1.Transient facial paralysis after myringotomy and ventilation tube insertion under sedation with sevoflurane inhalation and four-quadrant blocks with lidocaine: a case report
Hyunjee KIM ; Joonhee LEE ; Younghoon JEON
Journal of Dental Anesthesia and Pain Medicine 2020;20(3):161-163
Myringotomy and ventilation tube insertion are widely performed in pediatric patients with chronic otitis media. This procedure is performed under general anesthesia or sedation with local anesthesia infiltration in pediatric patients. In this case report, we report a case of transient facial paralysis in a pediatric patient who underwent myringotomy and ventilation tube insertion using sevoflurane inhalation and four-quadrant blocks with lidocaine.
2.A Case of Suspected Acute Esophageal Anisakiasis With Dysphagia
Joonhee HAN ; Heung Up KIM ; Sejin KIM ; Hyun Joo SONG
The Korean Journal of Helicobacter and Upper Gastrointestinal Research 2023;23(4):311-316
Anisakiasis is a zoonotic parasitic infection associated with consumption of raw fish or uncooked seafood. We report a rare case of suspected esophageal anisakiasis-induced dysphagia. A 66-year-old man patient without any medical history was admitted to our hospital for evaluation of acute dysphagia. Following intake of abalone sashimi for dinner, he experienced sudden difficulty with swallowing the day before his emergency department visit. He developed skin rash and pruritus throughout his body, shortly thereafter. He also had chest and upper abdominal pain and diarrhea. He had experienced similar symptoms after consumption of raw fish on two previous occasions. Dysphagia improved 9 days later. Gastroscopy performed after symptom onset showed small erosions and edematous mucosa in the mid esophagus. Abdominopelvic computed tomography (CT) showed distal esophageal wall thickening and small bowel obstruction with concomitant ascites. We suspected anisakiasis based on the following criteria: 1) Skin rash after the third episode of consumption of raw fish or seafood (anisakiasisspecific immunoglobulin E class 4). 2) CT-documented small intestinal obstruction and ascites. 3) Eosinophil-dominant fluid observed on ascitic fluid analysis. Therefore, it is reasonable to conclude that temporary dysphagia in this patient was attributable to esophageal anisakiasis associated with raw seafood consumption.
3.Awake craniotomy using a high-flow nasal cannula with oxygen reserve index monitoring - A report of two cases -
Joonhee GOOK ; Ji-Hye KWON ; Keoungah KIM ; Jung Won CHOI ; Ik Soo CHUNG ; Jeonjin LEE
Anesthesia and Pain Medicine 2021;16(4):338-343
Background:
Awake craniotomy is a well-tolerated procedure for the resection of brain tumors residing within or close to the eloquent cortical areas. Monitored anesthesia care (MAC) is a dominant anesthetic approach for awake craniotomy; however, it is associated with inherent challenges such as desaturation and hypercapnia, which may lead to various complications. The prevention of respiratory insufficiency is important for successful awake craniotomy. As measures to avoid respiratory depression, the use of high-flow nasal cannula (HFNC) can improve patient oxygenation and monitor the oxygen reserve index (ORi) to detect hypoxia earlier. Case: We report two cases of awake craniotomy with MAC using HFNC and ORi. We adjusted the fraction of inspired oxygen of the HFNC according to the ORi level. The patient underwent successful awake craniotomy without a desaturation event or additional airway intervention.
Conclusions
Combined HFNC and ORi monitoring may provide adequate oxygen reserves in patients undergoing awake craniotomy.
4.Individualized Tumor Response Testing for Prediction of Response to Paclitaxel and Cisplatin Chemotherapy in Patients with Advanced Gastric Cancer.
Jee Hyun KIM ; Keun Wook LEE ; Yeul Hong KIM ; Kyung Hee LEE ; Do Youn OH ; Joonhee KIM ; Sung Hyun YANG ; Seock Ah IM ; Sung Ho CHOI ; Yung Jue BANG
Journal of Korean Medical Science 2010;25(5):684-690
The purpose of our study was to determine the most accurate analytic method to define in vitro chemosensitivity, using clinical response as reference standard in prospective clinical trial, and to assess accuracy of adenosine triphosphate-based chemotherapy response assay (ATP-CRA). Forty-eight patients with chemo-naive, histologically confirmed, locally advanced or metastatic gastric cancer were enrolled for the study and were treated with combination chemotherapy of paclitaxel 175 mg/m2 and cisplatin 75 mg/m2 for maximum of six cycles after obtaining specimen for ATP-CRA. We performed the receiver operator characteristic curve analysis using patient responses by WHO criteria and ATP-CRA results to define the method with the highest accuracy. Median progression free survival was 4.2 months (95% confidence interval [CI]: 3.4-5.0) and median overall survival was 11.8 months (95% CI: 9.7-13.8) for all enrolled patients. Chemosensitivity index method yielded highest accuracy of 77.8% by ROC curve analysis, and the specificity, sensitivity, positive and negative predictive values were 95.7%, 46.2%, 85.7%, and 75.9%. In vitro chemosensitive group showed higher response rate (85.7% vs. 24.1%) (P=0.005) compared to chemoresistant group. ATP-CRA could predict clinical response to paclitaxel and cisplatin chemotherapy with high accuracy in advanced gastric cancer patients. Our study supports the use of ATP-CRA in further validation studies.
Adenosine Triphosphate/*analysis
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Adult
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Aged
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Antineoplastic Agents, Phytogenic/administration & dosage
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Antineoplastic Combined Chemotherapy Protocols/*administration & dosage
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Cisplatin/administration & dosage
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Drug Screening Assays, Antitumor/*methods
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Female
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Humans
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Korea
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Male
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Middle Aged
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Outcome Assessment (Health Care)/methods
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Paclitaxel/administration & dosage
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Reproducibility of Results
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Sensitivity and Specificity
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Stomach Neoplasms/*diagnosis/*drug therapy/metabolism
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Treatment Outcome