Advanced gastric cancer. The findings of delayed phase dynamic CT and radiologic-histopathologic correlation

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Monzawa, Shuichi; Omata, Kosaku; Nakazima, Hiroto; Yokosuka, Noriko; Ito, Atuko; Araki, Tsutomu

2000-01-01

The aim of this study was to describe delayed phase dynamic CT findings of advanced (T2-T4) gastric cancer and to correlate with histopathologic findings. Quadruple phase dynamic CT including delayed imaging taken five minutes after the start of injection of contrast material was performed in 43 patients with 45 advanced gastric cancer and 20 control subjects with no gastric lesions. On delayed phase CT scans, the attenuation of the gastric wall was equal to or lower than that of the liver parenchyma in the control subjects, therefore, the presence of higher attenuation in the gastric wall was considered to be abnormal and defined as delayed enhancement. Histopathologic findings in the tumors showing delayed enhancement were compared with those in the tumors without this feature. Delayed enhancement was seen in 26 (57%) of the 45 tumors. Eleven of 25 differentiated-type tumors and 15 of 20 undifferentiated-type tumors showed delayed enhancement (p<.05). Delayed enhancement was seen in one of five medullary type tumors, in 11 of 25 intermediate-type tumors, and in 14 of 15 scirrhous-type tumors (p<.005). Delayed enhancement was frequently seen in the tumors with abundant fibrous tissue stroma. Delayed phase dynamic CT may be useful for the characterization of advanced gastric cancer. (author)

The Relationship between RUNX3 Expression, Nursing Strategies and Nutritional Status in Elderly Patients with Advanced Gastric Cancer.

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Song, Wen; Teng, Wenhui; Shi, Xinyan; Liu, Xiaozhen; Cui, Zheng; Tian, Zibin

2017-06-01

The aim of this study was to explore the relationship between nutritional status and expression of RUNX3 in gastric cancer cells and to investigate the effects of nursing strategies on the nutritional status of elderly patients with advanced gastric cancer. Forty-eight elderly patients admitted at Affiliated Hospital of Qingdao University with advanced gastric cancer and 30 healthy controls were selected as subjects from 2014-15. The correlation between RNX3 gene expression and nutritional status of the gastric cancer patients was investigated. The patients with advanced gastric cancer who had low expression of RUNX3 gene were treated with holistic nursing while routine nursing was taken for those patients who had normal or high expression of RUNX3 gene. The nutritional statuses of these patients were evaluated after 3 months of nursing. After a follow-up of 1 year, the influence of different nursing methods on the survival time was evaluated. Compared with normal gastric tissue, the expression of RUNX3 gene and protein in tissues of advanced gastric cancer were significantly decreased ( P nutritional statuses of advanced gastric cancer patients with low expressions of RUNX3 were lower ( P nutritional statuses of patients with low expressions of RUNX3 were notably improved after holistic nursing, becoming equivalent to those with normal or high expression of RUNX3 who received routine nursing ( P >0.05). The survival time of patients with low expression of RUNX3 who received holistic nursing were similar to patients with normal or high expression of RUNX3 who received routine nursing ( P >0.05). RUNX3 is correlated with the occurrence and development of advanced gastric cancer. The low nutritional status of elderly advanced gastric cancer patients with low expressions of RUNX3 can be significantly enhanced by holistic nursing, thereby prolonging survival time.

Preoperative chemoradiotherapy for locally advanced gastric cancer

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Pepek Joseph M

2013-01-01

Full Text Available Abstract Background To examine toxicity and outcomes for patients treated with preoperative chemoradiotherapy (CRT for gastric cancer. Methods Patients with gastroesophageal (GE junction (Siewert type II and III or gastric adenocarcinoma who underwent neoadjuvant CRT followed by planned surgical resection at Duke University between 1987 and 2009 were reviewed. Overall survival (OS, local control (LC and disease-free survival (DFS were estimated using the Kaplan-Meier method. Toxicity was graded according to the Common Toxicity Criteria for Adverse Events version 4.0. Results Forty-eight patients were included. Most (73% had proximal (GE junction, cardia and fundus tumors. Median radiation therapy dose was 45 Gy. All patients received concurrent chemotherapy. Thirty-six patients (75% underwent surgery. Pathologic complete response and R0 resection rates were 19% and 86%, respectively. Thirty-day surgical mortality was 6%. At 42 months median follow-up, 3-year actuarial OS was 40%. For patients undergoing surgery, 3-year OS, LC and DFS were 50%, 73% and 41%, respectively. Conclusions Preoperative CRT for gastric cancer is well tolerated with acceptable rates of perioperative morbidity and mortality. In this patient cohort with primarily advanced disease, OS, LC and DFS rates in resected patients are comparable to similarly staged, adjuvantly treated patients in randomized trials. Further study comparing neoadjuvant CRT to standard treatment approaches for gastric cancer is indicated.

Preoperative chemoradiotherapy for locally advanced gastric cancer

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Pepek, Joseph M; Chino, Junzo P; Willett, Christopher G; Palta, Manisha; Blazer III, Dan G; Tyler, Douglas S; Uronis, Hope E; Czito, Brian G

2013-01-01

To examine toxicity and outcomes for patients treated with preoperative chemoradiotherapy (CRT) for gastric cancer. Patients with gastroesophageal (GE) junction (Siewert type II and III) or gastric adenocarcinoma who underwent neoadjuvant CRT followed by planned surgical resection at Duke University between 1987 and 2009 were reviewed. Overall survival (OS), local control (LC) and disease-free survival (DFS) were estimated using the Kaplan-Meier method. Toxicity was graded according to the Common Toxicity Criteria for Adverse Events version 4.0. Forty-eight patients were included. Most (73%) had proximal (GE junction, cardia and fundus) tumors. Median radiation therapy dose was 45 Gy. All patients received concurrent chemotherapy. Thirty-six patients (75%) underwent surgery. Pathologic complete response and R0 resection rates were 19% and 86%, respectively. Thirty-day surgical mortality was 6%. At 42 months median follow-up, 3-year actuarial OS was 40%. For patients undergoing surgery, 3-year OS, LC and DFS were 50%, 73% and 41%, respectively. Preoperative CRT for gastric cancer is well tolerated with acceptable rates of perioperative morbidity and mortality. In this patient cohort with primarily advanced disease, OS, LC and DFS rates in resected patients are comparable to similarly staged, adjuvantly treated patients in randomized trials. Further study comparing neoadjuvant CRT to standard treatment approaches for gastric cancer is indicated

Hemostatic radiation therapy in advanced gastric cancer

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Novaes, P.E.R.S.; Possik, R.A.; Peres, O.; Abrao, A.

1987-01-01

Nine patients with advanced bleeding gastric cancer are treated with 4MVC linear accelerator or cobaltotherapy inparallel opposed fields to epigastric region. The radiation therapy is employed as an hemostatic procedure and the results of treatment are analysed. The doses ranged of 1000 rad to 4000 rad, 150 to 300 rad/day, five days a week. (M.A.C.) [pt

Exome sequencing identifies early gastric carcinoma as an early stage of advanced gastric cancer.

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Guhyun Kang

Full Text Available Gastric carcinoma is one of the major causes of cancer-related mortality worldwide. Early detection and treatment leads to an excellent prognosis in patients with early gastric cancer (EGC, whereas the prognosis of patients with advanced gastric cancer (AGC remains poor. It is unclear whether EGCs and AGCs are distinct entities or whether EGCs are the beginning stages of AGCs. We performed whole exome sequencing of four samples from patients with EGC and compared the results with those from AGCs. In both EGCs and AGCs, a total of 268 genes were commonly mutated and independent mutations were additionally found in EGCs (516 genes and AGCs (3104 genes. A higher frequency of C>G transitions was observed in intestinal-type compared to diffuse-type carcinomas (P = 0.010. The DYRK3, GPR116, MCM10, PCDH17, PCDHB1, RDH5 and UNC5C genes are recurrently mutated in EGCs and may be involved in early carcinogenesis.

Retrospective analysis of treatment outcomes after postoperative chemoradiotherapy in advanced gastric cancer

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Kim, Sup; Kim, Jun Sang; Jeong, Hyun Yong; Noh, Seung Moo; Kim, Ki Whan; Cho, Moon June

2011-01-01

To evaluate retrospectively the survival outcome, patterns of failure, and complications in patients treated with postoperative chemoradiotherapy (CRT) in advanced gastric cancer. Between January 2000 and December 2006, 80 patients with advanced gastric cancer who received postoperative concurrent CRT were included. Pathological staging was IB-II in 9%, IIIA in 38%, IIIB in 33%, and IV in 21%. Radiotherapy consisted of 45 Gy of radiation. Concurrent chemotherapy consisted of a continuous intravenous infusion of 5-fluorouracil and leucovorin on the first 4 days and last 3 days of radiotherapy. The median follow-up period was 48 months (range, 3 to 83 months). The 5-year overall survival, disease-free survival, and locoregional recurrence-free survivals were 62%, 59%, and 80%, respectively. In the multivariate analysis, significant factors for disease-free survival were T stage (hazard ratio [HR], 0.278; p = 0.038), lymph node dissection extent (HR, 0.201; p = 0.002), and maintenance oral chemotherapy (HR, 2.964; p = 0.004). Locoregional recurrence and distant metastasis occurred in 5 (6%) and 18 (23%) patients, respectively. Mixed failure occurred in 10 (16%) patients. Grade 3 leukopenia and thrombocytopenia were observed in 4 (5%) and one (1%) patient, respectively. Grade 3 nausea and vomiting developed in 8 (10%) patients. Intestinal obstruction developed in one (1%). The survival outcome of the postoperative CRT in advanced gastric cancer was similar to those reported previously. Our postoperative CRT regimen seems to be a safe and effective method, reducing locoregional failure without severe treatment toxicity in advanced gastric cancer patients.

Gastric metastasis from invasive lobular breast cancer, mimicking primary gastric cancer: A case report.

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Kim, Dae Hoon; Son, Seung-Myoung; Choi, Young Jin

2018-03-01

Gastric metastasis from invasive lobular breast cancer is relatively rare, commonly presented among multiple metastases, several years after primary diagnosis of breast cancer. Importantly, gastric cancer that is synchronously presented with lobular breast cancer can be misdiagnosed as primary gastric cancer; therefore, accurate differential diagnosis is required. A 39-year-old woman was visited to our hospital because of right breast mass and progressive dyspepsia. Invasive lobular carcinoma of breast was diagnosed on core needle biopsy. Gastroscopy revealed a diffuse scirrhous mass at the prepyloric antrum and diagnosed as poorly differentiated adenocarcinoma on biopsy. Synchronous double primary breast and gastric cancers were considered. Detailed pathological analysis focused on immunohistochemical studies of selected antibodies, including those of estrogen receptors, gross cystic disease fluid protein-15, and caudal-type homeobox transcription factor 2, were studied. As a result, gastric lesion was diagnosed as metastatic gastric cancer originating from breast. Right breast conserving surgery was performed, and duodenal stent was inserted under endoscopic guidance to relieve the patient's symptoms. Systemic chemotherapy with combined administration of paclitaxel and trastuzumab was initiated. Forty-one months after the diagnosis, the patient is still undergoing the same therapy. No recurrent lesion has been identified in the breast and evidence of a partial remission of gastric wall thickening has been observed on follow-up studies without new metastatic lesions. Clinical suspicion, repeat endoscopic biopsy, and detailed histological analysis, including immunohistochemistry, are necessary for diagnosis of metastatic gastric cancer from the breast.

Efficacy of prophylactic splenectomy for proximal advanced gastric cancer invading greater curvature.

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Ohkura, Yu; Haruta, Shusuke; Shindoh, Junichi; Tanaka, Tsuyoshi; Ueno, Masaki; Udagawa, Harushi

2017-05-25

For proximal gastric cancer invading the greater curvature, concomitant splenectomy is frequently performed to secure the clearance of lymph node metastases. However, prognostic impact of prophylactic splenectomy remains unclear. The aim of this study was to clarify the oncological significance of prophylactic splenectomy for advanced proximal gastric cancer invading the greater curvature. Retrospective review of 108 patients who underwent total or subtotal gastrectomy for advanced proximal gastric cancer involving the greater curvature was performed. Short-term and long-term outcomes were compared between the patients who underwent splenectomy (n = 63) and those who did not (n = 45). Patients who underwent splenectomy showed higher amount of blood loss (538 vs. 450 mL, p = 0.016) and morbidity rate (30.2 vs. 13.3, p = 0.041) compared with those who did not undergo splenectomy. In particular, pancreas-related complications were frequently observed among patients who received splenectomy (17.4 vs. 0%, p = 0.003). However, no significant improvement of long-term outcomes were confirmed in the cases with splenectomy (5-year recurrence-free rate, 60.2 vs. 67.3%; p = 0.609 and 5-year overall survival rates, 63.7 vs. 73.6%; p = 0.769). On the other hand, splenectomy was correlated with marginally better survival in patients with Borrmann type 1 or 2 gastric cancer (p = 0.072). For advanced proximal gastric cancer involving the greater curvature, prophylactic splenectomy may have no significant prognostic impact despite the increased morbidity rate after surgery. Such surgical procedure should be avoided as long as lymph node involvement is not evident.

Radiotherapy combined with tegafur for inoperable advanced gastric carcinomas

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Matsumoto, K; Asakawa, H; Otawa, H; Yamada, S [Miyagi Prefectural Adult Disease Center, Natori (Japan)

1982-02-01

A total of 58 cases with inoperable advanced gastric carcinomas were treated by radiotherapy combined with tegafur, and the result was analyzed mainly from the aspects of life expectancies and some prognostic factors. Median survival time of all cases was 8.9 months. Actuarial survival rates at one, two, three, four and five years were 45%, 22%, 14%, 14% and 11% respectively. Cancer type, histologic type, tumor size and radiation effect on the primary lesion were chosen as the prognostic factors, and examined using median survival time as a parameter. Borrmann IV type cancer showed an unequivocally poor prognosis, whereas no significant prognostic differences were seen among other types. Poorly differentiated adenocarcinoma gave a poor prognosis. Radiation effect on the primary lesion seemed to have a positive correlation with prognosis, while life expectancies became shorter with the increase of tumor size. It seems, from the present study, that this combination therapy contributes a great deal to life prolongation of patients with inoperable advanced gastric carcinomas.

A rare case with synchronous gastric gastrointestinal stromal tumor, pancreatic neuroendocrine tumor, and uterine leiomyoma.

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Arabadzhieva, Elena; Yonkov, Atanas; Bonev, Sasho; Bulanov, Dimitar; Taneva, Ivanka; Vlahova, Alexandrina; Dikov, Tihomir; Dimitrova, Violeta

2016-11-15

Although gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract, they comprise less than 1% of all gastrointestinal tumors. Neuroendocrine tumors (NET) of the gastro-enteropancreatic system are also rare, representing about 2% of all gastrointestinal neoplasms. Pancreatic localization of NET is extremely uncommon-these tumors are only 1-5% of all pancreatic cancers. We describe an unusual case with triple tumor localization-a gastric tumor, a formation in the pancreas, which involves the retroperitoneal space, and a uterine leiomyoma. The exact diagnosis was confirmed with immunohistochemical study after surgical treatment of the patient. Distal pancreatic resection, splenectomy, partial gastrectomy, omentectomy, and hysterectomy were performed. The histological examination proved an epithelioid type of gastric GIST. Immunostaining showed focal positive expression of c-kit and no mitotic figures per 50 HPF. Histology of the pancreatic and retroperitoneal formation proved a well-differentiated NET with origin from the islets of Langerhans. The immunohistochemical study demonstrated co-expression of chromogranin A and synaptophysin. This is the fourth case published so far of a patient with synchronous pancreatic NET and gastric GIST. The main objective of the study is to present a unique case because we have not found any reports for coexistence of the described three types of neoplasm, as in our patient, and we hope that it will be valuable in the future investigations about the genesis, diagnosis, and treatment of these types of tumors.

Neoadjuvant chemoradiotherapy for cStage IIIA/IIIB locally advanced gastric cancer

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Inoue, Tatsushi; Suto, Hiromasa; Kashiwagi, Hirotaka

2010-01-01

We evaluated the impact of neoadjuvant chemoradiotherapy (NACRT) with radio-enhancing S-1 for locally advanced gastric cancer. Patients who had a gastric cancer infiltrating into other organs (T4) or with bulky N2 were enrolled in this study. They received oral S-1 (65 mg/m 2 /day) administration and 50 Gy radiotherapy followed by radical surgery. In 12 subjects (male:female ratio, 7:5; mean age, 70.0 years), 10 (83.3%) completed NACRT and 12 (100%) underwent curative resection. Histopathological efficacy (≥Grade 1b) and down staging were observed 6 patients (75.0%) and 5 (62.5%), respectively, in 8 T4 patients. The efficacy was ≥Grade 2 in all 4 patients with bulky N2. No extra-nodal invasion was noted. In this series 1-and 3-year survival rates were 90.9% and 60.6%, respectively, during a mean observation period of 18.6 months. This procedure is applicable even to hemorrhaging patients. Outstanding antineoplastic effects are expected in locally advanced gastric cancer. (author)

OUR EXPERIENCE OF HYPERTHERMIC INTRAPERITONEAL CHEMOTHERAPY FOR PATIENTS WITH ADVANCED GASTRIC CANCER

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A. D. Kaprin

2015-01-01

Full Text Available Purpose. Improvement of the results of treatment of patients with locally advanced and metastatic gastric cancer. Material and methods. From the 2010–2014 we performed 30 surgeries using techniques HICT. Among patients there were 17 men and 13 women. The median of age was 50 years. Locally advanced gastric cancer (T4a-T4b was observed in 22 cases, including 4 patients in the emergency immunocytochemical study with peritoneal lavage detected cancer-free (Cyt + cells in the abdominal cavity. The group of patients with metastatic gastric cancer accounted for 8 patients. Narrow carcinomatosis (P1 was 4 cases, carcinomatosis (P2-P3 — 4. Adjuvant systemic chemotherapy in the study group was not carried out. In the control group No 1 (n = 51 performed surgery alone, without additional anticancer therapy. In the control group No 2 (n = 66, a combined treatment (surgery + chemotherapy. Results. Follow-up median was 25 months. Overall 1-year survival rate for all three groups was 55%, 39% and 52%, respectively. Median survival in the intervention group versus 21.4 months in the 8 and 12 months, respectively. The most effective HICT is shown for patients with locally advanced gastric cancer. In the study group, median overall survival was 29 months. The survival rate of 1-, 2-, 3-year-old was equal to 68%, 61% and 42%. In the first control group, 1-year survival of 45%. None of the patients did not survive 2 years. In the second control group, one-year survival rate was 60%, 2-year survival is not. Results of treatment of metastatic gastric cancer proved to be more modest. In the main group the median survival was 10 months, compared with 6 and 7 months of the two control groups. There were no statistically significant differences. Conclusions. 1. Availability of limited dissemination, free cancer cells in the abdominal cavity, as well as a massive defeat of serous membrane of the stomach can be seen as indications for HICT in gastric cancer. 2. In

Correlation of primary tumor FDG uptake with histopathologic features of advanced gastric cancer

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Kim, Hae Won; Won, Kyoung Sook; Song, Bong Il; Kang, Yu Na

2015-01-01

Histopathologic features could affect the FDG uptake of primary gastric cancer and detection rate on FDG PET/CT. The aim of this study was to evaluate the FDG uptake of primary gastric cancer by correlating it with the histopathologic features of the tumors. Fifty patients with locally advanced gastric adenocarcinoma who were referred for preoperative FDG-PET/CT scans were enrolled in this study. The detection rate of PET/CT and maximum standardized uptake values (SUV max ) of the primary tumor were compared using the WHO, Lauren, Ming and Borrmann classifications and tumor size and location. In 45 of the 50 patients (90 %), the primary gastric tumors were detected by FDG PET/CT. On comparison using the WHO classification, the detection rate and SUV max of the tubular type were significantly higher than those of the poorly cohesive type. On comparison using the Lauren and Ming classifications, the SUV maxs of the intestinal type and expanding type were significantly higher than those of the diffuse and infiltrative type, respectively. On comparison using the Borrmann classification and tumor size and location, there was no significant difference in the detection rate and SUV max of primary gastric tumors. This study demonstrates that the poorly cohesive type according to the WHO classification, diffuse type according to the Lauren classification and infiltrative type according to the Ming classification have low FDG uptake in patients with locally advanced gastric carcinoma. Understanding the relationship between primary tumor FDG uptake and histopathologic features would be helpful in detecting the primary tumor by FDG PET/CT in patients with gastric cancer

Anti-angiogenic Therapy in Patients with Advanced Gastric and Gastroesophageal Junction Cancer: A Systematic Review.

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Chen, Li-Tzong; Oh, Do-Youn; Ryu, Min-Hee; Yeh, Kun-Huei; Yeo, Winnie; Carlesi, Roberto; Cheng, Rebecca; Kim, Jongseok; Orlando, Mauro; Kang, Yoon-Koo

2017-10-01

Despite advancements in therapy for advanced gastric and gastroesophageal junction cancers, their prognosis remains dismal. Tumor angiogenesis plays a key role in cancer growth and metastasis, and recent studies indicate that pharmacologic blockade of angiogenesis is a promising approach to therapy. In this systematic review, we summarize current literature on the clinical benefit of anti-angiogenic agents in advanced gastric cancer. We conducted a systematic search of PubMed and conference proceedings including the American Society of Clinical Oncology, the European Society for Medical Oncology, and the European Cancer Congress. Included studies aimed to prospectively evaluate the efficacy and safety of anti-angiogenic agents in advanced gastric or gastroesophageal junction cancer. Each trial investigated at least one of the following endpoints: overall survival, progression-free survival/time to progression, and/or objective response rate. Our search yielded 139 publications. Forty-two met the predefined inclusion criteria. Included studies reported outcomes with apatinib, axitinib, bevacizumab, orantinib, pazopanib, ramucirumab, regorafenib, sorafenib, sunitinib, telatinib, and vandetanib. Second-line therapy with ramucirumab and third-line therapy with apatinib are the only anti-angiogenic agents so far shown to significantly improve survival of patients with advanced gastric cancer. Overall, agents that specifically target the vascular endothelial growth factor ligand or receptor have better safety profile compared to multi-target tyrosine kinase inhibitors.

Current Molecular Targeted Therapy in Advanced Gastric Cancer: A Comprehensive Review of Therapeutic Mechanism, Clinical Trials, and Practical Application

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Kaichun Li

2016-01-01

Full Text Available Despite the great progress in the treatment of gastric cancer, it is still the third leading cause of cancer death worldwide. Patients often miss the opportunity for a surgical cure, because the cancer has already developed into advanced cancer when identified. Compared to best supportive care, chemotherapy can improve quality of life and prolong survival time, but the overall survival is often short. Due to the molecular study of gastric cancer, new molecular targeted drugs have entered the clinical use. Trastuzumab, an antibody targeting human epidermal growth factor receptor 2 (HER2, can significantly improve survival in advanced gastric cancer patients with HER2 overexpression. Second-line treatment of advanced gastric cancer with ramucirumab, an antibody targeting VEGFR-2, alone or in combination with paclitaxel, has been proved to provide a beneficial effect. The VEGFR-2 tyrosine kinase inhibitor, apatinib, can improve the survival of advanced gastric cancer patients after second-line chemotherapy failure. Unfortunately, none of the EGFR targeting antibodies (cetuximab or panitumumab, VEGF targeting monoclonal antibodies (bevacizumab, mTOR inhibitor (everolimus, or HGF/MET pathway targeting drugs has a significant survival benefit. Many other clinical trials based on molecular markers are underway. This review will summarize targeted therapies for advanced gastric cancer.

The role of palliative radiation therapy in symptomatic locally advanced gastric cancer

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Tey, Jeremy; Back, Michael F.; Shakespeare, Thomas P.; Mukherjee, Rahul K.; Lu, Jiade J.; Lee, Khai Mun; Wong, Lea Choung; Leong, Cheng Nang; Zhu Ming

2007-01-01

Purpose: To review the outcome of palliative radiotherapy (RT) alone in patients with symptomatic locally advanced or recurrent gastric cancer. Methods and Materials: Patients with symptomatic locally advanced or recurrent gastric cancer who were managed palliatively with RT at Cancer Institute, Singapore were retrospectively reviewed. Study end points included symptom response, median survival, and treatment toxicity (retrospectively scored using the Common Toxicity Criteria v3.0 [CTC]). Results: Between November 1999 and December 2004, 33 patients with locally advanced or recurrent gastric cancer were managed with palliative intent using RT alone. Median age was 76 years (range, 38-90 years). Twenty-one (64%) patients had known distant metastatic disease at time of treatment. Key index symptoms were bleeding (24 patients), obstruction (8 patients), and pain (8 patients). The majority of patients received 30 Gy/10 fractions (17 patients). Dose fractionation regimen ranged from an 8-Gy single fraction to 40 Gy in 16 fractions. Median survival was 145 days, actuarial 12-month survival 8%. A total of 54.3% of patients (13/24) with bleeding responded (median duration of response of 140 days), 25% of patients (2/8) with obstruction responded (median duration of response of 102 days), and 25% of patients (2/8) with pain responded (median duration of response of 105 days). No obvious dose-response was evident. One Grade 3 CTC equivalent toxicity was recorded. Conclusion: External beam RT alone is an effective and well tolerated modality in the local palliation of gastric cancer, with palliation lasting the majority of patients' lives

Recent advances in gastric emptying scintigraphy

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Urbain, J.L.C.; Mayeur, S.M.

1996-01-01

Gastric emptying scintigraphy was introduced more than 25 years ago by Grittith and still remains the gold standard to assess gastric emptying. Test meals, radiopharmaceuticals and acquisition procedures have been refined and optimized over the years and the test procedure is now pretty well standardized. However, in its most common use, gastric emptying scintigraphy provides little information on gastric physiology. Over the last decade, modelling of the liquid and solid emptying curves have brought some insight in the complex gastric physiology. Compartmental analysis of the stomach has also provided information on the pathophysiological mechanisms of delayed gastric emptying. Over the past 5 years, the most dramatic development in gastric emptying scintigraphy has been the introduction of Digital Antral Scintigraphy (DAS). Digital Antral scintigraphy basically consists in dynamically imaging of the stomach and the use of a refined Fourier transform processing method. This new procedure allows for the visualization of antral contractions and, alike manometry, permits quantitative characterization on the frequency and amplitude of these contractions. Overall, this new procedure provides a unique, non invasive tool to characterize gastric motility, to define the pathophysiologic mechanisms of gastric motor disorders and to evaluate the effect of new gastro-kinetic compounds. (authors). 241 refs., 5 figs

Prevalence of Helicobacter pylori infection in advanced gastric carcinoma

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Irami Araújo-Filho

2006-12-01

Full Text Available BACKGROUD: There is substantial evidence that infection with Helicobacter pylori plays a role in the development of gastric cancer and that it is rarely found in gastric biopsy of atrophic gastritis and gastric cancer. On advanced gastric tumors, the bacteria can be lost from the stomach. AIMS: To analyze the hypothesis that the prevalence of H.pylori in operated advanced gastric carcinomas and adjacent non-tumor tissues is high, comparing intestinal and diffuse tumors according to Lauren's classification METHODS: A prospective controlled study enrolled 56 patients from "Hospital Universitário", Federal University of Rio Grande do Norte, Natal, RN, Brazil, with advanced gastric cancer, treated from February 2000 to March 2003. Immediately after partial gastrectomy, the resected stomach was opened and several mucosal biopsy samples were taken from the gastric tumor and from the adjacent mucosa within 4 cm distance from the tumor margin. Tissue sections were stained with hematoxylin and eosin. Lauren's classification for gastric cancer was used, to analyse the prevalence of H. pylori in intestinal or diffuse carcinomas assessed by the urease rapid test, IgG by ELISA and Giemsa staining. H. pylori infected patients were treated with omeprazole, clarithromycin and amoxicillin for 7 days. Follow-up endoscopy and serology were performed 6 months after treatment to determine successful eradication of H. pylori in non-tumor tissue. Thereafter, follow-up endoscopies were scheduled annually. Chi-square and MacNemar tests with 0.05 significance were used. RESULTS: Thirty-four tumors (60.7% were intestinal-type and 22 (39.3% diffuse type carcinomas. In adjacent non-tumor gastric mucosa, chronic gastritis were found in 53 cases (94.6% and atrophic mucosa in 36 patients (64.3%. All the patients with atrophic mucosa were H. pylori positive. When examined by Giemsa and urease test, H. pylori positive rate in tumor tissue of intestinal type carcinomas was

Advanced gastric adenocarcinoma. Influence of preoperative radiation therapy on toxicity and long-term survival rates

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Malzoni, Carlos Eduardo

1996-01-01

The surgical treatment of gastric cancer has better long-term survival rates when performed in patients with early gastric cancer. Worse results are obtained in treatment of advanced gastric cancer. Most patients in west centers are treated in advanced stages. A great number of them go through a surgical treatment unable by itself to cure them. the frequent local recurrence caused by failure of the surgical treatment has been keeping poor survival rates in patients with advanced gastric cancer for decades. The desire of improving survival is the reason of the use of adjuvant therapies. This paper achieved the retrospective study of the influence of preoperative radiation therapy (2000 cGy) in long-term survival rates (120 months) of patients with advanced gastric cancer on stages IIIa, IIIb and IV. The possible injuries caused in the liver and kidney were observed also as well as first group was treated by surgical and radiation therapies and the second received surgical treatment only. There was no statistical difference between the two groups when sex, age, race, occurrence of other diseases, nutritional assessment, TNM stage, occurrence of obstruction or bleeding caused by tumor, surgical procedure and hepatic and renal function were considered. Survival rates and changes on hepatic and renal function were statistically compared. The results showed a statistic improvement on the long-term survival rates of stage IIIa patients treated by preoperative radiation therapy. No statistic difference was observed on hepatic or renal function between the groups. No adverse influence of radiation therapy method was detected by the used parameters. There was no statistical difference between the two groups when immediate surgical complications were considered. (author)

Preoperative chemoradiotherapy in locally advanced gastric cancer, a phase I/II feasibility and efficacy study

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Trip, Anouk K. [Department of Radiation Oncology, Netherlands Cancer Institute – Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands); Poppema, Boelo J. [Department of Medical Oncology, University Medical Centre Groningen (Netherlands); Berge Henegouwen, Mark I. van [Department of Surgical Oncology, Academic Medical Centre – University of Amsterdam (Netherlands); Siemerink, Ester [Department of Internal Medicine, Ziekenhuisgroep Twente, Hengelo (Netherlands); Beukema, Jannet C. [Department of Radiation Oncology, University Medical Centre Groningen (Netherlands); Verheij, Marcel [Department of Radiation Oncology, Netherlands Cancer Institute – Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands); Plukker, John T.M. [Department of Surgical Oncology, University Medical Centre Groningen (Netherlands); Richel, Dick J. [Department of Medical Oncology, Academic Medical Centre – University of Amsterdam (Netherlands); Hulshof, Maarten C.C.M. [Department of Radiation Oncology, Academic Medical Centre – University of Amsterdam (Netherlands); Sandick, Johanna W. van [Department of Surgical Oncology, Netherlands Cancer Institute – Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands); Cats, Annemieke [Department of Gastroenterology and Hepatology, Netherlands Cancer Institute – Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands); Jansen, Edwin P.M. [Department of Radiation Oncology, Netherlands Cancer Institute – Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands); Hospers, Geke A.P., E-mail: g.a.p.hospers@umcg.nl [Department of Medical Oncology, University Medical Centre Groningen (Netherlands)

2014-08-15

Objectives: This study was initiated to investigate the feasibility and efficacy of preoperative radiotherapy with weekly paclitaxel and carboplatin in locally advanced gastric cancer. Methods: In a prospective study, patients with locally advanced gastric cancer stage IB-IV(M0) were treated with chemoradiotherapy followed by surgery 4–6 weeks after the last irradiation. Chemoradiotherapy consisted of radiation to a total dose of 45 Gy given in 25 fractions of 1.8 Gy, combined with concurrent weekly carboplatin and paclitaxel. Results: Between December 2007 and January 2012, 25 patients with cT3 (64%) or cT4 (36%) gastric cancer were included. One patient discontinued concurrent chemotherapy in the 4th week due to toxicity, but completed radiotherapy. Another patient discontinued chemoradiotherapy after the 3rd week due to progressive disease. Grade III adverse events of chemoradiotherapy were: gastrointestinal 12%, haematological 12% and other 8%. All patients, except one who developed progressive disease, were operated. Surgical complications were: general/infectious 48%, anastomotic leakage 12%, and bowel perforation 8%. Postoperative mortality was 4%. Microscopically radical resection rate was 72%. Pathological complete response rate was 16% and near complete response rate 24%. Conclusions: In this study, preoperative chemoradiotherapy for patients with locally advanced gastric cancer was associated with manageable toxicity and encouraging pathological response rates.

Preoperative chemoradiotherapy in locally advanced gastric cancer, a phase I/II feasibility and efficacy study

International Nuclear Information System (INIS)

Trip, Anouk K.; Poppema, Boelo J.; Berge Henegouwen, Mark I. van; Siemerink, Ester; Beukema, Jannet C.; Verheij, Marcel; Plukker, John T.M.; Richel, Dick J.; Hulshof, Maarten C.C.M.; Sandick, Johanna W. van; Cats, Annemieke; Jansen, Edwin P.M.; Hospers, Geke A.P.

2014-01-01

Objectives: This study was initiated to investigate the feasibility and efficacy of preoperative radiotherapy with weekly paclitaxel and carboplatin in locally advanced gastric cancer. Methods: In a prospective study, patients with locally advanced gastric cancer stage IB-IV(M0) were treated with chemoradiotherapy followed by surgery 4–6 weeks after the last irradiation. Chemoradiotherapy consisted of radiation to a total dose of 45 Gy given in 25 fractions of 1.8 Gy, combined with concurrent weekly carboplatin and paclitaxel. Results: Between December 2007 and January 2012, 25 patients with cT3 (64%) or cT4 (36%) gastric cancer were included. One patient discontinued concurrent chemotherapy in the 4th week due to toxicity, but completed radiotherapy. Another patient discontinued chemoradiotherapy after the 3rd week due to progressive disease. Grade III adverse events of chemoradiotherapy were: gastrointestinal 12%, haematological 12% and other 8%. All patients, except one who developed progressive disease, were operated. Surgical complications were: general/infectious 48%, anastomotic leakage 12%, and bowel perforation 8%. Postoperative mortality was 4%. Microscopically radical resection rate was 72%. Pathological complete response rate was 16% and near complete response rate 24%. Conclusions: In this study, preoperative chemoradiotherapy for patients with locally advanced gastric cancer was associated with manageable toxicity and encouraging pathological response rates

The usefulness of multiplanar reconstruction images in preoperative t-staging of advanced gastric cancer

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Koo, Young Baek; Kim, Suk; Lee, Jun Woo; Kim, Soo Jin; Choo, Ki Seok; Lee, Tae Hong; Moon, Tae Yong; Lee, Suk Hong; Jeon, Tae Yong

2004-01-01

The purpose of this study was to evaluate the performance of multidetector-row CT (MDCT) in the preoperative T-staging of patients with advanced gastric cancer. A total of 65 patients with an established diagnosis of advanced gastric cancer (T2 or more) were evaluated with MDCT. The protocol of MDCT consisted of high-quality (HQ) mode helical scanning with a slice thickness of 2.5 mm. The axial CT images were reconstructed with a slice thickness of 5 mm. MPR images were reconstructed from the raw axial data with a slice thickness of 5 mm. A comparison between the standard axial and axial MPR images was performed by two radiologists with regard to the evaluation of the tumor location and T-stage. These findings were compared with the pathologic and surgical findings. T-staging of the advanced stomach cancer was correct in 89% (58/65) and 69% (45/65) of the MPR images and axial images, respectively. The MPR images improved the detection rate (5 lesions) of the tumors and increased the accuracy of the T-staging (13 lesions) in comparison with the axial images. The MPR images are of greater diagnostic value for the evaluation of omental seeding (5 lesions: axial images, 9 lesions: MPR images), tumor location and extension. Multiplanar reconstruction (MPR) images provide increased confidence in the location and T-staging of certain cases of advanced gastric cancer, such as those in locations where CT images are susceptible to be affected by the difficulties associated with partial volume averaging. In this study, the MPR images provided more precise information about the tumor location and T-staging than the standard axial images in the preoperative evaluation of advanced gastric cancer

Endoscopic Ultrasound-Guided Drainage of Intra-Abdominal Abscess after Gastric Perforation in a Patient Receiving Ramucirumab and Paclitaxel for Advanced Gastric Cancer

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Koichiro Mandai

2017-01-01

Full Text Available Gastrointestinal perforation is a serious adverse event that occurs in approximately 1% of patients receiving ramucirumab and paclitaxel. A 67-year-old man with unresectable advanced gastric cancer was admitted to our hospital and treated with ramucirumab and paclitaxel. Gastric perforation occurred during the second cycle of chemotherapy. Although the patient’s condition improved without surgery, an abscess developed in the intra-abdominal fluid collection resulting from the perforation. We performed endoscopic ultrasound-guided abscess drainage. The patient improved and was discharged in satisfactory condition. Endoscopic ultrasound-guided drainage is a treatment option for patients with intra-abdominal abscess following gastric perforation due to ramucirumab.

Second-line treatments: moving towards an opportunity to improve survival in advanced gastric cancer?

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Salati, Massimiliano; Di Emidio, Katia; Tarantino, Vittoria; Cascinu, Stefano

2017-01-01

Gastric cancer is the third leading cause of cancer-related death globally with approximately 723 000 deaths every year. Most patients present with advanced unresectable or metastatic disease, only amenable to palliative systemic treatment and a median survival uncommonly exceeding 12 months. Over the last years, the efficacy of chemotherapy combination has plateaued and the introduction of the anti-human epidermal growth factor receptor 2 trastuzumab has resulted in a limited survival gain in the upfront setting. After this positive experience, first-line treatment with new targeted therapies failed to improve the outcome of advanced gastric cancer. On the contrary, second-line options, including monochemotherapy with taxanes or irinotecan and the anti-vascular endothelial growth factor receptor 2 ramucirumab, either alone or combined with paclitaxel, opened new therapeutic rooms for an ever-increasing number of patients who maintain an acceptable performance status across multiple lines. This article provides an updated overview on the current management of advanced gastric cancer and discusses how the different treatment options available may be best combined to favourably impact the outcome of patients following the logic of a treatment strategy.

Value of the prognostic nutritional index in advanced gastric cancer treated with preoperative chemotherapy.

Science.gov (United States)

Sun, Jianyi; Wang, Donghai; Mei, Ying; Jin, Hailong; Zhu, Kankai; Liu, Xiaosun; Zhang, Qing; Yu, Jiren

2017-03-01

The prognostic nutritional index (PNI) is a useful parameter indicating the immune and nutritional status of cancer patients; this study investigated the prognostic value of the PNI in advanced gastric cancer patients treated with preoperative chemotherapy. We retrospectively reviewed 117 advanced gastric cancer patients who met the inclusion criteria for preoperative chemotherapy and underwent surgical resection from July 2004 to December 2011. The patients were divided into PNI-high (PNI ≥ 45) and PNI-low (PNI  0.05). Cox regression analysis indicated that yield pathologic T (ypT), yield pathologic N (ypN) stage, and prechemotherapy PNI were independent prognostic factors (ypT: HR = 2.914, 95% CI = 1.312-6.470, P = 0.009; ypN: HR = 4.909, 95% CI = 1.764-13.660, P = 0.003; prechemotherapy PNI: HR = 1.963, 95% CI = 1.101-3.499, P = 0.022). The prechemotherapy PNI is a useful predictor of the long-term outcome of patients with advanced gastric cancer treated with preoperative chemotherapy. Copyright © 2016 Elsevier Inc. All rights reserved.

Evaluation of dynamic serum thiol/disulfide homeostasis in locally advanced and metastatic gastric cancer

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Mutlu Hizal

2018-04-01

Full Text Available Background: Gastric cancer is one the most diagnosed cancer and the third leading cause of death from cancer worldwide. As an indicator of antioxidant capacity thiol/disulfide homeostasis regulates detoxification, cell signal mechanisms, apoptosis, transcription and antioxidant defense mechanisms. Disregulation of thiol/disulfide homeostasis identified in other cancer types by recent data. In this study, we aimed to evaluate the thiol/disulfide homeostasis in advanced gastric cancer patients. Methods: The patients who diagnosed with gastric cancer and healthy control subjects were included to study. Serum samples for the thiol-disulphide test were obtained at the time of diagnosis. Thiol-disulphide homeostasis tests were measured by the automated spectrophotometric method. Thiol-disulphide homeostasis was also measured according to clinical and laboratory features. Results: Thirty newly diagnosed advanced gastric adenocarcinoma patients and 28 healthy controls were enrolled in the study. The native thiol (NT and total thiol (TT levels of patients' group were significantly lower compared with controls (p = 0.001 and p < 0.001. In the CEA high (≥5.4 ng/ml group, DS/NT ratio were higher compared with CEA low (<5.4 ng/ml group (p = 0.024. In CA.19-9 high (≥28.3 kU/L group, both DS and DS/NT ratio were significantly higher compared with a CA19-9 low(<28.3 kU/L group (p < 0.05 both. The correlation between CEA and DS levels was also significant (p = 0.02. There was also a positive correlation between CEA levels and DS/NT ratio (p = 0.01. Conclusion: Derangements of thiol/disulfide homeostasis may have a role in gastric cancer pathogenesis and the higher level of oxidative stress may relate to extensive and aggressiveness of the advanced disease. The diagnostic and prognostic values of thiol/disulfide products need to identify with further studies. Keywords: Thiol, Disulfide, Oxidative stress, Gastric cancer, Metastatic

Chemotherapy for advanced gastric cancer.

Science.gov (United States)

Wagner, Anna Dorothea; Syn, Nicholas Lx; Moehler, Markus; Grothe, Wilfried; Yong, Wei Peng; Tai, Bee-Choo; Ho, Jingshan; Unverzagt, Susanne

2017-08-29

Gastric cancer is the fifth most common cancer worldwide. In "Western" countries, most people are either diagnosed at an advanced stage, or develop a relapse after surgery with curative intent. In people with advanced disease, significant benefits from targeted therapies are currently limited to HER-2 positive disease treated with trastuzumab, in combination with chemotherapy, in first-line. In second-line, ramucirumab, alone or in combination with paclitaxel, demonstrated significant survival benefits. Thus, systemic chemotherapy remains the mainstay of treatment for advanced gastric cancer. Uncertainty remains regarding the choice of the regimen. To assess the efficacy of chemotherapy versus best supportive care (BSC), combination versus single-agent chemotherapy and different chemotherapy combinations in advanced gastric cancer. We searched the Cochrane Central Register of Controlled Trials, MEDLINE and Embase up to June 2016, reference lists of studies, and contacted pharmaceutical companies and experts to identify randomised controlled trials (RCTs). We considered only RCTs on systemic, intravenous or oral chemotherapy versus BSC, combination versus single-agent chemotherapy and different chemotherapy regimens in advanced gastric cancer. Two review authors independently identified studies and extracted data. A third investigator was consulted in case of disagreements. We contacted study authors to obtain missing information. We included 64 RCTs, of which 60 RCTs (11,698 participants) provided data for the meta-analysis of overall survival. We found chemotherapy extends overall survival (OS) by approximately 6.7 months more than BSC (hazard ratio (HR) 0.3, 95% confidence intervals (CI) 0.24 to 0.55, 184 participants, three studies, moderate-quality evidence). Combination chemotherapy extends OS slightly (by an additional month) versus single-agent chemotherapy (HR 0.84, 95% CI 0.79 to 0.89, 4447 participants, 23 studies, moderate-quality evidence), which is

Expression of caspase-3 predicts prognosis in advanced noncardia gastric cancer.

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Amptoulach, Sousana; Lazaris, Andreas C; Giannopoulou, Ioanna; Kavantzas, Nikolaos; Patsouris, Efstratios; Tsavaris, Nikolaos

2015-01-01

There is strong evidence that tumor growth is not only a result of uncontrolled cell proliferation but also of decreased apoptosis. Caspase-3 is a member of interleukin-1 beta-converting enzyme which is involved in the induction of apoptosis. Data on the expression of caspase-3 in patients with gastric cancer and its association with patient outcome are somewhat contradictory. We aimed to investigate the potential relation of the expression of caspase-3 protein with response to therapy and overall survival in patients with advanced noncardia gastric cancer. Tumor tissue samples collected from 359 consecutive patients with gastric cancer stage IV were retrospectively analyzed for the expression of caspase-3 in the primary tumor. The DNA apoptotic index assessed by the terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate-biotin nick end labeling method. All patients were followed up until death. Caspase-3 was expressed in 43.5 % of tumors. Caspase-3 expression compared to no expression was related with a higher DNA apoptotic index (p gastric cancer is a predictor of poor response to treatment and survival. Further studies are needed to fully elucidate the prognostic value of caspase-3 expression in these patients.

Association of IL-1beta gene polymorphism with cachexia from locally advanced gastric cancer

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Zhang, Dianliang; Zheng, Hongmei; Zhou, Yanbing [Department of General Surgery, Affiliated Hospital of Qingdao University Medical College, Qingdao 266003 (China); Tang, Xingming; Yu, Baojun; Li, Jieshou [Research Institute of General Surgery, Jinlin Hospital, Nanjing University, Nanjing 210093 (China)

2007-03-14

IL-1beta has been implicated in inflammatory episode. In view of the inflammatory nature of cancer cachexia, we determined the predictive value of IL-1B-31 T/C, -511 C/T, +3954 C/T and IL-1RN VNTR gene polymorphisms on the occurrence of cachexia associated with locally advanced gastric cancer. The study included 214 patients and 230 healthy volunteers. Genomic DNA was prepared from peripheral blood leukocytes. Genotypes and allele frequencies were determined in patients and healthy controls using restriction fragment length polymorphism analysis of polymerase chain reaction products. The overall frequencies of IL-1B-31 T, -511 T, +3954 T and IL-1RN VNTR alleles in patients with locally advanced gastric cancer were all comparable with those in controls. No significant differences were found in the distribution of IL-1B-31 T, -511 T and IL-1RN VNTR between patients with cachexia and without. Patients with cachexia showed a significantly higher prevalence of IL-1B+3954 T allele than those without (P = 0.018). In a logistic regression analysis adjusted for actual weight, carcinoma location and stage, the IL-1B+3954 CT genotype was associated with an odds ratio of 2.512 (95% CI, 1.180 – 5.347) for cachexia. The IL-1B+3954 T allele is a major risk for cachexia from locally gastric cancer. Genetic factors studied are not likely to play an important role in the determination of susceptibility to locally advanced gastric cancer.

Association of IL-1beta gene polymorphism with cachexia from locally advanced gastric cancer

International Nuclear Information System (INIS)

Zhang, Dianliang; Zheng, Hongmei; Zhou, Yanbing; Tang, Xingming; Yu, Baojun; Li, Jieshou

2007-01-01

IL-1beta has been implicated in inflammatory episode. In view of the inflammatory nature of cancer cachexia, we determined the predictive value of IL-1B-31 T/C, -511 C/T, +3954 C/T and IL-1RN VNTR gene polymorphisms on the occurrence of cachexia associated with locally advanced gastric cancer. The study included 214 patients and 230 healthy volunteers. Genomic DNA was prepared from peripheral blood leukocytes. Genotypes and allele frequencies were determined in patients and healthy controls using restriction fragment length polymorphism analysis of polymerase chain reaction products. The overall frequencies of IL-1B-31 T, -511 T, +3954 T and IL-1RN VNTR alleles in patients with locally advanced gastric cancer were all comparable with those in controls. No significant differences were found in the distribution of IL-1B-31 T, -511 T and IL-1RN VNTR between patients with cachexia and without. Patients with cachexia showed a significantly higher prevalence of IL-1B+3954 T allele than those without (P = 0.018). In a logistic regression analysis adjusted for actual weight, carcinoma location and stage, the IL-1B+3954 CT genotype was associated with an odds ratio of 2.512 (95% CI, 1.180 – 5.347) for cachexia. The IL-1B+3954 T allele is a major risk for cachexia from locally gastric cancer. Genetic factors studied are not likely to play an important role in the determination of susceptibility to locally advanced gastric cancer

Evaluation of PET and laparoscopy in STagIng advanced gastric cancer: A multicenter prospective study (PLASTIC-study)

NARCIS (Netherlands)

H.J.F. Brenkman (Hylke J.F.); Gertsen, E.C. (E. C.); E. Vegt (Erik); R. van Hillegersberg (Richard); M.I. van Berge Henegouwen; S.S. Gisbertz (Suzanne S.); M. Luyer (Misha); G.A.P. Nieuwenhuijzen (Gerard); J.J.B. van Lanschot (Jan); S.M. Lagarde (Sjoerd); W.O. de Steur (Wobbe O.); H.H. Hartgrink (H.); J.H.M.B. Stoot (Jan); K.W.E. Hulsewé (Karel W.E.); E.J. Spillenaar Bilgen (Ernst Jan); M.J. van Det (Marc J.); E.A. Kouwenhoven (Ewout); D.L. van der Peet (Donald); F. Daams (Freek); J.W. van Sandick (J.); N.C.T. Grieken (Nicole); J. Heisterkamp (Joos); B. van Etten (Boudewijn); J.W. Haveman; J.-P.E.N. Pierie (Jean-Pierre); Jonker, F. (F.); Thijssen, A.Y. (A. Y.); E.J.T. Belt (Eric); P. van Duijvendijk (Peter); Wassenaar, E. (E.); H.W.M. van Laarhoven (Hanneke); Wessels, F.J. (F. J.); N. Haj Mohammad; H.F. van Stel (Henk); G.W.J. Frederix (Geert); P.D. Siersema (Peter); J.P. Ruurda (Jelle)

2018-01-01

textabstractBackground: Initial staging of gastric cancer consists of computed tomography (CT) and gastroscopy. In locally advanced (cT3-4) gastric cancer, fluorodeoxyglucose positron emission tomography with CT (FDG-PET/CT or PET) and staging laparoscopy (SL) may have a role in staging, but

Evaluation of PET and laparoscopy in STagIng advanced gastric cancer: a multicenter prospective study (PLASTIC-study).

Science.gov (United States)

Brenkman, H J F; Gertsen, E C; Vegt, E; van Hillegersberg, R; van Berge Henegouwen, M I; Gisbertz, S S; Luyer, M D P; Nieuwenhuijzen, G A P; van Lanschot, J J B; Lagarde, S M; de Steur, W O; Hartgrink, H H; Stoot, J H M B; Hulsewe, K W E; Spillenaar Bilgen, E J; van Det, M J; Kouwenhoven, E A; van der Peet, D L; Daams, F; van Sandick, J W; van Grieken, N C T; Heisterkamp, J; van Etten, B; Haveman, J W; Pierie, J P; Jonker, F; Thijssen, A Y; Belt, E J T; van Duijvendijk, P; Wassenaar, E; van Laarhoven, H W M; Wessels, F J; Haj Mohammad, N; van Stel, H F; Frederix, G W J; Siersema, P D; Ruurda, J P

2018-04-20

Initial staging of gastric cancer consists of computed tomography (CT) and gastroscopy. In locally advanced (cT3-4) gastric cancer, fluorodeoxyglucose positron emission tomography with CT (FDG-PET/CT or PET) and staging laparoscopy (SL) may have a role in staging, but evidence is scarce. The aim of this study is to evaluate the impact and cost-effectiveness of PET and SL in addition to initial staging in patients with locally advanced gastric cancer. This prospective observational cohort study will include all patients with a surgically resectable, advanced gastric adenocarcinoma (cT3-4b, N0-3, M0), that are scheduled for treatment with curative intent after initial staging with gastroscopy and CT. The modalities to be investigated in this study is the addition of PET and SL. The primary outcome of this study is the proportion of patients in whom the PET or SL lead to a change in treatment strategy. Secondary outcome parameters are: diagnostic performance, morbidity and mortality, quality of life, and cost-effectiveness of these additional diagnostic modalities. The study recently started in August 2017 with a duration of 36 months. At least 239 patients need to be included in this study to demonstrate that the diagnostic modalities are break-even. Based on the annual number of gastrectomies in the participating centers, it is estimated that approximately 543 patients are included in this study. In this study, it is hypothesized that performing PET and SL for locally advanced gastric adenocarcinomas results in a change of treatment strategy in 27% of patients and an annual cost-reduction in the Netherlands of €916.438 in this patient group by reducing futile treatment. The results of this study may be applicable to all countries with comparable treatment algorithms and health care systems. NCT03208621 . This trial was registered prospectively on June 30, 2017.

Increased risk of gastric adenocarcinoma after treatment of primary gastric diffuse large B-cell lymphoma

International Nuclear Information System (INIS)

Inaba, Koji; Morota, Madoka; Mayahara, Hiroshi; Ito, Yoshinori; Sumi, Minako; Uno, Takashi; Itami, Jun; Kushima, Ryoji; Murakami, Naoya; Kuroda, Yuuki; Harada, Ken; Kitaguchi, Mayuka; Yoshio, Kotaro; Sekii, Shuhei; Takahashi, Kana

2013-01-01

There have been sporadic reports about synchronous as well as metachronous gastric adenocarcinoma and primary gastric lymphoma. Many reports have dealt with metachronous gastric adenocarcinoma in mucosa-associated lymphoid tissue lymphoma of stomach. But to our knowledge, there have been no reports that document the increased incidence of metachronous gastric adenocarcinoma in patients with gastric diffuse large B-cell lymphoma. This retrospective study was conducted to estimate the incidence of metachronous gastric adenocarcinoma after primary gastric lymphoma treatment, especially in diffuse large B-cell lymphoma. The retrospective cohort study of 139 primary gastric lymphoma patients treated with radiotherapy at our hospital. Mean observation period was 61.5 months (range: 3.7-124.6 months). Patients profile, characteristics of primary gastric lymphoma and metachronous gastric adenocarcinoma were retrieved from medical records. The risk of metachronous gastric adenocarcinoma was compared with the risk of gastric adenocarcinoma in Japanese population. There were 10 (7.2%) metachronous gastric adenocarcinoma patients after treatment of primary gastric lymphomas. It was quite high risk compared with the risk of gastric carcinoma in Japanese population of 54.7/100,000. Seven patients of 10 were diffuse large B-cell lymphoma and other 3 patients were mixed type of diffuse large B-cell lymphoma and mucosa associated lymphoid tissue lymphoma. Four patients of 10 metachronous gastric adenocarcinomas were signet-ring cell carcinoma and two patients died of gastric adenocarcinoma. Metachronous gastric adenocarcinoma may have a more malignant potential than sporadic gastric adenocarcinoma. Old age, Helicobacter pylori infection and gastric mucosal change of chronic gastritis and intestinal metaplasia were possible risk factors for metachronous gastric adenocarcinoma. There was an increased risk of gastric adenocarcinoma after treatment of primary gastric lymphoma

Clinical benefit of palliative radiation therapy in advanced gastric cancer

International Nuclear Information System (INIS)

Kim, Michelle M.; Rana, Vishal; Janjan, Nora A.

2008-01-01

Background. Local progression of advanced gastric cancer often manifests as bleeding, dysphagia/obstruction, or pain. We evaluated the magnitude and durability of palliation with radiotherapy (RT). Material and methods. From 1996 to 2004, 37 gastric cancer patients were treated with palliative RT (median dose 35Gy in 14 fractions). Nearly two-thirds of all patients received concurrent chemoradiation therapy (CRT). Index pre-treatment symptoms were gastric bleeding, dysphagia/obstruction, and pain in 54%, 43%, and 19% of patients, respectively. Results. The rates of control for bleeding, dysphagia/obstruction, and pain were 70% (14/20), 81% (13/16), and 86% (6/7), respectively. These symptoms were controlled without additional interventions for a median of 70%, 81%, and 49% of the patient's remaining life, respectively. Patients receiving CRT had a trend towards better median overall survival than those receiving RT alone (6.7 vs. 2.4 months, p=0.08). Lower (<41 Gy) biologically effective dose (BED, assuming an alpha/beta ratio of 10 for early responding tissues) predicted for poorer local control (6-month local control 70% vs. 100%, p=0.05) while T4 tumors had a trend towards inferior local control (6-month LC 56% vs. 100%, p=0.06). Discussion. Palliative RT controls symptoms for most of the remaining life in the majority of gastric cancer patients. The role of a higher dose of RT (BED ≥ 41 Gy), especially in patients with T4 tumors, remains to be established. In order to accurately define the role for radiotherapy in palliation of these symptoms, prospective randomized studies need to be conducted

Management of advanced gastric cancer: An overview of major findings from meta-analysis

Science.gov (United States)

Cai, Danxian; Li, Wende; Hui, Jialiang; Liu, Chuan; Zhao, Yanxia; Li, Guoxin

2016-01-01

This study aims to provide an overview of different treatment for advanced gastric cancer. In the present study, we systematically reviewed the major findings from relevant meta-analyses. A total of 54 relevant papers were searched via the PubMed, Web of Science, and Google scholar databases. They were classified according to the mainstay treatment modalities such as surgery, chemotherapy and others. Primary outcomes including overall survival, response rate, disease-free survival, recurrence-free survival, progression-free survival, time-to-progression, time-to failure, recurrence and safety were summarized. The recommendations and uncertainties regarding the treatment of advanced gastric cancer were also proposed. It was suggested that laparoscopic gastrectomy was a safe and technical alternative to open gastrectomy. Besides, neoadjuvant chemotherapy and adjuvant chemotherapy were thought to benefit the survival over surgery alone. And it was demonstrated in the study that targeted therapy like anti-angiogenic and anti-HER2 agents but anti-EGFR agent might have a significant survival benefit. PMID:27655725

Clinical benefit of palliative radiation therapy in advanced gastric cancer

Energy Technology Data Exchange (ETDEWEB)

Kim, Michelle M.; Rana, Vishal; Janjan, Nora A. (Dept. of Radiation Oncology, Univ. of Texas M.D. Anderson Cancer Center, Houston, Texas (US)) (and others)

2008-03-15

Background. Local progression of advanced gastric cancer often manifests as bleeding, dysphagia/obstruction, or pain. We evaluated the magnitude and durability of palliation with radiotherapy (RT). Material and methods. From 1996 to 2004, 37 gastric cancer patients were treated with palliative RT (median dose 35Gy in 14 fractions). Nearly two-thirds of all patients received concurrent chemoradiation therapy (CRT). Index pre-treatment symptoms were gastric bleeding, dysphagia/obstruction, and pain in 54%, 43%, and 19% of patients, respectively. Results. The rates of control for bleeding, dysphagia/obstruction, and pain were 70% (14/20), 81% (13/16), and 86% (6/7), respectively. These symptoms were controlled without additional interventions for a median of 70%, 81%, and 49% of the patient's remaining life, respectively. Patients receiving CRT had a trend towards better median overall survival than those receiving RT alone (6.7 vs. 2.4 months, p=0.08). Lower (<41 Gy) biologically effective dose (BED, assuming an alpha/beta ratio of 10 for early responding tissues) predicted for poorer local control (6-month local control 70% vs. 100%, p=0.05) while T4 tumors had a trend towards inferior local control (6-month LC 56% vs. 100%, p=0.06). Discussion. Palliative RT controls symptoms for most of the remaining life in the majority of gastric cancer patients. The role of a higher dose of RT (BED >= 41 Gy), especially in patients with T4 tumors, remains to be established. In order to accurately define the role for radiotherapy in palliation of these symptoms, prospective randomized studies need to be conducted.

Cost-effectiveness of Paclitaxel + Ramucirumab Combination Therapy for Advanced Gastric Cancer Progressing After First-line Chemotherapy in Japan.

Science.gov (United States)

Saito, Shota; Muneoka, Yusuke; Ishikawa, Takashi; Akazawa, Kouhei

2017-12-01

The combination of paclitaxel + ramucirumab is a standard second-line treatment in patients with advanced gastric cancer. This therapy has been associated with increased median overall survival and progression-free survival compared with those with paclitaxel monotherapy. We evaluated the cost-effectiveness of paclitaxel + ramucirumab combination therapy in patients with advanced gastric cancer, from the perspective of health care payers in Japan. We constructed a Markov model to compare, over a time horizon of 3 years, the costs and effectiveness of the combination of paclitaxel + ramucirumab and paclitaxel alone as second-line therapies for advanced gastric cancer in Japan. Health outcomes were measured in life-years (LYs) and quality-adjusted (QA) LYs gained. Costs were calculated using year-2016 Japanese yen (¥1 = US $17.79) according to the social insurance reimbursement schedule and drug tariff of the fee-for-service system in Japan. Model robustness was addressed through 1-way and probabilistic sensitivity analyses. The costs and QALYs were discounted at a rate of 2% per year. The willingness-to-pay threshold was set at the World Health Organization's criterion of ¥12 million, because no consensus exists regarding the threshold for acceptable cost per QALY ratios in Japan's health policy. Paclitaxel + ramucirumab combination therapy was estimated to provide an additional 0.09 QALYs (0.10 LYs) at a cost of ¥3,870,077, resulting in an incremental cost-effectiveness ratio of ¥43,010,248/QALY. The incremental cost-effectiveness ratio for the combination therapy was >¥12 million/QALY in all of the 1-way and probabilistic sensitivity analyses. Adding ramucirumab to a regimen of paclitaxel in the second-line treatment of advanced gastric cancer is expected to provide a minimal incremental benefit at a high incremental cost per QALY. Based on our findings, adjustments in the price of ramucirumab, as well as improves in other clinical parameters such as survival

Effect of depression on the immune function and tumor load in patients with advanced gastric cancer

Directory of Open Access Journals (Sweden)

Hai-Bo Shi

2017-06-01

Full Text Available Objective: To study the correlation between depression and immune function as well as tumor load in patients with advanced gastric cancer. Methods: 98 patients diagnosed with advanced gastric cancer in our hospital between May 2013 and September 2016 were selected and divided into depression group (n=39 with HAMD scores >50 and non-depression group with HAMD scores≤50 (n=39, serum was collected to detect the levels of cytokines interleukin-2 (IL-2, IL-4, IL-10, IL-17, interferon-γ (IFN-γ and transforming growth factor β1 (TGF- β1 as well as tumor markers carcinoembryonic antigen (CEA, carbohydrate antigen 199 (CA199, CA724, TK-1 and sLAG-3, and gastric cancer tissues were collected to determine the expression of cell cycle-related proteins CyclinD1, CDK4 and E2F. Results: Serum IL-2, IFN-γ and IL-17 levels of depression group were significantly lower than those of non-depression group (P<0.05 while IL-4, IL-10, TGF-β1, CEA, CA199, CA724, TK-1 and sLAG-3 levels were significantly higher than those of non-depression group (P<0.05; CyclinD1, CDK4 and E2F protein expression in tumor tissues of depression group were significantly higher than those of non-depression group (P<0.05. Conclusions: Depression can inhibit the anti-tumor immune response in patients with advanced gastric cancer, and then promote cancer cell proliferation and increase tumor load.

Effect of depression on the immune function and tumor load in patients with advanced gastric cancer

Institute of Scientific and Technical Information of China (English)

Hai-Bo Shi

2017-01-01

Objective:To study the correlation between depression and immune function as well as tumor load in patients with advanced gastric cancer.Methods: 98 patients diagnosed with advanced gastric cancer in our hospital between May 2013 and September 2016 were selected and divided into depression group (n=39) with HAMD scores >50 and non-depression group with HAMD scores≤50 (n=39), serum was collected to detect the levels of cytokines interleukin-2 (IL-2), IL-4, IL-10, IL-17, interferon-γ (IFN-γ) and transforming growth factorβ1 (TGF-β1) as well as tumor markers carcinoembryonic antigen (CEA), carbohydrate antigen 199 (CA199), CA724, TK-1 and sLAG-3, and gastric cancer tissues were collected to determine the expression of cell cycle-related proteins CyclinD1, CDK4 and E2F.Results:Serum IL-2, IFN-γand IL-17 levels of depression group were significantly lower than those of non-depression group (P<0.05) while IL-4, IL-10, TGF-β1, CEA, CA199, CA724, TK-1 and sLAG-3 levels were significantly higher than those of non-depression group (P<0.05);CyclinD1, CDK4 and E2F protein expression in tumor tissues of depression group were significantly higher than those of non-depression group (P<0.05).Conclusions:Depression can inhibit the anti-tumor immune response in patients with advanced gastric cancer, and then promote cancer cell proliferation and increase tumor load.

Gastric cancer

International Nuclear Information System (INIS)

Salek, T.

2007-01-01

Gastric cancer is still a major health problem and a leading cause of cancer mortality despite a worldwide decline in incidence. Primarily due to early detection of the disease, the results of treatment for gastric cancer have improved in Japan, Korea and several specialized Western centres. Surgery offers excellent long-term survival results for early gastric cancer (EGC). In the Western world, however more than 80 % of patients at diagnosis have an advanced gastric cancer with a poor prognosis. The aim of surgery is the complete removal of the tumour (UICC R0-resection), which is known to be the only proven, effective treatment modality and the most important treatmentrelated prognostic factor. The prognosis after surgical treatment of gastric cancer remains poor. Neoadjuvant chemotherapy is a rising option in locally advanced gastric cancer. Adjuvant chemoradiation has been shown to be beneficial in gastric cancer patients who have undergone suboptimal surgical resection. The benefits of adjuvant chemotherapy alone seem to be very small, Untreated metastatic gastric cancer is associated with a median survival of only 3 - 4 months, but this can be increased to 8 - 10 months, associated with improved quality of life, with combination chemotherapy. Currently, no standard combination chemotherapy regimen exists, although regimens utilizing both cisplatin and 5-fluorouracil, such as epirubicin/cisplatin/fluorouracil (ECF) or docetaxel/cisplatin/fluorouracil (DCF) are amongst the most active. Newer chemotherapeutic agents, including irinotecan, oxaliplatin and taxanes, show promising activity, and are currently being tested with biologics in clinical trials. (author)

Correlation Between Infection Status of Epstein-Barr Virus and 18F-Fluorodeoxyglucose Uptake in Patients with Advanced Gastric Cancer.

