Long-term Follow-up Of Cases Research Articles

Cardiac cystic echinococcosis: a long-term follow-up case report

Cardiac cystic echinococcosis: a long-term follow-up case report

Bilateral refractory frozen shoulders treated with conservative and surgical treatments—a case report of long-term follow-up

Keywords Frozenshoulder.Physiotherapy.Arthroscopiccapsularrelease.Casereport.Long-termfollow-upIntroductionShoulder stiffness is a major cause of shoulder disability andpain. It was first described in the late 19th century [1, 2].The term frozen shoulder was first described by Codman in1934, who stated the common features of slow onset painnear the insertion of the deltoid, inability to sleep on theaffected side, painful and restricted elevation and externalrotation, and a normal radiological appearance [3]. Clinicalfeatures of idiopathic frozen shoulder are classically charac-terized by three stages: freezing, frozen, and thawing phases[4]. Their characteristic clinical feature is decreasing motionwith pain, severely restricted motion, and recovering fromstiffness, respectively. The estimated prevalence of frozenshoulder is 2–5% in the general population [5, 6]. Patientswith frozen shoulder are observed commonly in their 40s to70s and predominately in females [7, 8]. In addition,20–30% of patients develop stiffness in the contralateralshoulders [7]. Though the natural history of frozen shoulderis not well understood, idiopathic frozen shoulder is consid-ered to be a self-limited disease [3, 9]. Normally, quite a fewpatients respond well with conservative treatments such assteroid injections and physiotherapy [10]. However, somepatients demonstrate little or no improvement or mildimprovement with various degrees of limited range ofmotion. In the recalcitrant cases, surgical intervention, suchas arthroscopic pan-capsular release [11], is indicated.We have experienced a case of bilateral idiopathic frozenshoulders which underwent arthroscopic pan-capsular releaseon one side and conservative treatment, which is mostlyperiodical physiotherapy, on the other side for 5 years. Thepurpose of this study is to report range of motion (ROM)recovery over time of this long-term follow-up case and toprovide guidelines for surgeon’s decision making.Case reportHistory A 56-year-old woman in good general health suf-fered from severe left shoulder pain, which was her

Congenital keratoconjunctivitis sicca and ichthyosiform dermatosis in 25 Cavalier King Charles spaniel dogs – part I: clinical signs, histopathology, and inheritance

The clinical presentation and progression (over 9 months to 13 years) of congenital keratoconjunctivitis sicca and ichthyosiform dermatosis (CKCSID) in the Cavalier King Charles spaniel dog are described for six new cases and six previously described cases. Cases presented with a congenitally abnormal (rough/curly) coat and signs of KCS from eyelid opening. Persistent scale along the dorsal spine and flanks with a harsh frizzy and alopecic coat was evident in the first few months of life. Ventral abdominal skin was hyperpigmented and hyperkeratinized in adulthood. Footpads were hyperkeratinized from young adulthood with nail growth abnormalities and intermittent sloughing. Long-term follow-up of cases (13/25) is described. Immunomodulatory/lacrimostimulant treatment had no statistically significant effect on Schirmer tear test results, although subjectively, this treatment reduced progression of the keratitis. Histopathological analysis of samples (skin/footpads/lacrimal glands/salivary glands) for three new cases was consistent with an ichthyosiform dermatosis, with no pathology of the salivary or lacrimal glands identified histologically. Pedigree analysis suggests the syndrome is inherited by an autosomal recessive mode.

Surgical treatment of esophagogastric dysfunction forty years after reverse gastric tube esophagoplasty for congenital esophageal anomaly

Background In 1968, Burrington first described use of the reverse gastric tube esophagoplasty for esophageal replacement in children with esophageal atresia or acquired stenosis. There are few documented cases of long-term follow-up of these patients. Case Report We describe a 41-year-old female who presented with progressive dysphagia 40 years after reverse gastric tube for a congenital esophageal stenosis as an infant. Repeated endoscopic dilations were unsuccessful in relieving her symptoms, and she subsequently underwent a modified Ivor-Lewis esophagogastrectomy with resection of the reverse gastric tube and reconstruction using her remaining gastric remnant. Conclusions This report describes what we believe to be the longest recorded follow-up after reverse gastric tube esophagoplasty and highlights the potential for long-term complications after surgery for congenital anomalies.

