bluuebunny/crossref_metadata_2025_split huggingface dataset:
488 SNAIL TRANSFECTION INDUCES EPITHELIAL-MESENCHYMAL TRANSITION WITH PROPERTIES OF CANCER STEM-LIKE CELL IN ESOPHAGEAL SQUAMOUS CELL CANCER
Authors: Tzao Ching , Wu Meng-Hsun , Chen Ben-Hen 
Published: September 2021

Abstract

Cancer stem-like cell (CSC) is an important player in tumorigenesis and tumor progression. Snail has been demonstrated as a key driver for epithelial-mesenchymal transition (EMT) that is closely linked with generation of stem-like cell in human cancer. We aim to investigate if Snail transfection induces EMT and properties of stem-like cell in esophageal squamous cell carcinoma (ESCC) cell lines.

Methods
A lentivirus system was used to transfect human Snail via a plasmid pLV-EF1a-hSnail-Hyg into KYSE-170 and KYSE-510 ESCC cell lines. Immunoblotting was used to determine expression of EMT associated markers including Vimentin, E-cadherin, Fibronectin and N-cadherin. Assays for cell migration and invasion were conducted in Snail-transfected cells and its vector control. Cytotoxicity (MTT) and cell proliferation assay was used to determine cell growth. Sphere formation assay and flow cytometry (FCM) were employed to characterize stem cell properties while examining expression of stemness genes by using real-time polymerase chain reaction (PCR).

Results
After Snail transfection, mesenchymal markers, Vimentin, N-cadherin increased, whereas epithelial marker E-cadherin decreased. Snail-transfected.
ESCC cells presented a significant increase in RNA expression of stemness genes such as Nanog, Oct4, ABCG2 and Sox2 with an induction in sphere formation. Moreover, ability of cell migration and invasion increased after Snail-transfection in ESCC with increased chemoresistance to cisplatin, taxol, and 5-Fluorouracil(5-FU) and an increase in radioresistance as well.

Conclusion
Our results demonstrated that Snail transfection induced EMT with properties of CSC in ESCC cell lines.
490 COLONIC INTERPOSITION FOR ESOPHAGEAL REPLACEMENT AFTER ESOPHAGECTOMY FOR CANCER—A SINGLE CENTER EXPERIENCE
Authors: Sabino Flávio , Guimarães-Filho Marco , Ribeiro Luciana , Fernandes Daniel , Felipe Pinto Luis 
Published: September 2021

Abstract

The standard esophageal replacement after esophagectomy for cancer treatment is a gastric conduit, as it is a simpler technique than the other options available, requiring only one anastomosis. However, when the stomach is not available, a left- or right colon graft interposition can be performed. The purpose of this study was to review our experience with colon interposition following esophagectomy for cancer and assess the surgical outcomes.

Methods
The clinical data and surgical outcomes form patients who underwent esophagectomy with colon interposition for cancer treatment, in a single institution, between January 1990 and December 2017. The results were compared with cases with gastric reconstruction.

Results
From January 1990 and December 2017, 25 cases of transhiatal esophagectomy with colon interposition were identified. In the same period, 97 cases of transhiatal esophagectomy with gastric pull-up were also performed. The patient’s clinical data and surgical outcomes are presented in Table 1. The indication for performing a colon interposition was positive distal margin in 87% of cases, gastric conduit ischemia in 8,7% and prior gastric surgery in 4,3%. The most common pull-up route was the posterior mediastinum (87%).

Conclusion
Our results are in line with the literature and demonstrate that colon interposition after esophagectomy is feasible and, despite having a significant morbimortality, appears to be a valuable alternative for the challenging situation where the stomach is not available.
492 TUMOR ASSOCIATED MACROPHAGE PROMOTES EPITHELIAL-TO-MESENCHYMAL TRANSITION IN ESOPHAGEAL SQUAMOUS CELL CANCER
Authors: Tzao Ching , Cheng Li-Yuan , Chang Chien-Chih 
Published: September 2021

Abstract

We aimed to investigate the role of tumor associated macrophage (TAM) in epithelial-to-mesenchymal transition (EMT) in esophageal squamous cell cancer (ESCC).

Methods
Expression of CD68 and EMT markers was determined in resected ESCC tumors by immunohistochemistry with clinicopathologic correlation. M2-polarized macrophages were generated from human U937 cells treated with 50 ng/ml phorbol myristate acetate (PMA) while cultured with PMA plus Th2 cytokines. KYSE-510 ESCC cell was co-cultured with M2 macrophages, followed by determination of expression for EMT markers by Western blot. In situ expression of E-cadherin and vimentin was determined using immunofluorescence staining Cell proliferation, invasion and extracellular matrix (ECM) adhesion assays were performed to determine phenotypic characteristics of cultured ESCC cells.

