Implantation on the suture material and efficacy of povidone-iodine solution

Suture implantation of viable exfoliated tumour cells may be responsible for local recurrence of colorectal cancer. Using a colon cancer cell line, we obtained a suture implantation without intraperitoneal metastasis in about 80% of the control animals, when sacrificed on the 2nd postoperative week. The cytotoxic efficacy of povidone-iodine (PVP-I) was tested in vivo by a rat model with viable intracaecal tumour cells, and in vitro by trypan blue exclusion and the MTT assay. In vivo PVP-I at 5% significantly reduced the incidence of tumour growth, while the product at 2.5% had a significant effect in only the monofilament polypropylene group. In an in vitro toxicity study, PVP-I higher than 0.16% was effective at killing almost all tumour cells. PVP-I had effective cytotoxicity in vivo and in vitro, being less cytotoxic in vivo than in vitro.

A chick wingless mutation causes abnormality in maintenance of Fgf8 expression in the wing apical ridge, resulting in loss of the dorsoventral boundary

We analyzed a Japanese chick wingless mutant (Jwg) to know a molecular mechanism underlying wing development. We observed expression patterns of eleven marker genes to characterize the mutant. Expressions of dorsoventral (DV) and mesenchymal marker genes were intact in nascent Jwg limb buds. However, expression of Fgf8, a marker gene for the apical ectodermal ridge (AER), was delayed and shortly disappeared in the wing regressing AER. Later on, ventral expression of dorsal marker genes of Wnt7a and Lmx1 indicated that the wing bud without the AER became bi-dorsal. In addition, the posterior mesoderm became defective, as deduced from the impaired expression patterns of Sonic hedgehog (Shh), Msx1, and Prx1. We attempted to rescue a wing by implanting Fgf8-expressing cells into the Jwg wing bud. We found that FGF8 can rescue outgrowth of the wing bud by maintaining Shh expression. Thus, the Jwg gene seems to be involved in maintenance of the Fgf8 expression in the wing bud. Further, it is suggested that the AER is required for maintenance of the DV boundary and the polarizing activity of the established wing bud.

Colorectal cancer after pelvic irradiation: case reports

Four patients with colorectal cancer after pelvic irradiation for gynaecological malignancies are reported. The interval between irradiation and the diagnosis of colorectal cancer was 15-28 years. Histological findings of radiation proctocolitis adjacent to the cancer were observed in all specimens. Ki-67 immunohistologic staining showed high cell proliferation activity in the irradiated mucosa of a recently removed specimen. Although irradiation has not been proved to induce colorectal cancer, considerable circumstantial evidence supports this belief. Awareness of this potential long-term complication is important when planing the follow-up of patients subjected to pelvic radiotherapy.

Recurrent colonic cancer developing at the site of a stapled stump: report of a case

We report herein the case of a 54-year-old woman who developed a recurrence of carcinoma in a stapled colon stump 2 years after undergoing an anterior resection for carcinoma of the rectosigmoid colon. At this time an end to end anastomosis (EEA) stapler had been used to perform a side-to-end anastomosis. The implantation of cancer cells was thought to have caused the recurrence.

[Dual biochemical modulation therapy using 5-FU, leucovorin and cisplatin on human rectal carcinoma xenografts in nude mouse]

This study examined a combined treatment for colorectal carcinoma, the dual biochemical modulation therapy, consisting of 5-FU, Leucovorin (LV) and Cisplatin (CDDP). We compared its anti-tumor effects with other treatments: 5-FU alone, CDDP alone and 5-FU with LV. Primary diffuse infiltrated colorectal carcinoma is well known for its biological malignancy and its lack of response to chemotherapy. We used SRM cells from a cell line of carcinoma of the rectum, and subcutaneously injected them into nude mice. The anti-tumor effects were estimated from the growth rate, inhibition rate and thymidylate synthetase inhibition rates in the tumor tissue. Results indicated that even if the concentration of 5-FU and LV were reduced by half, these combined with CDDP were more effective than other therapies. Dual biochemical modulation therapy is particularly promising because the reduction of the dosages would reduce the side effects while still serving as an excellent anti-tumor therapy.