Total femur replacement for Ewing’s sarcoma after wide resection of the proximal femur: a long-term follow-up case study

Abstract Background: Total femur replacement is a relatively rarely performed procedure for the reconstruction of an affected limb after resection of a malignant bone tumor. Objective: Report total femur replacement in a 17-year-old male patient after wide resection of the right femur for involvement of the proximal segment of the bone by Ewing’s sarcoma. Results: The complications that often arose from the use of the tumor prostheses after the tumor resection, e.g., infection and migration/dislocation of the artificial bonehead, were overcome successfully. The patient has been under follow-up for a relatively long period of time (16 years) since the surgery. The operated limb function is now rated at 70% according to the rating system by Musculo-Skeletal Tumor Society (MSTS). The patient has almost completely regained his ability to walk and carries on with activities of daily living. Conclusion: If appropriate measures are taken to deal with the complications, favorable function of the operated limb can be expected to be maintained for long periods after reconstruction using this technique.

A case of long-term follow-up of upper central incisors with periapical lesions after an eco-mechanical root canal therapy

A case of long-term follow-up of upper central incisors with periapical lesions after an eco-mechanical root canal therapy

The sequential changes of carcinoma cuniculatum: a case report with 11-year follow-up

Carcinoma cuniculatum (CC) has been regarded as a well differentiated subtype of oral squamous cell carcinoma (SCC) that is characterized by keratin cores and keratin-filled crypts, but lacking obvious cytological malignancy. There have been relatively few case reports of oral CC, and descriptions of the long-term prognosis are scarce. In addition, the process of change from CC to conventional SCC is still poorly understood. In 1983, an 80-year-old woman admitted for a white spot underwent an excision biopsy, and CC was diagnosed. This lesion then recurred in 1993, with the same diagnosis, but it changed into conventional SCC when it recurred in 1994. Tissue materials from the three surgical treatments were examined with hematoxylin and eosin stain as well as with immunohistochemical stains for Ki-67 and for p53 and p63 gene products (P53, P63). While expressions of P53 protein and Ki-67 became stronger with every recurrence, the opposite tendency was obtained for P63 expression. This is the first report to describe a case of long-term follow-up of CC in which the expression modes of oncogene products were analyzed.

Clinical and pathological changes in a long-term follow-up case of dermatofibrosarcoma protuberans

The Journal of DermatologyVolume 38, Issue 2 p. 203-205 Clinical and pathological changes in a long-term follow-up case of dermatofibrosarcoma protuberans Yuki YAMAMOTO, Yuki YAMAMOTO Departments of DermatologySearch for more papers by this authorSeiko TOYOZAWA, Seiko TOYOZAWA Departments of DermatologySearch for more papers by this authorKoji UEDE, Koji UEDE Departments of DermatologySearch for more papers by this authorYoshinao ODA, Yoshinao ODA Department of Anatomical Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, JapanSearch for more papers by this authorYasushi NAKAMURA, Yasushi NAKAMURA Clinical Laboratory Medicine, Wakayama Medical University, Wakayama,Search for more papers by this authorFukumi FURUKAWA, Fukumi FURUKAWA Departments of DermatologySearch for more papers by this author Yuki YAMAMOTO, Yuki YAMAMOTO Departments of DermatologySearch for more papers by this authorSeiko TOYOZAWA, Seiko TOYOZAWA Departments of DermatologySearch for more papers by this authorKoji UEDE, Koji UEDE Departments of DermatologySearch for more papers by this authorYoshinao ODA, Yoshinao ODA Department of Anatomical Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, JapanSearch for more papers by this authorYasushi NAKAMURA, Yasushi NAKAMURA Clinical Laboratory Medicine, Wakayama Medical University, Wakayama,Search for more papers by this authorFukumi FURUKAWA, Fukumi FURUKAWA Departments of DermatologySearch for more papers by this author First published: 29 September 2010 https://doi.org/10.1111/j.1346-8138.2010.00938.x Yuki Yamamoto, M.D., Ph.D., Department of Dermatology, Wakayama Medical University, 811-1 Kimiidera, Wakayama 641-0012, Japan. Email: [email protected] This case was presented at the 23rd annual meeting of Japanese Association of Dermatologic Surgery in 2008, and briefly published in the Japanese Journal of Dermatologic Surgery (2009; 13: 62–63) in Japanese. Some of the clinical photographs are shown in this brief document. This was declared at the submission of this case report. Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Volume38, Issue2February 2011Pages 203-205 RelatedInformation

