Intrahepatic Duct Incision and Closure for the Treatment of Multiple Cholelithiasis in a Dog.

This report describes the successful intrahepatic duct incision and closure for the treatment of multiple cholelithiasis in a dog with untreated hypothyroidism. A 12-year-old spayed female Spitz dog weighing 11.3 kg was diagnosed with multiple cholelithiasis, and a quadrate liver lobectomy and cholecystectomy were performed. Large gallstones were located in the left liver lobe's intrahepatic duct distal to the anastomosis of the intrahepatic ducts of the left medial and lateral lobes. The dilated intrahepatic duct was packed off with wet gauze, and incision and closure were performed on the most dilated section, which was proximal to the largest gallstone. After surgery, the patient showed normal liver function and was discharged with normal total bilirubin and C-reactive protein levels. On postoperative day 83, no stones were observed in the dilated common bile duct (CBD), and the degree of dilatation of the CBD had decreased from 9 mm to 4 mm, with no obstructions. Right intrahepatic gallstones were confirmed without dilatation. Hypothyroidism was managed medically. Hepatic duct incision and closure can be performed in dogs with multiple cholelithiasis. Although not the first option, intrahepatic bile duct incision proves to be a new alternative for the successful treatment of cholelithiasis in dogs.

Cystadenocarcinoma of the intrahepatic bile duct in a dog.

A 14-year-old spayed female Shih-Tzu was referred to the Veterinary Medical Teaching Hospital of Konkuk University for evaluation of an abdominal mass. In diagnostic imaging, two large cystic masses were identified. The affected liver lobes were surgically resected, and the specimens were submitted for histopathological evaluation and immunohistochemical staining. The two cystic lesions were diagnosed as biliary cystadenocarcinoma (BCAC). Recurrence and regional invasion were identified on ultrasonography 36 days postoperatively. The patient died on postoperative day 271. To the best of our knowledge, previously reported case studies of BCAC in dogs presented limited clinical information. In this report, we present a detailed picture comprising a range of clinical information and histopathological examination of BCAC in a dog.

Understanding inactivation of Listeria monocytogenes and Escherichia coli O157:H7 inoculated on romaine lettuce by emulsified thyme essential oil.

Effects of thyme essential oil (TEO) emulsion (TEE) with cationic charge formulated using cetylpyridinium chloride (CPC) on attachment strength and inactivation of Listeria monocytogenes and Escherichia coli O157:H7 on romaine lettuce surface were examined in this study. Regardless of the inoculation time (2 h and 24 h), pathogen attachment was stronger on the adaxial surface of the romaine lettuce than on the abaxial surface because of the lower roughness of the former. Moreover, attachment strength increased with increasing inoculation time. TEE washing had the strongest inhibitory effect on pathogen attachment at 2 h when compared with that of TEO, CPC, and sodium hypochlorite (SH), demonstrating a 3.32 and 2.53 log-reduction in the size of the L. monocytogenes and E. coli O157:H7 populations, respectively, compared to the control samples. Additionally, the TEE washing effects were maintained even after inoculation for 24 h, and it decreased attachment to adaxial surface of the samples. These results indicate that TEE could be a good alternative to SH in improving the microbiological safety of romaine lettuce.

Evaluation of Clinical Performance of TiNi-Based Implants Used in Chest Wall Repair after Resection for Malignant Tumors.

In this study, we assessed the outcomes after surgical treatment of thoracic post-excision defects in 15 patients, using TiNi knitted surgical meshes and customized artificial TiNi-based ribs. METHODS: Eight patients were diagnosed with advanced non-small cell lung cancer (NSCLC) invading the chest wall, of which five patients were T3N0M0, two were T3N1M0, and one was T3N2M0. Squamous cell carcinoma was identified in three of these patients and adenocarcinoma in five. In two cases, chest wall resection and repair were performed for metastases of kidney cancer after radical nephrectomy. Three-dimensional CT reconstruction and X-ray scans were used to plan the surgery and customize the reinforcing TiNi-based implants. All patients received TiNi-based devices and were prospectively followed for a few years. RESULTS: So far, there have been no lethal outcomes, and all implanted devices were consistent in follow-up examinations. Immediate complications were noted in three cases (ejection of air through the pleural drains, paroxysm of atrial fibrillation, and pleuritis), which were conservatively managed. In the long term, no complications, aftereffects, or instability of the thoracic cage were observed. CONCLUSION: TiNi-based devices used for extensive thoracic lesion repair in this context are promising and reliable biomaterials that demonstrate good functional, clinical, and cosmetic outcomes.

