OpenMed/multicare-articles huggingface dataset:
Case report: Anterior mediastinal mass in a patient with pleural effusion and dyspnea
Authors: Lin Gu, Gaojie Xin, Yue Qu, Kai Wang, Ke Jiang, Shijie Xing, Ai Huang
Journal: Front Surg (2023)
Keywords: anterior mediastinal mass, complete response, composite lymphoma, dyspnea, gene rearrangement
MeSH terms: Case Reports

Background:
Compound lymphoma is an uncommon type of lymphoid malignancy, and those consisting of concurrent B- and T-cell tumors are relatively rare.
Case summary:
A 41-year-old man was presented with a 1-month history of progressively worsening cough, chest tightness, and dyspnea after exercise, which could be relieved following rest. Contrast-enhanced computed tomography scan demonstrated a 7.4 × 4.9 cm2 heterogeneous mass in the anterior mediastinum, where a large area of cystic liquid existed, and multiple enlarged lymph nodes in the mediastinum. Since the biopsy failed to yield an exact diagnosis and there was no sign of metastasis, the tumor was surgically resectioned. Surgical findings included obscure boundaries and consistent tumor stiffness with pericardial and pleural invasion. Further pathological examination combined with immunophenotype and gene rearrangement test found the mass composite of angioimmunoblastic T-cell lymphoma (AITL) and B-cell lymphoma. The patient recovered well after R0 resection and received chemotherapy with four cycles of CHOP combined with chidamide 2 weeks after surgery. The patient has had a complete response for over 60 months.
Conclusion:
In conclusion, we reported a composite lymphoma of AITL combined with B-cell lymphomas. Our experience provides the first successful attempt to treat this rare disease with combined surgery and chemotherapy.
From sensorimotor inhibition to freudian repression: insights from psychosis applied to neurosis
Authors: Ariane Bazan
Journal: Front Psychol (2012)
Keywords: freud, lacan, efference copy, inhibition, psychosis, repression, sensorimotor, unconscious

First, three case studies are presented of psychotic patients having in common an inability to hold something down or out. In line with other theories on psychosis, we propose that a key change is at the efference copy system. Going back to Freud's mental apparatus, we propose that the messages of discharge of the motor neurons, mobilized to direct perception, also called "indications of reality," are equivalent to the modern efference copies. With this key, the reading of the cases is coherent with the psychodynamic understanding of psychosis, being a downplay of secondary processes, and consequently, a dominance of primary processes. Moreover, putting together the sensorimotor idea of a failure of efference copy-mediated inhibition with the psychoanalytic idea of a failing repression in psychosis, the hypothesis emerges that the attenuation enabled by the efference copy dynamics is, in some instances, the physiological instantiation of repression. Second, we applied this idea to the mental organization in neurosis. Indeed, the efference copy-mediated attenuation is thought to be the mechanism through which sustained activation of an intention, without reaching it - i.e., inhibition of an action - gives rise to mental imagery. Therefore, as inhibition is needed for any targeted action or for normal language understanding, acting in the world, or processing language, structurally induces mental imagery, constituting a subjective unconscious mental reality. Repression is a special instance of inhibition for emotionally threatening stimuli. These stimuli require stronger inhibition, leaving (the attenuation of) the motor intentions totally unanswered, in order to radically prevent execution which would lead to development of excess affect. This inhibition, then, yields a specific type of motor imagery, called "phantoms," which induce mental preoccupation, as well as symptoms which, especially through their form, refer to the repressed motor fragments.
Solitary Fibrous Tumor: Case Report of Intrapulmonary Location
Authors: Adil Arsalane, Abdelfetah Zidane, Hicham Fenane, Amine Azami, Ismail Essadi, Abderrahim Raissi, Issam Lalya, Yacine Msougar
Journal: Case Rep Oncol Med (2018)
MeSH terms: Case Reports

Solitary fibrous tumors are relatively rare neoplasms that commonly occur in the pleura, especially visceral pleura. However, an intrapulmonary site of this kind of tumors is even rarer. These tumors can be characterized by a heterogeneous evolution and have a benign or malignant behavior. Wide surgical resection is essential to cure the patient and to avoid recurrence. We present here the clinical, imaging, and histological features of a case with solitary fibrous tumor growing inside the lung.
Conventional Coronary Angiography Induced Takotsubo Cardiomyopathy Complicated with Cardiac Tamponade
Authors: Min Gyu Kang, Kye-Hwan Kim, Jin-Sin Koh, Young-Hoon Jeong, Jin-Yong Hwang, Jeong Rang Park
Journal: Case Rep Cardiol (2017)
MeSH terms: Case Reports

