[en] Preoperative irradiation of fast neutron was performed as a new combination therapy in 33 cases of esophageal cancer, and its histological effect was examined on resected specimens. Ef₂ was obtained in 45.3% and Ef₃ in 27.3%. These values were higher than those obtained by conventional preoperative radiation. Fast neutron was effective in serrated, spiral or infundibular tumors and in a₂.a₃ cases and in cases showing a high histological differentiation, compared with conventional radiation. (Chiba, N.)

[en] Double isotope method was applied to carry out simultaneous and quantitative analysis of hepatobiliary and gastrointestinal scintigrams. A scinticamera with parallel collimator for medium energy was connected to a computer to distinguish the two isotopes at a time. 4mCi of sup(99m)Tc-(Sn)-pyridoxylideneisoleucine (Tc-PI) and 200 μCi of ¹¹¹In-diethylenetriaminepentaacetic acid (In-DTPA) were administrated by i.v. injection and per oral, respectively. Three normal (two women and a man) and 16 patients after the operation of gastric cancer (10 recovered by Roux-en Y method after the total gastrectomy, and 6 recovered after the operation replacing the jejunum between the esophagus and duodenum) were investigated. The process of bile secretion and its mixing with food were followed by the scanning quantitatively. The analysis of time-activity variation at each organ indicated that the replacing operation gave more physiological recovery than that by Roux-en Y method. This method is noninvasive to patients and is promissing to follow the process or activity of digestion in any digestive organ after surgery. (Nakanishi, T.)

[en] Twelve cases of carcinoma of the rectum were treated preoperatively by combination therapy with 5-fluorouracil (5-FU) suppository (100 mg twice a day consecutively, a total dose of more than 4,000 mg) and irradiation (300 rad x 3/week, a total dose of 3,000 rad). This group was compared with 34 cases given single preoperative 5-FU therapy and 24 control cases given no preoperative adjuvant modality. The group treated by preoperative combination therapy showed marked antitumor effects macroscopically and histologically. In addition, decrease in local recurrence was expected for this group, compared with the other two groups. (Chiba, N.)

[en] In order to obtain preoperative data on the regional lymph nodes in 21 cases of esophageal or cardiac cancer, lymphoscintigraphy was performed by the sophageal submucosal injection of technetium 99m-renium colloid. Of 289 surgically resected lymph nodes, 68 were visualized on scintigrams, and 17 (25%) of them showed metastasis. Nine (4.1%) of 221 non-visualized lesions showed metastasis. In cases in which RI was also administrable to the anal side of tumor, intraperitoneal lymphnodes were visualized. The method proved effective for the preoperative prediction of possible lymphnode metastases. (Chiba, N.)

[en] Scintigraphy with sup(99m)Tc in vivo labeled red blood cells was performed in 36 patients suspected of having gastrointestinal bleeding and in 10 control subjects. Eighteen of the 36 patients had positive findings. Nine of the 18 patients were confirmed to have had bleeding at operation. The duration required for the detection of bleeding by scintigraphy ranged between 10 minutes and 20 hours. Bleeding was detected within 2 hours in half of the patients. When ++ or more of occult blood was seen in the feces, positive findings were obtained on delayed scan. When 200 ml of gastrointestinal bleeding was clinically seen, it could be detected within 24 hours after injection of sup(99m)Tc in vivo labeled red blood cells. (Namekawa, K.)

[en] Twelve patients undergoing surgery for carcinoma of the bile duct at the liver hilus were treated with cobalt-60 beam (180 rad/day with fields of 6 x 8 cm and a total of 4,000 rad) and were compared with 6 control patients without irradiation therapy. More satisfactory results were obtained in the group with irradiation than in the group without it, irrespective of cases of noncurative or curative resection. Three-year survival rate after irradiation therapy was 20% (one of the five patients) in non-irradiated group and 44.4% (4 of the 9 patients) in irradiated group. Of six patients with macroscopically curative resection in the irradiated group, five were still alive or survived 2 years or more after irradiation therapy. These results suggest that cobalt-60 beam is effective as an adjuvant therapy following surgery for carcinoma. (Namekawa, K.)

