12 results on '"Hye Rim Jeon"'
Search Results
2. The Association between Weight Change and Depression in Korean Adults: The Korea National Health and Nutrition Examination Survey 2010-2012
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Hye-Rim Jeon, Ji Eun Lee, Kyungdo Han, Yang-Hyun Kim, Kyung-Hwan Cho, Suk Won Park, Soo Lee, Jin Hee Yoon, and Ji Hyun Kim
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Gerontology ,medicine.medical_specialty ,National Health and Nutrition Examination Survey ,business.industry ,Weight change ,030209 endocrinology & metabolism ,medicine.disease ,Obesity ,03 medical and health sciences ,0302 clinical medicine ,Family medicine ,medicine ,030212 general & internal medicine ,business ,Association (psychology) ,Depression (differential diagnoses) - Published
- 2017
3. A comparison of oxycodone and fentanyl in intravenous patient-controlled analgesia after laparoscopic hysterectomy
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Nan Seol Kim, Jin Hun Chung, Ho Soon Chung, Hyun Young Lee, Yonghan Seo, Seong Taek Mun, Kyu Sik Kang, Ji Won Chung, Sie Hyeon Yoo, Hyung Youn Gong, and Hye Rim Jeon
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medicine.medical_specialty ,Clinical Research Article ,business.industry ,Nausea ,Laparoscopic hysterectomy ,oxycodone ,fentanyl ,Surgery ,Fentanyl ,Ketorolac ,lcsh:RD78.3-87.3 ,Anesthesiology and Pain Medicine ,Patient satisfaction ,lcsh:Anesthesiology ,Anesthesia ,Anesthesiology ,Medicine ,medicine.symptom ,business ,postoperative pain ,Oxycodone ,medicine.drug ,Intravenous Patient-Controlled Analgesia - Abstract
Background We planned to compare the effect of intravenous oxycodone and fentanyl on post-operative pain after laparoscopic hysterectomy. Methods We examined 60 patients were randomized to postoperative pain treatment with either oxycodone (n = 30, Group O) or fentanyl (n = 30, Group F). The patients received 10 mg oxycodone/100 µg fentanyl with ketorolac 30 mg before the end of anesthesia and then continued with patient-controlled analgesia for 48 h postoperatively. Results The accumulated oxycodone consumption was less than fentanyl during 8, 24 and 48 h postoperatively. Numeric rating score of Group O showed significantly lower than that of Group F during 30 min, 2, 4, 8 and 24 h postoperatively. The incidences of adverse reactions were similar in the two groups, though the incidence of nausea was higher in the Group O during the 24 and 48 h postoperative period. Conclusions Oxycodone IV-PCA was more advantageous than fentanyl IV-PCA for laparoscopic hysterectomy in view of accumulated oxycodone consumption, pain control and cost beneficial effect. However, patient satisfaction was not good in the group O compared to group F.
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- 2015
4. Reversible Pulmonary Arterial Hypertension Associated with Dasatinib for Chronic Myeloid Leukemia
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Hye Rim Jeon, Jeong Eun Yi, Sung-Eun Lee, Dong-Wook Kim, Eun-Jung Jang, Ho Joong Youn, Ju Hee Bang, Hae Ok Jung, Yun Jeong Oh, Soo-Hyun Kim, Ji Hyung Hong, Soo Young Choi, and Jin Eok Park
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Adult ,Male ,Cancer Research ,medicine.medical_specialty ,medicine.drug_class ,Hypertension, Pulmonary ,Vasodilator Agents ,Dasatinib ,Case Report ,Antineoplastic Agents ,Pharmacology ,Doppler echocardiography ,Pulmonary arterial hypertension ,Tyrosine-kinase inhibitor ,New york heart association ,Sildenafil Citrate ,Internal medicine ,hemic and lymphatic diseases ,Leukemia, Myelogenous, Chronic, BCR-ABL Positive ,Medicine ,Humans ,Diuretics ,Antihypertensive Agents ,medicine.diagnostic_test ,business.industry ,Chronic myeloid leukemia ,Myeloid leukemia ,Imatinib ,Middle Aged ,Calcium Channel Blockers ,Discontinuation ,Oncology ,Cardiology ,Ventricular pressure ,business ,medicine.drug - Abstract
We describe two cases of pulmonary arterial hypertension (PAH) that occurred under dasatinib treatment and were resolved after dasatinib discontinuation. Two patients with chronic phase chronic myeloid leukemia (CML) were switched to dasatinib therapy because of hematological progress while receiving imatinib. These patients had New York Heart Association (NYHA) functional class II dyspnea with elevated right ventricular systolic pressure (RVSP), which progressed under dasatinib treatment. After dasatinib treatment was discontinued, subjective symptoms were improved to NYHA functional class I and the follow-up transthoracic Doppler echocardiography showed improved RVSP. Treatment with an alternate tyrosine kinase inhibitor was initiated and had been continued without development of dyspnea or elevation of RVSP. This report suggests that dasatinib can cause the reversible PAH, therefore, routine cardiopulmonary evaluation before and during treatment with dasatinib may be needed in CML patients with clinical manifestations.
