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peripheral facial nerve palsy ( fnp ) can result from idiopathic ( primary ) or detectable ( secondary ) causes . secondary causes include systemic viral or other infections , trauma , ischemia , tumor , and extrinsic compression.1 however , secondary fnp by external compression has rarely been reported.2,3,4,5 therape...	peripheral facial nerve palsy ( fnp ) is a mononeuropathy that affects the peripheral part of the facial nerve . primary causes of peripheral fnp remain largely unknown , but detectable causes include systemic infections ( viral and others ) , trauma , ischemia , tumor , and extrinsic compression . peripheral fnp i...
aplasia cutis is a condition in which localized or generalized areas of skin are absent at birth . bullous aplasia cutis congenita is a subtype rarely seen in its initial form ; in most cases , it is found as a flat scar once the bullae have already reabsorbed . in some cases , there is underlying neural tube defects ....	aplasia cutis congenita is a rare condition characterized by the absence of skin and sometimes other underlying structures such as bone or dura . it can be a part of various syndromes and can be associated with multiple genetic diseases , malformation patterns , or a combination of all . it is even considered as a ...
while aortic valve replacement ( avr ) is the treatment of choice for several aortic valve disorders ; it is important to recognize some complications post this surgical procedure . most importantly , these include valve dehiscence , conduction abnormalities , thrombosis , infective endocarditis , fistulas , and left v...	we present a case of a pseudoaneurysm arising from the left ventricular outflow tract / aortic root as a complication of aortic valve surgery . a 45-year - old nigerian female presented to our institution 's emergency department with chest discomfort . she had three bioprosthetic aortic valve replacements in the pr...
the most common organisms causing mucormycosis belong to the genera rhizopus , lichtheimia , and mucor . physicians should maintain a high index of suspicion while encountering nonmycobacterial cavitary lesions not responding to antibiotic therapy . a 44-year - old man presented to us with the chief complaints of on an...	cavitary lung lesions have a specific array of differential diagnosis . among rare causes is mucormycosis that should not be overlooked . a high index of suspicion is necessary for a correct diagnosis and aggressive management . it usually occurs in immunosupressed patients . it is a life - threatening , rapidl...
trichotillomania is a common impulse control disorder seen in both children and adults characterized by the intense urge to pull out one 's hair which then results in hair loss over the scalp , eyebrows , and/or pubic areas . pulling is often caused or preceded by stress and anxiety which is then relieved after the hai...	trichotillomania is a disorder of an impulsive hair pulling that occurs in both adults and children alike . trichotillomania is seen in children and often has other psychiatric comorbidity . here , we present an interesting case of a mother who had trichotillomania and recovered with treatment following which she r...
in 1987 , researchers hunting for cytotoxic cell surface molecules isolated a cdna from activated cd8 t cells and called it cytotoxic t cell antigen ( ctla)-4 ( 2 ) . genetic studies provided a clue that connected ctla-4 to t cell costimulation : ctla-4 and cd28 both mapped to the same chromosomal neighborhood and shar...	ctla-4 was first identified in 1991 as a second receptor for the t cell costimulation ligand b7 . uncertainties about its biological function plagued the early years after its discovery until 1995 , when it was confirmed to be an inhibitor of t cell responses . ctla-4 has since scored in the clinic as a target for ...
extramammary paget 's disease ( empd ) is a rare cutaneous , intraepithelial adenocarcinoma involving primarily the epidermis but occasionally extending into the underlying dermis which accounts for < 1% of carcinomas in vulva and majority of the patients are postmenopausal females . it presents with a long - standing ...	extramammary paget 's disease is a rare cutaneous , intraepithelial adenocarcinoma involving primarily the epidermis but occasionally extending into the underlying dermis . the condition typically presents as a red , velvety , pruritic skin rash of the vulva region which closely mimics a multitude of other , more com...
in a recent article for critical care link and colleagues reported that the reversible platelet glycoprotein iib / iiia antagonist tirofiban may prevent platelet activation and preserves platelet numbers during continuous venovenous haemodialysis in patients with cardiogenic shock . acute kidney failure is a frequent c...	link and colleagues present a pilot study investigating platelet function and platelet numbers in patients with cardiogenic shock and acute kidney failure undergoing continuous venovenous haemodialysis . their data indicate a significantly reduced platelet loss with combined therapy of unfractionated heparin plus tir...
a 56-year - old man was hospitalized because of pain and numbness in his left hand since he slipped a week earlier . , we found that the motor and sensory functions of his left hand were normal . his laboratory data , including anti nuclear antibody , anti - neutrophil cytoplasmic antibody , and rheumatoid arthritis fa...	floating thrombi in the aortic arch are very rare and an unusual source of systemic embolism . herein , a case of a 3-cm thrombus in the aortic arch is reported . it was a floating , highly mobile thrombus attached to the lesser curvature of the aortic arch . the patients had a hypercoagulable disorder induced by p...
idiopathic granulomatous mastitis ( igm ) is an uncommon disease which usually arises in premenopausal women shortly after their last childbirth . its etiology is unclear , however , breast - feeding and the use of oral contraceptives could exert an influence in its pathogenesis . very often clinical and radiological f...	granulomatous mastitis is a rare benign inflammatory disease of the breast with multiple etiologies such as tuberculosis , sarcoidosis , foreign body reaction , and mycotic and parasitic infections . in contrast , idiopathic granulomatous mastitis ( igm ) is characterized by the presence of chronic granulomatous lobu...
a 66-year - old japanese woman was referred to us with a 6-month history of decreased vision and metamorphopsia in the left eye . visual acuity was 20 / 16 for the right eye and 20 / 32 for the left eye . fundus examination showed mild epiretinal membrane in the macula of the right eye , and an elevated , oval , 1-disc...	it has been reported that pulsations in abnormal vessels are observed on indocyanine green ( icg ) angiography in half of patients with polypoidal choroidal vasculopathy ( pcv ) , although the mechanism of the pulsation is unknown . in this study , we report a case of pcv showing venous pulsations at an arterio - ven...
acute subdural hemorrhage requires emergent neurosurgery or close observation because of its high mortality rate . a number of cases who showed rapid resolution of acute subdural hemorrhage with neurological improvements have been reported2,6,7 ) . herein , we present a case who showed rapid resolution of acute subdura...	acute subdural hematoma is usually a neurological emergency that requires hematoma evacuation or close observation . however , spontaneous resolutions of an acute subdural hematoma without surgical interventions have been reported rarely . we report on a case who showed rapid resolution of an acute subdural hematom...
