• Title/Summary/Keyword: Patient-Controlled

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Primary Parotid Non-Hodgkin's Lymphoma: A Case Report (원발성 이하선 비호지킨 림프종: 증례보고)

  • Cho, Geon;Suh, In Suck;Tak, Kyoung Seok;Park, Young Kyu;Ko, Eung Yeol;Sung, Ha Min;Shin, Mi Kyung
    • Archives of Craniofacial Surgery
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    • v.11 no.2
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    • pp.99-102
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    • 2010
  • Purpose: Primary malignant lymphomas of the salivary glands are uncommon, representing only 1.7% to 3.1% of all salivary neoplasms and 0.6% to 5% of all tumors and tumor-like lesions of the parotid gland. Lymphomas of the parotid glands are usually manifestations of a systemic disease process but primary lymphomas of the parotid glands are rare. Most of these lesions are classified as extranodal non-Hodgkin's lymphoma. We report the clinicopathological features of primary malignant lymphoma of the parotid gland based on an analysis of our cases. Methods: The subject was a 48-year-old male patient with a malignant lymphoma originating in the parotid gland, which had been slowly increasing in size over previous 6 months. The diagnosis was established by MRI and a superficial lobectomy. After diagnosis, the patient was referred to an oncologist for staging and medical treatment. Results: The stage was IIIA. The patient was treated with chemotherapy following surgery with rituximab and CHOP (Cyclophosphamide, Adriamycin, Vincristine, Prednisolone). The tumor was controlled successfully by chemotherapy. The patient was followed up for 1 year with no relapse. Conclusion: A case of primary non-Hodgkin's lymphoma of the parotid gland was treated with a superficial parotidectomy and chemotherapy. The disease was well controlled after a 1 year follow-up.

Comparison of Ondansetron with Ondansetron and Dexamethasone in Preventing of PONV in Major Gynecologic Surgery (부인과 수술 후 Ondansetron과 병용한 Dexamethasone의 오심, 구토 예방과 제통 효과의 비교)

  • Lee, Kee-Heung;Shin, Hyo-Sang;Jeon, Young-Hoon;Kim, Si-Oh;Hong, Jung-Gil
    • The Korean Journal of Pain
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    • v.14 no.1
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    • pp.76-82
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    • 2001
  • Background: Postoperative nausea and vomiting (PONV) are common after general anesthesia and patient controlled analgesia (PCA) using opioids. This study was designed to compare the effectiveness of ondansetron plus dexamethasone versus ondansetron alone in the prevention of PONV in a patient undergoing a PCA. Methods: We studied 166 ASA I, and II in-patients undergoing general anaesthesia for major gynecological surgery. After induction of anesthesia, Group 1 (n = 64) received intravenous (IV) dexamethasone 10 mg and Group 2 (n = 102) received IV saline 2 ml before the surgical incision. Each patient received IV meperidine 50 mg as a loading dose. Meperidine 5 mg/kg, ketorolac 3.6 mg/kg and ondansetron 8 mg diluted in 40 ml solutions were connected to PCA pump for postoperative pain control. Mean arterial blood pressure, heart rate, pain score and symptom-therapy score were checked at 1, 4, 8, 16, 24, and 36 hours after the PCA connection. Results: For Group 1 and Group 2, respectively, the overall incidence of PONV was 12.5% and 23.5%. The pain scores were lower in patients receiving a combination of ondansetron and dexamethasone than those on ondansetron alone at 4 hr (P < 0.05), 8 hr (P < 0.05) and 16 hr (P < 0.05). Conclusions: This study suggests that the combination of ondansetron and dexamethasone is not more effective than ondansetron alone in the prevention of postoperative nausea and vomiting in women having PCA following major gynecological surgery but is more effective for pain control.

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The Effects of Acupuncture Treatment on Hwa-byung patient's Insomnia: Patient-assessor blind, Randomized, Placebo-controlled Clinical trial (화병환자의 불면증상에 대한 침치료 유효성 평가연구: 환자-평가자 눈가림, 무작위배정, 일반대조군 임상시험)

