腔内聚乙烯十二指肠-空肠导管对体重调节的作用:猪动物模型可行性研究

目的评估十二指肠-空肠导管（Endoluminal Duodeno-Jejunal Tube，EDJT）在活体猪实验动物模型中减缓体重增加的可行性，及其在中短期生存中的安全性。方法本项研究共用8只45kg重的Yorkshire猪，其中3只置入180emEDJT，1只置入360cm EDJT，另4只猪作为对照组。切开十二指肠，将EDJT导管缝合固定在十二指肠近Vater壶腹起始处。结果评估全部猪的不适反应和体重，每日一次，共7周，未发现严重并发症发生。术后7周3组动物的平均体重变化百分率：对照组、180cm组和360cm组分别是22．5％，6％和-2．8％。EDJT组（180cm组、360cm组）体重增加明显减慢，与对照组相比，有统计学意义（P=0．05）。结论EDJT可以安全使用，无肠梗阻、肠套叠或胰腺炎等并发症发生。EDJT可明显减缓体重增加。     

Effect of the free radical scavenger MCI-186 on spinal cord reperfusion after transient ischemia in the rabbit

Objective: Paraplegia remains a serious complication of aortic operations. The production of free radicals during reperfusion after transient ischemia is believed to induce secondary spinal neuronal injury, resulting in paraplegia. The aim of the present study was to clarify the protective effect and method of administration of antioxidants on the neurological and histological outcome in the animal model for reperfusion injury after transient spinal cord ischemia. Methods: New Zealand white rabbits underwent surgical exposure of the abdominal aorta that was clamped for 15 minutes to achieve spinal cord ischemia. Group A animals received two 10 mg/kg doses of 3-methyl-l-phenyl-2-pyrazolin-5-one (MCI-186) at the time of release of the aortic clamp and 30 minutes later. In group B, MCI-186, 5 mg/kg, was given three times, at the time of aorta clamp release, 30 minutes and 12 hours later. In group C (control group), one dose of vehicle was administered. Neurological status was assessed using modified Tarlov’s score until 168 hours after operation. Spinal cord sections were examined microscopically to determine the extent of ischemic neuronal damage. Results: Groups A and B animals had better neurological function than group C (p(0.001). In contrast, group C animals exhibited paraplegia or paraparesis with marked neuronal necrosis. The number of surviving neurons within examined sections of the spinal cord was significantly greater in group B than in group C (p(0.001). Conclusion: In a 15-minute ischemia-reperfusion model using rabbits, systemic repetitious administration of MCI-186, a free radical scavenger, was found to have a protective effect on the spinal cord neurons both neurologically and histologically. We postulate that the drug minimizes the delayed neuronal cell death for reperfusion injury after transient ischemia by reducing the free radical molecules. Moreover, it was thought that we could protect delayed neuronal cell death more effectively by administering MCI-18612 hours later.     

Anti-tumor activity of human recombinant TNF against human malignant glioma cell lines and combined effect with Hu INF-beta

Human TNF was detected fairly recently and at present the anti-tumor activity of human recombinant TNF is being examined against various malignant tumors of human origin. In the present study, we report the anti-tumor activity of recombinant human TNF against human malignant glioma cell lines in vitro and in vivo, in addition to its combined effects with HuIFN-beta. The in vitro study was conducted as follows. Thirteen human glioma cell lines were exposed to 100 U/ml TNF, 1,000 IU/ml HuIFN-beta, or both, and the suppression rate was calculated on days 3, 5 and 7. In the in vivo study, nude mice carrying a human glioma cell line, KMS II, in the subcutaneous tissues were divided into groups and drugs were administered intratumorally as described below. 1) control, 2) TNF 5,000 U single administration, 3) TNF 5,000 U, intermittently administered (once/week for two weeks), 4) TNF 5,000 U, continuously administered (3/week for two weeks), 5) HuIFN-beta 50 X 10(4) IU (3/week for two weeks), and 6) combination of 4) with 5). Results of the in vitro study revealed some suppressive effects on proliferation of tumor cells on day 7 in all 13 glioma cell lines examined with 100 U/ml TNF. And also, especially in 8 of 13 cell lines, the suppression rate was more than 30%. The suppressive effects of TNF were augmented by combined use of HuIFN-beta in all cell lines, giving a range of suppression of 67.8 to 99.3%. The in vivo study revealed that the mean tumor weight ratios (control = 100%) on day 19 (the end of the experiment) were as follows; single administration of TNF: 41.3%, intermittent: 46.7%, continuous: 26.7%, HuIFN-beta: 65.9%, combination: 18.5%. Statistical analysis disclosed significant suppressive effects on tumor proliferation between the control group and 3 TNF-administered groups (single, intermittent, and continuous) and that suppression in the continuously administered group was more severe in comparison with the group given single administration. Moreover, it was suggested that combination therapy with TNF and Hu IFN-beta was more effective than a single therapy with TNF only or HuIFN-beta only. From the results described above, it was found that human recombinant TNF had some cytotoxic effects against human malignant gliomas in vitro and in vivo, although the degree of cytotoxicity was not always higher in comparison with the effects of TNF.     

