No abstract available.

The traditional treatment of splenic artery aneurysm (SAA) is generally surgery and/or transcatheter arterial embolization, but recently, the treatment of SAA using a stent graft has been reported. However, the acute angle of the celiac axis, as well as the tortuous path of the splenic artery makes the use of stent graft difficult for treatment of aneurysms. We report here a case of SAA treated with the technique of double overlapping metallic stents.
Aneurysm* ; Axis, Cervical Vertebra ; Blood Vessel Prosthesis ; Splenic Artery* ; Stents*

An asymptomatic 26-year-old man was initially admitted with a suspicious mediastinal mass. On the basis of the contrast-enhanced chest CT findings, aneurysm formation involving the left cervical aortic arch associated with subaortic left innominate vein was diagnosed. The aneurysm was confirmed by MR angiography and DSA. The arch aneurysm was surgically removed. We describe this case, and review the literature.
Adult ; Aneurysm* ; Angiography ; Aorta, Thoracic* ; Brachiocephalic Veins* ; Humans ; Tomography, X-Ray Computed

We report a case of multiple myeloma with gastric involvement occurring in a patient who underwent an upper gastrointestinal series (UGIS), CT and MRI. UGIS depicted a luminal protruding mass, while contrast-enhanced CT demonstrated marked thickening of the gastric wall, with subtle contrast enhancement. At T1- and T2-weighted MR imaging, the mass showed iso- and intermediate signal intensity, respectively. After the administration of contrast material, subtle homogeneous enhancement was apparent.
Case Report ; Contrast Media/administration & dosage ; Human ; Magnetic Resonance Imaging ; Male ; Middle Age ; Multiple Myeloma/pathology/*radiography ; Stomach Neoplasms/pathology/*radiography ; Tomography, X-Ray Computed

PURPOSE: To determine evaluate the clinical effectiveness of low-dose erythromycin (EM) therapy in patients with diffuse panbronchiolitis (DPB), and to correlate the pulmonary function testing (PFT) changes seen at serial high-resolution CT (HRCT) withthe results of post-treatment. MATERIALS AND METHODS: We retrospectively evaluated 13 DPB patients [seven men and six women aged 23-68 (mean, 46.2) years] who had undergone PFT, HRCT, and transbronchial or open lung biopsy prior to long-term, low-dose EM therapy (250 mg twice daily for more than six months). The interval between initial and follow-up study ranged from 7 to 32 (mean, 16.6+/-8.0) months, and we compared the changes in HRCT findings and PFT parameters before and after treatment. RESULTS: At HRCT after EM therapy, the extent of centrilobular nodules (p=0.006), peripheral bronchiolar wall thickening (p=0.02), and areas of low attenuation (p=0.011) decreased significantly, while FVC and FEV1 showed significant increases: FVC, from 2.47+/-0.83 to 2.74+/-0.95 (p=0.028); and FEV1, from 1.66+/-0.75 to 1.95+/-0.87 (p=0.02). As the extent of peripheral bronchiolar wall thickening (r=-0.609, p=0.047) and areas of low attenuation (r=-0.687, p=0.041) decreased at serial HRCT, FVC and FEV1 increased significantly. CONCLUSION: Long-term follow-up HRCT findings showed that for DPB patients, lowdose EM provides effective treatment. In addition, HRCT appears to be valuable for the objective evaluation of responses to EM therapy.
Biopsy ; Bronchiolitis ; Erythromycin* ; Female ; Follow-Up Studies ; Humans ; Lung ; Male ; Respiratory Function Tests* ; Retrospective Studies

The azygous anterior cerebral artery (ACA) is a rare type of ACA anomaly. In the conventional angiography, cognition of its realm is difficult without considerable reading. Clinically, misreading its nature causes confusion during the surgical approach to its associated cerebral aneurysm. We report this rare clinical experience with an angiographic and surgical review.
Aneurysm ; Angiography ; Anterior Cerebral Artery ; Cerebral Angiography ; Cognition ; Intracranial Aneurysm

