Sturge weber syndrome: A case report.

This report presents a 14-year-old male with seizures and facial port-wine stains, who upon further evaluation was found to have SWS. Early diagnosis and consistent treatment of Sturge-Weber syndrome in children are essential to prevent seizures and improve quality of life. Anti-seizure medications play a crucial role in preventing and controlling seizures.

Effect of "T2-rim sign" related parameters on high-intensity focused ultrasound ablation of uterine fibroids.

PURPOSE: To investigate the effect of "high-signal-intensity peripheral rim on T2-weighted MR images (T2-rim sign)" related parameters on non-perfused volume ratio (NPVR) after high-intensity focused ultrasound (HIFU) ablation of uterine fibroids. METHODS: Data from 616 patients with uterine fibroids treated with HIFU were retrospectively analyzed. Univariate and multivariate logistic regression was used to analyze the factors influencing the ablation effect. The effect of T2-rim sign on ablation parameters and results was also analyzed. Spearman correlation analysis was used to compare the correlation between coverage ratio, average thickness of T2-rim sign and NPVR in 207 cases of fibroids with T2-rim sign. RESULTS: The presence of T2-rim sign was an independent risk factor affecting the ablation effect. The coverage ratio of T2-rim sign was negatively correlated with treatment efficiency (r = -0.174, p = 0.012) and NPVR (r = -0.186, p = 0.007), and positively correlated with energy efficiency factor (EEF) (r = 0.156, p = 0.024). The average thickness of T2-rim sign was positively correlated with treatment intensity (r = 0.203, p = 0.003) and negatively correlated with NPVR (r = -0.363, p < 0.001). There was a negative correlation between the average thickness of the T2-rim sign and NPVR in isointense fibroids (r = -0.484, p < 0.001). CONCLUSION: The presence of T2-rim sign increases the difficulty of ablation and reduces the ablation effect. In clinical practice, the presence and related parameters of T2-rim sign should be fully considered when screening for HIFU indications and formulating treatment plans.

Prevention of Argentinian flag sign in intumescent cataracts using anterior chamber air bubble and cortical fluid release techniques.

BACKGROUND: To investigate the efficiency of a new method for the prevention of argentinian flag sign during the process of continuous, circular, and centered anterior capsulotomy (CCC) on the anterior capsule in cortically liquefied intumescent cataracts. This study was registered in an appropriate registry and the registration number of registration was xyy11[2022]-XJSFX-087; The date of of registration was 2022-04-29. METHODS: Preoperative examinations including slit-lamp examination, ocular A-scan ultrasonography, and Ultrasound Biomicroscopy (UBM) UBM were conducted on 61 patients with intumescent cataracts. Cases with cortically liquefied intumescent cataracts were selected and after staining with indocyanine green, the anterior chamber air bubble technique was used to compress the anterior capsule, and liquefied cortex was aspirated using a puncture needle. Corrected Distance Visual Acuity (CDVA) and intraocular pressure were recorded on postoperative days 1, 1 week, 1 month, and 6 months. Intraoperative and postoperative complications were documented and analyzed. RESULTS: Fifty eyes were identified as having cortically liquefied intumescent cataracts. No cases of the Argentinian flag sign occurred, and standard capsulorrhexis was achieved, facilitating smooth phacoemulsification. All patients achieved satisfactory outcomes at follow-ups of 1 day, 1 week, 1 month, and 6 months postoperatively. Mild corneal edema was observed in three cases on the first postoperative day, with no other complications noted. CONCLUSIONS: The anterior chamber air bubble technique combined with cortical fluid release technique can prevent the occurrence of the Argentinian flag sign in cortically liquefied intumescent cataracts, this method is simple, convenient and economic for the clinical promotion.

Progressive Dysphagia in Joubert Syndrome: A Report of a Rare Case.

Joubert syndrome is an uncommon, autosomal recessive disorder characterized by abnormal brain development involving the underdevelopment or absence of the cerebellar vermis. The classic clinical features include developmental delays, hypotonia, abnormal eye movements, and hyperpnea. On brain magnetic resonance imaging (MRI), an essential finding for the diagnosis of Joubert syndrome is a cerebellar and brainstem malformation called the molar tooth sign, characterized by a hypoplastic cerebellar vermis with dysplasia of the superior cerebellar peduncles. Here, we describe a case of a two-month-old female with an atypical presentation of Joubert syndrome. Her initial clinical presentation included respiratory distress and concerns for reflux complicated with aspiration pneumonia. Early recognition of clinical and radiologic findings for Joubert syndrome enables an early diagnosis, and therefore timely interventions for improving the child's development and quality of life.

