OpenMed/multicare-articles huggingface dataset:
CD8 Positive T Lymphocyte Infiltration of Liver Metastases of Uveal Melanoma: A Case Report
Authors: Naoki Takahashi, Kazuto Tajiri, Ko Kagoyana, Shinichi Tanaka, Ichiro Yasuda
Journal: Front Oncol (2021)
Keywords: cd8 positive t lymphocyte, host immune response, liver metastasis, malignant melanoma, uveal melanoma
MeSH terms: Case Reports

A 78-year-old Japanese man was referred for examination of multiple small nodules on his liver detected by magnetic resonance imaging (MRI). These small nodules were hyperintense on T1-weighted MRI, and were in hepatobiliary phase on gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid enhanced MRI. Five years earlier, he had undergone curative enucleation of his left eye for uveal melanoma. US-guided biopsy revealed that the liver nodules were metastases of melanoma. Pathological examination also showed infiltration of CD8 positive T lymphocytes. The metastatic nodules remained unchanged for more than 2 years and he was not further treated. This pathology and clinical course suggest that the systemic immune response of the host could suppress hepatic metastases of uveal melanoma.
Resection of an intra-operative ruptured hepatocellular carcinoma with continuous pringle maneuver and in situ hypothermic perfusion through the inferior mesenteric vein: a case report
Authors: Yueh-Ming Lin, Li-Wei Chiang, Shih-Ho Wang, Chih-Che Lin, Chao-Long Chen, Carlos A Millan, Chih-Chi Wang
Journal: World J Surg Oncol (2013)
MeSH terms: Carcinoma, Hepatocellular / surgery, Hepatectomy / methods, Intraoperative Complications, Liver / injuries, Liver Neoplasms / surgery, Mesenteric Veins / surgery, Postoperative Hemorrhage / prevention & control, Case Reports, Adult, Catheterization, Humans, Hypothermia, Induced, Male, Perfusion, Prognosis, Recovery of Function, Reperfusion Injury / prevention & control, Rupture, Vascular Surgical Procedures

Intra-operative tumor rupture is a serious complication during resection of large hepatocellular carcinoma (HCC) leading to more blood loss. We report our experience in applying continuous Pringle maneuver with in situ hypothermic perfusion via inferior mesenteric vein catheterization to the portal vein of the remnant liver for resection during an extended left lobectomy of a large HCC which ruptured intraoperatively. Using this method, we successfully managed the patient without any further morbidity. This technique provides easier accessibility of in situ perfusion, decreases operative blood loss and prevents warm ischemic injury to the remnant liver during parenchymal transection. This method could be effective for the resection of large ruptured HCC.
Helicobacter Pylori-Negative MALT Lymphoma: A Series of Two Cases Presenting with Life-Threatening Upper Gastrointestinal Bleeding
Authors: Seo Hyun Kim, Youssef Soliman, Vikas N Chitnavis, Maithili V Chitnavis
Journal: Case Rep Gastrointest Med (2023)
MeSH terms: Case Reports

Mucosa-associated lymphoid tissue (MALT) lymphoma is a common cause of gastric lymphoma. Although most cases are associated with an H. pylori infection, approximately 10% are H. pylori-negative. Patients with gastric MALT lymphoma are usually asymptomatic or present with nonspecific symptoms such as abdominal pain, dyspepsia, weight loss, and occult gastrointestinal bleeding. In this report, we describe two patients with H. pylori-negative MALT lymphoma who both presented with acute upper gastrointestinal bleeding that led to hemodynamic instability. After resuscitation, emergent endoscopy was performed. Both patients had the t (11; 18) (q21; q21) translocation, which prompted direct treatment by radiotherapy.
Giant paratesticular dedifferentiated liposarcoma with intraabdominal extension: a case report
Authors: Muhammad Hasif Azizi, Iqbal Hussain Rizuana, Yin Ping Wong, Khairiyah Sidek, Xeng Inn Fam
Journal: Front Oncol (2023)
Keywords: dedifferentiated liposarcoma, giant liposarcoma, giant paratesticular liposarcoma, laparoscopic, paratesticular tumour, radical orchidectomy, rhabdomyosarcoma, testicular mass
MeSH terms: Case Reports

