• Title/Summary/Keyword: 부인과 수술

Search Result 67, Processing Time 0.027 seconds

Snuffbox Arteriovenous Fistula Formation for Hemodialysis (Snuffbox에 시행한 혈액투석을 위한 동정맥루조성술)

  • 서필원;류재욱;박정옥;장성욱;김미순;박성식;김삼현
    • Journal of Chest Surgery
    • /
    • v.37 no.2
    • /
    • pp.154-159
    • /
    • 2004
  • The arteriovenous fistula (AVF), which maintains satisfactory blood flow, is necessary to the patients of end-stage renal disease for the long term hemodialysis. We performed the snuffbox fistula as the first operation for hemodialysis vascular access. This study was performed to investigate the patency rates, complications, risk factors for occlusion of the AVF, and the types of reoperations. Material and Method: We performed 146 snuffbox fistulas from Jun. 1994 to Dec. 2001 The records of the patients except six patients who were lost from follow up were analyzed retrospectively, Mean age and male:female ratio were 52$\pm$15 years (range, 17∼79 years) and 80 : 60 respectively. Diabetes mellitus and hypertension were combined in 47 patients and 101 respectively. Preoperative levels of creatinine and potassium were 9.09$\pm$3.68 mg/dL (range, 2.55∼20.09 mg/dL) and 4.7$\pm$0.9 mmol/L (range, 2.3∼8.1 mmol/L). One hundred thirteen cases of the snuffbox fistulas were done at left side hand and the others at right hand. Result: Mean follow up period of the patients was 41.8$\pm$31.0 months (range, 0.2∼108,8 months). During the follow up period, 35 occlusions of AVF occurred and these AVFs were patent for 9.8$\pm$10.1 months (range, 0.1∼40.4 months). The patency rates of f month, and 1, 2, 3, 5 years were known as 92.8, 80.2, 73.8, 71.3, 69.6% respectively. Right sided snuffbox fistulas (p-value=0.045) and old age (p-value=0.048) were revealed as significant risk factors for occlusion of AVF. The postoperative complications consisted of occlusions of AVF caused by intimal hyperplasia of vein in 24, thrombosis in nine, stenosis of anastomosis site in three, and venous hypertensions in two. After the first operation 37 patients underwent 86 reoperations. Conclusion: The snuffbox fistulas showed acceptable patency rates and low complication rates. The snuffbox fistulas as the first operation for AVF formation can be a good option for the patients with end-stage renal disease.

Review of 2015 Major Medical Decisions (2015년 주요 의료판결 분석)

