임신능이 확인된 가임 여성에서의 Deciduosis의 유병율

김미란,유영옥,노덕영,류순원,권동진,김장흡,김진홍,임용택,김은중,정재근,이진우,Kim, Mee-Ran,Lew, Young-Oak,Ro, Duck-Yeong,Ryu, Sun-Won,Kwan, Dong-Jin,Kim, Jang-Heub,Kim, Jin-Hong,Lim, Yong-Taik,Kim, Eun-Jung,Jung, Jae-Keun,Lee, Jin-Woo 대한생식의학회 2000 Clinical and Experimental Reproductive Medicine Vol.27 No.4

Objective: Extrauterine formation of decidua of stromal cells has been well described, particularly in the cervix and ovary. The apparent hormonal mechanisn of this phenomenon suggestes a relationship to endometriosis. Whether formation of ectopic decidua represents a marked progestational response of endometriosis or an independent peritoneal-stromal reaction to pregnancy is unclear. This study was designed to determine the prevalence of deciduosis in the patients whose fertility were proven. Design: Prospective study of patients who had undergone cesarean delivery without history of endometriosis. Materials and Methods: The study was performed in 179 full tenn pregnant women. During the cesarean section, the pelvic organs were thoroughly investigated and the biopsies were collected at the lesions suspicious endometriosis. And then microscopic examination of removed tissues were done. Results: Of the 179 patients who underwent cesarean delivery, 48 women (26.8%) had the lesions suspicious endometriosis such as adhesion, pigmented spots. The ovary was the most frequently ocurred site (79.2%). Microscopically, decidual cells were observed in 34 cases (70.8%) of 48 biopsed patients. Conclusion: Endometriosis has been known to be associated with subfertility. Our observations found the prevalence of deciduosis was 19.0% (34/179) in tenn pregnant women whose fertilites were proven. We suggests that the deciduosis maya manifestation of endometriosis during pregnancy. However, further follow up study should be done to confirm this clinicopathologic process.

난소기능평가를 위한 Gonadotropin Releasing Hormone Agonist Stimulation Test (GAST)의 효용성에 관한 연구

김미란,송인옥,연혜정,최범채,백은찬,궁미경,손일표,이진우,강인수,Kim, Mee-Ran,Song, In-Ok,Yeon, Hye-Jeong,Choi, Bum-Chae,Paik, Eun-Chan,Koong, Mi-Kyoung,Song, Il-Pyo,Lee, Jin-Woo,Kang, Inn-Soo 대한생식의학회 1999 Clinical and Experimental Reproductive Medicine Vol.26 No.2

