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Nina S Cohen, Michael J Goretsky, Robert J Obermeyer
BACKGROUND: Hemorrhage during Nuss bar removal is an uncommon but feared complication that can be life threatening if not controlled rapidly. This study aims to identify the incidence and sources of large volume hemorrhage, discuss successful management strategies, and provide patient care recommendations. METHODS: An IRB approved (#15-11-WC-0214), single institution retrospective chart review was performed on patients who underwent Nuss bar removal over a 15-year interval...
June 20, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Jacob R Bledsoe, Emanuel Della-Torre, Lucrezia Rovati, Vikram Deshpande
Immunoglobulin G4-related disease (IgG4-RD) is an uncommon disorder that demonstrates characteristic clinicopathologic features including sclerosing lesions with storiform fibrosis, increased IgG4+ plasma cells with an increased IgG4+/IgG+ plasma cell ratio, obliterative phlebitis, and often an increased serum IgG4 level. This review summarizes the characteristic histopathologic and clinical features of IgG4-RD with detailed discussion of the histopathologic characteristics of the most commonly involved anatomic sites...
June 2018: APMIS: Acta Pathologica, Microbiologica, et Immunologica Scandinavica
Daniela Gomes Cunha, Luiza Erthal de Britto Pereira Kassuga-Roisman, Luisa Kelmer Côrtes de Barros Silveira, Fabiane Carvalho de Macedo
Clear cell acanthoma is an uncommon type of benign epithelial tumor. Typically, it is a solitary lesion found on the lower limbs. It presents as a nodule or small plaque with slow and well-defined growth. Diagnosis used to be clinical and histopathological, but the advent of dermoscopy has led to an increase in diagnostic accuracy. We describe a case in which dermoscopy proved highly useful for diagnosis of the lesion.
June 2018: Anais Brasileiros de Dermatologia
Lixia Sun, Yaru Dong, Xin Wang, Baihui Shan, Min Zhang
RATIONALE: Sporotrichosis is the most common subcutaneous mycosis. It is caused by the dimorphic fungus Sporothrix schenckii. Ocular sporotrichosis is uncommon and has been rarely reported. PATIENT CONCERNS: We describe a 34-year-old female who presented with a nodule increasing in size near the medial angle of the left eye. Originally, she was misdiagnosed with a dacryocyst space-occupying lesion, and the lesion was removed by surgery. DIAGNOSES: Findings of fungal structures in the histopathological examination contributed to the diagnosis of Sporothrix dacryocystitis...
June 2018: Medicine (Baltimore)
Yilun Wang, Min Zhu, Yunqi Bao, Li Li, Liping Zhu, Feng Li, Jinhua Xu, Jun Liang
RATIONALE: Cutaneous mucormycosis is an uncommon disease and occurs rarely in immunocompetent patients. PATIENT CONCERNS: We reported the case of a 37-year-old man presenting with a skin lesion on the left side of the chest wall with no history of trauma or primary diseases. He was firstly misdiagnosed as tuberculosis and the proper treatment was thus delayed. DIAGNOSES: Histopathological examination and fungal culture of the lesion confirmed cutaneous mucormycosis...
June 2018: Medicine (Baltimore)
Renwei Chen, Xicheng Deng, Jinwen Luo, Peng Huang
INTRODUCTION: Cardiac myxomas are the most frequent primary cardiac tumor in adults. The incidence in pediatric patients is extremely low. Heavy calcification of an atrial myxoma is uncommon in children. CASE PRESENTATION: An 18-month-old boy was admitted for a significant precordial systolic murmur. Transthoracic echocardiography revealed a cardiac mass extending from the inferior vena cava across the right atrium and tricuspid valve into the right ventricle with severe tricuspid regurgitation...
June 2018: Medicine (Baltimore)
Chang Hwa Hong, Young Koo Lee, Sung Hun Won, Dhong Won Lee, Sang Il Moon, Woo Jong Kim
RATIONALE: Tarsal tunnel syndrome (TTS) is a compressive neuropathy of the posterior tibial nerve or one of its branches within the tarsal tunnel that is often caused by a variety of space-occupying lesions, such as ganglia, lipomas, varicosities, neural tumors, trauma, or systemic disease. The os sustentaculi is a small accessory bone, bridged to the posterior aspect of the sustentaculum tali by fibrocartilage. To the best of our knowledge, this is a rare case of successful treatment of TTS caused by the os sustantaculi...