Refractive Stability of LASIK with the VISX 20/20 Excimer Laser vs ZB5M Phakic IOL Implantation in Patients with High Myopia (>−10.00 D): A 10-Year Retrospective Study

To compare the long-term outcomes of LASIK and ZB5M phakic intraocular lens implantation (PIOL) (Domilens) for high myopia (>-10.00 diopters [D]). This long-term (10 years) follow-up retrospective interventional case series study included 126 eyes that underwent LASIK and 52 eyes that underwent ZB5M angle-supported PIOL implantation. Both groups of eyes were similar in terms of preoperative spherical equivalent refraction (SE), corrected distance visual acuity (CDVA), and age. Mean preoperative SE was -14.33 D in the LASIK group and -14.84 D in the PIOL group. At 10-year follow-up, mean postoperative SE was -1.47±2.00 D in the LASIK group and -1.01±1.36 D in the PIOL group (P=.21). In the LASIK group, 67% of eyes were within ±1.00 D of emmetropia at 2 years after surgery, compared to 42% at 10 years. In the PIOL group, 68% of eyes were within ±1.00 D of emmetropia 2 years after implantation compared to 53% at 10 years. In the LASIK group, 43.5% of eyes achieved UDVA of 20/40 or better 10 years after surgery compared to 67.9% in the PIOL group (P=.02). The ZB5M angle-supported PIOL was shown to have better predictability and stability compared to LASIK over 10 years. However, reductions in endothelial cell count over time were observed in eyes with PIOLs.

Spinal Cord Injury Caused by Bone Cement after Percutaneous Vertebroplasty - One Case of Long-term Follow-up and the Result of Delayed Removal -

Among the complications of percutaneous vertebroplasty, bone cement leakage into the spinal canal doesn't happen very often, but this could provoke a severe neurologic deficit. It is not certain whether this neurologic deficit may be permanent or reversible. Yet if the bone cement is left in the spinal canal, trivial events such as minor trauma could worsen the neurologic symptoms. The authors treated a 75-year-old female patient with Nurick's grade IV neurologic deficit, which was due to cement leakage into the spinal canal after previous vertebroplasty of T8 and T9. She had been having a neurologic deficit for 9 years, and it became aggravated after a minor trauma to Nurick's grade V. After the cement in the spinal canal was removed, her neurologic symptoms were improved to Nurick's grade II. Leaving a cement mass in the spinal canal may be a risk factor for additional neurologic injury even when suffering only a minor trauma, and the neurologic symptoms can be improved after removal of the cement, even for the case with a long-term neurological defect.

