The image displays a histopathological examination of a disc fragment extracted during a surgical procedure. The tissue section is stained with hematoxylin and eosin (H&E), a common staining technique used to visualize cellular structures and morphology. The magnification of the image is 40x, and there is a scale bar indicating 200 micrometers for reference.

In the image, we can observe two main features: liquefaction degeneration and granulation surrounding the sequestered disc fragment. Liquefaction degeneration appears as an area of tissue breakdown and disintegration, which is a result of the degenerative process. The affected tissue may exhibit a loss of normal cellular architecture and organization.

Surrounding the sequestered disc fragment, we can see granulation tissue. Granulation tissue is characterized by the presence of new blood vessels, inflammatory cells, and fibroblasts. This tissue forms as part of the body's natural healing response to injury or inflammation. The presence of granulation tissue around the disc fragment indicates an ongoing healing process in response to the sequestered disc.

Overall, the image provides a clear visualization of the histopathological findings in the extracted disc fragment, highlighting the degenerative changes and the body's healing response.

Histopathological findings. Representative images of HE-stained sections of the disc fragment extracted during the operation, showing liquefaction degeneration and granulation surrounding the sequestered disc fragment. Scale bar: 200 μm (hematoxylin and eosin [H & E] × 40)

Consistent with observations during the operation , histopathological analysis revealed liquefaction degeneration and granulation surrounding the sequestered disc fragment ( Fig. 5 ) .


Offer a thorough analysis of the image
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The image presents a histopathological examination of the liver tissue, showcasing various pathological features. The visual representation of the liver biopsy reveals several key findings, including interphase activity, confluent necrosis, hepatic duct proliferation, and biliary stasis.

In the image, one can observe areas of interphase activity, which are characterized by the presence of inflammatory cells and hepatocyte damage at the interface between the liver parenchyma and the portal tracts. This activity is indicative of ongoing inflammation and liver injury.

Confluent necrosis, another feature visible in the image, is characterized by the presence of large areas of dead liver cells. These areas appear as irregularly shaped regions with a loss of cellular structure and are often surrounded by inflammatory cells.

The image also displays hepatic duct proliferation, which is evident by the increased number and size of bile ducts within the liver tissue. This proliferation is a response to liver injury and can be seen as an attempt to restore normal bile flow.

Lastly, the image shows biliary stasis, which is characterized by the accumulation of bile within the liver tissue due to impaired bile flow. This can be observed as areas with a greenish-brown coloration, representing the buildup of bile pigments.

Overall, the image provides a detailed view of the liver tissue's histopathological findings, highlighting the presence of inflammation, necrosis, duct proliferation, and biliary stasis. These features are indicative of significant liver injury and may be associated with various liver diseases.

In liver biopsy interphase activity , confluent necrosis , hepatic duct proliferation , and biliary stasis were detected ( Fig. 3 ) .


Characterize the image using a well-detailed description
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The image displays a cirrhotic liver affected by Wilson disease. The liver's surface exhibits an irregular texture, with both small and large nodules present. These nodules, which can be described as micronodular and macronodular, are scattered across the liver, giving it a heterogeneous appearance. The color of the liver may appear abnormal, possibly with a mix of dark and light areas, indicating the severity of the cirrhosis. Overall, the image provides a clear visual representation of the gross appearance of a cirrhotic liver in Wilson disease, highlighting the mixed nodularity and the impact of the condition on the organ's structure.

Gross appearance of cirrhotic liver in Wilson disease.

Cirrhosis may be micronodular or macronodular ( Fig. 4 ) , or it may be mixed .


Break down the elements of the image in a detailed manner
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The image is a fetal MRI scan, specifically using the single-shot fast spin echo (SSFSE) sequence. It provides a coronal view of the fetal thoracic region, allowing for a clear visualization of the bronchial anatomy. In this image, the carina, which is the point where the trachea divides into the left and right main bronchi, is situated lower than the aortic arch and is approximately at the level of the sixth or seventh thoracic vertebra.

The right main bronchus is depicted as stenotic, or narrowed, and is indicated by a blue arrow. It originates from the sloping left main bronchus, which is marked by a red arrow. The position of the pseudo carina, or the false carina, is low and is highlighted by a white arrow. The combination of these anatomical features results in the formation of a bridging bronchus, which is classified as type II.

Overall, the image provides a detailed representation of the fetal bronchial anatomy, with specific focus on the stenotic right main bronchus, the sloping left main bronchus, and the low position of the pseudo carina.

