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Example of successful ET-GP ablation without PVI. One hundred thirty-five sites were tested with synchronized HFS; 16.5 minutes of RF ablation was performed on 13 ET-GPs. PVs remained electrically connected. Pacemaker interrogation after 12 months showed no evidence of atrial arrhythmia since ET-GP ablation. The patient has remained symptom free and off all antiarrhythmic drugs. AP = anterior posterior; AF = atrial fibrillation; AT = atrial tachycardia; ET-GP = ectopy-triggering ganglionated plexuses; GP = ganglionated plexuses; HFS = high frequency stimulation; LAA = left atrial appendage; LIPV = left inferior pulmonary vein; LSPV = left superior pulmonary vein; PA = posterior anterior; PV = pulmonary vein; RAO = right anterior oblique; RF = radiofrequency; RIPV = right inferior pulmonary vein; RSPV = right superior pulmonary vein.

A 62-year-old male patient with advanced undernutrition caused by a multiple system atrophy for at least 3 years was referred to our tertiary center for PRG. The PRG procedure was performed under local anesthesia with fluoroscopic guidance after informed consent of the patient.

Fluoroscopic image (A) showing the opacification of the pseudoaneurysm (black arrow) by direct puncture with the 22G needle (white arrow) in contact with the gastrostomy tube (blue arrows). The fluoroscopic control image (B) shows the complete opacification of the aneurysm (arrowhead) with injection of a 0.5 ml mixture of Lipiodol and Glubran 2 (ratio 1/1).

Abdominal CT scan without injection in axial section (A) confirms the complete filling of the pseudoaneurysm with the Lipiodol/Glubran2 mixture (white arrow). The coronal section scan (B) injected at arterial time shows the preserved permeability of the upper epigastric artery (dotted arrow).

HE deteriorated in 2 (10%) out of 10 patients who received and 6 (30%) out of 10 patients who did not receive mannitol. HE deterioration was not significantly different between patients who received and those who did not receive mannitol (1-sided Fisher’s exact = 0.085).

A ventilation and perfusion lung scan was performed. Analysis of the perfusion images revealed multiple mismatched segmental/subsegmental defects (particularly in the right lung) and matched non-segmental defects along the periphery of both lungs (A). Analysis of the ventilation images revealed moderate heterogeneity of tracer deposition with retention of radiotracer in the central bronchi and several areas of diminished ventilation along the periphery of both lungs (B). Both images are of the anterior view.

8-Week-old mice were anesthetized by isoflurane inhalation anesthesia. The right femur was then shaved and scrubbed with betadine. All instruments and pin implants were sterilized before use. A 1 cm surgical incision was made over the anterolateral distal femur to expose the mid-point femur. A mid-shaft transverse fracture was made using a sharp scalpel. A 24-gauge stainless-steel pin was passed into the intramedullary canal to stabilize the fracture with the keen flexed. Radiographs were taken immediately after surgery and before sacrifice to confirm pin placement and fracture pattern. Animals were given buprenorphine (0.05 mg/kg) to alleviate any surgical pain. Sutures were checked daily for 3 days and removed on day 7.

We considered a “clinical case” (C) as an illness of variable severity manifested by enteric signs with presence of Salmonella and in absence of isolation of other enteric pathogens. When Salmonella isolation occurred and no enteric signs were shown the condition was referred as a “non-clinical case” (NC).

(A) Transabdominal scan performed at 25 weeks 4 days in coronal plane: the cleft lip appeared as an anhecogenic area at the level of the left upper lip. (B) Transverse section of fetal chest at 25 weeks 4 days: the red arrow pointed to the defect between the left atrium (LA) and the coronary sinus (CS). (C) The three-vessel and tracheal (3VT) view at the upper mediastinum showed a supernumerary vessel to the left of the pulmonary trunk and arterial duct. The red arrow pointed to the persistent left superior vena cava (PLSVC) draining into the right atrium.

Brain MRI (3 T) of case 8. Lacunar lesions in superior-anterior-medial surface of right thalamus in the proximity inferior surface of caudal nucleus (arrows) (A: coronal T2* weighted image and B: axial T2 weighted image). Microvascular leukoencephalopathy (Fazekas grade 3). No hemosiderin accumulation in basal ganglia in T2* weighted images. No medial temporal lobe atrophy (C and D: coronal and axial T1 weighted images)

Cross-sectional CTL reformatted image in an obliqued dorsal plane set in a soft tissue window of a dog in group 2 at 1 min post-injection demonstrating the presence of an efferent lymphatic tract (arrow heads) coursing from the injection site (red dotted outline) to the right dorsolateral mandibular lymph node (star). See Supplementary Video 1 for corresponding percutaneous fluorescence using NIRF.