Objectives: The aims of this study are 1) to determine if GAST is a better indicator in predicting ovarian response to COH compared with patient's age or basal FSH level and 2) to evaluate its role in detecting abnormal ovarian response. Design: Prospective study in 118 patients undergoing IVF-ET using GnRH-a short protocol during May-September 1995. Materials and Methods: After blood sampling for basal FSH and estradiol $(E_2)$ on cycle day two, 0.5ml (0.525mg) GnRH agonist ($Suprefact^{(r)}$, Hoechst) was injected subcutaneously. Serum $E_2$ was measured 24 hours later. Initial $E_2$ difference $({\Delta}E_2)$ was defined as the change in $E_2$ on day 3 over the baseline day 2 value. Sixteen patients with ovarian cyst or single ovary or incorrect blood collection time were excluded from the analysis. The patients were divided into three groups by ${\Delta}E_2$; group A (n=30):${\Delta}E_2$<40 pg/ml, group B (n=52): 40 pg/ml${\leq}{\Delta}E_2$<100 pg/ml, group C (n=20): ${\Delta}E_2{\leq}100$ pg/ml. COH was done by GnRH agonist/HMG/hCG and IVF-ET was followed. Ratio of $E_2$ on day of hCG injection over the number of ampules of gonadotropins used ($E_2hCGday$/Amp) was regarded as ovarian responsiveness. Poor ovarian response and overstimulation were defined as $E_2$ hCGday less than 600 pg/ml and greater than 5000 pg/ml, respectively. Results: Mean age $({\pm}SEM)$ in group A, B and C were $33.7{\pm}0.8^*,\;31.5{\pm}0.6\;and\;30.6{\pm}0.5^*$, respectively ($^*$: p<0.05). Mean basal FSH level of group $A(11.1{\pm}1.1mlU/ml)$ was significantly higher than those of $B(7.4{\pm}0.2mIU/ml)$ and C $(6.8{\pm}0.4mIU/ml)$ (p<0.001). Mean $E_2hCGday$ of group A was significantly lower than those of group B or C, i.e., $1402.1{\pm}187.7pg/ml,\;3153.2{\pm}240.0pg/ml,\;4078.8{\pm}306.4pg/ml$ respectively (p<0.0001). The number of ampules of gonadotropins used in group A was significantly greater than those in group B or C: $38.6{\pm}2.3,\;24.2{\pm}1.1\;and\;18.5{\pm}1.0$ (p<0.0001). The number of oocytes retrieved in group A was significantly smaller than those in group B or C: $6.4{\pm}1.1,\;15.5{\pm}1.1\;and\;18.6{\pm}1.6$, respectively (p<0.0001). By stepwise multiple regression, only ${\Delta}E_2$ showed a significant correlation (r=0.68, p<0.0001) with $E_2HCGday$/Amp, while age or basal FSH level were not significant. Likewise, only ${\Delta}E_2$ correlated significantly with the number of oocytes retrieved (r=0.57, p<0.001). All four patients whose COH was canceled due to poor ovarian response belonged to group A only (Fisher's exact test, p<0.01). Whereas none of 30 patients in group A (0%) had overstimulation, 14 patients among 72 patients (19.4%) in group B and C had overstimulation (Fisher's exact test, p<0.01). Conclusions: These data suggest that initial $E_2$ difference after GAST may be a better prognostic indicator of ovarian response to COH than age or basal FSH level. Since initial $E_2$ difference demonstrates significant association with abnormal ovarian response such as poor ovarian response necessitating cycle cancellation or overstimulation, GAST may be helpful in monitoring and consultation of patients during COH in IVF-ET cycle.

교육기회의 메리토크라시 구조 ― 대학 유형과 서열별 진학기회를 중심으로 ―

김미란(Kim Mee-Ran) 고려대학교 교육문제연구소 2004 敎育問題硏究 Vol.0 No.20

본 연구는 한국의 대학생 조사를 통해 교육기회 구조를 실증적으로 분석한 것이다. 고등교육 기회에는 부모의 직업과 학력 등의 사회계층에 따른 불평등이 존재하며 특히 학업성적으로 좌우되는 대학 유형과 서열별 진학기회에도 부모의 사회계층요인이 작용하고 있음을 알 수 있었다. 이를 성별로 분석하면 고등교육 진학기회 뿐 아니라 대학 유형별·서열별 진학기회에 대한 출신 계층의 영향력은 남자보다 여자에게 강하게 나타난다. 특히 지방 출신의 여학생은 지방 출신의 남학생보다 서울 소재의 유명대학에 진학하는 기회가 적어 성에 따른 교육기회의 차별적 구조를 형성하고 있음을 알 수 있었다. 이 같은 분석을 통해 고등교육기회의 계층간 불평등 구조를 밝히고 교육기회의 성차에 대한 메카니즘을 시사했다는 점에서 중요한 의의를 찾을 수 있을 것이다. This paper analysis the structure of educational opportunities in South-Korea, Which has strong tradition of Confucianism and is famous for intense competition for admission to colleges and universities. In line with analysis of inquiry to college and university students in Seoul, it investigates how inequality in educational opportunities remains in South-Korean society in which the equal opportunities seem to be growing. The main findings are as follows : 1) in spite of popularization of higher education, there still remains inequality in educational opportunities due to social class of a student portrayed by job and educational background of his/her parents: and 2) the social class affects admission opportunities for college and university types ranked by the student's individual abilities in accordance with their school performance, the is, by merit. It is confirmed that inheritance of a mechanism reproducing the social class exists in the system of higher education of which opportunities are thought to be offered to everybody based on the meritocratic principle. However, 3) the Knowledge is gained that a factor of merit-that is, one's ability rather than that of the social class-dominates admission of male students the top universities in accordance with a mechanism that excellent male students from local towns and villages can enter top universities even though they belong to lower classes. Therefore, the result that a factor of the social class has strong effect on educational opportunities for female students is acquired. In spite of the fact that differences in educational opportunities and their correlation with the social class emerge from discrepancy between the two genders, mechanism how and why the differences that come out have been hardly studied. Therefore, the kind of previously overlooked viewpoint on female students considered in this paper may shed light on various aspects of gender studies in addition to studies of educational opportunities and social class.

