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PMC8437380_01_BCTT-13-519-g0007.jpg
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PMC8437380_BCTT-13-519-g0007_A_1_3.webp
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Pathological results of hepatic space-occupying lesions after surgery. Haematoxylin-eosin (H&E) staining of biopsy samples (40x) magnification. (A) Immunohistochemical staining results of hepatic space-occupying lesions after surgery: Melan A + (B), ki-67 10% (C).
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Postoperative pathological report (Figure 7) described the liver structure as destroyed with unclear tumor tissue boundaries and no capsules.
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f0007
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PMC8437380_01
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PMC8437380
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file_0124107
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PMC8437380_01
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CC BY-NC
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PMC3687645_02_cpe-21-011-g001.jpg
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PMC3687645_cpe-21-011-g001_undivided_1_1.webp
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Sequencing of the AAAS gene. Novel homozygous mutation: IVS7+1 G to
A. The parents were heterozygous for the same mutation.
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Sequencing analysis of the AAAS gene was then performed, and a novel homozygous mutation was identified in our patient, involving the first base of the donor splice site of IVS7 (IVS7+1 G>A) (Fig. 1).
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fig_001
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PMC3687645_02
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PMC3687645
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file_0025996
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PMC3687645_02
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CC BY-NC-ND
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PMC7262964_01_fgene-11-00492-g0001.jpg
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PMC7262964_fgene-11-00492-g0001_A_1_7.webp
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(A) Pedigree of the HSAN-VI family with segregation analysis. The black symbols represent the affected members, and the arrow indicates the proband. Red text represents the variants. (B-G) Aspects of the phenotype of the proband. The proband has an ankle ulcer (B), necrosis of the astragalus (C), moderate scoliosis (D), phalangeal joint contracture (E,F), and cataract (G).
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We identified a Chinese family with HSAN (Figure 1A).
He consistently could not perceive noxious thermal/gelid stimuli or innocuous warm stimuli, which had resulted in the ankle ulcer and necrosis of the astragalus (Figures 1B,C).
The proband had moderate scoliosis (with a Cobb angle of 33 ) without centrum malformation (Figure 1D).
The brothers presented with arthrogryposes of the fingers, foot extroversion, knee recurvation deformities, and myasthenia; hence, they achieved independent ambulation at 3 years of age (Figures 1E,F). The proband had thin blue scleras and corneal ulcers and was subsequently diagnosed with a cataract (Figure 1G).
HSAN-VI patients, suggesting changes in cell adhesion and the cytoskeleton, which is in accordance with the expectation that DST variants can alter cytoskeletal filament networks (Figure 2E and Supplementary Figure 1). However, we did not observe any change in DST expression by RNAseq or qPCR (Figure 2E).
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PMC7262964_01
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PMC7262964
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file_0102987
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PMC7262964_01
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PMC6388523_01_JOVR-14-109-g004.jpg
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PMC6388523_JOVR-14-109-g004_a_1_4.webp
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(a) OCT macula. (b and c) GCL OCT. (d) OCT optic nerve. Stable condition from four months to one year of treatment, some recovery of ANFL from the initial drop after four months.
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Exactly one year later, VA and OCTs [Figure 4] were stable, despite some increase in ANFL from the original improvement seen after four months of treatment, and some non-significant thickening of macula and thus increased GCL.
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F4
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PMC7283137_01_gr1.jpg
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PMC7283137_gr1_undivided_1_1.webp
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MRI of the left ankle showing "dot in circle sign".
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There was hypointense dot noted at the centre of the lesion in T2 weighted image giving rise to "dot in circle sign" (Fig. 1: MRI of the left ankle showing "dot in circle sign").
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fig0005
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PMC7283137_01
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PMC7283137
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file_0103821
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PMC7283137_01
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CC BY-NC-ND
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PMC3938365_01_abd-89-01-0141-g01.jpg
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PMC3938365_abd-89-01-0141-g01_A_1_2.webp
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A. Keratotic erythematous-violaceous papules, distributed on the
umbilical and paraumbilical areas. B. Keratotic violaceous papules
distributed on scrotum and penile body
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At the dermatological exam he presented erythematous-violaceous papules of keratotic surface, grouped on the upper limbs, paravertebral, paraumbilical, inguinal, scrotum and penile regions, right thigh and knees (Figure 1).
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f01
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PMC3938365_01
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file_0031468
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CC BY-NC
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PMC3938365_01_abd-89-01-0141-g02.jpg
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PMC3938365_abd-89-01-0141-g02_undivided_1_1.webp
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Cornea verticillata: Yellowish lines that converge to a spot close to central
cornea region
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In the ophthalmological investigation the diagnosis was cornea verticillata (Figure 2).
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f02
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PMC3938365_01
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PMC3938365
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file_0031470
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PMC3938365_01
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CC BY-NC
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PMC3938365_01_abd-89-01-0141-g03.jpg
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PMC3938365_abd-89-01-0141-g03_A_1_2.webp
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A. Proliferation of capillary vases, ectasia and congestion of the
lumen in the papillary dermis, thickening of epidermis (HE100X). B.
Proliferation of capillary vases, ectasied, congested close to the dome of the
papillary dermis (HE 400X)
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The biopy of umbilical lesion resulted compatible with angiokeratoma (Figure 3).
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f03
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PMC3938365_01
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PMC3938365
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file_0031471
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PMC3938365_01
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CC BY-NC
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PMC10174457_01_fonc-13-1143335-g001.jpg
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PMC10174457_fonc-13-1143335-g001_undivided_1_1.webp
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Timeline of disease development and treatment courses.
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PMC10174457_01_fonc-13-1143335-g002.jpg
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PMC10174457_fonc-13-1143335-g002_undivided_1_1.webp
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Example of the dose distribution on MRI from the SBRT course, composed of five 10-Gy fractions delivered over consecutive days. The transverse, sagittal, and coronal views demonstrate the isodose levels from 50 Gy (prescription) to 25 Gy.
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SBRT, delivering 50 Gy in five fractions to the segment 5 liver tumor. SBRT was performed on a hybrid magnetic resonance/linear accelerator (MR/Linac) platform using MR-guided online adaptive radiotherapy (MRgOART) ( Figure 2 ).
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f2
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PMC10174457_01
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PMC10174457_01_fonc-13-1143335-g003.jpg
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PMC10174457_fonc-13-1143335-g003_undivided_1_1.webp
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PET CT comparison of the disseminated disease before (top row) and after (bottom row) the SBRT course combined with ImT (nivolumab/relatlimab). The primary tumor treated with SBRT (compare to
Figure 2
) as well as some of the metastases are annotated on the pre-treatment imaging.
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ImT-induced hepatitis, and systemic therapy was discontinued out of concern for another severe ImT-related adverse event (irAE). Interval PET/CT 3 months after SBRT showed a CMR with no suspicious hypermetabolic activity within the surgical cavity and complete resolution of all FDG-avid lesions in the liver (including unirradiated ones) and axial spine where hypermetabolism had previously been identified ( Figure 3 ).
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PMC10174457_01
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PMC3884199_01_crg-0007-0442-g01.jpg
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PMC3884199_crg-0007-0442-g01_a_1_6.webp
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a Endoscopic image depicting a 3-cm mass in the descending portion of the duodenum that is adjacent to the oral side but does not involve the papilla of Vater. The papilla of Vater is indicated by an arrow. b Endoscopic ultrasonography image showing the tumor partially invading the head of the pancreas (arrow). c Duodenography showing a protruding lesion in the descending portion of the duodenum (arrow). d Computed tomography image showing an ill-defined hypervascular mass (arrow). The tail of the pancreas had been minimally resected during a previous surgery. e Magnifying endoscopy depicting a diminished surface pattern of the gastrointestinal epithelium across the entire surface of the tumor. f Magnifying endoscopy combined with NBI depicting a diminished capillary network pattern.
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EGD revealed an ulcerated polypoid mass in the descending portion of the duodenum; the mass was adjacent to the oral side, but did not involve the papilla of Vater (fig. 1a). Endoscopic ultrasonography showed the tumor to be partially invading the head of the pancreas (fig. 1b).
Duodenography revealed a protruding lesion at the wall of the pancreatic side of the descending portion of the duodenum (fig. 1c).
Abdominal enhanced computed tomography depicted a well-contrasted, hypervascular mass (fig. 1d).
