체외수정을 통한 대리모 출산에 대한 인식 조사

박준철,김종인,이정호,Park, Joon-Cheol,Kim, Jong-In,Rhee, Jeong-Ho 대한생식의학회 2007 Clinical and Experimental Reproductive Medicine Vol.34 No.2

목 적: 뮬러관 기형과 같이 자궁이 없는 환자들에 있어 시행되어지는 체외수정을 통한 대리모 출산에 대한 사회적 인식을 조사하기 위하여 이 연구를 계획하였다. 연구방법: 본원 산부인과를 방문한 불임 환자 및 본원에 근무하는 간호사, 사무직 여직원을 대상으로 설문지 조사를 통하여 이루어졌다. 배포된 설문지 중 회수된 211명, 즉 불임 환자 60명을 포함하여 기혼 여성이 152명, 미혼 여성이 58명을 대상으로 하였다. 대리모에 찬성한 군과 반대한 군으로 나누어 윈도우용 SPSS 10.0을 이용하여 Pearson x$^2$ test, Fisher's exact test 등으로 비교하였으며 통계적인 유의성의 판정은 p-value<0.05를 기준으로 하였다. 결 과: 전체 응답자 중 17명 (8.1%)만이 자궁이 없는 불임여성의 대리모 시술에 찬성하였으며, 125명 (59.2%)에서는 입양을 선택하였다. 대리모에 찬성하는 군은 반대한 군에 비하여 나이, 결혼 여부, 교육 정도, 수입 정도뿐만 아니라 불임 여부에 따라서도 유의한 차이가 없었다. 그러나 종교에 따라서는 기독교인에게서 찬성률이 유의하게 높았다 (p=0.023). 대리모의 대상으로는 혈연관계가 아닌 제 3자를 선택한 경우가 66.5%로 가장 많았고 친구가 0.6%로 나타났으며, 혈연관계로는 자매 24.5%, 시누이 3.9%이었으며 어머니를 선택한 경우도 4.5% 있었다. 결 론: 체외수정을 통한 대리로 출산은 뮬러관 기형과 같은 자궁이 없는 불임 부부에게는 분명한 치료 방법이 될 수 있지만, 본 연구에서 보듯이 한국 사회에서는 부정적인 시각이 더 많다고 하겠다. 앞으로 광범위 의식 조사가 이루어진 뒤, 이 시술에 대한 의사의 역할 및 여러 문제에 관한 법적, 윤리적 지침이 마련되어야 할 것으로 생각된다. Objectives: The aim of this study was to find out the attitude of Korean women towards IVF surrogacy which is not yet regulated by the law. Methods: We evaluated with a questionnaire, in how far IVF surrogacy was accepted in different groups of Korean women. Total 300 questionnaires were sent out to women who visited our infertility clinic, and to the nurses and office workers of our hospital. Among them, 246 questionnaires were returned, and 211 of them (85.7%) were complete and analyzed. The responders were 58 unmarried women and 153 married women including 60 infertile patients. Results: Only 17 (8.1%) women believed that IVF surrogacy was an acceptable treatment for infertile women without uterus (eg. MRKH or hysterectomized patients), and 125 (59.2%) women chose the adoption. There were no significant differences in response amongst different age group, marital status, or in relation to income level or educational level, or infertility status. A significantly higher level of acceptance was noted only in religious groups, especially in Christians. Most of responders (66.5%) chose unrelated and unknown women as a desirable host, and 28.4% of responders chose the sister or sister-in-law. Conclusions: Overall the different groups were critical towards IVF Surrogacy in Korea, irrespective of the infertile patient group. Despite the established clinical ability to have her own genetic child in women without uterus, this survey reveals that only minority supports the IVF surrogacy. So we need the survey with large, randomized population and then make a regulation about the IVF surrogacy in law.

