• Title/Summary/Keyword: Intravascular

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Effects of Fasting versus Non-Fasting on Emetic Complications in Radiological Examinations Using Intravascular Non-Ionic Iodinated Contrast Media: A Systematic Review and Meta-Analysis

  • Hyewon Choi;Hyunsook Hong;Min Jae Cha;Soon Ho Yoon
    • Korean Journal of Radiology
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    • v.24 no.10
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    • pp.996-1005
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    • 2023
  • Objective: To compare the incidence of aspiration pneumonia, nausea, and vomiting after intravascular administration of nonionic iodinated contrast media (ICM) between patients who fasted before contrast injection and those who did not. Materials and Methods: Ovid-MEDLINE and Embase databases were searched from their inception dates until September 2022 to identify original articles that met the following criteria: 1) randomized controlled trials or observational studies, 2) separate reports of the incidence of aspiration pneumonia, nausea, and vomiting after intravascular injection of non-ionic ICM, and 3) inclusion of patients undergoing radiological examinations without fasting. A bivariate beta-binomial model was used to compare the risk difference in adverse events between fasting and non-fasting groups. The I2 statistic was used to assess heterogeneity across the studies. Results: Ten studies, encompassing 308013 patients (non-fasting, 158442), were included in this meta-analysis. No cases of aspiration pneumonia were reported. The pooled incidence of nausea was 4.6% (95% confidence interval [CI]: 1.4%, 7.8%) in the fasting group and 4.6% (95% CI: 1.1%, 8.1%) in the non-fasting group. The pooled incidence of vomiting was 2.1% (95% CI: 0.0%, 4.2%) in the fasting group and 2.5% (95% CI: 0.7%, 4.2%) in the non-fasting group. The risk difference (incidence in the non-fasting group-incidence in the fasting group) in the incidence of nausea and vomiting was 0.0% (95% CI: -4.7%, 4.7%) and 0.4% (95% CI: -2.3%, 3.1%), respectively. Heterogeneity between the studies was low (I2 = 0%-13.5%). Conclusion: Lack of fasting before intravascular administration of non-ionic ICM for radiological examinations did not increase the risk of emetic complications significantly. This finding suggests that hospitals can relax fasting policies without compromising patient safety.

Alveolar rhabdomyosarcoma with massive disseminated intravascular coagulopathy treated with systemic chemotherapy

  • Yoon, Byung Gyu;Baek, Hee Jo;Oh, Burm Seok;Han, Dong Kyun;Choi, Yoo Duk;Kook, Hoon
    • Clinical and Experimental Pediatrics
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    • v.58 no.12
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    • pp.505-508
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    • 2015
  • It is uncommon for pediatric patients with rhabdomyosarcoma to present with clinical and/or laboratory features of disseminated intravascular coagulation (DIC). We report a case of metastatic alveolar rhabdomyosarcoma with severe bleeding because of DIC in a 13-year-old boy. He experienced persistent oozing at the site of a previous operation, gross hematuria, and massive epistaxis. Two weeks after initiating combination chemotherapy consisting of vincristine, doxorubicin, and cyclophosphamide, the patients' laboratory indications of DIC began to resolve. During this period, the patient received massive blood transfusion of a total of 311 units (26 units of red blood cells, 26 units of fresh frozen plasma, 74 units of platelet concentrates, 17 units of single donor platelets, and 168 units of cryoprecipitate), antithrombin-III and a synthetic protease inhibitor. Despite chemotherapy and radiation therapy, he died 1 year later because of disease progression. In children with metastatic rhabdomyosarcoma and massive DIC, prompt chemotherapy and aggressive supportive care is important to decrease malignancy-triggered procoagulant activities.

