39 results on '"Ji Hyang Lee"'
Search Results
2. The effect of type of anesthesia on intra-and postoperative blood loss at elective cesarean section
- Author
-
Jeong Eun Kim, Ji Hyang Lee, Eun Ju Kim, Myung Woo Min, Jong Seouk Ban, and Sang Gon Lee
- Subjects
blood loss ,cesarean section ,general anesthesia ,hemoglobin ,spinal anesthesia ,Anesthesiology ,RD78.3-87.3 - Abstract
BackgroundIn cesarean section (c-sec) it is known that women receiving spinal anesthesia have decreased intraoperative blood loss compared to women receiving general anesthesia. However, we should always consider postoperative bleeding (postpartum bleeding) that may follow. The amount of postpartum bleeding can be substantial. Therefore, we sought to evaluate the effect of type of anesthesia retrospectively on intra- and postoperative blood loss by comparing the changes of postoperative Hb, Hct at c-sec.MethodsWe retrospectively compared the medical records of 287 elective c-sec patients. We excluded medical and obstetric conditions that may predispose such patients to increased blood loss. Subsequent detailed record analysis included 152 patients that received spinal anesthesia (group S), and 135 patients that received sevoflurane for general anesthesia (group G).ResultsIn comparison with the preoperative Hb, rates of Hb in the 1st postoperative day in group S significantly decreased compared to group G, but there was no significant difference in decreasing rates of Hb in the 3rd postoperative day between groups S and G. Estimated blood loss (EBL) of the intraoperative and operative day in group S was significantly lower compared to group G, but there was no significant difference in EBL of 1st and 2nd postoperative day between groups S and G.ConclusionsWe conclude that group S had a decrease in blood loss between the intraoperative and operative day and there was no significant differences in postoperative blood loss compared with group G.
- Published
- 2012
- Full Text
- View/download PDF
3. Anesthetic experience of a patient with tracheomegaly -A case report
- Author
-
Mi Young Kim, Eun Joo Kim, Byung Woo Min, Jong Suk Ban, Sang Kon Lee, and Ji Hyang Lee
- Subjects
tracheobronchomegaly ,tracheomegaly ,tracheostomy tube ,Anesthesiology ,RD78.3-87.3 - Abstract
Tracheomegaly or tracheobronchomegaly is a rare syndrome that consists of marked dilatation of the trachea and the major bronchi, and this is usually due to a congenital defect of the elastic and muscle fibers of the tracheobroncheal tree. Physicians have had only limited experience with performing anesthesia in patients with this type of syndrome. This syndorme is diagnosed by roentenological investigation and this condition is frequently associated with chronic respiratory infection and partial airway obstruction. In this report, we present a case of performing tracheostomy for a patient with tracheomegaly, and this was probably secondary to mechanical ventilator therapy. The regular tracheostomy tube did not provided sufficient length to allow the cuff to lie properly in the trachea in this patient. Because of the peri-cuff air leakgae and hypercapnea after tracheostomy, we needed a longer tracheostomy tube. But we didn't have such a tube and we didn't know any other method, so we couldn't perform tracheostomy. Therefore, we introduced a method of reducing the length of the endotracheal tube to a suitable size until a longer tracheostomy tube can be obtained for those patients having tracheomegaly.
- Published
- 2010
- Full Text
- View/download PDF
4. Epidural anesthesia for the patient with type IV spinal muscular atrophy -A case report
- Author
-
Seon Jin Kim, Eun Ju Kim, Byung Woo Min, Jong Seouk Ban, Sang Gon Lee, and Ji Hyang Lee
- Subjects
epidural anesthesia ,spinal muscular atrophy ,Anesthesiology ,RD78.3-87.3 - Abstract
Spinal muscular atrophy (SMA) is a rare lower motor neurone disease in which anesthetic management is often difficult as a result of muscle weakness, hypersensitivity to non-depolarizing neuromuscular blocking agent, and succinylcholine induced hyperkalemia. We describe a 50-year-old patient with type IV SMA for synovectomy. We decided to use an epidural technique to avoid muscle relaxants and tracheal intubation. After operation, there was no exacerbation of neurologic signs and symptoms.
- Published
- 2010
- Full Text
- View/download PDF
5. Combined spinal-epidural anesthesia for cesarean section in a patient with Moyamoya disease -A case report
- Author
-
Kwang Suk Shim, Eun Ju Kim, Ji Hyang Lee, Sang Gon Lee, Jong Seouk Ban, and Byung Woo Min
- Subjects
combined spinal-epidural anesthesia ,ephedrine ,moyamoya disease ,phenylephrine ,Anesthesiology ,RD78.3-87.3 - Abstract
Moyamoya disease is a rare progressive occlusive disease of the internal carotid arteries. We report a case of combined spinal-epidural anesthesia in a patient with Moyamoya disease presenting for Cesarean section. Hypotension associated with spinal anesthesia for Cesarean section is the most common and serious adverse effect despite the use of uterine displacement and volume preload. We continuously infused phenylephrine and ephedrine to prevent hypotension. The intraoperative hemodynamic state was stable. The patient had no significant postoperative complications.
- Published
- 2010
- Full Text
- View/download PDF
6. Ascertaining injury risk issues through big data analysis: text-mining based analysis of national emergency response data
- Author
-
Jin-Young Won, Yu-Rim Lee, Myeong-Heum Cho, Yun-Tae Kim, and Ji-Hyang Lee
- Subjects
injury ,text-mining ,EMS data ,novelty ,scalability ,health policy ,Public aspects of medicine ,RA1-1270 - Abstract
ObjectivesInjury prevention can be achieved through various interventions, but it faces challenges due to its comprehensive nature and susceptibility to external environmental factors, making it difficult to detect risk signals. Moreover, the reliance on standardized systems leads to the construction and statistical analysis of numerous injury surveillance data, resulting in significant temporal delays before being utilized in policy formulation. This study was conducted to quickly identify substantive injury risk problems by employing text mining analysis on national emergency response data, which have been underutilized so far.MethodsWith emerging issue and topic analyses, commonly used in science and technology, we detected problematic situations and signs by deriving injury keywords and analyzing time-series changes.ResultsIn total, 65 injury keywords were identified, categorized into hazardous, noteworthy, and diffusion accidents. Semantic network analysis on hazardous accident terms refined the injury risk issues.ConclusionAn increased risk of winter epidemic fractures due to extreme weather, self-harm due to depression (especially drug overdose and self-mutilation), and falls was observed in older adults. Thus, establishing effective injury prevention strategies through inter-ministerial and interagency cooperation is necessary.
- Published
- 2024
- Full Text
- View/download PDF
7. Blood transcriptome differentiates clinical clusters for asthma
- Author
-
Jin An, MD, PhD, Seungpil Jeong, PhD, Kyungtaek Park, PhD, Heejin Jin, PhD, Jaehyun Park, PhD, Eunsoon Shin, PhD, Ji-Hyang Lee, MD, PhD, Woo-Jung Song, MD, PhD, Hyouk-Soo Kwon, MD, PhD, You Sook Cho, MD, PhD, Jong Eun Lee, PhD, Sungho Won, PhD, and Tae-Bum Kim, MD, PhD
- Subjects
Asthma ,Cluster ,Transcriptome ,Pathway ,Immunologic diseases. Allergy ,RC581-607 - Abstract
Background: In previous studies, several asthma phenotypes were identified using clinical and demographic parameters. Transcriptional phenotypes were mainly identified using sputum and bronchial cells. Objective: We aimed to investigate asthma phenotypes via clustering analysis using clinical variables and compare the transcription levels among clusters using gene expression profiling of the blood. Methods: Clustering analysis was performed using 6 parameters: age of asthma onset, body mass index, pack-years of smoking, forced expiratory volume in 1 s (FEV1), FEV1/forced vital capacity, and blood eosinophil counts. Peripheral blood mononuclear cells (PBMCs) were isolated from whole blood samples and RNA was extracted from selected PBMCs. Transcriptional profiles were generated (Illumina NovaSeq 6000) and analyzed using the reference genome and gene annotation files (hg19.refGene.gft). Pathway enrichment analysis was conducted using GO, KEGG, and REACTOME databases. Results: In total, 355 patients with asthma were included in the analysis, of whom 72 (20.3%) had severe asthma. Clustering of the 6 parameters revealed 4 distinct subtypes. Cluster 1 (n = 63) had lower predicted FEV1 % and higher pack-years of smoking and neutrophils in sputum. Cluster 2 (n = 43) had a higher proportion and number of eosinophils in sputum and blood, and severe airflow limitation. Cluster 3 (n = 110) consisted of younger subjects with atopic features. Cluster 4 (n = 139) included features of late-onset mild asthma. Differentially expressed genes between clusters 1 and 2 were related to inflammatory responses and cell activation. Th17 cell differentiation and interferon gamma-mediated signaling pathways were related to neutrophilic inflammation in asthma. Conclusion: Four clinical clusters were differentiated based on clinical parameters and blood eosinophils in adult patients with asthma form the Cohort for Reality and Evolution of Adult Asthma in Korea (COREA) cohort. Gene expression profiling and molecular pathways are novel means of classifying asthma phenotypes.
