OpenMed/multicare-articles huggingface dataset:
Safety and Feasibility of Salvage Endoscopic Combined Intrarenal Surgery in Embolized Kidney
Authors: Alfonso Benincasa, Federico Nicolosi, Giovanni Lughezzani, Nicolò Maria Buffi, Paolo Casale, Rodolfo Hurle, Massimo Lazzeri, Pasquale Cardone, Giorgio Guazzoni, Alberto Saita
Journal: J Endourol Case Rep (2016)
MeSH terms: Case Reports

Background:
Although endoscopic combined intrarenal surgery (ECIRS) is well established as primary approach to complex lithiasis, no evidences are still available on its use in salvage context.
Case presentation:
A male patient, of 55 years of age, underwent many unsuccessful surgical procedures to treat large and multiple right kidney stones, including percutaneous nephrolithotomy (PCNL). The latter was complicated by severe postoperative hemorrhage, managed with super-selective renal artery embolization (SRAE). Therefore he came to our institution to achieve a complete resolution of the urolithiasis. Preoperative evaluation included CT scan and renal scintigraphy to establish kidney and stone morphologic features and residual renal function. Salvage ECIRS was performed and postoperative assessment showed a complete resolution of lithiasis and absence of renal function impairment.
Conclusion:
To our knowledge, this is the first case of salvage ECIRS reported in literature after previous failed PCNL. Even after SRAE, this procedure appears as safe and as efficacious as standard salvage PCNL when performed by experienced hands.
Endoscopic Surgery under Fluoroscopic Guidance Is Useful for Diagnosing and Treating Epiphyseal Osteomyelitis Caused by Mycobacterium Species
Authors: Hironori Ochi, Katsuaki Taira, Naho Nemoto, Noboru Oikawa, Soya Nagao, Tadamasa Takano, Kazuo Kaneko
Journal: Case Rep Orthop (2018)
MeSH terms: Case Reports

Osteomyelitis caused by Mycobacterium species may be difficult to diagnose and treat. We report a case of treatment for osteomyelitis caused by Mycobacterium species in the epiphysis of the right proximal tibia. A 28-month-old boy presented to a hospital with symptoms of fever and right knee pain. He had been vaccinated with Mycobacterium bovis Bacille Calmette-Guérin (BCG) at five months of age. The epiphyseal radiolucent lesion had increased in size and extended to the metaphysis through the physis on a plain radiograph of the right proximal tibia. Surgical drainage and curettage of the lesion were performed with an endoscope under C-arm fluoroscopy. The intraoperative histopathological examination revealed granulation tissue composed of caseous necrosis and Langerhans giant cells, revealing Mycobacterium species to be the causative pathogen. Because of suspected osteomyelitis caused by BCG, the antituberculosis drugs were administered orally from an early postoperative stage. A plain radiograph taken eight months postoperatively showed bone regeneration in the area of curettage and a slight physeal bridge, in addition to normalization of the inflammatory response on blood sampling. It was possible to perform accurate diagnosis and rapid treatment for epiphyseal osteomyelitis caused by Mycobacterium species using endoscopic surgery under fluoroscopic guidance.
Voluntary initiation of movement: multifunctional integration of subjective agency
Authors: Patrick Grüneberg, Hideki Kadone, Kenji Suzuki
Journal: Front Psychol (2015)
Keywords: agency (psychology), assistive robotics, motion, multifunctionality, multimodality, neurorehabilitation, subjectivity

