Endovascular Treatment for Acute Tandem Occlusion Stroke: Results from Case Series of 17 Patients.

BACKGROUND AND PURPOSE: Tandem occlusive lesion, a major challenge for thrombectomy in acute anterior circulation strokes, is poorly represented in randomized trials. This study demonstrates the findings of thrombectomy in tandem occlusion and comparative analysis of two treatment groups (extracranial versus intracranial first subgroup). PATIENTS AND METHODS: We enrolled and divided 17 patients with acute tandem ischemic stroke who received endovascular treatment into two groups. Group 1 with completed (100%) internal carotid artery (ICA) occlusion was treated by an extracranial stent, whereas Group 2 with severe (70%-99%) ICA occlusion was prioritized with intracranial thrombectomy. Data of clinical parameters, imaging and angiographic results, periprocedural complications, and results after 3 months were collected and analyzed. RESULTS: The mean age of patients was 70.2 ± 8.8 years, and males accounted for 94.1%. The National Institutes of Health Stroke Scale and Alberta Stroke Program Early CT Score (ASPECTS) baseline were 16.6 ± 4.2 and 7.6 ± 1.1, respectively, with occlusive side was 52.9% on the right. Group 1 including ten cases (58.8%) was treated extracranial lesion with carotid stent before intracranial thrombectomy, and Group 2 with seven cases (41.2%) was prioritized intracranial thrombectomy. In total 17 procedures, there were ten stent retrievers (58.8%), four aspirations (23.5%), and three Solumbra (17.7%). No re-occlusion of carotid stent postoperation was recorded. The good revascularization (thrombolysis in cerebral infarction 2b-3) was archived in 82.4% of patients, while symptomatic hemorrhage was seen in 2 cases (11.8%). Three months after treatment, patients with favorable clinical outcome (Modified Rankin Scale ≤2) accounted for 47.1%. CONCLUSION: Our study determined a promising outcome with reasonable good recanalization and clinical recovery for endovascular intervention in tandem ischemic. In the subgroup of treatment, "extracranial stent first" had more complex disease with completed ICA occlusion which required longer procedure time may lead to worse outcome.

An Update on the Progress of Isolation, Culture, Storage, and Clinical Application of Human Bone Marrow Mesenchymal Stem/Stromal Cells.

Bone marrow mesenchymal stem/stromal cells (BMSCs), which are known as multipotent cells, are widely used in the treatment of various diseases via their self-renewable, differentiation, and immunomodulatory properties. In-vitro and in-vivo studies have supported the understanding mechanisms, safety, and efficacy of BMSCs therapy in clinical applications. The number of clinical trials in phase I/II is accelerating; however, they are limited in the size of subjects, regulations, and standards for the preparation and transportation and administration of BMSCs, leading to inconsistency in the input and outcome of the therapy. Based on the International Society for Cellular Therapy guidelines, the characterization, isolation, cultivation, differentiation, and applications can be optimized and standardized, which are compliant with good manufacturing practice requirements to produce clinical-grade preparation of BMSCs. This review highlights and updates on the progress of production, as well as provides further challenges in the studies of BMSCs, for the approval of BMSCs widely in clinical application.

Basilar artery thrombectomy: assessment of outcome and identification of prognostic factors.

Mechanical thrombectomy (MT) has been demonstrated as an effective treatment for acute ischemic stroke (AIS), thanks to large vessel occlusion (LVO), especially in case of anterior cerebral artery with many randomized clinical trials (RCTs) every year. On the other hand, there is a limited number of basilar artery occlusion (BAO)-related studies which have been conducted. The fact prompts our range of case studies, which furnish BAO understanding with our experience, results and some prognosis factors of MT. This retrospective and single-center study was conducted on 22 patients who were diagnosed with BAO and underwent the treatment of MT from October 2012 to January 2018. Clinical feature such as radiological imaging, procedure complications, and intracranial hemorrhage were all documented and evaluated. All the studies' results based on performance using modified Rankin scale score (mRS) and mortality at 90 days. The results from these BAO patients study indicated that the posterior circulation Acute Stroke Prognosis Early CT Score (pcASPECTS) recorded before the intervention was 7.7 ± 1.6, while the admission National Institutes of Health Stroke Scale (NIHSS) was 17.5 ± 5.4. 15/22 cases achieved successful recanalization (TICI, Thrombolysis in Cerebral Infarction scale, of 2b-3), accounting for 68.2%. The results highlighted 50% of the favorable outcome (mRS 0-2) occupying 11 out of 22 patients in total and the overall mortality was 36.4%. The intracranial hemorrhagic complication was detected in three cases (13.6%). Placing in juxtaposition the poor-outcome group and the favorable-outcome group, we could witness statistically significant difference (P < 0.05) suggesting both good baseline image (pc-ASPECTS ≥ 7) and recanalization (TICI 2b-3) were two good prognosis factors. Our case series showed that MT would be an effective and feasible treatment for BAO. The pre-procedural pcASPECTS ≥ 7 and post-procedural good recanalization (TICI 2b-3) were two important prognosis factors for predicting good clinical outcome.

