Interposed colon between remnants of the small intestine exhibits small bowel features in a patient with short bowel syndrome.

We describe herein the case of a 48-year-old man who underwent emergency massive resection of the small intestine due to a strangulated ileus, which led to short bowel syndrome (SBS), as he was left with only 7 cm of jejunum and 8 cm of ileum with ileocecal valve. He then received interposition of a colon segment between the jejunum and ileum remnants isoperistaltically. For 24 months after the operation, he has been able to tolerate oral intake, but still requires partial home parenteral nutritional support during the night on a bimonthly basis. Biochemical and nutritional parameters, including the analysis of minerals and trace elements, indicated that the patient was in relatively good health. Histological examination revealed that the mucosa of the interposed colon showed hypertrophy and hyperplasia of the crypt glands, and cells resembling Paneth cells which are usually seen in the small intestine, suggesting that the colon segment exhibits adaptive changes to the small intestine. Colon interposition may be a useful technique in patients with SBS when the small bowel is too short for the other surgical considerations.

Purification and properties of extracellular carboxyl proteases of acid-tolerant bacteria, isolated from compost.

Four strains of acid-tolerant and protein-using bacteria were isolated from compost. Two of them, Gram-negative strains MB8 and MB11, were identified as a new genus close to Stenotrophomonas species MB8 and Burkholderia species MB11, respectively. Both bacteria produced extracellular carboxyl proteases (CP) in acid-casein-starch medium. The enzymes, termed CP MB8 and CP MB11, purified through ion exchange and gel filtration chromatographies had molecular weights of 61,000 (CP MB8) and 36,000 (CP MB11) as estimated by SDS-PAGE, and showed optimum activities with hemoglobin as a substrate at pH 3.5 (CP MB8) and pH 3.7 (CP MB11) at 55 degrees C. Both of the enzymes were not inhibited by pepstatin, DAN, or EPNP. These results suggest that both enzymes are members of the pepstatin-insensitive carboxyl proteinase family (EC 3.4.23.33), except for a larger molecular weight of the CP MB8 enzyme.

[A case of hepatocellular carcinoma with bone metastasis responding to oral administration of UFT].

A 63-year-old male patient with a mass in the left chest wall was referred to our hospital. An osteoclastic area was found in the mass of the left 4th rib by computed tomography; the mass was hard and little movable. There was an irregular and poorly demarcated low-density area, 5 cm in diameter, in the liver anterior superior segment. Aspiration from the mass of the chest wall indicated adenocarcinoma (class V) and forecast of metastatic lesion. The titer of serum AFP showed an extremely high level of 1,100 ng/ml. According to these findings, the patient was diagnosed as having hepatocellular carcinoma with bone metastasis and treated by the administration of oral UFT (300 mg/day). Six months later, the mass in the left chest wall was completely eliminated, the size of the hepatic lesion changed to 2.5 cm, and the titer of AFP decreased to the normal range (8.4 ng/ml). Treatment of hepatocellular carcinoma with bone metastasis is often ineffective, but this is a rare case showing the clinical effectiveness of oral administration of UFT.

[Clinico-pathological studies on the lymph node metastases of the gastric cancer invading to proper muscle layer].

In 65 patients who underwent surgical resection of the gastric cancer invading to proper muscle layer (pm cancer), lymph node involvement at the time of resection and the site of recurrence were investigated. Patients who underwent gastrectomy for submucosal (sm cancer) or subserosal (ss alpha.beta cancer) gastric cancers during the same period served as controls. Lymph node involvement was positive at a higher rate in the pm cancer than in the sm cancer, but the rate for number of lymph node metastases was not dependent on the stage of lesions. Of the lesions in the pm cancer, those of the Borrmann type involved lymph nodes at a particularly high rate. Of the metastatic pattern in the lymph nodes, the rate of severe metastases in pm cancer was higher than in the sm cancer. In the pm cancer, the cancer recurred in the liver and peritoneum, but not in any lymph nodes, thus suggesting that the surgical resection and the dissection of regional lymph nodes had been successful.

[A case of drug-induced esophageal ulcer developed at the esophageal constriction due to the right aortic arch].

A 26-year-old male has a tooth extracted at a dental surgery, and was given 40 mg Froben, as an anti-inflammatory analgesic agent, and ingested one tablet without water. After 2 days, anterior chest pain occurred. Esophagography and endoscopy were performed and multiple esophageal ulcers were confirmed. Esophagography revealed an esophageal stenosis which was considered to be caused by the extramural compression on the oral side of the ulcers. In the chest roentogenography and CT scanning, the right aortic arch was observed. This case was diagnosed as having drug-induced esophageal ulcer developed at the esophageal constriction due to the vascular ring.

[Enhanced effect of intraperitoneal administration of CDDP combined with caffeine against peritoneal metastasis].

The enhanced effect of CDDP combined with caffeine against P-388 leukemia was investigated. No synergistic effect was shown after one hour simultaneous treatment with CDDP and caffeine. But the growth inhibition was enhanced by the addition of caffeine after one hour treatment with CDDP. It is suggested that caffeine inhibits DNA repair by the reduction of CDDP-induced elongation of G2 + M phase. The increase in life span of mice after ip transplantation was observed by frequent ip injections of caffeine after CDDP injection. It is suggested that the effect of intraperitoneal administration of CDDP against peritoneal metastasis is enhanced by combination with caffeine.