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BMC Zoology Aug 2023Dromedary camel heart morphology is a crucial research topic with clinical applications. The study aims to understand the dromedary camel anatomy, morphology, and...
BACKGROUND
Dromedary camel heart morphology is a crucial research topic with clinical applications. The study aims to understand the dromedary camel anatomy, morphology, and architecture of the ventricular mass.
RESULTS
Sagittal and transverse gross sections were compared to sagittal, transverse, and 3D render volume reconstruction computed tomography (CT) scans. The subepicardial fat, which covered the heart base, the coronary groove (sulcus coronarius), the left longitudinal interventricular groove (sulcus interventricularis paraconalis), and the right longitudinal interventricular groove (sulcus interventricularis subsinuosus), had a relatively low density with a homogeneous appearance in the 3D render volume CT. The pericardium in the color cardiac window was identified better than the black and white window (ghost). Transverse and sagittal CT scans demonstrated the internal structures of the heart, including the right atrioventricular orifice (ostium atrioventriculare dextrum), right atrioventricular orifice (ostium atrioventriculare sinistrum), and aortic orifice (ostium aortae), chordae tendineae, the cusps of the valves (cuspis valvae), and the papillary muscles (musculi papillares). The papillary muscle (musculi papillares) was presented with a more moderate density than the rest of the heart, and the cusps of the valves (cuspis valvae) had a lower density. The ventricular wall (margo ventricularis) exhibited different densities: the outer part was hyperdense, while the inner part was hypodense. The thicknesses of the ventricular mural wall and the interventricular septum (septum atrioventriculare) were highest at the midpoint of the ventricular mass, and the lowest value was present toward the apical part. The coronary groove (sulcus coronarius) circumference measured 51.14 ± 0.72 cm, and the fat in the coronary groove (sulcus coronarius) (56 ± 6.55 cm) represented 28.7% of the total cross-sectional area.
CONCLUSION
The current study provided more information about ventricular mass measurements by gross and CT analysis on the heart, which provides a valuable guide for future cardiac CT investigations in camels in vivo.
PubMed: 37596650
DOI: 10.1186/s40850-023-00173-w -
Cerebellum (London, England) Jun 2024We describe a male patient presenting with cerebellar ataxia and behavioural frontotemporal dementia in whom imaging showed cerebellar atrophy. He had significantly low...
We describe a male patient presenting with cerebellar ataxia and behavioural frontotemporal dementia in whom imaging showed cerebellar atrophy. He had significantly low N-acetyl aspartate to creatine (NAA/Cr) area ratio on MR spectroscopy of the cerebellum, primarily affecting the vermis. CT body scan showed extensive abnormal tissue within the mesentery, the retroperitoneum and perinephric areas. PET-CT showed increased tracer uptake within the wall of the aorta suggestive of an aortitis and within the perinephric tissue bilaterally. Biopsy of the perinephric tissue confirmed IgG4 disease. Treatment with steroids and mycophenolate improved his clinical state, but he developed symptoms attributed to pericardiac effusion that necessitated treatment initially with drainage and subsequently with pericardial window. After a course of rituximab, he had an episode of sepsis that did not respond to appropriate treatment and died as a result. Both the imaging findings and neurological presentation with cerebellar ataxia and behavioural frontotemporal dementia are novel in the context of IgG4 disease.
Topics: Humans; Male; Cerebellar Ataxia; Immunoglobulin G4-Related Disease; Middle Aged; Frontotemporal Dementia
PubMed: 37558930
DOI: 10.1007/s12311-023-01592-8 -
International Journal of Surgery Case... Aug 2023Echinococcus granulosus causes hydatid disease. The most affected organ is the liver which is followed by the lungs. The pleural cavity being the primary location of...
INTRODUCTION AND IMPORTANCE
Echinococcus granulosus causes hydatid disease. The most affected organ is the liver which is followed by the lungs. The pleural cavity being the primary location of hydatid cysts is rare and should be discussed further. This paper documents a rare case of primary pleural hydatidosis which can present with a merely isolated cough followed by dyspnea. The diagnosis and surgical treatment along with post-operative medications are vital in this case.
