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Genomic organization of the PMS1 gene. The UCSC genome browser (http://genome.ucsc.edu) was used to display the location and genomic organization of PMS1 on chromosome 2q32.2. (A) The position of PMS1 gene was highlighted and genomic region of Exon 6-9 covering approximately 10 kb is magnified. (B) Scheme of PMS1_V1 transcript including alternative splicing of exons. The AUG represents the start codon and the asterisk represents the stop codon. The mutation position is highlighted in red. Non-coding regions are indicated by open boxes and common coding open reading frames (ORF) are indicated by filled boxes. (C) Comparison of PMS1 wild type DNA sequence and the c.900delT (p.D300fs) sequence showed the generation of a stop codon and resulted in a mutant of 307 amino acids. | 99.6 |
The radiographic study at T0 highlighted a tibial oblique non-displaced fracture; the fibula was intact. The X-ray exam at T20 showed irregular and blunted fracture margins due to the bone resorption. At T35 an early radiopaque callus with undulating and irregular contour was visible. The radiographic study at T50 showed an achieved complete osseous union of the fracture (Figure 1). | 99.94 |
(A) Preoperative axis Fiesta sequence showed the enlarged petrosal venous complex (white arrow) compressed the right trigeminal nerve root. (B) Axis Fiesta sequence showed shrinkage of the right petrosal venous complex (white arrow) at 1 week after operation. (C) Axis Fiesta sequence showed that the right petrosal venous complex had shrunk again. (D) Preoperative sagittal Fiesta sequence showed that the ACIA (white arrow) compressed the root of trigeminal nerve. (E) Sagittal Fiesta sequence showed that the ACIA (white arrow) had shrunk at 1 week after operation. (F) Sagittal Fiesta sequence showed that the ACIA (white arrow) had shifted from the trigeminal nerve at 6 months after operation. AICA = anterior inferior cerebellar artery. | 99.94 |
All had hysterectomies due to antenatally diagnosed MAP based on USS. We optimized their haemoglobin level and counselling sessions were arranged before surgery. All had steroids cover (intramuscular dexamethazone 6 mg twice daily for 48 hours) for fetal lung maturation. Classical caesarean with midline laparotomy and peripartum hysterectomy was performed at 35 to 36 weeks under general anesthesia with participating multidisciplinary surgical and anesthetic team. The mean duration of the surgery was 180 minutes. | 99.9 |
Four women had peripartum hysterectomy due to primary PPH (three for atonic uterus and one due to uterine rupture) and two were due to secondary PPH following failed conservative management of MAP. The latter two were opted for a conservative management where placenta was left in situ after caesarean section and uterus repair. Both received methotrexate to accelerate placental apoptosis. One woman presented with severe secondary PPH after three weeks and received massive blood transfusion and an emergency hysterectomy was performed after resuscitation. The other woman presented with suspected infection and mild bleeding after four weeks. An examination under anesthesia and attempted evacuation of products (ERPC) was performed. She had an emergency hysterectomy due to the placenta being densely adherent to the uterine wall. | 99.94 |
A 72-year-old man with a 10-year history of CHD and hyperlipidemia started evolocumab therapy once a month after he had developed excess myalgia due to statin treatment. His hematological laboratory data were normal. His CHD diagnosis had been supported by coronary computed tomographic angiography findings. He had complained of chest pain at various times between the age of 65 and 70 years. He had a family history of CHD. | 100 |
This patient presented with new-onset congestive heart failure secondary to severe MR associated with undiagnosed MVP. The onset of the MR appeared to be relatively acute as his functional capacity was normal one week prior to his admission and lack of left atrial enlargement on imaging. | 99.94 |
48-year-old male patient with pancreatic ductal adenocarcinoma treated with distal pancreatectomy. A Angiogram of the coeliac trunk demonstrates bleeding of the splenic artery (arrow). B Angiographic control after stent-graft implantation in the splenic artery shows no evidence of bleeding and minor spasm of the distal splenic artery (arrow). C Reintervention eight days later with recurrence of bleeding distal to the initial implanted stent-graft (arrow). D Angiography after implantation of a second stent-graft shows a successful treatment of the bleeding | 100 |
The patient was staged according to the 2014 International Federation of Gynecology and Obstetrics (FIGO) classification as IA. Adjuvant chemotherapy with a bleomycin-etoposide-cisplatin (BEP) scheme was recommended for three cycles that started in January 2018 and were completed in March of the same year. | 99.94 |
Alessandro is a 68‐year‐old doctor. He has moderate chronic obstructive airways disease. He contracts COVID‐19 while caring for patients with the same disease. He develops respiratory failure. Jason is a 52‐year‐old businessman who contracted COVID‐19 while travelling for business reasons. He is otherwise well but develops respiratory failure. | 99.94 |