Ampicillin-sulbactam was empirically started. He underwent ultrasound-guided percutaneous drainage of the splenic abscess which revealed brown purulent fluid. Streptococcus anginosus grew in cultures from both blood and the drainage. Ampicillin-sulbactam was changed to benzylpenicillin based on antibiotic susceptibility.

Fig. 1 Hyperextension varus bicondylar fracture due to a fall from height. Radiological images of a 59-year-old Chinese male with HBTPF. a Red line and orange line showed the reversed slope. White arrow shows the small bone fragment of the fracture. b The red arrow showed the anterior compression fracture. c Red arrow showed the tension failure. d–h 3D computed tomography reconstruction preoperatively

Hyperextension varus bicondylar fracture due to a fall from height. Radiological images of a 59-year-old Chinese male with HBTPF. a Red line and orange line showed the reversed slope. White arrow shows the small bone fragment of the fracture. b The red arrow showed the anterior compression fracture. c Red arrow showed the tension failure. d–h 3D computed tomography reconstruction preoperatively

Rehabilitation exercises were initiated on postoperative day 1. Patients were encouraged to perform quadriceps-strengthening exercises as well as distal limb activity. They were discharged in one or two weeks after surgery and underwent physical therapy during the following 12 weeks.

Four patients in our cohort with localized ES received salvage whole lung irradiation (WLI) following pulmonary recurrence: two (50%) had clearance of pulmonary disease and remained alive and disease-free at 118 and 138 months after recurrence. Eleven patients with initially metastatic disease involving the unilateral or bilateral lungs underwent WLI as part of their definitive therapy: eight (73%) had clearance of pulmonary disease and seven (64%) remained alive.

All patients took DOACs or warfarin for at least 1 month prior to the procedure. All antiarrhythmic drugs were discontinued for at least 5 half‐lives prior to the ablation. Transesophageal echocardiography was performed to confirm the absence of any left atrial (LA) thrombi before the ablation.

Impression: The EEG was markedly abnormal when awake and asleep. There were abundant multi-focal and diffuse epileptiform discharges and multiple recorded seizures with multifocal onset. Findings were consistent with epileptic encephalopathy and a predominance of myoclonic or brief tonic seizures.

We report a series of patients with SB-CHS patients who underwent skull base surgery followed by particle therapy. High dose particle therapy such as PT or CIRT following an appropriate surgical resection achieved local tumor control in the majority of patients.

Clinical photographs. a fresh socket; b cortico-cancellous porcine and filled socket; c collagen sheet covering secured with silk sutures; d site healing at 3 months; e implant placement into healed site; f healed site; g cone beam computed tomography 3 years after implant placement and h after 10 years from first surgery1

Lateral X-ray analysis showed a mandibular retrusion with a regular mandibular plane angle. Panoramic X-ray evidenced the presence of all third molars. A full-mouth periapical X-ray presented clear aspects of periodontal chronic disease with generalized lack of bone (Figures 13(a)–13(d)).

Treatment objectives were to inactivate the periodontal disease by initial causal therapy with scaling and root planningmaintain the sagittal relationshipfavor mesial tipping of 1.1 and 2.1 to solve the interincisor diastemaperform intrusion and retrusion of central incisors by optimizing their position in the alveolar boneperform surgery to improve recession on 2.1 following the orthodontic treatment

A 50‐year‐old man injured his left hand by a rail wheel at work. (Case 1). (A) Flap design to show two perforators outside the intermuscular septum line. (B) Intraoperative elevation of the anterolateral thigh (ALT) deep fascia flap. (C) The soft tissue defect in the left hand & the intraoperative view after harvest of the free ALT deep fascia flap.

A 21‐year‐old man injured his left hand with a hot roller at work. (Case 2). (A) The flap design. (B) Intraoperative elevation of the ALT deep fascia flap. (C) The soft tissue defect in the left hand & the intraoperative view after harvest of the free ALT deep fascia flap.

A 24‐year‐old man crushed his 3–5 fingers of the left hand with a machine at work. (Case 3). (A) Operative incision and design of the multilobed ALT deep fascia flap. (B) Intraoperative elevation of the multilobed ALT deep fascia flap. (C) The soft tissue defect in the left hand & the intraoperative view after harvest of the free multilobed ALT deep fascia flap. (D) The intraoperative view after transfer of the free multilobed ALT deep fascia flap.

Retrospective CT analysis showed that the stenosis of the left upper PV appeared near the atrial junction and the dilatated and tortuous PV in the lingular segment of the LUL (Figure 2e–f). The left major fissure was incomplete lobulation (Figure 2b–f). PV stenosis and venous infarction after ablation therapy for AF were diagnosed.

