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PMC6240727_01_gr3.jpg
PMC6240727_gr3_undivided_1_1.webp
Clinical course and transition of hemoglobin levels. PAD, post-admission day; SAVR, surgical aortic valve replacement. Black arrow, red blood cell transfusion.
Under anticoagulant control of prothrombin time-international normalized ratio at 2.0-2.5, the patient did not develop recurrent anemia in the perioperative period (Fig. 3).
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PMC8128129_01_IMCRJ-14-301-g0001.jpg
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MRI-longitudinal view, five days after epidural catheter insertion, showing L3-4 epidural abscess (arrow).
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Axial MRI of lumbar epidural abscess.
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Image of lumbar epidural abscess during surgery.
Since there were no changes in symptoms in the patient after using antibiotics, after two days, surgery was indicated to remove the absces and, clean the epidural area (Figure 3).
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PMC5457933_01_1349-7235-56-0861-g002.jpg
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The macroscopic findings at autopsy; the digestive tract and the other abdominal organs have become a single mass.
Severe adhesion of the digestive tract was observed, which formed a cluster with the abdominal organs (Fig. 2).
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PMC5457933_01_1349-7235-56-0861-g003.jpg
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Photomicrographs of Hematoxylin and Eosin (H&E) staining sections (left: H&E stainingx40, right: H&E stainingx400). Panel A shows the tubulopapillary pattern and Panel B shows the sarcomatous pattern.
A histological examination of the Hematoxylin and Eosin (H&E) staining sections revealed neoplastic cells with a tubulopapillary appearance (Fig. 3A), as well as tightly packed spindle cells (Fig. 3B), which represented epithelioid and sarcomatous tumor components, respectively.
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PMC6299974_01_fimmu-09-02944-g0001.jpg
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Unique CARD11 mutation in a four-generation family. (A) Pedigree of patients in a four-generation BENTA family. Squares and circles represent males and females, respectively, and black represents affected patients. (B) Sanger DNA sequencing showing a novel in-frame 12 bp deletion in genomic DNA derived from PBMC isolat...
IgH gene rearrangement analysis demonstrated a polyclonal B-cell lymphocytosis pattern (Supplementary Figure 1). The family reported that parents were not related and were of Caucasian origin (Figure 1A). This analysis revealed a heterozygous four amino acid deletion and missense mutation within exon 5 of CARD11 (NM_03...
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PMC8599274_01_fvets-08-749713-g0001.jpg
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Pain scoring 2 h prior to, during, and after treatment with morphine via a C1-C2 epidural catheter in a horse. The vertical lines indicate the timing and dose of morphine administration. Each data point represents a pain score. Time zero is the time of C1-C2 catheter placement and first morphine dose.
The pain scores from just prior to epidural catheter placement until hospital discharge are depicted in detail in Figure 1.
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PMC8599274_01_fvets-08-749713-g0002.jpg
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Heart rate in beats per minute 2 h prior to, during, and after treatment with morphine via a C1-C2 epidural catheter in a horse. The vertical lines indicate the timing and dose of morphine administration. Each data point represents a heart rate. Time zero is the time of C1-C2 catheter placement and first morphine dose.
In response to epidural morphine, the heart rate decreased and remained within physiological limits for the remainder of his hospitalization (Figure 2).
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PMC9019075_01_fsurg-09-852757-g0001.jpg
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Abdominal ultrasonography images in the epigastric sagittal view: a hypoechoic, irregularly shaped solid mass was seen adjacent to the IVC.
Ultrasound of the abdomen showed a retroperitoneal tumor measuring 4.8 x 2.3 cm (Figure 1).
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Preoperative contrast-enhanced CT images. The border between the tumor and IVC was indistinct.
Abdominal contrast enhanced computed tomography (CT) revealed a retroperitoneal mass 34 mm x 27 mm in size, near right renal veins extending to inferior vena cava, and it was pushing the pancreas forward (Figure 2). Abdominal contrast enhanced CT did not reveal any evidence of retroperitoneal enlarged lymph nodes. The ...
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Preoperative contrast-enhanced CT images revealed a ball-shaped mass with heterogeneous enhancement in the left lung lobe.
The CT scan of the chest showed a tumor in the lingual segment of the upper lobe of the left lung, consisting of ground-glass nodules with unclear boundaries; The tumor was approximately 1.3 cm x 1.1 cm in size and multiple short burls can be seen around the edges of the tumor. There were no enlarged lymph nodes in the...
