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Chronic Subdural Hematoma, a Cause of Persistent Post-Dural Puncture Headache in the Postpartum Period 认领
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作者 Daniel Kanyata Omar Ahmed Nassir +4 位作者 Christopher K. Musau Victoria Adhiambo Gamba Mariatu Tamimu Michelle Gathecha Lily Nyamai 《妇产科期刊(英文)》 2021年第3期272-278,共7页
<strong>Background</strong><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><strong>:</stron... <strong>Background</strong><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><strong>:</strong></span></span></span><span><span><span style="font-family:""> </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">Chronic subdural heamatoma (CSDH) is a disease that predominantly occurs in the elderly population. This is because of physiological atrophy of the brain parenchyma and frailty which leads to higher risk of </span><span style="font-family:Verdana;">falls.</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">CSDH is unusual in the younger population but can be seen in the context of impact injuries in the younger population and mostly in males.</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Case Reports</span></b></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">: </span></b></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">We describe CSDH in 4 young postpartum mothers with no history of</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> trauma. All had cesarean section births under spinal anaesthesia.</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">The 4 mothers’ ages range from 24 y</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">ea</span></span></span><span style="font-family:Verdana;"><span style="font- 展开更多
关键词 Case Report Post Dural Puncture Headache
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A Case Report about Persistent Left Superior Vena Cava: Is it Always Asymptomatic? 认领
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作者 Özge Çetinarslan Arda Payas Ibrahim Taskin Rakici 《心血管病(英文)》 2021年第1期52-57,共6页
<div style="text-align:justify;"> A persistent left superior vena cava (PLSVC) is a rare malformation which affects approximately 0.3<span>% </span><span>-</span><span> &l... <div style="text-align:justify;"> A persistent left superior vena cava (PLSVC) is a rare malformation which affects approximately 0.3<span>% </span><span>-</span><span> </span><span>0.5% of the population and it is presented along with a right-sided superior vena cava in 82.2% of the cases reported</span><span minion="" pro="" capt","serif";color:#943634;"="" style=""> </span><span minion="" pro="" capt","serif";color:#943634;background:yellow;"=""></span><span>[<a href="#ref1">1</a>]</span><span color:#943634;background:yellow;"=""></span><span minion="" pro="" capt","serif";color:#943634;background:yellow;"=""></span><span>.</span><span "=""><span> Clinicians diagnose it incidentally by difficulties with pacemaker implantation, central venous catheterization or screening for another etiologies when it is not accompanied by other anomalies it is typically asymptomatic. W. Schummer </span><i><span>et al.</span></i><span> described the embryogenesis and the anatomic variations of persistent LSVC according to the positioning of a central venous catheter on the chest radiograph: type I, normal;type II, only PLSVC;type IIIa, right and left superior vena cava with connection;type IIIb, right and left superior vena cava without connection</span></span><span> </span><span>[<a href="#ref2">2</a>]</span><span>. </span><span "=""><span>In 92% of individuals with PLSVC, the PLSVC drains into a dilated coronary sinus (CS) and rest 8% drain directly into the left atrium. PLSVC is caused by a failure in the closure of the left anterior cardinal vein during embryogenic development</span></span><span minion="" pro="" capt","serif";color:#943634;"=""><span> </span><span style="background:yellow;"></span></span><span color:#943634;"=""><span>[<a href="#ref3">3</a>]</span><span style="background:yellow;"></span></span><span minion="" pro="" capt","serif";color:#943634;background:yellow;"=""></span><span>. </span><span>The coronary sinus (CS) is a vein that transmits venous blood to the right atrium though atrioventricular groove 展开更多
关键词 Case Report Persistent Left Superior Vena Cava (PLSVC) Congenital Heart Disease COVID-19 Cardiac Imaging
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文章速递Gastrointestinal cytomegalovirus disease secondary to measles in an immunocompetent infant:A case report 认领
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作者 Qing-Hua Yang Xiao-Peng Ma +4 位作者 Dong-Ling Dai Da-Ming Bai Yu Zou Si-Xi Liu Jian-Ming Song 《世界胃肠病学杂志:英文版》 SCIE CAS CSCD 2021年第15期1655-1663,共9页