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Na, Sae Jung; Park, Hye Lim; O, Joo Hyun; Lee, Sung Yong; Song, Kyo Young; Kim, Sung Hoon

2017-01-01

Epstein-Barr virus-associated gastric cancer (EBVaGC) is one of the four molecular subtypes of gastric cancer, as defined by the classification recently proposed by The Cancer Genome Atlas. We evaluated the correlation between EBV positivity and 18 F-fluorodeoxyglucose ( 18 F-FDG) uptake by positron emission tomography/computed tomography (PET/CT) in patients with gastric cancer. We retrospectively enrolled patients with gastric cancer who underwent pretreatment 18 F-FDG PET/CT and subsequent surgical resection, and then were diagnosed with advanced gastric cancer (pathologic stage ≥T2 with any N stage). Maximum standardized uptake values (SUV max ) of gastric cancer were measured by pretreatment 18 F-FDG PET/CT. EBV sequences were detected by in situ hybridization (ISH) techniques. We analyzed the correlation between EBV positivity, clinicopathologic features and metabolic activity of the primary tumor. A total of 205 patients were included and 15 (7.3%) patients were identified as having EBV-positive gastric cancer. Age, gender, tumor location, and histological type showed no significant differences between EBV-positive and negative groups. EBV-positive cancer is significantly more frequent in the higher-metabolic-tumor group than in the lower one (p=0.032). The mean SUV max of gastric cancers showed significant differences between EBV-positive and negative groups (9.9±4.2 vs. 7.0±4.8, p=0.026). The infection status of EBV was significantly related to the 18 F-FDG uptake of primary tumors in patients with advanced gastric cancer. Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

Biochemical modulation of 5-fluorouracil by methotrexate in patients with advanced gastric carcinoma.

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Pérez, J E; Lacava, J A; Dominguez, M E; Rodriguez, R; Barbieri, M R; Ortiz, E H; Romero Acuña, L A; Langhi, M J; Romero Acuña, J M; Vallejo, C T; Leone, B A; Machiavelli, M R; Romero, A O

1998-10-01

A phase II trial was conducted to evaluate the efficacy and toxicity of a modulation of 5-fluorouracil (5-FU) by methotrexate (MTX) (with leucovorin (LV) rescue) as first-line chemotherapy in patients with locally advanced (inoperable) or metastatic gastric carcinoma. From July 1993 through August 1996, 36 patients with advanced gastric carcinoma received a regimen that consisted of: MTX 200 mg/m2 diluted in 250 ml normal saline by intravenous infusion over 20 minutes at hour 0; 5-FU 1,200 mg/m2 intravenous push injection at hour 20. Beginning 24 hours after MTX administration all patients received LV 15 mg/m2 intramuscularly every 6 hours for six doses. Cycles were repeated every 15 days. One patient was not assessable for response. Objective regression was observed in 15 of 37 patients (43%; 95% confidence interval, 26%-60%). One patient (3%) achieved complete response and 14 (40%) achieved partial response. No change was recorded in 14 patients (40%) and progressive disease was noted in six patients (17%). The median time to treatment failure was 7 months and the median survival was 12 months. Toxicity was within acceptable limits but one therapy-related death resulting from severe leukopenia occurred. The dose-limiting toxicity was mucositis. Five episodes of grade 3 or 4 stomatitis were observed and caused dosage modifications of MTX and 5-FU. Biochemical modulation of 5-FU by MTX appears as an attractive modality in patients with advanced gastric cancer. Further investigation both in experimental and clinical fields is needed to clearly define its role and to design the best modulatory strategy.

Gastric Cancer: Current Status of Diagnosis and Treatment

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Takahashi, Tsunehiro; Saikawa, Yoshiro; Kitagawa, Yuko

2013-01-01

Gastric cancer is the second leading cause of death from malignant disease worldwide and most frequently discovered in advanced stages. Because curative surgery is regarded as the only option for cure, early detection of resectable gastric cancer is extremely important for good patient outcomes. Therefore, noninvasive diagnostic modalities such as evolutionary endoscopy and positron emission tomography are utilized as screening tools for gastric cancer. To date, early gastric cancer is being treated using minimally invasive methods such as endoscopic treatment and laparoscopic surgery, while in advanced cancer it is necessary to consider multimodality treatment including chemotherapy, radiotherapy, and surgery. Because of the results of large clinical trials, surgery with extended lymphadenectomy could not be recommended as a standard therapy for advanced gastric cancer. Recent clinical trials had shown survival benefits of adjuvant chemotherapy after curative resection compared with surgery alone. In addition, recent advances of molecular targeted agents would play an important role as one of the modalities for advanced gastric cancer. In this review, we summarize the current status of diagnostic technology and treatment for gastric cancer

A case of advanced gastric cancer resected for rebleeding after palliative radiotherapy for hemostasis

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Muneoka, Yusuke; Ichikawa, Hiroshi; Ishikawa, Takashi

2016-01-01

We report a case of advanced gastric cancer (AGC) that was resected for rebleeding after palliative radiotherapy for hemostasis. A 74-year-old man with Stage IV gastric cancer received chemotherapy and achieved stable disease. After 23 months, he experienced continuous bleeding from the tumor due to regrowth. Palliative radiotherapy was conducted to control the bleeding, and the tumor successfully achieved hemostasis. However, 6 weeks later, the patient experienced rebleeding and developed hemostatic shock. We then performed a successful emergency gastrectomy. Bleeding negatively affects quality of life in patients with AGC and is potentially lethal. Although palliative radiotherapy for bleeding of gastric cancer is a safe and useful treatment within a short time frame in cases of rebleeding, emergency gastrectomy may be necessary. Therefore, when we select this treatment, the possibility of subsequent surgical treatment must be considered. (author)

Comparison of long-term results between laparoscopy-assisted gastrectomy and open gastrectomy with D2 lymph node dissection for advanced gastric cancer.

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Hamabe, Atsushi; Omori, Takeshi; Tanaka, Koji; Nishida, Toshirou

2012-06-01

Laparoscopy-assisted gastrectomy (LAG) has been established as a low-invasive surgery for early gastric cancer. However, it remains unknown whether it is applicable also for advanced gastric cancer, mainly because the long-term results of LAG with D2 lymph node dissection for advanced gastric cancer have not been well validated compared with open gastrectomy (OG). A retrospective cohort study was performed to compare LAG and OG with D2 lymph node dissection. For this study, 167 patients (66 LAG and 101 OG patients) who underwent gastrectomy with D2 lymph node dissection for advanced gastric cancer were reviewed. Recurrence-free survival and overall survival time were estimated using Kaplan-Meier curves. Stratified log-rank statistical evaluation was used to compare the difference between the LAG and OG groups stratified by histologic type, pathologic T status, N status, and postoperative adjuvant chemotherapy. The adjusted Cox proportional hazards regression models were used to calculate the hazard ratios (HRs) of LAG. The 5-year recurrence-free survival rate was 89.6% in the LAG group and 75.8% in the OG group (nonsignificant difference; stratified log-rank statistic, 3.11; P = 0.0777). The adjusted HR of recurrence for LAG compared with OG was 0.389 [95% confidence interval (CI) 0.131-1.151]. The 5-year overall survival rate was 94.4% in the LAG group and 78.5% in the OG group (nonsignificant difference; stratified log-rank statistic, 0.4817; P = 0.4877). The adjusted HR of death for LAG compared with OG was 0.633 (95% CI 0.172-2.325). The findings show that LAG with D2 lymph node dissection is acceptable in terms of long-term results for advanced gastric cancer cases and may be applicable for advanced gastric cancer treatment.

Gastric cancer: a primer on the epidemiology and biology of the disease and an overview of the medical management of advanced disease.

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Shah, Manish A; Kelsen, David P

2010-04-01

Gastric cancer is a cause of significant morbidity and cancer-related mortality worldwide. Despite recent advances in targeted therapy and understanding of the biology and development of the malignancy, progress in the treatment of gastric cancer has been limited. Most newly diagnosed patients will present with incurable disease, and have a median survival of less than 1 year. Although the disease has widespread ethnic and epidemiologic differences, medical management of gastric cancer does not distinguish among the various disease subtypes. The recent report of the ToGA phase III study has validated Her2 as a molecular target in this disease, supporting the concept that a greater understanding of the biology of gastric cancer subsets may improve treatment selection and overall outcome of individual patients. This article summarizes the epidemiology and ethnic variation of this disease to crystalize subtypes of gastric cancer in the context of current and future medical management of advanced disease.

Gastric Adenocarcinoma Presenting with Gastric Outlet Obstruction in a Child

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Abdulrahman Al-Hussaini

2014-01-01

Full Text Available Gastric carcinoma is extremely rare in children representing only 0.05% of all gastrointestinal malignancies. Here, we report the first pediatric case of gastric cancer presenting with gastric outlet obstruction. Upper endoscopy revealed a markedly thickened antral mucosa occluding the pylorus and a clean base ulcer 1.5 cm × 2 cm at the lesser curvature of the stomach. The narrowed antrum and pylorus underwent balloon dilation, and biopsy from the antrum showed evidence of Helicobacter pylori gastritis. The biopsy taken from the edge of the gastric ulcer demonstrated signet-ring-cell type infiltrate consistent with gastric adenocarcinoma. At laparotomy, there were metastases to the liver, head of pancreas, and mesenteric lymph nodes. Therefore, the gastric carcinoma was deemed unresectable. The patient died few months after initiation of chemotherapy due to advanced malignancy. In conclusion, this case report underscores the possibility of gastric adenocarcinoma occurring in children and presenting with gastric outlet obstruction.

Clinicopathological study of asymptomatic gastric cancer and symptomatic gastric cancer

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Sato, Toshiteru

2008-01-01

Gastric cancer can be classified into two categories based on the absence or presence of symptoms at diagnosis. Differences in clinicopathological features and prognoses between asymptomatic gastric cancer (ACG) and symptomatic gastric cancer (SGC) can be used to inform diagnosis strategies and ultimately improve survival rates. All cases of gastric cancer (239 AGC, 323 SGC) diagnosed in our hospital between 1997 and 1999 were used in this study. ACG patients showed significantly higher frequency of males, cases of early cancer, cases found by a mass screening program, cases treated by endoscopic resection, cases treated by curative operation, cases of type 0 macroscopic finding, cases of histologically-differentiated type, and stage I cases. By contrast, SGC patients showed significantly higher numbers of cases treated by chemotherapy alone or best support care, cases of type 2, 3, and 4 macroscopic findings, cases occupying the whole stomach, and cases of stage II, III, IV. Statistically significant differences were also found for the 5-year survival rate (83.3% in AGC, 41.2% in SGC), the incidence of early cancer (90.1% in AGC, 83.7% in SGC), and for advanced cancer (38.7% in AGC, 22.7% in SGC). The higher incidence of advanced cases in SGC than in AGC (40.0% vs. 13.0%), coupled with the low 5-year survival rate of advanced SGC (22.7%), provides strong evidence of the importance of diagnosing gastric cancer during its asymptomatic period. (author)

Everolimus for Previously Treated Advanced Gastric Cancer: Results of the Randomized, Double-Blind, Phase III GRANITE-1 Study

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Ohtsu, Atsushi; Ajani, Jaffer A.; Bai, Yu-Xian; Bang, Yung-Jue; Chung, Hyun-Cheol; Pan, Hong-Ming; Sahmoud, Tarek; Shen, Lin; Yeh, Kun-Huei; Chin, Keisho; Muro, Kei; Kim, Yeul Hong; Ferry, David; Tebbutt, Niall C.; Al-Batran, Salah-Eddin; Smith, Heind; Costantini, Chiara; Rizvi, Syed; Lebwohl, David; Van Cutsem, Eric

2013-01-01

Purpose The oral mammalian target of rapamycin inhibitor everolimus demonstrated promising efficacy in a phase II study of pretreated advanced gastric cancer. This international, double-blind, phase III study compared everolimus efficacy and safety with that of best supportive care (BSC) in previously treated advanced gastric cancer. Patients and Methods Patients with advanced gastric cancer that progressed after one or two lines of systemic chemotherapy were randomly assigned to everolimus 10 mg/d (assignment schedule: 2:1) or matching placebo, both given with BSC. Randomization was stratified by previous chemotherapy lines (one v two) and region (Asia v rest of the world [ROW]). Treatment continued until disease progression or intolerable toxicity. Primary end point was overall survival (OS). Secondary end points included progression-free survival (PFS), overall response rate, and safety. Results Six hundred fifty-six patients (median age, 62.0 years; 73.6% male) were enrolled. Median OS was 5.4 months with everolimus and 4.3 months with placebo (hazard ratio, 0.90; 95% CI, 0.75 to 1.08; P = .124). Median PFS was 1.7 months and 1.4 months in the everolimus and placebo arms, respectively (hazard ratio, 0.66; 95% CI, 0.56 to 0.78). Common grade 3/4 adverse events included anemia, decreased appetite, and fatigue. The safety profile was similar in patients enrolled in Asia versus ROW. Conclusion Compared with BSC, everolimus did not significantly improve overall survival for advanced gastric cancer that progressed after one or two lines of previous systemic chemotherapy. The safety profile observed for everolimus was consistent with that observed for everolimus in other cancers. PMID:24043745

[Clinical significance of prognostic nutritional index in patients with advanced gastric cancer].

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Song, Shubin; Liu, Honggang; Xue, Yingwei

2018-02-25

To investigate the relationship of prognostic nutritional index (PNI) with clinicopathological factors and the clinical significance of PNI in predicting the survival in patients with advanced gastric cancer. Clinicopathological and follow-up data of 1150 patients with advanced gastric cancer who underwent radical gastrectomy from January 2007 to December 2010 at the Department of Gastrointestinal Surgery, Harbin Medical University Cancer Hospital were analyzed retrospectively. The PNI value was calculated [PNI=absolute value of lymphocyte(10 9 /L)×5 + serum albumin (g/L)] and was grouped according to the mean value of PNI. Relationships of PNI with gender, age, tumor size, depth of invasion, tumor differentiation, tumor stage, tumor location, lymph node metastasis and tumor marker detection level were analyzed. At the same time, for the survival analysis of patients, log-rank method was used for univariate analysis, and Cox method was used for multivariate analysis. Of 1150 cases, 846 were males and 304 were females with an average age of 62 (24 to 88) years. The average maximum diameter of tumor was 5.4(1.0 to 20.0) cm. Tumor of 159 cases located in the gastric fundus, 221 cases in the gastric body, 705 cases in the gastric antrum and 65 cases in the whole stomach. Well differentiated tumors were found in 198 cases and poorly differentiated tumors in 952 cases. As for depth of tumor invasion, 165 cases were T2, 343 cases were T3 and 642 cases were T4. According to TNM stage, 53 cases were stage I(, 397 cases were stage II( and 700 cases were stage III(. The average lymph node metastasis rate was 25.0%, meanwhile lymph node metastasis was N0 in 296 cases, N1 in 246 cases, N2 in 277 cases and N3 in 331 cases. Blood examination showed hemoglobin ≤130 g/L in 544 cases and >130 g/L in 606 cases; carcinoembryonic antigen ≤5 μg/L in 903 cases and >5 μg /L in 247 cases; carbohydrate antigen 19-9 ≤37 kU/L in 927 cases and >37 kU/L in 223 cases. In whole patients

Comparison on Efficacy of S-1 Respectively Combined with Oxaliplatin and Docetaxel for Advanced Gastric Cancer

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Junna Zhi

2014-03-01

Full Text Available Objective: To compare the short-term efficacy and safety of S-1 respectively combined with oxaliplatin (OXA and docetaxel (TXT in treatment of advanced gastric cancer. Method: Forty-three patients with advanced gastric cancer were randomly divided into OXA group (n ＝ 26 and TXT group (n ＝ 17. Drug usage was as follows: oral administration of 40 mg/m2 S-1 during days 1 - 14, twice a day; intravenous injection of 130 mg/m2 OXA on day 1; intravenous injection of 60 mg/m2 TXT on day 1; 3 weeks as one cycle. The efficacy, adverse reactions and quality of life were evaluated 2 cycles after treatment. Results: Adverse reactions could be evaluated in all cases, and efficacy be evaluated in 42 cases. The response rates (RR were 57.7% and 31.3% respectively in OXA and TXT groups, without statistical significance (P ＝ 0.096. The incidence of total leukopenia (100.0%, stomatitis (35.3% and constipation (76.5% was obviously higher in TXT group than in OXA group (50.0%, 3.8%, 38.4%, with statistical significance (P ＝ 0.019, 0.006, 0.015, while that of neurotoxicity lower than in OXA group (53.8% vs. 17.6%, with statistical significance (P ＝ 0.018. Conclusion: For advanced gastric cancer, S-1 combined with OXA is similar to efficacy of combined with TXT, but with less adverse reactions.

Studies on Several Hormone Responses Following Intravenous Alimentation: Insulin and growth hormone responses following oral or intravenous alimentation in patient with far advanced gastric cancer

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Sung, H. K.; Koh, J. H.; Ryu, Y. W.; Lee, J. O.; Lee, C. W.; Kim, J. Y.; Lee, J. K.

1975-01-01

Glucose tolerance, insulin and growth hormone responses following glucose for amino acids administration by means of parenteral or oral load were studied in patients with far advanced gastric cancer. Hormone responses following nutrients load showed in patients with gastric cancer were compared to those of healthy subjects. Results were as follows:1) Blood sugar appearance following oral glucose administration was diminished in patients with far advanced gastric cancer. 2) The insulin responses of gastric cancer following oral glucose were also diminished as compared to that of normal subjects and were identical with parenteral route. 3) Parenteral administration of glucose or amino acids to patients with gastric cancer resulted in a increase of plasma growth hormone level. 4) Lower insulin response to amino acids was observed on parenteral administration in patient with gastric cancer as in healthy subjects. 5) Author discussed that the low insulin response after oral glucose administration showed in gastric cancer, and any additional insulin requirement arise when longer periods of parenteral amino acid administration are necessary, as in the patient with malnutrition.

Studies on Several Hormone Responses Following Intravenous Alimentation: Insulin and growth hormone responses following oral or intravenous alimentation in patient with far advanced gastric cancer

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Sung, H K; Koh, J H; Ryu, Y W; Lee, J O; Lee, C W; Kim, J Y; Lee, J K [Korea Atomic Energy Research Institute, Seoul (Korea, Republic of)

1975-09-15

Glucose tolerance, insulin and growth hormone responses following glucose for amino acids administration by means of parenteral or oral load were studied in patients with far advanced gastric cancer. Hormone responses following nutrients load showed in patients with gastric cancer were compared to those of healthy subjects. Results were as follows:1) Blood sugar appearance following oral glucose administration was diminished in patients with far advanced gastric cancer. 2) The insulin responses of gastric cancer following oral glucose were also diminished as compared to that of normal subjects and were identical with parenteral route. 3) Parenteral administration of glucose or amino acids to patients with gastric cancer resulted in a increase of plasma growth hormone level. 4) Lower insulin response to amino acids was observed on parenteral administration in patient with gastric cancer as in healthy subjects. 5) Author discussed that the low insulin response after oral glucose administration showed in gastric cancer, and any additional insulin requirement arise when longer periods of parenteral amino acid administration are necessary, as in the patient with malnutrition.

[Current standards in the treatment of gastric cancer].

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Hacker, Ulrich; Lordick, Florian

2015-08-01

Endoscopic resection is established in the treatment of early gastric cancer. More advanced gastric cancer requires gastrectomy and D2 lymphadenectomy. Perioperative chemotherapy improves overall survival in locally advanced gastric cancer representing a standard of care. Locally advanced adenocarcinomas of the esophago-gastric junction can alternatively be treated with concurrent radiochemotherapy. In metastatic disease, systemic chemotherapy improves survival, quality of life and symptom control. Trastuzumab plus chemotherapy should be used together with first-line chemotherapy in HER2 positive gastric cancer patients. Second- and third-line therapy is now well established. The anti-VEGFR2 antibody Ramucirumab improves survival in second line treatment both as a monotherapy and in combination with paclitaxel and represents a novel treatment option. © Georg Thieme Verlag KG Stuttgart · New York.

Tumor response evaluation after neoadjuvant chemotherapy in locally advanced gastric adenocarcinoma: a prospective, multi-center cohort study

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De Martini, Paolo; Ceresoli, Marco; Mari, Giulio M.; Costanzi, Andrea; Maggioni, Dario; Pugliese, Raffaele; Ferrari, Giovanni

2017-01-01

Background To verify the prognostic value of the pathologic and radiological tumor response after neoadjuvant chemotherapy in the treatment of locally advanced gastric adenocarcinoma. Methods A total of 67 patients with locally advanced gastric cancer (clinical ≥ T2 or nodal disease and without evidence of distant metastases) underwent perioperative chemotherapy (ECF or ECX regimen) from December 2009 through June 2015 in two surgical units. Histopathological and radiological response to chemotherapy were evaluated by using tumor regression grade (TRG) (Becker’s criteria) and volume change assessed by CT. Results Fifty-one (86%) patients completed all chemotherapy scheduled cycles successfully and surgery was curative (R0) in 64 (97%) subjects. The histopathological analysis showed 19 (29%) specimens with TRG1 (less than 10% of vital tumor left) and 25 (37%) patients had partial or complete response (CR) assessed by CT scan. Median disease free survival (DFS) and overall survival (OS) were 25.70 months (range, 14.52–36.80 months) and 36.60 months (range, 24.3–52.9 months), respectively. The median follow up was 27 months (range, 5.00–68.00 months). Radiological response and TRG were found to be a prognostic factor for OS and DFS, while tumor histology was not significantly related to survival. Conclusions Both radiological response and TRG have been shown as promising survival markers in patients treated with perioperative chemotherapy for locally advanced gastric cancer. Other predictive markers of response to chemotherapy are strongly required. PMID:29299362

Advanced Gastric Cancer and Perfusion Imaging Using a Multidetector Row Computed Tomography: Correlation with Prognostic Determinants

International Nuclear Information System (INIS)

Zhang, Huan; Pan, Zilai; Du, Lianjun; Yan, Chao; Ding, Bei; Song, Qi; Ling, Huawei; Chen, Kemin

2008-01-01

Objective : To investigate the relationship between the perfusion CT features and the clinicopathologically determined prognostic factors in advanced gastric cancer cases. Materials and Methods : A perfusion CT was performed on 31 patients with gastric cancer one week before surgery using a 16-channel multi-detector CT (MDCT) instrument. The data were analyzed with commercially available software to calculate tumor blood flow (BF), blood volume (BV), mean transit time (MTT), and permeability surface (PS). The microvessel density (MVD), was evaluated by immunohistochemical staining of the surgical specimens with anti-CD34. All of the findings were analyzed prospectively and correlated with the clinicopathological findings, which included histological grading, presence of lymph node metastasis, serosal involvement, distant metastasis, tumor, node, metastasis (TNM) staging, and MVD. The statistical analyses used included the Student's t-test and the Spearman rank correlation were performed in SPSS 11.5. Result : The mean perfusion values and MVD for tumors were as follows: BF (48.14+/-16.46 ml/100 g/min), BV (6.70+/-2.95 ml/100 g), MTT (11.75+/-4.02 s), PS (14.17+/-5.23 ml/100 g/min) and MVD (41.7+/-11.53). Moreover, a significant difference in the PS values was found between patients with or without lymphatic involvement (p = 0.038), as well as with different histological grades (p 0.04) and TNM stagings (p = 0.026). However, BF, BV, MTT, and MVD of gastric cancer revealed no significant relationship with the clinicopathological findings described above (p > 0.05). Conclusion : The perfusion CT values of the permeable surface could serve as a useful prognostic indicator in patients with advanced gastric cancer

Advanced Gastric Cancer and Perfusion Imaging Using a Multidetector Row Computed Tomography: Correlation with Prognostic Determinants

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Zhang, Huan; Pan, Zilai; Du, Lianjun; Yan, Chao; Ding, Bei; Song, Qi; Ling, Huawei; Chen, Kemin [Jiaotong University, Jiaotong (China)

2008-04-15

Objective : To investigate the relationship between the perfusion CT features and the clinicopathologically determined prognostic factors in advanced gastric cancer cases. Materials and Methods : A perfusion CT was performed on 31 patients with gastric cancer one week before surgery using a 16-channel multi-detector CT (MDCT) instrument. The data were analyzed with commercially available software to calculate tumor blood flow (BF), blood volume (BV), mean transit time (MTT), and permeability surface (PS). The microvessel density (MVD), was evaluated by immunohistochemical staining of the surgical specimens with anti-CD34. All of the findings were analyzed prospectively and correlated with the clinicopathological findings, which included histological grading, presence of lymph node metastasis, serosal involvement, distant metastasis, tumor, node, metastasis (TNM) staging, and MVD. The statistical analyses used included the Student's t-test and the Spearman rank correlation were performed in SPSS 11.5. Result : The mean perfusion values and MVD for tumors were as follows: BF (48.14+/-16.46 ml/100 g/min), BV (6.70+/-2.95 ml/100 g), MTT (11.75+/-4.02 s), PS (14.17+/-5.23 ml/100 g/min) and MVD (41.7+/-11.53). Moreover, a significant difference in the PS values was found between patients with or without lymphatic involvement (p = 0.038), as well as with different histological grades (p 0.04) and TNM stagings (p = 0.026). However, BF, BV, MTT, and MVD of gastric cancer revealed no significant relationship with the clinicopathological findings described above (p > 0.05). Conclusion : The perfusion CT values of the permeable surface could serve as a useful prognostic indicator in patients with advanced gastric cancer.

Staging laparoscopy improves treatment decision-making for advanced gastric cancer.

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Hu, Yan-Feng; Deng, Zhen-Wei; Liu, Hao; Mou, Ting-Yu; Chen, Tao; Lu, Xin; Wang, Da; Yu, Jiang; Li, Guo-Xin

2016-02-07

To evaluate the clinical value of staging laparoscopy in treatment decision-making for advanced gastric cancer (GC). Clinical data of 582 patients with advanced GC were retrospectively analyzed. All patients underwent staging laparoscopy. The strength of agreement between computed tomography (CT) stage, endoscopic ultrasound (EUS) stage, laparoscopic stage, and final stage were determined by weighted Kappa statistic (Kw). The number of patients with treatment decision-changes was counted. A χ(2) test was used to analyze the correlation between peritoneal metastasis or positive cytology and clinical characteristics. Among the 582 patients, the distributions of pathological T classifications were T2/3 (153, 26.3%), T4a (262, 45.0%), and T4b (167, 28.7%). Treatment plans for 211 (36.3%) patients were changed after staging laparoscopy was performed. Two (10.5%) of 19 patients in M1 regained the opportunity for potential radical resection by staging laparoscopy. Unnecessary laparotomy was avoided in 71 (12.2%) patients. The strength of agreement between preoperative T stage and final T stage was in almost perfect agreement (Kw = 0.838; 95% confidence interval (CI): 0.803-0.872; P advanced GC and decrease unnecessary exploratory laparotomy.

SAMS: The synchronization and monitoring system for ATF [Advanced Toroidal Facility] data acquisition

International Nuclear Information System (INIS)

Greenwood, D.E.

1987-01-01

SAMS performs much of the synchronization of the distributed data acquisition system for the Advanced Toroidal Facility (ATF). SAMS is responsible for propagating shot information and managing te data system directories and logical names. This paper describes how SAMS communicates with other processes, both within the VAX cluster that supports most of the ATF data acquisition and on VAXes that are connected to the cluster via DECnet. 3 refs

Automated VMAT planning for postoperative adjuvant treatment of advanced gastric cancer.

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Sharfo, Abdul Wahab M; Stieler, Florian; Kupfer, Oskar; Heijmen, Ben J M; Dirkx, Maarten L P; Breedveld, Sebastiaan; Wenz, Frederik; Lohr, Frank; Boda-Heggemann, Judit; Buergy, Daniel

2018-04-23

Postoperative/adjuvant radiotherapy of advanced gastric cancer involves a large planning target volume (PTV) with multi-concave shapes which presents a challenge for volumetric modulated arc therapy (VMAT) planning. This study investigates the advantages of automated VMAT planning for this site compared to manual VMAT planning by expert planners. For 20 gastric cancer patients in the postoperative/adjuvant setting, dual-arc VMAT plans were generated using fully automated multi-criterial treatment planning (autoVMAT), and compared to manually generated VMAT plans (manVMAT). Both automated and manual plans were created to deliver a median dose of 45 Gy to the PTV using identical planning and segmentation parameters. Plans were evaluated by two expert radiation oncologists for clinical acceptability. AutoVMAT and manVMAT plans were also compared based on dose-volume histogram (DVH) and predicted normal tissue complication probability (NTCP) analysis. Both manVMAT and autoVMAT plans were considered clinically acceptable. Target coverage was similar (manVMAT: 96.6 ± 1.6%, autoVMAT: 97.4 ± 1.0%, p = 0.085). With autoVMAT, median kidney dose was reduced on average by > 25%; (for left kidney from 11.3 ± 2.1 Gy to 8.9 ± 3.5 Gy (p = 0.002); for right kidney from 9.2 ± 2.2 Gy to 6.1 ± 1.3 Gy (p plans (4.2% and 9.1%, respectively; p plans compared to manVMAT plans, the predicted NTCPs for the left and right kidney and the liver-PTV were significantly reduced by 11.3%, 12.8%, 7%, respectively (p ≤ 0.001). Delivery time and total number of monitor units were increased in autoVMAT plans (from 168 ± 19 s to 207 ± 26 s, p = 0.006) and (from 781 ± 168 MU to 1001 ± 134 MU, p = 0.003), respectively. For postoperative/adjuvant radiotherapy of advanced gastric cancer, involving a complex target shape, automated VMAT planning is feasible and can substantially reduce the dose to the kidneys and the liver

Treatment strategies for locally advanced rectal cancer with synchronous resectable liver metastasis

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Youn Young Park

2018-01-01

Full Text Available Approximately one-third of patients with colorectal cancer are estimated to be diagnosed with synchronous liver metastasis (LM. The only method to get cured is to achieve curative resection for both primary and LM. When it comes to locally advanced rectal cancer with synchronous LM, determination of the treatment strategy for each individual is a quite complex procedure, because it demands sophisticated consideration for both local and systemic control. Timing for the application of systemic chemotherapy (CTx, determination of a chemotherapeutic agent, radiation dose and fractions, and sequencing of preoperative treatment and surgeries are all essential components for establishing optimal treatment strategies for the patients with this disease. In this article, treatment strategies proposed in the literature will be reviewed in the light of oncologic outcomes and treatment toxicity with their possible advantages and disadvantages. Owing to a lack of concrete evidences for the best strategy, this article can guide authors to a better way of determining more tailored treatment for each individual.

Molecular targeted therapy for advanced gastric cancer.

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Kim, Jong Gwang

2013-03-01

Although medical treatment has been shown to improve quality of life and prolong survival, no significant progress has been made in the treatment of advanced gastric cancer (AGC) within the last two decades. Thus, the optimum standard first-line chemotherapy regimen for AGC remains debatable, and most responses to chemotherapy are partial and of short duration; the median survival is approximately 7 to 11 months, and survival at 2 years is exceptionally > 10%. Recently, remarkable progress in tumor biology has led to the development of new agents that target critical aspects of oncogenic pathways. For AGC, many molecular targeting agents have been evaluated in international randomized studies, and trastuzumab, an anti-HER-2 monoclonal antibody, has shown antitumor activity against HER-2-positive AGC. However, this benefit is limited to only ~20% of patients with AGC (patients with HER-2-positive AGC). Therefore, there remains a critical need for both the development of more effective agents and the identification of molecular predictive and prognostic markers to select those patients who will benefit most from specific chemotherapeutic regimens and targeted therapies.

Correlation between spontaneous apoptosis and the expression of angiogenic factors in advanced gastric adenocarcinoma.

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Ikeguchi, M; Cai, J; Fukuda, K; Oka, S; Katano, K; Tsujitani, S; Maeta, M; Kaibara, N

2001-06-01

The aim of this study was to investigate whether angiogenic factors influence the occurrence of spontaneous apoptosis in advanced gastric cancer. The apoptotic indices (AIs) of 97 tumors from 97 patients with advanced gastric cancer (pT3, pN0, pM0, Stage II) were analyzed by the terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate biotin nick end labeling (TUNEL) method. Intratumoral microvessel densities (IMVDs) of tumors stained with anti-CD34 monoclonal antibody were quantified under x 200 magnification using computer-assisted image analysis. The expressions of angiogenic factors, such as vascular endothelial growth factor (VEGF), thymidine phosphorylase (dThdPase), transforming growth factor-alpha (TGF-alpha), and p53 were analyzed immunohistochemically and compared with IMVDs and AIs. The mean IMVD of the 97 tumors was 365/mm2 (range 147-990/mm2). The mean AI of tumors was 2.1% (range 0-11.3%). A significant inverse correlation between the AIs and the IMVDs was shown (p = -0.278, P = 0.0064). The mean IMVDs of tumors with high expressions of dThdPase, TGF-alpha, or p53 were significantly higher than those of tumors with low expressions of these factors. The mean AI of tumors with high expressions of dThdPase was significantly lower than that of tumors with low expressions of dThdPase (P = 0.023). However, no significant correlations were detected between AIs and the expression levels of VEGF, TGF-alpha, or p53. In gastric cancer, dThdPase may play an important role in tumor progression by increasing microvessels and by suppressing apoptosis of cancer cells.

Krukenberg tumors diagnosed during pregnancy simultaneously with advanced gastric cancer; A case report

International Nuclear Information System (INIS)

You, Myung Won; Jung, Yoon Young; Shin, Jung Hwan; Hong, Young Ok

2015-01-01

Krukenberg tumors recognized during pregnancy are rarely reported. The preoperative diagnosis can be challenging because of the confusing morphological features and symptoms during pregnancy. Here, we report a case of a 29-year-old pregnant woman at 29 weeks gestation presenting with bilateral solid ovarian masses, which were later diagnosed as metastatic ovarian cancer originating from advanced gastric cancer. This case suggests that Krukenberg tumors should be considered when bilateral ovarian solid masses are encountered regardless of pregnancy

Krukenberg tumors diagnosed during pregnancy simultaneously with advanced gastric cancer; A case report

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You, Myung Won; Jung, Yoon Young; Shin, Jung Hwan; Hong, Young Ok [Eulji Hospital, Eulji University School of Medicine, Seoul (Korea, Republic of)

2015-06-15

Krukenberg tumors recognized during pregnancy are rarely reported. The preoperative diagnosis can be challenging because of the confusing morphological features and symptoms during pregnancy. Here, we report a case of a 29-year-old pregnant woman at 29 weeks gestation presenting with bilateral solid ovarian masses, which were later diagnosed as metastatic ovarian cancer originating from advanced gastric cancer. This case suggests that Krukenberg tumors should be considered when bilateral ovarian solid masses are encountered regardless of pregnancy.

Postoperative radio-chemotherapy in locally advanced gastric cancer

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Garrido, Marcelo; Bustos, Marisa; Orellana, Eric; Madrid, Jorge; Galindo, Hector; Sanchez, Cesar; Pimentel, Fernando; Guzman, Sergio; Butte, Jean Michel; Alvarez, Manuel; Besa, Pelayo

2009-01-01

Background: Overall 5 years survival for surgically excised gastric cancer is 30%. Adjuvant treatment may improve the surgical results. Aim: To assess treatment results and toxicity in patients with surgically excised gastric cancer, treated with adjuvant radiotherapy and concomitant continuous 5-Fluorouracil (5-FU). Material and Methods: Forty one patients aged 32 to 73 years (29 males) with stage II-IVA gastric cancer, subjected to a total or subtotal gastrectomy and D2 nodal dissection between 1997 to 2006, were studied. They received adjuvant radiotherapy to the gastric bed and draining lymphatic nodes in a total dose of 50.4 Gy in 28 fractions and chemotherapy with continuous infusion 5-FU, 200 mg/m2/day. Results were compared to historical controls matched according to demographic parameters and tumor characteristics. Results: Eighteen patients were in stage II, 10 in stage IIIA, nine in stage IIIB and four in stage IVA. Twelve patients had an N0 nodal status, 15 were N1, nine were N2 and five were N3. After a mean follow up of 32 months, 26 patients (63%) were alive. Five year overall survival was 49.6% for surgery plus radiochemotherapy compared to 30.7% for the historical group subjected only to surgery (p =0.002). Radiotherapy was associated with grade 1-2 toxicity and treatment was completed without interruptions in all patients. Chemotherapy was delayed temporarily in 3 patients. Conclusions: Adjuvant radio-chemotherapy improved overall survival in gastric cancer, compared to historical controls subjected only to surgical treatment

Clinical studies on the visualization of gastric lesions using virtual CT endoscopy

International Nuclear Information System (INIS)

Kim, Hideki; Takashima, Sumio; Kaminou, Toshio; Hayashi, Seisyo; Nishida, Norifumi; Matsuoka, Toshiyuki; Nakamura, Kenji; Yamada, Ryusaku

2001-01-01

We evaluated the clinical usefulness of virtual CT gastro endoscopy (VCTGE). The subjects were 124 patients with endoscopically identified gastric lesions. VCTGE images were obtained using a GE-Navigator. We evaluated VCTGE in the visualization of gastric lesions for their presence and morphology. The detection rate of all gastric lesions by VCTGE was 76% (94 of 124 patients). The smallest detectable early gastric cancer was II c measuring 10 x 8 mm. The detection rates of each gastric lesion by VCTGE were 73% in early gastric cancer, and 90% in advanced gastric cancer. VCTGE imaging in the advanced gastric cancer was good in 12 (30%), fair in 25 (60%) and poor in 4 (10%). VCTGE imaging in early gastric cancer was good in 20 (46%), fair in 12 (27%) and poor in 12 (27%). The significance P level was 0.005 between the evaluation of the imaging of advanced and early gastric cancer. VCTGE visualized the characteristics of diverse gastric lesions and was considered useful for the detection and the diagnosis of these lesions. (author)

Intraoperative Radiotherapy Combined With Adjuvant Chemoradiotherapy for Locally Advanced Gastric Adenocarcinoma

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Fu Shen; Lu Jiade; Zhang Qing; Yang Zhe; Peng Lihua; Xiong, Fei

2008-01-01

Purpose: To evaluate the efficacy of intraoperative radiotherapy (IORT) followed by concurrent chemotherapy and external beam RT (EBRT) in the treatment of locally advanced gastric adenocarcinoma. Methods and Materials: A total of 97 consecutive and nonselected patients with newly diagnosed Stage T3, T4, or N+ adenocarcinoma of the stomach underwent gastrectomy with D2 lymph node dissection between March 2003 and October 2005. Of the 97 patients, 51 received adjuvant concurrent chemotherapy (5-fluorouracil, leucovorin, docetaxel, and cisplatin) and EBRT (EBRT group) and 46 received IORT (dose range, 12-15 Gy) immediately after gastrectomy and lymph node dissection before concurrent chemoradiotherapy (EBRT+IORT group). Results: After a median follow-up of 24 months, the 3-year locoregional control rate was 77% and 63% in the two groups with or without IORT, respectively (p = 0.05). The 3-year overall survival and disease-free survival rate was 47% and 36% in the EBRT group and 56% and 44% in the EBRT+IORT group, respectively (p > 0.05). Multivariate analyses revealed that the use of IORT, presence of residual disease after surgery, and pN category were independent prognostic factors for locoregional control and that IORT, pN, and pT categories were independent prognostic factors for overall survival (p < 0.05). Four patients experienced Grade 3 or 4 late complications, but no significant difference was observed between the two groups. Conclusions: Radical gastrectomy with D2 lymph node dissection and IORT followed by adjuvant chemoradiotherapy appeared to be feasible and well-tolerated in the treatment of locally advanced gastric cancer. The addition of IORT to the trimodality treatment significantly improved the 3-year locoregional control rate

Gastric neuroendocrine tumours.

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Crosby, David A; Donohoe, Claire L; Fitzgerald, Louise; Muldoon, Cian; Hayes, Brian; O'Toole, Dermot; Reynolds, John V

2012-01-01

Gastric neuroendocrine tumours (NETs) are increasingly recognised, and management decisions may be difficult due to an incomplete understanding of aetiology, natural history and optimum therapy. This article presents a current understanding based on recent advances in epidemiology, classification, molecular profiling, and treatment. Relevant medical literature was identified from searches of PubMed and references cited in appropriate articles identified. Selection of articles was based on peer review, journal and relevance. Gastric NETs may be divided into three clinical prognostic groups: type I is associated with autoimmune atrophic gastritis and hypergastrinaemia, type II is associated with Zollinger-Ellison syndrome, and type III lesions are gastrin-independent, have the greatest metastatic potential and poorest prognosis. There has been an increased frequency of gastric NETs reported. Management approaches have evolved in parallel with advances in endoscopic staging and surgery, as well as improved understanding of the biology and natural history of NETs. Gastric NETs present a spectrum of activity from indolent tumours to metastatic malignancy. Treatment decisions for patients must be individualised and are best managed by a multidisciplinary team approach. The current evidence base is limited to small series and efforts to treat patients within clinical networks of expertise are warranted. Copyright © 2012 S. Karger AG, Basel.

Gastric wall shortening in early gastric cancer: upper gastrointestinal series and pathologic correlation

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Kim, In Jae; Choi, Chul Soon; Kim, Eun Ah; Kim, Kyu Sun; Yun, Ku Sub; Kim, Ho Chul; Bae, Sang Hun; Kang, Gu; Shin, Hyung Sik

1995-01-01

To investigate the causes of gastric wall shortening in early gastric cancer, upper gastrointestinal study was correlated with pathologic findings. We evaluated 41 cases (M:F = 1.7:1, average age = 49) of early gastric cancer, retrospectively. The gastric wall shortening were classified as Grade I; none, Grade II; intermediate, and Grade III; prominent. Pathologic findings such as size of lesions, depth of tumor invasion, degree of the submucosal fibrosis, degree of thickness of the submucosa and muscularis propria, and morphologic patterns of lesions including conversing mucosal folds were correlated with the degree of gastric wall shortening on upper gastrointestinal series. Submucosal fibrosis was present in 4 cases in Grade I (n = 21), 4 cases in Grade II (n = 6) and 8 cases in Grade III (n = 10). Positive conversing mucosal folds were seen in 5 cases in Grade I (n = 17), 0 case in Grade II (n = 2) and 9 cases in Grade III (n = 9). Gastric wall shortening was significantly associated with submucosal fibrosis and conversing mucosal folds of early gastric cancer. (ρ = 0.0001, and ρ = 0.02, respectively) Upper gastrointestinal finding of gastric wall protrusion in patients with early gastric cancer should not misinterprete as advanced gastric cancer since the finding could be a result of submucosal fibrosis

Cost-Effectiveness Analysis of Second-Line Chemotherapy Agents for Advanced Gastric Cancer.

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Lam, Simon W; Wai, Maya; Lau, Jessica E; McNamara, Michael; Earl, Marc; Udeh, Belinda

2017-01-01

Gastric cancer is the fifth most common malignancy and second leading cause of cancer-related mortality. Chemotherapy options for patients who fail first-line treatment are limited. Thus the objective of this study was to assess the cost-effectiveness of second-line treatment options for patients with advanced or metastatic gastric cancer. Cost-effectiveness analysis using a Markov model to compare the cost-effectiveness of six possible second-line treatment options for patients with advanced gastric cancer who have failed previous chemotherapy: irinotecan, docetaxel, paclitaxel, ramucirumab, paclitaxel plus ramucirumab, and palliative care. The model was performed from a third-party payer's perspective to compare lifetime costs and health benefits associated with studied second-line therapies. Costs included only relevant direct medical costs. The model assumed chemotherapy cycle lengths of 30 days and a maximum number of 24 cycles. Systematic review of literature was performed to identify clinical data sources and utility and cost data. Quality-adjusted life years (QALYs) and incremental cost-effectiveness ratios (ICERs) were calculated. The primary outcome measure for this analysis was the ICER between different therapies, where the incremental cost was divided by the number of QALYs saved. The ICER was compared with a willingness-to-pay (WTP) threshold that was set at $50,000/QALY gained, and an exploratory analysis using $160,000/QALY gained was also used. The model's robustness was tested by using 1-way sensitivity analyses and a 10,000 Monte Carlo simulation probabilistic sensitivity analysis (PSA). Irinotecan had the lowest lifetime cost and was associated with a QALY gain of 0.35 year. Docetaxel, ramucirumab alone, and palliative care were dominated strategies. Paclitaxel and the combination of paclitaxel plus ramucirumab led to higher QALYs gained, at an incremental cost of $86,815 and $1,056,125 per QALY gained, respectively. Based on our prespecified

A Bayesian network meta-analysis on second-line systemic therapy in advanced gastric cancer.

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Zhu, Xiaofu; Ko, Yoo-Joung; Berry, Scott; Shah, Keya; Lee, Esther; Chan, Kelvin

2017-07-01

It is unclear which regimen is the most efficacious among the available therapies for advanced gastric cancer in the second-line setting. We performed a network meta-analysis to determine their relative benefits. We conducted a systematic review of randomized controlled trials (RCTs) through the MEDLINE, Embase, and Cochrane Central Register of Controlled Trials databases and American Society of Clinical Oncology abstracts up to June 2014 to identify phase III RCTs on advanced gastric cancer in the second-line setting. Overall survival (OS) data were the primary outcome of interest. Hazard ratios (HRs) were extracted from the publications on the basis of reported values or were extracted from survival curves by established methods. A Bayesian network meta-analysis was performed with WinBUGS to compare all regimens simultaneously. Eight RCTs (2439 patients) were identified and contained extractable data for quantitative analysis. Network meta-analysis showed that paclitaxel plus ramucirumab was superior to single-agent ramucirumab [OS HR 0.51, 95 % credible region (CR) 0.30-0.86], paclitaxel (OS HR 0.81, 95 % CR 0.68-0.96), docetaxel (OS HR 0.56, 95 % CR 0.33-0.94), and irinotecan (OS HR 0.71, 95 % CR 0.52-0.99). Paclitaxel plus ramucirumab also had an 89 % probability of being the best regimen among all these regimens. Single-agent ramucirumab, paclitaxel, docetaxel, and irinotecan were comparable to each other with respect to OS and were superior to best supportive care. This is the first network meta-analysis to compare all second-line regimens reported in phase III gastric cancer trials. The results suggest the paclitaxel plus ramucirumab combination is the most effective therapy and should be the reference regimen for future comparative trials.

Phase III randomized trial comparing 5-fluorouracil and oxaliplatin with or without docetaxel in first-line advanced gastric cancer chemotherapy (GASTFOX study).

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Zaanan, Aziz; Samalin, Emmanuelle; Aparicio, Thomas; Bouche, Olivier; Laurent-Puig, Pierre; Manfredi, Sylvain; Michel, Pierre; Monterymard, Carole; Moreau, Marie; Rougier, Philippe; Tougeron, David; Taieb, Julien; Louvet, Christophe

2018-04-01

In advanced gastric cancer, doublet regimen including platinum salts and fluoropyrimidine is considered as a standard first-line treatment. The addition of docetaxel (75 mg/m 2  q3w) to cisplatin (75 mg/m 2  q3w) and 5-fluorouracil has been shown to improve efficacy. However, this regimen (DCF) was associated with frequent severe toxicities (including more complicated neutropenia), limiting its use in clinical practice. Interesting alternative docetaxel-based regimens have been developed that need to be validated. GASTFOX study is a randomized phase III trial comparing FOLFOX alone or with docetaxel at 50 mg/m 2 (TFOX regimen) in first-line treatment for advanced gastric cancer. In both arms, cycle is repeated every 2 weeks until disease progression or unacceptable toxicity. Main eligibility criteria: histologically proven locally advanced or metastatic gastric or esogastric junction adenocarcinoma, HER negative status, measurable disease, ECOG performance status 0 or 1, and adequate renal, hepatic and bone marrow functions. The primary endpoint is radiological/clinical progression-free survival (PFS). A difference of 2 months for the median PFS in favor of TFOX is expected (HR = 0.73) Based on a two-sided α risk of 5% and a power of 90%, 454 events are required to show this difference. Secondary endpoints included overall survival, overall response rate, safety, quality of life and the therapeutic index. This study is planned to include 506 patients to demonstrate the superiority of TFOX over FOLFOX in first-line advanced gastric cancer treatment (NCT03006432). Copyright © 2018 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

Laparoscopy Assisted versus Open Distal Gastrectomy with D2 Lymph Node Dissection for Advanced Gastric Cancer: Design and Rationale of a Phase II Randomized Controlled Multicenter Trial (COACT 1001).

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Nam, Byung Ho; Kim, Young-Woo; Reim, Daniel; Eom, Bang Wool; Yu, Wan Sik; Park, Young Kyu; Ryu, Keun Won; Lee, Young Joon; Yoon, Hong Man; Lee, Jun Ho; Jeong, Oh; Jeong, Sang Ho; Lee, Sang Eok; Lee, Sang Ho; Yoon, Ki Young; Seo, Kyung Won; Chung, Ho Young; Kwon, Oh Kyoung; Kim, Tae Bong; Lee, Woon Ki; Park, Seong Heum; Sul, Ji-Young; Yang, Dae Hyun; Lee, Jong Seok

2013-09-01

Laparoscopy-assisted distal gastrectomy for early gastric cancer has gained acceptance and popularity worldwide. However, laparoscopy-assisted distal gastrectomy for advanced gastric cancer is still controversial. Therefore, we propose this prospective randomized controlled multi-center trial in order to evaluate the safety and feasibility of laparoscopy assisted D2-gastrectomy for advanced stage gastric cancer. Patients undergoing distal gastrectomy for advanced gastric cancer staged cT2/3/4 cN0/1/2/3a cM0 by endoscopy and computed tomography are eligible for enrollment after giving their informed consent. Patients will be randomized either to laparoscopy-assisted distal gastrectomy or open distal gastrectomy. Sample size calculation revealed that 102 patients are to be included per treatment arm. The primary endpoint is the non-compliance rate of D2 dissection; relevant secondary endpoints are three-year disease free survival, surgical and postoperative complications, hospital stay and unanimity rate of D2 dissection evaluated by reviewing the intraoperative video documentation. Oncologic safety is the major concern regarding laparoscopy-assisted distal gastrectomy for advanced gastric cancer. Therefore, the non-compliance rate of clearing the N2 area was chosen as the most important parameter for the technical feasibility of the laparoscopic procedure. Furthermore, surgical quality will be carefully reviewed, that is, three independent experts will review the video records and score with a check list. For a long-term result, disease free survival is considered a secondary endpoint for this trial. This study will offer promising evidence of the feasibility and safety of Laparoscopy-assisted distal gastrectomy for advanced gastric cancer. NCT01088204 (international), NCCCTS-09-448 (Korea).

[Synchronous Double Cancer Involving Gastric Cancer Resembling a Submucosal Tumor with Stenosis in the Pylorus and Ascending Colon Cancer - A Case Report].

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Miyauchi, Tatsuomi; Miyaki, Akira; Ida, Arika; Kishibe, Saki; Yamaguchi, Kentaro; Shiozawa, Shunichi; Usui, Takebumi; Kuhara, Kotaro; Kono, Teppei; Naritaka, Yoshihiko

2016-11-01

An 82-year-old woman presented to our hospital with a complaint of frequent vomiting. She was admitted for intensive examination and treatment. Abdominal computed tomography revealed that her stomach was severely expanded, and the wall of the ascending colon was thickened throughout its circumference. Upper gastrointestinal endoscopy uncovered severe stenosis in the pylorus and an elevated lesion resembling a submucosal tumor on the posterior wall of the pylorus. Biopsies of the lesion revealed that it was of Group 1. On colonoscopy, type 2 cancer was found in the ascending colon throughout the circumference, and the biopsies revealed that it was of Group 5. Upper gastrointestinal endoscopy was repeated, and the same result was obtained. The possibility of malignancy could not be excluded; therefore, distal gastrectomy and right colectomy were performed. In terms of histopathology, both resected specimens displayed poorly differentiated adenocarcinoma; however, immunohistochemical studies revealed differences in staining at the two sites. The case was diagnosed as synchronous double cancer involving gastric cancer resembling a submucosal tumor with stenosis in the pylorus and ascending colon cancer. Gastric cancer resembling a submucosal tumor is usually difficult to diagnose on biopsy. If the endoscopic findings reveal an elevated lesion resembling a submucosal tumor with stenosis, then the possibility of carcinoma should be considered, and the most suitable treatment should be selected.

Synchronous GISTs associated with multiple sporadic tumors: a case report

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Danila Comandini

2017-08-01

Full Text Available Gastrointestinal stromal tumors (GISTs are rare neoplasms, but they also represent the most common mesenchymal tumors of the gastrointestinal tract originating from the cell of Cajal. GIST incidence ranges around 1% of all gastrointestinal malignancies. Approximately 5% of all GISTs have a hereditary etiology. The remaining 95% of GISTs are considered sporadic events, with up to 75% of cases driven by a constitutional activation of the c-KIT proto-oncogene. GISTs are generally solitary lesions. Nonetheless, multiple sporadic GISTs can occur and present as synchronous or metachronous tumors, usually associated with familial GIST. Here, we report a case of primary prostate and lung tumors associated with gastric and small bowel GISTs, unrelated to any known hereditary syndrome. Also, in the case we describe, the prostatic tumor came before the GISTs, while the lung tumor occurred later in time and led to pulmonary lobectomy plus lymphoadenectomy, with a diagnosis of nonsmall cell lung cancer. With the exception of a slight difference in lymphoid infiltration, the abdominal and gastric GIST nodules shared the same proliferative MIB1 index and mitotic count. However, the genetic analysis revealed that the gastric GIST and abdominal tumors were characterized by two different c-KIT mutations. This molecular heterogeneity supported the hypothesis of two different synchronous GISTs arising from stomach and ileum. At present, the patient is disease free and has already completed the third year of adjuvant therapy with imatinib. This case supports the importance of the analysis of c-KIT mutational status to distinguish metastases from synchronous multicentric GISTs, with relevant implications in therapeutic decisions, as well as the importance of a dedicated multidisciplinary team and of a radiological follow-up after the diagnosis of a primary GIST, to discover a relapse of the GIST or, possibly, additional malignancies.

Audit of advanced gastric cancer at Ibn Sina Hospital, Khartoum ...

African Journals Online (AJOL)

Sudan Journal of Medical Sciences ... Background: Worldwide, gastric cancer is the second most common cancer (second to lung cancer). ... and age influences the clinico-pathological features of gastric cancer and to audit the outcome of ...

Study of gastric cancer in atomic bomb survivors

International Nuclear Information System (INIS)

Takayama, Sadamatsu; Tadehara, Futoshi; Okusaki, Ken; Ito, Yoshiko; Ogawa, Junichiro; Kato, Masafumi; Ito, Chikako; Oyama, Hiroko; Mito, Kazuyo.

1990-01-01

Ten gastric cancer A-bomb survivors who had been false negative in mass screening for gastric cancer one year before the diagnosis were entered in a study determining an adequate interval of gastric mass screening for A-bomb survivors. Doubling time of cancer was determined on X-ray films. Of the 10 A-bomb survivors, 8 had entered the city after the bombing and the other two had been exposed at 1,700 m and 2,500 m, respectively, from the hypocenter. Six had early gastric cancer and the other 4 had advanced cancer. Doubling time averaged 19.1 months for early cancer and 7.6 months for advanced cancer. Three measurements of tumor diameter available for 4 A-bomb survivors revealed a very rapid increase in doubling time during the progression period from early to advanced cancer. An interval of one year seems to be adequate in mass screening to detect early cancer. (N.K.)

Multidetector CT of Locally Invasive Advanced Gastric Cancer: Value of Oblique Coronal Reconstructed Images for the Assessment of Local Invasion

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Jung, Jin Hee; Kim, Ah Yong; Kim, Hye Jin; Yook, Jeong Hwan; Yu, Eun Sil; Jang, Yoon Jin; Park, Seong Ho; Shin, Yong Moon; Ha, Hyun Kwon [Asan Medical Center, Seoul (Korea, Republic of)

2010-01-15

To evaluate the diagnostic value of oblique coronal reconstructed CT images to determine the local invasion of advanced gastric cancer (AGC). Thirty-four consecutive patients, who were suspected to have locally invasive advanced gastric cancer (more than T3 stage) on a preoperative MDCT scan and underwent a diagnostic or curative laparotomy, were enrolled in this study. Two reviewers performed an independent blind review of three series of MDCT images in random order; axial (AXI), conventional coronal (CCI), and oblique coronal (OCI) (parallel to long axis of gastric body and pancreas) images. In assessing the local invasion, the reader's confidence for the local invasion of AGC was graded using a five point scale (1 = definitely negative, 5 = definitely positive: T4). With surgical findings and histopathological proofs as reference standards, the diagnostic performance of the three different plans of CT images was employed for the verification of local invasion of AGC on a preoperative CT scan using the receiver operating characteristic (ROC) method. Agreements between the two reviewers were analyzed using weighted kappa statistics. Results: In 19 out of 34 patients, local invasion was confirmed surgically or histopathologically (13 pancreas invasion, 6 liver invasion, 4 major vascular invasion, 3 colon and mesocolon invasion, and 2 spleen invasion). The diagnostic performance of OCI was superior to AXI or CCI in the local invasion of AGC. The differences in the area under the curve of AXI (0.770 {+-} 0.087, 0.700 {+-} 0.094), CCI (0.884 {+-} 0.058, 0.958 {+-} 0.038), and OCI (0.954 {+-} 0.050, 0.956 {+-} 0.049), were statistically significant for both reviewers. Inter-observer agreement was excellent for OCI ({kappa}= .973), which was greater than CCI (({kappa}= .839), and AXI (({kappa}= .763). On a CT scan, OCI might be a useful imaging technique in evaluating locally invasive advanced gastric cancer.

Effect of preoperative S-1 combined with regional transcatheter arterial chemoembolization on malignant degree of locally advanced gastric cancer

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Ru-Juan Xu

2016-07-01

Full Text Available Objective: To study the effect of preoperative S-1 combined with regional transcatheter arterial chemoembolization on malignant degree of locally advanced gastric cancer. Methods: A total of 134 patients who were diagnosed with advanced gastric cancer in our hospital from May 2012 to December 2014 were selected for study, received surgical resection after chemotherapy, and were divided into intravenous chemotherapy group and combined treatment group according to different chemotherapy regimens. After chemotherapy and before operation, serum tumor marker levels were detected; after operation, recurrence and metastasis-related molecule levels in tumor tissue were detected. Results: After chemotherapy and before operation, serum CEA, CA199, CA72-4, TSGF, ESM-1 and DKK-1 levels of combined treatment group were significantly lower than those of intravenous chemotherapy group; TET1, TET2, LATS1 and RUNX3 levels in tumor tissue of combined treatment group were higher than those of intravenous chemotherapy group while Sipa1, GOLPH3, AEP, MT2- MMP, OPN, Galectin-1, Galectin-3 and Galectin-9 levels were lower than those of intravenous chemotherapy group. Conclusions: Compared with systemic intravenous chemotherapy, preoperative S-1 combined with regional transcatheter arterial chemoembolization can more effectively kill gastric cancer cells and prevent tumor recurrence and metastasis at molecular level.

Two-Step Laparoscopic Surgery for a Patient with Synchronous Double Cancer of the Colon and Stomach Accompanied by Severe Chronic Obstructive Pulmonary Disease

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Kazuhito Yajima

2013-01-01

Full Text Available Laparoscopic treatment strategies for synchronous intra-abdominal malignancies have not yet been standardized. We report a successful case of two-step laparoscopic surgery for synchronous double cancer of the colon and stomach accompanied by severe chronic obstructive pulmonary disease (COPD. A 66-year-old man with COPD was diagnosed as having advanced colon cancer and early gastric cancer. On admission, he could not go upstairs (Grade III according to the Hugh-Jones classification and his forced expiratory volume in 1 second was 600 mL (35.9%. The patient initially underwent laparoscopy-assisted sigmoidectomy with D3 lymphadenectomy, followed by laparoscopy-assisted distal gastrectomy with D1 lymphadenectomy 68 days later. The patient's each postoperative course was uneventful with no pulmonary complications, and the patient was discharged 9 and 11 days after the first and second operations, respectively. The present case demonstrates that two-step laparoscopic surgery may be a safe and feasible surgical procedure for high-risk patients with synchronous intra-abdominal malignancies.

Evaluation of the efficacy and toxicity of protocol cisplatin, 5-fluorouracil, leucovorin compared to protocol fluorouracil, doxorubicin and mitomycin C in locally advanced and metastatic gastric cancer

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Andrić Zoran

2012-01-01

Full Text Available Introduction. Still there is no consensus on the choice of the most efficient and the least toxic chemotherapy regimen in the treatment of advanced gastric cancer. Nowadays few therapy protocols are available for treating this disease. Objective. Study was conducted to compare the efficacy and toxicity of FAM (flurouracil, doxorubicin, mitomycin C with CDDP and FU/FA (cisplatin, 5-fluorouracil, leucovorin protocols in patients with locally advanced and metastatic gastric cancer. Methods. This randomized study involved a group of 50 patients with locally advanced or metastatic gastric cancer, who had not previously undergone chemotherapy treatment. Progression free survival, overall survival and drug toxicity were evaluated. For statistical analysis chi-square test, Kaplan-Meier curve and the log rank test were used. Results. The overall response rate was 20% in the group treated with FAM and 24% in the group treated with CDDP, FU/FA (4% of patients from each group had complete response, but without significant statistical difference. Median survival was 10.9 months in the FAM group and 11.8 months in CDDP, FU/FA group, with no statistically significant difference. Non-haematological and haematological toxicities of CDDP, FU/FA were considerably less frequent than of FAM, and there was no treatment related deaths in any of the groups. Conclusion. Both investigated regimens demonstrated moderate efficacy. The study shows in favour of justified application of both protocols, while in regard to toxicity CDDP and FU/FA can be recommended as preferable treatment for locally advanced and metastatic gastric cancer. New strategies should be considered for better efficacy in the treatment of advanced gastric cancer. New strategies are necessary with the goal to achieve a better therapeutic effect.

Molecular biology of gastric cancer.

Science.gov (United States)

Cervantes, A; Rodríguez Braun, E; Pérez Fidalgo, A; Chirivella González, I

2007-04-01

Despite its decreasing incidence overall, gastric cancer is still a challenging disease. Therapy is based mainly upon surgical resection when the tumour remains localised in the stomach. Conventional chemotherapy may play a role in treating micrometastatic disease and is effective as palliative therapy for recurrent or advanced disease. However, the knowledge of molecular pathways implicated in gastric cancer pathogenesis is still in its infancy and the contribution of molecular biology to the development of new targeted therapies in gastric cancer is far behind other more common cancers such as breast, colon or lung. This review will focus first on the difference of two well defined types of gastric cancer: intestinal and diffuse. A discussion of the cell of origin of gastric cancer with some intriguing data implicating bone marrow derived cells will follow, and a comprehensive review of different genetic alterations detected in gastric cancer, underlining those that may have clinical, therapeutic or prognostic implications.

The role of surgery in the therapeutic approach of gastric cancer liver metastases.

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Mastoraki, Aikaterini; Benetou, Christina; Mastoraki, Sotiria; Papanikolaou, Ioannis S; Danias, Nikolaos; Smyrniotis, Vassilios; Arkadopoulos, Nikolaos

2016-09-01

Gastric cancer (GC) currently prevails as the second cause of death by malignancy worldwide. Estimations suggest that 35 % of affected patients appear with synchronous distant metastases. The vast majority of patients present with hepatic metastatic disease, sometimes accompanied by synchronous peritoneal and lung dissemination. The disease mostly remains asymptomatic at an early stage, with few reported cases of incidental abdominal discomfort. As the cancer advances, symptoms such as nausea or vomiting arise, along with indigestion and dysphagia, blood loss in the form of melena or hematemesis, as well as anorexia and weight loss. Having spread to the liver, it also causes jaundice due to hepatomegaly and general inanition. Despite recent research on the therapeutic strategies against GC metastatic disease, surgical resection appears the only potentially curative approach. Unfortunately, the majority of patients are not eligible to undergo surgical intervention. With regard to treatment modalities of the advanced stage disease, the role of metastasectomy is still debatable and quite unclear, while prolonged survival was succeeded only under certain specific circumstances. Systemic chemotherapy remains however another option, as well as local management in the form of cryotherapy, radiofrequency ablation, or transcatheter arterial chemoembolization. The aims of this review were to evaluate the results of surgical treatment for metastatic GC with special reference to the extent of its histological spread and to present the recent literature in order to provide an update on the current concepts of advanced surgical management of this entity. Relevant publications in the last two decades are briefly reviewed.

Advances in Understanding How Heavy Metal Pollution Triggers Gastric Cancer

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Wenzhen Yuan

2016-01-01

Full Text Available With the development of industrialization and urbanization, heavy metals contamination has become a major environmental problem. Numerous investigations have revealed an association between heavy metal exposure and the incidence and mortality of gastric cancer. The mechanisms of heavy metals (lead, cadmium, mercury, chromium, and arsenic contamination leading to gastric cancer are concluded in this review. There are four main potential mechanisms: (1 Heavy metals disrupt the gastric mucosal barrier by decreasing mucosal thickness, mucus content, and basal acid output, thereby affecting the function of E-cadherin and inducing reactive oxygen species (ROS damage. (2 Heavy metals directly or indirectly induce ROS generation and cause gastric mucosal and DNA lesions, which subsequently alter gene regulation, signal transduction, and cell growth, ultimately leading to carcinogenesis. Exposure to heavy metals also enhances gastric cancer cell invasion and metastasis. (3 Heavy metals inhibit DNA damage repair or cause inefficient lesion repair. (4 Heavy metals may induce other gene abnormalities. In addition, heavy metals can induce the expression of proinflammatory chemokine interleukin-8 (IL-8 and microRNAs, which promotes tumorigenesis. The present review is an effort to underline the human health problem caused by heavy metal with recent development in order to garner a broader perspective.

[Eleven Patients with Gastric Cancer Who Received Chemotherapy after Stent Placement for Gastric Outlet Obstruction].

