• 한국산학기술학회논문지
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• 제17권12호
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• pp.128-137
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• 2016

본 연구는 신생아 중환자실에 입원한 미숙아를 대상으로 캥거루식 접촉이 미숙아의 신체발달, 외부환경 적응, 어머니의 역할수행 자신감에 미치는 효과를 파악하기 위해 시도되었다. 연구대상은 B광역시에 소재한 1개 종합병원에서 제왕절개분만을 한 미숙아와 미숙아 어머니로서 캥거루식 접촉을 시행 한 실험군 19명과 캥거루식 접촉을 하지 않은 대조군 19명이다. 자료수집기간은 2013년 6월 1일부터 2015년 6월 30일까지이며, 실험군에게 캥거루식 접촉을 하루 3회(1회 60분), 총 10회를 실시하였다. 미숙아의 신체발달(체중, 신장, 머리둘레)과 외부환경 적응(체온, 심박동수, 산소포화도)을 캥거루식 접촉 전에 측정하였고, 중재를 제공한 후 다시 측정하였다. 어머니 역할수행 자신감은 자가보고식 설문지로 측정하였다. 연구결과 캥거루식 접촉을 시행한 실험군과 접촉을 시행하지 않은 대조군 간의 차이에서 미숙아의 신체발달은 통계적으로 유의한 차이가 없었으며(체중 t=-0.83, p=.21 신장 t=-0.34, p=.37, 머리둘레 t=1.29, p=.10), 외부환경 적응에서 산소포화도가 유의한 차이가 있었다(t=2.27, p=.02). 미숙아 어머니의 역할수행 자신감은 유의한 차이가 없었다(t=-0.41, p=.34). 결론적으로 캥거루식 접촉은 미숙아의 외부환경 적응에 효과가 있는 것으로 나타났다.

• 한국임상수의학회지
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• 제22권4호
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• pp.450-452
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• 2005

A 3-year-old, 43kg, pregnant Great Pyrenese was examined for clinical signs of acute weakness and anorexia for 4 days. The dog was in lateral recumbency at referral. The rectal temperature was within reference range, and the respiratory and heart rates were 36 breaths/min and 58 beats/min, respectively. The abdomen was distended, and several puppies were palpated. The mean fetal head diameter was 2.8cm in the ultrasonographic examination. The initial complete blood count and serum biochemical examinations revealed mild dehydration, mud hyperglycemia, hypochloremia, hyperkalemia, hyponatremia, and low sodium-potassium ratio. Serum BUN and total cholesterol values were slightly high. Hypoadrenocortical crisis was suspected on the basis of signs of acute collapse, hyponatremia and hyperkalemia. Adrenal gland function was evaluated by an ACTH stimulation test. The baseline cortisol concentration was $18.6{\mu}g/dl$ and the concentration at 1 hour after administration of tetracosactrin (ACTH, Synacthen) was $8{\mu}g/dl$. The dog was treated for the correction of assumed hypoadrenocortical crisis and substantial hyperkalemia. In addition to rapid infusion with saline solution, other medications administered intravenously included sodium bicarbonate and cimetidine hydrochloride. The dog was monitored with repeated serum electrolyte examination. After clinical stabilization, cesarean section was performed. All of 13 puppies were delivered, and the dog recovered from anesthesia without complications. The values of postpartum blood tests returned to normal or within reference range. The dog remained healthily.

• 한국임상수의학회지
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• 제30권5호
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• pp.384-386
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• 2013

2년령 암컷 잉글리쉬 불독이 근친 유래의 동결정액을 이용한 인공수정을 위해 내원하였다. 배란 후 이틀 뒤 자궁 내 인공수정을 실시하였다. 정액을 해동 후 컴퓨터 기반의 정액 분석기를 사용하여 평가한 결과, 해동된 정자는 정상 모양을 가지고 있었고 운동성이 89.8%였다. 초음파와 방사선 촬영을 통하여 8마리를 임신한 것을 확인하였고, 인공 수정 후 60일 째 제왕절개를 실시하였다. 8마리의 산자가 안전하게 분만이 되었지만, 모든 산자들에서 심각한 활모양 다리, 구개열, 구순열, 확장된 두부(頭部) 등을 포함한 기형이 관찰되었다.

