수중 분만

박문일(Moon Il Park),신동열(Dong Yul Shin),배종운(Jong Woon Bae),김현희(Hyun Hee Kim),정성로(Sung Ro Chung),김경헌(Kyoung Hun Kim),문수지(Soo Jee Moon) 대한산부인과학회 2000 Obstetrics & Gynecology Science Vol.43 No.2

Recently, water birth - labor and/or delivery under warm water - is acceptable and natural to many foreign countries as a method of gentle birth. Although some limitations after water birth were reported, a recent international conference explored many of the issuses and indicated the potential scale and the advantages for its inclusion among the options for labor and delivery under water. We experienced a case of water birth who underwent labor and delivery under water. She delivered normal healthy female baby without conventional episiotomy. No obstetrical ans fetal complications were observed during entire procedure of water birth. So, we report this case with brief review of the literatures.

제대정맥 내피세포에서 Amiloride 유도체에 의한 Apoptosis 반복

박규창,박규상,문수지,Park, Kyu Chang,Park, Kyu Sang,Moon, Soo Jee 대한소아청소년과학회 2003 Clinical and Experimental Pediatrics (CEP) Vol.46 No.1

Purpose : Human umbilical vein endothelial cells(HUVECs) play an important role in regulating blood flow by releasing vasoactive substances. It has been reported that endothelial impairment and dysfunction might be a primary cause of placental vascular disease, which is manifested clinically as preeclampsia in mother and intrauterine growth restriction in fetus. Furthermore, the frequency of apoptotic changes is increased in umbilical and placental tissues from growth-restricted pregnancies. However, the various mechanisms of umbilical endothelial cell apoptosis have not been broadly proposed. We investigate the effects of amiloride derivatives on apoptotic death of HUVECs and identify their ionic mechanism. Methods : HUVECs were purchased from Clonetics, and cultured on endothelial cell growth medium. MTT assay and flow cytometry were used for assessing cytotoxic effect and confirming the apoptosis. Changes in intracellular ion concentrations were measured with specific fluorescent dyes and fluorescence imaging analysis system. Results : Amiloride derivatives elicited cytotoxic effects on HUVECs with dose-dependent manners and the rank order of potency is HMA($IC_{50}\;11.2{\mu}M$), MIA>EIPA>>amiloride. HMA-induced cytotoxicity is dependent on extra- and intracellular pH, that is, increase extra- and intracellular pH augmented the cytotoxic effects of HMA. HMA dose-dependently reduced intracellular major ions, such as $K^+$ and $Cl^-$. Interestingly, the depletion of intracellular ions induced by HMA was also significantly enhanced at alkaline extracellular pH. Conclusion : Amiloride derivatives induce apoptosis of HUVECs with dose and pH dependent manners. They reduce intracellular $K^+$ and $Cl^-$ concentration, which is also extracellular pH dependent. 목 적 : 제대정맥은 모체의 혈액을 태아로 운반하여 산소와 영양물질을 공급하는 유일한 통로이다. 이러한 제대 혈류의 장애가 있을 시 자궁내 성장제한, 임신성 고혈압 등을 초래할 수 있다. 제대-태반 혈관의 내피세포 손상을 유발하는 원인 중 amiloride 유도체들을 중심으로 내피세포에 미치는 amiloride 유도체들의 작용을 밝히고, 세포 내 이온농도 변화와 apoptosis 간의 관계를 규명하고자 하였다. 방 법 : 인간 제대정맥 내피세포는 Clonetics로부터 구입하였으며, 내피세포 성장에 필요한 여러 성장인자가 포함된 배지에서 배양하였다. MTT 방법과 flow cytometry 방법을 이용하여 세포독성 효과 및 apoptosis를 확인하였다. 세포 내 이온농도 변화를 측정하기 위해서는 각각의 목적에 적합한 형광염료들을 세포 내에 부하시켜 놓은 뒤, 형광 현미경과 연결된 영상분석장치를 이용하여 관찰하였다. 결 과 : 1) Amiloride 유도체들은 농도 의존적으로 HUVEC의 사멸을 나타내었으며, 각각의 정도는 HMA($IC_{50}$; $11.2{\mu}M$), MIA($13.6{\mu}M$)>EIPA($30.8{\mu}M$)>>amiloride($106{\mu}M$) 순이었다. 2) 세포주기 분석결과 apoptosis의 특징적인 sub $G_0/G_1$ ploidy peak를 나타냈으며, 이러한 작용은 caspase 억제제에 의해 감소되었다. 3) Annexin-V와 propidium iodide 이중 염색 결과 apoptosis로 진행된 세포의 비율(73.0%)을 대조군(11.3%)에 비해 현저히 증가시켰다. 4) HMA에 의한 apoptosis 효과는 세포외액의 pH를 높이거나, $NH_4Cl$을 투여하여 세포내액의 pH를 높일 경우 크게 증가하였다. 5) HMA는 농도 의존적으로 세포내 주요 이온인 $K^+$ 및 $Cl^-$의 세포내 농도를 감소시켰으며, 이러한 효과 역시 세포외액의 pH를 높일수록 현저하게 증가하였다. 결 론 : 이상의 결과들로 미루어 볼 때, HUVEC에서 amiloride 유도체들에 의한 apoptosis 과정에 세포내 주요 이온 농도 감소가 일부 관여하고 있을 것이라 생각된다.

