선행 제왕절개 후의 질식 분만시 성공군과 실패군의 비교연구

최현수(Hyun Soo Choi),이상욱(Sang Wook Yi),오영승(Young Seung Oh),진규섭(Kyu seop Jin),이보연(Bo yon Lee),이선경(Seun Kyung Lee),허주엽(Chu Yeop Huh),김승보(Seung Bo Kim) 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.10

제왕 절개의 비율은 최근 까지 지난 20년동안 증가되어 왔으며 이러한 증가는 반복 제왕 절개의 증가와 관련된 것이다. 최근 제왕 절개후 질식 분만에 관한 연구에서는 반복 제왕절개시 올 수 있는 수술 후 합병증, 산모 및 태아의 이환율의 증가 등과 비교해 이 시도가 비교적 안전한 방법으로 등을 보고 하고있는 반면 또한 제왕 절개후 질식 분만시 올 수 있는 자궁 파열과 이로 인한 태아와 산모의 위험성에 관한 보고도 있다. 이에 본원에서는 제왕 절개후 질식 분만을 원해 내원한 산모를 대상으로 성공군과 실패군 사이에 여러 요인을 비교 분석하여 성공에 관여한 인자를 예측하고자 하였다. 연구 대상은 1997년 3월부터 1999년 3월까지 선행 제왕 절개 후 질식 분만을 위해 내원한 환자중 질식 분만 시도시 위험성이 적다고 판단되는 120명의 산모를 대상으로 했으며 성공군과 실패군 사이에 산모의 나이, 제태 연령, 질식 분만한 과거력의 유무, 선행 제왕 절개의 적응증, 초음파로 예측한 태아 몸무게, 신생아 몸무게, 입원시 자궁 경부 상태, Bishop score, CPD index(Cephalopelvic disproportion Index)를 비교 분석 하였다. 120명의 산모중 87명(72.5%)이 성공 하였으며 33명(27.5%)이 실패 하였고 자궁 파열이나 열개와 같은 합병증은 발견되지 않았다. 두 대조군 사이에 산모의 나이(P=0.012), Bishop score(P=0.002), CPD index(P=0.015)에서 의미있는 차이를 보였으며 기타 요인에서는 의미있는 차이를 보이지 않았다. 결론적으로 선행 제절 이후 질식 분만 시도 시에 금기가 아닌 경우 입원시 X선 골반 계측을 통한 CPD index와 Bishop score을 통해 성공 가능성에 대한 예측에 도움을 줄 수 있으며 앞으로 이 요인들과 함께 다른 요인들과의 연관성에 대한 연구를 통해 선행 제왕 절개후 질식 분만 시도시에 올 수 있는 위험성을 줄일 수 있을 것으로 생각된다. 이상과 같은 연구 결과로 또한 추후 성공의 예후 인자로 사용되어 질 수 있고, 앞으로 이 시도의 성공과 관련된 다른 인자와의 연관성을 통한 면밀한 검토가 필요할 것으로 사료된다. Objectives: Vaginal birth or trial of labor after previous cesarean section has become one of the most remarkable changes in obstetric practice. The safety and efficacy of a trial of labor and vaginal birth after previous cesarean are well documented. The purpose of this report is to predict the likelihood of vaginal birth in patients undergoing a trial of labor after previous cesarean delivery using factors known at the time of hospital admission. Method: In this retrospective study, 120 women who attempted vaginal birth at Kyung-Hee University Hospital from March 1997 to March 1999. An attempt to identify possible prognostic factors for success of such a trial was made and we evaluated the variables of significant predictive value and the patients' characteristics in the success group and failure group of women who attempted VBAC. Result: 87 cases(72.5%) in 120 cases succeeded in VBAC and 33 cases(27.5%) failed. In this comparative groups in VBAC, there was significant difference in CPD index(cephalopelvic disproportion index) and Bishop score, but no significant difference in gestational age, the estimated fetal weight by sonography and newborn birth weight. Conclusion: In this study, Bishop score and CPD index and age may be useful and valid predictor of success in VBAC and this information could be particularly valuable. The CPD index may prove most important in determining if a vaginal birth should occur after a cesarean section because it can clearly identify some patients who need a repeat cesarean section.

