We report a case of Noonan syndrome with classical cardinal features, including short stature, hypertelorism, low-set ears, pectus excavatum, short neck, kyphoscoliosis, clinodactyly, cryptochidism and pulmonary stenosis. The orofacial findings in the patient have been emphasized to highlight the need of dental treatment and care during multidisciplinary treatment planning for the patients with Noonan syndrome.
We reported a case of a 60 year old man with painful swelling on the posteromedial compartment and functional limitation to flex both knees. The radiological study shows a solid tumor in the soft tissues. MRI scanner of both knees revealed an ossified mass inside popliteal cyst. In the literature consulted it is not reported a case about giant ossified bodies in both knees. They're only three cases-report of single large ossified masses presenting as osteochondral lesions in the popliteal cyst, a one of them report more than two loose bodies in a knee.
In conclusion, we presented a case non described in the consulted literature of loose bodies ossified in bilateral popliteal cyst.
Xenotransplantation of isolated pig islets have been regarded as the future treatment of choice for patients with type I diabetes. The parameters influencing islet isolation outcome are related to donor characteristics and pancreas procurement process. Warm ischaemia time (WIT) is one of the crucial factors influencing islet isolation efficacy. Therefore the aim of this study was to establish a method of pig pancreas procurement from heartbeating donors and impact on isolation outcome. The pancreatomy was performed after anesthesia followed by intraductal injection of the cold University of Wisconsin solution. Digestion procedure was carried out according to stationary method using a two-component enzyme blend of Collagenase NB8 and Neutral Protease (Serva). Reduction of the warm ischaemia time were feasible under laboratorial condition as far as application of Serva two-component enzyme blend for pig islet isolation.
Although acute superior mesenteric artery (SMA) occlusion comprises two-thirds of the pathology in patients with acute mesenteric ischemia, non-occlusive mesentery ischemia and mesenteric venous thrombosis are rarely encountered. We herein aim to present the outcomes of endovascular surgery in a patient with SMA occlusion who developed peritonitis following endovascular embolectomy and stenting. Old female patient admitted to emergency service with a complaint of abdominal pain for the past 4 days. Contrast abdominal CT in the emergency service revealed the existence of a thrombus that almost occludes the lumen with a size of 2,5-3 cm at proximal SMA and that distal SMA and distal branches were unobstructed with no evidence of abdominal free fluid and typical ischemia in bowel loops. Thrombectomy was performed to remove the acute thrombus which was proximal to SMA. The patient was treated by end-to-end anastomosis of the 50 cm-long unaffected bowel segment with small intestine at distal end and with transverse colon at proximal end, following necrotic bowel resection. The patient was released from hospital 10 days after the surgery without complication. It has been suggested that CT must be used as the primary imaging method since it has high sensitivity (93.3%) and specificity (95.9%) for suspected acute SMA occlusion. Surgical intervention must be planned upon clinical or radiological suspicion before the development of a septic condition. We conclude that endovascular intervention must be considered primarily for protection of intestinal segments unless complications of SMA thrombus have developed.
The antiphospholipid syndrome (APS) is an autoimmune disease defined by clinical (generally thrombotic disorders due to hypercoagulability) and laboratory manifestations (anticardiolipin antibodies of IgG and/or IgM isotype and lupus anticoagulant). The clinical syndrome causes coronary heart disease, abortion, venous thrombosis, stroke and ischemic presentations in other organs. Atypical presentations, including movement disorders and fascicular third nerve palsy, were reported. The main goal of the article is to report a patient with sixth and seventh cranial nerves palsy related to APS.
Case Report: A 66-year-old hypertense female presented sudden left hemicranial headache associated with horizontal diplopia and dizziness. The patient was discharged with diagnosis of idiopathic palsy of the left sixth nerve in the context of chronic hypertension. Two months later the patient was admitted due to worsening of the left hemicranial headache and left facial peripheral paresis. The brain CT scan and MRI studies were normal. An exhaustive analysis of blood and cerebrospinal fluid was performed, and the only pathologic findings were lupus anticoagulant and IgM anti-cardiolipin and anti-B2 glycoprotein antibodies. The patient was treated with 150 mg of acetylsalicylic acid and after 5 months showed an incomplete recovery of the seventh nerve lesion. The paraclinical study was repeated, showing IgM anti-B2 glycoprotein antibody raised. During follow-up a diagnosis of coronary heart disease was done by the Cardiologist.
Discussion: The reported patient met laboratory criteria of APS, showed cardiac thrombotic disease, and compressive, infiltrative, infectious or inflammatory causes of cranial multineuritis were ruled out. The results may suggest the presence of an ischemic microvascular occlusion of vasa nervorum related to APS as the mechanism of disease.