openmed-community/multicare-case-images

image_id stringlengths 21 64	file stringlengths 25 76	caption stringlengths 0 3.23k	text_references stringlengths 0 2.44k	tag stringlengths 2 39	case_id stringlengths 11 14	article_id stringlengths 8 11	file_id stringlengths 12 12	patient_id stringlengths 11 14	license stringclasses 9 values
PMC11324202_01_cro-2024-0017-0001-539776_F03.jpg	PMC11324202_cro-2024-0017-0001-539776_F03_a_1_2.webp	a October 2022 PET/CT scan showing FDG activity of the distal body lesion. b Repeat PET/CT June 2023 PET/CT scan showing activity of the pancreatic body lesion. The interim PET/CT scan showed no change.	An initial PET scan performed in October 2022 demonstrated intense FDG activity in the distal body of the pancreas (Fig. 3a). PET showed normal uptake throughout the pancreas without evidence of metastatic disease in the chest, abdomen, or pelvis (Fig. 3b).	F3	PMC11324202_01	PMC11324202	file_0160211	PMC11324202_01	CC BY-NC
PMC10552855_01_fped-11-1247343-g001.jpg	PMC10552855_fped-11-1247343-g001_undivided_1_1.webp	Purpuric lesions over the face.	After chest drain and aspiration of chylous fluid, at 12 h of age, the neonate acutely developed well-demarcated erythematous macules that progressed rapidly to develop irregular central areas of blue-black purpuric lesions over the face, abdomen, and arms (Figures 1, 2).	F1	PMC10552855_01	PMC10552855	file_0136976	PMC10552855_01	CC BY
PMC10552855_01_fped-11-1247343-g002.jpg	PMC10552855_fped-11-1247343-g002_undivided_1_1.webp	Purpuric lesions over the abdomen and the arm.	After chest drain and aspiration of chylous fluid, at 12 h of age, the neonate acutely developed well-demarcated erythematous macules that progressed rapidly to develop irregular central areas of blue-black purpuric lesions over the face, abdomen, and arms (Figures 1, 2).	F2	PMC10552855_01	PMC10552855	file_0136977	PMC10552855_01	CC BY
PMC11177082_04_gr1.jpg	PMC11177082_gr1_A_1_10.webp	Case 4. (A) Preoperative. (B) Longitudinal and elliptical incisions. (C-E) Dissection of the aneurysmal vein from the vessel bed. (F) After removal of thrombi and fibrotic tissue from the vein. (G) After removal of the redundant vessel wall. (H) Aneurysmorrhaphy with calibration to a 28 Fr chest tube. (I) After removal of clamps and establishment of haemostasis. (J) Simple interrupted suture of the skin (patient's tattoos have been slightly blurred in images to protect their privacy).	After removal of the thrombi and the previously placed stent entrapped in atheromatous plaques, the venous wall was recalibrated and the reconstructed vein was shortened to lie appropriately in the vessel bed (Fig. 1).	fig1	PMC11177082_01	PMC11177082	file_0156469	PMC11177082_04	CC BY
PMC11177082_05_gr2.jpg	PMC11177082_gr2_A_1_5.webp	Case 5. (A) Preoperative. (B) Dissection of the aneurysmal vein. (C) Aneurysmorrhaphy with calibration to a 28 Fr chest tube. (D) Simple interrupted suture of the skin. (E) Two weeks post-operative.	AVF placement five years ago, and presented to the clinic with a severely tortuous aneurysm of the cephalic vein, which had resulted in multiple bleedings from wounds on the stretched skin. After aneurysmorrhaphy of the cephalic vein, part of the vessel was resected and re-anastomosed to achieve a desirable venous length (Fig. 2).	fig2	PMC11177082_02	PMC11177082	file_0156479	PMC11177082_05	CC BY
PMC11177082_04_gr1.jpg	PMC11177082_gr1_A_1_10.webp	Case 4. (A) Preoperative. (B) Longitudinal and elliptical incisions. (C-E) Dissection of the aneurysmal vein from the vessel bed. (F) After removal of thrombi and fibrotic tissue from the vein. (G) After removal of the redundant vessel wall. (H) Aneurysmorrhaphy with calibration to a 28 Fr chest tube. (I) After removal of clamps and establishment of haemostasis. (J) Simple interrupted suture of the skin (patient's tattoos have been slightly blurred in images to protect their privacy).	After removal of the thrombi and the previously placed stent entrapped in atheromatous plaques, the venous wall was recalibrated and the reconstructed vein was shortened to lie appropriately in the vessel bed (Fig. 1).	fig1	PMC11177082_04	PMC11177082	file_0156469	PMC11177082_04	CC BY
PMC11177082_05_gr2.jpg	PMC11177082_gr2_A_1_5.webp	Case 5. (A) Preoperative. (B) Dissection of the aneurysmal vein. (C) Aneurysmorrhaphy with calibration to a 28 Fr chest tube. (D) Simple interrupted suture of the skin. (E) Two weeks post-operative.	AVF placement five years ago, and presented to the clinic with a severely tortuous aneurysm of the cephalic vein, which had resulted in multiple bleedings from wounds on the stretched skin. After aneurysmorrhaphy of the cephalic vein, part of the vessel was resected and re-anastomosed to achieve a desirable venous length (Fig. 2).	fig2	PMC11177082_05	PMC11177082	file_0156479	PMC11177082_05	CC BY