Fetal MRI SSFSE sequence shows the stenotic right main bronchus (blue arrow) comes from the sloping left main bronchus (red arrow), the position of pseudo carina is low (white arrow).which form a bridging bronchus in type II. LMB, left main bronchus; MRI, magnetic resonance imaging; SSFSE, single-shot fast spin echo.

On the coronal view , the carina was obviously lower than the aortic arch , which was located at approximately the sixth or seventh thoracic vertebra ( Fig. 2 ) .


Explain the various aspects of the image before you
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The image displays a gross specimen of an eyeball, which measures approximately 2.5 cm in width, 2.5 cm in height, and 1.3 cm in depth. On the scleral surface of the eyeball, there is a gray-white growth visible. This growth does not extend to the posterior half of the eyeball or involve the optic nerve. Additionally, the outer surface of the eyeball exhibits prominent vascular markings, which are also visible in the image.

Gross specimen of the eyeball of the size 2.5 cm × 2.5 cm × 1.3 cm with a gray-white growth attached on the scleral surface, with no involvement of the posterior half of the eyeball and optic nerve

Outer surface of the eyeball was gray-white with prominent vascular markings [ Figure 5 ] .


The image is a computed tomography angiography (CTA) scan focusing on the left middle cerebral artery (MCA). In this scan, the left MCA appears to have nearly normal vascularity. The image likely displays a series of cross-sectional slices or a 3D reconstruction of the blood vessels in the brain, with the left MCA being the primary focus.

The blood vessels in the image are likely highlighted using a contrast agent, making them more visible against the surrounding brain tissue. The left MCA can be seen branching off from the main cerebral artery and extending into smaller branches, supplying blood to various regions of the brain.

The image may show the left MCA in comparison to the right MCA or other blood vessels in the brain, allowing for a clear assessment of its vascularity. The nearly normal appearance of the left MCA suggests that there are no significant blockages, narrowing, or other abnormalities in the blood vessel that could potentially lead to reduced blood flow or other complications.

Overall, the image provides valuable information about the health and function of the left middle cerebral artery, indicating that it is in a nearly normal state and not showing any major issues that could impact blood flow to the brain.

Computed tomography angiography showing almost normal vascularity of the left middle cerebral artery.

However , the left MCA showed almost normal vascularity on CT angiography ( Figure 4 ) .


The image consists of six panels, labeled a through f, each displaying different aspects of the tissue sample under various magnifications and staining techniques.

Panel a, magnified at 200x, shows abundant CD3+ T cells within the portal tracts. These cells appear as small, round structures with a darker center, representing the nucleus, and a lighter surrounding area, representing the cytoplasm. The CD3+ T cells are densely packed and distributed throughout the portal tracts.

Panel b, magnified at 100x, displays scattered PAX8+ B cells within the portal tracts. These cells are also round in shape but are less densely distributed compared to the CD3+ T cells. The PAX8+ B cells are interspersed among other cell types within the tissue.

Panel c, magnified at 600x, highlights the presence of Reed-Sternberg cells throughout the portal and periportal areas. These cells are large, with a distinctive bilobed nucleus and prominent nucleoli, giving them an "owl's eye" appearance. The surrounding tissue contains a mix of other cell types.

Panel d, also magnified at 600x, shows the Reed-Sternberg cells positive for Epstein-Barr virus (EBV) using Epstein-Barr encoding region in situ hybridization. The positive cells exhibit a specific staining pattern, indicating the presence of EBV within the cells.

Panel e, magnified at 600x, demonstrates the Reed-Sternberg cells positive for CD15. The positive cells exhibit a distinct staining pattern, highlighting the expression of the CD15 marker on the cell surface.

Finally, panel f, magnified at 600x, reveals the Reed-Sternberg cells positive for CD30. Similar to the previous panels, the positive cells display a unique staining pattern, indicating the expression of the CD30 marker on the cell surface.

Overall, the image provides a comprehensive view of the cellular composition within the portal tracts, highlighting the presence of CD3+ T cells, PAX8+ B cells, and Reed-Sternberg cells positive for EBV, CD15, and CD30.

There were also abundant CD3+ T cells (a; ×200) and scattered PAX8+ B cells (b; ×100) within the portal tracts. H&E shows Reed-Sternberg cells (c; ×600) throughout the portal and periportal areas positive for EBV (by Epstein-Barr encoding region in situ hybridization) (d; ×600), CD15 (e; ×600), and CD30 (f; ×600).

Immunohistochemical stains confirmed that the portal inflammation was composed primarily of CD3 + T lymphocytes , interspersed CD20 + / PAX-5 + B cells , and focal histiocytes ( Fig. 2 ) .