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Image showing spindle-shaped tumor cells with areas of hypercellularity that were arranged in fascicles, bundles and interlacing patterns.
The histopathological examination showed a well-circumscribed mass composed of spindle cells arranged in interlaced and bundles (Figure 4). The nucleus is deeply stained, the end is blunt, located in the center, with a certain degree of heteromorphism and pleomorphism (Figure 4).
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The histopathological examination of the excised mass combined with the pathology expert group discussion considered lung adenocarcinoma.
The histopathological examination of the excised mass showed lung adenocarcinoma (Figure 5).
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Contrast-enhanced CT images at 18 months after second surgery: lump in upper lobe of the right lung.
Follow-up based on patient's recent medical history, chest and abdominal physical examination, complete blood count, liver function tests, tumor markers monitoring, ultrasound scan of the abdomen every 3 months, CT scans of the lung, abdomen and head every 6 months. 20 months after resection of inferior vena cava leiom...
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Contrast-enhanced CT images at 18 months after second surgery: lump in lower lobe of the right lung.
Follow-up based on patient's recent medical history, chest and abdominal physical examination, complete blood count, liver function tests, tumor markers monitoring, ultrasound scan of the abdomen every 3 months, CT scans of the lung, abdomen and head every 6 months. 20 months after resection of inferior vena cava leiom...
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The metastasis of inferior vena cava sarcoma in lung.
The immunohistochemical results of postoperative specimens were consistent with the metastasis of inferior vena cava leiomyosarcoma (Figure 8).
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Historical and current information from this case organized as a timeline.
During on-going regular follow-up visits no evidence of recurrence or metastasis was observed from December 2020 to October 2021 (Figure 9).
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PMC7332490_01_SNI-11-149-g001.jpg
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Angio-CT scan. (a) Cavernous segment of the right internal carotid artery, below the line of projection of the planum sphenoidale (red dotted line). (b) Cavernous segment of the left internal carotid artery with its posterior genu above the line of projection of the planum sphenoidale (red dotted line). (c) Enlargement...
SAH, but showed an expansive process in the sella turcica associated with sellar enlargement [Figure 1]. SAH was then confirmed by lumbar puncture (Fisher I).
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(a) Intraoperative image showing the carotid aneurysm (white arrow), compressing the left oculomotor nerve; (b) schematic representation of the aneurysm (white arrow), compressing the oculomotor nerve; (c) image after microsurgical clipping (black arrow). AC: Anterior clinoid; CN II: Optic cranial nerve; CN III: Oculom...
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Postoperative left carotid angiography (a: Frontal; b: Oblique; and c: Lateral) showing the clip adjacent to the cavernous segment of the left internal carotid artery, with complete aneurysm occlusion.
He underwent control cerebral angiography on the 2nd postoperative day that demonstrated complete aneurysm occlusion [Figure 4], with no residual neck and no vasospasm and complemented the study with magnetic resonance imaging (MRI) of the sella turcica that was consistent of pituitary macroadenoma with apoplexy [Figur...
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Sella turcica magnetic resonance imaging consistent with pituitary macroadenoma with apoplexia (a: Axial fluid-attenuated inversion recovery; b: Coronal T1 with gadolinium; and c: Sagittal T1 with gadolinium).
He underwent control cerebral angiography on the 2nd postoperative day that demonstrated complete aneurysm occlusion [Figure 4], with no residual neck and no vasospasm and complemented the study with magnetic resonance imaging (MRI) of the sella turcica that was consistent of pituitary macroadenoma with apoplexy [Figur...
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PMC6302554_01_SNI-9-252-g001.jpg
PMC6302554_SNI-9-252-g001_a_1_2.webp
(a) Axial CT scan showing the Fisher Grade 3 aneurysmal subarachnoid hemorrhage. (b) Axial CT showing a left subdural hematoma with 3.94 mm of midline shift
A 72-year-old female presented with a Fisher Grade 3 and World Federation of Neurological Societies Grade V aneurysmal subarachnoid hemorrhage (SAH) and an acute left traumatic subdural hematoma (SDH) post fall [Figure 1a and b].