PMC10803410_01_fcvm-10-1329952-g005.jpg	PMC10803410_fcvm-10-1329952-g005_E_1_1.webp	Timeline of the diagnostics, therapeutic interventions, and disease status of the present case. CEZ, cephazolin; CMR, cardiac magnetic resonance; CT, computed tomography; CXR, chest radiograph; COVID-19, coronavirus disease; Dx, diagnosis; ECG, electrocardiogram; FDG/PET, glucose analog 2-[18F]-fluoro-2-deoxy-d-glucose positron emission tomography; iv, intravenous; JVD, jugular vein distention; MMSE, methicillin-sensitive Staphylococcus aureus; MRI, magnetic resonance imaging; NPS, nasopharyngeal swab; P/E, physical examination; PF, pericardial fluid; RT-PCR, reverse-transcriptase polymerase chain reaction; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2; SBT/ABPC, ampicillin-sulbactam; TTE, transthoracic echocardiography; VATS-biopsy, video-assisted thoracoscopic biopsy.	We present a summarized illustration of the case presentation in Figure 5.	F5	PMC10803410_01	PMC10803410	file_0144917	PMC10803410_01	CC BY
PMC11217479_01_fonc-14-1396869-g001.jpg	PMC11217479_fonc-14-1396869-g001_A_1_6.webp	The patient's CT scans at baseline, at best response, and at the last evaluation. (A-C) Evolution of a left supraventricular node. (D-F) Retroperitoneal node. The images in (A) and (D) were taken before starting immunotherapy treatment, while the images in (B) and (E) are those at the best response (this patient experienced a partial response with a -76% reduction in the target lesions). The images in (C) and (F) are the last scans of the patient in January 2024, when the decision to stop the treatment was made after 34 months. The red lines denote measurable disease.	Based on the MSI-H result, the patient was enrolled in a basket clinical trial, in which he underwent treatment for 34 months with second-line atezolizumab with partial response (-76%) and complete metabolic response with excellent treatment tolerance ( Figure 1 ).	f1	PMC11217479_01	PMC11217479	file_0157231	PMC11217479_01	CC BY
PMC10944301_01_IMCRJ-17-157-g0001.jpg	PMC10944301_IMCRJ-17-157-g0001_undivided_1_1.webp	Shows inferonasal iris coloboma in the right eye of the patient.	The pupil in the right eye was pear-shaped with a notch at the inferonasal location (Figure 1).	f0001	PMC10944301_01	PMC10944301	file_0151159	PMC10944301_01	CC BY-NC
PMC10944301_01_IMCRJ-17-157-g0002.jpg	PMC10944301_IMCRJ-17-157-g0002_undivided_1_1.webp	Shows lateral temporal iris coloboma in the left eye of the patient.	The pupil in the left eye was pear-shaped with a notch toward the left canthus (Figure 2).	f0002	PMC10944301_01	PMC10944301	file_0151160	PMC10944301_01	CC BY-NC
PMC10851815_01_cureus-0016-00000051933-i01.jpg	PMC10851815_cureus-0016-00000051933-i01_undivided_1_1.webp	Preoperative extraoral portrait view	A male patient, age 75, arrived at the prosthodontics department with chief complaints of worn-down teeth, difficulty chewing, and aesthetic concerns (Figure 1).	FIG1	PMC10851815_01	PMC10851815	file_0147008	PMC10851815_01	CC BY
PMC10851815_02_cureus-0016-00000051933-i02.jpg	PMC10851815_cureus-0016-00000051933-i02_undivided_1_1.webp	Preoperative photograph showing generalized attrition and restored cervical attrition	The patient had a reduced VDO and generalized attrition affecting all of the teeth, according to a clinical examination, along with generalized cervical abrasion, which was restored by composite resin (Figure 2).	FIG2	PMC10851815_02	PMC10851815	file_0147009	PMC10851815_02	CC BY
PMC10851815_02_cureus-0016-00000051933-i03.jpg	PMC10851815_cureus-0016-00000051933-i03_undivided_1_1.webp	Panoramic radiograph showing the requirement of root canal treatment	A radiograph examination revealed the requirement of root canal treatment for 12, 13, 15, 22, 24, 25, 31, 32, 33, 34, 35, 41, 42, 43, and 46 (Figure 3).	FIG3	PMC10851815_02	PMC10851815	file_0147010	PMC10851815_02	CC BY
PMC10851815_02_cureus-0016-00000051933-i04.jpg	PMC10851815_cureus-0016-00000051933-i04_undivided_1_1.webp	Facebow record	The Hanau spring bow recorded the orientation jaw relation, and Dawson's technique captured the centric relation (CR) (Figure 4).	FIG4	PMC10851815_02	PMC10851815	file_0147011	PMC10851815_02	CC BY
