BACKGROUND: Malpositioning of the endotracheal tube within airway after intubation may results in serious complications, such as accidental extubation and inadvertent endobronchial intubation. Therefore, early detection of malposioning of the endotracheal tube is very impotant for deciding patient's prognosis. METHODS: We assessed the distance from the tip of the endotracheal tube to the carina according to the patient's age, sex, and the time, the location, and the route of intubation. The chest x-ray was taken for 333 patients (men, 226: women, 107) who were admitted to the intensive care unit of Wonju Christian Hospital from march 1, 1995 to February 28, 1996. Chest x-ray was obtained after intubation to verify endotracheal tube position. Appropriate endotracheal tube position on chest x-ray was defined as between 2 and 6 cm above the carina. RESULTS: Of the 333 intubations, 106 (31.8%) endotracheal tubes were inappropriately placed according to the chest x-ray. The percentage of malpositioned endotracheal tubes (<2 cm) was higher in women than in men (11.2% vs. 5.3%, p<0.05), with higher in night (7 PM to 7 AM) than in day (7 AM to 7 PM) (42% vs. 24%, p<0.05). Distance from the carina to the tip of endotracheal tube is 4.34 +/- 1.77cm in women and 5.23 +/- 1.64cm in men. Thus, position of the endotracheal tube in women is deeper than men (p<0.001). CONCLUSIONS: We conclude that the chest x-ray for confirmation of endotracheal tube position after endotracheal intubation may remain the standard of practice. And endotracheal tube position should be carefully assessed immediately after tracheal intubation, particularly in women and at night.
Female ; Gangwon-do ; Humans ; Incidence* ; Intensive Care Units ; Intubation ; Intubation, Intratracheal* ; Male ; Prognosis ; Thorax*

It is well known that some inhalation anesthetics and ancillary drugs are metabolized in the liver. Since this fact was reported (Read, 1672: Dripps, 1977) the influence of different anesthetics on the liver has been of great interest up to date. The most cause of postoperative hepatic dysfunction seems to be acute viral hepatitis, but there are some other causes such as anesthetic damage and untoward reactions to the drugs used in the intraoperative or postoperative periods(Bahior & Davidson, 1967: Bruce, 1972). Halothane is usually a safe and effective inhalation anesthetic agent but on occation it has damaged the liver. Many papers have reported these untoward reactions, and then attention began to be paid to other anesthetic agents. The author selected random samples of 100 adult femal patients who had lower abdominal operations at Wonju Christian Hospital between May 1982 to August 1982. Their physical status was ASA class l & ll, liver function tests were within normal limits and they had no previous history of operation or liver disease. They were divided into five groups according to the anesthetic agent used(halothane, ethrane, ether, Thalsmonal neuroleptanesthesia and lidocaine epidural anesthesia). The liver function tests were performed before surgery, and on the 1st, 3rd, 5th, and 7th postoperative days. The results were as follows. 1) BUN, total protein, albumin, globulin and total cholesterol were not significantly changed. 2) The values of SGOT &SGPT were slightly increased elevated on the first postopday, and on the 3rd day after operation and then gradually decreased. On the 7th day after operation they had returned to the preoperative levels. The changes of the values were within normal limits. 3) Alkaline phosphatase, total bilirubin and direct bilirubin were not significantly influenced by the anesthetic agents. It is suggested that the influence of variable anesthetic agent on the liver is not significant, and that the changes of the liver function tests were minimal, and the values of the tests have usually returned to normal by the 7th day after operation.
Adult ; Alkaline Phosphatase ; Anesthetics* ; Anesthetics, Inhalation ; Aspartate Aminotransferases ; Bilirubin ; Cholesterol ; Enflurane ; Ether ; Gangwon-do ; Halothane ; Hepatitis ; Humans ; Inhalation ; Lidocaine ; Liver Diseases ; Liver Function Tests ; Liver*

Primary aldosteronism is typically characterized by hypertension, hypokalemia, elevated plasma aldosterone concentration, and suppressed plasma renin activity. Surgieal excision of the tumor mostly cures hypertension as well as electrolyte and hormonal abnormalities in patient with aldosterone-producing adenoma. We have experienced the anesthetic management of unilateral adrenalectomy in a 32 years old male, who was diagnosed as aldosterone-producing adenoma, under the general anesthesia with careful monitoring. Postoperative recovery was uncomplicated.
Adenoma ; Adrenalectomy ; Adult ; Aldosterone ; Anesthesia, General ; Humans ; Hyperaldosteronism* ; Hypertension ; Hypokalemia ; Male ; Plasma ; Renin

