• 지역사회간호학회지
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• 제25권3호
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• pp.198-206
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• 2014

Purpose: The purposes of this study were to identify the prevalence and influencing factors of fecal incontinence, and to analyze the association between fecal incontinence and depression. Methods: The subjects of this study were 233 women living in rural areas, and data were collected using questionnaires from February 24 to May 30, 2012. Fecal incontinence was measured with the Continence Grading Score, and depression with the Geriatric Depression Scale. Collected data were analyzed using SPSS through $x^2$-test, Fisher's exact test, t-test and ANOVA. Results: Of the subjects, 16.7% had fecal incontinence. The prevalence of fecal incontinence was higher in older women ($x^2=23.55$, p<.001), those with vaginal delivery ($x^2=4.81$, p=.049), those with parity of 4 or more ($x^2=13.47$, p=.003), and those with urinary incontinence ($x^2=26.36$, p<.001). The level of depression was significantly higher in older women (F=19.27, p<.001), those with low academic qualification (F=18.17, p<.001), those with urinary incontinence (F=4.15, p=.043), and those with fecal incontinence (F=14.90, p<.001). Conclusion: These results suggest that there should be supports by public health care for fecal incontinence prevention and care programs in order to promote the physical and emotional health of rural women.

• 대한간호학회지
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• 제43권3호
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• pp.420-430
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• 2013

Purpose: The aim of this study was to review the literature to determine whether intensive pelvic floor muscle training during pregnancy and after delivery could prevent urinary and fecal incontinence. Methods: Randomized controlled trials (RCT) of low-risk obstetric populations who had done Kegel exercise during pregnancy and after delivery met the inclusion criteria. Articles published between 1966 and 2012 from periodicals indexed in Ovid Medline, Embase, Scopus, KoreaMed, NDSL and other databases were selected, using the following keywords: 'Kegel, pelvic floor exercise'. The Cochrane's Risk of Bias was applied to assess the internal validity of the RCT. Fourteen selected studies were analyzed by meta-analysis using RevMan 5.1. Results: Fourteen RCTs with high methodological quality, involving 6,454 women were included. They indicated that Kegel exercise significantly reduced the development of urinary and fecal incontinence from pregnancy to postpartum. Also, there was low clinical heterogeneity. Conclusion: There is some evidence that for antenatal and postnatal women, Kegel exercise can prevent urinary and fecal incontinence. Therefore, a priority task is to develop standardized Kegel exercise programs for Korean pregnant and postpartum women and make efficient use of these programs.

• Clinical and Experimental Pediatrics
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• 제51권11호
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• pp.1136-1139
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• 2008

The genitourinary tract and gastrointestinal system are interdependent but share the same embryological origin, pelvic region, and sacral innervation. Although children with voiding disturbances often present with bowel dysfunction, this coexistence was considered coincidental until recently. However, it is now accepted that dysfunction in emptying of both systems is interrelated. Afferent impulses carrying sensory information are transmitted through the spinal cord and brainstem toward several cortical and subcortical areas, resulting in conscious control of the bladder and bowel. Alteration in these afferent pathways can result in dysfunction, including urinary and fecal incontinence. Distal gastrointestinal tract problems such as constipation might induce an inhibitory rectovesical reflex that interferes with normal voiding. Therefore, lower urinary tract function seems to be closely associated with distal gastrointestinal tract function.

• Journal of Korean Neurosurgical Society
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• 제47권6호
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• pp.473-476
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• 2010

Sacral nerve stimulation (SNS) is an effective treatment for bladder and bowel dysfunction, and also has a role in the treatment of chronic pelvic pain. We report two cases of intractable pain associated with cauda equina syndrome (CES) that were treated successfully by SNS. The first patient suffered from intractable pelvic pain with urinary incontinence and fecal incontinence after surgery for a herniated lumbar disc. The second patient underwent surgery for treatment of a burst fracture and developed intractable pelvic area pain, right leg pain, excessive urinary frequency, urinary incontinence, voiding difficulty and constipation one year after surgery. A SNS trial was performed on both patients. Both patients' pain was significantly improved and urinary symptoms were much relieved. Neuromodulation of the sacral nerves is an effective treatment for idiopathic urinary frequency, urgency, and urge incontinence. Sacral neuromodulation has also been used to control various forms of pelvic pain. Although the mechanism of action of neuromodulation remains unexplained, numerous clinical success reports suggest that it is a therapy with efficacy and durability. From the results of our research, we believe that SNS can be a safe and effective option for the treatment of intractable pelvic pain with incomplete CES.

