OpenMed/multicare-articles huggingface dataset:
Case Report: Primary Cardiac T-Cell Lymphoma With Complete Atrio-Ventricular Block Diagnosed by Endomyocardial Biopsy
Authors: Panpan Chen, Yuanyuan Hao, Xi Qiu, Xibin Xiao, Wei Zhu, Yang Xu, Wenbin Qian
Journal: Front Immunol (2022)
Keywords: t-cell lymphoma, case report, complete atrioventricular block, immunotherapy, primary cardiac lymphoma
MeSH terms: Heart Neoplasms / diagnosis, Heart Neoplasms / drug therapy, Lymphoma, Lymphoma, T-Cell / diagnosis, Lymphoma, T-Cell / drug therapy, Case Reports, Biopsy, Female, Heart, Humans, Middle Aged

Primary cardiac lymphoma (PCL) is a rare disease, the definite diagnosis of which is sometimes difficult and mainly relies on endomyocardial biopsy. Primary cardiac T-cell lymphoma (PCTL) is an extremely rare sub-type of PCL. Here, we report on a 47-year-old female with PCTL who presented with fever, syncope, palpitations, and a third-degree atrioventricular block (AVB) on electrocardiogram. Chemotherapy was administered with two courses of methotrexate, cyclophosphamide, liposomal doxorubicin, vincristine, and dexamethasone (MTX-CHOP). As the tumor vanished, AVB changed from third degree to second degree and finally to sinus rhythm. In conclusion, endomyocardial biopsy is valuable in the diagnosis of primary cardiac lymphoma. It is worth noting that alterations in the electrocardiogram may indicate an attack on the heart by PCTL.
Nephrotic Syndrome as an Extramuscular Manifestation of Anti-EJ Antibody-Positive Dermatomyositis: A Case Report and Review of the Literature
Authors: Syoko Tsubouchi, Takahiro Mizuuchi, Yusuke Yamamoto, Daiki Fujimori, Kayo Ishii, Mayu Tago, Eri Kato, Hiroaki Mori, Haeru Hayashi, Koichiro Tahara, Tetsuji Sawada
Journal: Case Rep Rheumatol (2022)
MeSH terms: Case Reports

Renal involvement is underestimated as an extramuscular manifestation of dermatomyositis (DM). Here, we describe a 67-year-old woman with anti-glycyl-transfer ribonucleic acid synthetase (anti-EJ) antibody and anti-ribonucleoprotein antibody-positive DM complicated by systemic sclerosis, who developed nephrotic syndrome concurrently with the exacerbation of DM, as indicated by incremental serum creatine kinase levels, high-intensity lesions on muscle magnetic resonance imaging, and active interstitial pneumonitis on chest computed tomography. Renal biopsy revealed the presence of immune-deposition in the glomerulus by immunofluorescence. To our knowledge, this is the first report describing the coexistence of anti-EJ antibody-positive DM and nephrotic syndrome. More reports of similar cases are warranted to substantiate the association.
Gonococcal subcutaneous abscess and pyomyositis: a case report
Authors: Anupop Jitmuang, Adhiratha Boonyasiri, Nukool Keurueangkul, Amornrut Leelaporn, Amorn Leelarasamee
Journal: Case Rep Infect Dis (2012)

Disseminated gonococcal infection (DGI) is an uncommon complication of Neisseria gonorrhoeae infection, its manifestation varies from a classic arthritis-dermatitis syndrome to uncommon pyogenic infections of several organs. Herein, we reported atypical presentation of DGI with subcutaneous abscess of right knee, pyomyositis of right lower extremity, and subsequently complicated by Escherichia coli pyomyositis. This infection responded to appropriate antimicrobial therapy and prompt surgical management with good clinical outcome.
Renal cell carcinoma presenting as a tumor on the scalp: A case report
Authors: Christina Krogerus, Matilda Svenning, Anette Pedersen Pilt, Hannah Trøstrup
Journal: Int J Surg Case Rep (2020)
Keywords: case report, renal cell carcinoma, skin metastasis
MeSH terms: Case Reports

