OpenMed/multicare-articles huggingface dataset:
Increase of IL-12 following reconstruction for total en bloc spondylectomy using frozen autografts treated with liquid nitrogen
Authors: Hideki Murakami, Satoru Demura, Satoshi Kato, Hideji Nishida, Katsuhito Yoshioka, Hiroyuki Hayashi, Kei Inoue, Takashi Ota, Kazuya Shinmura, Noriaki Yokogawa, Xiang Fang, Hiroyuki Tsuchiya
Journal: PLoS One (2013)
MeSH terms: Bone Transplantation / methods, Interleukin-12 / metabolism, Plastic Surgery Procedures / methods, Spinal Neoplasms / surgery, Case Reports, Research Support, Non-U.S. Gov't, Adolescent, Adult, Aged, Cryopreservation / methods, Female, Fibula / transplantation, Follow-Up Studies, Humans, Ilium / transplantation, Lumbar Vertebrae / surgery, Male, Middle Aged, Nitrogen, Sacrum / surgery, Spinal Neoplasms / metabolism, Spinal Neoplasms / secondary, Transplantation, Autologous, Treatment Outcome, Young Adult, Interleukin-12, Nitrogen

Background:
Total en bloc spondylectomy (TES) is a surgery designed to achieve complete resection of a malignant spinal tumor such as spinal metastasis. Although this procedure decreases the rate of local recurrence, it is questionable whether local control prolongs patient's survival. We developed a "second-generation TES" that brings about TES enhancing antitumor immunity to prolong patient's survival. Our purpose is to present a second-generation TES applied tumor-induced cryoimmunology and assess the immunity-enhancing effect after implementing this surgery.
Methods:
We performed a retrospective review of prospectively collected data in second-generation TES as carried out in 56 cases. In second-generation TES, instead of harvesting autograft from the ilium or fibula, the resected lamina and vertebral body from TES are frozen using liquid nitrogen and used as grafted bone for spinal reconstruction. In recent 26 of the 56 cases, in addition to the TES procedure, a small amount of the tumor tissue from the resected tumor-bearing vertebra was also placed into liquid nitrogen. This small amount of tumor tissue was then implanted subcutaneously on one side of the axilla. In 52 of 56 cases, measurement of interleukin 12 (IL-12) was performed before surgery and at both 1 and 3 months after surgery.
Results:
IL-12 increased after TES surgery in 38 of 52 cases (73.1%). The mean IL-12 relative concentrations at both 1 and 3 months after surgery, as compared to before surgery, were significantly higher (121±89 and 149±111%: P<0.05 and P<0.01).
Conclusions:
Our results show that second-generation TES may provide not only a local radical cure but also a systemic immunological enhancement. Further prolonged survival in patients with a malignant spinal tumor is promising by second-generation TES.
Childhood Hypopigmented Mycosis Fungoides: A Rare Diagnosis
Authors: Cláudia Patraquim, Maria Miguel Gomes, Carla Garcez, Filipa Leite, Tereza Oliva, António Santos, Armando Pinto
Journal: Case Rep Pediatr (2016)
MeSH terms: Case Reports

Primary cutaneous lymphomas (PCL) are rare in pediatrics. Mycosis fungoides (MF) is the most frequent PCL diagnosed in childhood. There are various clinical variants of MF, including the hypopigmented MF (HMF). We present a 5-year-old boy with an 18-month history of progressive, generalized, nonpruritic hypopigmented lesions with central lacy erythema. He had no improvement with emollients. Skin biopsy showed typical features of HMF. He was treated with topical corticosteroids and tacrolimus and narrow-band ultraviolet B (NBUVB) phototherapy, with good response. HMF may mimic multiple skin disorders. Unusual hypopigmented skin lesions should be biopsied. Though phototherapy is effective, recurrence is common.
Pediatric Orbital Floor Reconstruction Using a Nonresorbable Polypropylene-Based Hernia Mesh: A Case Report
Authors: Gauri Sharma, Deepankar Shukla, Nitin D Bhola, Rozina Vishnani
Journal: Cureus (2023)
Keywords: orbit, orbital floor fracture, orbital fracture, pediatric trauma, white eyed
MeSH terms: Case Reports

