These results suggest that additional US and thorough examinations are necessary if a lesion cannot be confirmed as a simple renal cyst on initial US. Furthermore, to improve the skill levels of healthcare professionals who perform and interpret US, a feedback system should be established where data related to complete medical screenings are available to the personnel involved.

Bronchoscope assisted percutaneous tracheostomy (PCT) was performed in 11 patients in our intensive care unit without any complications. A bronchoscope was inserted through an endotracheal tube and we could observe the tracheal lumen throughout the procedures of PCT. This technique could confirm the insertion of tracheal tubes and avoid the serious complications in a conventional blind puncture, such as accidental extubations of the endotracheal tubes before insertion, miscanulations in the tracheal lumen, and esophageal injuries. We recommend the bronchoscope assisted PCT as a safer procedure rather than a conventional blind puncture.