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자궁외 임신 환자의 임상적 고찰

  • 신현선
    • Journal of Korean Academy of Nursing
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    • v.1 no.1
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    • pp.64-76
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    • 1970
  • This report will present a clinical and statistical analysis of 210 case of Ectopic pregnancies who were treated at the Department of Obstetrics and Gynecology at Chung Nam Medical Center from January, 1966 to March, 1970. The results obtained are as follows; 1. The total number of Ectopic pregnancies was 8.22%. 2. The occurrence of Ectopic pregnancy was high in June(13.81%), low in October(2.98%). There was a higher occurrence of Ectopic pregnancy in the summer than in the winter. 3. The average age of all patients was 33.25 years. The most frequent age for this type of pregnancy was 31-35 years (32.86%) . The youngest patient was 18 years old and the oldest was 50. 4. Multipara occurred in 82.38% of the cases; Mulipara in 17. 62% and the occurrence of primipara was especially high, 20.95%. 5. 48.09% of the women had previously experienced normal deliveries; 42.8% had received artificial abortions and 5.23% had experienced spontaneous abortions. 3.8% had a previous history of Ectopic pregnancy. It was found that the occurrence of Ectopic pregnancy was more frequent in those women who had a D & C in the Past. 6. The average length of infertility was 21.7 months. The shortest length was 60 days; longest period of infertility was 19 years. 7. The occurrence of Ectopic pregnancy is higher (29.27%) in patient who have experienced only one previous D & C. The total number of patients who received a D & C was 58.57%. 3. Ectopic symptoms appeared during the first 4.7 weeks (mean) and most frequently occurred between the 5th and 6th weeks (48.57%) of pregnancy. The Symptoms were: -99.04% complained of lower abdominal pains. -80.95% experienced abnormal uttering bleeding. -42.38% experienced bleeding before the occurrence of pain. -18.57% experienced pain before the occurrence of bleeding. -8.57% experienced both pain and bleeding. -7.62% experienced only bleeding. -22.86% experienced only pain. 9. In-77.62% of the cases the annexal mass palpated. 91.42% complained of abdominal tenderness. 42.38% complained of pain when the cervix was examined. 10. Culdocentesis was performed in 86.19% of the cases. In 92.82% of the cases the presence of an Ectopic pregnancy was accurately diagnosed 11. 71.90% of the Ectopic pregnancies occurred in the ampule portion of the ovarian tube, of the total number of gestations, 40.95% were tubal abortions and 59.05% were ruptured. The ruptured group occurred more frequently in the islamic portion and interstitial portion of the tube than the aborted group. The aborted group occurred more frequently in the fimbrial extremities of the tube. 12. The blood pressure (systolic) was noted at 119-80mmHg in 81.89% of the total cases. Hemoglobin value was noted at over 8gm/㎗ in 58.57% of the cases. The average blood transfusion was 2.3 pints. 13. In 52.86% of the Ectopic pregnancies the right side of the ovarian tube was affected. The left side of the tube was affected in 47.14% of the cases. 14. 3.33% of the patients were not given an accurate diagnosis. 15. The kinds of operation performed were as follows; Salpingectomy, 41.43%; Adnectomy, 38.57% and Adnectomy with total hysterectomy, 19.05%. 16. The patient mortality rate was significantly small; only 1 case out of 210 died. This patient most likely had a profuse hemorrhage because of a ruptured tube before her admission to the hospital. 17. The patients personal feelings and attitudes must be treated with care. Particularly patients who are concerned about vaginal bleeding or the impossibility of another pregnancy.