Magnifying endoscopy showed a diminished mucosal surface pattern of the gastrointestinal epithelium across the surface of the tumor (fig. 1e).
Furthermore, combined with narrow-band imaging (NBI), it also showed a highly dense assembly of microvessels on the surface of the tumor that did not form a capillary network pattern (fig. 1f).
Although partial resection of the pancreas had already been performed for a metastatic tumor of the pancreatic tail, the remnant pancreas was of rich volume (fig. 1d).
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F1
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PMC3884199_01
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PMC3884199
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file_0028963
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PMC3884199_01
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PMC3884199_01_crg-0007-0442-g02.jpg
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PMC3884199_crg-0007-0442-g02_a_1_6.webp
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a Macroscopic findings of the resected specimen reveal a polypoid mass in the descending portion of the duodenum that appears ulcerative and friable. The papilla of Vater is indicated by an arrow. b Histologic findings show that the surface of the tumor was coated by granulation tissue consisting of inflammatory cells, fibrosis and edematous stroma. c Histologic image shows dysplastic clear cells containing glycogen and arranged in an alveolar pattern. d-f Immunohistochemical staining demonstrates that the clear cells are positive for vimentin (d) and CD10 (e) and negative for CK7 (f), confirming the diagnosis of RCC with clear cell histology.
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Macroscopic findings of the resected specimen indicated that the polypoid mass at the descending portion of the duodenum was ulcerative and friable (fig. 2a).
Histologic findings revealed that the surface of the tumor was coated by granulation tissue consisting of inflammatory cells, fibrosis and edematous stroma (fig. 2b).
Furthermore, the cancerous lesion comprised clear cells containing glycogen that were arranged in an alveolar pattern (fig. 2c).
Immunohistology showed that the tumor cells were positive for vimentin and CD10 and negative for CK7 (fig. 2d-f).
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F2
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PMC3884199_01
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PMC3884199
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PMC4664549_01_opth-9-2139Fig1.jpg
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PMC4664549_opth-9-2139Fig1_undivided_1_1.webp
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Iris holes and corectopia in OD.. Abbreviation: OD, right eye.
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The slit lamp examination showed multiple iris holes and corectopia in OD (Figures 1 and 2), clear cornea in both eyes (OU), and no alterations in OS.
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f1-opth-9-2139
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PMC4664549_01
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PMC4664549
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PMC4664549_01
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PMC4664549_01_opth-9-2139Fig2.jpg
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PMC4664549_opth-9-2139Fig2_undivided_1_1.webp
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Iris holes and corectopia in OD.. Abbreviation: OD, right eye.
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The slit lamp examination showed multiple iris holes and corectopia in OD (Figures 1 and 2), clear cornea in both eyes (OU), and no alterations in OS.
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f2-opth-9-2139
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PMC4664549_01
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PMC4664549
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file_0047119
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PMC4664549_01
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CC BY-NC
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PMC4664549_01_opth-9-2139Fig3.jpg
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PMC4664549_opth-9-2139Fig3_undivided_1_1.webp
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Peripheral anterior synechiae in OD.. Abbreviation: OD, right eye.
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The gonioscopy revealed 360 isolated peripheral anterior synechiae in OD (Figure 3) and a visible open-angle up to ciliary body in OS.
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f3-opth-9-2139
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PMC4664549_01
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PMC4664549
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file_0047120
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PMC4664549_01
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PMC4664549_01_opth-9-2139Fig4.jpg
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PMC4664549_opth-9-2139Fig4_undivided_1_1.webp
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Retina and optic disc in OD.. Abbreviation: OD, right eye.
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The fundoscopy (Figures 4 and 5) presented cup-disc ratio 0.9 vertical (V) x0.9 horizontal (H), visible lamina cribrosa pores, preserved macula, and peripheral pigment mobilization in OD.
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f4-opth-9-2139
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PMC4664549_01
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PMC4664549
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file_0047121
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CC BY-NC
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PMC4664549_01_opth-9-2139Fig5.jpg
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PMC4664549_opth-9-2139Fig5_undivided_1_1.webp
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Retina and optic disc in OS.. Abbreviation: OS, left eye.
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The fundoscopy (Figures 4 and 5) presented cup-disc ratio 0.9 vertical (V) x0.9 horizontal (H), visible lamina cribrosa pores, preserved macula, and peripheral pigment mobilization in OD.
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f5-opth-9-2139
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PMC4664549_01
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PMC4664549
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file_0047122
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PMC4664549_01
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CC BY-NC
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PMC4664549_01_opth-9-2139Fig6.jpg
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PMC4664549_opth-9-2139Fig6_A_2_2.webp
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Automated perimetry in OD.. Abbreviations: OD, right eye; MS, mean sensitivity; MD, mean defect; LV, loss variance; CLV, corrected loss variance; SF, short-term fluctuation; RF, reliability factor; IOP, intraocular pressure; Refr S/C/A, Refraction spheric/cylinder/axis.
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The automated perimetry (Figures 6 and 7) and manual perimetry (Figures 8 and 9) showed central island vision in OD and ring scotoma in OS.
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f6-opth-9-2139
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PMC4664549_01
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PMC4664549
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file_0047123
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PMC4664549_01
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CC BY-NC
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PMC4664549_01_opth-9-2139Fig7.jpg
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PMC4664549_opth-9-2139Fig7_A_2_2.webp
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Automated perimetry in OS.. Abbreviations: OS, left eye; MS, mean sensitivity; MD, mean defect; LV, loss variance; CLV, corrected loss variance; SF, short-term fluctuation; RF, reliability factor; IOP, intraocular pressure; Refr S/C/A, Refraction spheric/cylinder/axis.
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The automated perimetry (Figures 6 and 7) and manual perimetry (Figures 8 and 9) showed central island vision in OD and ring scotoma in OS.
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f7-opth-9-2139
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PMC4664549_01
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file_0047124
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PMC4664549_01
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CC BY-NC
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PMC4664549_01_opth-9-2139Fig8.jpg
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PMC4664549_opth-9-2139Fig8_undivided_1_1.webp
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Manual perimetry in OD.. Abbreviation: OD, right eye.
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The automated perimetry (Figures 6 and 7) and manual perimetry (Figures 8 and 9) showed central island vision in OD and ring scotoma in OS.
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f8-opth-9-2139
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PMC4664549_01
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PMC4664549
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file_0047125
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PMC4664549_01
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PMC4664549_01_opth-9-2139Fig9.jpg
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PMC4664549_opth-9-2139Fig9_undivided_1_1.webp
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Manual perimetry in OS.. Abbreviation: OS, left eye.
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The automated perimetry (Figures 6 and 7) and manual perimetry (Figures 8 and 9) showed central island vision in OD and ring scotoma in OS.
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f9-opth-9-2139
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PMC4664549_01
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PMC4664549
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file_0047126
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PMC4664549_01
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CC BY-NC
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PMC4322374_01_JCIS-5-3-g002.jpg
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PMC4322374_JCIS-5-3-g002_undivided_1_1.webp
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52-year-old male with atypical chest pain. Coronary computed tomography angiography curved planar reformation image of the mid left anterior descending coronary artery. The white arrow marks an area suspicious for significant stenosis (>70%).
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The calcium score was 140 and CCTA revealed calcified and noncalcified coronary atherosclerosis with a mixed, stenotic plaque in the mid left anterior descending coronary artery (LAD) [Figure 1].
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F1
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PMC4322374_01
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PMC4322374
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file_0039095
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PMC4322374_01
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CC BY-NC-SA
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PMC4322374_01_JCIS-5-3-g003.jpg
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PMC4322374_JCIS-5-3-g003_bottom_2_2.webp
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52-year-old male with atypical chest pain. Static rubidium-82 perfusion images (17 segment polar maps) demonstrates no difference between stress (top) and rest perfusion (bottom). Images were acquired 150 s after injection of 1110 MBq Rb82. Total acquisition time was 270 s.
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Myocardial perfusion and coronary flow reserve were normal during adequate stress response to adenosine (140 mug/kg/min) [Figure 2].
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F2
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PMC4322374_01
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PMC4322374
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file_0039096
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PMC4322374_01
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PMC4322374_01_JCIS-5-3-g004.jpg
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PMC4322374_JCIS-5-3-g004_undivided_1_1.webp
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53-year-old male presenting with severe chest pain and cardiac arrest, which was successfully treated with resuscitation and cardioversion. 12-lead electrocardiogram shows massive ST-elevation consistent with anterior ST-elevation myocardial infarction.
