1.Prediction of Mid-term Platelet Transfusion in Stable Trauma Patients Using Rotational Thromboelastometry
Ha Jin LIM ; Hyunseok JANG ; Naa LEE ; Euisung JEONG ; Yunchul PARK ; Younggoun JO ; Jungchul KIM ; Young Eun LEE ; Hyun-Jung CHOI ; Seung-Jung KEE ; Jong Hee SHIN ; Myung Geun SHIN
Annals of Laboratory Medicine 2024;44(1):74-81
Background:
Rotational thromboelastometry (ROTEM; TEM International GmbH, Munich, Germany) is a global coagulation test that guides evidence-based platelet transfusion in trauma patients. We evaluated ROTEM parameters for predicting mid-term (five days) platelet transfusion in trauma patients.
Methods:
Maximum clot firmness and clot amplitudes after 5, 10, and 15 mins (A5, A10, and A15, respectively) of fibrin-specific ROTEM (FIBTEM) and extrinsically activated ROTEM (EXTEM) were retrospectively collected from 82 hospitalized, stable, non-bleeding trauma patients after successful initial resuscitation. Platelet-specific ROTEM (PLTEM) was calculated by subtracting FIBTEM from EXTEM. Platelet transfusions were reviewed for five days after ROTEM.
Results:
The areas under the curve for FIBTEM, EXTEM, and PLTEM predicting platelet concentrate transfusion of > 12 U at mid-term were 0.915–0.923, 0.878–0.896, and 0.551–0.735, respectively. FIBTEM and EXTEM parameters were comparable to those of fibrinogen, fibrin/fibrinogen degradation products, D-dimer, and antithrombin III. Strong correlations (r > 0.7) were noted between platelet count and EXTEM (A5, A10, and A15) or PLTEM (A5), platelet function (per platelet count) and EXTEM (A10 and A15), and fibrinogen levels and all FIBTEM parameters.
Conclusions
FIBTEM and EXTEM can reliably predict mid-term platelet transfusion in trauma patients. FIBTEM, EXTEM, and PLTEM parameters correlate with conventional coagulation tests (platelets and fibrinogen).
2.A Case of Remission of Refractory Eosinophilic Otitis Media Treated With Dupilumab
Hyunseok CHOI ; Dongha KIM ; Sung Won CHAE ; Jae Jun SONG
Korean Journal of Otolaryngology - Head and Neck Surgery 2024;67(9):496-500
Eosinophilic otitis media is characterized by highly viscous middle ear effusion and associated with bronchial asthma and chronic rhinosinusitis with nasal polyps. It is difficult to treat with conventional therapy such as corticosteroid and ventilation tube insertion. We have encountered a 58-year-old patient with refractory eosinophilic otitis media who was successfully treated with dupilumab.
3.A Case of Remission of Refractory Eosinophilic Otitis Media Treated With Dupilumab
Hyunseok CHOI ; Dongha KIM ; Sung Won CHAE ; Jae Jun SONG
Korean Journal of Otolaryngology - Head and Neck Surgery 2024;67(9):496-500
Eosinophilic otitis media is characterized by highly viscous middle ear effusion and associated with bronchial asthma and chronic rhinosinusitis with nasal polyps. It is difficult to treat with conventional therapy such as corticosteroid and ventilation tube insertion. We have encountered a 58-year-old patient with refractory eosinophilic otitis media who was successfully treated with dupilumab.
4.A Case of Remission of Refractory Eosinophilic Otitis Media Treated With Dupilumab
Hyunseok CHOI ; Dongha KIM ; Sung Won CHAE ; Jae Jun SONG
Korean Journal of Otolaryngology - Head and Neck Surgery 2024;67(9):496-500
Eosinophilic otitis media is characterized by highly viscous middle ear effusion and associated with bronchial asthma and chronic rhinosinusitis with nasal polyps. It is difficult to treat with conventional therapy such as corticosteroid and ventilation tube insertion. We have encountered a 58-year-old patient with refractory eosinophilic otitis media who was successfully treated with dupilumab.
5.A Case of Remission of Refractory Eosinophilic Otitis Media Treated With Dupilumab
Hyunseok CHOI ; Dongha KIM ; Sung Won CHAE ; Jae Jun SONG
Korean Journal of Otolaryngology - Head and Neck Surgery 2024;67(9):496-500
Eosinophilic otitis media is characterized by highly viscous middle ear effusion and associated with bronchial asthma and chronic rhinosinusitis with nasal polyps. It is difficult to treat with conventional therapy such as corticosteroid and ventilation tube insertion. We have encountered a 58-year-old patient with refractory eosinophilic otitis media who was successfully treated with dupilumab.
6.A Case of Remission of Refractory Eosinophilic Otitis Media Treated With Dupilumab
Hyunseok CHOI ; Dongha KIM ; Sung Won CHAE ; Jae Jun SONG
Korean Journal of Otolaryngology - Head and Neck Surgery 2024;67(9):496-500
Eosinophilic otitis media is characterized by highly viscous middle ear effusion and associated with bronchial asthma and chronic rhinosinusitis with nasal polyps. It is difficult to treat with conventional therapy such as corticosteroid and ventilation tube insertion. We have encountered a 58-year-old patient with refractory eosinophilic otitis media who was successfully treated with dupilumab.
