Ertay Boran

Giant Aortic Pseudoaneurysm with Stanford Type A Aortic Dissection after Aortic Valve Replacement

Giant pseudoaneurysm of the ascending aorta is a rare but dreadful complication occurring several months or years after aortic surgery. Thoracic aortic aneurysms tend to be asymptomatic and were previously often diagnosed only after a complication such as dissection or rupture. We present a rare case of giant ascending aneurysm with Stanford type A aortic dissection occurring 6 years after aortic valve replacement and also illustrate the potential dimensions the ascending aorta may reach by a pseudoaneurysm and dissection after AVR.

Late-Onset BK Viruria in Renal Transplant Recipients

BACKGROUND Most cases of BK virus (BKV) infections emerge within the 1st years of kidney transplantation. We aimed to determine the prevalence of late-onset BKV infection and whether there are any differences between risk factors in early and late BKV infections. METHODS In this single-center retrospective study, we reviewed 300 kidney transplant recipients that were under regular follow-up and selected recipients with BKV infection and recorded associated risk factors, connection with immunosuppression, and responses to modification of treatment. RESULTS BKV was detected within the 1st 5 years after transplantation in 20 patients (6.6%, group 1) and after 5 years in 15 patients (5.0%, group 2). There were no significant differences between the 2 groups regarding age, sex, sex mismatches, donor type, BKV elimination time, serum creatinine, and estimated glomerular filtration rate at the times of BKV detection and last follow-up visit. In group 1, 2 recipients had biopsy-proven BKV-associated nephropathy (BKVAN), 3 recipients had BK viruria and viremia without BKVAN (biopsy proven), and 15 recipients (75%) had only BK viruria. In group 2, all of the patients had only BK viruria. In this group, on detection of BK viruria and immediate modification of immunosuppressive regimens prevented BK viremia. CONCLUSIONS Routine screening of renal transplant recipients for BKV was indicated not only during the 1st 5 years, but also for the full follow-up period after transplantation.

Giant chondrosarcoma of rib: surgical resection and reconstruction with titanium bar, polypropylene mesh, and muscle advancement flap

Primary malignant tumours of the chest wall are rare. Chondrosarcoma is the most common malignancy of the sternum. Chondrosarcoma derived from rib is rare. Wide resection treatment is important because it is resistant to chemotherapy and radiotherapy.

Acute Lung Injury- ARDS in H1N1: Timing of Therapy

In some viral or bacterial infections, a minority of patients developed rapidly progressive pneumonia leading to acute lung injury (ALI)-acute respiratory distress syndrome (ARDS).