BACKGROUND Gastrointestinal cytomegalovirus(CMV)disease occurs commonly in immunocompromised/immunodeficient patients with advanced human immunodeficiency virus infection,neoplasm,solid organ transplantation,hematopoi... BACKGROUND Gastrointestinal cytomegalovirus(CMV)disease occurs commonly in immunocompromised/immunodeficient patients with advanced human immunodeficiency virus infection,neoplasm,solid organ transplantation,hematopoietic stem cell transplantation,or treatment with immunosuppressants,but is rarely reported in association with measles infection.CASE SUMMARY We describe a case of extensive gastrointestinal CMV disease secondary to measles infection in a 9-mo-old boy who presented with persistent fever and bloody diarrhea.His condition was improved after ganciclovir treatment.Serological analysis of CMV showed negative immunoglobulin(Ig)M and positive IgG.Blood CMV-DNA was 9.26×103 copies/mL.The diagnosis of gastrointestinal CMV disease was confirmed by histopathological findings of intranuclear and intracytoplasmic inclusions and Owl’s eye inclusion.This case highlights the differential diagnosis and histopathological characteristics of gastrointestinal CMV infection and laboratory tests.CONCLUSION Extensive gastrointestinal CMV lesions can be induced by the immune suppression secondary to measles infection.Rational,fast,and effective laboratory examinations are essential for suspected patients. 展开更多
关键词 Cytomegalovirus Diarrhea Gastrointestinal Infant Measles Case report
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文章速递Managing esophagocutaneous fistula after secondary gastric pullup:A case report 认领
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作者 Johan F Lock Stanislaus Reimer +5 位作者 Sebastian Pietryga Rafael Jakubietz Sven Flemming Alexander Meining Christoph-Thomas Germer Florian Seyfried 《世界胃肠病学杂志:英文版》 SCIE CAS CSCD 2021年第16期1841-1846,共6页
BACKGROUND Gastric pull-up(GPU)procedures may be complicated by leaks,fistulas,or stenoses.These complications are usually managed by endoscopy,but in extreme cases multidisciplinary management including reoperation m... BACKGROUND Gastric pull-up(GPU)procedures may be complicated by leaks,fistulas,or stenoses.These complications are usually managed by endoscopy,but in extreme cases multidisciplinary management including reoperation may be necessary.Here,we report a combined endoscopic and surgical approach to manage a failed secondary GPU procedure.CASE SUMMARY A 70-year-old male with treatment-refractory cervical esophagocutaneous fistula with stenotic remnant esophagus after secondary GPU was transferred to our tertiary hospital.Local and systemic infection originating from the infected fistula was resolved by endoscopy.Hence,elective esophageal reconstruction with freejejunal interposition was performed with no subsequent adverse events.CONCLUSION A multidisciplinary approach involving interventional endoscopists and surgeons successfully managed severe complications arising from a cervical esophagocutaneous fistula after GPU.Endoscopic treatment may have lowered the perioperative risk to promote primary wound healing after free-jejunal graft interposition. 展开更多
关键词 Esophageal fistula Gastric fistula Esophageal stenosis Esophageal perforation Endoscopic vacuum therapy Free-jejunal graft Autogenous jejunum transplantation Case report
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文章速递Pregnancy associated spontaneous coronary artery dissection:A case report and review of literature 认领
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作者 Kalyan Prudhvi Jayasree Jonnadula +1 位作者 Venkata Ram Pradeep Rokkam Gurusaravanan Kutti Sridharan 《世界心脏病学杂志:英文版(电子版)》 2021年第4期103-110,共8页
BACKGROUND Pregnancy-associated spontaneous coronary artery dissection(PSCAD)is an important cause of chest pain and acute myocardial infarction in pregnant and postpartum women.Pregnancy is considered an isolated ris... BACKGROUND Pregnancy-associated spontaneous coronary artery dissection(PSCAD)is an important cause of chest pain and acute myocardial infarction in pregnant and postpartum women.Pregnancy is considered an isolated risk factor for spontaneous coronary artery dissection.The etiology,pathogenesis,and incidence of PSCAD are not known.CASE SUMMARY We present a case of a 33-year-old postpartum female who presented with sudden onset chest pain and was diagnosed with spontaneous coronary artery dissection and needed urgent catheterization revealing left anterior descending coronary artery dissection.She underwent emergent coronary artery bypass graft surgery with good post-operative recovery.CONCLUSION Most patients with PSCAD can be managed conservatively with medical management and have good outcomes.Patients with high-risk presentations benefit from the invasive approach.Coronary artery bypass graft may be required in select few patients based on angiography findings.Due to the risk of recurrent spontaneous coronary artery dissection,subsequent pregnancies are discouraged. 展开更多
关键词 Pregnancy Spontaneous artery dissection Acute coronary syndrome Coronary artery bypass surgery Percutaneous coronary intervention Pregnancy Dissection Myocardial Infraction Case report
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文章速递Device closure of fistula from left lower pulmonary artery to left atrium using a vascular plug:A case report 认领
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作者 Rudrapratap Mahapatra Dibyasundar Mahanta +2 位作者 Jogendra Singh Debasis Acharya Ramachandra Barik 《世界心脏病学杂志:英文版(电子版)》 2021年第4期111-116,共6页
