OpenMed/multicare-articles huggingface dataset:
Two pediatric patients with hemiplegic migraine presenting as acute encephalopathy: case reports and a literature review
Authors: Yu Xiang, Fei Li, Zhenfeng Song, Zhi Yi, Chengqing Yang, Jiao Xue, Ying Zhang
Journal: Front Pediatr (2023)
Keywords: diagnosis, encephalopathy, hemiplegic migraine, pediatric, treatment

Introduction:
Hemiplegic migraine (HM) is a rare subtype of migraine. HM in children may be atypical in the initial stage of the disease, which could easily lead to misdiagnosis.
Methods:
We report two cases of atypical hemiplegic migraine that onset as an acute encephalopathy. And a comprehensive search was performed using PubMed, Web of Science, and Scopus. We selected only papers that reported complete clinical information about the patients with CACNA1A or ATP1A2 gene mutation.
Results:
Patient #1 showed a de novo mutation, c.674C>A (p. Pro225His), in exon 5 of the CACNA1A gene. And patient #2 showed a missense mutation (c.2143G>A, p. Gly715Arg) in exon 16 of the ATP1A2. Together with our two cases, a total of 160 patients (73 CACNA1A and 87 ATP1A2) were collected and summarized finally.
Discussion:
Acute encephalopathy is the main manifestation of severe attacks of HM in children, which adds to the difficulty of diagnosis. Physicians should consider HM in the differential diagnosis of patients presenting with somnolence, coma, or convulsion without structural, epileptic, infectious, or inflammatory explanation. When similar clinical cases appear, gene detection is particularly important, which is conducive to early diagnosis and treatment. Early recognition and treatment of the disease can help improve the prognosis.
When salpingectomy is not salpingectomy-ipsilateral recurrence of tubal pregnancy
Authors: Simona Fischer, Marc J N C Keirse
Journal: Obstet Gynecol Int (2009)
MeSH terms: Case Reports

Theoretically, total salpingectomy eliminates the risk of an ipsilateral tubal pregnancy. However, total salpingectomy is difficult to achieve using endoloops alone. We describe a situation where this resulted in an ipsilateral recurrence of tubal pregnancy which required emergency intervention and removal of the tubal remnants.
Iatrogenic Right-Sided Pneumothorax Presenting as ST-Segment Elevation: A Rare Case Report and Review of Literature
Authors: Bashar Alzghoul, Ayoub Innabi, Anusha Shanbhag, Kshitij Chatterjee, Farah Amer, Nikihil Meena
Journal: Case Rep Crit Care (2017)
MeSH terms: Case Reports

Pneumothorax is a well-recognized complication of central venous line insertion (CVL). Rarely, pneumothorax can lead to electrocardiogram (ECG) findings mimicking ST-segment elevation myocardial infarction. We present a 63-year-old man with iatrogenic right-sided pneumothorax who developed ST-segment elevation on a 12-lead ECG suggestive of myocardial infarction. The ECG findings completely resolved after needle decompression and chest tube placement. This case points up this rare electrocardiographic finding with discussion of possible mechanisms and differential diagnosis.
Safe and Effective Reduction Technique for Intertrochanteric Fracture with Ipsilateral Below-Knee Amputated Limb
Authors: Hironori Ochi, Tomonori Baba, Takahiro Hamanaka, Yu Ozaki, Taiji Watari, Yasuhiro Homma, Mikio Matsumoto, Kazuo Kaneko
Journal: Case Rep Orthop (2017)
MeSH terms: Case Reports

The positioning of the patient on the fracture table is critical for the successful reduction and operative fixation of intertrochanteric hip fractures. However, this manipulation is challenging with patients who have undergone amputations of their legs. A 97-year-old man presented to the emergency department with symptom of right hip pain following a mechanical fall. He had a below-knee amputation on his right leg following a traffic accident as a 19-year-old and had a below-knee patellar tendon bearing prosthesis fitted to his lower limb for mobility. Radiographs of his pelvis revealed a displaced intertrochanteric fracture of the right side femur. The patient was positioned on a fracture table, as in the standard procedure. The method of inverting the traction boot to accommodate the flexed knee and stump described by Al-Harthy could be used to provide traction and rotational control. Internal fixation was performed using a short femoral nail. Postoperatively, the patient could walk with full weight bearing using a prosthesis on his affected limb. The method of inverting the traction boot to accommodate the flexed knee and stump can be used safely and effectively to achieve and maintain fracture reduction during fixation of intertrochanteric fractures for patients with a below-knee amputated limb.
A case report: Feasibility of a near infrared ray vision system (Photo dynamic eye®) for the postoperative ischemic complication of gallbladder carcinoma
Authors: Koichiro Sakata, Daiki Kijima, Takashi Furuhashi, Katsuhiko Morita, Toshihiko Abe
Journal: Int J Surg Case Rep (2018)
Keywords: bile duct stricture, bile leakage, gallbladder carcinoma, ischemic complication, near-infrared ray vision system, preservation of the bile duct