Amniotic fluid was assessed from pregnant women with a positive result for COVID-19 in 11 studies . Only one study reported a positive result for SARS-CoV-2 . This study was a case report conducted in Iran on a 22-year-old woman who delivered a baby at 33 weeks of gestation through a C-section. Throat swab samples were obtained and analyzed from the neonate over several days. This neonate had a positive result for SARS-CoV-2 24 h after birth and a week later. The neonate had no severe symptoms. The mother in this study died due to respiratory complications . No SARS-CoV-2 infection was found in the rest of studies that evaluated amniotic fluid . | 99.9 |
The patient was positioned ~60 min after the intravenous administration of 8.3 mCi of FDG (fluorodeoxyglucose uptake). A non-contrast CT scan was acquired from the skull base to the mid thighs. A 3D emission scan of the same area was acquired. The patient's fasting glucose level was 94 mg/dl. | 99.94 |
Two nodules in the upper lobes with bilateral cervical adenopathy and a right supraclavicular adenopathy and a retroperitoneal adenopathy with omental thickening and peritoneal implants in the pelvis were observed. It also revealed bilateral adrenal lesions with right renal mass. These findings were suggestive of cardiac sarcoma or cardiac lymphoma of the heart (Figure 1D) (Supplementary Video 1). | 99.94 |
The patient was treated with high doses of dexamethasone to relieve symptoms. He developed a severe symptomatic bradycardia and long pauses suddenly. A single chamber pacemaker VVI was implanted as a backup because the patient was in atrial fibrillation and no need for atrial lead in this case. | 99.94 |
A complete resorption of the fCM was already visible in the area of the skull. The newly formed bone appeared in the fine trabecular structure above the local bone of the skull Figure 9c. The borders of the former cortex were only difficult to detect. Such a result of vertical augmentation can be considered optimal and can otherwise only be achieved with autogenous bone grafting. Another optimal result was achieved in the lower jaw Figure 9d. Here the cortical structure of the mandible was still clearly visible. The augmented area showed complete resorption of the fCM and new bone formation in the sense of lateral augmentation. | 99.9 |
A further sample showed an almost complete resorption of the fCM with the creation of a bowl-shaped defect in the former augmented area Figure 9i. In the marginal area of the defect a bone regeneration could be seen from the marginal area. Such a defect shows a good regeneration potential with the aim of a vertical augmentation after healing of the newly formed defect. | 99.94 |
(A) Preoperative photograph of a 63-year-old female (BMI 18.8) with a flexible cavus foot. She has pain on palpation of metatarsal heads 1-5. She had seen 20 foot and ankle specialists over the past 10 years and was diagnosed with fat pad atrophy. (B) Postoperative photograph 12 months after 6 mL of autologous fat was injected into the forefoot. | 100 |
We describe a case of Legionella longbeachae infection in mainland China that was diagnosed by metagenomic next-generation sequencing (mNGS). The patient developed an epileptic seizure after he underwent treatment with moxifloxacin and had a prolonged corrected QT interval at a later stage of treatment. | 99.94 |
All surgeries performed with preoperative cranial 3.0T MRI and standardized stereotactic procedures. The stereotactic apparatus was Leksell G frame (Elekta). The coordinates calculated and trajectory designed with Medtronic S7 Neuro Navigation System (Medtronic Navigation) to target the STN. Bilaterally Medtronic DBS electrodes (Model 3389 electrode; Medtronic) implanted under local anesthesia and IPG (Activa PC; Medtronic) implanted under general anesthesia. All the operations achieved in 1 day. Postsurgery stimulation parameters were set 4 weeks postoperation and gradually achieved the optimal stimulation parameters in 3 months. | 99.9 |
Thirty-two client-owned dogs were admitted to the veterinary teaching hospital (Centre Hospitalier Universitaire Vétérinaire) of the Université de Montréal. Dogs were recruited after physical and neurological examinations by a board-certified veterinary neurologist (H.L.M.R.). Owner’s written consent was obtained for each patient. | 99.5 |
Intra-operative photographs demonstrating sequence of robotic RPLND a) suture transverse colon mesentery to anterior abdominal wall b) medialisation of duodenal-jejunal flexure c) exposure of aorta and left gonadal vein d) dissection along left gonadal vein to left renal vein e) exposure of left renal vein f) completed dissection. | 99.9 |
Histopathology from the operative resection demonstrated T1N1M0 Grade 2 multifocal neuroendocrine tumour in the terminal ileum and jejunum with a total of 8 deposits of grade small bowel NET. Six of the twenty-two excised lymph nodes demonstrated metastatic tumour deposits. | 99.94 |
Radiograph on the left demonstrating what appears to be significant medial overhang and malalignment of the tibial component. A subsequent aligned radiograph of the same knee demonstrating a perfectly aligned tibial component. Note the presence of excess cement in and around the joint | 99.9 |
