• Title/Summary/Keyword: intractable

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An Acute Postoperative Intractable Hyperventilation after an Endoscopic Third Ventriculostomy

  • Lee, Hae-Mi;Shin, Kyung-Bae;Kim, Seong-Ho;Jee, Dae-Lim
    • Journal of Korean Neurosurgical Society
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    • v.51 no.3
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    • pp.173-176
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    • 2012
  • This report describes a rare case of postoperative hyperventilation attack after an endoscopic third ventriculostomy in a 46-year-old woman. About 60 min after the termination of the operation, an intractable hyperventilation started with respiratory rate of 65 breaths/min and $EtCO_2$, 16.3 mm Hg. Sedation with benzodiazepine, thiopental sodium, fentanyl, and propofol/remifentanil infusion was tried under a rebreathing mask at a 4 L/min of oxygen. With aggressive sedative challenges, ventilation pattern was gradually returned to normal during the 22 hrs of time after the surgery. A central neurogenic hyperventilation was suspected due to the stimulating central respiratory center by cold acidic irrigation solution during the neuroendoscopic procedure.

In Vitro Cancer Chemopreventive Activities of Polysaccharides from Soybeans Fermented with Phellinus igniarius or Agrocybe cylindracea

  • Shon, Yun-Hee;Nam, Kyung-Soo
    • Journal of Microbiology and Biotechnology
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    • v.11 no.6
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    • pp.1071-1076
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    • 2001
  • Chemopreventive activities of polysaccharides from soybeans fermented with either Phellinus igniarius or Agrocybe cylindracea were investigated by measuring the induction of quinone reductase (QR), glutathione S-transferase (GST) activities, and glutathione (GSH) levels in the cell culture along with inhibition of polyamine biosynthesis. The polysaccharides from soybeans fermented with P. igniarius strongly (p<0.005) induced QR activity at all concentrations tested. The extract not only induced GST activity in a dose-dependent manner in the concentration range of 0.1-1.0 mg, but significantly induced GSH revels in cultured Hepa 1c1c7 cells with a maximal 1.4-fold increase at 0.1 mg. The polysaccharides from soybeans fermented with A. cylindracea were effective in inhibiting polyamine metabolism. These results suggest that polysaccharides from soybeans fermented with P. igniarius or A. cylindracea have cancer chemopreventive activities in in vitro models and, therefore, could be considered as potential agents for cancer chemoprevention.

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Surgical Treatment of the Atlantoaxial Osteoarthritis

  • Jin, Kwang-Ouk;Kim, Young-Woo;Rim, Dae-Cheol;Ahn, Sung-Ki
    • Journal of Korean Neurosurgical Society
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    • v.41 no.4
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    • pp.264-266
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    • 2007
  • Atlantoaxial facet joint osteoarthritis is rare, often undiagnosed because it may be misdiagnosed as occipital neuralgia, or degenerative cervical spondylosis. Unilateral occipitocervical pain aggravated by head rotation is a specific symptom. Conservative treatment is usually effective. But when the patient complains of intractable neck pain localized to occipitocervical junction and unresponsive to medical therapy, surgical treatment should be considered. Though a few reports of surgically treated atlantoaxial osteoarthritis has been published, surgical outcome is favorable. A case of a surgically treated atlantoaxial osteoarthritis is presented with a review of the literatures.

Intractable Pain Management of Lung Cancer Involving in Both Brachial Plexuses (양측 상박 신경총 침범으로 불인성 통증을 동반한 폐암환자의 통증치료 경험)

  • Na, Ae-Ja;Suh, Jae-Hyun;Kim, Sung-Nyeun
    • The Korean Journal of Pain
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    • v.5 no.1
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    • pp.99-102
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    • 1992
  • Severe intractable pain with paresthesia and severe dyspnea produced by lung cancer involving both brachial plexuses, refractory to ordinary pharmacologic approaches, was managed by epidural morphine and bupivacaine administration with the continuous Baxter infusion system. Chest pain, which is somatic pain in character, was well managed with the epidural morphine and bupivacaine administrations. However paresthesia and tingling sensation of the hand and forearm were poorly controlled by epidural morphine, and were finally managed by bolus epidural injections of bupivacaine. Supportive therapy included epidural steroid injection and TENS, but the effect was not satisfactory. Severe dyspnea seemed to aggrevate cancer related pain.

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Laryngotracheal Separation for Chronic Intractable Aspiration (만성 흡인에 대한 후두기관 분리술의 유용성)

  • 이강진;성명훈;박범정;성원진;노종렬;민양기;이철희;이재서;김광현
    • Korean Journal of Bronchoesophagology
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    • v.7 no.2
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    • pp.140-145
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    • 2001
  • Background and Objectives: Intractable aspiration in patients with impaired protective function of the larynx often results in multiple episode of aspiration pneumonia, repeated hospitalizations and expensive nursing care. The purpose of this study was to review the authors’experience and Patient outcome with the laryngotracheal separation (LTS) procedure. Materials and Methods A retrospective review of 9 patients who underwent LTS between 1996 and 2001 was conducted. Ages ranged from 3 to 72 years. Results : Seven patients were expected to have morbid aspiration as a consequence of acquired neurologic injuries and two were congenital neurologic injuries. Two patients had a postoperative fistula, which was well controlled with local wound care and minor procedure. Following LTS, aspiration was effectively controlled in all patients and four were able to tolerate a regular diet. Conclusion : LTS is a low-risk, successful. definitive procedure which decreases the potential for aspiration, pulmonary complication, hospitalizations and increases quality of life, especially in patent with irreversible upper airway dysfunction and Poor speech potential.

