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The clinicopathologic variables including mode of infiltrative growth were investigated by multivariate analysis using quantification theory II to evaluate multivariately their effects on the hepatic metastasis and to discriminate liver metastasis after curative resection for advanced colorectal cancer. Subject were 194 patients with advanced colorectal who had hepatic metastasis (107 synchronous and 87 metachronous) and 261 patients with the disease who were free from any recurrence for more than 5 years. The factor with the greatest influence was lymph node metastasis followed by the depth of invasion. Mode of infiltrative growth was though to be one of the useful indicators of hepatic metastasis after curative resection of colorectal cancer. Discrimination of hepatic metastasis was achieved with 75.2% success rate in the cases of Dukes B and Dukes C after curative resection. Discriminative analysis using quantification theory II was thought to be useful for the prediction of liver metastasis after curative resection for colorectal cancer.

転移性肝癌症例で,血清中および大腸癌部,転移性肝癌部のTNF-α, IL-1β, IL-2, IL-6, GM-CSFを測定し,転移性肝癌患者のサイトカイン動態を検討した.術前の血清中各サイトカインは健常人と比較し高値を示した.さらに,切除した組織中の各サイトカインを測定したところ,転移性肝癌部ではTNF-α, GM-CSFが高値を,非癌肝組織部ではIL-2, IL-6が高値を示した.また大腸癌原発巣の癌部でもTNF-α,GM-CSFが高値を,非癌部粘膜ではIL-1β,IL-2,IL-6が高値を示した.さらに当科で樹立した5つの転移性肝癌細胞株の培養上清中でTNF-α, IL-6, GM-CSFが高値を示した.以上よりこれらのサイトカイン特にTHF-α, GM-CSFが腫瘍の増殖に強くかわっており,またIL-2,IL-6が発癌とともに産生されてくることが示唆され,癌の発生,転移の診断に血清中のこれらのサイトカインの測定が有用と思われた.

大腸癌肝転移切除例52例を対象として,切除成績について検討した.肝切除後の1年生存率は77.9%,3年生存率は51.0%,5年生存率は39.7%であった.肝切除後の予後に影響を与える因子としては,原発巣の所見では転移陽性リンパ節数で,2つ以下の症例と3つ以上の症例では,2つ以下の症例の予後が良好であった.肝転移巣の所見では,同時性の肝転移が異時性より予後不良の傾向を認めたが,転移個数,H因子の程度別では差を認めなかった。肝切除方法を小範囲切除,広範囲切除,複数肝切除の3方法に分けて検討したが,3者間の予後に有意差はなかった.術後に動注化学療法を行った症例と行わなかった症例の生存率の検討では,施行症例の予後が有意に良かった.最近の動注化学療法の成績を考慮すると,同時性肝転移の治療にあたっては,原発巣の切除とともにできる範囲での肝切除術を行い,術後早期から動注化学療法を行うことが良好な結果をもたらすのではないかと思われた.

Hepatocyte growth factor (HGF) has been shown to have hepatotrophic and renotropic functions for regeneration of the liver and kidney through its mitogenic, motogenic, and morphogenic properties. To examine the involvement of HGF in lung regeneration after acute injury, we analyzed changes of HGF mRNA, HGF activity, and HGF receptors in the rat lung after lung insult and measured HGF concentration in sera of patients with various lung diseases. Following the onset of acute lung injury induced by intratracheal hydrochloride injection, a compensatory DNA synthesis occurred in the bronchial epithelium with a peak at 24 h and in the alveolar epithelium with a peak at 48 h. Expression of HGF mRNA in the rat lung remarkably increased only 3 h after the treatment and HGF activity in the lung also increased to about 3-fold at 6 h later. HGF receptors in the lung but not in the other noninjured organs were down-regulated 12 h later. These marked increases in HGF mRNA and HGF activity and the concomitant down-regulation of HGF receptor occurred before the marked compensatory DNA synthesis in bronchial and alveolar epithelial cells. HGF concentration in sera of patients with various lung diseases, as measured by radioimmunoassay, was much higher than that in healthy donors. These results suggest that HGF is newly produced in the lung after acute lung injury and may have a role in regeneration of the lung.

