OpenMed/multicare-articles huggingface dataset:
Preoperative evaluation of the efficacy of radio-hyperthermo-chemotherapy for soft tissue sarcoma in a case series
Authors: Hisaki Aiba, Satoshi Yamada, Jun Mizutani, Norio Yamamoto, Hideki Okamoto, Katsuhiro Hayashi, Hiroaki Kimura, Akihiko Takeuchi, Shinji Miwa, Takashi Higuchi, Kensaku Abe, Yuta Taniguchi, Yoshihiro Araki, Hiroyuki Tsuchiya, Takanobu Otsuka
Journal: PLoS One (2018)
MeSH terms: Hyperthermia, Induced, Preoperative Period, Sarcoma / drug therapy, Sarcoma / radiotherapy, Adult, Combined Modality Therapy, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Sarcoma / diagnostic imaging, Sarcoma / surgery, Tomography, X-Ray Computed, Treatment Outcome

Purpose:
Radio-hyperthermo-chemo (RHC) therapy, which combines radiotherapy, hyperthermia, and chemotherapy, for malignant soft tissue tumors has been introduced with the aim of decreasing the possibility of local recurrence after surgery. To avoid unnecessary neoadjuvant therapy and to plan the appropriate surgical treatment, surveillance of RHC therapeutic efficacy during treatment is necessary. In this study, we determined the optimal response criteria to evaluate the efficacy of RHC by comparing preoperative images before and after RHC with pathological evaluation of necrosis in the resected tumor.
Patients and methods:
From 2004 to 2014, 20 patients were enrolled into this study. Needle biopsy revealed 6 cases of myxoid liposarcoma, 6 cases of undifferentiated pleomorphic sarcoma, 4 cases of myxofibrosarcoma, and 4 cases of synovial sarcoma. Based on the Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 or modified RECIST, we calculated the responses to RHC therapy by comparing pre- and post-RHC therapy images. In addition, resected specimens underwent pathological analysis to evaluate response based on tumor necrosis. The correlation between assessment based on preoperative images and resected tumors were evaluated by the Spearman's rank-order correlation coefficient.
Result:
From the surgical specimens, pathological assessment of necrosis in resected tumor were assessed as less than 50% (2 cases), 50-90% (9 cases), 90-99% (6 cases), and total necrosis (3 cases). Use of the RECIST 1.1 underestimated good responders as stable disease (SD) or progressive disease (PD) in 5 out of 15 cases; on the other hand, use of the modified RECIST did not underestimate the pathological assessment of necrosis. The correlations between responses based on preoperative images and those based on histological assessments were 0.23 (RECIST 1.1) and 0.76 (modified RECIST).
Conclusion:
Because pathological responses can be underestimated using the RECIST 1.1, the modified RECIST, which take into consideration tumor viability, as assessed by contrast MRI, should also be considered when evaluating the efficacy of RHC.
Giant duodenal lipoma: an unusual cause of gastrointestinal bleeding (a case report)
Authors: Marouane Baiss, Anwar Rahali, Hicham Elmajdoubi, Jalil Mdaghri, Khalid Lahlou, Rahal Mssrouri, Said Benamr, Abdellatif Settaf
Journal: Pan Afr Med J (2021)
Keywords: lipoma, case report, duodenum, endoscopy, melena
MeSH terms: Duodenal Neoplasms / diagnosis, Gastrointestinal Hemorrhage / etiology, Lipoma / diagnosis, Case Reports, Duodenal Neoplasms / complications, Duodenal Neoplasms / pathology, Humans, Lipoma / complications, Lipoma / pathology, Male, Middle Aged

Duodenal lipoma is a rare location of visceral lipomas, most are found incidentally via endoscopy or surgery and usually are asymptomatic. We report the case of a 58-year-old patient with an active bleeding duodenal lipoma. Although endoscopic treatment was scheduled initially, surgical intervention ultimately was indicated due to large size of tumor.
Case Report: Interferon-γ Restores Monocytic Human Leukocyte Antigen Receptor (mHLA-DR) in Severe COVID-19 With Acquired Immunosuppression Syndrome
Authors: Steffen Dickel, Clemens Grimm, Katharina Amschler, Sebastian Uwe Schnitzler, Julie Schanz, Onnen Moerer, Didier Payen, Bjoern Tampe, Martin Sebastian Winkler
Journal: Front Immunol (2021)
Keywords: covid-19, sars-cov-2, acquired immunosuppression syndrome, acute respiratory distress syndrome, case report, intensive care, interferon-y, monocytic human leukocyte antigen receptor
MeSH terms: Acquired Immunodeficiency Syndrome / drug therapy, Acquired Immunodeficiency Syndrome / immunology, Acquired Immunodeficiency Syndrome / pathology, COVID-19 Drug Treatment, COVID-19 / immunology, COVID-19 / pathology, HLA-DR Antigens / immunology, Interferon-gamma / administration & dosage, Monocytes / immunology, SARS-CoV-2 / immunology, Severity of Illness Index, Case Reports, Research Support, Non-U.S. Gov't, Humans, Male, Middle Aged, Monocytes / pathology, HLA-DR Antigens, IFNG protein, human, Interferon-gamma

