• 제목/요약/키워드: Gynecology department

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의료분쟁 판례분석 (Analysis of Medical Disputes Precedent)

  • 임복희
    • 한국콘텐츠학회논문지
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    • 제10권11호
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    • pp.294-303
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    • 2010
  • 의료사고란 의료서비스를 제공할 경우 발생하는 예기치 않은 사고'를 말하며, 의사는 환자치료에 대한 책임을 진다. 의료분쟁은 치료를 받는 과정에서 피해를 입었다고 생각하는 환자와 환자 진료에 대한 의무를 다하지 못한 의사 개인 간의 분쟁이다. 불행하게도 실제로 의료분쟁은 상호이해를 통하거나 상호 의사소통을 통한 공무상의 접근대신에 의료분쟁소송으로 나타나고 있다. 본 연구의 배경은 의료분쟁의 판례 분석을 통하여 의료분쟁의 유사한 사례를 예방하기 위한 기초자료를 제공하기 위하여 시도되었다. 본 연구의 결과는 다음과 같다. 첫째, 의료기관 설립구분에서는 병원급이 62.9%로 가장 많았다. 둘째, 의료분쟁의 발생 원인으로는 수술이 27.8%로 가장 많았고 그다음이 주의의무 위반 20.6% 그리고 진료가 11.3%를 차지하였다. 셋째, 진료과목에 따른 평균 배상급액은 산부인과가 38,384,000원으로 가장 높았다. 결론적으로 의료분쟁을 해결하기 위한 가장 좋은 방법은 의료분쟁의 원인 자체를 예방하기 위하여 진료과정에서 보다 세심한 주의를 기울여야 할 것이다.

Expression of P-glycoprotein is Positively Correlated with p53 in Human Papilloma Virus Induced Squamous Intraepithelial Lesions of Uterine Cervix: Poor Prognosis Association

  • Singh, Madhulika;Singh, Uma;Mathur, Neeraj;Shukla, Yogeshwer
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권12호
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    • pp.6039-6045
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    • 2012
  • This study was conducted to assess the predictive value of p-glycoprotein (p-gp) and p53 immunoexpression in human papillomavirus (HPV) infected cases of cervical dysplasia. Expression of both p-gp and p53 proteins was detected in cervical smears from 177 squamous intraepithelial lesions (SIL) cases along with 183 "atypical squamous cells of unknown significance" (ASCUS) and 150 normal cases. HPV 16 and 18 infection was detected by polymerase chain reaction using type-specific primers for HPV sub-types. There were no significant detectable p53 and p-gp expression in the normal cervix smears (p>0.05). In the ASCUS group 10 cases were positive for both p53 and p-gp immunoreactivity. In cervical dysplasia cases, p53 was positive in 86 (48.58%) while p-gp was positive in 93 (52.54%) and the two markers showed a highly significant correlation (r=0.92, p<0.001). Expression of p53 and p-gp was associated with grade of SIL (p<0.001). A positive correlation between the presence of HPV and expression of proteins p53 and p-gp in smears of patients with cervical lesions was also noted (p<0.001). Thus, p53 and p-gp immunostaining in cervical smears may act as an auxiliary biomarker for detection of HPV-associated cervical lesions. Additionally, a significant positive correlation between ascending grades of SIL and labeling indices of markers suggests that p53 and p-gp can be used as an adjunct to cytomorphological interpretation of conventional cervical Pap smears.

Resveratrol Exerts Differential Effects in Vitro and in Vivo against Ovarian Cancer Cells

  • Stakleff, Kimberly Sloan;Sloan, Tricia;Blanco, Denise;Marcanthony, Sharon;Booth, Tristan D.;Bishayee, Anupam
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권4호
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    • pp.1333-1340
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    • 2012
  • Epithelial ovarian cancer represents the most lethal gynecological cancer, and the high mortality rate makes this malignancy a major health concern. Poor prognosis results from an inability to detect ovarian cancers at an early, curable stage, as well as from the lack of an effective therapy. Thus, effective and novel strategies for prevention and treatment with non-toxic agents merit serious consideration. Resveratrol, obtained from grapes, berries, peanuts and red wine, has been shown to have a potent growth-inhibitory effect against various human cancer cells as well as in in vivo preclinical cancer models. The objective here was to evaluate potential antitumor effects of resveratrol in both in vitro and in vivo NuTu-19 ovarian cancer models. In vitro an invasion assay was performed. After 48 h, the numbers of viable cells that invaded the extracellular matrix layer were reduced by 94% with resveratrol in comparison to control. For the in vivo anti-tumor assessment, 10 rats were injected with NuTu-19 cells into the ovarian bursa. Thereafter, half were provided with a diet mixed with a dose of 100 mg resveratrol/kg body weight/day for 28 days. Following sacrifice, anticancer effects were assessed by histological evaluation of ovarian as well as surrounding tissues, and immunohistochemical detection of cell proliferation and apoptosis, but there were no observable differences between the control and resveratrol-treated groups for any of the biological endpoints. While resveratrol is effective in suppressing the in vitro cellular invasion of NuTu-19 ovarian cancer cells, these effects do not appear to impact on in vivo NuTu-19 ovarian cancers in rats.

