Gastric Colon Research Articles

Whole-body 18F-fluorodeoxyglucose positron emission tomography/computed tomography images before and after chemotherapy for Kaposi sarcoma and highly active antiretrovirus therapy

Kaposi sarcoma is an acquired immunodeficiency syndrome-related disease that mainly involves the skin, gastrointestinal gut, and lungs. Whole-body 18F-fluorodeoxyglucose-positron emission tomography and computed tomography (FDG-PET/CT) scanning is useful for simultaneous detection of multiple lesions of Kaposi sarcoma. We present a 67-year-old man with a history of infection with human immunodeficiency virus who presented with numerous cutaneous lesions. FDG-PET/CT images showed lesions in the skin, lung, and lymph nodes. The gastrointestinal lesions were detected using gastric fiberscopy (GF) and colon fiberscopy (CF). After Kaposi sarcoma therapy, the uptake in the lesions of the skin, lung, and lymph nodes decreased, but new lesions were detected in the pancreas and lumbar spine. He had pancreatitis and Candida spondilitis. Whole-body FDG-PET/CT is useful for detecting lesions and determining the extension to which the disease has spread, adding the gastrointestinal lesions by GF and CF. After therapy, FDG-PET/CT can be used to demonstrate which lesions remain active and to determine the overall response to treatment. In this case, we show how useful FDG-PET/CT is and how difficult it is to treat Kaposi sarcoma.

Stem cells and colon cancer: The questionable cancer stem cell hypothesis

The fine-tuning between cell proliferation and differentiation of self-renewing stem cells and pluripotent progenitors in gastric glands and colon epithelial crypts is coordinated by the mechanisms that regulate colon epithelial cell migration and guidance along the crypt axis. This leads to the acquisition of specialized cellular functions and the exfoliation of desquamated senescent and apoptotic epithelial cells at the apical mucosa interface with the gut lumen. Self-renewing stem cells and pluripotent progenitors are involved in the clonal and polyclonal growth of digestive tumors. Several lines of evidence support the existence of a subpopulation of cancer cells with stem cell-like (SCL) phenotypes in solid tumors of breast and digestive system. Consistently, epithelial cancer cell lines in long-term culture are phenotypically and functionally heterogeneous. It is suggested that only a small proportion of transformed cells are clonogenic in vivo and ex vivo to form colonies and to initiate tumor growth in immunodeficient mice. A discrete subpopulation of tumor -initiating SCL cancer cells are highly competent to survive, propagate and spread through the invasive and metastatic cascade. A better understanding of the mechanisms driving the plasticity and pluripotency of stem cells, their derived progenitors and SCL colon cancer initiating cells during tumor progression will open new avenues for the early detection and treatment of local and distant tumors of the digestive tract.

Simultaneous Laparoscopy-assisted Distal Gastrectomy and Right Hemicolectomy for Synchronous Advanced Gastric and Colon Cancer

Concurrent laparoscopic surgery for the synchronous gastric and colon cancer in one patient is not only a rare procedure, but also has some demerits such as longer operation time, more blood loss, and the use of additional laparoscopic ports. Moreover, laparoscopy-assisted distal gastrectomy with extraperigastric lymph node dissection is still controversial in the case of advanced gastric cancer. We report the successful laparoscopic surgery of a 78-year-old patient with synchronous advanced gastric and right colon cancers. The laparoscopy-assisted distal gastrectomy with extraperigastric lymph node dissection followed by right hemicolectomy through 7 ports was carried out. All procedures were successfully performed without complications and the patient has had no evidence of recurrence for 33 months after the operation. Synchronous neoplasms that are distantly located from one another could be treated using minimally invasive technique, which may sufficiently relieve patients' postoperative distress in selected cases.

