Jung Tack Kim, M.D.

Iatrogenic carotid artery pseudoaneurysm recognized by ultrasound
Morimoto, Maki; Lee, Mitchell Y; Kim, Jung T
2011 Apr;25(2):385-386, Journal of cardiothoracic & vascular anesthesia
— id: 130895, year: 2011, vol: 25, page: 385, stat: Journal Article,

Pollen counts and suicide rates. Association not replicated
Woo JM; Gibbons RD; Rogers CA; Qin P; Kim JB; Roberts DW; Noh ES; Mann JJ; Postolache TT
2011 Feb;125(2):168-175 L, Acta psychiatrica Scandinavica
Woo JM, Gibbons RD, Rogers CA, Qin P, Kim JB, Roberts DW, Noh ES, Mann JJ, Postolache TT. Pollen counts and suicide rates. Association not replicated. Objective: To replicate a previously reported association between pollen counts and county suicide rates in the continental United States, across space and time. Method: The authors evaluated the relationship between airborne pollen counts and suicide rates in 42 counties of the continental United States, containing a pollen-counting station participating in the Aeroallergen Monitoring Network in the United States (N = 120 076 suicides), considering years' quarter, age group, sex, race, rural/urban location, number of local psychiatrists, and median household income, from 1999 to 2002. The county-level effects were broken into between-county and within-county. Results: No within-county effects were found. Between-county effects for grass and ragweed pollen on suicide rates lost statistical significance after adjustment for median income, number of psychiatrists, and urban vs. rural location. Conclusion: Future research is necessary to reappraise the previously reported relationship between pollen levels and suicide rates that may have been driven by socioeconomic confounders
— id: 148447, year: 2011, vol: 125, page: 168, stat: Journal Article,

Suicide and prescription rates of intranasal corticosteroids and nonsedating antihistamines for allergic rhinitis: an ecological study
Woo, Jong-Min; Gibbons, Robert D; Qin, Ping; Komarow, Hirsh; Kim, Jong Bae; Rogers, Christine A; Mann, J John; Postolache, Teodor T
2011 Oct;72(10):1423-1428, Journal of clinical psychiatry
OBJECTIVE: To estimate the relationship between antiallergy drug prescription rates and suicide across the United States and over time. The relationship between allergy, allergens, and suicidal behavior and suggestions of a possible immune mediation led us to hypothesize that intranasal corticosteroids, known to reduce local airway production of T-helper cell type 2 cytokines, may be associated with reduced risk of suicide relative to antihistamines, which only secondarily affect cytokine production. METHOD: The authors evaluated the relationship of suicide rates at the county level in the United States (N = 120,076 suicides) with prescriptions for intranasal corticosteroids and nonsedating antihistamines, in interaction with antidepressant prescriptions and other socioeconomic variables, for the period from 1999 to 2002. Suicide rate data were derived from state vital record systems based on local death certificate registries, and county-level allergy and antidepressant prescription data were obtained from IMS Health Incorporated (Plymouth Meeting, Pennsylvania). RESULTS: The prescription volume of intranasal corticosteroids was associated with a lower suicide risk (P = .0004), while that of antihistamines was associated with a modestly greater suicide risk (P = .0001). Adjustment for antidepressant prescriptions did not affect these relationships. CONCLUSIONS: This is the first study, to our knowledge, to find a possible association between completed suicide and medications for allergic rhinitis and also the first report of an association of intranasal corticosteroid use with a lower suicide rate. This association should be considered preliminary and deserving of further investigation
— id: 148446, year: 2011, vol: 72, page: 1423, stat: Journal Article,

