Fatty Acid Composition and Applications of Eriobotrya japonica Seed Oil.

The loquat (Eriobotrya japonica) is commonly found in Japan. Its fruits are consumed raw or used in processed foods, and its leaves are used as a traditional medicine and in the manufacturing of cosmetics. Additionally, its seeds have several industrial applications. Therefore, this study aimed to estimate the fatty acid composition of loquat seed oil, and to evaluate its potential application as a deodorant. Palmitic acid, linoleic acid, behenic acid, and lignoceric acid were found to be the primary fatty acids present in the seeds, among which linoleic acid was involved in the deodorization of allyl methyl sulfide. Based on these results, loquat seed oil has potential for use in deodorant production.

A study on fatty acids in seeds of Euterpe oleracea Mart seeds.

Fatty acids of Euterpe oleracea Mart seeds were analyzed in hexane and diethyl ether extracts. The hexane extract contained dodecanoic acid (3), tetradecanoic acid (4), hexadecanoic acid (7), and 9-octadecenoic acid (10). The diethyl ether extract contained (10). The oil of Mart seeds was obtained firstly by methanol extract and further extracted with diethyl ether. The hexane and diethyl ether extracts were then analyzed for antioxidant effects. Both extracts demonstrated a 1,1-diphenyl-2-picrylhydrazyl radical elimination effect similar to that of α-tocopherol and an active oxygen inhibition effect. Significant quantities (0.6212 mg/mL) of polyphenol, in comparison to the standard rejected gallic acid, were found in the extract oil of Mart seeds by the methanol extraction.

Suppressive ability of defatted rice bran against lipid oxidation in cookies containing iron.

Cookies containing iron, defatted rice bran, and several oils were prepared, and their oxidative stability evaluated. Oxidation was suppressed by the defatted rice bran, but a limit to the suppressive effect was observed. The maximum peroxide values obtained with defatted rice bran were low, and similar, regardless of the degree of unsaturation of the oils. A chemical analysis suggested that proteins and polyphenols in the defatted rice bran contributed to the suppressive effect. Cookies without the defatted rice bran showed decreasing maximum peroxide value as the relative humidity increased. No such dependence was observed for the cookies containing defatted rice bran. The water sorption isotherm of defatted rice bran indicated that the weak dependence was due to low water sorption.

Pharmacological activity of compounds extracted from persimmon peel (Diospyros kaki THUNB.).

Persimmon peels (Diospyros kaki THUNB.) are discarded during the production of dried fruit. The 2-methoxy-4-vinylphenol (8) which is component of persimmon peel had high antioxidant activity on the DPPH (1,1-diphenyl-2-picrylhydrazyl) radical scavenging assay and SOD (superoxide dismutase) assay. And (8) had higher tyrosinase inhibiting activity than that of arbutin using both L-tyrosine and L-DOPA as substrates. In addition, tyrosinase inhibiting activity of synthesized 2-methoxy-4-vinylphenol glycoside (8a) was studied. (8a) had tyrosinase inhibiting activity, suggesting that (8a) has possibilities for ingredient of cosmetics that are possessed of whitening effect.

Predictive factors for anastomotic leakage in the neck after retrosternal reconstruction for esophageal cancer.

BACKGROUND/AIMS: Anastomotic leakage after transthoracic esophagectomy for esophageal cancer can induce life-threatening morbidity. This study investigated the predictive factors for anastomotic leakage in the neck after retrosternal reconstruction. METHODOLOGY: A total of 129 esophageal carcinoma patients undergoing transthoracic esophagectomy and esophagogastric anastomosis in the neck via a retrosternal approach were enrolled between April 1985 and March 2002. Predictive factors for anastomotic leakage were statistically evaluated. In a preliminary study using 18 cases, thoracic inlet space (TIS) was recommended to be extended more than 700 mm2. RESULTS: Partial resection of the bony structures was performed in 32 patients. The method of anastomosis and partial resection of bony structures according to the TIS independently influenced the likelihood of anastomotic leakage, with hand-sewn anastomosis and an absence of partial resection increasing its occurrence. CONCLUSIONS: Stapled anastomosis following the partial resection of the sternum and the left clavicle is recommended to avoid anastomotic leakage. These findings should be clarified by a randomized controlled study in a high-volume hospital.

