Hybrid transgastric approach for the treatment of gastroesophageal junction pathologies.

Flexible endoscopy has evolved to the point that it includes many endoluminal procedures that once required open or laparoscopic surgery, for instance, antireflux surgery, pyloromyotomy, mucosal and submucosal tumor resections, and even full-thickness resection. However, these procedures remain technically demanding due to flexible technology issues: difficult imaging, limited energy devices, lack of staplers, unsatisfactory suturing abilities, and so on. Transgastric laparoscopy or hybrid laparoscopy/flex endoscopy has been described for almost two decades as an alternative to a pure endoluminal approach, mainly for pancreatic pseudocyst drainage and full-thickness and mucosal resection of various lesions. The approach has never been widely adopted mostly due to cumbersome and difficult to maintain methods of gastric access. We propose to expand the indications of transgastric laparoscopy by using novel endoscopically placed ports to replicate endoscopic procedures particularly in the difficult to access proximal stomach such as endoluminal antireflux surgery. Under general anesthesia, five female pigs (mean weight: 27.6 kg) had endoscopic placement of 3, 5 mm intragastric ports (Endo-TAGSS, Leakwood KS, USA) using a technique similar to percutaneous endoscopic gastrostomy. A 5-mm laparoscope was used for visualization. Laparoendoscopic-assisted plication of the gastroesophageal junction (GEJ) was performed using 3-0 interrupted sutures (Polysorb®, Covidien, Mansfield, MA, USA). A functional lumen imagine probe (EndoFLIP®, Crospon, Inc., Galway, Ireland) was used to measure diameter, cross sectional area (CSA), distensibility, and compliance of GEJ before and after intervention. Once the TAGSS ports were removed, the gastrotomies were closed by using endoscopic over-the-scope clips. At the end of the procedure, animals were euthanized. Five laparoendoscopic-assisted endoluminal plications were performed. The mean operative time was 65.6 min (Endoscopic evaluation: 3.2 min, TAGSS Insertion: 11 min, EndoFLIP evaluation + GEJ Plication: 43.25 min, gastric wall closure: 15 minutes). In all cases, this technique was effective and allowed to achieve an adequate GEJ plication by endoscopic grading and EndoFLIP measurements. Median pre-plication GEJ diameter (D) and median pre-plication GEJ cross-sectional area (CSA) were 11.42 mm (8.6-13.6 mm) and 104.8 mm2 (58-146 mm2). After the procedure, these values were decreased to 6.14 mm (5.7-6.6 mm) and 29.8 mm2 (25-34 mm2) respectively (p = 0.0079). Median pre-plication distensibility (d) and compliance (C) were 7.87 mm2/mmHg (2.4-22.69 mm2/mmHg) and 190.56 mm3/mmHg (70.9-502.8 mm3/mmHg). After the procedure, these values decreased to 1.5 mm2/mmHg (0.7-2.2 mm2/mmHg) and 52.17 mm3/mmHg (21.9-98.7 mm3/mmHg) respectively (p = 0.0317). No intraoperative events were observed. Endoscopically, all valves were felt to be transitioned from a Hill grade 3 (normal state for the animal model) to a Hill grade 1 at the procedure completion. A hybrid laparoendoscopic approach is a feasible alternative for performing intragastric procedures with the assistance of conventional laparoscopic instruments; especially in cases where the intervention location limits the access to standard endoscopy or where endoscopic technology is inadequate. Further evaluation is planned in survival models and clinical trials.

Impact of fermentation on nitrogenous compounds of cocoa beans (Theobroma cacao L.) from various origins.

Tangential filtration technique was used to separate and quantify three different fractions of nitrogenous compounds depending on their molecular size, during cocoa fermentation. On every phenotype and origin analyzed, protein profile of non-fermented samples was similar. During fermentation course, proteins get degraded with a concomitant increase in amino acids content. Peptides between 3 and 10 kDa were observed at low levels. A strong correlation between amino acids and ammonia nitrogen, a fermentation marker was found. Attention was drawn on each fraction, and enabled to point out other phenomenon occurring during fermentation. The migration of some nitrogenous compounds towards the bean shell during fermentation was demonstrated. Acetone treatment of cocoa powder prior to SDS-PAGE led to losses of nitrogenous compounds. This result gives clues on the tanning phenomenon carried out by polyphenols on nitrogenous compounds, phenomenon which increases during fermentation.

