Sirukumab pharmacokinetics following subcutaneous administration was linear at doses ranging 25 -100 mg and was comparable between Japanese and Caucasian subjects. A single subcutaneous administration of 25, 50, or 100 mg sirukumab appeared to be well tolerated by both Japanese and Caucasian healthy male subjects.
The right top pulmonary vein (RTPV), a rare pulmonary vein (PV) variant draining the right upper lobe, arises independently from the right superior PV, travels posterior to the right bronchial tree and drains directly into the left atrium (LA) or another PV. We report an RTPV discovered on preoperative computed tomography (CT) scanning in a 60-y-old man who subsequently underwent prone thoracoscopic esophagectomy and subcarinal lymph node dissection. The preoperative CT scan showed an anomalous vessel 7.8 mm in diameter arising from the right upper lobe, running posterior to the right main bronchus (RMB), and draining directly into the LA. To our best knowledge, this is the largest reported RTPV (7.8 mm in diameter) and is an extremely rare variant, passing posterior to the RMB and draining into the LA.
Introduction:The appropriate management of postoperative pancreatic fistula (POPF) after gastrectomy is believed to decrease the incidence of subsequent complications. Previous reports have indicated a relationship between subsequent complications of POPF and drain fluid amylase levels (D-AMY), but this indicator did not offer adequate sensitivity and specificity. In this study, we searched for indicators using highly precise D-AMY levels to predict the onset of subsequent complications.
Materials and methods:We performed a retrospective study of 377 patients who underwent gastrectomy between 2014 and 2020 and whose D-AMY levels were measured. D-AMY levels were measured once a day, and we initiated treatment for pancreatitis if levels were ≥ 1500 U/L. We compared the incidence of complications and various clinical factors, including D-AMY level, and also strove to determine a clinically useful cut-off value. Results: There were 64 patients (17.0%) who were diagnosed as having pancreatitis by D-AMY levels ≥ 1500 U/L and required treatment. The significant risk factors were D-AMY ≥ 766 U/L on postoperative day (POD) 2 (p=0.0415, OR=32.46), and a total D-AMY of ≥ 6801 U/L from POD 0 to POD 4 (p=0.0023, OR=55.85). The area under the receiver operator characteristics curve, sensitivity and specificity were 0.84511, 78.6% and 90.9%, and 0.96834, 82.4% and 96.7% for the POD 2 and POD 0-4 cut-off values, respectively.
Conclusion:The POD 2 cut-off value correlated with POPF complications after gastrectomy, but the concomitant use of the cut-off value for the period from POD 0-4 facilitated even more accurate prediction of subsequent onset of complications.
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