[Considerations on intraoperative radiation therapy and therapeutic ratio]

In conjunction with the clinical development of intraoperative radiation therapy (IORT), the ability to demonstrate an improvement in therapeutic ratio is critical and an evaluation of treatment complications is essential. The tolerance dose of the normal tissue in IORT is discussed, and if small field is applied, the greater part of tissues or organs tolerate intraoperative irradiations up to 25 Gy. The optimal dose has been estimated on each organs with malignant tumors. Intraoperative "boost" dose electron therapy given in combination with external beam irradiation has been demonstrated as good treatment modalities concerning with therapeutic ratio.

Identification of new C27 and C24 bile acids in the bile of Alligator mississippiensis

Biliary bile acids of Alligator mississippiensis were analyzed by gas-liquid chromatography-mass spectrometry after fractionation by silica gel column chromatography. It was shown that the alligator bile contained 12 C27 bile acids and 8 C24 bile acids. In addition to the C27 bile acids, such as 3 alpha,7 alpha,12 alpha-trihydroxy-5 beta-cholestanoic acid, 3 alpha,7 alpha,12 alpha-trihydroxy-5 alpha-cholestanoic acid, 3 alpha,7 alpha-dihydroxy-5 beta-cholestanoic acid, 3 alpha,12 alpha-dihydroxy-5 beta-cholestanoic acid, 7 alpha,12 alpha-dihydroxy-3-oxo-5 beta-cholestanoic acid, and 3 alpha,12 alpha-dihydroxy-7-oxo-5 beta-cholestanoic acid, identified previously in the bile of A. mississippiensis, 3 alpha,7 beta-dihydroxy-5 beta-cholestanoic acid, 3 alpha,7 beta,12 alpha-trihydroxy-5 beta-cholestanoic acid, 7 beta,12 alpha-dihydroxy-3-oxo-5 beta-cholestanoic acid, 3 alpha,7 alpha,12 alpha,24-tetrahydroxy-5 beta-cholestanoic acid, 3 alpha,7 alpha,12 alpha,26-tetrahydroxy-5 beta-cholestanoic acid, and 1 beta,3 alpha,7 alpha,12 alpha-tetrahydroxy-5 beta-cholestanoic acid were newly identified. And in addition to the C24 bile acids, such as chenodeoxycholic acid, ursodeoxycholic acid, cholic acid, and allocholic acid, identified previously, deoxycholic acid, 3 alpha,7 alpha-dihydroxy-5 beta-chol-22-enoic acid, 3 alpha,7 alpha,12 alpha-trihydroxy-5 alpha-chol-22-enoic acid, and 3 alpha,7 alpha,12 alpha-trihydroxy-5 beta-chol-22-enoic acid were newly identified.

So-called "papillary and cystic neoplasm of the pancreas." An immunohistochemical and ultrastructural study

A case of so-called "papillary and cystic neoplasm of the pancreas" (PCNP) was reported and investigated immunohistochemically and ultrastructurally. A tumor of the pancreatic head in a 21-year-old female was curatively resected. The tumor was cystic and histologically consisted of uniform cells in papillary and solid structure. Although there was no immunoreactivity for pancreaticogut hormones or secretory products of the pancreas in the tumor cells, most of the tumor cells were diffusely immunoreactive for neuron-specific enolase (NSE). Some neurosecretory granules were detected in the tumor cells ultrastructurally. Both facts suggested endocrine cell character of the tumor. Certain cases of PCNP might show a differentiation to endocrine cells.

A case of malignant cystic endocrine tumor of the pancreas

A malignant pancreatic endocrine tumor with a cystic appearance in a 66-yr-old woman was reported. Total pancreatectomy was performed under the diagnosis of cystadenocarcinoma. The tumor was large and cystic, but the solid portion of the tumor showed histologically a ribbon-like array of small uniform cells typical for endocrine tumors. Immunohistochemically, most tumor cells were immunoreactive for neuron-specific enolase, chromogranin, and Leu 7-epitope. Ultrastructurally, innumerable neurosecretory granules were demonstrated in the cytoplasm of most tumor cells. The patient survived for 5.5 yr after operation despite liver metastases, some of which also showed cystic appearances.

[Postoperative nutritional assessment in gastric and colorectal cancer]

From the 200 malnutritional cancer patients, we had obtained, so called, prognostic nutritional index (PNI): PNI = 10 X Alb. + 0.005 Lymph. C., where Alb. is serum albumin level (g/dl) and Lymph. C. is total lymphocytes count of peripheral blood level. This index, as we had reported, shows linear predictive model correlating the risk of operative complication, mortality or both with nutritional status. In this study, we report on the utility of the PNI as a nutritional index (NI) for postoperative patients. The subjects of this study were 22 gastric cancer patients (G group), performed total gastrectomy or proximal gastrectomy, and 18 colorectal cancer patients (C group), underwent colectomy or rectal resection and anastomosis but amputation. All these cases underwent nutritional support by TPN postoperatively. The values of NI of both groups were the lowest at the first postoperative day, and increased gradually to the seventh postoperative day. And the value of C group was higher than that of G group throughout the TPN period: From the first postoperative day to the 14th day. These results reflected the result obtained from the estimation of nitrogen balance, urinary 3-methylhistidine excretion and serum rapid turnover protein (transferrin, prealbumin and retinol binding protein). These results suggest that the NI is useful to estimate the improvement of the postoperative nutritional status.

Restraining factors affecting setting expansion of phosphate-bonded investments

The effects of several factors on the setting expansion of a phosphate-bonded investment used in a steel casting ring were studied. The results show that the setting expansion under the conditions analyzed can be characterized only as a most unreliable means to partly compensate for the solid thermal contraction of casting alloys in a precision-requiring technique.

Non-restraining factors affecting setting expansion of phosphate-bonded investments

Only a few studies on the setting expansion of phosphate-bonded investments have been published. In the present work the effect on the non-restrained setting expansion of mixing time, mixing liquid, mixing device, and volume mixed was investigated for selected brands of this type of investment. It was found that all variables studied may greatly affect the setting expansion, and that the use of the special liquid delivered by the manufacturers in most cases causes an unacceptably high expansion. A modification of the brands studied appears necessary before they can be employed in a precision-requiring technique.

Erythrocyte deformability improving action of beta-pyridylcarbinol tartrate

beta-Pyridylcarbinol tartrate was found to prevent the hyperosmotically induced worsening of filterability of rat erythrocytes after in vivo treatments. The effect is attributed to the prevention of the morphological change of the erythrocytes from normal discocytes to echinocytes. The study was made using a scanning electron microscope.

Changes of portal vein pressure and intrahepatic blood vessels after surgery for biliary atresia

The portal vein pressure was measured and biopsies of the liver were taken during the corrective operation in 31 patients with biliary atresia and during relaparotomy in 16 patients free from jaundice 4 mo to 9 yr after a successful corrective operation. Because the portal vein pressure was higher than 200 mmH2O in about 70% of patients during the corrective operation, portal hypertension appears to have already developed in most of the patients with biliary atresia at 2-4 mo of age. In the patients who had had frequent episodes of postoperative cholangitis, the portal vein pressure was elevated and the amount of interstitial tissue in the liver was markedly increased at reoperation compared with those at the corrective operation. These results showed that postoperative cholangitis aggravated portal hypertension and fibrosis of the liver. On the contrary, the portal vein pressure declined in patients in whom active bile drainage had persisted and cholangitis had not been complicated after operation. An early corrective operation and prevention of postoperative cholangitis are of the greatest important for prevention of development of the portal hypertension and cirrhosis of the liver in long-term survivors after surgery for biliary atresia.