This paper investigates subjective agency (SA) as a special type of efficacious action consciousness. Our central claims are, firstly, that SA is a conscious act of voluntarily initiating bodily motion. Secondly, we argue that SA is a case of multifunctional integration of behavioral functions being analogous to multisensory integration of sensory modalities. This is based on new perspectives on the initiation of action opened up by recent advancements in robot assisted neuro-rehabilitation which depends on the active participation of the patient and yields experimental evidence that there is SA in terms of a conscious act of voluntarily initiating bodily motion (phenomenal performance). Conventionally, action consciousness has been considered as a sense of agency (SoA). According to this view, the conscious subject merely echoes motor performance and does not cause bodily motion. Depending on sensory input, SoA is implemented by means of unifunctional integration (binding) and inevitably results in non-efficacious action consciousness. In contrast, SA comes as a phenomenal performance which causes motion and builds on multifunctional integration. Therefore, the common conception of the brain should be shifted toward multifunctional integration in order to allow for efficacious action consciousness. For this purpose, we suggest the heterarchic principle of asymmetric reciprocity and neural operators underlying SA. The general idea is that multifunctional integration allows conscious acts to be simultaneously implemented with motor behavior so that the resulting behavior (SA) comes as efficacious action consciousness. Regarding the neural implementation, multifunctional integration rather relies on operators than on modular functions. A robotic case study and possible experimental setups with testable hypotheses building on SA are presented.
Rectoperineal Fistula Presented 5 Months After Repair of Severe Obstetric Perineal Laceration: A Case Report
Authors: Yusuke Ohara, Tsuyoshi Enomoto, Yohei Owada, Katsuji Hisakura, Yoshimasa Akashi, Koichi Ogawa, Manami Doi, Kazuhiro Takahashi, Osamu Shimomura, Kinji Furuya, Jaejeong Kim, Shinji Hashimoto, Rena Ohara, Mana Obata-Yasuoka, Hiromi Hamada, Tatsuya Oda
Journal: Front Surg (2021)
Keywords: anal incontinence, gastrointestinal surgery, obstetric laceration, rectoperineal fistula, surgical site infection
MeSH terms: Case Reports

Introduction: Obstetric severe perineal laceration can frequently occur as a surgical site infection (SSI), which sometimes leads to rectovaginal fistula after repair. We encountered a rare case of a rectoperineal fistula 5 months after repair of a severe perineal laceration. Case presentation: The patient was a 39-year-old woman who underwent repair of a fourth-degree perineal laceration after vaginal delivery. Five months after primary repair, she presented with perineal swelling and pain followed by uncontrollable flatulence or passage of feces at the perineum, which was finally diagnosed as a rectoperineal fistula. Transperineal repair with fistulous tract excision was performed for the rectoperineal fistula. Closure of the rectum, perineal body, and vagina was performed layer-by-layer constructing a thick perineum to prevent anal dysfunction. The fistula was successfully closed, and the patient did not show any symptoms of fecal incontinence 6 months after surgery. Discussion: As the rectoperineal fistula might have resulted in SSI at the primary repair of the obstetric injury, the delayed occurrence of the rectoperineal fistula was unusual. A perineal approach should be performed for complete fistulous tract excision, reconstruction of a robust perineal structure, and preservation of anal sphincter function.
Case report: two patients with partial DiGeorge syndrome presenting with attention disorder and learning difficulties
Authors: Bülent Hacıhamdioğlu, Merih Berberoğlu, Zeynep Şıklar, Figen Doğu, Pelin Bilir, Şenay Savaş Erdeve, Aydan İkincioğulları, Gönül Öçal
Journal: J Clin Res Pediatr Endocrinol (2011)
Keywords: digeorge syndrome, adolescent, psychiatric problems
MeSH terms: Attention Deficit Disorder with Hyperactivity / etiology, DiGeorge Syndrome / complications, DiGeorge Syndrome / diagnosis, Learning Disabilities / etiology, Case Reports, Adolescent, DiGeorge Syndrome / psychology, Facies, Humans, Male, Phenotype

DiGeorge syndrome (DGS) has classically been characterized by the triad of clinical features including congenital cardiac defects, immune deficiencies secondary to aplasia or hypoplasia of the thymus, and hypocalcaemia due to small or absent parathyroid glands. The phenotypic features of these patients are much more variable and extensive than previously recognized. The acknowledgement of similarities and phenotypic overlap of DGS with other disorders associated with genetic defects in 22q11 has led to an expanded description of the phenotypic features of DGS including palatal/speech abnormalities, as well as cognitive, neurological and psychiatric disorders. Here, we report the cases of two DGS patients with dysmorphic facial features who were initially admitted to the Psychiatry Department for attention disorder and learning difficulties.
Loss of 4q21.23-22.1 is a prognostic marker for disease free and overall survival in non-small cell lung cancer
Authors: Faik G Uzunoglu, Ebba Dethlefsen, Annkathrin Hanssen, Michaela Wrage, Lena Deutsch, Katharina Harms-Effenberger, Yogesh K Vashist, Matthias Reeh, Guido Sauter, Ronald Simon, Maximillian Bockhorn, Klaus Pantel, Jakob R Izbicki, Harriet Wikman
Journal: PLoS One (2014)
MeSH terms: Biomarkers, Tumor / genetics, Carcinoma, Non-Small-Cell Lung / diagnosis, Carcinoma, Non-Small-Cell Lung / genetics, Chromosome Aberrations, Chromosomes, Human, Pair 4 / genetics, Lung Neoplasms / diagnosis, Lung Neoplasms / genetics, Research Support, Non-U.S. Gov't, Aged, Allelic Imbalance, Carcinoma, Non-Small-Cell Lung / pathology, Cohort Studies, DNA Copy Number Variations, Disease-Free Survival, Female, Humans, Lung Neoplasms / pathology, Male, Microsatellite Repeats / genetics, Biomarkers, Tumor