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Endo, Shunji; Nakagawa, Tomo; Konishi, Ken; Ikenaga, Masakazu; Ohta, Katsuya; Nakashima, Shinsuke; Matsumoto, Kenichi; Nishikawa, Kazuhiro; Ohmori, Takeshi; Yamada, Terumasa

2017-01-01

Endoscopic placement of self-expandable metallic stents is reportedly effective for gastric outlet obstructions due to advanced gastric cancer, and is less invasive than gastrojejunostomy. For patients who have good performance status, we administer chemotherapy after stent placement, although the safety and feasibility of this chemotherapy have not yet been discussed in full. Between 2011 and 2015, 15 patients at our institution underwent endoscopic gastroduodenal stent placement for gastric outlet obstruction due to gastric cancer. Eleven of these patients were administered chemotherapy after stent placement. In our case series, we did not observe any specific adverse event caused by stent placement plus chemotherapy. Adverse events after chemotherapy included anemia of CTCAE Grade 3 in 7 patients. Stent-in-stent placement was needed in 2 patients. Neither stent migration nor perforation was observed. Therefore, chemotherapy after stent placement for gastric outlet obstruction due to gastric cancer was considered safe and feasible. Stent placement is useful not only as palliative care for patients with terminal-stage disease, but also as one of the multimodal therapeutic strategies for gastric cancer.

Modified vs. standard D2 lymphadenectomy in distal subtotal gastrectomy for locally advanced gastric cancer patients under 70 years of age.

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Zhang, Chun-Dong; Zong, Liang; Ning, Fei-Long; Zeng, Xian-Tao; Dai, Dong-Qiu

2018-01-01

The present study was conducted to investigate the prognosis and survival of patients with locally advanced gastric cancer who underwent distal subtotal gastrectomy with modified D2 (D1+) and D2 lymphadenectomy, under 70 years of age. The five-year overall survival rates of 390 patients were compared between those receiving D1+ and D2 lymphadenectomy. Univariate and multivariate analyses were used to identify factors that correlated with prognosis and lymph node metastasis. Tumor size (P=0.039), pT stage (P=0.011), pN stage (PD2 lymphadenectomy removes sufficient lymph nodes to improve staging accuracy and survival. Therefore, D2 lymphanectomy is recommended in distal subtotal gastrectomy for locally advanced gastric cancer, especially for cancers of larger size and higher pT stage.

[Effect of neoadjuvant chemotherapy on nutritional status of locally advanced gastric cancer].

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Deng, Guopeng; Qu, Jianjun; Zhai, Shengyong; Shi, Yiran; Wang, Xinbo

2018-03-25

To study the effect of neoadjuvant chemotherapy on nutritional status in patients with locally advanced gastric cancer. Cases inclusion criteria: (1)18-65 years old; (2) Gastric cancer confirmed by gastroscopic biopsy; (3) Preoperative TNM stage III( according to the AJCC stage 2000 standard; (4) Kamosfsky functional status score> 60 points; (5)Receiving neoadjuvant chemotherapy voluntarily and signing the informed consent form. Case exclusion criteria: (1)Having contraindications of chemotherapy and surgery; (2) Suffering from heart, liver and kidney and other underlying diseases; (3) Concurrent with malignant diseases, wasting disease or other digestive diseases. According to the above criteria, clinical data of 73 patients of stage III( gastric cancer receiving neoadjuvant chemotherapy at Weifang People's Hospital from May 2015 to March 2017 were prospectively collected. The cohort study was adopted. After removing 3 patients who did not complete the chemotherapy, a total of 70 patients who completed the chemotherapy were included in the study. All the patients received SOX chemotherapy without nutritional support during chemotherapy. Changes of body composition and nutritional indicators were analyzed before and after chemotherapy, and according to the tumor regression after chemotherapy, patients were divided into response group (complete or sub-total tumor regression) and non-response group (tumor part, with or without a small amount of retreat) for stratified analysis. Of 70 gastric cancer patients, 40 were male and 30 were female with a age of (53.8±6.4) (28 to 64) years. There were 26 cases (37.1%) of stage III(a, 35 cases (50.0%) of stage III(b and 9 cases (12.9%) of stage III(c. There were 41 cases in response group and 29 cases in non-response group. Three patients (4.3%) were complete remission (CR) and 38 patients (54.3%) were partial remission (PR) in response group, while 23 cases (32.9%) were stable disease (SD) and 6 cases (8.6%) were progressive

Chemotherapy or targeted therapy as second-line treatment of advanced gastric cancer. A systematic review and meta-analysis of published studies.

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Iacovelli, Roberto; Pietrantonio, Filippo; Farcomeni, Alessio; Maggi, Claudia; Palazzo, Antonella; Ricchini, Francesca; de Braud, Filippo; Di Bartolomeo, Maria

2014-01-01

Chemotherapy is a cornerstone in treatments of gastric cancer, but despite its benefit, less than 60% of patients receive salvage therapy in clinical practice. We performed a systematic review and meta-analysis based on trial data on the role of second-line treatment of advanced gastric cancer. MEDLINE/PubMed and Cochrane Library were searched for randomized phase III trials that compared active therapy to best supportive care in advanced gastric cancer. Data extraction was conducted according to the PRISMA statement. Summary HR for OS was calculated using a hierarchical Bayesian model and subgroup analysis was performed based on baseline Eastern Cooperative Oncology Group Performance Status (ECOG) performance status (0 vs. 1 or more). A total of 1,407 patients were evaluable for efficacy, 908 were treated in the experimental arms, with chemotherapy (231 pts) or with targeted therapies (677 pts). The risk of death was decreased by 18% (HR = 0.82; 95% CI, 0.79-0.85; posterior probability HR≥1: Chemotherapy and ramucirumab were able to decrease this risk by 27% and 22%, respectively. No differences were found between chemotherapy and ramucirumab. In patients with ECOG = 0 a greater benefit was found for chemotherapy with a reduction of the risk of death by 43% and no benefits were found for ramucirumab or everolimus. In patients with ECOG = 1 or more a significant reduction of the risk of death by 32% was reported in patients treated with ramucirumab, even if no significant difference was reported between chemotherapy and ramucirumab. This analysis reports that active and available therapies are able to prolong survival in patients with advanced gastric cancer with a different outcome based on initial patient's performance status. New trials based on a better patient stratification are awaited.

Circulating tumor DNA functions as an alternative for tissue to overcome tumor heterogeneity in advanced gastric cancer.

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Gao, Jing; Wang, Haixing; Zang, Wanchun; Li, Beifang; Rao, Guanhua; Li, Lei; Yu, Yang; Li, Zhongwu; Dong, Bin; Lu, Zhihao; Jiang, Zhi; Shen, Lin

2017-09-01

Overcoming tumor heterogeneity is a major challenge for personalized treatment of gastric cancer, especially for human epidermal growth factor receptor-2 targeted therapy. Analysis of circulating tumor DNA allows a more comprehensive analysis of tumor heterogeneity than traditional biopsies in lung cancer and breast cancer, but little is known in gastric cancer. We assessed mutation profiles of ctDNA and primary tumors from 30 patients with advanced gastric cancer, then performed a comprehensive analysis of tumor mutations by multiple biopsies from five patients, and finally analyzed the concordance of HER2 amplification in ctDNA and paired tumor tissues in 70 patients. By comparing with a single tumor sample, ctDNA displayed a low concordance of mutation profile, only approximately 50% (138/275) somatic mutations were found in paired tissue samples, however, when compared with multiple biopsies, most DNA mutations in ctDNA were also shown in paired tumor tissues. ctDNA had a high concordance (91.4%, Kappa index = 0.784, P < 0.001) of HER2 amplification with tumor tissues, suggesting it might be an alternative for tissue. It implied that ctDNA-based assessment could partially overcome the tumor heterogeneity, and might serve as a potential surrogate for HER2 analysis in gastric cancer. © 2017 The Authors. Cancer Science published by John Wiley & Sons Australia, Ltd on behalf of Japanese Cancer Association.

Comparison of Oral Contrast-Enhanced Transabdominal Ultrasound Imaging With Transverse Contrast-Enhanced Computed Tomography in Preoperative Tumor Staging of Advanced Gastric Carcinoma.

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He, Xuemei; Sun, Jing; Huang, Xiaoling; Zeng, Chun; Ge, Yinggang; Zhang, Jun; Wu, Jingxian

2017-12-01

This study assessed the diagnostic performance of transabdominal oral contrast-enhanced ultrasound (US) imaging for preoperative tumor staging of advanced gastric carcinoma by comparing it with transverse contrast-enhanced computed tomography (CT). This retrospective study included 42 patients with advanced gastric cancer who underwent laparoscopy, radical surgery, or palliative surgery because of serious complications and had a body mass index of less than 25 kg/m 2 . A cereal-based oral contrast agent was used for transabdominal oral contrast-enhanced US. Retrospective analyses were conducted using preoperative tumor staging data acquired by either transabdominal oral contrast-enhanced US or transverse contrast-enhanced CT. Both contrast-enhanced US and contrast-enhanced CT examinations were reviewed by 2 experienced radiologists independently for preoperative tumor staging according to the seventh edition of the TNM classification. The accuracy, sensitivity, and specificity were calculated by comparing the results of contrast-enhanced US and contrast-enhanced CT with pathologic findings. The overall accuracies of the imaging modalities were compared by the McNemar test. No significant difference was noted in the overall accuracy of transabdominal oral contrast-enhanced US (86% [36 of 42]) and transverse contrast-enhanced CT (83% [35 of 42] P > .999). For stage T2 to T4 gastric cancer, the accuracies of transabdominal oral contrast-enhanced US were 88%, 86%, and 98%, respectively, and those of transverse contrast-enhanced CT were 93%, 83%, and 90%. The overall accuracy of transabdominal oral contrast-enhanced US was comparable with that of transverse contrast-enhanced CT for preoperative tumor staging of advanced gastric cancer. © 2017 by the American Institute of Ultrasound in Medicine.

Biologically Inspired Intercellular Slot Synchronization

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Alexander Tyrrell

2009-01-01

Full Text Available The present article develops a decentralized interbase station slot synchronization algorithm suitable for cellular mobile communication systems. The proposed cellular firefly synchronization (CelFSync algorithm is derived from the theory of pulse-coupled oscillators, common to describe synchronization phenomena in biological systems, such as the spontaneous synchronization of fireflies. In order to maintain synchronization among base stations (BSs, even when there is no direct link between adjacent BSs, some selected user terminals (UTs participate in the network synchronization process. Synchronization emerges by exchanging two distinct synchronization words, one transmitted by BSs and the other by active UTs, without any a priori assumption on the initial timing misalignments of BSs and UTs. In large-scale networks with inter-BS site distances up to a few kilometers, propagation delays severely affect the attainable timing accuracy of CelFSync. We show that by an appropriate combination of CelFSync with the timing advance procedure, which aligns uplink transmission of UTs to arrive simultaneously at the BS, a timing accuracy within a fraction of the inter-BS propagation delay is retained.

Virtual gastroscopy using spiral CT in gastric lesions

International Nuclear Information System (INIS)

Shin, Sang Soo; Kang, Heoung Keun; Jeong, Yong Yeon; Yoon, Man Won; Song, Sang Gook; Jeong, Gwang Woo

1998-01-01

To compare virtual gastroscopy using spiral CT with conventional endoscopy for the detection and evaluation of gastric lesions. During a previous six-month period, 30 patients with pathologically-proven gastric lesions underwent conventional endoscopy and virtual gastroscopy using spiral CT. There were 18 cases of advanced gastric carcinoma, eight benign ulcers, and four submucosal tumors(two leiomyomas, two lymphomas). Source images of virtual gastroscopy were three-dim-ensionally reconstructed within an Advantage Windows Workstation and virtual gastroscopic images were obtained using Navigator Software. On analysis, images were graded according to their quality(excellent, good, poor). Virtual gastroscopic images were interpreted by two radiologists blinded to conventional endoscopic findings, and were subsequently compared with endoscopic findings in terms of detectability and findings. In the cases of advanced gastric carcinoma, lesions were classified according to Borrmann's system. For virtual gastroscopy, overall image quality was excellent in 21 cases(70%), good in five(17%), and poor in four(13%). Lesions were detected in 25 cases(83%). Among the 18 advanced gastric carcinomas, virtual gastroscopy image quality was excellent in 14 cases(78%), good in two(11%), and poor in two(11%). Lesions were detected in 16 cases(89%). Two Borrmann type IV cases were not detected. Among the eight benign ulcers, virtual gastroscopy image quality was excellent in three cases(38%), good in three(38%), and poor in two(25%). The detection of lesion was possible in five cases(63%). In all submucosal tumors, virtual gastroscopy image quality was excellent. Lesions were detected in all cases. Virtual gastroscopy using spiral CT is safe and noninvasive, and for the evaluation of gastric lesions may be complementary to axial CT. It successfully detects gastric lesions, and in depicting the pattern of gastric folds its image quality is excellent.=20

Adjuvant radiochemotherapy in the treatment of completely resected, locally advanced gastric cancer

International Nuclear Information System (INIS)

Baeza, Mario R.; Osvaldo Giannini, T.; Raul Rivera, S.; Gonzalez, Pablo; Gonzalez, Julio; Vergara, Ernesto; Castillo, Cesar del; Madrid, Jorge; Vines, Eugenio

2001-01-01

Purpose: To analyze the efficacy and toxicity of adjuvant whole abdomen irradiation (WAI) and concomitant chemotherapy in the treatment of completely resected, high-risk gastric cancer. Methods and Materials: Between October 1990 and September 1997, 52 patients with completely resected gastric cancer, with lymph node and/or serosal involvement, were treated. Ages were 16-78 (median, 53.5) years. Treatment was either total- or sub-total gastrectomy, followed by WAI, 2100 cGy/21 fractions plus a 2400 cGy/16 fractions boost to the tumor bed. Chemotherapy consisted of either 5-fluorouracil (5-FU) 450-500 mg/m 2 i.v. for 5 days first and 5th week or 200-300 mg/m 2 continuous infusion during irradiation. No further chemotherapy was given. Results: With a minimum follow-up of 30 months and a median follow-up of 43.5 months, 25 of the 52 patients have died. Overall 5-year survival rate is 54%. Three patients sustained Grade 3-5 complications. Two patients with Grade 5 complications (malabsorption syndrome) died 31 and 56 months after the beginning of the treatment, respectively, with no evidence of recurrent tumor. For patients with involvement of the lymph nodes alone (n=19) the 5-year survival was 69%, which was significantly better than the 36% 5-year survival observed for those patients with both serosal and lymph node involvement (n=26, p=0.004). Conclusion: Adjuvant radiochemotherapy, WAI, and concomitant 5-FU, is a feasible and a fairly well-tolerated treatment for patients with locally advanced (involvement of the lymph nodes or serosa) gastric carcinoma who undergo complete resection. The 54% overall 5-year survival compares favorably with the survival reported after surgery alone for those patients

Synchronization in complex networks

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Arenas, A.; Diaz-Guilera, A.; Moreno, Y.; Zhou, C.; Kurths, J.

2007-12-12

Synchronization processes in populations of locally interacting elements are in the focus of intense research in physical, biological, chemical, technological and social systems. The many efforts devoted to understand synchronization phenomena in natural systems take now advantage of the recent theory of complex networks. In this review, we report the advances in the comprehension of synchronization phenomena when oscillating elements are constrained to interact in a complex network topology. We also overview the new emergent features coming out from the interplay between the structure and the function of the underlying pattern of connections. Extensive numerical work as well as analytical approaches to the problem are presented. Finally, we review several applications of synchronization in complex networks to different disciplines: biological systems and neuroscience, engineering and computer science, and economy and social sciences.

Peripheral venous blood neutrophil-to-lymphocyte ratio predicts survival in patients with advanced gastric cancer treated with neoadjuvant chemotherapy

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Chen L

2017-05-01

Full Text Available Li Chen,1 Yanjiao Zuo,1 Lihua Zhu,2 Yuxin Zhang,3 Sen Li,1 Fei Ma,4 Yu Han,5 Hongjiang Song,1 Yingwei Xue11Department of Gastrointestinal Surgery, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, Heilongjiang, 2Department of Pathogen Biology, School of Basic Medical Sciences, North China University of Science and Technology, Tangshan, Hebei, 3Department of General Surgery, Mudanjiang First People’s Hospital, Mudanjiang, 4Department of Breast Surgery, 5Department of Gastrointestinal Oncology, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, Heilongjiang, People’s Republic of ChinaBackground: Accurate and useful predictors of gastric carcinoma treated with neoadjuvant chemotherapy are lacking at present. We aim to explore the potential prognostic significance of the neutrophil-to-lymphocyte ratio (NLR in advanced gastric cancer receiving S-1 plus oxaliplatin (SOX or oxaliplatin and capecitabine (XELOX regimen.Methods: We enrolled 91 patients with advanced gastric cancer treated with neoadjuvant chemotherapy from August 2008 to September 2015. The peripheral venous blood samples were collected before neoadjuvant chemotherapy. The NLR was divided into two groups: low NLR <2.17 group and high NLR ≥2.17 group. Univariate analysis on disease-free survival (DFS and overall survival (OS were generated using the Kaplan–Meier method and compared using the log-rank test. Prognostic factors were assessed by univariate analyses, and the independent prognostic factors were evaluated using multivariate analysis (Cox’s proportional-hazards regression model.Results: The univariate analysis showed that median DFS and median OS were worse for high NLR values than low NLR values before neoadjuvant chemotherapy (median DFS: 19.97 and 26.87 months, respectively, P=0.299; median OS: 25.83 and 29.73 months, respectively, P=0.405. Multivariate analysis showed that the NLR before neoadjuvant

Method of synchronizing independent functional unit

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Kim, Changhoan

2018-03-13

A system for synchronizing parallel processing of a plurality of functional processing units (FPU), a first FPU and a first program counter to control timing of a first stream of program instructions issued to the first FPU by advancement of the first program counter; a second FPU and a second program counter to control timing of a second stream of program instructions issued to the second FPU by advancement of the second program counter, the first FPU is in communication with a second FPU to synchronize the issuance of a first stream of program instructions to the second stream of program instructions and the second FPU is in communication with the first FPU to synchronize the issuance of the second stream program instructions to the first stream of program instructions.

Comparison of radiologic and pathologic findings of gastric MALToma

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Lee, Dong Ho; Lee, Ju Hie; Ko, Young Tae [Kyunghee Univ. Hospital, Seoul (Korea, Republic of)

1997-02-01

To evaluate the radiologic findings of gastric MALToma, and to correlate these with its pathologic findings. We retrospectively reviewed the pathologic slides of gastrectomy and gastroscopic biopsy specimens obtained between 1982 and 1996, and collected nine cases of gastric MALToma. Eight of these had been surgically confirmed, and one had been diagnosed by gastroscopic biopsy. A gastrointestinal series comprised eight cases; five involved sonography and five, CT. The lesions were located at the body in five cases, at the antrum in one, and at the body and antrum in three cases. Pathologic diagnosis was low grade MALToma in four cases, and mixed high and low grade MALToma in five cases. Initial radiologic diagnosis was gastric lymphoma in four cases, early gastric carcinoma in three, and advanced gastric carcinoma in two cases. On retrospective analysis, radiologic diagnosis was changed to lymphoma in both cases initially diagnosed as advanced gastric carcinomas. One case showed marked thickening of the gastric wall, with poor enhancement on CT, and the other case showed a very small and shallow ulcer in comparison to diffuse infiltration of tumor in the upper gastrointestinal series. The final radiologic diagnosis was gastric lymphoma in six cases, and early carcinoma in three. Radiologic findings of gastric MALToma were EGC II c-like lesion in three cases, marked gastric wall thickening in two, multiple discrete lesions in two, hyperugosity of gastric folds with discrete lesions in one, and diffuse infiltrative lesion with small ulcer in one case. The pathologic diagnosis of gastric MALToma was made by the presence of lymphoepithelial lesions, centrocyte-like cells, reactive follicles, plasma cell infiltration, and follicular colonization. There were no significant correlations between radiologic findings and pathologic results such as depth of tumor invasion, low grade MALToma or mixed high and low grade MALToma. There are no specific radiologic characteristics

Simultaneous Occurrence of Early Gastric Carcinoma and Mucosa-Associated Lymphoid Tissue Lymphoma of the Omentum

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Tomohiro Murakami

2014-03-01

Full Text Available The simultaneous association of gastric carcinoma with omental mucosa-associated lymphoid tissue (MALT lymphoma is a rare event that has not been reported previously. We focused on the hypothetic pathogenetic mechanisms, diagnosis and treatment of this rare condition. A 55-year-old woman with Helicobacter pylori infection underwent distal gastrectomy in our hospital. Three independent early gastric cancers and a mass near the cecum were diagnosed preoperatively. Pathological review of the resected stomach showed three independent early signet ring cell gastric carcinomas, and the mass in the omentum near the cecum was shown to be omental MALT lymphoma. Due to the nature of the patient's disease, she was started on medical eradication of H. pylori. Synchronous gastric adenocarcinoma and omental MALT lymphoma is a rare event. Special attention given to H. pylori-associated gastric cancer patients can avoid misdiagnosis and lead to adequate treatment.

[Conversion Therapy Using Etoposide and Cisplatin Chemotherapy for Liver Metastases from Advanced Gastric Mixed Adenoneuroendocrine Carcinoma - A Case Report].

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Inaba, Yoko; Fujita, Maiko; Ninomiya, Riki; Hashimoto, Daijo

2017-11-01

Gastric mixed adenoneuroendocrine carcinoma(MANEC)with multiple liver metastases is a rare condition with most data being derived from case reports. We present a case with liver metastases from gastric MANEC that respond remarkably to chemotherapy. Sixty-one-year-old male with severe anemia referred to surgical consultation due to advanced gastric cancer with multiple liver metastases. To relieve uncontrollable tumor bleeding, simple distal gastrectomy for symptom palliation was performed. Based on the tentative diagnosis with gastric poorly differentiated adenocarcinoma, a course of TS-1 and oxaliplatin therapy was administrated. Thereafter final diagnosis with neuroendocrine carcinoma with tubular adenocarcinoma was made, and the chemotherapy was switched to etoposide and cisplatin. Follow up abdominal CT scan after the third course of the therapy showed remarkable tumor shrinkages(PR). In anticipation of the chemotherapy effects in the adjuvant setting, we performed liver metastasectomy for curative intent. Two of 6 resected liver specimens showed no viable cancer cells at all (pCR). However, immediately after the surgery, multiple liver metastases developed, and the recurrent masses had kept growing up rapidly. The third line carboplatin and etoposide chemotherapy was given once but was withdrawn because of bone marrow suppression. At the present, the patient is alive with recurrent diseases for 18 months after initial diagnosis.

Neonatal Intrathoracic Stomach without Gastric Volvulus.

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Bokka, Sriharsha; Mohanty, Manoj Kumar

2016-10-01

Intrathoracic stomach is a rare and serious congenital abnormality. The anomaly may be complicated by gastric volvulus and can lead to ischemic gastric infarction in the neonate. If diagnosed antenatally, neonatal management can be planned in advance so as to reduce morbidity. This anomaly must be differentiated from the more common congenital diaphragmatic hernia, as associated pulmonary hypoplasia is common in the latter and rare with gastric herniation. We report a case of intrathoracic stomach in a neonate without volvulus, fortunately a rare entity which was managed operatively, and the child has been under regular follow-up.

Surgical treatment of gastric carcinoma with ovarian metastases

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Olesinski Tomasz

2017-12-01

Full Text Available Ovarian metastases from extragenital neoplasms are rare. The prevalent sites of the primary tumors were the breast, colorectum and the stomach. The Krukenberg tumor (KT is defined as a gastrointestinal cancer which metastasized to the ovaries. Metastasis to the ovary may appear at the time of diagnosis of the primary tumor (synchronous or during observation (metachronous. Common clinical presentations are abdominal distention, pain, palpable mass, bloating, ascites or pain during sexual intercourse. Diagnosis can be made by ultrasound examinations, CT or EMR scans, laparotomy and/or a biopsy of the ovary. The current standard treatment for patients with metastatic gastric cancer is systemic chemotherapy, however, treatment strategy for KTs from gastric cancer has not been clearly established and surgical treatment is considered mainly for metachronous tumors. The prognosis of patients with ovarian metastasis of gastric cancer origin is poorer compared with that of other primary tumors. Although the results of cytoreductive surgery – especially in combination with modern chemotherapy – seems to be promising, the optimal therapeutic strategies for such patients requires further prospective studies.

Combination of cisplatin/S-1 in the treatment of patients with advanced gastric or gastroesophageal adenocarcinoma: Results of noninferiority and safety analyses compared with cisplatin/5-fluorouracil in the First-Line Advanced Gastric Cancer Study.

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Ajani, J A; Buyse, M; Lichinitser, M; Gorbunova, V; Bodoky, G; Douillard, J Y; Cascinu, S; Heinemann, V; Zaucha, R; Carrato, A; Ferry, D; Moiseyenko, V

2013-11-01

The aim of developing oral fluorouracil (5-FU) is to provide a more convenient administration route with similar efficacy and the best achievable tolerance. S-1, a novel oral fluoropyrimidine, was specifically designed to overcome the limitations of intravenous fluoropyrimidine therapies. A multicentre, randomised phase 3 trial was undertaken to compare S-1/cisplatin (CS) with infusional 5-FU/cisplatin (CF) in 1053 patients with untreated, advanced gastric/gastroesophageal adenocarcinoma. This report discusses a post-hoc noninferiority overall survival (OS) and safety analyses. Results (1029 treated; CS = 521/CF = 508) revealed OS in CS (8.6 months) was statistically noninferior to CF (7.9 months) [hazard ratio (HR) = 0.92 (two-sided 95% confidence interval (CI), 0.80-1.05)] for any margin equal to or greater than 1.05. Statistically significant safety advantages for the CS arm were observed [G3/4 neutropenia (CS, 18.6%; CF, 40.0%), febrile neutropenia (CS, 1.7%; CF, 6.9%), G3/4 stomatitis (CS, 1.3%; CF, 13.6%), diarrhoea (all grades: CS, 29.2%; CF, 38.4%) and renal adverse events (all grades: CS, 18.8%; CF, 33.5%)]. Hand-foot syndrome, infrequently reported, was mainly grade 1/2 in both arms. Treatment-related deaths were significantly lower in the CS arm than the CF arm (2.5% and 4.9%, respectively; Psafety profile and provides a new treatment option for patients with advanced gastric carcinoma. Copyright © 2013 Elsevier Ltd. All rights reserved.

Laparoscopic subtotal gastrectomy for advanced gastric cancer: technical aspects and surgical, nutritional and oncological outcomes.

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Nakauchi, Masaya; Suda, Koichi; Nakamura, Kenichi; Shibasaki, Susumu; Kikuchi, Kenji; Nakamura, Tetsuya; Kadoya, Shinichi; Ishida, Yoshinori; Inaba, Kazuki; Taniguchi, Keizo; Uyama, Ichiro

2017-11-01

Higher morbidity in total gastrectomy than in distal gastrectomy has been reported, but laparoscopic subtotal gastrectomy (LsTG) has been reported to be safe and feasible in early gastric cancer (GC). We determined the surgical, nutritional and oncological outcomes of LsTG for advanced gastric cancer (AGC). Of the 816 consecutive patients with GC who underwent radical gastrectomy at our institution between 2008 and 2012, 253 who underwent curative laparoscopic gastrectomy (LG) for AGC were enrolled. LsTG was indicated for patients with upper stomach third tumors, who hoped to avoid total gastrectomy, nutritional status were primarily assessed. Of 253 patients, the morbidity (Clavien-Dindo classification grade ≥ III) was 17.0% (43 patients). The 3-year overall survival and 3-year recurrence-free survival rates were 80.2 and 73.5%, respectively. LcDG, LsTG and LTG were performed in 121, 27 and 105 patients, individually. Morbidity was strongly associated with LTG (P = 0.001). Postoperative loss of body weight was significantly greater after LTG in comparison with LcDG or LsTG (P nutritional point of view.

Pinning Synchronization of Linear Complex Coupling Synchronous Generators Network of Hydroelectric Generating Set

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Xuefei Wu

2014-01-01

Full Text Available A novel linear complex system for hydroturbine-generator sets in multimachine power systems is suggested in this paper and synchronization of the power-grid networks is studied. The advanced graph theory and stability theory are combined to solve the problem. Here we derive a sufficient condition under which the synchronous state of power-grid networks is stable in disturbance attenuation. Finally, numerical simulations are provided to illustrate the effectiveness of the results by the IEEE 39 bus system.

Advances in the diagnosis and treatment of gastric neuroendocrine neoplasms

OpenAIRE

Tan, Huangying

2016-01-01

Gastric neuroendocrine neoplasms (g-NENs) are a group of heterogeneous tumors arising from the endocrine cells of stomach. Most g-NENs progresses slowly and have a long disease course; however, some other g-NENs grow rapidly, similar to the progression of gastric adenocarcinoma. g-NENs have complex and diverse clinical manifestations and their prognosis and treatment strategies depend highly on clinical subtype, pathological grade, tumour stage, and other factors. Due to their low prevalence,...

Recent Advances in the Gastric Mucosal Protection Against Stress-induced Gastric Lesions. Importance of Renin-angiotensin Vasoactive Metabolites, Gaseous Mediators and Appetite Peptides.

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Brzozowski, Tomasz; Magierowska, Katarzyna; Magierowski, Marcin; Ptak-Belowska, Agata; Pajdo, Robert; Kwiecien, Slawomir; Olszanecki, Rafal; Korbut, Ryszard

2017-01-01

Stress is known to cause severe adverse effects in the human gastrointestinal tract including mucosal microbleedings and erosions or even gastric ulceration but the mechanism of these complications has not been fully elucidated. The pathogenesis of stress-induced gastric damage involves the fall in Gastric Blood Flow (GBF), an increase in gastric acid secretion and gastric motility, enhanced adrenergic and cholinergic nerve activity and the rise in gastric mucosal generation of reactive oxygen species. The gastric mucosal defense mechanisms against the deleterious effect of stress include the activation of the hypothalamic-pituitary-adrenal axis which has been linked with glucocorticoids release capable of counteracting of stress-induced gastric lesions. Here we summarize the novel gastroprotective mechanisms against stress damage exhibited by angiotensin-(1-7), the newly discovered metabolite of Renin-Angiotensin System (RAS), the gaseous mediators such as nitric oxide (NO), hydrogen sulfide (H2S) or Carbon Monoxide (CO), and the food intake controlling peptides ghrelin, nesfatin- 1 and apelin possibly acting via brain-gut axis. These bioactive molecules such as RAS vasoactive metabolite angiotensin-(1-7) and appetite peptides have been shown to afford gastroprotective effect against stressinduced gastric lesions mainly mediated by an increase in gastric microcirculation. Gaseous mediators protect the gastric mucosa against stress lesions by mechanism involving the activation of PG/COX and CO/HO-1 biosynthetic pathways, and their anti-inflammatory and anti-oxidizing properties. Thus, these new components add new mechanistic aspects to the common cooperation of NO/NO-synthase, PG/COX systems and vasoactive sensory neuropeptides including CGRP but their gastroprotective efficacy against experimental stress ulcerogenesis requires the confirmation in human clinical trials. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Mass-like Dieulafoy's lesion associated with advanced gastric cancer at the antrum of stomach: a case report and literature review.

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Huang, Hsi-Lan; Leung, Chi Yan; Cheng, Chien-Jui

2017-10-10

Dieulafoy's lesion, also known as a caliber-persistent artery, is a shallow, small, and rare lesion that occurs along the lesser curvature of proximal stomach. It is rare for a Dieulafoy's lesion to present as a mass-like lesion that coexists with gastric cancer. To our best knowledge, we report the first case and histopathological pictures of a mass-like Dieulafoy's lesion coexisting with advanced gastric cancer in the antrum of the stomach. A 57-year-old female presented with a 6-month history of intermittent epigastric dull pain and dyspepsia. Subsequent upper gastrointestinal endoscopy revealed a friable mass that was located between the distal antrum and the pyloric ring. Biopsy revealed it to be an intestinal type adenocarcinoma. Subtotal gastrectomy was performed after neoadjuvant chemotherapy. Grossly, a large irregular plaque-like tumor lesion was noted at the anterior wall of the distal antrum and pylorus ring near the lesser curvature, measuring 5.6 × 4.8 × 1.0 cm. Histopathological examination of the resected stomach revealed that the plaque-like lesion largely consisted of numerous abnormally large-caliber and tortuous arteries in the submucosa. The increased fibrosis of the submucosa resulted in the formation of elevated plaque. The intestinal type adenocarcinoma was noted to be largely confined to the mucosa layer, with focal submucosal and muscular propria involvement. The patient was discharged one week after the subtotal gastrectomy, and she was alive and well 17 months after discharge, with no major complications. This is the first case of a mass-like Dieulafoy's lesion coexisting with advanced gastric cancer at the distal antrum area. This case highlights the possibility of life-threatening gastric bleeding after mucosal resection or biopsy that could be encountered by endoscopists.

Significance of lymphadenectomy with splenectomy in radical surgery for advanced (pT3/pT4) remnant gastric cancer.

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Sugita, Hiroki; Oda, Eri; Hirota, Masahiko; Ishikawa, Shinji; Tomiyasu, Shinjiro; Tanaka, Hiroshi; Arita, Tetsumasa; Yagi, Yasushi; Baba, Hideo

2016-04-01

To date, the optimal surgical strategy for remnant gastric cancer has not been determined. The purpose of this study was to clarify the significance of lymphadenectomy with splenectomy in remnant gastric cancer surgery. This retrospective cohort study was conducted at the Kumamoto Regional Medical Center. The primary endpoint was overall survival after surgery. We retrospectively analyzed the clinicopathologic features, surgical treatments, and long-term prognosis of remnant gastric cancer patients treated with total gastrectomy. A total of 80 patients with gastric cancer in the remnant stomach after distal gastrectomy and who underwent total gastrectomy were enrolled in the study. Splenectomy was performed in 38 patients. Lymph node metastasis in the splenic hilum was not observed in the patients with pT1/pT2 tumors, whereas nodal metastasis at the splenic hilum was detected in 30.4% of the patients with pT3/pT4 tumors. The survival rate of the patients with pT3/pT4 tumors who underwent splenectomy was significantly higher than that of the patients who did not undergo splenectomy, although there was no difference in the patients with pT1/pT2 tumors. Among the patients classified as R0, the survival rate of the patients with pT3/pT4 tumors who underwent splenectomy was significantly higher than that of the patients who did not undergo splenectomy. Lymphadenectomy with splenectomy in radical surgery is beneficial for patients with advanced (pT3/pT4) remnant gastric cancer. Copyright © 2016 Elsevier Inc. All rights reserved.

Sequence-dependent toxicity profile in modified FAMTX (fluorouracil-adriamycin-methotrexate) chemotherapy with lenograstim support for advanced gastric cancer: a feasibility study

NARCIS (Netherlands)

Westermann, A. M.; Taal, B. G.; Swart, M.; Boot, H.; Craanen, M.; Gerritsen, W. R.

2000-01-01

For advanced irresectible gastric cancer, sequential high-dose methotrexate and 5-fluorouracil (both on day 1) combined with adriamycin on day 15 (FAMTX regimen), cycled every 28 days, is a fairly effective but toxic treatment, with a high incidence of neutropenic fever, dose reductions and dose

Expression of inflammation-related genes is altered in gastric tissue of patients with advanced stages of NAFLD.

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Mehta, Rohini; Birerdinc, Aybike; Neupane, Arpan; Shamsaddini, Amirhossein; Afendy, Arian; Elariny, Hazem; Chandhoke, Vikas; Baranova, Ancha; Younossi, Zobair M

2013-01-01

Obesity is associated with chronic low-grade inflammation perpetuated by visceral adipose. Other organs, particularly stomach and intestine, may also overproduce proinflammatory molecules. We examined the gene expression patterns in gastric tissue of morbidly obese patients with nonalcoholic fatty liver disease (NAFLD) and compared the changes in gene expression in different histological forms of NAFLD. Stomach tissue samples from 20 morbidly obese NAFLD patients who were undergoing sleeve gastrectomy were profiled using qPCR for 84 genes encoding inflammatory cytokines, chemokines, their receptors, and other components of inflammatory cascades. Interleukin 8 receptor-beta (IL8RB) gene overexpression in gastric tissue was correlated with the presence of hepatic steatosis, hepatic fibrosis, and histologic diagnosis of nonalcoholic steatohepatitis (NASH). Expression levels of soluble interleukin 1 receptor antagonist (IL1RN) were correlated with the presence of NASH and hepatic fibrosis. mRNA levels of interleukin 8 (IL8), chemokine (C-C motif) ligand 4 (CCL4), and its receptor chemokine (C-C motif) receptor type 5 (CCR5) showed a significant increase in patients with advanced hepatic inflammation and were correlated with the severity of the hepatic inflammation. The results of our study suggest that changes in expression patterns for inflammatory molecule encoding genes within gastric tissue may contribute to the pathogenesis of obesity-related NAFLD.

Systemic immune–inflammation index as a useful prognostic indicator predicts survival in patients with advanced gastric cancer treated with neoadjuvant chemotherapy

Directory of Open Access Journals (Sweden)

Chen L

2017-12-01

Full Text Available Li Chen,1,* Ying Yan,2,* Lihua Zhu,3 Xiliang Cong,1 Sen Li,1 Shubin Song,1 Hongjiang Song,1 Yingwei Xue1 1Department of Gastrointestinal Surgery, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, Heilongjiang, 2Department of Internal Oncology, Harbin The First Hospital, Harbin, Heilongjiang, 3Department of Pathogen Biology, School of Basic Medical Sciences, North China University of Science and Technology, Tangshan, Hebei, China *These authors contributed equally to this work Background and objective: A novel systemic immune–inflammation index named SII (SII=N×P/L, which is based on neutrophil (N, platelet (P and lymphocyte (L counts, has emerged and reflects comprehensively the balance of host inflammatory and immune status. We aimed to evaluate the potential prognostic significance of SII in patients with advanced gastric cancer who received neoadjuvant chemotherapy.Subjects and methods: The retrospective analysis included data from 107 patients with advanced gastric cancer undergoing neoadjuvant chemotherapy and 185 patients with pathology-proven gastric cancer. The optimal cutoff value of SII by receiver operating characteristic curve stratified patients into low SII (<600×109/L and high SII (SII ≥600×109/L groups. The clinical outcomes of disease-free survival (DFS and overall survival (OS were calculated by Kaplan–Meier survival curves and compared using log-rank test. Univariate and multivariate Cox proportional hazards regression models were used to analyze the prognostic value of SII.Results: The results indicated that SII had prognostic significance using the cutoff value of 600×109/L on DFS and OS in univariate and multivariate Cox regression survival analyses. Low SII was associated with prolonged DFS and OS, and the mean DFS and OS for patients with low SII were longer than for those with high SII (57.22 vs 41.56 months and 62.25 vs 45.60 months, respectively. Furthermore, we found that patients

Regorafenib for the Treatment of Advanced Gastric Cancer (INTEGRATE): A Multinational Placebo-Controlled Phase II Trial.

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Pavlakis, Nick; Sjoquist, Katrin M; Martin, Andrew J; Tsobanis, Eric; Yip, Sonia; Kang, Yoon-Koo; Bang, Yung-Jue; Alcindor, Thierry; O'Callaghan, Christopher J; Burnell, Margot J; Tebbutt, Niall C; Rha, Sun Young; Lee, Jeeyun; Cho, Jae-Yong; Lipton, Lara R; Wong, Mark; Strickland, Andrew; Kim, Jin Won; Zalcberg, John R; Simes, John; Goldstein, David

2016-08-10

We evaluated the activity of regorafenib, an oral multikinase inhibitor, in advanced gastric adenocarcinoma. We conducted an international (Australia and New Zealand, South Korea, and Canada) randomized phase II trial in which patients were randomly assigned at a two-to-one ratio and stratified by lines of prior chemotherapy for advanced disease (one v two) and region. Eligible patients received best supportive care plus regorafenib 160 mg or matching placebo orally on days 1 to 21 of each 28-day cycle until disease progression or prohibitive adverse events occurred. The primary end point was progression-free survival (PFS). Final analysis included data to December 31, 2014. A total of 152 patients were randomly assigned from November 7, 2012, to February 25, 2014, yielding 147 evaluable patients (regorafenib, n = 97; placebo, n = 50). Baseline characteristics were balanced. Median PFS significantly differed between groups (regorafenib, 2.6 months; 95% CI, 1.8 to 3.1 and placebo, 0.9 months; 95% CI, 0.9 to 0.9; hazard ratio [HR], 0.40; 95% CI, 0.28 to 0.59; P regorafenib was seen (median, 5.8 months; 95% CI, 4.4 to 6.8 v 4.5 months; 95% CI, 3.4 to 5.2; HR, 0.74; P = .147). Twenty-nine patients assigned to placebo received open-label regorafenib after disease progression. Regorafenib toxicity was similar to that previously reported. In this phase II trial, regorafenib was effective in prolonging PFS in refractory advanced gastric adenocarcinoma. Regional differences were found, but regorafenib was effective in both regional groups. A phase III trial is planned. © 2016 by American Society of Clinical Oncology.

Diagnostic significance of computed tomography in gastric cancer

International Nuclear Information System (INIS)

Kang, Eun Young; Cha, Sang Hoon; Seol, Hae Young; Chung, Kyoo Byung; Suh, Won Hyuck

1985-01-01

Gastric cancer is the most common gastrointestinal malignancy in Korea. Identification and evaluation of gastric mass lesions and regional-distant metastasis by abdominal CT scan are important for the treatment planning and prognostic implications of gastric cancer patients. Author reviewed CT scans of 61 cases of pathology proven gastric cancer, retrospectively, for recent 20 month from July 1983 to Feb. 1985 at Department of Radiology, Korea University, Hae Wha Hospital. The results were as follows: 1. There were 50 cases of advanced adenocarcinoma, 8 cases of early gastric cancer, 2 cases of leiomyosarcoma, and 1 case of lymphoma in total 61 cases. 2. The sex ratio of male to female was 2 : 1. Age distribution was from 24 to 75 year old and peak incidence was in 6th decade. 3. The most frequent site of involvement with gastric cancer was gastric antrum in 51% 4. 48 of 50 patients with advanced gastric adenocarcinoma (96%) had a wall thickness greater than 1 cm, and all of 8 cases of early gastric cancer had a wall thickness less than 1 cm. Regional lymph node tumor infiltration was found in 100% of gastric wall thickness greater than 2.0 cm, in 64% of cases of 1.5 to 2.0 cm, in 50% of cases of 1.0 to 1.5 cm, and 12.5% of cases of less than 1.0 cm. 5. In a comparison of enlargement of regional lymph node by CT scan to tumor infiltration of regional lymph node by histology, sensitivity was 52%, specificity was 87%, and reliability was 66%. 6. The structure involved by distant metastasis of these cases were the retroperitoneal lymph node in 15, liver in 8, and pancreas in 3. 7. The diagnostic accuracy of CT staging was considered about 68% by correlation of the surgical and histological findings. 8. The CT scan is one of the accurate and simple tool for evaluation of size, shape, extent, as well as distant metastasis in the cases of gastric malignancies

Gastric mucosa in Mongolian and Japanese patients with gastric cancer and Helicobacter pylori infection

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Matsuhisa, Takeshi; Yamaoka, Yoshio; Uchida, Tomohisa; Duger, Davaadorj; Adiyasuren, Battulga; Khasag, Oyuntsetseg; Tegshee, Tserentogtokh; Tsogt-Ochir, Byambajav

2015-01-01

AIM: To investigate the characteristics of gastric cancer and gastric mucosa in a Mongolian population by comparison with a Japanese population. METHODS: A total of 484 Mongolian patients with gastric cancer were enrolled to study gastric cancer characteristics in Mongolians. In addition, a total of 208 Mongolian and 3205 Japanese consecutive outpatients who underwent endoscopy, had abdominal complaints, no history of gastric operation or Helicobacter pylori eradication treatment, and no use of gastric secretion inhibitors such as histamine H2-receptor antagonists or proton pump inhibitors were enrolled. This study was conducted with the approval of the ethics committees of all hospitals. The triple-site biopsy method was used for the histologic diagnosis of gastritis and H. pylori infection in all Mongolian and Japanese cases. The infection rate of H. pylori and the status of gastric mucosa in H. pylori-infected patients were compared between Mongolian and Japanese subjects. Age (± 5 years), sex, and endoscopic diagnosis were matched between the two countries. RESULTS: Approximately 70% of Mongolian patients with gastric cancer were 50-79 years of age, and approximately half of the cancers were located in the upper part of the stomach. Histologically, 65.7% of early cancers exhibited differentiated adenocarcinoma, whereas 73.9% of advanced cancers displayed undifferentiated adenocarcinoma. The infection rate of H. pylori was higher in Mongolian than Japanese patients (75.9% vs 48.3%, P gastritis changed from antrum-predominant gastritis to corpus-predominant gastritis with age in both populations. CONCLUSION: Gastric cancer was located in the upper part of the stomach in half of the Mongolian patients; Mongolian patients were infected with non-East-Asian-type H. pylori. PMID:26217093

IPTV inter-destination synchronization: A network-based approach

NARCIS (Netherlands)

Stokking, H.M.; Deventer, M.O. van; Niamut, O.A.; Walraven, F.A.; Mekuria, R.N.

2010-01-01

This paper introduces a novel network-based approach to inter-destination media synchronization. The approach meets the need for synchronization in advanced TV concepts like social TV and offers high scalability, unlike conventional end-point based approaches. The solution for interdestination media

Distributed Initial Synchronization for 5G small cells

DEFF Research Database (Denmark)

Berardinelli, Gilberto; Tavares, Fernando Menezes Leitão; Tirkkonen, Olav

2014-01-01

Time synchronization in a large network of small cells enables efficient interference management as well as advanced transmission techniques which can boost the network throughput. In this paper, we focus on the distributed initial synchronization problem and propose different solutions aiming at...

Subgroup analysis of East Asians in RAINBOW: A phase 3 trial of ramucirumab plus paclitaxel for advanced gastric cancer.

Science.gov (United States)

Muro, Kei; Oh, Sang Cheul; Shimada, Yasuhiro; Lee, Keun-Wook; Yen, Chia-Jui; Chao, Yee; Cho, Jae Yong; Cheng, Rebecca; Carlesi, Roberto; Chandrawansa, Kumari; Orlando, Mauro; Ohtsu, Atsushi

2016-03-01

East Asia has higher gastric cancer incidence and mortality rates than other regions. We present a subgroup analysis of East Asians in the positive study RAINBOW. Patients with advanced gastric or gastroesophageal junction adenocarcinoma previously treated with platinum and fluoropyrimidine received ramucirumab 8 mg/kg or placebo on days 1 and 15 plus paclitaxel 80 mg/m(2) on days 1, 8, and 15 of a 28-day cycle. Of 665 intention-to-treat patients, 223 were East Asian. Median overall survival was 12.1 months for ramucirumab plus paclitaxel and 10.5 months for placebo plus paclitaxel (hazard ratio: 0.986, 95% confidence interval: 0.727-1.337, P = 0.929). Median progression-free survival was 5.5 months for ramucirumab plus paclitaxel and 2.8 months for placebo plus paclitaxel (hazard ratio: 0.628, 95% confidence interval: 0.473-0.834, P = 0.001). Objective response rates were 34% for ramucirumab plus paclitaxel and 20% for placebo plus paclitaxel. Grade ≥ 3 neutropenia (60% vs 28%) and leukopenia (34% vs 13%) were higher for ramucirumab plus paclitaxel. The rate of febrile neutropenia was low (4% vs 4%). Special interest adverse events included any grade bleeding/hemorrhage (55% vs 25%), proteinuria (27% vs 7%), and hypertension (22% vs 2%). Ramucirumab plus paclitaxel significantly improves progression-free survival and response rate, with prolonged median overall survival and an acceptable safety profile in East Asians with advanced gastric cancer. © 2015 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

Evaluation of gastric cancer detectability on respiratory triggered-diffusion weighted image

International Nuclear Information System (INIS)

Ichiba, Noriatsu; Fukuda, Kunihiko; Takahashi, Naoto; Nikaido, Takashi; Urashima, Mitsuyoshi; Kitagawa, Hisashi

2007-01-01

The objective of this study was to assess the ability of respiratory triggered diffusion-weighted image (RT-DWI) to detect gastric cancer and to determine whether there is any correlation between the detectability of RT-DWI and the location of cancerous tissues. Sixty-nine gastric cancer patients (71 lesions) underwent pre-operative magnetic resonance (MR) imaging and total or partial gastrectomy. Scans of the stomach were acquired using a 1.5T MR scanner. Our protocol consisted of T1WI, T2WI and DWI (b value=800 sec/mm 2 ). The location of gastric cancer was classified into three areas -U, M and L. The condition of the gastric contents and the relation between the location of intraluminal gas and gastric lesions were also evaluated. There were 42 early gastric cancers and 29 advanced cancers in a total of 71 lesions. In early gastric cancers, 15 lesions were detected out of 42 lesions (35.7%) and, in advanced gastric cancers, 27 lesions were detected out of 29 lesions (93.0%). Pathological volumes of the detected lesions ranged between 12 mm x 8 mm x 1 mm and 190 mm x 135 mm x 10 mm (median 57 mm x 35 mm x 5 mm), and those of the undetected lesions ranged between 5 mm x 2 mm x 1 mm and 67 mm x 47 mm x 1.5 mm (median 23 mm x 17 mm x 1 mm). Detectability of the lesions appeared to be higher in the following three conditions when the gastric lumen was filled with mainly fluid rather than gas when there was no intraluminal gas adjacent to the lesion when the imaging quality of RT-DWI was good. RT-DWI was found to have a high detection (93.0%) rate of advanced gastric cancers. To improve the detectability of early gastric cancers, we should endeavor to minimize the susceptibility artifact from intraluminal gas in the stomach and select higher resolution protocols. (author)

Gastric ulceration in dog: A review

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J. D. Parrah

Full Text Available The common acid related diseases of the upper gastrointestinal tract could be considered as primarily due to the defect in barrier function either of the gastric mucosal or duodenal epithelium leading to the formation of gastric or duodenal ulcers. An attempt was made in this review to discuss the classification, pathophysiology, diagnosis and treatment of gastric ulcer in dogs. Early surgical advances in the management of peptic ulcers are emphasized that were then subsequently replaced by pharmacological treatment (histamine H2-receptor antagonists, proton pump inhibitors and considered as the major strategy against the acid disorders. [Vet World 2013; 6(7.000: 449-454

Timing of chemotherapy and survival in patients with resectable gastric adenocarcinoma

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Arrington, Amanda K; Nelson, Rebecca; Patel, Supriya S; Luu, Carrie; Ko, Michelle; Garcia-Aguilar, Julio; Kim, Joseph

2013-01-01

AIM: To evaluate the timing of chemotherapy in gastric cancer by comparing survival outcomes in treatment groups. METHODS: Patients with surgically resected gastric adenocarcinoma from 1988 to 2006 were identified from the Los Angeles County Cancer Surveillance Program. To evaluate the population most likely to receive and/or benefit from adjunct chemotherapy, inclusion criteria consisted of Stage II or III gastric cancer patients > 18 years of age who underwent curative-intent surgical resection. Patients were categorized into three groups according to the receipt of chemotherapy: (1) no chemotherapy; (2) preoperative chemotherapy; or (3) postoperative chemotherapy. Clinical and pathologic characteristics were compared across the different treatment arms. RESULTS: Of 1518 patients with surgically resected gastric cancer, 327 (21.5%) received perioperative chemotherapy. The majority of these 327 patients were male (68%) with a mean age of 61.5 years; and they were significantly younger than non-chemotherapy patients (mean age, 70.7; P advanced gastric cancer. CONCLUSION: This study supports the implementation of a randomized trial comparing the timing of perioperative therapy in patients with locally advanced gastric cancer. PMID:24392183

Impact of splenic hilar lymph node metastasis on prognosis in patients with advanced gastric cancer.

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Son, Taeil; Kwon, In Gyu; Lee, Joong Ho; Choi, Youn Young; Kim, Hyoung-Il; Cheong, Jae-Ho; Noh, Sung Hoon; Hyung, Woo Jin

2017-10-13

Impact of splenic hilar LN dissection during total gastrectomy for proximal advanced gastric cancer is controversial. The objective of this study was to assess the impact on prognosis of splenic hilar lymph node(LN) metastasis compared to that of metastasis to other regional LN groups. Patients who underwent total gastrectomy with D2 LN dissection from 2000 to 2010 were reviewed retrospectively. The clinicopathologic characteristics and long-term results of patients with splenic hilar LN metastasis were compared to those of patients with only metastasis to other extraperigastric LNs (stations #8a, #9, #11, or #12a). To investigate the survival benefit of performing splenic hilar LN dissection, the estimated therapeutic index for the procedure was calculated by multiplying the incidence of metastases in the hilar region by the survival rates for individuals with nodal involvement in that region. Of 602 patients, 87(14.5%) had hilar LN metastasis. The 5-year overall and relapse-free survival rates for patients with hilar LN metastasis were 24.1% and 12.1%, respectively. These rates were similar to those for patients with metastasis to other extraperigastric LNs ( P > 0.05), with similar recurrence patterns. Overall survival in the hilar LN metastasis group was better than that for patients with distant metastasis( P hilar LN dissection was 3.5, which was similar to index values for LN dissection at other extraperigastric LNs. Dissection of splenic hilar LNs during total gastrectomy for advanced gastric cancer allows for a prognosis similar to that achieved with dissection of extraperigastric LNs.

Oral fluoropyrimidine versus intravenous 5-fluorouracil for the treatment of advanced gastric and colorectal cancer: Meta-analysis.

Science.gov (United States)

Zhang, Linlin; Xing, Xiaoli; Meng, Fanlu; Wang, Yan; Zhong, Diansheng

2018-01-01

5-Fluorouracil (5-Fu) is one of the most commonly prescribed antineoplastic agents against gastric and colorectal cancers. Continuous infusion would be the optimal way of its administration, however, may usually cause thrombosis, infection, and prolonged hospital stay. Oral fluoropyrimidines would be an attractive alternative, but their efficiency and toxicities for the treatment of gastric and colorectal cancer are still obscure as compared with infusion 5-Fu. Literature retrieval, trials selection and assessment, data collection, and statistic analysis were performed according to the Cochrane Handbook. The outcome measures were tumor response rate, progression-free survival, overall survival, and adverse effects. Twenty-nine randomized controlled trials, comprising totally 15 154 patients, were included. Meta-analysis showed similar overall outcome in terms of response rate (1.01; 95% confidence interval [CI], 0.92-1.12), progression-free survival (hazard ratio 1.00; 95%CI, 0.94-1.06), and overall survival (hazard ratio 0.96; 95%CI, 0.92-1.01) between oral fluoropyrimidine-based and intravenous 5-Fu-based regimens in gastric and colorectal cancer patients. The risk of grade 3/4 neutropenia, thrombocytopenia, and stomatitis was more prominent in intravenous 5-Fu-based regimens; while more frequent grade 3/4 hand-foot syndrome, diarrhea, and anorexia were detected in oral fluoropyrimidine-based regimens. Oral-fluoropyrimidines showed equivalent response and similar survival outcomes, but different toxicity profiles, as compared with intravenous 5-Fu. Thus, it would be a more convenient and adjustable alternative in treatment of advanced gastric and colorectal cancer. © 2017 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

A novel approach for the detection of early gastric cancer: fluorescence spectroscopy of gastric juice.

Science.gov (United States)

Deng, Kai; Zhou, Li Ya; Lin, San Ren; Li, Yuan; Chen, Mo; Geng, Qiu Ming; Li, Yu Wen

2013-06-01

This study aimed to investigate the efficacy of fluorescence spectroscopy of gastric juice for early gastric cancer (EGC) screening. Gastric juice was collected from 101 participants who underwent endoscopy in the Outpatient Endoscopy Center of Peking University Third Hospital. The participants were divided into three groups: the normal mucosa or chronic non-atrophic gastritis (NM-CNAG) group (n = 35), advanced gastric cancer (AGC) group (n = 33) and EGC group (n = 33). Fluorescence spectroscopic analysis was performed in all the gastric juice samples and the maximum fluorescence intensity of the first peak (P1 FI) was measured. The mean fluorescence intensity of P1 FI of gastric juice in AGC (92.1 ± 10.7) and EGC (90.8 ± 12.0) groups was significantly higher than that in the NM-CNAG group (55.7 ± 7.5) (AGC vs NM-CNAG, P = 0.006 and EGC vs NM-CNAG, P = 0.015, respectively). The areas under the receiver operating characteristic curves for the detection of AGC and EGC were 0.681 (95% confidence interval [CI] 0.553-0.810, P = 0.010) and 0.655 (95% CI 0.522-0.787, P = 0.028). With the P1 FI of ≥47.7, the sensitivity, specificity and accuracy for detecting EGC were 69.7%, 57.1% and 63.2%, respectively. The enhancement of P1 FI of gastric juice occurs at the early stage of gastric cancer. Fluorescence spectroscopy of gastric juice may be used as a novel screening tool for the early detection of gastric cancer. © 2013 The Authors. Journal of Digestive Diseases © 2013 Wiley Publishing Asia Pty Ltd and Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine.

Gastric cancer and obstructive uropathy

International Nuclear Information System (INIS)

Saida, Yukihisa; Tsunoda, H.S.; Matsueda, Kiyoshi; Kurosaki, Yoshihisa; Kuramoto, Kenmei

1990-01-01

In recent 5 years, we have experienced 24 cases of advanced gastric cancer associated with obstructive uropathy. Included were 19 cases of undifferentiated, 3 cases of differentiated and 2 cases of unknown histological type. Obstructive uropathy is diagnosed based on the typical radiological findings such as dilatation and delayed demonstration of the upper collecting systems. Pathologically, undifferentiated type of gastric cancer had tendency to spread infiltratively along the vessels, nerves and the lymphatics without alteration of the ordinary anatomical structures. In such cases, mucosal surface of the urinary tract tended to be spared in spite of extensive tumor invasion. It was proven that several radiological findings were characteristic of urinary tract involvement secondary to gastric cancer. Either thread-like ureteral stricture by IVU or ring-like appearance of the ureter by CT is one of those typical findings. Renal sinus involvement may occur continuously to diffuse retroperitoneal invasion and it appears as a thickened wall of renal pelvis or soft tissue mass directly extending into the fatty tissue of renal sinus by CT. In such cases IVU has less diagnostic ability because of the lack of mucosal destruction. If the urinary bladder is involved, it typically shows chestnut-bur appearance by IVU and diffuse wall thickening by CT. In cases of advanced gastric cancer, particularly in cases of histologically undifferentiated type, CT and IVU images should be carefully interpreted in consideration of the infiltrative part of tumor extention. (author)

A Spatiotemporal-Chaos-Based Cryptosystem Taking Advantage of Both Synchronous and Self-Synchronizing Schemes

Science.gov (United States)

Lü, Hua-Ping; Wang, Shi-Hong; Li, Xiao-Wen; Tang, Guo-Ning; Kuang, Jin-Yu; Ye, Wei-Ping; Hu, Gang

2004-06-01

Two-dimensional one-way coupled map lattices are used for cryptography where multiple space units produce chaotic outputs in parallel. One of the outputs plays the role of driving for synchronization of the decryption system while the others perform the function of information encoding. With this separation of functions the receiver can establish a self-checking and self-correction mechanism, and enjoys the advantages of both synchronous and self-synchronizing schemes. A comparison between the present system with the system of advanced encryption standard (AES) is presented in the aspect of channel noise influence. Numerical investigations show that our system is much stronger than AES against channel noise perturbations, and thus can be better used for secure communications with large channel noise.

[A case of advanced gastric cancer with carcinomatosa peritonitis effectively treated by 5-FU and low-dose CDDP therapy].

Science.gov (United States)

Saito, E; Kunii, Y; Wada, G; Tsuchiya, S; Yamasaki, T; Sakakibara, N

1997-07-01

A 66-year-old woman was admitted to our clinic for appetite loss and abdominal distension in August 1995. Endoscopic study revealed an advanced gastric cancer in the upper body of her stomach. Abdominal CT study revealed massive ascites and para-aortic lymph nodal involvement. Cytological study of the ascites revealed class V. She was diagnosed to be in the terminal stage of gastric cancer with carcinomatosa peritonitis. Combination chemotherapy with 5-fluorouracil (5-FU) and low-dose cisplatin (CDDP) was given by continuous intravenous injection of 5-FU 500 mg/day, and intermittent intravenous injection of CDDP 30 mg/week was performed for reduction of the ascites and her complaint. Endoscopic study 6 weeks after starting chemotherapy could not find crater of the gastric cancer but only a shallow ulcerative lesion. The biopsy specimen of that lesion was group III. No ascites and over 50% reduction of the para-aortic lymph node were found by the abdominal CT study. This state persisted over 4 weeks. No myelo-suppression, renal dysfunction or any severe side effect were observed during chemotherapy. Her performance status improved from 3 to 1.

Expression of Inflammation-Related Genes Is Altered in Gastric Tissue of Patients with Advanced Stages of NAFLD

Directory of Open Access Journals (Sweden)

Rohini Mehta

2013-01-01

Full Text Available Obesity is associated with chronic low-grade inflammation perpetuated by visceral adipose. Other organs, particularly stomach and intestine, may also overproduce proinflammatory molecules. We examined the gene expression patterns in gastric tissue of morbidly obese patients with nonalcoholic fatty liver disease (NAFLD and compared the changes in gene expression in different histological forms of NAFLD. Stomach tissue samples from 20 morbidly obese NAFLD patients who were undergoing sleeve gastrectomy were profiled using qPCR for 84 genes encoding inflammatory cytokines, chemokines, their receptors, and other components of inflammatory cascades. Interleukin 8 receptor-beta (IL8RB gene overexpression in gastric tissue was correlated with the presence of hepatic steatosis, hepatic fibrosis, and histologic diagnosis of nonalcoholic steatohepatitis (NASH. Expression levels of soluble interleukin 1 receptor antagonist (IL1RN were correlated with the presence of NASH and hepatic fibrosis. mRNA levels of interleukin 8 (IL8, chemokine (C-C motif ligand 4 (CCL4, and its receptor chemokine (C-C motif receptor type 5 (CCR5 showed a significant increase in patients with advanced hepatic inflammation and were correlated with the severity of the hepatic inflammation. The results of our study suggest that changes in expression patterns for inflammatory molecule encoding genes within gastric tissue may contribute to the pathogenesis of obesity-related NAFLD.

Phase I dose-finding study of sorafenib with FOLFOX4 as first-line treatment in patients with unresectable locally advanced or metastatic gastric cancer.

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Chi, Yihebali; Yang, Jianliang; Yang, Sheng; Sun, Yongkun; Jia, Bo; Shi, Yuankai

2015-06-01

To determine the maximum tolerated dose (MTD), dose-limiting toxicity (DLT) and efficacy of sorafenib in combination with FOLFOX4 (oxaliplatin/leucovorin (LV)/5-fluorouracil) as first-line treatment for advanced gastric cancer, we performed a phase I dose-finding study in nine evaluable patients with unresectable locally advanced or metastatic gastric cancer or gastroesophageal junction adenocarcinoma. According to modified Fibonacci method, the design of this study was to guide elevation of the sorafenib dosage to the next level (from 200 mg twice daily to 400 mg twice daily and then, if tolerated, 600 mg twice daily). If the patient achieved complete response (CR), partial response (PR) or stable disease (SD) after eight cycles of treatment, combination chemotherapy was scheduled to be discontinued and sorafenib monotherapy continued at the original dose until either disease progression or unacceptable toxicity. In sorafenib 200 mg twice daily group, DLT was observed in 1 of 6 patients, and in 400 mg twice daily group, it was observed in 2 of 3 patients. Seven of 9 (77.8%) evaluable patients achieved PR, with a median overall survival (OS) of 11.8 [95% confidence interval (CI): 8.9-14.7] months. Common adverse effects include hand-foot syndrome, leukopenia, neutropenia, anorexia, and nausea. Twice-daily dosing of sorafenib 200 mg in combination with FOLFOX4 was proven effective and safe for the treatment of advanced gastric cancer, and could be an appropriate dosage for subsequent phase II clinical studies.

The role of leptin in gastric cancer: Clinicopathologic features and molecular mechanisms

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Lee, Kang Nyeong; Choi, Ho Soon; Yang, Sun Young; Park, Hyun Ki; Lee, Young Yiul; Lee, Oh Young; Yoon, Byung Chul; Hahm, Joon Soo; Paik, Seung Sam

2014-01-01

Highlights: • Leptin and Ob-R are expressed in gastric adenoma and early and advanced cancer. • Leptin is more likely associated with differentiated gastric cancer or cardia cancer. • Leptin proliferates gastric cancer cells via activating the STAT3 and ERK1/2 pathways. - Abstract: Obesity is associated with certain types of cancer, including gastric cancer. However, it is still unclear whether obesity-related cytokine, leptin, is implicated in gastric cancer. Therefore, we aimed to investigate the role of leptin in gastric cancer. The expression of leptin and its receptor, Ob-R, was assessed by immunohistochemical staining and was compared in patients with gastric adenoma (n = 38), early gastric cancer (EGC) (n = 38), and advanced gastric cancer (AGC) (n = 38), as a function of their clinicopathological characteristics. Gastric cancer cell lines were studied to investigate the effects of leptin on the signal transducer and activator of transcription-3 (STAT3) and extracellular receptor kinase 1/2 (ERK1/2) signaling pathways using MTT assays, immunoblotting, and inhibition studies. Leptin was expressed in gastric adenomas (42.1%), EGCs (47.4%), and AGCs (43.4%). Ob-R expression tended to increase from gastric adenoma (2%), through EGC (8%), to AGC (18%). Leptin induced the proliferation of gastric cancer cells by activating STAT3 and ERK1/2 and up-regulating the expression of vascular endothelial growth factor (VEGF). Blocking Ob-R with pharmacological inhibitors and by RNAi decreased both the leptin-induced activation of STAT3 and ERK1/2 and the leptin-induced expression of VEGF. Leptin plays a role in gastric cancer by stimulating the proliferation of gastric cancer cells via activating the STAT3 and ERK1/2 pathways

Advances in molecular biomarkers for gastric cancer: miRNAs as emerging novel cancer markers.

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Wu, Hua-Hsi; Lin, Wen-chang; Tsai, Kuo-Wang

2014-01-23

Carcinoma of the stomach is one of the most prevalent cancer types in the world. Although the incidence of gastric cancer is declining, the outcomes of gastric cancer patients remain dismal because of the lack of effective biomarkers to detect early gastric cancer. Modern biomedical research has explored many potential gastric cancer biomarker genes by utilising serum protein antigens, oncogenic genes or gene families through improving molecular biological technologies, such as microarray, RNA-Seq and the like. Recently, the small noncoding microRNAs (miRNAs) have been suggested to be critical regulators in the oncogenesis pathways and to serve as useful clinical biomarkers. This new class of biomarkers is emerging as a novel molecule for cancer diagnosis and prognosis, including gastric cancer. By translational suppression of target genes, miRNAs play a significant role in the gastric cancer cell physiology and tumour progression. There are potential implications of previously discovered gastric cancer molecular biomarkers and their expression modulations by respective miRNAs. Therefore, many miRNAs are found to play oncogenic roles or tumour-suppressing functions in human cancers. With the surprising stability of miRNAs in tissues, serum or other body fluids, miRNAs have emerged as a new type of cancer biomarker with immeasurable clinical potential.

