OpenMed/multicare-articles huggingface dataset:
Ventricular Septal Defect in an Octogenarian: A Case Report of VSD Surgical Repair Concomitant with Coronary Artery Bypass and Valvular Surgery
Authors: Eiki Tayama, Satoshi Fujita, Tomohiro Ueda, Ken-Ich Imasaka, Naofumi Enomoto, Hirofumi Onitsuka, Yukihiro Tomita
Journal: Case Rep Cardiol (2012)

Finding an untreated or asymptomatic large ventricular septal defect (VSD) in an elderly patient is uncommon. The present case was an 81-year-old man who suffered from acute myocardial infarction due to three-vessel coronary disease, mitral and tricuspid valve insufficiency, and high-flow perimembranous VSD (Qp/Qs 2.3). Although the patient was elderly and the VSD had been asymptomatic for a long time, we considered that high-flow VSD and valve diseases should be repaired simultaneously with coronary disease. Then, he underwent elective surgery, namely, VSD patch repair concomitant with coronary artery bypass grafting, and mitral and tricuspid annuloplasty. His postoperative course was uneventful. We conclude that, even for an octogenarian, surgical repair of VSD is recommendable, if surgical indications are appropriate.
Management of Septic Open Abdomen in a Morbid Obese Patient with Enteroatmospheric Fistula by Using Standard Abdominal Negative Pressure Therapy in Conjunction with Intrarectal One
Authors: Fahri Yetisir, A Ebru Salman, Hasan Zafer Acar, Mehmet Özer, Muhittin Aygar, Gokhan Osmanoglu
Journal: Case Rep Surg (2015)

Introduction. Management of open abdomen (OA) with enteroatmospheric fistula (EAF) in morbid obese patient with comorbid disease is challenging. We would like to report the management of septic OA in morbid obese patient with EAF which developed after strangulated recurrent giant incisional hernia repair. We would also like to emphasize, in this case, the conversion of EAF to ileostomy by the help of second Negative Pressure Therapy (NPT) on ostomy side, and the chance of new EAF occurrence was reduced with intrarectal NPT. Case Presentation. 62-year-old morbid obese woman became an OA patient with EAF after strangulated recurrent giant hernia. EAF was converted to ostomy with pezzer drain by the help of second NPT on ostomy. Colonic distention was reduced with the third NPT application via rectum. Abdominal reapproximation anchor (ABRA) system was used for delayed abdominal closure. Conclusions. Using the 2nd NPT on ostomy side may help in the maturation of the ostomy created in a difficult condition in an open abdomen. Using the 3rd NPT through rectum may decrease the chance of EAF formation by reducing the pressure difference between intraluminal pressure and extraluminal pressure in hollow viscera.
Sequential Venous Percutaneous Transluminal Angioplasty and Balloon Dilatation of the Interatrial Septum during Percutaneous Edge-to-Edge Mitral Valve Repair
Authors: Rezo Jorbenadze, Johannes Patzelt, Meinrad Gawaz, Peter Seizer, Harald F Langer
Journal: Case Rep Cardiol (2017)
MeSH terms: Case Reports

Percutaneous edge-to-edge mitral valve repair (PMVR) is widely used for selected, high-risk patients with severe mitral valve regurgitation (MR). This report describes a case of 81-year-old woman presenting with severe and highly symptomatic mitral valve regurgitation (MR) caused by a flail of the posterior mitral valve leaflet (PML). PMVR turned out to be challenging in this patient because of a stenosis and tortuosity of both iliac veins as well as sclerosis of the interatrial septum, precluding the vascular and left atrial access by standard methods, respectively. We managed to achieve atrial access by venous percutaneous transluminal angioplasty (PTA) and balloon dilatation of the interatrial septum. Subsequently, we could advance the MitraClip® system to the left atrium, and deployment of the clip in the central segment of the mitral valve leaflets (A2/P2) resulted in a significant reduction of MR.
Case report: Autoimmune nodopathy with concurrent serum and CSF IgG4 anti-neurofascin 155 antibodies
Authors: Wanyu Wang, Lingchun Liu, Mingzhi Zhang, Ruihan Yang, Da Liu, Shunyu Yang, Qiang Meng
Journal: Front Immunol (2022)
Keywords: anti-gd1b antibodies, anti-neurofascin 155 antibodies, autoimmune nodopathy (an), case report, chronic inflammatory demyelination polyneuropathy (cidp), sensory ataxia
MeSH terms: Immunoglobulin G, Polyradiculoneuropathy, Chronic Inflammatory Demyelinating, Case Reports, Research Support, Non-U.S. Gov't, Adult, Autoantibodies, Cell Adhesion Molecules, Humans, Immunoglobulins, Intravenous / therapeutic use, Male, Nerve Growth Factors, Prospective Studies, Rituximab / therapeutic use, Young Adult, Autoantibodies, Cell Adhesion Molecules, Immunoglobulin G, Immunoglobulins, Intravenous, Nerve Growth Factors, Rituximab

