scholarly journals Evaluation of the extent of damage to the esophageal wall caused by press-through package ingestion

PeerJ ◽  
2019 ◽  
Vol 7 ◽  
pp. e6763
Author(s):  
Takuya Tamura ◽  
Hajime Okamoto ◽  
Toyoaki Suzuki ◽  
Yoichi Nakanishi ◽  
Daisuke Sugiyama
Keyword(s):  
Esophageal Injury ◽  
Esophageal Wall ◽  
Esophageal Tissue ◽  
Ingested Foreign Body ◽  
Frictional Forces ◽  
Damage Depth ◽  
Degree Of Damage ◽  
Extent Of Damage ◽  
Silicon Sheet ◽  
Scratch Tests

Press-through package (PTP) is the most common accidentally ingested foreign body in Japan. Accidental ingestion of PTP can result in esophageal damage. An approach for evaluating the risk of esophageal injury has not been established. Therefore, we used porcine esophageal tissue and silicone sheets to establish a method for assessing the risk of esophageal damage on accidental PTP ingestion. We pathologically evaluated porcine lower esophageal tissue using a scratch tester. Using porcine esophageal tissue, scratch tests were performed with 4 test objects and pathological damage was compared. It was assumed that each object was accidentally ingested. The objects were polyvinylidene chloride (PVDC)-coated polyvinyl chloride (PVC) PTP, soft PThPa, round PTP, and a disposable scalpel. The porcine esophagus was replaced with a silicon sheet, and an automatic friction machine was used for quantitative evaluation. The silicon sheet was scratched using HHS 2000 with 750-g load at 50 mm/min. We investigated the frictional force exerted on the surface for each of the objects. The degree of damage (depth) was the highest for the disposable scalpel, followed by PVDC-coated PVC PTP, while the degree of damage (depth) was the lowest for soft PThPa and round PTP. The mean frictional forces on the silicon sheet were 524.0 gf with PVDC-coated PTP, 323.5 gf with soft PThPa, 288.7 gf with round PTP, and 922.7 gf with the disposable scalpel. We developed approaches to qualitatively and quantitatively evaluate the risk of esophageal damage after accidental PTP ingestion. Our findings indicate that the risk of gastrointestinal damage after accidental PTP ingestion is low with soft PTP and round PTP.

scholarly journals Esophageal injury during pulmonary vein isolation

2015 ◽  
Vol 18 (4) ◽  
pp. 188
Author(s):  
D. V. Losik ◽  
V. V. Shabanov ◽  
R. T. Kamiev ◽  
S. N. Artemenko
Keyword(s):  
Case Report ◽  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
Clinical Case ◽  
Rare Complication ◽  
Esophageal Injury ◽  
Esophageal Wall

This clinical case report shows a rare complication following pulmonary vein isolation, with the esophageal wall injured during the procedure and a hematoma developed on the wall.

scholarly journals Nonthermal Irreversible Electroporation to the Esophagus: Evaluation of Acute and Long‐Term Pathological Effects in a Rabbit Model

2021 ◽  
Author(s):  
Yue Song ◽  
Jingjing Zheng ◽  
Lianhui Fan
Keyword(s):  
Atrial Fibrillation ◽  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
Irreversible Electroporation ◽  
Rabbit Model ◽  
Muscle Layer ◽  
Esophageal Injury ◽  
Basal Cells ◽  
Esophageal Tissue ◽  
Nonthermal Irreversible Electroporation

