scholarly journals Intrathecal Pump Implantation in the Cisterna Magna for Treating Intractable Cancer Pain

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Yaling Lou ◽  
Yuefeng Rao ◽  
Zhiying Feng
Keyword(s):  
Cancer Pain ◽  
Drug Dose ◽  
Axillary Lymph ◽  
Drug Infusion ◽  
Refractory Pain ◽  
The Face ◽  
The Right ◽  
Intractable Cancer Pain ◽  
Remaining Time ◽  
Pump Implantation

A 54-year-old male patient with postoperative axillary lymph node, intrapulmonary, intracranial, and cervical spine metastases of left liver cancer was suffering from severe, persistent, and pricking pain in the right dorsal shoulder and right arm since 3 months. The drug dose of the fentanyl transdermal patch was gradually increased after admission and an adjuvant analgesic was also included, but neither treatment alleviated the pain. It was gradually alleviated after intramedullary analgesic infusion through intrathecal pump implantation in cistern magna. Terminally ill patients often have the desire to spend their remaining time at home, which however becomes a challenge in the face of refractory pain. At present, no palliative chemoradiation or ablative or stimulant neurosurgical options are available to manage pain in cancer patients. Based on the findings of this report, we concluded that an intramedullary drug infusion system can have a significant analgesic effect in patients with cervical metastasis and refractory cancer pain.

scholarly journals Efficacy and Safety of Ropivacaine Addition to Intrathecal Morphine for Pain Management in Intractable Cancer

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Ying Huang ◽  
Xihan Li ◽  
Tong Zhu ◽  
Jian Lin ◽  
Gaojian Tao
Keyword(s):  
Pain Relief ◽  
Adverse Effects ◽  
Cancer Pain ◽  
Barthel Index ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Intrathecal Morphine ◽  
Drug Infusion ◽  
Intrathecal Catheter ◽  
Intractable Cancer Pain

Objective. Although intrathecal drug infusion has been commonly adopted for terminal cancer pain relief, its adverse effects have made many clinicians reluctant to employ it for intractable cancer pain. The objective of this study is to compare the efficacy and security of an intrathecal continuous infusion of morphine and ropivacaine versus intrathecal morphine alone for cancer pain.Methods. Thirty-six cancer patients received either a continuous morphine (n=19) or morphine and ropivacaine (n=17) infusion using an intrathecal catheter through a subcutaneous port. Numerical Rating Scale (NRS) scores and the Barthel Index were analyzed. Adverse effects and complications on postoperative days 1, 3, 7, and 15 were also analyzed.Results. All patients experienced pain relief. Compared to those who received morphine alone, patients receiving morphine and ropivacaine had significantly lower postoperative morphine requirements and higher Barthel Index scores on the 15th postsurgical day (P<0.05). Patients receiving morphine and ropivacaine had lower NRS scores than patients receiving morphine alone on postoperative days 1, 3, 7, and 15 (P<0.05). Negative postsurgical effects were similar in both groups.Conclusions. Morphine and ropivacaine administration through intrathecal access ports is efficacious and safe and significantly improves quality of life.

scholarly journals Breast Angiosarcoma with a Preoperative Diagnosis of Late Recurrence of Breast Cancer: A Case Report

2021 ◽  
pp. 604-609
Author(s):  
Rika Kouhashi ◽  
Shinichiro Kashiwagi ◽  
Yuka Asano ◽  
Tamami Morisaki ◽  
Sae Ishihara ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Preoperative Diagnosis ◽  
Vascular Endothelial Cells ◽  
Interstitial Fibrosis ◽  
Late Recurrence ◽  
Breast Conserving Surgery ◽  
Surrounding Tissue ◽  
Axillary Lymph ◽  
Elevated Lesion ◽  
The Right

