• Title/Summary/Keyword: Cancer Pain Management

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A Clinical Review of Bowel Disorders following Colorectal Cancer Surgery (대장악성종양수술 후 배변장애에 대한 치험 1례)

  • Yang, Jae-Hoon;Park, Sang-Gu;Kim, Dong-Woong;Moon, Goo;Lee, Ji-Yeon
    • The Journal of Internal Korean Medicine
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    • v.22 no.1
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    • pp.113-118
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    • 2001
  • In July, 2000, A 71-year-old man complained of these symptoms: frequent defecation, urgent need to defecate, fecal leakage, anal pain, flatus, and diarrhea after surgery for colorectal cancer. The symptoms are caused specifically by injury to the bowel and sphincter function. The patient suffered physically and psychologically; but, there was no special treatment in western medicine. Therefore, we treated him with electrical acupuncture for the management of sphincter tone and the alleviation of anal pain. We also treated him with herbal medicine for the recovery of strength and gastro-colic function. As a consequence of these treatments, the bowel disorders improved immediately and successfully, even though there were some limitations. So, We report this case with a brief review of related literatures.

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Treatment of Opioid Withdrawal Syndrome Triggered by Oxycodone/Naloxone with Dexmedetomidine

  • Se-Il Go;Jung Hoon Kim;Jung Hun Kang
    • Journal of Hospice and Palliative Care
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    • v.26 no.1
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    • pp.18-21
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    • 2023
  • The combination of oxycodone and naloxone is useful for cancer pain management. Naloxone, as a pure opioid antagonist, cannot be used simultaneously with opioids. However, owing to its low bioavailability, it can be used in an oral composite formulation. We present the case of a 55-year-old man with gastric cancer who experienced severe opioid withdrawal syndrome (OWS) triggered by oxycodone/naloxone that was successfully managed with dexmedetomidine. He had been in a stable condition on intravenous morphine to alleviate cancer pain. Intravenous morphine was switched to oral oxycodone/naloxone for discharge from the hospital. The patient suddenly developed restlessness, heartburn, and violent behavior 30 minutes after taking oxycodone/naloxone. We attempted sedation with midazolam and propofol, but paradoxical agitation and desaturation occurred. Next, we tried dexmedetomidine and the patient showed a decreased heart rate and reduced agitation. The patient was eventually stabilized by increasing the dose of dexmedetomidine. This report informs clinicians of the possibility of OWS when switching from opioids to oxycodone/naloxone, which can be overcome with the appropriate use of sedatives and dexmedetomidine depending on the patient's condition.

Radiation Synovectomy: when, which disease, and which joint (방사성 동위원소 활액막절제술의 임상응용)

  • Choi, Chang-Woon
    • 대한핵의학회:학술대회논문집
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    • 1999.05a
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    • pp.196-199
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    • 1999
  • Radiation synovetomy with various radiopharmaceuticals has been used to alleviate pain and swelling of rheumatoid arthritis and related joint diseases for more than 40 years. It is an attractive alternative to the surgical synovectomy for the management of the various joint diseases. Recently, the development of new radiopharmaceuticals labeled with $^{90}Y,\;^{32}P,\;^{186}Re,\;^{188}Re,\;^{153}Sm,\;^{165}Dy$ and $^{166}Ho$, for the effective management of synovial inflammation and related arthritic problems are gaining attention. In this article the general concepts and the clinical application of radiation synovectomy are reviewed.

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Nurse의s Perception in the Homecare Needs of Cancer Patient (간호사가 지각한 암환자의 퇴원후 가정간호요구)

  • Kwon, In-Soo;Eun, Young
    • Journal of Korean Academy of Nursing
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    • v.28 no.3
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    • pp.602-615
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    • 1998
  • The purpose of this descriptive study was to identify the homecare needs of the discharged patient with cancer as perceived by nurses caring hospitalized cancer patients. At two hospitals in Gyeongnam, 74 nurses responded to an open-ended questionnaire consisting of four need categories : 1) educational & informational need, 2) physical need, 3) emotional need, 4) social need. Respondents were asked to list above ten needs of cancer patient in each category. Two researchers analyzed the data by content analysis method. The findings are summarized as follows : 1) A total of 1,417 need items were generated by nurses. The largest number of needs were in the educational & informational need category(475 items, 36.3%). Physical(414 items, 31.6%), emotional (237 items, 18.1%) need were the second, third largest, and social(184 items, 14.0%) need made up the smallest category. 2) In the educational & informational need category, there were seven subcategories of prognosis, diet & exercise, medication & pain, wound care, folk remedy, personal hygiene, comfort. The need items related to prognosis of cancer accounted for almost a half(48.2%) of the total. 3) In the physical need category, there were ten subcategories of personal hygiene, skin & tissue, nutrition, side effect on treatment, exercise, pain, elimination, equipment, comfort & safety, others. The largest number of needs were in subcategory of the personal hygiene(82 items, 19.8%). 4) In the emotional need category, there were four subcategories of emotional support related to disease, emotional support related to routine life, spiritual support, maintenance of relationship with nurse & doctor. The largest number of needs were in subcatgory of the emotional support related to disease(96 items, 40.5%). 5) In the social need category, there were five subcategories of support for social life, household management, legal support, the use of volunteer service, financial support. The largest number of needs were in support for social life subcategory(58 items, 31.5%).