Takotsubo cardiomyopathy (TCM) is a transient left ventricular dysfunction that typically occurs after emotional or physical stress. TCM has a benign prognosis and serious complications are uncommon. However, though very rarely reported, cardiac tamponade has occurred on some occasions. We hereby report the case of a 70-year-old woman who underwent coronary angiography with an ergonovine provocation test to evaluate recurrent chest pain and was readmitted 7 days later presenting with TCM, followed by left ventricular outflow tract obstruction and cardiac tamponade.
Case Report: Bi-allelic missense variant in the desmocollin 3 gene causes hypotrichosis and recurrent skin vesicles
Authors: Khalid Al Hawsawi, Mazin Al Jabri, Mazen S Dajam, Bashaer Almahdi, Waseem K Alhawsawi, Safdar Abbas, Abeer Al Tuwaijri, Muhammad Umair, Majid Alfadhel, Sultan Al-Khenaizan
Journal: Front Genet (2022)
Keywords: dsc3, hyptsv, missense variant, novel mutation, saudi patient
MeSH terms: Case Reports

Background: Hypotrichosis with Recurrent Skin Vesicles (HYPTSV) is an extremely rare condition, having autosomal recessive inheritance. Here in we report a 4-years- old Saudi boy who presented with a history of recurrent skin blisters that are localized to the extremities and hypotrichosis since birth. Methods: The present study describes a consanguineous Saudi family segregating HYPTSV in an autosomal recessive fashion. A single proband (II-1) exhibited features such as diffused non-scarring alopecia on the scalp, intraepidermal blister, post-inflammatory hyperpigmented macules, and follicular hyperkeratosis. DNA of the index was subjected to whole-genome sequencing (WGS). Furthermore, 3D protein modeling was performed for the mutated and normal protein. Results: WGS revealed a novel bi-allelic missense variant (c.154G>C; p. Val52Leu) in the DSC3 gene, which segregated perfectly using Sanger sequencing. In addition, 3D protein modeling revealed a substantial change in the mutated DSC3 protein as compared to the normal DSC3 protein. Conclusion: This is the 3rd novel variant reported in the DSC3 gene associated with the HYPTSV phenotype. This report further strengthens the evidence that bi-allelic variants in the DSC3 cause severe HYPTSV in humans.
Findings From Somatic and Cerebral Near-Infrared Spectroscopy and Echocardiographic Monitoring During Ductus Arteriosus Ligation: Description of Two Cases and Review of Literature
Authors: Carolina Michel-Macías, Deneb Algedi Morales-Barquet, Alfonso Martínez-García, Daniel Ibarra-Ríos
Journal: Front Pediatr (2020)
Keywords: hspda (hemodynamically significant patent ductus arteriosus), nirs (near infrared spectroscopy), cerebral oxygenation, ductus arteriosus, multisite nirs, postligation cardiac syndrome, somatic-cerebral difference, tissue oxygenation
MeSH terms: Case Reports

Background: Preterm infants with hemodynamically significant patent ductus arteriosus (HsPDA) are exposed to low cerebral tissue oxygen saturation (rScO2) values. Additionally, infants requiring surgical ligation are at risk of further changes in cerebral oxygenation and postligation cardiac syndrome (PLCS). Previous studies have assessed the effect of PDA ligation on rScO2 with variable results. Cases description: In this report we analyse near-infrared spectroscopy (NIRS) and echocardiographic findings of two patients who underwent ligation of PDA and presented low cardiac output. Literature on regional tissue oxygenation saturation (rSO2) before and after PDA ligation was briefly reviewed. Discussion: Cerebral oxygenation values before and after PDA ligation may be influenced by gestational age, vasopressor use, ductal shunt volume, time of exposure HsPDA, chronological age and the presence of cerebral autoregulation. PLCS complicates 28-45% of all PDA ligations and is associated with higher mortality. Cerebral and somatic NIRS monitoring in the postoperative period may enhance the identification of PLCS at early stages. Conclusion: Cerebral oxygenation in the perioperative period of PDA ligation may be influenced by numerous clinical factors. Early detection of PLCS using multisite NIRS after ligation could prevent further alterations in cerebral hemodynamics and improve outcomes. A decrease in somatic-cerebral difference and/or a significant drop in somatic NIRS values may precede clinical signs of hypoperfusion. NIRS values should be interpreted as trends along with echocardiographic findings to guide goal directed interventions.
Resection in the popliteal fossa for metastatic melanoma
Authors: Ugo Marone, Corrado Caracò, Maria Grazia Chiofalo, Gerardo Botti, Nicola Mozzillo
Journal: World J Surg Oncol (2007)
MeSH terms: Lymph Node Excision, Melanoma / secondary, Melanoma / surgery, Skin Neoplasms / pathology, Case Reports, Adult, Groin, Humans, Knee, Lymphatic Metastasis, Male, Melanoma / pathology

