OpenMed/multicare-articles huggingface dataset:
Can the Diagnostics of Triangular Fibrocartilage Complex Lesions Be Improved by MRI-Based Soft-Tissue Reconstruction? An Imaging-Based Workup and Case Presentation
Authors: Niels Hammer, Ulrich Hirschfeld, Hendrik Strunz, Michael Werner, Thomas Wolfskämpf, Sabine Löffler
Journal: Biomed Res Int (2017)
MeSH terms: Image Processing, Computer-Assisted, Magnetic Resonance Imaging / methods, Triangular Fibrocartilage / diagnostic imaging, Triangular Fibrocartilage / pathology, Case Reports, Adult, Aged, 80 and over, Humans, Imaging, Three-Dimensional, Male, Reproducibility of Results, X-Ray Microtomography

Introduction. The triangular fibrocartilage complex (TFCC) provides both mobility and stability of the radiocarpal joint. TFCC lesions are difficult to diagnose due to the complex anatomy. The standard treatment for TFCC lesions is arthroscopy, posing surgery-related risks onto the patients. This feasibility study aimed at developing a workup for soft-tissue reconstruction using clinical imaging, to verify these results in retrospective patient data. Methods. Microcomputed tomography (μ-CT), 3 T magnetic resonance imaging (MRI), and plastination were used to visualize the TFCC in cadaveric specimens applying segmentation-based 3D reconstruction. This approach further trialed the MRI dataset of a patient with minor radiological TFCC alterations but persistent pain. Results. TFCC reconstruction was impossible using μ-CT only but feasible using MRI, resulting in an appreciation of its substructures, as seen in the plastinates. Applying this approach allowed for visualizing a Palmer 2C lesion in a patient, confirming ex postum the arthroscopy findings, being markedly different from MRI (Palmer 1B). Discussion. This preliminary study showed that image-based TFCC reconstruction may help to identify pathologies invisible in standard MRI. The combined approach of μ-CT, MRI, and plastination allowed for a three-dimensional appreciation of the TFCC. Image quality and time expenditure limit the approach's usefulness as a diagnostic tool.
Persistent Upbeat Positional Nystagmus in a Patient with Bilateral Posterior Canal Benign Paroxysmal Positional Vertigo
Authors: Akihide Ichimura, Shigeto Itani
Journal: Case Rep Otolaryngol (2019)
MeSH terms: Case Reports

Here, we report a patient with persistent positional upbeat nystagmus in a straight supine position with no evident abnormal central nervous system findings. A 43-year-old woman with rotatory positional vertigo and nausea visited our clinic 7 days after the onset. Initially, we observed persistent upbeat nystagmus in straight supine position with a latency of 2 s during the supine head roll test. However, an upbeat nystagmus disappeared on turning from straight to the left ear-down supine position, and while turning from the left to right ear-down position, an induced slight torsional nystagmus towards the right for >22 s was observed. In the Dix-Hallpike test, the left head-hanging position provoked torsional nystagmus towards the right for 50 s. In prone seated position, downbeat nystagmus with torsional component towards the left was observed for 45 s. Neurological examination and brain computed tomography revealed no abnormal findings. We speculated that persistent positional upbeat nystagmus in this patient was the result of canalolithiasis of benign paroxysmal positional vertigo of bilateral posterior semicircular canals.
Case Report: Galvanic Vestibular Stimulation in the Chronic Spinal Cord Injury Patient
Authors: Tais Nunes Nascimento, Catarina Costa Boffino
Journal: Front Rehabil Sci (2022)
Keywords: case report, galvanic vestibular stimulation, non-invasive neuromodulation, rehabilitation, spinal cord injury
MeSH terms: Case Reports