Supravalvular aortic stenosis of the diffuse type: 29 years follow-up after aortic endarterectomy and symmetric enlargement of the ascending aorta and of the three coronary sinuses

Supravalvular aortic stenosis is a rare congenital anomaly characterized by variable amounts of left ventricular outflow tract obstruction distal to the aortic valve. Macroscopically, it is categorized into three morphologic subtypes: membranous, hourglass, and diffuse. The diffuse type is the most rare, and its surgical repair is the most challenging due to variable length of ascending aorta hypoplasia. Surgical treatment options of supravalvular aortic stenosis are well established for the membranous and hourglass type, whereas they are challenging and less well defined for the diffuse type. We present a case of long-term follow-up (29 years) after a very complex surgical repair of supravalvular aortic stenosis of the diffuse type, with focus on technical aspects. To our knowledge, the present case represents one of the longest follow-up routines in the English language literature of surgical treatment of supravalvular aortic stenosis.

Collagenous Gastritis

Purpose: Collagenous Gastritis is a histological diagnosis characterized by a dramatically thickened subepithelial collagen band in the gastric mucosa associated with an inflammatory infiltrate. Children usually present with epigastric pain with severe anemia as compared to adults who present with chronic watery diarrhea attributed to concomitant collagenous colitis. Collagenous Gastritis is a rare entity with less than 35 cases reported thus far. We report a case of Collagenous Gastritis in a teenager presenting as abdominal pain and anemia. Methods: 17 year old Iraqi female, with a one year history of profound anemia, presented with intermittent lower abdominal pain for the last 1 year. Pain typically occurred every 2–3 days. This was associated with intermittent loose stools 5–6 times daily. Occasional nausea was reported but review of systems was negative for anorexia, weight loss, hematemesis, melena or hematochezia. No recent antibiotics or travel history was provided. Physical examination was essentially unremarkable. Laboratory evaluation revealed a hemoglobin of 12.1 g/dl which was on iron supplementation in comparison to a hemoglobin of 7.0 g/dl noted a year prior. Biochemical profile, C-Reactive Protein and Celiac panel were all within normal limits. Patient underwent an upper endoscopy which revealed diffuse erythematous mucosa of the whole stomach. Biopsies were taken and revealed a markedly thickened subepithelial band of collagen (basement membrane) with variable thickness (about 40–95 microns. Moderate chronic infiltrate was noted in the lamina propria. These findings were suggestive of Collagenous Gastritis. Results: Not Applicable Conclusion: Collagenous gastritis is a rare entity of unknown etiology, pathogenesis and prognosis. Gastroenterologists and pathologists need to be aware of this condition when evaluating adolescents with abdominal pain, anemia and chronic diarrhea, particularly when endoscopy reveals nodularity of gastric mucosa. The identification, reporting and long-term follow-up of cases will shed more light on the prognosis and management of this puzzling condition.

P.053 Schwannoma of the mandible

The long-term follow-up case of monostotic fibrous dysplasia of the maxilla in a 10-year-old girl is described with her endocrinologic data and therapeutic consequence of calcitonin administration in association with surgical interventions. The fibrous dysplasia tends to become more quiescent or static after skeletal growth ceases, but the causative has been still unknown to date. In this case reported changes of calciotropic hormones in the serum were well corresponding to the ceasing of the tumor growth at the puberty and reflected to the calcitonin administration. Although calcitonin has been applied to the fibrous dysplasia associated with McCune Albright syndrome, no histologic changes have been described after the calcitonin treatment. This report might be the first description of bone remodeling after the calcitonin treatment for the fibrous dysplasia of the maxilla in immature people. Data of this case may provide a clue to the pathogenesis of fibrous dysplasia. Surgical intervention can be performed after the local bone calcification by a calcitonin treatment, because of alleviation of vigorous hemorrhage by the bone remodeling.

