Tolosa Hunt Syndrome: MRI Findings.

Tolosa-Hunt syndrome (THS) is an idiopathic inflammatory condition involving the cavernous sinus and orbital apex with an incidence of 1 case per million per year. We report on a case of a 70-year-old male with atypical MRI findings, vision loss, and painless ophthalmoplegia.  Ophthalmic evaluation revealed his best-corrected visual acuity was 20/40 in the right eye and counting fingers at a 0.5-foot distance in the left eye. External examination of the left eye revealed limited ocular movement, proptosis, and a positive relative afferent pupillary defect. Complete blood count, inflammatory markers, and full biochemistry tests, including thyroid and liver function tests, were within the normal range. A magnetic resonance imaging of the orbits with and without contrast demonstrated a homogenously enhancing lesion at the posterior intraconal compartment of the left orbit, extending to the orbital apex with the involvement of the adjacent extraocular muscles. The patient was started on intravenous methylprednisolone 60 mg daily and later discharged on prednisone 5 mg daily with partial symptom improvement on follow-up. Resection and biopsy revealed a soft tissue lesion with mixed inflammatory infiltrate. The clinical, pathological, and imaging findings favored the diagnosis of THS.

Effects of lignocellulosic biomass type on the economics of hydrothermal treatment of digested sludge for solid fuel and soil amendment applications.

Digested sludge is a waste stream from anaerobic digestion (AD) in wastewater treatment plants. Hydrothermal treatment (HTT) of sludge mixed with lignocellulosic biomass is an attractive approach to improve sludge dewaterability and generate value-added products. However, process economics has not been well understood. In this study, firstly, the effect of biomass type on the energy properties of hydrochars was studied. Secondly, two scenarios were simulated to evaluate the effects of biomass type on the economics (processing 50,000 tonnes of sludge per year) of HTT of digested sludge for solid fuel and soil amendment applications. The two HTT scenarios included sludge alone and sludge-biomass mixtures (four cases for four biomass feedstocks) at 180 °C for 60 min. In both scenarios, HTT liquids were returned to existing AD facilities for biomethane production to offset the energy cost of the HTT process. The results showed that the higher heating value significantly increased from 16.0-17.0 MJ kg-1 in the sludge alone case to 18.0-23.0 MJ kg-1 in sludge-biomass mixtures (except for rice husk). With the use of saved transport cost as a revenue source, HTT of sludge-biomass led to a net present value (NPV) range of AU$ 9.9-20.3 million (20 years) and an internal rate of return (IRR) range of 25.0 %-45.2 % for solid fuel application of resulting hydrochar compared to an NPV of AU$ 18.4 million and an IRR of 55.0 % from HTT of sludge alone scenario. HTT of sludge-biomass led to a NPV range of AU$ 4.5-14.5 million and an IRR range of 17.2 %-35.7 % for soil amendment application while the hydrochar from HTT of sludge alone was not recommended for soil application due to the high contents of heavy metals. This study provides useful and critical information for process scale-up and commercialization for integration into wastewater treatment plants.