No abstract available.
Ligaments* ; Pelvic Organ Prolapse*

PURPOSE: About 30% of the cause of admission of the patient with end-stage renal disease is reported to be related with complications of vascular access (VA). To achieve good outcome after VA surgery, routine mapping of artery and vein is recommended for the patients who are planned to have vascular access surgery. But evidence supporting routine application of ultrasonogram (USG) is scarce and the situation in Korea is different from western countries where most of the guidelines are produced. We compared the results of the vascular access surgery after physical examination only with those after selective examination with USG. METHODS: Two hundred and forty eight consecutive patients who received VA surgery in Dongsan Medical Center from Jun 2010 to May 2011 were included. Clinical data were retrospectively analyzed and the immediate postoperative failure and early suitability of hemodialysis were compared. RESULTS: One hundred eight patients (group 1) received VA without USG, 140 after USG study. Overall 13 failures were developed. There was no difference between the two groups in terms of early failure (5.6% vs. 5.0%). CONCLUSION: Selective application of duplex sonographic evaluation of vascular status in the patients who need vascular access surgery in Korea is a reasonable policy to save the limited health financial source with acceptable results.
Arteries ; Arteriovenous Shunt, Surgical ; Humans ; Kidney Failure, Chronic ; Korea ; Physical Examination ; Preoperative Care ; Renal Dialysis ; Renal Insufficiency ; Retrospective Studies ; Ultrasonography, Doppler, Duplex ; Veins

Chlorfenapyr is a widely used, moderately hazardous pesticide. Previous reports have indicated that chlorfenapyr intoxication can be fatal in humans. We reported the first non-fatal case of chlorfenapyr-induced toxic leukoencephalopathy in a 44-year-old female with resolution of extensive and abnormal signal intensities in white matter tracts throughout the brain, brain stem, and spinal cord on serial magnetic resonance imaging.
Adult ; Brain/*radiography ; Brain Stem/radiography ; Female ; Humans ; Insecticides/*toxicity ; Leukoencephalopathies/*etiology/radiography ; *Magnetic Resonance Imaging ; Pyrethrins/*toxicity ; Spinal Cord/*radiography ; White Matter/radiography

Acute ischemic stroke due to embolic occlusion of the middle cerebral artery (MCA) in patients with chronic ipsilateral internal carotid artery (ICA) occlusion is quite rare. Several previous reports demonstrated that intra-arterial (IA) thrombolytic therapy or aspiration thrombectomy using the cross-circulation technique via an alternative collateral pathway is feasible in acute stroke patients with an unfavorable direct route to the occluded sites. However, stent-retriever embolectomy via the cross-circulation approach has not been reported in the literature. The present paper reports the first case of successful stent-retriever embolectomy for acute MCA occlusion via the patent posterior communicating artery (PComA) by using Trevo XP ProVue stent-retriever in a patient with acute MCA stroke and chronic occlusion at the origin site of the ipsilateral ICA.
Arteries* ; Carotid Artery, Internal ; Embolectomy* ; Humans ; Middle Cerebral Artery ; Stroke ; Thrombectomy ; Thrombolytic Therapy

Purpose: This study aimed to identify independent predictors of favorable outcomes associated with emergent carotid artery stenting (CAS) in patients with acute anterior circulation stroke. Materials and Methods: This study included 93 patients with acute stroke who underwent emergent CAS to treat stenoocclusive lesions in the cervical internal carotid artery (ICA) within 6 hours of the onset of the associated symptoms. Data were compared between patients with and without favorable outcomes. The independent predictors of a favorable outcome were determined via logistic regression analysis (modified Rankin Scale 0–2 at 90 days). Results: Intracranial tandem occlusion was noted in 81.7% of patients (76/93) among which (76/93), 55 of whom underwent intracranial recanalization therapy. Intracranial reperfusion was successful in 74.2% (69/93) and favorable outcomes were noted in 51.6% of patients (48/93). The mortality rate was 6.5% (6/93). In logistic regression analysis, diffusion-weighted imaging-Alberta Stroke Program Early CT Score [odds ratio (OR), 1.487; 95% confidence interval (CI), 1.018–2.173, p = 0.04], successful reperfusion (OR, 5.199; 95% CI, 1.566–17.265, p = 0.007), and parenchymal hemorrhage (OR, 0.042; 95% CI, 0.003–0.522, p = 0.014) were independently associated with a favorable outcome. Conclusion Baseline infarct size, reperfusion status, and parenchymal hemorrhage were independent predictors of favorable outcomes after emergent CAS to treat stenoocclusive lesions in the cervical ICA in patients with acute anterior circulation stroke.

