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Hypospadias occurs sporadically in male livestock and is characterized by a non‐fused urethra during fetal development. In this study, perineal hypospadias, a bifid scrotum, penile hypoplasia, and bilateral abdominal cryptorchidism were diagnosed in a neonatal Holstein male calf. Septicemia was also suspected due to hypothermia, blurred conjunctivae, and loss of sucking and swallowing reflexes. Gross pathology revealed that both testicles were located intraabdominally caudally to the kidneys. Histopathological examination of the hypospadias showed a urothelium‐lined mucosal fold and parts of the corpus cavernosum penis and prepuce in the subcutis. Whole genome sequencing was performed on the affected calf. Analysis of short‐read coverage depth along the chromosomes identified an entire extra copy of chromosome 26. Based on the comparison of available variant calling data from the sire, the identified trisomy 26 is due to non‐disjunction of homologous chromosomes during the generation of paternal gametes. We have shown for the first time an association between bovine hypospadias and trisomy 26, which adds to the understanding of variation in fetal male sexual development. [ABSTRACT FROM AUTHOR]

Purpose: This retrospective systematic literature review aimed to summarize available data regarding epidemiology, etiology, presentation, investigations, differentials, treatment, prevention, monitoring, complications, and prognosis for radiation-induced cavernous malformations (RICMs) in pediatric patients. Methodology: Review conducted per PRISMA guidelines. Google Scholar, PubMed, Trip Medical Database, and Cochrane Library searched utilizing a keyphrase, articles filtered per inclusion/exclusion criteria, duplicates excluded. Based on criteria, 25 articles identified, 7 further excluded from the systematic data but included in discussion (5 × insufficient data, 2 × other systematic reviews). Results: Many studies did not contain all explored data. 2487 patients reviewed, 325 later found to have RICM (143 male, 92 female). Mean age at irradiation 7.6 years (range 1.5–19). Mean total radiation dose 56 Gy (12–112). Most common indications for radiation—medulloblastoma 133x, astrocytoma 23x, ependymoma 21x, germinoma 19x. Mean age at RICM diagnosis 18 years (3.6–57). Mean latency to RICM 9.9 years (0.25–41). Most common anatomic locations—temporal 36, frontal 36, parietal 13, basal ganglia 16, infratentorial 20. Clinical presentation—incidental 270, seizures 19, headache 11, focal neurological deficit 7, other 13. 264 patients observed, 34 undergone surgery. RICM bled in 28 patients. Mean follow-up 11.7 years (0.5–50.3). Prognostic reporting highly variable. Conclusions: From our data, pediatric RICMs appear to display slight male predominance, present about 10 years after initial irradiation in late teen years, and present incidentally in majority of cases. They are mostly operated on when they bleed, with incidental lesions mostly being observed over time. Further prospective detailed studies needed to draw stronger conclusions. [ABSTRACT FROM AUTHOR]

Les fentes frontales orbitaires supérieures font partie des fentes rares craniofaciales décrites par Tessier en 1976, dont la survenue est le plus souvent sporadique. Elles sont numérotées 9, 10 et 11 dans cette classification et siègent respectivement latéralement, médianement et médialement vis-à-vis de la partie supérieure de l'orbite. Leurs expressions cliniques sont variables sur les tissus mous et osseux, avec une dissociation d'atteinte possible, et vont d'un simple défaut esthétique à la mise en jeu du pronostic fonctionnel oculaire. Le scanner est systématiquement justifié dans ce cadre. Leur prise en charge doit être adaptée au vu du polymorphisme des atteintes et repose sur une prise en charge multidisciplinaire, avec une reconstruction chirurgicale des parties molles urgente en cas de mise en jeu du pronostic oculaire. Dans les autres cas, la prise en charge est différée mais doit rester précoce afin de permettre un bon développement de l'enfant. Superior orbital frontal clefts are one of the rare craniofacial clefts described by Tessier in 1976, and occur most often sporadically. They are numbered 9, 10 and 11 in this classification, and are located respectively laterally, in the middle and medially to the upper part of the orbit. Their clinical expression is variable on soft tissue and bone, with possible dissociation of involvement. They range from a simple aesthetic defect to an eyes functional prognosis. CT scans are systematically required in this context. Their management must be adapted to the polymorphism of the damage, and is based on multidisciplinary approach. In case of ocular risk, the eyelid reconstruction is an emergency. In all other cases, treatment is deferred, but must be carried out at an early stage to ensure the child's healthy development. [ABSTRACT FROM AUTHOR]

The first case of a morphological abnormality in the broadnose skate Bathyraja brachyurops is reported. The specimen was captured by a vessel fishing in the Southwest Atlantic Ocean off the coast of Argentina. Radiographs and mammographs were used to visualize the abnormality in greater detail. The specimen exhibited a lack of union between both pectoral fins and the head region. Ventral photographs revealed that the propterygia does not articulate with the antorbital cartilage or there is a malformation in the antorbital cartilage. It could cause the pectoral fins to be incomplete. The rest of the body seemed to have developed normally, with the rostrum, the other fins, and the caudal area showing no abnormalities. Even though it is difficult to assess the causes of the abnormalities, it is believed that they may be due to environmental factors, such as heavy metal pollution. The pectoral-fin deformity could interfere with locomotion, feeding, or mating, affecting intraspecific competition. [ABSTRACT FROM AUTHOR]

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Research on embryonic development is entering into a new era. As a traditionally descriptive discipline within anatomy, embryologists have formed international consortia and digitized important histological collections for preservation and open access. Embryonic development has recently received a wider attention in context with temporo-spatial transcriptomics at single cell level. These can be expected to fuel the realization of the transdisciplinary significance of efforts to decipher embryonic development. Addressing its complexities encompasses a wealth of challenges that intersect across the domains of science, society, and politics underlining its outstanding importance as well as its inherently interdisciplinary nature. The challenges of this field are by no means confined to understanding the intricate biological mechanisms but also have humanitarian implications. To fully appreciate the mechanisms underlying human development, principles of embryogenesis have predominantly been analyzed employing animal models which allow us to broaden our view on developmental processes. As a result of recent pioneering work and technical progress centered around stem cell-based 3D approaches, we are entering into a historical new phase of learning about mammalian embryonic development. In vertebrates, a growing concern now focuses the reduction of animal experimentation. This perspective article outlines the major challenges in this amazing field that offer an enormous potential for basic biomedical sciences as well as related translational approaches if they are tackled in a multidisciplinary discourse. [ABSTRACT FROM AUTHOR]

Introduction Hemangiomas are benign vascular lesions. The complicated hemangiomas that are causing significant functional or cosmetic problems need surgical excision. This paper presents a novel technique of reconstruction using surgical mesh after removal of a facial hemangioma.Case report A 50-year-old male patient presented with right cheek swelling for more than 40 years causing disproportion of the face. A flap was raised by a nasolabial linear incision, then a 4*2 cm surgical mesh was put in, and the wound closed cosmetically. The excised tissue was sent for histopathological examinations and the results confirmed hemangioma. After more than two years follow up, the patient’s face was symmetrical with normal facial contour.Conclusion The application of surgical mesh for patients who seek functional and cosmetic improvements after hemangioma removal is a constructive method that gives the desired outcome for the patient.

