경추 신경공 골성 협착의 평가에서 사위 관상면 MRI의 객관성 및 단순촬영사진과의 일치도$^1$

서영란,윤대영,배상훈,최철순,Seo, Yeong-Ran,Yun, Dae-Yeong,Bae, Sang-Hun,Choe, Cheol-Sun 대한영상의학회 2003 대한영상의학회지 Vol.48 No.1

목적: 경추 신경공 골성 협착의 평가에서 사위 관상면 자기공명영상을 고식적 자기공명영상와 비교하고 또한 사위 관상면 자기공명영상 - 사위 단순 촬영사진의 일치도를 고식적 자기공명 영상 -사위 단순 촬영사진 사이 일치도와 비교함으로 해서 사위 관상면 자기공명영상의 유용성을 알아보고자 하였다. 대상과 방법: 고식적 자기공명영상, 사위 관상면 자기공명영상 및 사위 단순 촬영사진을 찍은 18명 환자의 108개 신경공에서 골극에 의한 신경공의 전후 방향 협착을 0(정상), 1 (정상적인 신경공의 전후 길이의 25%이하가 골극에 의해 좁아짐), 2 (정상적인 신경공의 전후 길이의 25% 이상이 골극에 의해 좁아짐)세 단계로 나누어 판독하였다. 먼저, 3명이 독립적으로 판독한 고식적 자기공명영상, 사위 관상면 자기공명영상, 사위 단순 촬영사진 결과에 대해 판독자간 일치도를 서로 비교하고, 합의된 결과를 토대로 구해진 사위 관상면 자기공명영상 -사위 단순 촬영사진 사이 일치도를 고식적 자기공명영상 - 사위 단순 촬영사진 사이 일치도와 비교하였다. 결과: 사위 관상면 자기공명영상의 판독자간의 판정 일치도 (kappa=0.88,very good)는 고식적 자기공명영상 (kappa=0.41,fair)에 비해 높았다. 사위 관상면 자기공명영상 - 사위 단순 촬영사진 사이의 판정 일치도 (kappa=0.63,good)역시 고식적 자기공명영상 - 사위 단순 촬영사진 사이 (kappa=0.41,fair)보다 높았다. 결론: 사위 관상면 자기공명영상은 경추 신경공 골성 협착의 평가에서 고식적 자기공명영상와 사위 단순 촬영사진 소견이 서로 잘 일치하지 않는 경우 보조적으로 이용될 수 있으리라 생각된다. Purpose: To determine the utility of oblique coronal MR (OMR) imaging in the evaluation of bony foraminal narrowing of the cervical spine by comparison of its findings with those of combined axial and sagittal MR (CMR) imaging and correlation with the findings of oblique radiography. Materials and Methods: One hundred and eight cervical neural foramina in 18 patients formed the basis of this study. Three radiologists working in a blind fashion independently graded the degree of bony narrowing of the foramina seen on OMR and CMR images and on oblique radiographs (0=none, 1=stenosis below 25% of AP dimension, 2=stenosis exceeding 25% of AP dimension). Inter-observer variance was measured for each modality, and for each of these and for each foramen, consensus was reached as to whether of CMR or OMR showed better correlation with radiographs. Results: Inter-observer variance in OMR was less (kappa=0.88) than in CMR (kappa=0.41). Correlation between the findings of OMR and radiography was also better (kappa=0.63) than between those of CMR and radiography (kappa=0.41). Conclusion: OMR can be a useful supplement in evaluating foraminal stenosis, especially when oblique radiographs and CMR images show discrepancies.

청각장애 영,유아의 어휘발달에 대한 종단연구 -초어 출현 이후의 표현어휘 발달-

서영란 ( Yeong Ran Seo ),박경란 ( Kyoung Ran Park ),김병하 ( Byung Ha Kim ) 대구대학교 한국특수교육문제연구소 2007 특수교육저널 : 이론과 실천 Vol.8 No.4

This study shows the increase number of expressive word by increasing age of children with hearing impairment, and the patterns of changes in part of speech. 8 children with hearing impairment who were found before chronological age 3 were involved in this study, and vocabulary data was collected every 6 months since the appearance of the proto-word. As a result, in the period of the appearance of the proto-word, they respectively show a marked difference. As they develop their vocabularies based on nouns, they gradually start using verbs and adjectives, and then utilizing grammatical morpheme after expressing some amounts of the content words. Furthermore, their vocabularies were increased dramatically in a specific period, however period of the dramatic increase differed among children. Through these results, we can expect that the patterns of vocabulary development of hearing impaired children are similar to those of the hearing children. The period of the rapid increase in vocabularies can be divided largely into two patterns: one is the pattern of the rapid increase of vocabularies immediately with the appearance of the proto-word, and the other that of rapid increase of the vocabularies between 6 months and 12 months after the appearance of the proto-word.