She had an upper endoscopy done three years earlier for persistent epigastric pain. Histopathology showed mild chronic gastritis with a normal esophagus and duodenum. She reported significant improvement in her epigastric pain until she developed a persistent watery diarrhea. Patient started taking venlafaxine 15 years prior to onset of her diarrhea. She also took NSAIDs for two years and sulfasalazine intermittently. She started taking secukinumab nine months prior to the onset of her diarrhea.

The filter paper screening also revealed no indication of congenital hypothyroidism ¸ adrenal hyperplasia¸ galactosemia ¸biotinidase deficiency¸ amino acid metabolism disorders and tyrosinemia typ1. Molecular genetics verification was impossible due to the patient's death.

Patient’s laboratory Fibrinogen response to treatment with: IVIG; VP-16 100 mg/mq once a week; high-dose steroids: 10 mg/mq; medium-dose steroids: 5 mg/mq once a day; low-dose steroids: 2.5 mg/mq once a day; Ruxolitinib: 5 mg BID (followed by dose tapering 5 mg/die over 10 days); Colchicine: 1 mg once a day. Fibrinogen normal range: 180–350 mg/dL

Patient’s laboratory ferritin response to treatment with: IVIG; VP-16 100 mg/mq once a week; high-dose steroids: 10 mg/mq; medium-dose steroids: 5 mg/mq once a day; low-dose steroids: 2.5 mg/mq once a day; Ruxolitinib: 5 mg BID (followed by dose tapering 5 mg/die over 10 days); Colchicine: 1 mg once a day. Ferritin normal range: 7–130 mg/dL

A 19-year-old male presented with a mass in the left side of the neck and hoarseness for 2 years. There was no family or other medical history relevant to the main complaint in this case. Laryngoscopy showed a submucosal mass in the laryngeal region. The tumour had compressed the left vocal cord.

Magnetic resonance images. (a) Coronal fat-suppressed T2-weighted image shows a dumbbell-shaped tumour extending to the paralaryngeal region through the lower edge of the thyroid cartilage. The yellow lines indicate slice position for Figures b-d. (b–d) The tumour has high peripheral signal intensity and low central signal intensity on T2-weighted images.

(a) Computed tomography (CT) component of a positron emission tomography (PET)-CT shows dilatation of the right internal auditory canal (white arrows) compared to the left internal auditory canal (white arrowheads). (b) Magnetic resonance cisternography reveals a vestibular schwannoma located between the internal auditory canal and the cerebellopontine angle (white arrow).

The cytokine and inflammatory cell activity within the lumen are interesting as this suggests injury to the endothelial lining. Our cases show widespread platelet and fibrin thrombi within myocardial vessels and the myocardial microvasculature which appears to persist even in cases with a prolonged disease. The presence of possible NP protein signals within the lumen of the vessel may also suggest persistence of viral presence in circulating monocytes as another stimulus for the microembolic phenomena (Figure 4).

Select radiographic imaging of the patient's workup during the third hospitalization. Arrows point to pathology where appropriate. A) Axial CT brain showing right cerebellar hemorrhage. B) 3D reconstruction of the MRV brain showing superior sagittal thrombosis and right transverse sinus thrombosis. C) Lower extremity venous doppler of the left posterior tibial vein showing age-indeterminate venous thrombosis. D) MRI brain DWI sequence showing diffusion restriction of the right cerebral peduncle. E) MRI brain T2 sequence showing right thalamic hemorrhage. F) Axial CTA chest showing right segmental pulmonary embolism. G) Axial CTA chest showing left pulmonary artery embolism. H) Coronal CT abdomen and pelvis with contrast showing large subacute right adrenal hematoma.

Radiographic images of the malformed hatchling. (a) Positioning of the hatchling for lateral image acquisition – spinal deformation clearly visible (arrow). (b) Ventral view – yolk sac visible and fusion of the two skulls indicated by arrow. (c) Lateral view – lordotic region of the spin indicated by arrow. (d) Dorsal view – point of fusion of the two necks indicated by arrow.

A healthy 2-year-old child presented febrile torticollis with painful 1-cm cervical lymph nodes . Blood tests showed an acute EBV infection. A CT scan associated with MRI showed an inflammatory process at the C1–C2 vertebrae and K. kingae-specific PCR was positive on biopsy.

A—Pre-operative appearance of left inguinal hernia—black arrow. B—Intraoperative appearance of the vaginal process with the testicle (black arrow) and hernia contents (red arrow). C—Intraoperative appearance of a twisted vaginal process to drain the contents of the hernia into the abdominal cavity. D—Intraoperative appearance of a twisted vaginal ridge with a ligature just next to the external inguinal canal. E—Intraoperative appearance of the closed external inguinal ring with single broken sutures (arrows). F—The appearance of the postoperative wound at the level of the inguinal canal immediately after the procedure.