High levels of aromatic amino acids in gastric juice during the early stages of gastric cancer progression.

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Kai Deng

Full Text Available BACKGROUND: Early-stage gastric cancer is mostly asymptomatic and can easily be missed easily by conventional gastroscopy. Currently, there are no useful biomarkers for the early detection of gastric cancer, and their identification of biomarkers is urgently needed. METHODS: Gastric juice was obtained from 185 subjects that were divided into three groups: non-neoplastic gastric disease (NGD, advanced gastric cancer and early gastric cancer (EGC. The levels of aromatic amino acids in the gastric juice were quantitated using high-performance liquid chromatography. RESULTS: The median values (25th to 75th percentile of tyrosine, phenylalanine and tryptophan in the gastric juice were 3.8 (1.7-7.5 µg/ml, 5.3 (2.3-9.9 µg/ml and 1.0 (0.4-2.8 µg/ml in NGD; 19.4 (5.8-72.4 µg/ml, 24.6 (11.5-73.7 µg/ml and 8.3 (2.1-28.0 µg/ml in EGC. Higher levels of tyrosine, phenylalanine and tryptophan in the gastric juice were observed in individuals of EGC groups compared those of the NGD group (NGD vs. EGC, P<0.0001. For the detection of EGC, the areas under the receiver operating characteristic curves (AUCs of each biomarker were as follows: tyrosine, 0.790 [95% confidence interval (CI, 0.703-0.877]; phenylalanine, 0.831 (95% CI, 0.750-0.911; and tryptophan, 0.819 (95% CI, 0.739-0.900. The sensitivity and specificity of phenylalanine were 75.5% and 81.4%, respectively, for detection of EGC. A multiple logistic regression analysis showed that high levels of aromatic amino acids in the gastric juice were associated with gastric cancer (adjusted β coefficients ranged from 1.801 to 4.414, P<0.001. CONCLUSION: Increased levels of tyrosine, phenylalanine and tryptophan in the gastric juice samples were detected in the early phase of gastric carcinogenesis. Thus, tyrosine, phenylalanine and tryptophan in gastric juice could be used as biomarkers for the early detection of gastric cancer. A gastric juice analysis is an efficient, economical and convenient method for

Applications of nanotechnology in gastric cancer: detection and prevention by nutrition.

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Elingarami, Sauli; Liu, Ming; Fan, Jing; He, Nongyue

2014-01-01

New and emerging technologies, such as nanotechnology, have the potential to advance nutrition science by assisting in the discovery, development, and delivery of several intervention strategies to improve health and reduce the risk and complications of several diseases, including gastric cancer. This article reviews gastric cancer in relation to nutrition, discussing gastric carcinogenesis in-depth in relation to prevention of the disease by nutrition, as well as current detection approaches using nanotechnology. The current status of molecular nutritional biomarkers for gastric cancer is also discussed, as well as future strategies for the tailored management of gastric cancer.

Randomized trials and quality assurance in gastric cancer surgery.

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Dikken, Johan L; Cats, Annemieke; Verheij, Marcel; van de Velde, Cornelis J H

2013-03-01

A D2 lymphadenectomy can be considered standard of surgical care for advanced resectable gastric cancer. Currently, several multimodality strategies are used, including postoperative monochemotherapy in Asia, postoperative chemoradiotherapy in the United States, and perioperative chemotherapy in Europe. As the majority of gastric cancer patients are treated outside the framework of clinical trials, quality assurance programs, including referral to high-volume centers and clinical auditing are needed to improve gastric cancer care on a nationwide level. Copyright © 2012 Wiley Periodicals, Inc.

Gastric carcinoma: when is palliative gastrectomy justified?

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Hubert Scheidbach

2011-12-01

Full Text Available Gastric carcinoma is frequently diagnosed with an advanced stage of non-curable tumor growth characterized by infiltration of the gastric serosa, peritoneal tumor spread and/or metastases within lymph nodes and liver. Currently, there is a controversy on the value of palliative resection with regard to the safety and benefit to the patient outcome. Based on the available literature, this overview summarizes the various aspects and interprets the limited data on the palliative resection of gastric carcinoma. It turns out that the available study results may indicate potential for an improved quality of life and a prolongation of survival if an acceptable morbidity and mortality are present.

Synchronicity from Synchronized Chaos

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Gregory S. Duane

2015-03-01

Full Text Available The synchronization of loosely-coupled chaotic oscillators, a phenomenon investigated intensively for the last two decades, may realize the philosophical concept of “synchronicity”—the commonplace notion that related eventsmysteriously occur at the same time. When extended to continuous media and/or large discrete arrays, and when general (non-identical correspondences are considered between states, intermittent synchronous relationships indeed become ubiquitous. Meaningful synchronicity follows naturally if meaningful events are identified with coherent structures, defined by internal synchronization between remote degrees of freedom; a condition that has been posited as necessary for synchronizability with an external system. The important case of synchronization between mind and matter is realized if mind is analogized to a computer model, synchronizing with a sporadically observed system, as in meteorological data assimilation. Evidence for the ubiquity of synchronization is reviewed along with recent proposals that: (1 synchronization of different models of the same objective process may be an expeditious route to improved computational modeling and may also describe the functioning of conscious brains; and (2 the nonlocality in quantum phenomena implied by Bell’s theorem may be explained in a variety of deterministic (hidden variable interpretations if the quantum world resides on a generalized synchronization “manifold”.

Clinical management of gastric cancer: results of a multicentre survey

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Zhang, Xiaolong; Wen, Feng; Jiang, Yu; Xu, Feng; Feng, Hong; Bi, Feng; Li, Qiu; Li, Nanjing; Wei, Wen; Yao, Wenxiu; Xie, Ke; Hu, Jiankun; Shen, Lida; Ji, Weizheng; Lu, You

2011-01-01

The National Comprehensive Cancer Network clinical practice guidelines in oncology-gastric cancer guidelines have been widely used to provide appropriate recommendations for the treatment of patients with gastric cancer. The aim of this study was to examine the adherence of surgical oncologists, medical oncologists, and radiation oncologists' to the recommended guidelines. A questionnaire asking the treatment options for gastric cancer cases was sent to 394 Chinese oncology specialists, including surgical oncologists, medical oncologists, and radiation oncologists working in hospitals joined in The Western Cooperative Gastrointestinal Oncology Group of China. The questionnaire involved a series of clinical scenarios regarding the interpretation of surgery, neoadjuvant, adjuvant, and advanced treatment planning of gastric cancer. Analysis of 358 respondents (91%) showed variations between each specialization and from the recommended guidelines in the management approaches to specific clinical scenarios. The majority of specialists admitted that less than 50% of patients received multidisciplinary evaluation before treatment. The participants gave different responses to questions involving adjuvant, neoadjuvant, and advanced settings, compared to the recommended guidelines. These results highlight the heterogeneity of the treatment of gastric cancer. Surgical oncologists, medical oncologists, and radiation oncologists are not adhering to the recommended guidelines

OPERABILITY RATE OF DISTAL GASTRIC CANCER AND THE EFFECT OF GASTRIC OUTLET OBSTRUCTION IN THE OPERABILITY RATE AND POSTOPERATIVE OUTCOME- A RETROSPECTIVE STUDY

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Rajesh T. R

2017-10-01

Full Text Available BACKGROUND Stomach cancer is the fourth most common malignancy in the world. 1 Except in countries where screening for stomach cancer is prevalent, most of the distal stomach tumours are diagnosed at advanced stage. Gastric outlet obstruction is usually believed to be a sign of locally-advanced disease. Complete surgical removal of the disease (R0 is the only potentially curative treatment for resectable gastric cancer. The aim of the study is to finda The operability rate of gastric cancer in our institution and the incidence of Gastric Outlet Obstruction (GOO in patients undergoing gastrectomy for distal gastric cancer. b To compare the postoperative outcome in patients with gastric outlet obstruction and those without gastric outlet obstruction. c To see if the histology of the tumour has any role in the development of GOO. MATERIALS AND METHODS This is a retrospective study. The study includes patients who were admitted with carcinoma stomach and underwent operative or nonoperative treatment in our institution during 2013 to 2015. RESULTS Overall operability rate was 45.8%. Operable patients in the GOO group were 47%. Operability in the no outlet obstruction group were 45%. Data shows a slightly increased predilection for GOO in diffuse and mixed type of tumours (statistically not significant. Intestinal tumours had significant rate of anaemia compared to diffuse tumours (p <0.005. Overall mortality was 6.7%. Mortality is higher in the GOO group (8.8%. CONCLUSION (a. Operability rate of distal gastric cancer in our institution is 45.8%. (b. Incidence of gastric outlet obstruction in patients undergoing gastrectomy is 38.2%. (c. Presence of gastric outlet obstruction does not influence operability rate (47% vs. 45%. (d. Morbidity and mortality after distal radical gastrectomy is comparable in both groups. (e. Both intestinal and diffuse histology have equal incidence of GOO. (f. Chronic blood loss and incidence of anaemia is more in

Clinical studies on gastric cancer and breast cancer among A-bomb survivors

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Yamagata, S; Ohya, M; Nagusa, Y; Harada, T; Tani, T [Hiroshima Univ. (Japan). Research Inst. for Nuclear Medicine and Biology

1977-04-01

Fifty-five cases of gastric cancer and 14 cases of breast cancer among A-Bomb survivors, which had been treated at Dept. of Surgery, Research Institute for Nuclear Medicine and Biology of Hiroshima Univ., were discussed. Both gastric cancer and breast cancer were recognized more in A-Bomb survivors of advanced age. Particularly, the number of gastric cancer in A-Bomb survivors of over 65-year old was about double the number of unexposed persons. Ratio of male to female in A-Bomb survivors with gastric cancer was 1.6:1, and the ratio of female was higher as compared to the ratio in unexposed persons (2.6:1). Gastric cancer of stage III and IV in A-Bomb survivors was 54.5%, and advanced cancer was comparatively few in A-Bomb survivors as compared to in unexposed persons (78.2%). Similarly, comparatively early stage breast cancer of stage I and II was recognized more in A-Bomb survivors. Particularly, T/sub 1/ and T/sub 2/ in which tumor was small in size showed very high percentage of 92.9% in A-Bomb survivors. In gastric cancer in A-Bomb survivors, poorly differentiated adenocarcinoma showed the highest percentage of 34.5%. However, there was no significant difference according to the exposure conditions. As to histological type of breast cancer, medullary tubular adenocarcinoma abounds mostly in both A-Bomb survivors (71.4%) and unexposed persons (75.9%). As the influence of operation, anemia was recognized before operation strongly in A-Bomb survivors with gastric cancer of over 65-year old. After the operation, transient rise of GOT and GPT was recognized in A-Bomb survivors of advanced age with gastric cancer. However, there was no difference in postoperative complications between A-Bomb survivors and unexposed persons.

Phase I and pharmacodynamic study of vorinostat combined with capecitabine and cisplatin as first-line chemotherapy in advanced gastric cancer.

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Yoo, Changhoon; Ryu, Min-Hee; Na, Young-Soon; Ryoo, Baek-Yeol; Lee, Chae-Won; Maeng, Jeheon; Kim, Se-Yeon; Koo, Dong Hoe; Park, Inkeun; Kang, Yoon-Koo

2014-04-01

A phase I trial of first-line vorinostat, an orally bio-available histone deacetylase inhibitor, in combination with capecitabine plus cisplatin (XP) was performed to assess recommend phase II trial dose in patients with advanced gastric cancer. Five dose levels of three-weekly vorinostat-XP were tested; vorinostat was dosed at 300-400 mg once daily on Days 1-14, capecitabine at 800-1,000 mg/m(2) twice daily on Days 1-14, and cisplatin at 60-80 mg/m(2) on Day 1. To assess the pharmacodynamics of vorinostat, histone H3 acetylation was assessed in peripheral blood mononuclear cells before the study treatment and at Day 8 of cycle 1. In total, 30 patients with unresectable or metastatic gastric adenocarcinoma were included. Dose-limiting toxicities were thrombocytopenia, fatigue, stomatitis, and anorexia. The following doses were recommended for phase II trial: 400 mg of vorinostat once daily, 1,000 mg/m(2) of capecitabine twice daily, and 60 mg/m(2) of cisplatin. The most common grade 3-4 toxicities were neutropenia (47 %), anorexia (20 %), thrombocytopenia (17 %), and fatigue (13 %). In overall, response rate was 56 % (95 % confidence interval [CI]: 32-81). With a median follow-up of 14.1 months, the median progression-free survival and overall survival were 7.1 months (95 % CI: 3.8-10.3) and 18.0 months (95 % CI: 4.8-31.1), respectively. The change in H3 acetylation after treatment with vorinostat correlated significantly with the vorinostat dose (300 vs. 400 mg/day) and the baseline level of H3 acetylation before treatment. Three-weekly vorinostat-XP regimen is feasible and recommended for further development in advanced gastric cancer.

[A recent trial of chemo-radiation with S-1 against gastric cancer].

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Saikawa, Yoshiro; Kiyota, Tsuyoshi; Nakamura, Rieko; Wada, Norihito; Yoshida, Masashi; Kubota, Tetsuro; Kumai, Koichiro; Shigematsu, Naoyuki; Kubo, Atsushi; Kitajima, Masaki

2006-06-01

A recent development of novel anticancer agents like S-1, CPT-11 or taxanes has improved a therapeutic outcome for advanced gastric cancer, while conventional anticancer agents showed less anticancer effect against gastric cancer. The present main drug in Japan is S-1, which is easily used for outpatient with a high efficacy rate and low toxicity, also shows better effect in combination with other anticancer drugs than S-1 alone. In the present article, we demonstrated significant meaning of additional radiation therapy with anticancer drugs like S-1. With novel anticancer drugs like S-1, we will expose a clinical advantage and appropriateness for chemo-radiation therapy against gastric cancer discussed in the present references according to chemo-radiation therapy. Although chemo-radiation therapy has been recognized as one of the standard therapies for gastric cancer in Western countries, radiation therapy was selected in Japan for palliation therapy of recurrent disease or a terminal cancer to improve patients' QOL. On the other hand, we demonstrated in our trial of chemo-radiation therapy with S-1/low-dose CDDP/radiation (TSLDR), which was applied to initial treatment against highly advanced Stage IV gastric cancer and revealed the usefulness of the regimen in anticancer effect and toxicity. In addition, chemo-radiation therapy including novel anticancer agents like S-1 will be discussed based on various kinds of view points, expecting a better clinical outcome of multimodal therapies against advanced gastric cancer.

No evidence for c-erbB-2 overexpression in gastric carcinogenesis

NARCIS (Netherlands)

Blok, P.; Craanen, M. E.; Dekker, W.; Offerhaus, G. J.; Tytgat, G. N.

1998-01-01

Conflicting data on c-erbB-2 overexpression in gastric carcinomas can be found in the literature with regard to overall prevalence, prognostic significance and the histological type according to Lauren. The majority of these studies have focused on advanced gastric carcinomas whereas data on

Lauren classification and individualized chemotherapy in gastric cancer.

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Ma, Junli; Shen, Hong; Kapesa, Linda; Zeng, Shan

2016-05-01

Gastric cancer is one of the most common malignancies worldwide. During the last 50 years, the histological classification of gastric carcinoma has been largely based on Lauren's criteria, in which gastric cancer is classified into two major histological subtypes, namely intestinal type and diffuse type adenocarcinoma. This classification was introduced in 1965, and remains currently widely accepted and employed, since it constitutes a simple and robust classification approach. The two histological subtypes of gastric cancer proposed by the Lauren classification exhibit a number of distinct clinical and molecular characteristics, including histogenesis, cell differentiation, epidemiology, etiology, carcinogenesis, biological behaviors and prognosis. Gastric cancer exhibits varied sensitivity to chemotherapy drugs and significant heterogeneity; therefore, the disease may be a target for individualized therapy. The Lauren classification may provide the basis for individualized treatment for advanced gastric cancer, which is increasingly gaining attention in the scientific field. However, few studies have investigated individualized treatment that is guided by pathological classification. The aim of the current review is to analyze the two major histological subtypes of gastric cancer, as proposed by the Lauren classification, and to discuss the implications of this for personalized chemotherapy.

Preliminary results of 'liver-first' reverse management for advanced and aggressive synchronous colorectal liver metastases: a propensity-matched analysis.

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Tanaka, Kuniya; Murakami, Takashi; Matsuo, Kenichi; Hiroshima, Yukihiko; Endo, Itaru; Ichikawa, Yasushi; Taguri, Masataka; Koda, Keiji

2015-01-01

Although a 'liver-first' approach recently has been advocated in treating synchronous colorectal metastases, little is known about how results compare with those of the classical approach among patients with similar grades of liver metastases. Propensity-score matching was used to select study subjects. Oncologic outcomes were compared between 10 consecutive patients with unresectable advanced and aggressive synchronous colorectal liver metastases treated with the reverse strategy and 30 comparable classically treated patients. Numbers of recurrence sites and recurrent tumors irrespective of recurrence sites were greater in the reverse group then the classic group (p = 0.003 and p = 0.015, respectively). Rates of freedom from recurrence in the remaining liver and of freedom from disease also were poorer in the reverse group than in the classical group (p = 0.009 and p = 0.043, respectively). Among patients treated with 2-stage hepatectomy, frequency of microvascular invasion surrounding macroscopic metastases at second resection was higher in the reverse group than in the classical group (p = 0.011). Reverse approaches may be feasible in treating synchronous liver metastases, but that strategy should be limited to patients with less liver tumor burden. © 2015 S. Karger AG, Basel.

Radiologic features of gastric leiomyosarcoma and leiomyoma

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Yang, Seoung Oh; Choi, Byung Ihn; Han, Man Chung; Kim, Chu Wan

1985-01-01

was seen in one case of cellular leiomyoma. 8. Diagnostic accuracy of gastric leimyosarcoma and gastric leiomyoma by U.G.I. study was 90% and 80% respectively. One case of gastric leiomyosarcoma arose from the fundus of stomach was difficult to difficultiate from advanced stomach cancer, Borrmann type I

Effect of glutamine-enriched nutritional support on intestinal mucosal barrier function, MMP-2, MMP-9 and immune function in patients with advanced gastric cancer during perioperative chemotherapy.

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Wang, Juan; Li, Yanfen; Qi, Yuanling

2017-09-01

We studied the effects of glutamine-enriched nutritional support on intestinal mucosal barrier, matrix metalloproteinase (MMP)-2, MMP-9 and immune function during perioperative chemotherapy in patients with advanced gastric cancer. The study was conducted on 94 patients with advanced gastric cancer admitted from April 2015 to March 2016. They were randomly divided into observation and control groups, n=47. Control group was given basic nutritional support whereas glutamine-enriched nutritional support was given to patients in observation group. High-performance liquid chromatography was used to measure lactulose and mannitol ratio in urine (L/M) and ELISA was used to measure D-lactate levels before chemotherapy and in the 1st, 2nd and 3rd cycle of chemotherapy. Immunoglobulin level was detected by immune turbidimetry assay, T lymphocyte subsets were determined by flow cytometry after 3 cycles of chemotherapy, MMP-2 and MMP-9 of patients were compared between the two groups. The serious adverse reactions incidence (grade and IV) of patients were observed. To evaluate the life quality of patients, QLQ-C30 was used after 6 months. The levels of L/M and D-lactate in both groups after the first cycle of chemotherapy were significantly higher than that before chemotherapy; they began to decline after the second or third cycle, but were still significantly higher than the levels before chemotherapy (pgroups after 1st, 2nd, 3rd cycle after chemotherapy, L/M and D-lactate levels of patients in the observation group were significantly lower than in the control group (pgroup was significantly lower than control group (pgroup were significantly higher than control group (pnutritional support can effectively protect the intestinal mucosal barrier function in patients with advanced gastric cancer in their perioperative chemotherapy, improve the level of MMP-2 and MMP-9 in patients with advanced gastric cancer, enhance their immune function, reduce the incidence of adverse

Cancer of the esophagus and gastric cardia: recent advances

NARCIS (Netherlands)

Tytgat, G. N. J.; Bartelink, H.; Bernards, R.; Giaccone, G.; van Lanschot, J. J. B.; Offerhaus, G. J. A.; Peters, G. J.

2004-01-01

Esophageal cancer and cancer of the gastric cardia, in particular adenocarcinomas, have shown a rapid and largely unexplained increase in incidence in many developed countries around the world. These diseases have a poor prognosis and current therapies have a modest impact on survival. This review

Telomerase activity in gastric cancer.

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Hiyama, E; Yokoyama, T; Tatsumoto, N; Hiyama, K; Imamura, Y; Murakami, Y; Kodama, T; Piatyszek, M A; Shay, J W; Matsuura, Y

1995-08-01

Although many genetic alterations have been reported in gastric cancer, it is not known whether all gastric tumors are capable of indefinite proliferative potential, e.g., immortality. The expression of telomerase and stabilization of telomeres are concomitant with the attainment of immortality in tumor cells; thus, the measurement of telomerase activity in clinically obtained tumor samples may provide important information useful both as a diagnostic marker to detect immortal cancer cells in clinical materials and as a prognostic indicator of patient outcome. Telomerase activity was analyzed in 66 primary gastric cancers with the use of a PCR-based assay. The majority of tumors (85%) displayed telomerase activity, but telomerase was undetectable in 10 tumors (15%), 8 of which were early stage tumors. Most of the tumors with telomerase activity were large and of advanced stages, including metastases. Survival rate of patients of tumors with detectable telomerase activity was significantly shorter than that of those without telomerase activity. Alterations of telomere length (reduced/elongated terminal restriction fragments) were detected in 14 of 66 (21%) gastric cancers, and all 14 had telomerase activity. Cellular DNA contents revealed that all 22 aneuploid tumors had detectable telomerase activity. The present results indicate that telomerase activation may be required as a critical step in the multigenetic process of tumorigenesis, and that telomerase is frequently but not always activated as a late event in gastric cancer progression.

Lymph node involvement in gastric cancer for different tumor sites and T stage: Italian Research Group for Gastric Cancer (IRGGC) experience.

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Di Leo, Alberto; Marrelli, Daniele; Roviello, Franco; Bernini, Marco; Minicozzi, AnnaMaria; Giacopuzzi, Simone; Pedrazzani, Corrado; Baiocchi, Luca Gian; de Manzoni, Giovanni

2007-09-01

The aim of lymphadenectomy is to clear all the metastatic nodes achieving a complete removal of the tumor; nevertheless, its role in gastric cancer has been very much debated. The frequency of node metastasis in each lymphatic station according to the International Gastric Cancer Association, was studied in 545 patients who underwent D2 or D3 lymphadenectomy from June 1988 to December 2002. Upper third early cancers have shown an involvement of N2 celiac nodes in 25%. In advanced cancers, there was a high frequency of metastasis in the right gastroepiploic (from 10% in T2 to 50% in T4) and in the paraaortic nodes (26% in T2, 32% in T3, 38 % in T4). N3 left paracardial nodes involvement was observed in an important share of middle third tumors (17% in T3, 36% in T4). Splenic hilum nodes metastasis were common in T3 and T4 cancers located in the upper (39%) and middle (17%) stomach. N2 nodal involvement was frequent in lower third advanced cancers. Metastasis in M left paracardial and short gastric nodes were observed in a small percentage of cases. Given the nodal diffusion in our gastric cancer patients, extended lymphadenectomy is still a rationale to obtain radical resection.

PLANNING PHASE 2 MULTICENTER RANDOMIZED TRIAL OF NEOADJUVANT CHEMO-RADIOTHERAPY FOLLOWED BY D2 GASTRECTOMY AND ADJUVANT CHEMOTHERAPY FOR LOCALLY ADVANCED GASTRIC CANCER

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V. Yu. Skoropad

2016-01-01

Full Text Available Introduction. The prognosis for surgical treatment of locally advanced gastric cancer remains disappointing. Neoadjuvant chemo-radiation therapy is relatively new and the least researched method of treatment, it is attracting more and more attention, mainly abroad in recent years. The aims of neoadjuvant therapy is the earliest start of systemic therapy, damage of the primary tumor and regional metastases, an increase in the percentage of radical operations, improving treatment outcome. Material and methods. The planning study is a multicenter, randomized clinical phase II trial. Patients of the first (experimental group will be treated as the followes: neoadjuvant chemo-radiotherapy (total tumor dose of 46 Gy in 23 fractions with the concurrent modified CapOX scheme followed by D2 gastrectomy and adjuvant chemotherapy. Patients of the second (control group will be treated with D2 gastrectomy and adjuvant chemotherapy. Adjuvant chemotherapy will be carried out under the following schemes (optional for the researchers: CapOX or FOLFOX. Toxicity evaluation of neoadjuvant chemo-radiotherapy and adjuvant chemotherapy will be conducted with NCI CTC Toxicity Scale Version 3.0. The main objectives of the trial are to assess the safety and immediate effectiveness of neoadjuvant chemo-radiotherapy according to the criteria of the frequency and severity of postoperative complications and mortality, and tumor response. We are planning to include 80 patients with morphologically confirmed gastric cancer сT2–4N1–3, сT3–4N0–3; М0. The proposed trial will be carried out in accordance with the principles of the Helsinki Declaration, it has been approved by local ethic committees of the participated institutions. Results. As a result of this multicenter randomized trial it is planned to show the reproducibility of obtained in MRRC and a number of foreign centers results – that is, the safety and high immediate effectiveness of neoadjuvant chemo

Advanced gastric adenocarcinoma. Influence of preoperative radiation therapy on toxicity and long-term survival rates; Adenocarcinoma gastrico avancado. Analise da toxicidade e da influencia da radioterapia pre-operatoria nos indices de sobrevivencia a longo prazo

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Malzoni, Carlos Eduardo

1996-12-31

The surgical treatment of gastric cancer has better long-term survival rates when performed in patients with early gastric cancer. Worse results are obtained in treatment of advanced gastric cancer. Most patients in west centers are treated in advanced stages. A great number of them go through a surgical treatment unable by itself to cure them. the frequent local recurrence caused by failure of the surgical treatment has been keeping poor survival rates in patients with advanced gastric cancer for decades. The desire of improving survival is the reason of the use of adjuvant therapies. This paper achieved the retrospective study of the influence of preoperative radiation therapy (2000 cGy) in long-term survival rates (120 months) of patients with advanced gastric cancer on stages IIIa, IIIb and IV. The possible injuries caused in the liver and kidney were observed also as well as first group was treated by surgical and radiation therapies and the second received surgical treatment only. There was no statistical difference between the two groups when sex, age, race, occurrence of other diseases, nutritional assessment, TNM stage, occurrence of obstruction or bleeding caused by tumor, surgical procedure and hepatic and renal function were considered. Survival rates and changes on hepatic and renal function were statistically compared. The results showed a statistic improvement on the long-term survival rates of stage IIIa patients treated by preoperative radiation therapy. No statistic difference was observed on hepatic or renal function between the groups. No adverse influence of radiation therapy method was detected by the used parameters. There was no statistical difference between the two groups when immediate surgical complications were considered. (author) 112 refs., 34 tabs.

Advanced gastric adenocarcinoma. Influence of preoperative radiation therapy on toxicity and long-term survival rates; Adenocarcinoma gastrico avancado. Analise da toxicidade e da influencia da radioterapia pre-operatoria nos indices de sobrevivencia a longo prazo

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Malzoni, Carlos Eduardo

1997-12-31

The surgical treatment of gastric cancer has better long-term survival rates when performed in patients with early gastric cancer. Worse results are obtained in treatment of advanced gastric cancer. Most patients in west centers are treated in advanced stages. A great number of them go through a surgical treatment unable by itself to cure them. the frequent local recurrence caused by failure of the surgical treatment has been keeping poor survival rates in patients with advanced gastric cancer for decades. The desire of improving survival is the reason of the use of adjuvant therapies. This paper achieved the retrospective study of the influence of preoperative radiation therapy (2000 cGy) in long-term survival rates (120 months) of patients with advanced gastric cancer on stages IIIa, IIIb and IV. The possible injuries caused in the liver and kidney were observed also as well as first group was treated by surgical and radiation therapies and the second received surgical treatment only. There was no statistical difference between the two groups when sex, age, race, occurrence of other diseases, nutritional assessment, TNM stage, occurrence of obstruction or bleeding caused by tumor, surgical procedure and hepatic and renal function were considered. Survival rates and changes on hepatic and renal function were statistically compared. The results showed a statistic improvement on the long-term survival rates of stage IIIa patients treated by preoperative radiation therapy. No statistic difference was observed on hepatic or renal function between the groups. No adverse influence of radiation therapy method was detected by the used parameters. There was no statistical difference between the two groups when immediate surgical complications were considered. (author) 112 refs., 34 tabs.

Phase II Study of Chemoradiotherapy With S-1 and Low-Dose Cisplatin for Inoperable Advanced Gastric Cancer

International Nuclear Information System (INIS)

Saikawa, Yoshiro; Kubota, Tetsuro; Kumagai, Koshi; Nakamura, Rieko; Kumai, Koichiro; Shigematsu, Naoyuki; Kubo, Atsushi; Kitajima, Masaki; Kitagawa, Yuko

2008-01-01

Purpose: The results of a pilot study using S-1/low-dose cisplatin/radiotherapy led us to hypothesize that the initial chemoradiotherapy regimen would induce a 70% efficacy rate with a 10% pathologic complete response rate. Patients and Methods: Only patients with unresectable or incurable advanced gastric cancer were eligible. The patients received induction S-1 and cisplatin therapy with radiotherapy followed by chemotherapy alone. Results: Of the 30 patients recruited and assessed, 29 were eligible for clinical evaluation of measurable lesions. The response rate was 65.5%, with 19 with a partial response, 8 with no change, and 2 with progressive disease of 29 patients. Of the 30 patients recruited, 10 (33.3%) underwent stomach resection and D2 LN dissections. The pathologic complete response rate was 13.3% (4 patients), and the R0 resection rate was 100% (10 patients). The survival analysis showed a median survival time of 25 months. Grade 3 toxicity occurred in 66.7% for leukocytopenia, 33.3% for thrombocytopenia, 23.3% for nausea and appetite loss, and 6.7% for anemia, diarrhea, and renal dysfunction. Although all the patients had been hospitalized with a poor performance status with a giant tumor, 97% (29 of 30) could be discharged after the first cycle, resulting in an improvement in quality of life. Conclusion: Chemoradiotherapy could be a powerful regimen for controlling tumor progression in advanced gastric cancer, improving patients' quality of life with tolerable toxicity. A complete histologic response rate of >10% would be expected, even for large tumors with metastatic lesions

Effect of preoperative oral S-1 combined with regional intra-arterial chemotherapy on malignant molecule expression in locally advanced unresectable gastric cancer tissue

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Lei Liu

2016-11-01

Full Text Available Objective: To study the effect of preoperative oral S-1 combined with regional intra-arterial chemotherapy on malignant molecule expression in locally advanced unresectable gastric cancer tissue. Methods: A total of 144 patients with locally advanced gastric cancer receiving surgical resection after neoadjuvant chemotherapy in our hospital between May 2012 and August 2015 were selected and randomly divided into experimental group who received preoperative oral S-1 combined with regional intra-arterial chemotherapy and control group who received preoperative intravenous systemic chemotherapy. The levels of serum tumor markers were determined after chemotherapy, and the expression levels of tumor suppressor genes and cell cycle-related molecules in tumor tissue were determined after surgical resection. Results: After neoadjuvant chemotherapy, the serum G-17, TK-1, CEA, CA19-9, CA12-5, CA72-4 and CK, CK-MB, ALT, AST levels of experimental group were significantly lower than those of control group; after surgical resection, the p16, p27, PTEN and TXNIP mRNA levels in tumor tissue of experimental group were significantly higher than those of control group while CyclinB2, CyclinD1, CyclinE, CDK1 and CDK2 mRNA levels were significantly lower than those of control group. Conclusions: Preoperative oral S-1 combined with regional intra-arterial chemotherapy can more effectively kill gastric cancer cells, reduce tumor load, inhibit cell cycle and promote cell apoptosis.

The economic burden of advanced gastric cancer in Taiwan.

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Hong, Jihyung; Tsai, Yiling; Novick, Diego; Hsiao, Frank Chi-Huang; Cheng, Rebecca; Chen, Jen-Shi

2017-09-16

Gastric cancer is one of the leading causes of cancer-related deaths in both sexes worldwide, especially in Eastern Asia. This study aimed to estimate the economic burden of advanced gastric cancer (AGC) in Taiwan. The costs of AGC in 2013 were estimated using resource use data from a chart review study (n = 122 with AGC) and national statistics. Annual per-patient costs, where patients' follow-up periods were adjusted for, were estimated with 82 patients who had complete resource use data. The costs were composed of direct medical costs, direct non-medical costs (healthcare travel and caregiver costs), morbidity costs, and mortality costs. Relevant unit costs were retrieved mainly from literature and national statistics, and applied to the resource use data. A broad definition of morbidity and mortality costs was employed to value the productivity loss in patients with unpaid employment, economically inactive and unemployed as well as the life years after the age of retirement. Their narrow definitions were also used in sensitivity analyses, using age- and/or sex-specific employment rates. Forgone future earnings/productivity loss were discounted at 3%. Annual per-patient costs were projected to estimate the total costs of AGC at the national level with an estimated number of patients with AGC (N = 2611) in Taiwan in 2013. The mean age of the 82 patients was 59.3 (SD: 11.9) years, and 67.1% were male. Per-patient costs were US$26,431 for direct medical costs, US$4669 for direct non-medical costs, US$5758 for morbidity costs, and US$145,990 for mortality costs (per death). These per-patient costs were projected to incur total AGC costs of US$423 million at the national-level. Mortality costs accounted for 77.3% of the total costs, followed by direct medical costs (16.3%), morbidity costs (3.6%), and direct non-medical costs (2.9%). AGC was found to exert a significant economic burden in Taiwan, incurring US$423 million in 2013. This represents about 0.08% of

Contrast-enhanced power Doppler endosonography and pathological assessment of vascularization in advanced gastric carcinomas--a feasibility study.

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Iordache, Sevastiţa; Filip, Maria-Monalisa; Georgescu, Claudia-Valentina; Angelescu, Cristina; Ciurea, Tudorel; Săftoiu, Adrian

2012-06-01

Besides representing angiogenesis markers, microvascular density (MVD) and vascular endothelial growth factor (VEGF) are two important tools for the assessment of prognosis in patients with gastric cancer. The aim of our study was to assess the Doppler parameters (resistivity and pulsatility indexes) and vascularity index (VI) calculated by contrast-enhanced power Doppler endoscopic ultrasound (CEPD-EUS) in correlation with the expression of intra-tumoral MVD and VEGF in patients with gastric cancer. The study included 20 consecutive patients with advanced gastric carcinoma, but without distant metastasis at initial assessment. All the patients were assessed by contrast-enhanced power Doppler endoscopic ultrasound (EUS) combined with pulsed Doppler examinations in the late venous phase. The vascularity index (VI) was calculated before and after injection of second generation microbubble contrast specific agent (SonoVue 2.4 mL), used as a Doppler signal enhancer. Moreover, pulsed Doppler parameters (resistivity and pulsatility indexes) were further calculated. The correlation between power Doppler parameters and pathological/molecular parameters (MVD assessed through immunohistochemistry with CD31 and CD34, as well as VEGF assessed through real-time PCR) was assessed. Kaplan-Meier survival analysis was used for the assessment of prognosis. Significantly statistical correlations were found between post-contrast VI and CD34 (p=0.0226), VEGF (p=0.0231), VEGF-A (p=0.0464) and VEGF-B (p=0.0022) while pre-contrast VI was correlated only with CD34 expression. Pulsatility index and resistivity index were not correlated with MVD or VEGF expression. Survival analysis demonstrated that VEGF-A is an accurate parameter for survival rate (p=0.045), as compared to VEGF (p=0.085) and VEGF-B (p=0.230). We did not find any correlation between the survival rate and ultrasound parameters (RI, PI, pre-contrast VI or post-contrast VI). Assessment of tumor vascularity using contrast

Down-regulation of TM4SF is associated with the metastatic potential of gastric carcinoma TM4SF members in gastric carcinoma

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Zhu Guanbao

2011-04-01

Full Text Available Abstract Background The aim of this study was to clarify the clinical significance of TM4SF members CD9, CD63 and CD82 in human gastric carcinoma. Methods By employing RT-PCR and immunohistochemistry, we studied the expression of CD9, CD63 and CD82 in 49 paired tissue specimens of normal gastric mucosa and carcinoma. All tissues were obtained from patients who underwent curative surgery. Results All normal gastric epithelium and gastric ulcer tissues strongly expressed transcripts and proteins of CD9, CD63 and CD82 as compared with corresponding controls. We found a significant correlation between CD63 mRNA level and different pM statuses (P = 0.036. Carcinomas in M0 stage revealed a stronger expression of CD63 than carcinomas in M1 stage. Expression of CD9 protein was found significantly stronger in pN0, pM0 than in advanced pN stages (P = 0.03, pM1 (P = 0.013, respectively. We found the relationship between CD63 expression, gender (p = 0.09 and nodal status (p = 0.028, respectively. Additionally, advanced and metastasized tumor tissues revealed significantly down-regulated CD82 protein expression (p = 0.033 and p = 0, respectively, which correlated with the tumor pTNM stage (p = 0.001. Conclusion The reduction of CD9, CD63 and CD82 expression are indicators for the metastatic potential of gastric carcinoma cells. Unlike their expression in other tumor types, the constitutive expression of CD63 may indicate that this factor does play a direct role in human gastric carcinogenesis.

How to stomach an epigenetic insult: the gastric cancer epigenome.

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Padmanabhan, Nisha; Ushijima, Toshikazu; Tan, Patrick

2017-08-01

Gastric cancer is a deadly malignancy afflicting close to a million people worldwide. Patient survival is poor and largely due to late diagnosis and suboptimal therapies. Disease heterogeneity is a substantial obstacle, underscoring the need for precision treatment strategies. Studies have identified different subgroups of gastric cancer displaying not just genetic, but also distinct epigenetic hallmarks. Accumulating evidence suggests that epigenetic abnormalities in gastric cancer are not mere bystander events, but rather promote carcinogenesis through active mechanisms. Epigenetic aberrations, induced by pathogens such as Helicobacter pylori, are an early component of gastric carcinogenesis, probably preceding genetic abnormalities. This Review summarizes our current understanding of the gastric cancer epigenome, highlighting key advances in recent years in both tumours and pre-malignant lesions, made possible through targeted and genome-wide technologies. We focus on studies related to DNA methylation and histone modifications, linking these findings to potential therapeutic opportunities. Lessons learned from the gastric cancer epigenome might also prove relevant for other gastrointestinal cancers.

Synchronous machines. General principles and structures; Machines synchrones. Principes generaux et structures

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Ben Ahmed, H.; Feld, G.; Multon, B. [Ecole Normale Superieure de Cachan, Lab. SATIE, Systemes et Applications des Technologies de l' Information et de l' Energie, UMR CNRS 8029, 94 (France); Bernard, N. [Institut Universitaire de Saint-Nazaire, Institut de Recherche en Electrotechnique et Electronique de Nantes Atlantique (IREENA), 44 - Nantes (France)

2005-10-01

Power generation is mainly performed by synchronous rotating machines which consume about a third of the world primary energy. Electric motors used in industrial applications convert about two thirds of this electricity. Therefore, synchronous machines are present everywhere at different scales, from micro-actuators of few micro-watts to thermo-mechanical production units of more than 1 GW, and represent a large variety of structures which have in common the synchronism between the frequency of the power supply currents and the relative movement of the fixed part with respect to the mobile part. Since several decades, these machines are more and more used as variable speed motors with permanent magnets. The advances in power electronics have contributed to the widening of their use in various applications with a huge range of powers. This article presents the general principle of operation of electromechanical converters of synchronous type: 1 - electromechanical conversion in electromagnetic systems: basic laws and elementary structures (elementary structure, energy conversion cycle, case of a system working in linear magnetic regime), rotating fields structure (magneto-motive force and Ferraris theorem, superficial air gap permeance, air gap magnetic induction, case of a permanent magnet inductor, magnetic energy and electromagnetic torque, conditions for reaching a non-null average torque, application to common cases); 2 - constitution, operation modes and efficiency: constitution and main types of synchronous machines, efficiency - analysis by similarity laws (other expression of the electromagnetic torque, thermal limitation in permanent regime, scale effects, effect of pole pairs number, examples of efficiencies and domains of use), operation modes. (J.S.)

The self-renewal signaling pathways utilized by gastric cancer stem cells.

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Fu, Ying; Li, Hui; Hao, Xishan

2017-04-01

Gastric cancer is a leading cause of cancer-related mortality worldwide. Cancer stem cells are the source of tumor recurrence and metastasis. Self-renewal is a marker of cancer stem cells and also the basis of long-lasting survival and tumor progression. Although the mechanism of gastric cancer stem cell self-renewal is not clear, there are several signaling pathways and environmental factors known to be involved. This mini review describes recent developments in the self-renewal signaling pathway of gastric cancer stem cell research. Advancements made in this field of research will likely support the development of novel therapeutic strategies for gastric cancer.

A case of gastric endocrine cell carcinoma which was significantly reduced in size by radiotherapy

International Nuclear Information System (INIS)

Azakami, Kiyoshi; Nishida, Kouji; Tanikawa, Ken

2016-01-01

In 2010, the World Health Organization classified gastric neuroendocrine tumors (NETs) into three types: NET grade (G) 1, NET G2 and neuroendocrine carcinoma (NEC). NECs are associated with a very poor prognosis. The patient was an 84-year-old female who was initially diagnosed by gastrointestinal endoscope with type 3 advanced gastric cancer with stenosis of the gastric cardia. Her overall status and performance status did not allow for operations or intensive chemotherapy. Palliative radiotherapy was performed and resulted in a significant reduction in the size of the tumor as well as the improvement of the obstructive symptoms. She died 9 months after radiotherapy. An autopsy provided a definitive diagnosis of gastric endocrine cell carcinoma, and the effectiveness of radiotherapy was pathologically-confirmed. Palliative radiotherapy may be a useful treatment option for providing symptom relief, especially for old patients with unresectable advanced gastric neuroendocrine carcinoma. (author)

Effect of Yunpi Huoxue soup combined chemotherapy on T lymphocyte subsets and nutritional status in patients with advanced gastric cancer

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Pei Xiang

2016-08-01

Full Text Available Objective: To observe the effect of Yunpi Huoxue soup combined with chemotherapy on T lymphocyte subsets and nutritional status in patients with advanced gastric cancer. Methods: A total of 94 cases patients with advanced gastric cancer were randomly divided into the treatment group (49 cases and the control group (45 cases according to the results of the draw. The control group was given chemotherapy, the treatment group was given Yunpi Huoxue soup on the basis of the control group. Treated for 6 weeks, observed the changes of T cell subsets (CD3, CD4, CD8 and CD4/CD8 and nutrition indexes: total protein (TP, albumin (ALB, prealbumin (PA and transferrin (TRF in the two groups. Results: After treatment, CD3, CD4, CD8 and CD4/CD8 in the treatment group were (57.38±4.03, (31.63±4.26, (30.82±3.52 and (1.16±0.20 respectively, there were no significant differences compared with before treatment; After treatment, the levels of CD3, CD4, CD8 and CD4/CD8 in the control group were significantly lower than those before treatment, and the differences were statistically significant; After treatment, the levels of CD3, CD4, CD8 and CD4/CD8 in the treatment group were significant higher than those in the control group after treatment, and the differences were statistically significant. After treatment, TP, ALB, PA and TRF in the treatment group were(54.22±5.93 g/L, (32.47±4.97 g/L, (2.52±0.43 g/L and (1.66±0.40 g/L respectively, there were no significant differences compared with before treatment; After treatment, the levels of TP, ALB, PA and TRF in the control group were significantly lower than those before treatment; After treatment, the levels of TP, ALB, PA and TRF in the treatment group were significant higher than those in the control group after treatment, and the differences were statistically significant. Conclusion: When chemotherapy for patients with advanced gastric cancer, Yunpi Huoxue soup is helpful to maintain the immune function and

Randomized Phase II trial of paclitaxel plus valproic acid vs paclitaxel alone as second-line therapy for patients with advanced gastric cancer

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Fushida S

2015-04-01

Full Text Available Sachio Fushida,1 Masahide Kaji,2 Katsunobu Oyama,1 Yasuo Hirono,3 Hideaki Nezuka,4 Toshiya Takeda,5 Tomoya Tsukada,1 Daisuke Fujimoto,3 Shigekazu Ohyama,6 Takashi Fujimura,7 Tetsuo Ohta1 On behalf of the Digestive Disease Support Organization (DDSO 1Department of Gastroenterological Surgery, Kanazawa University Hospital, Kanazawa, 2Department of Surgery, Toyama Prefectural Central Hospital, Toyama, 3First Department of Surgery, Fukui University Hospital, Fukui, 4Department of Surgery, Yatsuo General Hospital, Toyama, 5Department of Surgery, Ishikawa Matto Central Hospital, Hakusan, 6Department of Surgery, Kanazawa Medical Center, Kanazawa, 7Toyama City Hospital, Toyama, Japan Abstract: The standard regimen of second-line chemotherapy for patients with unresectable gastric cancer has not been established. However, weekly paclitaxel (wPTX has become the preferable second-line chemotherapy in Japan. Histone deacetylase (HDAC inhibitors have been shown to have antiproliferative activity through cell-cycle arrest, differentiation, and apoptosis in gastric cancer cells. One HDAC inhibitor, valproic acid (VPA, also inhibits tumor growth by inducing apoptosis, and enhances the efficacy of paclitaxel in a mouse xenograft model of gastric cancer. wPTX plus VPA as a second-line chemotherapy is expected to improve survival in gastric cancer patients. A multicenter randomized Phase II study was conducted to compare the effects of wPTX plus VPA and wPTX alone. A total of 66 patients participated in this study. The primary end point of the study was overall survival, and secondary end points were progression-free survival, response rate, and assessment of peripheral neuropathy. Keywords: valproic acid, paclitaxel, second-line therapy, advanced gastric cancer 

Companion diagnostics for the targeted therapy of gastric cancer.

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Yoo, Changhoon; Park, Young Soo

2015-10-21

Gastric cancer is the fourth most common type of cancer and represents a major cause of cancer-related deaths worldwide. With recent biomedical advances in our understanding of the molecular characteristics of gastric cancer, many genetic alterations have been identified as potential targets for its treatment. Multiple novel agents are currently under development as the demand for active agents that improve the survival of gastric cancer patients constantly increases. Based on lessons from previous trials of targeted agents, it is now widely accepted that the establishment of an optimal diagnostic test to select molecularly defined patients is of equal importance to the development of active agents against targetable genetic alterations. Herein, we highlight the current status and future perspectives of companion diagnostics in the treatment of gastric cancer.

Relationship of preoperative gastric cancer CT enhancement ratio and perfusion parameters with serum tumor marker levels and proliferation molecule expression in tumor lesions

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Yong-Hong Wang

2017-06-01

Full Text Available Objective: To study the relationship of preoperative gastric cancer CT enhancement ratio and perfusion parameters with serum tumor marker levels and proliferation molecule expression in tumor lesions. Methods: A total of 68 patients with gastric cancer treated in the Second Hospital of Yulin City between May 2012 and May 2016 were chosen as observation group and sub-divided into early and middle gastric cancer group (n=41 and advanced gastric cancer group (n=27 according to the tumor stage; 50 patients diagnosed with benign gastric diseases in our hospital during the same period were selected as benign gastric lesion group. CT enhancement rate and perfusion parameters of three groups of patients were detected by CT scan, serum tumor marker levels were evacuated by enzyme-linked immunosorbent assay (ELISA, and the proliferation gene mRNA expression levels were detected by RTPCR method. Results: CER, AF, BV and CL levels of advanced gastric cancer group were higher than those of early and middle gastric cancer group and benign gastric lesion group; serum CA72-4, CA19-9, CA125 and CEA contents of advanced gastric cancer group were higher than those of early and middle gastric cancer group and benign gastric lesion group; CADM1, miRNA-34a and Cystatin M mRNA expression in tissue of advanced gastric cancer group were lower than those of early and middle gastric cancer group and benign gastric lesion group while Survivin and I2PP2A mRNA expression were higher than those of early and middle gastric cancer group and benign gastric lesion group. The Pearson test showed that the CT enhancement rate and perfusion parameters in patients with gastric cancer are directly correlated with the serum tumor marker levels and the proliferation gene expression in tumor lesions. Conclusion: Preoperative gastric cancer CT enhancement rate and perfusion parameters are directly related to the tumor malignancy, and can be used as a reliable method for the long-term tumor

Prophylactic total gastrectomy in hereditary diffuse gastric cancer

DEFF Research Database (Denmark)

Bardram, Linda; Hansen, Thomas V O; Gerdes, Anne-Marie

2014-01-01

Inactivating mutations in the CDH1 (E-cadherin) gene are the predisposing cause of gastric cancer in most families with hereditary diffuse gastric cancer (HDGC). The lifetime risk of cancer in mutation positive members is more than 80 % and prophylactic total gastrectomy is recommended. Not all...... mutations in the CDH1 gene are however pathogenic and it is important to classify mutations before this major operation is performed. Probands from two Danish families with gastric cancer and a history suggesting HDGC were screened for CDH1 gene mutations. Two novel CDH1 gene mutations were identified....... Hospital stay was 6-8 days and there were no complications. Small foci of diffuse gastric cancer were found in all patients-intramucosal in six and advanced in one. Preoperative endoscopic biopsies had revealed a microscopic cancer focus in two of the patients. Our data confirmed the pathogenic nature...

Lack of death receptor 4 (DR4) expression through gene promoter methylation in gastric carcinoma.

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Lee, Kyung Hwa; Lim, Sang Woo; Kim, Ho Gun; Kim, Dong Yi; Ryu, Seong Yeob; Joo, Jae Kyun; Kim, Jung Chul; Lee, Jae Hyuk

2009-07-01

To determine the underlying mechanism for the differential expression, the extent of promoter methylation in tumor necrosis factor-related apoptosis-inducing ligand (TRAIL)-related genes acting downstream of TRAIL was examined in early and advanced gastric carcinomas. The extent of promoter methylation in the DR4, DR5, DcR1, DcR2, and CASP8 genes was quantified using bisulfite modification and methylation-specific polymerase chain reaction. The promoters for DcR1, DcR2, and CASP8 were largely unmethylated in early gastric carcinoma, advanced gastric carcinoma, and controls, with no significant difference among them. Protein levels of DR4, DcR1, and DcR2 as revealed by immunohistochemistry correlated with the extent of the respective promoter methylation (P < 0.05 in all cases). Hypomethylation, rather than hypermethylation, of the DR4 promoter was noted in invasive gastric malignancies, with statistical significance (P = 0.003). The promoter methylation status of TRAIL receptors in gastric carcinoma may have clinical implications for improving therapeutic strategies in patients with gastric carcinoma.

Study of metastatic lymph nodes in advanced gastric cancer with spiral computed tomograph

International Nuclear Information System (INIS)

Su Yijuan

2008-01-01

Objective: To study the characteristics of spiral computed tomography (SCT) in the diagnosis of lymph nodes metastases in gastric cancer. Methods: The characteristics of spiral computed tomography (SCT) of metastatic lymph nodes in 35 gastric cancer patients were analyzed and compared with operation and pathology. Results: A total amount of 379 lymph nodes (positive 173, negative 206) were detected by SCT and confirmed by pathology in metastasis-positive or metastasis-negative patients. The positive rate with diameter of lymph nodes ≥ 10 mm is 62.7%. The positive rate with ir- regular shape and uneven enhancement lymph nodes were 96.3% and 89.4%. If the attenuation values, more than or equal to 25 HU in plain scan or 70 HU in arterial phase or 80 HU in venous phase, were used as the threshold to detect the metastasis-positive lymph nodes, the positive rate were 55.7%, 56.3%, 67.8% respectively. Conclusion: SCT is valuable in judging the metastasis in gastric cancer. The reference of diameter ≥ 10mm, combining with the shape and the attenuation values can dramatically improve the diagnosis of lymph node metastasis in gastric cancer. (authors)

Association of Helicobacter pylori infection with gastric cancer.

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Alexander, G A; Brawley, O W

2000-01-01

Helicobacter pylori has generated public health interest since its identification in 1983. Past studies have suggested that the bacterium plays a role in the pathogenesis of gastric cancer. More recent studies support the conclusion that the association of H. pylori with gastric cancer is causal. The purpose of this article is to review the available evidence supporting the association of H. pylori with gastric cancer. We performed a critical review of the relevant literature published in the English language on H. pylori and gastric cancer using MEDLINE, Index Medicus for the years 1985 to 1997. The reference lists of selected articles also were reviewed to capture citations for further pertinent studies. H. pylori is thought to be the major cause of chronic atrophic gastritis. H. pylori gastritis is worldwide in distribution. H. pylori is now categorized by the International Agency for Cancer Research as a group 1 carcinogen, i.e., an agent that is carcinogenic to humans. Several reports from the United States have found the highest frequencies of gastric cancer in geographic areas and populations with the highest rates of acquisition of H. pylori infection. The high prevalence of H. pylori infection has been documented most notably in blacks and Hispanics, who also are at high risk for gastric cancer. New studies that focus on the epidemiology and pathology of H. pylori improve our understanding of its relationship with gastric cancer and advance the development of gastric cancer prevention and control strategies that are proposed.

Fractional order control and synchronization of chaotic systems

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Vaidyanathan, Sundarapandian; Ouannas, Adel

2017-01-01

The book reports on the latest advances in and applications of fractional order control and synchronization of chaotic systems, explaining the concepts involved in a clear, matter-of-fact style. It consists of 30 original contributions written by eminent scientists and active researchers in the field that address theories, methods and applications in a number of research areas related to fractional order control and synchronization of chaotic systems, such as: fractional chaotic systems, hyperchaotic systems, complex systems, fractional order discrete chaotic systems, chaos control, chaos synchronization, jerk circuits, fractional chaotic systems with hidden attractors, neural network, fuzzy logic controllers, behavioral modeling, robust and adaptive control, sliding mode control, different types of synchronization, circuit realization of chaotic systems, etc. In addition to providing readers extensive information on chaos fundamentals, fractional calculus, fractional differential equations, fractional contro...

Review article: the investigation and management of gastric neuroendocrine tumours.

Science.gov (United States)

Basuroy, R; Srirajaskanthan, R; Prachalias, A; Quaglia, A; Ramage, J K

2014-05-01

Gastric carcinoids (GCs) or neuroendocrine tumours (NETs) are increasingly identified at endoscopy, and account for 0.6-2% of all gastric polyps identified. The SEER database in the US has demonstrated a rising incidence of gastric NETs amongst all NETs; from 2.2% between 1950 and 1969 to 6.0% between 2000 and 2007. To review the literature and assist clinicians in managing patients with GCs. A literature search was conducted through MEDLINE using search terms: gastric, carcinoid, neuroendocrine tumour, therapy, endoscopy, mucosal resection, submucosal dissection. Relevant articles were identified through manual review. The reference lists of these articles were reviewed to include further appropriate articles. There are three types of GCs with important epidemiological, pathophysiological, histological and endoscopic differences that affect prognosis and management. Type 1 and 2 GCs develop in the context of hypergastrinaemia that originates from achlorhydria in atrophic gastritis and a gastrinoma, respectively. Type 3 GCs occur sporadically and independent of gastrin. The histological type, grade and Ki67 index are used to determine prognosis and direct clinical management. Type 1 GCs >1 cm in size and type 2 GCs should be assessed for invasion beyond the submucosa with EUS prior to endoscopic resection with EMR or ESD. Type 3 GCs should be managed as per recommendations for gastric adenocarcinoma. The treatment of advanced disease is multimodal. Patients with gastric carcinoids should be discussed in a specialist neuroendocrine tumour multidisciplinary meeting to ensure all treatment options are explored in localised and advanced disease. Areas of controversy exist that need further research. © 2014 John Wiley & Sons Ltd.

Radiological evaluation of early gastric cancer: analysis of 104 cases

International Nuclear Information System (INIS)

Choi, Byung Ihn; Kim, Jae Hyung; Han, Man Chung

1987-01-01

During the two year period from January 1985 to December 1986, 161 cases were confirmed as early gastric cancer by pathologic mapping at Seoul National University Hospital. Among them, the authors reviewed 104 cases of early gastric cancer for the evaluation of diagnostic value of double contrast upper gastrointestinal series. Early gastric cancer was most common in 5th and 6th decade (64%) and male to female ratio was 2:1. Double contrast upper GI series could detect 97 out of 104 cases (93%). Among them, 62 cases were diagnosed as early gastric cancer, 32 as advanced gastric cancer and 3 as benign lesion. Detection rate according to the size was 100% in lesion larger than 2cm and 87% in lesion smaller than 2cm. Predictability of early gastric cancer according to size was 66% in lesion smaller than 3cm and 43% in lesion larger than 3cm. Detection rate according to the location of the tumor was almost similar between gastric body (94%) and antrum (93%), however was very low in anterior wall lesion (70%). Predictability of early gastric cancer was 69% in gastric body lesion, 52% in gastric antral lesion and 44% in greater curvature lesion. Detection rate according to the type of macrospecimen was 100% in type I, III and IIc+III. Type IIb showed the lowest detection rate (75%). Predictability of early gastric cancer was high in type IIc (68%) and low in type I (20%)

Consideration of clinicopathologic features improves patient stratification for multimodal treatment of gastric cancer.

Science.gov (United States)

Cho, In; Kwon, In Gyu; Guner, Ali; Son, Taeil; Kim, Hyoung-Il; Kang, Dae Ryong; Noh, Sung Hoon; Lim, Joon Seok; Hyung, Woo Jin

2017-10-03

Preoperative staging of gastric cancer with computed tomography alone exhibits poor diagnostic accuracy, which may lead to improper treatment decisions. We developed novel patient stratification criteria to select appropriate treatments for gastric cancer patients based on preoperative staging and clinicopathologic features. A total of 5352 consecutive patients who underwent gastrectomy for gastric cancer were evaluated. Preoperative stages were determined according to depth of invasion and nodal involvement on computed tomography. Logistic regression analysis was used to identify clinicopathological factors associated with the likelihood of proper patient stratification. The diagnostic accuracies of computed tomography scans for depth of invasion and nodal involvement were 67.1% and 74.1%, respectively. Among clinicopathologic factors, differentiated tumor histology, tumors smaller than 5 cm, and gross appearance of early gastric cancer on endoscopy were shown to be related to a more advanced stage of disease on preoperative computed tomography imaging than actual pathological stage. Additional consideration of undifferentiated histology, tumors larger than 5 cm, and grossly advanced gastric cancer on endoscopy increased the probability of selecting appropriate treatment from 75.5% to 94.4%. The addition of histology, tumor size, and endoscopic findings to preoperative staging improves patient stratification for more appropriate treatment of gastric cancer.

Gastric Necrosis due to Acute Massive Gastric Dilatation

Directory of Open Access Journals (Sweden)

Ibrahim Aydin

2013-01-01

Full Text Available Gastric necrosis due to acute massive gastric dilatation is relatively rare. Vascular reasons, herniation, volvulus, acute gastric dilatation, anorexia, and bulimia nervosa play a role in the etiology of the disease. Early diagnosis and treatment are highly important as the associated morbidity and mortality rates are high. In this case report, we present a case of gastric necrosis due to acute gastric dilatation accompanied with the relevant literature.

Gastric Necrosis due to Acute Massive Gastric Dilatation.

Science.gov (United States)

Aydin, Ibrahim; Pergel, Ahmet; Yucel, Ahmet Fikret; Sahin, Dursun Ali; Ozer, Ender

2013-01-01

Gastric necrosis due to acute massive gastric dilatation is relatively rare. Vascular reasons, herniation, volvulus, acute gastric dilatation, anorexia, and bulimia nervosa play a role in the etiology of the disease. Early diagnosis and treatment are highly important as the associated morbidity and mortality rates are high. In this case report, we present a case of gastric necrosis due to acute gastric dilatation accompanied with the relevant literature.

[Clinical trials of laparoscopic gastric cancer surgery in South Korea: review and prospect].

Science.gov (United States)

Zhu, Chunchao; Zhao, Gang; Cao, Hui

2018-02-25

Laparoscopic technology is gradually accepted in gastric cancer surgery, whose efficacy has been demonstrated by some clinical researches. Randomized controlled trials (RCT) are considered as the most important evidence to prove clinical outcomes of laparoscopic surgery for gastric cancer. Korean gastric surgeons have made great contributions to RCT in laparoscopic gastric cancer surgery. KLASS (Korean Laparoscopic Gastrointestinal Surgery Study Group) is one of the most important forerunner and global leader of clinical trials of gastric cancer treatment. KLASS series clinical trials are attracting global attention because of the significant value of surgical treatment for gastric cancer. The RCTs in Korea involve in many aspects of laparoscopic gastrectomy for gastric cancer, including laparoscopy application in early gastric cancer (KLASS-01, KLASS-03 and KLASS-07), advanced gastric cancer (KLASS-02 and KLASS-06), function-preserving gastrectomy (KLASS-04,KLASS-05) and sentinel node navigation surgery (SENORITA trial). In order to share some informations of these RCTs, we review and prospect some important clinical trials of laparoscopic gastric cancer surgery in Korea. With the experience of Korean gastric surgeons, we can make more progress in our own clinical trials of laparoscopic gastric cancer surgery.

Percutaneous transhepatic sclerotherapy with embolization of the drainage vein for a gastric varix

OpenAIRE

Yoshimatsu, Rika; Yamagami, Takuji; Miura, Hiroshi; Okuda, Kotaro

2014-01-01

We experienced a case with a gastric varix that did not have a catheterizable main drainage vein and had multiple afferent veins. For this case we successfully performed percutaneous transhepatic sclerotherapy using the following procedure. After the drainage vein was embolized by metallic coils and n-butyl cyanoacrylate from a microcatheter that was advanced through the gastric varix, 5% ethanolamine oleate-iopamidol was infused into the gastric varix from one main afferent vein under balloo...

Gastric applications of electrical field stimulation.

LENUS (Irish Health Repository)

Hogan, Aisling M

2012-02-01

Advances in clinical applications of electricity have been vast since the launch of Hayman\\'s first cardiac pacemaker more than 70 years ago. Gastric electrical stimulation devices have been recently licensed for treatment of gastroparesis and preliminary studies examining their potential for use in refractory obesity yield promising results.

Mastication suppresses initial gastric emptying by modulating gastric activity.

Science.gov (United States)

Ohmure, H; Takada, H; Nagayama, K; Sakiyama, T; Tsubouchi, H; Miyawaki, S

2012-03-01

Because various mastication-related factors influence gastric activity, the functional relationship between mastication and gastric function has not been fully elucidated. To investigate the influence of mastication on gastric emptying and motility, we conducted a randomized trial to compare the effects of mastication on gastric emptying and gastric myoelectrical activity under conditions that excluded the influences of food comminution, taste, and olfaction. A (13)C-acetate breath test with electrogastrography and electrocardiography was performed in 14 healthy men who ingested a test meal with or without chewing gum. Autonomic nerve activity was evaluated by fluctuation analysis of heart rate. Gastric emptying was significantly delayed in the 'ingestion with mastication' group. Gastric myoelectrical activity was significantly suppressed during mastication and increased gradually in the post-mastication phase. A decrease in the high-frequency power of heart rate variability was observed coincidentally with gastric myoelectrical activity suppression. These findings suggest that initial gastric emptying is suppressed by mastication, and that the suppression is caused by mastication-induced inhibition of gastric activity (UMIN Clinical Trial Registration no. UMIN000005351).

