• Title/Summary/Keyword: Aspiration technique

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Effectiveness of Anchoring with Balloon Guide Catheter and Stent Retriever in Difficult Mechanical Thrombectomy for Large Vessel Occlusion

  • Yi, Ho Jun;Kim, Bum-Tae;Shin, Dong-Sung
    • Journal of Korean Neurosurgical Society
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    • v.65 no.4
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    • pp.514-522
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    • 2022
  • Objective : A distal navigation of a large bore aspiration catheter during mechanical thrombectomy (MT) is important. However, delivering a large bore aspiration catheter is difficult to a tortuous or atherosclerotic artery. We report the experience of anchoring with balloon guide catheter (BGC) and stent retriever to facilitate the passage of an aspiration catheter in MT. Methods : When navigating an aspiration catheter failed with a conventional co-axial microcatheter delivery, an anchoring technique was used. Two types of anchoring technique were applied to facilitate distal navigation of a large bore aspiration catheter during MT. First, a passage of aspiration catheter was attempted with a proximal BGC anchoring technique. If this technique also failed, another anchoring technique with distal stent retriever was tried. Consecutive patients who underwent MT with an anchoring technique were identified. Details of procedure, radiologic outcomes, and safety variables were evaluated. Results : A total of 67 patients underwent MT with an anchoring technique. Initial trial of aspiration catheter passage with proximal BGC anchoring technique was successful for 35 patients (52.2%) and the second trial with distal stent retriever anchoring was successful for 32 patients (47.8%). Overall, navigation of a large bore aspiration catheter was successful for all patients (100%) without any procedure related complications. Conclusion : Our study showed the usefulness of anchoring technique with proximal BGC and distal stent retriever during MT, especially in those with an unfavorable anatomical structure. This technique could be an alternative option for delivering an of aspiration catheter to a distal location.

Transtracheal aspiration technique in diagnosis of lower respiratory tract disease in the cow (Transtracheal aspiration technique에 의한 소의 하부호흡기계 질병진단)

  • Oh, Tae-ho;Han, Hong-ryul
    • Korean Journal of Veterinary Research
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    • v.29 no.4
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    • pp.577-587
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    • 1989
  • 소의 하부호흡기계 질병을 진단하고자 기침과 비루를 주증상으로 하는 31두의 환우와 임상증상을 나타내지 않는 9두의 소에 5 fr. urinary catheter를 이용한 transtracheal aspiration technique를 적용하고 이 방법의 유용성 및 분리된 병원성 세균과 세포상을 임상증상과 관련하여 조사하여 다음과 같은 결과를 얻었다. Transtracheal aspiration technique은 구강내 정상상재균에 오염되지 않은 가검물을 하부호흡기로부터 채취하는데 호흡장애와 합병증을 유발하지 않았다. 총 40두로부터 분리한 세균중 Pasteurella multocida가 48.7%로 가장 많이 분리되었으며 점액 화농성 염증이 40%로 가장 많이 나타났다. 심한 임상증상을 보인 소중 점액화농성 염증이 60%로 가장 많이 나타났으며 Pasteurella multocida가 63.2%로 높게 분리되었다. 경미한 임상증상을 보인 소에서는 염증세포에 따른 세포상이 고루 나타났으며 Pasteurella multocida가 40% 분리되었다. 세포학적 관찰에서는 정상인 경우는 섬모원주상피세포가 다수 관찰되었고 점액성 염증인 경우는 소수의 호중구 및 상피세포가 관찰되었으며 점액화농성 염증인 경우는 다수의 밀집된 호중구, 상피세포 및 점조한 삼출물이 동시에 관찰되었다. 복합세포성 염증에서는 대식구, 호중구, 임파구 및 상피 세포가 혼재하였다. 이상의 결과로부터 transtracheal aspiration technique은 소의 하부호흡기계 질병을 진단하는데 실제 임상에서 응용할 수 있는 쉽고 안전하며 유익한 방법으로 사료된다.

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Surgical Resuscitation of a Patient with Cerebral Herniation Secondary to Massive Hemorrhage in the Basal Ganglia: Ultrasound-monitored Aspiration

  • Jung, Youn-Ho;Park, Jae-Chan;Hamm, In-Suk
    • Journal of Korean Neurosurgical Society
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    • v.37 no.4
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    • pp.300-302
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    • 2005
  • The authors report a case of hyperacute, massive hemorrhage in the left basal ganglia with severe midline shift that was treated successfully by the ultrasound-monitored free hand aspiration technique. Every effort was made to shorten time until removal of considerable amount of the hematoma and minimize duration of cerebral herniation, avoiding additional irreversible neurological deficit. A burr hole aspiration technique was preferred to standard craniotomy procedure, and any time-consuming procedures such as stereotactic frame application were abandoned. A burr hole was localized on the basis of computed tomography images simply and quickly with a ruler, and safety of the aspiration procedure was augmented by real-time ultrasound monitoring. Such minimally invasive technique relieved cerebral herniation successfully while avoiding time consumption and the morbidity of major craniotomy procedure. Early resuscitation of the patient with cerebral herniation in this case resulted in excellent recovery of the patient's neurological deficit. The patient's mentality started to improve rapidly and was clear six months after the surgery.

