OpenMed/multicare-articles huggingface dataset:
An operation in the park bench position complicated by massive tongue swelling
Authors: Hiroyuki Koizumi, Satoshi Utsuki, Madoka Inukai, Hidehiro Oka, Shigeyuki Osawa, Kiyotaka Fujii
Journal: Case Rep Neurol Med (2012)
MeSH terms: Case Reports

This paper presents a case of massive tongue swelling as a complication after an operation in the park bench position. A 43-year-old male who had undergone a resection of a mass in the petrous bone of the clivus showed massive tongue swelling after the surgery in the left park bench position. A direct compression of the bite block caused the swelling of tongue. Tongue swelling may become fatal if it progresses to an airway obstruction; therefore the intraoperative and postoperative management is important.
Case report: Gene mutations and clinical characteristics of four patients with osteopetrosis
Authors: Yu Chen, Lina Zhou, Xianmin Guan, Xianhao Wen, Jie Yu, Ying Dou
Journal: Front Pediatr (2023)
Keywords: clcn7, tcirg1, mutation, osteopetrosis, variants
MeSH terms: Case Reports

Osteopetrosis is characterized by increased bone density caused by decreased osteoclasts or dysfunction of their differentiation and absorption properties, usually caused by biallelic variants of the TCIRG1(OMIM:604592)and CLCN7(OMIM:602727) genes. Herein, the clinical, biochemical, and radiological manifestations of osteopetrosis in four Chinese children are described. Whole-exome sequencing identified compound heterozygous variants of the CLCN7 and TCIRG1 genes in these patients. In Patient 1, two novel variants were identified in CLCN7:c.880T > G(p.F294V) and c.686C > G(p.S229X). Patient 2 harbored previously reported a single gene variant c.643G > A(p.G215R) in CLCN7. Patient 3 had a novel variant c.569A > G(p.N190S) and a novel frameshift variant c.1113dupG(p.N372fs) in CLCN7. Patient 4 had a frameshift variant c.43delA(p.K15fs) and variant c.C1360T in TCIRG1, resulting in the formation of a premature termination codon (p.R454X), both of which were reported previously. Our results expand the spectrum of identified genetic variation in osteopetrosis and provide a deeper understanding of the relations between genotype and clinical characteristics of this disorder.
Case report: Microsurgical replantation of heel skin and subcutaneous tissue
Authors: Jian Zhou, Shusen Chang, Chengliang Deng, Guangtao Huang, Wenhu Jin, Wei Chen, Zairong Wei
Journal: Front Surg (2023)
Keywords: composite tissue, microsurgical, reconstruction, replantation, tissue avulsion
MeSH terms: Case Reports

A 36-year-old healthy male patient was presented to the emergency room 3 h after experiencing a laceration to the left foot caused by a porcelain shard. The defect measured 7.5 × 6.0 × 0.8 cm, and the composite amputated tissue consisted of skin and subcutaneous layers. The terminal branch of the lateral calcaneal artery was first anastomosed end-to-end to the corresponding artery in the wound defect. The lateral calcaneal nerve was anastomosed after blood flow was restored. The two lateral veins were anastomosed end-to-end to the corresponding veins in the wound defect. Postoperatively, 1.0 × 1.5 cm area of skin necrosis was present at the distal end of the tissue, which healed smoothly after two weeks of dressing changes. The patient had retained excellent aesthetic and functionality by the 37 month follow up. Although such isolated amputation is relatively rare, microsurgical replantation is, thus, a feasible option in the management of heel amputation.
Case Report: A Child With Hemophilia A Serves as Donor for Hematopoietic Stem Cell Transplantation to Cure His Brother's Severe Aplastic Anemia
Authors: Gabriella Kertész, Krisztián Kállay, Csaba Kassa, Marianna Zombori, Imre Bodó, Csongor Kiss, István Szegedi, Gergely Kriván
Journal: Pathol Oncol Res (2022)
Keywords: children, hematopoietic stem cell transplantation (hsct), hemophilia a, hepatitis associated bone marrow failure (habmf), severe aplastic anemia (saa)
MeSH terms: Anemia, Aplastic / therapy, Graft vs Host Disease, Hematopoietic Stem Cell Transplantation, Hemophilia A / complications, Hemophilia A / therapy, Case Reports, Child, Humans, Male, Siblings, Transplantation Conditioning

