An 84-Year-Old Man with a History of Myeloma and Biphosphonate-Related Osteonecrosis of the Jaw Treated with Preoperative Vascular Embolization Before Partial Maxillectomy.

BACKGROUND Bisphosphonates and anti-receptor activator of nuclear factor kappa B antibodies are used to treat bone diseases associated with increased osteoclast activity, including myeloma. However, they can cause osteonecrosis of the jaw, known as medication-related osteonecrosis of the jaw. This report presents a case of a patient with a history of myeloma who required posterior maxilla resection for bisphosphonate-related osteonecrosis of the jaw, in which preoperative embolization prevented unexpected bleeding related to vascular injury and allowed for a safe procedure with minimal bleeding.

Preoperative endovascular arterial embolization to avoid maxillary artery injury in maxillary gingival cancer surgery.

For maxillary gingival carcinomas, especially those in the molar region, surgical resection is often performed beyond the maxillary tuberosity. Bleeding from the posterior superior alveolar or maxillary artery into the pterygoid process is difficult to stop during partial maxillary resection. Advances in catheterization and materials have enabled the embolization of various vessels.

Importance of Awareness and Careful Follow-Up of Suspected IgG4-Related Periaortitis.

IgG4-related disease may cause large vessel vasculitis, which often affects males in their 60s. Here, we report a case of suspected IgG4-related periaortitis in a 76-year-old man with lower left-side chest pain and hypertension based on computed tomography findings of thickened lesions surrounding the abdominal aorta and mesenteric arteries after ruling out acute cardiovascular diseases. His serum IgG4 levels were high, but the C-reactive protein and D-dimer levels were within normal limits.

Dual segmentation models for poorly and well-differentiated hepatocellular carcinoma using two-step transfer deep learning on dynamic contrast-enhanced CT images.

The aim of this study was to develop dual segmentation models for poorly and well-differentiated hepatocellular carcinoma (HCC), using two-step transfer learning (TSTL) based on dynamic contrast-enhanced (DCE) computed tomography (CT) images. From 2013 to 2019, DCE-CT images of 128 patients with 80 poorly differentiated and 48 well-differentiated HCCs were selected at our hospital. In the first transfer learning (TL) step, a pre-trained segmentation model with 192 CT images of lung cancer patients was retrained as a poorly differentiated HCC model.

Jejuno-jejunal intussusception caused by a percutaneous endoscopic gastrojejunostomy tube in a pediatric patient: A case report.

Rationale: Although percutaneous endoscopic gastrojejunostomy (PEG-J) tubes are believed to reduce the side effect of aspiration, cautious catheter management is required. Intussusception is a serious complication of these tubes.

Patient Concerns: A 7-year-old boy bedridden with hypoxic encephalopathy owing to drowning at the age of 1 year was admitted our hospital with urinary retention for 1 month.

CT-based mediastinal compartment classifications and differential diagnosis of mediastinal tumors.

Division of the mediastinum into compartments is used to help narrow down the differential diagnosis of mediastinal tumors, assess tumor growth, and plan biopsies and surgical procedures. There are several traditional mediastinal compartment classification systems based upon anatomical landmarks and lateral chest radiograph. Recently, the Japanese Association of Research of the Thymus (JART) and the International Thymic Malignancy Interest Group (ITMIG) proposed new mediastinal compartment classification systems based on transverse CT images.

Double cystic duct preoperatively diagnosed and successfully treated with laparoscopic cholecystectomy: A case report.

Introduction: A single gallbladder with a double cystic duct is a very rare finding. In addition, few cases with this rare condition are preoperatively diagnosed. However, the preoperative confirmation or suspicion of this rare condition could facilitate safe laparoscopic cholecystectomy, which is a minimally invasive therapeutic modality for gallbladder disease.

Open pelvic ring fracture and multiple fractures of the lower extremities: a case report.

A 73-year-old female was hit by a car, and transferred to our hospital. On examination, her consciousness was alert, but her vital signs were unstable. There are three 10-cm open wounds on her right buttock.

