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      • KCI등재

        체외수정시술 환자에서 황체기 보강 시 근주 투여와 경구 투여의 연속적 이용

        김상돈,지병철,이정렬,서창석,김석현,문신용,Kim, Sang-Don,Jee, Byung-Chul,Lee, Jung-Ryeol,Suh, Chang-Suk,Kim, Seok-Hyun,Moon, Shin-Yong 대한생식의학회 2010 Clinical and Experimental Reproductive Medicine Vol.37 No.1

        목 적: 체외수정시술 시 황체기 보강은 근주, 경질, 경구 등의 다양한 방법으로 이루어지고 있는데, 경구 투여법은 환자의 순응도가 높고 비교적 안전한 방법이다. 본 연구에서는 황체기 보강을 근주로 시작하여 경구 투여로 전환하는 방법의 효용성과 전환 시기에 따른 결과를 비교 분석하고자 하였다. 연구방법: 2003년 9월부터 2009년 6월까지 분당서울대학교병원에서 체외수정시술을 시행받은 환자에서 배아 이식 후 태아 심박동까지 확인된 76주기를 대상으로 하였다. 과배란유도는 GnRH agonist long protocol (n=7) 또는 GnRH antagonist protocol (n=66)을 이용하였으며 3주기에서는 냉동배아 이식을 시행하였다. 황체기 보강을 위하여 난자 채취일부터 매일 progest in oil 50 mg을 근주하였고, 태아 심박동이 확인된 후 임신 6~7주 (n=17) 또는 8주 이후 (n=59)에 micronized progesterone (Utrogestan, Laboratoires Besins International, France) 300 mg을 매일 경구로 투여하였다. 결 과: 대상군 전체의 유산율은 3.9% (3/76)이었으며, 경구 투여 전환시의 임신 주수는 평균 8주 4일 (난자 채취일로부터 $46{\pm}5.8$일)이었다. 황체기 보강을 임신 6~7주 사이에 경구 투여로 전환한 17주기 중에서 1례의 자연유산이 확인되었으며 유산 시 주수는 9주 4일이었다. 8주 이후에 경구 투여로 전환한 59주기 중에서는 2례의 자연유산이 확인되었으며 (11주 3일, 11주 4일), 두 군의 자연유산율은 각각 5.6%와 3.4%로 두 군 간에 통계적으로 유의한 차이는 없었다 (p=0.678). 결 론: 체외수정시술 후 황체기 보강을 시행하는 경우 태아 심박동이 확인된 이후에 근주 투여를 경구 투여로 전환하는 방법은 비교적 낮은 유산율을 보임을 확인하였으며, 특히 8주 이전에 전환하는 것도 유용한 방법이라 사료된다. Objectives: The aim of this study was to assess appropriate time to convert intramuscular progesterone support to oral administration for luteal phase support in in vitro fertilization (IVF). Methods: Seventy-six cycles of IVF in which fetal heart beat was identified after treatment were included. Patients underwent controlled ovarian hyperstimulation with GnRH agonist long protocol (n=7) or GnRH antagonist protocol (n=66). Cryopreserved embryo transfer was performed in three cycles. Luteal support was initiated by daily intramuscular injection of progesterone, and after confirmation of fetal heart beat, converted to oral micronized progesterone (Utrogestan, Laboratoires Besins International, France) 300 mg daily before or after 8 gestational weeks. The oral progesterone was continued for 11 weeks. Results: Overall clinical abortion rate was 3.9% (3/76) and mean time to conversion was $8^{+4}$ gestational weeks ($46{\pm}5.8$ days after oocytes retrieval). The abortion rate was 5.6% (1/17) and 3.4% (2/59) in patients with conversion before 7 weeks and after 8 weeks, respectively, which were not statistically significant (p=0.678). The miscarriages were occurred at $9^{+4}$ weeks, $11^{+3}$ weeks and $11^{+4}$ weeks. Conclusion: Sequential luteal support using intramuscular and oral progesterone yields a relatively low clinical abortion rate. If fetal heart beat confirmed, sequential regimen appears to be safe and convenient method to reduce patients' discomfort induced by multiple injections.

