Medicine
-
Case Reports
Congenital diaphragmatic hernia in association with congenital short esophagus: A case report.
Congenital diaphragmatic hernia (CDH) associated congenital anomalies are present in about 25%. Congenital short esophagus (CSE) is a relatively rare condition. Both CDH and congenital intrathoracic stomach caused by CSE can be diagnosed in utero. However, CSE can be easily misdiagnosed in utero. ⋯ To our knowledge, this is the first documented case of this rare type of CDH combined with congenital intrathoracic stomach caused by CSE. This condition could not be surgically repaired due to the extremely short esophagus. Early recognition of intrathoracic stomach associated with CSE is important as it is associated with difficult management and significant postnatal complications. The prognosis is cautiously guarded, and the parents should be appropriately counseled.
-
Iliac arterial fibromuscular dysplasia (FMD) was rarely reported and its demographic, clinical, and imaging features have not been precisely described resulting in uncertain therapeutic methods. ⋯ To our knowledge, this is the first bilateral common and internal iliac arterial FMD case in China, with unique asymptomatic dissection, aneurysm, and renovascular hypertension. Screening for secondary hypertension in young population and for iliac or renal arterial FMD is therefore suggested with CTA and reconstruction from neck to pelvis and MRA in those with intracranial disorders. Among youth FMD, the potential of PTRA in renovascular hypertension out of antihypertensive drugs and stent in dissection is novelly indicated.
-
The respective involvements of both the thalamus and exhibitionism in cerebral X-linked adrenoleukodystrophy (X-ALD) have not been reported. ⋯ We recommend that physicians should not disregard X-ALD in patients with isolated psychiatric symptoms, including hypersexual behavior. The combination of detailed clinical evaluation, MRI, and next generation genetic sequencing can expedite the diagnostic process of atypical variant of X-ALD.
-
Although numerous reconstruction protocols have been reported for lower leg trauma, those for distal leg trauma remain few. We present the case of a woman with an implant exposure wound, who was successfully treated through fat grafting, without major flap surgery. ⋯ Fat grafting is one kind of cell therapy and potentially has regenerative effects during wound healing. Fat grafting is critical in the healing processes of complicated wounds and might be considered a step in reconstruction surgery.
-
Spasticity is a major complication after stroke, and botulinumtoxin A (BoNT-A) injection is commonly used to manage focal spasticity. However, it is uncertain whether BoNT-A can improve voluntary motor control or activities of daily living function of paretic upper limbs. This study investigated whether BoNT-A injection combined with robot-assisted upper limb therapy improves voluntary motor control or functions of upper limbs after stroke. ⋯ BoNT-A injection in combination with multidisciplinary rehabilitation treatment, including robot-assisted arm training, should be recommended for subacute spastic stroke patients to enhance appropriate motor recovery.