임신중 태동수의 객관적 측정을 위한 모델개발에 관한 연구

박문일 ( Moon Il Park ),이문휘 ( Moon Hwi Lee ),박지수 ( Jee Soo Park ),신동열 ( Dong Yul Shin ),황정혜 ( Jeong Hyae Hwang ),고승권 ( Seung Kwon Koh ) 대한주산의학회 1998 大韓周産醫學會雜誌 Vol.9 No.3

임신 제 1삼분기에 소파수술후 50여일 이후에 발견된 감입태반

문형(Hyung Moon),황윤영(Youn Yeung Hwang),이용태(Yong Tae Lee),이문휘(Moon Hwi Lee) 대한산부인과학회 2000 Obstetrics & Gynecology Science Vol.43 No.7

During 1st and 2nd trimester, placenta accreta is rarely found and is not easy to diagnosis during these trimester. From time to time placenta accreta is found after induced abortion or spontaneous abortion. We had experienced a case of placenta increta which was found about 50 days after D&C due to missed abortion at local clinic. So we presented it with a brief case history and brief review of the concerned literatures.

두 공존태아와 동반된 완전포상기태

박현종 ( Hyun Jong Park ),이문휘 ( Mun Hwi Lee ),문영진 ( Young Jin Moon ),임기은 ( Ki Eun Lim ),하창원 ( Chang Won Ha ),권자영 ( Ja Young Kwon ),박용원 ( Yong Won Park ) 대한주산의학회 2009 Perinatology Vol.20 No.4

Hydatidiform mole with a coexisting fetus is rare, but this condition has recently shown an increased incidence because of assisted reproduction technology. In most of the reported cases, termination at diagnosis was preferred due to poor fetal survival and maternal risk factors such as vaginal bleeding, preeclampsia, hyperthyroidism, potential of malignant change. However, considering the value of pregnancy by assisted reproduction technology, whether to continue or to terminate this condition is a dilemma. Based on currently available information, it seems that it is reasonable to allow the pregnancy to continue in the absence of maternal complications. We report on a case of the complete hydatidiform mole with two coexisting fetuses with a brief reviews of the literature.

임상 ; 임신성 부종에 대한 수중운동의 효과

임기은 ( Ki Eun Lim ),문영진 ( Young Jin Moon ),조태승 ( Tae Seung Cho ),이문휘 ( Mun Hwi Lee ),장지혜 ( Ji Hye Jang ) 대한주산의학회 2012 Perinatology Vol.23 No.3

목적: 임신성 부종이 있는 산모를 대상으로 수중운동을 실시하여 수중운동이 부종감소 효과가 있는지 알아보고자 하였다. 방법: 2011년 1월부터 8월까지 제주 한라병원에 내원한 임신성부종이 있는 임산부 30명을 대상으로 하였다. 45분간 수중운동을 실시하였고 수중운동 시행 전, 후에 산모의 활력상태, 소변 비중, 체중, 태아 심박동수, 양쪽 장딴지 부피를 측정하여 비교하였다. 결과: 수중운동 시행 후 우측 장딴지의 부피는 1,714mL에서 1,428mL로 286mL 감소하였고(P<0.0001), 좌측 장딴지의 부피는 1,644mL에서 1,377 mL로 267mL 로 감소하였으며(P<0.0001), 양측 장딴지의 부피는 3,359mL에서 2,805mL로 553mL 감소하였다(P<0.0001). 소변비중은 1.0197에서 1.0150으로 감소하였다(P=0.004). 산모의 체중과 심박동수, 혈압 및 태아 심박동수는 통계학적으로 유의한 변화는 보이지 않았다. 결론: 임신성 부종을 치료하는 방법으로 수중운동이 효과적이고 안전한 방법으로 생각된다. Purpose: To confirm the effect of water exercise program for treating the gestational edema. Methods: Both low leg volume, body weight and urine specific gravity were measured in thirty women with gestational edema before and after water exercise program. Fetal heart rate, maternal heart rate and maternal blood pressure were measured before and after water exercise program. Results: Right leg volume was decreased by 286 ml from 1714 to 1428mL (P<.0001), left leg volume was decreased by 267mL from 1,644 to 1,377mL (P<0.0001), and total leg volume was decreased by 553mL from 3,359 to 2,805mL (P<0.0001). Urine specific gravity was decreased by 0.0047 from 1.0197 to 1.0150 (P=0.004). Maternal body weight, heart rate, blood pressure, and fetal heart rate were showed no significant change. Conclusion: Water exercise program is effective and safe method for treating the gestational edema.

