ABSTRACT
We experienced a case of sudden occurrence of complete left bundle branch block during emergency surgery. A 59-year-old man suffered from facial bone fracture and eye ball injury. Repair of facial bone and removal of eye ball surgery were scheduled. Chest X-ray, echocardiography, blood counts and laboratory data were within normal limits. Awake intubation was performed. Anesthesia was maintained with 2-3% sevoflurane in 1 l x min(-1) of oxygen and 2 l x min(-1) of nitrous oxide. After induction of anesthesia, tracheostomy was performed with combined use of local anesthesia with 6 ml of 1% lidocaine with 1/200000 epinephrine. Then removal of eye ball surgery was started and finished uneventfully. During repair of facial bone fracture, we found an unexpected complete left bundle branch block. After rapid infusion of 1000 ml acetic Ringer's solution, the complete left bundle branch block disappeared. After surgery, mannitol administration at the previous hospital was noticed. Complete left bundle branch block in this case might have been induced by hypovolemia and hyperpotassemia due to osmotic diuresis by mannitol.
Subject(s)
Bundle-Branch Block/etiology , Emergencies , Facial Bones/injuries , Humans , Male , Middle Aged , Ophthalmologic Surgical Procedures , Skull Fractures/surgeryABSTRACT
To determine low hemoglobin concentrations in the washed fluid is useful for calculation of blood loss and that in the supernatant is also useful for evaluation of hemolysis during extracorporeal circulation or in the blood preparations. The HemoCue Low Hemoglobin Photometer is a new lightweight device, which is easily movable anywhere and is able to determine hemoglobin concentration in low ranges (0.03-3.00 g.dl-1). We investigated the accuracy and reliability of the HemoCue Low Hemoglobin Photometer. Blood samples were diluted with saline containing heparin into six tubes. The hemoglobin concentrations of each diluted sample were measured by the HemoCue Low Hemoglobin Photometer, and were compared with the calculated values. A high positive correlation was found between the values measured by the HemoCue Low Hemoglobin Photometer (Y) and the calculated values (X); Y = 1.047 X, r = 0.999, P < 0.0001. It took only 11-54 seconds (mean value: 31.4 seconds) for the measurement. It is concluded that the HemoCue Low Hemoglobin Photometer is a reliable and useful device for measurement of low hemoglobin concentration.
Subject(s)
Hemoglobinometry/instrumentation , Photometry/instrumentation , Evaluation Studies as Topic , Humans , Sensitivity and SpecificityABSTRACT
To utilize n-3 polyunsaturated fatty acid (PUFA) for a wide range of applications, we prepared phospholipids (PLs) containing PUFAs as constituent fatty acids (PUFA-PLs) via commercially available lipase OF-mediated transacylation with PL from soy (Soy-PL) and ethyl ester of PUFA (PUFA-Et). In a preliminary study to evaluate PUFA-incorporation (wt%) on phosphatidylcholine (PC), we observed that dehydration of Soy-PL is critical. PUFA-incorporation in PLs increased with acyl ratio and time. Finally, maximum PUFA-incorporation (47.1 ± 2.1 wt%) was obtained using the following reaction conditions: 2.0 mmol of Soy-PL, a PUFA-Et/Soy-PL acyl ratio of 7, 13 mL of hexane, 2.2 × 10(5) U of lipase OF, 500 rpm of agitation, a temperature of 37°C, and 72 h of reaction time. The analysis of fatty acid composition at the sn-2 position of obtained PL revealed that PUFAs incorporated into Soy-PL localized to the sn-2 position of the PL molecule in spite of using lipase OF whose positional specificity is random for triacylglycerol.