The traumatic spinal cord injury can generate sequels with high clinical severity and dysfunction and limitations of irreversible character. Current studies seek to reverse the sequelae and gain functionality in these individuals. Galvanic vestibular stimulation (GVS) has shown to be beneficial in spinal cord function as an evaluation correlated to functionality and for stimulation with physiological and functional characteristics in disease and healthy people. The present study observed the effects of Noise Galvanic Vestibular Stimulation in a patient with chronic spinal cord injury with tetraplegia on postural and trunk control. The evaluations were the Functional Independence Measure (FIM), the American Spinal Injury Association (ASIA) evaluation, and the Clinical Posturography, using force platform to assess postural balance, in the sitting position, through Sensory Organization and Functional Reach Tests. Ten sessions of Noise Galvanic Vestibular Stimulation associated with customized vestibular and neurofunctional rehabilitation were performed. The effects observed were increments in all assessments and tests that include modifications in functional independence, motor and sensory levels, change in disability grade from A (complete) to C (incomplete), and improvements in postural balance and trunk control. The phenomenon of stochastic resonance has shown benefits in postural control in people without vestibular lesions and we could observe some of these phenomena in our patients. We emphasize the need for evaluation with larger populations to observe the phenomena and effects in this group of patients and potential benefits and limitations.
Case Report: Deep Brain Stimulation to the Ventral Internal Capsule/Ventral Striatum Induces Repeated Transient Episodes of Voltage-Dependent Tourette-Like Behaviors
Authors: Joan A Camprodon, Tina Chou, Abigail A Testo, Thilo Deckersbach, Jeremiah M Scharf, Darin D Dougherty
Journal: Front Hum Neurosci (2021)
Keywords: dbs, mdd, pet, tourette syndrome, brain stimulation, neuromodulation

Deep Brain Stimulation (DBS) is an invasive device-based neuromodulation technique that allows the therapeutic direct stimulation of subcortical and deep cortical structures following the surgical placement of stimulating electrodes. DBS is approved by the U.S. Federal Drug Administration for the treatment of movement disorders and obsessive-compulsive disorder, while new indications, including Major Depressive Disorder (MDD), are in experimental development. We report the case of a patient with MDD who received DBS to the ventral internal capsule and ventral striatum bilaterally and presented with 2 weeks of voltage-dependent Tourette-like symptoms including brief transient episodes of abrupt-onset and progressively louder coprolalia and stuttered speech; tic-like motor behavior in his right arm and leg; rushes of anxiety, angry prosody, angry affect; and moderate amnesia without confusion. We describe the results of the inpatient neuropsychiatric workup leading to the diagnosis of iatrogenic voltage-dependent activation of cortico-subcortical circuits and discuss insights into the pathophysiology of Tourette as well as safety considerations raised by the case.
Esophageal Trachea, a Unique Foregut Malformation Requiring Multistage Surgical Reconstruction: Case Report
Authors: Roberto Tambucci, Océane Wautelet, Astrid Haenecour, Geneviève François, Christophe Goubau, Isabelle Scheers, Marin Halut, Renaud Menten, Sandra Schmitz, Caroline de Toeuf, Thierry Pirotte, Beelke D'hondt, Raymond Reding, Alain Poncelet
Journal: Front Pediatr (2020)
Keywords: esophageal malformations, foregut malformations, long-gap esophageal atresia, tracheal malformations, tracheal stenting, tracheomalacia, tracheoplasty
MeSH terms: Case Reports

Abnormal connections between the esophagus and low respiratory tract can result from embryological defects in foregut development. Beyond well-known malformations, including tracheo-esophageal fistula and laryngo-tracheo-esophageal cleft, rarer anomalies have also been reported, including communicating bronchopulmonary foregut malformations and tracheal atresia. Herein, we describe a case of what we have called "esophageal trachea," which, to our knowledge, has yet to be reported. A full-term neonate was born in our institution presenting with a foregut malformation involving both the middle esophagus and the distal trachea, which were found to be longitudinally merged into a common segment, 3 cm in length, located just above the carina and consisted of esophageal tissue without cartilaginous rings. At birth, the esophagus and trachea were surgically separated via right thoracotomy, the common segment kept on the tracheal side only, creating a residual long-gap esophageal atresia. The resulting severe tracheomalacia was treated via simultaneous posterior splinting of such diseased segment using an autologous pericardium patch, as well as by anterior aortopexy. Terminal esophagostomy and gastrostomy were created at that stage due to the long distance between esophageal segments. Between ages 18 and 24 months, the patient underwent native esophageal reconstruction using a multistage traction-and-growth surgical strategy that combined Kimura extra-thoracic esophageal elongations at the upper esophagus and Foker external traction at the distal esophagus. Ten months after esophageal reconstruction, prolonged, refractory, and severe tracheomalacia was further treated via anterior external stenting using a semitubular ringed Gore-Tex® prosthesis, through simultaneous median sternotomy and tracheoscopy. Currently, 2 years after the last surgery, respiratory stabilization, and full oral feeding were stably achieved. Multidisciplinary management was crucial for assuring lifesaving procedures, correctly assessing anatomy, and planning for multiple sequential surgical approaches that aimed to restore long-term respiratory and digestive functions.
Emergence in elderly patient undergoing general anesthesia with xenon
Authors: Maria Sanfilippo, Ahmed Abdelgawwad Wefki Abdelgawwad Shousha, Antonella Paparazzo
Journal: Case Rep Anesthesiol (2013)

