Comparison of Doppler-Guided Transanal Hemorrhoidal Dearterialization for Grade III and IV Hemorrhoids in Vietnam.

INTRODUCTION: This study aimed to assess the short- and long-term outcomes of Doppler-guided transanal hemorrhoidal dearterialization (THD) for grade III and IV hemorrhoidal disease in Vietnam. METHODS: In a prospective observational design, patients treated for grade III and IV hemorrhoidal disease with the THD method at the National Hospital of Traditional Medicine (Hanoi, Vietnam) were included between June 2012 and December 2013. Patients were evaluated postoperatively at the time they were discharged from the hospital (short-term outcome) and 6 months after surgery (long-term outcome). RESULTS: A total of 128 patients were enrolled in the study, 94 were classified with grade III disease and 34 with grade IV. Grade IV hemorrhoidal patients reported on average 18.2 years of disease symptom duration, while grade III hemorrhoidal patients reported 11.2 years. All patients with grade III and grade IV hemorrhoidal disease had good outcomes at discharge day and reported to return to work in a median of 6 days after THD. At long-term follow-up, the results were good for 80.9% of patients from grade III hemorrhoidal disease and 61.8% of patients from grade IV hemorrhoidal disease. Patient satisfaction with the procedure and outcomes was 93.6% for grade III and 85.3% for grade IV hemorrhoidal patients. CONCLUSIONS: The THD technique was shown to be safe for both grade III and IV hemorrhoidal patients. The THD technique showed better results with grade III hemorrhoidal patients as compared to grade IV hemorrhoidal patients.

Congenital Erythropoietic Porphyria: Mutation of the Uroporphyrinogen III Cosynthase Gene in a Vietnamese Patient.

Congenital erythropoietic porphyria (CEP) arises from an autosomal recessive inherited disorder of the porphyrin metabolism, which leads to the accumulation of uroporphyrinogen I in bone marrow, skin and several other tissues by a deficiency of uroporphyrinogen III cosynthase (UROS). We studied a Vietnamese patient and her family suffering from severe cutaneous photosensitivity with skin fragility, bullous lesions and hypertrichosis on light-exposed areas. A missense mutation in the UROS gene was identified as a transversion of G to T at nucleotide 11,776, resulting in a substitution of valine by phenylalanine at codon 3 of exon 2. The patient showed a homozygous mutant profile, and the heterozygous state was observed in the parents. The activity of mutated UROS expressed in Escherichia coli was less than 16.1% that of the control, indicating that the markedly reduced activity of UROS is responsible for CEP. We described for the first time a mutation in the UROS gene in a Southeast Asian patient and a molecular diagnosis for the identification of clinically asymptomatic heterozygous mutation carriers and families with CEP.

Growth performance, plasma Fatty acids, villous height and crypt depth of preweaning piglets fed with medium chain triacylglycerol.

A study was conducted to investigate the effects of feeding medium chain triacylglycerol (MCT) on growth performance, plasma fatty acids, villus height and crypt depth in preweaning piglets. A total of 150 new born piglets were randomly assigned into one of three treatments: i) Control (no MCT); ii) MCT with milk (MCT+milk); iii) MCT without milk (MCT+fasting). Body weight, plasma fatty acid profiles, villus height and crypt depth were measured. Final BW for the Control and MCT+fasting was lower (p<0.05) than MCT+milk. The piglets fed with MCT regardless of milk provision or fasting had greater medium chain fatty acids (MCFA) than the Control. In contrast, the Control had greater long chain fatty acid (LCFA) and unsaturated fatty acid (USFA) than the MCT piglets. The piglets fed with MCT regardless of milk provision or fasting had higher villus height for the duodenum and jejunum after 6 h of feeding. Similar observations were found in piglets fed with MCT after 6 and 8 days of treatment. This study showed that feeding MCT to the piglets before weaning improved growth performance, with a greater concentration of MCT in blood plasma as energy source and a greater height of villus in duodenum, jejunum and ileum.