• 대한한방소아과학회지
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• 제17권2호
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• pp.37-53
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• 2003

Objective : To find risk factor and symptoms for transferred newborn from postpartum care center Method : We performed a follow-up study using medical record. Subjects comprised 188 neonates(include 4 twins) and 184 women in childbed who were hospitalized in oriental postpartum care center from January, 1, 2002 to December, 31, 2002. Result: Transferred newborn was total 24, N.V.D. 17, C.S. 7, male and female were 12 separately. The symptom of transfer was fever(16), diarrhea(4), jaundice(3), convulsion(1) Transferred number and rate was male 12(10.7%), female 12(15.8%). In delivery method, total normal vaginal delivery(N.V.D.) was 136 and transferred 17(12.5%), total cesarean section(C.S.) was 52 and transferred 7(13.5%). Transferred rank was N.V.D. female(17.9%). C.S. male(15.6%), C.S. female(10%), N.V.D.(8.6%). Of the 188 neonates. immature infants were 2 and transferred 1(50%), term infants were 184, transferred 23(12.5%), post-term infants were 2 and transferred none(0%). In age of women in childbed, transferred ratio was 15.4%(over 35), 15.2%(25-29), 10.5%(30-34). In fever,. C.S. infants were more transferred than N.V.D. and male infant had a tendency to transfer in later period of hospitalization and female in early period. It seems that transfer was related to abortion. In diarrhea, all was N.V.D. and their diagnosis was rotavirus. The average age of women in childbed was yonger(28.5). In jaundice, all was 1st, and average birth weight was lighter(3153g). The average age of women in childbed was older(30). In convulsion, birth weight was lighter(3153g), and age of women in childbed was older(30). Conclusion : There's any relation with sex and delivery method, birth weight and mother's age in transfer. But we cannot find any statistically significance. Further prospective studies are needed to find risk factors in transfer.

• Clinical and Experimental Pediatrics
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• 제54권6호
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• pp.246-252
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• 2011

Purpose: The outcomes of small for gestational age (SGA) infants especially in extremely low birth weight infants (ELBWIs) are controversial. This study evaluated the mortality and morbidity of ELBWIs, focusing on whether or not they were also SGA. Methods: The medical records of 415 ELBWIs (birth weight<1,000 g), who were inborn and admitted to the Samsung Medical Center neonatal intensive care unit from January 2000 to December 2008, were reviewed retrospectively. Mortality and morbidities were compared by body size groups: very SGA (VSGA), birth weight ${\leq}$3rd percentile; SGA, 3rd to 10th percentile; and appropriate for gestational age (AGA) infants, >10th percentile for gestational age. For gestational subgroup analysis, groups were divided into infants with gestational age ${\leq}24^{+6}$ weeks (subgroup I), $25^{+0}$ to $26^{+6}$ weeks (subgroup II), and ${\geq}27^{+0}$ weeks (subgroup III) Results: Gestational age was $29^{+2}{\pm}2^{+6}$ weeks in the VSGA infants (n=49), $27^{+5}{\pm}2^{+2}$weeks in the SGA infants (n=45), and $25^{+4}{\pm}1^{+4}$ weeks in AGA infants (n=321). Birth weight was $692{\pm}186.6$ g, $768{\pm}132.9$ g, and $780{\pm}142.5$ g in the VSGA, SGA, and AGA groups, respectively. Cesarean section rate and maternal pregnancy-induced hypertension were more common in the VSGA and SGA than in AGA pregnancies. However, chorioamnionitis was more common in the AGA group. The mortalities of the lowest gestational group (subgroup I), and also of the lower gestational group (subgroup I+II) were significantly higher in the VSGA group than the SGA or AGA groups (P=0.020 and P=0.012, respectively). VSGA and SGA infants showed lower incidence in respiratory distress syndrome, ductal ligation, bronchopulmonary dysplasia, intraventricular hemorrhage than AGA group did. However, by multiple logistic regression analysis of each gestational subgroup, the differences were not significant. Conclusion: Of ELBWIs, extremely SGA in the lower gestational subgroups, had an impact on mortality, which may provide information useful for prenatal counseling.

