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Multicentre baseline proton magnetic resonance spectroscopic data on primary progressive multiple sclerosis (PPMS) patients are acquired and analysed, using automatic analysis software. The metabolite ratios did not differ from centre to centre. The average N0-acetylaspartate/creatine (NAA/Cr) ratio in PPMS was significantly lower compared to normal controls. No significant differences were observed in this ratio between lesion-containing regions (LC R) and normal-appearing tissues (NAT). Strong lipid resonances, even in the absence of lesions, are observed in the both grey and white matter in these patients. These observations suggest extensive diffuse and/or microscopic pathology in PPMS. No significant correlation between any of the metabolite ratios and the Extended Disability Scale Score (EDSS) or with other MR measures such as lesion burden and enhancement volumes is observed. [ABSTRACT FROM AUTHOR]

Dengue fever (DF) including dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS) may lead to serious complications in the postoperative period. It is a potential danger of bleeding from the cut tissues. Separate guidelines are not available for the management of surgical patients with dengue fever. [ABSTRACT FROM AUTHOR]

Multicentre baseline proton magnetic resonance spectroscopic data on primary progressive multiple sclerosis (PPMS) patients are acquired and analysed, using automatic analysis software. The metabolite ratios did not differ from centre to centre. The average N- acetylaspartate/creatine (NAA/Cr) ratio in PPMS was significantly lower compared to normal controls. No significant differences were observed in this ratio between lesion-containing regions (LCR) and normal-appearing tissues (NAT). Strong lipid resonances, even in the absence of lesions, are observed in the both grey and white matter in these patients. These observations suggest extensive diffuse and/or microscopic pathology in PPMS. No significant correlation between any of the metabolite ratios and the Extended Disability Scale Score (EDSS) or with other MR measures such as lesion burden and enhancement volumes is observed. Multiple Sclerosis (2004)10, S73-S78 [ABSTRACT FROM PUBLISHER]

Background: Autologous breast reconstruction is associated with significant pain impeding early recovery. Our objective was to evaluate the impact of replacing surgeon-administered local infiltration with preoperative paravertebral (PVB) and erector spinae plane (ESP) blocks for latissimus dorsi myocutaneous flap reconstruction., Methods: Patients who underwent mastectomy with latissimus flap reconstruction from 2018 to 2022 were included in three groups: local infiltration, PVB, and ESP blocks. Block effect on postoperative length of stay (LOS) and the association between block status and pain, opioid consumption, time to first analgesic, and postoperative antiemetic administration were assessed., Results: 122 patients met the inclusion criteria for this retrospective cohort study: no block (n=72), PVB (n=26), and ESP (n=24). On adjusted analysis, those who received a PVB block had a 20-hour shorter postoperative stay (95% CI 11 to 30; p<0.001); those who received ESP had a 24-hour (95% CI 15 to 34; p<0.001) shorter postoperative stay compared with the no block group, respectively. Using either block was associated with a reduction in intraoperative opioids (23 morphine milligram equivalents (MME)), 95% CI 14 to 31, p<0.001; ESP versus no block: 23 MME, 95% CI 14 to 32, p<0.001)., Conclusions: Replacing surgical infiltration with PVB and ESP blocks for autologous breast reconstruction reduces LOS. The comparable reduction in LOS suggests that ESP may be a viable alternative to PVB in patients undergoing latissimus flap breast reconstruction following mastectomy. Further research should investigate whether ESP or PVB have better patient outcomes in complex breast reconstruction., Competing Interests: Competing interests: None declared., (© American Society of Regional Anesthesia & Pain Medicine 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

A new color coding scheme which can fully retrieve the directional information of diffusion tensor image (DTI) with maximum use of the color space is proposed and implemented. This new scheme overcomes the loss of directional information in conventional schemes and easy to implement. Comparison between the new scheme and the conventional color coding method are presented using the DTI data of human brain.

An adaptive fuzzy c-means (FCM) clustering algorithm is explored for segmentation of three-dimensional (3D) multi-spectral MR images. This algorithm takes into consideration of both noise and 3D intensity non-uniformity. This algorithm models the intensity nonuniformity of MR images as a gain field or bias field that slowly varies in space, which is approximated by a linear combination of smooth basis functions made up of polynomials with different orders. The contextual constraints are included by introducing a regularization term into the cost function of FCM. The regularization term is a measure of aggregation of local voxels that tend to overcome the noise in voxel labeling. We present our scheme both for bias and gain fields, with special attention is paid to robust estimation of the bias field.