Angiosarcoma is a malignant mesenchymal tumor characterized by the presence of vascular endothelial cells. Although rare, angiosarcoma developing in the mammary glands has a poor prognosis. We report a case of breast angiosarcoma with a preoperative diagnosis of late recurrence of breast cancer. A 78-year-old woman noticed a tumor in her right breast and visited our hospital. The patient had undergone breast-conserving surgery and axillary lymph node dissection from the right breast 12 years before the visit. The tumor was diagnosed as T4bN0M0, stage IIIB. Anastrozole was administered as postoperative adjuvant therapy for 5 years; the patient also received 50-Gy whole-breast radiation therapy after surgery. Physical examination during her visit revealed an elevated lesion with blue purpura around the nipple in the right breast. We performed breast ultrasound and detected a well-defined 19.6 × 16.4 × 10.7 mm hypoechoic tumor in the left subareolar area. The patient underwent core needle biopsy (CNB). Based on the CNB specimen findings, she was suspected to experience late local recurrence after surgery. Therefore, she underwent total mastectomy after breast-conserving surgery. A dark-red tumor sized 18 × 12 mm was found in a specimen from the nipple. The pathological diagnosis of the specimen revealed short spindle-shaped tumor cells with strong nuclear pleomorphism and a significant interstitial fibrosis. Immunohistochemistry using D2-40 and CD31 antibodies showed irregular luminal proliferation at the anastomosis, infiltration into the surrounding tissue, and massive necrosis, thereby leading to the diagnosis of breast angiosarcoma. We have reported a case of breast angiosarcoma with a preoperative diagnosis of late recurrence of breast cancer.

scholarly journals Chronic (Rasmussen’s) Encephalitis in an Adult

2003 ◽  
Vol 30 (3) ◽  
pp. 263-265 ◽  
Author(s):  
Richard Wennberg ◽  
Sukriti Nag ◽  
Mary-Pat McAndrews ◽  
Andres M. Lozano ◽  
Richard Farb ◽  
...  
Keyword(s):  
Visual Field ◽  
Right Visual Field ◽  
Loss Of Consciousness ◽  
Mild Head Injury ◽  
Partial Seizures ◽  
Complex Partial Seizures ◽  
The Past ◽  
Rasmussen’S Encephalitis ◽  
The Face ◽  
The Right

A 24-year-old woman was referred because of incompletely-controlled complex partial seizures. Her seizures had started at age 21, after a mild head injury with brief loss of consciousness incurred in a biking accident, and were characterized by a sensation of bright flashing lights in the right visual field, followed by numbness and tingling in the right foot, spreading up the leg and to the arm, ultimately involving the entire right side, including the face. Occasionally they spread further to involve right facial twitching with jerking of the right arm and leg, loss of awareness and, at the onset of her epilepsy, rare secondarily generalized convulsions. Seizure frequency averaged three to four per month. She was initially treated with phenytoin and clobazam and subsequently changed to carbamazepine 800 milligrams per day. She also complained that her right side was no longer as strong as her left and that it was also numb, especially the leg, but felt that this weakness had stabilized or improved slightly over the past two years.

The Essence of Christianity and the Cross of Christ

1914 ◽  
Vol 7 (4) ◽  
pp. 538-594
Author(s):  
Benjamin B. Warfield
Keyword(s):  
New Haven ◽  
Liberal Theology ◽  
Religious System ◽  
The World ◽  
Cross Of Christ ◽  
The Face ◽  
Divinity School ◽  
The Common ◽  
The Cross ◽  
The Right

