A Young Case with Endolymphatic Sac Tumors Presented with Right-sided Hearing Loss and Facial Hemi-paralysis

Background: Endolymphatic sac tumors (ELSTs) are uncommon low-grade, locally invasive epithelial tumor that originates from the endolymphatic sac of the inner ear and temporal bone. It is a rare event with less than 300 cases worldwide. In this article, we present a case of ELTS who presented with facial asymmetry and hearing loss. In this article, we present a case of ELTS who presented with facial asymmetry and hearing loss.                    Case presentation: A 15-year-old female was admitted to our hospital with right-sided facial hemiplegia and hearing loss in her right ear which was started and progressed within two years. Except for facial hemiparalysis, other physical examinations were normal. In her audiological investigations, severe hearing loss of her right ear was evident. Imaging studies were indicative of ELSTs. This diagnosis was confirmed by histopathological investigations. Discussion: ELST is an aggressive papillary tumor that arises from the endolymphatic sac. In most cases, this tumor presents as a solitary growth. It usually presents with hearing loss but can be associated with other symptoms like tinnitus, vertigo and nerve VII paralysis. Imaging studies play a crucial role in the diagnosis of ELST, as it can reveal a characteristic soft-tissue mass involving the temporal bone, with bony erosion and extension into adjacent structures. Surgery is considered as the main form of treatment for ELSTs. Conclusion: ELSTs are exceedingly rare events. Here we presented a case of ESLT with right facial hemiplegia and right ear deafness

Deep Learning for Vascular Segmentation and Applications in Phase Contrast Tomography Imaging

Automated blood vessel segmentation is vital for biomedical imaging, as vessel changes indicate many pathologies. Still, precise segmentation is difficult due to the complexity of vascular structures, anatomical variations across patients, the scarcity of annotated public datasets, and the quality of images. We present a thorough literature review, highlighting the state of machine learning techniques across diverse organs. Our goal is to provide a foundation on the topic and identify a robust baseline model for application to vascular segmentation in a new imaging modality, Hierarchical Phase Contrast Tomography (HiP CT). Introduced in 2020 at the European Synchrotron Radiation Facility, HiP CT enables 3D imaging of complete organs at an unprecedented resolution of ca. 20mm per voxel, with the capability for localized zooms in selected regions down to 1mm per voxel without sectioning. We have created a training dataset with double annotator validated vascular data from three kidneys imaged with HiP CT in the context of the Human Organ Atlas Project. Finally, utilising the nnU Net model, we conduct experiments to assess the models performance on both familiar and unseen samples, employing vessel specific metrics. Our results show that while segmentations yielded reasonably high scores such as clDice values ranging from 0.82 to 0.88, certain errors persisted. Large vessels that collapsed due to the lack of hydrostatic pressure (HiP CT is an ex vivo technique) were segmented poorly. Moreover, decreased connectivity in finer vessels and higher segmentation errors at vessel boundaries were observed. Such errors obstruct the understanding of the structures by interrupting vascular tree connectivity. Through our review and outputs, we aim to set a benchmark for subsequent model evaluations using various modalities, especially with the HiP CT imaging database

Subarachnoid block with low dose of bupivacaine and sufentanil in patients with coronary artery disease

BACKGROUND: Subarachnoid block with local anesthetics and opioids enable efficacious spinal anesthesia because of their synergistic effect and permit the use of low-dose local anesthetics, which results in a stable hemodynamic state. The purpose of this study was to describe the cardiovascular effects of spinal anesthesia with low-dose bupivacaine and sufentanil on patients with coronary artery disease. METHODS: This study was a double-blind randomized clinical trial. A total of 18 patients who had known coronary artery disease were enrolled. Our subjects underwent spinal block for lower limb surgery with 7.5 mg hyperbaric bupivacaine 0.5% and 5 &micro;g sufentanil. Complications related to anesthesia such as hypotension, bradycardia, vasopressor need, and blood or volume use were recorded. RESULTS: The average mean arterial pressure decreased 15% in the first 15 min of spinal block in our cases. No patients presented with hypotension and the subjects were without complaints during the spinal anesthesia. All patients remained alert, and no ST segment changes were observed intraoperatively and until 6 h after the operation. Baseline ejection fraction (EF) 40% or less was observed in 10 patients and these subjects were compared with other patients. Systolic and diastolic blood pressures, mean arterial pressure, and heart rate decreased during the first 15 min in response to spinal anesthesia in both groups of patients, but decreased more significantly in patients with EF &gt; 40%. CONCLUSION: We recommend spinal block with low-dose bupivacaine and sufentanil in patients with coronary artery disease and especially in patients with low EF. &nbsp; Keywords: Bupivacaine, Coronary Artery Disease, Subarachnoid Block&nbsp; </span

Case Report: Combination Therapy with Mesenchymal Stem Cells and Granulocyte-Colony Stimulating Factor in a Case of Spinal Cord Injury

Introduction: Various neuroregenerative procedures have been recently employed along with neurorehabilitation programs to promote neurological function after Spinal Cord Injury (SCI), and recently most of them have focused on the acute stage of spinal cord injury. In this report, we present a case of acute SCI treated with neuroprotective treatments in conjunction with conventional rehabilitation program. Methods: A case of acute penetrative SCI (gunshot wound), 40 years old, was treated with intrathecal bone marrow derived stem cells and parenteral Granulocyte-Colony Stimulating Factor (G-CSF) along with rehabilitation program. The neurological outcomes as well as safety issues have been reported. Results: Assessment with American Spinal Injury Association (ASIA), showed neurological improvement, meanwhile he reported neuropathic pain, which was amenable to oral medication. Discussion: In the acute setting, combination therapy of G-CSF and intrathecal Mesenchymal Stem Cells (MSCs) was safe in our case as an adjunct to conventional rehabilitation programs. Further controlled studies are needed to find possible side effects, and establish net efficacy

U100: An Innovative USERN Platform for Education and Research Without Borders

The article's abstract is no available