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임신한 당뇨환자에서 인슐린 lispro 투여로 저혈당을 예방한 2 예 보고
임문환(Moon Whan Im),박운호(Un Ho Park),이정은(Jung Eun Lee),고선환(Sun Hwan Koh),임수빈(Soo Bin Im),이정례(Jeong Rye Lee),이지영(Ji Young Lee),황성욱(Sung Ook Hwang),이우영(Woo Young Lee) 대한산부인과학회 2002 Obstetrics & Gynecology Science Vol.45 No.7
Insulin therapy is indicated in the treatment of gestational diabetic women and overt diabetic pregnant women for hyperglycemia after failure to respond to the diets and exercise regimens. The insulin is administered to mimic normal pancreatic function. The normal pancreas secretes 50% of the total daily insulin as mealtime boluses. This delivery may be mimicked by four-injection-per-day of combination of NPH and regular insulin (RI). Hypoglycemia is a well-recognized complication of intensive insulin therapy in patients with Type Ⅱ diabetes. Recently, it has been reported that insulin-lispro, an analogue of regular human insulin with a peak insulin action achieved with a 1 hour after injection improves postprandial glucose concentration in non-pregnant diabetic patients. Treatment of gestational or diabetic pregnant women with NPH and insulin-lispro has significantly lower postprandial glucose levels without an increase in hypoglycemic events. Here, we report 2 cases of hyperglycemic control with four times daily administration of NPH & insulin-lispro on diabetes in pregnancy, with brief reviews.
임문환(Moon Whan Im),임대훈(Dae Hoon Im),한상훈(Sang Hoon Han),이정례(Jeong Rye Lee),박지현(Jee Hyun Park),황성욱(Sung Ook Hwang),노인화(In Hwa Noh),송은섭(Eun Seop Song),고승권(Seung Kwon Koh),이병익(Byoung Ick Lee),김종화(Jong Hwa 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.3
N/A Objective : Our purpose was to evaluate the safety and efficacy of pelviscopic surgery. Methods : Between May 1996 and April 2000, we evaluated indication of operation, mean age, parity, previous operation history, type of operation, duration of hospitalization and complications. Results : The results are summarized as follows ; 1) The mean age of patients was 34.8 years with ranges between 20 and 55 years old. 2) The majority of patients were between 36 years and 40 years old(23.6%). 3) The major clinical indications included 174 cases of adnexal mass(33.4%), 125 cases of ectopic pregnancy(24.0%), 59 cases of endometriosis(11.3%). 4) The types of operation composed of 168 cases diagnostic laparoscopy(30.7%), salpingectomy(17.2%), cystectomy(11.4%), LAVH(11.2%). 5) Previous laparotomy history was found in 146 cases(28.0%). 6) The mean duration of hospitalization was 4.4 days. Conclusion : The pelviscopy can be safely performed, resulting in reduced surgical morbidity, less blood loss, less postoperative discomfort and pain, shortened hospital stays and shorter recovery days. With the increased use of markers and ultrasonography to decrease the possibility of inappropriate surgery, combined with more defined exterpation techniques, the interest in laparoscopic ovarian surgery is burgeoning. And technologic advances afford us the opportunity to offer patients a number of alternatives to open surgery. The choice of anesthetic technique varies with requirements of the surgeon, the health status and preference of the patient, the type of facility and the availability of well trained professionals, support personnel and equipment. In conclusion, the pelviscopic surgery is alternative to laparotomy.
TDx - FLM 을 이용한 태아의 폐성숙도 평가의 의의
임문환(Moon Whan Im),최원식(Won Sick Choe),황성욱(Sung Ook Hwang),황태율(Tae Yul Hwang),이정례(Jeong Rye Lee),박지현(Jee Hyun Park),노인화(In Hwa Noh),고승권(Seung Kwon Koh),이병익(Byoung Ick Lee),이우영(Woo Young Lee),홍윤철(Yun Chu 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.11
N/A Objective : The TDX analyzer, an automated fluorescence polarimeter, has been utilized to assess surfactant content in amniotic fluid. Amniostat-FLM is an immunologic semiquantitative agglutination test for determining the presence of phosphatidylglycerol in human amniotic fluid at concentration indicative of fetal lung maturity. We evaluated the usefulness of the recently introduced TDx-FLM assay in determining fetal lung maturity. Methods : Seventy-three samples of amniotic fluid were analyzed. Among them, 18 samples were compared with Amniostat-FLM assay. Results : Surfactant/albumin ratio using TDx-FLM assay increased with longer gestational age. And the concordance rate between Amniostat-FLM assay and TDx-FLM assay was 66.9%. Conclusion : The TDx-FLM assay appears to be a useful test in the field of fetal lung maturity testing.