a 42-year - old man with hcv was referred to our hospital in august 2004 because of diarrhea and bloody stool . ten years before admission , he had been diagnosed with total uc endoscopically and histologically . colonoscopic examination revealed reddish and edematous mucosa with multiple erosions through the entire co...	a 42-year - old man with chronic hepatitis c and ulcerative colitis ( uc ) was referred to our hospital in august 2004 because of bloody diarrhea . he was clinically and endoscopically diagnosed with flare of uc . after informed consent had been obtained , he was treated with peg - ifn--2a . four weeks after init...
the presence of pancreatic tissue outside its normal localization and without anatomic and vascular continuity with the normal pancreas is termed heterotopic pancreas ( hp ) ; pancreatic rests , ectopic , aberrant , or accessory pancreas are the other terms to describe the entity . hp may occur throughout the gastroint...	a 9-year - old boy presented with duodenal pancreatic rest causing obstruction and required surgical intervention . he had been treated at the age of 4 months for a choledochal cyst . both choledochal cyst and heterotopic pancreas are entities that are commonly encountered in children , but the incidental presence ...
eccrine angiomatous hamartoma ( eah ) is a benign enlargement of eccrine components , accompanied by abundance of vascular channels . the anomaly is usually asymptomatic , but pain , hypertrichosis , and hyperhidrosis have been reported in a few patients . a 26-year - old female presented with a 2.5 cm 1.5 cm blue - c...	hamartomatous , circumscribed swellings of the extremities make an interesting study . presentations are manifold and the naevi are not always present from birth . excessive growth of hairs leads to remarkable appearance of such swellings . a young woman presented to the dermatology department , complaining of tend...
motor branch or recurrent branch of the median nerve , also called as the thenar branch , innervates the intrinsic muscles of the thumb ( abductor pollicis brevis , opponens pollicis , and the superficial head of the flexor pollicis brevis ) . it has an important role in the movements of the thumb and thus in many acti...	we present a 62-year - old female patient who had an anatomic variation in the median nerve of the left hand . during surgery for releasing the left carpal tunnel , an abnormally high level of origin of the thenar muscular branch of the median nerve was detected , at 2.5 cm above the proximal border of transverse car...
a 15-year - old female developed fever , stinging eyes and headache , followed one day later by sudden appearance of flaccid blisters on the face with subsequent dissemination to more than 70% of the whole integument and development of mucosal erosions . thirty days before , she had been operated on the nose and medica...	toxic epidermal necrolysis is a rare but clinically well - described dermatological pathology . however , clinical pictures of this disorder in text books do not reflect its dynamic evolution . usually , the desquamative post - bullous stage is represented , neglecting the initial bullous stage as well as the skin ...
urinary bladder metastasis from solid tumors is rare and represents 2% of all bladder neoplasms . direct extension from the cervix , prostate and colon is not unusual but metastasis from a distant organ is extremely rare . breast cancer represents as a primary site in about 2.5% cases of all metastatic bladder cancer ....	breast carcinoma is the most common nondermatologic cancer diagnosis in women . common metastatic sites include lymph nodes , lung , liver , and bone . breast carcinoma metastatic to the bladder has been reported only sporadically . most patients were symptomatic breast cancer with evidence of disseminated diseas...
antibiotics are well known to alter neuronal functioning , with penicillin being the best studied on not only a clinical level but on a basic science level as well . after multiple reports emerged on the probable relation between high dose penicillin and seizure , detailed animal studies emerged that showed toxic doses...	a 66-year - old male receiving intravenous piperacillin and nafcillin for a post - surgical wound infection developed intermittent myoclonic jerks of all four extremities that disappeared after discontinuation of these two medications . in addition there was a mild yet definite intermittent encephalopathic effect ; h...
reed 's syndrome refers to the onset of uterine leiomyomas with cutaneous leiomyomas , the latter occurring segmentally or affecting a particular dermatome , that are classified into type 1 and 2 . type 1 is caused by a novel postzygotic segmental mutation ; type 2 reflects an additional postzygotic loss of heterozygos...	reed 's syndrome or familial myomatosis cutis et uteri , an autosomal dominant inherited condition with incomplete penetrance , is characterized by multiple cutaneous and uterine leiomyomas.[1 ] uterine leiomyomas usually commence earlier compared to that in the general population and cutaneous leiomyomas may precede ,...
to meet the wide variety of consulting needs that undergraduate neuroscience programs and departments have , the pdcs maintains a database of faculty consultants with expertise in a broad range of areas . specific areas include ( but are not limited to ) : curriculum ( evaluation , development , designing / improving s...	in 2007 fun established the fun program and department consultations service , or fun - pdcs . since that founding , the service has provided numerous consultation recommendations to undergraduate programs seeking assistance with external program reviews , designing and improving courses and many other programmatic n...
patients commonly present with acute cholinergic crisis , intermediate syndrome , or delayed polyneuropathy . they may also present with pancreatitis or hepatitis . here a 75-year - old homemaker presented to our emergency department following deliberate self - harm consuming around 100 ml chlorpyrifos along with small...	renal complications due to organophosphate poisoning are very rare . we are presenting a unique case of transient distal renal tubular acidosis due to organophosphate poisoning , which to the best of our knowledge is the first of its kind . an elderly female after deliberate self - harm with ingestion of chlorpyrif...
evaluation of athletic hip pain routinely includes radiographs and magnetic resonance imaging ( mri ) . computed tomography ( ct ) is applied at some centers and in certain clinical scenarios . although mri ( arthrogram ) alone can clearly define changes to labrum or cartilage , osseous pathology may be underappreciat...	femoro - acetabular impingement is a common cause of hip pain in young athletes . evaluation typically includes radiographs and magnetic resonance imaging . it is important to appreciate uncommon diagnoses and the role of complimentary imaging . this clinical vignette emphasizes the need complete imaging with ct ...
there is an increased incidence of major and minor congenital abnormalities in infants born to epileptic mothers ( 6 - 7% compared with 2c3% in the general population ) . sodium valproate is a popular drug because of its broad range of anticonvulsant effects and relative freedom from sedative and behavioral effects . e...	antenatal use of anticonvulsant valproic acid can result in a well - recognized cluster of facial dysmorphism , congenital anomalies and neurodevelopmental retardation . in this report , we describe a case with typical features of fetal valproate syndrome ( fvs ) . a 26-year - old female with epilepsy controlled on s...
the female child is six - years - old and comes from fortaleza in the state of ceara in brazil . initial symptoms began six months ago and included fever , asthenia , and weight loss . tests findings include : cbc : normochromic and very microcytic anemia ( hb : 7.1 g ) , leucopenia ( 3,300 wbc ) , and thrombopenia ( 7...	we report the case of a six - year - old brazilian girl referred for splenomegaly who first presented with fever , asthenia , and weight loss . geographical location , clinical exam , and blood laboratories suggested kala - azar . serology confirmed kala - azar diagnosis , but direct evidence of the parasites was not...