大腸癌67例につき同一腫瘍内の異なる5つの部位の核DNA量をflow cytometryにて測定し,DNA heterogeneityの頻度,臨床病理学的所見との関係につき検討した.部位によりploidy patternに違いがみられたのが16例,すべてaneuploidyであるがDNA indexの異なる細胞集団がみられたのが11例で,計27例(40.3%)にheterogeneityが認められた.heterogenityの有無と腫瘍の部位,大きさ,深達度,リンパ管侵襲,リンパ節転移の有無,stageとは相関がみられなかったが,中分化腺癌,静脈侵襲陽性例,肝転移例はheterogeneityを有した症例の方が有意に多かった.また深達度s(a2)以上,肝転移例,stage III以上の進行例はaneuploidyのみでheterogeneityのみられた症例でその頻度が最も高かった.つぎに,生検組織と手術摘出標本とのDNA indexの値を比較したところ,全体では良好な相関が得られたが,heterogereityを有する症例では相関はみられなかった.

In patients with gastric cancer undergoing initial operation, the correlation between the albumin level as the index for preoperative nutritional state and the non-specific immunity was studied in consideration of the degree of advancement. The subjects were 69 cases operated on from February 1985 till December 1988, and the albumin level and 12 non-specific immunity parameters were measured before operation. There were multiple correlations between the preoperative albumin level and non-specific immunity parameters, and the correlation coefficient was as high as 0.8237 in the patient group in stage III+IV. PHA·ConA lymphocyte blastogenetic reaction in the stage I+II group and the WBC·PPD intradermal reaction in the stage III+IV group were highly contributing parameters. That is, in the stage I+II group, it was found that the function of PHA was more contributable than the number of helper T-cells, and the function of Con A did than the number of suppressor T-cells, to the preoperative albumin level. While in the stage III+IV group, the contribution of the entire cellular immunity was great. Improvement of nutritional state and the preoperative immunotherapy are expected to be of help to the surgical therapeutics.

大腸癌114例(治癒切除79例,非治癒切除35例)の切除標本パラフィン包埋ブロックより切片を作製し,抗ras p21モノクロナール抗体を用いて免疫組織学的にABC法で染色し,ras p21の発現と病理学的所見ならびに予後との関係について検討した.ras p21の陽性率は51.8%(59/114)であった.腫瘍径,静脈侵襲の有無組織型ではras p21の陽性率との関に一定の関係はみられなかったが,リンパ節転移例,リンパ管侵襲を認めた症例では,ras p21の陽性率は有意に高かった.また壁深達度,進行度が進んだもの程陽性例が多くなる傾向がみられた.術後3年間の再発率はras p21陽性群に高く,統計学的に有意な差は認められなかったが,ras p21陰性群のほうがras p21陽性群より高い生存率を示し,ras p21の発現と大腸癌の臨床的予後との関連が示唆された.

直腸癌術後局所再発の因子として,従来より壁深達度,リンパ節転移,外科的剥離面,脈管侵襲などがあげられていたが,外科的剥離面に関係していると考えられる神経浸潤が局所再発に強く関係していた,1979年から1988年までに治癒切除となった直腸癌155例を臨床病理学的に再検討した結果,局所再発は16例(10.3%)に見られた,検討因子として性別,年齢,占居部位,肉眼型,治癒切除,術式,組織学的壁深達度,リンパ節転移,Dukes分類,脈管侵襲,組織型,ew,神経浸潤を挙げ,その各因子と局所再発の関係を統計学的に検討した.性別,年齢,占居部位,肉眼型,治癒切除,術式,組織型は統計学的には局所再発に関係がなかった.組織学的壁深達度ではpm・alss群とa2s・alsi群の間に有意差(p

Atomic Layer Deposition (ALD) of Hf and Zr oxide films is of considerable interest and promise for future generation Metal-lnsulator-Metal (MIM) structures in memory applications. Hafnium and zirconium alkylamides such as tetrakis(ethylmethylamino) hafnium (TEMAH) and tetrakis (ethylmethylamino) zirconium (TEMAZ) are the most considered precursors. However, their relatively low thermal stability might become a drawback under heated distribution conditions that could result in vaporizer clogging or insufficient long-term stability. Moreover, these precursors may not be suitable if higher deposition temperature processes are sought. Alternative ALD precursors with improved thermal stability could be viable alternatives. Among the precursor families that could be considered (halides, alkoxides, beta-diketonates, tetranitrates, etc.), metallocenes are particularly attractive. New hafnocenes - dimethyl bis(ethylcyclopentadienyl) hafnium, Hf(EtCp)2Me2, and dimethyl bis(methylcyclopentadienyl) hafnium, Hf(MeCp)2Me2 - with improved physical properties and thermal stability are studied here. The thermal behavior of these new precursors has been extensively characterized for vapor pressure, thermal stability, and evaporation kinetics. The ALD behavior of Hf(EtCp)2Me2 with Cfe as co- reactant was investigated at high temperature (350- 400degC), an ALD deposition rate of 0.72 A/cycle was achieved. Hf(EtCp)2Me2 showed the best compromise between thermal stability, physical properties, and deposition behavior. Similar zirconocenes were also studied: ZrCp2Me2, Zr(MeCp)2Me2, Zr(EtCp)2Me2 and Zr(EtCp)(NMe2)3.

