OpenMed/multicare-articles huggingface dataset:
Pancreatic acinar cystadenoma in a background of diffuse multifocal pancreatic cystic lesions: A case report
Authors: Mohammed Abdulrahman Alkhateeb, Deena Boqari, Nabeel Khalid Mansi
Journal: Int J Surg Case Rep (2020)
Keywords: acinar cell cystadenoma (aca), case report, diffuse, intraductal papillary mucinous neoplasm (ipmn), neoplasm
MeSH terms: Case Reports

Introduction:
Acinar cell cystadenoma (ACA) is very rare and benign neoplasm of the pancreas; it arises from the normal acinar parenchyma of the pancreas and may exist as solitary or diffuse lesions.
Presentation of case:
We here present a case of thirty-seven years old gentleman who incidentally was found to have multifocal cystic lesions distributed throughout the tail, body and uncinate process of the pancreas.
Discussion:
Pre-operative diagnosis of pancreatic ACA remains very difficult and challenging despite advances in imaging techniques. Due to diffuse involvement of the pancreas by different size cystic lesions in this case, the initial diagnosis was suspected to be SB-IPMNs. A Surgical resection was performed, and pathological analysis of the lesions was consistent with ACAs.
Conclusion:
To avoid unnecessary major pancreatic resection and its consequent complications. We hereby recommend clinicians to have a high index of suspicion for ACA within the differential of pancreatic cystic neoplasm.
Type d syndrome of inappropriate antidiuretic hormone secretion in a schizophrenia patient with polydipsia
Authors: Takahira Yamauchi, Manabu Makinodan, Tomohisa Nagashima, Kuniaki Kiuchi, Yoshinobu Noriyama, Toshifumi Kishimoto
Journal: J Brain Dis (2009)
Keywords: hyponatremia, plasma osmolality, polydipsia, schizophrenia, water intoxication
MeSH terms: Case Reports

A 55-year-old man with schizophrenia developed water intoxication due to primary polydipsia. His manner of antidiuretic hormone secretion was investigated by water loading and infusion of hypertonic saline to clarify the form of the syndrome of inappropriate antidiuretic hormone secretion. The plasma antidiuretic hormone level, which may be involved in the occurrence of water intoxication, was consistently low in this patient, and linked to type D syndrome of inappropriate antidiuretic hormone secretion, designated "hypovasopressinemic antidiuresis". Although this type is not common, it should be considered as a pathophysiology for water intoxication in schizophrenia patients.
Atopic keratoconjunctivitis complicated by Kocuria koreensis keratitis: the first case
Authors: Noriko Inada, Jun Shoji, Satoru Yamagami
Journal: Allergy Asthma Clin Immunol (2017)
Keywords: atopic dermatitis, atopic keratoconjunctivitis, kocuria keratitis, shield ulcer
MeSH terms: Case Reports

Background:
Patients with atopic dermatitis have a predisposition to Staphylococcus aureus and a Herpes simplex virus infection. The treatment of atopic diseases with steroid and immunosuppressive agents induces opportunistic infection. However, there is a concern regarding visual prognosis in patients with atopic keratoconjunctivitis (AKC) complicated with infectious keratitis. We report an unusual case of an atopic shield ulcer with Kocuria keratitis.
Case presentation:
A 51-year-old Japanese man presented with a 14-day history of eye pain and visual loss in his left eye. At the initial examination, a shield ulcer was observed in the upper-central cornea of the left eye, and the conjunctiva in both eyes had a velvety appearance due to papillary formation, as well as hyperemia and swelling in the palpebral area. The shield ulcer showed white stromal opacification in the marginal zone with a coral-like appearance. Samples were obtained by corneal scraping, and Kocuria sp. was identified by microbiological examination including culture and matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. The 16S rRNA gene sequence analysis was performed using isolated Kocuria strain from the patient. The obtained DNA sequence showed 99% homology with Kocuria koreensis. The combination of corneal scraping and instillation of cefmenoxime antibiotic ophthalmic solution was considered useful for the treatment of Kocuria keratitis.
Conclusion:
Clinicians should be aware of Kocuria keratitis as a corneal complication of AKC, and that rapid diagnosis of Kocuria keratitis may improve visual prognosis.
Long-term follow-up of a patient with 5q31.3 microdeletion syndrome and the smallest de novo 5q31.2q31.3 deletion involving PURA
Authors: Maria Clara Bonaglia, Nicoletta Zanotta, Roberto Giorda, Grazia D'Angelo, Claudio Zucca
Journal: Mol Cytogenet (2015)
Keywords: 5q312q313 deletion, 5q313 microdeletion syndrome, array-cgh, neurodevelopmental phenotype, pura gene
MeSH terms: Case Reports

