Surgery is the only hope to cure gastric cancer. The aim of surgery is the complete removal of the tumor (UICC RO-resection), which is known to be the only treatment modality proven effective and the most important treatment-related prognostic factor. The type of surgical treatment for gastric cancer is determined by the patient's medicosurgical status and the stage of disease. Improved survival and quality of life(QOL) are the major criteria for the therapeutic strategy. For patients with early gastric cancer, minimal invasive surgery is attempted for the improvement of QOL. Minimal invasive surgery can be performed only when there is no evidence for residual disease, especially in lymphnodes. Therefore, precise prediction and selection of node-negative patients is important for the application of minimal invasive surgery. However, long-term survival data are needed for these new techniques to become more generally accepted. For patients with advanced gastric cancer, aggressive and extended surgical approaches are recommended for the improvement of survival. Distal subtotal gastrectomy is the procedure of choice whenever tumor-free margin can be obtained, with the exception of proximal tumors that can be treated by total gastrectomy. Extended lymphadenectomy should be the choice of lymphadenectomy for experienced surgeons with a low morbidity and mortality. If a surgeon can perform combined resection of adjacent organs safely, it is recommended when a direct invasion is suspicious. Distal pancreatectomy should be avoided unless direct invasion is definite. Splenectomy for the purpose of lymph node dissection is be mandatory, and surgeons should consider preservation of the spleen when there is no definite splenic hilar lymph node enlargement or any direct invasion to the spleen. Cytoreductive surgery with intraperitoneal chemotherapy is a useful and promising procedure for the treatment of peritoneal metastasis. The therapeutic approach should be stratified according to the patient's status, tumor status,and QOL after resection. Above all, the treatment strategy should be specific and tailored to each patient for the improved survival and QOL.
Drug Therapy ; Gastrectomy ; Hope ; Humans ; Lymph Node Excision ; Lymph Nodes ; Mortality ; Neoplasm Metastasis ; Pancreatectomy ; Spleen ; Splenectomy ; Stomach Neoplasms* ; Surgeons

No abstract available.
Drug Therapy* ; Fistula*

No abstract available.
Neoplasm Metastasis* ; Stomach Neoplasms*

No abstract available.
Adenocarcinoma*

No Abstract Available.
Endothelial Cells* ; Vitrectomy*

The detection rate of early gastric cancer has been increasing owing to advances in diagnostic techniques. Several different types of minimally invasive approaches to improve quality of life have been developed for the treatment of EGC due to excellent prognosis of EGC patients. Although minimally invasive surgery for the treatment of EGC has gained its popularity, most surgeons are still performing conventional method of open surgery. Conventional Open surgery for the treatment of early gastric cancer, however, is needed to reduce the invasiveness under the influence of technique in MIS. Surgical treatment of EGC should be decided on a case-by-case basis and each surgeon's method of maximum competency.
Humans ; Prognosis ; Quality of Life ; Stomach Neoplasms

No abstract available.
Colorectal Neoplasms*

Leiomyosarcoma of the inferior vena cava(IVC) is a rare tumor and has a poor prognosis. Recently, newer imaging modalities including ultrasound, computed tomographic scan, magnetic resonance imaging and cavovenography make it possible to detect in its early stage of proression. The best therapeutic management is surgical resection and the effects of postoperative adjuvant therapies on patients' survival are still debatable. We report herein our experience of 45-year-old woman whose leiomyosarcoma of the IVC was successfully resected without reconstruction of the IVC.
Female ; Humans ; Leiomyosarcoma* ; Magnetic Resonance Imaging ; Middle Aged ; Prognosis ; Ultrasonography ; Vena Cava, Inferior*

No abstract available.

It has been postulated that programmed cell death via apoptosis may be critical for remodelling of glomeruli after inflammatory injury. To understand the regulatory mechanism of apoptosis in experimental crescentic glomerulonephritis (CGN), we examined the MIB-1 score (proliferation index, PI) and apoptotic index during the progression of experimental CGN to end-stage renal failure. CGN was induced in New Zealand White rabbits by administration of guinea pig anti-GBM IgG after sensitization with guinea pig IgG and their kidneys were analyzed for the development of crescents through sequential renal biopsies. Serum creatinine levels progressively increased in a time course until day 45. The PI in glomeruli, tubular epithelial cells, and interstitium progressively increased during the progression of experimental CGN. The mean numbers of MIB-1 positive intraglomerular nuclei (PI) were significantly correlated with degrees of crescent formation and the numbers of apoptotic cells in the glomeruli, tubules, and interstitium. Significant apoptosis was present from day 1 (15.8 10.16 cells/glomerular cross section) and increased in number with the proliferative lesions as glomerular inflammation continued. Moreover, apoptosis increased during the resolution of the glomerular inflammation, and many apoptotic cells were present in the sclerotic lesions in day 17 (18.6 12.99 cells/glomerular cross section). As glomerular inflammation subsided, cellular crescents progressed to fibrous crescents with a reduction of cellularity by day 45. On day 45, the glomerular PI and the numbers of apoptotic cells were markedly decreased. The correlations found in CGN between the creatinine level and the percentage of crescents, between the percentage of crescent and PI, and between the PI and number of apoptotic cells support the hypothesis that there is a change in the glomerular and tubulo-interstitial apoptosis under pathologic conditions. These findings indicate that apoptosis plays an essential role in the resolution of intra- and extraglomerular inflammation and in the elimination of glomerular cells within the sclerotic regions for progressive CGN. The regulation of the apoptotic phenomenon and increased PI during CGN may be important in the progression of glomerular inflammation and the development of pathologic glomerular sclerosis.
Animals ; Anti-Glomerular Basement Membrane Disease ; Apoptosis* ; Biopsy ; Cell Death ; Creatinine ; Epithelial Cells ; Glomerulonephritis* ; Guinea Pigs ; Immunoglobulin G ; In Situ Nick-End Labeling ; Inflammation ; Kidney ; Kidney Failure, Chronic ; Rabbits ; Sclerosis