Sonshin Takao

Endothelial Cells Potentiate Oxidant-Mediated Kupffer Cell Phagocytic Killing

Phagocytosis and killing of circulating organisms by Kupffer cells (KCs) are discrete, important components of host defense. However, the killing mechanism(s) are not fully understood, and the potential role of adjacent nonparenchymal cells such as hepatic endothelial cells has not been defined. Rat KCs -/+ an hepatic endothelial cell enriched cellular fraction (HECEF) were incubated with Candida parapsilosis and assayed for phagocytosis and phagocytic killing by validated fluorochromatic vital staining. The role of reactive oxygen metabolites in KC phagocytic functions was examined by inhibition with superoxide dismutase and/or catalase. Diphenyleneiodonium and allopurinol were used to examine the potential roles of NADPH oxidase and xanthine oxidase, respectively, in generating these toxic oxidants. Coculture with HECEF increased KC phagocytic activity (from 75% to 88%) and candidacidal activity (from 20% to 31%). Superoxide dismutase, catalase, diphenyleneiodonium, or allopurinol caused inhibition of candidacidal activity, but did not affect phagocytosis, and did not block the potentiation of phagocytosis or of killing caused by coculture with HECEF. Reactive oxygen intermediates generated by both NADPH oxidase and xanthine oxidase-dependent pathways are important in KC killing of Candida parapsilosis. In vitro, KC phagocytosis and killing are potentiated (via a non-oxidant-mediated mechanism) by coculture with a preparation of hepatic non-parenchymal cells composed primarily of endothelial cells.

The Impact of Oxygen Transport Variables on the Outcome in Patients Who Undergoing Surgery for Esophageal Cancer.

食道癌術後早期の酸素運搬量と術後合併症の関連を右開胸切除食道癌133例を用いて検討した.前期94例の検討では, 縫合不全, 呼吸不全および入院死亡例の術後6時間の酸素運搬量は合併症がない症例に比べて有意に低下していたが1病日以降では差を認めず, 術後6時間の酸素運搬量の低下と以後の合併症発生の関連が示唆された.後期39例では術後12時間以内の酸素運搬量を600ml/min/m2以上に維持するように循環管理を行った.その結果, 縫合不全は前期28.7%から後期10.3%に, 呼吸不全は19.1%から5.1%に減少し, 入院死亡は前期8.5%に対して後期では認められなかった.食道癌切除術における術後早期の酸素運搬量の値は術後の縫合不全, 呼吸不全さらに入院死亡発生と密接な関連をもつと同時に, 術後12時間以内の酸素運搬量の増加は重症合併症予防の有用な手段となると考えられた.

A Case of Surgically Treated Triple Cancer. Sigmoid Colon Cancer, Skin Cancer and Mucin-producing Pancreatic Cancer.

症例は68歳の男性である.1974年に血便を主訴として来院し, 当院においてS状結腸癌 (高分化型腺癌) の診断のもとにS状結腸切除術を施行した.15年後の1989年7月, 左手背部の腫瘤を主訴として来院し, 径2×2cm大の腫瘤の切除を行ったところ, 腫瘤は病理組織学的に扁平上皮癌であった.さらに2か月後の1989年9月, 背部痛を主訴として来院した.Computed tomography, endoscopic retrograde pancreatogram, ultrasonographyなどによって膵癌と診断し, 膵頭十二指腸切除術を施行した.この腫瘍はいわゆる粘液産生膵癌であった.外科的に切除された3重複癌は極めてまれである.今回の症例の詳細に文献的考察を加えて報告した.