• 제목/요약/키워드: intractable

검색결과 684건 처리시간 0.025초

Spinal Cord Stimulation for Intractable Visceral Pain due to Chronic Pancreatitis

  • Kim, Jin-Kyung;Hong, Seok-Ho;Kim, Myung-Hwan;Lee, Jung-Kyo
    • Journal of Korean Neurosurgical Society
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    • 제46권2호
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    • pp.165-167
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    • 2009
  • Pain caused by chronic pancreatitis is medically intractable and resistant to conventional interventional or surgical treatment. We report a case of spinal cord stimulation (SCS) for intractable pain due to chronic pancreatitis. The patient had a history of nonalcoholic chronic pancreatitis and multiple emergency room visits as well as repeated hospitalization including multiple nerve block and morphine injection for 3 years. We implanted surgical lead at T6-8 level on this patient after successful trial of percutaneous electrode. The patient experienced a decreased visual analog scale (VAS) scores for pain intensity and amount of opioid intake. The patient was followed for more than 14 months with good outcome and no further hospitalization. From our clinical case, spinal cord stimulation on intractable pain due to chronic pancreatitis revealed moderate pain control outcome. We suggest that SCS is an effective, noninvasive treatment option for abdominal visceral pain. Further studies and long term follow-up are needed to fully understand the effect of SCS on abdominal visceral pain.

악성동통(惡性疼痛) 치료(治療)를 위(爲)한 경막외(硬膜外) 터널 카데터 거치법(据置法) (A Treatment for Intractable Pain)

  • 전재규;정정길;정상범
    • The Korean Journal of Pain
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    • 제1권1호
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    • pp.59-63
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    • 1988
  • Recently, epidural tunnelling was introduced for the convenience of keeping a catheter inserted for a long period of time. We had 15 cases in which used epidural tunnelling for the treatment of intractable pain mainly in terminal cancer patients. Epidural puncture with cannulation was carried out in the same technique as used for epidural anesthesia. After the subcutaneous epidural tunnelling was done from the site of the epidural entry to the anterior chest, just under the slim using a tunnelling device, the catheter was threaded through the tunnelling needle at the site of the outlet, was fixed and the tip of the catheter was connected to a filter. Five ml (2 mg) of saline diluted morphine can be given at home as needed when intractable pawn occurs. This long-term treatment of intractable pain by morphine injections through the epidural cannula place by subcutaneous tunnelling, is very convenient for the patient's daily routine and a better alternative in such a situation. Our technique, its advantages and problems were described in this paper.

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3개월간 한방치료를 받은 난치성 자궁경부 이형증 환자 1례 (A Case of Intractable Cervical Dysplasia Patient Treated with Korean Medicine for Three Months)

  • 한재현;김성수;성신;방선휘
    • 대한한방부인과학회지
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    • 제25권4호
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    • pp.154-160
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    • 2012
  • Objectives: This report is aimed to investigate the efficacy of Korean medicine including intravenous Cultivated Wild Ginseng(Panax ginseng C.A. Meyer) Pharmacopuncture(CWGP) with intractable cervical dysplasia patient. Methods: A 49-year-old woman who was diagnosed as cervical dysplasia on Feb 2012 was treated with Korean medicine for 3 months. Korean medicine includes intravenous CWGP, acupuncture, moxibustion and herbal medicine. The effect of therapies was evaluated with human papillomavirus deoxyribonucleic acid(HPV DNA) testing. And lower limb cold sense and genital pruritus were recorded with Visual Analogue Scale(VAS). Results: Lower limb cold sense and genital pruritus were decreased from VAS 8-9(2012.04.11.) to VAS 1-2(2012.07.10.). HPV DNA test result was changed from positive to negative. From these results, this report suggests that the Korean medicine, especially CWGP may be a useful method to treat intractable cervical dysplasia. Conclusions: This report shows that Korean medical treatments are effective on intractable cervical dysplasia.

성대 주입술과 리도카인 주입술을 통해 치료한 난치성 근긴장성 발성장애 (Intractable Muscle Tension Dysphonia Treated by Injection Laryngoplasty and Lidocaine Injection)

  • 안유영;정준영;박기남;이승원
    • 대한후두음성언어의학회지
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    • 제32권2호
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    • pp.94-97
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    • 2021
  • Muscle tension dysphonia (MTD) is a voice disorder characterized by excessive tension of the laryngeal muscles during phonation. Voice therapy is the gold standard of treatment for MTD. However, patients with MTD do not always respond to voice therapy. Multidisciplinary approaches have been attempted to treat intractable MTD such as lidocaine instillation, lidocaine injection to recurrent laryngeal nerve, botox injection and excision of false ventricle using CO2 laser. Recently, injection laryngoplasty is suggested that assists in more efficient phonation and voice therapy to MTD patients. A patient with intractable MTD underwent lidocaine injection and injection laryngoplasty showed improved voice quality and remained stable until postoperative 3 months without any complications.