- Published
- 2024
- Full Text
- View/download PDF
8. Effects of bepotastine, a nonsedating H1-antihistamine, for the treatment of persistent cough and allergic rhinitis: a randomised, double-blind, placebo-controlled trial
- Author
-
Ji-Hyang Lee, Ji-Yoon Oh, Hyouk-Soo Kwon, Tae-Bum Kim, You Sook Cho, and Woo-Jung Song
- Subjects
Medicine - Abstract
Background Empirical therapy with oral histamine-1 receptor antagonists (H1RAs) is often used for patients with suspected upper airway cough syndrome. No placebo-controlled trials with nonsedating H1RAs (nsH1RAs) have evaluated validated cough outcomes. The objective of the present study was to assess the effect of an nsH1RA, bepotastine, on cough outcomes in patients with allergic rhinitis and persistent cough. Methods A randomised, double-blind, placebo-controlled trial was conducted. Adult patients with persistent cough (>3 weeks in duration) and symptomatic allergic rhinitis were recruited and randomly assigned to receive either bepotastine or placebo at a 1:1 ratio. The primary outcome was cough-specific quality of life assessed using the Leicester Cough Questionnaire (LCQ). Secondary outcomes included cough severity visual analogue scale (VAS), throat VAS, Cough Hypersensitivity Questionnaire, Sinonasal Outcome Test-22 score and drug adverse events. Results Between October 2021 and September 2022, 50 participants (43 females; mean age 46.28 years; median cough duration 3 months) were assigned to either the bepotastine 10 mg twice daily or placebo group in a 1:1 ratio. After 2 weeks of treatment, both bepotastine and placebo groups showed significant improvements in the LCQ scores, but there was no significant difference in the magnitude of change between the groups (3.45±2.10 versus 3.04±2.94, p=0.576). Secondary outcomes were also comparable. Conclusions Despite the relatively small sample size, our study clearly demonstrated that a 2-week treatment with bepotastine did not provide therapeutic benefits for cough outcomes. These findings suggest against the use of nsH1RAs with the intention of improving cough outcomes, even in patients with persistent cough and allergic rhinitis.
- Published
- 2023
- Full Text
- View/download PDF
9. Roles of real-world evidence in severe asthma treatment: challenges and opportunities
- Author
-
Youngsoo Lee, Ji-Hyang Lee, So Young Park, Ji-Ho Lee, Joo-Hee Kim, Hyun Jung Kim, Sang-Heon Kim, Kian Fan Chung, and Woo-Jung Song
- Subjects
Medicine - Abstract
Recent advances in asthma research have led to the development of novel biologicals that hinder the pathological actions of key molecules in severe asthma. Traditional randomised controlled studies (RCTs), the gold standard for evaluating the efficacy and safety of medical interventions with excellent internal validity, have proven the clinical benefits and favourable safety profiles of type 2 biologicals in severe asthma. However, RCTs are not always ideal because of shortcomings such as limited external validity and practical issues in the management of severe asthma that cannot be solved through strictly designed clinical trials. Thus, the applicability of their findings may be questioned because treatment adherence is frequently poor in the real world. Real-world evidence includes a wide range of real-world data (RWD) collected from multiple sources in clinical practice, such as electronic medical records, healthcare insurance claims and retrospective or prospective patient registries. RWD may help clinicians decide how to manage patients with severe asthma. Real-world evidence is also gaining attention in addressing clinical questions not answered by traditional RCTs. Because there are various types of RWD with different possibilities and limitations, it is important to decide which type of RWD could be “fit for purpose” to address a specific question. This narrative review discusses the challenges and opportunities of RWD for evaluating the effectiveness and clinical outcomes of biological treatments for severe asthma.
- Published
- 2023
- Full Text
- View/download PDF
10. Precision Medicine Intervention in Severe Asthma (PRISM) study: molecular phenotyping of patients with severe asthma and response to biologics
- Author
-
Ji-Hyang Lee, Piers Dixey, Pank Bhavsar, Katie Raby, Nazanin Kermani, Marc Chadeau-Hyam, Ian M. Adcock, Woo-Jung Song, Hyouk-Soo Kwon, Sei-Won Lee, You Sook Cho, Kian Fan Chung, and Tae-Bum Kim
- Subjects
Medicine - Abstract
Severe asthma represents an important clinical unmet need despite the introduction of biologic agents. Although advanced omics technologies have aided researchers in identifying clinically relevant molecular pathways, there is a lack of an integrated omics approach in severe asthma particularly in terms of its evolution over time. The collaborative Korea–UK research project Precision Medicine Intervention in Severe Asthma (PRISM) was launched in 2020 with the aim of identifying molecular phenotypes of severe asthma by analysing multi-omics data encompassing genomics, epigenomics, transcriptomics, proteomics, metagenomics and metabolomics. PRISM is a prospective, observational, multicentre study involving patients with severe asthma attending severe asthma clinics in Korea and the UK. Data including patient demographics, inflammatory phenotype, medication, lung function and control status of asthma will be collected along with biological samples (blood, sputum, urine, nasal epithelial cells and exhaled breath condensate) for omics analyses. Follow-up evaluations will be performed at baseline, 1 month, 4–6 months and 10–12 months to assess the stability of phenotype and treatment responses for those patients who have newly begun biologic therapy. Standalone and integrated omics data will be generated from the patient samples at each visit, paired with clinical information. By analysing these data, we will identify the molecular pathways that drive lung function, asthma control status, acute exacerbations and the requirement for daily oral corticosteroids, and that are involved in the therapeutic response to biological therapy. PRISM will establish a large multi-omics dataset of severe asthma to identify potential key pathophysiological pathways of severe asthma.
- Published
- 2023
- Full Text
- View/download PDF
11. Assessment of Treatment Response in Patients With Severe Asthma Using Visual and Quantitative Analysis of Chest CT.
- Author
-
Han Na Lee, Jin An, Miji Lee, Hye Jeon Hwang, Jooae Choe, Jihye Yoon, Ji-Hyang Lee, Min-Hye Kim, Young-Joo Cho, Sang Min Lee, Tae-Bum Kim, and Joon Beom Seo
- Published
- 2024
- Full Text
- View/download PDF
12. Efficacy of non-sedating H1-receptor antihistamines in adults and adolescents with chronic cough: A systematic review
- Author
-
Ji-Hyang Lee, Ji Won Lee, Jin An, Ha-Kyeong Won, So-Young Park, Ji-Ho Lee, Sung-Yoon Kang, Yoshihiro Kanemitsu, Hyun Jung Kim, and Woo-Jung Song
- Subjects
Non-sedating H1-receptor antihistamine ,Asthma ,Allergic rhinitis ,Atopic cough ,Chronic cough ,Immunologic diseases. Allergy ,RC581-607 - Abstract
Background: Nasal symptoms frequently coexist in patients with chronic cough, and non-sedating H1-receptor antihistamines (nsH1RAs) are often prescribed for cough management in several countries. However, recommendations on the use of nsH1RAs vary among chronic cough guidelines. This study aimed to examine the efficacy of nsH1RAs over placebos in adolescents or adults with chronic cough or allergic respiratory conditions that may present as chronic cough. Methods: Electronic databases were searched for studies published until November 2020. Randomized placebo-controlled trials of nsH1RAs reporting cough endpoints in adolescents or adults with chronic cough or cough-associated allergic respiratory conditions (allergic rhinitis, allergic asthma, or atopic cough) were included. Results: A total of 10 placebo-controlled trials were identified. Three studies (one study each involving allergic rhinitis, allergic rhinitis with comorbid asthma, and atopic cough) described baseline and post-treatment cough scores, and all reported significant improvements in subjective cough scores; however, the magnitude of improvement was greater in the 2 studies of patients with atopic cough (relative improvement in cough frequency score: −36.6 ± 8.4%) or seasonal allergic rhinitis-associated cough (cough frequency score: −44.0 ± 7.3% and cough intensity score: −65.7 ± 8.3%) than in the 1 study of allergic rhinitis patients with comorbid asthma (−4.0 ± 1.3%). Meanwhile, the other 7 trials found conflicting results but lacked information on the baseline cough score and did not use validated cough measurement tools; thus, their clinical relevance could not be determined. Conclusion: Despite the widespread use of nsH1RAs in patients with chronic cough, only a few clinical trials examining their benefits on cough outcomes have been conducted. There may be a subgroup of patients, particularly those with seasonal allergic rhinitis-associated cough or atopic cough, whose cough may improve with nsH1RA treatment. However, adequately powered trials with validated cough measurement tools are warranted to confirm the role of nsH1RAs in the management of patients with allergic phenotypes of chronic cough.