Orbital floor fracture is the most common type of orbit-related injury seen in pediatric age groups. It is also called a white-eyed blowout fracture when the usual signs of orbital fracture-periorbital edema, ecchymosis, and subconjunctival hemorrhage are absent. Several materials are used for orbital defect reconstruction. The most popular and widely used material is titanium mesh. We present a case of a 10-year-old boy with a white-eyed blowout fracture of the floor of the orbit of the left side. The patient had a history of trauma, after which he developed diplopia in the left eye. On examination, his upward gaze was restricted in the left eye, which was suggestive of inferior rectus muscle entrapment. The orbital floor reconstruction was done using a hernia mesh made up of nonresorbable polypropylene material. This case demonstrates the utility of nonresorbable materials in orbital defect reconstruction in pediatric patients. Further studies are needed to better understand the scope of polypropylene-based materials in the floor of orbit reconstruction and their benefits and shortcomings in the long run.
Babesia in a Nonsplenectomized Patient Requiring Exchange Transfusion
Authors: Dikshya Sharma, Bindu Mudduluru, Elias Moussaly, Neville Mobarakai, Matthew Hurford
Journal: Case Rep Infect Dis (2015)

Babesiosis is a tick born zoonosis caused by red blood cell parasites of the genus Babesia. It is caused predominantly by B. microti and B. divergens, microti being more common in the US. The parasites are transmitted by Ixodes tick to their host but infection can also spread by blood transfusion and perinatally. Clinical manifestations vary from subclinical infection to fulminating disease depending upon the immune status of the patient. About half of patients, hospitalized with babesiosis, develop complication with fatality rates of 6 to 9% which increase up to 21% among those with immunosuppression. A case of 58-year-old previously healthy man, infected by B. microti, was reported on 2000 who presented with severe disease characterized by severe anemia, DIC, and renal and respiratory failure. First case of overwhelming septic shock without respiratory involvement due to babesiosis in a healthy patient with an intact spleen was published in a case report on 2011. Since our patient here is an immunocompetent healthy male with intact spleen presenting with severe babesiosis requiring exchange transfusion, this presentation of Babesia is rare and warrants further study.
Leveraging investments in Ebola preparedness for COVID-19 in Sub-Saharan Africa
Authors: Rodgers Ayebare, Peter Waitt, Stephen Okello, Mubaraka Kayiira, Maureen Atim Ajok, Irene Nakatudde, Nahid Bhadelia, Mohammed Lamorde
Journal: AAS Open Res (2020)
Keywords: covid-19 preparedness, coronavirus, ebola, sars-cov-2

The emergence of SARS-CoV-2 in China and transmission to more than 80 territories worldwide, including nine countries in Africa, presents a delicate situation for low-resource settings. Countries in Eastern and Central Africa have been on high alert since mid-2018 in anticipation of regional spread of the Ebola virus from the Democratic Republic of Congo. Significant investment has been made to support enhanced surveillance at point of entry and hospitals, infection control practices, clinical case management, and clinical research. With a new threat on the horizon, African countries have an opportunity to leverage the existing capacities for Ebola preparedness to brace for the imminent threat.
Prolonged airway obstruction after posterior occipitocervical fusion: a case report and literature review
Authors: Masahiro Morita, Masuhiro Nobuta, Hirotsune Naruse, Hiroaki Nakamura
Journal: Adv Orthop (2011)
MeSH terms: Case Reports

The purpose of this paper was to inform the reader that prolonged upper airway obstruction after posterior cervical spine surgery is a possible complication for patients with metastatic tumor of upper cervical spine. A 49-year-old man presented severe neck pain during posture changes due to metastatic spinal tumor of C2. Occipitocervical fusion following removal of the posterior arch of C1 and laminectomy of C2 via the single posterior approach was performed 2 weeks after radiation therapy. After the surgery, life-threatening airway obstruction due to pharyngeal oedema occurred immediately after extubation that required emergency tracheostomy. The airway obstruction did not improve well during the patient's postoperative course. Once pharyngeal oedema occurs in patients with metastatic tumor of upper cervical spine who undergo posterior cervical spine surgery following radiation therapy to the neck, the pharyngeal oedema may be constant for a long period of time.
Omphalocele with intra abdominal anomalies
Authors: Muataz A Al Ani, Safira A Ali Khan
Journal: J Neonatal Surg (2014)
Keywords: duplication cyst, multicystic kidney, omphalocele
MeSH terms: Case Reports

