OpenMed/multicare-articles huggingface dataset:
Preoperative diagnosis of a gastric extremely well-differentiated adenocarcinoma: A case report
Authors: Katsushi Suenaga, Shiro Matsumoto, Alan Kawarai Lefor, Yoshimasa Miura, Yoshinori Hosoya, Daigo Kuboki, Hidenori Haruta, Kentaro Kurashina, Atsushi Kihara, Daisuke Matsubara, Yasunari Sakuma, Joji Kitayama, Naohiro Sata
Journal: Int J Surg Case Rep (2020)
Keywords: case report, ewda of the stomach, endoscopic submucosal dissection, preoperative biopsy, submucosal tumor
MeSH terms: Case Reports

Introduction:
Gastric adenocarcinomas with low grade atypia may be difficult to diagnose as gastric cancer by preoperative biopsy. We report an extremely well-differentiated adenocarcinoma (EWDA) of the stomach which appeared like a submucosal tumor diagnosed by preoperative endoscopic submucosal dissection.
Presentation of case:
A 70-year-old male was referred with a 3-month history of a submucosal-appearing lesion in the gastric wall found on endoscopy. Biopsies of the lesion were performed and were inconclusive for neoplasia. Endoscopic ultrasonography showed a low echoic tumor growing into the fourth layer of the gastric wall. It was difficult to identify the tumor by repeat biopsy. Endoscopic submucosal dissection of the lesion was performed and revealed adenocarcinoma, and laparoscopic total gastrectomy was performed. Histopathologic evaluation showed that the tumor was stage IIA (T3N0M0). There is no recurrence 12 months after resection.
Discussion:
Gastric EWDAs are rare lesions, accounting for 0.6% of all gastric cancers. It is difficult to diagnose gastric EWDA especially if it appears like a submucosal tumor. This lesion was finally diagnosed by endoscopic submucosal dissection.
Conclusion:
Endoscopic submucosal dissection may facilitate establishing the preoperative diagnosis of a tumor thought to be a gastric EWDA based on its endoscopic appearance and pathological findings.
Chronic Expanding Hematoma in the Popliteal Fossa after Pseudoaneurysm Surgery because of Nail Puncture
Authors: Serdar Yilmaz, Deniz Cankaya, Alper Deveci, Bulent Ozkurt, Mehmet Emin Simsek, Abdullah Yalcin Tabak, Murat Bozkurt
Journal: Case Rep Orthop (2014)

Hematomas caused by surgery or trauma that persist and expand slowly for more than a month are defined as chronic expanding hematomas (CEH). Magnetic resonance imaging (MRI) is useful for the diagnosis. Total excision with the pseudocapsule is the treatment method. Pseudoaneurysms result from arterial wall disruptions and can be mistaken for CEH. We present a rare case report of a 45-year-old man with a large, painful swelling in his left popliteal fossa. He had a puncture wound by a nail 11 years ago and a gradually expanding mass occurred in his popliteal fossa. A pseudoaneurysm was detected and operated a year later. After surgery, a gradually expanding mass recurred in his popliteal fossa. On the arteriography, the popliteal artery was occluded and the blood flow was maintained with collateral vessels. On MRI, an enormous swelling of 115 × 107 × 196 cm in diameter was seen. It was diagnosed as CEH and was excised completely protecting the collateral vessels and there was no recurrence after a year from the surgery.
Electroconvulsive Therapy in a Renal Transplantation Patient: A Rare Combination of Disease and Treatment
Authors: Giovanni Malaty, Kerilyn Godbe, Mehdi Elmouchtari, Gurjot Malhi, Justin White, Azziza Bankole, Tracey Criss
Journal: Case Rep Psychiatry (2020)
MeSH terms: Case Reports