Abstract 1295: Inhibition of platelet derived growth factor receptor tyrosine kinase reduces lymphangiogenesis of human gastrointestinal cancer

Abstract Objective: Vascular endothelial growth factor (VEGF)-C/D induces lymphangiogenesis by activating VEGF receptor (VEGFR)-3, which is expressed on lymphatic endothelial cells. Platelet derived growth factor receptor (PDGF-R) has also been detected on lymphatic endothelial cells and PDGF-BB acts as a lymphangiogenic factor in murine fibrosarcoma. We have previously reported that PDGF-R is expressed by lymphatic endothelial cells in human gastric cancer and its expression levels in tumor tissue correlate with lymph node metastasis. In this study, we examined whether inhibition of PDGF-R tyrosine kinase signaling by imatinib affects lymphangiogenesis and lymph node metastasis of human gastrointestinal cancer cells growing in the orthotopic site of nude mice. Methods: TMK-1 human gastric cancer cells or KM12SM human colon cancer cells were injected into the orthotopic site of nude mice. Groups of mice (n=10) received saline (control), imatinib, the cancer chemotherapeutic irinotecan, or a combination of imatinib and irinotecan. The lymphatic vessels were then stained with antibodies against Lyve 1. Results: Lymphatic endothelial cells as well as activated fibroblasts in the tumor stroma express PDGF-R. Four weeks of treatment with imatinib and irinotecan significantly inhibited lymph node metastasis (relative to control or single-agent therapy). Imatinib alone or in combination with irinotecan significantly decreased number and area of lymphatic vessels in the tumor stroma. Conclusion: Administration of a PDGF-R tyrosine kinase inhibitor in combination with irinotecan inhibits the lymph node metastasis of orthotopically implanted gastrointestinal cancer cells in nude mice by blocking PDGF-R signaling in tumor-associated lymphatic endothelial cells. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 1295.

Screening and Identification of Recombinant Anti-Idiotype Antibodies against Gastric Cancer and Colon Cancer Monoclonal Antibodies by a Phage-Displayed Single-Chain Variable Fragment Library

Several monoclonal antibodies (McAbs) have been developed that show high sensitivity and specificity to gastric cancer and colorectal cancer. However, few of the antigens recognized by these antibodies have been identified. The authors now report the selection of anti-idiotype (anti-id) antibodies of MGb1 McAb against gastric cancer and MC5 McAb against colorectal cancer using phage-displayed single-chain variable fragment (ScFv) libraries. After purification, the anti-id antibodies were approximately 30 kd and could be recognized by MGb1/MC5 McAb. Anti-id antibodies significantly blocked the binding of MGb1 and MC5 to gastric cancer/colorectal cancer cells, respectively, suggesting that the antibodies were specific to MGb1 and MC5. Antibodies against gastric and colorectal cancer could be detected in mice at 6 weeks after immunization with the anti-id antibodies. At week 8, antibody titers reached 1:400. The anti-id antibodies may be useful as novel reagents for developing vaccines against gastric cancer and colorectal cancer.

The Prevalence of Colorectal Neoplasia in Patients With Gastric Cancer

The goal of this study was to determine the prevalence of colorectal neoplasia, using colonoscopy surveillance, in a cohort of patients with gastric cancers. The association between gastric cancer and colorectal cancer has been conflicting. A total of 543 patients (males, 362; females, 181) with gastric cancer were matched with 2 persons from the population without a diagnosis of gastric cancer as confirmed by endoscopy according to age (+/-2 y), sex, date of colonoscopy examination (+/-2 wk), and endoscopist. Main Outcome was the prevalence of colorectal neoplasia diagnosed by colonoscopy. A significantly higher colorectal cancer prevalence was found in the gastric cancer group, that is, 19 of 543 (3.5%) versus 14 of 1086 (1.3%; P<0.001). The odds of developing colorectal cancer were higher in the presence of gastric cancer (odds ratios, 3.46; 95% confidence interval: 1.51-7.91). Four of the 119 (3.4%) gastric cancer patients below 50 years of age had colorectal cancer in contrast with no cases in the matched controls. The prevalence of colorectal adenoma was higher in the gastric cancer group, with a prevalence of 215 in 543 (39.6%) versus 311 in 1086 (28.6%; P<0.001). The risk of adenoma was also greater among gastric cancer patients (odds ratios, 1.76; 95% confidence interval: 1.34-2.25). Our data reveal a higher prevalence and risk of colorectal cancer in patients diagnosed with gastric cancer, particularly in patients below 50 years of age. Additional studies are needed to explore the geographical differences in the association between gastric cancer and colon cancer.

