• 제목/요약/키워드: ovarian mass

검색결과 118건 처리시간 0.027초

자궁외 임신 환자의 임상적 고찰

  • 신현선
    • 대한간호학회지
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    • 제1권1호
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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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부인과(婦人科) 냉증환자(冷症患者)의 변증유형(辨證類型)과 사상체질(四象體質)과의 관계에 대한 소고(小考) (Study for Relationship between the Type of Differentiation of Symptoms and Signs of Oriental Gynecology and Sasang Constitution (In the Field of the Patiehts who chiefly complained Feeling of Cold))

  • 이인선;김종원;이상훈
    • 사상체질의학회지
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    • 제9권2호
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    • pp.263-281
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    • 1997
  • We studied the relationship between each type which was figured out by the question paper given to the patients who chiefly complained feeling of cold and Sasang constitution. The results are as follows. 1. Diagnoses in woman's disease with feeling of cold(冷病) are abdomnal mass(uterine myoma, ovarian cyst), dysmenorrhea, leukorrhea and infertility, orderly in number. They have commoness in the origin of disease which are stagnation of Qi(氣滯) and blood stasis(血瘀), cold(寒), damp(濕) and we can find the causes of feeling of cold are stagnation of blood(血瘀) and harmness of damp(水毒). 2. In the type of survey through the question paper, the largest number of the origin of that disease is cold, the next is blood stasis and dificiency of Qi(氣虛), dificiency of blood(血虛), stagnation of Qi, damp phlegm(濕痰) etc. 3. (1)The numbers by constitutional assortment of object are like this. Taeumin are 23 persons,Soumin 14 and Soyangin 6, so we can find the feeling of cold turn up evenly in all constitution but the number of Soyangin was relatively small. (2)The inclination of constitutional type is the highest in Soumin and they often have and feel strongly disorders of their body. (3)We could find the corelation of theoretical background of Sasang Medicine in constitutional type of survey. 4. (1)The numbers by constitutional assortment of the patients with feeling of cold and numbness(冷痺症) are like this. Taeumin are 16 persons, Soumin 7 and Soyangin 3, as are like the distribution of 3-(1). (2)The inclination of constitutional type is the highest Soumin, so they have multiple type of differentiation of symptoms and signs and their symptoms is old and severe, therefore they need long time for cure. In all, except the symptom with feeling of cold caused by dificiency of the blood and insufficiency of yang(氣虛와 陽虛) that we meet frequently on clinic is numerous, the number of that caused by stagnation of Qi and blood(氣滯와 血滯) alike dysautonomia is also large. And we can find the feeling of cold turn up evenly in all constitution but the number of Soyangin was relatively small. Within the case of Soumin, they have both dificiency of Qi and blood, have complex source, so their symptoms are old and severe and they need long time for cure. In Taeumin, they are of large number with dificiency of Qi and we think thst that are concerned with the symptom of exterior cold.

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골 대사 및 phytochemicals의 estrogen 효과 (Bone Metabolism and Estrogenic Effect of Phytochemicals)

  • 김보경;김미향
    • 생명과학회지
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    • 제28권7호
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    • pp.874-883
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    • 2018
  • 전 세계적인 인구 고령화 현상으로 인하여 골다공증은 주요한 질병으로 대두되고 있다. 골다공증은 뼈의 질량과 강도가 감소하여 골절의 위험이 증가하는 질환으로 조골세포의 골 형성 및 파골세포의 골 흡수의 불균형으로 인해 발생하는 질환이다. 조골세포에 의한 골 형성은 BMP, RUNX2, $Wnt/{\beta}-catenin$ 경로 등을 통하여 활성화 되며, 파골세포에 의한 골 흡수는 RANKL과 RANK의 결합에 의해서 시작된다. 폐경기 여성은 호르몬 불균형에 의해 여러 질병의 위험에 처해 있으며, 폐경기 여성의 약 30%에서 관찰되는 골다공증은 폐경기 여성에게서 발생되는 가장 흔한 대사성 질환이기도 하다. Estrogen이 부족할 때 파골세포의 골 흡수가 촉진되므로, 특히 폐경 여성에서 골다공증의 발생위험이 증가하게 된다. 호르몬대체요법은 폐경기 증후군의 증상을 경감시키거나 치료하기 위해 널리 사용되어 왔으나, 호르몬 치료를 장기간 실시할 경우 유방암, 난소암, 자궁암 등의 부작용 위험성이 매우 높은 것으로 알려져 있다. 따라서 최근 들어 여러 부작용을 보완하기 위해 폐경기 증후군 증상에 대처할 수 있는 estrogen과 유사한 활성을 지닌 식물성 estrogen인 phytoestrogen에 대한 연구가 활발히 진행되고 있다. 따라서, 본 총설에서는 조골세포 및 파골세포의 분화 기전에 대한 선행연구를 알아보고 골 대사에서의 estrogen의 역할 및 phytoestrogen과 관련한 연구들에 대해서도 살펴보았다.

