• 제목/요약/키워드: obstetrics %26 gynecology

검색결과 288건 처리시간 0.031초

정규수술환자 중 마취통증의학과로 협진 의뢰한 환자의 분석 (Analysis of Anesthetic Consultation in Elective Surgical Patients)

  • 하지원;정성수
    • 대한치과마취과학회지
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    • 제10권1호
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    • pp.7-12
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    • 2010
  • Background: This study was carried out to contribute to effective management of operated patients by analyzing cooperative details about patients who were taken elective operation and consulted to the department of anesthesiology. Patients and Methods: One thousand patients who have been consulted to department of Anesthesiology, Chonnam National University Hospital from 2008. November to 2009. March were analyzed. The gender, age, cooperative departments, cooperative reason, the number of cancelled cases and cancelled reason were evaluated. Results: Among 1000 patients, there were 470 females and 530 males. After adjusting for age, middle-aged people which range 45 to 64 year-old are 39.9% and over 65 year-old people are 30.3%. Cooperative department is distributed to orthopedics which is highest occupying 20.6%, neurosurgery, otorhinolaryngology, obstetrics and gynecology in order. Dentistry occupied 2.0%. By specifying reasons of cooperation, cardiovascular diseases distribute to 38.4% which is the highest, the respiratory diseases, 17.5% and the endocrine diseases including diabetes 13.2%. Arranging details, hypertension is 23.9%, ECG abnormality 14.5%, chronic bronchitis in chest radiographic interpretation 14.2%. Of 1,000 consulted patients, delayed or cancelled cases are 58. And the reasons were 26 cases of need of appropriate the blood-sugar level. 26 cases needed appropriate treatment for comorbidities and others 6. Conclusion: Thoroughly evaluating patients before operation and maintenace of active cooperative system between operative department and anesthesiology department can contribute to reduction of cancellation rate and effective management of both hospitalizing and operating rooms.

체외수정 시술 전 한방치료가 여성 불임 환자의 임신성공율에 미치는 영향 (Influence of Herbal Medicine and Acupuncture Treatment on the Pregnancy Rate in Infertile Women before In Vitro Fertilization-Embryo Transfer)

  • 박영선;백정한
    • 대한한의학회지
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    • 제32권5호
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    • pp.25-40
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    • 2011
  • Objectives: This study was performed to assess whether herbal medicine and acupuncture before in vitro fertilizationembryo transfer (IVF-ET) is effective on clinical pregnancy. Methods: From May 2010 to January 2011, a prospective analysis study was performed in 38 patients planning to undergo IVF-ET after taking herb medicine and acupuncture treatment. This study investigated the pregnancy rate and analyzed the change of dysmenorrhea by visual analog scale (VAS), body heat and condition of premenstrual syndrome (PMS), vaginal discharge and menstruation status. Results: 1. During herbal medicine and acupuncture treatment, five patients (13.16%) naturally became pregnant and six patients (15.79%) withdrew. After treatment, 15 patients (39.47%) received IVF-ET, 12 patients (31.58%) did not. 2. The biochemical pregnancy rate was 26.67%, the clinical pregnancy rate 26.67%, miscarriage rate 25% and ectopic pregnancy rate was 0%. 3. After treatment, PMS, dysmenorrhea and dysmenorrhea VAS was significantly decreased and the overall menstrual status improved. 4. After treatment, temperature difference of CV17-CV12 and CV4-CV12 increased, but it was not a statistically significant difference. 5. After treatment, decrease of hemoglobin and protein and increase of total bilirubin and creatinine were statistically significant. All the blood test results were within normal levels which proves safety of treatment. Conclusions: This study suggests that herbal medicine and acupuncture treatment before IVF-ET shows similar pregnancy rates with existing rates, but contributes to increasing the possibility of natural pregnancy.

An explanatory model of quality of life in high-risk pregnant women in Korea: a structural equation model

