체외수정시술로 출생한 쌍생아의 임상적 경과에 대한 비교 분석

김경아,민우경,임재우,전누리,원혜성,김정훈,김애란,이필량,이인식,김기수,김암,피수영,Kim, Kyung-Ah,Min, Uoo-Gyung,Lim, Jae-Woo,Jun, Nu-Lee,Won, Hye-Sung,Kim, Chung-Hoon,Kim, Ellen Ai-Rhan,Lee, Pil-Ryang,Lee, In-Sik,Kim, Ki-Soo,Kim, Ahm,Pi 대한소아청소년과학회 2003 Clinical and Experimental Pediatrics (CEP) Vol.46 No.3

목 적 : 불임의 증가와 함께 체외수정시술에 의한 신생아의 출생이 점차 증가하고 있으나, 이들에 대한 임상적 예후와 경과에 대한 연구가 미비한 실정으로 본원에서 출생한 체외수정 쌍생아의 임상적 경과 및 예후를 알고자 본 연구를 시행하였다. 방 법 : 1995년 1월부터 2000년 6월까지 6년간 서울아산병원에서 분만된 신생아 460쌍 중 250쌍의 자연 수정에 의한 쌍생아(대조군)와 체외 수정 시술에 의해 출생한 156쌍의 쌍생아를 대상으로 재태연령, 출생체중, 성비, 입원률, 1분/5분 Apgar 점수, 동맥관개존증의 발생 및 인도신 치료 여부, 신생아 호흡 곤란 증후군, 일과성 빈호흡, 황달, 미숙아망막증, 뇌출혈, 괴사성 장염, 패혈증, 전해질 이상, 선천적 기형의 발생 유무를 비교하였으며, 입원기간과 사망률을 알아보고 비교 분석하였다. 또한 산모의 나이와 출산력 및 조기양막파열, 임신성 고혈압, 조기진통의 발생 여부와 임신 중의 입원횟수와 입원기간을 비교하였다. 결 과 : 6년간 본원에서 출생한 쌍생아는 총 460쌍이었으며 이중 체외수정시술에 의해 출생한 쌍생아는 156쌍(34.1%)이었다. 산모의 과거력과 임신성 합병증, 임신기간, 출산 형태에 대한 비교에서 산모의 나이, 출산력, 입원기간 등은 두 군 사이에 차이가 없었으나, 체외수정시술을 받은 산모에서 조기진통의 횟수가 많았고, 입원 횟수가 의미있게 많았다. 분만 형태의 비교에서 체외수정시술을 받았던 군이 자연수정군에 비해 수술로 분만한 경우가 의미있게 많았으며(93% vs 82%) 응급 수술보다 정규 수술이 의미있게 많았다. 신생아의 비교에 있어서 몸무게, 성비, 동맥관개존증의 발생 및 인도신 치료 여부, 신생아 호흡 곤란 증후군, 일과성 빈호흡, 황달, 미숙아망막증, 뇌출혈, 괴사성 장염, 패혈증, 선천적 기형의 발생 유무, 생존율, 입원기간 등은 두 군간에 의미 있는 차이가 없었고, 1분, 5분 Apgar 점수가 자연수정군에서 높았으며, 전해질의 이상소견이 체외수정시술군에서 의미있게 많았다. 체외수정시술에 의한 쌍생아군에서 첫 번째 아가와 두번째 아가를 비교하였을 때 출생체중, 신생아 집중치료실 입원율, 입원기간 등은 차이는 없었으나, 신생아 호흡 곤란 증후군, 동맥간개존증, 패혈증, 괴사성장염 등은 두번째 아가에서 유의하게 많았다. 결 론 : 체외수정시술에 의한 쌍생아의 출생은 전체 쌍생아 출생아의 34.1%로 많은 부분을 차지하였고, 산과적 합병증 및 주산기 예후를 비교하였을 때 체외수정군과 자연수정군이 유의한 차이가 없었다. Purpose : To examine various neonatal outcomes and perinatal factors resulting from assisted reproduction compared to that of spontaneous conception. Methods : This is a retrospective study. The control cases were all twins of spontaneous conception born between periods from January 1995 to June 2000. The study cases were identified from twins conceived by assisted reproduction in the same time peried. A total of 460 sets of twins consisted of 250 twins of spontaneous conception and 156 twins of assisted reproduction were studied. The primary outcomes were neonatal morbidity and mortality and the secondary outcomes were perinatal factors including number, length and cost of hospitalization for the delivery. Results : No differences were seen in various neonatal factors including gestational age, birth weight and incidences of respiratory distress syndrome, patent ductus arteriosus, necrotizing enterocolitis, hyperbilirubinemia, sepsis, intraventricular hemorrhage and the length of hospitalizations. Lower one minute and five minute Apgar scores and frequently encountered electrolyte abnormalities were observed in neonates of assisted reproduction. In general, the second twin of assisted reproduction had increased incidences of respiratory distress syndrome, sepsis and necrotizing enterocolitis than the first twin. Increased frequencies of preterm labor, hospitalization and elective cesarean section were seen among mothers who underwent artifical conception. However, overall hospital costs in terms of mothers hospitalization for the delivery and neonates hospitalization did not show differences. Conclusion : Assisted reproduction twins had similar neonatal morbidities, mortalities and perinatal morbidities compared to those born by spontaneous conception.

