• Journal of Digestive Cancer Research
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• v.4 no.2
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• pp.77-82
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• 2016

The 26^th World Congress of the International Association of Surgeons, Gastroenterologists and Oncologists (IASGO) was held in Seoul, Korea from September 8 to 10, 2016. In this congress, I gave a State-of-the-Art Lecture II entitled "Mesenteric Approach in Pancreatoduodenectomy." The ideal surgery for pancreatic head cancer is isolated pancreatoduodenectomy, which involves en bloc resection using a non-touch isolation technique. My team has been developing isolated pancreatoduodenectomy for pancreatic cancer since 1981, when we developed an antithrombogenic bypass catheter for the portal vein. In this operation, the first and most important step is the use of a mesenteric approach instead of Kocher's maneuver. The mesenteric approach allows dissection from the non-cancer infiltrating side and determination of cancer-free margins and resectability, followed by systematic lymphadenectomy around the superior mesenteric artery. This approach enables early ligation of the inferior pancreatoduodenal artery and total mesopancreas excision. It is the ideal surgery for pancreatic head cancer from both oncological and surgical viewpoints. The precise surgical techniques of the mesenteric approach are herein described.

• Asian-Australasian Journal of Animal Sciences
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• v.20 no.5
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• pp.795-801
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• 2007

Patients with Type I diabetes mellitus have been treated with porcine insulin for several decades and pigs have recently been deemed an ideal source of microencapsulated islet cells for clinical xenotransplantation. In this study, neonatal pigs were anesthetized and sacrificed prior to a pancreatectomy. Islet cells were isolated from pancreas via collagenase digestion. Islet cells were separated and collected by hand under microscopic guidance. These cells were suspended in 1.4% sodium alginate solution and encapsulated by dropping them into 1.1% calcium chloride solution and in which the round gel in size was 250-400 ${\mu}m$ in diameter. Viability of the microencapsulated islet cells cultured in medium at $37^{\circ}C$ was assessed by MTT assay. Furthermore, insulin released in response to glucose challenge was investigated using an enzyme-linked immunosorbent assay. Secretion of insulin was low in response to the basal glucose solution (4.4 mM) in medium and was significantly higher in response to the high glucose solution (16.7 mM). The viability of microencapsulated islet cells did not differ significantly over a period of 7 days; that is, the increasing pattern of insulin concentration in the culture medium after glucose stimulation interval day was similar throughout the 7 days cultivation. In summary, experimental evidences indicated that the effects of alginate-microencapsulation prolonged survival of the neonatal porcine islets in vitro cultures and the insulin response to glucose of the islets was maintained.