Portray the image with a rich, descriptive narrative
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The image displays a comprehensive visual representation of the involvement of BLTR1 in macrophage infiltration and neointima formation in wire-injured femoral arteries. It consists of several panels, each showcasing different aspects of the experiment.

In the first panel, Doppler images depict blood flow in the femoral arteries of two groups of mice: wild-type (WT) and BLTR1-deficient (KO) mice, four weeks after wire injury (WI). The images are color-coded, with red hues indicating regions of maximum perfusion, yellow representing medium perfusion values, and blue signifying the lowest perfusion values. Arrows within the images point to the blood flow in the injured femoral arteries.

The second panel presents cross-sections of mouse femoral arteries stained with hematoxylin and eosin (H&E) at four weeks after WI. These images provide a clear view of the arterial structure and the neointima formation in the injured arteries.

In the third panel, the neointima is stained with anti-HMGB1 and anti-CD36 antibodies to visualize HMGB1 and macrophage infiltration, respectively. These images highlight the presence and distribution of these molecules within the neointima area.

The fourth panel shows vascular smooth muscle cells (VSMCs) stained with anti-α-SMA antibody, providing a visual representation of the VSMCs within the arterial structure.

At the bottom of the image, there are quantifications of various parameters. These include the LDPI ratio, which is calculated as the ratio of blue-to-red pixels in the injured artery (WI) versus non-injured arteries (Control), neointima volumes in the cross-sections of injured femoral arteries, and the numbers of HMGB1-positive and CD36-positive cells in the neointima area. The data are presented as means ± SEMs, and statistical significance is indicated with asterisks.

Overall, the image provides a detailed and informative visual representation of the role of BLTR1 in macrophage infiltration and neointima formation in wire-injured femoral arteries, with multiple panels illustrating different aspects of the experiment and quantifications to support the findings.

Involvement of BLTR1 in macrophage infiltration and neointima formation in wire-injured femoral arteries. Doppler images: Blood flow in the femoral arteries of WT and BLTR1-deficient (KO) mice at 4 wks after wire injury (WI) was assessed using a LDPI analyzer. In these color-coded images, red hue indicates regions of maximum perfusion, medium perfusion values are shown in yellow, and lowest perfusion values are represented as blue. Arrows indicate blood flow in an injured femoral artery. Photographs are representative of 5-6 independent experiments. H&E: Cross sections of mouse femoral arteries were prepared at 4 wks after WI, and stained with H&E. HMGB1 and CD36: HMGB1 and macrophage infiltration in the indicated neointima were stained with anti-HMGB1 antibody and anti-CD36 antibody, respectively. α-SMA: VSMCs were stained with anti-α-SMA antibody. Images are representative of 5–6 independent experiments. Bottom: LDPI ratio was quantified as the ratio of the blue-to-red pixels in the injured artery (WI) vs. non-injured arteries (Control). Neointima volumes in the cross sections of injured femoral artery were determined using an image analyzer. Numbers of HMGB1-positive and CD36-positive cells in neointima area were quantified, and data were presented as the means ± SEMs of 3-4 independent experiments. **P < 0.01 vs. WT mice.

Likewise , macrophage infiltration into neointima was also markedly attenuated in BLTR1 deficient mice ( Figure 5 ) , suggesting BLTR1 contributed to vascular inflammation and subsequent neointima formation induced by damage associated mediators secreted in the injured vasculatures .


The image displays a gross pathology specimen, which is an irregular ovoid mass. The mass is quite large, as it measures 9 cm at its greatest dimension. The color of the mass is a mixture of tan and pink, giving it a distinct appearance. The surface of the mass is smooth and is covered by a serosal layer.

One of the striking features of the image is the prominent vasculature on the mass, which indicates a well-developed network of blood vessels. This could be a sign of the mass being highly vascularized, which is often seen in certain types of tumors or lesions.

In the center of the mass, there is a noticeable ulcer. The ulcer is not uniform in shape, as it measures 2.5 cm in one dimension and 1.5 cm in the other. An arrow in the image points to this central ulcer, drawing attention to its significance.

Overall, the image provides a clear visualization of the gross pathology of the irregular ovoid mass, highlighting its size, color, surface characteristics, vasculature, and the presence of a central ulcer.

Gross pathology showing an irregular ovoid mass measuring 9 cm in its greatest dimension, with a smooth serosal surface, prominent vasculature, and a 2.5 × 1.5 cm central ulcer (arrow).

