{"title":"Elongated styloid process and cervical spondylosis.","authors":"Zeliha Unlu, Sebnem Orguc, Gorkem Eskiizmir, Asim Aslan, Petek Bayindir","doi":"10.4137/ccrep.s792","DOIUrl":"https://doi.org/10.4137/ccrep.s792","url":null,"abstract":"<p><strong>Background: </strong>Dysphagia, is a significant sign of many different lesions in upper digestive system especially in proximal esophagus. Tumors, gastroesophageal reflux, achalasia and extrinsic compressions are the most common causes that may lead to dysphagia in geriatric population. Cervical osteophyte induced dysphagia, is one of the uncommon reasons of dysphagia, therefore other causes of dysphagia must be excluded to establish the exact diagnosis. Eagle syndrome is one of the considerable reason which may lead to misdiagnosis in patients with cervical osteophytes. In this case report, we represent four patients who had dysphagia due to anteriorly located cervical osteophytes and evaluate the patients with special reference to Eagle syndrome.</p><p><strong>Material and methods: </strong>After a detailed anamnesis and ENT examination, cervical plain radiographs in four projections and Towne radiographs were obtained for every patient. After that, magnetic resonance imaging (MRI) of cervical spine and barium swallowing studies were performed to evaluate the presence of esophageal compression.</p><p><strong>Results: </strong>Eagle syndrome was excluded due to absence of other symptoms and physical signs, eventhough unilateral or bilateral elongation of styloid processes was found in all of the patients.</p><p><strong>Conclusion: </strong>Cervical osteophytes induced dysphagia is a rare clinical entity, diagnosis should be done by a careful examination, intensive radiologic evaluation. Moreover, all the other causes like Eagle syndrome should be excluded during the diagnosis of cervical osteophyte induced dysphagia.</p>","PeriodicalId":89909,"journal":{"name":"Clinical medicine. Case reports","volume":"1 ","pages":"57-64"},"PeriodicalIF":0.0,"publicationDate":"2008-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4137/ccrep.s792","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31824605","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}
Hung-Chin Tsai, Yao-Shen Chen, Susan Shin-Jung Lee, Yu-Hung Lin, Shue-Ren Wann, Cheng Len Sy, Yung-Ching Liu
{"title":"Hepatocyte growth factor level in cerebrospinal fluid as an additional marker in patient with drug-resistant streptococcus pneumoniae meningitis treated with linezolid.","authors":"Hung-Chin Tsai, Yao-Shen Chen, Susan Shin-Jung Lee, Yu-Hung Lin, Shue-Ren Wann, Cheng Len Sy, Yung-Ching Liu","doi":"10.4137/ccrep.s759","DOIUrl":"https://doi.org/10.4137/ccrep.s759","url":null,"abstract":"<p><p>Hepatocyte growth factor (HGF) is a multifunctional cytokine that has well-defined mitogenic, motogenic, and morphogenic functions on the epithelial cells. Strong increases of HGF concentrations in cerebrospinal fluid (CSF) are only present in patients with acute bacterial meningitis. We report a 15-year-old young man with drug resistant Streptococcus pneumoniae meningitis complicated with right 6th cranial nerve palsy. He presented with fever, headache and neck stiffness for 3 days and was treated with intravenous antimicrobial agents including linezolid and dexamethasone successfully. An association between CSF HGF concentrations and CSF proteins is observed (r = 0.897, p = 0.039. Pearson correlation test). This result showed that HGF level in CSF might act as an additional marker in patients with bacterial meningitis. </p>","PeriodicalId":89909,"journal":{"name":"Clinical medicine. Case reports","volume":"1 ","pages":"53-5"},"PeriodicalIF":0.0,"publicationDate":"2008-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4137/ccrep.s759","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31824604","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}
Khalid A Al-Anazi, Mahmoud D Aljurf, Fahad I Al-Mohareb, Laila Al-Dabal, Mohammed Zaitoni, Majed Halim