      • KCI등재

        다가구매입임대주택이 주변지역에 미치는 외부효과에 관한 연구

        김상돈,이주형,Kim, Sang-Don,Lee, Joo-Hyung 한국주거학회 2008 한국주거학회 논문집 Vol.19 No.5

        The objective of his study is to research the effect of the 'Dagagu' housing purchase and the public rental housing supply on the nearby community. In the case of public rental housing, many studies have demonstrated that the perception that a public rental house is a low income dwelling has an external effect on the residents immediately outside the area such as the perception of the lowering of house prices. However, an advanced research concerning the 'Dagagu' housing purchase and public rental housing has not been carried out because it has only recently been enforced. Through a survey conduced of residents who live nearby the 'Dagagu' housing purchase and public rental housing the aim of his study is to show how the residents perceive the renal houses and are influenced by them. At the same time, this study demonstrates the external effect of rental house supply by analyzing the housing price around the area. Most people who live in the near by 'Dagagu' housing purchase and public renal housing have a negative opinion of his housing because they believe that the residential prices will depreciate. However, only about 40% of the people felt that the residential price depreciation as a result of the 'Dagagu' housing purchase and public rental housing supply was not visible.

      • SCOPUSSCIEKCI등재

        파종성 악성 핍지신경교종 환자에서 시행한 뇌실내 Methotrexate의 효과 - 증례보고 -

        김상돈,정용구,김세훈,임동준,조태형,이훈갑,서중근,이기찬,Kim, Sang-Don,Chung, Yong-Gu,Kim, Se-Hoon,Lim, Dong-Jun,Cho, Tae-Hyung,Lee, Hoon-Gap,Suh, Jung-Keun,Lee, Ki-Chan 대한신경외과학회 2001 Journal of Korean neurosurgical society Vol.30 No.7

        Oligodendrogiomas account for about 4 per cent of intracranial gliomas and surgery is known to be an essential first step to establish an accurate diagnosis and when oligodendrogliomas recur with or without anaplastic features after initial resection, radiation and chemotherapy consisting of the administration of procarbazine, lomustine, and vincristine are usually indicated. We report our experience of an excellent result with intraventricular methotrexate chemotherapy for a patient with disseminated anaplastic oligodendroglioma. A 29-year-old male patient presented with diplopia and headache for two months. MRI showed a irregular, faintly enhanced mass in the posterior fossa. The hisotological diagnosis was an anaplaplastic oligodendroglioma and he was treated with chemotherapy of PCV regimen and radiotherapy followed by surgery. CSF dissemination was revealed by a follow-up MRI during the period. Intraventricular methotrexate(0.175mg/kg) was given twice a week for 4 weeks through ommaya reservoir and the size of the multiple tumors was decreased significantly on follow-up MRI. This case report suggests that an aggressive treatment involving intravent-ricular chemotherapy may be helpful even when anaplastic oligodendrogliomas disseminates to leptomeninges.

      • KCI등재

        "덕은 가르쳐질 수 있는가?"라는 물음의 도덕교육적 함의

        김상돈 ( Sang Don Kim ) 한국윤리교육학회 2009 윤리교육연구 Vol.0 No.20

        소크라테스는 『프로타고라스』와 『메논』에서 "덕은 가르쳐질 수 있는가?"라는 물음을 제시한다. 프로타고라스와 메논은 미묘한 차이가 있기는 하지만 모두 덕은 가르쳐질 수 있다고 주장한다. 하지만 소크라테스는 덕의 교육가능성과 덕의 지식가능성을 논리적으로 연결시키면서 만약 프로타고라스와 메논이 덕의 지식가능성을 입증하지 못한다면 그들은 부당 전제의 오류를 범하게 되는 것임을 주장한다. 왜냐하면 덕의 교육가능성은 덕의 지식가능성에 의존하기 때문이다. 덕의 지식가능성에 대한 논의는 "덕이란 무엇인가?"라는 물음에 관한 논쟁으로 이어진다. 그러나 두 대화편 모두에서 덕의 본질에 대한 최종적인 결론은 발견되지 않는다. 따라서 덕의 교육가능성 역시 미해결의 과제로 남게 된다. 소피스트의 상대주의적 관점을 비판하고 이성에 근거한 객관적인 지식을 추구한 것으로 알려진 소크라테스가 덕의 지식가능성과 교육가능성에 대해 확신하지 않았다는 점은 다소 의아한 것이다. 그렇다면 프로타고라스, 메논과의 논쟁에서 보여준 소크라테스의 의구심은 어떤 의미로 해석될 수 있는가? 본 논문은 덕의 교육가능성에 대한 물음과 논쟁을 분석하여 그것에 담긴 도덕교육적 함의를 탐색한다. This study is focused on Socratic question, "Can be virtue teachable", in Protagoras and Meno. In Protagoras, Protagoras insists that he can teach virtue, in particular, civic virtue, and he know what it is. But Socrates presents some questions to him. According to Socrates, we cannot have a conviction about the possibility, if we don`t have the knowledge about what virtue is. Similarly in Meno, Meno also ask a question to Socrates. The teachability of virtue and the possibility as knowledge of virtue are correlated. Socrates examines two theses. But the conclusion is disappointed. Socrates still open the question those two possibilities. This means that he, too, has not a cogent argument on what virtue is. Socrates`s hesitation shows a lot of implications about moral education. Can we teach morals? What is the moral that we intend to teach. Is it the same as Socratic virtue? Or, Is it different with ancient Greek virtue. Greek, arete, can it be interpreted as virtue, modern language? We can find the answer about these questions, by distinguishing and moral. Virtue can be totally reduced into moral. It has some different logical structure. Here, we can find the true meaning of virtue ethics. In moral education, moral virtue and moral principle or moral rule have competed each other. Nevertheless, without principle, virtue cannot be justified as contents of moral education, because teaching is possible by principle. Moral principle, moral rule, and moral knowledge cannot be separated in concept. Contrarily, moral knowledge with virtue is ineffective in moral education.

