While pneumatosis cystoides intestinalis （PCI） is a rare disease entity associated with a wide variety of gastrointestinal and non-gastrointestinal disorders, PCI associated with massive intra- and retroperitoneal f...While pneumatosis cystoides intestinalis （PCI） is a rare disease entity associated with a wide variety of gastrointestinal and non-gastrointestinal disorders, PCI associated with massive intra- and retroperitoneal free air is extremely uncommon, and is difficult to diagnose differentially from perforated peritonitis. We present two cases of PCI associated with massive peritoneal free air and/or retroperitoneal air that mimicked perforated peritonitis. These cases highlight the clinical importance of PCI that mimics perforated peritonitis, which requires emergency surgery. Preoperative imaging modalities and diagnostic laparoscopy are useful to make an accurate diagnosis.展开更多
Although mesenterioaxial gastric volvulus is an uncommon entity characterized by rotation at the transverse axis of the stomach, laparoscopic repair procedures have still been controversial. We reported a case of mese...Although mesenterioaxial gastric volvulus is an uncommon entity characterized by rotation at the transverse axis of the stomach, laparoscopic repair procedures have still been controversial. We reported a case of mesenterioaxial intrathoracic gastric volvulus, which was successfully treated with laparoscopic repair of the diaphragmatic hiatal defect using a polytetrafluoroethylene mesh associated with Toupet fundoplication. A 70-year-old Japanese woman was admitted to our hospital because of sudden onset of upper abdominal pain. An upper gastrointestinal series revealed an incarcerated intrathoracic mesenterioaxial volvulus of the distal portion of the stomach and the duodenum. The complete laparoscopic approach was used to repair the volvulus. The laparoscopic procedures involved the repair of the hiatal hernia using polytetrafluoroethylene mesh and Toupet fundoplication. This case highlights the feasibility and effectiveness of the laparoscopic procedure, and laparoscopic repair of the hiatal defect using a polytetrafluoroethylene mesh associated with Toupet fundoplication may be useful for preventing postoperative recurrence of hiatal her-nia, volvulus, and gastroesophageal reflux.展开更多
Although chemotherapy and chemoradiation therapy improve the clinical outcomes and decrease locoregional failure in patients with advanced cancer, they may lead to an increased risk of malnutrition in these patients d...Although chemotherapy and chemoradiation therapy improve the clinical outcomes and decrease locoregional failure in patients with advanced cancer, they may lead to an increased risk of malnutrition in these patients due to their gastrointestinal side effects. Many cancer patients are already malnourished as a result of their cancer-bearing status. Consequently, these patients experience poor clinical outcomes due to various infectious and noninfectious complications. Nutritional management that is based on frequent monitoring of the nutritional status of patients can ensure that they receive adequate calories and certain nutrients, which is vital to improve their clinical outcomes and quality of life.展开更多
Background Specific nutrients combined with exercise may prevent a loss of lean body mass and consequently prevent sarcopenia.We examined the effects of 2 weeks of supplementation with L-carnitine and a single dose of...Background Specific nutrients combined with exercise may prevent a loss of lean body mass and consequently prevent sarcopenia.We examined the effects of 2 weeks of supplementation with L-carnitine and a single dose of branched-chain amino acids(BCAAs)on energy metabolism and body composition before and after exercise and on post-exercise muscle soreness in healthy subjects.Methods A total of 12 young,untrained,healthy women were randomly assigned to two groups who received either 2 weeks of supplementation with L-carnitine(1000 mg/day)and a single dose of BCAAs plus 200 kcal energy(LCAR+BCAA group,n=6)or 200 kcal energy alone(control group,n=6)before 60 min of exercise.Energy substrate metabolism and body composition by bio-impedance were examined before and after exercise.Delayed-onset muscle soreness(DOMS)was evaluated by using a visual analogue scale for 3 days after exercise.Results Serum concentrations of free and acyl-L-carnitine in the LCAR+BCAA group were not significantly different from those in the control group.There were no significant differences in body composition before or after exercise between the two groups.Although serum free fatty acid levels 120 min after the oral ingestion of BCAAs were significantly lower in the LCAR+BCAA group than in the control group,there were no significant differences in serum free fatty acid levels immediately after and 60 min after exercise.DOMS for 3 days after exercise was lower in the LCAR+BCAA group than in the control group,but this difference was not significant.Conclusion Continuous supplementation with L-carnitine combined with a dose of BCAAs in young,untrained,healthy subjects caused a blunted response of stimulated lipolysis after exercise.展开更多
文摘While pneumatosis cystoides intestinalis （PCI） is a rare disease entity associated with a wide variety of gastrointestinal and non-gastrointestinal disorders, PCI associated with massive intra- and retroperitoneal free air is extremely uncommon, and is difficult to diagnose differentially from perforated peritonitis. We present two cases of PCI associated with massive peritoneal free air and/or retroperitoneal air that mimicked perforated peritonitis. These cases highlight the clinical importance of PCI that mimics perforated peritonitis, which requires emergency surgery. Preoperative imaging modalities and diagnostic laparoscopy are useful to make an accurate diagnosis.
