클로미펜에 얇은 자궁내막을 보이는 환자에서 성선자극호르몬 병합 과배란유도시 클로미펜과 레트로졸의 임상적 효용성

이은주,박현종,양효인,이경은,서석교,김혜연,조시현,최영식,이병석,박기현,조동제,Lee, Eun-Joo,Park, Hyun-Jong,Yang, Hyo-In,Lee, Kyung-Eun,Seo, Seok-Kyo,Kim, Hye-Yeon,Cho, Si-Hyun,Choi, Young-Sik,Lee, Byung-Seok,Park, Ki-Hyun,Cho, Dong-Ja 대한생식의학회 2009 Clinical and Experimental Reproductive Medicine Vol.36 No.2

목 적: 클로미펜을 사용한 배란유도시 얇은 자궁내막을 보였던 환자들에서 성선자극호르몬에 클로미펜 또는 레트로졸을 병합 투여하는 과배란유도 방법의 임상적 효용성을 비교 분석하고자 하였다. 연구방법: 이전의 클로미펜을 사용한 배란유도 주기에서 8 mm 미만의 얇은 자궁내막을 보였던 불임 환자들에서 시행된 성선자극호르몬 병합 과배란유도/인공수정 51주기가 연구에 포함되었다. 월경주기 제3일째부터 5일 동안 클로미펜+성선자극호르몬 군은 일일 클로미펜 100 mg을 투여하였고 (n=26) 레트로졸+성선자극호르몬 군은 일일 레트로졸 2.5 mg 또는 5 mg을 투여하였다 (n=25). 양 군에서 월경주기 제5~7일째부터 우성난포의 크기가 18 mm 이상에 도달할 때까지 이틀에 한 번씩 성선자극호르몬은 75~150 IU를 투여하였다. 양 군에서 성선자극호르몬 총 사용량, 자궁내막의 두께, 자궁내막의 형태, hCG 투여일의 14 mm 이상 난포의 수, hCG 투여일, 임신율, 다태 임신율을 비교하였으며 통계 분석은 Mann-Whitney U test or Fisher's exact test 등을 이용하였다. 결 과: 연령, 불임기간, 이전 인공수정 횟수, 기저 혈중 LH, FSH, $E_2$ 농도, 불임의 원인 등의 임상적 특성은 양 군간 차이가 없었다. 성선자극호르몬 병합 과배란유도시 배란전 자궁내막의 두께는 이전의 클로미펜을 사용한 주기와 비교하여 유의하게 증가되었다. 성선자극호르몬 총 사용량, hCG 투여일, 자궁내막의 삼중선 비율, 임신율 및 다태 임신율은 유의한 차이가 없었다. 클로미펜+성선자극호르몬 군에 비하여 레트로졸+성선자극호르몬 군에서 14 mm 이상 난포의 개수는 유의하게 적었고 ($3.7{\pm}1.7$ vs. $2.8{\pm}1.7$, p=0.03). 배란 전 자궁내막 두께는 유의하게 두꺼웠다 ($7.7{\pm}1.5\;mm$ vs. $9.1{\pm}1.7\;mm$, p<0.05). 결 론: 배란유도를 위하여 클로미펜 사용시 얇은 자궁내막을 보였던 환자들에서 인공수정을 위한 과배란유도시클로미펜 또는 레트로졸을 성선자극호르몬과 병합하여 사용하는 방법은 클로미펜의 자궁내막에 대한 부정적인 효과를 피할 수 있는 것으로 사료된다. 적절한 자궁내막의 발달 및 적절한 난포의 성장 측면에서 성선자극호르몬에 레트로졸을 병합하는 과배란유도 방법이 클로미펜을 병합하는 방법에 비하여 더 유용할 수 있으나 추가적인 대규모 전향적 연구가 필요할 것으로 사료된다. Objective: The aim of this study was to compare the clinical efficacy of clomiphene citrate (CC) and letrozole combined with gonadotropins for controlled ovarian stimulation (COS) in patients with CC-induced thin endometrium Methods: Fifty-one intrauterine insemination cycles performed in patients who previously had a thin endometrium (<8 mm) to ovulation induction using CC were included in this study. A CC 100 mg/day (CC+gonadotropin group, n=26) or letrozole 2.5 or 5 mg/day (letrozole+gonadotropin group, n=25) was administered on day 3~7 of the menstrual cycle, combined with gonadotropins at dose 75~150 IU every other day starting on day 5~7. We compared total dose of gonadotropin used, endometrial thickness, endometrial pattern, number of follicles ${\geq}14\;mm$ on hCG day, pregnancy rate and multiple pregnancy rate between the two groups, which were statistically analyzed using Mann-Whitney U test or Fisher's exact test, where appropriate. Results: There were no significant differences in clinical characteristics such as age, duration of infertility, number of previous IUI cycles, basal serum hormone levels and cause of infertility between the two groups. In both groups, the endometrium was significantly thicker than that of previous ovulation induction cycles using CC. No significant differences were found in the total dose of gonadotropin used, day of hCG administration, the rate of triple endometrium and pregnancy rate. The number of follicles ${\geq}14\;mm$ was significantly lower ($3.7{\pm}1.7$ vs. $2.8{\pm}1.7$, p=0.03) and the endometrium on hCG day was significantly thicker ($7.7{\pm}1.5$ vs. $9.1{\pm}1.7$, p=0.001) in letrozole+gonadotropin group compared to CC+gonadotropin group. Conclusion: The clomiphene citrate and letrozole combined with gonadotropins appear to avoid the undesirable effects on the endometrium frequently seen with CC for ovulation induction. However, in terms of adequate endometrial development or optimal follicular growth, letrozole may be more beneficial than CC for gonadotropin-combined COS in patients with CC-induced thin endometrium. Further prospective randomized controlled studies in a larger scale will be necessary to confirm our findings.

