No abstract available.

BACKGROUND: Persistent auras after temporal lobectomy may be bothersome to the patients even though they are seizure free. But most authors specifically are concerned about the seizure outcome itself. The aim of the present study was to investigate which factors are related to persistent auras in patients with temporal lobe epilepsy(TLE) after temporal lobectomy. METHODS: We have retrospectively analysed many factors in 38 TLE patients with aura. All patients underwent anterior temporal lobectomy with amygdalo-hippocampectomy. Twenty three patients were seizure and aura free (completely seizure-free) and 15 patients had persistent auras(persistent auras) in spite of seizure-free. Characteristics of auras, past medical history, presence of secondary GTC, seizure frequency, age of surgery, age of onset, duration of habitual seizure, ictal EEG pattern, and pre- and postoperative MRI findings were compared between group with completely seizure-free and group with persistent aura. RESULTS: Characteristics of aura, past medical history, presence of secondary GTC, seizure frequency, ictal EEG pattern, age of onset, and age of surgery had no statistical differences between both groups. Seizure duration of group with persistent aura seemed to be longer than that of group with completely seizure-free(13.6 years vs 17.0 years, median test, p=0.10) and remained hippocampus in postsurgical MRI seemed to be related to persistent auras(Fisher's exact test, p=0.06). CONCLUSIONS: We found that there were suggestive differences in seizure duration and remained hippocampus between the two groups.
Age of Onset ; Anterior Temporal Lobectomy ; Electroencephalography ; Epilepsy* ; Epilepsy, Temporal Lobe ; Hippocampus ; Humans ; Magnetic Resonance Imaging ; Prognosis ; Retrospective Studies ; Seizures ; Temporal Lobe

PURPOSE: To identify prognostic factors associated with a favorable outcome after vitrectomy for patients with macular epiretinal membrane (ERM). METHODS: The authors retrospectively reviewed the records of 63 patients (64 eyes) with macular ERM, who were treated by vitrectomy between 2003 and 2008, and followed for more than 6 months. RESULTS: The mean follow-up period was 13.21 +/- 9.11 months and the mean best corrected visual acuity after vitrectomy was log MAR 0.32 +/- 0.34. Univariate analysis revealed the patients in the group with a postoperative log MAR of 0.3 or better had better preoperative visual acuity and shorter symptom duration; multivariate analysis revealed the same results. In 24 eyes, intraretinal structures which contained pseudoholes, intraretinal cysts, retinal folds and vitreoretinal traction were analyzed with Cirrus HD-OCT, however, there was no correlation with visual acuity after vitrectomy. CONCLUSIONS: The present study demonstrated vitrectomy for macular ERM resulted in favorable visual improvement. The preoperative visual acuity and symptom duration were a significant prognostic factor.
Epiretinal Membrane ; Eye ; Follow-Up Studies ; Humans ; Multivariate Analysis ; Retinaldehyde ; Retrospective Studies ; Traction ; Visual Acuity ; Vitrectomy

Massive hydrothorax is uncommon but well recognized complication of peritoneal dialysis. Possible mechanisms include a disorder of lymphatic drainage, pleuro-peritoneal pressure gradient, and congenital diaphragmatic defects. Hydrothorax in a CAPD patient caused by infiltrative disease or malignancy is very rare. Recently, two cases of hydrothorax in CAPD patients caused by systemic amyloidosis involving diaphragm were reported. However, no case of pleuro-peritoneal communication secondary to HCC infiltrating diaphragm was reported. This case was of a hydrothorax due to HCC in a CAPD patient. We performed video-assited thoracoscopic resection of diaphragmatic mass, diaphragmatic repair and thoracoscopic talc pleurodesis. This case showed that malignancy might be considered as a cause of a hydrothorax in a CAPD patient.
Carcinoma, Hepatocellular

