OpenMed/multicare-articles huggingface dataset:
Indocyanine green fluorescence image-guided total laparoscopic living donor right hepatectomy: The first case report from Mainland China
Authors: Xiangfei Meng, Hongguang Wang, Yinzhe Xu, Mingyi Chen, Weidong Duan, Shichun Lu
Journal: Int J Surg Case Rep (2018)
Keywords: fluorescence, indocyanine green, laparoscopy, living donor liver transplantation, right hepatectomy

Introduction:
Total laparoscopic living donor right hepatectomy (TLDRH) is sporadically reported worldwide. Liver transection margin used to be determined by ischemic demarcation or intraoperative ultrasonography. To identify the site of bile duct division relied on preoperative MRCP and intraoperative cholangiography, which is experience demanding.
Presentation of case:
A 34-year-old man volunteered for living donation to his brother who suffered decompensated HBV-related cirrhosis. Right lobe donation without MHV fulfilled the volumetric criteria. After hilum dissection, ICG was injected into the right portal branch. Right lobe was transected tracing the real-time fluorescence-enhanced borderline and the course of MHV. The right bile duct was transected above the bifurcation that was fluorescently visualized within the parenchyma. The liver graft was retrieved from a pre-made suprapubic incision after simple vascular clamping. The warm ischemia time was 6 min. The recipient procedure was successful with back-table graft venoplasty using cryopreserved iliac artery allografts. The donor recovered uneventfully and was discharged from hospital on POD 7.
Discussion:
The operative time, blood loss and postoperative course of donor is comparable to those undergoing ordinary laparoscopic right hepatectomy in our institute. ICG fluorescence can real-timely visualize the surgical margin and biliary branches of right lobe, which helps preserve every last bit of functional liver volume for the donor and avoid the complicated traditional intraoperative cholangiography.
Conclusion:
TLDRH proves to be achievable in surgical teams confortable with both laparoscopic hepatectomy and LDLT. ICG fluorescence navigation could make the procedure simplified, safer and more accurate. More practice and technical modification are necessary.
Physiologically Difficult Airway in the Patient with Severe Hypotension and Metabolic Acidosis
Authors: Joseph Capone, Vicko Gluncic, Anita Lukic, Kenneth D Candido
Journal: Case Rep Anesthesiol (2020)
MeSH terms: Case Reports

The expertise to recognize and manage the difficult airway is essential in anesthesiology. Conventionally, this refers to anatomical concerns causing difficulties with facemask ventilation and/or with tracheal intubation. Severe derangements in patients' physiology can make induction and intubation likewise difficult, and approximately 30% of critically ill patients had cardiovascular collapse subsequently to intubation. We present the case of a 58-year-old male with a past medical history of type II diabetes and hypertension who presented with altered mental status due to severe metabolic acidosis with a pH of 6.8 on admission to the intensive care unit. The anesthesia team was called to urgently intubate the patient. Upon arrival, the patient was localizing to pain and was hypocapnic, tachycardic, and hypotensive despite ongoing therapy with norepinephrine, vasopressin, and bicarbonate drips. Bedside point-of-care ultrasound showed hyperdynamic left ventricle with no other abnormalities. The patient was induced with IV ketamine, and dissociation occurred with maintenance of spontaneous respirations, which was followed by laryngoscopy and intubation causing only minimal hemodynamic changes. The patient was subsequently dialyzed and treated supportively. He was discharged from the hospital two weeks later-neurologically intact and at his baseline. Combination of hypotension and severe metabolic acidosis is particularly a challenging setting for airway management and a major risk factor for adverse events, including cardiopulmonary arrest. Hemodynamically stable induction agents should be preferred. In addition, sustaining spontaneous ventilation and avoiding periods of apnea in the peri-intubation period is paramount-any buildup of CO2 could push a critically low pH even lower and cause cardiovascular collapse. Sympathomimetic properties of ketamine make this induction agent a particularly appealing choice in this setting. This case report further supports the concept that severe physiologic perturbations-in which conventional induction techniques are not feasible-should be included in the current definition of a difficult airway.
Unilateral hydronephrosis and renal damage after acute leukemia
Authors: Egle Simanauskiene, Valentina Daugelaviciene, Arvydas Laurinavicius, Ugnius Mickys, Vaida Simonyte, Goda Vaitkeviciene, Gilvydas Verkauskas
Journal: Case Rep Med (2012)
MeSH terms: Case Reports

