scholarly journals Polypoidal Intestinal Metaplasia and Dysplasia of the External Urethral Meatus

2012 ◽  
Vol 2012 ◽  
pp. 1-2 ◽  
Author(s):  
Mary Mathew ◽  
Bhavna Nayal ◽  
Lakshmi Rao ◽  
Raghunath Narayanan Unni ◽  
Joseph Thomas
Keyword(s):  
Intestinal Metaplasia ◽  
Urethral Stricture ◽  
Single Case ◽  
Clinical Suspicion ◽  
Pathological Examination ◽  
Rare Occurrence ◽  
Urethral Meatus ◽  
High Degree

Urethral mucosa with intestinal metaplasia and dysplasia is a rare occurrence. To date only a single case has been reported in a male with long-standing urethral stricture. We present a 33-year-old female with polypoid intestinal metaplasia and dysplasia of the external urethral meatus in the absence of an inciting factor. Intestinal metaplasia of the urethral mucosa may undergo dysplasia, emphasizing the necessity of a high degree of clinical suspicion and vigilant pathological examination of these lesions.

Resolving visual and conceptual interference among object concepts requires medial temporal lobe cortex

2019 ◽  
Author(s):  
Danielle M. Douglas ◽  
Louisa Lok Yee Man ◽  
Rachel N. Newsome ◽  
Haley Park ◽  
Hira M. Aslam ◽  
...  
Keyword(s):  
Medial Temporal Lobe ◽  
Single Case ◽  
Brain Lesion ◽  
Semantic Features ◽  
Prefrontal Cortical ◽  
Visual Interference ◽  
Multiple Stimulus ◽  
Feature Overlap ◽  
Visually Based ◽  
High Degree

Semantic features, such as prototypical visual form or function, are often shared across multiple object concepts. How, then, are we able to resolve interference between object concepts that look alike but perform different functions (e.g., hairdryer and gun) or that do similar things but look rather dissimilar (e.g., hairdryer and comb)? We examined this issue in the current neuropsychological single-case study by asking whether perirhinal cortex (PRC) critically enables resolution of interference among object concepts at the level of their conceptually- and visually-based semantic features. We tested three patients with differing lesion profiles using a novel discrimination task involving stimuli for which visual and conceptual similarity were not linked across object concepts. We found that D.A., an individual with a brain lesion that includes PRC, was impaired at discriminating among object concepts when there was a high degree conceptual and visual semantic feature overlap among choices. We replicated this result in a second testing session. Conversely, patients with selective hippocampal or ventromedial prefrontal cortical lesions were unimpaired on this task. Importantly, D.A.’s performance was intact when (i) conceptual and visual interference among object concepts was minimized, and (ii) when the discriminations involved simple stimuli that did not require assessment of multiple stimulus dimensions. These results reveal a novel semantic deficit in a patient with PRC damage, suggesting that this structure represents object concepts in a manner that can be flexibly reshaped to emphasize task relevant semantic features.

scholarly journals Euglycemic Diabetic Ketoacidosis after a Single Dose of Empagliflozin in a Patient with Pancreatitis

2021 ◽  
Vol 11 (2) ◽  
pp. 216-218
Author(s):  
Marta Brandão Calçada ◽  
Luís Fernandes ◽  
Rita Soares Costa ◽  
Sara Montezinho ◽  
Filipa Martins Duarte ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Diabetic Ketoacidosis ◽  
Drug Class ◽  
Clinical Suspicion ◽  
Laboratory Findings ◽  
Sodium Glucose Cotransporter ◽  
History Of ◽  
High Degree ◽  
Euglycemic Diabetic Ketoacidosis

Sodium-glucose cotransporter 2 inhibitors (SGLT2i) are the most recently approved drug class for the treatment of type 2 diabetes mellitus (T2D). Although they are largely well-tolerated, their intake has been associated with euglycemic diabetic ketoacidosis (DKA) in some rare cases. We report the case of a 70-year-old male with type 2 diabetes and no history of DKA, who started therapy with empagliflozin one day before presenting with acute pancreatitis and laboratory findings consistent with euglycemic DKA. SGLT2i can induce euglycemic DKA from the first dose. Given the atypical presentation, a high degree of clinical suspicion is required to recognize this complication.

