경구용 및 질용 PGE₂의 유도분만 효과에 관한 임상적 비교고찰

김상우(SW Kim),서병희(BH Suh),이재현(JH Lee) 대한산부인과학회 1983 Obstetrics & Gynecology Science Vol.26 No.12

유도분만의 적용이 되는 각각 30명의 산모(초산부 15예, 경산부 15예)를 대상으로 각각 경구용 PGE₂는 경구로, 질용 PGE₂정제는 질후벽 자궁경관밑에 투여 하여 다음과 같은 결과를 얻었다. 1. 유도분만 성공율은 경구용 PG군에서 67%(20/30예)이었는데, 초산부 60%(9/l5예), 경산부 73%(11/15 예)이 있고, 질용 PG군에서는 77%(23/30)로 초산부 66%(10/15예) . 경산부 87%(13/15예)이었다. 2. 진통초발까지의 소요시간은 경구용 PG군에서 평균 7시간 13분, 질용 PG군에서 평균 4시간 45분이었으며, 투약개시부터 태아만출까지의 소요시간은 경구용 PG군에서 평균 18시간 37분, 질용 PG군에서 10시간 33분으로 진통초발시간과 태아만출까지의 소요시간이 질용 PG에서 월등히 빨랐다. 3. 경구용 PG군에서 정상질식분만은 70%, 질식흡인분만 23%, 제왕절개술 7%이었고 질용 PG군에서는 정상질식분만 80%, 질식흡인분만 17%, 제왕절개분만 3%이었다. 4. 경구용 PG군에서 분만된 신생아의 Apgar score는 1분에서 7이상이 90%(27/30예) , 5분에서 7이상이 100%이었고, 분만된 신생아가 태변염색된 경우는 17% (5/30예)이었다. 질용 PG군은 분만된 신생아의 Apgar score가 1분, 5분에서 모두 7~8이상으로 양호한 편이었고, 태변염색된 경우는 10%이었으며 특기할 만한 신생아의 이상소견은 발견할 수 없었다. 5. 경구용 PG에서 투약도중 나타난 부각용은 오심 10% (3/30예) , 구토 3% (1/30예)이었고 질용 PG군에서는 부작용이 없었다. 6. 경구용 PG와 Oxytocin정맥점적주입을 병용하여 시도한 유도분만 10예중 80%(8/10예) 에서 유도분만에 성공하였으므로 경구용 PG에 의한 총유도분만 성공율은 93% (28/30예) 이었고 질용 PG와 oxytocin정맥점적 주입을 병용한 7예증 6예에서 질식분만에 성공하였으므로 질용 PG에 의한 총유도분만성공율은 96.6%(29/30 예) 이었으며 1예에서만 제왕절개술이 시행되었다. 이상의 결과로 미루어 보아 경구용 PG나 질용 PG가 특별한 부작용이 없으면서 높은 유도분만성공율을 보이고 있으며 질용 PG가 경구용 PG보다 진통초발까지의 시간과 태아만출까지의 시간이 비교적 빠르게 나타났고 경산부에 비하여 성공율이 약간 떨어지는 초산부는 PG단독사용보다는 oxytocin정맥점적주입의 병용에 의한 유도분만으로 좋은 성과를 거둘 수 있다고 생각된다. Intravaginal Prostaglandin E₂ on the Unfavorable Cervix Induction of labor for obstetrics or medical reasons is an integral part of modern obstetric practice. The standard method employed in the authors, institution has been amniotomy and intravenous oxytocin for many years while, during the last 2 or 3 years, oral administration of prostaglandin Es tablets has been used before intravenous infusion of oxytocin to induce labor as well as to ripen the cervix. Also a ideal method for the induction of labor would be simple, safe, effective and noninvasive, there by increasing acceptance by the patient and reducing the risks associated with amniotomy. The intravaginal administration of prostaglandin E₂ tables which is the easiest way to apply prostaglandin can provide these benefit. This is a report to compare the efficiency of oral PG for the induction of labor. Induction of labor was performed in the