Case Reports in Surgery最新文献

{"title":"Velopharyngeal Stenosis After Adenotonsillectomy in a Child: A Case Report.","authors":"Elisamia Ngowi, Adil Datoo, Mayila Mbuki, Irene Godlove Msamba, Jacqueline Gabone, Christopher Mwansasu","doi":"10.1155/cris/7184710","DOIUrl":"10.1155/cris/7184710","url":null,"abstract":"<p><p>Velopharyngeal stenosis is a rare condition characterized by partial or complete obliteration of the velopharyngeal port and may present with snoring, obstructive sleep symptoms, and speech abnormalities, typically following oropharyngeal surgery. We report the case of a 6-year-old boy who developed persistent diurnal and nocturnal snoring accompanied by recurrent coughing 4 months after adenotonsillectomy. Endoscopic evaluation revealed significant stenosis of the velopharyngeal port. The patient initially underwent surgical release and dilation of the stenotic segment, resulting in temporary symptom improvement; however, symptoms recurred 2 months later due to restenosis. A second surgical intervention was performed with placement of a stent across the stenotic segment to maintain patency during healing. Following stent placement, the patient experienced complete resolution of symptoms, and no further recurrence was observed during follow-up. This case highlights velopharyngeal stenosis as a rare but clinically significant complication of adenotonsillectomy in children and underscores the challenges associated with its management because of the risk of recurrence. It also demonstrates the potential role of stenting as an adjunctive measure to prevent restenosis and achieve sustained symptom resolution. Awareness of this complication and meticulous surgical technique during oropharyngeal procedures may help reduce its occurrence and improve patient outcomes.</p>","PeriodicalId":9600,"journal":{"name":"Case Reports in Surgery","volume":"2026 ","pages":"7184710"},"PeriodicalIF":0.6,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13377614/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148577113","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":"Dual Impact: Coup-Contrecoup Brain Injury in a Young Cyclist-A Case Report.","authors":"Abhishek Kumar, Shashikant Prasad, Majid Anwer, Anurag Kumar, Anil Kumar","doi":"10.1155/cris/9963242","DOIUrl":"10.1155/cris/9963242","url":null,"abstract":"<p><strong>Introduction: </strong>Coup-contrecoup brain injury occurs when trauma produces focal damage both at the site of impact (coup) and at the contralateral side (contrecoup) due to intracranial pressure (ICP) dynamics and rotational forces. These injuries are frequently seen in high-velocity accidents and often demand staged neurosurgical intervention.</p><p><strong>Case presentation: </strong>We report a case of a 14-year-old boy presenting with altered sensorium following a road traffic accident. Initial CT revealed a large left frontal extradural hematoma (EDH) with mass effect and contralateral right frontotemporoparietal contusion. He underwent emergency left frontal craniotomy and evacuation of ~150 mL of EDH. Despite initial improvement, the patient developed neurological deterioration with anisocoria on postoperative day three. Repeat CT revealed worsening contralateral contusion with subdural hematoma (SDH) and midline shift. A right frontotemporoparietal decompressive craniectomy with lax duraplasty was performed, resulting in resolution of mass effect. The patient showed progressive neurological recovery, was decannulated, discharged on postoperative day 18, and later underwent elective cranioplasty with good functional outcome.</p><p><strong>Conclusion: </strong>Coup-contrecoup injuries are mechanistically linked to rotational acceleration, ICP gradients, and skull deformation, rather than simple rebound forces. Frontal and temporal lobes are most commonly involved. Clinical predictors of outcome include Glasgow coma scale (GCS), pupillary reactivity, presence of SDH, and systemic secondary insults. These injuries are dynamic, with contralateral lesion progression often necessitating vigilant monitoring and timely intervention. Management requires repeat neuroimaging, control of ICP, and staged surgical procedures when indicated.