• Title/Summary/Keyword: Korean Gynecology

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Depression, Anxiety, and Spouse Support in Married Women Who had Received Gynecologic Cancer Treatment (부인암 치료를 받은 기혼여성들의 우울, 불안, 배우자 지지)

  • Lee Inn Sook
    • Journal of Korean Public Health Nursing
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    • v.17 no.1
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    • pp.58-68
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    • 2003
  • This study was conducted to explore the depression, anxiety, spouse support, and the difference of these variables according to the general characteristics and disease related characteristics in married women who had received gynecologic cancer treatment. The subjects consisted of 62 patients with cervical cancer, 18 patients with ovarian cancer, and 7 patients with endometrial cancer who were admitted to the department of obstetrics and gynecology, 3 education hospital in Seoul from January, 1996 to August, 1999. The data were collected from March 25 to July 25, 2000 by using a mailed questionnaire. The results were as follows : 1. The mean score of depression was 35.1 with the range from 20 to 76. The mean score of the anxiety was 38.6 with the range from 24 to 58. The mean score of the spouse support was 33.8 with the range from 12 to 48. 2. The score of depression was significantly different by the general characteristics: woman's education level(p=.040), economic level(p=.002), and the satisfactory level on married life(p=.009). The score of spouse support was significantly different by the general characteristics: woman's education level(p=.009), spouse's education level(p=.001), spouse's religion (p=.004), economic level(p=.008), and the satisfactory level on married life(p=.000). The scores of depression, anxiety, and spouse support were not significantly different by the disease related characteristics. 3. The score of depression had a positive correlation with anxiety(r=.731), and a negative correlation with spouse support(r=-.425). 4. The main influencing factors on the depression were economic level$(13.4\%)$ and satisfactory level on married life$(4.4\%)$. The main influencing factors on the spouse support were satisfactory level on married life$(23.6\%)$ and spouse's education level$(9.2\%)$. Based upon the above findings, the depression, anxiety, and spouse support of women who had received gynecologic cancer treatment were higher than healthy married women. The score of depression and anxiety had a negative correlation with spouse support. The factors influencing spouse support were satisfactory level on married life and spouse's education level. Therefore it is recommended that nursing intervention for women who had received gynecologic cancer treatment would be focused to improve spouse support for alleviating depression and anxiety level.

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Congruence of Patients문 Health Problems Between Nurses and Patients in the Field of Maternity Nursing (모성간호영역의 환자건강문제에 대한 간호사ㆍ환자간의 일치)

  • 장순복
    • Journal of Korean Academy of Nursing
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    • v.22 no.3
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    • pp.237-388
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    • 1992
  • This study was done to identify the degree of congruence between nurses and patients on patients' health problems. The purposes of this study were 1. To compare the health problems of parturient women as identified by interview and in the nursing record. 2. To compare the health problems of patients who have had gynecological surgery as identified by interview and in the nursing record. 3. To compare the health problems of chemotherapy patients as identified by interview and in the nursing record. The design of this study was a comparative descriptive design. The subjects were 205 Obstetric-Gynecologic patients. The tool for this study was an 11 item questionnaire, including one open ended question on the patient's problem during the past one day. Data was collected through interviews and an audit of the nursing records during the period from March 22, 1992 to April 29, 1992. Data was analyzed using by frequencies and percentiles. The result of this study were summarized as follows : Pain was the most prevalent complaint for parturient women by interview(60.3% ) and from the nursing records(83.2%). There was no record in the nursing records about the complaints of lack of information and emotional problems even though there were complaints of communication problems (17.6%) and of emotional problems(3.5%) identified in the interviews but there were more records of cardiopulmonary problems in nurses record(9.1%) than the patient interviews (3.3%). In the nursing records 25.9% of the identified records identified pain problems compared with 23.3% in the interviews. In the nursing records, 22.3% of the records identified nutrition problem as compared with 18.2% in the interview. There were only a very few emotional problem identified in the nursing records (3.7%) as compared to 18.2% in the interviews. There were no comments about communication problems in the nursing records but 5.2% of the subjects mentioned of communication problems in the patient interview. There were problems in five categories for the parturient women ; comfort, communication, activity and rest, elimination, emotions, and there were problems in ten categories for the surgery patients : comfort, elimination, communication, emotions, nutrition, cardiopulmonary, thermoregulation, physical integrity, host defense and activity /rest. There were also problems in the same ten categories for chemotherapy Patients. On the other hand, in the nursing records, only comfort activity /rest, and elimination problems were identified for the parturient women, there were only seven categories of problems : comfort, elimination, cardiopulmonary, activity /rest, and nutrition for the gynecology surgical patients, and for the chemotherapy Patients, comfort, nutrition, physical integrity, cardiopulmonary, activity /rest, thermoregulation, emotion and elimination were the categories identified, and no communication problems were identified. It was found that there was low congruence between the patients' problems as identified through patient interview and as recorded in the nursing records. Therefore it can be concluded that the main content of the nursing records is the physical problems of the patients and this is not in congruence with the patients' reported problems in the emotional and communication domain.

