Paraplegia after transforaminal epidural steroid injection in a patient with severe lumbar disc herniation - A case report.

BACKGROUND: Transforaminal epidural steroid injection (TFESI) is a conservative treatment for patients with lumbar disc herniation (LDH). However, there are reports of various complications that can occur after TFESI; among these, paraplegia is a serious complication. CASE: A 70-year-old woman who was unable to lie supine due to low back pain exacerbation during back extension underwent TFESI. After injection, there was pain relief and the patient was able to lie supine; however, paraplegia developed immediately. Magnetic resonance imaging confirmed cauda equina syndrome (CES) due to nerve compression from L1-2 LDH. We determined that the patient's LDH was already severe enough to be considered CES and that the TFESI procedure performed without an accurate understanding of the patient's condition aggravated the disease. CONCLUSIONS: It is important to accurately determine the cause of pain and disease state of a patient to establish a correct treatment plan before TFESI is performed.

Shear-wave elastography in thyroid ultrasound: Can be a predictor of extrathyroidal extension and cervical lymph node metastasis in papillary thyroid carcinoma?

ABSTRACT: This study aimed to investigate whether extrathyroidal extension (ETE) and cervical lymph node metastasis (LNM) can be predicted using elasticity parameters of shear-wave elastography (SWE) combined with B-mode ultrasound (US) of papillary thyroid carcinomas (PTCs).We retrospectively reviewed 111 patients who underwent preoperative SWE evaluation among PTC patients from July 1, 2016 to June 20, 2018. Patients were divided into 2 groups based on the presence or absence of ETE based on pathology reports. Univariate and multivariate analyses of clinical and radiologic features including B-mode US features, US patterns, and SWE parameters were performed. These analyses were repeated in LNM positive and negative groups. The diagnostic performance of SWE parameters were also evaluated.Of the 111 patients, 33 had ETE, 78 did not have ETE, 44 had LNM, and 67 did not have LNM. A taller-than-wide shape and T3 stage on US were associated with ETE. Female sex, total thyroidectomy, and T3 stage on US were associated with LNM. When B-mode US and SWE were combined, there was no improvement in diagnostic performance.Combination of SWE and B-mode US findings is not useful for predicting ETE and LNM status in PTC patients.

Photocatalytic oxidation of gas-phase elemental mercury by nanotitanosilicate fibers.

Photocatalytic fibers were generated from the continuous evaporation of titanium tetraisopropoxide with tetraethyl orthosilicate through a flame burner. The morphology, the crystal form, and the components of the nanotitanosilicate fibers were analyzed by Raman spectroscopy, Field emission-scanning electron microscope, X-ray diffraction, and Brunauer-Emmett-Teller surface area analysis. The nanotitanosilicates prepared by three different carrier gases (air, N(2), and Ar) were tested for their photocatalytic ability to remove/oxidize gas-phase elemental mercury. Under UV black light, the Hg(0) capture efficiencies were 78%, 86%, and 85% for air, N(2), and Ar, respectively. For air, the value was close to 90%, even under household fluorescent light. The Hg(0) capture efficiency by nanotitanosilcate was measured under fluorescent light, UV black light, and sunlight.