의과대학부속병원 의사들의 양.한방 협진에 대한 인식

이은주,박한솔,이소영,배다정,이탁근,신현규,Lee, Eun-Joo,Park, Han-Sol,Lee, So-Young,Bae, Da-Jung,Lee, Tag-Gun,Shin, Hyeun-Kyoo 대한한방내과학회 2012 大韓韓方內科學會誌 Vol.33 No.3

Objectives : This study was aimed to promote the cooperative system of Korean and Western medicine in the dual health care system through a survey of physicians on recognition, problems and solution of the cooperative system. Methods : The research took place at Dongguk University Hospital from May 25 to 27, 2009 with 44 professors, residents, and interns employed by the hospital. Results : Of total 44 surveyed doctors, positive and moderate responses on the cooperative system between Korean and Western medicines were 40.9% and 43.2%, respectively. They scored it positive (62.5%) and moderate (31.3%) based on their experiences. These results can be supposed to represent the environment for the interdisciplinary medicine. Even in the interdisciplinary hospital of Korean and Western medicine, 68.2% of responders had no experience of the cooperative medical system. Expected interdisciplinary efficient departments were ordered rehabilitation medicine, neurology and orthopedics and associated with musculoskeletal disorders, the most frequent diseases treated by Korean traditional medicine. Conclusions : Korean and Western medical doctors, as medical personnel, intellectual persons as well as specialists, need a recognition and attitude to understand and respect each others' medicine. However, both groups also realize there are many complicated issues in the treatment of patients. It is difficult to require a change of Western doctors' perceptions and attitude toward Korean traditional medicine only with results of a survey. For the efficient cooperative system in the medical field, Korean medical doctors will need to study and consider specific problems mentioned by Western medicine.

경피적 내시경적 위루술을 이용한 병적 공기 연하증 치료 경험 1례

이은주,송애령,최은진,황진복,오희종,이영환,Lee, Eun-Joo,Song, Ae-Ryong,Choi, Eun-Jin,Hwang, Jin-Bok,Oh, Hee-Jong,Lee, Young-Hwan 대한소아소화기영양학회 2000 Pediatric gastroenterology, hepatology & nutrition Vol.3 No.1

