Pub Date : 2021-07-31DOI: 10.30579/mbse.2021.4.2.111
Hyun Kuk Kim, Sung Soo Kim, Y. Ki, D. Choi, K. Park
Anomalous high take-off of the right coronary artery (RCA) ostium above the sinuses of valsalva is extremely rare. It was not well visualized on conventional coronary angiography. A 52-year-old man was referred to emergency department presenting as chest pain. Because electrocardiography showed ST elevation in the inferior lead, he underwent emergent cardiac catherization, which revealed mild stenosis in the left coronary artery. However, the ostium of the RCA could not be found arising from the coronary cusp despite using aortogram with pigtail. Intraprocedural coronary computed tomography angiography showed a near total occlusion in the middle RCA, which had an anomalous take-off from the left anterior superior aspect of the ascending aorta, 2 cm above the left main coronary artery. Judkins left 4 guiding catheter via femoral approach could be engaged in the ostium of RCA. Successful percutaneous angioplasty using the Guidezilla extension catheter as additional backup support was performed.
{"title":"Role of coronary CT angiography in anomalous high take-off of right coronary artery with ST elevation myocardial infarction: a case report","authors":"Hyun Kuk Kim, Sung Soo Kim, Y. Ki, D. Choi, K. Park","doi":"10.30579/mbse.2021.4.2.111","DOIUrl":"https://doi.org/10.30579/mbse.2021.4.2.111","url":null,"abstract":"Anomalous high take-off of the right coronary artery (RCA) ostium above the sinuses of valsalva is extremely rare. It was not well visualized on conventional coronary angiography. A 52-year-old man was referred to emergency department presenting as chest pain. Because electrocardiography showed ST elevation in the inferior lead, he underwent emergent cardiac catherization, which revealed mild stenosis in the left coronary artery. However, the ostium of the RCA could not be found arising from the coronary cusp despite using aortogram with pigtail. Intraprocedural coronary computed tomography angiography showed a near total occlusion in the middle RCA, which had an anomalous take-off from the left anterior superior aspect of the ascending aorta, 2 cm above the left main coronary artery. Judkins left 4 guiding catheter via femoral approach could be engaged in the ostium of RCA. Successful percutaneous angioplasty using the Guidezilla extension catheter as additional backup support was performed.","PeriodicalId":259565,"journal":{"name":"Medical Biological Science and Engineering","volume":"25 10","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120873992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-31DOI: 10.30579/mbse.2021.4.2.83
Wonjin Lee, K. Jung
Corresponding author Ki Tae Jung Department of Anesthesiology and Pain Medicine, Chosun University Hospital, 365 Pilmun-dearo, Donggu, Gwangju 61453, Korea Tel: +82-62-220-3223 Fax: +82-62-223-2333 E-mail: mdmole@chosun.ac.kr ORCID: https://orcid.org/0000-0002-2486-9961 Anesthetic procedures using a neuromuscular blocking drug (NMBD) always have a potential risk of residual neuromuscular block (RNMB) associated with serious respiratory complications despite the use of reversal agents. Due to the risk of RNMB, neuromuscular monitoring is a very important tool for assessing patient safety. Recently, the importance of quantitative neuromuscular monitoring has been highlighted because of the advent of sugammadex, which determines dosage based on the degree of NMB. Neuromuscular monitoring, which has been used clinically since the 1970s, is an appropriate method for assessing the level of neuromuscular blockade (NMB) after the use of a NMBD during anesthesia. Although the basic principles have not changed considerably, recent technical advances in neuromuscular monitoring devices can help anesthesiologists with convenient quantitative neuromuscular monitoring to accurately evaluate the levels of NMB, choose an appropriate NMBD, and avoid RNMB. The recently released electromyography-based devices provide more accurate values than acceleromyography (AMG). Although AMG has a problem with overestimation, modern AMG devices with new three-dimensional technology overcome this limitation. Anesthesiologists should increase their knowledge of neuromuscular mechanisms and monitoring, including how to use the latest device for proper neuromuscular monitoring and patient safety. In this review, we have explored the short history of neuromuscular monitoring devices and the latest trends in technology development.