The safety and efficacy of electroconvulsive therapy (ECT) for the treatment of psychiatric disorders have been demonstrated in a wide variety of patients, including postoperative patients and those who are pregnant. While several reports highlight the safety of this treatment in heart and liver transplantation patients, there is a relative lack of literature detailing the safety profile of ECT in an individual with recent kidney transplantation. Here, we explore the case of a patient with a recent renal transplant secondary to diabetes-related end-stage renal disease (ESRD) who underwent a successful course of ECT treatment. A 57-year-old Caucasian male with a past psychiatric history of schizoaffective disorder, bipolar type, and a past medical history of end-stage renal disease with recent right renal transplantation was admitted to the inpatient psychiatry unit. The admission was via a temporary detention order (TDO) for suicidality and auditory hallucinations promoting self-harm. The patient's depressive and delusional history was well-documented and had been refractory to several courses of psychotherapeutic and pharmacologic management. Electroconvulsive therapy was subsequently initiated and was well-tolerated. Treatments progressively alleviated his depressive and psychotic symptoms and did not adversely affect the function of his transplanted kidney, which was closely monitored throughout the treatment process. This case demonstrated the safety and efficacy of ECT treatment in an individual with recent renal transplant and may prompt further trials into establishing safety and efficacy in larger study populations.
Myocardial Infarction as an Initial Presentation of Essential Thrombocythemia With Calreticulin (CALR) Mutation (None Type 1, None Type 2)
Authors: Mohammad Afana, Mohammad Abu-Tineh, Anil Ellahie, Omar Ismail, Deena Sideeg, Afaf Albattah, Mohamed A Yassin
Journal: Cureus (2023)
Keywords: calreticulin, essential thrombocythemia, myeloproliferative neoplasm, myocardial infarction, thrombosis
MeSH terms: Case Reports

Essential thrombocythemia (ET) is one of the classical Philadelphia-negative myeloproliferative neoplasms with different mutations that can be associated with it, like Janus kinase 2 (JAK2), myeloproliferative leukemia protein (MPL), and Calreticulin (CALR) (types 1 and 2). However, there is a lack in the literature concerning other types of CALR mutations and their clinical significance and prognosis. Here we report a 42-year-old male with type 2 diabetes who presented with an inferior ST-elevation myocardial infarction and thrombocytosis. The diagnosis of ET with CALR (neither type 1 nor type 2) was confirmed, which suggests the pathognomonic feature of this mutation.
A Rare Case of Mesenteric Chylous Cyst in Infant: Case Report and Review of Literature
Authors: Alessia Salatto, Flavia Indrio, Vittoria Campanella, Marina Curci, Cosetta Maggipinto, Raffaella Cocomazzi, Francesco Canale, Maria Nobili, Fabio Bartoli
Journal: Front Surg (2021)
Keywords: chylous, laparacospy, laparotomy, lymphatic malformation, mesenteric cyst
MeSH terms: Case Reports

The occurrence of a mesenteric cyst (MC) is common in adults while in children and in infants is rare. In adults mesenteric cysts are often asymptomatic and discovered incidentally; however, in children they commonly present with symptoms of abdominal pain or distension with fever and leucocytosis. We report on a rare case, in our experience, of Mesenteric Chylous cyst (MCC) in an infant with signs and symptoms of intestinal obstruction. Discussion of literature is also reported.
Successful Treatment of High-Level Aminoglycoside-Resistant Enterococcus faecalis Bacteremia in a Preterm Infant with Ampicillin and Cefotaxime
Authors: Jennifer Tam, Santina J Lee, Vibhuti Shah, Shaun K Morris
Journal: Case Rep Infect Dis (2018)
MeSH terms: Case Reports

Enterococcal bloodstream infections are usually treated with single-agent antibiotics. In persistent infections, synergistic combination therapy is often required with a beta-lactam and an aminoglycoside antibiotic. High-level aminoglycoside-resistant (HLAR) enterococci are increasingly prevalent and preclude the use of this combination. The use of ampicillin with a third-generation cephalosporin to treat endovascular HLAR Enterococcus infections is becoming more established in the adult population; however, the literature on treatment of such infections in children remains scarce. We report a preterm neonate with persistent HLAR Enterococcus faecalis bacteremia from day of life 9 to 17 despite treatment with ampicillin and vancomycin. On day of life 17, antibiotic treatment was switched to ampicillin and cefotaxime, with subsequent clearance of blood cultures on day of life 20. To our knowledge, this is the first report illustrating the use of ampicillin and cefotaxime for an HLAR E. faecalis infection in a neonate.
Rocuronium-sugammadex use for electroconvulsive therapy in a hemodialysis patient: a case report
Authors: Shigeaki Kurita, Katsuyuki Moriwaki, Kazuhisa Shiroyama, Mikako Sanuki, Yukari Toyota, Minoru Takebayashi
Journal: JA Clin Rep (2016)
Keywords: electroconvulsive therapy, hemodialysis, rocuronium, sugammadex

