ABSTRACT
Coenzyme Q10 (CoQ10) deficiency can manifest diversely, from isolated myopathy to multisystem involvement. Immune dysregulation has not been reported as a feature of the disease. We report a four-year old girl with failure to thrive, recurrent infections, developmental delay with hypotonia, and CoQ10 deficiency with impaired immune function, which improved after CoQ10 and immunoglobulin replacement therapy. Immune dysfunction in CoQ10 deficiency should be considered and treated appropriately.
Subject(s)
Ataxia/immunology , Ataxia/metabolism , Immunity/physiology , Mitochondrial Diseases/immunology , Mitochondrial Diseases/metabolism , Muscle Weakness/immunology , Muscle Weakness/metabolism , Ubiquinone/analogs & derivatives , Ubiquinone/deficiency , Ataxia/diagnosis , Ataxia/drug therapy , Child, Preschool , Enzyme Replacement Therapy , Female , Humans , Immunoglobulin G/blood , Immunoglobulin G/immunology , Lymphocyte Subsets/immunology , Lymphocyte Subsets/metabolism , Mitochondrial Diseases/diagnosis , Mitochondrial Diseases/drug therapy , Muscle Weakness/diagnosis , Muscle Weakness/drug therapy , Treatment Outcome , Ubiquinone/immunology , Ubiquinone/metabolism , Ubiquinone/therapeutic useABSTRACT
AIM: Laparoscopic gastrectomy (LG) is still not a widely accepted option for the treatment of invasive gastric cancer. This study was conducted to evaluate the results of LG for gastric adenocarcinoma in two French surgical departments. METHODS: Between 2001 and 2007, 51 patients underwent LG for gastric cancer. The results were compared to those of 79 patients who had open gastrectomy (OG) during the same study period. RESULTS: Mean age was 61 years (31-81) and 66 years (27-88) in the LG group and in the OG group, respectively. The sex ratio was 21 women to 30 men and 25 women for 54 men in the LG group and the OG group, respectively. The mean operative duration was 260 minutes (90-420) and 200 (120-360) the LG group and the OG group, respectively (P=0.11). Estimated operative blood loss was 150 ml (50-870) and 240 (120-955) in the LG group and the OG group, respectively (P=0.07). The mean number of harvested lymph nodes was 19 (8-51) in the LG group and 22 (3-101) in the OG group, respectively (P=0.76). The overall mortality rate was 0% and 2.5% in the LG group and the OG group, respectively (P=0.49). The overall abdominal morbidity rate was 12% and 16.4% in the LG group and the OG group, respectively (P=0.42). The mean duration of hospital stay was 8.0 days (5-23) and 11.5 days (5-31) in the LG group and the OG group, respectively (P=0.023). Survival analysis at 1, 2, and 3 years showed no significant difference between the two groups. CONCLUSION: LG for cancer is feasible and safe in patients with invasive gastric cancer. However, randomized controlled trials are necessary to accurately define the role of laparoscopy in the treatment of gastric cancer.
Subject(s)
Adenocarcinoma/surgery , Gastrectomy/methods , Laparoscopy , Stomach Neoplasms/surgery , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Prospective StudiesABSTRACT
The increasingly simple postoperative course of major surgery has challenged the routine use of drainage after most abdominal surgical procedures. Therefore a prospective study was designed to determine if abdominal drainage could be safely avoided after liver resection and was evaluated in 61 consecutive patients. There was one postoperative death (1.7%) from variceal bleeding. Four other patients (6.7%) developed an abdominal complication: two right subphrenic hematomas requiring reoperation in one case and two incisional ascitic leaks requiring incisional repair in one patient. There was neither a subphrenic abscess nor bile peritonitis. Postoperative hospitalization was 11.5 +/- 3 days in the entire group and 8.5 +/- 1 days in patients without complications. These results suggest that liver resection can be performed safely without abdominal drainage and that the routine use of drains is unnecessary.