Background:
Purine-rich element binding protein A (PURA, MIM 600473), is considered the crucial phenocritical gene for an emerging 5q31.3 microdeletion syndrome. To date, at least seven affected individuals with overlapping 5q31.2q31.3 deletions, varying in size from 2.6 to 5 Mb, have been reported sharing neurologic features such as severe developmental delay, neonatal hypotonia, early feeding difficulties, respiratory distress and EEG abnormalities. The recent finding that de novo PURA point mutations are indeed sufficient to cause the severe neurological symptoms also observed in patients with 5q31.2q31.3 deletion further reinforces the gene's causative role in 5q31.3 microdeletion syndrome.
Case presentation:
The present patient, aged 26 years, is the oldest reported individual and carries the smallest de novo 5q31.2q31.3 microdeletion encompassing PURA (360 kb). Her clinical history summarizes the mainly neurodevelopmental phenotype described in children with 5q31.3 microdeletion syndrome. In addition, our patient exhibited a remarkable deterioration of clinical symptoms, starting at the beginning of adolescence, pubertal delay and primary amenorrhea. While epileptic seizures were successfully treated during her life, feeding problems showed a poor outcome, her respiratory problems increased and eventually became severe enough to cause her death.
Conclusion:
The clinical and molecular findings reported here provide further evidence that 5q31.3 microdeletion syndrome is a clinically discernible PURA-related disorder and describe the previously unreported natural evolution of the disease in a 26 years old patient.
Gross Hematuria following SARS-CoV-2 Vaccination
Authors: Maryam Sattari, Jourdan Mckinnis, Amir Kazory
Journal: Case Rep Med (2023)
MeSH terms: Case Reports

In the setting of the rapid development of currently available vaccines for coronavirus disease of 2019 (COVID-19), little is known about their less frequent potential side effects. Raising the awareness of clinicians and front-line healthcare workers about the less well-known potential side effects of vaccination is important. We describe the self-limited occurrence of gross hematuria in two elderly men on a combination of aspirin and another antiplatelet or anticoagulant following their second dose of the Moderna COVID-19 vaccination. While the bleeding seems to be self-limited, the long-term course currently remains elusive.
Fibromatous uterus in a 16-year-old girl: a case report
Authors: Athina C Tsili, Ekaterini D Lentoudi, Maria I Argyropoulou, Nikolaos Dalkalitsis, Anna Batistatou, Evangelos Paraskevaidis, Konstantine Tsampoulas
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

Although uterine leiomyomas are the most common neoplasms of the female genital tract, this is not the case when referring to women under the age of 20. Only a few cases of uterus leiomyomas have been reported in this age. Preoperative imaging evaluation is mandatory in adolescent women for the accurate detection, localization, and characterization of uterus leiomyomas. We report a case of a 16-year-old girl admitted to our hospital for pain and abdominal distention. The patient underwent multidetector CT examination of the abdomen and MR examination of the pelvis. Both imaging modalities revealed uterine enlargement and the presence of innumerable variably sized leiomyomas. Histopathologic examination following exploratory laparotomy confirmed the presence of uterus leiomyomas. The patient underwent laparoscopic myomectomy two years after the first operation, following MR examination of the pelvis.
First Reported Case of Donor Related Candida Endophthalmitis after Descemet Membrane Endothelial Keratoplasty
Authors: Matthew Thompson, David Carli
Journal: Open Ophthalmol J (2017)
Keywords: candida, dmek, candida albicans, candida glabrata, corneal donor rim contamination, descemet stripping endothelial keratoplasty, fungal keratitis
MeSH terms: Case Reports

Purpose:
To report the first case of Candida donor to host transmission following descemet membrane endothelial keratoplasty (DMEK).
Methods:
A retrospective case report.
Results:
A patient underwent uneventful DMEK. Following surgery the donor rim was culture positive for Candida. The patient developed fungal endophthalmitis that was treated medically with multiple injections of voriconazole and amphotericin. Medical treatment was unable to clear the infection and removal of the donor material was required. Following removal the infection subsided.
Conclusion:
Candida interface keratitis and endophthalmitis can occur following DMEK and may be difficult to treat medically. Early removal of the donor material should be considered.
Case report: Application of three-dimensional technologies for surgical treatment of portosystemic shunt with segmental caudal vena cava aplasia in two dogs
Authors: Jinsu Kang, Myungryul Yang, Yonghwan Kwon, Chorok Jeong, Namsoo Kim, Suyoung Heo
Journal: Front Vet Sci (2022)
Keywords: caudal vena cava aplasia, dog, portosystemic shunts, three-dimensional, vascular model
MeSH terms: Case Reports

