• 제목/요약/키워드: digestive disease

검색결과 438건 처리시간 0.021초

Postoperative Clinical Outcomes of Colonic Stent Placement as Bridge-to-surgery vs. Emergency Surgery in Left-sided Malignant Colonic Obstruction

  • Choe, Eun Ju;Lee, Yong Kang;Jeon, Han Ho;Choi, Jong Won;Park, Byung Kyu;Won, Sun Young;Seo, Jeong Hun;Lee, Chun Kyon;Cho, Yong Suk
    • Journal of Digestive Cancer Research
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    • 제9권2호
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    • pp.43-49
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    • 2021
  • Background/Aims: Colonic stenting as a bridge to elective surgery is an alternative for emergency surgery in patients with acute malignant colonic obstruction. However, since its benefits are uncertain, we aimed to establish whether it has better clinical outcomes. Methods: The patients with acute malignant left-sided colon obstruction enrolled from January 2009 to December 2018 in National Health Insurance Service Ilsan Hospital. The patients were enrolled to undergo colonic stenting as a bridge to elective surgery or emergency surgery. The following oncological outcomes were assessed: incidence of complete remission, disease progression, local recurrence, and systemic recurrence. Results: Out of 40 patients, 33 received self-expanding metallic stent (SEMS) as a bridge-to-surgery, and 7 underwent emergency surgery. More stoma was made in case of emergency surgery with statistical significance (p < 0.001). There were no significant differences in complete remission rate in curable left-sided malignant colonic obstruction between SEMS as a bridge-to-surgery and emergency surgery. Complete remission was achieved for 3 patients (42.9%) in the non-stent group and 27 patients (81.8%) in the stent group. There was no statistically significant difference in oncologic outcomes between the two groups (p = 0.069). According to multi-variate analysis, advanced TNM stage, Adjuvant chemotherapy, and SEMS bridge-to-surgery were significantly associated with disease-free survival. Disease-free survival rate differed significantly between the two groups (p = 0.024). Conclusions: SEMS as a bridge-to-surgery might be an effective strategy and reduce stoma formation in acute malignant left-sided colon obstruction.

종합 건강검진 과정에서 나타난 일부 중년기 여성의 건강문제 (Health Problem of the Middle-Aged Women)

  • 성미혜
    • 대한간호학회지
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    • 제29권2호
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    • pp.258-270
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    • 1999
  • This study was carried out to offer the basic data for more qualitative lives of the middle-aged women through their health maintenance and control. So, the researcher reviewed and analyzed the health problems of the middle-aged women, the differences of main symptoms in each subject, positive ratcs in screening tests, the difference of screening tests with age and the correlation of obesity and blood pressure with screening tests. All subjects were 218 women(40-59years) who had a check-up at a comprehensive health check-up center in K University Hospital in Seoul from July 1, 1998 to August 31. 1998. Questionaires were developed to get subjects, general characteristics. main symptoms, medical examination and diagnosed disease by the researcher referring through the questionaires of comprehensive health check-up center and the medical recorders were used as a tool of study. The researcher analyzed the data with SPSS PC+ ; the distribution of the subjects, general characteristics and main symptoms with percentage : the difference between main symptoms and screening tests with X$^2$-test, ANOVA. The results are as follows. 1) Among the age distribution, most were 40-45 years old and unemployed. 2) The most common complaints were indigestion in digestive system, cough in respiratory system, heart beat in cardiovascular system, general sweat in endocrine system. edema in urinary system, easy bruise in hematologic system, backache in musculoskeletal system, headache in psychoneurologic system, lochia in gynecology, itch in dermatology system, eye ball pain in visual system and tinnitus in auditory system. 3) In main symptoms according to age, the 40-45 age group had a higher rate of complaints in digestive system and gynecology than other age group ; the 46-49 age group in endocrine system. 4) The main symptoms according to diagnosis had no difference statistically. 5) The screening tests which showed high rates of abnormality were mammography(the highest), abdominal ultrasonography, upper gastrointestinal series/gastrofiberscopy, PFT. In all age group the highest rate of abnormality was seen in mammography. 6) In screening tests according to age. the 46-49 age group showed higher positive rates of pap smear, blood sugar test, urine test than any other age group ; the 50-55 age group showerd higher positive rates of obesity, BP, chest X-ray, abdominal ultrasonography, ESR, SGOT, CRP and urine micro. 7) In correlation of obesity with screening test, the obesity group showed higher positive rates of blood pressure, chest X-ray, abdominal ultrasonography, HCT and CRP than the normal weight group. 8) In correlation of blood pressure with screening test, the hypertension group showed higher positive rate of obesity, chest X-ray, abdominal ultrasonography, pap smear and blood sugar than the normal blood pressure group. In conculusion, the middle-aged women have various physical symptoms and affected by age. The obesity and BP have an important effect on the health of the middle aged women. Therefore, this study is considered significant as data for qualitative lives of the middle-aged women playing an important part of family health care by catching of their health problem complaints for prevention of disease and promotion of health.

