• 제목/요약/키워드: Old patient

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말기 담낭암 환자의 통증조절을 위해 MS Contin 투여중 발생한 호흡억제 -증례 보고- (Respiratory Depression during Oral MS-Contin Administration for Pain Management of Gall Bladder Cancer)

  • 이철우;이병호;이용희
    • The Korean Journal of Pain
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    • 제9권1호
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    • pp.239-243
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    • 1996
  • MS-Contin is an oral controlled-release preparation of morphine sulfate that has been used widely in the management of advanced cancer pain. It prolongs plasma concentration of morphine with no observable accumulation properties following repeated dosing, thereby promoting uninterrupted sleep and hopefully improving patient's quality of life. The common side effects of MS Contin are nausea, vomiting, drowsiness and constipation. But these symptoms are usually mild and respiratory depression is a rare problem. We experienced respiratory depression during oral administration of MS contin for the pain management of advanced gall bladder cancer of 76 years old male patient with metastasis at liver, intestine and cervical lymph node. After we increased the dosage of MS Contin from 160mg to 220mg per day, due to abdominal pain, we observed morphine reaction of MS Contin overdose such as pinpoint pupil, deeply slow respiration below 8/minute, and drowsiness. After intravenous bolus injection of 0.4 mg naloxone followed by continuous administration of 0.2 mg/hr for 4 hours, the patient regained consciousness. The administered route of morphine was changed to intravenous PCA (patient controlled analgesia). There was no aspiration sign as confirmed by chest x-ray. The patient was comfortable and delayed no signs of respiratory depression until now.

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경막외강 유착제거술후 발생한 $S_2$ 피부분절부위의 감각변화 -증례 보고- (The Sensory Change on the $S_2$ Area after Epidural Adhesiolysis -A case report-)

  • 이상철;조대현;윤태균;이병건
    • The Korean Journal of Pain
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    • 제9권1호
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    • pp.256-259
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    • 1996
  • Epidural adhesiolysis is a convenient and safe method for the management of back pain. However, we experienced a case where a patient developed sensory change to S2 area after epidural adhesiolysis. Male patient, 43 years old, was admitted to our pain clinic for epidural adhesiolysis for back pain. Patient was experiencing pain radiating to left thigh, and sensory change and motor disturbance to the S1 area. Patient's symptoms and signs were much improved on the first day of epidural adhesiolysis. Patient, however, complained of numbness of perineal and S2 areas after the next day of injections. We postulated the cause of this complication was due to: compression of nerve root by the large volume of injectate and hematoma, and the side effect of local anesthetic, hypertonic saline and steroid.

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살모넬라균에 의한 파열된 하행흉부대동맥류의 치험 -1례 보고- (Ruptured Aneurysm of Descending Thoracic Aorta due to Salmonella Arteritis 1 Case Report)

  • 조창욱;김정철
    • Journal of Chest Surgery
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    • 제30권1호
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    • pp.103-107
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    • 1997
  • A very rare case of mycotic aneurysm in the descending thoracic aorta due to salmonellosis was treated in our hospital The patient was a 62 year-old male who 48 days before the operation was admitted to the depart,cent of internal medicine complaining of fever. nausla. vomiting, and loose stool. He was treated for 35 days and discharged. Three days after discharge, however, the patient was readmitted to the hospital comE긴ainin프 of $\ulcorner$i포ht uppe$\ulcorner$ 킥uadrant abdominal pain. Fever developed on the third hospiti린 day, and on the eighth hospital day, the patient complAined of back pain and epigastric pale. A simple chest x-ray showed evidence of hemothorax in the left plueral space, and therefore, computed tomography of the chest was done. The patient was diagnosed as a ruptured mycotic aneurysm of the descending thoracic aorta, and was transferred to our Department of Thoracic and CArdiovascular Surgery. The aneurysm and infected tissues was widely debrided, and the site was then patched with a Dacron graft. Salmonella choleraesuis was identified in the blood and aneurysm cultures, and antibiotics were administered for weeks according to the sensitivity of the organism. The patient experienced no complication thereafter and for the last three months since the operation, he has been leading a healthy and normal social life.