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The electrocardiogram showed ST-elevation [Figure 3].
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F3
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PMC4322374_01
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PMC4322374
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file_0039098
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PMC4322374_01
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CC BY-NC-SA
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PMC4322374_01_JCIS-5-3-g006.jpg
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PMC4322374_JCIS-5-3-g006_undivided_1_1.webp
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52-year-old male with atypical chest pain. Fractional flow reserve (FFRCT = 0.52) derived from coronary computed tomography images and based on a physiologic model of coronary blood flow using three principles: (1) The total resting coronary blood flow can be quantified relative to the myocardial mass, (2) The microcirculatory vascular resistance at rest is inversely proportional to the size of the supplying coronary arteries, and (3) The vasodilatory response of the coronary microcirculation to adenosine can be predicted, allowing computational modeling of maximal hyperemia. The integration of the physiological model into 3-dimensional computational models allows computation of coronary flow and pressure under hyperemic conditions.
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FFRCT analysis [Figure 5]. FFRCT analysis was performed at HeartFlow (Redwood
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PMC4322374_01
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PMC4322374
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PMC4322374_01
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PMC4956902_01_gr2.jpg
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PMC4956902_gr2_undivided_1_1.webp
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The image shows extensive mixed type necrosis with a focal rounded area of suppurative necrosis on the left side (dashed line) (H&E stain, 100x). The elastic stain in the inset highlights, in black, the elastic layer of the blood vessel wall, which is partially destroyed (arrows) by the inflammation (Verhoeff stain, 200x).
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This constellation of features was diagnostic of granulomatosis with polyangiitis (GPA) (Fig. 2).
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fig2
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PMC4956902_01_gr3.jpg
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PMC4956902_gr3_undivided_1_1.webp
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Follow up chest radiograph (posteroanterior view) performed following treatment, demonstrates significant decrease in size of largest lesion in mid lung zone (white arrow).
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On repeat chest radiograph four weeks after treatment, there was interval improvement in the airspace disease density (Fig. 3).
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fig3
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PMC2628935_01_1752-1947-3-5-1.jpg
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PMC2628935_1752-1947-3-5-1_undivided_1_1.webp
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A 12-lead ECG showing a 4.2 second pause.
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The result of her 12-lead ECG is shown in Figure 1.
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F1
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PMC2628935_01
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PMC2628935
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file_0011747
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PMC6381922_01_cro-0012-0029-g01.jpg
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PMC6381922_cro-0012-0029-g01_A_1_4.webp
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Microscopic section. Hematoxylin and eosin stained section of the bone marrow showing hypoplasia, x20 (A). Hematoxylin and eosin stained section of the bone marrow showing hypoplasia, x40 (B). Alcian blue staining demonstrates serous degeneration, x20 (C). Immunostaining for CD8, x20 (D).
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Alcian blue staining confirmed a picture of serous degeneration (Fig. 1).
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F1
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PMC6381922_01
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PMC6381922
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file_0090263
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PMC6381922_01
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CC BY-NC
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PMC9066584_01_acc-09-01-6-g001.jpg
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PMC9066584_acc-09-01-6-g001_undivided_1_1.webp
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Cytopathologic finding of cerebrospinal fluid revealing large malignant cells, some with a signet-ring appearance.
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Subsequently, a lumbar puncture was performed and CSF analysis was compatible with LMC (Figure 1).
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f1
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PMC9066584_01
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PMC9066584
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PMC9066584_02_acc-09-01-6-g003.jpg
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PMC9066584_acc-09-01-6-g003_undivided_1_1.webp
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Brain MRI, axial FLAIR, revealing hypersignal and locoregional thickening of the superior frontal sulcus.
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Head CT scan revealed a hyperintense right frontoparietal lesion with surrounding oedema, suggestive of malignancy on brain MRI (Figure 3).
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PMC9066584_02_acc-09-01-6-g004.jpg
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PMC9066584_acc-09-01-6-g004_undivided_1_1.webp
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Neoplastic cells in the CSF with pleomorphic nuclei and prominent nucleoli.
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CSF analysis revealed atypical malignant signet-ring cells and gastric adenocarcinoma LMC was assumed (Figure 4).
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PMC3328781_01_jcav03p0158g02.jpg
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PMC3328781_jcav03p0158g02_A_1_3.webp
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Baseline radiologic assessment of the patient in September 2009 before initiation of sorafenib therapy. A: sonography showing a 10 cm lesion in the liver. B: Magnetic resonance imaging (MRI) of the liver revealing a large lesion in the right liver lobe and several diffuse smaller nodules in the total liver. C: MRI scan of the soft tissue metastasis in the autochthonic spine musculature.
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A) in September 2009. At the time of diagnosis, a moderately differentiated metastasis to the thyroid gland and several metastases to the autochthonic spine musculature and the vertebral bodies with stenoses of the spinal canal (L I) and the neuroforamina (Th XII to L I) were present (Figure 2).
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PMC3328781_01_jcav03p0158g03.jpg
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PMC3328781_jcav03p0158g03_A_1_3.webp
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Staging after sorafenib monotherapy and before initiation of additional panobinostat treatment. A: Contrast enhanced (left) and native sonography (right) showing necrosis (> 75%) in the largest lesion. B: MRI scan of the liver showing a mixed radiologic response compared to baseline. C: MRI scan of the soft tissue metastasis.
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September 2009 and showed a mixed response in MRI scan 6 weeks after treatment start with partly necrotic or decreased lesions but also increasing and novel lesions in the liver and stable soft tissue and bone metastases. Sonography revealed a large lesion (11 cm) in the right liver lobe which was more than 75% necrotic but also 8 additional lesions up to 5 cm (Figure 3).
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PMC3328781_01_jcav03p0158g04.jpg
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PMC3328781_jcav03p0158g04_A_1_3.webp
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Staging after 8 weeks of sorafenib and panobinostat combination therapy. A: Contrast enhanced (left) and native sonography (right). B: MRI scan of the liver. C: MRI scan of the soft tissue metastasis.
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Staging was performed after three cycles in January 2010 (Figure 4).
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F4
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PMC3328781_01
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PMC3328781
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file_0019905
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PMC3328781_01
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CC BY-NC-ND
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PMC3328781_01_jcav03p0158g05.jpg
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PMC3328781_jcav03p0158g05_A_1_2.webp
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Time course of transaminases and AFP under sorafenib and panobinostat treatment. (A) Serum levels of GOT, GPT and gamma-GT remained in the normal range under panobinostat (< 50 U/l for GOT and GPT, < 60 U/l for gamma-GT) but rapidly increased again after cessation of panobinostat intake. (B) The tumor marker alpha-fetoprotein (AFP) decreased under the combination therapy with sorafenib and panobinostat but rised again under sorafenib monotherapy (normal level < 10 ng/ml). Panobinostat treatment period is indicated in the figure.
|
Although transaminases and gamma-GT were initially elevated (maximum GOT 130 U/l, GPT 178 U/l, gamma-GT 167 U/l), these parameters rapidly normalized under sorafenib therapy and stayed in the normal range until the end of treatment with panobinostat (Figure 5A).
Interestingly, the initially elevated tumor marker alpha-fetoprotein (AFP) returned to normal values already under sorafenib therapy despite a lack of radiologic response at this stage (Figure 5B).
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F5
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PMC3328781_01
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PMC3328781
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file_0019908
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PMC3328781_01
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CC BY-NC-ND
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PMC3363304_01_opth-6-661f1.jpg
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PMC3363304_opth-6-661f1_A_1_9.webp
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Enhanced magnetic resonance imaging and operative views. (A-C) At the onset, a 9 mm heterogeneous intracranial lesion attached to the tuberculum sellae can be seen. The mass was close to the left optic nerve anterior to the chiasm. (D-F) Preoperatively, thin sliced enhanced magnetic resonance imaging showed the lesion had extended into the left optic canal (red arrow). (G-I) The tumor was successfully removed including the intracranial lesion by opening the optic canal.
|
However, enhanced magnetic resonance imaging (MRI) showed a 9 mm heterogeneous intracranial lesion attached to the TS around the left optic nerve anterior to the chiasm (Figure 1A-C).
Thin sliced enhanced MRI revealed that the intracranial lesion had extended into her left optic canal, even though the size of the main mass was almost the same as earlier (Figure 1D-F).