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- 2014
5. Predictive factors for successful imatinib cessation in chronic myeloid leukemia patients treated with imatinib
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Hye Rim Jeon, Jeong-A Kim, Jin Eok Park, Sung-Hyun Kim, Sukjoong Oh, Joon Seong Park, Yun Jeong Oh, Ji Young Byeun, Soo-Hyun Kim, Ju Hee Bang, Jae Yong Kwak, Hawk Kim, Dong Hoe Koo, Dae Young Zang, Dae-Young Kim, Hyeoung Joon Kim, Yeung-Chul Mun, Sung-Eun Lee, Eun-Jung Jang, Yeo Kyeoung Kim, Seong Hyun Jeong, Dong-Wook Kim, Soo Young Choi, Michael J. Mauro, and Young Rok Do
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Adult ,Male ,medicine.medical_specialty ,Antineoplastic Agents ,Piperazines ,Young Adult ,Myelogenous ,Leukemia, Myelogenous, Chronic, BCR-ABL Positive ,Internal medicine ,medicine ,Humans ,Young adult ,Aged ,business.industry ,Myeloid leukemia ,Imatinib ,Hematology ,Middle Aged ,medicine.disease ,Discontinuation ,Surgery ,Transplantation ,Leukemia ,Pyrimidines ,Imatinib mesylate ,Benzamides ,Imatinib Mesylate ,Female ,business ,medicine.drug - Abstract
Although recent studies have suggested that cessation of imatinib (IM) in chronic myeloid leukemia patients can be associated with sustained response, further validation is needed to explore predictive factors. In a prospective, multicenter study, chronic phase patients were eligible for cessation of IM therapy after more than 3 years if they had no detectable BCR-ABL1 transcript for at least 2 years. A total of 48 patients with a median age of 47 years (19-74 years) were enrolled. Twenty patients received IM for post-transplant relapse. After a median follow-up of 15.8 months (1.4-28.2 months) after IM discontinuation, nine of the non-transplant group lost undetectable molecular residual disease (UMRD) and major molecular response (MMR), whereas none of the 20 patients in the transplant group experienced UMRD loss. Probabilities for sustained MMR and UMRD were 64.4% and 66.3% in the non-transplant group, respectively. Of nine patients re-treated with IM, eight patients re-achieved MMR at a median of 1.7 months (0.9-2.8 months). Seven of these patients re-achieved UMRD at a median of 5.6 months (2.8-12.1 months). Previous transplantation, IM duration, and UMRD duration were significantly associated with sustained molecular responses. Our data strongly suggest that immunological control contributes to sustained suppression of residual leukemia cell expansion and that IM can be safely discontinued in patients with post-transplant relapse.