Postoperative adjuvant chemoradiation in completely resected locally advanced gastric cancer

International Nuclear Information System (INIS)

Arcangeli, Giorgio; Saracino, Biancamaria; Arcangeli, Giancarlo; Angelini, Francesco; Marchetti, Paolo; Tirindelli Danesi, Donatella

2002-01-01

Background: The 5-year survival of patients with completely resected node-positive gastric cancer ranges from 15% to 25%. We explored the feasibility of a chemoradiation regime consisting of concomitant hyperfractionated radiotherapy and 5-fluorouracil protracted venous infusion (5-FU PVI). Materials and Methods: Forty patients received a total or partial gastrectomy operation and D2 nodal resection for Stage III gastric cancer; they were then irradiated by linac with 6-15-MV photons. The target included the gastric bed, the anastomosis, stumps, and regional nodes. A total dose of 55 Gy was given in 50 fractions using 1.1 Gy b.i.d. All patients received a concomitant 200 mg/m2/day 5-FU PVI. Patients were examined during the follow-up period as programmed. Toxicity was recorded according to RTOG criteria. Results: After a median follow-up of 75.6 months (range: 22-136 months), 24 (60%) patients had died, and 16 (40%) were alive and free of disease. The 5-year actuarial incidence of relapse was 39%, 22%, and 2% for distant metastases, out-field peritoneal seeding, and in-field local regional recurrences, respectively. The 5-year actuarial cause-specific survival was 43%. Three patients survived more than 11 years. Acute ≥ Grade 3 toxicity consisted of hematologic (22.5%) and gastrointestinal toxicity (nausea and vomiting 22.5%, diarrhea 2.8%, and abdominal pain 2.6%). No late toxicity was observed. Conclusion: This regime of concomitant 5-FU PVI and hyperfractionated radiotherapy was well tolerated and resulted in successful locoregional control and satisfactory survival

Successful treatment of local recurrence of advanced gastric cancer using curative gastrectomy via distal pancreatectomy after chemoradiotherapy

International Nuclear Information System (INIS)

Sakai, Kenji; Kobayashi, Teruyuki; Higashiguchi, Masaya

2016-01-01

The patient was a 65-year-old woman. She was diagnosed with advanced gastric cancer with liver invasion. After receiving systemic chemotherapy (S-1 plus PTX) for 3 months, she underwent total gastrectomy and partial hepatectomy in May 2008. Because she developed celiac artery circumference lymph node recurrence in November 2010 during postoperative adjuvant chemotherapy consisting of S-1 plus PTX, we changed her chemotherapy regimen to CPT-11 plus CDDP. We observed an increase in the size of the lymph nodes in August 2013 and the response was poor even after switching to DOC. However, the lymph nodes continued to increase in size and we administered radiotherapy of 60.4 Gy/33 Fr that resulted in shrinkage of the nodes. We observed an increase in lymph node size and pancreas invasion in September 2015, including an expansion of the mid pancreatic duct. We performed distal pancreatectomy without identifying the recurrence observed in November 2015 assuming it was an exacerbation. Six months after the surgery, the recurrence was not apparent. We report an example of long-term survival that was achieved for Stage 4 gastric cancer. The patient underwent combined modality therapy for 8 years, and local recurrence was controlled via a primary operation. (author)

Weekly oxaliplatin, 5-fluorouracil and folinic acid (OXALF) as first-line chemotherapy for elderly patients with advanced gastric cancer: results of a phase II trial

International Nuclear Information System (INIS)

Santini, D; Vincenzi, B; Russo, A; Caraglia, M; Virzi, V; Cascinu, S; Tonini, G; Graziano, F; Catalano, V; Di Seri, M; Testa, E; Baldelli, AM; Giordani, P; La Cesa, A; Spalletta, B

2006-01-01

Elderly patients have been often excluded from or underrepresented in the study populations of combination chemotherapy trials. The primary end point of this study was to determine the response rate and the toxicity of the weekly oxaliplatin, 5-fluorouracil and folinic acid (OXALF) regimen in elderly patients with advanced gastric cancer. The secondary objective was to measure the time to disease progression and the survival time. Chemotherapy-naive patients with advanced gastric cancer aged 70 or older were considered eligible for study entry. Patients received weekly oxaliplatin 40 mg/m2, fluorouracil 500 mg/m2 and folinic acid 250 mg/m2. All drugs were given intravenously on a day-1 schedule. A total of 42 elderly patients were enrolled. Median age was 73 years and all patients had metastatic disease. The response rate according to RECIST criteria was 45.2% (95% CIs: 30%–56%) with two complete responses, 17 partial responses, 13 stable diseases and 10 progressions, for an overall tumor rate control of 76.2% (32 patients). Toxicity was generally mild and only three patients discontinued treatment because of treatment related adverse events. The most common treatment-related grade 3/4 adverse events were fatigue (7.1%), diarrhoea (4.8%), mucositis (2.4%), neurotoxicity (2.4%) and neutropenia (4.8%). The median response duration was 5.3 months (95% CIs: 2.13 – 7.34), the median time to disease progression was 5.0 months (95% CIs: 3.75 – 6.25) and the median survival time was 9.0 months (95% CIs: 6.18 – 11.82). OXALF represents an active and well-tolerated treatment modality for elderly patients with locally advanced and metastatic gastric cancer

Weekly oxaliplatin, 5-fluorouracil and folinic acid (OXALF as first-line chemotherapy for elderly patients with advanced gastric cancer: results of a phase II trial

Directory of Open Access Journals (Sweden)

Vincenzi B

2006-05-01

Full Text Available Abstract Background Elderly patients have been often excluded from or underrepresented in the study populations of combination chemotherapy trials. The primary end point of this study was to determine the response rate and the toxicity of the weekly oxaliplatin, 5-fluorouracil and folinic acid (OXALF regimen in elderly patients with advanced gastric cancer. The secondary objective was to measure the time to disease progression and the survival time. Methods Chemotherapy-naive patients with advanced gastric cancer aged 70 or older were considered eligible for study entry. Patients received weekly oxaliplatin 40 mg/m2, fluorouracil 500 mg/m2 and folinic acid 250 mg/m2. All drugs were given intravenously on a day-1 schedule. Results A total of 42 elderly patients were enrolled. Median age was 73 years and all patients had metastatic disease. The response rate according to RECIST criteria was 45.2% (95% CIs: 30%–56% with two complete responses, 17 partial responses, 13 stable diseases and 10 progressions, for an overall tumor rate control of 76.2% (32 patients. Toxicity was generally mild and only three patients discontinued treatment because of treatment related adverse events. The most common treatment-related grade 3/4 adverse events were fatigue (7.1%, diarrhoea (4.8%, mucositis (2.4%, neurotoxicity (2.4% and neutropenia (4.8%. The median response duration was 5.3 months (95% CIs: 2.13 – 7.34, the median time to disease progression was 5.0 months (95% CIs: 3.75 – 6.25 and the median survival time was 9.0 months (95% CIs: 6.18 – 11.82. Conclusion OXALF represents an active and well-tolerated treatment modality for elderly patients with locally advanced and metastatic gastric cancer.

Cumulative Radiation Exposure during Follow-Up after Curative Surgery for Gastric Cancer

International Nuclear Information System (INIS)

Lee, Yeo Jin; Chung, Yong Eun; Lim, Joon Seok; Kim, Joo Hee; Kim, Young Jin; Lee, Hye Jeong; Kim, Myeong Jin; Kim, Ki Whang; You, Je Sung

2012-01-01

To quantify the cumulative effective dose (cED) of radiation due to repeated CT and PET/CT examinations after curative resection of gastric cancer and to assess the lifetime attributable risk (LAR) estimates based on Biological Effects of Ionizing Radiation VII models. Patients who underwent a curative resection for gastric cancer between January 2006 and December 2006 and were followed-up until May 2010 were included in this study. The cED was calculated by using the dose-length product values and conversion factors for quantitative risk assessment of radiation exposure. cED and LAR were compared between early and advanced gastric cancer patients and among American Joint Committee on Cancer TNM stage groups (stage I, II, and III). The nonparametric Mann-Whitney U and Kruskal-Wallis tests, followed by a post-hoc analysis with Bonferroni adjustment, were employed as part of the statistical analysis. The overall median cED was 57.8 mSv (interquartile range [IQR], 43.9-74.7). The cED was significantly higher in the advanced (median, 67.0; IQR, 49.1-102.3) than in the early gastric cancer group (median, 52.3; IQR, 41.5-67.9) (p < 0.001), and increased as the TNM stage increased. For radiation exposure, 62% of all patients received an estimated cED of over 50 mSv, while 11% of patients received over 100 mSv. The median LAR of cancer incidence was 0.28% (IQR, 0.20-0.40) and there were significant differences between the early gastric cancer and advanced gastric cancer group (p < 0.001) as well as among the three TNM stage groups (p = 0.015). The LAR of cancer incidence exceeded 1% in 2.4% of the patients. The cED increases proportionally along with tumor stage and, even in early gastric cancer or stage I patients, cED is much higher than that found among the general population. Considering the very good prognosis of early gastric cancer after curative surgery, the cED should be considered when designing a postoperative follow-up CT protocol.

SSAT State-of-the-Art Conference: Current Surgical Management of Gastric Tumors.

Science.gov (United States)

Norton, Jeffrey A; Kim, Teresa; Kim, Joseph; McCarter, Martin D; Kelly, Kaitlyn J; Wong, Joyce; Sicklick, Jason K

2018-01-01

The current era of gastric surgery is marked by low morbidity and mortality rates, innovative strategies to approach resections with a minimally invasive fashion or hyperthermic intraperitoneal chemotherapy (HIPEC), as well as improved understanding of the biology of sporadic and hereditary stromal, neuroendocrine, and epithelial malignancies. In 2017, the Society for Surgery of the Alimentary Tract convened a State-of-the-Art Conference on Current Surgical Management of Gastric Tumors with both international experts and emerging leaders in the field of gastric surgery. Martin D. McCarter, MD of the University of Colorado discussed the current management of gastric gastrointestinal stromal tumors (GIST). Kaitlyn J. Kelly, MD of the University of California, San Diego discussed the management of gastric carcinoid tumors. Jeffrey A. Norton of Stanford University discussed recent advances in the management of gastric adenocarcinoma including a focus on hereditary diffuse gastric cancer (HDGC). Joseph Kim, MD of Stony Brook University discussed a systematic approach to minimally invasive gastrectomy for cancer. Joyce Wong, MD of Pennsylvania State University discussed the role for cytoreductive surgery (CRS) and HIPEC for gastric adenocarcinoma. This review provides gastrointestinal surgeons with a concise update on the current surgical management of gastric tumors.

Bodily Synchronization Underlying Joke Telling

Directory of Open Access Journals (Sweden)

R. C. Schmidt

2014-08-01

Full Text Available Advances in video and time series analysis have greatly enhanced our ability to study the bodily synchronization that occurs in natural interactions. Past research has demonstrated that the behavioral synchronization involved in social interactions is similar to dynamical synchronization found generically in nature. The present study investigated how the bodily synchronization in a joke telling task is spread across different nested temporal scales. Pairs of participants enacted knock-knock jokes and times series of their bodily activity were recorded. Coherence and relative phase analyses were used to evaluate the synchronization of bodily rhythms for the whole trial as well as at the subsidiary time scales of the whole joke, the setup of the punch line, the two-person exchange and the utterance. The analyses revealed greater than chance entrainment of the joke teller’s and joke responder’s movements at all time scales and that the relative phasing of the teller’s movements led those of the responder at the longer time scales. Moreover, this entrainment was greater when visual information about the partner’s movements was present but was decreased particularly at the shorter time scales when explicit gesturing in telling the joke was performed. In short, the results demonstrate that a complex interpersonal bodily dance occurs during structured conversation interactions and that this dance is constructed from a set of rhythms associated with the nested behavioral structure of the interaction.

Gastric cancer perforation: experience from a tertiary care hospital.

Science.gov (United States)

Kandel, Bishnu Prasad; Singh, Yogendra; Singh, Keshav Prasad; Khakurel, Mahesh

2013-01-01

Gastric cancer perforation can occurs in advanced stage of the disease and is often associated with a high morbidity and mortality. Peritonitis due to perforation needs emergency laparotomy and different surgical procedures can be performed for definitive treatment. Surgical procedures largely depend on the stage of the disease and general condition of the patient. This study was carried out to evaluate the outcome and role of different surgical procedures in gastric cancer perforation. Medical record of patients with gastric perforation, who were treated during ten years period, was reviewed retrospectively. Data regarding clinical presentation, surgical procedures, staging and survival of patients were obtained. Features suggestive of diffuse peritonitis were evident in all cases. The majority of the patients underwent emergency surgery except one who died during resuscitation. The majority of patients were in stage III and stage IV. Surgical procedure includes simple closure and omental patch in five patients, simple closure and gastrojejunostomy in nine patients, gastrectomy in six patients and Devine's antral exclusion in one patient. Surgical site infection was the most common (45.5%) postoperative complication. Four patients died within one month of the surgery. Three patients who underwent gastrectomy survived for one year and one patient survived for five years. Although gastric cancer perforation usually occurs in advanced stage of the disease, curative resection should be considered as far as possible.

Glycoprofiling of Early Gastric Cancer Using Lectin Microarray Technology.

Science.gov (United States)

Li, Taijie; Mo, Cuiju; Qin, Xue; Li, Shan; Liu, Yinkun; Liu, Zhiming

2018-01-01

Recently, studies have reported that protein glycosylation plays an important role in the occurrence and development of cancer. Gastric cancer is a common cancer with high morbidity and mortality owing to most gastric cancers are discovered only at an advanced stage. Here, we aim to discover novel specific serum glycanbased biomarkers for gastric cancer. A lectin microarray with 50 kinds of tumor-associated lectin was used to detect the glycan profiles of serum samples between early gastric cancer and healthy controls. Then lectin blot was performed to validate the differences. The result of the lectin microarray showed that the signal intensities of 13 lectins showed significant differences between the healthy controls and early gastric cancer. Compared to the healthy, the normalized fluorescent intensities of the lectins PWA, LEL, and STL were significantly increased, and it implied that their specifically recognized GlcNAc showed an especially elevated expression in early gastric cancer. Moreover, the binding affinity of the lectins EEL, RCA-II, RCA-I, VAL, DSA, PHA-L, UEA, and CAL were higher in the early gastric cancer than in healthy controls. These glycan structures containing GalNAc, terminal Galβ 1-4 GlcNAc, Tri/tetraantennary N-glycan, β-1, 6GlcNAc branching structure, α-linked fucose residues, and Tn antigen were elevated in gastric cancer. While the two lectins CFL GNL reduced their binding ability. In addition, their specifically recognized N-acetyl-D-galactosamine structure and (α-1,3) mannose residues were decreased in early gastric cancer. Furthermore, lectin blot results of LEL, STL, PHA-L, RCA-I were consistent with the results of the lectin microarray. The findings of our study clarify the specific alterations for glycosylation during the pathogenesis of gastric cancer. The specific high expression of GlcNAc structure may act as a potential early diagnostic marker for gastric cancer.

Synchronization coupled systems to complex networks

CERN Document Server

Boccaletti, Stefano; del Genio, Charo I; Amann, Andreas

2018-01-01

A modern introduction to synchronization phenomena, this text presents recent discoveries and the current state of research in the field, from low-dimensional systems to complex networks. The book describes some of the main mechanisms of collective behaviour in dynamical systems, including simple coupled systems, chaotic systems, and systems of infinite-dimension. After introducing the reader to the basic concepts of nonlinear dynamics, the book explores the main synchronized states of coupled systems and describes the influence of noise and the occurrence of synchronous motion in multistable and spatially-extended systems. Finally, the authors discuss the underlying principles of collective dynamics on complex networks, providing an understanding of how networked systems are able to function as a whole in order to process information, perform coordinated tasks, and respond collectively to external perturbations. The demonstrations, numerous illustrations and application examples will help advanced graduate s...

Malignant gastric outlet obstruction managed by endoscopic stenting: a prospective single-centre study

DEFF Research Database (Denmark)

Havemann, Maria Cecilie; Adamsen, Sven; Wøjdemann, Morten

2008-01-01

-to-treat principle. All patients were offered endoscopic stenting. Oral intake before and after stenting was assessed using the gastric outlet obstruction score system (GOOSS). Various lengths of duodenal Hanaro(R) self-expanding nitinol stents were delivered through a therapeutic endoscope. Outcome criteria were......Objective. Endoscopic stenting for malignant gastric outlet obstruction was chosen as the primary strategy by which to palliate this complication, which is dominated by weight loss and anorexia. Advanced upper gastrointestinal tract cancers present late and life expectancy is limited. Only smaller...... multicentre studies point to endoscopic stenting as superior to surgery in terms of clinical outcome and cost. Material and methods. Forty-five consecutive patients with gastric outlet obstruction as a result of advanced upper GI-tract malignancy were enrolled in accordance with the intention...

Endoscopic submucosal dissection for early gastric cancer on the lesser curvature in upper third of the stomach is a risk factor for postoperative delayed gastric emptying.

Science.gov (United States)

Yoshizaki, Tetsuya; Obata, Daisuke; Aoki, Yasuhiro; Okamoto, Norihiro; Hashimura, Hiroki; Kano, Chise; Matsushita, Megumi; Kanamori, Atsushi; Matsumoto, Kei; Tsujimae, Masahiro; Momose, Kenji; Eguchi, Takaaki; Okuyama, Shunsuke; Yamashita, Hiroshi; Fujita, Mikio; Okada, Akihiko

2018-02-07

Advances in Endoscopic submucosal dissection (ESD) technology have established ESD for early gastric cancer as a safe and stable technique. However, ESD may induce delayed gastric emptying and the cause of food residue retention in the stomach after ESD is not clear. This study aimed to clarify risk factors for delayed gastric emptying with food retention after gastric ESD. We retrospectively examined for food residue in the stomach 1 week after ESD was performed for early gastric carcinoma at Osaka Saiseikai Nakatsu Hospital from February 2008 to November 2016. Food residue was observed in 68 (6.1%) of 1114 patients who underwent gastric ESD. The percentage of lesions located on the lesser curvature of the upper third of the stomach was 45.6% (31/68) in the food residue group and 3.5% (37/1046) in the non-food residue group, which was significantly different (P gastric ESD. Of the 68 patients, 3 had food residue in the stomach on endoscopic examination for follow-up observation after the ESD ulcer had healed. Delayed gastric emptying with food retention after gastric ESD was associated with lesions located in the lesser curvature of the upper stomach, submucosal invasion of the lesion, age older than 80 years, and post-ESD bleeding, though it was temporary in most cases.

Bone metastases from gastric cancer

International Nuclear Information System (INIS)

Seto, Mikito; Tonami, Norihisa; Koizumi, Kiyoshi; Sui, Osamu; Hisada, Kinichi

1983-01-01

We have studied bone scintigrams in 60 patients with gastric cancer. Of these 60 patients, bone metastases were found in 15 patients (25 %). There were no evidence of bone metastases in polypoid lesions, cancers of the antrum, carcinomas in situ, advanced cancers without invasion to serosa, cancer with N 0 or N 1 regional lymph node metastases, highly deferenciated adenocarcinomas and papillary adenocarcinomas. On the contrary, high rates of bone metastases were seen in cancers of the corpus, advanced cancers with invasion to neighbouring structures and tubular adenocarcinomas. Of these 15 patients with bone metastasis, 3 patients showed very similar clinical features and the findings of ''diffuse bone metastases on bone scintigrams.'' Cancer of the antrum showed high rates of liver metastases, while cancers of the corpus showed high rates of bone stastases. Sixty percent of the patients with bone metastases did not have liver metastases and there seemed to be no significant relationship between liver metastases and bone metastases. From these results we suppose that non-portal tract through the vertebral venous plexus instead of portal tract may be the other route of bone metastases from gastric cancer. (author)

Synchronization and anti-synchronization coexist in Chen-Lee chaotic systems

International Nuclear Information System (INIS)

Chen, J.-H.; Chen, H.-K.; Lin, Y.-K.

2009-01-01

This study demonstrates that synchronization and anti-synchronization can coexist in Chen-Lee chaotic systems by direct linear coupling. Based on Lyapunov's direct method, a linear controller was designed to assure that two different types of synchronization can simultaneously be achieved. Further, the hybrid projective synchronization of Chen-Lee chaotic systems was studied using a nonlinear control scheme. The nonlinear controller was designed according to the Lyapunov stability theory to guarantee the hybrid projective synchronization, including synchronization, anti-synchronization, and projective synchronization. Finally, numerical examples are presented in order to illustrate the proposed synchronization approach.

Apoptosis and cell proliferation in the development of gastric carcinomas: associations with c-myc and p53 protein expression.

Science.gov (United States)

Ishii, Hideaki H; Gobé, Glenda C; Pan, Wenshen; Yoneyama, Juichi; Ebihara, Yoshiro

2002-09-01

Patients with gastric carcinomas have a poor prognosis and low survival rates. The aim of the present paper was to characterize cellular and molecular properties to provide insight into aspects of tumor progression in early compared with advanced gastric cancers. One hundred and nine graded gastric carcinomas (early or advanced stage, undifferentiated or differentiated type) with paired non-cancer tissue were studied to define the correlation between apoptosis (morphology, terminal deoxyribonucleotidyl transferase-mediated dUTP-digoxigenin nick end-labeling), cell proliferation (Ki-67 expression, morphology) and expression and localization of two proteins frequently having altered expression in cancers, namely p53 and c-myc. Overall, apoptosis was lower in early stage, differentiated and undifferentiated gastric carcinomas compared with advanced-stage cancers. Cell proliferation was comparatively high in all stages. There was a high level of p53 positivity in all stages. Only the early- and advanced-stage undifferentiated cancers that were p53 positive had a significantly higher level of apoptosis (P cancers that had either c-myc or p53-positivity. The results indicate that low apoptosis and high cell proliferation combine to drive gastric cancer development. The molecular controls for high cell proliferation of the early stage undifferentiated gastric cancers involve overexpression of both p53 and c-myc. Overexpression of p53 may also control cancer development in that its expression is associated with higher levels of apoptosis in early and late-stage undifferentiated, cancers. Copyright 2002 Blackwell Publishing Asia Pty Ltd

Power quality improvement of single-phase photovoltaic systems through a robust synchronization method

DEFF Research Database (Denmark)

Hadjidemetriou, Lenos; Kyriakides, Elias; Yang, Yongheng

2014-01-01

An increasing amount of single-phase photovoltaic (PV) systems on the distribution network requires more advanced synchronization methods in order to meet the grid codes with respect to power quality and fault ride through capability. The response of the synchronization technique selected...... is crucial for the performance of PV inverters. In this paper, a new synchronization method with good dynamics and accurate response under highly distorted voltage is proposed. This method uses a Multi-Harmonic Decoupling Cell (MHDC), which cancels out the oscillations on the synchronization signals due...

A Novel Electrochemical Microfluidic Chip Combined with Multiple Biomarkers for Early Diagnosis of Gastric Cancer

Science.gov (United States)

Xie, Yao; Zhi, Xiao; Su, Haichuan; Wang, Kan; Yan, Zhen; He, Nongyue; Zhang, Jingpu; Chen, Di; Cui, Daxiang

2015-12-01

Early diagnosis is very important to improve the survival rate of patients with gastric cancer and to understand the biology of cancer. In order to meet the clinical demands for early diagnosis of gastric cancer, we developed a disposable easy-to-use electrochemical microfluidic chip combined with multiple antibodies against six kinds of biomarkers (carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9), Helicobacter pylori CagA protein (H.P.), P53oncoprotein (P53), pepsinogen I (PG I), and PG-II). The six kinds of biomarkers related to gastric cancer can be detected sensitively and synchronously in a short time. The specially designed three electrodes system enables cross-contamination to be avoided effectively. The linear ranges of detection of the electrochemical microfluidic chip were as follows: 0.37-90 ng mL-1 for CEA, 10.75-172 U mL-1 for CA19-9, 10-160 U L-1 for H.P., 35-560 ng mL-1 for P53, 37.5-600 ng mL-1 for PG I, and 2.5-80 ng mL-1for PG II. This method owns better sensitivity compared with enzyme-linked immunosorbent assay (ELISA) results of 394 specimens of gastric cancer sera. Furthermore, we established a multi-index prediction model based on the six kinds of biomarkers for predicting risk of gastric cancer. In conclusion, the electrochemical microfluidic chip for detecting multiple biomarkers has great potential in applications such as early screening of gastric cancer patients, and therapeutic evaluation, and real-time dynamic monitoring the progress of gastric cancer in near future.

Gastric volvulus with partial and complete gastric necrosis

Science.gov (United States)

Shukla, Ram Mohan; Mandal, Kartik Chandra; Maitra, Sujay; Ray, Amit; Sarkar, Ruchirendu; Mukhopadhyay, Biswanath; Bhattacharya, Malay

2014-01-01

Here, we report two interesting cases of gastric necrosis in acute gastric volvulus due to eventration of the diaphragm. Both the cases presented with a significant challenge and were managed successfully. The management of the cases is presented and relevant literature is discussed. To the best of our knowledge, this is the first case report of gastric volvulus with gastric necrosis requiring complete and partial gastrectomy in the available English literature. PMID:24604987

Gastric volvulus with partial and complete gastric necrosis

Directory of Open Access Journals (Sweden)

Ram Mohan Shukla

2014-01-01

Full Text Available Here, we report two interesting cases of gastric necrosis in acute gastric volvulus due to eventration of the diaphragm. Both the cases presented with a significant challenge and were managed successfully. The management of the cases is presented and relevant literature is discussed. To the best of our knowledge, this is the first case report of gastric volvulus with gastric necrosis requiring complete and partial gastrectomy in the available English literature.

Synchronous gastric and sebaceous cancers, a rare manifestation of MLH1-related Muir-Torre syndrome

Czech Academy of Sciences Publication Activity Database

Švec, Jiří; Schwarzová, L.; Janošíková, B.; Štekrová, J.; Mandys, V.; Kment, M.; Vodička, Pavel

2014-01-01

Roč. 7, č. 8 (2014), s. 5196-5202 ISSN 1936-2625 Grant - others:GA MŠk(CZ) Prvouk-P27/LF1/1; Univerzita Karlova(CZ) CZ.2.16/3.1.00/24024 Institutional support: RVO:68378041 Keywords : germline mutation * gastric cancer * MLH1 Subject RIV: EB - Genetics ; Molecular Biology Impact factor: 1.891, year: 2014

Trousseau's syndrome in a patient with advanced stage gastric cancer.

Science.gov (United States)

Chien, Tai-Long; Rau, Kung-Ming; Chung, Wen-Jung; Tai, Wei-Chen; Wang, Shih-Ho; Chiu, Yi-Chun; Wu, Keng-Liang; Chou, Yeh-Pin; Wu, Chia-Che; Chen, Yen-Hao; Chuah, Seng-Kee

2015-09-14

Patients with cancer are at high risk for thrombotic events, which are known collectively as Trousseau's syndrome. Herein, we report a 66-year-old male patient who was diagnosed with terminal stage gastric cancer and liver metastasis and who had an initial clinical presentation of upper gastrointestinal bleeding. Acute ischemia of the left lower leg that resulted in gangrenous changes occurred during admission. Subsequent angiography of the left lower limb was then performed. This procedure revealed arterial thrombosis of the left common iliac artery with extension to the external iliac artery, the left common iliac artery, the posterior tibial artery, and the peroneal artery, which were occluded by thrombi. Aspiration of the thrombi demonstrated that these were not tumor thrombi. The interesting aspect of our case was that the disease it presented as arterial thrombotic events, which may correlate with gastric adenocarcinoma. In summary, we suggested that the unexplained thrombotic events might be one of the initial presentations of occult malignancy and that thromboprophylaxis should always be considered.

Prolapsing Gastric Polyp Causing Intermittent Gastric Outlet Obstruction.

Science.gov (United States)

Kosai, Nik Ritza; Gendeh, Hardip Singh; Norfaezan, Abdul Rashid; Razman, Jamin; Sutton, Paul Anthony; Das, Srijit

2015-06-01

Gastric polyps are often an incidental finding on upper gastrointestinal endoscopy, with an incidence up to 5%. The majority of gastric polyps are asymptomatic, occurring secondary to inflammation. Prior reviews discussed Helicobacter pylori (H pylori)-associated singular gastric polyposis; however, we present a rare and unusual case of recurrent multiple benign gastric polyposis post H pylori eradication resulting in intermittent gastric outlet obstruction. A 70-year-old independent male, Chinese in ethnicity, with a background of diabetes mellitus, hypertension, and a simple renal cyst presented with a combination of melena, anemia, and intermittent vomiting of partially digested food after meals. Initial gastroscopy was positive for H pylori; thus he was treated with H pylori eradication and proton pump inhibitors. Serial gastroscopy demonstrated multiple sessile gastric antral polyps, the largest measuring 4 cm. Histopathologic examination confirmed a benign hyperplastic lesion. Computed tomography identified a pyloric mass with absent surrounding infiltration or metastasis. A distal gastrectomy was performed, whereby multiple small pyloric polyps were found, the largest prolapsing into the pyloric opening, thus explaining the intermittent nature of gastric outlet obstruction. Such polyps often develop from gastric ulcers and, if left untreated, may undergo neoplasia to form malignant cells. A distal gastrectomy was an effective choice of treatment, taking into account the polyp size, quantity, and potential for malignancy as opposed to an endoscopic approach, which may not guarantee a complete removal of safer margins and depth. Therefore, surgical excision is favorable for multiple large gastric polyps with risk of malignancy.

Helicobacter pylori Therapy for the Prevention of Metachronous Gastric Cancer.

Science.gov (United States)

Choi, Il Ju; Kook, Myeong-Cherl; Kim, Young-Il; Cho, Soo-Jeong; Lee, Jong Yeul; Kim, Chan Gyoo; Park, Boram; Nam, Byung-Ho

2018-03-22

Patients with early gastric cancers that are limited to gastric mucosa or submucosa usually have an advanced loss of mucosal glandular tissue (glandular atrophy) and are at high risk for subsequent (metachronous) development of new gastric cancer. The long-term effects of treatment to eradicate Helicobacter pylori on histologic improvement and the prevention of metachronous gastric cancer remain unclear. In this prospective, double-blind, placebo-controlled, randomized trial, we assigned 470 patients who had undergone endoscopic resection of early gastric cancer or high-grade adenoma to receive either H. pylori eradication therapy with antibiotics or placebo. Two primary outcomes were the incidence of metachronous gastric cancer detected on endoscopy performed at the 1-year follow-up or later and improvement from baseline in the grade of glandular atrophy in the gastric corpus lesser curvature at the 3-year follow-up. A total of 396 patients were included in the modified intention-to-treat analysis population (194 in the treatment group and 202 in placebo group). During a median follow-up of 5.9 years, metachronous gastric cancer developed in 14 patients (7.2%) in the treatment group and in 27 patients (13.4%) in the placebo group (hazard ratio in the treatment group, 0.50; 95% confidence interval, 0.26 to 0.94; P=0.03). Among the 327 patients in the subgroup that underwent histologic analysis, improvement from baseline in the atrophy grade at the gastric corpus lesser curvature was observed in 48.4% of the patients in the treatment group and in 15.0% of those in the placebo group (Pgastric cancer who received H. pylori treatment had lower rates of metachronous gastric cancer and more improvement from baseline in the grade of gastric corpus atrophy than patients who received placebo. (Funded by the National Cancer Center, South Korea; ClinicalTrials.gov number, NCT02407119 .).

The Synchronic Fallacy

DEFF Research Database (Denmark)

Hansen, Erik W.

, to exist, in order to underline the cognitive basis of man's (comprehension of) existence. A theory of history (existence) is set up on the basis of the traditional dualistic sign function, and the traditional sound-law concept and sound development are reinterpreted in terms of the theory's system...... of definitions. Historical linguistics ('change') is not dependent on an arbitrary synchronic theory. The two language universals polysemy and synonymy are reinterpreted and defined in accordance with the advanced definitions. Louis Hjelmslev's glossematic theory is the general horizon of the argument...

Gastric emptying in patients with gastric ulcer

Energy Technology Data Exchange (ETDEWEB)

Harding, L.K.; Anselmi, M.; Donovan, I.A.; Alexander-Williams, J. (Dudley Road Hospital, Birmingham (UK); Birmingham General Hospital (UK))

1982-06-01

The estimated volume of meal in the stomach 30 mins after sup(113m)In-DTPA administration was determined in patients with gastric ulcer and normal controls by 1) relating counts in the stomach to those in the whole field of view of the gamma camera and 2) aspirations. In the normal controls there was no significant difference between the two methods but in the gastric ulcer patients, the gamma camera method predicted significantly more meal in the stomach than was recovered by aspiration. It was suggested that the large low lying stomach found in gastric ulcer disease causes extensive overlap of the small bowel and invalidates measurements of gastric emptying made by a gamma camera.

Gastric emptying in patients with gastric ulcer

International Nuclear Information System (INIS)

Harding, L.K.; Anselmi, M.; Donovan, I.A.; Alexander-Williams, J.

1982-01-01

The estimated volume of meal in the stomach 30 mins after sup(113m)In-DTPA administration was determined in patients with gastric ulcer and normal controls by 1) relating counts in the stomach to those in the whole field of view of the gamma camera and 2) aspirations. In the normal controls there was no significant difference between the two methods but in the gastric ulcer patients, the gamma camera method predicted significantly more meal in the stomach than was recovered by aspiration. It was suggested that the large low lying stomach found in gastric ulcer disease causes extensive overlap of the small bowel and invalidates measurements of gastric emptying made by a gamma camera. (U.K.)

Anti-cancer effects of newly developed chemotherapeutic agent, glycoconjugated palladium (II) complex, against cisplatin-resistant gastric cancer cells

International Nuclear Information System (INIS)

Tanaka, Mamoru; Kamiya, Takeshi; Joh, Takashi; Kataoka, Hiromi; Yano, Shigenobu; Ohi, Hiromi; Kawamoto, Keisuke; Shibahara, Takashi; Mizoshita, Tsutomu; Mori, Yoshinori; Tanida, Satoshi

2013-01-01

Cisplatin (CDDP) is the most frequently used chemotherapeutic agent for various types of advanced cancer, including gastric cancer. However, almost all cancer cells acquire resistance against CDDP, and this phenomenon adversely affects prognosis. Thus, new chemotherapeutic agents that can overcome the CDDP-resistant cancer cells will improve the survival of advanced cancer patients. We synthesized new glycoconjugated platinum (II) and palladium (II) complexes, [PtCl 2 (L)] and [PdCl 2 (L)]. CDDP-resistant gastric cancer cell lines were established by continuous exposure to CDDP, and gene expression in the CDDP-resistant gastric cancer cells was analyzed. The cytotoxicity and apoptosis induced by [PtCl 2 (L)] and [PdCl 2 (L)] in CDDP-sensitive and CDDP-resistant gastric cancer cells were evaluated. DNA double-strand breaks by drugs were assessed by evaluating phosphorylated histone H2AX. Xenograft tumor mouse models were established and antitumor effects were also examined in vivo. CDDP-resistant gastric cancer cells exhibit ABCB1 and CDKN2A gene up-regulation, as compared with CDDP-sensitive gastric cancer cells. In the analyses of CDDP-resistant gastric cancer cells, [PdCl 2 (L)] overcame cross-resistance to CDDP in vitro and in vivo. [PdCl 2 (L)] induced DNA double-strand breaks. These results indicate that [PdCl 2 (L)] is a potent chemotherapeutic agent for CDDP-resistant gastric cancer and may have clinical applications

Diagnosis and evaluation of gastric cancer by positron emission tomography

Science.gov (United States)

Wu, Chen-Xi; Zhu, Zhao-Hui

2014-01-01

Gastric cancer is the second leading cause of cancer mortality worldwide. The diagnosis of gastric cancer has been significantly improved with the broad availability of gastrointestinal endoscopy. Effective technologies for accurate staging and quantitative evaluation are still in demand to merit reasonable treatment and better prognosis for the patients presented with advanced disease. Preoperative staging using conventional imaging tools, such as computed tomography (CT) and endoscopic ultrasonography, is inadequate. Positron emission tomography (PET), using 18F-fluorodeoxyglucose (FDG) as a tracer and integrating CT for anatomic localization, holds a promise to detect unsuspected metastasis and has been extensively used in a variety of malignancies. However, the value of FDG PET/CT in diagnosis and evaluation of gastric cancer is still controversial. This article reviews the current literature in diagnosis, staging, response evaluation, and relapse monitoring of gastric cancer, and discusses the current understanding, improvement, and future prospects in this area. PMID:24782610

Gastric cancer-derived MSC-secreted PDGF-DD promotes gastric cancer progression.

Science.gov (United States)

Huang, Feng; Wang, Mei; Yang, Tingting; Cai, Jie; Zhang, Qiang; Sun, Zixuan; Wu, Xiaodan; Zhang, Xu; Zhu, Wei; Qian, Hui; Xu, Wenrong

2014-11-01

This study was designed to investigate the role of PDGF-DD secreted by gastric cancer-derived mesenchymal stem cells (GC-MSCs) in human gastric cancer progression. Gastric cancer cells were indirectly co-cultured with GC-MSCs in a transwell system. The growth and migration of gastric cancer cells were evaluated by cell colony formation assay and transwell migration assay, respectively. The production of PDGF-DD in GC-MSCs was determined by using Luminex and ELISA. Neutralization of PDGFR-β by su16f and siRNA interference of PDGF-DD in GC-MSCs was used to demonstrate the role of PDGF-DD produced by GC-MSCs in gastric cancer progression. GC-MSC conditioned medium promoted gastric cancer cell proliferation and migration in vitro and in vivo. Co-culture with GC-MSCs increased the phosphorylation of PDGFR-β in SGC-7901 cells. Neutralization of PDGFR-β by su16f blocked the promoting role of GC-MSC conditioned medium in gastric cancer cell proliferation and migration. Recombinant PDGF-DD duplicated the effects of GC-MSC conditioned medium on gastric cancer cells. Knockdown of PDGF-DD in GC-MSCs abolished its effects on gastric cancer cells in vitro and in vivo. PDGF-DD secreted by GC-MSCs is capable of promoting gastric cancer cell progression in vitro and in vivo. Targeting the PDGF-DD/PDGFR-β interaction between MSCs and gastric cancer cells may represent a novel strategy for gastric cancer therapy.

Diversity of the Gastric Microbiota in Thoroughbred Racehorses Having Gastric Ulcer.

Science.gov (United States)

Dong, Hee-Jin; Ho, Hungwui; Hwang, Hyeshin; Kim, Yongbaek; Han, Janet; Lee, Inhyung; Cho, Seongbeom

2016-04-28

Equine gastric ulcer syndrome is one of the most frequently reported diseases in thoroughbred racehorses. Although several risk factors for the development of gastric ulcers have been widely studied, investigation of microbiological factors has been limited. In this study, the presence of Helicobacter spp. and the gastric microbial communities of thoroughbred racehorses having mild to severe gastric ulcers were investigated. Although Helicobacter spp. were not detected using culture and PCR techniques from 52 gastric biopsies and 52 fecal samples, the genomic sequences of H. pylori and H. ganmani were detected using nextgeneration sequencing techniques from 2 out of 10 representative gastric samples. The gastric microbiota of horses was mainly composed of Firmicutes (50.0%), Proteobacteria (18.7%), Bacteroidetes (14.4%), and Actinobacteria (9.7%), but the proportion of each phylum varied among samples. There was no major difference in microbial composition among samples having mild to severe gastric ulcers. Using phylogenetic analysis, three distinct clusters were observed, and one cluster differed from the other two clusters in the frequency of feeding, amount of water consumption, and type of bedding. To the best of our knowledge, this is the first study to investigate the gastric microbiota of thoroughbred racehorses having gastric ulcer and to evaluate the microbial diversity in relation to the severity of gastric ulcer and management factors. This study is important for further exploration of the gastric microbiota in racehorses and is ultimately applicable to improving animal and human health.

Gastric cancer

International Nuclear Information System (INIS)

Douglass, H.O.

1988-01-01

This book contains 10 selections. Some of the titles are: Radiation therapy for gastric cancer; Experimental stomach cancer: Drug selection based on in vitro testing; Western surgical adjuvant trials in gastric cancers: Lessons from current trials to be applied in the future; and Chemotherapy of gastric cancer

Incidence trends and mortality rates of gastric cancer in Israel.

Science.gov (United States)

Lavy, Ron; Kapiev, Andronik; Poluksht, Natan; Halevy, Ariel; Keinan-Boker, Lital

2013-04-01

Gastric cancer is the fourth most common malignancy worldwide. The incidence trends and mortality rates of gastric cancer in Israel have not been studied in depth. The aim of our study was to try and investigate the aforementioned issues in Israel in different ethnic groups. This retrospective study is based on the data of The Israel National Cancer Registry and The Central Bureau of Statistics. Published data from these two institutes were collected, summarized, and analyzed in this study. Around 650 new cases of gastric cancer are diagnosed yearly in Israel. While we noticed a decline during the period 1990-2007 in the incidence in the Jewish population (13.6-8.9 and 6.75-5.42 cases per 100,000 in Jewish men and women, respectively), an increase in the Arab population was noticed (7.7-10.2 and 3.7-4.2 cases per 100,000 in men and women, respectively). Age-adjusted mortality rates per 10,000 cases of gastric cancer decreased significantly, from 7.21 in 1990 to 5.46 in 2007, in the total population. The 5-year relative survival showed a slight increase for both men and women. There is a difference in the incidence and outcome of gastric cancer between the Jewish and Arab populations in Israel. The grim prognosis of gastric cancer patients in Israel is probably due to the advanced stage at which gastric cancer is diagnosed in Israel.

Gastroscopic treatment of gastric band penetrating the gastric wall

DEFF Research Database (Denmark)

Jess, Per; Fonnest, G

1999-01-01

Gastric wall penetration of a gastric band after operation for morbid obesity is a well known late complication. The treatment is usually reoperation. In this case report we show that a band penetrating the gastric wall can be successfully treated by gastroscopic operation. This technique is more...

Gastric diverticulum causing gastric outlet obstruction in the setting of duodenal atresia

Directory of Open Access Journals (Sweden)

Devashis Mukherjee

2018-04-01

Full Text Available Duodenal obstruction due to duodenal atresia occurs in 1 in 10,000 live births and is the most common type of intestinal obstruction in neonates [1–3]. Gastric outlet obstruction in the newborn period from causes other than hypertrophic pyloric stenosis is very uncommon [3]. Potential etiologies include gastric volvulus, antral web, and duplication cysts. Gastric diverticula in the infant is even more rare, with only a few case reports published, and only one describes a gastric diverticulum in the presence of a duodenal atresia [4–8]. In this report, we describe the first case of a gastric outlet obstruction due to a gastric diverticulum in the presence of duodenal atresia. Keywords: Duodenal atresia, Gastric diverticulum, Gastric outlet obstruction

Gastric pseudolymphoma

International Nuclear Information System (INIS)

Blum, U.; Hellerich, U.; Bodendoerfer, G.; Wimmer, B.; Ruf, G.; Freiburg Univ.; Freiburg Univ.

1989-01-01

Gastric pseudolymphoma is an uncommon benign lesion which poses a difficult problem in diagnosis and management. Lymphoid hyperplasia of the stomach, however, may occasionally precede true gastric lymphoma. Endoscopic, radiologic and pathological findings are not generally helpful in establishing the diagnosis preoperatively. Benign gastric lymphoid hyperplasia could be mistaken radiologically for ulcerated gastric carcinoma and pathologically for malignant lymphoma. Recognition of this condition is important to prevent unnecessary treatment by surgery or radiotherapy. About 140 case reports have been published to date. This paper describes the cases of two further patients. (orig.) [de

Gastrointestinal Stromal Tumour with Synchronous Bone Metastases: A Case Report and Literature Review

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Philippe Rochigneux

2017-01-01

Full Text Available Gastrointestinal stromal tumours (GISTs are mesenchymal tumours of the digestive tract, derived from Cajal interstitial cells. Bone metastases are very rare, and there is no consensus regarding their treatment. Here, we present the unusual case of a 66-year-old man with a gastric GIST with synchronous bone and liver metastases, fully documented at the pathological and molecular levels with a KIT exon 11 mutation. After 9 months of imatinib, the scanner showed a 33% partial response of target lesions. We also review the literature and describe the characteristics, treatment, and outcome of all cases previously reported.

Gastrointestinal Stromal Tumour with Synchronous Bone Metastases: A Case Report and Literature Review.

Science.gov (United States)

Rochigneux, Philippe; Mescam-Mancini, Lénaig; Perrot, Delphine; Bories, Erwan; Moureau-Zabotto, Laurence; Sarran, Anthony; Guiramand, Jérôme; Bertucci, François

2017-01-01

Gastrointestinal stromal tumours (GISTs) are mesenchymal tumours of the digestive tract, derived from Cajal interstitial cells. Bone metastases are very rare, and there is no consensus regarding their treatment. Here, we present the unusual case of a 66-year-old man with a gastric GIST with synchronous bone and liver metastases, fully documented at the pathological and molecular levels with a KIT exon 11 mutation. After 9 months of imatinib, the scanner showed a 33% partial response of target lesions. We also review the literature and describe the characteristics, treatment, and outcome of all cases previously reported.

Diagnostic value of triphasic incremental helical CT in early and progressive gastric carcinoma

International Nuclear Information System (INIS)

Gao Jianbo; Yan Xuehua; Li Mengtai; Guo Hua; Chen Xuejun; Guan Sheng; Zhang Xiefu; Li Shuxin; Yang Xiaopeng

2001-01-01

Objective: To investigate helical CT enhancement characteristics of gastric carcinoma, and the diagnostic value and preoperative staging of gastric carcinoma with triphasic incremental helical CT of the stomach with water-filling method. Methods: Both double-contrast barium examination and triphasic incremental helical CT of the stomach with water-filling method were performed in 46 patients with gastric carcinoma. Results: (1) Among these patients, normal gastric wall exhibited one layered structure in 18 patients, two or three layered structure in 28 patients in the arterial and portal venous phase. (2) Two cases of early stomach cancer showed marked enhancement in the arterial and portal venous phase and obvious attenuation of enhancement in the equilibrium phase. On the contrary, 32 of the 44 advanced gastric carcinoma was showed marked enhancement in the venous phase compared with the arterial phase ( t = 4.226, P < 0.05). (3) The total accuracy of triphasic incremental helical CT in determining TNM-staging was 81.0%. Conclusion: Different types of gastric carcinoma have different enhancement features. Triphases incremental helical CT is more accurate than conventional CT in the preoperative staging of gastric carcinoma

Helicobacter pylori infection, glandular atrophy and intestinal metaplasia in superficial gastritis, gastric erosion, erosive gastritis, gastric ulcer and early gastric cancer

OpenAIRE

Zhang, Chuan; Yamada, Nobutaka; Wu, Yun-Lin; Wen, Min; Matsuhisa, Takeshi; Matsukura, Norio

2005-01-01

AIM: To evaluate the histological features of gastric mucosa, including Helicobacter pylori infection in patients with early gastric cancer and endoscopically found superficial gastritis, gastric erosion, erosive gastritis, gastric ulcer.

Synchronization of metronomes

Science.gov (United States)

Pantaleone, James

2002-10-01

Synchronization is a common phenomenon in physical and biological systems. We examine the synchronization of two (and more) metronomes placed on a freely moving base. The small motion of the base couples the pendulums causing synchronization. The synchronization is generally in-phase, with antiphase synchronization occurring only under special conditions. The metronome system provides a mechanical realization of the popular Kuramoto model for synchronization of biological oscillators, and is excellent for classroom demonstrations and an undergraduate physics lab.

Gastric microbiota and carcinogenesis: the role of non-Helicobacter pylori bacteria: a systematic review

Directory of Open Access Journals (Sweden)

Emanuel Dias-Jácome

Full Text Available Background and aim: Helicobacter pylori is the strongest risk factor for gastric cancer. However, recent advances in DNA sequencing technology have revealed a complex microbial community in the stomach that could also contribute to the development of gastric cancer. The aim of this study was to present recent scientific evidence regarding the role of non-Helicobacter pylori bacteria in gastric carcinogenesis. Methods: A systematic review of original articles published in PubMed in the last ten years related to gastric microbiota and gastric cancer in humans was performed. Results: Thirteen original articles were included. The constitution of gastric microbiota appears to be significantly affected by gastric cancer and premalignant lesions. In fact, differences in gastric microbiota have been documented, depending on Helicobacter pylori status and gastric conditions, such as non-atrophic gastritis, intestinal metaplasia and cancer. Gastric carcinogenesis can be associated with an increase in many bacteria (such as Lactobacillus coleohominis, Klebsiella pneumoniae or Acinetobacter baumannii as well as decrease in others (such as Porphyromonas spp, Neisseria spp, Prevotella pallens or Streptococcus sinensis. However, there is no conclusive data that confirms if these changes in microbiota are a cause or consequence of the process of carcinogenesis. Conclusions: Even though there is limited evidence in humans, microbiota differences between normal individuals, pre-malignant lesions and gastric cancer could suggest a progressive shift in the constitution of gastric microbiota in carcinogenesis, possibly resulting from a complex cross-talk between gastric microbiota and Helicobacter pylori. However, further studies are needed to elucidate the specific role (if any of different microorganisms.

Gastric microbiota and carcinogenesis: the role of non-Helicobacter pylori bacteria - A systematic review.

Science.gov (United States)

Dias-Jácome, Emanuel; Libânio, Diogo; Borges-Canha, Marta; Galaghar, Ana; Pimentel-Nunes, Pedro

2016-09-01

Helicobacter pylori is the strongest risk factor for gastric cancer. However, recent advances in DNA sequencing technology have revealed a complex microbial community in the stomach that could also contribute to the development of gastric cancer. The aim of this study was to present recent scientific evidence regarding the role of non-Helicobacter pylori bacteria in gastric carcinogenesis. A systematic review of original articles published in PubMed in the last ten years related to gastric microbiota and gastric cancer in humans was performed. Thirteen original articles were included. The constitution of gastric microbiota appears to be significantly affected by gastric cancer and premalignant lesions. In fact, differences in gastric microbiota have been documented, depending on Helicobacter pylori status and gastric conditions, such as non-atrophic gastritis, intestinal metaplasia and cancer. Gastric carcinogenesis can be associated with an increase in many bacteria (such as Lactobacillus coleohominis, Klebsiella pneumoniae or Acinetobacter baumannii) as well as decrease in others (such as Porphyromonas spp, Neisseria spp, Prevotella pallens or Streptococcus sinensis). However, there is no conclusive data that confirms if these changes in microbiota are a cause or consequence of the process of carcinogenesis. Even though there is limited evidence in humans, microbiota differences between normal individuals, pre-malignant lesions and gastric cancer could suggest a progressive shift in the constitution of gastric microbiota in carcinogenesis, possibly resulting from a complex cross-talk between gastric microbiota and Helicobacter pylori. However, further studies are needed to elucidate the specific role (if any) of different microorganisms.

Psuedotumoral gastric varices

International Nuclear Information System (INIS)

Yoon, Yong Kyu; Kim, Choon Won

1974-01-01

The roentgenographic recognition of gastric varices often is difficult, even when there is a history of liver disease or splenomegaly without demonstrable esophageal varices. An apparant polypoid filling defect with exaggerated mucosal folds in proximal portion of the gastric body and funds on upper GI series, accompanied by hematemesis and splenomegly should suggest the presence of pseudotumoral gastric varices. We have an experience a case of polypoid filling defects in gastric fundus of psudotumoral gastric varices of 49 years old Korean woman, which was diagnosed by surgical and histopathological findings

Synchronization and Collective Dynamics of Flagella and Cilia as Hydrodynamically Coupled Oscillators

Science.gov (United States)

Uchida, Nariya; Golestanian, Ramin; Bennett, Rachel R.

2017-10-01

Cooperative motion of flagella and cilia faciliates swimming of microorganisms and material transport in the body of multicellular organisms. Using minimal models, we address the roles of hydrodynamic interaction in synchronization and collective dynamics of flagella and cilia. Collective synchronization of bacterial flagella is studied with a model of bacterial carpets. Cilia and eukaryotic flagella are characterized by periodic modulation of their driving forces, which produces various patterns of two-body synchronization and metachronal waves. Long-range nature of the interaction introduces novel features in the dynamics of these model systems. The flagella of a swimmer synchronize also by a viscous drag force mediated through the swimmer's body. Recent advance in experimental studies of the collective dynamics of flagella, cilia and related artificial systems are summarized.

[AFP-producing gastric cancer and hepatoid gastric cancer].

Science.gov (United States)

Wang, Y K; Zhang, X T

2017-11-23

AFP-producing gastric cancer(AFPGC) and hepatoid adenocarcinoma of the stomach (HAS) are two special subtypes of gastric cancer. There are both correlation and difference between them. AFPGC is usually identified as primary gastric cancer with serum AFP level more than 20 ng/ml or showed AFP positive staining by immunohistochemistry. The diagnosis of HAS is mainly dependent on the pathological character of hepatocellular carcinoma-like differentiation of gastric cancer. The morbidity of AFPGC and HAS are rather low, especially the incidence of HAS is about 1%. The prognoses of these two subtypes are poorer than that of common gastric adenocarcinoma, due to a high incidence rate of liver metastasis and lymph node metastasis. With the development of next-generation sequencing and other genomic technologies, gastric cancers, including these two rare subtypes, are now being investigated in more detail at the molecular level. Treatment remains the biggest challenge, early diagnosis and radical resection can dramatically improve patients'prognosis. Monitoring serum AFP and abdominal imaging examination during follow-up is important for early detection of liver metastasis. In combination with local treatment methods such as transarterial chemoembolization and radiofrequency ablation of liver may further extend patients'survival time. Targeted therapy owes a great potential value in the future.

Robust Timing Synchronization in Aeronautical Mobile Communication Systems

Science.gov (United States)

Xiong, Fu-Qin; Pinchak, Stanley

2004-01-01

the rankings of the Gardner Zero-Crossing Detector and both versions of the Early-Late Gate Synchronizer. The least robust models are the high and low-sample-rate Sliding Window Synchronizers. Consequently, the recommended replacement synchronizer for NASA's Advanced Air Transportation Technologies mobile aeronautical communications system is the high-sample-rate Modified Sliding Window Synchronizer. By incorporating this synchronizer into their system, NASA can be assured that their system will be operational in extremely adverse conditions. The quick convergence time of the MSWS should allow the use of high-level protocols. However, if NASA feels that reduced system complexity is the most important aspect of their replacement synchronizer, the Gardner Zero-Crossing Detector would be the best choice.

Gastric stem cells and gastric cancer stem cells

OpenAIRE

Han, Myoung-Eun; Oh, Sae-Ock

2013-01-01

The gastric epithelium is continuously regenerated by gastric stem cells, which give rise to various kinds of daughter cells, including parietal cells, chief cells, surface mucous cells, mucous neck cells, and enteroendocrine cells. The self-renewal and differentiation of gastric stem cells need delicate regulation to maintain the normal physiology of the stomach. Recently, it was hypothesized that cancer stem cells drive the cancer growth and metastasis. In contrast to conventional clonal ev...

Gastric inhibitory polypeptide does not inhibit gastric emptying in humans

DEFF Research Database (Denmark)

Meier, Juris J; Goetze, Oliver; Anstipp, Jens

2004-01-01

) = 0.15, P = 0.15 for intact GIP; r(2) = 0.21, P = 0.086 for total GIP). We conclude that gastric emptying does not appear to be influenced by GIP. The secretion of GIP after meal ingestion is not suppressed by its exogenous administration. The lack of effect of GIP on gastric emptying underlines......The insulinotropic gut hormone gastric inhibitory polypeptide (GIP) has been demonstrated to inhibit gastric acid secretion and was proposed to possess "enterogastrone" activity. GIP effects on gastric emptying have not yet been studied. Fifteen healthy male volunteers (23.9 +/- 3.3 yr, body mass....... Gastric emptying was calculated from the (13)CO(2) exhalation rates in breath samples collected over 360 min. Venous blood was drawn in 30-min intervals for the determination of glucose, insulin, C-peptide, and GIP (total and intact). Statistical calculations were made by use of repeated-measures ANOVA...

Successful Gastric Volvulus Reduction and Gastropexy Using a Dual Endoscope Technique

Directory of Open Access Journals (Sweden)

Laith H. Jamil

2014-01-01

Full Text Available Gastric volvulus is a life threatening condition characterized by an abnormal rotation of the stomach around an axis. Although the first line treatment of this disorder is surgical, we report here a case of gastric volvulus that was endoscopically managed using a novel strategy. An 83-year-old female with a history of pancreatic cancer status postpylorus-preserving Whipple procedure presented with a cecal volvulus requiring right hemicolectomy. Postoperative imaging included a CT scan and upper GI series that showed a gastric volvulus with the antrum located above the diaphragm. An upper endoscopy was advanced through the pylorus into the duodenum and left in this position to keep the stomach under the diaphragm. A second pediatric endoscope was advanced alongside and used to complete percutaneous endoscopic gastrostomy (PEG placement for anterior gastropexy. The patient’s volvulus resolved and there were no complications. From our review of the literature, the dual endoscopic technique employed here has not been previously described. Patients who are poor surgical candidates or those who do not require emergent surgery can possibly benefit the most from similar minimally invasive endoscopic procedures as described here.

Hereditary Diffuse Gastric Cancer

Science.gov (United States)

... Hereditary Diffuse Gastric Cancer Request Permissions Hereditary Diffuse Gastric Cancer Approved by the Cancer.Net Editorial Board , 10/2017 What is hereditary diffuse gastric cancer? Hereditary diffuse gastric cancer (HDGC) is a rare ...

Adjuvant chemo radiation in completely resected gastric cancer: experience of the National Cancer Institute of Chile

International Nuclear Information System (INIS)

Isa O, Nicolas; Russo N, Moises; Lopez V, Hernan

2014-01-01

Background: Gastric cancer is one of the most lethal tumors in the Chilean population. Aim: To report the results of adjuvant chemoradiotherapy in advanced gastric cancer. Material and Methods: Review of medical records of patients with locoregionally advanced gastric cancer, subjected to a curative resection and treated with adjuvant chemoradiotherapy. The treatment was based on he INT 0116/SSWOG protocol, which includes 5-fluorouracil as a single agent. Patients were followed for a median of 58 months. Results: The records of 168 patients (99 men) treated between 2004 nd 2011, were reviewed. Median survival as 41 months. Median lapses between surgery and onset of chemo and radiotherapy were 12 and 17 weeks, respectively. Overall three and five years survival was 53 and 41%, respectively. On multivariate analysis the factors associated with a lower survival were an antral location of the tumor, presence of signet ring cells and more than 5 involved lymph nodes. Conclusions: Three and five years survival of gastric cancer patients subjected to adjuvant chemoradiotherapy was 53 and 41% respectively.These results are similar to those reported elsewhere

Special Section on Synchronization in Nonlinear Science and Engineering

Science.gov (United States)

Ikeguchi, Tohru; Tokuda, Isao

Synchronization is a ubiquitous phenomenon of coupled nonlinear oscillators, commonly found in physics, engineering, biology, and other diverse disciplines. It has a long research history back to Christiaan Huygens, who discovered synchronized motion of two pendulum clocks in 1673. It is very easy to observe synchronization in our daily life: e.g., metronomes, candle fires, pet-bottle oscillators, saltwater oscillators, and so on(See, for example, experimental movies at http://www.youtube.com/user/IkeguchiLab?feature=watch). For the last few decades, significant development has been made from both theories and experiments on synchronization of coupled limit cycle oscillators as well as coupled chaotic oscillators. Applications have been also developed to communication technologies, controlling techniques, and data analysis. Combined with the idea from complex network theory, neuroscience, and systems biology, the research speed of synchronization has been even accelerated. This Special Section of NOLTA is primarily dedicated to the recent advanced development of basics and applications of synchronization in science and engineering. A number of qualified works is included, ranging from experimental study on synchronization of Huygens' system, analog circuits, and singing voice to applied study of synchronization in communication networks. One invited paper is devoted to comprehensive reviews on generalized synchronization of chaotic oscillators. On behalf of the editorial committee of the special section, the guest editors would like to express their sincere thanks to all the authors for their excellent contributions. In particular, they are grateful to Prof. Dr. Ulrich Parlitz for contributing his distinguished review article. They would also like to thank the reviewers and the members of the guest editorial committee, especially Prof. Hiroo Sekiya of Chiba University and the editorial staffs of the NOLTA journal, for their supports on publishing this Special

Changes in Gut Hormones After Roux en Y Gastric bypass, Sleeve Gastrectomy, and Adjustable Gastric Banding

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Miroslav Ilić

2015-12-01

Full Text Available The obesity epidemic has burdened healthcare systems worldwide. Bariatric surgery is currently the most effective method for long-term weight loss in obese adults, but the exact mechanism of weight loss is poorly understood. Bariatric procedures were initially classified by their presumed mechanism of action into restrictive, malabsoptive, or mixed procedures; however, due to recent advancements in the field of neuroendocrinology, hormones are increasing being recognized as important regulators of satiation, hunger, and energy expenditure. Studies examining changes in gut hormones following bariatric surgery have yielded conflicting results and the relationship between these hormones and weight loss is nothing but clear. This review will summarize the effect of Roux en Y gastric bypass, sleeve gastrectomy and adjustable gastric banding on various gut hormones including ghrelin, cholecystokinin, glucagon-like polypeptide-1, peptide YY3, and pancreatic polypeptide. Furthermore, the relationship between these hormones and weight loss will be examined.

Control and synchronization of chaos in nonlinear systems and prospects for application. Pt.1

International Nuclear Information System (INIS)

Fang Jinqing

1996-01-01

Main progress in one challenging subject of nonlinear science--control and synchronization of chaos in nonlinear systems are reviewed systematically, including recent advance in controlling and synchronizing hyperchaos. Current methods and principles of schemes of chaos control and synchronization are classified and summarized in detail. Potential prospects for application are commented both in theory and experiment. The whole review is divided into two parts. In the first one, subject on the mechanism and method of chaos control are analyzed and discussed extensively. In the second one, the synchronization of non-chaos, chaos, hyperchaos and their control and application are described. Main trends for development of the subject is mentioned. (101 refs.)

Gastric Sleeve Surgery

Science.gov (United States)

... Videos for Educators Search English Español Gastric Sleeve Surgery KidsHealth / For Teens / Gastric Sleeve Surgery What's in ... or buying healthy food ) Preparing for Gastric Sleeve Surgery Preparing for this major operation takes months of ...

Surgical resection of late solitary locoregional gastric cancer recurrence in stomach bed.

Science.gov (United States)

Watanabe, Masanori; Suzuki, Hideyuki; Maejima, Kentaro; Komine, Osamu; Mizutani, Satoshi; Yoshino, Masanori; Bo, Hideki; Kitayama, Yasuhiko; Uchida, Eiji

2012-07-01

Late-onset and solitary recurrence of gastric signet ring cell (SRC) carcinoma is rare. We report a successful surgical resection of late solitary locoregional recurrence after curative gastrectomy for gastric SRC carcinoma. The patient underwent total gastrectomy for advanced gastric carcinoma at age 52. Seven years after the primary operation, he visited us again with sudden onset of abdominal pain and vomiting. We finally decided to perform an operation, based on a diagnosis of colon obstruction due to the recurrence of gastric cancer by clinical findings and instrumental examinations. The laparotomic intra-abdominal findings showed that the recurrent tumor existed in the region surrounded by the left diaphragm, colon of splenic flexure, and pancreas tail. There was no evidence of peritoneal dissemination, and peritoneal lavage fluid cytology was negative. We performed complete resection of the recurrent tumor with partial colectomy, distal pancreatectomy, and partial diaphragmectomy. Histological examination of the resected specimen revealed SRC carcinoma, identical in appearance to the previously resected gastric cancer. We confirmed that the intra-abdominal tumor was a locoregional gastric cancer recurrence in the stomach bed. The patient showed a long-term survival of 27 months after the second operation. In the absence of effective alternative treatment for recurrent gastric carcinoma, surgical options should be pursued, especially for late and solitary recurrence.

A case of right-sided Bochdalek hernia incidentally diagnosed in a gastric cancer patient.

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Kikuchi, Satoru; Nishizaki, Masahiko; Kuroda, Shinji; Kagawa, Shunsuke; Fujiwara, Toshiyoshi

2016-06-01

Bochdalek hernia (BH) is generally congenital, presenting with respiratory distress. However, this pathology is rarely detected in adults. Some adult cases of BH present with symptoms attributed to the hernia, but incidental detection of BH is increasing among asymptomatic adults due to advances in imaging modalities. This report presents the management of incidental BH patients detected in the preoperative period of gastric cancer. An asymptomatic 76-year-old woman was diagnosed with advanced gastric cancer during follow-up after radiotherapy for uterine cervical cancer. Computed tomography (CT) was performed to exclude metastatic gastric cancer, incidentally detecting right-sided BH. We planned distal gastrectomy with lymph node dissection for gastric cancer and simultaneous repair of BH using a laparoscopic approach. We performed laparoscopic gastrectomy for gastric cancer and investigated the right-sided BH to assess whether repair during surgery was warranted. Herniation of the liver into the right hemithorax was observed, but was followed-up without surgical repair because the right hepatic lobe was adherent to the remnant right anterior hemidiaphragm and covered the huge defect in the right hemidiaphragm. No intra- or postoperative pneumothorax was observed during pneumoperitoneum. Regardless of symptoms, repair of adult BH is generally recommended to prevent visceral incarceration. However, BH in asymptomatic adults appears to be more common than previously reported in the literature. Surgeons need to consider the management of incidental BH encountered during thoracic or abdominal surgery.

Effect of dopamine on bethanechol-stimulated gastric mucosal blood flow and gastric acid secretion in dogs with gastric fistula

DEFF Research Database (Denmark)

Hovendal, C P; Bech, K

1982-01-01

of gastric mucosal blood flow, whereas stimulation of beta, muscarinic, and 'gastrinergic' receptors mainly occurs indirectly via changes in parietal cell function. The main effect of dopamine seems to be on gastric motility, whereas the effect on gastric acid secretion is of minor importance.......The aim of the present study was to investigate the effect of Dopamine on bethanechol-stimulated gastric acid secretion and mucosal blood flow. dopamine was used alone and in conjunction with selective blockade of the alpha, beta, and dopaminergic receptors. An increasing and dose......-dependent stimulation of gastric acid secretion was found for dopamine at 1, 5, and 10 micrograms/kg/min. A significant inhibition of gastric acid secretion was found with the highest dose of dopamine (40 micrograms/kg/min). the stimulatory effect seems to be mediated by more than one receptor, whereas the inhibition...

Autoimmunity and Gastric Cancer

Science.gov (United States)

Bizzaro, Nicola; Antico, Antonio; Villalta, Danilo

2018-01-01

Alterations in the immune response of patients with autoimmune diseases may predispose to malignancies, and a link between chronic autoimmune gastritis and gastric cancer has been reported in many studies. Intestinal metaplasia with dysplasia of the gastric corpus-fundus mucosa and hyperplasia of chromaffin cells, which are typical features of late-stage autoimmune gastritis, are considered precursor lesions. Autoimmune gastritis has been associated with the development of two types of gastric neoplasms: intestinal type and type I gastric carcinoid. Here, we review the association of autoimmune gastritis with gastric cancer and other autoimmune features present in gastric neoplasms. PMID:29373557

Dermatologia comparativa: paquidermatoglifia adquirida associada a carcinoma gástrico avançado Comparative Dermatology: acquired pachydermatoglyphia associated with advanced gastric carcinoma

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Jonas Ribas

2007-12-01

Full Text Available Demonstra-se um caso de paquidermatoglifia adquirida em paciente do sexo masculino, de 67 anos, associada a carcinoma gástrico avançado. Trata-se de síndrome paraneoplásica com manifestações cutâneas que podem ser comparadas à superfície rugosa do estômago bovino.We report the case of a 67-year-old man suffering from acquired pachydermatoglyphia associated with advanced gastric carcinoma. This is a paraneoplasic syndrome with skin manifestations that may be compared to the wrinkled surface of the bovine stomach.

Primary Closure versus Gastric Resection for Perforated Gastric

African Journals Online (AJOL)

Perforated gastric ulcer is one of the most life‑threatening complications of peptic ulcer disease with high .... tubes were removed and oral nutrition resumed. The .... surgical approach for perforated gastric cancer: One‑stage vs. two‑stage ...