[Development of quality of life questionnaire for patients with colorectal cancer in surgical area--a study of reliability and validity of Tokyo Yamabuki Forum Version]

We developed a new questionnaire in the surgical area based on a core quality of life (QOL) questionnaire for patients with gastrointestinal cancer. In this study, we investigated the validity and reliability of a QOL questionnaire (Tokyo Yamabuki Forum Version) for patients with colorectal cancer. The questionnaire was composed of 17 items including 5 scales (basic sensory scale, psychological scale, physiological scale, defection-related scale and active scale) and a face scale as an global scale. The time needed to answer questionnaires was expected to be around 7 minutes and the questionnaires should basically be answered by the patients themselves everyday in the hospital. The study was performed in 10 hospitals in the Tokyo area, and 394 samples collected from 21 patients with rectal and colonic cancers were analyzed. A number of respondents failed to answer the question "Do you feel your foods tasty?", so we judged this item inappropriate and deleted it from the analysis. Fifteen items, including 5 scales showed satisfactory internal consistency and construct validity in correlation and factor analyses. Performance status showed a low correlation between each item, each scale and the global scale, while SDS and STAI showed an inordinately negative correlation with the fundamental and physical scales. Especially, SDS revealed an extremely close correlation with the active scale, and STAI showed an excessive correlation with the psychological scale. In the time course of QOL under chemotherapy, reductions (aggravations) were observed in both the total score of 15 items and global scale within one week postoperatively, but after that recovered to preoperative levels at 2 weeks postoperatively. A tendency to QOL improvement was observed 2 weeks after starting chemotherapy or chemoimmunotherapy. QOL of 13 patients was measured over 3 months, and the longest term was 8 months. The results suggested that this QOL questionnaire has sufficient reliability and validity to be usable for patients with colorectal cancer in the surgical area and that this model is applicable for long-term QOL surveys and frequent measurement.

[A model for sensitivity determination of anticancer agents against chemical-induced colon cancer in rats]

Chemically-induced colon cancer was used to test the sensitivity of tumors to chemotherapeutic agents. Thirty-four Sprague-Dawley rats received dimethylhydrazine (40 mg/kg) s.c. once weekly for 10 weeks to induce colon cancer. Twenty weeks after beginning the carcinogen treatment, a barium enema was performed to determine the size of colon tumors. The animals were divided into CDDP group and CPT-11 group, in which the maximum tolerable dose of each drug was given. After 5 weeks of treatment, the barium enema was repeated. "Response" was assessed on the basis of tumor doubling time. Response rates in the CDDP and CPT-11 groups were 6% and 35%, respectively. This reflects the clinical data of those drugs and confirms the results of our previous study. The present study may be a predictive model for screening anticancer drugs for human colorectal malignancy.

Growth rate of experimental colon cancer in the absence of fecal stream and antitumor effect of UFT in rats

Growth rate of a chemically-induced colon tumor in the absence of fecal stream was investigated and the tumors to a chemotherapeutic agent tested. Eighty Sprague-Dawley rats received dimethylhydrazine (40 mg/kg) s.c. once weekly for 10 wk to induce colon cancer. Then a colostomy was performed to produce a defunctioning colon without fecal stream. 22 wk after beginning the carcinogen treatment, a barium enema was performed to visualize tumors in the defunctionalized colon. 29 rats died postoperatively and 16 had no tumor radiographically. The remaining 35 rats were divided into a control group and UFT treatment group. After 5 wk of treatment, the barium enema was repeated. The mean doubling time of 19 tumors in the control group was 9.8 days +/- 4.0 (SD). Response to UFT was judged as effective when the doubling time exceeded 17.8 days, calculated from the mean +/- 2SDs in the control group. The response rate of UFT was 48%. The growth rate of colon tumors without fecal stream was faster and more stable than those with fecal stream; as a result, the sensitivity to UFT became higher than that in tumors with fecal stream (36%), which was reported in our previous study. The present experimental system may be more accurate for assessing the response to chemotherapeutic agents.

