Evaluation of early graft function in orthotopic liver transplants in dogs.
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Animals↗
Biomedical subjects
K Kanemitsu
Publications and source records attributed to K Kanemitsu.
[Surgical treatment of chronic pancreatitis without pancreatic duct dilation].
In 11 patients with chronic pancreatitis without dilation of the main pancreatic duct, 4 had segmental lesions of the pancreas and 7 had diffuse lesions of the pancreas. Patients with the segmental lesion had a relatively good pancreatic function and were relieved from pain by surgical treatment for the segmental lesion. On the other hand, patients with the diffuse lesion had far advanced dysfunction of the pancreas and were not improved by drainage operation of the pancreatic duct. For such cases, total or near total pancreatectomy has been indicated to relieve pain at the price of creating insulin dependent diabetes. To control pain and to reserve pancreatic function as long as possible in these cases, we performed the resection of all the pancreatic nervous plexus for such 3 patients and have obtained good results, although follow-up periods are still short. This new approach may offer a means of relieving pain with preservation of endocrine function in selected patients with chronic pancreatitis, especially in patients who have not dilated pancreatic duct.
Adult↗
A new surgical approach for control of pain in chronic pancreatitis: complete denervation of the pancreas.
With the aim of pain control in chronic pancreatitis without the morbidity of insulin-dependent diabetes, a new procedure was devised to completely resect the postganglionic pancreatic nerves and to totally free the pancreas from the posterior abdominal wall. This procedure was performed on two patients with follow-up periods of 24 and 10 months. Pain was resolved in both patients, and their blood glucose levels were substantially unchanged. This new approach offers a means of relieving pain with preservation of endocrine function in selected patients with chronic pancreatitis, especially in patients who have a small pancreatic duct.
Adult↗
[Attenuation efficiency of hearing protectors for workers exposed to noise].
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Adult↗
Immunoelectrophoretic analyses of antigenic and human specific proteins of red cell membrane.
Rabbit antisera were raised for red cell stroma extracted with each of the following solutions; 5 mM phosphate buffer pH 8.0 (A antigen). 5 mM EDTA containing 5 mM 2-mercaptoethanol (B), 1/15 M phosphate buffered saline (C), 0.05% SDS (D), 50 mM Tris-HCl buffer pH 8.0 containing 1% SDS, 1 mM EDTA and 1% 2-mercaptoethanol (E) and 1% Triton X-100 (F). Crossed immunoelectrophoresis showed that E antigen produced relatively numerous precipitation lines, 7-9, against each of the antisera, suggesting that E solution was superior to the others for membrane solubilization. However, the Ouchterlony test demonstrated potent precipitin activity in anti-C, and the antiserum absorbed with monkey stroma which was extracted with F solution was proved to have strict human specificity. By adopting the antiserum to affinity chromatography, human specific antigens were isolated. The antigens gave four bands moving faster than Band 5 at SDS-polyacrylamide gel electrophoresis none of which was stained by Schiff's reagent. Using absorbed anti-C, human specificity of blood stains kept us to for two years could be identified.
Animals↗
An esterase isozyme in non-hemoglobin proteins of cell lysate reacting with mushroom lectin.
Of 20 kinds of plant lectins examined, agglutinin activity of only mushroom lectin was inhibited with non-hemoglobin proteins of the red cell lysate. Chromatography of non-hemoglobin proteins on DEAE-cellulose and on hydroxylapatite resulted in isolating a protein which gave a single precipitation line with esterase activity in immunoelectrophoresis. SDS-polyacrylamide gel disc electrophoresis demonstrated that the protein consisted of two subunits molecular weight of which was approximately 100,000 each.
Agglutination↗
The specificity of anti-A agglutinins from immunized rabbits and plant lectins.
A+ and A- rabbits were immunized with human A red cells, saliva of A+ or A- rabbits or human A.Se. A- rabbits responded well against A.Se saliva and A cells and slightly against A+ saliva, whereas A+ rabbits produced high-titered antibody against A cells which was abolished by absorption with O cells. Agglutination inhibition tests showed that anti-A from A- rabbits immunized with A.Se or A cells was not inhibited with A+ saliva, and anti-A from rabbits immunized with A cells was not absorbed with A.Se saliva. Hydroxylapatite chromatography separated each of A.Se and A+ saliva into three fractions of which the 1st and 3rd fractions of A.Se and only the 3rd of A+ had A activity. The 3rd fraction of A.Se and A+ did not inhibit anti-A from any rabbits immunized but the 1st of A.Se inhibited anti-A from all rabbits except for A+ immunized with A cells. The 1st and 2nd fractions reacted slightly with anti-A from A- immunized with A+ and from A+ immunized with A cells. D. biflorus anti-A distinguished human A from rabbit one but Mushroom anti-A could not. These results suggested qualitative differences between human and rabbit saliva A antigens.
ABO Blood-Group System↗
Combination of intraoperative radiation with resection of cancer of the pancreas.
