Tumor-to-tumor metastasis: an extremely rare combination with renal cell carcinoma as the donor and a pancreatic neuroendocrine tumor as the recipient

Background Tumor-to-tumor metastasis is a rare phenomenon in which primary tumor cells metastasize hematogenously into another tumor. Herein, we report an extremely rare case of a renal cell carcinoma metastasis into a pancreatic neuroendocrine tumor exhibiting a tumor-to-tumor metastasis. Ours is the third reported case worldwide. Case presentation The patient, a 72-year-old male, was referred to our hospital for further examination and treatment due to high levels of prostate-specific antigen. A left renal tumor and pancreatic head tumor were revealed incidentally on screening computed tomography. There were suspected to be a renal cell carcinoma and primary pancreatic neuroendocrine tumor or pancreatic metastasis from the renal cell carcinoma according to preoperative examination. The left nephrectomy and subtotal stomach-preserving pancreaticoduodenectomy were performed because of the pancreatic tumor indicated for operation in either case of diagnosis. Postoperative pathological examination showed a diagnosis of clear cell renal cell carcinoma for the left renal tumor. The pancreatic tumor was diagnosed with clear cell renal cell carcinoma metastasis into the pancreatic neuroendocrine tumor, that is to say tumor-to-tumor metastasis. Conclusion In some cases, conservative approach is selected for pancreatic neuroendocrine tumor patients who meet some requirements. However, if such patients exhibit tumor-to-tumor metastasis which combines with renal cell carcinoma and pancreatic neuroendocrine tumor as this case, conservative approach leads to progression of renal cell carcinoma. Therefore, conceiving the possibility of tumor-to-tumor metastasis, it is necessary to carefully choose a treatment plan for pancreatic neuroendocrine tumor patients associated with renal cell carcinoma, not easily choosing conservative approach.

“Person” in CIC and CCEO Matrimonial Law. On the Idea of Vetera et Nova Harmonization in the Church Doctrine and Jurisprudence

serious confrontation with the subject: “Person” in the Code of Matrimonial Law (CIC and CCEO), is an—invariably relevant—challenge that the study of canon law and jurisprudence have to face. The argument for the validity of this conclusion is provided by the famous John Paul II’s thesis, proclaimed in the Familiaris Consortio exhortation (1981) and the famous 1997 Address to the Roman Rota, which can be summarized in the following words: the foundation and structural principle of interpersonal (ethical and legal!) relationships in marriage is matrimonial love. This axiom—still insufficiently present in the thoughts of canonists and church judges—reflects the deepest truth, of which “prophetically” the author of the monumental works Love and Responsibility and The Acting Person gave testimony; the truth that not elsewhere, but in the conciliar spiritually person-centric vision of matrimonial community (communio/consortium), a hermeneutic key should be sought for an adequate and complete understanding of the structure of marriage, harmoniously integrating its two personal and institutional dimensions.Karol Wojtyła’s/John Paul II’s brilliant thought deserved to be confronted with the premises that prove the hypothesis that the mere declarative identification in the expressed judgments/concepts with the idea of a personalistic aggiornamento (“programmed” especially in numbers 47–52 of the Council’s Constitution Gaudium et Spes) does not yet guarantee the adequacy and completeness of the canonistic approaches to the “truth of matrimony.” This is both in the sphere of theological exposure in accordance with the Magisterium (in the light of the “Image of God”) and at the praxis level: the interpretation and application of the normative records in the nodal canons of CIC and CCEO. The first part of the study is dedicated to illustrating such a state of affairs – in various proposals of doctrine and jurisprudence: from a concept that is completely misguided and destined to fail in advance; through a concept that, because of its extremely conservative approach to the need for vetera et nova harmonisation, has not stood the test of time, to concepts, indeed, universally acknowledged in the study of canon law, whose authors (or their adherents), after all, should be suggested to implement certain necessary corrections: bigger or smaller. In the second part, the research contemplation focuses on the conclusions of the realization of the conciliar postulate of “harmonization” in presenting a person-centric vision of matrimony. These synthetic remarks constitute an attempt to show the basis for an adequate interpretation of the formula adopted by the two codes announced in the title: “a partnership of the whole of life”.

