OpenMed/multicare-articles huggingface dataset:
Intrajejunal Infusion of Levodopa-Carbidopa Gel Can Continuously Reduce the Severity of Dropped Head in Parkinson's Disease
Authors: Hiroshi Kataoka, Yasuhiko Sawada, Tadashi Namizaki, Naotaka Shimozato, Hitoshi Yoshiji, Satoshi Ueno
Journal: Front Neurol (2017)
Keywords: parkinson, antecollis, dropped head, intrajejunal infusion, levodopa-carbidopa intestinal gel
MeSH terms: Case Reports

Dropped head can occur in patients with Parkinson's disease and make their quality of life unpleasant because they cannot obtain a frontal view. The pathophysiologic involvement of dopamine agonist or central or peripheral mechanisms has been proposed. Levodopa therapy with the withdrawal of dopamine agonists was sometimes effective, but the effect in most patients did not persist for the entire day. We describe a patient with Parkinson's disease whose dropped head responded throughout the day to the continuous intrajejunal infusion of levodopa-carbidopa intestinal gel (LCIG). During off-periods before treatment with LCIG, severe akinesia and freezing of gait were evident, and she could not continuously obtain a frontal view because of the dropped head. About 20 min after the intrajejunal infusion of LCIG, these features remarkably improved, and she could obtain a frontal view. The angle of dropped head was improved from 39.39 to 14.04°. This case suggests that infusion of LCIG can reduce the severity of dropped head for a longer period than oral levodopa.
A Rare Case of Malignant Tumor of the Larynx with Good Prognosis: Laryngeal Chondrosarcoma
Authors: Abderrahim Elktaibi, Issam Rharrassi, Nabil Hammoune, Youssef Darouassi, Mohammed Amine Hanine, Haddou Ammar
Journal: Case Rep Oncol Med (2019)
MeSH terms: Case Reports

Laryngeal chondrosarcoma is a rare laryngeal tumor that most frequently originates from the cricoid cartilage. The majority of lesions are low grade and the distinction from benign chondromas must be made. We present a case of a laryngeal chondrosarcoma arising from the cricoid cartilage in a 75-year-old Arab man who presented with hoarseness, dysphonia, and dyspnea. Endoscopic and radiological examinations showed a mass of the wall of his larynx with displaced structures, airway obstruction, and destruction of the cartilage. The patient underwent total laryngectomy. Histological examination supported the diagnosis of low-grade chondrosarcoma. Five months later, the radiological and clinical findings showed no evidence of recurrence or metastases. Laryngeal chondrosarcomas remain a rare disease of unknown etiology, with slow and insidious symptoms. The treatment is surgical, given the importance of preserving the larynx to patients' quality of life. The prognosis is favorable and metastases rarely occur.
Anesthetic management in an adult moyamoya disease patient undergoing mitral valve plasty for severe mitral regurgitation
Authors: Kazutomo Saito, Hiroaki Toyama, Yutaka Ejima, Masanori Yamauchi
Journal: JA Clin Rep (2016)
Keywords: cardiopulmonary bypass, intra-aortic balloon pumping, moyamoya disease, preconditioning, sevoflurane

Background:
Despite several previous reports, there are no established procedures for intraoperative management in moyamoya disease patients requiring cardiac surgery.
Case presentation:
Herein, we report the case of a 42-year-old man who was scheduled to undergo mitral valve plasty for severe mitral regurgitation. He had been diagnosed with moyamoya disease on the onset of cerebral ischemia at 41 years of age. During the cardiac surgical procedure, the patient was maintained on inhalation anesthesia with 1 to 1.5 % sevoflurane. Sevoflurane causes cerebral vasodilation followed by increased cerebral blood flow, and moreover we expected a sevoflurane preconditioning-induced neuroprotective effect. In addition, we used pulsatile perfusion support to maintain cerebral circulation with intra-aortic balloon pumping during the cardiopulmonary bypass. We aimed to keep the mean arterial pressure constantly above 70 mmHg. We were able to maintain regional cerebral oxygen saturation at 80 % of the baseline value, and could not detect the progression of neurological deficits using follow-up brain single photon emission computed tomography. The patient was discharged 16 days after admission.
Conclusions:
The details of the clinical course of his case will add to our knowledge regarding intraoperative management options in moyamoya disease patients requiring cardiac surgery. We suggest that pulsatile blood flow supported by intra-aortic balloon pumping and sevoflurane anesthesia for increasing cerebral blood flow and for possible neuroprotection may be efficacious for anesthetic management of moyamoya disease patients.
Evaluation of coronary flow is useful in patients with left coronary cusp thrombus formation after left ventricular assist device implantation
Authors: Tasuku Sato, Michinari Hieda, Shutaro Futami, Mitsuhiro Fukata, Akira Shiose
Journal: Eur Heart J Case Rep (2023)
MeSH terms: Case Reports

