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MMA angiography is then performed to visualize the MMA anatomy and to determine which of its branches are feeding the external membrane of the cSDH. Figure 3 shows frontal and lateral selective MMA angiograms demonstrating areas of contrast blush in the subdural hematoma.

Bone mass density (BMD) showed osteopenia with multiple fractures. The patient was evaluated by ultrasonography and was found to have a 3.2 × 2 cm2 heterogenous hypoechoic mass involving the medial aspect of the left thigh with increased vascularity (Figure 1).

A baby boy with vertex presentation was born with vaginal delivery associated to the Kristeller maneuver at 39 weeks of gestation. Obstetric history was significant for maternal trauma due to an accidental fall down the stairs at 37 weeks of gestation. An accurate prenatal ultrasound did not show trauma-related lesions or abnormalities.

Acute SH in the neonatal period is a rare condition that requires prompt diagnosis and possible urgent intervention with a more limited surgical approach. Clinical and diagnostic approaches toward a neonatal scrotal hematoma should receive careful consideration as abdominal in origin and pre-operative CT scan or MRI in addition to abdominal/scrotal ultrasound should be added as part of the diagnostic work-up.

Another incidental finding included aortic stenosis caused by dystrophic calcification in the cusps of the aortic valve. Left ventricular hypertrophy (heart weight 415 g) was caused by both aortic stenosis and amyloid deposition. The aorta revealed severe atherosclerosis. The abscess lesion around the right femoral prosthesis was not evaluated.

We described herein a case of gastric perforation secondary to systemic AA amyloidosis. Persistent infection around the right femoral prosthesis for 1‐year period was regarded as the amyloidogenic chronic inflammatory event. Continuous drainage from the abscess lesion was performed for the last 4 months. Chronic fibrosing diverticulitis in the sigmoid colon was another candidate of the amyloidogenic inflammatory lesion in the present case.

Patient 6 (Table 1) died on 6/2019 after multimodal long-term treatment of NF2-associated complications by respiratory paralysis in order to compression of the brainstem by incurable vestibular schwannomas. The patient was immediately transferred from the place of death to the Department of Legal Medicine and an autopsy was carried out the next day by a forensic pathologist with more than 40 years of experience.

Intraoperative findings showed the tumor invading the transverse mesocolon. White arrows indicate tumor invasion to the transverse mesocolon (A). The tumor invasion was suspected at the neural plexus around the common hepatic artery and gastroduodenal artery. White arrows indicate tumor invasion to the neural plexus around the hepatic arteries (B). Complete tumor resection was achieved by resecting the neural plexuses and superior mesenteric vein (SMV) with 4 cm length. White arrows indicate remaining tumor cells surrounded by fibrosis (C)

Clinical timeline of a 14-year-old girl diagnosed with SARS-CoV-2-related multisystem inflammatory syndrome with severe myocardial dysfunction and refractory shock. The timeline shows the time course of the clinical evolution and the timing of the multimodal therapeutic approach based on immunomodulatory drugs and extracorporeal blood purification with continuous renal replacement therapy (CRRT) plus CytoSorb hemoperfusion.

Table 1Spontaneous chromosomal instability in peripheral blood cells from two unrelated patients with a Rothmund-Thomson-like phenotype. Patients Controls Observed aberrationsPatient APatient BControls totalParents of patient A Parents of patient B Control 1Control 2MotherFatherMotherFatherChromatid Gaps7419125353Chromatid Breaks105103001Chromosome Gaps146102021Chromosome Breaks434111100Total aberrations1311344311475No. scored metaphases5251318505453565451Aberrations/ metaphase0.25*0.22*0.11*0.080.060.210.070.130.10* Significant at p < .05 at the chi-square test

Figure 1 -Spontaneous breaks and gaps in two unrelated Italian patients with a clinical presentation reminiscent of Rothmund-Thomson syndrome. Selected representative images document the spontaneous breaks and gaps observed in the QFQ-banded chromosome spreads from blood samples of the two patients herein reported.

This report brings attention to a salivary gland tumor that was not noticed by the patient and parents or on initial oral examination. It was the bony erosion caused by the tumor that was incidentally noted upon systematic examination of the cone beam CT images. This highlights the importance of thorough clinical and radiographic examinations beyond the area of chief complaint.

A 45-year-old man with no relevant past medical history presented to the eye casualty service complaining of sudden onset central ‘white ring’ and decreased vision in the right eye (RE) over the past seven days. Best-corrected visual acuity (BCVA) was 6/12 in the right eye and 6/6 in the left eye (LE). Intraocular pressure was 14 mmHg in both eyes. Examination of the RE showed no cells in the right anterior chamber and 1+ vitreous cells; fundus examination revealed a yellow placoid lesion involving the macular area with no signs of vasculitis or retinal necrosis. Examination of the LE was unremarkable.

