Comparison of Liqui-PREP(TM) and Conventional Preparations in Thyroid Fine Needle Aspiration

BACKGROUND: Liqui-PREP(TM) (LP) is a new liquid-based cytologic preparation that produces a thin layer of cells. METHODS: Thyroid aspirates were obtained from 189 patients and divided to prepare pairs of conventional preparation (CP) and LP slides. The CP slides were routinely diagnosed by attending staffs and classified into the six categories. LP slides were independently evaluated by three cytopathologists and classified in an identical manner. Agreements between CP and LP diagnoses were investigated and interobserver variability of thyroid aspiration cytology results obtained using the LP method was determined using kappa values. RESULTS: CP and LP slides from 155 patients (83%) were identically classified by all of three cytopathologists. Concurrences between CP and LP diagnoses for the three cytopathologists were 89% (kappa=0.78), 92% (kappa=0.87), and 85% (kappa=0.70), respectively. Interobserver agreement among the three cytopathologists for LP slides ranged from substantial to almost perfect (kappa=0.84, 0.74 and 0.84). However, a lack of interobserver agreement was found for LP slides of the undetermined category as determined by original CP-based diagnoses. Moreover, cytomorphological alterations in the benign category appeared more worrisome for LP slides. CONCLUSIONS: An awareness of the novel cytomorphologic changes induced by the LP method is needed to avoid misinterpretations.

Production of monoclona antibody to infectious bursal disease virus as a diagnostic methods

No abstract available.

Clinical Investigation of Hemodynamic Changes during Anesthesia for Cesarean Section in Patients with Kyphoscoliosis / 대한마취과학회지

Kyphoscoliosis is a disease manifested as lateral curvature of spine and accompanying rotation of the vertebrae, resulting in distortion of rib cage. A curve greater than 40 degrees in considerd to be severe and most likely to be associated with physiologic derangements in cardiac and pulmonary function. Restrictive lung disease and pulmonary hypertension progressing to cor pulmonale are the major causes of mortality in patients with kyphoscoliosis. However, pregnancy itself increases cardiac output and circulating blood volume, and decreases total lung capacity due to enlarged uterus. So tidal volume is increased in pregnant women to compensate. But in kyphoscoliosis patients pulmonary fucntion is already impaired and cardiovascular reserve is minimal. So there is increasing tendency in actue cor pulmonale. Recently we experienced a case of cesarean section in patient with kyphoscoliosis, and observed severe hemodynamic changes especially in pulmonary capillary wedge pressure and cardiac output. And we investigated 7 cases of cesarean section of patients with kyposcoliosis.

Scheduling and Auditing of Anesthetic Record using Personal Computer / 대한마취과학회지

Now, in the 1980s computer literacy is an integral part of education. This is a result of both normal cultural evolution and revolutionary technical advances which have greatly deereased the cost of computers and made them for far easier to use and understand. Accordingly, the possible application for the anesthetist are varied and range from educational game to sophiscated servo control of vital signs. The following is an experience of application program named AMS(Anesthetic Management System). The AMS is for scheduling and auditing of anesthetic record. The usage is simple and accurate but have some problems including lack of uniformity in data input especially type of anesthesia and anesthetic agent used. Authors expect the better programs which can be used in risk analysis in anesthsiology will be developed.

Intraoperative Thrombelastographic ( TEG ) Monitoring and Treatment of Massive Transfused Patients / 대한마취과학회지

We have 3 more cases of experiences of massive transfusion undergoing hepatobiliary surgery above 20 units of whole blood, packed RBCs, FFP or cryoprecipitate under thrombelastographic guidance and monitoring intraoperatively. One of them had been transfused with 98 units of whole blood and 16 units of PRBC during a couple of times operation without any post-massive transfused pulmonary complications. TEG was originally developed by Hartert in 1948 but its clinical use has been limited. Recently as increases of severe and persistent coagulopathy that accompanies end-stage liver diseases and leads to massive intraoperatve bleeding, minute-to-minute monitoring of the coagulation system is mandatory for successful completion of surgery and for patient survival. Under the condition of our clinical experiences TEG appears to be a very effective method of monitoring blood coagulation. First, blood coagulabilty can be observed rapidly and simply in acute clinical situations within 30 minutes. Second, it assesses the quality of blood clot including the influence of cellular and humoral elements and pathologic conditions. The last, under the reliable guidance of TEG we could facilitate the segmental blood transfusion rather than using whole blood intraoperatively and it is to be a moment of the development of PRBC transfusion set by Kim et al.

On Anesthesia for Burned Patients(I): Clinical analysis of anesthesia for burned patients during recent 3 years / 대한마취과학회지

We analyzed 560 cases of anesthesia for burned patients from January 1986 to December 1983 after establishment of burn center in Hangang Sacred Heart Hospital. The results were as follws; 1) The number of patients was 121 in 1986, 203 in 1987 and 236 in 1988. 2) Among 560 cases, 411 (73.4%) cases were male and the most common age group was under 10-year-old (181 cases, 32.4%). 3) Most frequent surgical procedure was skin graft (453 cases 80.9%) and early escharectomy was increased. 4) Inhalation anesthesia was 496 cases (88.6%) and intravenous anesthesia was decreased (16.5% in 1986 and 0.4%, in 1988). 5) The duration of anesthesia was 2.5+/-1.61 hours in 1986, 2.6+/-1.20 hours and 1.5+/-0.89 hours in 1988. It was shortened respectively. 6) Flame burn was the most common cause of burn (65.9%) and the patient with 30-40% burned surface area were most frequent (22.1%).

Fixation of Epidural Catheters using Blood Set - Report of 120 cases / 대한마취과학회지

Secure fixation is essential for continous epidural catheterization on a long-term-basis. Adhesive tape or surgical knots were commonly used for those patients, but the surgical knot method has a tendency to cause strangulation of catheter. Another invasive technique, subcutaneous tissue tunnelling is more safe than other methods but requires sophisticated technique and time. We employed a simple device using a blood transfusion set for patients who have epidural catheters placed safely on their backs. In 120 patients treated for postoperative and chronic pain by means of this technique, the results were as follows: 1) Five of 120 patients (4.2%) developed backache and pruritus, but there were no instances of respiratory depression, local infection and headache. 2) Nine of 120 patients (7.5%) failed booster-injections, but two cases were due to be non-technical errors. 3) The duration of fixation was 1-3 days in most cases (85%), the longest being for 21 days.

Malignant Hyperthermia Syndrome / 대한마취과학회지

MHS is a myopathic disorder transmitted by a dominant autosomal gene. The seriousness of the problem is underscored by the fact that the mortality rate, until recently, has ranked the highest among the complications of modern anesthesia. During halothane anesthesia we experienced a case of MHS with high temperature and rigidity after succinylcholine, observed change of serum electrolytes, and noted CPK and myoglobin in the urine. The patient was managed with surface cooling, bicarbonate, diurectics, mechanical ventilator and corticosteroids. The patient survived without any sequelae and was discharged after 10 days.