No abstract available.
Diazepam* ; Hemodynamics* ; Morphine* ; Pancuronium* ; Respiration, Artificial*

No abstract available.
APACHE* ; Intensive Care Units* ; Critical Care*

The intensive care unit(ICU) of Severance Hospital was opened on October 18, 1968 with 7 beds and expanded to 19 beds on February 2, 1981. Statistical analysis of the ICU patients has already been reported three time from 1970 to 1981. The following is clinical analysis of 3,498 cases and ventilator cases from March 1981 to February 1984. 1) During the 3 years the total number of patients was 3,498. In 1981 1,053 patients, in 1982 1,179 patients, in 1983 1,256 patients were admitted. 2) Total admission time in the ICU was 17,061 days. The average patient stay in ICU was 4.9days. The majority of the patients (2,675 cases, 76.6%) stayed in ICU less than 5 days. The number of patients stayin in ICU more than 9 days increased every year from 94 cases (8.8%) in 1981 to 130 cases (10.4%) in 1983. 2) The number of pre-teens was 1,090 cases, about 31.2% of the total patients and represented the highest number of patients admitted to the ICU. The mortality in the pre-teen group was the highest of numbered 148, a mortality rate of 13.6%. 4) The number of patients admitted to the cardiothoracic surgery department was 1,591 cases(45.5%) being highest among all department. Out of 100 patients who died, the pediatric service had the highest mortality rate, 29.2%. 5) All ICU patients have been divided into two categories, operative and non-operative cases. The operative cases numbered 1,889 and non-operative 1,609. Mortality rate was 4.9% for the operative cases and 15% for the non-operative. 6) Total mortality was 334 in number, an overall mortality rate of 9.5% in 3 years. It has decreased annually, 131 cases (mortality rate 12.3%) in 1981, 105 case (7.7%) in 1982, 97 cases(7.7%) in 1983. 7) Ventilator cases numbered 1,921 in 3years. Ventilator day increased year by year, 1, 220 days in 1981, 19,904 in 1982, 2,299 days in 1983. Total ventilatior days in 1983 increased 72.9% compared with the number in 1981. 8) The number of deaths under ventilator support was 90 in 1981, 71 in 1982 and 80 in 1983 respectively. Mortality rate has decreased every year: 16.1% in 1981, 11.2% in 1982 and 10.8% in 1983. From the above results, it can be concluded that the total number of ICU patients and ventilator cases are increasing and the attendant mortality rate is decreasing year by year.
Humans ; Critical Care ; Mortality ; Ventilators, Mechanical

Hydroxyzine hydrochloride, a minor tranquilizer and a ataratic, was tested clinically for effectiveness as a premedicant separate dosages of 1 and 2 mg/kg. Each 30 patients were in the physical status class 1 and 2 by A.S.A. classification, and the age distribution was from 20 to 60 years. The following results were obtained. 1) Emotionally calm response was seen in 70% in the hydroxyzine 1 mg/kg (group 1), and in 93.3%, in the 2 mg/kg (group 2). 2) Mental alertness was seen in 86. 6% in group 1, and in 66. 6% in group 2. 3) Complications after premedication were chilling and shivering, hypertension, nausea, and headache, and were not serious. Therefore this premedication was satisfactory in most cases, especially in group 2.
Age Distribution ; Classification ; Headache ; Humans ; Hydroxyzine* ; Hypertension ; Nausea ; Premedication ; Shivering

Coronary artery disease is an ever-increasing problem to anesthesiologists as more patients with severe coronary artery are being accepted for surgery. Four cases of aortocoronary bypass graft procedure were done at Severance hospital. The procedure itself can result in perioperative myocardial infarction leading to death. Greater understanding of and constant attention to the myocardial oxygen supply and demand may reduce the incidence of perioperative myocardial infarction. Among the four patients, three tolerated the anesthesia and surgery well without gross pre and postoperative complications. However one patient developed hypotension in the recovery room and died 6 hours postoperatively, in spite of an intensive efforts at resuscitation. The problems, complications and precautions for anesthesia are discussed.
Anesthesia* ; Coronary Artery Bypass ; Coronary Artery Disease ; Coronary Vessels ; Humans ; Hypotension ; Incidence ; Myocardial Infarction ; Oxygen ; Postoperative Complications ; Recovery Room ; Resuscitation ; Transplants