  • Yoo, Hyun Jung;Lee, Dong Pil;Lee, Jung Sun;Jeong, Hye Seung;Park, Tae Shin
    • The Korean Society of Law and Medicine
    • /
    • v.17 no.1
    • /
    • pp.299-346
    • /
    • 2016
  • There were also various decisions made in medical area in 2015. In the case that an inmate in a sanatorium was injured due to the reason which can be attributable to the sanatorium and the social welfare foundation that operates the sanatorium request treatment of the patient, the court set the standard of fixation of a party in medical contract. In the case that the family of the patient who was declared brain dead required withdrawal of meaningless life sustaining treatment but the hospital rejected and continued the treatment, the court made a decision regarding chargeable fee for such treatment. When it comes to the eye brightening operation which received measure of suspension from the Ministry of Health and Welfare for the first time in February, 2011, because of uncertainty of its safety, the court did not accept the illegality of such operation itself, however, ordered compensation of the whole damage based on the violation of liability for explanation, which is the omission of explanation about the fact that the cost-effectiveness is not sure as it is still in clinical test stage. There were numerous cases that courts actively acknowledged malpractices; in the cases of paresis syndrome after back surgery, quite a few malpractices during the surgery were acknowledged by the court and in the case of nosocomial infection, hospital's negligence to cause such nosocomial infection was acknowledged by the court. There was a decision which acknowledged malpractice by distinguishing the duty of installation of emergency equipment according to the Emergency Medical Service Act and duty of emergency measure in emergency situations, and a decision which acknowledged negligence of a hospital if the hospital did not take appropriate measures, although it was a very rare disease. In connection with the scope of compensation for damage, there were decisions which comply with substantive truth such as; a court applied different labor ability loss rate as the labor ability loss rate decreased after result of reappraisal of physical ability in appeal compared to the one in the first trial, and a court acknowledged lower labor ability loss rate than the result of appraisal of physical ability considering the condition of a patient, etc. In the event of any damage caused by malpractice, in regard to whether there is a limitation on liability in fee charge after such medical malpractice, the court rejected the hospital's claim for setoff saying that if the hospital only continued treatments to cure the patient or prevent aggravation of disease, the hospital cannot charge Medical bills to the patient. In regard to the provision of the Medical Law that prohibit medical advertisement which was not reviewed preliminarily and punish the violation of such, a decision of unconstitutionality was made as it is a precensorship by an administrative agency as the deliberative bodies such as Korean Medical Association, etc. cannot be denied to be considered as administrative bodies. When it comes to the issue whether PRP treatment, which is commonly performed clinically, should be considered as legally determined uninsured treatment, the court made it clear that legally determined uninsured treatment should not be decided by theoretical possibility or actual implementation but should be acknowledged its medical safety and effectiveness and included in medical care or legally determined uninsured treatment. Moreover, court acknowledged the illegality of investigation method or process in the administrative litigation regarding evaluation of suitability of sanatorium, however, denied the compensation liability or restitution of unjust enrichment of the Health Insurance Review & Assessment Service and the National Health Insurance Corporation as the evaluation agents did not cause such violation intentionally or negligently. We hope there will be more decisions which are closer to substantive truth through clear legal principles in respect of variously arisen issues in the future.

  • PDF

Use of Auxins for Rhizome Propagation and Shading Effect on Growth of Asarum sieboldii Mio. (세신(細辛)의 근경삽(根莖揷)번식에 있어서 오옥신의 이용과 차광재배(遮光栽培))

  • Kim, Sun-Gon;Park, Chung-Heon;Choi, Dong-Geun;Hwang, Chang-Ju;Chin, Seong-Kye
    • Korean Journal of Medicinal Crop Science
    • /
    • v.2 no.3
    • /
    • pp.198-204
    • /
    • 1994
  • This study was carried out to investigate the auxin(IAA, IBA, NAA) treatment and the effect of shading rate in Asarum sieboldii. The results obtained were summerized as follows: By the soaking treatment of auxins to the cutted rhizome enhanced root growth and plant weight. By the increment of shading rate, plant growth was much better compare to the control. Leaf fallen times appeared about 20 days more earlier at plain area then the alpain area. Root yield was much higher by the treatment of shading then the conventional cultivation so it seem to be the useful for large scale cultivations of A. sieboldii.

  • PDF

Anti-osteoporotic Activity of Gojineumja Aqueous Extracts on the Ovariectomized Mice (난소적출 마우스에서 고진음자(固眞飮子) 물 추출물의 골다공증 개선 효과)

