OpenMed/multicare-articles huggingface dataset:
A new vector system for targeted integration and overexpression of genes in the crop pathogen Fusarium solani
Authors: Mikkel Rank Nielsen, Anna Karolina Rilana Holzwarth, Emmett Brew, Natalia Chrapkova, Samba Evelyne Kabemba Kaniki, Kenneth Kastaniegaard, Trine Sørensen, Klaus Ringsborg Westphal, Reinhard Wimmer, Teis Esben Sondergaard, Jens Laurids Sørensen
Journal: Fungal Biol Biotechnol (2019)
Keywords: agrobacterium tumefaciens-mediated transformation, bostrycoidin, fluorescence, fusarium, fusarubin, heterologous expression, polyketides, secondary metabolites, transformation

Background:
Besides their ability to produce several interesting bioactive secondary metabolites, members of the Fusarium solani species complex comprise important pathogens of plants and humans. One of the major obstacles in understanding the biology of this species complex is the lack of efficient molecular tools for genetic manipulation.
Results:
To remove this obstacle we here report the development of a reliable system where the vectors are generated through yeast recombinational cloning and inserted into a specific site in F. solani through Agrobacterium tumefaciens-mediated transformation. As proof-of-concept, the enhanced yellow fluorescent protein (eYFP) was inserted in a non-coding genomic position of F. solani and subsequent analyses showed that the resulting transformants were fluorescent on all tested media. In addition, we cloned and overexpressed the Zn(II)2Cys6 transcriptional factor fsr6 controlling mycelial pigmentation. A transformant displayed deep red/purple pigmentation stemming from bostrycoidin and javanicin.
Conclusion:
By creating streamlined plasmid construction and fungal transformation systems, we are now able to express genes in the crop pathogen F. solani in a reliable and fast manner. As a case study, we targeted and activated the fusarubin (PKS3: fsr) gene cluster, which is the first case study of secondary metabolites being directly associated with the responsible gene cluster in F. solani via targeted activation. The system provides an approach that in the future can be used by the community to understand the biochemistry and genetics of the Fusarium solani species complex, and is obtainable from Addgene catalog #133094.
Dyspnea and wheezing after adenosine injection in a patient with eosinophilic bronchitis
Authors: Rodrigo Cartin-Ceba, Marie Christine Aubry, Kaiser Lim
Journal: Case Rep Med (2009)
MeSH terms: Case Reports

A 58-year-old nonsmoker female was referred for evaluation of chronic cough of 13 months duration. After an initial work-up, the patient was diagnosed to have chronic cough due to eosinophilic bronchitis. The diagnostic work-up for eosinophilic bronchitis and bronchial biopsy is discussed. Eosinophilic bronchitis is differentiated from asthma. In addition, the patient developed dyspnea, flushing, and wheezing after the administration of adenosine during a cardiac stress test in spite of a negative methacholine challenge. This indirect stimulus of airway hyperresponsiveness suggests the possible involvement of mast cells in eosinophilic bronchitis.
Case Report: Clinical characteristics and genetic analysis of two patients with hereditary hemorrhagic telangiectasia
Authors: Qiu-Ying Wang, Yu-Xuan Feng, Ying-Wei Zhu, Yu-Xia Sun, Jing-Duan Xu, Hui-Min Shi, Yi-Min Mao, Hong-Wei Jiang
Journal: Front Genet (2022)
Keywords: arteriovenous malformations, brain abscesses, dyspnea, hereditary hemorrhagic telangiectasia, pulmonary arteriovenous fistula
MeSH terms: Case Reports

