• Radiation Oncology Journal
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• 제8권2호
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• pp.241-253
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• 1990

1980.6.부터 1985.12.까지 고신의료원 치료방사선과에서 방사선 단독 치료한 병기 IIb 자궁경부암 환자 331명에 대하여 후향적으로 생존율 치료 실패 및 합병증 등에 영향을 미칠 수 있는 방사선 치료요소들을 분석조사 하였다. 5년 생존율과 무병생존율은 각각 $82.8{\%}$와 $82.4{\%}$였다. 방사선 치료 6주 경과에 분석한 골반내 관해율은 전골반 외부 조사후 강내조사한 예에서는 $98.6{\%}$였고 축소조사한 추가 치료한 예에서는 $71.6{\%}$였다. 전골반 방사선 조사후 완전관해를 보였던 예에서의 5년 생존율은 $98.9{\%}$였지만 국소치료실패 및 원격전이한 예에서는 $12.9{\%}$였다. Point A에 $7500{\~}8500$ cGy를 조사한 예에서는 $88.5{\%}$의 5년 생존율을 보였고 합병증은 $4.9{\%}$였지만 그 이상의 조사량에서는 생존율은 증가한지 않았고 합병증만 증가하였다. $18.7{\%}$(62예)에서 치료실패를 보였는데, 이중국소치료실패가 $72.6{\%}$(45예), 국소 및 골반임파 치료실패가 $3.2{\%}$(2예)였으며 원격전이 실패는 $24{\%}$(15)였다. 합병증은 $15.1{\%}$(50예)였는데 이중 $42{\%}$가 직장 출혈 및 협착이였다. Point A의 조사량은 8500 cGy가 합병증 유발의한계 조사량 이였으며 합병증의 $70{\%}$가 그 이상의 조사양에서 발생하였다. 직장 합병증은 6500 cGy이상에서 발생하였고 방광합병증은 7500 cGy이상에서 발생하였다. 사망의 원인으로는 국소치료실패로 인한 전신쇠약이 대다수였으며 전체 사망원인으로는 국소치료 실패로 인한 전신쇠약이 대다수였으며 전체 사망원인의 $73.7{\%}$였고 그외 폐, 간, 뼈 전이순이였으며 방사선합병증으로 인한 사망은 3예에 지나지 않았다. 상기와 같은 결과에 대한 결론으로 크기가 아주 큰 종양이나 Barrel형태의 종양의 방사선 치료에는 지금 많이 사용되고 있는 4000 cGy이상의 외부 조사량이 강내조사전에 골반관해를 성취하기 위해 필요한 것을 알 수 있었다.

• Journal of Trauma and Injury
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• 제18권2호
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• pp.175-178
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• 2005

Fat embolism syndrome is a collection of respiratory, neurological and cutaneous symptoms and signs associated with trauma and other disparate surgical and medical conditions. The incidence of clinical syndrome is low while the embolization of marrow fat appears to be an almost inevitable consequence of long bone fractures. The pathogenesis is a subject of conjecture and controversy. There are two theories which have gained acceptance(mechanical theory, biochemical theory). Onset of symptom is usually within 12 to 72 hours, but may manifest as early as 6 hours to as late as 10 days. The classic triad of fat embolism syndrome involves pulmonary changes, cerebral dysfunction and petechial rash. The cornerstone of treatment is preventing the stress response, hypovolemia and hypoxia and operative stabilization of fractures. Corticosteroid are the only drugs which have repeatedly shown a positive effect on the prevention and treatment of fat embolism syndrome. We report a case of post-traumatic fat embolism syndrome with severe cerebral involvement without respiratory distress. A 55 years old female had a traffic accident. She sustained pelvic bone fracture and both humerus fracture. Approximately 4 hours after the accident, mental status change developed without a focal neurologic deficits. She had no respiratory symptom and sign. Her brain MRI showed multiple cerebral fat embolism lesion. The patients received supportive treatment with corticosteroid, albumin. Her neurologic status stabilized over several days. After orthopedic surgery, she was discharged 62 days after admission.

