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      • 신생아 호홉곤란증후군에서 Surfactant 투여군과 대조군의 임상적 비교관찰

        오연균 圓光大學校 醫科學硏究所 1995 圓光醫科學 Vol.11 No.2

        We performed a randomized clinical trial comparing intratracheal administration of surfactant with assisted ventilatiory treatment with mechanical ventilation alone for treatment of neonatal respiratory distress syndrome. Twenty two premature infants with respiratory distress syndrome were randomly assigned to surfactant-treated or control group. Thirteen infants (mean gestational age: 29.3±1.8weeks, mean birth weight: l,424±227.3gm) were given surfactant-TA. and nine infants received intermittent mandatory ventilation only. The results were as follows: 1) We investigated the severity of respiratory distress syndrome by grading .which were severe, intermediate and minimal, at each point. Intermediate and severe categories were more rapidly changed to minimal in the surfactant-treated group than the control. Especially, those were improved at the 24 hours after surfactant administration significantly(46.2 vs 0%) (p<0.05). 2) Within 6 to 96hours of replacement of surfactant, there were significantly improved oxygenation with decreased FiO2 and increased a/APO2 and diminished the need for respiratory support with decreased Ⅵ index and mean airway pressure in the surfactant-treated group than the control(p<0.05∼0.005). 3) A decrease in the need for respiratory support was also reflected by a shortening of the total duration in assisted ventilation(6.7 vs 11.5days), supplemental oxygen(17.5 vs 32.25days)and high supplemental oxygen over 40%(3.0 vs 4.7days) in the surfactant-treated group. 4) In the surfactant-treated group, sepsis, IVH, PDA and NEC occured more often, and pneumothorax, pulmonary interstitial emphysema, bronchopulmonary dysplasia and apnea occured less. But, the difference of these complications were not significant. 5) Infants in the surfactant-treated group had decreased mortality, but it was not significant. And, the major causes of death were pulmonary hemorrhage and sepsis in both groups, but there was no significant difference between two groups. We concluded that replacement of surfactant is effective therapy that can improve the pulmonary function with diminution the need for oxygen and respiratory support.

      • KCI등재후보

        극소 저체중 출생아(<1,250 g)에서 고나트륨혈증 발생 및 뇌출혈과의 관계

        오연균,이수호,소철환,금승운,유승택,최두영 대한신생아학회 2011 Neonatal medicine Vol.18 No.1

        Purpose: Hypernatremia most frequently occurs in the immature newborn and be severe in association with intraventricular hemorrhage (IVH). This study examined the frequency, onset and risk factors of hypernatremia, and the relationship between hypernatremia and IVH in very low birth weight (VLBW; <1,250 g) infants. Methods: We retrospectively reviewed the medical records of 55 VLBW infants admitted between January 2006 and December 2009 to the neonatal intensive care unit of Wonkwang University Hospital and who survived over 7 days. Serum sodium concentration,sodium intake, fluid and weight loss, as suggested risk factors of hypernatremia, and the incidence of IVH were evaluated. The infants were divided into a hypernatremia group (≥150 mEq/L) and nonhypernatremia group, and were compared. Results: Incidence of hypernatremia in the VLBW infants was 52.7%, and mean starting time of hypernatremia was 2.8±1.3 days. There were no differences in the sodium and fluid intake between the two groups. Weight loss at day 3 after birth was significantly higher in the hypernatremia compared to the nonhypernatremia group (P<0.05); thereafter weight loss was non-significantly higher. The incidence of IVH in VLBW infants was 38.2%, and the difference between the two groups was not significant. Conclusion: Hypernatremia occurs commonly in VLBW infants and is most commonly caused by weight loss in the early days after birth. Incidence of IVH is not likely influenced by hypernatremia with marginally elevated sodium concentration. 목적: 고나트륨혈증은 미숙아에서 자주 볼 수 있으며 심한 경우 뇌출혈을 일으킬 수 있다. 이에 미숙아 중 극소 저체중 출생아(<1,250 g)에서 과나트륨혈증의 발생빈도, 출현시기, 발생의위험요인을 알아보며, 뇌출혈 발생과의 관계도 알아보고자 본연구를 시행하였다. 방법: 2006년 1월부터 2009년 12월까지 원광대학교 병원NICU에서 7일 이상 생존하였던 1,250 g 미만의 극소 저체중 출생아 55예를 대상으로 하였다. 환아들의 의무기록을 이용하여출생 후 6일 동안 고나트륨혈증의 발생빈도, 출현시기, 고나트륨혈증 유발의 위험 요인으로 알려진 Na 투여량, 수액 공급량, 소변배출양, 체중 감소, 그리고 뇌출혈 발생 유무를 후향적으로조사하고, 이들을 혈청 나트륨이 단 1회라도 150 mEq/L 이상으로 검사된 경우의 고나트륨혈증군과 비고나트륨혈증군으로 구분하여 비교 하였다. 결과: 1,250 g 미만의 극소 저체중 출생아에서, 1) 고나트륨혈증의 빈도는 52.7%이고, 처음 출현한 시기는 출생 후 2.8±1.3일이었다. 2) 고나트륨혈증을 보인 군의 Na 투여량이 보이지 않은군에 비해 더 많아 보였으나 의의는 없었다. 3) 고나트륨혈증을보인 군과 보이지 않은 군의 수액투여량은 차이가 없었다. 4) 고나트륨혈증을 보인 군과 보이지 않은 군의 소변배출량은 차이가 없었다. 5) 고나트륨혈증을 보인 군(3.52±2.19%)의 체중 감소가 보이지 않은 군(2.00±3.24%)에 비해 생후 3일째 의의 있는 감소를 보였으며(P<0.05) 이후에도 체중감소의 정도가 더 심하였으나 의의는 없었다. 6) 뇌출혈의 빈도는 38.2% (21/55명)이었으며, 고나트륨혈증을 보인 군(14/29명, 41.4%)과 보이지 않은 군(9/26명, 34.6%)의 뇌출혈 발생 빈도의 차이는 의의가 없었다. 결론: 극소 저체중 출생아에서 출생초기의 고나트륨혈증은자주 유발되며 출생 초기의 심한 체중감소가 발생의 중요 요인으로 보이나, 약간 높은 혈청내 Na 농도는 뇌출혈 발생에 영향이 적은 것으로 보인다.

