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RISS 인기검색어
- 검색키워드
- 저자 : 조의경(EK Cho) (검색결과 2 건)
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안영옥(YO Ahn),이재옥(JO Lee),조의경(EK Cho),안정자(JJ Ahn),강신명(SM Kang) 대한산부인과학회 1983 Obstetrics & Gynecology Science Vol.26 No.11
The data presented are based on 28 cases of pelvic tubercu1osis among 4830 cases of gynecologic patients admitted into Ewha Womans University Hospital, Seoul for past 12 years (197l~1982). The incidence of pelvic tuberculosis was 0.58%, l: l72 cases which was consi dered fairly high In the past history, the most cases of pelvic tuberculosis (61%, l7 cases) revealed one or more extra pelvic tuberculous lesions including pulmonary tuberculosis(46%, 13 cases), peritonitis {7%, 2 cases), lymphadenitis in neck (3.6%, 1 case) or sal pingitis (3.6%, 1 case). In family history, some 18% of cases with pelvic tuberculosis have had pulmonary tuberculosis in their family members. It was an important finding that majority (86%, 24 cases) of the cases with pelvic tuberculosis were in febrile and 66% of them had mild fever (36.8뫌~ 37.4뫌) which is likely to be overlooked in the diagnosis. The remaining associated findings of abdominal distension (43%, 12 cases) and infertility (39%, 11 cases} were also important from the diagnostic points of view Palpable mass was noticed in 50% of the pelvic tuberculosis, however certain percents (11%) of the cases were symptomless or negative findings. Preoperatively or postoperatively, only 25% of the patient were able to be susp ected as pelvie tuberculosis. There was ll% or 4 cases with pelvic tuberculosis were unrecognized or missed even in the surgery simply because majority of them (3 cases) were infertile pati ents associated with other disease masked such as adenomyosis, pseudocyst or serous ovarian cyst. In the surgery, the operator should be familiar and expert with operative findings and the final diagnosis should be based on meticulous and multipte or repeated hist opathologic studies. The most important points of treatment is considered to be early diagnosis as well as understanding of basic concepts on the tuberculosis. Primary antituberculous medication is considered to be choice of treatment. However it failed, surgical approach by skilled hand of gynecologist is imperative
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이남희(NH Lee),이재옥(JO Lee),조의경(EK Cho),우복희(BH Woo),강신명(SM Kang) 대한산부인과학회 1982 Obstetrics & Gynecology Science Vol.25 No.12
Maternal deaths encountered in Ewha Woman`s University Hospital for the period of 20 years from 1961 to 1980 were 111 cases including 60 cases of hospital deaths and 51 cases of deaths on arrival among 36682 live births. In this paper the overall leading causes of maternal death, the possible preventibility and the end result of comparative observation on the maternal deaths between early 1960`s and late 1970`s will be discussed. 1.The average hospital maternal mortality over the recent 4 years (1977~`80,9 deaths) were 108 per 100,000 live births. It was decreased tremendously to about one-half in comparison to 185 of the early 1960s` (1961~`66,19 deaths). 2.Direct causes of hospital maternal deaths over the recent 4 years ( 6 cases): Over the recent 4 years (1977~`80), major cause of maternal deaths or risk factors was hemorrhage (22.0%, all of 2 cases were due to abruptio placentae), and the hemorrhagic deaths were in increasing tendency when it is compared with the early 1960s` ( 10.5%, 1961~`66). The rest of death were due to preeclampsia (11.1%, 1 death), sepsis following pregnancy termination (1/9 deaths) and anesthesia (1/9 deaths). Over the past 20 years it was important to noted that the hospital maternal deaths rate due to sepsis following pregnancy termination, hemorrhagic abruptio placentae and infectious hepatitis apperaed to be increased although the deaths due to toxemia or uterine atonic bleeding have been relatively decreased. 3.Indirect causes of hospital maternal deaths or risk factors ( 3 cases over the recent 4 years): The incidence of infectious hepatitis-deaths was markedly increased up to 22.2% or 2 cases of total deaths over the recent years. It was compared with 5.3% of late 1960s`(1967~`71) and 15.4% of early 1970s` (1972~`76). The other was ruptured cerebral aneurysm. 4.Deaths on arrival (D.O.A.): Over the recent 4 years (1977~`80). there were 12 cases of deaths on arrival. The major causes of D.O.A. were also hemorrhage (33%, 4 cases), eclampsia (17%, 2 cases), septic abortion (17%, 2 cases), amnionic fluid embolism (17%, 2 cases), and anesthesia (17%, 2 cases). Two cases of hemorrhagic deaths were due to retained placenta resulted from home deliveries without medical attendant. And the other 2 cases of hemorrhagic deaths transferred from general practitioners were a case of uterine rupture probably due to oxytocin abused and a case of abruptio placentae. 5.Preventability of maternal deaths. (1)The hospital deaths. The possible preventable maternal deaths over the recent 4 years (1977~`80) accounted for 55% or getting less to about one-half of the early 1960s` (905) because not only the incidence of delayed admission or lacking the prenatal cares by patient-herself against the serious risk factors of toxemia or abruptio placentae have been markedly decreased, but the medical management of toxemia or post-abortive sepsis seemed to be improved. However the inevitable deaths including infectious hepatitis, choriocarcinoma or ruptured aneurysm were significantly increased over the recent years or late 1970s`(1977~`80). (2)The deaths on arrival: Over the recent years (1977~`80) the incidence of preventable deaths on arrival among the home deliveries on delayed admission transferred from the family side were fortunately decreased to 25% of the total D.O.A. or one-half of the early 1960s`(53.3%). However one of the unsolved problems was that the incidence of preventable D.O.A. referred from general practitioners were 50% of the D.O.A. or increasing steadily over the recent years. All such causes of the D.O.A. or risk factors were considered to be and result of the unskilled managements including bougination for termination of midtrimester pregnancy, toxemia or obstetric anesthesia.
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