Subclavian Artery Pseudoaneurysm Following Bedside Temporary Hemodialysis Catheter Insertion: A Case Report.

A pseudoaneurysm of the subclavian artery following central venous catheter placement is a rare but potentially fatal complication that often requires surgical intervention. However, surgical repair of the subclavian artery remains challenging. Herein, we report the case of a male patient undergoing hemodialysis who developed a pseudoaneurysm of the subclavian artery after a bedside central vein catheter placement. Hemostasis was successfully achieved by selecting the pseudoaneurysm using a microcatheter. At the 10-month follow-up, the pseudoaneurysm was completely excluded, and the patient was in a stable condition. The patient underwent native arteriovenous fistula creation and hemodialysis. Endovascular treatment could be an effective nonsurgical treatment for subclavian artery pseudoaneurysms and has been attempted as a first-line treatment option.

Gastrointestinal Air Motion Artifact Which Can Be Mistaken for Active Gastrointestinal Bleeding in Multidetector Computed Tomography: Phantom and Clinical Study.

OBJECTIVES: We investigated the computed tomographic characteristics of gastrointestinal air motion artifact (GIAMA), which can be misinterpreted as active gastrointestinal bleeding. METHODS: We simulated GIAMA using 3 types of air-ball phantoms (air-ball in water, air-ball in oil, air-water-ball in oil) and a bovine intestine in oil phantom. We also performed a retrospective clinical review of precontrast abdominal computed tomography images of 76 patients to investigate the frequency, location, shape, and maximum density of hyperdense GIAMA. RESULTS: In phantom studies, air motion artifacts appeared as dark and bright streak artifacts at the borders of a moving air-ball and water or oil. In the clinical study, hyperdense GIAMA was visualized in 60 (79.0%) of 76 patients. The small intestine was most commonly affected (46.4%), and the intramural type had the highest frequency (58.0%). CONCLUSION: Knowing the radiologic features of GIAMA can assists radiologists in identifying active gastrointestinal bleeding sites accurately.

Phenomena of Nano- and Micro-Pore Formation on Ti-(10~50)Ta Alloys by Plasma Electrolytic Oxidation for Dental Implants.

In this study, the phenomena of nano and micro-pore formation on Ti-(10~50)Ta alloys by plasma electrolytic oxidation for dental implants was investigated using various experimental techniques. The Ti­xTa alloys having Ta contents of 10, 30, and 50 wt.% were prepared using arc-melting vacuum furnace. Micro-pore formation was performed using a potentiostat in 1 M H3PO4 electrolyte by using a potentiostat at various applied voltage (180 V, 210 V, and 240 V). The microstructure of Ti­xTa alloys changed from α' phase to ß + α″ phase with Ta content increased. The applied potential increased, the numbers of micro-pore per unit area decreased, whereas the area ratio of occupied by micro-pores increased. The Ta contents increased, the numbers of micro-pore per unit area decreased, whereas the area ratio of occupied by micro-pores increased at 210 V and 240 V. The thickness of oxide layer and micro-pore size can be controlled by applied potential.

Analysis of Flow Characteristics between Tandem Flexible Structures Based on PIV: Substantial Applications for the Removal of Microplastics.

This study emphasizes the potential risk posed by microplastics, particularly in tap water. Numerous studies have reported the removal of microplastics, but the limitations in addressing this issue remain challenging. To tackle this problem, a new method is introduced using tandem flexible structures (FSs) for microplastic removal. The present study focused on understanding the hydrodynamic characteristics between FSs to utilize microplastic removal. This comprehension of fluid flow and FSs offers valuable insights for improving the efficiency of microplastic removal methods. Therefore, the optimal conditions for removing microplastics were experimentally investigated inside the FSs gap region. Based on the gap distance and height, the flow structures between FSs were investigated. A small secondary vortex structure that could trap particles from upstream was continuously maintained behind the upstream FSs under certain geometric conditions. It is shown that this vortex structure has an effective way of confining the particles from upstream. The persistency of a small secondary vortex was also evaluated. This study may be helpful to researchers working on microplastic removal and FSs with a tandem arrangement.

Safety and efficacy of fluoroscopy-guided urethral catheterization in case of failed blind or cystoscopy-assisted urethral catheterization.