Follicular fluid cerebellin and betatrophin regulate the metabolic functions of growing follicles in polycystic ovary syndrome

  • Ersahin, Aynur Adeviye;Acet, Mustafa;Ersahin, Suat Suphan;Acet, Tuba;Yardim, Meltem;Kenanoglu, Omer;Aydin, Suleyman
    • Clinical and Experimental Reproductive Medicine
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    • 제44권1호
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    • pp.33-39
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    • 2017
  • Objective: The aim of this study was to assess the changes of follicular fluid (FF) and serum levels of cerebellin precursor protein 1 (cbln1) and betatrophin in patients with polycystic ovary syndrome (PCOS) undergoing in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) with a gonadotropin-releasing hormone (GnRH) antagonist protocol. Methods: Twenty infertile women with PCOS and 20 control women diagnosed as poor responders undergoing ovarian stimulation with a GnRH antagonist were included. Blood samples were obtained during ovum pick-up. Follicular fluid from a dominant follicle was collected from the subjects. Using enzyme-linked immunosorbent assays, FF and serum levels of cbln1 and betatrophin were measured in both groups of participants. Metabolic and hormonal parameters were also determined and correlated with each other. Results: Both groups of women had similar serum and FF betatrophin levels ($55.0{\pm}8.9ng/mL$ vs. $53.1{\pm}10.3ng/mL$, p=0.11). The serum and FF betatrophin levels of poor responders were found to be similar ($49.9{\pm}5.9ng/mL$ vs. $48.9{\pm}10.7ng/mL$, p=0.22). Conversely, the FF cbln1 levels of PCOS women were found to be significantly higher than the serum cbln1 levels ($589.1{\pm}147.6ng/L$ vs. $531.7{\pm}74.3ng/L$, p<0.02). The FF cbln1 levels of control participants without PCOS were significantly higher than their serum cbln1 levels ($599.3{\pm}211.5ng/L$ vs. $525.3{\pm}87.0ng/L$, p=0.01). Positive correlations were detected among body mass index, insulin resistance, serum insulin, total testosterone, and betatrophin levels in the PCOS group. Conclusion: Follicular fluid betatrophin and cbln1 concentrations may play a pivotal role on follicular growth in PCOS subjects undergoing IVF/ICSI with an antagonist protocol.

Should Cut-Off Values of the Risk of Malignancy Index be Changed for Evaluation of Adnexal Masses in Asian and Pacific Populations?

  • Yavuzcan, Ali;Caglar, Mete;Ozgu, Emre;Ustun, Yusuf;Dilbaz, Serdar;Ozdemir, Ismail;Yildiz, Elif;Gungor, Tayfun;Kumru, Selahattin
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권9호
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    • pp.5455-5459
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    • 2013
  • Background: The risk of malignancy index (RMI) for the evaluation of adnexal masses is a sensitive tool in certain populations. The best cut off value for RMI 1, 2 and 3 is 200. The cut off value of RMI-4 to differentiate benign from malignant lesions is 450. Our aim was to evaluate the efficiency of four different malignancy indexes (RMI1-4) in a homogeneous population. Materials and Methods: We evaluated a total of 153 non-pregnant women with adnexal masses who did not have a history of malignancy and who were above 18 years of age. Results: A cut-off value of 250 for RMI-1 provided 95.9% inter-observer agreement, yielding 95.9% specificity, 93.5% negative predictive value, 75.0% sensitivity and 82.8% positive predictive value. A cut-off value of 250 for RMI-1 showed high performance in preoperative diagnosis of invasive malignant lesions than cut-off value of 200 in our population. A cut-off value of 350 for RMI-2 provided 94.5% inter-observed agreement, yielding 94.2% specificity, 93.4% negative predictive value, 75.0% sensitivity and 77.4% positive predictive value. RMI-2 showed the higher performance when the cut-off value was set at 350 in our population. A cut-off value of 250 provided 95.2% inter-observer agreement, yielding 95.0% specificity, 93.2% negative predictive value, 75.0% sensitivity, and 88.0% positive predictive value. RMI-3 showed the highest performance to diagnose malignant adnexal masses when the cut-off value was set at 250. In our study, RMI-4 showed similar statistical performance when the cut-off value was set at 400 [(Kappa: 0.684/p=0.000), yielding 93.8% inter-observer agreement, 93.4% specificity, 93.4% negative predictive value, 75.0% sensitivity, and 75.0% negative predictive value]. Conclusions: We showed successful utilization of RMIs in preoperative differentiation of benign from malignant masses. Many studies conducted in Asian and Pacific countries have reported different cut-off values as was the case in our study. We think that it is difficult to determine universally accepted cut-off values for RMIs for common use around the globe.

