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Enhancing the outcomes of diabetic vitrectomy with pharmacological adjuvants

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World Journal of Methodology 2025年第2期15卷 15-20页

作者： Chun-Yao Cheng Wen-Rui Hao Tzu-Hurng Cheng department of Ophthalmology Cathay General HospitalTaipei 10633TaiwanChina Division of cardiology Department of Internal MedicineShuang Ho HospitalMinistry of Health and WelfareTaipei Medical UniversityNew Taipei City 23561TaiwanChina Division of cardiology Department of Internal MedicineSchool of MedicineCollege of MedicineTaipei Medical UniversityTaipei 11002TaiwanChina department of Biochemistry School of MedicineCollege of MedicineChina Medical UniversityTaichung City 404328TaiwanChina

This editorial offers insights from a minireview by Venkatesh et al,who explored pharmacological adjuvants for diabetic ***,they synthesized current knowledge and evaluated the efficacy of various adjunctive therapies in improving the outcomes of diabetic retinopathy and managing associated ***,we highlight the key roles of pharmacological adjuvants in optimizing surgical techniques,minimizing intraoperative challenges,and enhancing postoperative *** further discuss the potential implications of this approach for clinical practice and future research directions in this evolving ***,this editorial underscores the importance of incorporating pharmacological adjuvants into standard diabetic vitrectomy care to improve surgical outcomes and thus patients’quality of life.

关键词： Diabetic vitrectomy Pharmacological adjuvants Surgical outcomes Diabetic retinopathy Clinical implications

Need for surveillance of concomitant peripheral artery disease in patients with coronary disease: results of the AGATHA survey in Malaysia

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Journal of Geriatric cardiology 2007年第4期4卷 195-199页

作者： Kui Hian Sim Kok Han Chee Inderjit Singh Choon Kiat Ang HoungBang Liew Kim Heung Tan Omar Ismail department of cardiology Sarawak General Hospital Sarawak Malaysia department of cardiology Universiti Malaya Medical Centre Petaling Jaya Malaysia department of cardiology Penang General Hospital Penang Malaysia

Background For patients with cardiovascular disease (CVD), co-existence of peripheral artery disease (PAD) predicts increased mortality, and such patients are also more likely to benefit from aggressive therapy. Surveillance of PAD is often neglected at health clinics. Our aim is to highlight the importance and ease of surveillance of PAD in patients with CVD. Objective To determine the prevalence of symptomatic and asymptomatic PAD in a Malaysian patient population with documented CVD. Methods and Results A total of 393 subjects with established CVD were recruited from three centres (85 women and 308 men), as part of a larger international (AGATHA) survey. PAD, determined by presence of claudicant symptoms on interview and/or abnormal ankle-brachial index (ABI) score of less than 0.9, was present in 21.4% of patients-of whom 64% were asymptomatic. Abnormal ABI is associated with higher systolic blood pressure and number of arterial beds affected. Conclusions Concomitant PAD is prevalent among CVD patients in Malaysia. ABI screening is simple and yields a high proportion of patients with extensive atherosclerosis who may require more aggressive atherosclerotic risk management.(J Geriatr Cardiol 2007;4:195-199.)

关键词： arteriosclerosis atherothrombosis Malaysia cardiovascular diseases epidemiologic factors anklebrachial index peripheral arterial disease

Assessment of left ventricular ejection fraction: comparison of two dimensional echocardiography, cardiac magnetic resonance imaging and 64-row multi-detector computed tomography

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Journal of Geriatric cardiology 2006年第1期3卷 2-8页

作者： Chee Khoon LIEW Rapaee ANNUAR Tiong Kiam ONG Sze Piaw CHIN Tobias Seyfarth Yean Yip FONG Choon Kiat ANG Houng Bang LIEW Kui Hian SIM department of cardiology sarawak general hospital Sarawak Malaysia University Malaysia sarawak Siemens Cardiac Solutions Erlangen Germany department of cardiology sarawak general hospital SarawakMalaysia