scholarly journals Chronic Constrictive Pericarditis

2013 ◽  
Vol 2013 ◽  
pp. 1-4
Author(s):  
Hossein Doustkami ◽  
Afshin Hooshyar ◽  
Nasrollah Maleki ◽  
Zahra Tavosi ◽  
Iraj Feizi
Keyword(s):  
Cardiac Catheterization ◽  
Constrictive Pericarditis ◽  
Gold Standard ◽  
Elevated Serum ◽  
Disease Process ◽  
Clinical Suspicion ◽  
Rare Clinical Entity ◽  
Good Recovery ◽  
Prompt Treatment ◽  
High Degree

Constrictive pericarditis (CP) is a rare clinical entity that can pose diagnostic problems. The diagnosis of CP requires a high degree of clinical suspicion. The gold standard for diagnosis is cardiac catheterization with analysis of intracavitary pressure curves, which are high and, in end diastole, equal in all chambers. We present a patient with unexplained dyspnea, recurrent right-side pleural effusion, and ascites. Analysis of the ascitic fluid revealed a high protein content and an elevated serum-ascites gradient. Echocardiography, computed tomography, and cardiac catheterization revealed the diagnosis of CP. He underwent complete pericardiectomy and to date has made a good recovery. The diagnosis of CP is often neglected by admitting physicians, who usually attribute the symptoms to another disease process. This case exemplifies the difficulty in diagnosing this condition, as well as the investigation required, and provides a discussion of the benefit and outcomes of prompt treatment.

scholarly journals Traumatic Urethral Injury without Pelvic Fracture in an Adult Female

2010 ◽  
Vol 10 ◽  
pp. 308-310 ◽  
Author(s):  
Nathan A. Bockholt ◽  
Kenneth G. Nepple ◽  
Charles R. Powell ◽  
Karl J. Kreder
Keyword(s):  
Adult Female ◽  
Pelvic Fracture ◽  
Acetabular Fracture ◽  
Bladder Neck ◽  
Motor Vehicle ◽  
Urethral Catheter ◽  
Urethral Injury ◽  
Rare Occurrence ◽  
Urethral Meatus ◽  
Vehicle Collision

A 23-year-old female was involved in a motor vehicle collision with multiple injuries, including a right acetabular fracture, but no pelvic fracture. Urology consultation was obtained due to difficulty placing a urethral catheter. Examination revealed a longitudinal urethral tear with vaginal laceration extending 2 cm from the urethral meatus proximally toward the bladder neck. The longitudinal urethral tear was repaired primarily. Traumatic female urethral injury in the absence of a pelvic fracture is an exceedingly rare occurrence.

scholarly journals A rare benign genitourinary tumor in a Japanese male: urinary retention owing to aggressive angiomyxoma of the prostate

Rare Tumors ◽  
2010 ◽  
Vol 2 (1) ◽  
pp. 43-45 ◽  
Author(s):  
Yugo Sawada ◽  
Fumio Ito ◽  
Hayakazu Nakazawa ◽  
Nobuhiko Tsushima ◽  
Hikaru Tomoe ◽  
...  
Keyword(s):  
Renal Dysfunction ◽  
Urinary Retention ◽  
Bladder Neck ◽  
English Literature ◽  
Pathological Examination ◽  
Aggressive Angiomyxoma ◽  
Urethral Meatus ◽  
First Case ◽  
Japanese Male ◽  
Old Japanese

Close examination of a 67-year-old Japanese man, who complained of persistent nocturia, revealed that a semitransparent polypoid tumor had developed from the bladder neck to the prostatic urethra obstructing the internal urethral meatus, which resulted in excessive urinary retention and post-renal dysfunction. The tumor was resected by a transurethral procedure and a pathological examination of specimens revealed aggressive angiomyxoma (AAM) of the prostate. AAM usually develops in the intrapelvic and perineal organs of females. So far as we know, this is the second case of primary prostatic AAM reported in the English literature, and is the first case where the patient encountered urethral obstruction.

