Background: Although there are many advances in the treatment of Acute Respiratory Distress Syndrome (ARDS), the mortality rate is still high (40%-60%). The new strategy \u2018protective ventilation\u2019 helped to lower the fatality rate and shortening the duration of mechanical ventilation in comparison with traditional modes. However, there is controversy about the effects of protective ventilation. Objectives: (1) To estimate the change of arterial blood gas and hemodynamic in the first 48hrs in the patients suffering from ALI or ARDS under protective ventilation. (2) To discover the disadvantages of this ventilation mode. Subjects: 30 ALI and ARDS patients (22 males and 8 females) treated at ICU, Viet Duc Hospital between April 2005 and October 2005. Method: Prospective and self-control study. Protective ventilation was applied for these patients. Artery blood gas, hemodynamic and disadvantages of protective ventilation were monitored during first 48hrs. Results: Protective ventilation significantly lowers airway pressure (p < 0.001). There was no change of PaCO2 (p > 0.05), and PaO2 was improved clearly after 12hrs of ventilation (p < 0.05). There were no significant changes of mean arterial pressure, heart rate and central venous pressure. 83.3% patients needed a high dose of sedation during protective ventilation. Conclusion: Protective ventilation lowered airway pressure, improved PaO2 and had no hemodynamic effect. However, patients required a high dose of sedation during this mode of ventilation.
Protective ventilation ; acute lung injury ; acute respiratory distress syndrome

Background: The change of blood pressure during hemodialysis has been noted for long time. However, there were few studies on the rise of blood pressure during hemodialysis. The clinical meaning of hypertension during hemodialysis has not been understood clearly. Objective: To study the role of calcium concentration in dialysate in the rise of blood pressure during hemodialysis sessions. Subjects and method: Prospective study performed on 9 stable patients on chronic hemodialysis treated at Viet Duc Hospital including 5 female and 4 male patients. The mean age of patients was 47.6 years. The patients had period 1 of 10 weeks of treatment using dialysate 1 A (with calcium concentration 1.8 mmol/l) and then they were switched to period 2 of 10 other weeks using dialysate 3A (with calcium concentration 1.25 mmol/l). Results:The blood pressure of patients during the period 2 using 3A dialysate was better controlled during hemodialysis sessions. The response to erythropoietin treatment was similar in both periods. The serum calcium was lower after using 3A dialysate. Conclusions: Using dialysate with lower calcium concentration can be helpful for controlling the hypertension during hemodialysis sessions. The appropriate calcium concentration in dialysate needs to be selected to avoid the hypocalcaemia in chronic hemodialysis patients.
Renal Dialysis ; Hypertension

Ischemic colitis (IC) is an underreported chronic disease characterized by the hypoperfusion of the bowel mucosa. The diagnosis and treatment may be challenging because its clinical course resembles other colitis or even colorectal malignancies. This paper reports an untypical case to underline the diversity of IC manifestation. A 68-year-old man with several comorbidities was admitted because of abdominal pain with a 6-month duration and a mass in the left lower quadrant. Colonoscopy revealed erosive pseudomembranous colitis narrowed colon segments with ulcerated mucosa mimicking colorectal cancer and inflammatory bowel disease. The stool cultures and Clostridium difficile toxin tests were negative. After the failure of conservative therapy, the Hartmann procedure with temporary ileostomy was performed uneventfully. The histological results of the surgical specimens revealed IC with focal pseudomembranous areas.