Objectives To compare left ventricular ejection fraction (LVEF) determined from 64-row multi-detector computed tomography (64-row MDCT) with those determined from two dimensional echocardiography (2D echo) and cardiac magnetic resonance imaging (CMR). Methods Thirty-two patients with coronary artery disease underwent trans-thoracic 2D echo, CMR and contrast-enhanced 64-row MDCT for assessment of LVEF within 48 hours of each other. 64-row MDCT LVEF was derived using the Syngo Circulation software; CMR LVEF was by Area Length Ejection Fraction (ALEF) and Simpson method and 2D echo LVEF by Simpson *** The LVEF was 49.13 ± 15.91% by 2D echo, 50.72 ± 16.55% (ALEF method) and 47.65 ± 16.58%(Simpson method) by CMR and 50.00 ± 15.93% by 64-row MDCT. LVEF measurements by 64-row MDCT correlated well with LVEF measured with CMR using either the ALEF method (Pearson correlation r = 0.94, P ＜0.01) or Simpson method (r = 0.92, P＜0.01). It also correlated well with LVEF measured using 2D echo (r = 0.80, P ＜ 0.01). Conclusion LVEF measurements by 64-row MDCT correlated well with LVEF measured by CMR and 2D echo. The correlation between 64-row MDCT and CMR was better than the correlation between 2D echo with CMR. Standard data set from a 64-row MDCT coronary study can be reliably used to calculate the LVEF.

关键词： ejection fraction echocardiography magnetic resonance imaging computed tomography

Cryptococcal meningitis with pulmonary cryptococcoma in an immunocompetent patient: A case report

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Asian Pacific Journal of Tropical Medicine 2020年第1期13卷 46-48页

作者： Kee Tat Lee Kar Ying Yong Hock Hin Chua department of Medicine Miri General HospitalSarawakMalaysia Infectious Disease Unit Department of MedicineSarawak General HospitalSarawakMalaysia

Rationale:Cryptococcal infections commonly occur in immunosuppressed patients and are uncommon in immunocompetent *** concerns:A 32 year old lady,active smoker presented with right chest pain,dry cough and loss of *** chest radiograph showed a lobulated lung mass in the right lower *** developed headache and right cranial nerve palsy during *** investigations were done including lumbar puncture,brain and chest ***:Cryptococcal meningitis with pulmonary ***:She received five months of effective antifungal treatment;however,the patient did not respond ***,removal of pulmonary cryptococcoma was ***:Her condition improved and she no longer had any ***:Disseminated cryptococcosis is rare in immunocompetent *** case highlights the importance of high index of suspicion and we postulate that lobectomy helped in reducing the cryptococcal burden in her body,thus facilitating better response to antifungal therapy.

关键词： Cryptococcoma Meningitis Immunocompetent Antifungal Lobectomy

Atherosclerosis in the elderly:a heavy burden to bear

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Journal of Geriatric cardiology 2005年第1期2卷 46-47页

作者： Sze Piaw Chin Kui Hian Sim department of cardiology sarawak general hospital KuchingSarawakMalaysia

The World Health Organization estimates there are over thirty-two million major atherothrombotic events occur worldwide each year with nearly seventeen million directly attributable deaths.

关键词： Atherosclerosis in the elderly

Intracoronary arterial retrograde thrombolysis with percutaneous coronary intervention: a novel use of thrombolytic to treat acute ST-segment elevation myocardial infarction

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Journal of Geriatric cardiology 2019年第6期16卷 458-467页

作者： Jin-Wen TIAN Mei ZHU Feng-Qi WANG Ke LI Chao-Fei ZHOU Bo LI Min WANG Jue-Lin DENG Bo JIANG Jing BAI Yi GUO Rong-Jie JIN Zhao ZHANG Ying LIN Ji-Hang WANG Shi-Hao ZHAO Ming-Zhi SHEN department of cardiology Hainan Hospital of PLA General Hospital Hainan China department of cardiology Chinese PLA General Hospital Beijing China

