Gastric carcinoma: review of the results of treatment in a community teaching hospital

<p>Abstract</p> <p>Background</p> <p>The aim of this study is to provide data on long term results of gastric cancer surgery and in particular the D1 gastric resection.</p> <p>Methods</p> <p>In the period 1992-2004, 235 male and female patients with a median age of 69 and 70 years respectively, were included with a stage I through IV gastric carcinoma, of which 37% was stage IV disease. Whenever possible a gastric resection was performed. In case of obstructive tumour growth palliation was provided by means of a gastro-enterostomy.</p> <p>Results</p> <p>Gastrectomy with curative intent was achieved in 50%, palliative resection in 22%, palliative surgery (gastro-enterostomy) in 10% and in 18% irresectability led to surgical exploration only. Patients in the curative intent group demonstrated a 47% survival after 5 years and up to 34% after 10 years. However metastases where seen in 32% of the patients after gastrectomy with curative intent. After palliative resection one year survival was 57%, whereas 19% survived more than 3 years. Overall postoperative morbidity and mortality rates were 40% and 13% respectively.</p> <p>Conclusion</p> <p>Long term survival after surgery for gastric cancer is poor and is improved by early detection and radical resection. However, palliative resection showed improved survival compared to gastro-enterostomy alone or no resection at all which may be an effect of adjuvant therapy.</p

Problems of Pediatrics Atopic and Nonatopic Asthma in Children: Two Di erent Diseases?

Abstract e majority of the studies in the eld of childhood asthma lie within the scope of allergy/atopic asthma; however, airway hyperresponsiveness is considered a marker of asthma, independent of the atopic status and should be regarded as a parallel pathological process that can lead to subsequent symptoms and clinical evidence of asthma in children, without the evidence of atopy. e aim of this study is to estimate the possible di erences in clinical and lung functions, and the immunological status of children with atopic and nonatopic asthma phenotypes. In a prospective study design, 54 children (age 3-18 years) in Germany were monitored via active surveillance, by twice-a-week phone calls. All the children were divided into two groups, based on their atopic status, clinical date and lung function tests. e rst 27 patients had atopic asthma (AA), whereas the second set of 27 patients had nonatopic asthma (NA). All patients underwent IgE and RAST tests for the most common inhalant allergens, and a quantitative measurement of Eosinophil Cationic Protein (ECP) by CAP-radioallergosorbent test-uorescence enzyme immunoassay (UniCAP, Pharmacia Diagnostics, Germany). Further, the IgA, IgM, IgG subclasses, IL-6 and CRP levels in the serum were tested. e resultant data showed signi cant di erences in the prevailing IgE level 317.5±58 g/l in AA versus 83±21 in NA. However, there was no signi cant distinction either in the ECP serum level in children with atopic and nonatopic asthma or in the IL-6 serum level. An unexpected result was the signi cant drop in the level of serum CRP in group NA -0.68±0.37 g/l; while in group AA this result was 1.5±0.38 g/l. No signi cant di erences were noted between the mean values of the IgM and IgG levels in patients of all groups; however, the IgG levels increased only in the children with nonatopic asthma. Our study did not reveal any type of immunoglobulin de ciency. e IgA level was relatively decreased in children with nonatopic asthma compared with those with the atopic form. Patients from group NA had signi cantly higher IgG4 subclass levels than patients from group AA. e results of our study show that both atopic and nonatopic asthma are diseases, with similar in ammatory changes, however having probably di erent pathogenetic immunological mechanisms. IJBM 2012; 2(3):214-221