The embryo transfer technique and cephalometry were used to investigate the effect of dam strain in intrauterine craniofacial growth and the severity of cleft lip and palate (CLP) in a CLP-susceptible CL/Fr strain of embryos. The CL/Fr strain of embryos at early blastocyst stage was transferred to the same dam strain and to the CLP-resistant C57BL dam strain. On the 18th gestational day, each dam was laparotomized to take out the fetuses. The spontaneous incidence of CLP in the fetuses was checked and a cephalometric observation of the craniofacial complex of each fetus was done just after laparotomy. The dorsoventral craniofacial size of the unaffected fetuses and the severity of CLP i the affected ones were compared between both dam strains. The following results were obtained: 1) The overall craniofacial sizes of the unaffected fetuses observed in the CL/Fr dam strain were significantly smaller than those seen in the C57/BL dam strain. Those of the affected fetuses observed in the CL/Fr dam strain were smaller than those seen in the C57BL dam strain although the interstrain difference was not significant. 20 The dam strain had a highly significant effect on the craniofacial size of the unaffected fetuses. 3) The CLP frequency in the CL/Fr dam strain was significantly higher than that in the C57BL dam strain. 4) The severity of CLP in the affected fetuses observed in the CL/Fr dam strain was significantly more serious than that seen in the C57BL dam strain. These results indicated that the CLP-susceptible CL/Fr dam strain retarded the intrauterine craniofacial growth of the fetuses and that the cleft condition in the affected fetuses observed in the CL/Fr dam strain was more seriously affected than that seen in the CLP-resistant C57BL dam strain. Thus, it can be concluded that the effect of the dam strain played an important role in the craniofacial morphogenesis of the CL/Fr strain of mouse fetuses that developed from the embryo transferred to the CL/Fr and C57BL dam strains along with the genotype of embryos.

We studied p53 expression in 46 colorectal carcinomas by immunohistochemistry. We examined the relationship between p53 expression and the pathological findings, the prognosis and tumor proliferative activity by Ki-67 staining or DNA ploidy pattern using an image cytometer. Expression of p53 was observed in 41.3% of carcinomas. No correlation was found between p53 expression and the depth of invasion, lymph node metastasis or Dukes' stage. No difference in survival was found between p53 positive and negative patients after curative surgery. We also studied the DNA ploidy pattern using an image cytometer in 28 carcinomas. Aneuploidy was found more frequently in the p53 positive areas than in the negative ones, but there was no significant difference. The DNA index showed no difference between the p53 positive and negative areas. We examined proliferating activity using Ki-67. There was no difference in the Ki-67 labeling index between p53 positive and negative areas. In the present study, there was no correlation between p53 expression and pathological findings, prognosis, tumor proliferative activity using Ki-67 staining or DNA ploidy pattern. Thus, p53 expression was suggested to have little relationship to grade of malignancy.

We studied the relationship between intratumoral DNA heterogeneity and clinicopathological findings in 85 colorectal cancers. DNA ploidy was analyzed in 5 specimens from different sites of each tumor. When the difference in the DNA index (D.I) between several peaks in the same tumor was more than 0.1, the tumor was considered to consist of heterogeneous subpopulations with different DNA clones. DNA heterogeneity was found in 34 cases (40.0%). There was no relationship between DNA heterogeneity and depth of tumor invasion, lymph node metastasis or stage. The incidence of heterogeneity was significantly higher in the tumor with lower differentiation, liver metastasis or vessel invasion.

