Anteja Krištić, L. Pažanin, Filip Kučak, Monica Stephany Kirigin, D. Katušin, B. Krušlin
Segmental testicular infarction is a rare cause of acute scrotum and can easily masquerade as a tumor on ultrasonography and color Doppler imaging. The present report of three cases describes three patients with segmental testicular infarction, which were all suspicious for tumor on ultrasonography/color Doppler imaging. All of the cases were finally diagnosed by pathological examination. It is hypothesized that if the arterial flow is impaired because of abnormalities in arteries, excessive intrascrotal movement of testis, torsion and detorsion (which are all risks with the bell-clapper anomaly) or an unobserved interruption of an arterial blood flow during operations, predisposition to a partial infarct will result, mostly in the upper pole of the testis. In this report, first case of infarction was in the center of the testis, second one in the lower pole and third in the upper pole. Third case had a small concurrent seminoma which was discovered microscopically on the permanent HE slides of the intraoperative biopsy. We could not find such a case in the literature. It is debatable if the cause of the infarction in this case is because of an anomaly in some vessel or because of the possible cancer-associated thrombosis of the adjacent seminoma. Diagnosis of segmental testicular infarction is a radiological problem in standard practice and the final diagnosis still belongs to the pathologist. Intraoperative biopsy is a fiducial option for correct diagnosis of the segmental lesion in testis of unsure origin.
{"title":"Segmental Infarction of the Testis: Report of Three Cases","authors":"Anteja Krištić, L. Pažanin, Filip Kučak, Monica Stephany Kirigin, D. Katušin, B. Krušlin","doi":"10.26502/acmcr.96550620","DOIUrl":"https://doi.org/10.26502/acmcr.96550620","url":null,"abstract":"Segmental testicular infarction is a rare cause of acute scrotum and can easily masquerade as a tumor on ultrasonography and color Doppler imaging. The present report of three cases describes three patients with segmental testicular infarction, which were all suspicious for tumor on ultrasonography/color Doppler imaging. All of the cases were finally diagnosed by pathological examination. It is hypothesized that if the arterial flow is impaired because of abnormalities in arteries, excessive intrascrotal movement of testis, torsion and detorsion (which are all risks with the bell-clapper anomaly) or an unobserved interruption of an arterial blood flow during operations, predisposition to a partial infarct will result, mostly in the upper pole of the testis. In this report, first case of infarction was in the center of the testis, second one in the lower pole and third in the upper pole. Third case had a small concurrent seminoma which was discovered microscopically on the permanent HE slides of the intraoperative biopsy. We could not find such a case in the literature. It is debatable if the cause of the infarction in this case is because of an anomaly in some vessel or because of the possible cancer-associated thrombosis of the adjacent seminoma. Diagnosis of segmental testicular infarction is a radiological problem in standard practice and the final diagnosis still belongs to the pathologist. Intraoperative biopsy is a fiducial option for correct diagnosis of the segmental lesion in testis of unsure origin.","PeriodicalId":72280,"journal":{"name":"Archives of clinical and medical case reports","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69344411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Acute skin failure is an event in which skin and underlying tissue die due to hypoperfusion concurrent with a critical illness [1]. Usually skin hypoperfusion is a late symptom in a shock setting and it is present in patients with an advanced multiorgan failure (MOF) dysfunction. Acute skin damage is mainly present in feet and hands as consequence of distal hypoperfusion due to hypotension or microthrombotic events [2]. Face is less commonly affected. In some cases of purpura fulminas there is anyway an important face skin involvement. Purpura fulminans is usually associated with meningococcal sepsis, varicella, and pneumococcal infections andor coagulation disorders [3-4]. We present the clinical case of a young woman occurring at our hospital with nose skin necrosis as first sing of shock setting.
