DC 초전도케이블 고전압 대용량 직류부하주기 시험

양병모(BM Yang),박진우(JW Park),조흥상(HS Jo),박흥석(HS Park),정채균(CK Jung),강지원(JW Kang) 대한전기학회 2013 대한전기학회 학술대회 논문집 Vol.2013 No.4

다태임신에서의 질식 선택적 유산술

목정은,김정훈,조윤경,박진우 대한산부인과학회 1996 Obstetrics & Gynecology Science Vol.39 No.9

The introduction of ovulation inducing agents and assisted reproductive technology(ART) has resulted in a substantial increase of multiple pregnancies of up to 30%. As the number of multiple fetus increases in utero, so does the incidence of complications and the possibility of adverse outcome. To mitigate the consequences of the multiple pregnancies and prevent complications, especially prematurity of the newborn, selective reduction is propoased. Several procedures has been performed for selective reduction. In this study, we selected the transvaginal selective reduction in an early gestational period. From September 1994 to November 1995, we performed the transvaginal selective embryonic reductions in 8 patients who carried multiple embryos, including 2 quadruplets, 4 triplets, and 2 twins. Of 2 patients who carried twins, a patients desired the embryo reduction and a patient suffered from uterine didephys. Eight multiple pregnancies were obtained by controlled ovarian hyperstimulation with intrauterine insemination(COH with IUI)(n=5) and in vitro fertilization(IVF)(n=3). We selected the embryo reduction technique using the mechanical destruction or absorption of the embryo(s) and amniotic fluid aspiration at 7 to 8 weeks of gestation. After procedures, 6 patients were remained as twin pregnancies, and 2 patients as singleton pregnancies. None of the remaining embryos vanished after procedures, and none of the patients suffered from complications such as abortion, vaginal bleeding, amniotic fluid leakage, and infection. Only 3 patients appealed abdominal discomfort and mild pain. There have been 4 sets of twin delivery and 1 singleton delivery. Three cases are ongoing state. Four patients were delivered after 36 weeks of gestation. A patient who was remained as twin pregnancy was delivered of a boy and a girl at 28 weeks of gestation due to preterm laborl. A girl was expired with hypoxic brain injury, but a boy was survived and healthy. There was no fetal anomaly related to the procedure in five cases. In conclusion, the early transvaginal selective reduction performed at 7 to 8 weeks of gestation appears to be a simple and relatively safe procedure with no affect on remaining fetuses.

체외수정시술시 난자채취일에 질식초음파 도플러를 이용한 자궁동맥 혈류측정의 임상적 유용성

목정은,김낙연,장윤석,강병문,김정훈,채희동,박진우 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.7

This study was performed to assess whether measurement of uterine artery blood flow impedance(the pulsatility index[PI] and resistance index [RI]) as determined by transvaginal color Doppler ultrasound on the day of oocyte retrieval in patients undergoing in vitro fertilization (IVF) can predict successful pregnancy. From August 1995 to January 1997, ninety-two infertile women with tubal or peritoneal factor infertility who had undergone IVF during controlled ovarian hyperstimulation(COH) cycles were allocated to the study group. The COH using luteal long protocol of GnRH agonist was used in all patients. Transvaginal color Doppler assessment of uterine artery blood flow impedance(PI and RI) on the day of oocyte retrieval was done. When the patients were grouped into pregnant(n=31) and nonpregnant(n=61), the mean value of PI and RI of the nonpregnant group were significantly higher than those of the pregnant group(2.86±0.62 vs 2.47±0.35 and 0.88±0.05 vs 0.85±0.04). The patients were also grouped according to whether the PI was low(1.00 to 1.99), medium(2.00 to 2.99), or high(≥3.00). The pregnancy rate were 33.3%, 44.8% and 10.7% for the low, medium, and high PI groups, respectively, and the pregnancy rate of the medium PI group was significantly higher than that of high PI group. The embryo implantation rates were 11.5%, 15.2% and 4.0% for the low, medium, and high PI groups, respectively, and the implantation rate of medium PI group was significantly higher than that of the high PI group, too. There was no correlation between the mean PI & RI value and serum E2 concentration on the day of hCG administration, or endometrial thickness measured on the day of oocyte retrieval. In conclusion, we fond that the measurements of uterine artery blood flow impedance(PI and RI) on the day of oocyte retrieval might predict subsequent pregnancy and implantation rates and also contribute much to effective management of infertile couples.

