Small Intestinal Metastasis from Esophageal Squamous Cell Carcinoma Presenting with Perforated Peritonitis.

Metastatic tumors of the small intestinal tract from extra-abdominal sites are rare. We report herein a rare case of small intestinal metastasis from esophageal carcinoma that presented with perforated peritonitis. A 71-year-old man with dysphagia was referred to our hospital for further examination and treatment, and was diagnosed with type 3 advanced esophageal squamous cell carcinoma of the lower thoracic esophagus.

Small Cell Type of Esophageal Neuroendocrine Carcinoma Resembling a Submucosal Tumor.

We report a rare case of primary small cell type esophageal neuroendocrine carcinoma with a unusual endoscopic form similar to a submucosal tumor with the results of the histological and immunohistochemical analyses. A 57-year-old woman with dysphagia was referred to our hospital for further examination and treatment, and was diagnosed as type 1s esophageal carcinoma in the middle thoracic esophagus. Endoscopy revealed a protruding esophageal carcinoma resembling a submucosal tumor with an irregular and nodular surface covered by non-neoplastic epithelium stained with iodine.

Liposome-encapsulated hemoglobin accelerates gastric wound healing in the rat.

Background: Liposome-encapsulated hemoglobin, a nanometer-sized artificial O2 carrier with a high O2 affinity (h-LEH), may facilitate O2 delivery to surgical wounds and thereby accelerate healing after gastrointestinal surgery.

Methods: Ten mL/kg of h-LEH (n = 25), empty liposome (n = 21) or homologous washed red blood cells (RBC, n = 22) was intravenously infused prior to the creation of a 10 mm incision and interrupted suture closure of the gastric wall in rats. After two and four days, the stomach was excised and the bursting pressure was determined by gradually inflating the stomach with air.

[Recent advances of endoscopic treatment for esophageal cancer].

The indications for endoscopic treatment are limited to cases without lymph node metastasis, because it is only a local therapy. The relationship between cancer depth and lymph node metastasis has been clarified based on the pathologic analysis of lymph nodes removed during esophagectomy for early esophageal cancer. Cancer confined to the lamina propria mucosa rarely undergoes lymph node metastasis and complete endoscopic resection (ER) is indicated.

Early carcinoma of the esophagus associated with achalasia treated by endoscopic mucosal resection: report of a case.

A case of endoscopically resected early esophageal carcinoma associated with achalasia is reported. A 63-year-old woman was made diagnosis of esophageal achalasia, sigmoid type and grade III. The patient was operated by Tokai University method, Heller's long esophagomyectomy, Hill's posterior cardiopexy, fundoplication and selective proximal vagotomy using a laparotomy.

Clinical analysis of reflux esophagitis following esophagectomy with gastric tube reconstruction.

Background: Recently, the rate of postoperative long-term survival has increased in cases of esophageal cancer. We report on our analysis of postoperative reflux esophagitis (RE) at Tokai University.

Methods: We enrolled 48 patients who underwent gastric tube reconstruction after esophagectomy.

Acceleration of the proliferative activity of esophageal carcinoma with invasion beyond the muscularis mucosae; immunohistochemical analysis using MIB-1 for the Ki-67 antigen.

Squamous cell carcinoma of the esophagus with cancer invasion beyond the muscularis mucosae is known to have lymph node metastasis and lymphatic or blood vessel invasion compared with intramucosal carcinoma. In submucosal and T2-3 carcinoma, lymph node and lymphatic/vascular involvement are shown more frequently, leading to a poor prognosis. Therefore, we examined proliferative activity of esophageal squamous cell carcinoma including early carcinoma in relation to clinicopathological findings.

Effect of dermal fibroblasts on long-term maintenance of regenerating xenotransplanted human esophageal epithelial cells in immunodeficient mice.

Objective: Artificial esophagus of various materials has been tried without satisfactory results. Effects of fibroblasts derived from human dermis on cultured human esophageal epithelial cells were investigated regarding their preservation over time.

Methods: Human esophageal epithelial cells (EE) were subcutaneously injected either alone or with human esophageal fibroblasts (EF) or human dermal fibroblasts (DF) into the flank of the BALB/cA-nu, scid mice of 8 to 12 weeks of age.

Successful treatment of severe reflux esophagitis with erythromycin in a patient with progressive systemic sclerosis and proximal gastrectomy.

A case of severe reflux esophagitis related to progressive systemic sclerosis (PSS) and proximal gastrectomy was successfully treated with oral erythromycin (EM). A 53-year-old woman was troubled with severe heartburn related to PSS for a long period and had undergone proximal gastrectomy for a gastric cancer a few months before. She was not readily made free from heartburn by any anti-ulcer drugs and she could barely eat.

A case of superficial esophageal cancer complicated with idiopathic muscular hypertrophy of the esophagus.

We hereby reported a case of 60-year old man with superficial esophageal cancer complicated with idiopathic muscular hypertrophy of the esophagus. Endoscopic ultrasonography and CT showed the thickness of esophageal muscular layer, but the accurate diagnosis could not be entertained before operation. Idiopathic muscular hypertrophy of the esophagus is an entity rarely encountered, and most cases are diagnosed at postmortem examination.

Acute oral selenium intoxication with ten times the lethal dose resulting in deep gastric ulcer.

A 48-year-old woman presented after taking 2000 mg of selenium dioxide, corresponding to 10 times the experimental lethal dose in animals. She presented with mildly altered consciousness and hematemesis. Endoscopy revealed mucosal damage throughout the oral cavity, esophagus, and stomach.

Immunohistochemical mucin expression of short-segment Barrett's esophagus.

Barrett's mucosa consists of metaplastic columnar epithelium (specialized columnar epithelium) of the esophagus. Recently, "short-segment Barrett's esophagus (SSBE)" was proposed. In the present study, we examined immunohistochemical mucin expression and the Ki-67 labeling index (LI) of SSBE, in 5-15 mm lengths.

Gastrointestinal cytomegalovirus infection in collagen diseases.

Cytomegalovirus infection of the gastrointestinal tract is a rare serious complication in patients with collagen diseases receiving immunosuppressive agents. We report 3 such cases diagnosed by endoscopy followed by proper treatment. The patients include 38 and 53 years old females with systemic lupus erythematosus.

Gastric tube cancer after esophagectomy for esophageal squamous cell cancer and its relevance to Helicobacter pylori.

Background/aims: Improvement of surgical skills and postoperative management has allowed longer postoperative survival for patients with esophageal cancer, among those some develop gastric tube cancer. We analyzed the characteristics of such patients we encountered as well as of reported cases of Japan. Furthermore, we investigated if Helicobacter pylori plays a role in carcinogenesis of the gastric tube in our cases.