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  • 1
    Online Resource
    Online Resource
    Mode I critical fracture energy of adhesively bonded joints between glass fiber reinforced thermoplastics
    Springer Science and Business Media LLC ; 2015
    In:  Applied Adhesion Science Vol. 3, No. 1 ( 2015-12)
    Details
    In: Applied Adhesion Science, Springer Science and Business Media LLC, Vol. 3, No. 1 ( 2015-12)
    Abstract: Critical fracture energies of adhesively bonded joints under mode I constant separation were experimentally investigated. Double cantilever beam (DCB) specimens comprising polyamide 6 (PA6) based fiber reinforced thermoplastics (GFRTP) were utilized for the experiments. The adherends of the joints were bonded with three different types of adhesives such as polyurethane and acrylates. A surface treatment method with a primer was applied to pre-bonded surface, matching with the different adhesives, which results in five combinations. Strongest combination, Plexus Primer PC120 and Plexus AO420, exhibited 2.95 kJ/m 2 in mode I critical fracture energy, which is much higher than those of ordinary epoxy adhesive and similar to those of rubber-modified very-ductile epoxy adhesives. Therefore, it is confirmed that adhesive bonding can be applied to join PA6 based GFRTP even for structural use, although the material is thought too difficult to bond adhesively.
    Type of Medium: Online Resource
    ISSN: 2196-4351
    URL: Article
    DOI: 10.1186/s40563-015-0036-2
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2015
    detail.hit.zdb_id: 2750262-4
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  • 2
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    Online Resource
    RA09.05: MDM2 AND ERCC1: NOVEL BIOMARKERS TO PREDICT THE RESPONSE TO NEOADJUVANT CHEMOTHERAPY FOR ESOPHAGEAL CANCER PATIENTS
    Oxford University Press (OUP) ; 2018
    In:  Diseases of the Esophagus Vol. 31, No. Supplement_1 ( 2018-09-01), p. 40-41
    Details
    In: Diseases of the Esophagus, Oxford University Press (OUP), Vol. 31, No. Supplement_1 ( 2018-09-01), p. 40-41
    Abstract: Neoadjuvant chemotherapy (NAC) by 5-fluorouracil (5-FU) and cisplatin followed by esophagectomy has been established as a standard approach for the patients with clinical stage II/III esophageal squamous cell carcinoma (ESCC) in Japan. However, NAC is not always effective in all these patients, and it is important to identify biomarkers for predicting the response. Therefore, the present study aimed to identify markers for predicting the response to chemotherapy and the clinical outcomes. Methods This study included 62 ESCC patients who underwent esophagectomy following NAC. We performed immunohistochemical analyses for murine double minute 2 (MDM2), thymidine phosphorylase (TP), dihydropyrimidine dehydrogenase (DPD), and excision repair cross-complementing rodent repair deficiency-1 (ERCC1) in surgical specimens following NAC and assessed the associations of the findings with clinicopathological features in individual patients. Results The MDM2 status and ERCC1 status demonstrated significant inverse associations with the response to NAC (MDM2: P = 0.025, ERCC1: P = 0.021). In addition, a high TP status in the tumor was significantly associated with tumor differentiation (P = 0.008), depth of invasion (P  〈  0.001), lymphatic invasion (P = 0.003), venous invasion (P  〈  0.001) and tumor stage (P = 0.006). Moreover, a high DPD status was associated with tumor differentiation (P = 0.008), depth of invasion (P  〈  0.001), venous invasion (P = 0.003) and tumor stage (P = 0.007). The TP status also significantly predicted the eventual clinical outcome of patients following surgery. Conclusion Recently, overexpression of MDM2 has been reported for poor prognosis in patients with ESCC treated by chemoradiotherapy. 5-FU metabolic enzymes, such as TP andDPD, have been investigated for sensitivity to 5-FU. ERCC1, a key component of homologous recombination-based repair of interstrand DNA cross-links, has been reported to predict sensitivity to cisplatin. In our study, MDM2 and ERCC1 immunoreactivity predict chemosensitivity of NAC based on 5-FU and cisplatin. High intratumoral TP status and DPD status are associated with tumor progression and prognosis in ESCC patients receiving NAC. Disclosure All authors have declared no conflicts of interest.
