Long-term survival after resection of brain metastases from esophagogastric junction adenocarcinoma: report of two cases and review of the literature.

The prognosis for brain metastasis from primary esophageal or gastric cancer is often poor because of late detection and a lack of effective treatments. We encountered two cases of long-term survival after resection of brain metastasis that was detected >1 year after primary esophagogastric junction adenocarcinoma resection. Both patients underwent total gastrectomy, middle to lower esophagectomy, and Roux-en-Y reconstruction using the jejunum, and intrathoracic anastomosis was performed via right thoracotomy and laparotomy for primary tumor resection as well as brain metastasis resection followed by CyberKnife irradiation.

[Physiologic pacemaker therapy for drug-resistant heart failure in a patient with dilated cardiomyopathy and first-degree atrioventricular block: a case report].

This is a report of a 65-year-old man with end-stage dilated cardiomyopathy, and first-degree atrioventricular (AV) block, which had been resistant to intensive medical therapy and was eventually treated using a DDD pacemaker. The optimal AV interval setting was determined using invasive right heart catheterization and Doppler echocardiography. At a pacing rate of 92/min, an AV interval setting between 200 and 100 msec increased left ventricular filling and enhanced myocardial contractility.