Splenic inflammatory pseudotumor (inflammatory myofibroblastic tumor).

We report a case of a splenic inflammatory pseudotumor (myofibroblastic tumor) in a 43-year-old man with a 5-year history of chronic bronchitis and sleep apnea syndrome. The patient was hospitalized because of a screen-detected splenic mass lesion. His sputum cultures revealed Mycobacterium avium complexes on only one occasion. Imaging studies revealed a 7 cm solitary tumorous lesion, and differential diagnoses of splenic hamartoma, hemangioma, lymphoma, and angiosarcoma were obtained from the radiologist. A splenectomy followed by pathological investigations was performed. By histology, the lesion contained fibroblastic or myofibroblastic spindle cell proliferations, accompanied by variable degrees of inflammatory cell infiltration. Ziehl-Neelsen staining did not reveal acid-fast bacteria. Immunohistochemically, the fibroblastic or myofibroblastic spindle cells were positive for vimentin, human smooth muscle actin, and muscle actin, but negative for desmin, CD8, CD21, CD23, CD35, p80, Epstein-Barr virus LMP, and human herpesvirus type 8. The infiltrating lymphoid cells demonstrated a nonneoplastic pattern. The results of in situ hybridization for Epstein-Barr virus encoded RNA were negative. The postoperative course was uneventful and he has had no recurrence in 22 months. His sleep apnea syndrome and chronic bronchitis have resolved spontaneously since the splenectomy.

Modified POSSUM to predict postoperative morbidity following gastrectomy.

BACKGROUND/AIMS: In order to predict morbidity after gastrectomy for gastric cancer in aged patients, the Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity (POSSUM) scoring system was applied. METHODOLOGY: A total of 123 patients who had gastrectomies for gastric cancer at the age of 75 or above, between 1994 and 2002, were enrolled in this study. Postoperative morbidities and mortalities were analyzed and POSSUM scores were calculated. RESULTS: The predicted mortality and morbidity rates according to the POSSUM scores in this series were 47.9% and 14.1% respectively. The observed morbidity and mortality rates were 39.8% and 1.6% respectively. Using these results, we created a modified POSSUM equation to predict the morbidity in this population, expressed as ln[R/(1-R)] = -2.59 + (0.087 x PS) + (0.013 x OS), where PS: Physiological Severity, OS: Operative Severity, R=predicted morbidity rate. We applied this equation prospectively to 26 patients who underwent gastrectomies in 2003. The figures for predicted morbidity and observed morbidity were 37.3% and 38.5% respectively, indicating that our modified equation predicted morbidity more accurately than the POSSUM. CONCLUSIONS: The POSSUM over-predicted the morbidity of patients who underwent gastrectomy. However, after creating a modified equation using data from retrospective analysis, a modified POSSUM was found to predict the prospective morbidity rate accurately.

Impact of splenectomy in patients with gastric adenocarcinoma of the cardia.

Previous reports have suggested that splenectomy treatment of gastric carcinoma of the cardia results in poor patient outcome, but the reason for this is unclear. This study aimed to clarify the impact of splenectomy for gastric carcinoma patients. A total of 118 patients with gastric carcinoma of the cardia were enrolled in this study. The characteristics of patients with lymph node metastasis at the splenic hilum were determined, and the effects of lymph node dissection or splenectomy on postoperative morbidity, mortality, and pattern of recurrence were evaluated. Advanced tumors were common in patients with lymph node metastasis at the splenic hilum, Siewert type III, greater curvature sites, larger and deeper tumors, multiple metastatic lymph nodes, and high incidences of para-aortic lymph node metastasis frequently observed. The effectiveness of lymph node dissection of the splenic hilum was low and equal to that of dissection of the para-aortic lymph nodes. Postoperative morbidity, as represented by pancreatic fistula, was high following splenectomy or pancreaticosplenectomy, but patient mortality did not occur. Hematogenous metastasis was common, as well as peritoneal metastasis after curative gastrectomy. Splenectomy should be limited in those patients with gastric cardia tumors invading the spleen or with metastatic bulky lymph nodes extending to the spleen.