Prediction of carotenoids, cyanide and dry matter contents in fresh cassava root using NIRS and Hunter color techniques.

Efforts are currently underway to improve carotenoids content in cassava roots through conventional breeding as a strategy to reduce vitamin A deficiency. However, only few samples can be quantified each day for total carotenoids (TCC) and ß-carotene (TBC) contents, limiting the gains from breeding. A database with >3000 samples was used to evaluate the potential of NIRS and chromameter devices to predict root quality traits. Maximum TTC and TBC were up to 25.5 and 16.6 µg/g (fresh weight basis), respectively. NIRS predictions were highly satisfactory for dry matter content (DMC, R(2): 0.96), TCC (R(2): 0.92) and TBC (R(2): 0.93). NIRS could also distinguish roots with high or low cyanogenic potential (R(2): 0.86). Hunter color parameters could also be used for predictions, but with lower accuracy than NIRS. NIRS or chromameter improve selection protocols, allowing faster gains from breeding. Results also demonstrate that TBC and DMC can be improved simultaneously (required for the adoption of biofortified cassava).

Near infrared spectroscopy as a new tool to determine cocoa fermentation levels through ammonia nitrogen quantification.

Fermentation is a key step in obtaining fine cocoa through the formation of potent aroma precursors. The fermentation level of cocoa beans is traditionally assessed by measuring the amount of ammonia nitrogen (NH3) using the time-consuming Conway technique. Near infrared spectroscopy (NIRS), a rapid and efficient tool, was used to analyze NH3 levels in several hundred cocoa samples at different fermentation levels from six geographical origins. Fermentation levels were expressed as the number of fermentation days and sum of temperatures. The correlation between Conway results and NIRS spectra enabled the development of a reliable and accurate NIRS calibration to determine NH3 content. We confirm that NH3 is produced during fermentation and its amount depends on the fermentation time, sum of temperatures and geographical origin. NIRS could be used by chocolate manufacturers as a routine method to sort cocoa samples according to their level of fermentation.

Stability across environments of the coffee variety near infrared spectral signature.

Previous study on food plants has shown that near infrared (NIR) spectral methods seem effective for authenticating coffee varieties. We confirm that result, but also show that inter-variety differences are not stable from one harvest to the next. We put forward the hypothesis that the spectral signature is affected by environmental factors. The purpose of this study was to find a way of reducing this environmental variance to increase the method's reliability and to enable practical application in breeding. Spectral collections were obtained from ground green coffee samples from multilocation trials. Two harvests of bean samples from 11 homozygous introgressed lines, and the cv 'Caturra' as the control, supplied from three different sites, were compared. For each site, squared Euclidean distances among the 12 varieties were estimated from the NIR spectra. Matrix correlation coefficients were assessed by the Mantel test. We obtained very good stability (high correlations) for inter-variety differences across the sites when using the two harvests data. If only the most heritable zones of the spectrum were used, there was a marked improvement in the efficiency of the method. This improvement was achieved by treating the spectrum as succession of phenotypic variables, each resulting from an environmental and genetic effect. Heritabilities were calculated with confidence intervals. A near infrared spectroscopy signature, acquired over a set of harvests, can therefore effectively characterize a coffee variety. We indicated how this typical signature can be used in breeding to assist in selection.

Development of NIRS equations for food grain quality traits through exploitation of a core collection of cultivated sorghum.

A sorghum core collection representing a wide range of genetic diversity and used in the framework of a sorghum breeding and genetics program was evaluated by near-infrared reflectance spectroscopy (NIRS) to predict food grain quality traits: amylose content (AM), protein content (PR), lipid content (LI), endosperm texture (ET), and hardness (HD). A total of 278 sorghum samples were scanned as whole and ground grain to develop calibration equations. Laboratory analyses were performed on NIRS sample subsets that preserved the core collection racial distribution. Principal component analysis performed on NIRS spectra evidenced a level of structure following known sorghum races, which underlined the importance of using a wide range of genetic diversity. Performances of calibration equations were evaluated by the coefficient of determination, bias, standard error of laboratory (SEL), and ratio of performance deviation (RPD). Ground grain spectra gave better calibration equations than whole grain. PR equation (RPD of 5.7) can be used for quality control. ET, LI, and HD equations (RPD of 2.9, 2.6, and 2.6, respectively) can be used for screening steps. Even with a small SEL in whole sample analysis, a RPD of 1.8 for AM confirmed that this variable is not easy to predict with NIRS.