Background Esophageal ulceration and fistula are severe complications of pulmonary vein isolation using thermal ablation. Nonthermal irreversible electroporation (NTIRE) is a promising new technology for pulmonary vein isolation in patients with atrial fibrillation. NTIRE ablation technology has been used to treat atrial fibrillation; however, the effects of NTIRE on esophageal tissue have not been clearly described. Methods and Results A typical NTIRE electrical protocol was directly applied to esophagi in 84 New Zealand rabbits. Finite element modeling and histological analysis with 120 slices were used to analyze electric field intensity distribution and subsequent tissue changes. A parameter combination of 2000 V/cm multiplied by 90 pulses output is determined to be an effective ablation parameters combination. Within 16 weeks after ablation, no obvious lumen stenosis, epithelial erythema, erosion, ulcer, or fistula was observed in the esophageal tissue. NTIRE effectively results in esophageal cell ablation to death, and subsequently, signs of recovery gradually appear: creeping replacement and regeneration of epithelial basal cells, repair and regeneration of muscle cells, structural remodeling of the muscle layer, and finally the restoration of clear anatomical structures in all layers. Conclusions Monophasic, bipolar NTIRE delivered using plate electrodes in a novel esophageal injury model demonstrates no histopathologic changes to the esophagus at 16 weeks. Data of this study suggest that electroporation ablation is a safe modality for pulsed electroporation ablation near the esophagus.

DOZ047.29: Pleural flap for partial esophageal substitution in case of difficult anastomosis

2019 ◽  
Vol 32 (Supplement_1) ◽  
Author(s):  
S De Napoli Cocci ◽  
S Faraj ◽  
A Guinot ◽  
S Joseph ◽  
D Caldari ◽  
...  
Keyword(s):  
Oral Feeding ◽  
Esophageal Reconstruction ◽  
Esophageal Wall ◽  
Parietal Pleura ◽  
Partial Reconstruction ◽  
Esophageal Tissue ◽  
Complications Of Surgery ◽  
Esophageal Substitution ◽  
Anterior Plane

Esophageal reconstruction in long-gap atresia remains challenging for the surgeon. Complications of surgery, regardless of choices and methods proposed, are frequents, sometimes serious, and can significantly delay baby's feeding, with increased disruption of orality. The ideal is a reconstruction with only esophageal tissue available. There is renewed interest for technical of elongation described initially by Foker, especially modified by Van Der Zee.1 But, elongation is not always so simple that provided. We report an observation of esophageal atresia (type 1 Ladd), treated by rapid elongation. On the sixth day of procedure, right pleurisy reveals a rip at the apex of inferior esophagus. Anastomosis was possible on the posterior plane, but impossible on the anterior plane. The anterior plane has been reconstituted with a flap of parietal pleura. The operative course was simple without any fistula. Oral feeding started at fifteenth day postanastomosis was quickly complete. Gastrostomy left by security has not been used. Three endoscopic dilations have been necessary at six weeks, two and five months after anastomosis. At the age of eleven months, the orality was perfect, and diet was diversified with pieces. Use a pleural flap to bury or isolate sutures is well known technic.2 But use only pleura to replace the esophageal wall is not described. Partial reconstruction of a hemiesophageal wall with only pleura is possible, despite difficult conditions. It is a trick easily achievable in case of difficulty, with a good result that is maintained over time.

Abstract 4648: Mechanism of Tissue Cooling With Cryoenergy Delivery to Pulmonary Veins: Tissue Temperature Distribution and Chonic Esophageal Effects

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Charles Dalegrave ◽  
Benhur D Henz ◽  
Yasuo Okumura ◽  
Mark Kolasa ◽  
Dylan V Miller ◽  
...  
Keyword(s):  
Temperature Distribution ◽  
Pulmonary Veins ◽  
Tissue Temperature ◽  
Esophageal Injury ◽  
Energy Sources ◽  
Esophageal Wall ◽  
Potential Complication ◽  
Internal Temperature ◽  
Chronic Effects ◽  
New Energy

