When first introduced, percutaneous dilatational tracheostomy (PDT) was performed using a bronchoscope. The bronchoscope itself, however, has several disadvantages, including interruption of ventilation. Modifications of the standard PDT technique have suggested that PDT can be safely performed without a bronchoscope. However, the safety of these modifications is unclear and many modifications have yet to be widely adopted. This study retrospectively evaluated the safety of a simplified PDT technique using the Cook® Ciaglia Blue Rhino™ in 186 patients. After confirming the underlying structures by palpation, PDT was performed without a bronchoscope or blunt dissection, 2.0 cm below the cricothyroid membrane. Ultrasonography was used only when palpation was difficult. Except for bleeding in three patients with coagulopathy, none of the patients experienced any early or late complications, and there were no deaths related to PDT. These findings confirm that PDT can be safely performed using a simplified technique, which may be useful in situations with limited equipment and medical personnel.
Airway Management ; Bronchoscopes ; Bronchoscopy ; Hemorrhage ; Humans ; Membranes ; Palpation ; Retrospective Studies ; Tracheostomy* ; Ultrasonography ; Ventilation

No abstract available.
Humans ; Subclavian Vein*

No abstract available.
Anesthesia, Spinal* ; Cesarean Section* ; Emergencies* ; Female ; Humans ; Neurofibromatosis 1* ; Pre-Eclampsia* ; Pregnancy

BACKGROUND: Choice of anesthetics in patients with a history of nephrectomy is very important for anesthesiologists. It is important for the anesthesiologist to preserve the ipsilateral kidney function and minimize deleterious effects. This study was performed to compare anesthetic agents on postoperative renal and hepatic function in patients who underwent nephrectomy. METHODS: From 2008 to 2012, 116 patients who underwent nephrectomy in our hospital were evaluated through a retrospective study. Anesthesia was maintained with desflurane-remifentanil in the desflurane group (Group D), and propofol-remifentanil, using a target controlled infusion pump (Group T). In order to evaluate postoperative renal and hepatic function, blood urea nitrogen (BUN), serum creatinine (Cr), estimated glomerular filtration rate (eGFR), aspartate aminotransferase (AST) and alanine aminotransferase (ALT) was measured preoperatively, postoperative day 1, 3 and 7. RESULTS: When compared to preoperative measures, Cr and BUN levels were elevated on postoperative day 1, 3 and 7 while eGFR was decreased in both groups. There was no significant difference between the two groups. AST and ALT were also mildly elevated on postoperative day 1, 3 and 7 in both groups. There was also no significant difference between the two groups. CONCLUSIONS: Anesthesia with desflurane-remifentanil or propofol-remifentanil alter postoperative renal and hepatic function with no significant difference between groups. Both desflurane and propofol may be chosen for general anesthesia undergoing nephrectomy patients.
Alanine Transaminase ; Anesthesia ; Anesthesia, General ; Anesthetics ; Aspartate Aminotransferases ; Blood Urea Nitrogen ; Creatinine ; Glomerular Filtration Rate ; Humans ; Infusion Pumps ; Isoflurane ; Kidney ; Nephrectomy* ; Propofol ; Retrospective Studies