Introduction:
Radical resection with or without preserving extra-hepatic bile duct has shown similar prognoses for gallbladder carcinoma (GB ca), although aggressive resection is essential. In preserving bile duct, ischemic complications are serious, life-threatening serious problems. Correct evaluation of the blood flow to the biliary tract is crucial.
Case presentation:
A case of gallbladder ca in a 62-year-old man was reported. The patient was diagnosed with stage Ⅱ GB ca (T2, N0, M0) by ultrasonography, computed tomography, magnetic resonance imaging, and endoscopic ultrasonography. Cholecystectomy and intraoperative frozen section examination were planned. After recognition of invasion to subserosa and negative cystic duct margin, radical dissection of the lymph nodes in the hepatoduodenal ligament with preserving biliary tract was performed. Three days after the operation, biliary peritonitis was revealed. Emergency laparotomy showed ischemic bile leakage. Proper blood flow of the biliary system was realized by a near-infrared ray vision system (Photo Dynamic Eye®: HAMAMATSU Photonics) using indocyanine green. Primary suture of the extra-hepatic biliary duct and T-tube drainage were selected. No stricture of the bile system nor recurrence was recognized for two years after surgery.
Discussion:
In the case of ischemic biliary complications, whether to preserve the extrahepatic bile duct is a critical issue for the surgeons. In this case study, the feasibility of authentic indocyanine green near-infrared imaging was shown for postoperative ischemic biliary situations.
Conclusions:
Authentic indocyanine green near-infrared imaging was feasible for the estimation of the blood flow to the postoperative ischemic biliary complication.
A Case of Congenital Isolated Adrenocorticotropic Hormone Deficiency Caused by Two Novel Mutations in the TBX19 Gene
Authors: Kong Weijing, Zou Liping, Zhang Tiantian, Zhang Pei, Meng Yan
Journal: Front Endocrinol (Lausanne) (2019)
Keywords: tbx19 gene, adrenocorticotropic hormone, cortisol, special appearance, thyroid-stimulating hormone
MeSH terms: Case Reports

Congenital isolated adrenocorticotropic hormone (ACTH) deficiency (CIAD) is a rare disorder which can result in 20% mortality in the neonatal period if misdiagnosed. A 2 years and 7 months old boy was hospitalized many times because of recurrent hypoglycemia. On initial physical examination, the patient showed special appearance and indications of fast growth (≥P97). Laboratory investigations revealed low levels of ACTH and cortisol in his plasma. Except thyroid-stimulating hormone, the anterior pituitary hormone concentrations were normal. Molecular data showed compound heterozygosity for two novel mutations in the TBX19 gene (encoding the transcription factor T-Box 19). Mutation c.205C>T was inherited from mother and the fragment deletion (from g.168,247,374 to g.168,278,264) was from father. Hydrocortisone replacement therapy was effective. We reported two novel TBX19 mutations, expanding the mutation spectrum of this disorder, in a CIAD patient who presented with special appearance, signs of fast growth, and thyroid-stimulating hormone derangement. In addition, for avoiding misdiagnosis, criterion for ACTH and cortisol detection of CIAD should be established.
Case report: Implantable cardioverter-defibrillator implantation with optimal medical treatment for lethal ventricular arrhythmia caused by recurrent coronary artery spasm due to tyrosine kinase inhibitors
Authors: Jifu Jin, Guang Xia, Yu Luo, Ying Cai, Ying Huang, Zhiyun Yang, Qinghui Yang, Bing Yang
Journal: Front Cardiovasc Med (2023)
Keywords: coronary artery spasm, implantable cardioverter-defibrillator, sudden cardiac death, tyrosine kinase inhibitors, ventricular arrhythmia
MeSH terms: Case Reports