- Published
- 2021
- Full Text
- View/download PDF
13. The role of allergen-specific IgE in predicting allergic symptoms on dog and cat exposure among Korean pet exhibition participants
- Author
-
Sung-Yoon Kang, Min-Suk Yang, So-Young Park, Jung-Hyun Kim, Ha-Kyeong Won, Oh Young Kwon, Ji-Hyang Lee, Ye-Won Kang, Jae-Woo Jung, Woo-Jung Song, Sae-Hoon Kim, Sang Min Lee, and Sang Pyo Lee
- Subjects
Allergy ,Cats ,Dogs ,Skin prick test ,Specific IgE ,Immunologic diseases. Allergy ,RC581-607 - Abstract
Background: The values of the skin prick test (SPT) and allergen-specific IgE (sIgE) measurement in predicting dog and cat allergies remain unclear. We aimed to evaluate the usefulness of SPT and sIgE measurement in predicting self-reported allergic symptoms during exposure to dogs and cats in Korean adults. Methods: A total of 552 participants in a pet exhibition in Korea completed questionnaires regarding exposure to dog or cat and the development of allergic symptoms during exposure. Study participants also underwent SPT using 3 different commercially available reagents, and had their blood drawn for measurement of serum total IgE and dog/cat-dander-IgE using ImmunoCAP®. Results: Measurement of sIgE for dog and cat dander allergens provided the highest positive and negative predictive values and sensitivity, but not specificity (58%, 87.2%, 67.9%, and 93.1% for allergic symptoms on dog exposure; 64.7%, 83.2%, 74.8%, and 88.9% for those on cat exposure, respectively), in predicting self-reported allergic symptoms on dog and cat exposure. The sIgE level consistently exhibited the highest area under the receiver operating characteristic curve (0.749 and 0.719 for allergic symptoms on dog and cat exposure, respectively). Careful interpretation of SPT and sIgE measurements maximized the positive and negative predictive values, sensitivity, and specificity for predicting allergic symptoms on dog exposure (71.4%, 87.3%, 75.3%, and 99.3%) and those on cat exposure (71.4%, 85.3%, 79.3%, and 98.9%). Conclusions: The measurement of dog and cat dander sIgE levels may be useful for the exclusion of allergic symptoms related to pet exposure. Collective interpretation of SPT and sIgE tests facilitates identification of allergic symptoms on dog or cat exposure, giving a better rule-in test result.
- Published
- 2020
- Full Text
- View/download PDF
14. Metagenome analysis using serum extracellular vesicles identified distinct microbiota in asthmatics
- Author
-
Jinho Yang, Chan Sun Park, Woo-Jung Song, Hyouk-Soo Kwon, Ha-Kyeong Won, Yoon-Keun Kim, Hae-Sim Park, Tae-Bum Kim, Jun-Pyo Choi, You Sook Cho, and Ji Hyang Lee
- Subjects
0301 basic medicine ,DNA, Bacterial ,Male ,lcsh:Medicine ,Extracellular vesicles ,Article ,03 medical and health sciences ,Extracellular Vesicles ,0302 clinical medicine ,medicine ,Humans ,Microbiome ,lcsh:Science ,Asthma ,Gastrointestinal tract ,Multidisciplinary ,biology ,Bacteria ,Microbiota ,lcsh:R ,Verrucomicrobia ,Bacteroidetes ,Diagnostic marker ,Diagnostic markers ,Middle Aged ,biology.organism_classification ,medicine.disease ,030104 developmental biology ,030228 respiratory system ,Metagenomics ,Case-Control Studies ,Immunology ,Metagenome ,Female ,lcsh:Q - Abstract
Different patterns of bacterial communities have been reported in the airways and gastrointestinal tract of asthmatics when compared to healthy controls. However, the blood microbiome of asthmatics is yet to be investigated. Therefore, we aimed to determine whether a distinct serum microbiome is observed in asthmatics by metagenomic analysis of serum extracellular vesicles (EVs). We obtained serum from 190 adults with asthma and 260 healthy controls, from which EVs were isolated and analyzed. The bacterial composition of asthmatics was significantly different from that of healthy controls. Chao 1 index was significantly higher in the asthma group, while Shannon and Simpson indices were higher in the control group. At the phylum level, Bacteroidetes was more abundant in asthmatics, while Actinobacter, Verrucomicrobia, and Cyanobacteria were more abundant in healthy controls. At the genus level, 24 bacterial genera showed differences in relative abundance between asthmatics and controls, with linear discriminant analysis scores greater than 3. Further, in a diagnostic model based on these differences, a high predictive value with a sensitivity of 0.92 and a specificity of 0.93 was observed. In conclusion, we demonstrated distinct blood microbiome in asthma indicating the role of microbiome as a potential diagnostic marker of asthma.
- Published
- 2020
15. Neuromuscular blockade reversal with sugammadex versus pyridostigmine/glycopyrrolate in laparoscopic cholecystectomy: a randomized trial of effects on postoperative gastrointestinal motility
- Author
-
Jihyun An, Eun Ju Kim, Kyeongyoon Woo, Hyunkyum Kim, Heeyun Noh, and Ji Hyang Lee
- Subjects
Adult ,Male ,glycopyrrolate ,Muscarinic Antagonists ,Anticholinergic agents ,gastrointestinal motility ,Sevoflurane ,Sugammadex ,defecation ,lcsh:RD78.3-87.3 ,Postoperative Complications ,medicine ,Humans ,Prospective Studies ,Rocuronium ,Glycopyrrolate ,Clinical Research Article ,business.industry ,Middle Aged ,flatulence ,Anesthesiology and Pain Medicine ,Cholecystectomy, Laparoscopic ,Pyridostigmine ,lcsh:Anesthesiology ,Anesthesia ,Neuromuscular Blockade ,sugammadex ,Drug Therapy, Combination ,Female ,Pyridostigmine Bromide ,cholinergic antagonists ,Cholinesterase Inhibitors ,business ,Propofol ,pyridostigmine bromide ,Neuromuscular Nondepolarizing Agents ,medicine.drug - Abstract
Background Acetylcholinesterase inhibitors (e.g., pyridostigmine bromide) are used for neuromuscular blockade (NMB) reversal in patients undergoing surgery under general anesthesia (GA). Concurrent use of anticholinergic agents (e.g., glycopyrrolate) decreases cholinergic side effects but can impede bowel movements. Sugammadex has no cholinergic effects; its use modifies recovery of gastrointestinal (GI) motility following laparoscopic cholecystectomy compared to pyridostigmine/glycopyrrolate. This study evaluated the contribution of sugammadex to the recovery of GI motility compared with pyridostigmine and glycopyrrolate. Methods We conducted a prospective study of patients who underwent laparoscopic cholecystectomy. Patients were randomly allocated to the experimental group (sugammadex, Group S) or control group (pyridostigmine-glycopyrrolate, Group P). After anesthesia (propofol and rocuronium, and 2% sevoflurane), recovery was induced by injection of sugammadex or a pyridostigmine-glycopyrrolate mixture. As a primary outcome, patients recorded the time of their first passage of flatus (‘gas-out time’) and defecation. The secondary outcome was stool types. Results One-hundred and two patients participated (Group S [n = 49], Group P [n = 53]). Mean time from injection of NMB reversal agents to gas-out time was 15.03 (6.36–20.25) h in Group S and 20.85 (16.34–25.86) h in Group P (P = 0.001). Inter-group differences were significant. Time until the first defecation as well as types of stools was not significantly different. Conclusions Sugammadex after laparoscopic cholecystectomy under GA resulted in an earlier first postoperative passage of flatus compared with the use of a mixture of pyridostigmine and glycopyrrolate. These findings suggest that the use of sugammadex has positive effects on the recovery of GI motility.
