ヨリ オオキナ ビョウヘン ノ イッカツ セツジョ オ メザシタ アタラシイ EMR シュギ : セッカイ ハクリホウ : ソウキ イガン ノ EMR テキオウ カクダイ ニ ムケテ

The standard indication of EMR for early gastric cancer in Japan is intra-mucosal cancer without ulcerative finding, histologically differentiated type, and less than 20 mm in diameter. Recently, in order to perform en block resection of early gastric cancer more than 20 mm in diameter and achieve histological evaluation precisely, several endoscopists have reported new EMR methods (cut and exfoliate method) using not only needle knife but also new devices such as IT knife, hooking knife and/or flex knife to cut around the lesion and exfoliate submucosa. From January 2001 to December 2002, we attempted to en bloc EMRs using needle knife, IT knife and/or hooking knife for 60 gastric cancers after informed concent, 40 lesions were according to the standard indication (group A) and 20 were not (group B). En bloc resection rates of group A and B were 82.5% (33/40) and 65.0% (13/20), respectively, these rates are higher than that of conventional methods (strip biopsy, aspiration method et al ). In the near feature, these advanced EMR techniques enable us to expand the indication criteria for early gastric cancer widely based on the results of analysis of lymph-node metastasis and prognostic data after EMR

A patient with octopus pot-shaped cardial cancer that metastasized to multiple organs

A 71-year-old male was admitted for abdominal fullness. The condition rapidly deteriorated in a short period (3weeks), and the patient died. Autopsy revealed a protruding lesion measuring about 3 cm with erosion measuring 5mmin diameter immediately below the esophago-gastric conjugation site, suggesting primary cardial undifferentiated adenocarcinoma. In the primary focus, changes on the mucosal surface were almost normal. However, below the mucosa, infiltration of cancer cells was observed in an approximately 3 cm area along the gastric wall. Simultaneously, the site of infiltration was markedly increased in deep areas. Extra serous infiltration was observed. The morphology was special, and resembled an octopus pot, a trap used to catch octopuses in Japan, with a narrow top and a broad base. In our patient, metastatic lesions were detected in multiple organs, including the stomach

Macromolecular organic matter in samples of the asteroid (162173) Ryugu

International audienceINTRODUCTION: Organic compounds in asteroids and comets contain information about the early history of the Solar System. They could also have delivered organic material to early Earth. The Hayabusa2 spacecraft visited the carbonaceous asteroid Ryugu and collected samples of its surface materials, which were brought to Earth in December 2020. RATIONALE: We investigated the macromolecular organic matter in the Ryugu samples, measuring its elemental, isotopic, and functional group compositions along with its small-scale structures and morphologies. Analytical methods used included spectro-microscopies, electron microscopy, and isotopic microscopy. We examined intact Ryugu grains and insoluble carbonaceous residues isolated by acid treatment of the Ryugu samples. RESULTS: Organic matter is abundant in the Ryugu grains, distributed as submicrometersized organic grains and as organic matter dispersed in matrix. The Ryugu organic matter consists of aromatic carbons, aliphatic carbons, ketones, and carboxyls. The functional grou