The first-line treatment of severe aplastic anemia is allogeneic hematopoietic stem cell transplantation with a matched sibling donor. However, co-morbidities of the identical donor can make donation difficult. We present a transplantation where in parallel with the patient's conditioning treatment, the preparation of the donor with severe hemophilia A required a special management with perioperative factor VIII substitution. Donation was successful without complications, and 18 months after transplantation, the patient and his donor are well without any long-term sequelae. To our knowledge, this is the first reported succesfull transplantation with hemophilic child serving as a bone marrow donor. The procedure did not mean a significant risk to donor health, so donors with hemophilia should not be excluded from donation.
Three-Layered Closure of Persistent Oroantral Fistula Using Chin Graft, Buccal Fat Pad, and Buccal Advancement Flap: A Case Report with Review of Literature
Authors: Shiv Prasad Sharma
Journal: Case Rep Dent (2019)
MeSH terms: Case Reports

Various techniques have been used for the repair of oroantral fistula (OAF) but majority of them have focused on the soft tissue closure alone, and most of the time, the osseous floor of the sinus was ignored. Existing literature supports that bone grafts supported by Buccal Fat Pad (BFP) heal well without undergoing significant resorption and necrosis. Through this case report, we wish to elaborate on the clinical success of using BFP and autogenous chin graft for simultaneous reconstruction of a large long-standing oroantral fistula with underlying osseous defect. The combination technique can prove beneficial for osseous regeneration of sinus floor and improve chances for future implant prosthetic rehabilitation.
A Rare Case of Hypersensitivity Pneumonitis due to Florida Red Tide
Authors: Raju Reddy, Nupur Verma, Tan-Lucien Mohammed
Journal: Case Rep Pulmonol (2019)
MeSH terms: Case Reports

Florida red tides occur annually due to proliferation of the marine dinoflagellate Karenia brevis, which produces neurotoxins known as brevotoxins. Inhalational exposure to brevotoxins usually results in upper airway symptoms only. Rarely does exposure lead to lower respiratory tract symptoms as in our case. We report a case of a 50-year-old man who presented with a 4-week history of dyspnea after exposure to the red tide. Computed tomography (CT) of the chest showed diffuse bilateral ground glass opacities and interstitial thickening. Bronchoalveolar lavage cultures and cytology were negative. The patient was started on steroids. Over the next few weeks, the patient's symptoms resolved. Repeat CT chest showed complete resolution of the ground glass opacities. Steroids were then tapered. Most patients who are exposed to algal blooms have self-limiting symptoms. Patients with asthma are particularly susceptible to worsening respiratory symptoms after exposure to brevotoxin aerosols. This case highlights that, in rare cases, exposure to red tide can results in severe lower respiratory tract symptoms.
A case series evaluating the serological response of adult asthma patients to the 23-valent pneumococcal polysaccharide vaccine
Authors: C R Laratta, K Williams, D Vethanayagam, M Ulanova, H Vliagoftis
Journal: Allergy Asthma Clin Immunol (2017)
Keywords: antibodies, asthma, capsular polysaccharide serotypes, corticosteroids, invasive pneumococcal disease, obstructive airways disease, ppsv23, pneumococcal polysaccharide vaccine, pneumococcal vaccine, prevention, serology, vaccination, vaccine responsiveness

Background:
Asthma is an independent risk factor for invasive pneumococcal disease; however, the immune response of adult asthma patients to pneumococcal vaccination is unknown. We explore the serologic response of patients with moderate to severe asthma to the 23-valent pneumococcal polysaccharide vaccine (PPSV23).
Methods:
Seventeen moderate to severe adult asthma patients that had not been vaccinated against pneumococcus over the 5 previous years were prospectively recruited from a tertiary care asthma clinic. Serum was analyzed for the presence of antibodies to five capsular polysaccharide (CP) antigens (6B, 9V, 19A, 19F, 23F) before and 4 weeks after PPSV23 vaccination.
Results:
There was a wide variability in baseline anti-CP antibody concentrations. Other than for serotype 19A, our patients frequently have baseline anti-CP antibody concentrations below 1 µg/mL (35% for serotype 19F, 41% for serotypes 9V and 23F, and 59% for serotype 6B). All post-vaccination geometric mean antibody concentrations were significantly higher than baseline. In the 31 tests where the baseline antibody concentration was <1 µg/mL, 77.4% had at least a twofold increase post-vaccination. Despite this, a large proportion of post-vaccination anti-CP antibody concentrations remained <1 µg/mL (51.6% of tests). Nine patients had at least one anti-CP antibody concentration <1 µg/mL post-vaccination. There was no difference between these patients and the remaining eight patients in demographic or clinical variables.
Conclusions:
Patients with moderate to severe asthma have variable baseline and low post-vaccination antibody concentrations to common CP antigens included in the PPSV23 vaccine. The clinical relevance of these observations remains to be determined since the threshold concentration in adults required for clinical protection from invasive pneumococcal disease is uncertain.
A Suggested Approach of Managing Excessive Maxillary Gingival Display in Terminal Dentition
Authors: Daniel Saad, Celine Moukarzel, Naim El Haddad, Anthony Rizk
Journal: Case Rep Dent (2020)
MeSH terms: Case Reports

