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간이식 수술중 중증도 대사성 산증시 중탄산나트륨을 투여하지 않은 환자에서의 산-염기의 변화
이유미,조현성,곽미숙,김갑수 대한마취과학회 1999 Korean Journal of Anesthesiology Vol.37 No.4
Background : Marked derangements in acid-base status are frequently seen during orthotopic liver transplantaton. To prevent the progression of metabolic acidosis, treatment with sodium bicarbonate has been recommended. However, sodium bicarbonate may exacerbate intracellular acidosis, increase plasma lactate, contribute to hypernatremia. The value of giving bicarbonate has been questioned. Accordingly, we reviewed the intraoperative the acid-base status of patients who underwent orthotopic liver transplatation. Methods : We reviewed ten patients showed severe metabolic acidosis (7.2 < pH < 7.30 and base deficit (BD) ≥ 10). Despite of BD ≥ 10, sodium bicarbonate was not given to all. Intraoperative pH and BD were analyzed retrospectively Results : At the anhepatic and immediate post-reperfusion periods, the pH was decreased (P < 0.05) and BD was increased (P < 0.05), but both were normalized at the end of surgery. The mean blood pressure transiently decreased at the immediate post-reperfusion pe(P < 0.05), but that was acceptable. Conclusions : This study showed that a severe metabolic acidosis is tolerated by the patients undergoing orthotopic liver transplantation without administration of sodium bicarbonate. (Korean J Anesthesiol 1999; 37: 631∼636)
만삭전 조기 양막파열 산모에서 양수내 감염의 발생양상 및 임상적 의의
이유미,김재원,김승욱,신희철,윤보현,전종관,양순하,채희동 대한산부인과학회 1994 Obstetrics & Gynecology Science Vol.37 No.9
분만진통이 선행되지 않은 만삭전 조기 양막파열을 주소로 서울대학교병원 산부인과에 입원한 산모 51명을 대상을 하여 경복부 천자를 시행하여 얻은 양수로 배양검사를 실시하고 임신의 경과와 분만된 신생아의 예후를 조사하여 다음과 같은 결과를 얻었다. 1. 양수 배양 결과 세균이 분리된 산모는 9명(17.6%)이었다. 2. 양수 배양양성군의 모든 산모가 조기 분만하였고 양수배양 양성군은 음성군에 비해 양수 천자에서 분만까지의 시간간격이 유의하게 짧았다. 3. 양수 배양양성군은 음성군에 비해 임상적 융모양막염의 발생률이 유으하게 높았으며 조직학적 융모양막염의 발생도 높은 경향을 보였다. 4. 양수 배양양성군의 신생아는 출생시 배양음성군의 신생아에 비해 임신주수 및 체중이 낮은 경향을 보였다. 5. 양수 배양양성군의 신생아 패혈증, 호흡부전증후군, 뇌실내 출혈, 기관지폐이형성증, 폐렴, 괴사성 장염 등의 신생아 이환율도 배양양성군에서 더 높았다. Objective: To determine the prevalence and microbiology of intraamniotic infection and to compare maternal and neonatal outcomes according to amniotic fluid culture results in patients with preterm premature rupture of membrances. Methods: Amniotic fluid was obtained by transabdominal amniocentesis in 51 patients with preterm premature rupture of membranes. Amniotic fluid was cultured for aerobic and anaerobic bacteria as well as for mycoplasmas. Fisheres exact test, Students t-test, and generalized Wilcoxon test for survival analysis were used for statistical comparisons. Results: 1) The prevalence of positive amniotic fluid cultures was 17.6%(9/51) and the most frequently isolated microorganism was Ureplasma urealyticum (n=7). 2) All patients with positive amniotic fluid culture delivered at preterm and the amniocetesis-to-delivery interval of patients with positive amniotic fluid cultures was significantly shorter than that of patients with negative amniotic fluid cultures (median 41.6 hr, range 7.5-295.0 hr vs. median 91.4 hr, range 2.5-3146.5 hr, respectively, p$lt;0.05:generalized Wilcoxon test for survival analysis). 3) The prevalence of clinical chorioamnionitis of the patients with positive amniotic fluid culture was significantly higher than that of patients with negative amniotic fluid culture. 4) The newborn infants born to mothers with positive amniotic fluid cultures had lower gestational ages and birth weights than those born to mothers with negative amniotic fluid cultures. 5) neonates of patients with positive amniotic fluid cultures had higher rate of perinatal complications than those with negative cultures. Conclusion : Microbial invasion of amniotic cavity is a risk factor for spontineous preterm delivery, perinatal morbidity and mortality in patients with preterm premature repture of membranes.
공동주택단지의 범죄 예방 설계를 위한 평가방법에 관한 연구
이유미,임동현,강부성,Lee, You-Mi,Lim, Dong-Hyun,Kang, Boo-Seong 한국주거학회 2011 한국주거학회 논문집 Vol.22 No.4
This study aims to make evaluation method as a means to evaluate the crime prevention through environmental design of multi-family housing. According to the analysis of correctness and usefulness of evaluation method in multi-family housing, the preliminary evaluation method is selected. The correctness and usefulness of evaluation method is examined by 2 works. One is analyzing the results of experts' advice about evaluation method. The other is analyzing the results of the case studies of 3 housing sites. Those improve evaluation method to measure the crime prevention through environmental design objectively. As a result, the system of classification is divided into evaluation area and evaluation item. Evaluation area is sorted into four types, i.e. public space, semi-public space, semi-private space, and equipment. Evaluation scores according to evaluation area are different. Evaluation scores of public space are 73. Those of semipublic space are 196. Those of semi-private space are 75, Those of equipment are 28. Evaluation item is divided into 20 items. 20 items are; the entrance of complex, apartment building, recreational space and parking space etc. Checklists according to evaluation items are proposed and detail evaluation criteria according to checklist are proposed.