P2P 오버레이 네트워크에서의 능동적 공격에 대한 방어

박준철,Park Jun-Cheol 한국통신학회 2006 韓國通信學會論文誌 Vol.31 No.4c

피어-투-피어(P2P) 네트워크는 개방적, 평면적, 자율적 특성으로 인하여 참여 피어들의 악의적인 공격에 근원적으로 취약하다. 본 논문에서는 부트스트래핑(bootstrapping) 단계 및 온라인 단계에서의 악의적 피어들의 공격을 효율적으로 방어하는 문제를 다룬다. 본 논문은 부트스트래핑 단계에서 네트워크의 신뢰성 있는 노드를 이용하여 새로 가입하는 피어에게 ID 관련 정보를 안전하게 부여하는 멤버쉽 처리 프로토콜을 제시한다. 이 신뢰성 있는 노드들은 새로운 피어들이 네트워크에 참여할 때만 사용되곤 그 이외의 P2P 동작에는 관여하지 않는다. 온라인 단계에서의 공격에 대하여 본 논문에서는 P2P 오버레이를 통해 전송되는 메시지의 구조를 제안하여, 메시지 변경, 재생 공격 및 잘못된 정보를 가지는 메시지 공격들의 검출이 용이해지도록 한다 제안한 기법들은 함께 적용되어 악의적 피어들의 속임수를 억제함으로써 피어들로 하여금 네트워크의 프로토콜을 준수하게 만든다. 제안 기법들은 기본적 P2P 오버레이 모델을 가정하여 비구조적 및 구조적의 다수 P2P 네트워크들에 적용될 수 있다. A peer-to-peer(P2P) network is inherently vulnerable to malicious attacks from participating peers because of its open, flat, and autonomous nature. This paper addresses the problem of effectively defending from active attacks of malicious peers at bootstrapping phase and at online phase, respectively. We propose a secure membership handling protocol to protect the assignment of ID related things to a newly joining peer with the aid of a trusted entity in the network. The trusted entities are only consulted when new peers are joining and are otherwise uninvolved in the actions of the P2P networks. For the attacks in online phase, we present a novel message structure applied to each message transmitted on the P2P overlay. It facilitates the detection of message alteration, replay attack and a message with wrong information. Taken together, the proposed techniques deter malicious peers from cheating and encourage good peers to obey the protocol of the network. The techniques assume a basic P2P overlay network model, which is generic enough to encompass a large class of well-known P2P networks, either unstructured or not.

불임 검사시 자궁난관 조영술의 진단 정확도

박준철,김종인,이정호,Park, Joon Cheol,Kim, Jong In,Rhee, Jeong Ho 대한생식의학회 2005 Clinical and Experimental Reproductive Medicine Vol.32 No.3

Objective: This study was performed to evaluate the accuracy of hysterosalpingography (HSG) for evaluating female infertility patients by comparison with hysteroscopic and laparoscopic examination. Methods and Material: Total 219 infertile patients were retrospectively analyzed between January 1, 2002 and December 31, 2003. Ninety seven patients (44.3%) were primary infertility, 122 patients (55.7%) were secondary infertility. We performed hysteroscopic and laparoscopic examination on next cycle when HSG revealed any abnormal finding, and 3~6 cycles later if HSG was normal. Results: The accuracy of HSG was 65.2% compared with hysteroscopic examination (sensitivity 88.4%, specificity 46.4%, false positive rate 53.6%, false negative rate 11.6%). The most common abnormal finding of hysteroscopy was uterine synechia (67.4%) followed by endometrial polyp, uterine anomaly (e.g. uterine septum), endometrial hyperplasia. Compared with laparoscopic examination, the accuracy of HSG was 76.9% (sensitivity 98.9%, specificity 70.6%, +LR 3.36, -LR 0.02). The positive predictive value of normal patent tube was excellent (99.6%) but that of proximal tubal blockage was only 46.7%. The unilateral tubal obstruction of HSG was poor accuracy (+LR 3.85 -LR 0.68) and 70% of those was patent by laparoscopic examination. Laparoscopic examination also revealed that 53% of patients had peritubal adhesion and 37% of patients has additional pelvic findings, especially endometriosis. Among the patients had normal HSG, 53.5% patients with normal ultrasonography was diagnosed endometriosis (25.6% of them had endometriosis stage I-II). Conclusion: Normal HSG shows a high negative predictive value. Nevertheless, the incidence of associated pelvic disease in the normal HSG group is high enough to warrant diagnostic laparoscopy if nonsurgical treatment is unsuccessful. Because HSG has poor accuracy in predicting distal tubal blockage and peritubal adhesion, and poor positive predictive value of proximal tubal blockage, laparoscopic examination could be considered in abnormal HSG group.