S-Adenosylmethionine Inhibits the Growth of Cancer Cells by Reversing the Hypomethylation Status of c-myc and H-ras in Human Gastric Cancer and Colon Cancer

A global DNA hypomethylation might activate oncogene transcription, thus promoting carcinogenesis and tumor development. S-Adenosylmethionine (SAM) serves as a major methyl donor in biological transmethylation events. The object of this study is to explore the influence of SAM on the status of methylation at the promoter of the oncogenes c-myc, H-ras and tumor-suppressor gene p16 (INK4a), as well as its inhibitory effect on cancer cells. The results indicated that SAM treatment inhibited cell growth in gastric cancer cells and colon cancer cells, and the inhibition efficiency was significantly higher than that in the normal cells. Under standard growth conditions, C-myc and H-ras promoters were hypomethylated in gastric cancer cells and colon cancer cells. SAM treatment resulted in a heavy methylation of these promoters, which consequently downregulated mRNA and protein levels. In contrast, there was no significant difference in mRNA and protein levels of p16 (INK4a) with and without SAM treatment. SAM can effectively inhibit the tumor cells growth by reversing the DNA hypomethylation on promoters of oncogenes, thus down-regulating their expression. With no influence on the expression of the tumor suppressor genes, such as P16, SAM could be used as a potential drug for cancer therapy.

Prognosis of cancer with branch duct type IPMN of the pancreas

To examine the coexistence of metachronous and synchronous cancer in branch duct intraductal papillary mucinous neoplasms of the pancreas (IPMN). We reviewed the records of 145 patients with branch duct IPMN between January 1991 and April 2008 and assessed the relationship between IPMN and intra- or extra-pancreatic carcinoma and the outcome of IPMN. The mean observation period was 55.9 +/- 45.3 mo. Among the 145 patients, the frequency of extra-pancreatic cancer was 29.0%. The frequency of gastric cancer, colon cancer, breast cancer, and pancreatic cancer were 25.5%, 15.7%, 13.7%, and 9.8%, respectively. Twenty (13.8%) of the patients died. The cause of death was extra-pancreatic carcinoma in 40%, pancreatic cancer in 25%, IPMN per se in 20%, and benign disease in 15% of the patients. The prognosis for IPMN depends not on the IPMN per se, but on the presence of intra- or extra-pancreatic cancer.

A Case of Thyroid Amyloidosis Misrecognized as Subacute Thyroiditis

Amyloid deposition in the thyroid is found in about 30-80% of the patients with primary or secondary amyloidosis. In a few patients with amyloidosis, the thyroid is enlarged and so called amyloid goiter occurs. The thyroid function usually remains normal, but occasionally hypothyroidism or thyrotoxicosis occurs in patients with thyroid amyloidosis. We have experienced one case of thyroid amyloidosis due to bronchiectasis and the patient developed painful goiter and transient thyrotoxicosis resembling subacute thyroiditis. Biopsies from the gastric antrum, duodenum, colon, kidney and thyroid were positive for deposition of amyloid. When patients have signs and symptoms of subacute thyroiditis, but they develop an unusual course, then the diagnosis of thyroid amyloidosis should be considered.

