OBJECTIVE: Many patients with long COVID experience neurological and psychological symptoms. Signal abnormalities on MR images in the corpus callosum have been reported. Knowledge about the metabolic profile in the splenium of the corpus callosum (CCS) may contribute to a better understanding of the pathophysiology of long COVID. MATERIALS AND METHODS: Eighty-one subjects underwent proton MR spectroscopy examination. The metabolic concentrations of total N-acetylaspartate (NAA), choline-containing compounds (Cho), total creatine (Cr), myo-inositol (mI), and NAA/Cho in the CCS were statistically compared in the group of patients containing 58 subjects with positive IgG COVID-19 antibodies or positive SARS-CoV-2 qPCR test at least two months before the MR and the group of healthy controls containing 23 subjects with negative IgG antibodies. RESULTS: An age-dependent effect of SARS-CoV-2 on Cho concentrations in the CCS has been observed. Considering the subjective threshold of age = 40 years, older patients showed significantly increased Cho concentrations in the CCS than older healthy controls (p = 0.02). NAA, Cr, and mI were unchanged. All metabolite concentrations in the CCS of younger post-COVID-19 patients remained unaffected by SARS-CoV-2. Cho did not show any difference between symptomatic and asymptomatic patients (p = 0.91). DISCUSSION: Our results suggest that SARS-CoV-2 disproportionately increases Cho concentration in the CCS among older post-COVID-19 patients compared to younger ones. The observed changes in Cho may be related to the microstructural reorganization in the CCS also reported in diffusion measurements rather than increased membrane turnover. These changes do not seem to be related to neuropsychological problems of the post-COVID-19 patients. Further metabolic studies are recommended to confirm these observations.

• MeSH
• Choline * metabolism   MeSH
• Corpus Callosum * diagnostic imaging   metabolism   MeSH
• COVID-19 * diagnostic imaging   metabolism   MeSH
• Adult MeSH
• Inositol metabolism   MeSH
• Creatine * metabolism   MeSH
• Aspartic Acid * analogs & derivatives   metabolism   MeSH
• Middle Aged MeSH
• Humans MeSH
• Magnetic Resonance Spectroscopy methods   MeSH
• Proton Magnetic Resonance Spectroscopy * methods   MeSH
• SARS-CoV-2 * MeSH
• Aged MeSH
• Case-Control Studies MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH

Corpus callosum (CC) je největší mozková komisura spojující levou a pravou mozkovou hemisféru. Obsahuje axony, které propojují především homotopické kortikální oblasti obou hemisfér. Konvenčním MR zobrazením je CC velmi dobře přehledné a hodnotitelné. Postižení corpus callosum lze rozdělit do tří kategorií - vrozené vady, signálové změny a atrofie. První dvě zmíněné jsou na MR většinou správně rozpoznány a zhodnoceny v popisech. Atrofie CC je naproti tomu často přehlížena a připisována pouze pokročilému věku. Může však být podmíněna celou řadou patologických stavů a reflektovat postižení jak bílé, tak šedé hmoty mozkové. K primárnímu postižení bílé hmoty a atrofii CC vedou patologické stavy podmiňující demyelinizaci a následný úbytek axonů. Atrofie CC může být také sekundárním důsledkem postižení šedé hmoty mozkové, konkrétně neuronů III. korové vrstvy, jejichž zánik je následován walleriánskou degenerací axonů projikujících skrze CC. Jelikož jsou vlákna v CC topograficky uspořádána, zánik neuronů určité korové oblasti koresponduje s úbytkem vláken v příslušném segmentu CC a výsledným obrazem je regionální atrofie CC. Článek si klade za úkol nabídnout širší pohled na problematiku atrofie CC, ukázat její pestrou diferenciální diagnostiku.

