A useful procedure for taking photograph of resected specimens

Histochemical, biochemical, and electron microscopic investigations on resected specimen have expanded in almost exponential manner in the past ten years and taking photograph of the specimens is also of importance for the examination of them. The specimens are, however, damaged during the time of taking photograph by various factors such as heat, dryness, light etc. For the investigations of this kind, the most important requirement for preservation of protoplasmic structure is to interrupt the dynamic process of the cell as prompt as possible and to stabilize the structure with a minimum of change. To prevent the damage of the specimens during the time of taking photograph, the following procedure is proposed: The specimen is dipped into cold saline solution, phosphate buffer, or cacodylate buffer. as soon as possible after operation. Photographic procedure is carried out upon the specimen dipped into the solution. By this procedure, the specimens can be protected from being damaged by heating and drying. Furthermore, the specimen can be preserved in its original shape due to the aid of buoyancy. This procedure has an another advantage : The photograph is in principle free from halation on the surface of the specimens. Thus, the proposed procedure is very useful for taking photograph of resected specimens in general

A case of cancer in the gastric remnant

This is a report of cancer of the stomach encountered in a 71-year-old man who admitted to the hospital with complain of epigastralgia. He had undergo a two third gastrectomy with gastroduodenostomy 24 years before because of severe gastritis. For several years he had ambulatory treatment for diabetes mellitus, which was under good control. Laboratory examination revealed that red-cell count was 4,800,000, white-cell count 11,500 ; hemoglobin was 12.7gr. per 100ml, hematocrit 49.5 per cent. Total serum protein was 8.2%. The stool was positive for occult blood and the urine negative for protein. X-ray studies in barium filled stomach in upright position revealed a filling defect in the lessor curvature side. In the prone and supine double contrast studies, a lesion was visualized of irregular outline with marked surface unevenness. Endoscopically, a rough tumor resembling Borrman Type III cancer was found near the stoma on the anterior wall of gastric remnant. Marginal blending and convergency of the folds showing sudden cessation around the ulcer were recognized as well. These findings led the authors to the diagnosis of the cancer developing in the gastric remnant and total gastrectomy with esophagojejunostomia was performed. Reports of cancer in the gastric remnant detected more than 20 years after the first operation are so small in number

Ketamine-amitriptyline therapy for the intractable cancer pain with restlessness

A combination therapy of ketamine-amtriptyline for the intractable pain with restlessness of cancer patients in the end stage was presented. Seven patients with peritonitis carcinomatosis due to recurrence of stomach cancer were administrated the therapy. They ranged in age from 29 to 79 years. The results were eminently desirable. Intractable pain with restlessness were diminished by the therapy though languid feeling was yet remained. Anodyne (pentazocine), which was nessesary many times in one day before the therapy, was not used in the duration of the therapy. The experimental and clinical studies of analgesic property of ketamine by HATANO revealed that it is more twice as potent an analgesic in low dosage compared with pethidine, despite its rather short duration of action. There was no respiratory depression. No hypotension nor bradycardia were observed during the therapy. The only use of ketamine however, could not release the pain and anguish of cancer patients. The author applied amitriptyline to these cases. The combination use of ketamine and amitriptyline could release them. These drugs demonstrated their full effect by the combination use