건조 마늘, 홍삼 및 이들 혼합물의 생리활성

Water extracts were extracted on water bath for 3 hrs at 90℃ after 5 times water was added to hot-air dried garlic (DG) and red ginseng (RG), respectively. Its extracts were dried on rotary evaporator, and then the mixture samples were prepared from RG extracts added to DG extracts at 5, 10, and 15%. To test biological activities such as DPPH, nitrite scavenging, tyrosinase, α-glucosidase, human gastric (AGS), and human colon cancer cell (HT-29) growth, dryness of DG, RG, and mixture samples were diluted 500～10,000 ㎍/mL adding deionized water, respectively. DPPH scavenging activities of mixture sample were slightly higher than DG and RG sample alone. Nitrite scavenging activity was the highest in DG, and the other samples were below 45%. Inhibition activity of tyrosinase was below 35.0% in tested all samples. Inhibition activity of α-glucosidase was lower in DG or RG alone, while its activity of mixture sample was increased in proportion to concentration of RG extracts. Inhibition of AGS cell growth was more effective in mixture samples than DG and RG alone, while inhibition of HT-29 cell growth was more effective in DG or RG alone than mixture samples.

Abstract B59: Preliminary clinical experiences of Phortress: Putative role for c-MET inhibition in antitumor activity

Abstract Experimental antitumor agent Phortress elicits selective activity in vitro and in vivo in human breast, ovarian and renal carcinoma models via a novel mechanism(s) of action. Prodrug Phortress [2-(4-amino-3-methylphenyl)-5-fluorobenzothiazole (5F 203) lysylamide dihydrochloride] liberates 5F 203 in the presence of cancer cells in vitro, and in plasma in vivo. 5F 203 is a potent aryl hydrocarbon receptor (AhR) ligand, resulting in induction of cyp1a1 transcription. CYP1A1-catalyzed biotransformation of 5F 203 to electrophilic species in sensitive tumor cells leads to cell death. Preclinical toxicokinetic studies in two rodent species led to a clinical starting dose of 3 mg/m2 Phortress. Three and six patients have received 3 mg/m2 and 4.25 mg/m2 Phortress respectively, by intravenous injection over a 15 minute period on day 1 of consecutive 21 day cycles. Phortress was generally well tolerated. Drug-related adverse reactions include fatigue and headache/arthralgia. In four patients, indications of stable disease have been achieved. One patient with colorectal carcinoma received nine 3 mg/m2 cycles before fatigue led to withdrawal. A mesothelioma patient received twelve 3 mg/m2 cycles; treatment was stopped after lung function tests revealed decreased TLco associated with disease progression. Two patients with renal cell carcinoma received four and sixteen 4.25 mg/m2 Phortress cycles before progressive disease led to withdrawal from trial. Germline and somatic mutations in the MET oncogene encoding transmembrane hepatocyte growth factor receptor tyrosine kinase (HGFTK) are thought to play a key role in the pathophysiology of hereditary and sporadic renal cell carcinoma (RCC). Indeed, aberrant MET activation has been detected in many carcinomas including breast, ovary, gastric and metastatic colon, promoting aggressive invasive growth through stimulation of cell migration, and inhibition of apoptosis. MET-dependent signaling includes the Ras-Raf-Mek-Erk and PI3K-Akt cascades. Downregulation (85% and 69%) of MET (HGFTK) activity has been observed in protein isolated from MCF-7 and MDA 468 breast cancer cells treated for 24 h with 1 M 5F 203; downstream of MET, inhibition of Erk, MapK, Mek kinase activity was observed. Samples were subjected to antibody microarray which tracked phosphorylation status of cell signalling proteins that regulate cell proliferation, stress and apoptosis. In scratch wound assays, 5F 203 (0.1 M) impeded renal TK10 as well as MCF-7 and MDA 468 cell motility. Inhibition of MET signaling may afford an important 5F 203 target. Further translational research will more comprehensively elucidate mechanisms of action of Phortress. Such studies may ultimately guide patient selection and predict tumor response. Citation Information: Mol Cancer Ther 2009;8(12 Suppl):B59.