골반내 종양으로 오인된 후복막강 지방육종

배재만 ( Jae Man Bae ),박경아 ( Keoung Ah Park ),김희승 ( Hee Seoung Kim ),이문휘 ( Mun Hwi Lee ),문영진 ( Young Jin Moon ),이영미 ( Young Mi Lee ),강순범 ( Soon Beom Kang ),이효표 ( Hyo Pyo Lee ) 대한산부인과학회 2006 Obstetrics & Gynecology Science Vol.49 No.9

Liposarcoma is the most common soft tissue sarcoma in adults and accounts for 9.8% to 16% in all soft tissue sarcomas. The common sites include limbs, buttocks, and retroperitoneum, et al. The early diagnosis of retroperitoneal liposarcoma may be difficult because of due to the late onset of symptoms and the tumors are frequently noted in a large size with the involvement of adjacent structures. Surgical therapy remains the most effective modality for the treatment of retroperitoneal liposarcoma. But, complete surgical resection of these tumors is often challenging and, at times, may be impossible. So, adjuvant radiation therapy is necessary for the improvement of prognosis in many cases. We report a case of retroperitoneal liposarcoma which was treated with complete surgical resection followed by adjuvant radiation therapy.

임신 제 1삼분기 유산 후 진단된 감입태반

호정규 ( Jeong Kyu Hoh ),정재은 ( Jae Eun Chung ),하창원 ( Chang Won Ha ),문영진 ( Young Jin Moon ),이문휘 ( Mun Hwi Lee ) 대한주산의학회 2007 Perinatology Vol.18 No.4

Placenta increta is a life threatening complication of pregnancy, causing severe post-curettage bleeding. It is usually presented in the postpartum period with hemorrhage during difficult placental removal. It is especially rare in the 1st and 2nd trimesters, which is not easy to find and diagnose. We have confirmed a case of placenta increta after emergency hysterectomy due to severe vaginal bleeding following the dilatation and curettage during the 1st trimester of her pregnancy. So we report it with a brief case history and review of the concerned literatures.

실비 장애인요양시설의 합리적 운영방안에 관한 연구

이문휘 원광대학교 대학원 2007 論文集 Vol.38 No.-

This study is focused on the purpose of discovering the rational management methods for the problems in the course of the management of the actual expense handicap facilities which are test-operated under control of the Ministry of Health and Welfare, and setting the foundational guidelines for the better of the efficiency and effectiveness in managing the facilities. The issues on the current condition in the management of the handicap facilities were classified into the three subjects, as follows ; 1. The current state of the demands and supplies of the handicap facilities 2. The issues on the classification of the facilities 3. The comparison of the actual expense handicap facilities and the private pay admission policy After the classification of the issues, they were investigated on the four standards as follows ; 1. The unreasonable budget assistance of the government 2. The issues on the classification of the facilities 3. The issues on the limitation in the criteria for the applicants and the issues on the reciept of the cost 4. The issues on the procedure of the admission In conclusion, there are many problems of the system in need of the improvement and resolution. Therefore, the directions for the improvement and development of the activation of the actual expense handicap facilities are suggested below. First, the management of the actual expense handicap facilities should be standardized in the way the existing facilities are managed, so that the economical matters of the welfare of the handicapped can be solved by the government. Second, the system of the actual expense handicap facilities should be widely promoted. In reality, considering Korea's low facility demand adequacy ratio, the handicapped cannot help using the brand new private pay handicap facilities because almost every existing facility is completely accomodated, making it impossible for them to wait until there appears any open spot for themselves. Third, the private pay admission system should be abrogated. When the system of the actual expense handicap facilities comes into effect and is activated in our society, the private pay admission system will be of less effect, in confusion of its purpose of the management. It is expected that there will be many challenges in the rational management of the actual expense handicap facilities which are in the step of test-operation. Above all, it is the most difficult matter that we can never apply the unified measure of finance to every provincial government when each provincial government is in different financial situation. Still, for all the difficulties, the charged admission system in the actual expense handicap facilities and the private pay admission system are the assignments to be considered systematically. Especially, the discrimination issue in the labor cost for the workers of the actual expense handicap facilities is the matter that should be immediately amended.