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응급실 체류 중에 의식이 저하된 환자의 특성: 의식명료 환자와의 비교연구 (Characteristics of patients with decreased mental status while staying in an emergency department: Comparative study with alert patients)

  • 문선희
    • 한국산학기술학회논문지
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    • 제19권10호
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    • pp.222-230
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    • 2018
  • 본 연구는 내원 당시에는 의식이 명료했으나 응급실 체류 중에 의식이 저하된 환자의 특성을 의식이 명료한 환자와 비교하여 파악하기 위한 후향적 조사연구이다. 연구대상은 일개 응급실에 방문한 응급환자 중 내원 당시에는 의식이 명료했으나 내원 후 의식저하를 보인 환자 90명과 내원당시 의식이 명료했으며 응급실 체류 중에도 의식저하가 없는 환자 중 무작위 추출한 100명이었다. 연구결과 의식저하 군은 의식명료 군에 비해 뇌혈관 질환, 간질환, 당뇨, 고혈압의 기저질환이 많았다(p=.001, p=.003, p<.001, and p=.002, respectively). 중증도 분류 결과 의식저하 군은 의식명료 군에 비해 중증도가 높았다(p<.001). 의식저하 군의 최종 진단명은 신경계 질환 64.9%, 소화기계 질환 63.3%로 의식명료 군과 차이가 있었다(p<.001). 의식저하 군 중 56명(62.2%)은 응급실 간호사에 의해 의식저하 상태가 발견되었다. 의식저하 군 중 9명은 심정지가 발생하여 심폐소생술을 받았다. 본 연구결과 응급실 간호사는 응급실 내원 당시 의식이 명료하더라도 중증도가 높고, 신경계 질환이나 소화기계 질환이 의심되는 환자는 의식수준을 자주 사정해야 함을 시사한다.

수지침 경험자들의 수지침에 대한 효율성과 효과성 인식정도 (Recognition of Efficiency and Effectiveness of the Experiences with Hand Acupuncture)

