Effect of music in combination with maternal voice on the pain of malformation alimentary tract infants undergoing placement procedures of peripherally inserted central venous catheter / 中国实用护理杂志

Objective@#To investigate the application of music intervention in combination with maternal voice during PICC placement procedures in malformation alimentary tract infants.@*Methods@#A total of 60 malformation alimentary tract infants were enrolled in the present study in Hunan Children Hospital from January to December 2018, infants were randomly assigned to the intervention group (n=30) and the control group (n=30). Patients in the control group received conventional nursing, the intervention group received music and maternal voice intervention method. The level changes of heart rate, respiratory rate, blood pressure, blood oxygen saturation and cortisol concentration were compared between two groups, meanwhile, the pain rating were assessed by Neonatal Infant Pain Scale (NIPS).@*Results@#Before procedure, no significant difference was found between the control and intervention group in heart rate, respiratory rate, systolic pressure, SpO2 and NIPS score (P>0.05). During and after the procedure, the mean heart rate [(144.43±15.93), (142.43±20.42) times/min], respiratory rate [(44.70±4.51) and (43.50± 4.12) times/min], systolic pressure [(87.40±8.53) and (86.10±4.60) mmHg] and NIPS score (5.34±0.71 and 5.19±0.87) of the intervention group was statistically lower compared to the control group [(160.97±39.35) and (159.17±31.87) times/min, (53.13±7.85) and (50.47±7.70) times/min, (97.60±9.82) and (94.27±7.23) mmHg, 6.17±0.54 and 6.15±0.66; during procedure, the mean SpO2 was statistically significantly higher, compared to the control group [(96.15±9.82)% versus (88.34±9.53)%]. The difference was statistically significantly (t=2.134-6.682, P<0.05). Before placement, the concentration of cortisol between the two groups showed no significant difference (P>0.05), and (208.91±21.07)ng/ml 5min after placement and (197.70±16.34) ng/ml immediately after placement, the cortisol concentration was statistically significantly lower, compared to the control group [(246.71±35.15), (230.95±21.81) ng/ml] (t=5.050-6.682, P<0.05). Compared with the control group, the time needed for PICC placement decreased remarkably in the intervention group [(15.62±3.30) min versus (24.63±4.26) min)](t=9.160, P<0.01).@*Conclusions@#Music in combination with maternal voice can significantly reduce stress levels, pain responses and time need for PICC placement, music and maternal voice is a potential intervention strategy in malformation alimentary tract infants undergoing PICC.

“Intraluminal” Pyloric Duplication: A Case Report / 소아외과

We report a neonatal case of “intraluminal” pyloric duplication cyst, causing gastric obstruction after birth. Endoscopy revealed a submucosal cystic lesion approximately 15 mm in size arising from the anterior and inferior surfaces of the pylorus obliterating the pyloric canal. After laparotomy, intraoperative cholangiography was performed, which documented no communication between the cyst and the bilio-pancreatic duct. Gastrotomy was performed transversally over the antrum, and the cyst delivered through the incision. The cyst was incised, the upper part of the cyst wall removed, and a mucosectomy performed on the inner cyst wall of the lower part. The mucosa and muscle of the margin of the cyst were approximated. At follow up of 10 months, the patient is well without any sign of gastric obstruction.

Congenital Anomalies of the Alimentary Tract in Children: Experience in a Tertiary Health Facility in Enugu, Nigeria .

Background: Congenital anomalies including those of the alimentary tract are among the leading causes of childhood morbidity and mortality. A variety of these anomalies could affect the alimentary tract with various medical as well as economic costs. The aim of the current study was to determine the prevalence of the different forms, maternal as well as birth characteristics and outcomes of the congenital anomalies of the alimentary tract in hospitalized children in Enugu. Methods: A 3 year retrospective audit of all hospitalized cases of alimentary tract anomalies was carried out. Case definitions of the different forms of alimentary tract anomalies studied were based on International Classification of Diseases and Related Problems, Tenth Edition (ICD-10). Data was analyzed using SPSS version 21.0 while level of statistical significance was set at p<0.05. Results: A total of 59 children (37 males and 22 females) with alimentary tract anomalies were admitted during the period under review. Anorectal malformations 26(44.1%), Hirschsprung’s disease 14(23.7%) and Ompalocoele 5(8.5%) were the most common anomalies observed. Congenital talipes equinovarus deformity of the lower limbs was the most predominant associated congenital anomaly. Maternal periconceptional use of herbal medications was reported in 7 (11.9) cases. The case fatality rate was 5.1%. Conclusion: A variety of alimentary tract anomalies do occur in children in our setting with some mothers having taken various forms of herbal medications in pregnancy. Efforts should be made to educate mothers on the need to avoid use of herbal concoctions during periconceptional period and in pregnancy as it could lead to a possible congenital anomaly.