Successful Emergency Endoscopic Treatment of Gastric Outlet Obstruction due to Gastric Bezoar with Gastric Pneumatosis

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Hirokazu Honda

2017-11-01

Full Text Available Gastric bezoars are rare and are usually found incidentally. They can sometimes cause severe complications, including gastric outlet obstruction (GOO or gastric pneumatosis (GP. In cases of bezoars with GP, the optimal treatment strategy has not yet been defined. We report the case of an 89-year-old man with a history of type 2 diabetes mellitus and hypertension who presented to our emergency room with a 2-day history of upper abdominal pain, nausea, and vomiting. Physical examination revealed no rebound tenderness or guarding, and laboratory values revealed no elevation of the serum lactate level. A computed tomography scan of the abdomen showed a dilated stomach with significant fluid collection, GOO, and GP due to a 42 × 40 mm mass composed of fat and air densities. Emergency esophagogastroduodenoscopy revealed two gastric bezoars, one of which was incarcerated in the pyloric region. We used various endoscopic devices to successfully break and remove the bezoars. We used endoscopic forceps and a water jet followed by an endoscopic snare to cut the bezoars into several pieces and remove them with an endoscopic net. Follow-up endoscopy confirmed that the gastric bezoar had been completely removed. As seen in this case, endoscopic treatment may be a safe and viable option for the extraction of gastric bezoars presenting with GOO and GP.

Successful Emergency Endoscopic Treatment of Gastric Outlet Obstruction due to Gastric Bezoar with Gastric Pneumatosis.

Science.gov (United States)

Honda, Hirokazu; Ikeya, Takashi; Kashiwagi, Erika; Okada, Shuichi; Fukuda, Katsuyuki

2017-01-01

Gastric bezoars are rare and are usually found incidentally. They can sometimes cause severe complications, including gastric outlet obstruction (GOO) or gastric pneumatosis (GP). In cases of bezoars with GP, the optimal treatment strategy has not yet been defined. We report the case of an 89-year-old man with a history of type 2 diabetes mellitus and hypertension who presented to our emergency room with a 2-day history of upper abdominal pain, nausea, and vomiting. Physical examination revealed no rebound tenderness or guarding, and laboratory values revealed no elevation of the serum lactate level. A computed tomography scan of the abdomen showed a dilated stomach with significant fluid collection, GOO, and GP due to a 42 × 40 mm mass composed of fat and air densities. Emergency esophagogastroduodenoscopy revealed two gastric bezoars, one of which was incarcerated in the pyloric region. We used various endoscopic devices to successfully break and remove the bezoars. We used endoscopic forceps and a water jet followed by an endoscopic snare to cut the bezoars into several pieces and remove them with an endoscopic net. Follow-up endoscopy confirmed that the gastric bezoar had been completely removed. As seen in this case, endoscopic treatment may be a safe and viable option for the extraction of gastric bezoars presenting with GOO and GP.

Efficacy of laparoscopic subtotal gastrectomy with D2 lymphadenectomy for locally advanced gastric cancer: the protocol of the KLASS-02 multicenter randomized controlled clinical trial

International Nuclear Information System (INIS)

Hur, Hoon; Lee, Hyun Yong; Lee, Hyuk-Joon; Kim, Min Chan; Hyung, Woo Jin; Park, Young Kyu; Kim, Wook; Han, Sang-Uk

2015-01-01

Despite the well-described benefits of laparoscopic surgery such as lower operative blood loss and enhanced postoperative recovery in gastric cancer surgery, the application of laparoscopic surgery in patients with locally advanced gastric cancer (AGC) remains elusive owing to a lack of clinical evidence. Recently, the Korean Laparoscopic Surgical Society Group launched a new multicenter randomized clinical trial (RCT) to compare laparoscopic and open D2 lymphadenectomy for patients with locally AGC. Here, we introduce the protocol of this clinical trial. This trial is an investigator-initiated, randomized, controlled, parallel group, non-inferiority trial. Gastric cancer patients diagnosed with primary tumors that have invaded into the muscle propria and not into an adjacent organ (cT2–cT4a) in preoperative studies are recruited. Another criterion for recruitment is no lymph node metastasis or limited perigastric lymph node (including lymph nodes around the left gastric artery) metastasis. A total 1,050 patients in both groups are required to statistically show non-inferiority of the laparoscopic approach with respect to the primary end-point, relapse-free survival of 3 years. Secondary outcomes include postoperative morbidity and mortality, postoperative recovery, quality of life, and overall survival. Surgeons who are validated through peer-review of their surgery videos can participate in this clinical trial. This clinical trial was designed to maintain the principles of a surgical clinical trial with internal validity for participating surgeons. Through the KLASS-02 RCT, we hope to show the efficacy of laparoscopic D2 lymphadenectomy in AGC patients compared with the open procedure. ClinicalTrial.gov, https://www.clinicaltrials.gov/ct2/show/NCT01456598?term

Radiological findings of gastric adenomyoma in a neonate presenting with gastric outlet obstruction.

Science.gov (United States)

Rhim, Jung Hyo; Kim, Woo Sun; Choi, Young Hun; Cheon, Jung-Eun; Park, Sung Hye

2013-03-01

Gastric adenomyoma is a rare tumour-like lesion composed of glandular components and smooth muscle bundles. We report a case of gastric adenomyoma in a 1-week-old neonate who presented with gastric outlet obstruction. To the best of our knowledge, this is the youngest child reported with gastric adenomyoma and a unique case demonstrating radiological findings of gastric adenomyoma in a young infant. At US, the lesion was seen as an asymmetrical mass-like wall-thickening of the pylorus. Upper gastrointestinal series showed findings similar to those seen in a case of hypertrophic pyloric stenosis. We suggest that gastric adenomyoma should be included in the causes of gastric outlet obstruction in neonates even though it is rare in young children.

The relationship between apoptosis and the expression of proliferating cell nuclear antigen and the clinical stages in gastric carcinoma.

Science.gov (United States)

Tao, K; Chen, D; Tian, Y; Lu, X; Yang, X

2000-01-01

The relationship between the apoptosis and the expression of proliferating cell nuclear antigen (PCNA) and the clinical stages in gastric cancers was studied. By using terminal deoxynucleotidyl transferase-mediated nick end labeling (TUNEL) technique and PCNA immunohistochemical staining, the apoptosis and the expression of PCNA in tissue of gastric carcinoma were assayed in situ, the index of apoptosis (AI), index of PCNA (PI) and the rate of AI/PI were calculated. AI and PI in gastric cancer tissues were (6.5 +/- 3.7)% and (49.8 +/- 15.9)% respectively, and the rate of AI/PI was 0.13 +/- 0.05, which were obviously different from those of normal gastric mucosa in paragastric cancer (P stages of gastric carcinoma, the AI was decreased, PI was increased and the rate of AI/PI decreased in gastric carcinoma. There was significant difference in them between the gastric cancer tissues and normal gastric mucosa in pericarcinoma in TNM stage II to IV (P gastric carcinoma. The AI, PI and the rate of AI/PI would become the prognostic factors in advanced gastric carcinoma.

New method for evaluation of perigastric invasion of gastric cancer by right lateral position CT

International Nuclear Information System (INIS)

Shirakawa, T.; Fukuda, K.; Tada, S.

1996-01-01

The purpose of this study was to evaluate usefulness of right lateral position CT in determining invasion of gastric cancer into adjacent organs. We assessed whether position shift, a change in the relative location of a gastric tumor and adjacent organs between the supine position and right lateral position CT, was a useful sign for absence of invasion into perigastric organs. In 37 patients with advanced gastric cancer with doubtful invasion into adjacent organs by conventional CT after 500 ml water oral intake, additive right lateral CT was performed. Of 24 cases of lesions in the gastric body, 16 had a position shift and no invasion into adjacent organs at surgery (T3), and 8 had no position shift and invasion (T4). The accuracy was 100%. Six gastric cardial and 7 pyloric tumors showed no position shift, and 3 cardial and 2 pyloric tumors were proved to be nonivasive (T3). The accuracy of cardial and pyloric tumor was 50 and 71%. We concluded that position shift may be useful in the diagnosis of invasion of adjacent organs by gastric cancer, limited to in cases with gastric body cancer. (orig.)

Itopride for gastric volume, gastric emptying and drinking capacity in functional dyspepsia.

Science.gov (United States)

Abid, Shahab; Jafri, Wasim; Zaman, Maseeh Uz; Bilal, Rakhshanda; Awan, Safia; Abbas, Aamir

2017-02-06

To study the effect of itopride on gastric accommodation, gastric emptying and drinking capacity in functional dyspepsia (FD). Randomized controlled trial was conducted to check the effect of itopride on gastric accommodation, gastric emptying, capacity of tolerating nutrient liquid and symptoms of FD. We recruited a total of 31 patients having FD on the basis of ROME III criteria. After randomization, itopride was received by 15 patients while 16 patients received placebo. Gastric accommodation was determined using Gastric Scintigraphy. 13 C labeled octanoic breadth test was performed to assess gastric emptying. Capacity of tolerating nutrient liquid drink was checked using satiety drinking capacity test. The intervention group comprised of 150 mg itopride. Patients in both arms were followed for 4 wk. Mean age of the recruited participant 33 years (SD = 7.6) and most of the recruited individuals, i.e ., 21 (67.7%) were males. We found that there was no effect of itopride on gastric accommodation as measured at different in volumes in the itopride and control group with the empty stomach ( P = 0.14), at 20 min ( P = 0.38), 30 min ( P = 0.30), 40 min ( P = 0.43), 50 min ( P = 0.50), 60 min ( P = 0.81), 90 min ( P = 0.25) and 120 min ( P = 0.67). Gastric emptying done on a sub sample ( n = 11) showed no significant difference ( P = 0.58) between itopride and placebo group. There was no significant improvement in the capacity to tolerate liquid in the itopride group as compared to placebo ( P = 0.51). Similarly there was no significant improvement of symptoms as assessed through a composite symptom score ( P = 0.74). The change in QT interval in itopride group was not significantly different from placebo (0.10). Our study found no effect of itopride on gastric accommodation, gastric emptying and maximum tolerated volume in patients with FD.

Synchronous gastric and duodenal metastases from head and neck squamous cell carcinoma: a unique presentation of upper gastrointestinal bleeding.

Science.gov (United States)

Tarangelo, Nicholas P; Kistler, C Andrew; Daitch, Zachary; Jiang, Wei; Quirk, Daniel M

2018-01-01

Metastatic disease to the stomach or duodenum is an infrequent diagnosis, and head and neck squamous cell carcinoma (HNSCC) is one of the least common primary malignancies that lead to gastric or duodenal metastases. We report the case of a 65-year-old man with human immunodeficiency virus infection and previously diagnosed HNSCC who presented with melena. The patient had a percutaneous endoscopic gastrostomy tube placed 3 months prior to his presentation. Laboratory testing was significant for normocytic anemia and a digital rectal examination was positive for melena. Esophagogastroduodenoscopy revealed numerous cratered nodules with contact bleeding in the stomach as well as the duodenum that appeared malignant. Biopsies of the gastric and duodenal nodules were positive for p40 and CK 5/6, consistent with metastatic squamous cell carcinoma.

The role of gastric scintigraphy in primary or post surgical disorders of gastric emptying

International Nuclear Information System (INIS)

Jian, R.; Lemann, M.; Rain, J.D.

1996-01-01

Gastric scintigraphy is the gold standard for the measurement of the gastric emptying of a meal because of its reliability and its reproducibility and the respect of physiological conditions. Moreover, this technique allows to measure the emptying of solid and liquid phases simultaneously. Symptoms motivating a gastric scintigraphy, suggest either a gastric stasis (dyspepsia) or a gastric incontinence (dumping syndrome). The two most frequent clinical conditions triggering this test are motility disorders following vagotomy, a delayed emptying of solids is often associated to an accelerated emptying of liquids. Gastric scintigraphy proves quite useful in these conditions, since the diagnosis of such complex abnormalities is uneasy to establish exclusively on a clinical basis. In idiopathic dyspepsia, gastric stasis is proved only in 50 % of the patients. However, a radionuclide study of gastric emptying is seldom ordered because of the common character and good tolerance of these symptoms. In everyday practice, gastric scintigraphy is considered only when gastric or intestinal obstructive lesions have been ruled out. A suggestive clinical picture and/or absence of a deteriorated general condition allow to prescribe a symptomatic treatment. More rarely, equivocal symptoms, degradation of the general condition and unresponsiveness to symptomatic drugs call for gastric scintigraphy. (authors). 241 refs., 2 figs

Overview of Cell Synchronization.

Science.gov (United States)

Banfalvi, Gaspar

2017-01-01

The widespread interest in cell synchronization is maintained by the studies of control mechanism involved in cell cycle regulation. During the synchronization distinct subpopulations of cells are obtained representing different stages of the cell cycle. These subpopulations are then used to study regulatory mechanisms of the cycle at the level of macromolecular biosynthesis (DNA synthesis, gene expression, protein synthesis), protein phosphorylation, development of new drugs, etc. Although several synchronization methods have been described, it is of general interest that scientists get a compilation and an updated view of these synchronization techniques. This introductory chapter summarizes: (1) the basic concepts and principal criteria of cell cycle synchronizations, (2) the most frequently used synchronization methods, such as physical fractionation (flow cytometry, dielectrophoresis, cytofluorometric purification), chemical blockade, (3) synchronization of embryonic cells, (4) synchronization at low temperature, (5) comparison of cell synchrony techniques, (6) synchronization of unicellular organisms, and (7) the effect of synchronization on transfection.

Molecular mechanisms and theranostic potential of miRNAs in drug resistance of gastric cancer.

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Yang, Wanli; Ma, Jiaojiao; Zhou, Wei; Cao, Bo; Zhou, Xin; Yang, Zhiping; Zhang, Hongwei; Zhao, Qingchuan; Fan, Daiming; Hong, Liu

2017-11-01

Systemic chemotherapy is a curative approach to inhibit gastric cancer cells proliferation. Despite the great progress in anti-cancer treatment achieved during the last decades, drug resistance and treatment refractoriness still extensively persists. Recently, accumulating studies have highlighted the role of miRNAs in drug resistance of gastric cancers by modulating some drug resistance-related proteins and genes expression. Pre-clinical reports indicate that miRNAs might serve as ideal biomarkers and potential targets, thus holding great promise for developing targeted therapy and personalized treatment for the patients with gastric cancer. Areas covered: This review provide a comprehensive overview of the current advances of miRNAs and molecular mechanisms underlying miRNA-mediated drug resistance in gastric cancer. We particularly focus on the potential values of drug resistance-related miRNAs as biomarkers and novel targets in gastric cancer therapy and envisage the future research developments of these miRNAs and challenges in translating the new findings into clinical applications. Expert opinion: Although the concrete mechanisms of miRNAs in drug resistance of gastric cancer have not been fully clarified, miRNA may be a promising theranostic approach. Further studies are still needed to facilitate the clinical applications of miRNAs in drug resistant gastric cancer.

Helicobacter pylori and primary gastric lymphoma. A histopathologic and immunohistochemical analysis of 237 patients.

Science.gov (United States)

Nakamura, S; Yao, T; Aoyagi, K; Iida, M; Fujishima, M; Tsuneyoshi, M

1997-01-01

Few previous articles have analyzed the relation between infection with Helicobacter pylori (H. pylori) and primary gastric lymphoma in a large number of patients. Resected and biopsied specimens from 237 patients with primary gastric lymphoma were investigated for H. pylori using hematoxylin and eosin stain, modified Giemsa stain, and immunohistochemistry. These specimens were compared with specimens from 29 patients with chronic active gastritis, 33 with peptic ulcers, and 41 with gastric carcinoma. H. pylori was detected in 145 of 237 patients (61%) with gastric lymphoma. The frequency of H. pylori positivity was higher in patients with lymphoma restricted to the mucosa and submucosa (76%) than in those with lymphoma invading beyond the submucosa (48%) (P gastritis (100%) (P gastritis and peptic ulcer. The H. pylori grading score for patients with lymphoma (0.9 +/- 1.0) was lower than for those with chronic active gastritis (1.9 +/- 0.8) (P < 0.001), peptic ulcers (2.2 +/- 1.0) (P < 0.001), or gastric carcinoma (1.2 +/- 1.1) (P < 0.05). These results suggest that H. pylori is more likely to be associated with early states of primary gastric lymphoma than with advanced states. Thus, H. pylori may disappear during the progression of primary gastric lymphoma.

Gastric-emptying tests

International Nuclear Information System (INIS)

Brown, M.L.; Malagelada, J.R.

1983-01-01

Mechanisms regulating gastric emptying have been characterized through many decades of experimental work. Both central and peripheral mechanisms are important. Central mechanisms are related to the center of vomiting and are probably influenced by psychologic and emotional factors. Peripheral mechanisms are located at both sides of the pylorus. Gastric mechanisms are stimulatory and are triggered mainly by distention of the stomach, although hormonal mechanisms may also participate (gastrin). However, with complex, nutrient-containing meals, the intragastric volume is not the primary determinant of gastric emptying. Inhibitory mechanisms of the gut are more important. The key factors are the pH, osmolality, and nutrient content of the chyme being emptied into the duodenum. Osmotic and pH-sensitive receptors are thought to reside in the duodenum. On the other hand, receptors triggered by nutrients extend much more distally into the duodenum and are sensitive to nutrient composition and load. Protein, carbohydrates, and lipids all inhibit gastric emptying, although the lipids are probably the most potent inhibitors. If the duodenal load or the characteristics of the emptying material are not adequate, inhibitory mechanisms will reduce gastric emptying at the expense of expanding the intragastric volume. It is therefore not possible to dissociate postprandial gastric emptying from postprandial gastric secretion

Macrophage migration inhibitory factor as a potential prognostic factor in gastric cancer

Science.gov (United States)

He, Long-Jun; Xie, Dan; Hu, Pin-Jin; Liao, Yi-Ji; Deng, Hai-Xia; Kung, Hsiang-Fu; Zhu, Sen-Lin

2015-01-01

AIM: To investigate macrophage migration inhibitory factor (MIF) expression and its clinical relevance in gastric cancer, and effects of MIF knockdown on proliferation of gastric cancer cells. METHODS: Tissue microarray containing 117 samples of gastric cancer and adjacent non-cancer normal tissues was studied for MIF expression by immunohistochemistry (IHC) semiquantitatively, and the association of MIF expression with clinical parameters was analyzed. MIF expression in gastric cancer cell lines was detected by reverse transcription-polymerase chain reaction (RT-PCR) and Western blot. Two pairs of siRNA targeting the MIF gene (MIF si-1 and MIF si-2) and one pair of scrambled siRNA as a negative control (NC) were designed and chemically synthesized. All siRNAs were transiently transfected in AGS cells with OligofectamineTM to knock down the MIF expression, with the NC group and mock group (OligofectamineTM alone) as controls. At 24, 48, and 72 h after transfection, MIF mRNA was analyzed by RT-PCR, and MIF and proliferating cell nuclear antigen (PCNA) proteins were detected by Western blot. The proliferative rate of AGS cells was assessed by methylthiazolyl tetrazolium (MTT) assay and colony forming assay. RESULTS: The tissue microarray was informative for IHC staining, in which the MIF expression in gastric cancer tissues was higher than that in adjacent non-cancer normal tissues (P < 0.001), and high level of MIF was related to poor tumor differentiation, advanced T stage, advanced tumor stage, lymph node metastasis, and poor patient survival (P < 0.05 for all). After siRNA transfection, MIF mRNA was measured by real-time PCR, and MIF protein and PCNA were assessed by Western blot analysis. We found that compared to the NC group and mock group, MIF expression was knocked down successfully in gastric cancer cells, and PCNA expression was downregulated with MIF knockdown as well. The cell counts and the doubling times were assayed by MTT 4 d after transfection, and

Endoscopic Color Doppler Ultrasonographic Evaluation of GastricVarices Secondary to Left-Sided Portal Hypertension

Science.gov (United States)

Sato, Takahiro; Yamazaki, Katsu; Kimura, Mutsuumi; Toyota, Jouji; Karino, Yoshiyasu

2014-01-01

Gastric varices that arise secondary to the splenic vein occlusion can result in gastrointestinal hemorrhaging. Endoscopic color Doppler ultrasonography (ECDUS) was performed in 16 patients with gastric varices secondary to splenic vein occlusion. This study retrospectively evaluated the role of ECDUS in the diagnosis of gastric varices secondary to splenic vein occlusion. Thirteen patients had co-existing pancreatic diseases: 8 with chronic pancreatitis, 4 with cancer of the pancreatic body or tail and 1 with severe acute pancreatitis. Of the remaining 3 patients, 1 had myeloproliferative disease, 1 had advanced gastric cancer, and the third had splenic vein occlusion due to an obscure cause. The endoscopic findings of gastric varices were: variceal form (F) classified as enlarged tortuous (F2) in 12 cases and large, coil-shaped (F3) in 4 cases, and positive for erosion or red color sign of the variceal surface in 4 cases and negative in 12 cases. ECDUS color flow images of gastric variceal flow clearly depicted a round fundal region at the center, with varices expanding to the curvatura ventriculi major of the gastric body in all 16 cases. The velocities of F3 type gastric varices were significantly higher than those of the F2 type. The wall thickness of varices positive for erosion or red color sign was significantly less than the negative cases. I conclude that ECDUS color flow images of gastric variceal flow depicted specific findings of gastric varices secondary to splenic vein occlusion at the round fundal region at the center, with varices expanding to the curvatura ventriculi major of the gastric body. PMID:26852679

New type of chaos synchronization in discrete-time systems: the F-M synchronization

Directory of Open Access Journals (Sweden)

Ouannas Adel

2018-04-01

Full Text Available In this paper, a new type of synchronization for chaotic (hyperchaotic maps with different dimensions is proposed. The novel scheme is called F – M synchronization, since it combines the inverse generalized synchronization (based on a functional relationship F with the matrix projective synchronization (based on a matrix M. In particular, the proposed approach enables F – M synchronization with index d to be achieved between n-dimensional drive system map and m-dimensional response system map, where the synchronization index d corresponds to the dimension of the synchronization error. The technique, which exploits nonlinear controllers and Lyapunov stability theory, proves to be effective in achieving the F – M synchronization not only when the synchronization index d equals n or m, but even if the synchronization index d is larger than the map dimensions n and m. Finally, simulation results are reported, with the aim to illustrate the capabilities of the novel scheme proposed herein.

New type of chaos synchronization in discrete-time systems: the F-M synchronization

Science.gov (United States)

Ouannas, Adel; Grassi, Giuseppe; Karouma, Abdulrahman; Ziar, Toufik; Wang, Xiong; Pham, Viet-Thanh

2018-04-01

In this paper, a new type of synchronization for chaotic (hyperchaotic) maps with different dimensions is proposed. The novel scheme is called F - M synchronization, since it combines the inverse generalized synchronization (based on a functional relationship F) with the matrix projective synchronization (based on a matrix M). In particular, the proposed approach enables F - M synchronization with index d to be achieved between n-dimensional drive system map and m-dimensional response system map, where the synchronization index d corresponds to the dimension of the synchronization error. The technique, which exploits nonlinear controllers and Lyapunov stability theory, proves to be effective in achieving the F - M synchronization not only when the synchronization index d equals n or m, but even if the synchronization index d is larger than the map dimensions n and m. Finally, simulation results are reported, with the aim to illustrate the capabilities of the novel scheme proposed herein.

Gastric emptying in morbid obesity

International Nuclear Information System (INIS)

Venzina, W.; Chamberlain, M.; Carruthers, S.G.; Grace, D.M.; King, M.; Mowbray, R.D.; Bondy, D.C.

1984-01-01

Weight loss following gastroplasty had no correlation with gastric emptying rate. Patients who showed transient prolongation of gastric emptying returned to normal one year later and showed no significant difference in weight loss from those who did not have temporary delayed gastric emptying. Perhaps gatroplasty (at least temporarily) reduces the gastric volume producing early satiation without affecting the gastric emptying rate as tested by a small volume radiolabelled test meal. Longer follow-up is indicated to see if delayed weight gain occurs because of gastric pouch stretching and if this has any correlation with gastric emptying rate. (Author)

Mesentero-axial gastric volvulus after removal of laparoscopic adjustable gastric band.

Science.gov (United States)

Pirmadjid, N; Pournaras, D J; Huan, S; Sujendran, V

2017-02-01

Despite the decreasing popularity of gastric banding, a large number of patients still have a band in situ. Although immediate postoperative complications are relatively rare, long-term complications of gastric banding are more common but are not reported to occur after band removal. We report a case of gastric volvulus and subsequent ischaemic perforation in a patient shortly after band removal, resulting in emergency laparotomy and total gastrectomy. Severe continuing pain persisting after band deflation and even gastric band removal should be treated as an emergency and urgent investigation should not be delayed.

Novel targeted agents for gastric cancer

Directory of Open Access Journals (Sweden)

Liu Lian

2012-06-01

Full Text Available Abstract Contemporary advancements have had little impact on the treatment of gastric cancer (GC, the world’s second highest cause of cancer death. Agents targeting human epidermal growth factor receptor mediated pathways have been a common topic of contemporary cancer research, including monoclonal antibodies (mAbs and receptor tyrosine kinase inhibitors (TKIs. Trastuzumab is the first target agent evidencing improvements in overall survival in HER2-positive (human epidermal growth factor receptor 2 gastric cancer patients. Agents targeting vascular epithelial growth factor (VEGF, mammalian target of rapamycin (mTOR, and other biological pathways are also undergoing clinical trials, with some marginally positive results. Effective targeted therapy requires patient selection based on predictive molecular biomarkers. Most phase III clinical trials are carried out without patient selection; therefore, it is hard to achieve personalized treatment and to monitor patient outcome individually. The trend for future clinical trials requires patient selection methods based on current understanding of GC biology with the application of biomarkers.

The Prognostic Role of the Platelet-Lymphocytes Ratio in Gastric Cancer: A Meta-Analysis.

Directory of Open Access Journals (Sweden)

Zhengshui Xu

Full Text Available Systemic inflammatory parameters, such as the elevator PLR (platelet-lymphocyte ratio, the NLR (neutrophil-lymphocyte ratio and the platelet count (PLT, have been found to be associated with the prognosis in gastric cancer; however, these results, especially those relating to the PLR, remain inconsistent. So we aimed to evaluate the prognostic role of the PLR in gastric cancer by conducting and presenting the findings of this meta-analysis.We conducted a systematic literature search in PubMed, Embase and the Cochrane Library to evaluate the prognostic value of the PLR in gastric cancer. The quality of the included studies was evaluated using the Newcastle Ottawa Quality Assessment Scale (NOS. The hazard ratio (HR /Odds Ratio (OR and its 95% confidence were pooled using a random effects model. A funnel plot based on overall survival was used to evaluate the publication bias.It total, 8 studies comprising 4513 patients with gastric cancer met the pre-setting inclusion criteria. In comparison to the normal PLR, an elevated PLR was correlated with a higher risk of lymph node metastasis with an OR of 1.50 (95% Cl:1.24-1.82; I2 = 17% and serosal invasion (T3 +T4 risk with an OR of 2.01 (95% Cl: 1.49-2.73; I2 = 55%, and an elevated PLR also increased the advanced stage (III +IV risk with an OR of 1.99 (95% Cl: 1.60-2.46; I2 = 28%. An elevated PLR was not a reliable predictor for OS with an HR of 0.99 (95% CI: 0.9-1.1; I2 = 12%.An elevated PLR was correlated with a higher risk of lymph node metastasis, serosal invasion and advanced stage (III +IV risk in gastric cancer; however, the PLR may not act as a negative predictor for the overall survival of gastric cancer.

Implementation of IEEE-1588 timing and synchronization for ATCA control and data acquisition systems

International Nuclear Information System (INIS)

Correia, Miguel; Sousa, Jorge; Combo, Álvaro; Rodrigues, António P.; Carvalho, Bernardo B.; Batista, António J.N.; Gonçalves, Bruno; Correia, Carlos M.B.A.; Varandas, Carlos A.F.

2012-01-01

Highlights: ► IEEE-1588 over Ethernet protocol is implemented for the synchronization of all clock signals of an ATCA AMC carrier module. ► The ATCA hardware consists of an AMC quad-carrier main-board with PCI Express switching. ► IEEE-1588 is to be implemented on a Virtex-6 FPGA. ► Timing signals on the ATX-AMC4-PTP are managed and routed by a crosspoint-switch implemented on a Virtex-6 FPGA. ► Each clock signal source may be independently located (on each of the AMC cards, RTM or ATCA backplane). - Abstract: Control and data acquisition (C and DA) systems for Fusion experiments are required to provide accurate timing and synchronization (T and S) signals to all of its components. IPFN adopted PICMG's Advanced Telecommunications Computing Architecture (ATCA) industry standard to develop C and DA instrumentation. ATCA was chosen not only for its high throughput characteristics but also for its high availability (HA) features which become of greater importance in steady-state operation scenarios. However, the specified ATCA clock and synchronization interface may be too limited for the timing and synchronization needs in advanced Physics experiments. Upcoming specification extensions, developed by the “xTCA for Physics” workgroups, will contemplate, among others, a complementary timing specification, developed by the PICMG xTCA for Physics IO, Timing and Synchronization Technical Committee. The IEEE-1588 Precision Time Protocol (PTP) over Ethernet is one of the protocols, proposed by the Committee, aiming for precise synchronization of clocks in measurement and control systems, based on low jitter and slave-to-slave skew criteria. The paper presents an implementation of IEEE-1588 over Ethernet, in an ATCA hardware platform. The ATCA hardware consists of an Advanced Mezzanine Card (AMC) quad-carrier front board with PCI Express switching. IEEE-1588 is to be implemented on a Virtex-6 FPGA. Ethernet connectivity with the remote master clock is located on

Itopride for gastric volume, gastric emptying and drinking capacity in functional dyspepsia

OpenAIRE

Abid, Shahab; Jafri, Wasim; Zaman, Maseeh Uz; Bilal, Rakhshanda; Awan, Safia; Abbas, Aamir

2017-01-01

AIM To study the effect of itopride on gastric accommodation, gastric emptying and drinking capacity in functional dyspepsia (FD). METHODS Randomized controlled trial was conducted to check the effect of itopride on gastric accommodation, gastric emptying, capacity of tolerating nutrient liquid and symptoms of FD. We recruited a total of 31 patients having FD on the basis of ROME III criteria. After randomization, itopride was received by 15 patients while 16 patients received placebo. Gastri...

History of Helicobacter pylori, duodenal ulcer, gastric ulcer and gastric cancer.

Science.gov (United States)

Graham, David Y

2014-05-14

Helicobacter pylori (H. pylori) infection underlies gastric ulcer disease, gastric cancer and duodenal ulcer disease. The disease expression reflects the pattern and extent of gastritis/gastric atrophy (i.e., duodenal ulcer with non-atrophic and gastric ulcer and gastric cancer with atrophic gastritis). Gastric and duodenal ulcers and gastric cancer have been known for thousands of years. Ulcers are generally non-fatal and until the 20th century were difficult to diagnose. However, the presence and pattern of gastritis in past civilizations can be deduced based on the diseases present. It has been suggested that gastric ulcer and duodenal ulcer both arose or became more frequent in Europe in the 19th century. Here, we show that gastric cancer and gastric ulcer were present throughout the 17th to 19th centuries consistent with atrophic gastritis being the predominant pattern, as it proved to be when it could be examined directly in the late 19th century. The environment before the 20th century favored acquisition of H. pylori infection and atrophic gastritis (e.g., poor sanitation and standards of living, seasonal diets poor in fresh fruits and vegetables, especially in winter, vitamin deficiencies, and frequent febrile infections in childhood). The latter part of the 19th century saw improvements in standards of living, sanitation, and diets with a corresponding decrease in rate of development of atrophic gastritis allowing duodenal ulcers to become more prominent. In the early 20th century physician's believed they could diagnose ulcers clinically and that the diagnosis required hospitalization for "surgical disease" or for "Sippy" diets. We show that while H. pylori remained common and virulent in Europe and the United States, environmental changes resulted in changes of the pattern of gastritis producing a change in the manifestations of H. pylori infections and subsequently to a rapid decline in transmission and a rapid decline in all H. pylori-related diseases.

Pilot study of postoperative adjuvant chemoradiation for advanced gastric cancer: Adjuvant 5-FU/cisplatin and chemoradiation with capecitabine

Science.gov (United States)

Lee, Hyung-Sik; Choi, Youngmin; Hur, Won-Joo; Kim, Hyo-Jin; Kwon, Hyuk-Chan; Kim, Sung-Hyun; Kim, Jae-Seok; Lee, Jong-Hoon; Jung, Ghap-Joong; Kim, Min-Chan

2006-01-01

AIM: To evaluate the efficacy and toxicity of postoperative chemoradiation using FP chemotherapy and oral capecitabine during radiation for advanced gastric cancer following curative resection. METHODS: Thirty-one patients who had underwent a potentially curative resection for Stage III and IV (M0) gastric cancer were enrolled. Therapy consists of one cycle of FP (continuous infusion of 5-FU 1000 mg/m2 on d 1 to 5 and cisplatin 60 mg/m2 on d 1) followed by 4500 cGy (180 cGy/d) with capecitabine (1650 mg/m2 daily throughout radiotherapy). Four wk after completion of the radiotherapy, patients received three additional cycles of FP every three wk. The median follow-up duration was 22.2 mo. RESULTS: The 3-year disease free and overall survival in this study were 82.7% and 83.4%, respectively. Four patients (12.9%) showed relapse during follow-up. Eight patients did not complete all planned adjuvant therapy. Grade 3/4 toxicities included neutropenia in 50.2%, anemia in 12.9%, thrombocytopenia in 3.2% and nausea/vomiting in 3.2%. Neither grade 3/4 hand foot syndrome nor treatment related febrile neutropenia or death were observed. CONCLUSION: These preliminary results suggest that this postoperative adjuvant chemoradiation regimen of FP before and after capecitabine and concurrent radiotherapy appears well tolerated and offers a comparable toxicity profile to the chemoradiation regimen utilized in INT-0116. This treatment modality allowed successful loco-regional control rate and 3-year overall survival. PMID:16489675

A method for establishing human primary gastric epithelial cell culture from fresh surgical gastric tissues.

Science.gov (United States)

Aziz, Faisal; Yang, Xuesong; Wen, Qingping; Yan, Qiu

2015-08-01

At present, biopsy specimens, cancer cell lines and tissues obtained by gastric surgery are used in the study and analysis of gastric cancer, including the molecular mechanisms and proteomics. However, fibroblasts and other tissue components may interfere with these techniques. Therefore, the present study aimed to develop a procedure for the isolation of viable human gastric epithelial cells from gastric surgical tissues. A method was developed to culture human gastric epithelial cells using fresh, surgically excised tissues and was evaluated using immunocytochemistry, periodic acid-Schiff (PAS) staining and cell viability assays. Low cell growth was observed surrounding the gastric tissue on the seventh day of tissue explant culture. Cell growth subsequently increased, and at 12 days post-explant a high number of pure epithelial cells were detected. The gastric cancer cells exhibited rapid growth with a doubling time of 13-52 h, as compared to normal cells, which had a doubling time of 20-53 h. Immunocytochemical analyses of primary gastric cells revealed positive staining for cytokeratin 18 and 19, which indicated that the culture was comprised of pure epithelial cells and contained no fibroblasts. Furthermore, PAS staining demonstrated that the cultured gastric cells produced neutral mucin. Granulin and carbohydrate antigen 724 staining confirmed the purity of gastric cancer and normal cells in culture. This method of cell culture indicated that the gastric cells in primary culture consisted of mucin-secreting gastric epithelial cells, which may be useful for the study of gastric infection with Helicobacter pylori and gastric cancer.

On Synchronization Primitive Systems.

Science.gov (United States)

The report studies the question: what synchronization primitive should be used to handle inter-process communication. A formal model is presented...between these synchronization primitives. Although only four synchronization primitives are compared, the general methods can be used to compare other... synchronization primitives. Moreover, in the definitions of these synchronization primitives, conditional branches are explicitly allowed. In addition

Virtual Teams and Synchronous Presentations: An Online Class Experience

Science.gov (United States)

Adkins, Joni K.

2013-01-01

Global expansion, cost containment, and technology advances have all played a role in the increase of virtual teams in today's workplace. Virtual teams in an online graduate information technology management class prepared and presented synchronous presentations over a business or non-profit sector case. This paper includes a brief literature…

Genetic mutation analysis of human gastric adenocarcinomas using ion torrent sequencing platform.

Directory of Open Access Journals (Sweden)

Zhi Xu

Full Text Available Gastric cancer is the one of the major causes of cancer-related death, especially in Asia. Gastric adenocarcinoma, the most common type of gastric cancer, is heterogeneous and its incidence and cause varies widely with geographical regions, gender, ethnicity, and diet. Since unique mutations have been observed in individual human cancer samples, identification and characterization of the molecular alterations underlying individual gastric adenocarcinomas is a critical step for developing more effective, personalized therapies. Until recently, identifying genetic mutations on an individual basis by DNA sequencing remained a daunting task. Recent advances in new next-generation DNA sequencing technologies, such as the semiconductor-based Ion Torrent sequencing platform, makes DNA sequencing cheaper, faster, and more reliable. In this study, we aim to identify genetic mutations in the genes which are targeted by drugs in clinical use or are under development in individual human gastric adenocarcinoma samples using Ion Torrent sequencing. We sequenced 737 loci from 45 cancer-related genes in 238 human gastric adenocarcinoma samples using the Ion Torrent Ampliseq Cancer Panel. The sequencing analysis revealed a high occurrence of mutations along the TP53 locus (9.7% in our sample set. Thus, this study indicates the utility of a cost and time efficient tool such as Ion Torrent sequencing to screen cancer mutations for the development of personalized cancer therapy.

Familial Gastric Cancers.

Science.gov (United States)

Setia, Namrata; Clark, Jeffrey W; Duda, Dan G; Hong, Theodore S; Kwak, Eunice L; Mullen, John T; Lauwers, Gregory Y

2015-12-01

Although the majority of gastric carcinomas are sporadic, approximately 10% show familial aggregation, and a hereditary cause is determined in 1%-3% cases. Of these, hereditary diffuse gastric cancer is the most recognized predisposition syndrome. Although rare, the less commonly known syndromes also confer a markedly increased risk for development of gastric cancer. Identification and characterization of these syndromes require a multidisciplinary effort involving oncologists, surgeons, genetic counselors, biologists, and pathologists. This article reviews the molecular genetics, clinical and pathologic features, surveillance guidelines, and preventive measures of common and less common hereditary gastric cancer predisposition syndromes. ©AlphaMed Press.

Fixed-time synchronization of memristor-based BAM neural networks with time-varying discrete delay.

Science.gov (United States)

Chen, Chuan; Li, Lixiang; Peng, Haipeng; Yang, Yixian

2017-12-01

This paper is devoted to studying the fixed-time synchronization of memristor-based BAM neural networks (MBAMNNs) with discrete delay. Fixed-time synchronization means that synchronization can be achieved in a fixed time for any initial values of the considered systems. In the light of the double-layer structure of MBAMNNs, we design two similar feedback controllers. Based on Lyapunov stability theories, several criteria are established to guarantee that the drive and response MBAMNNs can realize synchronization in a fixed time. In particular, by changing the parameters of controllers, this fixed time can be adjusted to some desired value in advance, irrespective of the initial values of MBAMNNs. Numerical simulations are included to validate the derived results. Copyright © 2017 Elsevier Ltd. All rights reserved.

Assessment of two methods of gastric decompression for the initial management of gastric dilatation-volvulus.

Science.gov (United States)

Goodrich, Z J; Powell, L L; Hulting, K J

2013-02-01

To assess gastric trocarization and orogastric tubing as a means of gastric decompression for the initial management of gastric dilatation-volvulus. Retrospective review of 116 gastric dilatation-volvulus cases from June 2001 to October 2009. Decompression was performed via orogastric tubing in 31 dogs, gastric trocarization in 39 dogs and a combination of both in 46 dogs. Tubing was successful in 59 (75·5%) dogs and unsuccessful in 18 (23·4%) dogs. Trocarization was successful in 73 (86%) dogs and unsuccessful in 12 (14%) dogs. No evidence of gastric perforation was noted at surgery in dogs undergoing either technique. One dog that underwent trocarization had a splenic laceration identified at surgery that did not require treatment. Oesophageal rupture or aspiration pneumonia was not identified in any dog during hospitalization. No statistical difference was found between the method of gastric decompression and gastric compromise requiring surgical intervention or survival to discharge. Orogastric tubing and gastric trocarization are associated with low complication and high success rates. Either technique is an acceptable method for gastric decompression in dogs with gastric dilatation-volvulus. © 2013 British Small Animal Veterinary Association.

Meningeal carcinomatosis as first manifestation of gastric carcinoma

International Nuclear Information System (INIS)

Romero R, Alfredo E; Mantilla H, Julio C; Melo U, Mario A; Barajas S, Paula A; Chinchilla O Sandra

2009-01-01

Meningeal carcinomatosis is defined as the malignant and widespread infiltration of the meninges due to the planting and growth of cancer cells within the leptomeningeal space. It occurs more frequently in patients with disseminated neoplastic disease, but it may occur after a disease free interval and may even be the first manifestation of cancer. The most common primary tumors in adults are breast (30-50%), lung (15-25%), melanoma (11%) and gastric cancer (0.16-0.69%); in marked contrast with pediatric cases in which lymphocytic leukemia is the most common. The following article describes an autopsy case of a patient with psychiatric symptoms, with no antecedents of importance, with progressive and fatal neurological impairment, whose pathological studies show meningeal carcinomatosis attributable to advanced gastric adenocarcinoma discovered de novo post mortem.

Treatment of gastric peritoneal carcinomatosis by combining complete surgical resection of lesions and intraperitoneal immunotherapy using catumaxomab

International Nuclear Information System (INIS)

Goéré, Diane; Gras-Chaput, Nathalie; Aupérin, Anne; Flament, Caroline; Mariette, Christophe; Glehen, Olivier; Zitvogel, Laurence; Elias, Dominique

2014-01-01

The peritoneum is one of the most frequent sites of recurrent gastric carcinoma after curative treatment, despite the administration of pre- and/or postoperative systemic chemotherapy. Indeed, the prognosis of peritoneal carcinomatosis from gastric carcinoma continues to be poor, with a median survival of less than one year with systemic chemotherapy. Whereas the prognosis of peritoneal carcinomatosis from colorectal cancer has changed with the development of locally administered hyperthermic intraperitoneal chemotherapy (HIPEC), survival results following carcinomatosis from gastric cancer remain disappointing, yielding a 5-year survival rate of less than 20%. Innovative surgical therapies such as intraperitoneal immunotherapy therefore need to be developed for the immediate postoperative period after complete cytoreductive surgery. In a recent randomised study, a clinical effect was obtained after intraperitoneal infusion of catumaxomab in patients with malignant ascites, notably from gastric carcinoma. Catumaxomab, a nonhumanized chimeric antibody, is characterized by its unique ability to bind to three different types of cells: tumour cells expressing the epithelial cell adhesion molecule (EpCAM), T lymphocytes (CD3) and also accessory cells (Fcγ receptor). Because the peritoneum is an immunocompetent organ and up to 90% of gastric carcinomas express EpCAM, intraperitoneal infusion of catumaxomab after complete resection of all macroscopic disease (as defined in the treatment of carcinomatosis from colorectal cancer) could therefore efficiently treat microscopic residual disease. The aim of this randomized phase II study is to assess 2-year overall survival after complete resection of limited carcinomatosis synchronous with gastric carcinoma, followed by an intraperitoneal infusion of catumaxomab with different total doses administered in each of the 2 arms. Close monitoring of peri-opertive mortality, morbidity and early surgical re-intervention will be done

In silico analysis and verification of S100 gene expression in gastric cancer

International Nuclear Information System (INIS)

Liu, Ji; Li, Xue; Dong, Guang-Long; Zhang, Hong-Wei; Chen, Dong-Li; Du, Jian-Jun; Zheng, Jian-Yong; Li, Ji-Peng; Wang, Wei-Zhong

2008-01-01

The S100 protein family comprises 22 members whose protein sequences encompass at least one EF-hand Ca 2+ binding motif. They were involved in the regulation of a number of cellular processes such as cell cycle progression and differentiation. However, the expression status of S100 family members in gastric cancer was not known yet. Combined with analysis of series analysis of gene expression, virtual Northern blot and microarray data, the expression levels of S100 family members in normal and malignant stomach tissues were systematically investigated. The expression of S100A3 was further evaluated by quantitative RT-PCR. At least 5 S100 genes were found to be upregulated in gastric cance by in silico analysis. Among them, four genes, including S100A2, S100A4, S100A7 and S100A10, were reported to overexpressed in gastric cancer previously. The expression of S100A3 in eighty patients of gastric cancer was further examined. The results showed that the mean expression levels of S100A3 in gastric cancer tissues were 2.5 times as high as in adjacent non-tumorous tissues. S100A3 expression was correlated with tumor differentiation and TNM (Tumor-Node-Metastasis) stage of gastric cancer, which was relatively highly expressed in poorly differentiated and advanced gastric cancer tissues (P < 0.05). To our knowledge this is the first report of systematic evaluation of S100 gene expressions in gastric cancers by multiple in silico analysis. The results indicated that overexpression of S100 gene family members were characteristics of gastric cancers and S100A3 might play important roles in differentiation and progression of gastric cancer

Benign gastric filling defect

Energy Technology Data Exchange (ETDEWEB)

Oh, K K; Lee, Y H; Cho, O K; Park, C Y [Yonsei University College of Medicine, Seoul (Korea, Republic of)

1979-06-15

The gastric lesion is a common source of complaints to Orientals, however, evaluation of gastric symptoms and laboratory examination offer little specific aid in the diagnosis of gastric diseases. Thus roentgenography of gastrointestinal tract is one of the most reliable method for detail diagnosis. On double contract study of stomach, gastric filling defect is mostly caused by malignant gastric cancer, however, other benign lesions can cause similar pictures which can be successfully treated by surgery. 66 cases of benign causes of gastric filling defect were analyzed at this point of view, which was verified pathologically by endoscope or surgery during recent 7 years in Yensei University College of Medicine, Severance Hospital. The characteristic radiological picture of each disease was discussed for precise radiologic diagnosis. 1. Of total 66 cases, there were 52 cases of benign gastric tumor 10 cases of gastric varices, 5 cases of gastric bezoar, 5 cases of corrosive gastritis, 3 cases of granulomatous disease and one case of gastric hematoma. 2. The most frequent causes of benign tumors were adenomatous polyp (35/42) and the next was leiomyoma (4/42). Others were one of case of carcinoid, neurofibroma and cyst. 3. Characteristic of benign adenomatous polyp were relatively small in size, smooth surface and were observed that large size, benign polyp was frequently type IV lesion with a stalk. 4. Submucosal tumors such as leiomyoma needed differential diagnosis with polypoid malignant cancer. However, the characteristic points of differentiation was well circumscribed smooth margined filling defect without definite mucosal destruction on surface. 5. Gastric varices showed multiple lobulated filling defected especially on gastric fundus that changed its size and shape by respiration and posture of patients. Same varices lesions on esophagus and history of liver disease were helpful for easier diagnosis. 6. Gastric bezoar showed well defined movable mass

Benign gastric filling defect

International Nuclear Information System (INIS)

Oh, K. K.; Lee, Y. H.; Cho, O. K.; Park, C. Y.

1979-01-01

The gastric lesion is a common source of complaints to Orientals, however, evaluation of gastric symptoms and laboratory examination offer little specific aid in the diagnosis of gastric diseases. Thus roentgenography of gastrointestinal tract is one of the most reliable method for detail diagnosis. On double contract study of stomach, gastric filling defect is mostly caused by malignant gastric cancer, however, other benign lesions can cause similar pictures which can be successfully treated by surgery. 66 cases of benign causes of gastric filling defect were analyzed at this point of view, which was verified pathologically by endoscope or surgery during recent 7 years in Yensei University College of Medicine, Severance Hospital. The characteristic radiological picture of each disease was discussed for precise radiologic diagnosis. 1. Of total 66 cases, there were 52 cases of benign gastric tumor 10 cases of gastric varices, 5 cases of gastric bezoar, 5 cases of corrosive gastritis, 3 cases of granulomatous disease and one case of gastric hematoma. 2. The most frequent causes of benign tumors were adenomatous polyp (35/42) and the next was leiomyoma (4/42). Others were one of case of carcinoid, neurofibroma and cyst. 3. Characteristic of benign adenomatous polyp were relatively small in size, smooth surface and were observed that large size, benign polyp was frequently type IV lesion with a stalk. 4. Submucosal tumors such as leiomyoma needed differential diagnosis with polypoid malignant cancer. However, the characteristic points of differentiation was well circumscribed smooth margined filling defect without definite mucosal destruction on surface. 5. Gastric varices showed multiple lobulated filling defected especially on gastric fundus that changed its size and shape by respiration and posture of patients. Same varices lesions on esophagus and history of liver disease were helpful for easier diagnosis. 6. Gastric bezoar showed well defined movable mass

Benign gastric filling defect

Energy Technology Data Exchange (ETDEWEB)

Oh, K. K.; Lee, Y. H.; Cho, O. K.; Park, C. Y. [Yonsei University College of Medicine, Seoul (Korea, Republic of)

1979-06-15

The gastric lesion is a common source of complaints to Orientals, however, evaluation of gastric symptoms and laboratory examination offer little specific aid in the diagnosis of gastric diseases. Thus roentgenography of gastrointestinal tract is one of the most reliable method for detail diagnosis. On double contract study of stomach, gastric filling defect is mostly caused by malignant gastric cancer, however, other benign lesions can cause similar pictures which can be successfully treated by surgery. 66 cases of benign causes of gastric filling defect were analyzed at this point of view, which was verified pathologically by endoscope or surgery during recent 7 years in Yensei University College of Medicine, Severance Hospital. The characteristic radiological picture of each disease was discussed for precise radiologic diagnosis. 1. Of total 66 cases, there were 52 cases of benign gastric tumor 10 cases of gastric varices, 5 cases of gastric bezoar, 5 cases of corrosive gastritis, 3 cases of granulomatous disease and one case of gastric hematoma. 2. The most frequent causes of benign tumors were adenomatous polyp (35/42) and the next was leiomyoma (4/42). Others were one of case of carcinoid, neurofibroma and cyst. 3. Characteristic of benign adenomatous polyp were relatively small in size, smooth surface and were observed that large size, benign polyp was frequently type IV lesion with a stalk. 4. Submucosal tumors such as leiomyoma needed differential diagnosis with polypoid malignant cancer. However, the characteristic points of differentiation was well circumscribed smooth margined filling defect without definite mucosal destruction on surface. 5. Gastric varices showed multiple lobulated filling defected especially on gastric fundus that changed its size and shape by respiration and posture of patients. Same varices lesions on esophagus and history of liver disease were helpful for easier diagnosis. 6. Gastric bezoar showed well defined movable mass

Polymorphism in the Methylenetetrahydrofolate Reductase and Thymidylate Synthase Gene Predicts for Response to Fluorouracil-based Chemotherapy in Advanced Gastric Cancer Patients

Directory of Open Access Journals (Sweden)

Jianwei Lu

2013-03-01

Full Text Available Objective: Fluorouracil (5-FU is widely used in the treatment of gastric cancer. Methylenetetrahydrofolate reductase (MTHFR and thymidylate synthetase (TS are important targets of many antimetabolites, including 5-FU. The relationship between polymorphism in the MTHFR (C677T, A1298C and TS (5`-TUR, 3`-UTR genotypes and sensitivity of gastric cancer to 5-FU-based chemotherapy is investigated in the present study. Methods: 173 patients with advanced gastric cancer were analyzed. All patients were treated with 5-FU-based chemotherapy (FOLFOX, FP and DCF regimen. DNA from peripheral blood leukocytes was obtained before the treatment. All genotypes were detected by PCR-RFLP. 12 germline polymorphisms within 2 genes were analyzed. The genotypes of MTHFR C677T, A1298C and TS 3`-TUR were analyzed in 173 patients while TS 5`-TUR in 135 patients. Results: The overall response rate (RR was 35.8%. The RR of the DCF regimen group was significantly higher than that of the FP and FOLFOX regimen groups (55.8% vs. 27.1%, 31.1%; P=0.006. The RR of the MTHFR C677T T/T genotype was significantly higher than that of the C/ C and C/T genotypes (73.3% vs. 28.0%; P=0.000. In MTHFR A1298C, a higher RR was observed in A/A genotype compared with the C/C and A/C genotypes (41.8% vs. 21.6%, P=0.011. The RR of -6/-6 bp and -6/+6 bp genotypes in TS 3`UTR was significantly higher than that of +6/+6 bp genotype (40.3% vs. 17.6%, P=0.014. There was no difference in RR according to TS 5`UTR polymorphism (2R/2R and 2R/3R: 41.7% vs. 3R/3R: 36.8%, P=0.487. The RR of MTHFR C677T T/T genotypes in FOLFOX or FP regimens was significantly higher than that of C/C and C/T genotypes (P=0.008, P=0.000 while no difference in DCF regimen. The RR of DCF regimen wassignificantly higher than that of FOLFOX and FP regimens in C/T and C/C genotypes (P=0.000. The MTHFR C677T T/T genotypes had a significantly higher incidence of grade 3/4 emesis (66.7% and stomatitis (30.0% than patients with C/T or

Stages of chaotic synchronization.

Science.gov (United States)

Tang, D. Y.; Dykstra, R.; Hamilton, M. W.; Heckenberg, N. R.

1998-09-01

In an experimental investigation of the response of a chaotic system to a chaotic driving force, we have observed synchronization of chaos of the response system in the forms of generalized synchronization, phase synchronization, and lag synchronization to the driving signal. In this paper we compare the features of these forms of synchronized chaos and study their relations and physical origins. We found that different forms of chaotic synchronization could be interpreted as different stages of nonlinear interaction between the coupled chaotic systems. (c) 1998 American Institute of Physics.

Synchronous ethernet and IEEE 1588 in telecoms next generation synchronization networks

CERN Document Server

2013-01-01

This book addresses the multiple technical aspects of the distribution of synchronization in new generation telecommunication networks, focusing in particular on synchronous Ethernet and IEEE1588 technologies. Many packet network engineers struggle with understanding the challenges that precise synchronization distribution can impose on networks. The usual “why”, “when” and particularly “how” can cause problems for many engineers. In parallel to this, some other markets have identical synchronization requirements, but with their own design requirements, generating further questions. This book attempts to respond to the different questions by providing background technical information. Invaluable information on state of-the-art packet network synchronization and timing architectures is provided, as well as an unbiased view on the synchronization technologies that have been internationally standardized over recent years, with the aim of providing the average reader (who is not skilled in the art) wi...

Effect of ionizing radiation on gastric secretion and gastric motility in monkeys

Energy Technology Data Exchange (ETDEWEB)

Danquechin Dorval, E.; Mueller, G.P.; Eng, R.R.; Durakovic, A.; Conklin, J.J.; Dubois, A.

1985-08-01

The prodromal syndrome of radiation sickness is characterized by nausea and vomiting but the pathophysiology and the treatment of this entity is largely unknown. The authors investigated this problem by determining the effects of ionizing radiation on gastric function with and without administration of the dopamine antagonist domperidone. They measured gastric electrical control activity (waves per minute), fractional emptying rate (percent per minute), acid output (microequivalents per minute), and plasma levels of immunoreactive beta-endorphin. Twelve conscious, chair-adapted rhesus monkeys were studied twice before, once immediately after, and once 2 days after a single 800-cGy (800 rads) /sup 60/Co total body irradiation. In addition to causing vomiting, total body irradiation transiently suppressed gastric electrical control activity, gastric emptying and gastric secretion, while increasing plasma levels of immunoreactive beta-endorphin. Domperidone had no effect on vomiting or gastric function either before or after irradiation, but it significantly increased plasma immunoreactive beta-endorphin.

Effect of ionizing radiation on gastric secretion and gastric motility in monkeys

Energy Technology Data Exchange (ETDEWEB)

Dorval, E.D.; Mueller, G.P.; Eng, R.R.; Durakovic, A.; Conklin, J.J.

1985-08-01

The prodromal syndrome of radiation sickness is characterized by nausea and vomiting but the pathophysiology and the treatment of this entity is largely unknown. The authors investigated this problem by determining the effects of ionizing radiation on gastric function with and without administration of the dopamine antagonist domperidone. They measured gastric electrical control activity (waves per minute), fractional emptying rate (percent per minute), acid output (microequivalents per minute), and plasma levels of immunoreactive Beta-endorphin. Twelve conscious, chair-adapted rhesus monkeys were studied twice before, once immediately after, and once 2 days after a single 800-cGy (800 rads) /sup 60/Co total-body irradiation. In addition to causing vomiting, total-body irradiation transiently suppressed gastric electrical control activity, gastric emptying and gastric secretion, while increasing plasma levels of immunoreactive Beta-endorphin. Domperidone had no effect on vomiting or gastric function either before or after irradiation, but it significantly increased plasma immunoreactive Beta endorphin.

Does remnant gastric cancer really differ from primary gastric cancer? A systematic review of the literature by the Task Force of Japanese Gastric Cancer Association.

Science.gov (United States)

Shimada, Hideaki; Fukagawa, Takeo; Haga, Yoshio; Oba, Koji

2016-04-01

Remnant gastric cancer, most frequently defined as cancer detected in the remnant stomach after distal gastrectomy for benign disease and those cases after surgery of gastric cancer at least 5 years after the primary surgery, is often reported as a tumor with poor prognosis. The Task Force of Japanese Gastric Cancer Association for Research Promotion evaluated the clinical impact of remnant gastric cancer by systematically reviewing publications focusing on molecular carcinogenesis, lymph node status, patient survival, and surgical complications. A systematic literature search was performed using PubMed/MEDLINE with the keywords "remnant," "stomach," and "cancer," revealing 1154 relevant reports published up to the end of December 2014. The mean interval between the initial surgery and the diagnosis of remnant gastric cancer ranged from 10 to 30 years. The incidence of lymph node metastases at the splenic hilum for remnant gastric cancer is not significantly higher than that for primary proximal gastric cancer. Lymph node involvement in the jejunal mesentery is a phenomenon peculiar to remnant gastric cancer after Billroth II reconstruction. Prognosis and postoperative morbidity and mortality rates seem to be comparable to those for primary proximal gastric cancer. The crude 5-year mortality for remnant gastric cancer was 1.08 times higher than that for primary proximal gastric cancer, but this difference was not statistically significant. In conclusion, although no prospective cohort study has yet evaluated the clinical significance of remnant gastric cancer, our literature review suggests that remnant gastric cancer does not adversely affect patient prognosis and postoperative course.

Impulsive Synchronization and Adaptive-Impulsive Synchronization of a Novel Financial Hyperchaotic System

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Xiuli Chai

2013-01-01

Full Text Available The impulsive synchronization and adaptive-impulsive synchronization of a novel financial hyperchaotic system are investigated. Based on comparing principle for impulsive functional differential equations, several sufficient conditions for impulsive synchronization are derived, and the upper bounds of impulsive interval for stable synchronization are estimated. Furthermore, a nonlinear adaptive-impulsive control scheme is designed to synchronize the financial system using invariant principle of impulsive dynamical systems. Moreover, corresponding numerical simulations are presented to illustrate the effectiveness and feasibility of the proposed methods.

Recurrent amplification of RTEL1 and ABCA13 and its synergistic effect associated with clinicopathological data of gastric adenocarcinoma.

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Araújo, T M; Seabra, A D; Lima, E M; Assumpção, P P; Montenegro, R C; Demachki, S; Burbano, R M; Khayat, A S

2016-01-01

Despite progression in treatment of gastric cancer, prognosis of patients remains poor, in part due to the low rate of diagnosis during its early stages. This paradigm implies the necessity to identify molecular biomarkers for early gastric cancer diagnosis, as well as for disease monitoring, thus contributing to the development of new therapeutic approaches. In a previous study, performed by array-Comparative Genomic Hybridization, we described for the first time in literature recurrent amplification of RTEL1 and ABCA13 genes in gastric cancer. Thus, the aim of the present study was to validate recurrent amplification of RTEL1 and ABCA13 genes and associate CNV status with clinicopathological data. Results showed RTEL1 and ABCA13 amplification in 38 % of samples. Statistical analysis demonstrated that RTEL amplification is more common in older patients and more associated with intestinal type and ABCA13 amplification increases the risk of lymph node metastasis and is more common in men. Co-amplification of these genes showed a significant association with advanced staging. aCGH is a very useful tool for investigating novel genes associated with carcinogenesis and RTEL1 amplification may be important for the development of gastric cancer in older patients, besides being a probable event contributing for chromosomal instability in intestinal gastric carcinogenesis. ABCA13 amplification may have age-specific function and could be considered a useful marker for predicting lymph node metastasis in resected gastric cancer patients in early stage. Lastly, RTEL1 and ABCA13 synergistic effect may be considered as a putative marker for advanced staging in gastric cancer patients.

Complex systems fractionality, time-delay and synchronization

CERN Document Server

Sun, Jian-Qiao

2012-01-01

"Complex Systems: Fractionality, Time-delay and Synchronization" covers the most recent developments and advances in the theory and application of complex systems in these areas. Each chapter was written by scientists highly active in the field of complex systems. The book discusses a new treatise on fractional dynamics and control, as well as the new methods for differential delay systems and control. Lastly, a theoretical framework for the complexity and synchronization of complex system is presented. The book is intended for researchers in the field of nonlinear dynamics in mathematics, physics and engineering. It can also serve as a reference book for graduate students in physics, applied mathematics and engineering. Dr. Albert C.J. Luo is a Professor at Southern Illinois University Edwardsville, USA. Dr. Jian-Qiao Sun is a Professor at the University of California, Merced, USA.

Cyclooxygenase-2 Expression in Chronic Gastritis and Gastric Carcinoma, Correlation with Prognostic Parameters

International Nuclear Information System (INIS)

Samaka, R.M.; Abdou, A.G.; Abd El-Wahed, M.M.; Kandil, M.A.; El-Kady, N.M.

2006-01-01

Background: Cyclooxygenase-2 (Cox-2) is the inducible form of cyclooxygenase enzyme. Cox-2 is induced in numerous processes such as cellular growth, differentiation, inflammation and tumorigenesis. Purpose: Assessment of Cox-2 expression in chronic gastritis s and gastric carcinoma. Material and Methods: Sixteen chronic gastritis (CG) and 43 gastric carcinoma cases were subjected to an immunohistochemical approach using anti Cox-2 antibody. Results: All CG cases displayed positive epithelial Cox-2 expression with only 25% positivity for stromal expression. Eighty six percent of gastric carcinoma showed epithelial Cox-2 expression that was significantly correlated with lymph node involvement (p=0.01), advanced stage (p=0.01), high micro vessel density (MVD) (p=0.0001), vascular invasion (p=0.002), peri neural invasion (p=0.0 I) and low apoptotic count (p<0.0001). Stromal Cox-2 expression was seen in 79% of gastric carcinoma cases and was significantly associated with low apoptotic count (p=0.0007), vascular invasion (p=0.001) and high micro vessel density (MVD) (p=0.0003). Only stromal Cox2 expression was significantly higher in gastric carcinoma than chronic gastritis (p=0.0001). Conclusions: Cox-2 appears to be involved in gastric carcinoma progression as it promotes angio genesis, suppresses apoptosis and facilitates invasion and metastasis Double expression of Cox-2 in gastric carcinoma epithelium and stroma and significant association between them demonstrate a paracrine cross effect between stromal and malignant epithelium

Efficacy and safety of angiogenesis inhibitors in advanced gastric cancer: a systematic review and meta-analysis

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Jing Yu

2016-10-01

Full Text Available Abstract Monoclonal antibodies and small molecule tyrosine kinase inhibitors (TKIs directed against the vascular endothelial growth factor (VEGF or its receptors have been investigated in several studies for the treatment of advanced gastric cancer (GC. In the present study, we aimed to evaluate the efficacy and safety of angiogenesis inhibitors in advanced GC. We searched published randomized controlled trials (RCTs comparing angiogenesis inhibitors with non-angiogenesis inhibitors for the treatment of GC. MEDLINE, EMBASE, and the Cochrane Controlled Trials Register were searched. The extracted data on progression-free survival (PFS and overall survival (OS were measured in terms of hazard ratios (HR and corresponding 95 % confidence intervals (CIs. In addition, risk ratios (RR and corresponding 95 % CIs were pooled for objective response rate (ORR, disease control rate (DCR, and risk of adverse events (AEs. Ten RCTs involving 2786 patients were included. Compared with non-angiogenesis inhibitor-containing regimens, angiogenesis inhibitor-containing regimens resulted in a significant improvement in OS (HR 0.80, 95 % CI 0.69–0.93, P = 0.004, prolonged PFS (HR 0.66, 95 % CI 0.51–0.86, P = 0.002, and superior ORR (RR 1.34, 95 % CI 1.09–1.65, P = 0.005 and DCR (RR 1.37, 95 % CI 1.17–1.61, P = 0.0001. Angiogenesis inhibitors were associated with a greater number of AEs, but most of these were predictable and manageable. However, hand-foot syndrome, diarrhea, and gastrointestinal (GI perforation were significantly increased in patients treated with angiogenesis inhibitors. In summary, angiogenesis inhibitor-containing regimens were superior to non-angiogenesis inhibitor-containing regimens in terms of OS, PFS, RR, and DCR in patients with advanced GC.

Histopathological, Molecular, and Genetic Profile of Hereditary Diffuse Gastric Cancer: Current Knowledge and Challenges for the Future.

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van der Post, Rachel S; Gullo, Irene; Oliveira, Carla; Tang, Laura H; Grabsch, Heike I; O'Donovan, Maria; Fitzgerald, Rebecca C; van Krieken, Han; Carneiro, Fátima

Familial clustering is seen in 10 % of gastric cancer cases and approximately 1-3 % of gastric cancer arises in the setting of hereditary diffuse gastric cancer (HDGC). In families with HDGC, gastric cancer presents at young age. HDGC is predominantly caused by germline mutations in CDH1 and in a minority by mutations in other genes, including CTNNA1. Early stage HDGC is characterized by a few, up to dozens of intramucosal foci of signet ring cell carcinoma and its precursor lesions. These include in situ signet ring cell carcinoma and pagetoid spread of signet ring cells. Advanced HDGC presents as poorly cohesive/diffuse type carcinoma, normally with very few typical signet ring cells, and has a poor prognosis. Currently, it is unknown which factors drive the progression towards aggressive disease, but it is clear that most intramucosal lesions will not have such progression.Immunohistochemical profile of early and advanced HDGC is often characterized by abnormal E-cadherin immunoexpression, including absent or reduced membranous expression, as well as "dotted" or cytoplasmic expression. However, membranous expression of E-cadherin does not exclude HDGC. Intramucosal HDGC (pT1a) presents with an "indolent" phenotype, characterized by typical signet ring cells without immunoexpression of Ki-67 and p53, while advanced carcinomas (pT > 1) display an "aggressive" phenotype with pleomorphic cells, that are immunoreactive for Ki-67 and p53. These features show that the IHC profile is different between intramucosal and more advanced HDGC, providing evidence of phenotypic heterogeneity, and may help to define predictive biomarkers of progression from indolent to aggressive, widely invasive carcinomas.