Background: Although pulmonary vein (PV) isolation has been used to treat AF, complications create important limitations. New energy sources, including cryothermal, have been developed to minimize these complications. The purpose of this study was to evaluate the effect of PV cryoablation on esophageal (ESO) temperatures acutely and correlate them with chronic effects on the esophageal wall. Methods: A 23 mm cryoballoon was placed in the LA of 10 dogs through a 12 Fr deflectable sheath. PV and ESO temperatures (TEMP) were recorded using 7–9 thermocouples (TC) outside the PVs and on the external and internal ESO surfaces during 2 cryoablations of 4 min duration. Results : Cryoablation of 15 PV (10 RIPV and 5 LIPV) during 1.7±0.6 ablations yielded a total of 168 TC time-TEMP profiles (6.4±2.4/PV). Minimum tissue TEMP was inversely dependent on the distance of the TC from the balloon surface (Table 1 ). All PVs were isolated acutely and 14/15 (93%) chronically. Minimum TEMP achieved at the PV surface and external ESO were similar (−32±8 and −37±9 at targets within 2.5 mm from the balloon respectively [P=NS]). A TEMP decrease at the internal ESO was seen during 15 of 25 (60%) ablations, but was significantly less pronounced than the external TEMP (17.9°C±13.3 and 6.1°C±24.8 [p<0.05]) resulting in a minimum recorded internal TEMP of −6.2°C. The ESO histological examination in 5 dogs showed very limited external lesions in these dogs (depth= 2.2±1.1, width3 18.6±7.4 and length= 12±5.7 mm), but no transmural or internal ulceration, fibrosis or scarring seen. Conclusion: Although PV cryoablation decreases external ESO temperature and produces minor lesions, significant chronic disruptive tissue damage was not seen. Esophageal injury is an unlikely, but potential complication of cryoablation, with internal temperature proving unhelpful in predict negative outcome.

scholarly journals Silicone-covered biodegradable magnesium-stent insertion in the esophagus: a comparison with plastic stents

2016 ◽  
Vol 10 (1) ◽  
pp. 11-19 ◽  
Author(s):  
Yue-Qi Zhu ◽  
Kai Yang ◽  
Laura Edmonds ◽  
Li-Ming Wei ◽  
Reila Zheng ◽  
...  
Keyword(s):  
Radial Force ◽  
Tissue Reaction ◽  
Tissue Response ◽  
Esophageal Injury ◽  
Plastic Stents ◽  
Esophageal Wall ◽  
Control Group ◽  
Stent Insertion ◽  
Biodegradable Magnesium

Background: We determined the feasibility of, and tissue response to silicone-covered biodegradable magnesium- and plastic-stent insertion into the esophagus in rabbits. Methods: The mechanical compression–recovery characteristics and degradation behaviors of the magnesium stent were investigated in vitro. A total of 45 rabbits were randomly divided into a magnesium- ( n = 15) and a plastic- ( n = 15) stent group, and underwent stent insertion into the lower third of the esophagus under fluoroscopic guidance; a control group ( n = 15) did not undergo the intervention. Esophagography was performed at 1, 2, and 4 weeks. Five rabbits in each group were euthanized at each time point for histological examination. Results: Silicone-covered magnesium stents showed similar radial force to plastic stents ( p > 0.05). The magnesium stents degraded rapidly in an acidic solution, but 90.2% ± 3.1% of the residual mass was maintained after a 2-week degradation in a solution with a pH of 4.0. All stent insertions were well tolerated. Magnesium stents migrated in six rabbits (one at 1 week, one at 2 weeks and four at 4 weeks), and plastic stents migrated in three rabbits (one at 2 weeks and two at 4 weeks; p > 0.05). Esophageal wall remodeling (thinner epithelial and smooth muscle layers) was similar in both stented groups ( p > 0.05), and the esophagus wall was found to be significantly thinner in the stented groups than in the control group ( p < 0.05). Esophageal injury and collagen deposition following stent insertion were similar and did not differ from the control group ( p > 0.05). Conclusions: Esophageal silicone-covered magnesium stents provided reliable support for at least 2 weeks, with acceptable migration rates and without causing severe injury or tissue reaction compared with plastic stents.