Gross anatomy and histology of the alimentary system of Characidae (Teleostei: Ostariophysi: Characiformes) and potential phylogenetic information

A compared study of the morphology of the alimentary tract and liver of seven selected species corresponding to the main clades of the Characidae family is presented herein. Three new set of characters corresponding to 1) alimentary tract gross anatomy, 2) alimentary tract histology and 3) liver gross anatomy are evaluated as potential sources of data for future phylogenetic studies of the Characidae. Not considerable interspecific variation was observed at the histological level and therefore this source is not considered to be phylogenetically informative at the taxonomic level analyzed. In contrast, liver and alimentary tract gross anatomy presented important interspecific variation while a relatively homogenous intraspecific morphology was observed. Those characters are optimized in tree-topologies from previous phylogenetic analyses and their evolution and potential relationship with ecological traits are discussed.

Un estudio comparado de la morfología del tracto alimentario y el hígado de siete especies seleccionadas correspondientes a los principales clados de la familia Characidae es presentada aquí. Tres nuevos conjuntos de caracteres correspondientes a 1) anatomía gruesa del tracto alimentario, 2) histología del tracto alimentario y 3) anatomía gruesa del hígado son evaluados aquí como potenciales fuentes de información para futuros estudios filogenéticos de los Characidae. No se observó una variación intraespecífica considerable a nivel histológico y consecuentemente esta fuente no es considerada como informativa filogenéticamente al nivel taxonómico analizado. En contraste, la anatomía gruesa del hígado y el tracto alimentario presentaron una variación interespecífica importante mientras que una relativamente homogénea variación intraespecífica fue observada. Estos caracteres son optimizados en topologías de árboles de análisis filogenéticos previos y su evolución y potencial relación con características ecológicas son discutidas.

A comparative study of CT virtual endoscopy imaging and pathologies of lower alimentary tract mesenchymal tumors / 中华内科杂志

Objective To study the pathological and immunohistochemical features of alimentary tract mesenchymal tumors and compare with computed tomographic virtue endoscopy (CTVE) imaging technology to evaluate the diagnostic value of CTVE in alimentary tract mesenchymal tumors. Methods Seventy-four pathological specimens of alimentary tract mesenchymal tumors were collected. The pathological features and the expression of CD117, CD34, SMA and S-100 were observed by immunohistochemical method with light microscope. The pathological types and characteristics were determined by pathologists and compared with CTVE imaging technology. Results In the 74 cases of alimentary tract mesenchymal tumors,40 cases were diagnosed as stromal tumor with pathological and immunohistochemical methods (54. 1%).Sixteen of them were malignant, accounting for 40% of the stromal tumor while 33 cases were diagnosed as leiomyoma(44. 6%)and 1 case as schwannoma(1.4%) . In the 74 GIMTs cases ,33 were jejunum GIMTs,21 were ileum GIMTs and 20 were large intestine GIMTs. Immunohistochemistry assay in the 74 GIMTs cases showed that 51.4% GIMTs were positive for CD117, approximately 36. 5% were positive for CD34 , 62.2% were positive for smooth-muscle actin (SMA) and 1. 4% were positive for S-100 protein. In the 74 GIMTs cases,69 cases were diagnosed right in the accuracy for location with CTVE(93. 2%) with 51 cases in small intestinal (94. 4%) and 18 cases in large intestinal (90. 0%). The sensitivity and the specificity of CTVE to distinguish benign from malignant stromal tumors by CTVE characteristics were 84. 2% and 85. 7%respectively. Conclusions GIST is common in GIMTs and is often originated from the small intestinal. The immunohistochemistry has great value in diagnosing alimentary tract mesenchymal tumors. The CTVE imaging technology also has great value in diagnosing alimentary tract mesenchymal tumors which can show the localization, shape size and artery of the tumor clearly. The diagnostic sensitivity and specificity of CTVE are high to distinguish benign from malignant alimentary tract GISTs. CTVE plays an important role in guiding the clinical management of GISTs.