Gross pathology revealed a tan-pink irregular ovoid mass measuring 9 cm in its greatest dimension , with a smooth serosal surface , prominent vasculature , and a 2.5 × 1.5 cm central ulcer ( Figure 4 ) .


Analyze the image in a comprehensive and detailed manner
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The image consists of two axial T2-weighted magnetic resonance (MR) images of an infant's brain, displayed side by side. The left image highlights the mild prominence of both lateral ventricles, which are indicated by black arrows. Additionally, there is an increased anterior inter-hemispheric distance, marked by a green arrow.

The right image, taken from the same infant, focuses on the enlarged subarachnoid space along the anterior aspect of the brain. This area is denoted by black arrows. The bilateral lateral ventricles are also prominent in this image, as indicated by green arrows. Furthermore, the anterior cranio-cortical distance is visibly increased, which is also marked by black arrows.

Both images together provide a visual representation of the complications associated with external hydrocephalus, as seen on CT and MRI scans without contrast.

BESS:
(Left ): Axial T2W MR image of the brain reveals mild prominence of both the lateral ventricles (black arrows) with increased anterior inter-hemispheric distance (green arrow).(Right): Axial T2W MR image of the same infant shows enlarged subarachnoid space along the anterior aspect of the brain (black arrows) with prominent of bilateral lateral ventricles (green arrows). Moreover, the anterior cranio-cortical distance (black arrows) is obviously increased.

CT and MRI without contrast are also important for evaluating the most common complications associated with external hydrocephalus ( 7 , 38 , 39 ) ( Figure 3 ) .


Share a comprehensive rundown of the presented image
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The image presents a side-by-side comparison of two medical imaging techniques: an ultrasound image on the left and a multiplanar reconstructed MR image on the right. Both images are focused on the chest area of a 55-year-old woman who had previously undergone surgery for invasive ductal carcinoma in her left breast.

In the ultrasound image, you can observe the breast tissue and surrounding structures. The image is grayscale, with different shades representing various tissue densities. A specific area of interest is highlighted, which corresponds to the pathological lymph node detected during the second-look ultrasound with coregistration.

On the right side, the multiplanar reconstructed MR image provides a more detailed view of the same region. This image is also grayscale, but with higher contrast and resolution compared to the ultrasound image. A rounded enhancing lesion is visible in the left internal mammary chain, marked by a green cross. This lesion was identified during the follow-up MR examination conducted six months after the initial surgery.

Overall, the image demonstrates the complementary nature of ultrasound and MR imaging in detecting and monitoring breast cancer-related abnormalities, such as the pathological lymph node and the enhancing lesion in this case.

Ultrasound image (left side) with the corresponding multiplanar reconstructed MR image (right side) of a 55-year-old woman who underwent a previous surgery of the left breast for invasive ductal carcinoma (IDC, pT2N0). After 6 months, a follow-up MR was performed showing a rounded enhancing lesion in the left internal mammary chain (green cross). Second-look ultrasound with coregistration revealed a pathological lymph node.


Describe the following image in detail
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The image is a chest X-ray of a patient with SHS, displaying a clear view of the patient's thoracic region. Both lungs are visible, and there is evidence of bilateral extensive pneumonic consolidation. This means that there are widespread areas of opacity in both lungs, indicating the presence of fluid or other material within the lung tissue.

The consolidation appears as patchy, irregular regions of increased density throughout the lungs, which is suggestive of an infective etiology. The affected areas are not confined to a single lobe or segment but are distributed across multiple regions in both lungs. The overall appearance of the lungs in the image is consistent with a severe respiratory infection or inflammation.

Chest X-ray of patient with SHS showing bilateral extensive pneumonic consolidation.

Chest X-ray was suggestive of bilateral , extensive , and patchy consolidation suggestive of infective etiology ( Figure 1 ) .


The image is an axial computed tomography (CT) scan of a 14-year-old female patient experiencing bilateral parotid pain and swelling. The image shows symmetric enlargement of the parotid glands, which are the largest salivary glands located in front of the ears and extending to the lower borders of the jaw. The enlargement of the glands is a key feature in this image, indicating viral sialadenitis.

In addition to the enlarged parotid glands, there is subtle stranding visible in the adjacent fat, marked by white arrows. This stranding appears as linear areas of increased density within the fat surrounding the glands, suggesting inflammation and edema.

The image also provides evidence of the involvement of the superficial cervical fascia and platysma muscles, which can be inferred from the context. These structures may appear thickened due to the inflammatory process.

