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  • 11
    ISSN: 1436-2813
    Keywords: hepatopancreatectomy ; hepatic protein synthesis ; DNA synthesis ; labeling index
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract To evaluate the effects of hepatopancreatectomy on the regenerative process of the liver, the serum protein changes, hepatic protein synthesis (HPS), and bromodeoxyuridine (BrdU) labeling index were measured in rats. Sprague-Dawley rats were divided into four groups according to the type of resection: A simple laparotomy was performed in the sham group; 68% of the liver was excised in the Hx group; 45% of the pancreas was excised in the Px group; and 45% of the pancreas and 68% of the liver were excised simultaneously in the HPx group. Serum total protein and albumin levels were significantly lower in the HPx group compared to the other three groups on postoperative day (POD) 3 (P〈0.05). HPS was markedly increased in the Hx and HPx groups. In the Hx group, it was significantly higher, peaking on POD 2, compared to the HPx group (P〈0.05), while in the HPx group, it was significantly higher compared to the Hx group (P〈0.05), peaking on POD 3. The BrdU labeling index, as a marker of DNA synthesis, was significantly suppressed in the HPx group on POD 1 compared to the Hx group (P〈0.05). Thus, compared to hepatectomy alone, hepatopancreatectomy suppresses DNA synthesis, causing a delay in the increase of protein synthesis in the regenerating liver, resulting in a more marked decrease in the serum protein level.
    Type of Medium: Electronic Resource
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  • 12
    ISSN: 1436-0691
    Keywords: resection of head of the pancreas ; arterial occlusive disease ; anomalous arrangement of arteries
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We resected the head of the pancreas in three patients with occlusive diseases or anomalous arrangement of the abdominal visceral arteries. The first patient who was diagnosed with cancer of the head of the pancreas; pancreatoduodenectomy (PD) was performed. Preoperative celiac angiography showed no significant occlusion of the celiac axis, while superior mesenteric arteriography visualized the common hepatic artery, with delayed retrograde filling. At the completion of the PD, an unsuspected atherosclerotic celiac occlusion was identified. Celiac reconstruction was performed. The second patient was diagnosed with cystadenoma of the head of the pancreas and had congenital ostial occlusion of the superior mesenteric artery (SMA), with dilated pancreaticoduodenal (PD) arcades as a celiacomesenteric collateral pathway. Duodenum-preserving resection of the head of the pancreas was performed, with preservation of the PD arcades. The third patient was diagnosed with cancer of the common bile duct, and exhibited a replaced common hepatic artery that arose from the SMA and formed PD arcades. PD was performed, with revascularization of the common hepatic artery. Following surgery, the three patients have done well for 18, 27, and 9 months, respectively. Careful preoperative investigation to identify abnormalities of the visceral arteries is necessary before resection of the head of the pancreas is performed.
    Type of Medium: Electronic Resource
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  • 13
    ISSN: 1436-0691
    Keywords: Key words: biliary tract carcinoma ; hepatoduodenal ligamentectomy ; replaced left hepatic artery
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract: Hepatoduodenal ligamentectomy (ligamentectomy) is the ultimate surgery for biliary tract carcinoma involving perioperative difficulties such as total hepatic ischemia during revascularization of the hepatic artery and the portal vein, patency of the reconstructed hepatic artery, and high incidence of related operative mortality. In the present study, modified ligamentectomies with extended right hepatic lobectomy, including resection of the caudate lobe, were performed on three patients with advanced biliary tract carcinoma in whom the left hepatic artery had been replaced and the original artery was preserved. In all patients, postoperative courses were uneventful: success of the resection was confirmed by histological examination. This procedure enabled en bloc resection of hepatoduodenal ligament with positive cancer invasion to take place. It was carried out safely without concern for the difficulties described above. In our view, ligamentectomy should be performed in all such cases.