A 14-year-old boy presented with asymptomatic right hydronephrosis detected on routine yearly ultrasound examination. Previously, he had at least two normal renal ultrasonograms, 4 years after remission of acute myeloblastic leukemia, treated by AML-BFM-93 protocol. A function of the right kidney and no damage on the left was confirmed by a DMSA scan. Right retroperitoneoscopic nephrectomy revealed 3 renal arteries with the lower pole artery lying on the pelviureteric junction. Histologically chronic tubulointerstitial nephritis was detected. In the pathogenesis of this severe unilateral renal damage, we suspect the exacerbation of deleterious effects of cytostatic therapy on kidneys with intermittent hydronephrosis.
Full response of a localized renal tumour after reduced-intensity conditioned hematopoietic stem cell transplantation
Authors: Anne-Claire Gac, Sylvain Chantepie, Michel Leporrier, Oumedaly Reman
Journal: Case Rep Med (2009)
MeSH terms: Case Reports

Graft versus tumor effect has been described in solid metastatic tumor. We reported here the case of a patient treated for an acute myeloid leukemia with reduced-intensity conditioned allograft and the effect of this procedure on concomitant of renal localised cancer. The effect of immune-mediated cytotoxicity on renal cancer is the more consistent explanation to understand the necrosis of this tumor. Any case of RIC allograft has been reported before to treat localised renal tumor.
BCR-ABL1-positive acute lymphoblastic leukemia following successful treatment of acute promyelocytic leukemia: case report
Authors: Shuang Fu, Mengqi Li, Hongtao Wang
Journal: Front Pharmacol (2023)
Keywords: bcr-abl1, pml-rarα, acute lymphoblastic leukemia, acute promyelocytic leukemia, secondary malignancy
MeSH terms: Case Reports

Acute promyelocytic leukemia (APL) is currently considered a disease with a higher cure rate. And cases of secondary malignant tumors following successful APL treatment are rare. Here we described a rare case of a 29-year-old man who was treated for APL in 2019 and developed BCR-ABL1-positive acute lymphoblastic leukemia 2 years later. The patient responded well to tyrosine kinase inhibitors and chemotherapy, and achieved a molecular remission. Although APL usually has a good prognosis, the prognosis of its secondary malignancies is uncertain. There are no effective measures to prevent the occurrence of secondary tumors. Continuing to increase the monitoring frequency of laboratory tests, especially the molecular biomarkers, is essential for the diagnosis and treatment of secondary malignancies after the patients achieving complete remission.
1p36 Deletion Syndrome and Left Ventricular Non-compaction Cardiomyopathy-Two Cases Report
Authors: Subin Jang, Allison Taber, Michael G Bateman, Marie E Steiner, Rebecca K Ameduri, Massimo Griselli
Journal: Front Pediatr (2021)
Keywords: 1p36 deletion syndrome, lvnc, cardiomyopathy, case report, non-compaction
MeSH terms: Case Reports

1p36 deletion is the most common terminal deletion syndrome in humans. Herein, we report two cases, a 5-month-old female and a 14.5-year-old female, both with 1p36 deletion and left ventricular non-compaction cardiomyopathy. They presented with severely depressed left ventricle function and underwent heart transplantation with excellent outcomes. Given the incidence of heart defects and cardiomyopathy in 1p36 deletion syndrome, it should be recommended that children with this genetic condition have screening for cardiac disease. These cases add to the current literature by demonstrating the potential therapeutic options for non-compaction in 1p36 deletion syndrome and showed the favorable outcomes.
Acute autonomic, sensory and motor neuropathy associated with meningoencephalitis
Authors: Satoko Kinoshita, Kazuma Sugie, Hiroshi Kataoka, Miho Sugie, Makito Hirano, Satoshi Ueno
Journal: Clin Med Case Rep (2009)
Keywords: acute autonomic, dysautonomia, intravenous immunoglobulin (ivig), meningoencephalitis, motor and sensory neuropathy (aasmn)
MeSH terms: Case Reports

