Cephalic Vein Cut-down for Totally Implantable Central Venous Access Devices With Preoperative Ultrasonography by Surgical Residents.

BACKGROUND/AIM: Cephalic vein (CV) cut-down for totally implantable central venous access devices (TICVADs) is not frequently used due to its low success rate. We compared the outcomes of CV cut-down using preoperative ultrasonography (US) performed by experienced surgeons versus surgical residents. PATIENTS AND METHODS: From December 2015 to December 2017, 10 surgeons implanted 212 TICVADs using CV cut-down with preoperative US. The surgeons were divided into two groups of five each: surgical residents (Group A, n=124 procedures) and experienced surgeons (Group B, n=88 procedures). Duration of operation time, completion rate, and complications were retrospectively analyzed. RESULTS: The completion rate was significantly higher in Group A (98.4% versus 92.0%, p=0.04). Duration of operation time (45.2±14.5 versus 42.0±13.1 minutes, p=0.22), rates of early complications (1.6% versus 1.1%, p=0.77) and late complications (3.2% versus 2.3%, p=0.68) were equivalent between the two groups. No fatal complications occurred in either group. CONCLUSION: CV cut-down can be safely performed by surgical residents under the use of preoperative US.

[A rare case of gallbladder cancer with giardiasis].

A 72-year-old man was referred to our hospital for suspected gallbladder cancer. We performed cholecystectomy with liver bed resection and lymph node dissection. Intraoperative cytological examination of the bile juice revealed some trophozoites of Giardia lamblia, and pathological examination revealed gallbladder cancer. Therefore, we diagnosed giardiasis associated with gallbladder cancer. We administered 750 mg per day metronidazole for 10 days. The patient was a farmer by occupation and used animal manure for agricultural purposes; he also consumed his own harvest, which was recognized as the infection route for his giardiasis. We reviewed the literature and found very few cases of giardiasis associated with gallbladder cancer.

Bcl-2 protein expression correlates with better prognosis in patients with advanced non-small cell lung cancer.

BACKGROUND: Regulation of apoptosis is an important mechanism during the development of tumors including non-small cell lung cancer (NSCLC). The aim of this study was to assess the relationship between p53 and bcl-2 expression and various clinicopathological features and survival in patients with NSCLC. MATERIALS AND METHODS: Histological specimens obtained from 120 patients with stage I-III NSCLC were examined immunohistochemically for p53 and bcl-2. RESULTS: Positive immunostaining for p53 was observed in 50 and for bcl-2 in 35 patients. Tumors with lymph node metastasis were significantly more likely to be bcl-2-positive. However, there was no correlation between p53 immunostaining and clinicopathological parameters. Cox proportional hazard multiple regression analyses identified gender, N status and bcl-2 expression as independent prognostic factors. When advanced stage tumors or tumors with lymph node metastasis were analyzed, a more favorable survival was noted in patients with bcl-2-positive tumors than those with bcl-2-negative tumors. CONCLUSION: Bcl-2 protein expression correlates with better prognosis in patients with advanced NSCLC.