Bladder Exstrophic diseases, referred to collectively as Bladder Exstrophy-Epispadiasis complex, are a spectrum of embryological anomalies with a rare prevalence of approximately 3.3 per 1,00,000 live births with a male gender predominance. An 18-year-old man presented to Urology Outpatient Department (OPD) with subumbilical abdominal wall defect, absent anterior bladder wall with epispadiasis and was diagnosed as a case of adult classic bladder exstrophy with Epispadiasis complex. There was no history of any fever, haematuria, dysuria or abdominal pain. His ultrasound abdomen and intravenous pyelography reported normal kidney function. He had a low Body Mass Index (BMI) (17.5 kg/m2) with serum creatinine of 0.6 mg/dL. The patient underwent a complete primary repair, including bladder template closure and bladder neck reconstruction using Young-Dees-Leadbetter technique. Epispadias was repaired with the Modified Cantwell-Ransley approach. Abdominal wall defect closure was done with the help of rectus abdominis muscle flap which was later grafted using Split Thickness Skin Graft (STSG). Postoperatively, a small vesicocutaneous fistula developed which healed spontaneously over two weeks period. On follow-up patient was on clean intermittent catheterisation with some incontinence episodes during night-time. Bladder exstrophy in adult patients is rare, as the condition is usually identified in the neonatal period and can be surgically corrected early on. Due to the complexity of the surgery, these cases require thorough multidisciplinary evaluation and careful planning for successful correction.

Congenital pulmonary airway malformation is a rare congenital malformation of the lower respiratory tract with a worldwide incidence of 1: 11,000 to 1: 33,000 live births. CPAM cases are increasingly being diagnosed antenatally with antenatal anomaly scans having been made compulsory with the availability of improved imaging technologies. Here, we present a case of CPAM in a 14-month-old child who was diagnosed with congenital anomaly during the antenatal scan and was managed with lobectomy to prevent further progression of the disease and preserve the function of normal residual lung parenchyma. Histopathological examination of the lobectomy specimen revealed CPAM type II. During clinical follow-up, the child is asymptomatic and is achieving his developmental goals as per his age.

Complete cerebellar agenesis is an extremely rare condition characterized by the complete absence of cerebellar tissue. Only a small number of cases have been reported, with varying motor and cognitive deficits. We describe a case of an 11-month-old baby with developmental delay, whose CT scan evaluation showed the complete absence of the cerebellum with no other associated cerebral malformation.

Objective: We aimed to investigate whether idiopathic cuneate gyrus herniation (ICH) is an anomaly or a normal variant, its prevalence, whether there is a coexisting finding or pathology, as well as to characterize it with magnetic resonance imaging (MRI) findings. Method: We evaluated 0-17-year-olds’ brain MR images from January 2021-August 2023 at our clinic. Standard brain protocols utilize 1.5 Tesla MRI scanners. ICH and congenital brain abnormalities were evaluated in optimal brain MRIs. Malformations were classified as posterior fossa anomalies (PFA), commissural and cortical developmental anomalies (CCDA), and midline malformations. Results: Our study comprised 691 pediatric brain MRIs with a mean age of 5.93±3.4 years, with 48.77% male and 51.23% female. The mean age of 32 ICH (+) patients was 6.19±4.02 years, with 40.63% male and 59.37% female. The prevalence of ICH was 32/691 (4.6%). In 63 (9.11%) congenital brain malformation patients, ICH presence differed (p=0.005). Congenital brain malformation patients with ICH showed a significantly higher PFA rate (n=8) than without ICH. The frequency of CCDA (n=23) and the association of PFA and CCDA (n=12) were significantly higher in ICH patients with congenital brain malformation. The frequency of congenital brain malformation was higher in 32 ICH (+) patients, with a rate of 50% (p

OBJECTIVE: To determine reasons for horses to have neck radiographs performed, the incidence of transposition of the ventral lamina of C6 onto 67 (TC67), and the final diagnoses for all horses. Our hypotheses were to find a similar incidence of TC67, as has been previously reported, and an increased incidence of neck pain and dysfunction in horses with TC67. ANIMALS: 135 horses. METHODS: Retrospective observational study. Medical records of 135 horses with cervical vertebral column radiographs between 2020 and 2022 were assessed. Patient signalment, reasons for radiographs, radiographic findings, and diagnoses were analyzed. The Shapiro-Wilk test was used for normality determination. Nonparametric tests were used to analyze data. RESULTS: 20% of horses were diagnosed with TC67. Significantly more horses with TC67 were warmblood horses (63%); TC67 was found in 28% of warmblood horses. There was no significant difference in signalment or whether horses were in work between the groups, although significantly more horses with TC67 performed in English disciplines (71%). No differences in reasons for examination or final diagnoses of neurologic disease, cervical orthopedic disease, or lameness were present between groups. In horses with neck pain, TC67 was significantly more common (31%) than in horses without (18%). CLINICAL RELEVANCE: Our results indicated that TC67 occurs more in warmblood horses. In the small group of horses with neck pain reported, TC67 was more commonly seen than in those without. Given the complexity of this region and the paucity of studies exploring neck pain and neck biomechanics, we suggest the need for standardized prospective studies. [ABSTRACT FROM AUTHOR]

