• 제목/요약/키워드: Medical indications

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융모막 융모생검 511례에 대한 임상적 연구: 10년(2000-2010년)간의 경험 (Ten-year Clinical Study of Chorionic Villus Sampling)

  • 김수현;심성한;백종우;차동현
    • Journal of Genetic Medicine
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    • 제8권1호
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    • pp.35-43
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    • 2011
  • 목적: 본원에서 최근 10년간 시행한 융모막 융모생검의 적응증에 따른 결과 및 합병증을 조사하고 현재 사용하고 있는 융모막 융모생검의 효용성을 분석해보고자 한다. 대상 및 방법: 2000년 4월부터 2010년 4월까지 최근 10년간 분당차병원 및 강남차병원에서 융모막 융모생검을 시행한 511례의 진료기록 및 검사 결과를 검토하였다. 각각의 환자에 해당되는 모든 적응증을 조사하고 중복을 허용하여 분석하였다. 태아 염색체 검사는 직접법과 배양법을 통하여 시행하였다. 결과: 각각의 적응증을 살펴보면 태아의 비후된 목덜미 두께를 포함한 비정상 초음파 소견이 294례(294/635, 46.3%)로 가장 높았다. 각각의 적응증에 따른 태아 염색체 이상의 양성예측도는 부모 중에 염색체 이상이 있는 경우가 66.7%(14/21)로 가장 높았다. 융모막 융모생검 상 모자이시즘은 3.1% (16/509)였고, 그 중에서 양수검사로 확인된 진모자이시즘은 2례, 태반에 국한된 모자이시즘은 11례였다. 융모막 융모생검 이후 4주 이내에 임신 종결된 경우는 6례로 태아손실률은 1.2% (6/511)였다. 결론: 융모막 융모생검은 산전 유전진단을 하는데 있어서 적합하고 신뢰할 수 있는 시술이다. 융모막 융모생검 결과 모자이시즘을 보이는 경우 반드시 양수검사를 통하여 진모자이시즘인지 태반에 국한된 모자이시즘인지 확인이 필요하다.

고맹(膏盲)과 고맹유(膏盲兪)에 관(關)한 문헌적(文獻的) 고찰(考察) (A STUDY ON GO-HWANG(膏盲) AND GO-HWANG-SU(膏盲兪))

  • 소재진;이윤호;김창환
    • Journal of Acupuncture Research
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    • 제20권5호
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    • pp.28-37
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    • 2003
  • Objective & Methods: In order to ascertain the names. locations. the way of getting acu-point and indications for moxibustion about Ko-Hwang(膏盲) and Go-Hwang-Su(膏盲兪). I have translated the text for Ko-Hwang(膏盲) and Go-Hwang-Su(膏盲兪) collected in several relative classical books. and performed literal investigation about it. Through the study, the following results are obtained. Results & Conclusions: 1. The two words Go(膏) and Hwang(盲) have different concepts each other originally. and Go-Hwang(膏盲) is the abbreviation of the words "Upon the Hwang(盲), Under the Go(膏)", which means "A gap of Heart and diaphragm" that is under the heart and on the diaphragm 2. Go-Hwang-Su(膏盲兪) is the acu-point which can treat the diseases located in the gap of Go(膏) and Hwang(盲), so they must not be named as Go-Hwang(膏盲) or Go-Hwang-Hyui(膏盲穴). 3. The origination of Go-Hwang-Su(膏盲兪) is speculated as the interval of Hwang-Bo-Mil(皇甫謐) and Son-Sa-Mak(孫思邈). And I think it had been created by Son-Sa-Mak(孫思邈) up to now. 4. The words "Four ribs and Three spaces(四肋三間)" those are founded in the text of The Entrance of Medicine(醫學入門) and The Great Success on Acupuncture and Moxibustion(針灸大成) are either the words those had been quoted from The Bible of Helping Life by Acupucture and Moxibustion(針灸資生經) in wrong way. or the misunderstanding of the original mind of Son-Sa-Mak(孫思邈) as being quoted in the text. So you should know it exactly as Son-Sa-Mak(孫思邈) had said. 5. When you search the acu-point Go-Hwang-Su(膏盲兪), you must pull the arms of patients forwardly to reveal the acu -point. because it is covered by the scapula in normal posture. 6. The indications for the use of Go-Hwang-Su(膏盲兪) are same as mentioned in this study. And it can grow the Yang-Gi(陽氣) more prosperous.