This study was performed to assess the prognostic relevance of genomic aberrations at chromosome 4q in NSCLC patients. We have previously identified copy number changes at 4q12-q32 to be significantly associated with the early hematogenous dissemination of non-small cell lung cancer (NSCLC), and now aim to narrow down potential hot-spots within this 107 Mb spanning region. Using eight microsatellite markers at position 4q12-35, allelic imbalance (AI) analyses were performed on a preliminary study cohort (n = 86). Positions indicating clinicopathological and prognostic associations in AI analyses were further validated in a larger study cohort using fluorescence in situ hybridization (FISH) in 209 NSCLC patients. Losses at positions 4q21.23 and 4q22.1 were shown to be associated with advanced clinicopathological characteristics as well as with shortened disease free (DFS) and overall survival (OS) (DFS: P = 0.019; OS: P = 0.002). Multivariate analyses identified the losses of 4q21.23-22.1 to be an independent prognostic marker for both DFS and OS in NSCLC (HR 1.64-2.20, all P<0.04), and especially in squamous cell lung cancer (P<0.05). A case report study of a lung cancer patient further revealed a loss of 4q21.23 in disseminated tumor cells (DTCs). Neither gains at the latter positions, nor genomic aberrations at 4q12, 4q31.2 and 4q35.1, indicated a prognostic relevance. In conclusion, our data indicate that loss at 4q21.23-22.1 in NSCLC is of prognostic relevance in NSCLC patients and thus, includes potential new tumor suppressor genes with clinical relevance.
Undigested Pills in Stool Mimicking Parasitic Infection
Authors: Fazia Mir, Ilyas Achakzai, Jamal A Ibdah, Veysel Tahan
Journal: Case Rep Gastrointest Med (2017)
MeSH terms: Case Reports

Background. Orally ingested medications now come in both immediate release and controlled release preparations. Controlled release preparations were developed by pharmaceutical companies to improve compliance and decrease frequency of pill ingestion. Case Report. A 67-year-old obese male patient presented to our clinic with focal abdominal pain that had been present 3 inches below umbilicus for the last three years. This pain was not associated with any trauma or recent heavy lifting. Upon presentation, the patient reported that for the last two months he started to notice pearly oval structures in his stool accompanying his chronic abdominal pain. This had coincided with initiation of his nifedipine pills for his hypertension. He reported seeing these undigested pills daily in his stool. Conclusion. The undigested pills may pose a cause of concern for both patients and physicians alike, as demonstrated in this case report, because they can mimic a parasitic infection. This can result in unnecessary extensive work-up. It is important to review the medication list for extended release formulations and note that the outer shell can be excreted whole in the stool.
Pott's Disease with Incidentally Discovered Multiple Brain Tuberculomas in a Previously Healthy 10-Year-Old Girl
Authors: May Albarrak, Abdulrahaman Alodayani, Nasir Al Otaibi, Yasser Albrikeet
Journal: Case Rep Infect Dis (2021)
MeSH terms: Case Reports

Pott's disease (PD) represents the most common form of spinal tuberculosis. Its association with brain tuberculomas is extremely rare. Herein, we report a previously healthy child with PD and concurrent multiple brain tuberculomas who was successfully treated with antituberculous therapy, surgical drainage of the paravertebral abscess, and adjuvant steroid therapy.
Trabectedin in the neoadjuvant treatment of high-grade pleomorphic sarcoma: report of a rare case and literature review
Authors: Markus K Schuler, Stephan Richter, Ivan Platzek, Bettina Beuthien-Baumann, Kathrin Wieczorek, Christine Hamann, Johannes Mohm, Gerhard Ehninger
Journal: Case Rep Oncol Med (2013)

