We propose a new telerobotic system for untact swab sampling to prevent the infection of medical staff during upper respiratory sample collection. The system consists of a slave robot and two master devices. The slave robot is designed to move a swab in 6 degrees of freedom within the facial area and to insert and remove the swab under remote control by an operator at the master site based on magnified imaging of the patient’s facial area. The insertion and removal of the swab into and from the nostril are implemented by means of a swab insertion unit; as the counterpart to this unit, the master system also includes a swab insertion device to control the swab insertion unit remotely. A force sensor installed on the swab holder enables monitoring of the force generated when the swab touches the target. In experiments, a virtual specimen was installed on the posterior nasopharynx wall of a life-size head phantom model. The nasopharyngeal swab samplings of the phantom model were successfully performed thanks to the force monitoring capability of the proposed telerobotic system, showing that this system is suitable for remote upper respiratory sample collection.

Intracranial dural arteriovenous fistula (DAVF) is rare and potentially life-threatening disease often presenting as vascular myelopathy. The early and proper diagnosis is challenging because the clinical manifestations are related to the distribution of the draining vein, not the fistula site, and imaging findings are similar to demyelinating disease of the spinal cord. The authors present the case of a 45-year-old man who developed acute progressive quadriplegia and respiratory difficulty with an enhancing, longitudinally extensive cervical cord lesion. These symptoms were highly suspicious for transverse myelitis but were caused by an intracranial DAVF. Intracranial DAVF with venous reflux to the brainstem and spinal cord is a rare but important differential diagnosis of progressive worsening myelopathy that is treatment resistant and gives the diagnostic impression of transverse myelitis.

Kim SH, et al. J Clin Neurol. 2025 Mar;21(2):131-136. https://doi.org/10.3988/jcn.2024.0485

Optic neuritis (ON) has been considered to be an important factor in the diagnosis of multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD), making ON detection increasingly critical for early diagnosis. Furthermore, subclinical ONs presenting no distinct decrease in visual acuity can be missed. Low contrast visual acuity (LC-VA) is known to be able to capture visual loss not seen in conventional high-contrast visual acuity (HC-VA) in MS. Therefore, to increase the sensitivity of ON detection, we investigated the advantage of LC-VA over conventional HC-VA. One hundred and eight patients with demyelinating disease (35 MS, 73 NMOSD) with ON at least 3 months prior and 35 controls underwent neuro-ophthalmic evaluation, including best-corrected conventional high contrast visual acuity (HC-VA) and 2.5% and 1.25% low contrast visual acuity (LC-VA). Receiver operating characteristic (ROC) curve analysis and the area under the curve (AUC) of various visual functions were used to determine the most relevant visual function test for the detection of optic nerve involvement. Additionally, the optimal cutoff point was obtained from the Youden index (J-index) as the points with the best sensitivity-specificity balance. When distinguishing ON from non-ON, the area under the ROC curve (AUC) was highest for the 2.5% LC-VA (0.835, P < 0.001; sensitivity 71.5%, specificity 88.6%), while it was 0.710 (P < 0.001) for the HC-VA and 0.770 (P < 0.001) for the 1.25% LC-VA. In discriminating between controls and ON, the AUC was also highest for the 2.5% LC-VA 0.754 (P < 0.001; sensitivity 71.5%, specificity 78.5%), while it was 0.719 (P < 0.001) for HC-VA and 0.688 (P < 0.001) for 1.25% LC-VA. In eyes with a history of ON (n = 137), the HC-VA and 2.5% LC-VA were abnormal in 64.2 and 71.5%, respectively (P < 0.001), with their combination detecting abnormalities in approximately 85.4% (P < 0.001). The 2.5% LC-VA was superior to HC-VA in detecting ON when distinguishing ON from non-ON or control. The 2.5% LC-VA might be a useful, feasible, and rapid method to detect ON. Furthermore, combining 2.5% LC-VA with conventional HC-VA would be better for detecting optic nerve involvements.

Park SH, et al. J Korean Med Sci. 2017 Nov;32(11):1857-1860. https://doi.org/10.3346/jkms.2017.32.11.1857