Hepatocyte growth factor (HGF) has been shown to have hepatotrophic and renotropic functions for regeneration of the liver and kidney through its mitogenic, motogenic, and morphogenic properties. To examine the involvement of HGF in lung regeneration after acute injury, we analyzed changes of HGF mRNA, HGF activity, and HGF receptors in the rat lung after lung insult and measured HGF concentration in sera of patients with various lung diseases. Following the onset of acute lung injury induced by intratracheal hydrochloride injection, a compensatory DNA synthesis occurred in the bronchial epithelium with a peak at 24 h and in the alveolar epithelium with a peak at 48 h. Expression of HGF mRNA in the rat lung remarkably increased only 3 h after the treatment and HGF activity in the lung also increased to about 3-fold at 6 h later. HGF receptors in the lung but not in the other noninjured organs were down-regulated 12 h later. These marked increases in HGF mRNA and HGF activity and the concomitant down-regulation of HGF receptor occurred before the marked compensatory DNA synthesis in bronchial and alveolar epithelial cells. HGF concentration in sera of patients with various lung diseases, as measured by radioimmunoassay, was much higher than that in healthy donors. These results suggest that HGF is newly produced in the lung after acute lung injury and may have a role in regeneration of the lung.

To examine the degree of the relative contribution of genetic and environmental effects to preimplantation development of mouse embryo in vitro, two-cell stage embryos collected from oviducts of five strains of inbred mice (DDD/Qdj, C3H/Qdj, C57BL/6J Sea, DBA/1J Sea, and BALB/C Sea) were cultivated up to the stage of expanded blastocyst for 72 hr. Both fertility and survival rates were calculated in each recipient and also in each strain. A Student-Newman-Keuls test for both rates showed a significant inter-strain difference and an analysis of variance done to estimate the relative importance of genetic and environmental effects on the preimplantation development of embryo showed a low degree of genetic determination for both rates. It was thus possible to conclude that the environmental effect played a more important role on preimplantation development of mouse embryo in vitro.

Embryo transfer effect and intrauterine effect of the dam on prenatal development of the craniofacial complex of mice embryos were investigated with the use of embryo transfer and cephalostat. DDD strain embryos were transferred to the three strains of recipients (DDD, C57BL, and DBA). The cephalometric observation of newborn offspring developed from transferred embryos was performed just after parturition. Dorso-ventral craniofacial size of newborn offspring was calculated using values of X- and Y-coordinates on a dorsoventral cephalogram. Statistical analysis showed that a significant intergroup difference in craniofacial size between transferred and nontransferred groups as well as a significant inter-strain difference among those of the three strains of recipients were observed. Thus, it was disclosed that embryo transfer technique might retard the prenatal development of craniofacial complex of transferred embryo and that the three strains of recipients contributed unequally to the prenatal development of craniofacial complex of transferred embryo through each of their intrauterine environments as a prenatal maternal effect. These results indicated that the intrauterine environment of the recipient played an important role in the prenatal development of the craniofacial complex of the mice embryo.

Hepatectomy has been performed as a treatment for hepatocellular carcinoma (HCC) and metastatic liver carcinoma. The prognosis has improved, but it is not sufficient. In our department hepatic arterial infusion chemotherapy using subcutaneous implanted reservoir has been undertaken in 21 of 66 patients who underwent hepatectomy in hepatocellular carcinoma and 13 of 30 in liver metastasis of colorectal carcinoma since 1986. There was no significant difference between the group with and without arterial infusion chemotherapy in HCC but there was a significant difference in metastasis of colorectal carcinoma. In unresectable cases, intra-arterial chemotherapy was undertaken, but there was no significant difference. On the other hand, 26 of 58 cases receiving arterial infusion chemotherapy have shown complications.

The craniofacial growth of F1 male offspring produced by a complete diallel cross of five strains of rats was observed with the use of cephalometry. Factor analysis was applied to several dimensions of dorsoventral and lateral cephalograms to assess the integration of the craniofacial complex with growth. The first three factors were chosen in each cephalogram, resulting in an explanation of 50.7% and 59.3% of the variation in the dorsoventral and lateral cephalograms, respectively, on an average throughout the period of the experiment, and disclosing that Factor I was associated most closely with the change in the craniofacial growth of rats. A further genetic analysis of the factor scores of each offspring lead to the conclusion that the growth changes of craniofacial width and length were more strongly influenced by the genetic effects; while those of upper jaw, nasal cavity, and pharyngeal part were more strongly influenced by the environmental effects.

