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급성 골반 복막염의 복강경 조기 배농치료의 임상적 효과
고민환 ( Min Whan Koh ),배연경 ( Yeun Kyoung Bae ),최윤영 ( Yoon Young Choi ) 대한산부인과학회 2006 Obstetrics & Gynecology Science Vol.49 No.8
목적 : 급성 골반염으로 진단된 젊은 가임기 여성에서 기존의 항생제만의 치료와는 달리 조기에 복강경 시술을 통하여 골반염의 진단 및 조기 배농치료를 하여 그 임상적 효과를 평가하고자 하였다. 연구 방법 : 임상적 급성 골반염이 진단된 환자들 중 복강경 수술을 시행한 30명을 연구군으로, 기존의 고식적 주사 항생제 치료를 받고 퇴원한 환자 34명을 대조군으로 하여 수술 전후 및 치료 전후 환자들의 증상의 변화, 체온, 백혈구 수치, 혈구침강계수, C-반응성 단백수치의 변화를 측정하여 치료결과를 평가하고 비교하였다. 결과: 평균재원기간은 각각 7.8일 및 6.9일로 유의한 차이가 없었으며, 활력증후의 변화는 입원당시 발열을 보인 환자들을 대상으로 37℃이하 정상체온으로 돌아오기까지의 기간을 분석한 결과 연구군의 경우 수술 후 더글라스와 혈종이 생겼던 1예를 제외하고 모두 수술 후 3일째 정상체온을 보였으며, 대조군의 경우 재원 5일 이상 되어도 정상체온으로 떨어지지 않은 경우가 6명(27%)으로 유의한 차이를 보였다. 그러나 급성골반염의 전형적 증상들의 현저한 호전을 보인 경우는 재원 4일째 각각 66%, 67%로 두 군간의 차이가 없었다. 검사실 결과 비교시 입원당 시 백혈구 증가증을 보였던 환자군들 중 재원 3일째 10,000/㎕ 이하의 정상수치를 보인 경우가 연구군 83%, 대조군 73%로 차이를 보였으나 통계적으로 유의하지 못했으며 염증반응 지표로 활용한 혈구침강계수, C-반응성 단백수치 결과의 변화도 통계적으로 유의한 차이는 없었다. 결론: 본 연구에서는 복강경 수술군이 항생제 치료군과의 비교시 발열의 현저한 호전을 보인 것 외에는 술 후 임상적 경과는 유의한 차이가 없었지만, 합병증 없이 비교적 빠른 호전을 보이는 경향이 있고 조기 복강경 개입은 복강경으로 확인한 골반강 및 복강의 병적 소견에 대한 진단과 동시에 적절한 처치가 가능하여 후유증 예방에 유용하므로 급성골 반복막염의 1차적 치료법으로 복강경하 배농치료는 효과가 있을 것으로 사료된다. Objective: The purpose of this study was to evaluate the clinical efficacy of the early pelviscopic intervention in the acute pelvic inflammatory disease of reproductive aged female. Methods: A clinical evaluation for 30 women who underwent pelviscopic pus drainage in the pelvic inflammatory disease from September 2001 to December 2004 was done. This study group was compared with the control group that 34 cases of intravenous antibiotics treatment performed and we evaluated the clinical and laboratory findings were recorded for all patients before and after treatment. Results: The mean hospital stay was 7.8 days and 6.9 days respectively (p=0.25). There was statistical difference in regarding to febrile status period, that is febrile status was significantly improved in pelviscopy group. The febrile status of the study group was normalized within postoperative third day except 1 case that postoperative hematoma was formed in cul de sac, but it was not normalized within hospital fifth day in 6 cases (27%) of the control group (p=0.05). But there was no statistical difference between the two groups in regarding to clinical symptom free period except febrile status, WBC count change, and ESR/CRP count change. Conclusion: In this study, no significant difference was found between the two groups in regarding to clinical progress. But this study suggested that the early pelviscopic pus drainage was effective first line treatment method for the acute pelvic inflammatory disease with less complications and relatively rapid clinical improvement. However further study with more expanded cases that early pelviscopic intervention was done for the prevention of long term complications of pelvic inflammatory disease will be needed.