{"title":"Nose Necrosis in Female Shocked Patient: Conservative Treatment with Heparin","authors":"Marco Stabile, L. Rosato, V. Navach","doi":"10.26502/acmcr.96550625","DOIUrl":"https://doi.org/10.26502/acmcr.96550625","url":null,"abstract":"Acute skin failure is an event in which skin and underlying tissue die due to hypoperfusion concurrent with a critical illness [1]. Usually skin hypoperfusion is a late symptom in a shock setting and it is present in patients with an advanced multiorgan failure (MOF) dysfunction. Acute skin damage is mainly present in feet and hands as consequence of distal hypoperfusion due to hypotension or microthrombotic events [2]. Face is less commonly affected. In some cases of purpura fulminas there is anyway an important face skin involvement. Purpura fulminans is usually associated with meningococcal sepsis, varicella, and pneumococcal infections andor coagulation disorders [3-4]. We present the clinical case of a young woman occurring at our hospital with nose skin necrosis as first sing of shock setting.","PeriodicalId":72280,"journal":{"name":"Archives of clinical and medical case reports","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69344470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In this article, we report the first case of embryonic cardiomyocyte implantation in a patient with severe ischemic heart lesions. In 1998, a 58-year-old male underwent coronary artery bypass grafting supplemented by injection of a pre-prepared suspension of human embryonic cardiomyocytes. During the next 24 years, the patient felt well and reported quite satisfactory quality of life. He is currently 82 years old and also feels well. He has no signs of circulatory insufficiency. No complications associated with cell implantation were observed during the entire follow-up period.
{"title":"Implantation of Embryonic Cardiomyocytes in a Post-Infarction Myocardium: A Long-Term Outcome after 25 Years of Follow-Up.","authors":"Yu L Schevchenko, V G Gudymovich","doi":"10.26502/acmcr.96550583","DOIUrl":"https://doi.org/10.26502/acmcr.96550583","url":null,"abstract":"<p><p>In this article, we report the first case of embryonic cardiomyocyte implantation in a patient with severe ischemic heart lesions. In 1998, a 58-year-old male underwent coronary artery bypass grafting supplemented by injection of a pre-prepared suspension of human embryonic cardiomyocytes. During the next 24 years, the patient felt well and reported quite satisfactory quality of life. He is currently 82 years old and also feels well. He has no signs of circulatory insufficiency. No complications associated with cell implantation were observed during the entire follow-up period.</p>","PeriodicalId":72280,"journal":{"name":"Archives of clinical and medical case reports","volume":"7 2","pages":"114-119"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10078966/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9272310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Linas Davainis, Dominyka Vasilevska, A. Žučenka, Birutė Davainienė, R. Pileckyte, Laimonas Griskvevicius
{"title":"A Severe Case of Invasive Rhino-Orbito-Cerebral Mucormycosis in a Patient with Acute T-Cell Leukemia with Successful Outcome: a Case Report and a Literature Review","authors":"Linas Davainis, Dominyka Vasilevska, A. Žučenka, Birutė Davainienė, R. Pileckyte, Laimonas Griskvevicius","doi":"10.26502/acmcr.96550572","DOIUrl":"https://doi.org/10.26502/acmcr.96550572","url":null,"abstract":"","PeriodicalId":72280,"journal":{"name":"Archives of clinical and medical case reports","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69343880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Endobronchial Ultrasound transbronchial needle aspiration (EBUS-TBNA) is currently considered as the gold standard technique for the assessment of mediastinal, hilar and centrally located lymph nodes and tumours. However, the ideal approach to sedation and oxygen supplementation during the procedure has not been clearly defined especially in particular clinical scenarios like total laryngectomy patients. In the following article we present the case of an EBUS-TBNA in a total laryngectomy patient done under moderate sedation and oxygenation using a heated High Flow Nasal Oxygen canula. The purpose of this case report is to shed light on the feasibility of the procedure under moderate sedation and the utility of the HFNO in special patients as those having a total laryngectomy.