Introduction:
Renal cell carcinoma (RCC) is often diagnosed as an incidental finding on imaging studies and about a fourth of patients have metastases by the time of diagnosis. RCC is known to metastasize widely but cutaneous metastases are considered uncommon and are rarely the presenting symptom of RCC. We present a case of RCC presenting with a tumor on the scalp.
Case:
A 65-year-old healthy man presented with a 9-month history of a growing mass on the scalp. Clinical examination revealed a pulsating, highly vascularized tumor that was excised. Histopathological findings were consistent with a metastasis from a renal cell carcinoma. Further investigations revealed a 13 cm kidney tumor with metastases to the lungs and mediastinum.
Discussion:
Cutaneous metastasis from RCC is uncommon and is rarely the initial symptom of RCC. The lesions often have a vascularized appearance and may be clinically confused with other vascular tumors. Skin metastasis is a sign of advanced disease and prognosis is poor.
Conclusion:
An occult RCC may present with a skin lesion. Skin metastasis from RCC is an important differential diagnosis in tumors with a vascular appearance, especially in patients with a previous history of RCC.
Prenatal diagnosis of a congenital postaxial longitudinal limb defect: a case report
Authors: Joana Pauleta, Maria Antonieta Melo, Luís Mendes Graça
Journal: Obstet Gynecol Int (2010)
MeSH terms: Case Reports

Introduction. Although congenital longitudinal fibular deficiency is one of the most common long bone deficiencies, there are few published cases of its prenatal diagnosis. Case report. A right longitudinal deficiency of the fibula associated with tibial shortening, foot equinovalgus, and absence of the fourth and fifth foot rays diagnosed at 22 weeks gestation is described. Sequential ultrasonographic surveillance was performed without obstetric complications. The anomaly was confirmed after birth, and conservative orthopaedic management was decided. Conclusion. Though rarely seen, postaxial longitudinal limb defect may be detected by ultrasound. The correct approach can only be decided after birth, when the functional impact of the anomaly can be fully evaluated.
A Massive Number of Extracellular Tropheryma whipplei in Infective Endocarditis: A Case Report and Literature Review
Authors: Nadji Hannachi, Florent Arregle, Hubert Lepidi, Jean-Pierre Baudoin, Frédérique Gouriet, Hélène Martel, Sandrine Hubert, Benoit Desnues, Alberto Riberi, Jean-Paul Casalta, Gilbert Habib, Laurence Camoin-Jau
Journal: Front Immunol (2022)
Keywords: tropheryma whipplei, electron microscopy, infectious endocarditis, rheumatoid arthritis, tocilizumab
MeSH terms: Arthritis, Rheumatoid / drug therapy, Endocarditis / complications, Endocarditis / diagnosis, Endocarditis / drug therapy, Endocarditis, Bacterial / diagnosis, Endocarditis, Bacterial / microbiology, Endocarditis, Bacterial / pathology, Whipple Disease / diagnosis, Whipple Disease / drug therapy, Case Reports, Review, Anti-Bacterial Agents / therapeutic use, Humans, Tropheryma, Anti-Bacterial Agents

Whipple's disease (WD) is a chronic multisystemic infection caused by Tropheryma whipplei. If this bacterium presents an intracellular localization, associated with rare diseases and without pathognomonic signs, it is often subject to a misunderstanding of its physiopathology, often a misdiagnosis or simply an oversight. Here, we report the case of a patient treated for presumed rheumatoid arthritis. Recently, this patient presented to the hospital with infectious endocarditis. After surgery and histological analysis, we discovered the presence of T. whipplei. Electron microscopy allowed us to discover an atypical bacterial organization with a very large number of bacteria present in the extracellular medium in vegetation and valvular tissue. This atypical presentation we report here might be explained by the anti-inflammatory treatment administrated for our patient's initial diagnosis of rheumatoid arthritis.
Transcatether closure of an atrial redirection baffle leak
Authors: Brian D Soriano, Karen K Stout, Colleen D Cailes, Thomas K Jones
Journal: Ann Pediatr Cardiol (2009)
Keywords: echocardiography, three-dimensional echocardiogarphy, transesophageal heart catheterization
MeSH terms: Case Reports

We present the case of a woman born with transposition of the great arteries, who was surgically repaired with the Mustard technique. Because of interatrial shunting, she was brought to the cardiac catheterization laboratory for device closure. Matrix-array 3D transesophageal echocardiography enabled visualization of both baffle leaks and demonstrated its orientation in a fashion superior to 2D imaging, had it been used alone. The leaks were successfully closed with a single transcatheter device.
A Splint-to-CT Data Registration Strategy for Maxillary Navigation Surgery
Authors: Shinsuke Yamamoto, Shigeo Hara, Toshihiko Takenobu
Journal: Case Rep Dent (2020)
MeSH terms: Case Reports