基金Supported by The Department of Surgery Fujita Health University School of Medicine and University Hospital
文摘Although mesenterioaxial gastric volvulus is an uncommon entity characterized by rotation at the transverse axis of the stomach, laparoscopic repair procedures have still been controversial. We reported a case of mesenterioaxial intrathoracic gastric volvulus, which was successfully treated with laparoscopic repair of the diaphragmatic hiatal defect using a polytetrafluoroethylene mesh associated with Toupet fundoplication. A 70-year-old Japanese woman was admitted to our hospital because of sudden onset of upper abdominal pain. An upper gastrointestinal series revealed an incarcerated intrathoracic mesenterioaxial volvulus of the distal portion of the stomach and the duodenum. The complete laparoscopic approach was used to repair the volvulus. The laparoscopic procedures involved the repair of the hiatal hernia using polytetrafluoroethylene mesh and Toupet fundoplication. This case highlights the feasibility and effectiveness of the laparoscopic procedure, and laparoscopic repair of the hiatal defect using a polytetrafluoroethylene mesh associated with Toupet fundoplication may be useful for preventing postoperative recurrence of hiatal her-nia, volvulus, and gastroesophageal reflux.
文摘Although chemotherapy and chemoradiation therapy improve the clinical outcomes and decrease locoregional failure in patients with advanced cancer, they may lead to an increased risk of malnutrition in these patients due to their gastrointestinal side effects. Many cancer patients are already malnourished as a result of their cancer-bearing status. Consequently, these patients experience poor clinical outcomes due to various infectious and noninfectious complications. Nutritional management that is based on frequent monitoring of the nutritional status of patients can ensure that they receive adequate calories and certain nutrients, which is vital to improve their clinical outcomes and quality of life.
文摘Background Specific nutrients combined with exercise may prevent a loss of lean body mass and consequently prevent sarcopenia.We examined the effects of 2 weeks of supplementation with L-carnitine and a single dose of branched-chain amino acids(BCAAs)on energy metabolism and body composition before and after exercise and on post-exercise muscle soreness in healthy subjects.Methods A total of 12 young,untrained,healthy women were randomly assigned to two groups who received either 2 weeks of supplementation with L-carnitine(1000 mg/day)and a single dose of BCAAs plus 200 kcal energy(LCAR+BCAA group,n=6)or 200 kcal energy alone(control group,n=6)before 60 min of exercise.Energy substrate metabolism and body composition by bio-impedance were examined before and after exercise.Delayed-onset muscle soreness(DOMS)was evaluated by using a visual analogue scale for 3 days after exercise.Results Serum concentrations of free and acyl-L-carnitine in the LCAR+BCAA group were not significantly different from those in the control group.There were no significant differences in body composition before or after exercise between the two groups.Although serum free fatty acid levels 120 min after the oral ingestion of BCAAs were significantly lower in the LCAR+BCAA group than in the control group,there were no significant differences in serum free fatty acid levels immediately after and 60 min after exercise.DOMS for 3 days after exercise was lower in the LCAR+BCAA group than in the control group,but this difference was not significant.Conclusion Continuous supplementation with L-carnitine combined with a dose of BCAAs in young,untrained,healthy subjects caused a blunted response of stimulated lipolysis after exercise.
