Notes

School 2 HLA (DRB1, & DQB1) alleles as well as IL7R (rs6897932) variations along with the threat regarding Multiple Sclerosis within Kerala, India.
BACKGROUND Laparoscopic distal gastrectomy for early gastric cancer has been widely accepted, but laparoscopic total gastrectomy has still not gained popularity because of technical difficulty and unsolved safety issue. We conducted a single-arm multicenter phase II clinical trial to evaluate the safety and the feasibility of laparoscopic total gastrectomy for clinical stage I proximal gastric cancer in terms of postoperative morbidity and mortality in Korea. The secondary endpoint of this trial was comparison of surgical outcomes among the groups that received different methods of esophagojejunostomy (EJ). METHODS The 160 patients of the full analysis set group were divided into three groups according to the method of EJ, the extracorporeal circular stapling group (EC; n = 45), the intracorporeal circular stapling group (IC; n = 64), and the intracorporeal linear stapling group (IL; n = 51). The clinicopathologic characteristics and the surgical outcomes were compared among these three groups. RESULTS There were no significant differences in the early complication rates among the three groups (26.7% vs. 18.8% vs. 17.6%, EC vs. IC vs. IL; p = 0.516). The length of mini-laparotomy incision was significantly longer in the EC group than in the IC or IL group. The anastomosis time was significantly shorter in the EC group than in the IL group. The time to first flatus was significantly shorter in the IL group than in the EC group. The long-term complication rate was not significantly different among the three groups (4.4% vs. 12.7% vs. 7.8%; EC vs. IC vs. IL; p = 0.359), however, the long-term incidence of EJ stenosis in IC group (10.9%) was significantly higher than in EC (0%) and IL (2.0%) groups (p = 0.020). CONCLUSIONS The extracorporeal circular stapling and the intracorporeal linear stapling were safe and feasible in laparoscopic total gastrectomy, however, intracorporeal circular stapling increased EJ stenosis.BACKGROUND AND AIMS Epinephric diverticula are frequently associated with esophageal motility disorder. Their management implies surgery, with 15% morbidity and 3% mortality rates. Flexible endoscopy could be an effective and safer approach for treating esophageal diverticulum with motility disorder. We report our experience of seven consecutive cases treated with per-oral endoscopic submucosal septotomy and myotomy (D-POEM). METHODS Seven consecutive patients were referred for symptomatic non-zenker's esophageal diverticulum. The steps of the procedure were as follows (i) analysis of the esophageal anatomy; (ii) vertical mucosal incision just above the upper edge of the diverticulum; (iii) submucosal tunneling by submucosal dissection, alongside the submucosal window of the diverticulum and the downstream septum; (iv) identification of the septum and the diverticular area; (v) diverticular septotomy followed by antegrade esocardial myotomy up to 2 cm below the cardia; and (vi) closure of the mucosal incision. RESULTS Three men and four women aged from 62 to 90 years were treated. Four patients had a diet with adapted texture before the treatment and five patients had weight loss (4 kg to 24 kg). At preoperative evaluation, all had an esophageal motility disorder at high-resolution manometry. The procedures were successfully performed in all the patients without per-operative complications. During the 30 postoperative days, no significant adverse events occurred. Three months after treatment, six patients (85%) had clinical improvement with complete or partial regression of dysphagia. BGB-16673 All the patients stabilized or gained weight after the treatment. CONCLUSION The D-POEM technique is a mini-invasive effective and safe technique to treat symptoms due to both esophageal motility disorder and distal esophageal diverticula. It could be a very interesting solution for non-surgical patients in the first time that could be extended to other patients after favorable larger series.BACKGROUND Despite the fact that thyroid surgery has evolved towards minimal incisions and endoscopic approaches, the role of total endoscopic thyroidectomy (TET) in thyroid cancer has been highly disputed. We performed a systematic review and meta-analyses of peer reviewed studies in order to evaluate the safety and effectiveness of TET compared with conventional open thyroidectomy (COT) in papillary thyroid cancer (PTC). METHOD Medical literature databases such as PubMed, Embase, the Cochrane Library, and Web of science were systematically searched for articles that compared TET and COT in PTC treatment from database inception until March 2019. The quality of the studies included in the review was evaluated using the Downs and Black scale using Review Manager software Stata V.13.0 for the meta-analysis. RESULTS The systematic review and meta-analysis were based on 5664 cases selected from twenty publications. Criteria used to determine surgical completeness included postoperative thyroglobulin (TG) levels, ss in TET are similar to those obtained for COT. TET was associated with significantly lower levels of transient hypocalcemia and better cosmetic satisfaction, and thus is the better option for patients with cosmetic concerns. Overall, randomized clinical trials and studies with larger patient cohorts and long-term follow-up data are required to further demonstrate the value of the TET.PURPOSE The aim of the study was to investigate the diagnostic accuracy of peri-thrombus vascular hyperintensity sign (PVHS) on three-dimensional (3D) black-blood (BB) contrast-enhanced MRI for the detection of intracranial thrombus location and length in acute ischemic stroke (AIS) patients. MATERIALS AND METHODS Consecutive AIS patients who underwent MRI including 3D BB contrast-enhanced MRI sequence within 8 h of clinical onset were prospectively evaluated. Two readers independently reviewed the 3D BB contrast-enhanced MRI data to assess the presence and location of PVHS. Findings were compared with those of contrast-enhanced MR angiography (CE-MRA) as the reference standard. RESULTS The PVHS was identified in 49% (63/129) of AIS patients with good agreement. The PVHS had 100% specificity, 88% negative predictive value, 89% sensitivity, and 100% positive predictive value for detection of acute arterial occlusions. Eight patients showed discordant thrombus locations between 3D BB contrast-enhanced MRI and CE-MRA.
Homepage: https://www.selleckchem.com/products/bgb-16673.html