저자들은 정신 지체를 가진 병적 공기 연하증환자를 임상 증상과 단순 흉부 X-선 사진상의 '식도 내 공기 징후'와 투시진단법으로 진단하여 보고하는 바이며, 본 증례와 같이 장기적으로 호전을 보이지 않는 공기 연하증 환자에서 조기에 PEG를 시행하여 공기를 빼내는 도구로 이용하면, 심각한 합병증의 발생을 예방할 수 있을 것으로 판단된다. We experienced a case of pathologic aerophagia in a 10-year-old girl who has mental retardation. It was observed that the abdomen was non-distended in the morning and became maximally distended in the evening. Increased passage of flatus, but normal eructation, was noted. Roentgenographic examination showed 'esophageal air sign', abnormal air shadow on proximal esophagus adjacent to the trachea, in simple chest X-ray and visible air swallowing fluoroscopically. We tried a percutaneous endoscopic gastrostomy (PEG) to decompress swallowed air in stomach. We suggest that placement of a PEG catheter in early life, especially in mentally retarded patients, that can be used as desufflator, can prevent the complications of aerophagia. 'Esophageal air sign' may be very helpful for early detection of pathologic aerophagia.

李應台(1556~1586) 묘 출토 상의류의 분류와 구성법

이은주(Lee Eun-Joo) 한복문화학회 2002 韓服文化 Vol.5 No.3

This study proposes a classification standard of the upper garment based on the excavated costume from the grave of Eung- T ae Lee(1556-1586) found at JeongSang-dong, Andong, KyungBuk province, Korea on APril 1998. This study also classifies the remaining clothes by the proposed standard and shows their characteristics and constructive methods.<br/> The first classification standard of the upper garment is based on the assumption that the clothes cover the upper<br/> body are the male upperwears.<br/> The second classification standard is based on the whole scale such as back length, width, and sleeve length and the third one is based on the other components including the shape of collar, length of side-open, armpit gusset. materials. arrangement of color.<br/> The upperwears from the grave of Yeung- Tae Lee consist of 7 pieces for male, 3 pieces for female. and 1 piece for children. Jukori. Hansam. and Jucksam are classified into male upperwear category, Jangjugori without side-open and Danjugori without side-open are classified into female upperwear category.<br/>

조선시대 품대의 구조와 세부 명칭에 관한 연구

이은주(Eun Joo Lee) 한국복식학회 2011 服飾 Vol.61 No.10

The ranking belts for Joseon dynasty officials that are based on references and relics are studied in this paper in terms of architecture, detailed names, and structural changes according to different time. Officials` uniforms consist of hats, clothes, belts, and shoes. Among these, the belt is an important sign that represents the wearer`s ranking. The ranking belts of the Joseon dynasty which were brought from Ming at the late stage of the Koryo dynasty became classified as the following four classes : Seo-dai(a rhinoceros` horn, 犀帶), Gum-dai(gold, 金帶), Eun-dai(silver, 銀帶), and Heug-gag-dai(black horn, 黑角帶). A ranking belt consists of a basic belt body(程) and a plaque that represents the wearer`s rank. A plaque consists of 20 plates: three front-center plates that represent the Sam-tai(三台) constellation, six front-side plates that represent the Namduyug constellation(南斗六星), seven back plates that represent the Big Dipper(北斗七星), left side Bo(輔), right side Pil(弼), and a couple of Tamie at both ends. The architecture of the belt body; the basic frame for ranking belts, shows some differences between the former and the latter periods of the Joseon dynasty. In the former period, the belt had a pair of a buckle so that the wearers were able to adjust the belt size. But later, the belt didn`t have the buckles to adjust the belt size and consequently it only performed a locking or unlocking function. Therefore, the belts in the latter period were longer than normal and one size fit all. In addition to the functional change of buckles, the shapes of the ranking belts show changes from the round shape to the square shape as time goes on.