가정보육시설과 기관보육시설의 질적 특성과 영아의 사회·정서 발달

최보가,문영경 대한가정학회 2004 Human Ecology Research(HER) Vol.42 No.1

The purposes of this study were to investigate the quality (structure and process) of home-based day care and center-based day care, and to examine socioemotional development among infants who were in both types of day care. The subjects of this study were 101 infants who were in home-based day care and 181 infants who were in center-based day care. The measurements were socio-emotional development scale and assessment scales for day care programs. Results indicated that, first, home-based day care did not significantly differ from center-based day care in terms of structure. Second, home-based day care were, to some degree, significantly different from center-based day care in the process: home-based day care had better play environment and play activities than did center-based day care. Lastly, there were significant differences in socio-emotional development among infants according to the type of day care: infants in home-based day care were more independent to their teacher and felt more secure in child care homes than was true for the infants in center-based day care.

소아의 위장관 이물질에 대한 임상적 고찰

이보형,이현경,김미정,최광해 영남대학교 기초/임상의학연구소 2001 Yeungnam University Journal of Medicine Vol.18 No.1

Background: The accidental swallowing of foreign body is a common problem in the children. Ingested foreign bodies may be managed by endoscopy, observation, or surgery. So we analyzed the methods of removal, type, location and complications of foreign bodies. Materials and Methods: This report reviewed 37 cases of ingested foreign body in the gastrointestinal tract at the Department of Pediatrics, Yeungnam University Hospital between January 1997 and April 2001. Results: The age ranged from 8 months to 8 years. The most prevalent age group was between 1 year and 2 years of age(19%). The male to female ratio was 2.1:1 with 25 male and 12 female patients. The type of foreign bodies were coins in 20 cases(54%), nail in 4 cases(11%), key in 4 cases(11%), pin in 2 cases(5.5%), necklace in 2 cases(5.5%) and others. The locations of foreign bodies were upper esophagus in 12 cases(32.5%), lower esophagus in 4 cases(10.8%), stomach in 16 cases(43.2%), small bowel in 5 cases(13.5%). 4. Presenting symptoms were variable with asymptomatic(59.4%), vomiting(19.0%), epigastric pain(8.1%), dysphagia(5.4%) and others. The methods for removal of foreign bodies included 20 cases of endoscopic removal(54.0%), 3 cases of spontaneous removal(8.1%) and there was no surgical removal. 14 cases(37.9%) did not confirmed removal of foreign body because of no revisit of our hospital. Endoscopic finding of patients were normal(15 cases), ulceration(2 cases), erosion(1 case), inflammation(1 case) , mucosal scratch(1 case). Conclusion: It appears that the endoscopic approach is the preferable method for the removal of upper gastrointestinal foreign bodies in the children.

전통발효식품으로부터 Chitin 분해 미생물의 분리 및 특성 규명

고보경,최인순,이상현,임채오,이성호,갈상완,최영주 Plant molecular biology and biotechnology research 2004 Plant molecular biology and biotechnology research Vol.2004 No.-

A bacterial strain CJ-3 which produced chitinase was isolated from Korean traditional soy sauce. Using 16S rDNA analysis, the strain CJ-3 was identified as Bacillus atrophaeus. The approximate molecular weight of the putative chitinase enzyme was 31.0 kDa and the enzyme activity was remarkably induced by addition of colloidal chitin (0.5, 1.0, 2.0%). The antioxidant activity was increased 53% by the browning reaction products of B. atrophaeus CJ-3. Escherichia. coli lipopolysaccharides (LPS)-induced production of nitric oxide (NO) was reduced up to 45% by the browning reaction product in RAW264.7 macrophage. Inhibition of cell viability in the presence of LPS was recovered to normal level by the browning reaction product. These results suggest that browning reaction of B. atrophaeus CJ-3 plays an important role for activation of immune system. B. atrophaeus CJ-3 exhibited optimum temperature and pH of 37℃ and pH 7.8~8.0, respectively. The major intracelluar free amino acid was determined to be glutamate.

