1.Inflammatory Disseminated Superficial Porokeratosis in a Patient with Choledocholithiasis.
Chee Won OH ; Jimi YOON ; Chi Yeon KIM
Korean Journal of Dermatology 2012;50(1):73-75
Disseminated superficial porokeratosis (DSP) is an autosomal dominant specific disorder of keratinization. Clinically, the lesions show a sharply demarcated and hyperkeratotic plaque with central atrophy, with a predilection for the extensor surface of the extremities. Unusual cases of DSP accompanied by severe pruritus have been reported as "eruptive pruritic papular porokeratosis" or "inflammatory DSP." Histopathologically, inflammatory DSP is characterized by the presence of cornoid lamella with a dense infiltration of lymphocytes in the perivascular area of the upper dermis. Here we report a case of inflammatory DSP in an 80-year-old man with choledocholithiasis.
Aged, 80 and over
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Atrophy
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Choledocholithiasis
;
Dermis
;
Extremities
;
Humans
;
Keratins
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Lymphocytes
;
Porokeratosis
;
Pruritus
2.A Nevus Comedonicus in the Genital Area.
Chi Yeon KIM ; Jimi YOON ; Chee Won OH
Korean Journal of Dermatology 2010;48(10):880-883
Nevus comedonicus is an uncommon skin disorder that clinically appears as linear groups of open comedones. A 6-year-old female patient presented with a nevus comedonicus accompanied by an epidermal nevus in her genital area. The histopathologic finding showed an atrophic, cystically dilated hair follicle containing abundant keratinous debris. She was treated with oral antibiotics. We report here on an unusual case of nevus comedonicus that occurred in the genital area.
Anti-Bacterial Agents
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Child
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Female
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Hair Follicle
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Humans
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Keratins
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Nevus
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Skin
3.Pityriasis Rosea-Like Rash Secondary to Intravesical Bacillus Calmette-Guerin Immunotherapy.
Chee Won OH ; Jimi YOON ; Chi Yeon KIM
Annals of Dermatology 2012;24(3):360-362
No abstract available.
Bacillus
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Exanthema
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Immunotherapy
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Pityriasis
4.Early diagnosis of negative-pressure pulmonary edema presenting as diffuse alveolar hemorrhage using lung ultrasonography -A case report-
Hee Won SON ; Yunho KANG ; Youngick AHN ; Jimi OH
Anesthesia and Pain Medicine 2024;19(2):144-149
Background:
Diffuse alveolar hemorrhage (DAH) is a potentially life-threatening condition that can occur due to a variety of disorders. Hence, rapid diagnosis and prompt initiation of appropriate treatment are imperative.Case: A 55-year-old woman with a deep neck infection underwent emergent tonsillectomy. General anesthesia and surgery proceeded uneventfully. Upon transfer to the post-anesthesia care unit, ongoing respiratory distress and occasional expectoration of blood-tinged sputum were noted. Lung ultrasonography (LUS) revealed multiple B-profiles and irregular pleural lines with subpleural consolidations. Emergent bronchoscopy with bronchoalveolar lavage was diagnostic of DAH. She underwent a comprehensive evaluation for rheumatologic and infectious etiologies of DAH, all of which yielded negative results. The patient was managed with steroids and conservative treatment.
Conclusions
The integration of LUS with clinical information allows for more rapid differentiation of acute respiratory failure causes. Therefore, anesthesiologists’ awareness and utilization of LUS findings of DAH can significantly contribute to appropriate management.
5.Stevens-Johnson Syndrome Induced by Vandetanib.
Jimi YOON ; Chee Won OH ; Chi Yeon KIM
Annals of Dermatology 2011;23(Suppl 3):S343-S345
Vandetanib is a once-daily oral anticancer drug that selectively inhibits key signaling pathways in cancer by targeting vascular endothelial growth factor receptors, epidermal growth factor receptors tyrosine kinase, and rearranged during transfection-dependent tumor cell proliferation and survival. The most frequently reported adverse events attributed to vandetanib include diarrhea, elevated aminotransferase, asymptomatic corrected QT interval prolongation, and hypertension. Though a number of randomized, doubleblind studies, including cutaneous adverse events attributed to vandetanib, have been reported along with these general symptoms, no case of Stevens-Johnson syndrome (SJS) has been reported. This paper demonstrates a case of SJS induced by vandetanib.