• Journal of Chest Surgery
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• 제12권4호
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• pp.418-423
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• 1979

Chest injuries due to blunt trauma often result in severe derangements that lead to death. And we have to diagnose and treat the patients who have blunt chest trauma immediately and appropriately. A clinical analysis was made on 324 cases of chest injury due to blunt trauma experienced at department of Thoracic and Cardiovascular Surgery, College of Medicine, Kyung Hee University during 8-year period from 1972 to 1979. Of 324 patients of blunt chest injuries, there were 189 cases of rib fracture, 121 of hemothorax or/and pneumothorax, 108 of soft tissue injury of the chest wall only, 41 of lung contusion, 24 of flail chest, 13 of scapular fracture, 7 of diaphragmatic rupture and others. The majority of blunt chest injury patients were traffic accident victims and falls accounted for the next largest group of accidents. Chest injuries were frequently encountered in the age group between 3rd decade and 4th decade [60%] and 238 patients were male comparing to 86 of female [Male: Female = 3:1 ]. In the patients who have the more number of fractured ribs, the more incidence of intrathoracic injury and intraabdominal organ damage were found. The principal associated injuries were head injury on 58 cases, long bone fractures on 37, skull fractures on 12, pelvic fractures on 10, renal injuries on 6 and intraabdominal organ injuries on 5 patients. The principle of early treatment of chest injury due to blunt trauma were rapid reexpansion of the lung by closed thoracotomy which was indicated on 96 cases, but open thoractomy was necessary on 14 cases because massive bleeding, intrapleural hematoma and/or fibrothorax, or diaphragmatic laceration-On 15 cases who were young and have multiple rib fracture with severe dislocation delayed elective open reduction of the fractured ribs with wire was done on the purpose of preserving normal active life. The over all mortality was 2.8% [9 of 324 cases] due to head injury on 3 cases, massive bleeding on 2,wet lung syndrome, acute renal failure on 1 and septicemia on 1 patient.

• 성인간호학회지
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• 제14권2호
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• pp.222-232
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• 2002

Background and Purpose: After the coronary angiography procedure, patients are required to remain on bed rest to reduce the risk of bleeding and hematoma formation at the puncture site. This prolonged bed rest in the supine position is difficult for many patients, who frequently complain of low back pain. The purpose of the study was to determine whether a specially designed exercise therapy and transcutaneous electrical nerve stimulation (TENS) had an effect on the alleviation of low back pain. Method: Sixty-two patients were assigned to one of three groups : specially designed exercise therapy plus TENS plus general nursing care (exercise group N=21), general nursing care plus TENS (TENS group, N=23) or general nursing care (control group, N=18). The exercise therapy consisted of five movements including stretching, pelvic tilting, knee to chest, modified situps and trunk rotation with minimizing the motion of the puncture site. The severity of low back pain was assessed by a visual analogue scale(VAS) every two hours. The use of analgesic and any development of bleeding or other complications were monitored as well. The level of serum ${\beta}$-endorphin was determined before and after the three interventions. Result: The pain score of the exercise group was significantly lowered compared to that of the other groups. There was no difference in the serum ${\beta}$-endorphin level among three groups. Analgesic were less frequently taken by the exercise group. However the incidence of bleeding complications was not significantly different among the three groups. Conclusion: Exercise therapy is more effective than general care or TENS in alleviating low back pain of the patients with coronary angiography.

• Asian Pacific Journal of Cancer Prevention
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• 제14권2호
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• pp.849-852
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• 2013

Background: Cancer of the uterine cervix is one of the most common cancers among women worldwide. Industrialized countries have dramatically reduced the incidence of mortality from cervical carcinoma in the last 50 years through aggressive screening programs utilizing pelvic examinations and Papanicolaou (Pap) smears but it still remains a major problem in the developing world. Objectives: This study was performed to determine knowledge, attitude and practice of Pap smear as a screening procedure among nurses in a tertiary hospital in north eastern India. Material and Methods: This cross sectional study was carried out with a questionnaire survey covering the socio demographic factors, knowledge, attitude and practices about Pap smear screening among 224 nurses in Regional Institute of Medical Sciences, Imphal, Manipur, India during December 2011. Results: Two hundred and twenty one participants (98.6%) had heard about cervical carcinoma but 18.3% lacked adequate knowledge regarding risk factors. Knowledge about the Pap smear was adequate in 88.8% of the respondents. Out of these, only 11.6% had Pap smear at least once previously. The most common reasons for non-participation in screening were lack of any symptoms (58.4%), lack of counselling (42.8%), physician does not request (29.9%) and fear of vaginal examination (20.5%). Conclusion: Although knowledge of Pap smear as a screening procedure for cervical cancer is high, practice is still low. The nurses who should be responsible for opportunistic screening of women they care for are not keen on getting screened themselves. If we can improve the practice of Pap smear screening in such experts, they should be able to readily provide appropriate and accurate information and motivate the general population to join screening programs.

