• 대한세포병리학회지
• /
• 제19권2호
• /
• pp.164-167
• /
• 2008

Malakoplakia is an uncommon chronic granulomatous inflammation that usually involves the urinary and gastrointestinal tracts, but rarely affects the female genital tract. We experienced a case of malakoplakia in a cervicovaginal smear in a 54-year-old woman. Colposcopic examination showed a friable, easily bleeding tissue in the uterine cervix and the vaginal fornix. The cervicovaginal smear consisted of numerous isolated histiocytes, polymorphonuclear leukocytes, lymphocytes, and plasma cells. The histiocytes had an abundant, granular, and degenerated cytoplasm with inflammatory cell debris. Michaelis-Gutmann bodies were readily identified.

• Radiation Oncology Journal
• /
• 제18권1호
• /
• pp.40-45
• /
• 2000

목적 : 수술 및 수술 후 보조적 방사선치료를 시행한 자궁내막암 환자의 예후인자, 재발 장소 및 생존율 등을 분석해 보고자 하였다. 대상 및 방법: 1991년 9월부터 1997년 12월까지 서을중앙병원에서 수술 및 방사선치료를 받은 27예의 자궁내막암환자를 대상으로 하였다. 수술은 단순자궁적출술이 6예, 단순자궁적출술 및 림프절 절제술이 8예, 근치적 자궁적출 술이 13예에서 시행되었다. 모든 환자에서 외부 방사선치료가 시행되었으며 이 중 16예에서 ovoid를 이용한 질내조사가 추가되었다. 조사선량은 외부 방사선치료는 총 50.4 Gy를 조사하는 것을 원칙으로 하였고, 질내조사는 1회 분할선량 4$\~$5 Gy씩 4내지 5회 시행하였다. 추적기간은 6개월에서 95개월로서 중앙추적기간은 30개월이었다. 결과:FIGO 병기는 I-18예(67$\%$), II-1(4$\%$), III-8예(29$\%$)이었고, 조직분화도는 1$\~$14예(52$\%$), 2$\~$6예(9$\%$), 3$\~$7예(26$\%$)이었다. 수술 후 조직 소견상 조직분화도가 나쁠수록, 자궁근층의 침범 정도가 심할수록, 자궁부속기의 침범이있는 경우, 림프-혈관 침범이 있는 경우 골반내 림프절이 양성을 보이는 경우가 많았으나 통계적인 의미는 없었다. 추적이 종료된 시점에서 사망한 환자가 한 예도 없어 전체 생존율은 100$\%$이었으나 3예에서 병이 재발되어 3년 및 5년 무병생존율이 각각 89.6$\%$,, 76.8$\%$이었다. 재발 장소는 골반내, 대동맥방림프절, 폐를 포함한 다발성 등이 각각 I예 이었고 질 재발은 관찰되지 않았다. FIGO 병기(p=0.01), 림프-혈관 침범(p=0.03), 골반내 림프절 침범(p=0.0001)등이 무병생존을에 영향을 미치는 것으로 나타났고 조직분화도가 나쁠수록 무병생존율이 저조한 경향을 보였다(p=0.1). 치료부작용으로는 1예에서만 Grade 1의 직장출혈이 나타났으나 중등도 이상의 합병증을 보인 경우는 없었다. 결론 : 수술후 조직학적 소견에 따른 외부방사선치료 및 추가 질내조사는 국소재발을 억제하는데 효과적인 것으로 판단되며 결과적으로 생존율을 향상시키는데 기여하는 것으로 생각된다. 다만, 병기 및 조직분화도에 따라 질내조사를 추가하지 않는 경우 질 재발이 호발하는 환자군에 대한 연구가 더 진행되어야 할 것으로 판단된다.

