Medicine
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Artificial cervical disc replacement (ACDR) has been reported to be an effective and safe surgical treatment for cervical spondylosis. However, iatrogenic fracture during ACDR surgery has rarely been reported. Considering its infrequency, we report a rare clinical case, with the aim of sharing our experience and exploring when to convert ACDR to fusion intraoperatively. ⋯ Iatrogenic fracture during ACDR is rare but does occur in clinic practice. Complete examination and an alternative approach determined before surgery are important for operative safety. Anterior cervical discectomy and fusion (ACDF) is recommended as a feasible remedial surgical strategy if ACDR fails intraoperatively.
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Colorectal cancer in children is rare, with delayed diagnosis and advanced stage at presentation in high mortality. Early detection of colorectal cancer is, therefore, important for better prognosis. ⋯ We recommend early and active evaluation, including a pediatric colonoscopy, in a child with suspected malignancy.
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Bilateral discoid medial menisci is an extremely rare abnormality of the knee joint. The presence of a discoid medial meniscus has been associated with magnetic resonance imaging (MRI) and radiographic changes in the tibial region, such as cupping of the medial tibial plateau and tibial physis collapse. While discoid medial meniscal tears with hypoplasia of the femoral medial condyles have not been previously reported. Herein, we report a case of bilateral discoid medial menisci associated with meniscal tears and femoral bone changes. ⋯ This case indicates a potential link between discoid medial menisci and hypoplasia of the femoral medial condyle. We recommend preservation of the discoid medial meniscus in asymptomatic patients, while arthroscopic partial meniscectomy and reshaping is recommended in symptomatic patients.
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We report on a patient who showed neural reorganization between injured cingula and the brainstem cholinergic nuclei following cerebral concussion. ⋯ Reorganization of cholinergic innervations between cholinergic nuclei in the basal forebrain and brainstem following injury of the anterior cingulum was demonstrated in a patient with cerebral concussion.
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Narcolepsy is a rare sleep disorder with disrupted sleep-architecture. Clinical management of narcolepsy lies dominantly on symptom-driven pharmacotherapy. The treatment role of repetitive transcranial magnetic stimulation (rTMS) for narcolepsy remains unexplored. ⋯ This case indicates that rTMS may be selected as a safe and effective alternative strategy for treating narcolepsy-like symptoms. Well-designed researches are warranted in future investigations on this topic.