Squeeze maneuver: an easy way to manage radiological contrast-medium extravasation.

BACKGROUND: Contrast-medium extravasation injuries may be self-limited to catastrophic. Adequate prophylactic measures are enforced when risk factors for extravasation are present, and prompt treatment can avoid serious complications. PURPOSE: To describe the squeeze maneuver, an effective method for the treatment of symptomatic contrast-medium extravasation. MATERIAL AND METHODS: Over a 3-month period, eight patients with >50 ml contrast-medium extravasation resulting in vascular compromise of the fingers were managed with the squeeze maneuver as follows. The intravenous catheter used for contrast-medium injection was removed, and the skin around the insertion site was cleaned with povidone-iodine. An 18-gauge needle was then used to puncture five to eight openings near the catheter insertion site as deeply as possible. We then began squeezing from the periphery of the swelling toward the needle holes. As the contrast medium drained, it was swabbed away with iodine-soaked cotton swabs. RESULTS: In all eight patients, the maneuver was successful with immediate resolution of the vascular compromise. CONCLUSION: The squeeze maneuver provides an easy way to manage radiological contrast-medium extravasation and can be performed immediately in the CT suite.

Airway changes in children with mucopolysaccharidoses.

OBJECTIVE: To assess the CT findings of the airway in children with mucopolysaccharidoses (MPS). MATERIAL AND METHODS: The study included 13 patients (9 boys, 4 girls; age range 2-17 years; mean age 9.2 years) with MPS: 6 with Hunter syndrome, 3 with Maroteaux-Lamy syndrome, 2 with Sanfilippo syndrome, 1 with Hurler/Scheie syndrome and 1 with Morquio syndrome. CT of the airways was done in the axial section with 3-mm collimation from the oropharynx at the level of C3 to the base of the lung. The shape of the vocal cords and trachea at the level of T1 was evaluated. The tracheal surface area (TSA) at the level of T1 was measured both in patients and in age-matched subjects. RESULTS: CT showed an abnormality of the vocal cords in 7 of the 13 patients. Six patients had an abnormal shape and 7 had an inhomogenous density. The abnormalities included elliptical (5 of 6) and star-shaped (1 of 6) cords. Eight of 13 tracheas were also abnormal, either U-shaped (6 of 8) or worm-shaped (2 of 8). The TSA was significantly smaller in patients (79.6+/-28.9 mm2) than in control subjects (138.1+/-50.1 mm2). The TSA of those < or =9 years was 61.4+/-15.2 mm2 as compared with 99.9+/-23.5 mm2 for the control group. The TSA of patients > or =11 years was 107.1+/-25.3 mm2 as compared with 187.6+/-32.0 mm2 for the control group. CONCLUSION: Significant changes in the shape of the vocal cords and trachea in patients with MPS were found. The most common abnormal configuration of trachea was the U-shape. The TSA was smaller in patients with MPS than in controls. The airway changes may be due to abnormal submucosal storage of substances such as keratan or dermatan sulfate.

Congenital nasal pyriform aperture stenosis and single central maxillary incisor: CT and MRI findings.

The authors report five cases of congenital nasal pyriform aperture stenosis (CNPAS). Four cases are presented as neonatal nasal obstruction and also have single central maxillary incisor (SCMI). Computed tomography examination indicates three of the SCMI are unerupted and one is erupted. The fifth case has an erupted SCMI and short stature. The associated SCMI in CNPAS is believed to be more than an isolated anomaly. Awareness of the associated features of CNPAS among the radiologist and otolaryngologist may help the diagnosis and treatment of the patient.

[Detection of the safety depth on human chest by computer tomographic scanning].

Knowledges of acupuncture has played a major role in the treatment of human diseases, and has been mentioned in ancient Chinese medical literature for thousands of years. The loci which are most commonly used as treatment sites are points on the Ren Channel, kidney Channel, Stomach Channel, Pericardium Channel, Lung Channel, Spleen Channel and Gallbladder Channel for those loci on the human chest, insertion depth beyond safety level, can create serious consequences other such as pneumothorax, internal organ bleeding or other damage. This study was designed to determine the real safety depth for each locus by using a current scientific approach. The study was carried out at Tri-Service General Hospital and Mackay General Hospital. The sample patient population was 120. According to their body weight and height, patients were divided into six groups with various body sizes, i.e. normal, over and under-weight adults, and by sex differences. After computer tomographic scanning chest, the relative acupuncture loci should be measured according to anatomical position, then the distance between surface of the chest and thoracic pleura can be defined as its safety depth. For each locus of the groups, the mean and its interval of confident can be found. The analysis of variance (ANOVA), t-test, and multiple regression were also calculated by computer. The results show that there are significant differences in body chest loci within the same sex but, for different body sizes, statistically significant differences for each locus appear, so the safety depth for each chest locus has actually been proved. Not only does his data provide useful information for clinical practices, but also the standard safety depth for each loci on the chest could this be established.