This case highlights the importance of thoroughly assessing all available radiographs and of seeking a second opinion where uncertain. Through a multidispliclinary approach this patient has been safely managed and continues to be reviewed at hospital by both the orthodontic and oral surgery departments. | 99.94 |
The patient was started on enteral nutrition with a goal rate of 70 ml/hour. Nausea and vomiting were managed with combination of antiemetics. She was referred to radiation oncology for stereotactic radiosurgery treatments. The patient was also referred for the Sarah Cannon clinical trial research program for further management of her metastatic melanoma. | 99.94 |
The endoscopic features of CMUSE and SBCD patients. a and b were double-balloon enteroscopy images from a patient with CMUSE showing multiple centripetal annular stenosis with circumferential ulcers located on of the fourth group small intestine. c was a double-balloon enteroscopy image from a SBCD patients showing luminal narrowing with multiple inflammatory polyp on anal site of the sixth group small intestine. d was a coloscopy image from patients with SBCD revealing a longitudinal ulcer with cobblestone appearance on the opposite site of terminal ileum | 99.7 |
There was no mortality in the immediate postoperative period or during the next six months of follow-up. The mean follow-up duration was 21.4 months (5-36 months). All patients tolerated oral diet at follow-up and there were no cases of recurrences. All patients were decannulated from tracheostomy after two months as per institutional protocol. | 99.9 |
The difference of the absolute ICP values between sensor reservoir® and NEUROVENT®-P-tel probe showed a range of 0.0 and 14.5 mmHg. The mean value of the ICP difference was 4.2 mmHg with a standard deviation of 3.94 mmHg. The absolute ICP values from the sensor reservoir® and the NEUROVENT®-P-tel probe presented parallel alignment in nine cases. As representative example of parallel alignment of absolute ICP values measured via sensor reservoir® and the NEUROVENT®-P-tel probe in a selected patient is shown in Fig. 3. After three months the NEUROVENT®-P-tel probe was explanted and the measurement of ICP value via sensor reservoir® was continued for the follow-up examination (Fig. 3).Fig. 3Parallel alignment of the absolute ICP values measured via the sensor reservoir® and the NEUROVENT®-P-tel probe in a selected patient | 99.94 |
A telemetric measurement with both the NEUROVENT®-P-tel probe and the sensor reservoir® provided a comprehensible change in ICP values depending on the patient's body position (Fig. 5).Fig. 5Dependency of ICP on the body position without implantation of a gravitational valve measured via sensor reservoir® and NEUROVENT®-P-tel probe in comparison (an example in a selected patient) | 99.3 |
The patient still had diplopia at the one-month follow-up in the clinic although motor function had improved. Diplopia was corrected with prisms glasses by the six-month clinic follow-up. The follow-up on loop recorder at one year did not reveal any atrial fibrillation. | 100 |
An AOP infarct can have variable presentations due to the wide range of functions controlled by the thalamus and heterogeneity in thalamic vascular anatomy. This case highlights the need for physicians to consider AOP stroke presenting as thalamic pathology in patients with generalized neurological symptoms and fluctuation of mental status without the cardinal signs of stroke so that prompt intervention can be initiated to minimize deficits in patients. Syncope patients who are managed and discharged from the ER should be closely monitored in the immediate post-discharge period for the emergence of new symptoms that may indicate the etiology of the syncope. | 99.9 |
TTE confirmed the reduction of the transvalvular aortic gradient associated with improved LV systolic function (ejection fraction = 40%; indexed stroke volume = 32 mL/m2) and lower systolic pulmonary arterial pressure (31 mmHg). BNP was markedly reduced (751 pg/mL). | 99.56 |
A 60-year-old male patient was referred to our otolaryngology department. The patient had an irrelevant past medical history with no known allergies. He had a history of smoking (25 pack-years).he reported with a long standing swelling in the right supraclavicular region. The swelling Persisted for more than ten years. | 100 |
The surgical exploration found the tumor attached to the cervical plexus. (FIG: 3).The excision of the mass was performed without damaging nerve. (FIG: 4).Fig 3Surgical exploration showing the tumor attached to the cervical plexus.Fig 4Excision of the mass. | 99.94 |
We experienced an extremely rare case with the right superior pulmonary vein translocation. There has been no report so far regarding this type of pulmonary vein translocation. And 3D images technologies help us to detect anatomical variations easily and can promote safer lung resection. | 99.94 |
Initial computed tomography (CT) scan of the abdomen revealed a large heterogeneously enhancing mass arising from the anterior wall of the stomach with a small amount of free fluid surrounding the liver and a moderate amount of fluid in the pelvis (Figure 1). | 99.94 |
We report the case of a previously fit and well 25-year-old female who developed rapidly evolving relapsing-remitting MS following a rear-end vehicle collision only a few days earlier. Her demyelinating disease involved the spinal cord and brainstem. We discuss the possible biological mechanisms that may underlie demyelination precipitated by physical trauma. | 99.94 |