This case report describes the application of three-dimensional (3D) technologies for the surgical treatment of portosystemic shunt (PSS) with segmental caudal vena cava (CVC) aplasia. Two client-owned dogs were diagnosed with PSS along with segmental CVC aplasia using computed tomography. Through 3D volume and surface rendering, the vascular anatomic anomaly of each patient was identified in detail. A patient-specific 3D vascular model was used for preoperative planning. According to the plan established based on the 3D rendered image and printed model, shunt occlusion was performed using cellophane banding in the first case. An ameroid constrictor was used in the second case. Both patients showed good recovery without any clinical symptoms or complications. The use of 3D technologies in small animals has many advantages, and its use in vascular surgery, as in these cases, is also a therapeutic option worth considering.
Severe Bilateral Breast Mucinous Carcinoma with Bilateral Lungs and Cutaneous Metastasis: A Case Report and Literature Review
Authors: Rong Pu, Yanchu Li, Xianyong Li
Journal: Case Rep Oncol Med (2018)
MeSH terms: Case Reports

The case of a female who had severe, rare, terminal breast mucinous carcinoma (BMC) and failed to receive surgery and chemotherapy was reported. The patient was diagnosed with pure BMC (ER++, PR++, CerbB-2-, and Ki-67 10%) accompanied with bilateral lungs, bilateral chest walls with skin ulcer (D = 14 cm), lymph nodes of bilateral armpits, and right supraclavicular metastases. ECOG (Eastern Cooperative Oncology Group) and NRS (Numeric Rating Scale) pain scores were 4 and 6, respectively. Because the patient refused traditional chemotherapy and radiotherapy on religious grounds, an herbal medicine containing Panax ginseng, Agrimonia pilosa, and white flower Patrinia herb was administered; extensive nursing for tumor debridement was also provided. Quality of Life (QOL) improved and pain reduced. Tumor-bearing survival time was prolonged. The present case dictates that herbal extract medicines and supportive treatment can be helpful for uncommon severe BMC as an appropriate alternative treatment.
Ketamine Use for Successful Resolution of Post-ERCP Acute Pancreatitis Abdominal Pain
Authors: Suneel M Agerwala, Divya Sundarapandiyan, Garret Weber
Journal: Case Rep Anesthesiol (2017)
MeSH terms: Case Reports

We report a case in which a patient with intractable pain secondary to post-endoscopic retrograde cholangiopancreatography (ERCP) acute pancreatitis is successfully treated with a subanesthetic ketamine infusion. Shortly after ERCP, the patient reported severe stabbing epigastric pain. She exhibited voluntary guarding and tenderness without distension. Amylase and lipase levels were elevated. Pain persisted for hours despite hydromorphone PCA, hydromorphone boluses, fentanyl boluses, and postprocedure anxiolytics. Pain management was consulted and a ketamine infusion was trialed, leading to a dramatic reduction in pain. This case suggests that ketamine may be a promising option in treating intractable pain associated with ERCP acute pancreatitis.
Successful Response of Pembrolizumab Rechallenge after Radiotherapy for a Patient with Bladder Cancer of Nonresponse of Pembrolizumab First Challenge
Authors: Taro Ikeda, Go Hasegawa, Gen Kawaguchi, Yohei Ikeda, Noboru Hara, Tsutomu Nishiyama
Journal: Case Rep Urol (2021)
MeSH terms: Case Reports

We report a patient with advanced bladder cancer in which the primary lesion and metastatic site disappeared following the pembrolizumab therapy rechallenge after radiotherapy for bladder cancer lesion of nonresponse of pembrolizumab first challenge. A 76-year-old man with advanced bladder cancer received three courses of the chemotherapy with gemcitabine and cisplatin combination; however, the chemotherapy was stopped because of adverse events. The patient started pembrolizumab therapy; however, the effect was not observed. Radiation therapy was given to the primary lesion and pelvic lymph node metastases for the purpose of local control of the lesions. Because the primary lesion was regrowth and para-aortic lymph node metastasis appeared, pembrolizumab therapy was resumed. Thereafter, the primary lesion and metastatic site disappeared.
Foreign Accent Syndrome, a Rare Presentation of Schizophrenia in a 34-Year-Old African American Female: A Case Report and Literature Review
Authors: Kenneth Asogwa, Carolina Nisenoff, Jerome Okudo
Journal: Case Rep Psychiatry (2016)