Objective:
To report a case of autoimmune nodopathy (AN) with concurrent serum and CSF immunoglobulin (Ig)G4 anti-neurofascin 155 (NF155) and anti-GD1b antibodies.
Methods:
A 20-year-old male presented distal weakness of the 4 limbs, hypoesthesia, absent tendon reflexes and sensory ataxia. Nerve conduction studies (NCS), MRI, and autoantibody tests were performed.
Results:
NCS revealed a diffuse demyelinating neuropathy in the peripheral nerve with motor and sensory involvement. MRI of the cervical and lumbar plexus showed diffuse enlargement. IgG4 anti-NF155 antibodies in both serum and CSF and IgG anti-GD1b antibodies in serum were positive. After treatment with IVIg, rituximab, and plasma exchange, the titer of the patient's anti-NF155 antibodies decreased, but symptoms did not significantly improve.
Discussion:
This patient presented a typical clinical feature of AN with serum and CSF anti-NF155 antibodies and serum anti-GD1b antibodies coexistent but poor response to IVIg, rituximab and plasma exchange. Early detection of antibodies may be helpful in both diagnosis and therapy of the disease. And prospective studies are necessary to demonstrate the potential role of anti-NF155 antibodies in CSF and help further understand this complex and heterogeneous disease.
Paraperesis: a rare complication after depressed skull fracture
Authors: Ali Asmat Syed, Anjum Arshad, Khatoon Abida, Sardha Minakshi
Journal: Pan Afr Med J (2012)
Keywords: fracture, depressed fracture, edema, paraperesis, skull
MeSH terms: Paraparesis / etiology, Skull Fracture, Depressed / complications, Case Reports, Humans, Male, Middle Aged, Paraparesis / physiopathology, Skull Fracture, Depressed / diagnosis, Skull Fracture, Depressed / pathology, Tomography, X-Ray Computed, Treatment Outcome

Depressed skull fracture is an inward buckling of the skull bones, often because of direct blow to a small surface area of the skull with a blunt object. Monoparesis is often among its clinical presentations, but midline depressed skull fracture presenting as motor weakness of both lower limbs (Paraperesis) has not yet been reported. We report the case of 55 year old male admitted to emergency department with alleged history of hit on head by a wooden rod. He had pain, mild swelling and a small cut over scalp without any symptoms & signs of neurological deficit. On day two of admission patient developed weakness of both lower limbs. On CT scan patient had bilateral depressed skull fracture of high parietal bone on either side of midline. Patient was managed conservatively, made remarkable recovery and was discharged after 2 weeks.
Desmoplastic infantile ganglioglioma
Authors: Salma Kamoun, Heifa Azouz, Marwa Zemmali, Slim Haouet, Nidhameddine Kchir
Journal: Pan Afr Med J (2019)
Keywords: tumor, central nervous system, infantile desmoplastic ganglioglioma
MeSH terms: Brain Neoplasms / diagnostic imaging, Craniotomy / methods, Ganglioglioma / diagnostic imaging, Magnetic Resonance Imaging / methods, Case Reports, Brain Neoplasms / surgery, Child, Female, Ganglioglioma / surgery, Humans, Seizures / etiology

The term desmoplastic infantile ganglioglioma was coined by VandenBerg et al in 1987. In their first report these authors referred to a rare, distinct brain tumor. About 60 cases of desmoplastic infantile ganglioglioma have been described in the literature since its first description. We report a case of a 6-year-old girl who was admitted for seizure without family history. Magnetic resonance imaging scan showed a hypodense area in the right temporal region. A right temporal craniotomy was performed and the tumor was excised. The pathologic examination revealed the diagnosis of desmoplastic infantile ganglioglioma.
ARMC5 Primary Bilateral Macronodular Adrenal Hyperplasia Associated with a Meningioma: A Family Report
Authors: M J Ferreira, J Pedro, D Salazar, C Costa, J Aragão Rodrigues, M M Costa, A Grangeia, J L Castedo, D Carvalho
Journal: Case Rep Endocrinol (2020)
MeSH terms: Case Reports