Giant paratesticular liposarcoma is a rare presentation of paratesticular tumor. We present a case of the largest paratesticular liposarcoma described to date with a weight of 4,100 g and measuring 460 × 210 × 130 mm. It was initially mistaken as an inguinoscrotal hernia until a contrast-enhanced computed tomography (CECT) scan of the abdomen and pelvis revealed a huge left paratesticular tumor extending from the scrotum to the mid-abdomen. The challenge was to achieve a tumor-free margin orchidectomy due to the poor fat plane of the tumor to the external iliac artery, psoas muscle, descending colon, and anterior abdominal wall. The surgery was started with laparoscopic dissection for the intraabdominal part of tumor from the vital structure, then followed by inguinal radical orchidectomy and inguinal mesh repair. Postoperative histopathological report revealed a paratesticular dedifferentiated liposarcoma with rhabdomyosarcomatous differentiation with clear margin. The patient had good recovery post operation.
Successful Treatment of Facial Acne Fulminans: Antimicrobial Agents and Oral Prednisolone as Promising Regimes
Authors: Amir Hossein Siadat, Anis Bostakian, Bahareh Abtahi-Naeini, Masoom Shahbazi
Journal: Case Rep Dermatol Med (2017)
MeSH terms: Case Reports

Acne fulminans (AF), also known as acne maligna, is a rare painful ulcerative form of acne with an abrupt onset and systemic symptoms. Its incidence appears to be decreasing, possibly because of earlier and better treatment of acne. This report highlights a case on a necrotizing facial wound due to AF that was successfully treated with oral prednisolone and antimicrobial medication.
Cases of acute mercury poisoning by mercury vapor exposure during the demolition of a fluorescent lamp factory
Authors: Sang Yoon Do, Chul Gab Lee, Jae Yoon Kim, Young Hoon Moon, Min Sung Kim, In Ho Bae, Han Soo Song
Journal: Ann Occup Environ Med (2017)
Keywords: chloroacne, elemental mercury, fluorescent lamp factory, korea, mercury vapor, occupational exposure, swan neck deformity
MeSH terms: Case Reports

Background:
In 2015, workers dismantling a fluorescent lamp factory in Korea were affected by mercury poisoning from exposure to mercury vapor.
Case presentation:
Eighteen out of the 21 workers who participated in the demolition project presented with symptoms of poisoning and, of these, 10 had persistent symptoms even at 18 months after the initial exposure to mercury vapor. Early symptoms of 18 workers included a general skin rash, pruritus, myalgia, sleep disturbance, and cough and sputum production. Following alleviation of these initial symptoms, late symptoms, such as easy fatigue, insomnia, bad dreams, and anxiety disorder, began to manifest in 10 out of 18 patients. Seven workers underwent psychiatric care owing to sleep disturbance, anxiety disorder, and depression, and three workers underwent dermatologic treatment for hyperpigmentation, erythematous skin eruption, and chloracne-like skin lesions. Furthermore, three workers developed a coarse jerky movement, two had swan neck deformity of the fingers, and two received care at an anesthesiology clinic for paresthesia, such as burning sensation, cold sensation, and pain. Two workers underwent urologic treatment for dysfunction of the urologic system and impotence. However, symptomatic treatment did not result in satisfactory relief of these symptoms.
Conclusion:
Awareness of the perils of mercury and prevention of mercury exposure are critical for preventing health hazards caused by mercury vapor. Chelation therapy should be performed promptly following mercury poisoning to minimize damage.
Adult Onset Still's Disease: A Case Report with a Rare Clinical Manifestation and Pathophysiological Correlations
Authors: Katerina M Antoniou, George A Margaritopoulos, Ioannis Giannarakis, Christianna Choulaki, Nikos Fountoulakis, Nikos M Siafakas, Prodromos Sidiropoulos
Journal: Case Rep Med (2013)

Adult-onset Still's disease is an inflammatory multisystemic disease of unknown etiology. Pleuritis is the most common pulmonary manifestation and pleural effusions are usually exudates with a predominance of neutrophils. We report a case of an eosinophilic pleural effusion as a novel and hitherto unrecognized manifestation of active adult-onset Still's disease. We also observed a marked NLRP3 inflammasome activation with increased production of IL-1β which coincided with the development and resolved upon remission of the pleural effusion suggesting a possible novel pathogenetic pathway for the development of pleural effusions in the context of the auto-inflammatory disorders.
MRI characterisation of adult onset alpha-methylacyl-coA racemase deficiency diagnosed by exome sequencing
Authors: Kristoffer Haugarvoll, Stefan Johansson, Charalampos Tzoulis, Bjørn Ivar Haukanes, Cecilie Bredrup, Gesche Neckelmann, Helge Boman, Per Morten Knappskog, Laurence A Bindoff
Journal: Orphanet J Rare Dis (2013)
MeSH terms: Exome, Magnetic Resonance Imaging / methods, Metabolism, Inborn Errors / diagnosis, Racemases and Epimerases / genetics, Case Reports, Research Support, Non-U.S. Gov't, Adolescent, Adult, Age of Onset, Female, Genes, Recessive, Humans, Metabolism, Inborn Errors / enzymology, Metabolism, Inborn Errors / genetics, Middle Aged, Siblings, Young Adult, Racemases and Epimerases, alpha-methylacyl-CoA racemase

