OpenMed/multicare-articles huggingface dataset:
Complete remission of advanced pancreatic cancer induced by claudin18.2-targeted CAR-T cell therapy: a case report
Authors: Guocheng Zhong, Xiaomin Zhang, Zheng Guo, Yujie Gao, Bochen Zhao, Xianhao Liu, Lei Chen, Jingqiao Qiao, Chuan Yu, Lixin Wang, Yisheng Li, Li Yu
Journal: Front Immunol (2024)
Keywords: car-t cell therapy, advanced pancreatic cancer, antigen-negative relapse, claudin182, complete remission
MeSH terms: Pancreatic Neoplasms / therapy, Receptors, Chimeric Antigen, Case Reports, Research Support, Non-U.S. Gov't, Aged, Cell- and Tissue-Based Therapy, Humans, Male, Neoplasm Recurrence, Local, Pathologic Complete Response, Recurrence, Receptors, Chimeric Antigen

Pancreatic cancer (PC) is one of the most malignant tumors in digestive system due to its highly invasive and metastatic properties. At present, conventional treatment strategies for PC show the limited clinical efficacy. Therefore, novel effective therapeutic strategies are urgently needed. Here, we report a case of complete remission of advanced PC induced by claudin18.2-targeted CAR-T cell therapy. The patient was a 72-year-old man who was diagnosed with pancreatic ductal adenocarcinoma 2 years ago, and he experienced tumor recurrence and multiple metastases after pancreaticoduodenectomy and multi-line chemotherapies, including liver, peritoneum, and cervical lymph node metastases. Then, the patient was referred to our department for further treatment of metastatic PC, and he was enrolled in a clinical trial of claudin18.2-targeted CAR-T cell therapy. After lymphodepleting chemotherapy, the patient received claudin18.2-targeted CAR-T cell infusion at a dose of 1.2 × 106 cells/kg on November 21, 2022. During CAR-T cell therapy, the patient experienced grade 2 cytokine release syndrome (CRS) and gastric mucosa injury, which were controlled by tocilizumab and conventional symptomatic and supportive treatment. The patient achieved a complete response (CR) 1 month after claudin18.2-targeted CAR-T cell therapy, and remained in clinical remission for 8 months. Unfortunately, the patient experienced claudin18.2-negative relapse in July, 2023. Despite antigen-negative relapse after claudin18.2-targeted CAR-T cell infusion, the patient achieved sustained remission for 8 months, which indicates that claudin18.2-targeted CAR-T cell therapy is an extremely effective therapeutic strategy for the treatment of advanced PC.
Vertebrobasilar dolichoectasia to trigeminal neuralgia: case report
Authors: Fangkun Jing, Haitao Huang, Yanfeng Li, Peizhuo Zang
Journal: J Surg Case Rep (2024)
Keywords: endovascular treatment, trigeminal neuralgia, vertebrobasilar dolichoectasia
MeSH terms: Case Reports

Vertebrobasilar dolichoectasia (VBD) is a dilated arterial disease with a diameter ˃4.5 mm. Trigeminal neuralgia (TN) is chronic neuropathic pain. Through the diagnosis and treatment of this case we believe that there is a significant risk associated with the endovascular treatment of VBD. The development of post-operative complications caused some functional impairment to the patient, but the improvement in TN symptoms with this endovascular treatment was unexpected. This treatment procedure was considered to be possibly related to the alteration of the tortuous path of the vessels, changing their course, allowing the displacement of vascular compression in the trigeminal root entry zone, and possibly also altering the hemodynamics of the posterior circulation, improving the progression of ischemia and hypoxia-induced demyelination of the trigeminal nerve. Due to the low incidence of this disease, there are not enough large sample studies for systematic statistical analysis.
Case report: Clinically mild encephalitis/encephalopathy with a reversible splenial lesion: an autopsy case
Authors: Maho Hayashi, Midori Ueda, Koji Hayashi, Ei Kawahara, Shin-Ichiro Azuma, Asuka Suzuki, Yuka Nakaya, Rei Asano, Mamiko Sato, Toyoaki Miura, Hiromi Hayashi, Kouji Hayashi, Yasutaka Kobayashi
Journal: Front Neurol (2024)
Keywords: autopsy
MeSH terms: Case Reports