Objective: To analyze the clinical features and genetic characteristics of two patients with hereditary hemorrhagic telangiectasia (HHT) and to review the relevant literature. Methods: The clinical data of two HHT patients admitted to the author's hospital between April 2019 and February 2022 were retrospectively analyzed. Meanwhile, the genetic analysis was performed with their consent. Results: The first patient was a 62-year-old woman who had been complaining of shortness of breath and fever for 20 days. Her previous medical history included brain abscess drainage and video-assisted thoracoscopic surgery for a pulmonary hemangioma. A right heart catheterization revealed no pulmonary arterial hypertension, and an abdominal enhanced magnetic resonance imaging revealed multiple arteriovenous malformations in the liver. Her ACVRL1 heterozygous variants were discovered through whole-exon gene testing. The second case involved a 47-year-old woman who had been experiencing chest tightness for the past 2 years. Several years ago, she underwent brain abscess drainage and embolization of a pulmonary arteriovenous fistula. Ultrasound revealed generalized hepatic vascular dilation, and enhanced computed tomography revealed numerous pulmonary venous fistulas scattered in both lungs as well as multiple arteriovenous malformations in the liver. Her whole-exon gene testing revealed that she, like her son, had heterozygous ENG variants. Conclusion: HHT patients may experience infection, bleeding, dyspnea, and other symptoms. Imaging is important in disease diagnosis and management because early detection and treatment can prevent major complications and disability or even death.
Abnormal Neuroimaging in a Case of Infant Botulism
Authors: Ryan J Good, Kevin Messacar, Nicholas V Stence, Craig A Press, Todd C Carpenter
Journal: Front Pediatr (2015)
Keywords: acute flaccid paralysis, human botulism immune globulin, infant botulism, neuroimaging, toxin
MeSH terms: Case Reports

We present the first case of abnormal neuroimaging in a case of infant botulism. The clinical findings of the patient with constipation, bulbar weakness, and descending, symmetric motor weakness are consistent with the classic findings of infant botulism. Magnetic resonance imaging (MRI), however, revealed restricted diffusion in the brain and enhancement of the cervical nerve roots. Traditionally, normal neuroimaging was used to help differentiate infant botulism from other causes of weakness in infants. Abnormal neuroimaging is seen in other causes of weakness in an infant including metabolic disorders and hypoxic-ischemic injury, but these diagnoses did not fit the clinical findings in this case. The explanation for the MRI abnormalities in the brain and cervical nerve roots is unclear as botulinum toxin acts at presynaptic nerve terminals and does not cross the blood-brain barrier. Possible explanations for the findings include inflammation from the botulinum toxin at the synapse, alterations in sensory signaling and retrograde transport of the botulinum toxin. The patient was treated with human botulism immune globulin and had rapid recovery in weakness. A stool sample from the patient was positive for Type A Clostridium botulinum toxin eventually confirming the diagnosis of infant botulism. The findings in this case support use of human botulism immune globulin when the clinical findings are consistent with infant botulism despite the presence of MRI abnormalities in the brain and cervical nerve roots.
Prenatal diagnosis of adrenal neuroblastoma: a case report with a brief review of the literature
Authors: Onur Erol, Dinç Süren, Melek Büyükkınacı Erol
Journal: Case Rep Obstet Gynecol (2013)

A case of adrenal cystic neuroblastoma detected at 37 weeks of gestation is reported. Postnatal ultrasonographic examination showed slightly increased in size demonstrating marked septations within the cyst. After the tumor was resected, histopathological examinations confirmed the diagnosis. The patient is developing normally at 1 year of age.
A Case of Chorioretinitis with Retinal Angiomatous Proliferation
Authors: Yanru Chen, Mingyan Wei, Qian Chen, Minghan Li
Journal: Case Rep Ophthalmol Med (2021)
MeSH terms: Case Reports

A 48-year-old woman had an acute blurred vision in the right eye immediately after drainage of liver abscess. Her best corrected visual acuity (BCVA) was 8/400; fundus photography suggested the diagnosis of endogenous endophthalmitis with chorioretinitis and vitritis. Due to the bad systemic condition, a systemic antibiotic combined with periocular triamcinolone (TA) was carried out first. Inflammatory cells in the vitreous cavity were decreased after treatment; however, fundus fluorescein angiography (FFA) showed abnormal dilation and leakage of the capillaries and retinal-choroidal anastomose, supporting that there was retinal angiomatous proliferation (RAP). Vitreous interleukin-6 (IL-6) was only slightly elevated; the ratio of interleukin-10 (IL-10) and IL-6 was less than 1, and the etiological test was negative. After receiving intravitreal vancomycin injection combined with periocular TA injection, the patient's BCVA was improved from 16/400 to 20/400 with a reduction in vitreous inflammatory cells. However, the patient's RAP was progressed and her BCVA was dramatically decreased to count finger/30 cm. After intravitreal injection of ranibizumab, the patient's BCVA was 5/400 with a significant shrink in lesions and absorption of hemorrhage, exudation, and fluid. Thus, we suggest that early anti-inflammatory treatment in conjunction with anti-VEGF may achieve a better prognosis in patients with inflammatory retinal angiomatous proliferation (RAP).
Does spontaneous renal hemorrhage mandate close surveillance for impending renal cell carcinoma? A case report and literature review
Authors: Abdullah W Aldughiman, Abdulrahman Alsunbul, Abdullah Al-Gadheeb, Muaiqel Almuaiqel, Ahmad Alzahrani, Tarek Alzahrani, Abdullah Alghamdi, Hamad Alakrash
Journal: Int J Surg Case Rep (2020)
Keywords: angioembolization, computed tomography, nephrectomy, renal cell carcinoma, wunderlich syndrome
MeSH terms: Case Reports

