OpenMed/multicare-articles huggingface dataset:
Surgical Treatment for Malunion of the Lateral Humeral Epicondyle with Posterior Subluxation of the Radial Head: A Case Report and Literature Review
Authors: Koichi Yano, Yasunori Kaneshiro, Hideki Sakanaka
Journal: Case Rep Orthop (2018)
MeSH terms: Case Reports

A 24-year-old right-handed man suffered right olecranon and lateral epicondylar fracture from high energy trauma. Fixation of olecranon was performed by a previous doctor. Three months after operation, he presented with limited range of motion (ROM) of the right elbow caused by malunion of the lateral epicondylar fracture and subluxation of the radiohumeral joint. Preoperative ROM of the right elbow was flexion 110° and extension -75°. Forearm rotation was pronation 85° and supination 65°. Fragment excision of the lateral epicondyle, which was 27 mm in length, and lateral collateral ligament repair using anchors were performed. Fourteen months postoperatively, contracture release of the elbow was performed. Twenty-four months postoperatively, radiograph of the elbow showed normal congruence without osteoarthritic changes and the ROM of the right elbow was flexion 120° and extension -35°. Forearm rotation was pronation 90° and supination 70°. In the surgical setting, in case of the size of the lateral epicondylar fragment is relatively large, the fragment should be fixed or lateral collateral ligament should be repaired when the instability of the elbow is found.
Effects of field parameters on IMRT plan quality for gynecological cancer: a case study
Authors: Albert Y C Fung, Charles A Enke, Komanduri M Ayyangar, Robert B Thompson, Weining Zhen, Natarajan V Raman, David Djajaputra, Sicong Li, Ramasamy M Nehru, Sushakumari Pillai, Paul Sourivong, Mary Headley, Ann L Yager
Journal: J Appl Clin Med Phys (2005)
MeSH terms: Adenocarcinoma / diagnostic imaging, Adenocarcinoma / radiotherapy, Endometrial Neoplasms / diagnostic imaging, Endometrial Neoplasms / radiotherapy, Quality Assurance, Health Care / methods, Radiometry / methods, Radiotherapy Planning, Computer-Assisted / methods, Body Burden, Female, Genital Neoplasms, Female / diagnostic imaging, Genital Neoplasms, Female / radiotherapy, Humans, Middle Aged, Radiography, Radiotherapy Dosage, Relative Biological Effectiveness, Reproducibility of Results, Sensitivity and Specificity, Treatment Outcome

Traditional external beam radiotherapy of gynecological cancer consists of a 3D, four-field-box technique. The radiation treatment area is a large region of normal tissue, with greater inhomogeneity over the treatment volume, which could benefit more with intensity-modulated radiation therapy (IMRT). This is a case report of IMRT planning for a patient with endometrial cancer. The planning target volume (PTV) spanned the intrapelvic and periaortic lymph nodes to a 33-cm length. Planning and treatment were accomplished using double isocenters. The IMRT plan was compared with a 3D plan, and the effects of field parameters were studied. Delineated anatomical contours included the intrapelvic nodes (PTV), bone marrow, small bowel, bladder, rectum, sigmoid colon, periaortic nodes (PTV), spinal cord, left kidney, right kidney, large bowel, liver, and tissue (excluding the PTVs). Comparisons were made between IMRT and 3D plans, 23-MV and 6-MV energies, zero and rotated collimator angles, different numbers of segments, and opposite gantry angle configurations. The plans were evaluated based on dosevolume histograms (DVHs). Compared with the 3D plan, the IMRT plan had superior dose conformity and spared the bladder and sigmoid colon embedded in the intrapelvic nodes. The higher energy (23 MV) reduced the dose to most critical organs and delivered less integral dose. Zero collimator angles resulted in a better plan than "optimized" collimator angles, with lower dose to most of the normal structures. The number of segments did not have much effect on isodose distribution, but a reasonable number of segments was necessary to keep treatment time from being prohibitively long. Gantry angles, when evenly spaced, had no noticeable effect on the plan. The patient tolerated the treatment well, and the initial complete blood count was favorable. Our results indicated that large-volume tumor sites may also benefit from precise conformal delivery of IMRT.
Rectus Abdominis Endometrioma after Caesarean Section
Authors: Igor Mishin, Anna Mishina, Sergiu Zaharia, Gheorghe Zastavnitsky
Journal: Case Rep Surg (2016)

