• Title/Summary/Keyword: Puncture

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Predictive value of C-reactive protein for the diagnosis of meningitis in febrile infants under 3 months of age in the emergency department

  • Lee, Tae Gyoung;Yu, Seung Taek;So, Cheol Hwan
    • Journal of Yeungnam Medical Science
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    • v.37 no.2
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    • pp.106-111
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    • 2020
  • Background: Fever is a common cause of pediatric consultation in the emergency department. However, identifying the source of infection in many febrile infants is challenging because of insufficient presentation of signs and symptoms. Meningitis is a critical cause of fever in infants, and its diagnosis is confirmed invasively by lumbar puncture. This study aimed to evaluate potential laboratory markers for meningitis in febrile infants. Methods: We retrospectively analyzed infants aged <3 months who visited the emergency department of our hospital between May 2012 and May 2017 because of fever of unknown etiology. Clinical information and laboratory data were evaluated. Receiver operating characteristic (ROC) curves were constructed. Results: In total, 145 febrile infants aged <3 months who underwent lumbar punctures were evaluated retrospectively. The mean C-reactive protein (CRP) level was significantly higher in the meningitis group than in the non-meningitis group, whereas the mean white blood cell count or absolute neutrophil count (ANC) did not significantly differ between groups. The area under the ROC curve (AUC) for CRP was 0.779 (95% confidence interval [CI], 0.701-0.858). The AUC for the leukocyte count was 0.455 (95% CI, 0.360-0.550) and that for ANC was 0.453 (95% CI, 0.359-0.547). The CRP cut-off value of 10 mg/L was optimal for identifying possible meningitis. Conclusion: CRP has an intrinsic predictive value for meningitis in febrile infants aged <3 months. Despite its invasiveness, a lumbar puncture may be recommended to diagnose meningitis in young, febrile infants with a CRP level >10 mg/L.

Contributory Role of BLT2 in the Production of Proinflammatory Cytokines in Cecal Ligation and Puncture-Induced Sepsis

  • Park, Donghwan;Ro, MyungJa;Lee, A-Jin;Kwak, Dong-Wook;Chung, Yunro;Kim, Jae-Hong
    • Molecules and Cells
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    • v.44 no.12
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    • pp.893-899
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    • 2021
  • BLT2 is a low-affinity receptor for leukotriene B4, a potent lipid mediator of inflammation generated from arachidonic acid via the 5-lipoxygenase pathway. The aim of this study was to investigate whether BLT2 plays any role in sepsis, a systemic inflammatory response syndrome caused by infection. A murine model of cecal ligation and puncture (CLP)-induced sepsis was used to evaluate the role of BLT2 in septic inflammation. In the present study, we observed that the levels of ligands for BLT2 (LTB4 [leukotriene B4] and 12(S)-HETE [12(S)-hydroxyeicosatetraenoic acid]) were significantly increased in the peritoneal lavage fluid and serum from mice with CLP-induced sepsis. We also observed that the levels of BLT2 as well as 5-lipoxygenase (5-LO) and 12-LO, which are synthesizing enzymes for LTB4 and 12(S)-HETE, were significantly increased in lung and liver tissues in the CLP mouse model. Blockade of BLT2 markedly suppressed the production of sepsis-associated cytokines (IL-6 [interleukin-6], TNF-α [tumor necrosis factor alpha], and IL-1β [interleukin-β] as well as IL-17 [interleukin-17]) and alleviated lung inflammation in the CLP group. Taken together, our results suggest that BLT2 cascade contributes to lung inflammation in CLP-induced sepsis by mediating the production of inflammatory cytokines. These findings suggest that BLT2 may be a potential therapeutic target for sepsis patients.