  • 이연주;박경민
    • 지역사회간호학회지
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    • 제12권1호
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    • pp.278-287
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    • 2001
  • The purpose of this study is to provide with basic information on application of hand acupuncture as a complementary and alternative therapy by giving some recognition of efficiency and effectiveness of hand acupuncture. And so, answers for questionnaires of 290 respondents were used for this research and collected from June 5 through 13, 1999 from adults twenty and over who were participating in the hand acupuncture training program in Seoul and had some direct experiences with hand acupuncture therapy, whatever they had been treated and/or had treated. To secure reliability of measurement tool. Cronbach'a has been calculated and Factor Analysis was done as Validity Analysis of question classification. Demograprucal characteristics of hand acupuncture experienced people and factors related to hand acupuncture experiences are calculated based on the real number and percentage. The degree of recognition of efficiency and effectiveness of hand acupuncture is made as average and standard deviation, while the degree of recognition of efficiency and effectiveness based on general characteristics come from one-way ANOVA. 1. According to socio-demographical analysis. the questioned could be classified firstly as age (40-49 : 32.5%. 30-39 : 24.9%. 50-59 : 21.9%. 60-69 : 14.7%. 20-29 : 6.0%). secondly gender (male 36.6%. female 63.4%). thirdly occupation (housewife: 43.8%. self-employed: 15.5%. company-employee: 14.8%). fourthly education (high school graduate: 41.9%, college graduate: 37.9%), and lastly monthly-income (1 to 2 million: 51.4%. 2 to 3 million: 20,3%) 2, As for the general aspects related to hand acupuncture. 80,0% of the respondents answered almost zero for the monthly average number of visit to hospital and 15.5% responded 1 to 2 visits, 6,2% of the respondents is complaining of a disorder of digestive system. 19,0% circulatory disease, 10.7% bad nervous system. By utilizing hand acupuncture, 84% of the questioned have following experiences in curing diseases: digestive system 47.3%, circulatory system 9.3%, nervous system 8.3%, 54,1% are curing 1 to 2 and 10.3% 3 to 4 patients on a daily basis with hand acupuncture. Research on the demerits of giving medical treatment with hand acupuncture shows 23,8% are feeling economic burden. 16.6% difficulty of learning and 16.2% weak theoretical backgrounds. 3. Among the efficiency recognition, possibility of general application is average 4,29 and simple treatment is 4,19. economic merits 4.36. possibility of establishment with supplementary and alternative medicine 4.17, medical effectiveness 4.09. 4, As a result of demographical analysis on the efficiency and effectiveness of hand acupuncture therapy, it appears that the recognition of efficiency based on occupation and the recognition of effectiveness based on monthly income are most significant to be noticed. In an orderly fashion. government-employee, self-employed, company-employee. and then housewife have perceived hand acupuncture very efficiently, And those who recognize hand acupuncture to be most effective are people earn 1 million to 2 million won a month, 5. The efficiency(p = .003) and effectiveness (p= .049) of hand acupuncture therapy by number of visit to hospital were statiscally significant, and effectiveness of hand acupuncture therapy by disease exist was statiscally significant (p= .033).

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Aeromonas veronii의 실험적 감염에 의한 양식 메기, Silurus asotus의 병리학적 변화 (Pathological Changes in Cultured Korean Catfish (Silurus asotus) Artficially Infected with Aeromonas veronii)

  • 김진도;도정완;최혜승;서정수;정승희;조혜인;박명애;이남실;박성우
    • 환경생물
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    • 제31권4호
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    • pp.486-492
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    • 2013
  • 최근 국내의 양식 메기에 표피 박리와 근육 괴사를 특징으로 하는 새로운 질병이 발생하였다. 그 폐사율은 낮으나 질병으로 인한 상품가치의 저하로 경제적 손실이 크다. 병어로부터 원인균을 분리하고 자연감염어와 인위감염어의 병리학적 변화를 관찰하였다. 원인균은 Aeromonas veronii로 동정되었으며, 원인균을 건강어에 인위감염시켜 폐사 및 증상의 발현을 매일 관찰하였다. 인위감염된 어류의 증상은 자연감염어와 유사하였으며 원인균을 감염시킨 후 7일 이내에 모두 폐사하였다. 병어의 조직표본을 제작하여 관찰한 결과, 자연감염어의 간, 비장, 신장의 울혈 및 간세포 변성과 비장 협조직의 초자적변성이 관찰되었으며, 특히 심장에서 염증성 변성과 세균응집체가 관찰되었다. 소화관에서의 울혈과 점막고 유층의 섬유화 현상도 특징적이었다. 자연감염어에 비해 약한 경향이지만 인위감염어의 조직학적 변화도 관찰되었으며, 소화관에서의 조직학적 변성은 관찰되지 않았다.

간흡충 충체의 부위별 항원성에 대한 면역조직화학적 연구 (Immunohistochemical study on the antigenicity of each organ structure of Clonorchis sinensis)