We report the first case of acute autonomic, motor and sensory neuropathy (AASMN) associated with meningoencephalitis. A 62-year-old man presented with fever, neck stiffness, and coma. Respiratory failure developed. Magnetic resonance images showed an abnormality in the medial temporal lobe. Cerebrospinal fluid analysis revealed pleocytosis with a high protein level. Intensive care gradually improved the consciousness level, but paralysis of the four extremities persisted. Nerve conduction studies revealed demyelinating sensory and motor polyneuropathy. Severe orthostatic hypotension, urinary retention, and constipation were also present. Clinical autonomic tests suggested both sympathetic and parasympathetic dysfunction. After intravenous immunoglobulin therapy, motor and sensory symptoms resolved rapidly; dysautonomia resolved gradually over the next 2 months. The response to immunological therapy and the presence of antecedent infection suggest that AASMN is a postinfectious, immune-mediated, autonomic, sensory and motor nervous system dysfunction.
A case report of cervical pregnancy after in vitro fertilization complicated by tuberculosis and a literature review
Authors: Kun Liu, Xuehong Zhang, Xiaoling Ma, Xueling Jia, Xiaodong Zhao, Xia Yang, Yufeng Zhang
Journal: Open Med (Wars) (2020)
Keywords: ivf, infertility, pregnant, treatment, tuberculosis
MeSH terms: Case Reports

Although female genital tuberculosis may lead to infertility, pregnancy is still possible, especially through in vitro fertilization (IVF). In this eventuality, even latent tuberculosis (TB) infection is prone to reactivate. Because some of the symptoms of TB overlap with those of pregnancy, diagnosis and treatment may be delayed. We report the case of a 30-year-old infertile woman with repeated genital tuberculosis (GTB) who underwent two laparoscopic surgeries and anti-TB treatments. The woman conceived through IVF and, unfortunately, a cervical pregnancy was diagnosed, together with a third recurrence of GTB. When the condition became stable after anti-TB treatment, the pregnancy was terminated using oral mifepristone in combination with an ultrasound-guided local injection of methotrexate. The gestational sac was expelled 4 days later with minimal blood loss. In view of the reciprocal influence and interconnection between IVF, pregnancy, and TB, we conducted a literature review to provide valuable information for early diagnosis and treatment, as well as for routine screening before IVF of TB in infertile patients.
Shoulder Pain Associated With Multiple Arteriovenous Malformations Successfully Treated With Embolization
Authors: Frank A Cusimano, Martyna Czarnik, Anthony Watkins, Adam Tonis, David A Greuner
Journal: Cureus (2023)
Keywords: arteriovenous malformations, capillary venous malformation, gelfoam, transarterial embolization, transvenous embolization, traumatic avm, vascular embolization
MeSH terms: Case Reports

A 44-year-old male presented with left upper extremity and shoulder pain with worsening functional impairment after years of repetitive use, overtraining, and multiple injuries from weightlifting and mixed martial arts. Imaging showed no obvious injury or ligamentous deformity other than mild osteoarthritis (OA) of the left glenohumeral joint. Duplex ultrasonography (US) revealed four arteriovenous malformations (AVMs) surrounding the shoulder joint and left upper extremity. The vasculature was mapped via angiography through a transradial approach. Initial treatment included transarterial embolization of two AVMs off the axillary artery and branching anterior circumflex humeral artery. Secondary treatment included embolization of two lesions months later via direct puncture, one through a transvenous approach and the second through direct transmalformation cannulation, via the nidus, near the clavicle and posterior scapular lateral border. Treatment resulted in significant improvement in pain and range of motion. Follow-up assessments revealed improvement in overall symptoms, recovered function, and return to exercise and competitive mixed martial arts. This case highlights the value of duplex ultrasonography, embolization, and transarterial and transvenous approaches for the treatment of AVM-associated extremity or joint pain.
Precision Medicine Tools to Guide Therapy and Monitor Response to Treatment in a HER-2+ Gastric Cancer Patient: Case Report
Authors: Adriana Aguilar-Mahecha, Sarah Joseph, Luca Cavallone, Marguerite Buchanan, Urszula Krzemien, Gerald Batist, Mark Basik
Journal: Front Oncol (2019)
Keywords: her-2+, t-dm1, ctdna, gastric cancer, patient derived xenograft, precision medicine
MeSH terms: Case Reports

Trastuzumab, has played a major role in improving treatment outcomes in HER-2 positive gastric cancer. However, once there is disease progression there is a paucity of evidence for second line therapy. Patient-derived xenografts (PDXs) in combination with liquid biopsies can help guide individual therapeutic decisions and have now started to be studied. In the present case we established a PDX model from a metastatic HER-2+ gastric cancer patient and after the first engraftment passage we performed a mouse clinical trial to test T-DM1 as an alternative therapy for the patient. The PDX tumor response served as a guide to administer T-DM1 therapy to the patient who responded to treatment before relapsing 6 months later. Throughout out the clinical follow up of the patient, ctDNA levels of HER-2 copy number and a PIK3CA mutation were monitored and we found their correlation with drug response and disease progression to outperform that of CEA levels. This study highlights the utility of applying precision medicine tools combining PDX models to guide therapy with circulating tumor DNA (ctDNA) to monitor treatment response and disease progression.
Congenital Laryngeal Cyst as a Rare Cause of Stridor in Infants: Two Case Reports
Authors: Samuel Chu, Farhana A, Farid R, Saraiza Abu Bakar
Journal: Cureus (2023)
Keywords: congenital laryngeal cyst, laryngeal lesions, otolaryngology, otolaryngology case report, paediatric ent, paediatric otolaryngology, stridor
MeSH terms: Case Reports

