BACKGROUND: With respect to the risk of developing diabetic vascular complications, the central purpose of most screening and detection program, is to identify people with diabetes at early stage so they might have advantages of early treatment to prevent complication of the disease. Oral glucose tolerence test(OGTT) is widely used for diagnosis of diabetes and impaired glucose tolerence, bit the performance of a complete OGTT is not only time consuming and expensive but physically demanding on the individual being tested. Determination of HbA1 and more recently of glycosylated total serum proteins(fructosamine) has been proposed as an alternative method of screening and diagnosis. The aim of our cross-sectional study is to compare the values of fructosamine and HbA1, for the ourpose of diabetes diagnosis with the OGTT as reference method. METHODS: In the study, from January 1996 to August 1996, we included 55 consecutive subjects in Kyeungssang Hospital. Blood samples for HbA1 and fructosamone determination were drawn at the same time as a fasting plasma glucose sample, and then all subjects underwent a standard 2-hour OGTT according to the World Health Organization recom-mandations, The subjects were classified according to the American Diabetes Association classification. RESULTS: In our study, we observed fasting plasma glucose of 145.32+/-75.00mg/deciliter, two-hour plasma glucose of 245.83+/-155.22mg/deciliter, HbA1 of 7.06+/-2.77%, and fructosamine of 308.77+/-128.23 micromol/liter. The correlation coefficient between FPG and HbA1 was 0.9098(p<.05), between FPG and fructosamine 0.7953(p Blood Glucose ; Classification ; Cross-Sectional Studies ; Diabetic Angiopathies ; Diagnosis* ; Diagnostic Tests, Routine ; Fasting ; Fructosamine* ; Glucose ; Glucose Tolerance Test ; Hemoglobin A, Glycosylated* ; Mass Screening ; ROC Curve ; World Health Organization

No abstract available.

We have experienced early extubation after 20 consecutive open heart surgeries for congenital heart disease between May 19 th and May 30 th this year. Eighteen of those 20 had the tracheal tube removed in the operating room immediately after operation. The reanlts were good and satisfactory. Two required postoperative ventilatory support for several hours at RICU. Sufentanil (Sufenta) 10-15 ug/kg was used intravenously as a major narcotic anesthetic for 18 podiatric patients and Fentanyl 50 ug/kg used for 2 adult Patients. The advantages of early extubation are as follows ; It is more physiologic, more comfortable, psychologically leas anxiety provoking for the patients and has less chance of pulmonary infection and less chance of ventilator mishaps arid it also shortens RICU stay and hospitalization. It is concluded that early extubation after open heart surgery for congenital heart disease has minimal risk and definite advantages in carefully selected patients.
Adult ; Anxiety ; Fentanyl ; Heart Defects, Congenital ; Heart Diseases* ; Heart* ; Hospitalization ; Humans ; Operating Rooms ; Sufentanil ; Thoracic Surgery* ; Ventilators, Mechanical

Subclavian vein catheterization is a well estab1ished technique in adults for central venous pressure monitoring and the infusion of irritant solutions. Its use in small children is less common, preaumably because of technical difficulties in inserting the catheter and the disk of major complications. During cardiac surgery heparinization potentially adds to the risk of hematoma forma-tion. But it is often preferred becauae of the greater stability of the catheter on the anterior chest wall and allows a greater freedom of the neck and upper limb movement. We have experienced 62 open heart surgeries for congenital heart disease between April 14th and Oecember 31th 1986. In 47 children ranging in age from 11 months to 15 years, there was a high succes rate and no morbidity. It is concluded that infraclavicular subclavian vein catheterization is a useful means of measuring central venous presaure and establishing a central infusion line in children undergoing open heart surgery.
Adult ; Catheterization ; Catheters ; Central Venous Pressure ; Child* ; Freedom ; Heart ; Heart Defects, Congenital ; Hematoma ; Heparin ; Humans ; Neck ; Subclavian Vein* ; Thoracic Surgery* ; Thoracic Wall ; Upper Extremity

No abstract available.
Female ; Pregnancy ; Pregnancy, Ectopic*

Due to the lowering of biological functions resulted from old age, the elderly is known to have many different clinical laboratory data compared with the young adults. But, in korea, such study is lacking. This research is to find the differences between the elderly and the young adults, and also to know the sexual differences, by comparing the outcomes of the clinical laboratory data. Along with that, it is to help clinical usage of the data in the future. The age of the elderly was between 60 and 83(average age 63.8), and that of the young controls was between 20 and 35. In both sexes, MCV, MCH, ESR, CRP,AST, ALT, gamma GTP, ALP, BUN, total cholesterol were significantly higher in the elderly than in the controls. And lymphocyte count(%), total bilirubin, direct bilirubin, total protein, albumin, T3 were significantly lower in the elderly than in the controls(P<0.05). Hemoglobin, Hct, platelet count, T4 were significantly lower only in the male elderly, and eosinophil count(%), creatinine were significantly higher only in the female elderly(P<0.05). HDLcholesterol was significantly higher only in the male elderly(P<0.01). There were no significant difference between two groups regarding WBCcount, segment neutrophil count(%), monocyte count(%), TSH. Many clinical laboratory data are different between the elderly and the young adults, and some clinical laboratory data also have sexual differences.
Aged* ; Bilirubin ; Cholesterol ; Creatinine ; Eosinophils ; Female ; Guanosine Triphosphate ; Humans ; Korea ; Lymphocytes ; Male ; Monocytes ; Neutrophils ; Platelet Count ; Young Adult*