Corpus callosum (CC) is the largest brain commissure interconnecting the left and right cerebral hemisphere. It consists of fibers projecting mainly to homotopical cortical regions and is well visualized on the conventional MR scans. The main types of callosal abnormalities are congenital defects, signal changes and atrophy, where the first two are rarely unnoticed and unreported - contrary to atrophy, which is frequently attributed to the old age only. Aside from age-related involution, callosal atrophy may be caused by a broad spectrum of pathological conditions damaging either white or gray matter. Demyelinating conditions lead to CC atrophy by primary damage of white matter. Loss of cortical neurons and subsequent wallerian degeneration lead to loss of axons projecting through CC and its secondary atrophy. Because fibers in CC are topographically arranged, loss of neurons in certain cortical regions corresponds to loss of fibers (and thus loss of volume) in certain segments of CC, resulting in regional callosal atrophy. The aim of this article is to provide a broader view on the atrophy of corpus callosum, present its differential diagnosis and potential practical use.

• MeSH
• Atrophy diagnostic imaging   etiology   pathology   MeSH
• Corpus Callosum * diagnostic imaging   pathology   MeSH
• Diagnosis, Differential MeSH
• Diffuse Axonal Injury diagnostic imaging   classification   pathology   MeSH
• Humans MeSH
• Magnetic Resonance Imaging MeSH
• Nervous System Diseases * diagnostic imaging   classification   pathology   MeSH
• Neurodegenerative Diseases diagnostic imaging   pathology   MeSH
• Multiple Sclerosis diagnostic imaging   pathology   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Research Support, Non-U.S. Gov't MeSH
• Review MeSH

BACKGROUND: The majority of fetal structural defects can be detected in the second trimester, thus this is the main time for screening for structural defects. 3D imaging of the fetal brain does not create a common part of this screening. METHODS: This prospective observational study was conducted at the Fetal Medicine Center of The Gynecological-Obstetrical Department of the University Hospital Olomouc in years 2017-2020. The study sample was 451 consecutively scanned morphologically normal fetuses attending for routine second trimester anatomical survey at 20-22 weeks of pregnancy. A transabdominal 3D ultrasound volume acquisition of fetal brain was obtained from an axial and sagittal plane using skull sutures as an acoustic window. RESULTS: Both the corpus callosum (CC) and the vermis (VC) were detected in 51.7% of examinations in the sagittal plane, and in 31.7% in the axial plane. In 61.9% of the examinations, there was at least partial detection in both planes. Maternal BMI was found to be the only significant predictor of the quality of imaging in both planes. CONCLUSION: 3D acquisition of fetal brain images in the sagittal plane followed by manipulation of acquired volume was valuable in assessment of corpus callosum and cerebellar vermis. This allows reconstruction of the sagittal plane that can be difficult to obtain in 2D imaging.

• MeSH
• Corpus Callosum diagnostic imaging   MeSH
• Pregnancy Trimester, Second MeSH
• Gestational Age MeSH
• Humans MeSH
• Pregnancy MeSH
• Ultrasonography, Prenatal methods   MeSH
• Cerebellar Vermis * MeSH
• Imaging, Three-Dimensional methods   MeSH
• Check Tag
• Humans MeSH
• Pregnancy MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Observational Study MeSH

Systemic infection may negatively modulate the development of cerebral white matter and long-term outcome of neonates. We analyzed the growth of corpus callosum (using cranial ultrasonography) and neurodevelopment (Bayley Scales of Infant Development, Third Edition) in 101 very low-birth-weight newborns. We observed significantly reduced corpus callosum length at 3 months of corrected age (44.5 mm vs 47.7 mm, P = .004) and diminished corpus callosum growth (0.07 mm/d vs 0.08 mm/d, P = .028) in infants who experienced systemic infection. The subgroup exhibited inferior neurodevelopmental outcomes with predominant motor impairment. The results suggest that length and growth of corpus callosum might be affected by systemic inflammatory response in preterm newborns. The changes in corpus callosum can contribute to adverse neurodevelopment at 2 years of corrected age. Serial ultrasonographic measurements of the corpus callosum may be suitable to identify preterm infants with increased risk of neurodevelopmental impairment.

