Frequency of Herpes Virus (HSV) in Esophageal Muscle Samples among Patients with Achalasia under Heller Myotomy

Background Despite years of research, the etiology of achalasia not well understood. Scientists suppose a role for autoimmunity, in this disorder, and probable viral agent, such as herpes virus (HSV). The aim was to find out the frequency of HSV in esophageal muscle samples in patients with achalasia under Heller's myotomy. Methods In this study, 60 patients with achalasia, after fulfilling the consent form, were underwent Heller’s myotomy surgery. Biopsy samples prepared for polymerase chain reaction (PCR) method for HSV DNA detection. After DNA-extraction, replication performed using specific primers. Results The mean age was 40.62 ± 5.08 years. Thirty-nine patients (65%) were female and 21 (35%) were male. Thirty-eight (63.3%) had no history but the else (36.7%) had a positive history of HSV. HSV-1 was positive in three patients (5%). Two females and one male were HSV-positive. Conclusions HSV-1 frequency is not notable among Iranian patients with achalasia. We suggest exploring other viruses, in special that involving the pathogenesis of achalasia, with a larger sample size.

ALARIOSIS OF CARNIVOROUS ANIMALS IN CENTRAL RUSSIA

The spread of alariosis of fishing animals of Central Russia was clarified and a circle of host agents among mammals was identified. The material for the study was the arcasses of trade animals. The period of work was 2018–2020. Animals were studied according to the method of complete helminthological study on K.I. Skryabin (1928). The tissue form of alariosis was examined by trichinelloscopic methods. During the reporting period, 107 heads of carnivorous animals (of which 27 heads (25.2%) are considered stray domestic) extracted in the territory of the Ryazan, Vladimir and Moscow regions. Of the Canidae family, 54 heads have undergone helminthological examination (29 foxes, 17 domestic dogs, 7 raccoon dogs, and 1 wolf). Of the cat (Felidae), 11 heads have been studied (domestic cats – 10, lynx – 1). Martens animals (Mustelinae) have been studied 42 heads (forest мartens – 19, stone мartens – 6, river otter – 4, ermines – 7, badgers – 2, аmerican mink – 4). Adult trematodes have been identified in 37 carnivorous animals (34.6%) in the thin part of the intestine. Canidae animals representing trade species (fox, raccoon dog, wolf) are 100% infected with the agent of alariosis. The intensity invasion of fox was 4–250 copies per head, raccoon dogs – 11–284, wolf – 84. The larval form of the agent was recorded in one fox (3.5%), 2 forest мartens (10.5%) and one аmerican mink (25.0%). Mesocercaries of trematodes were localized in a transparent capsule in lung parenchyma, in diaphragm muscle tissue, in esophageal muscle tissue.

Clinical impact of peroral endoscopic myotomy for esophageal motility disorders on esophageal muscle layer thickness

Background and study aims Previously, we reported that esophageal muscle layer thickness was associated with technical complexity of peroral endoscopic myotomy (POEM). However, there are no data regarding the mid-term effects of POEM procedures on esophageal muscle layer thickness. Therefore, we conducted this study to elucidate mid-term effects of POEM procedures, and to examine whether postoperative changes in esophageal muscle layer thickness were related to particular clinico-pathological features in patients with esophageal motility disorders. Patients and methods Seventy-four consecutive patients with esophageal motility disorders who underwent POEM at Kobe University Hospital from April 2015 to December 2016 were prospectively recruited into this study. First, we investigated the esophageal muscle layer thickness values obtained at 1 year after POEM. Second, we evaluated the effects of a reduction in muscle layer thickness on various clinico-pathological features. Results At 1 year after POEM, mean thickness of the inner circular muscle at 0 cm, 5 cm, and 10 cm from the esophagogastric junction was 1.06 ± 0.45 mm, 0.99 ± 0.36 mm, and 0.97 ± 0.44 mm, respectively. Among all sites, muscle layer thickness had significantly decreased after POEM. However, univariate logistic regression analysis demonstrated that no clinical factors were associated with esophageal muscle layer thickness after POEM procedure. Conclusions We demonstrated for the first time that thickness of the esophageal muscle layer was significantly decreased after POEM. This result reveals that changes in esophageal muscle layer thickness caused by esophageal motility disorders are reversible.

PS01.109: A RARE TUMOR OF THE CERVICAL ESOPHAGUS: SCHWANNOMA

Background Schwannomas esophagus is very rarely seen. In this study, a schwannoma case with cervical esophagus was presented. Methods A 26-year-old female presented with dysphagia. In esophageal ultrasonography, a homogeneous, hypoechoic, and smooth-sided lesion originating from the proximal esophagus muscularis propria was detected. MRI revealed a well-defined mass lesion located in the cervical esophagus. Results The left cervical incision was performed and the lesion was enucleated. After the enucleation, saline was inserted into the enucleated area, and air was injected into the nasogastric tube to investigate the possibility of mucosal injuries. The esophageal muscle layers were then primarily closed with absorbable sutures. Frozen section examination was benign. Postoperative histopathological evaluation was assessed as accordance with schwannoma (Figure). Oral diet was started on the 3th postoperative day. There were no complications postoperatively. The patient was discharged on the 5th postoperative day. Conclusion The vast majority of esophageal tumors are cancer. Benign esophagial tumors constitute less than 1% of all esophageal tumors. Approximately 80% of benign esophagus tumors are leiomyomas. Esophageal schwannoma is very rare and difficult to diagnose by endoscopy and imaging methods. In these cases, surgery provides both definitive diagnosis and treatment. Disclosure All authors have declared no conflicts of interest.