{"title":"A short review of history and technical advances in quantitative neuromuscular monitoring devices","authors":"Wonjin Lee, K. Jung","doi":"10.30579/mbse.2021.4.2.83","DOIUrl":"https://doi.org/10.30579/mbse.2021.4.2.83","url":null,"abstract":"Corresponding author Ki Tae Jung Department of Anesthesiology and Pain Medicine, Chosun University Hospital, 365 Pilmun-dearo, Donggu, Gwangju 61453, Korea Tel: +82-62-220-3223 Fax: +82-62-223-2333 E-mail: mdmole@chosun.ac.kr ORCID: https://orcid.org/0000-0002-2486-9961 Anesthetic procedures using a neuromuscular blocking drug (NMBD) always have a potential risk of residual neuromuscular block (RNMB) associated with serious respiratory complications despite the use of reversal agents. Due to the risk of RNMB, neuromuscular monitoring is a very important tool for assessing patient safety. Recently, the importance of quantitative neuromuscular monitoring has been highlighted because of the advent of sugammadex, which determines dosage based on the degree of NMB. Neuromuscular monitoring, which has been used clinically since the 1970s, is an appropriate method for assessing the level of neuromuscular blockade (NMB) after the use of a NMBD during anesthesia. Although the basic principles have not changed considerably, recent technical advances in neuromuscular monitoring devices can help anesthesiologists with convenient quantitative neuromuscular monitoring to accurately evaluate the levels of NMB, choose an appropriate NMBD, and avoid RNMB. The recently released electromyography-based devices provide more accurate values than acceleromyography (AMG). Although AMG has a problem with overestimation, modern AMG devices with new three-dimensional technology overcome this limitation. Anesthesiologists should increase their knowledge of neuromuscular mechanisms and monitoring, including how to use the latest device for proper neuromuscular monitoring and patient safety. In this review, we have explored the short history of neuromuscular monitoring devices and the latest trends in technology development.","PeriodicalId":259565,"journal":{"name":"Medical Biological Science and Engineering","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124923791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-31DOI: 10.30579/MBSE.2021.4.1.48
Doosik Kim, Ho Chul Lee, S. Ryu, Ju Deok Kim
A tension pneumothorax arising during surgery is a rare occurrence, however it is a medical emergency that requires immediate decompression. Early diagnosis of a pneumothorax in pa tients with hypoxemia during general anesthesia, especially when accompanied by a pulmonary embolism during surgery, is not straightforward as it differs from the clinical symptoms seen in patients who have spontaneous ventilation. However, if it develops into a tension pneumothorax, serious hemodynamic side effects may occur. Therefore, the anesthesiologist needs a sufficient understanding of differential diagnosis methods, such as lung sound auscultation and C-arm fluoroscopy. These can be easily utilized in the operating room, and rapid treatment can be performed through consultation with thoracic surgeons.
{"title":"Tension pneumothorax and pulmonary embolism during neurosurgery: a case report","authors":"Doosik Kim, Ho Chul Lee, S. Ryu, Ju Deok Kim","doi":"10.30579/MBSE.2021.4.1.48","DOIUrl":"https://doi.org/10.30579/MBSE.2021.4.1.48","url":null,"abstract":"A tension pneumothorax arising during surgery is a rare occurrence, however it is a medical emergency that requires immediate decompression. Early diagnosis of a pneumothorax in pa tients with hypoxemia during general anesthesia, especially when accompanied by a pulmonary embolism during surgery, is not straightforward as it differs from the clinical symptoms seen in patients who have spontaneous ventilation. However, if it develops into a tension pneumothorax, serious hemodynamic side effects may occur. Therefore, the anesthesiologist needs a sufficient understanding of differential diagnosis methods, such as lung sound auscultation and C-arm fluoroscopy. These can be easily utilized in the operating room, and rapid treatment can be performed through consultation with thoracic surgeons.","PeriodicalId":259565,"journal":{"name":"Medical Biological Science and Engineering","volume":"56 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129879586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-31DOI: 10.30579/MBSE.2021.4.1.10
Jeong-Wook Park, K. Jung, Bo Hyun Jang, Sang Hun Kim
Background: We investigated the effects of intravenous fluid warmers on intraoperative core temperatures at low flow rates during the maintenance fluid therapy. Methods: We conducted a prospective, non-blinded, randomized controlled trial in 99 patients, scheduled for elective spinal fusion surgery with more than 3 hours of general anesthesia. They were randomly distributed into groups using Mega Acer Kit (group M; n=30), Ranger (group R; n=32), or ThermoSens (group T; n=32). The infused flow rate of the fluid was determined as one-third of the preoperative fluid deficit (4-2-1 rules) during fasting times, and the third space loss during surgery (2 mL/kg), per hour. The primary outcome was intraoperative final and lowest esophageal temperature (T eso _ Final, lowest T eso ). Results: T eso _Final, lowest T eso , and intraoperative T eso were not significantly different between groups (p=0.512, and p=0.393, p=0.066, respectively). However, the temperature change from baseline T eso to T eso _Final was significantly different between the groups (p=0.044), which of group M were significantly lower than group T (p=0.033). After adjustment with baseline T eso , the differences of least squares means showed the significant differences between groups M and T at 2.5 hours (p=0.020) and 3 hours (p=0.006). Conclusions: The Mega Acer Kit, Ranger, and ThermoSens have a similar effect on intraoperative core temperatures with the low flow rates, but The Mega Acer Kit is more effective at controlling core temperature than the ThermoSens if the fluid infusion time is over 2.5 hours.