{"title":"A case of EBUS-TBNA in a Total Laryngectomy Patient using High Flow Nasal Oxygen","authors":"Ralph Nehme","doi":"10.26502/acmcr.96550575","DOIUrl":"https://doi.org/10.26502/acmcr.96550575","url":null,"abstract":"Endobronchial Ultrasound transbronchial needle aspiration (EBUS-TBNA) is currently considered as the gold standard technique for the assessment of mediastinal, hilar and centrally located lymph nodes and tumours. However, the ideal approach to sedation and oxygen supplementation during the procedure has not been clearly defined especially in particular clinical scenarios like total laryngectomy patients. In the following article we present the case of an EBUS-TBNA in a total laryngectomy patient done under moderate sedation and oxygenation using a heated High Flow Nasal Oxygen canula. The purpose of this case report is to shed light on the feasibility of the procedure under moderate sedation and the utility of the HFNO in special patients as those having a total laryngectomy.","PeriodicalId":72280,"journal":{"name":"Archives of clinical and medical case reports","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69343885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Anil K. Chokkalla, David L Paul, E. Tam, S. Devaraj
Thyroid-stimulating hormone (TSH) measurement is central to the diagnostic workup of thyroid diseases. TSH activity is inverse log-linearly related to thyroxine (T4) hormone levels. An isolated elevation of TSH with normal T4 is defined as subclinical hypothyroidism, which is treated by hormone replacement therapy. TSH immunoassays are prone to various interferences, including biotin, heterophile antibodies and macro-TSH complexes. These interferences often lead to misdiagnosis of thyroid dysfunction, potentiating unnecessary clinical investigation and management. This case reports a spuriously elevated TSH in a clinically euthyroid 17-year-old female with a past medical history of Hashimoto’s thyroiditis. By performing a series of troubleshooting experiments such as serial measurement, dilution tests and polyethylene glycol precipitation, we demonstrated potential interference due to the macro-TSH complex.
{"title":"Immunoassay Interference due to Macro-TSH: A Case Study of a Pediatric Patient with Hashimoto's Thyroiditis","authors":"Anil K. Chokkalla, David L Paul, E. Tam, S. Devaraj","doi":"10.26502/acmcr.96550585","DOIUrl":"https://doi.org/10.26502/acmcr.96550585","url":null,"abstract":"Thyroid-stimulating hormone (TSH) measurement is central to the diagnostic workup of thyroid diseases. TSH activity is inverse log-linearly related to thyroxine (T4) hormone levels. An isolated elevation of TSH with normal T4 is defined as subclinical hypothyroidism, which is treated by hormone replacement therapy. TSH immunoassays are prone to various interferences, including biotin, heterophile antibodies and macro-TSH complexes. These interferences often lead to misdiagnosis of thyroid dysfunction, potentiating unnecessary clinical investigation and management. This case reports a spuriously elevated TSH in a clinically euthyroid 17-year-old female with a past medical history of Hashimoto’s thyroiditis. By performing a series of troubleshooting experiments such as serial measurement, dilution tests and polyethylene glycol precipitation, we demonstrated potential interference due to the macro-TSH complex.","PeriodicalId":72280,"journal":{"name":"Archives of clinical and medical case reports","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69343946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rony Carlos Preti, Lívia da Silva Conci, L. P. Cunha, Sérgio Luís Gianotti Pimentel, L. Zacharias, M. L. Ribeiro Monteiro
Purpose : To describe a case of atypical full-thickness macular hole (FTMH) in a patient with pachychoroid spectrum disease. The efficacy of surgical intervention is discussed. Observations: A 64-year-old woman presented with poor vision and metamorphopsia in her left eye (OS). Swept-Source Optical Coherence Tomography (SS-OCT) revealed a grade II FTMH in association with serous macular detachment and indocyanine green angiography (ICGA) showed choroidal hyperpermeability in OS. The patient underwent pars plana vitrectomy (PPV), inner limiting membrane peel, and 20% SF6 gas fill. Macular hole closure was achieved successfully on early postoperative, with opening of FTMH in the right eye in the first posoperative week when patient in positioning. Unusual hyper-autoflurescent peripapillary spots appeared in OS early after PPV with slowly resolution, but followed by RPE mottling. Complete subretinal fluid reabsorption was observed only at 12 months of follow-up. Conclusions and Importance : FTMH with large subretinal detachment can still be closed with standard PPV technique without fluid drainage. Atypical evolution of this case could be explained by the overlapping of two distinct eye conditions (vitreoretinal interface disease and central serous chorioretinopathy). Multimodal imaging was a useful tool for diagnostic and long-term follow-up significantly helping to understand the unusual postoperative evolution of the case.
