Primary malignant fibrous histiocytoma of the kidney: Report of a case

Primary renal malignant fibrous histiocytoma is extremely rare. The prognosis is generally poor because of the high rate of local recurrence even if radical surgery is performed. We report a case of primary renal malignant fibrous histiocytoma in a 43-year-old woman. A well-defined renal mass (10x9x7cm) with lobulated contour was revealed by abdominal ultrasonography and computerized tomography in our patient who presented with left-flank pain. The contralateral kidney and renal functions were normal. No other primary tumor focus was detected by screening performed to exclude a metastasis to the kidney. However, a nodule consistent with metastasis was identified in the liver. The patient underwent left radical nephrectomy. A huge, yellowish-white, partly necrotic neoplasm infiltrating the renal parenchyma, perirenal fat and adrenal tissue was revealed by gross examination. Microscopically, the tumor was composed of pleomorphic spindle to polygonal cells arranged in fascicles and storiform structures with extensive necrosis. Twelve mitotic figures were noted in 10 high power fields. Immunohistochemical staining for vimentin and CD68 were positive whereas pan-cytokeratin, smooth muscle actin, S-100, HMB-45 and desmin were negative. "A pleomorphic type of malignant fibrous histiocytoma" was diagnosed based on both the microscopic and immunohistochemical findings. The patient presented with multiple bilateral lung metastasis three years after nephrectomy. Histopathological examination is essential since malignant fibrous histiocytoma cannot be differentiated clinically and radiologically from other lesions with kidney involvement. The overall prognosis is unfavorable with a recurrence rate of more than 50% and the 5-year-survival rate is only 14%

Investigation of human herpesvirus 6 infections in kidney and bone marrow/stem cell transplant recipients [Böbrek ve kemi·k i·li·gi·/kök hücre alicilarinda i·nsan herpesvi·rus 6 enfeksi·yonunun araştirilmasi]

PubMed ID: 14593901In this study, active human herpesvirus (HHV)-6 infection were investigated in 39 renal and 9 bone marrow/stem cell transplant recipients. For this purpose, the presence of HHV-6 DNA in patients sera have been searched by nested polymerase chain reaction (nPCR). In addition, HHV-6 IgM and IgG antibodies were performed by micro-enzyme immunoassay (EIA) to detect seronegative patients before transplantation and IgM response in active or primary HHV-6 infection. Active infection with HHV-6 DNA positivity was detected in 5.3% of renal and 22.2% of bone marrow/stem cell transplant recipients. Active HHV-6 infection was found to be related with asemptomatic reactivation, graft disfunction and cytomegalovirus disease in renal transplant recipients, and, fever and graft versus host disease in bone marrow/stem cell transplant recipients. It has been concluded that, the investigation of HHV-6 DNA by nPCR in the transplant sera, was a practical and useful method for the laboratories, in order to diagnose active HHV-6 infection, while HHV-6 IgG antibody detection was also useful for the differentional diagnosis of primary infection or reactivation/reinfection, but HHV-6 IgM antibodies has low value to detect active HHV-6 infection

Increasing suction pressure during endotracheal suctioning increases the volume of suctioned secretions, but not procedure-related complications: A comparative study in open system endotracheal suctioning

PubMed: 32859482Objectives: To compare the effect of three different suction pressures (80 mmHg, 150 mmHg, 250 mmHg) with the open system suction method in terms of the volume of secretions and complications development in intubated intensive care patients. Research methodology/design: This study was planned as a prospective, experimental, self-controlled design. The study sample included 47 patients. Data were collected using a data collection and patient follow-up form from patient records. Setting: Single adult intensive care unit in a university hospital. Results: Fifty five percent of the patients were male, 61.7% were older than 65 years and 38.32% had lung infection. The amount of suctioned secretions tended to increase significantly with increasing negative pressure and there was a significant difference between the pressures in terms of the median volume of suctioned secretions (p 0.05). Tachycardia, bradycardia, hypoxaemia, tracheal mucosal damage or mucosal bleeding were not observed during suctioning with three different suction pressures. Conclusion: It may be assumed that 250 mmHg suction pressure, via compliance with open system suction method related procedures, is being more effective and equally safe for secretion cleaning in comparison to the 80 and 150 mmHg suction pressures. © 2020 Elsevier LtdWe thank to Assoc. Prof. Dr. Timur K?se for the data analysis and interpretation, Nurse S?rma G?l Akman (who voluntarily accepted to be an independent observer) for giving support to collect data. We thank to all healthcare workers in anesthesia and reanimation intensive care unit in the hospital for their efforts and cooperation in research. We also thank to patients who participated in the study and their families