A hemi-interhemispheric approach was used, and the tumor was successfully removed (Simpson grade 2) including the intracranial lesion by opening the optic canal (Figure 1G-I).
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f1-opth-6-661
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PMC3363304_01
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PMC3363304
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file_0020612
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PMC3363304_01
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NO-CC CODE
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PMC3363304_01_opth-6-661f2.jpg
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PMC3363304_opth-6-661f2_A_1_6.webp
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Fundus photograph and results of Humphrey static perimetry. (A and B) At the onset, fundus photograph showed that the retina and disc were normal. (C and D) At the onset, Humphrey static perimetry showed inferior temporal field defect in the left eye (30-2 strategy MD -17.57 dB), and normal field in the right eye. (E) One year after the onset, Humphrey static perimetry showed the visual field was almost normal (30-2 strategy MD -2.35 dB). (F) One month after surgery, Humphrey static perimetry showed a mild temporal hemianopia (30-2 strategy MD -3.19 dB).
|
The results of ophthalmoscopic examinations were normal (Figure 2A and B).
Static perimetry 30-2 with the Humphrey field analyzer (HFAII 745; Carl Zeiss AG, Oberkochen, Germany) showed an inferior temporal field defect in the left eye (Figure 2C and D).
At the 1-year follow-up examination, her BCVA remained in 1.2, and the visual field was almost normal in the left eye without any treatment (Figure 2E).
One month after surgery, her BCVA improved to 1.2, and a mild temporal hemianopia was detected in the left eye (Figure 2F).
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f2-opth-6-661
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PMC3363304_01
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PMC3363304
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file_0020621
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PMC3363304_01
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NO-CC CODE
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PMC3363304_01_opth-6-661f3.jpg
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PMC3363304_opth-6-661f3_undivided_1_1.webp
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Pattern visual evoked potentials.. Notes: At the onset, the pattern visual evoked potentials elicited by transient and steady-state stimuli to the left eye were undetectable. One month after surgery, pattern visual evoked potentials were present but had a prolonged P100 latency of 170 ms in the left eye (mean: 105.2 +- 6.4 ms; normal range: 92.4 to 118.0 ms).. Abbreviation: VEP, visual evoked potentials.
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The pattern VEPs elicited by transient and steadystate stimuli to the left eye were undetectable (Figure 3).
The pattern VEPs were present but had a prolonged P100 latency of 170 ms (Figure 3).
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f3-opth-6-661
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PMC3363304_01
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PMC3363304
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file_0020627
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PMC3363304_01
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NO-CC CODE
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PMC6731353_01_gr1.jpg
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PMC6731353_gr1_undivided_1_1.webp
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Gram stain of the blood culture.
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A blood culture was positive for gram-positive rod on the day after her first hospital visit (Fig. 1).
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fig0005
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PMC6731353_01
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PMC6731353
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file_0096161
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PMC6731353_01
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CC BY-NC-ND
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PMC5828284_01_autopsy-08-01e2018002-g01.jpg
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PMC5828284_autopsy-08-01e2018002-g01_B_1_1.webp
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Photomicrographies showing the main histological findings. Images A - (case 1; 10X) and B - (case 1; 20X) show cells that are interspersed within agglomerates of fibrin and present as loosely arranged clusters or glandular-like structures. Occasionally, the glandular structures show columnar cells. Image C - Histiocytes show strong cytoplasmic immunostaining for CD68 (case 1; 20X). Image D - Mesothelial cells show strong immunohistochemical positivity for calretinin. (case 1; 20X). Objective magnifications are in parenthesis after the case number.
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An incidental finding at histological examination was an agglomerate of polyhedral cells and histiocytes admixed with fibrin and erythrocytes, and focally forming strips or tubular arrays that were not attached to the valve, which appeared to correspond macroscopically to a thrombus (Figures 1A and 1B).
Immunohistochemistry was positive for calretinin in some of the cells and for CD68 in others, allowing the identification of a biphasic lesion, with mesothelial cells and macrophages, respectively (Figures 1C and 1D), and the diagnosis of a mesothelial/monocytic incidental cardiac excrescence.
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g01
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PMC5828284_01
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PMC5828284
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file_0077989
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PMC5828284_01
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CC BY-NC
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PMC5828284_03_autopsy-08-01e2018002-g02.jpg
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PMC5828284_autopsy-08-01e2018002-g02_undivided_1_1.webp
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Photomicrographs from cases 2 and 3. Image A - Hematoxylin and eosin (H&E) staining displays sheets and blocks of epithelioid cells within a fibrin matrix, associated with macrophages (case 2; 20X). Image B - Agglomerate of polyhedral cells and histiocytes embedded in fibrin (case 3; 20X). Image C - CD68 immunostaining shows cytoplasmic positivity in the solid cells clusters demonstrating the histiocytic nature of these cells (case 3; 20X). Image D - Calretinin immunostaining shows mesothelial cells in middle of histiocytic cells (case 3; 20X). Objective magnifications are in parenthesis after the case number.
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Additionally, and apart from the fibrotic area, an agglomerate of polyhedral cells and histiocytes were found embedded in fibrin (Figure 2B), compatible with mesothelial/monocytic incidental cardiac excrescence (Figures 2C and 2D).
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g02
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PMC5828284_02
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PMC5828284
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file_0077990
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PMC5828284_03
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CC BY-NC
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PMC5828284_03_autopsy-08-01e2018002-g02.jpg
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PMC5828284_autopsy-08-01e2018002-g02_undivided_1_1.webp
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Photomicrographs from cases 2 and 3. Image A - Hematoxylin and eosin (H&E) staining displays sheets and blocks of epithelioid cells within a fibrin matrix, associated with macrophages (case 2; 20X). Image B - Agglomerate of polyhedral cells and histiocytes embedded in fibrin (case 3; 20X). Image C - CD68 immunostaining shows cytoplasmic positivity in the solid cells clusters demonstrating the histiocytic nature of these cells (case 3; 20X). Image D - Calretinin immunostaining shows mesothelial cells in middle of histiocytic cells (case 3; 20X). Objective magnifications are in parenthesis after the case number.
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Additionally, and apart from the fibrotic area, an agglomerate of polyhedral cells and histiocytes were found embedded in fibrin (Figure 2B), compatible with mesothelial/monocytic incidental cardiac excrescence (Figures 2C and 2D).
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g02
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PMC5828284_03
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PMC5828284
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file_0077990
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PMC5828284_03
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CC BY-NC
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PMC6370615_01_fneur-10-00064-g0001.jpg
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PMC6370615_fneur-10-00064-g0001_A_1_4.webp
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EEG demonstrations before quinidine therapy. (A) Interictal EEG before quinidine therapy showed a large number of 3-5 Hz slow waves with middle and high amplitude in the anterior region in background. (B) Multiple-spike-and-slow-waves of 0.5-1 Hz were observed during the sleep period. (C) Slow spike-and-slow-waves of 1.5-2.5 Hz were observed when the patient was awake. (D) Ictal EEG of the tonic seizure showed short-term fast rhythms burst of 16-20 Hz.
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Slow spike-and-slow-waves of 1.5 to 2.5 Hz were observed during awake time (Figure 1).
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F1
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PMC6370615_01
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PMC6370615
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file_0089956
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PMC6370615_01
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CC BY
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PMC6370615_01_fneur-10-00064-g0002.jpg
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PMC6370615_fneur-10-00064-g0002_A_1_2.webp
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The changes of the seizure frequency and epileptiform discharges along with the changes of quinidine dosages. (A) The patient was given quinidine at a starting dosage of 5 mg/kg/day. The dose slowly increased and maintained at 13.75 mg/kg/day. As the dosage of quinidine increased, the frequency of tonic seizures (the main type of seizures in the patient) gradually reduced from 16 times per month to 4 times per month. (B) The epileptiform discharge of EEG was 1,323 times per 24 h before taking the quinidine. The epileptiform discharge was 512 times per 24 h in the 3rd month, 652 times per 24 h in the 6th month, 598 times per 24 h in the 9th month. With the increase of dosages, the epileptiform discharge showed a significant reduction.
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The frequency of tonic seizures subsided by 75% (Figure 2A), whereas the frequency of the other types of seizures was not reduced significantly.
The epileptiform discharges decreased by 54.80% (Figure 2B).
