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Increased generation of reactive oxygen species is thought to be a major cause of tissue in ischemia-reperfusion injury. Left and median lobes of rat livers were subjected to 20 minutes of ischemia followed by reperfusion for up to 120 minutes. Superoxide radical generation was enhanced to 338 μmol/minute/g tissue after 60 minutes of reperfusion,and 367 μmol/minute/g tissue after 120 minutes. Superoxide generation in the liver of the control animal was 260 μmol/minute/g tissue. The activity of xanthine oxidase, a superoxide radical-generating enzyme, was also elevated in the liver treated with ischemia-referfusion. These results indicate that xanthine oxidase-catalyzed reaction is an important source for the superoxide generation in rat liver treated with ischmia-referfusion. The activities of superoxide dismutase and catalase, enzyme responsible in removing superoxide radical and hydrogen peroxide, were measured. Cu, Zn-superoxide dismutase activity was significantly higher in reperfused liver after ischemia than in control. However, the activity of Mn-containing superoxide dismutase was significantly low in reperfusion. The extent of tissue damage by ischemia-reperfusion was evaluated by measuring lipid peroxidation. Thiobarbituric acid reactive substance was significantly elevated in the liver treated with 60 minutes of ischemia followed by 60 minute of reperfusion. These results suggested that increased reactive oxygen species and diminished activities of enzyme removing toxic oxygen species rendered the damages on the liver which was sujected to ischemia followed by reperfusion.
Purpose: Senior surgeons prefer open gastrectomy (OG), while young surgeons prefer laparoscopic gastrectomy (LG). The purpose of this study was to evaluate the surgical outcomes of LG performed by a senior surgeon who was an expert in OG during his learning period, by comparing them with LGs performed by a young surgeon. Materials and Methods: A senior surgeon performed 50 curative gastrectomies with laparoscopy (LG-S group) from March 2015 to August 2016. A young surgeon's initial 50 LGs comprised the LG-Y group. Clinicopathological characteristics and surgical outcomes were compared between the LG-S and LG-Y groups. Results: D2 lymphadenectomy was more frequently performed in the LG-S group than in the LG-Y group (P=0.029). The operation time and number of retrieved lymph nodes did not significantly differ between the 2 surgeons (P=0.258 and P=0.410, respectively). Postoperative hospital stay and postoperative complication rate were similar between 2 groups (P=0.234 and P=1.000, respectively). Similarly, significant decreases in operation time with increasing case numbers were observed for both surgeons, whereas the number of retrieved lymph nodes increased significantly in the LG-Y group but not in the LG-S group. Conclusions: The LG outcomes when performed by the senior surgeon were comparable to those when performed by the young surgeon, despite performing more extended lymphadenectomies. Senior surgeons who are experts in OG should not refrain from performing LG.