Background. Pleomorphic sarcoma is an aggressive soft tissue sarcoma. In patients with high-risk extremity sarcomas, the significant survival benefits conferred by an intense regimen of neoadjuvant chemoradiotherapy and surgery were reported. To our knowledge, this is the first report in the literature of the neoadjuvant use of trabectedin in a patient with high-grade pleomorphic sarcoma, ineligible for standard neoadjuvant combination therapy with an anthracycline-based regimen. Case Presentation. Here we present a 58-year-old White male with a large tumor in the left thigh, but with no signs of metastases. Owing to the history of severe heart attack, three cycles of neoadjuvant trabectedin were administrated to achieve surgically wide margins. After two cycles, an 18F-FDG-PET showed a large proportion of the central tumor area was without metabolic activity. According to RECIST and Choi criteria, the tumor was stable. After the third cycle of trabectedin, the patient underwent a complete resection, which revealed completely necrotic high-grade pleomorphic sarcoma (stage pT2b), with only a small vital area. Conclusion. The present paper on a promising treatment with neoadjuvant trabectedin of patients with high-grade pleomorphic sarcoma might suggest that such treatment approach may provide a greater chance of cure and survival of such patients.
Long-Term Remission of a Spinal Atypical Teratoid Rhabdoid Tumor in Response to Intensive Multimodal Therapy
Authors: Fahd Refai, Haneen Al-Maghrabi, Hassan Al Trabolsi, Jaudah Al-Maghrabi
Journal: Case Rep Pediatr (2019)
MeSH terms: Case Reports

Atypical teratoid rhabdoid tumors (ATRTs) are rare and aggressive central nervous system tumors that infrequently arise in spinal locations in young children. Provided clinical and diagnostic suspicion is high, the histopathological diagnosis is relatively straightforward to secure by testing for the characteristic loss of the tumor suppressor protein SMARCB1/INI1. Here, we describe a case of thoracic spinal ATRT in a three-year-old boy that showed characteristic aggressive progression until managed with intensive multimodal therapy to achieve durable long-term remission. In doing so, we review the histopathological features, management, and current advances in molecular biology that hold promise for personalized ATRT therapy.
Synovitis, Acne, Pustulosis, Hyperostosis, and Osteitis Syndrome with Purely Osteolytic, Not Osteosclerotic, Lesions Mimicking a Malignant Tumor
Authors: Hideyuki Kinoshita, Takeshi Ishii, Hiroto Kamoda, Yoko Hagiwara, Toshinori Tsukanishi, Sumihisa Orita, Kazuhide Inage, Naoya Hirosawa, Seiji Ohtori, Tsukasa Yonemoto
Journal: Case Rep Rheumatol (2020)
MeSH terms: Case Reports

Synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome is a rare inflammatory disorder with multiple phenotypes. The syndrome has identifiable radiologic characteristics that are the most important when making a diagnosis. X-rays of cases diagnosed with SAPHO syndrome reveal sclerotic lesions or mixed lytic and sclerotic lesions. Pure osteolytic lesions in SAPHO syndrome are rare, and to the best of our knowledge, no study has reported the radiologic change of purely osteolytic lesions to osteosclerotic lesions over time. Herein, we report on the case of a woman experiencing severe left thigh acute pain and having a medical history of palmoplantar pustulosis. Although SAPHO syndrome was suspected because of palmoplantar pustulosis, based on radiologic findings, bone metastasis of a malignant tumor or chronic bacterial osteomyelitis owing to a purely osteolytic lesion was suspected. However, needle biopsy revealed no malignancy and bacterial culture was negative, thus suggesting SAPHO syndrome. Nonsteroidal anti-inflammatory drugs, bisphosphonates, and corticosteroids were administered, which improved the left thigh pain. Furthermore, the radiologic change of osteolytic lesions to osteosclerotic lesions over time was confirmed, leading to the diagnosis of SAPHO syndrome. Our case demonstrates that knowledge of atypical radiologic findings is necessary to diagnose initial SAPHO syndrome.
A Rare Case of Pembrolizumab-Induced Reactivation of Hepatitis B
Authors: Anita Pandey, Susan Ezemenari, Maksim Liaukovich, Ivan Richard, Avezbakiyev Boris
Journal: Case Rep Oncol Med (2018)
MeSH terms: Case Reports

Hepatitis B virus (HBV) infection is common across the world, especially in Asia, Africa, Southern Europe, and Latin America. The association of HBV infection in patients suffering from different oncological conditions is well established. Many cases of HBV reactivation have been reported in patients on immunosuppressive chemotherapy and in patients undergoing hematopoietic bone marrow transplantations. Only one case has been reported so far of HBV reactivation in a patient treated with programmed cell death receptor 1 (PD-1) checkpoint inhibitors in the setting of HIV status. We report a case of a 51-year-old male, former smoker, diagnosed with stage IV poorly differentiated adenocarcinoma of the lung, and started on pembrolizumab, who developed reactivation of chronic hepatitis requiring antiviral therapy.
Coarctation of the Aorta as a Complication of Surgical Ligation of Patent Ductus Arteriosus in a Premature Infant
Authors: Amna Qasim, Soham Dasgupta, Sunil K Jain, Amyn K Jiwani, Ashraf M Aly
Journal: Case Rep Pediatr (2017)
MeSH terms: Case Reports

