Anti-reflux mucosectomy with band ligation in the treatment of refractory gastroesophageal reflux disease.

For patients with refractory gastroesophageal reflux disease (rGERD), the American Society for Gastrointestinal Endoscopy recommends surgical treatment such as fundoplication to reduce the diameter of the cardia [1]. Several endoscopic treatments are described using new devices, but they suffer from a lack of feasibility and high costs [2]. Anti-reflux mucosectomy (ARMS) could also narrow the esophagogastric junction (EGJ) as a result of tissue shrinkage induced during cicatrization [3] [4]. We applied this technique using band ligation (ARMS-b) in the management of rGERD. [...

Effect of seeding date on winter canola (Bassica napus L.) yield and oil quality in southern Ontario

Winter canola or winter oilseed rape (Brassica napus L.) is not commonly grown in Canada. While winter oilseed rape is the dominant growth form in Europe, Canadian canola production is dominated by spring types in western Canada. Research conducted in the 1980s indicated that the environmental conditions in southern Ontario are well suited to the production of winter canola. Since then, however, interest in the crop has ebbed and little to no research has been conducted on the agronomic issues that potentially limit its adoption in the province. The objective of this research was to identify an optimal seeding date for winter canola in southern Ontario. Three winter canola hybrids were evaluated across five seeding dates ranging from early September to late October. Results established the first two weeks of September as the optimal seeding period for winter canola in southern Ontario. Seeding winter canola during this period, such that greater than 600 GDD could be accumulated before the first fall frost, not only reduced winterkill to approximately 20% but also maximized yield potential and ensured optimal oil quality. Winter canola showed great potential for production in southern Ontario and its addition to current crop rotations would diversify and enhance crop production practices in this portion of the province.The accepted manuscript in pdf format is listed with the files at the bottom of this page. The presentation of the authors' names and (or) special characters in the title of the manuscript may differ slightly between what is listed on this page and what is listed in the pdf file of the accepted manuscript; that in the pdf file of the accepted manuscript is what was submitted by the author

Clinical usefulness of a treatment algorithm for pancreatic pseudocysts.

International audienceBACKGROUND: Endoscopic procedures have become a first-line approach to the treatment of pancreatic pseudocysts. OBJECTIVE: Our purpose was to determine the results of a therapeutic algorithm including EUS-assisted drainage, transpapillary drainage, and conventional endoscopic drainage in terms of (1) feasibility and efficacy of the endoscopic procedure and (2) morbidity. DESIGN: Prospective study with a treatment algorithm drawn up before the endoscopic procedure, including either conventional endoscopic transmural drainage (CTMD), conventional transpapillary drainage (CTPD), or EUS-guided transmural drainage (EUS-GTD). PATIENTS: A total of 50 patients, including 15 women and 35 men with a mean age of 51 years, were included in this prospective study. RESULTS: The mean size of the pseudocysts was 8.2 cm (range 3-12 cm). A total of 29 pseudocysts did not bulge into the digestive wall (58%); 24 (48%) neither bulged nor communicated with the pancreatic duct. EUS-GTD was performed on 28 patients (56%), CTMD on 13 patients (26%), and CTPD on 8 patients (16%), and endoscopic procedures failed in 1 patient. Technical feasibility was 98% (49/50), and clinical success was achieved in 90% of the cases and disappearance of the pseudocysts in 96% of the cases without significant differences among the 3 groups. The morbidity rate was 18% (9 cases). Five superinfections occurred in the EUS-GTD group and 1 in the CTMD group. One death occurred from late bleeding in the CTMD group. LIMITATION: Randomization of patients in this prospective study was not possible because of the different characteristics of the pseudocysts. CONCLUSION: With this algorithm, clinical success was achieved in 45 (90%) of the cases and disappearance of the pseudocysts in 48 (96%) of the cases with a reasonable morbidity rate. In half of the cases, EUS is required for treating pancreatic pseudocyst

First European human gastric peroral endoscopic myotomy, for treatment of refractory gastroparesis