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(a) Angiography (anteroposterior view) confirms the presence of a 5.5 x 3.4 x 3.7 mm superiorly projecting aneurysm arising from the supraclinoid internal carotid artery (ICA) with a 2.5 mm neck. (b) Angiography showing good occlusion of the fundus but some residual neck filling of the right ICA
Cerebral angiography showed a superiorly projecting 5.5x3.4x3.7 mm3 aneurysm arising from the supraclinoid internal carotid artery (ICA) [Figure 2a]. She underwent balloon assisted coiling of the right paraophthalmic aneurysm using microvention coils one day after the SAH [Figure 2b].
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(a and b) Angiography showing severe vasospasm of the right (3a), left A1s and its distal branches
Angiography one week post coiling showed severe vasospasm of the bilateral A1s and its distal branches [Figure 3a and b].
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PMC7351623_01_CEG-13-249-g0001.jpg
PMC7351623_CEG-13-249-g0001_A_1_2.webp
There was a mass near the cecum. The elevation of tissue fascia and free air were detected (A). There were several small polyps at ileocecal section (B).
The CT revealed a mass with elevation of tissue fascia and free air near the cecum (Figure 1A). We did not detect the mass from the resected specimen (Figure 1B), and pathological examination revealed no malignancy.
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The enhanced CT in December 2017 showed the mass of 38mm with dyeing ring form in the left rectus abdominis muscle. The mass was located near the ileostomy closure scar. The triangle points to the tumor.
The mass was located near the scar of ileostomy closure (Figure 2).
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The MRI in April 2018 showed the mass of 40mm in the left rectus abdominis muscle. The mass showed low intensity area like muscle in T2 weighted images (A). It was uniformly enhanced (B). The triangle points to the tumor.
T2 weighted image showed a low intensity area similar to muscle (Figure 3A), and the tumor was uniformly enhanced (Figure 3B).
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The final form after resection of tumor (A). The gray zone is the part that was removed. The defect was repaired with a simple closure and the defect was closed by suturing the right anterior layer of rectus sheath to the left aponeurosis of external oblique muscle (B). We used fascia lata patch as on lay mesh on defec...
We used a fascia lata patch measuring 15 cm x 5 cm (Figure 4E) to repair the defect in the left abdomen (Figures 4F and 5A-C).
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The tissue image is a magnified view of the red square part in the lower right image. The black line at the bottom left shows 50microm. The size of the mass was 45mmx45mm, the cut surface was white (A). The growth of fibroblasts was seen, the nuclear heteromorphic was poor. There was abundant collagen fibers between fi...
The macroscopic view of the resected tumor revealed its whitish color (Figure 6A). Pathological analysis revealed the growth of fibroblasts, defect of the nuclear heteromorphism, and presence of abundant collagen fibers between fibroblasts (Figure 6B). Additionally, a nuclear-positive image of beta-catenin was observed...
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PMC4759896_01_MEAJO-23-150-g001.jpg
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At presentation (a) Color fundus photograph of the right eye showed chorioretinal scar along the superotemporal arcade, deep creamy lesion inferior to the scar with bleb like subretinal fluid with macular involvement as demonstrated in the optical coherence tomography (b); (c and d) two areas of early hypofluorescence ...
Late indocyanine green showed defined areas of hypofluorescence corresponding to a scar and recent choroidal ischemia [Figure 1].
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PMC7358707_01_gr1.jpg
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MRI Brain: showing ring enhancing lesions before (A) and after (B) the treatment.
T2 and FLAIR hyper-intense) lesions of varying sizes in cerebral hemispheres, right basal ganglia and cerebellum with perilesional edema. The largest lesion was located on right frontal lobe and measured 30 x 24 mm, surrounded by vasogenic edema and causing mass effects (Fig. 1: A). Repeated MRI after a month of treatm...
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Thickened mucosa throughout oropharynx, supraglottic larynx including the epiglottis, aryepiglottic folds, piriform sinuses, and false vocal cords. Narrowing of the airway including effacement of the piriform sinuses and vallecula. Mild thickening of the true vocal cords. Prominent soft tissue with erosive change in th...
Computed tomography of the neck was performed and revealed diffuse thickening of the mucosal oropharynx, supraglottic larynx, aryepiglottic folds, piriform sinuses, and true/false vocal cords (Fig. 1, Fig. 2).
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Hematoxylin and eosin stained section demonstrating multiple multinucleate giant cells containing numerous organisms consistent with Histoplasma spp. (40x).
Histologic examination of the biopsy revealed granulomatous mucositis with multinucleated giant cells containing multiple budding yeast forms (Fig. 3) that stained with Grocott's methenamine silver (Fig. 4) and were consistent with histoplasma species.