Two twin infant boys were referred from the otolaryngology outpatient clinic (ENT) for the complaint of white patches of hair and pigmentary skin changes since birth. These symptoms were also associated with sensorineural deafness. They were born of consanguineous parents through normal vaginal delivery. Family history revealed the presence of similar skin symptoms and deafness in their paternal uncle (Figure 1). | 100 |
This study has several limitations. The follow-up time for radiographic assessment of 1 month was short. The current series assessed the early postoperative change of knee alignment. The indication for either HTO technique was determined preoperatively according to the correction angle. This may affect the amount of change in JLCA. | 99.2 |
All patients except one had mild side effects such as bruises and pain in place of liposuction or febrile 1-2-day reactions. Two children (P1 and P4) had an increase in the number of seizures during second and third days after the first transplantations (Table 4). | 99.7 |
What can be indicated for an ORIF (Open Reduction and Internal Fixation) to reduce a first Lisfranc dislocation? We learned from this case that the tibialis anterior tendon can be trapped between the medial and intermediate cuneiform bones in the event of a first Lisfranc dislocation. We found out we had to carry out an ORIF (Open Reduction and Internal Fixation) unless we achieved immediate anatomical reduction. | 99.9 |
The procedure conventionally known as ‘Toilet Mastectomy’ was done. Resection of the breast was done followed by axillary clearance. Hemostasis was secured and a drain was placed. The fat was closed with Vicryl 2.0 and the skin was closed with a stapler. The specimen was sent to the laboratory for histopathology. | 99.94 |
The founder mutation was analyzed as previously described . Expression of the human telomerase reverse transcriptase gene (hTERT) was analyzed by qPCR. GAPDH was used as the internal control gene. The primer sequences for hTERT were: 5’- CCG ATT GTG AAC ATG GAC TAC GT -3’(forward); 5’- CGT AGT TGA GCA CGC TGA ACA -3’(reverse). The primer sequences for GAPDH were: 5’-CTC TGC TCC TCC TGT TCG AC-3’(forward); 5’-GCG CCC AAT ACG ACC AAA TC-3’(reverse). | 99.6 |
Preoperative dynamic computed tomography study. a Low-density area (arrow head) located adjacent to the scar of radiofrequency ablation (arrow) in the plain phase. b The image of early phase does not show early staining on the area. c The image of late phase visualized a well-defined mass with enhancement on the area. d The image of multiplanar reconstruction of the tumor (arrow head) with the bile duct thrombus (asterisk). BDTT continued from the tumor into the right hepatic duct | 99.9 |
Preoperative magnetic resonance imaging findings. The tumor (arrow head) adjacent to the scar of radiofrequency ablation (arrow) exhibits low intensity on the T1-weighted image (a) and a slightly high intensity on T2- (b) and diffusion-weighted images (c). d Hepatobiliary phase of sagittal scan shows a low-intensity mass (asterisk) that continued from the tumor into the right hepatic duct | 99.8 |
Implantation was successful in all animals (100%; n = 12/12). The mean procedural and fluoroscopy times were 35 (15–80) and 7.5 (3–28) minutes. Implanted occluder size was 15 mm in all animals. Devices were implanted in appropriate position without residual shunt on echography (Figure 1). Animal sacrifice was performed after a mean delay of 31 (28–38) days (n = 6) and 89 (84–91) days (n = 6). No relevant clinical complication was observed during the follow-up period. | 99.25 |
Microscopic findings of a duodenal tumor. The transition region between the IPMA (left and upper side) and normal duodenal mucosa (right side) (a). This intraductal tumor has intermediate level nuclear atypia (b) and was diagnosed as an IPMA with intermediate dysplasia. IPMA: intraductal papillary mucinous adenoma | 99.9 |
We describe a case of squamous cervical carcinoma with leptomeningeal carcinomatosis diagnosed at an advanced stage to illustrate the diagnosis and clinical presentation of patients with this condition and highlight the preventive role of the population-based cervical cancer screening programs. | 99.94 |
Stroke was clinically diagnosed by the caring neurologist based on the revision of relevant patient documents and was based on clinical presentation with a recent onset of a neurological deficit for 24 hours and cerebrovascular imaging results. The primary neuroimaging procedures used in the diagnosis of ischaemic stroke were non-contrast CT and diffusion-weighted MRI . | 99.9 |
Case studies:(a)Patient with congenital anomalies areas in the right and left sides of the lower dental arch;(b)Patient with congenital anomalies in the right lateral area of the lower dental arch;(c)Patient with total congenital anomalies in the lower dental arch. | 99.9 |