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F2
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PMC6370615_01
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PMC6370615
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file_0089960
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PMC6370615_01
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CC BY
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PMC5864713_01_NCI-5-67-g001.jpg
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PMC5864713_NCI-5-67-g001_undivided_1_1.webp
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A nodule with large localized areas of necrosis under the thyroid capsule (H&E, x40).
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F1
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PMC5864713_01
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PMC5864713
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file_0078898
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PMC5864713_01
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CC BY-NC-SA
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PMC5864713_01_NCI-5-67-g002.jpg
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PMC5864713_NCI-5-67-g002_undivided_1_1.webp
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Focal papillary proliferations around large necrosis areas (H&E, x100).
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F2
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PMC5864713_01
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PMC5864713
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file_0078899
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PMC5864713_01
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CC BY-NC-SA
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PMC5864713_01_NCI-5-67-g003.jpg
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PMC5864713_NCI-5-67-g003_undivided_1_1.webp
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Thyrocytes of papillary carcinoma with a large oncocytic cytoplasm aligned around the fibrovascular core (H&E, x400).
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F3
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PMC5864713_01
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PMC5864713
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file_0078900
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PMC5864713_01
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CC BY-NC-SA
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PMC5864713_01_NCI-5-67-g004.jpg
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PMC5864713_NCI-5-67-g004_undivided_1_1.webp
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Extensive strong positivity with cytokeratin 19 and papillary structures (Immunohistochemistry, x400).
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F4
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PMC5864713_01
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PMC5864713
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file_0078901
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PMC5864713_01
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CC BY-NC-SA
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PMC5864713_01_NCI-5-67-g005.jpg
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PMC5864713_NCI-5-67-g005_undivided_1_1.webp
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Focal weak positive staining with HBME 1 (Immunohistochemistry, x400).
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F5
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PMC5864713_01
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PMC5864713
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file_0078902
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PMC5864713_01
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CC BY-NC-SA
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PMC5864713_01_NCI-5-67-g006.jpg
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PMC5864713_NCI-5-67-g006_undivided_1_1.webp
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No staining with galectin-3 was observed (Immunohistochemistry, x400).
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F6
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PMC5864713_01
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PMC5864713
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file_0078903
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PMC5864713_01
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CC BY-NC-SA
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PMC5864713_01_NCI-5-67-g007.jpg
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PMC5864713_NCI-5-67-g007_undivided_1_1.webp
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Cytologic examination revealed presence of mild hypochromia with large oncocytic morphology, focal overlapping, and infrequent intranuclear inclusion (PAP EA 50, x400).
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F7
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PMC5864713_01
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PMC5864713
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file_0078904
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PMC5864713_01
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CC BY-NC-SA
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PMC5864713_01_NCI-5-67-g008.jpg
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PMC5864713_NCI-5-67-g008_undivided_1_1.webp
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Magnetic Resonance Imaging (MRI) showed a 2.5x1.5-cm mass lesion in the right superior mesencephalon.
|
During MRI at our center (Fig. 8), a mass was detected in the brain stem. "Astrocytoma," as a 2nd synchronous primary tumor, was detected in the patient who underwent surgery at an external center at the patient's request.
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F8
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PMC5864713_01
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PMC5864713
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file_0078905
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PMC5864713_01
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CC BY-NC-SA
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PMC3934774_01_cro-0007-0039-g01.jpg
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PMC3934774_cro-0007-0039-g01_undivided_1_1.webp
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CT scan of the chest with density in bronchus intermedius.
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A 31-year-old white male with a known history of colon carcinoma was referred to the Interventional Pulmonary service for right lower lobe infiltrates and mucous plugging on computed tomography (CT) with concern for pneumonia (fig. 1).
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F1
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PMC3934774_01
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PMC3934774
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file_0031238
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PMC3934774_01
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CC BY-NC
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PMC3934774_01_cro-0007-0039-g02.jpg
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PMC3934774_cro-0007-0039-g02_undivided_1_1.webp
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Bronchus intermedius mass.
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Bronchoscopy was performed revealing a broad based mass completely obstructing the bronchus intermedius (fig. 2).
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F2
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PMC3934774_01
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PMC3934774
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file_0031239
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PMC3934774_01
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CC BY-NC
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PMC3934774_01_cro-0007-0039-g03.jpg
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PMC3934774_cro-0007-0039-g03_undivided_1_1.webp
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Bronchus intermedius after endobronchial debulking.
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It was possible to pass a probe into the right lower lobe, and subsequent photoablation and mechanical debulking revealed that the mass was arising near the origin of the superior basal segment of the right lower lobe (RB6) and could be resected (fig. 3).
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F3
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PMC3934774_01
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PMC3934774
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file_0031240
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PMC3934774_01
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CC BY-NC
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PMC6514481_02_cro-0012-0322-g01.jpg
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PMC6514481_cro-0012-0322-g01_A_1_3.webp
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Part of the dose distribution of the VMAT plan with three 6 MeV photon FFF beams for an occipital metastasis (A. transversal view, B. coronal view, C. sagittal view).
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In individual 1, mean HU were measured in the high dose (1 x 7 Gy) area of the adjacent skull to the occipital brain metastasis (Fig. 1).
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F1
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PMC6514481_01
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PMC6514481
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file_0092827
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PMC6514481_02
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CC BY-NC
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PMC6514481_02_cro-0012-0322-g01.jpg
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PMC6514481_cro-0012-0322-g01_A_1_3.webp
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Part of the dose distribution of the VMAT plan with three 6 MeV photon FFF beams for an occipital metastasis (A. transversal view, B. coronal view, C. sagittal view).
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In individual 1, mean HU were measured in the high dose (1 x 7 Gy) area of the adjacent skull to the occipital brain metastasis (Fig. 1).
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F1
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PMC6514481_02
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PMC6514481
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file_0092827
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PMC6514481_02
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CC BY-NC
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PMC6514481_02_cro-0012-0322-g02.jpg
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PMC6514481_cro-0012-0322-g02_A_1_3.webp
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Dose distribution of the AP-PA fields of 10 MeV photons for treatment of callus formation in the right femur (A. transversal view, B. coronal view, C. sagittal view).
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A dose of 5 x 4 Gy was prescribed to the right femur using an AP-PA field of 10 MeV photons (Fig. 2).
In individual 2, mean HU were measured in the target area of the right femur (Fig. 2) and in a non-irradiated area of the right femur.
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F2
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PMC6514481_02
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PMC6514481
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file_0092830
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PMC6514481_02
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CC BY-NC
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PMC4735458_01_gr1.jpg
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PMC4735458_gr1_undivided_1_1.webp
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Vertebral bony destruction with paraspinal collection (thin arrow) and cortical thickening and irregularity of the right 3rd rib (thick arrow).
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CH50, hemoglobin electrophoresis, and neutrophil oxidative burst test were normal. Computerized tomography again showed a paraspinal collection now extending from the 2nd to the 8th thoracic vertebrae, with mild bone destruction also involving the right third rib (Fig. 1).
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fig0005
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PMC4735458_01
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PMC4735458
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file_0049397
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PMC4735458_01
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CC BY-NC-ND
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PMC8242995_01_gr1.jpg
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PMC8242995_gr1_undivided_1_1.webp
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Computed tomography angiography reconstruction showing thoracic aneurysm.
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Computed tomography (CT) angiography confirmed the 7.2 cm fusiform aneurysm of the distal aortic arch, with an ectatic ascending aortic segment measuring up to 3.7 cm in diameter and a descending thoracic aneurysm measuring 4.2 cm (Fig. 1).
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fig1
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PMC8242995_01
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PMC8242995
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file_0119804
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PMC8242995_01
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CC BY-NC-ND
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PMC8242995_01_gr3.jpg
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PMC8242995_gr3_A_1_5.webp
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(A) Angiogram demonstrating aneurysm and origins of innominate artery (IA) and left common carotid artery (LCCA) retrograde puncture access. (B) Left subclavian artery (LSA) cannulation and occlusion. (C) Snaring of custom made device (CMD) preload wire into the LCCA. (D) LCCA BeGraft deployment and flaring. (E) Final placement of device.
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The left VA and distal SCA could be seen to be perfused via collateral flow (Fig. 3).
