OpenMed/multicare-articles huggingface dataset:
Kinematic and neurophysiological consequences of an assisted-force-feedback brain-machine interface training: a case study
Authors: Stefano Silvoni, Marianna Cavinato, Chiara Volpato, Giulia Cisotto, Clara Genna, Michela Agostini, Andrea Turolla, Ander Ramos-Murguialday, Francesco Piccione
Journal: Front Neurol (2013)
Keywords: assisted-force-feedback, brain-machine interface, motor-training, operant learning, proprioception

In a proof-of-principle prototypical demonstration we describe a new type of brain-machine interface (BMI) paradigm for upper limb motor-training. The proposed technique allows a fast contingent and proportionally modulated stimulation of afferent proprioceptive and motor output neural pathways using operant learning. Continuous and immediate assisted-feedback of force proportional to rolandic rhythm oscillations during actual movements was employed and illustrated with a single case experiment. One hemiplegic patient was trained for 2 weeks coupling somatosensory brain oscillations with force-field control during a robot-mediated center-out motor-task whose execution approaches movements of everyday life. The robot facilitated actual movements adding a modulated force directed to the target, thus providing a non-delayed proprioceptive feedback. Neuro-electric, kinematic, and motor-behavioral measures were recorded in pre- and post-assessments without force assistance. Patient's healthy arm was used as control since neither a placebo control was possible nor other control conditions. We observed a generalized and significant kinematic improvement in the affected arm and a spatial accuracy improvement in both arms, together with an increase and focalization of the somatosensory rhythm changes used to provide assisted-force-feedback. The interpretation of the neurophysiological and kinematic evidences reported here is strictly related to the repetition of the motor-task and the presence of the assisted-force-feedback. Results are described as systematic observations only, without firm conclusions about the effectiveness of the methodology. In this prototypical view, the design of appropriate control conditions is discussed. This study presents a novel operant-learning-based BMI-application for motor-training coupling brain oscillations and force feedback during an actual movement.
Case Report: A Malignant Liver and Thoracic Solitary Fibrous Tumor: A 10-Year Journey From the Brain to the Liver and the Spine
Authors: Min Mao, Lei Zhou, Chaojun Huang, Xudong Yan, Shuo Hu, Huabin Yin, Qinghua Zhao, Dianwen Song
Journal: Front Surg (2020)
Keywords: liver, malignant tumor, metastasis, solitary fibrous tumor, spine
MeSH terms: Case Reports

Solitary fibrous tumors are rare neoplasms that originate from mesenchymal tissues and have been found to occur in any site, including the spine and liver. Although most of solitary fibrous tumors have benign features, only 10-20% are malignant and prone to metastasis. No previous reports have described the malignant and metastatic Solitary fibrous tumor arising in both of the liver and thoracic vertebrae. In this article, we present the case of a 60-year-old woman who underwent gross total resection of a meningeal tumor in 2007. She presented 10 years later with a thoracic vertebral mass that caused relentless pain and a lesion in the right lobe of liver. She underwent marginal excision of the T3 tumor with T2-4 pedicular screw fixation in March 2017, then right hemi-hepatectomy was performed to remove the liver lesion in June 2017. Both of the lesions were confirmed to be a metastatic and malignant tumor after surgery. The literature lacks randomized controlled trials and large studies that define the natural history of malignant solitary fibrous tumors and recommendations of precise management plan for the disease. However, the best choice for treatment is gross total resection, which probably provide the optimal treatment to achieve long-term disease-free survival.
Intraosseous follicular adenomatoid odontogenic tumour-a case report
Authors: Farhan Durrani, Royana Singh
Journal: Int J Dent (2009)
MeSH terms: Case Reports

The adenomatoid odontogenic tumour is a relatively uncommon lesion which mainly affects females in their second decade of life. It exhibits a predilection for the anterior region of the maxilla. The lesion is usually associated with the crown of an embedded tooth, most commonly the maxillary canine. In this paper, we present a case of adenomatoid odontogenic tumor affecting the left maxillary region in a 24-year-old female. The authors also discuss clinical, radiographic, histopathologic, and therapeutic features of the case.
Management of unpredictable outcomes of costochondral grafts
Authors: Mmathabo G Sekhoto, Risimati E Rikhotso, Sumetha Rajendran
Journal: Int J Surg Case Rep (2019)
Keywords: case report, maxillofacial, paediatric, temperomandibular joint, trauma