99mtc pertechnetate scintigraphy is routinely used to detect testicular torsion and differentiate this condition from acute epididymo - orchitis . however , differentiation of torsion from hydrocele and testicular or scrotal abscess may be difficult . in this report , we present a 5-year old child in whom epididymitis ...	scintigraphic differentiation between acute torsion , hydrocele and testicular or scrotal abscess can be difficult . doppler sonography may provide useful complimentary information toward diagnosis . the authors describe a 5-year - old child where epididymitis with hydrocele was misdiagnosed as testicular torsion o...
nemazee had been studying the deletion of autoreactive b cells in transgenic mice whose b cells all expressed receptors specific for a particular mhc molecule . when this transgene was bred onto mice that expressed that mhc protein , as expected , these mice lacked autoreactive b cells in the periphery . but to nemazee...	in 1993 , david nemazee and martin weigert independently showed that autoreactive b cells could proofread , alter , and reexpress modified receptors to become nonautoreactive . this process , called receptor editing , has since gained prominence as the main mechanism of b cell tolerance .
duodenal atresia and stenosis are rare causes of intestinal obstruction in the newborn , with a prevalence of 1 in 5,000 to 10,000 live births , with duodenal stenosis occurring less frequently than duodenal atresia.1 however , these intestinal tract anomalies occur significantly more frequently in patients with down s...	duodenal stenosis and duodenal atresia are well - known gastrointestinal anomalies in patients with down syndrome . although duodenal atresia presents early and classically with vomiting in the immediate neonatal period , the presentation of duodenal stenosis can be significantly more subtle and the diagnosis delayed...
among stage iiia non - small cell lung cancer patients , t4n0 - 1 cases can be good candidates for surgery and have a relatively favorable postoperative prognosis [ 1 , 2 ] . however , most t4 cases with thoracic vertebral invasion may not be operated as complete resection with vertebrectomy is challenging . we report ...	we present a case who had left upper lobectomy with total vertebrectomy after arterial embolization in preparation for intraoperative bleeding . a 35-year - old man complained of left back pain . chest ct revealed a tumor in s1 + 2 of the left lung , invading the third thoracic vertebra . as no nodal or distant met...
although priapism has been reported as a complication of malignant tumor metastasis , leukemia , sickle cell disease , embolism and spinal canal stenosis [ 1 , 2 , 3 , 4 , 5 ] , there are few reports of priapism as a complication of colorectal cancer in the absence of penile metastasis . here we report a patient with r...	a 65-year - old man was admitted with penile tenderness and dysuria due to priapism . enhanced computed tomography revealed metastatic tumors in the liver , lung , sacrum and lymph nodes . advanced rectal cancer , detected by colonoscopy as a primary tumor , was treated with chemotherapy ( folfox4 ) . although the ...
acromegaly is a syndrome seen in adults due to excessive production of pituitary growth hormone as a result of an adenoma or hyperplasia of the eosinophilic cells of the anterior pituitary gland . the main clinical features of acromegaly are skeletal overgrowth affecting the hands , feet , and skull along with spinal d...	depression is one of the commonest disorders encountered in general hospital psychiatry . acromegaly is a condition with excessive growth hormone secretion that may at times present with oversychopathology . we present the case of a 33-year - old lady with depression and acromegaly that successfully resolved after ...
we investigated a tbe outbreak , comprising 6 cases , in a mountain region in western austria in july 2008 . the index case occurred in a 43-year - old shepherd who had stayed for 24 days at his alpine pasture ( 1,564 m above sea level ) before he was hospitalized for nonbacterial urethritis and nonspecific influenza -...	we report transmission of tick - borne encephalitis virus ( tbev ) in july 2008 through nonpasteurized goat milk to 6 humans and 4 domestic pigs in an alpine pasture 1,500 m above sea level . this outbreak indicates the emergence of ticks and tbev at increasing altitudes in central europe and the efficiency of oral t...
neurofibroma is a benign peripheral nerve sheath tumor arising from the schwann cells and perineural fibroblasts . oral involvement is noted in 3.4 - 92% of adults and 40% of children with nf1 . a 28-year - old male patient reported [ figure 1 ] with the chief complaint of a painless swelling in the right upper back to...	neurofibroma is a benign peripheral nerve sheath tumor and is the most frequent tumor of neural origin . its presence is one of the clinical criteria for the diagnosis of neurofibromatosis type 1 ( nf1 ; a common hereditary disease occurring in one out of every 3000 births ) . the diagnosis can sometimes be made at...
chorea may be the manifestation of a wide variety of degenerative , vascular , metabolic , or toxic disorders involving the central nervous system , in which dysfunction of the basal ganglia , particularly of the striatum , is generally assumed to be responsible . we report an index case of generalized chorea secondary...	chorea is a rare manifestation of poisoning . we report an index case of a young woman who developed generalized chorea following propiconazole toxin ingestion . as large series on neurological complications of toxic compounds are difficult to be compiled , it is of interest to report our experience . this report a...
a technique of orthotopic rat liver transplantation has been shown in a recent journal of visualized experiments paper . portal vein and infra - hepatic vena cava anastomoses were performed using the quick - linker assisted cuff technique . this technique was chosen among other revisions of the original kamada 's techn...	orthotopic rat liver transplantation is a popular model , which has been shown in a recent jove paper with the use of the " quick - linker " device . this technique allows for easier venous cuff - anatomoses after a reasonable learning curve . the device is composed of two handles , which are carved out from scalpe...
a 46-year - old gentleman presented with sudden onset of loss of vision following blunt trauma to the right eye . the patient had sustained the injury when he was assaulted with a stone . he had undergone cataract surgery with posterior chamber ( pc ) iol in the right eye three months ago elsewhere . on examination h...	a 45-year - old man presented with post - traumatic aniridia . we describe the combined surgery done to treat both aniridia and epiretinal membrane simultaneously . a combined aniridia intraocular lens and vitreoretinal surgery was done . the case report highlights the advantage of combined surgery in terms of cost...
eed is a localized , low - grade form of leukocytoclastic vasculitis of unknown pathogenesis characterized by persistent , symmetrical , red - purple papules , nodules , and plaques affecting the extensor surfaces of the extremities , the ears , trunk and buttocks . dermatitis herpetiformis is an autoimmune blistering ...	erythema elevatum diutinum ( eed ) is a rare skin disease that initially presents as leucocytoclastic vasculitis and later resolves with fibrosis . dermatitis herpetiformis is an autoimmune blistering disease characterized by granular deposits of immunoglobulin a ( iga ) in dermal papillae . we report a rare associ...