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Adverse Reactions to Protamine Sulfate used for Heparin Neutralization in a Dog Receiving a Blood Transfusion

  • Bae, Seulgi;Yun, Sungho;Oh, Taeho
    • 한국임상수의학회지
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    • 제34권3호
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    • pp.197-199
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    • 2017
  • A 14-year-old castrated male ShihTzu diagnosed with chronic kidney disease (CKD) 6 months prior was referred to our clinic. The patient had been experiencing symptoms such as vomiting, poor appetite and hind limbs weakness. Hematology tests showed that he had a non-regenerative anemia. With aggressive treatment, the patient's state had gotten worse. He showed ragged breath, vomiting blood and loss of consciousness temporarily. Hematocrit maintained low level. Gastric hemorrhage was strongly suspected by hematemesis. Whole blood transfusion was performed and heparin was used as an anticoagulant. Prior to transfusion, the blood cross matching between donor and patient was performed and the result was compatible. After the transfusion was stabilized, 1 mg of protamine sulfate for each 100 units of heparin was prepared and given intravenously over 3 minutes to reverse the effects of heparin. Immediately after protamine injection, the patient conducted severe anaphylactic shock. Protamine sulfate is used to reverse the anticoagulant action of heparin in dogs and humans. The adverse reaction of protamine sulfate range from mild reaction to fetal cardiac arrest. When using protamine sulfate as heparin neutralization, it can lead to the death of a patient cause of anaphylactic shock. For this reason, the protamine sulfate should be injected slowly with antihistamine and the clinician should carefully monitor patients.

태음인(太陰人) 위완한병(胃脘寒病)으로 진단한 하지 부종 및 위약감을 호소하는 심부정맥혈전증 여환 1례 (A Case Report on Underlying Edema and Weakness by Deep Vein Thrombosis(DVT) Diagnosed with Taeumin Wiwanhanbyeong)

  • 오지원;강민수;양성필;김진영;이의주
    • 사상체질의학회지
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    • 제29권2호
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    • pp.202-209
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    • 2017
  • Objectives The purpose of this study is to investigate the effect of Choweseuncheng-tang on Underlying Edema and weakness by Deep Vein Thrombosis(DVT) in a 74-year-old female patient. Methods Patient was treated with Jowiseungcheong-tang. Patient's symptom was assessed NRS, Tape measurement, Motor grade. The treatment was executed three times everyday from May 19th to May 23th, 2017. Patient was observed from May, 18th to May, 23th. Results After 5 days of using Jowiseungcheng-tang, patient's edema symptoms and weakness were evaluated by NRS, Tape measurement, Motor grade. After the treatment, Tape measurement score decreased. The score of Motor grade increased. However, the score of NRS was nonsignificant. Conclusions The results suggest that Jowiseungcheng-tang can be a valuable option in treating Underlying Edema and weakness by DVT.

하악골 부분절제술을 받은 환자에서 발생한 기도 관리 실패 (Failed Airway Management in a Patient with Wound Hematoma After Partial Mandibulectomy and Reconstruction with Free Flap)

  • 김석곤;송재격;강봉진;김철환;최규운
    • 대한치과마취과학회지
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    • 제13권3호
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    • pp.127-131
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    • 2013
  • We experienced failed airway management in a patient who had partial mandibulectomy and reconstruction with free-flap. 40 year-old man (height: 164 cm, body weight: 59 kg) with malignant melanoma on #38 tooth area of mandibular body was scheduled for partial mandibulectomy and reconstruction with free flap. Approximately fifteen-hours after surgery, the patient was extubated without complication. Seven hours after extubation, we experienced respiratory failure andfailed airway managementdue to airway edema and neck. We failed orotracheal intubation with direct laryngoscopy andlaryngeal mask airway, thus we tried tracheostomy but the patient was hypoxic state for more than 30 minutes. The patient had got hypoxic brain damage in whole cerebral cortex and basal ganglia. We should have the policy of airway management of the patients who have massive oro-maxillo-facial surgery and all medical personnel who treat these patients should be educated the policy and airway management methods.

