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신선 고환조직 정자와 냉동보존-융해 고환조직 정자를 이용한 난자세포질내 정자주입술 결과의 비교 연구
최영식,최영민,김수웅,백재승,지병철,구승엽,서창석,김석현,김정구,문신용,Choi, Young-Sik,Choi, Young-Min,Kim, Soo-Woong,Paick, Jae-Seung,Jee, Byung-Chul,Ku, Seung-Yup,Suh, Chang-Suk,Kim, Seok-Hyun,Kim, Jung-Gu,Moon, Shin-Yong 대한생식의학회 2008 Clinical and Experimental Reproductive Medicine Vol.35 No.2
목 적: 무정자증 불임부부에서 신선 (fresh) 고환정자 (testicular spermatozoa)와 냉동보존-융해(cryopreserved-thawed) 고환정자를 사용한 난자세포질내 정자주입술 (intracytoplasmic sperm injection, ICSI)의 결과를 비교하고자 하였다. 연구방법: 신선 고환정자 및 냉동보존-융해 고환정자를 사용하여 ICSI 시술을 시행하기로 계획된 총 109주기 (66명)를 대상으로 하였고 신선 고환정자를 사용하기로 계획한 군 (신선 고환정자군, fresh group)에는 92주기 (61명)이 포함되었고 냉동보존-융해 고환정자를 사용하기로 계획한 군 (냉동보존-융해 고환정자군, cryopreserved-thawed group)에는 17주기 (13명)가 포함되었다. 양 군간에 수정률, 착상률, 임신률, 유산률 등 ICSI 시술의 결과들을 비교하였고 통계학적 분석은 Mann-Whitney U 검정 및 Fisher의 정확한 검정을 적절하게 사용하였다. 결 과: 신선 고환정자를 사용하여 ICSI 시술을 시행하기로 계획된 총 92주기 중 9주기에서 고환정자를 추출할 수 없어 시술 주기가 취소되었다. 냉동보존-융해 고환정자군과 비교하여 신선 고환정자군에서 수정률이 높은 경향을 보였고 ($58.0{\pm}27.8%$ vs. $45.9{\pm}25.0%$, p=0.076) 양질의 배아 수는 통계적으로 유의하게 높았다 ($0.9{\pm}1.2$ vs. $0.2{\pm}0.5$, p=0.002). 그러나 임상적 임신율, 착상률, 유산율은 양 군간에 통계적으로 유의한 차이가 없었다. 결 론: ICSI 시술을 위하여 냉동보존-융해 고환정자를 사용하는 경우 수정률 및 배아의 질이 감소하지만 임신율, 착상률, 유산율에는 영향을 미치지 않는 것으로 사료된다. 또한, ICSI 시술이전에 고환정자를 확보하고 냉동보존-융해 고환정자를 사용한다면 난자채취 당일 정자를 확보하지 못하여 주기를 취소하는 경우나 여성배우자의 불필요한 과배란유도를 줄일 수 있으며 반복적인 고환정자추출술로 인한 고환기능의 손상을 줄일 수 있는 유용한 방법으로 사료된다. Objective: To compare the outcomes of intracytoplasmic sperm injection (ICSI) with fresh and cryopreserved-thawed testicular spermatozoa in patients with azoospermia. Methods: One hundred and nine cycles (66 couples) where ICSI was planned with fresh or cryopreserved-thawed testicular spermatozoa were included in this study; Ninety two cycles (61 couples) with fresh testicular spermatozoa (fresh group) and seventeen cycles (13 couples) with cryopreserved-thawed testicular spermatozoa (cryopreserved-thawed group). We compared ICSI outcomes such as fertilization rate, implantation rate, pregnancy rate and miscarriage rate, which were statistically analyzed using Mann-Whitney U test or Fisher's exact test, where appropriate. Results: In 9 out of the 92 cycles where ICSI was planned with fresh testicular spermatozoa, testicular spermatozoa could not be retrieved. Fertilization rate tended to be higher in the fresh group than in the cryopreserved-thawed group ($58.0{\pm}27.8%$ vs. $45.9{\pm}25.0%$, p=0.076). The number of high quality embryos was significantly higher in the fresh group ($0.9{\pm}1.2$ vs. $0.2{\pm}0.5$, p=0.002). However, there were no significant differences in clinical pregnancy rate, implantation rate and miscarriage rate between the two groups. Conclusion: The results of this study suggest that although the use of cryopreserved-thawed testicular sperm for ICSI in patients with azoospermia may reduce fertilization capacity and embryo quality, it may not affect pregnancy rate, implantation rate and miscarriage rate. If testicular sperm can be obtained before ICSI procedure, the use of cryopreserved-thawed testicular sperm may also avoid unnecessary controlled ovarian hyperstimulation and cancellation of oocyte retrieval when spermatozoa cannot be retrieved as well as damage on testicular function by repeated TESE.