Pathological examination. a: Colposcopic biopsy: Microscopic hematoxylin-eosin stained section with an original magnification of 100 showed squamos epithelium with a few lymphocytes infiltrating the stroma. b: TVS-guided vaginal wall biopsy: A microscopic hematoxylin-eosin-stained section with an original magnification of 400 showed adenocarcinoma cells that contained considerable mucus with a nucleus pushed into a crescent shape. c: Colorectal colonoscopy: A microscopic hematoxylin-eosin-stained section with an original magnification of 400 (ileocecal valve and rectal) showed adenocarcinoma cells that contain considerable mucus with a nucleus pushed into a cresent shape. d: Immunohistochemistry showed neoplastic cells that stained positive for CK | 99.9 |
There is insufficient evidence supporting the use of etanercept as an effective steroid-sparing agent in sarcoidosis. Marques et al. describe a case of peripheral neuropathy successfully treated with etanercept . The patient had discontinued infliximab and adalimumab in succession after developing neutralizing antibodies to these agents but responded to etanercept. The study suggests that etanercept may be considered when there is treatment failure with other biologic agents. | 99.9 |
The lesion was invading the thyroid cartilage and thyroid gland. The incisional biopsy was suggestive of low-grade myofibroblastic sarcoma. The patient underwent total laryngectomy with total thyroidectomy and partial pharyngectomy (Figure 2). The strap muscles were free of tumor. Primary reconstruction of the pharynx was done. | 99.94 |
Five male patients in this cohort developed normal puberty progressing to Tanner stage 5 with normal gonadotropin and testosterone concentrations. The youngest male (age 2y) also had a normal mini-puberty (Table-S2). Patient M1 fathered a healthy child at age 30y. | 99.94 |
Transthoracic echocardiography showed a giant mass (white arrow) in the right atrium (a-b). Transesophageal echocardiogram clearly showed the mass obstructed into the tricuspid valves and retracted to the right atrium afterwards (c-d). RA: right atrium; RV: right ventricle | 99.9 |
Binucleated cells were frequently seen in the tissue sections of the tumor. The nuclei had coarse nuclear chromatin containing multiple prominent nucleoli. The cytological findings confirmed the presence of a sarcoma most likely OS or chondrosarcoma. Histopathology examination showed a mesenchymal proliferation of neoplastic cells in different parts of the tumor. Areas of osseous differentiation within the mass containing bony spicules and wavy bone formation were associated with the vast areas of cartilaginous differentiation with chondroblasts in lacunar spaces (Fig. 4). Frequent mitotic figures were present in osseous parts. | 99.94 |
The missense mutation Lys125Glu was identified in a 3 years old boy who experienced a simple FS at 19 months old. The FS occurred 7 times in the following year. He started to have myoclonic seizures since 2 years old. EEGs showed generalized spike-and-slow waves (Figure 1E). His MRI was normal. He was born to unrelated parents after an uneventful pregnancy. He got seizure-free with valproate on a dose of 25 mg/kg/day. He had normal intelligent and motor development. | 100 |
a Preoperative computed tomography showing brachiocephalic artery aneurysm (black arrow) measuring 32 mm in diameter with thickened aortic wall. b Preoperative computed tomography showing severe atherosclerotic changes in the aortic arch and orifice of the arch vessels | 99.9 |
a Schematic drawing of the isolated cerebral perfusion technique. Black arrows indicate perfusion sites and the numbers representing the order of perfusion. b Intraoperative view showing thickening and hardness of the ascending aortic wall. c Completed drawing of partial arch replacement. d Postoperative computed tomography showing no anastomotic aneurysm and no abnormal flow in the previous aneurysm | 99.8 |
Surgery gave good relief of her pain on the left knee but symptoms were persistent on the right side. An MRI of her right knee identified progressive disintegration of the chondral surface of the knee and the formation of further unstable osteochondral flaps (Fig. 3).Fig. 3T1 weighted coronal MRI image showing extensive defect of medial femoral condyle in comparison with relatively normal lateral femoral condyle. Red arrow indicates medial lesion. Blue arrow indicates noral lateral femoral condyle.Fig. 3 | 100 |
She underwent a further right knee arthroscopy at the age of 23 years. General anaesthetic was managed similarly and was unremarkable. The findings were of progression and extension of the osteochondritis and grade III degenerate change. Histopathological review of the tissue sample showed a small fragment of normal appearing cartilage. The patient reports significant benefit from the surgeries and her knee pain is controlled with codeine and paracetamol as required at the time of writing. | 100 |
Additional file 3. Representative ultrasound image of the vessel wall tenting. An example of when the needle does not puncture but presses the anterior wall of the vessel due to elasticity. Ultrasound-guided internal jugular venous catheterization of the long-axis in-plane approach in a pediatric patient is provided for improved visualization. | 99.8 |
a Thorax computed tomography scan showing a mass in the posterior mediastinum that compresses the left main bronchus and infiltrates the aorta with obstruction greater than 50%. b Positron emission tomography-computed tomography scan showing hypermetabolic lesion that compresses the left main bronchus and infiltrates the aorta. c Endobronchial ultrasound showing a rounded lesion adjacent to the left main bronchus. d Image of the real-time fine needle puncture of the tumor for sampling | 99.94 |