An Effect of Dietary Chlorella on Bone Mineral Density in Postmenopausal Women

  • Yong-Ho Kim;Yoo-Kyeong Hwang;Su-Mi Ko;Jung-Min Hwang;Yong-Woo Lee;Hee-Kyung Seong;Dong-Uk Kim
    • 대한의생명과학회지
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    • 제8권4호
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    • pp.217-221
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    • 2002
  • Age-related osteopenia and osteoporosis are common in postmenopausal women due to decrease in bone mass and ovarian function. A therapy for osteoporosis would depend on only drugs to inhibit bone loss, hormonal replacement therapy, exercise and dietary supplementation and it is very hard to fad an ideal therapy for osteoporosis as yet. Chlorella which is rich in minerals such as calcium magnesium fatty acids, vitamins and sterol, could be applicable for prevention and co-treatment of osteoporosis, but it has yet to be studied. The purpose of this study was to assess the relationship between the effect of dietary chlorella on bone mineral density (BMD) and nutritional improvement. BMD was measured in the femural neck and lumber spine portion. Nutritional and bone turnover markers from blood samples were assessed serum lkaline phosphatase, hemoglobin, number of erythrocytes and total protein. Studies for the femur neck measurement showed that normal BMD increased 2.1% for the group fed chlorella supplemented diet for four month and increased 6.6% fur group treated for one year when compared to the control group, and for the lumber spine measurements the few month group showed an increase of 9.1% over the control group, the one year group showed an increase of 64.2% over the control group. Hemoglobin content, number of erythrocytes and total protein showed similar increased patterns with BMD measurement, meanwhile, serum alkaline phosphatase increased 3% for the four month group and decrease 16% for the one year group compare to the control group. In conclusion, the postmenopausal women fed chlorella supplemented diet results in an increase in BMD. This is a marked increment in lumber spine, enhancement of nutritional state and stable bone turnover. This data showed a positive relationship between BMD and nutritional change with chlorella treatment, and suggested that chlorella dietary may lead to improving and preventing rapid loss of BMD in postmenopausal women.

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Plasma metabolites associated with physiological and biochemical indexes indicate the effect of caging stress on mallard ducks (Anas platyrhynchos)

  • Zheng, Chao;Wu, Yan;Liang, Zhen Hua;Pi, Jin Song;Cheng, Shi Bin;Wei, Wen Zhuo;Liu, Jing Bo;Lu, Li Zhi;Zhang, Hao
    • Animal Bioscience
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    • 제35권2호
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    • pp.224-235
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    • 2022
  • Objective: Cage rearing has critical implications for the laying duck industry because it is convenient for feeding and management. However, caging stress is a type of chronic stress that induces maladaptation. Environmental stress responses have been extensively studied, but no detailed information is available about the comprehensive changes in plasma metabolites at different stages of caging stress in ducks. We designed this experiment to analyze the effects of caging stress on performance parameters and oxidative stress indexes in ducks. Methods: Liquid chromatography tandem mass spectrometry (LC/MS-MS) was used to determine the changes in metabolites in duck plasma at 5 (CR5), 10 (CR10), and 15 (CR15) days after cage rearing and traditional breeding (TB). The associated pathways of differentially altered metabolites were analyzed using Kyoto encyclopedia of genes and genomes (KEGG) database. Results: The results of this study indicate that caging stress decreased performance parameters, and the plasma total superoxide dismutase levels were increased in the CR10 group compared with the other groups. In addition, 1,431 metabolites were detected. Compared with the TB group, 134, 381, and 190 differentially produced metabolites were identified in the CR5, CR10, and CR15 groups, respectively. The results of principal component analysis (PCA) show that the selected components sufficiently distinguish the TB group and CR10 group. KEGG analysis results revealed that the differentially altered metabolites in duck plasma from the CR5 and TB groups were mainly associated with ovarian steroidogenesis, biosynthesis of unsaturated fatty acids, and phenylalanine metabolism. Conclusion: In this study, the production performance, blood indexes, number of metabolites and PCA were compared to determine effect of the caging stress stage on ducks. We inferred from the experimental results that caging-stressed ducks were in the sensitive phase in the first 5 days after caging, caging for approximately 10 days was an important transition phase, and then the duck continually adapted.