Computer-assisted navigation plays an important role in modern craniomaxillofacial surgery. Although headpins and skull posts are widely used for the fixation of the reference frame, they require the use of invasive procedures. Headbands are easily displaced intraoperatively, thus reducing the accuracy of the surgical outcome. This study reported the utility of a novel splint integrated with a reference frame and registration markers for maxillary navigation surgery. A maxillary splint with a 10 cm resin handle was fabricated before surgery, to fix the reference frame to the splint. The splint was set after the incorporation of fiducial gutta-percha markers into both the splint and resin handle for marker-based pair-point registration. A computed tomography (CT) scan was acquired for preoperative CT-based planning. A marker-based pair-point registration procedure can be completed easily and noninvasively using this custom-made integrated splint, and maxillary navigation surgery can be performed with high accuracy. This method also provides maximum convenience for the surgeon, as the splint does not require reregistration, and can be removed temporarily when required. The splint-to-CT data registration strategy has potential applicability not only for maxillary surgery but also for otolaryngologic surgery, neurosurgery, and surgical repair after craniofacial trauma.
Multivalvular infective endocarditis with Proteus mirabilis
Authors: Amber Bux, Ahmad Mustafa, Muhammad Niazi, Umesh Manchandani, Neville Mobarakai, James Lafferty, Vincent DeChavez
Journal: IDCases (2022)
Keywords: infective endocarditis, multivalvular, proteus
MeSH terms: Case Reports

Proteus species belong to the Enterobacteriaceae family and are gram-negative-rods, commonly known to cause urinary tract infections and asymptomatic bacteriuria in elderly patients with risk factors such as diabetes mellitus and urinary catheterization. However, Proteus species are rarely known to cause infective endocarditis. We present a case of an 85-year-old female who presented due to decreased responsiveness with urine and blood cultures growing Proteus mirabilis. While she was being treated for her urinary tract infection, her echocardiogram showed vegetation on the left coronary cusp of the aortic valve and left pulmonic valve leaflet. Uncontrolled tachyarrhythmias and new-onset atrial fibrillation complicated the hospital course. Later, she became bradycardic during the hospital stay, and all rate-control medications were held. Unfortunately, she went into cardiac arrest and spontaneous circulation could not be established with resuscitation attempts and she expired. To our knowledge, this is a rare case of native valve infective endocarditis secondary to Proteus mirabilis, leading to uncontrolled tachyarrhythmias and death.
Clinical and immunological features of an APLAID patient caused by a novel mutation in PLCG2
Authors: Qi Peng, Dong Luo, Yi Yang, Yinghua Zhu, Qingming Luo, Huan Chen, Dapeng Chen, Zhongjun Zhou, Xiaomei Lu
Journal: Front Immunol (2023)
Keywords: aplaid, ngs, plcg2, autoinflammation disease, phospholipase cγ2
MeSH terms: Autoimmune Diseases, Inflammatory Bowel Diseases, Case Reports, Research Support, Non-U.S. Gov't, Child, Humans, Mutation, Phospholipase C gamma / genetics, Phospholipase C gamma / metabolism, Syndrome, Phospholipase C gamma

Background:
The APLAID syndrome is a rare primary immunodeficiency caused by gain-of-function mutations in the PLCG2 gene. We present a 7-year-old APLAID patient who has recurrent blistering skin lesions, skin infections in the perineum, a rectal perineal fistula, and inflammatory bowel disease.
Methods:
To determine the genetic cause of our patient, WES and bioinformatics analysis were performed. Flow cytometry was used for phenotyping immune cell populations in peripheral blood. Cytokines released into plasma were analyzed using protein chip technology. The PBMCs of patient and a healthy child were subjected to single-cell RNA-sequencing analysis.
Results:
The patient carried a novel de novo missense mutation c.2534T>C in exon 24 of the PLCG2 gene that causes a leucine to serine amino acid substitution (p.Leu845Ser). Bioinformatics analysis revealed that this mutation had a negative impact on the structure of the PLCγ2 protein, which is highly conserved in many other species. Immunophenotyping by flow cytometry revealed that in addition to the typical decrease in circulating memory B cells, the levels of myeloid dendritic cells (mDCs) in the children's peripheral blood were significantly lower, as were the CD4+ effector T cells induced by their activation. Single-cell sequencing revealed that the proportion of different types of cells in the peripheral blood of the APLAID patient changed.
Conclusions:
We present the first case of APLAID with severely reduced myeloid dendritic cells carrying a novel PLCG2 mutation, and conducted a comprehensive analysis of immunological features in the ALPAID patient, which has not been mentioned in previous reports. This study expands the spectrum of APLAID-associated immunophenotype and genotype. The detailed immune analyses in this patient may provide a basis for the development of targeted therapies for this severe autoinflammatory disease.
Severe intermittent anxiety attacks. A diagnosis challenge in temporal lobe epilepsy
Authors: Abdulaziz T Alshomrani, Radwan M Zaidan, Yosef T Abdulmalik, Nader M Alrahili
Journal: Neurosciences (Riyadh) (2017)
MeSH terms: Anxiety / diagnosis, Epilepsy, Temporal Lobe / diagnosis, Case Reports, Research Support, Non-U.S. Gov't, Adult, Anticonvulsants / therapeutic use, Anxiety / complications, Diagnosis, Differential, Epilepsy, Temporal Lobe / complications, Epilepsy, Temporal Lobe / drug therapy, Humans, Male, Anticonvulsants