The aim of this paper is to report a suggested approach for the management of excessive maxillary gingival display with terminal dentition. A segmental osteotomy of the maxillary process was performed, and the latter used as grafting material for lateral sinus augmentation that was performed simultaneously. Following the graft maturation period, implants were inserted and rehabilitated with a fixed dentogingival prosthesis. Consequently, the mandible was prosthetically restored following the new occlusal plane dictated by the rehabilitated maxilla. Clinically, the procedure showed a drastic improvement in the patient's appearance, eliminating the excessive gingival display. Radiologically, it led to a vertical translation of the maxillary process level in an apical direction. Nevertheless, the resected process used as grafting material was noticed to have a suboptimal behavior as long as it showed increased intrasinusal resorption, barely sufficient for a regular implant accommodation. The described therapy concept seems to be a plausible approach when it comes to manage excessive maxillary gingival displays in edentulous patients or those presenting a terminal dentition. However, at the time of sinus augmentation, authors recommend to graft a mixture of resected maxillary process and a bone substitute material, in order to get more stable results.
Case report: Epidural blood patches are effective in treating intracranial hypotension due to a subarachnoid-pleural fistula
Authors: Hua Huang, Ting-Ting Wei, Zhong-Feng Niu, Liang Yu, Fei-Fang He
Journal: Front Surg (2022)
Keywords: tarlov cyst, epidural blood batch, intracranial hypotension, posterior mediastinal mass, subarachnoid-pleural fistula
MeSH terms: Case Reports

Background:
Intracranial hypotension (IH) is usually associated with cerebrospinal fluid (CSF) leakage and/or CSF hypotension, and epidural blood patch (EBP) therapy has been proven to be effective for treating spontaneous IH and post-dural puncture headaches. Tarlov cysts (TCs) are common lesions of the sacral spine. They have rarely been reported in thoracic locations and are even less common in the posterior mediastinum, which can lead to their misdiagnosis as neurogenic tumors.
Case presentation:
Here, we report the case of a 60-year-old woman who developed an orthostatic headache after the thoracoscopic resection of a TC in the posterior mediastinum that was presumed to be a schwannoma preoperatively. The patient was finally diagnosed with IH caused by a subarachnoid-pleural fistula (SPF) and was cured by targeted EBP treatment.
Conclusion:
This is a case to show that a single targeted EBP treatment is effective for a patient with IH caused by an SPF after thoracoscopic resection of a TC. This case reminds us to be vigilant that a TC may be masquerading as a posterior mediastinal neurogenic tumor, and a detailed examination should be performed to identify it before deciding on a surgical procedure. In addition, postural headache after thoracoscopic spinal surgery should be alert to the possibility of IH induced by an SPF. Once it occurs, early treatment is necessary, and targeted EBP treatment can serve as a safe and effective alternative when conservative treatment fails.
Interimplant papilla reconstruction by using demineralized freeze dried bone allograft block fixed by titanium screw: a case report
Authors: Preeti Charde, M L Bhongade, Aniruddha Deshpande, Anendd Jadhav, Kaustubh Thakare, Priyanka Jaiswal
Journal: Case Rep Dent (2012)