CASE PRESENTATION
We present a case of a 45-year-old who suffered from a cough for more than one week which did not subside after taking medications. This symptom was followed by dyspnoea for which an X-ray was done which showed left-sided pleural effusion, a complication of pleural hydatidosis. Computed tomography showed multiple cysts in the pleural cavity which confirmed the diagnosis of primary pleural hydatidosis as the cysts were not present in any other sites. Blood work revealed eosinophilia which is significant in parasitic diseases. A left posterolateral thoracotomy was performed, and the cysts were surgically removed. Additionally, empyemectomy and pleurectomy were done. The patient was then treated with anti-parasitic therapy and was advised to get X-rays during the follow-up visits. The X-rays were normal and indicated that there was no disease recurrence.
CLINICAL DISCUSSION
Echinococcus granulosus is a parasitic worm that causes hydatid disease. The primary location is the liver. A diagnosis of intrathoracic but extrapulmonary disease, which involves the presence of hydatid cysts in the pleura, heart, pericardium, mediastinum, chest wall, and diaphragm, is difficult in individuals lacking a primary cyst in a common location (Isitmangil et al., 2003; Saeedan et al., 2020).
CONCLUSION
This case implies the significance of a cough of more than a week that is not relieved by medications. This should be carefully evaluated and followed in cases that have a rare diagnosis requiring surgery. A diagnosis of primary pleural hydatidosis with left-sided pleural effusion and atelectasis with mediastinal shift to the right side was made which was treated with a surgical procedure.
PubMed: 37517250
DOI: 10.1016/j.ijscr.2023.108533 -
European Heart Journal. Case Reports Jul 2023Primary effusion lymphoma (PEL) is a non-Hodgkin lymphoma that is exclusively generated by body cavity effusion. Primary effusion lymphoma develops in patients infected...
BACKGROUND
Primary effusion lymphoma (PEL) is a non-Hodgkin lymphoma that is exclusively generated by body cavity effusion. Primary effusion lymphoma develops in patients infected with human immunodeficiency virus (HIV) and is associated with the human herpes virus (HHV)-8 infection. However, there are sporadic cases without HHV-8 infections or any history of immunodeficiency, called 'PEL-like lymphoma'.
CASE SUMMARY
An 83-year-old man was admitted to our institution because of shortness of breath, fatigue, and facial oedema. Laboratory findings were unremarkable, including negative results for HIV antibodies. Transthoracic echocardiography revealed massive pericardial effusion surrounding the entire heart, which resulted in the early diastolic collapse of the right ventricular free wall, indicating elevated intra-pericardial pressure. He underwent pericardial centesis and 700 mL of pericardial fluid was drained. Adenosine deaminase (ADA) in the pericardial effusion showed an abnormally high value of 221 U/L. Cytological examination revealed a cellular population compatible with diffuse large B-cell lymphoma with prominent blastic characteristics and negative for HHV-8 latent nuclear antigens. Thus, the patient was diagnosed with HHV-8 unrelated HIV-negative PEL-like lymphoma. He was followed for more than 10 months in complete remission after a single pericardial drainage without any chemotherapy.
DISCUSSION
Exhaustive drainage of the lymphomatous effusion may induce complete remission in some patients with PEL-like lymphoma. Furthermore, the ADA value in the pericardial effusion may serve as a valuable guide to facilitate the accurate diagnosis of PEL-like lymphoma.
PubMed: 37497267
DOI: 10.1093/ehjcr/ytad305 -
AME Case Reports 2023Rupture of a thymoma is rare, and due to its rarity, the mechanism of rupture remains unclear. Here we report a case of a ruptured thymoma that ruptured due to an...
BACKGROUND
Rupture of a thymoma is rare, and due to its rarity, the mechanism of rupture remains unclear. Here we report a case of a ruptured thymoma that ruptured due to an increase in the intratumoral pressure caused by recurrent hemorrhaging.
