Surgical Management of Multiple Aneurysms Including Distal Anterior Cerebral Artery Aneurysms / 대한뇌혈관학회지

OBJECTIVE: The goal of this study is to evaluate the surgical outcome of multiple aneurysms including distal anterior cerebral artery (DACA) aneurysms. MATERIAL AND METHOD: From May 1989 to March 2000, 12 patients with multiple aneurysms including DACA aneurysms, presented with subarachnoid hemorrhage, had been surgically treated. Their medial record and radiological studies were studied retrospectively. Of 12 patients, in 5 patients, all of the aneurysms were clipped through a single craniotomy extended from midline to pterion in one stage, in 5 patients, multiple aneurysms were treated through separate craniotomies in one stage and 2 patients were treated in staged operation. RESULTS: Two patients showed Glasgow Outcome Scale (GOS) 5-4, 2 patients showed GOS 3-2 and 1 patient showed GOS 1 in 5 patients treated through a single craniotomy in one stage, 2 patients showed GOS 5-4 and 3 patients showed GOS 3-2. All patients treated in staged operation showed favorable outcome. CONCLUSION: In surgical management of multiple aneurysms including DACA aneurysms surgery through separate bony windows in two stages seemed to show more favorable outcome.

Cadaveric Kidney Transplantation / 대한마취과학회지

Recently, with the help of medical development which is able artificially to control respiration, circulation, nutrition and excretion, human beings may still survive in spite of brain death. We have had experience with the first case of cadaveric kidney transplantation in Korea. Because the prognosis of kidney transplantation is relatively good in comparison to the five-year survival rate of cancer patients and because postoperative rehabilitation is fair, nowadays kidney transplantation is popular. With the limitations of confluent acceptance and supplimental functioning together of the living kidney, cadaveric kidney transplantation has been preferred, although several problems still exist. We have used the conventional method to maintain the cadaver donor's life after clarification of death. As soon as brain death was confirmed on EEG monitoring, then an artificial respirator was applied to the tracheotomy site, adequate urinary excretion was maintained and infection prevented. At the same time, the HL-A(human lymphocyte-antigen) compatibility test and ABO blood matching had to be performed before anesthesia. The patient's intraoperative and postoperative course was satisfactory and he now has no problems of physical or social activity. However cadaveric kidney transplantation is in the early phase in Korea, and therefore further improvement is needed, and several problems should be solved. We hope many cadaveric kidney transplantations will be performed.

Changes of Blood Gases during Halothane-N2O-O2 Anesthesia / 대한마취과학회지

This study was designed to investigate the ranges of pH, PaO2 PaCO2, and SaO2, before and during halothane-N2O-O2-pancuronium anesthesia under controlled ventilation (Vr: 500-600ml, f: 18-20/min). For the study, 25 surgical patients were selected with physical status ASA class l and ll and age ranging from 20 to 60 years. Samples of arterial and venous blood were collected before and during anesthesia, and sent for immediate gas analysis. The arterial blood gas samples before and during anesthesia revealed values within normal limits. After testing, we were able to control the blood gas patterns by ventilation to produce ideal conditions for patients undergoing anesthesia.