Neoadjuvant radiochemotherapy in the treatment of fixed and semi-fixed rectal tumors. Analysis of results and prognostic factors

PURPOSE: To report the retrospective analysis of patients with locally advanced rectal cancer treated with neodjuvant radiochemotherapy. METHODS AND MATERIALS: From January 1994 to December 2003, 101 patients with fixed (25%) or semi-fixed (75%) rectal adenocarcinoma were treated by preoperative radiotherapy with a dose of 45Gy at the whole pelvis and 50.4Gy at primary tumor, concomitant to four weekly chemotherapies with 5-Fluorouracil (425 mg/m(2)) and Leucovorin (20 mg/m(2)). In 71 patients (70.3%) the primary tumor was located up to 6 cm from the anal verge and in 30 (29.7%) from 6.5 cm to 10 cm. Age, gender, tumor fixation, tumor distance from the anal verge, clinical response, surgical technique, and postoperative TNM stage were the prognostic factors analyzed for overall survival (OS), disease-free survival (DFS), and local control (LC) at five years. RESULTS: Median follow-up time was 38 months (range, 2–141). Complete response was observed in eight patients (7.9%), partial in 54 (53.4%) and absence in 39 (38.7%). OS, DFS and LC were 52.6%, 53.8%, and 75.9%, respectively. Distant metastasis occurred in 40 (39.6%) patients, local recurrence in 20 (19.8%) and both in 16 (15.8%). Patients with fixed tumors had lower OS (17% Vs 65.6%; p < 0.001), DFS (31.2% Vs 60.9%; p = 0.005), and LC (58% Vs 82%; p = 0.004). Patients with tumors more than 6 cm above the anal verge had better LC (93% Vs 69%; p = 0.04). The postoperative TNM stage was a significant factor for DFS (I:64.1%, II:69.6%, III:35.2%, IV:11.1%; p < 0.001) and for LC (I:75.7%, II: 92.9%, III:54.1%, IV:100%; p = 0.005). Patients with positive lymph nodes had worse OS (37.9% Vs 70.4%, p = 0.006), DFS (32% Vs 72.7%, p < 0.001) and LC (56.2% Vs 93.4%; p < 0.001). CONCLUSION: This study suggests that the neoadjuvant treatment employed was effective for local control. Fixation of the lesion and lymph nodes metastasis were the main adverse prognostic factors. Distant failures were frequent, supporting the need of new drugs for adjuvant chemotherapy

A Case of Lipoma in the Deep Part of Neck

It is comparatively rare that lipoma is found in the deep part of neck, though lipoma is often found in parts of back, neck, breast, etc. And so the authors reported a case of lipoma in 71-year-old woman that was made the diagnosis of lipoma in the deep part of neck, from the clinical symptoms and CT examination, and was confirmed histologically after the enucleation under general anesthesia

玄米粉を用いた発酵パンの製造について

玄米は、精白米に対してビタミンB_1、ビタミンE、脂肪酸、食物繊維などの含有量が多く、保健効果が大きい。また精米のためのコストも抑えられる。そこで、玄米粉を使用した製パンについて検討した。1.生地の発酵温度は25℃より30℃で行った方が良好な結果を得た。2.加水量は小麦粉製造パンより多く、玄米粉に対して90%が適当であった。3.グルテン添加量15%で良好に膨らんだパンが出来た。また、グルテンの存在はパンの焼き色にも大きく影響を与えた。4.グルテン添加と同時にグルコマンナン(0.5%)を粉末状態で添加することにより、さらに良好に膨らみ、保存状態が安定したパンを作ることが出来た。また、グルコマンナンの添加は、玄米粉特有の臭いや味を消去し、風味を改善した。Brown rice contains vitamin B_1, vitamin E, fatty acids and dietary fiber further than polished rice at the high concentration, and it is called having the high health effect. In the manufacturing, it is possible to hold the cost low by using brown rice. Therefore, the breadmaking using brown rice flour was examined. 1.On the fermentation temperature of dough, 30℃ was more suitable than 25℃. 2.The hydration quantity was more abounding than the breadmaking from wheat flour, and 90% was adequate for brown rice flour. 3.It was possible to make the good bread by adding gluten at the 15% concentration to the flour. And, gluten also greatly affected the burn color of the bread. 4.It was possible to obtain stabilized and swollen form, when glucomannan is added with gluten. Furthermore, glucomannan removed the peculiar smell and taste of brown rice flour, and the flavor was improved

鼻中隔膿瘍の1症例

われわれは外傷後両側鼻閉と鼻漏を呈したため近医ではアレルギー性鼻炎として治療を受けていた13歳の男子中学生で,鼻中隔血腫が膿瘍化し軽度の鞍鼻を呈した症例を経験した.鼻中隔膿瘍の報告は1914年から1985年までに90例を数え本例を加えて若干の統計的考察を加えた.A 13-year-old boy was admitted to the hospital because of traumatic nasal septal hematoma. His condition had been treated as a nasal allergy because of nasal obstruction and rhinorrhea. Nine weeks after injury, surgery was performed. As septal cartilage had been destroyed by infection, he had a mild saddle nose. Ninety cases of nasal septal abscess reported in Japanese literature from 1914 to 1985 are also reviewed

Antitumor Agents. 282. 2′-( R )- O -Acetylglaucarubinone, a Quassinoid from Odyendyea gabonensis As a Potential Anti-Breast and Anti-Ovarian Cancer Agent

A new quassinoid, designated 2′-(R)-O-acetylglaucarubinone (1), and seven known quassinoids (2–8) were isolated, using bioactivity-guided separation, from the bark of Odyendyea gabonensis (Pierre) Engler [syn. Quassia gabonensis Pierre (Simaroubaceae)]. The structure of 1 was determined by spectroscopic analysis, and by semi-synthesis from glaucarubolone. Complete 1H and 13C NMR assignments of compounds 1–8 were also established from detailed analysis of two-dimensional NMR spectra, and the reported configurations in odyendene (7) and odyendane (8) were corrected. Compound 1 showed potent cytotoxicity against multiple cancer cell lines. Further investigation using various types of breast and ovarian cancer cell lines suggested that 1 does not target the estrogen receptor (ER) or progesterone receptor (PR). When tested against mammary epithelial proliferation in vivo using a Brca1/p53-deficient mice model, 1 also caused significant reduction in mammary duct branching