OC-108 is a useful alternative treatment for hemorrhoids.

A randomized, controlled trial of adjuvant immunochemotherapy with PSK (Kureha Chemical Industry Co., Tokyo, Japan) in curatively resected colorectal cancer was studied in 35 institutions in the Kanagawa prefecture. From March 1985 to February 1987, 462 patients were registered. Four hundred forty-eight of those patients (97.0 percent) satisfied the eligibility criteria. The control group received mitomycin C intravenously on the day of and the day after surgery, followed by oral 5-fluorouracil (5-FU) administration for over six months. The PSK group received PSK orally for over three years, in addition to mitomycin C and 5-FU as in the control group. At the end of February 1990, the median follow-up time for this study was four years (range, three to five years). The disease-free survival curve and the survival curve of the PSK group were better than those of the control group, and differences between the two groups were statistically significant (disease-free survival, P = 0.013; survival, P = 0.013). These results indicate that adjuvant immunochemotherapy with PSK was beneficial for curatively resected colorectal cancer.

We investigated 91 cases of acute cholangitis, including 42 of severe cholangitis and 49 of mild cholangitis. The incidence of endotoxemia was 78.6 percent in 42 and 32.6 percent in the 49 patients. In the 42 with severe cholangitis, remarkable leukocytosis, thrombocytopenia, decrease of serum CH50, C3, plasma fibronectin and phagocytic index were characteristic. Disseminated intravascular coagulation (DIC) was observed in 76.2 percent. Since there was a positive correlation between platelet counts and levels of CH50 and C3, the decrease of platelet count, and the occurrence of DIC in patients with endotoxemia were thought to be closely related to the consumption of complements. There was no difference in mortality rate between nonsurgical treatment (57.8 percent) and the emergency bile drainage treatment (56.5 percent). The results of therapy depended on the degree of complicating DIC. We conclude that acute cholangitis was aggravated by endotoxemia and that severe cholangitis was accompanied by DIC induced by a decline in phylaxis.

By co‐culturing regional lymph node B‐cells and HAT‐sensitive mutant cells obtained from RPMI‐1788 cells, no less than 20,000 Epstein‐Barr (EB)‐transformed colonies were obtained from 32 patients with gastric cancer. From B‐cell cultures generating antibodies reactive with gastric cancer tissues as well as cultured gastric cancer cells, two EB‐transformed cell clones termed C418–59 and C1218–39 were isolated. Both of them produced human IgM‐class antibodies, termed Mab418–59 and Mab 1218–39, respectively. Both antibodies reacted with an antigen with a molecular weight of 45 kd existing in gastric cancer MKN‐45, MKN‐1, and Kato‐III cells, and also with all of 4 adenocarcinomas of the stomach in paraffin sections. The antigen recognized by both antibodies was identified as a kind of cytoskeletal protein, cytokeratin 18, In this study, it was confirmed that B‐cell clones generating autoantibodies against cytokeratin 18 were present in some patients with gastric cancer.

Stones extracted from patients with hepatolithiasis were analysed by infrared spectrophotometry. Cholesterol stones containing 70% or more cholesterol were found in 12 out of 55 cases. Judging from the lodging site of the stones, the degree of dilatation of the cystic duct, and the presence of cholecystitis, five of the cases were considered to be cholesterol stones produced in the liver. Two out of the five cases were a 44-year-old female and a 46-year-old female, respectively, with normal bifurcation of intrahepatic ducts, and stones were found in the lateral branches of dilated cystic bile ducts. The other three were 2 males and 1 female with an average age of 33. In these cases, the posterior descending branch bifurcated from the left hepatic duct, and stones were lodged in the dilated bile ducts distal to the junction of the left hepatic duct and the posterior descending branch. It is our conclusion that at least the former two were cases of "primary cholesterol hepatolithiasis" in view of the shape of the stones conforming to the hepatic duct, their easy morcellation, and the high cholesterol contents.

Seven patients with active Crohn's disease were treated with cyclosporin A orally for 16 weeks. The initial dose was 8 mg/kg/day and the subsequent dose was adjusted to maintain the plasma concentration of cyclosporin A of approximately 200 ng/ml. The mean value of the Crohn's disease activity index before treatment was 194.3 +/- 57.4. It was gradually decreased reaching a nadir at 12 weeks (139.0 +/- 45.6, p less than 0.05) and one enterocutaneous fistula was closed. White blood cell counts, hemoglobin and alpha-2-globulin did not significantly improve during treatment. Cyclosporin A could be indicated when steroids, sulfasalazine or azathioprine are not effective or not tolerated.

An age- and sex-matched comparative study of bone disorders between control and patient groups after gastric surgery was performed with the cooperation of a number of hospitals in Japan. In males after gastric surgery a high incidence of bone atrophy was observed in the 5th and 6th decades. In females, however, there was no marked difference between patient and control groups. Evaluation by operative procedures showed that the incidence of bone atrophy was higher in male patients after Billroth II or total gastrectomy than in the patients after Billroth I gastrectomy.

Of a total 44 patients with Crohn's disease, 10 patients with 9 internal and 15 external fistulae, some of which were recurrent, were analyzed at the Department of Surgery, Yokohama City University between 1973 and 1988. Twenty-two fistulae were treated with medical and nutritional therapy using either total parenteral or enteral hyperalimentation by which the closure rate of the internal and external fistulae was 0 (0/9) and 42 per cent (9/14), respectively. The nutritional status of all the patients with fistulae treated by nutritional therapy improved, especially those whose fistulae were closed. However, 8 of 9 internal fistulae and 5 of 15 external fistulae finally required resection of the fistula with the distal stenotic bowel segment. The re-opening rate of fistulae following successful medical/nutritional therapy and surgical therapy was 88.9 per cent (8/9) and 53.8 per cent (7/13), respectively, and the mean interval until recurrence was shorter in the patients who underwent medical and nutritional therapy (4.5 months) than in those who underwent surgical therapy (19.4 months). Thus, using medical and nutritional therapy, none of the internal fistulae were closed, but 9 of 14 external fistulae were. The optimal management of internal fistulae is therefore thought to be bowel resection to include the distal stenotic lesion, while medical and nutritional therapy is thought to be of value for external fistulae.