The utility of intraoperative radiation therapy (IORT) as an adjuvant to the surgical resection of pancreatic cancer was studied. In 1976, as our first trial with this combined therapy, we applied IORT with 30 Gy of electron beam with 8 MeV to 15 patients to prevent local recurrence around the celiac axis and superior mesenteric artery after standard pancreatectomy. However, the combined therapy did not show an improvement in survival rate as compared to that of 19 patients with standard operation alone. Autopsies of three patients with the combined therapy did not show involved lymph nodes in the radiation field, but did show local recurrence around the aorta outside the radiation field. By comparison, we performed extended operation without IORT on nine patients, with almost complete dissection of the lymph nodes around the aorta, from the diaphragm to the level of the inferior mesenteric artery. This extended surgery did not improve survival time, and autopsy showed local recurrence in spite of the dissection of lymph nodes. Therefore, since 1984, we have performed IORT with a dose of 30 Gy, 9 MeV, and an extended radiation field from the diaphragm above to the inferior mesenteric artery below, following extended operation on 14 patients. The five-year cumulative survival rate of these cases was 33.3%. Four autopsies showed improvement of local control rate. No radiation-related complications were noticed postoperatively in patients who underwent extended IORT following pancreatectomy. We were encouraged to continue this approach for the cure of pancreatic cancer.
Adult↗
Evaluation of the efficacy of combined continuous arterial infusion and systemic chemotherapy for the treatment of advanced pancreatic carcinoma.
PURPOSE: To evaluate the effects of combined continuous transcatheter arterial infusion (CTAI) and systemic chemotherapy in patients with advanced pancreatic carcinoma. METHODS: CTAI was performed in 17 patients with stage IV pancreatic cancer with (n = 11) or without (n = 6) liver metastasis. The reservoir was transcutaneously implanted with the help of angiography. The inferior pancreatic artery (IPA) was embolized to achieve delivery of the pancreatic blood supply through only the celiac artery. The systemic administration of gemcitabine was combined with the infusion of 5-fluorouracil via the reservoir. Treatment effects were evaluated based on the primary tumor size, liver metastasis, and survival time and factors such as tumor size, tumor location, and stage of pancreatic carcinoma; the embolized arteries were analyzed with respect to treatment effects and prognosis. RESULTS: A catheter was fixed in the gastroduodenal artery and splenic artery in 10 and 7 patients, respectively. Complete peripancreatic arterial occlusion was successful in 10 patients. CT showed a decrease in tumor size in 6 of 17 (35%) patients and a decrease in liver metastases in 6 of 11 (55%) patients. The survival time ranged from 4 to 18 months (mean +/- SD, 8.8 +/- 1.5 months). Complete embolization of arteries surrounding the pancreas was achieved in 10 patients; they manifested superior treatment effects and prognoses (p < 0.05). CONCLUSION: In patients with advanced pancreatic cancer, long-term CTAI with systemic chemotherapy appeared to be effective not only against the primary tumor but also against liver metastases. Patients with successfully occluded peripancreatic arteries tended to survive longer.
Adult↗
Vascular encasement by pancreatic cancer: correlation of CT findings with surgical and pathologic results.
PURPOSE: The purpose of this study was to correlate thin-slice high-resolution helical CT findings of arterial and venous involvement in pancreatic cancers with surgical and histopathologic results. METHOD: Forty-eight patients with pancreatic cancer underwent preoperative thin-slice high-resolution helical CT, followed by surgical dissection of the pancreatic vessels during curative or palliative surgery. Major vessels running within 1 cm from the tumor margin were evaluated. CT appearance was graded on a 0-4 scale (0: none, 1: <24%, 2: 25-49%, 3: 50-74%, 4: 75-100%) by circumferential contiguity of tumor to vessels. Resected specimens were available from 26 patients. RESULTS: Surgical correlation of CT findings was available in 89 veins and 83 arteries, and both surgical and histologic correlation was available for 42 veins and 29 arteries. At surgical observation, 29 of 35 veins (82.9%) evaluated as CT grade 3 or 4 were found to be involved, whereas only 18 of 30 arteries (60%) evaluated as CT grade 3 or 4 were proved to be involved. On microscopic observation, tumor invasion to the portal venous systems was confirmed in 15 of 42 (35.7%) vessels, and this invasion was depicted as from CT grades 1 to 4. In arteries, tumor invasion was seen in 3 of 29 vessels (10.3%), all of which were graded as 3 or 4 by CT. CONCLUSION: The grading system of vascular invasion should differ between arteries and veins. Involvement of the venous system exceeding one-half circumference of the vessels (grade 3 or 4) was suggestive of vascular invasion; however, this criterion was not always satisfactory for the evaluation of tumor invasion in the arterial system.
Adult↗
A case of early cancer in cystic intrahepatic duct associated with congenital choledochal cyst.
Herein, we report an extremely rare case of early cancer localized in the cystic intrahepatic duct, which is associated with the choledochal cyst including both the intra- and extrahepatic duct (type IV-A cyst). A small polypoid lesion in the cyst was detected by computed tomography. Extensive resection of the choledochal cyst with lobectomy was performed on the tumor in a 23-year-old woman. Tubular adenocarcinoma localized in the wall of the cystic left hepatic duct was histologically confirmed. Awareness of the diagnostic and treatment modalities, with a focus on potential malignancy in the cystic intrahepatic duct, in cases with anomalous arrangement of the pancreatobiliary duct is necessary.
Adenocarcinoma↗