Yuji Shinagawa

Ganglioside antigen of DU‐PAN‐2 in a human pancreatic cancer

DU‐PAN‐2 reactive gangliosides were isolated from the tumor of a patient with pancreatic cancer (duct cell carcinoma, moderately differentiated adenocarcinoma), having a negative Lewis blood phenotype, and were analyzed by means of TLC‐immunostaining, enzyme‐linked immunosorbent assay (ELISA), permethylation study, 1H NMR spectroscopy and fast atom bombardment mass spectrometry. The structures of the gangliosides were found to be NeuAcα2‐3Ga1β1‐3G1cNAcβ1‐3Ga1β1‐4Glcβ1‐1′Cer, containing normal and hydroxy fatty acids. By TLC‐immunostaining and ELISA with chemically synthesized gangliosides, DU‐PAN‐2 was demonstrated to react strongly with IV3αNeuAc‐Lc4Cer, weakly with IV3αNeuAc‐nLc4Cer, and moderately with IV6αNeuAc‐Lc4Cer and IV6αNeuAc‐nLc4Cer. Thus it was concluded that the DU‐PAN‐2 reactive ganglioside in the tumor is IV3αNeuAc‐Lc4Cer and that DU‐PAN‐2 has a rather broad specificity.

Solitary pancreatic metastasis of malignant fibrous histiocytoma treated by distal pancreatectomy.

A tumor in the body of the pancreas was detected in a 31-year-old man who had undergone a resection of a malignant fibrous histiocytoma (MFH) of the left distal femur 2 years before. The patient underwent a distal pancreatectomy with regional lymph node dissection. The surgical specimen revealed MFH metastatic to the pancreas. He is alive without recurrence or metastasis at 1 year after pancreatectomy. This case seems to be the first report of successfully resected pancreatic metastasis of a malignant fibrous histiocytoma in the published literature, as far as we can determine.

Pylorus-Preserving pancreatoduodenectomy in Japan: History and present status

We review several Japanese reports regarding pylorus-preserving pancreatoduodenectomy (PPPD), including our previous survey of a totll of 313 patients who had undergone PPPD as of September, 1989 at 82 major medical facilities. PPPD in Japan was initially performed in 1981 in a patient with leiomyosarcoma of the pancreas. Because of extensive growth of the tumor, right hemicolectomy was also performed and the alimentary tract was reconstructed in the new Billroth I procedure. Many reports have since indicated that PPPD yields favorable results. The patient characteristics ranged widely, from benign diseases to malignancies, including cancer of the pancreas. The use ofPPPD is how increasing both in Japan and in the United States and Europe. The operative techniques, reconstruction methods, morbidity, mortality, survival, and pathophysiology of PPPD in Japan are reviewed in comparison with these factors in the Whipple resection.

Effect of total gastrectomy on remnant islet cell function after major pancreatectomy in rats.

This study was designed to investigate the effect of total gastrectomy on remnant islet cell function after 85% distal pancreatectomy in rats. Eight-week-old Wistar male rats were divided into the following three groups: group 1, laparotomy; group 2, distal pancreatectomy; and group 3, distal pancreatectomy with total gastrectomy. Four weeks after the operation, i.v. glucose tolerance tests (ivGTT) were performed. The body weight in group 3 rats 4 weeks after the operation was significantly lower than that of the other two groups (p <0.05). Glucose tolerance was impaired in both groups 2 and 3; group 3 was more impaired than group 2. Immunoreactive insulin (IRI) concentration in both groups 2 and 3 was much lower than that in group 1 throughout the ivGTT. Furthermore, IRI concentration in group 3 was lower than group 2 at all times. The integrated secretion of insulin for the 45 minutes after glucose injection was lower in group 3 than in group 2. It is concluded that total gastrectomy injures remnant pancreatic endocrine function after 85% distal pancreatectomy in rats.

Clinopathological analysis of magnetic resonance imaging of pancreatic carcinoma.

膵癌のmagnetic resonance (MR) 像の成り立ちに関わる因子を明らかにするため, 術前MR像と, 手術時所見, 切除標本割面像, 病理組織像, 切除標本MR像とを対比検討した. 術前MRimagingが施行された膵癌症例17例を対象とした. 術前MR像を, I型: 周囲膵組織と明瞭なコントラストをもつもの, II型: 周囲組織より突出する腫瘍としてのみ確認しうるもの, III型: 脈管の変形のみを認めるもの, IV型: 腫瘍を確認しえないもの, と分類した. I型は肉眼的には結節型, 組織学的には髄様型で, 末梢側の炎症や萎縮が軽度なものが多かった. III型やIV型では肉眼的には浸潤型, 組織学的には硬性型のものが多く, 末梢側の炎症や萎縮は高度であった. 術前と切険標本のMR像の間に, 大きな隔たりはなく, motionartifactの影響は小さいと判断された. 膵癌のMR像は腫瘍と周囲膵組織の性状々よく反映しており. 外科的に有用な情報を提供しうるものと思われた.