BACKGROUND Pulmonary artery-to-left atrial fistula is a variant of pulmonary arteriovenous fistula and is a developmental anomaly.Delayed presentation,cyanosis and effort intolerance are some of the important features... BACKGROUND Pulmonary artery-to-left atrial fistula is a variant of pulmonary arteriovenous fistula and is a developmental anomaly.Delayed presentation,cyanosis and effort intolerance are some of the important features.The diagnosis is confirmed by computed tomography or pulmonary artery angiography.Catheter-based closure is preferred to surgery.CASE SUMMARY Left pulmonary artery-to-left atrial fistula is rare.A 40-year-old male presented with effort intolerance,central cyanosis,and recurrent seizures.He had a large and highly tortuous left pulmonary artery-to-left atrial fistula associated with a large aneurysmal sac in the course.Catheter-based closure was performed using a vascular plug.CONCLUSION Left pulmonary artery-to-left atrial fistula is relatively uncommon compared to right pulmonary artery-to-left atrial fistula.Percutaneous closure by either a transeptal technique or guide wire insertion into the pulmonary vein through the pulmonary artery is preferred.The need for an arteriovenous loop depends on the tortuosity of the course of the fistula and the size of the device to be implanted because a larger device needs a larger sheath,necessitating firm guide wire support to facilitate negotiation of the stiff combination of the delivery sheath and dilator. 展开更多
关键词 Pulmonary artery Left atrium Fistula Hemangioma Catheter-based Vascular plug Case report
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文章速递Transperineal core-needle biopsy of a rectal subepithelial lesion guided by endorectal ultrasound after contrast-enhanced ultrasound: A case report 认领
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作者 Qiong Zhang Jie-Ying Zhao +4 位作者 Hua Zhuang Chun-Yan Lu Jin Yao Yuan Luo Yong-Yang Yu 《世界胃肠病学杂志:英文版》 SCIE CAS CSCD 2021年第13期1354-1361,共8页
BACKGROUND Rectal subepithelial lesions(SELs) are commonly seen in endoscopic examination, generally manifested as bumps with a smooth surface. Precise preoperative diagnoses for rectal SELs are difficult because abno... BACKGROUND Rectal subepithelial lesions(SELs) are commonly seen in endoscopic examination, generally manifested as bumps with a smooth surface. Precise preoperative diagnoses for rectal SELs are difficult because abnormal tissues are not easily to be obtained by regular endoscopic forceps biopsy. Traditional guidance modalities of preoperative biopsy, including endoscopic ultrasound, computed tomography, and transabdominal ultrasound, are often unsatisfactory. An updated, safe, and effective biopsy guidance method is required. We herein report a new biopsy guidance modality—endorectal ultrasound(ERUS) combined with contrastenhanced ultrasound(CEUS).CASE SUMMARY A 32-year-old woman complained of a mass inside the rectovaginal space for 9 years, which became enlarged within 1 year. A rectal SEL detected by endoscopy was suspected to be a gastrointestinal stromal tumor or exophytic uterine fibroid. Pathological diagnosis was difficult because of unsuccessful transabdominal core needle biopsy with insufficient tissues, as well as vaginal hemorrhage. A second biopsy was suggested after multiple disciplinary treatment discussion, which referred to a transperineal core needle biopsy(CNB) guided by ERUS combined with CEUS. Adequate samples were procured and rectal gastrointestinal stromal tumor was proved to be the pathological diagnosis. Imatinib was recommended for first-line therapy by multiple disciplinary treatment discussion. After the tumor shrunk, resection of the rectal gastrointestinal stromal tumor was performed through the posterior vaginal wall. Adjuvant therapy was applied and no recurrence or metastasis has been found by the last follow-up on December 13, 2019.CONCLUSION Transperineal CNB guided by ERUS and CEUS is a safe and effective preoperative biopsy of rectal SELs yet with some limitations. 展开更多
关键词 Transperineal core needle biopsy Endorectal ultrasound Contrast-enhanced ultrasound Rectal subepithelial lesion Case report
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文章速递Effects of intravascular laser phototherapy on delayed neurological sequelae after carbon monoxide intoxication as evaluated by brain perfusion imaging:A case report and review of the literature 认领
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作者 Chuan-Ching Liu Chun-Sheng Hsu +2 位作者 Hsin-Chen He Yuan-Yang Cheng Shin-Tsu Chang 《世界临床病例杂志》 SCIE 2021年第13期3048-3055,共8页
