Objective: High-quality cardiopulmonary resuscitation (CPR) needs to be provided to cardiac arrest victims. The chest compression at a 5-6 cm depth and 100-120 beats per minute are recommended according to the 2015 CPR guidelines. The physical forces to the patient’s chest wall cause inevitable complications. This study analyzed the CPR-related complications based on computed tomography (CT). Methods: This was a retrospective, single-center study. The study period was from 2009 to 2019. The cardiac arrest victims received the CPR in or out-of-hospital. After the return of spontaneous circulation, CTs were performed on some survivors. The complications detected on CTs were reviewed, and the types and frequencies of complications, age, sex, arrest location, CPR duration, the survival discharge were investigated. Results: Among 1,357 cardiac arrest patients during the study period, 368 patients were enrolled. The average age was 64.2, and 66.3% were male. The average CPR duration was 24.6 minutes. The most frequent complication was rib fracture (73.6%). Lung contusion (41.3%), hemothorax (22.0%), sternal fracture (19.3%), and retrosternal hemorrhage (13.6%) were also detected. Those with rib fractures, sternal fractures, and retrosternal hemorrhage were older (P<0.001). Those with rib fractures, lung contusion, hemothorax received longer CPR (P=0.032, P=0.003, and P=0.041). Low survival discharge rates were observed in patients with rib fractures, sternal fractures, and pneumothorax (P=0.002, P=0.014, and P=0.016). Conclusion The rib fracture, sternal fracture, and retrosternal hemorrhage were frequent in older patients. Those with rib fractures, lung contusion, or hemothorax received the longer CPR. The survival discharge rates were low in the rib fracture, sternal fracture, pneumothorax patients.

Objective: High-quality cardiopulmonary resuscitation (CPR) needs to be provided to cardiac arrest victims. The chest compression at a 5-6 cm depth and 100-120 beats per minute are recommended according to the 2015 CPR guidelines. The physical forces to the patient’s chest wall cause inevitable complications. This study analyzed the CPR-related complications based on computed tomography (CT). Methods: This was a retrospective, single-center study. The study period was from 2009 to 2019. The cardiac arrest victims received the CPR in or out-of-hospital. After the return of spontaneous circulation, CTs were performed on some survivors. The complications detected on CTs were reviewed, and the types and frequencies of complications, age, sex, arrest location, CPR duration, the survival discharge were investigated. Results: Among 1,357 cardiac arrest patients during the study period, 368 patients were enrolled. The average age was 64.2, and 66.3% were male. The average CPR duration was 24.6 minutes. The most frequent complication was rib fracture (73.6%). Lung contusion (41.3%), hemothorax (22.0%), sternal fracture (19.3%), and retrosternal hemorrhage (13.6%) were also detected. Those with rib fractures, sternal fractures, and retrosternal hemorrhage were older (P<0.001). Those with rib fractures, lung contusion, hemothorax received longer CPR (P=0.032, P=0.003, and P=0.041). Low survival discharge rates were observed in patients with rib fractures, sternal fractures, and pneumothorax (P=0.002, P=0.014, and P=0.016). Conclusion The rib fracture, sternal fracture, and retrosternal hemorrhage were frequent in older patients. Those with rib fractures, lung contusion, or hemothorax received the longer CPR. The survival discharge rates were low in the rib fracture, sternal fracture, pneumothorax patients.

Multiple cranial neuropathies (MCN) can be caused by various etiologies, such as autoimmune diseases, neurovascular diseases, tumors, or infections. Among the various etiologies of MCN, malignant lymphoma is a major cause. Anaplastic lymphoma kinase-negative anaplastic large cell lymphoma (ALK-ALCL) is an extremely rare subtype of T-cell lymphoma that exhibits aggressive behavior, particularly when affecting the central nervous system (CNS). The rarity of ALK-ALCL often leads to a relative delay in diagnosis compared to other types of lymphoma. We experienced a patient with MCN, for whom malignant lymphoma was suspected and diagnosed with ALK-ALCL, which simultaneously involved multiple cranial nerves, bilateral submandibular glands (SMGs), and the stomach within a relatively short time. Herein, we report our diagnostic experience of ALK-ALCL, along with a literature review.

Multiple cranial neuropathies (MCN) can be caused by various etiologies, such as autoimmune diseases, neurovascular diseases, tumors, or infections. Among the various etiologies of MCN, malignant lymphoma is a major cause. Anaplastic lymphoma kinase-negative anaplastic large cell lymphoma (ALK-ALCL) is an extremely rare subtype of T-cell lymphoma that exhibits aggressive behavior, particularly when affecting the central nervous system (CNS). The rarity of ALK-ALCL often leads to a relative delay in diagnosis compared to other types of lymphoma. We experienced a patient with MCN, for whom malignant lymphoma was suspected and diagnosed with ALK-ALCL, which simultaneously involved multiple cranial nerves, bilateral submandibular glands (SMGs), and the stomach within a relatively short time. Herein, we report our diagnostic experience of ALK-ALCL, along with a literature review.