Introduction:
Renal cell carcinoma (RCC) classically presents as a triad of hematuria, loin pain, and a palpable mass. However, Renal cell carcinomas (RCCs) nowadays are more commonly present as incidental findings rather than symptomatic. Wunderlich syndrome is a rare first presentation of RCC.
Presentation of case:
We present a clinical case of spontaneous renal hemorrhage with unclear etiology that was treated with therapeutic embolization and was found to have renal mass after long follow up.
Discussion and conclusion:
In regards to treating Wunderlich syndrome, some authors favor angioembolization and follow up. Others proposed radical nephrectomy in conditions with no apparent etiology and normal contralateral kidney because of the high incidence of small renal tumors. Spontaneous perinephric hematoma of unknown etiology should be followed up regularly with a CT image for concerning of impending renal tumor.
Case Report: Traumatic anterior cerebral artery aneurysm in a 4-year old child
Authors: Sunil Munakomi, Karuna Tamrakar, Pramod Chaudhary, Binod Bhattarai, Iype Cherian
Journal: F1000Res (2015)
Keywords: cerebral angiography, pseudo-aneurysm, trauma

Traumatic intracranial aneurysm in the proximal part of the anterior cerebral artery in the pediatric population has not been documented so far. Here we report the case of a 4 year-old child who developed a pseudo-aneurysm after minor head trauma and was managed successfully with trapping of the aneurysm. A ventriculo-peritoneal shunt was placed as the child became dependent on extraventricular drain during the post-operative period. The patient made excellent recovery in neurological status within 1 month of post-operative clinical follow up.
Chronic abdominal pain after laparoscopic hernia repair due to mesh graft migration to the cecum: a case report
Authors: Abdullah AlShammari, Fatima Alyousef, Amal Alyousif, Zainab Alsulabi, Fatimah AlJishi, Isra Siraj, Hissah Alotaibi, Mohammad Aburahmah
Journal: Patient Saf Surg (2019)
Keywords: abdominal pain, cecum, hernia repair, mesh graft migration
MeSH terms: Case Reports

Background:
Hernia repair with mesh graft is one of the most common procedures in general surgery. Mesh graft repair is the treatment of choice for umbilical and periumbilical hernias to minimize recurrence. One of the rare but serious complications is mesh graft migration to viscus. These complications can occur months to years after repair and their diagnosis can be challenging as they may present as vague abdominal pain only.
Case presentation:
A 74-year-old gentleman with multiple medical comorbidities was diagnosed with a para-umbilical hernia after which he underwent a laparoscopic hernia repair at our hospital using a mesh graft with no complications. On postoperative day 10, he presented to the emergency room (ER) complaining of colicky abdominal pain in the right iliac fossa for 1 day associated with diarrhea. A Computed Tomography (CT) scan of the abdomen and pelvis showed diffuse wall thickening of the cecum and terminal ileum with small free air worrisome for perforation. The decision was made in the ER to discharge him home on antibiotics. The patient then returned back multiple times to the ER for the same complaint along with bleeding per rectum for which he underwent further investigations. Months later, the patient presented again with the same symptoms. A CT scan revealed recurrence of a periumbilical hernia and thickening of the medial wall of the cecum with mesh graft material. The patient was then taken to surgery and intra-operative findings revealed migration of almost 50% of the mesh graft size to the cecum and part of the mesh graft was eroding the distal part of ileum just proximal to the ileocecal junction. Adhesolysis and limited right hemicolectomy with ileocolic anastomosis was done. The patient had an uneventful recovery after revisions surgery without any perioperative complications. He was discharged home on postoperative readmission day 5 and followed up at 2 weeks and 3 months without any delayed complications or subjective complaints.
Conclusion:
It is important to consider mesh graft migration to viscus as a cause of persistent abdominal pain and bleeding per rectum irrespective of the time of presentation post hernia repair.
A rare case of a 34-year-old patient diagnosed late with Kallmann syndrome: case report
Authors: Eppy Buchori Aristiady, Desiree Alberta
Journal: Pan Afr Med J (2022)
Keywords: kallmann syndrome, anosmia, case report, hypogonadotropic-hypogonadism, olfactory bulb
MeSH terms: Hypogonadism / diagnosis, Hypogonadism / etiology, Kallmann Syndrome / diagnosis, Kallmann Syndrome / drug therapy, Case Reports, Adult, Hormone Replacement Therapy / methods, Humans, Male