Introduction. It is a consensus that the postoperative cognitive function is impaired in elderly patients after general anaesthesia, and such category patient takes more time to recover. Xenon is a noble gas with anesthetic properties mediated by antagonism of N-methyl-D-aspartate receptors. With a minimum alveolar concentration of 0.63, xenon is intended for maintaining hypnosis with 30% oxygen. The fast recovery after xenon anaesthesia was hypothesized to be advantageous in this scenario. Case Presentation. We report the case of 99-year-old woman who underwent sigmoid colon carcinoma resection with colorectal anastomosis. We carried out the induction phase by propofol, oxygen, fentanil, and rocuronium bromide, and then we proceeded to a rapid sequence endotracheal intubation consequently. The patient was monitored by IBP, NIBP, ECG, cardiac frequency, respiratory rate, capnometry, TOF Guard, blood gas analysis, and BIS. For maintenance we administrated oxygen, remifentanil, rocuronium bromide, and xenon gas 60-65%. Shortly after the end of surgery the patients started an autonomous respiratory activity, and a high BIS level was also recorded. Decision was made by our team to proceed into the emergence phase. The residual neuromuscular block was antagonized by sugammadex, modified Aldrete score was implicated, and we got our patient fully awake without any cognitive dysfunction or delirium. Conclusion. The rapid emergence to full orientation in very elderly patient who had been anesthetized by xenon shows concordance to the high BIS values and the clinical signs of the depth of anesthesia.
Pseudoaneurysm of the superior lateral genicular artery: case report of a rare complication after total knee arthroplasty
Authors: Pramod Saini, Sanjay Meena, Rajesh Malhotra, Shivanand Gamanagatti, Vijay Kumar, Vaibhav Jain
Journal: Patient Saf Surg (2013)
Keywords: embolization, genicular artery, pseudo aneurysm, stiff knee, total knee arthroplasty
MeSH terms: Case Reports

Background:
Pseudoaneurysm of superior lateral genicular artery following total knee arthroplasty is a rare complication and has been reported following lateral release performed for eversion of patella in a knee with tight lateral structures.
Case presentation:
This report describes a case of pseudo aneurysm of superior lateral geniculate artery that developed after primary Total knee arthroplasty for a stiff knee in a 68 year old patient. Patient presented with pain and rapidly increasing swelling in early post operative period. Diagnosis was made on duplex ultrasound and confirmed by angiography. Angiographic coil embolisation of the pseudoaneurysm was performed. Since no lateral release was performed in this case, the probable mechanism was shear injury to the vessel.
Conclusion:
Pseudoaneurysm of superior lateral genicular artery can occur in absence of lateral release by shear injury to an atherosclerotic vessel. Angiographic coil embolisation appears to be the best method for treating such post arthroplasty pseudoaneurysm because of less chance of infection, non interference with rehabilitation and diagnosis and treatment during same procedure.
Wharton's Duct Sialolith of Unusual Size: A Case Report with a Review of the Literature
Authors: Nithin Mathew Cherian, Sankar Vinod Vichattu, Ninan Thomas, Aabu Varghese
Journal: Case Rep Dent (2014)