A model for sensitivity determination of anticancer agents against chemically-induced colon cancer in rats

Chemically-induced colon cancer was used to test the sensitivity of tumors to chemotherapeutic agents. Seventy-one Sprague-Dawley rats received dimethylhydrazine (20mg/kg) s.c. once weekly for 20 weeks to induce colon cancer. Then a barium enema was performed to see the size of colon tumors. The animals were divided into three groups that were subjected to the following treatments: 5-fluorouracil (5 FU); 1-(2-tetrahydrofuryl)-5 FU(FT); and a mixture of FT and uracil (UFT). After 5 weeks of treatment, the barium enema was repeated. "Response" was assessed on the basis of tumor doubling time. Response rates in the 5-FU, FT, and UFT groups were 25%, 33% and 36%, respectively and this reflects the clinical data of these drugs. The present system may be a predictive model for screening anticancer drugs for human colorectal cancer.

[Inhibitory effects of OK-432 administered orally on colon carcinoma induced by DMH in rats]

Inhibitory effects of OK-432 administered orally on DMH-induced colon tumors in rats were examined. As for the immunological parameter, NK activity was measured. ODC activity and nuclear DNA ploidy pattern of the tumor involved areas were evaluated and the histological examination was done in the process of the occurrence of tumors. Rats were divided into four groups as follows; control group, OK-432 group, DMH group and DMH+OH-432 group. As for the appearance of DMH induced colon tumors, the average numbers of tumors per rat in the DMH+OK-432 group were inhibited significantly compared with those in the DMH group, and the rate of cancer in situ in the DMH+OK-432 group significantly increased compared with that in the DMH group. NK activity of lymphocytes in the spleen and lymph nodes in the colon was increased after the oral administration of OK-432, but it was decreased following the peak activity, and it was lower level than that of the control group. An appropriate oral administration of OK-432 may be effective against chemically induced carcinoma of the colon.

[Anatomical measurements of the internal anal sphincter--the relative site of the dentate line in the internal anal sphincter]

Not only the length and the width of the internal anal sphincter but also the relative site of the dentate line in the internal anal sphincter were investigated in 62 resected specimens obtained by abdominoperineal resection of the rectum for malignancy. Mean length and width of the internal sphincter were 25.8 +/- 4.1mm (mean +/- standard deviation) and 4.0 +/- 1.1mm, respectively. The length of the internal sphincter from its distal end to the level of the dentate line was 11.3 +/- 3.1mm, which corresponded to 44% of the total length of the internal sphincter. The individual difference in the site of the dentate line in the internal sphincter was objectively demonstrated. It seems to be therefore important to modulate the extent of sphincterotomy in order to minimize postoperative anal dysfunction on the surgery for fissure or fistula-in-ano, in which sphincterotomy is widely practiced up to the level of the dentate line.

[Abnormal adductor movement of the vocal cords in spasmodic dysphonia]

Adductor movement of the vocal cords in initial/ke/phonation was recorded using a laryngeal fiberscope, CCD camera, and videocassette recorder. Three patients with adductor spasmodic dysphonia (SD), a 53 year old male and 48 and 52 year old females, and 7 normal volunteers participated in this study. During the examination, the subject sat on a chair holding a microphone about 20 cm away from his or her lips. A laryngeal fiberscope was inserted through either side of the nostril. The tip of the fiberscope was positioned just caudal to the tip of the epiglottis to get a complete view of both sides of the vocal cords. The examiner told the subject to make the speech sound/ke/repeatedly, and to insert a sufficient inspiratory period between each phonation. The vocal cord images were recorded at 30 frames per second and printed successively from several frames ahead of the beginning of adductor movement to the frame of initial adjustment of the membranous part of the vocal cords following a time code indicator. The tips of both sides of the vocal processes and anterior commissure were marked, then, scanned and transported to a personal computer. An imaginary line connecting the vocal process and anterior commissure was drawn on the screen of the computer, which was done on both sides of the vocal cords. Then, an angle made by the two lines was measured in degrees and stored. The time and speed of adductor movement varied among subjects. Normal subjects, however, never failed to finish making the explosive sound in /ke/ before initial vocal cord adjustment.(ABSTRACT TRUNCATED AT 250 WORDS)

[Establishment and characterization of a human rectal cancer cell line, SRM from primary diffuse infiltrating type cancer]