This confirmed the phrenic nerve lesion. Any mechanical cause of the phrenic nerve lesion was ruled out on a chest X-ray and chest computed tomography. We concluded that she was desaturating due to paralysis of the left hemidiaphragm and the rib cage muscle weakness secondary to the underlying disorder. | 100 |
A premature neonate was born at 33 weeks of gestation via spontaneous vaginal delivery to nonconsanguineous parents with a birth weight of 1.880 kg. She was admitted immediately to the neonatal intensive care unit after initial resuscitation in the delivery room. | 99.94 |
Surgical procedure. (a) A 12-mm port was directly into the gastric lumen under direct vision from endoscopy. (b–h) Three interrupted stitches of full-thickness with an extracorporeal knot using the laparoscopic knot pusher. (i) The oral endoscopic findings after gastric wall repair. | 99.9 |
Peripheral blood smear showing lymphocytosis with (A) small mature lymphocytes and (B) occasional lymphocytes with cytoplasmic projections (arrow). (C) Whole body 18fluorodeoxyglucose positron emission tomography/computerized tomography (18FDG-PET-CT) scout film showing splenomegaly and diffuse increased uptake in the spleen. (D) Follow-up 18FDG-PET-CT showing complete metabolic response. | 99.9 |
Figure S1 Representative examples of ERP with ST‐segment elevation and ERP with J wave. (A) Representative ECG from a healthy female subject with no ERP. (B) Example of malignant ERP with ST segment elevation in a subject presenting with sudden cardiac death (SCD). (C) Example of benign ERP with J wave pattern in a healthy subject. | 99.44 |
Direct sequencing analysis of the pathogenic variants in USH2A identified in this study. a Sequence shown the heterozygous nonsense variant c.4217C > A (p.Ser1406X) and the corresponding wild-type sequence. b Sequence shown the heterozygous missense variant c.8232G > C (p.Trp2744Cys) and the corresponding wild-type sequence. c Sequence shown the heterozygous one-base-substitution variant c.8559-2A > G and the corresponding wild-type sequence. d Sequence shown the heterozygous one-base-substitution variant c.11389 + 3A > T and the corresponding wild-type sequence. e Sequence shown the heterozygous missense variant c.11780A > G (p.Asp3927Gly) and the corresponding wild-type sequence. Arrows indicate the position of variants | 99.9 |
Transpancreatic sphincterotomy technique. (a) Fluoroscopy image showed the guidewire inserted in the pancreatic duct. (b) The septum was cut with a sphincterotome from the pancreatic duct towards the bile duct axis. (c) The placement of pancreatic duct stent. (d) After a stent was placed in the pancreatic duct. (e) Cannulation toward the bile duct was performed. (f) The biliary cannulation was successfully achieved. | 99.8 |
Patient 80002 presented with a solitary brain metastasis that was surgically resected. His PSA was elevated and morphology of the tumour specimen was consistent with an adenocarcinoma of prostatic origin; immunohistochemistry (IHC) markers for neuroendocrine differentiation were negative. | 100 |
Electrocardiogram performed 1 day after hospital admission in a 18‐year‐old patient with pure acute myocarditis. It shows a diffuse ST elevation with pericarditis pattern without terminal QRS notching or slurring and a reciprocal ST depression in aVR and V1 leads | 100 |
Coronavirus infection disease 2019 (COVID‐19) may present with different symptoms and complications. Acrocyanosis and digital necrosis may be associated with COVID‐19. We describe two patients with COVID‐19 who died with acrocyanosis and digital necrosis at the terminal stage of their illness. | 99.9 |
TG’s is a unique case that adds considerable value to the body of knowledge regarding the possibilities of recovery after major TBI. The key takeaway underscores the role of non-invasive neuromodulation in harnessing the positive impacts of neuroplasticity. | 99.9 |
This extremely low incidence combined with the unusual involvement of the extensor tendon sheath makes the diagnosis of tuberculous TS of the extensor tendons of the hand a very unique and rare entity that was mentioned in very few case reports . | 99.9 |
The patient was positioned in the lateral decubitus position (Fig. 1). A dynamic reference base and a surveillance marker were placed. An intraoperative CT was taken and registered with the software. Pedicle screw trajectory planning was performed (Fig. 2). A surgeon-controlled foot pedal activated and positioned the robot arm to the planned pedicle trajectory. Stab incisions were made on the skin using a scalpel. Pedicle screws were inserted under neuromonitoring using navigated instruments guided by the robotic arm (Fig. 3). This sequence was repeated until all pedicle screws had been placed.Fig. 1Patient positioning for SP-LLIFFig. 2Intraoperative pedicle screw placement planningFig. 3Minimally invasive lumbosacral pedicle screw placement with a navigated robot-assisted positioning system | 99.94 |
