Thoracoscopic enucleation of esophageal stromal tumor.

Gastrointestinal stromal tumor is a rare entity, especially in the esophagus. We report a patient with a stromal tumor of the esophagus who underwent a thoracoscopic enucleation of the tumor. The patient was a 61-year-old man complaining of slight dysphagia. A submucosal tumor of the middle thoracic esophagus was found endoscopically. The tumor was approximately 4.0 cm in diameter measured by endoscopic ultrasonography. On 17 May 2001, thoracoscopic enucleation of the esophageal tumor was performed using a Kodama Di-suction. The Kodama Di-suction was useful for the thoracoscopic enucleation of the submucosal tumor of the esophagus, acting as both a dissector and a sucker. The patient's course was uneventful after surgery. Histopathologically the esophageal tumor revealed a high cellularity, consisting of spindle cells, and the tumor cells were immunohistochemically positive for CD34 and c-kit protein, but not for a-smooth muscle actin or S-100 protein. From these findings, the esophageal submucosal tumor was diagnosed as gastrointestinal stromal tumor, distinguished from leiomyoma.

[Development of chromogenic agar medium for isolation of enterohaemorrhagic Escherichia coli O26].

Agar media for isolation of enterohaemorrhagic Escherichia coli (EHEC) have been developed primarily for E. coli O157, because this bacterium has most frequently caused EHEC infection. However, there have been few studies for isolation of other serotypes of EHEC, and media appropriate for isolation of such organisms, especially from food samples, are not yet available. Among such serotypes, E. coli O26 has often been isolated from clinical specimens from patients and animals, but not from food samples in outbreaks, because of lack of an appropriate method for isolation. In this study, we tried to develop a new chromogenic agar medium for selective isolation of E. coli O26 using the characteristics of E. coli O26. Fifteen strains of E. coli O26, 11 strains of E. coli O157 and 36 strains of other sero-types E. coli were tested for fermentation of rhamnose, cellobiose, dulcitol, salicin, raffinose, sorbitol, sucrose, lactose, mannitol, arabinose, maltose, xylose and glucose. Rhamnose was fermented by all E. coli strains except for E. coli O26. The other substrates were not effective for differentiating E. coli O26 from the other strains of E. coli. Thus the medium containing rhamnose and 5-bromo-4-chloro-3-indolyl-beta-D-galactopyranoside, which is a substrate of beta-galactosidase specific to coliforms, produced a color of E. coli O26 colonies different from colors of the other bacteria. Furthermore, cefixime and sodium tellulite were added to the composition of the medium for gaining higher selectivity.