Anesthetic complications in pediatric patients undergoing cochlear implantation
Yeh, Joseph S; Mooney, Kimberly L; Gingrich, Kevin; Kim, Jung T; Lalwani, Anil K
2011 Oct;121(10):2240-2244, Laryngoscope
OBJECTIVES/HYPOTHESIS: Cochlear implantation (CI) is effective in the treatment of childhood sensorineural hearing loss and is associated with minimal surgical complications. We investigated the incidence of anesthetic complications in young patients undergoing general anesthesia for CI. STUDY DESIGN: Retrospective chart review. METHODS: A retrospective chart review of 123 patients younger than 18 years, who underwent CI between 2007 and 2008, was conducted for identification of intra- and postoperative anesthesia-related complications. The relation of collected variable to the complication events was analyzed using logistic regression. RESULTS: Of the 123 CI procedures, eight patients had nine anesthesia-related complications, yielding a complication rate of 6.5% and included the following: postoperative wheezing/stridor (5 cases), laryngospasm (3 cases), and emesis during inhalational induction (1 case). Divided by age group, 12 patients were <12 months with one complication (8%), 18 patients were between 1 and 2 years with one complication (5.6%), 35 patients were between 2 and 5 years with one complication (3%), 39 patients were between 5 and 12 years with five complications (13%), and 19 patients were older than 12 years with no complication (0%). Logistic regression failed to identify a significant association of any collected variable(s) with the observed complications. The incidence of complications is similar to that previously reported in elderly patients (4.3%) (Pearson chi(2) , P = .523). CONCLUSIONS: General anesthesia is well tolerated by pediatric patients undergoing CI, even under 1 year of age. Significant perioperative complications are primarily respiratory, are usually free of long-term sequelae, and occur with an incidence similar to other reported age groups
— id: 137895, year: 2011, vol: 121, page: 2240, stat: Journal Article,

Cochlear implantation is associated with minimal anesthetic risk in the elderly
Coelho, Daniel H; Yeh, Joseph; Kim, Jung T; Lalwani, Anil K
2009 Feb;119(2):355-358, Laryngoscope
OBJECTIVES/HYPOTHESIS: Most elderly patients with severe to profound hearing loss are not being referred for cochlear implantation (CI), the only intervention to significantly improve hearing and quality of life in this population. Possible concern over the risks of anesthetic in the elderly may be one of the foremost concerns. The authors investigated whether advanced age is a risk factor when undergoing general anesthesia for cochlear implantation. STUDY DESIGN: Retrospective chart review. METHODS: A retrospective chart review was conducted at a tertiary academic referral center of 70 patients older than 70 years, who underwent CI with general anesthesia between 1984 and 2007, and for whom anesthesia records were available. Patients were divided into anesthetic risk group A (American Society of Anesthesiologist classification [ASA] I/II) and B (ASA III/IV). Intraoperative and postoperative anesthesia-related complications were identified. RESULTS: Of the 70 patients, 44 were in group A and 26 were in group B, both with a mean age of 77. Four patients, one from group A and three from group B, required intraoperative pressors for blood pressure support. There were no anesthesia-related complications in group A, but there were three (12% of group B and 4% overall) in group B: delayed extubation, postoperative congestive heart failure, and urinary retention. There was no long-term morbidity or mortality. CONCLUSIONS: General anesthesia is well tolerated by elderly patients undergoing cochlear implantation. Preexisting medical condition of the patient as defined by ASA is a better predictor of intraoperative and postoperative complication than age alone
— id: 97753, year: 2009, vol: 119, page: 355, stat: Journal Article,

The use of continuous positive airway pressure during an awake craniotomy in a patient with obstructive sleep apnea
Huncke, Tessa; Chan, Jenny; Doyle, Werner; Kim, Jung; Bekker, Alex
2008 Jun;20(4):297-299, Journal of clinical anesthesia
We describe the anesthetic management of a morbidly obese patient with obstructive sleep apnea who underwent awake craniotomy. The patient's personal continuous positive airway pressure (CPAP) machine was used to support ventilation intraoperatively. Dexmedetomidine was used as the primary sedative. During cortical mapping, the CPAP was discontinued. The patient was comfortable and able to cooperate with language testing
— id: 93336, year: 2008, vol: 20, page: 297, stat: Journal Article,

Endpoint for successful, ultrasound-guided infraclavicular brachial plexus block - Reply
Morimoto, M; Popovic, J; Kim, JT; Kiamzon, H; Rosenberg, AD
2008 MAY ;55(5):308-309, Canadian journal of anaesthesia
— id: 79107, year: 2008, vol: 55, page: 308, stat: Journal Article,