cases of each 30 women between 39th and 44th weeks of pregnancy who were admitted to the Dept. of Obstetrics and Gynecology of Kyung Hee Univ. Hospital from June 1981 to May 1983. The pelvic score for induction was determined by Bishop scoring method. and the Bishop score of the patient of our studies were all below 5. The result were as follows. 1. The success rate in induction with oral PGE₂ were 60% in primigravida(9 of 15 cases), 73%(11 of 15 cases) in multigravida. The success rate in induction with vaginal PGE₂ were 66%(10 of 15 cases) in primigravids, 87%(13 of 15 cases) in multigravida. 2. Mean induction delivery time of oral PGE₂ group was 18 hours 37 minutes and time interval from medication to active labour was 7 hours 13 minutes. Mean induction delivery time of vaginal PGE₂ group was 10 hours 33 minutes and time interval from medication to active labour was 4 hours 45 minutes 3. In oral PG group, normal vaginal delivery was 70%, vacuum delivery was 23%, cesarean delivery was 7%, In vaginal PG group, normal vaginal delivery was 80%, vacuum delivery was 17%, cesarean delivery was 3%. 4. In oral PG group, over 7(at 1 minutes) of Apgar score was 90%, over 7(at 5 minute) was 100% and meconium stained fetus was 17%(5 of 30 cases). In vagina1 PG group, over 7 of 8(at 1 and 5 minutes) of Apgar score was all and meconium stained fetus was 10%(3 of 30 cases). 5. In oral PG group, 11 of 12 cases(91%) of fetal monitoring patients showed reactive pattern. In vaginal PG group, 9 cases of fetal monitoring patients were all reactive pattern. Their NST results were all reactive and 4 of 9 cases were applicated with CST(their results were all negative) 6. Maternal side effects during oral PG induction were nausea(10%, 3 of 30 cases). vomiting(3%, 1 of 30 cases), but they were disappeared spontanecusly without specific treatment, and there was no side effects during vaginal PG induction. 7. In failed cases with only oral PG, successful induction rate with combined therapy of oral PG and oxytocin was 93%(23 of 30 cases) and 2 cases of cesarean delivery were carried out. In failed cases with only vaginal PG, successful induction rate with combined therapy of vaginal PGE₂ and oxytocin was 97%(29 of 30 cases) and only 1 case of cesarean section was carried out.