Background:
The major histocompatibility complex (MHC) class II characterized by monocytes CD14+ expression of human leukocyte antigen receptors (HLA-DR), is essential for the synapse between innate and adaptive immune response in infectious disease. Its reduced expression is associated with a high risk of secondary infections in septic patients and can be safely corrected by Interferon-y (IFNy) injection. Coronavirus disease (COVID-19) induces an alteration of Interferon (IFN) genes expression potentially responsible for the observed low HLA-DR expression in circulating monocytes (mHLA-DR).
Methods:
We report a case of one-time INFy injection (100 mcg s.c.) in a superinfected 61-year-old man with COVID-19-associated acute respiratory distress syndrome (ARDS), with monitoring of mHLA-DR expression and clinical tolerance.
Observations:
Low mHLA-DR pretreatment expression (26.7%) was observed. IFNy therapy leading to a rapid increase in mHLA-DR expression (83.1%).
Conclusions:
Severe ARDS in a COVID-19 patient has a deep reduction in mHLA-DR expression concomitantly with secondary infections. The unique IFNy injection was safe and led to a sharp increase in the expression of mHLA-DR. Based on immune and infection monitoring, more cases of severe COVID-19 patients with low mHLA-DR should be treated by IFNy to test the clinical effectiveness.
A case report of neuronal intranuclear inclusion disease with paroxysmal peripheral neuropathy-like onset lacking typical signs on diffusion-weighted imaging
Authors: Jiayu Fu, Chen Zhao, Guanghao Hou, Xiaoxuan Liu, Mei Zheng, Yingshuang Zhang, Shuo Zhang, Danfeng Zheng, Yixuan Zhang, Xiao Huang, Shan Ye, Dongsheng Fan
Journal: Front Neurol (2023)
Keywords: notch2nlc gene, neurodegenerative disease, neuronal intranuclear inclusion disease, peripheral neuropathy, skin biopsy
MeSH terms: Case Reports

Background:
Neuronal intranuclear inclusion disease (NIID) is a slowly progressive neurodegenerative disease characterized by eosinophilic hyaline intranuclear inclusions and the GGC repeats in the 5'-untranslated region of NOTCH2NLC. The prevalent presence of high-intensity signal along the corticomedullary junction on diffusion-weighted imaging (DWI) helps to recognize this heterogeneous disease despite of highly variable clinical manifestations. However, patients without the typical sign on DWI are often misdiagnosed. Besides, there are no reports of NIID patients presenting with paroxysmal peripheral neuropathy-like onset to date.
Case presentation:
We present a patient with NIID who suffered recurrent transient numbness in arms for 17 months. Magnetic resonance imaging (MRI) showed diffuse, bilateral white matter lesions without typical subcortical DWI signals. Electrophysiological studies revealed mixed demyelinating and axonal sensorimotor polyneuropathies involving four extremities. After excluding differential diagnosis of peripheral neuropathy through body fluid tests and a sural nerve biopsy, NIID was confirmed by a skin biopsy and the genetic analysis of NOTCH2NLC.
Conclusion:
This case innovatively demonstrates that NIID could manifest as paroxysmal peripheral neuropathy-like onset, and addresses the electrophysiological characteristics of NIID in depth. We broaden the clinical spectrum of NIID and provide new insights into its differential diagnosis from the perspective of peripheral neuropathy.
Case Report: Early Recognition, Treatment, and Occupational Safety Protection are Crucial for Methanol Toxicity
Authors: Xiaomei Wu, Meifeng Gu, Wei Wang, Hainan Zhang, Zhenchu Tang
Journal: Front Med (Lausanne) (2022)
Keywords: fireworks factory, methanol poisoning, occupational exposure, prevention, sequela
MeSH terms: Case Reports

