The “Double” Tessier 7 Cleft: An Unusual Presentation of a Transverse Facial Cleft

2018 ◽  
Vol 55 (6) ◽  
pp. 903-907 ◽  
Author(s):  
Janani A. Raveendran ◽  
Jerry W. Chao ◽  
Gary F. Rogers ◽  
Michael J. Boyajian
Keyword(s):  
Functional Outcome ◽  
Unusual Presentation ◽  
Facial Cleft ◽  
Craniofacial Anomaly ◽  
The Right

Congenital macrostomia, or Tessier number 7 cleft, is a rare craniofacial anomaly. We present a unique patient with bilateral macrostomia that consisted of a “double” transverse cleft on the left side and a single transverse cleft on the right side. A staged reconstructive approach was used to repair the “double” left-sided clefts. This staged technique produced a satisfactory aesthetic and functional outcome.

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.

Abstract T P238: Microglial CX3CR1 Required for M2 Polarization and Recovery After Intracerebral Hemorrhage

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Roslyn A Taylor ◽  
Matthew D Hammond ◽  
Youxi Ai ◽  
Lauren H Sansing
Keyword(s):  
Bone Marrow ◽  
Flow Cytometry ◽  
Intracerebral Hemorrhage ◽  
Gait Analysis ◽  
Functional Outcome ◽  
Cylinder Test ◽  
M2 Microglia ◽  
Inflammatory Phenotype ◽  
Peripheral Leukocytes ◽  
The Right

Introduction: Intracerebral hemorrhage (ICH) results in the activation of microglia, the resident immune cells of the central nervous system. Microglia may polarize into an M1, pro-inflammatory phenotype, or an M2 phenotype associated with repair. CX3CR1 is a chemokine receptor on microglia and monocyte subsets. CX3CR1-null microglia have been shown to have dysregulated inflammation. We hypothesize that CX3CR1-null microglia have a prolonged M1 phenotype, contributing to worse functional outcome after ICH. Methods: ICH was modeled by injection of 20μl of blood into the right striatum. Neurological deficit was quantified using digital gait analysis, cylinder test, and beam walking. Mice were sacrificed 14 days after ICH; brains were harvested for flow cytometry and immunohistochemistry (IHC). C57BL/6 (WT) and CX3CR1 GFP/GFP (CX3CR1-null) mice were irradiated and reconstituted with bone marrow from WT mice carrying the congenic marker CD45.1 to generate bone marrow chimeras (CD45.1WT or CD45.1CX3CR1-null). M1 microglia were identified as expressing MHCII and M2 microglia with CD206. Results: The CD45.1CX3CR1-null mice show worse functional outcome 14 days after ICH by cylinder test (p=0.002), beam walking (p=<0.001) and gait analysis (p=0.02). By flow cytometry, few peripheral leukocytes remain in the brain at 14 days, indicating that F4/80 + and CD11b + cells visualized by IHC are likely microglia, not peripheral macrophages. By IHC, CD45.1 CX3CR1-null mice have significantly more amoeboid F4/80 + MHCII + cells per field (M1 microglia) than CD45.1WT mice (p=0.02). CD45.1 CX3CR1-null mice have significantly fewer CD11b + CD206 + cells per field (M2 microglia) compared to CD45.1WT mice (p=0.04). Conclusions: Our results suggest microglial CX3CR1 signaling is necessary for microglia to transition from M1 to M2 and contribute to recovery after ICH.

Agenesis of the right lung: An unusual presentation

1968 ◽  
Vol 3 (1) ◽  
pp. 93
Author(s):  
W.K. Sieber
Keyword(s):  
Unusual Presentation ◽  
The Right

Foot Macrodactyly Associated with Klippel-Trenaunay Syndrome

2021 ◽  
Vol 23 (5) ◽  
pp. 375-380
Author(s):  
Maurizio De Pellegrin ◽  
Désirée Moharamzadeh ◽  
Giacomo Placella ◽  
Vincenzo Salini
Keyword(s):  
Functional Outcome ◽  
Congenital Malformation ◽  
Patient’S Satisfaction ◽  
Length Difference ◽  
Custom Made ◽  
The Difference ◽  
The Right ◽  
Klippel Trenaunay Syndrome

Klippel-Trenaunay syndrome is a rare congenital malformation which may be associated with macrodactyly. The main problem is the need for custom-made shoes. We describe the case of a female newborn affected by Klippel-Trenaunay syndrome, with a larger and longer right foot; the difference increased progressively and, at 5 years of age, the right foot was 50% larger and 38% longer than the left one. Due to the progression of the deformity, reduction surgery was advised to reduce the foot’s width. Resection of the second ray and 2nd cuneiform was performed. The result was excellent and there were no complications during a 10-year follow-up period with a decrease of width and length difference to 10% and 4%, respectively, in comparison to the contralateral foot. There were no gait anomalies. Abnormal foot width and length represented the main problems and guided the surgical strategy. Second ray resection was effective, without complications and with a good long-term functional outcome. Possibility of wearing fashionable conventional shoes without insoles was achieved to the patient’s satisfaction

scholarly journals Recurrent transient heading disorientation heralding acute posterior cerebral artery (PCA) infarction