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The Graft-take and Growth of Grafted Peppers (Capsicum annuum L.) Affected by Temperature, Relative Humidity, and Light Conditions During Healing and Acclimatization (접목활착 기간 중 온도.상대습도 및 광조건이 고추 접목묘의 활착 및 생육에 미치는 영향)

  • Jang, Yoon-Ah;Moon, Ji-Hye;Lee, Ji-Weon;Kim, Seung-Yu;Chun, Chang-Hoo
    • Journal of Bio-Environment Control
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    • v.18 no.4
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    • pp.385-392
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    • 2009
  • This study was performed to evaluate the influence of temperature, relative humidity, and light conditions during healing and acclimatization on the graft-take and growth of grafted peppers (Capsicum annuum L.), in order to propose optimum environmental conditions for the healing and acclimatization of grafted peppers. The healing and acclimatization period was for six days and was divided into three stages (Stage I, II and III), of which each period was two days. Grafted peppers were healed under the condition of 30 and 95% relative humidity (RH) during Stage I. During Stage II and III, grafted peppers were healed and acclimatized under different temperatures ($20^{\circ}C$, $25^{\circ}C$, or $30^{\circ}C$) and RH conditions (75%, 85% or 95%). The growth of grafted peppers was greater under lower temperature and lower relative humidity conditions. The graft-take just after the end of healing and acclimatization was greater grafted peppers under high RH condition. However, the graft-take of peppers which were healed and acclimatized under $30^{\circ}C$ and RH 95%, dropped by about 10 percent on day seven after healing and acclimatization. And also, grafted peppers were healed and acclimatized under the different temperatures ($25^{\circ}C$ or $30^{\circ}C$), RH conditions (65%, 75% or 85%), and light condition (dark or light). Lower RH (to 65%) and light condition at $25^{\circ}C$ during healing and acclimatization promoted the graft-take and growth of grafted peppers.

Analysis of a Groundwater Flow System in Fractured Rock Mass Using the Concept of Hydraulic Compartment (수리영역 개념을 적용한 단열암반의 지하수유동체계 해석)

  • Cho Sung-Il;Kim Chun-Soo;Bae Dae-Seok;Kim Kyung-Su;Song Moo-Young
    • The Journal of Engineering Geology
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    • v.16 no.1 s.47
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    • pp.69-83
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    • 2006
  • This study aims to evaluate a complex groundwater flow system around the underground oil storage caverns using the concept of hydraulic compartment. For the hydrogeological analysis, the hydraulic testing data, the evolution of groundwater levels in 28 surface monitoring boreholes and pressure variation of 95 horizontal and 63 vertical water curtain holes in the caverns were utilized. At the cavern level, the Hydraulic Conductor Domains(fracture zones) are characterized one local major fracture zone(NE-1)and two local fracture zones between the FZ-1 and FZ-2 fracture zones. The Hydraulic Rock Domain(rock mass) is divided into four compartments by the above local fracture zones. Two Hydraulic Rock Domains(A, B) around the FZ-2 zone have a relatively high initial groundwater pressures up to $15kg/cm^2$ and the differences between the upper and lower groundwater levels, measured from the monitoring holes equipped with double completion, are in the range of 10 and 40 m throughout the construction stage, indicating relatively good hydraulic connection between the near surface and bedrock groundwater systems. On the other hand, two Hydraulic Rock Domains(C, D) adjacent to the FZ-1, the groundwater levels in the upper and lower zones are shown a great difference in the maximum of 120 m and the high water levels in the upper groundwater system were not varied during the construction stage. This might be resulted from the very low hydraulic conductivity$(7.2X10^{-10}m/sec)$ in the zone, six times lower than that of Domain C, D. Groundwater recharge rates obtained from the numerical modeling are 2% of the annual mean precipitation(1,356mm/year) for 20 years.

A Study on Smoking among Korean Rural Residents (일부(一部) 농촌주민(農村住民)들의 흡연(吸煙)에 관(關)한 조사(調査))