June 2018: Medicine (Baltimore)
Andrew L J Dunn, Jerad M Gardner, Jennifer R Kaley, William Bellamy, Sara C Shalin
Recent studies have identified kinase fusions in Spitzoid melanocytic neoplasms, and approximately 10% of Spitzoid neoplasms harbor anaplastic lymphoma kinase (ALK) rearrangements and corresponding ALK immunoreactivity. Deep penetrating nevi (DPN), a subset of melanocytic neoplasms, have histologic and immunohistochemical overlap that have historically supported classification of DPN with blue/cellular blue nevi (CBN). However, HRAS mutations have rarely been detected in DPN, thereby also linking them to Spitz nevi...
July 2018: American Journal of Dermatopathology
Sally L Painter, Zuzana Sipkova, Beatrice Emmanouil, Dorothy Halliday, Allyson Parry, John S Elston
OBJECTIVE: Neurofibromatosis type 2 (NF2) is an uncommon but well-recognized disorder characterized by multiple schwannomas and meningiomas. Adults typically present with hearing loss and balance disturbance, and children with ocular, dermatological, and neurological signs. Clinical diagnosis is confirmed by neuroimaging and genetic testing. Although ophthalmic features are present in patients with NF2, there are no reports correlating genetic severity subtypes with ophthalmic involvement...
June 19, 2018: Journal of Neuro-ophthalmology: the Official Journal of the North American Neuro-Ophthalmology Society
Keisuke Obase, Greg W Douhan, Yosuke Matsuda, Matthew E Smith
Cenococcum geophilum forms sclerotia and ectomycorrhizas with host plants in forest soils. We demonstrated the differences in genetic diversity of C. geophilum between cultured isolates from sclerotia and those from ectomycorrhizal roots in the same 73 soil samples based on glyceraldehyde-3-phosphate dehydrogenase (GAPDH) gene sequences and newly developed microsatellite markers. Based on GAPDH sequences, 759 cultured isolates (553 from sclerotia and 206 from ectomycorrhizas) were classified into 107 "genotypes" with sequence variation of up to 8...
April 18, 2018: Mycologia
Arish Noor, Amruta Panwala, Faripour Forouhar, George Y Wu
Herpes virus hepatitis varies in presentation, ranging from asymptomatic to acute liver failure, in both immunocompetent and immunocompromised individuals. Hepatitis caused by herpes viridae family is uncommon and usually results in mild diseases. It is also often self-limited, although in certain populations especially immunosuppressive patients it can cause severe infections, leading to acute to fulminant hepatic failure. In addition, some isolated cases of fulminant disease in immunocompetent individuals have been reported...
June 20, 2018: Journal of Digestive Diseases
Prashanth Rawla, Tagore Sunkara, Krishna Chaitanya Thandra, Vinaya Gaduputi
Hypertriglyceridemia (HTG) is an uncommon but well-established cause of acute pancreatitis (AP) comprising up to 7% of the cases. The clinical course of HTG-induced pancreatitis (HTGP) is highly similar to that of AP of other etiologies with HTG being the only distinguishing clinical feature. However, HTGP is often correlated with higher severity and elevated complication rate. At present, no approved treatment guideline for the management of HTGP is available, although different treatment modalities such as insulin, heparin, fibric acids, and omega 3 fatty acids have been successfully implemented to reduce serum triglycerides (TG)...
June 19, 2018: Clinical Journal of Gastroenterology
Desmond P Kidd
OBJECTIVE: Neurological complications of systemic sarcoidosis are uncommon and the natural history and optimal treatments under-researched. With the advent of modern biological therapies, it is important to define the clinical characteristics and immunopathology of the disease. METHODS: Patients referred to and treated within the Centre for Neurosarcoidosis over a 15 year period who had biopsy-proven "highly probable" disease of the central nervous system were studied prospectively...