Macroscopy predicts tumor progression in gastric cancer: A retrospective patho-historical analysis based on Napoleon Bonaparte's autopsy report.

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Dawson, Heather; Novotny, Alexander; Becker, Karen; Reim, Daniel; Langer, Rupert; Gullo, Irene; Svrcek, Magali; Niess, Jan H; Tutuian, Radu; Truninger, Kaspar; Diamantis, Ioannis; Blank, Annika; Zlobec, Inti; Riddell, Robert H; Carneiro, Fatima; Fléjou, Jean-François; Genta, Robert M; Lugli, Alessandro

2016-11-01

The cause of Napoleon Bonaparte's death remains controversial. Originally suggested to be gastric cancer, whether this was truly neoplastic or a benign lesion has been recently debated. To interpret findings of original autopsy reports in light of the current knowledge of gastric cancer and to highlight the significance of accurate macroscopy in modern-day medicine. Using original autopsy documents, endoscopic images and data from current literature, Napoleon's gastric situation was reconstructed. In a multicenter collection of 2071 gastric cancer specimens, the relationship between tumor size and features of tumor progression was assessed. Greater tumor size was associated with advanced pT, nodal metastases and Borrmann types 3-4 (pNapoleon's autopsy with present-day knowledge to support gastric cancer as his terminal illness and emphasizes the role of macroscopy, which may provide valuable information on gastric cancer progression and aid patient management. Copyright © 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

Ultrasonographic gastric antral area and gastric contents volume in children.

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Schmitz, Achim; Thomas, Schraner; Melanie, Fruehauf; Rabia, Liamlahi; Klaghofer, Richard; Weiss, Markus; Kellenberger, Christian

2012-02-01

Cross-sectional gastric antral area (GAA) measurements by ultrasonography (US) have been proposed for preoperative assessment of gastric volume in adults but not been validated in children. This study investigates whether in children gastric volumes can be predicted by US performed in different patient positions. Gastric fluid and air volumes were examined by magnetic resonance imaging before or up to 120 min after ingestion of 7 ml·kg(-1) diluted raspberry syrup in healthy volunteers who had fasted overnight. GAA was measured with US three times each in supine (SUP), elevated 45° degree supine (E45) and right decubital (RDC) position using imaging planes defined by vascular landmarks. Correlation coefficients (Pearson) between GAA and gastric volumes were calculated and Bland-Altman analysis performed. Sixteen children aged from 6.4 to 12.8 (9.2) years were included in 23 examinations: 6 after overnight fasting, 3 directly after, and 14 with a delay of 74 ± 35 min after fluid intake. GAA was 221 ± 116, 218 ± 112, and 347 ± 188 mm(2) for SUP, E45, and RDC position, respectively. The best correlation between body weight corrected total gastric/gastric fluid volume (TGV(w)/GFV(w)) with GAA was found for RDC position (R = 0.79; P < 0.01/R = 0.78; P < 0.01). Bias and precision of calculated and measured GFV(w) was 0 ± 2.8 ml·kg(-1). Correlations between GAA and TGV(w) or GFV(w) in children are best in the RDC position, but not sufficient to predict GFV(w) with a given GAA. Interpretation of isolated GAA values may be misleading. © 2011 Blackwell Publishing Ltd.

Gastric and intestinal surgery.

Science.gov (United States)

Fossum, Theresa W; Hedlund, Cheryl S

2003-09-01

Gastric surgery is commonly performed to remove foreign bodies and correct gastric dilatation-volvulus and is less commonly performed to treat gastric ulceration or erosion, neoplasia, and benign gastric outflow obstruction. Intestinal surgery, although commonly performed by veterinarians, should never be considered routine. The most common procedures of the small intestinal tract performed in dogs and cats include enterotomy and resection/anastomosis. Surgery of the large intestine is indicated for lesions causing obstruction, perforations, colonic inertia, or chronic inflammation.

Mouse Models of Gastric Cancer

Science.gov (United States)

Hayakawa, Yoku; Fox, James G.; Gonda, Tamas; Worthley, Daniel L.; Muthupalani, Sureshkumar; Wang, Timothy C.

2013-01-01

Animal models have greatly enriched our understanding of the molecular mechanisms of numerous types of cancers. Gastric cancer is one of the most common cancers worldwide, with a poor prognosis and high incidence of drug-resistance. However, most inbred strains of mice have proven resistant to gastric carcinogenesis. To establish useful models which mimic human gastric cancer phenotypes, investigators have utilized animals infected with Helicobacter species and treated with carcinogens. In addition, by exploiting genetic engineering, a variety of transgenic and knockout mouse models of gastric cancer have emerged, such as INS-GAS mice and TFF1 knockout mice. Investigators have used the combination of carcinogens and gene alteration to accelerate gastric cancer development, but rarely do mouse models show an aggressive and metastatic gastric cancer phenotype that could be relevant to preclinical studies, which may require more specific targeting of gastric progenitor cells. Here, we review current gastric carcinogenesis mouse models and provide our future perspectives on this field. PMID:24216700

Current Trend Towards Using Soft Computing Approaches to Phase Synchronization in Communication Systems

Science.gov (United States)

Drake, Jeffrey T.; Prasad, Nadipuram R.

1999-01-01

This paper surveys recent advances in communications that utilize soft computing approaches to phase synchronization. Soft computing, as opposed to hard computing, is a collection of complementary methodologies that act in producing the most desirable control, decision, or estimation strategies. Recently, the communications area has explored the use of the principal constituents of soft computing, namely, fuzzy logic, neural networks, and genetic algorithms, for modeling, control, and most recently for the estimation of phase in phase-coherent communications. If the receiver in a digital communications system is phase-coherent, as is often the case, phase synchronization is required. Synchronization thus requires estimation and/or control at the receiver of an unknown or random phase offset.

Synchronization method for grid integrated battery storage systems during asymmetrical grid faults

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Popadić Bane

2017-01-01

Full Text Available This paper aims at presenting a robust and reliable synchronization method for battery storage systems during asymmetrical grid faults. For this purpose, a Matlab/Simulink based model for testing of the power electronic interface between the grid and the battery storage systems has been developed. The synchronization method proposed in the paper is based on the proportional integral resonant controller with the delay signal cancellation. The validity of the synchronization method has been verified using the advanced laboratory station for the control of grid connected distributed energy sources. The proposed synchronization method has eliminated unfavourable components from the estimated grid angular frequency, leading to the more accurate and reliable tracking of the grid voltage vector positive sequence during both the normal operation and the operation during asymmetrical grid faults. [Project of the Serbian Ministry of Education, Science and Technological Development, Grant no. III 042004: Integrated and Interdisciplinary Research entitled: Smart Electricity Distribution Grids Based on Distribution Management System and Distributed Generation

Pinning-controlled synchronization of complex networks with bounded or unbounded synchronized regions

International Nuclear Information System (INIS)

Yan-Li, Zou; Guan-Rong, Chen

2009-01-01

This paper studies pinning-controlled synchronization of complex networks with bounded or unbounded synchronized regions. To study a state-feedback pinning-controlled network with N nodes, it first converts the controlled network to an extended network of N+1 nodes without controls. It is shown that the controlled synchronizability of the given network is determined by the real part of the smallest nonzero eigenvalue of the coupling matrix of its extended network when the synchronized region is unbounded; but it is determined by the ratio of the real parts of the largest and the smallest nonzero eigenvalues of the coupling matrix when the synchronized region is bounded. Both theoretical analysis and numerical simulation show that the portion of controlled nodes has no critical values when the synchronized region is unbounded, but it has a critical value when the synchronized region is bounded. In the former case, therefore, it is possible to control the network to achieve synchronization by pinning only one node. In the latter case, the network can achieve controlled synchronization only when the portion of controlled nodes is larger than the critical value. (general)

Characterization of fasted human gastric fluid for relevant rheological parameters and gastric lipase activities

DEFF Research Database (Denmark)

Pedersen, Pernille Barbre; Vilmann, Peter; Bar-Shalom, Daniel

2013-01-01

be considered important during development of gastric simulated media. Further, the activity of the HGL is active even under fasted gastric conditions and might contribute to the digestion and emulsification of lipid-based drug delivery systems in the entire gastrointestinal tract. HGL should therefore......PURPOSE: To characterize human gastric fluid with regard to rheological properties and gastric lipase activity. In addition, traditional physicochemical properties were determined. METHODS: Fasted HGA were collected from 19 healthy volunteers during a gastroscopic examination. Rheological...... be considered in gastric evaluation of lipid-based drug delivery systems....

Bimonthly 24 h infusion of high-dose 5-fluorouracil vs EAP regimen in patients with advanced gastric cancer. A randomized phase II study.

Science.gov (United States)

Popov, I P; Jelić, S B; Krivokapić, Z V; Jezdić, S D; Pesko, P M; Micev, M T; Babić, D R

2008-01-01

To investigate the activity and toxicity of high dose (HD) infusional 5-FU in comparison to EAP regimen as first-line chemotherapy in patients with advanced gastric cancer. Histologically confirmed measurable advanced gastric cancer, age EAP arm: doxorubicin (40 mg/m(2)), etoposide (360 mg/m(2)), and cisplatin (80 mg/m(2)) every 28 d; HD 5-FU arm: 5-FU 2.6 g/m(2) 24 h infusion, biweekly. Sixty patients were randomized. Patient characteristics (arms EAP/HD 5-FU): Median age 57/55 yr, median PS 1/1, LAD (patients) 3/8, M1 (patients) 27/22. Median number of cycles (range): EAP arm 4 (2-8), HD 5-FU arm 2 (1-8). Worst toxicity per cycle (grade 3 and 4 in%): Neutropenia 20/3, thrombocytopenia 9/0, anemia 9/13, diarrhea 3/10, nausea 17/7, vomiting 10/0 for EAP and HD 5-FU arms, respectively. All patients were eligible for response in both arms. Confirmed response rate (95%CI): EAP arm 34% [16-50%]/HD 5-FU arm 10% (0-21%), no change: 46/40%, progression of disease: 20/50, respectively. Overall survival (range): EAP arm A 7 mo [3-27], HD 5-FU arm 6 mo (4-25). Infusional HD 5-FU showed a low incidence of severe toxicity. But given the low efficacy of 5-FU in the dosage we applied in the study, it cannot be recommended as a single treatment for further studies. Assessment of higher dose intensity and/or dose density of 5-FU, with introduction of other active drugs in combination, could be an option for further studies.

Levels of matrix metalloproteinase-1 and tissue inhibitors of metalloproteinase-1 in gastric cancer

Science.gov (United States)

Kemik, Ozgur; Kemik, Ahu Sarbay; Sümer, Aziz; Dulger, Ahmet Cumhur; Adas, Mine; Begenik, Huseyin; Hasirci, Ismail; Yilmaz, Ozkan; Purisa, Sevim; Kisli, Erol; Tuzun, Sefa; Kotan, Cetin

2011-01-01

AIM: To evaluate the levels of preoperative serum matrix metalloproteinase-1 (MMP-1) and tissue inhibitor of metalloproteinase-1 (TIMP-1) in gastric cancer. METHODS: One hundred gastric cancer patients who underwent gastrectomy were enrolled in this study. The serum concentrations of MMP-1 and TIMP-1 in these patients and in fifty healthy controls were determined using an enzyme-linked immunosorbent assay. RESULTS: Higher serum MMP-1 and TIMP-1 levels were observed in patients than in controls (P < 0.001). Serum MMP-1 and TIMP-1 levels were positively associated with morphological appearance, tumor size, depth of wall invasion, lymph node metastasis, liver metastasis, perineural invasion, and pathological stage. They were not significantly associated with age, gender, tumor location, or histological type. CONCLUSION: Increased MMP-1 and TIMP-1 were associated with gastric cancer. Although these markers are not good markers for diagnosis, these markers show in advanced gastric cancer. PMID:21547130

The distinctive gastric fluid proteome in gastric cancer reveals a multi-biomarker diagnostic profile

Directory of Open Access Journals (Sweden)

Eng Alvin KH

2008-10-01

Full Text Available Abstract Background Overall gastric cancer survival remains poor mainly because there are no reliable methods for identifying highly curable early stage disease. Multi-protein profiling of gastric fluids, obtained from the anatomic site of pathology, could reveal diagnostic proteomic fingerprints. Methods Protein profiles were generated from gastric fluid samples of 19 gastric cancer and 36 benign gastritides patients undergoing elective, clinically-indicated gastroscopy using surface-enhanced laser desorption/ionization time-of-flight mass spectrometry on multiple ProteinChip arrays. Proteomic features were compared by significance analysis of microarray algorithm and two-way hierarchical clustering. A second blinded sample set (24 gastric cancers and 29 clinically benign gastritides was used for validation. Results By significance analysyis of microarray, 60 proteomic features were up-regulated and 46 were down-regulated in gastric cancer samples (p Conclusion This simple and reproducible multimarker proteomic assay could supplement clinical gastroscopic evaluation of symptomatic patients to enhance diagnostic accuracy for gastric cancer and pre-malignant lesions.

Differential diagnosis of gastric adenoma and type IIa early gastric cancer

International Nuclear Information System (INIS)

Tsuchigame, T.; Ogata, Y.; Sumi, M.; Fukui, K.; Saito, R.; Nakashima, K.; Urata, J.; Arakawa, A.; Saito, Y.; Takahashi, M.

1991-01-01

The endoscopic and radiographic findings of 45 gastric adenomas in 39 patients were followed for 6 months to 13 years and compared with type IIa early gastric cancer observed in 9 patients. Difficulties in the diffential diagnosis of these disorders were evaluated. The following features were suggestive of gastric adenomas: clustered lesions; protuberance with gentle slope; smooth surface; and relatively young patients. Discrimination of adenoma from type IIa early gastric cancer is often difficult by visual observation alone; biopsy was essential in most patients. A group III adenoma verified on biopsy should be followed closely because the lesion may harbor a cancer (so-called carcinoma-in-adenoma) or a cancer may later develop. (orig.)

Gastric intestinal metaplasia: an intermediate precancerous lesion in the cascade of gastric carcinogenesis

International Nuclear Information System (INIS)

Malik, T.H.; Hong, X.; Sayahan, M.Y.A.

2017-01-01

Gastric intestinal metaplasia, an intermediate lesion in the development of intestinal-type gastric cancer, is observed in the milieu of long standing non-atrophic gastritis and atrophic gastritis. Most patients with intestinal metaplasia remain asymptomatic unless cobalamin deficiency occurs secondary to loss of glands (that produce intrinsic factor and acid). Genetic events that predispose to development of gastric intestinal metaplasia remains an enigma. Mechanisms leading to the progression of atrophy to metaplasia still needs to be comprehensively explored. Many studies in the literature describe a positive effect of typing intestinal metaplasia and concluded that intestinal metaplasia type III carries the highest risk for developing gastric cancer while others refute it. It is well established that Helicobacter pylori infection is the most important factor for the development of chronic gastritis, gastric intestinal metaplasia as well as gastric cancer. Countries with a higher prevalence of Helicobacter pylori infection and gastric cancer also have a high tendency of being prevalent for intestinal metaplasia. However, it remains elusive whether eradication of Helicobacter pylori infection tends to regress gastric intestinal metaplasia or reduce the subsequent risk of cancer development. Putting together, more prospective cohort studies should be designed to identify factors (antioxidants; anti-inflammatory drugs; food therapy) that may contribute in the regression of intestinal metaplasia, when used simultaneously with eradication therapy. Furthermore, molecular markers for evaluation of intestinal metaplasia, and the potential point-of-no-return should be further investigated. Consensus is also required to advocate a timeframe for surveillance of patients with gastric intestinal metaplasia. (author)

Ramucirumab plus paclitaxel versus placebo plus paclitaxel in patients with previously treated advanced gastric or gastro-oesophageal junction adenocarcinoma (RAINBOW): a double-blind, randomised phase 3 trial.

Science.gov (United States)

Wilke, Hansjochen; Muro, Kei; Van Cutsem, Eric; Oh, Sang-Cheul; Bodoky, György; Shimada, Yasuhiro; Hironaka, Shuichi; Sugimoto, Naotoshi; Lipatov, Oleg; Kim, Tae-You; Cunningham, David; Rougier, Philippe; Komatsu, Yoshito; Ajani, Jaffer; Emig, Michael; Carlesi, Roberto; Ferry, David; Chandrawansa, Kumari; Schwartz, Jonathan D; Ohtsu, Atsushi

2014-10-01

VEGFR-2 has a role in gastric cancer pathogenesis and progression. We assessed whether ramucirumab, a monoclonal antibody VEGFR-2 antagonist, in combination with paclitaxel would increase overall survival in patients previously treated for advanced gastric cancer compared with placebo plus paclitaxel. This randomised, placebo-controlled, double-blind, phase 3 trial was done at 170 centres in 27 countries in North and South America, Europe, Asia, and Australia. Patients aged 18 years or older with advanced gastric or gastro-oesophageal junction adenocarcinoma and disease progression on or within 4 months after first-line chemotherapy (platinum plus fluoropyrimidine with or without an anthracycline) were randomly assigned with a centralised interactive voice or web-response system in a 1:1 ratio to receive ramucirumab 8 mg/kg or placebo intravenously on days 1 and 15, plus paclitaxel 80 mg/m(2) intravenously on days 1, 8, and 15 of a 28-day cycle. A permuted block randomisation, stratified by geographic region, time to progression on first-line therapy, and disease measurability, was used. The primary endpoint was overall survival. Efficacy analysis was by intention to treat, and safety analysis included all patients who received at least one treatment with study drug. This trial is registered with ClinicalTrials.gov, number NCT01170663, and has been completed; patients who are still receiving treatment are in the extension phase. Between Dec 23, 2010, and Sept 23, 2012, 665 patients were randomly assigned to treatment-330 to ramucirumab plus paclitaxel and 335 to placebo plus paclitaxel. Overall survival was significantly longer in the ramucirumab plus paclitaxel group than in the placebo plus paclitaxel group (median 9·6 months [95% CI 8·5-10·8] vs 7·4 months [95% CI 6·3-8·4], hazard ratio 0·807 [95% CI 0·678-0·962]; p=0·017). Grade 3 or higher adverse events that occurred in more than 5% of patients in the ramucirumab plus paclitaxel group versus placebo

Lymphogenous metastasis to the transverse colon that originated from signet-ring cell gastric cancer: A case report and review of the literature.

Science.gov (United States)

Sonoda, Hirofumi; Kawai, Kazushige; Yamaguchi, Hironori; Murono, Koji; Kaneko, Manabu; Nishikawa, Takeshi; Otani, Kensuke; Sasaki, Kazuhito; Yasuda, Koji; Tanaka, Toshiaki; Kiyomatsu, Tomomichi; Hata, Keisuke; Nozawa, Hiroaki; Ishihara, Soichiro; Aikou, Susumu; Yamashita, Hiroharu; Ushiku, Tetsuo; Seto, Yasuyuki; Fukayama, Masashi; Watanabe, Toshiaki

2017-12-01

Metastases to the colon are rare and a high-frequency primary region is the stomach. In cases of metastases to the colon, the morphological type of the metastatic region is mostly the infiltrating type of poorly differentiated or undifferentiated adenocarcinoma with lymph and blood vessel invasion. A case of cancer metastasis to the transverse colon that originated from advanced gastric cancer, which shows the difficulties in the precise diagnosis of metastases to the colon, is presented. In the present case, the gastric carcinoma was determined to be an advanced infiltrative ulcerative adenocarcinoma and the colon carcinoma was determined to be a superficial depressed adenocarcinoma. After surgery, the colon carcinoma was diagnosed as a metastatic adenocarcinoma from gastric adenocarcinoma with high invasion of vessels, by immunohistopathological analysis of CK7, CK20, p53 and HER-2. In this report, previously reported cases of metastases to the colon from gastric cancer were reviewed and their morphological characteristics were analyzed. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Molecular-targeted therapy for chemotherapy-refractory gastric cancer: a case report and literature review.

Science.gov (United States)

Kuo, Hung-Yang; Yeh, Kun-Huei

2014-07-01

The prognosis of advanced gastric cancer (AGC) remains poor despite therapeutic advances in recent decades. Several recent positive phase III trials established the efficacy of second-line chemotherapy for metastatic gastric cancer in prolonging overall survival. However, malnutrition and poor performance of AGC in late stages usually preclude such patients from intensive treatment. Many targeted-therapies failed to show a significant survival benefit in AGC, but have regained attention after the positive result of ramucirumab was announced last year. Among all targeted agents, only trastuzumab, a monoclonal antibody against Human epidermal growth factor receptor-2 (HER2) protein, has been proven as having survival benefit by addition to first-line chemotherapy. Herein we reported a patient who benefited from adding trastuzumab to the same second-line combination chemotherapy (paclitaxel, 5-fluorouracil, and leucovorin) upon progression of bulky liver metastases. At least five months of progression-free survival were achieved without any additional toxicity. We also reviewed literature of molecularly-targeted therapy for chemotherapy-refractory gastric cancer, including several large phase III trials (REGARD, GRANITE-1, EXPAND, and REAL-3) published in 2013-2014. Copyright© 2014 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

Synchronization on effective networks

International Nuclear Information System (INIS)

Zhou Tao; Zhao Ming; Zhou Changsong

2010-01-01

The study of network synchronization has attracted increasing attentionrecently. In this paper, we strictly define a class of networks, namely effective networks, which are synchronizable and orientable networks. We can prove that all the effective networks with the same size have the same spectra, and are of the best synchronizability according to the master stability analysis. However, it is found that the synchronization time for different effective networks can be quite different. Further analysis shows that the key ingredient affecting the synchronization time is the maximal depth of an effective network: the larger depth results in a longer synchronization time. The secondary factor is the number of links. The increasing number of links connecting nodes in the same layer (horizontal links) will lead to longer synchronization time, whereas the increasing number of links connecting nodes in neighboring layers (vertical links) will accelerate the synchronization. Our analysis of the relationship between the structure and synchronization properties of the original and effective networks shows that the purely directed effective network can provide an approximation of the original weighted network with normalized input strength. Our findings provide insights into the roles of depth, horizontal and vertical links in the synchronizing process, and suggest that the spectral analysis is helpful yet insufficient for the comprehensive understanding of network synchronization.

Synchronization on effective networks

Energy Technology Data Exchange (ETDEWEB)

Zhou Tao [Web Sciences Center, University of Electronic Science and Technology of China, Chengdu 610054 (China); Zhao Ming [Department of Modern Physics, University of Science and Technology of China, Hefei 230026 (China); Zhou Changsong, E-mail: cszhou@hkbu.edu.h [Department of Physics, Hong Kong Baptist University, Kowloon Tong (Hong Kong)

2010-04-15

The study of network synchronization has attracted increasing attentionrecently. In this paper, we strictly define a class of networks, namely effective networks, which are synchronizable and orientable networks. We can prove that all the effective networks with the same size have the same spectra, and are of the best synchronizability according to the master stability analysis. However, it is found that the synchronization time for different effective networks can be quite different. Further analysis shows that the key ingredient affecting the synchronization time is the maximal depth of an effective network: the larger depth results in a longer synchronization time. The secondary factor is the number of links. The increasing number of links connecting nodes in the same layer (horizontal links) will lead to longer synchronization time, whereas the increasing number of links connecting nodes in neighboring layers (vertical links) will accelerate the synchronization. Our analysis of the relationship between the structure and synchronization properties of the original and effective networks shows that the purely directed effective network can provide an approximation of the original weighted network with normalized input strength. Our findings provide insights into the roles of depth, horizontal and vertical links in the synchronizing process, and suggest that the spectral analysis is helpful yet insufficient for the comprehensive understanding of network synchronization.

Features of gastritis predisposing to gastric adenoma and early gastric cancer

OpenAIRE

Meining, A; Riedl, B; Stolte, M

2002-01-01

Background/Aims: Helicobacter pylori gastritis is a risk factor for the development of gastric cancer. The results of several studies indicate that gastric adenomas, which are considered premalignant lesions, may also be associated with H pylori gastritis. However, it is not clear whether there are different patterns of gastritis in these patients compared with patients with gastric cancer or patients with H pylori gastritis alone. Therefore, this study was designed to investigate the pattern...

Gastric Metastasis of Ectopic Breast Cancer Mimicking Axillary Metastasis of Primary Gastric Cancer

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Selami Ilgaz Kayılıoğlu

2014-01-01

Full Text Available Ectopic breast tissue has the ability to undergo all the pathological changes of the normal breast, including breast cancer. Gastrointestinal metastasis of breast cancer is rarely observed and it is very difficult to differentiate gastric metastases from primary gastric cancer. We present a case of 52-year-old female, who suffered from abdominal pain. Physical examination showed a palpable mass in the left anterior axilla and computerized tomography revealed gastric wall thickening with linitis plastica. When gastroscopic biopsy showed no signs of malignancy, excisional biopsy was performed in the left axilla. Histological examination revealed invasive lobular carcinoma of the breast, consistent with ectopic breast cancer. Further gastroscopic submucosal biopsies and immunohistochemical studies revealed gastric metastases of invasive lobular carcinoma. Axillary ectopic breast tissue carcinomas can mimic axillary lymphadenopathies. Additionally, gastric metastasis of breast cancer is an uncommon but possible condition. To the best of our knowledge, this is the first report of ectopic breast cancer with gastric metastasis.

Gastric ulceration subsequent to partial invagination of the stomach in a dog with gastric dilatation-volvulus.

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Parton, Amanda T; Volk, Susan W; Weisse, Chick

2006-06-15

CASE DESCRIPTION-An 8-year-old castrated male German Shepherd Dog was evaluated because of abdominal distension, retching, and vomiting. CLINICAL FINDINGS-Gastric dilatation-volvulus was suspected on the basis of the dog's signalment, history, clinical signs, and results of clinicopathologic analyses and abdominal radiography. Celiotomy was performed, and gastric dilatation-volvulus was confirmed along with splenomegaly. Gastric invagination was performed over an area of gastric necrosis. The dog was reevaluated 21 days later after an episode of collapse. Findings of physical examination and clinicopathologic analyses were suggestive of internal hemorrhage. Abdominal ultrasonography and subsequent celiotomy revealed severe gastric ulceration at the gastric invagination site, splenic torsion, and a focal splenic infarct. TREATMENT AND OUTCOME-Splenectomy and gastrectomy of the necrotic tissue were performed. The dog was discharged from the hospital, and the owner was instructed to administer gastroprotectants and feed the dog a bland diet. The dog was reported to be healthy 3.25 years after surgery. CLINICAL RELEVANCE-Findings suggest that complications associated with the gastric invagination procedure include severe gastric ulceration that may require subsequent surgery. Prolonged treatment with gastroprotectants following gastric invagination surgery may be necessary to avoid gastric ulceration in dogs.

Genomic dysregulation in gastric tumors.

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Janjigian, Yelena Y; Kelsen, David P

2013-03-01

Gastric cancer is among the most common human malignancies and the second leading cause of cancer-related death. The different epidemiologic and histopathology of subtypes of gastric cancer are associated with different genomic patterns. Data suggests that gene expression patterns of proximal, distal gastric cancers-intestinal type, and diffuse/signet cell are well separated. This review summarizes the genetic and epigenetic changes thought to drive gastric cancer and the emerging paradigm of gastric cancer as three unique disease subtypes. Copyright © 2012 Wiley Periodicals, Inc.

Synchronization of chaotic systems

International Nuclear Information System (INIS)

Pecora, Louis M.; Carroll, Thomas L.

2015-01-01

We review some of the history and early work in the area of synchronization in chaotic systems. We start with our own discovery of the phenomenon, but go on to establish the historical timeline of this topic back to the earliest known paper. The topic of synchronization of chaotic systems has always been intriguing, since chaotic systems are known to resist synchronization because of their positive Lyapunov exponents. The convergence of the two systems to identical trajectories is a surprise. We show how people originally thought about this process and how the concept of synchronization changed over the years to a more geometric view using synchronization manifolds. We also show that building synchronizing systems leads naturally to engineering more complex systems whose constituents are chaotic, but which can be tuned to output various chaotic signals. We finally end up at a topic that is still in very active exploration today and that is synchronization of dynamical systems in networks of oscillators

Endoscopic stenting versus operative gastrojejunostomy for malignant gastric outlet obstruction.

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Chandrasegaram, Manju D; Eslick, Guy D; Mansfield, Clare O; Liem, Han; Richardson, Mark; Ahmed, Sulman; Cox, Michael R

2012-02-01

Malignant gastric outlet obstruction represents a terminal stage in pancreatic cancer. Between 5% and 25% of patients with pancreatic cancer ultimately experience malignant gastric outlet obstruction. The aim in palliating patients with malignant gastric outlet obstruction is to reestablish an oral intake by restoring gastrointestinal continuity. This ultimately improves their quality of life in the advanced stages of cancer. The main drawback to operative bypass is the high incidence of delayed gastric emptying, particularly in this group of patients with symptomatic obstruction. This study aimed to compare surgical gastrojejunostomy and endoscopic stenting in palliation of malignant gastric outlet obstruction, acknowledging the diversity and heterogeneity of patients with this presentation. This retrospective study investigated patients treated for malignant gastric outlet obstruction from December 1998 to November 2008 at Nepean Hospital, Sydney, Australia. Endoscopic duodenal stenting was performed under fluoroscopic guidance for placement of the stent. The operative patients underwent open surgical gastrojejunostomy. The outcomes assessed included time to diet, hospital length of stay (LOS), biliary drainage procedures, morbidity, and mortality. Of the 45 participants in this study, 26 underwent duodenal stenting and 19 had operative bypass. Comparing the stenting and operative patients, the median time to fluid intake was respectively 0 vs. 7 days (P < 0.001), and the time to intake of solids was 2 vs. 9 days (P = 0.004). The median total LOS was shorter in the stenting group (11 vs. 25 days; P < 0.001), as was the median postprocedure LOS (5 vs. 10 days; P = 0.07). Endoscopic stenting is preferable to operative gastrojejunostomy in terms of shorter LOS, faster return to fluids and solids, and reduced morbidity and in-hospital mortality for patients with a limited life span.

Gastric retention and gastric ileus in diabetes mellitus

International Nuclear Information System (INIS)

Hoeffel, J.C.; Senot, P.; Champigneulle, B.; Drouin, P.

1980-01-01

Report of 2 cases of paralytic ileus of the stomach (gastric atony) and of 14 cases of gastric retention, diagnosed from the radiographs obtained from a group of 1500 diabetic patients within seven years. These disorders occur in diabetes mellitus present for many years and associated with peripheral neuropathy. The above findings often present diagnostic and therapeutic problems. Conservative drug therapy is usually sufficient management. (orig.) [de

Adjuvant IMRT/XELOX radiochemotherapy improves long-term overall- and disease-free survival in advanced gastric cancer

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Boda-Heggemann, J.; Schneider, V.; Weiss, C.

2013-01-01

Purpose: In a retrospective analysis, adjuvant intensity-modulated radiation therapy (IMRT) combined with modern chemotherapy improved advanced gastric cancer survival rates compared to a combination of three-dimensional conformal radiation therapy (3D-CRT) and conventional chemotherapy. We report on the long-term outcomes of two consecutive patient cohorts that were treated with either IMRT and intensive chemotherapy, or 3D-CRT and conventional chemotherapy. Patients and methods: Between 2001 and 2008, 65 consecutive gastric cancer patients received either 3D-CRT (n = 27) or IMRT (n = 38) following tumor resection. Chemotherapy comprised predominantly 5-fluorouracil/folinic acid (5-FU/FA) in the earlier cohort and capecitabine plus oxaliplatin (XELOX) in the latter. The primary endpoints were overall survival (OS) and disease-free survival (DFS). Results: Median OS times were 18 and 43 months in the 3D-CRT and IMRT groups, respectively (p = 0.0602). Actuarial 5-year OS rates were 26 and 47 %, respectively. Within the IMRT group, XELOX gave better results than 5-FU/FA in terms of OS, but this difference was not statistically significant. The primary cause of death in both groups was distant metastasis. Median DFS times were 14 and 35 months in the 3D-CRT and IMRT groups, respectively (p = 0.0693). Actuarial 5-year DFS rates were 22 and 44 %, respectively. Among patients receiving 5-FU/FA, DFS tended to be better in the IMRT group, but this was not statistically significant. A similar analysis for the XELOX group was not possible as 3D-CRT was almost never used to treat these patients. No late toxicity exceeding grade 3 or secondary tumors were observed. Conclusion: After a median follow-up period of over 5 years, OS and DFS were improved in the IMRT/XELOX treated patients compared to the 3D-CRT/5-FU/FA group. Long-term observation revealed no clinical indications of therapy-induced secondary tumors or renal toxicity. (orig.)

Adjuvant IMRT/XELOX radiochemotherapy improves long-term overall- and disease-free survival in advanced gastric cancer

Energy Technology Data Exchange (ETDEWEB)

Boda-Heggemann, J.; Schneider, V. [Heidelberg Univ., Universitaetsmedizin Mannheim (Germany). Dept. of Radiation Oncology; Weiss, C. [Heidelberg Univ., Universitaetsmedizin Mannheim (Germany). Dept. of Biomathematics and Medical Statistics] [and others

2013-05-15

Purpose: In a retrospective analysis, adjuvant intensity-modulated radiation therapy (IMRT) combined with modern chemotherapy improved advanced gastric cancer survival rates compared to a combination of three-dimensional conformal radiation therapy (3D-CRT) and conventional chemotherapy. We report on the long-term outcomes of two consecutive patient cohorts that were treated with either IMRT and intensive chemotherapy, or 3D-CRT and conventional chemotherapy. Patients and methods: Between 2001 and 2008, 65 consecutive gastric cancer patients received either 3D-CRT (n = 27) or IMRT (n = 38) following tumor resection. Chemotherapy comprised predominantly 5-fluorouracil/folinic acid (5-FU/FA) in the earlier cohort and capecitabine plus oxaliplatin (XELOX) in the latter. The primary endpoints were overall survival (OS) and disease-free survival (DFS). Results: Median OS times were 18 and 43 months in the 3D-CRT and IMRT groups, respectively (p = 0.0602). Actuarial 5-year OS rates were 26 and 47 %, respectively. Within the IMRT group, XELOX gave better results than 5-FU/FA in terms of OS, but this difference was not statistically significant. The primary cause of death in both groups was distant metastasis. Median DFS times were 14 and 35 months in the 3D-CRT and IMRT groups, respectively (p = 0.0693). Actuarial 5-year DFS rates were 22 and 44 %, respectively. Among patients receiving 5-FU/FA, DFS tended to be better in the IMRT group, but this was not statistically significant. A similar analysis for the XELOX group was not possible as 3D-CRT was almost never used to treat these patients. No late toxicity exceeding grade 3 or secondary tumors were observed. Conclusion: After a median follow-up period of over 5 years, OS and DFS were improved in the IMRT/XELOX treated patients compared to the 3D-CRT/5-FU/FA group. Long-term observation revealed no clinical indications of therapy-induced secondary tumors or renal toxicity. (orig.)

Evaluation of gastric carcinoma with CT three-dimensional imaging compared with conventional barium study

International Nuclear Information System (INIS)

Ju Shenghong; Chen Feng; Zheng Kai'er; Sun Jun

2002-01-01

Objective: To assess the role of three-dimensional (3D) CT imaging including CT virtual gastroscopy (CTVG), surface-shaded display (SSD), and Raysum Display in the evaluation of gastric carcinoma compared with upper gastrointestinal series (UGI). Methods: In 43 histologically proved gastric carcinoma patients (37 advanced gastric carcinomas and 6 early gastric carcinomas), the results of CTVG and 3D CT imaging were compared to that of UGI. Two observers blindly evaluated images with all four techniques in terms of image quality, artifacts, diagnostic confidence, and Borrmann classification. Sensitivities of lesion detection and classification based on Borrmann classification of CTVG and 3D CT were determined by comparing them to surgical and histological findings. Results: The lesion detection sensitivity of CTVG, SSD, Raysum, and UGI by two observers were 98%, 67%, 60% and 84%, and 98%, 70%, 70% and 88%, respectively. The Borrmann's classification sensitivity by two observers were 76%, 49%, 38% and 49%, and 78%, 51%, 35% and 43%, respectively. Overall image quality of CTVG, SSD, and Raysum was considered similar to that of UGI by both observers (P>0.05). There was no statistical significant difference for advanced lesion (with diagnostic confidence of 3 or above) in detection sensitivity between CTVG and UGI (χ 2 = 0.50 and 0.25, P>0.05), but the lesion detection sensitivity of SSD and Raysum display were lower than that of UGI (χ 2 4.17, 7.11 and 5.14, 4.17, P 2 = 4.90 and 4.92, P 2 = 2.25, P > 0.05). Excess fluid remained in the stomach and patient respiratory movement during breath holds were the reasons causing severe artifacts (6.1%) that influenced the diagnostic evaluation. Conclusion: The performance of CTVG was equivalent to UGI in the Borrmann's classification. CTVG has potential in the detection of early gastric carcinoma. The value of SSD and Raysum display was limited in the evaluation of gastric carcinoma when used alone clinically

Adjuvant chemoradiotherapy combined with cisplatin, 5-fluorouracil and folinic acid for locally advanced gastric cancer

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Muharrem Kocar

2016-04-01

Conclusion: The addition of combination chemotherapy with cisplatin, infusional 5-fluorouracil and folinic acid before and after chemoradiotherapy was found to be safe and effective in patients with operated gastric cancer.

Pneumatosis in canine gastric dilatation-volvulus syndrome.

Science.gov (United States)

Fischetti, Anthony J; Saunders, H Mark; Drobatz, Kenneth J

2004-01-01

Retrospectively, 243 dogs with radiographic evidence of gastric dilatation-volvulus (GDV) were studied for radiographic signs of pneumatosis (intramural gas), pneumoperitoneum, splenomegaly, and severity of gastric distention. The sensitivity, specificity, and predictive value of these imaging signs as predictors of gastric wall necrosis, as determined by visual inspection at surgery or necropsy, were determined. The sensitivity and specificity of gastric pneumatosis were 14.1% and 92.7%, respectively. The prevalence of gastric wall necrosis was 26.6%. The positive and negative predictive values of gastric pneumatosis for predicting gastric necrosis were 40.9% and 74.9%, respectively. Gastric pneumatosis and pneumoperitoneum were identified together in four dogs. Pneumoperitoneum, either alone or in conjunction with pneumatosis, yielded similar results as a test for gastric necrosis. Splenomegaly and severity of gastric distention were insensitive and nonspecific for gastric wall necrosis. Splenomegaly did not predict the need for splenectomy at surgery. Although pneumatosis and pneumoperitoneum are relatively specific signs of gastric wall necrosis, the utility of these signs as a test for gastric necrosis is limited in clinical practice. The significance of pneumatosis should be taken into consideration with previous treatments for gastric decompression, as percutaneous gastric trocharization or orogastric intubation may increase the number of false-positive results.

Vanillin abrogates ethanol induced gastric injury in rats via modulation of gastric secretion, oxidative stress and inflammation

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Abdulrahman Al Asmari

Full Text Available Vanillin is commonly used as an additive in food, medicine and cosmetics, but its effect has not yet been studied in gastric injury. Therefore the effect of vanillin was studied in experimental gastric ulcer. Gastric secretion and acidity were studied in pylorus ligated rats. Ulcer index, levels of gastric mucus, malondialdehyde (MDA, myeloperoxidase activity (MPO, expression of nuclear factor kappa B (NF-κB p65, and histopathological changes were determined in ethanol induced gastric ulcer. Pre treatment with vanillin significantly reduced gastric secretion (P < 0.001 and acidity (P < 0.0001 and gastric ulcer index scores (P < 0.001. and augmented the gastric mucosal defense. Vanillin significantly restored the depleted gastric wall mucus levels (P < 0.0001 induced by ethanol and also significantly attenuated ethanol induced inflammation and oxidative stress by the suppression of gastric MPO activity (P < 0.001, reducing the expression of NF-κB p65 and the increased MDA levels (P < 0.001. Vanillin was also effective in alleviating the damage to the histological architecture and the activation of mast cells induced by ethanol.Together the results of this study highlight the gastroprotective activity of vanillin in gastric ulcers of rats through multiple actions that include inhibition of gastric secretion and acidity, reduction of inflammation and oxidative stress, suppression of expression of NF-κB, and restoration of the histological architecture. Keywords: Gastric ulcers, Pylorus ligation, Ethanol, Vanillin, Inflammation, Oxidative stress

Managing obstructive gastric volvulus: challenges and solutions

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Rodriguez-Garcia HA

2017-03-01

Full Text Available Hector Alejandro Rodriguez-Garcia,1 Andrew S Wright,2–4 Robert B Yates1–3 1Department of Surgery, Center for Esophageal and Gastric Surgery, 2Center for Videoendoscopic Surgery, 3Hernia Center, 4Institute for Simulation and Interprofessional Studies, UWMC, University of Washington, Seattle, USA Abstract: Gastric volvulus is the abnormal torsion of the stomach along its short or long axis. Most patients who experience gastric volvulus present with mild or intermittent gastric obstructive symptoms. However, severe acute gastric volvulus can result in complete gastric outlet obstruction and ischemia. Consequently, acute gastric volvulus warrants immediate evaluation and management. The goals of management are to relieve the obstruction and prevent recurrent volvulus. Techniques to manage gastric volvulus depend on patient characteristics and the presence of gastric ischemia. In the absence of gastric ischemia, gastric volvulus can be managed with anterior abdominal wall gastropexy or paraesophageal hernia repair. If gastric ischemia is present, operative resection of the affected portion of the stomach is indicated. When operative management is indicated, many patients with gastric volvulus can be managed with minimally invasive (laparoscopic, endoscopic, or laparoendoscopic techniques. Keywords: gastric volvulus, paraesophageal hernia, hiatal hernia

Characteristics of Metachronous Gastric Tumors after Endoscopic Submucosal Dissection for Gastric Intraepithelial Neoplasms

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Tomoyuki Boda

2014-01-01

Full Text Available Background. Recently, endoscopic submucosal dissection (ESD has become a standard treatment method for early gastric cancer and concurrent stomach preservation. However, metachronous recurrences have become a major problem. We evaluated the incidence and clinicopathologic features of and examined the risk factors for metachronous gastric tumors. Methods. A total of 357 patients who underwent ESD for gastric tumors (245 early gastric cancers and 112 adenomas and were followed up for more than 12 months without recurrence within the first 12 months were enrolled. We investigated the incidence and clinicopathologic features of metachronous tumors after ESD. We also analyzed the potential risk factors for metachronous tumors using the Kaplan-Meier method and Cox’s proportional hazards model. Results. The annual incidence of metachronous tumors after ESD was 2.4%. The median period until discovery after initial ESD was 26.0 months, and the median observation period was 52.6 months. Male patients developed metachronous tumors more frequently (P=0.04, and the hazard ratio of female to male patients was 0.36 (95% confidence interval: 0.11–0.89. Conclusions. Patients with a previous history of gastric tumors have a high risk of subsequent gastric tumor development and male patients should be carefully followed up after ESD for gastric tumor.

Review article: Pathogenesis and management of gastric carcinoid tumours.

Science.gov (United States)

Burkitt, M D; Pritchard, D M

2006-11-01

Gastric carcinoid tumours are rare, but are increasing in incidence. To discuss tumour pathogenesis and outline current approaches to patient management. Review of published articles following a Pubmed search. Although interest in gastric carcinoids has increased since it was recognized that they are associated with achlorhydria, to date there is no definite evidence that humans taking long-term acid suppressing medication are at increased risk. Type I tumours are associated with autoimmune atrophic gastritis and hypergastrinaemia, type II are associated with Zollinger-Ellison syndrome, multiple endocrine neoplasia-1 and hypergastrinaemia and sporadic type III carcinoids are gastrin-independent and carry the worst prognosis. Careful investigation of these patients is required, particularly to identify the tumour type, the source of hypergastrinaemia and the presence of metastases. Treatment can be directed at the source of hypergastrinaemia if type I or II tumours are still gastrin responsive and not growing autonomously. Type III tumours should be treated surgically. Advances in our understanding of the pathogenesis of gastric carcinoids have led to recent improvements in investigation and management. Challenges remain in identifying the genetic and environmental factors, in addition to hypergastrinaemia, that are responsible for tumour development in susceptible patients.

Content-based intermedia synchronization

Science.gov (United States)

Oh, Dong-Young; Sampath-Kumar, Srihari; Rangan, P. Venkat

1995-03-01

Inter-media synchronization methods developed until now have been based on syntactic timestamping of video frames and audio samples. These methods are not fully appropriate for the synchronization of multimedia objects which may have to be accessed individually by their contents, e.g. content-base data retrieval. We propose a content-based multimedia synchronization scheme in which a media stream is viewed as hierarchial composition of smaller objects which are logically structured based on the contents, and the synchronization is achieved by deriving temporal relations among logical units of media object. content-based synchronization offers several advantages such as, elimination of the need for time stamping, freedom from limitations of jitter, synchronization of independently captured media objects in video editing, and compensation for inherent asynchronies in capture times of video and audio.

Gastric residual volume (GRV) and gastric contents measurement by refractometry.

Science.gov (United States)

Chang, Wei-Kuo; McClave, Stephen A; Hsieh, Chung-Bao; Chao, You-Chen

2007-01-01

Traditional use of gastric residual volumes (GRVs), obtained by aspiration from a nasogastric tube, is inaccurate and cannot differentiate components of the gastric contents (gastric secretion vs delivered formula). The use of refractometry and 3 mathematical equations has been proposed as a method to calculate the formula concentration, GRV, and formula volume. In this paper, we have validated these mathematical equations so that they can be implemented in clinical practice. Each of 16 patients receiving a nasogastric tube had 50 mL of water followed by 100 mL of dietary formula (Osmolite HN, Abbott Laboratories, Columbus, OH) infused into the stomach. After mixing, gastric content was aspirated for the first Brix value (BV) measurement by refractometry. Then, 50 mL of water was infused into the stomach and a second BV was measured. The procedure of infusion of dietary formula (100 mL) and then water (50 mL) was repeated and followed by subsequent BV measurement. The same procedure was performed in an in vitro experiment. Formula concentration, GRV, and formula volume were calculated from the derived mathematical equations. The formula concentrations, GRVs, and formula volumes calculated by using refractometry and the mathematical equations were close to the true values obtained from both in vivo and in vitro validation experiments. Using this method, measurement of the BV of gastric contents is simple, reproducible, and inexpensive. Refractometry and the derived mathematical equations may be used to measure formula concentration, GRV, and formula volume, and also to serve as a tool for monitoring the gastric contents of patients receiving nasogastric feeding.

Serum and gastric fluid levels of cytokines and nitrates in gastric diseases infected with Helicobacter pylori.

Science.gov (United States)

Mehmet, N; Refik, M; Harputluoglu, M; Ersoy, Y; Aydin, N Engin; Yildirim, B

2004-04-01

This case control study presents data on the concentrations of nitrite and nitrate and a variety of pro-inflammatory cytokines such as interleukin-1 beta (IL-1 beta), interleukin-2R (IL-2R), interleukin-6 (IL-6), interleukin-8 (IL-8) and tumor necrosis factor TNF-alpha in gastric fluid and serum. Patients with gastritis, gastric ulcer and gastric cancer are studied and grouped according to infection by Helicobacter pylori. The 208 patients who underwent upper gastrointestinal endoscopic examination were classified as follows; H. pylori-positive gastritis (n = 32), H. pylori-negative gastritis (n = 32), H. pylori-positive ulcers (n = 34), H. pylori-negative ulcers (n = 34), 43 patients with H. pylori-positive gastric cancer in addition to 33 H. pylori-negative healthy control individuals. Gastric fluids and blood samples were taken concomitantly. Cytokines and nitrite and nitrate determinations were attempted as soon as possible after collection of the samples. Nitrite and nitrate levels of serum and gastric fluids of H. pylori-positive gastritis and ulcers were higher than H. pylori-negative gastritis and ulcers. The concentrations of total nitrite and nitrate and cytokines (TNF-alpha, IL-2R, IL-6, and IL-8) in gastric fluids and sera of H. pylori-positive gastric cancer patients were higher than H. pylori-negative control groups. IL-1 beta level was significantly elevated in gastric fluid of infected cancer patients but not in serum. Taken together, the results suggest that an increase in cytokine-NO combination in gastric mucosa previously reported by many studies is not restricted to local infected gastric tissue but also detected in gastric fluid and sera of H. pylori-positive subjects and may have an important role in the pathogenesis and development of common gastric diseases.

Napoleon Bonaparte's gastric cancer: a clinicopathologic approach to staging, pathogenesis, and etiology.

Science.gov (United States)

Lugli, Alessandro; Zlobec, Inti; Singer, Gad; Kopp Lugli, Andrea; Terracciano, Luigi M; Genta, Robert M

2007-01-01

Numerous hypotheses on the cause of Napoleon Bonaparte's death have been proposed, including hereditary gastric cancer, arsenic poisoning, and inappropriate medical treatment. We aimed to determine the etiology and pathogenesis of Napoleon's illness by a comparison of historical information with current clinicopathologic knowledge. Evaluation of Napoleon's clinical history, original autopsy reports, and of historical documents. The clinicopathologic data from 135 gastric cancer patients were used for comparison with the data available on Napoleon. At least T3N1M0 (stage IIIA) gastric cancer. Napoleon's tumor extended from the cardia to the pylorus (>10 cm) without infiltration of adjacent structures, which provides strong evidence for at least stage T3. The N1 stage was determined by the presence of several enlarged and hardened regional (perigastric) lymph nodes, and the M0 stage by the absence of distant metastasis. Analysis of the available historical documents indicates that Napoleon's main risk factor might have been Helicobacter pylori infection rather than a familial predisposition. Our analysis suggests that Napoleon's illness was a sporadic gastric carcinoma of advanced stage. Patients with such tumors have a notoriously poor prognosis.

A Methodology for the Design and Verification of Globally Asynchronous/Locally Synchronous Architectures

Science.gov (United States)

Miller, Steven P.; Whalen, Mike W.; O'Brien, Dan; Heimdahl, Mats P.; Joshi, Anjali

2005-01-01

Recent advanced in model-checking have made it practical to formally verify the correctness of many complex synchronous systems (i.e., systems driven by a single clock). However, many computer systems are implemented by asynchronously composing several synchronous components, where each component has its own clock and these clocks are not synchronized. Formal verification of such Globally Asynchronous/Locally Synchronous (GA/LS) architectures is a much more difficult task. In this report, we describe a methodology for developing and reasoning about such systems. This approach allows a developer to start from an ideal system specification and refine it along two axes. Along one axis, the system can be refined one component at a time towards an implementation. Along the other axis, the behavior of the system can be relaxed to produce a more cost effective but still acceptable solution. We illustrate this process by applying it to the synchronization logic of a Dual Fight Guidance System, evolving the system from an ideal case in which the components do not fail and communicate synchronously to one in which the components can fail and communicate asynchronously. For each step, we show how the system requirements have to change if the system is to be implemented and prove that each implementation meets the revised system requirements through modelchecking.

Vanillin abrogates ethanol induced gastric injury in rats via modulation of gastric secretion, oxidative stress and inflammation.

Science.gov (United States)

Al Asmari, Abdulrahman; Al Shahrani, Hamoud; Al Masri, Nasser; Al Faraidi, Ahmed; Elfaki, Ibrahim; Arshaduddin, Mohammed

2016-01-01

Vanillin is commonly used as an additive in food, medicine and cosmetics, but its effect has not yet been studied in gastric injury. Therefore the effect of vanillin was studied in experimental gastric ulcer. Gastric secretion and acidity were studied in pylorus ligated rats. Ulcer index, levels of gastric mucus, malondialdehyde (MDA), myeloperoxidase activity (MPO), expression of nuclear factor kappa B (NF-κB) p65, and histopathological changes were determined in ethanol induced gastric ulcer. Pre treatment with vanillin significantly reduced gastric secretion ( P  Vanillin significantly restored the depleted gastric wall mucus levels ( P  Vanillin was also effective in alleviating the damage to the histological architecture and the activation of mast cells induced by ethanol. Together the results of this study highlight the gastroprotective activity of vanillin in gastric ulcers of rats through multiple actions that include inhibition of gastric secretion and acidity, reduction of inflammation and oxidative stress, suppression of expression of NF-κB, and restoration of the histological architecture.

The prognostic value of CXC-chemokine receptor 2 (CXCR2) in gastric cancer patients

International Nuclear Information System (INIS)

Wang, Zhenglin; Liu, Hao; Shen, Zhenbin; Wang, Xuefei; Zhang, Heng; Qin, Jing; Xu, Jiejie; Sun, Yihong; Qin, Xinyu

2015-01-01

CXC chemokine receptor 2 (CXCR2) has been reported to play an important role in the proliferation and invasion of gastric cancer cells. The present study aims to investigate the impact of CXCR2 expression on the overall survival (OS) of gastric cancer patients after radical resection. Intratumoral CXCR2 expression was evaluated with immunohistochemistry on tissue microarrays containing tumor samples of 357 gastric cancer patients from a single center. CXCR2 expression levels were correlated to clinicopathological variables and OS. CXCR2 expression was mainly located in the cytoplasm of gastric carcinoma cells. High CXCR2 expression was associated with poor tumor differentiation (p = 0.021), increased tumor depth (p < 0.001), lymph node metastasis (p < 0.001), advanced TNM stage (p < 0.001) and short OS (p = 0.001). CXCR2 expression was an independent prognostic factor for OS (p = 0.001) in multivariate analysis, and could be combined with TNM stage to generate a predictive nomogram for clinical outcome in patients with gastric cancer. Intratumoral CXCR2 expression is a novel independent predictor for survival in gastric cancer patients. CXCR2 might be a promising therapeutic target of postoperative adjuvant treatment. The online version of this article (doi:10.1186/s12885-015-1793-9) contains supplementary material, which is available to authorized users

Fast Self-Synchronization between LowVoltage Microgrid and Inverter using Virtual Synchronous Converter

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Md Ruhul Amin

2017-12-01

Full Text Available In this paper, a fast self-synchronization known as virtual synchronous converter (VSCon between single-phase microgrid and inverter in low-voltage microgrid, has been developed in Matlab/Simulink. The idea is to any phase locked loop (PLL circuit for inverter-microgrid synchronization in order to improve the synchronization time. As known, it is difficult and lengthy process to tune the PLL gain parameters to reach suitable performance for synchronizing among the voltage, phase-angle and frequency between them. Due to this problem, a fast self synchronization technique is needed in order to minimize the time losses at the microgrid connection. Therefore, the VSCon has been developed which is based on the synchronous generator mathematical model but in virtual environment representation. It has been applied in the inverter control for generating switching pattern to the inverter switches in order to respond to the grid voltage for improve the synchronization. For a prove of concept, several simulation tests in MATLAB models have been conducted, in order to see the effectiveness of this VSCon. First test has been conducted, when a 240V, 50Hz frequency grid source is used for observing the self-synchronization the system with the power flows output. Furthermore, the next test is conducted when the grid frequency is changed from the rated frequency at 50Hz to 51Hz and the result shows the VSCon in inverter control takes nearly 40ms to synchronize to this new frequency value. The test on grid phase-angle delay also been tested when ac grid voltage has 150 phase delay. As from all the results, the improved inverter control with VSCon structure is able to have fast and self-synchronized between the invertergrid connection before the power from the inverter can be transferred.

Prognostic factors in patients with node-negative gastric cancer: an Indian experience

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Ranganathan Rama

2011-05-01

Full Text Available Abstract Background The status of the regional nodes is the most important prognostic factor in gastric cancer. There are subgroups of patients with different prognosis even in node-negative patients of gastric cancer. The aim of this study is to analyze the factors influencing the prognosis in Indian patients with node-negative gastric cancer. Methods This was a retrospective analysis of patients who underwent radical gastrectomy in a tertiary cancer centre in India between1991 and 2007. The study group included only patients with histologically node-negative disease. Various clinical, pathological and treatment related factors in this group of patients were analyzed to determine their prognostic ability by univariate and multivariate analyses. Results Among the 417 patients who underwent gastrectomy during this period, 122 patients had node-negative disease. A major proportion of the patients had advanced gastric cancer. The 5-year overall survival and disease-free survival in all node-negative gastric cancer patients was 68.2% and 67.5% respectively. The overall recurrence rate in this group was 27.3%. On univariate analysis, the factors found to significantly influence the disease-free survival were the size, location and presence or absence of serosal invasion of the primary tumor. However, on multivariate analysis, only tumor size more than 3 cm and serosal invasion were found to be independently associated with an inferior survival. Conclusion Serosal invasion and primary tumor size more than 3 cm independently predict a poor outcome in patients with node-negative gastric cancer.

Detection of free gastric cancer cell in peripheral and portal blood

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Bang, Ho Yoon; Lee, Jong Inn [Korea Cancer Center Hospital, Seoul (Korea, Republic of)

1998-01-01

In fact, there is no definite treatment modality after liver or hematogenous metastasis in the gastric cancer. So it is important to develop a new method to predict the high risk patients for systemic recurrence. If we can detect metastatic cell in circulation, it may be beneficial in assessing tumor progression, metastatic potential and prognosis. To establish the RT-PCR methodology for detection of CEA expressing cancer cells in peripheral and portal blood and to define the relationship between peripheral and portal blood detection rate of gastric cancer patients, we performed RT-PCR analysis with peripheral and portal blood samples from 24 patients with gastric cancer (stage Ia,b, n=3; stage II, n=2; stage IIIa, n=9; stage IIIb, n=7; stage IV, n=3) and checked serum CEA level preoperatively. Mean age was 49.2 years old and male : female was 1.2 : 2 (13:11 patients). The mean serum CEA level was 10.4 ng/ml and that was higher than normal in only 2 cases. There was no positive case of tumor cell in portal and peripheral blood using RT-PCR and CEA gene specific primer. Our results indicate that the incidence of circulating cancer cells is unexpectedly very low even in advanced gastric cancer patients. (author). 20 refs.

Detection of free gastric cancer cell in peripheral and portal blood

International Nuclear Information System (INIS)

Bang, Ho Yoon; Lee, Jong Inn

1998-01-01

In fact, there is no definite treatment modality after liver or hematogenous metastasis in the gastric cancer. So it is important to develop a new method to predict the high risk patients for systemic recurrence. If we can detect metastatic cell in circulation, it may be beneficial in assessing tumor progression, metastatic potential and prognosis. To establish the RT-PCR methodology for detection of CEA expressing cancer cells in peripheral and portal blood and to define the relationship between peripheral and portal blood detection rate of gastric cancer patients, we performed RT-PCR analysis with peripheral and portal blood samples from 24 patients with gastric cancer (stage Ia,b, n=3; stage II, n=2; stage IIIa, n=9; stage IIIb, n=7; stage IV, n=3) and checked serum CEA level preoperatively. Mean age was 49.2 years old and male : female was 1.2 : 2 (13:11 patients). The mean serum CEA level was 10.4 ng/ml and that was higher than normal in only 2 cases. There was no positive case of tumor cell in portal and peripheral blood using RT-PCR and CEA gene specific primer. Our results indicate that the incidence of circulating cancer cells is unexpectedly very low even in advanced gastric cancer patients. (author). 20 refs

Helical CT findings of gastric wall thickening by peptic ulcer : compared with gastric adenocarcinoma with ulcer

International Nuclear Information System (INIS)

Jung, Won Jung; Choi, Jong Chul; Seo, Keum Soo; Koo, Bon Sik; Park, Byeong Ho; Kim, Chung Ku; Lee, Ki Nam; Nam, Kyung Jin

2000-01-01

To compare on the basis of helical CT findings gastric wall thickening of peptic gastric ulcer with that of gastric adenocarcinoma with ulcer. Thirty-eight patients with pathologically proven gastric lesion (17 cases of peptic ulcer and 21 cases of ulcerative or ulceroinfiltrative gastric cancer (Borrman type II, III) underwent helical CT, and the findings were retrospectively reviewed in terms of maximum abnormal wall thickness, preservation of the inner enhancing layer, the presence three discriminate layers of gastric wall, and enhancement pattern. The enhancement pattern of abnormally thick wall was compared with that of the portal phase of back muscle, and was defined as low, iso, or high. The Chi-square test and Student t test were used for statistical analysis. In cases of peptic ulcer and gastric cancer with ulceration, maximum abnormal wall thickness was 7-30 (mean, 16.1)mm, and 11-33 (mean, 21.8)mm, respectively. The inner enhancing layer was preserved in 15 of 17 patients (88.2%) and one of 21 (4.8%); three discriminate layers of gastric wall were observed in 8 of 17 patients (47.0%), and one of 21 (4.8%). The enhancement pattern was low in 12 of 17 patients (70.5%), and 3 of 21 (14.3%); iso in 4 of 17 (23.5%), and 4 of 21 (19.0%), and high in one of 17 (5.9%), and 14 of 21 (66.7%). All figures refer, respectively, to the two distinct conditions. In terms of preservation of the inner enhancing layer, three discriminate layers of gastric wall, and a low enhancement pattern, there were statistically significant differences between peptic ulcer and gastric adenocarcinoma with ulcer. Where the enhancement was high, however, the statistically significant difference between the two conditions was even greater. There was no statistically significant difference in terms of gastric wall thickness or iso-attenuation of thickened gastric. Helical CT findings of gastric wall thickening, preservation of the inner enhancing layer, and three discriminate layers of

Helical CT findings of gastric wall thickening by peptic ulcer : compared with gastric adenocarcinoma with ulcer

Energy Technology Data Exchange (ETDEWEB)

Jung, Won Jung; Choi, Jong Chul; Seo, Keum Soo; Koo, Bon Sik; Park, Byeong Ho; Kim, Chung Ku; Lee, Ki Nam; Nam, Kyung Jin [College of Medicine, Dong A University, Pusan (Korea, Republic of)

2000-02-01

To compare on the basis of helical CT findings gastric wall thickening of peptic gastric ulcer with that of gastric adenocarcinoma with ulcer. Thirty-eight patients with pathologically proven gastric lesion (17 cases of peptic ulcer and 21 cases of ulcerative or ulceroinfiltrative gastric cancer (Borrman type II, III)) underwent helical CT, and the findings were retrospectively reviewed in terms of maximum abnormal wall thickness, preservation of the inner enhancing layer, the presence three discriminate layers of gastric wall, and enhancement pattern. The enhancement pattern of abnormally thick wall was compared with that of the portal phase of back muscle, and was defined as low, iso, or high. The Chi-square test and Student t test were used for statistical analysis. In cases of peptic ulcer and gastric cancer with ulceration, maximum abnormal wall thickness was 7-30 (mean, 16.1)mm, and 11-33 (mean, 21.8)mm, respectively. The inner enhancing layer was preserved in 15 of 17 patients (88.2%) and one of 21 (4.8%); three discriminate layers of gastric wall were observed in 8 of 17 patients (47.0%), and one of 21 (4.8%). The enhancement pattern was low in 12 of 17 patients (70.5%), and 3 of 21 (14.3%); iso in 4 of 17 (23.5%), and 4 of 21 (19.0%), and high in one of 17 (5.9%), and 14 of 21 (66.7%). All figures refer, respectively, to the two distinct conditions. In terms of preservation of the inner enhancing layer, three discriminate layers of gastric wall, and a low enhancement pattern, there were statistically significant differences between peptic ulcer and gastric adenocarcinoma with ulcer. Where the enhancement was high, however, the statistically significant difference between the two conditions was even greater. There was no statistically significant difference in terms of gastric wall thickness or iso-attenuation of thickened gastric. Helical CT findings of gastric wall thickening, preservation of the inner enhancing layer, and three discriminate layers of

Intrathoracic gastric volvulus in infancy

Energy Technology Data Exchange (ETDEWEB)

Al-Salem, A.H. [Dept. of Surgery, Qatif Central Hospital, Qatif (Saudi Arabia)

2000-12-01

Intrathoracic gastric volvulus is a very rare surgical emergency. Early diagnosis and treatment are of great importance to prevent gastric gangrene and perforation or gastric obstruction and dilation, which may lead to cardiorespiratory arrest. We report two infants who presented with intrathoracic gastric volvulus. This was associated with recurrent diaphragmatic hernia in one and congenital paraoesophageal hernia in the other. Aspects of diagnosis and treatment are also discussed. (orig.)

Intrathoracic gastric volvulus in infancy

International Nuclear Information System (INIS)

Al-Salem, A.H.

2000-01-01

Intrathoracic gastric volvulus is a very rare surgical emergency. Early diagnosis and treatment are of great importance to prevent gastric gangrene and perforation or gastric obstruction and dilation, which may lead to cardiorespiratory arrest. We report two infants who presented with intrathoracic gastric volvulus. This was associated with recurrent diaphragmatic hernia in one and congenital paraoesophageal hernia in the other. Aspects of diagnosis and treatment are also discussed. (orig.)

Comparison of Serum CA72-4 and CEA Levels in Patient with Endoscopically Suspected Gastric Carcinoma.