Longitudinal monitoring of acute (day 1 to 3) and chronic (day 30 and 60) changes after transient middle cerebral artery occlusion (tMCAO) . a1-a6 Six optical microscopic images of the cranial window before and after tMCAO. The yellow dashed square represents a microprism. b1-b6 Six top-view visible optical coherence tomography angiography en face images of the region marked by blue dashed square in a1. Black scale bar: 1 mm; red scale bar: 400 μm

Our first objective is to highlight OHS as a risk factor for respiratory acidosis during labor. Our second objective is to illustrate that the established tests for OHS lack utility in the obstetric population. Health Insurance Portability and Accountability Act written authorization for publication of this case report was obtained from the patient. This paper adheres to the CARE guidelines .

Preoperative endoscopy image and sinus computed tomography (CT) scan. a Preoperative endoscopy image. The blue arrow indicates the persistent flow of cerebrospinal fluid (CSF) backwards into the right posterior nostril. b Sinus CT scan. The black arrow indicates the place of lesion tissue protruding into right sphenoid sinus

Endoscopy images. a Intraoperative endoscopy image. The blue arrow points to the lesion tissue and skull base defect in the lateral wall of the right sphenoid sinus. b Endoscopy image 2 months after surgery. The black arrow indicates repaired area of the skull base defect

Schematic figure of surgical portal and lesion. (A) The frontal view of the surgical portal; (B) the lateral view of the surgical portal and lesion. The anterolateral portal of the hip joint was used as the “visual portal.” The planer knife was inserted through the posterolateral portal and the posterior capsule was planned to reveal the superior gemellus and inferior gemellus. The calcified lesion was then excised.

Exome sequencing was performed for the index proband in a CLIA-certified and CAP- and ISO 15189-accredited laboratory (Blueprint Genetics) as previously described.9 Segregation of the identified variant was performed by Sanger sequencing in the Clinical Genomics Laboratory at IWK Health.

Perioperative electrocardiographic changes. a One month before the operation: atrial fibrillation. b On admission to the operating room: sinus rhythm. c Eighteen min after the start of surgery: short runs of multifocal premature ventricular contractions (PVCs) are observed. d Twenty min after the start of surgery: torsades de pointes (TdP) lasting for 15 s. e After the start of isoproterenol: sinus rhythm: PVCs and TdP have disappeared

A telemedicine consultation was conducted three months post-discharge and the patient was reportedly asymptomatic and partially returned to previous level of activity and work. Lowered endurance was his only complaint. He reported compliance to medical care and medications.

Representative histology of congenital hepatic fibrosis. a Case 1. Broad fibrous bands containing abnormal bile duct profiles with anastomosing and ectasia separate the parenchyma into nodules without hepatocyte regeneration. b Case 3. The portal tract is expanded with prominent fibrosis. There are centrally located bile ducts with luminal dilatation and numerous smaller bile ducts at the limiting plate. The portal vein is hardly appreciated. c Case 9. The bile ducts are ectatic and irregular. The portal veins are small and the portal arteries are prominent and supernumerous. d Case 4. Trichrome stain highlights the portal fibrosis with embedded abnormal bile ducts. Magnification: 100x

Magnetic resonance imaging (MRI) of the thoracic spine confirmed osteomyelitis at T7-T8 and a similar yet earlier infectious process occurring at T10-T11 (Figure 2A). Blood culture results at day 3 revealed methicillin-resistant S. aureus (MRSA). A CT-guided biopsy of the spinal abscess was scheduled but was later cancelled per the patient's request. The patient was managed on an in-patient basis for a total of 16 days with serial blood cultures. Repeat blood cultures at the end of week 1 remained positive for MRSA. The patient’s right IJV vascular catheter was removed and tested positive for MRSA. The catheter was replaced on two separate occasions and tested positive for MRSA both times. Vancomycin therapy was superseded by IV daptomycin (800 mg post-dialysis tri-weekly) and rifampin (300 mg twice daily) due to persistent bacteremia.

The authors present data on serial sBTLA levels in a 2011-14 patient cohort admitted with acute illness due to confirmed bloodstream infection. Their principal finding was of an association between persistently elevated sBTLA levels at day 7 and mortality at 90 days and 12 months.

This case report was approved by the Institutional Review Board of Kyungpook National University Chilgok Hospital (No. 2021-07-012). All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committees and with the Helsinki Declaration (as revised in 2013). Written informed consent was obtained from the patient.

The elbow has been captured on the lateral view of the forearm radiograph and the secondary ossification center of the olecranon has been marked with a border (dotted line). The patient is a male aged 12. According to the Sauvegrain and Dimйglio method the olecranon ossification stage with a rectangular shape is 6. This stage was found to be a cutoff point in association with disturbed bone union after ESIN of forearm shaft fracture.