Surgical treatment was decided and with general anaesthesia by posterior approach we perform a T10-L3 posterolateral arthrodesis using autologous bone and two-level posterior Smith-Petersen corrective osteotomies (SPO) . Weak intraoperative bone was observed so fenestrated pedicle screws reinforced with PMMA were used to increase the insertional torque and pull-out strength preventing instrumentation failure. The procedure was performed for a main author. | 100 |
Case reports of CMVR developing following systemic immunosuppression with corticosteroids and steroid-sparing agents have also been reported . A case of CMVR in an HIV negative patient was reported following long-term systemic prednisolone for severe asthma; this patient had decreased T cell response to antigens . CMVR has also been reported in patients using oral corticosteroids and azathioprine or mycophenolate mofetil for systemic lupus erythematosus in spite of normal CD4 T cell counts . It is theorized these patients had a reduction in T-cell function resulting in CMVR. CMVR has also been observed with selective IgG2 deficiency following corticosteroids for inflammatory pulmonary disease . | 99.8 |
A 12-month-old female with no significant medical history presented to the ED with listlessness four days following one day of resolved gastrointestinal symptoms. Her symptoms began after ingestion of birthday cake with rose-gold frosting from a local bakery (Images 1 and 2). | 100 |
His medical history included hypothyroidism caused by autoimmune thyroiditis and arterial hypertonia but no previous report of liver or kidney disease. He presented with an excellent Karnofsky performance status of 100% (according to Eastern Cooperative Oncology Group 0). | 99.94 |
Quantitative immunoglobulin (Ig) assay of the blood revealed an elevation of IgG with 2600 mg/dL (670–1840 mg/dL) and reduced values of IgA with 55 mg/dL (103–595 mg/dL) and IgM with 20 mg/dL (36–238 mg/dL). Serum immunofixation confirmed IgG gammopathy with lambda light chain and Bence–Jones lambda expression. Immunofixation of the urine revealed excretion of lambda light chain and Bence–Jones lambda. | 99.9 |
Hepatic venous pressure gradient measurement with a trans-jugular liver biopsy and gastroscopy revealed a clinically significant portal hypertension (pressure gradient of 30 mmHg) with small esophageal varices. The A liver biopsy confirmed extensive deposition of AL amyloid of lambda light chain type (Fig. 1). Fig. 1Liver biopsy and immunohistochemistry. a Amyloid P and b lambda light chain. Both are colored brown and typically localized near to each other (compare the two pictures) | 99.94 |
To our knowledge this is the first reported case of a successful simultaneous liver and kidney transplantation followed by reduced high-dose melphalan (70% dosage) conditioning therapy plus subsequent ASCT in a patient with systemic AL amyloidosis of a very extended degree accompanied by the diagnosis MM of IgG lambda subtype resulting in complete remission for more than 3 years without the need for an IMid-based maintenance therapy. | 99.94 |
A 56-year-old hypertensive and diabetic male presented to our tertiary care center with complaints of retrosternal chest discomfort of one-month duration. Physical examination was unremarkable with a pulse rate of 78 beats per minute and blood pressure of 130/80 mm Hg. The past medical history was significant for ST-segment elevation inferior wall myocardial infarction one month back for which he underwent a primary PCI of the right coronary artery (RCA) at a local hospital. Cardiac enzymes creatine kinase (CK-MB) and troponin-T were elevated and the echocardiogram revealed inferior wall hypokinesia with a left ventricular ejection fraction of 50%. | 100 |
Sequential cine angiograms (A) left anterior oblique (LAO) caudal view demonstrating a small pseudoaneurysm (white arrow) at the proximal stent edge taken two weeks post percutaneous coronary intervention (PCI); (B) LAO caudal view done four weeks post PCI demonstrating a progression in the size of pseudoaneurysm (white arrow head) at the proximal stent edge. | 99.9 |
The patient was received at our institute four weeks post-PCI for further management and to delineate the exact anatomical details of the aneurysm; the patient underwent CT coronary angiography which showed a 24 x 17 mm large pseudoaneurysm (Figures 3-4) arising from proximal RCA approximately 12 mm from the ostium along the proximal end of the RCA stent. The flow within the stent distally and the rest of the RCA was maintained. Mild focal ectasia was noted at the distal end of the stent. | 100 |
(A) Cine angiogram in left anterior oblique (LAO) cranial view showing a 22 mm x 15 mm pseudoaneurysm arising at the level of proximal stent edge (white arrow); (B) Cine angiogram in LAO view showing a large 26 mm x 19 mm pseudoaneurysm arising at the level of proximal stent edge (white arrow) with inferior extension (white arrow head). | 99.75 |
The aneurysmal sac contained blood mixed with pus which was removed and the cavity was washed with antibiotics. The proximal and distal RCA were ligated and the distal end of the venous graft was anastomosed to the posterior descending artery. Histopathological examination of the aneurysmal tissue showed fibrin with entrapped leucocytes along with RBC’s and the tissue culture grew Pseudomonas aeruginosa. Patient was treated with IV antibiotics according to the culture sensitivity for four weeks and was discharged in a stable condition. Patient had a good postoperative recovery and remained asymptomatic on follow-up. | 100 |