• 대한영상의학회지
• /
• 제79권6호
• /
• pp.315-322
• /
• 2018

목적: 속발성 분만 후 출혈 환자에서 임상 양상 및 혈관 조영술의 특징과 경도관 동맥 색전술의 결과를 알아보고자 하였다. 대상과 방법: 속발성 분만 후 출혈로 인해 단일 3차 의료기관에서 동맥 색전술을 시행한 38명의 환자를 대상으로 분만 방식, 출혈 원인, 임상 증상, 혈관 조영술 소견, 색전 물질과 방법, 결과 등에 대하여 후향적으로 분석하였다. 결과: 20명(53%)의 환자가 제왕절개를 시행하였으며, 출혈 원인은 의인성 혈관 손상(n = 11), 잔류 태반(n = 10), 자궁근 무력증(n = 8), 후천성 자궁 동정맥 기형(n = 5) 등이었다. 간헐적(50%) 및 지속적(50%) 대량 질 출혈이 임상적으로 관찰되었다. 7명(18%)의 환자에서 내원 시 저혈량 쇼크를 보였다. 혈관 조영술 상 18명이 양성 소견을 보였으며, 제왕절개 후 가성동맥류 빈도가 통계학적으로 의미 있게 높았다(p < 0.001). 젤폼 이외에 N-butyl cyanoacrylate (7예), 미세 코일(7예)을 사용하였다. 출혈 부위 초선택이 가능하였던 10명의 환자(26.3%)에서는 단측 혈관 선택 색전술만으로 지혈이 성공적이었다. 기술적 성공률은 100%였으며, 임상적 성공률은 97.4%이었다. 추적 관찰이 가능했던 16명에서 정상 월경 주기를 보였으며, 1예의 정상 임신이 관찰되었다. 결론: 속발성 분만 후 출혈은 저혈량 쇼크를 보일 수 있으며, 양성 출혈 소견을 보이는 빈도가 높았다. 따라서 조기 혈관 조영술과 동맥 색전술이 필요하리라 생각된다.

• 대한간호학회지
• /
• 제1권1호
• /
• pp.64-76
• /
• 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.

• 대한한방부인과학회지
• /
• 제33권2호
• /
• pp.44-62
• /
• 2020

Objectives: The purpose of this study is to evaluate the effectiveness of herbal medicine for recovery and treatment of cervical intraepithelial neoplasia (CIN) after loop electrosurgical excision procedure (LEEP). Methods: We searched two english, one chinese and four korean database up to November 4, 2019. Randomised controlled trials (RCTs) were eligible. Primary outcome included Human papilloma virus (HPV) clearance rate and the effective ratio of treatment. And vaginal bleeding time and volume, improvement of symptoms, and recovery of wound were regarded as secondary outcomes. The risk of bias was assessed by two independent authors using the Cochrane risk of bias tool. Results: Of 47 screened, 10 RCTs were included. Number of participants per study ranged from 58 to 360. The studies which used HPV clearance rate as primary outcome were considered as low risk of bias. Most of the studies had considerable heterogeneity in terms of type of intervention, comparison and time-points for outcome measurement. Compared to LEEP alone, herbal vaginal suppository combined group showed favorable results for HPV clearance in patients (5 studies, n=627, 95% CI 1.26 to 1.55, I²=75%). And compared to LEEP alone, herbal external application also showed favorable results for HPV clearance in patients (2 studies, n=252, 95% CI 1.19 to 1.61, I²=86%). Three studies reported mild and temporary adverse events, and no serious adverse events were reported. Conclusions: The studies showed that herbal medicine can significantly effective on recovery of CIN after LEEP. However, included studies suffered from incomplete reporting, high or unclear risk of bias and substantial heterogeneity between studies. In the Future, further high-quality RCTs are needed to prove effectiveness of herbal medicine for CIN after LEEP and reduce the risk of bias.