Kallmann syndrome (KS) is a rare genetic disorder manifested by the combination of hypogonadotropic-hypogonadism and olfactory dysfunction. It is usually diagnosed at 14 - 16 years of age due to delayed puberty. However, delays in diagnosis have been reported in a few cases. We presented a 34-year-old man presented with primary infertility as the chief complaint. Physical examination revealed bilateral gynecomastia, Tanner stage 2, and anosmia. Hormonal studies show a hypogonadotropic hypogonadism profile. Genetic testing revealed a normal male karyotype. Abdominal ultrasonography (USG) revealed a small prostate, and testicular USG demonstrated small testicles. Neuroimaging study revealed olfactory bulb agenesis and hypoplasia of the olfactory sulcus. Treatment was done by testosterone replacement therapy, and the patient is now on a regular follow-up. In conclusion, suspected clinical features of KS may guide the diagnosis with comprehensive hormonal and imaging studies. However, the reported patient was diagnosed extremely late.
Odontogenic keratocyst looks can be deceptive, causing endodontic misdiagnosis
Authors: K M Veena, Rekha Rao, H Jagadishchandra, Prasanna Kumar Rao
Journal: Case Rep Pathol (2011)
MeSH terms: Case Reports

Odontogenic keratocyst (OKC) is the cyst arising from the cell rests of dental lamina. It can occur anywhere in the jaw, but commonly seen in the posterior part of the mandible. Radiographically, most OKCs are unilocular when presented at the periapex and can be mistaken for radicular or lateral periodontal cyst. When the cyst is multilocular and located at the molar ramus area, it may be confused to ameloblastoma. Lots of cases have been reported in the literature where OKC is associated with the nonvital tooth. So trauma could be one of the reasons in inducing this cyst. In our case, it was in the anterior region at the periapex of nonvital tooth having traumatic occlusion. Hence, the diagnosis of radicular cyst was made and endodontic treatment was done.
Surgical Repair Using Suture Bridge Technique for Triceps Tendon Avulsion
Authors: Ryogo Furuhata, Yusaku Kamata, Aki Kono, Taichi Nishimura, Shinya Otani, Hideo Morioka
Journal: Case Rep Orthop (2021)
MeSH terms: Case Reports

Triceps tendon avulsion is a rarely occurring tendinous injury. Various surgical procedures, such as repair using sutures through the transosseous tunnel or suture anchors, have been reported for treating triceps tendon avulsion. However, standard surgical treatment has not yet been established. Here, we present a case of triceps tendon avulsion treated using the suture bridge technique. A 58-year-old man who fell on his left elbow from standing height presented to our hospital. Plain radiography revealed an avulsion fracture of the left olecranon process, suggesting triceps tendon avulsion. We performed surgical repair of the avulsed bone fragments and ruptured triceps tendon. We inserted suture anchors into the ulna, proximal to the fracture site, and passed the sutures through the full thickness of the triceps. Subsequently, fracture fragments were reduced and fixed by pulling them together with the triceps. We inserted knotless anchors into the ulna distal to the fracture site and fixed the avulsed bone fragments and triceps tendon using the suture bridge technique. The patient recovered well in five months and reported no elbow pain or limited range of motion. This suture bridge technique is advantageous as it prevents iatrogenic fracture and knot irritation, and it would be indicated in cases with poor bone quality or thin skin soft tissue of the olecranon.
Dermatomyositis associated with omalizumab therapy for severe asthma: a case report
Authors: Samira Jeimy, Pari Basharat, Fiona Lovegrove
Journal: Allergy Asthma Clin Immunol (2019)
Keywords: adverse drug reaction, biologics, dermatomyositis, omalizumab
MeSH terms: Case Reports