국가직업능력표준을 활용한 컴퓨터 응용기계설계과용 능력중심 교육과정 개발
구자길(Gu Ja-Gil),류형룡(Ryu Hyeong-Ryong),편영식(Pyoun Young-Sik) 한국산학기술학회 2005 한국산학기술학회논문지 Vol.6 No.1
지식, 기술, 정보가 경쟁력의 원천이 되는 산업 발전의 변화추세에 따라 세계 각국은 일-교육·훈련-자격의 긴밀한 연계체제인 국가직업능력표준을 통해 국가 인적자원 개발 시스템을 개선해 나아가고 있다. 우리나라에서도 노·사·정 합의에 의해 2002년부터 전 산업분야에 적용될 국가직업능력표준이 개발되고 있다. 본 연구에서는 이렇게 개발된 국가직업능력표준을 이용하여 우리나라 기능대학/전문대학의 컴퓨터 응용기계설계과에서 활용할 수 있는 교육과정과 교재개발방안을 개발하여 제시한다. According to the trend that knowledge information and technology become resource of international competitiveness in industrial development, some countries of world are improving national human resource development system through National Occupational Standards, which is inseparable link system of work-education and training-qualification. National Occupational Standards have been developed for over all industries by Human Resource Development Korea since 2002. Purpose of this study is to develop a competency based curriculum of computer mechanical design department in junior college or polytechnic college by systematic curriculum and instructional development model based on Korean National Occupational Standards. A guide line how to develop education and training program is presented also.
난자 세포질내 정자 주입술 및 포배기 배아이식 후 임신된 두 쌍의 일란성 쌍태아
이현정 ( Hyun Jung Lee ),최영식 ( Young Sik Choi ),이정렬 ( Jung Ryeol Lee ),정연경 ( Youn Kyung Chung ),지병철 ( Byung Chul Jee ),구승엽 ( Seung Yup Ku ),서창석 ( Chang Suk Suh ),최영민 ( Young Min Choi ),김정구 ( Jung Gu Kim 대한산부인과학회 2006 Obstetrics & Gynecology Science Vol.49 No.7
One of the most important complications in assisted reproductive technology (ART) is multiple pregnancy, which is associated with an increased risk of maternal and perinatal complications. There have been several attempts to achieve the highest pregnancy rates while minimizing multiple pregnancy rates in in vitro fertilization and embryo transfer (IVF-ET). One approach for this purpose is extended embryo culture and transfer of fewer (one or two) blastocysts. However, there are emerging concerns about the increase of the risk for embryo splitting and subsequent monozygotic multiple pregnancy with this approach. Recently, there have been several reports on the possible increased risk of monozygotic twinning after extended embryo culture and blastocyst transfer. We have experienced a case of two sets of monozygotic twins after intracytoplasmic sperm injection (ICSI) and transfer of two blastocysts. We report the first case of pregnancy of monozygotic twins after blastocysts transfer with a brief review of literature in Korea.
체외수정시술을 위한 과배란유도에 있어 GnRH Antagonist의 임상적 효용성과 혈중 호르몬 농도의 변화
문신용,천은경,김상돈,최영식,지병철,구승엽,서창석,최영민,김정구,김석현,Moon, Shin-Yong,Chun, Eun-Kyung,Kim, Sang-Don,Choi, Young-Sik,Jee, Byung-Chul,Ku, Seung-Yup,Suh, Chang-Suk,Choi, Young-Min,Kim, Jung-Gu,Kim, Seok-Hyun 대한생식의학회 2004 Clinical and Experimental Reproductive Medicine Vol.31 No.4
Objectives: To evaluate the efficacy of GnRH antagonist cetrorelix in women undergoing controlled ovarian hyperstimulation (COH) for in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) and to determine changes in serum hormone concentrations during cetrorelix administration. Methods: We performed a clinical trial on 30 patients undergoing COH with highly purified follicular stimulating hormone (HP-FSH) and gonadotropin releasing hormone antagonist (GnRHant), cetrorelix. FSH was administrated from day 2 or 3 of cycle with fixed dose and adjusted according to individual response. 0.25 mg of cetrorelix was injected daily subcutaneously from stimulation day 5 until the day of hCG administration. Daily ultrasound monitoring was performed for growing follicles and serum levels of luteinizing hormone (LH), estradiol ($E_2$) and progesterone were measured daily during cetrorelix administration. Up to 4 embryos were transferred. Results: Mean age of enrolled patients was $32.0{\pm}3.4$ years (mean $\pm$ S.D.). All of 30 patients underwent oocyte pick-up, and embryo transfer was done in 28 patients. The total and mean numbers of received oocytes were 196 and $6.5{\pm}4.7$, the number of fertilized eggs was 111, and the fertilization rate was 56.6%. Total duration of FSH administration was $9.2{\pm}2.2$ days and mean of $24.3{\pm}7.7$ ampules of HP-FSH was administered. Total duration of cetrorelix administration was $5.7{\pm}1.9$ days. Serum LH and progesterone levels were maintained in the range of $1.4{\sim}2.9\;mIU/mL$ and $0.3{\sim}0.6\;ng/mL$, which respectively reflected effective prevention of premature LH surge. Clinical pregnancies were achieved in 9 patients, and overall clinical pregnancy rate was 30.0% per oocyte retrieval, and 32.1% per embryo transfer. Conclusion: GnRH antagonist is safe and convenient for COH for IVF-ET and effective with optimal pregnancy rate.