Epilepsy is a kind of brain dysfunction caused by abnormal synchronous discharge of brain neurons, and is one of the common diseases of the nervous system. Patients need to take anti-epileptic drugs regularly for a long time to achieve seizures-free. For pregnant women, antiepileptic drugs can enter the fetus through the placental barrier causing adverse effects. Lamotrigine and levetiracetam have the lowest potential teratogenic risk, oxcarbazepine has a low risk, topiramate has high risk, while valproic acid has the most severe teratogenic effect and negative effects on the neuropsychological development of children exposed in utero, and should be avoided as far as possible. At present, the management of antiepileptic drugs is still a difficult clinical problem. Pre-pregnancy preparation and rational decision-making of antiepileptic drugs usage during pregnancy are very important. [ABSTRACT FROM AUTHOR]

Background: Developmental toxicity tests are extremely expensive, require a large number of animals, and are time-consuming. It is necessary to develop a new approach to simplify the analysis of developmental endpoints. One of these endpoints is malformation, and one group of ongoing methods for simplifying is in silico models. In this study, we aim to develop a quantitative structure–activity relationship (QSAR) model and identify the best algorithm for predicting malformations, as well as the most important and effective physicochemical properties associated with malformation. Methods: The dataset was extracted from a reliable database called COMPTOX. Physicochemical properties (descriptors) were calculated using Mordred and RDKit chemoinformatics software. The data were cleaned, preprocessed, and then split into training and testing sets. Machine learning algorithms, such as gradient boosting model (GBM) and logistic regression (LR), as well as deep learning models, including multilayer perceptron (MLP) and neural networks (NNs) trained with train set data and different sets of descriptors. The models were then validated with test set and various statistical parameters, such as Matthew's correlation coefficient (MCC) and balanced accuracy (BAC) score, were used to compare the models. Results: A set of descriptors containing with 78% AUC was identified as the best set of descriptors. Gradient boosting was determined to be the best algorithm with 78% predictive power. Conclusions: The descriptors that were the most effective for developing models directly impact the mechanism of malformation, and GBM is the best model due to its MCC and BAC. [ABSTRACT FROM AUTHOR]

Objective: We aimed to investigate whether idiopathic cuneate gyrus herniation (ICH) is an anomaly or a normal variant, its prevalence, whether there is a coexisting finding or pathology, as well as to characterize it with magnetic resonance imaging (MRI) findings. Method: We evaluated 0-17-year-olds’ brain MR images from January 2021-August 2023 at our clinic. Standard brain protocols utilize 1.5 Tesla MRI scanners. ICH and congenital brain abnormalities were evaluated in optimal brain MRIs. Malformations were classified as posterior fossa anomalies (PFA), commissural and cortical developmental anomalies (CCDA), and midline malformations. Results: Our study comprised 691 pediatric brain MRIs with a mean age of 5.93±3.4 years, with 48.77% male and 51.23% female. The mean age of 32 ICH (+) patients was 6.19±4.02 years, with 40.63% male and 59.37% female. The prevalence of ICH was 32/691 (4.6%). In 63 (9.11%) congenital brain malformation patients, ICH presence differed (p=0.005). Congenital brain malformation patients with ICH showed a significantly higher PFA rate (n=8) than without ICH. The frequency of CCDA (n=23) and the association of PFA and CCDA (n=12) were significantly higher in ICH patients with congenital brain malformation. The frequency of congenital brain malformation was higher in 32 ICH (+) patients, with a rate of 50% (p<0.001). Conclusion: We found that ICH is more frequent than reported and may be associated with congenital brain malformations. ICH must be differentiated from pathology to avoid unnecessary procedures. Congenital brain abnormalities may accompany ICH and should be carefully screened. [ABSTRACT FROM AUTHOR]

Congenital facial nerve (FN) malformations are uncommon. Our aim is to determine the clinical and radiological features of FN malformations along with the associated cochlear and vestibular malformations. We conducted a retrospective study including children with a profound sensorineural hearing loss who were candidates for cochlear implantation. We evaluated the presence of FN malformations through temporal bone computed tomography scan and magnetic resonance imaging. We recorded an aberrant FN course in five out of 165 patients in a total of 9 ears. They consisted of a bifurcation of the mastoid segment, an anterior or posterior displacement of the labyrinthine segment and a hypoplasia of the geniculate ganglion. Associated inner ear malformations included vestibular aqueduct dilation, cochlear hypoplasia and total labyrinthine aplasia. We noted a bilateral agenesis of the cochlear nerve in three patients. Facial nerve malformations should be suspected in patients presenting a congenital hearing loss especially in association with other temporal bone malformations. Their pre-operative discovery is helpful in planning the surgical procedure. [ABSTRACT FROM AUTHOR]

Simple Summary: This report characterized complete thoracic ectopia cordis (EC) affecting two newborn lambs from different locations in Brazil, contributing to the knowledge about this rare condition in sheep. Two male newborn lambs presented exteriorized hearts without pericardial coverage, delineated in the thoracic cleft by a fibrous ring of the pericardium and adjacent skin. Clinical findings in the lambs, aside from the EC, were unremarkable. EC is an extremely rare congenital malformation in sheep, with limited cases documented globally. The pathogenesis and etiology remain uncertain, involving potential genetic and environmental factors. Cardiac congenital defects related to inheritance and teratogenesis have been reported in veterinary species and humans worldwide. Among these, ectopia cordis (EC), characterized by an externalized heart through a cleft, is extremely rare in sheep. This report presents the diagnostic features of two cases of complete thoracic EC in newborn lambs. Clinical findings in the lambs, aside from the EC, were unremarkable. Both animals exhibited exteriorized hearts without pericardial coverage, delineated in the thoracic cleft by a fibrous ring of the pericardium and adjacent skin. Histologically, the epicardium was thickened by fibrous tissue in both lambs, with one animal also showing marked edema, hemorrhage, and neutrophilic inflammatory infiltration. The prognosis of EC in the lambs of this study was poor, with fatal outcomes despite attempts at surgical correction. [ABSTRACT FROM AUTHOR]