  • Jin Kim;Jong-Yil Chai;Weon-Gyu Kho;Kyu-Hyuk Cho;Soon-Hyung Lee
    • Parasites, Hosts and Diseases
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    • 제29권1호
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    • pp.21-30
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    • 1991
  • 간흡충의 충체 부위별 항원성을 알아보고자 면역조직화차적 방법을 이용하여 간흡충의 소화기관, 생식기관, 배설기관, 흡반, 표피 등의 염색강도를 비교 관찰하였다. 간흡충 실험 감염 후 2~8주 된 토끼에서 담관 내 충체를 포함하는 간 조직을 얻어 중성 포르말린 용액에 고정하고 파라핀으로 포매한 다음 4 $\mu\textrm{m}$두께로 잘라 항원으로 이용하였다. 항-간흡충 항체(1차 항체)는 실험 감염 10주 된 고양이 혈청을 희석하여 사용하였고 peroBidaseconjugated goat anti-cat IgG를 2차 항체로 하여 간접 면역효소 염색을 시행하였다. 가장 적합한 1차 항체의 희석 농도는 1 : 1,000~1 : 2,000, 2차 항체의 희석 농도는 1 : 1,000이었다. 충체의 장 상피세포, 장 내용물 및 배설낭은 1차 항체 희석 농도 1 : 1,000~1 : 2,000에서 강한 양성 반응을 보인 반면, 자궁 및 일부 자궁 내 충란, 난관선, 웅성 생식기관 등은 1차 항체 회석 농도 1 : 1,000에서 미약한 양성 반응을 나타내었다. 한편, 흡반, 표피, 표피하 세포, 충체 실질 등은 1차 항체 회석 농도 1 : 1,000에서도 음성 반응을 나타내었다. 이상의 결과를 종합하면, 간흡충 감염시 숙주의 항체 반응은 충체의 소화-분비 기관에서 유래된 이른바 분비-배설 항원에 의해 가자 강력하게 유발되는 것으로 추측된다.

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Prospective Multicenter Study of the Challenges Inherent in Using Large Cell-Type Stents for Bilateral Stent-in-Stent Placement in Patients with Inoperable Malignant Hilar Biliary Obstruction

  • Yang, Min Jae;Kim, Jin Hong;Hwang, Jae Chul;Yoo, Byung Moo;Lee, Sang Hyub;Ryu, Ji Kon;Kim, Yong-Tae;Woo, Sang Myung;Lee, Woo Jin;Jeong, Seok;Lee, Don Haeng
    • Gut and Liver
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    • 제12권6호
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    • pp.722-727
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    • 2018
  • Background/Aims: Although endoscopic bilateral stent-instent placement is challenging, many recent studies have reported promising outcomes regarding technical success and endoscopic re-intervention. This study aimed to evaluate the technical accessibility of stent-in-stent placement using large cell-type stents in patients with inoperable malignant hilar biliary obstruction. Methods: Forty-three patients with inoperable malignant hilar biliary obstruction from four academic centers were prospectively enrolled from March 2013 to June 2015. Results: Bilateral stent-in-stent placement using two large cell-type stents was successfully performed in 88.4% of the patients (38/43). In four of the five cases with technical failure, the delivery sheath of the second stent became caught in the hook-cross-type vertex of the large cell of the first stent, and subsequent attempts to pass a guidewire and stent assembly through the mesh failed. Functional success was achieved in all cases of technical success. Stent occlusion occurred in 63.2% of the patients (24/38), with a median patient survival of 300 days. The median stent patency was 198 days. The stent patency rate was 82.9%, 63.1%, and 32.1% at 3, 6, and 12 months postoperatively, respectively. Endoscopic re-intervention was performed in 14 patients, whereas 10 underwent percutaneous drainage. Conclusions: Large cell-type stents for endoscopic bilateral stent-in-stent placement had acceptable functional success and stent patency when technically successful. However, the technical difficulty associated with the entanglement of the second stent delivery sheath in the hook-cross-type vertex of the first stent may preclude large cell-type stents from being considered as a dedicated standard tool for stent-in-stent placement.

체질진단분류(體質診斷分類)에 따른 질병(疾病) 및 증상유형(症狀類型)에 관한 임상적(臨床的) 연구(硏究) II (문진표를 중심으로) (A CLINICAL STUDY OF THE TYPE OF DISEASE AND SYMPTOM ACCORDING TO SASANG CONSTITUTION CLASSIFICATION)

