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Management of patients undergoing dialysis after inguinal hernia surgery has not been standardized. This report presents the results of 9 patients with inguinal hernias (11 hernias) who were undergoing continuous ambulatory peritoneal dialysis (CAPD). All patients treated in this hospital since 2007 have returned to CAPD within 3 days after surgery without switching to hemodialysis (HD). The mean durations for resuming CAPD after surgery were 7.6 days from 1998 through 2007 and 2.3 days since 2008. The surgical procedure was performed with a polypropylene mesh in all cases. Local anesthesia was utilized for one patient with low cardiac function. All patients recovered rapidly, with no uremia or dialysis-related complications. No leakage or hernia recurrence was observed over the subsequent observation period (56.2 months). This experience suggests the possibility that interim HD can therefore be skipped in patients undergoing CAPD if the hernia sacs are closed tightly. Local anesthesia seems to be safe for high-risk hernia patients undergoing CAPD.

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The relationship between family history of gastric carcinoma and gastric carcinoma in Japanese under 40 years of age was analyzed. The subjects were 108 gastric carcinoma patients (86% were diffuse type) at 9 hospitals in the Kanto area of Japan. Firstly, incidence of gastric carcinoma among the parents of the subjects were compared with that in the general population. Observed/expected (O/E) ratios (P‐value) were 1.8 (0.06) for all subjects, 1.3 (0.62) for male subjects, 2.1 (0.04) for female subjects, 0.5 (0.41) for early carcinoma, 2.6 (P<0.01) for advanced carcinoma, 2.3 (0.22) for intestinal‐type carcinoma and 1.7 (0.13) for diffuse‐type carcinoma. Association between gastric carcinoma and parents’ history of gastric carcinoma was strong among women and regarding advanced carcinoma, and the difference in O/E ratios between early and advanced carcinoma was remarkable. Secondly, factors related to advanced‐stage gastric carcinoma were analyzed. Histological type (diffuse and intestinal types) was not related, but family history of gastric carcinoma among parents and grandparents was related to advanced stage, and the relationship was independent of other factors. The odds ratio (95% confidence interval) was 3.3 (1.1–9.9). Family history may be related to stage of gastric carcinoma through its relationship to the manner or speed of the tumor's progression. We hypothesis that some genetic factor exists which is involved both in progression from early to advanced stage and in occurrence of gastric carcinoma.

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This book is printed on paper suitable for recycling and made from fully managed and sustained forest sources. Logging, pulping and manufacturing processes are expected to conform to the environmental regulations of the country of origin.A catalogue record for this book is available from the British Library.

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