Reliability of three sites for measuring fat depth on the beef carcass

1989 ◽  
Vol 29 (2) ◽  
pp. 165 ◽  
Author(s):  
DL Hopkins
Keyword(s):  
The Other ◽  
Marked Variation ◽  
Biplot Analysis ◽  
Beef Carcasses ◽  
Degree Of Damage ◽  
Extent Of Damage ◽  
Beef Carcass

Over a 12-month period, damage at the P8 rump and 12thl13th rib sites was evaluated on 10 968 beef carcasses at 4 Tasmanian abattoirs. Damage at the 8th/9th rib site was monitored on 507 carcasses at 1 abattoir for 3 months. A biplot analysis showed a marked variation between and within abattoirs for the extent of damage at the P8 and 12th/ 13th rib sites. This demonstrated that the length of time over which evaluations were made was likely to influence subsequent interpretations. However, the percentage of carcasses measurable on one or other of the sides exceeded 90% for both the P8 and 12th/13th rib sites, with no evidence that 1 site was more reliable than the other. Factors such as worker technique influenced the extent of damage, demonstrating that conscientious management could reduce the problem. The method of mechanical hide removal was not found to have a bearing on the degree of damage. Under the conditions of this study, the extent of damage and difficulty of measurement precludes the use of the 8th/9th rib site as an alternative for measuring fat depth.

scholarly journals Endoscopic Management of Double Esophageal Perforation by Ingested Foreign Body Using Over-the-Scope Clip: A Case Report

2020 ◽  
Vol 11 (02) ◽  
pp. 153-155
Author(s):  
Prasanta Debnath ◽  
Pravin Rathi ◽  
Sujit Nair ◽  
Suhas Udgirkar ◽  
Sanjay Chandnani
Keyword(s):  
Case Report ◽  
Foreign Body ◽  
Pleural Effusion ◽  
Esophageal Perforation ◽  
Endoscopic Management ◽  
Esophageal Wall ◽  
Threatening Condition ◽  
Life Threatening ◽  
Ingested Foreign Body ◽  
Over The Scope Clip

AbstractEsophageal perforation is a life-threatening condition with a high mortality rate. First described around 300 years ago, management of this fatal condition has emerged from surgical to endoscopic modalities with much less morbidity and mortality when instituted early. We present this case of 55-year-old male, with double esophageal perforation by meat bone, perforating lower esophageal wall, leading to localized hydropneumothorax on right side with mild bilateral pleural effusion managed endoscopically with Over-the-Scope-Clip. Endoscopic management of esophageal perforation has been well mentioned in literature, without any mention of such management in case of double esophageal perforation. Surgery with or without endoscopy remains the main stay of management of such cases.

Technical Aspects in Esophageal Lengthening: An Investigation of Traction Procedures and Suturing Techniques in Swine

2018 ◽  
Vol 29 (05) ◽  
pp. 481-484 ◽  
Author(s):  
Christina Oetzmann von Sochaczewski ◽  
Evangelos Tagkalos ◽  
Andreas Lindner ◽  
Hauke Lang ◽  
Axel Heimann ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Mechanical Stability ◽  
Breaking Strength ◽  
Esophageal Wall ◽  
Dorsal Wall ◽  
Technical Aspects ◽  
Usp 4 ◽  
Esophageal Tissue ◽  
Traction Suture ◽  
Suturing Techniques

