ABSTRACT
Introduction: Hepatocellular carcinoma (HCC) associated with concurrent portal vein tumour thrombus (PVTT) and bile duct tumour thrombus (BDTT) is sporadic and presents a puzzle to management with miserable prognostic. Case presentation: The authors reported a case of HCC in the right liver with PVTT involving the right portal vein and BDTT developing in the common bile duct, detected in a 43-year-old man. The patient was admitted to our hospital with abdominal pain in the right hypochondrium and obstructive jaundice. Imaging studies showed a large mass in the right liver with invasion of the first branch of the portal vein and dilated intrahepatic bilateral bile ducts. A liver biopsy confirmed the diagnosis of hepatocellular carcinoma. Right hepatectomy plus thrombectomy en bloc with extrahepatic bile duct resection was performed. Subsequently, the patient received a postoperative adjuvant transarterial chemoembolization (PA-TACE) 1 month after surgery. Discussion: In the present case, the authors were not aiming for curative treatment by aggressive management but for palliative treatment. At the time of diagnosis, the tumour had already invaded the portal bifurcation. Hepatectomy plus thrombectomy en bloc with resection of common bile duct can remove biliary obstruction caused by BDTT, optimize portal flow by eliminating PVTT, and reduce the tumour burden, consequently improving the quality of life and liver function. Then, PA-TACE takes care of microfoci left behind by the surgery, which may prolong survival time. Conclusion: An aggressive therapeutic strategy should be considered in exceptional cases for resectable HCC with PVTT and obstructive BDTT. However, the follow-up period remains limited. A longer duration of observation is necessary to definitively assess the surgery's impact on patient's recurrence and survival time.
ABSTRACT
We use state-level data to evaluate the connection between outbreaks of COVID-19 and stock returns over the period January-June 2020. We show that daily increases in the number of infected cases, hospitalized cases, and deaths are negatively associated with next day stock returns of firms headquartered in the same state. The relationship is weaker among states with high levels of medical resources and states that are likely to get support from the federal government. In addition, we find that the negative effect is reduced for firms that report an expectation that an outbreak will increase revenues and for firms with a strong corporate social responsibility practice. We believe our study is the first paper to assess cross-sectional stock price reactions to COVID-19 as a function of the state-level impact of the pandemic outbreak.
ABSTRACT
In this article, the authors apply the relative air pollution index (RAPI) proposed by Pham Ngoc Ho for aggregate assessment of daily air pollution level (RAPId) using data from 3 daily standards (1, 8, and 24 h) of each country's standard, including Vietnam Technical Regulation QCVN 05:2013/MONRE. By using the automated data of ambient air at 3 monitoring stations in Cam Pha coal mining area, Quang Ninh province in 2018, results of the frequency of pollution by month (f%) have shown that overall, the air quality in dry season (October-March) is worse than that in rainy season (April-September). Results of pollution frequency by month in a year f% also indicate that air pollution in 2018 at 3 stations is mostly at level I (no pollution) with f% ranged from 10 to 58.3%, but pollution level II-IV (light pollution-very heavy pollution) also happened as f% fluctuated from 20 to 42% in some months. Comparing with air quality assessment in 2011-2015 at this area by periodic monitoring equipment of Quang Ninh Center for Environmental Monitoring, results in 2018 have shown that individual index of RAPI is consistent with the current status of air quality with high accuracy. To compare with RAPId, we used VN_AQId index of the Vietnam Environment Administration (VEA). Comparison results show that both indices do not encounter eclipsing effect. However, ambiguous effect occurred in the case of VN_AQId index (warning not suitable for reality in some cases). In addition, advantages and limitations of these two methods have been analyzed and explained in detail.
Subject(s)
Air Pollutants , Coal Mining , Environmental Monitoring , Air Pollutants/analysis , Environmental Monitoring/methods , VietnamABSTRACT
OBJECTIVE: This case report describes the clinical and surgical management of a patient with a unilateral alveolar cleft and associated extremely atrophied totally edentulous maxilla. METHOD: Two zygomatic implants and four endosseous oral implants were placed under general anesthesia in a compromised maxilla to rehabilitate a 33-year-old patient with cleft lip and palate. The two specially designed zygomatic implants were utilized to avoid the need for bone grafting in the patient. The final prosthetic rehabilitation was an esthetic and functional maxillary overdenture prosthesis supported by implants. RESULTS: Preliminary results have shown how dental prostheses supported by endosseous implants in grafted alveolar cleft are a reliable possibility in the dental rehabilitation of this malformation. CONCLUSION: The use of zygomatic implants may be considered a reliable alternative to more resource-demanding techniques such as bone grafting in patients with cleft palate.
