Successful treatment of central retinal artery occlusion using hyperbaric oxygen therapy

Central retinal artery occlusion (CRAO) is considered an ophthalmologic emergency. The prognosis of this disease is very poor. Currently, there is no generally effective therapy available to treat CRAO. Hyperbaric oxygen therapy (HBOT) can increase the volume of oxygen delivered to the ischemic retinal tissue until spontaneous or assisted reperfusion occurs. We report the case of a patient who experienced sudden visual loss due to CRAO that was treated with HBOT. The patient was an 81-year-old woman who presented with CRAO in her right eye (OD). She exhibited “hand motion” visual acuity before treatment. She underwent three sessions of HBOT at a pressure of 2.8 atmospheres absolute, performed over 3 days. After 4 days in hospital, her visual acuity improved to 0.4 (OD) for far vision and 0.5 (OD) for near vision. Her vision was stable without the supply of oxygen; therefore, she was discharged

Successful management of heterotopic cornual pregnancy with laparoscopic cornual resection

AbstractObjectiveTo examine the feasibility of laparoscopic cornual resection for the treatment of heterotopic cornual pregnancy.Study designWomen who underwent laparoscopic cornual resection for heterotopic cornual pregnancy at our hospital between January 2003 and March 2015 were retrospectively analyzed. We evaluated significant parameters such as operative complications and postoperative pregnancy outcomes of concomitant pregnancy.ResultsThirteen patients with heterotopic cornual pregnancy were included in the study. All were pregnant through assisted reproductive technology, and the diagnosis was made at a median of 6+6 weeks (range 5+4–10+0). They were successfully treated with laparoscopic cornual resection and admitted for a median of 4 days (range, 2–7) postoperatively. The median operative time was 65min (range, 35–145min) and estimated blood loss was 200mL (range, 10–3000mL). There was a spontaneous abortion at 7+6 gestational weeks in a patient who received bilateral cornual resection. Seven patients delivered babies at term and 3 at preterm. All 10 women delivered without any maternal or neonatal complications. Two were lost to follow-up.ConclusionsLaparoscopic cornual resection is a feasible primary approach for the management of heterotopic cornual pregnancy

Risk of Incident Dementia According to Metabolic Health and Obesity Status in Late Life: A Population-Based Cohort Study.

CONTEXT: The risk for dementia among subjects who are obese with normal metabolic profiles, or called metabolically healthy obese (MHO), remains uninvestigated. OBJECTIVE: To determine the association between late-life metabolic health and obesity status and risk of incident dementia. DESIGN: Retrospective cohort study. SETTING: The National Health Insurance System, Republic of Korea. PATIENTS: A total of 12,296,863 adults >50 years old who underwent health examinations from 2009 to 2012 without baseline history of dementia. MAIN OUTCOME MEASURE: Incident overall dementia, Alzheimer's disease (AD), and vascular dementia (VaD). RESULTS: Among subjects ≥60 years old, 363,932 (6.4%) developed dementia during a median follow-up of 65 months (interquartile range 51 to 74 months). The MHO group showed the lowest incidence of overall dementia [hazard ratio (HR) 0.85; 95% CI, 0.84 to 0.86] and AD (HR 0.87; 95% CI, 0.86 to 0.88), but not VaD, compared with the metabolically healthy nonobese group. All components of metabolic syndrome except obesity significantly elevated the risk of dementia, and these associations were more pronounced in VaD. In particular, being underweight dramatically increased the risk of dementia. CONCLUSIONS: The MHO phenotype in late life demonstrated lower risk of overall dementia and AD but not VaD. Additional studies in other populations are warranted to elucidate current results and may predict individuals most at risk for developing dementia

Ionothermal Synthesis of a Novel 3D Cobalt Coordination Polymer with a Uniquely Reported Framework: [BMI] 2

