Whole blood viscosity in preeclampsia and its relationship with severity and postpartum antihypertensive requirement

( Ji Hea Byun ),( Ji Young Kwon ),( Hyun Sun Ko ),( In Yang Park ),( Jong Chul Shin ),( Jeong Ha Wie ) 대한산부인과학회 2019 대한산부인과학회 학술대회 Vol.105 No.-

Objective: To assess the value of hemorheological parameters as a severity index in preeclampsia and its relationship with need for postpartum antihypertensive medication. Methods: This study was a retrospective cohort study including consecutive women with preeclampsia in a tertiary center between January 2017 and December 2018. A total of 80 consecutive pregnancy with preeclampsia were further divided into preeclampsia without severe feature (n=48) and with severe feature (n=32). We compared hemorheological alterations of women in two preeclampsia groups with those of matched normotensive women (n=80). We also compared hemorheological alterations and demographic factors according to needs for hypertensive medication at postpartum 6 weeks. Results: Both systolic and diastolic viscosities were significantly higher in women with preeclampsia with severe feature than women with preeclampsia without severe feature and normotensive women. (p =0.016 and p = <0.001, respectively). Women requiring postpartum hypertensive medication had higher systolic and diastolic whole blood viscosities than women who were not on postpartum hypertensive medication (p=0.003 and p =0.008). After multivariate logistic regression, systolic viscosity (aOR 2.951, 95% Confidence interval 1.216-7.159), p=0.017) and diastolic viscosity (aOR 1.243[95% CI 1.006-1.534], p=0.044) were found to be associated with needs for postpartum antihypertensive medication. Conclusion: In women with preeclampsia, maternal whole blood systolic and diastolic viscosities were related to the severity of preeclampsia and associated with needs for postpartum antihypertensive therapy.

Placenta volume at 10-12 weeks of gestation is a predictor of preterm delivery

( Ji Hea Byun ),( Jeong Ha Wie ),( In Yang Park ),( Ji Young Kwon ) 대한산부인과학회 2018 대한산부인과학회 학술대회 Vol.104 No.-

Objective: To evaluate the performance of three-dimensional (3D) placenta volume (PV) and 3D power Doppler indices at first trimester of pregnancy in the prediction of preterm delivery. Methods: A prospective cohort study including women with single pregnancies who underwent sonogram between 10-12 weeks of gestation. PV and 3D Doppler indices including vascularization index (VI), flow index (FI) and vascularization flow index (VFI) were measured using 3D power Doppler imaging and the VOCAL technique. Preterm delivery is defined as a spontaneous delivery before 37 weeks of gestation with labor or premature rupture of membrane. Cases of preeclampsia was excluded. The predictive ability of each variable was evaluated using receiver-operating characteristic (ROC) curves. Results: Of 342 women included, 300 women were followed until delivery and preterm delivery was occurred in 35 women. Low Z-value of PV, VI, FI, and VFI were significantly associated with preterm delivery by Mann-Whitney U-test. (p= 0.002, 0.025, 0.029 and 0.013, respectively). Multivariate analysis showed that Z-value of PV was significantly associated with preterm delivery (Odds ratio 0.449; 95% confidence interval 0.280-0.720, p = 0.001). Other 3D power Doppler indices and prepregnant BMI were not significant factors. Conclusion: The study suggests that low 3D PV between 10 -12 weeks of gestation is associated with subsequent spontaneous preterm delivery.

Risk-Factor analysis of increased hemorrhage during cesarean myomectomy

( Ji Young Kwon ),( Ji Hea Byun ),( Inhye Shin ),( Subeen Hong ),( Rayon Kim ),( In Yang Park ) 대한산부인과학회 2020 대한산부인과학회 학술대회 Vol.106 No.-