背景:我们研究了在维持液体治疗过程中，在低流速下静脉液体加热器对术中核心温度的影响。方法:我们对99例患者进行了一项前瞻性、非盲性、随机对照试验，这些患者计划在3小时以上的全身麻醉下进行择期脊柱融合手术。使用Mega Acer Kit随机分组(M组;n=30)， Ranger (R组;n=32)，或ThermoSens (T组;n = 32)。液体的注入流速为禁食期间术前液体亏缺量(4-2-1规则)的三分之一，手术期间空间损失的三分之一(2ml /kg)，每小时。主要转归为术中最终、最低食道温度(teso _最终、最低teso)。结果:teso组间最终teso、最低teso、术中teso差异无统计学意义(p=0.512、p=0.393、p=0.066)。但各组间从基线teso到teso _Final的温度变化差异有统计学意义(p=0.044)，其中M组显著低于T组(p=0.033)。经基线T eso调整后，最小二乘均数差异显示M组和T组在2.5 h (p=0.020)和3 h (p=0.006)时差异有统计学意义。结论:在低流速下，Mega Acer Kit、Ranger和ThermoSens对术中核心温度的控制效果相似，但当输注时间超过2.5小时时，Mega Acer Kit比ThermoSens对核心温度的控制更有效。
{"title":"Effect of intravenous fluid warming devices on intraoperative core temperature during maintenance fluid therapy: a prospective randomized controlled trial","authors":"Jeong-Wook Park, K. Jung, Bo Hyun Jang, Sang Hun Kim","doi":"10.30579/MBSE.2021.4.1.10","DOIUrl":"https://doi.org/10.30579/MBSE.2021.4.1.10","url":null,"abstract":"Background: We investigated the effects of intravenous fluid warmers on intraoperative core temperatures at low flow rates during the maintenance fluid therapy. Methods: We conducted a prospective, non-blinded, randomized controlled trial in 99 patients, scheduled for elective spinal fusion surgery with more than 3 hours of general anesthesia. They were randomly distributed into groups using Mega Acer Kit (group M; n=30), Ranger (group R; n=32), or ThermoSens (group T; n=32). The infused flow rate of the fluid was determined as one-third of the preoperative fluid deficit (4-2-1 rules) during fasting times, and the third space loss during surgery (2 mL/kg), per hour. The primary outcome was intraoperative final and lowest esophageal temperature (T eso _ Final, lowest T eso ). Results: T eso _Final, lowest T eso , and intraoperative T eso were not significantly different between groups (p=0.512, and p=0.393, p=0.066, respectively). However, the temperature change from baseline T eso to T eso _Final was significantly different between the groups (p=0.044), which of group M were significantly lower than group T (p=0.033). After adjustment with baseline T eso , the differences of least squares means showed the significant differences between groups M and T at 2.5 hours (p=0.020) and 3 hours (p=0.006). Conclusions: The Mega Acer Kit, Ranger, and ThermoSens have a similar effect on intraoperative core temperatures with the low flow rates, but The Mega Acer Kit is more effective at controlling core temperature than the ThermoSens if the fluid infusion time is over 2.5 hours.","PeriodicalId":259565,"journal":{"name":"Medical Biological Science and Engineering","volume":"136 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124248681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-31DOI: 10.30579/MBSE.2021.4.1.34
Hyun Kuk Kim, K. Lim, Sung Soo Kim, Joo-Young Na
Despite ticagrelor’s proven superiority to clopidogrel in treating patients with acute coronary syndrome, it is unclear whether its actions are mediated by antiplatelet inhibition or by some other pleotropic effect. In this study, we used a porcine model of acute myocardial infarction (AMI) to evaluate the efficacy of ticagrelor administered at a similar level of platelet inhibition to that seen with clopidogrel. Twenty pigs were grouped according to the P2Y12-receptor inhibitors (ticagrelor or clopidogrel). Platelet inhibition was monitored by measuring adenosine diphosphate - induced platelet aggregation. A chronic ischemic heart model was artificially generated by embolization of the middle left anterior descending coronary artery. Animals received a maintenance dose of the antiplatelet agents. Two-dimensional echocardiography was performed on the surviving animals 2 weeks later. Both 180 mg ticagrelor and 600 mg clopidogrel exerted a significant and consis-tent antiplatelet effect showing platelet aggregation inhibition of 50.7±22.9% and 45.5±21.0%, respectively, p=0.614), which persisted for up to 2 weeks. However, no significant differences were observed in ventricular arrhythmia (40% vs. 50%, respectively; p=0.886). The ejection fraction measured 2 weeks after surgery was 44.6±7.4% in the ticagrelor group and 36.9±5.7% in the clopidogrel group (p=0.091). In a chronic ischemic heart failure model with a similar level of platelet inhibition, ticagrelor was no better than clopidogrel in reducing mortality and improving cardiac function.
