scholarly journals GCT-55. INTRACRANIAL GERMINOMA ORIGINATING FROM ATYPICAL LOCATION WITH SUBCLINICAL ADH INSUFFICIENCY

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii339-iii339
Author(s):  
Yuki Kuranari ◽  
Tomoru Miwa ◽  
Maya Kono ◽  
Tokunori Kanazawa ◽  
Kazunari Yoshida
Keyword(s):  
Lateral Ventricle ◽  
Clinical Symptoms ◽  
Septum Pellucidum ◽  
Unusual Presentation ◽  
Imaging Findings ◽  
Partial Removal ◽  
Intracranial Germinoma ◽  
History Of ◽  
Periventricular Lesion ◽  
Saline Test

Abstract INTRODUCTION Intracranial germinomas are rare tumors which usually develop in the midline structures and affect in 90% of cases the pineal gland and suprasellar regions. Sometimes they involve basal ganglia, septum pellucidum, and other regions. We report a very unusual presentation of an intracranial germinoma originating from the lateral ventricle. METHODS A 10-year-old boy presented with a 1-year history of polydipsia and polyuria. During the hypertonic saline test, a low ADH was detected and established the diagnosis of subclinical ADH insufficiency. MRI showed a heterogeneously enhancing periventricular lesion in the lateral ventricle, but no other abnormal findings, including hypophyseal stalk. Initially, the correlation of imaging findings and clinical symptoms were not clear. With suspected subependymoma, tumor removal was performed by small craniotomy. Since the intra-operative pathological diagnosis was germinoma, we performed only partial removal of the tumor. After establishing the histological diagnosis of germinoma, the patient received chemotherapy using carboplatin and etoposide, followed by radiation therapy. MRI showed no recurrence for five years after treatment. RESULTS/ CONCLUSION Our case presents two atypical features. First, intracranial germinoma originating from the lateral ventricle is quite rare. Though the cases with intracranial germinoma originating from septum pellucidum and corpus callosum have been reported, this case is even different. Second, imaging findings did not match clinical symptoms. The cause of subclinical ADH deficiency may be the occult hypophyseal germinoma. In conclusion, we report a 10-year-old case with a very unusual presentation of an intracranial germinoma originating from the lateral ventricle.

Organization of restrictive quarantine measures to prevent especially dangerous infections

2020 ◽  
pp. 6-11
Author(s):  
Petr Ilyin
Keyword(s):  
Infectious Diseases ◽  
Clinical Symptoms ◽  
International Health ◽  
World Health ◽  
The World ◽  
History Of ◽  
Entire History ◽  
Health Organization ◽  
Former Ussr ◽  
Health Regulations

Especially dangerous infections (EDIs) belong to the conditionally labelled group of infectious diseases that pose an exceptional epidemic threat. They are highly contagious, rapidly spreading and capable of affecting wide sections of the population in the shortest possible time, they are characterized by the severity of clinical symptoms and high mortality rates. At the present stage, the term "especially dangerous infections" is used only in the territory of the countries of the former USSR, all over the world this concept is defined as "infectious diseases that pose an extreme threat to public health on an international scale." Over the entire history of human development, more people have died as a result of epidemics and pandemics than in all wars combined. The list of especially dangerous infections and measures to prevent their spread were fixed in the International Health Regulations (IHR), adopted at the 22nd session of the WHO's World Health Assembly on July 26, 1969. In 1970, at the 23rd session of the WHO's Assembly, typhus and relapsing fever were excluded from the list of quarantine infections. As amended in 1981, the list included only three diseases represented by plague, cholera and anthrax. However, now annual additions of new infections endemic to different parts of the earth to this list take place. To date, the World Health Organization (WHO) has already included more than 100 diseases in the list of especially dangerous infections.

