A 65-year-old male suffering from acute spinal cord injury leading to incomplete tetraplegia presented with severe recurrent Clostridium difficile(C. difficile) infection subsequent to antibiotic treatment for pneumon...A 65-year-old male suffering from acute spinal cord injury leading to incomplete tetraplegia presented with severe recurrent Clostridium difficile(C. difficile) infection subsequent to antibiotic treatment for pneumonia. After a history of ineffective antimicrobial therapies, including metronidazole, vancomycin, fidaxomicin, rifaximin and tigecycline, leading to several relapses, the patient underwent colonoscopic fecal microbiota transplantation from his healthy son. Four days subsequent to the procedure, the patient showed a systemic inflammation response syndrome. Without detecting an infectious cause, the patient received antimicrobial treatment, including tigecycline, metronidazole, vancomycin via polyethylene glycol and an additional enema for a period of seven days, leading to a prompt recovery and no reported C. difficile infection relapse during a 12 wk follow up.展开更多
BACKGROUND Humeral shaft fractures are relatively common in adults.Rotational malalignment is reported as one complication but severe rotational deformity of the humerus is extremely rare.To our knowledge,only three c...BACKGROUND Humeral shaft fractures are relatively common in adults.Rotational malalignment is reported as one complication but severe rotational deformity of the humerus is extremely rare.To our knowledge,only three cases of symptomatic humeral malrotation have been reported.There are sparse literature reports of humeral reconstruction correction.CASE SUMMARY We present a case of extreme rotational deformity of the humerus(180°)after humeral shaft fracture.The patient complained of pain and difficulties with activities of daily living.In addition,she found the deformity cosmetically unacceptable.Therefore,she was searching for surgical correction.Neurolysis of the radial nerve followed by derotational osteotomy of the humerus and internal fixation were performed.Postoperatively,the patient demonstrated transient iatrogenic radial nerve palsy which recovered completely during postoperative follow-up.The Disabilities of the Arm,Shoulder,and Hand score improved from 55 preoperatively to 16 at the final 2-year follow-up.CONCLUSION Single-stage radial neurolysis,derotational osteotomy and stable fixation is a feasible option to improve anatomic and functional problems of severely malrotated humeral shaft fractures.展开更多
In contrast to common colonic epithelial neoplasms, polypoid mesenchymal tumors of the colon are extremely rare. The majority of uncommon gastrointestinal mesenchymal tumors are associated with the so-called gastroint...In contrast to common colonic epithelial neoplasms, polypoid mesenchymal tumors of the colon are extremely rare. The majority of uncommon gastrointestinal mesenchymal tumors are associated with the so-called gastrointestinal stromal tumors (GIST). We present a case of a rare colonic pleomorphic sarcoma, macroscopically mimicking a common epithelial colonic polyp, which did not match the criteria of GIST. In this case report we discuss the clinical and pathological characteristics of a rare polypoid-shaped, pleomorphic colonic sarcoma and refer a mark-off to other rare mesenchymal neoplasms of the gut.展开更多
文摘A 65-year-old male suffering from acute spinal cord injury leading to incomplete tetraplegia presented with severe recurrent Clostridium difficile(C. difficile) infection subsequent to antibiotic treatment for pneumonia. After a history of ineffective antimicrobial therapies, including metronidazole, vancomycin, fidaxomicin, rifaximin and tigecycline, leading to several relapses, the patient underwent colonoscopic fecal microbiota transplantation from his healthy son. Four days subsequent to the procedure, the patient showed a systemic inflammation response syndrome. Without detecting an infectious cause, the patient received antimicrobial treatment, including tigecycline, metronidazole, vancomycin via polyethylene glycol and an additional enema for a period of seven days, leading to a prompt recovery and no reported C. difficile infection relapse during a 12 wk follow up.
文摘BACKGROUND Humeral shaft fractures are relatively common in adults.Rotational malalignment is reported as one complication but severe rotational deformity of the humerus is extremely rare.To our knowledge,only three cases of symptomatic humeral malrotation have been reported.There are sparse literature reports of humeral reconstruction correction.CASE SUMMARY We present a case of extreme rotational deformity of the humerus(180°)after humeral shaft fracture.The patient complained of pain and difficulties with activities of daily living.In addition,she found the deformity cosmetically unacceptable.Therefore,she was searching for surgical correction.Neurolysis of the radial nerve followed by derotational osteotomy of the humerus and internal fixation were performed.Postoperatively,the patient demonstrated transient iatrogenic radial nerve palsy which recovered completely during postoperative follow-up.The Disabilities of the Arm,Shoulder,and Hand score improved from 55 preoperatively to 16 at the final 2-year follow-up.CONCLUSION Single-stage radial neurolysis,derotational osteotomy and stable fixation is a feasible option to improve anatomic and functional problems of severely malrotated humeral shaft fractures.
文摘In contrast to common colonic epithelial neoplasms, polypoid mesenchymal tumors of the colon are extremely rare. The majority of uncommon gastrointestinal mesenchymal tumors are associated with the so-called gastrointestinal stromal tumors (GIST). We present a case of a rare colonic pleomorphic sarcoma, macroscopically mimicking a common epithelial colonic polyp, which did not match the criteria of GIST. In this case report we discuss the clinical and pathological characteristics of a rare polypoid-shaped, pleomorphic colonic sarcoma and refer a mark-off to other rare mesenchymal neoplasms of the gut.
