All patients except one (95.5%) were initially diagnosed by upper endoscopy and biopsy. The tumor location was the 1st or 2nd portion in the great majority of patients (20/22, 90.9%): 2nd portion 11, bulb 6, superior duodenal angle 3, 3rd portion 1, 4th portion 1. The most Peptide 17 patients (81.8%)

had advanced diseases (stage III 9 and IV 9). Pancreatic invasion was observed in 6 (27.3%) and 9 (40.9%) had distant metastasis. Twelve patients (54.5%) underwent surgery, 12 (54.5%) took anticancer chemotherapy including 8 cases of adjuvant therapy, and 7 (31.8%) radiotherapy. The median survival time was 24.3 months (95% CI 14.6–34.0). One year and 3 years survival rates were 55% and 22%., The advanced disease at the time of diagnosis was an independent prognostic factor for survival on multivariate analysis (hazard ratio 5.811, 95% CI 1.954–17.288, p = 0.002). Conclusion: Primary duodenal adenocarcinoma is prevalent among the elderly male. It developed mostly in the upper portion and could be diagnosed endoscopically. The

majority of the patients were diagnosed at the advanced stage which was an independent prognostic FXR agonist factor. These suggest that early diagnosis by through endoscopic examination beyond the bulb would be required for improving prognosis of primary duodenal adenocarcinoma. Key Word(s): 1. duodenum; 2. neoplasm; 3. non-ampullary; 4. adenocarcinoma; Presenting Author: PING-I HSU Corresponding Author: PING-I HSU Affiliations: Kaohsiung Veterans General Hospital Objective: Platelet ADP-receptor antagonists impair the healing of peptic ulcers, and 9% of patients with a history of peptic ulcer bleeding who take clopidogrel have recurrent ulcer bleeding

within one year. The aim of this randomized controlled trial was to investigate whether histamine-2 receptor antagonist can prevent recurrent peptic ulcer in atherosclerotic patients with long-term use of thienopyridine. We also investigated the effects of histamine-2 receptor antagonist on the antiplatelet action of thienopyridine. Methods: Long-term thienopyridine (clopidogrel or ticlopidine) users with peptic ulcer history who did not have peptic ulcers on enrollment Ponatinib were randomly assigned to receive either famotidine (20 mg b.i.d.) or placebo for 6 months. Eradication therapy was administered if endoscopy on enrollment revealed H. pylori infection. Follow-up endoscopy was carried out at the end of the 6th month and whenever severe epigastric discomfort, hematemesis or melena occurred. Platelet aggregation tests were performed on days 1 and 28 for patients who participated in the pharmacodynamic study. Results: The cumulative incidence of recurrent peptic ulcer during the 6-month period was 8.8% among patients given famotidine (n = 91) and 7.8% among patients given placebo (n = 90) (difference, 1.0%; 95% confidence interval, −7.0%–9.0%; P = 0.805).