Clinical analysis of the patients with premature ovarian failure: Compliance of the treatment

김미라 ( Mi La Kim ),Joo Myung Kim,Ho Won Han,Jong Young Jun,Kwan Young Joo 대한산부인과학회 2008 대한산부인과학회 학술대회 Vol.94 No.-

정지용 시에 나타난 감각의 전환 연구 -청각적 특성을 중심으로-

김미라(Kim, Mi-La) 한국현대문학회 2021 한국현대문학연구 Vol.- No.63

이 글은 정지용 중 · 후기시에 나타난 소리 이미지의 성격적 변화를 분석한다. 시작(詩作) 초기에 의성어 · 의태어 중심으로 등장하던 소리는 후기에 이르러 작고 미미한 소리로 변모하고, 그러한 소리를 듣고자 하는 시적 화자의 태도 역시 분명한 변화가 목격된다. 이를 바탕으로 정지용 시의 청각성이 근대적 소리가 요청하던 규율화된 신체 리듬에 대한 저항성을 띠고 있으며, 탈근대적 성격을 지닌 ‘감각’함이라는 하나의 사건으로 나아감을 밝히고자 한다. 정지용 시의 생생한 감각에 대해서는 그간 다수의 논의가 진행되어 왔으나, 대부분이 1930년대 경성의 모더니즘이란 틀 안에서 근대적 시각성의 원리를 중점에 두고 해석된 경향이 있다. 그러나 그러한 시각적 성격에 기반을 둔 분석은 식민지라는 시공간적 특수성으로부터 근대적 주체 구성의 실패라는 결과를 도출해 냄으로써 정지용 시에 나타난 감각의 전환과 그로부터 포착되는 독특한 청각적 특성에 대한 해석을 제한한다. 근대시에 대한 청각적 접근의 배제는 기본적으로 낭독을 중심으로 하던 시가의 형태와 작별한 것이 크게 기인한 것으로 보인다. 하지만 정지용 시의 청각성은 리듬이라는 형식이 아니라 청각적 이미지와 청자의 태도라는 시의 행위를 주요한 기제로 삼는 것으로서, 내용적 측면에서 발생하는 청각성을 드러낸다. 정지용 후기시의 확장된 청각성은 적극적으로 듣는 행위를 통해 외부에서 발생하는 다양한 소리를 내부로 통합하며 듣는 감각을 하나의 사건으로 인지하고 외부 세계와 시적 화자의 내부를 연결 짓는 매개로 작용한다. 이 글에서는 중기에서 후기로 나아가는 변곡점에 있는 정지용 시편들을 꼽아 해당 시에서 나타나는 청각성과 그 변화의 흐름에 집중하여 정지용의 시적 세계를 다시 읽어낸다. 해당 작업을 통해 정지용 문학의 감각적 깊이를 한 층 더하면서 정지용 문학을 꿰뚫는 공통감각을 탐색하는 데에 기여할 수 있으리라 기대한다. This study analyzes the characteristic of the change in the sound images in Jeong, Ji-yong’s middle and late poetry. The majority of the sound images of his early poetry were composed of onomatopoeia and mimetic words, but then in later period, they had been transfigured into rather small and weak sounds. The change in the attitude of the poetic speaker, who now tries to listen to such sounds is also observed. Based on these grounds, this study aims to reveal that the auditory in Jeong, Ji-yong’s poetry has the resistance to the modernity, which had disciplined one’s body rhythm, and has allowed auditory in his poems to develop into an event of ‘sense’, the characteristic of post-modernism. There have been quite a researches about the vivid senses in Jeong, Ji-yong’s poems, yet, most of them tend to be interpreted with an emphasis on the principle of visuality in the frame of modernism in 1930’s Kyungsung. The visual-centered analyses, however, has not only restricted the interpretations on the transformation of the senses in Jeong, Ji-yong’s poetry, since the spatiotemporal characteristic of a colonial period make the poetic speaker fail to be a modern subject. They have not been allowed to capture the unique auditory characteristics of his poems. The exclusion of the auditory approach to the modern Korean poetry seems to be largely due to the separation from the reciting style of poems in the pre-modern era. However, the auditory characteristic of Jeong, Ji-yong’s poetry is not based on a poetic rhythm, but has auditory images and actions in poetry, such as the listener’s attitude, as the main mechanism, revealing the auditory feature in terms of content. The expanded auditory characteristic of Jeong, Ji-yong’s latter poems, integrating various sounds generated from the outside via listening, recognizes the listening as an event, and acts as a medium connecting the outside world with the inside of the poetic speaker. Thus, this study tries to reimagine Jeong, Ji-yong’s poems at the inflection points, from the middle to the latter in his literary, with the focus of the auditory characteristics. By this work, it is expected to be able to contribute to the exploration of the common theme that penetrate through Jeong, Ji-yong’s literature while expand the understanding of senses in his poems at the same time.

