Heterotopic gastrointestinal cyst mimicking chronic cholecystitis: a case report

<p>Abstract</p> <p>Introduction</p> <p>Heterotopic gastric mucosa is described almost everywhere in the gastrointestinal tract, from the oral cavity to the rectum. The occurrence of heterotopic gastric tissue in the gallbladder is rare. A choristoma can be defined as a new growth developing from a displaced anlage not normally present in the anatomical site where it developed. We present an extremely uncommon case of a cyst (choristoma) attached to the gallbladder, which contained gastric and intestinal mucosa.</p> <p>Case presentation</p> <p>A 33-year-old woman was hospitalized with clinical symptoms of chronic cholecystitis. The laboratory findings were within the normal range. Abdominal ultrasonography revealed a thickened gallbladder wall and a stone in the cystic duct was suspected. In the course of laparoscopic cholecystectomy, a cyst was visualized in the vicinity of the duct and the gallbladder neck. Microscopic examination of the removed cyst revealed evidence of gastric, duodenal and small-intestinal mucosa. The immunohistochemical study revealed many endocrine cells, which were positive for several endocrine cell markers such as chromogranin, serotonin, gastrin and so on. It can be inferred that the observed cyst had arisen from the foregut early in the development of the gastrointestinal tract.</p> <p>Conclusion</p> <p>The presence of endocrine cells together with epithelial cells supports the hypothesis that these had developed simultaneously, and that the endocrine cells had probably supported the development of the epithelial cells by the release of hormones and growth factors. To the best of the authors' knowledge, this report is the first to report a gastrointestinal cyst choristoma with endocrine cells in the region of the cystic duct and gallbladder.</p

A modular soft robotic wrist for underwater manipulation

This article presents the development of modular soft robotic wrist joint mechanisms for delicate and precise manipulation in the harsh deep-sea environment. The wrist consists of a rotary module and bending module, which can be combined with other actuators as part of a complete manipulator system. These mechanisms are part of a suite of soft robotic actuators being developed for deep-sea manipulation via submersibles and remotely operated vehicles, and are designed to be powered hydraulically with seawater. The wrist joint mechanisms can also be activated with pneumatic pressure for terrestrial-based applications, such as automated assembly and robotic locomotion. Here we report the development and characterization of a suite of rotary and bending modules by varying fiber number and silicone hardness. Performance of the complete soft robotic wrist is demonstrated in normal atmospheric conditions using both pneumatic and hydraulic pressures for actuation and under high ambient hydrostatic pressures equivalent to those found at least 2300 m deep in the ocean. This rugged modular wrist holds the potential to be utilized at full ocean depths (\u3e10,000 m) and is a step forward in the development of jointed underwater soft robotic arms