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Development of an enteric fistula after surgery is a major therapeutic complication. In this study, we retrospectively examined the potential relationship between preoperative laboratory data and patient mortality by collecting patient data from a tertiary medical center. We included patients who developed enteric fistulas after surgery for gastrointestinal (GI) cancer between January 2005 and December 2010. Patient demographics and data on preoperative and pre-parenteral nutritional statuses were compared between surviving and deceased patients. Logistic regression analysis and receiver operating characteristic (ROC) curves were used to determine the predictors and cut-off values, respectively. Patients with incomplete data and preoperative heart, lung, kidney, and liver diseases were excluded from the study; thus, out of 65 patients, 43 were enrolled. Logistic regression analysis showed that blood urea nitrogen-to-creatinine (BUN/Cr) ratio [p = 0.007; OR = 0.443, 95% confidence interval (CI), 0.245-0.802] was an independent predictor of mortality in patients who developed enteric fistulas after surgery for GI cancer. In conclusion, the results of our study showed that a high preoperative BUN/Cr ratio increases the risk of mortality in patients who develop enteric fistulas after surgery for GI cancer., (Copyright © 2012. Published by Elsevier B.V.)

Cancer is one of the most common causes of morbidity and mortality. Genes whose products play a critical role in regulation of the immune response include the HLA antigen and cytokine families of genes. Oral cancer is common in men in developing countries, and its frequency is increased by using betel-quid, tobacco, and alcohol. The association between certain HLA Class I and Class II haplotypes and cancer has been documented in a variety of tumors. There was no previous data concerning the association of specific HLA Class II DQA1, DQB1 alleles, or haplotypes with oral cancer patients. In this study, we enrolled 134 Taiwanese patients with histologically confirmed oral cancer and 268 age- and gender-matched healthy Taiwanese adults as control group to investigate the association between HLA-DQA1, HLA-DQB1 allele frequencies and oral cancer patients by using polymerase chain reaction with sequence-specific primers. We found that both HLA-DQA1* and HLA-DQB1* allele frequencies in oral cancer patients revealed no significant difference from those of control groups. Haplotype frequencies of HLA*DQA1-0103-DQB1*0601 in oral cancer patients were significantly lower than those of the control group (odds ratio: 0.18, 95% confidence interval: 0.054-0.583, p(c)=0.02). Our data suggest that HLA DQA1*0103-DQB1*0601 haplotype may be protective with regard to the development of oral cancer., (Copyright © 2011. Published by Elsevier B.V.)

We describe a 65-year-old man who had undergone choledochoduodenostomy (CDS) for choledocholithiasis 25 years prior to admission to our hospital for cholangitis. Abdominal sonography and computerized tomography (CT) scan revealed a tumor mass at the hilar region with bilateral intrahepatic duct dilatation. Upper gastrointestinal endoscopic examination indicated the site of the CDS. Biopsy was taken from the mucosa of the bile duct, and pathology revealed well-differentiated adenocarcinoma. CT scan and angiography further confirmed unresectable hilar bile duct cancer. Conservative treatment with intra-arterial chemotherapy was arranged. After briefly reviewing the hypothesized pathogenesis and radiographic diagnosis of this rare case, we recommend that chronic cholangitis consequent to CDS should be closely followed for late development of biliary tract malignancy.