</p>","PeriodicalId":9600,"journal":{"name":"Case Reports in Surgery","volume":"2026 ","pages":"9963242"},"PeriodicalIF":0.6,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13346583/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148419040","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":"First Documented Ivor Lewis Oesophagectomy for Oesophageal Squamous Cell Carcinoma in Somalia: A Case Report From a Resource-Limited Setting.","authors":"Resul Nusretoğlu, Elmi Kasim Osman","doi":"10.1155/cris/7934976","DOIUrl":"10.1155/cris/7934976","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Oesophageal squamous cell carcinoma is associated with poor prognosis, particularly in resource-limited settings where access to advanced staging, multi-modal oncology treatment and complex surgical care is constrained. Ivor Lewis oesophagectomy is an established surgical approach for selected mid- and distal oesophageal tumours, but its implementation requires specialised surgical, anaesthetic and peri-operative support. To the best of our knowledge, this is the first documented report of Ivor Lewis oesophagectomy for oesophageal squamous cell carcinoma performed in Somalia.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Case presentation: &lt;/strong&gt;A 42-year-old female presented with a 3-month history of progressive dysphagia affecting both solid and liquid foods. Upper gastrointestinal endoscopy demonstrated a mid-oesophageal mass, and biopsy confirmed Grade 1 well-differentiated squamous cell carcinoma. Contrast-enhanced CT of the chest and abdomen showed a mid/subhilar oesophageal tumour with luminal narrowing and proximal oesophageal dilatation, without radiological evidence of distant metastasis. Because PET-CT and endoscopic ultrasound were unavailable, precise T and N staging could not be determined; therefore, the disease was clinically staged as cT2-T3 Nx M0 and considered resectable. Neoadjuvant chemoradiotherapy was considered, but timely access to standardised treatment was limited. Upfront curative-intent surgery was therefore selected after assessment of resectability, patient fitness and available local resources. The patient underwent open Ivor Lewis oesophagectomy with gastric conduit formation, limited lymphadenectomy, feeding jejunostomy placement and hand-sewn intra-thoracic oesophagogastric anastomosis. Operative time was 5 h, estimated blood loss was 800 mL and there were no intra-operative complications.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Discussion: &lt;/strong&gt;Post-operative CT demonstrated small bilateral pleural effusions, mild pneumothorax and pneumomediastinum, which were managed conservatively without reoperation or invasive intervention. A post-operative day-7 contrast swallow study showed no anastomotic leak or obstruction. The final histopathology confirmed Grade 1 well-differentiated squamous cell carcinoma with an R1 resection margin, indicating microscopic tumour involvement at the margin. The exact lymph node yield and number of metastatic lymph nodes were not clearly documented, limiting complete pathological nodal staging and assessment of lymphadenectomy adequacy. Intra-operative frozen-section margin assessment was not performed because this facility was not reliably available. At 7 weeks' follow-up, the patient was tolerating oral intake with no clinical evidence of anastomotic leak or stricture, and oncology review was arranged for consideration of adjuvant treatment and structured surveillance.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This case demonstrates the technical feasibility of open Ivor Lewis oesophagectomy for oesophageal ","PeriodicalId":9600,"journal":{"name":"Case Reports in Surgery","volume":"2026 ","pages":"7934976"},"PeriodicalIF":0.6,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13343308/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148410619","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 Challenging Management of Gallbladder Masses: A Case of Xanthogranulomatous Cholecystitis and Diffuse Biliary Hamartomatosis Mimicking Gallbladder Metastatic Cancer.","authors":"Chiara D'Alterio, Stefania Brozzetti","doi":"10.1155/cris/1343763","DOIUrl":"10.1155/cris/1343763","url":null,"abstract":"<p><strong>Background: </strong>Xanthogranulomatous cholecystitis (XGC) is a rare form of chronic cholecystitis characterized by progressive fibrosis of the gallbladder wall. Its clinical, laboratory, and radiological features often mimic gallbladder carcinoma (GC), making preoperative diagnosis challenging. A definitive diagnosis is usually established by histopathological examination. As XGC may occasionally coexist with malignancy, surgical resection is generally recommended.