분만진통 제 2 기에서의 모체의 산소흡입이 제대혈액가스분석 결과에 미치는 영향

목정은,한지수,김암,이인식,이필량,강은희,박진우,정낙운 대한산부인과학회 1996 Obstetrics & Gynecology Science Vol.39 No.6

1995년 7월 1일부터 1995년 12월 31일까지 서울중앙병원 산부인과에 분만을 위해 입원한 합병증이 없었던 만삭의 단태 미산부를 입원 순서대로 산소흡입을 하지않은 대조군(I군), 분만 제2기에 `pushing`을 시작하는 순간부터 산소를 분당 5리터의 속도로 마스크를 통해 흡입하게 한 군 (II군), 10리터의 속도로 흡입하게 한 군(III군)으로 분류한 후, 질식분만이 이루어진 예에서 제대 동정맥에서 각각 형액을 채취하여 가스분석(pH, pCO2, pO2, base excess, HCO3, CO2 content, O2 saturation) 및 co-oxymetry(total hemoglobin, hemoglobin O2 saturation(%), hemoglobin CO2 saturation(%), volume %O2, methemoglobin)를 시행하여 다음의 결과를 얻었다. 1. 총 74예를 대상으로 하였으며, I군이 23예, II군이 27예, III군이 24예 였다. 2. 각 군의 환자의 연령과 분만시 임신주수는 서로 유의한 차이가 없었다(27.4±2.5, 27.1±3.1, 26.8±3.4; 39.7±1.2, 39.9±1.3, 39.5±1.3). 3. 분만 진통 제1기 및 2기의 기간은 각 군 사이에 유의한 차이가 없었다(482.6±92.7분, 509.8±106.3분, 487.6±83.7분; 39.3±16.2분, 46.3±18.1분, 34.5±11.3분). 4. I군과 II군의 제대동맥혈 가스 분석 및 co-oxymetry 결과는 모든 지표에서 유의한 차이를 보이지 않았다. 5. 제대 동정맥 모두에서 pH는 I군에 비해 III군에서 높은 결과를 보였으나 통계적으로 유의하지는 않았다(동맥; 7.27±0.08, 7.30±0.04, 정맥; 7.30±0.07, 7.33±0.05). 6. III군은 I군에 비해 제대동맥의 경우 pO2(18.5±4.7, 21.5±4.9)가 유의하게 높은 값을 나타냈으며, hemoglobin O2 saturation(64.4±17.3, 42.6±14.0)과 volume %O2(19.2±14.1, 6.2±2.0)는 유의하게 낮은 값을 보였고, 그 이외의 지표들에 대해서는 유의한 차이를 보이지 않았다. 7. I군과 II군의 제대정맥혈 가스 분석 및 co-oxymetry 결과에서는 pCO2의 값은 유의한 차이를 보였으나(42.4±5.6, 39.1±5.2), 그 이외의 모든 지표에서는 유의한 차이가 없었다. 8. III군은 I군에 비해 제대 정맥의 경우 pO2(22.8±6.3, 26.4±5.3)과 O2 saturation(35.4±13.8, 43.7±12.4)는 유의하게 높은 값을 나타내었으며, hemoglobin O2 saturation(70.1±13.9, 54.1±12.6)과 volume % O2(14.7±8.7, 9.8±6.2)는 유의하게 낮은 값을 보였고, 그 이외의 지표들에 대해서는 유의한 차이를 보이지 않았다. 9. 분만방법, 성비, 출생 체중, 아프가 수치 및 태변 착색으로 본 분만 결과는 세 군 사이에 유의한 차이가 없었다. 결론적으로, 분만 진통중인 정상적인 임신경과를 보인 임신부에게 마스크를 통해 산소를 흡입하게 하는 방법은 투여속도를 높일 경우에는 (10리터/분) 태아의 산염기 평형에 유리하게 작용할 수 있을 것으로 판단되나 추후 더 많은 대상을 통한 연구가 필요할 것으로 사료된다. The purpose of this study was to evaluate the effect of maternal oxygen inhalation during the second stage of labor on umbilical cord blood gas and co-oxymetry values. Seventy four normal term singleton nulliparous gravidas were randomized into the study and divided into 3 groups. In therapy groups, patients received oxygen by a tight fitting face mask during the second stage of labor until fetal delivery at flow rates of 5 L/min(group II) and 10 L/min(group III). Patients who did not receive oxygen were classified as control group(group I). After delivery, umbilical arterial and arterial and venous blood gas analyses and co-oxymetry were done. The results of group I and II did not show significant differences except venous pCO2(42.4±5.6 vs 39.1±5.2, p$lt;0.04). Group III showed significantly higher arterial pO2 value(21.5±4.9 vs 18.5±4.7, p$lt;0.05) and venous pO2 and O2 saturation values(26.4±5.3 vs 22.8±6.3, 43.7±12.4 vs 35.4±13.8, respectively; p$lt;0.05) than those of Group I. Cord blood hemoglobin O2 saturation and volume %O2 were recorded significantly lower value in group III than in group I. However, cord pH in group III was higher than that of control group, but the difference was statistically not significant. In conclusion, high-flow oxygen therapy(10L/min) to normal term laboring women, may guarantee fetal or neonatal acid-base balance.