Hiroyuki Soga

Endothelin-1 levels in portal venous blood in relation to hepatic tissue microcirculation disturbance and hepatic cell injury after ischemia/reperfusion.

This study was conducted to clarify the role of endothelin-1 in the portal vein after hepatic ischemia/reperfusion and to ascertain whether it is related to hepatic microcirculation disturbance. Using a canine ischemic liver model, the portal and systemic endothelin-1 levels were measured before ischemia, then after 1h and 2h of reperfusion, and comparatively evaluated with the serum levels of GOT and lactic dehydrogenase (LDH). As an indicator of liver tissue microcirculation, tissue blood flow volume (TBF) was also measured in the site subjected to ischemia. The animals were divided into: group 1, which received ischemia for 30 min; group 2, which received ischemia for 60 min; and group 3, which received a sequence repeated four times of 15 min ischemia and 10 min reperfusion. The portal endothelin-1 level became significantly elevated after reperfusion compared to that before ischemia in all groups, being significantly higher in group 2 than in the other groups. The systemic endothelin-1 level also increased after reperfusion; significantly in group 2. The portal endothelin-1 level was generally higher than the systemic level, which again was statistically significant in group 2. After 2h of reperfusion, a significant positive correlation was found between the portal endothelin-1 level and serum LDH, whereas a significant negative correlation was found between the portal endothelin-1 level and TBF. The finding that the portal endothelin-1 level became elevated after hepatic ischemia/reperfusion suggests that it probably plays an essential role in hepatic ischemia/ reperfusion injury by adversely influencing tissue microcirculation.

The suppression of postoperative liver metastasis caused by the continuous intraportal infusion of angiogenesis inhibitor FR-118487 in a rabbit colon cancer model

The inhibitory effect of FR-118487, a potent angiogenesis inhibitor, on neovascularization induced by the VX2 tumor was confirmed in a rabbit corneal assay. The antimetastatic effect of FR-118487 was also investigated in 21 rabbits. Spontaneous liver metastases were induced by VX2 tumor cell implantation into the ascending colonic wall. FR-118487 was then infused continuously into the portal vein for 7 days after resection of the primary lesion at a dose of 1mg/ kg/day (FR-1 group) or 3 mg/kg/day (FR-3 group). The incidence of liver metastases was 71.4%, occurring in 5 of 7 rabbits, in each of the FR-1 and FR-3 groups, compared with 100%, being all of 7 rabbits, in the control group. The number of metastatic foci tended to be less in the FR-1 (31.0±36.0) and FR-3 (24.6±45.1) groups than in the control group (83.7±73.9) and the weight of metastatic foci was significantly less in the FR-1 (1.4±1.8 g) and FR-3 (1.3±2.0 g) groups than in the control group (6.5±4.9 g) (P<0.05). However, leakage of the colonic anastomosis and body weight loss were limited to the FR-3 group. These results suggest that the continuous intraportal infusion of FR-118487 at 1mg/kg/day suppressed liver metastases by inhibiting angiogenesis, without producing any adverse effects.

The presentation of a double aortic arch in adulthood in association with congestive heart failure attributed to a previously silent aortic regurgitation

This paper describes an adult case of a double aortic arch (DAA; Edwards type IA). The patient had been asymptomatic for DAA but presented difficulty in swallowing in association with congestive heart failure, which she experienced as the result of attending to her sick husband while she apparently suffered from a silent aortic regurgitation. The symptoms disappeared and the patient recovered from heart failure following medical treatment. The patient soon discontinued the outpatient treatment and, after 2 years, the identical symptoms recurred under similar circumstances. In this paper we demonstrate that an asymptomatic case of DAA has the potential to clinically manifest itself.

Splenic Hamartoma. A Report of Two Cases.

脾過誤腫は, 脾臓に発生するまれな良性腫瘍で, 本邦では24例の報告がある. 最近, われわれは脾過誤腫の2症例を経験したので報告する. 腫瘍は, 画像診断上特徴ある所見を呈し, 超音波検査では低エコー像として, CTでは低濃度域像として描出され, 造影CTでは1例において強く濃染された. MRIではT1強調画像にて等～低信号を, T2強調画像にて低信号を示した. 血管造影は1例に行われ, 腫瘍濃染像を呈した. 2例とも脾腫瘍として脾摘出術を施行し, 術後の病理組織学的検索により脾過誤腫と診断された.

A trial of the intraperitoneal administration of recombinant interferon-.BETA. for the prevention of the postoperative peritoneal recurrence in gastric cancer with serosal invasion.

漿膜露出胃癌の腹膜再発防止の目的でRecombinant interferon-β (IFN-β) の術後腹腔内投与を試みた.胃癌癌性腹水10例では著効2例, 有効4例 (奏効率60%) を得た. 特に低分化腺癌, 印環細胞癌に強い効果を認めた. 発熱以外の重篤な副作用はなく, 剖検例の検索で癒着を促進するような刺激作用は認めなかった. 漿膜露出胃癌13例に対する術後腹腔内投与では, 縫合不全, イレウスなどの合併症は無く治癒手術例では腹膜再発を認めていない.S2, 肉眼的治癒手術例を対象にIFN-βの術後腹腔内投与の有無での比較試験を行っており, 術後補助療法としての本法の評価を明らかにしたいと考えている.