  • Lee, Go-Eun;Kim, Nam-Kwon;Kim, Hang-Yi;Kang, Hyung-Won
    • Journal of Oriental Neuropsychiatry
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    • v.23 no.1
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    • pp.31-48
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    • 2012
  • Objectives: The purpose of this research is to examine the effects of acupuncture treatment on Hwa-byung patient's insomnia. Methods: The study was performed through a patient-assessor blind, randomized, placebo-controlled trial in which the volunteers, data collectors and analysts were unaware of individuals who were receiving the treatment. A total of thirty-seven volunteers were divided into 2 groups. 18 subjects were placed into a trial group and 19 subjects into a control group by a randomization table. The trial group was treated on bilateral Shigu, Ahnmyun, B62 (Shinmaek), and K6 (Chohae), while the control group was not given any other treatment. The ISI(Insomnia Severity Scale) was measured as the 1st evaluative instrument, and then a comparative analysis was conducted by comparing the results with those measured by a Likert scale for major symptoms of Hwa-byung, PSQI, Hwa-byung scale, BDI, STAI, and STAXI. Results: In the ISI, PSQI, and the Likert scale regarding major symptoms of Hwa-byung, Hwa-byung scale, BDI, and STAI, more significant decreases were found in those concerning the trial group compared to those of the control group from a statistical perspective. However, in the STAXI, regarding the trial group, there was no significant decrease compared to the control group. Conclusions: The results suggest that acupuncture treatment is effective in the treatment regarding Hwa-byung patients who suffer from insomnia.

The Effect of Postoperative Propacetamol on Acute Pain and Endocrine-Metabolic Response in Gynecological Surgery (부인과 수술 후 통증관리에 있어서 프로파세타몰의 모르핀 절감 및 내분비 대사에 대한 효과)

  • Han, Tae-Hyung;Seo, Jae-Wan;Shin, Baek-Hyo;Son, Jong-Chan
    • The Korean Journal of Pain
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    • v.10 no.2
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    • pp.170-178
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    • 1997
  • Background: The analgesic efficacy and safety of propacetamol, an injectable prodrug of acetoaminophen, in combination with intravenous morphine PCA were studied in 40 patients after gynecological surgery requiring lower abdominal incision. Methods: Using a double-blind, randomized, parallel-group design, the effects of four(every 6 hr) intravenous injections of 2 g propacetamol(=1 g acetoaminophen) were compared with four injections of placebo(PL) immediately after surgery. Efficacy of cumulative dose of morphine and number of boluses requested was assessed over 24 hours by automated recording on the PCA device. It was assessed on pain scores rated on a ten-point verbal scale along with vital signs, $K^+$, glucose, BUN, creatinine, PT and PTT were measured along with stress hormones(epinephrine, norepinephrine and cortisol). Results: There were no differences in demographic data between two groups. Propacetamol group demonstrated approximately 21% morphine sparing effect compared to placebo group($33.1{\pm}10.4$ mg vs $41.4{\pm}8.0$ mg). No significant differences noted in $K^+$, glucose, BUN, Creatinine, PT and PTT levels. There were significant increases in norepinephrine and cortisol in placebo group postoperatively, compared to preoperative values. At the same time, propacetamol group also showed significant changes in these hormones. Both group revealed high degree of patient satisfaction. Conclusion: Propacetamol showed significant morphine sparing effect to some degree. Side effects were much less in propacetamol group with subsequently high patient satisfaction. The secretion of stress hormone were not blocked by postoperative propacetamol injections. Authors concluded that propacetamol should be considered as an excellent adjuvant analgesics in postoperative pain control in opioid patient controlled analgesia.

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Pain Management via a Subcutaneous Infusion of Ketamine in a Patient with Complex Regional Pain Syndrome - A case report - (케타민 피하 주입을 이용한 복합부위통증증후군 환자의 통증 관리 - 증례보고 -)

  • Suh, Jeong Hun;Koo, Mi Suk;Nahm, Francis Sahngun;Shin, Hwa Yong;Choi, Yong Min;Jo, Ji Yon;Lee, Sang Chul;Kim, Yong Chul
    • The Korean Journal of Pain
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    • v.20 no.2
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    • pp.190-194
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    • 2007
  • Complex regional pain syndrome (CRPS), which is a syndrome that is defined by pain and sudomotor and/or vasomotor instability, is usually resistant to conventional treatment. Here, a case involving a 30-year-old male patient with CRPS type I who showed severe intractable right shoulder pain with allodynia and hyperalgesia despite being treated with oral medications, nerve blocks including thoracic sympathetic neurolysis, and spinal cord stimulation is described. The patient frequently visited the emergency room due to severe uncontrollable breakthrough pain. Although a favorable effect was observed in response to intermittent ketamine infusion therapies that were performed on an outpatient basis, acute exacerbation of pain occurred frequently during the night and could not be controlled. Therefore, subcutaneous ketamine infusion therapy using a patient-controlled analgesic system was attempted and found to effectively control acute exacerbation of pain during 6 weeks of infusion without serious complications.

