OpenMed/multicare-articles huggingface dataset:
Case report: An N-of-1 study using amplitude modulated transcranial alternating current stimulation between Broca's area and the right homotopic area to improve post-stroke aphasia with increased inter-regional synchrony
Authors: Erika Omae, Atsushi Shima, Kazuki Tanaka, Masako Yamada, Yedi Cao, Tomoyuki Nakamura, Hajime Hoshiai, Yumi Chiba, Hiroshi Irisawa, Takashi Mizushima, Tatsuya Mima, Satoko Koganemaru
Journal: Front Hum Neurosci (2024)
Keywords: amplitude modulation, aphasia, coherence, stroke, transcranial alternating current stimulation
MeSH terms: Case Reports

Over one-third of stroke survivors develop aphasia, and language dysfunction persists for the remainder of their lives. Brain language network changes in patients with aphasia. Recently, it has been reported that phase synchrony within a low beta-band (14-19 Hz) frequency between Broca's area and the homotopic region of the right hemisphere is positively correlated with language function in patients with subacute post-stroke aphasia, suggesting that synchrony is important for language recovery. Here, we employed amplitude-modulated transcranial alternating current stimulation (AM-tACS) to enhance synchrony within the low beta band frequency between Broca's area and the right homotopic area, and to improve language function in a case of chronic post-stroke aphasia. According to an N-of-1 study design, the patient underwent short-term intervention with a one-time intervention of 15 Hz-AM-tACS with Broca's and the right homotopic areas (real condition), sham stimulation (sham condition), and 15 Hz-AM-tACS with Broca's and the left parietal areas (control condition) and long-term intervention with sham and real conditions (10 sessions in total, each). In the short-term intervention, the reaction time and accuracy rate of the naming task improved after real condition, not after sham and control conditions. The synchrony between the stimulated areas evaluated by coherence largely increased after the real condition. In the long-term intervention, naming ability, verbal fluency and overall language function improved, with the increase in the synchrony, and those improvements were sustained for more than a month after real condition. This suggests that AM-tACS on Broca's area and the right homotopic areas may be a promising therapeutic approach for patients with poststroke aphasia.
Retroperitoneal bronchogenic cyst mimicking an adrenal cyst: case report
Authors: Hajra Idrees, Raza Zarrar, Ceylan A Taslicay, Khaled M Elsayes
Journal: BJR Case Rep (2023)
Keywords: computed tomography, bronchogenic cyst, magnetic resonance imaging, retroperitoneum
MeSH terms: Case Reports

Bronchogenic cysts are rare lesions that form during early embryogenesis and are commonly located in the mediastinum. Retroperitoneal bronchogenic cysts (RBs) are exceptionally rare, with only a handful of cases reported in the modern literature. Here, we report an RB found incidentally on imaging in a patient with suspected nephrolithiasis. We also review the unique imaging and histopathological findings of this entity and discuss why prophylactic surgery is considered the treatment of choice.
Case report: complete long-lasting response to multimodal third line treatment with neurosurgical resection, carmustine wafer implantation and dabrafenib plus trametinib in a BRAFV600E mutated high-grade glioma
Authors: Barbara Castelli, Marco Tellini, Melina Guidi, Marco Di Nicola, Laura Giunti, Anna Maria Buccoliero, Maria Luigia Censullo, Alessandro Iacono, Isacco Desideri, Lorenzo Genitori, Iacopo Sardi, Carla Fonte
Journal: Front Oncol (2024)
Keywords: braf inhibitors, brafv600e, mek inhibitors, dabrafenib, high-grade glioma, pleomorphic xanthoastrocytoma, target therapy, trametinib
MeSH terms: Case Reports

Dabrafenib plus trametinib is a promising new therapy for patients affected by BRAFV600E-mutant glioma, with high overall response and manageable toxicity. We described a complete and long-lasting response in a case of recurrent anaplastic pleomorphic xanthoastrocytoma CNS WHO-grade 3 BRAFV600E mutated. Due to very poor prognosis, there are a few described cases of high-grade glioma (HGG) patients treated with the combined target therapy as third-line treatment. The emergence of optimized sequencing strategies and targeted agents, including multimodal and systemic therapy with dabrafenib plus trametinib, will continue to broaden personalized therapy in HGG improving patient outcomes.
Successful Retrieval of 35 Razors From the Stomach via Upper Gastrointestinal (GI) Endoscopy: A Case Report
Authors: Mostafa Shehata, Hosameldin Abdelrahman Dafalla, Yashbir Singh
Journal: Cureus (2024)
Keywords: endoscopy, overture, pica syndrome, sharp foreign body ingestion, upper gi
MeSH terms: Case Reports