This case emphasizes the importance of prompt comprehensive investigation of anemia and myositis in patients infected with SARS‐CoV‐2. More data are required to ascertain the relation between hemolytic anemia and myositis with SARS‐CoV‐2 infections especially in the setting of underlying malignancy. Further data needed to direct immunosuppression treatment in patients with hematologic complications associated with SARS‐CoV‐2.

The therapist was a 48-year-old man with an MD and a license to practice as a psychiatric specialist and clinical psychologist in Japan. He was familiar with CBT and ACT and was certified as a CBT therapist at the Center for the Development of Cognitive Behavioral Therapy Training in Japan. He has been an ACT therapist in the Association for Contextual Behavioral Science and a supervisory doctor of psychiatry certified by the Japanese Society of Psychiatry and Neurology.

She was asked to choose clinically relevant target behaviors (CRBs) consistent with her values and to record them in her daily activity log after the intake for daily self-monitoring. CRBs for the time being were to go out and to get up earlier than 11 am.

The patient has provided informed consent for publication of the case. A 51-year-old man underwent esophagogastroduodenoscopy (EGD) for the annual health checkup examination. He had no remarkable medical history and no abnormality was observed on physical examination.

The image shows different steps of the surgical procedure viewed through the exoscope. Upper left: curettage of the posterosuperior bony ear canal. Lower left: oval window exposure with the titanium piston visible in the surgical field. Upper right: one-shot diode laser stapedotomy. Lower right: titanium piston crimped to the long process of the incus

None of the patients had objective preoperative VII cranial nerve palsy or reported subjective tinnitus or vertigo. These three parameters were unchanged both on postoperative day 1 and at the 3-month evaluation. There were no intraoperative or postoperative complications. All patients were dismissed on a postoperative day 1.

Examples of RPE on axial fat-suppressed T2-weighted Dixon images. a A 17-year-old male with left-sided peritonsillar infection and abscess. b A 13-year-old male with right-sided odontogenic infection. c An 18-year-old male with superficial (lateral) lymphadenitis. d A 59-year-old male with infected thyroid mass (papillary carcinoma)

Examples of anterior (a) and posterior (b) mediastinal edema on axial fat-suppressed T2-weighted Dixon images. a A 46-year-old female with tonsillitis had edema in the anterior mediastinum at the level of the manubrium sterni (asterisk). b A 48-year-old female with peritonsillar and parapharyngeal abscesses had edema in the posterior mediastinum at the level of the Th3 vertebra (asterisk)

This case of reinfection in an immunocompetent host several months after an asymptomatic infection raises concerns on the duration of protective immunity and suggests that immunity may begin to wane in patients who acquired the initial infection during the first wave of the pandemic. The potential contributing role of arterial hypertension and cardiometabolic comorbidities as risk factors for reinfection deserves investigation.

Radiological findings of the central mucoepidermoid carcinoma (MEC) arising from a glandular odontogenic cyst (GOC) of the mandible. a Panoramic radiograph showing a radiolucent cystic lesion (yellow arrows) in the right third molar region of the mandible. b CT showing a unilocular radiolucent lesion with a lingual side cortical bone resorption of the mandible. c Oral photography showing a cystic cavity in the same area after surgery. d MRI showing a contrast defect in the same area after the biopsy was taken

Serial dilutions of serum from patient “c” revealed monoclonal lambda light chain by both FLC-Modified SIFE and MASS-FIX/MALDI at a concentration of about 1.15 mg/L. MASS-FIX/MALDI identified free lambda light chains in a patient with history of monoclonal IgG lambda and free monoclonal lambda light chains when FLC-Modified SIFE did not detect monoclonal lambda light chains. The total SFLC concentration of free lambda light chain was 0.92 mg/L in the specimen addressed above. Serial dilutions of serum from patient “d” with a diagnosis of lambda LCMM revealed monoclonal lambda light chains to a concentration of 1.42 mg/L by FLC-Modified SIFE while MASS-FIX/MALDI was positive to a concentration of 2.84 but not at 1.42 mg/L.