객체지향 시스템으로부터 컴포넌트를 식별하기 위한 모델 기반의 정량적 재공학

이은주,Lee, Eun-Joo 한국정보처리학회 2007 정보처리학회논문지D Vol.14 No.1

객체지향 기술은 단위가 되는 클래스가 지나지게 세밀하고 한정적이어서 재사용의 효용이 떨어진다. 컴포넌트는 객체보다 큰 단위로서 복잡도를 효율적으로 관리해주고 품질과 재사용성을 향상시킨다. 또한 MDA나 SOA와 같은 새로운 프레임워크가 등장하면서 컴포넌트 기술의 중요성은 더 커지게 되었다. 따라서 객체지향 시스템을 분석하여 새로운 환경에 적합한 컴포넌트로 재공학하는 기술이 필요하다. 본 논문에서는 객체지향 시스템으로부터 컴포넌트를 식별하기 위한 모델 기반의 정량적 재공학 방법을 제안한다. 본 방법에서는 이전 연구를 확장하여 시스템모델과 프로세스를 상세히 정의하고 정형화하였다. 객체지향 시스템으로부터 시스템 모델을 구성하고 이 모델을 사용하여 정량적 방법으로 컴포넌트들을 추출하고 정제한다. 또한 지원 도구를 개발하여 현재 존재하는 객체지향 시스템에 적용하여 유효성을 확인한다. Due to the classes in object-orientation, which are too detailed and specific, their reusability can be decreased. Components, considered to be more coarse-grained compared to objects, help maintain software complexity effectively and facilitate software reuse. Furthermore, component technology becomes essential by the appearance of the new frameworks, such as MDA, SOA, etc. Consequently, it is necessary to reengineer an existing object-oriented system into a component-based system suitable to those new environments. In this paper, we propose a model-based quantitative reengineering methodology to identify components from object-oriented systems. We expand system model and process, which are defined in our prior work, more formally and precisely. A system model, constructed from object-oriented system, is used to extract and refine components in quantitative ways. We develop a supporting tool and show effectiveness of the methodology through applying it to an existing object-oriented system.

후기 학령기 아동의 성지식 요구

이은주,Lee Eun Joo 한국아동간호학회 2000 Child Health Nursing Research Vol.6 No.2

The goal of this research was to provide the basic data of sexual education for late schooler by finding out what they want to know about sex, or to see, if any, its relevancy between female and male students and between each grade. The sample for this research was a total of 453 students in 4th, 5th and 6th grade from 12 different classes at two elementary schools which were located in C city and in B province. The children were requested to write down three points on what they want to know or to learn most about sex, and their answers were put through two analytical stages in order to classify and to examine. The followings are the conclusions from the data. 1. The female cluster took 44.2% out of the whole sample, and there were 151 students per each grade. The specific girl ratios for each grade were 42.4%, 50.3% and 39.7% respectively. 2. It was noted that a total of 1,195 questions were gathered from the students writings, 45% of the questions was raised by the female students. The 4th grade students raised 432questions (43.8% by the girl) while the 5th. and the 6th grade students raised 387 (53.2% by the girl) and 376 questions (42.3% by the girl) respectively. The average number of questions per students was 2.6 while the female students raised 2.8 questions which was more than the average 2.5 questions by male students. It was the 4th grade female student cluster, which raised the most question (3.0) while the 6th grade male students raised the least question (2.4) in average. 3. The questions raised by the children could be divided into seven categories of the knowledge need on sex. They were Reproduction (310 questions, 25.9%), Sexual Culture (230, 19.2%), Concept of sex (125, 18.0%), Changes of Puberty (172, 14.4%), Sexual Health (119, 10.0%), Anatomy and Physiology of Reproductive System (78, 6.5%) and Sexual Tendency and behavior (71, 5.9%). 4. 'Reproduction' was the most frequently raised questions not only by both sex groups but also by the 5th grade students. Both sexes in the 4th grade showed the highest interest in Sexual Culture while it was Changes in Puberty for the both sexes in the 6th grade. The knowledge need on sex of the children indicated what they understand sexuality. They apprehended sex as sex, gender and sexuality in an inclusive way. They showed a major interest in the biological sex and the sexual activities. It seems that the children managed to understand clearly the meaning of gender, furthermore, they even pointed out that the streotyped sex role, patrimonial system and the sexual discrimination were unreasonable. The students possessed not only the least but also the most negative understanding in regard of sexuality. Two suggestions were made from the above conclusions for the practical sex education as well as its research. 1. For the practice: The sex education for the elementary upper grade school student should be relevant with their cognitive characteristics, also it should be more specific on the reproductive organs of both sexes, the actual scenes of the pregnancy and child delivery procedures. The gender concept should be added to the biological sex education, which will lead them to understand the unreasonableness of today's male-superior phenomenon and correct them. It is also necessary to develop educational programs for this age group so as to help them to understand sex in the sense of sexuality as well. 2. For the research: It is not easy to draw out a through conclusion since this study was carried out as one-time data collection. Yet it is undeniably helpful for the sex education if we can understand what the children want to know about sex, how much they know about it by conducting deep-interview researches through a small number of sample.