Isolated rectus abdominis muscle endometriosis is very uncommon with less than 20 case reports being published to date since its first description in 1984 by Amato and Levitt. We report another case of isolated rectus abdominis endometriosis in a 37-year-old patient with a previous caesarian section. We also discuss the diagnostic and treatment particularities in these patients. In our case, the treatment was only surgical and currently the patient is disease-free during the 24-month follow-up.
Successful Treatment of Opioid Dependence with Flexible Doses of Injectable Prolonged Release Buprenorphine
Authors: Oscar D'Agnone
Journal: Case Rep Psychiatry (2019)
MeSH terms: Case Reports

Opioid dependence (OD) may be effectively treated with well-evidenced regimens including psychosocial and pharmacotherapeutic interventions. Treatment has benefits but also limitations including risk of diversion, impact of mandatory daily supervision, and stigma. An injectable prolonged release buprenorphine with flexible dose options has recently been approved by the European Commission and is available in the UK and other European Countries. Initial positive treatment experience in patients with different clinical scenarios (patients with no recent treatment history, a transfer from oral methadone, and change from sublingual buprenorphine tablets) provides evidence of the potential benefit in a range of situations for this therapeutic option. Adoption of the injectable form was clinically successful with no withdrawal signs, nor evidence of use of other drugs. Patient reported outcomes were positive including reduction in cravings and anxiety and improved attitude, relationships, and general mood.
Checks and Balances in Autoimmune Vasculitis
Authors: Rebeca Hid Cadena, Wayel H Abdulahad, G A P Hospers, T T Wind, Annemieke M H Boots, Peter Heeringa, Elisabeth Brouwer
Journal: Front Immunol (2018)
Keywords: giant cell arteritis, immune checkpoint inhibitors, immune checkpoints, immune-related adverse events, vasculitis
MeSH terms: Aging / immunology, Aging / pathology, Antineoplastic Agents / administration & dosage, Antineoplastic Agents / adverse effects, Autoimmune Diseases / chemically induced, Autoimmune Diseases / immunology, Autoimmune Diseases / pathology, Melanoma / drug therapy, Melanoma / immunology, Melanoma / pathology, Vasculitis / chemically induced, Vasculitis / immunology, Vasculitis / pathology, Case Reports, Research Support, Non-U.S. Gov't, Review, Aged, Humans, Male, Antineoplastic Agents

Age-associated changes in the immune system including alterations in surface protein expression are thought to contribute to an increased susceptibility for autoimmune diseases. The balance between the expression of coinhibitory and costimulatory surface protein molecules, also known as immune checkpoint molecules, is crucial in fine-tuning the immune response and preventing autoimmunity. The activation of specific inhibitory signaling pathways allows cancer cells to evade recognition and destruction by the host immune system. The use of immune checkpoint inhibitors (ICIs) to treat cancer has proven to be effective producing durable antitumor responses in multiple cancer types. However, one of the disadvantages derived from the use of these agents is the appearance of inflammatory manifestations termed immune-related adverse events (irAEs). These irAEs are often relatively mild, but more severe irAEs have been reported as well including several forms of vasculitis. In this article, we argue that age-related changes in expression and function of immune checkpoint molecules lead to an unstable immune system, which is prone to tolerance failure and autoimmune vasculitis development. The topic is introduced by a case report from our hospital describing a melanoma patient treated with ICIs and who subsequently developed biopsy-proven giant cell arteritis. Following this case report, we present an in-depth review on the role of immune checkpoint pathways in the development and progression of autoimmune vasculitis and its relation with an aging immune system.
Large mesenteric cyst mimicking tuberculous ascites
Authors: Cumhur Dulger, Ertan Adali, Serhat Avcu, Zehra Kurdoglu
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

Background. Intraabdominal lesions such as mesenteric cysts are uncommon disorders. Most are discovered incidentally during routine abdominal examinations. Methods. We report a patient with a mesenteric cyst masquerading as tuberculous peritonitis and ascites. Conclusion. Mesenteric cysts generally do not show typical clinical findings. They may also present with peritoneal tuberculosis findings such as low albumin gradient ascites with high ascitic adenosine deaminase levels. Surgery is used to remove a wide variety of mesenteric cysts. A correct diagnosis can be made by the combined use of radiographic and sonographic examinations in conjunction with the clinical signs.
Cardiac Amyloidosis Presenting as Biventricular Systolic Heart Failure
Authors: Monique Oye, Aaron Richardson, Edin Sadic, Ahmad Alkhasawneh, Gladys Velarde
Journal: Case Rep Cardiol (2021)
MeSH terms: Case Reports