Clinically mild encephalitis/encephalopathy with a reversible splenial lesion is a clinicoradiological syndrome characterized by transient neuropsychiatric symptoms and hyperintensity of the splenium of the corpus callosum on diffusion-weighted MRI. Although intramyelinic edema and inflammatory cell infiltration can be predicted by MRI, the pathology of the splenium of the corpus callosum remains unknown. We encountered a case of clinically mild encephalitis/encephalopathy with a reversible splenial lesion and hypoglycemia in a patient who died of sepsis, and an autopsy was performed. The postmortem pathological findings included intramyelinic edema, myelin pallor, loss of fibrous astrocytes, microglial reactions, and minimal lymphocytic infiltration in the parenchyma. Based on these findings, transient demyelination following cytotoxic edema in the splenium of corpus callosum was strongly considered a pathogenesis of "clinically mild encephalitis/encephalopathy with a reversible splenial lesion" associated with hypoglycemia, and it could be generalized for the disease associated with the other causes. As cytotoxic edema could be the central pathology of the disease, the recently proposed term cytotoxic lesions of the corpus callosum may be applicable to this syndrome.
Management of Concomitant Intrusion and Complicated Crown-Root Fracture Injury of Maxillary Central Incisors in a Child
Authors: Tariq Abu Haimed, Samah S Abdeltawab, Rayyan A Kayal, Mona H Almotairi, Khalid H Zawawi
Journal: Case Rep Dent (2023)
MeSH terms: Case Reports

Dental intrusions are a severe type of injury because they impact the neurovascular supply of the tooth as well as the supporting tissues which predispose the tooth to necrosis and root resorption. Management of these injuries requires repositioning of the teeth under close monitoring to avoid complications. The management becomes more comprehensive when an intrusion is combined with other injuries, such as a crown-root fracture. This case report represents a 4-year follow-up of a child who suffered from a concomitant injury of intrusion and complicated crown-root fracture to the maxillary immature permanent central incisors. The management involved a multidisciplinary approach including endodontics, pedodontics, orthodontics, periodontics, and prosthodontics. Given the guidelines of dental trauma and the circumstances of the case, the fractured teeth were root canal treated, filled with a bioceramic plug and gutta-percha, and then restored with posts/cores and temporary crowns. The intrusion was managed initially by passive eruption followed by an active orthodontic eruption, after which the teeth were restored with permanent ceramic crowns. Throughout the course of treatment, the teeth showed no complications of root resorption or ankylosis, although one tooth developed a periapical infection which was managed by apical surgery. At the 4-year follow-up, the teeth revealed healthy periodontium and good esthetics.
A Novel Surgical Technique Using a Hockey Stick-Like Guided Knife to Go Through the Eyes of a Needle for Trigger Finger
Authors: Saaya Amano, Yukio Mikami, Tetsushi Chikamoto, Kanzo Amano, Toshiaki Kanazawa, Nobuo Adachi
Journal: J Hand Surg Glob Online (2023)
Keywords: case report, eyes of a needle technique, percutaneous surgery, special guided knife, trigger finger
MeSH terms: Case Reports

Trigger finger surgery is primarily managed with open surgery accompanied by 10-14 days of postoperative recovery, which may interrupt activities of daily living. In the past, we attempted to perform percutaneous surgery by inserting a hockey stick-shaped guide knife through a scalpel incision several millimeters long. Sometimes, we encounter difficult cases wherein triggering does not disappear despite repeated attempts to release the A1 pulley through the small incision, thus forcing us to extend the incision. As a result, the postoperative recovery is sometimes prolonged. We describe our experience using a novel percutaneous procedure in which a guide knife was inserted through one or two 20-gauge needle holes, instead of a scalpel skin incision, to release the A1 pulley. We describe a new method that minimizes skin and soft tissue damage and reliably shortens posttreatment recovery.
Case report: Preliminary study on the diagnosis and treatment of respiratory distress in patients with giant nodular goiter complicated with severe COVID-19
Authors: Fang Wang, Xing Yu, Zhangxia Ren, Yong Wang
Journal: Front Med (Lausanne) (2023)
Keywords: covid-19, diagnosis and treatment plan, giant nodular goiter, respiratory distress, surgery
MeSH terms: Case Reports