{"title":"Successful management of invasive pulmonary nocardiosis and aspergillosis in a patient with T-cell lymphoma: a case report.","authors":"Khalid A Al-Anazi, Mahmoud D Aljurf, Fahad I Al-Mohareb, Laila Al-Dabal, Mohammed Zaitoni, Majed Halim","doi":"10.4137/ccrep.s817","DOIUrl":"https://doi.org/10.4137/ccrep.s817","url":null,"abstract":"<p><p>In patients with malignant hematological disorders receiving immunosuppressive therapy, invasive pulmonary infections are serious complications that are associated with high morbidity and mortality. In immunocompromised hosts with impaired cellular immunity, two or more organisms may coexist leading to a wide range of clinical and radiological manifestations. Reported here is an old man who was diagnosed to have angioimmunoblastic T-cell lymphoma at King Faisal Specialist Hospital and Research Centre in Riyadh in December 2004. The lymphoma was treated with various immunosuppressive agents including alemtuzumab. In October 2006, the patient was admitted with severe bronchopneumonia caused by Nocardia asteroides and Aspergillus niger that was complicated by septic shock. The invasive pulmonary infections were successfully treated with trimethoprim-sulphamethoxazole, amikacin and liposomal amphotericin-B (amBisome). </p>","PeriodicalId":89909,"journal":{"name":"Clinical medicine. Case reports","volume":"1 ","pages":"65-71"},"PeriodicalIF":0.0,"publicationDate":"2008-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4137/ccrep.s817","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31824606","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}
Markus S Juchems, Deniz Uyak, Andrea S Ernst, Hans-Juergen Brambs
{"title":"Monitoring gastric filling, satiety and gastric emptying in a patient with gastric balloon using functional magnetic resonance imaging-a feasibility report.","authors":"Markus S Juchems, Deniz Uyak, Andrea S Ernst, Hans-Juergen Brambs","doi":"10.4137/ccrep.s781","DOIUrl":"https://doi.org/10.4137/ccrep.s781","url":null,"abstract":"<p><strong>Background: </strong>Intragastric balloons are used for short term weight loss therapy in obese. It is possible to monitor the ballon with sonography, however this method is sometimes insufficient in obese patients. Therefore MRI seems to be a potential therapy-monitoring option.</p><p><strong>Purpose: </strong>In this feasibility report we want to demonstrate the potential use of functional MRI in monitoring gastric filling, patient satiation and gastric emptying in a obese patient who previously received intragastric balloon placement.</p><p><strong>Material and methods: </strong>We selected one patient (male, 178 cm, 127 kg, BMI = 40,5 kg/m(2)) who recently received a gastric balloon and visualized gastric motility in presence of the gastric balloon before and after food intake. Fast cross-sectional images in one breathhold spin echo or gradient echo sequences were aquired. Real-time gastric motion was performed with cine mode.</p><p><strong>Results: </strong>MRI offers perfect visualisation of gastric balloons in obese patients. Gastric filling and emptying can be monitored in correlation to patient satiety sensation. MRI can visualize the gastric balloon with degree of filling and possible leakages. Cine mode sequences demonstrate gastric motility and gastric wall peristalsis.</p><p><strong>Conclusion: </strong>MR is a valuable imaging alternative for patients with intragastric balloons.</p>","PeriodicalId":89909,"journal":{"name":"Clinical medicine. Case reports","volume":"1 ","pages":"41-4"},"PeriodicalIF":0.0,"publicationDate":"2008-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4137/ccrep.s781","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31824601","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}
{"title":"The management of a patient with a cervical disc herniation: a case report.","authors":"Sherry Tsao, Peter Pidcoe","doi":"10.4137/ccrep.s727","DOIUrl":"https://doi.org/10.4137/ccrep.s727","url":null,"abstract":"<p><strong>Purpose: </strong>To present the management of a patient with a cervical disc herniation and illustrate the efficacy of cervical traction as a main form of treatment for cervical disc herniation in conjunction with a home exercise program.</p><p><strong>Background: </strong>A 71-year-old white female diagnosed with cervical disc herniation at the levels of C5-6 and C6-7 presented to physical therapy with neck pain radiating into the left upper extremity down to the 5th digit of the left hand.</p><p><strong>Treatment: </strong>The patient reported to outpatient physical therapy for cervical disc herniation and radiculopathy. After initial evaluation she received intermittent cervical traction and was given a home exercise program consisting of cervical lateral flexion stretch, unilateral wall stretch for pectoralis muscles and to continue with her over the door cervical traction.</p><p><strong>Conclusion: </strong>Cervical traction and a good home exercise program have been shown to reduce cervical disc herniation and its subsequent symptoms.</p>","PeriodicalId":89909,"journal":{"name":"Clinical medicine. Case reports","volume":"1 ","pages":"45-9"},"PeriodicalIF":0.0,"publicationDate":"2008-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4137/ccrep.s727","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31824602","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}