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fig3
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PMC8242995_01
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PMC8242995
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file_0119805
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PMC8242995_01
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CC BY-NC-ND
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PMC8242995_01_gr4.jpg
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PMC8242995_gr4_undivided_1_1.webp
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Computed tomography volume reconstruction of surveillance scan performed one month after repair.
|
Follow up CT a month later showed that the stent graft, LCCA fenestration and IA were patent, and that the proximal LSA had been occluded as planned with collateral perfusion of the left VA and LSA distal to the vascular plug (Fig. 4).
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fig4
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PMC8242995_01
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PMC8242995
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file_0119810
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PMC8242995_01
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CC BY-NC-ND
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PMC7712411_01_j_med-2020-0228-fig001.jpg
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PMC7712411_j_med-2020-0228-fig001_undivided_1_1.webp
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Injury of the vastus medialis muscle, which was visible on the clinical examination of the lower thigh. Parental consent was obtained for publication of this clinical photograph.
|
At clinical examination, the girl showed functional impairment of the right knee (limited flexion of 30%), muscle contracture, and localized pain (Figure 1).
|
j_med-2020-0228_fig_001
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PMC7712411_01
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PMC7712411
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file_0112618
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PMC7712411_01
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CC BY
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PMC7712411_01_j_med-2020-0228-fig002.jpg
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PMC7712411_j_med-2020-0228-fig002_a_1_2.webp
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Preoperative magnetic resonance imaging. (a) Focal mass-like FAVA, which produced progressive thigh pain over the last year; (b) the sagittal image shows maximal mass hyperintensity in T2-weighted images.
|
T1-weighted MRIs showed heterogeneous and hyperintense signal related to the fat component (Figure 2), and the injection of intravenous contrast clearly revealed the malformed venous component. The solid mass was found to have partially replaced the normal vastus medialis muscle fibers, with fibrofatty overgrowth and varied appearances of clusters of thick-walled muscular vessels; multiple soft-tissue planes were found to be involved as well, showing hypoechoic intralesional clots or development of phleboliths, with low-flow venous parameters that were also barely detectable by Doppler sonography.
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j_med-2020-0228_fig_002
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PMC7712411_01
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PMC7712411
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file_0112619
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PMC7712411_01
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CC BY
| |
PMC3347879_01_dee-0002-0169-g01.jpg
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PMC3347879_dee-0002-0169-g01_undivided_1_1.webp
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Cognition, mood, and daily functioning at baseline for an 84-year-old female with 14 years of education.
|
For this 84-year-old White woman, the neuropsychology test results, presented in figure 1, show some mild decreased performance on measures of executive function (CLOX1, FAS, TMT B), speed (TMT A), working memory (WAIS Digit span), and on the attention index score of the RBANS.
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F1
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PMC3347879_01
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PMC3347879
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file_0020215
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PMC3347879_01
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CC BY-NC-ND
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PMC5698921_01_f1000research-6-13246-g0001.jpg
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PMC5698921_f1000research-6-13246-g0001_undivided_1_1.webp
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Abdominal computed tomography images.. Left image, * indicates the gallbladder; right image, the arrows indicates the fistula.
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Abdominal computed tomography scan with contrast media showed the gallbladder walls had diffuse thickened and blurred edges, and the right and transverse abdominal muscles were almost covered and embedded with minute hypo-dense ailments compatible with relapsing phlogistic processes ( Figure 2).
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f2
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PMC5698921_01
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PMC5698921
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file_0074236
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PMC5698921_01
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CC BY
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PMC10395095_01_fmed-10-1225167-g0001.jpg
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PMC10395095_fmed-10-1225167-g0001_undivided_1_1.webp
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Chest X-ray on admission.
|
Chest x-ray (Figure 1) showed a right apical pneumothorax (with chest tube previously inserted) and extensive diffuse bilateral consolidations with bronchus sign.
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F1
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PMC10395095_01
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PMC10395095
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file_0009173
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PMC10395095_01
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CC BY
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PMC10395095_01_fmed-10-1225167-g0002.jpg
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PMC10395095_fmed-10-1225167-g0002_undivided_1_1.webp
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Fluids from WLL.
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During the second procedure, a complete left lung lavage and a partial right lung lavage were performed (Figure 2).
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F2
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PMC10395095_01
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PMC10395095
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file_0009174
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PMC10395095_01
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CC BY
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PMC6886636_01_1262_Fig2.jpg
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PMC6886636_1262_Fig2_undivided_1_1.webp
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Chest x-ray showing no abnormalities
|
Chest x-ray did not show any abnormalities (Fig. 2).
|
f2-1262-1-9774-1-10-20191030
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PMC6886636_01
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PMC6886636
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file_0098930
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PMC6886636_01
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CC BY-NC
| |
PMC2828432_01_1757-1626-3-37-1.jpg
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PMC2828432_1757-1626-3-37-1_a_1_2.webp
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(a) Evidence of three contrast-enhancing lesions within the left cerebellar side on a CT central nervous system scan. (b) right kidney infarction.
|
Whole body computed tomography (CT) (Figure 1a) revealed two contrast-enhancing lesions within the left cerebellar and occipital cerebral regions, suggestive of septic emboli.
Multiple similar lesions were observed in the liver, spleen and kidneys (Figure 1b).
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F1
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PMC2828432_01
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PMC2828432
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file_0013883
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PMC2828432_01
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CC BY
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PMC2828432_01_1757-1626-3-37-2.jpg
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PMC2828432_1757-1626-3-37-2_undivided_1_1.webp
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Transthoracic echocardiogram showing a mitral vegetation of 15 x 13 mm on the anterior cusp.
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A mild mitral valve incompetence was also detected (Figure 2).
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F2
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PMC2828432_01
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PMC2828432
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file_0013885
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PMC2828432_01
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CC BY
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PMC2828432_01_1757-1626-3-37-3.jpg
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PMC2828432_1757-1626-3-37-3_undivided_1_1.webp
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Brain magnetic resonance imaging (MRI) revealing left side cerebellar abscesses.
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However, MRI of the brain revealed abscessualization of the cerebellar lesions (Figure 3).
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F3
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PMC2828432_01
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PMC2828432
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file_0013886
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PMC2828432_01
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CC BY
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PMC5491809_01_1349-7235-56-1157-g001.jpg
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PMC5491809_1349-7235-56-1157-g001_A_1_5.webp
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Colonoscopic images in the rectum (A), sigmoid colon (B), transverse colon (C), and descending colon (D, E) on admission. Colonoscopy revealed the exacerbation of ulcerative colitis in the rectum (A) and sigmoid colon (B). Although there were no active findings from the cecum to the transverse colon (C), we found long luminal edematous swelling and multifocal massive discharge of pus throughout the descending colon (D, E). The mucosa of the descending colon appeared to be nearly intact.
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Colonoscopy on admission revealed widespread shallow ulcers in the rectum and coarse mucosa with mucous, pus, and blood in the sigmoid colon (Fig. 1A and B).
Although there were no active UC findings from the cecum (terminal ileum) to the splenic flexure (Fig. 1C), we found long luminal edematous swelling and multifocal discharge of pus throughout the descending colon (Fig. 1D and E).
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g001
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PMC5491809_01
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PMC5491809
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file_0069703
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PMC5491809_01
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CC BY-NC-ND
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PMC5491809_01_1349-7235-56-1157-g002.jpg
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PMC5491809_1349-7235-56-1157-g002_A_1_2.webp
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A computed tomography scan immediately after the colonoscopy (A, B). The scan showed a diffusely thickened wall with a narrowed lumen and intramural air-filled abscess cavities and multifocal low-density areas of abscesses within the wall of the descending colon. The arrows and arrowheads indicate the lumen of the descending colon and air-filled abscess cavities, respectively.
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Computed tomography immediately after colonoscopy showed a diffusely thickened wall with a narrowed lumen and intramural air-filled abscess cavities and multifocal low-density areas of abscesses (Fig. 2), particularly within the wall of the descending colon.
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g002
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PMC5491809_01
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PMC5491809
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file_0069708
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PMC5491809_01
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CC BY-NC-ND
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PMC5491809_01_1349-7235-56-1157-g003.jpg
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PMC5491809_1349-7235-56-1157-g003_A_1_3.webp
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Colonoscopic images in the sigmoid colon (A) and descending colon (B) and a computed tomography scan (C) after improvement. Colonoscopy revealed mucosal healing in the sigmoid colon (A), and the blood vessels became visible. Although the descending colon was in the process of healing (B), we detected the improvement of the mucosal edema, discharge of pus, and the degree of stenosis. Although a computed tomography scan still showed a thickened wall with a narrowed lumen, the intramural air-filled abscess cavities within the wall of the descending colon had diminished.
