No abstract available.

No abstract available.
Antibodies*

The prevalence of low serum urea nitrogen concentrations (<6 mg/dL) in our patient population was 3.8% (452 per 11,911 determinations), representing 372 individual cases. Of these, 323 of the patients' charts were located, reviewed, and classified into disease groups. Malignant tumor was found in 25.1% of the 323 patients, the remaining patients without malignant tumor had various clinical conditions; pregnancy (19.5%), infectious diseases (12.1%), trauma (10.2%), cerebrovascular accident (6.2%), hepatopathy (5.3%), and miscellaneous conditions (21.6%). The prevalence in female and young aged patients under 5 years was considered due to the lower reference range in these groups than in that of female adult groups, and moreover pregnancy in another superimposing factor in the former group. In regards to the causes of this condition, our study corresponded well to the textbook cited etiology of the low serum nitrogen concentration, although malnutrition and hepatopathy were inverted in their incidental order. We postulated, through the present study, that the low serum urea nitrogen concentration is not pathognomonic findings to suggest specific disease or conditions, but rather to reflect patient's general conditions such as hydration, nutrition, or administration of certain drugs.
Adult ; Communicable Diseases ; Female ; Humans ; Malnutrition ; Nitrogen* ; Pregnancy ; Prevalence ; Reference Values ; Stroke ; Urea*

No abstract available.

This study was performed to guide the effective utilization of blood and optimal blood ordering schedule for various elective surgeries, based on the analysis of 1,462 transfused surgical procedures and 5,933 blood units transfused during operation in the period of two years through January, 197 to December, 1988 at Yeungnam University Hospital. The frequency of transfusion, and mean transfused units were evaluated and recommended blood unit for each surgical procedure was proposed. We assure that the successful establishment of this guideline can lead to substantial monetary saving, reduced blood outdating, and a decreased blood bank workload with a more appropriate allocation of the technician's time and effort.
Appointments and Schedules ; Blood Banks

The technique of radial artery cannulation and its complications are well documented, but serious complications are rare. This is a report of one case of amputation of wrist due to finger necrosis developed from the radial artery cannulation in patient who had craniectomy surgery. This 52-year-old 79 kg male underwent subdural hematoma removal surgery. Right radial artery cannulation was carried out percutaneously using 22 gauge Teflon extracath needle after modified Allen's test appeared to be positive. It was intermittently flushed by heparinized solution. His arterial blood pressure was maintained 100/70-110/80 mmHg and 5 units of banked whole blood and 1 unit of fresh frozen plasma were transfused during 8-hours operation. Cannula was removed on the 9th hour after operation because that was obstructed. On the 12th hour after removal of cannula, his right hand noted to be cool and cyanotic. So, warm towel and hot bag applied continuously on the right hand and the right stellate ganglion block was carried out every day for 4 times. However, on the 10th day after removal of cannula, necrotic change of all fingers of the right hand became worse and skin of fingers were shrunken. Therefore, disarticulation of the right wrist carried out on the 71th day of his hospitalization.
Amputation* ; Arterial Pressure ; Catheterization* ; Catheters ; Disarticulation ; Extremities* ; Fingers ; Hand ; Hematoma, Subdural ; Heparin ; Hospitalization ; Humans ; Male ; Middle Aged ; Necrosis ; Needles ; Plasma ; Polytetrafluoroethylene ; Radial Artery* ; Skin ; Stellate Ganglion ; Wrist

This study deals with the changes in the concentrations of blood glucose and electrolytes during open heart surgery. Blood glucose and electrolytes in connection with age, disease and anesthetic period were measured in 25 patients about to undergo heart surgery which were performed between June 1986 and August 1986 in Yeungnam University Hospital. Because glucose solution is commonly used as priming solution, and the priming solution is hyperglycemic and hyperosmolar, glucose level of priming solution in this study was adjusted to 100-200 mg% level to minimize hyperglycemic and hyperosmolar effect. The following results were obtained. 1. Glucose level of priming solution before extracorporeal circulation was 151.6+31.3 mg%. 2. With body cooing, blood glucose level was elevated. As duration of extracorporeal circulation is prolonged, blood glucose level was elevated more, but no difference between age and diseases were observed. On warning, blood glucose level was progressively lowered. 3. Despite the low serum potassium level during by-pass, the potassium level was progressively elevated following by pass, cut the serum potassium level was low compared to control values. Elevated calcium level was maintained during by pass.
Blood Glucose* ; Calcium ; Electrolytes ; Extracorporeal Circulation ; Glucose ; Heart* ; Humans ; Potassium ; Thoracic Surgery*