Background:
Recently, rocuronium with subsequent use of sugammadex was proposed for electroconvulsive therapy (ECT) as an alternative to succinylcholine. Because sugammadex is cleared via the kidney with no metabolism, it is unknown that rocuronium-sugammadex use is safe in hemodialysis patients who received ECT.
Case presentation:
In this case report, we used rocuronium with subsequent administration of sugammadex in a 69-year-old female, hemodialysis patient, scheduled for ten ECT sessions for severe major depression. In the initial eight sessions, we tested the feasibility of rocuronium-sugammadex use for ECT. During the series of four ECT sessions, we measured plasma concentrations for the sum of sugammadex and sugammadex-rocuronium complex and observed whether possible residual sugammadex affected muscle relaxation during subsequent sessions of ECT. The results showed the feasibility of rocuronium-sugammadex use as muscle relaxants for ECT in patients undergoing hemodialysis. However, an accumulation of sugammadex did occur even after two sessions of hemodialysis, and residual sugammadex decreased the effect of the rocuronium given in the subsequent ECT sessions. Rocuronium-sugammadex was successfully utilized as muscle relaxants for ECT in this patient.
Conclusions:
Our experience in this case may indicate that if succinylcholine is contraindicated, rocuronium-sugammadex can be an alternative method for muscle relaxation during ECT in patients undergoing hemodialysis. When this rocuronium-sugammadex procedure is used, the effect of residual sugammadex after hemodialysis on the subsequently administered rocuronium should be considered.
Malignant Transformation of an Ovarian Endometrioma during Endometriosis Treatment: A Case Report
Authors: Hiroaki Takagi, Emi Takata, Jinichi Sakamoto, Satoko Fujita, Masahiro Takakura, Toshiyuki Sasagawa
Journal: Case Rep Obstet Gynecol (2018)
MeSH terms: Case Reports

Dienogest (DNG) is considered to be effective against ovarian endometrioma (OMA). We report a rare case of OMA transformation to ovarian cancer during long-term endometriosis treatment with a periodic administration of a gonadotropin-releasing hormone agonist (Gn-RH agonist) and DNG. The patient was a 41-year-old Japanese woman. OMA and adenomyosis of the uterus were revealed via computed tomography. Consequently, she underwent conservative treatment without undergoing surgery because her overall status was poor. She received cyclic therapy (Gn-RH agonist and DNG) for approximately eight years. However, she reported lumbago and underwent close medical examination at our hospital after about eight years of treatment. Under the suspicion of malignant transformation, she underwent surgery. The pathological diagnosis was clear cell carcinoma of the right ovary (stage 2B). After surgery, she received six courses of chemotherapy (conventional TC). No evidence of disease was observed after chemotherapy. Our findings suggest that malignant transformation of OMA can occur during DNG treatment. Since the delayed detection of ovarian cancer greatly affects the prognosis, women older than 40 with OMA are encouraged to undergo regular check-ups every few months.
Case report: Combined therapy of bilateral subthalamic nucleus deep brain stimulation and spinal cord stimulation significantly improves motor function in a patient with multiple system atrophy with predominant parkinsonism
Authors: Jiping Li, Shanshan Mei, Xiaohua Zhang, Yunpeng Wang, Xiaofei Jia, Jinlong Liu, Erhe Xu, Wei Mao, Yuqing Zhang
Journal: Front Neurosci (2022)
Keywords: deep brain stimulation, freezing of gait, multiple system atrophy, spinal cord stimulation, subthalamic nucleus
MeSH terms: Case Reports

