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태아곤란증으로 제왕절개 분만한 신생아에 대한 임상적 고찰
최훈,이홍균,김복린,조용균,유태환,서정식,김동영,박규희,차문영 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.3
분만중 태아곤란증으로 제왕절개술을 시행한 168예를 대상으로 신생아의 예후를 중심으로 분석한 바는 다음과 같다. 1. 태아곤란증을 적응증으로 시행한 제왕절개분만아의 1분 저 Apgar 점수[<7]의 빈도는 총 59예로 35%, 5분 저Apgar 점수[<7] 출생아의 빈도는 총 19예로 11%였으며, 저 Apgar 점수의 빈도는 조사군에서 통계적으로 의미 있게 높았다. 2. 태아곤란증을 나타낸 임부 168예 중 107예 [64.9%]에서 한 가지 이상의 산과적 합병증을 가지고 있었으며, 태변침착, 조산, 주수에 비해 태아가 작은 경우, 임신성 고혈압, 조기 파막 등의 합병증이 있었으며, 대조군[24.5%]에 비해 산과적 합병증이 유의있게 많았다. 3. 임신주수에 따른 1분과 5분 저 Apgar 점수의 빈도는 37주 이하인 군[64%]이 38 42주와 42주 이상인 군보다 유의있게 많았다. 또 신생아 체중에 따른 1분과 5분 저 Apgar 점수의 빈도는 2,500 gm 미만의 저 체중아군[69%]이 2,500 3,999 gm 군보다 유의있게 많았다. 4. 조사군의 50%에서 호흡기 합병증, 신생아 고빌리루빈혈증, 급성 장염, 황달과 피부 감염같은 한가지 이상의 합병증을 동반하였고, 대조군[10.5%]과는 유의한 차이를 보였다. 5. 주산기 사망은 조사군에서 3.0% 있었으며, 대 조군[0%]과는 유의한 차이를 보였다. 이상에서 저자들이 태아곤란증으로 제왕절개 분만한 신생아의 예후를 관찰한 바 신생아의 합병증과 주산기 사망이 많았으며, 저 Apgar 점수의 빈도도 의미있게 높았다. Over the past 2 decades, the use of fetal heart rate monitoring has been paralleled by the increased Cesarean section rate. And the physician may choose the option of a $quot;safe$quot; Cesarean section over allowing a labor to continue with any sign or possibility of fetal or maternal stress during labor. This study was undertaken to evaluate the outcomes of the neonates delivered by Cesarean section for fetal distress. In this study, we reviewed the clinical records of 168 patients who had had Cesarean section for fetal distress at the department of obstetrics and gynecology in Sanggye Paik Hospital, InJe university from Jan. 1993 to Dec. 1995. The results were as follows : 1. The number of neonates with low Apgar score of 1 minute[< 7] was 59[35%] and that with low Apgar score of 5 minute[< 7] was 19[11%]. 2. About two thirds of cases[64.9%] were associated with one or more obstetric complications and the complications were meconium staining, preterm delivery, small for dates, and premature rupture of membranes,etc. These were significantly increased in the study group. 3. The number of neonates with low Apgar score of 1 minute and 5 minute was significantly increased in a group with gestational age below 37 weeks, and in a group with birth weight below 2,500 gm. 4. Various kinds of neonatal complications such as respiratory problems,neonatal hyperbilirubinemia, acute gastroenteritis, jaundice, and skin infection were significantly increased in the neonates delivered by Cesarean section for fetal distress. 5. Perinatal mortality was significantly increased in the neonates delivered by Cesarean section for fetal distress. From the above results, we concluded that neonatal complications, low Apgar score, and perinatal mortality rates were increased in the neonates delivered by Cesarean section for fetal distress.
남성&여성 당뇨인, 그들만의 고민- 당뇨병 환자의 임신
최훈,Choe, Hun 사단법인 한국당뇨협회 2005 당뇨 Vol.189 No.-
당뇨병은 임신의 금기증이 절대 아니다. 당뇨병이 있는 가임의 여성은 임신 전부터 철저한 혈당 조절과 산과의와의 상담을 통해 계획된 임신을 하고, 임신기간 동안 적극적인 산전진찰과 체계적인 혈당관리를 한다면 건강한 태아를 분만할 수 있다. 무엇보다 임신전과 임신 전반기를 통한 혈당조절이 가장 중요하다는 것을 명심해야 할 것이다.
최훈,기순종,정석구,이준예 대한마취과학회 1980 Korean Journal of Anesthesiology Vol.13 No.4
Endotracheal intubation has been a routine practice in general anesthesia and is accepted by anesthetiste and surgeons as an integral part of airway management during anesthesia and operation. Paradoxically however, there have been several cases of obstruction of the airway which occured due to endotracheal intubation. The authors experienced two cases of airway obstruction due tendotracheal and endobronchial techniques, using tubes with malfunctioning cuffs. The lumen of an endotracheal tube was collapsed by intracuff pressure, shortly after inflation of the cuff and resulted in extremely high airway resistance. In the other case, gradual leakage of air from the distal cuff of a Carlens tube led to collapse of the distal cuff. This promoted the movement of blood, secretions, and pus from the diseased right lung to the normal healthy left lung in association with the left lateral recumbent position, which in turn resulted in total airway obstruction.
자발성 두개내 저압 환자에서 뇌척수액 누출부위에 근접하여 재시행한 경막외 혈액 봉합술에 의한 치료 경험 1예
최훈,정일상,한영진,손지선 대한마취통증의학회 2005 Korean Journal of Anesthesiology Vol.49 No.4
Spontaneous intracranial hypotension (SIH) occurs without any preceding events such as lumbar puncture, surgery, trauma, or medical illness. It is characterized by a postural headache that is aggravated in the erect or sitting position, and relieved in the supine position. A postural headache usually resolves either spontaneously or with conservative treatment. An autologous epidural blood patch (EBP) is an effective strategy for managing a postural headache that persists or is aggravated despite conservative treatments. We report a case of SIH with confirmed cerebrospinal fluid (CSF) leakage at the thoracic level, which was managed successfully with an autologous EBP at the lumbar and thoracic levels. We believe that success rate of an epidural blood patch in these cases is dependent on the approximation of the blood injection to the leak site.
대학생이 인지하는 크루즈 여행의 제약요인과 태도가 여행의도에 미치는 영향
최훈,이광옥 한국해양관광학회 2019 해양관광학연구 Vol.12 No.2
Although a number of studies have been done exploring the satisfaction of cruise tourism, little investigation has been done of discouraging factors of cruise tourism at universities. The purpose of this study was to gather information how college students perceive discouraging factors of cruise tourism and find out the relationship between discouraging factors of cruise tourism and students' attitude and intention of cruise tourism. 250 students was chosen for questionnaire survey. The survey was conducted on November, 2019. Various inferential statistics were used as appropriate to test hypotheses. Major findings of the study were as follows: 1. 60 percent of respondents traveled abroad and they prefer to cruise western Europe, Mediterranean, and Northern Europe. 2. Most respondents tended to view that they would invest time and money for cruise travel, and would plan for cruise as security is guaranteed and interest for cruise travel is increased. This result supported Chun(2015) and Yoon's(2016) study. 3. The result showed a statistically positive correlation between perceived the attitude of cruise's travel and intention of future cruise traveling.