Stroke after percutaneous transhepatic variceal obliteration of esophageal varix in Caroli syndrome

  • Lee, Yoo Min;Lee, Yoon;Choe, Yon Ho
    • Clinical and Experimental Pediatrics
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    • v.56 no.11
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    • pp.500-504
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    • 2013
  • Here we present the case of an 11-year-old female patient diagnosed with Caroli syndrome, who had refractory esophageal varices. The patient had a history of recurrent bleeding from esophageal varices, which was treated with endoscopic variceal ligation thrice over a period of 2 years. However, the bleeding was not controlled. When the patient finally visited the Emergency Department, the hemoglobin level was 4.4 g/dL. Transhepatic intrajugular portosystemic shunt was unsuccessful. Subsequently, the patient underwent percutaneous transhepatic variceal obliteration. Twenty hours after this procedure, the patient complained of aphasia, dizziness, headache, and general weakness. Six hours later, the patient became drowsy and unresponsive to painful stimuli. Lipiodol particles used to embolize the coronary and posterior gastric veins might have passed into the systemic arterial circulation, and they were found to be lodged in the brain, kidney, lung, and stomach. There was no abnormality of the portal vein on portal venography, and blood flow to the azygos vein through the paravertebral and hemiazygos systems was found to drain to the systemic circulation on coronary venography. Contrast echocardiography showed no pulmonary arteriovenous fistula. Symptoms improved with conservative management, and the esophageal varices were found to have improved on esophagogastroduodenoscopy.

Case Report on Traditional Korean Medicine of an Acute Intracerebral Hemorrhage Patient Diagnosed with Moyamoya Disease (모야모야병으로 인한 출혈성 뇌졸중 환자 1례에 대한 증례보고)

  • Park, Jong-il;Kim, Geun-yeob;Ko, Heung;Shin, Son-mi;Kim, Ki-tae
    • The Journal of Internal Korean Medicine
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    • v.37 no.2
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    • pp.420-426
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    • 2016
  • Objective: This case report examined a patient to determine if traditional Korean medicine treatment was effective for treating acute intracerebral hemorrhage (ICH) diagnosed with moyamoya disease.Method: The patient was treated with herbal medicine, acupuncture, and Western medicine and was followed up with for symptoms, vital signs, and brain computed tomography (CT) scans.Results: During the treatment, the patient’s mental state was mostly alert. The patient’s headaches were improved after the use of painkillers; the patient’s fever and blood pressure were well controlled. The cerebral hematoma was removed smoothly.Conclusion: Traditional Korean medical therapy (herbal medicine and acupuncture) along with Western methods appeared to be effective in managing the acute phase of ICH diagnosed with moyamoya disease.

Efficacy of Daehuanghuanglianxiexin-tang in stabilization of hypertension patient's blood pressure (『상한론(傷寒論)』 변병진단체계(辨病診斷體系)에 근거하여 대황황련사심탕(大黃黃連瀉心湯) 투여 후 혈압이 안정된 고혈압 증례 보고)

  • Choi, Jae-Young;Lee, Soong-in;Lee, Sung-Jun
    • 대한상한금궤의학회지
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    • v.10 no.1
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    • pp.125-132
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    • 2018
  • Objective : The purpose of this study is to review a case of hypertension. The patient was 41 years, a male. We stabilized blood pressure after administration of Daehuanghuanglianxiexin-tang. In this paper, we review the interpretation of Shanghanlun by analyzing the patient's progress, diagnosis, treatment. Methods : Blood pressure changes have been monitored during the period. Additionally, We have observed the patients' compliance and accompanied symptom by the timeline analysis. Results : According to Shanghanlun disease pattern identification diagnostic system, Wediagnosed a Greater yang disease. The patient was treated with Daehuanghuanglianxiexin-tang for 2 months. Daehuanghuanglianxiexin-tang was able to control blood pressure to under 120mmhg / 80mmhg. During the treatment period, the accompanied symptom Stiffness and pain in posterior neck has improved, patient's compliance was good, and symptoms improved without significant complication Conclusions : Taking of the Daehuanghuanglianxiexin-tang makes patient's blood pressure controlled to safe and stable range and eases the discomfort of posterior neck pain.

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Computer-controlled local anesthetic delivery for painless anesthesia: a literature review

  • Kwak, Eun-Jung;Pang, Nan-Sim;Cho, Jin-Hyung;Jung, Bock-Young;Kim, Kee-Deog;Park, Wonse
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.16 no.2
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    • pp.81-88
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    • 2016
  • Local anesthesia is administered to reduce pain during dental treatments, but may itself cause pain and contribute to increased dental fear. Computer-controlled local anesthetic delivery (CCLAD) is one the method to reduce patient pain during local anesthesia; it is a device that slowly administers anesthetics by using a computerized device to control the injection speed. This literature review aims to provide an objective assessment of the usefulness of CCLAD for controlling pain by reviewing papers published to date that have used CCLAD.