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We report a case of lethal air embolism during diagnostic arthroscopy using air to distend an acutely injured knee. Air had escaped from the joint through an intra-articular fracture and entered the venous system. During arthroscopy, pressure within the joint may be 5 to 10 times higher than venous pressure, so any medium may escape. We advise that the use of air, especially in freshly injured joints, should be abandoned in favour of saline or carbon dioxide.

Esophageal suction biopsies were taken in 24 subjects with proven gastroesophageal reflux, 12 subjects with suspected reflux, and 20 healthy controls. Sixty-two percent of the patients with proven reflux, 33% of the patients with suspected reflux, and 10% of the control subjects had neutrophilic and/or eosinophilic granulocytes in the lamina propria. Lymphocytes, plasma cell, and basophilic granulocytes were shown to be constituents of the normal esophageal mucosa. All epithelial dimensions showed marked individual variations in reflux patients and controls. The relative length of stromal papillae as expressed in percent of total epithelial thickness showed a linear correlation with relative basal cell thickness and an indirect linear correlation with epithelial thickness. Elongation of stromal papillae in proven reflux could only be demonstrated by arbitrary retrospective stratification of the data. Hyperplasia of the basal zone and thinning of the epithelium were not observed in the reflux patients. It is concluded that granulocytic infiltrates and not epithelial alterations are the most prominent histological finding in gastroesophageal reflux.

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A case of phlegmonous gastritis, diagnosed for the first time without laparotomy and with spontaneous recovery, is described. The only procedure allowing nonsurgical diagnosis of this disease is endoscopic snare ("jumbo") biopsy of the giant folds in the diseased parts of the stomach. Snare biopsy includes submucosal tissue which is the main site of histological changes in phlegmonous gastritis.