[A case of stage IV gastric cancer with multiple liver metastases and carcinomatous ascites responding to TS-1 for six months before progression].

We report the case of a 72-year-old male with Stage IV gastric cancer accompanied by multiple liver metastases and carcinomatous ascites which responded to chemotherapy using TS-1. Treatment of the patient with daily oral administration of 120 mg TS-1 for 4 weeks resulted in complete regression of the liver metastases and ascites, as well as a 35% reduction in the size of the primary lesion. After 2 cycles, the primary tumor size was reduced to 55% and serum CA19-9 and CA125 levels were decreased to the normal ranges. This regimen was effective without any adverse effects, and improved the patient's QOL, for 6 months before progression of liver lesions. The patient received chemotherapy at our outpatient clinic for 10 months after the first treatment, after which he died of peritonitis carcinomatosa. The current case suggests that TS-1 may have a potent therapeutic efficacy in advanced gastric cancer patients.

Sclerotherapy with a ligation of incompetent veins for a stasis ulcer due to varix cruris: minimal invasive therapy for varix cruris.

A retrospective analysis was performed on 11 patients (mean age 50 years), consisting of 8 men and 3 women, with a stasis ulcer due to varix cruris who underwent sclerotherapy with a ligation of incompetent veins on an outpatient basis. The follow-up ranged from 26 to 76 months (mean 53 months). The ulcers healed in 14 to 128 days (mean 41 days) after this procedure except in 1 patient. Three patients healed within 1 month and 7 others within 2 months. Only 1 patient needed over 2 months to heal. A recurrence of the ulcer was observed in 1 case 59 days after healing, and incompetent perforating veins were newly identified. This patient required an additional endoscopic subfascial division of the perforating veins and is now in the process of healing. No deterioration of the ulcer was observed. Thrombophlebitis and faintness were observed in 1 patient each. Neither pulmonary embolism nor deep venous thrombosis was observed. In conclusion, sclerotherapy with a ligation of any incompetent veins was found to be a safe and effective treatment for a stasis ulcer due to varix cruris; however, long-term observation will be required to confirm the effectiveness of this procedure. To successfully use combination therapy with less or minimally invasive procedures, a precise diagnosis of vein incompetency is crucial.