Pure red cell aplasia(PRCA) is characterized by anemia, absence of reticulocytes in the peripherial blood and selective erythroid hypoplasia in the bone marrow. Acquired PRCA is often associated with thymoma but may also occur in many diverse conditions, such as chromic lymphocytic leukemia, systemic lupus erythematosus, autoimmune disorders, T gamma lymphocytosis, acquired hypogammaglobulinemia, acquired immunodeficiency syndrome. Recently we experienced a case of T cell chronic lymphocytic leukemia associated with pure red cell aplasia. A 65-year-old man was presented with severe anemia. absolute reticulocytopenia, hepatosplenomegaly and lymphocytosis(T cell marker' CD2, CD7 positive). Bone marrow findings showed a marked decrease in erythroid precursors and normal maturations of granulocytic and megakaryocytic series, which were consistent with pure red cell aplasia. So we report this case with a review of the literature.
Acquired Immunodeficiency Syndrome ; Aged ; Anemia ; Bone Marrow ; Common Variable Immunodeficiency ; Humans ; Leukemia, Lymphocytic, Chronic, B-Cell* ; Leukemia, Lymphoid ; Lupus Erythematosus, Systemic ; Lymphocytosis ; Red-Cell Aplasia, Pure* ; Reticulocytes ; Thymoma

Purpose: This study was performed to investigate the role of the perioperative neutrophil-to-lymphocyte ratio (NLR) as an early predictor of major postoperative complications after total gastrectomy for gastric cancer. Methods: This single-center, retrospective study reviewed consecutive patients with gastric cancer who underwent total gastrectomy at a single institution from March 2009 to March 2021. The postoperative complications were graded according to the Clavien-Dindo classification. We analyzed the patient demographics and surgical outcomes according to the grade of postoperative complications in the major complications group (≥grade III) and the no major complications group (Results: Out of 212 patients (mean age, 64.1 years; 152 male [71.7%]), 63 (29.7%) underwent minimally invasive surgery. Twenty-five (11.8%) were in the major complications group and 187 (88.2%) were in the no major complications group. There was a significant difference in the NLR on POD 2 (16.54 vs. 8.83, P = 0.033) between the 2 groups. According to the receiver operating characteristic curve for the NLR on POD 2, the cutoff was calculated to be 9.6. In multivariate analysis, an NLR on POD 2 of ≥9.6 and an American Society of Anesthesiologists physical status classification of ≥III were statistically significant predictors of major postoperative complications. Conclusion Determination of the NLR on POD 2 is a simple and useful method for the early prediction of major complications after total gastrectomy for gastric cancer.

Background: Atherogenic dyslipidemia, which is frequently associated with type 2 diabetes (T2D) and insulin resistance, contributes to the development of vascular complications. Statin therapy is the primary approach to dyslipidemia management in T2D, however, the role of non-statin therapy remains unclear. Ezetimibe reduces cholesterol burden by inhibiting intestinal cholesterol absorption. Fibrates lower triglyceride levels and increase high-density lipoprotein cholesterol (HDL-C) levels via peroxisome proliferator- activated receptor alpha agonism. Therefore, when combined, these drugs effectively lower non-HDL-C levels. Despite this, few clinical trials have specifically targeted non-HDL-C, and the efficacy of triple combination therapies, including statins, ezetimibe, and fibrates, has yet to be determined. Methods: This is a multicenter, prospective, randomized, open-label, active-comparator controlled trial involving 3,958 eligible participants with T2D, cardiovascular risk factors, and elevated non-HDL-C (≥100 mg/dL). Participants, already on moderate-intensity statins, will be randomly assigned to either Ezefeno (ezetimibe/fenofibrate) addition or statin dose-escalation. The primary end point is the development of a composite of major adverse cardiovascular and diabetic microvascular events over 48 months. Conclusion This trial aims to assess whether combining statins, ezetimibe, and fenofibrate is as effective as, or possibly superior to, statin monotherapy intensification in lowering cardiovascular and microvascular disease risk for patients with T2D. This could propose a novel therapeutic approach for managing dyslipidemia in T2D.

