C. B. Wood

Fatty acid composition of normal and malignant cells and cytotoxicity of stearic, oleic and sterculic acids in vitro

The aim of this study was to investigate the hypothesis that saturated fatty acids are differentially cytotoxic to cancer cells. Three studies were undertaken to: (1) measure the toxicities of stearic and oleic acids to normal and malignant cells in vitro, (2) assess if there is any relationship between toxicity and relative fatty acid composition and (3) determine whether the relative fatty acid composition of a cancer cell line could be modified by sterculic acid, an inhibitor of delta-9-desaturase. Stearic (18:0) and oleic (18:1) acids inhibited the colony-forming abilities of five human cancer cell lines and two non-neoplastic cell lines in a dose-dependent fashion. The concentration of oleic acid required to reduce colony formation ability by 50% was 2.5-6.0-fold greater than that of stearic acid. Addition of sterculic acid to a cancer cell line resulted in steady-state levels of stearic acid and increasing percentage of oleic acid.

Endometriosis developing during tamoxifen therapy.

Tamoxifen has recently been suggested as treatment for endometriosis. We report a patient who developed endometriosis after starting tamoxifen therapy for benign breast disease.

A study of histochemical changes in mucus from patients with ulcerative colitis, Crohn's disease, and diverticular disease of the colon

The colonic mucosa produces a protective and lubricating layer of mucus. In certain conditions, the quantity and quality of this mucus is impaired. This study assessed the histochemical changes in mucus in inflammatory bowel disease compared with the severity and extent of the condition. Biopsy specimens were taken from 62 patients (32 with ulcerative colitis; ten with colonic Crohns disease; ten with diverticular disease; ten with normal controls) and sections stained with high iron diamine-alcian blue to distinguish sulphated mucins from sialomucins. Normal subjects showed a predominance of sulphated mucins. The patients with Crohns and diverticular disease also demonstrated this normal pattern. Of the 20 patients with ulcerative colitis, and without demonstrable dysplastic changes, only one showed a moderate increase in sialomucins. However, of the 12 patients with extensive colitis and dysplastic changes, ten had an increase in sialomucins. Thus, the predominant sialomucin pattern was seen mainly in patients with dysplasia. It may, therefore, indicate patients at high risk of malignancy.

Cystic lymphangioma of the colon - Endoscopic and histologic features

Cystic lymphangiomas are rare benign tumors of the gastrointestinal tract. Such a lesion was found in the colon of a man who presented with diarrhea and rectal bleeding. The colonoscopic appearances of a smooth, soft polypoid lesion on a broad base should alert the clinician to suspect such a lesion. Histologically the lesion is characterized by submucosal lymphatic spaces with a smooth muscle component in the wall. Though colonoscopic excision, injection, or rupture of the cyst have been advocated as possible modes of treatment, surgical excision is still considered to be the treatment of choice.

Mucosal field change in colorectal cancer

One hundred surgically excised colorectal carcinomas were examined histochemically using the high-iron diamine-alcian blue stain. Transitional mucosa surrounding the tumor was identified in 90 cases. The extent varied from 0 to 17 cm (mean 3.1 cm). In addition, the appearance of multiple patch lesions of increased sialomucin production was confirmed at sites far removed from the tumor in 35 cases. A predominant sialomucin pattern was seen in the proximal resection margin in 14 cases (17.9 percent), occurring as an isolated patch in 6 (43 percent). Sialomucin was also seen in the distal resection margin in 15 cases (15.9 percent), occurring as a direct extension of transitional mucosa surrounding the tumor in 12 (80 percent). These findings suggest that sialomucin production is a primary phenomenon that occurs as part of a field change in the human colon that develops cancer, and that these changes may occur in a resection margin and, by inference, remain at an anastomosis after resection.

The sialomucin content of colonic resection margins

In a prospective trial, the resection margins of 130 patients who underwent apparently curative resection for colorectal cancers were examined. Sialomucin was markedly increased in 17.0 percent of proximal resection margins and 17.3 percent in distal resection margins. Clinical follow-up has demonstrated four patients who have developed local recurrence of their disease. Three of these patients had increased sialomucin staining in the resection margins at the time of initial surgery. High iron diamine-alcian blue staining of resection margin may identify those patients at risk of developing local recurrence of colorectal cancer or metachronous tumor following apparently curative resection.

Laparoscopic endocorporeal mobilization followed by extracorporeal sutureless anastomosis for the treatment of carcinoma of the left colon

Surgery has become progressively more reliant on technology. The technique of colonic anastomosis utilizing the biofragmentable anastomotic ring (BAR) is one such example. The benefits of therapeutic laparoscopy have been applied to the arena of colorectal surgery. A case is presented that combines these two modalities in a patient with colon cancer, laparoscopic mobilization of the large bowel, exteriorized resection, and BAR anastomosis.

A scanning electron microscopy study of changes in the colonic mucus layer during chemical carcinogenesis

Scanning electron microscopy was used to examine the appearances of the colonic mucus layer of rats during chemical carcinogenesis with dimethylhydrazine. The normal colonic mucus layer had a dense homogenous appearance and provided a complete cover for the mucosal epithelium. At high magnifications tiny fenestrations could be seen in this mucus layer. During carcinogenesis these fenestrations enlarged, increased in number, and coalesced, causing focal defects in the mucus layer, which eventually broke into strands and clumps of mucus. The findings indicate that the colonic mucus layer develops progressive abnormalities during carcinogenesis which result in breakdown of its integrity and exposure of the mucosal epithelium to colonic contents.

Technique for in vivo perfusion of chemotherapeutic agents into the rat liver

Abstract The toxic side effects of many cancer chemotherapeutic agents prevent their use in high concentrations. This paper describes a technique for the administration of large doses of chemotherapeutic agents to the rat liver in an in vivo isolated perfusion system. This method is applicable for testing the effect of various agents on liver pathophysiology. No alteration in liver function, liver weight, or histological pattern was noted following perfusion with high concentrations of 5-fluorouracil.

Ulcerative Colitis and Polyposis Coli: Surgical Options

Until a medical cure for ulcerative colitis is available, it is up to the surgeon to provide a solution. With the wealth of experience now available, the operation of ileal pouch with anal anastomosis must be considered as an option in treating the young or well-motivated patient. Screening of families in whom polyposis coli has been found can prevent colon cancer developing. For this group of patients, who may be totally asymptomatic, to be able to offer a reconstructive operation may make it easier for such patients to accept colectomy. The value of consultation between medical and surgical gastroenterologists in order to time surgery is vital, and an exact histologic diagnosis in inflammatory bowel disease may prevent the potential disaster of constructing an ileal pouch in a patient with Crohns disease. The construction of a pouch is not difficult, being made up of several familiar surgical steps in an unfamiliar setting. However, it is a long operation, frequently taking more than 4 hours, and mucosal protectomy can be rather awkward. For these reasons and the problems with patient counseling, we believe ileal pouch with anal anastomosis operations should be performed at referral centers. We still have to decide on the best type of pouch to use, but it is encouraging that better antibiotics, safer anesthesia, and new techniques such as the intraluminal bypass tube and rectal sleeve dissection have helped to make this operation more successful for a greater number of patients.