The relationship of self-concept (self-esteem and mastery) and social support to psychological distress was studied among 68 Israeli women immediately prior to undergoing biopsy for suspected cancer (acute stress) and 3 months later for the noncancer group (everyday stress). It was predicted that women with stronger self-concepts and more social support would experience less state depression and state anxiety during the acute crisis than women with weaker self-concepts and less social support. It was further predicted that self-concept would be more critical than social support due to the acute nature of the event. Finally, self-concept was predicted to be related to psychological distress both during the acute and everyday stress situations (a direct effect), while social support was predicted to be related to psychological distress only during the acute stress situation (a buffering effect). The hypotheses were generally confirmed. However, self-concept and social support were seen as complexly related to psychological distress during the acute phase, one not necessarily being more critical than the other. The selective employment of available resistance resources to fit the situation and implications for preventive intervention were discussed.

Cyclins D1, D2 and D3 play important roles in cell proliferation and differentiation. Although their abnormal expression has been linked to cancer development and progression in a number of tissues, the expression of cyclin D2 and D3 proteins in colon cancer has not yet been characterised. In this study, we examined cyclin D1, D2 and D3 protein expression by Western blot analysis in tumour and adjacent normal colon tissues of 57 patients. In addition, we examined D-type cyclins protein expression in HT29 and LoVo39 cell lines from colon carcinomas, as a function of induced proliferation and differentiation. In both cell lines, the expression of the three D-type cyclins increased as a result of induced proliferation, whereas the expression of cyclin D3 increased as a result of induced differentiation. In colon tumours, cyclin D1 was overexpressed in 44%, cyclin D2 was overexpressed in 53% and cyclin D3 was overexpressed in 35% of the cases. We also found that in 16% of the cases, cyclin D3 protein expression was reduced in the tumour, as compared to the adjacent normal tissue. Examination of D-type cyclin protein overexpression in relation to the TNM stage of the tumours revealed that overexpression of cyclins D1 and/or D2, but not cyclin D3, is linked to colon carcinogenesis and that overexpression of cyclin D2 may be related to a higher TNM stage of the tumour.

The functional success rate of the ileoanal reservoir procedure for ulcerative colitis is quite high. Despite the few early and late complications described there is now widespread acceptance of this procedure in the management of ulcerative colitis. We report a patient who developed an adenocarcinoma in the rectal cuff four years after having a pelvic pouch procedure. This new late complication brings to light several points including the importance of a radical total mucosectomy. The purpose of this paper is to discuss concern as to whether or not this procedure is indicated in colitis patients in whom severe dysplasia is the primary indication for surgery. Abdominal colectomy, rectal mucosectomy and ileoanal pouch anastomosis has gained increased acceptance as an alternative to total proctocolectomy and end ileostomy in the management of ulcerative colitis. A concern about this procedure is the fate of any islets of rectal mucosa left behind or regenerated in the cuff of rectal muscle stripped of its mucosa. The literature suggests that residual islets of mucosa appear in up to 20% of these procedures.' Regeneration of islets, however, does not seem to occur.2 This concern is particularly relevant in patients in whom the indication for surgery is severe dysplasia.3The increased risk of developing colonic carcinoma in patients with ulcerative colitis has been known for many years, especially in younger age groups who have had more extensive colitis for longer than 20 years.45 Cancer in colitis is frequently a fatal illness whch is entirely preventable by a total colectomy.3 A recent report suggests that a pelvic pouch is indicated even in the presence of colonic cancer providing that the cancer does not invade the pelvic floor muscles and the resection margins do not damage the sphincter mechanism.6Case report We report the first patient to have undergone a total colectomy, rectal mucosectomy and ileoanal pelvic pouch anastomosis, who subsequently developed a cancer in the residual rectal cuff. This 59 year old man was diagnosed as having ulcerative colitis at age 21. He was well for 28 years until 1977 when he was found to have

Epidemiological studies have shown that high serum levels of insulin-like growth factor-I are associated with an increased risk of colon and other types of cancer. The aim of this study was to determine whether short intervention with dietary tomato lycopene extract will affect serum levels of the insulin-like growth factor system components in colon cancer patients. The study had a double-blind, randomized, placebo-controlled design. Colon cancer patients (n=56), candidates for colectomy, were recruited from the local community a few days to a few weeks before surgery. Personal and medical data were recorded. Plasma concentrations of insulin-like growth factor-I and II and insulin-like growth factor-I-binding protein-3 were assayed by routine laboratory methods. Lycopene was assayed by high-performance liquid chromatography. Plasma lycopene levels increased by twofold after supplementation with tomato lycopene extract. In the placebo-treated group, there was a small nonsignificant increase in lycopene plasma levels. The plasma concentration of insulin-like growth factor-I decreased significantly by about 25% after tomato lycopene extract supplementation as compared with the placebo-treated group (P<0.05). No significant change was observed in insulin-like growth factor-I-binding protein-3 or insulin-like growth factor-II, whereas the insulin-like growth factor-I/insulin-like growth factor-I-binding protein-3 molar ratio decreased significantly (P<0.05). Given that high plasma levels of insulin-like growth factor-I have been suggested as a risk factor for various types of cancer including colon cancer, the results support our suggestion that tomato lycopene extract has a role in the prevention of colon and possibly other types of cancer.

Lycopene, the main carotenoid found in tomatoes and tomato-based products, has been reported to be protective against several types of cancer. Assessment of changes in plasma concentration of carotenoids following ingestion of lycopene-rich food sources does not necessarily predict changes in lycopene concentration or distribution of its isomers in other body tissues. Our aim was to determine the relationship between concentrations of lycopene and other tomato carotenoids in human serum and body tissues after tomato-oleoresin supplementation. Tomato lycopene oleoresin (30 mg/d) or a placebo was administered for 1 to 7 weeks to seventy-five volunteers undergoing elective haemorrhoidectomy or peri-anal fistulotomy. Carotenoid concentration and isomer distribution in blood and in the surgically removed skin and adipose tissues was measured by HPLC. The serum concentration of lycopene increased after supplementation from 0·26 (SD 0·12) to 0·52 (SD 0·25) mmol/l (n 35; P, 0·0001). In the placebo group (n 40), lycopene serum concentration did not change significantly. Serum lycopene concentration after treatment was 2·2-fold greater in the lycopene group than in the placebo group, a slightly higher ratio than that found in skin and adipose tissue (1·6-and 1·4-fold higher than the placebo, respectively). A significant correlation between serum and tissue concentrations was found for both b-carotene and lycopene in the placebo group, whereas in the lycopene-supplemented group the correlation between serum and tissues remained the same for b-carotene but for lycopene was weak. Lycopene supplementation did not significantly change the proportion of all-trans v. cis isomers in the serum and tissues, despite the fact that more than 90 % of the supplemented lycopene was in the all-trans form. These results show that tomato-oleoresin supplementation increases lycopene concentrations in serum and in adipose tissue and skin. The ability to increase lycopene levels in tissues is one of the prerequisites for using it as a food supplement with health benefits.

Preoperative Imatinib therapy can shrink large rectal GISTs, improving the chances of successful radical surgery and decreasing the risk of considerable morbidity.

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This method could give rise to a reduction in false-negative results during examination of biopsies using the conventional histopathological methods. The present method may be complementary to existing methods for precise demarcation of the zone of colostomy prior to colon cancer surgery.