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目的:当科で吸引式痔核結紮器による内痔核治療を受けた318例を対象に，自覚症状の改善度から吸引式痔核結紮術の適応と限界を考察した．結果:来院時の自覚症状は，出血222例（69.8％），脱出89例（28.0％），肛門の違和感81例（25.5％）であった．治療後の症状改善度は，出血は99.0％に症状の改善が見られ，肛門の違和感84.0％，脱出36.0％であった．脱出に対する有効性は他の2症状に比べて改善度が低かった．またGoligher分類別に奏効率を見ると，grade1:96.0％，grade2:92.2％，grade3:46.9％，grade4:0％であった．結論:以上から，grade1，2が吸引結紮療法のもっとも良い適応であり，grade3では3～4回施行し，有効ならば継続，無効であれば手術に切り替える．grade4では本治療による改善度は低く，手術療法が第1選択である．

Background Tissue samples from patients with pathologic (p) stage III colorectal cancer were tested for sensitivity to 5-fluorouracil (5-FU). On the basis of the results, patients were divided into 5-FU–sensitive and 5-FU–resistant groups, and both groups were treated with fluoropyrimidine (UFT) as postoperative adjuvant chemotherapy. Recurrence, 5-year survival rates, and 5-year recurrence-free survival rates were compared. Methods The anticancer sensitivity test described in this study was carried out using tumor samples obtained surgically from 34 patients with curatively resectable colorectal cancer that had been diagnosed definitively as pstage III (IIIa, 23 patients; IIIb, 11 patients). Regardless of tumor sensitivity or resistance to 5-FU, all 34 patients were subsequently treated daily with UFT at 300 mg/day as postoperative adjuvant chemotherapy. Treatment was initiated 3 weeks after surgery and continued for 2 years. Results Of the 34 patients with pstage III colorectal cancer, the tumors of 16 (47%) were 5-FU–sensitive (S group) and 18 (53%) were 5-FU–resistant (R group). The recurrence rates in the S and R groups following postadjuvant therapy with UFT were 25% and 61%, respectively, which is a significantly lower response in the S group (P = .045). The odds ratio of recurrence in the R group vs. the S group was 4.71. The 5-year survival rate was 85.7% in the S group and 46.7% in the R group, but the difference was not significant (P = .066). The 5-year recurrence-free survival rate was significantly higher in the S group than in the R groups (71% vs. 32%, P = .010). According to Cox’s multivariate analysis of recurrence-free survival, the sensitivity test was significantly predictive. Conclusion Administration of UFT as postoperative adjuvant therapy to 5-FU–resistant patients had no significant effect on outcome.

High performance liquid chromatography (anion-exchange, reversed-phase ion-pair and gel permeation chromatography) and ultrafiltration have been employed to analyze 188Re-ethylenediamine-N,N,N´,N´-tetrakis(methylenephosphonic acid) complexes ( 188Re-EDTMP), prepared from the tin chloride reduction or sodium borohydride reduction in the presence or absence of rhenium carrier. The HPLC analysis showed that the 188Re-EDTMP complexes were mixtures of components and the distribution of the components was dependent upon the total amount of rhenium present and the reducing agents (SnCl2, NaBH4). The ultrafiltration analysis showed that the distribution of nominal molecular weight of 188Re-EDTMP was dependent upon the presence of rhenium carrier and the reducing agents. In addition, it was found that the proportion of chemical species with bigger molecular weight in no-carrier-added 188Re(SnCl2)-EDTMP was larger than that in carrier-added 188Re(SnCl2)-EDTMP.

No-carrier-added 177Lu was produced by the 176Yb(n,γ)177Yb→177Lu process using enriched 176Yb2O3. The radiochemical separation of the nca 177Lu from the macroscopic ytterbium target was investigated by reversed-phase ion-pair HPLC. Effects of the concentrations of 2-hydroxyisobutyric acid and 1-octanesulfonate in the eluent, the amount of Yb2O3, the type and length of the C18 column on the separation efficiency were examined. Under optimum conditions, the nca 177Lu was obtained in radiochemically pure form from 5 mg of Yb2O3 with a separation yield of 84%.