scholarly journals Rare Occurrence of Inhibitors in Von Willebrand Disease: A Case Report

2022 ◽  
Vol 8 ◽  
Author(s):  
Bipin P. Kulkarni ◽  
Kirti Ghargi ◽  
Chandrakala Shanmukhaiah ◽  
Shrimati D. Shetty
Keyword(s):  
Correct Diagnosis ◽  
Severe Form ◽  
Von Willebrand Disease ◽  
Rare Occurrence ◽  
Standard Assay ◽  
Type 3 ◽  
Von Willebrand ◽  
High Degree ◽  
Willebrand Factor ◽  
Inhibitor Titer

Introduction: Type 3 Von Willebrand Disease (VWD) is the least common but the most severe form of a disease, with a prevalence of about 0. 5 to 1 per million in Western countries. The prevalence of type 3 VWD in the developing countries, with a high degree of consanguinity, is about 6 per million. Moreover, due to underdiagnosis of the milder cases, the prevalence of type 3 VWD is about 50% of the cases. Rarely, some patients develop the Von Willebrand Factor (VWF) inhibitors, which may subsequently develop severe anaphylactic reactions on further exposure to the VWF containing factor replacement therapy. The prevalence of inhibitor development in patients with type 3 VWD has been shown to be in the range of 5.8 to 9.5%. In the absence of a gold standard assay for the quantitation of VWF inhibitors, a correct diagnosis and management of these patients are often challenging.Objectives: The objective of this study is to standardize the Bethesda assay for the VWF inhibitors and to estimate the VWD inhibitor titer in two cases of congenital type 3 VWD, which developed the VWF inhibitors.Results and Conclusions: We could successfully standardize the Bethesda assay for the quantitation of VWF inhibitors in two patients with congenital type 3 VWD with inhibitors.

scholarly journals Rare Fetus-in-Fetu: Experience From a Large Tertiary Pediatric Referral Center

2021 ◽  
Vol 9 ◽  
Author(s):  
Mao Xiaowen ◽  
Cheng Lingxi ◽  
Lin Song ◽  
Pan Shengbao ◽  
Yang Xiaohong ◽  
...  
Keyword(s):  
Open Surgery ◽  
Clinical Characteristics ◽  
Ultrasound Examination ◽  
Single Case ◽  
Case Reports ◽  
Alpha Fetoprotein ◽  
Pathological Examination ◽  
Fetus In Fetu ◽  
Antenatal Ultrasound ◽  
Referral Center

Objective: Fetus-in-fetu (FIF) is an extremely rare disease, and most prior publications are single case reports. Here, we describe the clinical characteristics, imaging manifestations, and the treatment and related complications of FIF from a large tertiary pediatric referral center.Materials: After institutional review board approval, patients with a diagnosis of FIF between January 2010 and November 2019 were further selected and reexamined. We analyzed the general clinical characteristics, imaging manifestations, treatment, and prognosis of the patients.Results: A total of seven (four male and three female) patients with FIF were included in the study. All patients were diagnosed with FIF during the antenatal ultrasound examination along with an abnormal increase in alpha fetoprotein, and it was confirmed by subsequent pathological examination. The median gestation period when FIF was first diagnosed was 25 (range: 22–32) weeks. Ultrasound, computed tomography, and magnetic resonance imaging were the main pre-operative diagnostic techniques used. All patients underwent FIF resection within 1 month after birth: four patients had open surgery and three had laparoscopic surgeries (one case was converted to open surgery); only one patient developed ascites after surgery. All patients are growing up healthy and without tumor recurrence at the last follow-up. The level of alpha fetoprotein decreased to normal within 1 year (range 3-10 months) after surgery performed.Conclusion: As the size of the FIF increases, it can be found and diagnosed in antenatal ultrasound examination. Surgery is an important curative treatment for FIF and generally results in excellent long-term quality of life.

scholarly journals The largest reported intrathoracic lipoma: a case report and current perspectives review