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A Comparative Study of the Effect of Two Analgesic Administration Methods on Post Operative Pain (수술환자에 었어서 마약성 진통제의 자가투여 방법과 근육주사 방법의 효과에 대한 비교연구)

  • 이정화
    • Journal of Korean Academy of Nursing
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    • v.27 no.2
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    • pp.401-410
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    • 1997
  • An acute pain is the common experience following surgery. Pain is a most miserable experience in person and most preoperative patients have fear o! postoperative pain. In nursing, it is very important to understand and relieve the pain of post oprative patients as much as possible. This study was designed to compare the descriptive patterns of pain between group of Patient Controlled Analgesia and group of traditional Muscular Injection in surgcal patients. This information can be utilited as data of understanding nursing care and treatment planning for pain in surgical patients. The subjects in this study were 45 post-hysterectomy patients in Gynecology ward in C. N. U. H., in Taejon. Data was collected from May 12 to June 27. 1996. The instrumants used for this study were subjective Visual Analog Scale, Objedive nonverbal pain scale composed of Facial Apperance. Vocal Sound Change, and Sweating score. and the Melzack's Mcgill pain Qusetionaire. nine Items of Developmental Pain Intensity Scale by Lee En Ok. Analysis of data was done by using S. P. S. S. percentage, t-test, x²-test. ANOVA, and Repeated measure ANOVA. Results were obtained as follows. 1. Hypothesis 1 : There was very highly statistically significant difference in subjective self-report pain score(Visual Analog Scale) between PCA Group and IM Group(P=0.0001). 2. Hypothesis 2 : There was very highly statistically significant difference in muscle strength score (Visual Analog Scale) between PCA Group and IM group(P0.0001). 3. Hypothesis 3 : There was very highly statistically significant difference in facial appearance score between PCA Group and IM group(P=0.0001). 4. Hypothesis 4 : There was very highly statistically significance difference in vocal sound change score between PCA Group and IM group(P=0.0001). 5. Hypothesis 5 : There was no statistically significant difference sweating scores between PCA group and IM group(F=2.50, P=0.1220). But, postoperation time of 12, 24 was statistically difference between two groups(P=0.0001). So, it was partially supported. 6. Hypothesis 6 : There was very highly statistically significant difference in vocabulary pain score between PCA Group and IM group. 7. Hypothesis 7 : There was very highly statistically significant difference in amounts of total analgesic between PCA Group and IM group. There was very highly statistically significant difference in Visual Analog Pain Score, Facial Appearance Score, Vocal Sound Change Score, Vocabulary Score, amounts of total analgesic between PCA group and IM group. So, It is verified to asses of postoperative pain with VAS, Checklist of facia appearance, vocal sound change, and sweating, and Vocabulary Scale.