Objectives: Extrapulmonary sequestration (EPS) within the diaphragm (ID‐EPS) is rare and requires additional procedures such as incision or detachment of the diaphragm from the lesion for diagnosis. This study aimed to describe the imaging findings and evaluate the diagnostic accuracy of ultrasonography and computed tomography (CT) for ID‐EPS. Material and Methods: Split diaphragm sign, shape of lesion edge, drainage vein into intra‐abdomen on ultrasound and CT, and lesion characteristics on ultrasound were compared between patients with ID‐EPS and with above‐diaphragm EPS (AD‐EPS) using Fisher's exact test. Results: Three and nine patients were diagnosed with ID‐EPS and AD‐EPS, respectively. Significant differences were observed between the two groups in the split diaphragm sign on ultrasound (presence/absence in patients with ID‐EPS vs AD‐EPS, 2/1 vs 0/9, P =.046), shape of lesion edge on ultrasound/CT (round/beak in patients with ID‐EPS vs AD‐EPS, 3/0 vs 0/9, P =.005 on both CT and ultrasound), lesion characteristics on ultrasound (presence/absence of cystic area within lesion in patients with ID‐EPS vs AD‐EPS, 0/3 vs 7/2, P =.046), and the drainage vein into the abdomen on CT (presence/absence in patients with ID‐EPS vs AD‐EPS; 2/1 vs 0/9, P =.046). No drainage veins were visualized in the abdomen on ultrasonography and no significant differences in the presence/absence of the split‐diagram sign on CT (presence/absence in patients with ID‐EPS vs AD‐EPS and ID‐EPS; 0/3 vs 0/9, P >.999; 1/2 vs 0/9, P =.250) were observed between the two groups. Conclusion: A combination of postnatal ultrasonography and CT was useful in predicting EPS located within the diaphragm. Access the CME test here and search by article title. [ABSTRACT FROM AUTHOR]

Hemangiomas are considered slow growing benign neoplasms. Primary thyroid hemangiomas are uncommon and may pose difficulty in diagnosis due to absence of distinctive imaging characteristics and related clinical symptoms. It is crucial to precisely identify these lesions to aid in implementing nonsurgical treatment plans rather than resorting to surgical procedures in certain cases. In this report we present a case of a 76-year-old female who presented with painless, rapid, and sudden notice of right-side neck swelling over a 1-day duration. Her radiological examinations raised the concern of a vascular lesion that was emoblized endovascularly. Then, it was surgically removed, which was eventually determined to be primary thyroid hemangioma. In addition, we present a literature review of previously published cases and discuss tumor pathophysiology, clinical presentations, radiology features, and differential diagnosis. [ABSTRACT FROM AUTHOR]

Objective To summarize the imaging findings of intracranial central nervous system (CNS) malformations children in the high-altitude plateau (Xigaze city). Methods We retrospectively reviewed the imaging data of the suspected patients having CNS malformations, which enrolled either by the clinic or by the ultrasound in the Shigatse People’s hospital from June, 2019 to June, 2023. All imaging data were interpreted by two experienced radiologists with consensus reading. Imaging characteristics were recorded roughly by primary/secondary, supra-/subtentorial malformation type and the corresponding clinical symptoms. Results A total of 36 children were included in this study, including 19 patients ≤ 1 year old (including 2 newborns), 7 patients between 1 and 3 years old, and 10 patients >3 years old. Seven cases underwent MRI examination, others having CT scan. Polygyria and pachygyria malformation were the most common type of congenital neurological malformations (7 cases, 31.8%), followed by cystic changes of the cerebral parenchyma (3 cases, 13.6%). Cerebral atrophy was the most common type of secondary CNS abnormalities group (8 cases, 57.1%), followed by communicative hydrocephalus (3 cases, 21.4%). Five patients in the congenital group and 4 patients in the secondary CNS group had the complex malformations. There were 8 dead cases (all in the ≤1-year-old group), 12 cases having neurological sequelae, 1 case with normal development and 15 cases with loss of follow-up. There were no significant differences between primary and secondary CNS group regarding the final outcome. Conclusion In this study, gyrus developmental malformation and encephalatrophy were the most common etiologies in infants’ CNS malformations. Reasonable use of imaging modalities will help depict the complicated CNS malformations and design individual treatment. [ABSTRACT FROM AUTHOR]

Arnold-Chiari Malformation is characterized by herniation of the tonsils of the cerebellum through the foramen magnum into the cervical spinal canal. The etiology of Arnold-Chiari Malformation remains unclear. Malformation may be accompanied by intracranial or extracranial developmental defects such as hydrocephalus, syringomyelia, encephalocele. Different classifications are made according to the accompanying malformation. Arnold-Chiari Malformation can remain asymptomatic during childhood or manifest with neurological symptoms such as headaches. Since there are many different complaints and findings in this malformation, patients present to various medical units. We present a patient who presented to the emergency department with recurrent vomiting after head trauma and was found to have Arnold-Chiari Malformation Type-1 incidentally. [ABSTRACT FROM AUTHOR]

Introduction: The algorithm of multimodal treatment (MMT) of arteriovenous malformations (AVMs) combined with intent-to-cure and presurgery embolization benefits was developed. The aim was to analyze the effectiveness of the MMT compared with unimodal intent-to-cure embolization in patient groups matched concerning clinical and angiographic characteristics.

BackgroundUnilateral pulmonary artery discontinuity (UPAD) is a rare fetal abnormality, for which a prenatal ultrasonographic diagnosis remains challenging. We report a case of left pulmonary artery discontinuity in association with Taussig–Bing syndrome, which has rarely been reported in the literature thus far.Case presentationA pregnant woman with a fetus with congenital heart disease (CHD) at 23 weeks gestation was referred to our center. She denied any familial history of genetic disorders in either spouse, and non-invasive prenatal testing (NIPT) also showed a low risk of CHD for the fetus. An ultrasound examination revealed a complex cardiac malformation indicative of left pulmonary artery discontinuity originating from the ductus arteriosus with Taussig–Bing syndrome. The family eventually chose to terminate the pregnancy and agreed to an autopsy, which confirmed that the prenatal echocardiographic diagnosis was correct. In addition, in this report, we review and analyze 17 reported cases of prenatal echocardiographic diagnoses of UPAD.ConclusionsUPAD is characterized by discontinuity between the proximal and distal pulmonary arteries, along with a ductal origin of the distal pulmonary artery. A discontinuous pulmonary artery originating from the ductus can be detected on prenatal sonography using ultrasound technology. The aim is to detect malformations earlier and carry out the necessary intervention measures as soon as possible.