Results
High expression of CD68 in resected ESCC correlated with worse survival. In addition, expression of CD68 in resected ESCC tumors correlated positively with expression of Snail and vimentin but inversely with E-cadherin. Compared with KYSE-510 cells cultured alone, those co-cultured with M2 macrophage showed higher expression of snail, vimentin, and fibronectin with a more spindle-shaped morphology, suggesting a mesenchymal differentiation. Further, cell proliferation, invasion and ECM adhesion were significantly more pronounced in M2 macrophage co-cultured ESCC cells.

Conclusion
EMT markers correlated with the number of TAM within resected ESCC tumors, suggesting an association of cancer inflammation in promoting EMT in ESCC. A link between cancer inflammation mediated by TAM deemed to be supported by increased expression of EMT markers and phenotypic changes related to EMT in ESCC cells co-cultured with M2 macrophage. Our results suggest an important role of TAM in promoting EMT in tumor microenvironment with regards to cancer inflammation in ESCC.
532 OUTCOME OF QUILICI’S HEPATIC SHOULDER PROCEDURE TO AUGMENT LAPAROSCOPIC HIATOPLASTY IN LARGE OR RECURRENT HIATAL HERNIA
Authors: Zacherl Johannes , Kertesz Viktoria , Höfle Cordula , Gensthaler Lisa , Eltschka Bernhard , Albinni Said , Schneider Florian , Schima Wolfgang , Sitzwohl Christian , Radlspöck Wolfgang 
Published: September 2021

Abstract

Laparoscopic hiatoplasty and fundoplication is the gold standard of surgical treatment of GERD and hiatal hernia. However, the main drawback of laparoscopic hiatal hernia repair is a substantial recurrence rate.
Hence, prosthetic meshs have been used to reduce the risk for recurrence. But meshs may cause major complications. As a consequence we adopted the hepatic shoulder plasty described by Quilici to augment the hiatal hernia repair in patients with a high risk for hernia recurrence.

Methods
Patients with large (&gt;4 cm) axial hiatal hernia, giant paraesophageal or with recurrent hernia consecutively underwent laparoscopic hernia repair with crural sutures and hepatic shoulder plasty. A Toupet or a floppy Nissen fundoplication was added. In patients with giant paraesophageal hernia the hernia sack was resected.
Perioperative complications were recorded. Follow-up comprised endoscopy and/or radiography and QoL-evaluation with the Eypasch score (GIQLI).

Results
Between 2012 and 2018 51 patients (mean age 71 years, 65% female) underwent Quilici’s procedure. Among them 33,3% had one or more previous hiatal hernia repair. There were no conversions. Postoperative complication rate was 7.8%. At follow-up after 2 years 6 recurrences (12%) were encountered, 4 of them were symptomatic (8%). One patient underwent reoperation due to hernia recurrence. In 84% QoL was significantly improved at follow-up.

Conclusion
In patients with high risk of recurrence, biological augmentation of the hiatal closure with the left lobe of the liver may be a valuable alternative to prosthetic reinforcement. We observed no complication attributable to liver lobe transposition.
547 THE ROLE OF HEAT SHOCK PROTEIN 90 IN HYPOXIA INDUCED ANGIOGENESIS AND EPITHELIAL-MESENCHYMAL TRANSITION OF ESOPHAGEAL SQUAMOUS CELL CANCER
Authors: Tzao Ching , Wang Chin-Kun 
Published: September 2021

Abstract

Hypoxia is known as an important trigger for the development of metastases in human cancers. Heat shock proteins (Hsps) are up-regulated by cellular stressors including hypoxia. To date, the functional role of Hsps within the hypoxic tumor microenvironment for esophageal squamous cell cancer (ESCC) remains poorly defined.

Methods
CoCl₂ was used to induce hypoxia in cultured ESCC cells which was confirmed by 2′,7′ –dichlorofluorescin diacetate (DCFDA) assay. 7-Dimethylaminoethylamino-17-demethoxygeldanamycin (17-DMAG), a selective Hsp90 inhibitor, was used to treat 2 ESCC cell lines, KYSE-170 and -510 cells pretreated with or without CoCl₂₂₂₂₂ in different concentrations, followed by cytotoxicity (MTT) and migration assays. In parallel, expression of Hsp90, vascular endothelial growth factor (VEGF), hypoxia-inducible factor-1α (HIF-1α), and markers related to epithelial-mesenchymal transition (EMT) such as snail/E-cadherin, by immunoblot or ELISA while analyzing cell proliferation and migration of treated ESCC cells.

