Acute basilar artery (BA) occlusion is a key etiology of devastating posterior circulation stroke, unless recanalization is performed early. Recanalization therapy is determined synthetically based on symptom onset time, stroke severity, and brain imaging. Herein, we report the case of a 72-year-old male patient presenting with minor neurological symptoms, but with thrombotic occlusion at the BA tip. Transcranial Doppler (TCD) showed systolic flow reversal along the vertebrobasilar arteries, and the patient benefited from endovascular thrombectomy. This case highlights the critical role of TCD in identifying hemodynamic insufficiency and determining the implementation of endovascular interventions to mitigate stroke progression.

Brain abscess, a life-threatening infection, can result from hematogenous spread. Although uncommon, Klebsiella pneumoniae can lead to brain abscess and systemic dissemination. In this case report, Klebsiella pneumoniae brain abscess, linked with prostate abscess, in a 57-year-old diabetic male with liver cirrhosis and hepatitis B, resulted in fatal sepsis despite antibiotic therapy. This case underscores Klebsiella's grave risk in immunocompromised patients, highlighting brain abscess and high mortality. Early diagnosis, treatment, and evaluation for multiple organ involvement are crucial.

Brain abscess, a life-threatening infection, can result from hematogenous spread. Although uncommon, Klebsiella pneumoniae can lead to brain abscess and systemic dissemination. In this case report, Klebsiella pneumoniae brain abscess, linked with prostate abscess, in a 57-year-old diabetic male with liver cirrhosis and hepatitis B, resulted in fatal sepsis despite antibiotic therapy. This case underscores Klebsiella's grave risk in immunocompromised patients, highlighting brain abscess and high mortality. Early diagnosis, treatment, and evaluation for multiple organ involvement are crucial.

Brain abscess, a life-threatening infection, can result from hematogenous spread. Although uncommon, Klebsiella pneumoniae can lead to brain abscess and systemic dissemination. In this case report, Klebsiella pneumoniae brain abscess, linked with prostate abscess, in a 57-year-old diabetic male with liver cirrhosis and hepatitis B, resulted in fatal sepsis despite antibiotic therapy. This case underscores Klebsiella's grave risk in immunocompromised patients, highlighting brain abscess and high mortality. Early diagnosis, treatment, and evaluation for multiple organ involvement are crucial.

Background and Objectives: Brain organoids have the potential to improve our understanding of brain development and neurological disease. Despite the importance of brain organoids, the effect of vascularization on brain organoids is largely unknown. The objective of this study is to develop vascularized organoids by assembling vascular spheroids with cerebral organoids. Methods: and Results: In this study, vascularized spheroids were generated from non-adherent microwell culture system of human umbilical vein endothelial cells, human dermal fibroblasts and human umbilical cord blood derived mesenchymal stem cells. These vascular spheroids were used for fusion with iPSCs induced cerebral organoids. Immunostaining studies of vascularized organoids demonstrated well organized vascular structures and reduced apoptosis. We showed that the vascularization in cerebral organoids up-regulated the Wnt/β-catenin signaling. Conclusions We developed vascularized cerebral organoids through assembly of brain organoids with vascular spheroids. This method could not only provide a model to study human cortical development but also represent an opportunity to explore neurological disease.

Purpose: We evaluated the risk factors for progression to chronic complicated bronchopleural fistula (BPF) after pulmonary resection using follow-up CT. Materials and Methods: We retrospectively reviewed 45 cases with BPF that had undergone pulmonary resection during 2010-2018. We compared the clinical and radiological characteristics of those with complicated BPF (n = 24) and those without complicated (sterilized) BPF (n = 21). The clinical and radiological risk factors for progression to chronic complicated BPF were examined by logistic regression analysis. Results: The thickness of the pleural cavity wall (p = 0.022), the size of the pleural cavity (p = 0.029), and the size increase of BPF on follow-up (p = 0.012) were significantly different between the two groups. The risk factors for progression to chronic complicated BPF were age > 70 years (odds ratio, 6.43; 95% confidence interval, 1.2–33.7), the thickness of the cavity wall > 5 mm (odds ratio, 52.5; 95% confidence interval, 5.1–545.4), and an increase in the size of the pleural cavity on follow-up CT (odds ratio, 12.5; 95% confidence interval, 2.1–73.5), only in the univariate analysis. Conclusion The risk factors for progression to chronic complicated BPF can be evaluated using follow-up CT.

A key challenge of anesthesia is to provide patients with safe and optimized anesthetic management to improve prognosis and minimize mortality and morbidity. To this end, the anesthesiologist should comprehensively understand the patient’s physical status through pre-anesthetic assessment and carefully monitor the patient during surgery. Several types of novel patient-monitoring devices may be useful to achieve this purpose. We report a case of anesthetic management in a patient with left internal carotid artery occlusion and penetrating aortic ulcer.

Hypopharyngeal mass is an uncommon condition in the aerodigestive tract. There were only a few cases have been published in the medical literature. We experienced a case of incidentally detected hypopharyngeal mass during endotracheal intubation. Hypopharyngeal mass was located at the right posterior pharyngeal wall. The hypopharyngeal mass was small and not obstruct the glottis, and endotracheal intubation was performed successfully. We have also briefly discussed symptoms, diagnosis, and related problems during general anesthesia of hypopharyngeal mass.

BACKGROUND: The interferon-gamma (IFN-γ) releasing assay (IGRA) is widely used for latent tuberculosis infection (LTBI) diagnosis. We evaluated the analytical performance of a new automated chemiluminescent immunoanalyzer-based IGRA (CLIA-IGRA), AdvanSure I3 (LG Life Sciences, Seoul, Korea) and compared it with that of the QuantiFERON-TB Gold In-Tube (QFT-GIT) assay. METHODS: Repeatability and reproducibility were evaluated at four levels. Detection capability, including limit of blank (LoB), limit of detection (LoD), and limit of quantification (LoQ), was evaluated using IFN-γ standard material (National Institute for Biological Standards and Control code: 87/586). Agreement between the results of two assays was evaluated using 341 blood samples from healthcare workers and patients at a tertiary care hospital. To determine the cut-off value of CLIA-IGRA for diagnosing LTBI, the ROC curve was analyzed. RESULTS: Repeatability and reproducibility were 4.86–7.00% and 6.36–7.88% CV, respectively. LoB, LoD, and LoQ were 0.022, 0.077, and 0.249 IU/mL, respectively. IFN-γ values between CLIA-IGRA and QFT-GIT showed a strong correlation within the analytical measurable range of both assays, especially when the value was low. Qualitative comparison of the two assays yielded a 99.1% overall agreement (kappa coefficient=0.98). A cut-off value of 0.35 IU/mL was appropriate for diagnosing LTBI. CONCLUSIONS CLIA-IGRA is a reliable assay for LTBI diagnosis, with performance similar to that of QFT-GIT.