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Query: UMLS:C0024623 (gastric cancer)
 36,219 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We examined peripheral insulin sensitivity in 32 patients with cancer (17 with stomach cancer, 7 with colorectal cancer, and 8 with lung cancer) and 6 normal control subjects by the euglycemic hyperinsulinemic glucose clamp technique. The relationships between insulin resistance and tumor factors (type and stage), malnutrition, and inflammatory reaction were evaluated. Insulin sensitivity often was reduced in patients with cancer; however, the amount of glucose metabolized was not related to tumor site or stage. The decreased glucose uptake was negatively correlated with the acute-phase response but was not correlated with body-weight loss, serum albumin, or resting energy expenditure. Our results suggest that insulin resistance in cancer patients was not induced by malnutrition. Although the qualitative presence of tumor might be the major factor inducing insulin resistance, other factors such as inflammatory reactions might be involved in the development of insulin resistance.
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PMID:Insulin resistance in patients with cancer: relationships with tumor site, tumor stage, body-weight loss, acute-phase response, and energy expenditure. 1144 78

Reflux esophagitis, dumping syndrome and malnutrition are included in the postgastrectomy complications. To prevent or minimize such sequelae, proximal gastrectomy with an interposed jejunal pouch has been advocated as an organ-preserving surgical strategy to improve quality of life for the patients. Proximal gastrectomy was performed in 44 patients with tumors in the upper third of the stomach; 21 had reconstruction using jejunal pouch interposition between the esophagus and the remnant stomach (JP group), while 23 had reconstruction by esophagogastrostomy (EG group). Re-construction method was selected by each patient on the basis of the informed consent. Thirty-five patients had early gastric cancer. Postoperative courses of patients were reviewed in terms of symptoms, weight maintenance, nutritional status, blood chemistry values, endoscopic findings, and radiographic appearances after a barium meal. Concentrations of gastrointestinal hormones were measured in response to a test meal. The JP procedure permitted increased dietary volume. The JP group showed fewer severe postoperative symptoms than the EG group. After operation, all patients examined in both groups showed hypergastrinemia and all patients examined in the JP group showed hypersecretinemia. In proximal gastrectomy, the JP procedure improved patient's post-operative quality of life.
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PMID:Proximal gastrectomy and jejunal pouch interposition: evaluation of postoperative symptoms and gastrointestinal hormone secretion. 1160 52

That severe malnutrition affects body function and psychological well-being is well documented. We addressed the question of whether quality of life relates to changes in variables such as food intake, body composition, and gastrointestinal symptomatology after gastrectomy for gastric cancer. Thirty-two patients undergoing gastric resection had their dietary intake, body composition, and specific and general aspects of quality of life determined preoperatively, at 12 months and, in the 15 surviving patients, several years after the operation. The patients lost 10% of their preoperative weight (mainly body fat) during the first year. Food intake did not correlate to changes in body composition or quality of life. Gastrointestinal symptoms adversely related to changes in lean body mass, meal size, and general aspects of quality of life for a long time after the operation. Gastrointestinal symptom control seems important to minimize impairment in quality of life, body composition, and eating after gastrectomy.
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PMID:Symptom control may improve food intake, body composition, and aspects of quality of life after gastrectomy in cancer patients. 1176 59

AIM:To study the relationship between trace element Mo and gastric cancer.MATERIALS AND METHODS: Soil samples were collected according to its type in different areas of Jiangxi Province; available molybdenum content in soil was measured by catalytic polarography and rank correlation method was used to analyse correlation between the mean of soil available molybdenum and mortality rate of gastric cancer in each county and city in Jiangxi Province. Gastric cancer cases were selected from the authors' hospital, occiput hair was collected to measure its molybdenum content with an atomic absorption spectrograph and controls were selected from the same hospital for comparison. Gastric cancer cases were selected from three hospitals at the same time, blood samples were taken on an empty stomach and serum molybdenum contents were measured with the atomic absorption spectrograph, and controls were selected from the same hospitals. Blind method was used in the whole course (chemical analysts did not know the source and nature of samples).RESULTS: A negative correlation existed between soil available molybdenum content and mortality rate of gastric cancer (r = -0.285, P < 0.05); hair molybdenum contents of gastric cancer cases were lower than those of healthy controls (0.308&mgr;g/g plus minus 0.673&mgr;g/g and 0.707&mgr;g/g plus minus 0.561&mgr;g/g respectively, P < 0.01); serum molybdenum contents of patients were also lower than those of healthy controls (21.84&mgr;g/L plus minus 7.49&mgr;g/L and 25.38&mgr;g/L plus minus 8.58&mgr;g/L respectively,P< 0.05).CONCLUSION: Deficiency of molybdenum may be one of the risk factors in gastric cancer.
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PMID:A study of the relationship between trace element Mo and gastric cancer. 1181 32