PMC10851815_03_cureus-0016-00000051933-i05.jpg	PMC10851815_cureus-0016-00000051933-i05_undivided_1_1.webp	Provisional crowns in situ	Temporary luting cement, Prime, Maharashtra, India) the provisional fixed restorations were scrutinized for aesthetics and phonetics (Figure 5). The adaptation of these provisional restorations was assessed over four weeks.	FIG5	PMC10851815_03	PMC10851815	file_0147012	PMC10851815_03	CC BY
PMC10851815_03_cureus-0016-00000051933-i06.jpg	PMC10851815_cureus-0016-00000051933-i06_A_1_2.webp	Master impression: (A) Maxillary Arch and (B) mandibular arch	Following this period, an impression of the entire arch was obtained using elastomeric impression material (GC Flexceed; GC India, Telangana, India) (Figure 6A, 6B).	FIG6	PMC10851815_03	PMC10851815	file_0147013	PMC10851815_03	CC BY
PMC10851815_03_cureus-0016-00000051933-i07.jpg	PMC10851815_cureus-0016-00000051933-i07_A_1_3.webp	Vertical and centric record transfer: (A) Left side, (B) right side, and (C) front side	The right and anterior segments underwent a similar process (Figures 7A-7C).	FIG7	PMC10851815_03	PMC10851815	file_0147015	PMC10851815_03	CC BY
PMC10851815_03_cureus-0016-00000051933-i08.jpg	PMC10851815_cureus-0016-00000051933-i08_undivided_1_1.webp	Metal copings try in	Subsequent to making wax patterns, metal copings were fabricated and evaluated in the patient's mouth to ensure a proper fit, which was subsequently confirmed by the working cast (Figure 8).	FIG8	PMC10851815_03	PMC10851815	file_0147018	PMC10851815_03	CC BY
PMC10851815_03_cureus-0016-00000051933-i09.jpg	PMC10851815_cureus-0016-00000051933-i09_undivided_1_1.webp	Final prostheses in situ	Finally, the PFM crowns were cemented, and subsequent occlusal adjustments were performed to ensure adequate contact and functionality (Figure 9).	FIG9	PMC10851815_03	PMC10851815	file_0147019	PMC10851815_03	CC BY
PMC10851815_04_cureus-0016-00000051933-i10.jpg	PMC10851815_cureus-0016-00000051933-i10_undivided_1_1.webp	Smile of satisfaction	The patient expressed satisfaction with the outcome, noting fulfilment in both the aesthetics and function of the teeth, which, in turn, restored his confidence and dignity (Figure 10).	FIG10	PMC10851815_04	PMC10851815	file_0147020	PMC10851815_04	CC BY
PMC11102740_01_IMCRJ-17-455-g0001.jpg	PMC11102740_IMCRJ-17-455-g0001_undivided_1_1.webp	A graph depicting motor power of extremities in relation to serum magnesium level.	Furthermore, bilateral deep tendon reflexes (knee, ankle, biceps, and triceps) were absent, plantar reflexes were up going, and the muscle strength was 3/5 in both lower extremities and 4+/5 in both upper extremities (Figure 1).	f0001	PMC11102740_01	PMC11102740	file_0155010	PMC11102740_01	CC BY-NC
PMC11102740_01_IMCRJ-17-455-g0002.jpg	PMC11102740_IMCRJ-17-455-g0002_undivided_1_1.webp	A graph depicting the serum magnesium level over the post-partum days.	Subsequently, the serum magnesium level was determined, and the patient was found to have severe hypermagnesemia, with a peak serum magnesium level of 6.4 mg/dl (normal laboratory level of serum magnesium: 1.7-2.2mg/dL) (Figure 2).	f0002	PMC11102740_01	PMC11102740	file_0155011	PMC11102740_01	CC BY-NC
PMC10473406_01_JIR-16-3715-g0001.jpg	PMC10473406_JIR-16-3715-g0001_A_1_8.webp	Total colonoscopy images. (A-D) First procedure performed on January 9, 2022, showing mucosal redness, edema, granular change, and multiple small mucosal ulceration. (E-H) Second procedure performed on January 28, 2022, showing multiple deep oval ulcers (arrows).	Following comprehensive history-taking, physical examination, and blood tests, he underwent colonoscopy, which revealed mucosal erythema, edema, granular changes, and multiple small mucosal ulcerations, and he was diagnosed with UC (Figures 1A-D). Repeat colonoscopy performed to further evaluate intestinal mucosal inflammation revealed several round, large, and oval deep ulcers throughout the colon (Figures 1E-H).	f0001	PMC10473406_01	PMC10473406	file_0135221	PMC10473406_01	CC BY-NC
PMC10473406_01_JIR-16-3715-g0002.jpg	PMC10473406_JIR-16-3715-g0002_A_1_2.webp	Abdominal CT scan findings. Image showing diffuse thickening of the colonic wall of ascending and descending colon (A) and sigmoid colon (B) (arrows), likely secondary to inflammation.	Abdominal computed tomography (CT) revealed a thickened colonic wall with pericolonic exudates (Figure 2).	f0002	PMC10473406_01	PMC10473406	file_0135229	PMC10473406_01	CC BY-NC
