Thoracic endovascular aortic repair (TEVAR) shows limitations in cases in which the aortic pathology involves the aortic arch. The study aims were to test a fenestrated aortic arch stent graft (FASG) with a preloaded catheter for the supraaortic arch vessels and to perform a preclinical study in swine to evaluate the safety and efficacy of this device. Six FASGs with 1 preloaded catheter and 5 FASGs with 2 preloaded catheters were advanced through the iliac artery in 11 swines. The presence of endoleaks and the patency and deformity of the grafts were examined with computed tomography (CT) at 4 weeks postoperatively. A postmortem examination was performed at 8 weeks. The mean procedure time for the one and two FASG groups was 30.2 (27.9-34.5) min and 43.1 (39.2-53.7) min. The mean time for the selection of the carotid artery was 4.8 (4.2-5.5) min and 6.2 (4.6-9.4) min. Major adverse event was observed in one of 11 pigs. One pig died at 4 weeks likely because of the effects of the high dose of ketamine, while the remaining 10 pigs survived 8-week. For both the one and two FASG groups, no endoleaks, no disconnection, no occlusion of the stent grafts were observed in the CT findings and the postmortem gross findings. The procedure with the FASG could be performed safely in a relatively short procedure time and involved an easy technique. The FASG is found to be safe and convenient in this preclinical study with swine.
Animals ; Aorta, Thoracic/*surgery ; Catheters ; Endovascular Procedures/adverse effects/*instrumentation ; *Stents ; Swine ; Tomography, X-Ray Computed

Concerns have been raised over alleged overuse of CT scanning and inappropriate selection of scanning methods, all of which expose patients to unnecessary radiation. Thus, it is important to identify clinical situations in which techniques with lower radiation dose such as plain radiography or no radiation such as MRI and occasionally ultrasonography can be chosen over CT scanning. This article proposes the arguments for radiation dose reduction in CT scanning of the chest and discusses recommended practices and studies that address means of reducing radiation exposure associated with CT scanning of the chest.
Human ; *Practice Guidelines ; Radiation Dosage ; Thorax ; Tomography, X-Ray Computed/*adverse effects/*methods

The infratemporal fossa abscess is an irregularly shaped cavity, situated below and media to the zygomatic arch. It consists of masseter and nervus vascularis, etc. Comparatively speaking, the low position of the infratemporal fossa has almost freed the patient from dental, nasal,ocular and aural source of pain. So facial acupuncture is more likely to cause the infection. But it is also possible that the patient get cryptogenic infection of maxillofacial cavity, the treatment of which needs further study.
Abscess ; pathology ; Acupuncture Therapy ; adverse effects ; Face ; Head ; Humans ; Masseter Muscle ; Tomography, X-Ray Computed ; Zygoma

Subphrenic splenic implantation is a rare disease, usually occurred followed the splenic trauma and splenectomy. Surgeries are often necessary for diagnosing and treating it. A 46-year-old male post-splenectomy patient, tolerating abdominal bloating and pain for more than 1 year, was admitted to the Second Xiangya Hospital, Central South University. Fundus bulge suggested a possibility of stromal tumors originating from the muscularispropria layer with endoscopic ultrasound. Slightly stomachic thickness was detected using enhanced computed tomography (CT). Without any improvement for symptoms after medication, the patient strongly requested to undergo an endoscopic therapy. Natural orifice transluminal endoscopic surgery (NOTES) result confirmed it as subphrenic splenic implantation with postoperative pathology. In this case, NOTES helped us to confirm the diagnosis, relieve the symptoms, as well as prevent secondary surgery injury, which would be helpful to other clinicians.
Endoscopy ; Gastric Fundus ; Humans ; Intraoperative Complications ; Male ; Middle Aged ; Splenectomy/adverse effects* ; Tomography, X-Ray Computed

Humans ; Diverticulum, Colon/surgery* ; Cholecystectomy/adverse effects* ; Tomography, X-Ray Computed

Colonoscopy is a safe procedure performed routinely worldwide. Splenic rupture is a rare complication of colonoscopy with several reported cases since 1974. We report the first case of a complication in the Republic of Korea. The literature on this rare complication is also reviewed here, with focus on the analysis of risk, diagnosis, and treatment. A 77-year-old patient receiving oral aspirin underwent colonoscopy with polypectomy. After 24 hours, the patient experienced dizziness and hypotension. Colonoscopy was performed to exclude intestinal bleeding, which could be diagnosed with hemoperitoneum. A computed tomography scan showed copious abdominal free blood and a splenic rupture. An urgent splenectomy was performed, which was the recognized procedure of choice. Physicians should have greater awareness of the possibility of splenic rupture following colonoscopy in order to avoid delay of diagnosis and treatment for this life-threatening complication.
Aged ; Colonoscopy/*adverse effects ; Hemoperitoneum/diagnosis ; Hemorrhage ; Humans ; Male ; Splenectomy ; Splenic Rupture/*diagnosis/etiology/surgery ; Tomography, X-Ray Computed