There is an increased incidence of submandibular gland duct developing sialoliths. Among them the sialoliths attaining a size of more than 1.5 cms are rare. Here we present a case with an abnormally sized sialolith in Wharton's duct and a review of the literature about the abnormally sized sialoliths and various anatomical and physiological considerations of the duct which contribute to the higher incidence of sialolith in the duct.
Haploinsufficiency of A20 in a Chinese child caused by loss-of-function mutations in TNFAIP3: A case report and review of the literature
Authors: Jing Liu, Yuese Lin, Xuandi Li, Hongjun Ba, Xiufang He, Huimin Peng, Shujuan Li, Ling Zhu
Journal: Front Pediatr (2023)
Keywords: a20, tnfaip3, autoinflammatory disease, children, haploinsufficiency of a20
MeSH terms: Case Reports

Case presentation:
A 3-year-and-6-month-old child was reported to have recurrent high fever with generalized lymph node enlargement and significant elevation of inflammatory markers such as C-reactive protein and procalcitonin in tests. Later, whole exome sequencing determined that the child's disease was haploinsufficiency of A20 (HA20).
Results:
After immunosuppressive therapy, the child's symptoms improved significantly, and the inflammatory markers dropped to the normal range.
Conclusion:
Because of the characteristics of HA20, this disease is often underdiagnosed and misdiagnosed in clinical practice. By reporting this case of HA20 in a child, we hope to increase the awareness of this disease in the clinic.
Chylothorax from Bilateral Primary Burkitt's Lymphoma of the Ovaries: A Case Report
Authors: A C Etonyeaku, O O Akinsanya, O Ariyibi, A J Aiyeyemi
Journal: Case Rep Obstet Gynecol (2012)

We present a case of bilateral ovarian Burkitt's lymphoma is an 18-year old. Diagnosis was made at histology of specimens obtained after an exploratory (diagnostic) laparotomy. Disease was advanced at presentation and complicated with both chylothorax and chylous ascites. Response to chemotherapy though dramatic was short lived. This underscores the need for high index of suspicion amongst clinicians. The availability of affordable less traumatic diagnostic procedures like laparoscopy and computerized tomography scans with facilities for guided biopsies in resource-poor settings can fast track diagnosis and hence treatment.
Occupational contact dermatitis from protein in sea products: who is the most affected, the fisherman or the chef?
Authors: B Loddé, P Cros, A M Roguedas-Contios, R Pougnet, D Lucas, J D Dewitte, L Misery
Journal: J Occup Med Toxicol (2017)
Keywords: contact dermatitis, maritime, seafood
MeSH terms: Case Reports

Background:
Protein contact dermatitis has frequently been reported in case studies (usually in cases involving contact with seafood products), but there are very few descriptive series. The objectives of this present study were firstly to determine the incidence of protein contact dermatitis among fishermen in France and compare it with data from onshore work involving seafood exposure. Second, to discover what factors could explain any differences. In order to answer these questions we analysed data from the French national occupational disease surveillance and prevention network (RNV3P) and occupational diseases declared to the French National Network for Monitoring and Prevention of Occupational Disease. This retrospective study was done for a 13 year period.
Case presentation:
Between 2000 and 2012, we only found eight cases of protein contact dermatitis in the French network. There were no cases of protein contact dermatitis in the seafaring population. The eight cases from the French network are essentially allergies to different fish and chefs are the professionals most affected. Atopy is present in half of these cases. In the seafaring population we found several cases of allergic delayed-time contact dermatitis due to bryozoans and to gloves but no protein contact dermatitis.
Conclusions:
Chefs who have to cook seafood are more at risk of occupational protein contact dermatitis than fishermen. We think that skin protection (that is to say glove wearing) is better implemented in the fishing sector than in the catering profession on shore in France.
Upper Extremity Compartment Syndrome in a Patient with Acute Gout Attack but without Trauma or Other Typical Causes
Authors: John G Skedros, James S Smith, Marshall K Henrie, Ethan D Finlinson, Joel D Trachtenberg
Journal: Case Rep Orthop (2018)
MeSH terms: Case Reports

