• Neonatal Medicine
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• 제18권1호
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• pp.111-116
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• 2011

목적: 다태임신에서 지연 분만이 신생아 사망률과 이환율에 미치는 영향에 대하여 알아보고자 하였다. 방법: 2005년 6월부터 2010년 7월까지 서울대학교병원에서 지연 분만 방법으로 출생한 아기들을 대상으로 후향적 고찰을 하였다. 결과는 신생아 사망률과 이환율로 하였으며, 이환율을 조사한 질병에는 뇌실 내 출혈, 신생아 호흡 곤란 증후군, 기관지폐 형성 이상, 뇌실 주위 백색질연화증, 자궁 외 성장지연 등을 포함하였다. 다태아 중 이후에 출생한 아기들의 결과를 처음 출생한 아기들, 그리고 재태주령과 출생체중이 비슷한 아기들로 이루어진 대조군의 결과와 비교하였다. 결과: 총 4쌍의 쌍둥이, 5쌍의 세 쌍둥이가 있었으며, 처음 출생한 아기들(그룹 1)은 9명, 이후에 출생한 아기들(그룹 2)은 14명이었다. 그룹 1의 재태주령은 22주 6일-27주 5일, 그룹 2의 재태주령은 24주 6일-28주 0일이었다. 첫 분만과 지연 분만 사이간격의 평균은 10일이었으며, 모든 세 쌍둥이 가운데 둘째와 셋째 아기 사이의 지연 분만은 없었다. 부당 경량아는 그룹 2보다 그룹 1에서 많았다(그룹 1: 66.7%, 그룹 2: 21.4%, P=0.03). 그룹 1과 2 사이에 사망률의 차이가 있었지만 통계적으로는 유의하지 않았다(그룹 1: 33.3%, 그룹 2: 7.1%, P=0.106). 그룹 2에 대한 대조군은 28명이었고, 그룹 2와 대조군 사이에 신생아기 사망률과 이환율은 통계적으로 의미있는 차이는 없었다. 결론: 대상수가 적기는 하지만, 다태임신에서 지연 분만으로 남아 있는 태아의 부당경량아 빈도는 줄일 수 있으며 재태 기간연장으로 인해 출생 후에 나쁜 영향을 끼치지는 않을 것으로 생각된다.

• The Korean Journal of Pain
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• 제10권1호
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• pp.34-41
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• 1997

Background : Patient-controlled analgesia(PCA) is a safe and effective technique for providing postoperative pain relief. Studies that compare epidural vs intravenous routes of opiate administration show conflicting results. We designed a prospective, randomized, controlled study to evaluate the safety and efficacy of epidural(EPI-PCA) morphine-bupivacaine versus intravenous (IV-PCA) nalbuphine when administered with a PCA system. Methods : Forty healthy women were randomly assigned to receive an epidural bolus of morphine 3 mg and 0.5% bupivacaine 10 ml, followed by a EPI-PCA with 0.01% morphine and 0.143% bupivacane (basal infusion 1 ml/hr, bolus 1 ml, lock-out interval 30 min) or intravenous bolus of nalbuphine 0.1 mg/kg followed by a IV-PCA with nalbuphine(basal infusion 1 mg/hr, bolus 1 ml, lock-out interval 20 min) for pain relief after cesarean delivery. This study was conducted for 2 days after cesarean section to compare the analgesic efficacy, side effects, patient satisfaction either as EPI-PCA or as IV-PCA. Results : EPI-PCA group had significant lower visual analog pain scale(VAS) at immediate postoperative period, whereas no significant difference was observed when pain was assessed at other time sequence. Urinary retention and pruritus were more frequent with EPI-PCA group, although the incidence of other side effects were the same. Conclusions : Although EPI-PCA with morphine-bupivacaine was of significantly lower VAS at immediate postoperative period, IV-PCA with nalbuphine is a safe and effective alternative to EPI-PCA with morphine-bupivacaine for providing pain relief after cesarean delivery. Further studies about IV-PCA with nalbuphine are needed to control the immediate postoperative pain and to further improve effective pain management.