Abdominal wall defects are associated with other intra-abdominal anomalies. We report two neonates with omphalocele associated with intra-abdominal anomalies. One neonate had multicystic kidney. Other neonate had duplication cyst of ileum which was missed during initial closure in neonatal life.
Angiosarcoma of the nasal cavity: a case report
Authors: José Luis Treviño-González, Ramiro Santos-Lartigue, Baltazar González-Andrade, Vicente J Villagomez-Ortiz, Mario Villegas, Erving Mario Venegas-García
Journal: Cases J (2009)

Angiosarcomas are malignant neoplasias of rapid growth that develop from endothelial cells. They represent 2% of all sarcomas and only 1-4% are located in the aerodigestive tract. Since 1977, only 16 cases have been reported.We present a 33-year-old male with spontaneous epistaxis that was refractory to cauterization. During physical examination, a smooth purplish tumor of 1.5 cm x 1.5 cm was identified. A CT scan showed a nonenhanced tumor in the left nostril on the uncinate process. A biopsy revealed an intermediate-grade angiosarcoma. Surgical removal followed by radiation therapy was performed with good result. Aerodigestive angiosarcomas have a better prognosis than angiosarcomas of other locations due to better cell differentiation and the presence of early symptoms. Recurrence can occur because of tumor tissue left during resection. Our patient continues tumor free after three years.
Cervical carcinoma in the setting of uterovaginal prolapse: comparing standard versus tailored management
Authors: Ryan M Kahn, Sushmita Gordhandas, Kiersten Craig, Tanaka J Dune, Kevin Holcomb, Eloise Chapman-Davis, Melissa K Frey
Journal: Ecancermedicalscience (2020)
Keywords: pd-l1, cervical cancer, procidentia, uterovaginal prolapse
MeSH terms: Case Reports

Objectives:
Cervical cancer in the setting of uterovaginal prolapse is exceedingly rare. Altered anatomy can complicate treatment of underlying cancer. We first present a rare case of cervical cancer with invasion of uterovaginal prolapse as well as a systematic review of similar reported cases in the literature. The objective of this study was to compare the practice patterns and outcomes regarding cervical cancer with invasion of procidentia.
Methods:
We conducted a systematic search of online databases (PubMed, Embase, Medline and the Cochrane Library) from 1990 to 2018 of all the cases of cervical cancer associated with stage III-IV uterovaginal prolapse. Patient demographics, pathology, surgical management, chemotherapy, radiation and disease-free survival were compared.
Results:
Fifteen reported cases of cervical cancer in the setting of procidentia were identified (squamous cell carcinoma-14, clear cell carcinoma-1). The mean age at diagnosis was 74 years (range 54-89). Thirteen percent (n = 2) of cases presented with FIGO stage I disease, 67% (n = 10) with stage II, and 20% (n = 3) with stage III. All cases had stage III-IV uterovaginal prolapse. 73% (11) were treated surgically including nine patients who underwent vaginal hysterectomy. Among patients who underwent primary surgery, 7% (1) received adjuvant chemotherapy, 33% (5) adjuvant radiotherapy and 21% (3) both adjuvant chemotherapy and radiation. 33% (5) of surgical cases included procedures to address the pelvic organ prolapse (colpoclesis (n = 3), uterosacral suspension (n = 1) and anterior posterior repair (n = 1)). Two patients died from the disease within 12 months, one patient died from other causes within 1 month, and the remainder of patients were free of disease at last reported follow-up (Table 1).
Conclusions:
Cervical cancer in the setting of stage III-IV uterovaginal prolapse can be managed successfully with standard treatment strategies (primary surgery with adjuvant therapy as necessary versus chemoradiation). When patients are surgical candidates, techniques to address the underlying prolapse can be used for symptomatic improvement.
Reconstruction of Gustilo type IIIC tibial open fracture caused by shotgun injury using combination Masquelet technique and cross-leg pedicle flap
Authors: Chun-Yen Chen, Yung-Cheng Chiu, Cheng-En Hsu
Journal: Int J Surg Case Rep (2020)
Keywords: cross-leg pedicle flap, masquelet technique, open proximal tibial fracture, shotgun injury
MeSH terms: Case Reports