  • Kang, Pock-Soo;Lee, Sung-Kwan
    • Journal of Preventive Medicine and Public Health
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    • v.13 no.1
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    • pp.77-86
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    • 1980
  • The present study was conducted to investigate smoking status and the relationship of smoking to hypertension and diseases on 1,504 subjects who were over 30-year-old age in Kyungsan Gun, Kyungpook province, during the period of 12 months from March 1978 to February 1979. The results obtained are summarized as follows: Of 1,504 subjects, 52.2 percent smoked. The percentage of males smoking showed 84.8 and the percentage of females was 30.7. There were no statistically significant differences between the rate of smoking and educational levels. Protestants demonstrated lower rates of smoking compared with other groups. Regarding the age started to smoke, 66.4 precent of male smokers and 16.9 percent of female smokers commenced smoking before the age of 19. In the regard to the average number of cigarettes smoked daily, 45.8 percent of male smokers consumed some 20 cigarettes and 24.1 percent of female smokers consumed some 10 cigarettes. 3.2 percent of male smellers smoked 40 or more cigarettes a day. Alcohol consumption was closely associated with smoking. 90.7 percent of male alcohol drinkers and 60.1 percent of female drinkers smoked. Cigarette smokers have higher rates of ailments than nonsmokers as a whole. The complaints of cough with sputum and shortness of breath revealed higher rates among smokers than among nonsmokers. Frequency of illnesses showed higher for smokers than for nonsmokers. Smokers were more likely than nonsmokers to suffer from chronic obstructive lung diseases such as chronic bronchitis, asthma, and emphysema. Abnormal systolic blood pressure (>160mmHg) and diastolic (>100) revealed significantly higher among smokers than among nonsmokers.

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The Optimal Pulse Oxygen Saturation in Very Low Birth Weight or Very Preterm Infants (극소 저체중 출생아에서 경피적 산소포화도의 적정 범위)

  • You, Sun-Young;Kang, Hye-Jin;Kim, Min-Jung;Chang, Mea-Young
    • Neonatal Medicine
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    • v.18 no.2
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    • pp.320-327
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    • 2011
  • Purpose: To determine the effect of changing practice guidelines designed to avoid hyperoxia or hypoxia in very low birth weight or very preterm infants. Methods: We analyzed a database of <1,500 g birth weight or <32 weeks of gestation infants who were born and admitted to the neonatal intensive care unit of Chungnam National University Hospital from January 2007 to July 2010. First, we defined the relationship between arterial partial pressure of oxygen ($PaO_2$) and pulse oxygen saturation ($SpO_2$). When we evaluated 96 pairs of $PaO_2$ and $SpO_2$ measurements, oxygen saturation was 90-94% at a $PaO_2$ of 43-79 mmHg on the oxyhemoglobin dissociation curve, according to pulse oximetry. Based on this observation, a change in practice was instituted in August 2008 with the objective of avoiding hypoxia and hyperoxia in preterm infants with targeting a $SpO_2$ 90-94% (period II). Before the change in practice, high alarms for $SpO_2$ were set at 100% and low alarms at 95% (period I). Results: Sixty-eight infants the met enrollment criteria and 38 (56%) were born during period II, after the change in $SpO_2$ targets. Demographic characteristics, except gender, were similar between the infants born in both periods. After correcting for the effect of confounding factors, the rates for mortality, severe retinopathy of prematurity, and IVH attended to be lower than those for infants in period II. No difference in the rate of patent ductus arteriosus needed to treat was observed. Conclusion: A change in the practice guidelines aimed at avoiding low oxygen saturation and hyperoxia did not increase neonatal complication rates and showed promising results, suggesting decreased mortality and improvements in short term morbidity. It is still unclear what range of oxygen saturation is appropriate for very preterm infants but the more careful saturation targeting guideline should be considered to prevent hypoxemic events and hyperoxia.

Effects of Supplemental Lighting on Growth and Yield of Sweet Pepper (Capsicum annuum L.) in Hydroponic Culture under Low Levels of Natural Light in Winter (동계시설내 보광이 수경재배 착색단고추(Capsicum annum L.)의 생육에 미치는 영향)

