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Background and Aims: In familial adenomatous polyposis (FAP), neoplastic lesions outside the colon have become increasingly important. The genotype-phenotype correlation has been established for duodenal polyps, and regular screening is recommended. However, this correlation remains unclear for small-intestinal lesions, except for reports on the relationship between their occurrence and Spigelman stage. Here, we used small-bowel capsule endoscopy (SBCE) to investigate the genotype-phenotype correlation of small-intestinal polyps in FAP., Methods: The genotype-phenotype correlation of small-intestinal polyps was investigated in patients with FAP who underwent SBCE, Esophagogastroduodenoscopy (EGD), and adenomatous polyposis coli (APC) gene analysis. Of 64 patients with FAP who underwent SBCE, 41 were included in the final analysis, 4 did not undergo a complete small intestine examination, and 19 did not undergo genetic analysis., Results: The prevalence (median number) of small-intestinal polyps by Spigelman stage was 26% (1.5), 0% (0), 44% (5), 60% (4), and 73% (25.5) for stages 0 to IV, respectively. Significantly more small-intestinal polyps were found in Spigelman stage III and IV groups than in the stage 0 group (P < .05). The APC variant was negative for 6 patients (15%), and the sites associated with more than 5 small-intestinal polyps were codons 278, 1062, 1114, 1281, 1307, 1314, and 1504., Conclusions: In FAP patients, SBCE surveillance is potentially recommended for patients with pathogenic variants in the APC gene at codons 278 and 1062 to 1504 or with Spigelman stage III or higher., (Copyright © 2023 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.)

Competing Interests: The authors declare that they have no conflict of interest.

A multicenter cooperative study was conducted to compare the clinical efficacy of UFT-M (UFT, Mitomycin C (MMC)) and UFT-D (UFT, Doxorubicin (DXR)). A total of 62 cases with adenocarcinoma were enrolled in this study. Eligible cases included 25 patients with gastric cancer, 22 with pancreas or biliary tract cancer and 10 with other cancers. They were divided into two groups; 30 in UFT-M and 27 in UFT-D. The treatment schedules were as follows: UFT 400-600 mg/day orally every day, MMC 4-6 mg/m2, IV, every week (UFT-M); UFT 400-600 mg/day orally every day, DXR 20 mg/m2, IV, every 3 weeks (UFT-D). For gastric cancer, 3 of 17 cases treated by UFT-M showed PR, whereas no case showed PR in UFT-D. As for toxicity, bone marrow suppression was more commonly observed in UFT-M than in UFT-D. There was no statistical difference in survival between the two treatment regimens. These results suggested that UFT-D was not effective but UFT-M was a more promising combination therapy against advanced gastric cancer.

Reported here are five cases of tick bite: in a 2-year-old boy, a 3-year-old girl, a 72-year-old woman, a 29-year-old woman, and a 51-year-old man. Four cases are thought to have occurred in a mountain area while one occurred in a city garden. None were accompanied with severe systemic symptoms or deuteropathies. The parasites were identified as the adult female tick Ixodes ovatus Neumann (3 cases) and Ixodes nipponensis Kitaoka et Saito (2 cases), which are commonly distributed in Japan.

Four patients with gallbladder cancer and two with bile duct cancer were treated with mitomycin C, carboquone, 5-fluorouracil and OK-432 (MQF-OK therapy) plus tegafur (FT) or UFT. MQF-OK therapy was administered according to our original method. FT and UFT were orally given in a dose of 600-800 mg/body/day and 300-400 mg/body/day, respectively. Three with gallbladder cancer and one with bile duct cancer showed PR. Myelosuppression was observed in all cases, but recovered in two weeks after MQF therapy. We recommend the further trial of MQF-OK therapy plus FT or UFT for gallbladder and bile duct cancer.