    Type of Medium: Online Resource
    ISSN: 1120-8694 , 1442-2050
    URL: Article
    DOI: 10.1093/dote/doy089.RA09.05
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2018
    detail.hit.zdb_id: 2004949-3
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  • 3
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    PS01.110: ACUTE NECROTIZING ESOPHAGITIS WITH ESOPHAGUS PERFORATION, TREATED BY THORACOSCOPIC ESOPHAGECTOMY
    Oxford University Press (OUP) ; 2018
    In:  Diseases of the Esophagus Vol. 31, No. Supplement_1 ( 2018-09-01), p. 81-81
    Details
    In: Diseases of the Esophagus, Oxford University Press (OUP), Vol. 31, No. Supplement_1 ( 2018-09-01), p. 81-81
    Abstract: Acute necrotizing esophagus is defined as the diffuse black pigmentation of the esophagus due to the necrosis of the esophageal mucosa, and so called ‘black esophagus’ from its endoscopic findings. The prevalence is only 0.001∼0.2%, although the mortality rate is up to 32%. Methods 67 years old female with medical history of diabetes mellitus, transported to the emergency room with hematemesis and conscious disorder. She had suffered from nausea and epigastralgia for two days. Her general status was in shock vitals and didn’t respond to rehydration. After intubation, emergency endoscopic examination revealed black pigmentation of the esophageal mucosa and diagnosed as acute necrotizing esophagitis. Antibiotics and blood absorption therapy had been started and the patient gradually stabilized. 1 week after the admission, esophagus perforation was suspected from the significant increase of the right pleural effusion and free air at the esophagus wall and the mediastinum on CT scan. Emergency thoracoscopy was performed and found that the esophagus was edematous and adventitia was colored into black. The esophagectomy with esophagostomy and enterostomy was performed. Results On resected specimen, mucosal necrosis was found only on squamous epithelium with three perforating areas in the middle to lower thoracic esophagus. No signs of inflammation nor ischemia was found on the gastric mucosa of the esophagogastric junction. After the operation, patient recovered generally well, except the severe stenosis of the cervical esophagus had developed. Although endoscopic dilation had been constantly performed, the reconstruction remains unsolved issue. Conclusion In acute necrotizing esophagitis, stabilization of the patient's condition by treating comorbid diseases is extremely important. Improving the nutritional status in addition to the administration of antacids and antibiotics is also required. Surgical intervention should be performed when perforating mediastinitis or abscess formation occurs. Primary closure shouldn’t be attempted, and esophageal resection with delayed reconstruction should be considered in addition to drainage. In this case, we could successfully rescued the patient with necrotic esophagitis by performing surgical intervention promptly. It is important to detect the esophagus perforation and mediastinitis early, not to miss the chance of surgical intervention for curative treatment. Disclosure All authors have declared no conflicts of interest.
    Type of Medium: Online Resource
    ISSN: 1120-8694 , 1442-2050
    URL: Article
    DOI: 10.1093/dote/doy089.PS01.110
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2018
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  • 4
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    Online Resource
    Different strategy of salvage esophagectomy between residual and recurrent esophageal cancer after definitive chemoradiotherapy
    AME Publishing Company ; 2018
    In:  Journal of Thoracic Disease Vol. 10, No. 3 ( 2018-3), p. 1554-1562
    Details
    In: Journal of Thoracic Disease, AME Publishing Company, Vol. 10, No. 3 ( 2018-3), p. 1554-1562
    Type of Medium: Online Resource
    ISSN: 2072-1439 , 2077-6624
    URL: Journal
    URL: Article
    DOI: 10.21037/jtd
    DOI: 10.21037/jtd.2018.03.04
    Language: Unknown
    Publisher: AME Publishing Company
    Publication Date: 2018
    detail.hit.zdb_id: 2573571-8
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  • 5
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    Online Resource
    A comparative analysis of clinicopathological factors between esophageal small cell and basaloid squamous cell carcinoma
    Ovid Technologies (Wolters Kluwer Health) ; 2019
    In:  Medicine Vol. 98, No. 8 ( 2019-02), p. e14363-
    Details