Anesthesia for the patients with mediastinal mass may be associated with significant respiratory and cardiovaacular complications due to compression of traeheobronchial trees, the pulmonary artery, heart and superior vena cava The authors present a case of a 6-year-old girl with a large mediastinal tumor located in anterior and superior mediaetinum. Preoperatively, the patient was asymptomatic and anesthesia was induced and maintained uneventfully. Operative finding was that 8 X 14 cm sized hemangioma was extended superiorly over thoracic outlet, posteriorly aorta and SVC, medially pericardium and right hilum and inferiorly right upper lung and pleura. Because difficulties in removal of the hemangioma were expected, exploratory thoracotomy was discontinued. On emergence, as soon as the patient was extubated due to irritability, the patient became cyanotic and was noticed bulging mass on right supraclavicular area, Intubation was attempted and during direct laryngoscopy, anesthesiologist also noticed a bulging mass in right oral cavity. Postoperatively, the patients airway was kept with endotracheal tube, but cyanosis appeared on the face and skin over the chest, but not below the abdomen. Bulging mass on right supraclavicular area, distension of neck vein and conjunctival edema were noticed only when the patient was crying or suctioned. Symptoms improved by deep sedation. We assumed that enlargement of hemangioma due to increased central blood volume occasionally compressed tracheobronchial tree and sup. vena cava when patient was irritable, crying and coughing. On 11th postoperative day, patient was transferred to the another hospital for the better treatment with endotracheal intubation.
Abdomen ; Airway Obstruction* ; Anesthesia ; Aorta ; Blood Volume ; Child ; Cough ; Crying ; Cyanosis ; Deep Sedation ; Edema ; Female ; Heart ; Hemangioma ; Humans ; Intubation ; Intubation, Intratracheal ; Laryngoscopy ; Lung ; Mouth ; Neck ; Pericardium ; Pleura ; Pulmonary Artery ; Skin ; Suction ; Thoracotomy ; Thorax ; Veins ; Vena Cava, Superior

BACKGROUND: It is difficult to manage intractable pain from advanced carcinoma of the upper abdomen. One method used to control pain associated with these malignancies is to block the splanchnic nerve. We investigated that VAS (visual analogue scale) difference before and after splanchnic nerve block (SNB) and pain relief day. Also we studied relationship between VAS before SNB and pain relief day. METHODS: A rewiew of 70 patients who took splanchnic nerve block (SNB) from September 1994 to February 1998 was carried out to assess age, sex, primary diseases, pain sites, VAS before and after SNB, date of diagnosis, date of SNB, date of death and pain relief day, etc. RESULTS: Of 70 patients, 44 were males and the remaining 26 were females. The causes of pain were stomach cancer 28 (40%), pancreatic cancer 18 (25%), gall bladder cancer 7 (10%), hepatoma 6 (8.6%) respcectively. Average day from diagnosis to SNB was 272 and average day from diagnosis to death was 341. So, patients died on the average 69 days after they took the splanchnic nerve block in pain clinic. VAS average before SNB was 8.01 and VAS average after SNB was 3.64. Patients felt pain relief during 35 days after SNB. Pain relief day of patients who had lower VAS before SNB was longer than that of patients who had higher VAS before SNB. CONCLUSION: Early application of splanchnic nerve block will make the patients endure the cancer pain more easily.
Abdomen ; Carcinoma, Hepatocellular ; Diagnosis ; Female ; Gallbladder Neoplasms ; Humans ; Male ; Pain Clinics ; Pain, Intractable ; Pancreatic Neoplasms ; Splanchnic Nerves* ; Stomach Neoplasms

Pain is a sensory experience that is subjective and individual. It frequently exceeds its protective function and becomes destructive. We have met one case of causalgia, three cases of Buergers disease, and one case of arteriosclerosis obliterance. They sufferred from persistent pain and exkausted with the marked distrophy of affected limbs. Management of these patient involving lower limbs is a continuing challenge. Many other therapheutic procedures could be tried for these patients, but we tried chemical lumbar sympathectomy for these cases. With respect to the lower extremity, four patients had neurolysis of the 1st, 2nd and 3rd ipsilateral or 2nd and 3rd bilateral lumbar ganglia using 3 to 5 ml pure alcohol for each space under the image intensifier. Immediately after these procedure, rest pain has relieved dramatically in most cases and marked skin temperature rising. This implied increased peripheral blood flow of sympathectomised portion and the relief of rest pain is probably explained by destrcution of the afferent pain fibres running with the sympathetic trunk.
Arteriosclerosis ; Causalgia ; Extremities ; Ganglia ; Humans ; Lower Extremity ; Running ; Skin Temperature ; Sympathectomy* ; Thromboangiitis Obliterans

Patients with chronic renal failure, generally, sufferred from normocytic normochromic anemia caused by decreased level of erythropoietin. But, secondary erythrocytosis has been reported in patients with several renal diseases; renal artery stenosis or throm- bosis, polycystic kidney disease, bilateral hydronephrosis, etc. We report one case of chronic renal failure combined with polycythemia vera. The case was 32 year-old man whose chief complaints were dyspnea, back pain, itching sensation, headache. 6 month ago, the laboratory examination showed only proteinuria and hematuria without deterioration of renal function. The renal function was aggravated with an accelerated course, and bone marrow examination revealed hypercellularity (erythroid predominance), and renal biopsy showed the finding of the end stage of renal disease which may be originated from IgA nephropathy.
Adult ; Anemia ; Back Pain ; Biopsy ; Bone Marrow Examination ; Dyspnea ; Erythropoietin ; Glomerulonephritis, IGA* ; Headache ; Hematuria ; Humans ; Hydronephrosis ; Immunoglobulin A* ; Kidney Failure, Chronic* ; Polycystic Kidney Diseases ; Polycythemia Vera* ; Polycythemia* ; Proteinuria ; Pruritus ; Renal Artery Obstruction ; Sensation