    Type of Medium: Electronic Resource
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  • 14
    ISSN: 1436-2813
    Keywords: Key Words: Castleman disease ; retroperitoneum
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 15
    ISSN: 1436-2813
    Keywords: Castleman disease ; retroperitoneum
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We describe herein the case of a 21-year-old woman in whom Castleman disease of the pararenal retroperitoneum was successfully resected. The patient was referred to our hospital from another hospital for investigation of a retroperitoneal mass in the right middle abdomen. Ultrasonography, computed tomography, and magnetic resonance imaging demonstrated a large retroperitoneal mass with heterogeneous imaging characteristics. An aortogram showed arterial feeding to this mass from a few lumbar arteries. Although a definitive preoperative diagnosis could not be made, surgical excision was performed and histopathological examination confirmed a diagnosis of the hyaline type of Castleman disease. The patient had an uneventful postoperative course and was discharged 14 days after her operation. She now leads an active social life without any signs of sequelae or recurrence 14 months later. To the best of our knowledge, only 2% (6/315) of all reported cases of Castleman disease have been located in the pararenal and retroperitoneal area.
    Type of Medium: Electronic Resource
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  • 16
    ISSN: 1432-2323
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. Percutaneous transhepatic portal vein embolization (PTPE) has been used to decrease the risk of hepatic failure after hepatectomy in patients with poor liver function. The effect of PTPE on hepatic drug-metabolizing activities is not clear. Therefore we examined the effect of portal vein branch ligation, a model of PTPE, on hepatic drug-metabolizing activities in Sprague-Dawley rats. Ligated and nonligated lobes were harvested separately. Drug-metabolizing activities and concentrations of components of the microsomal cytochrome P-450 monooxygenase system were examined. In ligated lobes, drug-metabolizing activities (lidocaine and aminopyrine) and enzymatic concentrations of the microsomal cytochrome P-450 monooxygenase system gradually decreased over 10 days. In nonligated lobes these functions were depressed rapidly to 60% of those before PBL but then recovered 10 days after PBL. From the viewpoint of drug metabolism, hepatic dysfunction occurred in both ligated and nonligated lobes. RID="" ID="" 〈E5〉Correspondence to:〈/E5〉 K. Izuishi, M.D.
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  • 17
    ISSN: 1432-2277
    Keywords: Preservation, heart, rat ; Heart, preservation, rat ; UW solution, heart, rat ; Pittsburgh solution, heart, rat
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The effectiveness of University of Wisconsin (UW) and University of Pittsburgh (UP) solutions for the preservation of rat hearts was compared. Lewis rat hearts were preserved with UW (group A, n=45) or UP (group B, n=45) solution for 0 or 24 h and then transplanted heterotopically into the recipients' abdomen. Ten recipients in each group were observed to obtain 1-week graft survival rates. Tissue water content and tissue content of adenine nucleotides were measured 2 h after transplantation in six grafts from each group. Six hearts preserved for 0 h and seven hearts preserved for 24 h were taken from each group 24 h after grafting for histopathology. The 1-week graft survival rates of groups A24 and B24 were 60% and 10%, respectively. In the 24-h preserved grafts, adenosine triphosphate (ATP) and energy charge [(ATP+adenosine diphosphate/2)/(ATP+adenosine diphosphate+adenosine monophosphate)] of groups A and B were 0.972±0.165 and 0.200±0.123 mg/g wet tissue (P〈0.05) and 74.4% and 61.1% (P〈0.05), respectively. The tissue water content of group A24 was 71.7%, whereas that of group B24 was 74.1% (P〈0.05). Histopathology revealed more severe muscle edema and necrosis and infiltration of polymorphonuclear cells in group B24 than in group A24. We conclude that UW solution is more appropriate for rat heart preservation than UP solution.