질식 자궁적출술이 질 전체 길이에 미치는 영향

김미라 ( Mi La Kim ),이원식 ( Won Sik Lee ),조연진 ( Joo Myung Kim ),김주명 ( Yeon Jean Cho ),주관영 ( Kwan Young Joo ),최규홍 ( Kyu Hong Choi ),이인국 ( In Kook Lee ),김재준 ( Jae Joon Kim ) 대한산부인과학회 2007 Obstetrics & Gynecology Science Vol.50 No.11

목적: 질식 자궁적출술을 시행받은 환자에서 수술이 질 길이에 미치는 영향에 대해 알아보고자 하였다. 연구 방법: 38개월의 기간 동안 한 명의 수술자에 의해 질식 자궁적출술을 시행 받은 환자 155명을 대상으로 연구를 하였다. 질식 자궁적출술시 질원개 탈출을 예방하기 위해 자궁천골인대의 상방 1.0~1.5 cm 부위와 질끝단을 재차 봉합하는 방법을 사용하였다. 환자의 임상적 특징 및 측정된 수술 전후의 질 전체 길이를 후향적으로 분석하였다. 결과: 술전에 측정된 평균 질 전체 길이는 7.32±0.84 cm였다. 수술 2개월 후, 평균 질 전체 길이는 7.42±0.77 cm로 길어졌으며 통계학적 유의성을 보였다 (P=0.045). 155명의 환자 중 81명은 술후 5개월에서 12개월 사이에 질 전체 길이가 다시 측정되었으며, 이들에서의 질 전체 길이는 술전과 비교하여 의미 있게 증가하였다 (7.3±0.82 cm vs 7.48±0.78 cm, P=0.011). 1년 이상의 기간이 지난 후에 다시 질 전체 길이가 측정된 환자는 30명이었으며, 이들에서도 질 전체 길이는 술전에 비해 의미 있는 증가를 보였다 (7.17±0.81 cm vs 7.46±0.66 cm, P=0.006). 결론: 질식 자궁적출술 후의 질 전체길이는 임상적인 의미는 미미하지만, 통계학적으로는 의미있는 증가를 보인다. Objective: The purpose of this study was to evaluate the impact of vaginal hysterectomy on total vaginal length (TVL). Methods: Retrospective analysis of 155 medical records of patients underwent vaginal hysterectomy by one surgeon with benign uterine pathology in the absence of prolapse between January 2004 and February 2007. After hysterectomy, uterosacral vaginal vault resuspension (anchoring to vaginal vault about 1.0~1.5 cm proximal at the ligament) was performed for prevention of vault prolapse. Patients` characteristics and TVL before and after surgery were evaluated. Results: Preoperative mean TVL was 7.32±0.84cm. At two months after the surgery, mean TVL was 7.42±0.77 cm. The change of vaginal length was statistical significance (P=0.045). Eighty-one patients were reevaluated at five to twelve months after surgery, mean TVL was longer than the preoperative results (7.3±0.82 cm vs 7.48±0.78 cm, P=0.011). We evaluated 30 patients who were followed at least 12 months after the surgery, the length was longer than the preoperative results, also (7.17±0.81 cm vs 7.46±0.66 cm, P=0.006). Conclusion: Although that appears to be statistically significant elongation of the total vaginal length after vaginal hysterectomy, the impact is unlikely to be clinically significant.