{"title":"Extremely low birthweight infant with wolf-hirschhorn syndrome: a dilemma in determination of the optimal timing of delivery.","authors":"Shigeo Iijima, Takehiko Ohzeki","doi":"10.4137/ccrep.s760","DOIUrl":"https://doi.org/10.4137/ccrep.s760","url":null,"abstract":"<p><p>Wolf-Hirschhorn syndrome (WHS) is characterized by multiple malformations as well as mental and developmental defects resulting from the absence of a distal segment of the short arm of chromosome 4. We experienced an extremely low birthweight infant with WHS. The male infant (birthweight 934 g) was born at 31 weeks' gestation by cesarean section due to intrauterine growth restriction and presented with the typical WHS phenotype. Chromosomal analysis showed a deletion: 46,XY,del(4)(p15.3 p16). Although the patient's respiratory distress syndrome resolved favourably and his subsequent condition was also stable, he had unusually severe retinopathy of prematurity and periventricular leukomalacia. We suppose that these severe complications were associated with not only prematurity but also with latent structural fragility due to WHS. Herein, we discuss the prenatal detection of WHS and the optimal timing of delivery. </p>","PeriodicalId":89909,"journal":{"name":"Clinical medicine. Case reports","volume":"1 ","pages":"37-40"},"PeriodicalIF":0.0,"publicationDate":"2008-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4137/ccrep.s760","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31824600","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}
{"title":"A Case of Hyper IgD and Periodic Fever Syndrome in Japan.","authors":"Hisashi Kawashima, Akiyoshi Hoshi, Hiroaki Ioi, Chiako Ishii, Satoshi Sato, Yasuyo Kashiwagi, Kouji Takekuma, Akinori Hoshika","doi":"10.4137/ccrep.s722","DOIUrl":"https://doi.org/10.4137/ccrep.s722","url":null,"abstract":"<p><p>We report a four-year-old Japanese girl with hyper IgD and periodic fever syndrome. There is a first report of hyper IgD syndrome (HIDS) of which the genomic study was done in Japan. In this report a girl complained of periodic fever and abdominal symptoms accompanied with high levels of mevalonic acid in urine and serum. She has been well controlled by non-steroidal anti-inflammatory drugs (NSAIDs) for 3 years. </p>","PeriodicalId":89909,"journal":{"name":"Clinical medicine. Case reports","volume":"1 ","pages":"33-5"},"PeriodicalIF":0.0,"publicationDate":"2008-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4137/ccrep.s722","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31824599","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}
{"title":"Cerebral Sinus and Venous Thrombosis Associated with von Willebrand Factor, Independently of Factor VIII.","authors":"Mari Terashima, Hiroshi Kataoka, Hirosei Horikawa, Hiroyuki Nakagawa, Toshiaki Taoka, Masanori Matsumoto, Kozue Saito, Kimihiko Kichikawa, Satoshi Ueno","doi":"10.4137/ccrep.s737","DOIUrl":"https://doi.org/10.4137/ccrep.s737","url":null,"abstract":"<p><strong>Background and purpose: </strong>Previous studies have linked procoagulant factor VIII (F VIII) to an increased risk of venous thrombosis, whereas the relation between plasma von Willebrand factor (VWF) and venous thrombosis remains poorly understood. Elevated VWF levels are frequently found in patients with cerebral sinus and venous thrombosis (CSVT), always in association with high F VIII levels. We describe a patient with CSVT accompanied by elevated VWF levels without high F VIII levels.</p><p><strong>Case description: </strong>A 23-year-old healthy man who had headache noticed difficulty in moving the right hand. On the following day, he lost consciousness and had partial seizures of the right hand. After regaining consciousness, weakness of the right extremities developed. The cranial angiogram confirmed occlusion of the superior sagittal sinus. The levels of VWF and F VIII were 238% and 101.9 IU/dl, respectively. We performed balloon percutaneous transluminal angioplasty and mechanical thrombectomy, leading to successful recanalization of the intracranial sinuses. VWF levels were decreased along with radiographic improvement, independently of F VIII.</p><p><strong>Conclusion: </strong>VWF may contribute to CSVT and that inhibition of VWF activity potentially has a role in the future treatment of pathological conditions related to venous thrombosis.</p>","PeriodicalId":89909,"journal":{"name":"Clinical medicine. Case reports","volume":"1 ","pages":"29-32"},"PeriodicalIF":0.0,"publicationDate":"2008-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4137/ccrep.s737","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31824598","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}