All surgeries were performed by the senior surgeon with the patient under spinal anaesthesia. We performed hip hemiarthroplasty with a posterolateral approach using a bipolar hip prosthesis. The utility of tranexamic acid is part of the routine perioperative care unless the contradictions are present. Participants who were on a regimen of tranexamic acid were administered 1 g intravenously (IV) after the anesthesia and another 1 g IV during wound closure. All patients were managed under the enhanced recovery after surgery (ERAS) pathway. All participants allowed full weight bearing on postoperative day 1.

a-b Computed tomography scan and three-dimensional reconstruction of the right hip in postoperative day 1 showed the distal extension of the fracture line down the lateral cortex; this leads to destabilization of the stem because the lateral buttress is lost

An 82-year-old woman suffered from severe pain in her left hip after she fell over while walking. Bilateral radiography of hips 1 h after the fall exhibited femoral neck fracture of the left hip. The patient received THA of the left hip 2 days after the injury. CT scan (Fig. 4 a) and three-dimensional reconstruction (Fig. 4 b) 1 day after the operation showed that periprosthetic fracture of the proximal femur affected the greater trochanter and the lateral cortex of the proximal femur. Fig. 4a-b Computed tomography scan and three-dimensional reconstruction of the left hip in postoperative day 1 showed the distal extension of the fracture line down the lateral cortex; this leads to destabilization of the stem because the lateral buttress is lost

a-b Computed tomography scan and three-dimensional reconstruction of the left hip in postoperative day 1 showed the distal extension of the fracture line down the lateral cortex; this leads to destabilization of the stem because the lateral buttress is lost

The tumour spheroid nodules showed an optimal and rapid vascularisation after transplantation on ED 11. The intravascular injection of Fluorescein revealed tumour spheroid vascularisation at day ED 17 (Figure 5). Haematoxylin staining confirmed the vascularisation of the tumour spheroid nodule (Figure 5C).

Verma et al. described postzosteric pseudoherniation of the skin in affected limbs. Histological examination surprisingly revealed neo-lymphangiogenesis to be responsible . Rahmatpour Rokni et al. reported the formation of cutaneous cysts after HZ with PHN .

Anatomical view during Combination of Erector Spina Plane Block and Thoracic Paravertebral Block. A The view of the block needle in the paravertebral area before the block. B Ten ml of 0.25% bupivacaine and five ml of 2% lidocaine were administered and pleural depression was observed. C Hydrodissection with 2 ml of saline solution was performed into the interfascial plane above the transverse process and below the erector spinae muscle. D Ten ml of 0.25% bupivacaine and five ml of 2% lidocaine were administered beneath the erector spinae muscle. The local anesthetic spread caudally and cranially beneath the erector spinae muscle. (ESM: Erector spinae muscles; LA: local anesthetic; PV space: Paravertebral space; T: Thoracic; TP: Transverse process)

Dataset of the left eye of an nAMD patient who has been diagnosed with fibrosis based on CFP but not confirmed by the PS-OCT algorithm (Patient 25). (a) Color fundus photography. The white outlines mark yellow discolorations which were interpreted as possible fibrosis by the expert reader. (b) Fibrosis segmentation map without any segmented areas. (c) B-scan of the fully compensated axis orientation going through the area suspected to be fibrotic on CFP. The trace of the B-scan is marked in (a) and (b). (d) Intensity B-scan at the same position with layer segmentation lines. Color scheme of axis orientation: –90° to +90°. Scale bar of the fibrosis map: 1 mm. Scale bars of the B-scans: 500 µm.

Sanger sequencing of the candidate variants was performed in the patients and the parents in order to confirm the presence of the variant and the pattern of inheritance. Variants were classified following the American College of Medical Genetics and Genomics and the Association for Molecular Pathology (ACMG/AMP) guidelines . Pathogenic and likely pathogenic variants have been submitted to ClinVar .

A) Sanger sequencing of a fragment encompassing variant c.456_459delTGAG from patient 12 and a control sample shows a reduction in the percentage of the allele with the variant in the cDNA compared to DNA. The sequence corresponds to the reverse strand. B) qPCR analysis of HSF2 gene expression in patient 12 and a control sample normalized to GAPDH shows less HSF2 expression in patient 12 (* p-value 0.014).

Global extracellular volume by cardiovascular magnetic resonance imaging of Case 1. Pathological values were obtained from the entire left ventricular circumference (A). Focal conspicuities were shown in late gadolinium enhancement (LGE) sequences. This showed inferolateral LGE consistent with regional wall motion abnormalities on echocardiography (B).

A: CT scan three weeks after fall in a 78-year-old female. There is no deformity but severe vacuum changes (solid white arrows) in both the anterior vertebra and T12-L1 disc space. B: MRI scan six weeks alter medical clearance but before surgery showing progressive collapse anteriorly and now there is 15 degrees of kyphotic deformity. The posterior vertebral wall of T12 is 20 mm compared to 22 and 24 of the adjacent vertebral bodies but the anterior part of T12 has collapsed to 8 mm resulting in a 67% collapse.

Figure 4 shows the extent that a dog-bite injury can have. A substance defect in the upper and lower lip was the result. Plastic reconstruction of the upper and lower lip was performed in an extensive operation under general anesthesia. Figure 5 shows the postoperative result for the patient about half a year after the accident.

