Our series of CDH1 mutation carriers is the largest to date and demonstrates that LBC might be the first manifestation of HDGC. A personal or family history of multiple LBCs at a young age, even without DGC, should prompt CDH1 mutation screening. It is paramount to identify mutation carriers early, so that they can benefit from prophylactic gastrectomy before they develop symptomatic, highly lethal DGC. We recommend a revision of the HDGC-defining criteria and propose for consideration the name 'Hereditary Diffuse Gastric and Lobular Breast Cancer' instead of HDGC.
A new tissue repair agent, RGTA11, is described for its ability to enhance colonic anastomosis repair and resistance to leakage. RGTA11 is a dextran derivative containing 110% carboxymethyl groups, 2.6% carboxymethyl benzylamide groups, and 36.6% carboxymethyl benzylamide sulfonate groups. RGTA11 was deemed efficient to protect the heparin-binding growth factors FGF2 against trypsin digestion. By this property RGTA11 mimicked heparin or heparan sulfate. We have also found that RGTA11 protected TGF beta 1 against trypsin digestion while heparin did not. RGTA11 was then tested in an in vivo wound-healing model of colonic anastomosis. Our results indicate that after 48 h, RGTA11- or RGTA11/FGF-2-treated animals presented a resistance of the anastomosis to leakage which was increased twofold (p < 0.05) over untreated controls. After 96 h and until day 7 there was no more difference with control animals. Our results suggest that RGTA11 presents potential clinical interest by preventing earlier leakage of colonic anastomosis.
Long-term functional results of coloanal anastomoses are satisfactory and, unlike early results, similar for both types of anastomosis. The functional benefit of a reservoir, seen in the first year after operation, is less evident with increasing time.
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