의료서비스에 대한 소비자만족과 기대불일치 모델의 검증

김미라 ( Kim Mi La ),이기춘 ( Lee Gi Chun ) 한국소비자학회 2004 소비자학연구 Vol.15 No.1

The purpose of this study was to develop the model of consumer satisfaction with medical services in the basis of expectation-disconfirmation theory. The major findings were as follows: 1. The level of consumer satisfaction with medical services was not high. The level of consumer satisfaction with physicians was the highest and the level with facilities was the lowest among the dimensions of the medical services. 2. In the model of the outpatient service, the performance of the personal aspects, the performance of the facilities, the perceived disconfirmation of the personal aspects and the perceived disconfirmation of the facilities had a casual effect. The performance of the facilities had the greatest casual effect among them. 3. In the model of the inpatient service, the performance of the personal aspects, the performance of the facilities and the perceived disconfirmation of the facilities had a casual effect. The performance of the facilities had the greatest casual effect among them.

Hysteroscopic management of cesarean section scar pregnancy(초)

김미라 ( Mi La Kim ),( Yeon Jean Cho ),( Bong Seok Kim ),( Won Sik Yoo ),( Jae Bum Yoon ),( Kwan Young Joo ),( Ho Won Han ),( Jong Young Jun ),( Joo Myung Kim ) 대한산부인과학회 2009 대한산부인과학회 학술대회 Vol.95 No.-

호스피스 자원봉사자의 죽음태도가 호스피스 자원봉사활동 참여태도와 지속의지에 미치는 영향 분석 : 대구·경북지역 호스피스 자원봉사자를 중심으로

김미라 ( Kim Mi La ),도수관 ( Doh Soogwan ) 한국사회복지정책학회 2018 사회복지정책 Vol.45 No.4

본 연구는 호스피스 기관에서 활동하고 있는 자원봉사자들을 대상으로 실시한 설문조사자료를 활용하여 호스피스 자원봉사자들의 죽음에 대한 태도가 호스피스 자원봉사활동 참여태도와 지속의지에 미치는 영향을 실증적으로 분석하였다. 본 연구의 주요 분석결과에 따르면, 호스피스 자원봉사자들이 죽음에 대해 부정적으로 인식할수록 그들의 호스피스 자원봉사활동 참여태도와 지속의지에 부정적인 영향을 미치는 것으로 나타났다. 아울러, 호스피스 자원봉사자의 대인관계가 좋을수록 자원봉사활동 참여태도와 지속의지에 긍정적인 영향을 미치는 것으로 나타났다. 본 연구의 이와 같은 분석결과는 호스피스 기관에서 활동하고 있는 자원봉사자들의 자원봉사활동 참여태도를 긍정적으로 전환하고 자원봉사활동 지속의지를 제고하기 위해서는 호스피스 자원봉사자들이 직면하거나 또는 경험하는 타인의 죽음에 대해 부정적인 인식을 갖지 않도록 하는 것이 중요함을 시사하고 있다. 따라서 호스피스 기관에서 활동하고 있는 자원봉사자들의 죽음에 대한 두려움과 부정적 인식을 긍정적으로 전환시키기 위해서는 향후 이들을 대상으로 인간의 죽음에 대한 인식과 관련된 다양한 교육 및 프로그램 운영을 적극적으로 실시할 필요성이 있다. This study seeks to empirically examine the impact of death attitude of hospice volunteers on their participation attitude and continuance will of volunteer activity. Results from empirical models, which are based on survey data analyses, indicate that a positive relationship exists between the hospice volunteers’ positive attitudes toward death and their active participation in hospice volunteering. This study also finds that the hospice volunteers’ positive attitudes toward death are positively related to their motivations for hospice volunteering and to their continuance will of hospice volunteer activity. Particularly, this study show that it is important for the hospice volunteers to maintain a good interpersonal relationship with other hospice volunteers because the good interpersonal relationship of hospice volunteers can be contributable to their active hospice volunteer participation and their continuance will of hospice volunteer activity. This study implies that there is an importance to putting a positive spin on negative attitudes toward death and dying for promoting active participation of the volunteers in hospice care and continuity of hospice volunteer activity. Thus, this study suggests that various death education programs for hospice volunteers need to be developed and offered to the hospice volunteers for putting a positive spin on negative attitudes of the volunteers toward death and dying.