Prognostic Value of the Anatomic Region of Metastatic Lymph Nodes in the Current TNM Staging of Gastric Cancer.

PURPOSE: The numeric N stage has replaced the topographic N stage in the current tumor node metastasis (TNM) staging in gastric carcinoma. However, the usefulness of the topographic N stage in the current TNM staging system is uncertain. We aimed to investigate the prognostic value of the topographic N stage in the current TNM staging system. MATERIALS AND METHODS: We reviewed the data of 3350 patients with gastric cancer who underwent curative gastrectomy. The anatomic regions of the metastatic lymph nodes (MLNs) were classified into 2 groups: perigastric and extra-perigastric. The prognostic value of the anatomic region was analyzed using a multivariate prognostic model with adjustments for the TNM stage. RESULTS: In patients with lymph node metastasis, extra-perigastric metastasis demonstrated significantly worse survival than perigastric metastasis alone (5-year survival rate, 39.6% vs. 73.1%, respectively, P<0.001). Extra-perigastric metastasis demonstrated significantly worse survival within the same pN stage; the multivariate analysis indicated that extra-perigastric metastasis was an independent poor prognostic factor (hazard ratio=1.33; 95% confidence interval=1.01-1.75). The anatomic region of the MLNs improved the goodness-of-fit (likelihood ratio statistics, 4.57; P=0.033) of the prognostic model using the TNM stage. CONCLUSIONS: The anatomic region of MLNs has an independent prognostic value in the numeric N stage in the current TNM staging of gastric carcinoma.

Treatment Modality Based Survival in Gastric Carcinoma Patients with Stand-Alone Peritoneal Metastasis: a Case-Control Study.

PURPOSE: To date, there are no promising treatments for gastric carcinoma with peritoneal metastasis. Some researchers have suggested a survival benefit of gastrectomy in select patients. This study investigated the survival of gastric carcinoma patients with stand-alone peritoneal metastasis according to the type of treatment modality. MATERIALS AND METHODS: We reviewed the data of 132 patients with gastric carcinoma and stand-alone peritoneal metastasis. We performed gastrectomy when the primary tumor was deemed resectable and systemic chemotherapy was administered. We analyzed patient survival according to the type of treatment, and the prognostic value of gastrectomy was evaluated in univariate and multivariate models. RESULTS: Among all patients, 70 underwent gastrectomy plus chemotherapy, 20 underwent gastrectomy alone, 36 underwent chemotherapy alone, and 6 received supportive care. The median patient survival was 13 months. Patients who underwent gastrectomy had significantly longer survival than those who did not undergo gastrectomy (14 vs. 8 months, P<0.001). Patients who received chemotherapy showed significantly longer survival than those who did not (13 vs. 7 months, P=0.032). Patients who underwent gastrectomy plus chemotherapy showed better survival than those who underwent other treatments. In multivariate analysis, gastrectomy was found to be an independent prognostic factor (hazard ratio, 0.52; 95% confidence interval, 0.33-0.82) in addition to chemotherapy. CONCLUSIONS: Our study showed that patients who underwent gastrectomy plus chemotherapy had the best survival. Although the survival benefit of gastrectomy remains uncertain, it is a favorable prognostic indicator in patients with stand-alone peritoneal metastasis.

Fertility-Sparing Surgery Using Knitted TiNi Mesh Implants and Sentinel Lymph Nodes: A 10-Year Experience.

