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Clinics and Practice
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Clinics and Practice is published by MDPI from Volume 11 Issue 1 (2021). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by MDPI on mdpi.com as a courtesy and upon agreement with PAGEPress.

Clin. Pract., Volume 1, Issue 3 (June 2011) – 37 articles

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159 KiB  
Case Report
US and MDCT Findings in a Caudal Blind Ending Bifid Ureter with Calculi
by Evren Ustuner, Ebru Dusunceli Atman, Cemil Yagci, Zafer Nida Tokatli and Caglar Uzun
Clin. Pract. 2011, 1(3), e77; https://doi.org/10.4081/cp.2011.e77 - 17 Nov 2011
Cited by 2 | Viewed by 1
Abstract
Herein we present a rare ureteric duplication anomaly; blind ending bifid ureter with calculi which is asymptomatic unless complicated by infection, reflux, calculi or malignancy. The diagnosis is often missed at intravenous urography (IVU) and US because the ipsilateral ureter and kidney are [...] Read more.
Herein we present a rare ureteric duplication anomaly; blind ending bifid ureter with calculi which is asymptomatic unless complicated by infection, reflux, calculi or malignancy. The diagnosis is often missed at intravenous urography (IVU) and US because the ipsilateral ureter and kidney are grossly normal. In this case the diagnosis was established with ultrasound (US) and mainly with multidetector computerized tomography (MDCT) imaging using multiplanar reformats and 3-D reconstructions which were unique to this case. MDCT scans not only revealed the exact diagnosis and anatomic relationships but also ruled out other pathologies included in the differential diagnosis as well, such as ureter and bladder diverticula. Full article
165 KiB  
Article
CD34+ Stem Cells from Umbilical Cord Blood
by Carlo Pafumi, Vito Leanza, Antonio Carbonaro, Gianluca Leanza, Alessandra Iemmola, Giusi Abate, Maria Grazia Stracquadanio and Alfio D’Agati
Clin. Pract. 2011, 1(3), e79; https://doi.org/10.4081/cp.2011.e79 - 27 Oct 2011
Cited by 4 | Viewed by 2
Abstract
We describe the relation between umbilical cord clamping time and two different enrichment system of CD34+ stem cells from umbilical cord blood with the proliferative ability and bone marrow reconstitution of the stem cells obtained. After an obstetrician performed the cord blood [...] Read more.
We describe the relation between umbilical cord clamping time and two different enrichment system of CD34+ stem cells from umbilical cord blood with the proliferative ability and bone marrow reconstitution of the stem cells obtained. After an obstetrician performed the cord blood collection, the purification of stem cells was performed either with a combination of monoclonal antibodies (negative selections) using the Stem Sep method, or with a positive cells selection based on their surface CD34 antigens using the Mini Macs system. An excellent recovery of haematopoietic progenitors [Burst Forming Unit Erythroids (BFUE); Colony Forming Unit Granulocytes and Macrophages (CFU-GM); and Colony Forming Unit Granulocytes, Erythroids, Monocytes and Macrophages (CFU-GME)], inversely related to the increase in clamping time, was performed with the Mini Macs system (54% of colonies, with 90% purity). With Stem Sep method, haematopoietic progenitor’s recovery was 35% (with 80% purity). By applying early clamping of umbilical cord blood we obtained a greater number of CD34+ cells and their clonogenic activity was increased with enrichment. This is a useful technique considering that the number of CD34+ stem cells usually contained from a unit of placental blood is enough for the transplant to a child, but not for an adult. Thus, using these methods, we can get a larger number of CD34+ stem cells which reduces the risk of Graft versus Host Disease also in adult patients, producing survival rates similar to those obtained with transplantation of bone marrow from unrelated donors. Full article
139 KiB  
Case Report
Unusual Case of a Graphite Foreign Body in the Anterior Chamber
by Anika Amritanand, Sheeja S. John, Swetha S. Philip, Deepa John and Sarada David
Clin. Pract. 2011, 1(3), e73; https://doi.org/10.4081/cp.2011.e73 - 20 Oct 2011
Cited by 6 | Viewed by 1
Abstract
Retained intraocular graphite foreign bodies are uncommon. Although they are generally inert, they have been reported to cause severe inflammatory reaction and progressive damage to intraocular structures. We report a case of a six-year-old girl with a retained intraocular graphite pencil lead foreign [...] Read more.
Retained intraocular graphite foreign bodies are uncommon. Although they are generally inert, they have been reported to cause severe inflammatory reaction and progressive damage to intraocular structures. We report a case of a six-year-old girl with a retained intraocular graphite pencil lead foreign body in the anterior chamber of the eye and discuss the various considerations in the management of such cases. Full article
54 KiB  
Case Report
64-Year-Old Male with Septic Arthritis of the Pubic Symphysis
by Ewa Konik, Brent Bauer and Mark Lee
Clin. Pract. 2011, 1(3), e76; https://doi.org/10.4081/cp.2011.e76 - 19 Oct 2011
Cited by 4 | Viewed by 1
Abstract
Septic arthritis of the pubic symphysis is a rare disease. Typical clinical features include fever, pubic or groin pain, pain with hip motion, and painful or waddling gait. Identified predisposing factors to develop an infection in pubic joint include female incontinence surgery or [...] Read more.