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Periprosthetic fracture.
Plain radiographs revealed a periprosthetic fracture with a spiral pattern, which started in the cervical area and reached the subtrochanteric area (Fig. 1).
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Postoperative radiograph. Internal fixation with trochanteric plate and cerclages.
Postoperative radiographs revealed a satisfactory reduction of the fracture (Fig. 2, Fig. 3).
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Hard and soft palates of a 5-year-old boy with a history of Furlow double-opposing Z-plasty palatoplasty (dashed line). Note the short palatal length and nonanatomical location of the velum relative to the posterior pharyngeal wall.
A short velum was noted (Fig 1), so he underwent palatal lengthening with double-opposing buccal flaps.
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CT scan before the initiation of osimertinib showed a primary tumor in left upper and lower lung and lymphadenopathy of hilar and mediastinum.
Lung computed tomography (CT) scan showed left upper lung tumor and hilar and mediastinal lymph node enlargement (Fig. 1).
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CT scan after prednisolone administration. The tumor size slightly reduced, and the axillary lymph node was completely diminished.
Prednisolone (0.6 mg/kg/day) was administered, and improvement of his symptoms and multiple lymphadenopathies was observed (Fig. 4).
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Preoperative ECG. The typical characteristics of the Brugada type 1 ECG pattern are shown
The ECG showed a coved V1 pattern, which remained unchanged [Figure 1].
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Day two postoperative X-rays of the right arm.
The humerus was shortened 2 cm and then fixed with a dynamic compression plate (see figure 1).
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Lateral view of the patient 4 years postinjury.
He had fixed deformities of 90 degrees at the proximal interphalangeal joints and 45 degrees at the distal interphalangeal joints (see figures 2-4).
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Anteroposterior view of the client 4 years postinjury.
He had fixed deformities of 90 degrees at the proximal interphalangeal joints and 45 degrees at the distal interphalangeal joints (see figures 2-4).
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Dorsal view of the right hand 4 years postinjury. Demonstrating numerous deformity involving the wrist and digits.
He had fixed deformities of 90 degrees at the proximal interphalangeal joints and 45 degrees at the distal interphalangeal joints (see figures 2-4).
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The blister appeared on the penile corpus 24 h after the circumcision.
At 24-h post-circumcision, the swelling had improved, but the blister remained (Figure 1).
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Superficial ulcer at the corpus, yellowish necrotic tissue at the glans, and crust were apparent.
On the third day, yellowish-necrotic tissue was observed on the lateral side of the glans (Figure 2).
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The penile wound healed 4 months after circumcision.
Four months after the circumcision event, the penis had healed without any cicatrix (Figure 3).
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Plain abdominal radiograph showing the metallic screw in the right iliac fossa
Plain radiographs [Figure 1] of the abdomen showed a metallic screw in the right lower quadrant.
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Right-sided mandibular swelling.
Examination showed a marked right-sided swelling (Fig. 1).
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Brain diffusion magnetic resonance imaging showing areas of restricted diffusion compatible with hyperintense infarction in the right frontal lobe (A), and hypointense infarction on apparent diffusion coefficient mapping (B) (arrows).
Brain diffusion magnetic resonance imaging showed multiple advanced stage infarctions (Figure 2).
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MRI of the left knee showing marked flakes and nodular long signals on T2-weighted MRI in the distal femur, proximal tibia, and even the osteoephysis.
The lesions were particularly evident in the right distal femur (Fig. 3).
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Hematoxylin and eosin (H&E) staining (magnificationx100) indicates tumor cells producing osteoid.
An open bone biopsy was performed on the bilateral distal femora and proximal tibiae, and four foci were found that exhibited mid-grade osteoblastic osteosarcoma (Fig. 4).
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Thoracolumbar MRI (A) shows a short signal on T2-weighted MRI in the T2 to T11, L1 to L5, and sacral vertebra. (B, C) Flake low signal shadows are observed outside of the spinal cord and dura in the T4-T5 and T9-T10 spinal body plane. MRI taken after neoadjuvant chemotherapy (A) indicated that the number of lesions inc...
In comparison to the previous MRI (Fig. 5B and C), the number of lesions had increased and the tumors in the spinal canal were amplified after the neoadjuvant chemotherapy (Fig. 5A).
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Clinical course of patient 1.
Patient 3 (Figures 1-3). Pneumonia developed 8, 12, and 7 days after the onset of illness in Patients 1, 2, and 3, respectively (Figure 4; P1A, P2A, and P3A).
