A comparative analysis of the rheographic indices of pancreatic blood flow in patients with stomach cancer and varying levels of serum amylase in the postoperative period

On the basis of findings from rheopancreatography a comparative analysis was done of changes in pancreatic bloodflow following radical operations on the stomach in patients presenting with elevated and normal levels of blood amilase. Increase in the serum amilase activity accompanied a drop in arterial blood filling of pancreas together with signs of development of venous plethora of the organ, disturbances in microcirculation still observable for more than 10 days following the operation.     

Determinants of plasma anti-oxidant vitamin levels in a population at high risk for stomach cancer

A high-performance liquid chromatographic method was developed for the determination of a new antiulcer agent, YJA-20379-2, in human plasma and urine. The sample preparation was simple: 2.5-volume of acetonitrile was added to the biological sample to deproteinize. A 50-microliter aliquot of the supernatant was injected onto a C18 reversed-phase column. The mobile phase employed was methanol-0.1M S?rensen phosphate buffer of pH 7.0-H2O (75:2:25, v/v/v), and was run at a flow-rate of 1.0 ml/min. The column effluent was monitored by ultraviolet detector at 295 nm. The retention time for YJA-20379-2 was approximately 7.0 min. The detection limits for YJA-20379-2 in human plasma and urine were both 100 ng/ml. The coefficients of variation of the assay (within-day and between-day) were generally low (below 9.16%) for both the human plasma and urine. No interference from endogenous substances was found.     

Serum and tissue CEA in colorectal cancer: clinical relevance

PURPOSE: This article is an analysis of the information derived from the determination of tumor-tissue concentration of CEA in patients with colorectal cancer. To ascertain the relationship between tumor marker content with the histologic aspects and serologic levels of CEA of this neoplam. MATERIALS AND METHODS: 136 patients with colorectal adenocarcinoma and 41 with colorectal benign processes are analyzed and followed during an average time of 27 months. The CEA of the serum were obtained preoperatively and postoperatively and measured by radioimmunoassay (RIA). Tissular CEA levels were determined with RIA. The histological characteristics are analyzed (Dukes classification, grade of differentiation, index of atypia, microscopic vascular and lymphatic involvement. RESULTS: 1) The cut off point of the tissular CEA with the best sensitivity and specificity for the diagnosis of normal mucosa is 386 ng/mg and for tumoral tissue is 1160 ng/mg. 2) There is no correlation between tissue and serologic CEA value. 3) The tissular level of CEA have a significant statistical correlation with Dukes stage (p < 0.003); other histological characteristics were no significative. 4) There are significant statistical correlations between serologic CEA and relapse but no with survival rates. CONCLUSIONS: 1) Serologic CEA levels depend on numerous factors. 2) There aren't correlations between preoperative serologic levels and tissular CEA levels. 3) Tissular CEA do not predict what patients will have an elevated serologic CEA level in relapse.     

Helicobacter pylori and stomach cancer]

The neoplasms and gastric mucosa colonization with Helicobacter pylori was studied in 40 stomachs resected for expansive (n = 20) and infiltrative (n = 20) carcinoma using Giemsa staining histological sections, histochemical reactions to oxyreductase, and urease test. In expansive carcinoma of the stomach, H. pylori was identifiable both in the tumour and surrounding gastric mucosa in 70 per cent of cases; infiltrative carcinoma appeared to be associated with gastric mucosa H. pylori in 80 per cent, whereas tumour H. pylori were recordable in 30 per cent of cases, which fact is dependent upon the histological structure of carcinoma. The role H. pylori plays in cancerogenesis is discussed.     