임문환(Moon Whan Im),이정례(Jeong Rye Lee),박지현(Jee Hyun Park),이우영(Woo Young Lee),황태율(Tae Yul Hwang),김우철(U Chul Kim),이정헌(Jeong Hun Lee),이병익(Byong Ick Lee) 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.12
N/A Reduced amniotic fluid volume generally leads to a poor perinatal outcome, especially when it is observed in the second trimester. The recent obstetric literatures have been reporting on various applications of amnioinfusion in the diagnostic, prophylactic and therapeutic management of oligohydroamnios. We experienced two cases of amnioinfusion, which were used to diagnose or to manage the midtrimester oligohydroamnios and we report them with a brief review.
임문환(Moon Whan Im),송경은(Kyung Eun Song),김현미(Hyun Mi Kim),김종필(Jong Pil Kim),이정례(Jeong Rye Lee),박지현(Jee Hyun Park),황성욱(Sung Ook Hwang),노인화(In Hwa Noh),고승권(Seung Kwon Koh),이병익(Byoung Ick Lee),이우영(Woo Young 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.12
N/A Objectives : Our study was to measure how well semiquantitative three-dimensional ultrasonographic measures of amniotic fluid in the third trimester, to investigate the relationship between three-dimensional amniotic fluid volume and amniotic fluid index, two dimensional amniotic fluid volumes. Methods : We compared amniotic fluid volume as measured by three-dimensional ultrasonographic techniques with amniotic fluid index including two dimensional amniotic fluid volume in 33 women during in the third trimester. Results : There was highly significant linear correlations of three-dimensional amniotic fluid volumes with AFI (r=0.6898) and two dimensional amniotic fluid volume (r=0.7926). Conclusion : Three-dimensional ultrasonographic technology has clinical significance as a tool to measure amniotic fluid volume. There are highly significant correlations of three dimensional amniotic volumes with AFI and two dimensional volume.
최효성 ( Hyo Seong Choi ),박지현 ( Jee Hyun Park ),김지연 ( Jee Yeon Kim ),임문환 ( Moon Whan Im ),이병익 ( Byoung Ick Lee ),이우영 ( Woo Young Lee ) 대한산부인과학회 2008 Obstetrics & Gynecology Science Vol.51 No.12
Hypertriglyceridemia is a rare cause of pancreatits. However the relationship between acute pancreatits and severe hypertrigyceridemia is well recognized. It can be a life- threatening complication if the degree of hypertrigyceridemia is severe enough. A serum triglyceride level of more than 1,000 to 2,000 mg/dL is the identifiable risk factor. The clinical course and management of hypertriglyceridemia induced acute pancreatitis is not different from other causes. The clinical course and management of hypertriglyceridemia induced acute pancreatitis during pregnancy are similar to the one during nonpregnant state. The prevalence of acute pancreatitis in pregnancy ranges between 1 in 1,000 to 1 in 3,000. Gestational hypertrigyceridemic pancreatits can be fatal, and maternal morbidity rate has an upward trend of 20%. We report a 31-year-old woman with coexistence of hypertrigyceridemia and acute pancreatits at 32 weeks gestation with a brief review of the literatures.