The Chinese deciduous fruit Prunus salicina Lindl is loved by people because of its distinctive flavor and significant industrial worth. This study presents the first report of abnormal leaf bud in Prunus salicina Lindl. Malformation of Prunus salicina Lindl leaf buds leads to abnormal development and growth, causing deformities and a decrease in fruit yield. Identifying the underlying causes and causative pathogens is essential for effective disease management. In this experiment, we observed the Malformation Syndrome in Prunus salicina Lindl and used the internal transcribed spacer (ITS) to compare fungal diversity between malformed and healthy leaf buds. These results show a higher level of fungal diversity in diseased leaf buds. Alternaria, Curvibasidium, Symmetrospora, Fonsecazyma, and other genera among the identified fungi are suspected to induce the malformations. Potential contributors to these malformations include Endophyte-plant_Pathogen and Plant_pathogen-Undefined_saprotroph. These findings provide valuable insights for further research on the etiology of plum bud diseases, identifying potential pathogens, and formulating control strategies.

SUMMARY: Introduction: Vascular anomalies comprise a diverse group of abnormalities in blood vessel morphogenesis that usually occur prenatally. Arterio-venous malformations (AVMs) are rare congenital vascular lesions accounting for 1.5% of all vascular anomalies, with 50% of them occur in the oral and maxillo-facial regions. Treatment of large, complex vascular lesions is a serious challenge for patients and surgeons because it can cause disfigurement and massive haemorrhage, which may be spontaneous or the result of surgical intervention. Our study aimed to demonstrate surgical management of massive AVMs of the head and neck. Method: This retrospective study shows the treatment outcomes of 28 patients with massive maxillo-facial vascular malformations, who presented to our department for treatment from 1 January 2015 to 31 July 2022. Results: Twenty-eight patients with a mean age of 17.32 ± 12.21 years (women: 15, men: 13) were enrolled in the study. Diagnosis included extra cranial AVMs of the head and neck region. Treatment modalities, in isolation or combination, included angioembolisation procedure, sclerotherapy, and surgery. Conclusion: Management of AVMs is challenging owing to the replacement of normal tissue by the diseased ones and the high rate of recurrence. Hence, multi-modal approaches are needed for the effective restoration of tissues.

Limb anomalies are widespread and diversified in arthropods. From trilobites to insects, they range from the loss to the addition or fusion of legs and may appear congenitally or be induced experimentally (e.g., amputation or injury). Basal chelicerates pycnogonids, or sea spiders, also show deformities. Despite being understudied compared to other arthropods, quite a high diversity of limb malformations has been reported in the literature. The present study reports the leg anomalies of two adult females Ammothea hilgendorfi (Böhm, 1879) observed with duplicated leg podomeres. Both individuals were described ethologically and morphologically. Although the current knowledge on pycnogonids is limited, the anomaly is likely due to a problem in the molting process; the specimens were unable to totally remove their old exuviae, which then stacked after the proximal leg segments. The second specimen also showed other leg deformities, hinting at a problem during the molting process itself. The discussion emphasizes that understanding how pycnogonids normally molt would not only help our understanding of how the abnormal patterns appeared but also put pycnogonids into perspective with other arthropods, a phylum in which they have a key taxonomic position.

Abstract Background Intervertebral disc herniation is widely recognized as the most common cause of myelopathy in dogs older than 2 years; however, the prevalence of various causes of myelopathy in younger dogs has not been reported. Hypothesis/Objectives To describe the prevalence, clinical presentation, and etiology of myelopathy in dogs aged 18 months or less. Secondarily, to investigate which clinical features were associated with each of the most common etiologies. Animals Two hundred twenty‐four dogs aged 18 months or less with myelopathy were included in the study. Methods Retrospective review of clinical records from 4 referral institutions. Multivariable logistic regression analyses assessed which clinical features were associated with each diagnosis. Results French bulldogs (n = 51, 22.8%), pugs (n = 18, 8.0%), crossbreeds (n = 12, 5.4%), and English bulldogs (n = 11, 4.9%) were the most frequently affected breeds. Overall, 31 diagnoses were reached. The 5 most frequent diagnoses were vertebral malformation (VM; n = 42, 18.8%), spinal arachnoid diverticulum (SAD; n = 28, 12.5%), traumatic fracture of the vertebral column (n = 22, 9.8%), atlantoaxial instability (n = 18, 8.0%), and osseous‐associated cervical spondylomyelopathy (n = 17, 7.6%). Intervertebral disc extrusion (IVDE) accounted for 4.5% of cases (n = 10). A final diagnosis of VM was associated with younger, screw‐tailed, and pug breeds with chronic signs of T3‐L3 myelopathy. SAD was associated with screw‐tailed and pug breeds with nonpainful clinical signs. Intervertebral disc extrusion was associated with older, screw‐tailed, and pug breeds with shorter duration of clinical signs. Conclusions and Clinical Importance Prioritization of differential diagnoses for dogs presenting with signs of myelopathy when aged 18 months or less should differ to those for older dogs, with IVDE not the most common cause in the former.

Introduction: Brain histamine is considered an endogenous anticonvulsant and histamine H1 receptor. H1R antagonists have, in earlier studies, been found to induce convulsions. Moreover, research during the last two decades has provided more information concerning the anticonvulsant activities of histamine H3R (H3R) antagonists investigated in a variety of animal epilepsy models. Methods: Therefore, the in vivo anticonvulsant effect of the H3R antagonist DL76, with proven high in vitro affinity, in vitro selectivity profile, and high in vivo antagonist potency in mice against maximal electroshock (MES)-induced seizures in mice, was assessed. Valproic acid (VPA) was used as a reference antiepileptic drug (AED). In addition, DL76 was tested for its reproductive and fetal toxicity in the same animal species. Results and discussion: Our observations showed that acute systemic administration (intraperitoneal; i.p.) of DL76 (7.5 mg/kg, 15 mg/kg, 30 mg/kg, and 60 mg/kg, i.p.) provided significant and dose-dependent protection against MES-induced seizures in female and male mice. Moreover, the DL76- provided protective effects were comparable to those offered by the VPA and were reversed when animals were co-administered the CNS-penetrant selective H3R agonist R-(a)-methylhistamine (RAM, 10 mg/kg, i.p.). Furthermore, the administration of single (7.5 mg/kg, 15 mg/kg, 30 mg/kg, or 60 mg/kg, i.p.) or multiple doses (3 × 15 mg/kg, i.p.) of H3R antagonist DL76 on gestation days (GD) 8 or 13 failed to affect the maternal body weight of mice when compared with the control mice group. No significant alterations were detected in the average number of implantations and resorptions between the control and DL76-treated groups at the early stages of gestation and the organogenesis period. In addition, no significant differences in the occurrence of skeletal abnormalities, urogenital abnormalities, exencephaly, exomphalos, facial clefts, and caudal malformations were observed. The only significant abnormalities witnessed in the treated groups of mice were in the length of long bones and body length. In conclusion, the novel H3R antagonist DL76 protected test animals against MES-induced seizures and had a low incidence of reproductive and fetal malformation with decreased long bone lengths in vivo, signifying the potential therapeutic value of H3R antagonist DL76 for future preclinical as well as clinical development for use in the management of epilepsy. [ABSTRACT FROM AUTHOR]