Adult ingestion of foreign bodies in the digestive system is a common clinical challenge, often involving mentally impaired individuals, criminals, and drug dealers or occurring accidentally. Encounters with multiple sharp foreign bodies are infrequent and pose significant risks, including gastrointestinal (GI) bleeding, perforation, internal fistulas, and infection. The choice between endoscopy and emergency surgery for removal is contentious, with the less invasive endoscopy typically favored as the first line of management, depending on the foreign body's location and endoscopic accessibility. The current literature on the treatment of numerous sharp foreign bodies is sparse. This case report illustrates the successful endoscopic removal of a large quantity of sharp foreign bodies (35 half blades) from the upper GI tract, utilizing various extraction tools. It also aims to contribute to the existing literature regarding management strategies for ingested sharp foreign bodies. A comprehensive account is provided of the clinical presentation, imaging studies, consultations, and endoscopic procedures performed, culminating in the patient's safe discharge from our facility.
Case report: Surgical treatment and literature review of a recurrent case of glucagonoma
Authors: Zhipeng Liu, Faji Yang, Yijie Hao, Qirong Jiang, Yisu Zhang, Qixuan Zheng, Yupeng Jiang, Jun Lu, Hengjun Gao
Journal: Front Oncol (2024)
Keywords: glucagonoma, liver metastasis 2, pancreatic neuroendocrine tumor, rare diseases, surgery
MeSH terms: Case Reports

A 40-year-old male patient was admitted due to abdominal distension and discomfort in the upper abdomen persisting for three days. Enhanced CT of the upper abdomen revealed an irregularly dense soft tissue area in the body and tail of the pancreas, approximately 7.6 × 3.1 cm in size, with blurred boundaries, and indistinct separation from the splenic artery and vein. Multiple liver lesions of varying sizes and slightly lower densities were also observed. Liver tumor biopsy considering a neuroendocrine tumor G2, combined with the medical history, led to a diagnosis of pancreatic neuroendocrine tumor G2 with liver metastasis. Physical examination showed mild tenderness in the upper abdomen but no other significant positive signs. During treatment, the patient developed multiple red papular rashes around the mouth, on both lower limbs, and the perineum, accompanied by itching. The glucagon level was 1138.3 pg/L. The patient underwent resection of the pancreatic body and tail, splenectomy, partial liver tumor resection, and cholecystectomy. Within five days post-surgery, the skin lesions began to crust and flake off. On the 14th day post-surgery, the serum glucagon level was rechecked at 136.4 pg/L. As of April 2024, progression of liver lesions was noted, with no significant skin symptoms during the period.
Case Report: Patent ductus arteriosus with tuberous sclerosis complex
Authors: Tingrui Chen, Xiaoxiao Wu, Yiping Wang
Journal: Front Cardiovasc Med (2024)
Keywords: icu, tsc, gene, patent ductus arteriosus, tuberous sclerosis complex
MeSH terms: Case Reports

A 33-year-old patient presented with a chief complaint of patent ductus arteriosus (PDA) persisting for over 30 years. Physical examination revealed bilateral facial angiofibromas, multiple nail fibromas, intraoral fibromas, and a 'shagreen patch' on the left lumbar region. Genetic testing was performed using a peripheral venous blood sample, which confirmed the diagnosis of Tuberous Sclerosis Type 2 (TSC2). Subsequently, the patient underwent cardiac color Doppler ultrasound and chest computed tomography angiography, which confirmed the presence of PDA. Tuberous sclerosis complex (TSC) is associated with cardiovascular diseases. The initial clinical manifestation of TSC is usually cardiac rhabdomyoma in children, and it is rarely reported in adults with PDA. In this case, the patient was diagnosed with PDA when he was young, and the genetic test showed heterozygous variation of TSC2 gene. The purpose of this article is to explore the correlation between TSC and PDA at the gene level through literature review.
Case report: Envafolimab combined with Endostar in the treatment of advanced non-small cell lung cancer with malignant pleural effusion
Authors: Changhong Dong, Chenxi Hu, Yanting Jiang, Kaiyuan Hui, Xiaodong Jiang
Journal: Front Oncol (2024)
Keywords: endostar, anti-angiogenic therapy, case report, envafolimab, immune checkpoint inhibitors, malignant pleural effusion, non-small cell lung cancer
MeSH terms: Case Reports

