간행물

경희의학 update

The Journal of Kyung Hee University

  • : 경희대학교 경희의료원
  • : 의약학분야  >  기타(의약학)
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  • : 연속간행물
  • : 연간
  • : 1010-0687
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수록정보
수록범위 : 1권1호(1985)~34권1호(2019) |수록논문 수 : 1,131
경희의학
34권1호(2019년 09월) 수록논문
최근 권호 논문
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1알레르기 비염 치료의 최신 지견

저자 : 민진영

발행기관 : 경희대학교 경희의료원 간행물 : 경희의학 34권 1호 발행 연도 : 2019 페이지 : pp. 1-9 (9 pages)

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2통풍의 최신 진단 분류 기준과 치료

저자 : 정상완 ( Sang Wan Chung ) , 홍승재 ( Seung-jae Hong )

발행기관 : 경희대학교 경희의료원 간행물 : 경희의학 34권 1호 발행 연도 : 2019 페이지 : pp. 10-16 (7 pages)

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Gout is the most common inflammatory arthritis in men characterized by extremely painful recurrent acute and chronic arthritis. Gout is associated with various comorbidities, such as, chronic renal disease and metabolic syndrome, including dyslipidemia, diabetes mellitus, cardiovascular disease and obesity. Thus it has an impact on morbidity and mortality. The goals of treatment for gout are fast pain relief and the prevention of future gout attacks and other comorbidities. In every gout treatment, dietary and life style modification can be recommended. For the proper management of gout, definite diagnosis should come first. In this article, a current classification for the diagnosis of gout and management strategies for gout will be described.

3Usefulness of Electrocardiogram-based Criteria for Left Ventricular Hypertrophy in Asians Undergoing Elective Surgery: A Preliminary Investigation

저자 : Jeong-hyun Choi , Eunsil Shin , Jeong Eun Kim , Sangho Lee , Wonsik Ahn

발행기관 : 경희대학교 경희의료원 간행물 : 경희의학 34권 1호 발행 연도 : 2019 페이지 : pp. 17-25 (9 pages)

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Background and Objectives: Preoperative electrocardiography (ECG) is performed as a screening test for heart disease. Left ventricular hypertrophy (LVH) is associated with an increased risk of cardiovascular morbidity and mortality. However, the accuracy of ECG in diagnosing LVH is controversial. Therefore, it is necessary to investigate the diagnostic accuracy of conventional ECG voltage criteria in screening for LVH in patients undergoing elective surgery.
Methods: We retrospectively reviewed the electronic medical records of patients aged ≥19 years who underwent elective surgery and had both preoperative standard 12-lead resting ECG and transthoracic echocardiography. LVH was diagnosed based on the Sokolow-Lyon index. Echocardiographic diagnosis of LVH was defined as a left ventricular mass index (LVMI) > 115 g/㎡ in men and > 95 g/㎡ in women.
Results: Our study included 412 patients. LVH was diagnosed in 46 patients based on ECG criteria and in 137 patients based on echocardiographically derived LVMI. The area under the curve was 0.596 (95% confidence interval 0.51-0.69, P=0.029). The sensitivity, specificity, positive and negative predictive values, and the error rate were 41.3, 67.8, 13.9, 90.2, and 35.2%, respectively.
Conclusions: In conclusion, ECG-based criteria to diagnose LVH in Asian patients undergoing elective surgery showed low sensitivity and specificity, indicating low diagnostic accuracy of this modality. Further studies that could improve the diagnostic accuracy of an ECG could reduce the economic burden by avoiding unnecessary tests and enable accurate preoperative evaluation of patients.

4Successful Extubation and Uneventful Recovery from General Anesthesia using Sugammadex in a Patient with Myotonic Dystrophy

저자 : Jong Hee Park , Hyunchul Kim , Yong Kuk Ko , Min Soo Kim , Jung Eun Kim , Mi Hwa Chung , Eun Mi Choi

발행기관 : 경희대학교 경희의료원 간행물 : 경희의학 34권 1호 발행 연도 : 2019 페이지 : pp. 26-30 (5 pages)

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Myotonic dystrophy is an autosomal dominant inherited disorder characterized by progressive muscle weakness and myotonia. Anesthesiologists face challenges during perioperative care of patients with myotonic dystrophy as they are sensitive to sedatives, inhalational anesthetics, and non-depolarizing neuromuscular blocking drugs. Reversal with acetylcholinesterase inhibitors from neuromuscular blockade is contraindicated as it may potentiate myotonia. Thus, we report a case of successful extubation and uneventful recovery from general anesthesia using sugammadex under neuromuscular function monitoring in a patient with myotonic dystrophy undergoing laparoscopic total hysterectomy.

5Intraoperative Thyroid Storm during a Tonsillectomy in a Patient with Undiagnosed Hyperthyroidism - A Case Report

저자 : Min Chul Chae , Eun-jin Moon

발행기관 : 경희대학교 경희의료원 간행물 : 경희의학 34권 1호 발행 연도 : 2019 페이지 : pp. 31-36 (6 pages)

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Thyrotoxic crisis is a rare, but devastating complication of hyperthyroidism, requiring immediate management. The diagnosis of intraoperative thyroid storm is based on tachycardia, hypertension and fever. However, these signs are nonspecific, so differential diagnoses are required especially in a patient with undiagnosed hyperthyroidism preoperatively. The clinical suspicion of thyrotoxicosis is an important key for initiating proper treatment and avoiding life threatening condition.
We experienced intraoperative thyroid storm in a 37-year-old female with unrecognized thyrotoxicosis undergoing a tonsillectomy. Preoperative tachycardia and unusual restlessness induced our suspicion of thyrotoxicosis when dynamically changed tachycardic dysarrhythmia was persisted during and after surgery.