- Published
- 2020
16. Emergency cesarean section performed in a patient with confirmed severe acute respiratory syndrome Coronavirus-2 -a case report
- Author
-
Jihyun An, Dong Hwan Lee, Eun Ju Kim, Kyeongyoon Woo, Hak Youle Park, and Ji Hyang Lee
- Subjects
0301 basic medicine ,medicine.medical_specialty ,Emergency Cesarean Section ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Case Report ,World health ,lcsh:RD78.3-87.3 ,03 medical and health sciences ,0302 clinical medicine ,Anesthesiology ,Pandemic ,medicine ,Severe acute respiratory syndrome coronavirus 2 ,030212 general & internal medicine ,Personal protective equipment ,Pandemics ,Pregnancy ,business.industry ,Pregnant women ,Outbreak ,COVID-19 ,medicine.disease ,030104 developmental biology ,Anesthesiology and Pain Medicine ,lcsh:Anesthesiology ,Emergency medicine ,business ,Cesarean section ,Coronavirus Infections - Abstract
Background: Since the first case of severe acute respiratory syndrome Coronavirus-2 (SARS-CoV-2) occurred in Wuhan in December 2019, the virus has spread globally. The World Health Organization declared the virus outbreak a pandemic on March 11, 2020. On January 19, 2020, a 35-year-old woman who returned from China was confirmed as the first SARS-CoV-2 infected case in Korea. Since then, it has spread all over Korea.Case: We report the first case of a SARS-CoV-2 positive woman delivering a baby through cesarean section at 37+6 weeks of pregnancy in the Republic of Korea.Conclusions: This case suggested that negative pressure operating room, skillful medical team, and enhanced personal protective equipment including N95 masks, surgical cap, double gown, double gloves, shoe covers, and powered air-purifying respirator are required at the hospital for safe delivery in such a case.
- Published
- 2020
17. Delayed local reactions after the first administration of the ChAdOx1 nCoV‐19 vaccine
- Author
-
Woo-Jung Song, Hyouk-Soo Kwon, Seongman Bae, Eunyong Shin, Hee-Sung Kim, Tae-Bum Kim, Jiwon Jung, Ji Hyang Lee, You Sook Cho, and Sung-Han Kim
- Subjects
2019-20 coronavirus outbreak ,Vaccines ,COVID-19 Vaccines ,Coronavirus disease 2019 (COVID-19) ,business.industry ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Immunology ,MEDLINE ,Immunization, Secondary ,COVID-19 ,Virology ,Letter to the Editors ,ChAdOx1 nCoV-19 ,Immunology and Allergy ,Medicine ,Humans ,business ,Administration (government) ,Local Reaction ,Letter to the Editor - Published
- 2021
18. Genome-wide association study of Korean asthmatics: a comparison with UK asthmatics
- Author
-
Sanghun Lee, Kian Fan Chung, Woo-Jung Song, Ji Hyang Lee, Jin An, Tae-Bum Kim, Hyouk Soo Kwon, Ah Ra Do, Ian M. Adcock, Sile Hu, Sungho Won, You Sook Cho, Woo Jin Kim, Hae Yeon Kang, and Hee Bom Moon
- Subjects
Pulmonary and Respiratory Medicine ,Genome-wide association study ,Allergy ,GENETICS ,Immunology ,IL1RL1 ,Single-nucleotide polymorphism ,human leukocyte antigen ,medicine ,Genetic predisposition ,Immunology and Allergy ,SNP ,Asthma ,Genetic association ,RISK ,Science & Technology ,Korea ,EXACERBATED RESPIRATORY-DISEASE ,business.industry ,Odds ratio ,asthma ,ALLELES ,medicine.disease ,United Kingdom ,Original Article ,business ,Life Sciences & Biomedicine - Abstract
Purpose Although genome-wide association studies (GWASs) represent the most powerful approach for identifying genes that influence asthma, to date, no studies have established genetic susceptibility to asthma in the Korean population. This study aimed to identify genetic variants associated with adult Korean asthmatics and compare them with the significant single nucleotide polymorphisms (SNPs) of UK asthmatics from the UK Biobank. Methods Patients were defined as having asthma if they were diagnosed by a doctor or taking medications for asthma. Controls were defined as individuals without asthma or chronic obstructive pulmonary disease. We performed quality control, genotype imputation, GWAS, and PrediXcan analyses. In the GWAS, a P value of < 5 × 10−8 was considered significant. We compared significant SNPs between Korean and UK patients with asthma. Results A total of 1,386 asthmatic patients and 5,205 controls were analyzed. The SNP rs1770, located near the human leukocyte antigen (HLA)-DQB1, was the most significant SNP (P = 4.5 × 10−10). In comparison with 24 SNPs in a GWAS of UK asthmatics, six SNPs were significant with the same odds ratio (OR) direction, including signals related to type 2 inflammation (e.g., IL1RL1, TSLP, and GATA3) and mucus plugging (e.g., MUC5AC). HLA-DQA1 showed an opposite OR direction. The HLA-DQB1 gene demonstrated significantly imputed mRNA expression in the lung tissue and whole blood. Conclusions The SNP rs1770 of HLA-DQB1 was the most significant in Korean asthmatics. Similarities and discrepancies were found in the genetic variants between Korean and UK asthmatics. GWAS of Korean asthmatics should be replicated and compared with those of GWAS of other ethnicities.
- Published
- 2021
19. Adverse Reactions of the Second Dose of the BNT162b2 mRNA COVID-19 Vaccine in Healthcare Workers in Korea
- Author
-
Miseo Kim, Seongman Bae, Joon Seo Lim, Seonhee Kwon, Jiwon Jung, Hyouk Soo Kwon, So Yun Lim, Jiyeon Joo, Yun Woo Lee, Eun Ok Kim, Ji Hyang Lee, Sun Hee Kwak, Tae-Bum Kim, and Sung-Han Kim
- Subjects
Adult ,Male ,medicine.medical_specialty ,COVID-19 Vaccines ,Coronavirus disease 2019 (COVID-19) ,Health Personnel ,education ,Brief Communication ,Preventive & Social Medicine ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Age groups ,Internal medicine ,medicine ,Humans ,030212 general & internal medicine ,Prospective Studies ,Young adult ,Prospective cohort study ,Adverse effect ,BNT162 Vaccine ,Aged ,business.industry ,SARS-CoV-2 ,Vaccination ,Adverse Reaction ,COVID-19 ,General Medicine ,Middle Aged ,Systemic reaction ,Chills ,BNT162b2 ,Female ,medicine.symptom ,business - Abstract
We conducted a prospective, mobile-based survey on the self-reported adverse reactions in healthcare workers (HCWs) who received both doses of the BNT162b2 mRNA vaccine. Of the 342 HCWs who completed the two-dose vaccination, 265 (77.5%) responded to the survey at least once. Overall, the rates of adverse reactions were higher after the second dose compared with the first dose (89.1% vs. 80.1%, P = 0.006). The most common systemic reactions were muscle ache (69.1%), fatigue (65.7%), headache (48.7%), chills (44.2%), and fever (32.1%), and were notably more common after the second dose vaccine as well. We also noted a sex difference in which the frequency of adverse reactions after the second dose of the vaccine was significantly higher in females, which was not observed after the first dose. The rates of adverse reactions were lower in older age groups, and the rates and severities of the adverse reactions decreased during the 3-day period following vaccination., Graphical Abstract
- Published
- 2021
20. Clinical characteristics of eperisone-induced immediate-type hypersensitivity.
- Author
-
Bomi Shin, Sun-Young Yoon, Ji-Hyang Lee, Ha-Kyeong Won, Jin An, Yewon Kang, Woo-Jung Song, Tae-Bum Kim, You Sook Cho, Hee-Bom Moon, and Hyouk-Soo Kwon
- Published
- 2020
- Full Text
- View/download PDF
21. Comparison of sugammadex and pyridostigmine bromide for reversal of rocuronium-induced neuromuscular blockade in short-term pediatric surgery: A prospective randomized study.
