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A 28 year old man suffering from long-standing mitral stenosis with regurgitation received a mitral valve replacement using the Type 6310 Beall prosthetic valve. Total bypass lasted for 2 hours, during which period anesthesia was maintained with intermittent intravenous injections of small doses of morphine and d-tubocurarine. Toward the end of the operation, the patient was tracheotomized and required assisted respiration by a Bird Mark 7 respirator for 2 days. He regained consciousness immediately after the end of the operation, made a fairly uneventful recovery, and was discharged from the hospital on the 29th postoperative day. Literature was reviewed stressing special importance of maintaining adequate oxygenation, lightest possible anesthesia, adequate circulating blood volume, and of postoperative fluid and electrolyte balance. Early and late causes of deaths were also reviewed.
A 34 year old male patient underwent emergency operation of tracheal resection and primary end-to-end anastomosis to correct of tracheal stenosis following tracheostomy. On admission, a No. 3 Magill plastic Portex tracheostomy tube had been placed in the previous tracheostomy opening. Stenotic narrowing was noted 4 cm above carina. Despite of severe narrowing of the lesion, anesthetic course was uneventful with nitrous oxide, oxygen and halothane by controlled respiration and serial blood gas analyses. Postoperative courses were also favorable with adequate respiratory cares. It is mandatory to perform serial blood gas analyses for the management of corrective operation on tracheal stenosis.
This paper presents a manufacture of the multiple subjects biotelemetry system using custom CMOS IC fabricated 1.5,um n-well process technology. The implantable circuits of the system except sensor interface circuits including FM transmitter are fabricated on a single chip with the size of 4 x q mm. It is possible to assemble the implantable system in a hybrid package as small as 3 x 3 x 2.5cm by using this chip. It's main function is to enable continuous measurement simultaneously up to 7-channel physiological signals from the selected one among 8 subjects. Another features of this system are to enable continuous measurement of physiological signals, and to accomplish ON/OFF switching of an implanted battery by subject selection signal with command signal from the external circuit. If this system is coupled with another appropriate sensors in medical field, various physiological parameters such as pressure, pH and temperature are to be measured effectively in the near future.