Background:
Traditionally metastatic melanoma of the distal leg and the foot metastasize to the lymph nodes of the groin. Sometimes the first site of nodal disease can be the popliteal fossa. This is an infrequent event, with rare reports in literature and when it occurs, radical popliteal node dissection must be performed.
Case presentation:
We report a case of a 36-year old man presented with diagnosis of 2 mm thick, Clark's level II-III, non ulcerated melanoma of the left heel, which developed during the course of the disease popliteal node metastases, after a superficial and deep groin dissection for inguinal node involvement. Five months after popliteal lymph node dissection he developed systemic disease, therefore he received nine cycles of dacarbazine plus fotemustine. To date (56 months after prior surgery and 11 months after chemotherapy) he is alive with no evidence of disease.
Conclusion:
In case of groin metastases from melanoma of distal lower extremities, clinical and ultrasound examination of ipsilateral popliteal fossa is essential. When metastatic disease is found, radical popliteal dissection is the standard of care. Therefore knowledge of anatomy and surgical technique about popliteal lymphadenectomy are required to make preservation of structures that if injured, can produce a permanent, considerable disability.
Short Term Oral Methylergonovine Maleate Prophylaxis for Status Migrainosus. Case Series and Review of Literature
Authors: Najiya Haque, Nauman Tariq
Journal: Front Neurol (2019)
Keywords: dihydroergotamine, headache, methergine, methylergonovine, migraine, status migrainosus

Background: Intravenous dihydroergotamine (DHE) is frequently used during inpatient hospitalizations or outpatient infusion therapies for 3-5 days in order to break the continuous cycle of status migrainosus. We tried a short term 7 days prophylaxis of oral methylergonovine after discharge in order to prevent status migrainosus relapse and extend the therapeutic benefit from IV DHE. Methods: Patients were diagnosed with status migrainosus in clinic setting based on the ICHD-III criteria. They received 1 mg IV DHE every 8 h along with metoclopramide for 3-5 days followed by methylergonovine maleate oral tablets as prophylaxis for 7 days post discharge. They were asked to maintain their headache diaries which included data on headache frequency and intensity. A post discharge follow up at 1 and 68 weeks was planned. Clinical improvement was defined as >50% decrease in frequency and intensity of headaches. Intensity was graded on verbal numerical rating scale (VNRS) with 10 being the worst possible pain. The institutes IRB and ethics committee exempted this study from review given that it had only 3 patients. Results: A total of 3 patients 25-45 years of age who benefited from IV DHE, consented to trial of Methylergonovine Maleate 0.4 mg oral tablets three times a day prophylaxis on the day of discharge for a period of 7 days. At 1 week post discharge, all of the 3 patients had reported sustained improvement with severity dropping from an average of 8/10 intensity to 3/10 on VNRS. The headaches frequency had dropped from daily to episodic in 2 of the 3 patients. At an average of 7 weeks post discharge, 2 out of the 3 patients had reported sustained benefit. The third patient relapsed to the pre-admission status migrainosus severity. One patient reported mild diarrhea and nausea but was still able to continue the drug for a week. Conclusion: Methylergonovine maleate after 3-5 days of IV DHE infusions may be a feasible treatment strategy for status migrainosus. This approach has the potential to prolonged the benefit of IV DHE and prevent relapse in to status migrainosus.
Minimal change disease and IgA deposition: separate entities or common pathophysiology?
Authors: Brandon S Oberweis, Aditya Mattoo, Ming Wu, David S Goldfarb
Journal: Case Rep Nephrol (2013)