OBJECTIVES: The aim of this cohort study is to improve the procedure of fertility-sparing surgery and to assess oncological and reproductive follow-up outcomes after radical trachelectomy (RT) for cervical cancer (T1a2-1bNxM0). METHODS: We have suggested the method combining sentinel lymph nodes (SLNs) and cervicoisthmic cerclage using a superelastic knitted TiNi mesh (KTNM) implant to facilitate the primary biomechanical/retention function of the uterus. Sixty-eight consented patients, who underwent fertility-sparing surgery using both transabdominal and laparoscopic route from 2009 through 2019, were recruited in the study and prospectively followed for a mean of 69 months. RESULTS: There were no intraoperative or postoperative complications. No cervical stenoses or mesh failures were noted in all cases. The 5-year overall and recurrence-free survival rates were 100% and 97%, respectively. Two patients indicated recurrence, it occurred in 3 and 36 months. There were 19 (28%) spontaneous pregnancies, 6 resulted in full-term delivery, whereas 2 and 11 ended in miscarriage and early abortion, respectively. CONCLUSIONS: This sparing-surgery technique is turned out to be feasible and efficient as allows to achieve well oncologic and fertility outcomes, mimicking the effect of the cervix. It complements existing surgical approaches and may provide further insight into how to overcome challenges even in aggravated cases or previously failed procedures.

The benefits of enhanced recovery after surgery for gastric cancer: A large before-and-after propensity score matching study.

BACKGROUND & AIMS: The benefits of enhanced recovery after surgery (ERAS) in patients undergoing gastrectomy have been reported in several studies; however, there is limited evidence supporting the efficacy of ERAS in clinical settings. We aimed to identify the benefits of ERAS in the clinical setting by investigating short-term surgical outcomes before and after the implementation of ERAS in patients who underwent gastrectomy. METHODS: We searched our gastric cancer database from 2008 to 2018 to identify patients who underwent gastrectomy before ERAS was implemented (2008-2009) and after the final version of ERAS was implemented (2016-2018). We enrolled 424 patients who were treated before ERAS was implemented and 565 patients who received our completed version of ERAS. After propensity score matching, each group included 219 patients, and short-term surgical outcomes were compared between the two groups. RESULTS: The length of hospital stay was significantly shorter in the ERAS group (8.8 vs. 11.5 days, p = 0.001), but the readmission rates were similar in the two groups, at 2.3%. There were no significant differences in morbidity, mortality, and complications of ≥ grade III between the groups. Of the complications, intra-abdominal bleeding (0% vs. 4.1%, p = 0.002) and intra-abdominal abscess (0% vs. 2.7%, p = 0.038) were significantly lower, whereas postoperative ileus was significantly higher in the ERAS group (8.6% vs. 0.5%, p < 0.001). In subgroup analyses by age, operative approach, and the extent of gastric resection, the ERAS group experienced a shorter hospital stay without increased readmission in all subgroups. CONCLUSIONS: These results demonstrated that ERAS was associated with a 3-day reduction in hospital stay without increased readmission after gastrectomy. This study validated the benefits of ERAS in the clinical setting of gastrectomy.

Structural Relationship among Physical Self-Efficacy, Psychological Well-Being, and Organizational Citizenship Behavior among Hotel Employees: Moderating Effects of Leisure-Time Physical Activity.

Critics argue that service firms should pay more attention to human resource management's psychological and voluntary aspects to contribute to overall organizational development. The purpose of this study was to investigate the effects of physical self-efficacy on the psychological well-being and organizational citizenship behavior among hotel employees and the moderating effects of leisure-time physical activity on the relationships between the previously mentioned variables. To achieve the research purpose, 346 hotel employees working at the room, food, beverage, and kitchen departments of 10 hotels located in Seoul, South Korea, participated in the study. The researchers visited their department meetings and provided a brief description of the present study and informed consent forms to participate in the study. After obtaining written informed consent forms, the researchers distributed the surveys and asked participants to complete them. Several statistical analyses, including descriptive statistics, confirmatory factor analysis (CFA) for examining the hypothesized model's psychometric properties, and structural equation modeling (SEM) for testing the hypotheses were conducted using SPSS Ver. 23.0 and AMOS 23.0. Results revealed that perceived physical ability and self-presentation confidence, and psychological well-being positively affected organizational citizenship behavior. Perceived physical ability also had a positive effect on psychological well-being. Lastly, leisure-time physical activity had a partial moderating role in the relationships between the variables mentioned above. This study suggests that promoting employees' participation in leisure-time physical activity is needed to improve service workers' organizational citizenship behavior via physical self-efficacy and psychological well-being enhancement.