      • SCOPUSSCIEKCI등재

        흉요추부 외측 강외 접근법(Lateral Extracavitary Approach)의 수술해부학적 구조 - 사체해부실험 -

        김상돈,서중근,하성곤,김주한,조태형,박정율,김현,Kim, Sang-Don,Suh, Jung-Keun,Ha, Sung-Kon,Kim, Joo-Han,Cho, Tae-Hyung,Park, Jung-Yul,Kim, Hyun 대한신경외과학회 2001 Journal of Korean neurosurgical society Vol.30 No.10

        Objective : The lateral extracavitary approach(LECA) to the thoracolumbar spine is known as one of procedure which allows not only direct vision of pathologic lesion, but also ventral decompression, and dorsal fixation of the spine through the same incision. However, some drawbacks of LECA, including the technically- demanding, time-consuming, unfamiliar surgical anatomy and excessive blood loss, make surgeons to hesitate to use this approach. This study is to provide the surgical anatomy of LECA using cadavers, for detailed informations when LECA is considered for the surgery. Methods : We performed the 10 cadaveric studies, 7 male and 3 female, and careful dissection was carried out on right side of thoracolumbar region, except one for thoracic region. The photographs with micro-lens were taken to depict the close-up findings and for demonstrating detailed anatomy. Results : The photographs and hand-drawings demonstrated the relationships among the musculature, segmental vessels and nerve roots seen during each dissection plane. The lateral branches of dorsal rami of spinal nerve and the transverse process were confirmed to be the most important landmark of this approach. Conclusion : We concluded that detailed anatomical findings for LECA through this step-by-step dissection would be useful during operative intervention to reduce the intraoperative complications in LECA.

      • 기관지천식 환자의 기관지분비물내 총 IgE 항체치 연구에서 유도객담검사의 유용성

        김상돈,서창희,김희연,남동호,박해심 (Sang Don Kim,Chang Hee Suh,Hee Yeon Kim,Dong Ho Nahm,Hae Sim Park) 대한천식알레르기학회 1998 천식 및 알레르기 Vol.18 No.2

        Background: IgE antibodies have been considered to play an important role in the pathogenesis of atapic asthma. However, there have been only few studies on the role of IgE in airway secretion in the pathogenesis of bronchial asthma. This might be partly due to difficulty in sampling of airway seceretion from asthmatic patients. Recently, sputum induction method by inhalation of nebulized hypertonic saline was developed, and proved to be valid and useful method for obtaining airway secretion from asthmatic patients for studying air- way inflammation. %jective and method: To evaluate the usefulness of sputum induction method for studying IgE antibodies in airway secretion from atopic asthmatic patients, total IgE levels in induced sputum from 54 atopic asthmatics were measured by enzyme-linked immunosorbent assay(ELISA) and tried to find an association with sputum eosinophilia. Result: Total IgE levels in induced sputum were significantly higher in atopic asthmatic patients(1.27+82.066 IU/ml) than in controls(0.203+0.291 IUgmP)(p<0.05). In atopic asthmatic patients, total IgE levels in induced sputum were not significantly different between patients with and without sputum eosinophilia(>5% of 200 counted leukocytes). There was a significant correlation of total IgE levels between induced sputum and serum in atopic asthmatic patients(r=0.60, p<0.05). Total IgE levels in induced sputum(1.278+ 2.066) were significantly higher than saliva sample(0.504 + 1.111 IU/ml) from atopic asthmatic patients(p<0.05). Conclusion '. These results suggest that total IgE levels are increased in the induced sputum of atopic asthmat,ic patients and sputum induction method is a useful tool for study- ing IgE antibodies in airway secretion from asthmatic patients.

      • KCI등재

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