Immunosuppressive mechanisms of deoxymethylspergualin and FK 506 on in vitro cytotoxic T lymphocytes.
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Biomedical subjects
Publications and source records attributed to H Izutani.
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A 73-year-old patient with acute aortic dissection in delayed shock state following sudden onset of chest-back pain and left sided hemothorax was successfully operated. Contrast enhanced CT demonstrated a crescent-shaped low density area in the descending aorta. Aortography showed ulcer-like projection (ULP) with minor leakage into left thorax, however, a flow in false lumen was not visualized. These findings suggested that the false lumen of type III aortic dissection was thrombosed in its early phase. The aneurysm was transected on left heart bypass through left thoracotomy. The entry of false lumen was found in proximal portion of descending aorta, in which fresh thrombus was filled. A graft was anastomosed and reinforced with felt strips in end-to-end. The postoperative course was uneventful. The ULP by aortography provides a possible sign of rupture in clinical course of aortic dissection.
A 58-year-old male was admitted because of severe dysphagia. Radiographic and endoscopic examination revealed squamous cell carcinoma of the esophagus. Physical examination revealed severe splenomegaly and swelling of the cervical and axillary lymph nodes. Laboratory data showed lymphocytosis (more than 90%), severe anemia and monoclonal hyperglobulinemia (IgA type). The patient received irradiation (60 Gy) to the esophageal lesion using Linac X-ray and 40 Gy to the left cervical and axillary region with a tele Co60. Radiotherapy showed a remarkable effect not only on the esophageal cancer but also the chronic lymphocytic leukemia.
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Organ procurement from non-heart-beating donors (NHBDs) may expand donor pools. In this study, the method of reanimation of heart, lung, and kidney in NHBDs by percutaneous cardiopulmonary support (PCPS) was evaluated. Thirteen beagles were asphyxiated after being given prostacyclin analogue, verapamil, propranolol, and nafmostat mesilate intravenously. Thirty minutes after cardiac arrest, the body was reperfused by PCPS for 1 hr. PCPS priming fluid contained the four drugs above and KCl. Eight hearts immersed in University of Wisconsin (Madison, WI) solution for 24 hr were transplanted orthotopically using leukocyte depleted blood cardioplegia, five left lungs immersed in modified Collins solution were transplanted orthotopically, and five kidneys immersed in University of Wisconsin solution were transplanted heterotopically. All donor hearts arrested without ventricular fibrillation. All transplanted hearts beat spontaneously, and all animals were weaned from cardiopulmonary bypass without inotropic support. The oxygen and carbon dioxide pressure of pulmonary vein blood in the donor lung were no different from those in the recipient lung. All transplanted kidneys made urine soon after reperfusion. These data suggested that hearts, lungs, and kidneys from NHBDs pretreated with four drugs and reanimated with PCPS can be transplanted successfully and that this method may expand the donor pool.
We examined the feasibility of using a polytetrafluoroethylene membrane (goretex) valve and transannular patch (TAP) for right ventricular outflow tract (RVOT) reconstruction in growing animal models. Eleven infant goats (Group A) and 12 infant sheep (Group B) underwent RVOT reconstruction under cardiopulmonary bypass. In Group A, a monocusp valve was constructed of goretex, and the RVOT was roofed over utilizing a TAP of bovine pericardium. In Group B, both a monocusp valve and a TAP were constructed of goretex. Animals were sacrificed at 6 or 12 postoperative months. Two goats in Group A died at 9 days and 4 months postoperatively due to RVOT obstruction caused by thrombus formation. Seven goats in Group A and 11 in Group B showed no pressure gradient across the valve. All animals in Group B revealed mild to moderate valvular insufficiency, but no ventricular deterioration. In contrast to the bovine pericardium, which showed a prominent fibroinflammatory reaction with calcified areas causing TAP shrinkage and RVOT stenosis, there was minimal calcification and inflammatory reaction directed against the goretex valve and TAP. We conclude that goretex can be used as a material from which to create both a monocusp valve and TAP for long-term RVOT reconstruction.