Introduction:
The shotgun injury may cause large-scale bone and soft tissue destruction especially when people get shot from a very close range. Here we present a case of Gustilo type IIIC open fractures of the proximal tibia with vascular injury, large bone and soft tissue defect treated with Masquelet technique in combination with cross-leg pedicle flap.
Presentation of case:
A 34-year-old man presented with open proximal tibial fracture of Gustilo type IIIC, AO/OTA (Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association) classification 41-C2.3, caused by a shotgun injury from very close range (2 m). The wound was complicated with anterior tibial artery injury and segmental bone loss. After radical debridement, the fracture was temporarily stabilized with external fixator, followed by double plate fixation with cement spacer filled into the bone defect in accordance with the Masquelet technique. The soft tissue defect was covered with a cross-leg pedicle flap. At 3 months after trauma, the cement spacer was replaced by mixed autologous and synthetic bone graft. The fracture had successfully healed by 12 months after trauma.
Discussion:
When the integrity of lower leg vessels is doubtful, the Masquelet technique in combination with cross-leg pedicle flap is an effective and safe alternative treatment for this condition.
Conclusion:
We recommend to manage Gustilo type IIIC open fractures of the proximal tibia with bone defect with Masquelet technique in combination with cross-leg pedicle flap especially when the free flap technique is relatively contraindicated or trauma surgeon is not a highly-skilled microsurgeon.
Frosted Branch Angiitis Secondary to Familial Mediterranean Fever Resembling Central Retinal Vein Occlusion
Authors: Serdar Ozates, Pınar Çakar Ozdal, Mehmet Yasin Teke
Journal: Case Rep Ophthalmol Med (2016)

Purpose. To report a case of unilateral frosted branch angiitis (FBA) resembling central retinal vein occlusion associated with Familial Mediterranean Fever (FMF). Case Report. A 32-year-old woman presented with progressive, painless vision loss in her left eye lasting for 2 days. She was clinically diagnosed with FMF 2 months ago. The best-corrected visual acuity (BCVA) was 20/20 in her right eye and there was light perception in the left. Ophthalmologic examination revealed severe retinal vasculitis showing clinical features of FBA in the left eye. 64 mg/day oral methylprednisolone was started. A significant improvement in retinal vasculitis was observed in two weeks. However, BCVA did not increase significantly due to subhyaloid premacular hemorrhage. Argon laser posterior hyaloidotomy was performed. One week after hyaloidotomy, visual acuity improved to 20/20 and intravitreal hemorrhage disappeared. Four months after the first attack, FBA recurred. Oral methylprednisolone dosage was increased to 64 mg/day and combined with azathioprine 150 mg. At the end of 12-month follow-up, the BCVA was 20/25 and development of epiretinal membrane was observed in the left eye. Conclusions. Frosted branch angiitis may occur with gene abnormalities as an underlying condition. Our case showed that FMF might be a causative disease.
Perioperative Management of a Patient Taking Suboxone® at the Time of Ambulatory Surgery
Authors: Shawn H Malan, Christopher H Bailey, Narjeet Khurmi
Journal: Case Rep Anesthesiol (2020)
MeSH terms: Case Reports

In 2016, more than 11 million people reported misuse of opioids in the previous year. In an effort to combat opioid use disorder (OUD), the use of agonist/antagonist is becoming increasingly common, with more than 2.2 million patients reporting use of a buprenorphine containing medication such as Suboxone®. Buprenorphine is a unique opioid which acts as a partial μ agonist and ĸ antagonist. These properties make it an effective tool in treating OUD and abuse. However, despite its advantages in treating OUD and abuse, buprenorphine can make it difficult to control acute perioperative pain. We present a case in which the Mayo Clinic Arizona protocol for patients undergoing minimally invasive ambulatory surgery while taking Suboxone® is successfully executed, resulting in adequate postoperative pain control and timely discharge from the postanesthesia recovery unit.
Flecainide-Induced Brugada Syndrome in a Patient With Skeletal Muscle Sodium Channelopathy: A Case Report With Critical Therapeutical Implications and Review of the Literature
Authors: Michele Cavalli, Barbara Fossati, Raffaele Vitale, Elisa Brigonzi, Vito A G Ricigliano, Lorenzo Saraceno, Rosanna Cardani, Carlo Pappone, Giovanni Meola
Journal: Front Neurol (2018)
Keywords: brugada syndrome, scn4a, flecainide, mexiletine, sodium skeletal muscle channelopathy
MeSH terms: Case Reports

