선행 제왕절개술 후 질식 분만: 성공의 예측인자들

동서연 ( Seo Yun Tong ),김여홍 ( Yeo Hong Kim ),최영준 ( Young Jun Choi ),김소라 ( So Ra Kim ),이보연 ( Bo Yon Lee ),이선경 ( Seon Kyung Lee ),허주엽 ( Chu Yeop Huh ),김승보 ( Seong Bo Kim ) 대한주산의학회 2003 Perinatology Vol.14 No.4

목적: 선행제왕절개 후 질식분만을 시도한 산모들 중 성공군과 실패군을 비교하여 성공을 예측할 수 있는 인자를 알아보고자 하였다. 방법: 1997년 3월부터 2003년 2월까지 경희대학교 의과대학 산부인과에서 선행제왕절개 후 질식분만을 위하여 내원한 환자중 질식분만의 금기가 아닌 경우 위험요소 등에 대하여 충분히 상의한 후 분만을 시도한 382명의 환자를 대상으로 하였다. 대상군의 의무기록을 통하여 분만당시 산모의 나이, 분만력, 제태연령, 신생아 몸무게, 입원시 자궁경부 상태 및 Bishop score, 분만의 진행과정, 결과 및 합병증을 조사하여 성공군과 실패군의 차이를 비교분석 하였다. 결과: 292(76.5%)명이 질식분만에 성공하였다. 여러 인자 중 태아의 몸무게(odds ratio, 0.2 ; 95% confidence interval (CI), 0.1-0.4), 입원시 Bishop score(odds ratio, 1.8 ; 95% CI, 1.5-2.1), 질식분만의 과거력(odds ratio, 3.6 ; 95% CI, 1.1-11.6)이 VBAC의 성공과 관련이 있었다. 또한 선행제왕절개시 적응증이 태위이상인 경우에 성공률이 높은 것으로 나타났다(odds ratio, 3.2 ; 95% CI, 1.2~8.6). 입원시 Bishop score로 VBAC의 성공을 예측할 수 있는 지 알아보기 위하여 receiver-operating characteristic curve 분석을 시행하였고, 5점을 cut-off로 하였을 때 47.4%의 민감도와 87.6%의 특이도를 보였다(AUC, 0.765 ; p<0.05). 결론: 출생체중, 질식분만의 과거력, 입원시 Bishop score가 선행제왕절개 후 질식분만을 고려하는 경우 성공의 예측인자로서 유용하게 사용되어 질 수 있을 것이다. Objective: The purpose of this report is to determine the predictable factors for successful vaginal birth after cesarean (VBAC). Methods: In this study, 382 women who attempted VBAC at Kyung-Hee university hospital were included. The medical records of them were reviewed retrospectively. Informations was collected about demographics, medical history, obstetric history, neonatal birth weight, complications, treatment, and outcome of the index pregnancy. Results: The overall success rate was 76.5% (292 cases). Among variables, neonatal birth weight (odds ratio, 0.2; 95% confidence interval, 0.1-0.4), Bishop score at admission (odds ratio, 1.8; 95% confidence interval, 1.5-2.1 ; p<0.05), and history of vaginal delivery (odds ratio, 3.6 ; 95% confidence interval, 1.1-11.6 ; p<0.05) were significant. The Bishop score showed most significant relationship with successful VBAC. The Bishop score 5 at admission had a sensitivity of 47.4% and a specificity of 87.6% in the prediction of successful VBAC. Malpresentation as indications of previous cesarean delivery showed more tendency to succeed than others. Conclusion: Several factors such as birth weight, Bishop score at admission, and history of vaginal delivery may be used to predict the success of VBAC.

사상의학(四象醫學) 전문의(專門醫)의 체질진단(體質診斷)결과 일치도에 관한 연구

함통일,황민우,이태규,김상복,이수경,고병희,Hahm, Tong-Il,Hwang, Min-Woo,Lee, Tae-Gyu,Kim, Sang-Bok,Lee, Soo-Kyung,Koh, Byung-Hee 사상체질의학회 2006 사상체질의학회지 Vol.18 No.3

1. Objectives The purpose of this study was to investigate the concordance rate of the diagnostic results among Sasang Constitutional Medicine(SCM) specialists. 2. Methods We carried out two studies in order to investigate the concordance rate of the diagnostic results between SCM specialists. We calculated the kappa value for analyzing concordance rate(using the SPSS program). 1) Study A : We investigated 142 clients who had taken health examinations and diagnosis of Sasang constitution from March 9, 2005 to March 29, 2005 at a health examination center of Kyung-Hee medical center. Every SCM specialist diagnosed 142 clients directly. Each SCM specialist don’t know the other specialist’s diagnosis. 2) Study B : We investigated 176 clients who had taken health examinations and diagnosis of Sasang constitution from January 2005 to March 2005 at the department of Occupational and Environmental medicine of Kyung-Hee medical center. One SCM specialist diagnosed 176 clients directly and the other specialist knowing previous specialist’s diagnosis, diagnosed each person indirectly 3. Results 1) The concordance rate of the diagnostic results among SCM specialists in study A was relatively high(kappa value=0.700). 2) The concordance rate of the diagnostic results among SCM specialists in study B was high(kappa value=0.895). 4. Conclusions We can confirm the concordance rate of the diagnostic results among SCM specialists is relatively high.