Retrospective analysis of contrast-enhanced computed tomographic findings related to obstructive shock due to ascending aortic dissection.

Objective: The objective of this study was to evaluate contrastenhanced computed tomography findings related to obstructive shock due to ascending aortic dissection (AAD).

Methods: The computed tomography findings in 9 AAD patients with shock, 11 AAD patients without shock, and 18 control subjects were evaluated for (1) pericardial effusion, (2) diameter of the inferior vena cava, (3) periportal hypodensity, (4) retrograde reflux of contrast material, (5) aortic and visceral enhancement, and (6) other factors (peripancreatic edema, bowel thickening/dilatation).

Results: Patients with shock showed the highest ratio of pericardial effusion, periportal hypodensity, and retrograde reflux of contrast material; largest inferior vena cava diameter; stronger aortic enhancement in both the arterial and portal phases; lowered splenic and pancreatic enhancement in the arterial phase; and stronger visceral (especially adrenal) enhancement, except for the renal medulla in the portal phase.

Operative strategy for descending and thoracoabdominal aneurysm repair with preoperative demonstration of the Adamkiewicz artery.

Background: Our study aimed to demonstrate the efficacy of preoperative intraarterial computed tomographic angiography to identify the Adamkiewicz artery (AKA). We also aimed to investigate the impact of identification of the AKA on the strategy for preventing spinal cord injury.

Methods: Thirty-seven patients (24 cases of descending aortic aneurysms and 13 cases of thoracoabdominal aortic aneurysms), were studied.

Endoscopic hemostasis for bleeding gastric varices treated by combination of variceal ligation and sclerotherapy with N-butyl-2-cyanoacrylate.

Background: Bleeding from esophagogastric varices is a serious complication of portal hypertension. The aim of the present study was to determine whether endoscopic sclerotherapy with injection of N-butyl-2-cyanoacrylate combined with variceal ligation was useful for hemostasis of bleeding gastric varices.

Methods: Twenty-seven patients with bleeding gastric varices underwent endoscopic treatment with variceal ligation followed by sclerotherapy with N-butyl-2-cyanoacrylate from November 1995 to November 2000.

The Adamkiewicz artery: demonstration by intra-arterial computed tomographic angiography.

Objective: The purpose of this study was to evaluate the feasibility of using multidetector-row CT angiography (CTA) with intra-arterial contrast injection (IA-CTA) to depict the artery of Adamkiewicz (arteria radicularis magna, ARM).

Methods: We performed IA-CTA in 27 preoperative patients with aneurysm or dissection of the descending thoracic or thoracoabdominal aorta. ARM was examined on multiplanar and curved planar reformation images and on the paging method, and we investigated detectability and visualization of the ARM, the level of branching, and right/left frequency as well as continuity from the origin to the ARM.

Cerebral lipiodol embolism: a complication of transcatheter arterial chemoembolization for hepatocellular carcinoma.

We report a case of cerebral lipiodol embolism following transcatheter chemoembolization (TACE) for hepatocellular carcinoma. A 70-year-old woman with a large unresectable hepatocellular carcinoma underwent TACE. Her level of consciousness deteriorated after the procedure, and magnetic resonance imaging and non-contrast computed tomography revealed a cerebral lipiodol embolism.

Wallerian degeneration of the middle cerebellar peduncle after pontine infarction: MR imaging.

Purpose: To report magnetic resonance (MR) imaging findings of wallerian degeneration of the pontocerebellar tract secondary to a pontine infarction.

Materials And Methods: We retrospectively reviewed cranial MR images obtained during the past seven years in our institution and selected those from patients with a chronic stage of pontine infarction and a hyperintense lesion at the central portion of the middle cerebellar peduncle on T2-weighted images.

Results: In three patients with a ventromedial pontine infarction, we found a symmetrical hyperintense lesion at the central portion of the middle cerebellar peduncle bilaterally on T2-weighted MR images in the chronic stage.