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- 2013
6. A comparison of sufentanil and fentanyl for patient-controlled epidural analgesia in arthroplasty
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Hee Cheol Jin, Sung Hwan Cho, Jeong Seok Lee, Sang-Hyun Kim, Se Jin Lee, Yong Ik Kim, Joon Ho Lee, Won Seok Chae, and Hye Rim Jeon
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ropivacaine ,Clinical Research Article ,medicine.medical_specialty ,Ropivacaine ,business.industry ,medicine.medical_treatment ,epidural analgesia ,Arthroplasty ,fentanyl ,Surgery ,Fentanyl ,Sufentanil ,lcsh:RD78.3-87.3 ,Anesthesiology and Pain Medicine ,sufentanil ,lcsh:Anesthesiology ,Anesthesia ,medicine ,Alfentanil ,Patient controlled epidural analgesia ,business ,medicine.drug - Abstract
Background The use of lipid soluble opioids such as fentanyl, alfentanil and sufentanil are recently on the increase for patient-controlled epidural analgesia (PCEA). In this study, the effects and adequate dose of sufentanil in arthroplasty were investigated. Methods Eighty patients scheduled for arthroplasty were enrolled for the study. Seventy-one patients (ASA physical status I-III) were randomly allocated into four groups. All groups received 0.1% ropivacaine through PCEA and each group received either fentanyl (group F: fentanyl 4 µg/ml) or sufentanil (group S1: sufentanil 0.5 µg/ml, group S2: sufentanil 0.75 µg/ml, and group S3: sufentanil 1.0 µg/ml). Postoperative pain scores were evaluated using VAS (visual analog scale, 0-10) and side effects such as hypotension, nausea/vomiting, pruritus and the degree of satisfaction were evaluated at 1, 6, 12, 24, 48 hours after surgery. Results Postoperative pain score (VAS) decreased gradually and the highest VAS score was recorded at 1 hour postoperative for all four groups. There were no differences in the degree of satisfaction and postoperative pain score between all groups. The incidence of pruritus was significantly lower in group S1 than in groups S2 and S3. Conclusions The incidence of side effects were significantly lower in group S1 (0.1% ropivacaine plus sufentanil 0.5 µg/ml). Therefore, 0.5 µg/ml of sufentanil through PCEA is the recommended dose for postoperative pain control in arthroplasty.
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- 2011
7. Relevance of hepatoduodenal ligament lymph nodes in resectional surgery for gastric cancer
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Sua Lee, Chung-Hwa Park, Yoon Ho Ko, Sin Sun Kim, Kyo-Young Song, Hye-Rim Jeon, and Han Hong Lee
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Male ,medicine.medical_specialty ,Duodenum ,Context (language use) ,Adenocarcinoma ,Metastasis ,Gastrectomy ,Stomach Neoplasms ,medicine ,Humans ,Stage (cooking) ,Lymph node ,Survival rate ,Neoplasm Staging ,Ligaments ,business.industry ,Cancer ,Hepatoduodenal ligament ,Middle Aged ,medicine.disease ,Prognosis ,Surgery ,medicine.anatomical_structure ,Liver ,Lymphatic Metastasis ,Lymph Node Excision ,Female ,Lymph ,Lymph Nodes ,business - Abstract
Background Hepatoduodenal lymph node (HDLN) positivity is considered distant metastasis in gastric cancer according to the seventh American Joint Committee on Cancer (AJCC) classification. In contrast, the International Union Against Cancer seventh edition and the Japanese Gastric Cancer Association both consider HDLN as a regional lymph node that can be included in the context of a curative resection. The purpose of this study was to determine whether there was justification for considering HDLN involvement as a distant metastasis for which resectional surgery could not have survival benefit. Methods This study enrolled consecutive patients with gastric cancer having D2 or greater resections, with removal and pathological assessment of the HDLN, between 1989 and 2009. The pathological stage of all patients was determined based on the seventh AJCC criteria, with HDLN included as a regional lymph node. Results A total of 1872 patients had their HDLN removed, of whom 68 had a metastatic lymph node in the hepatoduodenal ligament. The 5-year survival rate of these 68 patients was 30 per cent, compared with 47·7 per cent for those with stage III (P < 0·001) and 9·8 per cent for those with stage IV (P = 0·007) HDLN-negative tumours. The 5-year survival rate of 41 patients with HDLN metastasis and no evidence of distant metastasis at any other site was significantly higher than that among 120 patients with stage IV disease without HDLN metastasis (P < 0·001), whereas 5-year survival did not differ between the 41 patients with stage I–III disease with HDLN metastasis and 568 patients with stage III tumours without HDLN metastasis (P = 0·184). HDLN metastasis was not a significant factor for survival in multivariable analysis. Conclusion It is inappropriate to include the HDLN in the distant metastatic lymph node group in gastric cancer. The seventh AJCC criteria for node grouping should be revised.