Long-term outcomes of 600 living donor liver transplants for pediatric patients at a single center.

This report concerns the long-term outcome of living donor liver transplantation (LDLT) for pediatric patients at a single center. Between June 1990 and December 2003, a total of 600 LDLTs, including 568 primary transplantations and 32 retransplantations, were performed for pediatric patients, who were immunosuppressed with FK506 and low-dose corticosteroids. Patient survival at 1, 5, and 10 years were 84.6%, 82.4%, and 77.2%, respectively, and the corresponding findings for graft survivals were 84.1%, 80.9%, and 74.5%. Multivariate analysis demonstrated that fulminant hepatic failure (FHF), a graft vs. body weight (GBWR) ratio of <0.8, and ABO-incompatible transplants were independently associated with both patient and graft survival. The retransplantation rate was 6%, and 55 patients (9.7%) have been completely weaned off immunosuppressants. Long-term patient and graft survival after pediatric LDLT for a large cohort of children at our hospital were found to be as good as those for cadaveric liver transplantation, although this series includes 13% liver transplantations with ABO-incompatible donors, which are obviously inferior in patient and graft survival. To obtain better outcomes for patients with FHF and for patients with ABO-incompatible transplants, immunosuppressive therapy needs to be improved.     

Correlation between changes in obesity from adolescence to young adulthood and family obesity--the results of cross sectional and longitudinal studies

We conducted a survey of 356 married couples and their 552 children living in Hisayama in Fukuoka prefecture in order to investigate the correlation between changes in obesity from adolescence to young adulthood. 1. A positive correlation between couples in weight and height could be found, but its coefficient was weak (r = 0.12, 0.10). There was no correlation between couples in BMI. 2. The correlation between parents and their children in height, weight and BMI was significantly positive (r = 0.18, 0.45), having a coefficient greater than that of the correlation between married couples. 3. The correlation coefficient between mother and child was greater than that of the correlation coefficient between father and child. 4. The BMI of a child with either parent obese was significantly greater than that of a child with neither parent obese. Obesity appeared more frequently in children whose BMI of parent was higher. 5. A positive correlation between the BMI of young adults and that of adolescents could be found, and the average BMI of the obesity group was higher than that of the non-obesity group even in the adolescent subjects. 6. Even after considering BMI during adolescence, the familial factor had a significant relationship to the BMI of young adulthood. These results suggest that obesity in adolescence will influence obesity in young adulthood, and that the appearance of obesity strongly correlates with the familial obesity factor. In conclusion, it is very important to take preventative measures, in cooperation with the family, early in a child's adolescent years in order to avoid obesity in adulthood.     

Double immunoelectron microscopic labelings of human chorionic gonadotropin and human placental lactogen in human chorionic villi

Simultaneous immunoelectron microscopic localization of human chorionic gonadotropin (HCG) and human placental lactogen (HPL) was examined on the same ultrathin section of human chorionic villi by means of the double labeling technique. Using specific rabbit antisera against HCG and HPL followed by goat anti-rabbit IgG-coated colloidal gold of different sizes (15 nm and 5 nm), immunoreactions of HCG were concentrated on middle-sized secretory granules of 200-300 nm and large dense bodies of 500-1000 nm, while those of HPL were exclusively located on small secretory granules of 80-180 nm. The present experiment provides direct evidence for our previous data that HCG and HPL seem to be stored in different granular components in the syncytiotrophoblast.     

Carcinoma of the main hepatic duct junction: indications, operative morbidity and mortality, and long-term survival

Carcinoma of the main hepatic duct junction tends to spread extensively along the hepatic ducts into the liver parenchyma. Therefore extensive resection of the bile ducts combined with hepatic resection is the procedure of choice. Between January 1973 and April 1989, 25 of 50 patients with this type of carcinoma underwent resection, a resectability rate of 50%. One patient died of staphylococcal sepsis on the postoperative day 42 after right trisegmentectomy and resection of the bile ducts, a hospital death rate of 4%. Twenty-four patients were discharged from the hospital. The 5-year actuarial survival rate calculated by the Kaplan-Meier method was 19%. Four patients lived longer than 5 years after surgery; the longest survival was 9 years after right trisegmentectomy and resection of the bile ducts. These four patients had clear margins at the resected bile ducts. This article was designed to clarify the point at issue by presenting our results in terms of indications, operative morbidity and mortality, and long-term survival.