A Case of Hepatoma with Duodenal Metastasis Proved by Liver Aspiration Cytology and Gastrofiberscopic Duodenal Biopsy (십이지장 궤양으로 발현된 전이성 간세포암종 1예)

  • Kim, Sung-Jin;Park, Seok-Gun;Han, Dong-Sun;Kim, Sung-Sook
    • The Korean Journal of Cytopathology
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    • v.2 no.2
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    • pp.105-110
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    • 1991
  • We report a case of hepatoma with duodenal metastasis in a 53 year-old male patient. Hepatoma was confirmed by fine needle aspiration cytology technique, and duodenal metastasis by gastrofiberscopic biopsy. Duodenal metastasis of hepatoma is rare. We briefly review the role of fine needle aspiration cytology technique in diagnosis of hepatoma.

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Identifying Frication and Aspiration Noise in the Frequency Domain: The Case of Korean AIveolar Lax Fricatives

  • Yoon, Kyu-Chul
    • Phonetics and Speech Sciences
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    • v.1 no.2
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    • pp.105-110
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    • 2009
  • This paper introduces the technique of semi-automatically identifying different types of noise in the frequency domain. Given the lower cutoff frequency of the frication noise, and a user-specified constant, the technique identifies the boundary between the frication and aspiration noise in a Korean lax fricative followed by the vowel /a/ by comparing the upper and lower sums of energy with respect to the cutoff frequency. The user-specified constant can be adjusted for different speakers. When the technique was applied to distinguish the two types of noise of Korean lax fricatives from the same speaker, the average and standard deviation of the difference between the manually inserted boundaries and the automatically inserted boundaries were 2.67ms and 1.80ms respectively.

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Modification of Oropharyngeal Aspiration Technique for Mouse Using Syringe Pump

  • Kim, Jin-Sung;Yang, Mi-Jin;Han, Sung-Gu;Kim, Choong-Yong;Han, Sang-Sup;Song, Chang-Woo
    • Toxicological Research
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    • v.23 no.3
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    • pp.239-244
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    • 2007
  • Respirable particles cause many occupational and environmental diseases of the lung. To study these diseases, laboratory animals are often exposed to these particles. Inhalation and instillation are the well-known techniques for experimental exposures of the lung to respirable particles. Recently, another technique called oropharyngeal aspiration (OPA) has been introduced for exposing the lung to pathogens and/or particles. The conventional OPA technique for the mouse is generally carried out using a micropipette with a fixed slant board. In order to modify the conventional OPA in this study, anesthetized mice were placed on an adjustable slant board, a syringe pump was used to deliver the solution to the oropharynx, and the mice were allowed to recover in vertically positioned tubes for 6 minutes until fully awaked. Most importantly, the whole process of OPA could be carried out simply by an examiner. This modified OPA technique was validated by exposing the mouse lung to Evans Blue dye with a success rate of 95%.

Critical Evaluation of Fine Needle Aspiration Cytology as a Diagnostic Technique in Bone Tumors and Tumor-like Lesions

  • Chakrabarti, Sudipta;Datta, Alok Sobhan;Hira, Michael
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.7
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    • pp.3031-3035
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    • 2012
  • Background: Though open surgical biopsy is the procedure of choice for the diagnosis of bone tumors, many disadvantages are associated with this approach. The present study was undertaken to evaluate the role of fine needle aspiration cytology (FNAC) as a diagnostic tool in cases of bony tumors and tumor-like lesions which may be conducted in centers where facilities for surgical biopsies are inadequate. Methods: The study population consisted of 51 cases presenting with a skeletal mass. After clinical evaluation, radiological correlation was done to assess the nature and extent of each lesion. Fine needle aspiration was performed aseptically and smears were prepared. Patients subsequently underwent open surgical biopsy and tissue samples were obtained for histopathological examination. Standard statistical methods were applied for analysis of data. Results: Adequate material was not obtained even after repeated aspiration in seven cases, six of which were benign. Among the remaining 44 cases, diagnosis of malignancy was correctly provided in 28 (93.3%) out of 30 cases and categorical diagnosis in 20 (66.67%). Interpretation of cytology was more difficult in cases of benign and tumor-like lesions, with a categorical opinion only possible in seven (50%) cases. Statistical analysis showed FNAC with malignant tumors to have high sensitivity (93.3%), specificity (92.9%) and positive predictive value of 96.6%, whereas the negative predictive value was 86.7%. Conclusion: FNAC should be included in the diagnostic workup of a skeletal tumor because of its simplicity and reliability. However, a definitive pathologic diagnosis heavily depends on compatible clinical and radiologic features which can only be accomplished by teamwork. The cytological technique applied in this study could detect many bone tumors and tumor-like conditions and appears particularly suitable as a diagnostic technique for rural regions of India as other developing countries.