발화분석을 통한 취학전 청각장애아동의 문법발달에 대한 종단연구

서영란 ( Yeong Ran Seo ) 대구대학교 한국특수교육문제연구소 2010 특수교육저널 : 이론과 실천 Vol.11 No.3

This study showed the hearing-impaired children’s longitudinal develop ment of grammar to arrange fundamental materials of their early linguistic development. The subjects of the study were two children, both of whom lived in Yeongnam area with normal-hearing parents and were diagnosed with hearing impairment before the age of two, without any additional disabilities. The utterances under natural circumstances were collected to investigate their grammatical at six-month intervals over the three years. Fourteen hundred utterances needed for the study were transcribed to analyze, by age, the developmental aspects of MLU(mean length of utterance), sentence formation, grammatical morphemes. The results of this study are as follows. First, there was a steady increase in MLUw(mean length of utterance in words) and MLUm(mean length of utterance in morphemes), showed the biggest increase in MLUm. Second, in forming simple and complex sentences, both of which were made, the use of complex sentences was increased rapidly. In order to form complex sentences, they used the simplest forms of connective endings, Some sentences contained two or more connective endings. Third, the number of used grammatical morphemes increased distinctly. Overall, the two children’s development of grammatical morphemes was a bit later or similar over hearing children’s. This study also showed that grammatical development slowed down temporarily immediately after the second surgery of a cochlear implant, which shows that hearing conditions affect language development.

자기공명담췌관조영술: 단발포고속스핀에코(SS-TSE)기법과 SENSE기술을 이용한 3차원고속스핀에코(3D-TSE)기법의 영상비교

최철순,윤대영,서영란,Choe, Cheol-Sun,Yun, Dae-Yeong,Seo, Yeong-Ran 대한영상의학회 2003 대한영상의학회지 Vol.49 No.6

목적:단발포고속스핀에코기법과 Sensitivity encoding(이하 SENSE)기술을 이용한 3차원고속 스핀에코기법의 자기공명담췌관조영술 (Magnetic Resonance Cholangiopancre-atography;이하 MRCP)을 비교하여 영상의 질을 평가하고자 하였다. 대상과 방법:간내 또는 간외질환으로 단발포고속스핀에코기법과 SENSE기술을 이용한 3차원 고속스핀에코기법의 MRCP를 시행한 40명을 대상으로 하였다.3인의 방사선과 의사가 담췌관계해부학구조물의 영상의 질을 점수화하여 비교,분석하였고,이어서 각 증례별로 두 기법간의 영상의 질을 직접 비교,분석하였다. 결과:간내담관,담낭관,총담관,췌관의 영상에서 모두 3차원고속스핀에코기법이 단발포고속스핀에코기법보다 높은 점수를 보였으나,간내담관과 총담관에 대한 3차원고속스핀에코기법의 우월성만이 통계적으로 유의한 차이를 보였다 (p<0.05).두 기법 모두에서 총담관이 각각 87.5%와 97.5%로 가장 잘 관찰되었으며,췌관의 경우 52.5-57.5%,담낭관의 경우 10.0-32.5%에서 양질의 영상을 얻을 수 있었다.각 증례별로 두 영상 방식을 직접 비교하였을 때 27예 (67.5%)에서는 3차원고속스핀에코기법이 우수하고,5예(12.5%)에서는 두 영상방식이 동등하 며 8예(20%)에서 단발포고속스핀에코기법이 우수하다고 판단하였으며 이는 통계적으로 유의 하였다 (p<0.05). 결론:담췌관계해부학구조물을 관찰하는데 있어 3차원고속스핀에코기법이 단발포고속스핀에코기법보다 양질의 정보를 제공하였다.그러나 두 기법모두에서 췌관과 담낭관을 보는 데에 제한이 있었지만 이점은 MR기기의 기술적 개선으로 더 나은 영상을 얻을 수 있을 것으로 생각한다. Purpose: To evaluate the relative image qualities obtained at magnetic resonance cholangiopancreatography (MRCP) turbo spin-echo (SSTSE) sequence and the three-dimensional turbo spin-echo (3D TSE) sequence with the sensitivity encoding (SENSE) technique. Materials and Methods: Forty patients with suspected hepatic and extrahepatic diseases underwent MRCP using the SSTSE sequence and the 3D TSE sequence with the SENSE technique. Three radiologists scored and compared the quality of images of anatomic structures in the hepatopancreatic biliary system, and then directly compared the quality of the images obtained using the two sequences in each set of cases. Results: For visualization of the intrahepatic bile duct, the cystic duct, the common bile duct, and the pancreatic duct, MRCP images obtained using the 3D TSE sequence with the SENSE technique were better than those obtained using the SSTSE sequence, though for the intrahepatic bile duct and common bile duct only, were these differences statistically significant (p<0.05). Quality was best for images of the common bile duct (87.5% for SSTSE and 97.5 % for 3D TSE with the SENSE technique). For the pancreatic and cystic duct, however, 52.5% and 10% of SSTSE images, respectively, and 57.5% and 32.5% of 3D TSE images, respectively, provided optimal image quality. In direct comparison, 3D TSE images obtained using the SENSE technique were better in 27 cases (67.5%), both images were equivocal in five cases (12.5%), and SSTSE images were better in eight cases (20%). These differences were statistically significant (p<0.05). Conclusion: For the visualization of anatomic structures in the hepatopancreatic biliary system, the 3D TSE sequence with the SENSE technique was better than the SSTSE sequence. For evaluation of the pancreatic and cystic duct, however, both techniques have their limitations and require further development