Malignant pleural effusion (MPE) is one of the common complications of lung cancer. The quality of life and prognoses for MPE patients are significantly compromised. Controlling the production of MPE can relieve patients' symptoms, improve their quality of life, and prolong their survival. This article presents a case of advanced non-small cell lung cancer (NSCLC) with MPE and negative driver genes. The patient received envafolimab and Endostar in combination, resulting in a complete reduction of MPE and durable clinical benefits. The exploratory use of this treatment method improved the quality of life of this patient and has the potential to prolong the survival of this patient.
Case report: tumefactive demyelinating lesions after the second cycle of alemtuzumab in multiple sclerosis; immune cell profile and biomarkers
Authors: Neus Rabaneda-Lombarte, Aina Teniente-Serra, Anna Massuet-Vilamajó, Cristina Ramo-Tello, Silvia Presas-Rodríguez
Journal: Front Immunol (2024)
Keywords: alemtuzumab, biomarkers, case report, immune subpopulations, multiple sclerosis, rebound, tumefactive demyelinating lesions
MeSH terms: Alemtuzumab / adverse effects, Alemtuzumab / therapeutic use, Biomarkers, Magnetic Resonance Imaging, Multiple Sclerosis, Relapsing-Remitting / drug therapy, Multiple Sclerosis, Relapsing-Remitting / immunology, Case Reports, Adult, B-Lymphocytes / drug effects, B-Lymphocytes / immunology, Brain / diagnostic imaging, Brain / immunology, Brain / pathology, Female, Humans, Th1 Cells / immunology, Th17 Cells / immunology, Alemtuzumab, Biomarkers

Objective:
We present a case of multiple tumefactive demyelinating lesions (TDLs) emerging 24 months after the second cycle of alemtuzumab treatment.
Methods:
A woman with relapsing-remitting multiple sclerosis (MS) discontinued fingolimod treatment due to gestational desire, which resulted in a severe disease exacerbation. Alemtuzumab was initiated, accompanied by regular clinical, radiological, and immunological monitoring.
Results:
She relapsed prior to the second cycle, exhibiting 12 T1Gd+ lesions, and peripheral blood showed an increase in B-cells and a decrease in T-cells. At 24 months following the second cycle, she developed cognitive impairment and multiple T1Gd+ lesions, including TDLs, were evident on the brain MRI. We found not only an increase in B-cells but also in Th1 central memory cells. Th1/Th17 cells increased 3 months before the detection of TDLs.
Conclusions:
TDLs can appear 24 months after the second cycle of alemtuzumab treatment in MS. The increase in Th1/Th17 cells could be a candidate biomarker for TDLs in alemtuzumab-treated MS patients.
Ischemic Myocardial Positron Emission Tomography Perfusion Without Epicardial Coronary Disease in Hypertrophic Obstructive Cardiomyopathy
Authors: Jason Galo, Rafey Feroze
Journal: Cureus (2024)
Keywords: coronary vessel disease, hypertrophic obstructive cardiomyopathy (hocm), microvascular angina, pet scans, refractory angina
MeSH terms: Case Reports

The presence of impaired microvascular coronary flow (MCF) identified by positron emission tomography myocardial perfusion imaging (PET-MPI) has been described in hypertrophic obstructive cardiomyopathy (HOCM) patients, contributes to blunted myocardial perfusion during vasodilator stress, and is a strong predictor of poor prognosis. A 45-year-old female with hypertension and obesity presented with angina. Her PET-MPI displayed vasodilator stress-induced global LV ischemia. However, her coronary angiogram revealed no obstructive coronary disease. These contradictory findings triggered a more thorough cardiac MRI with diffuse myocardial fibrosis, indicating high-risk HOCM. She underwent implantable cardioverter-defibrillator (ICD) placement due to non-sustained ventricular tachycardia and syncope. While this patient lacked epicardial coronary disease, her PET-MPI demonstrated global LV ischemia due to decreased MCF, leading to inadequate augmentation of myocardial perfusion during hyperemia. This is a well-described phenomenon responsible for anginal symptoms in HOCM patients. HOCM hearts have abnormally thick coronary arterioles and decreased capillary density, leading to increased oxygen diffusion distances and reduced perfusion. The presence of vasodilator-induced, global ischemia on PET-MPI without epicardial stenosis should raise suspicion for HOCM with impaired MCF, which represents a high-risk population with an almost 10 times greater risk of cardiovascular mortality compared to hypertrophic cardiomyopathy with preserved MCF.
A case of IgG4-related ophthalmic disease after SARS-CoV-2 vaccination: case report and literature review
Authors: Peixuan Zhang, Qian Wu, Xiao Xu, Minliang Chen
Journal: Front Immunol (2024)
Keywords: covid-19, igg4, igg4-related ophthalmic disease, sars-cov-2, autoimmunity, case report
MeSH terms: COVID-19 Vaccines / adverse effects, COVID-19, Eye Diseases / chemically induced, Immunoglobulin G4-Related Disease / chemically induced, Case Reports, Review, Humans, Immunoglobulin G, Vaccination, COVID-19 Vaccines, Immunoglobulin G

