OpenMed/multicare-articles huggingface dataset:
Case Report: 68Ga-FAPI PET/CT, a more advantageous detection mean of gastric, peritoneal, and ovarian metastases from breast cancer
Authors: Tianyue Li, Xiaojing Jiang, Zhaoqi Zhang, Xiaolin Chen, Jianfang Wang, Xinming Zhao, Jingmian Zhang
Journal: Front Oncol (2022)
Keywords: 18f-fdg, 68ga-fapi, pet/ct, breast cancer, gastric metastasis, ovarian metastasis, peritoneal carcinomatosis
MeSH terms: Case Reports

Breast cancer is the most common malignant tumor in adult women. Its common metastatic sites are lymph nodes, bones, lungs, the liver, and the brain. It is so rare for a patient with breast cancer to have metastases of the gastrointestinal tract, peritoneum, and ovary at the same time that the clinical reporting rate is low. We present a case of a 61-year-old woman who underwent right mastectomy and chemoradiotherapy 3 years ago because of mixed invasive ductal-lobular breast cancer. This time, she came to the hospital due to the symptom of stomach discomfort for 2 weeks. The gastroscopy biopsy result showed gastric metastasis from breast cancer. Then, 18F-FDG imaging and 68Ga-FAPI PET/CT imaging were performed for further diagnosis; 68Ga-FAPI PET/CT demonstrated a significantly elevated FAPI activity in the thickened gastric wall, peritoneum, and bilateral adnexal areas, which was superior to that of 18F-FDG. Finally, a biopsy of suspicious lesions was taken for pathological and histochemical examination, which confirmed that, in addition to the gastric metastasis, the peritoneum and bilateral ovaries were all consistent with metastatic breast cancer.
Case report: Hepatic epithelioid angiomyolipoma with elevated alpha-fetoprotein and a history of breast cancer
Authors: Xiaowei Zhang, Jun Chen, Bifei Huang, Lihong Wang
Journal: Front Surg (2022)
Keywords: alpha-fetoprotein, breast cancer, case report, hepatic epithelioid angiomyolipoma, hepatocellular carcinoma
MeSH terms: Case Reports

Background:
Perivascular epithelioid cell tumors have characteristic histological and immunohistochemical profiles. Epithelioid angiomyolipomas in the liver have particularly rare characteristics. These tumors are relatively small and lack clinical and imaging specificity. Thus, they can be easily misdiagnosed as other primary or metastatic tumors prior to surgery. Due to the significant epithelioid morphology and atypia of hepatic epithelioid angiomyolipoma (HEAML), intraoperative frozen section pathologic diagnosis might be challenging.
Case presentation:
A 33-year-old woman was admitted to our hospital for elevated alpha-fetoprotein (AFP) levels after a regular checkup following breast cancer surgery. Initially, liver cancer was suspected based on enhanced magnetic resonance imaging and color Doppler ultrasonography. Her serum AFP levels were 23.05 ng/ml. The patient underwent laparoscopic right hepatic tumor resection. Based on intraoperative cryopathology, hepatocellular carcinoma was considered a likely diagnosis. However, postoperative pathology confirmed a right HEAML. The patient underwent regular checkups for 23 months without exhibiting recurrence or distant metastasis.
Conclusion:
HEAML can be easily misdiagnosed on preoperative imaging and intraoperative cryopathology. Medical professionals must be aware of this possibility and proceed with caution. Postoperative pathological examination with assessment of IHC markers was helpful in diagnosing HEAML. HEAML has low malignant potential. Surgical resection is the mainstay of treatment, and most patients have a good prognosis.
Evidence that a STAT3 Mutation Causing Hyper IgE Syndrome Leads to Repression of Transcriptional Activity
Authors: Sameer Bahal, Maha E Houssen, Ania Manson, Lorena Lorenzo, Mark A Russell, Noel G Morgan, Fariba Tahami, Sofia Grigoriadou
Journal: Case Reports Immunol (2019)
MeSH terms: Case Reports