Septic arthritis of the pubic symphysis is a rare disease. Typical clinical features include fever, pubic or groin pain, pain with hip motion, and painful or waddling gait. Identified predisposing factors to develop an infection in pubic joint include female incontinence surgery or postpartum period; sports, especially soccer; pelvic malignancy; and intravenous drug abuse. The most often identified microorganisms were Staphylococcus aureus and Pseudomonas aeruginosa. Osteomyelitis complicates the majority of cases, and about half of the patients require surgical debridement along with a prolonged antibiotic treatment. We report a case of Streptococcus anginosus septic arthritis of the pubic symphysis. The patient did not have any of the above risk factors. Full article
101 KiB  
Case Report
Triplane Fracture of the Distal Radius
by Christopher Pearce and Raymond Chung
Clin. Pract. 2011, 1(3), e75; https://doi.org/10.4081/cp.2011.e75 - 19 Oct 2011
Cited by 6 | Viewed by 1
Abstract
We report the case of a 14-year-old boy who sustained a displaced triplane fracture of the distal radius. This was treated with closed reduction and application of a cast with good clinical and radiological results. We discuss (for the first time) the reasons [...] Read more.
We report the case of a 14-year-old boy who sustained a displaced triplane fracture of the distal radius. This was treated with closed reduction and application of a cast with good clinical and radiological results. We discuss (for the first time) the reasons for the rarity of this fracture at the distal radius compared to the distal tibia. Full article
120 KiB  
Case Report
An Unusual Burn Caused by Hot Argy Wormwood Leaf Water
by Xun Liang, Xu-Lin Chen, Fei Wang and Feng Guo
Clin. Pract. 2011, 1(3), e71; https://doi.org/10.4081/cp.2011.e71 - 14 Oct 2011
Cited by 1 | Viewed by 1
Abstract
An unusual burn case caused by hot wormwood leaf water was discussed. A 29-year-old woman sustained a 7% second-degree burn on both buttocks and left thigh. This case report highlights a rare cause of a chemical burn that may become more common with [...] Read more.
An unusual burn case caused by hot wormwood leaf water was discussed. A 29-year-old woman sustained a 7% second-degree burn on both buttocks and left thigh. This case report highlights a rare cause of a chemical burn that may become more common with increasing use of this Chinese traditional medicine. The prevention measures of this burn injury were also presented. Full article
68 KiB  
Case Report
Severe Hypothyroidism Associated with the Degree of Edema in a Patient with Nephrosis
by Hiroyuki Kinoshita, Amiko Ishii, Akiko Hayakawa, Mutsuko Yasuda, Seiji Inoshita and Fumiatsu Yakushiji
Clin. Pract. 2011, 1(3), e78; https://doi.org/10.4081/cp.2011.e78 - 13 Oct 2011
Cited by 5 | Viewed by 1
Abstract
We report the pleural fluid values of thyroid hormones and their carrier proteins in a patient who suffered from nephrotic syndrome with renal insufficiency and transient hypothyroidism. The pleural effusion was transudate. The concentrations of thyroxine-binding globulin (TBG), thyroxine-binding prealbumin (TBPA), and albumin [...] Read more.
We report the pleural fluid values of thyroid hormones and their carrier proteins in a patient who suffered from nephrotic syndrome with renal insufficiency and transient hypothyroidism. The pleural effusion was transudate. The concentrations of thyroxine-binding globulin (TBG), thyroxine-binding prealbumin (TBPA), and albumin (Alb) were approximately 30-50% of the plasma. The concentrations of total triiodothyronine (TT3), total tetraiodothyronine (TT4), free triiodothyronine (FT3), and free tetraiodothyronine (FT4) were approximately 30-50% of the plasma. Hypothyroidism was associated with the degree of edema. After improving systemic edema, proteinuria remained unchanged but the patient did not require levothyroxine. We speculate that the large amount of transudation of thyroid hormones with their carrier proteins from the blood vessels to the third space (edema and pleural effusion), thereby reducing thyroid hormones in the plasma, was associated with hypothyroidism. Full article
54 KiB  
Case Report
Forgotten Intrauterine Device Contributing to Infertility
by Gabriel O. Igberase
Clin. Pract. 2011, 1(3), e74; https://doi.org/10.4081/cp.2011.e74 - 13 Oct 2011
Cited by 2 | Viewed by 1
Abstract
The aim of the study is to show that long standing forgotten intrauterine device contributes to infertility, reporting three cases presented at Central Hospital Warri, Nigeria, a government tertiary health center. Three cases of forgotten intrauterine contraceptive device (IUCD) contributing to infertility were [...] Read more.