Background/Aims: Accurate neoplastic prediction can significantly decrease costs associated with pathology and unnecessary colorectal polypectomies. Narrow band imaging (NBI) and dual-focus (DF) mode are promising emerging optical technologies for recognizing neoplastic features of colorectal polyps digitally. This study aimed to clarify the clinical usefulness of NBI with and without DF assistance in the neoplastic prediction of small colorectal polyps (<10 mm). Methods: This cross-sectional study included 530 small colorectal polyps from 343 consecutive patients who underwent colonoscopy at the University Medical Center from September 2020 to May 2021. Each polyp was endoscopically diagnosed in three successive steps using white-light endoscopy (WLE), NBI, and NBI-DF and retrieved for histopathological assessment. The diagnostic accuracy of each modality was evaluated with reference to histopathology. Results: There were 295 neoplastic polyps and 235 non-neoplastic polyps. The overall accuracies of WLE, WLE+NBI, and WLE+NBI+NBI-DF in the neoplastic prediction of colorectal polyps were 70.8%, 87.4%, and 90.8%, respectively (p<0.001). The accuracy of WLE+NBI+NBI-DF was significantly higher than that of WLE+NBI in the polyp size ≤5 mm subgroup (87.3% vs. 90.1%, p<0.001). Conclusions NBI improved the real-time neoplastic prediction of small colorectal polyps. The DF mode was especially useful in polyps ≤5 mm in size.

Background: Bone marrow stem cells with their plasticity can be used to replace and repair the other damaged organs and tissues, so they can also be used to obtain bone healing of nonunions. Objective: to evaluate the results of percutaneous autologous bone marrow grafting to treat the tibia diaphyseal nonunions. Subjects and methods: 12 patients with noninfected nonunion of the tibia were diagnosed and treated in Viet Duc Hospital. About 250mL of marrow was aspirated, then separated and concentrated by density gradient centrifugation. The final mononuclear cell mass containing stem cells and progenitors was washed in 30ml of 0.9% NaCL and then injected into the damaged sites. Patients were evaluated by clinical and X-rays examinations with at least 6 months follow-up. Results: None of the patients had post - op complications. Bone union was obtained in eleven of the twelve patients (91,7%) at an average of 15,3 weeks (range, 9 - 30 weeks), the bone marrow grafts used for these patients who had bone union contained a mean of 5,65 \xb1 3,74 x 106 (0,95 - 11,73 x 106) CD34(+) stem cells in total. Conclusions: Percutaneous autologous bone - marrow grafting is a minimally invasive alternative and a simple, effective, safe method for the treatment of the tibia diaphyseal nonunions with the comparative bone healing rate. \r\n', u'\r\n', u'
Tibia/ pathology ; Bone Marrow/ anatomy & ; histology ; surgery

Geographical and racial factors constitute important distinctions between Kawasaki disease (KD) and multisystem inflammatory syndrome in children (MIS-C), but no study has been conducted in Vietnam. Forty-one children with KD from January 2018 to July 2020 and 42 with KD/MIS-C from August 2020 to December 2022 were included in this study. Of the patients, 52.3% were aged between 12 and 35 months. Only two were aged over 5 years, and both were belong to the KD/MIS-C group. A 59.5% of the patients were male. Apart from fever, all symptoms tended to be more frequent in patients with KD/MIS-C. The prevalence of diffuse skin rash, hand and foot edema or erythema and gastrointestinal signs was significantly higher in patients hospitalized with KD/MIS-C. There was no significant difference in laboratory findings between the two groups. Coronary artery dilation was more frequently observed in patients with KD/MIS-C compared to those with KD (40.5% vs. 14.6%, P = 0.009).

Toxocariasis, a zoonotic infection transmitted by Toxocara canis (from dogs) and Toxocara cati (from cats) larvae, poses rare but severe risks to humans. We present a case of hepatic visceral larva migrans (VLM) caused by Toxocara canis in a 21-year-old male with a history of close contact with a pet dog. Initial symptoms and imaging findings mimicked a pyogenic liver abscess. The initial laboratory investigations revealed neutrophilia and elevated levels of IgE. Despite broad-spectrum antibiotics, persistent fever prompted further investigation. Subsequent serological testing for Toxocara antibodies and histopathological analysis of liver tissue demonstrating eosinophil infiltrates and Charcot-Leyden crystals led to a confirmed diagnosis of a liver abscess caused by Toxocara canis. Serological testing for Toxocara antibodies and histopathological analysis of liver tissue confirmed a Toxocara canis-induced liver abscess. Albendazole treatment yielded significant clinical improvement. This case highlights the necessity of considering toxocariasis in liver abscess differentials, particularly in high-seroprevalence regions like Vietnam. Relying solely on serological tests may be insufficient, emphasizing the need for corroborative evidence, including invasive procedures like liver biopsy, for accurate hepatic toxocariasis diagnosis.