Author Correction: Evaluation of dental arch dimensions in 12 year-old Vietnamese children - A cross-sectional study of 4565 subjects.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

The Effects of Adipocytes on the Regulation of Breast Cancer in the Tumor Microenvironment: An Update.

Obesity is a global pandemic and it is well evident that obesity is associated with the development of many disorders including many cancer types. Breast cancer is one of that associated with a high mortality rate. Adipocytes, a major cellular component in adipose tissue, are dysfunctional during obesity and also known to promote breast cancer development both in vitro and in vivo. Dysfunctional adipocytes can release metabolic substrates, adipokines, and cytokines, which promote proliferation, progression, invasion, and migration of breast cancer cells. The secretion of adipocytes can alter gene expression profile, induce inflammation and hypoxia, as well as inhibit apoptosis. It is known that excessive free fatty acids, cholesterol, triglycerides, hormones, leptin, interleukins, and chemokines upregulate breast cancer development. Interestingly, adiponectin is the only adipokine that has anti-tumor properties. Moreover, adipocytes are also related to chemotherapeutic resistance, resulting in the poorer outcome of treatment and advanced stages in breast cancer. Evaluation of the adipocyte secretion levels in the circulation can be useful for prognosis and evaluation of the effectiveness of cancer therapy in the patients. Therefore, understanding about functions of adipocytes as well as obesity in breast cancer may reveal novel targets that support the development of new anti-tumor therapy. In this systemic review, we summarize and update the effects of secreted factors by adipocytes on the regulation of breast cancer in the tumor microenvironment.

Impact of body mass index and waist circumference on blood pressure: A cross-sectional survey in a population living in the Vietnam northern mountainous.

AIMS: Several epidemiological studies have indicated that elevated blood pressure (BP) is associated with the surfeit of body weight. Body fat accumulation is considered as be a significant factor contributing to the nexus between obesity and hypertension. Two of the most common indicators used to characterize the associations of BP are body mass index (BMI) and waist circumference (WC). This study was aimed to describe the differences in some characteristics among people aged 20 and above in three communes of a district in Vietnam and analyze the correlation between BMI and WC, and BP. MATERIALS AND METHODS: We conducted a survey with a cross-sectional design of 734 subjects in three communes in Chiem Hoa district of the Vietnam northern mountainous region. RESULTS: It was found that except for BMI, there were significant differences in some physical characteristics between genders (p < 0.05). Particularly, the effects on Systolic Blood Pressure (SBP) or Diastolic Blood Pressure (DBP) of WC were more significant than that of BMI in genders. The impacts of WC on SBP as well as DBP were also stronger than that of BMI in age groups with the cut-off point 60 than BMI. CONCLUSIONS: This study provides the science evidence in support of public and preventive health interventions to the locals residing in studied area. We recommend the existing correlations in subjects belonging to different ethnicities and continents.

Reduced Need of Infiltration Anesthesia Accompanied With Other Positive Outcomes in Diode Laser Application for Frenectomy in Children.

Introduction: The abnormal maxillary labial frenum is common in children during the primary or mixed dentition stage. A conventional surgery for this abnormality usually requires infiltration anesthesia which leads to fear in children and consequent noncooperation during the surgery. The aim of present study was to evaluate the reduction in the need of infiltration anesthesia, intraoperative bleeding control and postoperative pain and wound healing in children when using the diode laser for abnormal labial frenum in the maxilla. Methods: The present study was carried out among 30 children attending the Hanoi Medical University, Vietnam. A Diode Laser with 810 nm wavelength and power of 0.8 W was used for frenectomy. Results: The proportion of procedures without any need of infiltration anesthesia was 70%, while 93.34% of children demonstrated positive and very positive behavior. Proportion of indolence on the first day after surgery was 83.3%. While 83.3% of children did not take any analgesics, not a single child complained of any pain 3 days after surgery. Conclusion: Our results indicated that the use of diode laser showed several benefits in maxillary labial frenectomy in children. These included reducing the need of infiltration anesthesia, increasing the children's cooperation as well as decreasing the postoperative pain.

Evaluation of dental arch dimensions in 12 year-old Vietnamese children - A cross-sectional study of 4565 subjects.