A previously healthy octogenarian presented with new onset heart failure symptoms. Comprehensive multimodality imaging including complete echocardiography with longitudinal strain analysis, cardiac magnetic resonance imaging (cMRI), nuclear medicine pyrophosphate (99-mcTcPYP) scan along with biomarker, monoclonal protein analysis, and fat pad biopsy confirmed diagnosis of transthyretin cardiac amyloidosis.
Internal hernia after laparoscopic-assisted proximal gastrectomy with jejunal interposition for gastric cancer: a case report
Authors: Kotaro Hirashima, Takashi Ishikawa, Shin-Ichi Kosugi, Yosuke Kano, Yu Sato, Hiroshi Ichikawa, Takaaki Hanyu, Takeo Bamba, Toshifumi Wakai
Journal: Surg Case Rep (2015)
Keywords: internal hernia, jejunal interposition, laparoscopic-assisted proximal gastrectomy

Internal hernia after gastrectomy is a rare complication. It can progress rapidly to vascular disturbance, necrosis, and perforation, therefore early diagnosis and surgical treatment is essential. We present a case of internal hernia following laparoscopic-assisted proximal gastrectomy with jejunal interposition reconstruction in a 68-year-old man, who presented with acute abdominal pain and vomiting. Computed tomography showed a whirl sign, ascites, and a closed-loop formation of the small intestine. We diagnosed an internal hernia and performed emergency surgery. Laparotomy revealed chyle-like ascites and extensive small intestine with poor color. We recognized that about 20 cm of jejunum from the ligament of Treitz was strangulated behind the pedicle of the jejunum lifted during laparoscopic-assisted proximal gastrectomy. We relieved the strangulation, whereupon the color of the strangulated intestine was restored. Therefore, we did not perform intestinal resection and reconstruction. Finally, we fixed the jejunal pedicle and mesentery of the transverse colon. We report this case as there are few reported cases of internal hernia after laparoscopic-assisted proximal gastrectomy.
A Case of Advanced Gastric Cancer with Folfiri as a Preoperative Chemotherapy
Authors: Hieu Van Nguyen, Hung Van Nguyen, Long Thanh Nguyen, Nga Quynh Pham, Hau Xuan Nguyen, Hien Xuan Nguyen, Vuong Thi Nguyen
Journal: Case Rep Oncol Med (2019)
MeSH terms: Case Reports

Introduction:
In advanced gastric cancer, preoperative chemotherapy is associated with survival benefit. FOLFIRI has demonstrated promising results in terms of survival and tolerance, especially in patients with poor performance status.
Case presentation:
A 59-year-old male, diagnosed with pT4bN2M0 gastric cancer, underwent gastrointestinal anastomosis and three cycles of EOX chemotherapy. Due to disease progression, he was switched to FOLFIRI regimen. After 12 cycles, the patient received a subtotal gastrectomy and D2 lymphadenectomy. Microscopic examination achieved pCR, and the patient has been surviving 34 months without recurrence. No severe toxicities of chemotherapy were recorded.
Conclusions:
FOLFIRI might be a safe and effective option in neoadjuvant treatment for advanced gastric cancer among patients with poor performance status or progression after first-line chemotherapy.
Postirradiation osteosarcoma of the maxilla: a case report and current review of literature
Authors: Imene Chabchoub, Olfa Gharbi, Sami Remadi, Sami Limem, Amel Trabelsi, Makrem Hochlef, Leila Ben Fatma, Amel Landolsi, Moncef Mokni, Chekib Kraiem, Slim Ben Ahmed
Journal: J Oncol (2009)
MeSH terms: Case Reports

Background. Radiation-induced sarcomas are well-known potential late sequelae of radiation therapy. They are of rare occurrence in jaw bones and are even rarer in the maxilla. Case report. We report a case of radiation-induced osteosarcoma involving the maxilla in a patient treated with radiotherapy for nasopharyngeal carcinoma 14 years ago. Despite neoadjuvant chemotherapy, surgical treatment could not be performed, and the patient received palliative chemotherapy. Conclusions. Radiation-induced osteosarcomas are aggressive and often elude early detection and timely intervention, rapidly leading to early demise of afflicted patients. Long-term patient follow-up and a high index of suspicion are crucial for timely intervention.
Giant hydronephrosis management in the Era of minimally invasive surgery: A case series
Authors: Abdulrahman Alsunbul, Tarek Alzahrani, Abdulrahman Binjawhar, Abdullah Aldughiman, Hossam S El-Tholoth, Ahmed Alzahrani, Hamad Alakrash
Journal: Int J Surg Case Rep (2020)
Keywords: giant hydronephrosis, laparoscopy, nephrectomy, nephrostomy

