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Background: Renal cell carcinoma (RCC) represent 2-3% of all malignant tumors in adults. Clear cell carcinoma is the most frequent histological type, and 25-30% of renal carcinoma have metastasis at the time of diagnosis. RCC very rarely metastasize to the colon. The objective of the present study is to report synchronous haematogenous solitary colonic metastasis that presented as severe recurrent lower gastrointestinal haemorrhage which required right hemicoloectomy and right nephrectomy plus chemotherapy. Clinical Case: We report the case of a 46-year old male patient who presented with multiple episodes of severe haemotochezia and anemia. He had a right flank mass. CT scan of the abdomen showed a large right kidney mass together with a lesion in the ascending colon, not connected to the renal mass. It also showed hepatic metastasis, lung metastasis and ascites. Colonoscopy revealed an ascending colonic mass. The patient was managed by right nephrectomy and right hemicolectomy. The pathology report of the colonic mass showed clear cell carcinoma with involvement of the colon from serosa to mucosa. It indicated the presence of haematogenous spread of the RCC as the mechanism of metastasis. The colonic haemorrhage did not recur. the patient survived close to a year after surgery. Conclusion: RCC metastasis to the colon is very rare and can be synchronous with the primary renal tumor and can be metachronous after nephrectomy. Also, it can be the result of direct invasion, haematogenous spread or after local recurrence following nephrectomy. Metastatic RCC requires surgery, immunotherapy, tyrosine kinase inhibitors, and mammalian target rapamycin inhibitors. Surgery is the first step for disease control and control bleeding from colonic metastasis. Metastectomy is indicated in localized disease and when surgically accessible. [ABSTRACT FROM AUTHOR]

Obstructive Sleep Apnea/Hypopnea Syndrome (OSAHS) is sleep-disordered breathing distinguished by repetitive cessation or reduction of airflow due to the collapse or narrowing of the upper airway during sleep with continued respiratory effort. A high level of incidence of OSAHS is correlated with obesity. Both severely obese patients and OSAHS patients manifest Long QT Syndrome (LQTS). It is reported that most obese patients undergoing weight reduction surgery positively reverse symptoms of LQST. Also, severely obese OSAHS undergoing the same surgery report alleviation of OSAHS symptoms. In this study, we presented preliminary results of the changes in QT and QTc intervals for obese OSAHS patients undergoing Roux-en-Y Gastric Bypass (RYGB) surgery and had their weight reduced, and were treated from OSAHS post-RYGB surgery. We developed an algorithm to detect the different waveforms in the ECG signal and calculated QT and QTc intervals. Results comparing the changes in the QT and QTc pre- and post-RYGB surgery for four apneic subjects (Aged 37.0 ± 8.9 years, Pre-RYGB BMI 51.7 ± 10.1 kg/m 2 , Post-RYGB BMI 35.6 ± 7.9 kg/m 2 ) were contrasted with a control group of 3 non-apneic subjects (Aged 32.7 ± 7.0 years, Pre-RYGB BMI 50.8 ± 11.8 kg/m 2 , Post-RYGB BMI 31.6 ± 2.9 kg/m 2 ) who underwent the same surgery. The results suggest that although the RYGB surgery is successful in weight loss and OSAHS symptoms reduction, apneic patients may continue to have non-reversible LQTS despite long-term weight reduction.