『온병조변(溫病條辨)』 대표 처방의 병리학적 분석과 질환 범위 고찰 (Pathologic Study on Representative Prescriptions in 『Wenbingtiaobian』 and their Coverage of Diseases)

  • 박미선;김영목
    • 동의생리병리학회지
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    • 제32권1호
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    • pp.1-12
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    • 2018
  • This article is for understanding characteristics of febrile disease through analysing usage of representative prescriptions in "Wenbingtiaobian", composition of their related prescriptions and their coverage of modern diseases. Analysis of prescriptions was based on "Translation of Wenbingtiaobian", "Modern Shanhanlun" and "Herbal Formula Science" and clinical papers were searched in China Academic Journals(CAJ) of China National Knowledge Infrastructure(CNKI). Conclusions are as follows. First, principles of modifying or formulating prescriptions for febrile diseases are clearing heat, nourishing yin or dispelling dampness. Second, Zengyechengqitang, Xinjiahuanglongtang and Huweichengqitang are applied to pattern of bowel excess such as constipation or ileus. Third, Jiajianfumaitang is applied to heart diseases, Sanjiafumaitang to liver and heart, Dadingfengzhu to liver diseases. Fourth, Jiajianzhengqisan related prescriptions are applied to spleen diseases like conspitation, diarrhea or gastritis. Fifth, Baihujiarenshentang is applied to diabetes or fever and Baihujiaguizhitang to gout or arthritis. Sixth, Xuanbaichengqitang is applied to lung diseases and Taorenchengqitang to gynecology diseases. Seventh, Sanrentang is applied lung diseases like cough or pneumonia, spleen diseases like diarrhea or enteritis and kidney diseases like edema, arthritis or leucorrhea. Eighth, Yinqiaosan and Sangjuyin tend to be applied to exogenous diseases and diseases of five organs of sense, Jiajianfumaitang and Sanjiafumaitang to heart diseases, Angongniuhuangwan to encephalopathy, Qingyingtang and Huabantang to skin diseases, Zengyetang to gastrointestinal disorders, Shashenmaidongtang to lung or spleen diseases.

초산모의 산전교육이 분만경험 지각, 어머니 역할 수행에 대한 자신감, 만족도에 미치는 효과 (The Effects of Prenatal Education on Primiparas' Perception of Delivery Experience, Self-Confidence and Satisfaction in Maternal Role Performance)

  • 오현이;심정신;김진선
    • 여성건강간호학회지
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    • 제8권2호
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    • pp.268-277
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    • 2002
  • A comparative study was conducted to identify the effects of prenatal education on primiparas' self-confidence, satisfaction in maternal role performance and perception of delivery experience. Data were collected from 91 primiparas from August 1 to 30, 2001 using structured questionnaires. The subjects were selected from 2 OB & GY hospitals which operate the same prenatal education programs in M city. One group of subjects was primiparas who did receive prenatal education (n= 44) and another group of subjects was primiparas who did not receive prenatal education (n= 47). This study hypothesized that primiparas in education group would have higher self- confidence, satisfaction in maternal role performance and perception of delivery experience than those of non-education group. Descriptive statistics, $x^2$-test, t-test, and correlation were used for data analyses. The results of this study were as follows: 1. Primiparas in prenatal education group would not have better perception of delivery experience than those of non-education group (t=1.405, p = 0.163). 2. Primiparas in prenatal education group would have higher self-confidence in maternal role performance than those of non-education group (t=7.669, p=0.000). 3. Primiparas in prenatal education group would have higher satisfaction in maternal role performance than those of non- education group (t=4.115, p = 0.000). 4. There was significant correlations between self-confidence and satisfaction (r=0.489, p=0.000). Moreover, there was significant correlation between self-confidence and perception of delivery experience (r = 0.284, p = 0.006). The results of this study indicated that prenatal education needs to be developed and applied to nursing practice to increase self-confidence and satisfaction in maternal role performance. Experimental studies are needed to identify the effect of prenatal education.