The aim of the study is to show that long standing forgotten intrauterine device contributes to infertility, reporting three cases presented at Central Hospital Warri, Nigeria, a government tertiary health center. Three cases of forgotten intrauterine contraceptive device (IUCD) contributing to infertility were seen. Two were inserted for contraceptive reasons while one was inserted while being managed for uterine synechae. Health care providers should ensure proper documentation of all procedures carried out, adequate counseling which should include taking an informed consent and also ensuring both short and long term follow up of their clients. Also all patients being evaluated for infertility and clients with past history of intrauterine device must have a speculum examination and ultrasound scan carried out. Full article
166 KiB  
Case Report
Sinus of Valsalva Aneurysm and Bicuspid Aortic Valve: Detection and Mechanism by Cardiac Magnetic Resonance Imaging
by Jen Li Looi and Andrew J. Kerr
Clin. Pract. 2011, 1(3), e72; https://doi.org/10.4081/cp.2011.e72 - 13 Oct 2011
Viewed by 1
Abstract
Cardiac magnetic resonance imaging (CMR) demonstrated a sinus of Valsalva aneurysm (SVA) with severe dilatation of the right coronary sinus in association with a congenital bicuspid aortic valve (BAV) and subaortic membrane. The SVA had not been apparent on echocardiography as the dilatation [...] Read more.
Cardiac magnetic resonance imaging (CMR) demonstrated a sinus of Valsalva aneurysm (SVA) with severe dilatation of the right coronary sinus in association with a congenital bicuspid aortic valve (BAV) and subaortic membrane. The SVA had not been apparent on echocardiography as the dilatation was outside standard echo image planes. On both CMR and echo, blood flow was eccentrically directed into the right coronary sinus by the domed posterior leaflet of the BAV. The impact of the aortic jet on the wall of the right coronary sinus is probably important in the aetiology of the sinus dilatation. CMR proved valuable in demonstrating the SVA and understanding its aetiology. Full article
85 KiB  
Case Report
Pneumomediastinum and Bilateral Pneumothorax Following near Drowning in Shallow Water
by Santhiya Govindaraj and Stalin Viswanathan
Clin. Pract. 2011, 1(3), e70; https://doi.org/10.4081/cp.2011.e70 - 03 Oct 2011
Viewed by 1
Abstract
We report pneumomediastinum, bilateral pneumothorax and acute respiratory distress syndrome in a victim of near drowning who was intoxicated and did not have thoracic or neck trauma. Chest radiograph revealed the above findings, later confirmed by computed tomography. He was in shock and [...] Read more.
We report pneumomediastinum, bilateral pneumothorax and acute respiratory distress syndrome in a victim of near drowning who was intoxicated and did not have thoracic or neck trauma. Chest radiograph revealed the above findings, later confirmed by computed tomography. He was in shock and also had gastrointestinal (GI) bleeding and renal dysfunction. With adequate resuscitative measures including fluids, blood transfusions, intercostal tube drainage and mechanical ventilation he made a complete recovery. Good prognostic indicators in near drowning patients include higher Glasgow Coma Scale, short submersion time and quick resuscitative measures even in the presence of serious cardiorespiratory or hemodynamic compromise. Full article
89 KiB  
Case Report
Non-Syndromic Bilateral Dentigerous Cysts Associated with Permanent Second Premolars
by Shiva Shirazian and Farzaneh Agha-Hosseini
Clin. Pract. 2011, 1(3), e64; https://doi.org/10.4081/cp.2011.e64 - 03 Oct 2011
Cited by 7 | Viewed by 1
Abstract
The dentigerous cyst is one of the most common developmental odontogenic cysts in the jaw. Occurrence of the bilateral dentigerous cyst is uncommon, and frequently associated with syndromes like basal cell nevus syndrome or cleidocranial dysplasia. There are few reports on the presence [...] Read more.
The dentigerous cyst is one of the most common developmental odontogenic cysts in the jaw. Occurrence of the bilateral dentigerous cyst is uncommon, and frequently associated with syndromes like basal cell nevus syndrome or cleidocranial dysplasia. There are few reports on the presence of bilateral dentigerous cyst in nonsyndromic patients, and most of these are associated with first and third molars. The reported case in this paper is bilateral dentigerous cysts associated with mandibular permanent second premolars, in the absence of any signs of syndrome. To our knowledge bilateral dentigerous cysts in these locations have not been previously reported. Full article
70 KiB  
Case Report
Celiacomesenteric Trunk: A Variation That Must Be Known Before Aortic Surgery
by Nicolas Lagoutte, Olivier Facy, Boris Guiu, Claire Favier and Nicolas Cheynel
Clin. Pract. 2011, 1(3), e69; https://doi.org/10.4081/cp.2011.e69 - 30 Sep 2011
Cited by 5 | Viewed by 1
Abstract
The celiac trunk and the mesenteric arteries may present variations with different clinical significance. A celiacomesenteric trunk was discovered in a patient with mesenteric ischemia and a history of aortic bypass without inferior mesenteric artery reimplantation. Despite thrombectomies and digestive resections, the patient [...] Read more.