[en] Preoperative US and CT images were compared with the resected specimens of gallbladder carcinoma. US showed a high diagnostic ability for tumors with protrusion, but a low ability for invasive types. CT showed a low diagnostic ability for the former, but a high ability for the latter. US or CT alone produced false negative rates of 33 % and 25 %, respectively, but their combination reduced the percentage to 11 %. However, there were also false positive cases, calling for more definite diagnostics by combination of other techniques. (Chiba, N.)

[en] Effects of preoperative ₆₀Co irradiation on wound healing of colonic suture in adult dogs of mixed breed were discussed. Wound healing 7 days after colonic suture was compared among dogs which received colonic suture immediately, or 3 days, or 7 days after the ₆₀Co irradiation. As a result, there was not a big difference in their wound healing among these dogs, and disorders of wound healing were not found. Bursting pressure at sutured sites was always lower in irradiated dogs than controls. Recovery of the bursting pressure was 2 days slower in irradiated dogs than non-irradiated dogs for 7 days after the suture. Bursting pressure was the lowest on the 3rd day after the suture in both groups. As to fine changes in irradiated dogs, appearance of recommunicating phenomena in blood vessels, delay of a decrease in avascular regions, delay of granulation, and hypertrophy of vascular walls seemed to be influenced by ₆₀Co irradiation, but there was not a big difference in these results between irradiated and non-irradiated dogs. An increase in postoperative concentration of hydroproline tended to be little lower in irradiated dogs than controls, which seemed to be influenced by the ₆₀Co irradiation. This result was also suggested from delay of granulation and remaining inflammations. Effects of ₆₀Co irradiation on wound healing of colonic suture seemed to be slight generally, because ruptured suture scarecely occurred in the irradiated dogs. When doses used in this experiment were calculated roughly by Ellis's method, irradiation of ₆₀Co seemed not to influence seriously wound healing if the total of 2,000 to 2,500 rad was irradiated in 8 to 10 doses to human colon. (Tsunoda, M.)

[en] The cervical esophagus of 22 adult mongrel dogs was irradiated in a schedule of 300 rad per fraction, 3 times a week, to either a total dose of 3000 or 6000 rad. 2 weeks after completion of irradiation, 1 cm of the esophagus in the irradiation field was resected, and Olsen type 1 layered anastomosis was performed. All of the animals were sacrificed for comparison with a non-irradiated group 2 weeks after surgery. Failure of the sutures occurred in 1 of 18 non-irradiated dogs (5.6%), 1 of 9 dogs given 3000 rad (11.1%), with no significant difference, and 5 of 7 given 6000 rad (71.4%), with a significant difference from the other two groups. Irradiation of 3000 or 6000 rad provoked decrease of the interstitial content of hydroxyproline to 70% or 85%, respectively. Although an increasing tendency was observed 2 weeks after anastomosis, the values of the irradiated groups were lower than those of the non-irradiated group. Histopathologically, a strong reaction, chiefly edema, was noted in the submucosal layer. (Chiba, N.)

[en] The effective hepatic blood index was noticed as a factor which decides liver function in pre- and postoperative periods of liver resection. The authors devised a method in which the index was calculated in an area of the liver from hepatic and splenic uptake of ₁₉₈Au-colloid and discussed its clinical significance. The normal value for the index was (183 +- 13) x 10^-₃/min. Following wide resection of the liver, the index decreased in proportion to the amount resected. The preoperatively predicted index for postoperative residual part of the liver roughly correlated with the actual postoperative index by a correlation coefficient, 0.67. The lower limit of the index for survival was estimated to be 50 x 10^-₃/min. The effective hepatic blood flow index can be a valuable indicator of liver function, especially on deciding the extent of liver resection. (Ueda, J.)