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Physical activity is important to improve recovery following surgery. This study investigated the impact of physical activity on the development of pneumonia after radical esophagectomy in patients with thoracic esophageal cancer in the subacute phase from postoperative day 11 to hospital discharge. This retrospective cohort study included 83 patients who underwent radical esophagectomy for esophageal cancer between 2016 and 2022. Physical activity was measured using an activity tracker, and the average number of steps between postoperative days 8 and 10 was examined. The primary outcome was pneumonia (Clavien-Dindo classification 2 or higher) developing between postoperative day 11 and hospital discharge. We used the receiver operating characteristic (ROC) curve analysis to calculate the optimal cutoff value of physical activity that can predict the development of pneumonia and define low physical activity. We used logistic regression analysis to investigate the impact of low physical activity on postoperative pneumonia. Pneumonia developed in 10 patients (12.0%) during the observation period. The optimal cutoff value of physical activity for predicting pneumonia was 1494 steps per day (sensitivity: 60.0%, specificity: 89.0%, area under the curve: 0.743). In multivariate analysis, low physical activity was an independent predictor of incident pneumonia [odds ratio: 12.10, 95% confidence interval: 2.21–65.90, p = 0.004], with adjustment for age, gastric tube reconstruction route, and postoperative recurrent nerve palsy. Physical activity following radical esophagectomy in patients with thoracic esophageal cancer was an independent predictor of the development of pneumonia in the subacute phase after radical esophagectomy. • Postoperative pneumonia is a common complication of esophagectomy. • This study examined the impact of physical activity on postoperative pneumonia. • Walking less than 1494 steps per day post-surgery was a predictor of pneumonia. • Promoting physical activity such as walking may prevent postoperative pneumonia. [ABSTRACT FROM AUTHOR]

Spontaneous esophageal perforation, also commonly referred to as Boerhaave's syndrome, is one of the most lethal diseases causing an acute abdomen. Though rare, emergent surgical intervention is often required and management can be various based upon the site of the perforation. This literature has been written in line with the SCARE criteria (Agha et al., 2020) [1]. A 76-year-old man presented with acute abdominal pain. Computed tomography (CT) revealed and an emergent esophagogastroduodenoscopy (EGD) was performed carefully, which revealed a 7 cm all-layer esophageal laceration in the left lower esophageal wall. In our case, a hiatal hernia was protruding into the mediastinum, and the perforation site was inside of it, but there was no invasion into the thoracic cavity, thus a transabdominal approach was performed without thoracotomy. This type of esophageal perforation within a hiatal hernia is quite rare and provides a unique clinical challenge. In addition, A review reported the average length of spontaneous esophageal perforation to be around 2 cm while our case had a perforation with a length of 7 cm. We chose the combination of the simple suture with omental buttress and wide drainage, but a complete fundoplication was impossible due to its large size of perforation. We chose the open abdominal approach because the case had high inflammation, a hiatal hernia and possibility of retro-gastric perforation. However, MIS should have been considered first if a situation or human resources allow it. • Esophageal perforation combined with a hiatal hernia is quite rare. • Our case had about 7cm of perforation though it is around 2cm on average. • We chose the trans abdominal approach due to the hiatal hernia. • In some conditions, thoracotomy is not required, and it would be beneficial when considering the invasiveness. [ABSTRACT FROM AUTHOR]

Although cellulose is generally considered not to affect the viscosity of the digesta in the upper gastrointestinal tract, we found previously that the ingestion of cellulose elevated the viscosity of the gastric, small intestinal, and cecal contents when particulate matter was included in the measurements. We hypothesized that the digesta viscosity influences absorption. Here, we examined the effects of crystalline cellulose on plasma glucose concentrations by infusing control and cellobiose- and cellulose-containing artificial digesta of ∼30 mL into the small intestine of rats. Cellulose, but not cellobiose, decreased the postinfusion plasma glucose concentration (P < 0.05), although cellulose did not cause adsorption or dilution of glucose. Among the physical properties of the artificial digesta, only viscosity was responsible for the decrease in the plasma glucose concentration, whereas water content, free water, bound water, and osmotic pressure were not. The cellulose-induced increase in digesta viscosity may delay glucose diffusion in the lumen, as found in our previous study. Cellulose also stimulated water absorption from the small intestine (P < 0.05), which may be attributable to increases in the water potential of the digesta moving through the small intestine. The ingestion of cellulose with meals, which increases digesta viscosity, is likely to modulate the postprandial plasma glucose concentration and to reduce the incidence of diarrhea associated with enteral nutrition. [ABSTRACT FROM AUTHOR]

A work of ultraviolet microspectrometry and immuno light microscopy of cinnamyl alcohol hydrogenase (CAD) in the cells of leaf blades was carried out on rice plants grown in a paddy field with (+Si) or without (−Si) application of a silicate fertilizer. The pattern of silicon distribution on the longitudinal surface of leaf blades by X-ray microanalyzer, morphological characteristics, and gross composition such as silica, other major mineral elements, cellulose, non-cellulosic polysaccharides, lignin and phenolic acids were also compared between both rice plants. The X-ray microanalysis of silicon indicated the higher deposit on dumbbell bodies and other surface area in the +Si rice plants compared with those of the −Si rice plants. The +Si rice plants also showed the lower immuno-reaction of antiserum of the CAD in the cell walls of sclerenchyma, vascular bundle sheath and metaxylem vessel cells. The +Si rice plants had the lower UV absorbance around 280 and 320 nm in the leaf blades compared with those of the −Si rice plants. Microscopic observations of leaf blades in both sets of rice plants were also consistent with results of phenolic acids examined. This study suggests that silica fertilization and/or silicate accumulation in the leaves can be associated with decreases of the phenolic biosynthesis in rice plants. [Copyright &y& Elsevier]

Abstract: This paper discusses time-dependent dielectric breakdown (TDDB) in n-FETs with HfSiON gate stacks under various stress conditions. It was found that the slope of Weibull distribution of Tbd , Weibull β, changes with stress conditions, namely, DC stress, unipolar AC stress and bipolar AC stresses. On the other hand, the time evolution component of stress-induced leakage current (SILC) was not changed by these stresses. These experimental results indicate that the modulation of electron trapping/de-trapping and hole trapping/de-trapping by stress condition changes the defect size in high-k gate dielectrics. Therefore, the control of injected carrier and the characteristics of trapping can provide the steep Weibull distribution of Tbd , leading to long-term reliability in scaled CMOS devices with high-k gate stacks. [Copyright &y& Elsevier]