지역별 오존농도 조사자료의 비교 : 부산시를 중심으로 the city of Busan

전보경,유수영,최금찬 동아대학교 환경문제연구소 2002 硏究報告 Vol.25 No.1

This study was to charaterize the concentrations of the spring and summer seasons for ozone. Ozone measured using the O3 Analyzer(49C, TEI.). Samples were measured from April to May, 1937 and from July to August, 1998. Five areas were investigated in Busan of which measured sites were Seomyeon, Sasang, Geumjeong, Yeongdo, Guseodong. Ozone concentrations in industry area(Sasang) were higher than the other sites. The maximum concentration is 0.038 ppm and the minimum is 0.012 ppm in this site

태양열 이용 냉난방 공조시스템 중 재생기의 하계 재생 능력에 관한 연구

김보철,최광환,금종수,김경철,김종렬 동의공업대학 1998 論文集 Vol.24 No.1

The humidity control is conducted not only for industrial applications but also for domestic ones. High humidity is a factor causing discomfort, thus the importance of using a LiCl(Lithium Chloride) solution has been recognized in recent years in connection with the high quality of goods to be manufactured. as well as cleanliness in a special environment against air pollution and environmental protection. This paper will examine the solar energy regenerator as a part of an open cycle solar energy absorption system for dehumidifying and drying purposes using LiCl solution. An outdoor experiment was done to find out how much could be regenerated in summer. It was found that regeneration rate was about 10kg/day at best in August, and about 5kg/day in September.

벼꽃으로부터 두 개의 calmodulin cDNA 유전자의 분리 및 특성 연구

고보경,고명수,김유정,정일선,최영주 신라대학교 자연과학연구소 2005 自然科學論文集 Vol.14 No.-

Ca^(2+)은 신호전달과정에서 중요한 작용을 하는데 CaM은 이러한 Ca^(2+)이은의 modulator로서 중요한 작용을 하는 것으로 알러져 있다. 벼꽃의 cDNA library로부터 rice genomic DNA(RCaM-2)를 probe로 사용하여 30여개의 Positive clones을 얻어 이 중 두 개의 벼꽃 calmodulin CDNA clone을 분리하였다. RFCaMs CDNA clone의 총염기수는 RFCaM-3은 831p, RFCaM-4는 751bp이고 open reading frame은 각각 149개의 아미노산으로 구성되어 있다. RFCaM-3 과 RFCaM-4의아미노산은 동일하지만 nucleotide 순서는 상당한 차이를 나타내고 있다. RFCaMs CDNA clone의 open reading flame은 protein serine/threonine kinase에 보존되어 있는 catalytic domain을 가지고 있다 RfCaM-3은 5'-untranslated region은 105bp, 3'-untranslated region은 270bp이고 RfCaM-4는 5'-untranslated region은 78bp, 3'-untranslatedregion은 283bp이다. RFCaMs는 Arabidopsis와 70%, potato와는 92%, carrot과는 98%의 유사성을 보였다. Genomic southern blot분석에 의하면 벼의 clamodulin 유전자들이 7-8개의 multigene family로 존재하는 것으로 나타났다. Two different calmodulin (CaM) cDNAs (RFCaM-3 and RFCaM-4) were isolated from a rice flower cDNA library by screening with a rice genomic probe (RCaM-2). Both cDNAs are 90% sequence homologous inside the coding region but are highly divergent outside this region. The polypeptides encoded by RFCaM-3 and RFCaM-4 show identical sequence homology. Comparison of the deduced amino acid sequence of the RFCaMs cDNA clone have identity to Arabidopsis (70%), potato (92%), carrot (98%), and barley and soybean (98%). Southern analysis revealed that both cDNAs are encoded by different genes. Four intense and a few weaker bands were observed in the restriction fragments. Most restriction fragments showed high intensity hybridization signals under stringent conditions, suggesting the presence of a small multigene family for CaM in the rice genome as in other plants.