  • Mihyeon Park;Sukhee Ahn
    • 여성건강간호학회지
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    • 제29권4호
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    • pp.302-316
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    • 2023
  • Purpose: This study aimed to develop and validate a structural model for the quality of life (QoL) among high-risk pregnant women, based on Roy's adaptation model. Methods: This cross-sectional study collected data from 333 first-time mothers diagnosed with a high-risk pregnancy in two obstetrics and gynecology clinics in Cheonan, Korea, or participating in an online community, between October 20, 2021 and February 20, 2022. Structured questionnaires measured QoL, contextual stimuli (uncertainty), coping (adaptive or maladaptive), and adaptation mode (fatigue, state anxiety, antenatal depression, maternal identity, and marital adjustment). Results: The mean age of the respondents was 35.29±3.72 years, ranging from 26 to 45 years. The most common high-risk pregnancy diagnosis was gestational diabetes (26.1%). followed by preterm labor (21.6%). QoL was higher than average (18.63±3.80). Above-moderate mean scores were obtained for all domains (psychological/baby, 19.03; socioeconomic, 19.00; relational/spouse-partner, 20.99; relational/family-friends, 19.18; and health and functioning, 16.18). The final model explained 51% of variance in QoL in high-risk pregnant women, with acceptable overall model fit. Adaptation mode (β=-.81, p=.034) and maladaptive coping (β=.46 p=.043) directly affected QoL, and uncertainty (β=-. 21, p=.004), adaptive coping (β=.36 p=.026), and maladaptive coping (β=-.56 p=.023) indirectly affected QoL. Conclusion: It is essential to develop nursing interventions aimed at enhancing appropriate coping strategies to improve QoL in high-risk pregnant women. By reinforcing adaptive coping strategies and mitigating maladaptive coping, these interventions can contribute to better maternal and fetal outcomes and improve the overall well-being of high-risk pregnant women.

국소 외음부 암에서 영역 림프절의 치료 (Management of Regional Lymph Nodes in Localized Vulvar Carcinoma)

  • 장원일;우홍균;박찬일;하성환;이효표;강순범;송용상
    • Radiation Oncology Journal
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    • 제26권1호
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    • pp.1-9
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    • 2008
  • 목적: 외음부 암환자에서 국소영역 치료실패에 대한 수술 후 방사선치료의 영향을 평가하고 임상적으로 림프절이 전이가 없는 환자들에서 서혜부 림프절에 대한 치료방침을 결정해 보고자 하였다. 대상 및 방법: 1979년 10월부터 2004년 6월까지 서울대학교병원에서 일차성 외음부 암으로 치료를 받은 환자 66명에 대해 후향적 분석을 시행하였다. 이들 중에서 원격전이가 있는 2명, 고식적 목적으로 치료를 받은 6명, 이전에 골반부 위 방사선 치료의 병력이 있는 3명, 추적관찰이 탈락된 4명, 의무기록이 불충분한 1명을 포함하여 16명의 환자들은 이번 분석에서 제외되었다. 50 명 중에 수술만 받은 환자가 35명, 수술과 방사선 치료를 받은 환자가 10명, 방사선 치료만을 받은 환자가 5명이었다. 결과: 5년 전체 생존율과 무병 생존율은 각각 91%, 78%였다. 12명(26%)에서 치료 실패를 보였으며, 국소 실패가 8명, 영역림프절 전이가 3명, 원격 전이가 1명이었다. 수술과 방사선치료를 같이 받은 환자들이 수술만을 받은 환자들보다 위험요인을 더 많이 가지고 있었지만, 무병 생존율은 두 집단에서 통계적으로 유의한 차이를 보이지 않았다(5년 무병 생존율 78% vs. 83%, p=0.66). 잠재성 림프절 전이의 빈도는 10%였다. 임상적으로 림프절 전이가 없었던 31명의 환자들 중에서 10명은 서혜부 림프절 절제술을 받지 않았지만, 이들 중에서 영역림프절 전이를 경험한 사람은 아무도 없었다. 결론: 치료실패의 위험요인을 가진 외음부 암자들에게 수술 후 방사선 치료는 잠재적인 이점을 가지고 있다. 임상적으로 림프절 전이가 없는 위험도가 낮은 환자들에게는 서혜부 림프절 절제술을 하지 않는 것이나 서혜부 림프절에 대해 예방적 방사선치료를 하는 것에 대해서 고려해 볼 수 있겠다.

Pap Smear Screening Results for Turkish Pregnant Women

  • Dinc, Ayten
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권11호
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    • pp.5835-5838
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    • 2012
  • Objective: Cervix cancer is one of the most common gynecological cancer types that cause cancer deaths among women. This study was planned based on a descriptive method in order to evaluate the results of PAP smear screening during pregnancy for prevention of cancer. Materials and Methods: The research involved 110 pregnant women registered at the Obstetrics and Gynecology Polyclinic of Bagcilar Training and Research Hospital and 86 non-pregnant women of the same ages as a control group. As criteria for acceptance were conditions such as not being in coitus within the last 48 hours, not using vaginal ovule, and not performing vaginal lavage. A survey consisting of 33 questions was conducted and the results were processed using Bethesda. Results: The average ages were $27.1{\pm}4.70$ for the pregnant women and $28.8{\pm}4.24$ for the control group. 60.7% of cases had previously heard of a PAP smear test, 49% were aware of why PAP smear tests were conducted, 26.4% of pregnant participants and 27.3% of non-pregnant participants had previously undergone a smear test. In this study, smear results of all cases were 95.4% sufficient. 18.2% of pregnant cases had an infection, 54.5% had reactive cellular change, and 0.9% had atypical squamous cells of undetermined significance (ASC-US). 16.3% of non-pregnant cases had an infection, 58.1% had reactive cellular change, 3.5% had atypical squamous cells of undetermined significance (ASC-US), and 1.2% had low-grade squamous intraepithelial lesions (LGSIL). Conclusion: PAP smear test is a good opportunity to identify pre-invasive lesions in early phases of pregnancy.