Introduction:
Temporomandibular joint (TMJ) ankylosis is a debilitating mandibular hypomobility disorder that may be associated with serious functional and aesthetic deformities including limited mouth opening, impaired mastication and disturbances of facial and mandibular growth. The ultimate treatment goal of TMJ ankylosis is to restore altered joint mechanics, correct associated dentofacial deformities and prevent reankylosis.
Presentation of case:
We present a case of a 16 year old patient who returned with excessive mandibular growth and TMJ reankylosis following treatment of TMJ ankylosis with CCGs when he was 8 years old.
Discussion:
Various treatment modalities for TMJ ankylosis have been described. These include gap arthroplasty (GAP), interpositional gap arthroplasty (IPG) and/or total joint reconstruction (with autogenous costochondral grafts or alloplastic materials), and distraction osteogenesis. Costochondral grafts (CCGs) are generally preferred for the treatment of TMJ ankylosis, especially in the growing patient. Their advantages include biocompatibility, no financial cost to the patient, low donor site morbidity, and most importantly their potential for mandibular growth. The growth of the mandible is however unpredictable.
Conclusion:
The optimal surgical management of this complex patient with combined orthognathic surgery and total alloplastic joint reconstruction is discussed.
Immune-Mediated Thrombotic Thrombocytopenic Purpura Following mRNA-Based COVID-19 Vaccine BNT162b2: Case Report and Mini-Review of the Literature
Authors: Vanessa Alexandra Buetler, Nada Agbariah, Deborah Pia Schild, Fabian D Liechti, Anna Wieland, Nicola Andina, Felix Hammann, Johanna A Kremer Hovinga
Journal: Front Med (Lausanne) (2022)
Keywords: adamts13, covid-19 vaccine, mrna sars-cov-2 vaccine, purpura, thrombotic thrombocytopenic
MeSH terms: Case Reports

Introduction:
An increasing number of case reports have associated vaccinations against coronavirus disease 2019 (COVID-19) with immune-mediated thrombotic thrombocytopenic purpura (iTTP), a very rare but potentially life-threatening thrombotic microangiopathy, which leads to ischemic organ dysfunction. Thrombus formation in iTTP is related to a severe deficiency of the specific von Willebrand-factor-cleaving protease ADAMTS13 due to ADAMTS13 autoantibodies.
Methods:
We present a case of iTTP following exposure to the mRNA-based COVID-19 vaccine BNT162b2 (Comirnaty®, Pfizer-BioNTech). In addition, we review previously reported cases in the literature and assess current evidence.
Results:
Apart from our case, twenty cases of iTTP occurring after COVID-19 vaccination had been published until the end of November 2021. There were 11 male and 10 female cases; their median age at diagnosis was 50 years (range 14-84 years). Five patients (24%) had a preexisting history of iTTP. Recombinant adenoviral vector-based vaccines were involved in 19%, mRNA-based vaccines in 81%. The median onset of symptoms after vaccination was 12 days (range 5-37), with 20 cases presenting within 30 days. Treatment included therapeutic plasma exchange in all patients. Additional rituximab, caplacizumab, or both these treatments were given in 43% (9/21), 14% (3/21), and 24% (5/21) of cases, respectively. One patient died, despite a prolonged clinical course in one patient, all surviving patients were in clinical remission at the end of the observational period.
Conclusion:
Clinical features of iTTP following COVID-19 vaccination were in line with those of pre-pandemic iTTP. When timely initiated, an excellent response to standard treatment was seen in all cases. ADAMTS13 activity should be determined pre-vaccination in patients with a history of a previous iTTP episode. None of the reported cases met the WHO criteria for assessing an adverse event following immunization (AEFI) as a consistent causal association to immunization. Further surveillance of safety data and additional case-based assessment are needed.
Cerebellar ataxia and sensory ganglionopathy associated with light-chain myeloma
Authors: Panagiotis Zis, Dasappaiah Ganesh Rao, Bart E Wagner, Lucinda Nicholson-Goult, Nigel Hoggard, Marios Hadjivassiliou
Journal: Cerebellum Ataxias (2017)
Keywords: amyloid, ataxia, cerebellar, myeloma, paraneoplastic, sensory ganglionopathy
MeSH terms: Case Reports