PMC10789894_01_acr-08-23-92-f1.jpg	PMC10789894_acr-08-23-92-f1_A_1_3.webp	Chest X-ray, CT and MRI findings. (A) Nodular shadow in the left lower lung field detected on chest X-ray. Orange arrow indicates the area of abnormal chest shadow. (B) Anterior mediastinal tumor with poor contrast effect detected on CT (size: 6.0 cm x 3.1 cm x 1.9 cm). The tumor grew from 2.2 to 6.0 cm within 21 months. Orange arrow indicates anterior mediastinal tumor. (C) Anterior mediastinal tumor detected on T2-weighted MRI. Chest MRI revealed that the main component of the tumor was liquid. Orange arrow indicates anterior mediastinal tumor. CT, computed tomography; MRI, magnetic resonance imaging.	A 75-year-old woman presented to our hospital with an abnormal chest shadow, which was identified during a medical examination (Figure 1A). Chest computed tomography (CT) revealed an inflammatory nodule in the lingula and an anterior mediastinal mass with a poor contrast effect measuring 6.0 cm x 3.1 cm x 1.9 cm (Figure 1B), which grew from 2.2 to 6.0 cm over 21 months. Low and high signals were detected on T1- and T2-weighted thoracic magnetic resonance imaging, respectively (Figure 1C). By POD 9, partially improving the subglottic stenosis (Figure 3C), thereafter the subglottic stenosis was almost completely alleviated by POD 12 (Figure 3D) (Figure S1A,S1B) and gradual improvement continued (Figure S1C). Hydrocortisone was discontinued on POD 14, and the tracheal cannula was removed on POD 22 (Figure S1D,S1E). Trachea-cutaneous fistula closure was performed on POD 35, and she was discharged on POD 42, remaining well (Figure S1F-S1H).	f1	PMC10789894_01	PMC10789894	file_0143997	PMC10789894_01	CC BY-NC-ND
PMC10789894_01_acr-08-23-92-f2.jpg	PMC10789894_acr-08-23-92-f2_A_1_2.webp	Laryngoscopic findings. (A) On POD 1, laryngoscopy revealed submucosal hemorrhage around the vocal cords and mild subglottic stenosis. None of the findings prompted emergency treatment. (B) On POD 4, laryngoscopy revealed progressive subglottic stenosis. POD, postoperative day.	L/min oxygen flow rate. Laryngoscopy showed submucosal hemorrhage around the vocal cords and mild subglottic stenosis just below the glottis; however, there was no arytenoid dislocation or findings necessitating emergency treatment (Figure 2A). However, her stridor became more severe and laryngoscopy was re-performed and revealed subglottic stenosis progression prompting emergency tracheotomy (Figure 2B).	f2	PMC10789894_01	PMC10789894	file_0144000	PMC10789894_01	CC BY-NC-ND
PMC10789894_01_acr-08-23-92-f3.jpg	PMC10789894_acr-08-23-92-f3_A_1_4.webp	Laryngoscopic findings after tracheostomy. (A) On POD 5, laryngoscopy of the glottis through the tracheostomy orifice suggested progressive subglottic stenosis. (B) On POD 7, laryngoscopy of the glottis through the tracheostomy orifice revealed almost complete airway obstruction. (C) On POD 9, laryngoscopy of the glottis through the tracheostomy orifice indicated partial improvement in the subglottic stenosis. (D) On POD 12, laryngoscopy of the glottis through the tracheostomy orifice revealed almost complete resolution of the subglottic stenosis. POD, postoperative day.	On POD 5, subglottic stenosis progressed further (Figure 3A). By POD 7, observation of the glottis through the tracheostomy orifice revealed almost complete airway obstruction (Figure 3B). By POD 9, partially improving the subglottic stenosis (Figure 3C), thereafter the subglottic stenosis was almost completely alleviated by POD 12 (Figure 3D) (Figure S1A,S1B) and gradual improvement continued (Figure S1C).	f3	PMC10789894_01	PMC10789894	file_0144002	PMC10789894_01	CC BY-NC-ND
PMC10837815_01_ijspt_2024_19_2_91642_190905.jpg	PMC10837815_ijspt_2024_19_2_91642_190905_undivided_1_1.webp	Initial contact during the WSP, from a posterior view	Figures 1 and 2 show images of the subject's pitching mechanics during initial foot contact from posterior and lateral views, respectively.	attachment-190905	PMC10837815_01	PMC10837815	file_0146355	PMC10837815_01	CC BY-NC
PMC10795896_01_rjad306f2.jpg	PMC10795896_rjad306f2_A_1_2.webp	(A) Inset of right RFF-STSG over right groin defect. (B) Four months postoperative. Well-healed RFF-STSG over right groin.	After operative hematoma evacuation and debridement, microbiology culture sampling and wash out, the PRS team utilized a right pedicled RFF with STSG for coverage of the exposed graft (Fig. 2A). After a 6-week hospitalization including rehabilitation, the patient was discharged home and ultimately completed a 6-week course of intravenous antibiotics (Fig. 2B).	f2	PMC10795896_01	PMC10795896	file_0144335	PMC10795896_01	CC BY-NC