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Oral intake was restarted with an elemental diet, and she was later discharged home after confirmation of the improvement of her condition via colonoscopy (Fig. 3A and B) and computed tomography (Fig. 3C).
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g003
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PMC5491809_01
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PMC5491809
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file_0069710
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PMC5491809_01
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CC BY-NC-ND
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PMC8329603_03_f1000research-8-59209-g0000.jpg
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PMC8329603_f1000research-8-59209-g0000_undivided_1_1.webp
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At the level of the medial tibial segment, bone exostosis can be observed on the deep planars, ~4 cm of diameter.
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At the level of the medial tibial segment a bone exostosis is found on the deep planars, ~4 cm of diameter ( Figure 1, Figure 2).
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f1
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PMC8329603_03
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PMC8329603
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file_0122074
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PMC8329603_03
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CC BY
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PMC8329603_03_f1000research-8-59209-g0001.jpg
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PMC8329603_f1000research-8-59209-g0001_undivided_1_1.webp
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Amputation of the distal phalanges of the first, second, third and fourth fingers, repeated due to recurrence.
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At the level of the medial tibial segment a bone exostosis is found on the deep planars, ~4 cm of diameter ( Figure 1, Figure 2).
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f2
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PMC8329603_03
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PMC8329603
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file_0122075
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PMC8329603_03
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CC BY
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PMC8329603_03_f1000research-8-59209-g0002.jpg
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PMC8329603_f1000research-8-59209-g0002_undivided_1_1.webp
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Malformations of the left lower limbs, (hip, knee and ankle), evident at the joint and periarticular level, where diffused exostoses are present.
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Both the ankle and the foot appeared to be twice the size of the contralateral limb for bone hyperplasia and connective tissue ( Figure 3, Figure 4).
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f3
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PMC8329603_03
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PMC8329603
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file_0122076
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PMC8329603_03
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CC BY
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PMC8329603_03_f1000research-8-59209-g0003.jpg
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PMC8329603_f1000research-8-59209-g0003_undivided_1_1.webp
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Complete ankylosis of the plantar flexion of 32 degrees.
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Both the ankle and the foot appeared to be twice the size of the contralateral limb for bone hyperplasia and connective tissue ( Figure 3, Figure 4).
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f4
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PMC8329603_03
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PMC8329603
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file_0122077
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PMC8329603_03
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CC BY
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PMC6450236_01_JCE-29-35-g001.jpg
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PMC6450236_JCE-29-35-g001_undivided_1_1.webp
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Parasternal long-axis view, M-Mode: left ventricle has normal diameters and normal thickness; interventricular septum has paradoxical movement; right ventricle is dilated
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Transthoracic echocardiography showed normal left ventricular chamber size and wall thicknesses (end-diastolic diameter 48 mm, interventricular septum 10 mm, and posterior wall 9 mm) [Figure 1] and normal systolic function (Simpson rule ejection fraction 60%); right ventricle was dilated (basal diameter 46 mm) [Video 1] with preserved longitudinal systolic function (TAPSE 24 mm, S': 12 cm/s).
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F1
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PMC6450236_01
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PMC6450236
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file_0091553
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PMC6450236_01
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CC BY-NC-SA
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PMC6450236_01_JCE-29-35-g002.jpg
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PMC6450236_JCE-29-35-g002_undivided_1_1.webp
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Apical four-chamber view, Color-Doppler: atrial septum has a width shunt; interventricular septum seems to have a close shunt
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Color-Doppler showed a significant left-to-right shunt both at interatrial and interventricular septum [Figure 2], and moderate mitral valve regurgitation was present probably due to a cleft in the anterior leaflet [Figure 3].
It demonstrated: A 25 mm ostium primum defect with hemodynamically significant left-to-right shunting, a "cleft" in the anterior leaflet leading to moderate regurgitation of AV valve, a restrictive small ventricular septal defect [Figures 4,5 and Videos 2,3].
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F2
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PMC6450236_01
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PMC6450236
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file_0091554
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PMC6450236_01
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CC BY-NC-SA
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PMC6450236_01_JCE-29-35-g003.jpg
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PMC6450236_JCE-29-35-g003_undivided_1_1.webp
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Parasternal short-axis mitral valve level: it shows a "cleft" of anterior leaflet (arrow)
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Color-Doppler showed a significant left-to-right shunt both at interatrial and interventricular septum [Figure 2], and moderate mitral valve regurgitation was present probably due to a cleft in the anterior leaflet [Figure 3].
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F3
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PMC6450236_01
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PMC6450236
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file_0091555
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PMC6450236_01
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CC BY-NC-SA
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PMC6450236_01_JCE-29-35-g004.jpg
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PMC6450236_JCE-29-35-g004_undivided_1_1.webp
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Transesophageal echocardiography four-chamber view, color-Doppler: ostium primum atrial septum defect (25 mm) with significant left-to-right shunt; high-velocity flow is evident at left atrioventricular leaflet level
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It demonstrated: A 25 mm ostium primum defect with hemodynamically significant left-to-right shunting, a "cleft" in the anterior leaflet leading to moderate regurgitation of AV valve, a restrictive small ventricular septal defect [Figures 4,5 and Videos 2,3].
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F4
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PMC6450236_01
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PMC6450236
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file_0091556
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PMC6450236_01
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CC BY-NC-SA
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PMC4866062_01_SNI-7-53-g001.jpg
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PMC4866062_SNI-7-53-g001_a_1_2.webp
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Computed tomography scans at presentation to a local physician (a) and on referral to our institution (b). (a) A heterogeneously enhanced mass was detected in the nasal cavity (arrow). (b) Computed tomography scan without contrast demonstrated rapid progression of the tumor. The tumor invaded into the left orbit (arrow)
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Computed tomography (CT) scan demonstrated a heterogeneously enhanced mass lesion centered in the left nasal cavity [Figure 1a].
CT scan, performed 3 months after the first scan, demonstrated that the enlarged mass lesion breaking through the medial wall of the left orbit and pushed the eye laterally [Figure 1b].
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F1
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PMC4866062_01
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PMC4866062
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file_0053619
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PMC4866062_01
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CC BY-NC-SA
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PMC4866062_01_SNI-7-53-g002.jpg
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PMC4866062_SNI-7-53-g002_a_1_2.webp
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Histological examination of the tumor cells. (a) Neoplastic cells occasionally arranging vascular channels. Mitotic figures are observed (arrowheads). (b) Positive immunohistochemical reaction of the tumor cells for CD31 was observed. Scale bars = 100 mum
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No mitosis and necrosis were observed [Figure 2a].
Immunohistochemical analysis was positive for factor VIII-related antigen, vimentin, CD34, and CD31 [Figure 2b].
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F2
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PMC4866062_01
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PMC4866062
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file_0053621
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PMC4866062_01
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CC BY-NC-SA
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PMC4866062_01_SNI-7-53-g003.jpg
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PMC4866062_SNI-7-53-g003_undivided_1_1.webp
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T1-weighted coronal magnetic resonance image with gadolinium enhancement before radical resection of the tumor. Note the tumor originating from the nasal cavity invading the anterior skull base (arrow)
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Magnetic resonance images indicated that the tumor had invaded the anterior skull base dura matter [Figure 3].
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F3
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PMC4866062_01
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PMC4866062
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file_0053623
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PMC4866062_01
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CC BY-NC-SA
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PMC3716026_01_JCHIMP-3-21419-g001.jpg
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PMC3716026_JCHIMP-3-21419-g001_a_1_2.webp
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A lateral skull radiograph (a) shows numerous lytic lesions classic for myeloma. More subtle, at the craniocervical junction (b), there is a destructive lesion of C2 resulting in compression (open arrow), abnormal flexion (small arrow), and translation, and potential instability.
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The axial skeleton, the spine, skull, pelvis, and ribs are more often affected than the limbs (Figs. 1-3).
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F0001
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PMC3716026_01
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PMC3716026
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file_0026618
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PMC3716026_01
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CC BY
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PMC3716026_01_JCHIMP-3-21419-g002.jpg
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PMC3716026_JCHIMP-3-21419-g002_undivided_1_1.webp
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A lateral thoracic spine radiograph shows multiple severe vertebral body compression fractures (small arrows), vertebra plana, also characteristic of multiple myeloma. At T11 and T12 (open arrows), mild vertebral sclerosis is a result of treatment and healing.