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Pelvic insufficiency fracture after radiotherapy in patients with cervical cancer in the era of PET/CT

  • Park, Shin-Hyung;Kim, Jae-Chul;Lee, Jeong-Eun;Park, In-Kyu
    • Radiation Oncology Journal
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    • v.29 no.4
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    • pp.269-276
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    • 2011
  • Purpose: To determine the incidence, risk factors, and clinical characteristics of pelvic insufficiency fracture (PIF) in patients with cervical cancer. Materials and Methods: Between July 2004 and August 2009, 235 patients with non-metastatic cervical cancer were treated with definitive chemoradiation or postoperative radiotherapy. Among 235 patients, 117 (49.8%) underwent the first positron emission tomography/computed tomography (PET/CT) within 1 year after radiotherapy. The median radiation dose was 55 Gy (range, 45 to 60 Gy). Medical charts and imaging studies, including PET/CT, magnetic resonance imaging (MRI), CT. bone scintigraphy were reviewed to evaluate the patients with PIF. Results: Among 235 patients, 16 developed PIF. The 5-year detection rate of PIF was 9.5%. The 5-year detection rate of PIF in patients who underwent the first PET/CT within a year was 15.6%. The median time to development of PIF was 12.5 months (range, 5 to 30 months). The sites of fracture included 12 sacroiliac joints, 3 pubic rami, 3 iliac bones, and 1 femoral neck. Eleven of 16 patients having PIF complained of hip pain requiring medications. One patient required hospitalization for pain control. The significant risk factors of PIF were old age, body mass index less than 23, bone mineral density less than -3.5 SD, and the first PET/CT within a year after radiotherapy. Radiation dose and concurrent chemotherapy had no impact on PIF rate. Conclusion: PIFs were not rare after pelvic radiotherapy in cervical cancer patients in the era of PET/CT. Timely diagnosis and management of PIF can improve quality of life in patients with cervical cancer, in addition to reducing unnecessary medical expenses.

Survey on Quality of Life, Mental Health and Subjective Health Status of Community Dwelling Cancer Patients (일 지역에 거주하는 암환자의 삶의 질, 정신건강 및 주관적 건강상태 조사)

  • Lee, Bo-Young;Jo, Heui-Sug;Kwon, Myung-Soon
    • Journal of Korean Public Health Nursing
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    • v.24 no.1
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    • pp.49-60
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    • 2010
  • Purpose: This study investigated the quality of life, mental health and subjective health status of community dwelling cancer patients. Methods: Subjects were 212 out-patients with cancer at Kangwon University Hospital. The study was conducted from July 10 to August 14, 2008. Quality of life as determined by the Euro Quality of life-5 Dimensions (EQ-5D) was measured using Korea Centers for Disease Control and Prevention(KCDC). Mental health and subjective health status were measured using KCDC. Results: EQ-5D determined degrees of difficulty were 25.5%(mobility), 25.2%(anxiety or depression), 23.6%(pain or discomfort), 20.3%(activities of daily living), and 13.7%(self care). An analysis of the association between several factors and mental health showed that the statistically significant factors were age, gender, medical coverage, and private insurance. An analysis of the association between several factors and subjective health status showed that the statistically significant factor was occupation. Conclusion: Cancer patients suffer from significant psychological distress. Programs that address mental and physical health would be beneficial.

Patient Controlled Analgesia for Pain Management after Upper Abdominal Surgery (Baxter $Infusor^{(R)}$를 이용한 상복부 술후 통증 자가 조절)

  • Lee, Jung-Koo;Kim, Jin-Mo;Chung, Jung-Kil;Cheun, Jae-Kyu
    • The Korean Journal of Pain
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    • v.5 no.2
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    • pp.229-233
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    • 1992
  • Recently a non-electronic, disposable and portable infusor, Baxter $Infusor^{(R)}$, has developed for delivering not only a continuous drug infusion but also extradoses of medication on a demand basis. The present study examined the impact of two methods of pain management on recovery in 20 patients undergoing upper abdominal surgery for stomach cancer. One group, 10 patients, received IV meperidine in the recovery room and IM meperidine on the ward on a PRN basis(PRN group). In the other group, 10 patients, a loading dose of nalbuphine 0.1mg/kg was given when the patient first complained of pain in the recovery room and patient controlled analgesia with IV nalbuphine, 0.5mg/kg day for continuous infusion, was initiated and continued for 72 hours(PCA group). The devices for PCA group was Baxter Infusor with patient control module which had flow rate 0.5ml/hr and lockout time was 15 min. As results of this study, the patients of PCA group get less pain than PRN group on operation day, the first and second days after surgery. VAPS values are $6.47{\pm}1.64$ vs $4.44{\pm}1.38$, $5.02{\pm}1.22$ vs $2.62{\pm}0.93$ and $3.22{\pm}1.47$ vs $2.02{\pm}0.71$ respectively pertaining to PRN and PCA groups(p<0.05). In conclusion, PCA group with IV nalbuphine provided more effective postoperative analgesia than PRN group with conventional meperidine IM.