We present the case of a 19-year-old female with a mild form of Autosomal Dominant Hyper IgE syndrome (HIES) associated with a loss-of-function mutation in STAT3. Within the first years of life she developed multiple, Staphylococcus aureus associated abscesses in the neck and face requiring frequent incision and drainage. Respiratory tract infections were not a feature of the clinical phenotype and a high resolution thoracic CT scan was unremarkable. Retained dentition was noted but fungal nail disease and recurrent thrush were absent. The total IgE was 970 IU/L, Lymphocyte counts and immunoglobulin levels were normal (IgG borderline 18.5 gr/L). There was suboptimal response to test immunisation with Pneumovax II vaccine. Th17 cell phenotyping revealed low levels of IL-17 expressing cells (0.3% of total CD4 T Cells numbers). Genetic analysis identified a missense mutation, N567D, in a conserved region of the linker domain of STAT3. Functional studies in HEK293 cells reveal that this mutation potently inhibits STAT3 activity when compared to the wildtype protein. This is consistent with other reported mutations in STAT3 associated with HIES. However, surprisingly, the magnitude of inhibition was similar to another STAT3 mutation (V637M) which causes a much more severe form of the disease.
Pediatric stroke presenting as a seizure
Authors: Katie L Ahmadzadeh, Vartika Bhardwaj, Steven A Johnson, Kathleen E Kane
Journal: Case Rep Emerg Med (2014)

Background. Childhood arterial ischemic stroke (AIS) is rare and may be difficult to diagnose. Management of acute stroke in any age group is time sensitive, so awareness of the manifestations and appropriate diagnostic procedures for pediatric AIS is vital to establishing care. We present a pediatric case of arterial ischemic stroke that presented to the emergency department (ED) after two seizures. Case Report. A five-year-old female with an existing seizure disorder presented to a pediatric ED after having two seizures. Postictal upon arrival, she underwent a computed tomography (CT) scan of her head. Family reported that she had complained of a severe headache and vomited; her seizures were described as different from those she had experienced in the past. Loss of grey white matter differentiation on the CT warranted magnetic resonance imaging (MRI), which demonstrated a right-sided stroke. After a complicated course in the hospital, the patient was discharged to a rehabilitation hospital. Why Should an Emergency Physician Be Aware of This? It is important that emergency physicians recognize that a seizure may be the initial symptom of a pediatric stroke regardless of an established seizure history. Pediatric seizures are relatively common; however consideration of the diagnosis of pediatric stroke may prevent unnecessary delays in treatment.
Sustained complete response of hepatocellular carcinoma with portal vein tumor thrombus following discontinuation of sorafenib: A case report
Authors: Kazue Shiozawa, Manabu Watanabe, Takashi Ikehara, Yasushi Matsukiyo, Michio Kogame, Masahiro Kanayama, Teppei Matsui, Yoshinori Kikuchi, Koji Ishii, Yoshinori Igarashi, Yasukiyo Sumino
Journal: Oncol Lett (2014)
Keywords: complete response, hepatocellular carcinoma, portal vein tumor thrombus, sorafenib

Hepatocellular carcinoma (HCC) is the third most common cause of cancer-associated mortality worldwide. No effective treatment has been established for unresectable advanced HCC, and the prognosis is poor. Sorafenib is an oral multi-targeted tyrosine kinase inhibitor for unresectable advanced HCC that significantly improves progression-free and overall survival. However, in the two large phase III clinical trials (the SHARP and Asia-Pacific trials), no cases of complete response (CR) were reported. The present study reports the case of a 68-year-old male with hepatitis C virus-related cirrhosis and multiple recurrent HCCs, with a tumor thrombus of the third portal vein following resection. The patient received 400 mg once daily (half the standard dose) of sorafenib for two years and achieved a CR. At the most recent follow-up examination at one year after the cessation of treatment, the patient was observed to be in remission without clinical or imaging evidence of disease recurrence.
Successful ablation of morphology-changing premature ventricular contractions under the guidance of local voltage potentials: A case report
Authors: Yang Chen, Yuncai Zhu, Peng Zhang, Tao He, Jie Liao
Journal: Front Cardiovasc Med (2023)
Keywords: qrs morphology, ablation, bi-morphology, local voltage potentials, premature ventricular contractions
MeSH terms: Case Reports

Premature ventricular contractions (PVCs) stemming from the aortic sinus cusp often have preferential conduction to two exits in the outflow tract and exhibited two different morphologies of PVCs, which may render radiofrequency catheter ablation (RFCA) difficult. A 67-year-old male patient underwent RACF for premature ventricular contractions (PVCs) characterizing by bi-morphology (left and right bundle branch block) on electrocardiogram. Dynamic changes in QRS morphology during ablation and evident local voltage potentials during electro-anatomical mapping were critical for identifying the real foci of origin of PVCs. Successful ablation was achieved at the left-right coronary cusp commissure.
Eosinophilic gastroenteritis in a young girl--long term remission under Montelukast
Authors: Ivo Quack, Lorenz Sellin, Nikolaus J Buchner, Dirk Theegarten, Lars C Rump, Bernhard F Henning
Journal: BMC Gastroenterol (2005)
MeSH terms: Acetates / therapeutic use, Eosinophilia / drug therapy, Gastroenteritis / drug therapy, Leukotriene Antagonists / therapeutic use, Quinolines / therapeutic use, Case Reports, Adolescent, Cyclopropanes, Female, Humans, Remission Induction, Sulfides, Acetates, Cyclopropanes, Leukotriene Antagonists, Quinolines, Sulfides, montelukast

