Hong Sik Lee

Hypertensive crisis during wide excision of gastrointestinal stromal cell tumor (GIST): Undiagnosed paraganglioma -A case report-

Although paraganglioma (PGL), an extra-adrenal retroperitoneal pheochromocytoma (PHEO), is a rare catecholamine-secreting neuroendocrine tumor, it can cause severe hypertensive crisis during anesthesia or surgery if undiagnosed preoperatively. Extraluminal perigastric masses may be presumed to be gastrointestinal stromal tumors (GISTs) or soft tissue sarcomas even when histologic confirmation is not possible. Therefore, without a histologic diagnosis or symptoms of excessive catecholamine secretion, PGL may be mistaken for GIST. We report a case of preoperatively undiagnosed PGL which caused hypertensive crisis during anesthesia for retroperitoneal mass excision.

Phrenic nerve palsy following coracoid infraclavicular brachial plexus block

Various methods of infraclavicular brachial plexus block have been introduced in the past, of which Wilsons coracoid infraclavicular brachial plexus block, a more lateral approach, consequently thought to be easier and safer. While only a few cases of transient ipsilateral phrenic nerve palsy after infraclavicular brachial plexus block have been reported, we describe a rare case of phrenic nerve palsy after Wilsons coracoid infraclavicular brachial plexus block.

Genetic polymorphisms in the serotonin receptor type 3B gene (HTR3B) and the clinical response to ondansetron in Koreans

We performed a pharmacogenetic study to analyse the correlation between the clinical responses to ondansetron during a 24-h postoperative period and two single nucleotide polymorphisms (−100_–102 delAAG and ins/delCA) in the serotonin receptor type 3B gene (HTR3B) in 280 Korean patients with tonsillectomy (TS, n=108) or surgery because of gynaecological problems (GY, n=172). The effect of CA/CA homogyzous variant of the ins/delCA allele on lowering the prevention of postoperative vomiting was significant, particularly during the initial 2 h postoperative period (P=0.034) and in the GY group (P=0.013 for complete response and P=0.009 for prevention of vomiting). However, we failed to detect a significant effect of genotypes for the −100_–102delAAG allele during our observation period. Our results suggest that ins/delCA polymorphism in the HTR3B may have clinical relevance to the expected clinical response to prevent postoperative vomiting in patients treated with ondansetron.

Right hydrothorax misconceived as atelectasis after left internal jugular vein catheterization -A case report-

Central vein catheterization is a common procedure for monitoring the central venous pressure, securing vascular access, administrating vasoactive drugs and removing air embolisms. However, many complications can occur, such as vessel injury, pneumothorax, hydrothorax, nerve injury, arrhythmia and infection at the insertion site. We encountered an unusual complication of a localized right hydrothorax that was initially misinterpreted as an atelectasis after left internal jugular vein catheterization and right lateral positioning for a left lower lobectomy.