Background/Aims: Endoscopic resection of colorectal polyps reduces mortality from colorectal cancer. We report here a novel resection method, known as noninjecting resection using bipolar soft coagulation mode (NIRBS), and assess its feasibility. This study aimed to compare the resection depth achieved with NIRBS to those achieved with cold snare polypectomy (CSP) and conventional endoscopic mucosal resection (CEMR). Methods: Patients with 6 to 9 mm colorectal polyps underwent endoscopic resection at Hoshigaoka Medical Center between October 2023 and January 2024. We analyzed the thickness of resected submucosal tissue following the use of NIRBS, CSP, and CEMR. Results: We identified 95 polyps, including adenomas and serrated lesions. The proportions of specimens containing submucosal tissue were 21.4%, 100.0%, and 97.9% in CSP, CEMR, and NIRBS, respectively. The median submucosal tissue thickness for CEMR and NIRBS was 1,167 and 1,125 µm, respectively, which was significantly greater than 0 µm for CSP. For NIRBS, the median thickness was 1,140 and 1,017 µm for the expert and non-expert endoscopists, respectively. Conclusions The depth of submucosal resection with NIRBS exceeded 1,000 μm regardless of endoscopist experience. NIRBS can be a useful resection method for patients with colorectal polyps, including those with non-submucosally invasive carcinomas.

Participants in our screening program for cerebrovascular disease are supposed to receive thyroid checkups at the time of ultrasound imaging of carotid arteries. Thus far, a total of 4,338 people have participated in this program. Of the total, 17 cases of papillary thyroid carcinoma were found (detection ratio: 0.39%). This study concerned with the 13 cases which underwent surgical treatment in our hospital. They all were diagnosed as early cancers--eight cases at stage N0 and five cases at stage N1--with an average tumor diameter of 11 mm. Besides, five cases of Basedow's disease (hyperthyroidism) and 15 cases of chronic thyroiditis were found (detection ratio: 0.35%). Of the 15 chronic thyroiditis cases, nine were found to have symptoms of hypothyroidism. We concluded that our screening program for cerebrovascular disease involving the ultrasonographic scans of the thyroid gland is very helpful not only in detecting malignancies at an early stage but also in screening for functional abnormalities of the thyroid.
Aspects of disease screening ; Ultrasonography ; Desiccated thyroid ; Thyroid Gland ; Diagnostic Neoplasm Staging

A 72-year-old man presented with chief complaints of back pain. Medical workup discovered infrarenal abdominal aortic aneurysm (AAA) with Stanford type B acute aortic dissection on CT. The dissection originated distal to the left subclavian artery and extended to the right commom iliac artery. All visceral arteries branched from the false lumen. The maximum diameter of the thoracic aneurysm was 4.8cm and that of the abdominal aneurysm was 6.5cm. Multiple renal infarcts were noted and the right kidney function was decreased. Initial surgery was performed 3 months after presentation using a graft technique. Advanced atherosclerosis and dissection were noted in the aneurysm making the arterial wall quite vulnerable. Hemorrhage was extensive and hemostasis difficult in the defective arterial wall. The patient became unstable so the aneurysm was closed and the surgical procedure was changed to right axillo-bifemoral bypass rather than the original surgical plan of anatomic reconstruction of the AAA. The patient tolerated the procedure well. We report a rare case of acute aortic dissection which extended through the AAA.