We have therefore carried out G-POEM in a 51-year-old diabetic woman who suffered from disabling and refractory clinical gastroparesis; this was confirmed with by gastric emptying scintigraphy that showed an increased gastric emptying half-time

Value-Added Potential of Expeller-Pressed Canola Oil Refining: Characterization of Sinapic Acid Derivatives and Tocopherols from Byproducts

Valuable phenolic antioxidants are lost during oil refining, but evaluation of their occurrence in refining byproducts is lacking. Rapeseed and canola oil are both rich sources of sinapic acid derivatives and tocopherols. The retention and loss of sinapic acid derivatives and tocopherols in commercially produced expeller-pressed canola oils subjected to various refining steps and the respective byproducts were investigated. Loss of canolol (<b>3</b>) and tocopherols were observed during bleaching (84.9%) and deodorization (37.6%), respectively. Sinapic acid (<b>2</b>) (42.9 μg/g), sinapine (<b>1</b>) (199 μg/g), and canolol (344 μg/g) were found in the refining byproducts, namely, soap stock, spent bleaching clay, and wash water, for the first time. Tocopherols (3.75 mg/g) and other nonidentified phenolic compounds (2.7 mg sinapic acid equivalent/g) were found in deodistillates, a byproduct of deodorization. DPPH radical scavenging confirmed the antioxidant potential of the byproducts. This study confirms the value<b>-</b>added potential of byproducts of refining as sources of endogenous phenolics

Identification, Characterization, and Quantification of an Anti-pyridoxine Factor from Flaxseed Using Ultrahigh-Performance Liquid Chromatography–Mass Spectrometry

In the present study, the anti-pyridoxine compounds linatine (1-[(<i>n</i>-γ-l-glutamyl)­amino]-d-proline) and 1-amino-d-proline (1ADP) were quantified following extraction from defatted flaxseed using aqueous isopropanol as a solvent, with extraction variables including time, temperature, and the solid/solvent ratio. Both linatine and 1ADP were identified, characterized, and quantified via UPLC/ESI-MS using authentic standards. To optimize the extraction conditions for these anti-pyridoxine compounds, a response surface methodology was applied using a second-order polynomial to describe the experimental data. The predicted model for the optimal extraction was significant (<i>P</i> < 0.05) with a <i>R</i>² of 0.82. A varietal analysis showed that the amount of anti-pyridoxine present in flaxseed ranged from 177 to 437 μg 1ADPE/g of whole seed. The current study establishes the content of specific anti-pyridoxine factors in flaxseed and positions the data for use in subsequent risk assessment modeling

Is endoscopic sphincterotomy avoidable in patients with sphincter of Oddi dysfunction?

International audienceAIM: Endoscopic sphincterotomy is an efficient means of treating sphincter of Oddi dysfunction (SOD), but it is associated with a morbidity rate of 20%. The aim of this study was to assess how frequently endoscopic sphincterotomy was performed to treat SOD in a group of patients with a 1-year history of medical management. METHODS: A total of 59 patients, who had been cholecystectomized 9.3 years previously on average, were included in this study and they all underwent biliary scintigraphy. Medical treatment was prescribed for 1 year. Endoscopic sphincterotomy was proposed for patients whose medical treatment had been unsuccessful. RESULTS: Eleven patients were rated group 1 on the Milwaukee classification scale, 34 group 2 and 14 group 3. The hile-duodenum transit time (HDTT) was lengthened in 32 patients. The medical treatment was efficient or fairly efficient in 45% of the group 1 patients, 67% of the group 2 patients, and 71.4% of the group 3 patients (P=0.29). Only 14 patients out of the 21 whose medical treatment was unsuccessful agreed to undergo endoscopic sphincterotomy. HDTT was lengthened in 11 of the 14 patients undergoing endoscopic sphincterotomy and in 21 of the 45 non-endoscopic sphincterotomy patients (P=0.03). Twelve of the 14 patients who underwent endoscopic sphincterotomy were cured. CONCLUSION: In this prospective series of patients with a 1-year history of medical management, only 23% of the patients with suspected SOD underwent endoscopic sphincterotomy although 54% had an abnormally long HDTT