Serum CA 15.3, CEA and ESR patterns in breast cancer

As the U.S. population ages, families must assume increasing responsibility for the care of elderly members. Disruptive nocturnal behaviors (DNBs) of elders, such as complaining and demanding help, may result in interactions with caregivers that threaten such arrangements. This study aimed to quantify such interactions by cross-correlating motor activity that was simultaneously recorded from the elders and caregivers. Forty-four elder-caregiver pairs reporting DNBs simultaneously kept sleep logs and wore activity recorders for 6 to 8 days. Day and night activity data were analyzed separately, because circadian variations would otherwise have overshadowed the elder-caregiver covariations of interest. An autoregressive model was fitted to each day and night data segment, and the data-model differences were used to calculate a cross-correlation function. Maximum significant values of the cross-correlation functions (rmax) exceeded .300 in 10 pairs of subjects. The unprocessed motor activity of these pairs looked so similar that rmax was interpreted as a measure of the subjects' interactions. The rmax was significantly larger for nighttime activity, especially in pairs who shared the same bed. It was smaller in pairs whose elders had high depression scores and in those with Parkinson's disease or related disorders. It was not affected by the presence of dementia. Analysis of the lags corresponding to significant values of rmax showed that, in cohabiting pairs, it was mainly the elders who initiated interactions. The findings provide unique, objective evidence that the night is a time of special difficulty for many caregivers of older Americans.     

Early gastric cancer in the remnant stomach

BACKGROUND/AIMS: Early gastric cancer in the remnant stomach is rare. Periodical endoscopic examinations are mandatory for patients with partial gastrectomy for a good prognosis. Our goal is to improve the surgical management of gastric cancer in the remnant stomach. We have retrospectively investigated a total of 15 rare cases of early gastric cancer after partial gastrectomy. METHODOLOGY: From 1976 to 1994, a total of 2,102 cases of gastric cancer were resected in our Department. Among these resected cases, 845 cases were histologically diagnosed as having early gastric cancer of the stomach. Of these, 15 patients had previously undergone a partial gastric resection. The time interval between the initial partial gastrectomy and the second resection of the remnant stomach, was more than 10 years for 8 patients (Group 1) and less than 10 years for 7 patients (Group 2). Here we investigate these rare cases of remnant early gastric cancer. RESULTS: The incidence of early gastric cancer in the remnant stomach was 1.8% (15/845). The cancer location in the remnant stomach was around the stoma and suture line in 75% of Group 1 and in 28.6% of Group 2. The incidence rate of mucosal cancer (m-cancer) was 87.5% for Group 1, and 14.3% for Group 2. Total gastrectomy was selected for 37.5% of Group 1, and for 100% of Group 2. No lymph node metastasis was discovered in both groups. The postoperative mortality was zero in both groups. One patient from Group 2, later died of liver metastasis 2 years after the second total gastrectomy, while the other 9 patients continued to live for more than 5 years with no gastric cancer recurrence to date. CONCLUSIONS: The outcome for patients with gastric cancer in the remnant stomach is generally considered poor. However, the outcome of early gastric cancer in the remnant stomach was good without major postoperative complications. Therefore, to improve surgical management of remnant-stump gastric cancer, early diagnosis is most important, using periodic endoscopic follow-up examinations, especially around the stoma. When mucosal cancer around the stoma is diagnosed, subtotal gastrectomy can be selected even in gastrectomized patient for a good prognosis.     

Celiacography in the diagnosis of stomach cancer

Selective celiacography after the Seldinger technic was performed in 24 patients with stomach pathology (cancer, ulcer, leiomyoma, cicatricial deformation of the stomach). Angiographic symptoms in gastric cancer are found to be mostly similar with those in ulcer and an inflammatory process. Celiacography fails to form an adequately precise judgement on the degree of gastric cancer local speed.     

Carcinoembryonic antigen (CEA) assays in obstructive colorectal cancer

Four of 40 patients with resectable colon or rectal cancer had tumors causing acute large bowel obstruction with colonic dilatation; all 4 patients had preoperative CEA titers above 10 ng/ml with a mean of 28 ng/ml. Thirty-six cancer patients without acute colon obstruction had a mean CEA titer of 4.5 ng/ml; only 6 of 36 patients had circulating CEA titers 10 ng/ml or greater. This suggested that pre-treatment CEA titers in patients with obstructing cancer are unusually high. Multiple CEA assays were performed on two of the 4 patients with colonic obstruction before and after bowel decompressive procedures and prior to their definitive treatment. Relief of obstruction alone produces marked reduction in circulating CEA; this suggested that not only the extent of disease but also the pathophysiological changes associated with obstruction influenced circulating CEA levels.     