Foreign Accent Syndrome (FAS) is a rare phenomenon where speech is characterized by a new accent to the patient's native language. More than 100 cases with the syndrome have been published, the majority of which were associated with observed insults of the speech center. Some other cases have been described without identifiable organic brain injury, especially in patients with psychiatric illness. This paper presents a patient with schizophrenia and FAS, without any evidence of organic brain injury. FAS recurred during psychotic exacerbation and did not reverse before transfer to a long-term psychiatric facility. The case is discussed in the context of a brief review of the syndrome.
Pure Primary Ovarian Squamous Cell Carcinoma Perforating the Rectum
Authors: Kazuya Mimura, Aiko Okada, Naotsugu Haraguchi, Kenjiro Sawada, Takuji Tomimatsu, Tadashi Kimura
Journal: Case Rep Obstet Gynecol (2017)
MeSH terms: Case Reports

Rectal perforation is uncommon in ovarian cancer, even in advanced stages. Pure primary ovarian squamous cell carcinoma is a very rare subtype of ovarian cancer and has not been reported to cause rectal perforation. A 50-year-old woman presented with rectal bleeding. Rectosigmoidoscopy suggested perforation of a pelvic tumor into the rectum. Abdominopelvic magnetic resonance imaging revealed a 9 cm heterogeneous mass in the pouch of Douglas. We performed complete cytoreduction, including an en-bloc resection of the tumor and rectosigmoid colon. Histopathology showed squamous cell carcinoma of the left ovary penetrating the rectal wall. A common symptom of rectal bleeding was caused by a very rare entity of ovarian cancer penetrating the rectal wall, but thorough evaluation led to its accurate diagnosis and appropriate treatment.
A case of hepatic venous outflow obstruction caused by migration of the remnant liver into the subphrenic space after extended posterior sectionectomy of the liver
Authors: Hiroki Kanno, Atsushi Yoshida, Yuichi Goto, Toru Hisaka, Yoshito Akagi, Koji Okuda
Journal: Int J Surg Case Rep (2020)
Keywords: hepatectomy, hepatic venous outflow obstruction, repositioning
MeSH terms: Case Reports

Introduction:
Hepatic venous outflow obstruction (HVOO) is a rare complication of hepatectomy. We report a case of HVOO caused by remnant liver migration into the subphrenic space after hepatectomy, which was successfully managed by repositioning of the remnant liver.
Presentation of case:
A 55-year-old Japanese man was diagnosed with a liver tumor on ultrasound. Contrast-enhanced CT revealed early enhancement in the arterial phase, followed by a washout in the late phase. Preoperative diagnosis was hepatocellular carcinoma, and hand-assisted laparoscopic extended posterior sectionectomy was performed. On postoperative day 1, middle hepatic vein (MHV) flow was not detected on ultrasound, and the portal flow was hepatofugal. CT during arterial portography revealed absence of the portal flow to the medial and anterior sections, and remnant liver migration into the subphrenic space. Therefore, we suspected that HVOO was caused by the remnant liver migration and performed redo laparotomy to reposition the remnant liver with suturing of the falciform ligament to the anterior abdominal wall. Postoperatively, contrast-enhanced CT demonstrated that the remnant liver remained in the anatomical position, and the medial and anterior sections were well enhanced.
Discussion:
HVOO might occur irrespective of whether the left triangular ligament is preserved. We believe that it is necessary to fix the remnant liver to the abdominal wall in cases with poor venous blood flow confirmed by intraoperative ultrasound. If kinking of the hepatic vein persists, stent insertion should be performed.
Conclusion:
HVOO after hepatectomy is rare but potentially fatal, and prevention and countermeasures should be discussed.
Use of Eflornithine (DFMO) in the Treatment of Early Alzheimer's Disease: A Compassionate Use, Single-Case Study
Authors: Jessica Alber, Kelly McGarry, Richard B Noto, Peter J Snyder
Journal: Front Aging Neurosci (2018)
Keywords: alzheimer's disease, amyloid pathology, case study, eflornithine (dfmo), mild cognitive impairment
MeSH terms: Case Reports