Background:
Cerebellar ataxia with sensory ganglionopathy is a rare neurological combination that can occur in some hereditary ataxias including mitochondrial diseases and in gluten sensitivity. Individually each condition can be a classic paraneoplastic neurological syndrome. We report a patient with this combination who was diagnosed with light-chain myeloma ten years after initial presentation.
Case presentation:
A 65-year-old Caucasian lady was referred to our Ataxia Clinic because of a 6-year history of progressive unsteadiness and a 2-year history of slurred speech. Past medical history included arterial hypertension. The patient was a non-smoker was not consuming alcohol excessively. There was no family history of ataxia. Neurological examination revealed prominent gaze-evoked nystagmus, heel to shin ataxia, gait ataxia, reduced reflexes and loss of vibration sensation in the legs. Cerebellar ataxia was confirmed using magnetic resonance spectroscopy of the cerebellum and sensory ganglionopathy using neurophysiological assessments including blink reflex study. A muscle biopsy that was arranged to explore the possibility of mitochondrial disease revealed amyloidosis. Urinalysis confirmed the presence of light chains. A bone marrow biopsy confirmed the diagnosis of light chain multiple myeloma.
Conclusions:
Whilst it could be argued that this could simply be a coincidence, the rarity of these conditions and the absence of an alternative aetiology for the neurological dysfunction argue in favour of a paraneoplastic phenomenon.
Phenotypic Expansion in Nasu-Hakola Disease: Immunological Findings in Three Patients and Proposal of a Unifying Pathogenic Hypothesis
Authors: Edoardo Errichiello, Efthimios Dardiotis, Fiorenza Mannino, Juha Paloneva, Teresa Mattina, Orsetta Zuffardi
Journal: Front Immunol (2019)
Keywords: nk cells, nasu-hakola disease (nhd), trem2, tyrobp, autoantibodies, bone cysts, microglia, neurodegeneration
MeSH terms: Killer Cells, Natural / immunology, Lipodystrophy / immunology, Neuroimmunomodulation / genetics, Neuroimmunomodulation / immunology, Osteochondrodysplasias / immunology, Subacute Sclerosing Panencephalitis / immunology, Case Reports, Adaptor Proteins, Signal Transducing / genetics, Adult, Female, Humans, Lipodystrophy / genetics, Membrane Glycoproteins / genetics, Membrane Proteins / genetics, Mutation, Osteochondrodysplasias / genetics, Pedigree, Phenotype, Receptors, Immunologic / genetics, Subacute Sclerosing Panencephalitis / genetics, Adaptor Proteins, Signal Transducing, Membrane Glycoproteins, Membrane Proteins, Receptors, Immunologic, TREM2 protein, human, TYROBP protein, human, Polycystic lipomembranous osteodysplasia with sclerosing leukoencephalopathy

Nasu-Hakola disease (NHD) is a rare autosomal recessive disorder characterized by progressive presenile dementia and bone cysts, caused by variants in either TYROBP or TREM2. Despite the well-researched role of TREM2 and TYROBP/DAP12 in immunity, immunological phenotypes have never been reported in NHD patients. We initially diagnosed an Italian patient, using whole exome sequencing, with classical NHD clinical sequelae who additionally showed a decrease in NK cells and autoimmunity features underlined by the presence of autoantibodies. Based on this finding, we retrospectively explored the immunophenotype in another two NHD patients, in whom a low NK cell count and positive autoantibody serology were recorded. Accordingly, Trem2-/- mice show abnormal levels of circulating proinflammatory cytokines and the dysfunction of immune cells, whereas knockout mice for Tyrobp, encoding the adapter for TREM2, exhibit increased levels of autoantibodies and defective NK cell activity. Our findings tend to redefine NHD as a multisystem "immunological" disease, considering that osteoclasts are derived from the fusion of mononuclear myeloid precursors, whereas neurological anomalies in NHD are directly caused by microglia dysfunction.
Benign osteoblastoma involving maxilla: a case report and review of the literature
Authors: K Bokhari, M S Hameed, M Ajmal, Rafi A Togoo
Journal: Case Rep Dent (2012)
MeSH terms: Case Reports

Background. Osteoblastoma is a rare benign tumor. This tumor is characterized by osteoid and bone formation with the presence of numerous osteoblasts. The lesion is more frequently seen in long bones and rarely involves maxilla and mandible. Due to its clinical and histological similarity with other bone tumors such as osteoid osteoma and fibro-osseous lesions, osteoblastoma presents a diagnostic dilemma. Case Report. Very few cases of osteoblastomas involving maxillofacial region have been reported in the literature. This case report involves osteoblastoma involving right maxilla in an 18-year-old male patient. Following detailed clinical examination, radiological interpretation, and histopathological diagnosis, surgical excision was performed. The patient was followed up for a period of 3 years and was disease free. Summary and Conclusion. Benign osteoblastoma involving jaw bones is a rare tumor. There is a close resemblance of this tumor with other lesions such as fibro-osseous lesions and odontogenic tumors and thus faces a diagnostic challenge. Surgical excision with a long-term follow-up gives good prognosis to this lesion-Benign Osteoblastoma.
Case report: Laparoscopic-assisted distal gastrectomy for gastric cancer in a patient with situs inversus totalis
Authors: Kaifeng Zhu, Qiang Hu, Yuanshui Sun
Journal: Front Surg (2023)
Keywords: case report, gastrectomy, gastric cancer, situs inversus totalis (sit), surgery
MeSH terms: Case Reports