양파 육질 및 껍질의 화학성분과 항산화 및 항암 활성 비교

양파 껍질의 폐기는 생리활성 물질이 손실 될 수 있으므로 양파 껍질을 이용한 연구는 폐자원을 활용한다는 면에서 의미가 있다. 이에 본 연구에서는 양파를 육질과 껍질로 나누어 이들의 총 플라보노이드 함량을 측정하였고 세포 내 활성산소종 제거 및 인체 암세포 증식 억제 효과에 대하여 비교 검토하였다. 양파 껍질은 육질과 비교했을 때 48배의 플라보이드 함량을 나타내어 양파 껍질에 플라보노이드 성분이 다량 함유되어 있음을 확인하였다. 양파 껍질의 A+M과 MeOH 추출물을 0.05 mg/ml의 농도로 HT-1080 세포에 처리하였을 때 지질 과산화물의 생성을 크게 억제시켰다. 이들 두 추출물들은 <TEX>$500{\mu}M$</TEX> <TEX>$H_2O_2$</TEX>만을 처리한 control군과 비교하였을 때 측정 시간 120분 동안 계속적으로 높은 세포 내 지질 과산화물 생성 억제능력을 나타내었고 특히 양파 껍질에 의한 저해 효과가 양파 육질보다 높았다. 양파 육질과 껍질의 추출물로부터 얻어진 분획물들 중에서는 양파 껍질의 85% aq. MeOH 및 BuOH 분획물에 의한 저해효과가 우수하였고 양파 육질의 경우에는 85% aq. MeOH 분획물에 의한 항산화효과가 높았다. 암세포증식 억제 실험에서 양파 껍질의 A+M 추출물의 <TEX>$IC_{50}$</TEX>은 AGS 및 HT-29 세포에서 각각 0.07 및 0.05 mg/ml로 양파 육질보다 저해효과가 높았고 껍질 MeOH 추출물의 <TEX>$IC_{50}$</TEX>은 두 세포에서 각각 0.75 및 3.31 mg/ml로 AGS 세포에 대한 증식 억제효과가 우수하였음을 관찰 할 수가 있었다. 분획물들 중에서는 양파 육질 및 껍질의 85% aq. MeOH 분획물의 AGS 세포에 대한 <TEX>$IC_{50}$</TEX>이 각각 0.04 및 0.03 mg/ml로 가장 높은 활성을 나타내었고. 이들 분획물들도 HT-29 세포보다는 AGS 세포에 대한 증식 억제효과가 높았음을 살펴 볼 수가 있었다. 대체로 water 분획물에 의한 활성산소종 저해 및 암세포 증식 억제효과는 분획물들 중 가장 낮았다. 이상의 결과로부터 양파 부산물인 껍질에도 생리활성 물질이 함유되어 있는 것으로 판단되므로 이를 활용한 양파가공품 개발이 필요하다고 여겨진다. In order to determine chemical components of onion flesh and peel, general nutrients, vitamin C, and total flavonoids were measured. Onion peel showed less moisture (14.3%) and no vitamin C compared to onion flesh. Onion peel contained more amounts of total flavonoids compared to onion flesh. In addition, the inhibitory effects of solvent extracts from onion flesh and peel on <TEX>$H_2O_$</TEX>-induced oxidative stress and growth of cancer cell lines (AGS human gastric adenocarcinoma and HT-29 human colon cancer cells) were investigated. Acetone with methylene chloride (A+M) and methanol (MeOH) extracts from onion flesh and peel appeared to significantly reduce the levels of intracellular reactive oxygen species (ROS) (p<0.05) and a greater antioxidant effect was observed in onion peel. Among fractions, 85% aq. methanol showed a higher protective activity against oxidative stress in both flesh and peel and there was no effect in the water and hexane fractions. The growth of cancer cells exposed to medium containing extracts and fractions from onion flesh and peel was inhibited dose-dependently. The growth of AGS was inhibited more in both flesh and peel compared to HT-29, and onion peel was more effective than onion flesh. Among fractions, 85% aq. methanol showed the greatest effect on growth inhibition in both flesh and peel. <TEX>$IC_{50}$</TEX> values of 85% aq. methanol fraction from onion flesh and peel on AGS were 0.04 and 0.03 mg/ml, respectively, while those on HT-29 were 0.23 and 0.04 mg/ml. From our results, 85% aq. methanol fraction had an inhibitory effect against oxidative stress and growth of cancer cells, suggesting that it may contain biological active compounds.