Retrospective study of the influence of alimentary tract reconstruction after gastrectomy on the blood glucose level in patients with gastric cancers combined with type 2 diabetes mellitus / 中国医师进修杂志

Objective To explore the influence of alimentary tract reconstruction after gastrectomy on the blood glucose level in patients with gastric cancers combined with type 2 diabetes mellitus. Methods From January 2004 to December 2009, the level of blood glucose and body weight before operation and 1,3,6 months after operation in 87 gastric cancer combined with type 2 diabetes mellims patients were retrospectively analyzed. These patients underwent different alimentary tract reconstructions,including 48 patients for Billroth I after distal subtotal gastrectomy (group A), 39 patients for esophageal Roux-en-Y jejunostomy after total gastrectomy (group B). Fasting blood glucose (FBG) level and body weight of these patients were compared. Results In group A, change of FBG before and after operation were not significant (P ＞ 0.05 ). The levels of FBG in group B were significantly lower in 1,3,6 months after operation [(6.7 ±0.8), (6.6 ±0.6), (6.8 ±0.7) mmol/L] than that before operation [(9.7 ± 1.4) mmol/L](P＜0.05). The lower value average difference of FBG at 1,3,6 months was significant between group A and group B (P＜0.05 ). In group B, 6 months after operation's total effective rate was 87.2% (34/39). Changes of body weight before and after operation in group A and group B were significant (P ＜ 0.05 ). But between two groups, the changes of body weight between 1,3,6 months and before operation were not significant (P ＞0.05).Conclusions Esophageal Roux-en-Y jejunostomy after total gastrectomy has obvious influence on FBG level in patients with gastric cancers combined with type 2 diabetes mellitus. It takes about 1 month to reveal the effect of operation and has nothing to do with weight loss.

Influence of alimentary tract reconstruction on gastric cancer patients complicated with type 2 diabetes mellitus (a report of 67 cases ) / 中华内分泌外科杂志

Objective To explore the influence of alimentary tract reconstruction on blood glucose level in gastric cancer patients complicated with type 2 diabetes mellitus. Methods Clinical data of 67 gastric cancer patients complicated with type 2 diabetes mellitus and the level of blood glucose before operation, one month, three month, six month after operation were retrospectively analyzed. BMI of 53 patients was lower than 25kg/m2,9 patients between 25～29.9 kg/m2 and 5 patients was higher than 30kg/m2 .Total gastrectomy with P-type jejunal pouch Roux-en-Y esophagojejunostomy was performed in 26 cases, and total gastrectomy with Roux-en-Y esophagojejunostomy was performed in 11 cases, distal subtotal gastrectomy with Roux-en-Y gastrojejunostomy in 30 cases. Results Operations on sixty-seven patients were all uneventfully. The mean fasting blood glucose level in the morning was 9.6±3.3 mmol/L before operation, 7.4±2.6 mmol/L one month after operation, 7.5±2.3 mmol/L three month after operation, and 7.7±2.9 mmol/L six month after operation. There were significant differences between the blood glucose level of before operation and one month after operation (P0.05). Conclusions Alimentary tract reconstruction has obviousinfluence on blood glucose level in type 2 diabetes mellitus patients. It takes about one month for reveal the effect of operation. This phenomenon is of value for clinical application. Its mechanism needs further research.

Retrospective study of the effect of alimentary tract reconstruction after gastrectomy on the treatment of type 2 diabetes mellitus / 中华内分泌外科杂志

Objective To research the effect of alimentary tract reconstruction after gastrectomy on the treatment of type 2 diabetes mellitus(non-insulin-dependent diabetes mellitus, NIDDM). Methods From January 2005 to January 2008, perioperative blood glucose level and insulin therapy in 24 gastric cancer or periampullary carcinoma patients with non-obesity type 2 diabetes were retrospectively analyzed. These patients underwent different alimentary tract reconstruction, including 8 patients for Billroth I, 10 for standard Whipples operation, 6 for esophageal Roux-en-Y jejunostomy after total gastrectomy. Glucose level and insulin dosage of thease patients were compared. Results In the patients underwent Billroth I operation, change of blood glucose level before and after operation was not significant(P＞0.05). The level of blood glucose in patients underwent Whipples operation and total gastrectomy were significant changed 1 and 2 months after the operation (P<0.001). In Billroth I group, 5 patients used insulin to control hyperglycemia preoperatively. After the operation, 2 patents maintained preoperative insulin dosage, 2 had to increase the use of insulin and 1 decreased the insulin dosage. In Whipples group, 6 patients used insulin preoperatively. Interestingly, 4 patents needed less insulin to control hyperglycemia and 2 were free of insulin dependance. In total gastrectomy group, there were 4 patients using insulin to control hyperglycemia. After the operation, 2 patents needed less insulin dosage and 2 stopped using insulin. Conclusions Both Whipples operation and total gastrectomy lead to decreased blood glucose level in NIDDM patients and less need of insulin.The effect of some types of alimentary tract reconstruction after gastrectomy on treatment of type 2 diabetes mellitus is assertive.