GnRH agonist 사용 중 심한 자궁출혈 환자에서의 자궁의 모세혈관확장증

김미라 ( Mi La Kim ),김주명 ( Joo Myung Kim ),이원식 ( Won Sik Lee ),주관영 ( Kwan Young Joo ),이인국 ( In Kook Lee ),김혜선 ( Hye Sun Kim ),홍성란 ( Sung Ran Hong ) 대한산부인과학회 2008 Obstetrics & Gynecology Science Vol.51 No.1

Telangiectasis of the uterus is an extremely rare but life-threatening disease because of massive uterine bleeding. The usage of GnRH agonist can cause regression and atrophy of the endometrium through induction of hypoestrogenism by pituitary down-regulation. But there is no clear explanation or report in the literature showing the relationship between uterine telangiectasis and GnRH agonist usage. We have experienced a patient with uncontrolled massive uterine bleeding after GnRH agonist treatment, who needed emergency hysterectomy. Pathologic tissue examination showed telangiectasis of the endometrium and myometrium. This is the first case report of telagiectasis of the uterus without other organ involvement. We report this case with a brief review of the literatures.

초음파상 난관수종으로 오인된 거대수뇨관 증례 1 예

김미라 ( Kim Mi La ),고윤희 ( Go Yun Hui ),조연진 ( Jo Yeon Jin ),백준길 ( Baeg Jun Gil ),우혁준 ( U Hyeog Jun ),홍준식 ( Hong Jun Sig ),조준형 ( Jo Jun Hyeong ),주관영 ( Ju Gwan Yeong ) 대한산부인과학회 2004 Obstetrics & Gynecology Science Vol.47 No.2

The retroperitoneal space of the posterior abdomen and the pelvic retroperitoneum contain the major neural, vascular and lymphatic supply to the pelvic viscera, the urinary system and colorectal system. A pain or mass in the pelvis may arise primarily from the reproductive organs, but it may just as easily arise from the retroperitoneal space, include the urinary tract and the gastrointestinal tract. Therefore, the gynecologic surgeon should be aware of the various conditions associated with retroperitoneal mass and the correct management of these disorders. Hydroureter may misdiagnose as a pelvic mass or retroperitoneal mass. The cause of hydroureter is mainly secondary obstruction such as malignancy, idiopathic retroperitoneal fibrosis and pelvic disease but primary obstructive megaureter should be considered. This report describes a case of marked hydroureter, misdiagnosed as a hydrosalpinx by ultrasound.

급격히 악화된 예후를 보인 자궁경부에 발생한 악성 혼합뮐러종양

김미경 ( Mi Kyoung Kim ),김미라 ( Mi La Kim ),심정연 ( Jeong Yun Shim ),성석주 ( Seok Ju Seong ),윤보성 ( Bo Sung Yoon ),송태종 ( Tae Jong Song ),이효진 ( Hyo Jin Yi ),정용욱 ( Yong Wuk Jung ) 대한산부인과학회 2012 Obstetrics & Gynecology Science Vol.55 No.12

Malignant mixed Mullerian tumor (MMMT) is a type of cancer that contains two cell types known as the adenocarcinoma and sarcoma. MMMT is a rare malignant cancer of the genital tract and particularly the prevalence of MMMT in the cervix is extremely rare. Due to the rare incidence of MMMT in cervix, its treatment has unestablished guidelines and has unclear prognosis. Based on the previous data, the prognosis of MMMT in the cervix is better than the prognosis of uterine MMMT. Here, we are reporting a case of cervix MMMT that is rapidly progressive with an extremely poor prognosis, which contradicts the previous data.

자궁경수술로 성공적으로 치료된 점막하 낭성자궁선근종 2예

김남숙 ( Nam Sook Kim ),김주명 ( Joo Myung Kim ),김미라 ( Mi La Kim ),이시원 ( Si Won Lee ),주관영 ( Kwan Young Joo ),김혜선 ( Hye Sun Kim ),김희숙 ( Hy Sook Kim ),홍성란 ( Sung Ran Hong ) 대한산부인과학회 2009 Obstetrics & Gynecology Science Vol.52 No.2

Two women presented with history of vaginal bleeding and abnormal transvaginal ultrasound findings. Saline infusion sonohysterography was done for preoperative evaluation and this imaging study revealed centrally located uterine mass with internal cystic portion. Our initial impression was submucosal myoma with cystic degeneration and hysteroscopic removal of the mass was performed. During the procedure, dark brownish cystic fluid was drained. The excised submucosal mass was pathologically diagnosed as adenomyosis and clinically as submucosal adenomyotic cyst. Submucosal adenomyotic cyst should be part of the differential diagnosis of submucosal uterine masses with cystic portion. We report two cases of submucosal adenomyotic cyst successfully treated with hysteroscopic resection and brief review on this topic.