We investigated the optimal indications for surgical palliation in advanced gastric cancer (AGC) patients presenting with gastrointestinal (GI) obstruction.

A retrospective analysis was performed on 53 consecutive patients who underwent surgical palliation for GI obstruction caused by AGC between 2000 and 2007 at Osaka National Hospital. The clinical course of each patient was followed until death. Postoperative

improvement of oral intake, achievement of hospital discharge, and implementation of chemotherapy in each patient were documented and used as a triad to assess the quality of life (QOL). Prognostic factors for overall survival Selleck Elacridar were investigated by univariate and multivariate analyses. In addition, postoperative morbidity and mortality rates were recorded.

Of the entire patient cohort, 64% demonstrated a QOL

improvement by having achieved the triad. Performance status (PS) of 1 or less was the only significant predictive factor for QOL improvement. The median survival time (MST) of the whole patient cohort following surgical palliation was 161 days, while the MSTs of patients fulfilling the triad and of those failing to achieve the triad were 253 and 60 days, respectively, with a significant difference between them (P < 0.0001). PS of 1 or less (hazard ratio 0.265, P = 0.0008) and recurrent disease (hazard ratio 0.394, P = 0.043) were identified as significant independent prognostic factors for longer survival on multivariate analysis. Overall morbidity and 30-day postoperative mortality Lapatinib supplier rates were 24.5% (13 patients) and 7.5% (4 patients) respectively.

In AGC patients presenting with GI obstruction, surgical palliation was beneficial in patients with PS of 0-1 and those with recurrent disease, in terms of improved QOL and prolonged survival, with acceptable operative morbidity and mortality rates.”
“Background: Distraction osteogenesis has been used to treat diminished skull space caused by craniosynostosis. Our report investigated the relationship between space volume change by computer technology and the intracranial pressure change. Cerebrospinal fluid (CSF) regular Oligomycin A datasheet test and CSF biochemistry test were

also performed to ensure the safety of distraction process.

Methods: Seven minipigs, weighing 15 to 20 kilograms, were chosen; 4 x 3 cm bone flap was lifted in the left parietal bone. The dura was carefully protected. The distractor and assisted apparatus were implanted. Distraction was started with 10-day latency, 1 mm/d distraction rates for 10 days. Twelve weeks after distraction, the distraction device and the assist apparatus were removed. All pigs underwent 3-dimensional computerized scans of the craniofacial skeleton, CSF pressure measurement, CSF regular test, and CSF biochemistry test before operation, after 7 days’ operation, immediately after distraction was finished, 4 weeks after distraction, 8 weeks after distraction, and 12 weeks after distraction.