High FDG uptake of the primary tumor in patients with metastatic gastric adenocarcinoma is associated with poor overall survival. Assessment of tumor FDG uptake has limited value for prediction of chemotherapeutic response, but provides useful information regarding prognosis.

A block copolymer containing a rodlike block is studied for its adsorption and formation of nanostructured thin films on the substrate surface. The block copolymer is poly(styrene-b-3-triethoxysilylpropylisocyanate) (PS-b-PIC) of which the PIC chain consists of repeating amide units with triethoxysilyl side groups. As the copolymer chains are adsorbed onto silica surfaces, the PIC blocks pack laterally on the plane in a smectic manner, and the PS chains segregate along the ordered PIC chains, resulting in stripe patterns. The width of the stripes formed on the silica surface appeared to be much larger that on the carbon surface. This was accounted for by the bilayered smectic packing of the rod blocks that is induced by rod-surface attractive interaction. The periodicity of the stripe pattern on the carbon surface indicates that interdigitated packing is preferred by the copolymers on the hydrophobic surface in a manner similar to those in the bulk state of rod-coils. Excess rod-coils on the bilayered smectic layer resulted in a terraced morphology due to large difference in the periodicity between the bilayered smectic layer at the substrate surface and the interdigitated smectic layer in the bulk.

The potential benefit of neoadjuvant chemotherapy with surgery in patients with locally advanced head and neck cancers merits further evaluation in future clinical trials.

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PurposeA meta-analysis was conducted to examine the question of whether combination regimens are more effective than monotherapy as a second-line chemotherapy in advanced gastric cancer.Materials and MethodsThe MEDLINE and the EMBASE databases and the Cochrane Central Register for Controlled Trials were searched using appropriate keywords. Only randomized controlled trials were eligible.ResultsTaxane-based study is rare; thus, four irinotecan-based studies were finally included in the meta-analysis. Out of 661 patients, 331 patients were assigned to combination therapy and 330 to monotherapy. Cisplatin or fluoropyrimidine (S-1 or 5-fluorouracil) was used as a combination partner to irinotecan. The pooled hazard ratio (HR) for overall survival (OS) and for progression-free survival (PFS) was 0.938 (95% confidence interval [CI], 0.796 to 1.104; p=0.442) and 0.815 (95% CI, 0.693 to 0.958; p=0.013). In subgroup analysis according to previous exposure to a partner agent, the PFS benefit of combination was observed only in the partially exposed group (HR, 0.784; 95% CI, 0.628 to 0.980; p=0.032).ConclusionSecond-line irinotecan-based combination was not associated with increased OS, but with PFS benefit, which seemed particularly significant for patients receiving combination with a new agent.

ObjectiveWe wanted to evaluate the efficacy of stent placement using the coaxial technique with a stiff, long introducer sheath in patients with technical failure using an angiographic catheter for the obstructions proximal to the descending colon.Materials and MethodsSelf-expandable metallic stent placement was attempted under fluoroscopy-guidance in 77 consecutive patients who had malignant colorectal obstruction. Stent placement was performed using an angiographic catheter and a guide wire. If the angiographic catheter could not be advanced over the guide wire into the obstructive lesions proximal to the descending colon, then a 6-Fr introducer sheath was used. The technical success rate, the clinical success rate and the complications were analyzed.ResultsSuccessful stent placement was achieved in 75 of 77 patients (97%). The angiographic catheter failed to advance into the obstructive lesions of 11 patients (M:F = 7:4; mean age, 65.5 years) whose lesions were at the level of the splenic flexure or transverse colon. Therefore, the coaxial technique was implemented in all these 11 patients using a 6-Fr stiff introducer sheath and then the stent placement was successful. There were no complications related to the use of a stiff introducer sheath. Clinical success, which was defined as relief of clinical obstructive bowel symptoms, was obtained within 24 hours in all of patients.ConclusionThe coaxial technique using a stiff introducer sheath can increase the technical success of fluoroscopy-guided, self-expandable metallic stent placement in patients with colonic obstruction proximal to the descending colon.

PURPOSE: This study attempts to examine the impact of respiratory muscle exercises on the respiratory function and quality of sleep among stroke patients. METHODS: A total of 20 stroke patients were randomly divided into a breathing-exercise training group(n=10) and a breathing-device-training group(n=10). Changes in pulmonary function, as well as the quality, were measured before and after the intervention. The breathing exercise was performed three times a week for a total of eight weeks. Breathing-device exercises made use of a lung-capacity-strengthening device and were performed for three times a week for eight weeks.

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