Kikuo Mori

Successful surgical management of penetrating cardiac injury

A 60-year-old Asian man who suffered penetrating thoracoabdominal injuries was admitted to our hospital in a state of shock. Because the results of a chest computed tomogram (CT) strongly suggested a left ventricular injury, an emergency thoracotomy was performed. A laceration of the left ventricle (3 cm) was sutured and was closed without cardiopulmonary bypass, and coexisting lacerations of the superior mesenteric artery (SMA) and small bowel were surgically repaired. During the procedure, cardiac arrest occurred, but the patient recovered without any apparent neurologic deficit. Postoperative examinations using echocardiogram, CT, and cardiac catheterization revealed a delayed rupture of the left ventricle. On the 28th day after surgery, he was transferred to another hospital for elective cardiac surgery. Primary management of penetrating cardiac injury is discussed in this report.

Primary non-Hodgkin's lymphoma in the dorsolumbar muscles

Abstract We report a case of primary soft tissue lymphoma with pulmonary involvement in a 57-year-old man, successfully treated with surgery and chemotherapy. The patient presented with a giant mass (16 × 20 cm) in the left dorsolumbar region. Computed tomography (CT) demonstrated a right-sided pulmonary tumor, in addition to the giant tumor in the left dorsolumbar muscles. On an incisonal biopsy, the left dorsolumbar muscle tumor was suspected to be a sarcoma, and en-bloc resection was therefore performed. During surgery, four left pulmonary tumors that had not been observed on CT were found and surgically resected. The patient was finally diagnosed with soft tissue non-Hodgkins B cell lymphoma with pulmonary involvement. After postoperative chemotherapy, the right pulmonary nodule disappeared. The patient was well and had no evidence of disease 22 months after surgery. To the best of our knowledge, primary soft tissue lymphoma is extremely rare.

Effects of nafamostat mesilate, somatostatin, and glucagon on caerulein‐induced acute pancreatitis in rats

The inhibitory effects of somatostatin (SMS) and glucagon (Gn) on acute pancreatitis were evaluated in an experimental acute pancreatitis model in male Wistar rats. The effects of these agents were compared with those of nafamostat mesilate (NM). The acute pancreatitis was induced by four serial subcutaneous injections of caerulein. The rats were divided into four groups. The first group (n=28) received SMS daily, the second group (n=28) received Gn daily, and the third group (n=28) received NM daily after the first injection of caerulein. The fourth group (n=42) received caerulein alone and served as the control group. Animals were sacrificed 4, 6, 8, 12, and 24 h, and 3 and 7 days after the first administration of caerulein and the degree of severity of the acute pancreatitis was evaluated by serial morphological and histological examinations of pancreatic tissues, as well as in terms of the serum concentrations of amylase and lipase. The characteristic findings of acute pancreatitis in the animals of all groups treated with SMS, Gn, or NM were markedly attenuated at all time points after the treatments compared with findings in the controls (caerulein alone) in terms of wet weight of pancreas, serum concentrations of amylase and lipase, formation of intracellular vacuoles in acinar cells, interstitial edema, and infiltration of an inflammatory cell component. The inhibitory effects of SMS, Gn, and NM on acute pancreatitis were similar at the doses used. These results suggest that SMS and Gn are as useful as NM, they may be of value for the treatment of acute pancreatitis.