A 2 year 9 month old boy was treated for a long time with a diagnosis of pneumonis. A biopsy of the neck mass performed under endotracheal anesthesia for 70 minutes. He was moved to the recovery room with an endotracheal tube, 50 min. later, cardiac arrest suddenly developed and was not resuscitated. Autopsy findings showed lymphosarcoma of the left lung with metastasis to the neck, liver and splsen, and a bilateral atypical pneunomia with left pleural malignant efficusion producing about 500ml. possible causes of death and the prevention are discussed.
Anesthesia* ; Autopsy ; Biopsy ; Cause of Death ; Diagnosis ; Heart Arrest ; Humans ; Infant ; Liver ; Lung* ; Lymphoma, Non-Hodgkin ; Male ; Neck ; Neoplasm Metastasis ; Recovery Room

A total of 6043 surgical cases were performed at S.D.A. Hospital from 1973 to 1979. These were analyzed statistically according to yearly numbers and emergency states, age, sex, anesthetic methods, anesthetic technique, duration of anesthesia, anesthetic agents and mortality. These were all inpatients operated under general anesthesia, and the results are as follows. Results. 1) Yearly numbers and emergency numbers were steadily increasing. 2) Sex ratio was 65%: 35% 2887 male cases(47.7%) and 5156 female cases(52.23%). 3) More than half of the age group was adult(21 to 60 years) 4) Halothane, nitrous oxide and neuromuscular blocker were used with increasing tendency. 5) The anesthetic technique was, in more than 90% of cases, was circle absorption system. 6) General surgery cases were 40% of the total of all departments. 7) In 66.95% of anesthesias the duration was 1 to 3 hours. 8) General anesthesia group was 98.63%. 9) Deathe occurred in 6 cases our of a total of 6043 cases.
Absorption ; Anesthesia* ; Anesthesia, General ; Anesthetics ; Emergencies ; Female ; Halothane ; Humans ; Inpatients ; Male ; Mortality ; Neuromuscular Blockade ; Nitrous Oxide ; Sex Ratio

This report is concerned with our clinical experience of 40 cases of anesthesia for open heart surgery at the Department of Anesthesiology, Seoul Adventist hospital during the period between July, 1988 and May, 1990. The results were as follows: 1) Among the 40 cases, 16 cases were congenital heart disease and 24 cases were acguired heart disease. 13 cases were male and 27 were female, Age was varied from 4 years to 71 years and mean was 33.2 years. 2) Morphine and glycopyrrolate were used as premedicants. 3) Thiopental, morphine and fentanly were used as induction agents, were injected singly or in combination. 4) Morphine, fentanyl and N2O were used as anesthetic agents in conjunction with halothane or enflurane. 5) Succinylcholine, vecuronium and pancuronium were used for intubation and maintenance of muscle relaxation. 6) The duration of eardiopulmonary bypass, aortic cross clamp, surgery and anesthesia in acquired heart disease were longer than in congenital heart disease, 7) Overall the mortality rate was 5% and the cause of death were air embolism and respiratory failue.
Anesthesia* ; Anesthesiology ; Anesthetics ; Cause of Death ; Embolism, Air ; Enflurane ; Female ; Fentanyl ; Glycopyrrolate ; Halothane ; Heart Defects, Congenital ; Heart Diseases ; Heart* ; Humans ; Intubation ; Male ; Morphine ; Mortality ; Muscle Relaxation ; Pancuronium ; Seoul ; Succinylcholine ; Thiopental ; Thoracic Surgery* ; Vecuronium Bromide