</p><p><strong>Case presentation: </strong>A 66-year-old woman presented with weight loss, epigastric discomfort, and a palpable mass in the right upper quadrant. Imaging revealed diffuse gallbladder wall thickening and a 33-mm vascularized mass in the gallbladder fundus, with suspected extension to the liver, transverse colon, and abdominal wall, strongly suggesting GC. Multiple hepatic cysts were also identified. Following multidisciplinary evaluation, laparoscopic exploration was performed. Hepatic and colonic infiltration, distortion of Calot's triangle, regional lymphadenopathy, and diffuse millimetric liver lesions initially suggested GC with intrahepatic metastases. However, histological examination of biopsied lesions excluded malignancy. After a 4-month recovery from COVID-19, the patient experienced clinical improvement and weight gain. Follow-up computed tomography (CT) showed regression of both the gallbladder mass and hepatic involvement, supporting a benign inflammatory process. During subsequent laparotomy, frozen-section analysis of the colonic infiltration confirmed inflammatory tissue. Radical cholecystectomy with en bloc resection of the adjacent liver parenchyma was performed. Final histopathology revealed diffuse XGC associated with diffuse biliary hamartomatosis.</p><p><strong>Conclusion: </strong>This case highlights the diagnostic challenge of distinguishing XGC from GC, particularly in the presence of biliary hamartomatosis. A stepwise diagnostic approach and multidisciplinary decision-making were essential to ensure accurate diagnosis and appropriate management.</p>","PeriodicalId":9600,"journal":{"name":"Case Reports in Surgery","volume":"2026 ","pages":"1343763"},"PeriodicalIF":0.6,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13316130/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148359670","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":"Extended Right Hepatectomy for Giant Hepatic Hemangioma: A Case Report.","authors":"Ana Gabriela Cabrera-Lizárraga, Omar Bermúdez-Ferro, Iaarah Montalvo-Gordon, Héctor Rendón-Dosal, Rubén R Lozano-Salazar","doi":"10.1155/cris/4016891","DOIUrl":"10.1155/cris/4016891","url":null,"abstract":"<p><p>Liver hemangioma is the most common benign liver tumor, often discovered incidentally. Symptom development and complications underscore the need for surgical intervention. Managing hemangiomas larger than 20 cm is challenging because of the risk of perioperative complications. We report a case of a patient with compressive symptoms caused by a 20 cm liver hemangioma in the right hepatic lobe. An extended right hepatectomy was performed, yielding a favorable postoperative outcome. This case demonstrates that surgical treatment can be a safe and effective option for selected patients when performed at highly specialized centers, with outcomes comparable to those reported in the literature. It provides evidence that intraoperative surgical decision-making is essential for an appropriate outcome in cases of giant symptomatic hemangioma.</p>","PeriodicalId":9600,"journal":{"name":"Case Reports in Surgery","volume":"2026 ","pages":"4016891"},"PeriodicalIF":0.6,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13317466/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148359677","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":"Post-Cholecystectomy Mirizzi Syndrome by Calculus in the Remaining Cystic Duct: Case Report and Review of Literature.","authors":"Jorge López-López, Luis García-Covarrubias, Selene Y Flores de León, Diana F Fernández-Ángel, David Ramírez-Tapia, José H Garza-Flores, Vicente González-Ruíz","doi":"10.1155/cris/6658220","DOIUrl":"10.1155/cris/6658220","url":null,"abstract":"<p><strong>Background: </strong>Mirizzi Syndrome (MS) is a rare cause of biliary obstruction. While laparoscopic cholecystectomy is the standard treatment, severe inflammation often necessitates subtotal cholecystectomy to prevent bile duct injury (BDI). However, retained stones in the gallbladder remnant or cystic duct can cause recurrent obstruction, termed post-cholecystectomy Mirizzi Syndrome (PCMS).