ABSTRACT
Individual differences in 5-FU metabolism are mainly attributed to individual differences in the activity of DPD, an enzyme that can metabolize more than 85% of 5-FU. Because urinary uracil is a reflection of DPD activity, it is measured to predict and prevent the occurrence of side effects caused by pyrimidine-type chemotherapeutic agents. From urinary uracil values measured in 84 gastrointestinal cancer patients, 0-60 mmol/g.creatinine was set as a standard. In patients whose urinary uracil values exceeded the standard, 5-FU tended to be accumulated when S-1, a DIF product, was administered and side effects, such as anorexia, vomiting and diarrhea occurred immediately after the start of S-1 administration. If an appropriate DIF product is selected and its dosage set based on the patient's urinary uracil value, the occurrence of side effects would be reduced. Subsequently, a continuation of medication would be possible.
Subject(s)
Antineoplastic Agents/urine , Dihydrouracil Dehydrogenase (NADP)/antagonists & inhibitors , Duodenal Neoplasms/drug therapy , Enzyme Inhibitors/urine , Fluorine Compounds/urine , Stomach Neoplasms/drug therapy , Uracil/urine , Adult , Aged , Antineoplastic Agents/administration & dosage , Antineoplastic Agents/therapeutic use , Dihydrouracil Dehydrogenase (NADP)/metabolism , Duodenal Neoplasms/enzymology , Duodenal Neoplasms/urine , Enzyme Inhibitors/administration & dosage , Enzyme Inhibitors/therapeutic use , Female , Fluorine Compounds/administration & dosage , Fluorine Compounds/therapeutic use , Humans , Male , Middle Aged , Stomach Neoplasms/enzymology , Stomach Neoplasms/urineABSTRACT
The sign of Leser-Trélat is a rare cutaneous manifestation of internal malignancy. Although adenocarcinoma is the most common malignant neoplasm associated with the sign of Leser-Trélat, we report what we believe to be the first case of adenocarcinoma of the duodenum associated with this sign. Because of the location of the tumor, we considered the possibility that the skin changes may be due to increased levels of epidermal growth factor (EGF) in this patient. However, no alteration in urine EGF levels was found.