6지텔만 증후군 환자의 전신마취관리 경험

저자 : 김태준 ( Tae-jun Kim ) , 이재우 ( Jae-woo Yi )

발행기관 : 경희대학교 경희의료원 간행물 : 경희의학 34권 1호 발행 연도 : 2019 페이지 : pp. 37-40 (4 pages)

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Gitelman syndrome is a rare autosomal recessive salt-losing renal tubulopathy characterised by hypomagnesemia, hypocalciuria and secondary aldosteronism, which results in hypokalemia and metabolic alkalosis. Acute exacerbation of the hypokalemia and the metabolic alkalosis may interfere with surgery and general anesthesia. Anesthesiologists should be aware of pathogenesis and clinical sypmtoms of Gitelman syndrome to prevent possible complications during perioperative period. It is important to keep an eye on the electrolytes and pH during and after surgery.

7초고도 병적 비만인 환자의 비만 수술을 위한 마취경험 1례 - 증례보고 -

저자 : 우길 ( Gil Woo ) , 정준영 ( Jun-young Chung )

발행기관 : 경희대학교 경희의료원 간행물 : 경희의학 34권 1호 발행 연도 : 2019 페이지 : pp. 41-45 (5 pages)

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Obesity is a public health problem that has become epidemic worldwide. Substantial literature has emerged to show that overweight and obesity are major causes of co-morbidities, including diabetes mellitus, cardiovascular diseases, various cancers and other health problems, which can lead to further morbidity and mortality. One of the treatments of morbid obesity is bariatric surgery and it needs general anesthesia. Obesity is a challenging problem to anesthesiologists because it leads to severe changes in metabolism and physiologic function, especially cardiovascular and respiratory system. We experienced anesthetic management of super morbidly obese patient. Roux-en-Y bypass surgery for weight loss was planned for a 28 year old, female patient (165 kg and 166cm, BMI: 60 kg/㎡). We made preparations in case of difficult airway management and used short acting drugs during maintenance of anesthesia. Finally, we can make successful airway management and maintain hemodynamic stability and make a fast and smooth recovery without any problem.

8흉벽에 발생한 일차성 시반종 - 증례보고 -

저자 : 김홍균 ( Hong-gyun Kim ) , 이재우 ( Jae-woo Yi )

발행기관 : 경희대학교 경희의료원 간행물 : 경희의학 34권 1호 발행 연도 : 2019 페이지 : pp. 46-49 (4 pages)

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Schwannoma is one of the most common benign tumors of the nerve sheath. Most common locations are flexor surfaces of the extremities, neck, mediastinum, retroperitoneum, posterior spinal roots, and cerebellopontine angle. Schwannoma occurs very rarely on the chest wall. Here, we have a case of chest wall schwannoma, which presented as incidentally detected chest wall tumors. Schwannoma, being a slow growing benign tumor, is incidentally detected on chest imaging done for vague complaints. Computerized tomography (CT) scan supports the diagnosis of schwannoma and is essential to assess the extent of the tumor. Treatment of choice is surgery, thoracoscopic approach is preferred.

9Huge Goiter로 기도협착이 있는 환자에서 Awake Bronchoscopic Intubation을 통한 기도 관리 - 증례보고 -

저자 : 권태완 ( Taewan Kwon ) , 강화자 ( Wha-ja Kang ) , 유안희 ( Ann Hee You )

발행기관 : 경희대학교 경희의료원 간행물 : 경희의학 34권 1호 발행 연도 : 2019 페이지 : pp. 50-55 (6 pages)

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The huge thyroid goiter is one of the risk factors of difficult airway. We report the anesthetic management of compromised airway with tracheal narrowing due to a huge goiter. After applying lidocaine spray, awake oral fiberoptic intubation was perfomed and intubation was done with 6.0mm reinforced armored tube. After successful total thyroidectomy, neuromuscular blockade was completely reversed by sugammadex and extubation was uneventful. No respiratory compromise was noted after extubation and the patient was discharged in 3 days after the surgery without any complications.

10주관절 전치환 수술을 위한 상완신경총 차단술을 시행하는 도중 발생한 국소마취제의 전신 독성 1례 - 증례보고 -

저자 : 이현정 ( Hyun Jeong Lee ) , 황태준 ( Tae Jun Hwang ) , 강희용 ( Hee Yong Kang )

발행기관 : 경희대학교 경희의료원 간행물 : 경희의학 34권 1호 발행 연도 : 2019 페이지 : pp. 56-59 (4 pages)

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Brachial plexus block is widely used technique for upper limb surgery. However, systemic toxicity can occur if local anesthetics are injected into the blood vessels or systemically absorbed. We experienced seizures after brachial plexus block. A 72-year-old female patient underwent ultrasound-guided supraclavicular brachial plexus block for left-sided revision total elbow replacement. At 15 minutes after injecting 30 mL of mepivacaine, the patient showed confusion and convulsion in her arms and legs. To minimize systemic toxicity, propofol 30 mg and midazolam 2 mg were administered, mask ventilation was performed, and lipid emulsion was infused at a rate of 0.25 ml/kg/min for 15 minutes intravenously. The operation was postponed and the patient recovered without sequalae after being transferred to intensive care unit. We report our clinical experience with a review of the relevant literature.

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(2006)홍길동 외 1명심리학41회 피인용

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