Mesenteric gastrointestinal stromal tumour presenting as intracranial space occupying lesion

BACKGROUND: Gastrointestinal stromal tumours (GIST) usually present with non-specific gastrointestinal symptoms such as abdominal mass, pain, anorexia and bowel obstruction. METHODS: We report a case of a 42 year old male who presented with a solitary intracranial space occupying lesion which was established as a metastasis from a mesenteric tumour. RESULTS: The patient was initially treated as a metastatic sarcoma, but a lack of response to chemotherapy prompted testing for CD117 which returned positive. A diagnosis of mesenteric GIST presenting as solitary brain metastasis was made, and the patient was treated with imatinib. CONCLUSION: We recommend that all sarcomas with either an intraabdominal or unknown origin be routinely tested for CD117 to rule out GIST

International Guidelines for Management of Metastatic Breast Cancer: Can Metastatic Breast Cancer Be Cured?

A distinctive subset of metastatic breast cancer (MBC) is oligometastatic disease, which is characterized by single or few detectable metastatic lesions. The existing treatment guidelines for patients with localized MBC include surgery, radiotherapy, and regional chemotherapy. The European School of Oncology–Metastatic Breast Cancer Task Force addressed the management of these patients in its first consensus recommendations published in 2007. The Task Force endorsed the possibility of a more aggressive and multidisciplinary approach for patients with oligometastatic disease, stressing also the need for clinical trials in this patient population. At the sixth European Breast Cancer Conference, held in Berlin in March 2008, the second public session on MBC guidelines addressed the controversial issue of whether MBC can be cured. In this commentary, we summarize the discussion and related recommendations regarding the available therapeutic options that are possibly associated with cure in these patients. In particular, data on local (surgery and radiotherapy) and chemotherapy options are discussed. Large retrospective series show an association between surgical removal of the primary tumor or of lung metastases and improved long-term outcome in patients with oligometastatic disease. In the absence of data from prospective randomized studies, removal of the primary tumor or isolated metastatic lesions may be an attractive therapeutic strategy in this subset of patients, offering rapid disease control and potential for survival benefit. Some improvement in outcome may also be achieved with optimization of systemic therapies, possibly in combination with optimal local treatment

p chart control limits based on a small number of subgroups

Due to the character of the original source materials and the nature of batch digitization, quality control issues may be present in this document. Please report any quality issues you encounter to [email protected], referencing the URI of the item.Includes bibliographical references.The classical Shewhart p chart procedure requires data from at least 20 subgroups for setting up valid control limits, when the true fraction nonconforming of the process is unknown. This data requirement has prevented the use of p charts in short run situations and during the early stages of a production run. This thesis offers a solution to this issue by proposing a method for setting up p chart control limits even when the data available is from only a small number of subgroups. The run length performance of the proposed method has been experimentally compared with two other methods. The applicability of these methods to a short run situation has also been assessed experimentally. The proposed method has been found to detect shifts in the process fraction nonconforming more often than the other two methods, while increasing the rate of false alarms by only a small amount

Liver disease in the Era of Coronavirus Disease 19 (COVID-19) pandemic

Coronavirus infections have caused outbreaks in humans: SARS-COV ((Severe Acute Respiratory Syndrome) and MERS-CoV (Middle East Respiratory Syndrome) resulting in significant mortality and morbidit

Evaluation of socioeconomic factors and achievement of sustained virologic response (SVR) in the treatment of hepatitis C virus (HCV)

Poster presented at: Aurora Scientific Day; May 24, 2017; Milwaukee, WI

Endovascular stenting of blunt thoracic aortic injury in an 11-year-old.

Blunt traumatic thoracic aortic injury in children is very rare. Open surgical repair is the definitive treatment. Thoracic endovascular aortic repair (TEVAR) for trauma has been performed in adults with good outcomes. Its use has been adopted in pediatric population, and its role is evolving. We report a successful TEVAR in a critically injured 11-year-old boy. To our knowledge, this is the youngest patient to be successfully treated with TEVAR

Skeletal metastases from recurrent paraganglioma of the urinary bladder.

Paragangliomas arising from the urinary bladder are extremely rare. Most of them are benign, and are curable with surgical resection alone, but about 10% are malignant and may metastasise to regional nodes or distant sites. We present the case of a 45 year male patient who had a recurrent paraganglioma of the urinary bladder with vertebral metastases. The patient was managed using a combination of palliative chemotherapy with carboplatin, etoposide and zoledronate and radiotherapy to the spine. However, the patient′s general condition rapidly deteriorated while on systemic treatment. This case demonstrates the unusually aggressive course that this disease may occasionally take

En bloc Liver kidney transplantation using donor splenic artery as inflow to the kidney. Report of two cases

The number of simultaneous liver kidney transplant has been increasing. This surgery is associated with an increased risk of complications, longer duration of surgery and longer ischemia time to the renal allograft. Two patients listed for liver-kidney transplant at our center underwent en bloc combined liver kidney transplantation using donor splenic artery as inflow. Patient 1 previously underwent cardiac catheterization which was complicated by a bleeding pseudo-aneurysm of the right external iliac artery, which required endovascular stenting of the external iliac artery and embolization of the inferior epigastric artery. Patient 2 was on vasopressor support and continuous renal replacement therapy at the time of transplant. We describe a novel technique of en bloc liver-kidney transplant with simultaneous reperfusion of both allografts using the donor splenic artery for renal inflow. This technique is useful in decreasing cold ischemia time and total operative time by simultaneous reperfusion of both allografts. It is a useful technical variant which can be used in patients with severe disease of the iliac arteries. This article is protected by copyright. All rights reserved