Appropriate routes of reconstruction following transthoracic esophagectomy.

BACKGROUND/AIMS: The effectiveness of reconstructive methods after esophagectomy remains controversial. METHODOLOGY: A total of 211 patients who underwent transthoracic esophagectomy and esophagogastric anastomosis using the gastric conduit were enrolled in this study. A retromediastinal approach was used in 79 patients and a retrosternal approach in 132. The surgical outcomes were compared between the two groups. RESULTS: In the retrosternal group, anastomotic leakage (26.5%), stenosis of the anastomosis (13.6%), and respiratory complications (18.2%) were frequently observed. Five patients died of aspiration pneumonia probably due to stenosis of the anastomotic site in the retrosternal group. In the retromediastinal group, two patients died from bleeding of a peptic ulcer in the gastric conduit. Partial resection of the manubrium significantly reduced the incidence of leakage in the retrosternal group (4/29 vs. 31/68, p=0.0305). Retrosternal approach and stage were independent prognostic factors for overall survival whereas only stage was an independent prognostic factor for disease-specific survival. CONCLUSIONS: Retrosternal reconstruction is suggested as the unwillingly adopted method of choice after palliative esophagectomy (R2) for the following radiotherapy. Partial resection of the bony structures can be used to prevent postoperative morbidity in this operative procedure. Retromediastinal reconstruction is the possible method of choice in patients receiving curative esophagectomy.

Lymph node status in patients with submucosal gastric cancer.

BACKGROUND: The aim of this study was to clarify the lymph node status in patients with submucosal gastric cancer. METHODS: Between April 1994 and December 1999, 615 patients with histologically proven submucosal gastric cancer who underwent curative resection were included in this study. The results of the surgery and predictive factors for lymph node metastasis were evaluated by univariate and multivariate analyses. The accuracy of the predictive factors was assessed in a second population of a further 186 patients. RESULTS: Lymph node metastasis was observed in 119 patients (19.3%). Multivariate analysis showed that pathologic tumor diameter (> or = 20 mm) and lymphatic invasion were independent predictive factors for lymph node metastasis. The incidence of lymph node metastasis without these 2 predictive factors was 1.8% (2 of 113), and it was 51.2% (85 of 166) with the 2 predictive factors, 9.5% (14 of 148) in tumors < 20 mm in diameter, and 5.3% (22 of 414) in tumors without lymphatic invasion. Among patients with a tumor < 20 mm in diameter, the incidence of lymph node metastasis was significantly reduced in those with a differentiated tumor: 4.2% (4 of 95). These results were almost identical to those observed in the second population. CONCLUSIONS: Lymph node status can be accurately predicted on the basis of pathologic tumor diameter < 20 mm, lymphatic invasion (absence), and histological type (differentiated) in patients with submucosal gastric cancer. Less extensive surgery for these patients might be reconsidered after confirmation of the reproducibility of the results of this study by an appropriately designed prospective clinical trial.

Therapeutic strategy for patients with pN0 gastric carcinoma.

