To prospectively investigate the apparent diffusion coefficient (ADC) and choline levels measured at hydrogen 1 ((1)H) magnetic resonance (MR) spectroscopy, to monitor therapeutic responses of ...hepatocellular carcinoma (HCC) to transcatheter arterial chemoembolization (TACE).
Institutional review board approval was obtained, and all patients and control subjects provided informed consent. Histologically proved large HCCs (>3 cm in diameter) were evaluated in 20 patients (16 men and four women; mean age, 59 years; range, 34-80 years) before TACE and 2-3 days after TACE. A control group of eight adults (five men and three women; mean age, 43 years; range, 24-76 years) with normal livers was examined by using the same protocol. Hepatic choline levels were measured by means of an external phantom replacement method, quantifying the peak at 3.2 ppm at (1)H MR spectroscopy. ADCs were measured for all lesions. A Wilcoxon rank sum test was used to compare absolute choline concentrations and ADCs at baseline between HCCs and normal liver parenchyma. Changes in choline levels and ADCs in the tumors before and after TACE were analyzed by using the Wilcoxon signed rank test.
The median preoperative choline level in patients with HCC (measured in 18 of the 20 patients) was 4.0 mmol/L (range, 0.0-17.2 mmol/L), which was significantly higher than that in patients with normal livers (n = 8) (median, 1.6 mmol/L; range, 0.0-2.1 mmol/L; P < .01). Among 18 patients with HCC, choline levels decreased significantly from before TACE to after TACE (P < .01). A significant increase in ADC from before TACE to after TACE in the 20 patients with HCC was also found (P < .01).
Hepatic choline levels and ADCs may allow monitoring of therapeutic responses of HCC to TACE although larger, more definitive and quantitative studies with clinical end points are needed.
Rectal prolapse as the initial clinical manifestation of colorectal cancer is uncommon. We describe the case of a 75-year-old woman who was diagnosed as having adenocarcinoma of the sigmoid colon ...after presenting with complete rectal prolapse. The tumor caused rectosigmoid intussusception and then it prolapsed out through the anus. She underwent rectosigmoidectomy and rectopexy. The postoperative course was uneventful. The relationship between colorectal cancer and rectal prolapse has not been clearly established. This case report describes an unusual presentation of colorectal cancer. It suggests that rectal prolapse can present as the initial symptom of colorectal cancer and may also be a presenting feature of the occult intra-abdominal pathology. The importance of adequate investigation such as colonoscopy should be emphasized in patients who develop a new onset of rectal prolapse.
Hydrostatic pressures (50 to 300 MPa) were applied at 0 degrees C for 50 min to determine the aggregation and viscoelastic properties of tilapia (Orechromis niloticus) myosin fragments: subfragment-1 ...(S-1) and rod. With pressure lower than 150-MPa treatment, S-1 underwent intermolecular interaction to increase its elastic properties. After a 200-MPa treatment, S-1 unfolded, aggregated, and decreased its solubility. A turbid solution was obtained after pressurization over 200 MPa. Further, S-1 transformed to a more elastic gel with pressure increasing. At 200 MPa, S-1 denatured entirely with no change of enthalpy detected by differential scanning calorimetry (DSC). However, all properties of rod did not change during pressurization. This study reveals that S-1 contributes the initiation of gel formation in myosin, and the role of rod is not clear.
Protease XXlll, from Aspergillus oryzae, was used to hydrolyze tuna cooking juice at 37degC for up to 6 h. The hydrolyzate obtained at the degree of hydrolysis of 25.68% (after hydrolysis for 2.5 h) ...displayed the highest 1,1-diphenyl-2-picrylhydrazyl (DPPH) scavenging effect, reaching 82.19%. Six major fractions (A, B, C, D, E, and F) of this hydrolyzate were obtained by Sephadex G-25 column chromatography using a 0.05 M phosphate buffer (pH 6.5) as the mobile phase. All six fractions displayed a scavenging effect for the DPPH radical, but the scavenging effect was only obvious in two fractions (B and C). After the solid content of hydrolyzates was concentrated from one to five times, the scavenging effect of the DPPH radical increased from 17% to 75% for fraction B, and from 13% to 66% for fraction C. Seven anti-oxidative peptides were isolated from the hydrolyzates (mixture of B and C fractions) by reversed-phase HPLC. The peptide sequences comprised four to eight amino acid residues, including Val, Ser, Pro, His, Ala, Asp, Lys, Glu, Gly, or Tyr.
Purpose
Current medical treatments for slow transit constipation (STC) are often ineffective, and total colectomy with ileorectal anastomosis has been the procedure of choice for selected patients ...with refractory STC. Today, minimally invasive approaches are being utilized in a greater number of procedures as surgeons become more familiar with the techniques involved. The aim of this study was to assess the safety and utility of hand-assisted laparoscopic total colectomy for STC.
Method
From January 2002 to December 2005, 44 women presented with complaints of intractable constipation and failed to respond to medical treatment. Slow transit constipation was diagnosed after a series of examinations, including a colonic transit test, anal manometry, balloon expulsion test, and barium enema. All eligible patients underwent a hand-assisted laparoscopic total colectomy with ileorectal anastomosis. Main outcome measures included the operative time, conversion to open procedure, blood loss, time to return of flatus, length of postoperative hospital stay, and complications.
Result
The mean operative time was 197 min (range, 125–295 min). The mean estimated blood loss was 113 ml (range, 100–300 ml). The mean day of first time to flatus was 2 days, and the mean hospital stay was 7.6 days. There was no conversion to an open procedure and no surgical mortality. In the following period, two patients developed intestinal obstruction, which underwent exploratory laparotomy. However, some 39 patients (88.6%) expressed excellent or good in satisfaction.
Conclusion
Hand-assisted laparoscopic total colectomy could be a safe and efficient technique in the treatment of STC.
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