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Integrative Review of Guidelines Related Symptom Management and Physical Activity for Developing of Self-Care Management Program for Cancer Survivors (암생존자의 자가관리 프로그램 개발을 위한 증상관리 및 신체적 활동 관련 가이드라인의 통합적 고찰)

  • Song, Chi Eun
    • The Journal of the Korea Contents Association
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    • v.18 no.4
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    • pp.586-600
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    • 2018
  • The purpose of this study attempted to collect basic data for development of an integrated self-management program for cancer survivors who completed cancer treatment. Self-management programs are divided into symptom management and physical activity management. Symptom management includes fatigue, sleep disturbance, pain, depression and anxiety. PubMed, CINAHL and EMBASE were used for searching guidelines. Based on the guideline quality evaluation, the final 8 guidelines were analyzed. The structured table was used to extract the screening subjects, timing, contents, subjects for comprehensive assessment and contents, and summarized contents related to the physical activity and exercise in non-pharmacological approach. As a result, after the completion of cancer treatment, all cancer survivors should be screened regularly using reliable and validated tools. In the case of fatigue, physical activity was recommended as the primary intervention, but it was recommended for other symptoms as adjuvant therapy. Therefore, Cancer survivors should be encouraged to be active in their physical activity, and maintain the moderate intensity physical activity as long as they have no complication related to the cancer treatment. Motivation strategies for physical activity need to be developed and applied.

Low-Level Laser Therapy in Dentistry (임상가를 위한 특집3 - 치과 영역에서의 저출력레이저요법)

  • Im, Yeong-Gwan;Kim, Ji-Yeon;Kim, Byung-Gook
    • The Journal of the Korean dental association
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    • v.49 no.11
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    • pp.679-687
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    • 2011
  • Low-level laser therapy (LLLT) is the application of light to pathology to promote tissue regeneration, reduce inflammation, and relieve pain. LLLT has a photochemical effect whereby the light is absorbed and exerts a chemical change. The clinical applications of LLLT include improvement in wound and bone healing processes, control of pain and tooth hypersensitivity, modulation of periodontal inflammation, the prevention and treatment of cancer therapy-induced oral mucositis, management of burning mouth syndrome, and improvement in temporomandibular disorder symptoms. Further research is needed to better elucidate the cellular mechanisms of LLLT and provide a solid scientific basis for the clinical application of LLLT in dentistry.

Gender Differences in Pain in Cancer Patients (성별에 따른 암환자의 통증 차이)

  • Kim, Hyun-Sook;Lee, So-Woo;Yun, Young-Ho;Yu, Su-Jeong;Heo, Dae-Seog
    • Journal of Hospice and Palliative Care
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    • v.4 no.1
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    • pp.14-25
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    • 2001
  • Purpose : To determine whether there exist gender differences in pain in Korean cancer patients and whether the depression and performance that are often expressed differently between men and women with cancer interact with pain. Method : The results of survey were collected from 140 in- and out-patients (78 male and 62 female) who had cancer treatment at one of the university hospital in Seoul for four months from February of 1999. The severity and interference of pain were examined with the self-reported survey based on Korean version of Brief Pain Inventory (BPI-K). Demographic and clinical information for all patient were compiled by reviewing their medical records, and the level of depression was examined with the Korean version of Beck Depression Inventory (BDI-K). Usual statistical methods, e.g., frequences, means and SDs were used to characterize the sample. The chi-square tests for categorical data and t-test for numerical data were used for group comparison. And the correlation between variables were performed using Pearson correlation coefficient. Resuts : 1) The mean scores of the worst pain for last 24-hours measured with the pain severity of BPI-K were 5.77 in male and 6.45 in female. The pain interference of BPI-K in men was in the order of mood (5.49), enjoy (5.36), and work (5.00), and in women were work (7.48), enjoy (7.16), and mood (6.53). 2) In pain severity, significant difference was found between men and women in the average pain for last 24-hours (t=-2.130, P=.035). In pain interference, significant difference was found between men and women in activity (t=-2.450, P=.015), mood (t=-2,321, P=.022), walk (t=-2.762, P=.007), work (t=-4.946, P=.000), relate (t=-2.595, P=.010), sleep (t=-2.071, P=.040), enjoy (t=-3.198, P=.001). 3) It was found that the items of pain and depression are significantly correlated in men but not in women. Men also exhibited higher correlation in the items of pain and performance status than women. Conclusions : Women report significantly greater average pain for last 24-hours and for all items of pain interference than men. Pain and depression are significantly correlated in men. The results of this study suggest that gender differences in pain should be considered for planning effective pain management program.

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