Hepatic portal venous gas after ingesting glyphosate: A case report and literature review.

Background: Glyphosate is a widely used herbicide. Clinical presentations of glyphosate intoxication show variation, but hepatic portal venous gas(HPVG) caused by glyphosate poisoning is rarely reported. Herein, we report a rare case of ominous HPVG after ingesting glyphosate. HPVG, which used to be an ominous abdominal radiologic sign, is associated with numerous underlying abdominal pathologies, ranging from benign conditions that require no invasive treatment to potentially lethal diseases that necessitate prompt surgical intervention. Case summary: A young woman who ingested 100 mL glyphosate 6-h prior was admitted to the emergency intensive care unit. Before admission to our hospital, the patient was administered gastric lavage treatment with 10000 mL of normal saline in the local hospital. After 14 h, her laboratory examinations showed systemic inflammatory response syndrome and multiple organ dysfunction syndrome, while the condition deteriorated. Computed tomography of the abdomen showed multilinear air densities in the portal vein, hepatic branches, and mesenteric vessels, intestinal obstruction, and intestinal necrosis. Septic shock and a severe abdominal infection were diagnosed. The patient was treated conservatively as they could not tolerate surgery and, after 20 h died of septic shock. Conclusion: We reviewed 289 cases of "hepatic portal venous gas" in PUBMED and analyzed the etiology and treatment of HPVG accompanied by the underlying pathology. We concluded that HPVG is a radiological sign associated with various diseases, and the prognosis mainly depends on the underlying cause and clinical condition. As glyphosate may erode the digestive tract, attention should be paid to the volume, pressure, and speed of gastric lavage in treating glyphosate poisoning to avoid fatal complications such as HPVG. Abdominal symptoms need to be closely observed, and changes in the early onset of the condition in clinical practice need to be responded to promptly.

Ultrasonographic evaluation of fetal posterior fossa anomalies: Six years experience of a tertiary center.

PURPOSE: The aim of this study is to reveal ultrasonographic features, associated anomalies and genetic errors in posterior fossa anomalies. As secondary aim postnatal outcomes of the cases were reviewed. METHODS: We conducted a retrospective case series from 2018 to 2024 involving fetuses with posterior fossa anomalies (PFA). Terminated cases confirmed by radiologic and postmortem pathologic findings and cases confirmed by postnatal clinical findings were included in the study. RESULTS: A total of 138 cases were included. In 81 (59%) cases there were multipl anomalies including cranial anomalies other than posterior fossa in 31 (22%) and non-central nerve system anomalies in 69 (50%) cases. Of the 94 cases born, 28 (20%) died within a median of 2 months, within 1.5 years at the latest. Of the 66 (48%) cases still living, 30 (22%) have neurodevelopmental delay in Denver II Turkish standardized test. CONCLUSIONS: It is crucial to have accurate and standardized prenatal classification and a multidisciplinary approach in fetuses with PFA. Specific ultrasonographic findings may be diagnostic especially where fetal MRI is not always available. We offer "arrow sign" to be tested whether it is accurate to diagnose Joubert syndrome by ultrasonography.

A Large Sigmoid Pseudo-Pedunculated Lipoma Mimicking an Adenoma: A Report of a Rare Case and Literature Review.

Large colonic lipomas exceeding 2.0 cm in size may rarely mimic colorectal adenomas and hence we referred to such lipomas as pseudo-pedunculated lipomas. They can exhibit surface erosions, fissure ulcerations, and mucosal erythema and can pose diagnostic dilemmas during colonoscopy. Our patient presented with iron deficiency anaemia and a positive faecal immunochemical test, a rare but recognised presentation of pseudo-pedunculated lipomas. Available advanced and refined procedures made endoscopic removal of large and even giant, symptomatic, pedunculated lipomas safe and should be the standard of care, while surgical intervention is rarely necessary. Nonetheless, utmost care must be exercised during endoscopic resection due to the high current needed to snare such large lesions to avoid deep thermal injury and perforation. Our case showed that large lipomas can be misinterpreted during endoscopy as adenomas. In experienced hands, endoscopic removal is safe and attainable.

Is the ulnar fovea sign positive only in foveal tears of the triangular fibrocartilage complex?