Background:
To investigate the practicality of emergency surgical and conservative medical treatments in patients with giant nodular goiter complicated by severe coronavirus disease 2019 (COVID-19)-related respiratory distress, evaluate the prognosis based on the two interventions, and explore the diagnosis and treatment plan of COVID-19-related respiratory distress in patients with giant nodular goiter.
Methods:
Four cases were retrospectively collected. Among them, two cases underwent emergency surgery, one case was treated with conservative treatment, whereas the fourth case underwent emergency surgery after failure of conservative therapy.
Results:
Dyspnea was significantly improved postoperatively, and the endotracheal tube was successfully removed 10.5 h after the operation, but inflammatory markers were greatly enhanced as compared to the preoperative values, patients with different degrees of fever, cough, and other discomforts postoperatively. Case 1 showed complete remission of all symptoms after 3 weeks, while case 2 displayed fever, cough, drowsiness, and other symptoms after the discharge and was eventually readmitted. In case 3, the conservative COVID-19 treatment marginally improved the pulmonary infection, fever, and other symptoms, but cough and other discomforts were persistent, along with delirium in later stages. Moreover, case 4 reported extubation failure after undergoing treatment with the standard new coronary pneumonia regimen in the tracheal intubation state; however, the patient was successfully weaned and extubated 9 days after emergency surgery to relieve the obstruction.
Conclusion:
Our preliminary exploration suggested that patients with giant nodular goiter and respiratory tract obstruction post-acute COVID-19 infection can undergo early surgery after surgical tolerance evaluation for a better prognosis.
Malignant Epithelioid Mesothelioma of the Tunica Vaginalis Testis Presenting as Hydrocele in a Kidney Transplant Recipient
Authors: Brett M Behers, Christopher W Guske, Benjamin J Behers, Spencer B Kortum, Isabella G Bermingham, Christina L Warner, Robert I Carey
Journal: Case Rep Urol (2024)
MeSH terms: Case Reports

Mesotheliomas of the tunica vaginalis testis are rare malignant tumors that can present as a scrotal mass or hydrocele. These tumors are typically aggressive with high rates of recurrence and metastasis. Suspected risk factors for malignant mesothelioma include asbestos exposure, chronic inflammation, trauma, and persistent hydrocele. We report the case of a malignant epithelioid mesothelioma of the tunica vaginalis testis that presented as a finding at hydrocelectomy and was ultimately treated with radical inguinal orchiectomy. This patient was on chronic immunosuppression therapy with tacrolimus and mycophenolate mofetil secondary to a kidney transplant but had none of the common risk factors for mesothelioma formation. To our knowledge, this is the first case describing a possible connection between chronic immunosuppression and mesothelioma of the tunica vaginalis. However, future studies are needed to investigate this association and discern whether this could have played a role in our patient or if his mesothelioma formation was coincidental.
Getting up With Lateral Thinking
Authors: Anita Patel, Stephen Kirker
Journal: Adv Rehabil Sci Pract (2024)
Keywords: falls, mangar elk, raizer chair, air mattress, case report, long lie, pressure sores, rehabilitation, rhabdomyolysis
MeSH terms: Case Reports

Introduction:
Falls in the community can have major impacts on patient lives. There can be long lasting physical and psychological consequences of a fall and subsequent long lie. The annual burden to ambulance services responding to falls at home is high. Affordable devices to help people get up from the floor, or reduce the risk of a long lie, would be useful and widely applicable.
Case report:
We present the case of 2 families who successfully used an air mattress and a bath lift to get the fallen person up off the floor following a fall, when they had previously called an ambulance. This has reduced their dependence on the ambulance service and has improved their confidence following falls.
Discussion/conclusion:
Affordable devices such as air mattresses can help people off the floor following a fall and prevent long lies as well as reduce the number of ambulance call outs.
Case Report: MR-LINAC-guided adaptive radiotherapy for gastric cancer
Authors: Yajun Song, Yun Zhang, Huadong Wang, Mengyu Zhao, Fada Guan, Zhenjiang Li, Jinbo Yue
Journal: Front Oncol (2023)
Keywords: mr-linac, adaptive planning, gastric cancer, magnetic resonance guided radiation therapy, online adaptive radiation therapy, radiotherapy
MeSH terms: Case Reports

Background:
The stomach is one of the most deformable organs. Its shape can be easily affected by breathing movements, and daily diet, and it also varies when the body position is different. The susceptibility of stomach has made it challenging to treat gastric cancer using the conventional image-guided radiotherapy, i.e., the techniques based on kilovoltage X-ray imaging. The magnetic resonance imaging guided radiotherapy (MRgRT) is usually implemented using a hybrid system MR-LINAC. It is feasible to implement adaptive radiotherapy using MR-LINAC for deformable organs such as stomach. In this case report, we present our clinical experience to treat a gastric cancer patient using MR-LINAC.
Case description:
The patient is a 58-year-old male who started having black stools with no apparent cause a year ago. Gastroscopy result showed pancreatic cancer, pathology: adenocarcinoma on gastric cancer biopsy, adenocarcinoma on gastric body minor curvature biopsy. The patient was diagnosed with gastric cancer (adenocarcinoma, cTxN+M1, stage IV, HER-2 positive). The patient was treated in 25 fractions with radiotherapy using MR-LINAC with online adaptive treatment plans daily. The target area in daily MR images varied considerably when compared with the target area on the CT simulation images. During the course of treatment, there have even been instances where the planned target area where the patient received radiotherapy did not cover the lesion of the day.
Conclusion:
Online adaptive MRgRT can be a meaningful innovation for treating malignancies in the upper abdomen. The results in the current study are promising and are indicative for further optimizing online adaptive MRgRT in patients with inoperable tumors of the upper abdomen.
Case report: Localized coloproctitis caused by novel Basidiobolus arizonensis in a dog
Authors: Annalise Black, Marcellina Wiertek, Sylvia Ferguson, Kathryn Wycislo, Laura Rayhel, Heather Reid, Nathan Wiederhold, Connie Cañete-Gibas
Journal: Front Vet Sci (2024)
Keywords: basidiobolomycosis, canine, case report, fungal, inflammatory bowel disease (ibd), proctitis, zygomycosis
MeSH terms: Case Reports