Comparison of long term survival outcomes between D1+ and D2 lymph node dissection for ≥ pT2 or pN+ gastric carcinoma: A large scale case-control study using propensity score matching.

BACKGROUND: D2 lymph node dissection (LND) is a widely performed as a standard procedure for advanced gastric cancer (AGC). However, there is little evidence supporting D2 over D1+ LND for gastric cancer treatment. This study compared the long-term outcomes of D2 and D1+ LND for AGC. METHODS: We retrospectively reviewed data on 1121 patients who underwent curative distal gastrectomy and had pathologic stage of ≥ pT2 or pN+. The patients were categorized into the D1+ and D2 LND groups, and long-term survival was compared in the original and propensity score matching (PSM) cohorts. RESULTS: Overall, 909 and 212 patients underwent D2 and D1+ LND, respectively. The D2 group showed more advanced stage and more frequently underwent open surgery. Postoperative morbidity was significantly higher in the D2 group (19.5% vs. 13.2%, p = 0.034); however, mortality or ≥ grade III complications did not significantly differ between the groups. The 5-year overall survival (OS) and disease-free survival (DFS) did not significantly differ between D2 and D1+ groups at the same stage. Multivariate analysis of prognostic factors revealed that the extent of LND did not significantly affect survival, after adjusting for tumor stage and other clinicopathological factors. In the PSM cohort, the D2 and D1 groups showed no significant difference in OS (p = 0.488) and DFS (p = 0.705). CONCLUSIONS: Long-term survival with D1+ LND was comparable to that with D2 LND for ≥ pT2 or pN + gastric carcinoma. A large randomized trial is warranted to validate the optimal extent of LND for gastric carcinoma.

Reduced anastomotic complications with intracorporeal esophagojejunostomy using endoscopic linear staplers (overlap method) in laparoscopic total gastrectomy for gastric carcinoma.

BACKGROUND: With advances in surgical technique and instrumentation, intracorporeal anastomosis is increasingly being performed for laparoscopic total gastrectomy (LTG). However, the benefits of intracorporeal anastomosis in reducing postoperative complications have not been demonstrated, although its technical feasibility has been proven in many studies. In this study, we investigated the impact of intracorporeal anastomosis in reducing postoperative complications after LTG. METHODS: We analyzed 410 consecutive gastric cancer patients who underwent LTG between 2008 and 2018. Of these, 118 underwent intracorporeal anastomosis using linear staplers (overlap method), while 292 underwent extracorporeal anastomosis using a circular stapler. Short-term surgical outcomes including postoperative complications were compared between the two groups. RESULTS: The two groups showed no significant differences in age, sex, comorbidity, and abdominal surgery history. D2 lymph node dissection was more frequently performed in the intracorporeal group because of the presence of more advanced cancer stages. The overall morbidity in the intracorporeal and extracorporeal group was 23.7% and 27.7%, respectively (p = 0.405). However, the intracorporeal group showed a significantly lower incidence of late complications (0.8% vs. 7.5%, p = 0.008). Concerning complications, the incidence of anastomotic bleeding (0% vs. 5.5%, p = 0.008) and anastomotic stenosis (0% vs. 4.5%, p = 0.024) was significantly lower in the intracorporeal group. In univariate and multivariate analyses, American Society of Anesthesiologists score and operative bleeding were independent predictive factors for postoperative complications in patients who underwent intracorporeal anastomosis. CONCLUSIONS: Intracorporeal anastomosis using linear staplers reduced anastomotic bleeding and stenosis compared to extracorporeal anastomosis after LTG. Future research will be required to determine the ideal method for intracorporeal anastomosis in LTG.

Prognostic Performance of Preoperative Staging: Assessed by Using Multidetector Computed Tomography-Between the New Clinical Classification and the Pathological Classification in the Eighth American Joint Committee on Cancer Classification for Gastric Carcinoma.