a 61-year - old woman came to our attention and was hospitalized for the acute onset of fever ( 38c ) , erythroderma , and pustulosis ; the pustules were mainly localized on her shoulders , upper arms , and trunk [ figure 1 ] . in the latter area clinical history revealed that she had been treating a bacterial inguinal...	acute generalized exanthematous pustulosis ( agep ) is an uncommon and self - limiting skin rash commonly caused by drugs and is characterized by the acute onset of fever , pustulosis , and neutrophilia from 4 to 10 days after the drug intake . we describe a case of agep in a 61-year - old woman that was hospitalized...
psychocutaneous diseases can present either as primary psychiatric diseases such as dermatitis artefacta and delusions of parasitosis or as secondary psychiatric conditions such as depression , anxiety or social phobia due to chronic dermatoses like psoriasis , atopic dermatitis , alopecia areata . while in the former ...	psychodermatology is an emerging specialty in dermatology which deals with the interactions between mind and skin . psychocutaneous diseases can be either primary psychiatric or primary cutaneous , with various degrees of associations between psyche and skin . unless the dermatologist cultivates a special interest in...
ventriculoperitoneal ( vp ) shunting for hydrocephalus is a common neurosurgical procedure in our daily practice . migration of distal part of vp shunt into the adjacent organs including bowel tract , thoracic cavity , heart , scrotum , umbilicus , abdominal wall , and urinary bladder is reported . a case of repeated s...	bladder migration and transurethral extrusion is an extremely rare complication of ventriculoperitoneal ( vp ) shunt . only eight cases have been reported in the english literature since 1995 . we report a case of a 4-year - old boy with cerebral palsy , hydrocephalus , and vp shunted on both sides who presented wi...
guided cell migration requires the generation of polarized plasma membrane protrusions such as filopodia , lamellipodia , blebs and invadopodia . although these protrusions differ structurally and in their composition , they each contribute to cell movement by pushing the leading edge forward . both axonal growth cones...	filopodia are highly dynamic , rod - like protrusions that are found in abundance at the leading edge of migrating cells such as endothelial tip cells and at axonal growth cones of developing neurons . one proposed function of filopodia is that of an environmental probe , which serves to sense guidance cues during ne...
a 44-year - old man , who had a medical history of panic disorder , visited another hospital due to dyspnea on mild exertion . a coronary angiography showed a single coronary artery originating from the right coronary ostium . a single coronary artery bifurcated into the right coronary artery and left main coronary art...	anomalous origin of a coronary aortic artery is a rare cardiac anomaly . although it can cause angina , syncope , and palpitations , most patients are asymptomatic . this anomaly requires surgical treatment or intervention because it is associated with sudden death . several surgical techniques , such as coronary r...
incidental vessel injury caused by some of these variations may require more extensive lung resection than would be necessary without repair during pulmonary resection . we herein describe a patient with a common trunk of the left pulmonary vein that was incidentally transected with a mechanical stapler during a left u...	a common trunk of the left pulmonary vein is an anatomical variation in the pulmonary vessels and may be incidentally transected during left upper lobectomy . difficulty in reconstruction of the left inferior vein often requires completion pneumonectomy . we herein describe a patient with lung cancer in the left up...
massive hemoptysis is a life - threatening medical emergency with mortality rates ranging as high as 75% . transcatheter embolization of bronchial arteries has been regarded as an effective and safe method for the management of massive hemoptysis . chronic pulmonary thromboembolism ( pte ) is one of these causes , thou...	bronchial artery embolization is the treatment of choice for the management of life - threatening massive hemoptysis . chronic pulmonary thromboembolism ( pte ) is one of the rare causes of hemoptysis . management of hemoptysis in chronic pte is a point of debate . in this article , we have reported one case of hem...
patients with obsessive compulsive disorder ( ocd ) have been traditionally described as having a good insight into their symptoms ; they perceive their obsessive - compulsive ( oc ) symptoms as excessive , unreasonable , and distressing . the dsm iv field trial demonstrated that about a quarter of the patients were un...	obsessive compulsive disorder ( ocd ) is commonly regarded as a disorder with good insight . however , it has now been recognized that insight varies in these patients . pathological beliefs seem to lie on a continuum of insight , with full insight at one end and delusion at the other . this can indeed pose a con...
fear of hypoglycaemia and gain in body weight are barriers for initiation of insulin therapy . modern insulin analogues are a convenient new approach or tool to glycaemic control , associated with low number of hypoglycaemia and favourable weight change . a1chieve , a multinational , 24-week , non - interventional stud...	background : the a1chieve , a multicentric ( 28 countries ) , 24-week , non - interventional study evaluated the safety and effectiveness of insulin detemir , biphasic insulin aspart and insulin aspart in people with t2 dm ( n = 66,726 ) in routine clinical care across four continents.materials and methods : data was c...
a 28-year - old woman , with primary infertility of three years was referred for laparoscopic myomectomy with a history of severe dysmenorrhea and a diagnosis of posterolateral wall myoma . on pelvic examination , a palpable myoma was noted on the posterior uterine surface , and the uterus was felt to be approximately ...	single port laparoscopic surgery ( spls ) , also called sils is the natural extension of multi - incisional laparoscopic surgery , in the quest for reduction of traumatic insult and residual scarring to the patient . today with the evolution of newer instruments , bidirectional self - retaining sutures , and surgical e...
several cell lines were isolated during independent experiments from dissected annulus fibrosus ( af ) tissue of mature bovine intervertebral discs ( ivd ) via a reproducible non - enzyme driven protocol . the cell lines were frozen at low passage number and they recovered well after freeze - thawing ( see fig . prelim...	the adult bovine ( bos taurus ) intervertebral disc is primarily comprised of two major tissue types : the outer annulus fibrosus ( af ) and the central nucleus pulposus ( np ) . we isolated several primary cell lineages of passage ( p ) 0 cells from the af tissue omitting typically used enzymatic tissue digestion pr...
a 52-year - old thai woman presented with asymptomatic annular erythematous plaques on the forehead and both cheeks that persisted for 2 years . dermatologic examination showed few discrete annular erythematous plaques on her forehead and both cheeks , 15 cm in diameter . there were solar lentigines and telangiectasias...	actinic granuloma is an uncommon granulomatous disease , characterized by annular erythematous plaque with central clearing predominately located on sun - damaged skin . the pathogenesis is not well understood , ultraviolet radiation is recognized as precipitating factor . we report a case of a 52-year - old woman ...
a 59-year - old asymptomatic diabetic male was referred to our retinal service with presumed diagnosis of asteroid hyalosis . the patient had undergone laser treatment and intravitreal preserved triamcinolone acetonide injection for clinically significant diabetic macular edema in the right eye 4 years previously . the...	we report a case of unusually long persistence of triamcinolone crystals after intra - vitreal injection . crystals were noted on fundus examination predominantly confined to the posterior pole . optical coherence tomography localized the crystals to the posterior hyaloidal surface . over 6 years of follow - up t...