AIM:To investigate the effect of gastroenteric reconstruction on the nutritional status of patients with gastric cancer after total gastrectomy.METHODS: From 1989-1994, nutritional status was studied in 24 patients, including 12 patients with the gastric reservoir and pyloric sphincter reconstruction (GRPS), 7 with Braun's esophago-jejunostomy (EJ) and 5 with Lawrance's Roux en Y reconstruction (RY).The ability of these patients to ingest and absorb the amount of nutrients was examined and compared, and metabolic balance test was performed to compare the efficiency of those patients to accumulate and use the absorbed nutrients.RESULTS:In the controlled hospital situation, the amount of food ingested by all the patients was greater than that required for maintenance of ideal body weight. In direct contrast, food intake in most patients with EJ or RY reconstruction significantly decreased when the patients returned home and that in EJ patients it was the lowest. The overgrowth of anaerobic bacteria was found in the jejunum in the patients with EJ and RY, due mainly to food stasis in the duodenum or in the Roux limb,caused by the operative procedure itself. In patients with GRPS,because of restoring of the alimentary continuity according to the normal digestive physiologic characters, all the nutritional parameters could fall in the normal range.CONCLUSION:The most common mechanism responsible for postoperative malnutrition was inadequate food intake. Having solved the problem of alkaline reflux esophagitis, it is imperative to preserve the duodenal food passage to reduce malabsorption and other complications after total gastrectomy.
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PMID:Consequence alimentary reconstruction in nutritional status after total gastrectomy for gastric cancer. 1181 81

Gastric cancer continues to be the second cause of cancer-related mortality in the world. Surgery is the only potentially curative therapy, although the adverse effects of surgery are considerable and include digestive symptoms, loss of appetite and malnutrition. Our study included 45 patients subjected to gastrectomy who were under treatment at our unit during 2000. The data given here refer to their first visit following surgery. The most frequent complications were diarrhoea (31%), pain (29%) and early dumping (24%). Other complications found were late dumping, nausea/vomiting and dysphagia. Anorexia appeared in 49% and 29% presented a negative attitude towards food. These complications give rise to insufficient food intake, leading to malnutrition, mainly marasmic in nature. Only 7% of the patients were normonourished, with 86% presenting slight or moderate malnutrition and 7% severe malnutrition. The mean Body Mass Index (BMI) of these patients was 20 +/- 3 kg/m2. The most frequent analytical alterations were anaemia with ferropenia and b12 deficit, and a reduction in the levels of zinc and retinol transporting protein. Many patients had impaired quality of life; 43% did not leave home and only 13% were able to work. Three groups were established depending on the time that had passed since the gastrectomy was performed before the first nutritional assessment (less than 3 months, from three months to a year, and over one year), without significant differences being found in any of the parameters studied. In this article we include recommendations for the nutritional handling and treatment of patients following gastrectomy.
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PMID:[Nutritional evaluation in patients with total gastrectomy]. 1242 99

Delayed gastrojejunocolic fistulas in patients previously operated for gastric cancer are often caused by local recurrence of the tumour. We present two cases of delayed gastrojejunocolic fistula without neoplastic recurrence. Both patients had been operated for adenocarcinoma several months earlier; a gastric Billroth 2 resection was performed in both cases. The first patient arrived at our hospital for chest pain, dyspepsia, weight loss, vomiting and diarrhoea. Blood tests showed low levels of vitamin B, proteins and cholesterol. The second patient was admitted for lipothymia, hyporexia, proctorrhagia, diarrhoea and weight loss. Blood tests showed macrocytic anaemia and hypoproteinaemia. The radiological and endoscopic examinations revealed a gastrojejunocolic fistula in both cases. Since gastrojejunocolic fistulas are rarely resolved by conservative treatment, we performed a gastric resection with a histological examination to exclude tumour recurrence in both patients. The aetiopathogenesis of gastrojejunocolic fistulas is unknown. It is conceivable that some agents (such as bile) may damage a mucosa that has been weakened by nutritional deficiency and/or postsurgical microvascular damage. Early and delayed gastrojejunocolic fistulas present the same clinical manifestations, namely, diarrhoea, abdominal pain, weight loss and hypoproteinaemia.
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PMID:[Benign gastrojejunocolic fistula as a complication of gastric resection for adenocarcinoma]. 1472 37