Repair using the pectoralis major muscle flap for anastomotic leakage after esophageal reconstruction via the subcutaneous route

Anastomotic leakage with an intractable cutaneous fistula frequently develops after an esophagectomy and reconstruction via the subcutaneous route. A pectoralis major muscle (PMM) flap was used for the treatment of 6 patients with esophageal cancer who developed anastomotic leakage with fistula after reconstruction via the subcutaneous route. A gastric tube and colon had been used for reconstruction in 2 and 4 patients, respectively. A trimming and repair of the leakage site was initially performed and the anastomotic site was then covered with a muscle flap. Recurrent anastomotic leakage did not develop in 5 patients. Among these patients, oral intake was initiated from 11-15 days after the repair operation in 4 patients. A patient having recurrent anastomotic leakage after a repair operation recovered well with conservative therapy. The coverage with a PMM flap over the repair site is a simple method for preventing the development of recurrent leakage after a repair operation. Even when recurrent anastomotic leakage has occurred after this operation, healing is normally expected by means of conservative treatment. We, therefore, recommend this method for the repair of intractable anastomotic leakage after reconstruction via the subcutaneous route for esophageal cancer.

Potential indications for ovarian autotransplantation based on the analysis of 5,571 autopsy findings of females under the age of 40 in Japan

Ovarian cryopreservation and autotransplantation could be of potential value for preservation of fertility in the patients with various malignancies. Ovarian tissue should be cryopreserved actively for fertility preservation, but stored tissue should be autotransplanted with much caution until reliable methods are established to detect minimal residual disease in grafts in precise and reproducible manners.

An Unexpected Case of Metachronous Diffuse Gastrointestinal Mantle Cell Lymphoma and Aggressive Metastatic Colonic Adenocarcinoma

Purpose: A 70-year-old woman was evaluated for hematochezia. Past history included hypertension. Physical examination was normal. Colonoscopy revealed pancolonic multiple erythematous polypoid lesions. Upper endoscopy showed nodular gastroduodenal mucosa. Diffuse gastrointestinal (GI) mantle cell lymphoma (MCL) was confirmed with histopathological and immunohistochemical studies. Staging PET/CT scan showed increased FDG uptake in gastric fundus and colon but no nodal involvement, suggesting primary GI MCL. Peripheral blood smear and bone marrow aspirate were normal. Combination chemotherapy consisted of 6 cycles R-CHOP regimen and maintenance rituxan. Endoscopy and PET/CT at 6 months confirmed successful response. Surveillance PET/CT at 12 months showed abnormality in the cecum. Colonoscopy revealed single 3 cm friable ulcerated cecal lesion suspicious for recurrence of MCL. Biopsy showed poorly differentiated adenocarcinoma. Right hemicolectomy revealed T4N2M0 with recurrence of MCL in appendix. After slow post-operative recovery, a restaging PET/CT was done prior to adjuvant chemotherapy. Multiple new hepatic lesions were confirmed as colon cancer metastases. After discussing treatment options, patient opted for hospice care. While colorectal cancer is a common GI malignancy, primary GI lymphoma is not. MCL often invades the GI tract but primary GI MCL is rare. Most frequent endoscopic finding of MCL is multiple lymphomatous polyposis, a rare entity accounting for 2% of primary GI lymphomas. MCL is a moderately aggressive disease. Median survival is 3 years. Most patients have advanced disease at diagnosis. 50% have bone marrow infiltration, 25% have involvement of GI tract. Leukemic transformation occurs in 25%. Tumor cells express pan-B-cell markers and the T-cell marker CD5. Overexpression of cyclin D1 has been noted. Combined chemotherapy, chemo-immunotherapy, peripheral stem cell transplantation are treatments of choice. Concomitant GI tract metachronous malignant lymphoma and adenocarcinoma are rare. Less than ten cases of synchronous GI MCL and colon cancer have been reported in literature. To our knowledge there has been no report of diffuse primary GI MCL with metachronous aggressive colon cancer detected incidentally. Further investigation of a potential relationship between MCL and colon cancer is warranted. Recognizing a relationship may help with accurate management and surveillance. Definitive studies are required to expand our findings and study the genetic basis of these observations.