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Mohammed Aldahmashi ◽  
Abdalmotaleb Elmadawy ◽  
Mahmoud Mahdy ◽  
Mohamed Alaa
Keyword(s):  
Single Case ◽  
Tumor Resection ◽  
Pathological Examination ◽  
Complete Excision ◽  
Case Presentation ◽  
Medical Checkup ◽  
Excellent Outcome ◽  
The Right ◽  
Intrathoracic Mass

Abstract Background The huge size intrathoracic lipomas are very rare. Few cases have been reported worldwide. To our knowledge, this presented case is one of the few cases reported. Here we report a single case as very huge intrathoracic lipoma compressing the right lung and displacing the diaphragm and liver downward. It has been managed by right posterolateral thoracotomy and complete excision, with excellent outcome. Case presentation A 32-year-old male presented with a symptomatic right intrathoracic mass, which was confirmed to be a lipomatous tumor using computed tomography. A penduculated tumor originating from the mediastinal pleura was resected through the conventional right posterior thoracotomy. Pathological examination indicated a diagnosis of fibrolipoma. Conclusion The tumor was symptomatic and relatively huge when detected during a medical checkup. This enabled the successful tumor resection via conventional thoracotomy approach. Although intrathoracic lipomas are histologically benign, careful observation and follow-up are crucial due to the possibility of recurrence.

scholarly journals Treatment of Ethylene Glycol Poisoning with Oral Ethyl Alcohol

2019 ◽  
Vol 2019 ◽  
pp. 1-3
Author(s):  
B. Achappa ◽  
D. Madi ◽  
T. Kanchan ◽  
N. K. Kishanlal
Keyword(s):  
Oxalic Acid ◽  
Ethylene Glycol ◽  
Ethyl Alcohol ◽  
Glycolic Acid ◽  
Clinical Suspicion ◽  
Toxic Metabolites ◽  
Ethylene Glycol Poisoning ◽  
High Degree

Ethylene glycol poisoning is not uncommon in India. The ill effects are primarily caused by its toxic metabolites: glycolic acid and oxalic acid. A 70-year-old female presented to our hospital with ataxia after ingestion of ethylene glycol. The reported case describes the management of ethylene glycol poisoning using oral ethyl alcohol as an alternative to the recommended intravenous ethyl alcohol and fomepizole that are not available for use in India. The need for high degree of clinical suspicion, targeted investigations, and early instigation of treatment is of prime importance in cases of ethylene glycol poisoning as it can lead to long-term complications or even death.

scholarly journals The evolving role of endoscopy in the diagnosis of premalignant gastric lesions

F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 715 ◽  
Author(s):  
William Waddingham ◽  
David Graham ◽  
Matthew Banks ◽  
Marnix Jansen
Keyword(s):  
Risk Assessment ◽  
Intestinal Metaplasia ◽  
Narrow Band Imaging ◽  
Sampling Error ◽  
Evolutionary Model ◽  
Chronic Atrophic Gastritis ◽  
Recent Advances ◽  
Increased Risk ◽  
High Degree

Gastric adenocarcinoma is a disease that is often detected late, at a stage when curative treatment is unachievable. This must be addressed through changes in our approach to the identification of patients at increased risk by improving the detection and risk assessment of premalignant changes in the stomach, including chronic atrophic gastritis and intestinal metaplasia. Current guidelines recommend utilising random biopsies in a pathology-led approach in order to stage the extent and severity of gastritis and intestinal metaplasia. This random method is poorly reproducible and prone to sampling error and fails to acknowledge recent advances in our understanding of the progression to gastric cancer as a non-linear, branching evolutionary model. Data suggest that recent advances in endoscopic imaging modalities, such as narrow band imaging, can achieve a high degree of accuracy in the stomach for the diagnosis of these premalignant changes. In this review, we outline recent data to support a paradigm shift towards an endoscopy-led approach to diagnosis and staging of premalignant changes in the stomach. High-quality endoscopic interrogation of the chronically inflamed stomach mucosa, supported by targeted biopsies, will lead to more accurate risk assessment, with reduced rates of under or missed diagnoses.

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