BACKGROUND: Since the eighth American Joint Committee on Cancer (AJCC) classification recently introduced the clinical classification for preoperative staging of gastric cancer, the new clinical classification has not been extensively validated yet. Therefore, in this study, we compared the prognostic performance of the new clinical classification and the pathologic classification for preoperative staging of gastric cancer. METHODS: We reviewed 3027 patients with gastric cancer who were surgically treated between 2009 and 2013. Patient survival was analyzed according to the preoperative stage by the clinical classification and the pathologic classification in the eighth AJCC classification. The prognostic performance was examined using the Akaike information criterion (AIC) value and Harrell c-index. RESULTS: Patient survival was significantly different across the different stages when both classifications were used. However, individual pairwise comparisons showed that survival differences between each stage were more distinctive and homogeneous in the pathologic classification. In the multivariate model adjusted for the final pathologic stage, preoperative staging by the pathologic classification was an independent prognostic factor, whereas the clinical classification was not. The pathologic classification showed a lower AIC value compared with the clinical classification (5100.64 vs. 5114.14). The Harrell c-index was higher in the pathologic classification than in the clinical classification (0.741 vs. 0.739). CONCLUSIONS: The new clinical classification in the eighth AJCC classification discriminates patient survival well. However, it does not appear to have a better prognostic performance compared with the pathologic classification for preoperative staging of gastric cancer.

Abdominal Drainage in the Prevention and Management of Major Intra-Abdominal Complications after Total Gastrectomy for Gastric Carcinoma.

PURPOSE: The role of prophylactic abdominal drainage in total gastrectomy is not well-established. This study aimed to evaluate the efficacy of abdominal drainage in the prevention and management of major intra-abdominal complications after total gastrectomy for gastric carcinoma. MATERIALS AND METHODS: We retrospectively reviewed the data of 499 patients who underwent total gastrectomy for gastric carcinoma in a high-volume institution. The patients were divided into drainage and non-drainage groups and compared for the development and management of major intra-abdominal complications, including anastomotic leak, abdominal bleeding, abdominal infection, and pancreatic fistulas. RESULTS: The drainage group included 388 patients and the non-drainage group included 111 patients. The 2 groups showed no significant differences in clinicopathological characteristics or operative procedures, except for more frequent D2 lymphadenectomies in the drainage group. After surgery, the overall morbidity (drainage group vs. non-drainage group: 24.7% vs. 28.8%, P=0.385) and incidence of major intra-abdominal complications (6.4% vs. 6.3%, P=0.959) did not significantly differ between the two groups. The non-drainage group showed no significant increase in the incidence rate of major intra-abdominal complications in the subgroups divided by age, sex, comorbidity, operative approach, body mass index, extent of lymphadenectomy, and pathological stage. Abdominal drainage had no significant impact on early diagnosis, secondary intervention or reoperation, or recovery from major intra-abdominal complications. CONCLUSIONS: Prophylactic abdominal drainage showed little demonstrable benefit in the prevention and management of major intra-abdominal complications of total gastrectomy for gastric carcinoma.

Repair of Orbital Post-Traumatic Wall Defects by Custom-Made TiNi Mesh Endografts.

Repairs of orbital post-traumatic and extensive malignant defects remain a major surgical challenge, in view of follow-up outcomes. Incorrect surgical management of injured facial structures results in cosmetic, ophthalmic, and social aftereffects. A custom-made knitted TiNi-based mesh (KTNM) endograft was employed to overcome post-surgical complications and post-resected lesions of the orbital area. Preoperative high-resolution computed tomography (CT) imaging and CAD modelling were used to design the customized KTNM in each case. Twenty-five patients underwent surgery utilizing the suggested technique, from 2014 to 2019. In all documented cases, resolution of the ophthalmic malfunction was noted in the early period. Follow-up observation evidenced no relapsed enophthalmos, hypoglobus, or diplopia as late complications. The findings emanating from our clinical observations allow us to claim that the KTNM indicated a high level of biocompatibility. It is simply modified intraoperatively to attach any desired shape/size for implantation and can also be screw-fixed, providing a good supporting ability. The KTNM precisely renders orbitozygomatic outlines and orbital floor, thus recovering the anatomical structure, and is regarded as an attractive alternative to Ti-based meshes and plates. Additionally, we report one of the studied cases, where good functional and cosmetic outcomes have been achieved.

