[A case of gastrojejunocolic fistula improved by elemental diet (author's transl)].
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Biomedical subjects
Publications and source records attributed to T Kano.
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Reduction of lymphoid tissue by splenectomy and/or thymectomy has been used as a part of immunosuppression in organ transplantation (4). More recently Walker (7), Johnson (2), Franksson (1) and Starzl (5,6) and their associates have shown that chronic depletion of lymphocytes by thoracic duct drainage decreases the incidence of rejection and hence increases renal graft survival. Mechanical removal of lymphocytes from circulation peripheral blood should theoretically achieve the same or similar effect on the immunity as thoracic duct drainage. Since September, 1979, five organ transplant recipients have received multiple lymphocytapheresis by IBM 2997 Blood Cell Separator as a mechanical pretransplant immunosuppression. The changes in cellular and humoral immunity and the clinical outcome are presented in this report.
We studied the effect of postoperative long-term cancer chemotherapy (PLCC) on the survival of the patients with stage IV gastric cancer, subjected to non-curative resection. The study was carried out with 90 patients receiving the PLCC from 1970 to 1978, and 95 patients received intraoperative one shot I.V. injection of Mitomycin-C from 1964 to 1978, and 106 patients without chemotherapy from 1964 to 1970. The PLCC consisted of the following combination: MMC intermittent intravenous injection (20 mg of MMC during operation followed by 10 mg on the next day, 4th week and every 3 months respectively): postoperative oral administration of FT-207 (600 mg/day) and; PSK (3 g/day) for more than 4 months after operation. The background factors were not significantly different among 3 groups. Two year survival rate was 18.9% in PLCC group, significantly higher than that of 7.4% in MMC group and 2.0% in no chemotherapy group which was respectively (P less than 0.05). The PLCC also demonstrated its be effective mess in prolonging the survival of the patients with hepatic metastasis or peritoneal dissemination.
To examine the role of host-dependent factors to natural rubella infection, the positive rates of HAI antibody according to HLA-A and -B antigens were studied in 93 children, aged 9 to 10, who were exposed only to a recent epidemic (single-exposure group), and in 199 adult females, aged 18 to 23, who were exposed also to a former epidemic (dual-exposure group). Furthermore, the phenotype frequencies of HLA antigens were investigated in seronegative subjects in both groups, as well as in 58 adult female vaccinees, in comparison with those of the Japanese population. The seropositive rates by the HLA antigens, 38.7% and 73.4%, respectively, in each exposure group were found in subjects having some HLA antigens. Several of these candidate HLA antigens varied in phenotype frequencies in seronegative subjects of all three groups from those of the average Japanese. Although a few types were statistically significant, no contradictory findings in susceptibility were obtained among the groups during the study, which suggested strongly that subjects with HLA-Bw51 and -Bw16 are susceptible. In addition, when the seropositive rates were compared in all combinations of HLA-A and -B antigens classified according to expected susceptibility, the positive rates were arranged in order of susceptibility with significant statistical differences in several groups.
Postoperative long term cancer chemotherapy (PLCC) with the combination of Mitomycin-C, FT-207, a furanyl analog of 5-fluorouracil, and PSK, an immunopotentiator, was prescribed for patients with advanced gastric cancer. Five year survival rates for all stage III and stage IV patients were 52.8 and 19.3 per cent in the PLCC group. The rates were 26.7 and 2.2 per cent in the control groups (p less than 0.05). In curative cases of stage IV, the 5-year survival rate was 50.0% in the PLCC group while the rate was 11.1% in the controls. Mean survival time of patients with peritoneal dissemination or hepatic metastases was 12.8 and 10.9 months, respectively, for the PLCC group, in contrast to the lower 6.4 and 4.3 months for the controls. Thus, the 5-year survival rate of advanced gastric cancer patients in stage III and stage IV was markedly improved when these patients were treated with the protocol. Our findings clearly show that adjuvant chemotherapy should be administered for a long period postoperatively in order to achieve a significant improvement in patients with gastric cancer.
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Fifteen patients had hepatic hemangiomas removed with liver resections that ranged in extent from local excision to right trisegmentectomy. There was no mortality and little morbidity. The propriety and feasibility of extirpative treatment of such liver tumors has been emphasized by this experience.
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Possible association between HLA antigens and antibody response to rubella vaccine was examined in 71 seronegative adult females, aged from 18 to 23, immunized with QEF vaccine. High responders (HAI antibody titer greater than or equal to 1:32) with HLA-B15 were significantly higher in frequency than those without HLA-B15 (p < 0.05). On the other hand, subjects with HLA-A9 had a tendency toward low immune responsiveness, including all the three non-responders. These results suggest that the antibody response to rubella vaccine may be influenced by the host-genetic factors relating to HLA antigens.
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