Background:
Eosinophilic gastrointestinal disorders are an emerging disease entity characterized by eosinophilic infiltration of the intestinal wall. Oral steroids can be still considered as first line treatment. Unfortunately relapses are quite common. Usually long term low-dose prednisone or immunosuppressive therapy is required, which is especially problematic in young patients. Thus a reliable steroid sparing agent with low side effects suitable for long term use is needed. There are strong hints to a similar pathophysiology of eosinophilic gastrointestinal disorders to that of asthma. Indeed leukotriene D4 plays an important role in the recruitment of eosinophils into the intestinal tissue causing damage. This patho-mechanism provides the rationale for the treatment with a leukotriene D4 receptor antagonist. Recently there have been first reports about successful short term use of Montelukast in eosinophilic gastrointestinal disorders.
Case presentation:
We report the case of a 17 year old girl with a long history of severe abdominal complaints leading to several hospitalizations in the past. Mimicking the picture of an intestinal tuberculosis she received an anti mycobacterial treatment without any success. Marked eosinophilia in blood, ascites and tissue samples of the intestinal tract finally lead to the diagnosis eosinophilic gastroenteritis. Tapering off prednisone caused another severe episode of abdominal pain. At that point leukotriene antagonist Montelukast was started at a dose of 10 mg once daily. Steroids could be tapered off completely within six weeks. The patient has been free of symptoms for over two years by now. Routine examinations, blood tests and endoscopy have rendered regular results. So far no side effects were noted.
Conclusion:
Here report about successful long term remission of eosinophilic gastroenteritis under Montelukast. Further randomized control trials are required to asses the full benefits of Montelukast therapy in the whole spectrum of eosinophilic gastrointestinal disorders.
Wernicke's Encephalopathy Mimicking Acute Onset Stroke Diagnosed by CT Perfusion
Authors: Alok Bhan, Rajiv Advani, Kathinka D Kurz, Elisabeth Farbu, Martin W Kurz
Journal: Case Rep Neurol Med (2014)

Background. Metabolic syndromes such as Wernicke's encephalopathy may present with a sudden neurological deficit, thus mimicking acute onset stroke. Due to current emphasis on rapid admission and treatment of acute stroke patients, there is a significant risk that these stroke mimics may end up being treated with thrombolysis. Rigorous clinical and radiological skills are necessary to correctly identify such metabolic stroke mimics, in order to avoid doing any harm to these patients due to the unnecessary use of thrombolysis. Patient. A 51-year-old Caucasian male was admitted to our hospital with suspicion of an acute stroke due to sudden onset dysarthria and unilateral facial nerve paresis. Clinical examination revealed confusion and dysconjugate gaze. Computed tomography (CT) including a CT perfusion (CTP) scan revealed bilateral thalamic hyperperfusion. The use of both clinical and radiological findings led to correctly diagnosing Wernicke's encephalopathy. Conclusion. The application of CTP as a standard diagnostic tool in acute stroke patients can improve the detection of stroke mimics caused by metabolic syndromes as shown in our case report.
A Case of Pancreatic Schwannoma Diagnosed Preoperatively by Endoscopic Ultrasonography-Guided Fine Needle Aspiration and Treated with Laparoscopic Surgery
Authors: Kazuao Hayashi, Atsunori Tsuchiya, Satoshi Ikarashi, Kazuyasu Takizawa, Shuji Terai
Journal: J Pancreat Cancer (2018)
Keywords: s-100, laparoscopic surgery, calcification, endoscopic ultrasonography-guided fine needle aspiration, schwannoma
MeSH terms: Case Reports

