Successful Management of an Elderly Patient with Dementia Using a Dual Gastric Tube After Surgical Treatment of Gastroduodenal Ulcer

We describe a technique which was employed for simultaneous drainage and enteral nutrition using a dual gastric tube from a gastrostomy for postoperative management of a gastroduodenal ulcer. Gastrostomy was performed and a 18 Fr. gastric drainage tube was inserted into the body of the stomach intraoperatively. A second tube was inserted into the jejunum through the gastric tube postoperatively. Use of the gastric tube for drainage and the second tube for feeding enabled an early start of enteral nutrition without consideration of the gastric condition. The technique is simple and could be beneficial for patients who experience complications such as minor leakage and severe pylorus stenosis, particularly those in older age group with dementia

Clinical Significance of Telomerase Activity and Telomere Length in Various Liver Diseases

We investigated the clinical significance of telomerase activity and telomere length in hepatocellular carcinomas (HCCs) and chronic liver diseases. Telomerase activity was assessed quantitatively using \u27Stretch PCR\u27 assay and telomere length by Southern blotting in 24 HCCs, 2 focal nodular hyperplasia, 8 liver cirrhosis, 10 chronic hepatitis and 8 histologically normal livers. The latter were obtained from normal sections of resected specimens of cholangiocellular carcinoma, metastatic liver tumor or hemangioma. The relative titers of telomerase activity (RTA) were significantly higher in HCCs (average, 54 units) than in chronic liver diseases (average, 0.6 units) (P<0.001). In comparison, RTA was less than 2 units in non-malignant liver tissues. Telomere length in cirrhotic liver tissues was significantly shorter than in normal livers and tended to be shorter than those in chronic hepatitis. Telomere length and RTA correlated with the grading of tissue derangement in chronic liver diseases. Our results suggest that RTA estimated by Stretch PCR assay might be clinically useful for accurate diagnosis of liver diseases, particularly HCCs. In addition, telomere length seems to having a possibility as a useful predictor for risk of hepatocarcinogenesis

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