A positive ulnar fovea sign is usually considered to be specific for foveal disruption of the distal radioulnar ligaments. A retrospective review was done of 73 patients with a positive ulnar fovea sign. Only 21 patients had a foveal tear on arthroscopic examination.Level of evidence: IV.

Multiple Intussusceptions with multiple polyps as identifiable lead point: A curious case report.

Intussusception is a condition in which the proximal segment of the bowel telescopes into the distal segment. 90% of the cases, especially in infants and toddlers, do not have any lead point and are due to lymphoid hypertrophy, following a viral infection. The presence of polyps in the form of lead point in children is rare. In fact, multiple polyps presenting as multiple sites intussusception are much rarer. We report a case of multiple intussusceptions in a 11-year-old female who presented with complaints of pain abdomen and blood-mixed stool. On imaging examination, she was found to having multiple polyps serving as a possible lead point, and was managed with hydroreduction. Imaging in case of multiple intussusception typically reveals concentric rings of bowel within the bowel giving a "target sign" on axial scans and a "pseudo-kidney sign" on coronal/sagittal CT scans. Our case report shows that, multiple intussusception due to multiple polyps can be a possibility for acute pain abdomen in children.

Understanding the shift to compulsion in addiction: insights from personality traits, social factors, and neurobiology.

Compulsion stands as a central symptom of drug addiction; however, only a small fraction of individuals who use drugs exhibit compulsive characteristics. Differences observed in Sign-trackers (ST) and Goal-trackers (GT) during Pavlovian conditioning may shed light on individual variances in drug addiction. Here, we focus on the behavioral attributes, formation processes, and neural mechanisms underlying ST and how they drive addiction toward compulsivity in humans. We will explore addiction from three interconnected levels: individual personality traits, social factors, and neurobiology. Furthermore, we distinguish between the processes of sensitization and habituation within ST. These nuanced distinctions across various aspects of addiction will contribute to our understanding of the addiction development process and the formulation of targeted preventive strategies.

Tension Pneumocephalus Caused by a Communicating Pneumothorax via a Nerve Root Avulsion.

Tension pneumocephalus (TP) is an unusual and potentially life-threatening condition characterized by a large volume of intracranial air causing compression and displacement of the underlying cerebral cortex. The symptoms of TP are non-specific. Diagnosis is generally made by demonstration of the classic "Mount Fuji" sign on computed tomography imaging. TP is most commonly seen in the early postoperative period after craniotomy or trauma involving fractures through the pneumatized sinuses. We present a rare case of TP which resulted from an inadequately decompressed pneumothorax communicating with root avulsions of C8 and T1.

Dual-Mode Embedded Impulse-Radio Ultra-Wideband Radar System for Biomedical Applications.

This paper presents a real-time and non-contact dual-mode embedded impulse-radio (IR) ultra-wideband (UWB) radar system designed for microwave imaging and vital sign applications. The system is fully customized and composed of three main components, an RF front-end transmission block, an analog signal processing (ASP) block, and a digital processing block, which are integrated in an embedded system. The ASP block enables dual-path receiving for image construction and vital sign detection, while the digital part deals with the inverse scattering and direct current (DC) offset issues. The self-calibration technique is also incorporated into the algorithm to adjust the DC level of each antenna for DC offset compensation. The experimental results demonstrate that the IR-UWB radar, based on the proposed algorithm, successfully detected the 2D image profile of the object as confirmed by numerical derivation. In addition, the radar can wirelessly monitor vital sign behavior such as respiration and heartbeat information.

A Vision-Language Model-Based Traffic Sign Detection Method for High-Resolution Drone Images: A Case Study in Guyuan, China.

As a fundamental element of the transportation system, traffic signs are widely used to guide traffic behaviors. In recent years, drones have emerged as an important tool for monitoring the conditions of traffic signs. However, the existing image processing technique is heavily reliant on image annotations. It is time consuming to build a high-quality dataset with diverse training images and human annotations. In this paper, we introduce the utilization of Vision-language Models (VLMs) in the traffic sign detection task. Without the need for discrete image labels, the rapid deployment is fulfilled by the multi-modal learning and large-scale pretrained networks. First, we compile a keyword dictionary to explain traffic signs. The Chinese national standard is used to suggest the shape and color information. Our program conducts Bootstrapping Language-image Pretraining v2 (BLIPv2) to translate representative images into text descriptions. Second, a Contrastive Language-image Pretraining (CLIP) framework is applied to characterize not only drone images but also text descriptions. Our method utilizes the pretrained encoder network to create visual features and word embeddings. Third, the category of each traffic sign is predicted according to the similarity between drone images and keywords. Cosine distance and softmax function are performed to calculate the class probability distribution. To evaluate the performance, we apply the proposed method in a practical application. The drone images captured from Guyuan, China, are employed to record the conditions of traffic signs. Further experiments include two widely used public datasets. The calculation results indicate that our vision-language model-based method has an acceptable prediction accuracy and low training cost.