Congenital laryngeal cysts are a rare cause of stridor in infants. These cysts may have serious clinical implications if not promptly recognized. A small laryngeal cyst may remain asymptomatic. However, if large, it can block the laryngeal inlet leading to acute airway obstruction, which is potentially life-threatening. In pediatric patients presenting with respiratory distress, prompt diagnosis and surgical management are crucial to avoid infant morbidity and mortality. We describe two cases of laryngeal vallecular cysts in infants and their management in our clinical practice.
Atypical Teratoid/Rhabdoid Tumor Originated From the Trigeminal Nerve in a Young Male Adult: Case Report and Review of the Literature
Authors: Fuxiang Chen, Wenzhong Mei, Wen Lu, Tiefa Zeng, Dezhi Kang, Xiyue Wu, Honghai You
Journal: Front Neurol (2020)
Keywords: adult, atypical teratoid/rhabdoid tumor, cranial nerve, surgery, trigeminal nerve
MeSH terms: Case Reports

Atypical teratoid/rhabdoid tumor (AT/RT) is a highly malignant central nervous system neoplasm predominantly found in children under the age of 3 years, and is extremely rare in adults. There is no specific clinical presentations or radiological features in reported cases of AT/RT. Diagnosis of brain AT/RT is mainly dependent on the classical pathological characteristics. We report a rare case of AT/RT arising from the trigeminal nerve and leading to progressively multiple cranial nerve palsies in a 25-year-old male patient. Microsurgical resection of the tumor has been performed and confirmed the diagnosis by postoperative pathology. To our knowledge, this is the second case of adult-onset AT/RT originating from the trigeminal nerve.
Daily 10 mg rivaroxaban as a therapy for ventricular thrombus related to left ventricular non-compaction cardiomyopathy: A case report
Authors: Huan Sun, Qini Zhao, Yanjing Wang, Robert Lakin, Haiyan Feng, Xingyu Fan, Huiling Luo, Dongmei Gao, Lin Liu, Yuquan He, Ping Yang
Journal: Medicine (Baltimore) (2018)
MeSH terms: Factor Xa Inhibitors / administration & dosage, Isolated Noncompaction of the Ventricular Myocardium / complications, Rivaroxaban / administration & dosage, Thrombosis / drug therapy, Ventricular Dysfunction, Left / drug therapy, Case Reports, Adult, Humans, Male, Thrombosis / etiology, Ventricular Dysfunction, Left / etiology, Factor Xa Inhibitors, Rivaroxaban

Rationale:
Left ventricular non-compaction cardiomyopathy (LVNC) is a rare heart disorder related to thrombosis. Anticoagulant therapy is suggested for the treatment of this disease. The success of the novel oral anticoagulant rivaroxaban as a treatment option for this disorder is unclear.
Patient concerns:
A 43-year-old man who felt dizzy at rest was found to have an intraventricular thrombus.
Diagnoses:
The thrombus was confirmed by echocardiography. And LVNC was diagnosed by cardiac magnetic resonance (CMR) and echocardiography.
Interventions:
He was prescribed a low dose (10 mg daily) of rivaroxaban as treatment.
Outcomes:
After 3 months, the thrombus diminished, and the manifestation disappeared.
Lessons:
Low dose of rivaroxaban may serve as a viable option for anticoagulation therapy in LVNC patients, with large clinical trials needed to determine the best course of treatment.
Bilateral Supracondylar Humerus Fracture in Pediatric after a Fall on an Outstretched Hand
Authors: Basam Alanazi, Jameel Fakeeha, Abdulrahman Pasha, Hussam Alqulaiti, Hani Alharbi, Jameel Mahmoud
Journal: Case Rep Orthop (2019)
MeSH terms: Case Reports