Primary bilateral adrenal macronodular hyperplasia is characterized by functioning adrenal macronodules and variable cortisol secretion. Familial clustering suggests a genetic cause that has been confirmed with the identification of some genetic mutations, including inactivating germline mutations, in armadillo repeat containing 5 (ARMC5) gene. The identification of the pathogenic variant enables the physician to identify and treat these patients earlier and more effectively. It has also been noticed that patients with germline causative variants show a different clinical spectrum, presenting specific clinical characteristics, as the association with the presence of meningiomas.
Intraoperative Hardware Failure of the Fassier-Duval Rescue System in a Pediatric Patient with Osteogenesis Imperfecta
Authors: Michael E Kahan, Nathan R Angerett, Jill C Flanagan
Journal: Case Rep Pediatr (2021)
MeSH terms: Case Reports

The use of telescopic intramedullary rods for the treatment of lower extremity deformity in children with osteogenesis imperfecta has been well described. The reinforcement of these weakened weightbearing bones with intramedullary devices leads to improvements in mobility that progress into adulthood. Although the current telescopic intramedullary rod systems are an upgrade from earlier systems, they are still associated with high rates of reoperation and complication. We describe a unique complication encountered during a revision which involved the male retriever system for the Fassier-Duval rod (FDR) (Pega Medical, Quebec, CA) experienced intraoperatively. To our knowledge, this mechanism of failure has not been previously described in the literature.
An unusual case of lower trunk brachial plexus zoster reactivation
Authors: Samantha J Burch, Elizabeth Shepard, Angelo B Lipira
Journal: Case Reports Plast Surg Hand Surg (2023)
Keywords: herpes zoster, lower trunk, zoster reactivation
MeSH terms: Case Reports

We discuss the case of a 42-year-old woman who presented with severe left cubital tunnel neuropathic pain and subsequently developed a vesicular rash spanning the C8-T1 dermatomal distribution. These symptoms resolved after initiation of acyclovir, highlighting VZV brachial plexopathy as a potentially treatable etiology of acute onset severe neuropathic pain.
Development of hepatocellular carcinoma in a patient 13 years after sustained virological response to interferon against chronic hepatitis C: a case report
Authors: Tsuyoshi Mashitani, Hitoshi Yoshiji, Masaharu Yamazaki, Yasuhide Ikenaka, Ryuichi Noguchi, Masatoshi Ishikawa, Hideto Kawaratani, Norihide Matsuo, Masahito Uemura, Junichi Yamao, Masao Fujimoto, Akira Mitoro, Masahisa Toyohara, Motoyuki Yoshida, Masayoshi Sawai, Chie Morioka, Tatsuhiro Tsujimoto, Mitsuteru Kitade, Kosuke Kaji, Yosuke Aihara, Hiroshi Fukui
Journal: Cases J (2009)

Background:
Although several recent reports have shown that hepatocellular carcinoma (HCC) developed in patients with chronic hepatitis C (CH-C) even after having a sustained virological response (SVR) to interferon (IFN) therapy, it is not common for HCC to develop more than 10 years after SVR.
Case presentation:
A 73-year-old Japanese man with CH-C who achieved SVR to IFN therapy 13 years ago was admitted into our hospital because of huge multiple liver tumors along with marked elevation of the tumor markers. Several diagnostic modalities strongly suggested HCC, and we performed histopathological examination. After confirming the diagnosis as well-differentiated HCC, we successfully treated these tumors with intensive combination therapies.
Conclusion:
Our report highlights the need for careful follow-up for more than 10 years even if the patients with CH-C achieve SVR to IFN therapy.
The Association of TNF-Alpha Inhibitors and Development of IgA Nephropathy in Patients with Rheumatoid Arthritis and Diabetes
Authors: Vedran Premužić, Ivan Padjen, Mislav Cerovec, Mario Laganović, Tajana Željković-Vrkić, Jelena Kos, Marijana Ćorić, Bojan Jelaković, Branimir Anić
Journal: Case Rep Nephrol (2020)
MeSH terms: Case Reports