Preliminary observations indicated that the scanning electron microscope was useful to compare the mucosal surface appearances of the normal large intestine with ulcerative colitis.The samples observed in this series were 22 resected specimen of normal large intestine, 2 resected specimen and 7 biopsied specimen of ulcerative colitis patients.The excised samples were washed with saline solution and fixed with 4% formaldehyde and 1.2% glutaraldehyde. Then they were cut by razor, and dehydrated by 30-100% alcohol using critical point drying method.Following above treatment, deposition of the cabon and gold was performed.Observation of the samples was performed with Hitachi H.H.S.-2R, M.S.M.-400, and S.-500.Regular crypts, tall villis, regular furrows and microvillis were observed on the surface of the normal large intestine.In chronic ulcerative colitis, irregular crypts, short villis, short and irregular microvillis and abundant mucus were observed.

担癌患者の免疫能を示す非特異的な免疫パラメーターは種々の背景因子に影響されるため,単一で評価することは因難である.今回51例の大腸癌(結腸癌:16,直腸癌:35)の手術前後に免疫パラメーターを測定し,進行度別にそれぞれの推移を比較検討した・術前値の比較では進行度に準じて,OKT 8細胞比,OKT 4/0KT 8比,PHA・ConAリンパ球幼若化反応(S.I.値),PPD皮内反応に免疫能の低下を示す値が得られた.手術侵襲の影響は術後2週目にリンパ球数,PHA・ConAリンパ球幼若化反応,PPD皮内反応にみられ,進行度が進むほど低下を示し遷延した。そして治癒切除例では3カ月目に,担癌除去後の回復が得られた.非治癒手術例の主病巣摘出は一時的ながら免疫能の回復を示した.以上,非特異的な免疫能の推移を観察し,それぞれの状態に応じた免疫賦活の必要性を痛感した.少数例ではあるが,術後OK-432の免疫療法を施行し,免疫パラメーターの推移を観察した.

カルチノイド3例, 平滑筋腫2例, 良性リンパ炉胞性ポリープ2例4病変, 血管脂肪腫1例, リンパ管腫2例, 血管腫2例4病変の6疾患12例16病変の内視鏡所見につき検討した.対象例は正常粘膜に覆われた平滑な病変が多く, 結節状の2病変, 径3mmの微小な1病変以外は粘膜下腫瘍の診断は比較的容易であった.血管腫では4病変中青色調が1病変, 暗赤色2病変, カルチノイドは3例中1例は黄色調であった.リンパ管腫はやや灰白色調で, 光沢, 透明感があり, 軟らかくcushion signが認められ, 大きいものでは体位変換により形状の変化がみられた.平滑筋腫, 良性リンパ炉胞性ポリープ, 血管脂肪腫ではその疾患に特有な所見に乏しく, 診断の困難な症例が多いと思われた.充実性の腫瘍は弾性硬で, とくにカルチノイドは硬く感じられた.粘膜下腫瘍の質的診断には肉眼所見だけではなく, 触診所見も重要であると思われた.

患者は20歳男性.腹痛および粘血便を主訴として入院した.入院時所見,入院後の経過検査より,それらの症状は終末回腸のリンパ濾胞増殖症に起因する腸重積によるものと思われた.後日の内視鏡検査にて,脾彎曲部に,表面平滑で光沢,透明感のある腫瘤を認めた.その腫瘤は体位変換圧迫により容易に変形することが内視鏡下に確認された.以上の所見より,粘膜下簍胞とくにリンパ管腫を疑い,内視鏡ポリペクトミーを施行した.摘出腫瘍は,1.2×1.1×0.8cmの嚢胞性リンパ管腫であった.本邦における大腸リンパ管腫の報告例は,自験例も含め42例と少なく,ポリペクトミー施行例はわずか11例のみである。本邦報告例について若干の文献的考察を加え報告した.リンパ管腫の性状を利用して,もっと積極的に内視鏡的ポリペクトミーを施行すべきと思われた.

Inferior mesenteric angiography has been performed before and after intra-arterial injection of noradrenaline (NA) in 15 patients with carcinoma of the colon and rectum.We discussed the usefulness of pharmacoangiography to evaluate the size of mass and tumor growth through the bowel wall.To compare the vascularization of tumor, angiography of resected specimen was also performed. Following NA injection, constriction of inferior mesenteric artery was observed in the majority of our cases.In 5 cases given NA 10 μg or more, marked arterial constriction caused failure of the filling of the tumor and prevented the correct diagnosis. Diagnostic effect of NA 2-5 beg injected in other 7 cases was approximately the same before and after the administration.In other 3 cases 2 to 5 μg of NA improved the diagnostic value to define the delineation and infiltration of the tumor.