Left ventricular assist device (LVAD) is essential for patients with severe heart failure, but there is a risk of thrombus formation on the aortic root and cusps, leading to coronary artery occlusion. Even with the narrowing of the echo-window due to LVAD, careful observation of coronary flow by transthoracic echocardiography can evaluate the patency of coronary flow non-invasively and immediately.
Two Different Meningioma Variants in the Same Tumor: A Rare Histopathological Finding
Authors: Reham Khubrani, Sadeq Al-Dandan
Journal: Case Rep Pathol (2019)
MeSH terms: Case Reports

We report a case of meningioma with both secretory and lipomatous features in an advanced middle aged female patient with a 3-month history of headaches and convulsions. Radiological findings are revised and compared to other reported cases in the literature.
Subsequent Development of Desmoid Tumor after a Resected Gastrointestinal Stromal Tumor
Authors: Areen Abdulelah Murshid, Hatim Q Al-Maghraby
Journal: Case Rep Pathol (2018)
MeSH terms: Case Reports

Desmoid tumors (deep fibromatosis) of the mesentery are rare mesenchymal tumors. They are often misdiagnosed, especially with a previous history of resection for gastrointestinal stromal tumor (GIST). Immunohistochemistry can help differentiate between these two tumors. In this article, we present a case we had encountered: a Desmoid tumor developing in a patient with a history of GIST 3 years ago. It is the first case of GIST with subsequent development of Desmoid tumor to be reported in Saudi Arabia. We discuss the two entities of Desmoid tumor and GIST by comparing their definitions, clinical presentations, histological features, immunohistochemistry stains, molecular pathogenesis, prognosis, and treatment. We also discuss the relationship between GIST and the subsequent development of Desmoid tumors and compare our case with case reports in literature.
Preoperative CT-Guided Near-Infrared Dye Marking for Thoracoscopic Resection of Pulmonary Nodules: A Case Report
Authors: Emanuele Voulaz, Alberto Testori, Felice D'Antuono, Umberto Cariboni, Marco Alloisio, Giuseppe Mangiameli
Journal: Front Surg (2022)
Keywords: ct guide, indocyanin green (icg), lung metastases, lung resection, preoperative marking for pulmonary nodule
MeSH terms: Case Reports

Localization of small-sized pulmonary nodules is challenging during video-assisted thoracoscopic surgery. Several preoperative strategies have been developed to mark these targets. We describe our localization strategy using a preoperative computed tomography-guided near-infrared dye marking.
Successful transplantation of a split crossed fused ectopic kidney into a patient with end-stage renal disease
Authors: Kristin L Mekeel, Shane M Daley, Paul E Andrews, Adyr A Moss, R L Heilman, Marek J Mazur, Harini A Chakkera, Khalid Hamawi, David C Mulligan, K Sudhakar Reddy
Journal: J Transplant (2010)
MeSH terms: Case Reports

Potential donors with congenital renal anomalies but normal renal function are often overlooked because of a possible increase in technical difficulty and complications associated with the surgery. However, as the waiting list for a deceased donor kidney transplant continues to grow, it is important to consider these kidneys for potential transplant. This paper describes the procurement of a crossed fused ectopic kidney, and subsequent parenchymal transection prior to transplantation as part of a combined simultaneous kidney pancreas transplant. The transplant was uncomplicated, and the graft had immediate function. The patient is now two years from transplant with excellent function.
Multicentric Castleman's Disease in a Child Revealed by Chronic Diarrhea
Authors: Sarra Benmiloud, Sana Chaouki, Samir Atmani, Moustapha Hida
Journal: Case Rep Pediatr (2015)