IgA nephropathy (IgAN) is a rather uncommon complication of TNF-alpha inhibition with a range of findings such as asymptomatic microscopic/macroscopic hematuria or different degrees of proteinuria and could progress to end-stage renal disease. We are reporting three patients with longstanding rheumatoid arthritis (RA), which developed IgAN while receiving TNF-alpha inhibitors. All off our three patients had RA, which lasted 2-4 years, and none of them had a prior history of chronic kidney disease. Two patients were treated with adalimumab while one patient was treated with golimumab. Discontinuation of anti-TNF-alpha therapy and initiation of immunosuppressive therapy led to improvement in serologic abnormalities and renal function in two patients, while the third patient's 24-hour proteinuria was only partially reduced, which supports previous reports on TNF-alpha inhibitor induced autoimmunity. Two of our patients had previously been diagnosed with type 2 diabetes mellitus while the third patient developed diabetes years after the onset of IgAN. This is in line with the previously described association of IgAN and diabetes mellitus. To our best knowledge, this is the first report to analyze the development of IgAN as a potential consequence of anti-TNF-alpha therapy and its possible association with pretreatment or posttreatment diabetes.
Familial segmental spinal myoclonus: a rare clinical feature of Friedreich's ataxia
Authors: Rajendra Singh Jain, Sunil Kumar, Shankar Tejwani
Journal: Springerplus (2015)
Keywords: atypical phenotype, frataxin gene, friedreich ataxia, segmental spinal myoclonus

Introduction:
Friedreich's ataxia (FRDA) is the most common autosomal recessive inherited ataxia. It is characterized by onset before the age of 25 year, progressive limb and truncal ataxia, lower limb areflexia, extensor plantars, dysarthria and impaired posterior column sensations. Other important associated features are skeletal deformity, hypertrophic cardiomyopathy and diabetes mellitus. Most of the patients (98%) have an unstable homozygous trinucleotide (GAA) expansion in intron-1 of chromosome 9 and 2% patients are compound heterozygous for GAA expansion and point mutations.
Case description:
We observed an adolescence onset FRDA exhibiting spinal segmental myoclonus (SSM) in a family. Triplet repeat primed polymerase chain reaction (TP-PCR) demonstrated unstable expansion of >66 GAA repeats.
Conclusions:
SSM is a unique and rare manifestation of FRDA. This might be the first case report of SSM in FRDA patient.
Primary Dural Lymphoma Mimicking En Plaque Cerebellopontine Angle Meningioma
Authors: Mei Xu, Ashish Bains, Yuan Rong
Journal: Case Rep Pathol (2021)
MeSH terms: Case Reports

Primary dural lymphoma (PDL) usually arises from the calvarial dura without the brain parenchyma or systemic involvement and thus may not be considered as a typical form of primary CNS lymphoma (PCNSL). It is exceedingly rare. When it occurs, it might not be suspected as a primary diagnosis on clinical and radiologic findings. We present a PDL case that occurs at the cerebellopontine (CP) angle mimicking en plaque meningioma. The tumor histopathology showed a lymphoproliferative disorder immunophenotypically consistent with a low-grade marginal zone lymphoma. Bone marrow and systemic involvements were not identified, and a diagnosis of PDL was established. As a residual tumor at the CP angle was inaccessible to surgery, postoperative radiation therapy was performed. No recurrence was found at 15-month follow-up. PDLs are mostly indolent and have a good prognosis. There is no doubt that the most important differential diagnosis is meningioma. Furthermore, the present case emphasizes the necessity of an intraoperative consultation and knowledge of this rare yet essential form of PCNSL so that appropriate studies can be ordered.
Cryosurgery, Intralesional Methotrexate and Imiquimod for Keratoacanthoma: Tuning the Combination
Authors: Georgios Gaitanis, Ioannis D Bassukas
Journal: Case Rep Dermatol Med (2019)
MeSH terms: Case Reports

Keratoacanthomas (KA) are self-regressing, destructively expanding keratinocyte skin neoplasms typically characterized by sudden onset of explosive growth followed by complete involution. Cryosurgery, intralesional methotrexate and imiquimod have been used alone or in combination of two for the treatment of KA. Presently 3 patients (49, 60, and 65 years old; two females, one suspected with Ferguson-Smith syndrome), with 5 KA (6-24 mm maximal diameter) were treated with the combination of cryosurgery (liquid N2, open spray, 2 cycles of 15 sec each) and intralesional methotrexate (2.5-30 mg cumulative dose) and subsequent daily application of imiquimod (14-35 days). Starting with 4 cryosurgery/intralesional methotrexate sessions and 5 weeks daily imiquimod, to document feasibility and efficacy we progressively reduced the intensity of the treatment to one cryosurgery/intralesional methotrexate (total dose: 5 mg) session and 14 days of daily imiquimod without compromising efficacy. KA stopped growing promptly with sustained clearance after 6-24 months follow up, implicating a huge potential of therapeutic synergy of the employed modalities in the management of KA. We suggest that, optimized, the present three modalities combination (one session mild cryosurgery/low dose, 5 mg intralesional methotrexate and 2 weeks once daily imiquimod) is a promising treatment for KA that merits evaluation in further studies.
Linoleic Acid Induced Acute Hepatitis: A Case Report and Review of the Literature
Authors: Mohammad Bilal, Yogesh Patel, Micheal Burkitt, Michael Babich
Journal: Case Reports Hepatol (2015)