the 2010 human influenza a ( h1n1 ) virus pandemic seriously affected many countries , including kuwait . in children , respiratory involvement usually occurs with h1n1 ; extra pulmonary problems are not common.1 liver involvement is rare and needs early identification and treatment . a 9-year - old child was admitted ...	liver involvement in pediatric influenza a ( h1n1 ) infection is rare . focused clinical evaluation and laboratory tests can rule out or identify hepatic complications early on . here we report on a 9-year - old boy treated by the gastroenterology , hepatology , and nutrition unit of al - adan hospital s pediatric ...
it is characterized by acute and mostly intense abdominal pain accompanied by peritonism and potentially meteorism , nausea , vomiting and in severe and advanced cases shock . in most cases abdominal pathologies cause this acute condition including but not limited to appendicitis , cholecystitis , pancreatitis , mese...	the clinical picture of an acute abdomen is frequently encountered in emergency medicine . in most cases abdominal pathologies underlie this condition , however , also extra - abdominal diseases may present or cause an acute abdomen . the fact that this condition is potentially life - threatening highlights the impor...
peritonitis is one of the most common factors responsible for morbidity and mortality in patients on continuous ambulatory peritoneal dialysis ( capd ) . approximately 48% of peritonitis episodes have a fungal etiology , candida species accounting for 75% . the reported incidence of mortality in bacterial peritonitis i...	peritonitis is one of the most common and important complications in patients on continuous ambulatory peritoneal dialysis ( capd ) . fungal peritonitis isreported in 48% of peritonitis episodes . fungal peritonitis due to paecilomyces species is not common . we report a case of capd peritonitis due to p. varioti...
intravenous thrombolytic therapy when given within 4.5 h from symptom onset remains the mainstay of treatment for ischemic stroke patients . while intravenous tissue plasminogen activator ( iv tpa ) has been shown to be effective in improving outcome , the most feared complication is symptomatic intracerebral hemorrhag...	symptomatic intracerebral hemorrhage ( sich ) occurs in up to 7% of stroke patients treated with thrombolytic therapy . there are limited data on the effectiveness of the reversal agents used for intravenous tissue plasminogen activator related intracranial bleeds . we report a patient with sich following intraveno...
the interpretation of a raised amylase in the acute surgical patient is crucial yet complicated as it is raised in a large number of conditions but with a low specificity . this report argues that a transient rise in serum amylase not caused by sepsis or pancreatitis can be caused by a splenic infarction . therefore an...	we present what maybe the only case of splenic infarction causing hyperamylasaemia in a patient with bacterial endocarditis . a 49-year - old gentleman presented a 24 hour history of vomiting , abdominal pain and fever . clinical examination showed diffuse upper abdominal tenderness , a mild tachycardia and a low g...
the utah lions eye bank has harvested 159 eyes from strangulations or hangings since 2003 . of these , 18 eyes ( 11% ) were not suitable for surgery , with 13 eyes being excluded during the screening process . the reasons for exclusion included hepatitis b positivity , human t lymphotrophic virus positivity , high risk...	the eyes of a 25-year - old male were collected by the utah lions eye bank after his suicide by hanging . following dissection of the corneoscleral buttons from intact globes , bilateral detached descemet s membranes with subsequent scrolling in the periphery were observed . we believe these findings were caused by...
coronary artery spontaneous dissection is a rare and uncommon cause of sudden cardiac death and acute coronary syndrome . we report a case of a 31-year - old male admitted to our hospital with an acute coronary syndrome . a dissection of the left main coronary artery was diagnosed with a multidetector computed tomograp...	spontaneous dissection of the coronary arteries is a rare disease with a wide range of clinical presentations ranging from angina to myocardial infarction ( mi ) ; its pathophysiology has not yet been fully established . in this paper , we present the case of a 31-year - old male with an acute coronary syndrome . the...
subtilisin solutions were prepared by mixing and vortexing of 1.25 , 5 , 8 , 12.5 , 15 , 17.5 , 20 , and 25 l of subtilisin stock solution ( sigma aldrich , catalogue number p4860 ; lot 056k1213 ) per ml of 100 mm phosphate buffer ( ph = 8 , filtered with a 0.25 m anotop filter ) , which yielded enzyme solutions at con...	the structural characterization of subtilisin mesoscale clusters , which were previously shown to induce supramolecular order in biocatalytic self - assembly of fmoc dipeptides , was carried out by synchrotron small - angle x - ray , dynamic , and static light scattering measurements . subtilisin molecules self - as...
mucus extravasation cysts or mucoceles are an extremely common lesion of the minor salivary glands . we report upon an unusual case of a submandibular gland mucocele presenting as a lateral neck swelling . the term plunging or cervical ranula refers to mucoceles that extend below the mylohyoid muscle , beyond the subli...	mucus extravasation cysts or mucoceles are an extremely rare occurrence in the major salivary glands . we report upon an unusual case of a submandibular gland mucocele presenting as a neck lump . it should therefore be considered in the differential diagnosis of swellings in the lateral neck . diagnosis and manag...
' mesotherapy ' is a non - surgical , minimally invasive method of drug delivery that consists of multiple intradermal or subcutaneous injections of a mixture of compounds ' melange ' in minute doses . it has gained disrepute because of inadequate scientific evidence to prove its efficacy . in spite of this , many new ...	mesotherapy refers to multiple injections of small quantity of the drug over a large area . the mesoguns available are expensive and the motor - driven models tends to waste the expensive material to be injected since the plunger stops after injecting without recoil . we searched for a less expensive device which w...
heidelberger and his postdoctoral fellow forrest kendall who had been rendered one handed ( but , by all accounts , no less dextrous ) by a farm threshing machine took advantage of purified bacterial polysaccharides ( isolated during their earlier studies ) for their quantitative experiments . they incubated varying ...	having defined the protein nature of antibodies under the tutelage of oswald avery , michael heidelberger was the first to apply mathematics to the reaction of antibodies and their antigens ( the precipitin reaction ) . heidelberger 's calculations launched decades of research that helped reveal the specificity , f...
it is the 10th anniversary of the mailing of the anthrax spores , a tragic event that resulted in five deaths , seventeen other known infections , and untoward fear among the population . the cleanup is estimated to have cost $ 1 billion . what have we learned and accomplished in the interim of course , one can not co...	abstractin the fall of 2001 , bacillus anthracis spores were spread through letters mailed in the united states . twenty - two people are known to have been infected , and five of these individuals died . together with the september 11 attacks , this resulted in a reevaluation of the risks and benefits of life sci...
