Hidenobu Osawa

Reduced expression of transforming growth factor-β receptors is an unfavorable prognostic factor in human esophageal squamous cell carcinoma

Transforming growth factor‐β (TGF‐β) inhibits epithelial cell proliferation. Inactivation of the TGF‐β signaling pathway is thought to play a role in tumorigenesis. Our purpose was to clarify the correlation between TGF‐β receptors or TGF‐β1 expression and the clinicopathologic characteristics of patients with esophageal squamous cell carcinoma (SCC). Immunohistochemical staining for TGF‐β type I receptor (TGF‐βR‐I), TGF‐βR‐II and TGF‐β1 was performed on surgical specimens obtained from 80 patients with esophageal SCC. Preoperative plasma TGF‐β1 levels were measured and correlated with pathologic features and clinical outcomes. Expression of TGF‐βR‐I and TGF‐βR‐II was reduced in 43 (53.8%) and 23 (28.8%) specimens, respectively. TGF‐β1 was overexpressed in 29 (36.3%). Reduced expression of TGF‐βR‐I and TGF‐βR‐II showed a significant association with depth of invasion (p = 0.0015 and p = 0.0012), lymph node metastasis (p = 0.0309 and p = 0.0059) and pathologic stage (p = 0.0103 and p = 0.0401). Overexpression of TGF‐β1 had a significant association with depth of invasion only (p = 0.0335). Reduced expression of TGF‐βR‐I and TGF‐βR‐II was correlated with cancer‐specific survival (p = 0.0324 and p = 0.0243). The mean preoperative plasma TGF‐β1 level was 10.5 ± 0.8 ng/ml in patients with esophageal carcinoma and was significantly higher compared to healthy controls (p < 0.01). We demonstrate that reduced expression of TGF‐β receptors in esophageal SCC appears to be correlated with depth of invasion, lymph node metastasis, pathologic stage and poor prognosis. TGF‐β receptor expression may play a key role in the progression of this cancer.

Laparoscopy-Assisted Resection of Ileocecal Intussusception Caused by Ileal Pedunculated Lipoma

We report on a case of ileal lipoma that prolapsed into the ascending colon and was resected by laparoscopy-assisted surgery. A 31-year-old male Japanese patient was admitted to our hospital because of hematochezia and anemia. Colonoscopy revealed a pedunculated polyp arising from the ileum. The surface was covered with slightly edematous mucosa. Abdominal computed tomography showed a low-density mass in the ascending colon. A diagnosis of pedunculated ileal lipoma with intussusception was made, and laparoscopy-assisted surgery was performed. The intussusception was reducted by resection of the lipoma. The surgical specimen was a 40 × 30 × 25 mm round tumor with a long stalk 11 cm in length. Microscopic examination of the specimen revealed ileal lipoma. Laparoscopic surgery is recommended for benign tumors of the small intestine because it is minimally invasive.

Idiopathic Omental Bleeding: Report of a Case

We report a case of idiopathic omental bleeding in a 27-year-old man who was brought to our hospital after the sudden development of intermittent abdominal pain, nausea, and fainting. Computed tomography showed intra-abdominal fluid and emergency laparotomy revealed a hemorrhagic mass in the omental bursa, which was excised. The patient was successfully treated and a diagnosis of idiopathic omental bleeding was made.

The direct visualization of structural array from laminin to dystrophin in sarcolemmal vesicles prepared from rat skeletal muscles

It has been biochemically shown that dystrophin and α‐ and β‐dystroglycan form an oligomeric complex which links laminin, a component of the basement membrane, to components of the subsarcolemmal cytoskeleton in skeletal muscle fibers. In the present study the dystrophin‐glycoprotein complex and its structural relationships to laminin and subsarcolemmal cytoskeleton were ultrastructurally examined in crude surface membranes prepared from rat skeletal muscles. Sarcolemmal vesicles within crude surface membranes were identified and characterized by fine protrusions on their outer surface and electron‐dense materials or patches associated with the inner surface. These two components were seen to be in register with each other across the sarcolemma. The fine protrusions were immunolabeled by anti‐α‐dystroglycan and reassociated with exogenous laminin. Immunolabeling in combination with laminin reassociation demonstrated that the electron‐dense materials contained dystrophin at laminin‐binding domains of the membrane. In addition, they were often associated with very fine filaments. These results provide morphological evidence for the biochemically proposed model of molecular array of dystrophin complex from the basement membrane to the subsarcolemmal cytoskeleton.

Single-incision laparoscopic surgery for a small-intestinal gastrointestinal stromal tumor: report of a case.

Our report concerns a 64-year-old man with a small-intestinal gastrointestinal stromal tumor (GIST), which was successfully treated with single-incision laparoscopic surgery (SILS). Small-bowel endoscopy detected a submucosal tumor located approximately 10 cm from the ligament of Treitz in the wall of the proximal jejunum. Contrast-enhanced computed tomography revealed a tumor (diameter, 4 cm) containing high- and low-density areas in the proximal jejunum. On 18F-fluorodeoxyglucose (FDG) positron-emission tomography (PET), the tumor demonstrated intense FDG uptake (maximum standard uptake value, 3.82), whereas it displayed high signal intensity on diffusion-weighted magnetic resonance images. No metastatic lesions were observed. The patient was diagnosed with a jejunal GIST. Wedge resection of the jejunum was performed using the SILS procedure. The tumor was histopathologically diagnosed as a low-grade malignant GIST. SILS is a useful resection technique for small-intestinal GIST.

Adult intussusceptions induced by a terminal ileum diverticulum: a case report

We herein report a case of adult intussusceptions induced by a terminal ileum diverticulum. Histological examination confirmed a terminal ileum diverticulum full of feces, and it was considered an infiltrated region. The clinical characteristics of previously reported adult intussusceptions are also discussed, including jejunoileal diverticulum and surgical management.