PMC11324202_01_cro-2024-0017-0001-539776_F03.jpg

PMC11324202_cro-2024-0017-0001-539776_F03_a_1_2.webp

a October 2022 PET/CT scan showing FDG activity of the distal body lesion. b Repeat PET/CT June 2023 PET/CT scan showing activity of the pancreatic body lesion. The interim PET/CT scan showed no change.

An initial PET scan performed in October 2022 demonstrated intense FDG activity in the distal body of the pancreas (Fig. 3a). PET showed normal uptake throughout the pancreas without evidence of metastatic disease in the chest, abdomen, or pelvis (Fig. 3b).

F3

PMC11324202_01

PMC11324202

file_0160211

PMC11324202_01

CC BY-NC

PMC10552855_01_fped-11-1247343-g001.jpg

PMC10552855_fped-11-1247343-g001_undivided_1_1.webp

Purpuric lesions over the face.

After chest drain and aspiration of chylous fluid, at 12 h of age, the neonate acutely developed well-demarcated erythematous macules that progressed rapidly to develop irregular central areas of blue-black purpuric lesions over the face, abdomen, and arms (Figures 1, 2).

F1

PMC10552855_01

PMC10552855

file_0136976

PMC10552855_01

CC BY

PMC10552855_01_fped-11-1247343-g002.jpg

PMC10552855_fped-11-1247343-g002_undivided_1_1.webp

Purpuric lesions over the abdomen and the arm.

After chest drain and aspiration of chylous fluid, at 12 h of age, the neonate acutely developed well-demarcated erythematous macules that progressed rapidly to develop irregular central areas of blue-black purpuric lesions over the face, abdomen, and arms (Figures 1, 2).

F2

PMC10552855_01

PMC10552855

file_0136977

PMC10552855_01

CC BY

PMC11177082_04_gr1.jpg

PMC11177082_gr1_A_1_10.webp

Case 4. (A) Preoperative. (B) Longitudinal and elliptical incisions. (C-E) Dissection of the aneurysmal vein from the vessel bed. (F) After removal of thrombi and fibrotic tissue from the vein. (G) After removal of the redundant vessel wall. (H) Aneurysmorrhaphy with calibration to a 28 Fr chest tube. (I) After removal of clamps and establishment of haemostasis. (J) Simple interrupted suture of the skin (patient's tattoos have been slightly blurred in images to protect their privacy).

After removal of the thrombi and the previously placed stent entrapped in atheromatous plaques, the venous wall was recalibrated and the reconstructed vein was shortened to lie appropriately in the vessel bed (Fig. 1).

fig1

PMC11177082_01

PMC11177082

file_0156469

PMC11177082_04

CC BY

PMC11177082_05_gr2.jpg

PMC11177082_gr2_A_1_5.webp

Case 5. (A) Preoperative. (B) Dissection of the aneurysmal vein. (C) Aneurysmorrhaphy with calibration to a 28 Fr chest tube. (D) Simple interrupted suture of the skin. (E) Two weeks post-operative.

AVF placement five years ago, and presented to the clinic with a severely tortuous aneurysm of the cephalic vein, which had resulted in multiple bleedings from wounds on the stretched skin. After aneurysmorrhaphy of the cephalic vein, part of the vessel was resected and re-anastomosed to achieve a desirable venous length (Fig. 2).

fig2

PMC11177082_02

PMC11177082

file_0156479

PMC11177082_05

CC BY

PMC11177082_04_gr1.jpg

PMC11177082_gr1_A_1_10.webp

Case 4. (A) Preoperative. (B) Longitudinal and elliptical incisions. (C-E) Dissection of the aneurysmal vein from the vessel bed. (F) After removal of thrombi and fibrotic tissue from the vein. (G) After removal of the redundant vessel wall. (H) Aneurysmorrhaphy with calibration to a 28 Fr chest tube. (I) After removal of clamps and establishment of haemostasis. (J) Simple interrupted suture of the skin (patient's tattoos have been slightly blurred in images to protect their privacy).

After removal of the thrombi and the previously placed stent entrapped in atheromatous plaques, the venous wall was recalibrated and the reconstructed vein was shortened to lie appropriately in the vessel bed (Fig. 1).

fig1

PMC11177082_04

PMC11177082

file_0156469

PMC11177082_04

CC BY

PMC11177082_05_gr2.jpg

PMC11177082_gr2_A_1_5.webp

Case 5. (A) Preoperative. (B) Dissection of the aneurysmal vein. (C) Aneurysmorrhaphy with calibration to a 28 Fr chest tube. (D) Simple interrupted suture of the skin. (E) Two weeks post-operative.

