Digestive disease management in Japan: a report on the 6th diagnostic pathology summer fest in 2012.

The 6th Diagnostic Pathology Summer Fest, held in Tokyo on August 25-26, 2012, opened its gates for everyone in the medical profession. Basic pathology training can contribute to the improvement of algorithms for diagnosis and treatment. The 6th Summer Fest with the theme 'Pathology and Clinical Treatment of Gastrointestinal Diseases' was held at the Ito International Research Center, The University of Tokyo. On August 25, 'Treatment of Early Gastrointestinal Cancer and New Guidelines' was discussed in the first session, followed by 'Biopsy Diagnosis of Digestive Tract: Key Points of Pathological Diagnosis for Inflammation and Their Clinical Significance' in the second session. On August 26, cases were discussed in the third session, and issues on pathological diagnosis and classification of neuroendorcrine tumor in the fourth session. The summaries of speeches and discussions are introduced along with the statements of each speaker. This meeting was not a formal evidence-based consensus conference, and 20 experts gave talks on their areas of specialty. Discussion was focused on how the management strategy should be standardized on the algorithm of patient care.

Chemoradiation therapy followed by endoscopic submucosal dissection for esophageal cancer.

We performed chemoradiation therapy (CRT) followed by an endoscopic submucosal dissection (ESD) for three patients with esophageal cancer. One patient refused surgery, and two patients were complicated with severe cardiopulmonary diseases. In all patients, CRT was effective in reducing tumor size, and the residual tumors were completely resected by ESD. All patients were recurrence-free for 6 months to 2.5 years. The combination of CRT plus subsequent ESD may be useful for treating patients with esophageal cancer who are not fit to undergo surgery.

The effects of lectins on indomethacin-induced small intestinal ulceration.

Growth factors, such as epidermal growth factor and keratinocyte growth factor, have considerable therapeutic potential for repairing mucosal injury in the intestine when given systemically. Recently, several lectins have been shown to have trophic effects on the intestine when given orally. We examined the effects of phytohaemagglutinin (PHA) and concanavalin A (Con-A) on indomethacin-induced intestinal injury in rat. Five-week-old rats were randomized to four groups (n=5), and intestinal injury was induced by indomethacin injection in three of these groups. Elemental diet (ED) feeding was then commenced. The groups were thus ED feeding/indomethacin untreated (control group), ED feeding/indomethacin treated (ED group), 0.1% PHA-supplemented ED feeding/indomethacin treated (PHA group) and 0.1% Con-A-supplemented ED feeding/indomethacin treated (Con-A group). After 7 days of feeding, macroscopic inflammatory scores, mucosal permeability, myeloperoxidase (MPO) activities and cell proliferation were determined. Macroscopic inflammatory scores, mucosal permeability and MPO activities were significantly lower in both lectin groups than that in control group. Twenty-four hour excretion rate of phenolsulphonphthalein was significantly lower in both lectin groups than that in ED group. Cell proliferation of the small intestine was significantly increased by both lectins. Lectin supplementation can induce ulcer healing following indomethacin-induced damage.