Search

To evaluate the effect of blood transfusion on incidence of postoperative hepatitis and prognosis of gastric cancer, the data of 493 patients having been operated on curatively in our hospital were divided into two groups: those who received transfusion before the beginning of components transfusion and those who received transfusion after that. The data indicated that the incidences of postoperative hepatitis increased from 3.7% to 5.4% after the beginning of transfusion of blood components, but the 5-year survival rates did not differ significantly. The 5-year survival rates of transfused patients and non-transfused patients were 57%, 84%, respectively (p less than 0.001) and the rates decreased according to the dose of whole blood and/or packed red cells. The same results were obtained when limited to stages I + II, But they were not deteriorated by fresh frozen plasma significantly. The result suggests that it is better to refrain from unnecessary blood transfusion and transfuse whole blood in the case of massive transfusion to decrease the incidence of postoperative hepatitis and more better to transfuse leucocyte-free blood to avoid immunological effect.

The influences of surgical stress on the local graft-versus-host reaction (GvHR) in F1 mice were studied. Skin incision to the F1 mice inflicted to 1 day prior to injection of parental spleen cells produced impairment of popliteal lymph node enlargement, however, this effect was not observed when GvHR was induced on the day 3 and 5 after operation. Spleen cells from hind limb amputated F1 mice exhibited suppressor activity on local GvH reaction when injected into naive syngenic F1 mice together. This suppressor activity was markedly detected 3 and 24 hrs after operation, then gradually reduced and completely disappeared on the day 7. These suppressor activity completely disappeared by the treatment with anti-Thy 1.2. antibody and complement. These results showed that GvH reaction was suppressed by the surgical stress, and this suppression was due to suppressor T lymphocytes in the spleen.

Many BRMs (biological response modifiers) have been used for post-operative immunochemotherapy. And their usefulness were also reported. Nevertheless it is still unknown that which route, how much doses and which timing are the most effective to administer these drugs. We used BRMs intratumorally and preoperatively. To reconfirm the efficacy of intratumoral injection therapy randomized study was performed in gastric carcinoma. Three hundred and ninety-five cases were entered, 199 cases in group A which were treated preoperatively with OK-432 intratumorally and 196 cases in group B which were control, respectively. In the cases which had marked infiltration of lymphoid cells in tumor sites, the two year survival rate of group A was significantly better than that of group B (p less than 0.05). On the study of recurrent forms, the distal lymph node metastasis was markedly decreased in group A. The ratio of metastasis to the distal lymph nodes in group A was 5-10% lesser than that in group B on the each depth of tumor invasion. The ratio of lymph nodes metastasis was almost similar in the each group, but the number of metastatic lymph nodes was significantly reduced in high grade tumor infiltrated cases in group A (p less than 0.005). These results suggest that preoperative endoscopically intratumoral administration of OK-432 suppresses the lymph node metastasis and improves the postoperative survival rate.

The effects of anesthesia and surgical procedures on natural killer (NK) cell activity were studied. The data indicated that splenic lymphocytes taken from mice 1 to 5 days after surgery showed significantly diminished activity of natural killing. When splenic lymphocytes were treated by anti-Thy 1 antibody and complement, NK activity to Lewis lung carcinoma cells was remarkably depressed in normal mice, but was not depressed in laparotomized mice. Peripheral lymphocytes from cancer patients following major surgery also showed depressed NK activity. The suppression was first detected during the operation. In patients undergoing major gastrointestinal surgery, the suppression was at its maximum during first three days and decreased to control levels by the day 7 to 14. Following major thoracic surgery, the suppression continued more longer.