BACKGROUND Delayed neurological sequelae(DNS)caused by carbon monoxide(CO)intoxication poses considerable treatment challenges for clinical practitioners.In this report,we used nuclear medicine imaging and the Mini-Me... BACKGROUND Delayed neurological sequelae(DNS)caused by carbon monoxide(CO)intoxication poses considerable treatment challenges for clinical practitioners.In this report,we used nuclear medicine imaging and the Mini-Mental State Examination(MMSE)to evaluate the effectiveness of intravascular laser irradiation of blood(ILIB)therapy for the management of DNS.CASE SUMMARY A 51-year-old woman presented to our medical center experiencing progressive bradykinesia,rigidity of limbs,gait disturbance,and cognitive impairment.Based on her neurological deficits,laboratory tests and imaging findings,the patient was diagnosed with delayed neurological sequelae of CO intoxication.She received intensive rehabilitation and ILIB therapy during 30 sessions over 2 mo after diagnosis.Brain single-photon emission computed tomography was performed both prior to and after ILIB therapy.The original hypoperfusion area in bilateral striata,bilateral frontal lobe,right parietal lobe,and bilateral cerebellum showed considerable improvement after completion of therapy.The patient’s MMSE score also increased markedly from 6/30 to 25/30.Symptoms of DNS became barely detectable,and the woman was able to carry out her daily living activities independently.CONCLUSION ILIB therapy could facilitate recovery from delayed neurological sequelae in patients with CO intoxication,as demonstrated by improved cerebral blood flow and functional outcomes in our patient. 展开更多
关键词 Carbon monoxide poisoning Delayed neurological sequelae Intravascular laser irradiation of blood Redistribution Single photon emission computed tomography Case report
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文章速递Crumbs homolog 2 mutation in two siblings with steroid-resistant nephrotic syndrome:Two case reports 认领
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作者 Jing Lu Yan-Nan Guo Li-Qun Dong 《世界临床病例杂志》 SCIE 2021年第13期3056-3062,共7页
BACKGROUND Crumbs homolog 2(CRB2)is a recently discovered gene that is closely related to the maintenance of normal polarity in podocytes;mutations can directly lead to steroid-resistant nephrotic syndrome(SRNS).Howev... BACKGROUND Crumbs homolog 2(CRB2)is a recently discovered gene that is closely related to the maintenance of normal polarity in podocytes;mutations can directly lead to steroid-resistant nephrotic syndrome(SRNS).However,the characteristics of nephrotic syndrome(NS)caused by CRB2 mutations have not been described.CASE SUMMARY We report a novel compound heterozygous mutation of the CRB2 gene in two siblings with SRNS.The two siblings had edema,proteinuria,hypoproteinemia and hyperlipidemia.Both their father and mother had normal phenotypes(no history of NS).Whole exon sequencing(WES)of the family showed a novel compound heterozygous mutation,c.2290(exon 8)C>T and c.3613(exon 12)G>A.Glucocorticoid therapy(methylprednisolone pulse therapy or oral prednisone)and immunosuppressive agents(tacrolimus)had no effect.During a 3-year follow-up after genetic diagnosis by WES,proteinuria persisted,but the patient was healthy.CONCLUSION CRB2 mutations related to SRNS often occur in exons 7,10,and 12.Clinical manifestations of SRNS caused by CRB2 mutations are often less severe than in other forms of SRNS. 展开更多
关键词 Steroid-resistant nephrotic syndrome Crumbs homolog 2 Proteinuria Compound heterozygous mutation Glomerulosclerosis Renal biopsy Case report
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文章速递Intracortical chondroma of the metacarpal bone:A case report 认领
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作者 Yuki Yoshida Ukei Anazawa +4 位作者 Itsuo Watanabe Hiraku Hotta Ryoma Aoyama Satoshi Suzuki Takeo Nagura 《世界临床病例杂志》 SCIE 2021年第13期3063-3069,共7页
BACKGROUND Intracortical chondroma of the metacarpal bone which could be painful is an extremely rare condition and previously only one case has been reported.Due to the similar physical features and appearance on cli... BACKGROUND Intracortical chondroma of the metacarpal bone which could be painful is an extremely rare condition and previously only one case has been reported.Due to the similar physical features and appearance on clinical imaging,it is difficult to differentiate between intracortical chondroma and osteoid osteoma.Therefore,pathological examination is usually required to establish a definite diagnosis,which is often carried out only after tumor removal.In this study,we describe a case of intracortical chondroma which developed in the metacarpal bone and demonstrate the utility of magnetic resonance imaging(MRI).CASE SUMMARY We present a case of a 40-year-old man with intracortical chondroma of the metacarpal bone who was strongly suspected of having a tumor,and it was confirmed using contrast-enhanced MRI and successfully treated with curettage.MRI performed before tumor removal revealed signal intensity similar to that of the nidus of an osteoid osteoma.However,no abnormal intensity was observed in the bone or soft tissues surrounding the tumor.Such abnormalities on images would indicate the presence of soft-tissue inflammation,which are characteristics of osteoid osteoma.Furthermore,contrast-enhanced imaging revealed no increased enhancement of the areas surrounding the tumor.This is the first report to describe the contrast-enhanced MRI features of intracortical chondroma.This may serve as a guide for clinicians when intracortical chondroma is suspected.CONCLUSION The contrast-enhanced MRI was useful for the differential diagnosis of intracortical chondroma. 展开更多
关键词 Chondroma Metacarpal bone Tumor Cartilage Osteoma Case report
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文章速递Vancomycin-related convulsion in a pediatric patient with neuroblastoma:A case report and review of the literature 认领