  • Kim, Yong-Bum;Bae, Jong-Hyang;Park, Me-Hea
    • Horticultural Science & Technology
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    • v.29 no.4
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    • pp.317-325
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    • 2011
  • This study was conducted to examine the effect of supplemental lighting on the growth and yield of hydroponically grown sweet pepper (Capsicum annuum L. cv. sprit) under low levels of natural light in winter. The plants were treated with natural light only (control), 3-hour supplemental lighting before sunrise, after sunrise and after sunset with high pressure sodium (HPS, 400W). As the result of these three treatments, the supplemental lighting promoted photosynthesis in the low light intensity condition and particularly photosynthesis was more active right after sun rise in the morning, 1.5-$3.0{\mu}molCO_2{\cdot}m^{-2}{\cdot}s^{-1}$ comparing to those of supplemental lighting after sunset, 0.5-$1.5{\mu}molCO_2{\cdot}m^{-2}{\cdot}s^{-1}$. Transpiration rate and stomatal conductance sharply increased with supplemental lighting after sunrise then they decreased again after turning the lights off. Stomatal size was observed $32.2{\mu}m^2$ after supplemental lighting, whereas the size of the natural light was almost closed at $7.7{\mu}m^2$. The average plant height of sweet papper cv. spirit was 185 cm before sunrise, 188 cm after sunrise and 208 cm after sunset with supplemental lighting for 3hours while the control was 171 cm. With supplemental lighting a better number of fruit set per plant was measured 4.3 before and after sunrise, 3.7 after sunset but 2.6 in the control. Interestingly, there were no significant differences in the sugar content ($^{\circ}Brix$) degree between treatment of supplemental lighting, whereas slight differences between seasons were seen. The marketable fruit yield of sweet pepper (cv. spirit) was $116.0kg{\cdot}ha$ with supplemental lighting, whereas the control (natural light only) was $75.8kg{\cdot}ha$. Despite of spending electricity and depreciation cost, the economic analysis showed net income with supplemental lighting after sunrise was 51% higher than control treatment in cv. spirit.

Effect of FSH Pretreatment on Follicle Development and Oocyte Recovery by Ultrasound-guided Aspiration in Holstein Heifers (젖소의 초음파 유도 채란율에 대한 FSH 전처리 효과의 비교)

  • Park, Chung-Saeng;Jo, Seong-Geun;Lee, Jeong-Gyu;Gang, Tae-Yeong;Park, Seong-Jae;Gong, Il-Geun;Choe, Min-Cheol
    • Korean Journal of Animal Reproduction
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    • v.21 no.2
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    • pp.147-156
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    • 1997
  • Ultrasound-guided follicular aspiration was performed in Holstein heifers once weekly with or without pretreatment of single or multiple decreasing doses using a total of 400 mg FSH. Oocytes were aspirated with a 6.5 MHz convex-array ultrasound trasducer designed for intravaginal use. All the visible follicles larger than 4 mm in diameter were punctured with a 17 gauge, 55 cm needle at each aspiration session and the follicular fluids containing oocytes were obtained by vacuum suction. The results obtained were as follows: As a preliminary experiment, the recovery rates of folicular oocytes by ultrasound-guided aspiration from the isolated ovaries of Korean native cows were compared between suction methods using manual syringe or vacuum pump. The recovery rate of oocytes using vacuum pump (80.7%) was significantly (P<0.05) higher than that using manual syringe (47.1%). The follicles were counted by their size in diameter with ultrasound image, and recovery rates and grades of follicular oocytes collected by ultrasound-guided aspiration were investigated in Holstein heifers pretreated with or without FSH. A group of heifiers were injected with multiple decreasing doses (twice a day for 3 days) of a total of 400 mg FSH. The other 2 groups were injected with a single dose of 400 mg FSH mixed with 25% PVP. Ultrasound observation of follicle population and/or ultrasound-guided transvaginal oocyte aspiration were performed 12 hrs following the last FSH injection in the multiple dose group, and 48 or 60 hrs after FSH injection in the single dose groups. Most of the visible follicles had small size of less than 3 mm in diameter in unstimulated heifers (71.0%), but medium size in all the heifers treated with FSH. (70.5 to 92.8%). The number of OPU follicles per session (4.6$\pm$1.9) were much less, compared to the vilsible follicle counts (9.7$\pm$2.2), in the nustimulated heifers due to the small dominant follicles. Among 4 goups of heifers the most visible as well as OPU follicles were observed in the heifers at 60 hrs following treatment of a single dose of 400 mg FSH (21.2$\pm$2.3 and 21.0$\pm$2.0), and the differences in both the follicle counts between the groups was found significant (P<0.05) The rates of oocyte recovery from the follicles by ultrasound-guilded aspiration were varied 46.3 to 75.0% in the heifers unstimulated and treated with a single dose of 400 mg FSH, but the group difference was not significant. The number of recovered oocytes per session a, pp.ared to be highest at aspiration at 60 hrs following single FSH (10.6$\pm$2.2) than at aspiration at 48 hrs after single FSH (7.8$\pm$2.7) or in the unstimulated heifers (3.4$\pm$3.0). The proportion of grade I and II oocytes to all oocytes collected was varied 31.8 to 64.0% between the groups. However, there was found no significant difference in both the number of oocytes recovered per session and the percentage and the percentage of grade I and II oocytes. From the above results it was concluded that the more oocytes of superior quality might be recovered economically by ultrasound-guided aspiration at 60 hrs following the pretreatment of a single dose of 400 mg FSH and by suction using a vacuum pump system of about negative pressure of 75 to 85 mmHg.