    Type of Medium: Electronic Resource
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  • 18
    ISSN: 1432-2277
    Keywords: Adhesion molecules, rat, liver transplantation ; Liver transplantation, adhesion molecules, rat ; Cytokines, liver transplantation, rat
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We investigated the role of adhesion molecules in the early phase of reperfusion following cold ischemia. Livers of male Lewis rats were preserved for 0 h (group A) or 24 h in University of Wisconsin (UW) solution without additives (group B) or in UW solution with anti-ICAM-1 antibody (group C) or anti-E-selectin-1, SLex and SLea antibodies (group D). The livers were then reperfused with diluted rat whole blood (DWB; groups A and B), DWB containing anti-ICAM-1 and LFA-1 antibodies (group C) or DWB containing anti-L-selectin, SLex and SLea antibodies (group D). The reperfusion was perfomed at 37°C for 1 h at 5 cm H2O of perfusion pressure. During reperfusion, hepatic microcirculation was assessed by monitoring portal and peripheral tissue blood flow. Bile production was significantly reduced in group B livers compared with those in group A. Anti-ICAM-1 and LFA-1 antibodies failed to improve hepatic microcirculation, whereas anti-LECAM-1, SLex and SLea antibodies significantly improved the microcirculation. Bile production in group C and D livers was comparable to that in group B livers. Preservation for 24 h significantly increased the release of TNF-α from 0.207 to 43.7 pg/g per hour during reperfusion. Monoclonal antibodies to the adhesion molecules did not suppress the release of TNF-α in groups C and D. Histological examination demonstrated a lack of leukocyte infiltration or thrombus in hetapic microvessels. The extent of hepatocyte necrosis did not differ among groups B, C, and D. We conclude that the microcirculatory disturbance in the early phase of reperfusion occurs as a result of the tethering of leukocytes through the interaction of the selectin family and their ligands, and that the ICAM-1-LFA-1 pathway is not involved in this step. The lack of improvement in bile production with antibodies to the selectin family and their ligands strongly suggests that other mechanisms participate in the deterioration of hepatic function.
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  • 19
    Electronic Resource
    Electronic Resource
    Springer
    Journal of hepato-biliary-pancreatic surgery 3 (1996), S. 498-501 
    ISSN: 1436-0691
    Keywords: glucagonoma ; malignant ; pancreaticoduodenectomy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Glucagonoma is a rare endocrine tumor of the pancreas. We report curative resection for malignant glucagonoma in 60-year-old Japanese man admitted to our department because of hyperglycemia and a pancreatic tumor (detected at another institution). On admission, his serum glucagon level was 580pg/ml. Computed tomography (CT) showed a tumor measuring approximately 2 cm in diameter, in the head of the pancreas. Angiography revealed a hypervascular lesion fed from the gastro-duodenal artery. Endoscopic retrograde cholangiopancreatography (ERCP), revealed a stenosis of the pancreatic duct in the head of the pancreas and dilation of the caudal side, with indications that the tumor had invaded the pancreatic duct. The tumor was diagnosed as a glucagonoma in the head of the pancreas. Pancreaticoduodenectomy was successfully performed. In the resected specimen, the tumor, which was well defined within the peripheral parenchyma of the pancreas, measured 3.3× 2.5×2.0 cm. The clinico-pathological stage of the tumor on pTNM classification was Stage III (pT1b, pN1, pM0). Although the prognosis for malignant glucagonoma is very poor because distant metastasis is frequently present when the tumor is diagnosed, and because of the hormonal effects of the tumor, the patient was well when discharged, without any complications, and no recurrence has been detected in the 6 years since the operation.
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  • 20
    ISSN: 1436-0691
    Keywords: Key words: liver cancer ; IVC invasion ; imaging findings
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract: The extent of cancerous invasion of the inferior vena cava (IVC) determined from resected liver cancer was examined pathologically. Ten patients presenting with liver cancer (metastatic liver cancer, five patients; hepatocellular carcinoma, three; and cholangiocellular carcinoma, two) were diagnosed with positive IVC invasion using preoperative imaging techniques of extracorporeal ultrasonography, computed tomography, magnetic resonance imaging, and vena cavography. The diagnostic criterion for positive IVC invasion by preoperative imaging was longitudinal IVC compression measuring over 50 mm, or transverse IVC compression extending to more than half the circumference of the IVC, or the presence of lesions protruding into the IVC lumen, or the presence of developed collateral veins. All patients underwent combined resection of the IVC. However, pathology results revealed that four of the ten patients had no cancerous invasion of the IVC, and that the extent of invasion along both the longitudinal and transverse axes of the IVC was much smaller than the compression shown by imaging results. We believe that detailed preoperative assessment, using a more precise imaging technique, as well as further intraoperative examination, is required to predict the full pathological extent of cancerous invasion of the IVC.
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