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.

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.

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.

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.

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.

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.

Objective: Long-acting injectable (LAI) antipsychotics, such as paliperidone palmitate (PP), are known to improve treatment adherence in patients with schizophrenia, which can lead to reductions in relapse and hospitalization rates. However, relatively few studies have demonstrated the economic impact of LAIs, especially in Asian populations. Methods: We conducted a claim-based mirror-image study to explore changes in healthcare utilization and associated costs, among 1,272 South Korean patients with schizophrenia (ICD-10-CM code F20), between the 1-year periods before and after the initiation of PP treatment. Results: Patients accessed outpatient services more frequently after versus before starting PP treatment, with the number of prescription days increasing by 133.45 (p ＜ 0.0001) and the associated costs increasing by USD 1,497.15 (p ＜ 0.0001). The number of admission days was reduced by 11.33 after starting PP treatment (p ＜ 0.0001) and the associated costs were reduced by USD 1,220.75 (p ＜ 0.0001). However, admission cost savings were different according to patients’ oral drug compliance. The daily dosages for benztropine, procyclidine, and propranolol decreased, showing that there were fewer side-effects after PP-treatment (p ＜ 0.0001). Conclusion Although the high acquisition cost of PP has been regarded as an obstacle to its clinical use, our results imply that the high prescription costs for PP may be counterbalanced by the reduced admission costs associated with its use. Economic outcomes for patients treated with LAIs should be investigated further to help healthcare decision-makers and providers to determine the value of LAIs relative to other treatment medications.