Background:
Despite significant progress in treating methanol poisoning, the lack of training, hazard communication, and occupational safety protection education contributes to the risk of occupational exposure and methanol toxicity. In addition, early diagnosis and timely medical care are essential to reduce the risk of morbidity and mortality, yet it remains a challenging procedure.
Case report:
A 35-year-old man working in a fireworks factory came to our emergency department with acute mental change and progressive disturbance of consciousness. The patient's vital signs were stable, and he presented with enlargement of both pupils with a weak reaction to light. Head computed tomography showed low signal intensities in the bilateral basal ganglia. He was admitted to the neurologic intensive care unit, where additional laboratory workup showed high anion-gap metabolic acidosis. Methanol poisoning was thus considered. Before being treated with sodium bicarbonate infusion, hemodialysis, folate, and high-dose vitamin B, the blood and urine samples were collected for toxicity tests, which turned out to be methanol poisoning. After 8 hours of hemodialysis, the patient's consciousness recovered, but he complained of a complete loss of vision in both eyes. Brain and optic nerve magnetic resonance images showed bilateral symmetric putamen lesions and optic neuropathy. Ophthalmic tests indicated visual pathway impairment and optic disc swelling but no fluorescein leakage. The right eye's vision was partially restored on the third day, but he could only count fingers at 20 cm. Unfortunately, his eyesight ceased to improve during the 6 months of follow-up.
Conclusions:
Early diagnosis and prompt treatment will improve the prognosis of methanol poisoning in terms of vision and patient survival. Awareness and supervision of commercial alcohol use are indispensable for similar industrial processes.
Use of selected samples to diagnose a tricky feline viral disease in a cat with uveitis and neurological signs
Authors: Julio Cesar Neves de Almeida, Heloísa Cristina Teixeira de Carvalho, Lana Isabella Gila, Nathana Beatriz Martins, Matias Pablo Juan Szabó, Aline Santana da Hora
Journal: Braz J Vet Med (2023)
Keywords: feline immunodeficiency virus, feline infectious peritonitis virus, feline leukemia virus, molecular diagnosis
MeSH terms: Case Reports

This case involved a 2-year-old neutered male domestic mixed-breed cat that was rescued from the street eight months earlier. The animal presented with weakness, hyporexia, progressive weight loss, fatigue, uveitis, pale mucous membranes, dehydration (7%), and pelvic limb paresis. Aqueous humor was collected for molecular analysis for the differential diagnosis of potential etiological agents [Feline coronavirus (FCoV), Feline leukemia virus (FeLV), Feline immunodeficiency virus (FIV), Toxoplasma gondii, Cryptococcus spp., Felid herpesvirus-1 (FHV-1) and Bartonella spp.] of feline uveitis. The sample was positive by real-time reverse transcription-polymerase chain reaction (RT-qPCR) for FCoV and RT-qPCR and real-time polymerase chain reaction (qPCR) for FeLV and qPCR FIV. The cat was euthanized due to poor clinical outcomes and prognosis. A cerebrospinal fluid (CSF) sample was collected and tested, and the same pathogens were found in the aqueous humor. Small-cell follicular multicenter lymphoma and multifocal pyogranulomatous meningoencephalitis were observed upon histopathological analysis. In this study, aqueous humor and cerebrospinal fluid samples were efficient for the detection of coinfection with FIV, FeLV, and FCoV.
Atypical Neuroleptic Malignant Syndrome Associated with Use of Clozapine
Authors: Quevedo-Florez Leonardo, Granada-Romero Juliana, Camargo-Arenas Juan Fernando
Journal: Case Rep Emerg Med (2017)
MeSH terms: Case Reports

The Neuroleptic Malignant Syndrome (NMS) is a medical emergency of infrequent presentation in the emergency department, which is associated with the use of psychiatric drugs, such as typical and atypical antipsychotics. Our case addresses a 55-year-old patient diagnosed with undifferentiated schizophrenia for 10 years, who had been receiving clozapine and clonazepam as part of their treatment. This patient presents the symptoms of Neuroleptic Malignant Syndrome without fever, which improves with treatment especially with the withdrawal of clozapine. In the absence of fever and clinical improvement, the patient is considered to have an atypical presentation of this disease.
Congenital Variants of Gastrointestinal Rotation Found at Resection of Hepatopancreatobiliary Tumors: A Case Series with Review of the Literature
Authors: David W Rittenhouse, Michael J Pucci, Jennifer L Brumbaugh, Charles J Yeo, Harish Lavu
Journal: Case Rep Pancreat Cancer (2016)
Keywords: cholangiocarcinoma, gastrointestinal malrotation, pancreatic ductal adenocarcinoma
MeSH terms: Case Reports