사염화탄소의 간독성에 대한 파두 다당류분획의 예방효과

이은경,길이룡,소동수,창동신,전선덕,정명규,문창규 한국환경독성학회 1996 환경독성보건학회지 Vol.11 No.2

In present study, we fractionated polysaccharides from Croton tiglium and investigated their hepatoprotective effects on CCI₄ intoxication. Polysaccharide fraction of which molecular weight is over 300,000(HP) showed the most potent hepatoprotective effects on CC1₄ intoxication. Lipid peroxidation, BAST and sALT were used as parameters to evaluate the liver damage. Glucose, xylose and arabinose were found to be monosaccharides composing sugar moiety of HP.

Zr계 Vitreloy 박막의 특성에 대한 조사

이경민,이병준,김병훈,이의완,박동수 慶北大學校 師範大學 科學敎育硏究所 1999 科學敎育硏究誌 Vol.23 No.-

We have grown Zr based vitreloy alloy thin films by thermal deposition methode and ion beam sputtering method and compared them with Zr-Ti-Cu-Ni-Be bulk metallic glass bulk. Thermal analysis caused Zr-Ti-Cu-Ni-Be bulk metallic glass to recrystallize in the two region. The onset point temperature of the first region was 414.12℃ and the peak temperature was 410.02℃. The onset point temperature of the second region was 445.21℃ and the peak point temperature was 454.45℃. The X-ray diffraction measurement and thermal analysis as a function of temperature showed that the bulk metallic glass thin films recrystallize in the same temperature region. As a result, Zr based vitreloy alloy was the same as phase transition of bulk metallic glass bulk and bulk metallic glass thin film.

IL-β의 인슐린 분비 자극효과와 그 과정에 관여하는 인자들

정인경,오승훈,강동묵,정재훈,민용기,이명식,이문규,김광원 대한당뇨병학회 2002 Diabetes and Metabolism Journal Vol.24 No.4

연구배경: IL­1β는 용량과 노출시간에 따라 인슐린분비에 대해 상반되는 효과를 가지고 있다. IL­1β의 인슐린 분비 억제효과는 제1혁명 당뇨병의 자가면역 기전과 관련되어 잘 알려져 있으나 인슐린 자극효과에 대해서는 아직 명백히 밝혀지지 않았다. 이에 저자 등은 IL­1β의 다양한 농도에 따라 백서의 췌도세포에서 인슐린 분비에 미치는 영향을 살펴보고, 그 기전으로 인슐린 생합성, iNOS의 발현, 칼슘통로의 활성도 변화여부를 알아보고자 하였다. 방법:200∼300g인 수컷 Sprague­Dawley 백서의 췌도를 변형된 Lacy&Kostianovsky's 방법으로 분리한 후 IL­1β의 다양한 농도(0, 0.5, 5, 50, 500pmol/L)에 2, 6, 24시간 노출시켜 췌도세포의 형태, 생존능을 관찰하고 인슐린 분비능 및 췌도세포내 인슐린 함량을 측정하였으며, 전전구 인슐린 mRNA발현, iNOS mRNA발현을 RT­PCR을 통해 확인하였고, 세포의 칼슘 통로 활성도 변화 여부를 측정하였다. 결과:1) IL­1β에 노출되 췌도의 생존능:2시간 노출시는 대조군과 차이가 없었으나, 6시간 고농도군과 24시간 모든 군에서 생존능이 감소되었다. 2)인슐린 분비능은 IL­1β를 2시간 5poml/L이상의 고농도와 6시간 0.5pmol/L 저농도 처리시 대조군에 비해 의미있게 증가하였으나, 6시간과 24시간 5poml/L이상의 고농도에서는 의미있게 인슐린의 분비가 억제 되었다. 3)췌도내 인슐린양의 변화는 IL­1β의 시간과 농도에 따라 배지내의 인슐린 변화와 비슷한 경향을 보였으나 통계학적으로 의미있는 차이는 없었다. 4)전전구인슐린의 mRNA발현은 2시간 50pmol/L이상 고농도의 IL­1β에서 의미있게 증가하였고, 6시간 처리군에서는 의미있는 차이는 없었으나, 24시간에서 IL­1β의 용량의존적으로 억제되었다. 5)iNOS mRNA는 IL­1β 처리 후 2시간부터 발현되기 시작하여, 6시간에 최고에 달한 후 24시간에는 점차 감소하였다. IL­1β의 처리시간과 무관하게 5poml/L이상의 고농도에서 용량에 따라 발현이 증가하였다. 6)칼슘통로 활성도는 IL­1β의 농도나 시간에 따라 유의한 차이가 없었다. 결론: IL­1β는 단시간 고용량이나 장기간 저용량에서 인슐린 분비와 생합성을 증가시키며, 이런 효과는 iNOS나 칼슘 통로 활성도 변화와는 무관한 것으로 생각된다. Background : The inhibitory effort of IL-1β on the insulin secretion has been validated in pathogenesis of type 1 diabetes, but complex results about the stimulatory effect of IL-1β have been reported. The aims of this study are to clarify the effects of IL-1βon insulin secretion of pancreatic islets and to investigate the mechanisms in terms of preproinsulin synthesis, inducible NOS expression, and calcium channel activity. Method : Islets were isolated from male Sprague-Dawley (SD) rat by modified Lacy-Kostianovsky's method. After islets were treated with different concentrations (0, 0.5, 5, 50, 500 pmol/L) and exposure time (2, 6, 24 hours) of IL-1β, morphology, viability, static stimulation of insulin to glucose, insulin content, preproinsulin mRNA expression, iNOS mRNA expression and calcium channel activity were measured. Results : 1) Viability o islets was reduced in high concentrations of long term exposure of IL-1β. 2) Insulin secretion was stimulated in islets treated with 5, 50, and 500 pmol/L of IL-1β for 2 hours. 3) Insulin content was not significantly different regardless of concentration and exposure time of IL-1β. 4) Preproinsulin mRNA expression increased in islets treated with 50, 500 pmol/L of IL-1β for 2 hours. After 24 hours, it decreased in dose dependent manner. 5) iNOS mRNA expression was detectable after 2 hours in the presence of IL-1β, peaks at 6 hour and decreased after 24 hours. It was increased above 5 pmol/L of IL-1β in dose dependent manner. 6) Activities of the voltage-dependent Ca^2+ channels were not different among groups. Conclusion : IL-1β plays a positive role in terms of insulin secretion and insulin synthesis in high concentration of short term or low concentration of long term. These effects of IL-1β might be neither dependent of iNOS pathway nor Ca^2+ channel activity (J Kor Diabetes Asso 431~443, 2000).