복강경 수술로 진단된 이소성 난소, 난소 기형종

김미란 ( Mee Ran Kim ),김장흡 ( Jang Heub Kim ),조현희 ( Hyun Hee Jo ),유영옥 ( Young Ok Lew ),정윤지 ( Youn Jee Chung ),김동식 ( Dong Sik Kim ) 대한산부인과학회 2010 Obstetrics & Gynecology Science Vol.53 No.12

The ectopic ovary is a rarely reported gynecologic entity. A variety of synonymous terms have been used to describe this condition, such as supernumerary ovary, accessory ovary, and ovarian implant syndrome. The etiology of ectopic ovary is poorly understood. The ectopic ovaries may occur in two ways. First, in the embryonic theories, they are believed to result from abnormal separation of a small portion of the developing and migrating ovarian primordium. Second, the accessory ovary can occur from acquired conditions such as inflammation and operations. In this report, we describe a case of the ectopic ovary with a mature cystic teratoma autoamputated into the cul-de-sac and subsequently diagnosed by laparoscopy.

난소의 세포자멸사에 있어 Bcl-2 Family Member의 역할

김미란 ( Mee Ran Kim ),김진홍 ( Jin Hong Kim ) 대한폐경학회 2004 대한폐경학회지 Vol.10 No.3

산화자극을 가한 세포의 성장 및 미토콘드리아 DNA의 손상에 미치는 에스트로겐의 항산화효과

김미란 ( Mee Ran Kim ),조현희 ( Hyun Hee Jo ),황성진 ( Sung Jin Hwang ),권동진 ( Dong Jin Kwon ),김장흡 ( Jang Heub Kim ),임용택 ( Yong Taik Lim ),유영옥 ( Young Ok Lew ),김은중 ( Eun Jung Kim ),이진우 ( Jin Woo Lee ),김진홍 ( Jin 대한폐경학회 2003 대한폐경학회지 Vol.9 No.4

목적: 산소에서 유리된 자유기가 나이와 관련된 노화나 만성질환을 유발하는 것으로 알려져왔다. 본 연구는 에스트로겐이 과산화수소에 의한 산화자극에 대한 항산화작용이 있는지 알아보고자 하였다. 연구방법: 인간 상피세포인 293 세포에 200 nM, 400 nM 농도의 과산화수소를 5분에서 60분 가하였다. 에스트로겐 전처리군은 10^(-6) M의 17-βestradiol을 산화자극 24 시간 전에 배양했다. 세포 생존율은 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide reduction을 이용했고 형태적 변화는 Hoescht 33342 염색이나 Acridine orange/Ethidium bromide 염색에서 에스트로겐 전처리 군에서 세포의 아폽토시스가 적게 관찰되었다. 역전사 중합효소 연쇄반응을 이용한 미토콘드리아 DNA의 발현은 과산화수소에 의한 자극에 감소는 것을 보였지만 에스토로겐을 전처리 한 군에서는 감소되지 않았다. 산화수소에 의한 산화자극이 미토콘드리아 DNA에 미치는 영향이 핵의 DNA에 미치는 영향보다 크며 에스트로겐 전처리군에서 과산화수소에 의한 산화자극에 의한 미토콘드리아 DNA의 손상이 적은 것으로 나타났다. 결론: 에스트로겐은 과산화수소에 의한 산화자극에 대해 항산화작용이 있으며, 산화자극에 대해 미토콘드리아 DNA의 손상을 보호하는 작용이 있다. Objectives: Oxygen-derives free radicals are responsible for the age-associated impairment at the cellular and tissue levels, The objective of this study investigate the antioxidant and protective properties of estrogen in human epithelial cells following oxidative stress. Methods: The 293 cells pretreated with 10^(-6) M 17-β estradiol for 24 hours prior to addition of the 200 nM, 400 nM if hydrogen peroxide for 5 to 60 min. Cell viability was assayed by 3-(4-5-dimethylthiazol-2-yl)-2, 5-diphenyl tetrazolium bromide reduction. RT-PCR was used examine the formation hydrogen peroxide-induced DNA damage in a 16.2kb mitochondrial fragment and an 17.7-kb fragment flanking the β-globin gene. Results: Preincubation of the cell with 10^(-6) M 17-β estradiol prior to addition of the oxidative stress prevented oxidative stress-induced cell damage by hydrogen peroxide. At DNA level, 17-β estradiol more inhibited the mitochondrial DNa damage than the nuclear DNA damage. Conclusion: The study demonstrate a potent protective activity of the antioxidant 17-β estradiol from oxidative stress. Estradiol can protect hydrogen peroxide-induced cell damage and mitochondrial DNA damage.