AVF placement five years ago, and presented to the clinic with a severely tortuous aneurysm of the cephalic vein, which had resulted in multiple bleedings from wounds on the stretched skin. After aneurysmorrhaphy of the cephalic vein, part of the vessel was resected and re-anastomosed to achieve a desirable venous length (Fig. 2).

fig2

PMC11177082_05

PMC11177082

file_0156479

PMC11177082_05

CC BY

PMC10803410_01_fcvm-10-1329952-g005.jpg

PMC10803410_fcvm-10-1329952-g005_E_1_1.webp

Timeline of the diagnostics, therapeutic interventions, and disease status of the present case. CEZ, cephazolin; CMR, cardiac magnetic resonance; CT, computed tomography; CXR, chest radiograph; COVID-19, coronavirus disease; Dx, diagnosis; ECG, electrocardiogram; FDG/PET, glucose analog 2-[18F]-fluoro-2-deoxy-d-glucose positron emission tomography; iv, intravenous; JVD, jugular vein distention; MMSE, methicillin-sensitive Staphylococcus aureus; MRI, magnetic resonance imaging; NPS, nasopharyngeal swab; P/E, physical examination; PF, pericardial fluid; RT-PCR, reverse-transcriptase polymerase chain reaction; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2; SBT/ABPC, ampicillin-sulbactam; TTE, transthoracic echocardiography; VATS-biopsy, video-assisted thoracoscopic biopsy.

We present a summarized illustration of the case presentation in Figure 5.

F5

PMC10803410_01

PMC10803410

file_0144917

PMC10803410_01

CC BY

PMC11217479_01_fonc-14-1396869-g001.jpg

PMC11217479_fonc-14-1396869-g001_A_1_6.webp

The patient's CT scans at baseline, at best response, and at the last evaluation. (A-C) Evolution of a left supraventricular node. (D-F) Retroperitoneal node. The images in (A) and (D) were taken before starting immunotherapy treatment, while the images in (B) and (E) are those at the best response (this patient experienced a partial response with a -76% reduction in the target lesions). The images in (C) and (F) are the last scans of the patient in January 2024, when the decision to stop the treatment was made after 34 months. The red lines denote measurable disease.

Based on the MSI-H result, the patient was enrolled in a basket clinical trial, in which he underwent treatment for 34 months with second-line atezolizumab with partial response (-76%) and complete metabolic response with excellent treatment tolerance ( Figure 1 ).

f1

PMC11217479_01

PMC11217479

file_0157231

PMC11217479_01

CC BY

PMC10944301_01_IMCRJ-17-157-g0001.jpg

PMC10944301_IMCRJ-17-157-g0001_undivided_1_1.webp

Shows inferonasal iris coloboma in the right eye of the patient.

The pupil in the right eye was pear-shaped with a notch at the inferonasal location (Figure 1).

f0001

PMC10944301_01

PMC10944301

file_0151159

PMC10944301_01

CC BY-NC

PMC10944301_01_IMCRJ-17-157-g0002.jpg

PMC10944301_IMCRJ-17-157-g0002_undivided_1_1.webp

Shows lateral temporal iris coloboma in the left eye of the patient.

The pupil in the left eye was pear-shaped with a notch toward the left canthus (Figure 2).

f0002

PMC10944301_01

PMC10944301

file_0151160

PMC10944301_01

CC BY-NC

PMC10851815_01_cureus-0016-00000051933-i01.jpg

PMC10851815_cureus-0016-00000051933-i01_undivided_1_1.webp

Preoperative extraoral portrait view

A male patient, age 75, arrived at the prosthodontics department with chief complaints of worn-down teeth, difficulty chewing, and aesthetic concerns (Figure 1).

FIG1

PMC10851815_01

PMC10851815

file_0147008

PMC10851815_01

CC BY

PMC10851815_02_cureus-0016-00000051933-i02.jpg

PMC10851815_cureus-0016-00000051933-i02_undivided_1_1.webp

Preoperative photograph showing generalized attrition and restored cervical attrition

The patient had a reduced VDO and generalized attrition affecting all of the teeth, according to a clinical examination, along with generalized cervical abrasion, which was restored by composite resin (Figure 2).

FIG2

PMC10851815_02

PMC10851815

file_0147009

PMC10851815_02

CC BY

PMC10851815_02_cureus-0016-00000051933-i03.jpg

PMC10851815_cureus-0016-00000051933-i03_undivided_1_1.webp

Panoramic radiograph showing the requirement of root canal treatment

A radiograph examination revealed the requirement of root canal treatment for 12, 13, 15, 22, 24, 25, 31, 32, 33, 34, 35, 41, 42, 43, and 46 (Figure 3).

FIG3

PMC10851815_02

PMC10851815

file_0147010

PMC10851815_02

CC BY

PMC10851815_02_cureus-0016-00000051933-i04.jpg

PMC10851815_cureus-0016-00000051933-i04_undivided_1_1.webp

Facebow record

The Hanau spring bow recorded the orientation jaw relation, and Dawson's technique captured the centric relation (CR) (Figure 4).

FIG4

PMC10851815_02

PMC10851815

file_0147011

PMC10851815_02

CC BY

PMC10851815_03_cureus-0016-00000051933-i05.jpg

PMC10851815_cureus-0016-00000051933-i05_undivided_1_1.webp

Provisional crowns in situ

Temporary luting cement, Prime, Maharashtra, India) the provisional fixed restorations were scrutinized for aesthetics and phonetics (Figure 5). The adaptation of these provisional restorations was assessed over four weeks.