Psychiatric symptoms are frequently reported with epilepsy. Anxiety symptoms are the most common psychiatric expressions of temporal lobe epilepsy (TLE). Longer duration of the epileptic manifestation can be mistaken for psychiatric diseases, particularly when psychiatric symptoms are the only manifestations of the disorder. Here we introduce a case of a 27-year-old Saudi man presented to our clinic with a history of sudden and severe anxiety attacks over the prior 2 years, each lasting for 2-3 days. The attacks recurred monthly without clear triggers, and he recovered his normal clinical state between them. His condition worsened with antidepressants and improved with antiepileptic. Later follow ups and work ups supported the diagnosis of temporal lobe epilepsy. Diagnosis after such presentation may be challenging and we tried, in this case, to enhance awareness of such an unusual presentation.
Young patient presenting acute coronary syndrome
Authors: Sungbae Ju, Hee-Sun Mun, Seonghoon Choi, Jung Rae Cho, Namho Lee, Min-Kyung Kang
Journal: J Clin Med Res (2015)
Keywords: acute coronary artery, coronary aneurysm, kawasaki disease
MeSH terms: Case Reports

The clinical presentation of Kawasaki disease (KD) is variable and clinical implication among adults is rarely important but coronary involvement. Here we report a young patient showing recurrent acute coronary syndrome (ACS) who had a history of high-grade fever and conjunctivitis when he was little. Coronary angiography revealed aneurysmal coronary artery change in this patient. There is no particular consensus on guidelines for treatment for KD in case of coronary aneurysm causing ACS. In this case, we treated him medically without stent implantation successfully.
Fusion proteins for treatment of retinal diseases: aflibercept, ziv-aflibercept, and conbercept
Authors: João Rafael de Oliveira Dias, Gabriel Costa de Andrade, Eduardo Amorim Novais, Michel Eid Farah, Eduardo Büchele Rodrigues
Journal: Int J Retina Vitreous (2016)
Keywords: aflibercept, conbercept, fusion proteins, vegf trap eye, vascular endothelial growth factor (vegf), ziv-aflibercept
MeSH terms: Review

In the last few years, monoclonal antibodies have revolutionized the treatment of retinal neovascular diseases. More recently, a different class of drugs, fusion proteins, has provided an alternative treatment strategy with pharmacological differences. In addition to commercially available aflibercept, two other drugs, ziv-aflibercept and conbercept, have been studied in antiangiogenic treatment of ocular diseases. In this scenario, a critical review of the currently available data regarding fusion proteins in ophthalmic diseases may be a timely and important contribution. Aflibercept, previously known as VEGF Trap Eye, is a fusion protein of VEGF receptors 1 and 2 and a treatment for several retinal diseases related to angiogenesis. It has firmly joined ranibizumab and bevacizumab as an important therapeutic option in the management of neovascular AMD-, DME- and RVO-associated macular edema. Ziv-aflibercept, a systemic chemotherapeutic agent approved for the treatment of metastatic colorectal cancer, has recently drawn attention because of its potential for intravitreal administration, since it was not associated with ERG-related signs of toxicity in an experimental study and in human case reports. Conbercept is a soluble receptor decoy that blocks all isoforms of VEGF-A, VEGF-B, VEGF-C, and PlGF, which has a high binding affinity for VEGF and a long half-life in vitreous. It has been studied in a phase three clinical trial and has shown efficacy and safety. This review discusses three fusion proteins that have been studied in ophthalmology, aflibercept, ziv-aflibercept and conbercept, with emphasis on their clinical application for the treatment of retinal diseases.
Pancreatitis and myocarditis followed by pulmonary hemorrhage, a rare presentation of leptospirosis- a case report and literature survey
Authors: Nuwan Ranawaka, Vijayabala Jeevagan, Panduka Karunanayake, Saroj Jayasinghe
Journal: BMC Infect Dis (2013)
MeSH terms: Hemorrhage / etiology, Leptospirosis / complications, Lung Diseases / etiology, Myocarditis / etiology, Pancreatitis / etiology, Case Reports, Adolescent, Hemorrhage / diagnosis, Humans, Lung Diseases / diagnosis, Male, Myocarditis / diagnosis, Pancreatitis / diagnosis

