RESUMEN
Anaplastic thyroid cancers (ATC) are a rapid growing and highly lethal form of thyroid cancer. Distant metastases of ATC are detected in about half of patients. Clinically, it is very rare to metastasize to the kidney. The most common initial symptoms of ATC are a palpable neck mass and accompanying compression symptoms of the upper aerodigestive tract. A 68-year-old patient was referred with a huge renal mass, which was detected during the evaluation of abdominal pain. Left total nephrectomy was performed. Histologically, the kidney tumor was a metastatic anaplastic thyroid carcinoma. To our knowledge, it is the first case of occult ATC presenting as a huge renal mass.
RESUMEN
Objective To investigate the curative efficacy of adjuvant therapy of atorvastatin in chronic subdural haematoma ( CSDH ) patients treated with trepanation and drainage and its effects on level of serum neuron specific enolase ( NSE ) .Methods 98 patients of CSDH who received therapy in our hospital from January 2014 to April 2016 were selected as research objects.Retrospectively analyzing their clinic materials,those patients were divided into the control group(n=46)and the observation group(n=52)according to therapeutic schemes.The control group were given therapy of trepanation and drainage.Besides that,the observation group were given atorvastatin additionally.2 months later,curative efficacy,China stroke scale (CSS)score and ability of daily life(ADL)score were compared between the two groups.And level of serum NSE between the two groups before treatment and after 7 days were compared.Results The total therapeutic efficacy ratio of CSDH in the observation group was 88.5%,which was statistically higher than that of 71.7% in the control group(P<0.05).2 months after the treatment,in comparison with the control group,the observation group has lower CSS score(15.89 ±3.24 points vs.19.21 ±4.17 points)and higher ADL score(95.24 ±11.36 points vs.89.05 ±10.12 points)with both statistical differences( P<0.05 ) .7 days after the treatment, level of serum NSE in the observation group was statistically lower than that in the control group (10.38 ±2.35 U/mL vs.14.06 ±2.68 U/mL,P <0.05).Conclusion Adjuvant therapy of atorvastatin is effective for CSDH patients treated with trepanation and drainage,and it could improve neurologic function,ability of daily life and reduce level of serum NSE.
RESUMEN
Objective To investigate the effect of 23.4% hypertonic saline(HTS)on intracranial pressure(ICP), cerebral peffusion pressure(CPP), cerebral blood flow(CBF)in poor-grade patients with subarachnoid hemorrhage(SAH).Methods Sixteen patients(Glasgow coma score ≤ 8)with poor-grade SAH received 23.4% hypertonic saline intravenously for elevated ICP.ICP, mean arterial pressure(MAP), CPP and the middle cerebral artery flow velocity(FV)were observed and recorded before and at 30, 60, 90,120, 150, 180 min after the injection respectively.Results Thirty minutes postinfusion, a significant increase in MAP, CPP, FV was seen together with a decrease in ICP(P<0.05).ICP remained reduced for 180 minutes, CPP and FV remained elevated for 90 minutes(P < 0.05).Conclusions HTS can significantly decrease ICP and improve CBF in patients with poor-grade subarachnoid hemorrhage and may be used for reversal of pathophysiologic changes caused by cerebral ischemia.