비주석 재귀신경망 앙상블 모델을 기반으로 한 조위관측소 해수위의 준실시간 이상값 탐지

이은주,김영택,김송학,주호정,박재훈,LEE, EUN-JOO,KIM, YOUNG-TAEG,KIM, SONG-HAK,JU, HO-JEONG,PARK, JAE-HUN 한국해양학회 2021 바다 Vol.26 No.4

상시 관측되는 조위관측소 해수위 자료는 결측값과 오측값을 포함하고 있으며, 그 중 오측 값은 이상값으로 분류되는 전처리 대상이다. 이러한 오측을 제거하기 위해 대표적으로 3𝜎 (three standard deviations) 규칙이 적용되어왔으나, 기상이변 등에 의한 극값이 존재하거나 3𝜎 범위 안에서도 오측이 존재하는 해수위 자료에는 그 적용이 어렵다. 본 연구에서 설계된 모델은 오측에 대한 사전 정보가 필요하지 않은 비주석 학습으로 구성되며, 재귀신경망과 앙상블 기법을 이용함으로써 실시간으로 수집되는 해수위 자료가 오측일 가능성을 발생한지 20분 이내로 제시한다. 검증이 완료된 모델은 평시 및 기상이변시의 정상값과 오측값을 잘 분리하며, 학습이 이뤄지지 않은 연도의 해수위 자료에서도 이상값 탐지가 가능함을 확인하였다. 본 연구의 관측 이상치 탐지 알고리즘은 조위관측소 해수위에 국한되지 않고 다양한 해양 및 대기자료의 이상치 탐지 인공신경망 모델에 확장 적용할 수 있다. Real-time sea level observations from tide gauges include missing and erroneous values. Classification as abnormal values can be done for the latter by the quality control procedure. Although the 3𝜎 (three standard deviations) rule has been applied in general to eliminate them, it is difficult to apply it to the sea-level data where extreme values can exist due to weather events, etc., or where erroneous values can exist even within the 3𝜎 range. An artificial intelligence model set designed in this study consists of non-annotated recurrent neural networks and ensemble techniques that do not require pre-labeling of the abnormal values. The developed model can identify an erroneous value less than 20 minutes of tide gauge recording an abnormal sea level. The validated model well separates normal and abnormal values during normal times and weather events. It was also confirmed that abnormal values can be detected even in the period of years when the sea level data have not been used for training. The artificial neural network algorithm utilized in this study is not limited to the coastal sea level, and hence it can be extended to the detection model of erroneous values in various oceanic and atmospheric data.

Covid-19이후 학생 수업참여를 위한 교수자의 경험 연구

이은주,김민정,송연주,Lee, Eun-Ju,Kim, Min-Jung,Song, Yeon-Joo 한국콘텐츠학회 2022 한국콘텐츠학회논문지 Vol.22 No.10

Covid-19이후 대학에서 비대면 수업이 필수적인 수업방식으로 채택되면서 학생의 수업참여를 독려할 수 있는 수업전략에 대한 관심이 높아지고 있다. 수업참여는 교육의 질을 높일 수 있는 선행 요건이기에 비대면 수업에서는 더욱 중요한 요건일 수밖에 없다. 따라서 본 연구는 2020년 이후 비대면 혹은 비대면과 대면 수업의 혼용으로 운영되어 온 D대학의 교수자 3인이 학생의 수업참여를 높이기 위해 시도한 경험과 고민을 살펴 보았다. 그 결과, 비대면 수업 초기 교수자와 학생 모두 시행착오를 거쳤으나 시간이 지남에 따라 학생들은 적극적으로 자신의 의견을 표현할 뿐 아니라 자발적으로 수업활동을 확장시켜 나가는 것을 확인할 수 있었다. 본 연구는 교수자 주도의 수업이 대면과 비대면의 적절한 조화와 다양한 매체의 활용으로 학습자 참여형 수업으로 발전할 수 있는 가능성을 발견하였다는 점에서 의의가 있다. 논의에 필요한 데이터는 자서전적 연구방법을 통해 수집하였다.