Successful Carapace Puncture Wound Repair with Polymethyl Methacrylate (PMMA) in an Amur Softshell Turtle (Pelodiscus maackii)

  • Ha, Minjong;Lee, Do Na;Ahmed, Sohail;Han, Janghee;Yeon, Seong-Chan
    • Journal of Veterinary Clinics
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    • v.39 no.4
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    • pp.185-191
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    • 2022
  • An Amur softshell turtle with multiple shell injuries was admitted to the Seoul Wildlife Center on 19 May 2021. The most severe lesion was a puncture wound requiring urgent closure. In addition to routine supportive therapy, the damaged shell was patched with biocompatible polymethyl methacrylate (PMMA) materials (bone cement and dental acrylic) and fiberglass. Despite a few methods to repair the carapace or plastron of hard-shelled turtles, shell repair in the Amur softshell turtle has rarely been reported. This paper reports the repair process of a puncture wound in the carapace of a softshell turtle using polymethyl methacrylate (PMMA). PMMA is a biocompatible acrylic polymer that forms a tight structure that holds the implant against tissue defects, such as skin, bones, and dentures. Fiberglass, a preferred fiber in various medical fields, was used with PMMA to provide extra strength and waterproof capability. After the procedure, there were no signs of edema, inflammation, bleeding, skin discoloration, or any other complications. Accordingly, this can be a method of choice in softshell turtles using biocompatible materials to cover the lesion in the carapace and provide appropriate wound management, supportive therapy, and a suitable course of antibiotics considering all other circumstances.

Transvaginal Direct Puncture and Ethanol Sclerotherapy for Cervicovaginal Venous Malformations: A Case Report and Literature Review (자궁경부 및 질에 발생한 정맥기형에 대한 질 경유 직접 천자 및 에탄올 경화요법: 증례 보고 및 문헌 고찰)

  • Gu Seong Jeong;Suk Hyun Bae;Young Soo Do;Hyoung Nam Lee;Sang Joon Lee
    • Journal of the Korean Society of Radiology
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    • v.82 no.3
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    • pp.688-692
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    • 2021
  • Cervicovaginal venous malformations are extremely rare. Sclerotherapy is proven to be effective for superficial venous malformations but not for venous malformations in the lower genital tract of female. A 52-year-old female presented with intermittent vaginal bleeding. The amount of vaginal bleeding gradually increased over 3 months. Contrast-enhanced pelvis CT showed several phleboliths and dilated vessels, but pelvic angiography showed no early draining veins, nidus, or feeding artery. We performed transvaginal direct puncture and ethanol sclerotherapy rather than surgical treatment because she wanted to preserve the uterus. After four sessions of sclerotherapy, she had significantly decreased vaginal bleeding without complications. Here, we report the first case of cervicovaginal venous malformations successfully treated with transvaginal direct puncture and ethanol sclerotherapy.

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

  • Kim, Myeong Soo;Kim, Gi Sung
    • Journal of Korean Neurosurgical Society
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    • v.63 no.2
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    • pp.188-201
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    • 2020
  • 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 noncontrast 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; <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.

SANDWICH-TYPE THEOREMS FOR A CLASS OF INTEGRAL OPERATORS ASSOCIATED WITH MEROMORPHIC FUNCTIONS

  • Cho, Nak-Eun
    • East Asian mathematical journal
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    • v.28 no.3
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    • pp.321-332
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    • 2012
  • The purpose of the present paper is to investigate some subordination and superordination preserving properties of certain integral operators de ned on the space of meromorphic functions in the puncture open unit disk. The sandwich-type theorems for these integral operators are also presented.

Clinical Application of Ultrasound-Guided Thyroid Fine Needle Aspiration Biopsy and Thinprep Cytology Test in Diagnosis of Thyroid Disease