Treatment with lavender aromatherapy in the post-anesthesia care unit reduces opioid requirements of morbidly obese patients undergoing laparoscopic adjustable gastric banding
Kim, Jung T; Ren, Christine J; Fielding, George A; Pitti, Abhishek; Kasumi, Takeo; Wajda, Michael; Lebovits, Allen; Bekker, Alex
2007 Jul;17(7):920-925, Obesity surgery
BACKGROUND: Parenteral administration of opioids and NSAIDs has been the mainstay for postoperative pain control in patients undergoing laparoscopic adjustable gastric banding (LAGB). Both classes of drugs, however, are associated with serious adverse effects. An addition of complimentary analgesic techniques may decrease requirement for traditional analgesics, thus reducing the incidence of side-effects. We designed the study to evaluate the effectiveness of Lavender aromatherapy in reducing opioid requirements after LAGB. METHODS: A prospective randomized placebo controlled study was carried out on 54 patients undergoing LAGB. Upon arrival to the post-anesthesia care unit (PACU), patients in the study group were treated with lavender oil, which was applied to the oxygen face mask; the control group patients received nonscented baby oil. Postoperative pain was treated with morphine. Numerical rating scores (0-10) were used to measure the level of pain at 5, 30, and 60 min. Sedation was evaluated using the Observer Assessment of Alertness/Sedation scale (0-5). Data analyzed included the amount of opioids, NRS, OAA/S, PACU discharge time, as well as the incidence of side-effects. RESULTS: The two groups were comparable with regard to patient characteristics, intraoperative drug use, and surgical time. Significantly more patients in the Placebo group (PL) required analgesics for postoperative pain (22/27, 82%) than patients in the Lavender group (LAV) (12/26, 46%) (P = .007). Moreover, the LAV patients required significantly less morphine postoperatively than PL patients: 2.38 mg vs 4.26 mg, respectively (P = .04). There were no differences in the requirements for post-operative antiemetics, antihypertensives, or PACU discharge time. CONCLUSIONS: Our results suggest that lavender aromatherapy can be used to reduce the demand for opioids in the immediate postoperative period. Further studies are required to assess the effect of this therapy on clinically meaningful outcomes, such as the incidence of respiratory complications, delayed gastric emptying, length of hospital stay, or whether this therapy is applicable to other operations
— id: 74527, year: 2007, vol: 17, page: 920, stat: Journal Article,

Case series: Septa can influence local anesthetic spread during infraclavicular brachial plexus blocks
Morimoto, Maki; Popovic, Jovan; Kim, Jung T; Kiamzon, Harald; Rosenberg, Andrew D
2007 Dec;54(12):1006-1010, Canadian journal of anaesthesia
PURPOSE: To ultrasonically identify the presence of septae within the neurovascular sheath and to assess their effect on local anesthetic spread when performing infraclavicular brachial plexus blocks. CLINICAL FEATURES: Thirty ASA status I and II patients scheduled for minor hand surgeries were enrolled in the study. Ultrasound guided infraclavicular brachial plexus blocks were performed on 28 patients. The images of the local anesthetic spread and the effect of the septum within the neurovascular sheath were analyzed. Septae were present in four of six patients where unilateral local anesthetic spread was seen. Septae were not visualized in the 22 patients with unrestricted local anesthetic spread after the initial injection. All 28 patients underwent their planned operations successfully with adequate anesthesia. CONCLUSIONS: Our study shows that the presence of septae within the neurovascular sheath may influence the pattern of local anesthetic spread associated with the infraclavicular approach to brachial plexus blocks
— id: 76335, year: 2007, vol: 54, page: 1006, stat: Journal Article,

Dexmedetomidine does not increase the incidence of intracarotid shunting in patients undergoing awake carotid endarterectomy
Bekker, Alex; Gold, Mark; Ahmed, Raza; Kim, Jung; Rockman, Caron; Jacobovitz, Glenn; Riles, Thomas; Fisch, Gene
2006 Oct;103(4):955-958, Anesthesia & analgesia
Systemic administration of dexmedetomidine (DEX) decreases cerebral bloodflow (CBF) via direct alpha-2-mediated constriction of cerebral blood vessels and indirectly via its effect on the intrinsic neural pathway modulating vascular smooth muscle. Reduction in CBF without a concomitant decrease in cerebral metabolic rate has raised concerns that DEX may limit adequate cerebral oxygenation of brain tissue in patients with already compromised cerebral circulation (e.g., carotid endarterectomy [CEA]). In this study, we established the incidence of intraarterial shunting used as a sign of inadequate oxygen delivery in a consecutive series of 123 awake CEA performed in our institution using DEX as a primary sedative. Data were prospectively recorded in 151 patients who underwent CEA during the study period. Eighteen patients were sedated with midazolam and fentanyl (M/F) for medical or logistical reasons. Patients thought to be at risk of an intraoperative stroke were treated with a prophylactic intraarterial shunt. These patients, as well as those who required general anesthesia, were excluded from the final analysis. Five patients (4.3%) in the DEX group required intraarterial shunts. The incidence of shunting in patient undergoing awake CEA in our institution is 10% (historical control). No patients developed a stroke or other serious complications. It appears that the use of DEX as a primary sedative drug for CEA does not increase the incidence of intraarterial shunts
— id: 68990, year: 2006, vol: 103, page: 955, stat: Journal Article,

