The over-the-scope clip (OTSC) system was developed for the closure of gastrointestinal defects but can also be used for endoscopic resection. This report describes the efficacy and safety of endoscopic full-thickness resection (eFTR) using the OTSC system. In this retrospective, observational, open-label case study, a total of 17 patients underwent eFTR using a dual clip and cap technique. The indications were: carcinoids, incompletely resected colon cancers involving the mucosa or submucosa, recurrent fibrosed adenoma of the colon, and submucosal lesions. The technical success was 94 % (16 /17). The complete resection (R0) rate was 100 %. There were no complications. In summary, the described minimally invasive method to perform eFTR of complex gastrointestinal lesions appears to be effective and safe.
Until recently there has been no technique available which reproducibly and safely allowed endoscopic closures of penetrating defects within the digestive tract. With the new "over the scope clipping system" (OTSC system®), which regarding design and function is similar to a bear-trap, a method is available for the endoscopic closure of fistulas and perforations. Here, we present a series of 10 patients, in whom different penetrating defects within the digestive tract could be closed in 9 of 10 cases successfully by the OTSC system®: fistulas (esophagotracheal, esophagopleural, gastrocutaneous and colovesical), perforations (after mucosectomy, after papillotomy and PEG misplacement) and anastomosal leakages (after gastrotomy and gastrectomy). In another case we demonstrate our first experience with the OTSC system® for the prevention of perforations during deep endoscopic R 0 resection of a T 1(sm1)G1 sigmoideal cancer after initial R 1 resection.
Specific volumes are presented for 4-n-pentyl-4'-cyanobiphenyl (5CB) and trans-4-(4'-octyl-cyclohexyl)-benzonitrile (8PCH) for temperatures between 300 and 370 K up to 300 MPa. The p,V m ,T data were determined for the liquid crystalline and isotropic phases, and partly also for the solid phase adjacent to the melting curve. Stable and metastable crystal phases can be distinguished. The density and melting temperature of the metastable form are lower than for the stable one. Volume and enthalpy changes accompanying the phase transitions are reported as well. The p,V m ,T data allow to calculate the entropy change for a hypothetical transition at constant volume. The molar volumes along the nematic-isotropic phase transition T NI (p) allow to determine the molecular field parameter y = S In T NI /0 In F N ,.
Until recently there has been no technique available which reproducibly and safely allows endoscopic closures of penetrating defects within the digestive tract. With the new "over the scope clipping system" (OTSC system), which regarding design and function is similar to a bear-trap, a method is available for the endoscopic closure of fistulas and perforations. The OTSC-systems are designed for permanent placement. However, in the case of misplacement or the need to remove the clip after healing of the defect, a technique for destroying and removing the clip should be available. We demonstrate for the first time the successful removal of the deeply penetrating OTSC system by using the Nd:YAG-Laser in 3 cases: (i) after closure of an oesophageal fistula, (ii) after closure of a perforation of the distal common bile duct in the roof of the papilla and (iii) after clip misplacement in a case of a wide oesophagomediastinal fistula resulting in a severe oesophageal stenosis. Clinically relevant thermal lesions were not observed after the procedure. If clinically necessary, the OTSC-system can be safely removed by the Nd:YAG Laser in centres for interventional endoscopy. Because of the small number of cases the method must still be considered as experimental and requires further validation. This will be possible with the help of a newly established OTSC registry ( www.endodo.de ).
P, V m , Tdata have been measured for the smectic, nematic and isotropic phases of 4'-n-octyl-biphenyl-4-carbonitrile (8CB) in the temperature range 300-370 K and pressures up to 300 MPa. At atmospheric pressure all phase transitions appear to be of first order due to a discontinuity in the density. The volume change at the smectic A -nematic transition is only a tenth of the volume change at the clearing temperature. At moderate pressures below 80 MPa the S A -N transition could be detected as a discontinuity in the period of oscillation in measurements with a high-pressure vibrating tube densimeter. At higher pressures the discontinuity seems to die away, possibly indicating a change from first order to second order transition. From the volume changes and the slopes of the transition lines we calculate the enthalpy changes at the phase transition. The p, V m , T data enable us to calculate the volume part of the entropy and the molecular field parameter y=9ln 7 N i/3ln V NI .
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