OBJECTIVE: Endovascular treatment is one of the most important treatments along with open craniotomy for cerebrovascular surgery. The successful treatment of endovascular disease relies on appropriate instruments and the surgeon's skill. Endovascular treatment needs to provide safe and stable access to the catheter cavity. Additionally, it is important to maintain a round shape without changing to an oval shape. The catheter for endovascular treatment has to be flexible and accommodate at least 0.027 inches of inner diameter. The 6-Fr Navien™ Intracranial Support Catheter (formerly the ReFlex Intracranial Catheter; Covidien Vascular Therapies, Mansfield, MA, USA) provides 0.072 inches of inner diameter. MATERIALS AND METHODS: We reviewed 61 cases for 56 cases of endovascular treatment with a Navien catheter. A triaxial system was used for all procedures with femoral arterial access. The Navien catheter was placed in the petrous segment of the internal carotid artery or third segment of the vertebral artery. The patients had various shapes of intracranial arteries, including tortuous vessels. RESULTS: The Navien catheter was used for 61 cases of endovascular treatment. We had 59 cases of coil embolization at unruptured and ruptured aneurysms and two cases of stent insertion into the middle cerebral artery. All the cases were successful without any catheter-related complications. CONCLUSION: The Navien catheter is a recently developed catheter that has several strengths compared with previously developed catheters. It provides a more stable environment for endovascular treatment. It provides a cavity sufficient for endovascular treatment devices. Additionally, it is sufficiently flexible to approach tortuous vessels.
Aneurysm, Ruptured ; Arteries ; Carotid Artery, Internal ; Catheters* ; Craniotomy ; Embolization, Therapeutic ; Endovascular Procedures ; Humans ; Intracranial Aneurysm ; Middle Cerebral Artery ; Reflex ; Stents ; Vascular Access Devices ; Vertebral Artery

OBJECTIVE: Researchers and clinicians have been unable to fully elucidate the natural course of and proper treatment for unruptured intracranial aneurysms (UIAs) smaller than or equal to 5 mm, particularly with regard to whether close observation or surgery is more appropriate. In this retrospective study, we evaluated the safety and efficacy of endovascular coil embolization of small (≤ 5 mm) asymptomatic UIAs by analyzing outcomes and complications associated with the procedure. MATERIALS AND METHODS: We analyzed data from 150 patients with small asymptomatic UIAs (≤ 5 mm) treated with coil embolization between January 2011 and December 2015. Three-dimensional angiography was used to measure aneurysm size. We evaluated procedure-related morbidity and mortality, immediate post-operative angiographic results, brain computed thomography follow-up results on post-operative day one, and clinical progress. RESULTS: UIAs occurred primarily in the anterior circulation area (142 cases, 94.67%), though eight patients exhibited UIAs of the posterior circulation. Following coil embolization, aneurysms with complete occlusion were observed in 137 cases (91.3%). Partial occlusion occurred in five cases (3.33%), while the procedure had failed in eight cases (5.33%). Procedure-related morbidity and mortality were five cases (3.33%) and zero cases, respectively. CONCLUSION: The endovascular treatment of small asymptomatic UIAs is associated with good short-term outcomes without permanent neurologic complications as well as low overall complication and morbidity rates. Thus, the procedure should be considered for patients with smaller asymptomatic UIAs.
Aneurysm ; Angiography ; Brain ; Embolization, Therapeutic* ; Endovascular Procedures ; Follow-Up Studies ; Humans ; Intracranial Aneurysm* ; Mortality ; Retrospective Studies

It is essential to predict possibility of difficulties beforehand in ventilating or intubating the patient for the safe airway management and anesthetic maintenance. Even if there is no internal invasion, external compression of an enlarged neck mass can cause tracheal stenosis. The patient with nontoxic goitor had symptoms of dysphagia, exertional dyspnea and wheezing. There was difficulty in endotracheal passage of small bronchoscope through the compressed portion of the trachea during preoperative bronchoscopic examination. We premolded an armored endotracheal tube to fit the patient's trachea based on chest radiography, computed tomography and brochoscopic findings. Endotracheal intubation and thyroidectomy was successful and the patient discharged without any complication. We report a new method of intubation in patient with nontoxic goiter that obstructs the trachea by compression.
Airway Management ; Bronchoscopes ; Deglutition Disorders ; Dyspnea ; Goiter ; Humans ; Intubation ; Intubation, Intratracheal ; Neck ; Respiratory Sounds ; Thorax ; Thyroidectomy ; Trachea ; Tracheal Stenosis

We experienced a case of bilateral vocal cord palsy following general anesthesia for craniotomy. The patient was a 43-year-old woman undergoing tumor resection for falx meningioma on frontal lobe. She had no laryngeal symptoms prior to operation. Spontaneous ventilation resumed after reversal of neuromuscular blockade. Following extubation, she showed signs of airway obstruction and dyspnea. Reintubation was done and symptoms improved. Three days after operation, we confirmed bilateral vocal cord palsy by fiberoptic laryngoscopy. We suggested that possible causes of bilateral vocal cord paralysis were hyperflexion of neck and long operating time.
Adult ; Airway Obstruction ; Anesthesia, General ; Craniotomy ; Dyspnea ; Female ; Frontal Lobe ; Humans ; Laryngoscopy ; Meningioma ; Neck ; Neuromuscular Blockade ; Ventilation ; Vocal Cord Paralysis ; Vocal Cords