- Author
-
Jihyun An, Ji-Hyang Lee, Eunju Kim, Kyeongyoon Woo, Hyunkyum Kim, Donghwan Lee, An, Jihyun, Lee, Ji-Hyang, Kim, Eunju, Woo, Kyeongyoon, Kim, Hyunkyum, and Lee, Donghwan
- Published
- 2020
- Full Text
- View/download PDF
22. Ultrasound-guided Lateral Femoral Cutaneous Nerve Block in Meralgia Paresthetica
- Author
-
Jeong Eun Kim, Ji Hyang Lee, Eun Ju Kim, Byung Woo Min, Jong Suk Ban, and Sang Gon Lee
- Subjects
medicine.medical_specialty ,Local anesthetic ,medicine.drug_class ,business.industry ,ultrasound ,Ultrasound ,meralgia paresthetica ,Anterior superior iliac spine ,Sensory system ,Case Report ,Lateral femoral cutaneous nerve ,medicine.disease ,Surgery ,Mononeuropathy ,Anesthesiology and Pain Medicine ,medicine.anatomical_structure ,lateral femoral cutaneous nerve ,medicine ,Inguinal ligament ,business ,Meralgia paresthetica - Abstract
Meralgia paresthetica is a rarely encountered sensory mononeuropathy characterized by paresthesia, pain or sensory impairment along the distribution of the lateral femoral cutaneous nerve (LFCN) caused by entrapment or compression of the nerve as it crossed the anterior superior iliac spine and runs beneath the inguinal ligament. There is great variability regarding the area where the nerve pierces the inguinal ligament, which makes it difficult to perform blind anesthetic blocks. Ultrasound has developed into a powerful tool for the visualization of peripheral nerves including very small nerves such as accessory and sural nerves. The LFCN can be located successfully, and local anesthetic solution distribution around the nerve can be observed with ultrasound guidance. Our successfully performed ultrasound-guided blockade of the LFCN in meralgia paresthetica suggests that this technique is a safe way to increase the success rate.
- Published
- 2011
23. Severe hemodynamic deterioration caused by cardiac herniation during endoscopic thoracic sympathicotomy in a patient with previously undiagnosed congenital pericardial defect
- Author
-
Eun Ju Kim, Jong-Seouk Ban, Joong-Ho Park, Ji-Hyang Lee, and Jihyun An
- Subjects
medicine.medical_specialty ,Supine position ,business.industry ,Thoracic cavity ,Mediastinum ,Ventricular Outflow Obstruction ,medicine.disease ,Surgery ,lcsh:RD78.3-87.3 ,Anesthesiology and Pain Medicine ,medicine.anatomical_structure ,lcsh:Anesthesiology ,Right coronary artery ,medicine.artery ,medicine ,Pericardium ,Myocardial infarction ,business ,Left posterior fascicular block ,Letter to the Editor - Abstract
Congenital pericardial defect is a rare but potentially fatal disorder as it can cause severe hemodynamic compromise. Its asymptomatic nature and lack of diagnostic roles in chest radiography or electrocardiography (ECG) make diagnosis difficult [1]. We report a case of a patient with previously undiagnosed pericardial defect, who developed ST elevation and severe hemodynamic deterioration during endoscopic thoracic sympathicotomy. A 24-year-old male (172.2 cm, 74.8 kg) with a history of being a healthy hepatitis B carrier and having a congenital fusion of the cervical vertebrae was scheduled for repair of hyperhidrosis by endoscopic thoracic sympathicotomy. He had no previous cardiopulmonary symptoms, but preoperative ECG showed left posterior fascicular block. Chest radiography revealed an enlarged left atrial appendage (Fig. 1). Fig. 1 Preoperative chest radiography shows enlarged left atrial appendage (arrow). For premedication, glycopyrrolate 0.2 mg, midazolam 2.0 mg, and famotidine 20 mg were administered. Preoperative vital signs were blood pressure (BP) 110/70 mmHg, heart rate (HR) 64 beats per minute (bpm), and oxygen saturation (SaO2) 98-99%. General anesthesia was induced with propofol 120 mg and rocuronium 50 mg. Intubation was performed using a 7.5 ID endotracheal tube. The operation began and the patient was placed in a reverse Trendelenburg position with the left side tilted upwards. To obtain a wider surgical field, carbon dioxide (CO2) was insufflated into the thoracic cavity with a maximum pressure of 10 mmHg at a flow rate of 1 L/min. Adhesiolysis was required since adhesions between the left lung and the mediastinum hindered visualization of the sympathetic ganglion. The operation was uneventful until the left lung was pulled from the heart toward the chest wall during adhesiolysis, and the dissected cardiac border was protruding out of the mediastinum. Almost immediately, the patient's ECG developed ST elevation, and the BP abruptly dropped to 62/32 mmHg. The operation was stopped and the patient was returned to the neutral supine position. Manual ventilation with a maximum pressure of 20 mmHg was performed. About a minute later, vital signs recovered, with BP 103/52 mmHg, HR 81 bpm, and SaO2 98%. The ECG returned to normal sinus rhythm. After discussion with the surgeon regarding the patient's condition, it was decided that the operation continue with the patient in the neutral supine position. Closer inspection of the cardiac border revealed complete absence of the left pericardium, with the origin of the left anterior descending artery abutting the mediastinum. After the operation of the left side was complete, the patient was tilted to the opposite position for the operation of the right side. No pericardial defect could be visually confirmed on this side, as massive amounts of adhesion were observed between the cardiac border and the lung. It was decided that the remainder of the operation continue without adhesiolysis on the right side, due to the risk of adverse events. The operation was completed without any further adverse events. The patient was taken to the postanesthesia care unit (PACU). One hour of observation in the PACU showed that the vital signs remained within the normal range. The patient was transferred to the general ward. He was discharged three days later without further complications. In this case, the most likely cause of the adverse events appears to be the occurrence of cardiac herniation. The mechanisms and symptoms of cardiac herniation caused by pericardial defect vary depending on whether the defect is right-sided or left-sided [2]. In a right-sided herniation, dextrorotation of the heart may cause torsion of the atrio-caval junction, compression of the vena cava, and ventricular outflow obstruction, leading to severe decreases in cardiac output. In a left-sided herniation, pressure may be applied on the myocardium and coronary arteries by the edges of the pericardial defect, causing fatal ventricular outflow obstruction, arrhythmia, and myocardial infarction [2]. Normally, traction of the lung during adhesiolysis only pulls the pericardium, not the heart itself. However, in this case, absence of the pericardium may have caused the heart to slip out of the mediastinum during the traction of the left lung toward the chest wall. Obstruction of the ventricular outflow caused by cardiac herniation appears to have resulted in sudden decreases in BP. ST elevation was found in lead II, suggesting that either the posterior left ventricular artery of the right coronary artery or the left circumflex artery were the coronary arteries compressed. Recovery of the neutral position and manual insufflation of the lung appear to have placed the herniated heart back into the mediastinum. Another possibility is that the insufflation of CO2 into the thoracic cavity may have created an atmosphere similar to a tension pneumothorax. Wolfer et al. [3] have documented that insufflation of CO2 under low pressure (< 10 mmHg) and low flow can be used safely. Thus in our patient, intrathoracic pressure was maintained at a maximum of 10 mmHg through the use of low flow CO2 at a rate of 1 L/min. ECG changes were observed about 10 minutes after gas insufflation, which suggests that this case is different from the situations in which symptoms appear immediately after gas insufflation, and resolve after the release of the insufflated gas [4,5]. In this case, vital signs were recovered by returning the patient to the neutral supine position and performing manual insufflation of the lung, without any reduction in intrathoracic pressure. This also suggests that the symptoms were probably caused by the cardiac herniation, rather than reflecting cardiovascular collapse induced by gas insufflation. It is difficult to diagnose pericardial defect preoperatively, but measures can be taken to reduce potential complications. Before undergoing surgical intervention and gas insufflation into the intrathoracic cavity, thorough evaluation employing echocardiography, chest computed tomography, and magnetic resonance imaging may be helpful. Careful monitoring throughout the course of the operation, particularly during events such as position changes and surgical manipulation, is also necessary. Unlike other reports of cardiovascular collapse during thoracoscopic procedures [4,5], it appears that the absence of the pericardium resulting in cardiac herniation led to hemodynamic deterioration accompanied by ECG changes in our patient. We report this case as this phenomenon is considered rare but should not be overlooked.