A full lengthening restoration of the tibia by unifocal lengthening amounting an unprecedented 33.5 cm was achieved. The importance of footplate in such immense bone defect and absent ankle joint can be appreciated in his demonstration. The extent and range of application of distraction osteogenesis has yet to be explored. This young patient showed high motivation and good compliance and we were able to successfully restore the tibial defect and further lengthening to correct limb discrepancy. Despite the duration of the treatment and the regular follow up the patient and his parents were satisfied with the results.

Clinical and radiological presentation of PP-FSI in a young female patient (see Table 1). (A) The neutral position without signs of posterior instability. (B) The corresponding fluoroscopic image with centered humeral head. (C) Changes in the shoulder contour can be observed. (D) The posterior subluxation of the humeral head during motion is revealed.

Transaxial T1 weighted magnetic resonance imaging slices with the manual (left) and inverse (right) plans for case number 6. The blue circles denote the isocentre size and position. The 18 Gy (prescription dose) and 12 Gy isodose lines are shown in yellow and green respectively. The improved concavity of the prescription isodose (red arrow) on the medial edge of target is shown on the inverse plan.

Chest X-ray showing massive left (a) and right (b) pneumothorax in COVID-19 patient 1; preoperative CT scan showing right pneumothorax with bulla of the apical segment of the lower lobe (c) and ground glass opacities (d) typical of COVID-19 disease in patient 2

Assessment of CPPopt in two exemplary patients. The pressure reactivity index (PRx) is plotted against cerebral perfusion pressure (CPP). ‘U-shaped’ curve relationships between CPP and PRx including estimation of optimal CPP (CPPopt) is obtained. PRx values > 0.3 indicate impaired pressure reactivity. The patient A reaches the minimum PRx for CPP values around 70–75 mmHg. The patient B has the CPPopt around 95–100 mmHg

Case 4: NGS sequencing of HGSNAT gene succeeded in retrieving the variants inherited from the mother (NM_152419.2:c.234+1G>A-p.? and c.710C>A-p.(Pro237Gln)) and enabled the identification of a heterozygous deletion of exon 15 (NM_152419.2:c.(1464+1_1465-1)_(1542+1_1543-1)del-p.?) which is carried by the paternal allele. This finding made it possible to confirm on a molecular basis the diagnosis of Sanfilippo type C in this patient.

The lung clearance index (LCI) measured by multiple breath washout (MBW) has been shown to be a sensitive measure to capture lung function abnormalities in cystic fibrosis (CF) patients. LCI can also be used to detect treatment effects in interventional trials. Lumacaftor/Ivacaftor is available for CF patients aged12 years and older who are homozygous for the F508del-CFTRbut the timing when starting treatment in patients with mild CF lung disease is sometimes a matter of debate. Here we present the case of a patient with mild CF who started therapy with Lumacaftor/Ivacaftor using LCI to assess the response to treatment.

Chest CT images depicting typical radiographic findings of COVID-19 pneumonia in children. 2A A unilateral chest CT from a 14-year-old boy with a cough. Ground-glass opacities under and parallel to the pleura (thick green arrow) in the inferior lobes of the left lungs. Ground-glass opacities distributed along the bronchovascular bundle (thin green arrow). 2B Bilateral ground-glass opacities with vascular thickening (arrowheads) in the subpleural area from a 13-year-old boy with a fever and a cough. 2C Local patchy shadowing (green arrow) image from a 6 month-old girl with a fever and a cough. 2D Lesions in the lower lobe of both lungs (green arrows) on chest CT obtained from a 15-year-old boy with a fever and a cough

The repeated three-dimensional computed tomography (3D-CT) of the trachea and the spirometry at 16-month follow-up. (A) There was partial absence at the right side of the trachea on the 3D-CT on admission (Red arrow pointed to the fistula). (B) The repeated CT at 16-month follow-up showed that the fistula was covered by the flap grafting (Red arrow). (C) The spirometry at 16-month follow-up showed that the ventilatory function was normal. (D) The flow-volume loop showed that no fixed or dynamic airway obstruction existed. Good patency and stableness of large airway was maintained after the treatment.

a Cutaneous mass HE × 200 Neoplastic round cells with numerous mitoses (arrows); b) Cutaneous mass Toluidine Blue × 400: numerous metachromatic granules in the cell cytoplasm; c) Renal biopsy: HEx200: Neoplastic round cells replacing the renal parenchyma (one residual tubule still visible); d) Renal biopsy: Toluidine Blue × 400: Regular inconspicuous metachromatic granulations (arrows)

A CT scan performed for the disease revaluation after six cycles of therapy showed more than a 75% reduction of the abdominal nodal mass and reduction of the concentric thickening of the sigmoid walls. A colonoscopy with multiple biopsies was performed. The pathology detected inflammatory infiltrated without residual neoplastic cells.

