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Rationale: Fetal giant cervical cyst (FGCC) is a rare congenital anomaly. Sometimes FGCC may extend into the mediastinum, and result in severe tracheal compression, which is a life-threatening event at birth. Patient concerns: We present a rare case of FGCC, which extended from the right neck into the superior mediastinum, and resulted in severe tracheal compression. Diagnoses: An FGCC was observed by ultrasonography and magnetic resonance imaging (MRI) at 27+4 weeks’ gestation (WG). Fetal MRI at 35+1 WG showed that the FGCC was 3.3 × 8.2 × 7.5 cm and extended from the right neck into the superior mediastinum. Severe tracheal compression was observed and the inside diameter of the narrowest section of tracheostenosis appeared thread-like and measured only 0.1 cm. Interventions: Cervical cyst reduction was performed prenatally under ultrasound guidance to alleviate the tracheal compression and maximize the chance of fetal survival 2 days before birth. At 36+3 WG, cesarean section was performed, and a female neonate was immediately delivered and intubated (3.5-mm tube) by an experienced anesthesiologist. Neonatal intralesional sclerotherapy and cystic component aspiration as guided by digital subtraction angiography were performed under general anesthesia. Anesthesia was maintained only with sevoflurane 3% in 2 L/min oxygen. Extubation was performed soon after surgery. Outcome: The neonate recovered uneventfully and was discharged 2 days postoperatively. After 140 days of follow-up, the neonate had recovered completely. Lessons: If an FGCC is suspected by abdominal ultrasound, a fetal MRI is recommended to assess the severity of tracheal compression before birth, if feasible. An anesthesiologist should assess the risk of intubation failure at birth according to those results. If fetal severe tracheal compression is detected and it may result in inability of intubation at birth, prenatal cervical cyst reduction under ultrasound guidance may be effective for alleviating tracheal compression at birth, if feasible. This could maximize the chance of fetal survival. Improvement of fetal short- and long-term outcomes is important.

Rationale: We herein present a case in which satisfactory analgesia and sedation were provided by the combination of epidural anesthesia with dexmedetomidine for exploratory laparoscopy in a patient who was highly suspected to have tuberculosis. This is an optimal anesthesia method to minimize the risk of nosocomial infection, especially in developing countries that lack sterilizers for anesthesia machines. Patient concerns: A 45-year-old woman suspected to have active tuberculosis was scheduled to undergo laparoscopy for definitive diagnosis of a pelvic mass. Diagnoses: Tuberculosis was diagnosed by exploratory laparoscopy. Interventions: The surgery was performed under general anesthesia to prevent pain and discomfort during the procedure. However, ventilation machine used by patients with tuberculosis may have a potential risk of nosocomial infection and need disinfection by a special sterilizer machine even when using a bacterial/viral filter-heat and moisture exchanger. Therefore, the surgery was performed under continuous epidural anesthesia combined with dexmedetomidine. Outcomes: The surgery was successfully completed, and pelvic tubercles were confirmed to be caseous necrotic tissue by pathologic examination. The patient began regular antituberculosis treatment after discharging from the gynecology department. Lessons: We conclude that administration of dexmedetomidine combined with epidural anesthesia can provide comfortable sedation for short laparoscopic procedures in patients with suspected tuberculosis. This technique can minimize the risk of nosocomial infection.

Rationale:Fetal giant cervical cyst (FGCC) is a rare congenital anomaly. Sometimes FGCC may extend into the mediastinum, and result in severe tracheal compression, which is a life-threatening event at birth.Patient concerns:We present a rare case of FGCC, which extended from the right neck i

Rationale:We herein present a case in which satisfactory analgesia and sedation were provided by the combination of epidural anesthesia with dexmedetomidine for exploratory laparoscopy in a patient who was highly suspected to have tuberculosis. This is an optimal anesthesia method to minimiz

Three cyclone separators with different inlet geometry were designed, which include a conventional tangential single inlet (CTSI), a direct symmetrical spiral inlet (DSSI), and a converging symmetrical spiral inlet (CSSI). The effects of inlet type on cyclone performance characteristics, including the collection efficiency and pressure drop, were investigated and compared as a function of particle size and flow rate in this paper. Experimental result indicated that the symmetrical spiral inlet (SSI), especially CSSI inlet geometry, has effect on significantly increasing collection efficiency with insignificantly increasing pressure drop. In addition, the results of collection efficiency and pressure drop comparison between the experimental data and the theoretical model were also involved.