Kiyonori Nishioka

Clinical significance of CDC25A and CDC25B expression in squamous cell carcinomas of the oesophagus.

CDC25A, CDC25B and CDC25C belong to a family of protein phosphatases which activate the cyclin-dependent kinase at different points of the cell cycle. According to accumulating evidence, CDC25A and CDC25B seem to possess oncogenic properties. We have analysed these expressions by immunohistochemistry, western blot and RT-PCR in a series of 100 patients with squamous cell carcinoma of the oesophagus. When compared with non-cancerous cells, CDC25A and CDC25B were strongly expressed in the cytoplasm of cancer cells, with positive (+) classification in 46% (46 cases) and 48% (48 cases), respectively. There was no significant correlation between CDC25A and CDC25B expression, nor was there any association with the expression of other cell cycle-regulating molecules, including cyclin D1, Rb, p16INK4, p27KIP1and PCNA (proliferating cell nuclear antigen). CDC25A (+), as well as CDC25B (+), was more frequently found in patients with deeper tumour invasion and lymph node metastasis, while tumour size was correlated only with CDC25A expression. Postoperative survival was significantly poorer for CDC25A (+) patients than CDC25A (–) patients, but was not affected by the CDC25B status. Nuclear localization of CDC25A was observed in 51 cases (51%), regardless of its cytoplasmic expression, and was not associated with clinico-pathological factors or prognosis. Multivariate analysis revealed only the CDC25A status to be an independent significant prognostic factor among these biological and clinico-pathological factors. CDC25A but not CDC25B may be a new prognostic factor for squamous cell carcinoma of the oesophagus. Thus, regulation of the G1 checkpoint in the cell cycle may be important in oesophageal carcinogenesis, which may also involve many other oncogenes.

Successful treatment of an esophageal hemangioma by endoscopic injection sclerotherapy: Report of a case

We report herein the case of a 46-year-old man in whom an esophageal hemangioma was successfully treated by endscopic injection sclerotherapy (EIS). The patient was admitted to hospital after a routine upper gastrointestinal series demonstrated a filling defect in the esophagus. Endoscopy, computed tomography (CT) images, and magnetic resonance imaging (MRI) subsequently revealed a hemangioma in the middle esophagus. EIS was performed using 99% ethanol and 1% polydocanol, and 4 weeks later, the tumor had almost disappeared. This patient has since been followed up carefully with periodic endoscopy and barium studies and additional sclerotherapy will be performed if necessary.

Primary splenic malignant lymphoma mimicking metastasis of rectosigmoid cancer: A case report

Highlights • Primary splenic malignant lymphoma should be included among the differential diagnoses of splenic tumors.• Curative resection might be a therapeutic option for the treatment of primary splenic malignant lymphoma.• Laparoscopy-assisted splenectomy is useful for reducing the length of incisions and the operative invasiveness.

Intraabdominal actinomycosis resulting in a difficult to diagnose intraperitoneal mass: A case report

Highlights • Actinomycosis is a chronic suppurative granulomatous disease caused by Actinomyces israelii.• Actinomycosis is one of the differential diagnoses of an abdominal mass.• The first choice of treatment for actinomycosis is surgical resection.

Efficacy of single-incision laparoscopic totally extraperitoneal repair for irreducible or incarcerated inguinal hernia: SILS-TEP for incarcerated inguinal hernia

The aim of this study was to evaluate the efficacy of single‐incision laparoscopic surgery for totally extraperitoneal repair (SILS‐TEP) of irreducible inguinal hernias and incarcerated inguinal hernias.

A resected case of medullary carcinoma of the ascending colon followed by infarction of the greater omentum mimicking anastomotic leakage

Highlights • Medullary carcinoma should be distinguished from other more aggressive, non-glandular tumors of the colon, because medullary carcinoma appears to have a better survival outcome than undifferentiated colon adenocarcinoma.• Omental infarction should be considered in the differential diagnosis of acute abdomen after surgery.

A Case of Bronchopleural Fistula Associated with Esophageal Surgery Successfully Closed by Injection of Fibrin Glue under Bronchoscopic Observation.

食道癌術後に発生した膿胸は治療に難渋することが多く, さらに気管支瘻を併発した場合は特に治療困難となる.気管支瘻に対する治療としては有茎性大網充填術, 有茎性筋肉充填術の外科的治療が行われているが, 胃管再建の食道癌術後早期の気管支瘻ではこれらの外科的治療が困難である.今回, 気管支をバルーン閉塞させてフィブリングルーを注入する方法が有効であったので報告する.症例は61歳の女性で, 胸部食道癌に対して食道亜全摘・胃管利用胸骨後径路再建を施行した.腫瘍は気管分岐部-左主気管支に浸潤しており, 潰瘍底が一部残存した.これに起因すると考えられる右膿胸を発生し胸腔ドレナージ, 胸腔内洗浄を施行したが, air leakを多量に認め気管支瘻の併発を認めた.術後43日目に気管支鏡下にB6bをバルーン閉塞させフィブリングルー3mlを注入したところ, air leakは消失し気管支瘻は閉鎖された.