This retrospective study evaluated the safety and efficacy of fluoroscopy-guided urethral catheterization in patients who failed blind or cystoscopy-assisted urethral catheterization. We utilized our institutional database between January 2011 and March 2023, and patients with failed blind or cystoscopy-assisted urethral catheterization and subsequent fluoroscopy-guided urethral catheterization were included. A 5-Fr catheter was inserted into the urethral orifice, and the retrograde urethrography (RGU) was acquired. Subsequently, the operator attempted to pass a hydrophilic guidewire to the urethra. If the guidewire and guiding catheter could be successfully passed into the bladder, but the urethral catheter failed pass due to urethral stricture, the operator determined either attempted again with a reduced catheter diameter or performed balloon dilation according to their preference. Finally, an appropriately sized urethral catheter was selected, and an endhole was created using an 18-gauge needle. The catheter was then inserted over the wire to position the tip in the bladder lumen and ballooned to secure it. We reviewed patients' medical histories, the presence of hematuria, and RGU to determine urethral abnormalities. Procedure-related data were assessed. Study enrolled a total of 179 fluoroscopy-guided urethral catheterizations from 149 patients (all males; mean age, 73.3 ± 13.3 years). A total of 225 urethral strictures were confirmed in 141 patients, while eight patients had no strictures. Urethral rupture was confirmed in 62 patients, and hematuria occurred in 34 patients after blind or cystoscopy-assisted urethral catheterization failed. Technical and clinical success rates were 100%, and procedure-related complications were observed in four patients (2.2%). The mean time from request to urethral catheter insertion was 129.7 ± 127.8 min. The mean total fluoroscopy time was 3.5 ± 2.5 min and the mean total DAP was 25.4 ± 25.1 Gy cm2. Balloon dilation was performed in 77 patients. Total procedure time was 9.2 ± 7.6 min, and the mean procedure time without balloon dilation was 7.1 ± 5.7 min. Fluoroscopy-guided urethral catheterization is a safe and efficient alternative in patients where blind or cystoscopy-assisted urethral catheterization has failed or when cystoscopy-urethral catheterization cannot be performed.

Detection and position evaluation of chest percutaneous drainage catheter on chest radiographs using deep learning.

PURPOSE: This study aimed to develop an algorithm for the automatic detecting chest percutaneous catheter drainage (PCD) and evaluating catheter positions on chest radiographs using deep learning. METHODS: This retrospective study included 1,217 chest radiographs (proper positioned: 937; malpositioned: 280) from a total of 960 patients underwent chest PCD from October 2017 to February 2023. The tip location of the chest PCD was annotated using bounding boxes and classified as proper positioned and malpositioned. The radiographs were randomly allocated into the training, validation sets (total: 1,094 radiographs; proper positioned: 853 radiographs; malpositioned: 241 radiographs), and test datasets (total: 123 radiographs; proper positioned: 84 radiographs; malpositioned: 39 radiographs). The selected AI model was used to detect the catheter tip of chest PCD and evaluate the catheter's position using the test dataset to distinguish between properly positioned and malpositioned cases. Its performance in detecting the catheter and assessing its position on chest radiographs was evaluated by per radiographs and per instances. The association between the position and function of the catheter during chest PCD was evaluated. RESULTS: In per chest radiographs, the selected model's accuracy was 0.88. The sensitivity and specificity were 0.86 and 0.92, respectively. In per instance, the selected model's the mean Average Precision 50 (mAP50) was 0.86. The precision and recall were 0.90 and 0.79 respectively. Regarding the association between the position and function of the catheter during chest PCD, its sensitivity and specificity were 0.93 and 0.95, respectively. CONCLUSION: The artificial intelligence model for the automatic detection and evaluation of catheter position during chest PCD on chest radiographs demonstrated acceptable diagnostic performance and could assist radiologists and clinicians in the early detection of catheter malposition and malfunction during chest percutaneous catheter drainage.

Fluoroscopy-Guided Percutaneous Transthoracic Pleural Forceps Biopsy in Patients With Exudative Pleural Effusion.

