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간세포암종에 대한 간동맥 화학색전술 후 발생한 급성호흡곤란증후군
조윤원,이정미,최자윤,유동훈,차라리,오혜원,김홍준,민현주,김현진,정운태,이옥재,하창윤,이선영 이화여자대학교 의과학연구소 2013 EMJ (Ewha medical journal) Vol.36 No.1
Transcatheter arterial chemoembolization (TACE) has become an effective alternative treatment strategy for patients with inoperable hepatocellular carcinoma (HCC). Although TACE is relatively safe, acute respiratory distress syndrome associated with pulmonary lipiodol embolism is a rare and potentially fatal complication. We report a rare case of acute respiratory distress syndrome after TACE for inoperable HCC. A 75-year-old man, with huge HCC in right lobe, was treated by TACE for the first time. Seven hours after uneventful TACE procedure, he felt dyspneic and his oxygen saturation recorded by pulse oximetry (SpO2) fell to 80% despite of applying non-rebreathing mask. He underwent mechanical ventilation with a protective ventilatory strategy. We experienced a case of acute respiratory distress syndrome after TACE for HCC.
Spontaneous rupture of uterine artery during pregnancy
( Hye Ri Hong ),( Yung Taek Ouh ),( Hye Mi Jin ),( Geum Joon Cho ),( Min Jeong Oh ),( Hai Joong Kim ) 대한산부인과학회 2012 대한산부인과학회 학술대회 Vol.98 No.-
BACKGROUND: Spontaneous rupture of uterine artery during pregnancy is extremely rare but can be life threatening. Presenting symptoms include acute-onset abdominal pain and maternal hypovolemic collapse due to hemoperitoneum. An atypical case of uterine artery rupture at 35 weeks of gestation occurred in a woman without either fetal distress or hemodynamic collapse. CASE: A 31-year-old, nulliparous woman without any medical history admitted at 35 weeks of gestation for pain on rt lower quadrant and radiated to the whole abdominal area. The first diagnosis included acute appendicitis and placenta abruptio. At the abdominal ultrasonography and fetal monitoring by ultrasound and cardiotocography, we were not find any finding. But, we had to emergency cesarean section due to increasing abdominal pain. Laparotomy revealed an about 1L hemoperitoneum. Active bleeding from a ruptured fundus uterine artery was observed and successfully treated by selective suture. CONCLUSION: Spontaneous rupture of a uterine vessel during pregnancy is an extremely rare complication. We should considered in cases presenting with severe abdominal pain without either fetal distress or hemodynamic collapse.
Characteristics of the Pelvic Floor During Pregnancy by 2d and 3d Ultrasound
( Hye Ri Hong ),( Geum Joon Cho ),( Ae Ra Kang ),( Hye Mi Jin ),( Yung Taek Ouh ),( Min Jeong Oh ),( Hai Joong Kim ) 대한산부인과학회 2011 Obstetrics & Gynecology Science Vol.54 No.8
The aim of this study was to evaluate morphological characteristics of the pelvic floor in pregnant women using 2- and 3-dimensional (D)-transperineal ultrasound and compare our findings with findings in non-pregnant women. Methods This case-control study included 40 nulliparous pregnant women at term and 28 nulliparous, non-pregnant women (age-matched). The 2D- and 3D-transperineal ultrasounds were carried out in the semi-supine position, after voiding, at rest and during the Valsalva maneuver. Various biometric parameters related to characteristics of the pelvic fl oor were measured. Results Satisfactory biometric measurements were obtained in all cases. The mean thickness of the levator ani muscle was significantly greater in pregnant women than in non-pregnant women ( P<0.05). The mean levator hiatus angle and transverse diameter of the levator hiatus were significantly lower in pregnant women than in non-pregnant women ( P<0.05). The anteroposterior diameter of the levator hiatus was not significantly different between pregnant women and non-pregnant women. Conclusion Pregnant women had significantly thicker the levator ani muscles but smaller hiatal areas, as measured by the levator hiatus angle and transverse diameter, than did non-pregnant women. Pregnancy itself may cause morphological changes to the pelvic floor to support the birth canal by closing the lower end of the pelvic cavity as a diaphragm. Further studies are needed to evaluate morphologic changes of the pelvic floor following delivery as measured by 2D and 3D-transperineal ultrasound.
Hye Ri Kim,Sun Mi Kim,Won Sub Kang,Hong Jun Jeon,Seung-Ho Jang,Duk-In Jon,Jeongwan Hong,Jong Hyun Jeong 대한정신약물학회 2023 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.21 No.3
Objective: To develop an evidence-based guideline for the diagnosis and treatment of antipsychotic-induced hyperprolactinemia by adapting existing high-quality clinical guidelines with a view to improve the clinical symptoms and long-term quality of life of patients by providing appropriate management. Methods: This guideline was developed according to the ADAPTE methodology. The adaptation process included determining key health questions, systematically searching and screening guidelines, evaluating the quality and contents of these guidelines, deriving recommendations for key questions, and performing a peer review. The selection criteria for the guideline search were (1) evidence-based guidelines, (2) published within the last 5 years, and (3) written in English or Korean. Results: After evaluating the quality and content, we finally selected three guidelines for adaptation. The final output of the development process was 25 recommendations for 10 key questions. We adopted the Agency for Health Research Quality methodology and presented the level of evidence from levels I to IV. In addition, we defined the recommendation grades from grade A (strongly recommended) to D (no recommendation) based on the level of evidence and clinical significance of the recommendation. Conclusion: The development and dissemination of the adapted guideline is expected to increase the certainty of medical decision making and improve the quality of medical care. Further studies on the effectiveness and applicability of the developed guideline are necessary.