Science.gov (United States)

Rehena, Z; Ghosh, C K; Afroz, F; Alam, M B; Ferdousi, S; Mahmuduzzaman, M; Sultana, T; Ahmed, A N

2015-07-01

Several serum tumour markers have been described for gastric cancer. Preoperative level of tumor marker helps to predict the diagnosis of gastric carcinoma. CA72-4 as a serum tumour marker for gastric cancer is evaluated, and compared its utility in this regard with that of carcinoembryonic antigen (CEA). Analysis of gastric carcinoma by serum levels of CEA and CA72-4 and their correlation with histopathology help the clinician to develop his management strategies for gastric carcinoma. A prospective observational study was carried out in the Department of Clinical Pathology, Bangabandhu Sheikh Mujib Medical University (BSMMU) in collaboration with Department of Surgery BSMMU, DMCH, Delta Hospital Limited, Dhaka, during the period of October 2010 to September 2011. Serum CA72-4 and CEA were analyzed in 71 endoscopically suspected patients for gastric carcinoma. Among them 58 cases were diagnosed as malignant gastric disease and 13 cases were nonmalignant gastric disease. Sensitivity of CA 72-4 and CEA were 48.3% and 31% respectively and specificity were 92.3% and 76.9% respectively. In poorly differentiated carcinoma, positivity for CA72-4 and CEA were 55.6% and 36.1% respectively. Because of the high positivity of CA72-4 in poorly differentiated carcinoma, CA72-4 is reliable tumour marker in advanced cases. As the sensitivity of CA72-4 was more than that of CEA in diagnosis of gastric cancer, CA72-4 can be used in conjunction with other diagnostic tests like endoscopy that would be more helpful for the patients.

Synchronization of Multipoint Hoists

Science.gov (United States)

A contractor has conceived an electrohydraulic feedback system that will provide position synchronization of four aircraft cargo hoists. To... synchronized hoist system. Test results show that the feedback system concept provides adequate synchronization control; i.e., the platform pitch and roll

Gastric Ulcers Syndrome in Donkeys

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Abelardo Morales Briceño

2015-09-01

Full Text Available This study aimed to describe gastric ulcer in donkeys. 10 donkeys (Equus asinus were studied in Bodonal de la Sierra, Badajoz-Extremadura, Spain. They were referred for necropsy and dead due to non-digestive causes. 4 males and 6 females were examined. The ages were classified of 4-16 years old. The stomach and gastric mucosa was evaluated for classified Merrit, 2003. Samples of gastric tissue were collected. The samples fixed in formalin were processed by conventional histological techniques and examined by histopathology. None of the donkeys presented clinical signs for gastric ulcers syndrome. Of the 10 donkeys studied, 10% had Grade 0; 30% Grade 1; 40% Grade 2; 10% Grade 3; and 10% Grade 4. In 30% (3/10 parasites such as Gasterophilus sp. were observed. The histological slices revealed severe damage on the gastric mucosa, a loss of continuity of the gastric mucosa with corium exposure, and subchorionic edema with parakeratotic hyperkeratosis, together with a mixed lymphoplasmocytic mononuclear infiltrate. In conclusion, we reported gastric ulcers syndrome in donkeys in Spain.

The curative management of synchronous rectal and prostate cancer

Science.gov (United States)

Kavanagh, Dara O; Martin, Joseph; Small, Cormac; Joyce, Myles R; Faul, Clare M; Kelly, Paul J; O'Riordain, Michael; Gillham, Charles M; Armstrong, John G; Salib, Osama; McNamara, Deborah A; McVey, Gerard; O'Neill, Brian D P

2016-01-01

Objective: Neoadjuvant “long-course” chemoradiation is considered a standard of care in locally advanced rectal cancer. In addition to prostatectomy, external beam radiotherapy and brachytherapy with or without androgen suppression (AS) are well established in prostate cancer management. A retrospective review of ten cases was completed to explore the feasibility and safety of applying these standards in patients with dual pathology. To our knowledge, this is the largest case series of synchronous rectal and prostate cancers treated with curative intent. Methods: Eligible patients had synchronous histologically proven locally advanced rectal cancer (defined as cT3-4Nx; cTxN1-2) and non-metastatic prostate cancer (pelvic nodal disease permissible). Curative treatment was delivered to both sites simultaneously. Follow-up was as per institutional guidelines. Acute and late toxicities were reviewed, and a literature search performed. Results: Pelvic external beam radiotherapy (RT) 45–50.4 Gy was delivered concurrent with 5-fluorouracil (5FU). Prostate total dose ranged from 70.0 to 79.2 Gy. No acute toxicities occurred, excluding AS-induced erectile dysfunction. Nine patients proceeded to surgery, and one was managed expectantly. Three relapsed with metastatic colorectal cancer, two with metastatic prostate cancer. Five patients have no evidence of recurrence, and four remain alive with metastatic disease. With a median follow-up of 2.2 years (range 1.2–6.3 years), two significant late toxicities occurred; G3 proctitis in a patient receiving palliative bevacizumab and a G3 anastomotic stricture precluding stoma reversal. Conclusion: Patients proceeding to synchronous radical treatment of both primary sites should receive 45–50.4 Gy pelvic RT with infusional 5FU. Prostate dose escalation should be given with due consideration to the potential impact of prostate cancer on patient survival, as increasing dose may result in significant late morbidity

A Robust Synchronization to Enhance the Power Quality of Renewable Energy Systems

DEFF Research Database (Denmark)

Hadjidemetriou, Lenos; Kyriakides, Elias; Blaabjerg, Frede

2015-01-01

The increasing penetration of renewable energy sources (RESs) in the power grid requires high-quality power injection under various grid conditions. The synchronization method, usually a phase-locked loop (PLL) algorithm, is directly affecting the response of the grid-side converter of the RES....... This paper proposes a new PLL algorithm that uses an advanced decoupling network implemented in the stationary reference frame with limited requirements for processing time to enable a fast and accurate synchronization even under harmonic distorted voltage and low-voltage grid faults. The robust response...... of the proposed PLL is validated, and the effect of the proposed synchronization on the performance of the grid-connected renewable energy system is investigated. This investigation proves that the robust, accurate, and dynamic response of the new PLL can enhance the quality of the injected power from the RES...

Advanced synchronous luminescence imaging for chemical and medical diagnostics

Science.gov (United States)

Vo-Dinh, Tuan

2006-09-05

A diagnostic method and associated system includes the steps of exposing at least one sample location with excitation radiation through a single optical waveguide or a single optical waveguide bundle, wherein the sample emits emission radiation in response to the excitation radiation. The same single optical waveguide or the single optical waveguide bundle receives at least a portion of the emission radiation from the sample, thus providing co-registration of the excitation radiation and the emission radiation. The wavelength of the excitation radiation and emission radiation is synchronously scanned to produce a spectrum upon which an image can be formed. An increased emission signal is generated by the enhanced overlap of the excitation and emission focal volumes provided by co-registration of the excitation and emission signals thus increasing the sensitivity as well as decreasing the exposure time necessary to obtain an image.

ACCELERATED HYPERFRACTIONATED RADIOTHERAPY IN THE TREATMENT FOR INOPERABLE, LOCALLY ADVANCED GASTRIC CANSER

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S. S. Litinskiy

2015-01-01

Full Text Available Purpose: to compare survival of patients with locally advanced inoperable gastric cancer (LAIGC, receiving accelerated hyperfractionated (AHF or conventionally fractionated (CF radiation therapy (RT. Methods and Materials. Between November 1993 and March 2010, 137 patients with LAIGC receiving CF (2 Gy daily or AHF (1.3 Gy b.i.d. to total at least 50 Gy RT in combination or without chemotherapy were retrospectively selected from the hospital database of Arkhangelsk clinical oncological dispensary. Overall survival (OS assessed using actuarial analysis, Kaplan – Meier method and Cox regression. results. The CF and AHF groups were 102 and 35 patients, respectively. Median follow-up time for all patients was 12 years. By the time of analysis 123 (90 % patients of all cohort died. Median, 7-year survival were 24 (95 % confidence intervals (CI, 17–31 vs 16 (95 % CI, 11–21 months, hazard ratio (HR=0.71 (95 % CI, 0.46–1.06, р=0.097; and 19 % (95 % CI 8–34 % vs 6% (95 % CI 2–13 % in the AHF and CF groups, respectively. In multivariate OS model the difference decreased to HR=0.87 (95 % CI, 0.49–1.55. The location of the tumor in median third (HR=0.60, 95 % CI, 0.37–0.99 in refer to upper third was the only independent factor influencing survival.  There was no influence of the total dose in chosen level on survival. conclusion. Our retrospective shows trend towards better OS for those LAIGC patients receiving RT in AHF regimen compared to CF. The prospective randomized study with conformal radiation technics is necessary to confirm these findings.

Sub-nanosecond clock synchronization and trigger management in the nuclear physics experiment AGATA

International Nuclear Information System (INIS)

Bellato, M; Isocrate, R; Rampazzo, G; Bazzacco, D; Bortolato, D; Triossi, A; Chavas, J; Mengoni, D; Recchia, F

2013-01-01

The new-generation spectrometer AGATA, the Advanced GAmma Tracking Array, requires sub-nanosecond clock synchronization among readout and front-end electronics modules that may lie hundred meters apart. We call GTS (Global Trigger and Synchronization System) the infrastructure responsible for precise clock synchronization and for the trigger management of AGATA. It is made of a central trigger processor and nodes, connected in a tree structure by means of optical fibers operated at 2Gb/s. The GTS tree handles the synchronization and the trigger data flow, whereas the trigger processor analyses and eventually validates the trigger primitives centrally. Sub-nanosecond synchronization is achieved by measuring two different types of round-trip times and by automatically correcting for phase-shift differences. For a tree of depth two, the peak-to-peak clock jitter at each leaf is 70 ps; the mean phase difference is 180 ps, while the standard deviation over such phase difference, namely the phase equalization repeatability, is 20 ps. The GTS system has run flawlessly for the two-year long AGATA campaign, held at the INFN Legnaro National Laboratories, Italy, where five triple clusters of the AGATA sub-array were coupled with a variety of ancillary detectors

Sub-nanosecond clock synchronization and trigger management in the nuclear physics experiment AGATA

Science.gov (United States)

Bellato, M.; Bortolato, D.; Chavas, J.; Isocrate, R.; Rampazzo, G.; Triossi, A.; Bazzacco, D.; Mengoni, D.; Recchia, F.

2013-07-01

The new-generation spectrometer AGATA, the Advanced GAmma Tracking Array, requires sub-nanosecond clock synchronization among readout and front-end electronics modules that may lie hundred meters apart. We call GTS (Global Trigger and Synchronization System) the infrastructure responsible for precise clock synchronization and for the trigger management of AGATA. It is made of a central trigger processor and nodes, connected in a tree structure by means of optical fibers operated at 2Gb/s. The GTS tree handles the synchronization and the trigger data flow, whereas the trigger processor analyses and eventually validates the trigger primitives centrally. Sub-nanosecond synchronization is achieved by measuring two different types of round-trip times and by automatically correcting for phase-shift differences. For a tree of depth two, the peak-to-peak clock jitter at each leaf is 70 ps; the mean phase difference is 180 ps, while the standard deviation over such phase difference, namely the phase equalization repeatability, is 20 ps. The GTS system has run flawlessly for the two-year long AGATA campaign, held at the INFN Legnaro National Laboratories, Italy, where five triple clusters of the AGATA sub-array were coupled with a variety of ancillary detectors.

Morbidity and Mortality of Laparoscopic Versus Open D2 Distal Gastrectomy for Advanced Gastric Cancer: A Randomized Controlled Trial.

Science.gov (United States)

Hu, Yanfeng; Huang, Changming; Sun, Yihong; Su, Xiangqian; Cao, Hui; Hu, Jiankun; Xue, Yingwei; Suo, Jian; Tao, Kaixiong; He, Xianli; Wei, Hongbo; Ying, Mingang; Hu, Weiguo; Du, Xiaohui; Chen, Pingyan; Liu, Hao; Zheng, Chaohui; Liu, Fenglin; Yu, Jiang; Li, Ziyu; Zhao, Gang; Chen, Xinzu; Wang, Kuan; Li, Ping; Xing, Jiadi; Li, Guoxin

2016-04-20

The safety and efficacy of radical laparoscopic distal gastrectomy (LG) with D2 lymphadenectomy for the treatment of advanced gastric cancer (AGC) remain controversial. We conducted a randomized controlled trial to compare laparoscopic and conventional open distal gastrectomy with D2 lymph node dissections for AGC. Between September 2012 and December 2014, 1,056 patients with clinical stage T2-4aN0-3M0 gastric cancer were eligible for inclusion. They were randomly assigned to either the LG with D2 lymphadenectomy group (n = 528) or the open gastrectomy (OG) with D2 lymphadenectomy group (n = 528). Fifteen experienced surgeons from 14 institutions in China participated in the study. The morbidity and mortality within 30 days after surgery between the LG (n = 519) and the OG (n = 520) groups were compared on the basis of the modified intention-to-treat principle. Postoperative complications were stratified according to the Clavien-Dindo classification. The compliance rates of D2 lymphadenectomy were similar between the LG and OG groups (99.4% v 99.6%; P = .845). The postoperative morbidity was 15.2% in the LG group and 12.9% in OG group with no significant difference (difference, 2.3%; 95% CI, -1.9 to 6.6; P = .285). The mortality rate was 0.4% for the LG group and zero for the OG group (difference, 0.4%; 95% CI, -0.4 to 1.4; P = .249). The distribution of severity was similar between the two groups (P = .314). Experienced surgeons can safely perform LG with D2 lymphadenectomy for AGC. © 2016 by American Society of Clinical Oncology.

Obliteration of gastric bleeding varices with NBCA

International Nuclear Information System (INIS)

Jiang Zaibo; Li Zhengran; Qian Jiesheng; Zhu Kangshun; Huang Mingsheng; Zhao Dabing; Pang Pengfei; Guan Shouhai; Shan Hong

2007-01-01

Objective: To study the feasibility of obliteration with NBCA(N-Butyl-2-Cyanoacrylate)for the treatment of gastric bleeding varices in terminal stage of portal hypertension. Methods: All 17 cases of upper gastrointestinal hemorrhage with portal hypertension, mean age 54 years, including 11 cases of advanced hepatocellular carcinoma with portal venous tumor emboli, 6 eases of cirrhosis and 3 cases with moderate to severe ascites; were selected for this study. According to the Child-Pugh classification, 3 cases were in class B and 14 cases in class C at admission. Left gastric, posterior and short gastric varices were shown in all patients on CT or MRI enhancement scannings, together with splenorenal and gastrorenal shunts in 3 and 3 cases respectively. Seven cases were approached through right midaxillary line transhepatic route, 4 cases through infra-cartilago ensiformis transhepatic route, and 6 cases through transsplenic approach. Nine eases took scheduled operation, and 8 cases under emergency operation. According to blood flow rate and variceal internal diameter, the proportion 1:4 of NBCA and lipiodol was selected for the embolization. The survival and symptom relief of the patients were followed up. Results: All cases were successfully engaged in embolization with NBCA, with all varices disappeared on post-operation angiography and CT enhancement scanning during follow-up. Pressure of portal vein rised 3 cmH 2 O after operation with one case having with transient irritable cough. The average survival time was over 5 months during 3-12 months follow-up. Four cases died postoperatively because of hepatic function exhaustion. Conclusion: Utilization of NBCA in obliteration for gastric bleeding varices is effective, feasible and reliable; with less complication, Keeping strict indications would surely raise the long-term efficacy. (authors)

Downregulation of tumor suppressor QKI in gastric cancer and its implication in cancer prognosis

International Nuclear Information System (INIS)

Bian, Yongqian; Wang, Li; Lu, Huanyu; Yang, Guodong; Zhang, Zhang; Fu, Haiyan; Lu, Xiaozhao; Wei, Mengying; Sun, Jianyong; Zhao, Qingchuan; Dong, Guanglong; Lu, Zifan

2012-01-01

Highlights: ► QKI expression is decreased in gastric cancer samples. ► Promoter hyper methylation contributes to the downregulation of QKI. ► QKI inhibits the growth of gastric cancer cells. ► Decreased QKI expression predicts poor survival. -- Abstract: Gastric cancer (GC) is the fourth most common cancer and second leading cause of cancer-related death worldwide. RNA-binding protein Quaking (QKI) is a newly identified tumor suppressor in multiple cancers, while its role in GC is largely unknown. Our study here aimed to clarify the relationship between QKI expression with the clinicopathologic characteristics and the prognosis of GC. In the 222 GC patients’ specimens, QKI expression was found to be significantly decreased in most of the GC tissues, which was largely due to promoter hypermethylation. QKI overexpression reduced the proliferation ability of GC cell line in vitro study. In addition, the reduced QKI expression correlated well with poor differentiation status, depth of invasion, gastric lymph node metastasis, distant metastasis, advanced TNM stage, and poor survival. Multivariate analysis showed QKI expression was an independent prognostic factor for patient survival.

Computed tomography findings of acute gastric volvulus

Energy Technology Data Exchange (ETDEWEB)

Millet, Ingrid; Orliac, Celine; Alili, Chakib; Taourel, Patrice [Hopital Lapeyronie, Department of Radiology, Montpellier (France); Guillon, Francoise [University Hospital of Montpellier, Department of Surgery, Montpellier (France)

2014-12-15

To assess the diagnostic performance of CT signs of gastric volvulus in both confirmed cases and control subjects. We retrospectively reviewed CT findings in 10 patients with surgically confirmed acute gastric volvulus and 20 control subjects with gastric distension. Two radiologists independently evaluated CT images for risk factors of gastric volvulus, direct findings of gastric volvulus by assessing gastric dilatation, the presence of an antropyloric transition point, the respective position of the different stomach segments and of the greater and lesser curvatures, stenosis of the gastric segments through the oesophageal hiatus and for findings of gastric ischemia. The sensitivity and specificity of each finding were calculated. The most sensitive direct signs of gastric volvulus were an antropyloric transition point without any abnormality at the transition zone and the antrum at the same level or higher than the fundus. The presence of both these two findings as diagnostic criteria of gastric volvulus had 100 % sensitivity and specificity for the diagnosis of gastric volvulus. There was no association between CT signs of ischemia and final bowel ischemia at pathology. CT is both highly sensitive and specific for diagnosing acute gastric volvulus. (orig.)

Computed tomography findings of acute gastric volvulus

International Nuclear Information System (INIS)

Millet, Ingrid; Orliac, Celine; Alili, Chakib; Taourel, Patrice; Guillon, Francoise

2014-01-01

To assess the diagnostic performance of CT signs of gastric volvulus in both confirmed cases and control subjects. We retrospectively reviewed CT findings in 10 patients with surgically confirmed acute gastric volvulus and 20 control subjects with gastric distension. Two radiologists independently evaluated CT images for risk factors of gastric volvulus, direct findings of gastric volvulus by assessing gastric dilatation, the presence of an antropyloric transition point, the respective position of the different stomach segments and of the greater and lesser curvatures, stenosis of the gastric segments through the oesophageal hiatus and for findings of gastric ischemia. The sensitivity and specificity of each finding were calculated. The most sensitive direct signs of gastric volvulus were an antropyloric transition point without any abnormality at the transition zone and the antrum at the same level or higher than the fundus. The presence of both these two findings as diagnostic criteria of gastric volvulus had 100 % sensitivity and specificity for the diagnosis of gastric volvulus. There was no association between CT signs of ischemia and final bowel ischemia at pathology. CT is both highly sensitive and specific for diagnosing acute gastric volvulus. (orig.)

The Advanced LIGO timing system

International Nuclear Information System (INIS)

Bartos, Imre; Factourovich, Maxim; Marka, Szabolcs; Marka, Zsuzsa; Raics, Zoltan; Bork, Rolf; Heefner, Jay; Schwinberg, Paul; Sigg, Daniel

2010-01-01

Gravitational wave detection using a network of detectors relies upon the precise time stamping of gravitational wave signals. The relative arrival times between detectors are crucial, e.g. in recovering the source direction, an essential step in using gravitational waves for multi-messenger astronomy. Due to the large size of gravitational wave detectors, timing at different parts of a given detector also needs to be highly synchronized. In general, the requirement toward the precision of timing is determined such that, upon detection, the deduced (astro-) physical results should not be limited by the precision of timing. The Advanced LIGO optical timing distribution system is designed to provide UTC-synchronized timing information for the Advanced LIGO detectors that satisfies the above criterium. The Advanced LIGO timing system has modular structure, enabling quick and easy adaptation to the detector frame as well as possible changes or additions of components. It also includes a self-diagnostics system that enables the remote monitoring of the status of timing. After the description of the Advanced LIGO timing system, several tests are presented that demonstrate its precision and robustness.

Predictive value of CHFR and MLH1 methylation in human gastric cancer.

Science.gov (United States)

Li, Yazhuo; Yang, Yunsheng; Lu, Youyong; Herman, James G; Brock, Malcolm V; Zhao, Po; Guo, Mingzhou

2015-04-01

Gastric carcinoma (GC) has one of the highest mortality rates of cancer diseases and has a high incidence rate in China. Palliative chemotherapy is the main treatment for advanced gastric cancer. It is necessary to compare the effectiveness and toxicities of different regimens. This study explores the possibility of methylation of DNA damage repair genes serving as a prognostic and chemo-sensitive marker in human gastric cancer. The methylation status of five DNA damage repair genes (CHFR, FANCF, MGMT, MLH1, and RASSF1A) was detected by nested methylation-specific PCR in 102 paraffin-embedded gastric cancer samples. Chi-square or Fisher's exact tests were used to evaluate the association of methylation status and clinic-pathological factors. The Kaplan-Meier method and Cox proportional hazards models were employed to analyze the association of methylation status and chemo-sensitivity. The results indicate that CHFR, MLH1, RASSF1A, MGMT, and FANCF were methylated in 34.3% (35/102), 21.6% (22/102), 12.7% (13/102), 9.8% (10/102), and 0% (0/102) of samples, respectively. No association was found between methylation of CHFR, MLH1, RASSF1A, MGMT, or FANCF with gender, age, tumor size, tumor differentiation, lymph node metastasis, and TNM stage. In docetaxel-treated gastric cancer patients, resistance to docetaxel was found in CHFR unmethylated patients by Cox proportional hazards model (HR 0.243, 95% CI, 0.069-0.859, p = 0.028), and overall survival is longer in the CHFR methylated group compared with the CHFR unmethylated group (log-rank, p = 0.036). In oxaliplatin-treated gastric cancer patients, resistance to oxaliplatin was found in MLH1 methylated patients (HR 2.988, 95% CI, 1.064-8.394, p = 0.038), and overall survival was longer in the MLH1 unmethylated group compared with the MLH1 methylated group (log-rank, p = 0.046). CHFR is frequently methylated in human gastric cancer, and CHFR methylation may serve as a docetaxel-sensitive marker. MLH1 methylation was

Case Report - Diaphragmatic eventration complicated by gastric ...

African Journals Online (AJOL)

Eventration of the diaphragm with gastric volvulus is uncommon. Gastric perforation in these cases is rare and usually associated with acute gastric volvulus with strangulation. We describe a case of diaphragmatic eventration with chronic gastric volvulus with gastric perforation without strangulation in an elderly man.

Metastatic Gastric Linitis Plastica from Bladder Cancer Mimicking a Primary Gastric Carcinoma: a Case Report

International Nuclear Information System (INIS)

Hong, Won Sun; Chung, Dong Jin; Lee, Jae Mun; Byun, Jae Ho; Hahn, Seong Tae

2009-01-01

Primary gastric carcinoma is the most common cause of linitis plastica. Less frequently, metastatic gastric cancer from the breast, omental metastases and non-Hodgkin lymphoma involving the stomach have been reported to show similar radiographic findings as for linitis plastica. A metastatic gastric cancer from bladder cancer is extremely rare. We present an unusual case, the first to our knowledge, of gastric linitis plastica that resulted from a metastatic urothelial carcinoma of the bladder

Bone metastases from gastric cancer. Clinical evaluation on bone scintigram

Energy Technology Data Exchange (ETDEWEB)

Seto, Mikito; Tonami, Norihisa; Koizumi, Kiyoshi; Sui, Osamu; Hisada, Kinichi [Kanazawa Univ. (Japan). School of Medicine

1983-07-01

We have studied bone scintigrams in 60 patients with gastric cancer. Of these 60 patients, bone metastases were found in 15 patients (25 %). There were no evidence of bone metastases in polypoid lesions, cancers of the antrum, carcinomas in situ, advanced cancers without invasion to serosa, cancer with N/sub 0/ or N/sub 1/ regional lymph node metastases, highly differentiated adenocarcinomas and papillary adenocarcinomas. On the contrary, high rates of bone metastases were seen in cancers of the corpus, advanced cancers with invasion to neighbouring structures and tubular adenocarcinomas. Of these 15 patients with bone metastasis, 3 patients showed very similar clinical features and the findings of ''diffuse bone metastases on bone scintigrams.'' Cancer of the antrum showed high rates of liver metastases, while cancers of the corpus showed high rates of bone metastases. Sixty percent of the patients with bone metastases did not have liver metastases and there seemed to be no significant relationship between liver metastases and bone metastases. From these results we suppose that non-portal tract through the vertebral venous plexus instead of portal tract may be the other route of bone metastases from gastric cancer.

Computed tomography findings of acute gastric volvulus.

Science.gov (United States)

Millet, Ingrid; Orliac, Celine; Alili, Chakib; Guillon, Françoise; Taourel, Patrice

2014-12-01

To assess the diagnostic performance of CT signs of gastric volvulus in both confirmed cases and control subjects. We retrospectively reviewed CT findings in 10 patients with surgically confirmed acute gastric volvulus and 20 control subjects with gastric distension. Two radiologists independently evaluated CT images for risk factors of gastric volvulus, direct findings of gastric volvulus by assessing gastric dilatation, the presence of an antropyloric transition point, the respective position of the different stomach segments and of the greater and lesser curvatures, stenosis of the gastric segments through the oesophageal hiatus and for findings of gastric ischemia. The sensitivity and specificity of each finding were calculated. The most sensitive direct signs of gastric volvulus were an antropyloric transition point without any abnormality at the transition zone and the antrum at the same level or higher than the fundus. The presence of both these two findings as diagnostic criteria of gastric volvulus had 100% sensitivity and specificity for the diagnosis of gastric volvulus. There was no association between CT signs of ischemia and final bowel ischemia at pathology. CT is both highly sensitive and specific for diagnosing acute gastric volvulus. CT is highly reliable for diagnosing acute gastric volvulus with two findings. The two signs are gastropyloric transition zone and abnormal location of the antrum. This allows fast surgical management of this emergency.

Cell Division Synchronization

Science.gov (United States)

The report summarizes the progress in the design and construction of automatic equipment for synchronizing cell division in culture by periodic...Concurrent experiments in hypothermic synchronization of algal cell division are reported.

Clinicopathological features and outcome in advanced colorectal cancer patients with synchronous vs metachronous metastases

NARCIS (Netherlands)

Mekenkamp, L. J. M.; Koopman, M.; Teerenstra, S.; van Krieken, J. H. J. M.; Mol, L.; Nagtegaal, I. D.; Punt, C. J. A.

2010-01-01

Synchronous metastases of colorectal cancer (CRC) are considered to be of worse prognostic value compared with metachronous metastases, but only few and conflicting data have been reported on this issue. We retrospectively investigated patient demographics, primary tumour characteristics and overall

Recent advances on synchronization of ovulation in goats, out of season, for a more sustainable production

Directory of Open Access Journals (Sweden)

J. Simões

2015-06-01

Full Text Available Goats show marked progressive seasonal reproduction at latitude > 25° and reproductive management should be adapted to market demands. The present review aimed to discuss the synchronization of ovulation for timed artificial insemination concerning new insights regarding a clean, green and ethical meat and milk production. Today, the induction of ovulation during breeding season or transitions periods is mainly based on progestagens/ progesterone (P4 devices intravaginally inserted on females, at least during 11 days, plus equine chorionic gonadotropin (eCG and prostaglandin F2 alfa administration. In last years a reduction to 20 mg of fluorogestone acetate was made and the successful reutilization of devices containing 0.3 g of P4 indicates a possible reduction of their levels. Shortening the period of exogenous progestagens/P4 priming (5 to 7 days is critical for a rational use of hormones. Moreover, the eCG exchange by socio-sexual cues (male effect seems to see a great advance, even if a previous photoperiod treatment, or equivalent method, being necessary in high latitudes. Research trends on these subjects are expected in future using different goats breeds in distinct regions of world.

Synchronization of femtosecond laser pulses and RF signal by using a Sagnac loop Mach-Zehnder interferometer

International Nuclear Information System (INIS)

Dai Hui; Hajima, Ryoichi

2008-11-01

For future advanced energy recovery linac to generate femtosecond X-ray pulses, precise synchronization between sub-systems is highly desired. Typical synchronization methods based on direct photo detection are limited by detector nonlinearities, which lead to amplitude-to-phase conversion and introduce excess timing jitter. In this paper, we experimentally demonstrate an optical-electronic mixed phase lock loop to synchronize the RF signal and laser pulses. In this synchronism setup, a Sagnac-loop Mach-Zehnder interferometer has been used to suppress the excess noise of direct photo detection. This scheme transfers the timing information into a intensity imbalance between the two output beams of the interferometer. As experimental demonstration, the single side-band phase noise of RF signal from the VCO is locked to the mode-locked Ti:Sapphire laser in the spectrum covering the range of 10 kHz to 1 MHz. This synchronization scheme greatly reduces the phase noise and timing jitter of the RF signal. (author)

Improvement of quality of life and survival using self-expandable metal stent placement for severe malignant stenosis of the gastric body: a case report

Directory of Open Access Journals (Sweden)

Kumagai Hozumi

2012-09-01

Full Text Available Abstract Introduction Advanced gastric carcinoma often decreases quality of life because of upper gastrointestinal tract stenosis. Self-expandable metal stents have been thought to be an effective, minimally invasive treatment for stenosis. However, the effectiveness of self-expandable metal stent placement for carcinomatous stenosis of the gastric body and antrum has not been clarified, and there have been few reports of such cases. Case presentation A 74-year-old Japanese woman developed stenosis of the gastric body and antrum caused by advanced gastric cancer during first-line chemotherapy. She developed weight loss and poor nutrition due to inadequate intake. Self-expandable metal stent placement for stenosis of the gastric body and antrum ameliorated her symptoms rapidly and improved her general condition and quality of life. Eight days after self-expandable metal stent placement, second-line chemotherapy could be administered safely. Oral intake and nutritional status were maintained for 117 days after self-expandable metal stent placement, and she died of gastric cancer 176 days after self-expandable metal stent placement and initiation of second-line chemotherapy. Conclusions Self-expandable metal stent placement for carcinomatous stenosis in the gastric body and antrum could be an effective therapeutic strategy for patients with inadequate oral uptake. It may provide rapid improvement of the patient’s general condition and oral intake with minimal complications, comparatively long-term symptom relief, and a survival benefit by allowing second-line chemotherapy.

A Possible Link between Gastric Mucosal Atrophy and Gastric Cancer after Helicobacter pylori Eradication.

Directory of Open Access Journals (Sweden)

Tomomitsu Tahara

Full Text Available The effect of H. pylori eradication in gastric cancer prevention can be attributed to the improvement of atrophic gastritis, which is a known risk of gastric cancer. However, gastric cancer has also been diagnosed after long-term H. pylori eradication. This study aimed to clarify the association between gastric atrophy and gastric cancer after H. pylori eradication, including its clinicopathological features.A total of 55 consecutive patients with 64 early gastric cancers (EGCs diagnosed after H. pylori eradication were enrolled. The degree of endoscopic atrophy and the histological degrees of mononuclear cell infiltration, atrophy, and metaplasia in the corpus and adjacent mucosa of the EGCs were determined and scored.The majority of EGCs (63/64 were located within the endoscopically assessed atrophic mucosa or along the atrophic border. The adjacent mucosa of the EGCs presented significantly higher degrees of all histological parameters than in the corpus (mononuclear cell infiltration, 0.86+/-0.09 vs. 0.51+/-0.11, P = 0.016; atrophy, 1.77+/-0.13 vs. 0.65+/-0.14, P<0.0001; metaplasia, 1.68+/-0.13 vs. 0.48+/-0.1, P<0.0001. The degree of endoscopic atrophy improved in the patients with longer post-H. pylori eradication periods; however, this trend was not observed for the histological parameters, and high degrees of atrophy and metaplasia were observed in the adjacent mucosa of the EGCs compared with the corpus during all periods (all P<0.05. The histological degrees of atrophy and metaplasia in the adjacent mucosa were particularly higher in the patients who underwent eradication due to gastric ulcers.Severe gastric atrophy remained in the adjacent mucosa of the EGCs after H. pylori eradication, which may be linked to gastric carcinogenesis.

Synchronization dynamics of two different dynamical systems

International Nuclear Information System (INIS)

Luo, Albert C.J.; Min Fuhong

2011-01-01

Highlights: → Synchronization dynamics of two distinct dynamical systems. → Synchronization, de-synchronization and instantaneous synchronization. → A controlled pendulum synchronizing with the Duffing oscillator. → Synchronization invariant set. → Synchronization parameter map. - Abstract: In this paper, synchronization dynamics of two different dynamical systems is investigated through the theory of discontinuous dynamical systems. The necessary and sufficient conditions for the synchronization, de-synchronization and instantaneous synchronization (penetration or grazing) are presented. Using such a synchronization theory, the synchronization of a controlled pendulum with the Duffing oscillator is systematically discussed as a sampled problem, and the corresponding analytical conditions for the synchronization are presented. The synchronization parameter study is carried out for a better understanding of synchronization characteristics of the controlled pendulum and the Duffing oscillator. Finally, the partial and full synchronizations of the controlled pendulum with periodic and chaotic motions are presented to illustrate the analytical conditions. The synchronization of the Duffing oscillator and pendulum are investigated in order to show the usefulness and efficiency of the methodology in this paper. The synchronization invariant domain is obtained. The technique presented in this paper should have a wide spectrum of applications in engineering. For example, this technique can be applied to the maneuvering target tracking, and the others.

FPGA based fast synchronous serial multi-wire links synchronization

Science.gov (United States)

Pozniak, Krzysztof T.

2013-10-01

The paper debates synchronization method of multi-wire, serial link of constant latency, by means of pseudo-random numbers generators. The solution was designed for various families of FPGA circuits. There were debated synchronization algorithm and functional structure of parameterized transmitter and receiver modules. The modules were realized in VHDL language in a behavioral form.

Customization of laparoscopic gastric devascularization and splenectomy for gastric varices based on CT vascular anatomy.

Science.gov (United States)

Kawanaka, Hirofumi; Akahoshi, Tomohiko; Nagao, Yoshihiro; Kinjo, Nao; Yoshida, Daisuke; Matsumoto, Yoshihiro; Harimoto, Norifumi; Itoh, Shinji; Yoshizumi, Tomoharu; Maehara, Yoshihiko

2018-01-01

Laparoscopic gastric devascularization(Lap GDS) and splenectomy (SPL) for gastric varices is technically challenging because of highly developed collateral vessels and bleeding tendency. We investigated the feasibility of customization of Lap GDS and SPL based on CT vascular anatomy. We analyzed 61 cirrhotic patients with gastric varices who underwent Lap GDS and SPL between 2006 and 2014. Lap GDS was customized according to the afferent feeding veins (left gastric vein (LGV) and/or posterior gastric vein (PGV)/short gastric vein (SGV)) and efferent drainage veins (gastrorenal shunt and/or gastrophrenic shunt, or numerous retroperitoneal veins) based on CT imaging. Thirty-four patients with efferent drainage veins suitable for balloon-occluded retrograde transvenous obliteration (B-RTO) underwent B-RTO instead of surgical GDS, with subsequent Lap SPL. Among 27 patients with gastric varices unsuitable for B-RTO, 15 patients with PGV/SGV underwent Lap GDS of the greater curvature and SPL, and 12 patients with LGV or LGV/PGV/SGV underwent Lap GDS of the greater and lesser curvature and SPL. The mean operation time was 294 min and mean blood loss was 198 g. There was no mortality or severe morbidity. Gastric varices were eradicated in all 61 patients, with no bleeding or recurrence during a mean follow-up of 55.9 months. The cumulative 3-, 5-, and 7-year survival rates were 92, 82, and 64%, respectively. Lap GDS and SPL customized based on CT vascular anatomy is a safe and effective procedure for treating gastric varices.

Diagnoses of gastric cancer and other gastric diseases by serum pepsinogen I and II levels

International Nuclear Information System (INIS)

Xiao Zhijian; Jiang Mengjun

1998-01-01

Serum pepsinogens I and II (PGI, PGII) levels were determined by PGI and PGII-RIA kits in 84 healthy controls and 128 patients of gastric diseases including 42 patients with gastric cancer. The results showed peptic ulcer cases had elevated PGI and PGII levels. The atrophic gastritis cases had low PGI levels and the gastric cancer cases had low PGI and low PGI/PGII ratio. Using the cut-off values of PGI<35 μg/L and PGI/PGII<1.5 for clinical purpose, the sensitivity and specificity of the test for gastric cancer was 73% and 78%, respectively. Combined with endoscope examination, the serum PGI and PGII levels are valuable for the early diagnosis of gastric cancer

Synchronizing Strategies under Partial Observability

DEFF Research Database (Denmark)

Larsen, Kim Guldstrand; Laursen, Simon; Srba, Jiri

2014-01-01

Embedded devices usually share only partial information about their current configurations as the communication bandwidth can be restricted. Despite this, we may wish to bring a failed device into a given predetermined configuration. This problem, also known as resetting or synchronizing words, has...... been intensively studied for systems that do not provide any information about their configurations. In order to capture more general scenarios, we extend the existing theory of synchronizing words to synchronizing strategies, and study the synchronization, short-synchronization and subset...

Significance of preoperative staging of gastric carcinoma by computed tomography

International Nuclear Information System (INIS)

Shin, Jie Yeul; Shim, Jeon Seop; Kim, Byung Young; Lee, Jong Kil

1989-01-01

Gastric cancer is the most common gastrointestinal tract malignancy in Korea. When the patients has been detected, these tumors are usually advanced. CT is important for planning of treatment, assessing surgical resectability, postoperative evaluation and prognosis. Author reviewed CT scan of 78 cases of confirmed gastric cancer by UGI series and endoscopic biopsy, for 14 months from May 1988 to June 1989 at Department of Diagnostic Radiology, Taegu Fatima Hospital. The results were as follows; 1. Male to female ratio was 1:6:1 and the peak age groups are 6th decade and 7th decade. 2. The most frequent site of involvement was gastric antrum in 44.9% (35/78). antrum and body in 23.1% (18/78) in the order. 3. The reliability of pancreatic involvement was 88.2%(45/51). 4. The diagnostic accuracy of CT staging was 66.7% (34/51) by correlation of surgical and pathological findings. 5. The most common cause of non-operation was 17 cases (60.3%) of stage IV, old age, operation refusal in the order. 6. The accuracy of regional lymph node involvement between CT and pathologic finding was 62.7% (32/51)

Exploiting Schemas in Data Synchronization

DEFF Research Database (Denmark)

Foster, J. Nathan; Greenwald, Michael B.; Kirkegaard, Christian

2005-01-01

Increased reliance on optimistic data replication has led to burgeoning interest in tools and frameworks for disconnected updates to replicated data.We have implemented a generic synchronization framework, called HARMONY, that can be used to build state-based synchronizers for a wide variety...... of tree-structureddata formats. A novel feature of this framework is that the synchronization process - in particular, the recognition of conflicts - is driven by the schema of the structures being synchronized.We formalize HARMONY's synchronization algorithm, state a simple and intuitive specification......, and illustrate, using simple address books as a case study, how it can be used to synchronize trees representing a variety of specific forms of applicationdata, including sets, records, tuples, and relations....

Evaluation of Gastric pH and Serum Gastrin Concentrations in Cats with Chronic Kidney Disease.

Science.gov (United States)

Tolbert, M K; Olin, S; MacLane, S; Gould, E; Steiner, J M; Vaden, S; Price, J

2017-09-01

Chronic kidney disease (CKD) is a highly prevalent condition in cats. Advanced CKD is associated with hyporexia and vomiting, which typically are attributed to uremic toxins and gastric hyperacidity. However, gastric pH studies have not been performed in cats with CKD. To determine if cats with CKD have decreased gastric pH compared to age-matched, healthy cats. Based on previous work demonstrating an association of hypergastrinemia and CKD, we hypothesized that cats with CKD would have decreased gastric pH compared to healthy, age-matched control cats. 10 CKD cats; 9 healthy control cats. All cats with concurrent disease were excluded on the basis of history, physical examination, CBC, plasma biochemistry profile, urinalysis, urine culture, serum total thyroxine concentration, and serum symmetric dimethylarginine concentration (controls only) obtained within 24 hours of pH monitoring and assessment of serum gastrin concentrations. Serum for gastrin determination was collected, and 12-hour continuous gastric pH monitoring was performed in all cats. Serum gastrin concentration, mean pH, and percentage time that gastric pH was strongly acidic (pH pH parameters including mean ± SD gastric pH (CKD, 1.8 ± 0.5; healthy, 1.6 ± 0.3; P-value = 0.23). These findings suggest that cats with CKD may not have gastric hyperacidity compared to healthy cats and, therefore, may not need acid suppression. Thus, further studies to determine if there is a benefit to acid suppression in cats with CKD are warranted. Copyright © 2017 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

Synchronous and Asynchronous Communication in Distance Learning: A Review of the Literature

Science.gov (United States)

Watts, Lynette

2016-01-01

Distance learning is commonplace in higher education, with increasing numbers of students enjoying the flexibility e-learning provides. Keeping students connected with peers and instructors has been a challenge with e-learning, but as technology has advanced, the methods by which educators keep students engaged, synchronously and asynchronously,…

Clinical Application of 18F-FDG PET in Gastric Cancer

International Nuclear Information System (INIS)

Yun, Mi Jin; Kim, Tae Sung; Hwang, Hee Sung

2008-01-01

PET or PET/CT detects only less than 50% of early gastric cancer and 62-98% of advanced gastric cancer. Therefore, mass screening programs are recommended for all adults over the age of 40 for early detection and early treatment of gastric cancer through endoscopy or various radiological tests. The most important step after diagnosis of gastric cancer is accurate staging, which mainly evaluates tumor resectability to avoid unnecessary surgery. Important factors that affect tumor resectability are whether the tumor can be separated from adjacent organs or important blood vessels, the extent of lymph node metastasis, presence of peritoneal metastasis, or distant organ metastasis. To evaluate the extent of local tumor invasion, anatomical imaging that has superior spatial resolution is essential. There are a few studies on prognostic significance of FDG uptake with inconsistent results between them. In spite of lower sensitivity for lymph node staging, the specificity of CT and PET are very high, and the specificity for PET tends to be higher than that for CT. Limited data published so far show that PET seems less useful in the detection of lung and bone metastasis. In the evaluation of pleural or peritoneal metastasis, PET seems very specific but insensitive as well. When FDG uptake of primary tumor is low, distant metastasis also tends to show low FDG uptake reducing its detection on PET. There are only a few data available in the evaluation of recurrence detection and treatment response using FDG PET or PET/CT

Diagnosis of gastric cancers by CT

International Nuclear Information System (INIS)

Zhu Jianbing; Gong Jianping; Huan Jian

1999-01-01

Forty two cases of gastric cancers were reviewed. The cancer had been examined by CT and was confirmed by operation and pathology. The diagnostic results of gastric cancers obtained by CT were compared with that from GI and fibro-gastroscopy examination. The results showed that the preparation of gastrointestinal tract before CT examination was important in the CT diagnosis of gastric cancer. CT in diagnosis of focus of gastric cancer and organ invasion is better than Gl and Fibro-gastroscopy and accuracy in diagnosis of gastric cancers is near to that of GI examination

Gastric Schwannoma: a case report

International Nuclear Information System (INIS)

Lee, Kye Ho; Jee, Keum Nahn

2006-01-01

Gastric Schwannoma is a rare benign intramural tumor arising from the stomach, and it accounts for only 0.1% of all the different kinds of gastric neoplasms, and it's less than 4% of all the benign gastric tumors. This tumor is very difficult to differentiate from the other mesenchymal tumors by the clinical, endoscopic and radiologic findings. In this study, we demonstrate the appearance of this tumor on endoscopic ultrasound and contrast-enhanced abdomen CT. We also show the histopathologic findings of a surgically confirmed gastric Schwannoma that was located in the proper muscle layer

BMI1 and Mel-18 oppositely regulate carcinogenesis and progression of gastric cancer.

Science.gov (United States)

Zhang, Xiao-Wei; Sheng, Ya-Ping; Li, Qian; Qin, Wei; Lu, You-Wei; Cheng, Yu-Fan; Liu, Bing-Ya; Zhang, Feng-Chun; Li, Jin; Dimri, Goberdhan P; Guo, Wei-Jian

2010-02-21

The BMI1 oncogene is overexpressed in several human malignancies including gastric cancer. In addition to BMI1, mammalian cells also express Mel-18, which is closely related to BMI1. We have reported that Mel-18 functions as a potential tumor suppressor by repressing the expression of BMI1 and consequent downregulation of activated AKT in breast cancer cells. However, the mechanisms of BMI1 overexpression and the role of Mel-18 in other cancers are still not clear. The purpose of this study is to investigate the role of BMI1 and Mel-18 in gastric cancer. BMI1 was found to be overexpressed in gastric cancer cell lines and gastric tumors. Overexpression of BMI1 correlated with advanced clinical stage and lymph node metastasis; while the expression of Mel-18 negatively correlated with BMI1. BMI1 but not Mel-18 was found to be an independent prognostic factor. Downregulation of BMI1 by Mel-18 overexpression or knockdown of BMI1 expression in gastric cancer cell lines led to upregulation of p16 (p16INK4a or CDKN2A) in p16 positive cell lines and reduction of phospho-AKT in both p16-positive and p16-negative cell lines. Downregulation of BMI1 was also accompanied by decreased transformed phenotype and migration in both p16- positive and p16-negative gastric cancer cell lines. In the context of gastric cancer, BMI1 acts as an oncogene and Mel-18 functions as a tumor suppressor via downregulation of BMI1. Mel-18 and BMI1 may regulate tumorigenesis, cell migration and cancer metastasis via both p16- and AKT-dependent growth regulatory pathways.

Genetics Home Reference: hereditary diffuse gastric cancer

Science.gov (United States)

... Health Conditions Hereditary diffuse gastric cancer Hereditary diffuse gastric cancer Printable PDF Open All Close All Enable Javascript ... Diffuse Gastric Cancer MedlinePlus Encyclopedia: Gastric Cancer National Cancer ... Option Overview General Information from MedlinePlus ( ...

Scintigraphic evaluation of gastric emptying and motility

International Nuclear Information System (INIS)

Linke, R.

2003-01-01

The stomach consists of two functionally distinct parts. The fundus and upper corpus mainly serve as a reservoir and exert primarily a tonic activity, which presses ingesta towards the antrum and duodenum. The phasic contractility of the lower corpus and antrum cause mechanical breakdown and mixing of the food particels. A complex regulation of these mechanisms provides a regular gastric emptying. Various disorders such as diabetes mellitus, mixed connective tissue diseases, gastritis, tumors, dyspeptic disorders but also drugs and gastric surgery may influence or impair gastric function and may cause typical symptoms such as upper abdominal discomfort, bloating, nausea and vomiting. However, the interpretation of gastrointestinal symptoms often is difficult. Radionuclide studies of gastric emptying and motility are the most physiologic tools available for studying gastric motor function. Gastric scintigraphy is non-invasive, uses physiologic meal and is quantitative. Emptying curves generated from the gastric ROI offer information whether a disorder is accompanied by a regular, fast or slow gastric emptying. Data on gastric contractions (amplitude and frequency) provide additional information to results obtained by conventional emptying studies. Depending on the underlying disorder, gastric emptying and peristalsis showed both corresponding and discrepant findings. Therefore, both parameters should be routinely assessed to further improve characterisation of gastric dysfunction by scintigraphy. (orig.) [de

Effects of sucralfate on gastric irritant-induced necrosis and apoptosis in cultured guinea pig gastric mucosal cells.

Science.gov (United States)

Hoshino, Tatsuya; Takano, Tatsunori; Tomisato, Wataru; Tsutsumi, Shinji; Hwang, Hyun-Jung; Koura, Yuko; Nishimoto, Kiyo; Tsuchiya, Tomofusa; Mizushima, Tohru

2003-01-01

We previously reported that several gastric irritants, including ethanol, hydrogen peroxide, and hydrochloric acid, induced both necrosis and apoptosis in cultured gastric mucosal cells. In the present study, we examined the effects of sucralfate, a unique gastroprotective drug, on gastric irritant-induced necrosis and apoptosis produced in vitro. Sucralfate strongly inhibited ethanol-induced necrosis in primary cultures of guinea pig gastric mucosal cells. The preincubation of cells with sucralfate was not necessary for its cytoprotective effect to be observed, thus making its mechanism of action different from that of other gastroprotective drugs. Necrosis of gastric mucosal cells induced by hydrogen peroxide or indomethacin was also suppressed by sucralfate. On the other hand, sucralfate only weakly inhibited ethanol-induced apoptosis. These results suggest that the cytoprotective effect of sucralfate on gastric mucosa in vivo can be explained, at least in part, by its inhibitory effect on gastric irritant-induced necrosis.

Analysis of interventional therapy for progressing stage gastric cancer

International Nuclear Information System (INIS)

Zhu Mingde; Zhang Zijing; Ji Hongsheng; Ge Chenlin; Hao Gang; Wei Kongming; Yuan Yuhou; Zhao Xiuping

2008-01-01

Objective: To investigate the interventional therapy and its curative effect for progressing stage gastric cancer. Methods: two hundred and twelve patients with progressing stage gastric cancer were treated with arterial perfusion and arterial embolization. Gastric cardia cancer was treated through the left gastric artery and the left inferior phrenic artery or splenic artery. Cancers of lesser and greater gastric curvature was treated either through the left and right gastric arteries or common hepatic artery or through gastroduodenal artery, right gastroomental artery or splenic artery. Gastric antrum cancers were perfused through gastroduodenal artery or after the middle segmental embolization of right gastroomental artery. Results: One hundred and ninety three cases undergone interventional management were followed up. The CR + PR of gastric cardia cancer was 53.13%; gastric body cancer 44.44%; gastric antrum cancer 10%; recurrent cancer and remnant gastric cancer 0. There was no significant difference in outcome between gastric cardia cancer and gastric body cancer (P>0.05) but significant differences were shown both between gastric cardia cancer and gastric antrum cancer, and between gastric body cancer and gastric antrum cancer (P<0.05), with 1 year and 2 years survival rates of 81% and 56% respectively. Conclusion: The interventional therapeutic effect of progressing stage gastric cancers is different due to the different sites of the lesions in the gastric tissue. The curative effect of gastric cardia cancer and gastric body cancer is better than that of gastric antrum cancer, recurrent cancer and remnant gastric cancer. (authors)

Asynchronized synchronous machines

CERN Document Server

Botvinnik, M M

1964-01-01

Asynchronized Synchronous Machines focuses on the theoretical research on asynchronized synchronous (AS) machines, which are "hybrids” of synchronous and induction machines that can operate with slip. Topics covered in this book include the initial equations; vector diagram of an AS machine; regulation in cases of deviation from the law of full compensation; parameters of the excitation system; and schematic diagram of an excitation regulator. The possible applications of AS machines and its calculations in certain cases are also discussed. This publication is beneficial for students and indiv

The overmethylated genes in Helicobacter pylori-infected gastric mucosa are demethylated in gastric cancers

Directory of Open Access Journals (Sweden)

Choi Sang-Wook

2010-11-01

Full Text Available Abstract Background The transitional-CpG sites between weakly methylated genes and densely methylated retroelements are overmethylated in the gastric mucosa infected with Helicobacter pylori (H. pylori and they are undermethylated in the gastric cancers depending on the level of loss of heterozygosity (LOH events. This study delineated the transitional-CpG methylation patterns of CpG-island-containing and -lacking genes in view of the retroelements. Methods The transitional-CpG sites of eight CpG-island-containing genes and six CpG-island-lacking genes were semi-quantitatively examined by performing radioisotope-labelling methylation-specific PCR under stringent conditions. The level of LOH in the gastric cancers was estimated using the 40 microsatellite markers on eight cancer-associated chromosomes. Each gene was scored as overmethylated or undermethylated based on an intermediate level of transitional-CpG methylation common in the H. pylori-negative gastric mucosa. Results The eight CpG-island genes examined were overmethylated depending on the proximity to the nearest retroelement in the H. pylori-positive gastric mucosa. The six CpG-island-lacking genes were similarly methylated in the H. pylori-positive and -negative gastric mucosa. In the gastric cancers, long transitional-CpG segments of the CpG-island genes distant from the retroelements remained overmethylated, whereas the overmethylation of short transitional-CpG segments close to the retroelements was not significant. Both the CpG-island-containing and -lacking genes tended to be decreasingly methylated in a LOH-level-dependent manner. Conclusions The overmethylated genes under the influence of retroelement methylation in the H. pylori-infected stomach are demethylated in the gastric cancers influenced by LOH.

Gastric extremely well differentiated adenocarcinoma of gastric phenotype: as a gastric counterpart of adenoma malignum of the uterine cervix

Directory of Open Access Journals (Sweden)

Ae Lee Won

2005-05-01

Full Text Available Abstract Background Most of gastric adenocarcinoma can be simply diagnosed by microscopic examination of biopsy specimen. Rarely the structural and cellular atypia of tumor cells is too insignificant to discriminate from benign foveolar epithelium. Case presentation A 67-year-old male presented with a gastric mass incidentally found on the abdominal computed tomography (CT for routine medical examination. Gastric endoscopic examination revealed a huge fungating mass at the cardia and mucosal biopsy was performed. Microscopically the biopsy specimen showed proliferation of bland looking foveolar epithelia in the inflammatory background and diagnosed as foveolar epithelial hyperplasia. Because the clinical and endoscopic features of this patient were strongly suggestive of malignancy, the patient underwent radical total gastrectomy. The resected stomach revealed a huge fungating tumor at the cardia. The cut surface of the tumor was whitish gelatinous. Microscopically the tumor was sharply demarcated from surrounding mucosa and composed of very well formed glandular structures without significant cellular atypia, which invaded into the whole layer of the gastric wall. Tumor glands were occasionally complicated or dilated, and glandular lumina were filled with abundant mucin. Immunohistochemically the tumor cells revealed no overexpression of p53 protein but high Ki-67 labeling index. The tumor cells and intraluminal mucin were diffusely expressed MUC1 and MUC5AC and only focally expressed MUC2. On abdominal CT taken after 12 months demonstrated peritoneal carcinomatosis and multiple metastatic foci in the lung. Conclusion The clinicopathologic profiles of gastric extremely well differentiated adenocarcinoma of gastric phenotype include cardiac location, fungating gross type, very similar histology to foveolar epithelial hyperplasia, foveolar mucin phenotype, lack of p53 overexpressoin and high proliferative index.

GTSE1 expression represses apoptotic signaling and confers cisplatin resistance in gastric cancer cells

International Nuclear Information System (INIS)

Subhash, Vinod Vijay; Tan, Shi Hui; Tan, Woei Loon; Yeo, Mei Shi; Xie, Chen; Wong, Foong Ying; Kiat, Zee Ying; Lim, Robert; Yong, Wei Peng

2015-01-01

Platinum based therapy is commonly used in the treatment of advanced gastric cancer. However, resistance to chemotherapy is a major challenge that causes marked variation in individual response rate and survival rate. In this study, we aimed to identify the expression of GTSE1 and its correlation with cisplatin resistance in gastric cancer cells. Methylation profiling was carried out in tissue samples from gastric cancer patients before undergoing neoadjuvent therapy using docetaxel, cisplatin and 5FU (DCX) and in gastric cancer cell lines. The correlation between GTSE1 expression and methylation in gastric cancer cells was determined by RT-PCR and MSP respectively. GTSE1 expression was knocked-down using shRNA’s and its effects on cisplatin cytotoxicity and cell survival were detected by MTS, proliferation and clonogenic survival assays. Additionally, the effect of GTSE1 knock down in drug induced apoptosis was determined by western blotting and apoptosis assays. GTSE1 exhibited a differential methylation index in gastric cancer patients and in cell lines that correlated with DCX treatment response and cisplatin sensitivity, respectively. In-vitro, GTSE1 expression showed a direct correlation with hypomethylation. Interestingly, Cisplatin treatment induced a dose dependent up regulation as well as nuclear translocation of GTSE1 expression in gastric cancer cells. Knock down of GTSE1 enhanced cisplatin cytotoxity and led to a significant reduction in cell proliferation and clonogenic survival. Also, loss of GTSE1 expression caused a significant increase in P53 mediated apoptosis in cisplatin treated cells. Our study identifies GTSE1 as a biomarker for cisplatin resistance in gastric cancer cells. This study also suggests the repressive role of GTSE1 in cisplatin induced apoptosis and signifies its potential utility as a therapeutic target for better clinical management of gastric cancer patients. The online version of this article (doi:10.1186/s12885

Redefining early gastric cancer.

Science.gov (United States)

Barreto, Savio G; Windsor, John A

2016-01-01

The problem is that current definitions of early gastric cancer allow the inclusion of regional lymph node metastases. The increasing use of endoscopic submucosal dissection to treat early gastric cancer is a concern because regional lymph nodes are not addressed. The aim of the study was thus to critically evaluate current evidence with regard to tumour-specific factors associated with lymph node metastases in "early gastric cancer" to develop a more precise definition and improve clinical management. A systematic and comprehensive search of major reference databases (MEDLINE, EMBASE, PubMed and the Cochrane Library) was undertaken using a combination of text words "early gastric cancer", "lymph node metastasis", "factors", "endoscopy", "surgery", "lymphadenectomy" "mucosa", "submucosa", "lymphovascular invasion", "differentiated", "undifferentiated" and "ulcer". All available publications that described tumour-related factors associated with lymph node metastases in early gastric cancer were included. The initial search yielded 1494 studies, of which 42 studies were included in the final analysis. Over time, the definition of early gastric cancer has broadened and the indications for endoscopic treatment have widened. The mean frequency of lymph node metastases increased on the basis of depth of infiltration (mucosa 6% vs. submucosa 28%), presence of lymphovascular invasion (absence 9% vs. presence 53%), tumour differentiation (differentiated 13% vs. undifferentiated 34%) and macroscopic type (elevated 13% vs. flat 26%) and tumour diameter (≤2 cm 8% vs. >2 cm 25%). There is a need to re-examine the diagnosis and staging of early gastric cancer to ensure that patients with one or more identifiable risk factor for lymph node metastases are not denied appropriate chemotherapy and surgical resection.

Histopathologic diversity of gastric cancers: Relationship between enhancement pattern on dynamic contrast-enhanced CT and histological type.

Science.gov (United States)

Tsurumaru, Daisuke; Miyasaka, Mitsutoshi; Muraki, Toshio; Nishie, Akihiro; Asayama, Yoshiki; Oki, Eiji; Oda, Yoshinao; Honda, Hiroshi

2017-12-01

To evaluate the diagnostic value of contrast-enhanced computed tomography gastrography (CE-CTG) to predict the histological type of gastric cancer. We analyzed 47 consecutive patients with resectable advanced gastric cancer preoperatively evaluated by multiphasic dynamic contrast-enhanced CT. Two radiologists independently reviewed the CT images and they determined the peak enhancement phase, and then measured the CT attenuation value of the gastric lesion for each phase. The histological types of gastric cancers were assigned to three groups as differentiated-type, undifferentiated-type, and mixed-type. We compared the peak enhancement phase of the three types and compared the CT attenuation values in each phase. The peak enhancement was significantly different between the three types of gastric cancers for both readers (reader 1, p=0.001; reader 2, p=0.009); most of the undifferentiated types had peak enhancement in the delayed phase. The CT attenuation values of undifferentiated type were significantly higher than those of differentiated or mixed type in the delayed phase according to both readers (reader 1, p=0.002; reader 2, p=0.004). CE-CTG could provide helpful information in diagnosing the histological type of gastric cancers preoperatively. Copyright © 2017 Elsevier B.V. All rights reserved.

Gastric Adenocarcinoma: A Multimodal Approach

Directory of Open Access Journals (Sweden)

Humair S. Quadri

2017-08-01

Full Text Available Despite its declining incidence, gastric cancer (GC remains a leading cause of cancer-related deaths worldwide. A multimodal approach to GC is critical to ensure optimal patient outcomes. Pretherapy fine resolution contrast-enhanced cross-sectional imaging, endoscopic ultrasound and staging laparoscopy play an important role in patients with newly diagnosed ostensibly operable GC to avoid unnecessary non-therapeutic laparotomies. Currently, margin negative gastrectomy and adequate lymphadenectomy performed at high volume hospitals remain the backbone of GC treatment. Importantly, adequate GC surgery should be integrated in the setting of a multimodal treatment approach. Treatment for advanced GC continues to expand with the emergence of additional lines of systemic and targeted therapies.

A Patient with Advanced Gastric Cancer Presenting with Extremely Large Uterine Fibroid Tumor

Directory of Open Access Journals (Sweden)

Kwang-Kuk Park

2014-01-01

Full Text Available Introduction. Uterine fibroid tumors (uterine leiomyomas are the most common benign uterine tumors. The incidence of uterine fibroid tumors increases in older women and may occur in more than 30% of women aged 40 to 60. Many uterine fibroid tumors are asymptomatic and are diagnosed incidentally. Case Presentation. A 44-year-old woman was admitted to our hospital with general weakness, dyspepsia, abdominal distension, and a palpable abdominal mass. An abdominal computed tomography scan showed a huge tumor mass in the abdomen which was compressing the intestine and urinary bladder. Gastroduodenal endoscopic and biopsy results showed a Borrmann type IV gastric adenocarcinoma. The patient was diagnosed with gastric cancer with disseminated peritoneal carcinomatosis. She underwent a hysterectomy with both salphingo-oophorectomy and bypass gastrojejunostomy. Simultaneous uterine fibroid tumor with other malignancies is generally observed without resection. But in this case, a surgical resection was required to resolve an intestinal obstruction and to exclude the possibility of a metastatic tumor. Conclusion. When a large pelvic or ovarian mass is detected in gastrointestinal malignancy patients, physicians try to exclude the presence of a Krukenberg tumor. If the tumors cause certain symptoms, surgical resection is recommended to resolve symptoms and to exclude a metastatic tumor.

Overview of Current Concepts in Gastric Intestinal Metaplasia and Gastric Cancer.

Science.gov (United States)

Jencks, David S; Adam, Jason D; Borum, Marie L; Koh, Joyce M; Stephen, Sindu; Doman, David B

2018-02-01

Gastric intestinal metaplasia is a precancerous change of the mucosa of the stomach with intestinal epithelium, and is associated with an increased risk of dysplasia and cancer. The pathogenesis to gastric cancer is proposed by the Correa hypothesis as the transition from normal gastric epithelium to invasive cancer via inflammation followed by intramucosal cancer and invasion. Multiple risk factors have been associated with the development of gastric intestinal metaplasia interplay, including Helicobacter pylori infection and associated genomics, host genetic factors, environmental milieu, rheumatologic disorders, diet, and intestinal microbiota. Globally, screening guidelines have been established in countries with high incidence. In the United States, no such guidelines have been developed due to lower, albeit increasing, incidence. The American Society for Gastrointestinal Endoscopy recommends a case-by-case patient assessment based upon epidemiology, genetics, and environmental risk factors. Studies have examined the use of a serologic biopsy to stratify risk based upon factors such as H pylori status and virulence factors, along with serologic markers of chronic inflammation including pepsinogen I, pepsinogen II, and gastrin. High-risk patients may then be advised to undergo endoscopic evaluation with mapping biopsies from the antrum (greater curvature, lesser curvature), incisura angularis, and corpus (greater curvature, lesser curvature). Surveillance guidelines have not been firmly established for patients with known gastric intestinal metaplasia, but include repeat endoscopy at intervals according to the histologic risk for malignant transformation.

Control of non-conventional synchronous motors

CERN Document Server

Louis, Jean-Paul

2013-01-01

Classical synchronous motors are the most effective device to drive industrial production systems and robots with precision and rapidity. However, numerous applications require efficient controls in non-conventional situations. Firstly, this is the case with synchronous motors supplied by thyristor line-commutated inverters, or with synchronous motors with faults on one or several phases. Secondly, many drive systems use non-conventional motors such as polyphase (more than three phases) synchronous motors, synchronous motors with double excitation, permanent magnet linear synchronous motors,

Anti-synchronization of chaotic oscillators

International Nuclear Information System (INIS)

Kim, Chil-Min; Rim, Sunghwan; Kye, Won-Ho; Ryu, Jung-Wan; Park, Young-Jai

2003-01-01

We have observed anti-synchronization phenomena in coupled identical chaotic oscillators. Anti-synchronization can be characterized by the vanishing of the sum of relevant variables. We have qualitatively analyzed its base mechanism by using the dynamics of the difference and the sum of the relevant variables in coupled chaotic oscillators. Near the threshold of the synchronization and anti-synchronization transition, we have obtained the novel characteristic relation

[Gastric magnetic resonance study (methods, semiotics)].

Science.gov (United States)

Stashuk, G A

2003-01-01

The paper shows the potentialities of gastric study by magnetic resonance imaging (MRI). The methodic aspects of gastric study have been worked out. The MRI-semiotics of the unchanged and tumor-affected wall of the stomach and techniques in examining patients with gastric cancer of various sites are described. Using the developed procedure, MRI was performed in 199 patients, including 154 patients with gastric pathology and 45 control individuals who had no altered gastric wall. Great emphasis is placed on the role of MRI in the diagnosis of endophytic (diffuse) gastric cancer that is of priority value in its morphological structure. MRI was found to play a role in the diagnosis of the spread of a tumorous process both along the walls of the stomach and to its adjacent anatomic structures.

Gastric and oesophageal emptying in obesity

Energy Technology Data Exchange (ETDEWEB)

Maddox, A.; Horowitz, M.; Wishart, J.; Collins, P. (Royal Adelaide Hospital (Australia))

1989-01-01

Gastric and esophageal emptying were evaluated in 31 obese patients and 31 control subjects. A double-isotope techniques was used to measure gastric emptying of a mixed solid/liquid meal, and esophageal emptying was measured as the time taken for a bolus of the solid meal to enter the stomach. Gastric emptying of the solid and the liquid meal and esophageal emptying were delayed in the obese patients compared with the control subjects. There were no significant relationships among gastric emptying, esophageal emptying, and upper gastrointestinal symptoms in the obese patients alone. However, in the total group of 62 subjects there were significant correlations between body mass index and both gastric and esophageal emptying. These results indicate that delayed gastric and esophageal emptying occurs frequently in obesity and that these abnormalties relate to body weight.

Absence of pepsinogen A3 gene expression in the gastric mucosa of patients with gastric cancer.

OpenAIRE

Kuipers, E J; Peña, A S; Crusius, J B; Defize, J; van der Stoop, P; Meuwissen, S G; Pals, G

1995-01-01