The clinicopathological significance of p53 overexpression in gastrointestinal cancer has not been clarified. The purpose of this study was to clarify the correlation between p53 overexpression and the clinicopathological factors in 142 patients with stage I-III colorectal cancer. Immunohistochemical staining was performed by the ABC method using NCL-p53-CM1. There was no significant difference between clinicopathological factors and p53 positivity. The 5-year survival rates for patients with positive p53 and with negative p53 were 74.6% and 79.3% respectively. Although the recurrence rate for patients with positive p53 was significantly higher than that for p53-negative patients, the curative resection rate for recurrence in patients with positive p53 was higher than in those with negative p53. Thus p53 overexpression is considered to be a promoting factor of recurrence for patients with colorectal cancer because of the high recurrence rate in patients with positive p53. However, p53 overexpression does not influence the survival rate for patients with colorectal cancer because the curative resection rate was high in p53-positive patients with recur-rence.

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Scintigraphic defecography was performed using^99mTc-DATA to quantitatively evaluate defecation in 26 patients after low anterior resection of rectal cancer (LAP-group), 19 patients with chronic constipation (C-group), 11 patients with miscellaneous anal symptoms (AN-group), and 12 normal volunteers. After introducing semi-solid artificial stool containing ^99mTc-DTPA into the rectum, right lateral images of the anorectum were serially obtained during voluntary evacuation. From the time activity curve of the whole rectum, the half emptying time (T1/2) and the percentage of rectal evacuation (evacuation ratio) were calculated. Three abnormal patterns were indentified: the flat type in which a temporary elevation of the RI activity, usually recorded in normal volunteers at the beginning of evacuation, was not recorded; the slow type in which T1/2 was over 20 seconds; and the poor evacuation type in which evacuation ratio was less than 80%. In the LAR-group, all the patients having very low amastomosis showed abnormal patterns irrespective of the type of reconstruction (straight or colonic J-pouch). In the C-group, 10 patients who had either slow pattern or poor evacuation pattern were suggested to have outlet obstruction. In the AN-group, the evacuation pattern differed from patient to patient. Scintigraphic defecography is useful in identifying abnormal evacuation in various anorectal disorders.

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Pain after excision of hemorrhoids performed under saddle block anesthesia was comparatively studied by dividing patients into 5 groups: an analgesic suppository was not administered after operation (Group A), administered immediately after operation (Group B), administered 3 hours after anesthesia (Group C), administered 4 hours after anesthesia (Group D), and administered 5 hours after anesthesia (Group E). After admini stration of the suppository, the patient ingested an analgesic when they felt pain, and the e fficacy of this medication was assessed based on time to ingestion of an analgesic after anesthesia and the amount of the oral drug used by the patients. Saddle block anesthesia was effective for at least 4 hours, but was not always effective for 5 hours. Time from anesthesia to first ingestion of the oral analgesic was 5.7±1.6 hours (mean±SD) in Group A, 10.3±7.1 in Group B, 12.4±6.6 in Group C, 19.5±9.2 in Group D, and 10.7±7.6 in Group E. Time was longer in Group A, B, C, and D in that order, but it became shorter again in Group E. Pain within 24 hours after operation and the amount of the analgesic used during the first five days after operation were the smallest in Group D.
In conclusion, administration of an analgesic suppository 4 hours after anesthesia was the most effective.

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An experimental study was carried out by using mice with mutated Apc gene at codon 1309. After breeding the mice, Apc gene mutation was confirmed by the allele specific PCR method. Fourty mutated mice were randomly divided into two groups maintaining sexual balance in each group. One group was treated with piroxicam (P-group), and the other was the control group (C-group). The P-group was given piroxicam in tap water at a concentration of 0.05%. The estimated total dose administed to each mouse was 1mg/kg. Mice were sacrificed at the 15th week, and polyps were counted by stereomicroscope. It was found that the number and size of polyps were much greater in the C-group than the P-group (number of polyps in gastrointestinal treact 30.81 vs 18.29).
Then a clinical study was performed on three familial adenomatous polyposis (FA-P) patients who had undergone total colectomy with ileorectal anastomosis (IRA). The piroxycam suppositories, which contained 20mg of piroxycam, were administered intrarectally once a day. Regression of adenomas was observed at 10 weeks. There were no complications or side effects of piroxycam. As a conclusion, piroxycam singnificantly decreased the occurence of polyps in the mouse model as well as the adenoma in the residual rectum of FAP patients. Postoperative intrarectal administration of piroxycam proved to be an effective chemopreventive agent for the rectal remnant by minimizing the side effects of oral NSAID.

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The efficacy of oral absorbent AST-120 (AST) on indomethacin (IND)-induced small intestinal ulcers was examined in rats. In addition, serum NOx and the composition of bile acids were determined to evaluate whether these play roles in the effect of AST. The rats injected IND subcutaneously twice, at a dose of 7.5 mg/kg, daily at 24-h intervals. Rats were divided into two groups, the AST group (peroral administration AST at 4g/kg) and control group (peroral administration CMC solution every day for 7 days). At 7 days after the first IND injection, the rats were sacrified and investigation was Conducted. The wet weight of the small intestine was significantly lighter in the AST group than in the control group. The number of small intestinal ulcers was significantly less in the AST group than in the control group. The macroscopic damage score was significantly lower in the AST group than in the control group. The efficacy of AST on IND-induced small intestinal lesions was confirmed, but there were no significant differences in serum NOx and the composition of fecal bile acids between the two groups. The mechanism that enables AST to reduce IND induced inflammation of small intestine remains unclear.

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Portal veins and biliary tracts are the routes of infection for suppurative liver abscess, and there are obscure cases. Occasionally, abscess formation due to liver metastases of malignant tumors is also observed. In the present study, a patient with rectum cancer as-sociated with pyogenic liver abscess was examined.
The patient was a 68-year-old male. He visited a local physician because of pain in the right hypochondric region and was admitted to our department after a liver tumor (s5, 6) with a diameter of 7cm and rectum cancer (Rs) had been diagnosed. The possibility of liver metastasis of rectal cancer could not be ruled out. After quick diagnosis of a liver abscess during high anterior resection (D3) ruling out metastasis, drainage of the abscess was performed. The etiologic organism of the abscess was Fusobacterium nucleatum.
Association of rectum cancer with liver abscess formation in isolated metastases is rare, but should be kept in mind when deciding on a therapeutic plan including liver resection.

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Cap polyposis is a rare inflammatory bowel disease of the large intestine. Its details and pathogenesis are still unknown but its histological appearances resemble those of mucosal prolapse syndrome. In this paper a case of cap polyposis is reported.
A 69-year-old male with a history of Buerger's disease visited our hospital with Complaints of diarrhea and mucosanguinous stool. Colonoscopy revealed sessile polyposis from the rectum to the proximal sigmoid with intervening normal mucosa. The biopsy specimens had intramucosal fibromusculosis. Defecography revealed spastic pelvic floor syndrome, and anorectal manometry indicated so-called outlet obstruction. The tentative diagnosis was mucosal prolapse syndrome, but it did not respond to treatment. Based on histopathologic findings of the polypectomy specimens which showed elongated, tortuous glands, fibromusculasis, and surface erosion with a 'cap' of fibrinous exudate, as cap polyposis, treatment with metronidazol improved the patient's condition. Therefore consi-dered it is that mucosal prolapse abnormal rectosigmoidal motility and immunological abnormality may be the main etiological factors in this case.

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