消化管ことに大腸に発生したリンパ管腫は稀で, 本邦における報告も46例にすぎない.今回横行結腸に発生したリンパ管腫を経験したので, 本症例を含め本邦報告集計47例について若干の検討を加えて報告する.症例は30歳, 女性で, 下腹部痛を主訴として来院した.入院後諸検査にて横行結腸に発生したリンパ管腫と診断し, 部分切除を施行した.摘出腫瘍は, 3.3×2.4cmのリンパ管腫であった.最近では内視鏡的にポリペクトミーを施行し成功した報告もあり, 今回の検討でその適応は最大径が2cm以下と考えられた.しかし, 2cm以上でも内容の吸引で腫瘍の縮小傾向がみられるものは積極的に内視鏡的ポリペクトミーを試みるべきと思われた.

Malignant melanoma of ano-rectal region is a very rare lesion and its 5-year survival rate is about IO per cent. Two cases of anorectal malignant melanoma are presented in this paper.According to Japanese General Rules for Clinical and Pathological Studies on Cancer of Colon, Rectum and Anus, first case is Rb, Borr. I, 4×3.5×2 cm, a quater of circ., a2, P0, H0, n(+), R3, absolute curative resection and second case is RbP, Borr. I, 10.5×3×5cm, subcirc. pm, P0, H0, ly1, v2, n(-), R3, absolute curative resection.First case was treated by adjuvant chemotherapy with METT inj. (MMC, Endoxan, Toyomycin, Tespanon).Second case has been treated by immunotherapy with Levamisole and BCG and some recurrence leions were treated with cryosurgery. Both cases survived only 8 months after radical operation.Complete resection with lymphadenectomy and adjuvant-therapy should be carried out in principle because of its high malignaucy.Cryo-immun otherapy is one whon wed of many methodon adjugant immuno-therapy and some benefit may be expected in the treatment for ano-rectal malignant melanoma.

81例の胃癌手術前後に非特異的免疫能を観察し, それぞれの状況下でどの指標が免疫能を反映し, いかに推移するかを検討した.術前に進行の程度を示す指標はリンパ球数とPPD皮内反応であった. 手術侵襲の免疫能への影響と担癌除去後の回復を示す指標は, 前者でリンパ球数, PPD皮内反応, OKT3, 4細胞比, OKT4/OKT8比が, 後者でLeu7, 11細胞比, PHA・ConAリンパ球幼若化反応がそれらを示した.非治癒切除となった症例の術後にはリンパ球数, OKT3細胞比, IgG-FcR (+) T細胞比に, 非切除手術例ではリンパ球数, OKT8細胞比, OKT4/OKT8比に免疫能の低下が認められた. 以上の指標はそれぞれでの免疫能を示しており, 補助療法施行時にも有用となる.

The double blind studies of bromelain for 161 patients following surgical or crvosurgical hemorrhoidectomy were performed.Every patient was apllied bromelain or placebo tablets orally, every two tablets, three times daily and seven-days duration.Scoring number for the postoperative focal inflammatory symptoms (1. swelling, 2. pain, 3. secretion and 4. bleeding) of every patient was recorded and finally all records were col-lected and analyzed.1. Statistical differences were recognized as follows:a) Ligation and excision group : 7 th day's secretion score, 10 th day's secretion score, loth day's total score, and case-ratio of pain from 1 st to 3rd day changeb) Cryosurgery group : 3rd day's bleeding score, and score-ratio of bleeding from 3 rd to 5th day change2. Moderate, but not statistical differences were noticed as follows:a) Ligation and excision group : 10th day's pain score, secretion total score, and 7th day's total scoreb) Cryosurgery group : score-ratio of pain from 3rd to 5th day change, and score-ratio of scretion from 1st to 3rd changeAs above results, it is thought that apllication of bromelain tablets for surgical hemor-rhoidectomy patients is favorable.Suitability of post-hemorrhoidectomy patients for bromelain double blind studies and reasonable selection of parameters were discussed.

Microscopic and Electron Microscopic changes in cells and tissue after freezing and thawing were studied." Cryonecrosis " is not apparent immediately after freezing and thawing macropically but within a few minutes the affected tissue reacts as if to any thermal insult with signs of inflammation and extravation of blood cells and lymphocytes. Shortly thereafter, intra-capillary thrombosis occurs.Cryotherapy is painless and promotes hemostasis. These additional advantage give greater support for its clinical use in treatment of bulky tumors of the anorectum for pallia-tion, and far the investigation of tumor antibody formation.