CASE REPORT: RARE FORM OF HIRSCHPRUNG’S DISEASE

2020 ◽  
Vol 30 (5) ◽  
pp. 82-84
Author(s):  
Ilja Skalskis
Keyword(s):  
Down Syndrome ◽  
Case Report ◽  
Clinical Symptoms ◽  
Hirschsprung Disease ◽  
Distal Colon ◽  
Total Colonic Aganglionosis ◽  
Sphincter Function ◽  
Anal Sphincter Function ◽  
History Of ◽  
High Index Of Suspicion

Hirschsprung disease (HD) is a developmental disorder characterized by the absence of ganglia in the distal colon, resulting in a functional obstruction. Incidence of total colonic aganglionosis (TCA) is 1 in 500 000 and it accounts for 5-10% of all cases of HD. HD should be suspected in patients with typical clinical symptoms and a high index of suspicion is appropriate for infants with a predisposing condition such as Down Syndrome (DS), or for those with a family history of HD. The treatment of choice for HD is surgical, such as Swenson, Soave, and Duhamel procedures. The goals are to resect the affected segment of the colon, bring the normal ganglionic bowel down close to the anus, and preserve internal anal sphincter function. We present a clinical case report of TCA in a child with Down syndrome (DS) and review of literature.

Etiology and clinical features of epididymo-orchitis: A single-center study in Tehran, Iran

2020 ◽  
Vol 20 ◽  
Author(s):  
Sara Abolghasemi ◽  
Mohammad Alizadeh ◽  
Ali Hashemi ◽  
Shabnam Tehrani
Keyword(s):  
Chlamydia Trachomatis ◽  
Clinical Symptoms ◽  
Urine Culture ◽  
Clinical Manifestations ◽  
Urinary Frequency ◽  
Serological Tests ◽  
Duration Of Symptoms ◽  
Two Samples ◽  
History Of ◽  
Tract Infections

Introduction: Epididymo-orchitis is a common urological disease among men. Little is known about the clinical and epidemiological aspects of the disease in Iran. Thus, the present study was aimed to investigate the etiology, clinical sequelae and risk factors of patients with epididymo-orchitis in Tehran, Iran. Materials and Methods: Patients presenting with epididymo-orchitis were prospectively analyzed in order to study the etiology and pattern of the disease. Bacteriological, molecular and serological tests were undertaken to look for Chlamydia trachomatis, Neisseria gonorrhoeae, Brucella spp., Mycoplasma spp, and other bacteria. Results: Fifty patients with epididymo-orchitis were evaluated according to their clinical symptoms, duration of symptoms, physical examination, and laboratory studies. The mean age of the patients was 53 years. Fever, dysuria, pain in the flanks, urinary frequency and discharges occurred in 58.0%, 50.0%, 50.0%, 28.0% and 6.0%, respectively. Bacterial pathogen was identified in 26% (13/50) of patients by urine culture. Escherichia coli was the etiological agent in 11/13 patients (84.6%). Two out of 50 patients (4.0%) were also positive for Chlamydia trachomatis. Two samples were serologically positive for Brucella spp. High Mean age, fever, urinary frequency, history of the underlying disease and history of urinary tract infections were found to have a significant association with the positive bacteriologic urine culture (P<0.05). Conclusions: The most common clinical manifestations were fever, dysuria, and abdominal pain. E. coli and C. trachomatis were the major causative agents. Use of a set of diagnostic approaches including clinical symptoms, urine culture and more precise techniques such as PCR should be taken into consideration for the definitive diagnosis.

scholarly journals Respiratory tract infections in children with allergic asthma on allergen immunotherapy during influenza season

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yuyun Li ◽  
Dongming Wang ◽  
Lili Zhi ◽  
Yunmei Zhu ◽  
Lan Qiao ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Allergic Asthma ◽  
Respiratory Tract Infections ◽  
Allergen Immunotherapy ◽  
Clinical Symptoms ◽  
Influenza Season ◽  
The Body ◽  
History Of ◽  
Tract Infections ◽  
Stage 1