In a recent number of The Harvard Theological Review, Professor Douglas Clyde Macintosh of the Yale Divinity School outlines in a very interesting manner the religious system to which he gives his adherence. For “substance of doctrine” (to use a form of speech formerly quite familiar at New Haven) this religious system does not differ markedly from what is usually taught in the circles of the so-called “Liberal Theology.” Professor Macintosh has, however, his own way of construing and phrasing the common “Liberal” teaching; and his own way of construing and phrasing it presents a number of features which invite comment. It is tempting to turn aside to enumerate some of these, and perhaps to offer some remarks upon them. As we must make a selection, however, it seems best to confine ourselves to what appears on the face of it to be the most remarkable thing in Professor Macintosh's representations. This is his disposition to retain for his religious system the historical name of Christianity, although it utterly repudiates the cross of Christ, and in fact feels itself (in case of need) quite able to get along without even the person of Christ. A “new Christianity,” he is willing, to be sure, to allow that it is—a “new Christianity for which the world is waiting”; and as such he is perhaps something more than willing to separate it from what he varyingly speaks of as “the older Christianity,” “actual Christianity,” “historic Christianity,” “actual, historical Christianity.” He strenuously claims for it, nevertheless, the right to call itself by the name of “Christianity.”

What of the Child? Preventing the Publication of Children's Names After the Age of 18

2021 ◽  
Vol 24 ◽  
pp. 1-31
Author(s):  
Sophy Baird
Keyword(s):  
Criminal Justice ◽  
Criminal Justice System ◽  
Justice System ◽  
Freedom Of Expression ◽  
Best Interests ◽  
Child Victims ◽  
Criminal Proceedings ◽  
The Right To Privacy ◽  
The Face ◽  
The Right

Children are afforded a number of protections when they encounter the criminal justice system. The need for special protection stems from the vulnerable position children occupy in society. When children form part of the criminal justice system, either by being an offender, victim, or witness, they may be subjected to harm. To mitigate against the potential harm that may be caused, our law provides that criminal proceedings involving children should not be open to the public, subject to the discretion of the court. This protection naturally seems at odds with the principle of open justice. However, the courts have reconciled the limitation with the legal purpose it serves. For all the protection and the lengths that the law goes to protect the identity of children in this regard, it appears there is an unofficial timer dictating when this protection should end. The media have been at the forefront of this conundrum to the extent that they believe that once a child (offender, victim, or witness) turns 18 years old, they are free to reveal the child's identity. This belief, grounded in the right to freedom of expression and the principle of open justice, is at odds with the principle of child's best interests, right to dignity and the right to privacy. It also stares incredulously in the face of the aims of the Child Justice Act and the principles of restorative justice. Measured against the detrimental psychological effects experienced by child victims, witnesses, and offenders, this article aims to critically analyse the legal and practical implications of revealing the identity of child victims, witnesses, and offenders after they turn 18 years old.

Manufacturability Analysis for Solid Freeform Fabrication

1999 ◽  
Author(s):  
R. K. Arni ◽  
S. K. Gupta
Keyword(s):  
Systematic Approach ◽  
Solid Freeform Fabrication ◽  
Second Step ◽  
Freeform Fabrication ◽  
Design Tolerance ◽  
The Face ◽  
The Right ◽  
The Given ◽  
Manufacturing Problems ◽  
Case Effect

Abstract This paper describes a systematic approach to analyzing manufacturability of parts produced using Solid Freeform Fabrication (SFF) processes with flatness, parallelism and perpendicularity tolerance requirements on the planar faces of the part. SFF processes approximate objects using layers, therefore the part being produced exhibits stair-case effect. The extent of this stair-case effect depends on the angle between the build orientation and the face normal. Therefore, different faces whose direction normal is oriented differently with respect to the build direction may exhibit different values of inaccuracies. We use a two step approach to perform the manufacturability analysis. We first analyze each specified tolerance on the part and identify the set of feasible build directions that can be used to satisfy that tolerance. As a second step, we take the intersection of all sets of feasible build directions to identify the set of build directions that can simultaneously satisfy all specified tolerance requirements. If there is at least one build direction that can satisfy all tolerance requirements, then the part is considered manufacturable. Otherwise, the part is considered non-manufacturable. Our research will help SFF designers and process providers in the following ways. By evaluating design tolerances against a given process capability, it will help designers in eliminating manufacturing problems and selecting the right SFF process for the given design. It will help process providers in selecting a build direction that can meet all design tolerance requirements.