• Clinical and Experimental Reproductive Medicine
• /
• 제40권3호
• /
• pp.131-134
• /
• 2013

Objective: To evaluate the effect of the addition of estradiol to luteal progesterone supplementation in GnRH antagonist cycles for infertile patients undergoing IVF/ICSI. Methods: One hundred and ten infertile patients, aged 28 to 39 years, were recruited for this prospective randomized study. They were randomly assigned to receive vaginal progesterone gel (Crinone) along with 4 mg estradiol valerate (group 1, n=55) or only Crinone (group 2, n=55) for luteal support. A GnRH antagonist multiple dose protocol using recombinant human FSH was used for controlled ovarian stimulation (COS) in all of the subjects. The COS results and pregnancy outcomes of the two groups were compared. Results: Group 1 and 2 were comparable with respect to the patient characteristics. The COS and IVF results were also comparable between the two groups. There were no differences in the clinical pregnancy rate (PR) and multiple PR between the two groups. However, the embryo implantation rate were significantly higher in group 1 than that in group 2 (22.2% vs. 13.3%, p=0.035). The incidence of luteal vaginal bleeding (LVB) was significantly lower in group 1 (7.4% vs. 27.8%, p=0.010). Conclusion: The addition of estradiol to luteal progesterone supplementation in GnRH antagonist cycles reduces the incidence of LVB and increases the embryo implantation rate in infertile patients undergoing IVF/ICSI.

• Journal of Gastric Cancer
• /
• 제6권3호
• /
• pp.189-192
• /
• 2006

위암과 관련된 급성 파종성 혈관 내 응고증의 발병 빈도는 0.68%로 보고되고 있으며 생존 기간은 $1{\sim}3$주로써 예후가 매우 불량하다. 본 증례는 47세된 여자가 호흡곤란과 질출혈을 주소로 내원하여 위암4기(골 및 골수전이)로 진단됨과 동시에 검사실 소견상 급성 파종성 혈관 내 응고증 소견을 보인 예이다. 현재 위암과 동반된 급성 파종성 혈관 내 응고증에 대한 표준 복합 항암화학요법 약제는 정립되어 있지 않다. 본 예에서는 irinotecan과 cisplatin 복합화학요법을 시행하여 환자의 증상 및 급성 파종성 혈관 내 응고증 소견이 호전되고 생존기간이 연장된 1예를 보고하는 바이다. 따라서 위암과 동반된 급성 파종성 혈관 내 응고증의 경우에는 혈액학적으로 불안정하더라도 대한 전신 항암화학요법을 시행함으로써 생존기간을 연장하고 환자의 삶의 질을 향상시킬 수 있다.

• 대한간호학회지
• /
• 제2권1호
• /
• pp.141-157
• /
• 1971

The peripheral infection is one of the major causes of maternal death, and although it is preventable through an effective prenatal as well as postnatal care its morbidity is increasing due to bacterial resistant to an effective antibiotics. The primary purpose of this study was to investigate the peripheral morbidity of 949 parturients who were admitted to the Obstetrics and Gynecologic department of Ewha Woman's University Hospital from January 1971 to September 1971. Among the 949 parturients, especially 40 normal parturients were selected (20, control soup was given complete aseptic care during labor and delivery and post delivery: 20, compare group was given the ordinary care practiced during labor and delivery and maternal ward of Ewha Woman's University Hospital) for bacteriologic test on vaginal flora twice, on admission and on complete cervical dilatation of each parturient. The results obtained from this study were as follows; 1. Majority of parturients age were 21 to 35 years old(90.83%), and educational level of 949 parturients was above high school. A large number of parturients socioeconomic level (according to their husbands' job) were moderate. 2, Among the 949 parturients, multipara (55.9%) were a little more than primipara (44. 1%) and 38.84% of parturients had experienced aborition. 3. In deliverty types, normal deliveries (804 cases) were more than cesarean section deliveries (145 cases) The peripheral morbidity after normal deliveries was 0.5%, and cesarean section deliveries, 23.45%. 4. Among 949 parturients incidence of hemorrhage eases (500cc or more bleeding) showed the higher peripheral morbidity (24.86%) than other cases (bleeding less than 500cc, 7.83%). 5. The majority of parturients (81.03%) had teen taking antenatal care, but most of them were taken irregular antenatal care. On the other hand, on admission, the parturients with complication were 30.32%, and their peripheral morbidity showed much higher (7.02%) than those with no complication (2.71%). 6. The incidence of peripheral morbidity in premature ruptured membrane was higher (10.91%) than normal parturienta (1.73%). 7. In the result of aseptic care during labor and delivery and post delivery, the number of cultured bacteria was legs in control group than Compare group (in control group, on admission 17, on complete cervical dilatation 12: in compare group, on admission 21 on complete cervical dilatation 21) . The most common bacteria were Staphylococcus (control group 14 on admission, compare group 16 on admission), and next Streptococcus, E- Coil, Bacillus Subtilis, in order. Also in control group the number. of colony were reduced (43%) more than in Compare group. Transient temperature elevation from 37℃ to 37.4℃ were noted in compare group (50%) than in control group (30%), and there was no one indicated above 38℃. In conclusion, the aseptic care is the test way of preventing peripheral infection as well as decreasing the puerperal morbidity. Therefore the most important nursing care is the aseptic care for each parturient during labor and delivery and peat delivery and also all the instruments must be cleaned and sterilized.