직업적 음성사용자에서 날달걀 먹기 전과 후의 음성 변화

김경아,권순복,김성원,이형신,홍종철,김영록,이봉주,한영진,유태현,이강대,Kim, Kyung-A,Kwon, Soon-Bok,Kim, Sung-Won,Lee, Hyung-Shin,Hong, Jong-Cheol,Kim, Yong-Rok,Lee, Bong-Joo,Han, Yung-Jin,Yu, Tae-Hyun,Lee, Kang-Dae 한국음성학회 2007 음성과학 Vol.14 No.2

The purpose of this study was to observe the effect of eating a raw egg by professional or nonprofessional voice users on their voice quality and the duration of the effect. 20 professional voice users and 20 nonprofessional voice users participated in the experiment and they had gone through stroboscopy to have no vocal or laryngeal diseases. The voice exam was performed three times: before eating a raw egg (1st period), right after eating it (2nd period), and 10 minutes later (3rd period). By using Multi-dimensional Voice Program which is a software of Computerized Speech Lab 4500 as a voice analysis instrument, the authors checked the F0, Jitter, Shimmer, Noise to harmonic ratio (NHR), and Voice Range Profile (VRP). Results showed as follows: Firstly, vocal hygiene was good in 57.5% of the total subjects and was poor in 42.5%. 40% of professional voice users and 75% of nonprofessional voice users hand good quality. 77.5% of the total subjects had the vocal fatigue while 22.5% of the subjects did not. 95% of the professional voice users and 60% of nonprofessional voice users complained the vocal fatigue. 60% of the total subjects reported a subjective vocal symptom. 65.0% professional voice users and 70.0% of nonprofessional voice users reported a voice symptom. From the results above, we suggest that eating a raw egg may lead to imporve voice quality of the professional voice users.

와류 현상을 이용하는 호흡기류센서

김경아,이인광,박준오,이수옥,신은영,김윤기,김경천,차은종,Kim, Kyung-Ah,Lee, In-Kwang,Park, Jun-Oh,Lee, Su-Ok,Shin, Eun-Young,Kim, Yoon-Kee,Kim, Kyung-Chun,Cha, Eun-Jong 대한의용생체공학회 2009 의공학회지 Vol.30 No.5

The present study developed a new technique with no physical object on the flow stream but enabling the air flow measurement and easily incorporated with the devices for cardiopulmonary resuscitation(CPR) procedure. A turbulence chamber was formed in the middle of the respiratory tube by locally enlarging the cross-sectional area where the flow related turbulence was generated inducing energy loss which was in turn converted into pressure difference. The turbulence chamber was simply an empty enlarged air space, thus no physical object existed on the flow stream, but still the flow rate could be evaluated. Computer simulation demonstrated stable turbulence formation big enough to measure. Experiment was followed on the proto-type transducer, the results of which were within ${\pm}5%$ error compared to the simulation data. Both inspiratory and expiratory flows were obtained with symmetric measurement characteristics. Quadratic curve fitting provided excellent calibration formula with a correlation coefficient>0.999(P<0.0001) and the mean relative error<1%. The present results can be usefully applied to accurately monitor the air flow rate during CPR.