OBJECTIVE: This study aimed to evaluate the diagnostic performance and procedural characteristics of fluoroscopy-guided percutaneous transthoracic pleural forceps biopsy (PTPFB) in patients with exudative pleural effusion. MATERIALS AND METHODS: Patients with exudative pleural effusion who underwent PTPFB between May 1, 2014, and February 28, 2023, were included in this retrospective study. The interval between percutaneous catheter drainage (PCD) and PTPFB, number of biopsies, procedural time, and procedure-related complications were evaluated. The sensitivity, specificity, and accuracy of diagnosing malignancy were computed for pleural cytology using PCD drainage, PTPFB, and combined PTPFB and pleural cytology. RESULTS: Seventy-one patients, comprising 50 male and 21 female (mean age, 69.5 ± 15.3 years), were included in this study. The final diagnoses were benign lesions in 48 patients (67.6%) and malignant in 23 patients (32.4%). The overall interval between PCD and biopsy was 2.4 ± 3.7 days. The interval between PCD and biopsy in the group that underwent delayed PTPFB was 5.2 ± 3.9 days. The mean number of biopsies was 4.5 ± 1.3. The mean procedural time was 4.4 ± 2.1 minutes. Minor bleeding complications were reported in one patient (1.4%). The sensitivity, specificity, and accuracy for pleural cytology, PTPFB, and combined PTPFB and pleural cytology were 47.8% (11/23), 100% (48/48), and 83.1% (59/71), respectively; 65.2% (15/23), 100% (48/48), and 88.7% (63/71), respectively; and 78.3% (18/23), 100% (48/48), and 93.0% (66/71), respectively. The sensitivity and accuracy of cytology combined with PTPFB were significantly higher than those of cytological testing alone (P = 0.008 and 0.001, respectively). CONCLUSION: Fluoroscopy-guided PTPFB is an accurate and safe diagnostic technique for patients with exudative pleural effusion, with acceptable diagnostic performance, low complication rates, and reasonable procedural times.

Contralateral brachial arterial access for endovascular treatment of recurrent axillofemoral bypass graft stump syndrome: A case report.

Axillofemoral bypass graft stump syndrome is an uncommon complication of axillofemoral bypass graft surgery. The traditional treatment is open surgical repair; however, endovascular recanalization can be achieved. Interventional treatment by approaching the brachial artery contralateral to the lesion site has rarely been reported in acute upper extremity ischemia. We report a case of recanalization through the left brachial artery due to embolic occlusion of the right brachial and axillary arteries and suspected axillofemoral bypass graft stump syndrome in a 71-year-old man. Access through the common femoral artery was impossible because the patient underwent reoperation of the left axillofemoral bypass and femorofemoral bypass due to occlusion of the right axillofemoral bypass and femorofemoral bypass surgery. Furthermore, bilateral radial arteries were occluded, allowing access to the left brachial artery. Two self-expandable stents were inserted into the occlusion of the right brachial and axillary arteries, and the stump area was covered. Aspiration thrombectomy was performed for embolism in the ulnar artery. Axillofemoral bypass graft stump syndrome can also be treated with interventional management. If access to the bilateral common femoral and radial arteries is not possible, an upper extremity arterial procedure through the contralateral brachial artery may be considered in cases of steno-occlusion of the upper extremities.

Effect of flow structures on natural ventilation performance in office model.

The recent Coronavirus Disease 2019 pandemic has highlighted the importance of indoor ventilation. In particular, ventilation is crucial in residential spaces and workspaces, where people spent most of their day. Natural ventilation is a cost-effective method for improving indoor ventilation. It can provide safe and comfortable residential and working environments without additional energy consumption. In this study, the ventilation performance was experimentally studied by measuring the concentration of ultrafine particulate matter according to the opening conditions of the windows and door of an office model in a wind tunnel. Furthermore, the internal flow structure in the office model was quantitatively analyzed through particle image velocimetry to determine the factors that affected the ventilation performance. The mean velocity inside the model and the ventilation performance increased with the opening angle of the windows. In particular, the opening condition of the door strongly affected the ventilation performance. This study is expected to provide a guideline for effectively improving the ventilation performance in indoor spaces.

Reversible Ortner's Syndrome as a Presenting Feature of Thyrotoxicosis in an Adolescent: A Rare Case Report.