Background:
Correct diagnosis is pivotal to understand and treat neurological disease. Herein, we report the diagnostic work-up utilizing exome sequencing and the characterization of clinical features and brain MRI in two siblings with a complex, adult-onset phenotype; including peripheral neuropathy, epilepsy, relapsing encephalopathy, bilateral thalamic lesions, type 2 diabetes mellitus, cataract, pigmentary retinopathy and tremor.
Methods:
We applied clinical and genealogical investigations, homozygosity mapping and exome sequencing to establish the diagnosis and MRI to characterize the cerebral lesions.
Results:
A recessive genetic defect was suspected in two siblings of healthy, but consanguineous parents. Homozygosity mapping revealed three shared homozygous regions and exome sequencing, revealed a novel homozygous c.367 G>A [p.Asp123Asn] mutation in the α-methylacyl-coA racemase (AMACR) gene in both patients. The genetic diagnosis of α-methylacyl-coA racemase deficiency was confirmed by demonstrating markedly increased pristanic acid levels in blood (169 μmol/L, normal <1.5 μmol/L). MRI studies showed characteristic degeneration of cerebellar afferents and efferents, including the dentatothalamic tract and thalamic lesions in both patients.
Conclusions:
Metabolic diseases presenting late are diagnostically challenging. We show that appropriately applied, homozygosity mapping and exome sequencing can be decisive for establishing diagnoses such as late onset α-methylacyl-coA racemase deficiency, an autosomal recessive peroxisomal disorder with accumulation of pristanic acid. Our study also highlights radiological features that may assist in diagnosis. Early diagnosis is important as patients with this disorder may benefit from restricted dietary phytanic and pristanic acid intake.
Hemophilia presenting as recurrent ocular hemorrhage
Authors: Luis Miguel Aquino, Felice Katrina Ranche
Journal: GMS Ophthalmol Cases (2020)
Keywords: bleeding, hemophilia, ocular hemorrhage, surgery
MeSH terms: Case Reports

Objective: Patients with hereditary bleeding disorders rarely present with intraocular or orbital hemorrhage as the initial symptom. The presence of such a condition can be easily overlooked when contemplating ophthalmic surgery, and can give rise to intraoperative and postoperative complications. Awareness of such conditions can improve surgical decisions. Methods: This is a case report of an eight-year-old Filipino male who sustained blunt trauma to his right eye, causing traumatic total hyphema with corneal staining. Subretinal hemorrhage was seen on ultrasound. The patient underwent anterior chamber washout with temporary keratoprosthesis and pars plana vitrectomy with silicone oil tamponade. Clearance of the hyphema was noted postoperatively. However, on follow-up after 19 days, the patient presented with recurrence of hyphema, new onset proptosis and peribulbar hemorrhage. Results: Imaging of the orbit revealed new-onset pseudoproptosis with intraocular and peribulbar hemorrhage. A bleeding disorder was suspected at this point. Further probing revealed a family history of prolonged bleeding time in an X-linked genetic inheritance pattern spanning three generations. Laboratory testing of prothrombin, partial thromboplastin, and factor assays were done, which revealed factor VIII deficiency, diagnostic of hemophilia A. No further surgery was done. The patient was given transfusions of fresh frozen plasma, which resolved the hemorrhage. Conclusions: Bleeding disorders present a dilemma in the surgical management of patients. In cases of traumatic hemorrhage, adequate history and physical examination should always be done to rule these out. Surgical outcomes in hemophiliacs can be improved with preoperative prophylactic treatment and close postoperative monitoring and care.
A Genetics Pearl for Counseling Patients with Epsilon-Sarcoglycan Myoclonus-Dystonia
Authors: Alissa S Higinbotham, Suzanne D DeBrosse, Camilla W Kilbane
Journal: Tremor Other Hyperkinet Mov (N Y) (2023)
Keywords: myoclonus, dystonia, education, genetic counseling, movement disorders, myoclonus-dystonia
MeSH terms: Dystonic Disorders / diagnosis, Dystonic Disorders / drug therapy, Dystonic Disorders / genetics, Case Reports, Female, Humans, Male, Sarcoglycans / genetics, Sarcoglycans, Myoclonic dystonia