지병철 ( Byung Chul Jee ),최영식 ( Young Sik Choi ),구승엽 ( Seung Yup Ku ),서창석 ( Chang Suk Suh ),최영민 ( Young Min Choi ),김정구 ( Jung Gu Kim ),문신용 ( Shin Yong Moon ),김석현 ( Seok Hyun Kim ) 대한산부인과학회 2005 Obstetrics & Gynecology Science Vol.48 No.3
목적: 산욕기 동안 체질량지수로 표현되는 과체중 또는 비만과 복부지방률로 표현되는 남성형 비만의 빈도를 각각 알아보고, 산욕기 각 시기별로 남성형 비만을 예측할 수 있는 체질량지수의 기준치를 제시하고자 하였다. 연구 방법: 만삭에 단태아를 출산한 43명의 건강한 여성을 대상으로 분만 다음날과 분만 1주째, 그리고 분만 6주째에 체질량지수를 구하고 생체 전기 임피던스법을 이용하는 체성분 분석기를 이용하여 복부지방률을 측정하였다. 결과: 체질량지수는 분만 Objective: To investigate the dynamics of body mass index (BMI) and abdominal fatness of women in postpartum period, and to find cut-off values of BMI to predict android obesity. Methods: Forty-three uncomplicated postpartum women were included. BMI and a
호르몬 대체요법 시행 폐경 여성에서 에스트로겐 수용체 유전자 Pvu2 및 Xba1 다형성 양상과 자궁내막 초음파검사 소견의 연관성
김혜진 ( Hye Jin Kim ),최영식 ( Young Sik Choi ),지병철 ( Byung Chul Jee ),구승엽 ( Seung Yup Ku ),서창석 ( Chang Suk Suh ),최영민 ( Young Min Choi ),김정구 ( Jung Gu Kim ),문신용 ( Shin Yong Moon ),김석현 ( Seok Hyun Kim ) 대한산부인과학회 2005 Obstetrics & Gynecology Science Vol.48 No.4
류형룡(Ryu Hyeong-Ryong),구자길(Gu Ja-Gil),편영식(Pyoun Young-Sik) 한국산학기술학회 2005 한국산학기술학회논문지 Vol.6 No.1
산업체가 요구하는 능력 중심의 현장 인력을 양성하기 위하여 산업인력공단에서는 국가직업능력표준을 개발하였고 국가직업능력표준에 의거하여 제시된 과정과 교재개발 방안에 따라 프로젝트 기반의 기계설계교육용 훈련프로그램를 개발하였다. 개발된 프로그램을 몇 개 대학에서 적용하면서, 그 유용성을 학생들이 과정 중 수행한 프로젝트보고서로서 제시하였다. In order to educate and train proper work forces who can satisfy the industry demands, Human Resource Development Korea had developed the Korean National Occupational Standards. Following to the competency-based-curriculum and the guide lines which were developed based on this standard, the training program for a machine design has been developed. It has been applied in several colleges and some typical examples which were carried out by students as term project are presented to show the effectiveness of the developed program.
김성렬(Seong Yeal Kim),김중규(Jung Gu Kim),최영식(Young Sik Choi) 대한두경부종양학회 1998 대한두경부 종양학회지 Vol.14 No.1
Fine needle aspiration cytology was used widely to select thyroid nodules for surgery. The result could be highly reliable for most malignancies and for benign nodules. The purpose of this study was to determine the value of frozen biopsy by directly comparing the results of preoperative fine needle aspiration cytology to frozen biopsy examination. In our university hospital, 103 patients with thyroid nodule were operated during the years 1996 through 1997. A comparison of accuracy of the fine needle aspiration cytology with frozen biopsy was made for 85 patients who underwent both procedures. The 85 patients were separated into two groups. The group I included 65 patients, whose preoperative fine needle aspiration cytology results were reported as benign or malignant lesion definitely. The group II included 85 patients, the patients whose reported fine needle aspiration cytologic result was suspicious for malignancy were regarded .as malignant lesion and results for follicular neoplasm were regarded as benign lesion. The accuracy of both procedures was compared on two group also. The sensitivity, specificity, and accuracy of frozen biopsy were 76.7%, 93.5%, and 85.2% in group I and 75.6%, 95.5%, and 85.9% in group II, respectively, compared with 63.3%, 87.1%, and 75.4% in group I and 65.4%, 81.8%, and 72.9% in group II for fine needle aspiration cytology. On benign lesion, the accuracy was 95.5% in frozen biopsy and 68.2% in fine needle aspiration cytology, 75.6% in frozen biopsy and 53.7% in fine needle aspiration cytology on malignant lesion. We conclude that although fine needle aspiration cytology is the reliable diagnostic test in the evaluation of thyroid nodule, frozen biopsy should be performed intraoperatively, because fine needle aspiration cytology is insufficiently sensitive for reliable surgical planning.