Strongyloidiasis, a chronic helminth infection caused by the parasitic nematode Strongyloides stercoralis, has various clinical manifestations. Although rare, duodenal obstructions and venous thromboembolism are possible complications of strongyloidiasis.This paper presents the case of a 47-year-old Vietnamese male with a history of right lower limb edema, anorexia, nausea, vomiting, diarrhea, and abdominal discomfort lasting for four months. Venous Doppler ultrasound detected a thrombus in the right femoral vein, while an abdominal CT scan revealed a mass lesion suggestive of a lower bile duct tumor. Esophageogastroduodenoscopy showed a friable duodenal cap mucosa with multiple ulcers and edematous mucosa of the second part of the duodenum that caused a partial lumen obstruction. The final histological examination of the biopsy specimen revealed chronic duodenitis with larvae consistent with Strongyloides stercoralis. The patient was treated with Ivermectin for two weeks and anticoagulation therapy for three months. After treatment and a six-month follow-up, the patient's gastrointestinal symptoms and leg swelling resolved completely. This is the first documented case of a patient in Vietnam with strongyloidiasis who presented with venous thromboembolism and duodenal obstruction. (Korean J Gastroenterol 2023;81:270-275)

Objective: This study aimed to investigate the impact of hyperandrogenism (HA) on the outcomes of ovulation induction (OI) using gonadotropin and intrauterine insemination (IUI) in patients with polycystic ovary syndrome (PCOS). Methods: This was a retrospective cohort study including 415 patients undergoing OI using gonadotropin and IUI treatment between January 2018 and December 2020 at a single infertility center. Baseline characteristics, clinical and laboratory parameters, and pregnancy outcomes were investigated. Results: Among the study population, there were 105 hyperandrogenic (25.3%) and 310 non-hyperandrogenic patients (74.7%). The live birth rate was lower in the HA group than in the non-HA group, but this difference did not reach statistical significance due to the limited sample size (14.3% vs. 21.0%, relative risk=0.68; 95% CI, 0.41–1.14, p=0.153). No predictive factors for live birth were identified through logistic regression analysis. Conclusion HA did not negatively affect the outcomes of OI using gonadotropin and IUI cycles in Vietnamese women with PCOS. The result may not be applicable elsewhere due to the large variation in the characteristics of women with PCOS across races and populations.

In our study, sixteen known phenolic compounds, including quercetin (1), methyl gallate (2), caesalpiniaphenol C (3), 8S,8′S,7′R-(‒)-lyoniresinol (4), 7,3′,5′-trihydroxyflavanone (5), sappanchalcone (6), sappanone A (7), taxifolin (8), fisetin (9), fustin (10), (+)-catechin (11), brazilin (12), 3,4,5-trimethoxyphenyl β-ᴅ-glucopyranoside (13), 1-(2-methylbutyryl)phloroglucinol-glucopyranoside (14), (+)-epi-catechin (15), and astragalin (16) and one mixture of two conformers of protosappanin B (17/18) were isolated from the stems of Caesalpinia decapetala var. japonica. Their structures were elucidated based on a comparison of their physicochemical and spectral data with those of literature. To the best of our knowledge, this represents the first isolation of compounds 3, 4, 8, 9, and 10 from C. decapetala and compounds 13 and 14 from the Caesalpinia genus. All the isolated compounds were evaluated for their inhibitory effect against the α-glucosidase enzyme.Among them, two flavonols (1 and 9), one chalcone (6), and one homoisoflavanone (7) exhibited an inhibitory effect on α-glucosidase action with an IC 50 range value of 5.08 ‒ 15.01 µM, stronger than that of the positive control (acarbose, IC 50 = 152.22 μM). Kinetic analysis revealed that compounds 1 and 9 showed non-competitive α-glucosidase inhibition, while the inhibition type was mixed for compounds 6 and 7.