Computed tomography images of the nasal cavity of a dog with Conidiobolus lamprauges rhinitis. Selection of baseline images before antifungal therapy; no intravenous contrast medium was used in the initial evaluation (A–C). Transverse (A) showing the unilateral nasal turbinates are obscured by the overlying soft tissue (white chevron) with small areas of gas in the non-dependent nasal passage (dashed arrow). The ventral nasal passage is obscured by soft tissue (white pound sign). Transverse (B) and dorsal (C) pretreatment showing the mucosa overlying the osseous nasal turbinates (white chevrons) eliminating gas between osseous scrolls. Selection of images after antifungal therapy (D–F). Transverse post-treatment (D) highlighting persistent nasal turbinates (white chevrons) that were previously obscured in the pretreatment study (A). Gas now fills the ventral nasal passage (white pound sign). Transverse (E) and dorsal (F) post-treatment showing the presence of gas between the nasal turbinates (white chevrons) with resolution of the soft tissue that had previously filled the nasal passages. Post-treatment images (D–F) demonstrate that the turbinates were obscured and that there is blunting of the osseous scrolls.

Representative posterior and anterior rhinoscopic images of a dog with Conidiobolus lamprauges rhinitis. (A) Posterior rhinoscopy with the dog in dorsal recumbency. Proliferative tissue extends caudally from the right side of the choanae (white chevron) with mild to moderately erythematous mucosa of the nasopharynx; (B) Anterior rhinoscopy in ventral recumbency. Turbinate mucosa that appears mildly erythematous and edematous (white chevron).

The patient was transferred from another hospital due to increasing hypoactivity and severe diarrhea. The referring hospital had ruled out coronavirus infection due to the absence of cough. Parents reported that the infant was healthy and had regular food intake until symptoms started six days prior to presentation. They denied exposure to or contact with infectious risk factors and affirmed that no cough/rhinorrhea symptoms were present.

We performed transabdominal cerclage (TAC) for four patients who experienced second trimester fetal losses due to troubles with the transvaginal cerclage placed at the time of vaginal RT. Details of the operative procedure are described in our previous report .

NGS screening detected two different variants in NRP1 in two families and four different variants in NRP2 in four families. All the variants were heterozygous. The clinical features of the probands and family members are shown in Table 3. A segregation analysis performed on family members carrying variants in NRP1 are shown in Figure 1. The pedigrees of families with variants in NRP2 are shown in Figure 2.

14 patients were identified to have undergone quadruple-stranded nonirradiated hamstring allograft ALCRs with a type I collagen wrap augmentation. The average age of the patients who underwent the procedure was 33 years of age (range 24-44). 0 out of 14 patients had reported rerupture at a minimum of 24 months postprocedure. None of the patients required further surgical intervention for instability. None of the patients had reported adverse events related to the surgical procedure. 1 of the 14 patients underwent repeat arthroscopy approximately 13 months postprocedure for a failed medial meniscus repair. The ACLR was noted to be intact at that time with signs of ligamentization.

(A) First case: CT head and neck with contrast showing right parotid gland mass measuring 8.5 × 8.4 × 8.3 cm with central necrosis and mass effect on sternocleidomastoid muscle. (B) Second case: neck CT scan showing poorly demarcated mass (arrow) occupying superficial lobe of right parotid gland.

Chest images before or after the first BT session. a Chest X-ray was normal before the right lower lobe BT treatment. b Chest CT revealed infiltrative shadows in the right lower zone with air bronchogram sign after the right lower lobe BT procedure. c Chest CT showed the infiltrates in the right lower lobe had significantly resolved after one-week of antibacterial treatment

Chest images after the second BT session. a chest CT showed new infiltrates in her left lower lobe after the left lower lobe BT treatment. b Chest X-ray showed the infiltrates in the left lower lobe had disappeared after five-day of antibacterial treatment

Chest X-ray before or after the final BT session. a There was no remarkable abnormality on chest X-ray before the third session of BT. b Chest X-ray revealed infiltrates newly developed in both upper lobes after both upper lobes BT procedure. c Chest X-ray showed the infiltrates in both upper lobes had diminished after 10-day of antibacterial treatment

Patient #5 had pharmacoresistant epilepsy. Axial sections on first line and coronal sections on second line of (A) ictal SPECT and (B) interictal SPECT visual analysis showed a possible epileptogenic zone in the left temporal lobe. (C) SISCOM performed with SPM confirmed a focal area of hyperperfusion in the left temporal lobe (arrow). The reference standard suggested left temporal lobe epilepsy.

