We analyzed amplification and expression of the c‐erbB‐2 gene in human breast cancers. Southern blot hybridization analysis demonstrated amplification of the c‐erbB‐2 gene in 10 out of 50 tumor DNAs examined. The degree of amplification was three‐ to twenty‐fold relative to normal placenta. The c‐erbB‐2 protein could be analyzed in 39 tumor tissues of the 50 samples by immune‐blotting, and elevated expression of the c‐erbB‐2 protein was found in 15 cases. On the other hand, expression of the c‐erbB‐2 products was not detected in normal breast tissues either by immuno‐blotting or by immuno‐histological analysis. These data indicate that transcriptional and/or translational activation of c‐erbB‐2 might occur in some breast cancers in addition to activation by gene amplification. The elevated expression of the C‐erbB‐2 protein was most strongly correlated with lymph‐node metastasis (P< 0.001), suggesting that c‐erbB‐2 expression is involved in promotion of the lymph‐node metastasis of human breast cancers. Therefore, immuno‐histological diagnosis with anti‐c‐erbB‐2 antibody might be useful as an indicator to predict lymph‐node involvement in breast cancer.

Thymidine kinase, the enzyme in the pyrimidine salvage pathway, and its isozymes were examined in 10 specimens of normal mammary gland, 10 fibroadenomas and 11 adenocarcinomas in human breasts. The average thymidine kinase activities in fibroadenomas and adenocarcinomas were about 3 and 8 times that in normal mammary gland. The mammary thymidine kinase isozymes were separated into two types by diethylaminoethyl (DEAE) cellulose column chromatography. The activity of the thymidine kinase isozyme eluted with 0.1 M sodium chloride in buffer was twofold higher in fibroadenomas and fourfold higher in adenocarcinomas than that in normal tissue. In adenocarcinomas, but not fibroadenomas, the activity of the other isozyme eluted with buffer alone was increased to 22-fold that in normal tissues. As the activity of the latter isozyme was not affected by deoxycytidine triphosphate, it may be involved closely in DNA replication.

We experienced a rare case of lymphoepithelial cyst of pancreas. The patient was a 68-year-old man in whom a cystic lesion in the pancreas was detected when he was admitted for chronic renal failure. On ultrasonography, we detected a cystic lesion, 3 cm in diameter, with a septum, in head and body of the pancreas. On both computed tomography and magnetic resonance imaging, the cystic lesion did not show solid components. Endoscopic retrograde cholangiopancreatography showed no abnormality in the pancreatic duct and did not detect the cystic lesion. Although the lesion showed no evidence of malignancy on the images, we could not rule out malignancy, since high levels of carcinoembryonic antigen and carbohydrate antigen 19-9 were detected. We therefore performed a pancreatoduodenectomy. In the resected specimen, the lesion was a well-circumscribed and multilocular cyst that contained yellowish-white keratinous material and had no solid components. Histologically, the cyst wall was composed of mature keratinizing squamous epithelium and lymphoid tissue; it was diagnosed as a benign lymphoepithelial cyst of the pancreas.

Background: Patients who have undergone esophagectomy with extensive lymph node dissection under thoracolapalotomy for advanced esophageal carcinomas frequently need long‐term nutrition support because of their inadequate oral intake. We have used tube enterostomy feeding for these patients not only immediately after the operations but also at home to prevent the development of malnutrition. Patients who receive long‐term tube enterostomy feeding often suffer from skin problems around the enteral nutrition catheters. Once the catheter is removed, the patient with anticipated malnutrition is subsequently unable to receive beneficial enteral nutrition. We have developed a new enteral access system that is placed subcutaneously. This subcutaneously implanted enteral nutrition port makes possible intermittent and long‐term enteral nutrition support not only for the postoperative period but also for home care. Methods: This system consists of the port (Infuse‐a‐Port, SMAP15 Snaplock Macro‐Port Venous Access System; Strato Medical Co) and the enteral nutrition tube (Enteral Tube 8F, 75 cm; Zeon Co). This system was applied to seven patients who had undergone esophagectomy. The port was placed on the lower chest subcutaneously, and the catheter was placed through the gastric tube and duodenum up to the jejunum. After the operation, a 20‐gauge port needle was placed, and enteral nutrition formula (Enterued; Termo Co) was started with the enteral nutrition pump. Results: No complications (eg, infection of skin, obstruction of tube) were observed from the postoperative period through the home care stage. The observation period for this implanted system ranged from 2 to 12 months. The patients were able to avoid the malnutrition anticipated after the extensive operations and continued to receive nutrition support safely and effectively at home. Conclusion: This new nutrition support system is safe and efficient for patients who anticipate long‐term enteral nutrition support. A subcutaneously implanted enteral nutrition port makes possible intermittent and long‐term nutrition support without patient discomfort and inconvenience. (journal of Parenteral and Enteral Nutrition 21:238–240, 1997)

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