coefficient (ml/g), which is defined by the ratio of the concentration of the complex per unit weight of the hydroxyapatite to the concentration in unit volume of the solution, increased with decreasing pH and ionic strength. These observations suggest that one of the causes of the adsorption of 188 Re-amp is considered to be the electrostatic forces between the negative 188 Re-amp complex and the positive HAP surface. The adsorption affinity of the 188 Re-amp complex for HAP increased in the order of 188 Re-EDBMP< 188 Re-NTMP< 188 Re-EDTMP. Furthermore, the adsorption coefficient of carrier-free 188 Re-EDTMP was larger than that of carrier-added one under the same conditions. From a detailed comparison of the effect of the Re carrier concentration on the adsorption coefficient of 188 Re-EDTMP with its structural analysis by HPLC, we concluded that the Re carrier effect on the adsorption coefficient was caused by the different distribution of the components in the 188 Re-EDTMP mixture between the carrier-free and the carrier-added complex.

消化器癌や乳癌においてVEGFの発現例は予後不良であるといわれている.本研究の目的は大腸癌におけるVEGFの予後因子としての意義を明らかにすることである.対象はstage I-IIIの大腸進行癌156例である.VEGFおよび腫瘍内微小血管の免疫組織染色はA-20およびCD34を用いて行った.VEGF陽性例における5年生存率は67.8%,血行性再発率は31%で,VEGF陰性例と比べ不良であった.VEGF陽性例ではMVDが高く,また血行性再発例でもMVDが高かった.多変量解析による分析で最も影響が強い予後因子のCEAとVEGFの組み合わせによる予後を検討したところVEGF+/CEA+の5年生存率は47.2%,血行性再発は50%で,他の3群と比べ不良であった.以上からVEGFとCEAの組み合わせは大腸癌の予後因子として意義があり,VEGF+/CEA+の予後は極めて不良である.

Background. Lymph node metastasis has been recognized as the most reliable prognostic factor for colorectal cancer. Of late, the clinical significance of p53 as a prognostic factor has been reported. The purpose of the current study was to elucidate the significance of these two factors in combination as a prognostic indicator for colorectal cancer.

The positron emitters11C,13N and18F and their labeled compounds have been produced for studies on plants using a newly developed positron emitting tracer imaging system. Although this system covers, at present, a limited area in a plant, the distribution of the positron emitter fed into the plant can be visualized dynamically. Further development of positron-emitter-labeled compounds is expected to elucidate the physiological function of plants in vivo.

p53蛋白の発現が消化器癌においてどのような臨床病理学的意義をもっかについては一定の見解が得られていない.この研究の目的は大腸癌治癒切除例におけるp53蛋白発現の臨床病理学的意義を明らかにすることである.対象はstage I～IIIの大腸進行癌治癒切除142例である.免疫組織染色はCM1を用い,ABC法により行い,p53蛋白の発現と臨床病理学的因子および予後との関係を検討した.その結果,臨床病理学的因子によるp53陽性率に差はみられなかった.p53陽性例のほうが有意に再発率が高く,無再発生存率が低かったが,p53陽性例とp53陰性例の間に生存率の差はみられなかった.この理由はp53陽性例のほうが再発の程度が軽度で,再発に対する切除率が高いことによると思われた.したがって大腸癌治癒切除例においてp53蛋白の発現は再発の危険因子であることが示唆された.

The transport of a positron-emitting isotope introduced into a plant was dynamically followed by a special observation apparatus called ‘Positron-Emitting Tracer Imaging System’ to observe the damage and recovery functions of plants in vivo. In the system, annihilation γ-rays from the positron emitter are detected with two planar detectors (5 × 6 cm2). The water containing ca. 5 MBq/ml of 18F was fed to the cut stem of soybean for 2 min and then the images of tracer activity were recorded for 30–50 min. When the midrib of a leaf near the petiole was cut just before measurement, the activity in the injured leaf was decreased but detected even at the apex. This result suggests that the damaged leaf recovered the uptake of water through the lamina. Maximum tracer activities in leaves of unirradiated plant were observed within 10 min, whereas those of irradiated plant at 100 Gy were observed after over 25 min. The final activity of irradiated plant after 30 min was lower than that of unirradiated plant. In case of beans, there was a difference in the absorption behavior of the 18F-labeled water between unirradiated and irradiated samples. These results show that the system is effective to observe the uptake and transportation of water containing positron emitting tracer for the study of damage and recovery functions of plants.