New trend of the development of vascular prostheses

人工血管の開発研究における動向について，我々の行ってきた研究をまじえて世界の動きを解析した。近年の砺究の流れは過去1世紀にわたる試行錯誤の上にあって，さらに大きく揺れ動いている。人工血管の内面に必要な抗血栓性の獲得においても，設計者によって考えを異にし，米国では，人工心臓に用いる抗血栓性合性高分子材料をもってそれに当てようとしているものが多い。我々はあくまで宿主のもつ諸機能を引き出し，自然の動きの一つとしての治癒を無理なく導いて，内皮細胞によって内面を覆わせる方法を採用している。そのいくつかの例として，超極細ポリエステル繊維製人工血管，結合組織管，バイオマトリックス人工血管，ヘパリン化生体組織由来人工血管，成長できる人工血管などについて解説した。Vascular prostheses have been used in the treatments of various vascular diseases. We expect much from their contribution in the field of further fine vascular surgery. In this communication, new trend of the development of them with our new ideas in our recent research works were described. 1. Healing process of fabric vascular prostheses. Neointima formation of the vascular prosthesis implanted in the descending thoracic aortae of experimental animals were described in detail. This showed a standard behaviour of various cells which contributed the construction of a new arterial wall. 2. Problems of vascular prostheses which were used in clinic. Several problems such as a bleeding from the graft wall, aneurysmal dilatation, and degenerative changes of the neointimae were explained in detail. These problems were related with the structure of each vascular prosthesis. 3. Vascular prostheses developing with new ideas. Several vascular prostheses developing today were described as follows. (a) Fabric prosthesis with high healing ability. A prosthesis made of ultra-fine polyester fibers which can accerelate cell migration and proliferation inside the prosthetic wall was introduced. The neointima in this prosthesis was constructed very rapidly compared with that of the prostheses made of polyester fiber ordinally used. (b) Antithrombogenic small diameter vascular prostheses. Large caliber vascular prostheses have been used very safely in clinic, however, small diameter ones were seldom used due to its low patency rate by their occlusion. The grafts should have an antithrombogenic property to prevent the thrombus formation. Recently, some technologies to give antithrombogenic property to the vascular prostheses were developed. They were a heparin slow release technique, antithrombogenic segmented polyurethane, highly hydrous surface, heparinized collagen tube, etc. They were applied for the development of small diameter vascular grafts and showed good results in some animal experiments. (c) Growable vascular graft. A vascular graft which can grow with the growth of its recipient baby was demonstrated. The animal study showed as expected growth and stop growing at the expected time. (d) Vascular graft for aorto-coronary bypass surgery. A small diameter antithrombogenic, and flexible vascular grafts were explained. They were developed along our own ideas. This showed high patency rate m animal experiments. (e)Endothelial cell seeding techniques. In human, endothelialization m the vascular grafts is delayed and the inner surface was thrombogenic for a long period of time. To accerelate the endothelialization, cell seeding technique have been investigated in the last decade. We developed a new technology to transplant autologous cells in the peripheral vein tissue for this purpose. This was very reliable and simple. It was applicable in any hospital without any special technique and facility. Peripheral venous tissue fragments were transplanted into the fabric vascular prosthetic wall. Endothelial cells and smooth muscle cells migrated and proliferated from the tissue fragments. The neointima was constructed very rapidly with this active cell migrations

Fundamental study of post operative intestinal adhesion -Findings on early stage of peritoneal inflammation by ultraviolet irradiation-

Early process of peritoneal inflammation on rat by ultraviolet irradiation was studied histologically and scanning electron microscopic· ally. After 1 minute irradiation of ultraviolet, minimal exudation on mesothelium was found. After 15 minutes irradiation, microvillies on mesothelium were covered with exudate. After 20 minutes, fibrin fibers appeared on intact mesothelium. Though the fibers wafted in exudate, the fibers could be cleared up by irrigation of saline. After 30 minutes, white and red cells appeared on the nest of fibrin fibers. After 45 minutes, edema came out at subserosal layer. After 1 hour, mesothelium was covered with fibrin fibers, white and red cells. But the coated fur could be washed off by jet irrigation of saline and intact mesothelium benearth the fur appeared. These results indicate that washing a peritoneal cavity by saline after abdominal operation is of practical value to prevent a intestinal adhesion due to post operative intestinal inflammation. Inflammatory changes of intestinal mesothlium was clearly demonstrated by scanning electron microscope and these observations revealed that scanning electron microscope was very useful for the study of inflammation which occured on the surfaces of organs

The effect of thermal bathing upon platelet function

The effect of thermal bathing upon platelet function was examined in clinically. Platelet number, adhesiveness and aggregation were examined in the 10 patients before and after a single bathing for 10 minutes, 41-43℃ in temperature. The diseases of the patients were external pile, duodenal ulcer, benign sigmoid colon polyp, etc. The specific diseases which interact the platelet function such as blood diseases and arterial occlusive diseases were not included. Antithrombogenic drugs were not used in any patients. The results of this study were summarized as follows. 1. Platelet number did not showd systemical alteration by the bathing. 2. Both platelet adhesiveness and aggregation were changed to the lower degree after the bathing except a few cases. From these results, it was clarified that the thermal bathing was effective to control the platelet function and also effective in clinically to the prevention, therapy and rehabilitation of arterial occlusive diseases of heart, brain and the extremities