Immunohistochemical detection of K-sam protein in stomach cancer

The K-sam gene, originally isolated as an amplified gene from the stomach cancer cell line KATO-III, is characterized by its preferential amplification in the undifferentiated type (diffuse type) of stomach cancer and encodes one of the receptors for heparin-binding growth factors or fibroblast growth factors. The K-sam gene has been isolated by different methods and has been designated BEK, TK14, and Cek2. The receptor for keratinocyte growth factor was also found to be encoded by the same gene. To examine the expression of the K-sam protein in stomach cancer, polyclonal antibody pK1-2 was raised against the extracellular domain of the gene product. This antibody detected K-sam proteins by Western blot and flow cytometry analyses in stomach cancer cell lines KATO-III and HSC39, in which the K-sam gene is amplified and overexpressed. By immunohistochemical analysis, 20 of 38 cases of the undifferentiated type of advanced stomach cancer were K-sam positive, whereas none of 11 cases of the differentiated or intestinal type revealed K-sam staining. The K-sam product was observed predominantly in diffusely infiltrative lesions. In one autopsy case, the K-sam protein was detected only focally in the primary tumor, whereas markedly increased staining for the K-sam product was detected diffusely in the metastasized tumor in the lymph node and liver. These results suggest that K-sam overexpression is associated with the malignant phenotype of the undifferentiated type of stomach cancer, such as infiltrative growth and metastasis.     

Use of intragastric pH measurement in stomach cancer

The method of intragastric pH-metry was used to assess the acid production in the stomach in 35 patients with gastric tumors. All patients with malignant tumors were divided into two groups with respect to site: tumors in the cardia and corpus (18 cases) and tumors in the antrum and pylorus (17 cases). Continuous low-rate production of acid was registered. For cardial and corporal tumors, histamine-refractory anacidity predominated, while continuous low- and medium-rate production of acid was observed in cases of pylorantral tumors. The procedure proved especially effective in determination of gastric secretion in patients with stomach tumors because due to its application it was found that hydrochloric acid secretion continued under the conditions when other methods failed to detect it.     

Elevated CEA in breast cancer patients with overlooked medullary thyroid carcinoma

After mastectomy and radiation for breast cancer, two patients were found to have persistent elevated CEA in their serum. This finding was erroneously attributed to occult metastases for the first patient and to local recurrence for the second. Overlooked medullary thyroid carcinoma (MTC) was the causal disease in both patients. A review of the literature stresses the frequency of CEA elevation in serum of MTC patients. A thorough search for any possible cause of elevated levels of CEA is advocated, particularly by thyroid sonogram with a needle aspiration biopsy when a nodule is discovered and by calcitonin assay in the serum.     

Suspected extragonadal germ-cell cancer syndrome presenting with an orbital mass and elevation of serum CEA, CA 19-9 and CA50 levels

Patients with extragonadal germ-cell cancer syndrome (EGCCS) represent a subgroup of patients with poorly differentiated carcinoma or adenocarcinoma of an unknown primary site for whom potentially curative therapy is available. We report the case of a young man presenting an orbital tumor and high serum levels of CEA, CA 19-9 and CA50 for whom an initial diagnosis of metastatic poorly differentiated carcinoma was made. Suspecting EGCCS, he was treated as for a germ-cell tumor. While in treatment, he underwent residual orbital mass resection, and the histologic diagnosis was embryonal carcinoma based on alpha-fetoprotein immunoperoxidase staining. We discuss the rare location at diagnosis, the impressive increase in the commonly considered gastrointestinal markers that he showed, and the potential utility of these markers for such patients.     

Emotional stress and blood melatonin levels

Blood serum melatonin concentrations were measured in male Wistar rats exposed to acute water-immersion emotional stress (ES) during intraperitoneal injections of physiological saline or different doses of melatonin. ES increased blood melatonin levels in rats receiving physiological saline 1 hour before or just after ES. When physiological saline was administered just ES, blood melatonin concentrations remained unchanged. The blood levels of melatonin both in control and stressed animals injected with exogenous melatonin were higher than those in rats given physiological saline alone. Immersion ES decreased blood melatonin concentrations in rats receiving different exogenous melatonin doses just before ES. However, in rats given melatonin, 1.0 mg/kg, after ES, its blood levels after ES was higher than those in the animals unexposed to stress. The findings suggest that it is just exogenous rather than endogenous melatonin that is consumed in rats injected with its different doses just prior to immersion ES.