Results
CoCl₂ induced hypoxia was supported by induction of reactive oxygen species (ROS). CoCl₂ (200 μM) significantly suppressed cell viability and proliferation with a concomitant up-regulation of VEGF and HIF-1α in a dose-dependent fashion. In contrast, cell migration was significantly increased in response to CoCl₂ while down-regulating E-cadherin with a concomitant increase in Snail expression. 17-DMAG decreased expression of VEGF and HIF-1α while inhibiting cell migration and invasion.

Conclusion
Our data demonstrate that CoCl2 induced hypoxia promotes EMT and angiogensis, which are inhibited by 17-DMAG. These results suggest that hypoxia induced EMT and angiogensis is Hsp90 dependent in ESCC.
622 CORRELATION ANALYSIS BETWEEN MAJOR FOOD GROUPS' CONSUMPTION AND THE RESULTS OF 24-HOURS OESOPHAGEAL PH-IMPEDANCE STUDIES
Authors: Morozov Sergey , Kropochev Vasily , Isakov Vasily 
Published: September 2021

Abstract

Aim
To evaluate association of number of gastroesophageal refluxes detected with oesophageal pH-impedance study with dietary patterns.

Methods
Food frequency questionnaire (Nutrilogic, Russia) was used to assess diet of subjects enrolled in the study in terms of nutrients consumption and food groups' structure. Dietary patterns were calculated according to the Healthy Eating Index (HEI), for the following major groups of foods: grains, fruits, vegetables, dairy products, meats, fats and confectioneries. The results are shown as a quotient of a division of actual values by the recommended. Oesophageal 24-hours pH-impedance (Ohmega, Laborie, the Netherlands) parameters were analysed. Spearman rank R was used to reveal correlation between number and type of gastroesophageal refluxes (GER) and the dietary patterns assessment.

Results
Forty consecutive patients (12 with gastroesophageal reflux disease, 28 females, age: 52.2 ± 12.9 y.o.) were enrolled. Mean energy value of the ration was 2302 ± 1391 kcal/day. Pattern of major food groups consumption was as follows: grains 1.4 ± 0.7, vegetables 1.1 ± 0.7, fruits 0.8 ± 0.9, dairy products 0.6 ± 0.6, meats 1.7 ± 1.0, fats 0.6 ± 0.8, confectioneries 0.3 ± 0.5. Mean number of GERs was 43.8 ± 24.4, acid GERs—26.2 ± 20.5 a day. Pattern of dairies consumption correlated with total number of GERs (Spearman R = 0.47, p &lt; 0.05), weak-acid GERs (R = 0.49, p &lt; 0.05), and non-acid GERs (R = 0.62, p &lt; 0.05). Consumption of confectioneries correlated with high (at 17 cm above LES) GERs: R = 0.47, p &lt; 0.05.

Conclusion
Type and number of gastroesophageal refluxes correlate with major food groups consumption. This preliminary results may serve as a basis for further research in larger comparative trials and may be considered when diet modification is planned for patients with GERD.
634 ROBOTIC-ASSISTED HIATAL HERNIA AND GASTROESOPHAGEAL DISEASE SURGERY: INITIAL RESULTS AND EXPERIENCE IN A SINGLE INSTITUTION
Authors: Farrarons Sara Sentí , Font Arantxa Clavell , Bosch Cristina Albero , Martin Marta Viciano , Savall Elisenda Garsot 
Published: September 2021

Abstract

Gastroesophageal reflux disease, associated with sliding or large paraesophageal hiatal hernia, represents a common disease that frequently needs a surgical solution. The repair of large paraesophageal hiatal hernias is still a challenge in minimally invasive surgery but the robotic approach seems to gain widespread acceptance because offers enhanced visualization, dexterity and reach, which may facilitate the hiatal reconstruction and mediastinal dissection.

Methods
Between June 2019 and February 2021, 23 patients (5 male, 18 female) underwent robotic approach fundoplication (19 sliding hernia, 3 paraesophageal and 2 gastroesophagic reflux) after being pre operative diagnosed. All surgeries were elective. Biosynthetic tissue absorbable mesh was applied in one patient with double time recurrence hernia. Sixteen patients underwent total fundoplication (Nissen), 6 patients had Toupet fundoplication, and one patient had hiatus repair without fundoplication.