• 한국한의학연구원논문집
• /
• 제13권2호통권20호
• /
• pp.27-36
• /
• 2007

Hibiscus syriacus is rarely used herb. For finding up new applications of this herb, the medicinal parts and expected efficacys that recorded in 24 classics of oriental medicine were inquired. As a result of the literature review, medicinal parts and expected efficacys of Hibiscus syriacus were as follows: The medicinal parts were mainly flower and bark. But the root, branch, leaf and fruit were mentioned too. Some unidentified medicinal parts seemed to be branch or bark. The mentioned symptoms that prescribed Hibiscus syriacus are intestinal 'wind', red-white dysentery, thirst with fever after dysentery, insomnia, 'wind' syndrom, leukorrhea, regurgitation, etc. And this herb was mentioned that applied externally for scabies, hemorrhoids, prolapse of the rectum, headache, extracted tooth, etc. Therefore, bleeding intestinal diseases, insomnia, vaginal or uterine hemorrhage(for internal use), scabies or mycosis, hemorrhoids. anal fistula, prolapse of the rectum, headache(for external use) were presented as expected efficacys of Hibiscus syriacus. In future, studies for verifying the efficacys are needed.

• Asian Pacific Journal of Cancer Prevention
• /
• 제16권18호
• /
• pp.8321-8325
• /
• 2016

Background: The incidence of hydatidiform mole (HM) differs among regions but has declined significantly over time. In Thailand, the initiation of universal health coverage in 2002 has resulted in a change of medical services countrywide. However, impacts of these policies on gestational trophoblastic disease (GTD) cases in Thailand have not been reported. This study aimed to find the incidence of hydatidiform mole (HM) in King Chulalongkorn Memorial Hospital (KCMH) from 1994-2013, comparing before and after the implementation of the universal coverage health policy. Materials and Methods: All cases of GTD in KCMH from 1994-2013 were reviewed from medical records. The incidence of HM, patient characteristics, treatment and remission rates were compared over two study decades between 1994-2003 and 2004-2013. Results: Hydatidiform mole cases decreased from 204 cases in the first decade to 111 cases in the seond decade. Overall incidence of HM was 1.70 per 1,000 deliveries. The incidence of HM in the first and second decades were 1.70 and 1.71 per 1,000 deliveries, respectively (p=0.65, 95%CI 1.54-1.88). Referred cases of nonmolar gestational trophoblastic neoplasia (GTN) increased from 12 (4.4%) to 23 (14.4%, p<0.01). Vaginal bleeding was the most common presenting symptom which decreased from 89.4% to 79.6% (p=0.02). Asymptomatic HM patients increased from 4.8% to 10.2% (p=0.07). Rate of postmolar GTN was 26%. Conclusions: The number of HM cases in this study decreased over 2 decades but incidence was unchanged. Referral rates of malignant cases were more common after universal health coverage policy initiation. Classic clinical presentation was decreased significantly in the last decade.