BackgroundEmphysematous cholecystitis is a rare variant of acute cholecystitis with a high mortality rate. The combination of emphysematous cholecystitis, liver abscess and pneumoperitoneum are even rarer. Herein we present a case of emphysematous cholecystitis in a senile diabetic lady who had worsening hemodynamics while undergoing hemodialysis.Case presentationA 64-year-old woman with history of type 2 diabetes mellitus and end stage renal disease with regular hemodialysis presented to the emergency department with a 1-day history of sudden onset of lassitude and hypotension during hemodialysis. The result of a computed tomography (CT)-scan revealed air encircling the gallbladder, liver parenchymal and minimal pneumoperitoneal and liver abscess with no cholelithiasis. The patient had received empirical antibiotics with piperacillin-tazobactam 2.25 g intravenous route every 6 h for 14 days and cholecystectomy with surgical debridement and lead an uneventful postoperative hospital course. Escherichia coli was demonstrated as well as blood culture and peritoneal fluid culture.ConclusionIn a senile diabetic and dialysis patient, we should take emphysematous cholecystitis into consideration once vague abdominal pain occurrs. Empirical antibiotic therapy and adequate surgical intervention should take place as soon as possible.

This paper proposes a new phase-locked-loop (PLL)-based inductive coupled contactless energy transfer (CET) analog frequency-shift keying (FSK) demodulator using a high-efficiency RF-to-dc rectifier for biomedical implanted devices. The analog FSK demodulator is composed of a modified CMOS three-stage rectifier, a voltage regulator, an FSK signal generator, and a PLL. The proposed modified single-stage rectifier with both positive and negative output voltages using a PMOS and an NMOS pass transistor, an inverter, and two capacitors has a small active area and can enhance the power conversion efficiency. The proposed RF-to-dc rectifier achieves an efficiency of 64% at 8.4 dBm. The power consumption of the demodulator is as low as 0.76 mW, and the active area is 0.084 mm 2 . The analog FSK demodulator supports a data rate of 100 kb/s to 1 Mb/s. The chip was implemented in a Taiwan Semiconductor Manufacturing Company (TSMC) 0.35-μm double-poly quadruple-metal CMOS technology to verify the proposed CET circuit. Two figures of merit are provided to illustrate the advantages of the proposed architecture. Index Terms-Contactless energy transfer (CET), frequencyshift keying (FSK) demodulator, phase-locked loop (PLL), power conversion efficiency, rectifier.

No abstract

No abstract

No abstract