• 한국임상수의학회지
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• 제33권6호
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• pp.389-391
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• 2016

A 10-month-old, intact female Shih-tzu dog with a pelvic limb ataxic gait, and urinary and fecal incontinence since birth, was examined by computed tomography and magnetic resonance imaging. The butterfly hemivertebra of the fourth lumbar vertebra, agenesis of the third sacral and coccygeal vertebrae, and spina bifida of the remaining sacral vertebra were observed on the computed tomography images. Magnetic resonance imaging revealed traction of the conus medullaris. The dog was diagnosed with sacrocaudal dysgenesis with presumptive tethered cord syndrome, and concurrent infectious cystitis was found by ultrasonography and urinary analysis. The Shih-tzu recovered from the cystitis, but still has the ataxic gait and urinary and fecal incontinence. This report summarizes the case of a dog with sacrocaudal dysgenesis that was identified by imaging diagnosis.

• Advances in pediatric surgery
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• 제12권1호
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• pp.115-125
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• 2006

Postoperative management of anorectal malformation consists of colostomy management and then management after definitive surgery. Colostomy management requires attention to certain details, i. e. complete decompression of the distal limb to avoid secondary megarectosigmoid and prevention and treatment of urinary tract infections in patients with rectourethral fistula. Management after definitive surgery requires the care of catheters placed in the rectourethral fistula or cloacal defect. Prevention and treatment of various complications after definitive operation, i. e. wound infection, anal stenosis or stricture, anal mucosal prolapse, and management of functional disorders, i.e. constipation, fecal incontinence and urinary incontinence are also necessary. In this review, recent trends for the prevention and treatment of the above mentioned problems after operation for anorectal malformation are presented.

• 대한간호학회지
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• 제41권6호
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• pp.780-787
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• 2011

Purpose: This study was conducted to examine activities of daily living (ADL) of older adults admitted to Korean long-term care hospitals (LTCHs), and to explore the patient and organizational factors that have an impact on the ADL of this population. Methods: A secondary analysis of the Korean minimum data set (K-MDS) of patients (N=14,369) and of the profiles of LTCHs (N=358) from the Health Insurance Review and Assessment Service was done between January and July 2008. The outcome variable was ADL score 6 months after baseline assessment. Multi-level linear regression was employed to explore the patient and organizational factors that affected ADL scores. Results: Of the patients, 45.4% had a baseline ADL score of between 31 and 40, with a score of 40 indicating that the patient was entirely dependent for all items. None of the organizational characteristics were significantly associated with effects on the ADLs of older adults who had been in a LTHC for at least 6 months. However, patient characteristics, such as age, baseline ADL, frequency of physical therapy, urinary incontinence, fecal incontinence, pressure ulcers, and having a tube or catheter, were significantly associated with ADL 6 months after baseline. Conclusion: In order to maintain and improve the ADL of older adults in LTCHs, we should develop strategies to prevent urinary and fecal incontinence, pressure ulcers, unnecessary tubes or catheters, providing adequate physical therapy. Additional studies should include more detailed information regarding nursing staff, including RN hours for direct care, education level and turnover.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제25권4호
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• pp.340-346
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• 2022

Purpose: The treatment and long term clinical outcomes of anorectal malformations (ARM) in children have always been the focus of pediatric surgeons. This study aimed at reporting our experience as far as long-term follow-up of ARM in children is concern. Methods: We enrolled patients treated between 1999 and 2019, and established selection criteria to choose appropriate subjects. A validated questionnaire was used to determine long-term quality of life outcomes. Results: Out of a total of 48 patients treated within the study period, 28 were enrolled in this study. Among the latter, more than 35% had at least one long-time complication, and more than 90% had a good lifestyle. Urinary and fecal continence was achieved in more than 95% of the patients using medical devices. Conclusion: This study aimed to bring up new concepts; taking into consideration all aspects of life in patients with ARM, from school life to sexuality, while evaluating fecal and urinary continence. This is essential for the improvement of the skills of the different specialists involved in the management of these patients, and for the implementation of strategies that can improve postoperative function. Most especially, it will also help improve communication between doctors to ensure an adequate transition of these children into adult life.