Preoperative and immediate postoperative X-Ray. Immediate postoperative X-Ray image in comparison of the preoperative counterparts shows satisfactory location of graft. a Preoperative coronal image. b Preoperative sagittal image. c Postoperative coronal image. d Postoperative sagittal image

Immediate postoperative MRI. Immediate postoperative MRI image shows complete cancelation of extral adipose tissue and adequate decompression. a Axial image of L2/3. b Axial image of L3/4. c Axial image of L4/5. d T2-weighted sagittal image. e Fat suppression image

Follow-up X-Rays. Follow-up imaging examination shows consistent spinal stability and excellent internal fixation. a Coronal image of 3 months after surgery. b Sagittal image of 3 months after surgery. c Coronal image of 6 months after surgery. d Sagittal image of 6 months after surgery. e Coronal image of 22 months after surgery. f Sagittal image of 22 months after surgery

Postoperative CT scan and MRI. Postoperative CT scan shows satisfactory fusion rate of joint facet. MRI has not detected reoccurrence of spinal epidural lipomatosis. a Sagittal CT image of 6 months after surgery. b Sagittal CT image of 22 months after surgery. c Sagittal MRI image of 6 months after surgery. d Sagittal MRI image of 22 months after surgery

Five patients were diagnosed with distant metastases at the initial assessment and received PCC as a first treatment. Fifty-five patients had been pretreated with surgery and/or chemoradiotherapy. Fifteen patients in a recurrent setting had received locoregional treatments with a curative intent (such as surgery or reirradiation).

Follow-up CT in August 2019 was significant for severe colonic diverticulosis and a right paracolic gutter lobular fluid-attenuated structure with features of a cystic lymphangioma that measured 11.7 cm (Figure 2). The patient opted for continued observation and repeat imaging.

Schizencephaly is uncommon cortical anomaly resulting from slit brain due to the cleft extending from pia matter to the ependymal cell of lateral ventricles. The condition was first described by Yakovlev and Wadsworth in 1946 as the infolding of gray matter along the clefts which are located in the area of primary fissure and associated with other CNS anomalies . Closed lip type of schizencephaly is characterized by inter-connected gray mater lined lips whereas the open lip type is characterized by open lips with a CSF filled cleft extending to the lateral ventricles . Our case was bilateral open lip type of schizencephaly.

Pathological and radiographical manifestations of the Case 4 patient. Left: Results of HE and immunohistochemical staining of the tumor tissues. Right: MRI images of the tumor that was located at the T12-L1 level. The tumor exhibited heterogenous iso-hyperintense with speckled hyperintense spots inside on T2WI (A) and patchy and cystic with nodules enhancement (B–D) on contrast-enhanced MR images.

This study was prompted by the need for rapid and painless treatments requiring less perseverance and with minimum pharmacological interactions. We report the results obtained in an objective follow-up of onychomycosis treatment with nitric acid 60% and provide preliminary evidence based on the patients treated.

Timeline of current episode: October 2018: patient referral to the department of conservative dentistry and endodontics at the Dental Medicine Clinic of Monastir; November 2018: removal of the semi-rigid plint and endodontic treatment; January 2019: clinical control; April 2019: radiographic follow-up at 3 months; Novembre 2020: radiographic follow-up at 2 years.

Additional laboratory tests were performed during the patient’s time in the hospital. A positive polymerase chain reaction (PCR) for CHIKV RNA was reported 1 week after the admission date because CHIKV PCR could not be accessed in the secondary care hospital. Skin biopsy revealed subepidermal vesicles containing acantholytic cells and reepithelization in the epidermis. Superficial and deep perivascular infiltration with lymphocytes in the dermis was noted (Fig. 3).Fig. 3Skin biopsy revealed subepidermal vesicles containing acantholytic cells and reepithelization in the epidermis

Laminectomy was performed in three cases via a separate 3 cm midline incision. Decompression of the spinal canal was possible via this limited approach. These cases were included despite the “partial MIS” character of approach due to the technical similarity to the other MIS-cases.

One patient in the MIS-group showed a blood loss > 2000 ml in posterior surgery due to severe liver cirrhosis despite limited approach. Indication in this case was a pincer-type fracture of T12 and L2 and successful spine surgery was mandatory prior to listing the patient for liver transplantation.

The additional tissue trauma for secure fixation of the reference clamp was very limited. Approach was performed via a 2 cm incision and a limited fascial incision of 1 cm on each side of the spinal process is sufficient for fixation and plausibility control by referencing the landmark with a navigated pointer. We did not notice any significant blood loss via this additional incision. There was no need for placement of draining tubes in any of the MIS-cases.

