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It is well known that type 2 diabetes (T2DM) is dramatically improved after bariatric surgery, although the mechanisms have not been clearly identified. The skill required for gastric surgery for gastric cancer is very similar to that needed in bariatric surgery. In this study, we evaluated the immediate improvement of T2DM after gastrectomy for gastric cancer.
A total of nine patients who were diagnosed with early gastric cancer (EGC) and already had T2DM underwent a 75 g oral glucose tolerance test (OGTT) before surgery and within two weeks after gastrectomy. Glucose, insulin, and c-peptide were measured before, and 30 and 60 minutes after ingesting 75 g of glucose. From these trials, we calculated the HOMA-IR, insulinogenic index, Matsuda index, and area under the curve (AUC).
The mean age of participants was 57.23 ± 11.08 years and eight of them were men. HOMA-IR (4.2 vs. 2.3,
Insulin sensitivity was immediately improved after gastrectomy for early gastric cancer in patients with T2DM.
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The FOURIER trial reported that inhibition of PCSK9 with evolocumab on a background of statin therapy lowered low-density lipoprotein (LDL) cholesterol levels to a median of 30 mg per deciliter (0.78 mmol per liter) and reduced the risk of cardiovascular events. Here, we report data from a single center focusing on the effect of a PCSK9 inhibitor antibody on hyperlipidemia.
We enrolled 29 hypercholesterolemia patients who had LDL cholesterol levels ≥ 70 mg per deciliter or non-HDL cholesterol ≥ 100 mg per deciliter and were divided into two groups (placebo n = 14, evolocumab n = 15), and participated in a 72 – 96 week, randomized, double-blind, placebo-controlled trial with statin therapy. Patients were randomly assigned to receive evolocumab (140 mg every 2 weeks or 420 mg monthly) or matched placebo via subcutaneous injection. Lipid changes during follow-up were analyzed.
The median LDL cholesterol level at baseline was 88 mg per deciliter, and the average LDL cholesterol level was 101.8 ± 20.0 mg per deciliter. At 4 weeks, the median LDL cholesterol level was 39 mg per deciliter, and the average LDL cholesterol level was 34.8 ± 51.8 mg per deciliter. Compared to placebo group, the LDL cholesterol levels were significantly reduced after treatment (
Evolocumab significantly reduced LDL cholesterol levels and was well tolerated.
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: Since endoscopic findings of primary gastric lymphoma are ambiguous and diverse, it is not easy to distinguish them from gastric adenocarcinoma or secondary gastric lymphoma. The aim of this study was to investigate the difference in clinical and endoscopic features between primary gastric lymphoma and gastric involvement of lymphoma.
: Forty-eight patients were enrolled in this retrospective study between June 2008 and February 2017. The patients were divided into primary gastric lymphoma group (primary group, n = 18) and gastric involvement group (secondary group, n = 30) based on whether or not they carried gastric lesions alone. Patients’ clinical characteristics, endoscopic findings and pathologic data were retrospectively reviewed based on electronic medical records.
: The mean age of patients was 63.3 ± 13.1 years and 29 patients were female (60.4%). Diffuse large B-cell lymphoma pathology (81.3%), gastric body involvement (47.9%) and ulceroinfiltrative morphology on endoscopy (43.8%) were common features. Regardless of the two groups, the initial endoscopic diagnosis was considered as lymphoma only in 41.7%. Compared with the primary group, fundus (
: Endoscopic diagnosis of gastric lymphoma is a challenge. There is no difference in endoscopic findings between the primary and secondary groups even when confirmed separately. However, when the lesion is present in the fundus, we keep in mind the possibility of secondary gastric lymphoma.
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Primitive neuroectodermal tumor (PNET) arising primarily in the lung is an extremely rare and aggressive malignancy with poor chances of patient survival. We present a case of long-term survival by a 29-year-old woman with PNET diagnosed after a hertological and immunohertochemical examination of a biopsy specimen obtained by performing video-assisted thoracic surgery. The patient underwent a left lower lung lobe lobectomy and 6 cycles of adjuvant chemotherapy. The patient has been free of any symptoms of the recurrence of the disease for 6 years after treatment completion.
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We report a case of difficult endotracheal intubation in a patient with tracheobronchopathia osteochondroplastica. A 65-year-old man was scheduled to undergo ulnar nerve decompression and ganglion excisional biopsy under general anesthesia. During induction of general anesthesia, an endotracheal tube could not be advanced through the vocal cords due to resistance. A large number of nodules were identified below the vocal cords using a Glidescope® video-laryngoscopy, and fiberoptic bronchoscopy revealed irregular nodules on the surface of the entire trachea and the main bronchus below the vocal cords. Use of a small endotracheal tube was attempted and failed. a laryngeal mask airway (LMA Supreme ™) rather than further intubation was successfully used to maintain the airway.
A report of a 79 year old male patient suffering from acute myocardial infarction with Mallory-Weiss tear after successful cardiopulmonary resuscitation(CPR) by emergency medical technician in the swimming pool is presented. Successful percutaneous coronary intervention(PCI) was done after appropriate transfusion. The patient survived and discharged without major complications after admitting 11days in the hospital. Importance of CPR in AMI patient is reiterated as complication such as Mallory-Weiss tear may arise.
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