Carcinoma, Non-Small-Cell Lung
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Cell Proliferation
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Diarrhea
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Hypertension
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Piperidines
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Protein-Tyrosine Kinases
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Quinazolines
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Receptor, Epidermal Growth Factor
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Receptors, Vascular Endothelial Growth Factor
;
Stevens-Johnson Syndrome
6.Rocuronium Induced Masseter Muscle Rigidity during Intubation in Patients with Dental Surgery
Moon Sik JUNG ; Hyunho LEE ; Hochang KIM ; Soon Eun PARK ; Jimi OH
Keimyung Medical Journal 2020;39(2):101-104
Masseter muscle rigidity (MMR), known as the ‘jaw of steel’, sometimes makes laryngoscope unusable due to the stiffness of the jaw. MMR during general anesthesia was previously considered as an early episode of malignant hyperthermia (MH). Generally, MMR occurs in the pediatric patients after induction with succinylcholine and volatile agents. However, MMR following the administration of non-depolarizing muscle relaxants is uncommon, although described in some reports. We report a case of 62-year-old male patient which developed MMR following intravenous administration of rocuronium during induction of anesthesia. Our patient was not found to be vulnerable to MH. Although fiberoptic nasotracheal intubation had been successfully performed in our case, an unanticipated difficult airway due to MMR can be experienced at any time. Therefore, we should be aware that, although rare, MMR can occur after using non-depolarizing muscle relaxant. Additionally, in case of any incident of MMR, anesthesiologists need to recognize the management of a difficult airway and to maintain adequate oxygenation in a variety of methods according to a difficult airway algorithm.
7.Rocuronium Induced Masseter Muscle Rigidity during Intubation in Patients with Dental Surgery
Moon Sik JUNG ; Hyunho LEE ; Hochang KIM ; Soon Eun PARK ; Jimi OH
Keimyung Medical Journal 2020;39(2):101-104
Masseter muscle rigidity (MMR), known as the ‘jaw of steel’, sometimes makes laryngoscope unusable due to the stiffness of the jaw. MMR during general anesthesia was previously considered as an early episode of malignant hyperthermia (MH). Generally, MMR occurs in the pediatric patients after induction with succinylcholine and volatile agents. However, MMR following the administration of non-depolarizing muscle relaxants is uncommon, although described in some reports. We report a case of 62-year-old male patient which developed MMR following intravenous administration of rocuronium during induction of anesthesia. Our patient was not found to be vulnerable to MH. Although fiberoptic nasotracheal intubation had been successfully performed in our case, an unanticipated difficult airway due to MMR can be experienced at any time. Therefore, we should be aware that, although rare, MMR can occur after using non-depolarizing muscle relaxant. Additionally, in case of any incident of MMR, anesthesiologists need to recognize the management of a difficult airway and to maintain adequate oxygenation in a variety of methods according to a difficult airway algorithm.
8.Unexpected anesthetic leakage from a damaged O-ring on the Selectatec back bar: A case report.
Young Uk KIM ; Jimi OH ; Chan Hye PARK ; Byung Moon CHOI ; Dong Min JANG ; Ji Yeon BANG
Anesthesia and Pain Medicine 2017;12(2):183-186
The Selectatec mounting system was devised to provide easy and quick on-site fitting of various vaporizers for the anesthetic machine. However, a quick changing system for the vaporizer can also damage the O-ring due to friction between the vaporizer and the Selectatec back bar. We herein report a case of an unexpected anesthetic gas leakage from a damaged O-ring on the Selectatec back bar, which resulted from exchanging the vaporizers between two operations. In cases using the Datex Ohmeda machine, it is not easy to detect leakages from the vaporizers because of the location of the check valve near to the fresh gas outlet. This complicates the use of the positive pressure leakage test to detect a low pressure system leakage on the Selectatec back bar. We recommend the preanesthetic negative pressure or low-flow leakage test to detect a low pressure leakage when exchanging vaporizers on the Selectatec system.