Background: Atherogenic dyslipidemia, which is frequently associated with type 2 diabetes (T2D) and insulin resistance, contributes to the development of vascular complications. Statin therapy is the primary approach to dyslipidemia management in T2D, however, the role of non-statin therapy remains unclear. Ezetimibe reduces cholesterol burden by inhibiting intestinal cholesterol absorption. Fibrates lower triglyceride levels and increase high-density lipoprotein cholesterol (HDL-C) levels via peroxisome proliferator- activated receptor alpha agonism. Therefore, when combined, these drugs effectively lower non-HDL-C levels. Despite this, few clinical trials have specifically targeted non-HDL-C, and the efficacy of triple combination therapies, including statins, ezetimibe, and fibrates, has yet to be determined. Methods: This is a multicenter, prospective, randomized, open-label, active-comparator controlled trial involving 3,958 eligible participants with T2D, cardiovascular risk factors, and elevated non-HDL-C (≥100 mg/dL). Participants, already on moderate-intensity statins, will be randomly assigned to either Ezefeno (ezetimibe/fenofibrate) addition or statin dose-escalation. The primary end point is the development of a composite of major adverse cardiovascular and diabetic microvascular events over 48 months. Conclusion This trial aims to assess whether combining statins, ezetimibe, and fenofibrate is as effective as, or possibly superior to, statin monotherapy intensification in lowering cardiovascular and microvascular disease risk for patients with T2D. This could propose a novel therapeutic approach for managing dyslipidemia in T2D.

Background: Atherogenic dyslipidemia, which is frequently associated with type 2 diabetes (T2D) and insulin resistance, contributes to the development of vascular complications. Statin therapy is the primary approach to dyslipidemia management in T2D, however, the role of non-statin therapy remains unclear. Ezetimibe reduces cholesterol burden by inhibiting intestinal cholesterol absorption. Fibrates lower triglyceride levels and increase high-density lipoprotein cholesterol (HDL-C) levels via peroxisome proliferator- activated receptor alpha agonism. Therefore, when combined, these drugs effectively lower non-HDL-C levels. Despite this, few clinical trials have specifically targeted non-HDL-C, and the efficacy of triple combination therapies, including statins, ezetimibe, and fibrates, has yet to be determined. Methods: This is a multicenter, prospective, randomized, open-label, active-comparator controlled trial involving 3,958 eligible participants with T2D, cardiovascular risk factors, and elevated non-HDL-C (≥100 mg/dL). Participants, already on moderate-intensity statins, will be randomly assigned to either Ezefeno (ezetimibe/fenofibrate) addition or statin dose-escalation. The primary end point is the development of a composite of major adverse cardiovascular and diabetic microvascular events over 48 months. Conclusion This trial aims to assess whether combining statins, ezetimibe, and fenofibrate is as effective as, or possibly superior to, statin monotherapy intensification in lowering cardiovascular and microvascular disease risk for patients with T2D. This could propose a novel therapeutic approach for managing dyslipidemia in T2D.

Background: Atherogenic dyslipidemia, which is frequently associated with type 2 diabetes (T2D) and insulin resistance, contributes to the development of vascular complications. Statin therapy is the primary approach to dyslipidemia management in T2D, however, the role of non-statin therapy remains unclear. Ezetimibe reduces cholesterol burden by inhibiting intestinal cholesterol absorption. Fibrates lower triglyceride levels and increase high-density lipoprotein cholesterol (HDL-C) levels via peroxisome proliferator- activated receptor alpha agonism. Therefore, when combined, these drugs effectively lower non-HDL-C levels. Despite this, few clinical trials have specifically targeted non-HDL-C, and the efficacy of triple combination therapies, including statins, ezetimibe, and fibrates, has yet to be determined. Methods: This is a multicenter, prospective, randomized, open-label, active-comparator controlled trial involving 3,958 eligible participants with T2D, cardiovascular risk factors, and elevated non-HDL-C (≥100 mg/dL). Participants, already on moderate-intensity statins, will be randomly assigned to either Ezefeno (ezetimibe/fenofibrate) addition or statin dose-escalation. The primary end point is the development of a composite of major adverse cardiovascular and diabetic microvascular events over 48 months. Conclusion This trial aims to assess whether combining statins, ezetimibe, and fenofibrate is as effective as, or possibly superior to, statin monotherapy intensification in lowering cardiovascular and microvascular disease risk for patients with T2D. This could propose a novel therapeutic approach for managing dyslipidemia in T2D.