Objective: To explore the clinical and chest computed tomography (CT) features and the outcome of immune checkpoint inhibitor-related pneumonitis (CIP). Methods: Clinical and chest CT data of 38 CIP patients with malignant tumors from the Cancer Hospital, Chinese Academy of Medical Sciences between August 2017 and April 2021 were retrospectively reviewed, and the outcomes of pneumonitis were followed up. Results: The median time from the administration of immune checkpoint inhibitors (ICIs) to the onset of CIP was 72.5 days in 38 patients with CIP, and 22 patients developed CIP within 3 months after the administration of ICIs. The median occurrence time of CIP in 24 lung cancer patients was 54.5 days, earlier than 119.0 days of non-lung cancer patients (P=0.138), with no significant statistical difference. 34 patients (89.5%) were accompanied by symptoms when CIP occurred. The common clinical symptoms were cough (29 cases) and dyspnea (27 cases). The distribution of CIP on chest CT was asymmetric in 31 cases and symmetrical in 7 cases. Among the 24 lung cancer patients, inflammation was mainly distributed ipsilateral to the primary lung cancer site in 16 cases and diffusely distributed throughout the lung in 8 cases. Ground glass opacities (37 cases) and consolidation (30 cases) were the common imaging manifestations, and organizing pneumonia (OP) pattern (15 cases) was the most common pattern. In 30 CIP patients who were followed up for longer than one month, 17 cases had complete absorption (complete absorption group), and 13 cases had partial absorption or kept stable (incomplete absorption group). The median occurrence time of CIP in the complete absorption group was 55 days, shorter than 128 days of the incomplete absorption group (P=0.022). Compared with the incomplete absorption group, there were less consolidation(P=0.010) and CIP were all classified as hypersensitivity pneumonitis (HP) pattern (P=0.004) in the complete absorption group. Conclusions: CIP often occurs within 3 months after ICIs treatment, and the clinical and CT findings are lack of specificity. Radiologic features may have a profound value in predicting the outcome of CIP.
Humans ; Immune Checkpoint Inhibitors/adverse effects* ; Retrospective Studies ; Pneumonia/drug therapy* ; Lung Neoplasms/drug therapy* ; Tomography, X-Ray Computed/methods*

OBJECTIVETo evaluate the diagnostic value of spirometrically controlled quantitative CT in silica-exposed workers.

METHODSWhole lung spiral scans at 50% vital capacity (VC) and image with high resolution CT(HRCT) at 10% VC and 90% VC level and 5 cm above/below carina were performed in 62 silica-exposed workers and 54 healthy adults. Automatic evaluation software, Pulmo, was used to evaluate the quantitative parameters and compared with clinical pulmonary function tests.

RESULTS9 workers with emphysema were detected by CT scans from 62 silica-exposed workers. The quantitative parameters of 10% VC and 90% VC were significantly different between the silica-exposed workers and the controls (P < 0.05). With the increasing of length of exposure to silica dust, the difference showed a ladder-like rising.

CONCLUSIONSpirometrically controlled quantitative CT is a sensitive, accurate and objective method. It is superior to conventional CT and pulmonary function tests for the early detection in silica-exposed workers, espicially for detecting early stage of small airway disease.

Humans ; Occupational Exposure ; Respiratory Function Tests ; Sensitivity and Specificity ; Silicon Dioxide ; adverse effects ; Spirometry ; Tomography, X-Ray Computed ; methods ; Vital Capacity

The factors influencing the incidence of common complications (pneumothorax and pulmonary hemorrhage) of CT-guided percutaneous needle biopsy of lumps near pulmonary hilum were investigated. CT-guided percutaneous needle biopsy of lumps near pulmonary hilum was performed on 48 patients. The complications of pneumothorax and pneumorrhagia as well as the contributing factors were analyzed statistically. The major complications associated with CT-guided needle biopsy included pneumothorax (13 cases, 27.1%) and pulmonary hemorrhage (14 cases, 20.24%). χ(2) test revealed that pneumothorax was associated with the lesion size and depth of needle penetration, and pulmonary hemorrhage with the depth of needle penetration and needle retention time with a significant P value. Pneumothorax was observed in 7 cases (17.5%) out of 40 cases with diameter of mass greater than 3 cm, and in 6 cases (60%) out of 10 cases with depth of needle penetration greater than 4 cm. Additionally, pulmonary hemorrhage was identified in 12 cases (41.4%) out of 29 cases with needle retention time longer than 15 min, and pulmonary hemorrhage in 7 cases (70%) out of 10 cases with depth of needle penetration greater than 4 cm. CT-guided percutaneous needle biopsy of lumps near pulmonary hilum is safe and effective. The key factors to prevent the complications include correct evaluation of lesion size, depth of needle penetration and the needle retention time before the operation.
Biopsy, Needle ; adverse effects ; methods ; Female ; Humans ; Lung Neoplasms ; pathology ; Male ; Middle Aged ; Risk Factors ; Tomography, X-Ray Computed

Diplopia ; etiology ; Fracture Fixation ; adverse effects ; methods ; Humans ; Orbital Fractures ; diagnosis ; diagnostic imaging ; surgery ; Orbital Implants ; Tomography, X-Ray Computed