감궁탕이 면역기능 저하 마우스의 임파구활성에 미치는 영향 (Effects of Gamgung-tang on Lymphocyte Activities in Immunodeficiency Mice)

  • 손윤희;김호창;문지선;백태선;김철호;전병훈;남경수
    • 동의생리병리학회지
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    • 제18권4호
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    • pp.995-1000
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    • 2004
  • This study was purposed to investigate the effect of Gamgung-tang(GGT) on immune responses induced by glucocorticoid in mice. GGT solution was treated by intraperitoneal injection for 7 days after glucocorticoid treatment(80㎎/㎏). And then B and T cell proliferation and cytolytic activity of natural killer(NK) cells were measured. There was 25% inhibition in B cell proliferation with treatment of glucocorticoid. However, B cell proliferation was not influenced by GGT treatment. T cell proliferation was also inhibited by 18.4% with treatment of glucocorticoid. On the other hand, T cell proliferation was increased dose-dependent manner in GGT treated group. Furthermore in purified T cell, the proliferation was furtherly increased than non-purified T cell. At concentration of 18㎎/mouse GGT, purified T cell proliferation was increase to above level of normal group. The cytotoxic activity of NK cell was decreased by 35.3% with treatment of glucocorticoid. In GGT treated group, the cytotoxic activity of NK cell was increased to the normal level. In purified NK cell, the cytolytic activity of NK cell was further increased than non-purifed NK cell. These results suggest that GGT may proliferate T cell that is suppressed by glucocorticoid, and activate NK cell activity.

Rec assay 및 효소학적 방법을 이용한 감궁탕의 안전성평가 (Evaluation of Safety with Gamgung-tang Using Rec assay and Enzymatic Methods)

  • 손윤희;백태선;문지선;김미경;김철호;전병훈;남경수
    • 동의생리병리학회지
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    • 제19권1호
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    • pp.98-101
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    • 2005
  • Gamgung-tang(GGT) that is included in Gamdu-tang(consists of Glycyrrhizae Radix, black beans) and Gunggui-tang(consists of Angelicae Radix and Cnidii Rhizoma), showed therapeutic effects of autoimmume thyroiditis in the previous reports. GGT was tested for the safety using Rec assay and enzymatic methods. In the Rec assay, Bacillus subtilis H-17$(Rec^+)$ and M-45$(Rec^-)$ strains were used to test DNA damage activity. From the results, there was no DNA damage of GGT. Hepatotoxicity of GGT to female ICR mice was also monitored by the measurements of serum(s)-GOT, s-GPT and LDH activities after oral feeding for 15 days. GGT was not shown any significant changes of s-GOT, s-GPT and LDH activities in mice sera.

난치성 암성 통증 제어를 위한 뇌정위적 대상회 절개술 (Treatment of Intractable Cancer Pain by Stereotactic Bilateral Anterior Cingulotomy)

  • 정진영;장종희;장진우;박용구;정상섭
    • Journal of Korean Neurosurgical Society
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    • 제30권4호
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    • pp.456-462
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    • 2001
  • Objective : Although cingulotomy has been applied to patients with affective disorders more frequently, there are numerous reports of its use for the control of severe pain. The goal of this study was to investigate the role of stereotactic bilateral anterior cingulotomy for intractable cancer pain. Method : Between January and June, 2000, we underwent stereotactic bilateral anterior cingulotomy in 6 patients for intractable cancer pain with poor response to opioids. The patients were suffering from widespread musculoskeletal or visceral pain. We made four lesions along the two tracks on either side of the cingulate cortex. Result : In all patients, pain reliefs after cingulotomy were dramatic and immediate. Five out of six patients did not require any opioids and one patient could reduce dose of opioids. There were no deaths or serious complications related to the procedure. Conclusion : These results suggested that a bilateral anterior cingulotomy might be useful method to control intractable cancer pain associated with the widespread metastatic disease. To provide rationale of bilateral anterior cingulotomy in intractable cancer pain, the theoretical mechanisms and role of bilateral anterior cingulotomy are discussed, along with our surgical techniques and the course of our patients.

