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태변 착색된 태아의 절대혈 산,염기 평형 및 가스분석에 관한 연구
정재현 ( Jae Hyun Chung ),김승욱 ( Syng Wook Kim ) 대한주산의학회 1990 大韓周産醫學會雜誌 Vol.1 No.1
The presence of meconium in the amniotic fluid was said to be a sign of “fetal distress” which may result in the birth of an asphyxiated infants. It was known that umbilical blood gas analysis was an objective index of fetal well-being. Umbilical arterial and venous blood gas analyses were carried out in total 438 infants for the purpose of measuring the acid-base balance of infants at or near term from pregnancies complicated by meconium passage in utero and researching the difference in umbilical blood acid-base and gas status between the meconium and nonmeconium group. About 2ml of umbilical cord blood was collected via doubly clamped cord immediately after the delivery and before the first breath was taken. Cord blood collection was made by a syringe coated with 1000 unit heparin. Immediately after blood collecction, umbilical blood acid-base and gas values were determined with the help of Blood Gas Analyzer Stat Profile 5. When the umbilical arterial and venous blood gases were compared between the meconium and nonmeconium group, there was a significant difference in the mean pH values and bicarbonate concentration. There was a significant increase in the incidence of acidemia(defined as umbilical arterial pH less than 7.2), low I-minute and and 5-minutes Apgar score(<7) in newborns with meconium as compared with those with nonmeconium. The mean carbon dioxide tension of umbilical arterial and venous blood in neonates with thick meconium was significantly higher than those with thin meconium. The frequency of acidemia, low 1-minute and 5-minutes Apgar score(<7)in the thick meconium group increased significantly than those in the thin meconium group. There was a greater incidence of meconium, Apgar score at l-minute or 5 minutes <7 in those neonates with umbilical arterial pH less than 7.2 than in those with higher pH values. It was concluded that the acid-base and gas status of fetal blood was significantly altered when meconium, especially thick meconium is present in amniotic fluid.
이인식 ( In Sik Lee ),윤보현 ( Bo Hyun Yoon ),신희철 ( Hee Chul Shin ),김승욱 ( Syng Wook Kim ) 대한주산의학회 1990 大韓周産醫學會雜誌 Vol.1 No.1
A review was made of the medical records of 46 pregnant patients with uterine myomas that were documented by ultrasonographic studies from January 1, 1986, to July 31, 1989. In 17 of these patients the myoma was on the fundus of uterus, in 15 it was on the anterior surface of uterus, in 7 it was on the isthmus of uterus, and in 6 it was on the posterior surface of uterus. Twenty-one cases of the myomas were 3cm to 5cm in diameter, 14 were 5cm to 10cm in diameter and 4 were equal to less than 3cm in diameter. No increase in size during pregnancy was observed in 38 myomas (82.8%). Only 5 (10.8%) increased in size more than 25% of the initial volume and 3(6.5%) decrease in size more than 25% of the initial volume. Vaginal bleeding developed in 17 of 46(36.9%); spontaneous abortion occured in 10 of 46(21.7%); secondary degeneration of the myomas developed in 6 of 46(13.0%); abdominal pain developed in 3 of 46(6.5%); preterm labor occured in 3 of 46(6.5%); failure to progress in labor occured in 3 of 46(4.4%); anemia developed in 2 of 46(4.4%); postpartum bleeding developed in 2 of 46(4.4%). The outcome of pregnancy associated in 10 of 46(21.7%); preterm delivery occured in 1 of 46(2.2%); term delivery occured in 35 of 46(76.1%). The methods of delivery were dependent more upon the intrinsic obstetric factors rather than on the locations or the size of the myoma.
Doppler초음파를 이용한 발육지연태아의 흉부하강대동맥 혈류속도파형의 양상
윤보현 ( Bo Hyun Yoon ),이필량 ( Pyl Ryang Lee ),김승협 ( Seung Hyup Kim ),신희철 ( Hee Chul Shin ),김승욱 ( Syng Wook Kim ) 대한주산의학회 1990 大韓周産醫學會雜誌 Vol.1 No.1
A real time sector scanner with a pulsed Doppler transducer was used to study and compare the blood flow velocity wavefroms of fetal descending thoracic aorta in 97 normal pregnancies and 50 cases of fetal growth retardation with 170 and 67 examinations, respectively. All pregnancies were in the third trimester. In both groups, A / B ratio, resistance index, and pulsatility index remained unchanged with increasing gestational age. In growth reatarded pregnancies, there were singnificant increases in A / B ratio, pulsatility index, and resistance index, and significant decrease in end diastolic velocity compared to those in normal pregnancies(p<0.05), reflecting increased peripheral vascular resistance. In the 8 distressed fetuses, Doppler findings were more pathological than those in the fetuses without distress. This method may be of value in the evaluation of fetal well-being in risk pregnancies by giving an early sign of hemodynamic changes in developing hypoxia.
정상임신중 Doppler초음파에 의한 태아 뇌의 내경동맥 혈류속도파형의 양상
신희철 ( Hee Chul Shin ),윤보현 ( Bo Hyun Yoon ),노정래 ( Cheong Rae Roh ),김완영 ( Wan Yung Kim ),최두석 ( Doo Seok Choi ),김승욱 ( Syng Wook Kim ) 대한주산의학회 1990 大韓周産醫學會雜誌 Vol.1 No.1
Blood flow velocity waveforms recorded by pulsed real time Doppler ultrasound from the fetal internal carotid artery were analysed in 123 normal pregnancies. One hundred twenty-eight determinations were carried out from the 29th to the 43th weeks of pregnancy. All cases presented highly pulsatile waveforms in the fetal internal carotid artery, with continuous forward flow during diastole. As gestation advances, the values for the A/B ratio and RI declined progressively indicating a gradual fall in resistance of the cerebral circulation in normal pregnancy. The reference values obtained from this study may be useful as a basis for new basic research and clinical application in prenatal care.