The Clinical Study for Upper Respiratory Infection in Surgical Intensive Care Unit Patients with Tracheostomies / 대한마취과학회지

Infections that occur within the surgical intensive care unit represent a significant cause of patient morbidity and mortality. In addition, hospital-related infections prolong hospital stay and increase hospital-charges. Moreover for the patient with tracheostomy, the possibility of cross-infection may impose an added risk when the general condition is poor. This study was undertaken to investigate the incidence of upper respiratory infection in patients with tracheostomies who had respiratory care in the surgical intensive care unit. The total number of cases in this study was 20, and the specimens for bacteriologic culture were taken especially from the regions of the upper respiratory tract via tracheostomy tubes on the 1,3,5,7 and 10th day after tracheostomy. The results obtained from the bacteriologic culture were as follows: 1_ The most frequently found organism was Pscudomonas aeruginosa, and newxt was staphylococcus, followed by beta-hemolytic streptococcus and Escherichia coli. Gram negative bacilli were 58.9% of all cultured organisms. 2) The greatest number of organism was seen on the third day and frequency of mixed growth was increased in process of time. 3) The comparative sensitivity test of Pseudomonas seruginosa showed that all strains were resistant to ampicillin, erythromyclin, penicillin and tetracycline and 70% of strains were sensitive to amikacin.

Recovery of Respiratory Paralysis due to Tetradotoxin Poisoning / 대한마취과학회지

A 54 year old man who had taken puffer fish and noticed generalized weakness 1 hour and 30 minutes afterward was admitted to our I.C.U. due to respiratory arrest and cardiac arrhythmia. He was treated with artificial respiration via pressure cycled respirator, supportive therapy including frequent endotracheal suctioning. fluid administration, correction of acid base imbalance, change of position and antibiotics for prevention of secondary infection. 31 hours afterward, he resumed normal respiration and clear mentality. After 5 days of total admission days, he was discharged without any sequelae.

The Clinical Study of Liver function in Operative Patients / 대한마취과학회지

Since ether was first introduced in Boston in 1846, many kinds of anesthetic techniques and agents have been developed. At the same time, there have been many controversies about the side effects following the use of anesthetic agents and they are studied actively by many investigators at the present time. The author chose 355 patients randomly who had received elective operation at the Pusan National University Hospital from October 1980 to March 1981 and made a study of their preand post-operative liver function test. The patients were divided into 3 groups and 214 the patients belonging to group l were anesthetized with general anesthesia and group 2 comprising 118 patients had spinal anesthesia and brachial plexus block was used in the group 3 of 23 patients. The results obtained were as follows: 1) The male to female ratio was about 3 to 2 (209 cases: 146 cases) and age distribution showed a range from 20 to 50 years(210 cases). 2) Pre-operative liver function test of group 1,2, and 3 proved to be abnormal in 75 cases, 23 cases, 6 cases respectively. 3) In patients of group 1, halothane alone(54 cases) and halothane with nitrous oxide(111 cases) were the most commonly used anesthetics. 4) Post-operative checkup of liver function test of 10 patients who were randomly selected from each group and who had previously had normal liver functions, 4 cases of group 1 turned out to be abnormal, but patients in group 2, and 3 showed no significant abnormality in the post-operative liver function test. 5) Anesthesia aggravated liver dysfunction of the patients of group l who had abnormal liver function prior to operation, but it returned to the pre-operative level within 10 days after operation.

A Clinical Study on Geriatric Anesthesia / 대한마취과학회지

The authors analyzed 508 cases of geriatric anesthesia over 60 years of age out of 12, 153 cases of total anesthesia performed from January, 1970 to December, 1977 at our department of B.N.U.H. and the results were obtained as follows. 1) Of the total 12 153 cases508 cases (4. 2%) were over 60 years of age, and these were subdivided into 303 male(59.7%) and 205 female (40. 3%). 2) Among the 508 cases of geriatric patients, age distributions were 397 cases(78.2%) in the age group of 60-69,93(18.3%)in 70-79 and 18(3.5%) in over 80. 3) The techniques of anesthesia were 311 cases(61.0%) of general anesthesia, 188(37.2%) of spinal and 9(1.8%) of the combination of these two. 4) The anesthetics were halothane 182 cases(35. 8%), tetracaine 197(38. 8%), diethyl ether 78(15. 4%), nitrous oxide 34(6. 7%) and methoxyflurane 17(3. 3%). 5) In the section of surgery, 190 cases(37.4%) were General Surgery, 116(22.8) Urology, 53(10. 4%) OrthOpedic Sulgery, alld 42(8. 3%) Ophthalmology in order of numbers. 6) For the duration of anesthesia, 334 cases(65. 8%) were in 1 to 3 hours, 70(13. 8%) within 4 hours, 56(11. 0%) within 1 hour and 48(9. 4%) over 4 hours. 7) Operation on head-neck were 122 cases(24. 0%) chest-upper abdomen 150(29. 5%), lower abdomen 104(20.5%), perineum 81(15. 9%) and extremities 51(10.1%). 8) Elective operations(327 cases, 64.4%) versus emergency(181 cases, 35.6%) was about 1.8: 1.