Negative pressure pulmonary edema is a recognized complication of airway obstruction, particularly after endotracheal extubation. The application of oxygen therapy and continuous positive airway pressure with the administration of diuretics under a rapid diagnosis usually clears pulmonary edema. We report a case of 61-year-old man who developed negative pressure pulmonary edema following extubation after an endoscopic submucosal dissection under general anesthesia.
Airway Extubation ; Airway Obstruction ; Anesthesia, General ; Continuous Positive Airway Pressure ; Diuretics ; Humans ; Middle Aged ; Oxygen ; Pulmonary Edema

BACKGROUND: A Stellate ganglion block (SGB) is a sympathetic nerve block method which has been used most frequently in pain clinics due to its wide range of indications. However, SGB leads to regional sympathetic denervation of the heart and to changes in the hemodynamics. The aim of this study was to compare hemodynamic effects as well as echocardiographic changes after a left SGB (LSGB). METHODS: Fourteen healthy male volunteers were studied. The LSGB was performed with 1% mepicacaine 6 ml. Arterial blood pressure, electrocardiographic and echocardiographic variables were measured before the LSGB, 15 and 30 minutes after the LSGB. RESULTS: Arterial blood pressure, ejection fraction and transmitral inflow velocity variables showed no significant changes compared to pre-LSGB values. P-P interval increased significantly 15 minutes after the LSGB, and the Q-T interval increased significantly 30 minutes after the LSGB. The diastolic pulmonary venous flow velocity decreased significantly 15 minutes after the LSGB. CONCLUSIONS: These results showed that a LSGB decreased the heart rate without detrimental changes of left ventricular relaxation in healthy male volunteers.
Arterial Pressure ; Autonomic Nerve Block ; Echocardiography ; Electrocardiography ; Heart ; Heart Rate ; Hemodynamics ; Humans ; Male ; Pain Clinics ; Relaxation ; Stellate Ganglion* ; Sympathectomy ; Ventricular Function, Left* ; Volunteers

BACKGROUND: Uncomplicated acute cystitis (CA-UAC) is one of the most common infections treated with antibiotics in the community. However, few data on etiology of CA-UAC and its susceptibility to antibiotics are available, primarily because, in Korea, insurance does not allow reimbursement for microbiological evaluation of CA-UAC. However, microbiologic data on community-acquired uncomplicated acute pyelonephritis (CA-UAPN) are available. The objective of the study was to evaluate the question of whether microbiologic data on CA-UAPN can be used for treatment of CA-UAC; therefore, etiology and antimicrobial susceptibility were compared between pathogens of CA-UAC and those of CA-UAPN. MATERIALS AND METHODS: During 2008, 538 CA-UACs and 1,265 CA-UAPNs were recruited retrospectively from 14 hospitals (UTI research group). Microbiologic data on etiology and susceptibility to antibiotics were collected retrospectively. RESULTS: Urine culture was positive in 131 CA-UACs (131/469, 27.9%) and 719 CA-UAPNs (719/1249, 57.6%). Escherichia coli was the most common pathogen in both groups [83.2% (109/131) in CA-UAC vs. 91.9% (661/719) in CA-UAPN]. Susceptibility to common UTI regimens, such as ciprofloxacin, extended-spectrum cephalosporins, and trimethoprim/sulfamethoxazole did not differ between urinary pathogens of CA-UACs and CA-UAPNs, however, a significant difference was observed in rates of resistance to ampicillin/sulbactam (16.5% vs. 42.9%, P<0.001, respectively). CONCLUSIONS: Rates of resistance of E. coli from CA-UAC and CA-UAPN to most antibiotics did not differ. For proper treatment, further microbiological evaluation for CA-UAC is mandatory.
Anti-Bacterial Agents ; Cephalosporins ; Ciprofloxacin ; Cystitis ; Escherichia coli ; Insurance ; Korea ; Pyelonephritis ; Retrospective Studies