In the beginning of anesthetic training, one of the clinical practices that anesthetists have to learn is manually controlled ventilator techniques. The popularity of manually controlled ventilatory techniques has been gradually decreased with increased use for anesthetic ventilators. However it is important and basic for the anesthetists to master manually controlled ventilator techniques skillfully. Recently, we analyzed the arterial blood gas in 30 cases before and during general anesthesia, and studied the effects of the manually controlled ventilation on the pulmonary gas exchange. The results were as follow; 1) Mean value of PaCO₂ during the manually controlled ventilation, 29.9±2.0 mmHg was decreased statistically comparing with that of PaCO₂ before the anesthesia, 39.8±2.8 mmHg. 2) Mean values of pH and HCO₃⁻ during the manually controlled ventilation were 7.48±0.03, 22.2±2.4 mEq/1, respectively and values before the anesthesia were 7.41±0.02, 25.2±1.8 mEq/1, respectively. 3) Mean value of PaO₂ and O₂ saturation during the manually controlled ventilation were 270.0±28.8 mmHg, 99.6±0.2%, respectively and values before the anesthesia were 92.5±4.0 mmHg, 96.9±1.0%, respectively. These results indicates that manually controlled ventilation at our department of anesthesiology produced mild hyperventilatory state. However these were no significant changes in cerebral blood flow and other biochemical parameters.
Anesthesia ; Anesthesia, General* ; Anesthesiology ; Cerebrovascular Circulation ; Hydrogen-Ion Concentration ; Pulmonary Gas Exchange ; Ventilation* ; Ventilators, Mechanical

The study was undertaken to determine the most adequate tidal volume when used volume preset ventilator during anesthesia. The thirty patients were received controlled mechanical ventilation with constant inspiratory pressure of 10 cmH2O and respiratory frequency of 12/minute. The results were as follows: 1) The PH was 7.39±0.01 and it is within normal limit. 2) The PaCO2 was 34.0±0.6 mmHg and it is a slightly hyperventilatory state. 3) The PaO2 was 228.0±8.2 mmHg. 4) The Buffer base was 20.7±0.3 mEq/L and it is a slightly buffer base deficient state. From the above results. We concluded that if patients were fully relaxed during general anesthesia, it is desirable to maintain the inspiratory pressure of anesthetic mechanical ventilator to 10 cmH2O for adequate alveolar ventilation.
Anesthesia ; Anesthesia, General ; Humans ; Hydrogen-Ion Concentration ; Respiration, Artificial ; Tidal Volume ; Ventilation ; Ventilators, Mechanical*

BACKGROUND: Recently technetium-99m sestamibi (99mTc MIBI), which dose not require withdrawal of thyroid hormone, has been used for imaging of thyroid carcinoma. The aim of this study was to determine the clinical usefulness of Tc MIBI scintigraphy after total thyroidectomy for thyroid carcinoma. The results were compared with those of standard 131I scintigraphy. METHODS: One hundred twelve patients with a median age of 44 years (range, 14-76 years) were included in the study. After optimal endogenous thyroid stimulating hormone stimulation (>50 mIU/mL), whole body scintigraphy using 4 mCi of 'I and 20 mCi of Tc sestamibi were done simultaneously. Concomitantly serum thyroglobulin and anti-thyroglobulin antibody levels were checked. If abnormal findings on any of the scintigraphic methods or high levels of thyroglobulin (> 10ng/mL) were detected, diagnostic imaging studies were done to confirm the existence of the disease. And high dose (150-200 mCi) 'I was administered as therapy and then whole body scans were performed again after the therapy. The presence or absence of thyroid cancer was established by pathologic, radiologic, and/or high dose I scan findings. RESULTS: In 11 patients, Tc MIBI scan revealed positive accumulations which were not found on 131I scan, of whom 6 had elevated thyroglobulin levels. In these cases, 5 cases were interpreted to have normal thyroid remnant and 6 cases showed pathologic findings (2 lung, 1 lymph node, 1 lung and lymph node, 1 local recurrent cancer, and 1 false positive accumulation of 99mTc MIBI). Metastasis or residual cancer were confirmed histologically in 1 and radiologically in 4 cases. Negative 99mTc MIBI scans, despite of positive I scans, occurred in 9 patients, of whom 2 had abnormal thyroglobulin levels. Seven cases were interpreted to have thyroid remnant, 2 cases were confirmed to have lung metastasis, and another one was misinterpreted due to breast shadow. CONCLUSION: In conclusion, these results suggest that 99mTc MIBI scan may have similar sensitivity and specificity for the detection of residual or metastatic differentiated thyroid carcinoma. The 99mTc MIBI scan, especially in cases of negative 131I scan despite of abnormal thyroglobulin levels, can be used as a very useful complementary diagnostic tool.
Breast ; Diagnostic Imaging ; Follow-Up Studies* ; Humans ; Lung ; Lymph Nodes ; Neoplasm Metastasis ; Neoplasm, Residual ; Radionuclide Imaging* ; Sensitivity and Specificity ; Technetium Tc 99m Sestamibi ; Thyroglobulin ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy ; Thyrotropin ; Whole Body Imaging