BACKGROUND AND OBJECTIVES: The prognosis for patients with pN0 gastric cancer is moderately hopeful (expected 5-year survival: 80%). However, the relevant prognostic factors and most appropriate surveillance protocol have not been identified. METHODS: We investigated 733 gastric cancer patients without lymph node metastasis for prognostic factors by uni- and multi-variate analysis and by documenting causes of death and recurrence patterns. RESULTS: Univariate analysis revealed that age, tumor location, macroscopic appearance, tumor diameter, invasion depth, lymphatic invasion, and venous invasion affected prognosis. Multivariate analysis showed that age (> or = 60 years), ill-defined macroscopic appearance, and undifferentiated histological type independently reduced survival rates. Age (> or = 60 years) and undifferentiated histological type adversely influenced prognosis in 507 early gastric cancer patients whereas ill-defined macroscopic appearance adversely affected prognosis in 226 advanced cancer patients. Recurrence patterns in these patients were similar to those produced by lymph node metastasis. The predominant recurrence pattern was peritoneal dissemination, observed 2-3 years post-resection. CONCLUSIONS: This study identified adverse prognostic factors in pN0 gastric cancer patients. Randomized controlled studies of adjuvant chemotherapy are necessary to assess whether such therapy is beneficial for patients with adverse prognostic factors.

Clinicopathological features of gastric carcinoma in younger and middle-aged patients: a comparative study.

Gastric carcinoma is relatively rare in patients under the age of 40. This study was undertaken to clarify the clinicopathological characteristics and surgical outcomes of gastric carcinoma in younger patients compared with those of middle-aged patients. The surgical results from 131 younger patients (aged < or = 40 years) and 918 middle-aged patients (aged 55-65 years) were compared retrospectively. Female gender, undifferentiated tumor type and lymphatic invasion were significantly more common in the younger patients. Survival time did not differ between the two groups. The depth of tumor invasion was the only prognostic factor in younger patients, whereas macroscopic appearance, tumor diameter, depth of invasion, lymph node metastasis, and venous invasion were all significant prognostic factors in middle-aged patients. Peritoneal recurrence was significantly more common in younger patients. A family history of gastric adenocarcinoma was observed in 25.9% of younger patients, but this did not affect survival outcomes. As depth of invasion affects prognosis independently, and peritoneal metastasis is the predominant pattern of recurrence, it is essential to establish an optimal prophylactic treatment for peritoneal metastasis to improve surgical outcomes in younger patients with advanced gastric cancer.

Prognostic factors after chemoradiotherapy for patients with inoperable esophageal squamous cell carcinoma.

BACKGROUND/AIMS: It is important to clarify the predictive and prognostic factors for chemoradiotherapy (CRT) in patients with inoperable esophageal cancer. METHODOLOGY: Forty-one patients with inoperable advanced esophageal cancer were evaluated. The predictive factors for the response to CRT (low-dose 5-FU and Cisplatin (FP) therapy plus 60 Gy of radiation) and the prognostic factors after CRT were analyzed. RESULTS: Of the 41 patients, seven achieved complete remission, 21 achieved partial remission, nine showed no change and four showed progressive disease. The median survival time was 19 months in patients with a tumor response, compared to 7 months in patients with non-responsive tumors. Only the serum cytokeratin (CYFRA) level independently predicted the responsiveness to treatment. In the multivariate analysis, the serum CYFRA level and the p53 gene mutation independently influenced prognosis. CONCLUSIONS: The presence of a p53 mutation in the biopsy specimen or a high serum CYFRA level may be predictive of an adverse therapeutic outcome.

Distribution of lymph node metastasis in gastric carcinoma.

BACKGROUND/AIMS: In gastric cancer, appropriate lymph node dissection increases survival, and hence it is of value to determine lymph node metastasis distribution in the early phase of progression. METHODOLOGY: This study involved a series of 274 consecutive patients with 1-6 lymph node metastases occurring after resection. The pattern of lymph node metastases was analyzed retrospectively. RESULTS: Of 102 patients with single lymph node metastasis, over 60% of metastases occurred in specific lymph nodes for each tumor. However, the remainder was scattered in an unpredictable manner including the para-aortic lymph nodes. Despite variations in invasiveness of tumors in patients with a single lymph node, the distribution remained unchanged. Nor was there any change in patients with an increased number of metastatic lymph nodes. However, in the latter group a higher proportion of metastases were widespread. About 85-90% of node was located within paragastric lymph nodes. CONCLUSIONS: Over 60% of metastatic lymph nodes would be eliminated by the dissection of specific areas determined by the site of the tumor. If the concept of sentinel lymph nodes in gastric cancer is valid, navigation surgery will be necessary for patients with early gastric cancer to locate such unpredictable metastasis.