Background: Gastrointestinal malrotation arises from intrauterine events that occur early in the first trimester of gestation, and can result in a midgut volvulus that classically presents in the neonatal period with bilious emesis. Gastrointestinal malrotation can present clinically with symptoms such as chronic abdominal pain or bowel obstruction, or remain completely asymptomatic only to be discovered as an incidental finding much later in life during surgical exploration for other diseases. We sought to identify the prevalence of gastrointestinal malrotation in patients undergoing surgical exploration for hepatopancreatobiliary (HPB) malignancy and describe the operative considerations of these cases. Case Presentation: We performed a retrospective review of our prospectively acquired HPB surgery database from January 1, 2006, to December 1, 2013. We identified three cases of gastrointestinal malrotation out of a total of 1220 HPB cases reviewed, which represents 0.2%. We found two cases of gastrointestinal malrotation in the setting of pancreatic ductal adenocarcinoma and one case in the setting of cholangiocarcinoma. All three patients underwent exploratory laparotomy with resection of their respective primary tumors. We searched the English literature for cases of HPB malignancy in the setting of gastrointestinal malrotation. Conclusion: Our case series and review of the literature underscore the rarity and complexity of these cases.
Rapid clinical improvement of atopic dermatitis in an Omalizumab treated patient
Authors: Susanna Bormioli, Andrea Matucci, Laura Dies, Francesca Nencini, Francesca Grosso, Enrico Maggi, Alessandra Vultaggio
Journal: Clin Mol Allergy (2019)
Keywords: anti-ige, atopic dermatitis, omalizumab, quality of life
MeSH terms: Case Reports

Background:
Atopic dermatitis is a chronic inflammatory skin disorder, whose symptoms and severity grossly depend on individual trigger factors. The majority of patients are satisfactorily treated with emollients together with topical and systemic therapies. However, treatment failure or long-term side effects with conventional treatment options can be a significant clinical problem. Recently, novel therapeutic approaches focus on targeting skewed immune responses providing a more effective, and less harmful approach. Among them, variable success has been reported using Omalizumab, when used in combination with classic therapies. This report describes an interesting case of severe adult onset difficult-to-treat atopic dermatitis dramatically improved in response to treatment with Omalizumab.
Case presentation:
We present a case of an adult male with severe allergic atopic dermatitis, with concomitant involvement of the face, neckline, trunk and forearms and systemic symptoms such as diarrhoea with important decrease of his daily quality of life. The patient had been prescribed oral steroids in addition to anti-histamines to no avail. Due to lack of response to classic therapies, strict diet, as well as to treatment with intravenous corticosteroids, an off-label treatment with Omalizumab based on patient weight and total IgE value was proposed. Clear clinical results were observed after only a few weeks with regards to systemic symptoms, and just after 2 months of treatment in regards to skin involvement.
Conclusions:
In the majority of treated patients the clinical improvement of cutaneous manifestations is expected after several months of treatment, as skin manifestations are the consequence of a chronic inflammatory process. The outstanding rapid response observed in this case as well as the persistence of the clinical remission suggests that the block of the IgE pathways modulate functions of cells involved in the pathogenic mechanisms of chronic skin inflammation but also in the acute phases observed in the flare-ups of the disease.
Variation of Finger Activation Patterns Post-stroke Through Non-invasive Nerve Stimulation
Authors: Henry Shin, Yang Zheng, Xiaogang Hu
Journal: Front Neurol (2018)
Keywords: electromyography, finger flexion, neuromuscular electrical stimulation, proximal nerve stimulation, stroke
MeSH terms: Case Reports