Intravascular Papillary Endothelial Hyperplasia (Masson tumor) of the Skull : Case Report and Literature Review

  • Park, Keuk-Kyu;Won, Yu-Sam;Yang, Jae-Young;Choi, Chun-Sik;Han, Ki-Young
    • Journal of Korean Neurosurgical Society
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    • v.52 no.1
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    • pp.52-54
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    • 2012
  • A 10-year-old female patient presented with a rapidly growing nodular mass lesion on her right frontal area. On skull radiography and computed tomography (CT) imaging, this mass had a well-demarcated punch-out lesion with a transdiploic, exophytic soft tissue mass nodule on the frontal scalp. Magnetic resonance (MR) imaging revealed the presence of a $1.5{\times}1.2{\times}1$ cm sized calvarial lesion. This lesion was hypointense on T1 and heterogenous hyperintense on T2 weighted MR images, and exhibited heterogeneous enhancement of the soft tissue filling the punch-out lesion after intravenous administration of gadolinium. En block removal of the tumor with resection of the rim of the normal bone was performed. The pathological diagnosis was intravascular papillary endothelial hyperplasia (IPEH). After surgery, no recurrence was found for 8 months. IPEH is a rare and benign reactive lesion usually found in thrombosed subcutaneous blood vessels. Involvement of skull bone is rare. In this article, we present a case of IPEH involving the calvarium, in a 10-year-old woman.

A Case of Subarachnoid Hemorrhage with Disseminated Intravascular Coagulation in a Maltese Dog (말티즈견에서 발생한 파종성혈관내응고를 동반한 거미막하 출혈 증례)

  • Jung, Hae-Won;Lee, Hee-Chun;Moon, Jong-Hyun;Jung, Dong-In
    • Journal of Veterinary Clinics
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    • v.31 no.4
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    • pp.337-340
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    • 2014
  • An 11-year-old male Maltese dog was presented with sudden onset of convulsion and right sided circling. On neurological examination, left side proprioception and menace reflexes were delayed. Blood examinations indicated severe thrombocytopenia and increased hepatic enzymes. On brain magnetic resonance imaging, lesions were founded on the left lateral subarachnoid space area. Those lesions showed hyperintense on T1-weighted images, hyperintense on T2-weighted images and hyperintense on fluid attenuated inversion recovery images. Cerebrospinal fluid analysis revealed xanthochromia and erythrophagocytosis. Coagulation test results demonstrated that fibrin degradation product and D-dimer concentrations were higher than normal range. The patient expired few hours after presentation. This case report demonstrates intracranial hemorrhage with disseminated intravascular coagulation in a dog.

Comparison of Intravascular Bonghan Ducts from Rats and Mice

  • Lee Byung-Cheon;Baik Ku-Youn;Cho Sung-Il;Min Chul-Hee;Johng Hyeon-Min;Hahm Jung-Hyun;Choi Chun-Ho;Yi Seung-Ho;Soh Kyung-Sun;Park Dae-Hun;Ahn Se-Young;Cheun Byeung-Soo;Soh Kwang-Sup
    • Journal of Society of Preventive Korean Medicine
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    • v.7 no.1
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    • pp.47-53
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    • 2003
  • New method to obtain Intravascular Bonghan ducts of rats and mice were developed By extracting blood from caudal veins and arteries that were hold by forceps we took broken pieces of BHDs which were examined using microscopes. The advantage of this method is to gain the pure BHD without fibrin, and its disadvantage is the smallness of the sample.

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A Case of Acrodermatitis Enteropathica with Chronic Diarrhea and Disseminated Intravascular Coagulation (만성 설사와 범발성 혈관내 응고 증후군을 초래한 장병성 선단 피부염 1례)

  • Lee, Ji-Eun;Huh, Jun-Ho;Choe, Byung-Ho
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.2 no.2
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    • pp.240-244
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    • 1999
  • Acrodermatitis enteropathica, an autosomal recessive disease, usually presents with severe acral and circumorificial dermatitis, diarrhea, alopecia, intercurrent bacterial infection during early infancy, and is eventually fatal if left untreated. We report a case of acrodermatitis enteropathica in a 2-month-old male infant who presented with chronic diarrhea not responsive to conventional therapy and developed disseminated intravascular coagulation (DIC). He showed the characteristic eczematoid skin lesions, chronic diarrhea, failure to thrive, and low serum zinc concenturation. $Zn^{2+}$ was administered with dramatic improvement of skin lesions, DIC and diarrhea. He rapidly catched up normal growth and development on continuing zinc supplementation.