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Recovery Trajectory in Tachycardia Induced Heart Failure Model (빈맥을 이용한 심부전 모델에서 회복궤도)

  • 오중환;박승일;원준호;김은기;이종국
    • Journal of Chest Surgery
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    • v.32 no.5
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    • pp.422-427
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    • 1999
  • Background: Tachycardia induced heart failure model would be the model of choice for the dilated cardiomyopathy. This more closely resembles the clinical syndrome and does not require major surgical trauma, myocardial ischemia and pharmacological or toxic depression of cardiac function. When heart failure is progressive, application of new surgical procedures to the faling heart is highly risky. It has been shown that recovery trajectory from heart failure is a new method in decreasing animal mortality. The purpose is to establish the control datas for recovery trajectory in the canine heart failure model. Material and Method: 21 mongrel dogs were studied at 4 stages(baseline, at the heart failure, 4 and 8 weeks after recovery). Heart failure was induced during 4 weeks of continuous rapid pacing using a pacemaker. Eight weeks of trajectory of recovery period was allowed. Indices of left ventricular function and dimension were measured every 2 weeks and the hemodynamics were measured by use of Swan-Ganz catheterization and thermodilution method every 4 weeks. Values were expressed as mean${\pm}$standard deviation. Result: 4(20%) dogs died due to heart failure. Left ventricular end-diastolic volume at the 4 stages were 40.8${\pm}$7.4, 82.1${\pm}$21.1, 59.9${\pm}$7.7 and 46.5${\pm}$6.5ml. Left ventricular end-systolic volume showed the same trend. Ejection fractions were 50.6${\pm}$4.1, 17.5${\pm}$5.8, 36.3${\pm}$7.3, and 41.5${\pm}$2.4%. Blood pressure and heart rate showed no significant changes. Pressures of central vein, right ventricle, pulmonary artery, and pulmonary capillary wedge showed significant increase during the heart failure period, normalizing at the end of recovery period. Stroke volumes were 21.5${\pm}$8.2, 12.3${\pm}$3.5, 17.9${\pm}$4.6, and 15.5${\pm}$3.4ml. Blood norepinephrine level was 133.3${\pm}$60.0pg/dL at the baseline and 479.4${\pm}$327.3pg/dL at the heart failure stage(p=0.008). Conclusion: Development of tachycardia induced heart failure model is of high priority due to ready availability and reasonable amenability to measurements. Recovery trajectory after cessation of tachycardia showed reduction of cardiac dilatation and heart function. Application of new surgical procedures during the recovery period could decrease animal mortality.