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作者 Qiao-Feng Ye Guang-Fei Wang +2 位作者 Yi-Xue Wang Guo-Ping Lu Zhi-Ping Li 《世界临床病例杂志》 SCIE 2021年第13期3070-3078,共9页
BACKGROUND Vancomycin is often used as an anti-infective drug in patients receiving antitumor chemotherapy.There are concerns about its adverse drug reactions during treatment,such as nephrotoxicity,ototoxicity,hypers... BACKGROUND Vancomycin is often used as an anti-infective drug in patients receiving antitumor chemotherapy.There are concerns about its adverse drug reactions during treatment,such as nephrotoxicity,ototoxicity,hypersensitivity reactions,etc.However,potential convulsion related to high plasma concentrations of vancomycin in children receiving chemotherapy has not been reported.CASE SUMMARY A 3.9-year-old pediatric patient with neuroblastoma receiving vancomycin to treat post-chemotherapy infection developed an unexpected convulsion.No other potential disease conditions could explain the occurrence of the convulsion.The subsequently measured overly high plasma concentrations of vancomycin could possibly provide a clue to the occurrence of this convulsion.The peak and trough plasma concentrations of vancomycin were 59.5 mg/L and 38.6 mg/L,respectively,which were much higher than the safe range.Simulation with the Bayesian approach using MwPharm software showed that the area under the concentration-time curve over 24 h was 1086.6 mg·h/L.Therefore,vancomycin was immediately stopped and teicoplanin was administered instead combined with meropenem and fluconazole as the anti-infective treatment strategy.CONCLUSION Unexpected convulsion occurring in a patient after chemotherapy is probably due to toxicity caused by abnormal pharmacokinetics of vancomycin.Overall evaluation and close therapeutic drug monitoring should be conducted to determine the underlying etiology and to take the necessary action as soon as possible. 展开更多
关键词 Vancomycin Neuroblastoma Convulsion Children Adverse drug reaction Case report
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文章速递Pulmonary arterial hyper-tension in a patient with hereditary hemorrhagic telangiectasia and family gene analysis:A case report 认领
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作者 Jian Wu Yuan Yuan +4 位作者 Xin Wang Dong-Ying Shao Li-Guo Liu Jian He Peng Li 《世界临床病例杂志》 SCIE 2021年第13期3079-3089,共11页
BACKGROUND Hereditary hemorrhagic telangiectasia(HHT)is a rare autosomal dominant genetic disease.Very few patients suffering from HHT present with associated pulmonary arterial hypertension(PAH),which may result in a... BACKGROUND Hereditary hemorrhagic telangiectasia(HHT)is a rare autosomal dominant genetic disease.Very few patients suffering from HHT present with associated pulmonary arterial hypertension(PAH),which may result in a poor prognosis.Here,we report a case of HHT with PAH.The patient’s clinical manifestations and treatment as well as genetic analysis of family members are reviewed,in order to raise awareness of this multimorbidity.CASE SUMMARY A 45-year-old Chinese woman was admitted to the hospital to address a complaint of intermittent shortness of breath,which had lasted over the past 2 years.She also had a 30-year history of recurrent epistaxis and 5-year history of anemia.She reported that the shortness of breath had aggravated gradually over the 2 years.Physical examination discovered anemia and detected gallop rhythm in the precordium.Chest computerized tomography and cardiac ultrasound demonstrated PAH and hepatic arteriovenous malformation.The formal clinical diagnosis was HHT combined with PAH.The patient was treated with ambrisentan and her condition improved for a time.She died half a year after the diagnosis.Genetic testing revealed the patient and some family members to carry an activin A receptor-like type 1 mutation(c.1232G>A,p.Arg411Gln);the family was thus identified as an HHT family.CONCLUSION We report a novel gene mutation(c.1232G>A,p.Arg411Gln)in a Chinese HHT patient with PAH. 展开更多
关键词 Hereditary hemorrhagic telangiectasia Pulmonary arterial hypertension Activin A receptor-like type 1 Activin receptor-like kinase 1 Arteriovenous malformation Endothelin receptor antagonist Case report
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文章速递Misdiagnosed dystrophic epidermolysis bullosa pruriginosa:A case report 认领
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作者 Zi Wang Yi Lin +3 位作者 Xing-Wu Duan Hai-Yan Hang Xia Zhang Ling-Ling Li 《世界临床病例杂志》 SCIE 2021年第13期3090-3094,共5页