Prenatal diagnosis by direct DNA analysis in facioscapulohumeral muscular dystrophy (FSHD) families

  • Choi, Soo-Kyung;Lee, Je-Hyeon;Kim, Bong-Yoon;Kim, Hyung-Goo;Cho, Eun-Hee;Ryu, Hyun-Mee;Kim, Young-Joe
    • Journal of Genetic Medicine
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    • 제2권1호
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    • pp.23-26
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    • 1998
  • Facioscapulohumeral muscular dystrophy (FSHD) is an autosomal dominant neuromuscular disorder which has been clinically shown to cause progressive weakness and result in atrophy of the facial muscles, shoulder girdle and upper arm muscles. The responsible gene for the FSHD has been located on chromosome 4q35-qter. The probes p13E-11 and pFR-1 detect DNA rearrangements associated with FSHD as under 28 kb DNA fragment in genomic southern analysis digested with EcoRI and the fragment contains 3.3 kb Kpn I tandem repeats. In this study, 4 fetuses with a family history of FSHD were analysed by genomic southern hybridization analysis with probes to determine whether they carried the deleted region. Of the 4 fetuses, three of them had mothers who were FSHD patients and the other one had a father affected with FSHD. After 10-11 weeks of gestation, we performed chorionic villi sampling and extracted DNA from uncultured and cultured tissue cells for the direct DNA analysis. The result of the southern analysis showed two fetuses having received about 15-18 kb of deleted genes from the father and the mother respectively, and found to be FSHD patients. The other two fetuses were shown to have two normal alleles from the parents and found to be normal. Two pregnancies which were determined to be normal were carried to term delivering two healthy babies.

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The treatment effect of novel hGHRH homodimer to male infertility hamster

  • Zhang, Xu-Dong;Guo, Xiao-Yuan;Tang, Jing-Xuan;Yue, Lin-Na;Zhang, Juan-Hui;Liu, Tao;Dong, Yu-Xia;Tang, Song-Shan
    • The Korean Journal of Physiology and Pharmacology
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    • 제22권6호
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    • pp.637-647
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    • 2018
  • Extra-hypothalamic growth hormone-releasing hormone (GHRH) plays an important role in reproduction. To study the treatment effect of Grin (a novel hGHRH homodimer), the infertility models of 85 male Chinese hamsters were established by intraperitoneally injecting 20 mg/kg of cyclophosphamide once in a week for 5 weeks and the treatment with Grin or human menopausal gonadotropin (hMG) as positive control was evaluated by performing a 3-week mating experiment. 2-8 mg/kg of Grin and 200 U/kg of hMG showed similar effect and different pathological characteristics. Compared to the single cyclophosphamide group (0%), the pregnancy rates (H-, M-, L-Grin 26.7, 30.8, 31.3%, and hMG 31.3%) showed significant difference, but there was no difference between the hMG and Grin groups. The single cyclophosphamide group presented loose tubules with pathologic vacuoles and significant TUNEL positive cells. Grin induced less weight of body or testis, compactly aligned tubules with little intra-lumens, whereas hMG caused more weight of body or testis, enlarging tubules with annular clearance. Grin presented a dose-dependent manner or cell differentiation-dependentincrease in testicular GHRH receptor, and did not impact the levels of blood and testicular GH, testosterone. Grin promotes fertility by proliferating and differentiating primitive cells through up-regulating testicular GHRH receptor without triggering GH secretion, which might solve the etiology of oligoasthenozoospermia.