Temporal breach management in chronic otitis media

In a retrospective study performed at the Otolaryngology, Head and Neck Surgery Department, Pitié-Salpêtrière Hospital, Paris from 1991 to March 2007, we determined surgical procedures for the treatment of tegmen breaches in chronic otitis media. Forty-two cases were examined: 76% corresponded to chronic otitis media with cholesteatoma, and 24% to chronic otitis media without cholesteatoma. Twenty-eight cases were operated using a combined approach, eight cases using a single suprapetrous approach, and six cases using a transmastoid approach. A total of 33% of the cases showed a meningocele or a meningoencephalocele treated through either a combined or a suprapetrous approach. No recurrence or neural/meningeal infectious involvement was found after a mean time of 43 months in the 36 long-term follow-up cases operated through the combined or suprapetrous approaches. Two cases included in the study were a loss to follow-up. Three of the former cases had already been operated for supracentimetric fissure using lower approach. Two out of the six patients operated using lower approach presented post surgery cerebrospinal fluid otorrhea. Combined or suprapetrous approaches seem to be best adapted to the treatment of supracentimetric or recurrent tegmen breaches, as well as to the precise examination and repair of meningeal lesions. Treatment for tegmen breach can be achieved in a single intervention, even when there is an ongoing infection of the middle ear. The mastoid approach should be used only for infracentimetric defects when there is no neural/meningeal lesion.

Ten-year Follow-up of Laser In Situ Keratomileusis for High Myopia

To evaluate the long-term outcomes of laser in situ keratomileusis (LASIK) for high myopia. A long-term (10 years) follow-up retrospective interventional case series study. The study included 196 myopic eyes of 118 patients with a mean preoperative spherical equivalent of -13.95 +/- 2.79 diopter (D) treated with myopic LASIK at the Instituto Oftalmológico de Alicante, Spain using the VISX 20/20 excimer laser (VISX Inc, Santa Monica, California, USA) and the Automated Corneal Shaper microkeratome (Chiron Vision, Irvine, California, USA). All patients were evaluated three months, one year, two years, five years, and 10 years postoperatively. The main outcome measures were refractive predictability and stability, mean corneal keratometry, topographical cylinder, safety, efficacy, stability of visual acuity, and postoperative complications. At 10 years, 82 (42%) of 196 eyes were within +/-1.00 D and 119 (61%) were within +/-2.00 D. Fifty-four (27.5%) eyes underwent retreatments attributable to under correction and/or regression. The myopic regression decreases with time in eyes that did not undergo retreatment with a mean rate of -0.25 +/- 0.18 D per year. Eleven eyes (5%) lost more than 2 lines of best spectacle-corrected visual acuity (BSCVA) and 78 eyes (40%) showed a postoperatively uncorrected visual acuity of 20/40 or better. Two eyes (1%) with more than 15 D myopic correction developed corneal ectasia. LASIK for myopia over -10 D is a safe procedure with myopic regression that slows down with time and a high rate of BSCVA increase in the long-term.

Aggressive periodontitis associated with Papillon‐Lefèvre syndrome: Report of a 14‐year follow‐up

This case report describes the periodontal management, therapeutic approach, and 14-year follow-up of a patient diagnosed with Papillon-Lefevre syndrome (PLS). A female child, diagnosed with PLS-associated periodontitis at the age of 9 years and 11 months, presented with hyperkeratosis of the palms and soles, as well as generalized aggressive periodontitis. The dental treatment comprised standard periodontal debridement, scaling and root planing, instructions on oral hygiene, restorations, extraction of hopelessly affected teeth and a therapeutic use of antibiotics. The concomitant supportive periodontal therapy and antibiotic coverage could not stop the loss of periodontal attachment and destruction of the alveolar bone. Four years after treatment was initiated, the last remaining teeth were extracted and complete dentures were constructed. The dentures have been periodically replaced and the patient continues to return for follow-up once a year. The combination of intensive periodontal treatment and antibiotic regimen only temporarily delayed periodontal disease progression and did not prevent loss of both primary and permanent teeth. The outcome of this long-term follow-up case report shows that management of PLS-associated periodontitis is further complicated when the patient is first seen in the mixed dentition stage or later. In these situations, the chances of controlling the progression of periodontal breakdown and minimizing tooth loss are greatly reduced.