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Experimental and Clinical Study of Staple-Line Reinforcement Using Expanded Polytetrafluoroethylene in Thoracoscopic Bullectomy for Spontaneous Pneumothorax (자연 기흉 환자에서 봉합선 보강이 흉강경 폐부분 절제술에 미치는 영향: 동물실험 및 임상연구)

  • 문석환;심성보;왕영필;윤정섭;조건현;박재길;박만실;최시영;곽문섭
    • Journal of Chest Surgery
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    • v.36 no.12
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    • pp.904-910
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    • 2003
  • Thoracoscopic bullectomy (VATS-B) is now the preferred treatment for spontaneous pneumothorax despite of higher recurrence rate than open thoracotomy. Several methods have been used to prevent this problem. The effectiveness of staple line reinforcement (SLR) in VATA-B using endostaplers was assessed by clinical and experimental study. Meterial and Method: In experimental study, canine lungs were harvested immediately (group I N=5) and 48 hours (group II N=5) after stapling. The pressures at which initial air leaks occurred were measured. In clinical study from February 1997 to March 1999, 106 procedures in 104 patients undergoing VATS-B for spontaneous pneumothorax were classified into two groups according to the presence of SLR and were compared. Result: The average pressure of the initial air leakage was significantly higher in SLR than that of staples alone (18$\pm$1.6 vs 48$\pm$3 mm Hg in group I; 23.8$\pm$1.9 vs 54$\pm$4.6 mm Hg in group II, p<0.001). In the clinical data, there were significant differences seen in the duration of drainage, the total length of endostaplers used, and the duration of the postoperative hospital stay between patients with staple alone and patients with SLR (4.4$\pm$1.4 vs 3.1$\pm$1.1 days in duration of drainage, 92.3$\pm$28.1 vs 71.1$\pm$30.6 mm in total length of endostaplers used, 5.9$\pm$1.9 vs 4.6$\pm$1.7 days in postoperative hospital stays, p<0.001). Conclusion: SLR was effective for preventing prolonged air leakage and responsible for shorter hospital stays after VATS-B for the treatment of spontaneous pneumothorax.

Analysis of Postpneumonectomy Complication without Balanced Chest Bottle (흉관 삽입술 없이 시행한 전폐절제술 후 발생한 합병증에 대한 분석)

  • Kim, Tae-Gyun;Chung, Won-Sang;Kang, Jung-Ho;Kim, Young-Hak;Kim, Hyuck;Jee, Heng-Ok;Lee, Chul-Bum;Ham, Shi-Young
    • Journal of Chest Surgery
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    • v.35 no.4
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    • pp.290-295
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    • 2002
  • Backgroud: Pneumonectomy carries the possibility of numerous dangerous complications as well as the vast effect the operation itself has on the cardiopulmonary function. Most of operations are done with the insertion of the chest tubes upon completion, but because of the high incidence of pyothorax as its complications, we have tried to analyze and compare the cases without inserting the chest tubes. Material and Method: During a 5 year period from January, 1996 to December 2000, 100 cases, which were operated at the Hanyang University Hospital, were selected using the patient's charts. The age, gender, indication of operation, associated diseases, and operation site(left or right) were classified accordingly and the postoperative complications and mortality were statistically analyzed using the $\chi$ 2-test. After resecting the lung, the intrathoracic pressure was set at -15 ~ -20cm $H_2O$ using the nelaton catheter, and the thoracotomy site was then closed. The gradual collection of the fluid and blood in the thorax of the operated side, as well as the mediastinum location, were observed carefully for 4~5 days postoperatively with the aid of the simple chest x-rays. Result: Of the 100 cases, 16 cases of pulmonary tuberculosis(16%), 81 cases of lung tumor(81%), 2 cases of bronchiectasis(2%), and 1 case of aspergilloma associated bronchiectasis were noted. There were 8 mortality cases(8%), and of the 34 cases(34%), 44 complications were noted. The age, sex, and operation site(left or right) were not statistically significant with the complications. 7 of the 16 cases of pulmonary tuberculosis(44%) and 27 of the 81 cases of lung tumor(33%) had complications, but they were found not to be statistically significant. The increase of the complication rate in the pulmonary tuberculosis patients was 3.86. The evidence of postoperative bleeding was observed in 6 cases with the 3 cases being the pulmonary tuberculosis patients and the 3 cases were others. This shows that the increase in postoperative bleeding in the pulmonary tuberculosis is statistically significant(p=0.019). Of the 100 cases, there were 8 mortality cases(8%), with 5 cases from the 81 cases of the lung tumor group(6.1%), 3 cases from the 16 cases of pulmonary tuberculoses group(18.7%).