    In: Medicine, Ovid Technologies (Wolters Kluwer Health), Vol. 98, No. 8 ( 2019-02), p. e14363-
    Abstract: Esophageal small cell carcinoma (E-SmCC) and basaloid squamous cell carcinomas (BSCCs) are both highly aggressive malignancies, but their detailed differences in clinical behaviors have remained virtually unknown. In addition, treatment strategies of the patients with E-SmCC have not been established. 29 cases of E-SmCC and 39 with BSCC were examined in this study to clarify the clinical features and outcome of the patients with E-SmCC and to compare the findings with those of BSCC. E-SmCCs presented a more advanced status than BSCC (TNM Stage: P  = .002). Esophagectomy was performed in 15 small cell carcinoma patients and 14 were treated with non-surgical/systemic therapy. The clinical outcome of the small cell carcinoma cases was significantly worse than those with BSCC ( P  = .001), but results of a stage-stratified analysis revealed that the Stage I small cell carcinoma patients presented favorable prognosis (3-year survival rate 100%, n = 4). In contrast, among those with Stage II–IV, clinical outcome tended to be better in the systemic therapy group (3-year survival rate 49%, n = 13) than the surgically treated group (3-year survival rate 0%, n = 12). E-SmCC was a more aggressive neoplasm than BSCC. However, early detection could possibly improve the clinical outcome of patients with E-SmCC. Systemic therapy could also benefit the patients with advanced disease (Stage II–IV).
    Type of Medium: Online Resource
    ISSN: 0025-7974 , 1536-5964
    URL: Article
    DOI: 10.1097/MD.0000000000014363
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2019
    detail.hit.zdb_id: 2049818-4
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  • 6
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    Online Resource
    PS01.124: AN OPTIMAL SURGICAL APPROACH AND THE EXTENT OF LYMPH NODE DISSECTION FOR BARRETT’S ADENOCARCINOMA
    Oxford University Press (OUP) ; 2018
    In:  Diseases of the Esophagus Vol. 31, No. Supplement_1 ( 2018-09-01), p. 85-85
    Details
    In: Diseases of the Esophagus, Oxford University Press (OUP), Vol. 31, No. Supplement_1 ( 2018-09-01), p. 85-85
    Abstract: An optimal surgical approach and the extent of lymph node dissection for Barrett's adenocarcinoma remain controversial. The standard surgical approach for Barrett's adenocarcinoma at our institution is performing thoracoscopic esophagectomy. Proximal gastrectomy is preferred in cases where distance between the proximal edge of the primary tumor and the esophagogastric junction is  〈  3 cm. However, some studies suggest a complete resection of Barrett's esophagus. Methods The clinicopathologic data of 36 patients with Barrett's adenocarcinoma who were admitted to our institution between 1994 and 2017 were retrospectively analyzed to assess the efficacy of lymph node dissection at each station using the index of estimated benefit from lymph node dissection (IEBLD). Results The tumor locations were found to be the middle thoracic, lower thoracic, and abdominal esophagus in 2 (5.6%), 17 (47.2%), and 17 (47.2%) cases, respectively. A total of 28 (77.8%), 6 (16.7%), and 2 (5.5%) patients underwent esophagectomy, proximal gastrectomy, and transhiatal esophagectomy, respectively. The overall lymph node metastasis rate was 41.6%. The IEBLD indexes of the middle/lower thoracic lymph and the abdominal lymph nodes were comparable, whereas those of the paraesophageal lymph nodes (#108 and 110) were relatively high. Conversely, the metastasis rates of the upper thoracic lymph nodes were 13.9%, with no IEBLD values. Cervical lymph node metastasis was not identified, and the significance of dissection was unclear. Stratified by the location of tumor, the ILBLD index of middle/lower thoracic lymph node was relatively high in Lt cases. Conversely, those of abdominal lymph nodes were high and those of middle thoracic lymph nodes were not identified in Ae cases. In proximal gastrectomy cases, the complete resection of Barrett's esophagus was not achieved in 2 (40%) cases with LSBE. Lymph node metastasis was identified in one case (#110). The recurrence-free survival rate was 100%. Conclusion The significance of upper thoracic lymph node dissection was unclear, whereas those of middle/lower thoracic lymph and the abdominal lymph nodes were comparable. The selection of an appropriate surgical approach at our institution was acceptable. The efficacy of complete resection of LSBE was not observed. Disclosure All authors have declared no conflicts of interest.