The use of bispectral index monitoring in the anesthetic management of a patient with Rett syndrome undergoing scoliosis surgery
Kim, Jung T; Muntyan, Igor; Bashkirov, Ignat L; Bloom, Marc; Hartmannsgruber, Maximilian W B
2006 Mar;18(2):161-162, Journal of clinical anesthesia
— id: 68740, year: 2006, vol: 18, page: 161, stat: Journal Article,

Evaluation of aromatherapy in treating postoperative pain: pilot study
Kim, Jung T; Wajda, Michael; Cuff, Germaine; Serota, David; Schlame, Michael; Axelrod, Deborah M; Guth, Amber A; Bekker, Alex Y
2006 Dec;6(4):273-277, Pain practice
This study compared the analgesic efficacy of postoperative lavender oil aromatherapy in 50 patients undergoing breast biopsy surgery. Twenty-five patients received supplemental oxygen through a face mask with two drops of 2% lavender oil postoperatively. The remainder of the patients received supplemental oxygen through a face mask with no lavender oil. Outcome variables included pain scores (a numeric rating scale from 0 to 10) at 5, 30, and 60 minutes postoperatively, narcotic requirements in the postanesthesia care unit (PACU), patient satisfaction with pain control, as well as time to discharge from the PACU. There were no significant differences in narcotic requirements and recovery room discharge times between the two groups. Postoperative lavender oil aromatherapy did not significantly affect pain scores. However, patients in the lavender group reported a higher satisfaction rate with pain control than patients in the control group (P = 0.0001)
— id: 69409, year: 2006, vol: 6, page: 273, stat: Journal Article,

Ultrasound-guided lumbar plexus block for open reduction and internal fixation of hip fracture
Morimoto, Maki; Kim, Jung T; Popovic, Jovan; Jain, Sudheer; Bekker, Alex
2006 Jun;6(2):124-126, Pain practice
PURPOSE: Ultrasound technology has been applied to increase both efficacy and safety of certain peripheral nerve blocks. This case report describes the first successful ultrasound-guided lumber plexus block. CLINICAL FEATURES: We describe a 91-year-old woman with aortic stenosis who successfully underwent open reduction and internal fixation of a fractured right hip with a lumbar plexus block. Ultrasound provided direct visualization to help identify the anatomical structures and guide the block needle during performance of the block. Complete block of the lumbar plexus was attained within 15 min, and the surgical procedure was performed uneventfully. CONCLUSION: The use of ultrasound has gained popularity to perform peripheral nerve blocks. In this case report, a successful lumbar plexus block was performed with ultrasound guidance. By direct visualization, using this technology may potentially reduce complications associated with lumbar plexus blocks
— id: 71212, year: 2006, vol: 6, page: 124, stat: Journal Article,

Anesthesia management of familial dysautonomia
Ngai, Jennie; Kreynin, Ilya; Kim, Jung T; Axelrod, Felicia B
2006 Jun;16(6):611-620, Paediatric anesthesia
Familial dysautonomia (FD) is an autosomal recessive inherited disorder, predominantly affecting the Ashkenazi Jewish population that is characterized by sensory and autonomic neuropathy. The protean manifestations and perturbations result in high morbidity and mortality. However, as a result of supportive measures and centralized care, survival has improved. As surgical options are increasing to symptomatically treat FD, anesthesiologists need to be familiar with this disorder. Because the Dysautonomia Center at NYU Medical Center is a referral center for FD patients, we have attained considerable anesthetic experience with FD. This article reviews clinical features of FD that could potentially affect anesthetic management and outlines our present practices
— id: 68934, year: 2006, vol: 16, page: 611, stat: Journal Article,