• 한국임상수의학회지
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• 제31권4호
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• pp.307-312
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• 2014

충북대학교 동물의료센터에 16년령 암컷 시츄견이 복부팽만과 배뇨, 배변곤란을 주증으로 내원하였다. 신체검사 시 복부에서 10 cm 가량의 종양이 촉진되었으며 방사선 상에서 확인되었고, 방광은 종양에 의해 배꼽 쪽으로 변위되어 있었다. 초음파 상에서 종양은 불균질한 실질과 국소적으로 무에코성 영역을 가지고 있었다. 혈액검사 소견상 혈소판증가증과 약한 호중구증가증이 나타났으며, 혈액화학치 검사 결과 ALP 상승을 확인할 수 있었다. 개복술을 시행하여 자궁경과 방광 사이의 $10.5{\times}9.6cm$ 크기의 단단한 종양이 요도를 포매하고 있는 것을 확인하고 주위조직과 둔성분리 후 절제하였다. 조직병리학적 검사와 면역화학 적 검사 결과 종양은 평활근육종으로 진단되었다. 수술 후 일주일 뒤 배뇨곤란을 주증으로 재 내원하였다. 배뇨곤란의 원인을 찾기 위하여 요도조영술을 실시하였으나 물리적인 폐색 등 특별한 원인을 찾을 수 없었다. 방광근과 방광조임근에 작용하는 몇몇 약물요법 등을 시행하였지만 반응이 없어 중장기의 보존요법이 지시되었으며 배뇨곤란 증상은 술 후 27일차에 갑작스럽게 호전되어 환자는 원활한 배뇨를 하게 되었다. 본 증례는 요도를 포매하고 있는 복강 내 종양의 수술 후 예후와 배뇨곤란과 같은 후유증을 나타낼 수 있음을 시사하고 있다.

• 대한한의학방제학회지
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• 제11권1호
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• pp.45-55
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• 2003

From the study of the symptom, pathology in prescription of Ha-Tong from The Bangyakhapeun. I have reserched 163 prescription. It can be concluded as follows. 1. Prescription about Fecal disease which was the most as 11.66% of the whole, following order Internal disease(6.75%), Uterus Disease(5.52%) Sick-by-Cold Disease(5.52%), Eye Disease(4.91%), Blood Disease(4.91%), Unbalanced humoral status Disease(4.91%), Gynecologic Disease(4.91%). 2. The Fecal Disease divide diarrhea and dysentery; The Internal Disease divides with Sik-sang(食傷) Chu-sang(酒傷), Sik-juck-yu-sang-han(食積類傷寒), Carbonic acid, Vomiting acid; The Uterus Disease divides with Urinnary Disadvantage, Urinary retention, Incontinence; The Sick-by-Cold Disease divides with yang-myung-byung(陽明病), sang-han-goi-jng(傷寒壞證), sang-han-bun-gal(傷寒煩渴), sang-han-sum-ou, sang-han-hyul-jng(傷寒血證), sang-han-ja-ri(傷寒自利), sang-han-bun-jo-jng(傷寒煩燥證). 3. The Diarrhea and Dysentery many used o-ryung-san, hwng-gum-jak-yak-tang(黃芩芍藥湯) hyang-ryun-hwan(香連丸) etc, and The Internal Disease many used pyung-we-san(平胃散) as a basic prescripton. 4. The organ problem use the Sil-yuol(實熱) of the liver, stomach, lung, uterus, small intestine; six natural factors problem used the Sil-jng(實證) of the wind, fire, heat, cold, dampness; And used Unbalanced humoral status, lntrnal hurt, qi and blood, seven extream feeling.