{"title":"Ticagrelor does not affect left ventricular remodeling following acute myocardial ischemia","authors":"Hyun Kuk Kim, K. Lim, Sung Soo Kim, Joo-Young Na","doi":"10.30579/MBSE.2021.4.1.34","DOIUrl":"https://doi.org/10.30579/MBSE.2021.4.1.34","url":null,"abstract":"Despite ticagrelor’s proven superiority to clopidogrel in treating patients with acute coronary syndrome, it is unclear whether its actions are mediated by antiplatelet inhibition or by some other pleotropic effect. In this study, we used a porcine model of acute myocardial infarction (AMI) to evaluate the efficacy of ticagrelor administered at a similar level of platelet inhibition to that seen with clopidogrel. Twenty pigs were grouped according to the P2Y12-receptor inhibitors (ticagrelor or clopidogrel). Platelet inhibition was monitored by measuring adenosine diphosphate - induced platelet aggregation. A chronic ischemic heart model was artificially generated by embolization of the middle left anterior descending coronary artery. Animals received a maintenance dose of the antiplatelet agents. Two-dimensional echocardiography was performed on the surviving animals 2 weeks later. Both 180 mg ticagrelor and 600 mg clopidogrel exerted a significant and consis-tent antiplatelet effect showing platelet aggregation inhibition of 50.7±22.9% and 45.5±21.0%, respectively, p=0.614), which persisted for up to 2 weeks. However, no significant differences were observed in ventricular arrhythmia (40% vs. 50%, respectively; p=0.886). The ejection fraction measured 2 weeks after surgery was 44.6±7.4% in the ticagrelor group and 36.9±5.7% in the clopidogrel group (p=0.091). In a chronic ischemic heart failure model with a similar level of platelet inhibition, ticagrelor was no better than clopidogrel in reducing mortality and improving cardiac function.","PeriodicalId":259565,"journal":{"name":"Medical Biological Science and Engineering","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131305389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-11-12DOI: 10.21203/rs.3.rs-103081/v1
A. Chong, Kweon-cheon Kim, Y. Kim, R. Hong
Background : The diffuse sclerosing variant of papillary thyroid carcinoma (DSV-PTC) is an uncommon variant of PTC. Although its histologic features are aggressive, its prognostic significance remains controversial. Case summary : Bone scan of 41-year-old woman with a history of breast and thyroid cancers showed suspected cervical osseous metastasis during the previous cancer follow-up. Further, magnetic resonance imaging was recommended. Preoperative fine needle aspiration cytology showed features of thyroid papillary carcinoma and postoperatively, the mass was diagnosed to DSV-PTC showing features of numerous and diffuse calcification and squamous metaplasia. Conclusion : Herein, we describe the pathologic features, including histologic and fine-needle aspiration cytologic features, and prognostic implications through a literature review.