    Type of Medium: Online Resource
    ISSN: 1120-8694 , 1442-2050
    URL: Article
    DOI: 10.1093/dote/doy089.PS01.124
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2018
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  • 7
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    Online Resource
    Combined thoracoscopic and endoscopic surgery for a large esophageal schwannoma
    Baishideng Publishing Group Inc. ; 2017
    In:  World Journal of Gastroenterology Vol. 23, No. 46 ( 2017-12-14), p. 8256-8260
    Details
    In: World Journal of Gastroenterology, Baishideng Publishing Group Inc., Vol. 23, No. 46 ( 2017-12-14), p. 8256-8260
    Type of Medium: Online Resource
    ISSN: 1007-9327
    URL: Article
    DOI: 10.3748/wjg.v23.i46.8256
    Language: Unknown
    Publisher: Baishideng Publishing Group Inc.
    Publication Date: 2017
    detail.hit.zdb_id: 2084831-6
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  • 8
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    Online Resource
    New endoscopic classification of the cardiac orifice in esophageal achalasia: Champagne glass sign
    Wiley ; 2016
    In:  Digestive Endoscopy Vol. 28, No. 6 ( 2016-09), p. 645-649
    Details
    In: Digestive Endoscopy, Wiley, Vol. 28, No. 6 ( 2016-09), p. 645-649
    Abstract: Endoscopy, barium esophagram and manometry are used in the diagnosis of achalasia. In the case of early achalasia, characteristic endoscopic findings are difficult to recognize. As a result, the diagnosis of achalasia is often made several years after symptom onset. Therefore, we examined the endoscopic findings of the cardiac orifice in achalasia and propose a new classification. Methods A total of 400 patients with spastic esophageal motility disorders who underwent peroral endoscopic myotomy (POEM) at our hospital between March 2014 and August 2015 were screened for this study. Champagne glass sign (CG) was defined as when the distal end of the lower esophageal sphincter relaxation failure (LESRF) was proximal to the squamocolumnar junction (SCJ) and the SCJ was dilated in the retroflex view. Specifically, CG‐1 was defined as a distance from the SCJ to the lower end of LESRF of 〈 1 cm, and CG‐2 was defined as a distance ≥1 cm. Results CG‐0 was seen in 73 patients (28.0%), whereas the CG sign was seen in 186 patients (71.3%), of whom 170 (65.1%) were CG‐1 and 16 (6.1%) were CG‐2. Conclusions The CG sign is often observed in esophageal achalasia patients. CG‐0 (equal to Maki‐tsuki ) was observed in 28.0% of achalasia patients only. Its absence with dilated SCJ cannot be used to rule out achalasia. Barium esophagram and manometry should be done if esophageal achalasia is strongly suspected.
    Type of Medium: Online Resource
    ISSN: 0915-5635 , 1443-1661
    URL: Issue
    URL: Article
    DOI: 10.1111/den.v28.6
    DOI: 10.1111/den.12642
    Language: English
    Publisher: Wiley
    Publication Date: 2016
    detail.hit.zdb_id: 2020071-7
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  • 9
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    Online Resource
    PS01.085: TREATMENT STRATEGY FOR AORTO-ESOPHAGEAL FISTULA
    Oxford University Press (OUP) ; 2018
    In:  Diseases of the Esophagus Vol. 31, No. Supplement_1 ( 2018-09-01), p. 73-73
    Details
    In: Diseases of the Esophagus, Oxford University Press (OUP), Vol. 31, No. Supplement_1 ( 2018-09-01), p. 73-73
    Abstract: Aorto-esophageal fistula (AEF) is relatively rare, but life-threatening condition. AEF is usually caused in the patients with thoracic aortic diseases, such as aneurysms, or after thoracic aortic surgery. We present our surgical strategy for AEF. Methods From May 2004 to November 2017, 12 patients with AEF were treated at our hospital. The age ranges from 44 to 83 years, and the number of male/female was 9/3. Five patients had previous thoracic endovascular aortic repair (TEVER) in the descending aorta, four patients had descending or total arch replacement. Two patients caused by rupture of thoracic aortic aneurysm, and one patient had penetration of esophagus caused by aspiration of Press Through Package. As the first procedures for surgical treatment, we perform TEVAR in order to prevent the fatal hemorrhage from aortic pseudoaneurysm. At the same day, removal of esophagus with debridement of adjacent infected tissues is performed by open thoracic procedure. After a few