The bilateral involvement of the parotid glands is a common finding in viral sialadenitis, as it occurs in up to 75% of patients. However, it is important to note that a small minority of patients may present with only unilateral involvement.

Overall, the image demonstrates the classic findings of viral sialadenitis, including bilateral enlargement of the salivary glands, fat stranding, and potential thickening of the superficial cervical fascia and platysma muscles. The patient's blood work, which tested positive for the parainfluenza virus, further supports the diagnosis.

Viral Sialadenitis. Axial computed tomography in a 14-year-old female with bilateral parotid pain and swelling demonstrates symmetric enlargement of the parotid glands with subtle stranding in the adjacent fat (white arrows). Blood work was positive for parainfluenza virus.

On imaging , classic findings include bilateral enlargement of the salivary glands , fat stranding , and thickening of the superficial cervical fascia and platysma muscles [ Figure 9 ] . [ 1213 ] Although bilateral involvement is seen in up to 75 % of patients , a small minority of patients may present with only unilateral involvement .


The image presents motion-corrected MRI data of a fetus with a double aortic arch at 32 weeks. It displays various anatomical structures, including the descending aorta, arterial duct, and left and right aortic arches, which are labeled accordingly. The image is divided into multiple panels, with the middle panel showing a contrast-enhanced MRI of the right-sided arch at 2 months postnatal age.

In the image, a ligamentous remnant of the left arch is predicted, marked by an asterisk. This finding is later confirmed during surgery, as shown in the right panel. Additionally, the distal remnant of the arterial duct is visible, which is analogous to the diverticulum of Kommerell and labeled with the letter "K." The image is accompanied by a video that provides more detail on the subject.

Motion-corrected MRI data from a fetus with double aortic arch at 32 weeks Shown are the descending aorta (DAo), arterial duct (D), and left (L) and right (R) aortic arches. At 2 months postnatal age, contrast-enhanced MRI could show a right-sided arch (middle panel); however, a ligamentous remnant of the left arch was predicted on the basis of the fetal MRI findings (asterisk); this finding was confirmed at surgery (right panel). The distal remnant of the arterial duct—analogous to the diverticulum of Kommerell—is also seen (K). See video 3 for more detail.

Example images from 3D reconstructed data are shown in Figure 3 , Figure 4 , Figure 5 ; appendix p 3 ; videos 2-4 ) .


Give an elaborate explanation of the image you see
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The image is a computed tomography (CT) scan of the right lower extremity, focusing on the right peroneal artery. The CT scan uses contrast to enhance the visualization of the blood vessels in the area. In the image, you can see the right peroneal artery, which is a branch of the tibioperoneal trunk, a major blood vessel in the lower leg.

The main feature of the image is a saccular aneurysm located just distal to the tibioperoneal trunk. The aneurysm appears as a bulging, balloon-like structure in the right peroneal artery. The dimensions of the aneurysm are notable, as it is quite large in size. The shape of the aneurysm is irregular, and it is evident that the arterial wall has weakened and expanded in this area.

The surrounding structures in the image, such as bones, muscles, and other blood vessels, provide context for the location of the aneurysm. The CT scan offers a detailed view of the lower leg's anatomy, allowing for a clear understanding of the aneurysm's position and its relationship to nearby structures.

Overall, the image provides a comprehensive view of the right peroneal artery aneurysm and its location in the lower leg, highlighting the importance of medical imaging in diagnosing and understanding vascular conditions.

Computed tomography scan of the right peroneal artery aneurysm.

A computed tomography scan with contrast of the right lower extremity demonstrated a 2.7- × 3.2- × 3.2-cm saccular aneurysm of his right peroneal artery just distal to the tibioperoneal trunk ( Fig 1 ) .


Clarify the contents of the displayed image with great detail
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The image displays a chest computed tomography (CT) scan, which is a type of medical imaging technique used to visualize the internal structures of the chest. In this particular image, the focus is on the lungs.

Both lungs are visible in the image, and there are noticeable abnormalities present in the form of bilateral airspace consolidation and ground-glass opacity. Bilateral airspace consolidation refers to the presence of dense, opaque areas in both lungs, which can be seen as irregular, solid regions within the lung tissue. These areas of consolidation indicate that the airspaces within the lungs are filled with fluid, pus, or other cellular debris, which can be a sign of infection, inflammation, or other lung conditions.

In addition to the areas of consolidation, the image also shows ground-glass opacity, which is a term used to describe a hazy, semi-transparent appearance in the lung tissue. This opacity is less dense than the consolidation areas and can be seen as a lighter, more diffuse pattern throughout the lungs. Ground-glass opacity can be indicative of various lung conditions, including infections, interstitial lung diseases, or even early-stage lung cancer.