농아동을 둔 농부모의 양육경험에 대한 질적 연구: 언어 선택을 중심으로

곽정란 ( Jeong Ran Kwak ),서영란 ( Yeong Ran Seo ),이정옥 ( Jeong Ok Lee ) 대구대학교 한국특수교육문제연구소 2011 특수교육저널 : 이론과 실천 Vol.12 No.1

The purpose of this study is to investigate deaf parents’ language choice in experiences of rearing their deaf children. A literature review was conducted, and an in-depth interview with five deaf parents who have deaf children. The conclusion of this study is as follows: First, the deaf parents who participated in this study were shocked when they noticed their children were deaf and such psychological shock gradually disappeared as their children started to use sign language. Second, most of the deaf parents had negative perception of cochlear implant surgery and rather hoped their deaf children to grow up deaf. Third, the deaf parents used sign language rearing their children and as a result their deaf children naturally obtained sign language skills. In this way the children were positively influenced in their emotional stability and language development. Fourth, the deaf parents taught their children how to interpret writings by reading the children fairy tales using sign language and helped their understanding by explaining what their children did not comprehend in an easy way using sign language for the deaf. Fifth, all of the deaf parents wanted to send their children to a school for the deaf but were concerned about school teachers’ abilities to use sign language.

연령과 청력역치에 따른 청각장애아동의 음운적 특성

서영란,김진숙,고도흥 한국음성과학회 2001 음성과학 Vol.8 No.2

This research with 40 hearing impaired children was performed to find out the characteristics of the phonological processes for each age, hearing loss degree and aided threshold degree through the transcriptions. The phonological processes. of hearing impaired children are similar to those of normal children with a peculiar type of patterns in phonological processes. The results show that: (1) Between 5 and 6 year old groups the phonological processes were significantly different in palatal backing, glottal replacement and frication; between 6 and 7 year old groups the phonological processes were significantly different in velar fronting, labialization, alveolization and labial assimilation; between 7 and 8 year old groups the phonological processes, labialization, alveolization and alveolar assimilation, however 8 year old group showed more phonological processes than 7 year old group. (2) Between moderately-severe and severe hearing impaired groups, phonological processes were significantly different in the omissions of postvocalic, nasal and velar, stopping and stop assimilation. The differences of severe and profound groups were not found at all. (3) Aided hearing thresholds did not show any significant difference.

인공와우 이식 아동의 말 지각에 관한 연구 : 만 6세 전ㆍ후에 수술한 아동의 말 지각 비교

김성곤,서영란,주미영 국립특수교육원 2008 특수교육연구 Vol.15 No.2

This study examined the timing suitable for transplanting Artificial cochlear by comparing two groups' ability differences of speech perception after we analysed as an object of this study both 15 children transplanted artificial cochlear under six years of age and 15 children transplanted artificial cochlear aged six and above. This study analysed hearing situations of both Auditory Only(AO) and Auditory Visual(AV) based on one syllable and two syllable examination of speech perception without any examples suggested by Kim, Soo-Jin(1988), and examined independent sampling t by using SPSS 12.0. As a result, there were meaningful differences of speech perception between children's groups transplanted at the age of 6 more or less in the situations of AO and AV without any examples. There were individual differences, but generally children transplanted under more or less six years of age had a little more performance ability of speech perception than children aged six and above. It was shown that, by reconsidering the operation of artificial cochlear which has been thoughtlessly performed today, this study would be a basic material of study to examine efficient rehabilitation methods of hearing-impaired children through carefully considering the suited timing for transplanting artificial cochlear. 본 연구는 만 6세 이전에 인공와우 수술을 한 아동 15명과 만 6세 이후에 수술한 아동 15명을 대상으로 아동의 집단 간 말 지각 능력의 차이를 비교하여 적절한 인공와우 이식시기에 대해 알아보았다. 김수진(1998)의 1음절과 2음절 말 지각 검사를 보기가 주어지지 않은 청각만(AO)의 듣기 상황과 청시각적(AV) 듣기 상황에서 실시하여 SPSS 12.0을 이용하여 독립표본 t검정을 하였으며 그 결과로는 보기가 제시되지 않은 AO 상황과 AV 상황에서 만 6세 전·후에 수술한 아동 집단 간의 말 지각 능력에서 유의한 차이가 나타났다. 개인차는 있었지만 전반적으로 만 6세 이전에 수술한 아동이 좋은 말 지각 수행 능력을 보였다. 본 연구는 무분별하게 실시되고 있는 인공와우 수술에 대해 재고하고 적절한 인공와우 이식 시기에 대해 신중하게 고려하여 청각장애 아동의 효율적인 재활 방안을 검토해 보는 기초 자료가 될 수 있을 것이다.