Introduction:
Giant hydronephrosis (GH) is a rare urological entity, described as more than 1 L of fluid contained in the renal collecting system. Ureteropelvic junction obstruction (UPJO) is the most common cause. GH if not discovered and managed early can result in long term complications. We present our experience in the late presentation of adult Giant hydornephrosis.
Presentation of cases:
We reviewed all the cases of patients with giant hydronephrosis who presented to our institute from December 2017-December 2019 at our institute. Pre-operative renal ultrasound, computed tomography with contrast and MAG-3 were performed on all patients to establish their diagnoses. The patients' demographic data, clinical presentation, preparatory investigations, indications for intervention, type of intervention, pre- and post-operative complications and durations of hospital stay were reported. Laparoscopic transperitoneal nephrectomy was completed in three cases without open conversion. One case proceeded to open conversion owing to a lack of space and severe adhesions. The mean operating time was 79.7 min (range: 65-95 min), estimated blood loss was 75 mL and the mean hospital stay was 4 days (range: 2-6 days).
Discussion:
The first case of GH was described in 1746. Since then, few cases have been described in the literature. A radiological definition, is the occupation of the hemi-abdomen by the kidney with a midline cross which is the height of five vertebral bodies. GH may be congenital or acquired. The most common presentation of GH is abdominal distention followed by fever and flank pain.
Conclusion:
When nephrectomy is indicated in giant hydronephrosis, the laparoscopic trans-peritoneal approach is feasible. Pre-operative decompression using a nephrostomy tube and suspension stitch use facilitate the surgery.
Identification of a female murder victim found in Burgenland, Austria in 1993
Authors: Christine Lehn, Andreas Rossmann, Matthias Graw, Gareth R Davies
Journal: Forensic Sci Res (2021)
Keywords: forensic sciences, bio-elements, forensic anthropology, geo-elements, human identification, provenance, stable isotope analysis
MeSH terms: Case Reports

In 1993, the skeletal remains of a female corpse were found in Burgenland, Austria. Initial identification of the approximately 25-35-year-old female appeared impossible, but the case was reopened 23 years later. By applying biogeochemical isotope methods to her body tissues, the geographical origin of the unknown corpse could be predicted. The results of the C, N, S, H, Sr, and Pb isotope analyses suggested that the female did not originate from Europe and most likely spent her youth in the northern Caribbean. Using these findings, the police were able to identify the woman within 2 weeks. The female came from the Dominican Republic and resided in Austria for only a short period before she was murdered. This case shows that isotope biogeochemistry investigations can provide the police with crucial information that enables unknown persons to be identified.KeypointsC-N-S-H and Sr-Pb isotope analyses were applied to human remains associated with a cold case.It was possible to determine the region of origin of the unknown deceased individual as the northern Caribbean.After 23 years, the murder victim was successfully identified.
Predominantly fibrous malignant mesothelioma in a cat
Authors: Alexander Th A Weiss, Afonso B da Costa, Robert Klopfleisch
Journal: Vet Med Int (2010)
MeSH terms: Case Reports

Malignant mesotheliomas are rare tumours in domestic cats. They occur within the abdominal or thoracic cavity and are regularly associated with pleural or peritoneal effusions. The histopathological diagnosis can be quite challenging, as these neoplasms may resemble other epithelial or mesenchymal neoplasms. However, differentiation can be achieved by immunohistochemistry in most cases. Here we describe the rare case of a malignant mesothelioma of the fibrous subtype in the thoracic cavity of a cat and discuss differential diagnoses and treatment options for this tumor type.
Use of Intrapleural Fibrinolytic Therapy in a Trapped Lung following Acute Traumatic Haemothorax
Authors: Chuan T Foo, Jurgen Herre
Journal: Case Rep Pulmonol (2021)
MeSH terms: Case Reports