Introduction. Minimal Change Disease (MCD) is the most common cause of nephrotic syndrome in children, while IgA nephropathy is the most common cause of glomerulonephritis worldwide. MCD is responsive to glucocorticoids, while the role of steroids in IgA nephropathy remains unclear. We describe a case of two distinct clinical and pathological findings, raising the question of whether MCD and IgA nephropathy are separate entities or if there is a common pathophysiology. Case Report. A 19-year old man with no medical history presented to the Emergency Department with a 20-day history of anasarca and frothy urine, BUN 68 mg/dL, Cr 2.3 mg/dL, urinalysis 3+ RBCs, 3+ protein, and urine protein : creatinine ratio 6.4. Renal biopsy revealed hypertrophic podocytes on light microscopy, podocyte foot process effacement on electron microscopy, and immunofluorescent mesangial staining for IgA. The patient was started on prednisone and exhibited dramatic improvement. Discussion. MCD typically has an overwhelming improvement with glucocorticoids, while the resolution of IgA nephropathy is rare. Our patient presented with MCD with the uncharacteristic finding of hematuria. Given the improvement with glucocorticoids, we raise the question of whether there is a shared pathophysiologic component of these two distinct clinical diseases that represents a clinical variant.
Two Cases of Cartilaginous Choristoma-Not Chondroma of the Bony External Auditory Canal
Authors: Kohei Yamahara, Yuki Katsura, Yuki Egawa, Kana Lee, Satoshi Ikegami
Journal: Case Rep Otolaryngol (2018)
MeSH terms: Case Reports

The presence of a cartilaginous mass on the bony external auditory canal is an unusual finding. Currently, two different diagnoses have been used to describe this type of mass: chondroma and cartilaginous choristoma. There is currently no consensus on which diagnosis is appropriate for this type of lesion. Choristoma is defined as a tumor-like growth of normal tissue occurring in an abnormal location. Histological examination alone cannot be used to distinguish between cartilaginous choristoma and chondroma, as both lesions comprise normal mature hyaline cartilage. To diagnose a mass as cartilaginous choristoma on the bony external auditory canal, it is necessary to confirm that it does not originate from the underlying periosteum. Here, we present the cases of two patients with typical cartilaginous masses on the bony external auditory canal, in which the surgical findings showed that the masses were not in contact with the underlying periosteum, indicating that cartilaginous choristoma-not chondroma-is an appropriate diagnosis for these mass lesions. The clinical findings (characteristic appearance and location) reported here may aid clinicians in the diagnostic and surgical management of these cartilaginous masses.
A Periprosthetic Femoral Fracture with Characteristics of Atypical Femoral Fracture
Authors: Shuya Tanaka, Tomoaki Fukui, Keisuke Oe, Tomoyuki Matsumoto, Takehiko Matsushita, Shinya Hayashi, Teruya Kawamoto, Ryosuke Kuroda, Takahiro Niikura
Journal: Case Rep Orthop (2019)
MeSH terms: Case Reports

Although the definition of atypical femoral fracture (AFF) excludes periprosthetic femoral fracture (PFF), the number of reports about PFF with characteristics of AFF is increasing. We present the case of such a fracture in this report. An 87-year-old woman who underwent bipolar hip arthroplasty for a femoral neck fracture 38 months prior reported left thigh pain with no history of trauma. Radiographs showed a simple transverse fracture at the level of the stem distal end with features of AFF: periosteal thickening of the lateral cortex, a medial spike, and a noncomminuted fracture. She presented other features resembling AFF: history of bisphosphonate use, prodromal symptoms, no associated trauma, and lateral bowing of the contralateral femur. The fracture showed nonunion after the initial osteosynthesis, and a revision surgery of the arthroplasty and osteosynthesis was performed. Nine months after the surgery, bony union was achieved and she regained the ability to walk. It is supposed that the fracture was influenced by a stress force related to implants and lateral bowing concentrating on the fracture site as a mechanical factor in addition to bisphosphonates as a biological factor. It would be important to recognize that AFF could occur at the peri-implant location, and early detection and treatment are essential.
Osteolysis following PE Wear of a Hastings Head on a Monoblock Hip Stem
Authors: Sarah Fischer, Valerie Polster, Miriam Ruhr, Robert Hube, Michael M Morlock
Journal: Case Rep Orthop (2021)
MeSH terms: Case Reports