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Clinical course of patient 2.
Patient 3 (Figures 1-3). Pneumonia developed 8, 12, and 7 days after the onset of illness in Patients 1, 2, and 3, respectively (Figure 4; P1A, P2A, and P3A).
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Clinical course of patient 3. BT, body temperature; CT, computed tomographic scan; CXP, chest X-ray photograph; Neg, negative PCR test; PCR, polymerase chain reaction test for COVID-19 nucleic acid; Pos, positive PCR test; RV, reference value.
Patient 3 (Figures 1-3). Pneumonia developed 8, 12, and 7 days after the onset of illness in Patients 1, 2, and 3, respectively (Figure 4; P1A, P2A, and P3A).
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MRI with axial T1WI (a), axial T2WI (b) and sagittal T1WI (c) images, obtained 3 months after hemorrhage, showing resorption of the hematoma and residual encephalomalacia in the right occipital lobe
Three months following the hemorrhage, on November 16, 1995, she underwent a brain Magnetic Resonance Imaging (MRI) that showed an area of encephalomalacia in the right occipital lobe [Figure 2].
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Anteroposterior (AP, a) and lateral (b) right internal carotid artery angiogram, performed 4 months after hemorrhage, showing a right occipital Spetzler-Martin grade III arteriovenous malformation (4 x 3 x 1.5 cm) with feeders from the posterior parietal and angular branches of the middle cerebral artery and early supe...
A subsequent DSA was performed on December 28, 1995, which revealed a Spetzler-Martin grade III (4 x 3 x 1.5 cm) occipital AVM supplied by the posterior parietal and angular branches of the middle cerebral artery (MCA) and draining through a superficial cortical vein into the right transverse sinus [Figure 3].
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Radiographic progression of bone non-union. (A) At the first visit, radiographs of the right hind limb show a diaphyseal comminuted fracture of the right femur with active bone callus formation and implant failure. (B) Three months after the first revision surgery, the radiographs of the right femur show implant loosen...
Radiographic examination revealed a closed, comminuted, mid-diaphyseal fracture of the right femur with notable bone callus formation and implant failure (Figure 1A). Radiographic examination indicated 30% femoral shortening and loosening of the four distal screws (Figure 1B). However, 4 months later, the lameness rema...
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Surgical procedures. (A) Debridement of the diaphyseal fracture site of the right femur using a harmonic scalpel. (B) Medullary recanalization using a 2.8-mm pin. (C) Autograft harvested from the ipsilateral seventh rib. (D) Fixation using a locking plate system followed by transplantation of the autologous rib; the as...
Tokyo, Japan) (Figure 3A). The medullary canal was recanalized by drilling a 2.8-mm pin into the canal from the fracture site (Figure 3B). The fractured edges were maximally distracted using bone-holding forceps, although the original bone length could not be restored due to excessive soft tissue tension. Tokyo, Japan)...
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(A) The clinical appearance of the patient with apparent fullness of the right upper eyelid; (B) Coronal computerized tomography scan showing bilateral superior orbital cystic lesions, more prominent on the right side (Red arrows); (C) Sagittal computerized tomography scan of the right orbit showing the fusiform lesion...
The superior fullness over the right upper eyelid was evident to the patient and disturbing for her cosmetically (Fig. 1A). The remaining extraocular muscles were preserved (Fig. 1B and C).
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Platelet and hemoglobin levels after starting antimicrobial therapy.
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Non-blanching erythematous palpable petechiae and purpura on the right thigh (A) and left arm (B).
Non-blanching erythematous palpable petechiae and purpura (Fig. 1) were found on both thighs, both arms, and the lower abdomen on June 16.
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Perivascular neutrophilic infiltration with leukocytoclastic debris is seen in the deep dermis (Hematoxylin and eosin stain, X 100) (A). Direct immunofluorescence staining demonstrates granular deposition of immunoglobulin A (B) and complement 3 (C) in dermal blood vessels. Arrows indicate the deposited immunoglobulin ...
Direct immunofluorescence (DIF) staining demonstrated granular deposition of immunoglobulin A and C3 in dermal blood vessels (Fig. 2).
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Sagittal MR T1-weighted, T2-weighted (a) T1-fat saturated post contrast (b), axial T1-post gadolinium (c), and axial T2-weighted (d) images demonstrating a T1 hypointense, T2 hyperintense enhancing mass centered in the L3 vertebral body with significant epidural and retroperitoneal extension and decreased marrow signal...