AbstractTo describle how respiratory tract infections (RTIs) that occurred in children with allergic asthma (AA) on allergen immunotherapy (AIT) during an influenza season. Data including clinical symptoms and treatment history of children (those with AA on AIT and their siblings under 14 years old), who suffered from RTIs during an influenza season (Dec 1st, 2019–Dec 31st, 2019), were collected (by face to face interview and medical records) and analyzed. Children on AIT were divided into 2 groups: stage 1 (dose increasing stage) and stage 2 (dose maintenance stage). Their siblings were enrolled as control. During the study period, 49 children with AA on AIT (33 patients in stage 1 and 16 patients in stage 2) as well as 49 children without AA ( their siblings ) were included. There were no significant differences in occurrences of RTIs among the three groups (p > 0.05). Compared with children in the other two groups, patients with RTIs in stage 2 had less duration of coughing and needed less medicine. Children on AIT with maintenance doses had fewer symptoms and recovered quickly when they were attacked by RTIs, which suggested that AIT with dose maintenance may enhance disease resistance of the body.

scholarly journals A case report of unilateral conductive hearing loss as a consequence of malignant sinonasal melanoma: the importance of completing a full clinical history and examination

2020 ◽  
Vol 36 (1) ◽  
Author(s):  
Victoria Blackabey ◽  
Olivia Kenyon ◽  
Rishi Talwar
Keyword(s):  
Hearing Loss ◽  
Case Report ◽  
Clinical Symptoms ◽  
Symptomatic Relief ◽  
Clinical History ◽  
Histological Diagnosis ◽  
Unusual Presentation ◽  
Sinus Surgery ◽  
Cancer Management ◽  
The Right

Abstract Background Sinonasal melanoma is a rare head and neck tumour. It is associated with a poor prognosis, high rates of loco-regional recurrence and distant metastasis. Treatment of the disease is therefore complicated, and because of limited data regarding the cancer, management is frequently tailored to the individual patient. We describe an unusual presentation of sinonasal melanoma with relevant histology, radiology and clinical photography. Case presentation The case report describes the presentation of a 64-year-old man to the Ear, Nose and Throat department with progressive right-sided hearing loss. A thorough history highlighted other clinical symptoms including unilateral nasal obstruction and epistaxis. Clinical examination showed a right middle ear effusion with a polypoidal lesion in the right nasal cavity. Relevant imaging demonstrated a destructive process that required further assessment. An endoscopic sinus procedure was performed to obtain histological diagnosis as well as providing symptomatic relief. Histology confirmed malignant mucosal melanoma. The patient underwent maxillectomy and orbital exenteration (due to further progression of disease) at a tertiary centre with a plan for subsequent immunotherapy. This however has been delayed due to further surgery to excise a metastatic lesion to the right femur. Conclusions This case report highlights the importance of a thorough clinical history and examination. An unusual presentation of a sinonasal tumour can easily be missed leading to a significant delay in treatment. The case report also describes the use of functional endoscopic sinus surgery in order to obtain histological diagnosis and to debulk the tumour, providing symptomatic relief. The current literature regarding management will be discussed as well as current developments guiding future treatment.

scholarly journals Spontaneous Uterine Rupture in a Preterm Pregnancy following Myomectomy

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Claire Sutton ◽  
Prue Standen ◽  
Jade Acton ◽  
Christopher Griffin
Keyword(s):  
Abdominal Pain ◽  
Caesarean Section ◽  
Uterine Rupture ◽  
Good Condition ◽  
Acute Onset ◽  
Uterine Wall ◽  
Unusual Presentation ◽  
Postoperative Course ◽  
Spontaneous Uterine Rupture ◽  
History Of

A 44-year-old nulliparous woman was transferred to a tertiary obstetric hospital for investigation of acute onset abdominal pain. She was at gestation of 32 weeks and 2 days with a history of previous laparoscopic fundal myomectomy. An initial bedside ultrasound demonstrated oligohydramnios. Following an episode of increased pain early the following morning, a formal ultrasound diagnosed a uterine rupture with the fetal arm extending through a uterine rent. An uncomplicated classical caesarean section was performed and the neonate was delivered in good condition but with a bruised and oedematous right arm. The neonate was transferred to the Special Care Nursery for neonatal care. The patient had an uncomplicated postoperative course and was discharged home three days following delivery. This is an unusual presentation of uterine rupture following myomectomy where the fetal arm had protruded through the uterine wall.

scholarly journals Neonatal Gastric Lactobezoar: Management with N-Acetylcysteine