• Perinatology
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• 제29권4호
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• pp.159-164
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• 2018

Objective: To compare neonatal respiratory morbidity of twins according to birth order related to gestational age and mode of delivery. Methods: We performed the retrospective research of the medical records of 3,224 neonates (1,612 twin pairs) born in a single center from January 2011 to December 2015. Subjects were classified into four gestational age groups: very (<32 weeks), moderate (32-33 weeks), late (34-36 weeks) preterm, and term (${\geq}37weeks$) groups. We investigated clinical characteristics and respiratory morbidity according to birth order related to gestational age group and mode of delivery. Results: We found increased risk of respiratory morbidity in second-born twin than first-born twin (P=0.039). Second-born twin was associated with increased risk of respiratory distress syndrome (RDS) in late preterm group (odds ratio [OR] 2.8, 95% confidence interval [CI] 1.30-5.95), and transient tachypnea of newborn in term group (OR 1.4, 95% CI 1.03-1.81). In vaginal delivery mode, there was no difference of respiratory morbidity between first and second-born twin in each group, but in cases of Cesarean delivery, second-born twin was related with a greater risk of RDS in late preterm group (OR 2.3, 95% CI 1.07-5.09). Birth order and Cesarean section independently increased the risk of RDS (adjusted OR [aOR] 1.69, 95% CI 1.12-2.54; aOR 2.14, 95% CI 1.25-3.66, respectively). Conclusion: Second-born twin and Cesarean delivery are associated with increased risk of RDS, especially in late preterm twins.

• The Korean Journal of Pain
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• 제35권1호
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• pp.86-96
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• 2022

Background: To explore the association between low back pain (LBP) and pelvic pain (PP) and rectus abdominis diastasis (RAD) in postpartum women and identify the characteristics and risk factors. Methods: Women diagnosed with RAD and a history of labor and delivery, between 2009 and 2018, were identified from six hospitals within the Partners Healthcare System. Univariate and multivariable binary logistic regression analyses were used to identify the risk factors associated with pain. Results: Age at onset of RAD in the non-cesarean delivery group was earlier than those in cesarean delivery (CD) group (P = 0.017). Women who underwent CD demonstrated 4.5 times greater risk of RAD than those who had no CD exposure. The cumulative composition ratio of LBP at every age stage of the period from 8 years pre-first delivery to 8 years post-first delivery was significantly higher than the other five conditions (RAD, umbilical hernia, PP, depressive disorder [DD], and strain of muscle, fascia, and tendon [SMFT]) (P for trend < 0.001). Women with DD, SMFT, and PP were more likely to have LBP (odds ratio [OR] = 1.91, 95% confidence interval [CI] 1.06 to 3.47, P = 0.032; OR = 4.50, 95% CI 1.64 to 12.36, P = 0.003; OR = 2.14, 95% CI 1.17 to 3.89, P = 0.013; respectively). Conclusions: In postpartum women with RAD, DD, SMFT, and PP were found to be risk factors contributing to the development of LBP. Race and LBP also played roles in the development of PP.

• Clinical and Experimental Reproductive Medicine
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• 제9권1_2호
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• pp.29-41
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• 1982

This retrospective clinical study was done based under the delivery records of 146 cases of twin pregnancies in Yonsei University, Severance Hospital and Wonju Christian Hospital from 1977 through 1980 with particular interest in the second twins. Clinical factors, Apgar scores related to neonatal prognosis, and perinatal mortality rate were statistically analyzed and the following results were obtained. The mean - birthweight for A (first) twins was 2,377 grams and for B (second) twins 2,296 grams. In comparison of the percentage of low-birth-weight (less than 2,500 grams) infants, there were more small B twins, but the difference was statistically not significant. Because there were no significant statistical differences in birth weight-grouping between A and B twins, they could be compared with the comprehensive Apgar scores, but this method was also shown to be statistically not significant. In comparison of the percentage of breech deliveries in A and B twins, the percentage was more than three times in B twin (A twin, 7.5 per cent; B twin, 24.0 per cent), and the difference was statistically very significant (p < 0.0005). There were no significant statistical differences between the Apgar scores of A and B twins in reference to the manner of delivery. According to the manner of delivery of B twins, spontaneous vertex delivery and total breech extraction revealed higher infant mortality rate than others. B twins presented by the vertex in 88 cases (61.0 per cent), by the breech in 55 cases (37.0 per cent), and by the shoulder in 3 cases (2.0 per cent). And this therefore disclosed no significant statistical differences in Apgar scores in relation to the presentation. The duration of labor appeared to have no clear correlation with the Apgar scores and the perinatal mortality of A and B twins. The delivery interval between A and B twins was 11.9 minutes on an. averge, varying from 3 to 65 minutes. The length of this interval was not found to have any significant effect on the Apgar scores and the perinatal mortality rate of B twin.

• 대한전자공학회논문지TC
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• 제48권3호
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• pp.19-27
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• 2011

광 네트워크 기술의 발달로 인해 오늘날 대부분의 네트워크는 수십 Gb/s를 지원한다. UDT(UDP-based Data Transfer protocol)는 대역폭과 지연시간이 큰 네트워크 환경에서 대용량 데이터 전송을 위한 프로토콜이다. 그러나 UDT는 고정된 sync-interval(0.01초) 간격으로 주기적인 rate control을 실행한다. 네트워크 트래픽 상태의 변화가 심한 환경에서는 sync-interval 동안 가용 대역폭을 충분히 활용하지 못하는 문제점이 발생한다. 본 논문은 sync-interval 구간에서 네트워크 트래픽 상태에 적응적인 rate control 기법을 제안한다. 네트워크 트래픽 상태는 RTT 변화를 바탕으로 판단한다. 제안 기법은 네트워크 상태를 4개의 구간으로 설정하여 패킷 sending period를 조절함으로써 rate control을 수행한다. 시뮬레이션 결과를 통하여 기존 UDT에 비해 throughput 과 안정성이 향상되었음을 보였다.