BACKGROUND Dystrophic epidermolysis bullosa pruriginosa(DEB-Pr)is a rare subtype of DEB,characterized by recurrent pruritus of the extremities,pruritus papules,nodules,and mossy-like plaques.To date,fewer than 100 cas... BACKGROUND Dystrophic epidermolysis bullosa pruriginosa(DEB-Pr)is a rare subtype of DEB,characterized by recurrent pruritus of the extremities,pruritus papules,nodules,and mossy-like plaques.To date,fewer than 100 cases have been reported.We report a misdiagnosed 30-year-old man with sporadic late-onset DEB-Pr who responded well to tacrolimus treatment,thereby serving as a guide to correct diagnosis and treatment.CASE SUMMARY A 30-year-old man presented with recurrent itching plaques of 1-year duration in the left tibia that aggravated and involved both legs and the back.Examination revealed multiple symmetrical,purple,and hyperpigmented papules and nodules with surface exfoliation involving the tibia and dorsum of the neck with negative Nissl's sign,no abnormalities in the skin,mucosa,hair,or fingernail,and no local lymph node enlargement.Blisters were never reported prior to presentation.Serum immunoglobulin E level was 636 IU/mL.Clinical manifestations suggested DEB-Pr.Histological examination showed subepidermal fissure,scar tissue,and milia.Direct immunofluorescence showed no obvious abnormalities.However,we were unable to perform electron microscopy or genetic research following his choice.We treated him with topical tacrolimus.After 2 wk,the itching alleviated,and the skin lesions began to subside.No adverse reactions were observed during treatment.CONCLUSION Topical tacrolimus is a safe treatment option for patients with DEB-Pr and can achieve continuous relief of severe itching. 展开更多
关键词 Differential diagnoses Dystrophic epidermolysis bullosa pruriginosa Pruritus Nodular prurigo Histopathological examinations Case report
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文章速递Spontaneous coronary dissection should not be ignored in patients with chest pain in autosomal dominant polycystic kidney disease:A case report 认领
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作者 Jun Qian Yan Lai +2 位作者 Li-Jun Kuang Fei Chen Xue-Bo Liu 《世界临床病例杂志》 SCIE 2021年第13期3095-3101,共7页
BACKGROUND When autosomal dominant polycystic kidney disease(ADPKD)presents with acute coronary syndrome(ACS),the possibility of spontaneous coronary artery dissection(SCAD)should be highly considered.In some cases,SC... BACKGROUND When autosomal dominant polycystic kidney disease(ADPKD)presents with acute coronary syndrome(ACS),the possibility of spontaneous coronary artery dissection(SCAD)should be highly considered.In some cases,SCAD is considered an extrarenal manifestation of ADPKD depending on the pathological characteristics of the unstable arterial wall in ADPKD.CASE SUMMARY Here,we report a 46-year-old female patient with ADPKD who presented with ACS.Coronary angiography revealed no definite signs of dissection,while intravascular ultrasound revealed a proximal to distal dissection of the left circumflex.After a careful conservative medication treatment,the patient exhibited favorable prognosis.CONCLUSION In cases of ADPKD co-existing with ACS,differential diagnosis of SCAD should be considered.Moreover,when no clear dissection is found on coronary angiography,IVUS should be performed to prevent missed diagnosis. 展开更多
关键词 Spontaneous coronary artery dissection Autosomal dominant polycystic kidney disease Intravascular ultrasound Case report
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文章速递Sarcomatoid carcinoma of the pancreas—multimodality imaging findings with serial imaging follow-up:A case report and review of literature 认领
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作者 Hyun Jae Lim Hye Seon Kang +4 位作者 Jeong Eun Lee Ji Hye Min Kyung Sook Shin Sun Kyoung You Kyung-Hee Kim 《世界临床病例杂志》 SCIE 2021年第13期3102-3113,共12页
BACKGROUND Sarcomatoid carcinoma of the pancreas is extremely rare and has an extremely poor prognosis.Although a few cases of sarcomatoid carcinoma of pancreas have been reported,most are focused on a histopathologic... BACKGROUND Sarcomatoid carcinoma of the pancreas is extremely rare and has an extremely poor prognosis.Although a few cases of sarcomatoid carcinoma of pancreas have been reported,most are focused on a histopathological review.To the best of our knowledge,there are no reports documenting multimodality imaging characteristics and chronological changes with emphasis on radiologic features.CASE SUMMARY A 64-year-old woman was admitted to Chungnam National University Hospital with acute appendicitis.Contrast-enhanced computed tomography of the abdomen revealed a 2.6 cm×2.8 cm multilobular cystic mass in the pancreatic tail.The pancreatic lesion showed suspected mural nodules and thin septa.Hence,mucinous cystic neoplasm of pancreas was considered.After 7 mo,the patient was readmitted for repeated epigastric abdominal pain and nausea.Follow-up contrast-enhanced computed tomography of the abdomen and magnetic resonance imaging revealed a marked enlargement(5.4 cm×4 cm),with a predominant internal solid component.The mass showed low signal intensity on a T1-weighted image and heterogeneously intermediate high signal intensity on a T2-weighted image. It showed diffusion restriction and peripheral rimenhancement on an arterial phase image, and progressive enhancement on portalvenous and delayed phase images. Distal pancreatectomy was performed. Basedon the morphology and immunohistochemical staining of the specimen,pancreatic sarcomatoid carcinoma was diagnosed.CONCLUSIONWe present the computed tomography, magnetic resonance imaging, and positronemission tomography computed tomography findings, pathologic features, andchronological changes for preoperative diagnosis. 展开更多
关键词 Carcinosarcoma Pancreas Computed tomography Magnetic resonance imaging Pancreatectomy Case report