Objective: We intended to identify the risk factors of increasing complications such as hemorrhage on occasions of a combined operation of myomectomy with cesarean section of patients with uterine myoma. Methods: A retrospective cohort study was done of all patients who underwent cesarean myomectomy for intramural leiomyoma during a cesarean section at a single university hospital. Cases identified with subserosal leiomyoma, placental disorder, and comorbid conditions related to coagulopathy were excluded. We entered factors found to be significantly associated with operative hemorrhage into multivariate logistic regression analysis to identify risk factors for hemorrhage. Results: A total of 302 women underwent cesarean myomectomy during the study period. Among these women, 212 pregnant women met the inclusion criteria. The proportion of women requiring transfusion was 6.6%. Postoperative ileus or fever occurred in 6 women (2.8%). Operative hemorrhage occurred in 23 women (10.8%). Women in the hemorrhage group had significantly more intraoperative blood loss, more hemoglobin drop, longer operative time and a longer postoperative stay in hospital than did women in the non-hemorrhage group (p = 0.007, < 0.001, 0.016, and < 0.001, respectively). Removed leiomyomas in the hemorrhage group showed significantly larger diameters (p = 0.048) and lower segmental location than did those in the control (p < 0.001). Multiple logistic regression analysis demonstrated that the parameters of leiomyoma, including lower segmental location (odds ratio [OR], 6.952; 95% confidence interval [CI], 2.342 - 20.638, p < 0.001) and the diameter (OR, 1.207; 95% CI, 1.047 - 1.391, p = 0.009), were significant independent predictors of hemorrhage after cesarean myomectomy. Conclusion: We identified that the cesarean myomectomy employed for the uterine myoma found with sizes below 10 cm and situated at either the uterine fundus or the middle portion of the uterus would leave no further complications, such as hemorrhage.

The Influence of previous vaginal delivery on cervical length

( Seonghye Park ),( Ji Hea Byun ),( Jeongha Wie ),( In Yang Park ),( Ji Young Kwon ) 대한산부인과학회 2019 대한산부인과학회 학술대회 Vol.105 No.-

Objective: Cervical length (CL) is a potential screening tool to predict preterm delivery for high risk women. Also it can be used for prediction of spontaneous labor or successful induction of labor. The objection of this presentation was to assess association between CL and previous vaginal delivery. Methods: Prospective observational cohort study was conducted from Jul. 2015 to Dec. 2017 at tertiary hospital. We measured CL at 18- 22 weeks, 22-26 weeks, 30-32 weeks and 36-37 weeks for all pregnant women who visited our hospital for antenatal care. Pregnant women with multifetal pregnancy, cerclage during pregnancy, fetal death in uterus and preterm delivery were excluded. Student t test was conducted between history of previous delivery and cervical length at each gestational week. Results: We included 595 pregnant women and their records of CL. At 18-22 weeks of gestation, there was no significant association between previous vaginal delivery and CL. At 22-26 weeks of gestation, women with previous vaginal delivery (N = 356) had a shorter CL compared with women without previous vaginal delivery (N=239). (mean CL in women with previous vaginal delivery 34.8 ± 5.8 mm, women without previous vaginal delivery, 36.4 ± 6.3 mm, P = 0.033). At 30-32 and 36-37 weeks of gestation, women with previous vaginal delivery had shorter CL than women without history of vaginal delivery significantly (P= 0.038 and 0.002, respectively). Maternal height, body mass index, birthweight, and gestational week at delivery were not associated with history of vaginal delivery. Conclusion: CL at 22-26 weeks and at 30 -32 weeks and 36-37 weeks are significantly associated with previous vaginal delivery. When we measure and use CL as a predictor for preterm or term labor, history of vaginal delivery should considered.

