간행물

경희의학 update

The Journal of Kyung Hee University

  • : 경희대학교 경희의료원
  • : 의약학분야  >  기타(의약학)
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  • : 연속간행물
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  • : 1010-0687
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수록정보
수록범위 : 1권1호(1985)~35권1호(2020) |수록논문 수 : 1,148
경희의학
35권1호(2020년 08월) 수록논문
최근 권호 논문
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1폐암 진단의 최신 지견

저자 : 이승현

발행기관 : 경희대학교 경희의료원 간행물 : 경희의학 35권 1호 발행 연도 : 2020 페이지 : pp. 1-10 (10 pages)

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2Comparison of Fentanyl and Sufentanil Intravenous Patient-controlled Analgesia after Laparoscopic Surgery: A Retrospective Study

저자 : Kum Hee Chung , Seunghoon Lee , Hayeon Kwak

발행기관 : 경희대학교 경희의료원 간행물 : 경희의학 35권 1호 발행 연도 : 2020 페이지 : pp. 11-16 (6 pages)

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Purpose: Postoperative pain affects patient recovery and can cause negative consequences. Fentanyl is widely used for postoperative pain management, but its side effects include nausea, vomiting, bradycardia, hypotension and itching. Sufentanil, which is 5 to 10 times more potent than fentanyl, has a fast onset and short duration of action. We compared the analgesic and side effects of fentanyl and sufentanil used in intravenous patient-controlled analgesia (IV PCA) after surgery in gynecological patients undergoing laparoscopic surgery.
Methods: A retrospective study was conducted on patients who underwent laparoscopic hysterectomy or laparoscopic myomectomy between January-April 2012 and January-April 2016. Depending on the opioid used for IV PCA, 21 patients with fentanyl 1000 mcg, 20 patients with sufentanil 150 mcg, and 26 patients with sufentanil 200 mcg were included in this study. The pain scores and side effects in each group were evaluated immediately after the surgery and at 1, 24, and 48 hours after surgery.
Results: There was no significant difference in pain scores among the three groups and there was no significant difference in the incidence of bradycardia, hypotension and pruritus. Incidences of nausea and vomiting were significantly lower in patients with sufentanil 150 mcg.
Conclusion: In patients undergoing laparoscopic surgery, using sufentanil for IV PCA may reduce side effects while achieving analgesic effects similar to those achieved with fentanyl.

3Convulsion following Spinal Anesthesia and Dexmedetomidine Sedation for Arthroscopic Meniscectomy: A Case Report

저자 : Ji Yoo Lee , Hee Yong Kang

발행기관 : 경희대학교 경희의료원 간행물 : 경희의학 35권 1호 발행 연도 : 2020 페이지 : pp. 17-21 (5 pages)

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The number of spinal anesthetic procedure for abdominal or leg surgery has increased because it is considered to have more advantages, especially in high-risk patients, and fewer complications than general anesthesia. The most common complications related to spinal anesthesia are post-dural puncture headache, back pain, hematoma, abscess, paresthesia or motor weakness and myoclonus. Convulsion is rarely reported as a complication of spinal anesthesia with bupivacaine. However, in our case, a 38-year-old healthy woman had convulsive episode following intrathecal administration of bupivacaine and infusion of dexmedetomidine for sedation. Before the convulsion, she complained of nausea and dyspnea and showed severe bradycardia. Immediately, the patient lost consciousness, showed upward eyeball deviation accompanied with a jerking of the upper limbs; at that time the blood pressure was 88/46 mmHg, the heart rate was 32 beats/min and the oxygen saturation of the blood was not detected. The patient fully recovered after manual ventilation, injection of ephedrine and hydration but she could not remember the episode. The possible etiologic factors of this transient convulsion after spinal anesthesia are difficult to clarify. Therefore, through our case study, we would like to look into the cause of the case and use it as an opportunity to emphasize that spinal anesthesia may lead to severe complication so careful monitoring is important.

4Anesthesia in Patients with Acute Intermittent Porphyria: A Case Report

저자 : Yun-jong Kim , Ann-hee You

발행기관 : 경희대학교 경희의료원 간행물 : 경희의학 35권 1호 발행 연도 : 2020 페이지 : pp. 22-24 (3 pages)

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Acute intermittent porphyria (AIP) is a rare meta-bolic disorder caused by deficiency of porphobilinogen deaminase. Acute attack of AIP may be precipitated by many factors during surgery including fasting, dehyd-ration, stress, infection, and drugs. The majority of acute attacks manifest as fluctuating blood pressure, tachycardia, electrolyte disturbances, and urinary retention. Even, bradycardia and sudden cardiac arrest can be occured. Therefore, selection and documentation of appropriate medications should be done in advance to prevent any perioperative crises. We report the safe use of propofol, rocuronium and sevoflurane in a patient affected with AIP.

5Treatment of Post-Dural Puncture Headache in Obstetric Patient using Epidural Blood Patch: A Case Report

저자 : Taejun Hwang , Hee Yong Kang

발행기관 : 경희대학교 경희의료원 간행물 : 경희의학 35권 1호 발행 연도 : 2020 페이지 : pp. 25-30 (6 pages)

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Accidental dural puncture (ADP) is a common complication of epidural catheter insertion, and may lead to post-dural puncture headache (PDPH), especially in obstetric patients. PDPH often occurs after ADP and may be associated with significant morbidity (severe headache, subdural hematoma). Conservative treatments such as bed rest, hydration, caffeine and acetaminophen are not effective enough. Epidural blood patch (EBP) is widely used to treat resistant PDPH, even if its efficacy in obstetric patients may be less than among general surgical patients. We report an ADP case before induction of labor in a 37-year-old parturient. Decided to perform epidural analgesia, the first attempt was made at L4-5 level and cerebrospinal fluid (CSF) leakage was observed at 3.5 cm depth. The second attempt was made at the L3-4 level and the catheter was successfully mounted. After 8 hours of ADP, the patient complained of headache and there was no effect of conservative management. The patient was admitted to the outpatient department of the pain clinic in 3 days after ADP and improved after receiving EBP. Through this case report, we will check the risk factor and management of PDPH and summarize the overall EPH.