Coronary artery spasm (CAS) may induce lethal ventricular arrhythmia due to severe and prolonged vessel constriction. Tyrosine kinase inhibitors are associated with the occurrence of CAS. Optimal medical treatment is the first-line therapeutic option for the management of CAS, whereas patients who experienced aborted sudden cardiac death (SCD) may benefit from implantable cardioverter-defibrillator (ICD) implantation. We report a case of a 63-year-old Chinese man receiving tyrosine kinase inhibitor treatment for liver cancer who presented with recurrent chest discomfort and syncope with an elevation of high-sensitivity troponin T. Emergent coronary angiography showed sub-total occlusion of the left anterior descending artery without other signs of CAS. Percutaneous transluminal coronary angioplasty with a drug-coated balloon was performed successfully with the guidance of intravascular ultrasound. After 5 months, the patient returned to the emergency room for chest discomfort and another episode of syncope. The electrocardiogram showed ST-segment elevation in the inferior and V5-V6 leads compared to the previous event. Coronary angiography was repeated immediately and showed significant luminal stenosis at the midportion of the right coronary artery (RCA), whereas, after administration of intracoronary nitroglycerine, a remarkable recovery of RCA patency was noticed. A diagnosis of CAS was made, and soon after that, the patient rapidly developed ventricular arrhythmia in the coronary care unit. After successful resuscitation, the patient recovered completely and received long-acting calcium channel blockers as well as nitrates therapy. ICD implantation was performed considering the high risk of recurrence of life-threatening ventricular arrhythmia. During the follow-up period, the patient has been free of angina, syncope, or ventricular arrhythmia, and ICD interrogation showed no ventricular tachycardia or ventricular fibrillation. We first reported the case of a patient with CAS induced by regorafenib treatment complicated with severe atherosclerotic coronary disease who survived from sudden cardiac arrest. ICD implantation is indicated in patients who experienced aborted SCD for the prevention of the next lethal ventricular arrhythmia.
Acute Respiratory Failure after Administration of Hydrogen Peroxide as an Emetic in a Cat
Authors: Leona Rauserova-Lexmaulova, Carlos Agudelo, Barbara Prokesova
Journal: Case Rep Vet Med (2019)
MeSH terms: Case Reports

Objective and case summary:
This case report describes a 5-year-old domestic short-haired cat that was orally administered with 4 mL of 3% hydrogen peroxide by the owner after suspecting ingestion of a foreign body by the cat. Shortly after the administration, the cat developed severe respiratory distress. Thoracic radiography showed an interstitial-to-alveolar pulmonary pattern, while echocardiography and heart injury markers ruled out a cardiac origin. Intensive management with oxygen, diuretics, bronchodilators, and sedation resulted in survival of the cat without further respiratory complications.
New and unique information provided:
To the best of our knowledge, this is the first report of a lung injury and acute respiratory failure after administration of hydrogen peroxide in a cat with successful management.
Homing of radiolabelled xenogeneic equine peripheral blood-derived MSCs towards a joint lesion in a dog
Authors: Charlotte Beerts, Glenn Pauwelyn, Eva Depuydt, Yangfeng Xu, Jimmy H Saunders, Kathelijne Peremans, Jan H Spaas
Journal: Front Vet Sci (2022)
Keywords: canine, cranial cruciate ligament tear, homing, mesenchymal stem cell, radiolabelling

Osteoarthritis (OA) is a highly prevalent condition in dogs, causing a substantial reduction in quality of life and welfare of the animals. Current disease management focusses on pain relief but does not stop the progression of the disease. Therefore, mesenchymal stem cells (MSCs) could offer a promising disease modifying alternative. However, little is known about the behavior and the mode of action of MSCs following their administration. In the current case report, 99mTechnetium labelled xenogeneic equine peripheral blood-derived MSCs were intravenously injected in a 9 year old dog suffering from a natural occurring cranial cruciate ligament rupture. The biodistribution of the MSCs was evaluated during a 6-h follow-up period, using a full body scintigraphy imaging technique. No clinical abnormalities or ectopic tissue formations were detected throughout the study. A radiopharmaceutical uptake was present in the liver, heart, lung, spleen, kidneys and bladder of the dog. Furthermore, homing of the radiolabelled MSCs to the injured joint was observed, with 40.61 % higher uptake in the affected joint in comparison with the healthy contralateral joint. Finally, a local radioactive hotspot was seen at a part of the tail of the dog that had been injured recently. The current study is the first to confirm the homing of xenogeneic MSCs to a naturally occurring joint lesion after IV administration.
Feasibility of multiple repeat gamma knife radiosurgeries for trigeminal neuralgia: a case report and review of the literature
Authors: Guy C Jones, Ameer L Elaimy, John J Demakas, Hansi Jiang, Wayne T Lamoreaux, Robert K Fairbanks, Alexander R Mackay, Barton S Cooke, Christopher M Lee
Journal: Case Rep Med (2011)
MeSH terms: Case Reports