Multicentric Castleman's disease is a rare benign and unexplained lymphoproliferative disorder that is extremely uncommon in children. It presents with fever, systemic symptoms, generalized lymphadenopathy, and laboratory markers of inflammation. Its treatment is not standardized and its prognosis is poor. We report a novel case of multicentric Castleman's disease in a 13-year-old girl who had presented with chronic diarrhea as the only initial presenting symptom. The diagnosis of celiac or inflammatory bowel diseases was suspected, but two and a half years later, the diagnosis of multicentric Castleman's disease was brought following the appearance of abdominal mass whose biopsy revealed Castleman's disease in the plasma cell form. The outcome was favorable after treatment by corticosteroid, chemotherapy, and surgery. The occurrence of diarrhea as the initial symptom of multicentric Castleman's disease without lymph node involvement is very rare. This case report underlines the diagnostic difficulties and the long interval between onset and diagnosis when diarrhea occurs first.
Case Report: Primary Aldosteronism and Subclinical Cushing Syndrome in a 49-Year-Old Woman With Hypertension Plus Hypokalaemia
Authors: Lihua Hu, Wenjun Ji, Meiyu Guo, Tieci Yi, Jie Wang, Minghui Bao, Yusi Gao, Han Jin, Difei Lu, Wei Ma, Xiaoning Han, Jianping Li, Zhenfang Yuan
Journal: Front Cardiovasc Med (2022)
Keywords: adrenal venous sampling, case report, hypertension, primary aldosteronism, subclinical cushing's syndrome
MeSH terms: Case Reports

Background:
Coexisting primary aldosteronism (PA) and subclinical Cushing's syndrome (SCS) caused by bilateral adrenocortical adenomas have occasionally been reported. Precise diagnosis and treatment of the disease pose a challenge to clinicians due to its atypical clinical manifestations and laboratory findings.
Case summary:
A 49-year-old woman was admitted to our hospital due to fatigue, increased nocturia and refractory hypertension. The patient had a history of severe left hydronephrosis 6 months prior. Laboratory examinations showed hypokalaemia (2.58 mmol/L) and high urine potassium (71 mmol/24 h). Adrenal computed tomography (CT) showed bilateral adrenal masses. Undetectable ACTH and unsuppressed plasma cortisol levels by dexamethasone indicated ACTH-independent Cushing's syndrome. Although the upright aldosterone-to-renin ratio (ARR) was 3.06 which did not exceed 3.7, elevated plasma aldosterone concentrations (PAC) with unsuppressed PAC after the captopril test still suggested PA. Adrenal venous sampling (AVS) without adrenocorticotropic hormone further revealed hypersecretion of aldosterone from the right side and no dominant side of cortisol secretion. A laparoscopic right adrenal tumor resection was performed. The pathological diagnosis was adrenocortical adenoma. After the operation, the supine and standing PAC were normalized; while the plasma cortisol levels postoperatively were still high and plasma renin was activated. The patient's postoperative serum potassium and 24-h urine potassium returned to normal without any pharmacological treatment. In addition, the patient's blood pressure was controlled normally with irbesartan alone.
Conclusion:
Patients with refractory hypertension should be screened for the cause of secondary hypertension. AVS should be performed in patients in which PA is highly suspected to determine whether there is the option of surgical treatment. Moreover, patients with PA should be screened for hypercortisolism, which can contribute to a proper understanding of the AVS result.
Case Report: Microfragmented Adipose Tissue Drug Delivery in Canine Mesothelioma: A Case Report on Safety, Feasibility, and Clinical Findings
Authors: Offer Zeira, Erica Ghezzi, Letizia Pettinari, Valentina Re, Davide M Lupi, Silvia L Benali, Simone Borgonovo, Giulio Alessandri, Francesco Petrella, Rita Paroni, Michele Dei Cas, Carlo Tremolada, Valentina Coccè, Augusto Pessina
Journal: Front Vet Sci (2021)
Keywords: adipose tissue, dog, drug delivery, mesothelioma, paclitaxel
MeSH terms: Case Reports

