No abstract

Immunohistochemistry of the S phase related proliferating cell nuclear antigen (PCNA) was studied as an alternative to ex-vivo bromodeoxyuridine (BrdU) immunohistochemistry for assessment of human colonic cell proliferation. From 16 subjects without colonic disease biopsy specimens were collected from five different sites along the colorectum and processed for BrdU Materials and methods BIOPSY SPECIMENSBiopsy specimens of endoscopically normal colonic mucosa were taken at five different sites from proximal to distal in the colorectum (ascending, transverse, and descending colon, sigmoid, and rectum) of 16 subjects who had had diagnostic colonoscopy because of abdominal complaints and who were found not to have any organic colonic disorders (seven men, nine women, mean age 49 years, range 17 to 76). All specimens were taken by one endoscopist (LGJBE) and completely processed by the same technician (AP-H). Specimens were immediately placed in RPMI 1640 tissue culture medium containing 10% fetal calf serum, 20 [1M 5-fluoro-uracil, 20 FM bromodeoxyuridine (Serva, Heidelberg, Germany), and 0 9% hydrogenperoxide during one hour at 37°C.The composition of the tissue culture medium was based on a 3 x 3 experiment in which optimal conditions for ex vivo labelling of mouse and human tissue with BrdU were determined. Intestinal specimens were incubated in RPMI 1640 medium containing 10% fetal calf serum and concentrations of 1, 2 or 3x 10-) M BrdU and 0 5, 1 or 2 10-5) M 5-fluorouracil. We found that the addition of hydrogen peroxide seemed to improve the label uptake, therefore in this experiment hydrogen peroxide 30% was added to final concentrations of 0-3, 0-9, and 1-8% respectively. Specimens were immersion fixed in 70% ethanol for at least 24 hours. Best results with regard to immunoreactivity and morphology, were obtained by incubation with RPMI 1640 medium containing 10% fetal calf serum, 2x 10-) M 5-fluoro-uracil, and 0-9% hydrogen peroxide.As maximum incorporation of BrdU can be expected after depletion of the endogenous pool 530 on 12 May 2018 by guest. Protected by copyright.

A retrospective review of 325 patients was undertaken to analyse whether involvement of the radial resection margin (RRM) could predict locally recurrent disease or distant metastases in patients who had curative surgery for rectal or rectosigmoid cancer. Information on the RRM was available in 253 patients. The RRM was involved in 31 (12 per cent). Nine of these 31 patients developed local recurrence (29 per cent), while only 17 local recurrences were diagnosed in 217 patients (8 per cent) without involvement of the RRM (P < 0.01). At 2 years the overall local recurrence rate was 10 per cent. Distant metastases were diagnosed in 46 patients (18 per cent) and RRM involvement was identified as a prognostic factor depending on lymph node involvement (N stage) (P = 0.02). Local recurrence and some distant metastases result from microscopically incomplete resection. Assessment of the radial depth of tumour invasion by careful histological examination of x791p4ecimen may be used for selection of patients for adjuvant radiotherapy and/or chemotherapy.

Summary iBackground In familial adenomatous polyposis the only curative treatment is colectomy, and the choice of operation lies between restorative proctocolectomy (RPC) and colectomy with ileorectal anastomosis (IRA). The RPC procedure carries a higher morbidity but, unlike IRA, removes the risk of subsequent rectal cancer. Since the course of familial adenomatous polyposis is influenced by the site of mutation in the polyposis gene, DNA analysis might be helpful in treatment decisions.

High-resolution MRI of the anorectal region without an endoluminal coil is feasible. The MR technique with an external phased array coil allows detailed imaging of the anal sphincter at rest, the rectum, and the surrounding pelvic structures with one single investigation. The results are promising and suggest useful applications in the management of anorectal diseases.