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25 Patients were received major spinal surgeries at main operating theater of Kangnam General Hospital from May 1990 to December 1990 by using the Haemonetics cell saver which was employed as an intraoperative blood salvage and autologous blood transfuser . The products of washed red blood cells were an average of 1490 cc packed RBC per case. Under the Light Microscopy, Washed RBC disclosed the morphologies of normal RBC size and shape. Fragmented RBCs or cell debris were not found and in one case agglutinated and denaturated RBCs were seen. While 20 patients were received spinal surgery prior to the untilization of cell saver, an average of 7.85 units of banked whole blood was transfused compared with 5.55 units in the cases of using the cell saver (p<0.05). Homologous banked blood utilization during spinal surgery declined more than 30% with the use of the cell saver. There was no evidence of infection, renal and/or hepatic failure related to the use of the cell saver. Haemonetics cell saver appeared to be safe, efficient and more over in some instanes life saving.
The journal of the Korean Society of Anesthesiologists was first Published in November 1968. It has been growing rapidly in quality as well as in quantity for the past 15 years. It now has an accumulation of 700 articles coming from many different fields on a wide variety of subjects. To develop further our Korean Anesthesia Society in conjunction with this journal, it is time to classify our experiences and knowledge in a convenient way to use these articles as a reference. Therefore, it has been decided to classify the 700 articles according to the subject material and these have a permanent record of this expressed opnions in these journals for ready reference in the future.
One of the characteristics that can predict the cariostatic effect of dental pit and fissure sealants is wear resistance of the material, and those for the expectation of the retention rate is the bond strength to enamel. Although the Bis-GMA resin based sealants are widely used, their mechanical properties are lower than those of composite filling resins because of lower cross-linking of the material. After incorporation of filler to the resin sealant, almost all the mechanical properties are improved except tensile strength. Incorporation of filler also results in higher abrasion resistance, and easy discrimination of the sealant. However there are a few reports on the mechanical properties and bond strength of sealant after incorporation of various amount of filler to the same resin for sealant. The purpose of this study was to determine the bond characteristics to enamel and the biaxial fracture strength of dental pit and fissure sealants after incorporation of various amount of glass fillers to the same unfilled resin sealant. Light cured pit and fissure sealants(CO and TM) were used as controls. Glass filler was incorporated in the chemically cures resin sealant(HP) with the ratio of 10, 30 and 50 wt.%, and was used as experimental groups, Two types of fillers, silane-coated and not coated, were used. For bonding test, flat enamel surface was made on sound premolar tooth by grinding with #600 silicone carbide paper. This surface was ached with 37% phosphoric acid for 30 second, and sealant filled gelatin capsule(3㎜ diameter) was attached to this surface. After immersion in 37% distilled water for 24 hours, shear bond properties were measured with a universal testing machine(Zwick 020, Germany) with the cross-head speed of 1㎜/min. From the lid-deflection calve obtained, shear bond strength, displacement at bond failure and elastic modules ratio was calculated. For biaxial fracture strength test, diameter of 10㎜ and thickness of 2㎜ specimens were made with the same materials as in bonding test. After immersion in 37℃ distilled water for 24 hours, biaxial fracture properties were measured with a universal testing machine(Zwick 020, Germany) with the cross-head speed of 0.5㎜/min. From this experiment, the following results were obtained. 1. The shear bond strength of unfilled HP to enamel surface was 13.870㎫, and those after filler incorporation were 18.956-19.684㎫. 2. The shear bond strength to enamel surface increased significantly after incorporation of filler with the ratio of 10, 30 and 50 wt.%(p<0.05), and the incorporation ratio did not influence on the shear bond strength(p>0.05). Silane treatment of the filler did not influenced on the shear bond strength(p>0.05). 3. The biaxial fracture strength of TM was 170.69㎫, and this was significantly higher than that of unfilled HP(p<0.05). Incorporation of the filler with the ratio of 10, 30 and 50 wt.% resulted in significantly lower biaxial fracture strength compared with that of unfilled HP(p<0.05). 4. In HP with the incorporation of filler 10 or 30 wt.% group, the biaxial fracture strength of silane coated and not-coated filler group was significantly different(p<0.05).
Cervical epidural block can be useful in the management of acute and chronic pain of the head, neck, shoulder, and arm, for selected patients. In spite of the widespread use of cervical epidural blocks for pain, there is limited published data on the specific technique and complications regarding the procedure. High levels of epidu- ral block do not appear to be associated with clinically significant circulatory or ventilatory changes unless the concentrations of local anesthetics used are great enough to produce paral- ysis of intercostal and phrenic nerves. However, high level of epidural block is associated with sympathetic block whieh may affect responses of circulatory and ventilatory systems. Accord- ingly, the possibility of major complications of cervical epidural block must be borne in mind. We experienced two cases of respiratory arrest during cervical epidural block with bupivacaine. This is a report regarding complications of cervical epidural block.
Background: This study examined hemodynamic variables, oxygen delivery, extraction, and consumption in response to acute progressive hypoxia and hypercarbia in the setting of apnea. Methods : Apnea was induced in 9 healthy mongrel dogs by disconnecting animals from mechanical ventilation of 30 minutes with pure oxygen. Hemodynamic variables, oxygen transport, extraction, and consumption were rapidly and repeatedly measured using pulmonary arterial and arterial catheters until cardiac output was undetectable. Results : The baseline PaO2, PaCO2, pH, base excess were 318±137 mm Hg, 36±3.5 mm Hg, 7.30±0.06, 6.81±2.65 mmol/l respectively. Hypercarbia and hypoxemia(76±33 mm Hg) was first noted at 1 and 4 minute respectively. Base excess was not changed. Indices of preload(PCWP and CVP) were increased early in the time course(P<0.05). In contrast, indices of afterload(SVR) increased later, just before cardiac decompensation began(P<0.05). No significant reduction of cardiac output, oxygen delivery, extractd consumption was detected just until abrupt cardiac decompensation started, 5 minute. Conclusions : These data suggest that the early increase in preload was primarily due to hypercarbia whereas the late increase in afterload was due to hypoxemia, but the main cause of acute cardiac decompensation was a critical decrease in arterial oxygen tension with some contribution of increased preload and afterload. (Korean J Anesthesiol 1997; 33: 1020∼1028)
This is a case report of massive hydrohemothorax as a complication of central venous pressure catheterization. This 54 year old male with bladder tumor was anesthetized for surgery of ileal conduit with cystectomy and then a right subclavian vein catheterization was performed, with a supraclavicular approach. Intravenous fluid runned rapidly through G.V.P cathear but no obvious signs of abnormality in the system of C.V.P. catheterization were noted exeept mild hypotension, tachycardia and gradual increase of C.V.P. during the whole prccedure of this operation. The patient had become cyanotic and difficult in respiratio postoperatively, therefore chest X-ray was taken in I.C.U, that showed a massive hydrohemothorax on the side of CV.P. catheter in place. We consequently found that the catheter was misplaced to the right pleural space. About 4500cc of bloody fluid was aspirated with closed thoracotomy and the chest tube was removed 2 days after thoracotomy. Since then all symptoms had been subsided.