Stability of cervical esophagogastrostomy via hand-sewn anastomosis after esophagectomy for esophageal cancer

The aim of the present study is to evaluate the outcome of hand-sewn esophagogastric anastomosis during radical esophagectomy for esophageal cancer. The outcomes of 467 consecutive esophageal cancer patients who underwent cervical esophagogastric anastomosis using interrupted and double-layered sutures after radical esophagectomy via right thoracotomy or thoracoscopic surgery were retrospectively reviewed. Anastomotic leakage, including conduit necrosis, occurred in 11 of 467 patients (2.4%); 7 of 11 (63.6%) cases experienced only minor leakage, whereas the other four (36.4%) patients had major leakage that required surgical or radiologic intervention, including two patients of conduit necrosis. Anastomotic leakages were more frequently observed after retrosternal reconstruction compared with the posterior mediastinal route (P < 0.0001). The median time to healing of leakage was 40 days (range: 14-97 days). Two patients (2/467, 0.4%) died in the hospital due to sepsis caused by the leakage and conduit necrosis. Twelve patients (2.6%) developed anastomotic stenosis, which was improved by dilatation in all patients. Hand-sewn cervical esophagogastric anastomosis is a stable and highly safe method of radical esophagectomy for esophageal cancer.

Measurement of psychological state changes at low dopamine transporter occupancy following a clinical dose of mazindol

RATIONALE

The beneficial effects of psychostimulant drugs in the treatment of psychiatric disorders occur because they increase the extracellular dopamine concentration by inhibiting re-uptake of extracellular dopamine at dopamine transporters. However, the psychological effects at low dopamine transporter occupancy have not been well demonstrated.

OBJECTIVES

The purpose of the study was to evaluate the psychological effects, dopamine transporter occupancy, and dopamine release induced by a single oral administration of a clinical dose of mazindol.

METHODS

Ten healthy male volunteers were orally administered a placebo and a clinical dose of mazindol (1.5 mg) on separate days. The psychological effects of mazindol were assessed using a visual analogue scale to detect alterations in the state of consciousness. The amount of blockade of dopamine transporters was assessed using positron emission tomography with [¹⁸F]FE-PE2I and extracellular dopamine release was measured as the amount of change in [¹¹C]raclopride binding.

RESULTS

Following administration of a clinical dose of mazindol, the dopamine transporters were blocked by 24-25 %, and the binding potential of [¹¹C]raclopride was reduced by 2.8-4.6 %. The differences of a score measuring derealisation and depersonalization associated with a positive basic mood were significantly correlated with the change in the [¹¹C]raclopride binding in the limbic striatum.

CONCLUSIONS

A subtle alteration in the state of consciousness was detected with a correlation to the changes in the [¹¹C]raclopride binding, which implies that a subtle alteration in extracellular dopamine concentration in the limbic striatum by a small amount of dopamine transporter occupancy can affect the state of consciousness. TRIAL REGISTRATION HTTPS://UPLOAD.UMIN.AC.JP/CGI-OPEN-BIN/CTR_E/CTR_VIEW.CGI?RECPTNO=R000009703 : UMIN000008232.

SO2 capture by ionic liquid and spectroscopic speciation of sulfur(iv) therein

The absorption of equimolar sulfur dioxide (SO₂) by tributyloctylphosphonium bicarbonate ([P₄₄₄₈]HCO₃) resulted in the formation of a corresponding bisulfite ionic liquid ([P₄₄₄₈][bisulfite]) accompanied by carbon dioxide (CO₂) release.

Photoexcitation dynamics of p-nitroaniline and N,N-dimethyl-p-nitroaniline in 1-alkyl-3-methylimidazolium-cation based ionic liquids with different alkyl-chain lengths

Back electron transfer and vibrational energy relaxation of p-nitroaniline and N,N-dimethyl-p-nitroaniline in ionic liquids were investigated using transient absorption spectroscopy.

