Comparative study on the inhibitory effects of antioxidant vitamins and radon on carbon tetrachloride-induced hepatopathy.

We have previously reported that radon inhalation activates anti-oxidative functions and inhibits carbon tetrachloride (CCl(4))-induced hepatopathy. It has also been reported that antioxidant vitamins can inhibit CCl(4)-induced hepatopathy. In the current study, we examined the comparative efficacy of treatment with radon, ascorbic acid and α-tocopherol on CCl(4)-induced hepatopathy. Mice were subjected to intraperitoneal injection of CCl(4) after inhaling approximately 1000 or 2000 Bq/m(3) radon for 24 h, or immediately after intraperitoneal injection of ascorbic acid (100, 300, or 500 mg/kg bodyweight) or α-tocopherol (100, 300, or 500 mg/kg bodyweight). We estimated the inhibitory effects on CCl(4)-induced hepatopathy based on hepatic function-associated parameters, oxidative damage-associated parameters and histological changes. The results revealed that the therapeutic effects of radon inhalation were almost equivalent to treatment with ascorbic acid at a dose of 500 mg/kg or α-tocopherol at a dose of 300 mg/kg. The activities of superoxide dismutase, catalase, and glutathione peroxidase in the liver were significantly higher in mice exposed to radon than in mice treated with CCl(4) alone. These findings suggest that radon inhalation has an anti-oxidative effect against CCl(4)-induced hepatopathy similar to the anti-oxidative effects of ascorbic acid or α-tocopherol due to the induction of anti-oxidative functions.

Comparative study on the inhibitory effects of α-tocopherol and radon on carbon tetrachloride-induced renal damage.

Since the 2011 nuclear accident in Fukushima, the effects of low-dose irradiation, especially internal exposure, are at the forefront of everyone's attention. However, low-dose radiation induced various stimulating effects such as activation of antioxidative and immune functions. In this study, we attempted to evaluate the quantitative effects of the activation of antioxidative activities in kidney induced by radon inhalation on carbon tetrachloride (CCl4)-induced renal damage. Mice were subjected to intraperitoneal (i.p.) injection of CCl4 after inhaling approximately 1000 or 2000 Bq/m3 radon for 24 h, or immediately after i.p. injection of α-tocopherol (100, 300, or 500 mg/kg bodyweight). In case of renal function, radon inhalation at a concentration of 2000 Bq/m3 has the inhibitory effects similar to α-tocopherol treatment at a dose of 300-500 mg/kg bodyweight. The activities of superoxide dismutase and catalase in kidneys were significantly higher in mice exposed to radon as compared to mice treated with CCl4 alone. These findings suggest that radon inhalation has an antioxidative effect against CCl4-induced renal damage similar to the antioxidative effects of α-tocopherol due to induction of antioxidative functions.

Ultrafast delocalization of cationic states in poly(N-vinylcarbazole) solid leading to carrier photogeneration.

Femtosecond measurements of the transient dichroism and near-IR time-resolved spectra revealed the ultrafast delocalization of the cationic state in poly(N-vinylcarbazole), leading to carrier photogeneration.

Implications of arterial anatomy in patients with cancer of the periampullary region.

BACKGROUND/AIMS: Preoperative information on arterial anatomy in the peripancreatic and hepatic areas is valuable to any surgeon performing pancreatoduodenectomy. METHODOLOGY: Between 1994 and 1998, 49 patients with periampullary cancer (31 distal bile duct and 18 ampullary tumors) underwent visceral angiography and radical pancreatoduodenectomy with lymphadenectomy. Surgically "significant" arterial variations and their effects on operative management and results were examined retrospectively. RESULTS: Arterial variations were found in 18 patients (37%); 15 (31%) were "significant" and 3 (6%) were "nonsignificant." All 15 patients with "significant" variants required specific type of various preservations of the hepatic arterial system. Intraoperative blood loss, transfused blood units, and operation time were greater in patients with "significant" variations than in patients without (P<0.05). Histopathologic diagnosis, tumor staging, morbidity, and mortality did not differ between the 2 groups. The 5-year survival was 33% for patients with "significant" variations and 63% for patients without (P<0.05). CONCLUSIONS: Information on arterial anatomy in the peripancreatic and hepatic areas is necessary for preoperative evaluation in patients requiring radical pancreatoduodenectomy. Presence of "significant" arterial variations may be considered as one of the negative prognostic factors in patients with periampullary cancer.

Double duct-to-mucosa pancreaticojejunostomy for bifid pancreatic duct.

We report a pancreaticojejunostomy with double duct-to-mucosa anastomotic technique after pyloruspreserving pancreaticoduodenectomy for chronic pancreatitis with bifid pancreatic duct. A 49-year-old Japanese man was diagnosed preoperatively as having chronic pancreatitis with common bile duct stricture and pseudocyst of the pancreatic head. In a pancreaticoduodenectomy, the main pancreatic duct (7mm in diameter) and a secondary pancreatic duct (4mm in diameter) were identified intraoperatively at the transected surface. Pancreatography showed the main pancreatic duct as well as thesecondary pancreatic duct that drained the remaining dorsal pancreas, allowing us to diagnose bifid pancreatic duct. The pancreaticojejunostomy was performed in an end-to-side manner to create double duct-to-mucosa anastomoses and to approximate the pancreatic parenchyma and jejunal seromuscular layers. Although bifid pancreatic duct is a rare anatomical anomaly, it behooves every surgeon who performs pancreatic resections to be aware of this entity and the techniques for dealing with it.

Lymphatic spread differs according to tumor location in extrahepatic bile duct cancer.