The Right to Freedom of Thought in the European Convention of Human Rights

2021 ◽  
pp. 1-34
Author(s):  
Patrick O’Callaghan ◽  
Bethany Shiner
Keyword(s):  
Human Rights ◽  
Personal Development ◽  
Industrial Revolution ◽  
European Convention ◽  
Inner Life ◽  
Article 9 ◽  
The Face ◽  
Technological Developments ◽  
Freedom Of Thought ◽  
The Right

Abstract This paper examines the right to freedom of thought in the European Convention on Human Rights against the background of technological developments in neuroscience and algorithmic processes. Article 9 echr provides an absolute right to freedom of thought when the integrity of our inner life or forum internum is at stake. In all other cases, where thoughts have been manifested in some way in the forum externum, the right to freedom of thought is treated as a qualified right. While Article 9 echr is a core focus of this paper, we argue that freedom of thought is further supported by Articles 8, 10 and 11 echr. This complex of rights carves out breathing space for the individual’s personal development and therefore supports the enjoyment of freedom of thought in its fullest sense. Charged with ‘maintaining and promoting the ideals and values of a democratic society’ as well as ensuring that individual human rights are given ‘practical and effective protection’, this paper predicts that the ECtHR will make greater use of the right to freedom of thought in the face of the emerging challenges of the Fourth Industrial Revolution.

Ambidexterity [L'Homme droit et l'Homme gauche: les Ambidextres]. (Revue philosophique, October, 1901.) Biervliet, J. J. van.

1902 ◽  
Vol 48 (201) ◽  
pp. 348-349
Author(s):  
Havelock Ellis
Keyword(s):  
Uniform Method ◽  
Careful Study ◽  
The Face ◽  
The Right ◽  
Two Sides ◽  
Careful Investigation

Professor van Biervliet has now completed his very careful study of right-sidedness and left-sidedness (already summarised in the Journal) by a still more careful investigation of ambidextrous persons. In the first place by photography, according to a special and uniform method, he finds that in the ambidextrous the two sides of the face, as well as the arms, are fairly alike, the face being slightly more developed on the right side, as among left-sided people, but not in so marked a degree. They occupy much the same position, indeed, throughout the investigation. When compared with right-sided and left-sided people as regards sensory acuteness, it is found that while the right-sided have predominant sensory acuteness on the right side, both the left-sided and the ambidextrous can see further, hear better, possess more acute tactile and muscular sense, on the left side, so that ambidexterity may be regarded as a variety of left-sidedness of more symmetrical anatomical type. In all respects the ambidextrous almost or quite resembled the left-sided.

scholarly journals A prospective study of 39 patients with trigeminal neuralgia treated with percutaneous balloon compression

2011 ◽  
Vol 69 (2a) ◽  
pp. 221-226 ◽  
Author(s):  
Wuilker Knoner Campos ◽  
Marcelo N. Linhares
Keyword(s):  
Trigeminal Neuralgia ◽  
Female Gender ◽  
Safe Procedure ◽  
Approval Ratings ◽  
Balloon Compression ◽  
Percutaneous Balloon ◽  
Percutaneous Balloon Compression ◽  
The Face ◽  
The Right ◽  
A Prospective Study

OBJECTIVE: Trigeminal neuralgia is the most common facial pain. It may be treated with percutaneous balloon compression (PBC), which is considered to be a safe and efficient procedure. The purpose of this study was to review our results with PBC and to assess the factors influencing the outcome. METHOD: A multivariate analysis was used to study 39 patients during a 50-month postoperative period. RESULTS: There was predominance of the female gender (54%), the right side of the face (84%) and V2V3 roots of trigeminal nerve (33%). The mean age was 62.3 years. No major complications or deaths occurred. Among all variables, postoperative hypoesthesia was the single prognostic factor capable of positively influencing the results (p=0.02). Most patients (80%) were pain-free after 50 months with a 90% satisfaction rate. CONCLUSION: PBC was a safe procedure with low morbidity, no mortality, high approval ratings, and was an important improving on patients' quality of life.

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