During the follow‐up elevated serum transaminases (Figure 2) and hypolipidemia (Table 1) persisted. At the age of 20 months the patient was hospitalized due to bacterial pneumonia and an episode of liver disease with hepatomegaly and a more than 10 times of ULN elevation of serum transaminases (AST > ALT) developed. No coagulopathy or hypoalbuminemia were observed. Serum ALT and liver volume normalized over the next month. Transient elastography with FibroScan revealed normal liver stiffness (E = 4.1 kPa; liver stiffness normal results <7 kPa).

This case demonstrates the importance of prompt identification and management of intraoperative anaphylaxis. Communication between medical providers to facilitate appropriate management is of the utmost importance. The induction immunosuppression agent should be carefully selected in patients with significant previous rabbit exposure or allergy.

The involvement of kidneys in syphilis has been reported in the literature with the majority of the cases presenting with nephrotic-range proteinuria . Rapidly proliferative glomerulonephritis is rarely reported in syphilis patients . We report a case of rapidly proliferative glomerulonephritis in a human immunodeficiency virus (HIV) patient with secondary syphilis that was successfully treated with penicillin.

This case report underscores the importance of keeping syphilis high in the differentials of rapidly worsening kidney function with proteinuria and hematuria in at-risk populations. Syphilis-induced rapidly proliferative glomerulonephritis is a highly aggressive disease that can cause permanent kidney injury if not diagnosed and treated in a timely manner.

Subsequent next‐generation DNA sequencing identified that he was homozygous for a pathogenic splicing mutation c.(1713 + delG);(c.1713 + delG) in intron 9 of the CP gene. There was much consanguinity within the wider family (Figure 2); a cousin was also found to have been diagnosed with ACP and his maternal grandfather died from liver cancer.

A 59-year-old man with anastomotic leak after esophagojejunostomy (case 24). a-b Esophagography showing an anastomotic leakage in the lower esophagus and irregular abscess in the pleural cavity. c–d Chest CT scan in the mediastinal and lung windows show mediastinal abscess and a small amount of pleural effusion before procedure

The present study confirmed previous data suggesting that local transfer of autologous may be a successful option to induce healing in ischemic SSc related fingertip DUs that are resistant to more traditional therapeutic approaches . Clinical improvements observed in our patient on DUs after AFG are definitely in line with more recent reports on the treatment of fibrosis of the skin and wound healing [32–37].

Congenital portosystemic shunts can be divided into two types: intrahepatic shunts in which there is an abnormal connection between the branches of the portal vein and either the inferior vena cava or the hepatic veins and less commonly the extrahepatic type in which the portal system is connected by one of the branches of the mesenteric veins. Congenital intrahepatic portosystemic shunts or Abernethy malformations are rare anatomical abnormalities characterized by an abnormal connection between the portal vein and the hepatic vein . Intrahepatic shunt anomalies occur predominantly in males and have been reported to affect only 0.0235% of the population . Here we describe a case of a non-cirrhotic woman with recurrent encephalopathy who was diagnosed at age 73 with a congenital intrahepatic type II Abernethy malformation.

Abdominal CT angiography revealed a dilated portal vein measuring up to 1.8 cm at the porta-hepatis along with dilated superior mesenteric and splenic veins. Multiple dilated vascular channels were seen within the right hepatic lobe. An intrahepatic portosystemic shunt between an enlarged middle hepatic vein and two separate branches of the right portal vein was visualized (Figures 1-2).

Cross-sectional view showing dilated portal vein measuring up to 1.8 cm at the porta-hepatis (white arrow) and multiple dilated vascular channels (black arrow) in the right hepatic lobe (segment V). An intrahepatic portosystemic shunt between the segment V portal venous branches and a peripheral hepatic vein draining into the middle hepatic vein was visualized (not shown here).

A liver biopsy showed normal architecture with no sign of inflammation or fibrosis. She received conservative management with lactulose and rifaximin. Hyperammonemia and encephalopathy resolved after the second day of admission and she was discharged with close outpatient follow up by gastroenterology and interventional radiology.