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Sarah Bajorek ◽  
Roel Basaldua ◽  
Katherine McGoogan ◽  
Charla Miller ◽  
Craig B. Sussman
Keyword(s):  
Treatment Regimen ◽  
Conservative Management ◽  
Clinical Symptoms ◽  
Unusual Presentation ◽  
Intravenous Fluids ◽  
Surgical Measures ◽  
Abdominal Symptoms ◽  
Bowel Rest

Gastric lactobezoars (GLBs) are the most common form of bezoars in neonates and consist of aggregations of undigested milk constituents. GLB can present with a variety of intra-abdominal clinical symptoms, and occasionally, extra-abdominal symptoms. Conservative management, with a period of bowel rest and intravenous fluids, is the most common treatment regimen for uncomplicated GLB. Surgical measures are reserved for the rare complications of obstruction and/or perforation. Although limited, utilization of the protein-cleaving enzyme N-acetylcysteine has been described for the disintegration of GLB in toddlers. In this paper, we discuss the first documented use of N-acetylcysteine for a neonatal GLB. Supporting literature, the infant’s unusual presentation, and details of the treatment regimen are discussed.

scholarly journals Adult Ocular Toxocariasis Mimicking Ciliary Body Malignancy

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Ahmad M. Mansour ◽  
Bachir Abiad ◽  
Fouad I. Boulos ◽  
Ramzi Alameddine ◽  
Fadi C. Maalouf ◽  
...  
Keyword(s):  
Case Report ◽  
Local Excision ◽  
Rapid Growth ◽  
Ciliary Body ◽  
Inflammatory Cells ◽  
Toxocara Canis ◽  
Unusual Presentation ◽  
Medial Rectus ◽  
Ocular Toxocariasis ◽  
History Of

Purpose. To discuss an unusual presentation of ocular toxocariasis.Methods. Case report.Results. A 40-year-old woman presented with decreased vision in the left eye with a long history of recurrent red eye from uveitis. Eosinophilia and positive ELISA titers forToxocara canisfavored the diagnosis of ocular toxocariasis. Over 3 months, an anterior scleral mass had a rapid growth raising the possibility of medulloepithelioma, which rarely can mimic uveitic syndromes. Surgical plan changed from local excision to enucleation. Histopathology demonstrated a large homogeneous mass of chronic inflammatory cells with inflammation of the overlying thinned out sclera, medial rectus insertion, and limbal cornea. The triad of peripheral granuloma, eosinophilia, and positive blood serology established the diagnosis of ocular toxocariasis.Conclusions. Ocular toxocariasis can mimic ocular malignancy such as medulloepithelioma in adults and rarely presents as an anterior scleral mass.

scholarly journals Renal Allograft Torsion: US and CT Imaging Findings of a Rare Posttransplant Complication

2016 ◽  
Vol 2016 ◽  
pp. 1-3 ◽  
Author(s):  
Rohit Dewan ◽  
Anil K. Dasyam ◽  
Henke Tan ◽  
Alessandro Furlan
Keyword(s):  
Doppler Ultrasound ◽  
Renal Allograft ◽  
Color Doppler ◽  
Color Doppler Ultrasound ◽  
Imaging Findings ◽  
Unenhanced Ct ◽  
Doppler Signals ◽  
History Of ◽  
Normal Blood Flow

Vascular torsion is a rare renal transplant complication which requires prompt diagnosis and surgery to salvage allograft function. We report here a case of renal allograft torsion with interesting imaging findings on unenhanced CT and color Doppler ultrasound. A 60-year-old woman with a history of pancreas and kidney transplant presented to the emergency room with nausea, vomiting, abdominal pain, and minimal urine output. Unenhanced CT of the abdomen demonstrated an enlarged and malrotated renal allograft with moderate hydronephrosis. Color Doppler ultrasound demonstrated lack of vascularity within the allograft. The patient was taken urgently to the operating room where the renal allograft was found twisted 360 degrees around the vascular pedicle. After the allograft was detorsed, the color of the kidney returned and the Doppler signals for arterial flow improved. Intraoperative biopsy showed no evidence of infarct or acute cellular rejection. The detorsed kidney was surgically fixed in position in its upper and lower poles. Follow-up ultrasound 1 day later demonstrated normal blood flow to the renal allograft and the serum level of creatinine returned to normal.

