[Thoracoscopic Plication for Congenital Diaphragmatic Eventration in an Adult].

Thoracoscopic plication for congenital diaphragmatic eventration in an adult. Diaphragmatic eventration is known to be abnormal elevation of diaphragm and congenital causes are due to abnormal diaphragm muscle development. Here we report surgical treatment of congenital diaphragmatic eventration. A 45-year-old woman who complained of cough was admitted to our hospital. She had history of cough and was diagnosed as diaphragmatic eventration in childhood. Chest X-ray showed elevated left hemidiaphragm with a bowel gas underneath. Under the diagnosis of congenital eventration of left hemidiaphragm, plication of the left diaphragm by video-assisted thoracoscopic surgery (VATS) was performed. One month after surgery, severe cough disappeared completely.

[Hemothorax complicated with celiac artery compression syndrome (CACS); report of a case].

We report a case of hemothorax complicated with celiac artery compression syndrome (CACS). A 43-year-old man presented with a sudden onset left back pain. Computed tomography (CT) showed its hemothorax, esophageal artery aneurysm and severe stenosis of the celiac truncus with its anterior compression by median accurate ligament, and a diagnosis of CACS associated with rupture of the aneurysm was made. Emergent transcatheter arterial embolization of the aneurysm resulted in a technical failure, although the patient's condition was stable and performed esophageal artery ligation through video-assisted thoracoscopic surgery on day 5 after onset. After surgery, the patient recovered without significant incidents. A cause of this aneurysmal development was supposed to be a significantly increased esophageal arterial blood flow with its luminal dilation to compensate a decreased celiac blood flow. Segmental arterial mediolysis could not be excluded as another cause.

[A case of duodenal epithelioid hemangioma causing gastrointestinal bleeding].

A case of epithelioid hemangioma of the duodenum causing bleeding was encountered. A 32-year-old man was admitted because of anemia. Endoscopic examination revealed a submucosal tumor with central depression in the 2nd portion of the duodenum. It was considered to be the bleeding focus of anemia. A partial resection of the duodenum was performed. The macro- and microscopic examination of the specimen revealed an epithelioid hemangioma. Hemangiomas of the intestinal tract are rare, representing only 0.3% of all tumors of the intestinal tract, and among them, hemangiomas of the duodenum are extremely rare, representing only 3.4% of those of the intestinal tract. Most hemangiomas of the duodenum are cavernous hemangiomas or capillary hemangiomas. We report the first case of epithelioid hemangioma of the duodenum.

Inhibitory effect of loxiglumide (CR 1505), a cholecystokinin receptor antagonist, on N-nitrosobis(2-oxopropyl) amine-induced biliary carcinogenesis in Syrian hamsters.

We evaluated the cholecystokinin (CCK) receptor antagonist loxiglumide (CR1505) for a possible inhibitory effect on biliary carcinogenesis in a hamster model. Experimental group I underwent cholecystoduodenostomy and ligation of the distal end of the common bile duct, after which the animals were injected with N-nitrosobis(2-oxopropyl)amine (BOP) alone. Group II, after the same surgical procedure as in group I, were given injections of BOP and then given loxiglumide in their diet. The sham-operated group underwent simple laparotomy and then were given injections of BOP. Loxiglumide significantly inhibited BOP carcinogenicity in the gallbladder and extrahepatic bile duct but not in the intrahepatic bile ducts or pancreas. Autoradiography showed that loxiglumide significantly suppressed (125)I-Bolton-Hanter (BH)-CCK-8 binding to CCK receptors in the gallbladder and extrahepatic bile duct but not in the liver or pancreas, and CCK binding to its receptors was observed in an area identified as cancer tissue. CCK receptor antagonists have an inhibitory effect on BOP carcinogenesis in the extrahepatic biliary tract, including the gallbladder and extrahepatic bile duct, of Syrian hamsters. The difference in the inhibitory effect of loxiglumide on biliary carcinogenesis in hamsters according to site may be due to differences in CCK receptors or the affinity of loxiglumide for such biliary tract organs. A difference between carcinogenesis in the intrahepatic bile ducts and extrahepatic biliary tract may be another reason.