Beyond the billboard: A review of other external sources of driver distraction.

Road corridors contain countless sources of distraction, each carrying the potential to draw drivers' eyes and minds off roads, thus increasing the risk of a crash. While the impact of billboards on driver distraction has received considerable attention, empirical data for other types of roadside advertising signs is very limited. Furthermore, the existing research examining other potential external sources of distraction is fragmentary, which makes it difficult to develop evidence-based road safety policies to mitigate risk. Therefore, the aim of this study was to conduct an exploratory review to ascertain and synthesise the available distraction-related literature for various types of roadside advertising signs (excluding billboards) and other potential external sources of distraction in the road corridor. Based on distraction-related theory and existing literature, 58 predefined categories of potential distraction sources were developed to guide an exploratory literature search using the Scopus database. Fourteen documents relating to external distraction sources were identified in the database search with a further five studies found using a backwards citation chaining search (N=19). However, no studies for non-billboard types of roadside advertising signs were found. Studies included those that investigated driver distraction in relation to construction zones, commercial logos contained within official traffic management Dynamic Message Signs (DMS) and service (logo) signs, drones, murals, roadside memorials and wind turbines. While one study investigated whether an external source of distraction can have a positive effect on driver behaviour, the remainder focused on the potential negative impacts on road safety of these sources of distraction. A key finding of the review is that crash risk increases when drivers continue to visually and cognitively engage with a source of distraction. Overall, the studies provide insights into the types of distractions that can be encountered in road corridors and the impact they can have on driver behaviour. However, more research is required before the mechanisms and pathways involved in these types of distractions can be effectively conceptualised, and thereby mitigated to reduce the burden of distraction risk and road trauma.

Hypomagnesemia Is Associated with the Skull CT Black Hole Sign in Patients with Spontaneous Intracerebral Hemorrhage.

OBJECTIVES: The evaluation of hypomagnesemia's significance in predicting the presence of the black hole sign in patients with intracranial hemorrhage (ICH) is currently under investigation. METHODS: The study included 261 patients with cerebral hemorrhage who underwent initial skull computed tomography (CT) within 24 hours of admission.Sixty-nine patients (26.4%) exhibited hypomagnesemia in the initial laboratory examinations. The black hole sign was observed in 123 patients (referred to as the black hole sign group, which includes patients with and without hypomagnesemia), while the remaining 138 patients (non-black hole sign group) did not exhibit this feature. The values of hypomagnesemia were assessed through multivariable logistic regression analyses. RESULTS: The black hole sign occurred in 45 of the 69 (65.2%) patients with hypomagnesemia, and in 78 of the 192 (40.6%) patients without hypomagnesemia.In the black hole sign group, hypomagnesemia was observed in 45 patients (36.6%). However, only 24 patients (19.5%) from the normal magnesium concentration group exhibited hypomagnesemia.The sensitivity, specificity, and positive and negative predictive values of hypomagnesemia for predicting the black hole sign were 69.9%, 82.5%, 36.6%, and 82.8% respectively.The odds ratios for hypomagnesemia, smoking history, and hypokalemia in predicting the presence of the black hole sign were 2.74, 1.971, and 1.629 correspondingly. CONCLUSIONS: The presence of hypomagnesemia may serve as a predictive factor for the black hole sign and rebleeding in patients with intracerebral hemorrhage (ICH), thereby providing valuable guidance for clinical treatment.

MOG-antibody-associated transverse myelitis with the H-sign and unusual MRI enhancement: a case report and literature review.

Transverse myelitis is the second most common symptoms in myelin oligodendrocyte antibody-associated diseases (MOGAD), causing obvious clinical manifestation. T2-hyperintense lesions mainly restricted to the gray matter in the spinal cord on axial magnetic resonance imaging, produce the H-sign, which is thought to be the typical finding of MOGAD. Contrast enhancement can be observed in some cases of myelin oligodendrocyte antibody-associated transverse myelitis (MOG-TM). However, reports on the enhancement pattern associated with the H-sign are rarely seen. In this report, we describe a case of pediatric MOG-TM in which the H-sign was observed without enhancement, while the surrounding white matter exhibited enhancement. This pattern contradicts the previously observed gray matter involvement. Then we reviewed the literatures of myelin oligodendrocyte antibody-positive myelitis to focus on the neuroimaging features and discuss the implications of our finding.