Adenocarcinoma arising in a colonic interposition following a total gastrectomy: Report of a case

A segment of the transverse colon can be used for gastric reconstruction after a total gastrectomy. This report presents the case of a 68-year-old woman with primary adenocarcinoma of the colon in a segment used for reconstruction after a total gastrectomy. The interposed colon developed colon carcinoma 9 years after the gastric reconstruction. The possibility of a primary carcinoma arising in a gastric colon interposition must be considered when employing the transverse colon as a gastric substitute.

제(除)간수 천일염 및 구운소금 절임 배추김치의 품질 및 in Vitro 항암 기능성 증진 효과

This study was carried out to improve quality and increase anticancer effect of baechu kimchi by changing various kinds of salt. The baechu cabbages were brined with purified salt (P), natural sea salt (NS), natural sea salt without bittern (NS-B) or baked (Guwun) salt (G) and mixed with other ingredients. Thereafter, the kimchis were fermented for 7 days at 15℃. The changes in pH and acidity of the P and G kimchis were slower than those of NS and NS-B kimchis. NS-B and G kimchis promoted the growth of Leuconostoc sp.; however, it inhibited the growth of Lactobacillus sp. when compared with P and NS brined kimchis. The sensory evaluation results indicated that NS-B and G kimchis were better than P and NS kimchi in taste, color and overall acceptability. Rheological property of texture (cutting strength) of NS-B and G brined kimchis was also much better. Anticancer effects of the kimchi juices and methanol extracts were investigated on AGS human gastric adenocarcinoma cells and HT-29 human colon carcinoma cells by MTT assay. NS-B and G kimchis significantly retarded the growth of both cancer cells compared to P and NS kimchis. From these results, kind of salt is very important when kimchi is prepared. It proved that removing bittern from natural sea salt is good ancient tradition when brining the cabbage. Using the baked salt is also a better method to improve the quality and anticancer effect of kimchi.

Transhiatal esophageal surgery for malignancy--a 7-year experience at a tertiary care hospital.

The aim of this study was to determine the outcomes of transhiatal esophagectomy for dysphagia for esophageal malignancy in terms of short and long-term morbidity and mortality and to determine the survival series. Case series study. South and West Surgical Ward, Mayo Hospital, Lahore, from January 2001 to December 2007. All patients referred electively or admitted through OPD presenting with features of progressive dysphagia due to malignancy were included in the study. The patients were investigated for site of stricture and extent of growth into the surrounding structures. All underwent transhiatal esophagectomy and gastric tube or colon was used as the conduit to restore continuity. Patients with squamous cell variety were referred to oncology department for chemoradiotherapy postoperatively. Morbidity and in-hospital mortality were recorded. A total of 42 patients were operated electively for malignant stricture esophagus through transhiatal approach. Site of lesion were 5 (11.9%) upper, 13 (31%) middle and 24 (58%) at lower end of esophagus. The TNM staging were stage I, IIa, IIb, III and IV in zero (0), 5 (11%), 10 (22%), 24 (57.8%) and 3 (7.1%) respectively. Mean operating time was 154 minutes and average blood loss of 371 ml. Postoperative complications included pneumothorax 16.7%, pulmonary complication (16.7%), anastomotic leakage (9.5%), wound infection (3.4%), recurrent laryngeal nerve injury (4.8%) and stricture formation (4.8%). Only 3 (7.1%) 30-day in-hospital mortality was recorded. Transhiatal esophagectomy is the surgical treatment of choice for resection of carcinoma esophagus specifically at the lower and mid-esophageal levels. The frequency of complications is lower as compared to transthoracic approach and the early stage of presentation can lead to high 5-year survival ratios.