Collagenous gastritis: a case report and review

In this article, we report a case of collagenous gastritis in a child and review the paediatric cases reported to date. Collagenous gastritis is a rare entity, with only less than 30 cases reported so far, including 12 children, since the first description of this entity by Colletti and Trainer in 1989. This is a histological diagnosis characterised by a dramatically thickened subepithelial collagen band in the gastric mucosa associated with an inflammatory infiltrate. Children with this condition often present with epigastric pain and severe anaemia, with no evidence of extragastric involvement, in contrast to the adult patients, where chronic watery diarrhoea is the main presentation due to associated collagenous colitis. A macroscopic pattern of gastritis with nodularity of gastric mucosa, erythema and erosions are characteristic endoscopic findings in paediatric patients. Specific therapy has not been established and resolution of the abnormalities, either endoscopic or histological, has not been documented. In conclusion, collagenous gastritis is a rare entity of unknown aetiology, pathogenesis and prognosis. Gastroenterologists and pathologists need to be aware of this condition when evaluating a child with epigastric pain, anaemia and upper gastrointestinal bleeding, particularly when endoscopy reveals the nodularity of gastric mucosa. The identification, reporting and long-term follow-up of cases will shed more light on this puzzling condition.

歯列不正を伴う侵襲性歯周炎症例の長期臨床経過

歯列不正を伴う侵襲性歯周炎症例の長期臨床経過

Control of a cluster of community-associated, methicillin-resistant Staphylococcus aureus in neonatology

To control an outbreak of community-associated MRSA (CA-MRSA) in a neonatology unit, an investigation was conducted that involved screening neonates and parents, molecular analysis of MRSA isolates and long-term follow-up of cases. During a two-month period in the summer of 2000, Panton-Valentine leukocidin (PVL)-producing CA-MRSA (strain ST5-MRSA-IV) was detected in five neonates. The mother of the index caseshowed signs of mastitis and wound infection and consequently tested positive for CA-MRSA. A small cluster of endemic, PVL-negative MRSA strains (ST228-MRSA-I) occurred in parallel. Enhanced hygiene measures, barrier precautions, topical decolonization of carriers, and cohorting of new admissions terminated the outbreak. Four months after the outbreak, the mother of another neonate developed furunculosis with the epidemic CA-MRSA strain. One infant had persistent CA-MRSA carriage resulting in skin infection in a sibling four years after the outbreak. In conclusion, an epidemic CA-MRSA strain was introduced by the mother of the index case. This spread among neonates and was subsequently transmitted to another mother and a sibling. This is the first report of a successfully controlled neonatology outbreak of genetically distinct PVL-producing CA-MRSA in Europe.

Composite paraganglioma–ganglioneuroma of the urinary bladder

Presented herein is the case of a 73-year-old man, complaining of dysuria, who had a composite paraganglioma-ganglioneuroma of the urinary bladder (CPGUB). At cystoscopy a submucosal tumor was found in the urinary bladder and resected after transurethral biopsy. The levels of serum catecholamine and 24 h urinary excretion of catecholamine and vanillylmandelic acid were elevated. Grossly, the resected tumor, measuring 4 x 3 x 2.5 cm, had a brownish cut surface with no necrosis and hemorrhage. Histologically, the tumor had alternating cellular and fibrous areas. The cellular areas consisted of polygonal cells, arranged in well-defined nests (Zellballen) and positive for Grimelius staining, with abundant amphophilic to acidophilic cytoplasm, occasionally containing eosinophilic hyaline globules and brown pigments. Although the nuclei of several polygonal cells were bizarre, mitoses and vascular invasion were not found. Fibrous areas consisted of spindle cells, resembling Schwann cell, admixed with ganglionic cells. To the authors' knowledge, only four cases of CPGUB have been reported in the English-language literature. Detailed reported cases and the present case showed no malignant features, such as extra-bladder infiltration and metastasis, and no recurrence in the short length of follow up. Accumulation of long-term follow-up cases may provide valuable prognostic information on this composite tumor.