일부 농촌지역 주민에서 혈청 CA19-9 및 CA125 농도에 영향을 미치는 인자에 관한 연구 (Factors Related to Serum Level of Carbohydrate Antigen 19-9 and Cancer Antigen 125 in Healthy Rural Populations in Korea)

  • 이수근;유근영;박수경;강대희;김진규;정준기;이명철
    • 대한핵의학회지
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    • 제32권1호
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    • pp.71-80
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    • 1998
  • 우리 나라의 일부 지역 주민에서 혈청 CA19-9과 CA125 농도의 분포를 관찰함으로써 경계치 설정 이전에 미리 예비적 자료를 확보하고, 두 종양표지자의 측정치에 영향을 미치는 인자들, 특히 음주와 흡연 습관에 대한 통계적 유의성을 평가하기 위해 단시적 조사연구를 시도하였다. 1995년에 일부 농촌지역 성인 171명(남자 76명, 여자 95명)을 대상으로 하여 설문조사와 혈청 검사를 통해 개개인의 음주, 흡연습관 및 생식요인에 관한 정보 및 혈청 CA19-9 및 CA125 농도를 분석한 결과는 다음과 같다. 1) 혈청 CA19-9 농도의 평균 및 표준편차는 남녀 각각 $10.4{\pm}11.1{\mu}/ml$, $10.1{\pm}10.0{\mu}/ml$로 남녀간의 차이가 없었으나, 혈청 CA125 농도의 평균 및 표준편차는 각각 $2.5{\pm}12.2{\mu}/ml$, $11.2{\pm}7.4{\mu}/ml$로 여자에서 높았다. 한편 현재 임상적으로 적용되고 있는 양성판정치를 근거로 하여 판정한 혈청 CA19-9 및 CA125 양성률은 각각 2.9%, 1.8%이었으며, 각각 남녀간에 통계적으로 유의한 차이는 없었다. 2) 혈청 CA19-9 농도는 일일 흡연량(r=0.23, p=0.054) 및 총 흡연량(r=0.28, p=0.017)과 양의 상관관계를 보였으며, 성별로는 여자에서만 유의한 상관관계를 나타내었다(일일흡연량 r=0.59, p=.0.026 ; 총흡연량 r=0.74, p=0.003). 3) 혈청 CA125 농도는 흡연시작연령(r=0.51, p=0.000) 과는 양의 상관관계를, 총흡연기간(r=-0.23, p=0.051) 및 총흡연량(r=-0.23, p=0.057)과는 음의 상관관계를 보였는데, 성별로는 남자에서만 흡연시작연령(r=0.28, p=0.031)과 유의한 상관관계를 나타내었다. 4) 혈청 CA125 농도는 여자에서 연령(r=-0.20, p=0.058), 생리중단 연령(r=-0.28, p=0.030), 총수유기간(r=-0.29, p=0.014)과 음의 상관관계를 보였다. 5) 혈청 CA19-9 및 CA125 농도는 비만, 학력, 그리고 음주와 유의한 상관관계가 없었으며, 여자에서는 혈청 CA19-9 및 CA125 농도간에 양의 상관관계를 보였다(r=0.20, p=0.047). 6) 연령 및 비만의 교란효과를 통제하기 위한 중회귀분석 결과, 혈청 CA19-9 농도와 유의한 회귀관계를 보이는 변수는 없었다. 이에 비해 혈청 CA125 농도는 전체대상례에선 흡연시작연령이 빠르거나(p=0.000), 총 흡연기간이 길거나(p=0.001), 총흡연량이 많거나(p=0.020), 생리중단연령이 늦거나(p=0.035), 수유를 오래 할수록(p=0.050) 감소하는 것으로 나타났으나, 성별로 분석하였을 때 여자에서 흡연인자들의 유의한 회귀관계가 모두 소실되었다. 결론적으로, 혈청 CA19-9 농도는 흡연, 음주, 월경-출산관련 변수들에 의해 영향을 받는 않는 것으로 보여 실제 임상에 적용할 때 이들 변수를 고려하지 않고도 이용될 수 있는 비교적 안정된 종양표지자로 생각된다. 이에 비해 혈청 CA125 농도는 흡연량이 증가할수록 감소하는 경향을 보였으나 연령과 비만지수에 따라 흡연량이 교란영향을 받고 있는 지표임을 알 수 있었다. 한편, 여성에서는 폐경연령과 총수유기간이 유의한 관계를 보여 향후 정상치역 결정시 생리, 수유 등의 변수를 고려해야 할 것으로 사료된다.

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