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Long Term Results of Microsurgical Dorsal Root Entry Zonotomy for Intractable Pain Associated with Brachial Plexus Injury

  • Park, Yeul-Bum;Kim, Seong-Ho;Kim, Sang-Woo;Chang, Chul-Hoon;Ahn, Sang-Ho;Jang, Sung-Ho
    • Journal of Korean Neurosurgical Society
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    • 제40권3호
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    • pp.143-147
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    • 2006
  • Objective : Brachial plexus injury can produce a intractable chronic neuropathic pain. This study was undertaken to assess the long term outcome of microsurgical dorsal root entry zonotomy[MDT]. Methods : Between October 1997 and December 2002, 21 patients received MDT because of a intractable pain resulting from brachial plexus injury. Of these, 19 patients were followed for more than 2 years. Fourteen of 19 patients were male and patient ages ranged from 22 to 69 years. Mean pain duration was 36.8 months and all patients had severe pain of $9{\sim}10$ visual analogue scale. To achieve complete destruction of abnormal dorsal horns, thermocoagulation of the posterolateral sulcus were performed and careful gluing was done to prevent postoperative adhesion and pain recurrence. Results : Of the 19 patients, 15 patients had excellent [>75% reduction in pain] and good [$51{\sim}75%$ pain relief] results in a average postoperative period of 4.1 years. One patient had a poor [less than 25% pain relief] result. Three patients were considered to have a fair result [$26{\sim}50%$ pain relief]. Postoperative complications were 2 transient ipsilateral ataxia and 1 CSF fistula that resolved without surgical revision. Conclusion : These results indicate that MDT provides excellent long-term pain relief in medically intractable chronic neuropathic pain following brachial plexus injury without significant complications.

생약혼합물이 사이토카인에 의한 갑상선세포의 Apoptosis에 미치는 영향 (Effect of Medicinal Plants on Cytokine-induced Apoptosis in Thyroid Cells)

  • 남경수;손옥례;김미경;박인경;김철호;조현국;전병훈;손윤희
    • 생약학회지
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    • 제36권2호통권141호
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    • pp.88-92
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    • 2005
  • Apoptosis plays an important role in autoimmune chronic (Hashimoto's) thyroiditis, a disorder that often results in hypothyroidism. The goal of this study was to induce apoptosis by the combination of inflammatory cytokines, interferon $(IFN)-{\gamma}$ and tumor necrosis factor $(TNF)-{\alpha}$, and to investigate a potential role of medicinal plants in the thyroid follicular cells (FRTL) in vitro. The apoptosis was evaluated by cellular viability, DNA fragmentation, and terminal deoxynucleotidyl transferase-mediated deoxy-UTP nick end labeling (TUNEL) assay. Extract of Gamgung-tang (GGT, Glycyrrhizae Radix, black beans, Angelicae Radix, and Cnidii Rhizoma) $(0.3{\sim}9.0mg/ml)$ was shown to maintain the viability of cells treated with $IFN-{\gamma}(100U/ml)$ and $TNF-{\alpha}$ (0.5 ng/ml). FRTL cells were found to undergo DNA fragmentation with the inflammatory cytokines. The extract of GGT inhibited DNA fragmentation in dose-dependent manner. The cells with TUNEL-positive nuclei were detected with $IFN-{\gamma}$ and $TNF-{\alpha}$ treatment. The number of TUNEL-positive cells decreased with the treatment of extract of GGT. These results indicate that medicinal plants inhibit the occurrence of apoptosis in thyroid follicular cells, therefore, may have therapeutic potential in the treatment of autoimmune chronic thyroiditis.

Midazolan과 Baclofen 투여에 의한 난치성 딸꾹질 환자의 치료 경험 -증례 보고- (Treatment of Intractable Hiccup with Midazolam and Baclofen -A case report-)

  • 양내윤;문동언;박철주;권오경;박종민;심재용;최종호
    • The Korean Journal of Pain
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    • 제10권2호
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    • pp.246-249
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    • 1997
  • Hiccup is defined as an abrupt involuntary contraction of the diaphragm and intercostal muscles with sudden closure of the glottis 35 msec after onset. The term "intractable" is given to those hiccups with a duration ranging from 24 hours to more than 25 years. Short hiccup bouts are mostly associated with gastric distention or alcohol intake, resolved spontaneously or with simple remedies. In contrast, intractable hiccup is a rare but disabling condition which can induce depression, weight loss and sleep deprivation. Although the pathophysiologic mechanisms of hiccup are still poorly understood, wide variety of pathological conditions such as: brain tumor, abdominal tumor, myocardial infarction, renal failure, abdominal surgery etc., can cause intractable hiccup. A 58-year-old male who had suffered from hepatocellular cancer was consulted from medical department due to intractable hiccup. Initial treatment modalities with administrations of metoclopramide and chlorpromazine and nerve block including phrenic nerve block, cervical epidural block and glossopharyngeal nerve block were not effective. Administration of midazolam and baclofen however achieved desirable effect.

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