Wandering spleen with chronic torsion.

Wandering spleen, a rare clinical entity with a high incidence of splenic torsion and infarction, was preoperatively diagnosed in a 28-year-old woman. Axial computed tomography showed the absence of the spleen in the left subphrenic space and a spleen-like mass in the pelvis, suggestive of a wandering spleen. A coronal contrast-enhanced computed tomography image exhibited the enlarged spleen suspended by elongated, dilated, and somewhat tortuous splenic vessels.

Mesorectum amputation technique for laparoscopic anterior resection.

The objective of this study was to assess our original procedure, the cutting off method (COM), where the rectum and mesorectum are cut off with an autosuture device simultaneously in laparoscopic anterior resection. From 2001 to 2003, laparoscopic anterior resection was performed in 21 patients at our institution using the COM (n = 14) and trimming method (TM; n = 7). We reviewed the medical records for operative duration, intraoperative blood loss, and postoperative complications.

Preoperative serum carcinoembryonic antigen and carbohydrate antigen 19-9 levels for the evaluation of curability and resectability in patients with pancreatic adenocarcinoma.

Background Purpose: Although carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA 19-9) are the most studied serum tumor markers that have been evaluated for diagnosis and prognosis in patients with pancreatic cancer, little is known of the value of these markers for the prediction of curability and resectability.

Methods: We retrospectively reviewed preoperative serum levels of CEA and CA 19-9 in 244 consecutive patients with pancreatic operations.

Results: Although 159 pancreatic operations seemed "resectable", 93 of them were judged curative (R0) and the other 66 turned out to be noncurative (R1/2).

Suture line recurrence in the jejunal pouch after curative proximal gastrectomy for gastric cancer: report of two cases.

We report two patients with suture line recurrence in the jejunal pouch after curative proximal gastrectomy for gastric cancer. The first patient was a 60-year-old asymptomatic woman with gastric cancer (T2N0M0) after curative proximal gastrectomy with jejunal pouch interposition. She had to undergo a second resection for suture line recurrence in the jejunal pouch 12 months later.

Gingival metastasis from rectal cancer.

We report a 51-year-old woman who had undergone surgical resection of Dukes'B rectal cancer. On postoperative day 30, she noticed a dark red swelling in the right upper gingival, for which immunohistochemical study of the biopsy specimen revealed metastasis from the rectal cancer.

Palliative surgical treatment for enterostasis caused by recurrent gastric cancer: analysis of survival and QOL based on pathological features.

To improve quality of life (QOL) and prolong survival, enterostasis caused by recurrent gastric cancer must be treated appropriately. We reviewed the current treatment retrospectively. The subjects were 43 patients with enterostasis caused by recurrent gastric cancer and treated by surgical procedures at our hospital from 1988 to 1997.

Protective effects of a hibernation-inducer on hepatocyte injury induced by hypothermic preservation.

Background/purpose: For hepatocyte-based cell therapy to be realistic, the method chosen for cryopreservation or hypothermic preservation is critical. The aim of the present study was to clarify whether D-Ala2-Leu5-enkephalin (DADLE), a hibernation inducer, has protective effects on hepatocytes with regard to hypothermic preservation injury.

Methods: A suspension of rat hepatocytes was stored at 4 degrees C for 24 h with or without DADLE.

Achalasia complicated by multiple intramucosal carcinomas: report of a case.

A 56-year-old woman underwent a laparoscopic Heller-Dor operation for esophageal achalasia in June 2002. As dysphagia became exacerbated and the oral intake became extremely poor, an esophagectomy was thus considered to be indicated. In September 2005, a transhiatal esophagectomy was performed, and the esophagus was reconstructed using a gastric tube through the posterior mediastinum.

Synergistic induction of antigen-specific CTL by fusions of TLR-stimulated dendritic cells and heat-stressed tumor cells.

Dendritic cell (DC)/tumor cell fusion cells (FCs) can induce potent CTL responses. The therapeutic efficacy of a vaccine requires the improved immunogenicity of both DCs and tumor cells. The DCs stimulated with the TLR agonist penicillin-killed Streptococcus pyogenes (OK-432; OK-DCs) showed higher expression levels of MHC class I and II, CD80, CD86, CD83, IL-12, and heat shock proteins (HSPs) than did immature DCs.

Where does the first lateral pelvic lymph node receive drainage from?

Background: Lateral pelvic lymph node dissection (LPLD) in the treatment of rectal cancer has risks and benefits. Avoidance of unnecessary LPLD is important, however, preoperative and/or intraoperative accurate detection of lateral lymph node metastases have not been established. If the lateral lymph node to which the fluid first spread from the primary lower rectal cancer is detected accurately, it may guide the need for LPLD and may assist in avoiding unnecessary dissection.

Successful preoperative chemotherapy with S-1 plus low-dose cisplatin for advanced gastric cancer with synchronous liver metastases: report of 2 cases.

We report 2 cases of advanced gastric cancer with synchronous liver metastases who were successfully downstaged using S-1 plus low-dose cisplatin chemotherapy followed by surgical resection. S-1 was administered orally (80 mg/m(2)/day) twice daily for 14 consecutive days, and cisplatin (15 mg/m(2)) was infused over 1 h on days 1 and 8. Successful downstaging of the hepatic metastases was confirmed by imaging analyses; however, neither patient showed a complete response of the primary lesion in the stomach.

Laparoscopic Collis gastroplasty and Dor fundoplication for reflux esophagitis complicated by a penetrating ulcer and shortened esophagus: a case report.

