• Journal of Chest Surgery
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• 제28권3호
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• pp.297-302
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• 1995

Video-assisted thoracic surgery [VATS is emerging as a viable alternatives to thoracotomy when surgical treatment of spontaneous pneumothorax is required.Apical blebs and bullaes of the lung can be resected,and pleural abrasion can be accomplished with minimal postoperative pain and a shorter postoperative stay in hospital. We compared our results with thoracoscopic management of spontaneous pneumothorax in 20 patients [group I with a group of 32 patients previously subjected to lateral limited thoracotomy [group II . Indications for operation, sex distribution, and average age [groupI, 24.7 years ; group II, 34.4 years were comparable. Operation time [112.42 54.7 min versus 124.8 35.3 min ; P 0.03 and chest tube duration [64.4 52.3 hours versus 97.7 45.4 hours ; P 0.01 were less in group I. Postoperative hospital stay was less in group I[3.84 0.99 days;P 0.01 , as was the use of parenteral narcotics after 48 hours. [5/20=25% versus25/32=78% . Pain was quantitated by verbal rating scale in postoperative 1 to 3 days. Patients undergoing VATS experienced significantly less postoperative pain. Postoperative complication was less in group I[1/20=5% versus 3/32=8.3% . In conclusion, Video-assisted thoracoscopic management of spontaneous pneumothrax allows performance of the standard surgical procedure while avoiding the thoracotomy incision.Video-assisted thoracic surgery [VATS is safe and offers the potential benefits of shorter postoperative hospital stays and less pain with cosmetic benefits.

• The Korean Journal of Pain
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• 제10권1호
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• pp.104-108
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• 1997

Spontaneous intracranial hypotension, a syndrome of low CSF pressure, occurs without preceding events such as lumbar puncture, back trauma, operative procedure or medical illness. The most characteristic symptom is an occipital or frontal headache which is aggrevated in the erect position and relieved in the supine position. This syndrome usually resolves spontaneously or with strict bed rest. When the headach persists or is incapacitating, more aggressive treatment may be necessary. Autologous epidural blood patch is highly effective in the management of spontaneous intracranial hypotension. Epidural blood produces an organized clot which effectively tamponade any dural CSF leak. The rapid relief of headache immediately after the infusion of blood occur by some other mechanism, such as an increase in subarachnoid pressure that is known to occur with infusion of fluid into the lumbar epidural space. We report three cases of spontaneous intracranial hypotension successfully treated with epidural blood patch.

• Advances in pediatric surgery
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• 제6권1호
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• pp.60-63
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• 2000

Spontaneous rupture of the eventrated diaphragm is not common. The authors report a case of spontaneous rupture of the congenital diaphragmatic eventration. An 8 year-old girl with right congenital diaphragmatic eventration and nephrotic syndrome was seen in emergency room because of severe abdominal pain and vomiting. She had intermittent abdominal pain for 1 year. Plain chest X-ray and ultrasonography showed entrapped bowels in the right thoracic area. Exploratory laparotomy revealed a ruptured right eventration. THE displaced abdominal viscera were repositioned into the abdominal cavity and the ruptured diaphragm was trimmed and plicated. The postoperative course was uneventful. Only one case of spontaneous rupture of eventrated diaphragmatic has been reported in the English literature.

• Journal of Dental Anesthesia and Pain Medicine
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• 제18권4호
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• pp.255-259
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• 2018

Sudden headache onset may rarely be caused by spontaneous intracranial hypotension (SIH). Other associated symptoms in patients with SIH are nausea, vomiting, vertigo, hearing alteration, and visual disturbance. This case report describes a 43-year-old female diagnosed with SIH who developed diplopia after resolution of an abrupt-onset headache, which was managed with conservative treatments, including bed rest and hydration. She was also diagnosed with secondary right sixth cranial nerve palsy. Although conservative management relieved her headache, the diplopia was not fully relieved. Application of an autologous epidural blood patch successfully relieved her diplopia, even after 14 days from the onset of visual impairment.

• The Korean Journal of Pain
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• 제24권4호
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• pp.231-234
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• 2011

Kummell's disease is a spinal disorder characterized by delayed post-traumatic collapse of a vertebral body with avascular necrosis. Although definitive treatment for Kummell's disease has not been established, it has been reported that percutaneous vertebroplasty or kyphoplasty has shown good results. However, these procedures are not recommended for severely collapsed vertebral bodies because of the risk of cement leakage or technical difficulties. Authors report a rare case of spontaneous reduction in vertebral height by the insertion of a working cannula into the vertebral body in Kummell's disease.