• 대한한의학회지
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• 제19권2호
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• pp.211-227
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• 1998

Benign Prostatic Hyperplasia(BPH) is the most common benign tumor seen in the western male, and it is found in 50% of men over 50 years of age. It is characterized by the formation of large discrete lesions in the periurethral region. As they enlarge, these nodules tend to compress the urethra and cause partial or almost complete obstruction of .urine flow. The etiology of BPH is uncertain, but the increasing incidence with advancing age suggests the possibility of an imbalance between male and female sex hormones. In the past, most patients have had multiple indications to support the decision to initiate therapy. But both the urologic surgeon and the patient must be clearly aware of the results that can be expected and the risks involved in achieving them. The aims of this study are to investigate and summarize the current trends of treatment for BPH so as to suggest the effective and available way to treat the disease. In Oriental medicine, the BPH is recognized as uroschesis and ischuria, and the etiology is mainly in stagnated blood and insufficiency of the kidneys. The point of treatment of BPH is recovery of urination, and the treatment can be approached in two ways through herb drugs and acupuncture. Some of the herb drugs have substances which reduce BPB. Acupuncture therapy stimulates the pelvic plexus and is reported to be effective for voiding. Suppository, massotherapy, rectal injection, locus injection and attachment of herb drugs to the navel or the acupoint are announced as the effective treatments. So, this study of the approach and application of these treatments on BPH would be necessary.

• Clinical and Experimental Reproductive Medicine
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• 제48권4호
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• pp.322-336
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• 2021

Objective: Endometriosis is a chronic debilitating inflammatory condition characterized by the presence of endometrial tissues outside the uterine cavity. Pelvic soreness and infertility are the usual association. Due to the poor effectiveness of the hormone therapy and the high incidence of recurrence following surgical excision, there is no single effective option for management of endometriosis. Mesenchymal stem cells (MSCs) are multipotent stromal cells studied for their broad immunoregulatory and anti-inflammatory properties; however, their efficiency in endometriosis cases is still a controversial issue. Our study aim was to evaluate whether adipose tissue-derived MSCs (AD-MSCs) could help with endometriosis through their studied anti-inflammatory role. Methods: Female Wistar rats weighting 180 to 250 g were randomly divided into two groups: group 1, endometriosis group; established by transplanting autologous uterine tissue into rats' peritoneal cavities and group 2, stem cell treated group; treated with AD-MSCs on the 5th day after induction of endometriosis. The proliferative activity of the endometriosis lesions was evaluated through Ki67 staining. Quantitative estimation of interferon γ, tumor necrosis factor-α, interleukin (IL)-6, IL-1β, IL-10, and transforming growth factor β expression, as well as immunohistochemical detection of CD68 positive macrophages, were used to assess the inflammatory status. Results: The size and proliferative activity of endometriosis lesions were significantly reduced in the stem cell treated group. Stem cells efficiently mitigated endometriosis associated chronic inflammatory reactions estimated through reduction of CD68 positive macrophages and the expression of the proinflammatory cytokines. Conclusion: Stem cell therapy can be considered a novel remedy in endometriosis possibly through its anti-inflammatory and antiproliferative properties.

• Journal of Korean Neurosurgical Society
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• 제66권1호
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• pp.33-43
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• 2023

Objective : To compare the outcomes of anterior lumbar interbody fusion (ALIF), oblique lumbar interbody fusion (OLIF), and transforaminal lumbar interbody fusion (TLIF) in terms of global sagittal alignment. Methods : From January 2007 to December 2019, 141 adult patients who underwent multilevel interbody fusion for lumbar degenerative disorders were enrolled. Regarding the approach, patients were divided into the ALIF (n=23), OLIF (n=60), and TLIF (n=58) groups. Outcomes, including local radiographic parameters and global sagittal alignment, were then compared between the treatment groups. Results : Regarding local radiographic parameters, ALIF and OLIF were superior to TLIF in terms of the change in the anterior disc height (7.6±4.5 mm vs. 6.9±3.2 mm vs. 4.7±2.9 mm, p<0.001), disc angle (-10.0°±6.3° vs. -9.2°±5.2° vs. -5.1°±5.1°, p<0.001), and fused segment lordosis (-14.5°±11.3° vs. -13.8°±7.5° vs. -7.4°±9.1°, p<0.001). However, regarding global sagittal alignment, postoperative lumbar lordosis (-42.5°±9.6° vs. -44.4°±11.6° vs. -40.6°±12.3°, p=0.210), pelvic incidence-lumbar lordosis mismatch (7.9°±11.3° vs. 6.7°±11.6° vs. 11.5°±13.0°, p=0.089), and the sagittal vertical axis (24.3±28.5 mm vs. 24.5±34.0 mm vs. 25.2±36.6 mm, p=0.990) did not differ between the groups. Conclusion : Although the anterior approaches were superior in terms of local radiographic parameters, TLIF achieved adequate global sagittal alignment, comparable to the anterior approaches.

