Minimally invasive Ivor Lewis esophagectomy for the management of iatrogenic esophageal perforation in a patient with esophageal cancer.

Esophageal perforation after endoscopic instrumentation is a surgical emergency. Prompt diagnosis and treatment have a significant impact on mortality. In the setting of esophageal cancer, iatrogenic perforation presents a difficult challenge for surgical management as primary repair is not feasible.

Bcl-2 overexpression enhances tumor-specific T-cell survival.

Although immunotherapy based on the adoptive transfer of tumor-specific T lymphocytes has been shown to result in dramatic clinical responses in some patients, the relatively low levels of engraftment and persistence of the adoptively transferred cells may limit these responses in many patients. In an attempt to develop strategies for prolonging the survival of adoptively transferred T cells, we have carried out studies in which T cells obtained from healthy donors as well as tumor-specific T cells were transduced with a retrovirus expressing the human Bcl-2 gene. Our results indicate that these transduced T cells overexpress Bcl-2, are resistant to death, and have a survival advantage following interleukin-2 withdrawal compared with control T cells transduced with a retrovirus expressing green fluorescent protein.

IL-15 enhances the in vivo antitumor activity of tumor-reactive CD8+ T cells.

IL-15 and IL-2 possess similar properties, including the ability to induce T cell proliferation. However, whereas IL-2 can promote apoptosis and limit CD8(+) memory T cell survival and proliferation, IL-15 helps maintain a memory CD8(+) T cell population and can inhibit apoptosis. We sought to determine whether IL-15 could enhance the in vivo function of tumor/self-reactive CD8(+) T cells by using a T cell receptor transgenic mouse (pmel-1) whose CD8(+) T cells recognize an epitope derived from the self/melanoma antigen gp100.