Ortner's or cardiovocal syndrome is hoarseness attributable to left recurrent laryngeal nerve (RLN) palsy associated with mechanical compression of the nerve by pathologically enlarged cardiovascular structures. Ortner's syndrome is a rare condition, and to our knowledge, only a few cases have been reported in Korea. Furthermore, this condition is extremely uncommon in pediatric patients with thyrotoxicosis-related RLN paralysis. We report a case of reversible Ortner's syndrome in an adolescent who presented with secondary pulmonary hypertension related to thyrotoxicosis.

[Comparison of True and Virtual Non-Contrast Images of Liver Obtained with Single-Source Twin Beam and Dual-Source Dual-Energy CT]. / 간의 ë‹¨ì¼ì„ ì› Twin Beamê³¼ ì´ì¤‘ì„ ì› 이중에너지 ì „ì‚°í™”ë‹¨ì¸µì´¬ì˜ì˜ 비조영증강 영상과 가상 비조영증강 영상의 비교 연구.

Purpose: To assess the magnitude of differences between attenuation values of the true non-contrast image (TNC) and virtual non-contrast image (VNC) derived from twin-beam dual-energy CT (tbDECT) and dual-source DECT (dsDECT). Materials and Methods: This retrospective study included 62 patients who underwent liver dynamic DECT with tbDECT (n = 32) or dsDECT (n = 30). Arterial VNC (AVNC), portal VNC (PVNC), and delayed VNC (DVNC) were reconstructed using multiphasic DECT. Attenuation values of multiple intra-abdominal organs (n = 11) on TNCs were subsequently compared to those on multiphasic VNCs. Further, we investigated the percentage of cases with an absolute difference between TNC and VNC of ≤ 10 Hounsfield units (HU). Results: For the mean attenuation values of TNC and VNC, 33 items for each DECT were compared according to the multiphasic VNCs and organs. More than half of the comparison items for each DECT showed significant differences (tbDECT 17/33; dsDECT 19/33; Bonferroni correction p < 0.0167). The percentage of cases with an absolute difference ≤ 10 HU was 56.7%, 69.2%, and 78.6% in AVNC, PVNC, and DVNC in tbDECT, respectively, and 70.5%, 78%, and 78% in dsDECT, respectively. Conclusion: VNCs derived from the two DECTs were insufficient to replace TNCs because of the considerable difference in attenuation values.

Design of Bronze-Rich Dual-Phasic TiO2 Embedded Amorphous Carbon Nanocomposites Derived from Ti-Metal-Organic Frameworks for Improved Lithium-Ion Storage.

Dual-phasic (DP)-TiO2 -based composites are considered attractive anode materials for high lithium-ion storage because of the synergetic contribution from dual-phases in lithium-ion storage. However, a comprehensive investigation on more efficient architectures and platforms is necessary to develop lithium-storage devices with high-rate capability and long-term stability. Herein, for the first time, a rationally designed bronze-rich DP-TiO2 -embedded amorphous carbon nanoarchitecture, denoted as DP-TiO2 @C, from sacrificial Ti-metal-organic frameworks (Ti-MOFs) via a two-step pyrolysis process is proposed. The bronze/anatase DP-TiO2 @C nanocomposites are successfully synthesized using a unique pyrolysis process, which decomposes individually the metal clusters and organic linkers of Ti-MOFs. DP-TiO2 @C exhibits a significantly high density and even distribution of nanoparticles (<5 nm), enabling the formation of numerous heterointerfaces. Remarkably, the bronze-rich DP-TiO2 @C shows high specific capacities of 638 and 194 mAh g-1 at current densities of 0.1 and 5 A g-1 , respectively, owing to the contribution of the synergetic interfacial structure. In addition, reversible specific capacities are observed at a high rate (5 A g-1 ) during 6000 cycles. Thus, this study presents a new approach for the synthesis of DP-TiO2 @C nanocomposites from a sacrificial Ti-MOF and provides insights into the efficient control of the volume ratio in DP-TiO2 anode architecture.

Renal Epithelioid Angiomyolipoma with Epithelial Cysts Mimicking Cystic Renal Cell Carcinoma: A Case Report of Combination of Two Rare Entities.