Background Clearance of coronary arterial thrombosis is necessary in patients with acute ST-segment elevation myocardial infarction (STEMI) undergoing urgent percutaneous coronary intervention (PCI). There is currently no highly-recommended method of thrombus removal during interventional procedures. We describe a new method for opening culprit vessels to treat STEMI: intracoronary arterial retrograde thrombolysis (ICART) with PCI. Methods & Results Eight patients underwent ICART. The guidewire was advanced to the distal coronary artery through the occlusion lesion. Then, we inserted a microcatheter into the distal end of the occluded coronary artery over the guidewire. Urokinase (5–10 wu) mixed with contrast agents was slowly injected into the occluded section of the coronary artery through the microcatheter. The intracoronary thrombus gradually dissolved in 3–17 min, and the effect of thrombolysis was visible in real time. Stents were then implanted according to the characteristics of the recanalized culprit lesion to achieve full revascularization. One patient experienced premature ventricular contraction during vascular revascularization, and no malignant arrhythmias were seen in any patient. No reflow or slow flow was not observed post PCI. Thrombolysis in myocardial infarction flow grade and myocardial blush grade post-primary PCI was 3 in all eight patients. No patients experienced bleeding or stroke. Conclusions ICART was accurate and effective for treating intracoronary thrombi in patients with STEMI in this preliminary study. ICART was an effective, feasible, and simple approach to the management of STEMI, and no intraprocedural complications occurred in any of the patients. ICART may be a breakthrough in the treatment of acute STEMI.

关键词： ST elevation myocardial infarction Therapeutic thrombolysis Thrombus Urokinase

Drug-eluting balloons versus new generation drug-eluting stents for the management of in-stent restenosis: an updated meta-analysis of randomized studies

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Journal of Geriatric cardiology 2019年第6期16卷 448-457页

作者： Lei GAO Ya-Bin WANG Jing JING Ming ZHANG Yun-Dai CHEN department of cardiology Chinese PLA General Hospital

Background New-generation drug-eluting stents (DES) was more effective in the treatment of in-stent restenosis (ISR) compared with the first-generation DES. Drug-eluting balloons (DEB) and new-generation DES had been available strategies in treatment of bare-metal stents/DES ISR (BMS/DES-ISR). Six new randomized trials have recently examined the angiographic outcomes and one-year clinical outcomes of DEB and new generation DES in BMS/DES-ISR. However, the optimal management for BMS/DES-ISR lesions remains controversial. Methods We searched the randomized clinical trials evaluating the angiographic outcomes and one-year clinical outcomes of DEB and new-generation DES in patients with BMS/DES-ISR. The primary endpoints were the angiographic outcomes, including the minimal luminal diameter (MLD), diameter stenosis %(DS%), late lumen loss (LLL), and binary restenosis (BR). Results A total of six randomized clinical trials with 1177 BMS/DES-ISR patients were included in our meta-analysis. For angiographic outcomes, there were significantly less MLD and more DS% with DEB compared to new-generation DES (MLD: MD =?0.18, 95% CI:?0.31– ?0.04, P < 0.001;DS%: MD = 5.68, 95% CI: 1.00–10.37, P < 0.001). Moreover, for one-year clinical outcomes, DEB was associated with a significant increase risk in target lesion revascularization (TLR)(RR = 2.93, 95% CI: 1.50–5.72, P = 0.002). However, DEB was associated with higher risks of major adverse cardiac event, target vessel revascularization, TLR, BR, and more DS% only in DES-ISR group. Conclusions DEB and new-generation DES have the similar clinical efficacy for the treatment of BMS-ISR. However, DES showed more MLD, less DS%, and a decreased risk of TLR for the treatment of DES-ISR.