Friction
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Intraoperative Awareness
;
Nebulizers and Vaporizers
;
Ventilators, Mechanical
9.Impact of carotid atherosclerosis in CHA2DS2-VASc-based risk score on predicting ischemic stroke in patients with atrial fibrillation
Dong-Hyuk CHO ; Jong-Il CHOI ; Jimi CHOI ; Yun Gi KIM ; Suk-Kyu OH ; Hyungdon KOOK ; Kwang No LEE ; Jaemin SHIM ; Seong-Mi PARK ; Wan Joo SHIM ; Young-Hoon KIM
The Korean Journal of Internal Medicine 2021;36(2):342-351
Background/Aims:
Vascular disease is an established risk factor for stroke in patients with atrial fibrillation (AF), which is included in CHA2DS2-VASc score. However, the role of carotid atherosclerosis remains to be determined.
Methods:
Three hundred-ten patients with AF who underwent carotid sonography were enrolled.
Results:
During a median follow-up of 31 months, 18 events (5.8%) of stroke were identified. Patients with stroke had higher carotid intima-media thickness (CIMT) (1.16 ± 0.33 mm vs. 0.98 ± 0.25 mm, p = 0.017). CIMT was significantly increased according to the CHA2DS2-VASc score (p < 0.001) and it was correlated with left ventricular mass index and early diastolic mitral annular velocity (e’), a ratio of early transmitral flow velocity to e’ (E/e’) and pulmonary artery systolic pressure (all p < 0.05). Cox regression using multivariate models showed that carotid plaque was associated with the risk of stroke (hazard ratio, 3.748; 95% confidence interval [CI], 1.107 to 12.688; p = 0.034). C-statistics increased from 0.648 (95% CI, 0.538 to 0.757) to 0.716 (95% CI, 0.628 to 0.804) in the CHA2DS2-VASc score model after the addition of CIMT and carotid plaque as a vascular component (p = 0.013).
Conclusions
Increased CIMT and presence of carotid plaque are associated with a high risk of ischemic stroke, and CIMT is related to myocardial remodeling and diastolic dysfunction, suggesting that carotid atherosclerosis can improve risk prediction of stroke in patients with AF, when included under vascular disease in the CHA2DS2-VASc scoring system.
10.Gender differences in the presentation of chest pain in obstructive coronary artery disease: results from the Korean Women’s Chest Pain Registry
Dong-Hyuk CHO ; Jimi CHOI ; Mi-Na KIM ; Hack-Lyoung KIM ; Yong Hyun KIM ; Jin Oh NA ; Jin-Ok JEONG ; Hyun Ju YOON ; Mi-Seung SHIN ; Myung-A KIM ; Kyung-Soon HONG ; Gil Ja SHIN ; Seong-Mi PARK ; Wan Joo SHIM
The Korean Journal of Internal Medicine 2020;35(3):582-592
Background/Aims:
Chest pain in patients with obstructive coronary artery disease (OCAD) is affected by several social factors. The gender-based differences in chest pain among Koreans have yet to be investigated.
Methods:
The study consecutively enrolled 1,549 patients (male/female, 514/1,035; 61 ± 11 years old) with suspected angina. The predictive factors for OCAD based on gender were evaluated.
Results:
Men experienced more squeezing type pain on the left side of chest, while women demonstrated more dull quality pain in the retrosternal and epigastric area. After adjustment for risk factors, pain in the retrosternal area (odds ratio [OR], 1.491; 95% confidence interval [CI], 1.178 to 1.887) and aggravation by exercise (OR, 2.235; 95% CI, 1.745 to 2.861) were positively associated with OCAD. In men, shorter duration (OR, 1.581; 95% CI, 1.086 to 2.303) and dyspnea (OR, 1.610; 95% CI, 1.040 to 2.490) increased the probability for OCAD, while left-sided chest pain suggested a low probability for OCAD (OR, 0.590; 95% CI, 0.388 to 0.897). In women, aggravation by emotional stress (OR, 0.348; 95% CI, 0.162 to 0.746) and dizziness (OR, 0.457; 95% CI, 0.246 to 0.849) decreased the probability for OCAD.
Conclusions
This is the first study to focus on gender differences in chest pain among Koreans with angina. Symptoms with high probability for OCAD were different between sexes. Our findings suggest that patient’s medical history in pretest assessment for OCAD should be individualized considering gender.