• The Korean Journal of Pain
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• 제18권1호
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• pp.56-59
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• 2005

The most effective treatment methods for a herniated lumbar disc remain questionable. This report follows the patients course, from the onset of pain through the completion of the non-surgical treatment, and shows that a lumbar herniated disc, with radiculopathy, can be successfully treated with a non-surgical approach. This report discusses the possible explanations for disc resorption: retraction into the intervertebral space, dehydration/shrinkage and resorption due to an inflammatory reaction. A non-surgical approach can be an effective treatment option for a herniated lumbar disc.

• Journal of Korean Neurosurgical Society
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• 제47권1호
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• pp.48-50
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• 2010

Spontaneous intracranial hypotension is often idiopathic. We report on a patient presenting with symptomatic intracranial hypotension and pain radiating to the right leg caused by a transdurallumbar disc herniation. Magnetic resonance (MR) imaging of the brain revealed classic signs of intracranial hypotension, and an additional spinal MR confirmed a lumbar transdural herniated disc as the cause. The patient was treated with a partial hemilaminectomy and discectomy. We were able to find the source of cerebrospinal fluid leak, and packed it with epidural glue and gelfoam. Postoperatively, the patient's headache and log radiating pain resolved and there-was no neurological deficit. Thus, in this case, lumbar disc herniation may have been a cause of spontaneous intracranial hypotension.

• 한방재활의학과학회지
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• 제25권2호
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• pp.189-196
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• 2015

Objectives The purpose of this study was to report the effect of Oriental medicine on spontaneous osteonecrosis of the knee. Methods Patients received Oriental treatment such as Bee-Venom therapy and acupuncture & moxibustion. The improvement of the pain intensity and recovery of gait was observed. Results During five weeks of treatment, patient's knee pain and gait disturbance were improved. Conclusions In this case, Oriental treatment on spontaneous osteonecrosis was effective to reduce pain and recover gait.

• 대한치과교정학회지
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• 제48권2호
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• pp.90-97
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• 2018

Objective: The aim of this study was to assess the analgesic effect of a single application of low-level laser therapy (LLLT) on spontaneous pain and pain on chewing after placement of initial archwires. Methods: Forty-two patients (26 women, 16 men) were randomly recruited for this split-mouth randomized clinical trial. Each patient received super-elastic nickel-titanium (NiTi) initial archwires (0.012, 0.014, 0.016, and 0.018-inch [in]) in the maxilla for leveling and alignment for an interval of 4 weeks between archwires. One side of the mouth was randomly designated as experimental, while the other side served as placebo. After insertion of each archwire, the experimental side was irradiated with a diode laser for 3 seconds each on 5 points facially and palatally per tooth, from the central incisor to first molar. On the placebo side, the laser device was held the same way but without laser application. A numerical rating scale was used to assess the intensity of spontaneous and masticatory pain for the following 7 days. The Mann-Whitney U test was used to compare pain scores between sides. Results: Patients in the LLLT group exhibited significantly lower mean scores for spontaneous pain after insertion of the initial two archwires (0.012-in and 0.014-in NiTi; p < 0.05), while there was no significant difference for 0.016-in and 0.018-in wires between the LLLT and placebo groups. LLLT significantly reduced chewing pain scores (p < 0.05) for all archwires. Conclusions: A single dose of LLLT considerably lessened postoperative pain accompanying the placement of super-elastic NiTi wires for initial alignment and leveling.

• 한국임상약학회지
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• 제28권2호
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• pp.81-87
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• 2018

Objective: There have been many cases of spontaneous adverse drug reactions to fentanyl at a regional pharmacovigilance center in the hospital. To assess the factors causing the adverse drug reactions reported in patients receiving fentanyl patient-controlled analgesia (PCA) monotherapy or in combination with fentanyl transdermal therapeutic system (TTS) for acute post-operative pain management. Methods: We conducted a retrospective cohort study with all patients prescribed fentanyl PCA for pain management after orthopedic surgery at a single university hospital from June 2012 to May 2013. We analysed the factors causing adverse drug reactions reported by a spontaneous reporting system in patients receiving fentanyl PCA monotherapy and those receiving fentanyl TTS in combination with fentanyl PCA. Results: Based on the spontaneous adverse drug reaction reporting, the risk ratio for the incidence rate of adverse drug reaction in the fentanyl TTS combination therapy group was 3.04 (95 % CI: 2.4-4.00, P < 0.0001), which was approximately 3-fold higher than that reported for fentanyl PCA monotherapy. Only 60 % of the adverse drug reactions were reported. Conclusion: It is inappropriate to add fentanyl TTS to fentanyl PCA to manage post-operative acute pain. There is a need to improve adverse drug reaction reporting. We expect that regular analysis of adverse drug reactions reported at regional pharmacovigilance centre would aid in appropriate drug utilization by patients.