Multicenter randomized phase II study of cisplatin and fluorouracil plus docetaxel (DCF) compared with cisplatin and fluorouracil plus Adriamycin (ACF) as preoperative chemotherapy for resectable esophageal squamous cell carcinoma (OGSG1003)

BACKGROUND

This phase II trial evaluated the efficacy of cisplatin and fluorouracil (CF)-based combination neoadjuvant chemotherapy on the outcome of patients with resectable locally advanced esophageal squamous cell carcinoma (ESCC). We compared the recurrence-free survival (RFS) associated with CF plus Adriamycin (ACF) with that associated with CF plus docetaxel (DCF) to select an alternative regimen in a new phase III trial investigating the optimal neoadjuvant treatment of patients with ESCC.

PATIENTS AND METHODS

Patients with resectable advanced ESCC were randomly assigned to either ACF (Adriamycin 35 mg/m2, cisplatin 70 mg/m2 i.v. on day 1, fluorouracil 700 mg/m2 continuous infusion for 7 days) every 4 weeks or DCF (docetaxel 70 mg/m2, cisplatin 70 mg/m2 i.v. on day 1, fluorouracil 700 mg/m2 continuous infusion for 5 days) every 3 weeks. Surgery was scheduled after completion of two cycles of chemotherapy. The primary end point was RFS, analyzed by the intention-to-treat.

RESULTS

Between October 2011 and October 2013, 162 patients at 10 institutions were enrolled in the study, all of whom were eligible and randomly assigned to the two groups (81 to the ACF group and 81 to the DCF group). The R0 resection rates for the ACF and DCF groups were equivalent (95.9% versus 96.2%, P = 0.93). The 2-year RFS and overall survival rates for DCF versus ACF were 64.1% versus 42.9% (hazard ratio 0.53, 95% confidence interval 0.33-0.83, P = 0.0057) and 78.6% versus 65.4% (P = 0.08), respectively.

CONCLUSION

Compared with ACF, DCF chemotherapy was associated with prolonged RFS for patients with resectable advanced ESCC. Thus, DCF chemotherapy has potential as a standard neoadjuvant therapy for resectable ESCC.

CLINICAL TRIAL REGISTRATION

University Hospital Medical Information Network Clinical Trials Registry of Japan (identification number UMIN000004555/000004616).

Structure and Thermal Behaviour of a Thermotropic Liquid Crystalline Polyimide (PI-LC)

Anomalous solid structures formed by a thermotropic liquid crystalline polyimide (PI-LC) were investigated by thermal analysis, polarized light microscopy and x-ray analysis. It was revealed that PI-LC should undergo a phase transition from the crystalline to the isotropic phase through the smectic or nematic phase in the temperature range 277–300 °C. The PI-LC filament extruded at 280 °C, at which temperature the polymer was in liquid crystalline phase, was formed to have a structure similar to the smectic C phase, while that extruded and melt-drawn at 310 °C, at which temperature the polymer was in the isotropic phase, had a structure similar to the smectic A phase.

Miscibility, Morphology and Tensile Properties of the Melt Blends of Liquid Crystalline Polyimide (PI-LC) with Two Different Thermoplastic Polyimides: Semicrystalline Polyimide (N-TPI) and Amorphous Poly(Ether-Imide) (PEI)

A liquid crystalline polyimide (poly[1, 3-bis[4-(4-aminophenoxy)-α, α-dimethylbenzyl]benzene pyromellitimide]: PI-LC) was blended with two kinds of thermoplastic polyimide: poly[3, 3′-(4, 4′-dioxybiphenyl)diphenylene pyromellitimide] (N-TPI) which is a semicrystalline polyimide having a melting point of 388 °C and poly[2, 2′-bis(3, 4-dicarboxyphenoxy)phenylpropane-2-phenylene bisimide] (PEI) which is an amorphous poly(etherimide) having a glass transition temperature at 220 °C. The miscibility of N-TPI and PI-LC was evaluated by DSC using enthalpy relaxation, and the phase diagram of their blend was drawn above the melting point of N-TPI. The result indicated that the PI-LC-rich blend was miscible in a wide range of compositions. However, the extruded samples of their blend, which had been prepared under a flow of high shear, showed a phase separation structure. In the other combination of PEI and PI-LC, the blend was immiscible, but at low composition of PI-LC their blend fibre showed higher tensile properties than the original PEI fibre.

