Intraoperative use of noninvasive ventilation during spinal anaesthesia in patients with severe chronic obstructive pulmonary disease undergoing orthopaedic surgery: A case report.

Compared with invasive mechanical ventilation, noninvasive ventilation (NIV) improves patient comfort and neurocognitive function; and reduces the likelihood of nosocomial infections and the need for sedation. NIV can also be used perioperatively to prevent postoperative pulmonary complications. This current report describes a case of a 64-year-old female patient with chronic obstructive pulmonary disease and chronic respiratory failure that underwent spinal anaesthesia during surgery. She was sedated with propofol. She brought her home ventilator equipment to the operating room and it was used in biphasic-positive airway pressure mode for immediate treatment of respiratory depression.

The synergistic effect of biomimetic electrical stimulation and extracellular-matrix-mimetic nanopattern for upregulating cell activities.

Endogenous bioelectric signaling and the extracellular matrix (ECM) are factors that have a great effect on the performance of cellular functions. Presenting an experimental platform to confirm the synergy effects of an electrical stimulation, which simulates endogenous bioelectricity, and nanopatterns that can be precisely fabricated in various patterns sizes makes it possible to consider those factors effectively. Herein, we have performed a comparison of cellular response to each of general electrical stimulation and biomimetic electrical stimulation (BES) and demonstrated the synergy effects of electrical stimulation and ECM-mimetic nanopatterns. BES has provided the most remarkable proliferation among different types of electrical stimulation and upregulated the behavior of cells through synergy effects with ECM-mimetic nanopatterns. Thus, it is believed that using the synergy effects of BES and ECM-like nanopatterns has broad applications in the biomedical field, such as cell culture with electrical stimulation, induction of cell growth, tissue repair, etc.

Spinal anesthesia for cesarean section in a super morbidly obese parturient: A case report.

INTRODUCTION: The population of obese individuals is increasing worldwide, and as a result, the number of mothers with super morbid obesity undergoing cesarean sections is also increasing. However, little is known about which anesthetic technique is appropriate for cesarean sections of super morbidly obese parturients. PATIENT CONCERNS: A 35-year-old woman with body mass index 61.3 kg/m at a gestational age of 37 weeks. DIAGNOSIS: The patient was super morbidly obese parturient. INTERVENTIONS: Spinal anesthesia was performed. A spinal needle was inserted into the L4-5 interspinous space in the sitting position. After confirmation of cerebrospinal fluid, 0.5% hyperbaric bupivacaine 9 mg and fentanyl 20 µg were injected into the subarachnoid space. OUTCOMES: After the administration of spinal anesthetics, the nerve block to the T8 dermatome level was confirmed, surgery was performed, and the fetus was delivered. The patient's vital signs were stable until the end of the operation. CONCLUSION: There is no established strategy for selecting a method of anesthesia in patients with morbid obesity (body mass index 40 kg/m or more). For this reason and considering the amount of bupivacaine used for spinal anesthesia, we wanted to share our experience with spinal anesthesia for cesarean section in a super morbidly obese parturients.

Nasogastric tube insertion difficulty in a patient with a large goiter: A case report.

Airway management under anesthesia is given special attention in patients who have large goiters. Nasogastric tube insertion may be difficult in intubated patients with large goiters. Several methods have been proposed to facilitate the insertion of nasogastric tubes in patients with endotracheal intubation; however, a standard insertion method has not been established. A 33-year-old man was admitted to our otolaryngology department for right thyroid lobectomy to remove a larger goiter. A thyroid computed tomography scan revealed a huge cystic mass with tracheal displacement. Although difficult intubation was expected, endotracheal intubation was performed successfully. An anesthesiologist attempted nasogastric tube insertion via the right nostril; however, this was not successful. Next, an angiography catheter was placed in a nasogastric tube, and the nasogastric tube was gently inserted with the patient's neck in mild flexion. This attempt also failed. Finally, the nasogastric tube was gently inserted via anterior displacement of the cricoid cartilage. The nasogastric tube advanced up to 60 cm. Surgery was performed, and the patient was discharged with no complications on postoperative day 8.

Snake fang-inspired stamping patch for transdermal delivery of liquid formulations.

A flexible microneedle patch that can transdermally deliver liquid-phase therapeutics would enable direct use of existing, approved drugs and vaccines, which are mostly in liquid form, without the need for additional drug solidification, efficacy verification, and subsequent approval. Specialized dissolving or coated microneedle patches that deliver reformulated, solidified therapeutics have made considerable advances; however, microneedles that can deliver liquid drugs and vaccines still remain elusive because of technical limitations. Here, we present a snake fang-inspired microneedle patch that can administer existing liquid formulations to patients in an ultrafast manner (<15 s). Rear-fanged snakes have an intriguing molar with a groove on the surface, which enables rapid and efficient infusion of venom or saliva into prey. Liquid delivery is based on surface tension and capillary action. The microneedle patch uses multiple open groove architectures that emulate the grooved fangs of rear-fanged snakes: Similar to snake fangs, the microneedles can rapidly and efficiently deliver diverse liquid-phase drugs and vaccines in seconds under capillary action with only gentle thumb pressure, without requiring a complex pumping system. Hydrodynamic simulations show that the snake fang-inspired open groove architectures enable rapid capillary force-driven delivery of liquid formulations with varied surface tensions and viscosities. We demonstrate that administration of ovalbumin and influenza virus with the snake fang-inspired microneedle patch induces robust antibody production and protective immune response in guinea pigs and mice.

Hierarchically Nanostructured CuO⁻Cu Current Collector Fabricated by Hybrid Methods for Developed Li-Ion Batteries.

We present a simple method of fabricating a hierarchically nanostructured CuO⁻Cu current collector by using laser ablation and metal mold imprinting to maximize the surface area. The laser ablation of the Cu current collector created the CuO nanostructure on the Cu-collector surface. The microstructure was transferred by subsequent imprinting of the microstructure metal mold on the Cu collector. Then, the laser-ablation nanostructure was formed. Consequently, a hierarchical structure is generated. The laser-ablated hierarchical CuO⁻Cu current collector exhibited an improved capacity while maintaining a cyclability that is similar to those of conventional graphite batteries.