The most common presenting symptom of infected CAA is fever and our patient was peculiar as he was afebrile throughout the presentation . Table 1 shows the reported cases of coronary stent infections secondary to Pseudomonas aeruginosa in the literature and all the reported patients had fever as the presenting symptom but our patient was unique as he was afebrile throughout the presentation. | 99.94 |
(A) A lamina pore can be seen within the optic disc cup (red arrowhead) in the optic disc photograph. (B) Multiple hyporeflective dots and a large hyporeflective region (red arrowhead) can be interpreted as lamina pores in en face optic disc images at the level of the LC. (C) Humphrey 24-2 pattern deviation plots show no glaucomatous visual field defect. Volume image (D) and horizontal B-scan image (E) corresponding to the green dotted line in (A). Note that the lamina structure was not fully defective in the hyporeflective region. (F) The LC defect can be seen in the inferior border of the optic disc rim (red arrowhead). (G) A wedge shaped hyporeflective region (red arrowhead) is also apparent in the en face image. (H) Humphrey 24-2 pattern deviation plots showed a glaucomatous visual field defect. Volume image (I) and horizontal B scan image (J) corresponding to the green dotted arrow in (F). Note that the lamina structure was fully defective in the hyporeflective region. | 99.7 |
Symptoms resolution was reported by day 2. Radiation therapy was started 3 weeks after for 8 weeks and cetuximab was reintroduced 28 days after with a lower dose of 250 mg/m2. Methylprednisolone 80 mg I.V. was added to dexchlorpheniramine 5 mg I.V. and the infusion flow rate of cetuximab was decreased to 2 mg/min. She tolerated it well and no side effects were reported all along the other additional infusions up to 10 weeks. At a follow-up of 18 months the patient is well with no evidence of tumor recurrence. | 99.94 |
Our patient had a history of breast cancer diagnosed at the age of 37 and treated with right radical mastectomy and adjuvant chemotherapy. She underwent total thyroidectomy for nontoxic multinodular goiter [thyroid-stimulating hormone (TSH) 3.77 of μU/mL and free thyroxine (T4) of 1.53 ng/dL] with a dominant colloid nodule of 30 mm at the age of 60; the histological analysis confirmed multinodular adenomatous goiter weighing 66 g with no signs of malignancy. She was medicated with levothyroxine 100 μg/day since the surgery and had no follow-up. She smoked 20 cigarettes a day for the last 50 years. | 100 |
Then patient did not report to the department for 2 to 3 months because he was suffering from Chickengunya. After that he had completely lost his voice and had tumbling gait due to lack of neuromuscular coordination. His oral examination revealed paralyzed right side of tongue because on protrusion tongue deviate to left side. He showed uncontrolled mandibular movements with increased salivation. | 100 |
We here show that the MitraClip procedure can be performed safely and effectively in patients with type II diabetes mellitus. Our short-term follow up shows an improvement in functional status in our patients with no negative influence on 3-month-mortality. | 99.56 |
Cross section of the resected specimen. A: Macroscopic picture of a cross section. B: Diagram of a cross section. The progression of the sigmoid colon cancer was reflected in the MRI findings. The macroscopic findings revealed the progression via the colovesical fistula. SC: sigmoid colon cancer. UBT: urinary bladder tumor. | 99.9 |
a Pulmonary angiogram of pulmonary arteriovenous malformation in the left lower lobe. b Selective angiogram of pulmonary arteriovenous malformation in the left lower lobe. c Embolisation of pulmonary arteriovenous malformation in the left lower lobe with a Amplatzer® vascular plug. d Amplatzer® vascular plug | 99.56 |
Staden display of IL36RN sanger sequencing results from Family 1. [vertical line shows cDNA position 62 at codon 21 in the NM_173170.1 transcript]. (a) control DNA with a homozygous T/T genotype. (b) example of parent DNA with T/C heterozygous genotype. (c) example of affected child DNA with C/C homozygous genotype. | 99.9 |
A: Baseline electrocardiogram showing prolonged QT interval. The heart rate is 97. The QTc is 504 ms. The ECG was recorded at 25 mm/s. B: Leads I and II showing monomorphic ventricular tachycardia on an ECG rhythm strip recorded in the Emergency Department. | 99.94 |
Mean serum IgG level increased from 9.2 g/L to 9.75 g/L by the end of Stage 1 with Subgam treatment and was maintained above the pre-Subgam level for 30 months of treatment (Fig 3). The overall mean serum IgG value was sustained for the 30–36 month period. | 99.75 |
One animal (1001) presented a minimal area of fluorescein staining at 24 h post-treatment and none at the other time points. Ocular grading sheets only indicated a score of ‘1’ for the area of cornea involved with an opacity score of ‘0’. The score value of ‘1’ was intended for the area of ‘fluorescein staining’ following the observation after the fluorescein solution instillation for this animal. This was considered related to a trauma to the cornea during experimental procedures rather than a treatment-related effect. | 99.3 |
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