We also observed interesting inhaler errors done by some of the patients during video monitoring (Table 3). No patient realized their mistakes while taking inhalers at home or was found correcting them in all the groups during the study period.Table 3Other observations during video monitoring.● The patient with pMDI actuated the inhaler correctly but inhaled through the nose instead of the mouth. All the medicine escaped from the device● The patient with pMDI and spacer actuated the inhaler in air and then attached it to the spacer for inhalation● The patient closed mouth during breath-hold but continued breathing through the nose● Patient was drinking water instead of gargling● Actuating pMDI multiple times in spacer before inhaling

The incision over the anterior compartment was placed 1 cm medial to the SPN and was directed proximally to the tibial tuberosity and distally to the anterolateral edge of the tibia facing their landmarks. The incision over the peroneal compartment was placed 1 cm lateral to the SPN and directed towards their landmarks proximally to the fibula head and distally to the lateral malleolus (Fig. 1).Figure 1Double incision with fascia opening for decompression of the anterior and peroneal compartments with black arrows showing the long scissors position to perform the fascial incisions.

(A) Bone marrow core biopsy histology at 200x magnification demonstrates hematoxylin and eosin (H&E) stained section showing hypercellular marrow with trilineage hematopoiesis with abundant small mature plasma cells. (B) CD138 immunostain highlights abundant plasma cells with membranous staining. Comparing Kappa immunostain (C) to Lambda immunostain (D) demonstrates dim kappa restricted plasma cells consistent with myeloma diagnosis.

Medical management was primarily considered with conventional anti-angina and anti-hypertensive medications with risk factor modification. An event monitor was provided to rule out any abnormal electrical activity or electrical pathways that can lead to sudden cardiac death (SCD). The patient was discharged two days after admission.

Illustrative patient 20. (A) A lot of clots (arrowhead) proximal to the occlusion segment (arrow). (B) Angiographic result after transcatheter aspiration. (C) Favorable antegrade flow was obtained after conventional balloon and drug-coated balloon (DCB) angioplasty.

After sternal infection had been diagnosed patients were re-admitted for wound debridement. The median hospital stay for revision surgery was 14 days and nearly all were treated with negative wound pressure. The patients had a median of four surgical debridements before a pectoralis major muscle flap was used.

The outcomes of a 4 week FES+VFBT program on the balance ability and balance confidence of five individuals with chronic motor iSCI are described here. This case series provides quantitative evidence that FES+VFBT can impact static and dynamic balance performance as assessed using clinical and biomechanical measures of balance.

Transorbital sonography showing measurement of the ONSD (distance numbered as 3 while number 2 refers to the optic nerve diameter) performed 3mm behind the globe on the transverse plane (a). Three-times magnification of the optic disc in patient 2 demonstrating elevation of the papilla (b)

A colonoscopy concluded the presence of right semi-circumferential rectal mass extending up to 3 cm from the anal verge with regular surface bulging in the rectal lumen. Pelvic magnetic resonance imaging (MRI) revealed a submucosal lesion in the right lateral wall of the lower rectum extending to the anal canal bulging into the rectal and anal lumen with exophytic development with close contact to the external sphincter without invasion or infiltration of adjacent organs (Figure 1).

CT scan. (A) Baseline. CT scan showed partial response after lenvatinib plus pembrolizumab treatment for 1 month (B) and 3 months (C). (D) CT scan showed progressive disease after stopping lenvatinib. (E) CT scan showed progressive disease after treatment with nivolumab plus chemotherapy for 1 month. (F) CT scan showed stable disease after treatment with nivolumab plus olaparib for 3 months. CT = Computed tomography.

This study reports an HBV infection-related liver cancer patient who failed both immunotherapy and chemotherapy treatment. A BRCA2 L2510P germline mutation was identified in this patient. The patient was then treated with PARP inhibitor olaparib and achieved SD.

This report describes a successful case of treatment with alectinib after crizotinib-induced hepatitis. This serious adverse event may be ascribed to crizotinib due to the temporal relationship between drug beginning and the transaminases elevation and due to its resolution after the medication interruption.

We present our case because it is extremely rare. No similar cases were found after reviewing articles in over a period of ten years. This is most likely associated with a particular location of the perforation – the splenic flexure is relatively distant from the uterus.

a Abdominal ultrasound showing a cystic lesion in the pancreatic tail (yellow arrow) and a slightly hyperechoic component (white arrow) in the cystic lesion. b Contrast-enhanced abdominal computed tomography shows a cystic mass with a diameter of 24 mm (yellow arrow)

The fracture healing was considerable fast in our described case and there were no side effects of the denosumab treatment. The defect after curettage was grafted with aqueous calcium sulphate. Johnson and Clayer demonstrated good clinical results and bone remodelling using this method for contained defects of bone after curettage procedures avoiding the side effects and potential complications of autologous bone grafting . The final X-ray after 4 years showed an almost entirely remodelled distal radius with intact articular surface and no signs of a tumour recurrence.