Primary diffuse infiltrative cancer of the large bowel shows poor prognosis. A human rectal cancer cell line, designated as SRM, was established from the metastatic lymph node of a 35-year-old female patient. SRM cells have been cultured with RPMI-1640 medium supplemented with 10% fetal calf serum and grew as monolayers, showing a tendency to pile up. The doubling time of this cell line was 23.0 hours, and the modal number of chromosomes was 64 at passage 14. The cells produced CA19-9 and TPA in the spent medium and formed tumors in nude mice, the histology of which was similar to that of the primary tumor. CA19-9 in the cytoplasma of the transplanted tumor cells was demonstrated by the ABC method and the c-myc oncogene was amplified in the transplanted tumor in nude mice.

Effect of sodium benzylideneascorbate on chemically-induced tumors in rats

Intravenous administration of sodium benzylideneascorbate (SBA) dose-dependently induced degeneration (vacuolar and eosinophilic degeneration and cell shrinkage and nuclear condensation, which are characteristic of apoptotic cell death) of 3'-methyl-4-dimethylaminoazobenzene-induced rat hepatocellular carcinoma. SBA did not significantly induce lymphocyte infiltration and fibrosis in the liver, nor damage the gross morphology of kidney and spleen cells. SBA failed to stimulate the production of tumor necrosis factor and interleukin-1 beta in both in vitro and in vivo systems. These results may suggest a direct antitumor action of SBA via induction of apoptosis in the tumor. However, SBA did not significantly affect the doubling time, or the extent of invasion and differentiation of dimethylhydrazine-induced colon carcinoma in rats. These data suggest that the conditions of SBA administration should be re-established for each tumor sample to produce maximum antitumor activity.

Reduced growth rate of dimethylhydrazine-induced colon tumors in rats

alpha-Difluoromethylornithine (DFMO) treatment has been shown to modify carcinogenesis in many experimental tumor models, including breast, urinary bladder, and colon. This study was designed to determine whether DFMO treatment can inhibit tumor growth on chemical-induced colon cancer in rats. Effectiveness of DFMO in combination with mitomycin C (MMC) was also evaluated. Forty-two Sprague-Dawley rats received dimethylhydrazine (20 mg/kg) s.c. once weekly for 20 wk to induce colon cancer. Then a double-contrast barium enema was performed, and colon tumors were detected. The animals were divided into four groups that were subjected to the following treatment: none; DFMO alone; MMC alone; and a combination of DFMO plus MMC. After 5 wk of treatment, the barium enema was repeated. For the evaluation of treatment efficacy, tumor doubling time was adopted. The mean tumor doubling time in the control group was 20.7 +/- 9.1 days (SD). "Response" was judged as effective when tumor doubling time in treatment groups was more than 38.9 days, calculated from the mean + 2 SDs in the control group. Response rates in the DFMO, MMC, and DFMO plus MMC groups were 40.0%, 10.0%, and 82.3%, respectively. DFMO was a more effective inhibitor of tumor growth than MMC, and DFMO in combination with MMC resulted in a synergic diminution of tumor growth. The double-contrast barium enema is useful to observe sequential tumor growth and may be appropriate for the evaluation of new treatment on experimental colon cancer in rats.

[Increased polyamine levels of normal-appearing mucosa and cancers in DMH induced cancer-bearing colon in rats]

Polyamine levels (putrescine, spermidine, spermine) in normal-appearing colonic mucosa of DMH administrated rats were measured in order to assess their importance as markers of precancerous changes. Mean putrescine, spermidine and spermine levels of normal-appearing mucosa were more than three times mean putrescine, more than twice mean spermidine and more than 1.5 times mean spermine levels of normal colonic mucosa. Mean polyamine levels of colon cancers were higher than those of normal-appearing mucosa but only spermidine level was significantly different between them. The mucosal polyamine levels may be a good biochemical marker to detect precancerous changes. There was no correlation between the polyamine levels and the growth rate of the colon cancers.