Coronavirus disease 19 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is affecting the world with a surge in cases. A variety of autoimmune diseases occur after SARS-CoV-2 infection or vaccination, of which IgG4-related disease (IgG4-RD) is an important type. IgG4-RD can involve multiple organs of the body. The ocular manifestation of IgG4-RD is called IgG4-related ophthalmic disease (IgG4-ROD). We herein report a patient diagnosed with IgG4-ROD. The patient developed ptosis and vision loss after SARS-CoV-2 vaccination, and the symptoms worsened after SARS-CoV-2 infection. After excluding other diseases like myasthenia gravis and Eaton-Lambert syndrome that may cause ptosis, the diagnosis of IgG4-ROD was confirmed by pathological examination. We discussed the predisposing factors, diagnosis and treatment of this patient to provide a more empirical and theoretical basis for clinical diagnosis and treatment. We conducted a literature review of previously reported cases of IgG4-RD following SARS-CoV-2 infection or vaccination. We retrieved a total of 9 cases, of which 5 developed symptoms after vaccination and 4 after infection. Demographic and clinical characteristics were summarized. In conclusion, our case represents the first case of proven IgG4-ROD after COVID-19 vaccination. We believe that IgG4-ROD and SARS-CoV-2 infection or vaccination are closely related, and the immune system disorder caused by SARS-CoV-2 infection or vaccination may be a key factor in the pathogenesis of IgG4-RD. But for now, there is no direct evidence that there is a causal relationship between SARS-CoV-2 infection or vaccination and IgG4-ROD, which still needs more research and exploration to confirm.
Endoscopic submucosal dissection for hypopharyngeal cancer simultaneous with immunotherapy for renal cell carcinoma
Authors: Tatsuro Hirao, Daisuke Kikuchi, Satoshi Yamashita, Hidehiko Takeda, Kenta Watanabe, Yuji Miura, Shu Hoteya
Journal: DEN Open (2024)
Keywords: double cancer, endoscopic submucosal dissection, hypopharyngeal cancer, less invasive therapy, local control
MeSH terms: Case Reports

We report a case of a man who was diagnosed with superficial hypopharyngeal cancer and recurrence of renal cell carcinoma in the duodenum, liver, and gluteus medius muscle simultaneously. He underwent endoscopic submucosal dissection for hypopharyngeal cancer in parallel with systemic immunotherapy for recurrent renal cell carcinoma, resulting in completely overcoming both malignancies. Endoscopic submucosal dissection is less invasive and can be performed in a shorter duration for treating superficial hypopharyngeal cancer compared with other treatment options, such as radiation therapy, chemotherapy, and surgery. Additionally, endoscopic submucosal carcinoma is adequately effective in controlling local lesions and has a satisfactorily good prognosis.
Idiopathic myointimal hyperplasia of mesenteric veins: radiological evaluation using CT angiography
Authors: Fumio Morimura, Hiromi Edo, Takafumi Niwa, Hiroaki Sugiura, Yohsuke Suyama, Soya Okazaki, Kazuyuki Narimatsu, Hiroki Ohno, Koichi Okamoto, Hideki Ueno, Shinya Yoshimatsu, Kosuke Miyai, Kohei Hamamoto, Hiroshi Shinmoto
Journal: BJR Case Rep (2023)
Keywords: ct angiography, bowel ischaemia, idiopathic myointimal hyperplasia of mesenteric veins
MeSH terms: Case Reports