Bacillus subtilis CJ-3의 항산화력 및 chitinase 특성규명

고보경,최영주 신라대학교 자연과학연구소 2004 自然科學論文集 Vol.13 No.-

전통발효 식품인 간장으로부터 chitinase 활성이 높으면서 갈변반응을 일으키는 균주인Bacillus subtilis CJ-3를 분리하여 균주의 생화학적 특성을 규명하였다. 분리된 균주는 2% colloidal chitin의 첨가에 의하여 chitinase 활성이 현저히 증가되었으며분자량은 대략 31.0 kDa으로 나타났다. 분리된 균주는 항산화 활성을 나타내었으며 갈변반응에 의하여 DPPH 전자공여능법에의한 항산화력은 9.2%에서 63.0%로 증가하였다. 분리된 균주의 최적 생육조건은 최적온도 37℃, 최적 pH 7.0 및 염 농도는 9% NaCl놈도까지는 잘 생육하는 것으로 나타났다. 분리된 균주의 주요 intracellular 유리아미노산은 glutamate로 나타났다. A bacterial strain CJ-3 which produced chitinase was isolated from Korean traditional soy sauce. Strain CJ-3 was identified as Bacillus subtilis. The Bacillus subtilis CJ-3 was cultured in LB medium containing colloidal chitin (0.5, 1.0, 2.0%) and determined molecular weight. The approximate molecular weight of the putative chitinase enzyme was 31.0 kDa and remarkably induced by addition of colloidal chitin. The antioxidant activity of Bacillus subtilis CJ-3 was increased 53% by browning reaction. The Bacillus subtils CJ-3 has an optimum temperature of 37℃, an optimum pH of 7.0-8.0, and stable concentration of 0.5-9.0% sodium chloride. The major intracelluar free amino acid was determined to be glutamate.

디지털 측방두부규격방사선사진과 MDCT의 3차원 재구성 영상을 이용한 합성측방두부규격방사선사진의 계측치 비교 및 머리 위치가 미치는 효과

김미자,최보람,허경회,이원진,허민석,이삼선,최순철 대한구강악안면방사선학회 2009 Imaging Science in Dentistry Vol.39 No.3

Purpose : To investigate the reproducibilities and compare the measurements in digital and MDCT-synthesized cephalometric radiograph, and to investigate the effect of head position on the measurement during imaging with MDCT. Materials and Methods : Twenty-two dry skulls (combined with mandible) were used in this study. Conventional digital cephalometric radiograph was taken in standard position, and MDCT was taken in standard position and two rotated position (10°left rotation and 10°right tilting). MDCT data were imported in OnDemand?? and lateral cephalometric radiograph were synthesized from 3D virtual models. Two types of rotated MDCT data were synthesized with default mode and with corrected mode using both ear rods. For all six images, sixteen angular and eleven linear measurements were made in V-Ceph?? three times. Reproducibility of measurements was assessed using repeated measures ANOVA and ICC. Linear and angular measurements were compared between digital and five MDCTsynthesized images by Student t-test. Results : All measurements in six types of cephalometric radiograph were not statistically different under ICC examination. Measurements were not different between digital and MDCT-synthesized images (P> .05). Measurements in MDCT-synthesized image in 10°left rotation or 10°right tilting position showed possibility of difference from digital image in some measurements, and possibility of improvement via realignment of head position using both ear rods. Conclusion : MDCT-synthesized cephalometric radiograph can substitute conventional cephalometric radiograph. The error on head position during imaging with MDCT have possibility that can produce measurement errors with MDCT-synthesized image, and these position error can be corrected by realignment of the head position using both ear rods. (Korean J Oral Maxillofac Radiol 2009; 39 : 133-47)

상악동을 침범하는 역위성 유두종의 증례보고

지용화,최보람,허경회,안창현,이삼선 대한구강악안면방사선학회 2009 Imaging Science in Dentistry Vol.39 No.2

The present study reports a case of inverted papilloma of the nasal cavity and infiltrating into the maxillary sinus. Inverted papilloma is an uncommon and locally aggressive benign tumor of the sinonasal region. The patient, 51-year-old male, presented with unilateral nasal obstruction and periodic swelling on the palate without pain. Enhanced CT scan revealed a heterogeneously enhancing solid mass in the nasal cavity and infiltrating into the right maxillary sinus, as well as an incidental, secondarily infected residual cyst m the periapical area of the right maxillary canine. The sinonasal mass was revealed as an inverted papilloma on histopathologic examination.