공공의료와 민간의료 자원을 활용한 선천성 이상 감시체계 모델
김광준(Kwang Jun Kim),임종한(Jong Han Leem),하은희(Eun Hee Ha),임문환(Moon Whan Im),홍윤철(Yun Chul Hong),이보은(Bo Eun Lee),문혜성(Hye Sung Moon),안정자(Jung Ja Ahn),우복희(Bock Hi Woo) 대한산부인과학회 2002 Obstetrics & Gynecology Science Vol.45 No.7
목적 : 한국에서 선천성 이상과 저체중아의 발생 원인을 규명하기 위하여, 역학적인 선천성이상모니터링 체계를 구축하는 것이 필요하다. 본 연구의 목적은 선천성 이상의 발생률과 발생 양상을 평가할 수 있는 선천성이상 감시체계의 새롭고 실제적인 모델을 설계하고, 시범적으로 인천시 연수구에서 이를 구축하는 것이다. 연구 방법 : 보건소와 민간 병의원이 협력하여 선천성이상을 모니터링 할 수 있는 감시체계를 구축하였으며, 인터넷 웹에 기반을 둔 전산화 보고체계와 자료관리체계가 만들어졌다. 훈련된 간호사가 2년동안 출생 신고서, 보건소 및 병의원 보고자료, 분만실 자료, 의무기록 등을 능동적으로 수집하였다 (1차년도 1998.12.1- 1999.11.31; 2차년도 2000.1.1-2000.12.31). 결과 : 1, 2차년도의 모니터링을 통하여, 본 연구에서는 1차년도 총출산 2482건중 25건, 2차년도 총 출산 3490건중 28건의 선천성이상 건수를 확인하였다. 총 출산아 1000명중 선천성이상 출산율은 1, 2차년도에 각각 10.1, 8.0이었다. 1차년도에 선천성이상의 가장 큰 비율은 근골격계 계통으로 전체의 28.0%이였다. 1차년도 소화기, 심혈관, 구개열 및 구개순 선천성이상의 비율은 전체의 20.0%, 12.0%, 12.0%이였다. 2차년도에 선천성이상의 가장 큰 비율은 소화기 계통으로 전체의 21.4%이였다. 2차년도 심혈관, 근골격계 선천성이상의 비율은 전체의 17.9%, 14.3%이였다. 결론 : 결론적으로, 우리는 인천시 연수구에서 인구집단을 대상으로 한 선천성이상 감시체계를 구축할 수 있었다. 한국에서 인구집단을 기반으로 한 선천성이상 감시체계를 구축하기 위한 가장 현실적인 방안은 우선 한 지역에서 보고에 참여하는 공공 및 민간병원 보고자를 조직하고, 보고체계 및 자료관리체계를 구축하며 실제적으로 적용 가능하고 효율적인 모델을 만들고, 이를 근거로 타지역에 이 모델을 확산시키는 것이다. Objective : To discover the etiology of birth defects and low birth weight, it is necessary to establish epidemiological birth defects monitoring system in Korea. Our aim was to develop new practical model in Incheon to establish birth defects monitoring system to evaluate the incidence rate and patterns of birth defects in Korea. Methods : Public health center and private hospitals and clinics participated in this monitoring system. Web based reporting system have been built. Trained nurses actively collected the records obtained from delivery units in the participating hospitals during 2 years (first year: December 1st, 1998-November. 31, 1999; second year: January 1 st, 2000-December 31 th, 2000). Results : Through this monitoring system at 1 st year and 2 nd year, we observed 25 birth defect cases from 2482 births, 28 birth defect cases from 3490 births including live births and stillbirths. The incidence of birth defect per thousand person was 10.1, 8.0 respectively. At 1st year, the highest proportion of birth defects was 28.0% in musculoskeletal system. The proportion of birth defects in gastrointestinal system, cardiovascular system and cleft lip & cleft palate were 20.0%, 12.0%. 12.0%. At 2 nd year, the highest proportion of birth defects was 21.4% in gastrointestinal system The proportion of birth defects in cardiovascular system and musculoskeletal system were 17.9% and 14.3%. Concluion : In conclusion, we could build population-based monitoring system for birth defects successfully in Yonsu gu, Incheon. To establish population-based monitoring system for birth defects in Korea, it is necessary to organize the reporters of public health center and private hospitals and clinics, to build an available reporting system, and to extend participating centers for birth defects monitoring systems.