신이론 신기술: 돼지사료에 공액리놀레산(CLA)의 첨가급여 효과

박준철,Park, Jun-Cheol 한국사료협회 2011 飼料 Vol.50 No.-

난관수종액이 생쥐 배아발달에 미치는 영향

박준철,김정아,김동자,배진곤,김종인,이정호,Park, Joon-Cheol,Kim, Jeong-A,Kim, Dong-Ja,Bae, Jin-Gon,Kim, Jong-In,Rhee, Jeong-Ho 대한생식의학회 2010 Clinical and Experimental Reproductive Medicine Vol.37 No.2

목 적: 난관수종액내의 사이토카인 농도를 측정하고, 사이토카인 농도가 다른 난관수종액을 이용하여 생쥐 배아 발생에 미치는 영향을 비교하고자 하였다. 연구방법: 난관수종액은 자궁난관 조영술에서 난관수종이 진단되어 복강경을 통한 난관 절제술을 시행하는 경우 난관 절제술 전에 난관으로부터 채취한 다음 3,000 rpm에서 10분간 원심분리시킨 후 상층액만을 $-20^{\circ}C$에서 보관하였다. 난관수종액의 사이토카인의 조성 및 농도를 확인하기 위하여 interleukin (IL)-$1{\alpha}$, IL-$1{\beta}$, IL-2, IL-4, IL-6, IL-8, IL-10, tumor necrosis factor (TNF)-$\alpha$, interferon (IFN)-$\gamma$, vascular endothelial growth factor (VEGF), epidermal growth factor (EGF), monocyte chemotactic protein (MCP)-1 등을 ELISA 방법으로 측정하였다. 기본 배양액에 난관수종액을 5%, 10%, 30%의 비율로 첨가하여 각 군별로 배반포로의 발달을 관찰하였다. 결 과: 난관수종액내에서 IL-$1{\alpha}$, IL-$1{\beta}$, IL-2, IL-4, IL-6, IL-8, IL-10, TNF-$\alpha$, IFN-$\gamma$, VEGF, EGF, MCP-1가 검출되었으며, 그 농도에 있어서는 큰 차이를 보였다. 정상 혈청 농도에 비하여 난관수종액-1은 IL-6, IL-10이 증가되어 있었고, 난관 수종액-2는 IFN-$\gamma$, MCP-1 및 VEGF가 증가되어 있었다. 각 난관수종액의 Th1/Th2 비는 HSF-1의 경우 IFN-$\gamma$:IL-10이 3.69로 정상인 데 비하여 HSF-2의 경우 IFN-$\gamma$:IL-10이 61.14로 크게 증가되어 있었다. 난관수종액을 포함하지 않는 배양액에서는 배반포기 발달률은 76.7%이었고, 난관수종액-1군은 74%로 대조군과 차이를 보이지 않았지만, 난관수종액-2군의 경우 27.7%로서 대조군 및 난관수종액-1군과도 유의한 차이를 보였다. 난관수종액-1의 경우 난관수종액 농도에 따른 차이는 없었으며, 난관수종액-2군의 경우 농도에 증가함에 따라 배반포로의 발달이 감소하기는 하였지만 통계적으로 유의하지는 않았다. 결 론: 난관수종액마다 사이토카인의 조성이 다르며 이에 따라 생쥐 배아발달에 미치는 영향이 다를 수 있다. 염증성 사이토카인이 증가된 난관수종액이 배아발달에 악영향을 미칠 것으로 추정된다. 특정 사이토카인에 의한 작용을 규명하기는 위해서는 향후 지속적인 연구가 필요할 것으로 생각된다. Objective: The aim of this study was to measure the concentrations of cytokines contained in the hydrosalpingeal fluid and to evaluate the effect on the mouse embryo development with the different cytokine concentration. Methods: The hydrosalpingeal fluids (HSF) were collected during the surgery for hydrosalpinx which was confirmed by hysterosalphingogram. The cytokines in HSF including interleukin (IL)-$1{\alpha}$, IL-$1{\beta}$, IL-2, IL-4, IL-6, IL-8, IL-10, TNF-$\alpha$, Interferon-$\gamma$ (IFN-$\gamma$), vascular endothelial growth factor (VEGF), epidermal growth factor (EGF), monocyte chemotactic protein-1 (MCP-1) were measured by ELISA method. HSF were added up to culture media with 5%, 10%, and 30% concentrations. The blastulation rates were compared. Results: IL-$\alpha$, IL-$1{\beta}$, IL-2, IL-4, IL-6, IL-8, IL-10, TNF-$\alpha$, IFN-$\bamma$, VEGF, EGF, and MCP-1 were detected, but the concentrations were different from each sample. IL-6 and IL-10 were increased in HSF-1 group, and IFN-$\gamma$, MCP-1, VEGF were increased in HSF-2 compared with normal serum range. The Th1/Th2 ratio of HSF-2 (IFN-$\gamma$:IL10) was highly elevated to 61.64, compared with that of HSF-1 (3.69). The blastulation rate was significantly decreased in HSF-2 group (27.7%) compared those of the HSF-1 group (74%) and control group (76.7%). It showed the trend that the blastulation rate was decreased depending on the concentration HSF of culture media in HSF-2 group, but it was not statistically significant. Conclusion: The composition and concentration of cytokines in each HSF were different, and increased proinflammatory cytokines in HSF might be associated with poor embryonic development. Further study will be needed about the effect of each cytokines in HSF.