• MeSH
• Corpus Callosum diagnostic imaging   growth & development   MeSH
• Causality MeSH
• Cohort Studies MeSH
• Infant MeSH
• Humans MeSH
• Follow-Up Studies MeSH
• Neurodevelopmental Disorders epidemiology   MeSH
• Infant, Premature MeSH
• Infant, Very Low Birth Weight MeSH
• Infant, Newborn MeSH
• Child, Preschool MeSH
• Prospective Studies MeSH
• Sepsis epidemiology   MeSH
• Ultrasonography methods   MeSH
• Check Tag
• Infant MeSH
• Humans MeSH
• Male MeSH
• Infant, Newborn MeSH
• Child, Preschool MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Observational Study MeSH
• Research Support, Non-U.S. Gov't MeSH

Systemic infection may negatively modulate the development of cerebral white matter and long-term outcome of neonates. We analyzed the growth of corpus callosum (using cranial ultrasonography) and neurodevelopment (Bayley Scales of Infant Development, Third Edition) in 101 very low-birth-weight newborns. We observed significantly reduced corpus callosum length at 3 months of corrected age (44.5 mm vs 47.7 mm, P = .004) and diminished corpus callosum growth (0.07 mm/d vs 0.08 mm/d, P = .028) in infants who experienced systemic infection. The subgroup exhibited inferior neurodevelopmental outcomes with predominant motor impairment. The results suggest that length and growth of corpus callosum might be affected by systemic inflammatory response in preterm newborns. The changes in corpus callosum can contribute to adverse neurodevelopment at 2 years of corrected age. Serial ultrasonographic measurements of the corpus callosum may be suitable to identify preterm infants with increased risk of neurodevelopmental impairment.

• MeSH
• Corpus Callosum diagnostic imaging   growth & development   MeSH
• Causality MeSH
• Cohort Studies MeSH
• Infant MeSH
• Humans MeSH
• Follow-Up Studies MeSH
• Neurodevelopmental Disorders epidemiology   MeSH
• Infant, Premature MeSH
• Infant, Very Low Birth Weight MeSH
• Infant, Newborn MeSH
• Child, Preschool MeSH
• Prospective Studies MeSH
• Sepsis epidemiology   MeSH
• Ultrasonography methods   MeSH
• Check Tag
• Infant MeSH
• Humans MeSH
• Male MeSH
• Infant, Newborn MeSH
• Child, Preschool MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Observational Study MeSH
• Research Support, Non-U.S. Gov't MeSH

Bi-allelic loss-of-function variants in genes that encode subunits of the adaptor protein complex 4 (AP-4) lead to prototypical yet poorly understood forms of childhood-onset and complex hereditary spastic paraplegia: SPG47 (AP4B1), SPG50 (AP4M1), SPG51 (AP4E1) and SPG52 (AP4S1). Here, we report a detailed cross-sectional analysis of clinical, imaging and molecular data of 156 patients from 101 families. Enrolled patients were of diverse ethnic backgrounds and covered a wide age range (1.0-49.3 years). While the mean age at symptom onset was 0.8 ± 0.6 years [standard deviation (SD), range 0.2-5.0], the mean age at diagnosis was 10.2 ± 8.5 years (SD, range 0.1-46.3). We define a set of core features: early-onset developmental delay with delayed motor milestones and significant speech delay (50% non-verbal); intellectual disability in the moderate to severe range; mild hypotonia in infancy followed by spastic diplegia (mean age: 8.4 ± 5.1 years, SD) and later tetraplegia (mean age: 16.1 ± 9.8 years, SD); postnatal microcephaly (83%); foot deformities (69%); and epilepsy (66%) that is intractable in a subset. At last follow-up, 36% ambulated with assistance (mean age: 8.9 ± 6.4 years, SD) and 54% were wheelchair-dependent (mean age: 13.4 ± 9.8 years, SD). Episodes of stereotypic laughing, possibly consistent with a pseudobulbar affect, were found in 56% of patients. Key features on neuroimaging include a thin corpus callosum (90%), ventriculomegaly (65%) often with colpocephaly, and periventricular white-matter signal abnormalities (68%). Iron deposition and polymicrogyria were found in a subset of patients. AP4B1-associated SPG47 and AP4M1-associated SPG50 accounted for the majority of cases. About two-thirds of patients were born to consanguineous parents, and 82% carried homozygous variants. Over 70 unique variants were present, the majority of which are frameshift or nonsense mutations. To track disease progression across the age spectrum, we defined the relationship between disease severity as measured by several rating scales and disease duration. We found that the presence of epilepsy, which manifested before the age of 3 years in the majority of patients, was associated with worse motor outcomes. Exploring genotype-phenotype correlations, we found that disease severity and major phenotypes were equally distributed among the four subtypes, establishing that SPG47, SPG50, SPG51 and SPG52 share a common phenotype, an 'AP-4 deficiency syndrome'. By delineating the core clinical, imaging, and molecular features of AP-4-associated hereditary spastic paraplegia across the age spectrum our results will facilitate early diagnosis, enable counselling and anticipatory guidance of affected families and help define endpoints for future interventional trials.