Treatment options for trigeminal neuralgia (TN) must be customized for the individual patient, and physicians must be aware of the medical, surgical, and radiation treatment modalities to prescribe optimal treatment courses for specific patients. The following case illustrates the potential for gamma knife radiosurgery (GKRS) to be repeated multiple times for the purpose of achieving facial pain control in cases of TN that have been refractory to other medical and surgical options, as well as prior GKRS. The patient described failed to achieve pain control with initial GKRS, as well as medical and surgical treatments, but experienced significant pain relief for a period of time with a second GKRS procedure and later underwent a third procedure. Only a small subset of patients have reportedly undergone more than two GKRS for TN; thus, further research and long-term clinical followup will be valuable in determining its usefulness in specific clinical situations.
Cosmetic Remodeling of the Smile: Combining Composite Resin and Ceramics over Teeth and Implants
Authors: Leonardo Fernandes da Cunha, Ubiracy Gaião, Rafael Coutinho Silva, Carla Castiglia Gonzaga, Gisele Maria Correr
Journal: Case Rep Dent (2017)
MeSH terms: Case Reports

The aim of this paper is to describe a restorative approach to the cosmetic remodeling of the teeth of a young adult patient with right maxillary lateral hypodontia and left lateral microdontia. A conservative restorative management was proposed to improve smile esthetics by combining direct composite resins and ceramics. Initially, periodontal therapy and dental bleaching were performed. Subsequently, direct composite resins were applied to the central incisors and canines to reestablish the sizes and shapes of these teeth. Finally, ceramics were placed on the implant and the microdontia to unite with the new alignment and color of the anterior teeth. Thus, conservative remodeling to improve the harmony of the smile was provided.
A Nonpalpable Nodule in Ectopic Axillary Breast Tissue: Consider Phyllodes Tumor
Authors: Eva Ruvalcaba-Limón, Verónica Bautista-Piña, Julio Ramírez-Bollas, Ruby Espejo-Fonseca, Sergio Rodríguez-Cuevas
Journal: Case Rep Pathol (2016)
MeSH terms: Case Reports

Benign and malignant pathology can develop in ectopic axillary breast tissue, such as fibroadenomas, phyllodes tumors, and breast cancer. We present a rare case of an asymptomatic 43-year-old woman with an axillary nodule which was identified during screening mammography within ectopic axillary breast tissue, initially considered as a suspicious lymph node. Radiologic studies were considered as Breast Imaging-Reporting Data System (BI-RADS) 4. A hyperdense, lobular, and well-circumscribed nodule was identified in mammogram while the nodule by ultrasound (US) was hypoechoic with indistinct microlobular margins, without vascularity by Doppler, and measuring 1.26 × 1 cm. Core-needle biopsy reported a fibroepithelial neoplasm. The patient was submitted to local wide-needle excision located in intraoperative radiography of the surgical specimen and margin evaluation. Final histopathological study reported a 1.8 × 1.2 cm benign phyllodes tumor, with irregular, pushing, and clear wide margins within normal ectopic breast tissue. The patient without surgical complications continued annual screening without recurrence during a follow-up that took place 24 months later.
Heel reconstruction with ALT free flap in a 4-year-old patient after a severe lawnmower injury. A case report
Authors: Emilio Trignano, Pietro Luciano Serra, Federica Grieco, Manuela Rodio, Silvia Rampazzo, Nicola Pili, Claudia Trignano, Corrado Rubino
Journal: Case Reports Plast Surg Hand Surg (2022)
Keywords: lawnmower, flap, microsurgery, pediatric, reconstruction, trauma
MeSH terms: Case Reports

Lawnmowers represent a danger in pediatric population. Frequently, traumas involve limbs. Among the different reconstructive techniques, a free flap is often needed. We discuss the first case of heel reconstruction with an anterolateral thigh flap in a 4-years-old patient after a lawnmower's trauma.
Sarcoidosis and Multiple Myeloma: A Case Report and Literature Review
Authors: Joao Tiago Serra, Aurelia Martinho, Fernanda Paixao Duarte, Fernando Aldomiro
Journal: Case Rep Hematol (2019)
MeSH terms: Case Reports