tetanus is a disease characterized by hypertonia and muscular spasms due to the toxin tetanospasmin formed by clostridium tetani . tetanus continues to be widespread , especially in the developing world though incidences have come down due to immunization . we present a case of tetanus in a young girl which initially m...	we report the case of a 15-year - old girl who was initially diagnosed to have a striatal toe . her condition progressed and she later developed clinical features consistent with tetanus . history of blunt trauma to nose was elicited retrospectively . antimicrobial therapy with metronidazole and both active and p...
the presence of oral synechia along with cleft palate is a rare syndrome . we encountered a case of cleft palate accompanied by congenital lateral oral synechia the infant was delivered normally at full term with a low birth weight of 1,750 g. there were no particularly notable points in the family history , medical hi...	cleft lip and palate are the most common congenital craniofacial anomaly in humans . the presence of oral synechia along with cleft palate is a rare syndrome . we encountered one case that had a cleft palate accompanied by congenital oral synechia due to a membranous adhesion between the floor of the mouth and the ...
the mayer - rokitansky - kster - hauser ( mrkh ) syndrome or mullerian duct agenesis is characterized by congenital aplasia of the uterus and the upper part ( 2/3 ) of the vagina in women showing normal development of secondary sexual characteristics and a normal 46 , xx karyotype . till date the presence of alopecia w...	a 17-year - old girl presented with alopecia involving lateral margins of the scalp with primary amenorrhea . there was no history of parental consanguinity , and no other siblings were having similar complaints . her secondary sexual characters were well developed with hypoplastic vagina . histopathological find...
coronary artery fistula ( caf ) is an unusual coronary artery abnormality , where connection exists between coronary artery and cardiac chamber or another blood vessel . caf originating from the left main trunk and left circumflex artery is very unusual and rarely reported in the literature . we describe a case of gian...	coronary artery fistula including the left trunk and left circumflex is uncommon . we present a 24-year - old male patient with a giant left main trunk and left circumflex artery to right ventricle fistula , which is diagnosed by transthoracic echocardiography and coronary computed tomography angiography . in this pa...
a 60-year - old man was presented to an orthopedician in the operating theatre as a case of difficult urinary catheterization . the patient was going for a lengthy orthopedic operation that required a drained urinary bladder beforehand . the urologist was called and he found the patient anesthetized , having circumcise...	hypospadias is a highly prevalent congenital anomaly . english articles , indexed in pubmed , published the long - term sexual and reproductive outcome following hypospadias repair . almost all repairable cases of hypospadias are operated in childhood . although distal hypospadias does not interfere with fertilit...
gram - positive infections account for up to 50% of cases of severe sepsis in the modern intensive care unit . the complex processes by which gram - positive organisms cause sepsis are poorly understood by comparison with gram - negative sepsis . much interest is currently focused on the role of certain protein exotoxi...	the production of superantigenic exotoxins by gram positive bacteria underlies the pathology of toxic shock syndrome . future treatment strategies for superantigen - mediated diseases are likely to be directed at blocking the three - way interaction between superantigen , t cell receptor and major histocompatibility ...
endometriosis is a common gynaecological condition characterised by the presence of endometrial glands and stroma at extrauterine sites . ectopic endometrial implants have been reported in nearly every tissue or organ , including the skin . of the reported cases of cutaneous endometriosis , over 70% the case of primary...	cutaneous endometriosis that arises de novo , without a prior history of surgery , is a rare phenomenon . the clinical diagnosis of cutaneous endometriosis remains challenging due to the variable clinical appearance and symptoms of the condition , and therefore must be considered in the differential diagnosis of any ...
immune checkpoint inhibition with anti - ctla-4 blockade ( e.g. , ipilimumab ) and anti - pd-1 antibodies ( e.g. , nivolumab ) has improved the poor prognosis of unresectable malignant melanoma [ 1 , 2 ] . these newly approved medications induce many types of immune - related adverse events ( iraes ) , including pneumo...	immune checkpoint inhibitors have drastically changed in the treatment of many kinds of malignancies , especially malignant melanoma . the focus of the recent experiments has not only been on their efficacy but also immune - related adverse events ( iraes ) . we report a case of fulminant hepatitis due to nivolumab...
the management of critically ill patients with a suspected invasive fungal infection based on predefined clinical and microbiological criteria or the punctuation of a score may be a valid approach when the definitive diagnosis is feasible only in a small proportion of patients . this is what vandewoude and colleagues p...	the clinical relevance of recovering aspergillus species in intensive care unit patients is unknown . diagnosis of invasive pulmonary aspergillosis is extremely difficult because there are no specific tests sensitive enough to detect it . the rapidly fatal prognosis of this infection without treatment justifies ear...
by using a previously described dna restriction analysis procedure ( 7 ) , we studied 76 archived adenovirus isolates collected among influenzalike - illness surveillance sites across iowa from 1992 to 2002 . among the 76 isolates , 40 ( 53% ) were ad7d2 , and 6 ( 8% ) were ad7h ( figure ) . the first ad7d2 specimen wa...	we evaluated 76 adenovirus type 7 ( ad7 ) isolates collected in iowa from 1992 to 2002 and found that genome type ad7d2 became increasingly prevalent . by 2002 , it had supplanted all other ad7 genome types . the association of ad7d2 with severe illness and death calls for heightened public health concern .
funding for travel or speaker honoraria : ( 1 ) istanbul ms days , novartis pharmaceuticals , speaker honoraria payment to mayo clinic . no personal compensation . ( 2 ) invited professor program , biogen - boston , speaker honoraria payment to mayo clinic . no personal compensation . other activities : grant review fo...	before the genomics technology revolution allowed us to do genome - wide science , genetics research relied on our limited knowledge about a subject to generate hypothesis and candidate genes to study . despite the level of naivet , several associations with susceptibility to a complex disease such as multiple sclerosi...
there is an increasing concern amongst the women and girls about the appearance of their external genitalia . many women and adolescent girls present with labia hypertrophy . a young girl presenting with labia hypertrophy is quite unusual . a child with severe hypertrophy of bilateral labia minora patient a , youngest ...	labia minora hypertrophy is a relatively uncommon surgical entity being popularised in the realm of vulvovaginal plastic surgeries . apart from the unaesthetic appearance of the hypertrophied minora , these cases are also associated with itching , hygiene problem , pain while sitting down , sports activities , diffic...
both interstitial granulomatous dermatitis ( igd ) and palisaded neutrophilic granulomatous dermatitis ( pngd ) are rare disorders typically associated with systemic autoimmune conditions . they probably represent different aspects of a disease spectrum encompassing the concept of autoimmunity - related granulomatous d...	aimboth interstitial granulomatous dermatitis ( igd ) and palisaded neutrophilic granulomatous dermatitis ( pngd ) are rare disorders typically associated with systemic autoimmune conditions . they probably represent different aspects of a disease spectrum encompassing the concept of autoimmunity - related granulomat...