난소의 생식세포 Apoptosis에 대한 JNK1과 JNK2의 역할

김미란 ( Mee Ran Kim ),최윤경 ( Yoon Kyong Choi ),송재연 ( Jae Yen Song ),신현미 ( Hyun Mi Shin ),정재은 ( Jae Eun Chung ),임용택 ( Young Taik Lim ),김장흡 ( Jang Heub Kim ),김진홍 ( Jin Hong Kim ),유영옥 ( Young Oak Lew ) 대한폐경학회 2007 대한폐경학회지 Vol.13 No.3

연구목적: 난자와 난포 과립막세포가 외부 자극에 대하여 JNK의 발현에 어떠한 영향을 미치는지 알아보고, JNK 유전자 중 JNK1이나 JNK2가 결핍된 마우스를 이용하여 난자와 과립막세포의 apoptosis에 대한 JNK유전자의 역할을 규명하고자 하였다. 연구재료 및 방법: 생후 21∼24일의 C57BL/6 마우스를 이용하여 과배란 유도를 통해 난자를 채취하여 자외선 조사 후 phospho-JNK에 대한 면역세포화학법을 시행했다. 과립막세포를 배양하고 자외선 조사 후 단백질을 추출하여 웨스턴블롯을 시행했다. Hepa 1c1c7 cell도 위와 같은 방법으로 웨스턴블롯팅을 시행하였다. JNK1이나 JNK2 유전자 결핍 마우스에서 난자의 apoptosis의 차이를 알기 위해 난소 전체의 난자의 수를 비교하였다. 과립막세포를 자외선 조사 2시간, 4시간, 6시간 후 고정하고 Hoescht 33342로 염색 후 현광현미경으로 핵의 형태를 관찰하여 apoptosis 여부를 판별했다. 결과: 자외선 조사 후 난자에서 인산화 JNK에 대한 면역세포화학염색 반응이 대조군에 비하여 현저히 증가되었다. Hepa 1c1c7 cell에서는 자외선 조사 후 인산화 JNK의 발현이 나타나지 않았으나 과립막 세포에서는 자외선 조사 30분 후 각각 55 kD와 46 kD의 인산화 JNK의 단백이 발현되었다. JNK1 유전자 결핍 마우스의 난소에서 총 난자의 수와 원시난포의 수는 출생 후 제 4일과 제 42일 정상 마우스에서와 유의한 차이가 없었다. JNK2의 경우도 JNK2 유전자 결핍 마우스의 난소에서 총 난자의 수와 원시난포의 수가 정상 마우스에서와 유의한 차이를 보이지 않았다. 자외선 조사에 의한 과립막세포의 apoptosis는 대조군의 13.0±3.3%에서 자외선 조사 2시간 후에 22.2±12.8%, 4시간 후에 32.0±10.4%, 6시간 후에 42.9±11.3%로 관찰되었다. JNK1 유전자 결핍 마우스의 난포 과립막 세포는 대조군의 10.5±4.1%에서 2시간 후에 18.3±9.1%, 4시간 후에 24.8±9.1%, 6시간 후에 29.5±12.4%의 apoptosis를 보여 부분적으로 apoptosis에 대한 보호작용이 있는 것으로 보였지만, 통계적인 의미가 없었다. JNK2 유전자 결핍 마우스에서도 정상 마우스에서의 apoptosis와 유의한 차이가 없었다. 결론: JNK는 포유동물의 세포 생리작용에 중요한 매개체로서 세포의 증식, 생존, 사망, DNA의 대사에 다양하게 작용하며 향후 치료적 표적으로 중요한 역할을 할 것으로 기대된다. JNK는 마우스의 난자와 과립막 세포에서 자외선 조사에 의해 특이적으로 활성화 되었다. JNK1이나 JNK2 유전자결핍 마우스를 이용한 연구 결과를 통하여 마우스의 난소에서 JNK1과 JNK2는 상호보완적으로 작용함으로 특이한 표현형을 발견할 수 없었다. 이러한 연구 결과는 향후 폐경 전 여성에서 비정상적으로 가속화되는 난자 고갈에 대한 JNK의 역할을 규명하는데 도움을 줄 수 있을 것이며 노화로 인한 자연적인 난소기능의 퇴화기전을 밝히는데 도움이 될 것으로 생각한다. Objectives: Each female is endowed with a finite numbers of oocytes, which when depleted leads to ovarian senescence, the menopause. The objective of this study was to investigate the role of JNK1 and JNK2 in murine ovarian germ cell apoptosis. Methods: Murine oocytes were retrieved by superovulation of female C57BL/6 mice at the age of 21∼24 days. At 10 minutes after UV