Information density threshold of urban road traffic signs based on visual comfort.

The content and density of traffic signs directly affect the operation of urban road traffic and drivers. To overcome the limitations of quantitative research on the density threshold of traffic signs on urban roads, a real vehicle experiment was conducted to record the psychological characteristics of drivers. Four psychological parameters of drivers-pupil area, fixation intensity, heart rate change rate, and heart rate variability-were explored. Subsequently, principal component analysis was used to present a new index, S, divided into 5 grade scales, to represent the driving visual comfort level. The information entropy theory was applied to quantify the amount of information on road traffic signs that are included in driving tests, and a regression relationship between the traffic sign information and comfort index S was established. The visual psychological load thresholds for different comfort levels were -2.289≤S < -1.526 for very comfortable, 1.526≤S < -0.763 for relatively comfortable, -0.763≤S ≤ 0.763 for comfortable, 0.763

Cleft Sign in MRI May Represent the Disruption of Cartilage Structure within Pubic Symphysis and Pubic Plate: A Cadaver Case Report.

BACKGROUND/OBJECTIVES: Long-standing groin pain is a severe issue for athletes, often associated with the cleft sign on magnetic resonance imaging (MRI) scans, yet its underlying causes are poorly understood. The purpose of this study is to histologically examine the pubic plate structure in cadavers with and without the cleft sign on MRI, shedding light on the pathology behind the cleft sign. METHODS: Three fresh human pelvic cadavers underwent 3.0T MRI to detect the cleft sign before histological dissection of pubic plates. Pubic plate tissues were fixed in formalin, decalcified, and processed. Of the two cleft sign-negative specimens, one was cut into sagittal sections, and the other was cut into coronal sections for histology. For the cleft sign positive specimen, a sagittal section was cut. Moreover, 5 µm thick sections were cut at different axial levels for each orientation. Sections were subjected to Safranin O, Alcian blue, and Herovici's staining or hematoxylin and eosin staining. RESULTS: MRI confirmed that one specimen had a cleft sign in the inferior region on both sides of the pubis and that two specimens had no cleft sign. Both sagittal and coronal sections showed the presence of a cartilage structure continuing from the pubic symphysis to 3 mm laterally within the pubic plate. In the specimen with a positive cleft sign, cartilage damage within the pubic symphysis and pubic plate was identified as revealed by Safranin O staining, Herovici's staining, and H&E staining. CONCLUSIONS: This study elucidated the existence of a cartilage component extending from the pubic symphysis to the pubic plate. The cleft sign in MRI correlated with a disruption in the cartilage component in histology within this specific area.

Insights into Population Status and Habitat Patches of Conservation Concern for the Endangered Indian Pangolin (Manis crassicaudata) in Nowshera District, Northwestern Pakistan.

The Indian pangolin (Manis crassicaudata) stands out among the four surviving species of Asian pangolins, being the sole species present in Pakistan and listed as endangered owing to trafficking and illicit commerce. In the present study, we explored the population status of the Indian pangolin and the existing suitable habitats in Nowshera district, Pakistan. We employed the line transect method to confirm the species presence and subsequent population estimation. In a survey effort of 156 km2, a total of 56 signs of Indian pangolin were recorded within the research area. Amongst the 56 signs, 46 were burrows (living burrows (53.57%) and feeding burrows (28.57%)). Digging was observed nine (16.07%) times, along with one direct sighting (1.7%). Our results revealed a population estimate of only 29 pangolins in the Nowshera district, with a population density of 0.013 individuals/km2. Later, MaxEnt was applied to the species' presence points, along with climatic and topographical variables. The MaxEnt model accuracy was good (AUC = 0.811). Of the total area studied, 210 km2 (12.01%) were highly suitable and 238 km2 (13.61%) were moderately suitable habitat for the Indian pangolin. To safeguard the fragile population and habitat of the Indian pangolin, we highly suggest strengthening watch and ward and law enforcement in the study area. By adopting a comprehensive approach that addresses both the direct threats to Indian pangolins and the underlying factors driving their decline, we can effectively protect this endangered species and ensure the preservation of its essential habitats for robust conservation.