Timely analysis of imaging data is critical for diagnosis and decision-making for proper treatment strategy in the cases of ischemic stroke. Various efforts have been made to develop computer-assisted systems to improve the accuracy of stroke diagnosis and acute stroke triage. The widespread emergence of artificial intelligence technology has been integrated into the field of medicine. Artificial intelligence can play an important role in providing care to patients with stroke. In the past few decades, numerous studies have explored the use of machine learning and deep learning algorithms for application in the management of stroke. In this review, we will start with a brief introduction to machine learning and deep learning and provide clinical applications of machine learning and deep learning in various aspects of stroke management, including rapid diagnosis and improved triage, identifying large vessel occlusion, predicting time from stroke onset, automated ASPECTS (Alberta Stroke Program Early CT Score) measurement, lesion segmentation, and predicting treatment outcome. This work is focused on providing the current application of artificial intelligence techniques in the imaging of ischemic stroke, including MRI and CT.

Purpose: This study aimed to compare the effects of different normalization methods on radiomics features extracted from magnetic resonance imaging (MRI). Materials and Methods: Preoperative T1-contrast enhanced MRI data from 212 patients with meningiomas were obtained from two university hospitals. The tumors were segmented using 3D Slicer software, and the PyRadiomics framework was used to extract radiomics features. We developed four experiments to predict the histological grade of meningiomas prior to surgery. The first experiment was performed without normalization.The next three experiments used the StandardScaler, MinMaxScaler, and RobustScaler to normalize radiomics features. The PyCaret framework was used for feature selection and to explore an optimized machine learning model for predicting meningioma grades. The prediction models were trained and validated using data from the first hospital. External test data from the second hospital were used to test the performance of the final models. Results: Our testing results demonstrated that meningioma grade prediction performance depends highly on the choice of the normalization method. The RobustScaler demonstrated a higher level of accuracy and sensitivity than the other normalization methods. The area under the receiver operating characteristic curve and specificity of the RobustScaler method were comparable to those of no-normalization but higher than those of the Standard and MinMaxScaler methods. Conclusion The results of our study suggest that careful consideration of the normalization method may provide a way to optimize the experimental results.Keywords: Meningiomas; Radiomics features; Magnetic resonance ima

Chordoid glioma is a rare low grade tumor typically located in the third ventricle. Although a chordoid glioma can arise from ventricle with tumor cells having features of ependymal differentiation, intraventricular dissemination has not been reported. Here we report a case of a patient with third ventricular chordoid glioma and intraventricular dissemination in the lateral and fourth ventricles. We described the perfusion MR imaging features of our case different from a previous report.
Adult ; Cerebral Ventricle Neoplasms/diagnosis/pathology/*secondary ; Fourth Ventricle/*pathology ; Glioma/diagnosis/*pathology ; Humans ; Lateral Ventricles/*pathology ; Magnetic Resonance Imaging/methods ; Male ; Third Ventricle/*pathology

BACKGROUND AND PURPOSE: Predictive factors associated with stent-retriever thrombectomy for patients with acute anterior circulation stroke remain to be elucidated. This study aimed to investigate clinical and procedural factors predictive of good outcome and mortality after stent-retriever thrombectomy in a large cohort of patients with acute anterior circulation stroke. METHODS: We analyzed clinical and procedural data in 335 patients with acute anterior circulation stroke treated with stent-retriever thrombectomy. A good outcome was defined as a modified Rankin Scale score of 0 to 2 at 3 months. The associations between clinical, imaging, and procedural factors and good outcome and mortality, respectively, were evaluated using logistic regression analysis. RESULTS: Using multivariate analysis, age (odds ratio [OR], 0.965; 95% confidence interval [CI], 0.944-0.986; P=0.001), successful revascularization (OR, 4.658; 95% CI, 2.240-9.689; P<0.001), parenchymal hemorrhage (OR, 0.150; 95% CI, 0.049-0.460; P=0.001), and baseline NIHSS score (OR, 0.908; 95% CI, 0.855-0.965; P=0.002) were independent predictors of good outcome. Independent predictors of mortality were age (OR, 1.043; 95% CI, 1.002-1.086; P=0.041), successful revascularization (OR, 0.171; 95% CI, 0.079-0.370; P<0.001), parenchymal hemorrhage (OR, 2.961; 95% CI, 1.059-8.276; P=0.038), and a history of previous stroke/TIA (OR, 3.124; 95% CI, 1.340-7.281; P=0.008). CONCLUSIONS: Age, revascularization status, and parenchymal hemorrhage are independent predictors of both good outcome and mortality after stent retriever thrombectomy for acute anterior circulation stroke. In addition, NIHSS score on admission is independently associated with good outcome, whereas a history of previous stroke is independently associated with mortality.
Brain Infarction ; Cohort Studies ; Hemorrhage ; Humans ; Logistic Models ; Mortality* ; Multivariate Analysis ; Prognosis ; Stents ; Stroke* ; Thrombectomy*

Aged ; Aged, 80 and over ; Humans ; Logistic Models ; Mortality ; Reperfusion ; Stroke ; Thrombectomy