만삭 전 임신부에서 분만유도 성공에 대한 임상,초음파 예측지표에 관한 연구

김시내 ( Shi Nae Kim ),박교훈 ( Kyo Hoon Park ),홍준석 ( Joon Seok Hong ),정희정 ( Hee Jung Jung ),강웅선 ( Woong Sun Kang ),신동명 ( Dong Myung Shin ),이정연 ( Jeong Yeun Lee ) 대한산부인과학회 2009 Obstetrics & Gynecology Science Vol.52 No.11

목적: 만삭 전 임신부에서 분만유도 시 유도성공을 예측할 수 있는 임상적 지표와 초음파 지표를 확인하고자 한다. 연구 방법: 단태임신으로 만삭 전 (임신 37주 미만)에 분만유도를 위해 입원한 임신부 103명을 대상으로 전향적 연구를 시행하였다. 경질초음파를 사용하여 자궁경부 길이를 측정하고 내진을 통해 Bishop점수를 측정하였다. 또한 분만유도 시 임신 주수, 출산력, 나이, 체질량지수를 측정하였다. 결과: 45명 (44%)에서 성공적인 분만유도가 이루어졌다. 다변량 논리회귀분석에서 출산력, 체질량지수, 분만유도 시 임신주수는 분만유도 성공을 예측하는 데 유의한 독립변수임을 나타내었다. 그러나 분만유도 시 임신주수는 통계적인 유의성에는 이르지 못하였다 (P=0.056). 임신부의 나이와 자궁경부 길이, Bishop점수는 분만유도 성공을 예측하는 데 유의한 관련성을 나타내지 않았다. 결론: 만삭 전 임신부의 분만유도에서 출산력, 체질량지수와 분만유도 시 임신주수는 분만유도의 성공여부를 예측하는 독립적 인자이다. 그러나 자궁경부 길이와 Bishop점수는 성공 예측에 있어 유용하지는 않은 것으로 나타났다. Objective: To identify the clinical and sonographic parameters which predict the likelihood of successful labor induction in preterm women. Methods: This prospective observational study enrolled 103 consecutive preterm women (<37 weeks gestation) with singleton gestations scheduled for induction of labor. Transvaginal ultrasound for measurement of the cervical length was performed and the Bishop score was determined by digital examination. The parameters studied were gestational age at induction, parity, maternal age, Bishop score, sonographic cervical length, and current body mass index (BMI). Univariate and multivariate statistical methods were used for data analysis. Results: Successful induction of labor occurred in 45 (44%) of women. Multiple logistic regression analysis identified parity, maternal BMI, and gestational age at induction as the independent predictors of successful labor induction in preterm women, although gestational age did not reach statistical significance (P=0.056). However, maternal age, sonographic cervical length, and Bishop score did not provide independent contribution to success of induction. Conclusion: In preterm women undergoing induction of labor parity, maternal BMI, and gestational age at induction were independent parameters in predicting successful induction of labor. However, sonographic cervical length and Bishop score had poor predictive values for success of labor induction.

자간전증이 prostaglandin E2 및 oxytocin을 사용한 분만유도에 미치는 영향

박교훈(Kyo Hoon Park),조용균(Yong Kyoon Cho),최훈(Hoon Choi),김복린(Bok Rin Kim),한성식(Sung Shik Han),이철민(Chul Min Lee),이홍균(Hong Kyoon Lee) 대한산부인과학회 2001 Obstetrics & Gynecology Science Vol.44 No.3

N/A Objective : The purposes of this study were 1) to determine whether preeclampsia itself affects failure of labor induction with prostaglandin E2 and oxytocin and 2) to investigate risk factors for failed induction in women with preeclampsia. Method : Fifty preeclamptic women and 175 nonpreeclamptic women requiring labor induction were studied prospectively. Intravaginal prostaglandin (PG) E2 tablet (Dinoprostone, The Upjohn company, 3 mg) followed by a second dose if the cervix assessed 6 hours later was 5 or less of Bishop score, and oxytocin were used for labor induction. Women with rupture of membrane, spontaneous contraction resulting in cervical change or an initial cervical examination showing more than 2 cm dilatation and 50% effacement were excluded. Statistics were analyzed with 2 test, Student t test, and multiple logistic regression. Results : 1) The women with preeclampsia had a significantly higher rate of failed induction than did those without preeclampsia [24% (2/50) versus 9% (16/175); p <0.05]. However, the women with preeclampsia had a higher rate of the use of magnesium sulfate, and were more likely to decrease gestational age at induction and increase maternal weight than those without preeclampsia (p <0.0001, respectively). There were no significant differences in prevalence of nulliparity and low initial Bishop score (≤3) between the women with and without preeclampsia. 2) Multiple logistic regression showed that preeclampsia itself was not associated with failed induction after correction of known confounding variables (odds ratio 0.22, 95% confidence interval 0.03-2). 3) In women with preeclampsia, the use of magnesium sulfate only was associated with increased risk of failed induction analyzed by multiple logistic regression(odds ratio 38.5, 95% confidence interval 1.6-897). Maternal weight with 70 kg or more was associated with increased risk of failed induction, but it is not statistically significant (p=0.055). Conclusion : 1) The risk of failed induction is increased in women with preeclampsia, but not by preeclampsia itself but by the use of magnesium sulfate, prematurity, and increased maternal weight secondary to preeclampsia. 2) The use of magnesium sulfate is independent risk factor for failed induction in women with preeclampsia.