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- 2013
8. Prognostic factors for outcomes of allogeneic stem cell transplantation in chronic phase chronic myeloid leukemia in the era of tyrosine kinase inhibitors
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Hee-Je Kim, Byung-Sik Cho, Soo-Hyun Kim, Yun Jeong Oh, Ji-Young Byeun, Eun-Jung Jang, Seung-Ah Yahng, Chong-Won Park, Chang-Ki Min, Yoo-Jin Kim, Jin Eok Park, Ju-Hee Bang, Soo Young Choi, Ki-Sung Eom, Seok Lee, Hye-Rim Jeon, Dong-Wook Kim, Sung-Eun Lee, Woo-Sung Min, and Jong Wook Lee
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Oncology ,Adult ,Male ,medicine.medical_specialty ,Disease status ,Multivariate analysis ,Transplantation Conditioning ,Adolescent ,medicine.drug_class ,Tyrosine-kinase inhibitor ,Young Adult ,Internal medicine ,Medicine ,Humans ,Transplantation, Homologous ,Protein Kinase Inhibitors ,Retrospective Studies ,business.industry ,Hematopoietic Stem Cell Transplantation ,Myeloid leukemia ,Hematology ,Chronic phase chronic myeloid leukemia ,Middle Aged ,Prognosis ,respiratory tract diseases ,Transplantation ,Treatment Outcome ,Immunology ,Chronic Disease ,Leukemia, Myeloid, Chronic-Phase ,Female ,Stem cell ,business ,Tyrosine kinase - Abstract
The aim of this study was to estimate the prognostic factors for the outcomes of chronic myeloid leukemia (CML) patients receiving allogeneic stem cell transplantation (SCT) in chronic phase (CP) in the era of tyrosine kinase inhibitors (TKIs). Ninety-seven patients who underwent allogeneic SCT in CP were analyzed. Forty-seven were TKI-naive at the time of transplant, and 50 received TKI(s) treatment before transplantation. After a median follow-up of 115.8 months, the 4-year overall survival and event-free survival were 80.4 and 58.8%, respectively. Multivariate analysis showed that there were no differences in survival outcomes based on prior TKI therapy. Older age was a prognostic factor for higher treatment-related mortality (TRM), and the type of graft source and younger age were associated with relapse, but prior TKI therapy and disease status at the time of transplant were not associated with either TRM or relapse. Additionally, a major molecular response at 1 month and an MR(4.5) at 3 months were important predictors of favorable long-term outcomes. This study demonstrates the prognostic factors for the outcomes of allogeneic SCT in CP CML and shows that survival outcomes were not affected by the administration of long-term multi-TKI treatment prior to transplantation.