Overall, the image provides a detailed view of the lung abnormalities, highlighting the bilateral airspace consolidation and ground-glass opacity, which can be helpful in diagnosing and managing various lung conditions.

Chest computed tomography revealed bilateral airspace consolidation and ground-glass opacity.

Chest computed tomography ( CT ) revealed bilateral airspace consolidation and ground-glass opacity ( Figure 2 ) .


The image is a chest x-ray taken a few weeks after the patient started hemodialysis. In the image, the patient's chest cavity can be seen, including the lungs, heart, and ribcage. The overall appearance of the lungs is clear, indicating that there is no pleural effusion present. This suggests that the patient's condition has improved since starting hemodialysis.

Additionally, a perm catheter can be observed in the image. The catheter is positioned correctly, allowing for efficient hemodialysis treatment. The placement of the catheter is important for the patient's ongoing care and treatment.

Overall, the chest x-ray image demonstrates the patient's progress after starting hemodialysis, with no signs of pleural effusion and a properly placed perm catheter.

Chest x-ray, few weeks after starting hemodialysis, showed no pleural effusion. Perm catheter is in place

Follow-up evaluation showed neither recurrence of symptoms nor recurrence of pleural effusion on chest x-ray ( see Figure 5 ) .


The image is a chest X-ray of a patient, showing a detailed view of their lungs. In the right lung, there are multiple patchy areas of consolidation distributed throughout the lung fields. These areas appear as irregular, dense regions, indicating possible infection or inflammation. Similarly, in the left lung, the upper zone also displays patchy consolidation, suggesting a similar issue. The overall appearance of the lungs in the image highlights the presence of a medical condition that affects both lungs, with a more pronounced impact on the right side.

Chest X-ray of a patient at presentation. Patchy areas of consolidation seen throughout the right lung and left upper zone

Chest roentgenogram showed patchy areas of consolidation throughout the right lung fields and left upper lobe [ Figure 1 ] .


The image presents a flowchart illustrating the adult pathway to screen for acute heart failure in COVID-19 patients admitted to the hospital. The flowchart begins with the patient's admission to the emergency department. From there, several tests are conducted, including electrolytes, urea and creatine tests, liver function tests, C-reactive protein tests, lactate dehydrogenase tests, chest X-rays, and electrocardiographs.

Based on the results of these tests, the flowchart guides the healthcare professionals through various decision points to determine the appropriate course of action. This may involve admitting the patient to a high dependency unit or an intensive care unit, depending on the severity of their condition. In some cases, a transthoracic echocardiogram may be performed to assess left ventricular function.

The flowchart aims to help identify COVID-19 patients at risk for severe heart failure and circulatory collapse while balancing the need to protect healthcare workers from virus exposure and preserving personal protective equipment.

Adult pathway to screen for acute heart failure in COVID-19 patients admitted to hospital. Abbreviations: ED, emergency department; EUC, electrolytes, urea and creatine; LFT, liver function test; CRP, C-reactive protein; LDH, lactate dehydrogenase; CXR, chest X-ray; ECG, electrocardiograph; HDU, high dependency unit; ICU, intensive care unit; TTE, transthoracic echocardiogram; LV, left ventricular.

We suggest the following algorithm ( Figure 1 ) , to better identify COVID-19 patients at risk for severe heart failure and circulatory collapse , whilst balancing the need to protect health care workers from virus exposure and to preserve personal protective equipment ( PPE ) :


Examine the image closely and share its details
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The image displays a gross specimen, which is a sample of biological tissue taken for examination. In this case, the specimen appears to have been removed from a patient during a surgical procedure. The tissue sample is shown in its natural state, without any staining or magnification.

The specimen is placed on a clean, flat surface, likely a tray or a petri dish, to provide a clear view of its features. The tissue has a distinct color, texture, and shape, which can provide valuable information about the patient's condition. The size of the specimen can also be observed, giving an idea of the extent of the affected area.

The image may also show some tools or instruments used during the procedure, such as forceps or a scalpel, which can help to provide context for the scale of the specimen. Additionally, there might be labels or annotations on the image to indicate specific areas of interest or to provide further information about the sample.

Overall, the image serves as a visual representation of the gross specimen, allowing researchers and medical professionals to study its features and gain insights into the patient's condition.