Dental implants are now considered as a predictable treatment modality for the oral rehabilitation of partially or fully edentulous patients. Recently emphasis has changed towards achieving a predictable esthetic success. Creating aesthetically successful implant-supported restoration in the anterior region of oral cavity depends on the presence of interimplant papilla when multiple implants are used. The present paper reports a case of interimplant papilla reconstruction in esthetic zone of maxilla during one stage early loading multiple implant procedure using demineralized freeze dried bone allograft block fixed by titanium screw.
Human metapneumovirus RNA in encephalitis patient
Authors: Oliver Schildgen, Thomas Glatzel, Tilman Geikowski, Bärbel Scheibner, Bertfried Matz, Lutz Bindl, Mark Born, Sergei Viazov, Anja Wilkesmann, Gisela Knöpfle, Michael Roggendorf, Arne Simon
Journal: Emerg Infect Dis (2005)
MeSH terms: Encephalitis, Viral / virology, Metapneumovirus / isolation & purification, Paramyxoviridae Infections / diagnosis, RNA, Viral / isolation & purification, Case Reports, Research Support, Non-U.S. Gov't, Base Sequence, Fatal Outcome, Humans, Infant, Male, Molecular Sequence Data, RNA, Viral / chemistry, Sequence Alignment, RNA, Viral

We describe a fatal case of encephalitis that might be correlated with primary human metapneumovirus (HMPV) encephalitis. Postmortem HMPV RNA was detected in brain and lung tissue samples from the patient. Furthermore, HMPV RNA was found in culture fluids from cells coincubated with lung tissue.
Renal Replacement Lipomatosis Presenting in the Setting of Ureteral Stricture with Absence of Renal Calculus Disease
Authors: Katrina Collins, Eric Brocken, Laura M Warmke, Temel Tirkes, Michael Hwang
Journal: Case Rep Pathol (2021)
MeSH terms: Case Reports

Renal replacement lipomatosis of the kidney is a rare, benign entity in which extensive fibrofatty proliferation of the renal sinus is associated with marked atrophy of the renal parenchyma. It is often associated with calculi or long-standing inflammation. This entity may be confused with a fatty neoplasm of the kidney. A 51-year-old woman with a past medical history of pancreas transplant for type 1 diabetes subsequently developed ureteral stricture. This was initially managed by a nephrostomy tube and nephroureterostomy stenting with periodic exchanges to help restore urine flow; however, the renal function of the kidney progressively declined with recurrent and complicated urinary tract infections. She presented for kidney transplant with right native nephrectomy. Gross examination of the right kidney revealed a 12.8 cm renal sinus lipomatous mass replacing much of the kidney. Microscopically, the mass consisted of mature adipose tissue with fibrous septae and occasional thick-walled vessels with prominent smooth muscle bundles. A rare atypical stromal cell was present, otherwise no significant cytologic atypia or lipoblasts were identified. After excluding fat-predominant angiomyolipoma and well-differentiated liposarcoma, a diagnosis of renal replacement lipomatosis was made. Renal replacement lipomatosis is a benign condition typically associated with a nonfunctioning or poorly functioning kidney often linked to renal calculus disease or chronic renal infection. The presentation in our case was atypical given an absence of associated renal calculus disease. This case is intended to increase awareness of this less commonly encountered entity as it may be confused with a fatty neoplasm of the kidney, some with malignant potential.
Case Report: Malignant Primary Sellar Paraganglioma With Unusual Genetic and Imaging Features
Authors: Stefan Stojanoski, Henning Bünsow Boldt, Dusko Kozic, Attila Patócs, Márta Korbonits, Milica Medic-Stojanoska, Olivera Casar-Borota
Journal: Front Oncol (2021)
Keywords: 68ga-dotanoc pet/ct, atrx mutations, mri, tp53 mutations, malignant sellar paraganglioma
MeSH terms: Case Reports