Introduction Traction procedures are useful to preserve the child's own esophagus in long-gap forms of esophageal atresia. To date, it remains unclear what suture size or position of the traction sutures is optimal to account for differences in anatomy and to reduce the risk of traction sutures being torn out of the esophageal tissue. Materials and Methods Explanted porcine esophagi (from swine aged 100–120 days and weighing 100–120 kg) were divided at the carinal level. Traction sutures were either placed circumferentially or only in the dorsal wall and the breaking strength—circumferential disruption of the muscular layer—was measured. Suture size (USP 4–0 vs. 5–0) was also evaluated in a similar way. Results Neither traction suture position did not influence breaking strengths between circumferentially placed traction sutures or those exclusively placed in the dorsal esophageal wall (Δ = 0.47 N, 95% confidence interval: −2.83 to 3.76 N, p = 0.771, n = 11 per group) nor differing suture sizes of USP 4–0 and USP 5–0 (Δ = 1.46 N, 95% confidence interval: −3.2 to 0.28 N, p = 0.0946, n = 9 per group) affected breaking strengths. Conclusion Suture size and suture positioning do not affect mechanical stability in Foker's procedure and therefore can be adapted as needed according to patient's anatomy and size.

scholarly journals Building damage in the Reefton area

1969 ◽  
Vol 2 (1) ◽  
pp. 130-134
Author(s):  
D. I. D. Bird ◽  
S. C. Gentry ◽  
J. P. Hollings
Keyword(s):  
Building Damage ◽  
The South ◽  
Very Old ◽  
Mining Town ◽  
Poor Condition ◽  
Property Owner ◽  
South West ◽  
Degree Of Damage ◽  
Area North ◽  
Extent Of Damage

This paper covers building damage occurring in the area between Inangahua Landing (approximately 14 miles north of Reefton,) Reefton itself and down to Totara Flat (approximately 16 miles south-west of Reefton). Reefton is an old mining town on the upper reaches of the Inangahua River some 20 miles above and to the south of Inangahua itself. It is administered as a County Town. The township of Reefton and in fact practically all structures in the area were situated on alluvial river flats, a fact of some significance in the damage observed. Almost without exception every property owner in the area suffered some damage.
The degree of damage was greatest in the Rotokehu area, north of Reefton, but the extent of damage was of course greatest in the Reefton Township. There were in all some 665 claims against the Earthquake and War Damage Commission totalling some $205,000. There were few structures of significance and most buildings in the area were old or very old, but a number of new structures have been built in the last few years. On account of age and arrears of maintenance many buildings in the area were in poor condition before the earthquake, although their age indicates they must have survived previous earthquakes.

Analyses of normal and abnormal esophageal transport using computer simulations

1994 ◽  
Vol 266 (4) ◽  
pp. G525-G543 ◽  
Author(s):  
M. Li ◽  
J. G. Brasseur ◽  
W. J. Dodds
Keyword(s):  
Computer Simulations ◽  
Circular Muscle ◽  
Major Elements ◽  
Intraluminal Pressure ◽  
Esophageal Wall ◽  
Main Body ◽  
Rapid Rise ◽  
Correct Model ◽  
Frictional Forces ◽  
The Mathematical Model

Mathematical modeling and computer simulations are combined with concurrent manometric and videofluoroscopic data to analyze the contractile behavior of the esophageal wall during normal and abnormal esophageal bolus transport. The study focuses on axial variations in intraluminal pressure in relationship to deformations of the esophageal wall during the transport process. Four case studies of esophageal bolus transport described by Kahrilas et al. (Gastroenterology 94: 73-80, 1988), one normal and three abnormal, are analyzed in detail by capturing the major elements of both the videofluoroscopic and concurrent manometric data in the mathematical model. In all cases a strong correlation between the deformations of the luminal wall and the axial variations of intraluminal pressure is observed. Simulation of normal bolus transport shows that, whereas only gentle variations in intrabolus pressure occur in the main body of the bolus due to weak frictional forces there, large frictional forces force a rapid rise in pressure near the bolus tail induced by circular muscle squeeze. Of particular interest is the analysis of incomplete clearance of bolus fluid in the aortic arch region. The only physically correct model consistent both with the videofluoroscopic and the manometric data implies the existence of two separate contraction waves, one above and one below the transition zone.(ABSTRACT TRUNCATED AT 250 WORDS)

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