OpenMed/multicare-articles huggingface dataset:
Optical Coherence Tomography Reveals New Insights into the Accommodation Mechanism
Authors: Mahmoud Mohamed Farouk, Takeshi Naito, Kayo Shinomiya, Hiroshi Eguchi, Khulood Mohammed Sayed, Toshihiko Nagasawa, Takashi Katome, Yoshinori Mitamura
Journal: J Ophthalmol (2015)

Purpose. To evaluate the movement of the anterior and posterior lens poles during naturally stimulated accommodation in children using anterior segment optical coherence tomography (OCT). Methods. This is a prospective, observational, noncomparative case series including 18 eyes of nine children. Analysis of the anterior segment in the accommodated and unaccommodated state (with cycloplegia) was done using anterior segment OCT. The main outcome measures were the position of the anterior and posterior lens poles (in relation to the cornea) and lens thickness (LT). Results. A Statistically significant forward movement of the anterior lens pole and backward movement of the posterior lens pole with an increase in LT were found during accommodation (P < 0.001). There was no significant difference between the degree of movement of the anterior lens pole and the posterior lens pole during accommodation (P = 0.944). Conclusions. Anterior segment OCT provides a rapid noncontact method for studying accommodation in children. The backward movement of the posterior lens pole during accommodation nearly equals the forward movement of its anterior pole. These data minimize the theoretical hydraulic effect of the vitreous during accommodation, adding more support to the capsular theory of Helmholtz.
A case report and literature review: pheochromocytoma-mediated takotsubo cardiomyopathy, which is similar to acute myocardial infarction
Authors: Zhiyu Zhang, Xia Guo, Jingyue Wang, Shipeng Wang, Yushi Wang
Journal: Front Cardiovasc Med (2023)
Keywords: ami, catecholamine, normetanephrine, pheochromocytoma, takotsubo cardiomyopathy
MeSH terms: Case Reports

A 52-year-old Chinese woman was admitted to a cardiac intensive care unit (CCU) due to nausea, vomiting, and dyspnea, which began a day before her hospitalization. Metoprolol succinate and conventional treatment for acute myocardial infarction (AMI) were initially administered to the patient based on electrocardiogram (ECG) findings and elevated cardiac troponin I (cTnI). However, the following day, she developed aggravated nausea, vomiting, fever, sweating, a flushed face, a rapid heart rate, and a significant rise in blood pressure. Furthermore, ultrasonic cardiography (UCG) displayed takotsubo-like changes; nevertheless, ECG indicated inconsistent cTnI peaks with extensive infarction. After coronary computed tomography angiography (CTA) ruled out (AMI), and in conjunction with the uncommon findings, we strongly suspected that the patient had a secondary condition of pheochromocytoma-induced takotsubo cardiomyopathy (Pheo-TCM). In the meanwhile, the use of metoprolol succinate was promptly discontinued. This hypothesis was further supported by the subsequent plasma elevation of multiple catecholamines and contrast-enhanced computed tomography (CECT). After one month of treatment with high-dose Phenoxybenzamine in combination with metoprolol succinate, the patient met the criteria for surgical excision and successfully underwent the procedure. This case report demonstrated that pheochromocytoma could induce TCM and emphasized the significance of distinguishing it from AMI (in the context of beta-blocker usage and anticoagulant management).
Transcranial magnetic stimulation for diplopia in a patient with spinocerebellar ataxia type 6: a case report
Authors: Kentaro Kawamura, Seiji Etoh, Megumi Shimodozono
Journal: Cerebellum Ataxias (2018)
Keywords: ataxia, binocular fusion, cerebellum, diplopia, motor cortex, nystagmus, ophthalmoparesis, sca6, single pulse, tms
MeSH terms: Case Reports