Hyhrid vascular grafts and one of our approaches

人工血管により高度な機能をもたす目的で，ハイブリット化が今日進められるようになってきた。この背景について説明するとともに，我々の独自に行っているハイブリット型人工血管作成の方法およびその成果について報告する。その具体的方法としては以下の通りである。末梢静脈小片を勇刀にて細切したのち，約20ccの生理的食塩水に入れて静脈組織細切片浮遊液を作った。次に高有孔性人工血管の一端より吸引管を挿入し，これを作成した液に入れ，吸引によって組織片を外側から人工血管壁に絡ませた。次に新鮮な血液を注ぎ，組織片をさらに固着させた。成犬胸部下行大動脈へこのような処理をしたポリエステル布製人工血管を植え込んだところ，植え込み5日目に新生血管壁内部に無数の内皮細胞の増殖像がみられ，35日目の例では吻合部はもとより，人工血管の中央部ですら内皮細胞による完全な被覆を認めた。 　以上のような方法で新生血管壁が容易に形成されることが判明したことより，今後，他の人工臓器分野でもハイブリット化が予測される。Recently, vascular grafts had contributed in the treatments of various vascular disease, and today, was required to have fine functions like native blood vessels. Many kinds of approaches to develop the ideal graft had been applied. In these efforts, endothelial cells seeding technique to fabric vascular prostheses was reported successfully, however, it was not for general use. To get and proliferate the endothelial cells, special techniques and facilities were required. Moreover, it was not available for emergency use, smce the cell culture needed a certain period of time. To overcome these problems, we developed a reliable method to make a hybrid vascular graft as follows. Tissue fragments suspension was prepared using a piece of peripheral vein. Highly porous fabric vascular prosthesis was immersed into the suspension fluid. The tissue fragments were trapped from the outer surface of the prosthesis by intraluminal suction. Preclotting procedure was adopted to immobilize the tissue fragments to the fabric of the prosthesis. The prostheses were implanted into the thoracic descending aortae of 15 dogs. There was no bleeding at the time of the implantation. Numerous endothelial cells proliferation was observed in the specimen for 5 days after implantation. The surface was covered with thin layer of fibrin. Full endothelialization was noticed in the specimens of 35 days. The graft wall was completely healed. This method was very simple and easy to prepare, but the efficacy to promote the healing of the neointima was excellent

Applications of critical point drying for scanning electron microscopic study of clay minerals

The scanning electron microscopic studies of the clay minerals have usually been made on air-dried samples. The air-drying method is, however, not always preferable for H(2)O rich clay minerals such as imogolite because of their strong contraction in the dehydration process. The present writers examined the critical point drying for H(2)O rich clay mineral (imogolite) and proved that this drying method is excellent in preservation of natural surface of the minerals than that of air-drying. Imogolite which examined was separated from Kurayoshi pumice beds. The samples were treated first with OsO(4) solution and then were dehydrated progressively with ethanol. After completing above treatments, the imogolites which sealed in vessel were dried successively at critical point of CO(2). The samples were mounted onto brass stubs and coated first with carbon and then with Au-Pd alloy. The Japan Electron Optics Laboratory Co. scanning electron microscope Model JSM-50A which was installed in the Division of Rehabilitation Medicine in the present Institute was used at the operating conditions: accelerating voltage 25kV, magnifications ranging from 3000 to 40000. The scanning electron micrographs of the air-dried imogolite are shown in plate I, and cry tical point dried ones are in plate II and III. The former shows twig-like shape which indicated the effect of contractility, whereas the latter exhibits softly curled and entangled threads. The diameter of these threads ranges from 280A to 560A

Suture Retention Strength of Expanded Polytetrafluoroethylene (ePTFE) Graft

Our meticulous investigation of ePTFE graft breakage when a wire placed at the edge of an ePTFE graft was pulled, revealed that, depending on the breakage pattern, a break starts much earlier than the peak suture retention strength, which is the current international indicator for anastomotic-site break strength. Furthermore, the breakage patterns differ based on the thickness of the wire and the fiber direction of the ePTFE graft. Based on these findings, we advocate measuring the peak suture retention strength using 0.10-mm sutures and a standardized wire thickness in order to assess the anastomotic retention strength of ePTFE grafts.</p

Application of the ultra-thin section method for high resolution electron microscopy of clay minerals

Clay mineral specimen for electron microscopy have usually been prepared by air-drying of a small drop of the suspensoin on a microgrid. The suspension method is, however, not always preferable for the observation of lattice images of clay minerals because of their preferred orientation in the air-drying process. The present writers proved that the embedding method is excellent in preservation of the nonorientated part of the crystal than that of susp, ension method. The interstratified kaolin/montmorillonite which was collected from clay bed at Itoigawa, Niigata prefecture is dehydrated progressively replacing H(2)O by ethanol, propylene oxide and Epon mixture solution and is lastly embedded in Epon 812. Ultra-thin sections are prepared with an LKB Ultratome, and are examined in a JEM-100C type electron microscope at an accelerating voltage of 100 kV. High resolution electron micrographs show lattice images reflecting irregular layer structures of kaolin and montmorillonite. Clear layer structure and lattice images can be well observed from everywhere of ultra-thin section of clay mineral (Fig. 1). Lattice images of 4.5 and 10A spacings can be observed in Fig. 2. Microstructures show some differences in spacing which emerged from combination of dehydrated montmorillonite and kaolin layers (Fig. 3)