Postoperative Body Mass Index Changes in Gastric Cancer Patients according to Reconstruction Type: Effectiveness of Long Jejunal Bypass on Weight Loss in Obese Patients after Distal Gastrectomy.

The aim of this study was to investigate and compare the change of body mass index (BMI) in patients after gastrectomy for cancer according to the type of reconstruction. BMI was followed in 260 patients who had undergone curative surgery for gastric cancer from March 2003 to December 2009. The procedures were Billroth I in 63 patients, Billroth II in 52 patients, Roux-en-Y in 54 patients, long Roux-en-Y (bypassed proximal jejunum over 100 cm) in 47 patients, and total gastrectomy in 44 patients. BMI reduction was greatest in the total gastrectomy group at postoperative 6 months, 1 year, and 2 years. Postoperative 3-year BMI reduction was greatest in the long Roux-en-Y group. BMI reductions of the total gastrectomy and long Roux-en-Y groups were similar during the follow-up period. Among the subtotal gastrectomy groups, BMI reduction was greatest in the long Roux-en-Y group, and there was statistical significance in comparing with Billroth I and II groups, but no statistical difference with the Roux-en-Y group. Given the limitations of patient number and follow-up period, it can be concluded that obese patients with gastric cancer not requiring total gastrectomy may benefit from long Roux-en-Y reconstruction with adequate BMI reduction and accompanying health improvement.

Usefulness of the recombinant liver stage antigen-3 for an early serodiagnosis of Plasmodium falciparum infection.

In order to develop tools for an early serodiagnosis of Plasmodium falciparum infection, we evaluated the usefulness of P. falciparum liver stage antigen-3 (LSA-3) as a serodiagnostic antigen. A portion of LSA-3 gene was cloned, and its recombinant protein (rLSA-3) was expressed in Escherichia coli and purified by column chromatography. The purified rLSA-3 and 120 test blood/serum samples collected from inhabitants in malaria-endemic areas of Mandalay, Myanmar were used for this study. In microscopic examinations of blood samples, P. falciparum positive rate was 39.1% (47/120) in thin smear trials, and 33.3% (40/120) in thick smear trials. Although the positive rate associated with the rLSA-3 (30.8%) was lower than that of the blood stage antigens (70.8%), rLSA-3 based enzyme-linked immunosorbent assay could detect 12 seropositive cases (10.0%), in which blood stage antigens were not detected. These results indicate that the LSA-3 is a useful antigen for an early serodiagnosis of P. falciparum infection.