Background:
Situs inversus totalis (SIT) is a rare congenital disease with a series of clinical features characterized by a mirror image distribution of the viscera to the normal anatomy.
Case presentation:
This study aims to report a 63-year-old male SIT patient with gastric cancer with a preoperative diagnosis of stage IIB gastric cancer (cT3N0M0), who underwent a preoperative multi-disciplinary treatment (MDT) discussion and an abdominal enhancement CT for visceral evaluation to ensure a successful operation. A laparoscopic-assisted distal gastrectomy including D2 lymph node dissection and Billroth I reconstruction was successfully performed. Laparoscopic radical gastric gastrectomy and D2 lymph node dissection were performed through the opposite surgical station to the conventional one, followed by digestive tract reconstruction under small incision-assisted direct vision. There was less blood loss throughout the operation, no postoperative complications, and the patient was discharged successfully 10 days after surgery. Histopathological examination showed ulcerated high-medium differentiated adenocarcinoma stage IB (PT2N0M0). There were no complications or tumor recurrence in the patient with examination 6 months after the operation.
Conclusion:
Surgery in a patient with gastric cancer and SIT can be safely performed by the application of 3D laparoscopy and small incisions to assist the digestive tract reconstruction under direct vision.
Radiofrequency ablation-induced superior vena cava stenosis in a 5-year-old boy with congenital left atrial appendage deformity: a case report and literature review
Authors: Jianxian Xiong, Yu Wenbo, Jianfeng Gao, Meifang Li, Dongmin Yu
Journal: Front Surg (2023)
Keywords: arrhythmias, complication, left atrial appendage aneurysm, radiofrequency ablation, superior vena cava
MeSH terms: Case Reports

Superior vena cava (SVC) stenosis is rarely caused by iatrogenic trauma. Herein, the case of a 5-year-old boy who underwent radiofrequency ablation for paroxysmal supraventricular tachycardia but developed SVC stenosis and related syndromes is reported. Notably, the child exhibited an enlarged left atrial appendage that had partially breached the pericardium. Subsequent interventions involved successful removal of the stenosis, artificial vascular reconstruction, and comprehensive radiofrequency ablation of the entire right atrium, along with ligation of the left atrial appendage under direct vision. As a result, the child experienced relief from symptoms.
Case Report: Retropancreatic fascia hernia protruding into the thoracic cavity through a Bochdalek hernia
Authors: Yoichi Nakagawa, Takuya Maeda, Hiroo Uchida, Shunya Takada, Akinari Hinoki, Chiyoe Shirota, Takahisa Tainaka, Wataru Sumida, Satoshi Makita, Hizuru Amano, Aitaro Takimoto, Yousuke Gohda
Journal: Front Pediatr (2023)
Keywords: bochdalek hernia, diaphragmatic hernia, internal hernia, retropancreatic fascia, retropancreatic fascia hernia
MeSH terms: Case Reports

Retropancreatic fascia hernia is a novel internal hernia originating from the retropancreatic fascial defect, which subsequently expands toward the dorsal aspect of the pancreatic body and migrates into the retroperitoneal space. We encountered a rare case of concomitant retropancreatic fascia and Bochdalek hernias. Here, we describe the imaging characteristics of this hernia type and its surgical strategies.
Use of an advanced collagen matrix dressing on patients with complex chronic lower extremity ulcers: A case series
Authors: Afsaneh Alavi, Jeannine Archer, Patricia Coutts
Journal: SAGE Open Med Case Rep (2021)
Keywords: chronic wounds, collagen, venous ulcer
MeSH terms: Case Reports