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- 2013
9. AB0484 Identification of Clinical and Serologic Factors Associated with Neutropenia in Patients with Systemic Lupus Erythematosus
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Jun Woo Lee, Hye-Rim Jeon, Sang-Hyun Kim, In Je Kim, and Mun Kyung Chung
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medicine.medical_specialty ,Leukopenia ,Anemia ,business.industry ,Immunology ,Neutropenia ,medicine.disease ,General Biochemistry, Genetics and Molecular Biology ,Confidence interval ,Serology ,Rheumatology ,hemic and lymphatic diseases ,Concomitant ,Internal medicine ,medicine ,Absolute neutrophil count ,Immunology and Allergy ,medicine.symptom ,skin and connective tissue diseases ,business ,Kidney disease - Abstract
Background Hematologic manifestations are common in systemic lupus erythematosus (SLE). Lymphopenia is most commonly found among leukopenia, but neutropenia is also found in about 50–60% of SLE patients. Most patients experience mild neutropenia while less than 5% of those experience moderate to severe neutropenia which can increase susceptibility to recurrent infection. Although it is crucial to understand risk factors associated with neutropenia in SLE patients, there is a paucity of clinical data regarding neutropenia in patients with SLE. Objectives This study was performed to identify the clinical and serologic factors that are associated with neutropenia in patients with systemic lupus erythematosus (SLE). Methods A total 160 admissions of 85 SLE patients between 2006 and 2013 were retrospectively reviewed. Neutropenia was defined as absolute neutrophil count (ANC) below 1,500/mm 3 . Baseline characteristics of the patients were compared between patients who experienced neutropenia and those without. Clinical and serological factors related to neutropenia episode during admission were analyzed using generalized estimating equation (GEE) and multivariate analysis. Results Thirty two (37.6%) patients experienced neutropenia, and neutropenia episode was found in 35 (21.9%) of admissions. Most of the neutropenia episodes were mild to moderate. Severe neutropenia of ANC 3 occurred in 14.3% of the cases. Patients with neutropenia had higher frequencies of ANA (100.0 vs 86.8%, P =0.042) and anti-dsDNA (87.5 vs 60.4%, P =0.008), and satisfied more SLE classification criteria at the time of the diagnosis than those without (4.8 vs 4.1, P =0.014) Clinical characteristics at admission such as comorbidities, concomitant medications, and SLEDAI were not different between admissions with and without neutropenia episode. Anemia, leukopenia, thrombocytopenia and low complement levels were frequently associated with neutropenic episodes. Co-existence of chronic kidney disease (OR,16.91; 95% confidence interval (CI), 2.09–136.6; P =0.008) and Sjogren9s syndrome (OR, 6.48; 95% CI, 1.46–28.66; P =0.014) was associated with increased risk of developing neutropenia. Conclusions This study demonstrates that most of neutropenia in SLE patients occur as part of hematologic and immunologic abnormalities. SLE patients with renal damage and Sjogren9s syndrome should be closely monitored for development of neutropenia. Disclosure of Interest None declared
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- 2016
10. Long-Term Assessment of Dasatinib-Induced Pulmonary Arterial Hypertension in Chronic Myeloid Leukemia
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Eun-Jung Jang, Young-Woo Jeon, Soo Young Choi, Sukjoong Oh, Hye-Rim Jeon, Soo-Hyun Kim, Jin-Eok Park, Dong-Wook Kim, Sung-Eun Lee, Jee Hyun Kong, and Yun Jeong Oh
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medicine.medical_specialty ,Sildenafil ,medicine.drug_class ,business.industry ,Immunology ,Ponatinib ,Urology ,Imatinib ,Cell Biology ,Hematology ,Radotinib ,Biochemistry ,Tyrosine-kinase inhibitor ,Dasatinib ,chemistry.chemical_compound ,chemistry ,Nilotinib ,hemic and lymphatic diseases ,Anesthesia ,Concomitant ,medicine ,business ,medicine.drug - Abstract
