Tetsushi Saishoji

Increased expression of membrane-associated phospholipase A2 shows malignant potential of human breast cancer cells

Background. Recently, the authors reported that membrane‐associated phospholipase A2 (M‐PLA2) was one of the acute phase reactants and increased in serum of patients with various malignant tumors.

Comparison of video‐assisted minithoracotomy and standard open thoracotomy for the treatment of non‐small cell lung cancer

This study represents a retrospective comparison of video‐assisted thoracic surgery (VATS) lobectomy with standard open lobectomy for non‐small cell lung cancer (NSCLC). The endpoints of this study include surgical stress as measured by interleukin 6 concentration and patient survival. A retrospective review was performed of 240 consecutive patients with clinical stage IA or IB NSCLC who underwent either VATS lobectomy (n = 67) or conventional open lobectomy (n = 173). The amount of blood loss was significantly less in the VATS group (110±75 ml) as compared to 165±90 ml for the open lobectomy group (P<0.05). A significantly lower incidence of postthoracotomy pain occurred in the VATS group (6.2±4.1 times/3days) than in the open lobectomy group (13.5±5.8 times/3 days, P<0.0001). The postoperative interleukin (IL)‐6 serum concentration of was significantly lower in the VATS group (112±43 pg/ml) than that in the open lobectomy group (351±133 pg/ml, P<0.001). There was no statistically significant difference in survival between the VATS and open lobectomy groups. The median follow‐up was 42 months in both groups. VATS lobectomy for NSCLC is a reasonable treatment option for selected patients with stage I NSCLC.

Closure of a gastric tube-tracheal fistula by transposition of a pedicled sternocleidomastoid muscle flap

We treated a 65-year-old man presenting with a gastric tube-tracheal fistula, who had undergone subtotal esophagectomy. The radiological and endoscopical findings demonstrated a 4-mm gastric tube-tracheal fistula located just above the sternum. Conservative treatment using a flexible fiberscope and/or gastrofiberscope, including factor XIII with fibrinogen (Beriplast P, Tisseel, and Borheal), α-cyanoacrylate (Aron-α-A),n-butyl-2-cyanoacrylate (histoacryl), and human antihemolytic factor XIII (Fibrogammin P) in addition to total parenteral nutrition with no oral intake did not result in closure of the fistula. The fistula was therefore transected and closed through an upper median sternotomy and right partial intercostal incision followed by transposition of the sternocleidomastoid muscle flap between the gastric tube and trachea. The postoperative course was uneventful.

Carcinoma of the breast in a 6-year-old girl: a review of the Japanese literature

A rare case of carcinoma of the breast in a 6-year-old Japanese girl is reported together with a review of the Japanese literature of this disease in childhood, totalling 17 patients, which confirms the good prognosis in the majority of cases. It is proposed that surgery, at least initially, should be conservative.