Ultrasound-guided Aspiration of the Iatrogenic Pneumothorax Caused by Paravertebral Block -A Case Report-

  • Park, Jin-Suk;Kim, Young-Hoon;Jeong, Su-Ah;Moon, Dong-Eon
    • The Korean Journal of Pain
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    • v.25 no.1
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    • pp.33-37
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    • 2012
  • Thoracic paravertebral block is performed for the treatment of patients with chronic pain, such as complex regional pain syndrome (CRPS) and post-herpetic neuralgia. Thoracic paravertebral block can result in iatrogenic pneumothorax. Because pneumothorax can develop into medical emergencies and needle aspiration or chest tube placement may be needed, early diagnosis is very important. Recently, thoracic ultrasonography has begun to be used to diagnose pneumothorax. In addition, ultrasound-guided aspiration can be an accurate and safe technique for treatment of pneumothorax, as the needle position can be followed in real time. We report a case of iatrogenic pneumothorax following thoracic paravertebral block for the treatment of chronic pain due to CRPS, treated successfully by ultrasound-guided aspiration.

Endovascular Stroke Therapy Focused on Stent Retriever Thrombectomy and Direct Clot Aspiration : Historical Review and Modern Application

  • Kang, Dong-Hun;Park, Jaechan
    • Journal of Korean Neurosurgical Society
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    • v.60 no.3
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    • pp.335-347
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    • 2017
  • Intravenous recombinant tissue plasminogen activator had been the only approved treatment for acute ischemic stroke since its approval in 1995. However, the restrictive time window, numerous contraindications, and its low recanalization rate were all limitations of this modality. Under those circumstances, endovascular stroke therapy went through a great evolution during the past two decades of intravenous thrombolysis. The results of the 2013 randomized trials for endovascular stroke therapy were neutral, although they were limited by insufficient imaging screening at enrollment, early-generation devices with less efficacy, and treatment delays. Huge progress was made in 2015, as there were five randomized clinical trials which all demonstrated the safety and efficacy of endovascular stroke treatment. Despite differences in detail patient enrollment criteria, all 5 trials employed key factors for good functional recovery; (1) screening with non-invasive imaging to identify the proximal occlusion and exclude a large infarct core, (2) using highly effective modern thrombectomy devices mainly with stent retriever, and (3) establishment of a fast workflow to achieve effective reperfusion. The results of those trials indicate that modern thrombectomy devices can allow for faster and more effective reperfusion, which can lead to improved clinical outcomes compared to intravenous thrombolysis alone. These advances in mechanical thrombectomy are promising in the global fight against ischemic stroke-related disability and mortality. Two current mainstreams among such mechanical thrombectomy techniques, "stent retriever thrombectomy" and "direct clot aspiration", are the topic of this review. Stent retriever thrombectomy using Solitaire and Trevo retriever will be firstly discussed. And, the commonalities and the differences between two major clot aspiration thrombectomy techniques; a direct aspiration first pass technique (ADAPT) and forced arterial suction thrombectomy (FAST), will be additionally explained. Finally, details regarding the combination of direct clot aspiration and stent retriever thrombectomy, the switching strategy and the Solumbra technique, will be described.

The Effect of Indwelling Silk Suture Following Aspiration in the Treatment of Chronic Lateral Malleolar Bursitis (흡입 후 견 봉합사 거치를 통한 만성 족관절 외과 점액낭염의 치료)

  • Lee, Bong-Jin;Lee, Sung-Rak;Kim, Seong-Tae
    • Journal of Korean Foot and Ankle Society
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    • v.9 no.1
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    • pp.38-41
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    • 2005
  • Purpose: To evaluate the drainage effect of silk suture following aspiration of the bursa as an early treatment of chronic lateral malleolar bursitis. Materials and Methods: Thirteen cases, which have over two weeks of history and over one year of follow-up, were investigated. The average duration of follow-up was 16.4 months. The average symptom duration before introduction into this study was 7.8 weeks. With an aseptic technique, the aspiration of the bursa was done with 18G needle and syringe and then the insertion of silk suture through the aspiration needle was performed. The amount of drainage was identified two or three times in a week and stitch out was done at the cessation of drainage. Over one year follow-up, recurrence, infection, pain, and limitation of range of motion were investigated by telephone interview. Results: Redness around the insertion site of silk suture was found in all cases, but there was no development of active infection or recurrence. The average duration of treatment is 10.4 days. Conclusion: The drainage with silk suture following aspiration of the bursa is less invasive and very effective method in the early treatment of chronic lateral malleolar bursitis.

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