Background:
Epsilon-sarcoglycan (SGCE) myoclonus-dystonia is autosomal dominant (AD) with reduced penetrance due to maternal imprinting 95% of the time. Patients may lack family history delaying diagnosis and treatment. Additionally, counseling patients on their risk of passing on the variant differs for females versus males.
Case report:
A woman in her thirties with typical phenotype of myoclonus-dystonia but lacking an AD pedigree was found to have a pathogenic variant in the SGCE gene. She was counseled that her daughters each have a 2.5% chance of expressing the phenotype.
Discussion:
Understanding the genetics of SGCE-myoclonus-dystonia enables effective genetic counseling and arrival at a timely diagnosis and treatment.
Summary:
In an era of advancing genetic analysis and precision medicine-based treatments, neurologists will be faced with increasing responsibility to properly counsel patients on the results of genetic testing. This case highlights a genetics pearl for counseling patients with epsilon-sarcoglycan myoclonus-dystonia, an autosomal dominant condition with penetrance differing by sex.
Langerhans Cell Histiocytosis Involving the Thymus and Heart With Simultaneous Thymoma: A Case Report
Authors: Ting Ji, Yuxia Zhong, Deyun Cheng
Journal: Front Oncol (2022)
Keywords: 18fdg-pet/ct, langerhans cell histiocytosis, heart, thymoma, thymus
MeSH terms: Case Reports

Langerhans cell histiocytosis (LCH) is a rare disease characterized by clonal expansion of CD1a+/CD207+ cells in lesions. The most frequent sites involved are bone and, less commonly, lymph nodes, lungs, and skin. The thymus or heart is rarely involved with LCH. In this case, we present a 73-year-old woman with a mediastinal mass. Histopathology after thymectomy identified this mass as type AB thymoma; notably, subsequent immunohistochemical tests showed lesions of LCH scattered in the region of thymoma. 18-Fluorodeoxyglucose PET/CT (18-FDG-PET/CT) was performed to make an overall assessment of the extent of this disease, which demonstrated suspicious cardiac involvement of LCH. This report highlights the importance of differentiating abnormalities of the thymus or mediastinal mass from LCH and the necessity of comprehensive evaluation for patients with LCH.
Adult diffuse hepatic hemangiomatosis
Authors: Neha Bhardwaj, Mayur Parkhi, Manish Kumar, Lileswar Kaman, Suvradeep Mitra
Journal: Autops Case Rep (2022)
Keywords: hemangioma, cavernous, liver, pathology, vascular neoplasms
MeSH terms: Case Reports

Diffuse hepatic hemangiomatosis (DHH) is an uncommon vascular lesion, though hemangiomas are the commonest benign tumors of the liver. The etiology is largely unknown to date; however, its association with giant cavernous hemangiomas (GCH) has been reported in the literature. We present herein, the case of a 37-year-old hypothyroid woman with abdominal fullness for 2 months. The contrast-enhanced computed tomography revealed multiple well-encapsulated lesions involving the liver lobes and was diagnosed as giant cavernous hemangiomas. Most of them, except the deep-seated ones, were enucleated. Histopathological examination highlighted the presence of GCH with irregular margin, replacement of hepatic parenchyma, and presence of multiple micro-hemangiomas suggesting the possibility of DHH further substantiated by retrospective radiological assessment. No extrahepatic vascular lesion was noted, and the post-operative recovery and follow-up were uneventful. Adult DHH is an uncommon entity. The diagnosis of DHH and its distinction from GCH are important from the management and prognostic point of view as recurrence, extrahepatic manifestations, features of consumption coagulopathy, and death from the complications are not uncommon.
Paroxysmal epigastric pain 30 years after abdominal trauma surgery-a case report
Authors: Yisheng Zhang, Xin Lu, Yiyao Xu
Journal: Front Surg (2023)
Keywords: choledocholithiasis, duodenal dilatation, epigastric pain, reconstruction, trauma surgery
MeSH terms: Case Reports