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Cervical Cancer Screening: Recommendations for Muslim Societies

  • Khodakarami, Nahid;Farzaneh, Farah;Yavari, Parvin;Akbari, Mohamad Esmaeil
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권1호
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    • pp.239-247
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    • 2016
  • Background: The overall cervical cancer incidence rate is low in Iran; however, because of a higher risk of death for cervical cancer, a disease that kills women in middle age, a cervical cancer control program is needed. The aim of this study was to provide consensus recommendation for cervical cancer prevention in Iran and other Muslim societies with low incidences of cervical cancer. Materials and Methods: Through a practical guideline development cycle, we developed six questions that were relevant to produce the recommendation. We reviewed 190 full text records of cervical cancer in Iran (1971 to 2013) of which 13 articles were related to the data needed to answer the recommendation questions. We also reviewed World Health Organization, IARC, GLOBOCAN report, Iran Ministry of Health cancer registry report and 8 available foreign countries guidelines. Lastly, we also evaluated the Pap smear results of 825 women who participated in the Iranian HPV survey, of whom 328 were followed-up after a 5-year interval. Results: The obtained data highlighted the burden of HPV and cervical cancer situation in Iran. Experts emphasized the necessity of a cervical cancer screening program for Iranian women, and recommended an organized screening program with a cytological evaluation (Pap smear) that would start at the age of 30 years, repeated every 5 years, and end at the age of 69 years. Meanwhile, there is no need for screening among women with a hysterectomy, and screening should be postponed to post-partum among pregnant women. Conclusions: An organized cervical cancer screening is a necessity for Iran as more than 500-900 women in middle age diagnosed with an invasive cervical cancer every year cannot be ignored. This recommendation should be taken into account by the National Health System of Iran and Muslim countries with shared culture and behavior patterns. CUBA HPV test could be consideration in countries Muslim country with appropriate budget, resources and facility.

항경련제 투여를 받는 가임기 간질 여성의 난소의 형태 및 월경주기에 관한 연구 (Ovarian Morphology and Menstrual Cycle of Reproductive Age Women Receiving Anti-Epilepsy Medication)

  • 박성호;구승엽
    • Annals of Clinical Neurophysiology
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    • 제4권1호
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    • pp.51-55
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    • 2002
  • Background : An increased frequency of reproductive endocrine disorders and polycystic ovary(PCO) has been reported in women with epilepsy. A possible role of the seizure disorder or, of the use of antiepileptic drugs(AEDs) has been suggested as the pathogenic mechanism. The objective of the present study was to assess the prevalence of reproductive endocrine disorders, such as PCO or menstrual abnormalities, in a series of women with epilepsy, examining the possible relationships of these disturbances with different epilepsy syndromes and AED treatment. Methods : Thirty epileptic women, all of reproductive age and none pubertal, pregnant, or lactating, were evaluated by clinical endocrinological assessment, and pelvic ultrasonography. Seven patients were on valproic acid(VPA), nineteen on carbamazepine(CBZ), and four on diphenylhydantoin(DPH) treatment, respectively. Results : Menstrual irregularity was observed in 8 women(26.7%), dysmenorrhea in 7(23.3%), and premenstrual syndrome in 1(3.3%). Ultrasonographic examination revealed that one women(3.3%) showed polycystic ovary, 4(13.3%) had ovarian cyst(s), and 2(6.7%) had uterine myoma, respectively. There was no difference in the prevalence of menstrual abnormalities or polycystic ovary according to the different preparations of AEDs. Conclusions : Data from this investigation suggest that, in Korean reproductive age women, the treatment of AEDs and the kind of medication may not have a significant effect on the prevalence of menstrual abnormalities or ultrasonographic polycystic ovary.