Background: Pancreatic tumors are often difficult to diagnose in atypical cases, and a pancreatic schwannoma is very rare. We present a case of pancreatic schwannoma with calcification diagnosed preoperatively by endoscopic ultrasonography (EUS)-guided fine needle aspiration (FNA) and treated with laparoscopic distal pancreatectomy. Presentation: A 72-year-old-woman was admitted to our hospital due to a 6 × 4.5 cm large tumor in the pancreatic tail. Imaging modalities revealed that the tumor was hypovascular and gradually enhanced with calcification, but was without cystic lesions. EUS revealed the tumor had a clear boundary with a low echoic mass. EUS-FNA was performed and spindle-shaped cells that were immunopositive for S-100 and negative for c-kit, CD34, and desmin were detected, resulting in a diagnosis of schwannoma. Laparoscopic distal pancreatectomy with splenectomy was safely performed without recurrence for a year. Conclusions: Schwannoma is very rare; however, characteristics of the tumor, such as calcification, can help the diagnosis and, if possible, EUS-FNA should be performed for an appropriate treatment decision.
Solid Right Ventricular Compression by Intraventricular Septum-Hematoma Induced after Percutaneous Coronary Intervention
Authors: Ibrahim El-Battrawy, Ibrahim Akin, Benedikt Münz, David Manuel Leistner, Michael Behnes, Thomas Henzler, Holger Haubenreisser, Theano Papavassiliu, Martin Borggrefe, Ralf Lehmann
Journal: Case Rep Cardiol (2016)

Intraventricular septum-hematoma is a rare complication following percutaneous coronary intervention (PCI). This complication may represent a challenge for accurate diagnosis and treatment. This case report is about a 60-year-old male patient being admitted with an acute coronary syndrome. Despite successful PCI with drug eluting stent implantation into the right coronary artery (RCA) the patient complained about recurrent angina pectoris according to Canadian Cardiovascular Society (CCS) class IV. Cardiac magnetic resonance imaging and transthoracic echocardiography revealed a massive 4.9 × 9.2 cm sized end-diastolic septum-hematoma, which compromised right ventricular cavity. Emergent recoronary angiography ruled out further contrast extravasation from the RCA. Conservative treatment was intended after discussion in the "heart-team." The patient completely recovered with nearly complete resolution of the hematoma after 6 months.
Surgical treatment of a distal radius and ipsilateral metacarpal hemophilic pseudotumor without recurrence or functional deficit: a case report
Authors: Yingjie Wang, Zehui Lv, Xiying Dong, Bin Feng, Xisheng Weng
Journal: Front Pediatr (2023)
Keywords: complete recovery, continuous follow-up, curettage and bone grafting, hemophilia a, intraosseous hemophilic pseudotumor
MeSH terms: Case Reports

Background:
Distal hemophilic pseudotumor (HP) occurring distal to the wrist appear to be secondary to intraosseous hemorrhage, which develops rapidly and should be treated primarily with long-term replacement therapy and cast immobilization. Surgical removal or even amputation is indicated when conservative management fails to prevent progression. Here, a practical strategy was described for those patients who cannot afford the cost of routine coagulation factor replacement therapy, namely immediate surgical curettage and bone grafting as well as continuous follow-up.
Case description:
A 7-year-old boy with a history of mild hemophilia A was admitted to our medical center because of a 2-year history of progressive swelling and pain around right forearm and hand. Coagulation factor VIII level was 11.1% of normal with no inhibitor. Radiographs revealed expansile swelling, bone destruction, and deformity of the distal right radius and the second metacarpal bone. He was diagnosed with distal HP. Surgical procedure of curettage and bone grafting was performed. The function and appearance of the right wrist were almost normal without discomfort at the 101-month follow-up. Significantly, the same patient was hospitalized again because of a year-long progressive swelling and pain around the left hand when he was 14 years old. X-ray showed multiple bone destruction of the left proximal phalanges of left thumb, middle finger and little finger with local pathological fractures. Surgical procedure of HPs including curettage and bone grafting was performed. Postoperative recovery was good, and the last clinical follow-up at 18 months after the operation displayed a satisfactory shape and functional outcomes.
Conclusions:
Curettage and bone grafting prove to be safe and feasible for patients with distal HP and continuous follow-up of patients with distal HP is very vital for timely finding and then treating successive HP in developing countries.
Placenta percreta causing spontaneous uterine rupture and intrauterine fetal death in an unscared uterus: A case report
Authors: J T Enebe, I J Ofor, I I Okafor
Journal: Int J Surg Case Rep (2019)
Keywords: case report, intrauterine fetal death, maternal morbidity, plcacenta percreta, uterine rupture