Multiple system atrophy with predominant parkinsonism (MSA-P) is a highly incapacitating disease with a short life expectancy and symptomatic therapy is still limited. In this report, we presented the case of a 65-year-old woman with a 3-year history of severe rigidity, bradykinesia, and gait dysfunction alongside severe freezing of gait diagnosed with MSA-P. She underwent combined therapy of bilateral subthalamic nucleus deep brain stimulation (DBS) and low-thoracic spinal cord stimulation (SCS). The double-blind evaluation of the Movement Disorder Society Sponsored Revision of the Unified Parkinson's Disease Rating Scale part III and 7-m Timed Up and Go at follow-ups showed her cardinal parkinsonian symptoms benefit significantly from DBS stimulation, while the improvement of SCS was mainly embodied in lower-limb symptoms. The combined stimulation achieved a better improvement of motor function than either DBS or SCS stimulation alone. Most notably, the improvement of lower-limb symptoms was significantly enhanced by the combined stimulation.
Limb girdle muscular dystrophy type 2G with myopathic-neurogenic motor unit potentials and a novel muscle image pattern
Authors: Ana Cotta, Julia Filardi Paim, Antonio Lopes da-Cunha-Junior, Rafael Xavier Neto, Simone Vilela Nunes, Monica Magalhaes Navarro, Jaquelin Valicek, Elmano Carvalho, Lydia U Yamamoto, Camila F Almeida, Shelida Vasconcelos Braz, Reinaldo Issao Takata, Mariz Vainzof
Journal: BMC Clin Pathol (2014)
Keywords: computed tomography, limb girdle muscular dystrophy, neurogenic, rimmed vacuoles, telethonin
MeSH terms: Case Reports

Background:
Limb girdle muscular dystrophy type 2G (LGMD2G) is a subtype of autosomal recessive muscular dystrophy caused by mutations in the telethonin gene. There are few LGMD2G patients worldwide reported, and this is the first description associated with early tibialis anterior sparing on muscle image and myopathic-neurogenic motor unit potentials.
Case presentation:
Here we report a 31 years old caucasian male patient with progressive gait disturbance, and severe lower limb proximal weakness since the age of 20 years, associated with subtle facial muscle weakness. Computed tomography demonstrated soleus, medial gastrocnemius, and diffuse thigh muscles involvement with tibialis anterior sparing. Electromyography disclosed both neurogenic and myopathic motor unit potentials. Muscle biopsy demonstrated large groups of atrophic and hypertrophic fibers, frequent fibers with intracytoplasmic rimmed vacuoles full of autophagic membrane and sarcoplasmic debris, and a total deficiency of telethonin. Molecular investigation identified the common homozygous c.157C > T in the TCAP gene.
Conclusion:
This report expands the phenotypic variability of telethoninopathy/ LGMD2G, including: 1) mixed neurogenic and myopathic motor unit potentials, 2) facial weakness, and 3) tibialis anterior sparing. Appropriate diagnosis in these cases is important for genetic counseling and prognosis.
Myxedema Coma Associated with Macroprolactinoma: Case Report and Review of the Literature
Authors: Elizabeth Jasola Omoniyi, Richard J Robbins
Journal: Case Rep Endocrinol (2022)
MeSH terms: Case Reports

Myxedema coma is a rare life-threatening presentation of severe hypothyroidism associated with a high mortality rate. Although most cases are due to primary thyroid failure, a minority have central hypothyroidism as the underlying cause. We report the case of a 69-year-old man who presented with obtundation, hypoglycemia, and hyponatremia. The patient's initial thyroid-stimulating hormone (TSH) was within normal limits. Subsequent evaluation revealed critical anterior pituitary insufficiency due to a macroprolactinoma and a diagnosis of myxedema coma after appropriate workup The finding of a normal serum TSH should not eliminate the possibility of myxedema coma.
Hiccup-Like Response in a Dog Anesthetized with Isoflurane
Authors: Enzo Vettorato, Federico Corletto
Journal: Case Rep Vet Med (2016)
MeSH terms: Case Reports

An eight-year-old, female intact Golden Retriever underwent magnetic resonance imaging (MRI) for investigation of urinary and faecal incontinence. Soon after induction of general anesthesia, tracheal intubation, and isoflurane administration, hiccup-like movements were evident. These hiccup-like movements did not respond to hyperventilation and increase of anesthetic. After having ruled out pulmonary disease, the animal was reanesthetized with a similar technique; hiccup-like movements reoccurred and did not stop after discontinuation of isoflurane and commencement of a propofol infusion. Eventually, a nondepolarizing neuromuscular blocking agent was administered to stop the hiccup-like response and allow MRI to be performed. This case report describes the pathophysiology of hiccup-like response and its management in a dog.
Left paraduodenal hernia: Embryological and radiological findings
Authors: Atish Vanmali, Jaynund Maharajh, Mario Haines
Journal: SA J Radiol (2021)
Keywords: diagnosis, internal hernia, paraduodenal hernia, surgery, upper abdominal pathology
MeSH terms: Case Reports