Therapeutic outcomes of continuous hyperthermic peritoneal perfusion against advanced gastric cancer with peritoneal carcinomatosis.

BACKGROUND/AIMS: To clarify the efficacy of therapeutic continuous hyperthermic peritoneal perfusion in peritoneal carcinomatosis of gastric cancer. METHODOLOGY: The subjects of this study were 73 advanced gastric cancer patients who underwent palliative surgery between 1992 and 1999. Therapeutic continuous hyperthermic peritoneal perfusion (T-CHPP) was performed in 21 patients, who had macroscopic peritoneal carcinomatosis or positive lavage cytology, were under 65 years old, had no concomitant disease, and gave informed consent. Fifty-two patients who did not meet the inclusion criteria formed the control group. After reconstruction of the alimentary tract, T-CHPP was carried out for 40 min with 300 mg of Cisplatin, 30 mg of mitomycin C, and 300 mg of etoposide in 5-6 L of physiological saline maintained at 42 degrees C to 43 degrees C. RESULTS: The survival of patients who had CY1, P1, P2, P3 was not affected by T-CHPP. Univariate analysis revealed that the degree of peritoneal carcinomatosis and adjuvant chemotherapy were prognostic factors. Furthermore, ill-defined macroscopic appearance and P3 independently affected prognosis, according to multivariate analysis. Patients treated by T-CHPP had higher incidences of respiratory failure (76.2% vs. 17.3%; p < 0.0001) and renal failure (14.3% vs. 0%; p < 0.0054) than those undergoing T-CHPP. CONCLUSIONS: As T-CHPP had no efficacy, a new therapeutic strategy such as chemosensitivity assessment or a well-structured randomized controlled trial is necessary to obtain good therapeutic results with T-CHPP.

Clinicopathological properties of poorly-differentiated adenocarcinoma of the stomach: comparison of solid- and non-solid-types.

BACKGROUND: The purpose of this study was to clarify the clinicopathological and biological properties of the poorly-differentiated types of gastric carcinoma (solid-type and non-solid-type). PATIENTS AND METHODS: A total of 1,558 patients with primary gastric adenocarcinomas were enrolled in this study. The surgical results were compared. RESULTS: Patients with non-solid-type tumors tended to be younger females with peritoneal or lymph node metastases and lymphatic invasion, and with tumors that were ill-defined, of larger diameter and deeper. Those patients with differentiated tumors tended to have the opposite characteristics of those patients with non-solid-type tumors. Patients with solid-type tumors had intermediate characteristics. The survival in patients with non-solid-type tumors was poor compared to those with differentiated or solid-type tumors. There was a significant difference in the survival of stage III tumors with either solid- or non-solid-type tumors (p=0.0480). CONCLUSION: Therapeutic strategies should be based on the histological type of the tumor in patients with poorly-differentiated gastric adenocarcinoma.

Comparison of results of surgery in the upper third and more distal stomach.

The results of surgery for gastric cancer in the upper third of the stomach and the more distal region were compared to explain the comparatively poor outcomes in the former. Characteristics and therapeutic results of 1245 patients who underwent curative gastrectomy (244 with tumors in the upper third of the stomach and 1001 with more distal cancers) were compared. Survival was significantly lower in patients with cancer of the upper third of the stomach than in patients with more distal cancers. There was a significant difference between the two groups in the survival of patients with advanced gastric cancer, particularly in those with pN1. Among patients with tumors deeper than T2 and pN1, survival was significantly reduced in those aged

Clinicopathologic characteristics and surgical outcomes of mucinous gastric carcinoma.