• MeSH
• Adaptor Protein Complex 4 genetics   MeSH
• Corpus Callosum diagnostic imaging   MeSH
• Child MeSH
• Adult MeSH
• Cohort Studies MeSH
• Infant MeSH
• Middle Aged MeSH
• Humans MeSH
• Magnetic Resonance Imaging methods   trends   MeSH
• Adolescent MeSH
• Young Adult MeSH
• Child, Preschool MeSH
• Cross-Sectional Studies MeSH
• Registries MeSH
• Spastic Paraplegia, Hereditary diagnostic imaging   genetics   MeSH
• Check Tag
• Child MeSH
• Adult MeSH
• Infant MeSH
• Middle Aged MeSH
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH
• Male MeSH
• Child, Preschool MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH
• Research Support, N.I.H., Extramural MeSH

Cytotoxické léze corpus callosum (cytotoxic lesions of the corpus callosum; CLOCCs) reprezentují skupinu stavů, které způsobují změny intenzity signálu v corpus callosum na MR. Etiologie tohoto jevu je velmi heterogenní. CLOCCs jsou asociovány se spektrem metabolických chorob, lékovou terapií, infekcemi, epileptickými záchvaty a mnoha jinými příčinami. Zdá se, že tyto léze jsou důsledkem stereotypní zánětlivé kaskády, která vede k masivnímu zvýšení hladin extracelulárního glutamátu. Konečným výsledkem je rozvoj cytotoxického edému. Škála klinických projevů je velmi rozmanitá. Neurologické symptomy zahrnují postižení hybnosti a/nebo citlivosti, kognitivní deficit, změny chování, závratě, poruchu vědomí a další. Hlavní diagnostickou metodou je MR, především difuzívážené zobrazení, na kterém se CLOCCs manifestují jako oblasti s restrikcí difuze. CLOCCs jsou ve většině případů reverzibilní. Prognóza a léčba obvykle závisí na etiologii, ale výsledný klinický stav bývá příznivý. Lékaři by měli být s touto nedávnou pojmenovanou diagnózou obeznámeni, především proto, že většina vyvolávajících příčin je léčitelná. V tomto sdělení shrnujeme dosavadní poznatky a prezentujeme pět případů CLOCCs.

Cytotoxic lesions of the corpus callosum (CLOCCs) represent a group of conditions that cause MRI signal intensity changes in the corpus callosum. Etiology of this phenomenon is very heterogenous. CLOCCs are associated with a spectrum of metabolic disorders, drug therapy, infections, epileptic seizures and many other causes. It appears that these lesions result from a stereotyped inflammatory cascade which leads to a massive increase in levels of extracellular glutamate. The final result is development of cytotoxic edema. The range of clinical features is very wide. Neurological symptoms include motor and/or sensory involvement, cognitive decline, behavioral changes, dizziness, loss of consciousness and others. The main diagnostic tool is MRI, especially diffusion-weighted images, where CLOCCs manifest as regions of restricted diffusion. CLOCCs are reversible in most cases. Prognosis and treatment generally depend on the etiology, but clinical outcome is usually favorable. Physicians should be familiar with this recently named diagnosis, primarily because most of the underlying causes are treatable. In this article, we summarize the current knowledge and describe five cases of CLOCCs.

