Efficacy and safety of cold forceps biopsy for diminutive pharyngeal neoplasms: Single-center, prospective pilot study.

BACKGROUND: Management of diminutive pharyngeal neoplasms is controversial. Thus, we conducted a single-center, prospective pilot study to investigate the efficacy and safety of endoscopic excision with cold forceps biopsy (CFB) of these lesions. PATIENTS AND METHODS: Thirty-nine lesions endoscopically diagnosed with narrow-band imaging as pharyngeal neoplasms of 3 mm or smaller were excised with CFB using jumbo biopsy forceps (cap diameter 2.8 mm, jaw volume 12.4 mm3 ). The primary outcome was endoscopically determined local remnant/recurrence rate 3 months after CFB. The secondary outcomes were histopathologically determined local remnant/recurrence rate; risk factors associated with the endoscopic remnant/recurrence; and incidence of intraoperative or delayed bleeding and other adverse events. RESULTS: Histological diagnosis of the 39 CFB-excised lesions were: 11 high-grade dysplasia (28.2%), 22 low-grade dysplasia (56.4%), two basal cell hyperplasia (5.1%) and four atypical squamous epithelium (10.3%).Twenty-seven patients (30 lesions) underwent follow-up endoscopy 3 months after CFB; the endoscopic and pathological local remnant/recurrence rate was 20% (6/30; 95% confidence interval (CI), 7.7-36.6%) and 16.7% (5/30; 95% CI, 5.6-34.7%), respectively. Location of the lesion in the hypopharynx was a significant risk factor associated with the endoscopic local remnant/recurrence (P = 0.049). No significant adverse events occurred. CONCLUSIONS: Cold forceps biopsy with jumbo biopsy forceps appears to be a safe and effective technique for excising diminutive pharyngeal neoplasms. Although small, the excised lesions may have a remarkably high frequency of high-grade dysplasia. (Clinical trial registration number: UMIN000037980).

[Study of the bacterial reduction effects of dry hand rubbing without disinfectant].

Handwashing is the most basic method of preventing infection. Hand rubbing with an alcohol-based handrub, is the most efficient and popular method. We found in several case studies that 3 minutes of dry hand rubbing without any disinfectant decreases the number of hand bacteria. In this study of 54 samples taken from 47 test subjects, we tried to determine how effectively this method decreases hand bacterial numbers. Except for 12 samples that were indeterminate, the number of hand bacteria in 36 (85.7%) out of 42 samples decreased. The average rate of decrease was 49.4% and the maximum rate was 98.3%. Although the most effective duration of dry hand rubbing varied among individuals, we estimated that 2 minutes is optimal. As dry hand rubbing without disinfectants decreases hand bacteria, we suggest that it can be an effective alternate method in emergency situations when water, soap or disinfectants are unavailable.