Assessment of alimentary tract reconstruction procedures after total gastrectomy / 国际外科学杂志

To resolve the agastric syndrome after total gastrectomy, researchers have performed varoius alimentary tract reconstruction procedures for patients. Meanwhile, because of controversial standpoints fol-lowing the total gastrectomy, more than eighty methods were published in the world. The highlight is focused on the discussion of whether a reservoir with the duodenal passage of foodstuff significantly beneficial to the patient's clinical and nutritional status after total gastrectomy. In this article, we reviewed and evaluated the progress of digestive tract reconstruction procedures after total gastrectomy in order to obtain a optimal opera-tion approach.

Aerobic bacterial microbiota in stomoxys calcitrans: preliminary studies in Brazil / Microbiota bacteriana aeróbica em Stomoxys calcitrans: estudos preliminares no Brasil

The stable fly, Stomoxys calcitrans, has a great importance in medical and veterinary health due to its feeding and reproductive habits, which can disseminate some pathogenic agents among hosts even at long distances. This study aimed to describe, for the first time in Brazil, the bacterial microbiota in segments of the stable fly. Bacterial species were isolated from three different segments (cuticle, mouth parts and abdominal alimentary tract) of the stable fly. Twenty dairy farms were visited in four municipalities: Barra Mansa, Quatis, Resende and Rio Claro in the State of Rio de Janeiro in order to collect 20 flies in each site. Dissection of the flies and procedures of isolation and identification of bacterial species were performed. A total of 161 colonies of 33 distinct species were isolated, such as Escherichia coli, Staphylococcus aureus, and S. intermedius. Stomoxys calcitrans may harbor bacterial agents on their cuticle, mouth parts and abdominal alimentary tract and these bacteria may be pathogenic to their hosts.

A mosca dos estábulos, Stomoxys calcitrans, possui grande importância médica e veterinária devido a seus hábitos alimentares e reprodutivos, visto que pode disseminar agentes patogênicos para hospedeiros, mesmo a longas distâncias. Esse estudo teve por objetivo, pela primeira vez no Brasil, descrever a microbiota bacteriana de segmentos da mosca dos estábulos. As espécies bacterianas foram isoladas de três diferentes segmentos (superfície externa, aparelho bucal e trato digestivo abdominal) de S. calcitrans. Foram visitadas 20 fazendas leiteiras em quatro municípios: Barra Mansa, Quatis, Resende e Rio Claro no Estado do Rio de Janeiro para coletar 20 moscas em cada uma delas. A dissecção das moscas e os procedimentos de isolamento e identificação bacteriana foram realizados. Um total de 161 colônias de 33 espécies distintas foi isolado, dentre elas Escherichia coli, Staphylococcus aureus e S. intermedius. Stomoxys calcitrans pode veicular agentes bacterianos presentes na superfície externa, aparelho bucal e trato digestivo abdominal e essas bacterias possuem potencial patogênico a diversos hospedeiros deste muscídeo.

Repair of Full-thickness Defects in the Alimentary Tract Wall with a Bovine Pericardium Patch and Glue