• Keywords
• restrikce difuze, reverzibilní léze,
• MeSH
• Corpus Callosum * diagnostic imaging   pathology   MeSH
• Brain Edema diagnostic imaging   etiology   pathology   MeSH
• Humans MeSH
• Magnetic Resonance Imaging methods   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Research Support, Non-U.S. Gov't MeSH
• Review MeSH

MERS - mírná encefalopatie s reverzibilní lézí splenia corporis callosi (SCC) je klinicko‑radiologický syndrom charakterizovaný akutní mírnou encefalopatií a reverzibilními změnami SCC při zobrazování magnetickou rezonancí mozku s difuzně váženým zobrazením (DWI). Bývá popisován v souvislosti s infekcí, především virovou. Prognóza je obecně příznivá. Většina pacientů má úplné vymizení příznaků během jednoho měsíce bez dlouhodobých neurologických následků. Prezentujeme případ desetiletého chlapce s náhle vzniklou dysartrií a klinicko‑radiologickým obrazem shodujícím se s tímto syndromem.

MERS - Mild encephalopathy with reversible splenial lesion of the corpus callosum is a clinical-radiological syndrome characterized by acute mild encephalopathy and reversible SCC changes in diffusion-weighted MRI (DWI) of the brain. It is described in connection with infection, especially viral. The prognosis is generally favourable. Most patients have complete resolution of symptoms within one month without long-term neurological sequelae. We present a case of a ten-year-old boy with sudden dysarthria and a clinical-radiological image which is consistent with this syndrome.

• Keywords
• mírná encefalopatie s reverzibilní lézí splenia corporis callosi,
• MeSH
• Agenesis of Corpus Callosum * diagnostic imaging   diagnosis   complications   MeSH
• Encephalomyelitis, Acute Disseminated diagnostic imaging   diagnosis   MeSH
• Corpus Callosum anatomy & histology   diagnostic imaging   pathology   MeSH
• Diagnosis, Differential MeSH
• Child MeSH
• Dysarthria etiology   complications   MeSH
• Encephalitis complications   MeSH
• Humans MeSH
• Brain Diseases * diagnostic imaging   physiopathology   therapy   MeSH
• Remission, Spontaneous MeSH
• Treatment Outcome MeSH
• Check Tag
• Child MeSH
• Humans MeSH
• Male MeSH
• Publication type
• Case Reports MeSH

BACKGROUND: Volumetric MRI surrogate markers of disease progression are lacking. OBJECTIVE: To establish cut-off values of brain volume loss able to discriminate between healthy controls and MS patients. METHODS: In total, 386 patients after first demyelinating event suggestive of MS (CIS), 964 relapsing-remitting MS (RRMS) patients, 63 secondary-progressive MS (SPMS) patients and 58 healthy controls were included in this longitudinal study. A total of 11,438 MRI scans performed on the same MRI scanner with the same protocol were analysed. Annualised percentage changes of whole brain, grey matter, thalamus and corpus callosum volumes were estimated. We investigated cut-offs able to discriminate between healthy controls and MS patients. RESULTS: At a predefined specificity of 90%, the annualised percentage change cut-off of corpus callosum volume (-0.57%) was able to distinguish between healthy controls and patients with the highest sensitivity (51% in CIS, 48% in RRMS and 42% in SPMS patients). Lower sensitivities (22%-49%) were found for cut-offs of whole brain, grey matter and thalamic volume loss. Among CIS and RRMS patients, cut-offs were associated with greater accumulation of disability. CONCLUSION: We identified cut-offs of annualised global and regional brain volume loss rates able to discriminate between healthy controls and MS patients.

• MeSH
• Atrophy pathology   MeSH
• Corpus Callosum diagnostic imaging   pathology   MeSH
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Longitudinal Studies MeSH
• Magnetic Resonance Imaging standards   MeSH
• Adolescent MeSH
• Young Adult MeSH
• Brain diagnostic imaging   pathology   MeSH
• Disease Progression * MeSH
• Multiple Sclerosis diagnosis   diagnostic imaging   pathology   MeSH
• Gray Matter diagnostic imaging   pathology   MeSH
• Aged MeSH
• Sensitivity and Specificity MeSH
• Thalamus diagnostic imaging   pathology   MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Observational Study MeSH
• Research Support, Non-U.S. Gov't MeSH