Detection of oxygen face mask defect by gas analysis during ambulatory surgery
Choi, Jieun S; Kim, Jung T
2005 Aug;17(5):406-407, Journal of clinical anesthesia
— id: 141290, year: 2005, vol: 17, page: 406, stat: Journal Article,

A double-blind prospective comparison of rofecoxib vs ketorolac in reducing postoperative pain after arthroscopic knee surgery
Kim, Jung T; Sherman, Orrin; Cuff, Germaine; Leibovits, Allen; Wajda, Michael; Bekker, Alex Y
2005 Sep;17(6):439-443, Journal of clinical anesthesia
STUDY OBJECTIVE: The aim of this study was to compare the analgesic efficacy of premedication with rofecoxib vs intravenous (IV) ketorolac in reducing postoperative pain after arthroscopic knee surgery. STUDY DESIGN: This is a prospective, randomized, double-blinded study. SETTING: This study was set at a university hospital. SUBJECTS: The subjects include 54 patients with American Society of Anesthesiologists physical statuses I, II, and III undergoing knee arthroscopy. INTERVENTIONS: Group 1 received 50 mg oral rofecoxib preoperatively with IV placebo injection, which was administered 20 minutes before the end of the operation. Group 2 received a preoperative placebo and 30 mg IV ketorolac 20 minutes before the end of surgery. MEASUREMENTS: The primary outcome measure was the proportion of patients reporting pain in the postoperative anesthesia care unit, 6 hours and 24 hours after discharge. Additional end points included the use of 5:325 mg oxycodone-acetaminophen (O/A) tablets, pain scores, patient's satisfaction survey, and comparison of side effects. Data were analyzed using independent samples t tests for continuous variables or chi2 tests for categorical variables. P < .05 was considered significant. RESULTS: The 2 groups were comparable with regard to patient characteristics, intraoperative medication use, and duration of surgery. There was no difference either in pain scores or O/A use in the postoperative anesthesia care unit. At 24 hours after discharge, significantly more patients in the ketorolac group (91%) reported pain than the rofecoxib group (63%) (P = .02). Sixty-one percent of patients in the ketorolac group used O/A during the first 24 hours vs 38% in the rofecoxib group. The difference, however, was not statistically significant. CONCLUSION: Preoperative rofecoxib is as effective as ketorolac for the treatment of pain after knee arthroscopy. Higher frequency of pain reporting at 24 hours by patients in ketorolac group is explained by the longer analgesic effect of rofecoxib. Future studies should directly compare gastrointestinal injury of these drugs, as well as cost-effectiveness of rofecoxib vs ketorolac
— id: 58974, year: 2005, vol: 17, page: 439, stat: Journal Article,

Tracheal tube cuff perforation during ventriculoatrial shunt procedure
Ranganathan, Pavithra; Kim, Jung T; Muntyan, Igor
2005 Dec;17(8):614-616, Journal of clinical anesthesia
We report a case of tracheal and endotracheal tube cuff perforation that occurred intraoperatively during a ventriculoatrial shunting procedure for a patient with normal pressure hydrocephalus. Unusual tracheal anatomy and technique were contributory factors. Use of noninvasive imaging devices to guide the intraoperative placement of catheters may avoid many of the complications related to anatomy, skill, and technique. The method of diagnosis, prevention, and management is discussed
— id: 63834, year: 2005, vol: 17, page: 614, stat: Journal Article,

Chronic granulomatous disease
Zambrano, Eduardo; Esper, Frank; Rosenberg, Rebecca; Kim, Jung; Reyes-Mugica, Miguel
2003 Nov-Dec;6(6):577-581, Pediatric & developmental pathology
— id: 132334, year: 2003, vol: 6, page: 577, stat: Journal Article,

Failure of subhypntoic doses of propofol to treat pruritus induced by intrathecal morphine following cesarean section
Beilin Y; Kim J; Kahn P
1996 ;82:S22-S22, Anesthesia & analgesia
— id: 90046, year: 1996, vol: 82, page: S22, stat: Journal Article,