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고관절치환술 후의 Rivaroxaban의 국내임상적용 (Rivaroxaban in Patients Undergoing Hip Arthroplasty in Korean Patients: Implications in Clinical Practice)

  • 유옥리;나현오;이정연
    • 한국임상약학회지
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    • 제24권1호
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    • pp.1-8
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    • 2014
  • Objective: Currently, rivaroxaban is widely used clinically for thromboprophylaxis after surgery. However, there are concerns on effectiveness and safety of rivaroxaban for its proper use. We aimed to evaluate the effectiveness and safety of rivaroxaban in orthopaedic patients after total hip replacement surgery in a large medical centre after the preferred formulary was switched from enoxaparin to rivaroxaban. Methods: The study was conducted on the patients who underwent hip arthroplasty surgery at the department of Orthopaedic Surgery at Seoul St. Mary's Hospital, South Korea. Electronic medical records were retrospectively reviewed to identify patients treated with rivaroxaban following total hip replacement between February 2011 and March 2012. Evaluation criteria included indications for use, dose, initiation and duration of therapy, drug interactions, adverse reactions, and status of health care reimbursement. The patients who were on enoxaparin were also reviewed as a reference. Results: We identified 57 patients who received rivaroxaban and 50 who received enoxaparin. All patients were prescribed the drugs for Korean Food and Drug Administration-approved indications. No thromboembolic or bleeding events were observed in either group. However, only 5.3% of rivaroxaban- treated patients had an appropriate length of prophylaxis and only 3.5% began rivaroxaban treatment at the recommended time. Surprisingly, 47.4% of rivaroxaban-treated patients received rivaroxaban despite being ineligible for reimbursement benefits. Conclusion: Rivaroxaban was generally well tolerated clinically. However, the duration of treatment, the time of initiation and patient eligibility for reimbursement require improvements, emphasising the need for education which indicates the area of pharmacists' involvement.

Update on genetic screening and treatment for infertile men with genetic disorders in the era of assisted reproductive technology

  • Lee, Seung Ryeol;Lee, Tae Ho;Song, Seung-Hun;Kim, Dong Suk;Choi, Kyung Hwa;Lee, Jae Ho;Kim, Dae Keun
    • Clinical and Experimental Reproductive Medicine
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    • 제48권4호
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    • pp.283-294
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    • 2021
  • A genetic etiology of male infertility is identified in fewer than 25% of infertile men, while 30% of infertile men lack a clear etiology, resulting in a diagnosis of idiopathic male infertility. Advances in reproductive genetics have provided insights into the mechanisms of male infertility, and a characterization of the genetic basis of male infertility may have broad implications for understanding the causes of infertility and determining the prognosis, optimal treatment, and management of couples. In a substantial proportion of patients with azoospermia, known genetic factors contribute to male infertility. Additionally, the number of identified genetic anomalies in other etiologies of male infertility is growing through advances in whole-genome amplification and next-generation sequencing. In this review, we present an up-to-date overview of the indications for appropriate genetic tests, summarize the characteristics of chromosomal and genetic diseases, and discuss the treatment of couples with genetic infertility by microdissection-testicular sperm extraction, personalized hormone therapy, and in vitro fertilization with pre-implantation genetic testing.

만성 족관절 불안정증에서 건이식을 이용한 외측 인대 재건술의 적응증 (The Indication of Ankle Lateral Ligament Reconstruction Using Tendon Graft in Chronic Ankle Instability)