Feasibility of No Prophylactic Antibiotics Use in Patients Undergoing Total Laparoscopic Distal Gastrectomy for Gastric Carcinoma: a Propensity Score-Matched Case-Control Study.

PURPOSE: Laparoscopic surgery is associated with lower surgical site infection (SSI) rates due to minimal skin incision and non-exposure of visceral organs. Most previous studies have analyzed the efficacy of prophylactic antibiotic use in open surgery. Here, we investigated the feasibility of total laparoscopic distal gastrectomy (TLDG) for gastric carcinoma without prophylactic antibiotic use. MATERIALS AND METHODS: Seventy-one patients who underwent TLDG without prophylactic antibiotic use were 1:1 propensity score matched with 393 patients who underwent TLDG with antibiotic prophylaxis. The short-term surgical outcomes, including SSI rates, were compared between the groups. RESULTS: After matching, 65 patients were selected in each group. The baseline clinicopathological characteristics were well balanced in the matched sample. In the matched group, there was no significant increase in postoperative morbidity in the non-prophylactic group compared with the prophylactic group (18.5% vs. 15.4%, P=0.640), and there were no grade 3≤ complications (1.4% vs. 0%, respectively; P=1.000). The SSI rates in the non-prophylactic and prophylactic groups were 3.1% and 1.5%, respectively (P=0.559). The time to gas passage, diet initiation, and mean hospital stay were not significantly different between the 2 groups. The SSI rate did not increase in the non-prophylactic group in the different subgroups based on different clinicopathological characteristics. CONCLUSIONS: Postoperative morbidity, including SSI rates, did not significantly increase in patients undergoing TLDG without prophylactic antibiotic use. A large prospective randomized trial is warranted to reappraise the efficacy of prophylactic antibiotic use in patients undergoing TLDG.

Surfactant type affects the washing effect of cinnamon leaf essential oil emulsion on kale leaves.

With increasing foodborne illness associated with fresh-cut produce, a chemical sanitizer to substitute chlorine is needed in the food industry. This study examined the washing effect of cinnamon leaf essential oil (CL-EO) emulsions on fresh-cut produce according to the ionic properties of surfactants. Washing effect of CL-EO emulsion (CLC) with cetylpyridinium chloride was the highest among all treatments on kale leaves. After CLC treatment, 1.83 and 1.54 log reductions against Listeria monocytogenes and Escherichia coli O157:H7 were achieved, respectively, compared to washing with distilled water, and had about 0.6 log-reductions higher than NaOCl treatment. CL-EO droplets in CLC had a positive ζ-potential (+55 mV) compared to other emulsions. These results indicate that ionic properties of surfactants are very important in the washing effect of CL-EO emulsion. Additionally, CLC treatment did not affect the quality of kale leaves during storage. Therefore, CLC can be an effective chemical sanitizer for washing kale leaves.

Combined effect of a positively charged cinnamon leaf oil emulsion and organic acid on the inactivation of Listeria monocytogenes inoculated on fresh-cut Treviso leaves.

This study was performed to examine the inhibitory effect of combined treatments with a positively charged cinnamon leaf oil (P-CL) emulsion and various organic acids against Listeria monocytogenes inoculated on fresh-cut Treviso leaves. Combined treatments with a P-CL emulsion and an organic acid exhibited a higher inhibitory effect than treatment with each alone or NaOCl. The highest inhibitory effect was achieved by combined treatment with the P-CL emulsion and lactic acid (LA), which showed a 2.85-log reduction compared to distilled water washing. In addition, the inhibitory effect of the combined treatment was maintained during 6 days of subsequent storage, and showed a 3.24-3.39-log reduction compared to unwashed samples. Treviso leaves treated with the P-CL emulsion and LA also maintained their sensorial properties, including appearance, odor, hardness, freshness, and overall acceptability, during subsequent storage. Therefore, combined treatment with a P-CL emulsion and LA can be used to effectively ensure the microbial safety and organoleptic quality of fresh-cut Treviso leaves.