[Graphic][1] Background: To explore a real incidence of dasatinib-induced pulmonary arterial hypertension (D-PAH) in clinical practice, we investigated 82 imatinib or other 2G tyrosine kinase inhibitor (TKI)-failed chronic myeloid leukemia (CML) patients who received dasatinib as a second-line therapy. Methods: Routine chest X-ray and Doppler echocardiography were regularly evaluated in all patients and additional tests were performed if dyspnea developed on treatment. Results: Median age at the time of starting dasatinib was 48 (16-82) years. Of 82 patients, 8 patients (9.8%) showed an elevation of right ventricular systolic pressure (RVSP>35mmHg) by Doppler echocardiography. Among them, 7 patients (8.5%) were considered D-PAH with a median dasatinib treatment duration of 32.6 (10.3-108.7) months. They underwent follow-up Doppler echocardiography median 5 (2-9) times. Five patients showed severe D-PAH (RVSP >70mmHg), 1 was moderate (RVSP 46mmHg), and 1 was mild (RVSP 41mmHg). Advanced studies such as pulmonary angiographic catheterization (patient 1 and 2) or pulmonary arterial computed tomography (patient 3 and 4) were performed for confirming D-PAH or ruling out PAH due to pulmonary vascular abnormality. Six patients had bilateral pleural effusion and 1 had unilateral pleural effusion. With sildenafil (n=5) + dose reduction (n=1) + switch to other TKI (n=6), all of patients improved dyspnea, and RVSP level was completely resolved in 3 patients. In addition, previous nilotinib therapy and concomitant pleural effusion were significant contributing factors for D-PAH. Conclusion: Regardless of complete resolution of pleural effusion, a patient with sustained dyspnea on dasatinib treatment should be carefully evaluated by Doppler echocardiography and a regular monitoring will be needed for early intervention. | Cohort | Age at PAH diagnosis (year) | Sex | Treatment duration before dasatinib (month) | Previous therapy for CML | Duration between initiation of dasatinib and diagnosis of PAH (month) | Daily mean dose of dasatinib (mg/d) | Duration between diagnosis of D-PAH and last follow up (month) | Treatment of D-PAH | Switch to other TKI | Outcome | | ------ | --------------------------- | --- | ------------------------------------------- | ------------------------------------------------------- | --------------------------------------------------------------------- | ----------------------------------- | -------------------------------------------------------------- | ------------------------------------ | ----------------------- | -------- | | 1 | 53 | M | 54.4 | Interferon, Hydroxyurea, Imatinib, nilotinib | 26.4 | 123 | 73.5 | Sildenafil | nilotinib and ponatinib | partial | | 2 | 50 | M | 36.6 | Interferon, Hydroxyurea, Imatinib, dasatinib, nilotinib | 50.3 | 112 | 55.2 | Sildenafil | nilotinib and radotinib | partial | | 3 | 37 | F | 31.7 | Imatinib, nilotinib | 21.7 | 88 | 39.7 | Sildenafil Dose de-escalation | radotinib | partial | | 4 | 45 | M | 70.9 | Hydroxyurea, Imatinib | 69.8 | 101 | 35.2 | Sildenafil Dose de-escalation | ponatinib | complete | | 5 | 59 | F | 107.4 | Interferon, Hydroxyurea, Imatinib | 83.6 | 92 | 14.3 | none | radotinib | partial | | 6 | 46 | F | 12.6 | Imatinib | 29.1 | 76 | 13.0 | Steroid, Sildenafil | radotinib | complete | | 7 | 38 | F | 30.2 | Imatinib | 33.1 | 98 | 10.2 | Dose reduction | NA | complete | Abstract 5535. Table 1. Characteristics of patients with dasatinib-induced PAH Disclosures No relevant conflicts of interest to declare. [1]: /embed/inline-graphic-2.gif
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- 2014
11. Awake during General Anesthesia with BispectralIndex Value of 35
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Soon Im Kim, Sekwang Park, Se Jin Lee, Hae Jin Suh, Sun Young Park, Mun-Gyu Kim, A Na Cho, Hye-Rim Jeon, Si Young Ok, and Sang Ho Kim
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medicine.medical_specialty ,Hypnosis ,Intraoperative Complication ,business.industry ,Surgery ,Desflurane ,Bispectral index ,Anesthesia ,Anesthetic ,medicine ,Anxiety ,Elective surgery ,medicine.symptom ,Complication ,business ,medicine.drug - Abstract
Awareness of intraoperative events in patients under general anesthesia is rare, but awareness during anesthesia is a serious complication that leads to anxiety and post-traumatic stress disorder. The Bispectral Index (BIS) has generally been accepted as a measurement of hypnosis under anesthesia. It is derived from a processed electroencephalogram and computer algorithm that assigns a numerical value based on the probability of consciousness. A 46-year-old, 65-kg male without underlying disease underwent elective surgery for ventral hernia. The patient in this case was administered an anesthetic that we frequently use and then average BIS value are 35. But he experienced awake during general anesthesia. We describe the first case of intraoperation awake under BIS 40 using desflurane.