The celiac trunk and the mesenteric arteries may present variations with different clinical significance. A celiacomesenteric trunk was discovered in a patient with mesenteric ischemia and a history of aortic bypass without inferior mesenteric artery reimplantation. Despite thrombectomies and digestive resections, the patient died. Anatomic variations like celiacomesenteric trunk must be known before aortic surgery. Full article
221 KiB  
Case Report
Hydrocephalus, a Rare Manifestation of Sarcoidosis
by Johan M. van Rooijen, Gerritje S. Mijnhout, Tom T.A. Aalders and R.B.J. de Bondt
Clin. Pract. 2011, 1(3), e66; https://doi.org/10.4081/cp.2011.e66 - 30 Sep 2011
Cited by 10 | Viewed by 1
Abstract
A 36-week-pregnant woman developed a symptomatic hydrocephalus. Chest imaging showed bihilar lymphadenopathy and histological examination of a mediastinal lymph node revealed non-caseating granulomas. After delivery, her neurologic complaints progressed. Placement of a ventriculoperitoneal drain (VPD) did not reduce the symptoms. However, steroids resulted [...] Read more.
A 36-week-pregnant woman developed a symptomatic hydrocephalus. Chest imaging showed bihilar lymphadenopathy and histological examination of a mediastinal lymph node revealed non-caseating granulomas. After delivery, her neurologic complaints progressed. Placement of a ventriculoperitoneal drain (VPD) did not reduce the symptoms. However, steroids resulted in rapid disappearance of the hydrocephalus. Hydrocephalus is a very rare manifestation of sarcoidosis. The diagnosis relies on the ability of clinicians to recognize this disorder. This case shows how a difference in opinion of the several specialists involved can lead to a delay in diagnosis and treatment. Full article
100 KiB  
Case Report
Delayed Diagnosis of Hydranencephaly in a Nine-Month-Old Child
by Athanasios K. Petridis, Ulf R Krause-Titz, Alexandros Doukas and Hubertus Maximilian Mehdorn
Clin. Pract. 2011, 1(3), e65; https://doi.org/10.4081/cp.2011.e65 - 29 Sep 2011
Cited by 3 | Viewed by 1
Abstract
We present a case of a child suffering of hydranencephaly. The interesting fact in the case is that there were no embryological examinations during pregnancy and therefore could the anomaly, which would have been easily avoided by regular visits to the obstetrician, not [...] Read more.
We present a case of a child suffering of hydranencephaly. The interesting fact in the case is that there were no embryological examinations during pregnancy and therefore could the anomaly, which would have been easily avoided by regular visits to the obstetrician, not be diagnosed timely. Education of mothers is always necessary irrespective on how developed a country is and how good the medical treatment and diagnostic tools are. Every pregnant woman needs to be well educated in matters of pregnancy monitoring. Full article
118 KiB  
Case Report
Testicular Atrophy Secondary to a Large Long Standing Incarcerated Inguinal Hernia
by Nikolaos S Salemis and Konstantinos Nisotakis
Clin. Pract. 2011, 1(3), e68; https://doi.org/10.4081/cp.2011.e68 - 28 Sep 2011
Cited by 1 | Viewed by 1
Abstract
Testicular atrophy is a rare but distressing complication of inguinal hernia repair. Apart from the postsurgical etiology, ischemic orchitis and subsequent testicular atrophy may occur secondary to compression of the testicular vessels by chronically incarcerated hernias. We present a rare case of testicular [...] Read more.
Testicular atrophy is a rare but distressing complication of inguinal hernia repair. Apart from the postsurgical etiology, ischemic orchitis and subsequent testicular atrophy may occur secondary to compression of the testicular vessels by chronically incarcerated hernias. We present a rare case of testicular atrophy secondary to a large long standing incarcerated inguinal hernia of 2-decade duration in a 79-year-old man. Testicular atrophy should be always considered in long standing incarcerated inguinal hernias and patients should be adequately informed of this possibility during the preoperative work-up. Preoperative scrotal ultrasonography can be used to determine testicular status in this specific group of patients. Full article
379 KiB  
Case Report
Neurothekeoma Palpebrae in Association with Multiple Superficial Angiomyxomas: Tegumental Angiomyxoma- Neurothekeoma Syndrome (TAN Syndrome)
by Tan Aik Kah, Ku Chui Yong and Faridah Hanom Annuar
Clin. Pract. 2011, 1(3), e67; https://doi.org/10.4081/cp.2011.e67 - 28 Sep 2011
Cited by 2 | Viewed by 1
Abstract
We report a case of 10-year-old Indian girl with history of multiple superficial angiomyxoma, presented with three months history of painless right upper lid swelling. There were no visual dysfunctions. Previously, the patient had multiple superficial angiomyxoma (left pinna, left upper cheek, left [...] Read more.