Renal angiomyolipomas (AMLs) are typically solid tumors, but there have been few reports of a rare cystic variant of AML. AML with epithelial cysts, where the epithelial cyst has a cuboidal epithelial lining, account for the majority of them. Next, epithelioid AML (EAML) with cystic changes due to hemorrhage and necrosis, which is composed of epithelioid cells with abundant eosinophilic cytoplasm, have also been reported. These rare cystic types of AML can be mistaken for other cystic tumors, such as cystic renal cell carcinoma, in preoperative imaging. We report the imaging findings of a rare case of EAML with epithelial cysts.

Pseudomembranous Aspergillus Tracheobronchitis: Case Report of a Rare Manifestation of Airway Invasive Aspergillosis.

Aspergillus tracheobronchitis, an uncommon form of invasive pulmonary aspergillosis, is characterized by the development of a pseudomembrane, ulcers, or an obstruction that is predominantly confined to the tracheobronchial tree. Pseudomembranous Aspergillus tracheobronchitis is the most severe form of Aspergillus tracheobronchitis, and only a few cases have been reported in Korea. We report the characteristic chest CT findings in a patient diagnosed with pseudomembranous Aspergillus tracheobronchitis after bronchoscopy and successfully treated by proper antifungal treatment.

Effect of trichome structure of Tillandsia usneoides on deposition of particulate matter under flow conditions.

The removal of particulate matters (PM) has emerged as one of the most significant issues in public health and environment worldwide. Environmentalists have proposed the use of indoor air-purifying plants as an eco-friendly strategy to resolve PM-related problems and effectively remove fine particulate matter (PM2.5). Among air-purifying plants, Tillandsia usneoides (L.) L. (T. usneoides) has been used as a biomonitor for heavy metals and air pollutants. However, the PM removal effect of T. usneoides and its primary mechanism remain unclear. Here, we investigated the PM removal performance of T. usneoides in a closed chamber under flow conditions, the effects of trichomes, and the array density according to the different types of PM. The chamber with bulk T. usneoides under flow conditions exhibited 16.5 % and 9.2 % higher removal efficiency in PM2.5T. usneoides for incense and A1 rigid PM, respectively, than that without T. usneoides. T. usneoides with trichome structure exhibited larger removal efficiencies of 7% and 2% in PM2.5 and PM10, respectively, than without trichome for incense particles. In addition, the increase in total effective surface was effective for the deposition of both PM types. The increase in effective surface area by trichome structure and array density of T. usneoides is a crucial factor for the deposition of PM.

Origin and organ-specific bioaccumulation pattern of perfluorinated alkyl substances in crabs.

Consumption of seafood is a major contributor to perfluorinated alkyl substances (PFASs) exposure. Crabs contain high levels of PFASs, and different PFASs are concentrated in their tissues depending on their habitat. Despite South Korea importing huge quantities of crabs, no investigation has been conducted on the effect of PFAS exposure. This study investigated the risk of exposure to PFASs when ingesting crabs. To determine the risk of exposure, 19 different PFAS species were measured in the edible parts (body, legs, offal, and eggs) of crabs originating from South Korea (n = 17), China (n = 14), India (n = 7), and Pakistan (n = 31), which were distributed in the fish markets of South Korea. The results revealed that, in contrast to short-chain PFASs, long-chain PFASs (PFCAs≥8, PFSAs≥6, and perfluorooactane sulfonamidoacetic acids (FOSAAs)≥8) were detected in crab samples from all four countries of origin, and in all the edible parts except for the legs. Perfluorooctanoic acid (PFOA; 16.9 ng/g in South Korea, 9.42 ng/g in China) and perfluoro-n-tridecanoic acid (PFTrDA; 5.35 ng/g in South Korea, 2.40 ng/g in China) were the predominant perfluoroalkyl carboxylic acids (PFCAs) detected in the crabs originating from South Korea and China, and perfluorooctane sulfonic acid (PFOS; 7.02 ng/g in Pakistan, 5.88 ng/g in India) was the predominant perfluoroalkyl sulfonic acids (PFSAs) detected in crabs originating from Pakistan and India. These results indicate that PFASs that are accumulated in crabs differ depending on the ocean from which they originate. The concentrations of PFOA and PFOS were significantly higher in the eggs and offal than in the legs and body of the crab. The average daily intake of PFOA and PFOS in South Koreans ranges from 0.01% to 0.07% based on the tolerable daily intake of EFSA and MFDS. These results establish the PFAS profiles and risk assessment of crabs that are distributed in South Korea.