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A Study on Characteristics of Jinsatak(陳士鐸)'s Clinic Theory (진사탁(陳士鐸) 임상 이론의 특징에 관한 연구)

  • Jeong, Kyung-Ho;Kim, Ki-Wook;Park, Hyun-Guk
    • Journal of Korean Medical classics
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    • v.22 no.3
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    • pp.31-51
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    • 2009
  • The characteristics of Jin's ideas on clinic theory can be arranged as follows. 1. Jin emphasized warming and tonifying[溫補] in treatment and the part that shows this the best is the taking care of[調理] the Vital gate[命門], kidney, liver, and spleen. His ideas were based on his understanding of a human life's origin, and was influenced by Seolgi(薛己), Joheon-ga(趙獻可) and Janggaebin(張介賓)'s Vital gate and source Gi theory(元氣說) so scholastically, he has that in common with them but was later criticized by later doctors such as Oksamjon(玉三尊) as an 'literary doctor(文字醫)' who followed the ideas of "Uigwan(醫貫)". 2. The warming and tonifying school[溫補學派], who were influenced by Taoism, said in their theory of disease outbreak[發病學說] that since one must not hurt one's Yin essence and Yang fire [陰精陽火] there is more deficiency than excess, so that was why they used tonifying methods. Jin was also like them and this point of view is universal in internal medicine, gynecology, pediatric medicine and surgery and so on. 3. Jin, who saw the negative form of pulse diagnosis[診脈] emphasized following symptoms over pulse diagnosis using the spirit of ‘finding truth based on truth[實事求是]' in "Maekgyeolcheonmi(脈訣闡微)", but emphasized 'the combination of pulse and symptoms[脈證合參]'. He understood pulse diagnosis as a defining tool for symptoms, and in "Seoksilbirok(石室秘錄)" simplified pulse diagnosis into 10 methods : floating/sunken(浮沉), slow/fast(遲數), large/fine(大小), vacuous/replete(虛實) and slippery/rough(滑澀). 4. Jin used 'large formulas(大方)' a lot that usually featured a large dose, and in " Bonchosinpyeon(本草新編)" he thought of the seven formulas(七方) and ten preparations(十劑) as the standard when using medicine. He did away with old customs and presented a 'new(新)' and 'extra(奇)' point of view. He especially used a lot of Insam(人蔘) when tonifying Gi and Geumeunhwa(金銀花) when treating sores and ulcers. 5. In the area of surgery Jin gave priority to the early finding and treatment of disease with internal treatment[內治] and was against the overuse of acupuncture. However records of surgical measures in a special situation like lung abscesses(肺癰) and liver abscesses(肝癰), and anesthetic measures using 'Manghyeongju(忘形酒)' and 'Singoiyak(神膏異藥)' and opening the abdomen or skull, and organ transplants using a dog's tongue are important data. 6. Jin stated the diseases of Gi and blood broadly. Especially in the principles of treating blood, blood diseases had to be forwarded[順] and Gi regulation[理氣] was the number one priority and stated the following two treatments. First, in "Jeonggiinhyeolpyeon(精氣引血篇)" of volume 6 of "Oegyeongmieon(外經微言)", for the rules for treating blood he stated the pattern identification of finding Gi in blood and blood in Gi. Second, he emphasized Gi regulation(理氣) in blood diseases and stated that the Gi must be tonifyed after finding the source of the loss of blood.

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Body Weight at Birth and at Age Three and Respiratory Illness in Preschool Children

  • Jeong, Yool-Won;Jung-Choi, Kyung-Hee;Lee, Jin-Hwa;Lee, Hwa-Young;Park, Eun-Ae;Kim, Young-Ju;Ha, Eun-Hee;Oh, Se-Young;Park, Hye-Sook
    • Journal of Preventive Medicine and Public Health
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    • v.43 no.5
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    • pp.369-376
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    • 2010
  • Objectives: The purpose of this study was to examine the associations of current body weight and body mass index (BMI) at age three and birth weight in developing chronic respiratory illness in childhood and identify possible interaction underlying its mechanism. Methods: The study was carried out with 422 children who were enrolled in a hospital-based birth cohort. Birth related anthropometric data were collected at birth. At age 3 years, the presence of respiratory symptoms was evaluated by using the Korean version of core questionnaire for wheezing and asthma from the International Study of Asthma and Allergies in Childhood (ISAAC). Physical examination was carried out to measure the child's weight and height. Results: Children in the lowest birth weight tertile (aOR = 3.97, 95% CI = 0.94-16.68) or highest BMI tertile (aOR = 3.68, 95% CI = 1.24-10.95) at three years of age were at an increased risk of chronic respiratory illness. Children who were initially in the lowest birth weight tertile but now belong in the highest weight tertile had higher risk of chronic respiratory illness compared to those who had remained in the middle tertile (OR=16.35, 95% CI=1.66-160.57). Conclusions: Children with lower birth weight or higher BMI were at an increased risk of chronic respiratory illness. In addition, children who were initially in the lowest birth weight tertile but are now in the highest weight tertile had higher risk of chronic respiratory illness compared to those who remained in the middle tertile.