Primární nádory srdce jsou vzácná onemocnění s výskytem kolem 0,02 % v dospělé populaci. V 25 % se jedná o tumory maligní, z nichž naprostou většinu představují sarkomy. Vedle nespecifických příznaků, jako je hubnutí, nechutenství či únava, se srdeční nádory mohou projevovat arytmií, srdečním selháváním nebo embolizační příhodou. Naše kazuistika popisuje primární lymfom srdce (PLS) vycházející z pravé komory a pravé síně, který se manifestoval malou plicní embolií. Při standardní léčbě nízkomolekulárním heparinem došlo ke vzniku perikardiálního výpotku s progresí do tamponády srdeční, která si vyžádala urgentní perikardiocentézu. V diagnostice srdečního nádoru hrála významnou roli magnetická rezonance (MR) srdce, kde bylo vysloveno podezření na lymfom. Konečná diagnóza difuzního velkobuněčného B-lymfomu byla stanovena histologicky z tkáně odebrané endomyokardiální biopsií. Doplňující vyšetření pozitronovou emisní tomografií (PET) a trepanobiopsií neprokázala extrakardiální lokalizaci tumoru. Následovala krátkodobě úspěšná chemoterapie s kompletní regresí nádoru. Po pěti měsících od posledního cyklu chemoterapie nicméně došlo k recidivě lymfomu v oblasti zadní části pravé postranní komory mozkové a splenium corporis callosi. K vyloučení nádorové duplicity bylo přistoupeno k odběru tumorózní tkáně metodou stereotaktické biopsie, při níž došlo ke krvácení s provalením do mozkových komor a následným exitus letalis.

Primary cardiac tumors are a rare disease, their incidence is around 0.02% in adults. Only 25% of primary cardiac tumors are malign and, of these, most are sarcomas. Symptoms include loss of weight, loss of apetite, fatique, thromboembolism, heart failure or arrhythmias. Our case report describes a primary cardiac lymphoma from the right atrium and the right ventricle that presented with a small pulmonary embolism. Administration of the low molecular weight heparin led into a pericardial effusion followed by the cardiac tamponade requiring an urgent pericardiocentesis. Cardiac magnetic resonance imaging (MR) was crucial in the diagnostic process as the imaging modality making an initial diagnosis. Histologic examination from the endomyocardial biopsy demonstrated a diffuse large B-cell lymphoma. Total-body pozitrone emission tomography (PET) and bone marrow biopsy confirmed a localized cardiac tumor. The patient received a targeted chemotherapy which led to the complete regression of the tumor. However, five months after the last cycle of chemotherapy, the lymfoma relapsed in the posterior part of the right lateral brain ventricle and in the area of splenium corporis callosi. To rule out the tumor duplicity, a stereotactic brain biopsy was performed. Unfortunately, it was complicated with an intracerebral bleeding followed by the patient‘s death.

• MeSH
• Biopsy adverse effects   MeSH
• Chest Pain etiology   MeSH
• Corpus Callosum diagnostic imaging   pathology   MeSH
• Lymphoma, Large B-Cell, Diffuse * diagnosis   drug therapy   MeSH
• Echocardiography MeSH
• Fatal Outcome MeSH
• Heparin, Low-Molecular-Weight therapeutic use   MeSH
• Intracranial Hemorrhages diagnostic imaging   etiology   MeSH
• Humans MeSH
• Magnetic Resonance Imaging MeSH
• Cerebral Ventricle Neoplasms diagnostic imaging   secondary   MeSH
• Heart Neoplasms * diagnostic imaging   epidemiology   drug therapy   pathology   MeSH
• Pericardial Effusion diagnostic imaging   therapy   MeSH
• Pericardiocentesis MeSH
• Positron Emission Tomography Computed Tomography MeSH
• Pulmonary Embolism diagnosis   etiology   drug therapy   MeSH
• Recurrence MeSH
• Aged MeSH
• Cardiac Tamponade therapy   MeSH
• Rare Diseases diagnostic imaging   epidemiology   drug therapy   pathology   MeSH
• Confusion etiology   MeSH
• Check Tag
• Humans MeSH
• Male MeSH
• Aged MeSH
• Publication type
• Case Reports MeSH