      • KCI등재

        허혈이 유도된 대뇌신경세포에 대한 항산화제 및 Ampa/kainate 수용체 길항제의 영향

        오연균,Oh, Yeon-Kyun 대한동의생리학회 2005 동의생리병리학회지 Vol.19 No.3

        To clarify the toxic effect on cultured neonatal mouse cerebral neurons damaged by ischemia, we examined the cytotoxicity induced by ischemia and the protective effect of antioxidant and AMPA/kainate receptor antagonist against ischemia-induced cytotoxicity on cultured cerebral neurons. For this study, mice were administrated with 20ug/kg cyclothiazide or 50U/kg vitamin E via intraperitoneal injection for 2 hours before ischemic induction. After cell culture for 7 days, cell viability, amount of neurofilament and protein kinase C activity were examined. Ischemia decreased significantly cell viability, amount of neurofilament and the increase of protein kinase C activity in these cultures. In the protective effect, vitamin I showed remarkably the increase of cell viability and amount of neurofilament, and the decrease of protein kinase C activity but, cyclothiazide did not showed any protective effect on ischemia-induced cytotoxicity. From these results, it is suggested that vitamin I is effective in blocking the neurotoxicity induced by ischemia, but cyclothiazide as a AMPA/kainate receptor antagonist is not.

      • KCI등재
      • KCI등재
      • 호흡집중 치료를 시행한 신생아의 임상적 고찰

        김연심,오연균 圓光大學校 醫科學硏究所 1990 圓光醫科學 Vol.6 No.1-2

        We analyzed the clinical data of 31 neonates who were treated with Mechanical Ventilation in NICU at WonKwang University Hospital (WUG) from Feb. 1987 to Jan. 1989. The results were as follows ; 1) According to diagnostic categories, hyaline membrane disease was the most common in 20 cases (64.5%), and then postasphyxia syndrome 4 cases (12.9%), apnea of prematurity 2 cases (6.5%), sepsis 2 cases (6.5%), in their order. 2) Twenty cases (64.5%) were born at WUH and others were born elesewhere, and male to female ratio was about 1.4 : 1. 3) Premature infants below 37 wks of gestational age were 24 cases (77.4%), and hyaline membrane disease were premature in 19 cases (95.0%). 4) Low birth weight infants below 2,500 gm were 26 cases (83.9%) and very low birth weight infants below 1,500 gm were 12 cases (38.7%). In 20 cases of hyaline membrane disease, all cases were below 2,500 gm and 11 cases (55.0%) were below 1,500 gm. 5) According to selected mode of mechanical ventilation, CPAP mode was used in 4 cases (12.9%) and IPPB in 27 cases (87.1%). In 29 cases (93.6%), assist ventilation was initiated before 24 hours of age and in total duration of mechanical ventilation, 22 cases (71.0%) were below 3 days and 4 cases (12.9%) above 7 days. 6) Complications were seen during mechanical ventilation were intracranial hemorrhage (32.3%), infection including sepsis and pneumonia (29.0%), extrapulmonary air leaks (9.7%), in their order. 7) Total survival rate was 45.2%. For each diagnostic categories, the survival rate in hyaline membrane disease was 40.0%, postasphyxia syndrome 50.0% and apnea of prematurity 100%. The survival rate in infants less than 999 gm was 0%, 1,000-1,499 gm 50.0%, and more than 2,500 gm 20.0%, and in infants of gestational age below 28 weeks was 0%, 29-32 weeks 57.1%, 33-36 weeks 63.6%, and above 37 weeks 42.9%. 8) Follow up observations were performed in 12 survival infants for the period of 16 months to 3 years and long term sequalae were observed in 4 cases (33.3%). They were spastic quadriplegia, seizure disorder, retinopathy of prematurity and bronchopulmonary dysplasia.

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