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Two Cases of Renal Stone Associated with Ketogenic Diet (케톤 식이요법 후에 발생한 신장 결석 2례)

  • Chung, Ju-Young;Koo, Ja-Wook;Kang, Hoon-Churl;Kim, Sang-Woo;Kim, Heung-Dong
    • Clinical and Experimental Pediatrics
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    • v.48 no.2
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    • pp.204-207
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    • 2005
  • Ketogenic diet is a high-fat, low-carbohydrate, low-protein diet used in the treatment of epilepsy since 1920's. Recently, it's use for intractable epilepsy in childhood has increased. Complications of ketogenic diet are known to include dehydration, vomiting, diarrhea, renal stones, metabolic derangement, hypercholesterolemia and refusal to eat. We experienced two cases of renal stones in children with intractable epilepsy during ketogenic diet.

Blockade of the Ganglion Impar for the Management of Intractable Coccygodynia (미골통 환자에서 시행한 외톨이(Impar) 교감신경절 차단 -증례 보고-)

  • Kim, Bu-Won;Shin, Jin-Woo;Song, Myung-Hee;Park, Eun-Kyung;Lee, Cheong;Suh, Byung-Te
    • The Korean Journal of Pain
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    • v.9 no.1
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    • pp.223-225
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    • 1996
  • Pain arising from disorders of the viscera and somatic structures within the pelvis and perineum is a frequent cause of discomfort and disability, especially among women. Recently, blockade of the ganglion impar(ganglion of Walther) has been introduced as an alternative means of managing intractable perineal pain of sympathetic origin. The first report of interruption of the ganglion impar for relief of perineal pain appeared in 1990. We successfully treated a patient who had suffered from intermittent severe coccygodynia with ganglion impar block.

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The Celiac Plexus Block and the Lumbar Sympathetic Ganglion block for the Upper and Lower Abdominal Cancer Pain -7 cases- (상하복부 암성통증에 대한 복강신경총 및 요부교감신경절 차단 -7예 보고-)

  • Gill, Hyun-Jue;Yoon, Duck-Mi;Oh, Hung-Kun;Ree, Ye-Chul
    • The Korean Journal of Pain
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    • v.1 no.2
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    • pp.171-176
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    • 1988
  • It is well known that the celiac plexus block is specially useful for relieve intractable upper abdominal pain caused by upper abdominal visceral malignancy or upper abdominal metastasis from distant organs. But in cases of lower abdominal or pelvic metastasis from upper abdominal malignancy, the lower abdominal intractable pain is remained after the successful celiac plexus block. We have reported 7 cases of celiac plexus block combined with lumbar sympathetic ganglion block, among the 305 cases of the celiac plexus block from 1968 to Nov. 1987, performed in patients with lower abdominal or back pain due to carcinomatosis of lower abdominal metastatic malignancy, that their results were excellent for pain relief.

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Continuous Caudal Block for Intractable Pain (지속적(持續的) 미추차단(尾椎遮斷)에 의한 동통관리(疼痛管理) 3예(三例))

  • Park, Wyun-Kon;Yoon, Duck-Mi;Oh, Hung-Kun
    • The Korean Journal of Pain
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    • v.2 no.1
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    • pp.85-88
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    • 1989
  • We experienced 3 cases of continuous caudal block. The first case had suffered from severe pain of the external genitalis after urethral injury from a car accident and this was controlled by continuous caudal block. The other 2 cases were a metastaric malignant tumor of the lumbar vertebra from cancer of the cervix and histiocytoma of the breast, and both had suffered from intractable pain of the lower extremity. But lumbar epidural block was impossible because of radiation fibrosis and previous operation scar of the spine. So a continuous caudal block was performed and the pain was controlled effectively. The longest duration was 50 days and there were no problems related catheter indwelling. Pain in the area of the lumbar and sacral nerve distribution can be controlled by continuous caudal block. Here in we reported 3 cases and reviewed the literature.

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Multi-vessel intractable coronary spasm development in a patient with aborted sudden cardiac death: a case study with intravascular ultrasound findings

  • Cho, Sungsoo;Kang, Tae Soo
    • Journal of Yeungnam Medical Science
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    • v.35 no.1
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    • pp.121-126
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    • 2018
  • Coronary spasm generally occurs in patients with minimal atherosclerotic plaque lesion, and it has a rather favorable prognosis. However, in some cases, coronary spasm may induce myocardial infarction and even sudden cardiac death (SCD). Here, we report a case in which multi-vessel intractable coronary vasospasm suddenly occurred in a diffuse atherosclerotic lesion after percutaneous coronary intervention (PCI) in a patient with aborted SCD. We identified the characteristics of the spasm portion in intravascular ultrasound (IVUS) images and conducted percutaneous cardiopulmonary bypass support-PCI with stenting as treatment. Intima and media thickening and a large attenuated plaque burden with rupture were identified in IVUS images at the obstructive spasm portion.