Introduction:
Placenta percreta is a rare; a life-threatening disorder of placentation and one of the components of the placenta accreta spectrum. It can lead to uterine rupture, an obstetric catastrophe that can be associated with increased maternal and fetal morbidity and mortality.
Presentation of case:
We present an unusual case of spontaneous uterine rupture due to placenta percreta in an unscarred uterus of a multiparous woman leading to spontaneous intrauterine fetal death. She presented with hypovolaemic shock following spontaneous rupture of the uterus and subsequent intra-peritoneal bleeding.
Discussion:
Uterine rupture occurs commonly in a scarred uterus from some form of trauma or injudicious use of oxytocics. However, uterine rupture occurring in the absence of prior scar or use of oxytocics is a rarity. Placenta percreta is an unusual cause of uterine rupture and subsequent intra-uterine fetal death. Placenta percreta occurs when the uterine wall is invaded by the placenta up to the level of the serosa. A high index of suspicion and thorough review of the patient is required for making this diagnosis. Misdiagnosis is associated with dare consequences of increased maternal morbidity and mortality.
Conclusion:
Placenta percreta is a rare disorder of placentation that can cause uterine rupture which can easily be misdiagnosed. Prompt diagnosis and institution of the appropriate care can help prevent catastrophic outcomes as demonstrated in the case reported.
Assembly-style making: How structured making serves as an on-ramp to creativity and engineering design
Authors: Sarah Lukowski, Megan Goeke, Bette Schmit, Marjorie Bequette
Journal: Front Psychol (2023)
Keywords: creativity, early engineering, family learning, informal learning, makerspace

Makerspaces, workspaces where families can explore materials and tools collaboratively, can provide an opportunity for creative expression and early engineering learning in community spaces. The present study examined a cardboard-focused museum makerspace that included an assembly-style activity. Assembly-style making uses instructions to support makers. Such activities have been critiqued as limiting creativity and engineering thinking. However, makers who are less comfortable in makerspaces may benefit from assembly-style activities helping to scaffold their entry into the space. We explored these criticisms and potential benefits of assembly-style making through developing case studies of video data taken by families in a makerspace. Visitors made creative and personally meaningful creations when engaged in assembly style making. Moreover, assembly-style making mediated a family less comfortable with making to get started in the space alongside ample evidence of families following engineering design processes. Contrary to popular belief, assembly-style making offers an important support to novice makers, without eliminating creativity and engineering design processes, and should be considered in the mix of activities available in makerspaces to support makers of all levels of comfort in making.
Management of Postoperative Myocardial Injury After Non-cardiac Surgery in Patients Aged ≥ 80 Years: Our 10 Years' Experience
Authors: Linggen Gao, Lei Chen, Bin Wang, Jing He, Chaoyang Liu, Rong Wang, Rui Cheng
Journal: Front Cardiovasc Med (2022)
Keywords: comanagement care model, management strategy, non-cardiac surgery, postoperative myocardial injury, prognosis

Background:
Postoperative myocardial injury (PMI) is associated with short- and long-term mortality. The incidence of PMI in very old patients is currently unknown. There is currently neither known effective prophylaxis nor a uniform strategy for the elderly with PMI.
Objective:
To share our 10 years of experience in the comprehensive management of PMI after non-cardiac surgery in patients aged ≥ 80 years.
Methods:
In this case series, we retrospectively collected and assessed the 2,984 cases aged ≥ 80 years who accepted non-cardiac surgery from 2011 to 2021 at the second Medical Center, Chinese PLA General Hospital. The incidence, risk factors, management strategy, and prognosis of surgical patients with PMI were analyzed.
Results:
A total of 2,984 patients met our inclusion criteria. The overall incidence of PMI was 14%. In multivariable analysis, coronary artery disease, chronic heart failure, and hypotension were independently associated with the development of PMI. The patients with PMI were at a higher risk of death (OR, 2.69; 95% CI, 1.78-3.65). They were more likely to have received low molecular heparin, anti-plantlet therapy, beta-blocker, early coronary angiography, and statin than patients without PMI. The 30-day (0.96% vs. 0.35%; OR 3.46; 95% CI, 1.49-7.98; P < 0.001) and 1-year mortality (5.37% vs. 2.60%; OR 2.35; 95% CI, 1.12-6.53; P < 0.001) was significantly higher in patients with PMI compared with those without PMI.
Conclusions:
The incidence of PMI in very old patients was high. The PMI is associated with an increased risk of 30 days and 1-year mortality. These patients can benefit from intensification of assessment and individualized care of multi-morbidities during the perioperative period. Especially cardiovascular medical treatments, such as antiplatelet, anticoagulation, β-blockers, and statins are very important for patients with PMI.