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- 2013
12. Six-Year Follow-Up Of Dasatinib-Related Pulmonary Arterial Hypertension (PAH) For Chronic Myeloid Leukemia In Single Center
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Sung-Eun Lee, Hye-Rim Jeon, Soo-Hyun Kim, Jin-Eok Park, Young-Woo Jeon, Soo Young Choi, Eun-Jung Jang, and Dong-Wook Kim
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medicine.medical_specialty ,business.industry ,Pleural effusion ,Immunology ,Cell Biology ,Hematology ,Radotinib ,medicine.disease ,Biochemistry ,Surgery ,Dasatinib ,Imatinib mesylate ,Blood pressure ,Right ventricular hypertrophy ,hemic and lymphatic diseases ,Internal medicine ,medicine.artery ,Pulmonary artery ,medicine ,Cardiology ,business ,Pulmonary wedge pressure ,medicine.drug - Abstract
Introduction Recent randomized trial (DASISION trial), compared clinical outcomes between dasatinib and imatinib in newly diagnosed (chronic myeloid leukemia) CML patients. Results showed that dasatinib had faster and deeper responses compared with imatinib, and thus dasatinib became to be considered as a first-line therapy in CML patients. However, the long-term administration of dasatinib has been reported to have a risk of pleural effusion and dasatinib-related (pulmonary arterial hypertension) PAH. So, we have prospectively evaluated for emergence of PAH in all CML patients treated with dasatinib in our institute. Materials and methods Between May 2005 and July 2013, a total of 89 CP CML patients on dasatinib treatment were tested with laboratory studies, Brain natriuretic peptide (BNP), echocardiography (echo) in the Catholic University of Korea, Seoul, and baseline functional capacity (NYHA or WHO functional class) was assessed. PAH was defined as mean pulmonary artery pressure (mPAP) of >25mmHg at rest, with wedge pressure < 15mmHg, or Rt. Ventricular systolic pressure (RVSP) of 40 mmHg on echocardiography. And patients who had abnormal RVSP and/or symptoms (New York heart association-NYHA class 3, 4) were performed with additional studies such as pulmonary angiographic catheterization or pulmonary arterial computed tomography. Results So far, 62 patients (70%) of total 89 were evaluated with echocardiography (46 male, 16 female). The median age was 48 year old (range, 22∼72). The median duration of disease was 8.5 years (range, 0.8∼16.1). The median mean daily dosage of dasatinib was 102mg (range, 73∼140mg). The duration of dasatinib treatment was 34.6 months (range, 0.5∼99.6). 8 of 66 patients (12.1%) showed abnormal echocardiographic findings as increased right ventricular systolic pressure or symptom. All of 8 patients had treated with dasatinib as second line, and had exertional dyspnea (2 patients on class 2, and 5 patients on class 3 of NYHA). 5 patients of these showed abnormal BNP levels. The mean RVSP in screened patients was 65.2 mmHg (range, 40∼108mmHg), 2 of 8 patients were confirmed diagnosis with overt PAH on as pulmonary angiographic catheterization, and right ventricular hypertrophy on pulmonary angiographic computed tomography. Clinical, functional, or hemodynamic improvements were observed within 5 months of dasatinib discontinuation and then, in 5 patients the treatment was switched to radotinib, and another 3 patients received reduced dosage of dasatinib. Conclusion Although the lowest estimate of incident PAH occurring in patients exposed to dasatinib was 0.45% in France group. our preliminary data show more higher incidence rates (8 of 66 patients, 12.1%) in Korea. So, we suggest that the long-term dasatinib treatment for CML requires careful attention to cardiopulmonary adverse effects. and routine cardiovascular and pulmonary evaluation on regular basis is strongly recommended before and during treatment with dasatinib. Disclosures: No relevant conflicts of interest to declare.
- Published
- 2013
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