Surgical ligation of a patent ductus arteriosus (PDA) is a commonly performed procedure. Complications are infrequent and most commonly include recurrent laryngeal nerve injury and rarely ligation of left pulmonary artery. We report a case of accidental ligation of the descending thoracic aorta leading to a clinically significant coarctation.
Contactin-associated protein 2 autoantibodies can be associated with multifocal motor-like neuropathy: a case report
Authors: Louisa Müller-Miny, Raoul Sauer, Andreas Schulte-Mecklenbeck, Catharina C Gross, Stjepana Kovac, Matthias Schilling, Carolin Beuker, Heinz Wiendl, Gerd Meyer Zu Hörste
Journal: Ther Adv Neurol Disord (2023)
Keywords: caspr2, case report, flow cytometry, multifocal motor neuropathy
MeSH terms: Case Reports

Autoantibodies against contactin-associated protein 2 (CASPR2) are usually associated with autoimmune encephalitis and neuromyotonia. Their association with inflammatory neuropathies has been described in case reports albeit all with distal symmetric manifestation. Here, we report a patient who developed distal arm paresis, dominantly of the right arm, over the course of 1 year. Electroneurography showed a conduction block of motor nerve conduction, nerve ultrasonography a swelling of the right median and ulnar nerve and flow cytometry an increase in natural killer (NK cells) in the blood and natural killer T (NKT) cells in the cerebrospinal fluid (CSF), therefore indicating a multifocal motor neuropathy-like (MMN-like) phenotype. CASPR2 autoantibodies were detected in serum and CSF. Through immunotherapy with intravenous immunoglobulins the patient showed clinical and neurographic improvement. We therefore describe the first association of CASPR2 autoantibodies with a MMN-like clinical manifestation, extending the spectrum of CASPR2-associated diseases.
Malignant Peripheral Nerve Sheath Tumor of Prostate: A Rare Case Report and Literature Review
Authors: Kun-Lin Hsieh, Chih-Cheng Lu, Chien-Feng Li, Yin-Hsun Feng, Alex C Liao
Journal: Case Rep Urol (2016)

A mid-aged male presented with progressive lower urinary tract symptoms (LUTS) for years. Huge prostate with low serum prostate-specific antigen (PSA) level was detected. The specimen from transurethral resection revealed surprising pathology finding as malignant peripheral nerve sheath tumor (MPNST). Considering its huge size (more than 300 gm) and location, we prescribed neoadjuvant chemotherapy firstly. The tumor became regressive and then radical surgical resection was achieved. Adjuvant multimodality treatment including concurrent chemoradiotherapy (CCRT) and target therapy was given. However, he expired about one year later. MPNST originating from prostate is very rare and seldom reported before. We here present this extremely rare disease and share our treatment experience.
Debut of Gastroesophageal Reflux Concomitant with Administration of Sublingual Immunotherapy
Authors: Jacob Juel
Journal: Case Rep Gastrointest Med (2017)
MeSH terms: Case Reports

Gastroesophageal reflux disease (GORD) is an often debilitating condition characterised by retrograde flow of content from stomach into the oesophagus, where the low pH of the stomach acid irritates the mucosa of the oesophagus. The most dominant symptoms in GORD are pyrosis, regurgitation, and dysphagia. Sublingual immunotherapy (SLIT) was first described in 1986. Following this description, the use has greatly increased in the treatment of allergic rhinitis, as an alternative to subcutaneously administered immunotherapy. Side effects are commonly of oropharyngeal and gastrointestinal nature, for example, swelling, itching, irritation, ulceration of the oropharynx and nausea, abdominal pain, vomiting, and diarrhoea. More serious side effects are dominated by respiratory tract and systemic manifestations. A 30-year-old male experienced refractory, relentless, and debilitation GORD subsequent to administration of sublingual immunotherapy for house dust mite in allergic rhinitis. The patient had to stop the SLIT after two weeks of administration due to GORD. The cessation resulted in rapid resolution of symptoms.