Multiple cranial neuropathies (MCN) can be caused by various etiologies, such as autoimmune diseases, neurovascular diseases, tumors, or infections. Among the various etiologies of MCN, malignant lymphoma is a major cause. Anaplastic lymphoma kinase-negative anaplastic large cell lymphoma (ALK-ALCL) is an extremely rare subtype of T-cell lymphoma that exhibits aggressive behavior, particularly when affecting the central nervous system (CNS). The rarity of ALK-ALCL often leads to a relative delay in diagnosis compared to other types of lymphoma. We experienced a patient with MCN, for whom malignant lymphoma was suspected and diagnosed with ALK-ALCL, which simultaneously involved multiple cranial nerves, bilateral submandibular glands (SMGs), and the stomach within a relatively short time. Herein, we report our diagnostic experience of ALK-ALCL, along with a literature review.

Multiple cranial neuropathies (MCN) can be caused by various etiologies, such as autoimmune diseases, neurovascular diseases, tumors, or infections. Among the various etiologies of MCN, malignant lymphoma is a major cause. Anaplastic lymphoma kinase-negative anaplastic large cell lymphoma (ALK-ALCL) is an extremely rare subtype of T-cell lymphoma that exhibits aggressive behavior, particularly when affecting the central nervous system (CNS). The rarity of ALK-ALCL often leads to a relative delay in diagnosis compared to other types of lymphoma. We experienced a patient with MCN, for whom malignant lymphoma was suspected and diagnosed with ALK-ALCL, which simultaneously involved multiple cranial nerves, bilateral submandibular glands (SMGs), and the stomach within a relatively short time. Herein, we report our diagnostic experience of ALK-ALCL, along with a literature review.

Multiple cranial neuropathies (MCN) can be caused by various etiologies, such as autoimmune diseases, neurovascular diseases, tumors, or infections. Among the various etiologies of MCN, malignant lymphoma is a major cause. Anaplastic lymphoma kinase-negative anaplastic large cell lymphoma (ALK-ALCL) is an extremely rare subtype of T-cell lymphoma that exhibits aggressive behavior, particularly when affecting the central nervous system (CNS). The rarity of ALK-ALCL often leads to a relative delay in diagnosis compared to other types of lymphoma. We experienced a patient with MCN, for whom malignant lymphoma was suspected and diagnosed with ALK-ALCL, which simultaneously involved multiple cranial nerves, bilateral submandibular glands (SMGs), and the stomach within a relatively short time. Herein, we report our diagnostic experience of ALK-ALCL, along with a literature review.

A 27-year-old female visited outpatient clinic for the evaluation of palpitation and dyspnea on exertion. Echocardiographic examination including transthoracic and transesophageal echocardiography revealed coarctation of aorta, bicuspid aortic valve, mitral valve prolapse, and sealed-up ventricular septal defect. Further evaluation with computed tomography angiography revealed another combined congenital anomaly of left isomerism with polysplenism and interrupted inferior vena cava and pulmonary embolism with deep vein thrombosis. After corrective surgery for the coarctation, she received anticoagulation therapy for the treatment and the secondary prevention of pulmonary embolism.
Adult ; Ambulatory Care Facilities ; Angiography ; Aortic Coarctation* ; Aortic Valve ; Bicuspid ; Dyspnea ; Echocardiography ; Echocardiography, Transesophageal ; Female ; Heart Septal Defects, Ventricular ; Humans ; Isomerism* ; Mitral Valve Prolapse ; Pulmonary Embolism ; Secondary Prevention ; Vena Cava, Inferior* ; Venous Thrombosis

Caseous mitral annular calcification describes a heavy calcification of the mitral annulus with central liquefaction. This rare variant of mitral annular calcification may resemble an intracardiac tumor, abscess, vegetation, or thrombus, a resemblance that often leads to unnecessary surgery. Typical echocardiographic findings include a large, round, bright echogenic mass with a central echolucent area. It is known to have a benign clinical outcome, and it is thus managed conservatively. Because this entity is not well known and has only rarely been described, we report two cases of mitral annular calcification encountered at our institution. The first patient was an elderly woman with exertional dyspnea who was found to have a solitary pulmonary nodule on plain chest radiography. This was determined to represent caseous calcification of the mitral annulus. The other patient was an elderly woman who had a history of cerebral embolic infarction. She did not have an intracardiac thrombus, but she did have caseous mitral annular calcification. Both patients were managed conservatively.
Abscess ; Aged ; Calcification, Physiologic ; Dyspnea ; Female ; Humans ; Infarction ; Mitral Valve ; Solitary Pulmonary Nodule ; Thorax ; Thrombosis ; Unnecessary Procedures

A 69-year-old man was admitted to undergo percutaneous coronary intervention (PCI) for chronic total occlusion of right coronary artery. He had diabetes mellitus, stable angina pectoris. Diagnostic coronary angiography demonstrated proximal total occlusion of right coronary artery. PCI was failed due to failure of balloon passage. Echocardiography was performed after PCI and thickened epicardial tissue at right atrioventricular groove was noted. It was highly echogenic and localized along the course of mid right coronary artery. In following echocardiogram after 12 days, the size of echogenic mass was decreased from 3.4 cmx2.6 cm to 1.7 cmx0.7 cm and we could conclude it was right coronary artery hematoma associated with PCI.
Aged ; Angina Pectoris ; Coronary Angiography ; Coronary Vessels ; Diabetes Mellitus, Type 2 ; Echocardiography ; Hematoma ; Humans ; Percutaneous Coronary Intervention