• KSII Transactions on Internet and Information Systems (TIIS)
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• 제9권10호
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• pp.3851-3866
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• 2015

The dynamic nature of opportunistic networks results in long delays, low rates of success for deliveries, etc. As such user experience is limited, and the further development of opportunistic networks is constrained. This paper proposes a prediction-based routing method for opportunistic networks (PB-OppNet). Firstly, using an ARIMA model, PB-OppNet describes the historical contact information between a node pair as a time series to predict the average encounter time interval of the node pair. Secondly, using an optimal stopping rule, PB-OppNet obtains a threshold for encounter time intervals as forwarding utility. Based on this threshold, a node can easily make decisions of stopping observing, or delivering messages when potential forwarding nodes enter its communication range. It can also report different encounter time intervals to the destination node. With the threshold, PB-OppNet can achieve a better compromise of forwarding utility and waiting delay, so that delivery delay is minimized. The simulation experiment result presented here shows that PB-OppNet is better than existing methods in prediction accuracy for links, delivery delays, delivery success rates, etc.

• Smart Structures and Systems
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• 제21권2호
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• pp.225-234
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• 2018

E-Health allows you to supersede the central patient wireless healthcare system. Wireless Body Sensor Network (WBSN) is the first phase of the e-Health system. In this paper, we aim to understand e-Health architecture and configuration, and attempt to minimize energy consumption and latency in transmission routing protocols during restrictive latency in data delivery of WBSN phase. The goal is to concentrate on polling protocol to improve and optimize the routing time interval and schedule communication to reduce energy utilization. In this research, two types of network models routing protocols are proposed - elemental and clustering. The elemental model improves efficiency by using a polling protocol, and the clustering model is the extension of the elemental model that Destruct Supervised Decision Tree (DSDT) algorithm has been proposed to solve the time interval conflict transmission. The simulation study verifies that the proposed models deliver better performance than the existing BSN protocol for WBSN.

• 한국정보통신학회논문지
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• 제20권5호
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• pp.1013-1019
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• 2016

본 논문에서는 Delay Tolerant Network(DTN)에서 Markov chain으로 노드의 속성 정보를 분석하여 노드의 이동경로를 예측하는 알고리즘을 제안한다. 기존 DTN에서의 예측기반 라우팅 기법은 노드가 미리 정해진 스케줄에 따라 이동하게 된다. 이러한 네트워크에서는 스케줄을 예측할 수 없는 환경에서 노드의 신뢰성이 낮아지는 문제가 있다. 본 논문에서는 이러한 문제를 극복하기 위해 노드의 속성 정보를 Markov chain을 적용하고 일정 구간에서 시간에 따른 노드의 이동 경로를 예측하는 CMCP(Context-awareness Markov-Chain Prediction)알고리즘을 제안한다. 제안하는 알고리즘은 노드의 속성 정보 중 노드의 속력과 방향성을 근사한 후 Markov chain을 이용하여 제한된 주기와 버퍼의 범위에서 확률전이 매트릭스를 생성하여 노드의 이동 경로를 예측하는 알고리즘이다. 주어진 모의실험 환경에서 노드의 이동 경로 예측을 통해 중계 노드를 선정하여 라우팅 함으로써 메시지 전송 지연 시간이 감소하고 전송률이 증가함 보여주고 있다.

• 전기전자학회논문지
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• 제19권3호
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• pp.385-391
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• 2015

본 논문에서는 IEEE802.11p WAVE 통신 시스템의 컨트롤 채널 효율성 증대를 위해 제정된 IEEE1609.4 기반 시간 동기 멀티채널 환경에서의 통신 성능을 분석하고 이를 향상시키기 위한 패킷 충돌 회피 기법에 대해 다룬다. 기존 연구에서는 어플리케이션 레이어에서의 소프트웨어적 메시지 스케줄링을 통한 방법이나 랜덤 백오프의 Contention Window 값을 임의로 변경하여 문제를 해결하고자 하였다. 본 논문에서는 패킷 충돌 회피를 위한 Channel Guard Interval 조정을 위한 방법을 제안하고 실차 테스트를 통하여 그 성능을 평가하였다. 평가 결과 PDR(packet delivery ratio) 90% 이상의 성능을 확인할 수 있었다.