경기도에서 분리한 병원성대장균의 역학적 특성 및 PFGE, 항생제 내성 연구

김경아,용금찬,정진아,허정원,허은선,박성희,최연숙,윤미혜,이정복,Kim, Kyung-A,Yong, Kum-Chan,Jeong, Jin-A,Huh, Jeong-Weon,Hur, Eun-Seon,Park, Sung-Hee,Choi, Yun-Sook,Yoon, Mi-Hye,Lee, Jong-Bok 한국미생물학회 2014 미생물학회지 Vol.50 No.4

병원성 대장균은 최근 3년간 경기도에서 발생한 학교급식식 중독의 주된 원인균으로서 그 역학적 특성을 정리하고 PFGE typing과 항생제 감수성 시험으로 분리균주의 특성을 알아보고자 하였다. 2010년부터 2012년까지 19건의 학교급식 식중독에 대한 역학조사보고서를 분석한 결과, 급식의 주된 운영방식은 직영(18건, 95%)이며, 고등학교에서 주로 발생하였다. 계절적 요인으로는 13건(65%)이 6월부터 9월에, 특히 여름방학 후 학기 초인 8월말부터 9월에 더 많이 발생하였다. 수요일(7건, 37%)과 목요일(7건, 37%)에 최초환자가 발생되어, 목요일 7건(37%) 금요일 5건(26%)에 주로 신고가 이루어 졌다. 추정위험에는 월요일(4건, 21%), 화요일(7건, 37%), 수요일(4건, 21%)에 노출되었고, 추정원인체로서 가능성이 높은 식품은 김치류가 50%(5건)를 차지하였다. 분리된 98균주는 EPEC, ETEC, EAEC, EHEC가 각각 50%, 34%, 15%, 1%이며, 항생제 감수성 시험 결과 ampicillin, nalidixic acid, sulfamethoxazole/trimethoprim, tetracycline에 대하여 각각 40%, 37%, 24%, 19%의 내성을 나타내었고, 2, 3세대 cephalosporins계, cabarpenem계, aminoglycosides계, 2세대 quinolones계 항생제에는 감수성이 있었으며, cefalotin, ampicillin/sulbactam, chloramphenicol에는 각각 29%, 25%, 6%가 중간내성을, 그리고 70%에서 한 가지 이상의 항생제에 내성이 관찰되었다. PFGE 분석결과, 57.6%의 similarity로 8개의 group과 32개의 profiles로 분류되었다. 개별적인 소규모 식중독에서 항생제 감수성과 유전자형의 연관성을 찾기가 어려웠으며, 동시에 발생한 대규모 식중독의 경우, 항생제 내성과 PFGE 유형이 매우 유사하여 동일 기원으로부터 유래한 병원성대장균에 의해 식중독 사고가 발생한 것으로 추정이 가능하였다. This study was conducted to survey the epidemiological characteristics and the isolated strains for pathogenic E. coli which was the major causative organisms for food poisoning occurred at school food services in the Gyeonggi-do area during the past three years. We investigated 19 accidents of food-borne disease outbreaks by pathogenic E. coli at school food services from 2010 to 2012. Food-borne disease outbreaks by pathogenic E. coli were usually occurred at direct management type (18 accidents, 95%) and high schools. For the seasonal factors, 13 accidents (65%) were occurred in June to September, especially the end of August and September after the summer holidays. The first patients were occurred on Wednesday (7 accidents, 37%) and Thursday (7 accidents, 37%), and they were mainly reported on Thursday (7 accidents, 37%) and Friday (5 accidents, 26%). The exposure of risk was estimated in Monday (4 accidents, 21%), Tuesday (7 accidents, 37%) and Wednesday (4 accidents, 21%), and kimchi (5 accidents, 50%) was estimated as the food of the high risk responsible for the outbreaks. 98 isolates of pathogenic E. coli consisted of PEC (50%), ETEC (34%), EAEC (15%), and EHEC (1%). The antibiotic resistance of pathogenic E. coli showed in the descending order of ampicilline (40%), nalidixic acid (37%), trimethoprim/sulfamethoxazole (24%), and tetracycline (19%). The antibiotics of second and third generation cephalosporins, cabarpenem, aminoglycosides, and second generation quinolones had antimicrobial susceptibilities and cefalotin, ampicillin/sulbactam and chloramphenicol showed medium resistance at 29%, 25%, and 6% respectively, and 70% of isolates were resistant to more than one antibiotic. By the PFGE analysis, they were classified into nine major groups and 31 profiles with 57% pattern similarity. It was very difficult to find the correlation of antimicrobial susceptibilities and genotype in the small scale-food poisoning, but the similarity of antimicrobial resistance and PFGE patterns in the large scale-food poisoning enabled the outbreaks to estimate the same pathotype of E. coli derived from identical origins.