Mesothelioma is a rare lethal tumor of dogs and humans involving cavities of the body. Dogs are considered a model for new drugs and therapeutic methods since they present spontaneous diseases similar to humans. Microfragmented adipose tissue (MFAT) uploaded by paclitaxel (PTX) is a drug delivery medium providing slow release of chemotherapic drugs. A dog affected by pleural, pericardial, and peritoneal mesothelioma was treated by 17 intracavitary ultrasound-guided injections of MFAT-PTX over 22 months. A long-lasting improvement of general conditions was observed, treatment was well-tolerated, and no toxicity or hypersensitivity was reported. Pharmacokinetic (PK) data indicated low drug localization in the circulatory system and a tendency to enter or remain in the extravascular compartments of the body. Indeed, low levels of free-circulating drugs for a short time produced low toxicity, whereas, a higher intracavitary PTX concentration can have major pharmacological efficacy. To our knowledge, this is the first time that mesothelioma has been treated using such a procedure, and this should be considered as a novel therapeutic approach. The low systemic absorption suggests the possible role of MFAT-PTX for loco-regional/intratumoral therapy also useful in other types of tumors, and further investigation is warranted.
Hemadsorption as a Treatment Option for Multisystem Inflammatory Syndrome in Children Associated With COVID-19. A Case Report
Authors: Juan Carlos Ruiz-Rodríguez, Luis Chiscano-Camón, Clara Palmada, Adolf Ruiz-Sanmartin, Marina García-de-Acilu, Erika Plata-Menchaca, Janire Perurena-Prieto, Manuel Hernandez-Gonzalez, Marcos Pérez-Carrasco, Pere Soler-Palacin, Ricard Ferrer
Journal: Front Immunol (2021)
Keywords: sars-cov-2, cytokine - immunological terms, hemoadsorption, inflammatory multisystemic syndrome, myocardial injury
MeSH terms: COVID-19 / complications, Hemoperfusion / methods, Systemic Inflammatory Response Syndrome / therapy, Case Reports, Adolescent, COVID-19 / therapy, Humans, Male, SARS-CoV-2, pediatric multisystem inflammatory disease, COVID-19 related

Multisystem Inflammatory Syndrome in Children (MIS-C) associated with COVID-19 is characterized by hypercytokinemia leading to overwhelming inflammation. We describe the use of a hemadsorption device as part of the supportive treatment for cytokine storm.
Cutaneous plasmablastic lymphoma in an immunocompetent patient with long-term pyrimethamine use for essential thrombocythemia: a case report and literature review
Authors: Ing Soo Tiong, Magreet Strauss, Michael B Y Lau, Shingirai Chiruka
Journal: Case Rep Hematol (2013)

We report a case of Epstein-Barr-virus-(EBV-) positive primary cutaneous plasmablastic lymphoma in a human-immunodeficiency-virus-(HIV-) negative, immunocompetent 62-year-old female patient. We postulate that her lymphoma development is due to the longstanding use of pyrimethamine for essential thrombocythemia. This has never been described in the literature.
Case Report: Single visit photo-activated disinfection in regenerative endodontics
Authors: Al-Shaimaa Abdel Hafiz Abdel Rahim, Fatma Abdelgawad, Ahmed M Abd Alsamed, Dalia Mohamed Moheb, Norhan Abdel Wahab El-Dokky
Journal: F1000Res (2019)
Keywords: necrotic tooth, open apex, regenerative endodontics, root canal disinfection
MeSH terms: Disinfection / methods, Phototherapy, Regenerative Endodontics, Root Canal Therapy, Tooth Fractures / therapy, Case Reports, Child, Female, Humans, Incisor

Background: Root canal disinfection is considered critical for achieving successful regenerative endodontic procedures. Photo-activated disinfection is a novel disinfection method that can help to achieve the goal of regenerative endodontics. This article reports the clinical and radiographic results after single visit regenerative endodontics using photo-activated disinfection. Methods: An 8.5-year-old girl complained of fractured upper right central incisor. Pulp necrosis was diagnosed on the basis of clinical findings. The root canal was irrigated with sodium hypochlorite solution (1.5%) followed by saline. Then, the canal was dried with paper points. A combination of a photosensitizer solution and low power laser light were applied. EDTA solution was used as a final irrigant. Bleeding was induced, followed by placement of collagen resorbable matrix and white mineral trioxide aggregate. Two days later, the tooth was sealed and restored with permanent filling. Results: Clinical findings revealed no pain on percussion or palpation tests. Radiographic examination revealed an increase in root length, an increase of apical root thickness and apical closure at the 12-month follow-up period. Conclusion: Regenerative endodontics using photo-activated disinfection achieved successful outcomes in the necrotic immature permanent tooth.
Carcinosarcoma of the thyroid gland
Authors: Mehmet Fatih Ekici, Cengiz Kocak, Zülfü Bayhan, Sezgin Zeren, Faik Yaylak, Mehmet Hüseyin Metineren, Fatma Emel Kocak
Journal: Case Rep Surg (2015)