Narrate the contents of the image with precision
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The image displays a preoperative aortography, which is a medical imaging technique used to visualize the anatomy of the aorta. In this particular image, the aorta is shown to be consistent with the findings from a computed tomography (CT) scan. The aortography reveals the structure and any potential abnormalities in the aorta, allowing for a clear understanding of the patient's anatomy.

The image likely shows the aorta in detail, with its various branches and blood vessels visible. The contrast between the aorta and the surrounding tissues is evident, making it easy to identify the specific anatomical features. The image also highlights the suitability of the patient's anatomy for the proposed repair, as confirmed by the intraoperative flush abdominal aortography. Overall, the image provides a clear and informative visualization of the aorta, which is crucial for planning and executing the necessary medical procedures.

Preoperative aortography demonstrating anatomy consistent with the computed tomography scan.

Intraoperative flush abdominal aortography confirmed computed tomography angiography findings and a suitable anatomy for the proposed repair ( Fig 2 ) .


The image is a schematic representation of a multi-modal Janus nanoparticulate system. This system consists of several components that contribute to its functionality in biomedical applications.

At the center of the image, there is a core/shell face composed of superparamagnetic iron oxide nanoparticles (SPION) and mesoporous silica nanoparticles (MSN). This core/shell structure is responsible for the T2 magnetic resonance imaging (MRI) contrast capabilities of the system.

On one side of the core/shell face, there is a gold nanoparticle face. This gold interface is responsible for providing the possibility of computed tomography (CT) imaging.

The gold nanoparticle face is also modified with a fluorescent dye, which is depicted in the image as a distinct element attached to the gold interface. This dye, Alexa Fluor® 647, allows for optical imaging of the system.

On the other side, the MSN face is functionalized with a tumor-targeting peptide, cRDG. This peptide is shown in the schematic as a separate element attached to the MSN face, enabling active tumor targeting.

Overall, the image provides a clear and detailed visualization of the multi-modal Janus nanoparticulate system, highlighting its various components and their roles in imaging and tumor targeting.

A schematic representing a multi-modal Janus nanoparticulate system composed of a SPION/MSN core/shell face and Au nanoparticle face. T2 MRI contrast capabilities arise from the encapsulated SPION with Au nanoparticles providing the possibility for CT imaging. As shown in this schematic, the system is functionalised with a fluorescent dye (Alexa Fluor® 647) for optical imaging in addition to cRDG for active tumour targeting. Reprinted with permission from reference [178]. Copyright (2018) American Chemical Society.

The gold interface was modified with a fluorescent dye ( Alexa Fluor® 647 ) and the MSN face with a tumour targeting peptide cRDG ( Figure 15 ) .


The image consists of two parts. In the top section, there are representative microphotographs of histological slices from the left ventricles of rat hearts. These slices are stained with Sirius Red, which highlights collagen fibers in red. The microphotographs display heart tissue samples from both short-term T3 treated rats and vehicle-treated rats, allowing for comparison between the two groups. A scale bar of 25 µm is provided to indicate the size of the structures in the images.

In the bottom section of the image, there is a quantitative analysis of the collagen-positive areas in the left ventricles of the different animal groups. This analysis is presented as a bar graph, with the percentage of positively stained collagen area expressed as a percentage of the total area. The graph includes data for short-term hyperthyroidism induced by daily subcutaneous injections of T3 for 1, 3, and 10 days (T31d, T33d, and T310d), as well as control animals injected daily with the vehicle for 1, 3, and 10 days (V1d, V3d, and V10d). The values are represented as means±SEM, and the statistical analysis (one-way ANOVA) indicates no significant differences between the groups.

Absence of signs of fibrosis in the left ventricles of 3, 5, 3’ triiodo-L-thyronine treated rats. (top) Representative microphotographs of histological slices stained with Sirius Red of hearts from short-term T3 treated and vehicle-treated rats (red color indicates collagen fibers; scale bar 25 µm). (bottom) Quantitative analysis of left ventricular collagen-positive areas in each of the different animal groups. The positively stained collagen area was expressed as a percentage of the total area. Short-term hyperthyroidism was induced by the daily subcutaneous injection of T3 (500 μg.kg-1) for 1 (T31d), 3 (T33d), and 10 (T310d) days. Control animals were injected daily with the vehicle for 1 (V1d), 3 (V3d), and 10 (V10d) days. Values are means±SEM. P not significant; n= 60 randomly chosen frames from 6 hearts per group (one-way ANOVA)

Sirius Red staining to determine collagen deposition showed no more connective tissue in the left ventricles of T31d , T33d , and T310d rats compared with their respective temporal controls ( Figure 4 ) .


