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  • 1
    Electronic Resource
    Electronic Resource
    Appraisal of Treatment Strategy by Staging Laparoscopy for Locally Advanced Gastric Cancer (2000)
    Springer
    World journal of surgery 24 (2000), S. 1130-1136 
    Details
    ISSN: 1432-2323
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. More accurate preoperative staging is necessary to determine the treatment strategy for locally advanced gastric cancer. Thirty-two patients with T3 or T4 gastric cancer expected to undergo curative resection based on conventional examinations underwent staging laparoscopy. The disease stages determined were compared with those obtained by conventional methods. The discrepancy rate of disease staging was 16 of 32 (50.0%), with down-staging in 5 of 32 (15.6%) and up-staging in 11 of 32 (34.4%). Of the 32 patients, 13 (40.6%) were found to have unsuspected peritoneal dissemination. The positive predictive value for peritoneal metastasis by staging laparoscopy was 100%, whereas the negative predictive value was 89% (17/19). The accuracy rate was 94%. After laparoscopy, 15 of the 32 (46.9%) were diagnosed as candidates for curative resection. Of these 15 patients who underwent surgery, 13 (86.7%) underwent curative resection (1 R0 and 12 R1); the remaining two underwent R2 resection because of peritoneal metastasis that was undetected by staging laparoscopy. Patients with tumors judged noncurable by laparoscopy (n= 11) received neoadjuvant chemotherapy. In 7 of the 11 cases, salvage surgery was done (one R0, three R1, three R2 resections). A second staging laparoscopy was performed in four cases to determine the indication for salvage surgery. Three of the four were judged to be curable and underwent curative resection. Staging laparoscopy is an effective tool for detecting unsuspected peritoneal metastasis, and it can increase the curative resection rate and decrease unnecessary laparotomy for advanced gastric cancer. Second-look laparoscopy enables accurate assessment of the chemotherapeutic response, which can help in decisions about salvage surgery.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002680010183
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  • 2
    Electronic Resource
    Electronic Resource
    Laparoscopic surgery for blind pouch syndrome following Roux-en Y gastrojejunostomy: Report of a case (1999)
    Springer
    Surgery today 29 (1999), S. 553-556 
    Details
    ISSN: 1436-2813
    Keywords: laparoscopy ; blind pouch syndrome ; post-operative adhesion
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report herein the case of a 59-year-old man in whom blind pouch syndrome was successfully treated by laparoscopic surgery. The patient had undergone distal gastrectomy and Roux-en Y gastrojejunostomy for a peptic ulcer 35 years previously, and had been suffering from watery diarrhea, anemia, weight loss, and pain in the left upper quadrant of his abdomen for serveral years. Long-term insufficient oral intake and the malabsorption of nutrients had resulted in severe emaciation. Gastrointestinal contrast study revealed a large blind pouch, 30 × 23 cm in diameter, draining into the gastrojejunostomy. Laparoscopic resection of the blind pouch was performed. Despite the presence of dense intraabdominal adhesions, we identified the blind pouch with the help of tattoo marks that had been made at the neck of the pouch preoperatively. After thoroughly dissecting the adhesions around the pouch, we resected the pouch at the neck. The patient had an uneventful postoperative course. This case report demonstrates that large blind pouches such as this may be effectively treated using laparoscopic surgery.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02482352
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    Laparoscopic Surgery for Blind Pouch Syndrome Following Roux-en Y Gastrojejunostomy: Report of a Case (1999)
    Springer
    Surgery today 29 (1999), S. 553-556 
    Details
    ISSN: 1436-2813
    Keywords: Key Words: laparoscopy ; blind pouch syndrome ; postoperative adhesion
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s005950050461
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    Paper (German National Licenses)
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  • 4
    Electronic Resource
    Electronic Resource
    Detection of microsatellite alterations in nipple discharge accompanied by breast cancer (2000)
    Springer
    Breast cancer research and treatment 60 (2000), S. 35-41 
    Details
    ISSN: 1573-7217
    Keywords: nipple discharge ; breast cancer ; diagnosis ; loss of heterozygosity
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Nipple discharge in breast cancer cases was examined loss of heterozygosity (LOH). DNA samples were extracted from both supernatant and cell pellet components of the discharge, and examined for LOH at microsatellite markers, D11S1818, D11S2000, D16S402, D16S504, D16S518, D17S520, and D17S786. At least one LOH was found in either the supernatant or cell pellet in seven out of 10 patients (70%). Five of seven samples, which were cytologically negative, were LOH positive, and only one case, which was cytologically positive, showed no LOH on the markers examined. All three samples, which were judged ‘negative’ by CEA measurement (〈400 ng/ml), were LOH positive. This method could be a useful novel diagnostic modality for nonpalpable breast cancer with nipple discharge.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1006336110322
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  • 5
    Electronic Resource
    Electronic Resource
    Selective augmentations of intratumoral 5-fluorouracil concentration by local immunotherapy with OK-432 and fibrinogen (2000)
    Springer
    Diseases of the colon & rectum 43 (2000), S. 402-407 
    Details
    ISSN: 1530-0358
    Keywords: Colorectal carcinoma ; Chemoimmunotherapy ; OK-432 ; 5′-DFUR ; PyNPase
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract PURPOSE: Pyrimidine nucleoside phosphorylase is an enzyme that converts 5′-deoxy-5-fluorouridine into its active metabolite, 5-fluorouracil. In colorectal cancer tissue pyrimidine nucleoside phosphorylase has been proven to be produced by macrophages in the cancer stroma despite presence of the cancer cells. We reported that local immunotherapy with OK-432 and fibrinogen induced aggregation of macrophages in the cancer stroma and enforced their pyrimidine nucleoside phosphorylase expression. Thus it was hypothesized that if colon cancer were treated with 5′-deoxy-5-fluorouridine, the 5-fluorouracil concentration in cancer tissues would be enhanced by local immunotherapy. The present study was conducted to investigate whether local immunotherapy for colon cancer could increase the intratumoral 5-fluorouracil concentration in patients given chemotherapy with 5′-deoxy-5-fluorouridine. METHODS: Twenty patients with resectable colorectal cancer were examined in this study. They were given 5′-deoxy-5-fluorouridine (600 mg/day) orally for seven days preoperatively. Nine randomly selected patients underwent intratumoral injection of OK-432 mixed with fibrinogen, which was performed on the third preoperative day (OK-432 and fibrinogen plus 5′-deoxy-5-fluorouridine group); eleven patients were given oral 5′-deoxy-5-fluorouridine only (5′-deoxy-5-fluorouridine group). The 5-fluorouracil concentration in tumor tissue and normal colon mucosa tissue was measured, and the influence of the local immunotherapy was assessed. RESULTS: The 5-fluorouracil concentration in the cancer tissue was increased by the local immunotherapy, whereas that in the normal colon mucosa was not influenced. Thus, the influence of local immunotherapy was selective to the cancer tissue where the mixture of OK-432 and fibrinogen was injected. CONCLUSION: In patients with colorectal cancer, selective high 5-fluorouracil concentration in the cancer tissue could be achieved by a combination of 5′-deoxy-5-fluorouridine and local immunotherapy with a mixture of OK-432 and fibrinogen.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02258309
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