关键词： Drug-eluting balloons Drug-eluting stents In-stent restenosis Meta-analysis

High-resolution computed tomography in patients with atypical 'cardiac' chest pain: a study investigating patients at 10-year cardiovascular risks defined by the Framingham and PROCAM scores

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Journal of Geriatric cardiology 2006年第1期3卷 17-21页

作者： Choon Kiat ANG Alan Yean Yip FONG Sze Piaw CHIN Tiong Kiam ONG Seyfarth M Tobias Chee Khoon LIEW Rapaee ANNUAR Houng Bang LIEW Kui Hian SIM Deptartment of cardiology sarawak general hospital Sarawak Malaysia Siemens Medical Solutions Germany Deptartment of cardiology sarawak general hospital SarawakMalaysia University Malaysia sarawak Malaysia

Background and objective Atypical 'cardiac' chest pain (ACCP) is not usually caused by myocardial ischaemia. Current noninvasive investigations for these symptoms are not yet as accurate as invasive coronary angiography. The latest 64-row multi-detector computed tomography (MDCT) technology is non-invasive, has high specificity and negative predictive values for the detection of significant coronary disease. Our aim was to investigate if this modality can provide more information in the assessment of outpatients with ACCP in addition to established cardiovascular risk scores. Methods Seventy consecutive patients presenting to the outpatient clinic with ACCP underwent 64-row MDCT scan of the coronary arteries. They were categorized into low, medium or high risk groups based upon the Framingham and PROCAM scores. We defined a clinically abnormal MDCT scan as coronary stenosis =50% or calcium score ＞400 Agatston. Results Fifty-three (75.7%) patients did not have clinically abnormal scans. Framingham score classified 43 patients as low-risk while PROCAM classified 59 patients as low-risk. MDCT scans were abnormal for 18.6% and 22.0% of the respective low-risk group of patients. For patients with medium-to-high risk, 33.3% and 36.4% of Framingham and PROCAM patient groups respectively had abnormal MDCT scans. Conclusion MDCT adds valuable information in the assessment of patients with ACCP by identifying a significant proportion of patients categorized as low-risk to have underlying significant coronary stenosis and coronary calcification by established cardiovascular risk scores.

关键词： multi-detector computed tomography atypical 'cardiac' chest pain coronary artery disease risk stratification

Clinical characteristics predicting erythema nodosum leprosum(ENL) among patients with multibacillary leprosy(MBL) in sarawak

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Asian Pacific Journal of Tropical Medicine 2009年第5期2卷 66-70页

作者： Yap Felix Boon Bin department of Dermatology Sarawak General HospitalJalan Hospital93586 KuchingSarawakMalaysia

Objective:To determine the clinical features predicting erythema nodosum leprosum(ENL) in a non endemic leprosy ***:Twenty newly diagnosed patients with MBL attending the skin clinic,sarawak general hospital from 1992 to 2007 were *** were divided into 2 groups,one with ENL and one without. Analysis of the presenting clinical features was done to determine the risk factors for *** square and student t test was used for statistical *** of significance was set at ***:ENL was present in 40%patients,all with lepromatous leprosy(LL).Clinical features that were seen more frequently in patients developing ENL include earlobe thickening(100%cf.25%,P =0.00),loss of the lateral third of the eyebrows(75%cf.16.7%,P=0.02) and mean bacteriology index(BI)(5.1 cf.2.9,P=0.03) and mean morphological index(MI)(17.8 cf.7.0,P =0.02).Number of thickened nerves(mean 2.5 cf. 1.4,P = 0.12),number of skin lesions(mean 19.4 cf.10.9,P = 0.15) and duration of illness(mean 15. 3 cf.12.8 months,P =0.68) did not predict ENL ***:Finding LL patients with thickened earlobes,loss of lateral third of the eyebrow,high BI and MI should alert treating clinician to the possibility of ENL in a non endemic leprosy area.

关键词： Leprosy Erythema nodosum leprosum(ENL) Multibacillary leprosy