BACKGROUND: The clinicopathologic characteristics of mucinous gastric carcinoma (MGC), an uncommon subtype of gastric carcinoma, were examined by comparing 45 MGC and 1255 non-MGC (NGC) cases. METHODS: Of 1300 gastric cancer patients, 1184 (early, n=568; advanced, n=616) underwent potentially curative or palliative resection. Age, sex, tumor location, tumor diameter, macroscopic appearance, depth of invasion, lymph node metastasis, lymphatic invasion, and venous invasion were monitored. RESULTS: In all registered patients, MGC patients' characteristics were as follows: advanced-stage disease (P=.0293), macroscopically ill-defined tumors (P=.0051), deeper invasion (P=.0046), and more lymph node involvement (P=.0008). Although there were no significant differences between curatively resected MGC and NGC advanced-cancer patients, in curatively resected early-cancer patients, depth of invasion (P=.0060) and lymphatic invasion (P=.0374) were significantly different. Survival time in all registered patients was shorter for MGC patients (P=.0489). Survival of curatively resected advanced and early gastric cancer patients was not significantly different. Age, macroscopic appearance, tumor diameter, depth of invasion, lymph node metastasis, and curability, but not histological type, were independent prognostic factors in all registered patients. Histological type also did not influence prognosis after curative resection. MGC patients had significantly more metastatic lymph nodes and lymphatic and venous invasion. Survival was significantly different (P=.0450) between all patients with undifferentiated and differentiated MGC, but not in curatively resected patients. CONCLUSIONS: MGC patients' poor prognosis correlates with advanced disease at diagnosis. Therapeutic and follow-up plans after curative resected MGC and NGC should remain the same, possibly with alterations according to the former's histological subtype.

Comparison of surgical results of D2 versus D3 gastrectomy (para-aortic lymph node dissection) for advanced gastric carcinoma: a multi-institutional study.

BACKGROUND: Curative gastrectomy is a promising approach for the treatment of gastric cancer; however, the optimal extent of lymph node dissection for advanced cancer remains controversial. The aim of this multi-institutional study was to evaluate the feasibility of D3 gastrectomy (para-aortic lymph node dissection) for advanced gastric cancer. The surgical results of D2 and D3 gastrectomy (para-aortic lymph node dissection) were retrospectively compared. METHODS: A series of 580 advanced gastric cancer patients were registered between 1992 and 2000. Of these, 430 underwent D2 gastrectomy and 150 underwent D3 gastrectomy. Survival time, prognostic factors, postoperative morbidity/mortality, and pattern of recurrence were compared. RESULTS: There was no significant difference in survival time between D2 and D3 patients. However, the survival times of D3 patients with tumor diameters measuring 50 to 100 mm or with pN1 disease were significantly longer than those of the corresponding D2 patients. Analysis of the survival of patients with tumor diameters measuring 50 to 100 mm revealed that D3 gastrectomy conferred a survival advantage only to patients with pN2 disease. The incidence of lymphatic recurrence was lower in D3 patients with 50- to 100-mm tumors than in the corresponding D2 patients. CONCLUSIONS: D3 gastrectomy might be beneficial in patients with advanced pN2 gastric cancer within the group with tumors measuring 50 to 100 mm. A randomized controlled trial of patients with 50- to 100-mm tumors should be performed to test the validity of this preliminary result.

Synthesis and cosmetic whitening effect of glycosides derived from several phenylpropanoids.

Plant-derived phenylpropanoid compounds (4-ethyl-2-methoxyphenol, 2,6-dimethoxyphenol, 2,3-dimethoxyphenol, 3,4-dimethoxyphenol, 3,5-dimethoxyphenol, 3,4-dihydroxycinnamic acid, 4-hydroxy-3-methoxycinnamic acid, and 3-hydroxy-4-methoxycinnamic acid) were glycosidated to form glycoside compounds. We evaluated the effects of these compounds on the inhibition of tyrosinase and melanin synthesis and their cytotoxicity from the viewpoint of their use as whitening agents in cosmetics. Some compounds had more potent tyrosinase-inhibiting activity than commercial arbutin, which was used as a control, and showed no cytotoxicity at low concentration ranges.