Establishment and characterization of human pancreatic adenocarcinoma cell line in tissue culture and the nude mouse.

We established a human pancreatic carcinoma cell line, designated SPH, from cancerous ascites of a 57-year-old male patient with ductal adenocarcinoma of the pancreas. The cells have been cultured for 32 months with RPMI-1640 medium supplemental with 10% fetal calf serum. The population doubling time of this cell line was about 35 h, and the modal number of chromosomes was 85 at passage 20. The cells produced CA19-9, SPan-1, and DUPAN-2 in the conditioned medium and formed tumors in nude mice, the histology of which was similar to that of the primary tumor. Based on these findings, this cell line is considered to be a very useful model for studying many aspects of primary and metastatic pancreatic cancer cell biology.

Anxiety, depression and quality of life in colorectal cancer patients.

BACKGROUND: Few studies have examined psychological distress and its relationship with quality of life (QL) dimensions in colorectal cancer patients. METHODS: One hundred and twenty-eight outpatients were given psychological tests for anxiety and depression (Hospital Anxiety and Depression Scale; HADS) and QL The European Organization for Research and Treatment of Cancer Quality-of-Life Questionnaire C30 (EORTC QLQ-C30) on the same occasion. The association between the patients' emotional function (EF) scoring on EORTC QLQ-C30 and their HADS scores was analyzed by multiple linear regression. RESULTS: Statistically significant negative relationships were found between EF and HADS-A (anxiety), HADS-D (depression), and HADS-T (total score), respectively, with the highest correlation coefficient being for HADS-A. However, HADS-D was significantly more highly correlated than HADS-A to other QL dimensions, and depression was more highly correlated than anxiety with reduced QL. CONCLUSION: The EF dimension of the EORTC QLQ-C30 predominantly assesses anxiety. Depression has a stronger impact on the global QL of patients than anxiety; therefore, the use of an additional instrument is recommended for the assessment of depression in outpatients with colorectal cancer.

Early oral feeding should be resumed following the resolution of gastric ileus.

BACKGROUND/AIMS: The main aim of the study was to assess the feasibility of early mobilization and early feeding following the resolution of gastric ileus in patients who have elective open colonic surgery. METHODOLOGY: This was a randomized controlled trial of patients who were assigned to one of the following two groups. Group 1: patients were encouraged to mobilize postoperatively. A radiopaque marker was given orally on the first postoperative morning and X-ray film was taken daily until more than 70% of the markers had been emptied out of the stomach. Then patients received a diet regardless of flatus or defecation. Group 2: patients were not enforced to mobilize and allowed a diet following flatus or defecation. RESULTS: No significant differences were noted in age, sex, and type of procedures in either group. No patient in group 1 vomited postoperatively, while postoperative time to oral diet was significantly shorter than that to the resumption of bowel function. No significant difference was seen in the incidence of complications. The time to first flatus in group 1 (median, 48 hours) was significantly shorter than that in group 2 (median, 67 hours). The length of hospitalization in group 1 (median, 7 days) was significantly shorter than that in group 2 (median, 10 days). CONCLUSIONS: Early mobilization and early feeding following the resolution of gastric ileus is safe and feasible without vomiting in patients who have elective colonic surgery.

Hypogastric nerve preservation does not increase local recurrence after surgical treatment of rectal carcinoma.

BACKGROUND/AIMS: The main aim of the study was to evaluate whether superior hypogastric plexus and hypogastric nerve can be preserved without increasing local recurrence while performing surgical treatment of rectal carcinoma. METHODOLOGY: This was a retrospective study of 129 patients with rectal carcinoma who underwent curative resection with two types of autonomic nerve-sparing operation. The superior hypogastric plexus and bilateral hypogastric nerves were resected in 61 patients and spared in 68 patients. The pelvic plexus was preserved in all the patients. Local recurrence and survival were compared between two operations. RESULTS: After three years, local recurrence cumulative rates were 13.1% after hypogastric nerve removing operation and 10.3% after hypogastric nerve preserving operation. Distant metastasis and corrected 5-year survival rates were 23.0 and 61.6%, respectively after hypogastric nerve-removing operation, while after hypogastric nerve-preserving operation those were 16.2 and 77.4%, respectively. There were no statistically significant differences in local recurrence, distant metastasis and survival between the two groups. CONCLUSIONS: Hypogastric nerve-preserving operation does not appear to carry an increased risk of local recurrence compared with hypogastric nerve-removing operation after an equivalent follow-up period.