Background:
In Patients with spinocerebellar ataxia type 6 (SCA6) are often treated by transcranial magnetic stimulation (TMS) over the motor cortex and cerebellum. However, few reports have examined effective therapeutic modalities for diplopia in SCA6 patients. In the current case, we applied single-pulse TMS over the motor cortex and cerebellum to improve ataxia, and observed an unexpected improvement of diplopia.
Case presentation:
A 62-year-old Japanese male with spinocerebellar ataxia type 6 (SCA6) was admitted to our hospital for exacerbation of ataxia. We administered single-pulse transcranial magnetic stimulation (TMS) over the hand motor area and the cerebellum with a circular coil to reduce ataxia. After the initiation of TMS, since diplopia unexpectedly improved, we started a quantitative assessment of diplopia by counting the number of fixation spots that he observed in his visual field. This assessment suggested that TMS had an immediate and cumulative effect on diplopia. We also delivered more localized stimulation only over the motor cortex with a Figure-8 coil, and diplopia improved immediately. Additionally, we administered a sham stimulation before the real stimulation over the motor cortex and the cerebellum. The sham stimulation improved diplopia, and greater improvement was observed with subsequent real stimulation. We also used a Hess chart examination and video recordings of binocular gross appearance to elucidate the changes in ocular movement objectively. However, these examinations did not reveal any obvious oculomotor changes.
Conclusions:
We applied single-pulse TMS to a SCA6 patient with diplopia, which improved without any adverse effects. TMS may have potential for the treatment of diplopia in SCA6 patients.
Intra-abdominal desmoplastic small round cell tumour: staging and surveillance with 18F-FDG PET/CT following peritonectomy and HIPEC
Authors: William Makis, Safwat Girgis
Journal: BJR Case Rep (2016)
MeSH terms: Case Reports

Intra-abdominal desmoplastic small round cell tumours are rare aggressive tumours of mesothelial origin with less than 60 cases reported in the literature. They are difficult to treat and the role of 18F-fludeoxyglucose positron emission tomography (PET)/CT scan in their management has not been established. A 41-year-old male presented with a 21-cm desmoplastic small round cell tumour and was managed with radiotherapy, surgery and chemotherapy, with each treatment monitored and guided by 18F-fludeoxyglucose PET/CT scan. We present the imaging findings of the serial PET/CT scans of this patient and their impact on management.
Diode Laser Surgery as a Conservative Management of Hairy Tongue Lesion Resistance to Treatment
Authors: Nazanin Samiei, Hadi Kaseb Ghane, Reza Fekrazad
Journal: Case Rep Dent (2021)
MeSH terms: Case Reports

Hairy tongue is a furry appearance on the dorsum surface of the tongue with variable colors. This lesion is due to defective shedding of filiform papillae. Various treatments are proposed for this condition like keratolytic agents, surgical procedure with a scalpel, or laser application. In this case study, we reported successful treatment of hairy tongue with a diode laser. The diode laser with wavelength 810 nm, power of 4 watts, a pulse width of 20 milliseconds, and an interval of 20 milliseconds by a 400-micron optical fiber was selected for treatment of this lesion. There was no bleeding during this minimally invasive surgery, and the patient experienced a low level of pain. Loss of taste function was completely resolved. Based on the result of this study, a diode laser can be a good alternative for minimally invasive surgical treatment of hairy tongue.
Cutaneous Ulcers as Initial Presentation of Localized Granulomatosis with Polyangiitis: A Case Report and Review of the Literature
Authors: Noreen Nasir, Syed Ahsan Ali, Hafiz Mohammed Mehmood Riaz
Journal: Case Rep Rheumatol (2015)

Background. Granulomatosis with polyangiitis (GPA) is an ANCA associated small vessel vasculitis characterized by necrotizing granulomatous inflammation involving the upper and the lower respiratory tract and the kidneys. The disease has a broad clinical spectrum that ranges from limited/localized involvement of a single organ system to a generalized systemic vasculitis that affects several organs with evidence of end organ damage. Atypical forms of the disease have been recognized with or without respiratory tract involvement with a long protracted course before manifesting as generalized disease. Case Presentation. We describe a 57-year-old woman who presented with recurrent fever and cutaneous ulcers on her legs who was diagnosed to have granulomatosis with polyangiitis (GPA) after an extensive evaluation which excluded infectious, other vasculitides, connective tissue disease and malignant etiologies. Conclusion. In the absence of typical manifestations, granulomatosis with polyangiitis (GPA) is indeed a diagnostic challenge to the physician. Atypical manifestations like unexplained recurrent fever and cutaneous ulcers nevertheless call for keeping a low threshold for the diagnosis of GPA as the disease can initially present in localized form before heralding into a generalized disease.
BioNetApp: An interactive visual data analysis platform for molecular expressions
Authors: Ali M Roumani, Amgad Madkour, Mourad Ouzzani, Thomas McGrew, Esraa Omran, Xiang Zhang
Journal: PLoS One (2019)
MeSH terms: Software, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't, Cluster Analysis, Metabolic Networks and Pathways, Metabolomics / methods