  • Cho, Su-Yun;Kim, Dong-Chul
    • The Journal of Korean Obstetrics and Gynecology
    • /
    • v.31 no.4
    • /
    • pp.16-38
    • /
    • 2018
  • Objectives: The objective of this in vivo study is to observe the anti-osteoporotic activities of Gojineumja aqueous extracts (GJEJ) on the ovariectomized (OVX) mice as compared to those of risedronate sodium (RES). Methods: Thirty five days after bilateral OVX, GJEJ was orally administered, for 35 days once a day and then the changes on the body weight and gain during experimental periods, femur weights, bone mineral density (BMD), bone strength (failure load), mineral contents - calcium (Ca) and inorganic phosphorus (IP), histological profiles and histomorphometrical analyses at sacrifice were conducted with serum biochemistry - osteocalcin contents and bone specific alkaline phosphatase (BALP) activities. And the results of GJEJ were compared with RES orally administered OVX mice. Results: As a result of OVX, noticeable increase of body weight and gains and serum osteocalcin levels, decrease of serum BALP activities, femur weights, femur Ca and IP contents, BMD and strength were observed as compared to those of sham control mice, respectively. Also, the decrease of all histomorphometrical indices indicating the bone mass and structure, and the increase of indices about resorption were also detected in the femur of OVX control. However, these estrogen-deficient osteoporotic signs were significantly and dose-dependently inhibited by 35 days of continuous oral treatment of GJEJ, at dose levels of 500, 250 and 125 mg/kg, respectively. Especially, GJEJ 500 mg/kg showed favorable inhibitory activities against estrogen-deficient osteoporosis symptoms induced by OVX as comparable to those of RES 2.5 mg/kg. Conclusions: The results in this study suggest that oral administrations of GJEJ have clear dose-dependent favorable anti-osteoporotic activities in OVX mice.

Pre-post changes of sexual satisfaction and spouse support of women who have had a hysterectomy (자궁적출술을 받은 부인의 수술전후 성만족 및 배우자 지지의 변화)

  • 장순복;정승은
    • Journal of Korean Academy of Nursing
    • /
    • v.25 no.1
    • /
    • pp.173-183
    • /
    • 1995
  • The research questions of this study were : Will the level of sexual satisfaction of women who have had a hysterectomy 4 months before be decreased compare to the level of sexsual satisfaction before the hysterectomy\ulcorner, Will the level of perceived spouse support of women who have had a hysterectomy 4 months before be decreased compare to the level before the hysterectomy\ulcorner, and What is the relationship between sexual satisfaction and spouse support\ulcorner This is a perspective descriptive correlational study. The number of subjects was 44. The subjects were limited to Korean women who had an abdominal or vaginal hysterectomy for non - malignant diseases, were married(living with their husbands), mentally healthy, and premenopause at the time of operation. The instrument was consisted of 4 items of demo-graphic characteristics, 13 items of spouse support, and 10 items of sexual satisfaction. The instrument of sexual satisfaction was a component of the Derogatis Sexual Function Inventory. Data analysis was done by paired t-test to see the differences between the pre-post scores of sexual satisfaction and spouse support. The Pearson Correlation Coefficiency was calculated to see the relationship between the scores of sexual satis-faction and spouse spport of pre-post hysterectomy. Results were summerized as follow : The mean age of the subjects was 43.5 years : 72.7% of the subjects were above middle school graduates : their mean income level was 1, 453, 000 Korean won and 86.4% of the subjects have had bi-lateral oophrectomy. 1. The scores of sexual satisfaction of women at 4 months after hysterectomy was decreased significantly compare to the score before hysterectomy(paired t=.274, p=.009). 2. The scores of spouse support of the women at 4 months after hysterectomy was not decreased significantly compare to the score before hysterectomy(paired t=.19, p=.847). 3. The scores of sexual satisfaction and spouse support before hysterectomy was significantly related(r=.5186, p=.000). 4. The scores of sexual satisfaction and spouse support at 4 months after hysterectnmy was significantly related(r=.4110, p=.005). It carl be conlcluded that the sexual satisfaction level could be decreased 4 months after the hyster ectomy, but the spouse support level may not be decreased at 4 months after hysterectomy. Further studies have to be done to identify the factors related to the decrease of sexual satisfaction and spouse support after hysterectomy.