No abstract available.
Leiomyoma* ; Vagina*

No abstract available.
Peritoneum*

Widely used tests for the detection of platelet antibodies in Korea include platelet suspension immunofluorescence test(PSIFT), enzyme immunoassay and mixed passive hemagglutination(MPHA). In these tests, removal of HLA antigens from platelet are required to detect platelet-specific antibodies. Modified antigen capture ELISA(MACE) is known to be very sensitive for the detection of platelet-specific antibodies, in which specific platelet glycoprotein, captured by the monoclonal antibody is used as a target antigen. MACE is very useful for the detection of platelet-specific alloantibodies in neonatal alloimmune thrombocytopenia(NAIT) and posttransfusion purpura(PTP). We employed MACE in our laboratory, using AP2(anti-GPIIb/IIIa, monoclonal), #30 sera(anti-PlA1), 90-545 sera(anti-HLA-B51+52) and LYS sera(multispecific HLA antibodies). LYS sera had been used as our positive control( 1:120) in MPHA. Platelet from PIA1(+), HLA-B5 I, blood group O healthy male donor, gave positive result with #30 sera(1:40) and negative result with 90-545 sera in MACE. With LYS sera, MACE showed negative in 1:120, but positive in 1:20. So LYS sera was thought to contain strong multispecific HLA antibodies and relatively weak antibody(-ies) reacting with GPllb/Illa. Further studies employing different monoclonal antibodies, such as anti-GPIb/IX, -GPIa/Ila and -GPIV are under way.
Antibodies* ; Antibodies, Monoclonal ; Blood Platelets ; Fluorescent Antibody Technique ; Glycoproteins ; HLA Antigens ; Humans ; Immunoenzyme Techniques ; Isoantibodies ; Korea ; Male ; Tissue Donors

No abstract available.
Amniotic Band Syndrome* ; Infant, Newborn

A subperiosteal ganglion has been very rarely reported, since Ollier reported first one in 1864. A subperiosteal ganglion is produced by mucoid degeneration and cyst formation within the periosteum, which results in cortical erosion. The characteristic plain radiolographic appearance of irregular cortical erosion and scalloping, with reactive periosteal bone spicules, has been considered pathognomonic of subperiosteal ganglion. Magnetic resonance imaging is performed to further characterize the soft tissue component of the mass. As in our patient, the characteristic signal intensities of magnetic resonance imaging are especially useful in identifying the lesion as a ganglion and in defining the lobular nature and the anatomical extent. We report here the case of a 35-year-old female who had a sudperiosteal ganglion of the distal radius.
Adult ; Female ; Ganglion Cysts* ; Humans ; Magnetic Resonance Imaging ; Pectinidae ; Periosteum ; Radius*

Accurate placernent of double-lumen endobronchial tube is essential for successful one lung anesthesia We studied 58 adult patients (38 males and 20 females) undergoing thoracic surgery under one lung anesthesia. We used the fiberoptic bronchoscope as an "introducer" over which the double lumen tube was advanced under direct vision. Correct position of the left side double-lumen endobronchial tube at supine position was determined by direct vision of cephalad surface of the bright blue bronchial cuff immediately below the carina. Correct position of the right side double lumen endobronchial tube at supine position was determined by direct vision of the right upper lobe bronchial orifice through the right upper labe ventilation slot. After the patient was repositioned, the position of the double lumen endobronchial tube was rechecked by fiberoptic bronchoscope. The results were as follows; 1) There was a significant correlation of correct depth of left and right double lumen endobronchial tube at supine position with height for both male and female patients. 2) Left side double lumen endobronchial tube: 58% of total cases (20 Case of 38 Case) were displaced by turning of the patient from supine to the lateral decubitus position. 3) Right side double lumen endobronchial tube: 65% of total cases (13 Case of 20 Case) were displaced by turning of the patient from supine to the lateral decubitus position.
Adult ; Anesthesia ; Bronchoscopes ; Female ; Humans ; Lung ; Male ; Supine Position ; Thoracic Surgery ; Ventilation

Studies were made to ascertain the relationship between arterial and end-tidal carbon dioxide tension in 19 patients during caesarean section under general anesthesia(Group 2). 27 nonpregnant patients scheduled for abdominal hysterectomy were also performed as a control group(Group I). 15 and 30 minutes after the induction of anesthesia in group I, and just before uterine incision, 15 minutes following induction in group 2, arterial blood was sampled for PaCO analysis and PETCO2(end-tidal CO2 tension) determined at the same time. In group 1, there was a statistically significant differences between PaCO2 and PETCO2 but in group 2, no differences between them were shown. The highly significant correlations between PaCO2 and PETCO2 in both groups were found. On the basis of the above results, we recommend that non-invasive measurement of PETCO2 can be used reliably in stead of measuring PaO2 to evaluate the ventilatory status during anesthesia in patients for caesarean section.
Anesthesia ; Anesthesia, General* ; Capnography ; Carbon Dioxide* ; Carbon* ; Cesarean Section* ; Female ; Humans ; Hysterectomy ; Pregnancy