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Conventional endoscopic resection (CER) includes polypectomy and endoscopic mucosal resection. The most common complications related to these techniques are post procedure bleeding and perforation. The aim of this study was to evaluate the outcomes of CER for colorectal neoplasms ≧20 mm and to clarify predictive factors for complications. We conducted a multicenter prospective study at 18 specialized institutes. From October 2007 to December 2010, 1,029 CERs were performed at participating institutes. We collected the data prospectively and analyzed gender, age, tumor size, gross appearance, mode of resection, etc. The mean size of polyps resected was 26.4 ± 8.6 mm (range 20–120 mm). The final pathology was Vienna classification category 1 or 2 in 24, category 3 in 502, and category 4 or 5 in 503 lesions. Post procedure bleeding and intra procedure perforation occurred, respectively, in 16 (1.6 %) and 8 cases (0.78 %). The overall complication rate was 2.3 %. Risk factors for bleeding in multivariate analysis were only patients under 60 years of age. Risk factors for perforation in multivariate analysis were en bloc resection and Vienna classification category 4–5. The difference of complication rate was not statistically significant regarding gender, size, tumor location, gross appearance, treatment method, and kind of insufflation. CER is a safe, efficient, and effective minimally invasive therapy for large colorectal lesions. However, care should be taken for post procedure bleeding in patients under 60 years of age and for perforation in cases of Vienna classification category 4–5 or when an en bloc resection is tried.

AbstractPrimary sclerosing cholangitis (PSC) is an autoimmune disease of the hepatobiliary system for which effective therapy has not been established. Leukocytapheresis (LCAP) therapy is known to effective in patients with ulcerative colitis (UC). In addition, effects of LCAP therapy were reported on some autoimmune diseases such as Crohn’s disease, rheumatoid arthritis and rapidly progressive glomerulonephritis. Here we report the case of a 29-year-old man with PSC associated with UC who was treated with LCAP therapy. He had a 16-year history of UC and a 12-year history of PSC. Although he was under treatment with prednisolone and ursodeoxycholic acid, exacerbation of UC and PSC-associated cholestasis were seen. Since he showed side effects of prednisolone, he was treated with LCAP. Not only improvement of UC, but also decreased serum alkaline phosphatase, ?-guanosine triphosphate and total bile acids, suggesting improvement of PSC-associated cholestaisis, were seen after treatment with LCAP. Our experience with this case suggests that LCAP therapy could be a new effective therapeutic strategy for patients with PSC associated with UC.Copyright © 2009 S. Karger AG, Basel

Inflammatory bowel disease (IBD) is a chronic inflammatory state associated with increased risk of intestinal cancers. The aim of this study is to examine serum concentrations of growth-related oncogene (GRO)-α, a cytokine with inflammatory and growth-regulatory properties, in patients with IBD. We measured serum concentrations of GRO-α in 60 patients with ulcerative colitis, 42 patients with Crohn's disease, 16 patients with other colitides, 12 patients with colorectal cancer, and 40 normal subjects using an enzyme-linked immunosorbent assay. We then analyzed how the cytokine was related to clinical and laboratory variables. Serum GRO-α concentrations in patients with active IBD were significantly higher than those in patients with quiescent disease, which in turn were higher than those in normal controls. Concentrations in patients with active ulcerative colitis were higher than in patients with active Crohn's disease. Analysis of paired serum samples showed a decrease in GRO-α after initiation of therapy. Furthermore, serum GRO-α correlated well with laboratory markers of IBD activity. We conclude that GRO-α may have an important role in development of IBD, and might itself be used as a marker of activity. Manipulation of GRO-α function might prove therapeutically useful.

5‐Thio‐L‐fucose‐containing trisaccharide H‐type II was synthesized. The 3′,4′‐O‐isopropylidene‐2‐azido‐2‐deoxylactoside derivative, which was prepared from lactose by azidonitration of lactal, was used as a starting material. By regio‐ and stereoselective 5‐thio‐L‐fucosylation of the 6,6′‐dibenzoate 5with 5‐thiofucosyl trichloroacetimidate 6and subsequent deprotection gave the 5‐thio‐L‐fucose‐containing H‐type II 1. Conformational analysis of the 5‐thio‐L‐fucose‐containing H‐type II and the native H‐type II was carried out through NOESY experiments. The observed NOE values between N‐acetylglucosamine and galactose, and galactose and fucose were same for these two trisaccharides. However, NOE values between fucose and N‐acetylglucosamine were significantly different. Binding of the 5‐thio‐L‐fucose‐containing H‐type II to lectins and antibodies were in some case stronger and in some case weaker than those of the native trisaccharide.