FIG5

PMC10851815_03

PMC10851815

file_0147012

PMC10851815_03

CC BY

PMC10851815_03_cureus-0016-00000051933-i06.jpg

PMC10851815_cureus-0016-00000051933-i06_A_1_2.webp

Master impression: (A) Maxillary Arch and (B) mandibular arch

Following this period, an impression of the entire arch was obtained using elastomeric impression material (GC Flexceed; GC India, Telangana, India) (Figure 6A, 6B).

FIG6

PMC10851815_03

PMC10851815

file_0147013

PMC10851815_03

CC BY

PMC10851815_03_cureus-0016-00000051933-i07.jpg

PMC10851815_cureus-0016-00000051933-i07_A_1_3.webp

Vertical and centric record transfer: (A) Left side, (B) right side, and (C) front side

The right and anterior segments underwent a similar process (Figures 7A-7C).

FIG7

PMC10851815_03

PMC10851815

file_0147015

PMC10851815_03

CC BY

PMC10851815_03_cureus-0016-00000051933-i08.jpg

PMC10851815_cureus-0016-00000051933-i08_undivided_1_1.webp

Metal copings try in

Subsequent to making wax patterns, metal copings were fabricated and evaluated in the patient's mouth to ensure a proper fit, which was subsequently confirmed by the working cast (Figure 8).

FIG8

PMC10851815_03

PMC10851815

file_0147018

PMC10851815_03

CC BY

PMC10851815_03_cureus-0016-00000051933-i09.jpg

PMC10851815_cureus-0016-00000051933-i09_undivided_1_1.webp

Final prostheses in situ

Finally, the PFM crowns were cemented, and subsequent occlusal adjustments were performed to ensure adequate contact and functionality (Figure 9).

FIG9

PMC10851815_03

PMC10851815

file_0147019

PMC10851815_03

CC BY

PMC10851815_04_cureus-0016-00000051933-i10.jpg

PMC10851815_cureus-0016-00000051933-i10_undivided_1_1.webp

Smile of satisfaction

The patient expressed satisfaction with the outcome, noting fulfilment in both the aesthetics and function of the teeth, which, in turn, restored his confidence and dignity (Figure 10).

FIG10

PMC10851815_04

PMC10851815

file_0147020

PMC10851815_04

CC BY

PMC11102740_01_IMCRJ-17-455-g0001.jpg

PMC11102740_IMCRJ-17-455-g0001_undivided_1_1.webp

A graph depicting motor power of extremities in relation to serum magnesium level.

Furthermore, bilateral deep tendon reflexes (knee, ankle, biceps, and triceps) were absent, plantar reflexes were up going, and the muscle strength was 3/5 in both lower extremities and 4+/5 in both upper extremities (Figure 1).

f0001

PMC11102740_01

PMC11102740

file_0155010

PMC11102740_01

CC BY-NC

PMC11102740_01_IMCRJ-17-455-g0002.jpg

PMC11102740_IMCRJ-17-455-g0002_undivided_1_1.webp

A graph depicting the serum magnesium level over the post-partum days.

Subsequently, the serum magnesium level was determined, and the patient was found to have severe hypermagnesemia, with a peak serum magnesium level of 6.4 mg/dl (normal laboratory level of serum magnesium: 1.7-2.2mg/dL) (Figure 2).

f0002

PMC11102740_01

PMC11102740

file_0155011

PMC11102740_01

CC BY-NC

PMC10473406_01_JIR-16-3715-g0001.jpg

PMC10473406_JIR-16-3715-g0001_A_1_8.webp

Total colonoscopy images. (A-D) First procedure performed on January 9, 2022, showing mucosal redness, edema, granular change, and multiple small mucosal ulceration. (E-H) Second procedure performed on January 28, 2022, showing multiple deep oval ulcers (arrows).

Following comprehensive history-taking, physical examination, and blood tests, he underwent colonoscopy, which revealed mucosal erythema, edema, granular changes, and multiple small mucosal ulcerations, and he was diagnosed with UC (Figures 1A-D). Repeat colonoscopy performed to further evaluate intestinal mucosal inflammation revealed several round, large, and oval deep ulcers throughout the colon (Figures 1E-H).

f0001

PMC10473406_01

PMC10473406

file_0135221

PMC10473406_01

CC BY-NC

PMC10473406_01_JIR-16-3715-g0002.jpg

PMC10473406_JIR-16-3715-g0002_A_1_2.webp

Abdominal CT scan findings. Image showing diffuse thickening of the colonic wall of ascending and descending colon (A) and sigmoid colon (B) (arrows), likely secondary to inflammation.

