[Two cases of neuroendocrine carcinoma in the biliary system with long-term survival].

We report here two cases of neuroendocrine carcinoma which occurred in the biliary system. The prognosis of neuroendocrine carcinoma in the biliary system is generally poor. However, based on the preoperative pathological diagnosis of neuroendocrine carcinoma, multidisciplinary treatment consisting of preoperative chemotherapy, chemoradiation therapy, curative resection and adjuvant chemotherapy seemed to be very effective and long-term survival was obtained in our two cases. Therefore it is essential to diagnose preoperatively to improve prognosis.

[Relationships between the changes in eating behavior and alleviation of symptoms observed in high and low risk groups of metabolic syndrome].

BACKGROUND: Eating behavior change (EBC) is essential to remedy metabolic syndrome (MetS). We carried out our clinic-based health and nutrition intervention informed by the transtheoretical model (TTM) to promote EBC. In particular, we aimed to foster EBC among individuals who were in the cognitive stage (C-level stage) of their health behavior, in contrast to the model positing that those in C-level stage are less likely to adopt EBC than those in the behavioral stage (B-level stage). The degree of each one's risk for MetS was also examined. SUBJECTS: The study population comprised 108 adults (38 males aged 58 +/- 10.8 SD and 70 females aged 60 +/- 6.6). METHODS: SUBJECTS were given instruction and support for over a 3-month period. MetS diagnostic criteria values, dietary intake and TTM were measured before and/or after the intervention. On the basis of their MetS and TTM scores, subjects were classified into two groups according to risk (high or low) and stage (C or B). Multiple linear regression analysis was performed. RESULTS: In both risk groups, EBC stage scores advanced in many subjects, progressing from C to B-level stage. Reduction in abdominal circumference and improvement of the MetS criteria values were also observed particularly in the high-risk group and those in the B-level stage. Stage-specific improvements in physical characteristics, the MetS criteria values and energy intake were likewise seen in both risk groups. Abdominal circumference reduction was negatively and positively correlated with EBC stage scores and fat energy ratio, respectively. CONCLUSION: From the results, it was proved that improvements of MetS criteria values concomitantly occurred with reduction of eating energy intake, especially fat energy, as well as advance of EBC from C to B-level stage. In addition, we found it effective to let the participants recognize their degrees of risk for MetS.

[Discrepancies between laparoscopic and histological findings in the stage diagnosis of chronic viral hepatitis].

We studied about the discrepancies of stage diagnosis between laparoscopic and histological findings in the clinical course of chronic viral hepatitis. We noticed discrepancies in 26% of chronic hepatitis B and 18% of chronic hepatitis C. Many cases were judged more advanced by laparoscopic staging than by histological staging. The group with different stage diagnosis showed high frequency of reddish markings and patchy markings indicating severe necro-inflammatory reaction and regenerative reaction in laparoscopic findings. This suggests that existence of active inflammation might be a cause of discrepancies in stage diagnosis. The cumulative incidence of hepatocellular carcinoma was significantly higher in the cases judged more advanced by laparoscopy even in the same histological stage. This indicates that laparoscopic staging should be more reliable for predicting prognosis in each patient.