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文章速递Acute pancreatitis and small bowel obstruction caused by a migratory gastric bezoar after dissolution therapy: A case report 认领
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作者 Ting-Ting Wang Jia-Jun He +2 位作者 Jun Liu Wei-Wei Chen Chao-Wu Chen 《世界临床病例杂志》 SCIE 2021年第13期3114-3119,共6页
BACKGROUND Bezoars are conglomerates of indigestible foreign material that can be found in the gastrointestinal tract.Gastric ulcer,gastrointestinal perforation,and intestinal obstruction are the main complications.Ac... BACKGROUND Bezoars are conglomerates of indigestible foreign material that can be found in the gastrointestinal tract.Gastric ulcer,gastrointestinal perforation,and intestinal obstruction are the main complications.Acute pancreatitis secondary to bezoar is rare.Here,we present a rare case of a migratory gastric bezoar complicated by acute pancreatitis and small bowel obstruction after dissolution therapy.CASE SUMMARY A-65-year-old woman underwent gastroscopy because of epigastric pain,which revealed a huge bezoar and a gastric ulcer 10 d prior.The patient was discharged with a prescription of drinking 1 L Coca-Cola daily for 6 d,without repeat gastroscopy.However,she suddenly developed epigastric pain,nausea and vomiting for 3 d.Abdominal computed tomography(CT)revealed mild inflammation of the pancreas.Magnetic resonance cholangiopancreatography showed no abnormalities in the pancreatic duct or common bile duct.The nasogastric tube still showed drainage of more than 1.6 L of dark fluid each day after symptomatic treatment.Abdominal CT re-examination suggested intestinal obstruction.Esophagogastroduodenoscopy revealed a huge yellowish hard mass in the jejunal lumen,and we used the basket and net to fragment the bezoar.She was discharged with a good outcome.CONCLUSION Endoscopic therapy is the first choice for gastric bezoars.When mechanical disintegration cannot be achieved,timing of repeat endoscopy is important during Coca-Cola dissolution therapy. 展开更多
关键词 Bezoar Intestinal obstruction Acute pancreatitis Dissolution therapy Endoscopy Case report
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文章速递Intracardiac,pulmonary cement embolism in a 67-year-old female after cement-augmented pedicle screw instrumentation:A case report and review of literature 认领
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作者 Tong-Zhou Liang Hai-Peng Zhu +2 位作者 Bo Gao Yan Peng Wen-Jie Gao 《世界临床病例杂志》 SCIE 2021年第13期3120-3129,共10页
BACKGROUND We report a case of Intracardiac,pulmonary,and intravenous cement embolism after cement-augmented pedicle screw instrumentation in treating spondylolisthesis underlying osteoporotic bone,which was successfu... BACKGROUND We report a case of Intracardiac,pulmonary,and intravenous cement embolism after cement-augmented pedicle screw instrumentation in treating spondylolisthesis underlying osteoporotic bone,which was successfully managed by conservative treatment.We describe the treatment and outcome of the patient,hoping to shed light on the management of bone cement embolism.CASE SUMMARY A 67-year-old female suffered from progressive low back pain and numbness in lower extremities for 30 years.She was diagnosed with L4 and L5 spondylolisthesis,spinal stenosis,and osteoporosis.The patient underwent spinal canal decompression,an interbody fusion of L4/5 and L5/S1,cement-augmented pedicle screw instrumentation in L4-L5 segments,and regular pedicle screw in S1 segments.Three days postoperatively,a sudden drop in oxygen saturation occurred.Computerized tomography scan confirmed Intracardiac,pulmonary,and intravenous embolism.The patient was treated conservatively by continuous low-flow oxygen inhalation,anti-coagulation,and antibiotic therapy for 1 mo and continued anticoagulation treatment for 6 mo.The patient showed no further symptoms in a 30-mo follow-up.CONCLUSION Intracardiac,pulmonary cement embolism after cement-augmented pedicle screw instrumentation is extremely rare.Careful clinical and radiographic evaluation is required in multiple sites of bone cement embolism.Conservative treatment may be a primary consideration in scattered emboli without life-threatening conditions,but a clinical decision should be made on an individualized basis. 展开更多
关键词 Osteoporosis Polymethyl methacrylate cement Pulmonary embolism Cement-augmented pedicle screw instrumentation Conservative treatment Case report
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文章速递Acute urinary retention in the first and second-trimester of pregnancy:Three case reports 认领
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作者 Lin Zhuang Xiao-Yin Wang +2 位作者 Yan Sang Jiao Xu Xue-Lian He 《世界临床病例杂志》 SCIE 2021年第13期3130-3139,共10页
