Radical Removal of Low-Differentiation Thymic Squamous Cell Carcinoma: A Rare Clinical Case.

The presented case report demonstrates the successful operative treatment of a patient with thymic carcinoma located in the anterior mediastinum, infiltrating the vena cava, and affecting the upper lobe of the left lung. Our multidisciplinary approach, incorporating various operative techniques, proved effective in treating this type of pathology. The Clinic for Thoracic Surgery at UMHAT Kaspela, Plovdiv admitted a 72-year-old female patient due to complaints related to her cardiovascular and respiratory systems. The patient presented with symptoms such as chest pain, shortness of breath, cough with expectoration, and the presence of blood in her sputum. Additionally, the patient exhibited an increased temperature and experienced shortness of breath at rest. Extensive imaging and diagnostic studies were performed, including computed axial tomography of the chest with contrast material, echocardiography, functional breathing tests, and laboratory tests. The clinical board unanimously agreed that operative treatment was necessary, and the techniques used included robot-assisted surgery and median sternotomy. A low-differentiated carcinoma was identified during the surgical intervention and confirmed through patho-anatomical examination (frozen section) and permanent histological preparation. Immunohistochemical examination revealed that the immunophenotype of the tumor corresponds to thymic neuroplastic squamous cell carcinoma (poorly differentiated). The patient had a smooth postoperative period and was discharged in a satisfactory general condition.

The role of extended resection in locally recurrent colorectal cancer with invasion of the aortoiliac bifurcation: a rare clinical case.

Colorectal carcinoma (CRC) is the third most common cancer and the fourth deadliest. Despite recent advances in screening methods and preoperative imaging techniques, the threat of colorectal cancer remains at an all-time high. Moreover, even after curative treatment, disease recurrence occurs in up to 40% of all cases. However, half of patients with recurrent disease do not register any distant metastases. Therefore, much effort should be expended in identifying and evaluating these patients, as many of them are suitable candidates for en bloc resections with perioperative chemoradiation. In fact, it has recently been found that overall survival benefits greatly from extended resections, provided that free margins are achieved intraoperatively. In this case report, we will present a case of locally advanced recurrent colorectal cancer invading the aortoiliac axis and our approach to achieving a R0 resection.

Optimization and Performance Analysis of CAT Method for DNA Sequence Similarity Searching and Alignment.

Bioinformatics is a rapidly developing field enabling scientific experiments via computer models and simulations. In recent years, there has been an extraordinary growth in biological databases. Therefore, it is extremely important to propose effective methods and algorithms for the fast and accurate processing of biological data. Sequence comparisons are the best way to investigate and understand the biological functions and evolutionary relationships between genes on the basis of the alignment of two or more DNA sequences in order to maximize the identity level and degree of similarity. This paper presents a new version of the pairwise DNA sequences alignment algorithm, based on a new method called CAT, where a dependency with a previous match and the closest neighbor are taken into consideration to increase the uniqueness of the CAT profile and to reduce possible collisions, i.e., two or more sequence with the same CAT profiles. This makes the proposed algorithm suitable for finding the exact match of a concrete DNA sequence in a large set of DNA data faster. In order to enable the usage of the profiles as sequence metadata, CAT profiles are generated once prior to data uploading to the database. The proposed algorithm consists of two main stages: CAT profile calculation depending on the chosen benchmark sequences and sequence comparison by using the calculated CAT profiles. Improvements in the generation of the CAT profiles are detailed and described in this paper. Block schemes, pseudo code tables, and figures were updated according to the proposed new version and experimental results. Experiments were carried out using the new version of the CAT method for DNA sequence alignment and different datasets. New experimental results regarding collisions, speed, and efficiency of the suggested new implementation are presented. Experiments related to the performance comparison with Needleman-Wunsch were re-executed with the new version of the algorithm to confirm that we have the same performance. A performance analysis of the proposed algorithm based on the CAT method against the Knuth-Morris-Pratt algorithm, which has a complexity of O(n) and is widely used for biological data searching, was performed. The impact of prior matching dependencies on uniqueness for generated CAT profiles is investigated. The experimental results from sequence alignment demonstrate that the proposed CAT method-based algorithm exhibits minimal deviation, which can be deemed negligible if such deviation is considered permissible in favor of enhanced performance. It should be noted that the performance of the CAT algorithm in terms of execution time remains stable, unaffected by the length of the analyzed sequences. Hence, the primary benefit of the suggested approach lies in its rapid processing capabilities in large-scale sequence alignment, a task that traditional exact algorithms would require significantly more time to perform.

Sternal reconstruction and omentoplasty after mediastinitis.

Deep sternal infections are serious complications after open heart surgery. We present a case of a 59-year-old female with uncontrolled diabetes who underwent aortocoronary bypass surgery in another cardiac surgery department. After the surgical intervention sternal dehiscence and wound infection occurred, which was followed by two unsuccessful attempts for sternal refixation. Two months after the initial procedure the patient was admitted to our institution with severe dyspnea and paradoxical movement of the thorax. Computed tomography revealed a huge defect of the sternum and metal osteosynthesis with a titanium plate and omentoplasty was performed. The patient was followed-up for one year with excellent postoperative result.

Takotsubo Cardiomyopathy after Elective Aortic and Mitral Valve Replacement.

Takotsubo cardiomyopathy is a syndrome characterized by transient acute left ventricular dysfunction, electrocardiographic changes that can mimic acute myocardial infarction and minimal release of myocardial enzymes in the absence of obstructive coronary artery disease (CAD). Reports of Takotsubo syndrome after cardiac surgery are exceptional. We describe a case of Takotsubo cardiomyopathy in a 57-year-old man after elective aortic and mitral valve replacement following recent convalescence from infective endocarditis. Takotsubo syndrome should be considered in the differential diagnosis of patients presenting acute myocardial infarction, cardiogenic shock or any low cardiac output syndrome after cardiac surgery.

Cardiac Echinococcosis Involving Left Ventricular Myocardium in an 18-Year-Old Patient.

The hydatid disease is one of the most common tapeworm infections. It is caused most commonly by Echinococcus granulosus and has an endemic distribution. The transmission to humans, which are intermediate hosts, occurs by ingestion of contaminated food and water or by direct contact with infected animals. Involvement of heart and pericardium is an extremely rare condition. We present a case of an 18-year-old female patient, admitted in cardiology department complaining of chest pain and subfebrility. Transthoracic echocardiography and contrast enhanced CT revealed huge well-organized intramyocardial cyst in the lateral left ventricular wall with a few daughter cysts. The diagnosis of cardiac echinococcosis was confirmed by serological blood test - ELISA. We performed total resection of the cyst using extracorporeal circulation. The postoperative period was uneventful. Albendazole treatment was administered. The patient was followed-up one year with good postoperative result without any signs of relapse of the disease. Cardiac hydatid disease is rarity, but it is a life-threatening condition because of the high risk of cyst perforation. Early diagnosis and treatment are crucial. Echocardiographic findings are extremely valuable for diagnosis. The results of surgical echinococcectomy combined with oral antihelmintic therapy postoperatively are preferred rather than conservative strategy alone.