Endoscopic mucosal resection using a partial transparent hood for lesions located tangentially to the endoscope

BACKGROUND

Numerous methods have been developed to resect early-stage gastric and esophageal cancers, but it is difficult to resect lesions viewed tangentially with the endoscope.

METHODS

We have designed and developed an original method of endoscopic mucosal resection using a partial transparent hood to treat difficult cases in which the lesions are located tangentially to the endoscope. The hood was attached on the right side of the endoscope and, after insertion into the stomach or the esophagus, was lightly pressed on the orad side of the lesion. Then the lesion was resected using grasping forceps and electrosurgical current snare.

RESULTS

The average diameter of specimens was 26 +/- 8 mm in gastric lesions and 20 +/- 3 mm in esophageal lesions, both 6 mm larger than those obtained by previous methods.

CONCLUSION

This device and technique were extremely useful for mucosal resection of lesions located tangentially to the endoscope.

Distribution of glucocorticoid receptor immunoreactivity in gastric mucosa of normal and adrenalectomized rats

Glucocorticoids have many effects in the stomach. It is well known that glucocorticoids function via the glucocorticoid receptor (GR). In this study, GR immunoreactivity in the gastric mucosa of normal and adrenalectomized (ADX) rats was examined immunohistochemically by using specific polyclonal antibodies against rat GR. In the gastric mucosa of normal rats, GR immunoreactivity was observed in the nuclei of morphologically identified parietal cells. Double immunohistochemical staining for GR and parietal cell, anti-parietal cell antibody-positive cells also had positive immunoreactions for GR. In the gastric mucosa of ADX rats, GR immunoreactivity was diminished in the nuclei of parietal cells but weak immunoreactivity was still observed. These results suggest that parietal cells in the gastric mucosa of rats are directly regulated by glucocorticoids via its receptors. Nuclear GR immunoreactivity in gastric parietal cells is thought to depend on the circulating ligands.

T-cell lymphoma presenting with pericardial and pleural effusion as the initial and primary lesion: cytogenetic and molecular evidence

A 90-year-old woman was admitted with progressive dyspnea. Chest roentgenogram and computed tomography revealed a massive pericardial effusion and bilateral pleural effusion, but no lymphomatous lesion was seen. A diagnosis of malignant lymphoma was made by cytological and immunological studies of the cells obtained from the pericardial effusion. Chromosome analysis showed a clonal abnormality and T-lineage clonality was determined by the rearrangement of the T-cell receptor gamma gene. The patient achieved remission with chemotherapy, but she later relapsed, with right pleural effusion, and died. She exhibited no lymphomatous features throughout the clinical course, indicating the possibility of malignant lymphoma originating from the pericardium and/or pleura.