Surgery for far-advanced colorectal cancer--extension of surgical indication and its results

The role of extended surgery for far advanced colorectal cancer (stage V, IV) was discussed. As the progression of colorectal cancer is relatively slow and small, as compared to cancers of other digestive organs, removal of the far advanced carcinoma by much extended operation was effective to enhance the survival or quality of life of patients. Combined resection of adjacent organ involved has given many patients chance of cure. Total pelvic eviscerations were performed for thirty eight patients with far-advanced rectal cancer which involved adjacent organs. The results were a 51.5% 5-year survival rate for curative resected group. For advanced rectal cancer with a high degree of lymph-node metastasis, extension of lymph-node dissection up to the para-aortic region or ileo-pelvic lateral dissection en bloc with the internal iliac vessels were effective for decreasing the incidence of local recurrence. For seventy two patients with liver metastasis, radical surgery with removal of liver metastatic lesions post removed intra arterial infusion therapy (5FU,MMC) was carried out and the resulting 5-year survival rate was 40% for patients with H1 liver metastasis. Removal of pulmonary metastatic lesions was also performed in sixty five patients and the 5-year survival rate was 40%. A complete removal of scattered tumors (P1,P2) and administration of anticancer drug-MMC (20-30mg) in the peritoneal cavity was conjugated to prolong the terms of survival of patients.     

Effects of paraquat on mitochondrial electron transport system and catecholamine contents in rat brain

 The effects of paraquat on rat brain were studied. Activities of complex I (NADH: ubiquinone oxidoreductase) in mitochondrial electron transport system, lipid peroxidation and the amount of catecholamines in rat brain were measured after acute paraquat exposure. Complex I activities were significantly lower and lipid peroxides were higher in the brains of a paraquat-treated group than in those of a control group. Lipid peroxide in rat serum, however, did not increase after paraquat exposure. A study of the time dependency of paraquat effects disclosed that mitochondrial complex I activities in rat brain as well as those in rat lung and liver gradually decreased prior to the appearance of respiratory dysfunction. As compared to controls, the dopamine in rat striatum was significantly lower in the paraquat-treated group. These results suggest that paraquat after crossing the blood-brain barrier might be reduced to the radical in rat brain, which may damage the brain tissue, especially dopaminergic neurons in striatum. We therefore propose that cerebral damage should be taken into consideration on paraquat exposure. Patients may therefore need to be followed up after exposure to high doses of paraquat. Received: 19 June 1995/Accepted: 18 January 1996     

Preoperative ultrasonography screening for liver metastases of patients with colorectal cancer

The clinical value of preoperative ultrasonography in screening for synchronous liver metastases was prospectively evaluated in 338 patients with colorectal cancer. Synchronous liver metastases were observed at laparotomy in 11.5% (39/338) of the patients. The liver metastases had been found by preoperative ultrasonography in 30 patients and missed in nine. The overall accuracy rate, sensitivity and specificity, and the positive and negative predictive values of this modality were 0.970, 0.769, 0.997, 0.968 and 0.971, respectively. In detecting liver metastases, the results were superior to those of biochemical blood tests and measurements of carcinoembryonic antigen serum levels. The accuracy of the ultrasonography was also superior to that of these other tests combined. The results indicate ultrasonography to be an indispensable preoperative examination for patients with colorectal cancer.     

Functional metal-porphyrazine derivatives and their polymers, 1. Synthesis of metal-[2,9or10(or 2,16or17)bis(3,4-dicarboxybenzoyl)]phthalocyanine derivatives

The diimide of metal-[2,9or10(or 2,16or17)bis(3,4-dicarboxybenzoyl)]phthalocyanine(diPc) (where i = imide) 2 or 3 were prepared from 3,4,3′,4′-benzophenonetetracarboxylic dianhydride (BTDA) ( 1 ), phthalic anhydride (PA), urea, and metal salts such as CuCl₂, CoCl₂, and FeCl₃ etc. at 170°C. In the case of copper, the diPc monomer 2 or 3 and the dimer 4 or 5 could be synthesized. Those copper complexes are stable to all of the chemical procedures. However, the core metals of Fe(III), Co(II), Ni(II) and Zn(II)-diPc were partially removed in the acid treatment. Metal phthalocyanine derivatives which have four carboxyl groups in the peripheral site, metal-[2,9or10(2,16or17)bis(3,4-dicarboxybenzoyl)] phthalocyanine(daPc) (a = acid) 6 or 7 , were synthesized by hydrolysis of the metal-diPc. The metal-daPc are soluble in water, in aprotic solvents such as N,N′-dimethylformamide, and also in sulfuric acid. The physicochemical properties of some metal-daPc derivatives were investigated.     

The effect of cyclosporine on murine thymic epithelial cells--an immunohistochemical study

The authors recently demonstrated that cyclosporine (CsA) treatment of mice caused a remarkable reduction of L3T4+Lyt-2- subset in the thymocytes as well as the striking decrease in the size and cellularity of the thymic medulla. To elucidate the underlying mechanism of such thymic alterations, an immunohistochemical study on the thymic epithelial cells was made in mice receiving CsA. In the medulla, a marked reduction of Ia-positive, keratin positive and Ulex europeus agglutinin 1 (UEA 1) binding epithelial cells was observed. CsA also induced a reduction of anti-keratin stainability of cortical epithelial cells and of Ia antigen expression by them. The results of this study indicate that CsA is not only directly impair thymocyte function but also may act on epithelial cells in the thymus. It is suggestive that CsA may affect T cell differentiation and maturation via alteration of Ia-positive thymic epithelial cells.     

Myelodysplastic syndrome with trisomy 11 associated with polycythemia vera

A 52-year-old male with myelodysplastic syndrome (MDS) who had a prior history of polycythemia vera is reported. Chromosome analysis revealed that the bone marrow and blood cells at the MDS phase contained trisomy of chromosome 11 as the sole cytogenetic change. Trisomy 11 is rarely found in hematologic neoplasia, and all of the reported cases with trisomy 11 were diagnosed as having nonlymphocytic neoplasia. In this report, a correlation between the chromosome change and leukemia/MDS developed in polycythemia vera is discussed.     

The effectiveness of wide anatomical resection and radical lymphadenectomy for patients with rectal cancer

The results of wide anatomical resection and radical lymphadenectomy which we termed the extended operation were examined. Materials consisted of 160 Japanese patients who underwent conventional operation during 1962–1968 prior to the introduction of extended operation, 113 patients who underwent extended operation since 1969, and 119 patients who underwent conventional operation from 1969 to 1976. The cumulative 5-year survival rates were 70% (1962–1968) and 67.8% (1969–1976) for the conventional operation groups and 90.3% for the extended operation group in Dukes B group (p<0.05). In Dukes C group, the rates were 26.3% (1962–1968) and 37.8% (1969–1976) for the conventional operation groups and 51.6% for the extended operation group. The incidences of local recurrence in Dukes B group were 25% (1969–1976) in the conventional operation group and 6.5% in the extended operation group, while in Dukes C group the rates were 45.0% (1969–1976) and 25%, respectively. Our study demonstrated that the extended operation resulted in a decrease in the local recurrence of rectal cancer and prognosis. We therefore recommend that extensive surgery be planned for advanced cases of rectal cancer.