A 58-year-old male was admitted to the liver surgery ward of Peking Union Medical College Hospital as the result of recurrent cholangitis in the past six months. Preoperative abdominal CT and gastrointestinal radiography showed duodenal dilatation and reconstruction of gastrointestinal tract, which might be related to the laparotomy and hemostasis performed due to traffic accident 30 years ago. The operative method of that surgery might be the reason for the patient's choledocholithiasis and duodenal dilatation.
Spontaneous Coronary Artery Dissection/Intramural Haematoma in Young Women with ST-Elevation Myocardial Infarction: "It Is Not Always a Plaque Rupture Event"
Authors: George Kassimis, Athanasios Manolis, Jonathan N Townend
Journal: Case Rep Cardiol (2015)

Spontaneous coronary artery dissection (SCAD) is an unusual, but increasingly recognized, cause of ST-elevation myocardial infarction (STEMI), especially among younger patients without conventional risk factors for coronary artery disease (CAD). Although dissection of the coronary intima or media is a hallmark finding, hematoma formation within the vessel wall is often present. It remains unclear whether dissection or hematoma is the primary event, but both may cause luminal stenosis and occlusion. The diagnosis of SCAD is made principally with invasive coronary angiography, although adjunctive intracoronary imaging modalities may increase the diagnostic yield. In STEMI patients, the decision whether to pursue primary percutaneous coronary intervention (PCI) or appropriate conservative medical therapy is based on clinical presentation, the extent of the dissection, the critical anatomy involvement, and the amount of ischaemic myocardium at risk. In this case report, we present two cases of young women with SCAD and STEMI, successfully treated with primary PCI. We briefly illustrate the characteristic aspects of the angiographic presentation and intravascular ultrasound-guided treatment. SCAD should always be considered in young STEMI patients without conventional risk factors for CAD with primary angioplasty to be required in patients with ongoing myocardial ischemia.
Dental extrusion with orthodontic miniscrew anchorage: a case report describing a modified method
Authors: Ricardo Fidos Horliana, Anna Carolina Ratto Tempestini Horliana, Alexandre do Vale Wuo, Flávio Eduardo Guillin Perez, Jorge Abrão
Journal: Case Rep Dent (2015)

In recent years, the skeletal anchorage through miniscrews has expanded the treatment options in orthodontics (Yamaguchi et al., 2012). We hereby present a modified method for tooth extrusion for cases where crown-lengthening surgery is contraindicated for aesthetic reasons. This modified method uses three orthodontic appliances: a mini-implant, an orthodontic wire, and a bracket. The aim of this case report was to increase the length of the clinical crown of a fractured tooth (tooth 23) by means of an orthodontic extrusion with the modified method of Roth and Diedrich.
Priapism in the Newborn: Shall We Intervene?
Authors: Rachida Laamiri, Nahla Kechiche, Mezri Maatouk, Besma Hagui, Walid Mnari, Mongi Mekki, Abdellatif Nouri
Journal: J Neonatal Surg (2017)
Keywords: management, neonatal, priapism
MeSH terms: Case Reports

Idiopathic neonatal priapism is rarely published. We report the case of a newborn presenting with priapism on the first day of life and reviewed the published data on the management and the follow up of this condition.
Migrant and Refugee Impact on Well-Being in Rural Areas: Reframing Rural Development Challenges in Greece
Authors: Apostolos G Papadopoulos, Loukia-Maria Fratsea
Journal: Front Sociol (2021)
Keywords: migrant aspirations, migrants, mobilities, refugees, rural greece, subjective well‐being

The paper aims to exemplify and discuss the changing conditions and challenges posed by the newly arriving populations of migrants and refugees in rural Greece, along with local people's views on the impact of the new arrivals in their rural places. Its main objective is to understand whether migrants and refugees create threats or opportunities for the local population, and whether movers and non-movers have a shared understanding of well-being in their rural areas. The analysis unveils the connections that are emerging between migrants and refugees and the economy, society and culture in rural receiving areas. Thus, the paper aims at showing the complexity of rural migrant flows and how the interactions between migrants, refugees and locals in the light of the well-being of rural areas may inform rural development in Greece. The paper is structured into five main sections following the introduction. The first section contains a discussion of the main concepts used as building blocks for creating a theoretical framing of well-being in rural areas. The second section develops a brief discussion of international and internal migration to rural areas in Greece, as well as providing some contextual information on the impact of the economic crisis and new developments in response to the recession. The third section includes a short presentation of the methodological approach and a description of the case study area. The fourth section is dedicated to an analysis of the narratives of international migrants, refugees, internal migrants, locals and stakeholders. Finally, the concluding section critically discusses the conceptualisations of rurality and well-being between the various population groups and articulates the challenges connected to well-being and mobilities in contemporary rural Greece.