Identification of Oligosaccharides in Human Milk Bound onto the Toxin A Carbohydrate Binding Site of Clostridium difficile

  • Nguyen, Thi Thanh Hanh;Kim, Jong Woon;Park, Jun-Seong;Hwang, Kyeong Hwan;Jang, Tae-Su;Kim, Chun-Hyung;Kim, Doman
    • Journal of Microbiology and Biotechnology
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    • 제26권4호
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    • pp.659-665
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    • 2016
  • The oligosaccharides in human milk constitute a major innate immunological mechanism by which breastfed infants gain protection against infectious diarrhea. Clostridium difficile is the most important cause of nosocomial diarrhea, and the C-terminus of toxin A with its carbohydrate binding site, TcdA-f2, demonstrates specific abolishment of cytotoxicity and receptor binding activity upon diethylpyrocarbonate modification of the histidine residues in TcdA. TcdA-f2 was cloned and expressed in E. coli BL21 (DE3). A human milk oligosaccharide (HMO) mixture displayed binding with TcdA-f2 at 38.2 respond units (RU) at the concentration of 20 μg/ml, whereas the eight purified HMOs showed binding with the carbohydrate binding site of TcdA-f2 at 3.3 to 14 RU depending on their structures via a surface plasma resonance biosensor. Among them, Lacto-N-fucopentaose V (LNFPV) and Lacto-N-neohexaose (LNnH) demonstrated tight binding to TcdA-f2 with docking energy of −9.48 kcal/mol and −12.81 kcal/mol, respectively. It displayed numerous hydrogen bonding and hydrophobic interactions with amino acid residues of TcdA-f2.

Human Papilloma Virus Frequency and Genotype Distribution in a Turkish Population

  • Akcali, Sinem;Goker, Asli;Ecemis, Talat;Kandiloglu, Ali Riza;Sanlidag, Tamer
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권1호
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    • pp.503-506
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    • 2013
  • Objectives: To determine human papillomavirus (HPV) frequency, genotypes and the relation between cervical smear results, risk factors and types in women living in Manisa, Turkey. Materials and Methods: A total of 410 women were included in the study. Cervical specimens were obtained for linear array HPV genotyping and pathological testing. Conventional Pap test and Bethesda system were used for evaluation of cytology specimens. Results: A total of 410 women with a mean age of 34.9 years were tested. A positive result of any HPV was found in 35 patients (8.5%). Among them, 26 different serotypes of HPV were identified and the most frequent type was HPV 16 (28.5%) followed by type 45 and 53 (11.4%). Patients were infected by 65.7% high risk, 11.4% probable high risk and 22.9% low risk HPV types. Multiple HPV positive results were found in 13 patients (37.1%). Patients with single partner, history of abnormal smear or condyloma had positive HPV results and this was statistically significant (p<0.05). Correlation analysis showed a statistically weak relation between positive HPV and abnormal smear results (r=0.120). Conclusions: Determining HPV types of genital HPV infections is important for epidemiological studies. We have found the rate of positive HPV as 8.5% which implies the need for extended screening programs in order to diagnose oncogenic HPV at an early stage.

정상 갑상선기능을 가진 여성에서 항갑상선항체가 체외수정시술결과에 미치는 영향 (Influence of Antithyroid Antibodies in Euthyroid Women on IVF-ET Outcome)

  • 김정훈
    • Clinical and Experimental Reproductive Medicine
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    • 제24권1호
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    • pp.143-151
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    • 1997
  • The present study was designed to investigate if antithyroid antibodies (ATA) could affect the pregnancy outcome in euthyroid women undergoing in vitro fertilization and embryo transfer (IVF-ET). From October 1995 to September 1996, 28 euthyroid women with ATA who underwent IVF-ET were studied. Fifty-one euthyroid women without ATA who underwent IVF-ET served as control. Thyroid peroxidase antibody (TPOA) and thyroglobulin antibody (TGA) were assayed using radio ligand assay kits as ATA. All patients included in study and control groups had only tubal factor in infertility. Long protocol of gonadotropin-releasing hormone agonist (GnRH-a) was used for controlled ovarian hyperstimulation (COH) in all patients. There were no significant differences between study and control groups in patient characteristics such as age, infertility duration and hormonal profile. There were also no significant differences between two groups with respect to the clinical response to COH and IVF results such as number of retrieved oocytes, fertilization rate, number of embryos frozen and number of embryos transfered. There were no correlations between ATA (TPOA and TGA) titers and fertilization rate. The clinical pregnancy rate per cycle seemed to be lower in the study group than in the control group (26.3% vs 39.3%), but the difference was not statistically significant. The biochemical pregnancy rate per cycle and miscarriage rate were significantly higher in the study group at 18.4% (7/38) and 40.0% (4/10) compared with 5.6% (5/89) and 11.4% (4/35) in the control group. In the study group, both TPOA and TGA titers were significantly higher in the biochemical pregnancy group than in the clinical pregnancy group or non-pregnancy group. In 10 women with ATA who achieved pregnancy following IVF-ET, both TPOA and TGA titers were significantly higher in the miscarriage group than in the ongoing or delivery group. In conclusion, euthyroid women with ATA appear to represent a less favorable subset within other tubal factor patients when treated with IVF-ET.

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