The existence of a sarcoidosis-lymphoma syndrome has been previously proposed since the relation between sarcoidosis and an increased risk of lymphoproliferative disorders is well established. Multiple myeloma is a malignant multifocal proliferation of clonal plasma cells within the bone marrow, and its association with sarcoidosis has been rarely described. We present a concurrent diagnosis of sarcoidosis and multiple myeloma and make a brief analysis of the reported cases in the literature. A 65-year-old woman underwent surgery for the excision of a wrist mass that presented 3 years before. Histological analysis showed sarcoid-type epithelioid granulomas without necrosis, establishing soft tissue sarcoidosis. Further evaluation revealed marked interstitial lung parenchyma lesions and large intrathoracic adenopathies. Bronchofibroscopy with transbronchial biopsy confirmed lung sarcoidosis. In addition, blood analysis showed monoclonal IgG kappa gammopathy. A bone marrow biopsy confirmed hypercellularity with 60% plasma cells and plasmocyte infiltration. Thus, the diagnosis of systemic sarcoidosis and multiple myeloma was established simultaneously. In a brief review of the literature, we identified 33 reports of cases with both sarcoidosis and multiple myeloma. We point out the importance of a high level of suspicion for the association of sarcoidosis with malignant haematological diseases such as multiple myeloma.
Uncommon Occurrences of Air Embolism: Description of Cases and Review of the Literature
Authors: Giorgio Berlot, Adriano Rinaldi, Marco Moscheni, Massimo Ferluga, Perla Rossini
Journal: Case Rep Crit Care (2018)
MeSH terms: Case Reports

Many different risk factors have been associated with the occurrence of gas embolism making this potentially lethal complication easily avoidable. However, this condition can occur in circumstances not commonly reported. Three different and extremely uncommon cases of gas embolism are presented and discussed: the first was caused by the voluntary ingestion of hydrogen peroxide, the second occurred during a retrograde cholangiopancreatography, and the last followed the intrapleural injection of Urokinase. Whereas in the first patient the gas embolism was associated with only relatively mild digestive symptoms, in the remaining two it caused a massive cerebral ischemia and an extended myocardial infarction, respectively. Despite a hyperbaric oxygen therapy performed timely in each case, only the first patient survived. The classical risk factors associated with gas embolism like indwelling central venous catheters, diving accidents, etc. are rather well known and thus somewhat preventable; however, a number of less common and difficult-to-recognize causes can determine this condition, making the correct diagnosis elusive and delaying the hyperbaric oxygen therapy, whose window of opportunity is rather narrow. Thus, a gas embolism should be suspected in the presence of not otherwise explainable sudden neurologic and/or cardiovascular symptoms also in circumstances not typically considered at risk.
Case Report: A Case of Epileptic Disorder Associated With a Novel CNTN2 Frameshift Variant in Homozygosity due to Maternal Uniparental Disomy
Authors: Wenjie Chen, Fei Chen, Yiping Shen, Zhixian Yang, Jiong Qin
Journal: Front Genet (2021)
Keywords: cntn2, epilepsy, genotype-phenotype correlation, neurodevelopmental disorder (ndd), uniparental disomy (upd)
MeSH terms: Case Reports

Background: Contactin 2, encoded by CNTN2 on chromosome 1q32.1, is a neural-specific glycoprotein and plays important roles in neurodevelopment. A deleterious homozygous variant in the CNTN2 gene was previously reported to cause autosomal recessive cortical myoclonic tremor and epilepsy. Since then, there has been no further report confirming the association of CNTN2 and epilepsy. Here, we reported one new case, who presented with epilepsy, carrying a novel homozygous frameshift variant in CNTN2. The clinical and genetic features of the patient were reviewed. Case presentation: The male patient presented with preschool age-of-onset neurodevelopmental impairment and focal seizures of temporal origin, and responded to valproate. A trio-whole exome sequencing revealed a novel homozygous frameshift variant in CNTN2 (c.2873_c.2874delCT, p.Thr958Thrfs). The patient's mother was a heterozygous carrier while his father was wild-type; they were both unaffected and non-consanguineous. Further study revealed that maternal uniparental disomy (1q32.1) unmasked the heterozygous variant of CNTN2 in the proband. Conclusions: This case enhanced the gene-disease relationship between CNTN2 and epilepsy, which will help to further understand this emerging disorder.