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Autologous breast reconstruction historically required flaps that were invasive, required prolonged operative times and recoveries, and resulted in varying degrees of donor site morbidity. We present our early results with a minimally invasive completely autologous breast reconstruction technique utilizing buried dermato-cutaneous (DMC) flaps and immediate fat grafting. A 25-patient, 43-breast consecutive case series is presented. Methods Select patients desiring autologous breast reconstruction who had sufficient breast ptosis and fat donor tissue were offered breast reconstruction with buried folded over DMC flaps with adipocyte transfer (DCAT). A Wise pattern mastectomy was performed, and fat was transferred into an inferiorly based, buried and folded DMC flap. Fat was also immediately grafted into the pectoralis, subpectoral space, and below pectoralis and serratus fascia. https://www.selleckchem.com/products/msc2530818.html Most patients underwent additional fat grafting at 3-month intervals to complete the reconstruction. Results Twenty-five consecutive patients (43 breasts) underwent the DCAT procedure with 18 (42%) free nipple grafts. Eight patients (8 breasts) had prior breast radiation, and 2 patients (2 breasts) required postmastectomy radiation. Average fat grafted at initial mastectomy was 70 mL per breast (range 50-103 mL). Nineteen patients (76%) underwent additional outpatient fat grafting. Two additional outpatient fat graft sessions (range 0-3) at 3-month intervals completed the reconstruction. Average fat grafted at the second stage was 217 mL (range 50-320 mL). Average follow-up was 20 months from DCAT and 12 months from last fat graft. Conclusion The DCAT procedure appears to provide a minimally invasive, autologous breast reconstruction alternative in select patients.Renal cell carcinoma (RCC) accounts for 3% of all adult malignancies and is known for metastatic initial presentation, unpredictable metastatic pathway, and late recurrence post-curative resection. We report a case of solitary late metastatic renal cell carcinoma to the pancreas more than 10 years after radical nephrectomy. A high index of suspicion must be maintained to detect RCC late recurrence and metastasis to rare and atypical locations. A lifelong follow-up is recommended.We present a case of a 79-year-old male with a Salmonella enteritidis prosthetic knee joint infection preceded by an episode of profuse diarrhea. The infection was treated with ceftriaxone antibacterial chemotherapy, and an arthroscopic knee joint washout. The initial treatment failed to eradicate the Salmonella infection. A second open washout procedure with the replacement of knee joint insert was performed along with the addition of ciprofloxacin to the ongoing ceftriaxone which eventually eradicated the infection. Although S. enteritidis is a very rare cause of prosthetic knee infection, suspicion of Salmonella as a potential causative agent should be borne in mind particularly if the onset of the symptoms is preceded by gastrointestinal manifestations.Objective The increasing incidence has led to more focus on pulmonary cryptococcosis in HIV-negative patients. We conducted a retrospective analysis of pulmonary cryptococcosis to understand the clinical characteristics, imaging features, diagnosis, treatment and prognosis of this disease in HIV-negative patients in respiratory department of a tertiary hospital in north China. Method We identified retrospectively those diagnosed with pulmonary cryptococcosis in the first medical center of Chinese People's Liberation Army General Hospital since 2009 to 2019. The clinical and image data were collected and analyzed. Results The study involved 34 patients with pulmonary cryptococcosis. All patients were diagnosed by histopathology. It accounted for 0.93‰ of the total number of patients admitted to respiratory department in the same period. The mean age was 49 years; 26 patients (76.5%) were male. Patients were predominantly immunocompetent (30, 88.2%), and there was no underlying disease for most patients (26, 76.5%). The most frequent symptoms were cough and expectoration. Fourteen (41.2%) patients showed no symptom or sign. Multiple lesions (21, 61.8%) and subpleural lesions (23, 67.6%) were the most common. Nodule was the most common abnormality on chest computed tomography image. Eight (23.5%) patients received serum Cryptococcus capsular polysaccharide antigen test, and seven patients showed positive result. All patients recovered after antifungal treatment. Conclusions Most patients of HIV-negative pulmonary cryptococcosis were mainly immunocompetent patients younger than 60 years without underlying diseases. There was lack of specificity in clinical manifestations and imaging findings. The prognosis of pulmonary cryptococcosis in HIV-negative patients was good.Background Although choanal atresia (CA) was first described 250 years ago, its description and understanding remain incomplete, as is the distinction between unilateral and bilateral CA. Among the surgical techniques introduced to manage this condition are intranasal Hegar's dilator (IHD) and transnasal endoscopic excision (TNEE). Objectives This study retrospectively evaluated the outcomes and effectiveness of IHD and TNEE in the treatment of patients with CA, including differences in the incidence of re-stenosis with these techniques. Methods Patients diagnosed with CA who underwent surgical interventions in the Otolaryngology Department of Al-Noor Specialist Hospital, Makkah, Saudi Arabia, between 1997 and 2017 were analyzed. Postoperative outcomes including re-stenosis rates were compared in patients who underwent IHD and TNEE. Factors associated with patient outcomes were analyzed, including ages at diagnosis and surgery, nationality, gender, type of atresia (unilateral/bilateral and bony/membranous/mixexperienced re-stenosis after revision surgery, which consisted of IHD. Twelve patients (40%) underwent stenting, with one developing re-stenosis. The relationships between surgical approach and re-stenosis after primary and secondary surgery were not statistically significant. Conclusion The outcomes in patients with CA treated with IHD and TNEE are comparable. Rates of re-stenosis and need for revision surgery do not differ significantly in patients treated with these surgical approaches.