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Predicting Lympho-Vascular Space Invasion in Endometrial Cancers with Mucinous Carcinomatous Components

  • Ilker, Selcuk;Nilufer, Cetinkaya;Firat, Cuylan Zeliha;Bulent, Ozdal;Hatice, Bayramoglu;Tayfun, Gungor
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권10호
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    • pp.4247-4250
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    • 2015
  • Objective: To determine the predictors of lympho-vascular space invasion (LVSI) in endometrial cancers which contain mucinous carcinomatous histology. Materials and Methods: Clinical and histopathological data of endometrial carcinomas with a mucinous carcinomatous component diagnosed between January 2007 and January 2014 at the Gynecologic Oncology Department of Zekai Tahir Burak Women's Health Education and Research Hospital were reviewed retrospectively. Results: Twelve patients (25.5%) were positive for LVSI and 35 (74.5%) patients were negative. Patients with LVSI were mostly staged higher than 1A. Mean age, BMI and parity were not significantly different between patient groups. Larger tumor diameter (${\geq}2cm$) (p=0.04) and elevated Ca125 and Ca-19.9 (p=0.01) levels were significant for predicting LVSI. We also found>1/2 myometrial invasion (p<0.001), cervical stromal involvement (p=0.002) and higher grade (2-3) (p=0.001) significant for predicting LVSI. In multivariate analysis we found only grade significant for predicting LVSI. Conclusions: Especially grade of tumor is a crucial factor for determining LVSI in endometrial cancers with mucinous carcinomatous components.

Effect of Korean Red Ginseng Crude Saponin on Blood Chemical Parameters of Guinea Pigs Exposed to TCDD

  • Hwang, Seock-Yeon;Youn, Nae-Young
    • 대한의생명과학회지
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    • 제9권1호
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    • pp.43-49
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    • 2003
  • This study was carried out to investigate the effect of crude ginseng saponin (CGS) on blood chemical parameters in adult female guinea pigs exposed to 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD). A total of 80 guinea pigs (800$\pm$20g) were divided into 8 groups: group 1 (normal control group) was given vehicle (corn oil containing small amount of acetone and DMSO) and saline; group 2 (single TCDD-treated) received TCDD (1 $\mu\textrm{g}$/kg, i.p.) and saline (i.p.); groups 3 and 4 were administered CGS at a daily i.p. doses of 10 and 20 mg/kg for 4 weeks, respectively; groups 5 and 6 were administered CGS (10 and 20 mg/kg, respectively) for 5 weeks starting 1 week before TCDD-exposure; groups 7 and 8 were administered CGS (10 and 20 mg/kg, respectively) for 3 weeks from 1 week after TCDD-exposure. CGS was prepared by Diaion HP-20 adsorption chromatography. Body weights of G2 were significantly decreased from the and week after TCDD-exposure (P<0.01). Body weights of the CGS-treated groups were also decreased by TCDD-exposure but the weight loss was greatly retarded compared with that of G2. Increase in blood glucose, amylase, lipase, total cholesterol, triglyceride, AST and LDL-cholesterol levels by TCDD exposure was significantly attenuated by the CCS-treatment (P<0.05). From these results, we found that saponin, the main active ingredient of gineseng, played a protective role in TCDD-induced toxicity and ginseng protected female animals from dioxin-induced toxic manifestation.

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교통사고 후 응급실에 내원한 경항통 환자의 경추 만곡 연구 (The Cervical Spine Curvature of Posterior Neck Pain Patients Who Visited Emergency Room After Whiplash Injury by Traffic Accident)

  • 조준영;이선행
    • 척추신경추나의학회지
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    • 제6권2호
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    • pp.121-132
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    • 2011
  • Objectives : The purpose of this study is to investigate the cervical spine curvature after whiplash injury by traffic accident. Methods : The cervical lateral radiographs of 102 outpatients who visited emergency room in Kyung-Hee university hospital at Gangdong after whiplash injury by road traffic accident were reviewed to measure the cervical spine angle using C1-7, C2-7 Cobb method, Sagittal tangent method, Jochumsen method and the Ishihara index by two oriental medical doctors. For statistics, we used SPSS version 17.0 for windows. Results : Means of cervical angle are $37.63{\pm}11.34^{\circ}$, $12.92{\pm}9.13^{\circ}$, $16.19{\pm}10.62^{\circ}$, $1.78{\pm}3.37$ and $8.51{\pm}9.78$ by C1-C7 Cobb Method, C2-C7 Cobb Method, Sagittal tangent method, Jochumsen method and Ishihara index, respectively. Hypolordosis is most numeral in patients by C1-C7 Cobb Method(n=40; 39.22%), Sagittal tangent method(n=68; 66.67%). And Straight is the most by Jochumsen method(n=54; 52.94%), but Normal is the most by Ishihara index(n=53; 51.96%). And Female has smaller curvature in cervical spine than male significantly by C2-C7 Cobb method and Sagittal tangent method(P<0.05). Conclusions : Whiplash injury tends to make hypolordosis or straight. And female has more vulnerable curvature than male in whiplash injury.

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