Illustrate the image through a descriptive explanation
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The image is a chest X-ray focusing on the mediastinal region. In this particular X-ray, there is a noticeable widening of the mediastinum, which is an abnormal finding. To help viewers identify this widening, a white arrow is pointing directly at the area of concern. The overall image provides a clear visualization of the chest structures, including the lungs and heart, allowing for a better understanding of the patient's condition.

Chest X ray - case 2: mediastinal widening (white arrow)

Chest X ray showed a mediastinal widening ( Figure 4 ) .


Write an exhaustive depiction of the given image
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The image is a computed tomography (CT) scan displaying a cross-sectional view of a patient's thoracic region. The focus of the image is on the mass that arises from the posterior costal arc of the eighth rib on the patient's left side. The mass appears to be well-defined and localized, with clear boundaries separating it from the surrounding tissues.

The eighth rib is visible in the image, and the mass can be seen originating from its posterior costal arc. The rib's structure is also discernible, with the curvature of the rib and its connection to the spine clearly visible. The patient's left side is marked for orientation purposes.

The CT scan also shows the medulla, which is not involved with the mass. The medulla appears to be intact and separate from the mass, indicating that the mass has not infiltrated or affected this area. The surrounding tissues and organs, such as the lungs and the diaphragm, can also be seen in the image, providing context for the location of the mass.

Overall, the image provides a detailed view of the mass and its relationship to the eighth rib and the medulla, allowing for a better understanding of the patient's condition.

A computed tomography scan shows that the mass arises from the posterior costal arc of the eighth rib on the patient’s left side and does not involve the medulla.


The image is a selected slice from a multi-modal MRI dataset of a patient with Parkinson's disease. It is a high-resolution, grayscale image that showcases the intricate details of the patient's brain anatomy. The MRI scan was performed using a 3T Siemens Skyra MR scanner at a university medical center.

In the image, various brain structures can be observed, such as the cerebral cortex, white matter, and deep brain nuclei. The contrast between different tissue types is evident, allowing for a clear distinction between gray and white matter. The image also highlights any potential abnormalities or changes in the brain structure that may be associated with Parkinson's disease.

Overall, the image provides valuable insights into the brain's anatomy and the potential effects of Parkinson's disease on the patient's brain.

Selected slice from a multi-modal MRI dataset of a patient with Parkinson's disease.

All participants were scanned at the University Medical Center Hamburg-Eppendorf , Germany , using a 3T Siemens Skyra MR scanner ( Figure 1 ) .


The image displays a gross anatomical view of the appendix and right kidney. The appendix appears to be abnormally adhered to the right kidney, indicating a pathological condition. The two organs are visibly connected, possibly due to the formation of a fistulous tract. The image likely shows the organs after they have been surgically removed from the patient during an appendectomy. The overall appearance of the appendix and right kidney may exhibit signs of inflammation or other abnormalities related to the medical condition.

Gross image of appendix adhered to right kidney.

An appendectomy was performed to allow for complete removal of the fistulous tract along with the right kidney ( Fig. 2 , Fig. 3 ) .


The image displays a microscopic view of a metastatic liver lesion at 400x magnification, using hematoxylin and eosin (H&E) staining. The stained tissue sample reveals the presence of mixed adenocarcinoma and high-grade neuroendocrine carcinoma. The adenocarcinoma cells appear as glandular structures, while the neuroendocrine carcinoma cells exhibit a more dispersed pattern. The H&E staining highlights the cellular details, allowing for the differentiation between the two types of cancer cells. The image provides a clear visualization of the coexistence of these two distinct cell types within the metastatic liver lesion.

Mixed adenocarcinoma high-grade neuroendocrine carcinoma in metastatic liver lesion (H&E, original × 400). H&E: hematoxylin and eosin stain.

Liver biopsy also showed mixed adenocarcinoma and neuroendocrine carcinoma , high-grade ( Fig. 7 ) .


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The image displays a collection of representative sample images of chest X-rays and CT scans. These images are arranged in a grid-like format, showcasing the variety of cases included in the mixed dataset used for analysis. The chest X-rays exhibit different lung conditions, with varying degrees of clarity and contrast, while the CT scans provide cross-sectional views of the chest, highlighting the internal structures and any abnormalities present. The image serves as a visual representation of the diverse dataset used in the study, emphasizing the range of cases and imaging techniques employed in the analysis.

Representative sample images of chest X-rays and CT scans used in the mixed dataset adopted for analysis.

Figure 3 presents a set of representative images used in the analysis .