To clarify the cell adhesion status in ulcerative colitis (UC)–associated colon neoplasm, expression of cell adhesion molecules were investigated and compared with that of sporadic colon neoplasm. A total of 14 low grade dysplasias, 16 high grade dysplasias, and 8 adenocarcinomas associated with UC and 17 sporadic adenomas with mild to moderate dysplasia, 22 adenomas with severe dysplasia, and 15 invasive adenocarcinomas were immunohistochemically examined using monoclonal antibodies against CD44, E-cadherin, alpha- and beta-catenin, and deleted colon carcinoma (DCC). CD44, especially its standard form, and DCC expression was stronger in the sporadic colon neoplasms than in the UC-associated lesions. Although E-cadherin did not show significant differences between the two cases, alpha-catenin was more expressed in sporadic colon adenomas with severe dysplasia and carcinomas than in their UC-associated counterparts. Membranous beta-catenin staining was stronger in UC-associated neoplasms, whereas sporadic lesions had greater cytoplasmic and nuclear expression. The differences in cell adhesion molecule expression suggests that UC-associated and sporadic colon neoplasms arise from different pathways of tumorigenesis. Cancer 2000;89:733–40. © 2000 American Cancer Society.

A continuous analyzer has been developed for automatic monitoring of nitrogen oxides (NOx) emission from stationary air pollution sources. This newly developed system has essentially adopted the principle of NO-O3chemiluminescence method with an atmospheric pressure detector and is furnished with an automatic corrector for air leakage in stack. Deliberation on the instrument construction and the gas sampling system has also been made in order to provide precision in NOxdetermination and easiness in maintenance of the instrument. The results of about six month practical operation of this instrument in the actual field of boiler emission gas at a large scale power station were quite satisfactory.

Two blood group antigens, H-type 2 and Lewis X trisaccharides containing 5-thio- l-fucose instead of l-fucose, were synthesized. 2-Azido-2-deoxy-lactose derivative 11was used as the common disaccharide intermediate. 5-Thio- l-fucosylation of the 2′-OH and 3-OH groups of 1,6-anhydro-2-azido-2-deoxy-lactose derivative by a trichloroacetimidate method gave α-linked trisaccharides stereoselectively.

Abstract: Churg‐Strauss syndrome (CSS), a relatively rare disorder which is associated with serious complications, has a highly variable courseand several possible manifestations. We present the case of a 35‐year‐old woman with a history of bronchial asthma, admitted for evaluation of lower abdominal pain and melena, whose clinical course had certain features in common with CSS. On admission, the white blood cell count was 45,300/mm3with 65% eosinophils, and the serum immunoglobulin E (5,300 u/ml) level was remarkably elevated. At colonoscopy, there were shallow ulcers, irregular in shape, throughout the large intestine. Abdominal pain and melena were relieved by oral administration of prednisolone. Most previously reported cases have not been recognized as having colonic involvement until surgery or autopsy. In only a few reports of CSS and related disorders were colonoscopic examination findings described.

This paper reports a case with an undifferentiated carcinoma of the esophagus which primarily developed symptoms due to metastatic lesions. The case was a 59-year-old woman with a primary manifestation of an abdominal mass and with subsequent dysphagia. A protruding lesion with ulceration was found at the lower third of the thoracic esophagus by endoscopic examination and was histologically proved to be an undifferentiated carcinoma by biopsy. The abdominal mass was initially thought to be due to metastasis to an abdominal lymph node based on the diagnosis image finding at admission, but it was consequently found by autopsy to be a metastatic tumor in the liver. Therefore, undifferentiated carcinoma of the esophagus should be take into account for differential diagnosis of an abdominal mass.

The first ß-selective chemical 5-thioglycosylation of a secondary alcohol was attained with the 2-deoxy-2-phthalimido-5-thioglucose derivative. Requirements of the carbonyl functional groups at C2 to exert anchimeric assistance are discussed on the basis of the results with various functional groups.

ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 200 leading journals. To access a ChemInform Abstract of an article which was published elsewhere, please select a “Full Text” option. The original article is trackable via the “References” option.

We investigated the relationship between histological factors and lymph node metastasis in 77 lesions with submucosally invasive colorectal carcinomas to establish useful criteria for lesions in which endoscopic treatment alone results in cure of malignancy. There were positive correlations between histological factors, including the level of invasion, the histologic grade, presence or absence of lymphatic invasion, presence or absence of budding, and lymph node metastasis (p < 0.05, p < 0.05, p < 0.005, p < 0.01). The presence or absence of venous invasion did not influence lymph node metastasis. Laparoscopic surgery involving lymph node dissection should be indicated for sm1 carcinoma lesions with unfavorable histological factors. In lesions diagnosed as sm2 or sm3 prior to resection, intestinal resection involving lymph node dissection by laparoscopic surgery should be directly performed without endoscopic resection.

ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 100 leading journals. To access a ChemInform Abstract of an article which was published elsewhere, please select a “Full Text” option. The original article is trackable via the “References” option.