irradiation, immunocytochemistry was performed. Ovarian granulosa cells were cultured from antral follicles. At the 24 hours of the culture period, UV was irradiated on culture dishes. After 30 minutes, protein was extracted and western blotting done. Same procedures were performed with Hepa 1c1c7 cells. Serial ovarian sections (8μm) were stained with modified Lee`s picric methyl blue, and we estimated the numbers of oocyte-containing primordial, primary and small preantral follicles of female mice at day 4 and day 42 postpartum. Ovarian granulosa cells were cultured from female wild-type and JNK1-/-or JNK2-/-mice. The granulosa cells were fixed at 2, 4, 6 hours after UV irradiation and stained with Hoescht 33342, and then evaluated for characteristics of apoptosis under fluorescence microscopy. Results: After UV irradiation, oocytes showed intense signal of phospho-JNK. In ovarian granulosa cells, JNK was activated to phospho-JNK after UV irradiation, but not in Hepa 1c1c7 cells. There was no difference in oocyte counts between wild type and JNK1-/-or JNK2-/-at day 4 and day 42 postpartum. The incidence of apoptosis of ovarian granulosa cells from wild type were 13.0±3.3%, 22.2±12.8%, 32.0±10.4%, 42.9±11.3% after 0, 2, 4, 6 hour of UV irradiation, respectively. The incidences were 10.5±4.1%, 18.3±9.1%, 24.8±9.1%, 29.5±12.4%, respectively in granulosa cells from JNK1-/-mice. These results showed only a partial suppression of apoptosis in granulosa cells from JNK1-/-mice, however, it was not statistically significant. There was no significant difference in the rate of apoptosis of granulosa cells after UV irradiation between wild type and JNK2-/-mice. Conclusion: JNK1 and JNK2 are recognized as critical regulators of various aspects of mammalian physiology, including cell proliferation, cell survival and cell death. This study showed that UV irradiation caused activation of JNK in murine oocytes and granulosa cells of ovary. In murine ovary, JNK1 and JNK2 may be redundant or have compensatory role to each other in apoptosis. These findings may help to elucidate the one of mechanisms for acceleration of oocyte depletion in women with premature menopause.