Vincristine delays gastric emptying and gastrointestinal transit of liquid in awake rats

We evaluated the effects of vincristine on the gastrointestinal (GI) motility of awake rats and correlated them with the course of vincristine-induced peripheral neuropathy. Vincristine or saline was injected into the tail vein of male Wistar rats (180-250 g) on alternate days: 50 microg/kg (5 doses, N = 10), 100 microg/kg (2, 3, 4 and 5 doses, N = 49) or 150 microg/kg (1, 2, or 5 doses, N = 37). Weight and stool output were measured daily for each animal. One day after completing the vincristine treatment, the animals were fasted for 24 h, gavage-fed with a test meal and sacrificed 10 min later to measure gastric emptying (GE), GI transit and colon weight. Sensory peripheral neuropathy was evaluated by hot plate testing. Chronic vincristine treatments with total cumulative doses of at least 250 microg/kg significantly decreased GE by 31-59% and GI transit by 55-93%. The effect of 5 doses of vincristine (150 microg/kg) on GE did not persist for more than 1 week. Colon weight increased after 2 and 5 doses of vincristine (150 microg/kg). Fecal output decreased up to 48 h after the fifth dose of vincristine (150 microg/kg). Vincristine decreased the heat pain threshold 1 day after 5 doses of 50-100 microg/kg or after 3-5 doses of 150 microg/kg. This effect lasted for at least 2 weeks after the fifth dose. Chronic intravenous vincristine treatment delayed GE and GI transit of liquid. This effect correlated with the peak increase in colon weight but not with the pain threshold changes.

Radiographic and clinical factors associated with improved outcomes in cancer patients with bowel obstruction

e20564 Background: The purpose of this study was to identify clinical and radiographic factors relevant to treatment outcomes in cancer patients presenting with bowel obstruction. Methods: Clinical and radiographic factors were retrospectively abstracted from records of inpatients referred for surgical consultation for suspected bowel obstruction (2000–2006). Patients were stratified by treatment: surgical treatment (ST), minimally invasive (percutaneous/endoscopic) procedures (MIP), or bowel rest (BR). Clinical outcomes such as status at discharge and median overall survival (OS) were examined. Results: Of 194 patients, 25% had a primary diagnosis of colorectal cancer. Computed tomography, plain radiographs, enteral contrast studies, and other modalities were used for diagnosis in 59%, 26%, 12%, and 3% of patients, respectively. 62% of obstructions were located in the small bowel, with the remaining 23% and 12% identified as gastric outlet and colon, respectively. Over 90% of patients treated with ST (n = 60) were discharged home and tolerated enteral feeding. In contrast, for patients treated with MIP and BR, 48% and 68% were discharged home, and 70% and 72% were able to tolerate enteral feeding, respectively. OS was similar for patients treated with ST (6.3 months) and for those whose bowel obstruction resolved with BR (6.4 months). For patients treated with MIP, however, OS was 1.4 months. Though significant differences in OS for patients treated with ST and MIP were observed (p&lt;0.0001), 30-day readmission rates were similar across treatment groups. Radiographic images demonstrating low grade obstruction, absence of ascites, and the absence of peritoneal carcinomatosis were associated with improved OS. Additional relevant clinical factors affecting OS included serum albumin level; however, no association was observed for age, tumor type, site of obstruction, previous bowel obstruction, or abdominal exploration. Conclusions: Clinical and radiographic factors affect treatment outcomes for cancer patients with bowel obstruction. Given that factors such as ascites, peritoneal carcinomatosis and low serum albumin result in poor OS, non-invasive procedures should be considered. No significant financial relationships to disclose.