Assessment of Ovarian Volume and Hormonal Changes after Ovarian Cystectomy in the Different Ovarian Tumor

박준철,배진곤,김종인,이정호,Park, Joon-Cheol,Bae, Jin-Gon,Kim, Jong-In,Rhee, Jeong-Ho The Korean Society for Reproductive Medicine 2008 Clinical and Experimental Reproductive Medicine Vol.35 No.2

목 적: 난소 용적 측정 및 기저 FSH, $E_2$, CCCT 검사를 통하여 가임기 여성에서 난소 낭종 제거술후 난소 배란능의 변화를 평가하고자 하였다. 연구방법: 난소 낭종으로 내원한 환자 중 35세 이하의 여성으로서 비교적 규칙적인 생리주기를 가지며 한쪽 난소에만 낭종을 가진 22명을 대상으로 자궁내막종군과 비자궁내막종군으로 구분하여 전향적 비교 분석을 시행하였다. 질 초음파를 이용하여 수술 1개월 전과 수술 3개월 후 생리주기 3일에 난소의 용적을 측정하였다. 또한 수술 전과, 수술 후 두 번의 정상 생리가 있은 뒤 기저 FSH, $E_2$, CCCT를 시행하였다. 대상 환자 22명 중 3명은 술후 검사를 계획한 3개월 전에 임신이 됨으로써 연구대상에서 제외하였다. 결 과: 수술 후 난소 용적은 자궁내막종군에서 $4.79{\pm}2.57\;cm^3$, 비자궁내막종군 중 직경 ${\geq}10\;cm$인 경우에서 $5.21{\pm}1.33\;cm^3$로서 건측과 비교하여 유의한 감소가 있었으나, 비자궁내막종군 중 직경 <10 cm인 경우는 $6.18{\pm}2.85\;cm^3$로서 유의한 용적 감소가 없었다. 수술후 자궁내막종군의 기저 FSH는 $4.25{\pm}0.20\;mIU/ml$, CCCT 10일째 FSH는 $3.79{\pm}0.80\;mIU/ml$였고, 비자궁내막종군은 각각 $4.24{\pm}0.85\;mIU/ml$, $4.28{\pm}0.92\;mIU/ml$로서 수술 전후의 기저 FSH, CCCT 결과 비교에서 각 군 모두 유의한 차이가 없었으며, 두 군간의 비교에서도 유의한 차이가 없었다. 결 론: 자궁내막종 절제술 및 10 cm 이상의 난소 낭종 절제술 후 난소 용적은 유의한 감소를 보였으나 10 cm 미만의 난소 낭종 제거술에서는 난소 용적의 유의한 감소가 없었다. 난소 배란능을 평가하기 위하여 측정한 기저 FSH, CCCT 검사 결과는 낭종 제거술 후에도 각 군 모두 유의한 차이를 보이지 않았다. 따라서 가임기 여성에서는 난소절제술 보다는 낭종 제거술이 우선 고려되어야 하며, 세심한 주의를 기울인다면 난소 배란능의 손상을 최소화할 수 있을 것으로 사료된다. Objectives: The aim of this study was to assess the change of ovarian reserve after removal of ovarian tumor using basal FSH, $E_2$, clomiphene citrate challenge test and ovarian volume. Methods: Twenty two patients with unilateral ovarian tumor, ${\leq}35$ years old, regular menstrual cycle were collected prospectively and divided into endometrioma or non-endometrioma group. We measured the ovarian volume with transvaginal ultrasonography on the day 3 of menstrual cycle within one month before and 3 months after surgery. Basal (cycle day 3) FSH, $E_2$ and CCCT were checked before surgery and repeated at least 2 spontaneous cycles later after surgery. Three patients that had been pregnant within 3 months after surgery