Established T1 (hypointense), T2 (hyperintense), and T1 enhanced magnetic resonance (MR) studies documented a large tumor centered at the L3 level with marked epidural compression and bilateral retroperitoneal extension [Figure 1].
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Post Stage 1 images on lateral plain film (a), AP plain film (b), axial CT (c), and midsagittal CT (d)
Pedicle screws were then connected with two rods and a crosslink [Figure 2].
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Final construct shown on AP (a) and lateral (b) plain films
T11 and T12 were taken, the psoas muscle was mobilized, and the anterolateral disc spaces of L2/3 and L3/4 were exposed allowing retroperitoneal tumor resection utilizing annulotomies and diskectomies [Figure 3]. The defect was reconstructed with an expandable cage and lateral plate, whereas the harvested rib was used ...
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A panoramic view of the jaws shows a well-defined unilocular radiolucency with central foci of calcification displacing the roots of the maxillary canine and premolar.
Panoramic (Fig. 1) and occlusal radiographs (Fig. 2) showed an oval well-defined unilocular expansile radiolucency measuring 2 x 1.7 cm.
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(A). Thick walled encapsulated lesion with intraluminal epithelial proliferation and extracapsular fibrous tissue with irregular mineralization (H&E- whole slide digital scan) (B). Multinodular intraluminal solid and cribriform proliferation, CEOT-like areas and extracapsular fibrous lesion with irregular mineralizatio...
A larger well-encapsulated lesion with a thick fibrous wall containing multinodular cellular proliferation with scanty connective tissue and multiple empty areas and, small fibrocellular proliferations interspersed with irregular mineralization partly attached to the extra-capsular surface (Fig. 3A & B).
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(A). Intraluminal nodules consisting of cuboidal or columnar epithelial cells in the shape of nests, rosette-like patterns and duct- like spaces with interlacing strands of oval, angular and elongated epithelial cells between nodules.Double layered basaloid epithelial cells in trabecular or cribriform configurations be...
Basaloid epithelial cells formed single and double layered trabecular or cribriform configurations between and connecting cell rich nodules (Fig. 4A & B). The endothelial lining of the blood vessels showed degenerative changes (Fig. 4A).
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CEOT -like area. (A). Island of polygonal epithelial cells with intracytoplasmic homogenous material and calcification (H& E x 400). (B). Polyhedral epithelial cells exhibiting intercellular bridges and calcification (H&E x 600).
Few areas showed collections of eosinophilic polyhedral squamous like epithelial cells with well-defined cell borders (Fig. 5A) and intercellular bridges (Fig. 5B). Calcified bodies were found through- out the lesion but were mostly associated with the polygonal cells (Fig. 5B).
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Congo-red positive islands of amorphous eosinophilic (amyloid like) material (x 200). (A). Light microscopy, (B). Apple green birefringence - partially crossed polarz, (C). Crossed polarz (x200).
Islands of amyloid- like material that were Congo-red positive and produced characteristic apple green birefringence on polarized microscopy were also found (Fig. 6A-C).
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(A). Fibrocellular tissue interspersed with irregular trabeculae of bone and cementum-like tissue and foci of hemorrhage (H&E x 40). (B). Fibrocellular connective tissue interspersed with ginger root-like trabeculae showing few lacunae and ovoid cementicles with prominent resting lines (H& E x 100).
Cellular areas showed spindle-shaped fibroblasts. (Fig. 7A & B).
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Confluence of woven and lamellar bone in maturing trabecule, (A). H&E x 200. (B). Polarized light microscopy x 200.
The maturing areas of the lesion showed a confluence of woven and lamellar bone (Fig. 8A & B).
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Abdominal magnetic resonance imaging (MRI). A round mass (white arrow) is shown in the middle part of the left kidney with a maximum diameter of 8.3 cm, heterogeneous signal with multiple partitions. (A) Axial plane. (B) Coronal plane.
Abdominal magnetic resonance imaging (MRI) showed a round mass in the middle part of the left kidney with a maximum diameter of 8.3 cm (Figure 1).
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Gross section of the tumor. A solid tumor of 8 cm was removed, with a smooth capsule and a clear boundary with renal parenchyma.
The pathology report revealed an 8.2-cm clear RCC, Fuhrman grade 2, with negative surgical margins (Figure 2).