[Raised polyamines in erythrocytes of DMH administrated rats with colonic cancers and those relationship to tumor volume]

The objective of this study was to assess, in a controlled experimental system, whether the concentrations of polyamines (Pa) in urine or erythrocytes increase during the process of colon carcinogenesis in rats, and whether such changes reflect tumor volume. Colon carcinoma was induced in Sprague-Dawley rats by subcutaneous injection of 1, -2 dimethylhydrazine (DMH). 24-hour urine and blood samples were collected and analysed for their Pa consent, with high pressure liquid chromatographic method. The levels of any Pa derivatives in either urine or erythrocytes at 32 weeks after the administration of DMH were not significantly high compared with the control group at the same week. However, certain increases of Pa in erythrocytes were observed in the levels of putrescine (1.3 times), spermidine (1.3 times), and spermine (1.5 times) respectively compared with the control group and there were high positive correlations between tumor volume and the levels of each Pa derivatives. On the ground of the results, Pa in erythrocytes seems to be the sensitive parameter for tumor volume compared with Pa in urine.

[Retrospective study of tumor growth and progression in gastric leiomyosarcoma; a care report]

Presented is the case of a 58-year-old female who had been found to have a submucosal tumor of the stomach during a group medical examination 7 years earlier. Since that time, the proliferative course of the tumor has been regularly observed and the diagnosis of a gastric smooth muscle sarcoma was finally determined after an endoscopic examination performed this year. On the basis of X-ray photographs taken periodically, the mass gradually proliferated from 1.3 to 3.5 cm in diameter during the observation period of 2392 days. According to the doubling time (DT) calculation of Horai et al, the DT was 0.69. The proliferation in this case was very slow and this seems to be a characteristic of a highly differentiated smooth muscle sarcoma of the stomach.

[Growth rate of experimental colonic cancer in rats]

Colonic cancers were induced in rats by subcutaneous injection of 1,2-Dimethylhydrazine. Tumor growth patterns were estimated by means of a double contrast barium enema technique. Tumor growth was almost exponential and the average doubling time was 20 +/- 5 (m +/- S.D.) days, at which time three different types of tumor growth patterns: Constant type, decreasing type and reaccelerating type, were noted. Serial double contrast barium enema technique appeared to be an useful method of studying in vivo primary colonic cancer growth patterns in rats.

[Treatment of malignant lymphoma of the small intestine in aged patients over 70]

Case histories of three elderly patients with a malignant lymphoma of the small intestine are described. Case No. 1 involved a 80-year-old male with a diffuse malignant lymphoma of medium size that was associated with a jejunal perforation. On the 64th day after surgery, he died of heart failure during the course of chemotherapy. Case No. 2 was a 76-year-old male with a diffuse malignant lymphoma of medium size in the ileocecum. He left hospital after surgery had relieved his symptoms, although 8 months after he developed active pulmonary tuberculosis during the course of chemotherapy. Case No. 3 involved a 76-year-old female with a diffuse malignant lymphoma of the mixed cell type in the terminal ileum. She died of heart failure complicated by a pulmonary disease on the 36th postoperative day. The therapeutic results of treating the malignant lymphoma in these 3 aged patients were all unfavorable. Thus, it is felt that special care should be taken in treating aged patients with this kind of disease.

[Deviation and rotation of the larynx in computer tomography]

Many authors described the clinical importance of asymmetry of the laryngeal framework. However, its pathogenesis is generally unknown. In this study, CT images of 315 Japanese subjects were investigated to define the laryngeal position relative to the midline of the cervical vertebra. The CT slice of each subject within 5 mm cephalad of the cricoarytenoid joint was traced. Then, the deviation and rotation angles were measured using our method. Seventy one percent of the subjects' larynges deviated and/or rotated to the right side, while 17% to the left side. Six percent showed neither deviation nor rotation. As to the rest of 6%, deviation and rotation were in opposite directions. Besides, the length of the thyroid alae were measured in 282 subjects. Left ala was longer in 55%, and right was in 23%, and almost equal in 22%. The conclusions are as follows, 1. The majority of the subjects' CT images showed deviation and/or rotation of the laryngeal framework to the right side. 2. So called idiopathic laryngeal deviation is a case which observed in those cases with remarkable deviation and/or rotation of the laryngeal framework. 3. Aging seemed to be an important factor in acceleration of the laryngeal deviation and rotation. 4. The type of diseases and the side of mass lesions had no statistical significance in deviation and rotation of the larynx.