A caes of amniotic fluid embolism treated by multidisciplinary treatment

( Yeo Nyeong Yoon ),( Ji Hea Byun ),( Jeong Ha Wie ),( Ji Young Kwon ) 대한산부인과학회 2022 대한산부인과학회 학술대회 Vol.108 No.-

The emergency cesarean section was decided due to the minimal variability with fetal heart rate(FHR) 130-140. Dexamethasone was given prior surgery to support the newborn’s lung development. The cesarean section was performed at 32+6weeks under spinal anesthesia and living baby weighing 1540g was delivered with apgar score of 5 and 7 at 1 minute and 5 minuet. Suddenly 3 hours after surgery, the clinical symptoms were founded with spontaneous cough,sputum,dyspnea, cyanosis of finger tip, low blood pressure, spO2 63% and performed chest x-ray, suggesting pulmonary edema. The immediate management was required by respiratory and cardiac department and performed intubation, bed side echocardoigram, added inotropic agent to improve blood pressure. Subsequently, cardiothorathic department was ready to perform extracorporeal membreane oxygenation(ECMO). For further evaluation, enhanced computerd tomography(CT) lung mediastinum and bronchoscopy was performed. The CT showed pulmonary edema and pleural effusion,combined pnemonia, suggesting amniotic fluid embolism. Additionally, to prevent exacerbation of hemorrhage the evaluation of coagulation parameter was performed and indicated management of antithrombin therapy. The patient stabilized and discharged the day 6 without complication.

농업환경에서의 자율주행을 위한 임베디드 보드 기반의 장애물 감지 방법에 관한 연구

변성우(Sung-Woo Byun),최지호(Ji Ho Choi),이혜민(Hea-Min Lee) 한국통신학회 2024 한국통신학회 학술대회논문집 Vol.2024 No.1

초등학생 가정을 대상으로 한 바이오에어로졸 노출과 아토피와의 연관성 평가

하진실,정혜정,변혜정,윤충식,김양호,오인보,이지호,하권철,Ha, Jin-Sil,Jung, Hea-Jung,Byun, Hyae-Jeong,Yoon, Chung-Sik,Kim, Yang-Ho,Oh, In-Bo,Lee, Ji-Ho,Ha, Kwon-Chul 한국환경보건학회 2011 한국환경보건학회지 Vol.37 No.6

Objectives: Exposure to bioaerosols in the indoor environment could be associated with a variety adverse health effects, including allergic disease such atopy. The objectives of this study were to assess children's exposure to bioaerosol in home indoor environments and to evaluate the association between atopy and bioaerosol, environmental, and social factors in Ulsan, Korea. Methods: Samples of viable airborne bacteria and fungi were collected by impaction onto agar plates using a Quick Take TM 30 and were counted as colony forming units per cubic meter of air (CFU/$m^3$). Bioaerosols were identified using standard microbial techniques by differential stains and/or microscopy. The environmental factors and possible causes of atopy based on ISAAC (International Study of Allergy and Asthma in Childhood) were collected by questionnaire. Results: The bioaerosol concentrations in indoor environments showed log-normal distribution (p < 0.01). Geometric mean (GM) and geometric standard deviation (GSD) of airborne bacteria and fungi in homes were 189.0 (2.5), 346.1(2.0) CFU/$m^3$, respectively. Indoor fungal levels were significantly higher than those of bacteria (p < 0.001). The concentration of airborne bacteria exceeded the limit recommended by the Korean Ministry of Environment, 800 CFU/$m^3$, in three out of 92 samples (3.3%) from 52 homes. The means of indoor to outdoor ratio (I/O) for airborne bacteria and fungi were 8.15 and 1.13, respectively. The source of airborne bacteria was not outdoors but indoors. GM of airborne bacteria and fungi were 217.6, 291.8 CFU/$m^3$ in the case's home and 162.0, 415.2 CFU/$m^3$ in the control's home respectively. The difference in fungal distributions between case and control were significant (p = 0.004) and the odds ratio was 0.996 (p = 0.027). Atopy was significantly associated with type of house (odds ratio = 1.723, p = 0.047) and income (odds ratio = 1.891, p = 0.041). Some of the potential allergic fungal genera isolated in homes were Cladosporium spp., Botrytis spp., Aspergillus spp., Penicillium spp., and Alternatia spp. Conclusions: These results suggest that there this should be either 'was little' meaning 'basically no significant association was found' or 'was a small negative' mean that an association was found but it was minor. It's a very improtant distinction. Association between airborne fungal concentrations and atopy and certain socioeconomic factors may affect the prevalence of childhood atopy.