  • 박재용;최기원;조재호;강찬;최경진;정진화;김학준;배서영;차승도;김기천;한승환;2015 대한족부족관절학회 보험장애판정위원회
    • 대한족부족관절학회지
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    • 제20권1호
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    • pp.12-18
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    • 2016
  • Purpose: The purpose of this study is to review the indications of ankle lateral complex reconstruction using tendon graft. Materials and Methods: We searched PubMed using the index, "ankle, instability, lateral ligament, reconstruction" from 1990 to present (September 30, 2015). We excluded 1) modified Brőstrom operation (MBO), 2) conventional tenodesis surgery, 3) review article, 4) technical note, and 5) articles written in another foreign language. We reviewed 24 papers through the publication events, operational method, the indications of surgery, and the specific features of the patient group. Results: There were the indications of 1) previous ligament surgery failure, 2) situation when ligament repair is impossible due to the ligament defect, 3) severe instability (preoperative talar tilt >$15^{\circ}$, anterior draw >10 mm or the difference of contralateral side talar tilt >$5^{\circ}$, anterior draw >3 mm), and 4) overweight (body mass index >$30kg/m^2$). Other considerations included 1) generalized joint laxity and 2) workers, highly-demanded or athlete highly-affected by instability. Conclusion: The ankle lateral complex reconstruction using tendon graft could be indicated in patients with the possibility of MBO failure with several considerations.

'맥상(脈狀)의 환측(患側)' 취혈(取穴)과 침(鍼) 치료(治療) 경과 확인 기준으로서의 촌구맥진(寸口脈診)의 의의(意義) (Significance of Chongu pulse diagnosis as the standard of measuring the result of the acupuncture on 'The affected part of the pulse wave')

  • 심소현;강민정;김재규;백진웅
    • 대한한의학원전학회지
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    • 제27권1호
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    • pp.47-56
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    • 2014
  • Objective : The aim of this study is to find out the significance of Chongu pulse diagnosis as the standard of measuring the result of the acupuncture on 'the affected part of the pulse wave' based on the literature. Method : (1) The clear concepts of the 'unaffected part' and the 'affected part' were organized. (2) The relation between the pulse diagnosis and the acupuncture in Hwangjenaekyung was studied. (3) The indications of Mu acupuncture treatment(繆刺法) and Geo acupuncture treatment(巨刺法) in Hwangjenaekyung was studied. (4) The types and changes of pulse diagnosis in Hwangjenaekyung was studied, especially based on the relation between Sambuguhu pulse diagnosis(三部九候脈診) and Chongu pulse diagnosis(寸口脈診). (5) By synthesizing these results, the significance of Chongu pulse diagnosis as the standard of measuring the result of the acupuncture on 'the affected part of the pulse wave' was found. Result & Conclusion : 1. When the affected part and the unaffected part are defined, it is necessary to make clear that which one of next three definitions is used ; Firstly, 'the broad sense of definition of the affected part and the unaffected part of the symptom', which contains the pulse wave. Secondly, 'the narrow sense of definition of the affected part and the unaffected part of the symptom', without the pulse wave. And thirdly, 'the definition of the affected and the unaffected part of the pulse wave', which has the only independent standard of the pulse wave. 2. Geo acupuncture treatment(巨刺法) is an acupuncture treatment which means the needling on 'the affected part of the pulse wave' based on Sambuguhu pulse diagnosis (三部九候脈診), and Mu acupuncture treatment(繆刺法) is an acupuncture treatment which means the needling on 'the unaffected part of the symptom based on the narrow sense of the definition'. The range of the indications of Mu acupuncture treatment(繆刺法) and Geo acupuncture treatment(巨刺法) contains most of the diseases which contains Rakbyung(絡病), Kyungbyung(經病) and Ojangbyung(五臟病). 3. Chongu pulse diagnosis(寸口脈診) contains not only the range of the indications of Sambuguhu pulse diagnosis(三部九候脈診), but also most of the diseases. 4. From synthesizing these results of the study on the literature, we infer that Chongu pulse diagnosis as the standard of measuring the result of the acupuncture on 'the affected part of the pulse wave' is significant.

소아서혜부탈장의 선택적 편대측 시험절개 (Selective Contralateral Exploration in Pediatric Inguinal Hernia)