Results
The mean age of the patients was 61 years. Biosynthetic mesh was used in one patient. The mean operative time was 127 minutes (80-240) and no intraoperative complications were described. There were no conversions to open or laparoscopic procedures. Nine of the twenty-three patients underwent redo hiatal hernia repairs and the mean hospital stay was 2 days. Only one patient had a major complication (Clavien Dindo 3b) requiring urgent surgery. The early and 30 day mortality rate was 0%.

Conclusion
In our experience, robotic approach to paraesophageal repair seems safe and effective with low complication rates even in high-risk patients and those with redo surgery. Subjectively, the robotic approach provides the surgeon better vision and maneuverability during the intervention. We hope to progressively increase the number of robotic cases to analyse long-term clinical outcomes such as hiatal hernia recurrences, need of medical therapy and quality of life.
635 ROBOTIC REDO FUNDUPLICATION FOR A TWO TIME RECURRENT HIATAL HERNIA. HOW WE DO?
Authors: Font Arantxa Clavell , Farrarons Sara Sentí , Bosch Cristina Albero , Martín Marta Viciano , Savall Elisenda Garsot 
Published: September 2021

Abstract

In the video we perform the crural robotic reinforcement with de use of biosynthetic mesh (Gore Bio-A) without any funduplication in a 37 years-old woman with a two time hernia hiatal recurrence. Although laparoscopic surgery to treat primary hiatal hernias (HHs) is the gold standard approach, the use of robotic platforms seems to gain weight. This video aims to show the step-by-step in a redo hiatal surgery and the benefits of robotic surgery.

Methods
Here in the video we present a 37-year old woman patient who underwent previously two laparoscopic Nissen fundoplication because of hiatal hernia and gastroesophageal reflux disease. The first surgery was done in 2015 and the patient needed a laparoscopic redo due to hiatal relapse, done in 2019 with nonabsorbable mesh reinforcement. Posteriorly, the patient visited our clinic for epigastric pain and vomits. The proper study with gastroscopy, CT scan and barium swallow was ruled out, pointing a new relapse. With this results, the patient was purposed a redo cruroplasty with robotic approach.

Results
In the video we perform the crural robotic reinforcement with de use of biosynthetic absorbable mesh (Gore Bio-A) without any funduplication. This video aims to show the step-by-step in a redo hiatal surgery and the benefits of robotic surgery. In our short experience and according to the related publications we believe the robotic platform is feasible, safe and effective.

Conclusion
Although laparoscopic surgery to treat primary hiatal hernias (HHs) is the gold standard approach, the use of robotic platforms in complicated procedures such as relapsed hiatal hernias or gastroesophageal reflux disease (GERD) recurrence seems to gain weight. This is because of robotic approach may help in demanding surgeries with fibrosis and modified anatomy so it provides more precision with the articulating arms and better visualisation due to a 3D view and stable camera.

Video
https://drive.google.com/file/d/1BjwLWiEaNZWv6ULO9p-rec1LgSopfb1f/view?usp=sharing
647 THE LEFT AND RIGHT RECURRENT LARYNGEAL NERVE LYMPH NODES POSSESS DIFFERENT ANATOMICAL CHARACTERISTICS AND RISK STRATIFICATIONS OF METASTASIS
Authors: Zhang Guoqing , Zhao Shanshan , Li Qiyuan , Yuan Lulu , Gao Gen , Li Jindong , Li Xiangnan 
Published: September 2021

Abstract

The left and right recurrent laryngeal nerve(RLN) are asymmetrical, and the precise differences and metastasis risk stratifications based on preoperative CT scan between the left and right RLN lymph nodes have not yet been analyzed. In this study, we compared the anatomical characteristics and generated prediction models to predict the probability of left and right RLN lymph node metastasis using preoperative clinical data in patients undergoing thoracolaparoscopic esophagectomy with cervical anastomosis to guide clinical treatment.

Methods
We retrospectively reviewed the clinical data of 1660 consecutive patients with thoracic esophageal cancer who underwent esophagectomy with cervical anastomosis at the Department of Thoracic Surgery at our center between January 2015 and December 2020 and investigated the anatomical characteristics and risks of bilateral RLN lymph nodes according to preoperative CT scan and pathological examination findings.

Results
A total of 299 and 343 patients who underwent left(right) RLN lymph node dissection were included in the final analysis. By plotting ROC curves, we concluded that the cutoff values of the long and short axis to predict metastasis of the left (right) RLN lymph nodes were 10 (8 mm) and 7.5 (6.5 mm), respectively. The short axis rather than the long axis was significantly associated with left RLN lymph node metastasis. Correspondingly, the long axis was much more important than the short axis in regard to the right RLN lymph nodes.