Review of 2010 Major Medical Decisions (2010년 주요 의료 판결 분석)

  • Lee, Jung-Sun;Seo, Young-Hyun;Yoo, Hyun-Jung
    • The Korean Society of Law and Medicine
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    • v.12 no.1
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    • pp.177-225
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    • 2011
  • Verdicts related to major medical litigation given by the Seoul Central District Court, the Seoul High Court and the Supreme Court in 2010 were analyzed. It's shown that in cases of the medical negligence regarding the occurrence of neonatal cerebral palsy, the plaintiff claims were dismissed using criteria proposed by associations of Obstetrics and Gynecology and Pediatrics in US, and thereof the burden of plaintiffs to prove the medical negligence has increased. In addition, in case of that the expected survival period of infants gets longer, payments for treatment and nursing after survival period determined by judges are made and it was judged to compensate it as a periodical indemnity. In case for the explanation obligation the most frequently mentioned in the medical litigation, in addition to cases of invoking the existing theory of explanation obligation, verdicts to mention the instructions of theory regarding instruction explanation obligation and the possibility of compensation for damages on property are given. Particularly, in cases for a liability of reparation by exaggerating the effects and not disclosing the risks related to treatment with stem cells, even if the treatment not approved by Food and Drug Administration is in violation of the Pharmaceutical Affairs Law, it's not illegal as violation in Pharmaceutical Affairs Law itself. But there is a certain verdict to present the possibility of an extension of the theory of explanation obligation by acknowledging the liability of reparation caused by illegal acts with no explanations of effects and risks of treatment with stem cell by doctors and pharmaceutical companies. In an incident in which a mental patient fell and died through the opened door of the roof at the hospital, a liability of reparation was acknowledged due to defects in structure installation management and this verdict drew an attention since the overall management responsibility about patients including structures was acknowledged to the hospital besides the obligations on medical practice. In case of the verdict without giving the opportunity to state the opinion with respect to the main legal issues, the responsibility of the court was emphasized since the court did not fulfill the explanation obligations. There were some cases in which payments for nursing and caring to a patient in vegetative state during the plastic surgery was admitted. However, in dental-related incidents, the proportion of cases in which plaintiff won was low since the difficulty of proving may be reflected. In the area of administrative litigation, unlike the existing position regarding arbitrary medical charge cover collected from patients in hospital, the verdict to admit the legitimacy of collection of medical treatment was given and attracted the attention of people. Verdict in which the expression related to medical advertisement was not exaggerated disposed the original verdict and pointed out the problem of excessive regulations on medical advertisement. The effort to analyze the trend of verdicts of court through reviewing the decisions and to organize should be continued, but the full decision should be disclosed as a base, and people and systems to enable the all time monitoring should be prepared.

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A Comparision of Surepath$^{TM}$ Liquid-Based Smear with a Conventional Smear for Cervicovaginal Cytology-with Reference to a Histological Diagnosis (자궁경부 조직 진단을 기준으로 Surepath$^{TM}$ 액상세포검사와 고식적 직접도말 자궁경부 세포검사법의 비교)