A 6-year-old male neutered boxer mix canine was presented for a one-month history of dyschezia, hematochezia, and constipation. Colonoscopy and endoscopic biopsies revealed non-specific lymphoplasmacytic, eosinophilic colitis. Despite pursuing various therapies over a 3.5-month clinical course (including hypoallergenic diet, antibiotics, prokinetics, laxatives, and anti-inflammatory glucocorticoids), the patient's condition did not improve. Two and a half months after initial presentation, the patient developed circumferential proctitis with multiple draining tracts and obstipation. Humane euthanasia and postmortem examination were elected. Gross and histological findings revealed locally extensive pyogranulomatous coloproctitis with many intralesional PAS-positive, GMS-negative 30-40 μm in diameter, hyaline, pauciseptate, irregularly branching fungal hyphae, hyphal bodies or chlamydospores and 25-45 μm in diameter thick-walled zygospores. Fungal culture of fluid from the draining tracts was performed, and DNA sequence analysis of the ITS and partial LSU of the nuclear ribosomal RNA genes were used to identify and confirm a novel species, Basidiobolus arizonensis. Basidiobolus spp. are saprobes in the order Basidiobolales and most commonly cause granulomatous infections of the skin, respiratory tract, and gastrointestinal tract in veterinary species and humans. To the authors' knowledge, this is the first report of novel Basidiobolus arizonensis causing localized coloproctitis in a dog.
Reading and writing from right to left after anterior cerebral artery stroke
Authors: Lílian Reuter, Guilherme Carvalho, Alex Reuter, Paula Caldeira
Journal: Dement Neuropsychol (2024)
Keywords: agraphia, dyslexia, infarction, anterior cerebral artery, motor cortex, rehabilitation of speech and language disorders, stroke
MeSH terms: Case Reports

This is the case report of a woman who started to write and read from right to left after anterior cerebral artery stroke, affecting the left supplementary motor area. No cases were found in the literature with exactly the same characteristics. She has been able to read and write faster after rehabilitation approach at Sarah Network of Rehabilitation Hospitals, in the Belo Horizonte city unit, Brazil, despite the maintenance of the inversion. She returned to her previous activities in an adaptive way. It was discussed how the dysfunction in this cerebral area and its connections may disturb the reading strategy and direction.
The efficacy of electroacupuncture for cervical nerve edema and movement disorder caused by the brachial plexus injury: a case report
Authors: Chao Wang, Yingjun Liu, Lu Li, Haijuan Zhang, Ziyu Ye, Linfang Zhao
Journal: Front Neurol (2024)
Keywords: brachial plexus injury, case report, cervical nerve edema, electroacupuncture, movement disorder
MeSH terms: Case Reports

The brachial plexus injury (BPI) is one of the most severe types of peripheral nerve injuries, often caused by upper limb traction injury. In clinic, the surgery is widely used to treat the BPI. However, surgery may need to be performed multiple times at different stages, which carries risks and brings heavy economic burden. In non-surgical treatment, splinting, local injection of corticosteroids, and oral corticosteroids can achieve significant short-term benefits, but they are prone to recurrence and may cause complications of mechanical or chemical nerve damage. In this report, we present a case of a 46-year-old female patient with BPI. The patient had difficulty in raising, flexing and extending of the left upper limb, and accompanied with the soreness and pain of neck and shoulder. After 3 months of EA treatment, a significant reduction in the inner diameter of the left C5 to C7 root at the outlet of brachial plexus nerve was detected by musculoskeletal ultrasound, and the soreness and pain in the left neck and shoulder were significantly reduced. The soreness and pain in the left neck and shoulder did not recur for 2 years.
Case summary:
The patient is a 46-year-old female with BPI. She experienced difficult in lifting, flexing and extending of the left upper limb, which accompanied by soreness and pain in the left neck and shoulder. After 3 months of EA treatment, the patient's pain and limb's movement disorder was improved. After 2 years of follow-up, the patient's left neck and shoulder showed no further pain.
Conclusion:
EA has shown satisfied efficacy in BPI, improving limb restrictions and relieving pain in patients for at least 2 years.
Invisible Active Bleeding Due to the Watershed Phenomenon
Authors: Miloud Dewilde, Birgitt Janssens
Journal: J Belg Soc Radiol (2024)
Keywords: ct angiography (cta), watershed phenomenon, abdominal, active bleeding, heart failure, veno-arterial extracorporeal membrane oxygenation (va-ecmo)
MeSH terms: Case Reports