( Hye Mi Jin ),( Geum Joon Cho ),( Hye Ri Hong ),( Yung Taek Ouh ),( Ji Hye Lee ),( Yeon Sun Kim ),( Hai Joong Kim ),( Min Jeong Oh ) 대한산부인과학회 2012 대한산부인과학회 학술대회 Vol.98 No.-
The objective of the study was to evaluate the effect of antenatal corticosteroids administration between 24 and 34 weeks of gestation on the incidence of respiratory disorder in neonates born between 34 0/7 and 36 6/7 weeks of gestation. The medical records of 146 women who delivered between 34 0/7-36 6/7 weeks` gestational age at Guro Hospital, Korea University Medical Center from January, 2009 through March, 2012 was retrospectively reviewed. Maternal medical histories, including diagnoses of antenatal diseases and medication, and gestational age at delivery documented in medical records, and neonatal information were reviewed. Then the incidence of respiratory distress syndrome (RDS) and requirement of respiratory assistance among neonates was analyzed. The gestational age at delivery was younger in the group with exposure to corticosteroids (246.9±6.7 vs 249.3±5.6 days; p=0.020). Respiratory assistance in the exposed group was more frequently required as compared to the exposure group (5(3.4%) vs 24(16.4%); p=0.05). There were no significant differences in the rate of RDS (2(4.3%) vs 8(8.1%); p=0.5). The administration of corticosteroids and females were significantly and independently associated with decreased need for respiratory assistance (aOR 0.215, 95% CI 0.066=0.703, p=0.01, aOR 0.316, 95% CI 0.121-0.824, p=0.02) It appears that the exposure to antenatal corticosteroids between 24 and 34 weeks of gestation is associated with a less need for respiratory assistant among neonates born at 34 0/7 to 36 6/7weeks of gestation. Further studies are needed to determine whether the administration of antenatal steroids to women that have experienced preterm labor is associated with a similar benefit.
Case Report : A case of vulvar hematoma with rupture of pseudoaneurysm of pudendal artery
( Hye Ri Hong ),( Kyu Ri Hwang ),( Sung Ae Kim ),( Jeong Eun Kwon ),( Hye Won Jeon ),( Ji Eun Choi ),( Young Ho So ) 대한산부인과학회 2014 Obstetrics & Gynecology Science Vol.57 No.2
Vulvar hematomas are uncommon outside of the obstetric population and may be the result of trauma to the perineum. Vulvar hematomas most often present with low abdominal pain and urologic and neurologic symptoms. The vulva has rich vascularization that is supplied by the pudendal artery, a branch of the anterior division of the internal iliac artery. We describe a rare case of a 15-cm-sized vulvar hematoma with the suggested rupture of a pseudoaneurysm of the left pudendal artery without trauma injury. A 14-year-old girl presented with sudden pain and swelling in her left labium and was successfully treated with selective arterial embolization and surgical evacuation. We provide a literature review and discuss patient treatment and management strategies.
( Bo Hye Kim ),( Hee Kyung Kim ),( Hye Jeong Cho ),( So Dam Hong ),( Jae Kyoung Shin ),( Hee Jin Hong ),( Sae Ahm Kim ),( Hak Su Kim ),( Suk Pyo Shin ),( Ha Na Park ),( Seong Gyu Hwang ),( Kyu Sung Ri 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Background: Pyogenic liver abscess is the most common type of visceral abscess with a mortality rate of 10% to 25%. The mortality of liver abscess markedly decreased due to the improvement of diagnostic methods, antibiotics and other treatment modalities. We describe the clinical feature, changing trends of etiology and poor prognostic factors of pyogenic liver abscess during the recent 2 decades. Methods: We retrospectively reviewed the medical records of patients with pyogenic liver abscess who were treated in CHA Bundang Medical Center between 1996 and 2014. The period was divided into period 1 (1996-2004) and period 2 (2005-2014). We compare these two groups in age, etiology, etc. Results: 148 patients were indentifi ed. 60 patients were included period 1 and 86 patients were included period 2. There were no signifi cant interval changes in symptom, sign, number and size of abscess and laboratory fi nding between the two periods. The average age increased in period 2 (aged 62. 7) relative to period 1 (aged 57. 2) (P=0. 001). Klebsiella pneumoniae was the most common pathogen both two periods. The most common infection route was biliary tract (45. 5%) in period 1 and cyptogenic cause (53. 8%) in period 2 (P=0. 042). Interestingly, the percentage of hepatobiliary malignacy in etiology increased from 4. 5% in Period 1 to 10. 2% in period 2. (P= 0. 03) Liver abscess originated from hepatobiliary problem showed a higher recurrent rate (P=0. 018). Conclusions:The average age of patients with pyogenic liver abscess has increased substantially and the predominant pathogen originates from the biliary tract because biliary procedures has increased. Hepatobiliary malignancy is the major risk factor and poor prognostic factor for pyogenic liver abscess. Therefore early diagnosis and close observation is important for patients with biliary problem or hepatobiliary malignancy.