Left paraduodenal hernia (PDH), may present as a surgical emergency with an increased risk of strangulation and incarceration. The diagnosis is challenging because of the non-specific presentation. In the absence of common epigastric or upper abdominal pathology and non-resolving symptoms, a high index of suspicion is required to diagnose left PDH. This report describes a case of radiologically diagnosed left paraduodenal hernia and subsequent successful surgery. It also includes a review of midgut embryology, and the anatomy and radiology of left PDH.
Chronic exertional compartment syndrome of the forearm in an elite rower
Authors: S O'heireamhoin, J F Baker, M Neligan
Journal: Case Rep Orthop (2011)
MeSH terms: Case Reports

We report a case of chronic exertional compartment syndrome (CECS) affecting the volar forearm compartment of an elite rower. CECS of the forearm is a less well recognised entity than lower limb CECS. We describe a typical history and detail a potential treatment.
Unresectable retiform hemangioendothelioma treated with external beam radiation therapy and chemotherapy: a case report and review of the literature
Authors: Alina Z Hirsh, Weisi Yan, Lihong Wei, A Gabriella Wernicke, Bhupesh Parashar
Journal: Sarcoma (2010)
MeSH terms: Case Reports

Retiform hemangioendothelioma (RH) is an infrequently encountered vascular neoplasm of intermediate or borderline malignancy. Treatment of RH is controversial. We present a case of a 44-year-old Asian male presenting with an unresectable RH of the pelvis. The patient was treated with concurrent low-dose Cisplatin and External beam Radiation (4140cGy in 180cGy per fraction). This is the first report of a clinical complete response and a long-term local control of this rare tumor. This has significant clinical implication, since it gives the first evidence of treatment of this rare tumor using concurrent low-dose chemotherapy and radiation.
Accumulated effects of factors determining plant development from somatic embryos of Abies nordmanniana and Abies bornmuelleriana
Authors: Ulrik Braüner Nielsen, Camilla Bülow Hansen, Ulrich Hansen, Vivian Kvist Johansen, Ulrika Egertsdotter
Journal: Front Plant Sci (2022)
Keywords: abies, conifer, embryo quality, germination, in vitro, nordmann fir, turkish fir

Despite a much later inception of somatic embryogenesis (SE) propagation protocols for gymnosperms than for angiosperm species, SE is becoming increasingly important due to its applications for commercial forestry. For many conifers, there are however still major bottlenecks in the SE plant production process limiting the use of SE for forestry operations, Christmas tree production and research projects. In the present case study, the effects on plant growth from different cultural factors applied during the SE developmental process were studied in two conifer species of high value for Christmas tree production. Seven clones of Abies nordmanniana and two clones of Abies bornmuelleriana were included in the study. Accumulated effects from cultural treatments were recorded from the start of germination of mature embryos of different quality scores through development into plants in the third growing period. Experimental factors of the cultural treatments included were: germination temperature, germination time, light conditions, survival ex vitro and traits for plant growth and vitality. The results reveal that most of the studied experimental factors influenced plant growth during the first three years however their relative importance was different. Plant survival rate at end of the nursery stage was strongly impacted by germination temperature (p<0.001), initial embryo score (p=0.007), clone (p<0.001) and to a lesser extend week of germination (p=0.017). This case-study highlights and quantifies the strong interrelation between the developmental steps of somatic embryogenesis and show the importance of considering all cultural steps when optimizing SE plant production protocols.
Modified use of thoracic and iliac branch endografts to treat an abdominal aortic aneurysm with an unusually narrow neck
Authors: Edward Norman, Matthew Harling, Alicia Levena Skervin, Celia Riga, Mohamed Khalifa, Richard Gibbs, Mohamad Hamady
Journal: BJR Case Rep (2016)
MeSH terms: Case Reports

Abdominal aortic aneurysms with hostile anatomy are a recognized hindrance to the continuing application of endovascular aortic interventions. Narrowed aneurysm necks pose technical difficulties, particularly in the absence of customized endografts. There are multiple suggested approaches to overcome shortened and angulated necks endovascularly; however, none of these address narrowed necks. We present a case where an endograft was used outside of its "instruction for use" by combining the thoracic and iliac branch technologies to overcome this problem. Expanding the use of commercially available endografts for aortic aneurysms with hostile anatomy could have significant practical and financial benefits.