Flip-Chip Process using Heat Transfer from an Induction-Heating Film

오태성,이광용,이윤희,정부양 대한금속·재료학회 2009 METALS AND MATERIALS International Vol.15 No.3

A new flip-chip technology to attach an IC chip directly to a substrate was studied using the heat transfer from an induction-heating film in an AC magnetic field. When applying a magnetic field of 230 Oe at 14 kHz, the temperature of a 600 μm-thick 5 mm × 5 mm Cu induction-heating film reached 250 °C within 60 s. The temperature of the glass substrate used in this process was kept below 118 °C at a distance of 1,350 μm from the Cu induction-heating film, which was maintained at 250 °C, implying that damage to a substrate can be minimized with the flip-chip process using heat transfer from an induction-heating film. Flip-chip bonding was successfully accomplished with the reflow of Sn-3.5Ag solder bumps by applying a magnetic field of 230 Oe at 14 kHz for 120 s to a Cu induction-heating film. A new flip-chip technology to attach an IC chip directly to a substrate was studied using the heat transfer from an induction-heating film in an AC magnetic field. When applying a magnetic field of 230 Oe at 14 kHz, the temperature of a 600 μm-thick 5 mm × 5 mm Cu induction-heating film reached 250 °C within 60 s. The temperature of the glass substrate used in this process was kept below 118 °C at a distance of 1,350 μm from the Cu induction-heating film, which was maintained at 250 °C, implying that damage to a substrate can be minimized with the flip-chip process using heat transfer from an induction-heating film. Flip-chip bonding was successfully accomplished with the reflow of Sn-3.5Ag solder bumps by applying a magnetic field of 230 Oe at 14 kHz for 120 s to a Cu induction-heating film.

만삭산모에서 유도분만의 성공예측지표로서 질식초음파를 이용한 자궁경부 관찰의 유용성

양순하(Soon Ha Yang),오정미(Jung Mi Oh),노정래(Cheong Rae Roh),정재현(Jae Hyun Chung) 대한산부인과학회 1998 Obstetrics & Gynecology Science Vol.41 No.11

N/A Objectives: The purposes of this study were to determine the usefulness of transvaginal ultrasonographic assessment of the uterine cervix and to compare the diagnostic performance of ultrasonographic and digital examination of the cervix in predicting a successful induction of labor. Study design: One hundred-one singleton term pregnancies without ruptured membranes admitted for the labor induction were included in this study. Digital examination and transvaginal ultrasonography of the uterine cervix were performed at the time of admission. Cervical parameters evaluated included cervical length, presence of funneling, funnel length, and funnel width. Labor induction was underwent by prostaglandin E2 (PGE2) vaginal suppository and/or pitocin intravenous infusion. Outcome variable was a successful labor induction within 48 hours after beginning of the induction. Results: The prevalence of induction failure was 10.9% (11/101). Receiver-operator characteristic (ROC) curve and multiple logistic regression analysis indicated a significant relationship between the successful induction of labor and cervical length <3.1 cm. The diagnositic indices of endocervical length was superior to those of Bishop's cervical score in predicting a successful induction of labor. In patients with cervical length <3.1 cm, the labor was induced successfully with fewer tablets of PGE2, less use of pitocin infusion, and shorter induction-delivery interval. Conclusion: Transvaginal ultrasonographical examination of the uterine cervix is more accurate than digital examination of the cervix in the prediction of a successful induction of labor in term gestation.

