Bacterial pollution and disinfection of the colonofiberscope

We have studied the effects of traditional methods of disinfection of the colonofiberscope and have found that serious pollution by both grampositive and gram-negative organisms occurs on the tip, tube, and operation panel of the scope after routine colonofiberscopic examinations. Colonic flora were found simultaneously on the examiner's hands and in the house dust during the clinical examination procedure. Sterilization of the scope, using commercially available antiseptics (ie, cresol, benzethonium chloride, and chlorhexidine), was found to be incomplete except for a rather satisfactory disinfection obtained by a combined brushing process in chlorhexidine solution. It is concluded that traditional sterilization methods inadequately disinfect the colonofiberscope for clinical use, thus microbial infection through the endoscopic route to and between the patients should be considered. Protection of the endoscopist and his assistant from infection also needs to be emphasized.     

Spontaneous rupture of the esophagus. Report of two cases successfully treated by intravenous high caloric nutrition and review of 59 cases collected from Japanese literature.

For the period from 1951 through 1975, 4 cases of spontaneous rupture of the esophagus have been successfully treated at the IInd Department of Surgery, Tohoku University Hospital, Sendai, Japan. Two cases of them conservatively treated with intravenous high caloric nutrition were reported. Fifty-nine Japanese cases of spontaneous rupture of the esophagus were reviewed. Symptoms, diagnosis, treatment and prognosis of the disease were discussed.     

A case of advanced gastric cancer with pulmonary carcinomatous lymphangiosis responding remarkably to combination chemotherapy of docetaxel (TXT) and TS-1

A 51-old-female patient was admitted because of dyspnea. This case was diagnosed inoperable advanced gastric cancer and pulmonary carcinomatous lymphangiosis. She was treated by combination of docetaxel (TXT) and TS-1. TXT (40 mg/m2) was administered on day 1, and TS-1 (80 mg/body/day) was then administered for 14 days followed by a 7-day interval as one course. After two courses of chemotherapy, carcinomatous lymphangiosis declined, tumor markers decreased, and dyspnea improved. Administration of oxygen was thus discontinued. No side effects appeared (hematological or non-hematological).