A case is presented of an 83-year-old female patient with a strong suspicion of active bleeding, but no diagnostic contrast blush could be seen on the original computed tomography (CT) scan. Teaching point: When performing CT angiography in veno-arterial extracorporeal membrane oxygenation (VA-ECMO), it is important to understand the altered haemodynamics, as flow-related artefacts such as the vascular watershed phenomenon can obscure bleeding.
A Rare Cause of Pain in a Patient Following Roux-en-Y Choledochojejunostomy
Authors: Kristiana Sather, Matthew Wheelwright, Guru Trikudanathan, Gregory Beilman
Journal: Case Rep Surg (2024)
MeSH terms: Case Reports

Introduction:
Sump syndrome is a rare complication following bilioenteric anastomosis, most commonly following choledochoduodenostomy. This is only the third case in the literature of sump syndrome of the distal common bile duct (CBD) following end-to-side Roux-en-Y choledochojejunostomy (RYCJ). Case Presentation. A 69-year-old man with a history of end-to-side RYCJ for recurrent primary choledocholithiasis presented 3 years postoperatively with right upper quadrant (RUQ) abdominal pain affecting his quality of life. The work up revealed mild leukocytosis and computed tomography (CT) imaging that showed dilation of the distal CBD remnant. He underwent endoscopic retrograde cholangiopancreatography (ERCP) with the removal of large amounts of debris with initial resolution of his pain, but the pain recurred after several months and after two further ERCPs with only short-term resolution of pain, he eventually underwent an open distal CBD excision and the pain has since resolved.
Conclusions:
This case report describes a rare case of sump syndrome following RYCJ that presented with abdominal pain alone. Sump syndrome may have a wide array of presenting symptoms, and the pathophysiology of sump syndrome varies based on bilioenteric reconstruction. Although it has rarely been reported to occur in the distal blind CBD remnant following either RYCJ or hepaticojejunostomy, it is important to consider this in the differential for patients with abdominal pain following any bilioenteric reconstruction.
Immune checkpoint inhibitor- and phosphatidylinositol-3-kinase inhibitor-related diabetes induced by antineoplastic drugs: two case reports and a literature review
Authors: Yue Gao, Mingyao Zhong, Lulu Gan, Cheng Xiang, Ling Li, Yimin Yan
Journal: Front Endocrinol (Lausanne) (2023)
Keywords: anti-tumor drug, cancer, diabetes mellitus, immune checkpoint inhibitor, phosphatidylinositol-3-kinase inhibitor
MeSH terms: Antineoplastic Agents / adverse effects, Diabetes Mellitus, Diabetic Ketoacidosis, Hyperglycemia, Case Reports, Research Support, Non-U.S. Gov't, Systematic Review, Female, Humans, Immune Checkpoint Inhibitors, Phosphatidylinositols, Antineoplastic Agents, Immune Checkpoint Inhibitors, Phosphatidylinositols

Immune checkpoint inhibitor (ICI)- and phosphatidylinositol-3-kinase inhibitor (PI3Ki)-related diabetes mellitus are common side effects of anti-tumor drug use that present mainly as hyperglycemia. Here, we present two case reports of diabetes mellitus caused by the use of tremelimumab and apalutamide, respectively, in cancer treatment, and a comprehensive, comparative review of the literature on these forms of diabetes. Case 1 presented with diabetic ketoacidosis and was diagnosed with ICI-related diabetes mellitus and treated with insulin. Case 2 was diagnosed with PI3Ki-related diabetes mellitus, and her blood glucose level returned to normal with the use of metformin and dapagliflozin. We systematically searched the PubMed database for articles on ICI- and PI3Ki-related diabetes mellitus and characterized the differences in clinical features and treatment between these two forms of diabetes.