외기유인형 주방ㆍ욕실 배기구의 기류측정 분석

이용호(Lee, Yong-Ho),김성용(Kim, Seong-Yong),박진철(Park, Jin-Chul),황정하(Hwang, Jung-Ha) 한국태양에너지학회 2012 한국태양에너지학회 논문집 Vol.32 No.6

This study conducted experiments to measure air currents in an experimental building according to external conditions, types of induction ducts, and types of internal sockets by applyingan external induction duct comprised of inducing openings and lines and induction units to the kitchen and bathroom vents at the rooftop of a super high-rise apartment building in order to help to improve the venting performance.The study also proposed the optimization of the external induction-style kitchen and bathroom vents capable of wind power generation. (1) As for air current distribution according to vent velocity changes, it increased the venting performance of the kitchen and bathroom by 1.0㎧ at ventvelocity of 2.0㎧ or higher and allowed for wind power generation. (2)As for air current distribution according to external velocity changes, it increased the venting performance of the kitchen and bathroom by 1.2㎧ at external velocity of 2.0㎧ or higher and allowed for wind power generation. (3) As for air currentdistribution according to wind direction changes (0∼180°), it was favorable for higher vent velocity when the angle between the external induction duct direction and prevailing wind direction was within±30°. (4) As for air current distribution according to induction duct type, the [M1] type combining the inducing opening sand lines with the induction units recorded the highest improvement effects in the kitchen and bathroom venting performance by increasing vent velocity by 46%. (5) As for air current distribution according to the changing types of internal sockets where them ainducts of the kitchen and bathroom are connected to the external induction ducts, the venturi tube type[Sv]increasedventvelocity by 66% based on the smoothest external inflow.

Experimental Verification of Induction Phenomenon on Telecommunication Lines by Applying Its Occurrence Mechanisms Using an Artificial ELF Source Generator

Sangmu Lee,Yoon-Myoung Gimm,Changsoo Eun 한국전자파학회JEES 2010 Journal of Electromagnetic Engineering and Science Vol.10 No.4

In this paper, an electromagnetic induction on a telecommunication line by the distribution line of a power provision system or a feeder line of an electrified railway system has been verified through experiments. The basic cause of induction occurrence by these practical power provision systems is the returning current through the earth. This principle has been confirmed by the experiments documented in this paper which implemented these mechanisms to incur an induction. Experimental methods were used to produce the returning current through the earth. The experiment to find a relationship between inducing strength and the distance between the two phase lines in a power provision line has also been included to confirm that, when the distance is enlarged, the induction effect increases as the crossnullification effect of magnetic fluxes decreases. An experiment for the existence of a shielding effect by another conduction length material has been addedas a protection measure against the induction.

In Defense of Hume’s Skeptical Argument against Induction

Jeonggyu Lee(이정규) 한국철학회 2015 철학 Vol.0 No.123

흄이 귀납에 대한 강력한 회의주의적 논변을 제시한 것은 잘 알려져 있다. 많은 철학자들은 흄의 귀납에 대한 기술이 비록 어떤 면에서는 부적합 할지라도, 그의 회의적 논변 자체는 여전히 반박 불가능한 것이라 생각한다. 하지만 오카샤는 이것이 옳지 않다고 주장한다: 일단 우리가 귀납을 적합하게 기술한다면, 흄의 논변은 이러한 귀납에 대한 적합한 기술에는 더이상 적용될 수 없다. 이 논문에서, 나는 오카샤에 반대하여, 흄의 회의적 논변이 귀납에 대한 적절한 기술 하에서도 여전히 적용될 수 있음을 논변할 것이다. It is well known that Hume gave a powerful skeptical argument against induction. Many philosophers think that even though Hume’s description of induction is inadequate in some respects, his skeptical argument is still irrefutable. However, Okasha argues that this cannot be right: Once we adequately describe what we are doing with induction, Hume’s skeptical argument cannot be applied to this adequate description of induction any more. In this paper, in opposition to Okasha, I will argue that Hume’s skeptical argument still can be applied even on the ‘adequate’ description of induction.