자궁경부무력증에서 Beriplast (TM) 를 이용한 Modified McDonald cerclage 15 예의 경험

황정혜,문형,박문일,이문휘,공미숙,정성로 대한산부인과학회 2000 Obstetrics & Gynecology Science Vol.43 No.8

Objectives : As a main treatment modality of Incompetent Internal Os of Cervix(IIOC), Transvaginal cerclage(TVC) has been performed. But Transabdominal cervico-isthmic cerclage(TCIC) has been selected in cases of at least one history of failed TVC and severe damaged uterine cervix, very short or congenital anomalous cervix, or removed state of uterine cervix due to another disease. However, this TCIC has not been popularized, due to dangerous operation procedure, and two laparotomies. There are also difficult operative situation performing TVC & TCIC, such as bulging amniotic membrane and in patients who have medical contraindication of laparotomies. In this reason, we designed Modified Mcdonald cerclage using Beriplast (TM) as an alternative of TCIC. Methods : We involved 15 patients who visited recurrent abortion clinic of Hanyang University Hospital, diagnosed as IIOC, who were appropriate for the above mentioned TCIC indications or had bulging amniotic membrane through cervical canal. Briefly explaining the procedure, at proximal portion of internal os of cervix, first cerclage was performed and about 1-2cm distal from first cerclage, second cerclage was done. For doing this, it is important that first cerclage band is as proximal as possible. And then, 1-3cc of Beriplast(TM) was injected in cervical canal between two McDonald cerclages. Results : The mean gestational age at operation was 16.9±4.3weeks. The live births were 13 cases among 15 cases(success rate was 86.7%). In 13 cases of success, the mean interval time between operation and delivery was 21.0±4.1weeks, and mean body weight of neonates was 3094±535gm. The failed 2 cases were as followings; one case failed after 2 weeks postoperatively and the other case was twin pregnancy. Conclusions : The burden of patients as well as of operator is considered as obstacles in performing TCIC in IIOC patients. In this circumstances, we designed the Modified McDonal cerclage. This method would be useful in cases of above mentioned operation indications. We named this procedure as $quot; Candy operation$quot;.

자궁경부암에서 자궁내막 및 체부침습의 의의

김경태,김승룡,조삼현,류기영,이문휘,조수현,문형 대한부인종양 콜포스코피학회 2000 Journal of Gynecologic Oncology Vol.11 No.1

Objective : The objective of this study was to evaluate clinical significance of endometrial and corporal extensions of Carcinoma of the uterine cervix. Methods : The 273 patients with locally advanced cervical cancer who underwent radical hysterectomy after neoadjuvant chemotherapy between Jan 1983 to May 1998 were included in this study and endometrial and corporal extension was examined by pathologic report. Then, clinical characteristics such as age, stage, tumor size, geographic contour, the lymph node and parametrial invasions, recurrence rate, and 5 year-survival rate were compared between extension(n=30) and non-extension(n=243) group. Pearson chi-square test, Fisher's exact test, and Kaplan-mayer survival analysis were used for calculation of statistical significance between two group. p-value less than 0.05 was considered to be clinically significant. Results : The incidence of endometrial and corporal extension in this locally advanced cervical cancer group was 11% (30/273). The endometrial and corporal extension were closely related with advanced stage, larger cervical tumor mass, endophytic type, and pelvic lymph node metastasis. However, 5-year disease free survival rates or 5-year actuarial survival rates did not show statistically significant differences between extension and non-extension group (7S% vs 83% and 81% vs 84%, respectively) Conclusion: The endometrial and corporal extension were closely associated to high risk factors of advanced cervical cancer. Though its clinical significance for poor outcome were not proved in this study, prospective study with more patients is needed to clarify its clinical significance.