abnormal variation of the posterior corneal curvature may occur in two forms : the generalized posterior keratoconus , characterized by an regular increase of the curvature of the entire posterior corneal surface has , and the circumscribed posterior keratoconus , in which a localized paracentral or central posterior c...	this paper documents a rare nonprogressive developmental disorder bilateral circumscribed posterior keratoconus in a 60-year - old man referred for a cataract surgery . for the first time ultrasound biomicroscopy was used to visualise the local anterior bulging of the posterior corneal surface with concomitant thin...
we report the case of a 58-year - old woman with intracranial hemorrhage associated with stress - induced cardiomyopathy . left ventricular dysfunction was confined to midventricular segments , and manifested with transient anterolateral wall aneurysm . although wall motion was severely impaired in the mid - segments ,...	introduction : we report the case of a 58-year - old woman with intracranial hemorrhage associated with stress - induced cardiomyopathy.results:left ventricular dysfunction was confined to midventricular segments , and manifested with transient anterolateral wall aneurysm . although wall motion was severely impaired ...
a 67-year - old male patient had undergone esophagectomy and intrathoracic esophagogastrostomy for carcinoma of the lower thoracic esophagus 27 months earlier . the original pathologic condition was determined to be moderately differentiated squamous cell carcinoma invading the lamina propria without lymph node metasta...	we report a very rare case of surgery on gastric conduit cancer . a 67-year - old male patient underwent esophagectomy and intrathoracic esophagogastrostomy for squamous cell carcinoma of the lower thoracic esophagus 27 months ago . upon follow - up , a gastric carcinoma at the intra - abdominal part of the gastric...
a 25-year - old female patient who earlier had implant placement in relation to 46 and 47 reported to our department for second stage surgery . 1994 , in which the attached mucosa at the top of the ridge is moved in a buccal direction at second stage surgery to obtain a papilla like formation and increased bulk of tiss...	peri - implant plastic surgery aims at improving the esthetic aspects of smile and masticatory function . over the years , several techniques such as tissue punch technique , full thickness flaps , and scalloping adjustment of flaps around implants have been employed ; it was very difficult to achieve a papilla like ...
it is incidentally found in autopsy specimens and surgical specimens with cryptorchidism and testicular germ cell tumor . this non - neoplastic lesion is usually seated in the mediastinum and septal part of the rete testis . it may present as a very small lesion detected in microscopic examination or a solid - cystic m...	there are several tumor - like lesions and miscellaneous neoplasms of the rete testis . we present a case with adenomatous hyperplasia of the rete testis ( ahrt ) . the patient was 24 years old with undescended testis and was referred to our hospital . there were no clinical or endocrine abnormalities . cryptor...
emphysematous cholecystitis ( ec ) is an uncommon variant of acute cholecystitis , which is caused by secondary infection of the gallbladder wall with gas - forming organisms [ 15 ] . the mortality rate of ec is as high as 25% because of its high complication rate [ 2 , 5 ] due to gangrene , gallbladder perforation , p...	emphysematous cholecystitis ( ec ) is an uncommon variant of acute cholecystitis , which is caused by secondary infection of the gallbladder wall with gas - forming organisms . the mortality rate of ec is still as high as 25% . emergency surgical intervention is indicated . open cholecystectomy has been tradition...
the causes of pulmonary embolism can be venous thromboembolism , and nonthrombotic embolism like septic , fat , air , amniotic fluid and tumour embolism . tumour embolism to lungs can arise from cancers of breast , stomach , liver , kidney and rarely from choriocarcinoma . choriocarcinoma is a malignant , trophoblastic...	pulmonary embolism carries a significant morbidity and mortality . metastatic choriocarcinoma presenting as pulmonary embolism is a rare event . here , we report a case of a 25-year - lady with a history of worsening shortness of breath for 4 months who was treated as a case of pneumonia and tuberculosis . owing to t...
for the self - assembling process , a solution containing 10 nm scaffold strand , 50 nm of each staple strand ( reverse - phase cartridge purified , bioneer inc . ) , 5 mm tris + 1 mm edta ( ph 7.9 at 20 c ) , 16 mm mgcl2 was heated to 80 c for 4 min , cooled down to 60c over the course of 80 min , and cooled further d...	tensegrity or tensional integrity is a property of a structure that relies on a balance between components that are either in pure compression or in pure tension for its stability [ 1,2 ] . tensegrity structures exhibit extremely high strength - to - weight ratios and great resilience , and are therefore widely used ...
hybridization is a controversial topic in coral reef ecology 1 , 2 . while small numbers of hybrid embryos can be produced in a few species in vitro , the evidence for hybrids in the field is often equivocal because the genetic techniques used for corals can not distinguish between hybridization and incomplete ...	hybridization is often cited as a potential source of evolutionary novelty in the order scleractinia . while hybrid embryos can be produced in vitro , it has been difficult to identify adult hybrids in the wild . here , we tested the potential for hybridization between two closely related species in the family fu...
a 44-year - old woman presented to the emergency room with shortness of breath and thoracic pain radiating to the left arm and shoulder . her vital signs showed a blood pressure of 158/102 mmhg , a pulse rate of 135 beats / min , a normal temperature and oxygen saturation of 100% on room air and no signs of heart fail...	we report on a 44-year - old woman presenting with chest pain and dyspnoea without previous stress - related events . by means of echocardiography severe left ventricular dysfunction and wall motion abnormalities resembling stress - induced cardiomyopathy ( tako tsubo ) were seen . laboratory investigation revealed...
accidents with a pneumatic nail gun , which has been used in the construction industry , have increased.2 ) however , reports on management of a patient with a nail gun injury to the cranium are rare . the authors report on a case of a patient treated with simple retraction after small skin and prophylactic antibiotic ...	a 56-year - old man had five nail gun - shots on his skull due to attempted suicide and was transferred to the emergency room . because the nail head played a role as a brake , the launched nail made a hole in the skull but did not entirely pass through it . if major artery or sinuses are not involved , cautious retr...
implantable cardioverter defibrillator ( icd ) implantation is performed at many centers in korea,1)2 ) however , icd lead extraction has not yet been reported . we report our experience of icd lead extraction using locking stylet and polypropylene dilator sheath in a patient with recurrent inappropriate shocks due to ...	a 46-year - old man presented to our institution with inappropriate implantable cardioverter - defibrillator ( icd ) shock delivery . the icd ( single chamber , dual shock coils ) was implanted for sustained monomorphic ventricular tachycardia with unstable hemodynamics and underlying systolic left ventricular dysfun...
patients with collagen vascular disease ( cvd ) such as rheumatoid arthritis , systemic lupus erythematosus , scleroderma , polymyositis , and dermatomyositis , are known to be sensitive to ionizing radiation 19 . irradiation to the lung in patients with interstitial pneumonia ( ip ) is also considered a relative contr...	key clinical messageinterstitial pneumonia ( ip ) sometimes precedes collagen vascular disease ( cvd ) onset . a patient with bladder cancer and mild ip received pelvic irradiation and experienced unexpectedly severe urinary toxicity followed by polymyositis onset and fatal ip exacerbation . careful observation for...
