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Submicrometer Si02-A1203 powders with compositions of 46.5 to 76.6 wt % A1203 were prepared by hydrolysis of mixed alkoxides. Phase change, mullite composition, and particle size of powders with heating were analyzed by DTA, XRD, IR, BET, and TEM. As-produced amorphous powders partially transformed to mullite and AI-Si spinel at around 980°C. The compositions of mullite produced at 1400' and 1550°C were richer in A1203 than the compositions of stable mullite solid solutions predicted from the phase diagram of the SiO2-AlZO3 system. Particle size decreased with increasing Al2O3 content. The sintered densities depended upon the amount of Si02-rich glassy phase formed during sintering and the green density expressed as a function of particle size. [

Dqimmtcwt cf.Y~irgcq Shinsku Unive8sity School of Medicine, arid S c w d Dipurttnoit of ,Si/rgcty, Fuc~ilg of Midicine. Utiiversify of Ihkyo, 7i,kyo. Jupuri tidcticr to: Ilr 7: fiikuyutnu, lkpirrtrnerit qf'Siirgety, C'unccr Ccritcjr Hospitul, 5-1-1 Tsukiji, Cliuo-kii, Tok-yo 103. .lal"nl Hepatic vein reconstruction i. . carried o u t following hepatectomy for cancer to pr'serve as m u c h of t h e remaining liver function as possible'. Occasionally, t h e use of reconstruction allows complete resection of a t u m o u r that involvcs t h c confluence of t h e three major hepatic veins'. This report describe; rcpcat hcpatectomy3 combined with two successful rcconstructions of a single ptcd 19 September 1995 rcmnant right hepatic vein at different sites after extended left hepatectomy. Surgical techniqueA 36-year-old man who had undergone colectomy with lymph node dissection for sigmoid colonic cancer was referred with a 6-cm liver metastasis involving the confluence of the left and middle hepatic veins. Extended left hcpatectomy removing both of the hepatic veins was performed. After 6months, a 2-cm tumour that invaded a tributary of the right hepatic vein was found deep in segment 5. A second hepatectomy was carried out with reconstruction of the tributary using a 2 5 c m greater saphenous vein graft. More than 1 year later a 4-cm tumour recurred around the root of the single remaining right hepatic vein. Transhepatic arterial chemotherapy (5-fluorouracil; total dose 20 g) was given hut the tumour diameter increased to 8 cm. A third hepatectomy with right hepatic vein re-reconstruction was conducted (Fig. I ) .Intraoperative ultrasonography confirmed tumour invasion of the hepatic venous trunk and an absence of thick accessory hepatic veins. After mobilizing the liver remnant, the right hepatic venous root and the suprahepatic and infrahepatic vena cava wcrc taped. Using Pringle's occlusion, liver transection was performed with a tumour clearance of over 1 cm. After total parenchymal division of segments 7 and 8, the right hepatic vein was transected, leaving a 2-cm free end at both stumps. A vcnovenous bypass was then formed bctwcen the liver-side stump of the hepatic vein and thc infrahcpatic vena cava using a 60-cm * a b Fig. 1 Right hepatic vein re-reconstriiction (asterisk indicates thc first reconstruction). a Liver transection under inflow and occasional outflow occlusion. b Vcnovenoua byp-lss formation and the second reconstruction using the common iliac vein graft (cava-side anastomosis was established on the b:ipass without any need for vascular occlusion, while total occlusion was rcquired for liver-sidc anastomosis) 762 63

We investigated the expression of intercellular adhesion molecule-1 (ICAM-1) and lymphocyte function-associated antigen-1 (LFA-1) by cells in the central nervous system (CNS) of Lewis rats during acute experimental allergic encephalomyelitis (EAE). A few endothelial cells in the CNS of normal rats expressed ICAM-1, whereas during the active phase of EAE, ICAM-1 was present on many endothelial cells. This alteration was detectable the day before clinical symptoms. Since histopathological studies showed few detectable mononuclear cells or inflammatory foci in any section of the preclinical rats, the expression of ICMA-1 was considered to be important at least in the early stage of inflammation. LFA-1 was seen on perivascular infiltrating cells. An increase in either ICAM-1- or LFA-1-positive cells was initially seen in the lumbosacral portion of the spinal cord, which then extended to the thoracic portion. The number of either ICAM-1- or LFA-1-positive cells peaked on the day of clinical onset in the lumbosacral portion. In contrast, in the thoracic portion, a peak in the number of either ICAM-1- or LFA-1-positive cells was observed on the day after clinical onset. This ascending extension of either ICAM-1- or LFA-1-positive cells was correlated with the progression of neurologic signs. It is suggested that increased expression of ICAM-1 and LFA-1 in the CNS of rat EAE may promote the extravasation of lymphocytes across the blood-brain barrier and be related to progression of the disease.

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