Introduction. Surgeon has significant role in the management of such rare and controversial clinical entities related to thyroid gland. In this case report we have presented an elderly patient with rapid enlargement in thyroid that was related to carcinosarcoma. Case Presentation. A 60-year-old lady was presented with rapid enlargement of the thyroid gland. A fine needle aspiration of the nodule in right lobe was performed several weeks before presentation to our clinic. End diagnosis was a papillary carcinoma of the thyroid with spindle cell component. Thus the nodule was recognized to be a carcinosarcoma. Conclusion. Thyroid surgery merits a multidisciplinary approach. Indeed the surgeon should make a conclusive decision in some controversial and rare clinical entities such as carcinosarcoma.
Bone Bruise of the Thoracic Spine Caused by Mild Physical Activity in Children
Authors: Kenji Yokoyama, Kenji Endo, Yoichiro Takata, Fumitake Tezuka, Hiroaki Manabe, Kazuta Yamashita, Toshinori Sakai, Takashi Chikawa, Akihiro Nagamachi, Koichi Sairyo
Journal: Case Rep Orthop (2017)
MeSH terms: Case Reports

Vertebral bone bruise (VBB) in children commonly occurs following a fall from a height, and more than one vertebral body may be affected. We encountered 6 children each with a single VBB caused by mild physical activity. All the children had tenderness on the corresponding spinous process with no neurologic findings. Magnetic resonance imaging (MRI) showed typical findings of VBB in all cases. The children were treated conservatively with a soft thoracolumbar brace and instructed to rest with no physical activity for a month. At follow-up 1 month later, the back pain had diminished, and the signal changes seen on MRI had disappeared in all cases. We conclude that mild physical activity may be a cause of VBB in children and good clinical results can be achieved by using a soft thoracolumbar brace and rest.
Disseminated intravascular coagulation as a possible cause of acute coronary stent thrombosis: a case report and literature review
Authors: Syed Amer, Ali Shafiq, Waqas Qureshi, Mohammed Muqeetadnan, Syed Hassan
Journal: Case Rep Crit Care (2012)

Disseminated intravascular coagulation (DIC), as a cause of acute coronary stent thrombosis, has not yet been reported to our knowledge. We report a case of 64-year-old male, who presented with non-ST-segment elevation myocardial infarction (NSTEMI). Coronary angiography revealed right coronary artery (RCA) stenosis and a drug eluting stent was deployed. Fifteen hours following the intervention, the patient developed an inferior wall ST elevation myocardial infarction. Repeat cardiac catheterization showed an acute in-stent thrombosis. Following thrombectomy, another stent was placed. The patient noted to have an acute drop in platelet count following the second intervention. Two hours following repeat intervention, the patient again developed chest pain and EKG showed recurrent ST-segment elevations in leads II, III, and aVF. Prior to repeat cardiac catheterization, the patient became unresponsive and developed cardiogenic shock. The patient was resuscitated and intubated, and repeat catheterization showed complete stent thrombosis. Intracoronary tissue plasminogen activator (tPA) was given. The platelet count further dropped. Additional studies confirmed the diagnosis of DIC. No further cardiac catheterization was done at this point. The patient then later had a cardiac arrest and unfortunately cardiopulmonary resuscitation could not revive him. Amongst the etiologies of acute stent thrombosis, DIC was deemed a possible cause.
Clinical Diagnosis of Slipped Capital Femoral Epiphysis in a Child With Negative Radiological Findings: A Case Report
Authors: Hamad S Alhassan, Youssef B Almushait, Abdullah Y Almarshad, Atheer Alghamdi, Thamer S Alhussainan
Journal: Cureus (2023)
Keywords: clinical diagnosis, delayed diagnosis, negative magnetic resonance imaging, negative xray, slipped capital femoral epiphysis
MeSH terms: Case Reports

Slipped capital femoral epiphyses (SCFE) is considered to be a very common disorder among adolescent age group. Multiple risk factors have been reported such as obesity, endocrine disorders, vitamin D deficiency, and panhypopituitarism. The diagnosis of SCFE is important especially in its early stages as this would prevent complications and delay in surgical intervention. The diagnosis is mainly done by radiological imaging and clinical evaluation. However, clinical evaluation is often overlooked. Herein, we present a case of a seven-year-old with SCFE that was diagnosed late due to negative radiological imaging and received late surgical intervention. Therefore, it is recommended that orthopedic surgeons use their clinical sense and examination skills to diagnose SCFE promptly, in order to maintain a short follow-up window to prevent any delay in surgical management and to observe for any progression, even if the radiological findings are normal.