Conclusion
There were different anatomical characteristics and precise metastasis risk stratifications between the left and right RLN lymph node metastases.
650 POSTOPERATIVE EARLY ORAL FEEDING PROGRAM ACCELERATES THE RECOVERY OF GASTROINTESTINAL FUNCTION IN ESOPHAGEAL CANCER PATIENTS
Authors: Wang Peiyu , Chen Xiankai , Li Yin , Liu Xianben 
Published: September 2021

Abstract

Although the early oral feeding program (EOF) pasting the esophagectomy has been demonstrated to be valuable in attenuating inflammatory responses and shortening hospital stay without increasing complications, its impacts on gastrointestinal function recovery have not been elegantly investigated. This study aimed to solve these issues.

Methods
A total of 110 esophageal cancer patients were included after reviewing a prospective database. Patients of EOF group were compared with patients of late oral feeding (LOF) group with respects to the appearance of first flatus and bowel movement after esophagectomy. Perioperative changes in serum gastrointestinal hormones were compared between EOF group and LOF group using variance analysis of repeated measurements. Multivariable logistic regression was conducted to detect risk factors for delayed recovery of gastrointestinal function after esophagectomy.

Results
Patients of EOF group showed significantly shorter time from the surgery to the appearance of first flatus (2.1 ± 0.8 d vs 3.4 ± 1.2 d, P &lt; 0.001) and bowel movement (3.2 ± 0.9 d vs. 5.5 ± 1.5 d, P &lt; 0.001) than those of LOF group. Patients of EOF showed increased levels of serum gastrin (P = 0.007) and motilin (P = 0.027) but decreased levels of somatostatin (P = 0.004) and cholecystokinin (P = 0.028) than patients of LOF group based on the repeated measurements on postoperative day 1, 3, and 5. Multivariable analysis demonstrated the EOF (vs. LOF) as a protective factor for delayed recovery of gastrointestinal function.

Conclusion
The postoperative EOF was demonstrated to accelerate the recovery of gastrointestinal function in esophageal cancer patients from the levels of clinical manifestation and hormone secretion. The EOF was anticipated to be highlighted in promoting perioperative managements.
655 EVALUATION OF THE MODIFIED DOR TECHNIQUE FOR SURGICAL TREATMENT OF ACALASIA
Authors: Lisboa Fernando Freire , Gomes Nathan Xavier , Silva Pedro Arthur Nascimento 
Published: September 2021

Abstract

Achalasia is the main esophageal motility disorder and has a significant negative impact on the patient's quality of life. Achalasia patients have dysphagia and vomiting, often associated with chest pain, leading to significant weight loss. The treatment of achalasia should be primarily to decrease the pressure of the lower esophageal sphincter. There are different therapeutic options for the treatment, and laparoscopic myotomy is the standard treatment, despite the improvement of new techniques such as POEM.

Methods
Prospective and retrospective study carried out in a university hospital with 33 patients with achalasia, operated with the wide myotomy technique associated with modified Dor fundoplication, from January 2017 to November 2020. The diagnosis was made by clinical, endoscopic, radiological and manometric studies. Symptomatic assessment and therapeutic success were performed using the Eckardt score before and after the operation. Rezende's classification was used to classify the degree of megaesophagus. The degree of megaesophagus was correlated with the result of the technique. The results were analyzed using the IBM SPSS Statistics Version 26 software.

Results
Patients with idiopathic achalasia 28 (84.8%). Preoperative Eckardt score average 5.93 points, preoperative clinical stage I = 7 (21.2%), clinical stage II = 12 (36.4%) and clinical stage III = 14 (42.4%). 48-hour postoperative hospital stay. Average postoperative Eckardt score 0.30 points, with 32 (97%) clinical stage 0, and 1 (3%) in clinical stage I in the postoperative period. Remission rate of the disease after treatment 100%. There was no correlation between the degree of the megaesophagus with the preoperative symptoms or with the therapeutic result. There were no complications or need for reintervention. There were no reports of symptoms of GERD.

Conclusion
According to clinical, radiological and endoscopic data, the technique was considered safe and effective for the treatment and regression of achalasia symptoms in all degrees of megaesophagus in the present study. In addition, the technique was also effective as an anti-reflux mechanism, preventing the onset of symptoms of iatrogenic GERD.