An attempt has been made to observe the temperatures of finger-tip skin, rectum and extra aural canal in different age and anesthesia method in order to investigate the influence of general anesthesia on thermoregulatory system.
During induction of anesthesia, finger-tip skin gradually increased in temperature, then opposite parallelism in temperature both of extra aural canal and rectum were seen in all of the groups.
In the next 60 minutes after induction, extra aural canal constantly decreased in temperature at rate of 0.7°C/h in the groups of more than one year and less than 60 years old patients under enflurane anesthesia and also 16-60 years old patients under NLA anesthesia. However, in the group of less than one year old patients under enflurane anesthesia significant decreases in temperature both of extra aural canal and rectum, 1.1°C/h and 0.35°C/h, were seen respectively.
It is summarized that the tendency of heat loss during anesthesia might be caused by effects of radiation and inhibition of heat product system. However, the protective reaction of hypothalamus against heat loss is still preserved in proportion to the depth of anesthesia. It is suspected that, β-endorphin suppresses the reaction of heat radia-tion. Consequently, remarkable heat loss was not seen under NLA anesthesia.

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von Willebrand's disease (vWD) is an inherited bleeding disorder due to deficiency or abnormality of von Willebrand factor (vWF).
The majority of patients with vWD tend to have clinical defects that are only associated with superficial bleeding. There is no specific age of onset of the disease, and a history of cutaneous or mucosal bleeding which includes epistaxis, menorrhagis, easy bruising or failure to clot after dental extraction
DDAVP (Deamino-8-D-arginine vasopressin), a synthetic analogue of anti-diuretic hormone, is the specific agent for the treatment of vWD and is effective to increase the excretion of the intrinsic factor from vascular endotherial cell.
A 46 year-old-male with vWD underwent total thyroidectomy and radical neck disection for cancer of thyroid under general anesthesia.
Before skin incision, 0.3μg/kg/ml of DDAVP was infused. Increase of vWF and VIII factors to the level of twice of preoperative value were obtained 20 minutes later.
During operation, urinary output decreased as expected, however, diuretics was not given to avoid, electolytes imbalance. Careful measurements of CVP, electolytes, CBC, and blood gases were required to maintain fluid balance and to control hemor-rhage. During 8 hours anesthesia, blood loss was 473ml, urinary volume was 151 ml, and fluid given was 1, 500ml.
Postoperative course was uneventful except transient blood pressure falling treated by volume loading. On the second operative day, normal urinary output was resumed.

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A 16-year-old female patient with IgA deficiency was scheduled for a living renal transplantation which donor was her mother. Recipient's past history revealed with no other clinical difficulties, but she had received blood transfusion during hemodialysis therapy. Anesthesia was maintained nitrous oxide, oxygen and halothane. We were concerned about the anaphylactic reaction between anti-IgA antibodies in recipient blood and IgA in donor's kidney, following to the recirculation of renal blood flow. However, at that time, ECG showed only wandering pacemaker, non-significant Q wave in II lead, and tachycardia after recirculation, there were no other complica-tions. Fortunately, in this case, anaphylactic reaction did not occur. We thought this might be due to the complete defect of IgA antibody in recipient blood, coexisting IgE deficiency, or sufficient wash of donor' s kidney before transplantation. And any infection, especially in upper airway, were not complicated in the postoperative period.

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