Experimental study of the evaluation of liver function on the opposite side during portacaval anastomosis and ligation of the left portal branch

Background. Hepatocellular carcinoma is likely to accompany liver cirrhosis in which the portal pressure increases with portasystemic shunt. When portal tumor thrombus is present in the primary bifurcation, blood flow differs between the thrombolic lobe and the non-thrombolic lobe. In those cases, it is difficult to evaluate exactly residual liver function by conventional test. Therefore, the following studies were performed. Materials and Methods. Adult mongrel dogs are divided into a control group(Cgroup), group undergoing ligation of the left portal branch(PL group), group undergoing portacaval anastomosis (PCS group) and group undergoing both ligation of the left portal branch and portacaval anastomosis (PL+PCSgroup)(n=5). ICG-R15 andMEGX15 in peripheral venous blood and right hepatic venous blood were determined. Mitchondrial metabolic capacity (adenosine triphosphate level, energy charge)was measured by high-performance liquid chromatography using liver biopsied specimens. Results. The MEGX ratio (right hepatic venous blood MEGX15/peripheral venous blood MEGX 15) positively correlated with energy charge in the right hepatic lobe. Conclusions. In evaluating liver function of the right hepatic lobe during portacaval shunt and the left portal branch ligation, the MEGX ratio may sensitively reflect the mitochondrial function

90サイダイ チョウコウレイシャ ニ タイシテ フクブ キンキュウ シュジュツ オ シコウシタ 2レイ

We report two cases of abdominal emergencies in patients of advanced age over ninety. Case 1 : A 98-year-old woman was referred to our hospital because of abdominal pain. Abdominal CT examination revealed air fluid level and bowel dilatation. Conservative therapy was started with a long decompression tube insertion. However, no symptomatic remission was attained. An emergency laparotomy was performed. At laparotomy, a strangulated intestinal ileus due to an adherent band of omentum was found. The ileus was treated by excision of the band. The patient’s postoperative course was uneventful. Case 2 : A 94-year-old man was referred to our hospital because of abdominal pain. Chest X-ray film showed free air under the right diaphragm. Perforation of digestive tract was suspected and an emergency laparotomy was done. Perforation of a gastric ulcer was found and closure of the hole with omentopexy was done. Postoperative pathohistological examination revealed a gastric cancer. However, the patient and his family rejected operation. The patient was discharged from the hospital５９days postoperatively

Diagnostic approach for patients with unidentified fever according to the classical criteria of fever of unknown origin in the field of autoimmune disorders

ArticleImmunological medicine. 42(4): 176-184 (2019)journal articl

Effect of intermittent liver ischemia on outcome in patients with hepatocellular carcinoma on liver cirrhosis

The influence on postoperative liver function of intermittent normothermic hepatic ischemia in cirrhotic patients was studied retrospectively. The mean total ischemia time was 88 (range30 - 140) minutes in the hemi-hepatic occlusion group, and68 (range 10 - 187) minutes in the total occlusion group. There were no operative deaths due to hepatic failure. Postoperative liver function improved within 1 week of the opera-tion. There was no significant difference in the incidence of postoperative complications between the groups. Thus normothermic hepatic ischemia is tolerated for up to 180minutes in the cirrhotic liver when an intermittent technique (15 minutes clamped and5 minutes unclamped) is used

Long-term maintenance of the mucosal healing induced by azacitidine therapy in a patient with intestinal Behçet's-like disease accompanied with myelodysplastic syndrome involving trisomy 8

ArticleImmunological medicine. 42(3): 135-141 (2019)journal articl