일본의 평생학습정책의 전개와 실천 - 지역재생 정책을 중심으로 -

김미란(Kim Mee-Ran) 한국평생교육학회 2005 평생교육학연구 Vol.11 No.2

일본사회는 출산율의 저하로 인한 소자녀화, 고령화 사회의 진전과 세계화, 정보화 등의 지식기반 산업사회의 도래로 평생학습을 통한 국가경쟁력 강화 방안을 추진하고 있다. 특히 지역사회의 기반이 약화되고 있는 상황에서 생애학습을 키워드로 지역사회의 활성화를 도모하고 있다. 일본의 생애학습을 통한 지역재생정책의 특징으로는 첫째, 정규학교를 포함한 전생애(life-long), 통생애(life-wide)에 걸친 지역 생애학습 시책을 강력하게 추진하고 있으며, 둘째, 범부처적인 차원에서 각 부처간의 연계, 중앙과 지방의 연계를 강화하고, 셋째, 소외계층에 대한 학습기회의 확대를 들 수 있다. 넷째로는 이 모든 활동을 지역 NPO 등과 같은 공공의 시점에서 추진하여 주민참여를 유도하고 있으며, 다섯째로는 상호학습, 혹은 학습공동체 활동의 학습 코디네이터 역할을 담당할 수 있는 지역리더양성을 통해 지역 활성화를 꾀하고 있다는 점을 특징으로 들 수 있다. 학교이외에서 실시되는 사회교육 뿐 아니라 가정과 학교를 아우르는 일본의 평생학습 정책과 그 구체적인 실천 사례는 우리 나라의 평생학습정책을 제고하는 데 있어 많은 시사점을 함축하고 있다. Amid the increasingly prevalent social tendencies toward having a small number of children and of an aging population in recent years and the advent of a knowledge-based society characterized by globalization and informatization, Japan is striving to achieve a lifelong learning society. In particular, in an era where the foundation of local communities is weakening, Japan is pushing for a number of community revival campaigns through lifelong learning in order to promote revitalization of local communities. The major characteristics of these campaigns are as follows: First, Japan is strongly pushing for a local lifelong learning policy encompassing both life-long and life-wide aspects, which include formal education. Second, Japan is strengthening linkages not only among central government ministries in an inter-ministry manner, but also between the central and local governments. Third, Japan is making a concerted effort to expand learning opportunities for the underprivileged. Fourth, Japan is implementing all these activities from public perspectives through active self-directed participation of local NPOs. Finally Japan tries to promote the vitality of a community through the training of community leaders who can play the role of learning coordinators. This lifelong learning policy being applied in Japan provides valuable ideas for uplifting Korea’s lifelong learning policy.

유연한 표면에 대한 동적 프로젝션 맵핑을 위한 적외선 마커 생성 방법

김미란(Mee ran Kim),박진호(Jin ho Park) 인문사회과학기술융합학회 2018 예술인문사회융합멀티미디어논문지 Vol.8 No.10

최근 몇 년 동안 동적 프로젝터 기반 증강현실은 많은 주목을 받아 왔다. 본 논문에서는 자유도가 높은 변형 가능한 표면을 탐지하고 실시간으로 이미지를 투사하여 정합하는 기술을 제안한다. 현재 변형 가능한 물체에 대한 프로젝션 맵핑 기술은 빛의 영향과 미세한 음영 혹은 노이즈 문제로 마커인식 오류가 나타난다. 이로 인해 목표물과 투사 된 이미지 사이 정확히 정합을 못하는 문제가 발행한다. 따라서 마커 탐지 정확도가 전반적으로 시스템의 성능을 결정한다. 이를 위해, 본 논문에서는 마커의 특징을 높이고 미리 학습한 특징과 비교하며 분류하는 방법으로 마커 탐지 정확도를 높여 실제 산업에서도 적용할 수 있게 하기 위함이다. 우리는 구별이 명확한 4가지 패턴으로 이루어진 마커를 디자인하였다. 시간별로 변형 가능한 표면에 대한 인지를 목표로 하므로 패턴들을 꼭지점으로 하는 메쉬를 재구성하고, 재구성된 메쉬에 텍스쳐를 맵핑함으로써 3차원 표면 인지 문제를 2차원 메쉬 생성 문제로 재해석한다. In recent years, dynamic projector-based augmented reality has attracted much attention. In this paper, we propose a technique to detect deformable surfaces with high degrees of freedom and project images in real time. Projection mapping techniques for currently deformable objects have marker recognition errors due to light effects and microscopic shading or noise issues. This causes a problem that the target and the projected image can not be precisely matched. Thus, the accuracy of marker detection generally determines the performance of the system. In this paper, we aim to improve the accuracy of marker detection and to apply it in real industry by enhancing the characteristics of markers and comparing them with previously learned features. We designed a marker with four distinct patterns. To recognize the deformable surface over time, we reconstruct the meshes with vertices of the patterns and map the texture to the reconstructed meshes to reinterpret the 3D surface recognition problem as a two dimensional mesh generation problem.

Ceramidase 억제가 난소 과립막 세포 사멸에 미치는 영향

김미란 ( Mee Ran Kim ),정재은 ( Jae Eun Chung ),이정원 ( Chung Won Lee ),조현희 ( Hyun Hee Jo ),황성진 ( Sung Jin Hwang ),권동진 ( Dong Jin Kwon ),유영옥 ( Young Ok Lew ),임용택 ( Young Taik Lim ),김장흡 ( Jang Heub Kim ),김은중,이 대한폐경학회 2004 대한폐경학회지 Vol.10 No.4