BACKGROUND Acute urinary retention(AUR)is rare during pregnancy.CASE SUMMARY We report on three pregnant women with AUR between the 10th and 18th wk of gestation.Case 1 was first diagnosed as urinary tract infection a... BACKGROUND Acute urinary retention(AUR)is rare during pregnancy.CASE SUMMARY We report on three pregnant women with AUR between the 10th and 18th wk of gestation.Case 1 was first diagnosed as urinary tract infection and developed a urinary tract infection due to urinary retention caused by urethral obstruction.Case 2 had a history of previous abdominal surgery for pelvic tuberculosis,leading to severe adhesions and a persistent retroverted uterus.In case 3,healthcare providers focused on the patient’s gastrointestinal symptoms and did not investigate her inability to void.Case 1 required manual disimpaction of the uterus and the knee-chest position.The other cases required immediate catheterization.The condition resolved in cases 1 and 2;these patients had normal pregnancies.Case 3 had severe complications at the time of consultation,leading to an abortion.CONCLUSION Retroverted uterus is the most common cause of AUR.Prompt recognition and diagnosis are required.Clinicians should be aware of the risk factors,etiology,and clinical presentation of AUR in the first and second trimester of pregnancy. 展开更多
关键词 Urinary retention Uterus Incarceration Adjuvant therapy Diagnosis Intervention Case report
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文章速递Sarcoidosis mimicking metastases in an echinoderm microtubuleassociated protein-like 4 anaplastic lymphoma kinase positive nonsmall-lung cancer patient:A case report 认领
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作者 Xi Chen Jie Wang +4 位作者 Wei-Li Han Kui Zhao Zhen Chen Jian-Ying Zhou Yi-Hong Shen 《世界临床病例杂志》 SCIE 2021年第13期3140-3146,共7页
BACKGROUND Rearrangements of the anaplastic lymphoma kinase(ALK)gene(ALK-positive)represent an oncogenic driver in approximately 3%-5%of non-small-lung cancer(NSCLC)patients.Sarcoidosis is a multisystem disease,and it... BACKGROUND Rearrangements of the anaplastic lymphoma kinase(ALK)gene(ALK-positive)represent an oncogenic driver in approximately 3%-5%of non-small-lung cancer(NSCLC)patients.Sarcoidosis is a multisystem disease,and its reported incidence in Asia is 1 or less per 100000 people per year.The co-occurrence of sarcoidosis and ALK-positive NSCLC is rare,and ALK-positive lung cancer is likely to spread quickly.Therefore,the co-occurrence of sarcoidosis is more easily misdiagnosed as metastatic lung cancer by radiological examination.CASE SUMMARY A 50-year-old man had a nodule in the left superior lobe,many small nodules in left superior and right lungs,and enlarged bilateral hilar,mediastinal,and right supraclavicular lymph nodes.Computed tomography-guided pulmonary biopsy of the nodule in the left superior lobe revealed echinoderm microtubuleassociated protein-like 4 gene-ALK positive NSCLC with concomitant noncaseating granuloma.This patient was treated with crizotinib.Thirty days later,a chest computed tomography scan revealed a dramatic decrease in the size of the left superior lobe nodule;however,the lesions in the right lung progressed.The right supraclavicular lymph nodes showed granulomas,and no tumor cells were identified in the specimens. The angiotensin-converting enzyme level was high.After 1 wk of methylprednisolone treatment, a significant response of all lesionswas revealed. Following radical resection of the lung cancer, noncaseatinggranulomas were observed in both lung tissues and lymph nodes, which resultedin a diagnosis of echinoderm microtubule-associated protein-like 4-ALK positiveNSCLC accompanied with sarcoidosis.CONCLUSIONOur experience illustrates that pathological evidence is needed to confirmmetastatic disease, especially when some suspected metastatic lesions arenegative for malignancy. 展开更多
关键词 Lung cancer Sarcoidosis Anaplastic lymphoma kinase Echinoderm microtubule-associated protein-like 4 anaplastic lymphoma kinase Metastasis Case report
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文章速递Three-dimensional printed talar prosthesis with biological function for giant cell tumor of the talus:A case report and review of the literature 认领
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作者 Qian-Dong Yang Mi-Duo Mu +1 位作者 Xu Tao Kang-Lai Tang 《世界临床病例杂志》 SCIE 2021年第13期3147-3156,共10页
BACKGROUND Giant cell tumors(GCT)are most commonly seen in the distal femur.These tumors are uncommon in the small bones of the hand and feet,and a very few cases have been reported.A giant cell tumor of the talus is ... BACKGROUND Giant cell tumors(GCT)are most commonly seen in the distal femur.These tumors are uncommon in the small bones of the hand and feet,and a very few cases have been reported.A giant cell tumor of the talus is rarely seen clinically and could be a challenge to physicians.CASE SUMMARY We report a rare case of GCT of the talus in one patient who underwent a new reconstructive surgery technique using a three-dimensional(3D)printing talar prosthesis.The prosthesis shape was designed by tomographic image processing and segmentation using technology to match the intact side by mirror symmetry with 3D post-processing technologies.The patient recovered nearly full range of motion of the ankle after 6 mo.The visual analogue scale and American Orthopaedic Foot and Ankle Society scores were 1 and 89 points,respectively.CONCLUSION We demonstrated that 3D printing of a talar prosthesis is a beneficial option for GCT of the talus. 展开更多
关键词 Three-dimensional printing technology Giant cell tumor Talar prosthesis Case report
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