Malignancies are rare in patients with IPEX syndrome. Only one prior report of a child with IPEX and malignancy has been described: an EBV virus-induced lymphoma after treatment with rapamycin. This patient developed cervical lymphadenopathy after 8 months of treatment with rapamycin. Biopsy confirmed CD20+ diffuse large B-cell lymphoma. He was refractory to three rounds of anti-CD20 monoclonal antibody and went into remission following treatment with cyclophosphamide and vincristine .

Incidental diagnosis of thyroid pathology is not uncommon. Thyroiditis and solitary thyroid nodule are amongst them. The risk of malignancy in solid nodules associated with thyroiditis is high . We also came across these 2 pathologies in our patient. Autoimmune thyroiditis like Hashimoto's thyroiditis (HT) and Grave's disease (GD) can have similar sonographic demonstrations. There are some radiological features which favor oneone on other but do not negate anyone of them. Typical heterogenicity and variable texture abnormalities are seen more in HT . Both HT and GD can have raised antithyroid peroxidase antibodies (TPO-Ab) but in GD 95% of patients have elevated anti-Thyroid stimulating hormone-receptor antibodies apart from TPO-Ab and anti-thyroglobulin antibodies. Tissue diagnosis is often not required for final diagnosis and the above findings are usually considered convincing for the management purpose . We considered the diagnosis of HT in our patient because of positive TPO-Ab and micronodular heterogenous echotexture in a normal sized gland. The co-existence of CC and incidental thyroiditis in our patient cannot be correlated without any good explanation and were probably isolated pathologies which were diagnosed simultaneously.

The study showed that some women resorted to mixed feeding when they perceived themselves not to be able to provide adequate milk because of the poor quality of diet.“The mother could not breastfeed because she said she does not have food to eat hence the child could not have milk. We introduced the nutritionist Miriam to follow up the case. There is a big problem because the ARV drugs are not supposed to be taken on an empty stomach.” (KII SCCS SCASCO).

“The mother could not breastfeed because she said she does not have food to eat hence the child could not have milk. We introduced the nutritionist Miriam to follow up the case. There is a big problem because the ARV drugs are not supposed to be taken on an empty stomach.” (KII SCCS SCASCO).

The extensor tendons and digital neurovascular bundles of both digits were returned to their respective anatomic positions. A hemostatic field was achieved using electrocautery. The periosteum was closed with polydioxanone sutures covering the plates and osteotomy sites. The skin was closed with interrupted vertical mattress 4-0 nylon sutures. A bulky dressing and volar splint were placed on the right hand maintaining an intrinsic plus position.

The mass occupied less than 25% of the circumference of the colon. Biopsy was significant for moderately differentiated adenocarcinoma consistent with prostatic origin. Prostate-specific antigen (PSA) was less than 0.01 ng/mL. The patient was deemed to not be a candidate for radiation therapy. The patient additionally declined chemotherapy given his advanced age. He was further referred to palliative care for management of his symptoms.

The present case has demonstrated how a bioengineered HAV can be used as an arterial bypass conduit in the setting of prior graft infection. This could provide a unique alternative to other graft options for the treatment of infected vascular prostheses. Further studies to demonstrate the utility of this approach are recommended.

Every patient was evaluated clinically and with MRI (Magnetic Resonance Imaging) pelvis before starting the treatment. All the patients received standard therapy of External Beam Radiotherapy (EBRT) by intensity‐modulated radiotherapy technique to a dose of 45‐50.4 Gy in 25‐28 fractions with concurrent chemotherapy of weekly Injection Cisplatin (40 mg/m2) or carboplatin (Area under curve = 2) followed by high dose rate brachytherapy. The entire treatment was completed within 8 weeks in all the patients. The patients were re‐evaluated for the clinical response after 3 months of completion of treatment with pelvic examination and MRI pelvis scan using RECIST (Response evaluation criteria in solid tumors) 1.1 criteria.18 Patients who had no residual disease were classified as clinical responders (CR) and patients who had residual or progressive disease were classified as non‐responders (NR).

This case of an adolescent with dramatic LS and concurrent SARS-CoV-2 infection suggests synergistic effects of viral and bacterial infections on inflammation and coagulation activation. It also highlights the limits of collective sanitary measures and their potential influence on individual health. Ongoing studies will help increasing knowledge about SARS-CoV-2 infection pathophysiology and improving patients' management and outcome.

The laparoscopic adrenalectomy was performed using the transabdominal technique. The patient is placed on beanbags in the lateral decubitus position. Three trocars are placed in the subcostal area. No local anesthesia was used during the surgical procedure.

We report a 12 11/12-year-old girl born SGA who received GH for 5 years without catch-up growth and was diagnosed with NS with a PTPN11 pathogenic variant. The concomitant diagnosis of SGA and NS may have affected the responsiveness of this child to the growth-promoting effect of GH treatment.