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AAPM 2025 - 67th Annual Meeting & Exhibition of the American Association of Physicists in Medicine

Advanced Imaging Aids Treatment of Lymphatic Plastic Bronchitis

By MedImaging International staff writers
Posted on 25 Jan 2017

Image: DCMRL (A) and lymphangiogram (B) images of the central lymphatic system of a plastic bronchitis patient (Photo courtesy of Maxim Itkin).

A new study describes how lymphatic imaging can help surgeons perform percutaneous embolization to remove the branching casts that form in the airways of plastic bronchitis patients.

Researchers at the Children's Hospital of Philadelphia (CHOP) and the University of Cincinnati used dynamic contrast-enhanced MR lymphangiography (DCMRL) and intranodal lymphangiography to investigate the mechanism of cast formation in seven adults patients (mean age 50 years) with plastic bronchitis, and to evaluate the therapeutic outcome of percutaneous lymphatic embolization for these patients, which involved inserting a combination of glue and coils through catheters to halt the abnormal flow of lymphatic fluid.

The researchers found that DCMRL established the presence of abnormal pulmonary lymphatic flow in six of the patients, which was confirmed by intranodal lymphangiography and thoracic duct injection that demonstrated lymphatic reflux, a communication of abnormal lymphatic channels with airways. The researchers then treated six of the seven with lymphatic embolization, using a combination of endovascular glue and coils.

After lymphatic embolization, five of the patients reported immediate and complete resolution of symptoms, and the sixth patient reported significant partial improvement. Four patients had transient abdominal discomfort, which was treated with analgesics and resolved before discharge in all subjects. The average follow-up period was 11 months after initial treatment. The study was published in the October 2016 issue of Annals of the American Thoracic Society.

“Based on these data, we postulate that many cases of idiopathic plastic bronchitis in adults have a lymphatic basis, and propose that the diagnosis be renamed ‘lymphatic plastic bronchitis’ in those subjects, to distinguish the disorder from the other forms,” concluded lead author radiologist Maxim Itkin, MD, of CHOP. “Percutaneous transabdominal catheterization and embolization of the pulmonary lymphatics is a safe and effective treatment for the acute manifestation of this disorder, but additional studies are needed to determine the long-term safety and durability of this approach.”

Plastic bronchitis is a condition characterized by expectoration of branching bronchial casts. Although the mechanism of cast formation in adults with plastic bronchitis remains poorly understood, abnormal pulmonary lymphatic flow resulting in molding of congealing lymphatic fluids in the airway can cause life-threatening respiratory distress, especially in children. In adults, the condition may go undiagnosed for years in patients who may initially be diagnosed with asthma or chronic cough.

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65 (29.802322387695): select jos_facebook.link from jos_facebook where cat=10

66 (30.994415283203): select jos_google_plus.link from jos_google_plus where cat=10

67 (38.14697265625): select jos_linkedin.link from jos_linkedin where cat=10

68 (41.961669921875): SELECT fid FROM jos_deeppockets WHERE id=294767853 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294767853 AND published='1' LIMIT 1

69 (33.140182495117): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=215 ORDER BY `ordering`

70 (274.8966217041): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294767853 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (222.92137145996): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294767853 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (44.822692871094): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

73 (84.877014160156): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (59.843063354492): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (48.160552978516): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (62.942504882812): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294767853 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (40.054321289062): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294767853 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (49.114227294922): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

90 (46.968460083008): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (29.802322387695): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (27.179718017578): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (59.843063354492): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (49.829483032227): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (32.186508178711): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (64.849853515625): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294767853 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294767853 AND published='1' LIMIT 1

105 (42.915344238281): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294767853 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294767853 AND published='1' LIMIT 1

106 (61.03515625): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294767853 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (61.03515625): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294767853 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (91.075897216797): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294767853 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294767853 AND published='1' LIMIT 1

109 (56.028366088867): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294767853 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294767853 AND published='1' LIMIT 1

110 (61.988830566406): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294767853 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (523.09036254883): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294767853 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (593.90068054199): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

113 (576.01928710938): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

114 (179.05235290527): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294767853 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294767853 AND published='1' LIMIT 1

115 (241.99485778809): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294767853 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294767853 AND published='1' LIMIT 1

116 (54.836273193359): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294767853 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294767853 AND published='1' LIMIT 1

117 (41.007995605469): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294767853 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294767853 AND published='1' LIMIT 1

118 (52.928924560547): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294767853 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294767853 AND published='1' LIMIT 1

119 (38.862228393555): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294767853 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294767853 AND published='1' LIMIT 1

120 (132.08389282227): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294767853 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294767853 AND published='1' LIMIT 1

121 (44.107437133789): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294767853 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294767853 AND published='1' LIMIT 1

122 (287.05596923828): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

123 (!!!!! 52336.931228638): SELECT * FROM jos_deeppockets WHERE jos_deeppockets.cat = 10 AND jos_deeppockets.type = 'deeppockets_item' AND jos_deeppockets.published = 1 AND jos_deeppockets.created + INTERVAL 14 DAY >= NOW() ORDER BY jos_deeppockets.hits DESC LIMIT 7

124 (494.95697021484): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294767853 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294767853 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 15422.821044922): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

126 (103.95050048828): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

127 (285.86387634277): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

128 (37.908554077148): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

129 (284.19494628906): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

130 (49.114227294922): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

131 (201.94053649902): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

132 (33.855438232422): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

133 (185.01281738281): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

134 (34.093856811523): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

135 (360.96572875977): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294767853 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

136 (324.01084899902): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294767853 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

137 (136.13700866699): SELECT name FROM jos_deeppockets WHERE id=215

138 (41.007995605469): SELECT name FROM jos_deeppockets WHERE id=215

139 (617.98095703125): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))215((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

140 (584.12551879883): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))215((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

141 (108.00361633301): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294767853 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294767853 AND published='1' LIMIT 1

142 (50.067901611328): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294767853 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294767853 AND published='1' LIMIT 1

143 (!!!!! 5250.9307861328): TRUNCATE TABLE jos_trademed_module

144 (!!!!! 3996.8490600586): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294767853 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

145 (154.01840209961): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294767853 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

146 (299.93057250977): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294767853 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

147 (187.87384033203): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294767853 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

148 (61.988830566406): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294767853 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294767853 AND published='1' LIMIT 1

149 (39.100646972656): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294767853 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294767853 AND published='1' LIMIT 1

150 (!!!!! 1192.0928955078): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6

151 (63.896179199219): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294767853 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294767853 AND published='1' LIMIT 1

152 (50.067901611328): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294767853 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294767853 AND published='1' LIMIT 1

153 (55.074691772461): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294767853 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294767853 AND type='deeppockets_item' AND published='1' LIMIT 1

154 (42.200088500977): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=215 or channel_id is null)

155 (37.908554077148): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=215 or channel_id is null)

156 (53.882598876953): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

157 (138.0443572998): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294767853 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294767853 AND published='1' LIMIT 1

158 (63.180923461914): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294767853 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294767853 AND published='1' LIMIT 1

159 (181.91337585449): select jos_twitters.link from jos_twitters where cat=10

160 (40.054321289062): select jos_facebook.link from jos_facebook where cat=10

161 (35.04753112793): select jos_google_plus.link from jos_google_plus where cat=10

162 (33.855438232422): select jos_linkedin.link from jos_linkedin where cat=10

163 (319.9577331543): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14202,14203)

164 (!!!!! 1074.0756988525): insert into jos_banners_delta values (14202,'2025-06-22 05:41:21','216.73.216.120','view'),(14203,'2025-06-22 05:41:21','216.73.216.120','view')

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