{"title":"Surgical Management of Full-Thickness Macular Hole In A Patient with Pachychoroid Spectrum Disease with Atypical Fundus Autofluorescence After Surgery","authors":"Rony Carlos Preti, Lívia da Silva Conci, L. P. Cunha, Sérgio Luís Gianotti Pimentel, L. Zacharias, M. L. Ribeiro Monteiro","doi":"10.26502/acmcr.96550594","DOIUrl":"https://doi.org/10.26502/acmcr.96550594","url":null,"abstract":"Purpose : To describe a case of atypical full-thickness macular hole (FTMH) in a patient with pachychoroid spectrum disease. The efficacy of surgical intervention is discussed. Observations: A 64-year-old woman presented with poor vision and metamorphopsia in her left eye (OS). Swept-Source Optical Coherence Tomography (SS-OCT) revealed a grade II FTMH in association with serous macular detachment and indocyanine green angiography (ICGA) showed choroidal hyperpermeability in OS. The patient underwent pars plana vitrectomy (PPV), inner limiting membrane peel, and 20% SF6 gas fill. Macular hole closure was achieved successfully on early postoperative, with opening of FTMH in the right eye in the first posoperative week when patient in positioning. Unusual hyper-autoflurescent peripapillary spots appeared in OS early after PPV with slowly resolution, but followed by RPE mottling. Complete subretinal fluid reabsorption was observed only at 12 months of follow-up. Conclusions and Importance : FTMH with large subretinal detachment can still be closed with standard PPV technique without fluid drainage. Atypical evolution of this case could be explained by the overlapping of two distinct eye conditions (vitreoretinal interface disease and central serous chorioretinopathy). Multimodal imaging was a useful tool for diagnostic and long-term follow-up significantly helping to understand the unusual postoperative evolution of the case.","PeriodicalId":72280,"journal":{"name":"Archives of clinical and medical case reports","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69344055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Tuberculosis of the Male Breast Mimicking Breast Cancer. A Case Report from Low-Resource Country","authors":"Kenfack B, Atemkeng Tsatedem F, Fouogue Tsuala J, Dobgima Pisoh W, Kenfack Bc, Sando Z","doi":"10.26502/acmcr.96550596","DOIUrl":"https://doi.org/10.26502/acmcr.96550596","url":null,"abstract":",","PeriodicalId":72280,"journal":{"name":"Archives of clinical and medical case reports","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69344112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. P. Manzano, João Henrique Sendrete de Pinho, Thainã de Oliveira Azambuja, D. S. Constantin, Vinicius Meneguette Gomes de Souza, Ricardo Luis Vita Nunes, Jaime Comar Filho, Frederico Teixeira Barbosa
Benign prostatic hyperplasia (BPH) is a common condition among older men that causes lower urinary tract symptoms. Although pharmacological treatments are available, surgery is often required. The development of surgical techniques has progressed, with robotic simple prostatectomy (RASP) being one of the minimally invasive techniques for larger prostates. However, ejaculatory dysfunction remains a common postoperative problem of BPH surgery, significantly impacting patients' quality of life. In 1990, Dixon et al. were the first to describe the urethral-sparing approach, which maintained anterograde ejaculation
{"title":"Urethral-Sparing Robot-Assisted Simple Prostatectomy: Case Series of the Initial Experience of a Brazilian Surgical Center","authors":"J. P. Manzano, João Henrique Sendrete de Pinho, Thainã de Oliveira Azambuja, D. S. Constantin, Vinicius Meneguette Gomes de Souza, Ricardo Luis Vita Nunes, Jaime Comar Filho, Frederico Teixeira Barbosa","doi":"10.26502/acmcr.96550600","DOIUrl":"https://doi.org/10.26502/acmcr.96550600","url":null,"abstract":"Benign prostatic hyperplasia (BPH) is a common condition among older men that causes lower urinary tract symptoms. Although pharmacological treatments are available, surgery is often required. The development of surgical techniques has progressed, with robotic simple prostatectomy (RASP) being one of the minimally invasive techniques for larger prostates. However, ejaculatory dysfunction remains a common postoperative problem of BPH surgery, significantly impacting patients' quality of life. In 1990, Dixon et al. were the first to describe the urethral-sparing approach, which maintained anterograde ejaculation","PeriodicalId":72280,"journal":{"name":"Archives of clinical and medical case reports","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69344135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Teaching NeuroImages: Bilateral Occlusion of the Central Retinal Vein due to Excess of Factor VIII Level","authors":"B. H, Kouame H, Oukkache B","doi":"10.26502/acmcr.96550611","DOIUrl":"https://doi.org/10.26502/acmcr.96550611","url":null,"abstract":"","PeriodicalId":72280,"journal":{"name":"Archives of clinical and medical case reports","volume":"42 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69344259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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