(A-C) Three consecutive axial slices of a tumor lesion in the second subtraction series for the patient with the highest prediction score. Histological reference revealed a Ki67 count of 80. (D-F) The corresponding axial slices for the patient with the lowest prediction score. Histological reference revealed a Ki67 count of 10.

Biopsies were collected from a 69-years old subject homozygous from the CFTR variant c.1584G>A. Crypts were isolated from rectal biopsies collected as described earlier . The crypts were cultured with Matrigel under specific medium conditions in order to produce a rectal organoid culture from this patient . The organoids were expanded and collected.

Treatment with AS-AT (300 mg/kg) for continuous 7 days significantly increased the urine output (Figure 6). There was also a significant increase in sodium and potassium excretion on the 7th day after treatment with 300 mg/kg AS-AT. These results were very similar to classical diuretic HCTZ.

(a) Primer design that amplifies multiple exons (4–10) containing and flanking the c.547C>G mutation (red dash) in exon 7. (b) No differential mRNA expression or alternatively spliced transcript can be detected in the affected individual III-10. (c) Sequencing results of the amplicons.

Example of a hepatic T1 map obtained by MOLLI sequence and the measurement of T1 relaxation time. (A) T1 map obtained by MOLLI sequence in a 13-year-old boy. (B) An example of the measurement of T1 relaxation time by the manual drawing of ROI with the exclusion of hepatic vasculature.

Radiographic bone modelling and density were normal with no features to indicate an underlying disorder that might predispose the patient to fracture. Bone profile and vitamin D (117.3 nmol/L) were normal and did not suggest bone fragility. The head computed tomography and ophthalmology examinations were normal.

(a) Bone marrow aspiration revealed a hypercellular marrow with diffuse infiltration of myeloblasts with vesicular nuclei and scanty cytoplasm. (b) Pleural fluid cytology (cell block) was notable for the presence of atypical cells with enlarged and hyperchromatic nuclei and scant cytoplasm (arrow).

This is possibly the first case report of a patient diagnosed with AML with leukemic pleural effusion associated with a high pleural ADA level. Additional studies are needed to determine more precise relationships between AML-associated pleural effusions and pleural ADA levels.

The table shows a positive correlation between QTc and free T4 levels in our patient. As free T4 levels increased the QTc of our patient also increased. The QTc interval dramatically decreased from 607 ms to 431 ms after receiving >24 hours of high dose methimazole (30 mg every six hours). Free T4 was not checked after initial testing during the December 2020 admission. Corrected QT interval (QTc) is in milliseconds; free thyroxine level (T4) is in nanograms per deciliter.

Chipboard wood. a An axial CT image displaying a hyperdense structure dislocated in periorbital soft tissues inferior and anterior to the right globe (arrow). Hyperdensity of the foreign object in this case is likely due to its industrial processing. b A photograph of a chipboard fragment after its removal from the soft tissues

A 49-year-old female presented with a swelling of her right eyelid. The patient reported the insertion of a metal paper clip into her upper eyelid alongside other self-manipulating incidents in the past. Conventional X-ray confirmed the presence of a radiopaque foreign object in projection of the upper eyelid (Fig. 6). Foreign body removal was achieved under local anaesthesia.Fig. 6Paper clip. Anteroposterior (a) and lateral (b) radiographs showing a linear radiopaque structure in projection of the upper eyelid (arrow)

Blood examination of this case. a Hemoglobin concentrations in the peripheral blood 1 month before and after the treatment. b Bilirubin concentrations in the peripheral blood 1 month before and after the treatment. c Blood lead concentrations in the peripheral blood 5 months before and after the treatment

Ultrasound-guided renal biopsies showed high effectiveness and safety but we did not perform any renal biopsies in the presented children with NWRTs to avoid upstaging of the disease . Surgical nephrectomies were performed after the discussion of each individual case with multidisciplinary pediatric oncology councils.

She arrived at our hospital while undergoing therapeutic hypothermia. Her height was 159 cm and weight 56 kg. Her blood pressure was 158/89 mmHg. Physical examination revealed coarse crackles in her whole chest. Blood tests revealed normal renal function and electrolytes. The plasma cibenzoline concentration was not checked.