scholarly journals Kejadian Leptospirosis pada Anjing di Daerah Istimewa Yogyakarta (CASE OF CANINE LEPTOSPIROSIS IN THE CITY OF YOGYAKARTA)

2017 ◽  
Vol 18 (3) ◽  
pp. 403
Author(s):  
Guntari Titik Mulyani ◽  
Sri Hartati ◽  
Yuli Santoso ◽  
Kurnia Kurnia ◽  
Agung Budi Pramono ◽  
...  
Keyword(s):  
Infectious Diseases ◽  
Clinical Symptoms ◽  
Emerging Infectious Diseases ◽  
Agglutination Test ◽  
Microscopic Agglutination Test ◽  
Severe Illness ◽  
Leptospira Interrogans ◽  
Veterinary Research ◽  
History Of ◽  
The City

Leptospirosis is a zoonotic disease, which is caused by Leptospira interrogans. The incidence of leptospirosis in dogs varies according to region and season, and is considered as emerging infectious diseases in humans. Clinical symptoms of leptospirosis in dogs vary greatly, some dogs are asymptomatic, with mild symptoms, and others progress to severe illness until death. The study aims to determine cases of canine leptospirosis in Yogyakarta, and identify the serovar that infect them. A total of 20 dogs without symptoms, with mild symptoms, to severe symptoms of leptospirosis were collected their serum and further tested using Microscopic Agglutination Test (MAT) conducted at the Center for Veterinary Research (BBLitvet) Bogor. History of vaccination is recorded as a consideration in interpreting the MAT results. The results showed that three out of the 20 samples were positive leptospirosis. Of the three positive samples, one was identified as serovar bataviae, another one as serovar bataviae and tarrasovi, and the last as serovar bataviae, tarrasovi, ichterohaemorrhagiae, canicola, celledoni, pyrogenes, cynopteri, and rachmati, respectively. The three dogs with leptospirosis showed similar clinical symptoms i.e. Anorexia, lethargy, and fever. It can be concluded that there are cases of canine leptospirosis in Yogyakarta which is predominantly caused by Leptospira interrogans serovar bataviae. ABSTRAK Leptospirosis adalah penyakit zoonosis, yang disebabkan oleh Leptospira interrogans. Kejadian leptospirosis pada anjing bervariasi menurut wilayah dan musim, dan dianggap sebagai penyakit menular yang muncul pada manusia. Gejala klinis leptospirosis pada anjing sangat bervariasi, beberapa anjing tanpa menunjukkan gejala, dengan gejala ringan, dan yang lain melanjut menjadi penyakit yang parah sampai kematian. Penelitian ini bertujuan untuk mengetahui kasus leptospirosis pada anjing di Propinsi Daerah Istimewa Yogyakarta, dan mengidentifikasi serovar yang menginfeksinya. Sebanyak 20 ekor anjing tanpa gejala, dengan gejala ringan, sampai gejala parah leptospirosis diambil serumnya guna pemeriksaan Microscopic Agglutination Test (MAT) yang dilaksanakan di Balai Besar Penelitian Veteriner (BBLitvet), Bogor. Sejarah vaksinasi dicatat sebagai bahan pertimbangan dalam menginterpretasi hasil pemeriksaan MAT. Hasil penelitian menunjukkan bahwa tiga dari 20 sampel positif leptospirosis. Satu sampel positif terhadap serovar Bataviae, satu sampel positif terhadap serovar Bataviae dan Tarrasovi, dan satu sampel lagi positif terhadap serovar Bataviae, Tarrasovi, Ichterohaemorrhagiae, Canicola, Celledoni, Pyrogenes, Cynopteri, dan Rachmati. Anjing yang positif leptospirosis menunjukkan gejala klinis yang sama berupa anoreksia, kelemahan, dan demam. Dari hasil penelitian ini dapat disimpulkan bahwa terdapat kasus leptospirosis pada anjing di Yogyakarta yang penyebabnya dominan oleh Leptospira interrogans serovar Bataviae.

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