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IIA형 Phospholipase A2에 의한 TNF-α와 IL-6 생성 기전
안재홍 ( Jae Hong Ahn ),박대원 ( Dae Won Park ),김진희 ( Jin Hee Kim ),배제준 ( Jei Jun Bae ),배연경 ( Yeun Kyoung Bae ),박윤기 ( Yoon Ki Park ) 영남대학교 기초/임상의학연구소 2004 Yeungnam University Journal of Medicine Vol.21 No.2
Background: Secretory phospholipase A2 (sPLA2) are a group of extracellular enzymes that release fatty acids at the sn-2 position of phospholipids. Group IIA sPLA2 (sPLA2-IIA) has been detected in the inflammatory fluids, and its plasma level increases in the inflammatory disease. This study examined the effect of sPLA2-IIA on mouse macropahges in order to investigate the potential mechanism of sPLA2-induced inflammation. Materials and Methods: Wild type PLA2 and mutant H48Q PLA2 were purified from HEK293 cells transfected with the corresponding plasmids, and the PLA2 activities were measured using 1-palmitoyl-2-[1-14C]linoleoyl-3-phosphatidylethanolamine as substrates. The TNF-α and IL-6 released in the supernatants were determined by ELISA. In addition, the TNF-α and IL-6 mRNA were analyzed by RT-PCR. Results: sPLA2-IIA stimulated the production of TNF-α and IL-6 in a dose- and time-dependent manner. In addition, the effect of sPLA2-IIA on cytokine production from the macrophage was found to be associated with the accumulation of their specific mRNA. The mRNA levels of TNF-α and IL-6 peaked at 2 and 6 hours in a time-dependent manner, respectively. Conclusion: In conclusion, the production of proinflammatory cytokine might be mediated by the binding of sPLA2-IIA to the receptors.
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복압성요실금 환자에서 Kontinence HMT2000을 이용한 바이오피드백과 전기자극치료의 효과
배연경,이대형,박성철,진성희,고민환,이태형 영남대학교 의과대학 2003 Yeungnam University Journal of Medicine Vol.20 No.1
Background: To evaluate the efficacy of EMG biofeedback and pelvic floor electrical stimulation in the stress urinary incontinence patients by Kontinence HMT2000. Materials and Methods: A group of 14 patients with stress urinary incontinence were treated with combined biofeedback and intravaginal electrical stimulation during 12 sessions from 2 weeks to 6 weeks. Results: At immediate post treatment, subjective cure rate was 28% and improvement rate was 57% and failure rate was 15%. Thus the overall success rate for this treatment was 85%. The result of 3 months after treatment showed cure rate 14% and improvement rate was 43%. Intravaginal pressure increased by an average of 11.9 cmH2O. Increased vaginal pressure was found in 93% of the patients and more than 50% increment of intravaginal pressure was 71%. Conclusions: Combined biofeedback and pelvic floor electrical stimulation by use of Kontinence HMT2000 is effective for the patients who have good compliance, relative low degree stress urinary incontinence. In order to attain good results, a well structured program that teaches specific muscle exercise and the patients should be followed by regular interval reinforcement treatment.
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임신 14주에 발생한 비반흔 자궁에서의 자발성 자궁 파열 1예
김정숙,김진희,배연경,박윤기 영남대학교 의과대학 2004 Yeungnam University Journal of Medicine Vol.21 No.2
Spontaneous uterine rupture of the unscarred uterus during the second trimester of pregnancy is rare, but it is a surgical emergency. Because it results in rapid deterioration of patient and high mortality despite of prompt operation and massive transfusion, early diagnosis and proper management are critical for optimizing patient care. We present a case of spontaneous uterine rupture with fetal death in 14 weeks gestation with a brief review of literatures.
KCI
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