days, excision of the infected graft or the aorta followed by new graft replacement with omental flap installation is performed. Four patients used homograft and four patients used rifampicin-soaked graft. After the patient's general condition improve, we plan to perform open surgery for reconstruction of esophagus. Results A 3-year survival rate was 50%, and perioperative mortality was 25%. Hospital mortality was noted in 3 patients due to sepsis, brainstem infarction and pulmonary hemorrhage (6–117 days after the first surgery). Late death occurred in 4 patients (n = 2: ileus, n = 1: carcinoma, n = 1: pneumonia). Eight patients could undergo esophagus reconstruction, by colon graft in 4 patients, a pedicled jejunum and a gastric tube in 2 patients, respectively. The duration from esophageal resection to reconstruction was 1–11 months. Conclusion Because AEF usually accompanied with hemodynamic instability, immediate surgical intervention is regarded as the only effective treatment. Corporation between gastrointestinal surgeons and cardiovascular surgeons is necessary to achieve this treatment. We share our experiences of AEF treatment and discuss surgical strategy. Disclosure All authors have declared no conflicts of interest.
    Type of Medium: Online Resource
    ISSN: 1120-8694 , 1442-2050
    URL: Article
    DOI: 10.1093/dote/doy089.PS01.085
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2018
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  • 10
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    PS01.181: ESOPHAGECTOMY FOR ESOPHAGEAL CARCINOMA TO ELDERLY PATIENTS OVER 75 YEARS OLD
    Oxford University Press (OUP) ; 2018
    In:  Diseases of the Esophagus Vol. 31, No. Supplement_1 ( 2018-09-01), p. 100-101
    Details
    In: Diseases of the Esophagus, Oxford University Press (OUP), Vol. 31, No. Supplement_1 ( 2018-09-01), p. 100-101
    Abstract: Recently, operation cases of elderly patients are increasing in esophageal carcinoma. Because elderly patients often have pre-existing disease and may easily cause postoperative complications, it is necessary to consider whether surgical treatment is appropriate for those elderly patients. The aim of this study is to investigate the safety of esophagectomy for elderly patients with esophageal carcinoma. Methods All 483 patients who underwent esophagectomy for esophageal carcinoma between April 2007 and March 2015 were included in this study. Patients were divided into two groups: elderly group (over 75 years old: n = 72) and control group (under 75 years old: n = 411). The short and long-term outcomes were retrospectively examined to those groups. Results In the elderly group, their median age was 77 [75–85] and all of their performance status was 0 or 1, except 4 patients. 66 cases of the elderly group had some comorbidity, which was significantly higher than that of the control group (93.0 vs. 80.2%, P = 0.007). Pre-surgical treatment was performed to 38.9% of the elderly group, whereas 58.9% in the control group (P = 0.002). No significant differences were demonstrated in clinical stage, occupation site, histological type and pathological stage between these groups. The operation time was relatively shorter in the elderly grou p compare to the control group (549 vs. 585min, P = 0.018). The number of dissected lymph node was also smaller in elderly group (31 vs. 35, P = 0.048). The postoperative complications such as pneumonia, recurrent laryngeal nerve paralysis did not show any difference between these groups. The 5-year overall survival rate (OS) and the 5-year disease specific survival rate (DSS) also did not show statistical differences between the elderly and control group (OS: 53.0 vs. 57.0%, P = 0.765; DSS: 64.6 vs. 62.7%, P = 0.605). Conclusion Between elderly and control group, there was no difference in postoperative complication and long-term survival. This study confirmed the safety of esophagectomy for elderly patients with esophageal carcinoma by reducing treatment stress such as neoadjuvant therapy, extended operation time and extensive lymphadenectomy. Disclosure All authors have declared no conflicts of interest.
    Type of Medium: Online Resource
    ISSN: 1120-8694 , 1442-2050
    URL: Article
    DOI: 10.1093/dote/doy089.PS01.181
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2018
    detail.hit.zdb_id: 2004949-3
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