The Very First Changes in the Tongue with the Development of Cancer

We describe the case of an elderly man with a 3-month history of pain at the tip of his tongue due to a lingual cancer. The lesion appeared slightly depressed and reddish. Our images show the very first changes in the tongue with the development of cancer. Patients with tongue pain often visit the internal medicine department first, so highlighting this case will help physicians detect lingual cancer quickly

Advanced Oropharyngeal Cancer Can Be Easily Missed During Esophagogastroduodenoscopy

The case of an elderly man with an advanced oropharyngeal cancer that was missed during esophagogastroduodenoscopy is described. He was referred for endoscopic resection of superficial esophageal squamous cell neoplasms. He died a month after referral due to an advanced oropharyngeal cancer with a metastatic lesion to the brain. Patients with esophageal squamous cell carcinoma are high risk for head and neck cancer. The pharynx is the most common site for cancer in the head and neck region. Consequently, the pharynx should be observed carefully when patients with esophageal squamous cell carcinoma undergo esophagogastroduodenoscopy

Modified line-assisted complete closure of the defect after gastric endoscopic full-thickness resection: a pilot study in porcine models

Background and study aims Closure after endoscopic full-thickness resection (EFTR) is challenging. We previously developed a simple endoscopic closure method: line-assisted complete closure (LACC). We performed a pilot study using porcine models to evaluate the feasibility of modified LACC after gastric EFTR. Patients and methods Six live pigs were included. EFTR (greater curvature of the gastric antrum [n = 3] and anterior wall of the gastric body [n = 3]) was performed under general anesthesia and the defect after EFTR was closed by modified LACC. The pigs were observed until postoperative day 4 (Day 4). The closure site was endoscopically evaluated and the presence or absence of peritonitis and fluid leakage was evaluated. The outcomes were the success rate of modified LACC on the day of the procedure, maintenance of defect closure, presence of peritonitis or leakage, and clinical course. Results Once complete closure was successfully achieved in all cases, maintenance of closure on Day 4 was not achieved. However, there was neither peritonitis nor fluid leakage. The defect was completely covered by surrounding tissues on Day 4 and the clinical course was good in all cases. Conclusions The feasibility of modified LACC after gastric EFTR was demonstrated in porcine models. Further improvement is needed to maintain defect closure

Wernicke's Encephalopathy in a Patient with Peptic Ulcer Disease

We report a 74-year-old man with Wernicke's encephalopathy (WE) whose only prior illness was peptic ulcer disease. Upper gastrointestinal endoscopy demonstrated gastric ulcer scars accompanied by marked deformity, without pathologic evidence of malignancy. WE due to peptic ulcer disease in previous reports was substantially associated with thiamine deficiency due to recurrent vomiting or surgical procedures. In our case, however, there was no history of vomiting or gastrointestinal surgery. Besides, we thoroughly ruled out other known clinical settings related to WE. There is the possibility that peptic ulcer disease itself provoked thiamine deficiency due to malabsorption

Resection depth for small colorectal polyps comparing cold snare polypectomy, hot snare polypectomy and underwater endoscopic mucosal resection

Background and study aims Small colorectal polyps are removed by various methods, including cold snare polypectomy (CSP), hot snare polypectomy (HSP), and underwater endoscopic mucosal resection (UEMR), but the indications for using these methods are unclear. We retrospectively assessed the efficacy of CSP, HSP, and UEMR for small polyps, focusing on the depth of the resected specimens. Patients and methods Outpatients with non-pedunculated small polyps (endoscopically diagnosed as 6 to 9 mm), resected by two endoscopists between July 2019 and September 2020, were enrolled. We histologically evaluated the specimens resected via CSP, HSP, and UEMR. The main outcome was the containment rate of the muscularis mucosa (MM) and submucosa (SM) tissues. Results Forty polyps resected via CSP (n = 14), HSP (n = 12), or UEMR (n = 14) were enrolled after excluding 13 polyps with resection depths that were difficult to determine. The rates of specimens containing MM and SM tissue differed significantly (57 % and 29 % for CSP, 92 % and 83 % for HSP, and 100 % and 100 % for UEMR, respectively (P = 0.005 for MM and P  Conclusions UEMR could be the best method to contain SM tissue without injection. Further studies are needed to evaluate the indication of UEMR for small polyps

Detectability of the Warm/Hot Intergalactic Medium Through Emission Lines of OVII and OVIII

Most of cosmic baryons predicted by the big-bang nucleosynthesis has evaded the direct detection. Recent numerical simulations indicate that approximately 30 to 50 percent of the total baryons in the present universe is supposed to take a form of warm/hot intergalactic medium (WHIM) whose X-ray continuum emission is very weak. To identify those missing baryons, we consider in detail the detectability of WHIM directly through emission lines of OVII (561, 568, 574, 665eV) and OVIII (653eV). For this purpose, we create mock spectra of the emission lines of WHIM using a light-cone output of the cosmological hydrodynamic simulations. Since the predicted fluxes are generally below the current detection limit, the unambiguous detection requires a dedicated X-ray satellite mission that we also discuss in detail. We find that our proposed mission is sensitive to the WHIM with gas temperature $T=10^{6-7}$K and overdensity $\delta=10-100$ up to a redshift of 0.3 without being significantly contaminated by the cosmic X-ray background and the Galactic emissions. Thus such a mission provides a unique and important tool to identify a large fraction of otherwise elusive baryons in the universe.Comment: 22 pages, 10 figures. To appear in PASJ, v55, Oct. 25 (2003) issu

Soft X-ray Transmission Spectroscopy of Warm/Hot Intergalactic Medium with XEUS

We discuss the detectability of Warm/Hot Intergalactic medium (WHIM) via the absorption lines toward bright point sources with a future X-ray satellite mission, XEUS. While we consider bright QSOs as specific examples, the methodology can be applied to bright GRB afterglows. We create mock absorption spectra for bright QSOs (more than 20 QSOs over the all sky) using a light-cone output of a cosmological hydrodynamic simulation. We assume that WHIM is under collisional and photo-ionization equilibrium. If WHIM has a constant metallicity of $Z=0.1Z_\odot$, approximately 2 O{\sc vii} absorption line system with $>3\sigma$ will be detected on average along a random line-of-sight toward bright QSOs up to $z=0.3$ for 30 ksec exposure.Comment: 34 pages, 17 figures. Substantial revision. PASJ, in press (2006, vol.58, August 25 issue