Liver Plasma Membrane and Nuclear T3 Receptor Binding in Obese Mice

김경아,( Kyung Ah Kim Lee,Paul A . Lachance ) 대한가정학회 1991 Family and Environment Research Vol.29 No.2

해외 파견 프로그램 - 세계 도서관 정보 대회 참가 후기

김경아,Kim, Gyeong-A 한국전문도서관협의회 2017 KSLA bulletin Vol.8 No.-

Cellular IP 핸드오프 성능개선

김경아,김종권,박재윤,Kim, Gyeong-A,Kim, Jong-Gwon,Park, Jae-Yun 한국정보처리학회 2002 정보처리학회논문지 C : 정보통신,정보보안 Vol.9 No.1

핸드오프는 무선 데이터 네트웍에서 TCP 성능을 저하시키는 가장 중요한 요인중 하나이다. 본 논문에서 패킷의 유신과, 중복이 없는 핸드오프 방법인 LPM(Last Packet Marking)을 제시한다. LPM은 Cellular IP 세미소프트 핸드오프를 개선한 방법으로 이동호스트에게 안전한 핸드오프 시점 알려준다. 새고 소개한 제어 패킷은 SPM(Semisoft reply Message) 하나이다. 컴퓨터 시뮬레이션을 통한 실험에서 LPM 방법은 패킷의 중복이나 유신이 없어서 TCP의 성능을 상당히 향상시켰다. Handoff is one of the most important factors that ma? degrade the performance of TCP connections in wireless data networks. In this paper, we present a lossless and duplication free handoff scheme called LPM (Last Packet Marking) for improving Cellular If semisoft handoff. LPM signals the safe handoff cue by sending a specially marked packet to mobile hosts. SPM (Semisoft rePly Message) is the only newly introduced control packet. Our performance study shows that LPM achieves lossless packet delivery without duplication and increases TCP throughput significantly.

수치해석을 이용한 플라스틱 풀리 성형품의 최적 성형에 관한 연구

김경아,한성렬,Kim, Kyung-A,Han, Seong-Ryeol 한국금형공학회 2020 한국금형공학회지 Vol.14 No.1

Plastic pulleys used for the purpose of power transmission have to very high roundness characteristics. The roundness of plastic pulleys is influenced by many factors. In this study, the effect of molding conditions on the roundness of pulleys was analyzed using a numerical analysis program. To improve the roundness, molding conditions that minimize the amount of deformation of the pulley were studied through an experimental design method. Among the experimental design methods, the Taguchi method was used, and the main molding conditions affecting the deformation of the pulley were the resin temperature and the holding pressure. It was found that the amount of deformation is reduced by about 2.86% when molding with the optimum molding conditions compared to when the optimum molding conditions are not applied.