We report a case of 10-year-old Indian girl with history of multiple superficial angiomyxoma, presented with three months history of painless right upper lid swelling. There were no visual dysfunctions. Previously, the patient had multiple superficial angiomyxoma (left pinna, left upper cheek, left upper limb, chest, right axilla, hard palate) and epidermal cyst (chin). The histopathological specimens were negative to S-100 protein antibody. Systemic review and family history was unremarkable. Excision biopsy and upper lid reconstruction were performed. Intraoperatively the tumor was multilobulated, firm, well encapsulated and did not invade the underlying tarsal plate. Histopathological features of the upperlid tumor were consistent with nerves sheath myxoma (neurothekeoma). To the best of the authors’ knowledge, this is the first reported case of neurothekeoma in association with multiple superficial angiomyxoma. Full article
214 KiB  
Case Report
Primary Sclerosing Cholangitis and Pregnancy
by Casper Q. Kammeijer, Robert A. De Man and Christianne J.M. De Groot
Clin. Pract. 2011, 1(3), e55; https://doi.org/10.4081/cp.2011.e55 - 26 Aug 2011
Cited by 8 | Viewed by 1
Abstract
Primary sclerosing cholangitis is a progressive disease, and coincidentally in pregnancy it is rare. It is characterized by progressive inflammation and destruction of bile ducts finally resulting in liver failure. A rare case of primary sclerosing cholangitis in pregnancy is presented. The course [...] Read more.
Primary sclerosing cholangitis is a progressive disease, and coincidentally in pregnancy it is rare. It is characterized by progressive inflammation and destruction of bile ducts finally resulting in liver failure. A rare case of primary sclerosing cholangitis in pregnancy is presented. The course of the pregnancy was marked by threatened preterm delivery and exacerbation of cholestasis. She was successfully treated with ursodeoxycholic acid (UDCA). Although, primary sclerosing cholangitis has both maternal and fetal effects on pregnancy, the overall outcome is favorable. Only few cases have been reported using high dose ursodeoxycholic acid for primary sclerosing cholangitis in pregnancy, it often improves pruritus but has no protection against stillbirth. Data on the safety to the fetus or neonate and long-term outcome are scarce. Full article
618 KiB  
Case Report
Internal Carotid Artery Pseudo Occlusion with Embolic Cerebral Ischemia and Low Flow in the Central Retinal Artery: A Diagnostic Challenge
by Christoph Roehrer, Michael Ertl, Mathias Altmann, Piotr Kasprzak, Ulrich Bogdahn, Gerhard Schuierer and Felix Schlachetzki
Clin. Pract. 2011, 1(3), e62; https://doi.org/10.4081/cp.2011.e62 - 17 Aug 2011
Cited by 1 | Viewed by 1
Abstract
We present a rare case of internal carotid artery pseudoocclusion (ICAPO) in a 60-yearold male Caucasian patient who experienced a reversible sudden loss of vision of the right eye for 10 min followed by recurrent blurring of vision as well as dysarthria and [...] Read more.
We present a rare case of internal carotid artery pseudoocclusion (ICAPO) in a 60-yearold male Caucasian patient who experienced a reversible sudden loss of vision of the right eye for 10 min followed by recurrent blurring of vision as well as dysarthria and numbness in the left face. The referring ophthalmologist admitted the patient for suspicious occlusion of the internal carotid artery causing anterior ischemic optic neuropathy (AION). Full article
275 KiB  
Case Report
Cytologic Diagnosis of Acinic Cell Carcinoma of Minor Salivary Gland: A Distinct Rarely Described Entity
by Rana Sherwani, Kafil Akhtar, Murad Ahmad and Abrar Hasan
Clin. Pract. 2011, 1(3), e58; https://doi.org/10.4081/cp.2011.e58 - 17 Aug 2011
Viewed by 1
Abstract
A rare case of acinic cell carcinoma of minor salivary gland with cervical lymph node metastasis in a 50-year-old man is reported and the literature regarding this type of tumor is reviewed. These tumors arise from either an intercalated duct stem cell or [...] Read more.
A rare case of acinic cell carcinoma of minor salivary gland with cervical lymph node metastasis in a 50-year-old man is reported and the literature regarding this type of tumor is reviewed. These tumors arise from either an intercalated duct stem cell or the reserve cell of the salivary gland terminal tubule but not from both simultaneously. Rarely these neoplasms arise from more mature acinar cells. It is clear that these tumors behave ominously. The 25 year determinate survival rate is 50%, with a 20% incidence of metastasis. Surgical excision is the treatment of choice. Radiotherapy, especially neutron therapy, has a place in the treatment of this tumor but the role of chemotherapy is not exactly known at this time. Full article
208 KiB  
Article
Interventricular Septal Rupture after Myocardial Infarction Despite Early Percutaneous Coronary Intervention
by Davran Cicek, Seher Gokay, Tonguc Saba, Ismail Sapmaz and Haldun Muderrisoglu
Clin. Pract. 2011, 1(3), e63; https://doi.org/10.4081/cp.2011.e63 - 11 Aug 2011
Viewed by 1
Abstract
Ventricular septal rupture (VSR) complicating acute myocardial infarction (AMI) is a serious clinical problem with high mortality rate due to cardiogenic shock or prolonged hemodynamic compromise. Despite multiple improvements in medical, interventional and surgical techniques, early and long-term prognosis after AMI related VSR [...] Read more.
