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제대-중대뇌 동맥의 도플러 비와 제대동맥 가스분석의 상관관계
목정은,원혜성,김암,이인식,이필량,신명신,강지안 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.1
Objectives: To assess Doppler flow imaging to determine the relationship between umbilical-cerebral Doppler ratio and fetal hypoxia. To establish the cut-off value of umbilical-cerebral artery pulsatility index ratio for prediction of fetal hypoxia. Design: Prospective study. Subjects: Forty-four normal controls and thirty high risk fetuses at 30 to 42 weeks of gestation. Interventions: Blood flow velocity waveforms from the umbilical and fetal middle cerebral artery were studied with Doppler color flow imaging for measurement of peak systolic, end-diastolic, time averaged maximum velocities and calculation of pulsatility index. Umbilical artery gas analysis was done immediately after delivery. Results: There was negative correlation between umbilical-middle cerebral PI ratio and cord PaO2(r = -0.65, p < 0.05). Cut-off value of 0.8 for umbilical-middle cerebral PI ratio to predict fetal hypoxia: sensitivity 80%, specificity 85%. Conclusion: Middle cerebral artery Doppler waveforms are useful for evaluation of fetal hypoxia.
자궁강내 인공수정 후 단각 자궁의 비소통성 흔적 자궁각에 임신된 불임 환자의 파열 전 진단 및 치료 1 예
목정은,장윤석,강병문,김정훈,정지윤,채희동,김종렬,이동헌 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.7
본 저자들은 울산대학교 의과대학 서울중앙병원 산부인과에서 단각 자궁을 가진 불임 환자에게 자궁강내 인공수정 후 단각 자궁의 비소통성 흔적 자궁각 임신 1예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다. The unicornuate uterus is caused by the non-development of one M llerian duct. The condition is associated with various degrees of rudimentary horn connected to the unicornuate uterus when one of the ducts develops only partially. Pregnancy in a rudimentary horn is rare and usually associated with fetal death and serious maternal morbidity or mortality. A case of pregnancy in the non-communicating rudimentary horn of unicornuate uterus after intrauterine insemination at 9 weeks of gestation is presented with brief review of literatures.
목정은,한지수,김암,이인식,이필량,장현정,정재걸,허주령 대한산부인과학회 1995 Obstetrics & Gynecology Science Vol.38 No.11
1993년 6월부터 1994년 9월까지 울산의대 서울중앙병원 산부인과에서 임신 37주 이전에 분 만한 68예를 대상으로 70예의 만삭 분만군(대조군)과 태반의 염증성 병변인 제대-융모막 혈 관염, 탈락막 내의 혈관이상 및 만성 융모염의 발생빈도에 대해 비교한 결과 다음과 같은 결론을 얻었다. 1. 조산군에서 대조군에 비해 제대-융모막 혈관염과 탈락막 내의 혈관이상 소견의 발생빈도가 유의하게 높았으며, 만성 융모염의 발생빈도는 두 군간에 차이가 없었다. 2. 조기진통이 선행하였던 조산군과 조기 양막파열이 선행하였던 조산군 사이의 태반의 염증성 병변의 발생빈도는 서로 유의한 차이가 없었다. 따라서 조산은 태반의 급성 및 만성 염증성 병변 또는 그에 따른 면역기전의 이상과 관계가 있으나, 조기 양막파열의 여부와 태반의 염증성 병변사이에는 관계가 없을 것으로 사료된다. 그러나 이러한 염증성 병변을 유발할 수 있는 모체와 태아간의 면역기전에 대하여는 추후 지속적인 연구가 이루어져야 할 것이다. To find the pathologic inflammatory processes of placenta that are significantly related to preterm bith, 138 women who delivered at Asan Medical Center between June 1993 and September 1994 were enrolled in this study. Microscopic features of placentas from 68 preterm deliveries were compared with those from 70 term deliveres for the point of absence or presence of umbilical chorionic vasculitis, decidual vascular abnormality and chronic villtis. Umbilical chronic vasculitis and decidual vascular abnormality were found in preterm birth group with a significantly higher frequency than those in control group . The incidence of placental pathologic lesions in preterm births was not statistically different between group with premature rupture of membrance and group without premature rupture of membrance . In conclusion, preterm births were strongly associated with placental lesions reflecting acute ascending bacterial infenction chronic immunologic or inflammatory conditions.
목정은,김정훈,조윤경,박진우 대한산부인과학회 1996 Obstetrics & Gynecology Science Vol.39 No.9
The introduction of ovulation inducing agents and assisted reproductive technology(ART) has resulted in a substantial increase of multiple pregnancies of up to 30%. As the number of multiple fetus increases in utero, so does the incidence of complications and the possibility of adverse outcome. To mitigate the consequences of the multiple pregnancies and prevent complications, especially prematurity of the newborn, selective reduction is propoased. Several procedures has been performed for selective reduction. In this study, we selected the transvaginal selective reduction in an early gestational period. From September 1994 to November 1995, we performed the transvaginal selective embryonic reductions in 8 patients who carried multiple embryos, including 2 quadruplets, 4 triplets, and 2 twins. Of 2 patients who carried twins, a patients desired the embryo reduction and a patient suffered from uterine didephys. Eight multiple pregnancies were obtained by controlled ovarian hyperstimulation with intrauterine insemination(COH with IUI)(n=5) and in vitro fertilization(IVF)(n=3). We selected the embryo reduction technique using the mechanical destruction or absorption of the embryo(s) and amniotic fluid aspiration at 7 to 8 weeks of gestation. After procedures, 6 patients were remained as twin pregnancies, and 2 patients as singleton pregnancies. None of the remaining embryos vanished after procedures, and none of the patients suffered from complications such as abortion, vaginal bleeding, amniotic fluid leakage, and infection. Only 3 patients appealed abdominal discomfort and mild pain. There have been 4 sets of twin delivery and 1 singleton delivery. Three cases are ongoing state. Four patients were delivered after 36 weeks of gestation. A patient who was remained as twin pregnancy was delivered of a boy and a girl at 28 weeks of gestation due to preterm laborl. A girl was expired with hypoxic brain injury, but a boy was survived and healthy. There was no fetal anomaly related to the procedure in five cases. In conclusion, the early transvaginal selective reduction performed at 7 to 8 weeks of gestation appears to be a simple and relatively safe procedure with no affect on remaining fetuses.
홍성목 대한건축학회 1968 建築 Vol.12 No.1
현대 목구조의 발달을 살펴볼 때 각종 목재의 강성상수를 구하는 것과, 또 각종 목재의 탄성상술을 구하는 것과 또 각종 접합의 과학적 분석 이외에, 눈에 뜨이게 매력을 느끼게 하는것이 최근 눈부시게 발달한 합성수지접착제를 이용한 여러 모양의 집성목재(glue-joint)와 합한(plywood)의 자유로운 유형이다. 접착접합(glue joint)의 여러 형태는 우리나라에서도 빨리 이용되었으면 하는 마음이 간절하다. 본고는 필자가 기술연수차 도영, Imperial College of Science and Technology: University of London에서 1966-1967학년도에 있었던 Timber Structure and Technology 과정을 수학한 귀국보고서의 일부이다.