[Extent of lymph node dissection in rectal carcinoma]

Basing on 170 specimens of advanced rectal cancers radically resected, metastatic rule and extent of lymph node dissection were studied in order to guide future surgical treatment. In 170 cases, 77 had lymph node metastases. The lymph node metastatic rate was 45.3% and metastatic degree was 8.9% (527/5 912). Metastasis of the rectal cancer, according to the lymphatic anatomy, can be divided into upward, lateral and downward drain. Because the rectal cancer at any site can lead to the upward metastasis, the upward lymph node dissection, up to the base of inferior mesenteric artery (the third line of lymph nodes), must be done in all rectal cases, otherwise, 10% of patients would have residual cancer. In view of the lateral metastasis occurring only in rectal cancers under the peritoneal reflection, for which lateral lymph node dissection is necessary or one eighth of patients would have residual lesion. Generally, no lateral lymph node dissection is needed in cancers above the peritoneal reflection. Pathologic factor influencing the lymphatic metastasis is the form of tumor growth, such as poorly differentiated and mucoid adenocarcinomas aggressively growing deeply and extensively resulting in a higher lymph node metastatic rate, for which lymph node dissection must be performed.

Methylation at specific altered aspartyl and asparaginyl residues in glucagon by the erythrocyte protein carboxyl methyltransferase

Protein carboxyl methyltransferases from erythrocytes and brain appear to catalyze the esterification of L-isoaspartyl and/or D-aspartyl residues but not of normal L-aspartyl residues. In order to identify the origin of these unusual residues which occur in subpopulations of a variety of cellular proteins, we studied the in vitro methylation by the erythrocyte enzyme of glucagon, a peptide hormone of 29 amino acids containing 3 aspartyl residues and a single asparagine residue. Methylated glucagon was digested with either trypsin, chymotrypsin, pepsin, or endoproteinase Arg C, and the labeled fragments were separated by high-performance liquid chromatography and identified. In separate experiments, methyl acceptor sites were determined by digesting glucagon first with proteases and then assaying purified glucagon fragments for methyl acceptor activity. Using both approaches, we found that the major site of methylation, accounting for about 62% of the total, was at the position of Asp-9. Chemical analysis of fragments containing this residue indicated that this site represents an L-isoaspartyl residue. A second site of methylation, representing about 23% of the total, was detected at the position of Asn-28 and was also shown to represent an L-isoaspartyl residue. Methyl acceptor sites were not detected at the positions of Asp-15 or Asp-21. Preincubation of glucagon under basic conditions (0.1 M NH4OH, 3 h, 37 degrees C) increased methylation at the Asn-28 site by 4-8-fold while methylation at the Asp-9 site remained unchanged. These results suggest that methylation sites can originate from both aspartyl and asparaginyl residues and that these sites may be distinguished by the effect of base treatment.

[Combination of radiation, chemotherapy and surgery in rectal cancer--an analysis of 128 patients]

The results of 128 patients with rectal cancer treated by the combination of surgery, preoperative radiotherapy and chemotherapy from June 1975 to December 1979 are reported and compared with those by operation alone. The 5 year survival rates of the different groups were: 69.5% (16/23) for radical surgery plus preoperative radiotherapy and chemotherapy (RRCG), 56% (14/25) for radical surgery plus preoperative radiotherapy, 53.8% (7/13) for radical surgery plus chemotherapy and 40% (10/25) for radical surgery alone. The 5 year survival rate of RRCG was significantly higher than that of the radical surgery alone group (P less than 0.05). The authors believe that the combination of preoperative radiotherapy, chemotherapy plus radical surgery improves the 5 year survival rate and is worthy of further study.

Transsexual sisters

The first documented case of sisters with transsexualism is reported. Given the low incidence of female transsexualism this is a most unlikely event and suggests that familial factors may be of aetological importance.

tau-Crystallin from the turtle lens: purification and partial characterization

A lens protein with a molecular mass near 46 000 daltons has been purified from the turtle lens. It is a monomeric protein which differs from other lens crystallins in its antigenicity, near-UV circular dichroism spectrum and amino acid composition. Like delta-crystallin, it has appreciable secondary structure (52% alpha-helix). This lens protein has been named tau-crystallin. tau-Crystallin cross-reacts with the novel 48 000 dalton protein identified recently in lenses of the sea lamprey. Although distinct, the possibility that tau-crystallin shares an ancestral relationship with delta-crystallin is discussed.

A histological study of the promotive effect of diethylstilbestrol on diethylnitrosamine initiated carcinogenesis of liver in rat

A single dose (80 mg/kg) of diethylnitrosamine (DEN) was given orally to castrated female Wistar rats. One week after that one half of the animals were treated with diethylstilbestrol (DES) 3 mg/kg/once a week subcutaneously. The other half of the animals received no any hormone or hormone derivatives. The change of the liver cells in animals treated with DEN alone failed to progress beyond the stage of hepatocellular alterations in foci or neoplastic nodules within 8 months, while most of those animals which received DES treatment after DEN initiation developed hepatocellular carcinomas after 6 months. This result denotes that the DES exerts a definite promotive effect on DEN initiated liver cell carcinogenesis.

Lithium associated thyroid cancer

This report documents papillary cell carcinoma of the thyroid occurring in a 55-year-old woman after three-and-a-half years of lithium therapy. She presented with unilateral thyroid enlargement causing tracheal deviation. There was no clinical suspicion of malignancy and the histological findings were totally unexpected.