A 44-year-old man presented with a chief complaint of constipation. Initial contrast-enhanced CT showed extensive bowel wall thickening, mainly in the left colon, with a thin cord-like inferior mesenteric vein (IMV), in contrast to ectatic mesenteric venous branches, suggesting bowel ischaemia owing to venous stasis. One month later, at the time of symptom exacerbation, CT angiography showed a cord-like IMV and ectatic mesenteric venous branches with early enhancement, suggesting the presence of an arteriovenous fistula (AVF). Owing to the progression of bowel ischaemia and necrosis with peritonitis, emergency surgery was performed. Surgical specimens showed focal myointimal hyperplasia of the proximal mesenteric veins in both ischaemic and non-ischaemic lesions of the resected colon, thus leading to the diagnosis of idiopathic myointimal hyperplasia of mesenteric veins (IMHMV) when combined with the clinical and imaging findings. IMHMV is a bowel ischaemic disease caused by non-thrombotic venous obstruction that requires bowel resection and has been suggested to be associated with AVF. Cord-like IMV and AVF in the mesentery are important CT findings that characterize IMHMV. CT angiography is useful in diagnosing IMHMV.
Denosumab combined with microwave ablation excisional scraping for giant cell tumor of the thoracic spine: a case report and literature review
Authors: Zukang Miao, Zhiwei Han, Kai Zheng, Ming Xu, Xue Yu, Changsheng Han, Xiuchun Yu
Journal: Front Oncol (2024)
Keywords: case report, denosumab, excisional scraping, giant cell tumor of bone, literature review
MeSH terms: Case Reports

Denosumab has recently become an important part of the treatment regime for spinal giant cell tumors of the bone (GCTB). Its use has significantly reduced the risk of surgery and postoperative complications in patients with spinal GCTB. However, the use of denosumab has not yet been optimized to reap the maximum benefits. Here, we have reported the case of a patient who was treated with denosumab in combination with excision and scraping for GCTB of the T10 vertebrae, which achieved good tumor control and no recurrence at the 2-year postoperative follow-up. We have also reviewed the case in the light of relevant literature as well as presented our ideas and recommendations for the optimal use of denosumab.
Case Report: Stüve-Wiedemann syndrome-a rare cause of persistent pulmonary hypertension of the newborn
Authors: Jessica Jin, Paula Rothämel, Johanna Büchel, Birgit Kammer, Theresa Brunet, Joseph Pattathu, Andreas W Flemmer, Claudia Nussbaum, Sebastian Schroepf
Journal: Front Pediatr (2024)
Keywords: pphn, stüve–wiedemann syndrome, case report, limb abnormalities, whole exome sequencing
MeSH terms: Case Reports

Introduction:
Persistent pulmonary hypertension of the newborn (PPHN) is a life-threatening condition characterized by hypoxemia due to elevated pulmonary vascular resistance. PPHN commonly arises secondary to various underlying conditions, including infection, meconium aspiration, and respiratory distress syndrome. Management includes pulmonary vasodilators, mechanical ventilation, oxygen supplementation, vasopressors, and volume replacement. Stüve-Wiedemann syndrome (SWS), a rare genetic disorder characterized by bone dysplasia, respiratory distress, hyperthermia, and swallowing difficulties, may present with pulmonary hypertension, indicating a poor prognosis.
Case description:
A term female neonate presented with secondary respiratory failure and severe PPHN of unknown etiology on the second day of life, necessitating intubation. Clinical findings included facial dysmorphia, camptodactyly, skeletal anomalies, and generalized muscular hypotonia. High-frequency oscillation ventilation and surfactant administration yielded marginal improvement. On the third day of life, a severe pulmonary hypertensive crisis necessitated inhaled and systemic pulmonary vasodilators along with volume and catecholamine therapy. Whole exome sequencing revealed a homozygous mutation in the leukemia inhibitory factor receptor (LIFR) gene, consistent with Stüve-Wiedemann syndrome.
Discussion/conclusion:
The case underscores the importance of considering and prompting evaluation of rare genetic causes in the differential diagnosis of PPHN, especially when other abnormalities are present and conventional therapies prove inadequate. Therapeutic strategies must account for the different pathophysiology of primary PPHN including vascular remodeling, as seen in SWS, which may not respond to pulmonary vasodilators typically employed in secondary PPHN due to vasoconstriction. In this case, the patient responded well to treatment for primary PPHN, but the use of high-frequency oscillation ventilation and surfactant was not helpful.