• Journal of Preventive Medicine and Public Health
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• 제26권3호
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• pp.400-411
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• 1993

The aim of this study is to analyze the variations among hospitals and hospital groups in resource use and procedures of diagnostic and therapeutic process, such as laboratory tests, radiologic examinations, tissue diagnosis, timing of surgery after admission, the time required for operation. The study was performed for five procedures including cesarean section (C/S), appendectomy, cholecystectomy, cataract extraction, and pediatric pneumonia. The 2,316 subjects were selected from medical insurance claims list, and from this list 413 cases were sampled for medical record review. The patterns of resource utilization and process of treatment were described according to hospitals and characteristics of hospital groups. The major results were as follows : 1. The numbers of laboratory and radiologic tests showed significant difference among hospitals and hospital groups. In case of hospital groups, we could find tendencies of more tests with increasing hospital bed size. 2. In general, the proportion of operative cases evaluated by tissue diagnosis postoperatively among all operations ranged from 28.3% to 100%. The proportion varied among hospital groups, of which general hospital A group(more than 15 specialty) showed the highest proportion. 3. Post-admission delay until operation and the time required for operative procedure were not invariable among hospitals and hospital groups. The duration of operation in tertiary hospitals was slightly shorter than general hospitals, with varying statistical significance. We could find that probably there were differences of quality among hospitals in some components of procedures, which suggested that the implementation of quality assurance activities would be mandatory. In this study, we simply described the patterns of resource utilization and some features of clinical process, with institution of the need for advanced studies with in-depth analyses for each component of diagnosis and treatment procedures.

• 대한기관식도과학회:학술대회논문집
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• 대한기관식도과학회 1993년도 제27차 학술대회 초록집
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• pp.76-76
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• 1993

기관내 삽관은 전신마취 및 기도 확보를 위해 시행되어 왔으나, 이비인후과 영역의 합병증으로는 육아종 등이 유발될 수 있는 문제점을 안고 있다. 이에 저자들은 1982년부터 1992년까지 만 10년 동안 본원 이비인후과에서 경험한 16례에서 아래와 같은 결과를 얻었다. 1. 연령 분포는 20세에서 49세까지가 84% 로써 가장 많았으며 남녀 비는 1 : 7 로써 여성에서 호발 하였다. 2. 임상증상으로 애성 12례(75 %), 후두 이물감 3례(18 %), 호흡곤란 1례(6 %)이었다. 3. 발생 부위로는 양측성 6례(37 %), 일측성 10례(63 %)중 우측 7례(70 %), 좌측 3례(30 %)이었고 발생 장소는 피열연골 성대돌기 8례(50 %), 성대 후방1/3 부위 6례(37 %), 성대 중앙 부위 2례(12 %)이었다. 4. 과거력상 삽관후 임상 증상 발현 기간은 1 개월이내 7례(44 %)로 가장 많았으며 4 개월 이상은 없었다. 5. 과거력상 수술 종류 및 빈도수는 제왕절개술이 6례(37 %)로써 가장 많았다. 6. 평균삽관 시간은 2시간 5분 이었다. 7. 튜브재질은 모두 rubber tube 이었다. 8. 수술후 재발은 1례(6 %)이었다.

• 한국콘텐츠학회논문지
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• 제13권9호
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• pp.270-280
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• 2013

본 연구의 목적은 선천성 근육사경과 산모의 직업적 활동 간의 관련성을 알아보는 것이다. 2006년부터 2011년 4월까지 수원 "C" 병원 재활의학과를 내원한 선천성 근육사경아동의 산모 89명을 대상으로 실시하였다. 결과는 첫째, 연구대상자의 일반적 특성을 보면, 출산 평균연령은 30.09세, 교육수준은 대졸이상이 많았으며, 초산이 82.0%로 나타났으며, 자연분만, 제왕절개, 흡입분만 순이었고, 분만 시 둔위여부는 20.2%로 나타났으며, 첫째 아동이 사경인 경우가 82.0%로 나타났고, 둘째, 연구대상자의 직업적 특성에서 직장생활을 한 산모가 59.6%이고 전문가 및 관련종사자가 45.3%를 차지하였고, 직장생활을 임신 3기까지 한 산모가 75.5%로 나타났고, 주로 서서 일하는 자세보다 앉아서 일하는 자세로 앉아서 일하는 시간이 7시간 이상이 54.7%로 나타났으며, 하루 평균 근무시간은 8.75시간으로 나타났고, 셋째, 연구대상자의 직무스트레스는 하위 25%이하 수준으로 나타났으며, 하위 요인별 정도에선 관계갈등영역에서만 상위 50%이상으로 나타났다. 넷째, 연구대상자의 직무스트레스와 직업적 업무 특성간의 상관관계를 보면, 스트레스(100점 환산)와 직무스트레스의 직무요구, 관계갈등, 보상 부적절, 직장문화와 양의 상관관계가 높게 나타났으며, 직장문화와 보상 부적절간에도 양의 상관관계가 높게 나타났다. 직업적 업무 중 하루 평균 근무시간과 평균 일주일 근무시간과 양의 상관관계가 높게 나타났다.