Background. Supracondylar humerus fracture (SCH) is common in the pediatric age group 5-7 years, mostly due to a fall on an outstretched hand. However, a bilateral SCH is rarely observed in this age group. Management of SCH is either surgical or conservative based on the following factors: patient age, fracture pattern and neurovascular involvement. Complications of a displaced SCH can be dramatically reduced by early surgical fixation. Acute complications include: neurovascular injury and compartment syndrome, and long term complications include: stiffness, infections and angular deformities. In this article, we present a rare case of bilateral supracondylar humerus fractures with a six-months follow-up.
Spontaneous atlanto-axial dislocation and trisomy 21: causal factors and management
Authors: Fah Bouaré, Mohamed Lmejjati, Davis Mpando
Journal: Pan Afr Med J (2019)
Keywords: atlanto-axial joint dislocation (c1-c2), down syndrome, neurosurgery, spinal cord compression, trisomy 21
MeSH terms: Atlanto-Axial Joint / diagnostic imaging, Down Syndrome / complications, Joint Dislocations / etiology, Joint Instability / etiology, Case Reports, Atlanto-Axial Joint / pathology, Female, Humans, Joint Dislocations / diagnostic imaging, Joint Dislocations / surgery, Joint Instability / diagnostic imaging, Magnetic Resonance Imaging, Odontoid Process / diagnostic imaging, Paresis / etiology, Radiography, Spinal Cord Compression / etiology, Tomography, X-Ray Computed, Young Adult

Spontaneous atlanto-axial (C1-C2) dislocation is an atlanto-axial instability, found in 10 to 30% of trisomy 21 patients, the majority of whom is asymptomatic. We report a case of a 21 years-old woman, with trisomy 21, admitted in our department presenting a spinal cord compression syndrome with right hemiparesis associated with a cervicalgia evolving for 3 months of admission without trauma. Standard cervical radiography showed a C1-C2 dislocation with posterior displacement of the odontoid process. A cervical computerized tomography revealed a C1-C2 dislocation with significant recoil of the odontoid process. A cervical magnetic resonance imaging (MRI) confirmed the bulbo-medullar junction compression on the dislocation. The surgical treatment consisted of a cervico-occipital fixation. The laxity of the transverse ligament is one of the main causes of C1-C2 dislocation; hypoplasia, malformation or complete absence of the odontoid process; are also predisposing factors. It must be early detected. The treatment of choice is surgical also by arthrodesis of C1 to C4 + graft and enlargement of the occipital foramen or occipito-cervical arthrodesis by synthetic graft and Cotrel-Dubousset system or occipito-C4 arthrodesis + laminectomy of C1 and enlargement of the occipital foramen.
Freestyle Local Perforator Flaps for Facial Reconstruction
Authors: Jun Yong Lee, Ji Min Kim, Ho Kwon, Sung-No Jung, Hyung Sup Shim, Sang Wha Kim
Journal: Biomed Res Int (2015)
MeSH terms: Face / abnormalities, Face / surgery, Facial Neoplasms / surgery, Perforator Flap, Plastic Surgery Procedures / methods, Case Reports, Adult, Aged, Child, Female, Humans, Male, Middle Aged

For the successful reconstruction of facial defects, various perforator flaps have been used in single-stage surgery, where tissues are moved to adjacent defect sites. Our group successfully performed perforator flap surgery on 17 patients with small to moderate facial defects that affected the functional and aesthetic features of their faces. Of four complicated cases, three developed venous congestion, which resolved in the subacute postoperative period, and one patient with partial necrosis underwent minor revision. We reviewed the literature on freestyle perforator flaps for facial defect reconstruction and focused on English articles published in the last five years. With the advance of knowledge regarding the vascular anatomy of pedicled perforator flaps in the face, we found that some perforator flaps can improve functional and aesthetic reconstruction for the facial defects. We suggest that freestyle facial perforator flaps can serve as alternative, safe, and versatile treatment modalities for covering small to moderate facial defects.
Operative Management of Sciatic Nerve Palsy due to Impingement on the Metal Cage after Total Hip Revision: Case Report
Authors: Alessandro Bistolfi, Giuseppe Massazza, Davide Deledda, Elisa Lioce, Maurizio Crova
Journal: Case Rep Med (2011)
MeSH terms: Case Reports

This paper discusses a sciatic nerve palsy developed after a right total hip revision with a Burch-Schneider metal cage. A sciatalgic nerve pain appeared after surgery, while the palsy developed in about fifteen days. An electromyography showed the delay of the nerve impulse gluteal level. During the surgical exploration of the hip, a compression of the nerve on the metal cage was observed. The nerve was isolated, released from the fibrotic tissue and from the impingement, and was protected with a muscular flap. The recover from the pain was immediate, while the palsy recovered one month later.