Medical student’s perception to different types of set induction in anatomy lectures

Suresh Narayanan,Suresh Narayanan,Nachiket Shankar,Vimala Ananthy 대한해부학회 2019 Anatomy & Cell Biology Vol.52 No.3

Set induction refers to the process of using a thought-provoking statement, interesting fact, or an audio-visual stimulus at the beginning of lecture to gain student’s attention and give an overview about the lecture topic. In the present study, students were introduced to three types of set induction namely narratives, food-based analogies and humor-based images or activities at the beginning of anatomy lecture and their response to it is collected and analyzed. The objective of the study is to estimate the difference in a questionnaire-based perception score between the three different types of set induction; estimate sex differences in the questionnaire-based perception score. Students rated the validated, 7-item perception questionnaire using a 5-point Likert scale. Students felt that food-based analogies and humor-based images were more interesting, motivated them to participate in lecture-discussion than the narrative set induction. The familiarity of set induction varied between all the three different types of set induction. There was no significant difference in the perception of different types of set induction between male and female undergraduate students. Based on the student’s feedback, it could also serve as a memory aid and ease the students learning experience. Majority of students responded positively to the use of set induction and recommended for its use in future classes.

Concerns of the anesthesiologist: anesthetic induction in severe sepsis or septic shock patients

윤석화 대한마취통증의학회 2012 Korean Journal of Anesthesiology Vol.63 No.1

Septic patients portray instable hemodynamic states because of hypotension or cardiomyopathy, caused by vasodilation, thus, impairing global tissue perfusion and oxygenation threatening functions of critical organs. Therefore, it has become the primary concern of anesthesiologists in conducting anesthesia (induction, maintenance,recovery, and postoperative care), especially in the induction of those who are prone to fall into hemodynamic crisis,due to hemodynamic instability. The anesthesiologist must have a precise anesthetic plan based on a thorough preanesthetic evaluation because many cases are emergent. Primary circulatory status of patients, including mental status, blood pressure, urine output, and skin perfusion, are necessary, as well as more active assessment methods on intravascular volume status and cardiovascular function. Because it is difficult to accurately evaluate the intravascular volume, only by central venous pressure (CVP) measurements, the additional use of transthoracic echocardiography is recommended for the evaluation of myocardial performance and hemodynamic state. In order to hemodynamically stabilize septic patients, adequate fluid resuscitation must be given before induction. Most anesthetic induction agents cause blood pressure decline, however, it may be useful to use drugs, such as ketamine or etomidate, which carry less cardiovascular instability effects than propofol, thiopental and midazolam. However, if blood pressure is unstable, despite these efforts, vasopressors and inotropic agents must be administered to maintain adequate perfusion of organs and cellular oxygen uptake. Septic patients portray instable hemodynamic states because of hypotension or cardiomyopathy, caused by vasodilation, thus, impairing global tissue perfusion and oxygenation threatening functions of critical organs. Therefore, it has become the primary concern of anesthesiologists in conducting anesthesia (induction, maintenance,recovery, and postoperative care), especially in the induction of those who are prone to fall into hemodynamic crisis,due to hemodynamic instability. The anesthesiologist must have a precise anesthetic plan based on a thorough preanesthetic evaluation because many cases are emergent. Primary circulatory status of patients, including mental status, blood pressure, urine output, and skin perfusion, are necessary, as well as more active assessment methods on intravascular volume status and cardiovascular function. Because it is difficult to accurately evaluate the intravascular volume, only by central venous pressure (CVP) measurements, the additional use of transthoracic echocardiography is recommended for the evaluation of myocardial performance and hemodynamic state. In order to hemodynamically stabilize septic patients, adequate fluid resuscitation must be given before induction. Most anesthetic induction agents cause blood pressure decline, however, it may be useful to use drugs, such as ketamine or etomidate, which carry less cardiovascular instability effects than propofol, thiopental and midazolam. However, if blood pressure is unstable, despite these efforts, vasopressors and inotropic agents must be administered to maintain adequate perfusion of organs and cellular oxygen uptake.