PURPOSE: The authors performed this experimental study to test the efficacy and possibility of using a bovine pericardial patch (BPP) with Histoacryl(R) glue for the repair of full-thickness defects in the alimentary tract wall of a mouse model. METHODS: The animal study was conducted under aseptic conditions using 20 rats (4-week-old, 250~300 g each). Rats with a BPP with Histoacryl(R) glue were used to evaluate the effectiveness, strength, adhesion formation, morphological changes, early complications and changes of the BPP character. We made a tube--like form with BPP and Histoacryl(R); we put it in saline (NaCl 0.9%), gastric juices and bile for 2 weeks to test the changes in the material and the strength of the attachment. We tested the BPP with glue attached to the full-thickness defects in the alimentary tract wall. After 3 weeks we scarified the mice and analyzed the patch attachment and microscopic finding. RESULTS: The attached BPP with Histoacryl(R) was put in saline (NaCl 0.9%), gastric juices and bile for 2 weeks, and there were no changes. The attached BPP with glue to the liver surface remained secure. There were no patch failures. We found just one significant adhesion with fibrosis in the surround tissue. But all the other animals mucosal healing was complete in 3 weeks. CONCLUSIONS: BPP with Histoacryl(R) glue may be an acceptable membrane for at least temporary repair of full-thickness defects in the alimentary tract wall. Further study is required.

Nutrition assessment in 328 patients with alimentary tract malignancy / 上海第二医科大学学报

Objective To prospectively assess the nutritional status in the patients with alimentary tract malignancy,and to elucidate the factors related to malnutrition.Methods The nutritional status of 328 patients with newly diagnosed alimentary tract malignancy was assessed using subjective global assessment(SGA)and serum levels of prealbumin and albumin.And the factors influencing the nutritional status of the patients with alimentary tract malignancy in different locations were analyzed.Results The prevalence of malnutrition was 64.43% in all,75.81% in colon cancer,63.24% in esophageal cancer,62.40% in gastric cancer and 60.27% in rectal cancer.The changes of nutritional status mainly manifested weight loss with the incidence of 67.39%,serum prealbumin level under 200 g/L with the incidence of 24.1% and serum albumin level less than 35 g/L with the incidence of 31.70%.And there was significant difference in weight loss and serum levels of prealbumin and albumin among the patients with different nutritional status(P=0.000).The factors that influence the nutritional status of the patients with alimentary tract malignancy include the location and TNM staging of tumors,and the age,appetite and digestive symptoms of the patients.Conclusion The patients with alimentary tract malignancy are susceptible to malnutrition due to the multiple factors such as the tumor location and metabolic impacts of tumor on host.Nutritional screening,assessment and early intervention should be emphasized in the inpatients with alimentary tract malignancy.

4 Cases of Disfunction of Blood Clotting Induced by Cefoperazoned/Sulbactam / 中国药房

OBJECTIVE:To study conditions of disfunction of blood clotting induced by cefoperazoned/sulbactam.METHODS:Cases of disfunction of blood clotting induced by cefoperazoned/sulbactam in our hospital from Mar to May in2004were analyzed statistically.RESULTS:The chief clinical manifestation was alimentary tract hemorrhage,which may relate to the dosage and course of treatment of cefoperazoned/sulbactam.CONCLUSION:The application of cefoperazoned/sulbactam in senile patients should be more prudent.

Efficacy assessment of early enteral nutrition intervention in patients with alimentary tract carcinoma after surgery / 中华全科医师杂志

Objective To study the difference in occurrence of complications and health economics between early enteral nutrition (EN) and total parenteral nutrition (TPN) in patients with alimentary tract carcinoma after surgical operation.Methods Totally,164 patients with alimentary tract carcinoma hospitalized at the Department of General Surgery in China-Japan Friendship Itospital,Beijing during September 2003 to December 2005 with nutritional intervention,84 cases with early EN and 80 with TPN within 24 to 48 hours after surgical operation,were reviewed.Nutrition index,complications,recovery of gastrointestinal movement,length of hospital stay after operation and total cost of the patients were analyzed. Results Serum level of prealbumin in EN group was (309?49) mg/L,significantly higher than that in TPN group of (277?46) mg/L (P

Alimentary tract examinations before laparoscopic cholecystectomy / 中国微创外科杂志

Objective To study the necessity of alimentary tract examinations before laparoscopic cholecystectomy (LC). Methods Alimentary tract examinations were carried out in 130 cases in preparation for LC. In addition, the clinical records of 4 cases with missed diagnosis of gastrointestinal cancer during LC were also retrospectively analyzed. Results Out of the 130 cases, alimentary tract examinations found 11 cases of gastric and duodenal ulcer, 1 case of paraesophageal hernia, 4 cases of duodenal diverticulum, 4 cases of gastric cancer and 3 cases of colon cancer. Afterwards the surgery was temporarily canceled in 10 cases, and the rest of the 13 cases received open surgery. Missed diagnosis in the 4 cases included 3 cases of gastric cancer and 1 case of colon cancer. Conclusions Gastrointestinal diseases are often concurrent with gallbladder diseases. It is necessary to consummate alimentary tract examinations before LC for determining the indication of the operation and avoiding the misdiagnosis of other diseases.