June 19, 2018: Journal of Neurology
Douglas Greer, Sean Heywood, David Croaker, Siva Gananadha
BACKGROUNDS: Gallstone disease and cholecystectomy have been uncommon in paediatric patients and associated with haemolytic disease and prematurity. Many countries have observed an increase in the prevalence of paediatric gallstones and cholecystectomy with increasing childhood obesity. The purpose of this study was to determine any trend in prevalence in Australian children and the role of obesity. METHODS: Chart review was conducted for patients undergoing cholecystectomy under 18 in 25 years between 1992 and 2016...
June 19, 2018: Pediatric Surgery International
Kosar Hussain, Sara Hussain, Jawed Abubaker, Raees Ahmed
An elderly, bed ridden patient with a history of stroke was admitted for management of aspiration pneumonia. Two days after insertion of a nasopharyngeal airway, sudden respiratory distress prompted further investigations which led to the eventual diagnosis and removal of the nasopharyngeal airway that had been aspirated. The device was removed under conscious sedation with fiber optic bronchoscopy.
June 2018: Turkish Journal of Emergency Medicine
Eric Donn, Ian Atkinson, Andrew McCague
Hemorrhagic cholecystitis is an uncommon form of acute cholecystitis which can be rapidly fatal. It may be hard to detect as it frequently presents with symptoms found in other, more common diagnoses. We report the case of a 63 year old man recently started on anticoagulation for deep vein thrombosis who was found to have hemorrhagic cholecystitis.
April 2018: Surgery Journal
Layth Al Attar, Aarati Keshary, Raid Abu-Awwad
Radiologic findings are important in narrowing differential diagnosis. This becomes imperative in unusual presentation of diseases. An uncommon finding on lung imaging is Cheerios signs. It is described as lesions with hypodense center and noticeable rim. These lesions are associated with bronchioloalveolar carcinoma representing lepidic growth. We present a case of rapidly worsening shortness breath and cough. Initial computed tomography scan of the chest showed cystic lesions on ground glass background in both lungs...
April 17, 2018: Curēus
M N Baig, Abdul Halim Dzufar, Colin G Murphy, Bill Curtin
Lateral femoral prosthesis perforation is an uncommon periprosthetic fracture. Periprosthetic fractures may be fixed with open reduction and internal fixation, or with revision arthroplasty, depending on the type of fracture, the condition of the host bone in the proximal femur, the stability of the implant, and occasionally the medical co-morbidities of the patient. Proximal femoral replacement is a complex and challenging procedure but provides a better chance of early mobilisation. We describe a case of treating a 71-year-old woman who presented with an unusual type of periprosthetic fracture, treated with a revision arthroplasty procedure using a proximal femur replacement...
April 17, 2018: Curēus
Vladimir Neychev, Vesela Ivanova, Tihomir Dikov, Georgi Todorov
A 67-year-old woman presented with clinical symptoms, radiological findings, and preoperative work-up highly suggestive of advanced stage IV carcinoma of the gallbladder (CG). An extended cholecystectomy with the excision of adjacent liver segments and loco-regional lymphadenectomy was performed. Final pathology results revealed diffuse xanthogranulomatous cholecystitis (XG) with ruptured Rokitansky-Aschoff sinuses with tumor-resembling adenomyosis without atypical or malignant cells. There was a reactive inflammatory and fatty degeneration of the adjacent hepatic tissue and a nonspecific inflammatory reaction of the enlarged periportal lymph nodes...
April 17, 2018: Curēus
Kelly Carmichael, Daniel Torres, Carlos J Jimenez, Matthew C Comley, Ernest B Evans
In this article, we report a case series on spanning external fixation for the treatment of open joint burn injuries in a pediatric population. We reviewed the case logs of all orthopedic surgeons from 2000 to 2010 at a burn hospital to identify pediatric patients with open joints secondary to burn injuries. Nine patients who sustained open joint injuries after a burn and treated with a spanning external fixator (SEF) were identified. Characteristics of the burns included: five elbow, four knee; seven flame, two electrical; average total body surface area affected 49...
April 16, 2018: Curēus
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