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Hypoxic-ischemic encephalopathy (HIE) is a major cause of neonatal morbidity and mortality. Electroencephalography (EEG) and brain magnetic resonance imaging (MRI) are frequently performed in these infants, but the prognostic value of the combined use of EEG and MRI needs additional exploration. The purpose of this study was to investigate, in neonates with HIE, the role of early EEG and conventional MRI in the prediction of infants at risk for persistent encephalopathy at 18 months of age. Thirty-four term infants with HIE were enrolled in this prospective study. EEG was recorded within the first 72 hours after birth and a brain MRI scan was done between 1 and 4 weeks of age. Denver Developmental Screening Test II was performed at 6, 12, and 18 months of age. Three infants (9%) had mild HIE, 21 infants (62%) had moderate HIE, and 10 infants (29%) had severe HIE. The EEG background was normal, moderately, severely, and extremely discontinuous in eight (24%), three (9%), sixteen (47%), and seven (20%) neonates, respectively. EEG background activities correlated significantly with HIE severity (p = 0.0001). MRI findings significantly correlated with EEG background (p = 0.001). Normal MRI scans and minimal basal ganglia lesions were always associated with normal EEG background. Patients with severe basal ganglia and thalamic lesions in MRI (n = 2) had extreme discontinuous EEG background. For the prediction of poor outcomes, abnormal EEG background activity had a sensitivity (Sn) = 100%, a specificity (Sp) = 100%, positive predictive value (PPV) = 100%, and negative predictive value (NPV) = 100%, whereas values of abnormal MRI scans were Sn of 100%, Sp = 43%, PPV = 82%, and NPV=100%. EEG background activity is the best element to predict abnormal outcomes. Severe basal ganglia and thalamic injuries on MRI scans are associated with poor outcomes. Otherwise, MRI does not contribute to the prediction of outcomes at 18 months of age.

Polyorchidism is a rare anomaly, defined as the presence of more than two testicles with about 100 cases reported in the literature. The majority of cases were triorchidism with occasional bilateral duplication. We report the case of a 32-year-old man with polyorchidism, presenting with primary infertility with oligoasthenoteratozoospermia semen profile. Scrotal examination revealed two discrete ovoid nontender, firm, mobile lumps with testicular sensation in the right side of the scrotum. Ultrasonography and magnetic resonance imaging confirmed the presence of double testes with double separate epididymides sharing a common vas deferens in the right side of the scrotum. It demonstrated similar echo texture and vascular flow in both right-sided testicles although smaller in size than the left testis. The case was managed conservatively without surgical intervention with follow-up. Tracing of similar conditions in the literature was discussed.

Lung nodules from low dose CT (LDCT) scans may be used for early detection of lung cancer. However, these nodules vary in size, shape, texture, location, and may suffer from occlusion within the tissue. This paper presents an approach for segmentation of lung nodules detected by a prior step. First, regions around the detected nodules are segmented; using automatic seed point placement levels sets. The outline of the nodule region is further improved using the curvature characteristics of the segmentation boundary. We illustrate the effectiveness of this method for automatic segmentation of the Juxta-pleural nodules.

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