Hexafluorenium was used to potentiat succinylcholine in 36 patients undergoing major surgery, mainly abdominal, of from 1/2 to 7 hours duration. Anesthesia consisted of thiopental-nitrous oxide-oxygen-ether or haIothane and ventilation was controlled. In a first group, succinylcholine was administered for intubaticn and repeated intermittently as required with a single dose of hexafluorenium after the intubating dose of succinylcholine had worn off. In a second group, succinylcholine was administered similary but hexafluorenium was also given intermittenly. In a third group, a single initial dose of hexafluorenium was given followed by succinylcholine intermittently. In a fourth group, both drugs were given intermittently throughout, 1) The apnea time of succinylcholine was prolonged about 8times after a single dose of hexafluorenium in the first and third groups but the prolongation was gradually lessened with successive doses of succinylchohne. Rut in second and fourth groups, the apnea times were significantly prolonged following successive dose of both drugs. 2) In third and fourth groups, fasieulation following succinylcholine was not observed and nausea, vomiting and muscle pains were not noted. 3) In recovery room, about 80% of patients could raise their heads by themselves but ether required longer recovery than halthane. 4) No bronchospasm or cardiovascular side effects were noted. It is considered that this drug combinations provides excellent relatation for surgery. The technique with a single dose of hexafluorenium seems particularlly suitable in cases which last from 30 minutes up to 2 or 3 hours and repeated doses of hexafluorenium and succinylchloin are advisable for longer major cases.
Anesthesia* ; Apnea ; Bronchial Spasm ; Drug Combinations ; Ether ; Head ; Humans ; Myalgia ; Nausea ; Recovery Room ; Relaxation* ; Succinylcholine ; Ventilation ; Vomiting

Transcutaneous oxygen and carbon dioxide tension (PtcO2 and PtcCO2) measured with a heated electrode was compared with arterial owygen and carbon dioxide tension (PaO2 and PaCO2) in 5 groups of 37 patients admitted to the Intensive Care Unit, Severance hospital, from October 1985 to February, 1986. The results were as follows 1) In the group I (6 neonate patients), the PtcO2 and PtcCO2 index was 0.89. 1.02. The relationship of the two method is given br the regreasion equation(in mmHg) : PaO2= 1.15 (PtcO2) +0.77(r: 0.86 P<0.001) PaCO2=0.87 (PtcCO2) +5.12(r: 0.91 P<0.001) 2) In the group 2(13 mpmsirgocal patients) the PtcO2 and PtCO2 index was 0.71, 1.03. The relationship of the two methods is given by the regression equation(in mmH7) : PaO2 = 1.42(7t707) -0.27 (r: 7.53 p<0.001) rac07=1.73 (7tc007) -7.43 (r: 0.74 p<0.001) 3) In the group 3(8 immediate postopen heart patients) PtCO2 index was 0.20, PtcCO2 index was 1.25. There was no correlation between PtcO2 and PaO2. The relationship of the two method is given by the regression equation(in mmHg) : PaCO2= 0.40(ftcCO2) +2l. 68(r: 0.60 p<0,005) 4) In the Group 4(9 postpen heart patient after extubation) PtCO2 & PtCO2 index was 0.60, 1.05, and the relationship of the two method is given by the regression equation (in mmHg): PaO2 =1.92 (PtcO2)+67.26 (r=0.68 P<0.001) 7aCO2=0.64 (PtcCO2)+14.87 (r=0.66 p<0.001) 5) In the group 5(COPD Patient) the Ptco2 and rtcc09 index was 0.84, 1.04. and th? relationship of the two method is given br the regression equation(in mmHg) PaO2 = 1,10 (PtcO2) +7.35 (r=0.81 p<0.001) PaCO2=0.52 (PtcCO2) +21.59 (r: 0.63 P<0.001) Continuous montiroing can reveal large fluctuations in PaO2 and PaCO2 which would be missed by the use of intermittent arterial samples. The transcutaneous electrode can be employed usefully in the neonate and hemodynamic-allr stable adult patient in Intensive Care Unit. However this method is not recommended to the patients in shock, immediate postoper-ative patient with peripheral vasoconstriction and poor perfusion.
Adult ; Blood Gas Monitoring, Transcutaneous ; Carbon Dioxide ; Electrodes ; Heart ; Hot Temperature ; Humans ; Infant, Newborn ; Intensive Care Units ; Oxygen ; Perfusion ; Shock ; Vasoconstriction

