Manual aspiration thrombectomy through proximal and distal supporting technique for the treatment of procedural distal A2 emboli: A technical case report

Disrupted clots that form during endovascular treatment for acute ischemic stroke can cause distal embolization. It is not easy to recanalize occluded vessels resulting from distal emboli. In particular, endovascular treatment of distal A2 emboli is very challenging because it is difficult to access such a distal location and maintain microcatheter stability throughout the procedure. We report a case of successful recanalization of A2 occlusion caused by procedural-induced distal emboli through a proximal and distal supporting technique

Strong Contrast Stagnation of Unilateral Vertebral Artery on Three-Dimensional Black Blood-Enhanced MRI Predicts Acute Medulla Infarction

Purpose This study aimed to evaluate angiographic and contrast enhancement (CE) patterns on three-dimensional (3D) black blood (BB) contrast-enhanced MRI in patients with acute medulla infarction. Materials and Methods From January 2020 to August 2021, we retrospectively analyzed stroke 3D BB contrast-enhanced magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) findings of patients visiting the emergency room for symptom evaluation of acute medulla infarction. In total, 28 patients with acute medulla infarction were enrolled in this study. Four types of 3D BB contrast-enhanced MRI and MRA were classified as follows: 1=unilateral contrast-enhanced vertebral artery (VA)+no visualization of VA on MRA; 2=unilateral enhanced VA+hypoplastic VA; 3=no enhanced VA+unilateral complete occlusion of VA; 4=no enhanced VA+normal VA (including hypoplasia) on MRA. Results Of the 28 patients with acute medulla infarction, 7 (25.0%) showed delayed positive findings after 24 hours on diffusion-weighted imaging (DWI). Of these patients, 19 (67.9%) showed CE of the unilateral VA on 3D BB contrast-enhanced MRI (type 1 and 2). Of the 19 patients with CE of VA on 3D BB contrast-enhanced MRI, 18 showed no visualization of enhanced VA on MRA (type 1), and 1 showed hypoplastic VA. Of the 7 patients with delayed positive findings on DWI, 5 showed CE of the unilateral VA and no visualization of the enhanced VA on MRA (type 1). Symptom onset to door time or initial MR check time was significantly shorter in the groups with delayed positive findings on DWI (P<0.05). Conclusion Unilateral CE on 3D BB contrast-enhanced MRI and no visualization of the VA on MRA are related to the recent occlusion of the distal VA. These findings suggest that the recent occlusion of the distal VA is related to acute medulla infarction, including delayed visualization on DWI

Acute Calcific Periarthritis of Proximal Interphalangeal Joint in a Professional Golfer's Hand

This report describes a 22-yr-old professional golfer with acute calcific periarthritis of the proximal interphalangeal joint of the 4th finger. We considered that the major cause for this condition may be the repeated minor traumas to the affected site. Also, since this condition is self-limiting, a correct diagnosis is required to avoid unnecessary tests and surgery

Comparative Genomic Analysis of the 2016 Vibrio cholerae Outbreak in South Korea

In August 2016, South Korea experienced a cholera outbreak that caused acute watery diarrhea in three patients. This outbreak was the first time in 15 years that an outbreak was not linked to an overseas source. To identify the cause and to study the epidemiological implications of this outbreak, we sequenced the whole genome of Vibrio cholerae isolates; three from each patient and one from a seawater sample. Herein we present comparative genomic data which reveals that the genome sequences of these four isolates are very similar. Interestingly, these isolates form a monophyletic Glade with V. cholerae strains that caused an outbreak in the Philippines in 2011. The V. cholerae strains responsible for the Korean and Philippines outbreaks have almost identical genomes in which two unique genomic islands are shared, and they both lack SXT elements. Furthermore, we confirm that seawater is the likely source of this outbreak, which suggests the necessity for future routine surveillance of South Korea's seashore.

Seasonal Sea Surface Temperature Asymmetry in the Northwestern Pacific Marginal Seas

Sea surface temperature (SST) is an important component of climate and weather systems at various time scales. Asymmetric seasonal SST variations in the Northwestern Pacific Marginal Seas (NWPMS) are investigated in this study using observation data and numerical model results. The asymmetry in SST seasonal variation is estimated quantitatively and compared with heat advection and surface net heat flux using SST data and atmospheric variables from the European Centre for Medium-Range Weather Forecast (ECMWF). The SST increases faster than it decreases, whereas air temperature increases slowly. Heat advection and surface heat flux were estimated using numerically modeled SST and ocean currents, which contribute to the asymmetry of seasonal SST variations. Heat advection shows good correlation with the SST seasonal variation asymmetry. Model results without currents along the boundary show more symmetrical SST variations. This suggests that heat advection is a prominent cause of asymmetry in the seasonal variation

Long-term Follow-up of Extensive Peri-anchor (Poly-L/D-lactic Acid) Cyst Formation after Arthroscopic Rotator Cuff Repair: A Case Report

Suture anchors are commonly used in shoulder surgeries, especially for rotator cuff tears. Peri-anchor cyst formation, however, is sometimes detected on follow-up radiologic image after surgery. The purpose of this report is to discuss the case of a patient who presented with regression of extensive peri-anchor cyst on postoperative 4-year follow-up magnetic resonance imaging and had good clinical outcome despite peri-anchor cyst formation after arthroscopic rotator cuff repair