Isolated unilateral absence of lunate is an extremely rare condition with only one such case reported in English literature so far. The rarity of this condition can lead to diagnostic dilemma, especially if patient has an old history of trauma or surgery around the wrist, leading to unnecessary intervention and difficulty in ensuring a good surgical outcome. We present such a case and discuss the clinical pointers to the diagnosis of this condition. Level of Evidence: Level V (Therapeutic) [ABSTRACT FROM AUTHOR]

Limb anomalies are widespread and diversified in arthropods. From trilobites to insects, they range from the loss to the addition or fusion of legs and may appear congenitally or be induced experimentally (e.g., amputation or injury). Basal chelicerates pycnogonids, or sea spiders, also show deformities. Despite being understudied compared to other arthropods, quite a high diversity of limb malformations has been reported in the literature. The present study reports the leg anomalies of two adult females Ammothea hilgendorfi (Böhm, 1879) observed with duplicated leg podomeres. Both individuals were described ethologically and morphologically. Although the current knowledge on pycnogonids is limited, the anomaly is likely due to a problem in the molting process; the specimens were unable to totally remove their old exuviae, which then stacked after the proximal leg segments. The second specimen also showed other leg deformities, hinting at a problem during the molting process itself. The discussion emphasizes that understanding how pycnogonids normally molt would not only help our understanding of how the abnormal patterns appeared but also put pycnogonids into perspective with other arthropods, a phylum in which they have a key taxonomic position. [ABSTRACT FROM AUTHOR]

Background: Intervertebral disc herniation is widely recognized as the most common cause of myelopathy in dogs older than 2 years; however, the prevalence of various causes of myelopathy in younger dogs has not been reported. Hypothesis/Objectives: To describe the prevalence, clinical presentation, and etiology of myelopathy in dogs aged 18 months or less. Secondarily, to investigate which clinical features were associated with each of the most common etiologies. Animals: Two hundred twenty‐four dogs aged 18 months or less with myelopathy were included in the study. Methods: Retrospective review of clinical records from 4 referral institutions. Multivariable logistic regression analyses assessed which clinical features were associated with each diagnosis. Results: French bulldogs (n = 51, 22.8%), pugs (n = 18, 8.0%), crossbreeds (n = 12, 5.4%), and English bulldogs (n = 11, 4.9%) were the most frequently affected breeds. Overall, 31 diagnoses were reached. The 5 most frequent diagnoses were vertebral malformation (VM; n = 42, 18.8%), spinal arachnoid diverticulum (SAD; n = 28, 12.5%), traumatic fracture of the vertebral column (n = 22, 9.8%), atlantoaxial instability (n = 18, 8.0%), and osseous‐associated cervical spondylomyelopathy (n = 17, 7.6%). Intervertebral disc extrusion (IVDE) accounted for 4.5% of cases (n = 10). A final diagnosis of VM was associated with younger, screw‐tailed, and pug breeds with chronic signs of T3‐L3 myelopathy. SAD was associated with screw‐tailed and pug breeds with nonpainful clinical signs. Intervertebral disc extrusion was associated with older, screw‐tailed, and pug breeds with shorter duration of clinical signs. Conclusions and Clinical Importance: Prioritization of differential diagnoses for dogs presenting with signs of myelopathy when aged 18 months or less should differ to those for older dogs, with IVDE not the most common cause in the former. [ABSTRACT FROM AUTHOR]

The endoplasmic reticulum (ER) is the largest membranous network serving as a region for protein, lipid and steroid synthesis, transport and storage. Detailed information about ER-cisternae, ER-tubules and rough endoplasmic reticulum (rER) is scarce in human blood cells. This study describes a series of giant inclusions and Auer bodies in promyeloblasts in six patients with acute promyelocytic leukemia (APL), by light microscopy, transmission electron microscopy (TEM) and cytochemical stains. TEM revealed that giant inclusions and pro-Auer bodies were associated with rER and surrounded by tubular structures composed of degenerated or redundant membrane in promyeloblasts, which corresponded with elements of the ER system. This paper reveals that in the promyeloblasts of APL, ER is the source of and transforms progressively into giant inclusions and Auer bodies. [ABSTRACT FROM AUTHOR]

2-naphthylamine (NAP) was classified as a group I carcinogen associated with bladder cancer. The daily exposure is mostly from cigarette and E-cigarette smoke. NAP can lead to testicular atrophy and interstitial tissue hyperplasia; however, the outcomes of NAP treatment on spermatogenesis and the associated mechanisms have not been reported. The study aimed to investigate the effect of NAP on spermatogenesis and sperm physiologic functions after being persistently exposed to NAP at 5, 20, and 40 mg/kg for 35 days. We found that sperm motility, progressive motility, sperm average path velocity, and straight-line velocity declined remarkably in the NAP (40 mg/kg) treated group, and the sperm deformation rate rose upon NAP administration. The testis immunity- and lipid metabolism-associated processes were enriched from RNA-sequence profiling. Plvap, Ccr7, Foxn1, Trim29, Sirpb1c, Cfd, and Lpar4 involved in testis immunity and Pnliprp1 that inhibit triglyceride and cholesterol absorption were confirmed to rise dramatically in the NAP-exposed group. The increased total cholesterol and CD68 levels were observed in the testis from the NAP-exposed group. Gpx5, serving as an antioxidant in sperm plasma, and Semg1, which contributes to sperm progressive motility, were both down-regulated. We concluded that the short-term exposure to NAP caused reproductive toxicity, primarily due to the inflammatory abnormality in the testis. [ABSTRACT FROM AUTHOR]