The patient was a 72-year-old man, who was referred to us at the beginning of July 2005 with a chief complaint of difficulty with swallowing. After a thorough medical examination, the patient was diagnosed with a penetrating ulcer due to reflux esophagitis, lower esophageal stricture, Barrett esophagus, and shortened esophagus. After administration of a proton pump inhibitor and 2 sessions of endoscopic dilatation, esophagitis was cured and the stricture was eliminated.

Xanthogranulomatous cholecystitis expressing high levels of DUPAN-II.

We report a case of xanthogranulomatous cholecystitis (XGC) showing high levels of serum DUPAN-II in a 65-year-old woman. Preoperative radiologic examination showed no abnormal findings except in the gallbladder. Endoscopic ultrasonography was effective for differentiating chronic cholecystitis from gallbladder cancer before the operation.

Clinicopathological and biological significance of mitotic centromere-associated kinesin overexpression in human gastric cancer.

Mitotic centromere-associated kinesin (MCAK) is a microtubule (MT) depolymerase necessary for ensuring proper kinetochore MT attachment during spindle formation. To determine MCAK expression status and its clinicopathological significance, real-time reverse transcriptase-polymerase chain reaction was used in 65 cases of gastric cancer. MCAK gene expression in cancer tissue was significantly higher than expression in non-malignant tissue (P<0.

Establishment and characterization of a cell line (BTIC) including HER-2-positive cells derived from pleural effusion of recurrent breast invasive ductal carcinoma, scirrhous type.

Human epidermal growth factor receptor-2 (HER-2) overexpression in breast cancer occurs in 20% to 30% of patients with breast cancer. Trastuzumab (Herceptin) targets HER-2 tyrosine kinase receptors expressed on tumor cells and mediates anti-proliferative effects against HER-2-positive tumor cells. Adjuvant chemotherapy with trastuzumab has improved the prognosis of patients with HER-2 positive high-grade breast cancer.

Combination chemotherapy using TS-1, Paclitaxel and cisplatin for multiple lung metastases from AFP-producing gastric cancer: a case report.

A 61-year-old male had undergone distal gastrectomy followed by right hepatectomy for alpha-fetoprotein-producing gastric cancer and liver metastasis. Subsequently, multiple lung metastases were detected by follow-up chest examinations. Despite treatment with TS-1/Irinotecan (CPT-11)/Cisplatin (CDDP) combination therapy, the metastases increased gradually in size and number.

Significance of preserving vagus nerve in ileocolon interposition after total gastrectomy.

Background/aims: We have performed ileocolon interposition for reconstruction (IR) after total gastrectomy in order to reduce postoperative symptoms such as heartburn, reflux esophagitis and nutritional disturbance. After IR, however, the frequency of diarrhea increased in the postoperative period. We therefore investigated whether post-IR diarrhea could be prevented by preserving the vagus nerve.

Systemic inflammatory response syndrome after hand-assisted laparoscopic distal pancreatectomy.

Background: Although the clinical benefits of hand-assisted laparoscopic surgery have been shown in several procedures including colorectal resection, splenectomy and gastrectomy, efficacy and invasiveness in pancreatic surgery have not been well investigated. We assessed the clinical benefits and invasiveness of hand-assisted laparoscopic distal pancreatectomy (HALS-DP) in relation to the occurrence of post-operative systemic inflammatory response syndrome (SIRS).

Methods: Subjects comprised 8 patients underwent HALS-DP (with splenectomy, n = 7; without splenectomy, n = 1) for benign or low malignant pancreatic lesions between March 2004 and December 2005.

Gastric ulcer after laparoscopic fundoplication for gastroesophageal reflux disease: significance of the eradication of Helicobacter pylori.

The occurrence of gastric ulcers after laparoscopic fundoplication for gastroesophageal reflux disease is not uncommon. Between December 1994 and December 2004, we performed laparoscopic fundoplication in 180 patients, of whom 4 (2.2%) men developed a gastric ulcer during follow-up.

Validity of modified gastrectomy combined with sentinel node navigation surgery for early gastric cancer.

Background: The present study examined the clinical validity of modified gastrectomy for early gastric cancer, in terms of the results of sentinel node navigation surgery (SNNS), using infrared ray electronic endoscopy (IREE) plus indocyanine green (ICG) staining.

Methods: One-hundred and sixty-one patients with fT1N0 gastric cancer were enrolled in the study. ICG (0.

The effect of denervation on liver regeneration in partially hepatectomized rats.

Background/aim: In a partial liver transplantation, the dissected hepatic nerves are left unrepaired during active liver regeneration. In fact, the pathophysiological influence of such hepatic denervation on liver regeneration has not yet been fully clarified. The aim of the present study is to elucidate the effect of total hepatic denervation on liver regeneration.

Laparoscopic intragastric full-thickness excision (LIFE) of posterior gastric lesions under flexible endoscopic control--a feasibility study.

Background: We have developed a new technique for treatment of intramucosal carcinoma which exceeds the standard indication for endoscopic mucosal resection and carcinoma invading the submucosa without lymph node metastasis that are located in the posterior wall of the stomach, which we refer to as laparoscopic intragastric full-thickness excision (LIFE) under flexible endoscopic control.

Surgical Technique: Three pigs were used for the study. Three trocars were used.

Establishment and characterization of an IGSK-2 cell line derived from ascitic fluid of recurrent hCG and somatostatin secreted adenocarcinoma of the stomach.

We examined a 32-year-old Japanese man who was clinically diagnosed with gastric cancer, type 4, and histopathologically diagnosed with mucinous and poorly differentiated adenocarcinoma (mucinous > poorly) of the stomach. We successfully established and characterized a cell line (designated as IGSK-2) derived from the ascitic fluid of the patient with recurrent and cisplatin-resistant carcinoma. The IGSK-2 cells grew in multi-layered culture in culture dishes.