Laparoscopy Assisted Colectomy with Extracorporeal Anastomosis

Abstract: Laparoscopy assisted colectomy with extracorporeal anastomosis was carried out in five patients. In three patients, the lesions were carcinoma with submucosal invasion and the histological results of the polypectomy specimen indicated the necessity of the subsequent colectomy. In the other two patients the lesions were either adenoma or carcinoma in adenoma. Under pneumoperitoneum, mobilization of the colon was performed using the laparoscopic technique. In three patients the mesenteric vessels of a segment of the colon were ligated and divided extracorporeally. In two patients the mesenteric vessels were clipped and divided intracorporeally. In all cases, extracorporeal resection of the colon and hand suture anastomosis were performed. Surgery time ranged from 3 hours and 20 minutes to 4 hours and 50 minutes. No postoperative complications were experinced. Four patients began to walk on the first postoperative day. Postoperative administration of analgesics was needed in four patients for two days or less after the operation. In all but one case, bowel sounds were audible from the first post-operative day onwards. In only one patient was the postoperative recovery delayed. Although sufficient future studies should be accumulated to confirm the advantages of this procedure, we can expect that laparoscopy assisted colectomy will become a useful procedure for benign and early malignant lesions in which colonoscopic removal was not possible or was suspected to be insufficient. (Dig Endosc 1944; 6 : 52–58)     

Hepatocellular carcinoma in 13 patients with hepatitis C virus-associated chronic hepatitis

Abstract Thirteen of 81 patients with chronic hepatitis and positive hepatitis C virus (HCV) antibody developed hepatocellular carcinoma (HCC) during a follow-up period of 54 ± 38 months. The histopathological findings in HCC-bearing liver in these patients included six cases of chronic persistent hepatitis [CPH; mean hepatitis activity index (HAI) score: 5.8] and seven cases of chronic aggressive hepatitis (CAH) 2A, or 2B (HAI) score: 13.6). Multiple biopsies of the liver in six cases revealed that five cases, including four with CPH at the time of HCC diagnosis, previously had histopathological findings identical to CAH 2A, and another case constantly had CPH during the 8-year follow-up. These findings suggest that HCV-associated HCC can occur even in patients with HCV antibody positivity and inactive or mild chronic hepatitis. This is of interest in the pathogenetic mechanisms of HCV-associated HCC.     

Human Chorionic Gonadotropin-Like Substance (hCG-LS)-Producing Urothelial Carcinoma: Immunohistological Location of hCG-LS

We experienced three cases of human chorionic gonadotropin-likesubstance (hCG-LS)-producing tumors of urothelial carcinoma(two cases of renal pelvic tumor and one case of bladder tumor),which revealed high levels of luteinizing hormone in the urine,serum and tissue. The pathological diagnosis was transitionalcell carcinoma, grade III (two cases) and undifferentiated carcinoma(one case). The present study is aimed to determine the locationof hCG-LS in tumor cells by an immunohistochemical approach.By the immuno peroxidase technique using anti-hCG-ßserum, hCG-LS was located in the cytoplasm of anaplastic giantcells and trophoblastic-like cells. In two cases the diseaseprogressed rapidly, to terminate fatally in a short time. hCG-LSproducing urothelial carcinomas generally seem to contain anaplasticgiant cells and/or trophoblastic-like cells, and are suggestiveof poor prognosis.     

鬼针草化学成分的研究（I）

目的研究鬼针草Bidens bipinnata地上部分的化学成分.方法采用硅胶、ODS柱色谱并结合HPLC分离纯化,通过理化鉴定和波谱分析鉴定其化学结构.结果从鬼针草的醋酸乙酯部位得到水杨酸(Ⅰ)、9,12,13-三羟基-10,15-十八碳二烯酸(Ⅱ)9,12,13-三羟基-10-十八烯酸(Ⅲ)、苄基-O-β-D-吡喃葡萄糖苷(Ⅳ)、苯乙基-O-β-D-吡喃葡萄糖苷(V)、(Z)-3-己烯基-O-β-D-吡喃葡萄糖苷(Ⅵ)、丁香酚苷(Ⅶ)、3-甲基-2-(2-戊烯基)-4-O-β-D-吡喃葡萄糖基-△2-环戊烯酮(Ⅷ).结论以上8个化合物中除水杨酸外,其余7个化合物均为首次从鬼针草中分离得到.