Abstract: Diabetic ketoacidosis (DKA) is rare in pregnancy, especially in pregnant women with normal glucose tolerance examined in early pregnancy. Once DKA occurs in pregnancy, the disease progresses rapidly and can be life-threatening for both mother and fetus. We concluded three cases of DKA in late pregnancy. The clinical manifestations, progression, and prognosis of the three cases are different, but all of the cases have normal glucose tolerance. We summarized the characteristics of pregnant women with DKA and analyzed and discussed them in conjunction with literature for reference by clinical doctors. Keywords: diabetic ketoacidosis, pregnancy, gestational diabetes mellitus
It is essential to avoid small vessels during stereo-electroencephalography (SEEG) electrode implantation. In this study, we proposed a 6-fold Compressed sensing accelerated, 5cm/s Low velocity encoded, 0.75mm Isotropic resolution Phase contrast Magnetic Resonance Angiography (CLIP-MRA). In CLIP-MRA, the compressed sensing based acceleration method was shown to achieve better image quality or shorter scan duration compared to parallel imaging based acceleration. CLIP-MRA was able to display not only cortical arteries and veins simultaneously, but also vessels in the skull. Safety and effectiveness of CLIP-MRA utilized preoperative SEEG planning were evaluated on a small patient cohort.
Objective To summarize the effectiveness of improved surgical techniques of corpus callosotomy in patients with refractory epilepsy. Methods A retrospective analysis was performed on the clinical data of 36 patients with refractory epilepsy, admitted to our hospital from July 2003 to July 2010; the incision via improved small bone window was summarized on skin incision,bone flap design, surgical advantages and disadvantages, and intraoperative precautions. Results A S-shaped or an approximately U-shaped incision was made in the right frontal scalp.The craniotomy was performed with a small trapezoid bone window (the topline,the baseline and the height:2,4 and 2.5 cm,respectively). With the help of microscope,the extent of sectioning consisted of the anterior 2/3 of the total length of the corpus callosum.Post-surgical outcome was assessed according to Engel's scale scores for 9 to 12 months of follow-up:6 patients were in grade Ⅰ,14 in grade Ⅱ,12 in grade Ⅲ and 4 in grade Ⅳ. Conclusion Improved corpus callosotomy has such advantages as little damage to the tissues,few complications and quick recovery,indicating that it is worth for further generalization.
Key words:
Corpus callosotomy; Refractory epilepsy; Small bone window
With 3D T2 FLAIR imaging, trigeminal nerve is clearly demonstrated with CSF nulled, while low SNR and low spatial resolution is always the limitation. In this study, we introduced a 0.75mm isotropic resolution whole brain 3D T2 FLAIR imaging in 5min 40sec based on a novel deep learning framework, and evaluated on a small patient cohort who underwent MR-guided robot-assist percutaneous balloon compression (PBC). To our knowledge, this is the first clinical report of MR-guided robot-assist PBC surgery based on DL accelerated 3D scan.
Objective To establish the refractory epilepsy (RE) rat model and study the effects of vagus nerve stimulation on electroencephalogram (EEG) in RE rats.Methods Based on the Lithium-Pilocarpine induced temporal lobe epilepsy model,screening out the anti-PB epileptic rats by Sodium Phenobarbital (PB).The rats were randomly divided into 3 groups:VNS group,sham-VNS group and control group.The parameters of the VNS were set as follows:frequency 30 Hz,pluse width 0.5 ms,current 1 mA,stimulation time 30s,interval 5 min,10 hours/day.Behavior and EEG were observed by Video-EEG systerm before and after four-week VNS in each group.Results (1) The frequency of seizures in VNS group was significantly reduced after 4-week VNS (P ＜ 0.05),but that of group sham-VNS and group control did not change significantly.(2) The indexs of group VNS,including the duration of seizures,the spike numbers and spike interval,were significantly reduced after 4-week VNS (P ＜ 0.05),however the sham-VNS and EP control groups did not change significantly.(3)The spectrogram showed cpileptiform-wave frequency of epileptic rat reduced after 4-week VNS,but the maximum energy value did not change obviously,though it was higher than that of normal rats with the same age.Conclusions The RE rat could be screened out by PB on the basis of TLE cpilepsy model.VNS could efficiently decrease the frequency of seizures,especially change the EEG pattern.
Key words:
Temporal lobe epilepsy ; Refractory epilepsy ; Vagus nerve stimulation ; Electroencephalogram ; Models animal
Functional MRI (fMRI) is gaining importance in the preoperative assessment of language for presurgical planning. However, inconsistencies with the Wada test might arise. This current case report describes a very rare case of an epileptic patient who exhibited bilateral distribution (right > left) in the inferior frontal gyrus (laterality index [LI] = –0.433) and completely right dominance in the superior temporal gyrus (LI = –1). However, the Wada test revealed a dissociation: his motor speech was located in the left hemisphere, while he could understand vocal instructions with his right hemisphere. A clinical implication is that the LIs obtained by fMRI should be cautiously used to determine Broca’s area in atypical patients; for example, even when complete right dominance is found in the temporal cortex in right-handed patients. Theoretically, as the spatially separated functions of motor speech and language comprehension (by the combined results of fMRI and Wada) can be further temporally separated (by the intracarotid amobarbital procedure) in this case report, these findings might provide direct support to Broca’s initial conclusions that Broca’s area is associated with acquired motor speech impairment, but not language comprehension per se. Moreover, this current finding supports the idea that once produced, motor speech can be independent from language comprehension.
Multi-robot systems have increasingly become instrumental in tackling search and coverage problems. However, the challenge of optimizing task efficiency without compromising task success still persists, particularly in expansive, unstructured environments with dense obstacles. This paper presents an innovative, decentralized Voronoi-based approach for search and coverage to reactively navigate these complexities while maintaining safety. This approach leverages the active sensing capabilities of multi-robot systems to supplement GIS (Geographic Information System), offering a more comprehensive and real-time understanding of the environment. Based on point cloud data, which is inherently non-convex and unstructured, this method efficiently generates collision-free Voronoi regions using only local sensing information through spatial decomposition and spherical mirroring techniques. Then, deadlock-aware guided map integrated with a gradient-optimized, centroid Voronoi-based coverage control policy, is constructed to improve efficiency by avoiding exhaustive searches and local sensing pitfalls. The effectiveness of our algorithm has been validated through extensive numerical simulations in high-fidelity environments, demonstrating significant improvements in both task success rate, coverage ratio, and task execution time compared with others.
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