The framework of [RMI]2[Co2(BTC)2(H2O)2] (RMI = 1-alkyl-3-methylimidazolium, alkyl; ethyl (EMI); propyl (PMI); butyl (BMI)), which has uniquely occurred in ionothermal reactions of metal salts and H3BTC (1,3,5-benzenetricarboxylic acid), an organic ligand, reappeared in this work. Ionothermal reaction of cobalt acetate and H3BTC with [BMI]Br ionic liquid as the reaction medium yielded the novel coordination polymer [BMI]2[Co2(BTC)2(H2O)2] (compound B2). Similar ionothermal reactions with different [EMI]Br and [PMI]Br as the reaction media have been previously reported to produce [EMI]2[Co3(BTC)2(OAc)2] (compound A1) and [PMI]2[Co2(BTC)2(H2O)2] (compound B1), respectively. In contrast with the trinuclear secondary building unit of A1, the framework structure of B1 and B2 consists of dinuclear secondary building units in common, but with subtle distinction posed by the different size of the incorporated cations. These structural differences amidst the frameworks showed interesting aspects, including guest and void volume, and were used to explain the chemical trend observed in the system. Moreover, the physicochemical properties of the newly synthesized compound have been briefly discussed

Combining SGLT2 Inhibition With a Thiazolidinedione Additively Attenuate the Very Early Phase of Diabetic Nephropathy Progression in Type 2 Diabetes Mellitus

Although both sodium glucose co-transporter 2 inhibition by dapagliflozin and thiazolidinedione, pioglitazone have glucose-lowering and anti-inflammatory effects, the therapeutic efficacy of their combination on diabetic nephropathy has not been investigated. 9-week-old male db/db mice were randomly assigned to 4 groups and administrated with (1) vehicle, (2) dapagliflozin, (3) pioglitazone, or (4) dapagliflozin and pioglitazone combination. Human proximal tubule (HK-2) cells were treated with glucose or palmitate acid in the presence of medium, dapagliflozin, pioglitazone, or both. Glomerular tuft area and mesangial expansion of the kidney more reduced in the combination group compared to control and single therapy groups. Podocyte foot process width and glomerular basement membrane thickness decreased regardless of treatment, while the combination group showed the slowest renal hypertrophy progression (P < 0.05). The combination treatment decreased MCP-1, type I and IV collagen expression in the renal cortex. Only the combination treatment decreased the expression of angiotensinogen, IL-6, and TGF-β while it enhanced HK-2 cell survival (all P < 0.05). In conclusion, dapagliflozin and pioglitazone preserved renal function, and combination therapy showed the greatest benefit. These findings suggest that the combination therapy of dapagliflozin with pioglitazone is more effective than the single therapy for preventing the progression of nephropathy in patients with type 2 diabetes

Temporal Trends of Emergency Department Visits of Patients with Atrial Fibrillation:A Nationwide Population-Based Study

The question of list decoding error-correcting codes over finite fields (under the Hamming metric) has been widely studied in recent years. Motivated by the similar discrete linear structure of linear codes and point lattices in R N, and their many shared applications across complexity theory, cryptography, and coding theory, we initiate the study of list decoding for lattices. Namely: for a lattice L ⊆ R N, given a target vector r ∈ R N and a distance parameter d, output the set of all lattice points w ∈ L that are within distance d of r. In this work we focus on combinatorial and algorithmic questions related to list decoding for the well-studied family of Barnes-Wall lattices. Our main contributions are twofold: 1. We give tight (up to polynomials) combinatorial bounds on the worst-case list size, showing it to be polynomial in the lattice dimension for any error radius bounded away from the lattice’s minimum distance (in the Euclidean norm). 2. Building on the unique decoding algorithm of Micciancio and Nicolosi (ISIT ’08), we give a list-decoding algorithm that runs in time polynomial in the lattice dimension and worst-case list size, for any error radius. Moreover, our algorithm is highly parallelizable, and with sufficiently many processors can run in parallel time only poly-logarithmic in the lattice dimension. In particular, our results imply a polynomial-time list-decoding algorithm for any error radius bounded away from the minimum distance, thus beating a typical barrier for natural error-correcting codes posed by the Johnson radius

Importance of Clinical and Echocardiographic Hemodynamic Assessment in Chronic Pulmonary Embolism

We describe a 42-year-old man presenting to the emergency department with cardiogenic shock. He had a prior history of acute pulmonary embolism (PE), and had been on anticoagulation for 2 years. Although computed tomographic pulmonary angiography performed at the emergency department showed no change in the extent of PE and did not support a role of surgical treatment, pulmonary embolectomy was recommended by attending physician based on clinical and echocardiographic hemodynamic findings like unstable vital sign and markedly enlarged right ventricle with severely depressed systolic function. Surgery confirmed the presence of fresh thrombi. After surgery, hemodynamic status was progressively improved, but the patient died due to pneumonia and pulmonary hemorrhage