( 1 ) patients may report dysuria , intermittency , haematuria , frequency , hesitancy , nocturia or sudden termination of voiding . a 62 year old lady presented to the hospital with a swelling in her right thigh . she had a past history of myelomeningocele spina bifida which had been closed at birth . she suffered fro...	we present a rare case of a vesicocutaneous fistula secondary to two large bladder calculi in a patient with spina bifida . a 62 year old lady presented with swelling of her right thigh and a calcified mass protruding through the subcutaneous tissues of her right groin . urine was seen to be draining from around th...
pityriasis amiantacea ( pa ) is a scalp disorder presenting with thick , silvery / yellowish , asbestos - like scales wrapping around and binding down tufts of hair . it is typically considered to be a reactive condition to several inflammatory diseases , which may affect the scalp , mainly including psoriasis , atopic...	clinical distinction between pityriasis amiantacea - like tinea capitis and pityriasis amiantacea due to noninfectious inflammatory diseases is a troublesome task , with a significant likelihood of diagnostic errors / delays and prescription of inappropriate therapies . we report a case of pityriasis amiantacea - lik...
wild type cd1 embryos were harvested , staged and stained by wholemount in situ hybridization using established methods , . measurement of palates before dissection and after staining confirmed that no significant shrinkage occurred ( data not shown ) . palatal explants were cultured ( 37c , 5% co2 ) using the trowell ...	we present direct evidence of an activator - inhibitor system in the generation of the regularly spaced transverse ridges of the palate . we show that new ridges , or rugae , marked by stripes of sonic hedgehog ( shh ) expression , appear at two growth zones where the space between previously laid - down rugae increa...
acute neurogenic pulmonary edema ( npe ) is an underdiagnosed yet a common clinical entity . presence of preoperative npe presents a dilemma to the neuroanesthetist due to the divergent goals of management of raised intracranial pressure and pulmonary edema and also the possible adverse interaction of the two condition...	neurogenic pulmonary edema may be a less - recognized consequence of obstructive hydrocephalus . the authors report a patient with acute obstructive hydrocephalus due to cerebellar metastatic lesion , who presented with neurogenic pulmonary edema . the edema resolved on placement of the ventriculoperitonial shunt ....
we report a 50-year - old female patient with a stage 2 idiopathic macular hole that closed spontaneously . the stage 2 idiopathic macular hole closed spontaneously in 6 weeks with a lamellar defect in the outer retina due to the formation of the bridging retinal tissue , but without any evidence of the common mechanis...	objectivewe report a 50-year - old female patient with a stage 2 idiopathic macular hole that closed spontaneously.methodthe case is presented on the basis of an observational case report.resultsthe stage 2 idiopathic macular hole closed spontaneously in 6 weeks with a lamellar defect in the outer retina due to the for...
arteriovenous malformations ( avms ) present with hemorrhage , seizures , headache or focal neurological deficits . cysts associated with avms are uncommon , and are usually a sequelae of stereotactic radiosurgery or after a hemorrhage . untreated and unruptured avms with large cysts are uncommon , with only five cases...	cysts associated with arteriovenous malformations ( avms ) are either secondary to hemorrhage or after radiosurgery . untreated and unruptured avms with large cysts are rare . we here describe a child with medial parietal avm associated with cyst , without any history of hemorrhage or radiosurgery . surgical excisi...
in december 2011 , a 51-year - old woman was admitted to our hospital due to massive hemoptysis . she had suffered from recurrent hemoptysis for five years and had undergone bronchial artery embolization many times . the patient s vital signs were stable . on chest examination , decreased breathing sound and crackle we...	a 51-year - old woman visited our hospital with massive hemoptysis . she had suffered from recurrent hemoptysis for five years and had undergone bronchial artery embolization many times . the patient had a history of pulmonary tuberculosis and bronchiectasis . chest radiography showed consolidation around the nod...
urban taxi drivers differ from other professional drivers with respect to their risk profiles for work - related low back disorders1 . biomechanical studies show that the driving activities within automobiles can impose postural strains on lumbar spines1 . reported that back pain is an important health problem fo...	[ purpose ] this study aimed to develop unilateral exercises for urban drivers and investigate the effect of these exercises on low back pain ( lbp ) . [ subject and methods ] a 40-year - old male driver , who complained of lbp on the left side at l35 levels , participated in this study . a two - session progra...
lichen planus ( lp ) is a common inflammatory disease affecting the skin , the mucous membranes , the genitalia , the nails and the scalp . prevalence of lichen planus in the general population ranges from 0.1 to 4 % and it is more common in females , especially in the perimenopausal period . pathophysiology of lp invo...	lichen planus ( lp ) is an inflammatory disease that affects the skin mainly the extremities and the trunk the mucous membranes , the genitalia , the nails and the scalp . the diagnosis of lp is usually established clinically based on the typical morphology and distribution of the lesions in conjunction with the as...
it is more common in female with female - to - male ratio of 3:1 . not all the cases of necrobiosis are associated with diabetes ; hence the terminology necrobiosis lipoidica diabeticorum has been abandoned . the ulcers in nl are quite painful leading to impaired quality of life of these patients . we present a case of...	ulcerative necrobiosis lipoidica ( nl ) in diabetic patients is a rare , painful condition . it is a difficult - to - treat condition , impairing quality of life of patients . although various drugs have been tried , none of them is consistently effective . biologics in the form of tnf - alpha inhibitors show pro...
however , variations in the facial nerve have been reported and they increase the risk of facial nerve injury during parotid surgery . herein , we report a unique case of a parotid tumor in conjunction with a facial nerve anomaly . key pointswe report a new variation in the facial nerve pattern , and an unusual relatio...	abstractthe branching pattern of the facial nerve varies among individuals . these variations increase the risk of facial nerve injury during parotid surgery . we report a new variation of the facial nerve and an unusual relationship with the retromandibular vein during parotid surgery.clinicians should recognize t...
porokeratosis is a genetic disease transmitted as an autosomal dominant trait featuring abnormal epidermal keratinization , which is histologically characterized by the presence of cornoid lamella . since then many variants of porokeratosis have been described , each with differing morphology , distribution , and clini...	porokeratosis represents a heterogeneous group of disorders characterized clinically by a distinctive ridge - like border and histologically by cornoid lamellae . gardner 's syndrome , a variant of familial adenomatous polyposis ( fap ) , is an autosomal dominant disease characterized by colorectal polyps , osteomas ...

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