  • 김영우;김진원
    • 사상체질의학회지
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    • 제11권1호
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    • pp.119-135
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    • 1999
  • 본 연구(硏究)는 1996.3월(月)에서 1998.11월(月)사이에 동의대학교(東義大學校) 한의과대학(韓醫科大學) 부속한방병원(附屬韓方病院)에 내원(來院) 가료중(加療中) 환자(患者) 196명을 대상(對象)으로 하였으며 사상체질(四象體質)의 판별(判別)은 사상변증내용(四象辨證內容) 설문조사지(設問調査紙)(I)과 사상체질분류검사(象體質分類檢査)(QSCCII)를 중심으로 하였다. 본 결과는 사상체질(四象體質)과 질병(疾病) 및 증상유형(症狀類形)에 대한 설문지(說問紙)를 비교하여 얻은 것이다. 1. 태음인(太陰인)은 체중증가(體重增加), 땀이 많이 난다. 몸이 붓는다. 허리가 아프다는 증상(症狀)과 기름진 음식(飮食)을 잘 먹으며 음식(飮食)을 짜게 먹는 편이 다른 체질(體質)에 비하여 더욱 유발(頻發)하였다. 2. 소음인(少陰인)은 안색이 나쁘다. 목의 이물감, 수면장애(睡眠障碍) 식욕감퇴(食慾減退), 쉽게 피로(疲勞)해짐, 식사(食事)와 무관한 위(胃)의 통증(痛症), 두통(頭痛), 생리통증상(生理痛症狀)과 기름진 음식(飮食)을 잘 안 먹는다. 음식(飮食)을 싱겁게 먹는 편이 다른 체질(體質)에 비하여 더욱 유발(頻發)하였다. 3. 통계적(統計的)으로 유의성(有意性)을 가지지는 못하였지만, 소양인(少陽人)은 호흡기계질환(呼吸器系疾患)에서 단순한 기침증상(症狀) 근골격계질환(筋骨格系疾患)에서 관절(關節)의 운동장애(運動障碍), 부인과계(歸人科系)에서 월경(月經)의 조기(調期)와 양(量)의 변화(變化)와 생식기(生殖器) 소양증(搔痒症), 피부계(皮膚系)에서 가려움증과 부스럼증 등은 다른 체질(體質)에 비하여 비교적 많았고 심혈관계질환(心血管系疾患), 혈액계질환(血液系疾患)은 비교적 적었다. 소음인(少陰人)은 전반적(全般的)인 소화기계질환(消化器系疾患), 호흡기계질환(呼吸器系疾患)에서 인흡(咽吸)의 이물감 통증, 심혈관계질환(心血管系疾患), 혈액계질환(血液系疾患), 근골격계질환(筋骨格系疾患)에서 통증(痛症)이나 비증(痺症), 정신신경계질환(精神神經系疾患)에서 정신계질환(精神系疾患), 부인과계(婦人科系)에서 월경통(月經痛)을 비롯한 유방(乳房)의 몽우리 냉증(冷症), 피부계(皮膚系)에서 발진(發疹)이나 두드러기, 시각계질환(視覺系疾患)과 청각계질환(聽覺系疾患)등이 다른 체질(體質)에 비해 많았다. 태음인(太陰人) 호흡기계질환(呼吸器系疾患)에서 목이 잘 쉬는 증상, 근골격계질환(筋骨格系疾患)에서 요통(腰痛), 정신신경계질환(精神神經系疾患)에서 신경계질환(神經系疾患), 피부계(皮膚系)에서 발진(發疹)이나 두드러기등이 다른 체질(體質)에 비하여 다소 많았으며 부인과계질환(婦人科系疾患)은 적었다.

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내경(${\ll}$內經(${\gg}$)에 나타난 허혈성 심질환에 대한 연구 (The Study on The ischemic heart disease Explained In Nei-jing(內經))

  • 홍천표;이원철
    • 대한한방내과학회지
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    • 제19권1호
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    • pp.144-156
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    • 1998
  • This study has been carried out to investigate the cause, pathological mechanism and treatment of symptoms regarded as the ischemic heart disease in Nei-jing(內經). I've got the following conclusions. 1. From the side of xing-bi(胸痺), the ischemic heart disease(IHD) was caused by that the energy in one's heart wasn't extended in the way of Yin-xie(飮邪), namely waste matter of human body and symptoms and treatment wern't written. 2. From the side of xin-bi (心痺), HID was catched by the mechanisms that the blood vessel is blocked. or the heart's blood was deficient owing to the mutation of mo-bi(脈痺), the lack of yang-ming(陽明) and excessive thoughts and worry and others. The symptoms were feeling oppressed in one's brest, palpitating, sudden dyspnea, the dryness of thorat, frequent belching and the fear by the inverse flow of the energy(氣). The treatment was that the yin(陰) was cured immediately, but the yang(陽) mustn't be attacked. 3. From the side of xing-tong(心痛), IHD was suffered from by mechanisms that following the han-sa(寒邪), namely the cold makes a invasion on humanbody, the vessel was blocked, spasm, filled and the amount of blood flow was poor, or caused by injury of vessel, the inverse flow and the disease of shi-dong(是動病) of shou-shao-xin-jing(手少陰心經) and so on. The pain was cramped into the upper and lower back or lower abdomen or throat and accompanied with nausea, abdominal dropsy, constipation, the impending of breathing and so on. The cure was mainly that acupuncture was applied at the jin-su(筋縮) region or meridian in relation to symptoms, but if the pain were severe, acupuncture mustn't be applied. The prog nosis was worse. 4. From the side of xing-tonge(心痛), IHD was divided into zhen-xing-tong(眞心痛) and jue-xing-tong(厥心痛), but pi-xiog-tong(脾心痛) and wei-xing-tong(胃心痛) out of jue-xing-tong(厥心痛) also included the symptoms of the digestive disease.

