Modified ultrafiltration (MUF) is a technique able to remove the excess body fluid and inflammatory mediators associated with the use of a cardiopulmonary bypass (CPB). It has been shown to reduce morbidity after cardiac operations in children. Application of MUF after adult cardiac operations has also been suggested being associated with a lower prevalence of early morbidity. However, the relationship between the concentration of mediators in the blood and postoperative morbidity remains yet to be proved. In this study, changes of various chemical mediators in the filtrate and blood before and after MUF have been evaluated in adult patients. Significant reductions of blood levels of inflammatory cytokines were not observed after MUF. On the other hand, MUF significantly elevated hematocrit, number of red cells, concentrations of albumine, coagulation Factor VII and X, platelet factor (PF)-4, and antithrombin (AT-) III.

Nicotiana tabacum cells were immobilized in the Ca-alginate gel beads coated with the cell-free gel film and then cultivated in the flask. The effects of the coating film thickness on intraparticle cell growth and cell leakage were investigated. The beads with the coating film of a desired thickness can be prepared by controlling the amount of free Ca2+ in the core beads. The optimum thickness for preventing cell leakage without inhibiting intraparticle cell growth was determined. The productivity of the phenolics, which was one of the secondary metabolites of tobacco cells, for the immobilization cultures was compared with that for the suspension culture. The phenolics production and release to the medium seemed to be promoted by the immobilization. The immobilization culture using the coated beads was very effective in promoting the extracellular productivity of the phenolics as well as preventing cell leakage. The immobilization method was applied to the culture system using an airlift bioreactor with a draft tube. Cell leakage was completely prevented throughout the 25-day cultivation without inhibiting cell growth.

膵癌の予後は不良であるが，中には拡大手術により長期生存する症例もある．1978年から1995年までに膵癌67例を切除した．門脈合併切除術は46例（69%）に施行され，術式別にみると膵全摘症例に多かった．門脈合併切除群（PV）と合併切除が必要なかった群（nonPV）に分けて，TNM因子について検討した．腫瘍の小さい症例はnonPV群に多くみられた．PV群では腫瘍の大きさにより生存月数には差がみられなかった．n因子はPV群において予後に関して極めて鋭敏な指標てあった．遠隔転移症例には長期生存例は皆無であった．腫瘍の大きさは門脈合併切除の適応を決める因子ではなく，リンパ節転移の有無こそが重要な因子であることが判明した．

Off-pump coronary artery bypass grafting (CABG) has become a popular procedure. However, temporary occlusion of the target vessel is sometimes a threat to the patients. Although ischemic preconditioning (IP) has been proposed to reduce myocardial injury, its effects remain controversial. The coronary veins represent an alternate route for delivery of therapeutic agents and arterial blood to the acutely ischemic myocardium. The aim of this study was to investigate the protective effect against myocardial ischemia and reperfusion injury of combined IP and synchronized coronary venous retroperfusion (SCVR) in an off-pump CABG model. Twenty-one pigs were assigned to 3 groups of 7 animals. In the control group, the left anterior descending coronary artery (LAD) was occluded for 45 min followed by 2 h of reperfusion using a left intrathoracic artery (LITA) bypass circuit. In the IP group, LAD occlusion was done for 5 min with 15 min of reperfusion, followed by 45 min of LAD occlusion. In the SCVR group, pretreatment before LAD occlusion was the same as in the IP group. Then, SCVR was commenced just after the start of LAD occlusion for 45 min. The percent systolic shortening of ischemic myocardium (measured by sonomicrometry) after reperfusion via the LITA was significantly (p < 0.001) greater in the SCVR group (14.6 +/- 3.3%) than in the control group (-1.6 +/- 5.6%, 95%CI: -24.3 - -8.1) or the IP group (0.7 +/- 8.0%, 95%CI: -22.0 - -5.8) after 30 min of reperfusion, and this difference persisted throughout the reperfusion period. Infarct size (expressed as a percentage of the area at risk) was significantly (p < 0.001) smaller in the SCVR group (2.4 +/- 2.7%) than in the control group (83.0 +/- 2.3%, 95%CI: -99.0 - -62.4) or the IP group (42.0 +/- 23.0%, 95%CI: -58.0 - -21.3). Combined SCVR and IP had a potent myocardial protective effect in the present off-pump CABG model. This method may be clinically feasible and may be able to prolong a safe coronary occlusion.