• Childhood Kidney Diseases
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• 제13권1호
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• pp.26-32
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• 2009

목 적 : 산전 초음파 이용의 증가로 인하여 선천성 수신증 발견 빈도가 증가하고 있고 VUR이 수신증의 원인 중 하나이다. 본 연구에서는 선천성 수신증의 정도와 VUR의 연관성을 조사하여 배뇨성 방광요도 조영술의 필요성을 알아보고자 하였다. 방 법 : 2004년 1월 1일 부터 2007년 12월 31일 까지 생후 1개월 이내에 선천성 수신증이 진단된 157명의 환아 254구의 신장을 대상으로 수신증의 등급 및 신우 전후직경이 VUR의 빈도와 연관성이 있는지를 연구하였다. 통계 분석은 SPSS 16.0을 이용하여 Chi-Square 법, ANOVA 법으로 분석하였으며, P값이 0.05 미만인 경우를 통계적으로 유의한 것으로 분석하였다. 결 과 : 수신증이 있는 254구의 신장 중 7.8%에 해당하는 20구의 신장에서 VUR이 동반되었다. 수신증 등급과 신우 전후직경은 VUR의 빈도와는 의미있는 상관관계가 없었고, 좌측이 우측보다 수신증의 정도와 VUR 등급이 유의하게 높았으며 VUR이 존재하는 경우 수신증의 자연 소실률이 현저히 낮은 것으로 나타났다. 결 론 : 본 연구에서 수신증 등급과 VUR의 유무와는 통계적 유의성이 없었다. 따라서 수신증의 심한 정도에 관계없이 모든 환아에서 VUR 유무를 확인하기 위해 배뇨성 방광요도조영술은 시행되어야 한다.

• 기본간호학회지
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• 제4권1호
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• pp.73-85
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• 1997

The purpose of this study was to find out the prevalence of the urinary incontinence and it's relating factors in women. The target population is 327 community dwelling women in the age of 30-70 years old at 6 cities in Korea. The data were collected from August, 1996 to December. 1996 with interview using structured questionaire composing of items of general characteristics, obstetric characteristics, disease characteristics, situation of experiencing urinary incontinence, discomfort due to urinary incontinence, and depression. The data were analysed with $SPSS/PC^+$ program, T-test, $x^2$ test, and ANOVA test. The results obtained from this study were as follows : 1) The prevalence of urinary incontinence in women is 37.7%(130/327). 2) The mean duration of experiencing the urinary incontinence was 75.9 months and the 60% of the respondents experienced a few frequency of urinary incontinence and the most common amount of urinary incontinence(91.5%) was somewhat small expressed as 'wetting their clothes'. 3) The common factors related to the urinary incontinence were coughing, sneezing, laughing aloudly, and the activities of need for hurry. 4) The most common situations of discomforts associated with urinary incontinence were having long journey, exercise, playing, and social meeting. 5) The incidence of urinary incontinence was significantly higher in woman who had more children, older age of last delivery, more vaginal delivaries, and less c-section. 6) The incidence of urinary incontinence was not affected with the disease characteristics of the respondents, however it was higher when the women had the physical problems of constipation, abdominal laparatomy and episode of urinary catheterization than who had not. 7) The most common symptom of urinary incontinence was the frequent urine(43.1%), and the next was the urgent urine(12.3), delayed urine(9.2%). 8) 90.7% of the epsodic urinary incontinence were not treated at al, however, they wanted to try the herb medicine(41.5%), Kegel exercise(27.7%), and biofeedback(10.0%). 9) The level of Depression in the group of urinary incontinence was higher than that of non incontinence group significantly. In conclusion, as urinary incontinence in women proved severe health problem, health care providers need to develop and provide nursing intervention of urinary incontinence such as pelvic muscle exercise with bio-feedback and psychological care.