- Published
- 2014
24. Recurrent paroxysmal supraventricular tachycardia in the beach chair position for shoulder surgery under general anesthesia
- Author
-
Eun Ju Kim, Sang Gon Lee, Jong Seouk Ban, Ji Hyang Lee, and Kyung-Yoon Woo
- Subjects
Tachycardia ,Mean arterial pressure ,business.industry ,Cardiac index ,lcsh:RD78.3-87.3 ,Anesthesiology and Pain Medicine ,Blood pressure ,medicine.anatomical_structure ,lcsh:Anesthesiology ,Hypovolemia ,Anesthesia ,Heart rate ,medicine ,Vascular resistance ,Sinus rhythm ,medicine.symptom ,business ,Letter to the Editor - Abstract
The beach-chair position is commonly used for shoulder surgery. Its advantages include ease of setup, less intraoperative blood loss, and a lower incidence of traction neuropathy [1]. However, caution is required as the position may induce undesirable physiologic changes including decrease in mean arterial pressure and cardiac index, and increase in peripheral vascular resistance [2]. Other serious complications include venous air embolism [3] and hemodynamic instability [4]. We experienced a case of recurrent paroxysmal supraventricular tachycardia (PSVT) progressing to pulseless electrical activity accompanied by hypotension during shoulder surgery performed in the beach-chair position. An 89-year-old female patient weighing 32 kg with a height of 145 cm presented for open reduction of nonunion of surgical neck fracture of the left humerus. She had been diagnosed with hypertension 5 years previously, and her current medications included benidipine, a calcium channel blocker, and thiazide, a diuretic. Preoperative laboratory tests were unremarkable. Chest radiography revealed cardiomegaly, and electrocardiogram showed left ventricular hypertrophy. Echocardiogram showed normal left ventricular systolic function with an ejection fraction of 65%. No premedication was given. Vital signs checked upon arrival in the operating room revealed heart rate of 95 beats per minute, blood pressure of 160/90 mmHg, and pulse oximetry at 95%. For induction of anesthesia, 30 mg of lidocaine, 50 mg of propofol, and 30 mg of rocuronium bromide were administered intravenously. Intubation was performed using a 7.0 mm cuffed tube. Anesthesia was maintained with 50% N2O-O2, sevoflurane 1.5 vol%, and remifentanil 0.05 µg/kg/min. For continuous monitoring of the arterial pressure and access to arterial blood gas analysis, a 22 gauge catheter was placed in the right radial artery. The patient's position was changed from supine to the beach-chair position. Invasive arterial blood pressure was measured with a transducer placed at the heart level. About 1-2 minutes after initiation of the beach-chair position, the blood pressure dropped to 85/35 mmHg. 50 µg of phenylephrine was administered intravenously, and the operation was continued with dopamine being infused at 5 µg/kg/min. Blood pressure was maintained around 110/65 mmHg. About one hour after the operation had begun, sudden tachycardia with a heart rate of 140 beats per minute occurred for 3 seconds before returning to normal sinus rhythm. Ten minutes later, the tachycardia recurred with a heart rate of 140 beats per minute. Normal sinus rhythm was recovered after administration of 10 mg of intravenous esmolol. Five minutes after the second tachycardia, a heart rate of 150 beats per minute was noted. Again, normal sinus rhythm was recovered with 10 mg of esmolol. However, as the basal heart rate was increased to 100 beats per minute, continuous administration of amiodarone at a rate of 15 mg per minute was begun. In addition, under the impression of tachycardia caused by hypovolemia, transfusion of one pint of packed red cells was started. Tachycardia of 150 beats per minute occurred again five minutes after the third tachycardia. Blood pressure dropped to 60/40 mmHg and echocardiogram showed loss of p waves and narrow QRS complexes (Fig. 1). The Valsalva maneuver was applied under the impression of PSVT with hypotension, but the technique was ineffective. Following immediate administration of 50 µg of phenylephrine, normal sinus rhythm was recovered and blood pressure increased to 100/60 mmHg. Adenosine and a defibrillator were prepared for potential incidences of PSVT, and the surgeon was informed of the patient's condition. The operation was terminated 3 minutes later, and total blood loss was estimated at 300 ml. During the dressing of the operative site, tachycardia with a rate of 150 beats per minute occurred with hypotension of 40/30 mmHg. 50 µg of phenylephrine was administered, but blood pressure failed to rise and normal sinus rhythm was not recovered. With adenosine prepared for administration, the patient was repositioned into the supine position. Normal sinus rhythm was recovered immediately after repositioning. Blood pressure rose to 100/60 mmHg, and heart rate was maintained at about 90 beats per minute. Following confirmation of hemodynamic stability, the patient was transferred to the postanesthesia care unit. Result from consultation to the Cardiology Department showed no specific findings on 24-hour Holter monitoring or cardiac markers. The patient was discharged two weeks after the operation without further problems. Fig. 1 Electrocardiogram and arterial pressure wave during the course of the operation. While electrocardiogram shifts from normal sinus rhythm to paroxysmal supraventricular tachycardia, arterial pressure gradually decreases to show a flat waveform. PSVT accounts for roughly 2.5% of arrhythmias during anesthesia. Its prevalence is about twice as high in females as in males, and the risk is five times higher in patients above 65 years of age. Known causes of PSVT include underlying cardiogenic diseases, systemic diseases, thyrotoxicosis, digitalis intoxication, pulmonary embolism, and pregnancy. Exercise and stress can be triggering factors in young and healthy patients. Sympathomimetic drugs such as isoproterenol, parasympathetic inhibitors including atropine, and hyperventilation may also cause PSVT. When a patient is anesthetized, PSVT can be precipitated by changes in autonomic nervous system tone, by drug effects, or by intravascular volume shifts. Venous pooling, which is posture dependent, can rapidly reduce central blood volume, leading to decreases in cardiac filling pressure, stroke volume, and cardiac output. In standing position, 8-10 ml/kg of blood moves from the thorax to the lower extremities, a total volume of approximately 500-700 ml in normal healthy adults [5]. Since the patient is in the beach-chair position in the case described here, venous pooling and bleeding caused by the operation have reduced central blood volume. In addition, in elderly patients, reflex tachycardia caused by postural changes is reduced by vagal dysfunction, which makes them vulnerable to hypotension. Therefore, the vasoconstriction response is increased in order to compensate, which may increase sympathetic activity. It appears that, in the current case, many of the factors described earlier may have played roles in the occurrence of PSVT. However, the fact that blood pressure and sinus rhythm were recovered merely by postural change while anesthetic depth and drug concentration were consistent suggests the following: that blood pooling in the beach-chair position and decreased intravascular volume due to bleeding may have acted as the main factors in the occurrence of PSVT. In conclusion, this case shows that the beach-chair position during general anesthesia may cause PSVT. In such a situation, hemodynamic instability and even pulseless electrical activity may occur depending on the patient's condition. Therefore, it appears that immediate repositioning to supine position is necessary for recovery of hemodynamic stability and normal sinus rhythm.
- Published
- 2013
25. Comparison of oxycodone and fentanyl for postoperative patient-controlled analgesia after orthopedic surgery.
- Author
-
Dong-won Lee, Jihyun An, Eunju Kim, Ji-hyang Lee, Hyun Kim, and Jong-chul Son
- Subjects
PATIENT-controlled analgesia ,OXYCODONE ,ORTHOPEDIC surgery ,FENTANYL ,POSTOPERATIVE pain treatment ,THERAPEUTICS - Abstract
Background: Oxycodone is widely used as bolus or patient-controlled analgesia (PCA) for control of postoperative pain. The aim of this study was to assess the efficacy and side effects of oxycodone for somatic pain by comparing oxycodone and fentanyl intravenous PCA after orthopedic surgery. Methods: Seventy-three patients undergoing orthopedic surgery were randomly assigned to receive fentanyl or oxycodone using intravenous PCA (potency ratio 1:60). Pain severity at rest and with movement and adverse effects were assessed at 1, 6, 24, and 48 hours after surgery. The PCA dose and patient satisfaction scores were measured at 48 hours after surgery. Results: The resting visual analogue scale (VAS) and moving VAS scores of the oxycodone group were significantly higher than those of the fentanyl group at 6 hours (P = 0.001, P = 0.021), but at 48 hours, the resting and moving VAS of the oxycodone group were significantly lower than those of the fentanyl group (P = 0.014, P = 0.037). There were no significant differences in adverse effects, satisfaction scores, dose of patientcontrolled mode, or total cumulative PCA dose. Conclusions: With a 1:60 ratio of oxycodone to fentanyl when using PCA for pain control after orthopedic surgery, the use of larger doses of oxycodone for 6 hours is effective in controlling early postoperative pain. [ABSTRACT FROM AUTHOR]
