Endoscopic Transsphenoidal Approach for Hemangiopericytoma in Sellar Region: A Case Report and Review of the Literature

Background: Hemangiopericytomas (HPCs) with aggressive behavior are rare in the central nervous system and extremely rare in the sellar region. Here we presented a clinical case of HPC in sellar region.

Laparoscopic Resection of a Giant Dedifferentiated Primary Retroperitoneal Mucinous Cystadenoma (PRMC) in a Young Woman: A Case Report and Literature Review

Background: PRMC is a very rare benign tumor of the abdominal cavity that usually occurs in women, and PRMC demonstrate no specific findings on CT. There are many reports on the differential diagnosis and discussion of PRMC imaging, but there are few reports on the treatment of dedifferentiated PRMC using laparoscopic resection and postoperative follow-up.

Immunotherapy for Advanced Small Cell Lung Cancer: A Case Report

In recent years, extraordinary achievements have been made in treating tumor immune checkpoints as targets, which significantly contributes to the research and development of novel immunologic drugs and their application in treating malignant tumors. However, few immunologic drugs can be administered to treat Small Cell Lung Cancer (SCLC). Currently, the focus of most clinical studies is placed on treating SCLC with a combination of immunotherapy and chemotherapy, which is relatively expensive and not covered by medical insurance, thus imposing a heavy economic burden on patients. Meanwhile, obvious adverse reactions occur during chemotherapy, which is still unacceptable to many patients and hence has not yet been widely adopted in clinical practice. Therefore, whether immunotherapy alone can help patients with SCLC, improve their quality of life, and prolong their survival time is a topic we will study in the future. In this case, an attempt was made to apply camrelizumab, an immunologic drug, in the treatment of SCLC in advanced stages, and a favorable efficacy was achieved.

Comparison of Lumboperitoneal Shunt and Stereotactic Ventriculoperitoneal Shunt in the Treatment of Refractory Idiopathic Intracranial Hypertension: A Case Report and Literature Review

Idiopathic Intracranial Hypertension (IIH) or Pseudotumor Cerebri (PTC) is a disorder of young obese females and characterized by headache, papilledema and raised intracranial pressure. However, it is in the absence of known pathological cause. Due to the uncertainty of etiology, it may lead to misdiagnosis and grave clinical prognosis. IIH is typically treated with Lumboperitoneal Shunting (LPS) and Ventriculoperitoneal Shunting (VPS), but shunts are prone to dysfunctions and infection, resulting in recurrent headaches in many patients after this treatment. We report a case of 41-year-old obese female (BMI: 30.9) with IIH, who has a history of hypertension (Blood pressure: 150/100 mmHg) and elevated intracranial pressure (Open pressure: 450 mmH2 O). After the failure of several medical treatments, the patient was offered LPS because of vision loss and headache, but the postoperative symptoms (intermittent headache, mainly total craniocerebral prickling pain with neck and shoulder pain) were not significantly relieved for 11 years. Therefore, considering the blockage of the primary shunt tube and the small ventricle in the patient, it has difficulty in puncture ventricle puncture. We have to treat with the stereotactic VPS (SVPS) for her exacerbation symptoms. More surprisingly, the hypertension was in the normal range (<115/80 mmHg) after the surgery (without taking antihypertensive medication). To compare the surgical therapeutic effects and complications of LPS and the SVPS in the treatment of idiopathic intracranial hypertension. Cerebrospinal Fluid (CSF) diversion with VPS or LPS is usually performed when the main symptom is vision loss; it also stabilizes headache and papilledema. LPS significantly alleviates symptoms in the short term, but due to excessive shunt of LPS for a long time, it is easy to be complicated with Chiari malformation and slit ventricle syndrome. Therefore, we encourage operating the SVPS on our patients for the favorable long-term outcome.

An Unusual Presentation of Cryptococcal Infection in a Post Renal Transplant Patient: A Case Report

Background: Cryptococcus neoformans is opportunistic yeast commonly found in soil contaminated by bird feces throughout the world. Cryptococcosis is a severe fungal infection in a with a high mortality rate among solid organ transplant recipients. The infection usually involves the lungs, central nervous system, skin, bones, and the urinary tract. Cryptococcosis continues to cause significant mortality and morbidity in immunocompromised patients.

