Daisy Joo

Since 2009, Dr. Joo’s endeavours have been purely clinical. As education coordinator in the department of Anesthesia at North York General Hospital, she established a rotation for PGY4 residents in a busy community hospital pediatric anesthesia practice. This rotation provided two weeks for each resident to learn regional techniques and other methods of providing care to pediatric patients requiring day surgery. In her time as the education coordinator, she also developed a clinical core rotation in pediatric anesthesia for anesthesia assistants completing the program at the Michener Institute.  This program was so successful that North York General Hospital has taken the lead in providing this pediatric anesthesia clinical core rotation to anesthesia assistants to all those in the Michener program that require a clinical placement not found at their base hospitals. In the last year, as part of the QBP Tonsillectomy committee, her team has developed a model of care for tonsillectomies that meet the objectives defined by the Ministry of Health and current evidence-based best practice. This model has been implemented at North York General Hospital with the goal of providing the best, standardized quality of care possible.

Research Synopsis

From 1997-2001 during graduate school as a PhD candidate Dr. Joo was supervised by Dr. Beverley Orser while working independently on a research project that yielded four major publications. The focus of her research was on determining the role of the glutamatergic AMPA receptor GluR2 subunit in neurodepression by anesthetic agents and neurotoxicity.

From 2001-2008, as a principal investigator in a scientist-track, the foci of Dr. Joo’s research was on 1) determining the possible mechanisms responsible for the upregulation of glutamatergic NMDA receptors in response to opioid exposure, i.e. to morphine and to remifentanil; 2) determining whether glutamatergic AMPA receptor modulation occurred in response to opioid exposure; and 3) determining whether delta opioid receptor activation by remifentanil is responsible for NMDA receptor upregulation as a possible mechanism for a pathological pain state.

Recent Publications

1. Zhao M, Joo DT.  Subpopulation of dorsal horn neurons displays enhanced N-methyl-D-aspartate receptor function after chronic morphine exposure.  Anesthesiology (2006) 104(4):815-25.
2. Joo DT.  Mechanisms of opioid tolerance: Emerging evidence and therapeutic implications.  Can J Anesth (2007) 54(12): 969-76.  
3. Zhao M, Joo DT.  Enhancement of spinal N-methyl-D-aspartate receptor function by remifentanil action at delta-opioid receptors as a mechanism for acute opioid-induced hyperalgesia or tolerance.  Anesthesiology (2008) 109:308-317.
4. Ng D, Pitcher GM, Szilard RK, Sertié A, Kanisek M, Clapcote SJ, Lipina T, Kalia LV, Joo D, McKerlie C, Cortez M, Roder JC, Salter MW, McInnes RR.  Neto1 is a novel CUB-domain NMDA receptor-interacting protein required for synaptic plasticity and learning.  PLoS Biol (2009) 7(2):e41. 
5. Joo DT, Wong GK.  Drug interactions:  lipoxygenase inhibitors interfere with ropivacaine-induced vasoconstriction.  Can J Anesth (2009) 56(4):279-281, 281-283.
6. Wong GK, Joo DT, McDonnell C.  Lipid resuscitation in a carnitine deficient child following intravascular migration of an epidural catheter.  Anaesthesia (2010) 65(2):192-195.  

Appointments

Pediatric Anesthesia Training and Practice Coordinator, North York General Hospital
North York General Hospital, Pediatric Pandemic Planning Committee
Pharmacy and Therapeutics representative for the Department of Anesthesia, North York General Hospital
Perioperative ORPFCC Member (Patient-FamilyCentred Care), North York General Hospital
Tonsillectomy QBP (Quality care,  Best Practice), North York General Hospital

Courses

Course Number: Stepping Stone program course work
Course Name: Effective Mentoring Skills, Teaching 101, Role Modelling