Anteroposterior radiographs of a 76-year-old man who underwent revision THA for a periprosthetic joint infection using extensively porous-coated stem alone. a Radiograph prior to stage 2 revision THA showing a Paprosky type IIIB femoral bone defect. b Postoperative radiograph at 6 months showing no bone restoration in the bone defect area (white arrow). c Postoperative radiograph at 5 years showing bone defects still existing and moderate stress shielding on both the medial and lateral sides

This is a unique clinical case that demonstrated a remarkable antitumor effect of nivolumab following previous treatment with a cancer‐specific peptide vaccine. Combination therapy comprising an immune checkpoint inhibitor with a cancer‐specific peptide vaccine could be a promising treatment option for patients with mRCC.

The case study presented here describes a free-floating oscillating thrombus in the left atrium of a dog. The most likely cause of this intracardiac thrombus was a combination of a hyperadrenocorticism and a preexisting heart disease resulting in an enhanced coagulability.

Another participant shared inadequate knowledge on certain behavioral changes being symptoms of schizophrenia. This participant’s son stopped playing badminton and suddenly went missing during training (patient was in badminton team of his school and was involved in an intensive training program at the onset of illness). The patient’s subsequent behavior of being socially withdrawn and keeping himself in his room was seen by the caregiver as a normal adolescent behavior which had substantially delayed professional help-seeking behavior.

(A) Concordance of CTNNB1 mutational status comparing NGS and Sanger sequencing results. (B) Representative visualization of NGS and Sanger sequencing results (case #60 and #31). (C) Concordance of CTNNB1 mutational status and nuclear β-catenin immunoreactivity. (D) Representative HE and nuclear β-catenin IHC staining (case #203).

Intraoperative photograph from the first surgery (relief of incarceration and diverticulectomy). a Meckel’s diverticulum in the umbilical hernia. b Dissection of Meckel's diverticulum using a linear stapler. c Hernial orifice (arrows) and Meckel's diverticulum (arrowhead) after relieving incarceration

This case shows unusual immunohistochemical results associated with NUT carcinoma. The patient's older age and the difference in cytohistological features of primary and metastatic carcinoma in the pleural fluid resulted in difficulty in making an accurate diagnosis.

Written informed consent for reporting the case and any accompanying images was acquired from the patient. A copy of the written informed consent is available for review by the Editor-in-Chief of this journal. Patient identifying related material was not used in this manuscript.

Right-to-left lateral radiograph of the neck including C3 to C5. A wide-based soft tissue opacity (*) is originating from the dorsal tracheal wall and markedly decreasing the height of the tracheal lumen at the level of C5. Note multiple wet-hair artifacts are superimposed on the ventral soft tissues at the level of C5. An IV catheter is present more cranially

A 37-year-old man (case 1) with recurvatum deformity on femur was treated with one-stage TKA and femoral osteotomy using a constrained condylar knee. a Anteroposterior view and lateral view before surgery. b X-ray at the first day after surgery showing an asymmetrical gap. c Long-term X-ray (91 months postoperatively) showing a stable component and no sign of pronounced wear on tibial insert

Preoperative examination revealed no contraindications to bronchial artery embolization and patient was placed under conscious sedation throughout the procedure. A 5-French Cobra catheter was placed in the descending aorta through the femoral artery using standard Seldinger technique.

Clinical case of a 94-year old male patients who received radiotherapy for a well-differentiated squamous cell carcinoma. a Pre-therapeutic situation in November 2015 showing an ulcerating and bleeding skin lesion on the left temple. Radiotherapy was performed using electron beams with a total of 51 Gy (27 Gy applied in 9 fractions followed by 24 Gy in 6 fractions). b Irradiation-induced dermatitis (grade 2) in December 2015 after completion of treatment. c Follow-up consultation in April 2016 showing a complete clinical response with no high-grade radiotherapy-related toxicities

The available literature on gamma-delta T-cell lymphomas mostly consists of case reports or small cumulative series. A standard treatment option for patients with HSGDTL has not been yet established because of the extreme rarity of this clinical entity. Our extensive literature review indicated only one other case discussing simultaneous HSTL and PMF. The case was published in 2014 April-June edition of the Avicenna Journal Medicine of a simultaneous HSGDTL and myelofobrosis (JAK2 negative). The results of JAK2 analysis in their case did not allow the authors to reach a final unequivocal decision whether or not the myelofibrosis was considered a primary or secondary etiology; as JAK2 mutation is only positive in 50% of PMF cases. We found no other cases of a simultaneous PMF and HSGDTL. Our case is unique from the Gabali et al. case report as our patient likely had a primary rather than a secondary myelofibrosis (due to HSTL) given the presence of JAK2 positive gene mutation .

