines for its treatment.

Methods: The records of patients with acute right colonic diverticulitis at Nagasaki University Graduate School and affiliated hospitals were reviewed and analyzed with the goal of establishing therapeutic guidelines. The time frame of the data analyzed was from 1984 to 2002.

Is a modified central bisegmentectomy a volume-saving operation for pediatric hepatoblastoma?

The authors report on an 11-month-old girl who presented with a hepatoblastoma. The tumor was located in Couinaud's segments IV, V, VII, and VIII. She received adjuvant chemotherapy in accordance with the Japanese Study Group for Pediatric Liver Tumor Protocol-2, and the tumor thereafter showed a partial response, involving segments IV and VIII.

Changes in serum levels of hepatocyte growth factor in patients undergoing adult-to-adult living-donor liver transplantation.

Changes in the serum concentration of hepatocyte growth factor (HGF), a potent mitogen for hepatocytes, were investigated in adult-to-adult living-donor liver transplantation (LDLT) in which liver regeneration is involved. Between August 2000 and November 2002, 15 consecutive adult-to-adult LDLTs were performed using the right lobe graft. The recipients were divided into two groups: acute liver failure (n=6) and chronic liver failure (n=9).

Carcinoembryonic antigen mRNA in the mesenteric vein is not a predictor of hepatic metastasis in patients with resectable colorectal cancer: a long-term study.

Purpose: The clinical value of carcinoembryonic antigen messenger ribonucleic acid in the draining venous blood has been controversial because of short observation period. The authors prospectively investigated the clinical significance of detection of carcinoembryonic antigen messenger ribonucleic acid in the draining venous blood to predict hepatic metastases in patients with resectable colorectal cancer.

Methods: Drainage venous blood from 80 patients who underwent curative resections for colorectal cancer were obtained immediately before surgery to determine the presence of cancer cells by means of reverse transcription polymerase chain reaction.

[D-Ala2, D-Leu5] enkephalin (DADLE) protects liver against ischemia-reperfusion injury in the rat.

Background: [D-Ala(2), D-Leu(5)] enkephalin (DADLE) is a synthetic delta class of opioid and is reported to induce hibernation as well as hibernation induction trigger (HIT) in the serum of hibernating mammals. DADLE and HIT have been demonstrated to protect the heart, lung, and jejunum against ischemia-reperfusion (I-R) injury. In the present study, we examined the effect of DADLE on I-R injury of the liver in rats.