2019 ◽  
Vol 1 (1) ◽  
pp. e000009
Author(s):  
Yong Chuan Chee ◽  
Beng Hooi Ong
Keyword(s):  
Case Report ◽  
Cerebral Infarction ◽  
Cerebral Artery ◽  
Transient Ischaemic Attack ◽  
Posterior Cerebral Artery ◽  
Underlying Mechanism ◽  
Unusual Presentation ◽  
Topographical Disorientation ◽  
Ischaemic Attack ◽  
The Right

ObjectiveHeading disorientation is a type of pure topographical disorientation. Reported cases have been very few and its underlying mechanism remains unclear. We report an unusual presentation of a 60-year-old man with recurrent transient heading disorientation heralding an acute posterior cerebral artery infarction.DesignCase report.ConclusionAcquired injury to the right retro-splenial region can result in a specific variant of topographical disorientation known as heading disorientation that may present as an atypical transient ischaemic attack-like symptom heralding acute cerebral infarction.

An Uncommon Polyp of the Right Colon: an Unusual Presentation of Melanoma

2020 ◽  
Author(s):  
Nicola Romano ◽  
Alessia Urru ◽  
Paola Romagnoli ◽  
Laura Paleari ◽  
Enrico Melani ◽  
...  
Keyword(s):  
Unusual Presentation ◽  
Right Colon ◽  
The Right

Primary Systemic Amyloidosis Presenting as Extensive Cutaneous Ulceration

2006 ◽  
Vol 10 (5) ◽  
pp. 253-256 ◽  
Author(s):  
Mohammed Alhaddab ◽  
Herbert Srolovitz ◽  
Nathan Rosen
Keyword(s):  
Crystal Violet ◽  
Congo Red ◽  
Systemic Amyloidosis ◽  
Unusual Presentation ◽  
Caucasian Woman ◽  
Advanced Stage ◽  
Amyloid Protein ◽  
Cutaneous Manifestations ◽  
The Right

Background: We report a case of primary systemic amyloidosis in a 78-year-old Caucasian woman presented as a nonhealing ulcer on the right thigh for 3 months. Histopathology of the skin revealed widely thickened walls of middermal and subcutaneous vessels from deposition of amorphous eosinophilic material that stained positively with Congo red and crystal violet. Objective: This case represents a very unusual presentation of primary systemic amyloidosis, one in which the cutaneous manifestations provided the first signs of a devastatingly widespread multiorgan infiltration of amyloid protein. Conclusion: This presentation of the disease may signify an advanced stage with a grave prognosis as our patient passed away 3 months after development of the cutaneous ulceration.

scholarly journals Unusual presentation of testicular rhabdomyosarcoma metastases to the right ventricle papillary muscle and tricuspid valve

2020 ◽  
Vol 15 (9) ◽  
pp. 1562-1565
Author(s):  
Deniz Akay Urgun ◽  
Biraj Bista ◽  
Mayil Krishnam
Keyword(s):  
Right Ventricle ◽  
Tricuspid Valve ◽  
Papillary Muscle ◽  
Unusual Presentation ◽  
The Right

Perinatal intracardiac teratoma: unusual presentation and review of the literature

2019 ◽  
Vol 29 (3) ◽  
pp. 439-441
Author(s):  
Anne Moreau de Bellaing ◽  
Lucile Houyel ◽  
Damien Bonnet
Keyword(s):  
Ventricular Arrhythmia ◽  
Right Ventricle ◽  
Surgical Resection ◽  
Cystic Mass ◽  
Unusual Presentation ◽  
Review Of The Literature ◽  
The Common ◽  
The Right ◽  
Almost All ◽  
Extracorporeal Support

AbstractIntracardiac teratomas are rare primary tumours. We report the case of an infant prenatally diagnosed with an isolated multi-cystic mass developed in the right ventricle causing neonatal refractory ventricular arrhythmia. Despite rescue extracorporeal support and partial surgical resection, he died as almost all the previous reported perinatal intracardiac teratomas whatever the prenatal tolerance and the size of the tumour. The common poor outcome of fetal intracardiac teratomas should be known when counselling parents during pregnancy.

Chronic myeloid leukaemia and priapism in a boy: A dramatic case with favourable functional outcome

1998 ◽  
Vol 65 (1) ◽  
pp. 120-122
Author(s):  
L.F. Martino ◽  
R. Gemelli ◽  
M. De Pasquale ◽  
V. Arcuri ◽  
O.L. Sicuro ◽  
...  
Keyword(s):  
Intensive Care ◽  
Chronic Myeloid Leukaemia ◽  
Functional Outcome ◽  
Myeloid Leukaemia ◽  
Doppler Examination ◽  
Corpora Cavernosa ◽  
The Right

In this work the authors describe a case of priapism lasting approx. 15 hours presenting chronic myeloid leukaemia in a 15-year-old boy. Aspiration of the corpora cavernosa was carried out and the boy remained in intensive care for 2 months, after which a Doppler examination was performed. This showed a moderate flow in the left artery and a poorer situation in the right.

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