{"title":"Diffuse Sclerosing Variant of Papillary Thyroid Carcinoma Presenting as Suspected Cervical Osseous Metastasis : A Case Report and Literature Review","authors":"A. Chong, Kweon-cheon Kim, Y. Kim, R. Hong","doi":"10.21203/rs.3.rs-103081/v1","DOIUrl":"https://doi.org/10.21203/rs.3.rs-103081/v1","url":null,"abstract":"\u0000 Background : The diffuse sclerosing variant of papillary thyroid carcinoma (DSV-PTC) is an uncommon variant of PTC. Although its histologic features are aggressive, its prognostic significance remains controversial. Case summary : Bone scan of 41-year-old woman with a history of breast and thyroid cancers showed suspected cervical osseous metastasis during the previous cancer follow-up. Further, magnetic resonance imaging was recommended. Preoperative fine needle aspiration cytology showed features of thyroid papillary carcinoma and postoperatively, the mass was diagnosed to DSV-PTC showing features of numerous and diffuse calcification and squamous metaplasia. Conclusion : Herein, we describe the pathologic features, including histologic and fine-needle aspiration cytologic features, and prognostic implications through a literature review.","PeriodicalId":259565,"journal":{"name":"Medical Biological Science and Engineering","volume":"109 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130607098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-31DOI: 10.30579/mbse.2020.3.2.36
B. Lee, C. So, Seung Hyun Lee, S. Yu
Percutaneous central venous catheters (PCVCs) provide parenteral nutrition to extremely low birth weight infants. Incorrect PCVC tip location and hyperosmolarity of total parenteral nutrition may lead to pericardial effusion, which has a high mortality rate. When imaging shows a curvature or loop in the catheter tip, pericardial effusion must be considered. Emergency pericardiocentesis and surgical pericardial window as treatments for pericardial effusion show no differences in mortality and complication rates in adults, but no studies have been performed in neonates. Here, we report a very low birth weight infant with pericardial effusion treated by surgical pericardial window.
{"title":"Pericardial effusion complicated by percutaneous central venous catheterization treated with pericardial window in a very low birth weight infant","authors":"B. Lee, C. So, Seung Hyun Lee, S. Yu","doi":"10.30579/mbse.2020.3.2.36","DOIUrl":"https://doi.org/10.30579/mbse.2020.3.2.36","url":null,"abstract":"Percutaneous central venous catheters (PCVCs) provide parenteral nutrition to extremely low birth weight infants. Incorrect PCVC tip location and hyperosmolarity of total parenteral nutrition may lead to pericardial effusion, which has a high mortality rate. When imaging shows a curvature or loop in the catheter tip, pericardial effusion must be considered. Emergency pericardiocentesis and surgical pericardial window as treatments for pericardial effusion show no differences in mortality and complication rates in adults, but no studies have been performed in neonates. Here, we report a very low birth weight infant with pericardial effusion treated by surgical pericardial window.","PeriodicalId":259565,"journal":{"name":"Medical Biological Science and Engineering","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117179796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-31DOI: 10.30579/mbse.2020.3.2.47
S. Yoon, Rakmin Choi, Jaedo Lee, Jongchan Won, Bousung Lee, K. Lee, Dongseok Kim, Jaeyoung Yang
Opioid-induced hyperalgesia is characterized by an increased pain response to noxious stimuli despite increased use of opioid medications. Here, we report the case of a 43-year-old woman diagnosed with post-laminectomy syndrome who presented with an increasing pain score following a morphine infusion via an implanted intrathecal drug delivery device. Her pain improved after reducing opioid doses and the administration of intravenous ketamine infusion therapy. Thus, the early suspicion of opioid-induced hyperalgesia is essential for patients with increasing pain refractory to augmented doses of opioid medications.
{"title":"Opioid-induced hyperalgesia after implantation of intrathecal morphine pump: a case report","authors":"S. Yoon, Rakmin Choi, Jaedo Lee, Jongchan Won, Bousung Lee, K. Lee, Dongseok Kim, Jaeyoung Yang","doi":"10.30579/mbse.2020.3.2.47","DOIUrl":"https://doi.org/10.30579/mbse.2020.3.2.47","url":null,"abstract":"Opioid-induced hyperalgesia is characterized by an increased pain response to noxious stimuli despite increased use of opioid medications. Here, we report the case of a 43-year-old woman diagnosed with post-laminectomy syndrome who presented with an increasing pain score following a morphine infusion via an implanted intrathecal drug delivery device. Her pain improved after reducing opioid doses and the administration of intravenous ketamine infusion therapy. Thus, the early suspicion of opioid-induced hyperalgesia is essential for patients with increasing pain refractory to augmented doses of opioid medications.","PeriodicalId":259565,"journal":{"name":"Medical Biological Science and Engineering","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122702057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-31DOI: 10.30579/mbse.2020.3.2.56
Hyun Young Lee, K. Jung, S. Cho, Sang Hun Kim
Huntington’s disease (HD) has a risk of potential perioperative complications such as aspiration, drug interactions with anesthetics, agitation, psychosis, shivering, and spasms. Thus, inexperienced anesthesiologists may face challenges in the management of HD patients. A 54-year-old man with HD was scheduled to undergo open reduction and internal fixation of an intertro-chanteric femur fracture. We successfully performed videolaryngoscope-guided intubation after propofol sedation and oral topical anesthesia, as awake fibreoptic bronchoscopy-guided intubation had failed because of noncooperation and choreiform movements. Total intravenous anesthesia was maintained with propofol and remifentanil infusion, and intraoperative neuromuscular block was controlled with rocuronium and sugammadex successfully, without any postoperative complications. His psychotropic medications were restarted from the morning of postoperative day 1. Videolaryngoscope-guided intubation, total intravenous anesthesia, use of rocuronium and sugammadex, and re-administration of psychotropic medication as soon as possible form one of the successful regimens for HD patients.
