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)~37권1호(2022) |수록논문 수 : 1,171
경희의학
37권1호(2022년 08월) 수록논문
최근 권호 논문
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저자 : 이유미 ( Yu-mi Lee )

발행기관 : 경희대학교 경희의료원 간행물 : 경희의학 37권 1호 발행 연도 : 2022 페이지 : pp. 1-10 (10 pages)

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Monkeypox is a zoonotic disease caused by monkeypox virus belongs to the Orthopox genus of the Poxviridae family, presenting with a skin rash similar to smallpox. Monkeypox has been recognized as an endemic infection in Central and West Africa. However, the incidence of monkeypox continues to increase in local communities, mainly in Europe, Canada, and the United States in 2022. The beginning of the spread was the case in a person with a history of travel to Nigeria on May 7 2022 in the United Kingdom. According to the World Health Organization report, the number of cases of monkeypox exceeded 26,000 in August 2022. The monkeypox virus is thought to be transmitted through contact with an infected body fluids and respiratory secretions. Sexual contact is presumed to be the main route of transmission in 2022, as the worldwide spread of monkeypox mainly occurred in men who have sex with men (MSM) or bisexual people. The typical rash that progresses to blisters, pustules, and crusts, spreading from the face to the extremities, is the main presentation of monkeypox. Post-exposure management with monkeypox vaccination such as modified vaccinia Ankara (MVA) vaccine or ACAM 2000 vaccine according to the exposure risk is necessary to block the transmission. The monkeypox patients with mild or uncomplicated infections require only symptomatic treatment. Antiviral agents such as tecovirimat or cidofovir can use in a high-risk groups for developing severe infections due to monkeypox. MSM and bisexuals should refrain from visiting areas where monkeypox has occurred and avoid contact with suspected monkeypox patients to break the cycle of an epidemic of monkeypox in 2022. In healthcare facilities, the suspicion of monkeypox based on epidemiologic exposure and clinical findings, and prompt reporting and prevention measures should be taken to hamper the spread of infection.

저자 : 백장현 ( Janghyun Paek ) , 오주영 ( Jooyoung Ohe )

발행기관 : 경희대학교 경희의료원 간행물 : 경희의학 37권 1호 발행 연도 : 2022 페이지 : pp. 11-20 (10 pages)

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Nowadays computer-guided “flapless” surgery for implant placement using templates is gaining popularity among clinicians and patients. The advantages of this surgical protocol are its minimally invasive nature, accuracy of implant placement, predictability, less post-surgical discomfort and reduced time required for definitive rehabilitation. Aim of this presentation is to describe the digital implant protocol, thanks to which is now possible to do a mini-invasive static guided implant surgery. This is possible thanks to a procedure named surface mapping based on the matching between numerous points on the surface of patient's dental casts and the corresponding anatomical surface points in the CBCT data. With some critical points and needing an adequate learning curve, this protocol allows to select the ideal implant position in depth, inclination and mesio-distal distance between natural teeth and or other implants enabling a very safe and predictable rehabilitation compared with conventional surgery. It represents a good tool for the best compromise between anatomy, function and aesthetic, able to guarantee better results in all clinical situations.

저자 : Gahee Kim , Junbum Lee , Sangho Lee , Jeong-hyun Choi

발행기관 : 경희대학교 경희의료원 간행물 : 경희의학 37권 1호 발행 연도 : 2022 페이지 : pp. 21-24 (4 pages)

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Sugammadex induced anaphylactic reaction is very urgent event as it is usually not anticipated in the advance. The incidence of anaphylactic reaction due to sugammadex is rare, 0.0039% to 0.3%, but it can occur even if there is no previous allergy history, and it often occurs after extubation, so immediate diagnosis and treatment are essential. This report presents a 70-year-old woman who had no previous exposure to sugammadex and allergy history and scheduled to undergo posterior lumbar interbody fusion L4-S1 to treat lumbosacral spondylolisthesis. Anesthesia via propofol, inhalational gas, remifentanil and rocuronium was used. The operation under general anesthesia went well without any problems The patient was administered sugammadex to reversal neuromuscular block, and delivered to post-anesthesia care unit (PACU). After arrival at PACU, she had anaphylactic reaction and received appropriate treatment including epinephrine. She discharged without any complications 6 weeks days after the surgery.

저자 : Miyun Kim , Hee Yong Kang

발행기관 : 경희대학교 경희의료원 간행물 : 경희의학 37권 1호 발행 연도 : 2022 페이지 : pp. 25-29 (5 pages)

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Anticipated difficult mask ventilation and intubation remains a daily challenge and a major cause of hypoxemia during anesthesia. Preoxygenation with a high-flow nasal oxygenation (HFNO) during induction of general anesthesia has recently become an appealing option to anesthesiologists. We describe the case of a 57-year-old male who underwent emergency flap salvage with angioplasty because of mandible area flap congestion. Mask ventilation was hardly implemented because mandible was irregular due to post-operative flap. We applied HFNO during induction. Although 5-min apnea time was needed for intubation, peripheral oxygen saturation was maintained at 100%. After surgery patient was discharged without respiratory complication. HFNO can secure a safe apnea time in difficult airway situations.

저자 : Ye Na Ahn , Hee Yong Kang

발행기관 : 경희대학교 경희의료원 간행물 : 경희의학 37권 1호 발행 연도 : 2022 페이지 : pp. 30-33 (4 pages)

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Pneumomediastinum and pneumothorax can be caused either spontaneously or secondarily by factors including airway trauma. A 52 year-old male patient entered the operating room for an emergency craniectomy. The initial SpO2 was 82% and the patient was mechanically ventilated with FiO2 of 1.0 throughout the surgery. Based on the preoperative chest X-ray, it was suspected that he had traumatic pneumomediastinum and pneumothorax due to numerous attempts of endotracheal intubation before the surgery, and a left chest tube was inserted at the end of the surgery. In this article, we report a case of anesthesia in a patient with a very recent traumatic pneumomediastinum and pneumothorax and had no time to properly evaluate or manage pneumomediastinum and pneumothorax before the anesthesia and surgery.

