The Effect of Increased Minute Ventilation on the Changes of End-Tidal Isoflurane Concentration and Bispectral Index / 대한마취과학회지

BACKGROUND: An increase in ventilation is known to accelerate the rate of the rise of alveolar concentration of inhalation anesthetics and increase the rate of anesthetic induction. However, it is still debatable whether or not a rise of alveolar isoflurane concentrations by increased minute ventilation (MV) actually increases the depth of anesthesia. METHODS: After anesthetic induction by intravenous thiopental and succinylcholine, and after the bispectral index (BIS) had recovered to 75 after intubation, isoflurane anesthesia was begun (inspired concentration:2 vol.%, respiratory rate:12/min, tidal volume: group I; 8 ml/kg, group II; 12 ml/kg). BIS, spectral edge frequency (SEF), blood pressure, pulse rate were recorded 1 minute before induction, and 1, 2, 3, 4, 5, 7 and 10 minutes after isoflurane anesthesia. End-tidal concentrations of isoflurane and CO2 (ET-iso and -CO2) were recorded at 1, 2, 3, 4, 5, 7 and 10 minutes after isoflurane anesthesia. RESULTS: The increase of ET-iso and the decrease of ET-CO2 were significantly fast in group II. There was no difference in BIS and SEF between the two groups. CONCLUSIONS: Increasing MV induced a rapid rise of alveolar isoflurane concentrations, but changes of BIS and SEF were not affected by increased MV.

A Case of EDTA Dependent Platelet Phagocytosis by Neutrophils in Mycosis Fungoides / 대한임상병리학회지

In vitro ethylene-diamine-tetra-acetic acid (EDTA) dependent satellitism and phagocytosis of platelets by neutrophils have been considered to be rare phenomena. It is associated with pseudothrombocytopenia, abnormal histogram of platelets and pseudoleukocytosis on complete blood cell count (CBC) by automated blood cell counter, but these findings are not found in heparinized or sodium citrated blood. It has no clinical significance such as bleeding tendency or abnormal platelet function. EDTA dependent platelet satellitosis and phagocytosis must be differentiated from true thrombocytopenia. We report a case of EDTA dependent platelet phagocytosis by neutrophils in a 68 year-old male patient who was diagnosed as mycosis fungoides. His EDTA blood smear showed frequent phagocytosis of platelets by neutrophils and occasional platelet satellitism. The bood cell counts were within normal limits without pseudothrombocytopenia. Phagocytized platelets were confirmed by immunohistochemistry using GpIIb/IIIa antibody and transmission electron micrographs.