We report a case of extended osteolysis, requiring a third revision of the left hip in an 85-year-old man 46 years after index operation. Major polyethylene (PE) wear occurred due to a missmatched combination of a bipolar Hastings head with a PE liner and head damage of the originally maintained stem. This case demonstrates that bipolar heads should not be used with PE cup liners since the respective bearing diameters cannot be guaranteed to match due to missing specifications. Furthermore, putting a Hastings head on an already damaged head of the stem should be omitted and rather the stem should initially be revised.
Cytomegalovirus Retinitis in Primary Immune Deficiency Disease
Authors: Jia Jeane Ngai, Ka Lung Chong, Shelina Oli Mohamed
Journal: Case Rep Ophthalmol Med (2018)
MeSH terms: Case Reports

Introduction:
To report an unusual case of CMV retinitis in Primary Immune Deficiency Disease (PIDD).
Case report:
13-year-old child with combined T and B cell deficiencies was diagnosed of bilateral zone 1 CMV retinitis. Intravitreal injections were unable to be given in a regular and timely manner under general anaesthesia due to her underlying systemic disease. The child was treated with intravenous ganciclovir for 8 weeks until eventual resolution of the retinitis. However, visual acuity deteriorated due to progressive optic nerve involvement.
Conclusion:
Paediatric patients often do not notice subtle symptoms of CMV retinitis. Although ocular manifestations are uncommon in PIDD, recognition and high index of suspicion will allow for timely referral, diagnosis, and treatment to be instituted for better visual outcomes.
A Rare Cause of Obstructive Sleep Apnea Syndrome: Retropharyngeal Lipoma
Authors: Okan Dilek, Omer Kaya, Cengiz Yilmaz, Gokhan Soker, Bozkurt Gulek, Mehmet Ali Akin
Journal: Case Rep Radiol (2017)
MeSH terms: Case Reports

Lipoma is the most common benign mesenchymal neoplasm. About 16% of lipomas arise in the head and neck region, especially in the posterior neck. Large lipomas that originate from the retropharyngeal space may cause dyspnea, dysphagia, and snoring and occasionally may lead to obstructive sleep apnea syndrome (OSAS). Herein, we report a 45-year-old male patient with OSAS caused by a giant retropharyngeal lipoma with emphasis on CT findings.
Does ICSI for in vitro fertilization cause more aneuploid embryos?
Authors: Xiangli Niu, Jiamin Long, Fangqiang Gong, Weihua Wang
Journal: Mol Cytogenet (2020)
Keywords: aneuploidy, blastocysts, icsi, oocytes, regular ivf
MeSH terms: Case Reports

Background:
High proportion of human embryos produced by in vitro fertilization (IVF) is aneuploidy. Many factors are related to the prevalence of embryonic aneuploidies, such as maternal age, sperm quality, and in vitro manipulation of oocytes. Oocytes are usually inseminated by intracytoplasmic sperm injection (ICSI) procedures for preimplantation genetic testing. There is still no available information whether insemination procedures, regular IVF or ICSI, affect embryonic aneuploidies.
Methods:
In this case report, a patient at her age of 47 years old received donated oocytes from a young donor for infertility treatment. Half of oocytes were inseminated by regular IVF and other half of oocytes were inseminated by ICSI. Fertilized oocytes were cultured to blastocyst stage and then biopsied for preimplantation genetic testing for aneuploidies (PGT-A). The proportions of aneuploidies were compared between two insemination procedures.
Results:
Forty-seven oocytes were retrieved, 23 were inseminated by regular IVF and 24 were removed from enclosed cumulus cells for ICSI. Out of 24 oocytes, 21 oocytes at metaphase II were inseminated by ICSI. After fertilization assessment, it was found that 12 oocytes from regular IVF fertilized normally. Nine blastocysts (75%) were biopsied and 1 (11.1%) was aneuploidy. By contrast, 19 out of 21 oocytes inseminated by ICSI fertilized normally, 14 blastocysts (73.7%) were obtained and 7 (50.0%) were aneuploidy. Transfer of a euploid blastocyst from regular IVF resulted in a healthy baby delivery.
Conclusion:
These results indicate that more embryos produced by ICSI are aneuploidy as compared with embryos produced by regular IVF. The results indicate that in vitro manipulation of oocytes for ICSI procedure may have adverse effect on human oocytes, and it may be one of the reasons causing aneuploid embryos in human IVF.