1979年から1990年までの根治度Aの大腸進行癌265例(再発87例,5年以上無再発例178例)を対象として,どの臨床病理学的因子が切除後の再発に強く影響しているかを多変量解析により検討した.対象例全体ではリンパ節転移,大きさ,環周度の順であった.再発形式別にみると肝転移再発ではリンパ節転移,深達度,vの順であり,リンパ節転移の程度が増すのにしたがって肝転移再発の頻度が増加した.肺転移再発ではリンパ節転移,発生部位,vの順であり,リンパ節転移の程度が増すのにしたがって肺転移再発の頻度が増加した,局所再発では肉眼型,CEA値,環周度の順であった.リンパ節転移再発ではリンパ節転移,大きさの順であり,リンパ節転移の程度が増すのにしたがってリンパ節転移再発の頻度が増加した.腹膜転移再発に強く影響する因子はなかった.以上の結果をふまえ再発形式別の再発予知因子を念頭においた術後の治療計画をたてる必要があると思われた.

No-Carrier-Added186Re was produced using the186W(p,n)186Re nuclear reaction with 13.6 MeV protons on thick targets of 99.79% isotopically enriched186WO3. The theoretical excitation functions for producing186Re, and possible radionuclidic impurities of182Re,183Re, and184Re were calculated using the ALICE code. Cross-sections of the186W(p,n)186Re reaction were measured up to 20 MeV using the stacked target method with thin foils of natural composition tungsten metal. The experimental and theoretical excitation functions were in good agreement. Targetry used at the TIARA cyclotron, and a radiochemical separation scheme for186Re are described.

No-carrier-added tantalum-183 was produced free of radiotantalum impurities by the 186 W(p,α) 183 Ta nuclear reaction using 13.6 MeV protons on thick targets of isotopically enriched 186 WO 3 . The proton energy was optimum for the simultaneous production of 186 Re and 183 Ta. The ALICE code was used to theoretically determine the optimum irradiation conditions for the production of 183 Ta with proton and deuteron nuclear reactions. A Bio-imaging analyser was used to illustrate the migration of 183 Ta species into a grass plant ( Cyperus microiria steud). 183 Ta has potential applications as a tracer for ecotoxicity studies, and for developmental studies for radiotantalum pharmaceuticals.

We report herein a case of malignant Schwannoma of the stomach in a 42-year-old man complaining of anal bleeding who was diagnosed accurately preoperatively by fiberoptic examination. Histopathological examination of the biopsy specimen revealed that the tumor was consisted of bundles of spindle-shaped cells with frequent mitotic figures arranged in palisading pattern. Furthermore, positivity for vimentin and S-100 protein was confirmed immunohistologically. In spite of curative total gastrectomy, liver metastases developed 10 months after the operation. Because of the lack of diagnostic criteria and prognostic indicators, there remain differences in opinions about standard operation for this disease. Metastases were almost always due to hematogeneous in a review of the literature, and lymphogeneous metastases and peritoneal dissemination were seldomly observed. Therefore, adequate removal of the tumor without extensive regional lymph node dissection can be regarded sufficient treatment of the tumor.

Formation cross sections of 95m Tc and 95g Tc via the 95 Mo (p, n) reaction have been measured to evaluate the production yield of 95m Tc which is expected to be a useful radiotracer of technetium isotopes. It was found from the cross section data that for incident proton energies above 15 MeV, the thick-target yield of 95m Tc was more than 20 μCi/μAh at the end of bombardment and the 95g Tc contamination was less than 1% after 12 d cooling. To examine the separation and purification of 95m Tc from target, we have carried out a test production of 95m Tc using a thick 95 Mo-enriched target. Other reactions of producing 95m Tc are compared and discussed in terms of the production yield and amounts of contaminants.