Motivation:
Systems biology faces two key challenges when dealing with large amounts of disparate data produced by different experiments: the integration of results across different experiments, and the extraction of meaningful information from the data produced by these experiments. An ongoing challenge is to provide better tools that can mine data patterns that could not have been discovered through simple visualization. Such mining capabilities also need to be coupled with intuitive visualization to portray those findings. We introduce a software toolbox entitled BioNetApp to mine these patterns and visualize them across all experiments.
Results:
BioNetApp is an interactive visual data mining software for analyzing high-volume molecular expression data obtained from multiple 'omics experiments. By integrating visualization, statistical methods, and data mining techniques, BioNetApp can perform interactive correlative and comparative analysis along time-course studies of molecular expression data. Correlation analysis provides several visualization features such as Kamada-Kawai, Fruchterman-Reingold Spring embedding network layouts, in addition to single circle, multiple circle and heatmap layouts, whereas comparative analysis presents expression-data distributions across samples, groups, and time points with boxplot display, outlier detection, and data curve fitting. BioNetApp also provides data clustering based on molecular concentrations using Self Organizing Maps (SOM), K-Means, K-Medoids, and Farthest First algorithms.
Conclusion:
BioNetApp has been utilized in a metabolomics study to investigate the metabolite abundance changes in alcohol induced fatty liver, where pair-wise analyses of metabolome concentration revealed correlation networks and interesting patterns in the metabolomics dataset. This study case demonstrates the effectiveness of the BioNetApp software as an interactive visual analysis tool for molecular expression data in systems biology. The BioNetApp software is freely available under GNU GPL license and can be downloaded (including the case-study data and user-manual) at: https://doi.org/10.5281/zenodo.2563129.
Solitary neurofibroma of the floor of the mouth: a case report
Authors: Motoyoshi Maruyama, Hiroaki Fushiki, Yukio Watanabe
Journal: Case Rep Otolaryngol (2011)
MeSH terms: Case Reports

We present a case of a solitary neurofibroma of the floor of the mouth protruding into the submandibular region. A 51-year-old female presented with a 2-year history of swelling of the floor of the mouth. MRI revealed that the mass measuring 50 × 70 mm showed a homogenous, low signal intensity on a T1-weighted image and high signal intensity on a T2-weighted image. The tumor was completely removed through a cervical approach. Cases of a solitary neurofibroma originating from the floor of the mouth are extremely rare.
A clinical case study of a psychoanalytic psychotherapy monitored with functional neuroimaging
Authors: Anna Buchheim, Karin Labek, Steffen Walter, Roberto Viviani
Journal: Front Hum Neurosci (2013)
Keywords: attachment, fmri, psychoanalysis, psychotherapy process q-set, single case studies

This case study describes 1 year of the psychoanalytic psychotherapy using clinical data, a standardized instrument of the psychotherapeutic process (Psychotherapy process Q-Set, PQS), and functional neuroimaging (fMRI). A female dysthymic patient with narcissistic traits was assessed at monthly intervals (12 sessions). In the fMRI scans, which took place immediately after therapy hours, the patient looked at pictures of attachment-relevant scenes (from the Adult Attachment Projective Picture System, AAP) divided into two groups: those accompanied by a neutral description, and those accompanied by a description tailored to core conflicts of the patient as assessed in the AAP. Clinically, this patient presented defense mechanisms that influenced the relationship with the therapist and that was characterized by fluctuations of mood that lasted whole days, following a pattern that remained stable during the year of the study. The two modes of functioning associated with the mood shifts strongly affected the interaction with the therapist, whose quality varied accordingly ("easy" and "difficult" hours). The PQS analysis showed the association of "easy" hours with the topic of the involvement in significant relationships and of "difficult hours" with self-distancing, a defensive maneuver common in narcissistic personality structures. In the fMRI data, the modes of functioning visible in the therapy hours were significantly associated with modulation of the signal elicited by personalized attachment-related scenes in the posterior cingulate (p = 0.017 cluster-level, whole-volume corrected). This region has been associated in previous studies to self-distancing from negatively valenced pictures presented during the scan. The present study may provide evidence of the possible involvement of this brain area in spontaneously enacted self-distancing defensive strategies, which may be of relevance in resistant reactions in the course of a psychoanalytic psychotherapy.
Anaplastic carcinoma of the pancreas mimicking submucosal gastric tumor: a case report of a rare tumor
Authors: Michimasa Fujiogi, Takashi Kobayashi, Masamichi Yasuno, Michio Tanaka
Journal: Case Rep Med (2013)