  • Lee, Kyung-Chul;Jung, Chan-Kwon;Jung, Eun-Sun;Choi, Yeong-Jin;Park, Jong-Sup;Lee, Kyo-Young;Lee, Ah-Won
    • The Korean Journal of Cytopathology
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    • v.18 no.1
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    • pp.20-28
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    • 2007
  • This study was performed to compare Surepath$^{TM}$ liquid-based smear and a conventional cervicovaginal smear with reference to a histological diagnosis. A hybrid capture test (HCII) was also performed and analyzed. We collected matched cases for cervicovaginal cytology-histology: 207 cases for conventional cytology (CC) and 199 cases for liquid-based cytology (LBC). HCII was performed in 254 patients. When a cytological diagnosis of ASCUS or above (ASCUS+) is classified as positive and a histological diagnosis of LSIL+ is classified as positive, the sensitivity and specificity for LBC was 91.7% and 75.9%, respectively and the sensitivity and specificity for CC was 62.6% and 96.1%, respectively. When a cytological and histological diagnosis of LSIL+ is classified as positive, the sensitivity and specificity for LBC was 77.5 and 96.6%, respectively and the sensitivity and specificity for CC was 49.7% and 100%, respectively. When a histological diagnosis of LSIL+ is classified as positive, the sensitivity and specificity for HCII was 78.9% and 78.1%, respectively. The concordance ratio between the cytological and histological diagnosis was 80.4% (kappa=76.0) for LBC and 56.5% (kappa=55.1) for CC. LBC is more sensitive and less specific then CC, as a cytological cutoff level of ASCUS, but more sensitive and equally specific, as a cytological cutoff level LSIL or HSIL. LBC is more reliable with a high concordance ratio between the cytological and histological diagnosis.

The Study on Effectiveness of Oriental Medicine Treatment for Lumbar Disc Herniation Inpatients on 208 Cases (요추 추간판 탈출증 입원환자 208례를 통한 한방치료의 효과 연구)

  • Jung, Jae-Hoon;Kim, Won-Woo;Seong, Ik-Hyun;Lee, Kap-Soo;Cho, Chang-Young;Kum, Chang-Jun;Kim, Hee-Jung;Ha, In-Hyuk
    • Journal of Korean Medicine Rehabilitation
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    • v.23 no.1
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    • pp.77-86
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    • 2013
  • This study was introduced the short-term effectiveness of Oriental medicine treatment for lumbar disc herniation inpatients. We selected 208 inpatients with a magnetic resonance imaging(MRI)-confirmed lumbar disc herniation since June 2012 until August 2012. Their demographics characterisitics, numeric rating scale(NRS) and Oswestry back-related disability index(ODI) for low or leg pain, lumbar flexion and extension angle were assessed at baseline and when discharged from the hospital. When it measured the straight leg raisingscale(SLR), the low side of the angle was examined. Treatment every patient has received as follow; herbal medicine, bee venom, acupuncture and physical examination, spinal manipulation. NRS of low back pain and leg pain and ODI is $5.6{\pm}2.3$, $4.9{\pm}2.8$ and $45.5{\pm}20.0$, respectively at baseline and $2.8{\pm}1.8$, $2.7{\pm}1.9$ and $27.2{\pm}14.1$, respectively when discharged from the hospital. range of motion(ROM) of lumbar flexion and extension angle and SLR is $70.0{\pm}27.1$, $15.4{\pm}7.2$ and $61.3{\pm}23.0$ respectively at baseline and $80.5{\pm}16.9$, $18.25{\pm}4.1$ and $73.2{\pm}14.0$, respectively when discharged from the hospital. It shows that statistically significant improved(P<0.001). Furthermore, regarding patient satisfaction with the treatment, excellent(33.7%), good(55.4%), normal(10.4%), poor(0.5%), it suggests that most patients(89%) satisfied with the treatment.

Neuroprotective Effects of Methanol Extract of Sophorae Subprostratae Radix on Glutamate Excitotoxicity in PC12 Cells and Organotypic Hippocampal Slice Cultures