The aim of this study was to investigate the efficacy of simvastatin to improved lipid profiles in hypercholesterolemic Korean patients. METHODS: From 25 hospitals in Korea, 478 hypercholesterolemic patients were enrolled from November 1996 to April 1998. The inclusion criteria was hypercholesterolemia over 240 mg/dl after diet therapy for 1 month or hypercholesterolemia over 220 mg/dl in patients with definite evidence of ischemic heart disease. Simvastatin 10mg was started and doubled up to 40mg if total cholesterol level remained higher than 200 mg/dl at monthly check. Of 478 subjects, 344 patients in whom study protocol was not violated were analyzed. RESULTS: Male to female ratio was 27:73 and 47% of the subjects were in 6th decade. Hypertension, coronary artery disease, and diabetes mellitus were present in 30, 10, and 4% of the subjects. Baseline lipid profile (mean of total cholesterol-LDL-HDL-triglyceride mg/dl) was 274-185-52-188. The dose of simvastatin for 3 months was 10/10/10mg in 61% of subjects, 10/20/20mg in 21%, 10/10/20mg in 7%, and 10/20/40mg in 12%. The change of total cholesterol level(before-4wk-8wk-12wk-withdrawal 4wk) was 274-209- 205-198-250, and the maximal reduction rate was 27%. The change of LDL-cholesterol was 185-123-116-110-159, with maximal reduction rate 39%. The change of HDL-cholesterol was 52-54-56-55-54, with maximal increase rate 9%. The change of tryglyceride was 188-161- 164-162-189, with maximal reduction rate 15%. The value before/after treatment of ApoA1, ApoB, and Lp(a) was 129/129, 138/83, and 9.3/10.7, respectively. The level of LDL-cholesterol at the end of treatment was below 100mg/dl in 36% of subjects, 100-130 in 45%, 130-160 in 16%, and over 160mg/dl in 4%. The reduction rate of LDL-cholesterol was different between subjects whose LDL decreased below 100 and those whose LDL did not decrease below 130mg/dl, which suggests the existence of the individual difference of responsiveness to simvastatin. There were only 3 subjects (0.9%) who showed increase of liver enzyme over 3 times as the upper normal limit. Conclusion: Simvastatin is effective in improving lipid profiles in hypercholesterolemic Korean patients without serious side effects.
Apolipoproteins B ; Cholesterol ; Coronary Artery Disease ; Diabetes Mellitus ; Diet Therapy ; Female ; Humans ; Hypercholesterolemia ; Hypertension ; Individuality ; Korea ; Liver ; Male ; Myocardial Ischemia ; Simvastatin*

The aim of this study was to investigate the efficacy of simvastatin to improved lipid profiles in hypercholesterolemic Korean patients. METHODS: From 25 hospitals in Korea, 478 hypercholesterolemic patients were enrolled from November 1996 to April 1998. The inclusion criteria was hypercholesterolemia over 240 mg/dl after diet therapy for 1 month or hypercholesterolemia over 220 mg/dl in patients with definite evidence of ischemic heart disease. Simvastatin 10mg was started and doubled up to 40mg if total cholesterol level remained higher than 200 mg/dl at monthly check. Of 478 subjects, 344 patients in whom study protocol was not violated were analyzed. RESULTS: Male to female ratio was 27:73 and 47% of the subjects were in 6th decade. Hypertension, coronary artery disease, and diabetes mellitus were present in 30, 10, and 4% of the subjects. Baseline lipid profile (mean of total cholesterol-LDL-HDL-triglyceride mg/dl) was 274-185-52-188. The dose of simvastatin for 3 months was 10/10/10mg in 61% of subjects, 10/20/20mg in 21%, 10/10/20mg in 7%, and 10/20/40mg in 12%. The change of total cholesterol level(before-4wk-8wk-12wk-withdrawal 4wk) was 274-209- 205-198-250, and the maximal reduction rate was 27%. The change of LDL-cholesterol was 185-123-116-110-159, with maximal reduction rate 39%. The change of HDL-cholesterol was 52-54-56-55-54, with maximal increase rate 9%. The change of tryglyceride was 188-161- 164-162-189, with maximal reduction rate 15%. The value before/after treatment of ApoA1, ApoB, and Lp(a) was 129/129, 138/83, and 9.3/10.7, respectively. The level of LDL-cholesterol at the end of treatment was below 100mg/dl in 36% of subjects, 100-130 in 45%, 130-160 in 16%, and over 160mg/dl in 4%. The reduction rate of LDL-cholesterol was different between subjects whose LDL decreased below 100 and those whose LDL did not decrease below 130mg/dl, which suggests the existence of the individual difference of responsiveness to simvastatin. There were only 3 subjects (0.9%) who showed increase of liver enzyme over 3 times as the upper normal limit. Conclusion: Simvastatin is effective in improving lipid profiles in hypercholesterolemic Korean patients without serious side effects.
Apolipoproteins B ; Cholesterol ; Coronary Artery Disease ; Diabetes Mellitus ; Diet Therapy ; Female ; Humans ; Hypercholesterolemia ; Hypertension ; Individuality ; Korea ; Liver ; Male ; Myocardial Ischemia ; Simvastatin*