Single Centre Experience on Decision Making for Mechanical Thrombectomy Based on Single-Phase CT Angiography by Including NCCT and Maximum Intensity Projection Images – A Comparison with Magnetic Resonance Imaging after Non-Contrast CT

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.

Abnormal Uterine Bleeding Due to Vascular Abnormality Caused by D&E : Doppler Sonography for Diagnosis and Transcatheter Arterial Embolization for Treatment

PURPOSE: We attempted to evaluate the usefulness of Doppler sonography in the diagnosis of uterine vascular abnormality caused by previous D&E, and to report that transarterial embolization is an exceelent treatment modality. MATERIALS & METHODS: We analyzed gray-scale US, color/duplex Doppler US and angiographic findings inseven patients with radiologically proven uterine vascular abnormality. Two of the seven cases were pseudoaneurysms and five of the seven cases were AVMs. In one of the AVMs, two small pseudoaneurysms were combined. In all cases, transarterial embolizations using 3mm coil or/and gelfoam particles were performed. Follow-up US studies, including color Doppler US, were performed. RESULTS: On color/duplex Doppler sonography, two cases of pseudoaneurysm showed blood pools with turbulent arterial flow, and five cases of AVM showed asymmetrically increased vascularity, with variable high velocities composed of the pulsatie arterial flow, with ahigh diastoic component. On angiography, the former showed pseudoaneurysmal sacs, and the latter densely opacified vascular tangles. No more abnormal uterine bleeding was shown, following transarterial embolization in all cases. CONCLUSION: Color/duplex Doppler sonography was valuable in the diagnosis or treatment of abnormal uterine bleeding caused by uterine vascular abnormality such as acquired AVM or pseudoaneurysm.

Abdominal Ultrasonographic Findings of Salmonellosis

PURPOSE: We evaluated the abdominal uttrasonographic findings of Salmonellosis. MATERIALS AND METHODS: This study included 64 patients who were confirmed as salmonellosis by blood culture. We retrospectively analyzed the abdominal ultrasonographic findings with particular attention to enlarged mesenteric lymph nodes(mesenteric lymphadenitis), thickening of bowel wall, especially terminal ileum and cecum(ileocecitis), hepatosplenomegaly, ascites, gallbladder wall thickening, and enlarged lymph nodes in porta hepatis. RESULTS: The 64 cases were observed as mesenteric lymph node enlargement(44 cases), wall thickening of the terminal ileum and cecum(36 cases), hepatomegaly and/or splenomegaly(42 cases), minimal ascites(8 cases), gallbladder wall thickening(6 cases), and enlarged lymph nodes in porta hepatis(4 cases). No abnormal finding was seen in 10 patients. CONCLUSION: The mesenteric lymph node enlargement, wall thickening of the terminal ileum and cecum, hepatomegaly and/or splenomegaly, minimal ascites, gallbladder wall thickening, and enlarged lymph nodes in porta hepatis are suggestive findings of salmonellosis on abdominal ultrasonography in patients with fever and acute abdomen.

Laryngeal Granuloma Following General Anesthesia and Anesthetic Experience for Resection of Granuloma - A case report / 대한마취과학회지

The authors have been experienced a case of laryngeal granuloma following endotracheal anesthesia which is rare in children and have used two different method of general anesthesia for resection of granuloma. These two methods are; 1) using endotracheal tube insertion for general anesthesia. 2) applying general anesthesia via under mask. Comparing with two different methods of general anesthesia, we come to the conclusion that the former is more reliable for clinical anesthesia because of supplying continuous positive pressure with oxygen and anesthetics in spite of poor operation field.