CASE DESCRIPTION
A 70-year-old woman presented 2 days prior persistent right chest and shoulder pain. A chest computed tomography (CT) scan revealed the presence of a mass occupying the anterior mediastinum and a right pleural effusion. It was diagnosed as an anterior mediastinum tumor. The increase in the levels of inflammatory markers and tumor necrosis observed on CT were suggestive of infection. As the general status of the patient was stable and she initially received antibiotic medical therapy, an improvement in the inflammatory marker levels was observed with antibiotic therapy. A surgical resection was performed 10 days after admission. Median sternotomy revealed a tumor extending from the mediastinum to the right thoracic cavity. Since the adhesion was strong and tumor invasion was suspected, the tumor was completely resected by combining a partial resection of the right middle and lower lobes with the pericardium. Pathological examination revealed that the tumor was a type B2 thymoma with fibrosis, necrosis, hemosiderosis, and hemorrhaging, suggesting recurrent hemorrhaging within the tumor.
CONCLUSIONS
Based on the findings of our case, recurrent hemorrhaging within the tumor led to an increase in the intratumoral pressure and chronic inflammation and necrosis weakened the tumor wall. These changes contributed to the subsequent rupture.
PubMed: 37492796
DOI: 10.21037/acr-23-44 -
AME Case Reports 2023Pentalogy of Cantrell (PC) is a congenital multiple malformation consisting of midline supraumbilical thoracoabdominal wall defects, anterior and pericardial diaphragm...
BACKGROUND
Pentalogy of Cantrell (PC) is a congenital multiple malformation consisting of midline supraumbilical thoracoabdominal wall defects, anterior and pericardial diaphragm defects, lower sternum defects, ectopia cordis and various intracardiac anomalies, that present a distinctive challenge for care-providers and surgeons.
CASE DESCRIPTION
Cases of PC in twin pregnancies is rare. We report a new born infant, weighing 2,400 g, the younger twin. After birth, he was transferred to the Children's Hospital of Soochow University due to the prenatal echocardiography indicated that he has ventricular septal defect (VSD), atrial septal defect (ASD) and aortic arch hypoplasia. From the appearance, the lower end of sternum is suspiciously missing, the apical beating point is located at the lower edge of the median xiphoid process of sternum, and the upper abdominal muscle below the beating area is defective. He has the clinical and imaging features of complete type of PC. Three surgical operations were performed in the neonatal period, including end-to-side anastomosis of aortic arch under cardiopulmonary bypass (CPB), patch repair of VSD, repair of ASD, ligation of ductus arteriosus, correction of cardiac vascular malformation and repair of chest and abdominal wall defect, and the postoperative recoveries went smoothly.
CONCLUSIONS
PC is a rare congenital dysplasia, and its condition is complex. Our case shows that surgery is an effective treatment method, and the prognosis is related to the complexity of malformations.
PubMed: 37492795
DOI: 10.21037/acr-23-14 -
Animals : An Open Access Journal From... Jun 2023Developmental anomalies are an important cause of stillbirth and early perinatal death in companion animals. Many of these disorders remain poorly understood and provide...
Developmental anomalies are an important cause of stillbirth and early perinatal death in companion animals. Many of these disorders remain poorly understood and provide an opportunity as a spontaneous animal model for human disease. Pentalogy of Cantrell is a rare congenital syndrome described in human neonates. It is a ventral midline closure defect with a proposed familial inheritance in humans. This syndrome involves five defects, including the thoracoabdominal wall, sternal, diaphragmatic, pericardial and cardiac malformations. Diverse expressions of these defects have been described in humans and sporadically in domestic animals. This severe syndrome commonly harbors a poor prognosis, posing an ethical and surgical dilemma. To better understand this syndrome and its presentation in dogs, we describe two rare cases of Pentalogy of Cantrell in a litter of papillon dogs. The affected puppies had anomalies compatible with the Pentalogy of Cantrell, including thoracoabdominal schisis, ectopia cordis, sternal cleft, pericardial agenesis, and diaphragmatic defects. The diagnosis was confirmed by advanced imaging (computed tomography) and postmortem examinations. The family history of this litter was explored and other cases in domestic animals were reviewed. This is the first report of the complete Pentalogy of Cantrell with ectopia cordis in the dog and the only report on papillons. Similar to human cases, possible familial inheritance and suspected male gender bias were observed. Further research on this novel animal model, its pathogenesis and its hereditary basis, may be helpful in better understanding this rare developmental disorder.
PubMed: 37443889
DOI: 10.3390/ani13132091