Although the operative mortality following elective aneurysmectomy has achieved satisfactory results, that following surgery for ruptured abdominal aortic aneurysms (AAAs) remains high. The purpose of this study was to identify the factors affecting the mortality rate associated with the treatment of ruptured AAAs. Between 1978 and 1999, 33 patients underwent emergency surgery for a ruptured AAA. The operative mortality was 33.3% and in-hospital mortality was 6.0%. Hypotension, defined as a systolic blood pressure <80 mmHg, was seen in 19 patients at the time of presentation, 9 of whom underwent surgery in this state. In the remaining 10 patients, it was possible to increase the systolic blood pressure to ≥80 mmHg preoperatively. Of the 11 patients who died within 30 days of surgery, 9 had hypotension at the time of induction of anesthesia and only 2 had a systolic blood pressure of ≥80 mmHg. A satisfactory outcome was achieved in patients whose condition met the following criteria: a systolic blood pressure ≥80 mmHg at the time of operation, minimal aortic cross-clamping time, less blood loss and blood transfusions, and a shorter operation time to repair the ruptured AAA. Concomitant heart disease was also found to be an important prognostic factor.

We report a case of localized pericardial mesothelioma with unusual histological features in a 44-year-old woman. Her radiological imagings showed an 11-cm pericardial tumor, between the heart and aortic arch. Microscopically, the tumor was predominantly composed of vacuolated cells and vaguely reminiscent of well differentiated "lipoma-like" liposarcoma, but only small foci of the tumor showed the papillotubular configuration. Histochemically, the tumor cells contained hyaluronic acid in the vacuoles but no lipids. Immunohistochemically, they showed immunoreactivity for cytokeratin, calretinin, vimentin, and epithelial membrane antigen. Ultrastructural study showed that the vacuoles of the tumor cells were intracytoplasmic lumina. The intracytoplasmic lumina and the surface membranes of the tumor cells had many long and slender microvilli with focal bush-like appearance. Desmosomes between adjacent cells were occasionally observed. To our knowledge, this is the first case report of epithelial type mesothelioma predominantly composed of vacuolated tumor cells, microscopically mimicking liposarcoma.

This paper describes the analysis of actual micro-surgery operation to determine the specifications of a tele-micro-surgery system. The implemented system for the connection of micro blood vessels consists of multiple micro co-located operation point slave manipulators, macro rotational-force-feedback-free master manipulators and a vision system which is comprised of a fixed viewpoint microscope and a movable monitor system. The parameters of the vision system can be controlled in accordance with the system's understanding of the operator's intention by monitoring the posture change of the operator. The experimental results showed the effectiveness of the developed system. in the experiment, a blood vessel of a rat with a diameter less than 1 mm was successfully sutured using needle with a curvature radius of 2 mm.

This paper describes the analysis of micro-surgery operation to determine the specifications of a tele-micro-surgery system. The implemented system for the connection of micro blood vessels consists of multiple micro co-located operation point slave manipulators, macro rotational-force-feedback-free master manipulators and a vision system which is comprised of a fixed viewpoint microscope and a movable monitor system. The parameters of the vision system can be controlled in accordance with the system's understanding of the operator's intention by monitoring the posture change of the operator. The experimental results showed the effectiveness of the developed system. In the experiment, a blood vessel of a rat with a diameter less than 1 mm was successfully sutured using needle with a curvature radius of 2 mm.