ABSTRACT
Abstract Advanced renal cell carcinoma accompanied by tumor thrombus in the venous system is present in up to 10% of cases. Extension of tumor thrombus above the diaphragm or into the right atrium represents level IV disease. Level IV tumors are typically treated with sterno-laparotomy approach with or without deep hypothermic circulatory arrest and veno-venous bypass. In this case report, the surgical technique for the resection of advanced RCC were described, with the concomitant use of transesophageal echocardiography for thrombus extraction without the veno-venous or cardiopulmonary bypass.
Subject(s)
Humans , Male , Female , Middle Aged , Carcinoma, Renal Cell/surgery , Thrombectomy/methods , Echocardiography, Transesophageal/methods , Venous Thrombosis/surgery , Kidney Neoplasms/surgery , Vena Cava, Inferior/surgery , Carcinoma, Renal Cell/diagnostic imaging , Tomography, X-Ray Computed , Reproducibility of Results , Treatment Outcome , Ultrasonography, Interventional , Venous Thrombosis/pathology , Kidney Neoplasms/diagnostic imagingABSTRACT
Simultaneous measurements of fluorescence and thermal emission have been made by a combined fluorescence and photoacoustic techniques on isolated thylakoids pretreated by a prolonged illumination of saturating light. The traces of the signals are used to calculate four characteristic parameters, energy storage, half-saturation intensity, number of photons to close reaction center, and a constant for quasi-equlibria between (re)oxidized and reduced quinone acceptors. These parameters are used to study the response of photosynthetic apparatus functioning under photoinhibition stress. The defense mechanism seems to possess an efficient cooperativity of reaction centers under stress conditions.