Common complications and treatments in the malignant obstruction of upper alimentary tract with stent insertion / 介入放射学杂志

Objective To explore the common complications and methods of treatment in the malignant obstruction of upper alimentary tract with stent insertion. Methods With interventional procedure under fluoroscopic guidance fourteen self expanding stents were implanted in twelve patients, including nine with strictures or obstructions of esophagus, three with obstructions of gastroduodenum. Of the fourteen, nine were coated stents and five were uncoated stents. Results All stents were implanted successfully, but complications after the procedure occurred sometimes. There complications included: 1. Food bolus obstructed in three patients. 2. Chest pain occurred in four patients. 3. Tumour overgrowth or hyperplasia of granulation tissue in three patients caused restenosis of gastrointestinal tract. 4. Stent replacement in three patients. 5. Hemorrhage occurred in two patients (over 300 ml) causing threat to life. Conclusions The implantation of self expanding stent is a simple and effective method offering good palliation for upper alimentary tract obstructions. The complications shoud be treated correctly.

Angiographic diagnosis and interventional treatment for alimentary tract bleeding of unknown causes / 介入放射学杂志

Objective To study the diagnoses and treatment of alimentary tract bleeding of unknown causes. Methods All cases were undergone angiographic exarmination. Results 23 cases of angiographic display of alimentary tract bleeding showed the localization and causes of bleeding were clear in 21 casses. 2 cases were negative in radiography. 8 had been given the treatment of interventional embolization. Conclusions This article showed the angiographic display for the diagnosis, and the interventional treatment of alimentary tract bleeding with points for attention.

Clinical X-ray Diagnosis of Tumors Composed of Smooth Muscles in Alimentary Tract (A Report of 40 Cases) / 实用放射学杂志

Objective To improve the diagnostic quality of tumors composed of smooth muscles in alimentary tract.Methods The clinical and X-ray date of 40 cases of smooth musles tumors confirmed by surgery and pathological examination.Results Fifteen cases in the esophagus (including leiomyoma 14,leiomyosarcoma 1)showed the following X-ray appearence:filling defect,unfolding of mucous membrane,widening of the canal and pericanal mass 25 cases in the stomach and intestine(including leiomyoma 6,leiomyoplastoma 7,leiomyosarcoma 12)showed the following X-ray changes depending on the way of tumor,grows,cyst formation caused by tumor necrosis,compression of the stomach or intestine and adjacent organs,rarely seen calcification in tumor.The X-ray changes of small intermascular leiomyoma were short of specific X-ray signs.Conclusion X-ray exeamination is a reliable diagnostic method for smooth muscles tumors in alimentary tract.

THE DIAGNOSIS AND TREATMENT OF ADULTS CASES WITH FOREIGN BODIES IN THE ALIMENTARY TRACT / 重庆医科大学学报

Three hundred and two cases of foreign bodies in the alimentary tract of adults treated in the First Hospital of the Chongqing University of Medical Sciences from 1958 to 1986 were analyzed with reference to the varietes and forms of the foreign bodies, their routes and ways of entrance into the alimentary tract and their clinical manifestations. Importance of early diagnosis and opportune treatment is emphasized. For detecting on transparent or semitransparent foreign bodies under fluro-scopy, the swallowed cotton fibers with barium emulsion waS found of help. Management of the cases depends on the condition of the foreign bodies. Early operation is of importance in cases of incarceration of the foreign bodies so as to prevent serious complications

THE USE OF TOTAL PARENTERAL NUTRITON (TPN) IN SURGICAL PATIENTS / 重庆医科大学学报

A series of 61 patients are presented, among them 38 patients(twenty with cancer of esophagus, two with cancer of cardia, four with cancer of the upper part of st- omach, and radical resection were done in all of them)have been supported by TPN during perioperative and postoperative period, none of leakage at the anastomostic stoma occured; five paients with external fistulas of the alimentary tract supported by TPN healed spontaneously in four, operative closure of fistula was necessary in one, and all were cured. TPN was used in other 18 patients with miscellaneous disease, among them two of the patients with acute haemorrhagic pancreatitis were cured.One patient with major nutritional problem is presented in detail, for whom TPN had been continued for 225 days.