Background: Recent genome-wide association screening (GWAS) studies have linked Alzheimer's disease (AD) neuropathology to gene networks that regulate immune function. Kan et al. recently reported that Arg1 (an anti-inflammatory gene that codes for arginase-1) is expressed in parts of the brain associated with amyloidosis prior to the onset of neuronal loss, suggesting that chronic brain arginine deprivation promotes AD-related neuropathology. They blocked arginine catabolism in their mouse AD model by administration of eflornithine (DFMO) to juvenile animals, effectively blocking the expression of AD-related amyloid pathology as the mice aged. We report results from a single-case study in which DFMO was administered, for the first time, in an attempt to slow progression of AD in a single woman with multi-domain, amnestic MCI who was unable to tolerate an acetylcholinesterase inhibitor. Methods: Patient C.S. is a 74-year old female with a 5-year history of cognitive decline who was placed on DFMO (500 mg b.i.d.) for 12 months, with amyloid PET scans (baseline and 12-months), APOE genotyping and neuropsychological exams at baseline, 3, 9, and 12 months. Results: C.S. suffered continued cognitive decline over 12 months, including progressive worsening of orientation, social functions and ability to engage in IADL's. She also showed progressive decline on measures of episodic memory and executive function. Florbetapir PET imaging yielded elevated total neocortical SUVr scores at both baseline (SUVr = 1.55) and at 12 months (SUVr = 1.69). Conclusions: We report a first attempt at using DFMO to slow AD progression. This 12-month single-case trial did not halt continued amyloidosis nor cognitive decline. Although this trial was predicated on data reported by Kan et al. (2015) showing that DFMO administered to juvenile AD-prone mice led to diminished amyloid aggregation, this attempt to treat an older mild AD patient may not be a fair test of Kan et al.'s model and results. A future trial might seek to block amyloidosis in young adults who are autosomal gene carriers for early onset AD, or perhaps in adults who are very clearly in the pre-clinical disease stage. Trial Registration: This trial was registered as a Compassionate Use IND #128888 with the United States Food and Drug Administration (FDA).
Intravitreal anti-vascular endothelial growth factor agents as an adjunct in the management of Coats' disease in children
Authors: Shalini Kaul, Mahesh Uparkar, Kruti Mody, Jaydeep Walinjkar, Mihir Kothari, S Natarajan
Journal: Indian J Ophthalmol (2010)
MeSH terms: Angiogenesis Inhibitors / administration & dosage, Antibodies, Monoclonal / administration & dosage, Aptamers, Nucleotide / administration & dosage, Retinal Diseases / drug therapy, Retinal Vessels / pathology, Telangiectasis / drug therapy, Vascular Endothelial Growth Factor A / antagonists & inhibitors, Case Reports, Adolescent, Antibodies, Monoclonal, Humanized, Bevacizumab, Child, Child, Preschool, Diagnosis, Differential, Drainage, Female, Humans, Injections, Laser Coagulation, Male, Retinal Diseases / diagnosis, Retinal Diseases / surgery, Telangiectasis / diagnosis, Telangiectasis / surgery, Tomography, Optical Coherence, Tomography, X-Ray Computed, Vitreous Body, Angiogenesis Inhibitors, Antibodies, Monoclonal, Antibodies, Monoclonal, Humanized, Aptamers, Nucleotide, Vascular Endothelial Growth Factor A, pegaptanib, Bevacizumab

We describe the role of intravitreal anti-vascular endothelial growth factor (VEGF) agents in Coats' disease in children. In a prospective, interventional, non-randomized case series, three patients (three eyes) aged 16, seven and two years were diagnosed to have Coats' disease. In Case 1 (16 yr/ male) with macular edema, previous laser photocoagulation being unsuccessful, intravitreal pegaptanib sodium (Macugen) was tried. Case 2 (seven yr/ male) and Case 3 (two yr/ female) were diagnosed to have Stage 4 Coats' and underwent external needle drainage, laser photocoagulation, SF6 gas injection and intravitreal injection of bevacizumab (Avastin). Reduction of exudation and attached posterior pole (Cases 2 and 3) was seen at a follow-up of six months and two months respectively. Intravitreal anti-VEGF agents may be successfully used as adjunct treatment in select cases of Coats' disease in childhood.
Case report: Treatment of tachycardia-induced cardiogenic shock with permanent His bundle pacing and atrioventricular node ablation
Authors: Tadej Žlahtič, Miša Fister, Peter Radšel, Marko Noč, Matjaž Šinkovec, David Žižek
Journal: Front Cardiovasc Med (2022)
Keywords: av node ablation, his bundle pacing, cardiac resynchronization therapy, cardiogenic shock, mechanical circulatory support, tachycardia-induced cardiomyopathy
MeSH terms: Case Reports

Tachycardia-induced cardiomyopathy (T-CMP) related to supraventricular arrhythmia is a rare and often unrecognized cause of refractory cardiogenic shock. When rhythm control interventions are ineffective or no longer pursued, atrioventricular node ablation (AVNA) with pacemaker implantation is indicated. Conduction system pacing provides normal synchronous activation of the ventricles after AVNA. However, there is a lack of data on pace and ablate strategy in hemodynamically unstable patients. We report on 2 patients with T-CMP presenting with refractory cardiogenic shock who were successfully treated with His bundle pacing in conjunction with AVNA.