7.A Case of Extramedullary Relapse of Acute Promyelocytic Leukemia in the External Auditory Canal and Temporal Bone
Hyunseok CHOI ; Jaeman PARK ; Sung Won CHAE ; Jae Jun SONG
Korean Journal of Otolaryngology - Head and Neck Surgery 2024;67(6):344-348
Extramedullary relapse of acute promyelocytic leukemia is rare and has been reported in 3%- 5% of patients. Relapse in the external auditory canal and the temporal bone is even more uncommon and scarcely reported. We encountered a 69-year-old male who complained about right ear pain and hearing loss. The patient had extramedullary relapse of acute promyelocytic leukemia in the right external auditory canal and in the temporal bone.
8.Cognitive Behavioral Therapy for Tinnitus: Outpatient-Based Treatment
Jong-Geun LEE ; Yongmin CHO ; Hyunseok CHOI ; Gi Hwan RYU ; Jaeman PARK ; Dongha KIM ; Sung-Won CHAE ; Jae-Jun SONG
Korean Journal of Otolaryngology - Head and Neck Surgery 2024;67(5):270-276
Background and Objectives:
Cognitive behavioral therapy (CBT) is a treatment option for subjective tinnitus. There are many reports on its clinical efficacy, but the protocol has not been well established. The purpose of this study was to set an outpatient-based CBT protocol and evaluate its clinical efficacy for tinnitus.Subjects and Method A total of 85 chronic tinnitus patients was assessed in this prospective study. After evaluating for eligibility, 30 patients completed CBT based on a protocol of 5 weekly sessions in an outpatient setting. Therapeutic efficacy was assessed by Tinnitus Handicap Inventory (THI) questionnaires and visual analogue scale (VAS) for tinnitus. The initial scores were compared with the final scores, which were assessed a month after the fifth CBT session.
Results:
The results showed that CBT reduced THI and VAS scores significantly (p<0.05).
Conclusion
The results of the study suggest that an outpatient-based CBT protocol can be clinically beneficial for patients with tinnitus.
9.Association between Atherosclerosis and High-Risk Colorectal Adenomas based on Cardio-Ankle Vascular Index and Ankle-Brachial Index
Jung Ho LEE ; Hyunseok CHO ; Sang Hoon LEE ; Sung Joon LEE ; Chang Don KANG ; Dae Hee CHOI ; Jin Myung PARK ; Seung-Joo NAM ; Tae Suk KIM ; Ji Hyun KIM ; Sung Chul PARK
The Korean Journal of Gastroenterology 2024;83(4):143-149
Background/Aims:
Colorectal adenomas are precancerous lesions that may lead to colorectal cancer. Recent studies have shown that colorectal adenomas are associated with atherosclerosis. The cardio-ankle vascular index (CAVI) and ankle-brachial index (ABI) are noninvasive methods for evaluating atherosclerosis. This study examined the association between atherosclerosis and high-risk colorectal adenomas based on the CAVI and ABI.
Methods:
The data of patients aged ≥50 years who had a colonoscopy and CAVI and ABI measurements from August 2015 to December 2021 at the Kangwon National University Hospital were analyzed retrospectively. After the colonoscopy, subjects were divided into no, overall, and high-risk (size ≥1 cm, high-grade dysplasia or villous adenoma, three or more adenomas) adenoma groups based on the pathology findings. The data were subjected to univariate and multivariate logistic regression analyses.
Results:
Among the 1,164 subjects, adenomas and high-risk adenomas were found in 613 (52.6%) and 118 (10.1%) patients, respectively. The rate of positive ABI (<0.9) and positive CAVI (≥9.0) were significantly higher in the high-risk adenoma group (22.0% and 55.9%) than in the no adenoma (12.3% and 39.6%) and the overall adenoma group (15.7% and 44.0%) (p=0.008 and p=0.006, respectively). Multivariate analysis revealed a positive CAVI and smoking status to be significantly associated with high-risk adenoma with an odds ratio of 1.595 (95% confidence interval 1.055–2.410, p=0.027) and 1.579 (1.072–2.324, p=0.021), respectively.
Conclusions
In this study, a significant correlation between positive CAVI and high-risk adenomas was observed. Therefore, CAVI may be a significant predictor for high-risk colorectal adenoma.
10.Effectiveness of Pregabalin in Treatment of Burning Mouth Syndrome
Seok-Youl CHOI ; Hyunseok CHOI ; Jae-Gu CHO
Korean Journal of Otolaryngology - Head and Neck Surgery 2022;65(11):692-696
Background and Objectives:
Burning mouth syndrome (BMS) is a chronic pain disorder involving a burning sensation of the oral cavity without any identifiable oral lesion. According to the recent studies, the pathogenesis of BMS is presumed to be caused by a neuropathic condition. Gabapentin and pregabalin have been used for various neuropathic pains, but pregabalin has several pharmacokinetic advantages over gabapentin. To our best knowledge, there are no recent studies reported on the administration of pregabalin in treating BMS in Korea. Therefore, in this study, we investigated the therapeutic effect of pregabalin in treating BMS.Subjects and Method We chose as candidates 33 patients diagnosed as BMS and took pregabalin for more than four weeks. Pregabalin was administered at 75 mg once a day for 2 to 4 weeks at first, and then the dose was modified depending on whether or not symptoms improved. Effectiveness of treatment was evaluated in the way that the patients subjectively answered whether or not symptoms were improved.
Results:
A total of 21 (63.6%) out of 33 patients were responsive to the treatment. Among those, at the last follow-up, 8 patients (38.1%) showed slight improvement, and 13 patients (61.9%) showed mostly improvement or disappearance of symptoms. The average time interval from starting pregabalin to the first symptom improvement was 50.1 days, and most patients showed symptom improvement within 8 weeks.
Conclusion
This study concludes that pregabalin can be added as a meaningful option in the treatment of BMS. The additional double-blind clinical study should be followed to further prove the effectiveness of pregabalin.

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