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Patient A maximum intensity projection (MIP) images. (A) Extravasated injection. (B) Repeated imaging. Arrows indicate the clinically relevant area of uptake.
Procedure parameters and images are compared in Table 3 and Figure 1.
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Patient B MIP images. (A) Initial re-staging imaging. (B) Second re-staging extravasated injection. (C) Repeated imaging. Arrows indicate the areas of relevant uptake which were not visible after extravasation.
This second re-staging study was compromised by a significant radiopharmaceutical extravasation and was repeated 3 days later. Procedure parameters and images are compared in Table 4 and Figure 2. The extravasated image SUVmax values were understated by 53-73%.
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Patient C MIP images. (A) Extravasated injection. (B) Repeated imaging.
Procedure parameters and images are compared in Table 5 and Figure 3.
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Patient D MIP images. (A) Extravasated injection. (B) Repeated imaging. Arrows indicate the areas of clinically relevant increased uptake.
Procedure parameters and images are compared in Table 6 and Figure 4.
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Patient E MIP images. (A) Extravasated injection. (B) Repeated imaging. Arrows indicate areas of relevant uptake between the two scans.
Procedure parameters and images are compared in Table 7 and Figure 5.
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Histological sample with hematoxylin and eosin stain showed a highly vascular tumor, containing abundant capillary vessels and stromal cells, intermingled with a rich population of red blood cells as well (400x).
Histological examination of the tumor specimen exposed a highly vascular tumor containing abundant capillary vessels and stromal cells intermingled with a large number of red blood cells that certified the occurrence of the intratumoral hemorrhage (Figure 2).
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(A) Computed tomography scan without contrast administration presents low-density shadow on the operative region. (B) Axial T1-weighted MRI with contrast infusion revealed no enhanced lesions in the cerebellum. MRI = magnetic resonance imaging.
A computed tomography (CT) scan without contrast infusion was taken 1 day after the operation and presented a low-density shadow on the operative region (due to tumor resection) and no abnormal density lesions on other regions (Figure 3A). The MRI with contrast infusion revealed no enhanced lesions in the cerebellum (F...
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Transthoracic echocardiogram showed elevated inflow gradient across the tricuspid valve. The mean gradient was increased to 27 mmHg
Transthoracic echocardiogram was limited by poor acoustic window, but showed elevated inflow gradient across the tricuspid valve with the mean pressure of 27 mmHg [Figure 1]. The aortic valve was trileaflet; the right and left coronary leaflets were mildly thickened with vegetation [Figure 3 and Video 1].
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TEE showed the right sinus of Valsalva aneurysm causing tricuspid inflow obstruction
Before direct current cardioversion, transesophageal echocardiogram (TEE) was performed demonstrating a large 3 cm right SVpA causing tricuspid inflow obstruction [Figure 2].
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TEE demonstrated mild thickening of the right and left coronary leaflets (arrows). TEE = Transesophageal echocardiogram
The aortic valve was trileaflet; the right and left coronary leaflets were mildly thickened with vegetation [Figure 3 and Video 1].
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Computed tomography reconstructed in the short axis confirmed a narrow-necked aneurysm arising from the right sinus of Valsalva. TEE = Transesophageal echocardiogram
Cardiac computed tomography (CT) confirmed the echocardiographic findings [Figure 4] demonstrating a narrow-necked pseudoaneurysm arising from the right sinus of Valsalva measuring 3.1 cm (width) x3.5 cm (length) x2 cm (height).
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Firmness and marked increase in size of the right breast as seen on presenting physical examination.
She developed a recurrent fluid collection involving her right breast (Figure 1).
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Axillary lymph node. Axillary lymph node of the same patient shows large atypical cells involving the sinusoidal and lymphatic space, consistent with anaplastic large cells involving the lymph node.
On histopathologic analysis, anaplastic large-cell lymphoma (ALCL), anaplastic lymphoma kinase (ALK)-negative was demonstrated in the fibrous capsule, cystic fluid, and axillary lymph nodes (Figures 2 and 3).
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Right axillary lymphadenopathy demonstrated on axial and coronal PET scan images with abnormal FDG avidity (A,B) and coronal CT images with contrast (C,D).
Imaging with CT and PET scans demonstrated residual right axillary lymphadenopathy with FDG avidity, as illustrated in Figure 4.
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Coronal CT slice of treatment plan showing isodose lines and contoured axillary nodal volume.
The axilla levels 1-3 were contoured and a lightly weighted posterior axillary field was used to bring the volume up to the prescription dose (Figure 5).
