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1.  Dexmedetomidine sedation for transesophageal echocardiography during percutaneous atrial septal defect closure in adult 
Pakistan Journal of Medical Sciences  2013;29(6):1456-1458.
Atrial septal defect (ASD) is second common congenital heart disease that often leads to adult period. Intracardiac or transesophageal echocardiography (TEE) is essential for percutaneous closure of ASD using Amplatzer septal occluder. Dexmedetomidine (DEX), which is a highly selective ╬▒2-agonist, has sedative and analgesic properties without respiratory depression in the clinical dose range. We report percutaneous closure of ASD with TEE under DEX sedation.
PMCID: PMC3905376  PMID: 24550975
Atrial septal defect; Transesophageal echocardiography; Dexmedetomidine sedation
2.  Lumbar Plexopathy Caused by Metastatic Tumor, Which Was Mistaken for Postoperative Femoral Neuropathy 
The Korean Journal of Pain  2011;24(4):226-230.
Surgical excision was performed on a 30-years old woman with a painful mass on her left thigh. The pathologic findings on the mass indicated fibromatosis. After the operation, she complained of allodynia and spontaneous pain at the operation site and ipsilateral lower leg. We treated her based on postoperative femoral neuropathy, but symptom was aggravated. We found a large liposarcoma in her left iliopsoas muscle which compressed the lumbar plexus. In conclusion, the cause of pain was lumbar plexopathy related to a mass in the left iliopsoas muscle. Prompt diagnosis of acute neuropathic pain after an operation is important and management must be based on exact causes.
doi:10.3344/kjp.2011.24.4.226
PMCID: PMC3248587  PMID: 22220245
fibromatosis; liposarcoma; neuropathic pain
4.  Dexmedetomidine and remifentanil in the perioperative management of an adolescent undergoing resection of pheochromocytoma -A case report- 
Korean Journal of Anesthesiology  2012;63(6):555-558.
A 15-year-old adolescent with unilateral multiple adrenal pheochromocytoma had an episode of subcortical intracerebral hemorrhage and seizure 6 weeks before the surgery. He was pretreated with terazosin, losartan, atenolol and levetiracetam for 2 weeks. Dexmedetomidine was started in the preoperative waiting area, and a combination of dexmedetomidine and remifentanil was continuously infused for most of anesthetic time. To control blood pressure, bolus injection of remifentanil and low-dose infusion of sodium nitroprusside, nicardipine, and esmolol were administered during three adrenergic crises. There was minimal post-resection hypotension, and his trachea was extubated safely 20 min after the surgery. He was discharged without noticeable complication. His catecholamine levels showed the steadily decreasing pattern during the operation in this case. Though a combination of dexmedetomidine and remifentanil may not prevent the hemodynamic instability impeccably during the tumor manipulation, this combination seems to be the way of interrupting release of catecholamines and minimizing hemodynamic fluctuations.
doi:10.4097/kjae.2012.63.6.555
PMCID: PMC3531537  PMID: 23277819
Catecholamine; Dexmedetomidine; Pheochromocytoma; Remifentanil
5.  Post-radiation Piriformis Syndrome in a Cervical Cancer Patient -A Case Report- 
The Korean Journal of Pain  2010;23(1):88-91.
The piriformis syndrome is a condition allegedly attributable to compression of the sciatic nerve by the piriformis muscle. Recently, magnetic resonance neurography and electrophysiologic study have helped to diagnose piriformis syndrome. High dose radiotherapy could induce acute and delayed muscle damage. We had experienced piriformis syndrome with fatty atrophy of piriformis muscle after radiotherapy for recurrent cervical cancer.
doi:10.3344/kjp.2010.23.1.88
PMCID: PMC2884211  PMID: 20552082
cervical cancer; piriformis atrophy; piriformis syndrome; postradiation neuropathy; sciatic neuropathy

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