Medicine
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Primary renal epithelioid hemangioendothelioma (EH) is a rare vascular tumor with intermediate biologic behavior and metastatic potential, and it is extremely rare and has only 4 cases in the current literatures. ⋯ Renal EH is a rare low-grade malignant tumor with characteristic histological structure. Locally excision has been considered as the optimal treatment and regular follow-up is necessary. Our present study reviewed the clinical and biological information of previous cases which were diagnosed as renal EH and we supplemented more data for further study.
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Achieving and maintaining viral suppression in young adults (18-24 years) living with HIV is challenging. Overall HIV viral suppression rates are lower in young as compared to older adults. Longitudinal data provide valuable insight on dynamics of viral suppression and variables of potential influence on HIV virological failure (VF), but is scarce in young adults living with HIV on combination antiretroviral therapy (cART). ⋯ Smaller, yet significant risk factors for VF were being infected through a blood transfusion or a needle accident (OR9.93, CI 1.34;73.84, and having started with cART with a nadir CD4 count >500 cells/μl (OR 11.36, CI 2.03;63.48). In our large cohort of young adults, the risk of VF has diminished over 15 years. Specific subgroups were identified to be at risk for suboptimal treatment.
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Case Reports
The consequence of endotracheal intubation in a 95-years old man for 839 days: A case report.
The benefits of prolonged endotracheal intubation (ETI) in comparison to early tracheotomy is still over the controversy. Little information is available in concern to prolonged ETI more than years. We report the consequence of oral ETI in a 95-year old man for 839 days. ⋯ During prolonged ETI, more attention should focus on airway humidification, proper cuff pressure and optimal time for tube exchange in order to avoid severe complications.
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Case Reports
Laparoscopic spleen-preserving pancreatic resection for intrapancreatic accessory spleen: Case report.
Intrapancreatic accessory spleen (IPAS) has been rarely noted radiologically because the spatial resolution of conventional images was low. The infrequent presence of the accessory spleen in the pancreatic tissue could lead to inappropriate diagnosis, thereby necessitating a therapeutic approach. The present study reported such cases and summarized the available imaging findings to reduce unnecessary invasive surgeries. ⋯ When an asymptomatic pancreatic mass is detected, the diagnosis of IPAS should not be excluded, especially if the lesion has the same imaging features as the spleen. As a definite diagnosis of IPAS is difficult by a single examination, multiple techniques might be essential.
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The hemi or subtotal/total glossectomy is usually approached by lip-jaw splitting procedure for advanced tongue cancer ablation. This highly invasive procedure can cause facial disfiguration, bone malunion, and osteoradionecrosis. The aim of this study is to compare the surgical outcome in free flap tongue reconstruction between novel parachute technique in an intact jaw and the conventional lip-jaw splitting procedure after tongue cancer ablation. ⋯ In the patients receiving parachute technique, operation time showed 34 minutes (P = .49) shorter, hospital stay showed 4 days (P = .32) shorter, and the infection rate of surgical site showed 6.6% (P = .64) less than with conventional technique. The survival rates of the flaps were both 100% without revision. The parachute technique is an effective and more accessible method for free flap setting in cases of tongue reconstruction without lip-jaw splitting, and provides patients with better aesthetic appearance.