Ventricular septal rupture (VSR) complicating acute myocardial infarction (AMI) is a serious clinical problem with high mortality rate due to cardiogenic shock or prolonged hemodynamic compromise. Despite multiple improvements in medical, interventional and surgical techniques, early and long-term prognosis after AMI related VSR still remain unpromising. We report a patient in whom an acute VSR was diagnosed 7 days after an anterior myocardial infarction treated with early primary percutaneous coronary intervention (pPCI). Full article
228 KiB  
Case Report
Post-Traumatic Extensive Knee Ganglion Cyst
by Mehran Mahvash, Majid Hashemi, Homajoun Maslehaty, Alexandros Doukas, Athanasios K. Petridis and Hubertus Maximilian Mehdorn
Clin. Pract. 2011, 1(3), e61; https://doi.org/10.4081/cp.2011.e61 - 11 Aug 2011
Cited by 2 | Viewed by 1
Abstract
A rare case of a posttraumatic extensive ganglion cyst of the anterolateral thigh with connection to the knee joint is presented. A 54- year-old man presented a palpable mass in the anterolateral region of his right thigh with a 15 months existing sense [...] Read more.
A rare case of a posttraumatic extensive ganglion cyst of the anterolateral thigh with connection to the knee joint is presented. A 54- year-old man presented a palpable mass in the anterolateral region of his right thigh with a 15 months existing sense of fullness and tightness. He had an accident with his bicycle 21 months ago. Magnetic resonance imaging (MRI) was performed showing a cyst inside the quadriceps femoris muscle between vastus lateralis and intermedius with connection to recessus suprapatellaris and knee joint. In addition MRI detected a traumatic lesion in the quadriceps femoris tendon in the near of the knee joint. The ganglion cyst was 18 cm long and was excised completely. Intraope - ratively, the knee joint connection was confirmed and excised as well. The ganglion cyst was filled with a gelatinous and viscous fluid. Full article
292 KiB  
Case Report
Melanocytoma of the Optic Nerve Head-A Diagnostic Dilemma
by Zalilawati Mohmad, Tan Aik Kah, Ku Chui Yong, Wan Haslina Wan Abdul Halim and Then Kong Yong
Clin. Pract. 2011, 1(3), e60; https://doi.org/10.4081/cp.2011.e60 - 11 Aug 2011
Cited by 10 | Viewed by 1
Abstract
The clinical features, autofluorescence, Bscan ultrasonography, optical coherence tomography and fluorescein angiography of the lesion were described. Multiple investigation modalities are needed to confirm the benign nature of the lesion. Careful evaluation and follow-up is crucial to avoid misdiagnosis and erroneous management. Full article
168 KiB  
Case Report
Canaliculitis in Supernumerary Puncta and Canaliculi
by Ku Chui Yong, Tan Aik Kah and Faridah Hanom Annuar
Clin. Pract. 2011, 1(3), e59; https://doi.org/10.4081/cp.2011.e59 - 11 Aug 2011
Cited by 2 | Viewed by 1
Abstract
We report the first case of supernumerary puncta and canaliculi presented with canaliculitis. A-59 year-old gentleman presented with painful swelling of the left lower lid for a week, which was associated with epiphora. The swelling was confined to the nasal aspect of the [...] Read more.
We report the first case of supernumerary puncta and canaliculi presented with canaliculitis. A-59 year-old gentleman presented with painful swelling of the left lower lid for a week, which was associated with epiphora. The swelling was confined to the nasal aspect of the left lower lid (0.5 × 0.5 mm) with inflamed overlying skin. Two puncta (0.5 mm apart) were noted. The outer punctum at the normal anatomical position was a cul-de-sac while the inner punctum it the caruncle was patent. We described the embryology leading to supernumerary puncta and canaliculi to explain the paradoxical patency of the abnormally located punctum as well as the pathomechanism leading to canaliculitis. The patient was treated with oral cloxacillin 500 mg, 6 hourly for 5 days; the cellulitis subsided after three days. Full article
70 KiB  
Case Report
Fluctuations in C-Reactive Protein in a Hepatoblastoma Patient with Thrombocytosis
by Yuya Sato, Ayaka Kokubu, Keitaro Fukushima, Mayuko Okuya, Susumu Hagisawa, Hidemitsu Kurosawa, Kenichi Sugita, Osamu Arisaka, Kentaro Okamoto and Takashi Tsuchioka
Clin. Pract. 2011, 1(3), e56; https://doi.org/10.4081/cp.2011.e56 - 09 Aug 2011
Cited by 1 | Viewed by 1
Abstract
We observed the changes in serum levels of interleukin 6 (IL-6) and C-reactive protein (CRP) in a patient with hepatoblastoma exhibiting thrombocytosis. The concomitant changes of IL-6 and CRP concentrations after the initiation of chemotherapy, in the absence of infection, suggested that the [...] Read more.