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The axial skeleton, the spine, skull, pelvis, and ribs are more often affected than the limbs (Figs. 1-3).
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F0002
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PMC3716026_01
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PMC3716026
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file_0026620
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PMC3716026_01
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CC BY
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PMC3716026_01_JCHIMP-3-21419-g003.jpg
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PMC3716026_JCHIMP-3-21419-g003_undivided_1_1.webp
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A frontal view of the shoulder shows a chronic pathological fracture of the surgical neck of the humerus (small arrow) across a large lytic lesion with a 'moth-eaten' appearance down the humeral shaft, and involving the clavicle and ribs. Note the missing 5th rib, destroyed by a plasmacytoma (open arrows).
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The axial skeleton, the spine, skull, pelvis, and ribs are more often affected than the limbs (Figs. 1-3).
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F0003
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PMC3716026_01
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PMC3716026
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file_0026621
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PMC3716026_01
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CC BY
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PMC2718207_01_kjr-1-226-g001.jpg
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PMC2718207_kjr-1-226-g001_A_1_4.webp
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Radiological and pathological findings of immature gastric teratoma in a 3-month-old boy.. A. Longitudinal US of the abdomen shows a 20 x 13 x 9 cm-sized mixed-echoic mass in the left upper abdomen, with multifocal cystic components (arrows).. B. Unenhanced abdominal CT at the level of the kidneys shows a well-defined heterogeneous mass displacing the left kidney posteriorly and the bowel loops medially (arrows). Note the presence of multiple nodular calcifications in the mass (arrowheads).. C. Enhanced abdominal CT at the level of the stomach shows a large exogastric, solid, cystic mass arising from the greater curvature of the stomach, and continuous with a protruding intraluminal polypoid mass (arrows). Note the well-enhanced gastric wall (arrowheads) and the presence of air bubbles in the gastric lumen (small slender arrow).. D. Gross specimen of the round exogastric mass, 14 x 9 x 6.5 cm in size, which originated from the posteroinferior wall of the stomach along its greater curvature (arrows). Cut section of the tumor shows some cystic areas filled with serous and mucous material, and keratin, and the presence of hemorrhagic foci.
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US revealed a large, mixed-echoic, solid and cystic mass in this same area (Fig. 1A), while unenhanced abdominal CT scans depicted a well-defined heterogeneous mass with intratumoral nodular calcifications (Fig. 1B) and a suspicious focal area of fat density.
These scans also indicated that the solid portion of the mass was well enhanced (Fig. 1C).
The gross specimen of the round exogastric mass thus obtained measured 14 x 9 x 6.5 cm and originated from the posteroinferior wall of the stomach along its greater curvature (Fig. 1D).
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F1
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PMC2718207_01
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PMC2718207
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file_0012745
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PMC2718207_01
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CC BY-NC
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PMC8164024_01_gr1.jpg
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PMC8164024_gr1_undivided_1_1.webp
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Non contrast axial CT initial scan in the emergency room demonstrated no significant intracranial pathology. However the soft tissue windows demonstrated loss of fat planes in the right parapharyngeal space (blue arrow) and masticator space (red arrow). (For interpretation of the references to colour in this Figure legend, the reader is referred to the web version of this article).
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Radiological assessment with CT head (Fig. 1) demonstrated thickening of the external auditory canal and middle ear with an ill-defined soft tissue mass pacifying the right mastoid air cells cavity.
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fig0005
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PMC8164024_01
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PMC8164024
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file_0118216
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PMC8164024_01
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CC BY
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PMC8164024_01_gr2.jpg
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PMC8164024_gr2_undivided_1_1.webp
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Axial STIR MRI sequence demonstrates hyperintensity (oedema) in multiple neck spaces including masticator space adjacent to the lateral pterygoid muscle (blue arrow). There is mucosal congestion within the nasopharynx (red arrow) with high signal noted posteriorly in the longus capitis muscle (green arrow) suggestive of extension through the retropharyngeal space. Note fluid secretions within the right mastoid air cells (yellow arrow). (For interpretation of the references to colour in this Figure legend, the reader is referred to the web version of this article).
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Subsequent MRI (Fig. 2 and Fig. 3) showed an extensive diffuse multi-compartmental enhancement with bone involvement suggestive of osteomyelitis.
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fig0010
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PMC8164024_01
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PMC8164024
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file_0118217
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PMC8164024_01
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CC BY
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PMC8164024_01_gr4.jpg
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PMC8164024_gr4_undivided_1_1.webp
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Axial FDG PET-CT demonstrates mild increased avidity in the right deep neck spaces including carotid and masticator spaces (arrow). The "low grade" nature of the tracer uptake suggests infective cause rather than malignant.
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In the view of disease progression while on treatment, PET -CT (Fig. 4) was arranged to rule out potential underlying neoplasms; but was furthermore supportive of an underlying infectious process.
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fig0020
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PMC8164024_01
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PMC8164024
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file_0118218
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PMC8164024_01
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CC BY
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PMC10421585_01_jvb-22-e20230030-g01-en.jpg
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PMC10421585_jvb-22-e20230030-g01-en_undivided_1_1.webp
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Sagittal reconstruction angiotomography of the abdominal aorta and its branches. The arrow indicates preoperative stenosis of the proximal portion of the celiac trunk and the post-stenotic dilatation.
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After the tomographic findings from the previous admission, the patient was scheduled for abdominal angiotomography the following month, which found stenosis of the celiac trunk (50%) (Figure 1).
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gf0100
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PMC10421585_01
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PMC10421585
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file_0009873
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PMC10421585_01
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CC BY
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PMC10421585_01_jvb-22-e20230030-g03-en.jpg
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PMC10421585_jvb-22-e20230030-g03-en_undivided_1_1.webp
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Sagittal reconstruction angiotomography of the abdominal aorta and its branches. The arrow indicates the improved celiac trunk stenosis after surgical intervention.
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The patient remained asymptomatic during the postoperative period and underwent a control angiotomography (Figure 3) 2 months after surgery, which showed improved celiac trunk stenosis at 60-70%, in addition to critical stenosis of almost 100% of the proximal segment of the splenic artery, with distal flow fed via collateral circulation originating from the gastroduodenal artery.
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gf0300
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PMC10421585_01
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PMC10421585
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file_0009874
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PMC10421585_01
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CC BY
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PMC4897088_01_gr1a.jpg
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PMC4897088_gr1a_undivided_1_1.webp
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41-year-old woman with chronic pulmonary embolism. Axial CT image of the chest demonstrating a mass extending outside the vessel wall with a large filling defect involving the left main pulmonary artery and extending into all sub-branches.
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Nonetheless, a CT scan of the chest using a protocol to evaluate for a pulmonary embolism was performed which was remarkable for a large filling defect involving the left main pulmonary artery and extending into all sub-branches, most pronounced in the left lower lobe (Figure 1A, Figure 1B, Figure 1C).
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fig1a
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PMC4897088_01
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PMC4897088
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file_0054529
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PMC4897088_01
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CC BY-NC-ND
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PMC8710692_01_fped-09-801719-g0002.jpg
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PMC8710692_fped-09-801719-g0002_undivided_1_1.webp
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Brain MRI performed 45 days after the first attack. Results showed almost complete regression of the WM abnormalities (compared with Figure 1).
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Brain MRI was performed 45 days later, and the WM abnormalities were almost completely subsided (Figures 2A-I).
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F2
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PMC8710692_01
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PMC8710692
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file_0128855
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PMC8710692_01
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CC BY
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PMC4000300_01_cru-0004-0042-g01.jpg
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PMC4000300_cru-0004-0042-g01_undivided_1_1.webp
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Diffusion-weighted magnetic resonance imaging of the brain on admission. Note the high-intensity areas suggesting acute phase of brain infarction in the left basal ganglia, left corona radiata, and left cerebral cortex (arrows).
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Diffusion-weighted magnetic resonance imaging showed high-intensity areas consistent with acute infarction in the left basal ganglia, left corona radiata, and left cerebral cortex (fig. 1).
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F1
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PMC4000300_01
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PMC4000300
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file_0033306
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PMC4000300_01
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CC BY-NC
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Subsets and Splits
Thyroid Cases and Ultrasounds
Retrieves a limited set of records related to thyroid or thyroid ultrasound, providing basic filtering but minimal analytical insight.