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Panoramic fundus photograph. (A) Huge neovascularization can be seen on the optic disc in the right eye. Hypopigmentation of the retinal area exists at upper peripheral region. (B) The entire retina is hypopigmented in the left eye. Major choroidal vessels can be seen throughout the retina. Neovascularization is not ap...
However, no neovascularization could be seen microscopically (Figure 2).
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Sagittal computed tomography scan images showed the right hydroureteronephrosis with the intravesical ureterocele of 7 cm x 4 cm. We can see how the ureterocele is completely intravesical without occupying the bladder neck
A computed tomography (CT) scan confirmed a 7 cm x 4 cm right intravesical ureterocele with Grade III of hydronephrosis [Figure 1].
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Postoperative coronal computed tomography scan image where we can see the ureterocele flap protruding in the bladder neck. The flap defect into the bladder neck, it appeared hypointense respect to the bladder contents and it was through the urethra
The following day, the patient returned with the flap protruding into the urethra, such as demonstrated by cystoscopy and CT scan findings [Figure 2].
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PMC5791444_01
CC BY-NC-SA
PMC6381921_01_cro-0012-0084-g01.jpg
PMC6381921_cro-0012-0084-g01_undivided_1_1.webp
Within 2 weeks after restarting erlotinib, severe pruritus developed again, followed by acneiform skin rush especially on her face.
However, within 2 weeks after restarting erlotinib, severe pruritus of grade 3 developed again, followed by acneiform skin rush especially on her face (Fig. 1).
F1
PMC6381921_01
PMC6381921
file_0090259
PMC6381921_01
CC BY-NC
PMC6381921_01_cro-0012-0084-g02.jpg
PMC6381921_cro-0012-0084-g02_undivided_1_1.webp
Within 5 days after starting the first 3-day dose of aprepitant, the prompt improvement of the pruritus and skin rush was observed.
Then, the prompt improvement was observed within 5 days after starting the first dose of aprepitant, leading to a score of 2 for the pruritus on the VAS (Fig. 2).
F2
PMC6381921_01
PMC6381921
file_0090260
PMC6381921_01
CC BY-NC
PMC6381921_01_cro-0012-0084-g03.jpg
PMC6381921_cro-0012-0084-g03_undivided_1_1.webp
Within 4 weeks after starting the first 3-day dose of aprepitant, the pruritus and skin rush again exacerbated.
However, the pruritus and skin rush gradually exacerbated thereafter, leading to scores of 4 and 8 for the pruritus on the VAS within 2 and 4 weeks, respectively (Fig. 3).
F3
PMC6381921_01
PMC6381921
file_0090261
PMC6381921_01
CC BY-NC
PMC6381921_01_cro-0012-0084-g04.jpg
PMC6381921_cro-0012-0084-g04_undivided_1_1.webp
After adopting the bi-weekly schedule of the 3-day dose of aprepitant, the pruritus and skin rush remained well-controlled throughout the subsequent treatment with erlotinib.
As the results, throughout the subsequent treatment with erlotinib, the pruritus and skin rush remained well-controlled within the scores of 2 and 4 for the pruritus on the VAS (Fig. 4).
F4
PMC6381921_01
PMC6381921
file_0090262
PMC6381921_01
CC BY-NC
PMC3742348_01_ndt-9-1095Fig1.jpg
PMC3742348_ndt-9-1095Fig1_undivided_1_1.webp
A portion of the electroencephalogram report is shown. Note the presence of background alpha activity and rapid rhythms on frontocentral regions, bilaterally.
The electroencephalogram was characterized by background alpha activity and rapid rhythms in the frontocentral regions, bilaterally, as shown in Figure 1.
f1-ndt-9-1095
PMC3742348_01
PMC3742348
file_0026836
PMC3742348_01
CC BY-NC
PMC3742348_01_ndt-9-1095Fig2.jpg
PMC3742348_ndt-9-1095Fig2_undivided_1_1.webp
An Axial fluid-attenuated inversion recovery image obtained by magnetic resonance imaging (MRI) is reported. Note the moderate lesions in the frontal subcortical white matter and in semi oval centres of both sides.
In particular, in long repetition time sequences, these cerebral areas showed hyperintensities compatible with a picture of gliosis, as shown in Figure 2.
f2-ndt-9-1095
PMC3742348_01
PMC3742348
file_0026837
PMC3742348_01
CC BY-NC