Covid-19: A Double Edged Sword-Rise in Complicated Ureteric Stone Disease

Introduction: Healthcare is facing one of the biggest challenges in the form of Coronavirus-19 pandemic. Various measures are taken by the government to curb its spread in the form of lockdowns, travel bans, and restrictions upon non-covid admission to assimilate resources to tackle pandemic has affected non-covid patients in the form of delayed treatment. Ureteric calculus can present acutely and in sub-acute forms but without proper treatment in due time may have serious consequences. In our study, we aim to investigate the effect of pandemic upon patients of ureteric calculi.

Biophysical Conceptual Doxastic Errors in Arterial Hypertension in Surgical and Medical Management, in the Frame of Navier Stokes Equations

Multiple tragic biophysical errors in relation to hypertension in surgery and medicine, constitute conceptual atrocities: 1) Many physicians believe that perfusion decays with the fourth power of the radius, which is the result of a doxastic misunderstanding of the Poiseuille equation. These phenomena are even more transcendent in the case of surgical situations when the homeostatic metastability is more critical and with less margin to be compensated. 2) Furthermore, when seen the occlusion of an artery, frequently, instead of measuring the radius, they measure the apparent cross-sectional area. 3) By reducing the driving pressure with antihypertensive drugs, we are decreasing axial pressure in the flow and consequently the perfusion. 4) The sphygmomanometer measures transmural pressure and not driving pressure which is what produces perfusion. 5) The main hemodynamic cause of damage is not transmural hypertension but Laplacian tension. 6) The damage to the arteries does not depend on transmural pressure but on the energy density per time, in units of Joules per cubic meter per second, or Watts per cubic meter. 7) Hypertension, ceteris parivus, increases perfusion. 8) The baroreceptors do not respond to transmural pressure but to Laplacian arterial tension. 9) The brain and the heart have self-regulation of their perfusion, but vasodilators increase perfusion in other tissues, reducing cerebral and coronary perfusion due to the stolen effect. 10). Strictly, all gradients constitute potential energy, as happens in the instances of the concentration gradients, temperature gradients, pressure gradients, and electrical gradients. 11) The derivative of pressure with respect to time, that is the change in pressure due to change in time, is the derivative of the work per volume per time (change in work density due to time), that is, power density. 12) What determines the perfusion is the axial gradient, not of pressure but energy. 13) Hyperbolically if we consider taking the pressure of a pachyderm, we would obtain readings significantly higher. 14) Pressure is, in reality, energy density, which means, energy per infinitesimal unit of volume. 15) The venous return consists of the blood flow returning to the right heart. Because the input of the right side must equal its output, then in the steady-state situation, the cardiac outputs of the right and left sides are essentially equal. Consequently, the systemic venous return matches the systemic cardiac output. The venous return should be equal to or less than the cardiac output. The heart, as a pump, cannot expel a volume that has not been received; notwithstanding, in the case of valve regurgitation, the heart can expel a fraction of the venous return twice. The clinical physician should ask himself or herself: Is the preload volume in the EDV or the pressure at the time of the EDV which has been diminished before starting the isovolumic contraction?

Possible Complication Pneumothorax of in COVID-19

Two male patients, 57 and 58 years old, were evaluated in our emergency department. The complaints of cough that had been continuing for 1 week was at the forefront in their histories. Diarrhea and fever accompanied. In both patients, the complaint of shortness of breath increased significantly in the last 6 hours. Although 20lt/min oxygen was given to hypoxemic patients, SpO2 values were in the range of 80% to 84%. Despite oxygen supplementation, the current sinus tachycardia (140bpm) did not improve. In the thorax x-ray evaluations which were performed immediately, it was seen that both patients had pneumothorax covering the entire left hemithorax. The patients were connected to the underwater drainage system by inserting a chest tube. In clinical radiological follow-up, pneumothorax regressed and lung parenchyma was re-expanded in both cases. A contralateral pneumothorax occurred in the second patient. Conditions observed in these cases show that pneumothorax can be caused by Covid-19 and may be mortal. Pneumothorax should be kept in mind in the presence of severe dyspnea, hypoxia and tachycardia when suddenly added to the clinic. Both patients died in their second week of intensive care unit treatment.

Influence of Neoadjuvant Chemotherapy on Anastomotic Complications and Long-Term Prognosis after Laparoscopic Radical Gastric Cancer Surgery

Objective: To analyze the occurrence of neoadjuvant chemotherapy on anastomotic complications after radical gastric cancer surgery and the influence of anastomotic complications on the long-term prognosis.