오존 기상처리방법에 의한 비스코스 레이온의 탈색효과

김경아,이문수,Kim, Gyoung-A,Lee, Mun-Soo 배재대학교 자연과학연구소 1998 自然科學論文集 Vol.10 No.1

본 연구는 오존의 강한 산화력을 이용하여 기상의 처리방법에 따른 비스코스 레이온의 탈색효과를 연구하였다. 오존이 발생할 때는 기체상태로 고농도이지만, 수용액 상태로 물에 녹이는 과정에서 기화요인에 의하여 오존의 손실이 많았다. 따라서 기존의 오존처리방법인 수용액상태의 처리방법이 아니라 기상의 오존을 직접 직물에 처리하므로 고농도의 오존을 단시간동안 처리하여 직물에 존재하는 색소를 산화시켜 탈색하는 방법을 사용하였다. 기상의 오존은 직접 유기색소와 반응하지 않기 때문에 물을 매개체로 하여 pick up ratio를 60%, 50%, 40%, 30%, 20%로 변화시키면서 비스코스 레이온의 탈색에 대하여 연구하였다. Pick up ratio가 40%일 때가 유기색소를 분해하는데 필요한 최적의 수산기가 발생하므로 처리포의 탈색효과가 가장 좋았다. 그러나 처리기간이 길수록 너무 과다하게 오존에 의해 산화되므로 강도와 신도의 저하를 초래하였다. 따라서 최적의 기상오존 처리시간은 60분정도에서 처리하는 것이 강도와 신도의 저하를 가장 적게 할 수 있고 백도도 향상시킬 수 있는 것으로 사료된다. We studied on the decoloring effect of viscose rayon by vapor type ozone processing using ozone's strong oxidation. When ozone is generated, it becomes high concentration in vapor state, but in the insolving process with water, there are a lot of lose of ozone. As a result, a study using ozone in vapor-high concentration state is needed. So, in this paper, vapor type ozone processing is used unlike previous ozone treatment method-an aqueous solution method-to get a good effect from shortening the processing time. When vapor type ozone processing was directly treated to fabrics, high concentration ozone was generated then in a short time oxidized a dye existed in fabrics and finally decolored it. As vapor type ozone did not directly response to an organic dye, viscose rayon's decolorization was to be studied by changing pick up ratio(60%, 50%, 40%, 30%, 20%) using water as a medium. When pick up ratio of water was 40%, fabric's whiteness was improved but tensile strength and elongation were reduced. So 60 minutes was assumed as the most adjust time to minimize the reduction of fabric's tensile strength and elongation moreover of maximize the improvement of whiteness.

자기주도적 학습능력이 간호학생의 임상실습만족도에 미치는 영향

김경아,Kim, Kyeong-Ah 한국임상보건과학회 2016 한국임상보건과학회지 Vol.4 No.2

Purpose. This study was to identify the relationship between self-directed learning and nursing student's satisfaction of clinical practice. Methods. This study was designed to measure the level of satisfaction according to the contents, guidance, environment, time, and the evaluation of clinical practice. Two hundred thirty-one nursing student from baccalaureate program in H-gun was sampled. A scale consisting of 75 questions, developed by the researcher, was used to gather data from September 14 through 27, 2012. The data was analyzed by descriptive statistics, paired t-test, pearson correlation, and multiple linear regression using the SPSS WIN 18.0 program. Results. The results were summarized : Self-directed learning didn't show a significant different by grade(t=0.83, p=.934). Nursing student's satisfaction of clinical practice didn't show a significant different by grade(t=0.26, p=.798). The relationship between self-directed learning correlated with the degree of nursing student's satisfaction in clinical practice(r=.44, p<.001). The factors of self-directed learning described nursing student's satisfaction of clinical practice as $R^2$=.215(F=9.858, p<.001). Conclusions. It was found that a higher degree of satisfaction in clinical practice depends on a higher degree of self-directed learning. Therefore, nursing faculty should plan intervention to improve satisfaction level of clinical practice by fostering self-directed learning.