We report the case of a 30-year-old Polynesian male with a severe gout flare of multiple joints and simultaneous acute compartment syndrome (ACS) of his right forearm and hand without trauma or other typical causes. He had a long history of gout flares, but none were known to be associated with compartment syndrome. He also had concurrent infections in his right elbow joint and olecranon bursa. A few days prior to this episode of ACS, high pain and swelling occurred in his right upper extremity after a minimal workout with light weights. A similar episode occurred seven months prior and was attributed to a gout flare. Unlike past flares that resolved with colchicine and/or anti-inflammatory medications, his current upper extremity pain/swelling worsened and became severe. Hand and forearm fasciotomies were performed. Workup included general medicine, rheumatology and infectious disease consultations, myriad blood tests, and imaging studies including Doppler ultrasound and CT angiography. Additional clinical history suggested that he had previously unrecognized recurrent exertional compartment syndrome that led to the episode of ACS reported here. Chronic exertional compartment syndrome (CECS) presents a difficult diagnosis when presented with multiple symptoms concurrently. This case provides an example of one such diagnosis.
Management of Acute Wilsonian Hepatitis with Severe Hemolysis: A Successful Combination of Chelation and MARS Dialysis
Authors: Jeremy Hassoun, Nathalie Hammer, Giulia Magini, Belen Ponte, Marie Ongaro, Anne-Laure Rougemont, Nicolas Goossens, Jean-Louis Frossard, Laurent Spahr
Journal: Case Reports Hepatol (2021)
MeSH terms: Case Reports

Wilson's disease is a rare hereditary disorder of copper metabolism leading to progressive accumulation of copper in several organs including the brain and the liver. Acute liver failure is a relatively rare hepatic manifestation of WD which may require urgent liver transplantation if medical treatment fails. We report here the case of a young woman who presented with classic acute Wilsonian hepatitis complicated by liver and renal failure and a severe hemolysis related to massive nonceruloplasmin bound copper accumulation requiring repeated blood transfusions. The early initiation of a combined treatment including conventional chelation therapy and repeated MARS dialysis sessions allowed a rapid control of hemolysis, a progressive decrease of free copper overload, and clinical recompensation without liver transplantation.
Case Report: Unusual Cause of Chest Pain: A Multi-Image Assessment of a Cardiac Mass
Authors: Javier Serrano-Roman, Santiago Saenz-Ancira, Jose C Armendariz-Ferrari, Valente Fernandez-Badillo, Enrique Solorzano-Pinot, Adrian Espejel-Guzman, Joaquin Berarducci, Alberto Aranda-Fraustro, Mauricio Garcia-Cardenas, Nilda Espinola-Zavaleta
Journal: Front Cardiovasc Med (2022)
Keywords: computed tomography angiography, echocardiography, myxoma, neovascularization, tumor
MeSH terms: Case Reports

Myxomas represent the most common benign primary cardiac tumor, they usually grow out of the interatrial septum into the left atrium with a pedunculated base. Intracardiac masses can be found incidentally on imaging studies, but symptomatology may arise secondary to the mass effect, embolization, and valvular function impairment. We present the case of a 75-year-old woman who arrived at the emergency department with atrial fibrillation and NSTEMI segment elevation myocardial infarction (NSTEMI) secondary to a highly vascularized neoplasm visible by coronary angiography and angiotomography. Scarce reports show high quality multi-imaging assessment of significantly vascularized myxomas with such atypical presentation. High-definition imaging studies played a fundamental role in the surgeon's management of a mass with a complex neovascularization.
Rectus abdominis muscle transplant for repair of abdominal wall defects required for cancer resections: Case report
Authors: Paul H Sugarbaker
Journal: Int J Surg Case Rep (2019)
Keywords: appendiceal cancer, hernia mesh, laparoscopy port site, muscle transplant, ovarian cancer, tumor cell entrapment

Background:
Cancer cells from peritoneal metastases may gain access to tissues of the abdominal wall. If laparotomy or laparoscopy is performed in a patient with peritoneal metastases, the abdominal incision or trochar sites may become seeded by cancer cells. Progression of disease may require resection if cancer at other sites can be controlled.
Methods:
Metastases in an appendectomy incision occurred from peritoneal metastases of an appendiceal mucinous adenocarcinoma. The clinical features and treatment strategy of this condition in a single patient was studied.
Results:
In this patient, cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) was used to eradicate the peritoneal metastases. The cancer isolated within the appendectomy site was resected leaving a large abdominal wall defect. The defect was closed by a rectus abdominis muscle flap dissected from the contralateral side of the abdominal wall. No mesh was required.
Conclusions:
Abdominal wall defects from resection of cancerous masses of the abdominal wall can be closed with a contralateral rectus abdominis muscle transplant in the absence of mesh.