Purpose: A transcutaneous proximal nerve stimulation technique utilizing an electrode grid along the nerve bundles has previously shown flexible activation of multiple fingers. This case study aimed to further demonstrate the ability of this novel stimulation technique to induce various finger grasp patterns in a stroke survivor. Methods: An individual with chronic hemiplegia and severe hand impairment was recruited. Electrical stimulation was delivered to different pairs of an electrode grid along the ulnar and median nerves to selectively activate different finger flexor muscles, with an automated electrode switching method. The resultant individual isometric flexion forces and forearm flexor high-density electromyography (HDEMG) were acquired to evaluate the finger activation patterns. A medium and low level of overall activation were chosen to gauge the available finger patterns for both the contralateral and paretic hands. All the flexion forces were then clustered to categorize the different types of grasp patterns. Results: Both the contralateral and paretic sides demonstrated various force clusters including single and multi-finger activation patterns. The contralateral hand showed finger activation patterns mainly centered on median nerve activation of the index, middle, and ring fingers. The paretic hand exhibited fewer total activation patterns, but still showed activation of all four fingers in some combination. Conclusion: Our results show that electrical stimulation at multiple positions along the proximal nerve bundles can elicit a select variety of finger activation patterns even in a stroke survivor with minimal hand function. This system could be further implemented for better rehabilitative training to help induce functional grasp patterns or to help regain muscle mass.
Simultaneous deletion of 3'ETV6 and 5'EWSR1 genes in blastic plasmacytoid dendritic cell neoplasm: case report and literature review
Authors: Zhenya Tang, Guilin Tang, Sa A Wang, Xinyan Lu, Ken H Young, Carlos E Bueso-Ramos, Yesid Alvarado, L Jeffrey Medeiros, Joseph D Khoury
Journal: Mol Cytogenet (2016)
Keywords: 12p-, blastic plasmacytoid dendritic cell neoplasm (bpdcn), cnkn1b, chromosomal abnormality, etv6, ewsr1, karyotype
MeSH terms: Case Reports

Background:
Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare hematologic malignancy. Based on literature reports of limited cases, over 50 % of BPDCN have chromosomal abnormalities, but no single chromosomal change has been identified as diagnostic of this entity.
Case presentation:
In this report, we present a case of BPDCN with complicated chromosomal abnormalities involving chromosomes 12 and 22 and resulting in a simultaneous partial deletion of ETV6 and EWSR1. Notably, these aberrations were identified in bone marrow myeloid precursors in the absence of bone marrow involvement by BPDCN.
Conclusion:
Analysis of 46 BPDCN cases with abnormal karyotypes (45 from literature reports plus this case) showed that 12p- is one of the most common structural aberrations in BPDCN. The ETV6 and CDKN1B on 12p deserve further investigations as potential markers of BPDCN.
Emerging Clinical Features of COVID-19 Related Pancreatitis: Case Reports and Review of the Literature
Authors: Vito Fiore, Rosalba Beretta, Andrea De Vito, Aleksandra Barac, Ivana Maida, David David Joeseph Kelvin, Claudia Piu, Vincenzo Lai, Giordano Madeddu, Salvatore Rubino, Goran Stevanovic, Stefan Korica, Sergio Babudieri
Journal: Front Med (Lausanne) (2022)
Keywords: covid-19, sars-cov-2, acute, angiotensin-converting enzyme, severe pancreatitis
MeSH terms: Case Reports

Introduction:
SARS-CoV-2 is fundamentally a respiratory pathogen with a wide spectrum of symptoms. The COVID-19 related pancreatitis is less considered than other clinical features. The purpose is to describe two cases of pancreatitis associated with COVID-19.
Methodology:
Patients' demographics, clinical features, laboratory, and instrumental findings were collected.
Results:
Two patients admitted to the hospital were diagnosed with COVID-19 and severe acute pancreatitis, according to the Atlanta criteria. Other causes of acute pancreatitis were excluded. Treatment included broad-spectrum antibiotics, proton pump inhibitors, and low molecular weight heparin. Steroids, oxygen, antifungal treatment, and pain killers were administered when appropriate. Both patients were asymptomatic, with normal vital parameters and blood exams, and were discharged in a good condition.
Conclusion:
It is recommendable to include lipase and amylase on laboratory routine tests in order to evaluate the need for the abdominal CT-scan and specific therapy before hospital admission of the patients with COVID-19 related life-threatening acute pancreatitis.
Management of Extramammary Paget's Disease: A Case Report and Review of the Literature
Authors: Rosa Guerra, Subhasis Misra
Journal: Case Rep Dermatol Med (2013)

Extramammary Paget's Disease (EMPD) is a rare condition of the skin that often involves the vulva, perianal region, scrotum, penis, and axilla. Although prognosis is generally favorable, it can be associated with neoplasms of the bladder, urethra, prostate, and rectum. This report presents a case of scrotal EMPD that failed treatment with imiquimod 5% cream and discusses benefits and complications of available treatment options. The variation of treatment success emphasizes the importance of further research.