BACKGROUND: Choice of anesthetics in patients with a history of nephrectomy is very important for anesthesiologists. It is important for the anesthesiologist to preserve the ipsilateral kidney function and minimize deleterious effects. This study was performed to compare anesthetic agents on postoperative renal and hepatic function in patients who underwent nephrectomy. METHODS: From 2008 to 2012, 116 patients who underwent nephrectomy in our hospital were evaluated through a retrospective study. Anesthesia was maintained with desflurane-remifentanil in the desflurane group (Group D), and propofol-remifentanil, using a target controlled infusion pump (Group T). In order to evaluate postoperative renal and hepatic function, blood urea nitrogen (BUN), serum creatinine (Cr), estimated glomerular filtration rate (eGFR), aspartate aminotransferase (AST) and alanine aminotransferase (ALT) was measured preoperatively, postoperative day 1, 3 and 7. RESULTS: When compared to preoperative measures, Cr and BUN levels were elevated on postoperative day 1, 3 and 7 while eGFR was decreased in both groups. There was no significant difference between the two groups. AST and ALT were also mildly elevated on postoperative day 1, 3 and 7 in both groups. There was also no significant difference between the two groups. CONCLUSIONS: Anesthesia with desflurane-remifentanil or propofol-remifentanil alter postoperative renal and hepatic function with no significant difference between groups. Both desflurane and propofol may be chosen for general anesthesia undergoing nephrectomy patients.
Alanine Transaminase ; Anesthesia ; Anesthesia, General ; Anesthetics ; Aspartate Aminotransferases ; Blood Urea Nitrogen ; Creatinine ; Glomerular Filtration Rate ; Humans ; Infusion Pumps ; Isoflurane ; Kidney ; Nephrectomy* ; Propofol ; Retrospective Studies

Salmonellae cause a number of characteristic clinical infections in humans, including gastroenteritis, enteric fever, bacteremia, focal metastatic infection and an asymptomatic chronic carrier state. We report a case of large hepatic cyst infected with Salmonella paratyphi A. A 47-year-old woman was admitted, because of abdominal complains (fullness and pain) and fever. On physical examination, a mass was palpated on right upper quadrant of the abdomen. The computerized tomography of the abdomen showed a large hepatic cyst, but not cystic infection. Aspiration and percutaneous drainage of the hepatic cyst were perfomed for the therapeutic decompression under fluoroscopic guidance. Cultures of the cyst fluid revealed growth of Salmonella paratyphi A. Radiologic contrast media after draining of the cyst fluid revealed no communication between the cyst and bile ducts. Infected hepatic cyst appeared to result from hematogenic seeding. One month later, the patient improved and was discharged without any complication.
Abdomen ; Bacteremia ; Bile Ducts ; Carrier State ; Contrast Media ; Cyst Fluid ; Decompression ; Drainage ; Female ; Fever ; Gastroenteritis ; Humans ; Middle Aged ; Physical Examination ; Salmonella paratyphi A* ; Salmonella* ; Typhoid Fever

Salmonellae cause a number of characteristic clinical infections in humans, including gastroenteritis, enteric fever, bacteremia, focal metastatic infection and an asymptomatic chronic carrier state. We report a case of large hepatic cyst infected with Salmonella paratyphi A. A 47-year-old woman was admitted, because of abdominal complains (fullness and pain) and fever. On physical examination, a mass was palpated on right upper quadrant of the abdomen. The computerized tomography of the abdomen showed a large hepatic cyst, but not cystic infection. Aspiration and percutaneous drainage of the hepatic cyst were perfomed for the therapeutic decompression under fluoroscopic guidance. Cultures of the cyst fluid revealed growth of Salmonella paratyphi A. Radiologic contrast media after draining of the cyst fluid revealed no communication between the cyst and bile ducts. Infected hepatic cyst appeared to result from hematogenic seeding. One month later, the patient improved and was discharged without any complication.
Abdomen ; Bacteremia ; Bile Ducts ; Carrier State ; Contrast Media ; Cyst Fluid ; Decompression ; Drainage ; Female ; Fever ; Gastroenteritis ; Humans ; Middle Aged ; Physical Examination ; Salmonella paratyphi A* ; Salmonella* ; Typhoid Fever

Eleven compounds (1–11) were isolated from the rhizomes of Osmunda japonica, and their structures were elucidated based on 1H, 13C-NMR and LC-IT-TOF MS data. Of these compounds, all compounds (1 – 11) have been previously reported, although five (6 – 9, 11) have not previously been isolated from this plant. The antioxidant activities of isolated compounds (1 – 11) were measured by DPPH and ABTS assays, and compound 10 showed the high antioxidant activity.
Plants ; Rhizome*