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A Case of Gastric Cancer Presenting Acute Disseminated Intravascular Coagulation Palliated with Combination Chemotherapy of Irinotecan and Cisplatin (위암과 동반된 급성 파종성 혈관 내 응고증에 대하여 Irinotecan, Cisplatin 복합화학요법으로 완화요법을 시행한 1예)

  • Lee, Sang-Hoon;Woo, In-Sook;Kim, Seon-Young;Song, Myung-Jun;Rho, Sang-Young;Koh, Su-Jin;Lee, Myung-Ah;Kang, Jin-Hyoung;Hong, Young-Seon;Choi, Myung-Gyu;Lee, Kyng-Shik
    • Journal of Gastric Cancer
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    • v.6 no.3
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    • pp.189-192
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    • 2006
  • Acute disseminated intravascular coagulation (DIC) associated with gastric cancer is not common and has short survival of 1 to 3 weeks. Systemic chemotherapy in spite of hematologic unstability for gastric cancer may prolong survival time. A 47-year-old woman who complained of dyspnea, vaginal bleeding and easy bruisibility was diagnosed to stage IV gastric cancer with acute disseminated intravascular coagulation based on the laboratory data. She also had multiple bone metastases and bone marrow involvement. This is the first case treated with combination chemotherapy of irinotecan and cisplatin for advanced gastric cancer complicated by disseminated intravascular coagulation at the time of diagnosis, With systemic chemotherapy, some of the bleeding symptoms and the DIC process improved, even not completely recovered. However the patient died of disease progression and survival time was 12 weeks.

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Conceptual Source Design and Dosimetric Feasibility Study for Intravascular Treatment: A Proposal for Intensity Modulated Brachytherapy (혈관내 방사선치료를 위한 이론적 선원 설계 및 선량적 관점에서의 적합성 연구: 출력변조를 이용한 근접치료에 대한 제안)

  • Kim Siyong;Han Eunyoung;Palta Jatinder R.;Ha Sung W.
    • Radiation Oncology Journal
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    • v.21 no.2
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    • pp.158-166
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    • 2003
  • Purpose: To propose a conceptual design of a novel source for intensity modulated brachytherapy. Materials and Methods: The source design incorporates both radioactive and shielding materials (stainless steel or tungsten), to provide an asymmetric dose intensity in the azimuthal direction. The intensity modulated intravascular brachytherapy was performed by combining a series of dwell positions and times, distributed along the azimuthal coordinates. Two simple designs for the beta-emitting sources, with similar physical dimensions to a $^{90}Sr/Y$ Novoste Beat-Cath source, were considered in the dosimetric feasibility study. In the first design, the radioactive and materials each occupy half of the cylinder and in the second, the radioactive material occupies only a quater of the cylinder. The radial and azimuthal dose distributions around each source were calculated using the MCNP Monte Carlo code. Results: The preliminary hypothetical simulation and optimization results demonstrated the 87$\%$ difference between the maximum and minimum doses to the lumen wall, due to off-centering of the radiation source, could be reduced to less than 7$\%$ by optimizing the azimuthal dwell positions and times of the partially shielded intravascular brachytherapy sources. Conclusion: The novel brachytherapy source design, and conceptual source delivery system, proposed in this study show promising dosimetric characteristics for the realization of intensity modulated brachytherapy in intravascular treatment. Further development of this concept will center on building a delivery system that can precisely control the angular motion of a radiation source in a small-diameter catheter.

A Case of Pulmonary Intravascular Lymphomatosis (폐를 침범한 혈관내 림프종증 1예)

  • Park, Sang-Jong;Bae, Sang-Su;Cheon, Eun-Mi;Kwon, O-Jung;Rhee, Chong-H.;Han, Yong-Chol;Kim, Jin-Guk;Lee, Kyung-Soo;Ko, Young-Hye
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.6
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    • pp.1390-1395
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    • 1997
  • Intravascular lymphomatosis(IVL) which was first described by pfleger and Tappeiner in 1959 is rare malignancy characterized by neoplastic proliferation of lymphoid cell lineage within the vascular lumen with little or no adjacent parenchymal involvement Its usual sites of involvement are central nervous system and skin or infrequently heart, lungs, pancreas, liver, spleen, kidney, adrenal glands, genitourinary tract, and bone marrow. Pulmonary involvement of IVL is not common. Symptoms of pulmonary involvement include dyspnea, cough and fever. Radiologicially, the disease is manifested with diffuse interstitial infiltrates. We report a recently experienced case of pulmonary intravascular lymphomatosis which was manifested with fever and chest pain.

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