Effect of flow and humidity on indoor deposition of particulate matter.

The removal of particulate matter (PM) is an important issue in public health and the global atmospheric environment. Various PM removal methods have been suggested to effectively remove PM particles. However, the effects of various factors on PM deposition are not completely clear. We quantitatively investigated the effects of flow and humidity difference in a closed chamber on PM deposition. To elucidate the parameters affecting the deposition of PM particles, PM removal efficiency and deposition constant were examined at different flow rates, flow directions, and relative humidity (RH) inside the closed system. The highest PM deposition rate was achieved under humid condition with the upward direction flow at a fan speed of RPM = 150. Mean velocity fields inside the test chamber were obtained by a particle image velocimetry (PIV) technique to quantitatively examine the effect of flow conditions on the PM deposition. The flow structure and RH inside the closed chamber have significant influence on PM deposition.

Removal of fine particulate matter (PM2.5) via atmospheric humidity caused by evapotranspiration.

Reduction of particulate matter (PM) has emerged as one of the most significant challenges in public health and environment protection worldwide. To address PM-related problems and effectively remove fine particulate matter (PM2.5), environmentalists proposed tree planting and afforestation as eco-friendly strategies. However, the PM removal effect of plants and its primary mechanism remains uncertain. In this study, we experimentally investigated the PM removal performance of five plant species in a closed chamber and the effects of relative humidity (RH) caused by plant evapotranspiration, as a governing parameter. On the basis of the PM removal test for various plant species, we selected Epipremnum aureum (Scindapsus) as a representative plant to identify the PM removal efficiency depending on evapotranspiration and particle type. Results showed that Scindapsus yielded a high PM removal efficiency for smoke type PM2.5 under active transpiration. We examined the correlation of PM removal and relative humidity (RH) and evaluated the increased effect of RH on PM2.5 removal by using a plant-inspired in vitro model. Based on the present results, the increase of RH due to evapotranspiration is crucial to the reduction of PM2.5 using plants.

CT Features of Vasculitides Based on the 2012 International Chapel Hill Consensus Conference Revised Classification.

Vasculitis, characterized by inflammation of vessel walls, is comprised of heterogeneous clinicopathological entities, and thus poses a diagnostic challenge. The most widely used approach for classifying vasculitides is based on the International Chapel Hill Consensus Conference (CHCC) nomenclature system. Based on the recently revised CHCC 2012, we propose computed tomography (CT) features of vasculitides and a differential diagnosis based on location and morphological characteristics. Finally, vasculitis mimics should be differentiated, because erroneous application of immunosuppressive drugs on vasculitis mimics may be ineffective, even deteriorating. This article presents the utility of CT in the diagnosis and differential diagnosis of vasculitides.

Surface Characteristics of Nano-Structured Silicon/Hydroxyapatite Deposition onto the Ti-Nb-Zr Alloy.

The Ti-Nb-Zr alloy was manufactured with 35 wt% of Nb and 10 wt% of Zr by arc melting furnace to be a beta phase. Electrochemical deposition of Si substituted Ca/P was performed by pulsing the potential with a method of cyclic voltammetry, and changed cyclic time between 10, 30, 70, and 150. The electrolyte was prepared by dissolving the reagent-grade chemicals: Ca(NO3)2, NH4H2PO4, and Na2SiO3 x 9H20 to be 1.67 of Ca/P ratio and silicon contents were controlled to be 1 wt%. The surface characteristics were observed by field-emission scanning electron microscopy, X-ray diffractometer, and electrochemical corrosion as a potentiodynamic test. The Si substituted hydroxyapatite layer was successfully formed on the Ti-35Nb-10Zr alloy substrate by electrochemical deposition. A surface morphologies showed needle like shape at 10 cycles, then changed to be a circular with increment of cycles. The Ca/P ratio was the range between 1.5 and 2.0, the crystalline of hydroxyapatite could be confirmed. The corrosion behavior of Si-HA deposition was related with surface shape and thickness by increment, of cyclic times. Higher cyclic times of deposition had higher corrosion potential and current density than that of lower cyclic surface.