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June 2016

Volume 3  Issue 2
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Case Report

Fatal Intestinal Perforation in Patient Treated with PD-1 Inhibitor

Kader Chouahnia*, Nahla Cucherousset, Boris. Duchemann, Laurent. Zelek

A 54-year-old man, former smoker, was diagnosed with localized lung squamous cell carcinoma in 2013. He was treated by surgery with bi-lobectomy. Definitive extension was pT3N1M0 and he received 4cycles of adjuvant chemotherapy with cisplatin vinorelbine. During adjuvant chemotherapy occurrence of metastasis of the right tibia, treated with radiotherapy.
 

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Case Report

Massive Chylous Ascites following Duodenorrhaphy with Omentum Patch

Hsiu-Yu Chi, Hong-Ming Chao*

Chylous ascites is a rare complication of abdominal surgery, but it prolongs the hospitalization and the patient’s prognosis. It is the postoperative accumulation of chyle in the peritoneal cavity and look like milky fluid and elevated triglyceride levels in the surgical drains. We present the patient who underwent an emergent surgery for a perforated duodenal ulcer complicated with postsurgical chylous ascites. Only a few studies with the limited data showed how to treat postoperative chylous ascites. The conservative treatment including paracentesis, a medium chain triglyceride (MCT) based diet, total parenteral nutrition (TPN) fasting and so on is recommended. Our patient was successfully treated with fasting, total parenteral nutrition (TPN) and albumin.

 

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Case Report

Boosting Dose of Ritonavir as a Cause of Widespread Hepatic Macrovesicular Steatosis

D Mital FRCP *

It is well documented that combination antiretroviral therapy (cART) can cause a range of lipid and adipose tissue abnormalities as part of lipodystrophy which include fat redistribution, insulin resistance and dyslipidaemia. Non alcoholic fatty liver disease is not uncommon in HIV infection and hepatic steatosis is a recognised side effect of many drugs comprising cART although the benefits on the liver outweigh the side effect profile. Ritonavir is commonly used as a sub-therapeutic ‘booster’ drug for increasing levels of other protease inhibitors to enable tolerable treatment levels.

 

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Original article

Usefulness of Chemoradiotherapy for Inoperable Gastric Cancer

Yoshiyuki Hoya*, Tetsuya Taki, Atsushi Watanabe, Tomoko Nakayoshi, Tomoyoshi Okamoto, Norio Mitsumori, Katsuhiko Yanaga*

In Japan, advanced or recurrent gastric cancer is usually treated by palliative surgery and/or chemotherapy. The development of new anticancer drugs has led to improved survival in patients with advanced or recurrent gastric cancer, and increased the chance of surgical treatment as a part of combined-modality therapy. However, the oncological benefit of aggressive resection and tumor reduction therapy for advanced or recurrent gastric cancer remain unclear. On the other hand, radiotherapy is not commonly used for the treatment of gastric cancer in Japan, where surgery is the standard local treatment, and adenocarcinoma is not generally regarded as radiosensitive.

 

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