Objective: : The purpose of this study was to suggest that computed tomography angiography (CTA) is valuable as the only preliminary examination for mechanical thrombectomy (MT). MT after single examination of CTA including non-contrast computed tomography (NCCT) and maximum intensity projection (MIP) improves door-to-puncture time as well as results in favorable outcomes. Methods: : A total of 157 patients who underwent MT at Dong Kang Medical Center from April 2015 to March 2019 were divided into two groups based on the examination performed prior to MT : CTA group who underwent CTA with NCCT and MIP, and NCCT+magnetic resonance image (MRi) group who underwent MRI including perfusion images after NCCT. In the two groups, time to CTA imaging or NCCT+MRi imaging after symptom onset, and time to arterial puncture and reperfusion were characterized as time-related outcomes. The evaluation of vascular recanalization after MT was defined as a modified thrombolysis in cerebral infarction (mTICI) scale. National Institutes of Health Stroke Scale (NIHSS) was assessed at the time of the visit to the emergency room and modified Rankin Scale (mRS) was assessed after 90 days. Results: : Typically, there were 34 patients in the CTA group and 33 patients in the NCCT+MRi group. A significantly shorter delay for door-to-puncture time was observed (mean, 86±22.1 vs. 176±47.5 minutes; p<0.01). Also, a significantly shorter door-to-imege time in the CTA group was observed (mean, 13±6.8 vs. 93±30.8 minutes; p<0.01). Moreover, a significantly shorter onset-to-puncture time was observed (mean, 195±128.0 vs. 314±157.6 minutes; p<0.01). Reperfusion result of mTICI ≥2b was 100% (34/34) in the CTA group and 94% (31/33) in the NCCT+MRi group, and mTICI 3 in 74% (25/34) in the CTA group and 73% (24/33) in the NCCT+MRi group. Favorable functional outcomes (mRS score ≤2 at 90 days) were 68% (23/34) in the CTA group and 60% (20/33) in the NCCT+MRi group. Conclusion : A single-phase CTA including NCCT and MIP images was performed as a single preliminary examination, which led to a reduction in the time of the procedure and resulted in good results of prognosis. Consequently, it is concluded that this method is of sufficient value as the only preliminary examination for decision making.

PURPOSE: The purpose of this study was to review our recent experiences with deep neck abscesses in children and adolescents and to provide helpful information in treatment and diagnosis by comparing them with those in other available literatures. METHODS: Medical records of 36 children and adolescents admitted for deep neck abscess at two hospitals from January 2000 to October 2010 were reviewed retrospectively. RESULTS: Male to female ratio was 1.4 : 1 and the mean age was 6.5 years. Painful neck swelling and fever were the most frequent symptoms in patients under thirteen years of age whereas trismus and headache were frequent symptoms in patients over fourteen years of age. Submandibular space was the most common site of deep neck abscess in patients under thirteen years of age, whereas peritonsillar space was the most common site in patients over fourteen years of age. The results of bacterial cultures were positive in 61.5% of drained cases. Staphylococcus aureus was the most commonly identified bacteria in 6 patients (37.5%) and 5 of them were under 2 years of age. Twenty six patients received surgical drainage while the others were treated with antibiotics only. There were no statistically significant differences in the durations of admission, fever after admission, and antibiotic treatment between surgical and medical treatment groups. CONCLUSION: The common sites of deep neck abscess, associated symptoms, and causative organisms were different between children and adolescents. As there were no differences in durations of admission, fever, or antibiotics treatments between surgical and medical treatment groups, surgical drainage may be avoided by early recognition and suspicion. However, if there is no improvement of symptoms or size of abscesses within 48-72 hours of antibiotic treatment, surgical drainage should be considered.
Abscess ; Adolescent ; Anti-Bacterial Agents ; Bacteria ; Child ; Drainage ; Female ; Fever ; Headache ; Hospitals, General ; Humans ; Male ; Medical Records ; Neck ; Staphylococcus aureus ; Trismus

No abstract available.
Tuberculosis, Miliary*

No abstract available.
Cisplatin* ; Drug Therapy* ; Humans ; Hysterectomy* ; Mitomycin* ; Uterine Cervical Neoplasms*

A 55-year-old woman suffered from upper abdominal pain for two months and remained refractile against the anti-ulcer regimen. The palliative gastrectomy specimen revealed multiple shallow ulcerations on the thickened mucosal folds mainly in the antrum and body along the greater curvature where multiple, whitish nodules were found in the submucosa. Microscopically, individual submucosal nodules clearly corresponded to the necrotizing granulomatous vasculitis which were featured with diffuse fibrinoid necrosis of arterial walls accompanying granuloma formation and heavy infiltration of neutrophils, eosinophils, histiocytes and giant cells. Similar vasculitic lesions involved venules and arterioles. There were scattered vasculitic changes in the liver biopsy specimens and omentum. There were no clinical presentations or serological support of systemic involvement including systemic lupus erythematosus, Henoch-Schoenlein purpura, cryoglobulinemia or Churg-Strauss granulomatous vasculitis. We conclude that this is a hitherto undescribed primary necrotizing granulomatous vasculitis predominantly involving the stomach.
Abdominal Pain ; Arterioles ; Biopsy ; Cryoglobulinemia ; Eosinophils ; Female ; Gastrectomy ; Giant Cells ; Granuloma ; Histiocytes ; Humans ; Liver ; Lupus Erythematosus, Systemic ; Middle Aged ; Necrosis ; Neutrophils ; Omentum ; Purpura, Schoenlein-Henoch ; Stomach* ; Ulcer ; Vasculitis* ; Venules