  • 이명덕
    • Advances in pediatric surgery
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    • 제1권1호
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    • pp.18-26
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    • 1995
  • For the prevention of later contralateral hernia as well as unnecessary contralateral exploration in pediatric patients with unilateral inguinal hernias, a reasonable indication of contralateral exploration is required. To examine the contralateral positivity, a prospective selective contralateral exploration has been performed by the author from Sept. 1985 to Dec. 1993, at Pediatric Surgical Section of the Department of Surgery, Kangnam St. Mary's Hospital, Catholic University Medical College. Among the total 1200 cases of pediatric inguinal hernias, 580 cases of contralateral side were explored at hernia operations, by the indications as; male with infant onset, 2)female of all age, 3)prematurity, 4)profuse ascites due to cirrhosis, nephrotic syndrome, and ventriculoperitoneal shunt, and 5)remarkable silk sign. Overall positive rate was 71.4%, and positive rates of each indication were 80.7%, 70.4%, 73.1%, 66.7%, and 72.0%, respectively. Right side hernia showed 67.0%, left s ide 75.7%, and positive familial history 71.8% of contralateral positivities. In male, getting older revealed lower positive rates and the rate suddenly dropped after 12 years of age. Birth order, mother's age at delivery, postmaturity did not show any significant differences between the rates. Recurrence was seen in 3(0.5%) ipsilateral and 2(0.3%) contralateral, both of which were negative esplorations on previons operations. Overall complication rate was 3.8%, including 1 infection, 14 fluid or blood accumulation, 5 edemas, 3 temporary testicular edemas, 2 persisting fevers, 2 enures is and one delayed recovery from anesthesia. Among 38 cases with contralateral hernias developed after unilateral surgery by authors(6 cases) or surgeons in other institutions, 14 were males with infant onset, 4 were prematurities and 9 were females. Therefore, 27(71.7%) cases were originally under the contralateral exploration indications. The primary site of the hermia was right in 25 and left in 13. With above results, the following indications for contralateral exploration could be suggested ; 1)under one year of age, both sex, 2)prematurity, 3) remarkable silk sign, 4)in the double checked suspicions among males with infant onset, all age females, ascites, left hernia and familial history. After 12 years of age, exploration is not required. Considering complications, contralateral explorations could be considered only in the following situations; 1)expert, experienced pediatric surgeon, 2)experienced pediatric anesthesiologist, 3)operations could be done smoothly in an hour, 4)good general condition of the patient.

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슬관절의 연골결손에 대한 자가 골연골 이식술 (Mosaicplasty for the Treatment of the Chondral Defect of the Knee)

  • 최남홍
    • 대한정형외과스포츠의학회지
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    • 제4권1호
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    • pp.12-17
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    • 2005
  • 슬관절의 연골 결손에 대한 치료로 여러가지 방법이 시행되어 왔는데, 기존의 방법들은 치 유된 결손 부위가 섬유연골로 덮히는 것으로 알려져 있다. 최근 시행되는 자가 골연골 이식술과 자가 연골세포 이식술은 결손 부위가 대부분 초자연골로 덮힌다고 알려져 있다. 이 논문에서는 자가 골연골 이식술의 기초적 연구, 적응증, 수술 기법, 수술 후 결과를 기술하고자 한다.

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Orbital Floor Fracture

  • Kim, Hyo Seong;Jeong, Eui Cheol
    • 대한두개안면성형외과학회지
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    • 제17권3호
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    • pp.111-118
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    • 2016
  • The medial wall and floor of the bony orbit are frequently fractured because of the delicate anatomy. To optimize functional and aesthetic results, reconstructive surgeons should understand the anatomy and pathophysiology of orbital fractures. Appropriate treatment involves optimal timing of intervention, proper indications for operative repair, incision and dissection, release of herniated tissue, implant material and placement, and wound closure. The following review will discuss the management of orbital floor fractures, with the operative method preferred by the author. Special considerations in operation technique and the complication are also present in this article.

슬관절의 연골결손에 대한 자가 골연골 이식술 (Mosaicplasty for The Treatment of the Chondral Defect of The Knee)

  • 최남홍
    • 대한관절경학회지
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    • 제12권3호
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    • pp.147-153
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    • 2008
  • 슬관절의 연골 결손에 대한 치료로 여러가지 방법이 시행되어 왔는데, 기존의 방법들은 치유된 결손 부위가 섬유연골로 재생되는 것으로 알려져 있다. 최근 시행되는 자가 골연골 이식술과 자가 연골세포 이식술은 결손 부위가 대부분 초자연골로 재생된다고 알려져 있다. 이 논문에서는 자가 골연골 이식술의 기초적 연구, 적응증, 수술 기법, 수술 후 결과를 기술하고자 한다.

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