Abdominal computed tomography (CT) revealed a thickened colonic wall with pericolonic exudates (Figure 2).

f0002

PMC10473406_01

PMC10473406

file_0135229

PMC10473406_01

CC BY-NC

PMC10789894_01_acr-08-23-92-f1.jpg

PMC10789894_acr-08-23-92-f1_A_1_3.webp

Chest X-ray, CT and MRI findings. (A) Nodular shadow in the left lower lung field detected on chest X-ray. Orange arrow indicates the area of abnormal chest shadow. (B) Anterior mediastinal tumor with poor contrast effect detected on CT (size: 6.0 cm x 3.1 cm x 1.9 cm). The tumor grew from 2.2 to 6.0 cm within 21 months. Orange arrow indicates anterior mediastinal tumor. (C) Anterior mediastinal tumor detected on T2-weighted MRI. Chest MRI revealed that the main component of the tumor was liquid. Orange arrow indicates anterior mediastinal tumor. CT, computed tomography; MRI, magnetic resonance imaging.

A 75-year-old woman presented to our hospital with an abnormal chest shadow, which was identified during a medical examination (Figure 1A). Chest computed tomography (CT) revealed an inflammatory nodule in the lingula and an anterior mediastinal mass with a poor contrast effect measuring 6.0 cm x 3.1 cm x 1.9 cm (Figure 1B), which grew from 2.2 to 6.0 cm over 21 months. Low and high signals were detected on T1- and T2-weighted thoracic magnetic resonance imaging, respectively (Figure 1C). By POD 9, partially improving the subglottic stenosis (Figure 3C), thereafter the subglottic stenosis was almost completely alleviated by POD 12 (Figure 3D) (Figure S1A,S1B) and gradual improvement continued (Figure S1C). Hydrocortisone was discontinued on POD 14, and the tracheal cannula was removed on POD 22 (Figure S1D,S1E). Trachea-cutaneous fistula closure was performed on POD 35, and she was discharged on POD 42, remaining well (Figure S1F-S1H).

f1

PMC10789894_01

PMC10789894

file_0143997

PMC10789894_01

CC BY-NC-ND

PMC10789894_01_acr-08-23-92-f2.jpg

PMC10789894_acr-08-23-92-f2_A_1_2.webp

Laryngoscopic findings. (A) On POD 1, laryngoscopy revealed submucosal hemorrhage around the vocal cords and mild subglottic stenosis. None of the findings prompted emergency treatment. (B) On POD 4, laryngoscopy revealed progressive subglottic stenosis. POD, postoperative day.

L/min oxygen flow rate. Laryngoscopy showed submucosal hemorrhage around the vocal cords and mild subglottic stenosis just below the glottis; however, there was no arytenoid dislocation or findings necessitating emergency treatment (Figure 2A). However, her stridor became more severe and laryngoscopy was re-performed and revealed subglottic stenosis progression prompting emergency tracheotomy (Figure 2B).

f2

PMC10789894_01

PMC10789894

file_0144000

PMC10789894_01

CC BY-NC-ND

PMC10789894_01_acr-08-23-92-f3.jpg

PMC10789894_acr-08-23-92-f3_A_1_4.webp

Laryngoscopic findings after tracheostomy. (A) On POD 5, laryngoscopy of the glottis through the tracheostomy orifice suggested progressive subglottic stenosis. (B) On POD 7, laryngoscopy of the glottis through the tracheostomy orifice revealed almost complete airway obstruction. (C) On POD 9, laryngoscopy of the glottis through the tracheostomy orifice indicated partial improvement in the subglottic stenosis. (D) On POD 12, laryngoscopy of the glottis through the tracheostomy orifice revealed almost complete resolution of the subglottic stenosis. POD, postoperative day.

On POD 5, subglottic stenosis progressed further (Figure 3A). By POD 7, observation of the glottis through the tracheostomy orifice revealed almost complete airway obstruction (Figure 3B). By POD 9, partially improving the subglottic stenosis (Figure 3C), thereafter the subglottic stenosis was almost completely alleviated by POD 12 (Figure 3D) (Figure S1A,S1B) and gradual improvement continued (Figure S1C).

f3

PMC10789894_01

PMC10789894

file_0144002

PMC10789894_01

CC BY-NC-ND

PMC10837815_01_ijspt_2024_19_2_91642_190905.jpg

PMC10837815_ijspt_2024_19_2_91642_190905_undivided_1_1.webp

Initial contact during the WSP, from a posterior view

Figures 1 and 2 show images of the subject's pitching mechanics during initial foot contact from posterior and lateral views, respectively.

attachment-190905

PMC10837815_01

PMC10837815

file_0146355

PMC10837815_01

CC BY-NC

PMC10795896_01_rjad306f2.jpg

PMC10795896_rjad306f2_A_1_2.webp

(A) Inset of right RFF-STSG over right groin defect. (B) Four months postoperative. Well-healed RFF-STSG over right groin.

After operative hematoma evacuation and debridement, microbiology culture sampling and wash out, the PRS team utilized a right pedicled RFF with STSG for coverage of the exposed graft (Fig. 2A). After a 6-week hospitalization including rehabilitation, the patient was discharged home and ultimately completed a 6-week course of intravenous antibiotics (Fig. 2B).

f2

PMC10795896_01

PMC10795896

file_0144335

PMC10795896_01

CC BY-NC