Background:
Paraganglioma occurs rarely in the sellar/parasellar region. Here, we report a patient with malignant paraganglioma with primary sellar location with unusual genetic and imaging features.
Case presentation:
A 31-year-old male presented with mild hypertension, headache, nausea, and vomiting. A sellar/parasellar tumor mass was revealed by magnetic resonance imaging (MRI), while an endocrine work-up found partial hypopituitarism, suggesting that it was a non-functioning pituitary tumor. Antihypertensive therapy and hormone replacement were initiated. Tumor reduction was achieved with transsphenoidal neurosurgery. However, histological diagnosis was not possible due to extensive tissue necrosis. After 4 years of stable disease, the residual tumor showed re-growth requiring gamma knife radiosurgery. Four years after the radiosurgery, MRI showed a significant tumor progression leading to a second neurosurgery. This time, pathological and immunohistochemical findings revealed paraganglioma. Plasma levels of metanephrine and normetanephrine were normal. A gene sequencing panel performed on DNA extracted from blood excluded germline mutations in 17 susceptibility genes. The patient developed new tumor masses in the neck, and the third surgery was performed. Immunohistochemistry demonstrated lack of ATRX (alpha thalassemia/mental retardation syndrome X-linked) protein in tumor cells, indicating an ATRX gene mutation. Molecular genetic analysis performed on tumor DNA revealed a combination of ATRX and TP53 gene abnormalities; this was not previously reported in paraganglioma. MRI and 68Ga-DOTANOC PET/CT revealed the full extent of the disease. Therapy with somatostatin LAR and 177Lu-DOTATATE Peptide Receptor Radionuclide Therapy (PRRT) was initiated.
Conclusion:
Although rare, paraganglioma should be considered in the differential diagnosis of sellar/parasellar tumor lesions, even in the absence of typical imaging features. ATRX gene mutation in paraganglioma is an early predictor of malignant behavior and a potential novel therapeutic marker when pharmacological therapy targeting mutated ATRX becomes available.
Tc-99m sulfur colloid SPECT-CT and assessment of functional liver reserve after Y90 radioembolization: A case report
Authors: YeeMei Chan, WingHang Luk, LikFai Cheng, HoFung Chan, N Y Pan, KaFai Ma
Journal: Int J Surg Case Rep (2019)
Keywords: spect -ct, segmentectomy and lobectomy of liver, tc-99m sulphur colloid, y90 radioembolization

Introduction:
Quantitative assessment is an essential tool in determining the proportion of liver to be reserved before lobectomy. Technetium-99 m sulfur colloid single-photon emission computed tomography (Tc-99 m SC SPECT-CT) can help in the quantitative assessment of functioning liver tissues and percentage of liver reserve before segmentectomy and lobectomy Matesan et al. (2017), Bowen et al. (2016) and Lam et al. (2013).
Presentation of case:
A 64-year-old man with alcoholic cirrhosis was admitted to our hospital with a 15 × 10 x 13 cm bilobar HCC. Y90 radioembolization was utilized to downstage the liver tumor. On follow-up CT scan of the liver after radiotherapy, the HCC was much reduced to 6.5 cm in size but still viable with elevated alpha fetoprotein ([AFP] from 225 to 381 to 959 ng/mL). Resection was considered. Constitutional indocyanine green retention at 15 min (ICG-R-15) was 22%. We introduced the Tc-99 m SC SPECT-CT scan in order to assess the percentage liver function of each lobe. It showed minimal uptake in the remaining functioning right lobe with a hypertrophic left lobe to whole liver uptake ratio of 87.1%. This finding gave us confidence to perform right hepatectomy.
Discussion:
We used Tc-99 m SC SPECT-CT to estimate the normal functional liver reserve after Y90 radioembolization of a hepatocellular carcinoma (HCC). To our understanding, it is the first case report using Tc-99 m SC to predict the percentage of functional liver reserve after yttrium-90 (Y90) radioembolization.
Conclusion:
Tc-99 m SC SPECT-CT is a novel helper used to assess the differential liver function after Y90 radioembolization of HCC and before segmentectomy and lobectomy of the liver.
A Complicated Case of Serratia marcescens Infective Endocarditis in the Era of the Current Opioid Epidemic
Authors: Ho-Man Yeung, Brijaé Chavarria, Dariush Shahsavari
Journal: Case Rep Infect Dis (2018)
MeSH terms: Case Reports

While bacteremia due to Serratia marcescens is not uncommon, it rarely causes infective endocarditis. We report an isolated case of a 53-year-old male with history of intravenous drug abuse who presented with multiple acute pain symptoms and was found to have S. marcescens bacteremia with septic emboli in his spleen, brain, and testes, secondary to a large aortic vegetation, as well as aortic infective endocarditis with severe aortic regurgitation requiring aortic valve replacement. His course of disease was further complicated by epidural and psoas abscesses and a necrotic testicle requiring orchiectomy due to his ongoing intravenous drug abuse. This case is an atypical presentation of S. marcescens infection, as he had no overt signs of infection such as fever or significant leukocytosis that are typical of bacteremia, and it also highlights the severity and complicated nature of S. marcescens-infective endocarditis.