  • Kim, Soo-Man;Shim, Eun-Sheb;Kim, Bum-Hoi;Sohn, Young-Joo;Kim, Sung-Hoon;Jung, Hyuk-Sang;Sohn, Nak-Won
    • The Journal of Korean Medicine
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    • v.29 no.5
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    • pp.29-40
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    • 2008
  • Objectives : It has been reported that Sophorae Subprostratae Radix (SSR) has a neuroprotective effect on cerebral ischemia in animals. In the present study, the authors investigated the neuroprotective effect of SSR on glutamate excitotoxicity. Glutamate excitotoxicity was induced by using NMDA, AMPA, and KA in PC12 cells and in organotypic hippocampal slice cultures. Methods :Methanolic extract of SSR was added at 0.5, 5, and 50 ${\mu}$g/ml to culture media for 24 hours. The effects of SSR were evaluated by measuring of cell viability, PI-stained neuronal cell death, TUNEL-positive cells, and MAP-2 immunoreactivity. Results : SSR increased PC12 cell viabilities significantly against AMPA-induced excitotoxicity, but not against NMDA-induced or KA-induced excitotoxicity. In organotypic hippocampal slice cultures damaged by NMDA-induced excitotoxicity, SSR attenuated neuronal cell death significantly in the CA1, CA3, and DG hippocampal regions and reduced TUNEL-positive cells significantly in CA1 and DG regions. In organotypic hippocampal slice cultures damaged by AMPA-induced excitotoxicity, SSR attenuated neuronal cell death and reduced TUNEL-positive cell numbers significantly in the CA1 and DG regions. In organotypic hippocampal slice cultures damaged by KA-induced excitotoxicity, SSR attenuated neuronal cell death significantly in CA3, but did not reduce TUNEL-positive cell numbers in CA1, CA3 or DG. In organotypic hippocampal slice cultures damaged by NMDA-induced excitotoxicity, SSR attenuated pyramidal neuron neurite retraction and degeneration in CA1. Conclusions : These results suggest that the neuroprotective effects of SSR are related to antagonistic effects on the NMDA and AMPA receptors of neuronal cells damaged by excitotoxicity and ischemia.

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A Prospective Study of Premenstrual Dysphoric Disorder (월경전 불쾌기분장애에 관한 전향적인 연구)

  • Kim, Ji-Yun;Joe, Sook-Haeng;Kwak, Dong-Il;Park, Yong-Kyun
    • Korean Journal of Psychosomatic Medicine
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    • v.5 no.1
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    • pp.52-62
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    • 1997
  • This study was designed to determine the frequency of premenstrual dysphoric disorder in gynecological outpatients, and also attempted to compare premenstrual change characteristics, functional impairment due to premenstrual changes and frequency of risk factors reported by women with confirmed premenstrual changes$(PMC^+)$(n=17) and those without confirmed premenstrual changes$(PMC^-)$(n=23). Forty gynecological outpatients who complained of premenstrual discomforts were asked to complete questionnaires on menstrual history, obstetric-gynecological history, and premenstrual change and functional impairment. The women were also asked to complete a daily rating form based on DSM-IV diagnostic criteria for one menstrual cycle. Absolute severity method, effect size method and percent change method were used to assess changes between follicular phase and luteal phase. The results of the study were as follows: 1) The frequency of premenstrual dysphoric disorder according to each of the three methods was 5% for the absolute severity method, 15% for the effect size method, and 27.5% for the percent change method. 2) The frequently reported symptoms were as follow: physical symptoms(64.7%) : lethargy, easy fatigability, or marked lack of energy(41.2%) : decreased interest in usual activities(29.4%) ; and marked affective lability(23.5%). 3) There were no significant differences in onset ages of premenstrual changes, regularities of premenstrual changes and changes of severity and duration of premenstrual symptoms over time between women with and without confirmed premenstrual changes. However, women with confirmed premenstrual changes reported both physical and emotional symptoms as earliest symptoms most frequently, while women without confirmed premenstrual changes reported only physical symptoms most frequently. 4) functional impairment was significantly higher in women with confirmed premenstrual changes than those without confirmed premenstrual changes, but impairment was not severe. 5) No differences were found between women with and without confirmed premenstrual changes in risk factors including demographic data, menstrual and obstetric and gynecological history. These results suggest that the prevalence of premenstrual dysphoric disorder varies with scoring methods. The women with confirmed premenstrual changes reported physical symptoms most frequently(64.7%). functional impairment was significantly higher in women with confirmed premenstrual changes, but impairment was not severe.

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