Skeletal muscle sodium channelopathies are a group of neuromuscular disorders associated with mutations in the SCN4A gene. Because principal sodium channel isoforms expressed in the skeletal muscles and the heart are distinct one from the other, this condition usually spares cardiac functioning. Nonetheless, evidence on a possible link between skeletal muscle and cardiac sodium channelopathies has emerged in recent years. To date, eight patients bearing pathogenetic mutations in the SCN4A gene and manifesting cardiac electrophysiological alterations have been reported in literature. Among these patients, three presented a phenotype compatible with Brugada syndrome. We report the case of a 29-year-old patient affected by non-dystrophic myotonia associated with a p.G1306E mutation in the SCN4A gene, who presented symptoms of syncope and palpitation after the introduction of flecainide as an anti-myotonic agent. ECG and ajmaline challenge were consistent with the diagnosis of Brugada syndrome, leading to the implantation of a cardioverter defibrillator. No mutation in causative genes for Brugada syndrome was detected. Mexiletine treatment reduced myotonia without any cardiac adverse events. This case report highlights the clinical relevance of the recognition of cardiac electrophysiological alterations in skeletal muscle sodium channelopathies. The discovery of a possible pathogenetic linkage between skeletal muscle and cardiac sodium channelopathies may have significant implications in patients' management, also in light of the fact that class 1C anti-arrhythmics are potential triggers for life-threatening arrhythmias in patients with Brugada syndrome.
Efficacy and Safety of Mepolizumab (Anti-Interleukin-5) Treatment in Gleich's Syndrome
Authors: Andrea Matucci, Francesco Liotta, Emanuele Vivarelli, Laura Dies, Francesco Annunziato, Marie Pierre Piccinni, Francesca Nencini, Sara Pratesi, Enrico Maggi, Alessandra Vultaggio
Journal: Front Immunol (2018)
Keywords: gleich’s syndrome, angioedema, anti-interleukin-5, biological agents, hypereosinophilia, mepolizumab
MeSH terms: Angioedema / drug therapy, Antibodies, Monoclonal, Humanized / administration & dosage, Fever / drug therapy, Hypereosinophilic Syndrome / drug therapy, Case Reports, Adult, Angioedema / blood, Angioedema / immunology, Angioedema / pathology, Antibodies, Monoclonal, Humanized / adverse effects, Fever / blood, Fever / immunology, Fever / pathology, Humans, Hypereosinophilic Syndrome / blood, Hypereosinophilic Syndrome / immunology, Hypereosinophilic Syndrome / pathology, Immunoglobulin M / blood, Immunoglobulin M / immunology, Interleukin-5 / antagonists & inhibitors, Interleukin-5 / blood, Interleukin-5 / immunology, Leukocyte Count, Male, Antibodies, Monoclonal, Humanized, IL5 protein, human, Immunoglobulin M, Interleukin-5, mepolizumab

Gleich's syndrome (GS) is characterized by recurrent episodes of angioedema, increase in body weight, fever, hypereosinophilia, and elevated serum IgM. The exact etiology remains unclear. Currently, the only treatment strategy is the administration of high dose of steroids during the acute phases. We report the case of a 37-year-old man suffering from GS with recurrent episodes of angioedema, fever, hypereosinophilia [6,000/mm3 (45%)], and high eosinophil cationic protein (ECP) (>200 μg/l), treated with oral steroids during the acute phase (prednisone 50-75 mg/day), the dose of maintenance being 25 mg/day. No monoclonal components were identified, and genetic tests exclude mutations including Bcr/Abl, JAK2 V617F, c-KIT D816V, and FIP1L1-PDGFRA. Using Luminex technology, we observed higher serum levels of interleukin (IL)-5, CCL2, and CCL11 during the acute exacerbations in comparison with the clinical remission phases though CCL11 did not achieve statistical significance. The flow-cytometric analysis identified a CD3+ CD8- lymphocyte population with high frequency of IL-4-, IL-5-, and IL-13-producing cells. No clinical benefit was observed after therapeutic strategies with imatinib, interferon-α, cyclosporine-A, and azathioprine. Due to high IL-5 serum levels, an intravenous treatment with anti-IL-5 monoclonal antibody mepolizumab (750 mg every 4 weeks) was started. A reduction in the rate of exacerbation phases/year (10 ± 3 vs 2 ± 1; p < 0.005), in the eosinophils count both in percentage (28.8 ± 12.8 vs 9.8 ± 3.9; p < 0.001) and absolute value (2,737 ± 1,946 vs 782 ± 333; p < 0.001) were observed as well as the ECP serum levels (132.7 ± 62.7 vs 21 ± 14.2 μg/l; p < 0.05). The daily dose of prednisone was significantly reduced (25 vs 7.5 mg). Any adverse effects were recorded. To the best of our knowledge, this case is the first report of the disease successfully treated with mepolizumab, and it could represent a novel therapeutic strategy in GS.