{"title":"Videolaryngoscope-guided intubation without neuromuscular blockade in a patient with Huntington’s disease","authors":"Hyun Young Lee, K. Jung, S. Cho, Sang Hun Kim","doi":"10.30579/mbse.2020.3.2.56","DOIUrl":"https://doi.org/10.30579/mbse.2020.3.2.56","url":null,"abstract":"Huntington’s disease (HD) has a risk of potential perioperative complications such as aspiration, drug interactions with anesthetics, agitation, psychosis, shivering, and spasms. Thus, inexperienced anesthesiologists may face challenges in the management of HD patients. A 54-year-old man with HD was scheduled to undergo open reduction and internal fixation of an intertro-chanteric femur fracture. We successfully performed videolaryngoscope-guided intubation after propofol sedation and oral topical anesthesia, as awake fibreoptic bronchoscopy-guided intubation had failed because of noncooperation and choreiform movements. Total intravenous anesthesia was maintained with propofol and remifentanil infusion, and intraoperative neuromuscular block was controlled with rocuronium and sugammadex successfully, without any postoperative complications. His psychotropic medications were restarted from the morning of postoperative day 1. Videolaryngoscope-guided intubation, total intravenous anesthesia, use of rocuronium and sugammadex, and re-administration of psychotropic medication as soon as possible form one of the successful regimens for HD patients.","PeriodicalId":259565,"journal":{"name":"Medical Biological Science and Engineering","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134255917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-31DOI: 10.30579/mbse.2020.3.2.31
Y. Jeon
the few decades, certain coronaviruses have become threat to humans. Coronaviruses such as severe acute respiratory syndrome-related coronavirus (SARS-CoV) and Middle East respiratory syndrome-related coronavirus (MERS-CoV) have caused lethal outbreaks in 2003 and 2012, respectively. In 2019, severe infectious coronavirus outbreak with unusual pneumonia was reported in Wuhan, China, which later became pandemic. Due to the similarity of coronavirus disease 2019 (COVID-19) to SARS-CoV, the virus was termed as SARS-CoV-2. Although viral proteases such as papain-like 2 protease (PL2 Pro ) are essential for virulence of SARS-CoV, limited information is available on the role of protease in viral pathogenesis. This article highlights the significance of ubiquitination in signal transduction for innate immune responses and the im-portance of deubiquitinase activity of PL2 Pro in inhibiting host antiviral activities.
{"title":"Papain-like 2 protease of coronavirus and innate immune response","authors":"Y. Jeon","doi":"10.30579/mbse.2020.3.2.31","DOIUrl":"https://doi.org/10.30579/mbse.2020.3.2.31","url":null,"abstract":"the few decades, certain coronaviruses have become threat to humans. Coronaviruses such as severe acute respiratory syndrome-related coronavirus (SARS-CoV) and Middle East respiratory syndrome-related coronavirus (MERS-CoV) have caused lethal outbreaks in 2003 and 2012, respectively. In 2019, severe infectious coronavirus outbreak with unusual pneumonia was reported in Wuhan, China, which later became pandemic. Due to the similarity of coronavirus disease 2019 (COVID-19) to SARS-CoV, the virus was termed as SARS-CoV-2. Although viral proteases such as papain-like 2 protease (PL2 Pro ) are essential for virulence of SARS-CoV, limited information is available on the role of protease in viral pathogenesis. This article highlights the significance of ubiquitination in signal transduction for innate immune responses and the im-portance of deubiquitinase activity of PL2 Pro in inhibiting host antiviral activities.","PeriodicalId":259565,"journal":{"name":"Medical Biological Science and Engineering","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114712403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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