Despite a slow decline in the incidence of gastric cancer over the last 90 years, we can still expect to see over 100,000 patients die of this disease each decade in England and Wales. The 5-year survival rate has not improved during this century, which is largely due to the stage at diagnosis being unchanged. There are a number of prognostic determinants in gastric cancer which have clinical relevance. Age is an important determinant; patients under 40 years commonly have more advanced diffuse lesions than older patients so that a higher index of suspicion needs to be maintained in younger patients with persistent symptoms. Conflicting reports make it unclear whether the duration of symptoms bears any relationship to tumor stage, but there is some evidence that actively shortening the symptom duration by early investigation can have a beneficial effect in the proportion of patients diagnosed with early cancers. The site of the tumor is important; unfortunately, the proportion of patients with cardia lesions is increasing and this has had the effect of reducing the overall survival. Tumor size should not play a part in the decision to resect a lesion as most studies show no clear relationship between tumor size and stage. Tumor stage is the most important prognostic determinant and efforts to increase the proportion of stage I cancers presenting for surgery can be shown to alter the natural history of the disease, by diagnosing it when it is still surgically curable.

ABO Blood-Group System↗

PubMedDate not supplied

Mucin histochemistry of submandibular and parotid salivary glands of man: light and electron microscopy.

Light-microscopy showed parotid serous acinar cells to contain neutral mucin, serous and mucous acinar cells of submandibular gland and intercalary ductal cells of both glands to contain acid and neutral mucins, and cells of striated ducts and excretory ducts to contain neutral mucin. Mucins were demonstrated ultrastructurally in a portion of the components of secretory granules of acinar cells and intercalary ductal cells, and in secretory granules of striated and excretory ductal cells. The mucins were all stained by techniques that reveal 1,2-glycols. Secretory granules of submandibular mucous and serous acinar cells and intercalary ductal cells were stained variably by the low iron-diamine technique for acid mucin, and those of mucous acinar cells by the high iron-diamine technique for sulphomucins mucin and possibly consisted of protein. The results suggest that one type of cell may be able to produce a range of secretory products and to package them variously into secretory granules.

Histocytochemistry↗

PubMedDate not supplied

Measurements of actinide gut-transfer factors in humans.

Measurements have been made of the gastrointestinal absorption in humans of 239Np and 242Cm administered together in citrate media. Using five volunteers, consistent results of (2.0 +/- 0.2) x 10(-4) and (1.7 +/- 0.3) x 10(-4) were obtained for Np and Cm respectively; the quoted uncertainties are the standard errors of the means. A progress report is given of work to measure the f1 value for Pu in humans. Early work suggests an f1 value of 2 x 10(-4).

Administration, Oral↗

PubMedDate not supplied

Artery weld strength after bipolar electrocoagulation is affected by electrolyte solutions around the artery.

We have recently shown that artery weld strength is significantly increased by increasing bipolar electrocoagulation time in fresh rabbit arteries, which had either 2 or 20 seconds of electrocoagulation under uniform conditions. In this study we investigated the effect of using either distilled water or physiologic saline around the artery during electrocoagulation in a total of 27 experiments, because it is the current practice to wash clot and liquid blood off bleeding ulcers with water. Fresh rabbit arteries were used, with a bipolar coagulation time of 2 seconds, with a constant weight of 500 gm applied to the head of the probe to standardize conditions. The bursting pressure of the coagulum was determined by cannulating the artery and increasing the pressure until the coagulum seal fractured. The artery weld strength was significantly lower when distilled water was used (median, 87.5 mm Hg; range, 10 to 225 mm Hg) compared with results when normal saline was used (median, 150 mm Hg; range, 100 to 850 mm Hg); by Mann-Whitney tests U = 42.5, Z = 2.36, and p = 0.018. These data suggest that more effective hemostasis of bleeding arteries may be achieved by not only more prolonged use of the diathermy probe, but also by using physiological saline as the washing solution instead of water, as is currently practiced.

Animals↗