We observed the changes in serum levels of interleukin 6 (IL-6) and C-reactive protein (CRP) in a patient with hepatoblastoma exhibiting thrombocytosis. The concomitant changes of IL-6 and CRP concentrations after the initiation of chemotherapy, in the absence of infection, suggested that the IL-6, which is synthesized in hepatoblastoma cells and induces thrombocytosis, also stimulated CRP production in the present case. IL-6 is thought to play an important role in thrombocytosis in hepatoblastoma. Full article
397 KiB  
Case Report
Dexmedetomidine for an Awake Fiber-Optic Intubation of a Parturient with Klippel-Feil Syndrome, Type I Arnold Chiari Malformation and Status Post Released Tethered Spinal Cord Presenting for Repeat Cesarean Section
by Tanmay H. Shah, Manasi S. Badve, Kowe O. Olajide, Havyn M. Skorupan, Jonathan H. Waters and Manuel C. Vallejo
Clin. Pract. 2011, 1(3), e57; https://doi.org/10.4081/cp.2011.e57 - 04 Aug 2011
Cited by 12 | Viewed by 1
Abstract
Patients with Klippel-Feil Syndrome (KFS) have congenital fusion of their cervical vertebrae due to a failure in the normal segmentation of the cervical vertebrae during the early weeks of gestation and also have myriad of other associated anomalies. Because of limited neck mobility, [...] Read more.
Patients with Klippel-Feil Syndrome (KFS) have congenital fusion of their cervical vertebrae due to a failure in the normal segmentation of the cervical vertebrae during the early weeks of gestation and also have myriad of other associated anomalies. Because of limited neck mobility, airway management in these patients can be a challenge for the anesthesiologist. We describe a unique case in which a dexmedetomidine infusion was used as sedation for an awake fiber-optic intubation in a parturient with Klippel-Feil Syndrome, who presented for elective cesarean delivery. A 36-yearold female, G2P1A0 with KFS (fusion of cervical vertebrae) who had prior cesarean section for breech presentation with difficult airway management was scheduled for repeat cesarean delivery. After obtaining an informed consent, patient was taken in the operating room and non-invasive monitors were applied. Dexmedetomidine infusion was started and after adequate sedation, an awake fiberoptic intubation was performed. General anesthetic was administered after intubation and dexmedetomidine infusion was continued on maintenance dose until extubation. Klippel-Feil Syndrome (KFS) is a rare congenital disorder for which the true incidence is unknown, which makes it even rare to see a parturient with this disease. Patients with KFS usually have other congenital abnormalities as well, sometimes including the whole thoraco-lumbar spine (Type III) precluding the use of neuraxial anesthesia for these patients. Obstetric patients with KFS can present unique challenges in administering anesthesia and analgesia, primarily as it relates to the airway and dexmedetomidine infusion has shown promising result to manage the airway through awake fiberoptic intubation without any adverse effects on mother and fetus. Full article
596 KiB  
Case Report
Giant Cell Tumor of Soft Tissue of Hand: Simple but Rare Diagnosis, Which Is Often Missed
by Sarwan Kumar and Lynn F. Carter
Clin. Pract. 2011, 1(3), e54; https://doi.org/10.4081/cp.2011.e54 - 13 Jul 2011
Cited by 2
Abstract
Giant cell tumor of soft tissue originally described in 1972 in two different series by Salm and Sissons is a rare entity, which is clinically and histopathologically indistinguishable from giant cell tumor of bone. Usually involve thigh, trunk, and lower extremities but rarely [...] Read more.
Giant cell tumor of soft tissue originally described in 1972 in two different series by Salm and Sissons is a rare entity, which is clinically and histopathologically indistinguishable from giant cell tumor of bone. Usually involve thigh, trunk, and lower extremities but rarely involve the hands. GCT-ST is a benign tumor, which can transform into malignant form and also has potential for recurrence and metastasis. We present an otherwise healthy, middle age female who originally presented with swellings on her left finger was diagnosed with giant cell tumor of soft tissue hand. Full article
232 KiB  
Case Report
Meckel’s Diverticulitis Causing Small Bowel Obstruction by a Novel Mechanism
by Vishalkumar G. Shelat, Kaiwen Kelvin Li, Anil Rao and Tay Sze Guan
Clin. Pract. 2011, 1(3), e51; https://doi.org/10.4081/cp.2011.e51 - 07 Jul 2011
Cited by 3
Abstract
Meckel’s diverticulum occurs in 2% of the general population and majority of patients remain asymptomatic. Gastrointestinal bleeding is the most common presentation in the paediatric population. While asymptomatic and incidentally found Meckel’s diverticulum may be left alone, surgery is essential for treating a [...] Read more.