6척추 마취 하에 시행한 요추 복강 단락술 수술: 증례보고

저자 : 구인회 ( In Hoe Koo ) , 강희용 ( Hee Yong Kang )

발행기관 : 경희대학교 경희의료원 간행물 : 경희의학 35권 1호 발행 연도 : 2020 페이지 : pp. 31-34 (4 pages)

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Cerebrospinal fluid (CSF) is produced in the ventricle approximately 500 mL a day, and hydrocephalus occurs when there is obstruction of the CSF due to subarachnoid hemorrhage, tumor, meningitis.
When hydrocephalus occurs, intracranial pressure is increased, and a shunt is placed in order to decompress it, which should help the flow and drainage of CSF.
In shunt surgery, general anesthesia is mostly performed and local anesthesia can be performed. Methods for shunt placement include ventriculoperitoneal shunt, lumbar-peritoneal shunt, and ventriculoatrial shunt.
In this case, we would consider alternative safe anesthetic method in patients who have undergone lumbar-peritoneal shunt with spinal anesthesia

7Successful Treatment of Parotid Infantile Hemangioma with Oral Propranolol: A Case Report and Literature Review

저자 : Sol Heo , Hoi Soo Yoon , Eun Hye Lee , Hae Woon Jung

발행기관 : 경희대학교 경희의료원 간행물 : 경희의학 35권 1호 발행 연도 : 2020 페이지 : pp. 35-40 (6 pages)

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Infantile hemangioma (IH) of the parotid gland is the most common tumor of the salivary gland in children. Various treatment modalities for parotid IH have been proposed with recent focus on oral propranolol. We describe the diagnosis and treatment course of a 32-day-old female infant with parotid IH who was initially misdiagnosed as having parotitis. After proper diagnosis of parotid IH, she was successfully treated with oral propranolol. Based on our case and other studies we reviewed in this paper, oral propranolol can be very effective and safe in the treatment of infants with parotid IH.

8Peripheral Precocious Puberty due to an Autonomous Ovarian Cyst and Possible Association to Application of Placental Cream

저자 : You Ree Kim , Hae Woon Jung

발행기관 : 경희대학교 경희의료원 간행물 : 경희의학 35권 1호 발행 연도 : 2020 페이지 : pp. 41-45 (5 pages)

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Precocious puberty is a disorder unique to children in which secondary sex characteristics develop before the age of 8 years in girls and 9 years in boys. The incidence of precocious puberty in Korea has substantially increased in recent years, especially among girls. Most of these cases are due to idiopathic central precocious puberty, whereas peripheral precocious puberty occurs infrequently. We experienced a case of a young girl with peripheral precocious puberty due to an autonomous ovarian cyst whose symptoms and signs of precocity occurred after frequent application of placental cream to the face. The diagnostic process is explained and possible association of the ovarian cyst to placental cream exposure is explored. The case highlights the clinical course and management of peripheral precocious puberty due to an autonomous ovarian cyst and emphasizes caution about the use of placental cream in children.

9요추 전 후방 유합술을 받는 환자에서 마취 중 발생한 심장성 쇼크: 증례보고

저자 : 안현준 ( Hyeon Jun An ) , 정준영 ( Jun Young Chung )

발행기관 : 경희대학교 경희의료원 간행물 : 경희의학 35권 1호 발행 연도 : 2020 페이지 : pp. 46-50 (5 pages)

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When spinal procedures are performed in prone position, pressure is necessarily exerted in the thoracic and abdominal regions. Such pressure induces obstruction of the inferior vena cava which in turn causes venous pooling, resulting in increased blood loss. Hence, many devices have been developed and are currently used to relieve pressure. Among them, a bolster is a device used to cushion the thoracic and abdominal regions, relieving pressure between the two bolsters thus preserving venous return, decreasing venous engorgement and minimizing blood loss. However, the surface area of contact between such devices and the patient is small, causing focal pressure points. Of note, patient malposition can cause severe thoracic wall compression and may even incite cardiogenic shock and must be closely monitored when changing the patient's position during surgery. In this case, the authors experienced an incidence of cardiogenic shock in a patient receiving anterior posterior lumbar fusion using only abdominal and thoracic bolsters and presents the case along with a review of current literature.

10척추 수술 중 발생한 지연성 아나필락시스 쇼크 마취경험 1례: 증례보고

저자 : 김주현 ( Ju Hyun Kim ) , 정준영 ( Jun Young Chung )

발행기관 : 경희대학교 경희의료원 간행물 : 경희의학 35권 1호 발행 연도 : 2020 페이지 : pp. 51-55 (5 pages)

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Interoperative anaphylactic shock is rare, but can cause severe cardiopulmonary failure and even death. Many drugs are responsible for causing anaphylactic shock during anesthesia, most commonly due to neuromuscular blocking agents, latex, and antibiotics. In addition, local anesthetics and opioids can also cause anaphylactic shock. In this case, we discuss a case of delayed anaphylactic shock occurring two hours after general anesthesia induction during spine surgery along with other reference materials.

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