J.Jpn. Surg. Soc.. 86(9): 1104-1107, 1985
Report on the annual meeting
SIGNIFICANCE OF ACTIVE NUTRITIONAL SUPPORT FOR MAINTENANCE OF IMMUNOPOTENTIATION ON THE SURGICAL TREATMENT OF ESOPHAGEAL CANCER
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Second Department of Surgery, Tohoku University School of Medicine, Sendai, Japan Tetsuro Nishihira, Katsu Hirayama, Minoru Akimoto, Satoru Sato, Ryuzaburo Shineha, Masaki Tan, Morio Kasai |
1. Preoperative immunological status : These patients were already suffering from malnutrition, because of the impossibility of peros intake. Natural killer (NK) cell activity and interleukin-II inducing activity of peripheral mononuclear cells in the above patients were clearly lower than such activities of cells in the patients with breast cancer whose nutritional condition was as normal as that of healthy people. These two immunological paramenters in the majority of the patients were improved by active total parenteral and enteral nutrition. However, there were a few patients whose nutritional status could not be improved.
2. Postoperative immunological status : The movement of peripheral lymphocyte subpopulation was successively checked with several kinds of monoclonal antibodies such as OKT-3 (anti-T cells), Leu-7 (anti-NK cells), OKIa-1 (anti-B cells), OKT-4 (anti-inducer and/or suppressor T cells) and OKT-8 (suppressor and/or cytotoxic T cells). In nutritionally controlled patients, the population of OKT-3, Leu-7 and OKIa-1 showed a pattern similar to the preoperative value, but in undernourished patients, that population was disturbed soon after the operation. Pattems of OKT-4 and OKT-8 showed a converse correlation. Nearly two weeks after operation, all these five kinds of population had changed. Moreover, nitrogen balance recovered from negative to positive. The time of this change is thought to be the turning point of surgical metabolism and the immunological status.
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