</p><p><strong>Case report: </strong>A 34-year-old female presented with PCMS 6 years after undergoing a subtotal cholecystectomy for MS. Despite initial conservative management, definitive resolution required secondary surgical intervention.</p><p><strong>Conclusion: </strong>As subtotal cholecystectomy becomes more frequent to avoid BDI, the incidence of PCMS is expected to rise. Clinicians must maintain a high index of suspicion. Management should be multidisciplinary; however, surgery remains the definitive treatment when conservative approaches fail.</p>","PeriodicalId":9600,"journal":{"name":"Case Reports in Surgery","volume":"2026 ","pages":"6658220"},"PeriodicalIF":0.6,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13312436/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148350935","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":"Caecal Bascule Volvulus: Diagnostic Challenges in a Rare cause of Large Bowel Obstruction.","authors":"Kaotharat Balogun, Níamh M Smyth, Charlotte Loh, Himanshu Yadav, David Beddy, Muyiwa Aremu","doi":"10.1155/cris/8788042","DOIUrl":"10.1155/cris/8788042","url":null,"abstract":"<p><p>Caecal bascule is the rarest form of caecal volvulus, representing 5%-20% of caecal volvulus cases and accounting for 0.2% of intestinal obstructions. Diagnosis can be delayed due to non-specific clinical and radiological features, increasing the risk of ischaemia or perforation. Herein, we report the case of a 70-year-old woman who presented with vague right iliac fossa (RIF) pain, nausea and bilious vomiting. Computed tomography (CT) of the abdomen and pelvis demonstrated a mesenteric 'whirl sign' concerning for a volvulus. Emergency laparoscopy demonstrated a distended caecum (C) folded anteriorly without torsion, consistent with caecal bascule. A right hemicolectomy with primary anastomosis was performed. The postoperative course was complicated by a small non-drainable collection, managed conservatively with antibiotics. Histopathology showed mild vascular congestion with normal architecture and no ischaemia, malignancy or inflammatory bowel disease. This case highlights the diagnostic challenge of caecal bascule and the importance of timely surgical intervention.</p>","PeriodicalId":9600,"journal":{"name":"Case Reports in Surgery","volume":"2026 ","pages":"8788042"},"PeriodicalIF":0.6,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13312435/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148350929","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 Microscopic Thymoma and Myasthenia Gravis: Key Points for Clinical Features and Surgical Management.","authors":"Nicola Rotolo, Francesca Franzi, Elena Asteggiano, Alberto Colombo, Stefano La Rosa, Elisa Nardecchia","doi":"10.1155/cris/1354084","DOIUrl":"10.1155/cris/1354084","url":null,"abstract":"<p><p>Microscopic thymoma (MT) is defined as solitary or multifocal small thymic epithelial nests <1 mm in diameter, occurring in approximately 15% of patients with myasthenia gravis (MG) and sometimes associated with thymic cysts. Its preoperative diagnosis is challenging due to its small size, and computed tomography (CT) scans are unable to detect it. MTs are considered incipient or precursor lesions of thymoma, detectable only via microscopic examination. We report a case of MT identified pathologically in the thymic tissue surrounding a thymic cyst in a 52-year-old female hospitalized for drooping eyelids and muscle weakness. A mediastinal CT scan revealed an enlarged thymic gland with an associated cyst in the anterior mediastinum. Due to symptomatic disease, we performed a right video-assisted thoracoscopic thymectomy. No macroscopic tumor was observed, but histopathological analysis revealed an acquired multilocular thymic cyst with multiple thymic epithelial islands (MTs) in the surrounding thymic tissue. All previous cases reported, except one, were symptomatic for MG and none were diagnosed before surgery. The morphological pattern of MT differs from conventional thymoma, and the latest WHO classification categorizes it as thymic nodular hyperplasia. To maximize the detection of MT nests, complete resection and thorough histopathological examination of the thymic gland and surrounding tissue are essential, even in the absence of macroscopic lesions. Here, we propose key points for the evaluation and management of MT.