  • Wei, Ying;Lu, Yao;Li, Chenxi
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.10
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    • pp.4689-4692
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    • 2016
  • Purpose: To study the clinical application value of ultrasound guided thyroid fine needle aspiration biopsy and thinprep cytology testing in diagnosis of thyroid disease. Methods: A total of 78 patients with thyroid nodules were enrolled, 34 males and 44 females, aged 33-64 years old with mean age of 47.6 years. All underwent thyroid module fine needle puncture after surgery to assess cell pathology and histopathological features. Results: Sufficient specimens were obtained from all of 78 patients, the cytological results of 73 cases (93.6 %) being consistent with pathological results. While 20 cases (25.6 %) were malignant tumors, 44 (56.4 %) were benign and 9 (11.5 %) were non-tumor lesions. The sensitivity of benign and malignant thyroid nodule by thyroid fine needle puncture was 90.9 %, specificity was 98.1 % and the positive predictive value was 96.3 %. Conclusions: It is demonstrated that ultrasound-guided thyroid fine needle aspiration biopsy and thinprep cytology testing have diagnostic value in clinical application for thyroid disease,showing good diagnostic coincidence rates with histopathological examination. They can thus be regarded as safe and effective for preoperative diagnosis and providing an appropriate basis for selection of surgery.

Transcranial Direct Middle Meningeal Artery Puncture for the Onyx Embolization of Dural Arteriovenous Fistula Involving the Superior Sagittal Sinus

  • Oh, Jae-Sang;Yoon, Seok-Mann;Shim, Jai-Joon;Bae, Hack-Gun
    • Journal of Korean Neurosurgical Society
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    • v.57 no.1
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    • pp.54-57
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    • 2015
  • A 66-year-old woman presented with intermittent paraparesis and generalized tonic-clonic seizure. Cerebral angiography demonstrated dural arteriovenous fistula (AVF) involving superior sagittal sinus (SSS), which was associated with SSS occlusion on the posterior one third. The dural AVF was fed by bilateral middle meningeal arteries (MMAs), superficial temporal arteries (STAs) and occipital arteries with marked retrograde cortical venous reflux. Transfemoral arterial Onyx embolization was performed through right MMA and STA, but it was not successful, which resulted in partial obliteration of dural AVF because of tortuous MMA preventing the microcatheter from reaching the fistula closely enough. Second procedure was performed through left MMA accessed by direct MMA puncture following small decortications of cranium overlying the MMA using diamond drill one week later. Microcatheter could be located far distally to the fistula through 5 F sheath placed into the MMA and complete obliteration of dural AVF was achieved using 3.9 cc of Onyx.

Thoughts on the phrase "夫氣之在脈也" of Miraculous Pivot(靈樞)·Nine needles and Twelve sources(九鍼十二原) (≪영추(靈樞)·구침십이원(九鍼十二原)≫의 "부기지재맥야(夫氣之在脈也)"구절에 대한 소고(小考))

  • Jeong, Chang-Hyun
    • Journal of Korean Medical classics
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    • v.27 no.4
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    • pp.21-27
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    • 2014
  • Objectives : Among the translations of the verse "Sa-gi is on the upper side, Tak-gi is on the middle side, Cheong-gi is on the under side(邪氣在上, 濁氣在中, 淸氣在下)" in the texts of Miraculous Pivot(靈樞) Nine needles and Twelve sources(九鍼十二原), the meanings of 'Ham-maek(陷脈)' and 'Joong-maek(中脈)' have contradictory versions. Methods : This study will identify the actual meaning of this verse through analysis of the phrase "夫氣之在脈也", followed by examination of the relationship between the meaning of "three-stratum puncture(三刺)" in the chapters Miraculous Pivot Handling needle(官鍼), Miraculous Pivot Jong-si(終始) and the meaning of "刺有三變" of Miraculous Pivot Longevity and character(壽夭剛柔), after which its application in later periods will be discussed. Results : The words 'Sa-gi', 'Tak-gi' and 'Cheong-gi' in the phrase "夫氣之在脈也" of Miraculous Pivot Nine needles and Twelve sources each correspond to the words 'yang pathogens(陽邪)', 'yin pathogens(陰邪)' and 'essence derived from food(穀氣)' of Miraculous Pivot 終始, respectively. Conclusions : The Upper-Middle-Lower of the phrase "夫氣之在脈也" in Nine needles and Twelve sources indicates the three levels of depth, in which 'Sa-gi', 'Tak-gi' and 'Cheong-gi' each dwell. 'Ham-maek' and 'Joong-maek' are categorizations according to the depth of needling.