초극소 저출생 체중아에서 발생한 Listeria Monocytogenes에 의한 조발형 패혈증 1례

문진화,오성희,문수지,Moon, Jin Hwa,Oh, Sung Hee,Moon, Soo Jee 대한소아감염학회 2000 Pediatric Infection and Vaccine Vol.7 No.2

저자들은 재태기간 26주에 조기 진통으로 분만 후 사망한 초극소 저출생 체중아에서 L. monocytogenes에 의한 패혈증과 이에 의한 사망을 관찰하였기에 이를 문헌 고찰과 함께 보고하는 바이다. Listeria monocytogenes is one of the important causes of neonatal sepsis and listerial neonatal infection manifests in two forms : Early-onset sepsis syndrome, associated with spontaneous abortion, still birth, preterm labor, granulomatosis infantiseptica, respiratory distress, sepsis, hemodynamic compromise and late-onset listerosis mainly associated with meningitis. Cases of neonatal listerosis reported in Korea have been rare and all were full term newborns. We, herein, report a case of early-onset sepsis due to L. monocytogenes in a extremely low birth weight infant who were born in a critical condition and succumbed in the second day of life despite the intensive care.

전시컨벤션 참가동기와 지역 연계관광상품 활성화방안 연구분석

신영선(Young Sun Shin),최훈(Hoon Choi),문수지(Soo Jee Moon) 한국관광연구학회 2009 관광연구저널 Vol.23 No.1

The purpose of this study is to suggest the direction for making a value added business of Exhibition & Convention with making use of the appealing tourism source of Gwangju Kimadaejung Convention Center. Data were collected from 258 in the `2006 Gwangju·Jeonnam Regional Innovation Convention & Exposition` which was held at Gwangju Kimdaejung Convention Center. Motivation data from sample were analyzed by factor and cluster analysis with t-test and ANOVA. Results suggested that Kimdaejung Convention Center has to have a differentiative plan from others, for example, the improvement of traffic system and accommodation for tourists, the development of tourism products related to around sightseeing places, the program developing a substantial course of `city tour bus` and the database of tourism information.

신생아 폐외 공기 누출의 임상적 고찰

김기중(Ki Joong Kim),김동남(Dong Nam Kim),이하백(Ha Baik Lee),문수지(Soo Jee Moon) 대한소아알레르기호흡기학회(구 대한소아알레르기 및 호흡기학회) 1995 소아알레르기 및 호흡기학회지 Vol.5 No.1

N/A A clinical study was performed on 27 newborn infants with pulmonary air leaks, who were admitted to the NICU of Hanyang University Hospital from January 1986 through December 1993.The results were as follows 1) The incidence of air leaks was 0.24% of overall newborn infants in both sexes. 2) Air leak incidence was variable according to the perinatal factors such as age of life (1 day' 81.5Y%), birth weight (normal: 66.7Y%), type of delivery (cesarean section' 57%). Apgal score (<6 at 5 minutes: 55.6%), gestational period (fullterm: 55.4%) and under lung disease (meconium aspiration syndrome' 48.1%). 3) Of the 27 patients of pulmonary air leaks, pneumothorax was most frequently observed in 21 subjects, and pneumomediastinum, pulmonary interstitial emphysema and pneumo- peritoneum were noted in order of frequency. Air leaks we e developed primarily in 10 and secondarily in 1 1 of the 21 patients with pneumothorax, respectively, which were found especially at the right thorax. 4) Clinical symptoms and signs were decreased breathing sound, tachypnea, cyanosis, chest retraction, apnea, lethargy and bradycardia in order of frequency. 5) With simple oxygen therapy, 8 patients were completely improved. However, out of the 18 patients who had underwater seal drainage, 10 patients were expired. In conclusion, early diagnosis and proper management for pulmonary air leaks of the newborn infants are absolutely needed.