Retained haemothorax is a common sequela of traumatic haemothorax and refers to blood that cannot be drained from the pleural cavity. We report a case of trapped lung secondary to retained haemothorax in a patient who sustained a penetrating chest injury. Initial chest computed tomography (CT) showed a large haemothorax that was managed with an intercostal drain insertion (ICD). Repeat chest CT and thoracic ultrasonography performed after ICD removal showed an organized pleural space resembling haematoma. ICD was reinserted with administration of intrapleural fibrinolytic therapy (IPFT). Subsequent chest CT showed the development of a pleural rind and trapped lung. A second ICD was inserted, and further IPFT were administered together with aggressive negative pressure suction. Haemoglobin remained stable. The patient made a full recovery and imaging performed two weeks later showed minor blunting of the costophrenic angle. This case highlights the feasibility and safety of IPFT in the management of trapped lung associated with traumatic retained haemothorax as an alternative to surgery.
Accidental Strangulation with Cervical Nerve Root Injury Caused by the Entrapment of Clothing in a Soybean Milling Machine
Authors: Kazuhiko Omori, Ikuto Takeuchi, Youichi Yanagawa
Journal: Case Rep Emerg Med (2019)
MeSH terms: Case Reports

The clothing of a forty-five-year-old man became entrapped by the mixing rotator while he was operating a soybean milling machine. His clothing was wound around the rotator, and tightened around his neck and chest, causing strangulation and a loss of consciousness. He was rescued by his coworkers and transported to our hospital by helicopter. Upon arrival, he regained consciousness. A physiological examination revealed multiple petechiae on his face and strangulation marks with subcutaneous hemorrhage on his neck and upper trunk. In addition, he had motor weakness of the right upper extremity and bilateral paresthesia from C5 to Th1. All radiological studies were negative. He was admitted for observation. After the patient's creatine phosphokinase level peaked and his focal neurological signs improved, he was discharged on foot on the 6th hospital day. Accidental ligature strangulation with cervical nerve root injury, in which an article of clothing is caught in an electrical machine and strangles the wearer, is very rare. This case is presented for its rarity and the unique pattern of injury.
Xanthogranulomatous pyelonephritis (XGPN) mimicking a "renal cell carcinoma with renal vein thrombus and paracaval lymphadenopathy"
Authors: Arvind Ganpule, Jitendra Jagtap, Sanika Ganpule, Amit Bhattu, Shailesh Soni, Ravindra Sabnis, Mahesh Desai
Journal: F1000Res (2013)

We present a case of Xanthogranulomatous pyelonephritis mimicking as a renal cell carcinoma. This was an elderly lady who presented with pyonephrosis due to urolithiasis. On evaluation she was found to have a space occupying mass in the right kidney. Further investigations revealed an enhancing tumor with renal vein thrombus and paracaval lymphadenopathy. Subsequent histopathology showed evidence of XGPN with no malignancy. This case report highlights the fact there are a number of imaging and clinical overlaps in the diagnosis, assessment and management of this entity.
Late onset periprosthetic infection of the hip caused by the fish pathogen Lactococcus garvieae in a patient not associated with fish exposure
Authors: Marianne Westberg, Hanne Brekke, Nils Olav Hermansen, Bernhard Flatøy
Journal: J Bone Jt Infect (2020)
Keywords: lactococcus garvieae, fish pathogen, periprosthetic hip infection, two-stage surgery
MeSH terms: Case Reports

Lactococcus garvieae is a fish pathogen, rarely causing opportunistic infections in humans. There are only a few cases reported in the literature, mainly endocarditis, suggesting an association with raw fish consumption. We report a case of a periprosthetic hip infection successfully treated with a two-stage revision surgery.
A Rare Case of Vascular Leiomyosarcoma Originating from a Branch Vessel of the External Iliac Vein
Authors: Akinaru Yamamoto, Wataru Nakata, Gaku Yamamichi, Go Tsujimura, Yuichi Tsujimoto, Mikio Nin, Hideaki Miwa, Masao Tsujihata
Journal: Case Rep Med (2018)
MeSH terms: Case Reports

Leiomyosarcoma arising from the external iliac vein is uncommon. This is a report of a 51-year-old Japanese man with venous leiomyosarcoma originating from a branch vessel of the left external iliac vein. The tumor was found during a medical examination, and the patient had no symptoms. Computed tomography showed a 72 × 49 mm mass adjacent to the left external iliac vein. The tumor was resected en-block along with ligation of the external iliac vein due to strong adhesion with the tumor. Histological examination showed venous leiomyosarcoma, and its origin was thought to be a branch vessel of the left external iliac vein. The patient has remained free from recurrence at 30 months after surgery.