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일부(一部) 농촌주민(農村住民)의 상병(傷病) 및 의료실태(醫療實態)에 관(關)한 조사연구(調査硏究) (A Study on Sickness and the Status of Medical Care in a Rural Area)

  • 박정선
    • Journal of Preventive Medicine and Public Health
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    • 제14권1호
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    • pp.65-74
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    • 1981
  • This survey was made to determine the overall health situation on (1) the status of sickness; (2) the medical care utilization; (3) the medical cost in Mi-Kum Myun, Nam Yang Ju Gun, Kyung-Gi Do. The survey with questionnaire was carried out with 2,840 peoples in 560 households from August 9th to 16th, 1979. The findings from the survey were as follows; 1. Annual morbidity rate of the prolonged ill cases was 97.2 per 1,000 population (male 94.7, female 99.6), The highest age specific morbidity rate was 274.5 of the 45-to 64-year group and the lowest was 21.9 of the 5-to 14-year group. 2. Annual morbidity rate of the new patients was 777.5 per 1,000 population(male 644.5, female 909.5). 3. The chief complaints distribution of the prolonged ill cases was: local pain 36.6%, indigestion 22.4%, and coughing 7.3%, respectively, In terms of age and sex distribution, a large number of female of the 45-to 64-year group complained of local pain or general pain and a large number of both sexes of the 25-to 44-year group complaned of indigestion. 4. The major diseases of the new patients which classified with International Classfication of Diseases (I.C.D.) were disease of the respiratory system, disease of the digestive system, and disease of the musculo-skeletal system and connective tissue for male, disease of the respiratory system, disease of the digestive system, and accident, poisoning, violence for female. 5. Total ill days of the 92 new patients were 536 days and average ill days per case were $6{\pm}38.3$ days. 6. The rate of receiving treatment in the prolonged ill cases was 82.2%(medical facilities 46.4%, drug stores 27.5%, herb medicine 8.3%). 7. The rate of receiving treatment by first choice of the new patients was 88.0% (drug stores 57.%, medical facilities 28.2%, and herb medicine 2.2%), and the rate of receiving treatment by second choice was 30.9% of first treatment cases (medical facilities 44.0%, drug store 44.0% and herb meicine 12.0%). 8. Annual hospitalization rate per 1,000 population was 12.0 (male 12.0, female 11.9). 9. The locations of medical facilities utilized by out-patients were: in the prolonged ill cases Seoul or other places 66.4%, Nam Yang Ju Gun 33.6%, in cases of the new patients Seoul or other places 35.1% and Nam Yang Ju Gun 64.9% respectively. 10. The satisfaction rate of the new patients by mode of receiving treatment was: in cases of primary utilization by first choice herb medicine 100.0%, medical facilities 88.5%, and drug stores 69.8%, in cases of secondary utilization medical facilities 100.0%, herb medicine 100.0%, and drug stores 72.7% respectively. 11. The medical cost per utilized facilities was as follows; in average medical fee per case out-patient 8.947 won, in-patient 266,000 won, drug stores 1,532 won, and herb medicine 15,607 won, in average medical fee per day out-patient 4,829 won, in patient 14,178 won, drug stores 891 won, and herb medicine 4,906 won respectively. 12. The sources of the hospital charges paid out were: there own expense 50.0%, debt 35.3%, and security of medical care 14.7% respectively.

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