The first patient, a 10-year-old girl, presented with pancytopenia and recurrent epistaxis, along with a history of repeated upper respiratory infections, café-au-lait spots, and microcephaly. Genetic testing revealed compound heterozygous mutations in the DNA ligase IV (LIG4) gene, leading to a diagnosis of LIG4 syndrome. The second patient, a 6-year-old girl, was seen for persistent thrombocytopenia lasting over two years and was noted to have short stature, hyperpigmented skin, and hand malformations. She had a positive result from chromosome breakage test. She was diagnosed with Fanconi anemia complementation group A. Despite similar clinical presentations, the two children were diagnosed with different disorders, suggesting that children with hemocytopenia and malformations should not only be evaluated for hematological diseases but also be screened for other potential underlying conditions such as immune system disorders. [ABSTRACT FROM AUTHOR]

Background: Pericardial tumors have a rare occurrence. The incidence of pericardial tumors is 6.7 to 12.8% of all cardiac tumors, which in turn accounts for only 0.001 to 0.03% of all malignancies. Lymphangiohemangiomas are tumors which can occur at any age group, in any part of the body. Lymphangiohemangioma of the pericardium is a rare phenomenon. Here we present an extremely rare case of pediatric pericardial lymphangiohemangioma presenting with massive pericardial effusion resulting in cardiac tamponade uniquely managed by subtotal pericardiectomy followed by administration of mTOR inhibitor based on the histopathology and PET scan. Case Presentation: A 6-year-old male child, 2nd twin of 3rddegree consanguineous marriage presented to the emergency department and was admitted in Pediatric Intensive Care Unit with complaints of progressive difficulty in breathing since 3 months cough and rhinorrhea since 2 days and chest pain since 2 days. His birth history, immunization and developmental history were not significant for the present complaints, Anthropometry was within normal range. Outcome and follow up: Postoperatively the patient improved gradually. Intercostal drains were removed and patient was shifted out of the ICU on O2 support with nasal prongs. However, he continued to have respiratory distress. Ultrasonography chest revealed consolidation and bilateral hemorrhagic pleural effusion. Repeat ultrasonographys showed increased pleural effusion. His respiratory distress increased so he was put onmechanical ventilation and Ultrasonography guided pleural tapping was done thrice. After starting Sirolimus, gradually, condition of the child improved, pleural effusion reduced, and he was shifted to the ward on High Flow Nasal Cannula. Conclusion: To our knowledge, this is the only reported case of diffuse pericardial lymphangiohematomatosis. In this particular case, subtotal pericardiectomy resulted in symptomatic relief by relieving the cardiac tamponade and resultant cardiac compression. This approach was preferred in this case over the other option of pericardial window creation taking into account the need for complete drainage of the massive pericardial tamponade, removal of adequate pericardial tissue which was acting as the source of pericardial effusion and acquiring adequate and representative tissue for histopathological diagnosis of the disease. [ABSTRACT FROM AUTHOR]

Les urgences chirurgicales néonatales regroupent un ensemble d'affections qui nécessitent une prise en charge immédiate et adéquate en raison d'une menace vitale ou fonctionnelle. Notre travail a pour but de déterminer la fréquence et les facteurs épidémiologiques ainsi que le pronostic à court et moyen termes. Nous rapportons une étude rétrospective des urgences chirurgicales néonatales colligées sur une période de 12 mois. Ont été inclus, tous les nouveau-nés admis dans le cadre d'une urgence chirurgicale, opérés ou non, durant la période néonatale. Les anomalies étaient dominées par 46,5 % par le tableau d'occlusion néonatale, 18,6 % des nouveau-nés avaient une atrésie de l'œsophage, 10,4 % une anomalie de la paroi abdominale, 9,3 % une anomalie thoracique et 5,8 % des anomalies neurologiques, 3,4 % admis pour des malformations de l'arbre urinaire et anomalies ORL et 2,3 % une cause tumorale. Sur le plan thérapeutique 79 % des nouveau-nés avaient bénéficié d'un geste chirurgical. L'évolution clinique est marquée par le décès de 32 patients, soit 37 %. Les urgences chirurgicales néonatales requièrent une prise en charge immédiate et adéquate. D'où l'intérêt du suivi des grossesses et du diagnostic anténatal et de l'examen systématique et minutieux du nouveau-né en salle de naissance afin d'améliorer la prise en charge et le pronostic. Neonatal surgical emergencies include conditions that require immediate and adequate management due to a vital or functional threat. Our paper aims to determine the frequency and epidemiological factors as well as the short- and long-term prognosis. We report a retrospective study of neonatal surgical emergencies collected over a period of 12 months. Included were all newborns admitted as part of a surgical emergency, operated on or not, during the neonatal period. The anomalies were dominated by 46.5% by the neonatal occlusion, 18.6% of the newborns had esophageal atresia, 10.4% an abdominal wall anomaly, 9.3% a thoracic anomaly and 5.8% neurological abnormalities, 3.4% admitted for malformations of the urinary tree and ENT abnormalities and 2.3% a tumor cause. Therapeutically, 79% of newborns had benefited from a surgical procedure. The clinical evolution is marked by the death of 32 patients that is 37%. Neonatal surgical emergencies require immediate and adequate management. Hence, the interest of monitoring pregnancies and antenatal diagnosis and systematic and careful examination of the newborn in the birth room in order to improve management and prognosis. [ABSTRACT FROM AUTHOR]

Purpose: Vascular anomalies are classified as either vascular tumors or vascular malformations. Vascular malformations can be difficult to diagnose and treat in the pediatric population and can masquerade as malignant processes. Understanding the genetics behind vascular malformations can lead to identification of specific mutations which can be treated with targeted immunotherapy. Methods: Our case presents a pediatric patient with progressively enlarging vascular malformation despite multiple surgical resections and systemic medical treatments who underwent genetic evaluation and was found to have PIK3CA mutation. Results: After identification of PIK3CA mutation, our patient was successfully treated with the p110ɑ-specific inhibitor, alpelisib, with both shrinkage of malformation on follow-up imaging as well as gains in her developmental milestones. Conclusion: Progressive vascular malformations in the pediatric population can be hard to diagnose and treat and are thought to arise from somatic mutations. Our case highlights a patient with progressive malformation despite multiple surgical resections who was successfully treated with targeted immunotherapy after proper identification of genetic mutation. [ABSTRACT FROM AUTHOR]