원인불명의 고열 및 흉수 이후 악화된 폐결핵후유증 소양인환자 치험 1례 보고 (A Case Report of a Soyangin Patient with Aftereffects of the Tuberculosis Aggravated after a Pleural Effusion and a High Fever of Unknown Origin)

  • 이재욱;허한솔;조혜원;임은철
    • 사상체질의학회지
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    • 제28권2호
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    • pp.163-175
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    • 2016
  • Objectives It is important to care aftereffects of the tuberculosis such as cough and sputum especially for the old. The purpose of this study is to report a case which showed symptoms improvement after treatment with Hyungbangjihwang-tang.Methods To evaluate the results of this treatment, Decrease of cough and sputum was assessed by Visual Analogue Scale(VAS). The patient`s oral intake and body weight were measured.Results The patient who suffered with cough and sputum after tuberculosis developed high fever and pleural effusion of unknown origin. After treatment with western and oriental medicine, high fever and pleural effusion were subsided but cough and sputum got worse and body weight was decreased after high fever and pleural effusion. So we prescribed Hyungbangjihwang-tang and then the symptoms of the patient were improved.Conclusions This study suggests that using Sasang constitutuional medical treatment is effective for Soyangin patient with afftereffects of the tuberculosis such as cough and sputum.

소양인(少陽人) 상소증(上消證)으로 진단한 배뇨장애를 호소하는 신경인성 방광 남환 1례 (A Case Report on Neurogenic bladder by Frontotemporal dementia Treated with Yanggyuksanhwa-tang)

  • 오지원;강민수;양성필;이의주
    • 사상체질의학회지
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    • 제30권3호
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    • pp.95-103
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    • 2018
  • Objective The purpose of this study is to investigate the effect of Yanggyuksanhwa-tang on Neurogenic bladder by Frontotemporal dementia in a 65-year-old male patient. Method Patient was treated with Yanggyuksanhwa-tang. Patient's symptom was assessed Total Frequency of urination, Frequency of nocturia, single voided volume. The treatment was executed three times everyday from March, 21th to March 29th of 2018. Patient was observed from March, 20th to March, 30th. Results During 8 days of Yanggyuksanhwa-tang, patient's symptoms were evaluated by Total Frequency of urination, Frequency of nocturia, single voided volume. After the treatment, Total Frequency of urination, Frequency of nocturia decreased. Single voided volume increased. Conclusion The results suggest that Yanggyuksanhwa-tang can be a valuable option in treating Neurogenic bladder by Frontotemporal dementia.

자궁경부무력증 진단을 받고 내원한 환자 임상 1례 (A Case Report of a Cervical Incompetence Patient)

  • 윤영진;이진무;이창훈;조정훈;장준복;이경섭
    • 대한한방부인과학회지
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    • 제24권2호
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    • pp.112-119
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    • 2011
  • Objectives: This study is to report the effect of oriental medicine on a cervical incompetence patient. Methods: The effectiveness of surgical cerclage in the cervical incompetence have had prolonged controversy. Herbal medicine was given to a cervical incompetence patient whom was suggested surgical cerclage. The patient was a 40-year-old female and treated with Dojeukgangki-tang gagambang. Results: After oriental herbal treatment, the clinical symptom of a cervical incompetence was improved and maintained, the patient was delivered in 38 weeks through cesarian section. Conclusions: Oriental herbal medicine and treatment have possibility to be a useful alternative to the surgical cerclage on cervical incompetence on the basis of more persistent study.

경추성 현훈 환자의 복합 한의진료 경과 및 삶의 질 변화 : CARE 가이드라인에 따른 증례보고 (Herbal Medicine and Local Acupuncture Point Stimulation Administration and Their Clinical Effect on Quality of Life for Cervicogenic Dizziness (CGD) Patient: A CARE Guideline Compliant Case Report)

  • 김은미;조희근
    • 대한한방내과학회지
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    • 제41권3호
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    • pp.414-423
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    • 2020
  • Background: This study examines the clinical effect on quality of life of herbal medicine and local acupuncture point stimulation administration for a cervicogenic dizziness (CGD) patient. This case report was described in accordance with CARE guidelines. Case Report: A 25 year-old female patient suspected to be suffering from CGD was examined. The patient was treated with herbal medicine and local acupuncture point stimulation. We used the Headache Impact Test-6 (HIT-6), Dizziness Handicap Inventory (DHI), Pittsburgh Sleep Quality Index (PSQI), 36-Item Short Form Health Survey Version 2 (SF-36v2), and verbal numerical rating scale (VNRS) to assess the patient's symptoms. As new herbal medicine and local acupuncture point stimulation were applied, dizziness, headache, and neck pain symptoms improved. Quality of life affected by the symptoms significantly improved. Adverse effects were not observed. Conclusions: This study may suggest that herbal medicine and local acupuncture point stimulation may be effective therapy for the treatment of typical symptoms in patients with CGD.