Anaplastic carcinoma of the pancreas (ACP) is a rare neoplasm of the pancreas. ACPs are aggressive neoplasms with a poorer prognosis than poorly differentiated ductal adenocarcinomas of the pancreas. The 3-year survival rate of patients with ACP is less than 3%, with a life expectancy of 10 to 20 months. We describe here a 64-year-old man with ACP mimicking a submucosal gastric tumor. The patient was found to have a giant mass mimicking a submucosal tumor. Total gastrectomy with splenectomy and partial resection of the tail of the pancreas were performed. The pathological diagnosis was ACP, with immunohistological findings showing pleomorphic-type ACP. Because the surgery was noncurative, the patient received adjuvant chemotherapy with paclitaxel but died of peritoneal dissemination and multiple liver metastases 4 months after surgery.
COVID-19: The Case of Three Patients with the Same Diagnosis but Different Clinical and Laboratory Features
Authors: Muhammed Atere, Sukhdev Singh, Krisha Arora, Zohaib Khan, Lloyd Muzangwa, Urvi Bhavsar, Jay M Nfonoyim
Journal: Case Rep Med (2020)
MeSH terms: Case Reports

SARS-CoV-2 is an RNA virus that causes COVID-19, which has been responsible for the pandemic that was declared in early 2020. Its pathological effect is majorly in the respiratory tract, but its full pathogenicity remains a mystery. Symptoms associated with COVID-19 include fever, cough, and shortness of breath. Some patients develop other symptoms like diarrhea. However, it is possible for other organs to be affected including the central nervous system, liver, and blood cells. The purpose of this case series is to unravel other factors associated with this disease, so we report three cases of COVID-19 that were hospitalized during the pandemic.
Case Report: First-Line Immunotherapy for Esophageal Squamous Carcinoma Combined With Hypopharyngeal Squamous Carcinoma Yields Sustained Survival Benefit
Authors: Yi Yang, Xiangliang Liu, Wei Song, Jin Lu, Na Yin, Xiaojun Ye, Xiao Chen
Journal: Front Immunol (2022)
Keywords: chemotherapy, esophageal cancer, hypopharyngeal squamous cell carcinoma, immunotherapy, sustained survival benefit
MeSH terms: Carcinoma, Squamous Cell / pathology, Esophageal Neoplasms / therapy, Esophageal Squamous Cell Carcinoma / therapy, Head and Neck Neoplasms, Hypopharyngeal Neoplasms / pathology, Hypopharyngeal Neoplasms / radiotherapy, Case Reports, Humans, Immunotherapy, Retrospective Studies, Squamous Cell Carcinoma of Head and Neck

Esophageal cancer, as one of the most common malignant tumors in the upper gastrointestinal tract, is highly invasive, with poor prognosis and low 5-year survival rate. Hypopharyngeal cancer has a low incidence among head and neck malignant tumors, but its prognosis is poor and it is prone to recurrence, and because the upper respiratory tract has similar tissue types as the upper gastrointestinal tract, it is prone to the second primary tumor of the upper gastrointestinal tract, however, such patients with double primary carcinoma are uncommon in the clinic, and most of them are already advanced at the time of diagnosis, losing the chance of surgical resection, with poor results and poor prognosis after radiotherapy treatment, therefore, the choice of treatment strategy for such inoperable resectable patients is still a great challenge for clinicians.In this case, we report a patient with a double primary esophageal squamous carcinoma combined with hypopharyngeal squamous carcinoma without family history of tumor, who achieved complete remission after first-line chemotherapy combined with immunotherapy, with both lesions shrinking and the hypopharyngeal tumor disappearing. The survival benefit was ensured at the same time.
Extended-Interval Gentamicin Dosing for Pulmonic Tularemia
Authors: Tyson Dietrich, Katelynn Garcia, Joe Strain, John Ashurst
Journal: Case Rep Infect Dis (2019)
MeSH terms: Case Reports

Francisella tularensis is a Gram-negative coccobacillus that is rarely encountered in clinical practice. Patients can present with cutaneous, pulmonary, cardiac, mucous membrane, or gastrointestinal involvement. A clinician should have a heightened suspicion in endemic areas or when outbreaks appear. Diagnosis is achieved through serological testing or polymerase chain reaction assays. Although historically the treatment of choice was streptomycin, gentamicin is now preferred due to its availability and relatively safer side effect profile with extended-interval dosing. Limited published evidence exists on the effectiveness of extended-interval gentamicin for tularemia. This case series describes four patients with pulmonic tularemia successfully treated with extended-interval dosing of gentamicin without treatment failure or relapse.
Phenotypic Features and Salivary Parameters in Patients with Ectodermal Dysplasia: Report of Three Cases
Authors: Mônica Fernandes Gomes, Luigi Giovanni Bernardo Sichi, Lilian Chrystiane Giannasi, José Benedito Oliveira Amorim, João Carlos da Rocha, Cristiane Yumi Koga-Ito, Miguel Angel Castillo Salgado
Journal: Case Rep Dent (2018)
MeSH terms: Case Reports

