[Local communication system between hospitals, clinics and nursing homes and their team approaches are essential in a consistent medical care for cancer patients]

Designated cancer care hospitals are responsible for constructing a local communication system between hospitals, clinics and nursing homes. Their team approaches are essential in a consistent medical care for cancer patients. Clinical pathway sheets shared by them will promote their collaboration and keep the consistency of medical care. Counseling and supporting section, palliative care unit and palliative care team in the designated cancer care hospital play an important role improving the quality of medical care for cancer patients.

Transforming growth factor-beta 1 derived from biliary epithelial cells may attenuate alloantigen-specific immune responses

Immune response to liver allografts may be different from that to other organ transplants since immunological manipulation easily attenuates immune-response to liver allografts. Numerous studies on the alloantigen-specific immune response have been carried out, however, the precise mechanisms involved in this attenuation are not clear yet. Here we suggest the attenuation of alloantigen-specific immune response by TGF-beta 1 derived from biliary epithelial cells. The transforming growth factor-beta 1 (TGF-beta 1) expression in rat liver was examined immunohistologically. Rat biliary epithelial cells (BEC) were purified from the perfused liver and added to allogeneic mixed lymphocyte reaction (allo-MLR) to assess their attenuating potential on allo-MLR and alloantigen-specific cytotoxic T lymphocyte (allo-CTL) induction. Immunohistological investigation revealed the expression of TGF-beta 1 in biliary epithelial cells. Both purified biliary epithelial cells and TGF-beta 1 attenuated allo-MLR and allo-CTL induction in a dose-dependent manner, and anti-TGF-beta 1 antibody partially relieved this attenuation. This study reveals that biliary epithelial cells, the major target cells of allo-antigen specific immune response, contain TGF-beta 1 and that they have a capacity to attenuate allo-MLR and allo-CTL induction.

[A case of right femoral anastomotic aneurysm accompanied by obstruction of left iliac and femoral artery]

The case was a 66-year-old man. Three years ago under a diagnosis of Arteriosclerosis obliterans he received: right aorto-femoral bypass grafting. This time left intermittent clandication was observed and we performed resection of aneurysm and femorofemoral cross over bypass grafting following a diagnosis of right aorto-femoral anastomotic aneurysm accompanied by obstruction of left iliac and femoral artery. Anastomotic aneurysm is one of the complications after prosthetic bypass grafting. In this paper we discussed the causes, precautions and treatment of anastomotic aneurysms.