a & b Histopathology analysis showed the hepatic sinusoids were markedly expanded by the selective proliferation of atypical lymphocytes (a: magnification × 100 and b: magnification × 200). c. The neoplastic cells were large in size with round to oval-shaped nuclei and scant cytoplasm (magnification × 400). d. The tumor cells were positive for CD20 (magnification × 200). e. CD31 immunohistochemical staining highlights the intravascular growth pattern of tumor cells (magnification × 200). f. The neoplastic cells were positive for EBER by in situ hybridization

A 70-year-old postmenopausal woman was referred to our gynecologic emergency unit with an impression of endometrial cancer after she presented with profuse vaginal bleeding of 3 hours associated with lower abdominal pain and protruding mass per vagina of 20 hours. She noticed the mass after experiencing urinary retention and was straining to void her bladder.

This case highlights that nonpuerperal uterine inversion should be included in the differential diagnosis when a patient presents with protruding vaginal mass and bleeding. Carefully conducted clinical examination including examination under anesthesia and pelvic ultrasonography can be valuable tools to reach at a diagnosis. Clinicians need to familiarize themselves with the principles of recommended surgical techniques in order to select the best approach. A combined vaginal and abdominal surgical approach can facilitate repositioning and/or hysterectomy when there is a large protruding vaginal mass.

Son et al. treated 3 patients with EMPVD. Two of them received definitive RT. The first case received 55.8 Gy to the primary and the second received 81.6 Gy to the primary and 45.6 Gy to the inguinal nodal areas. The last case received adjuvant RT to a total dose of 55.8 Gy. The RT fields encompassed 2–3 cm radially the clinically visible disease. In all cases 6 MV photons and 9 MeV electrons were used.

Tanaka et al. treated 2 EMPVD patients with definitive RT. Both received 60 Gy with electrons. The patients were also treated with CO2 laser therapy and Mohs micrographic surgery respectively because of local recurrence. They had a complete response and a disease free survival of 3 and 7 years respectively.

A 24 yrold male patient with a noncontributory medical history reported to our hospital with the chief complaint of pain in lower right back teeth for the past 3-4 months and food lodgment/cold sensitivity in lower left back teeth. Clinical examination revealed deep carious lesions in tooth #46 and #36. Tooth #46 was tender on percussion whereas tooth #36 was asymptomatic. Sensibility testing [cold test and EPT] on both the teeth revealed the non-vitality in tooth #46 while tooth #36 was vital.

Figure 1A) Pre operative radiograph revealing unusual root canal anatomy of tooth #44 and 45; B) Pre operative radiograph revealing unusual root canal anatomy of tooth #35 and 34; C) Panoramic radiograph illustrating some form of abnormal root and root canal system morphology associated with each of the mandibular premolars.

A) Pre operative radiograph revealing unusual root canal anatomy of tooth #44 and 45; B) Pre operative radiograph revealing unusual root canal anatomy of tooth #35 and 34; C) Panoramic radiograph illustrating some form of abnormal root and root canal system morphology associated with each of the mandibular premolars.

Radiographs revealed the presence of at least two roots in mandibular premolars bilaterally (Fig. 1) but did not provide any clue regarding the three-dimensional structure and internal morphology of the root canals. Conventional radiography has an inherent disadvantage of providing a two-dimensional image of a three-dimensional object resulting in superimposition of images.

Pedigree and genetic results from Family 1. (A) Pedigree of the family I suggesting an autosomal recessive mode of inheritance. (B) Electropherogram showing wild-type and mutant sequence of the p.W202Cfs*37 mutation identified in Family 1. (C) Analysis of the cDNA from affected family members revealed the mutation resulted in skipping of exon 2. (D) RT-PCR over the mutation shows the reduction in transcript size in the mutant allele and also the presence of some wild-type sized transcript.

The mother reported uncomplicated pregnancies for the affected siblings. Individual IV-4 had perinatal respiratory problems due to choanal atresia that was surgically corrected. Mildly dysmorphic facies were observed in the three affected siblings as they grew (Table 1). By late teens microcephaly was recognised in IV-4. There were no other evident skeletal abnormalities evident in the affected siblings.

Six patients developed herpes zoster while under immunosuppression for underlying rheumatic disease; their median age was 11.6 years (range 5.9 – 16.5). Median time to event was 8.4 months (range 4.1 – 63 months). Four of the six cases with herpes zoster occurred within the first 12 months of the onset of the immunosuppressive therapy.