Trigeminal neuralgia has been treated in many ways, both medical and surgical. We wished to determine the efficancy of low frequency electrical acupuncture therapy for nine patients suffering from trigeminal neuralgia with Model 6,26 and G6805 Electrotherapeutic Apparatus. The results were as follows: (1)Initisl.beneficial during 1aw frequency electrical acupuncture therapy was recognized in a11 cases (2) Longterm.baneficial effect was seen in 77%, excluding 3 cases with no improvement. (3) Low frequency elactrical acupuncture therapy seemed to be valuable, preceding medical and .surgical treatment for acute trigemieal neuralgia.
Acupuncture Therapy ; Acupuncture* ; Humans ; Neuralgia ; Trigeminal Neuralgia*

Pain is as old as mankind and is one of the physiological defense mechanisms, but when it lasts long, it may be harmful. We decided to conduct an exploratory trial with nerve block and acupuncture for 134 patients referred to this clinic with chronic or intractable pain syndromes. We used Model 6.25 and G6805 Electrotherapeutic Apparatus for acupuncture therapy. The results were as follows: (1) Sex and age distribution: 64 were male, 79 were female and 91 patients were over 40 years of age. (2) Localigation of pain: Scapular and upper extemities in 53 among 143 patients. (3) Method of treatment: Nerve block 84, low frequency electrical acupuncture 92 and combined therapy in 3 patients. (4) Effect of treatment: 92% of various nerve blocks and 88% of low frequency electrical acupuncture therapy gave good results.
Acupuncture ; Acupuncture Therapy ; Age Distribution ; Defense Mechanisms ; Female ; Humans ; Male ; Nerve Block* ; Pain Clinics* ; Pain, Intractable

A 27 year-old male patient, who had cervical tracheal stenosis due to accidental inhalation of zinc dichloride gas, underwent tracheal reconstruction (tracheal resection and end to end anastomosis). Preoperatively, a special radiologic study (tracheography), pulmonary function tests and arterial blood gas analysis were performed for accurate diagnosis (to determine the location, degree and extent of the stricture) and to detect any associated abnormalities in the lung-function. Atropine and diazepam were given for premedication. After intramuscular injection of ketamine and succinylcholine, orotracheal intubation was done above the lesion, and N2O and halothane were added for maintenance of anesthesia. Respiration was assisted or controlled when necessary with gallamine. The lesion was approached through an anterior transverse cervical incision. The trachea. was dissected clear and transected distal to the lesion. The distal tracheal segment was then intubated through the operating field with a sterile cuffed endotracheal tube (the 2nd tube). This was connected to the anesthetic machine. After resection of the lesion and anastomosis. of the posterior tracheal wall, the 2nd tube was removed and orotracheal tube was pushed into the distal trachea. After complete anastomosis the orotracheal tube was placed above the suture line.Continuous arterial blood gas analysis during and after anesthesia was helpful for evaluation of the state of arterial blood oxygenation and ventilation.
Adult ; Anesthesia* ; Atropine ; Blood Gas Analysis ; Diagnosis ; Diazepam ; Gallamine Triethiodide ; Halothane ; Humans ; Inhalation ; Injections, Intramuscular ; Intubation ; Ketamine ; Male ; Oxygen ; Premedication ; Respiration ; Respiratory Function Tests ; Succinylcholine ; Sutures ; Trachea ; Tracheal Stenosis ; Ventilation ; Zinc