Meckel’s diverticulum occurs in 2% of the general population and majority of patients remain asymptomatic. Gastrointestinal bleeding is the most common presentation in the paediatric population. While asymptomatic and incidentally found Meckel’s diverticulum may be left alone, surgery is essential for treating a symptomatic patient. Despite advances in imaging and technology, pre-operative diagnosis is often difficult. We present a first report of an unusual mechanism of small bowel obstruction due to Meckel’s diverticulitis in a paediatric patient. The diagnosis was only apparent at laparotomy. Full article
235 KiB  
Case Report
Lobar Flexible Fiberoptic Lung Lavage: Therapeutic Benefit in Severe Respiratory Failure in Pulmonary Alveolar Proteinosis and Influenza A H1N1 Pneumonia
by Antonello Nicolini and Cornelius Barlascini
Clin. Pract. 2011, 1(3), e53; https://doi.org/10.4081/cp.2011.e53 - 05 Jul 2011
Cited by 5
Abstract
Lobar fiberoptic lung lavage is a well-known procedure used in primary pulmonary alveolar proteinosis (PAP); the use of this procedure has increased in the recent years. This procedure has also been used in other pulmonary diseases such as desquamative interstitial pneumonia with good [...] Read more.
Lobar fiberoptic lung lavage is a well-known procedure used in primary pulmonary alveolar proteinosis (PAP); the use of this procedure has increased in the recent years. This procedure has also been used in other pulmonary diseases such as desquamative interstitial pneumonia with good results. We describe a case of extremely severe respiratory failure due to concurrence of PAP and Influenza A H1N1 virus pneumonia which resolved with the help of this procedure. The patient, a 41- year-old woman, needed less mechanical ventilation after undergoing lobar fiberoptic bronchoscopic lavage. Moreover, a rapid and progressive improvement in the computed tomography of the lungs was observed. Flexibile fiberoptic bronchoscopic lobar lavage is a simple, safe procedure used not only in milder disease, but also in particular severe cases in which the physiological derangement of whole lung lavage would not be tolerated by patient or when extra-corporeal membrane oxygenation is not available. Full article
195 KiB  
Case Report
Successful Neuroendoscopic Treatment of Intraventricular Brain Abscess Rupture
by Takafumi Nishizaki, Norio Ikeda, Shigeki Nakano, Takanori Sakakura, Masaru Abiko and Tomomi Okamura
Clin. Pract. 2011, 1(3), e52; https://doi.org/10.4081/cp.2011.e52 - 05 Jul 2011
Cited by 7
Abstract
Intraventricular rupture of a brain abscess is still associated with a high mortality rate. Here, we report such a case in a patient with normal immunity that was treated successfully using neuroendoscopic approach. A 69-yearold man who had presented with headache and fever [...] Read more.
Intraventricular rupture of a brain abscess is still associated with a high mortality rate. Here, we report such a case in a patient with normal immunity that was treated successfully using neuroendoscopic approach. A 69-yearold man who had presented with headache and fever developed confusion and restlessness. Magnetic resonance imaging revealed a mass with ring enhancement extending to the right ventricle. Emergency aspiration of cerebrospinal fluid (CSF) from the spinal canal revealed severe purulent meningitis. Bacterial culture of the CSF and blood was negative. Because of prolonged consciousness disturbance, the patient underwent evacuation of the intraventrcular abscess using a neuroendoscope. The pus was centrifuged and collected for bacterial culture, and this revealed Streptococcus intermedius/milleri. After implantation of a ventricular catheter, gentamicin sulfate was administered twice a day for 9 days. Cefotaxime sodium was also administered intravenously for 14 days, followed by oral administration of cefcapene pivoxil hydrochloride for 10 days. The patient made a complete recovery, and was discharged 31 days after admission. After 20 months of follow-up, he is doing well and has returned to his work. In cases of intraventricular rupture of a brain abscess, a neuroendoscopic approach is useful for evacuation of intraventricular debris or septum, and identification of the causative bacterium for selection of antibiotics, possibly reducing the period of hospitalization. Full article
203 KiB  
Case Report
The Immediate Effects of a Novel Auditory and Proprioceptive Training Device on Gait after Stroke
by Eric G. Johnson, Everett B. Lohman, Abel Rendon, Ektaben G. Dobariya, Shubhada S. Ramani and Lissie E. Mayer
Clin. Pract. 2011, 1(3), e46; https://doi.org/10.4081/cp.2011.e46 - 05 Jul 2011
Cited by 1
Abstract
This case report describes the immediate effects of a new rehabilitation tool on gait in a chronic stroke patient. Specifically, we measured step length symmetry and gait velocity in a 47 year-old male stroke patient who was currently receiving outpatient physical therapy. Objective [...] Read more.
This case report describes the immediate effects of a new rehabilitation tool on gait in a chronic stroke patient. Specifically, we measured step length symmetry and gait velocity in a 47 year-old male stroke patient who was currently receiving outpatient physical therapy. Objective gait measurements were taken using the GAITRite before, during, and after a 5 minute training session. Step length symmetry improved 26% during the first minute of training, 71% by the fifth minute of training, and 72% after a 5 minute rest period post-training. Gait velocity increased by 5.5% after 5 minutes of training. Clinical research is warranted to validate this new training tool as a useful adjunctive rehabilitation activity for improving spatial and temporal aspects of gait after stroke. Full article
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