Akihiro Okuda

Segmental autotransplantation of the pancreas after total pancreatectomy for advanced periampullary carcinoma —A case report—

A case is reported here in which segmental autotransplantation of the pancreas was performed after total pancreatectomy for advanced periampullary carcinoma in an attempt to preserve pancreatic endocrine function. The postoperative course was uneventful. The requirement of insulin decreased after the operation and the daily profile examination, done 5 months following surgery, showed a permissive fluctuation of blood sugar levels without insulin injection. Thus, segmental autotransplantation of the pancreas offers a method of preserving pancreatic endocrine function after total pancreatectomy for periampullary carcinoma in selected patients.

Multichannel myocardial temperature probe.

We present a new system to measure myocardial temperature at multiple points in myocardium. This system consists of a probe with multiple thermocouples, a data collector, and a personal computer. We have demonstrated a change in distribution of temperature in myocardium during hypothermic cardioplegic arrest.

Surgical Patch Treatment of SVC Syndrome Caused by Transvenous Pacemaker Lead.

症例は56歳, 男性. 徐脈型心房細動にて永久ペースメーカー植込み術を施行され術後2年より, 顔面浮腫が出現した. 静脈造影像にて左無名静脈の狭窄, 左右無名静脈合流部付近上大静脈に高度の狭窄像を認め, 内頸静脈圧と上大静脈に20mmHgの圧較差を認めた. 保存的治療に抵抗性であったため手術を施行した. 胸骨正中切開後, ペースメーカーリードは Locking Stylet を用い抜去した. 上大静脈の狭窄部壁は硬く, 肥厚していた. 組織学的に静脈硬化像を認めた. 狭窄部位は自己心膜パッチで拡大術を施行し, 術後症状は軽快した. 本症は抗凝血薬療法が奏功することが多いとされるが, 保存的治療に抵抗性で静脈硬化を伴うものは病変部の不可逆的な閉塞あるいは狭窄を伴っている可能性があり外科的治療が有効であると考えられた.