Several dietary supplements used for weight loss have been reported to cause hepatotoxicity. Conjugated Linoleic Acid (CLA) is a dietary supplement that has been shown to cause reduction in body fat mass. Here, we present the first case of CLA induced acute hepatitis in the United States and only the third case in the worldwide literature along with a brief review of the literature.
Acute Appendicitis Secondary to Appendiceal Endometriosis
Authors: João Paulo Nunes Drumond, André Luis Alves de Melo, Demétrius Eduardo Germini, Alexander Charles Morrell
Journal: Case Rep Surg (2020)
MeSH terms: Case Reports

Endometriosis in the vermiform appendix is a rare condition that affects women of childbearing age. The clinical picture can simulate inflammatory acute abdominal pain, especially acute appendicitis. Laboratory and imaging tests may assist in the diagnosis but are not conclusive. This article reports a case of acute appendicitis caused by appendiceal endometriosis for which laparoscopic appendectomy and diagnostic confirmation were performed after histopathological analysis.
Extradural Motor Cortex Stimulation might improve episodic and working memory in patients with Parkinson's disease
Authors: Carla Piano, Marco Ciavarro, Francesco Bove, Daniela Di Giuda, Fabrizio Cocciolillo, Anna Rita Bentivoglio, Beatrice Cioni, Tommaso Tufo, Paolo Calabresi, Antonio Daniele
Journal: NPJ Parkinsons Dis (2020)
Keywords: neurophysiology, neuroscience
MeSH terms: Case Reports

Electric Extradural Motor Cortex Stimulation (EMCS) is a neurosurgical procedure suggested for treatment of patients with advanced Parkinson's disease (PD). We report two PD patients treated by EMCS, who experienced worsening of motor symptoms and cognition 5 years after surgery, when EMCS batteries became discharged. One month after EMCS restoration, they experienced a subjective improvement of motor symptoms and cognition. Neuropsychological assessments were carried out before replacement of batteries (off-EMCS condition) and 6 months afterward (on-EMCS condition). As compared to off-EMCS condition, in on-EMCS condition both patients showed an improvement on tasks of verbal episodic memory and backward spatial short-term/working memory task, and a decline on tasks of selective visual attention and forward spatial short-term memory. These findings suggest that in PD patients EMCS may induce slight beneficial effects on motor symptoms and cognitive processes involved in verbal episodic memory and in active manipulation of information stored in working memory.
Simultaneous three-port thoracoscopic surgery for bilateral lung cancers with a pulmonary vein anomaly: A case report
Authors: Miho Akabane, Tadasu Kohno, Sakashi Fujimori, Naoko Kimura, Souichirou Suzuki, Mitsuaki Kawashima, Shinichirou Kikunaga
Journal: Int J Surg Case Rep (2019)
Keywords: bilateral lung cancers, partial anomalous pulmonary venous connection, simultaneous thoracoscopic resection

Introduction:
Simultaneous resection of bilateral lung cancers is technically challenging but may be preferable to a staged procedure in patients with a partial anomalous pulmonary venous connection (PAPVC) in an affected lobe. We performed single-stage resection of bilateral lung cancers in a patient with a PAPVC.
Presentation of case:
A 73-year-old man was diagnosed as having bilateral lung cancers (right, cT3N1M0, stage IIIA and left, cT2aN0M0, stage IB). Left upper trisegmentectomy was performed, followed by right upper lobectomy with deep wedge bronchoplasty. A PAPVC was found incidentally in the affected right upper lobe and successfully divided. The postoperative course was uneventful and he commenced chemoradiotherapy.
Discussion:
Resection of the PAPVC, which was located in the same lobe as the lung cancer, would have mitigated load increase in the right heart and may have alleviated the adverse effects of bilateral lung resection. Moreover, the single-stage procedure likely shortened the overall duration of treatment.
Conclusion:
Single-stage bilateral thoracoscopic resection may have advantages over staged procedures in some patients with PAPVCs.