Using mutant-allele-specific amplification procedure, patients with colorectal tumors were analyzed for K-ras point mutations in the stool and the tumor tissue. K-ras mutation of DNA purified from the stool was detected in 10 of 40 (25.0%) cancer patients, and in 3 of 10 (30.0%) adenoma patients. Otherwise, in the cases whose tumors contained the mutations, it was detected with the frequency of 71.4% in cancers, and 100% in adenomas. This frequency tended to decrease in the cancers of distal colon or small size, but there was no significant. This study suggested that stool analysis of genetic alterations would develop diagnostic method for colorectal cancer.
Six patients with hepatocellular carcinoma were subjected to percutaneous microwave coagulation therapy (PMCT) by ultrasonic guiding. The size of the main tumor in the present cases was limited to not more than 2 cm. From 18 to 48 days after PMCT, each patient was subjected to surgery and pathological examination. By macroscopic observation, the PMCT area including both non-tumor and tumor regions looked yellowish white, and the boundary was clearly recognized. In the histological examination, the coagulation area surrounded by fibrous capsule was found, and deletion of nuclei and changes in stainability were observed in the marginal region. These changes indicated obvious coagulation necrosis, but the changes became less intense toward the center in the area, and in some portions, the tissue was indistinguishable from viable cells by light microscopy. In 2 cases out of the 6, part of the tumor remained outside the coagulation area. Since only the area determined by the microwave electorode is coagulated to cause necrosis on PMCT, sufficient safety margin should be required.
We experienced six patients with resected hepatocellular carcinoma (HCC) following interferon (IFN) therapy. Hepatitis virus C-RNA in polymerase chain reaction was positive in all patients prior to the IFN therapy. HCV-RNA became negative in two patients following IFN therapy, and was re-positive at the time of detection of HCC. In histological studies prior to the IFN therapy, pre-cirrhosis was diagnosed in four out of six patients and chronic active hepatitis 2B (CAH2B) in one according to the Europian classification. In non-cancerous portion of the liver, cirrhosis developed in five patients, and CAH2B in one. There was no significant correlation among the interval of HCC detection following IFN therapy, tumor size, tumor location, and histological findings. Patients should be carefully followed up by serum α fetoprotein levels or ultrasonography of the liver during and following IFN therapy.
We studied the influence of EIS on the respiro-circulatory condition of patients with portal hypertension. Subjects were fifty patients with portal hypertension who were successfully injected more than 5.0 ml of sclerotant into varices. A prospective randomized controlled trial was proposed to elucidate the effect of prophylactic administration of pure oxygen. Twenty-five patients inhaled pure oxygen (O2), remaining twenty-five patients did not during EIS. Respiro-circulatory function of patients was evaluated by monitoring O2 saturation, pulse rate and blood pressure during EIS. PaO2 was measured before and after EIS in seven patients without O2. EIS by the 5% ethanolamine oleate with iopamidol (EOI) was performed under X-ray monitoring. O2 saturation in patients without O2 inhalation was lowered, whereas that in patients with O2 inhalation was stable during EIS. O2 saturation during injection of EOI and after EIS in patients without O2 inhalation was significantly lower than that in patients with O2 inhalation. Pulse rate was significantly lower and a rise in blood pressure was smaller in patients given O2. No significant differences of PaO2 was noted before and after EIS. In conclusion, the monitoring of O2 saturation, pulse rate and blood pressure is necessary during EIS. Prophylactic administration of pure oxygen may be useful for prevention of hypoxic state and respiro-circulatory stabilization during EIS.