BACKGROUND/AIMS: Identification of nodal involvement according to primary tumor location in extrahepatic bile duct carcinoma may guide surgical therapy. METHODOLOGY: Pathologic data of 81 patients who underwent curative operation for bile duct carcinoma were studied to clarify the differences in lymphatic spread from distal bile duct carcinoma, middle bile duct carcinoma, and proximal bile duct carcinoma. RESULTS: Lymph node metastases were present in 25 of 41 patients (61%) with distal bile duct carcinoma, 9 of 19 (47%) with middle bile duct carcinoma, and 11 of 21 (52%) with proximal bile duct carcinoma. The number of positive nodes per node-positive patient was greater in patients with middle bile duct carcinoma than in those with distal- or proximal bile duct carcinoma (mean 5.33 vs. 3.56 or 2.64, p < 0.05). Lymph nodes in the hepatoduodenal ligament were most frequently involved regardless of the primary tumor location. The frequency of distal- and middle bile duct carcinoma patients with metastasis to the superior mesenteric or para-aortic nodes was significantly higher than that of proximal bile duct carcinoma patients (p < 0.05 and p < 0.05). CONCLUSIONS: Patterns of lymphatic spread were different according to primary tumor location in bile duct carcinoma. Metastatic nodes were spread widely, from the hepatoduodenal ligament or posterior pancreaticoduodenal region to the nodes around the superior mesenteric artery and abdominal aorta, in distal- and middle bile duct carcinoma.

Staging with helical computed tomography and laparoscopy in pancreatic head cancer.

BACKGROUND/AIMS: Helical computed tomography provides valuable information about extent of pancreatic cancer. However, it remains difficult to detect small distant metastases. Laparoscopic examination is becoming standard for cancer staging. METHODOLOGY: Between 1995 and 1999, 45 patients with radiologically resectable pancreatic head cancer were analyzed retrospectively to clarify the indications for and role of staging laparoscopy. Computed tomography was examined for tumor size and spread to portal or superior mesenteric veins (PV) and celiac or superior mesenteric arteries (A). RESULTS: There were 29 (64%) patients with resectable disease, 4 (9%) with localized unresectable, and 12 (27%) with metastatic (hepatic in 7 and peritoneal in 5). Patients with metastatic disease were more likely to present with abdominal pain, vomiting, and back pain than were patients with resectable disease (p < 0.05). The mean tumor size and involvement of PV or A were greater in metastatic patients than in resectable patients (p < 0.005 or p < 0.01). The survival rate for patients with metastatic disease was lower than that for patients with resectable disease (p < 0.0001). CONCLUSIONS: According to clinical features and computed tomography findings, laparoscopic exploration is recommended for cancer staging. Helical computed tomography and staging laparoscopy categorize patients into those with localized and those with metastatic disease which considerably correlated with survivals.

Indications for pylorus-preserving gastrectomy for gastric cancer based on lymph node metastasis.

BACKGROUND/AIMS: It is necessary to study the relation between lymph node metastasis in the suprapyloric or lesser curvature regions and clinicopathologic findings in order to determine the indications for pylorus-preserving gastrectomy. METHODOLOGY: We reviewed all pertinent data from the cases of 109 patients with gastric cancer located mainly in the middle third of the stomach focusing particularly on status of lymph node metastasis and clinicopathologic findings. All patients had been treated by conventional gastrectomy with regional lymph node dissection (D2 or D3). RESULTS: Lymph node metastases were found in the lesser curvature or suprapyloric regions in 18 patients. Primary tumors were located in the lesser curvature side in 15 of these 18 patients and in the greater curvature side in only 3. Primary tumors in the greater curvature side with involvement in the lesser curvature or suprapyloric lymph nodes were greater than 4.0 cm in diameter, whereas primary tumors in the lesser curvature side with such metastasis were greater than 1.3 cm. CONCLUSIONS: Indications for pylorus-preserving gastrectomy with preserving of the pyloric branch of the vagal nerve perhaps can be expanded to middle stomach cancer located in the greater curvature side that is less than 4.0 cm in diameter.

Prognostic factors after pancreatoduodenectomy with extended lymphadenectomy for distal bile duct cancer.

BACKGROUND: Since 1995, we have been performing pancreatoduodenectomy with regional and para-aortic lymph node dissection for patients with distal bile duct cancer. Prognostic indicators after extended lymphadenectomy have not been fully understood. HYPOTHESIS: Pancreatoduodenectomy with extended lymphadenectomy and adjuvant chemotherapy is the treatment of choice for patients with distal bile duct cancer. DESIGN: In a retrospective study, univariate and multivariate models were used to analyze the effect of patient demographics, tumor characteristics, and treatment factors on long-term survival. SETTING: Oita Medical University and its affiliated hospitals in Japan. PATIENTS: From 1995 to 1999, 27 patients with distal bile duct cancer underwent pancreatoduodenectomy with extended lymphadenectomy. In 9 patients fluorouracil (500 mg/d) was infused continuously for 14 days after surgery as adjuvant chemotherapy. MAIN OUTCOME MEASURES: Clinicopathologic characteristics and long-term results. RESULTS: In 6 patients (22%) major surgical complications occurred including 1 in-hospital death (3.7%). For 26 patients, the survival rates were 65% for 1 year and 37% for 3 and 5 years. Univariate analysis found that the absence of lymph node metastasis, no more than 2 involved nodes, and negative resection margins were predictors of survival. Multivariate analysis with a Cox proportional hazards regression model revealed that favorable factors for survival included up to 2 positive nodes, negative resection margins, and the use of postoperative adjuvant chemotherapy. CONCLUSIONS: Patients with up to 2 positive lymph nodes had a more favorable prognosis than that of other patients. We recommend pancreatoduodenectomy with extended lymphadenectomy and adjuvant chemotherapy for the treatment of patients with distal bile duct cancer.