Experience with a new device for pathological assessment of colonic endoscopic submucosal dissection.

Endoscopic submucosal dissection (ESD) is gaining popularity worldwide in the treatment of neoplastic lesions of the gastrointestinal tract. However, the experience in Western countries is quite limited and restricted to large or academic centers. Besides, this approach requires an optimal pathological assessment. The aim of this study was to report our experience with colonic ESD using a new device that allows complete handling of the resected specimens and especially of lateral margins, for pathological analysis. In a 1-year period, 14 patients (6 men, 8 women, age range 50-82 years) underwent colonic ESD in a non-academic hospital. The endoscopic procedure was carried out successfully en bloc in more than 90 % of cases. Perforation requiring surgery occurred in one patient (7 %). Pathological assessment with the new device allowed entire and complete examination of both the deep and lateral margins of the excised specimens. Colonic ESD is a viable option for non-surgical treatment of large bowel lesions even in relatively small centers and in non-academic settings. The new device allows good handling of the specimens, and it seems to be useful for the entire examination of the resection margins.

Surface morphology of the human pleura. A scanning electron microscopic study.

The superficial morphology of the pleura has been observed in humans by scanning electron microscopy (SEM). Pleural samples from the visceral, mediastinal, diaphragmatic and costal normal human pleura were observed, and a thorough morphometric study was performed. The most evident feature was the ubiquitous presence of microvilli and micropores. The secretion and absorption activities therefore should not be regarded as accomplished by different topographic zones of the pleura. Discontinuities and clefts were observed at the level of cellular junctions; absorption of high weight molecules and cells from the pleural space may be facilitated at this level, but the structures which were observed in humans may not be considered "stomata," according to the definition of such morphologic units as we give in the present study. Cilia and blebs, described in the experimental animal or in other mesothelia, were not seen in the human pleura.

The glycocalyx of the epithelial cells of the colon, observed in normal and ulcerous colitic conditions.

Biopsies of subjects affected by ulcerous colitis were stained with ruthenium Red. Alterations of the cellular coat and glycocalyx of the epithelial cells of the colon were identified.