Deficiency of the mannose-binding lectin (MBL) protein, an antigen-recognition molecule involved in systemic and mucosal innate immunity, is determined by variant alleles in MBL2 gene promoter and exon-1 regions. We conducted a population-based study on 305 stomach cancer cases and 427 controls in Warsaw, Poland to determine whether MBL2 gene variants predispose to stomach cancer. Single nucleotide polymorphisms (SNPs) in MBL2 were determined by TaqMan. The 5 tested MBL2 variants are in complete linkage disequilibrium and comprise 6 different haplotypes. The risk of stomach cancer was increased in subjects carrying the H/H promoter genotype (OR = 1.8, 95%CI 1.1-2.9; p = 0.020) relative to L/L carriers, after adjustment for age, gender, education and smoking. Carrying at least one D exon-1 allele was associated with nonsignificant excess risk (OR = 1.5, 95% CI 0.9-2.4; p = 0.081). In haplotype analysis, the HYD haplotype was associated with increased risk of stomach cancer when compared with HYA, the most common haplotype (OR = 1.9, 95% CI 1.1-3.2; p = 0.021). In diplotype analysis, subjects carrying the YA/D haplotype combination showed the highest risk (OR = 3.0, 95% CI 1.2-7.1; p = 0.015), compared with YA/YA. Further analyses to examine the joint effect of MBL2 and IL-1B polymorphisms, previously shown to predispose to stomach cancer, indicated that the combination of at-risk IL-1B genotypes (CT or TT at location -511) and HYD MBL2 haplotype was associated with a 3.5-fold risk (OR = 3.5, 95% CI 1.6-7.6; p = 0.001). Our findings suggest that the codon 52 D MBL2 variant causing a cysteine > arginine replacement, but not B and C variants producing glycine substitutions, is specifically associated with gastric cancer risk.
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PMID:Mannose-binding lectin-2 genetic variation and stomach cancer risk. 1735 1

The serum level of six acute phase proteins (APP) has been evaluated preoperatively and for a few days in the postoperative period. Thirty patients undergoing total gastrectomy for gastric cancer have been studied in two subgroups according to their nutritional status. Those with gastric cancer had significantly higher baseline serum levels of alpha 1 acid glycoprotein (alpha1AGP) and C-reactive protein (CRP) than a control group. Malnourished patients also had reduced acute phase response for alpha1AGP and alpha 1 antitrypsin (alpha1AT) a higher increase of CRP and fibrinogen, and a lower decrease for transferrin and retinol binding protein (RBP).
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PMID:Effects of malnutrition on the acute phase response of plasma proteins in patients undergoing total gastrectomy. 1682 94

We investigated the clinical features and measures for tuberculosis with diabetes mellitus, AIDS, gastrectomy, malignant tumor, or receiving anti-tumor necrosis factor-alpha. In these days, tuberculosis patients with diabetes mellitus are increasing. Their tuberculosis is often found in advanced cases and the periods of symptomatics are short. In short, in tuberculosis with diabetes mellitus, the progress of tuberculosis is fast. Japanese patients of tuberculosis with AIDS are frequent in mid-life and increasing. Extra-pulmonary tuberculosis including disseminated tuberculosis is frequent with patients of AIDS. The prognosis of them is improved with the spread of HAART treatment. The most frequent occasion for gastrectomy is gastric cancer and the prognosis is good. Many of them are thin and malnutrition. The prognosis of tuberculosis with malignant tumor is bad, especially with lung cancer and malignant lymphoma. People receiving infliximab, an antitumor necrosis factor-alpha, are frequent to have onset of tuberculosis. Particularly, extra-pulmonary tuberculosis, including disseminated tuberculosis are often. Tuberculin reaction before receiving infliximab are weak. No one, receiving chemoprophylaxis, has onset of tuberculosis. When the rate of chemoprophylaxis increases, the number of tuberculosis patients decreases. Immunocompromised hosts need to be examined periodical or extraordinary when they had symptoms of tuberculosis to discover the onset of tuberculosis. To prevent the onset of tuberculosis, patients who previously infected tuberculosis should receive active chemoprophylaxis regardless of their age.
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PMID:[The clinical features for tuberculosis in compromised hosts]. 1709 86


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