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암환자의 통증 치료에 대한 펜타닐 - TTS 의 유효성과 안정성
김훈교(Hoon Kyo Kim),이경식(Kyung Shik Lee),홍영선(Young Seon Hong),이복근(Bok Keun Lee),송치원(Chi Won Song),박진노(Jin No Park),조석구(Suk Ku Cho),김재유(Jae Yoo Kim) 대한내과학회 1999 대한내과학회지 Vol.57 No.3
N/A The transdermal administration of narcotics is one of the alternative ways of providing adequate pain relief for the patients with chronic cancer pain. A Phase 4 trial was conducted to evaluate the efficacy and safety of Fentanyl-TTS in adult patients with cancer-related pain in Korea. Methods : Patients with histologically confirmed malignancy, who have pain related to the cancer and/or therapy, pain necessitating the use of opoid analgesics, age of 18 yr or older, ability to communicate effectively with study personnel, and signed on informed consent were included. The patients were titrated with a short-acting narcotic to control their cancer pain before they are converted to a fentanyl-transdermal therapeutic system(TTS). Short acting parenteral morphine and MS contin were used as rescue medications. All patients were evaluated initially and were followed up with a pain visual analogue scale(VAS), quality of life(QOL)-VAS. Patients were asked to keep the daily record for 21 days about pain VAS, QOL-VAS, amount of rescue morphine used, and side effects. Results : Twenth two patients were enrolled from January 1996 to October 1997. The dose of fentanyl-TTS required, ranged between 25 and 75 ug/hr (25 ㎍/hr in 13, 50 ㎍/hr in 4, and 75 ㎍/hr in 2). The mean dose of morphine required before the use of the fentanyl-TTS was 135.3 mg (20-285 mg/day), but it was decreased after the use of the fentanyl-TTS. Pain VAS and QOL-VAS were in adquate level during the fentanyl- TTS treatment. Patients favored continuous use of fentanyl after the study was finished. Side effect of fentanyl-TTS was minimal. Conclusion : Transdermal fentanyl seems to be a convenient and effective analgesic for the control of cancer related pain in Korean. A controlled trial comparing fentanyl-TTS to morphine needs to be followed. (Korean J Med 57:348-356, 1999)
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Primary Empty Sella Syndrome 에 동반된 뇌하수체 기능저하중 및 중추성 요붕증 1 예
최정숙,김한성,권기호,박양훈,제영성,이복근,서보정,오정열 대한내과학회 1994 대한내과학회지 Vol.47 No.2
The empty sella syndrome results from and extension of the subarachnoid space into an intrasellar portion with expansion of sella and flattening of the pituitary gland. The empty sella syndrome is distinguisted between $quot;primary$quot; (without prior surgical or radiotherapeutic procedurea) and $quot;secondary$quot; (following such procedure) cases. In this syndrome, the endocrine function is usually normal and this syndrome which is accompanied with endocrinologic abnormalities and diabetes insipidus is rarely reported. We discribed a patients of central type of diabetes insipidus, hypoptuitarism including growth retardation and sexual infantilism in the primary empty sella syndrome. So we present this case with a review of the literature.
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