아토피성 천식 환아에서의 지연형 피부반응

임지연(Ji Yeon Lim),이하백(Ha Baik Lee),문수지(Soo Jee Moon) 대한소아알레르기호흡기학회(구 대한소아알레르기 및 호흡기학회) 1993 소아알레르기 및 호흡기학회지 Vol.3 No.1

N/A Allergen challenge in sensitized atopic individuals with specific inhalant allergen can result in biphasic, immediate - and late - clinical responses in a variety of tissues including the skin, the lung and the nose. This study was designed to assess possible relationship between cutaneous late phase reaction and clinical course of asthma in 37 atopic asthmatics during performing skin prick test with house dust mite extracts. The results of the study were as follows: 1. The clinical symptoms of asthma seems to be more severe in patients with biphasic cutaneous reaction than in patients without cutaneous LPR. 2. Serum IgE level was higher in asthmatics with cutaneoua LPR than without cutaneous LPR, but peripheral eosinophil count was no significant difference between two groups. 3. The degree of early cutaneous response to house dust mite (Df, Dp) was larger in asthmatics with cutaneous LPR than in asthmatics without cutaneous LPR. 4. Duration of cutaneous LPR was variable from 10 hours to 120 hours, there was no significant correlation between the duration of cutaneous LPR and the severity of asthma. In conclusion, cutaneous LPR in children with atopic asthma has clinical significance and further clinical studies for the LPR are needed.

소아의 호흡기도내 이물 흡인의 임상적 고찰

이부헌(Bu Heon Lee),이하백(Ha Baik Lee),문수지(Soo Jee Moon),박철원(Chol Won Park) 대한소아알레르기호흡기학회(구 대한소아알레르기 및 호흡기학회) 1995 소아알레르기 및 호흡기학회지 Vol.5 No.1

N/A Aspiration of foreign bodies into the airway is a common cause in accidental death of children. In most patients the aspiration is manifested by a triad of choking while eating, coughing, and wheezing ' but the presentation may be more subtle, resulting in prolonged and misguided therapy for asthma and pneumonia prior to correct diagnosis. The purpose of this investigation was to record the frequent age and commom materials , and for early diagnosis and treatment, and for reducing the complication, finally for prevention. Approximately 85/ of the patients studied were less than 18 months of age (mean age was 18 months), and most common aspiration material was peanut(57). Parental negligence is the most common important factor, neither to obtain the relcvant history nor to recognize its significance. If there should be given more careful attention not to reach potential material or food such as peanut by small children , the overall incidence of foreign body aspiration in children must be reduced by half and thus the problem could be largely prevented.

합병증이 없는 발육지연태아에서 태아심박수의 비정상적 케이오스적 및 주기적역동

염명걸 ( Myung Kul Yum ),김남수 ( Nam Su Kim ),오재원 ( Jae Won Oh ),김창렬 ( Chang Ryul Kim ),문수지 ( Soo Jee Moon ),황정혜 ( Jung Hae Hwang ),박문일 ( Mun Il Park ) 대한주산의학회 1997 Perinatology Vol.8 No.4

소아 예방접종시 유의할 사항

문수지 한국의학사 1986 診斷과治療 Vol.6 No.6

생후 2개월 이내의 영아에서 발생한 B군 연쇄상 구균에 의한 감염증의 임상적 연구

안희정,설인준,문수지 한양대학교 의과대학 1991 한양의대 학술지 Vol.11 No.1

Since 1970, the group B streptococcus has become significant causeof neonatal septicemia and/or meningitis, in recent years the group B streptococcus and E.coli are most common etiologic agent of septicemia and/or meningitis in infants less than two months of age. We have analized 8 cases of group B streptococcal infection who admittedto the department of Pediatrics, Hanyang University Hospital from May1985 to January 1990. The results were as followings. 1. Onset of disease was between 2 days 46 days of age and male to female ratio is 1:1. 2. Of the 8 cases of group B streptococcal infection, 2 cases were sepsis, 2 cases were sepsis and 1 case was urinary tract infection. 3. Five cases were delivered by NSVD, 3 cases were by c-section and all of the infants had normal birth weight with full term at delivery. Maternal obstetric and neonatal complication were not detected except premature rupture of membrane in 1 case of early onset type. 4. The most common presenting symptoms were fever and poor feeding 5. Peripheral blood white cell counts were variable from leukocytopenia to leukocytosis 6. There were adnormal brain CT findings in 3 cases of B streptococcal meningitis. 7. One case of late onset type died on 1st of admission, 4 cases were recovered without sequale and 3 cases were discharged against advice.