were excluded in analysis. Results: The ovarian volume was reduced significantly after surgery in endometrioma and non-endometrioma ${\geq}10\;cm$ group ($4.79{\pm}2.57\;cm^3$ and $5.21{\pm}1.33\;cm^3$, respectively), but not in the non-endometrioma <10 cm group ($6.18{\pm}2.85\;cm^3$). After surgery, basal FSH and cycle day 10 FSH on CCCT in endometrioma and non-endometrioma were $4.25{\pm}0.20\;mIU/ml$ and $3.79{\pm}0.80\;mIU/ml$, $4.24{\pm}0.85\;mIU/ml$ and $4.28{\pm}0.92\;mIU/ml$, respectively. There were neither significant difference in comparison with the preoperative results nor between two groups. Conclusions: Enucleation of ovarian mass was associated with a significant reduction in ovarian volume in endometrioma and non-endometrioma larger than 10cm in diameter. Hormonal markers for evaluation of ovarian reserve, such as basal and cycle day 10 FSH on CCCT, were not changed significantly in each group. In reproductive age women, conservative enucleation or cystectomy rather than oophorectomy should be considered even in a large benign tumor and ovarian function could be reserved by meticulous operative technique.

PANI/PAN 나노웹의 제조와 전기전도성

박준철,안병욱,강태진,Park, Jun-Chul,Ahn, Byung-Wook,Kang, Tae-Jin 한국섬유공학회 2006 한국섬유공학회지 Vol.43 No.4

Polyaniline(PANI)/pelyacrylronitrile(PAN) nanoweb was obtained by electrospinning and in situ polymerization. The electrospinning dope was prepared through dissolving purified PAN in dimethylsulfoxide. To obtain PAN nanoweb of the proper morphology for PANI in situ polymerization, the dopes were electrospun with varying voltage, tip-to-collector distance(TCD) and dope concentration. Then, PANI, one of the conductive polymers, was polymerized on the surface of PAN nanoweb by in situ polymerization. The relationship between the electrical conductivity of PANI/PAN nanoweb and several polymerization variables was investigated. Aniline concentration, diffusion time, polymerization time, and molar ratio of aniline to oxidant (ammonium persulfate) were handled. The electrical conductivity was measured by 4-point probe method.