Commercial Common Sense in Contract Interpretation: Observations on the Court of Appeal in Technix v Fitzroy and The Malthouse v Rangatira

The contemporary principles of contract interpretation require courts to have regard to a number of factors to determine the meaning of a contract, including the plain meaning of the express contractual language, the contract's context, and commercial common sense. These principles superseded the narrower plain meaning rule, which directed courts to interpret contracts in a manner largely consistent with the plain and ordinary meaning of their express words. Since their manifestation some 20 years ago, these principles have undergone change, development and elaboration to the extent that some commentators now claim the approach to contract interpretation more closely resembles the former plain meaning rule, with courts giving "primacy" to the words of the contract in order to deliver "commercial certainty". This article argues that while courts must give primacy to the express contractual language, that does not mean courts should maintain an unwavering loyalty to the plain meaning of those words, even if their meaning is clear. Courts that adopt this approach, referred to by some as the "conservative approach", risk obscuring the true meaning of a contract that can only be obtained through the careful balancing of a contract's internal and external factors, including commercial common sense. This article demonstrates the problem with the "conservative approach" through the analysis of two Court of Appeal decisions, and argues that courts should not overstate the circumstances in which departure from the plain meaning of a contract should occur.

Revisiting the Zimbabwean Unfair Labour Practice Concept

The 2013 Constitution of Zimbabwe entrenches the broad right to fair labour practices. The right is given effect to in Part III of the Labour Act (Chapter 28:01), which provides an exhaustive list of unfair labour practices which can be committed by employers, trade unions, workers' committees, and other persons. The Labour Act predates the 2013 Constitution. The constitutionalisation of the right to fair labour practices necessarily carries with it the attendant difficulties of reconciling the new rights and the pre-existing regulatory framework. This article seeks to contribute towards a practical understanding of the Zimbabwean unfair labour practice concept in the light of the constitutionalisation of the right to fair labour practices. It explores the nature and scope of the concept of unfair labour practice and examines its relationship with the constitutional right. Further, the contribution critiques the formalistic and conservative approach adopted by the Constitutional Court in explaining this relationship. The article commences with a brief discussion of the origins of the concept and its reception in Zimbabwean labour law. Following from this, the contribution critically analyses the unfair labour practice concept from statutory and constitutional perspectives. It argues for an expanded paradigm of the concept. This can be achieved if the judiciary moves away from pedantic approaches to the interpretation of labour rights. Therefore, the clarion call is for a purposive and expansive interpretation of the right to fair labour practices, which promotes constitutionalism. In addition, the contribution calls upon the legislature to reconsider the viability of the exhaustive list of unfair labour practices in Part III of the Labour Act, given the constitutionalisation of the broad right to fair labour practices.

Pneumatocele formation following COVID-19 pneumonia. Is there a role for surgical intervention?

COVID-19 mainly causes a lower respiratory tract illness, meaning there has been great interest in the chest and lung radiological findings seen during the course of the disease. Most of this interest has centred around the computed tomographic findings. Most commonly, computed tomographic images report ground-glass opacities but a less common finding, and potential complication associated with COVID-19, is pneumatocele formation. In this case series, we describe the presentation and management of three patients with large pneumatoceles that developed during the recovery phase of COVID-19. A conservative approach is most recommended, with surgical intervention reserved for complicated cases that cause cardiorespiratory compromise.

Olgular Işığında İleusun Güncel Cerrahi Tedavisi

More than 200 million operations are performed worldwide each year. Most of these patients have comorbid features such as advanced age (1). Postoperative ileus is an annoying condition that usually develops after abdominal surgeries. The incidence of postoperative ileus after colorectal surgery is more common than other surgeries. Incidence rtes vary between 10% and 30% of the incidence of postoperative ileus have been reported (2,3). Various risk factors have been identified for the development of ileus. These risk factors are; It can be summarized as advanced age, open surgical approaches, the difficulty of the operation, operation time intestines, decrease in hematocrit or need for blood transfusion /crystalloid and late mobilization. In most cases, more than one of these risk factors is observed. Ileus pathophysiology; it was defined by Vater et al as impared motility and intestinal wall edema (4). Although some publications argue that mechanical ileus can be treated conservatively within 12 hours by rejecting the rule of thumb (5), what we have experienced in these two cases is that the conservative approach is not sufficient in the treatment of such cases. And perhaps to insistence on conservative treatment may cause irreversible damage to the general condition of the patient. We aimed in this study to examine current surgical treatments in two ileus cases with a complex picture. Keywords: Ileus, abdominal surgery, treatment of ileus