Ectodermal dysplasia (ED) is a rare hereditary disorder affecting the development of ectoderm-derived organs and tissues. The aim of this study was to describe phenotypic features and the therapeutic approach in dentistry among three patients with ED, correlating their data with the literature. Additionally, to investigate the salivary gland disorders and their impacts on oral microbiota, we performed salivary tests, including salivary flow rate, salivary buffering capacity, and concentration levels of mutans streptococci, lactobacilli, and yeasts. All patients presented oligodontia, resulting in a significant masticatory dysfunction and aesthetic impairment. The counts of mutans streptococci (n=3) and yeasts (n=2) were high; on the other hand, the count of lactobacilli (n=3) was low. Therefore, salivary and microbiological tests showed that the patients with ED, particularly the hypohidrotic type, presented a high risk of enamel caries and susceptibility to oral infections, which may be likely triggered by reduction of salivary flow and/or possible immunological disorders.
Multiple Cutaneous Metastases as Initial Presentation in Advanced Colon Cancer
Authors: Sudheer Nambiar, Asha Karippot
Journal: Case Rep Gastrointest Med (2018)
MeSH terms: Case Reports

Skin metastases from advanced colorectal cancer are relatively rare and occur most often when the cancer is advanced, following the spread to other organs. Cutaneous metastases occur in about 3% of advanced colorectal cancers. We present an extremely rare case of a 68-year-old woman with advanced ascending colon adenocarcinoma that presented with multiple rapidly progressing painless cutaneous metastatic lesions with no other distant metastases. Of all the tumors, breast cancer most commonly spreads as cutaneous metastasis is followed by lung, colorectal, renal, ovarian, and bladder cancers. Cutaneous metastases can present in a variety of clinical manifestations, such as a rapidly growing painless dermal or subcutaneous nodule with intact overlying epidermis or as ulcers. In cases where the cutaneous deposit is isolated, as in visceral metastasis, there is a role for radical management such as wide local excision and reconstruction. In our patient, since she had multiple cutaneous metastases she began treatment with palliative systemic combination chemotherapy.
Ewing's Sarcoma of the Breast in a Young Woman: A Case Report and Review of the Literature
Authors: Simona Papi, Francesca Combi, Silvia Segattini, Silvia Accogli, Enza Palma, Anna Gambini, Alessia Andreotti, Gabriele Luppi, Giovanni Tazzioli
Journal: Front Oncol (2022)
Keywords: ewing’s sarcoma (es), breast mass, breast surgery, case report, chromosomal translocation, peripheral primary neuroectodermal tumor, sarcoma
MeSH terms: Case Reports

Ewing's Sarcoma Family Tumors (ESFT) include classic Ewing's sarcoma of bone, extra-skeletal Ewing's sarcoma (EES), malignant small cell tumor of the chest wall (Askin tumor), and soft tissue-based Peripheral Primitive Neuroectodermal tumors (pPNET). The t(11;22)(q24;q12) translocation is associated with 85% of tumors and leads to EWS-FLI-1 (Ewing's Sarcoma-Friend Leukemia Integration-1) formation. This is a potent transforming gene that encodes a chimeric protein that plays a role in the genesis of Ewing's Sarcoma and Primitive Neuroectodermal Tumors. The breast location of ESFT remains exceptional. The prognosis is among the poorest of all subtypes of breast cancer and even poorer than other extraosseous Ewing's sarcomas. We describe the case report of a 23-year-old patient with a growing breast lump, who required an accurate and challenging diagnostic estimation and who ultimately resulted in a peripheral primary neuroectodermal tumor (pPNET). Through this case description and a brief narrative review of the literature, we aim to highlight the rarity of ESFT located in the breast. Histopathological confirmation is mandatory for all growing masses of the breast to reach a conclusive diagnosis and plan the correct treatment. Patients with rare diagnoses should always be centralized in breast units, conducting multidisciplinary meetings and, when necessary, the diagnosis should be shared through wider national or international registries.