Objective We determined whether hepatic intra-arterial infusion of 5-fluorouracil (5-FU) in patients with synchronous hepatic metastases from colorectal cancer, in whom the primary lesion was resectable but hepatic metastatic lesions were non-resectable helped improve survival time when administered on the basis of the results of the anticancer drug sensitivity test. Patients and methods The study population consisted of 29 patients with synchronous hepatic metastases from colorectal cancer who underwent surgical resection of the primary lesion alone. Of these 29 patients, 21 received hepatic intra-arterial infusion of 5-FU postoperatively after the 5-FU sensitivity test. The remaining 8 patients underwent surgical resection of the primary lesion but neither sensitivity testing nor hepatic intra-arterial chemotherapy. Tissue fragments were cultured, with each concentration of 5-FU in the thermoreversible gelation polymer forming a three-dimensional structure at 37°C. The viability of tumor cells was evaluated according to WST methods; inhibitory concentration of 50% (IC50) values were calculated. We considered cancer tissue to be sensitive to IC50 values that were below twice the peak plasma concentration (120 μg/ml). Results Of the 21 patients, 10 had sensitivity to 5-FU and 11 had no sensitivity. The response rates were 90.0% and 9.1%, respectively. The median survival times were 38 months and 10 months in these groups, respectively, and 7 months in patients who received no chemotherapy. This finding indicates a significantly longer survival time in the sensitive group, compared with either the insensitive group or the no chemotherapy group (P = .0014 P = .0023). The cumulative survival rate was significantly higher in the sensitive group compared with the insensitive group (P = .0001) Conclusions Ultimately, the group with sensitivity to 5-FU showed a significantly longer median survival time than the insensitive group.

The purpose of this study is to utilize the thermo-reversible gelation polymer in which the sol-gel transitting phase is reversibly changed by temperature in a three-dimensional culture system. Human cancer cells have been observed to form multicellular spheroids, whereas fibroblasts slowly develop into small spheroids with the culture medium including this polymer. This polymer has some advantages for use as a culture material, as follows: first, cancer cells grow three-dimensionally in the aqueous solution of this polymer; second, it is easy to harvest cells or spheroids in the aqueous solution of this polymer by simply cooling down the temperature; and third, the culture medium including this polymer is so translucent that the cells or spheroids can be observed through a phase-contrast microscope. We thus conclude that this polymer is a very useful material for three-dimensional cultures.

PURPOSE: It frequently is observed that widely varying prognoses are given for patients with the same extent of liver metastases from colorectal cancer, even though the same treatment is performed on these patients. One of the reasons for this variance is that prognostic factors for these patients have not been defined. This study was designed to elucidate which clinicopathologic factors were the most important in the prognosis of 73 patients with unresectable synchronous liver metastasis from colorectal cancer. METHODS: Univariate and multivariate analysis of 11 clinicopathologic factors were performed using the Cox proportional hazard model. Survival curves were generated using the Kaplan-Meier method. RESULTS: Extent of liver metastases was the most significant variable in this survival analysis, although the extent of lymph node metastases of the primary lesion also was significant. However, the method of treatment was not a significant determinant in the survival for patients with unresectable liver metastases. Median survival of patients with H1, H2, and H3 was 13, 12, and 6 months, respectively, and there was a significant difference between survival curves for patients with H1 and patients with H3. Median survival of patients with n0, n1 and n2 was 13, 7, and 7 months respectively, and there was a significant difference between survival curves for patients with n0 and patients with n2. Median survival of 6 patients with H1 and n0 and of 17 patients with H3 and n2 was 28 and 4 months, respectively. There was a significant difference in survival curves between these two groups. CONCLUSION: Longevity of patients with unresectable synchronous liver metastases from colorectal cancer is affected adversely by the presence of nodal metastases and extent of liver metastases. This should be considered in the planning treatment.

The transport of l8F-water introduced into irradiated plants was followed dynamically by the detection of annihilation γ -rays from a positron emitter using a “Positron-Emitting Tracer Imaging System”. Tracer activities at the vein of top leaf of unirradiated soybean (Glysine max) were observed in a short time, whereas those in plants irradiated with a doses up to 100 Gy were delayed with increase in dose. In the case of rose (Rosa sp. Rote Rose), radiation using a dose of 800 Gy for disinfestation as a quarantine procedure inhibited flowering. Uptake and transport of 18F-water through the cut stem was changed significantly by irradiation. These results show that the system is effective in observing the damage of irradiated plants and is useful for the study of physiological functions of plants.