- Published
- 2018
- Full Text
- View/download PDF
26. Dexmedetomidine combined with midazolam vs. dexmedetomidine alone for sedation during spinal anesthesia.
- Author
-
Douk-Keun Yoon, Jong-Seouk Ban, Sang-Gon Lee, Ji-Hyang Lee, Eunju Kim, and Jihyun An
- Subjects
DEXMEDETOMIDINE ,SPINAL anesthesia ,MIDAZOLAM ,BOLUS drug administration ,CONSCIOUS sedation ,BRADYCARDIA ,PATIENTS - Abstract
Background: Dexmedetomidine is a useful sedative agent for spinal anesthesia. However, it has been reported that dexmedetomidine decreases heart rate in a dose-dependent manner. In the current study, we compared the administration of a bolus dose of midazolam and bolus loading of dexmedetomidine over 10 min with the goal of identifying an additional method of sedation. Methods: Ninety patients classified as American Society of Anesthesiologists physical status I–II who were undergoing spinal anesthesia were divided into two groups. In the midazolam and dexmedetomidine combined group (group MD), 10 min after bolus loading of 0.05 mg/kg midazolam, 0.5 μg/kg/h dexmedetomidine was continuously infused. In the dexmedetomidine group (group D), 1 μg/kg dexmedetomidine was infused over 10 min, and then 0.5 μg/kg/h dexmedetomidine was continuously infused. Results: At 10 min, the sedation depth of the two groups was almost equal. In both groups, the bispectral index was within the optimal score range of 55–80 and the Ramsay Sedation Scale score was within the optimal range of 3–5. Satisfaction with sedation for both patient and surgeon did not differ between the two groups. At 10 min, heart rate was significantly lower (P < 0.010) in group D and mean blood pressure was significantly lower (P < 0.010) in group MD. The prevalence of bradycardia, hypotension, and hypoxia did not differ statistically between the two groups (P = 0.714, P = 0.089, P = 0.495, respectively). Conclusions: Midazolam bolus and dexmedetomidine continuous infusion (the regimen of group MD) may be an additional sedation method for patients who have severe bradycardia. [ABSTRACT FROM AUTHOR]
- Published
- 2016
- Full Text
- View/download PDF
27. A case of postoperative serotonin syndrome following the administration of fentanyl, palonosetron, and meperidine -A case report-.
- Author
-
Chiu Lee, Eun-Ju Kim, Soohyun Joe, Jong Seouk Ban, Ji-hyang Lee, and Ji-hyun An
- Subjects
SEROTONIN ,FENTANYL ,DRUG antagonism ,ANESTHESIA ,THERAPEUTICS - Abstract
Serotonin syndrome is an unexpected adverse reaction of serotonergic medication. Some drugs used by anesthesiologists may cause serotonin syndrome. Serotonin syndrome is known to be related to 5-hydroxytryptamine 1A and 5-hydroxytryptamine 2A agonism. However, recent research has revealed evidence that 5-hydroxytryptamine 3 (5-HT
3 ) antagonism can also play a role in serotonin syndrome. Among the 5-HT3 antagonists, palonosetron is the most highly specific. In this study, we present the first case of fentanyl- and meperidine-induced serotonin syndrome precipitated by palonosetron in general anesthesia. [ABSTRACT FROM AUTHOR]- Published
- 2015
- Full Text
- View/download PDF
28. Comparison of oxycodone and fentanyl for postoperative patient-controlled analgesia after laparoscopic gynecological surgery.
- Author
-
Joong-Ho Park, Chiu Lee, Youngmin Shin, Ji-Hyun An, Jong-Seouk Ban, and Ji-Hyang Lee
- Subjects
POSTOPERATIVE pain treatment ,PATIENT-controlled analgesia ,GYNECOLOGIC surgery ,OXYCODONE ,FENTANYL ,POSTOPERATIVE period ,LAPAROSCOPIC surgery ,THERAPEUTICS - Abstract
Background: Opioids are widely used in boluses and patient-controlled analgesia (PCA) for postoperative pain control. In this study, we compared the effects of oxycodone and fentanyl on postoperative pain in patients with intravenous patient-controlled analgesia (IV-PCA) after laparoscopic gynecological surgery. Methods: Seventy-four patients undergoing elective total laparoscopic hysterectomy or laparoscopic myomectomy were randomly assigned to the administration of either fentanyl or oxycodone using IV-PCA (potency ratio 1 : 60). The cumulative dose administered in the patient-controlled mode during the initial 48 hours after the operation was measured. Patients were also assessed for postoperative pain severity, adverse effects, and patient satisfaction. Results: No significant differences were observed in patient satisfaction with the analgesia during the postoperative period. Patients in the oxycodone group experienced significantly more dizziness compared to the fentanyl group. Patients in the oxycodone group showed significantly lower consumption of opioid in the patient-controlled mode (10.1 ± 8.5 ml vs. 16.6 ± 12.0 ml, P = 0.013). Conclusions: Our data suggest that oxycodone and fentanyl demonstrated similar effects, and therefore oxycodone may be a good alternative to fentanyl in postoperative pain management. Further studies in various clinical settings will be needed to determine the adequate potency ratio. [ABSTRACT FROM AUTHOR]
- Published
- 2015
- Full Text
- View/download PDF
29. Intramuscular hematoma with motor weakness after trigger point injection: A case report.
- Author
-
Sang Gyun Kim, Kwang Seok Shim, Dong Won Lee, Eun ju Kim, Sang-Gon Lee, Ji-Hyang Lee, and Ji hyun An
- Published
- 2017
- Full Text
- View/download PDF
30. Severe desaturation while attempting one-lung ventilation for congenital cystic adenomatoid malformation with respiratory distress syndrome in neonate.
- Author
-
Ji-Hye Seok, Eun-Ju Kim, Jong-Seouk Ban, Sang-Gon Lee, Ji-Hyang Lee, Da-Mi Seo, and Kwang-Seok Shim
- Subjects
LUNG surgery ,SURGICAL instruments ,CONGENITAL disorders ,HYPOXEMIA ,SURGICAL complications ,RESPIRATORY distress syndrome treatment - Abstract
There are many methods for achieving one-lung ventilation (OLV) during thoracic surgery in neonates and the accuracy of OLV may affect postoperative outcome. The authors have performed OLV using a 5 Fr Arndt endobronchial blocker (AEB, Cook Inc., Bloomington, IN, USA) on a neonate diagnosed with congenital cystic adenomatoid malformation and respiratory distress syndrome (RDS) associated with marked mediastinal shift. In spite of sufficient preoxygenation, sudden and severe fall in oxygen saturation had occurred. Since neonates with RDS may develop sudden and severe desaturation, rapid intubation with anticipation of potential difficulty is necessary as well as sufficient preoxygenation. [ABSTRACT FROM AUTHOR]
- Published
- 2013
- Full Text
- View/download PDF
31. Successful tracheal intubation using fiberoptic bronchoscope via an I-gelTM supraglottic airway in a pediatric patient with Goldenhar syndrome -A case report-.
- Author
-
Young-Lok Kim, Da-Mi Seo, Kwang-Seok Shim, Eun-Ju Kim, Ji-Hyang Lee, Sang-Gon Lee, and Jong-Seouk Ban
- Subjects
TRACHEA intubation ,FIBER optics ,BRONCHOSCOPES ,PEDIATRIC research ,HUMAN abnormalities ,TONSILLECTOMY ,THERAPEUTICS - Abstract
The I-gel
TM is a single-use supraglottic airway device introduced in 2007 which features a non-inflatable cuff and allows passage of a tracheal tube owing to its large diameter and short length of the airway tube. In this case, the authors experienced a difficult airway management on a 4-year-old boy with underlying Goldenhar syndrome who underwent a tonsillectomy. Intubation using a laryngoscope was unsuccessful at the first attempt. In the following attempt, we used the I-gelTM supraglottic airway for ventilation and were able to achieve successful intubation with a cuffed tube by using fiberoptic bronchoscope through the I-gelTM supraglottic airway. The authors suggest that I-gelTM is a useful device for ventilation and it has many advantages for tracheal intubation in pediatric patients with difficult airway. [ABSTRACT FROM AUTHOR]- Published
- 2013
- Full Text
- View/download PDF
32. Experience of severe desaturation during anesthetic induction period in an obese adult patient with Prader-Willi syndrome -A case report-.