OBJECTIVE: The purpose of this study was to determine the difference of temperature effects on the nerve conduction variables and to obtain correction factors for temperature in demyelinated and normal peripheral nerves. METHOD: The compound muscle action potentials (CMAPs) were recorded with wrist stimulation during cooling and warming in 10 control subjects and 13 subjects with demyelinating neuropathies. The temperature of cooling and warming were 18degrees C and 40degrees C, respectively. The time of cooling and warming were 60 minutes and composed of successive 4 sessions of 15 minutes. The skin temperature of thenar area, latency, amplitude, duration, and area of CMAPs were measured before and after each session of 15 minutes of cooling or warming. RESULTS: The time constants of parameters of CMAPs were of higher tendency in cooling than in warming. The time constants of latency of CMAP were higher in subjects with demyelinating neuropathy than in controls (p<0.05): 33.3+/-4.0 minutes versus 27.2+/-2.2 minutes in cooling; 30.0+/-7.8 minutes versus 19.6+/-3.3 minutes in warming. The temperature correction factor of latency of CMAPs was 0.23+/-0.03 msec/degrees C in control and 0.33+/-0.06 msec/degrees C in subjects with demyelinating neuropathies (p<0.05). CONCLUSION: When studying a subject with demyelinating neuropathies, we should warm the extremity for more sufficient time than in normal subject, or may applicate a differenct temperature correction factors.
Action Potentials ; Extremities ; Neural Conduction ; Peripheral Nerves ; Peripheral Nervous System Diseases* ; Skin Temperature ; Wrist

OBJECTIVE: To investigate the patterns of the temperature effect on motor nerve conduction parameters according to various warming methods and to obtain the most valuable method of warming in clinical setting. METHOD: Twenty normal subjects were studied. After limb cooling in cold water, the cooled hands were warmed by hot pack, fan heater, and whirl pool. The median motor responses were recorded at abdnctor pollicis brevis after the stimulation at the wrist during warming at 1 min interval until the temperature increment reached plateau. We measured the temperature changes and conduction parameters were measured at each examination. RESULTS: The time constants for temperature increment and distal motor latency, duration, area of compound muscle action potentials showed shorter tendency by hot pack and whirl pool than by fan heater (p<0.05). For the measurement of distal motor latency, time constant of whirl pool (2.49 1.21 min) was shorter than that of fan heater (7.12 3.12 min) or hot pack (5.96 1.98 min) (p<0.05). CONCLUSION: These findings suggest that the use of whirl pool is the most effective method for warming of the cooled limb.
Action Potentials ; Extremities ; Hand ; Neural Conduction* ; Water ; Wrist

Asphyxiating thoracic dysplasia(ATD;Jeunes's syndrome) is a rare variety of short limb dwarfism. It is characterized by an extremely small thorax when compared to the ab-dominal circumference, which frequently results in respiratory distress. Other anomalies as-sociated with Jeune's syndrome are pelvic bone malformations and renal dysplasia. It was first described and namely by Jeune et al. in 1954. Jeune's syndrome is an autosomal rece-ssive trait and has a 25% recurrence risk. These patients died at early age due to respirat-ory insufficiency. Death due to uremia has occurred in number of children surviving infan-cy, following progressive renal failure, hypertension and hepatic failure. About 50 cases have been reported in the world literature. We experienced a case of small thorax with short limb dwarfism on antenatal ultraso- und examination and then the baby was delivered by cesarean section. The diagnosis was confirmed to Asphyxiating thoracic dysplasia by clinical features, radiological findings and pathological findings. We reported a case of Asphyxiating thoracic dysplasia with review of literatures.
Cesarean Section ; Child ; Diagnosis ; Dwarfism ; Extremities ; Female ; Humans ; Hypertension ; Liver Failure ; Pelvic Bones ; Pregnancy ; Recurrence ; Renal Insufficiency ; Thorax ; Uremia

No abstract available.
Ultrasonography*

The percutaneous coronary intervention (PCI) has been a great advance in the treatment of coronary artery disease since implantation of bare metal stents (BMS) decreased acute recoil and arterial shrinkage caused by balloon angioplasty. However, neointimal hyperplasia leading to in-stent restenosis after BMS implantation has been emerged a new obstacle. Recent introduction of drug-eluting stents (DES) contributes a powerful breakthrough to PCI. Many large well-controlled randomized trials have shown that DES remarkably reduces restenosis and target vessel revascularization in de novo lesions when compared with BMS. Therefore the application of DES have been expanded to the complex lesions such as left main, multi-vessel, bifurcation, in-stent restenosis, or chronic total occlusion. The safety and effectiveness of DES are still under evaluation with ongoing trials. However, some problems such as very late stent thrombosis remained to be solved. In this review article, we summarize the past, present and future of DES with updated result of clinical trials.
Angioplasty, Balloon ; Angioplasty, Balloon, Coronary ; Coronary Artery Disease ; Drug-Eluting Stents ; Glycosaminoglycans ; Hyperplasia ; Percutaneous Coronary Intervention ; Stents ; Thrombosis