Simple Summary: This study investigated the sublethal effects of three insecticides (spirotetramat, cyantraniliprole, and pymetrozine) on Aphis gossypii. The effects of sublethal concentrations (LC10, LC30, LC50, and LC70) of the insecticides on the developmental period, survival rate, adult longevity, fecundity, and deformity rate were compared with those of the control. Spirotetramat and cyantraniliprole caused malformation in the F1 but not the F2 generation of A. gossypii. The net reproductive rate (R0) decreased significantly compared to that of the control (43.8) for all insecticides except cyantraniliprole at the LC10 (37.5). Therefore, sublethal concentrations (over the LC30) of the three insecticides could aid in the management of A. gossypii by affecting its population density. The toxicity and sublethal effects of three insecticides (spirotetramat, cyantraniliprole, and pymetrozine) on Aphis gossypii, a major agricultural pest, were investigated. The nymphal stage showed greater susceptibility than the adult stage to all the insecticides, with a difference of up to 8.9 times at the LC50 of spirotetramat. The effects of sublethal concentrations (LC10, LC30, LC50, and LC70) of the insecticides on the on the developmental period, survival rate, adult longevity, fecundity, and deformity rate were compared with those of the control. Compared with the control, cyantraniliprole and pymetrozine did not significantly affect the developmental period in the parental or F1 generation when applied at the nymphal stage at any concentration. Nonviable nymphs occurred in the F1 generation when both nymphs and adults were treated with spirotetramat and cyantraniliprole but not in the F2 generation. The age-specific maternity (lxmx) of A. gossypii treated with sublethal concentrations (LC10, LC30) decreased with increasing concentration. Spirotetramat at the LC30 resulted in significant differences in all life table parameters (R0, rm, λ, T, DT) compared with those of the control. Similarly, compared with that of the control (43.8), the net reproductive rate (R0) significantly decreased for all the insecticides except cyantraniliprole at the LC10 (37.5). Therefore, this study indicated that sublethal concentrations (over the LC30) of spirotetramat, cyantraniliprole, or pymetrozine might be useful for the density management of A. gossypii. [ABSTRACT FROM AUTHOR]

Cobb syndrome is a rare neurocutaneous disease characterized by multiple spinal vascular anomalies and vascular skin lesions affecting the corresponding dermatome. We present a case of a 12-year-old boy with history of spinal arteriovenous malformation (AVM) extending from T4-T5 status post partial embolization 3 years ago and hyperpigmented patch overlying his thoracic back region presenting with 2 days of back pain and lower extremity numbness and weakness. He had multiple Type III AVMs within the spinal and paraspinal tissues involving the T4-T7 vertebral elements, most extensively T4 and T5. The largest aneurysm located at the confluence of the main AVM nidus was a 4 mm anterior spinal artery aneurysm, which was embolized with partial embolization of the main AVM nidus, resulting in complete aneurysm occlusion. This report provides valuable insight on the natural history, recurrence risk, and treatment options of Cobb syndrome to aid in early diagnosis and improve outcomes. [ABSTRACT FROM AUTHOR]

Research on embryonic development is entering into a new era. As a traditionally descriptive discipline within anatomy, embryologists have formed international consortia and digitized important histological collections for preservation and open access. Embryonic development has recently received a wider attention in context with temporo-spatial transcriptomics at single cell level. These can be expected to fuel the realization of the transdisciplinary significance of efforts to decipher embryonic development. Addressing its complexities encompasses a wealth of challenges that intersect across the domains of science, society, and politics underlining its outstanding importance as well as its inherently interdisciplinary nature. The challenges of this field are by no means confined to understanding the intricate biological mechanisms but also have humanitarian implications. To fully appreciate the mechanisms underlying human development, principles of embryogenesis have predominantly been analyzed employing animal models which allow us to broaden our view on developmental processes. As a result of recent pioneering work and technical progress centered around stem cell-based 3D approaches, we are entering into a historical new phase of learning about mammalian embryonic development. In vertebrates, a growing concern now focuses the reduction of animal experimentation. This perspective article outlines the major challenges in this amazing field that offer an enormous potential for basic biomedical sciences as well as related translational approaches if they are tackled in a multidisciplinary discourse.

Aim: To evaluate the repercussions of periodontitis and diabetes association on rat pregnancy and newborns. Methods: Diabetes was induced in female Wistar rats 24 h after birth through the administration of Streptozotocin. The diabetic condition of the rats was further confirmed in adulthood. After mating, the pregnant rats were distributed into four experimental groups (n = 12 rats/group): nondiabetic and diabetic with and without periodontitis. Periodontitis was induced by a ligature inserted into the first molar on day 0 of pregnancy. Body weight, water and feed consumption were evaluated weekly, and an oral glucose tolerance test was performed on day 17 of pregnancy. On day 21 of pregnancy, the animals were anesthetized and killed for organ removal. The hemimandibles were collected to analyze alveolar bone loss. Immunological and biochemical parameters were evaluated in the maternal blood samples, and reproductive performance was analyzed. The newborns were weighed, and anomalies evaluated. Results: The group with diabetes and periodontitis had a greater degree of alveolar bone loss, along with higher relative pancreatic weight, blood glucose levels, triglyceride and inflammatory cytokine levels, hepatic transaminase activity, and embryonic losses. In addition, these newborns had increased body weight, placental weight, a greater number of ossification centers, and a higher rate of visceral and skeletal anomalies. Conclusion: The combination of maternal diabetes and periodontitis negatively impacts maternal parameters and fetal development. The findings reinforce the importance of maintaining maternal oral health to ensure the general health of the offspring, especially in cases where diabetes is present.

Targeted medical therapies for the treatment of vascular malformations is an exciting and evolving area of research. As the identification of specific causative genetic mutations involved in vascular malformations becomes more accessible and inexpensive, the development of targeted therapies to address these genetic anomalies becomes all the more enticing. It is an excellent example of the potential of translational research where basic science discoveries are translated to clinical practise from ‘bench to bedside’. In this mini-review we aim to synopsise some of the recent studies published in this area with specific focus on the paediatric population. We also aim to highlight the growing demand for future research in the field to elucidate further the optimum duration of treatments, strategies for discontinuation, potential for combination of therapies and the effects of prolonged use of these medications.

ABSTRACT Collie Eye Anomaly (CEA) is a congenital genetic defect primarily found in Collie dogs but occasionally in other breeds. Its significance lies in its genetic implications for breeding in predisposed breeds. Diagnosing CEA can be challenging and relies on clinical history, epidemiological data, clinical and ophthalmological examinations, and ocular ultrasonography to assess the extent of damage and prognosis. This article presents a case of CEA in a 6-month-old Border Collie dog who exhibited reduced vision and acute hyphema. The condition was diagnosed through direct ophthalmoscopy and ocular ultrasonography