Background:
Leptospirosis is a potentially fatal disease which can cause multi-organ dysfunction. It can rarely present as acute pancreatitis. This is the first ever report of leptospirosis presenting with acute pancreatitis and myocarditis followed by diffuse pulmonary hemorrhages to the best of our knowledge.
Case presentation:
A 15-year-old South Asian boy presented with high grade fever, epigastric discomfort and was anicteric on admission. He developed tachycardia, transient hypotension, changes of electro-cardiogram and positive troponin I suggestive of myocarditis. Acute pancreatitis was diagnosed with 12 fold high serum amylase and with the evidence of computerized tomography. Then he developed diffuse pulmonary hemorrhages and later acute renal failure. Leptospirosis was confirmed by positive leptospira IgM, negative IgG and strongly positive Microscopic Agglutination Test. Other possible infective and autoimmune causes were excluded. Patient recovered completely with antibiotics and the supportive care.
Conclusion:
This case illustrates diagnostic difficulties especially in resource poor settings where leptospirosis is common. Additionally it highlights the fact that leptospirosis should be considered in patients presenting with pancreatitis which can be complicated with myocarditis and diffuse pulmonary hemorrhages. We hypothesize that Toll like receptors may play a role in such systemic involvement.
Retroperitoneal Fat Necrosis in Response to an Episode of Acute Pancreatitis
Authors: M B Gilani, T Akcan, M Peterson, A Zahid
Journal: Case Rep Gastrointest Med (2021)
MeSH terms: Case Reports

Acute pancreatitis can result in fat necrosis, typically occurring in the peripancreatic region within weeks to months, and it generally appears as a low attenuation collection, with minimal heterogeneity. There are no specific imaging features that can diagnose retroperitoneal fat necrosis which may imitate other entities including certain malignancies, which may lead to invasive studies for diagnosis. Herein, we present a case of extensive retroperitoneal fat necrosis beyond the peripancreatic region that developed 10 days after an episode of acute pancreatitis.
Empirical research on Kano's model and customer satisfaction
Authors: Feng-Han Lin, Sang-Bing Tsai, Yu-Cheng Lee, Cheng-Fu Hsiao, Jie Zhou, Jiangtao Wang, Zhiwen Shang
Journal: PLoS One (2017)
MeSH terms: Consumer Behavior, Personal Satisfaction, Adult, Aged, Bicycling, Decision Making, Empirical Research, Female, Humans, Male, Middle Aged, Models, Theoretical, Nigeria, Odds Ratio, Quality of Health Care, Young Adult

Products are now developed based on what customers desire, and thus attractive quality creation has become crucial. In studies on customer satisfaction, methods for analyzing quality attributes and enhancing customer satisfaction have been proposed to facilitate product development. Although substantial studies have performed to assess the impact of the attributes on customer satisfaction, little research has been conducted that quantitatively calculate the odds of customer satisfaction for the Kano classification, fitting a nonlinear relationship between attribute-level performance and customer satisfaction. In the present study, the odds of customer satisfaction were determined to identify the classification of quality attributes, and took customer psychology into account to suggest how decision-makers should prioritize the allocation of resources. A novel method for quantitatively assessing quality attributes was proposed to determine classification criteria and fit the nonlinear relationship between quality attributes and customer satisfaction. Subsequently, a case study was conducted on bicycle user satisfaction to verify the novel method. The concept of customer satisfaction odds was integrated with the value function from prospect theory to understand quality attributes. The results of this study can serve as a reference for product designers to create attractive quality attributes in their products and thus enhance customer satisfaction.