ABSTRACT
We report two cases of the rare complication of a colonoscope incarcerated in an inguinal hernia. The first patient was a 73-year-old man in whom a colonoscope was incarcerated in a left inguinal hernia on attempted withdrawal. The incarcerated colonoscope was successfully reduced manually under fluoroscopic guidance. The hernia was subsequently repaired using an extraperitoneal approach followed by a successful colonoscopy. The second patient was a 74-year-old man in whom the colonoscope became incarcerated in a left inguinal hernia on insertion. Similar to the first case, the colonoscope was manually reduced under fluoroscopy and the entire colonoscopy was then uneventfully performed. An advanced sigmoid cancer was identified and treated with sigmoidectomy. The hernia resolved after this operation. When a colonoscope becomes incarcerated in an inguinal hernia, the manual reduction should be attempted. Subsequent colonoscopy can be safely performed under certain circumstances.
ABSTRACT
Esophageal neuroendocrine neoplasms are extremely rare, and their prognosis is poor. Mixed neuroendocrine non-neuroendocrine neoplasms (MiNENs) are even more rare and are defined as tumors consisting of neuroendocrine carcinoma and either adenocarcinoma or squamous cell carcinoma. We report a rare case featuring endoscopic submucosal dissection (ESD) for an esophageal MiNEN, arising from the ectopic gastric mucosa in the lower thoracic esophagus. A 92-year-old male patient was referred to this hospital for investigation of an esophageal tumor. An endoscopic examination revealed a 10 mm elevated lesion, with 8 mm flat areas on the anal side, within the ectopic gastric mucosa located in the lower thoracic esophagus. ESD was carried out, and a histopathological examination revealed a tubular adenocarcinoma composed of differentiated neuroendocrine cells. Immunohistochemical staining was positive for synaptophysin and negative for chromogranin A. The labeling index of Ki-67 was more than 80%. Based on these results, we diagnosed the lesion as an esophageal MiNEN, arising in the ectopic gastric mucosa of the esophagus. The patient remains alive, without recurrence of cancer, 24 months after ESD.
ABSTRACT
Aquatic organisms have been used to investigate the safety of chemicals worldwide. One such assessment is an algal growth inhibition test. Algal growth inhibition tests are commonly performed using a growth chamber with fluorescent lamps as the lighting source, as test guidelines require continuous uniform fluorescent illumination. However, fluorescent lamps contain mercury, which has been identified as hazardous to humans and other organisms. The Minamata Convention (adopted in 2013) requires reduction or prohibition of products containing mercury. On the other hand, light-emitting diodes do not contain mercury and provide a photosynthetically effective wavelength range of 400-700 nm which is an adequate light intensity for algal growth. Light-emitting diodes are thus preferable to fluorescent lamps as a potential light source in algal growth inhibition tests. In this study, we investigated if light-emitting diodes could be substituted for fluorescent lamps in growth inhibition studies with green alga (Pseudokirchneriella subcapitata), diatom (Navicula pelliculosa), and cyanobacteria (Anabaena flos-aquae). Algal growth inhibition tests were performed using five different chemicals known to have different modes of action and are assigned as reference substances in the test guidelines. The results of each algal test showed similar values between light-emitting diodes and fluorescent lamps in terms of conditions for the growth inhibition rate and percent inhibition in yield of each chemical. It was therefore concluded that using light-emitting diodes instead of fluorescent lamps as a lighting source had no effect on the algal growth inhibition test results.