</p>","PeriodicalId":9600,"journal":{"name":"Case Reports in Surgery","volume":"2026 ","pages":"1354084"},"PeriodicalIF":0.6,"publicationDate":"2026-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13311198/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148350898","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":"Concurrent Amyand and Littre Hernias With Incidental Hodgkin Lymphoma: A Diagnostic and Surgical Challenge.","authors":"Jia Chyi Tay, Woon Teen Sia, Siti Shakinah Sobri, Li Jie Thee","doi":"10.1155/cris/1130953","DOIUrl":"10.1155/cris/1130953","url":null,"abstract":"<p><p>We report a rare case of a 62-year-old man with a right giant inguinoscrotal hernia and a concurrent retroperitoneal mass. Preoperative imaging was inconclusive regarding the hernia sac contents and the nature of the pelvic mass. Intraoperatively, the hernia sac contained the caecum, appendix, Meckel's diverticulum (MD) and terminal ileum-confirming the simultaneous presence of Amyand and Littre hernias. Additionally, a left-sided retroperitoneal solid-cystic mass was identified and excised. This case underscores the diagnostic difficulties posed by complex hernias and highlighted the surgical challenges involved in managing coexisting intra-abdominal pathologies. Histopathological examination revealed a mesenteric cyst with infarcted tissue and an incidental diagnosis of mixed cellularity classical Hodgkin lymphoma (MCCHL) from the lymph node, adding a haematological dimension to this already rare surgical case.</p>","PeriodicalId":9600,"journal":{"name":"Case Reports in Surgery","volume":"2026 ","pages":"1130953"},"PeriodicalIF":0.6,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13304216/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148344049","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":"Successful Management of Hepatic Abscess From Ingested Foreign Body: A Case Report.","authors":"Samin Rostamzadeh, Fatemeh Shahrahmani, Davood Salehi, Mohammadreza Mohammad Hosseiniazar","doi":"10.1155/cris/6987968","DOIUrl":"10.1155/cris/6987968","url":null,"abstract":"<p><p>Hepatic abscess secondary to foreign body ingestion is a rare but potentially life-threatening condition. Although most ingested foreign bodies pass harmlessly through the gastrointestinal tract, sharp objects may perforate the gastric or intestinal walls, migrate into adjacent organs, and lead to abscess formation. This report describes a 22-year-old female with a 10-year history of systemic lupus erythematosus (SLE) who presented with persistent epigastric discomfort, nausea, and vomiting for 2 weeks. Initial evaluations, including laboratory tests and abdominal ultrasonography, were unremarkable. Subsequent endoscopy revealed a foreign body lodged in the distal stomach that could not be removed endoscopically. A contrast-enhanced computed tomography (CT) scan demonstrated a 7 cm × 5.6 cm abscess in the left hepatic lobe. The patient underwent laparotomy, which confirmed a toothpick penetrating the gastric wall and lodging in the liver. The abscess was drained, and gastrorrhaphy was performed. The patient recovered uneventfully following antibiotic therapy and was discharged in stable condition, with no recurrence during follow-up. Foreign body-induced hepatic abscesses are uncommon, and diagnosis can be challenging because classical signs of infection may be absent or attenuated. Endoscopy remains the first-line diagnostic and therapeutic approach; however, surgical intervention is required when the foreign body is embedded or complications occur. Clinicians should maintain a high index of suspicion in patients with persistent or unexplained abdominal symptoms, particularly in immunocompromised individuals.</p>","PeriodicalId":9600,"journal":{"name":"Case Reports in Surgery","volume":"2026 ","pages":"6987968"},"PeriodicalIF":0.6,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13291716/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148326967","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}