Angiomyolipoma of the Liver

Angiomyolipoma, a rare benign liver tumor, was observed in a 50-year-old woman examined with US, CT, MR imaging and angiography. Dynamic studies using CT and MR imaging were valuable in differentiating the disease from hepatocellular carcinoma with fat deposits.

Doppler sonography of the deep lingual artery

Purpose: To clarify the Doppler sonographic features of the lingual artery in normal subjects and to evaluate those of patients with cancer of the tongue.

Material and Methods: Sixty-seven volunteers and 12 patients with cancer and/or leukoplakia of the tongue were examined with an intraoral sonographic probe. The visibility of the deep lingual artery was determined on transverse and anteroposterior images. On the transverse images, the vascular index, which was defined as the number of colored pixels, was measured on bilateral lingual arteries. Thereafter, the degree of symmetry was evaluated for normal subjects and patients.

Results: In normal subjects, between younger and older volunteers, there were no significant differences in visibility of the trunk but differences were found between the two groups for the dorsal branches. The vascular indices of the right and left sides were not different. The characteristic Doppler sonographic feature was vasculature in and around the tumors in the patients with cancer of the tongue. The symmetry indices of the cancer patients were significantly different from those of normal subjects.

Conclusion: Doppler sonography should be an important procedure for evaluation of tongue neoplasms.

Development of compartment for studies on the growth of protein crystals in space

To clarify the growth mechanism of a protein crystal, it is essential to measure its growth rate with respect to the supersaturation. We developed a compartment (growth cell) for measuring the growth rate (<0.1 nm s(-1)) of the face of a protein crystal at a controlled supersaturation by interferometry over a period of half a year in space. The growth cell mainly consists of quartz glass, in which the growth solution and a seed crystal are enclosed by capillaries, the screw sample holder, and a helical insert. To avoid the destruction of the cell and the evaporation of the water from the solution inside the cell, we selected the materials for these components with care. The equipment was successfully used to examine the growth of a lysozyme crystal at a controlled supersaturation in space, where convection is negligible because of the microgravity environment, thereby advancing our understanding of the mechanism of protein crystal growth from solution. The technique used to develop the growth cell is useful not only for space experiments but also for kinetic studies of materials with very slow growth and dissolution rates (<10(-3) nm s(-1)).

Effects of heat-killed Lactobacillus kunkeei YB38 on human intestinal environment and bowel movement: a pilot study

It is well known that lactic acid bacteria supplementation is beneficial for intestinal conditions such as microbiota; however, the effects of killed-lactic acid bacteria on intestinal conditions are largely unclear. This study aimed to evaluate the effect of heat-killed Lactobacillus kunkeei YB38 (YB38) at a dose of approximately 10 mg/day on human intestinal environment and bowel movement. This single-blind study enrolled 29 female subjects with a low defecation frequency who consumed heat-killed YB38 at four increasing dosage levels: 0 (placebo), 2, 10, and 50 mg. Each dose was consumed daily for two weeks, with a two-week baseline period preceding the dosing-period and a two-week washout period ending the study. Observed levels of Bacteroides fragilis group significantly decreased with intake of heat-killed YB38 at ≥10 mg/day compared with levels during placebo intake (P<0.01). Faecal pH significantly decreased with 10 and 50 mg/day intake (P<0.01 and 0.05, respectively). Acetic acid levels tended to increase in faeces at the 50 mg/day dose (P<0.1). Bowel movement tended to increase in all heat-killed YB38 intake periods (P<0.1). In conclusion, heat-killed YB38 altered human intestinal microbiota at doses of ≥10 mg/day and tended to increase bowel movement at ≥2 mg/day. This is the first study to show the intestinal microbiota-altering effect of L. kunkeei and to report the bowel movement-improving effect of heat-killed lactic acid bacteria.