한국노인의 식생활

곽동경,신현옥,이혜연 연세대학교 생활과학대학 1975 婦學 Vol.8 No.-

强靭鑄鐵의 熔接性에 關한 硏究

曺東震,韓俊澤,劉憲一,朴龍鎭,金錫胤,慶在浩 弘益大學校 1974 弘大論叢 Vol.6 No.-

The matrix of ductile cast iron are welded by pre-heating it at 300℃ in the room temperature. Through the mechanical, non-desbructive testing and analysis of the composition. the possibility if arc welding of ductile cast iron are studied as follows; 1. L electrode is the best among them in weldability, impact value and machinability. The next is LB electrode followed by S electrode. C electrode is last. However, the tensile strength showed in the following order: LB, S, L, C. 2. LB, S, L, C, all are available for the welding of cast iron. 3. The above experiment showed that L and LB are good in general. In addition LB is low in price, we therefore prospect that it will be widely used as the electrode for cast iron.

산업간호사의 응급처치 직무지침 개발을 위한 기초조사

전경자,조동란 순천향대학교 산업의학연구소 1996 순천향산업의학 Vol.2 No.1

Emergency care of occupational health nurses is essential to minimize the impact of incidents in the industry. The purpose of this study was to describe the characteristics of 211 injury cases and the contents of emergency care provided by 21 OHNs. Emergency care was classified to management, education and direct care. As the results, major injuries were fracture, sprain, and abrasion. Direct care were dressing, hemostatic action, medication, and ice compress, etc. Direct care were implemented more actively than education or management related to emergency care. It was proposed that job guideline should be corrected and supplemented. And it was recommended that continuing education of emergency care should be executed.

Preionization-Stabilized Multiple Transmission Lines TE N_2-Laser

朴東秀,金裕榮,金庚燦 慶北大學校 1980 論文集 Vol.29 No.-

Achieving high output power in N_2 laser, we used fast electric discharge (~10 nsec), large volume (~0.2 liter) and homogenized discharge. In order to perform the fast discharge, we have designed a lasing cavity driven by TE-type transmission lines and low inductance spark gap, and utilized multiple transmission lines to provide increased lasing volume. Multiple lines should effect on reducing the line impedance. We have derived the good homogeneity of laser discharge from the uniform spatial distribution of the initiating electrons provided by the preionizer. Present work enabled the stability of the main glow discharge relatively insensitive to the surface quality of the main electrodes.

우리나라의 現行 租稅體系에 관한 硏究

朴東燮,姜景圭 明知大學校 經濟硏究所 1989 경영연구 Vol.5 No.1