Yoshiyuki Kawashima

Attenuation of ischemic liver injury by prostaglandin E1 analogue, misoprostol, and prostaglandin I2 analogue, OP-41483

BACKGROUND Prostaglandin has been reported to have protective effects against liver injury. Use of this agent in clinical settings, however, is limited because of drug-related side effects. This study investigated whether misoprostol, prostaglandin E1 analogue, and OP-41483, prostaglandin I2 analogue, which have fewer adverse effects with a longer half-life, attenuate ischemic liver damage. STUDY DESIGN Thirty beagle dogs underwent 2 hours of hepatic vascular exclusion using venovenous bypass. Misoprostol was administered intravenously for 30 minutes before ischemia and for 3 hours after reperfusion. OP-41483 was administered intraportally for 30 minutes before ischemia (2 microg/kg/min) and for 3 hours after reperfusion (0.5 microg/kg/min). Animals were divided into five groups: untreated control group (n=10); high-dose misoprostol (total 100 microg/kg) group (MP-H, n=5); middle-dose misoprostol (50 microg/kg) group (MP-M, n=5); low-dose misoprostol (25 microg/kg) group (MP-L, n=5); and OP-41483 group (OP, n=5). Animal survival, hepatic tissue blood flow (HTBF), liver function, and histology were analyzed. RESULTS Two-week animal survival rates were 30% in control, 60% in MP-H, 100% in MP-M, 80% in MP-L, and 100% in OP. The treatments with prostaglandin analogues improved HTBF, and attenuated liver enzyme release, adenine nucleotrides degradation, and histologic abnormalities. In contrast to the MP-H animals that exhibited unstable cardiovascular systems, the MP-M, MP-L, and OP animals experienced only transient hypotension. CONCLUSIONS These results indicate that misoprostol and OP-41483 prevent ischemic liver damage, although careful dose adjustment of misoprostol is required to obtain the best protection with minimal side effects.

Cold preservation of the human colon and ileum with University of Wisconsin solution

The inclusion of the colon in the intestinal graft resulted in worsening patient and graft outcome and increased the incidence of infection and rejection. In this study, we examine the role of ischemia on the barrier function of the epithelium during cold ischemia.

Limited Surgery for Early Cancer in the Middle Part of the Stomach : A Retrospective Study Based on Lymph Node Metastasis

胃中部早期胃癌144例の所属リンパ節への転移状況をretrospectiveに検討し, 縮小手術の可能性と合理的なリンパ節郭清範囲について検討した.リンパ節転移は6例 (4.2%) で, m癌, Sm癌の転移率はおのおの1.1%, 9.8%であった.sm癌で大きさ5.1cm以上, 混合型 (IIa+IIcなど), porにリンパ節転移が多かった.リンパ節転移部位は (1),(3),(4d),(7),(8a) であった.胃中部早期胃癌の縮小手術の適応を胃切除と系統的リンパ節郭清範囲の縮小との観点から想定した.縮小手術は内視鏡的治療の適応外で肉眼型と大きさにかかわらず深達度M癌, 深達度SM癌 (SM1またはSM2) は, 大きさ5.0cm以下の隆起型 (I, IIa) または陥凹型 (IIc, III) が適応となる.porのSM癌は縮小手術の適応とはなりえない.また, 縮小手術としては, 分節胃切除, リンパ節は,(1),(3),(4d),(7),(8a) を郭清するのが合理的と考える.

Advanced and Recurrent Esophageal Carcinoma: Combination Chemotherapy with Etoposide, Leucovorin, 5-Fluorouracil, and Cisplatin

Survival of patients with esophageal carcinoma treated with surgery and/or radiation has been very poor. The clinical development of cisplatin (CDDP) based chemotherapy has changed the outcome of patients with esophageal carcinoma. The combinations of 5-fluorouracil (5-FU) and CDDP, 5-FU and leucovorin, and CDDP and etoposide are synergistic in experimental and clinical models. We have used etoposide, leucovorin, 5-FU, and CDDP in advanced or recurrent esophageal squamous cell carcinoma since January, 1991, and we evaluate herein the tumor reduction and the postoperative morbidity and mortality.