This study aimed to define the width and length of the dental arch in 12-year-old Vietnamese children, and to elucidate differences between genders and among ethnic groups. A cross-sectional study was conducted in 4565 12 years-old children from the 4 major ethnic groups in Vietnam (Kinh, Muong, Thai, and Tay), with a healthy and full set of 28 permanent teeth that had never had any orthodontic treatment and with no reconstructive materials at the measured points. The mean variables in all subjects were 36.39 mm for upper inter-canine width; 46.88 mm for upper inter-first molar width; 59.43 mm for upper inter-second molar width; 10.41 mm for upper anterior length; 32.15 mm for upper posterior length 1; 45.52 mm for upper posterior length 2; 28.31 mm for lower inter-canine width; 41.63 mm for lower inter-first molar width; 54.57 mm for lower inter-second molar width (LM2W); 7.06 mm for lower anterior length (LAL); 26.87 mm for lower posterior length 1 (LP1L); and 41.29 mm for lower posterior length 2. Significant differences in these parameters between genders were found in all ethnic groups, except for LAL in the Kinh and Thai groups, and LP1L in the Tay group. Significant ethnic differences were also found in almost all parameters except LM2W in both males and females. Taken together, the representative sizes of dental arches of 12-year-old Vietnamese children have been defined. Our data indicate that there are some variations in dental arch dimensions among ethnic groups and between genders.

The possible zoonotic diseases transferring from pig to human in Vietnam.

Southeast Asia is considered one of worldwide hotspots consisting many distinct zoonotic infections. With optimal condition for the development of various pathogens, Vietnam is facing serious risks of zoonotic diseases. Besides, more than 50% Vietnamese people settle in rustic areas and earn their livings through small-scale animal breeding. It is possible that zoonotic diseases can be easily spread to the population by close contact with the infected animals, their infected residues, contaminated water, soil, or other possible means of transmission. In fact, zoonotic infections-transmissible infections between vertebrate animals and humans-cover a wide range of diseases with distinctive clinical and epidemiological highlights. With insufficient understanding and swift alteration in toxicity of the pathogens, these infections have gained more concerns due to sophisticated routes of transmission and harmful threats to humans. Recently emerging viral diseases exerted potential dangers to human beings, which required many countries to impose immediate actions to prevent any complications. Vietnam has recorded several cases of zoonotic diseases, especially pig-related illnesses; however, the studies on these diseases in this country remain limited. This work aims to highlight the zoonotic diseases transferring from pigs to humans and discuss risk factors of these diseases in Vietnam.

The higher prevalence of developmental defects of enamel in the dioxin-affected region than non-dioxin-affected region: result from a cross-sectional study in Vietnam.

Developmental defects of enamel (DDE) are induced and regulated by several factors including genetics and the environment. There is evidence showing that dioxin in polluted areas has a strong effect on the health and development of teeth. However, there has been no study on DDE in the dioxin-affected regions in Vietnam. To identify the effect of dioxin on the prevalence of DDE in studied areas in Vietnam, a cross-sectional study was conducted in 2200 adults in the A Luoi district in the Thua Thien Hue province (the dioxin-affected region) and in the Kim Bang district in the Ha Nam province (dioxin-unaffected region) in 2015. All subjects were interviewed using a structured questionnaire and their teeth were examined and scored for enamel defects based on the 1992 FDI criteria. The defected teeth were then photographed. Our results showed that the DDE rate in A Luoi was 20.5% when measured as mouth prevalence and 5.8% when measured as tooth prevalence, while the rates in Kim Bang were 10.4 and 2.32% for mouth and tooth prevalence, respectively. Demarcated opacities were predominated in both districts (45.5% in A Luoi and 52.2% in Kim Bang). The DDE rate of the anterior teeth group was higher than that of the posterior teeth group. Most lesions presented on the buccal surface of the tooth. Overall, the DDE prevalence in the dioxin-affected region was 2.2 times higher than that in non-dioxin-affected region in the studied regions in Vietnam.

Anatomical Characteristics of Thalamus-Cortical Sensory Tract in the Human Brain Using Diffusion Tensor Tractography at 3.0 Tesla Scanner.

BACKGROUND: Our knowledge about characteristics of the thalamocortical tract (THT) according to the cerebral origin is still few of studies about this structure on Vietnamese. AIM: Here, we aim to characterise the morphology of the thalamocortical tract in the human brain using diffusion tensor tractography (DTT) at 3.0 tesla scanner. METHODS: Fifty healthy subjects have enrolled in this study. Reconstructed images of the thalamocortical tract in the human brain were built using DTT at 3.0 tesla scanner. RESULTS: The median length of the right thalamocortical tract was 130.64 mm, and the left THT was 123.14 mm, and an average of two sides was 126.34 mm. The difference between the two sides was statically significance (p < 0.001). The median fibre number of the right THT was 401.50, and the left THT was 315.00, and an average of two sides was 365.50. There was a diverse branch of THT: two branches (5%); three branches (25%); four branches (42%); five branches (16%); six branches (12%); in which branched contralateral for the right was 50%, and for the left was 50%. CONCLUSION: Using the DTI and 3D image reconstruction techniques allow to build the image of sensory THT intuitively and accurately, which helps to identify the morphological characteristic of the thalamocortical tract of healthy people without invasive effects.