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3 "Bradycardia"
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Development of severe junctional bradycardia after dexmedetomidine infusion in a polypharmacy patient: a case report and literature review
Soeun Jeon, Eunsoo Kim, Sun Hack Lee, Sung In Paek, Hyun-Su Ri, Dowon Lee
Kosin Med J. 2023;38(1):50-55.   Published online December 7, 2022
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Abstract PDFPubReader   ePub   CrossRef-TDMCrossref - TDM
The authors report a case of newly manifested severe junctional bradycardia following dexmedetomidine administration during spinal anesthesia in a polypharmacy patient. A 77-year-old woman receiving multiple medications, including a beta-blocker and a calcium channel blocker, underwent right total knee arthroplasty. After spinal anesthesia, intravenous dexmedetomidine was initiated as a sedative; her heart rate decreased, followed by junctional bradycardia (heart rate, 37–41 beats/min). Dexmedetomidine was discontinued, and a dopamine infusion was initiated. Seven hours after surgery, junctional bradycardia persisted; a temporary transvenous pacemaker was inserted, and the beta-blocker and calcium channel blocker were discontinued. The patient was discharged on postoperative day 11 without any sequelae. Anesthesiologists should be aware of dexmedetomidine’s inhibitory effects on the cardiac conduction system, especially in geriatric patients taking medications with negative chronotropic effects and in combination with neuraxial anesthesia.
A Case of an Infant Diagnosed with Cow's Milk Allergy and Concurrent Meat Allergy via ImmunoCAP ISAC®
So Yoon Jo, Chan Ho Lee, Sung Won Kim, Yoon Ha Hwang
Kosin Med J. 2019;34(1):72-77.   Published online June 30, 2019
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Abstract PDFPubReader   ePub   CrossRef-TDMCrossref - TDM

Approximately 13–20% of infants with milk allergies concurrently exhibit beef allergies. Here, we report a 24-month-old infant who exhibited both pork and beef allergies, concurrently with a milk allergy. The infant's laboratory test results were: 3.73 ISU-E (ISAC standardized unit for IgE) for cow milk β-lactoglobulin, 23.8 ISU-E for casein, 12.8 ISU-E for cow milk Bos d 6 of serum albumin, and 4.85 ISU-E for cat Fel d 2. This case report summarizes an infant patient diagnosed with a meat allergy that was associated with cow's milk allergy, using ImmunoCAP ISAC®. Not only ImmunoCAP ISAC® but also immunocap can be used to diagnose milk allergy and meat allergy at the same time, immunocap testing for component antigen is rare. ImmunoCAP ISAC® is used to diagnose these allergies in our case study, as it has advantage that only 1ml of blood is needed to run various component antigen tests.


Citations to this article as recorded by  
  • Preparation, Identification and Application of β-Lactoglobulin Hydrolysates with Oral Immune Tolerance
    Linghan Tian, Qianqian Zhang, Yanjun Cong, Wenjie Yan
    Foods.2023; 12(2): 307.     CrossRef
Persistent Complete Atrioventricular Block after Induction of General Anesthesia in a Healthy Patient
Gyeong-Jo Byeon, Hye-Jin Kim, Hyun-Su Ri, Su Sung Lee, Hee Young Kim
Kosin Med J. 2019;34(1):65-71.   Published online June 30, 2019
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Abstract PDFPubReader   ePub   CrossRef-TDMCrossref - TDM

A 38-year-old female patient had bradycardia in the preoperative electrocardiogram (ECG), and she showed severe bradycardia, with the heart rate (HR) under 40 beats per minute (bpm) even after arrival in the operating room. Immediately after endotracheal intubation, ventricular tachycardia with HR over 200 bpm occurred, but it disappeared voluntarily. The surgery was postponed for additional cardiac evaluation because of the persistent severe bradycardia. On postanesthesia day 2, complete atrioventricular (AV) block appeared. We expected spontaneous recovery over 2 weeks, but the complete AV block persisted. A permanent pacemaker was eventually inserted, and the patient was discharged without other complications on day 4 after insertion of the pacemaker. We report this case because complete AV block has commonly occurred in patients with risk factors such as first AV block, secondary AV block, or bundle branch block, but complete AV block has occurred despite the absence of arrhythmia in this patient.

KMJ : Kosin Medical Journal