- Author
-
Joon Woo Choi, Eun-Ju Kim, Byung Woo Min, Jong Seouk Ban, Sang Gon Lee, and Ji-Hyang Lee
- Subjects
ANESTHETICS ,PRADER-Willi syndrome ,MUSCLE hypotonia ,INTELLECTUAL disabilities ,OBESITY ,SHORT stature ,HYPOGONADISM - Abstract
Prader-Willi syndrome is characterized by infantile hypotonia, childhood-onset obesity, short stature, mental retardation, hyperphagia, hypogonadism. After infantile hypotonia phase, patient is prone to morbid obesity due to hyperphagia. Complications associated with morbid obesity are recognized as the main risk factors for death the life-span of patients with Prader-Willi syndrome. We experienced desaturation and bronchospasm during arteriovenous fistula surgery in an obese adult with Prader-Willi syndrome. [ABSTRACT FROM AUTHOR]
- Published
- 2012
- Full Text
- View/download PDF
33. Severe hemodynamic deterioration caused by cardiac herniation during endoscopic thoracic sympathicotomy in a patient with previously undiagnosed congenital pericardial defect.
- Author
-
Joong-Ho Park, Eun-Ju Kim, Jong-Seouk Ban, Ji-Hyang Lee, and Ji-Hyun An
- Subjects
HEPATITIS B ,HYPERHIDROSIS ,THORACIC surgery ,PERICARDIUM ,HEMODYNAMICS ,ELECTROCARDIOGRAPHY ,PATIENTS - Abstract
The article presents a case study of a 24-year-old male with medical history of hepatitis B carrier and congenital fusion of the cervical vertebrae was scheduled for repair of hyperhidrosis by endoscopic thoracic sympathicotomy. The article the discusses the absence of the pericardium has resulted in cardiac herniation which led to hemodynamic deterioration accompanied by Electrocardiography (ECG) changes in the patient.
- Published
- 2014
- Full Text
- View/download PDF
34. Intradermal testing increases the accuracy of an immediate-type cefaclor hypersensitivity diagnosis
- Author
-
Ji-Hyang Lee, MD, PhD, Chan Sun Park, MD, PhD, Min Ju Pyo, BS, A. Ryang Lee, BS, Eunyong Shin, MD, Young-Sang Yoo, MD, Woo-Jung Song, MD, PhD, Tae-Bum Kim, MD, PhD, You-Sook Cho, MD, PhD, and Hyouk-Soo Kwon, MD, PhD
- Subjects
Beta-lactams ,Cephalosporins ,Cefaclor ,Immediate hypersensitivity ,Intradermal skin test ,IgE quantification ,Immunologic diseases. Allergy ,RC581-607 - Abstract
Background: Hypersensitivity reactions to cefaclor have increased in accordance with its frequent use. However, only limited data are available on the diagnostic value of skin tests for these conditions, particularly intradermal tests (IDTs). Objective: To evaluate the clinical usefulness of IDT compared to the ImmunoCAP test in patients with cefaclor-induced immediate-type hypersensitivity. Methods: We conducted a retrospective chart review from January 2010 to June 2020 of adult subjects from 2 tertiary hospitals in Korea with a history of suspected immediate-type hypersensitivity to cefaclor, and who had undergone ImmunoCAP and IDT. Results: Overall, 131 subjects diagnosed with cefaclor hypersensitivity were included in the analysis. Fifty-nine patients (59/131, 45.04%) were positive in both IDT and ImmunoCAP. Fifty-four (54/131, 41.22%) and 6 (6/131, 4.58%) subjects showed positive results only with IDT or the ImmunoCAP test, respectively. Twelve subjects (12/131, 9.16%) were negative by both tests but reacted positively in a drug provocation test. The frequency of IDT positivity was similar regardless of the severity of reactions. However, positivity of ImmunoCAP was lower in subjects with mild reactions compared to those with anaphylaxis. Regarding the diagnosis of cefaclor hypersensitivity, the overall sensitivity of IDT and ImmunoCAP was 0.863 and 0.496, respectively while the specificity was 1. The combination of IDT and ImmunoCAP further increased this sensitivity to 0.908. Conclusion: IDT was more sensitive than ImmunoCAP for the diagnosis of cefaclor allergy, regardless of the severity of the hypersensitivity reaction. Therefore, we recommend a combination of IDT and ImmunoCAP for the diagnosis of cefaclor hypersensitivity.
- Published
- 2022
- Full Text
- View/download PDF
35. Objective cough frequency monitoring in real-world practice
- Author
-
Ji-Hyang Lee, Woo-Jung Song, Eva Millqvist, and Alyn H. Morice
- Subjects
Medicine - Published
- 2021
- Full Text
- View/download PDF
36. Use of laryngeal mask after repeated endotracheal intubation failure in a patient with tracheobronchopathia osteochondroplastica: case report
- Author
-
Sang Gyun Kim, Hyun Kim, Jong Chul Son, Ji-Hyang Lee, Jihyun An, and Eunju Kim
- Subjects
difficult intubation ,laryngeal mask airway ,tracheobronchopathia osteochondroplastica ,Medicine (General) ,R5-920 - Abstract
We report a case of difficult endotracheal intubation in a patient with tracheobronchopathia osteochondroplastica. A 65-year-old man was scheduled to undergo ulnar nerve decompression and ganglion excisional biopsy under general anesthesia. During induction of general anesthesia, an endotracheal tube could not be advanced through the vocal cords due to resistance. A large number of nodules were identified below the vocal cords using a Glidescope® video-laryngoscopy, and fiberoptic bronchoscopy revealed irregular nodules on the surface of the entire trachea and the main bronchus below the vocal cords. Use of a small endotracheal tube was attempted and failed. a laryngeal mask airway (LMA Supreme ™) rather than further intubation was successfully used to maintain the airway.
- Published
- 2018
- Full Text
- View/download PDF
37. Atropine injection followed by coronary artery spasm with ventricular tachycardia during spinal anesthesia -A case report
- Author
-
Joon-Ho Lee, Ji-Hye Seok, Young-Lok Kim, Ji-Hyang Lee, Sang-Gon Lee, Eun-Ju Kim, and Da-Mi Seo
- Subjects
atropine ,bradycardia ,coronary artery spasm ,spinal anesthesia ,ventricular tachycardia ,Anesthesiology ,RD78.3-87.3 - Abstract
Bradycardia may occur during spinal anesthesia with atropine commonly used as a treatment. A 44-year-old female with no known history of any underlying diseases, developed a coronary spasm following ventricular tachycardia when 0.5 mg of atropine was injected intravenously to treat bradycardia during spinal anesthesia. The imbalance caused by atropine in the sympathovagal activity may predispose the coronary artery to develop spasms with ventricular tachycardia. Therefore prudent use of atropine should be accompanied by close monitoring.
- Published
- 2013
- Full Text
- View/download PDF
38. Successful tracheal intubation using fiberoptic bronchoscope via an I-gel™ supraglottic airway in a pediatric patient with Goldenhar syndrome -A case report
- Author
-
Young-Lok Kim, Da-Mi Seo, Kwang-Seok Shim, Eun-Ju Kim, Ji-Hyang Lee, Sang-Gon Lee, and Jong-Seouk Ban
- Subjects
airway management ,fiberoptic bronchoscope ,goldenhar syndrome ,laryngeal mask airway ,pediatric ,Anesthesiology ,RD78.3-87.3 - Abstract
The I-gel™ is a single-use supraglottic airway device introduced in 2007 which features a non-inflatable cuff and allows passage of a tracheal tube owing to its large diameter and short length of the airway tube. In this case, the authors experienced a difficult airway management on a 4-year-old boy with underlying Goldenhar syndrome who underwent a tonsillectomy. Intubation using a laryngoscope was unsuccessful at the first attempt. In the following attempt, we used the I-gel™ supraglottic airway for ventilation and were able to achieve successful intubation with a cuffed tube by using fiberoptic bronchoscope through the I-gel™ supraglottic airway. The authors suggest that I-gel™ is a useful device for ventilation and it has many advantages for tracheal intubation in pediatric patients with difficult airway.
- Published
- 2013
- Full Text
- View/download PDF
39. Recurrent paroxysmal supraventricular tachycardia in the beach chair position for shoulder surgery under general anesthesia
- Author
-
Kyung-Yoon Woo, Eun-Ju Kim, Ji-Hyang Lee, Sang Gon Lee, and Jong Seouk Ban
- Subjects
Anesthesiology ,RD78.3-87.3 - Published
- 2013
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.