The objective of this case series was to assess the wound healing effectiveness of a collagen matrix wound dressing containing partially denatured collagen, carboxymethyl cellulose, alginate and ethylenediaminetetraacetic acid in chronic lower extremity ulcers. A total of nine patients with refractory lower extremity ulcers were treated with the collagen contact layer in addition to standard of care. Wound healing progress was measured at 2, 4 and 8 weeks. An average decrease in wound size of 73% was achieved across patients at week 8, with complete healing in two patients. The intervention was easy to use and well tolerated by patients. The results of this study, although preliminary, suggest that the advanced collagen matrix dressing represents an effective and safe treatment strategy for healing refractory chronic lower extremity ulcers of varying etiologies. Further investigation is needed to evaluate efficacy in a larger randomized clinical trial with focus on cost-effectiveness and impact on patient's quality-of-life.
Prolonged use of ertapenem to treat infected diabetic foot ulcers
Authors: Ashwin Algudkar, Gidon Ellis, Fareeduddin Ahmad, Hilary Tindall
Journal: Case Rep Med (2010)
MeSH terms: Case Reports

We present the case of a diabetic man who was successfully treated with ertapenem for over 4 months for severe infection of his foot ulcers. After initial unsuccessful treatment with empirical intravenous antibiotics, ertapenem was started on microbiology advice and led to a marked improvement in the soft-tissue infection. Ertapenem was continued for a total of 137 days under close clinical and biochemical monitoring and produced a complete resolution of the foot infection. This is the first documented case that we know of in which ertapenem has been safely used for this duration of time.
Femoral neck stress fracture in a young female recruit: case report
Authors: Hélder Fonte, Ricardo Rodrigues-Pinto
Journal: SICOT J (2018)

Introduction:
Femoral neck stress fractures are uncommon and depending on their location, can be at high risk for non-union and significant morbidity. Their prevalence is higher among runners and military recruits, and women seem to be at higher risk.
Methods:
A 27-year-old female, who was enrolled in military recruit, reported left side groin pain after a strenuous running exercise. Due to persistent pain an X-Ray was ordered, which revealed no signs of acute lesions. Further imaging studies with CT scan and MRI identified a compression-type femoral neck stress fracture.
Results:
The patient was submitted to conservative treatment consisting of restricting from full weight-bearing. Six weeks after she initiated partial weight-bearing, becoming asymptomatic at seven months. Follow-up imaging studies revealed union of the fracture.
Discussion:
This diagnosis should be considered when evaluating military and athlete populations. Early recognition of these injuries is crucial because complication and morbidity rates are high.
Peritoneal tuberculosis with elevated CA-125 mimicking ovarian cancer with carcinomatosis peritonei: Crucial CT findings
Authors: Jerry Chin-Wei Chien, Chia-Lang Fang, Wing P Chan
Journal: EXCLI J (2016)
Keywords: carcinomatosis peritonei, computed tomography (ct), ovarian cancer, peritoneum, tuberculosis
MeSH terms: Case Reports

Preoperative diagnosis of peritoneal tuberculosis is often difficult because of confusion with ovarian cancer. A 56-year-old woman was admitted to our hospital with abdominal fullness. Ascites, prominent bilateral ovaries, and elevated CA-125 were noted. Computed tomography showed thickened peritoneum and strandings in the mesentery and omentum. Exploratory laparotomy was performed under the provisional diagnosis of ovarian cancer, but the final diagnosis was peritoneal tuberculosis. Careful evaluation of bilateral fallopian tubes and ovaries and peritoneum are helpful for correct diagnosis.
Breast Tuberculosis: A Case Report
Authors: Margarida Pimentel Nunes, Inês Branco Carvalho, Isabel Araújo, Raquel Almeida, José Araújo
Journal: Cureus (2023)
Keywords: breast abscess, breast cancer differential diagnosis, breast tuberculosis, mastitis, mycobacterium tuberculosis, scrofula
MeSH terms: Case Reports

Breast tuberculosis (BTB) is a rare manifestation of tuberculosis (TB), and it is more common in countries with a high incidence of TB. We describe a case of a 36-year-old Angolan woman, who had a history of breast reduction surgery, presenting with right breast enlargement, pain, purulent discharge through multiple skin openings, fever, and abdominal pain, progressively worsening in the past year. She had already undergone several surgical drainages and six months of treatment with ciprofloxacin, with no improvement. Breast ultrasound and MRI were performed, which revealed a large fluid collection, with several small abscesses and surrounding adenopathies, complicated by multiple fistulae. The fluid was drained through needle aspiration, which was found to be sterile for bacteria, mycobacteria, and fungi. A lymph node biopsy showed necrosis without granulomas, and the biopsy culture was positive for Mycobacterium tuberculosis (Mt). This case shows how a rare manifestation can simulate bacterial breast abscesses or cancer, and hence a high index of suspicion is necessary to reach the correct diagnosis and ensure appropriate treatment delivery in these patients.