저자 : Junbum Lee , Gahee Kim , Sangho Lee , Jeong-hyun Choi

발행기관 : 경희대학교 경희의료원 간행물 : 경희의학 37권 1호 발행 연도 : 2022 페이지 : pp. 34-38 (5 pages)

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Charcot-Marie-Tooth (CMT) disease is a hereditary motor and sensory neuropathy of the peripheral nervous system. The initial presentation is usually foot drop or muscle wasting of the distal part of the leg. The symptom eventually progresses to atrophy of respiratory muscles, vocal cord and diaphragm. CMT patients require special caution during the general anesthesia. CMT disease can cause malignant hyperthermia, respiratory insufficiency and hyperkalemia during anesthesia. This report presents a 50-year-old man who has been diagnosed CMT disease and scheduled to undergo anterior cervical discectomy and fusion to treat cervical spinal stenosis. Propofol and remifentanil were used for the total intravenous anesthesia, and rocuronium was used for muscle relaxant purpose. Several intraoperative monitoring methods were performed to proceed the anesthesia safely, and the patient was discharged without any complications 5 days after the surgery. This case report with comprehensive literature review investigates possible adverse events and special cautions during the general anesthesia of CMT patients, and discusses adequate intraoperative monitoring to avoid such problems.

저자 : 조용현 ( Yong Hyun Cho ) , 신광일 ( Kwang Il Shin ) , 신옥영 ( Ok Young Shin ) , 김선희 ( Sun Hee Kim ) , 장원 ( Won Jang ) , Hyun Seok Lee , 고현철 ( Hyun Chul Go ) , 고우형 ( Woo Hyeong Ko ) , 권재현 ( Jae Hyun Kwon ) , 김영도 ( Young Do Kim )

발행기관 : 경희대학교 경희의료원 간행물 : 경희의학 37권 1호 발행 연도 : 2022 페이지 : pp. 39-44 (6 pages)

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Intermittent left bundle branch block (LBBB) can be caused by cardiovascular disease, and in this case, it can be a factor that increases the patient's mortality, so the patient should be treated with caution. We experienced a case of bipolar hemiarthroplasty of an 87-year-old female with angina history under general anesthesia. Preoperative electrocardiography showed complete LBBB without subjective symptoms. We report a case of intermittent LBBB which changed to a normal sinus rhythm after injecting phenylephrine.

저자 : Seok Jae Lee , Hoi Soo Yoon , Hoe Kyoung Koo , Yong Seong Choi

발행기관 : 경희대학교 경희의료원 간행물 : 경희의학 37권 1호 발행 연도 : 2022 페이지 : pp. 45-49 (5 pages)

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Neonatal cyanosis is a common condition in neonatal intensive care units which is associated with various diseases. The cause is multiple, and it usually presents ominous manifestations, especially when it occurs concerning neonatal sepsis, cyanotic congenital heart disease, and airway abnormalities. However, transient cyanosis due to abnormal forms of hemoglobin is also reported, and early detection is essential to avoid unnecessary investigations and delays in management. We describe a case of transient neonatal cyanosis due to the c.190C > T mutation in the HBG2 gene who was initially misdiagnosed as having other causes. After a proper diagnosis of congenital methemoglobinemia, he was successfully treated with conservative management. Transient neonatal cyanosis caused by methemoglobinemia without cardiorespiratory dysfunction has no specific therapy and it resolves naturally.

저자 : 김지유 ( Ji Yoo Kim ) , 최용성 ( Yong Sung Choi )

발행기관 : 경희대학교 경희의료원 간행물 : 경희의학 37권 1호 발행 연도 : 2022 페이지 : pp. 50-54 (5 pages)

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Artery catheterization is a common procedure done in neonatal intensive care unit. However, as a complication, vasospasm, thrombosis, embolism, infection, and peripheral ischemia or skin necrosis can happen. Peripheral ischemia may further damage adjacent skin, nerve, muscle. To prevent further damage, proper management is necessary. Although there are no proper guidelines on peripheral ischemia, nitroglycerin has been commonly used as a salvage treatment, after limb elevation and warm bag application. We report a case of a preterm infant who had ischemic change after artery catheterization and improved after nitroglycerin spray, and epidermal growth factor ointment application. The patient had a successful recovery in 14 days, without any complication.

저자 : 김선영 ( Seon Young Kim ) , 구회경 ( Hoe Kyoung Koo ) , 최용성 ( Yong Sung Choi )

발행기관 : 경희대학교 경희의료원 간행물 : 경희의학 37권 1호 발행 연도 : 2022 페이지 : pp. 55-59 (5 pages)

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Congenital constriction band syndrome is a rare disease, also called amniotic band syndrome. The etiology of this disease is not well known and there are no definitive diagnostic criteria yet. It causes anomalies that involve in various organs, however hand deformities are the most common. We present a case of congenital constriction band syndrome with multiple anomaly types in hand and foot such as amputation of fingers and toes, syndactyly and constriction ring. The syndactyly was found on the right hand from the first finger to the fifth finger. The patient was admitted to the neonatal intensive care unit, and the evaluation of neural defects and craniofacial anomalies was normal. Rehabilitation treatment was performed on the right hand through a consultation. Z-plasty surgery was performed at 2 and 6 months of age.

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