To understand human behavior

from perspective of science

(natural science, social science)
( )

Hermann
Rorschach 1921



9.6

To see is to believe.

But you see what you

believe. And you believe
what you hope to be true.

 ( )
p q
p & q
p v q

p q ~p v q
p q ~q ~p
~(p & q) ~p v ~q
~ (p v q) ~p & ~q
 p q ~p ~q
p q pq ~p ~q
+ + + +
+ - - +
- + + -
- - + +

(X)
(O)
 p q ~q ~p ~p v q
p q p q ~p v q
+ + + +
+ - - -
- + + +
- - + +

 ~(p q) p & ~q
~(p q) ~(~p v q) p & ~q

p q ~(p q) p & ~q
+ + - -
+ - + +
- + - -
- - - -

~()


 ( )
pq
p&q
pvq
p q ~p v q
p q ~q ~p
~(p & q) ~p v ~q
~ (p v q) ~p & ~q
Subdural hematoma

6-9
6-10
6-11
6-12
What is the diagnosis?
Pneumonia or atelectasis ?

(p q)

(~q ~P)

So, atelectasis
 Urine Output
Normal heart, kidney, endocrine, volume status
normal urine output
(pq qp)

(p1 & p2 & p3 & p4) q ~q (~p1 ~p2 ~p3 ~p4)

too many interfering factors:

renal diseases, diuretics, mannitol, glycerol,
hyperglycemia, DI, ATN diuretic phases
 P (A)
P (AB) = P (AB) / P (B)

(narrow down)
P (AB1 B2 B3 B4)
 50

a.
b.

(1/25)3
(2/49)3
5

Unusual ! ()

?
(mechanism)?
 (mechanism)

?
(mechanism)?

Q: ?
A: R1, intern, CR

why?
?


0 A=B, B=C A=C

1 H = 0
2 S 0
3 ?

S0
Driving force: big bang theory
?( )( )
S0?
Stotal = Ssystem + Ssurrounding ( )
(
)
Any organized structure is not stable. It need to disorganize the
surrounding to maintain its organization.

Apple,IBM
Who will win in the market?
Garage industry
window vs DOS
i-phone vs Nokia
G 0 = -RT ln (K)
Air molecules in a room
(1/2)n 0

 Hunds rule ( )

()
 species
Mutation
Isolation

Epigenetics
Divine, human, animal

Metric space: compatible vs complete

( )
( )
l

l ( )
l

l (necrosis vs apoptosis)

l
40
41
42


1492, sail to the unknown world.



DNA ( ? ?)

Schrdinger equation
Q: ?
A:

Vs
(will)

520 km/ 28.5 hr
We can do something impossible.
60
 2014

2017


 The chance favors the prepared mind.

70 Km
100 Km
240 Km
380 Km
520 Km

( )

228


1.
2.

1.
2.
3.
4.
 Limbic system vs cortex system
vs
Fight or flight

, ,

 Palliative critical care
Sequence
( )

( )

MRSA, PDRAB
(septic shock, MOF) ( penicillin )

DNR
 They do not know what they do not know.
We do not know what they do not know.
We do not know what we do not know.
 55 years, male, CAD-III s/p CABG, aspirin in use
Now, AMI again, PCI dissection, emergent bypass CABG

Risk factors: redo-CABG, aspirin, prolonged bypass

PM 9 10 11 12
HR 110 110 110 110
SBP 120/80 120/80 120/80 120/80
CVP 8 8 8 8
Chest tube (mL) 400 350 300

WB transfused 400 350 300

Blood loss: 1050 mL/3 hrs
ICU VS: re-open to check bleeding
CVS VS: platelet, cryoprecipitate, PRBC transfusion
 PT, PTT
History physical exam. Lab exam.
History:
Past history
Op. history
PE:
Surgical wound (sternotomy, saphenous vein)
NG tube, CVP,
Petechia, ecchymosis
Lab:
CBC (Plt)
PT, PTT
Bleeding time

collect more information

 Q: ?
A:

85 years, female, AMI & cardiogenic shock, IABP dependent 2 weeks

85 years, lung cancer, pneumonectomy, estimated FEV1: 0.35L/sec

Heart transplantation, op night
BP , CVP , U/O , SvO2
D/D
Heart failure or tamponade ?
How to decide?
Echo

SOP, 80-20 rule

70%
 ?
?
( )
7D