Antibacterial activities of a cinnamon essential oil with cetylpyridinium chloride emulsion against Escherichia coli O157:H7 and Salmonella Typhimurium in basil leaves.

This study examined the antibacterial activities of two different cinnamon essential oil emulsions against Escherichia coli O157:H7 and Salmonella Typhimurium on basil leaves. Cinnamon oil (0.25%) treatments containing CPC (0.05%) exhibited greater effects on the pathogenic bacteria than cinnamon oil treatment without this emulsifier (p < 0.05). Treatment with cinnamon bark and leaf oil emulsions (CBE and CLE, respectively) reduced the populations of E. coli O157:H7 by 4.10 and 5.10 log CFU/g, and S. Typhimurium by 2.71 and 2.82 log CFU/g, respectively. Scanning electron micrographs showed morphological changes in the two pathogenic bacteria following emulsion treatment. In addition, there was no difference in the color or ascorbic acid content of the basil leaves by the emulsion treatment. These results suggest that CBE or CLE treatment can be an effective way to ensure the microbial safety of minimally processed vegetables and a good alternative to chlorination treatment in the fresh produce industry.

Comparison of the short-term outcomes of reduced-port laparoscopic surgery and conventional multiport surgery in colon cancer: a propensity score matching analysis.

PURPOSE: The feasibility of reduced-port laparoscopic surgery (RPS) in colon cancer remains uncertain. This study aimed to compare the short-term outcomes of RPS and multiport surgery (MPS) in colon cancer using propensity score matching analysis. METHODS: A total of 302 patients with colon cancer who underwent laparoscopic anterior resection (AR) (n = 184) or right hemicolectomy (RHC) (n = 118) by a single surgeon between January 2011 and January 2017 were included. Short-term outcomes were compared between RPS and MPS. RESULTS: Seventy-three patients in the AR group and 23 in the RHC group underwent RPS. After propensity score matching, the RPS and MPS groups showed similar baseline characteristics. In the AR group, patients who underwent RPS (n = 72) showed a shorter operation time (114.4 ± 28.7 minutes vs. 126.7 ± 34.5 minutes, P = 0.021) and a longer time to gas passage (3.6 ± 1.7 days vs. 2.6 ± 1.5 days, P = 0.005) than MPS (n = 72). Similarly, in the RHC group, the operation time was shorter (112.6 ± 26.0 minutes vs. 146.5 ± 31.2 minutes, P = 0.005), and the time to first flatus was longer (2.7 ±1.1 days vs. 3.8 ± 1.3 days, P = 0.004) in the RPS group (n = 23) than in the MPS group (n = 23). Other short-term outcomes were similar for RPS and MPS in both the AR and RHC groups. CONCLUSION: The short-term outcomes of RPS were found to be acceptable compared to those of MPS in colon cancer surgery.

Improving the Microbial Safety of Fresh-Cut Endive with a Combined Treatment of Cinnamon Leaf Oil Emulsion Containing Cationic Surfactants and Ultrasound.

Endive is widely consumed in a fresh-cut form owing to its rich nutritional content. However, fresh-cut vegetables are susceptible to contamination by pathogenic bacteria. This study investigated the antibacterial activities of the combined treatment of cinnamon leaf oil emulsion containing cetylpyridinium chloride or benzalkonium chloride (CLC and CLB, respectively) as a cationic surfactant and ultrasound (US) against Listeria monocytogenes and Escherichia coli O157:H7 on endive. The combined treatment of CLC or CLB with US reduced the population of L. monocytogenes by 1.58 and 1.47 log colony forming units (CFU)/g, respectively, and that of E. coli O157:H7 by 1.60 and 1.46 log CFU/g, respectively, as compared with water washing treatment. The reduction levels of both pathogens were higher than those observed with 0.2 mg/ml sodium hypochlorite. In addition, the combined treatment showed no effect on the quality of the fresh-cut endive (FCE). In particular, the degree of browning in FCE was less for the treatment group than for the control and water washing treatment groups. Thus, cationic surfactant-based cinnamon leaf oil emulsions combined with US may be an effective washing treatment for the microbial safety of FCE.