도로교통소음의 전파특성 및 영향

박준철,김윤신,강대준,Park, Joon-Cheol,Kim, Yoon-Shin,Kang, Dae-Joon 한국환경보건학회 2008 한국환경보건학회지 Vol.34 No.4

This study was performed to investigate propagation characteristics and effects of road traffic noise generated from vehicles. Noise levels of expressway and general road were measured at four points in a straight line based on distance from the road, and analyzed. The average noise level of expressway was 78.9 dBA at 5 m, 76.4 dBA at 10 m, 72.0 dBA at 20 m, 69.0 dBA at 30 m. That of general road was lower about $3.1{\sim}3.5\;dBA$ than that of expressway. There was no significant difference in distance attenuation between expressway noise and general road noise. The farer the distance from source is, the more the attenuation is. The influence range of noise is assessed by noise environmental standards or road noise limits. Noise levels of the time zone were measured at a boundary line of apartment to grasp noise variation by time. The time zone of lowest noises was $3{\sim}4$ a.m. and that of highest noise was $8{\sim}10$ a.m. Data recorded on tapes were analyzed to understand the characteristics of frequency because these characteristics are important factors to plan the noise reduction measures, namely path measures.

조기 난소기능 부전증 환자에서 자가면역 질환과의 상관관계

박준철,김종인,이정호,Park, Joon-Cheol,Kim, Jong-In,Rhee, Jeong-Ho 대한생식의학회 2004 Clinical and Experimental Reproductive Medicine Vol.31 No.3

Objective: To assess the association with autoimmune endocrine diseases and detection rate of autoimmune antibodies and its clinical significance in patients with premature ovarian failure. Methods: Twenty eight patients with primary or secondary amenorrhea manifesting hormonal and clinical features of premature ovarian failure (primary POF: 7, secondary POF: 21) were investigated. We tested them TFT, 75 g OGTT, ACTH and S-cortisol for thyroiditis, IDDM, Addison's disease, and antithyoglobulin antibody, antimicrosomal antibody, antinuclear antibody, rheumatic factor, anti-smooth muscle antibody, anti-acetylcholine receptor antibody for non-organ specific autoimmune disorders. Results: Only one patient was diagnosed as IDDM and no patients had abnormal TFT or adrenal function test. More than one kind of autoantibody was detected in 11 patients of all (39.2%): 5 patients (71.4%) of primary POF group and 6 patients (21.4%) of secondary POF group. Eleven patients (39.3%) had antithyroglobulin antibody, 4 (14.3%) had antimicrosomal antibody, 2 (7.1%) had antinuclear antibody, 2 (7.1%) had rheumatic factor, 1 (3.6%) had anti-smooth muscle antibody, 1 (3.6%) had anti-acetylcholine receptor antibody. Conclusions: Premature ovarian failure may occur as a component of an autoimmune polyglandular syndrome, so patients should be measured with free thyroxine, thyroid-stimulating hormone, fasting glucose and electrolytes. Measurement of thyroid autoantibodies in POF patients may be important in identifying patients at risk of developing overt hypothyoidism, but other autoantibodies may not be suitable for screening test.

PRF, MUF 집성재의 휨 강도와 접착 성능 평가

박준철,김건호,홍순일,Park Jun-Chul,Kim Keon-Ho,Hong Soon-Il 한국가구학회 2004 한국가구학회지 Vol.15 No.2

As glulam is a woody material, it is necessary to be more careful in a gluing process. It takes 6-7 hours at $40-60^{\circ}C$ to harden PRF resin used in making structural glulam, and about 24 hours at room temperature. In the present process which can not use a press continuously, reducing the hardening time is necessary to increase production. The experiment was done to compare the adhesive properties of PRF resin and MUF resin through bending test, block shear strength test and water soaking test. In comparing the bending strength of prediction MOE is 1.2 times higher that actual MOE. PRF and MUF do not show significant difference in MOE and MOR, and in block shear strength test, such as shear strength and wood failure rate. However, in water soaking and boiling water soaking tests PRF and MUF show the significant difference in delamination rate.