Anal endosonography in the diagnosis and management of perianal endometriosis: report of a case.

We report a rare case of perianal endometriosis, diagnosed in a 39-year-old woman who presented with a several-day history of a painful mass in the perineum. Perianal examination showed redness and swelling in the right anterior direction. A soft tumor was palpated, but there was no evidence of an episiotomy scar, or of fistula orifices. An anal endosonography in the right anterior direction revealed a sharply defined lesion, 17 x 14 mm in diameter, with high echoic enhancement at its center. The lesion was located along the edge of the external anal sphincter but did not involve it. Based on these endosonographic findings, the tumor was not considered to be an abscess or fistula. We detected its location, and judged it possible to enucleate the tumor under local anesthesia without injuring the anal sphincter. The operation was performed uneventfully and a histological diagnosis of endometriosis was confirmed. Using anal endosonography, we were able to determine the exact anatomic relationship of the lesion in the internal and external sphincter, which substantially influenced the diagnosis and operative procedures.

Effect of Lactobacillus casei on a novel murine model of abdominal sepsis.

BACKGROUND: Lactobacilli are one of the probiotics and there is strong evidence for the efficacy of lactobacilli administration as a nonspecific immunostimulant in increasing host defense mechanisms. The present study tested the hypothesis that heat-killed Lactobacillus casei (LC9018) has a protective activity against fecal peritonitis. METHODS: Cecal ligation and tip resection (CLTR) induced fecal peritonitis was developed as a novel mouse model of abdominal sepsis, and the effects of LC9018 pretreatment on survival after CLTR, of the peritoneal exudate cells before or after CLTR and of bacterial growth in the peritoneal cavity after CLTR were investigated. RESULTS: Mortality after CLTR varied directly with the length of the opened bowel. To obtain a sublethal experimental group, the length of the opened bowel was fixed at 4 mm, where mortality was 87%, for further experiments. Survival of mice after CLTR was augmented in mice that had been pretreated intraperitoneally (ip) with LC9018 24 h previously. Viable bacterial growth in the peritoneal cavity was markedly inhibited in LC9018-pretreated mice. Peritoneal exudate cell accumulation observed 24 h after ip injection of LC9018 was significantly enhanced, suggesting that augmentation of the resistance of mice to CLTR was caused especially by the induction of polymorphonuclear cells. CONCLUSIONS: CLTR may provide a reproducible and simple murine model of bacterial sepsis and pretreatment with LC9018 developed a protective activity against CLTR surgery.

Influence of perioperative blood transfusion on the prognosis of patients with gastric cancer receiving anticancer chemotherapy.

BACKGROUND: The deleterious effect of blood transfusions on survival has been reported in patients with cancers of various organs. However, it remains unclear whether there is any adverse effect of blood transfusion when the patients are administered anticancer drugs after surgery for gastric cancers.METHODS: Data from patients with gastric resection for advanced gastric cancer were retrospectively analyzed to determine the influence of perioperative blood transfusion on the survival rate. All patients were administered anticancer drugs (mitomycin C [MMC] and tegafur-uracil [UFT]). Sixty-nine (33%) of 208 patients received blood transfusion perioperatively, while 139 patients (67%) did not receive transfusion. Multivariate analysis of clinicopathologic prognostic factors, including blood transfusion, was performed. Lymphocyte subsets were measured to investigate the immunosuppressive effect of blood transfusion.RESULTS: The 5-year survival rate was 48.8% in the 69 transfused patients and 66.9% in the 139 non-transfused patients ( P < 0.01). Cox's multiple regression analysis showed that, when patients received anticancer drugs, perioperative blood transfusion was not a significant factor affecting survival after the gastric cancer surgery. However, the CD4/CD8 ratio at 3 months after the surgery was significantly lower in the transfused group than in the non-transfused group.CONCLUSION: Blood transfusion did not affect the survival of operated patients who received postoperative adjuvant chemotherapy. However, the finding that the ratio of CD4/CD8 after surgery was significantly higher in the non-transfused group than in the transfused group supports the notion that transfusion causes broad-spectrum immunosuppression.