Background:
Omalizumab is a humanized monoclonal antibody widely used for treatment of persistent allergic asthma and antihistamine-refractory chronic urticaria. Immediate adverse events to omalizumab are well characterized. Delayed anaphylactoid and serum sickness-like reactions have also been described; however, their relationship to the drug remains uncertain, and the frequency is unknown.
Case presentation:
We present a case of a 59-year old female who developed amyopathic dermatomyositis (DM) after receiving omalizumab infusions for steroid-refractory severe asthma. After 6 months of omalizumab, the patient developed an erythematous, intensely pruritic cutaneous eruption. Skin biopsy indicated nonspecific features of dermatitis. However, neither topical corticosteroids nor gabapentin and maximal doses of multiple antihistamines gave her relief. On follow-up clinical exam 8 months later, she had classic cutaneous features of dermatomyositis, with confirmatory repeat skin biopsy. Laboratory investigations revealed negative myositis specific antibodies, positive antinuclear antibody, and negative anti-histone antibodies. Creatine kinase, lactate dehydrogenase, aspartate aminotransferase, alanine aminotransferase levels and C-reactive protein were also within normal limits. These findings supported the clinical impression of amyopathic DM. The patient's symptoms improved with oral corticosteroid therapy. A malignancy screen was negative. There was no evidence of end organ dysfunction.
Conclusions:
Dermatomyositis is not a known adverse effect of omalizumab therapy. DM has a low incidence, but potentially life threatening consequences. Amyopathic DM may represent up to 21% of cases of DM, with similar risks of malignancy and end organ dysfunction. DM has been associated with biologic therapy. Using the Naranjo adverse drug reaction (ADR) probability scale, our patient had a "probable" omalizumab related ADR. A more likely explanation is that the patient had underlying DM that remained occult due to chronic corticosteroid therapy. Our case highlights the need for clinical vigilance and maintenance of a broad differential when patients on biologic therapies present with cutaneous eruptions. In our patient, the cutaneous clinical features of DM became pronounced over serial assessments. Laboratory markers may be deceptively normal, as in amyotrophic DM, or confounded by ongoing corticosteroid therapy. There are important clinical implications of prompt diagnosis, given the association of DM with end organ disease including interstitial lung disease, and possible concomitant malignancy.
Conversion Disorder: Early Diagnosis and Personalized Therapy Plan Is the Key
Authors: Lauren Miller, Robert L Archer, Nidhi Kapoor
Journal: Case Rep Neurol Med (2020)
MeSH terms: Case Reports

Conversion disorder is characterized by one or more symptoms of altered voluntary motor or sensory functions that cannot be explained by a neurological disease (Keynejad, 2019; Samuels et al., 2019). We present a patient with conversion disorder and discuss her process in overcoming this disorder. Additionally, we review the literature about this specific disorder. A 15-year-old white female was diagnosed with conversion disorder and has shown significant recovery with physical therapy and group therapy since. It is essential to recognize this disorder early to lessen the financial burden on families and to speed up the recovery process for these patients.
Transient Thyroiditis after Surgery for Tertiary Hyperparathyroidism: A Case Report
Authors: Yasser Ali Hakami
Journal: Front Endocrinol (Lausanne) (2015)
Keywords: adrenergic beta-antagonists, hyperparathyroidism, parathyroidectomy, post-operative period, thyroid function tests, thyroiditis
MeSH terms: Case Reports

Parathyroid (PTH) exploration surgery carries the risk of developing post-operative thyroiditis due to vigorous manual manipulation of the thyroid gland during surgery. Post-operative thyroiditis has a wide spectrum of clinical manifestations. However, it remains underreported. Here, we describe a case of post-operative transient thyroiditis in a 33-year-old male who developed 3 days after parathyroidectomy for PTH hyperplasia. We review the limited literature regarding this interesting entity.