  • PDF

Effect of Mutan Isolated from Streptococcus mutans on the Healing of Bone Defect in Rat (Streptococcus mutans로부터 분리한 Mutan이 흰쥐의 골결손부 치유에 미치는 영향)

  • Kwon, Hyun-Jung;Kim, Yong Hyun;Han, Kook-Il;Jung, Eui-Gil;Han, Man-Deuk
    • Journal of dental hygiene science
    • /
    • v.15 no.2
    • /
    • pp.98-105
    • /
    • 2015
  • We investigated the effects of a mutan (water-insoluble ${\alpha}$-glucans) isolated from Streptococcus mutans on the healing of bone defect in rat. Sprague-Dawley rats were divided into control (saline-treated), lipopolysaccharide (LPS)-treated, and mutan-treated groups (n=6 per group). Experimental bone defects were surgically created with round fissure bur at the buccal surface of the left mandibular. The control groups was administered with saline solution (0.1 ml/100 g), while the LPS and mutan group was given LPS and mutan (1 mg/kg body weight) three times weekly. After 4 weeks the rats were sacrificed, the healing of bone defect was assessed by bone mineral density (BMD) and micro-computed tomography (${\mu}CT$) examination. Percent bone volume (bone volume/tissue volume [BV/TV]), trabecular thickness (Tb.Th), and trabecular number (Tb.N) parameters of ${\mu}CT$ showed higher values in control group than LPS and mutan group. Bone surface/volume ratio (BS/BV), trabecular bone pattern factor (Tb.Pf), and structure model index parameters of ${\mu}CT$ showed higher values in LPS group than mutan group. BMD values of mutan treated-alveolar bones were significantly lower for than that of the LPS group. Therefore, we suggest that mutan, water-insoluble ${\alpha}$-glucans from S. mutans may be induce the induction of periodontal diseases.

Comparison of Gene Expression Profile in Eutopic Endometria with or without Endometriosis: A Microarray Study (자궁내막증 환자와 대조군에서의 자궁내막 유전자 발현의 차이: Microarray를 이용한 연구)

  • Chung, Min-Ji;Chung, Eun-Jung;Lee, Shin-Je;Kim, Moon-Kyu;Chun, Sang-Sik;Lee, Taek-Hoo
    • Clinical and Experimental Reproductive Medicine
    • /
    • v.34 no.1
    • /
    • pp.19-31
    • /
    • 2007
  • Objective: Pathogenesis of the endometriosis is very complex and the etiology is still unclear. Our hypothesis is that there may be some difference in gene expression patterns between eutopic endometriums with or without endometriosis. In this study, we analyzed the difference of gene expression profile with cDNA microarray. Methods: Endometrial tissues were gathered from patients with endometriosis or other benign gynecologic diseases. cDNA microarray technique was applied to screen the different gene expression profiles from early and late secretory phase endometria of those two groups. Each three mRNA samples isolated from early and late secretory phase of endometrial tissues of control were pooled and used as master controls and labeled with Cy3-dUTP. Then the differences of gene expression pattern were screened by comparing eutopic endometria with endometriosis, which were labeled with Cy5-dUTP. Fluorescent labeled probes were hybridized on a microarray of 4,800 human genes. Results: Twelve genes were consistently over-expressed in the endometrium of endometriosis such as ATP synthase H transporting F1 (ATP5B), eukaryotic translation elongation factor 1, isocitrate dehydrogenase 1 (NADP+), mitochondrial ribosomal protein L3, ATP synthase H+ transporting (ATP5C1) and TNF alpha factor. Eleven genes were consistently down-regulated in the endometriosis samples. Many extracellular matrix protein genes (decorin, lumican, EGF-containing fibulin-like extracellular matrix protein 1, fibulin 5, and matrix Gla protein) and protease/protease inhibitors (serine proteinase inhibitor, matrix metalloproteinase 2, tissue inhibitor of metalloproteinase 1), and insulin like growth factor II associated protein were included. Expression patterns of selected eight genes from the cDNA microarray were confirmed by quantitative RT-PCR or real time RT-PCR. Conclusion: The result of this analysis supports the hypothesis that the endometrium from patients with endometriosis has distinct gene expression profile from control endometrium without endometriosis.