• Journal of Yeungnam Medical Science
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• 제7권1호
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• pp.95-103
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• 1990

1989년 8월 1일부터 1990년 4월 30일까지 영남대학교 의과대학 산부인과에서 대량출혈이 예상되는 18명의 환자에서 21례의 자가수혈을 시행하여 관찰한 결과 자가수혈의 가장 많은 적응증으로는 전치태반이었으며(10/21) 수술후 자가수혈 및 homologous transfusion의 빈도도 제일 많았다. 출혈위험이 있는 산모 20례중 6례에서 자가수혈로 인해 homologous transfusion을 피할 수 있었다. 혈액 채취전후의 혈압 및 맥박, 호흡 및 reticulocyte등은 통계학적으로 별차이점이 없었고, 채혈전후에 시행하였던 태아감시장치상 약 8례에서 약간의 이상이 나타났으나 대부분 자세변화 및 산소공급으로 20분 이내에 정상으로 돌아왔다. 태어난 신생아중 거대아 1명, 저체중아 3명이었으며 14명이 정상체중아였고, 분만전의 채혈로 인한 이상소견을 발견할 수가 없었다. 채취전후의 혈액학적 변화로소 채취전 Hct는 $34.1{\pm}2.9%$였고, 채취 후는 $31.8{\pm}2.4%$로 유의성이 있었다(P<0.01). 대부분의 혈액 채취시간은 4-8분 정도였으며 채혈시 산모에서 특별한 합병증을 발견하지 못하였다. 3명을 제외하고 15명이 채혈후 3주 이내에 분만하였다. 상기한 여러가지 결과 대량출혈이 예상되는 산모에 있어서 수술전에 혈액을 채취하여 필요할 때 사용할 수 있는 자가수혈은 산모 및 태아에 있어 특별한 이상을 발견할 수 없었다. 그러므로, 산모에 있어서 자가수혈은 homologous transfusion을 피할 수 있는 매우 유용한 한 방법일 수 있다는 결론을 얻었고, 채혈시 나타났던 태아감시상의 여러가지 이상소견에 대해서는 더 많은 연구가 필요할 것으로 사료된다.

• Kidney Research and Clinical Practice
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• 제37권4호
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• pp.356-365
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• 2018

Background: Woman kidney donors face obstetric complication risks after kidney donation, such as gestational hypertension and preeclampsia. Studies on childbirth-related complications among Asian women donors are scarce. Methods: This retrospective cohort study included woman donors aged 45 years or younger at the time of kidney donation in a single tertiary hospital between 1985 and 2014. Pregnancy associated complications were investigated using medical records and telephone questionnaires for 426 pregnancies among 225 donors. Matched non-donor controls were selected by propensity score and the maternal and fetal outcomes were compared with those of donors. Primary outcomes were differences in maternal complications, and secondary outcomes were fetal outcomes in pregnancies of the donor and control groups. Results: A total of 56 cases had post-donation pregnancies. The post-donation pregnancies group was younger at the time of donation and older at the time of delivery than the pre-donation pregnancies group, and there were no differences in primary outcomes between the groups except the proportion receiving cesarean section. Comparison of the complication risk between post-donation pregnancies and non-donor matched controls showed no significant differences in gestational hypertension, preeclampsia, or composite outcomes after propensity score matching including age at delivery, era at pregnancy, systolic blood pressure, body weight, and estimated glomerular filtration ratio (odds ratio, 0.63; 95% confidence interval, 0.19-2.14; P = 0.724). Conclusion: This study revealed that maternal and fetal outcomes between woman kidney donors and non-donor matched controls were comparable. Studies with general population pregnancy controls are warranted to compare pregnancy outcomes for donors.