Evidence of increases of phytol and chlorophyllide by enzymatic dephytylation of chlorophylls in smoothie made from spinach leaves.

Phytol is a diterpene alcohol found abundantly in nature as the phytyl side chain of chlorophylls. Free form of phytol and its metabolites have been attracting attention because they have a potential to improve the lipid and glucose metabolism. On the other hand, phytol is unfavorable for those who suffering from Refsum's disease. However, there is little information on the phytol contents in leafy vegetables rich in chlorophylls. This study indicated that raw spinach leaves contain phytol of 0.4-1.5 mg/100 g fresh weight. Furthermore, crude enzyme extracted from the leaves showed the enzyme activities involved in dephytylation of chlorophyll derivatives and they were high at mild alkaline pH and around 45°C, and lowered at 55°C or above. Under the optimum pH and temperature for such enzymes determined in the model reaction using the crude enzyme, phytol content in the smoothie made from raw spinach leaves increased with an increase of chlorophyllide, another reaction product. Comparison between the increased amounts of phytol and chlorophyllide showed that the enzymatic dephytylation of chlorophylls was critically responsible for the increase of phytol in the smoothie. PRACTICAL APPLICATION: Phytol, which is released by the enzymes related to chlorophyll metabolism in plants, has been investigated because of its potential abilities to improve the lipid metabolism and blood glucose level. In contrast to such health benefits, they are known to be toxic for patients suffering from Refsum's disease. This research for the first time reports the phytol content in raw spinach leaves and that phytol can be increased in the smoothie made from spinach leaves by the action of endogenous enzymes on chlorophyll derivatives under a certain condition. These results help control phytol content in the smoothies.

[Tracheal repair injury during thoracoscopic surgery for esophageal cancer after induction chemotherapy; report of a case].

72-year-old female had thoracoscopic esophagectomy for advanced thoracic esophageal cancer after induction chemotherapy with CDDP(70 mg/m2, day 1) +5-FU (650 mg/m2, day 1-5). Since the membranous portion of trachea was injured due to dense adhesion thoracoscopic surgery was converted to mini-thoracotomy. Injured portion was closed with 4-0 absorbable suture, and covered with gastric tube for reconstruction through posterior mediastinal route. No respiratory complications occurred after surgery and the patient discharged at the 12 post operative days.

Immunochemotherapy with PSK and fluoropyrimidines improves long-term prognosis for curatively resected colorectal cancer.

Long-term survival, which extends beyond 5 years, is a desired outcome for colorectal cancer patients. In the present study, we retrospectively compared the 10-year overall survival between the control group and the polysaccharide kureha (PSK) group and analyzed the factors influencing the prognosis. The control group was treated exclusively with oral fluoropyrimidines, whereas the PSK group was treated with fluoropyrimidines, given in conjunction with PSK for 24 months. The 10-year survival rates for the PSK group (81.9%) were significantly superior to those of the control group (50.6%). In Dukes' C cases, the 10-year overall survival rates for the PSK group were also significantly higher than those of the control group. In cases with lymphatic invasion graded ly2-ly3 or venous invasion graded v2-v3, the 10-year overall survival rates were 80.6% in the PSK group, which were significantly superior, compared to 25.9% in the control group. Analysis by Cox's proportional hazard model showed a significant difference between the control and PSK groups. These results indicate that postoperative adjuvant immunochemotherapy with PSK greatly improves prognosis at 10 years. On the basis of these results, we recommend postoperative adjuvant immunochemotherapy combined with PSK for patients with Dukes' C and in cases with ly2-ly3 or v2-v3 invasion.

Does a correlation exist between tumor occupation rate and Dukes classification in rectal cancer?

This study was undertaken to evaluate the correlation between tumor occupation rate and stage in rectal cancer patients. 210 patients with histologically confirmed adenocarcinoma of the rectum were evaluated. Retrospectively, we divided the subjects' pathological specimens into four groups: group A, tumor occupied less than one fourth of the colic lumen; group B, tumor occupied one fourth to one half of the colic lumen; group C, tumor occupied one half to three quarters of the colic lumen; group D, tumor occupied more than three quarters of the colic lumen. As the tumor occupation rate increased, more invasive cases were observed. Patients of group A had significantly longer survival than those of the other groups. Tumor occupation rates correlated significantly with the Dukes classification (r = 0.546, P < 0.0001). Tumor occupation rate is a primitive method but an easy and inexpensive technique for judging tumor stage. This method can assist in preoperative evaluation, thereby reducing the need for other redundant methods.