에큐메니칼 선교에 기초한 선교교육의 방향에 관한 연구

이은주,Lee, Eun Joo 한국기독교교육학회 2021 기독교교육논총 Vol.- No.66

코로나19 바이러스로 인해 전 세계는 이전에 경험해보지 못한 상황에 직면해 있다. 이런 바이러스의 위협 가운데서 지구공동체는 생명을 지키기 위해 고군분토하고 있다. 이러한 상황에서 한국의 교회는 코로나19 바이러스를 유포하여 공동체를 위협하는 이기적인 집단으로 비판을 받고 있다. 이런 비판과 함께 도덕적이지 못하고 다른 종교와 문화에 배타적인 교회의 모습도 거론되면서 한국 사회로부터 교회는 외면을 받고 있다. 이러한 한국 교회의 신뢰 상실의 문제에는 여러 원인이 있지만 교회의 양적 성장과 기독교의 세력 확장을 지향하는 선교의 방향도 그 원인 가운데 하나이다. 복음을 전하겠다는 열정이 교회의 신뢰저하의 현상으로 나타나면서 오히려 선교를 방해하고 있는 실정이다. 이러한 문제에 직면하여 새로운 선교에 대한 패러다임의 전환이 요청된다. 복음화와 선교의 열정이 교회의 양적성장으로만 나아가는 것이 아니라 이 땅위에서 구원활동을 하시는 하나님의 뜻에 따라 이 세상을 섬기는 방향으로 전환되도록 요청되는 것이다. 이러한 선교의 실마리를 에큐메니칼 선교에서 찾을 수 있다. 에큐메니칼 선교는 WCC를 중심으로 전개된 에큐메니칼 운동에서 논의된 선교의 새로운 패러다임으로 이 세상에서 생명을 지향하는 하나님의 구원활동에 동참하는 것을 목표로 한다. 기독교교육도 전통적인 선교의 맥락에서 기독교의 세력 확장의 도구의 역할을 감당했다. 이런 기독교 교육의 역할을 반성하며 하나님 나라를 위한 실천운동으로의 방향전환을 에큐메니칼 운동 안에서 시도했다. 바로 에큐메니칼 선교에 기초한 기독교 교육적 논의가 이루어진 것이다. 배타성과 공격적인 선교, 그리고 생명보다 교권체제에 대한 관심으로 이 사회에서 신뢰를 상실한 한국교회가 하나님 나라의 모델로서의 모습을 회복하고, 생명지향적인 공동체로 전환하기 위해서 에큐메니칼 선교에 기초한 선교교육의 방향성 확립이 요청된다. 더 나아가 교회 공동체 안에서 이러한 선교교육을 실행해야 하는 것은 한국교회의 시급한 과제이다. 이 논문은 바로 기독교교육이 에큐메니칼 선교에 기초하여 세상을 섬기는 사명자들을 양성하는 선교교육으로서의 역할의 가능성을 탐색한다. 이를 위해 선교와 선교교육에 대한 논의들이 담긴 에큐메니칼 문서들을 활용한다. Due to COVID-19, the entire world is facing the unprecedented phenomenon. Amid the threat of the virus, the global community is struggling for life. In such circumstances, churches in Korea have been criticised as selfish groups threatening the community by spreading the virus. With such criticism, they are disregarded by Korean society because their immorality and exclusive attitude towards other religions and cultures were also mentioned in public. There are many reasons for Korean churches to lose trust from people. One of the reasons for that is the quantitative growth of church and expansion of the power of church, which is a direction that has been practised so far as a missionary goal. The zeal for spreading gospel has undermined the trust of church and become a deteriorating factor for mission, which is irony. In such problematic situations, the change of paradigm is required for new mission. The passion for evangelisation should not only focus on the quantitative growth of church; it should change its direction for serving the world in lieu with the plan of God for the activity of redemption on this land. A hint of such mission can be found in ecumenical mission. Ecumenical mission is a new paradigm which was discussed in ecumenical movement led mainly by WCC, and its aim is to participate in activities of redemption of God for life in this world. Christian education has been a tool for the expansion of Christian power in the context of traditional mission. Reflecting on the role of Christian education as such, the change of direction as practical movement for the kingdom of God was tried in ecumenical movement: the beginning of the discussion of Christian education based on ecumenical mission. Due to exclusivity, aggressive mission, and the excessive attention to the system of ecclesiastical authority rather than life, Korean churches, which have lost trust in this society, should recover themselves as the model of the kingdom of God, and the establishment of mission education based on ecumenical mission is required for them to become a community towards life. Furthermore, this is an urgent task for Korean churches to implement such mission education in a church community.