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( Seung Ah Choe ),( Hye Jun Lee ),( Kyoung Yong Moon ),( Yong Beom Kim ),( Yong Tark Jeon ) 대한산부인과학회 2008 Journal of Womens Medicine Vol.1 No.2
A cutaneous fistula involving the reproductive organ is a rare complication of surgery. A 32-year-old woman with Crohn`s disease who had undergone several laparotomies complained of a bloody discharge during menstruation through a small opening in the operative scar. A tubocutaneous fistula was identified and resected at the time of surgical exploration. One should suspect a communication with a reproductive organ in the case of a cutaneous opening with bleeding during menstruation. The only corrective treatment for a refractory fistula in patients with Crohn`s disease is surgery. Patients with longstanding inflammatory bowel disease are more vulnerable to this rare type of fistula following multiple surgeries.
Choe, Seung Ah,Cho, Sung-Il The Korean Society for Preventive Medicine 2014 Journal of Preventive Medicine and Public Health Vol.47 No.6
Objectives: Child mortality remains a critical problem even in developed countries due to low fertility. To plan effective interventions, investigation into the trends and causes of child mortality is necessary. Therefore, we analyzed these trends and causes of child deaths over the last 30 years in Korea. Methods: Causes of death data were obtained from a nationwide vital registration managed by the Korean Statistical Information Service. The mortality rate among all children aged between one and four years and the causes of deaths were reviewed. Data from 1983-2012 and 1993-2012 were analyzed separately because the proportion of unspecified causes of death during 1983-1992 varied substantially from that during 1993-2012. Results: The child (1-4 years) mortality rates substantially decreased during the past three decades. The trend analysis revealed that all the five major causes of death (infectious, neoplastic, neurologic, congenital, and external origins) have decreased significantly. However, the sex ratio of child mortality (boys to girls) slightly increased during the last 30 years. External causes of death remain the most frequent origin of child mortality, and the proportion of mortality due to child assault has significantly increased (from 1.02 in 1983 to 1.38 in 2012). Conclusions: In Korea, the major causes and rate of child mortality have changed and the sex ratio of child mortality has slightly increased since the early 1980s. Child mortality, especially due to preventable causes, requires public health intervention.
Significance of the serum CA-125 level in intrauterine insemination cycles
Choe, Seung-Ah,Ku, Seung-Yup,Jee, Byung-Chul,Suh, Chang-Suk,Kim, Seok-Hyun,Choi, Young-Min,Kim, Jung-Gu,Moon, Shin-Young The Korean Society for Reproductive Medicine 2011 Clinical and Experimental Reproductive Medicine Vol.38 No.3
Objective: There are limited data regarding the significance of elevated serum CA-125 level during IUI cycles, even though it is used widely during the initial evaluation of infertile patients. The aim of this study was to investigate the prognostic value of serum CA-125 levels during IUI cycles. Methods: Among the patients with controlled ovarian stimulation and IUI cycles at Seoul National University Hospital from Jan 2005 through Dec 2009, 92 cases with no identified endometriotic lesion, ovarian tumor, salpingeal lesion, or uterine myoma were selected. To compare the clinical characteristics between the pregnancy group and the non-pregnancy group, the Mann-Whitney U test and Fisher's exact test were used. Results: The overall pregnancy rate was 18.5% (17/92). The pregnancy group showed a higher number of follicles 16 mm in diameter ($p$=0.036), endometrial thickness ($p$ <0.001), ampules of gonadotropin ($p$=0.009), and higher body mass index ($p$=0.022) than the non-pregnancy group. No significant difference was observed in the serum CA-125 level or the proportion of patients with CA-125 exceeding 17 IU/mL between the two groups. Conclusion: The prognostic value of serum CA-125 level among infertile patients with IUI cycles is considered limited.
Choe Seung-Ah,Seol Hyun-Joo,Kwon Ji Young,Park Chan-Wook,Kim Minhyoung,이지연,Kim Min-A,Hwang Han-Sung,Na Sunghun,Shim Jae-Yoon,Kim Kunwoo,Ryu Hyun Mee 대한의학회 2021 Journal of Korean medical science Vol.36 No.4
In 2019, the Korean Society of Maternal-Fetal Medicine developed the first Korean clinical practice guidelines for prenatal aneuploidy screening and diagnostic testing. These guidelines were developed by adapting established clinical practice guidelines in other countries that were searched systematically, and the guidelines aim to assist in decision making of healthcare providers providing prenatal care and to be used as a source for education and communication with pregnant women in Korea. This article delineates clinical practice guidelines specifically for maternal serum screening for fetal aneuploidy and cell-free DNA (cfDNA) screening. A total of 19 key questions (12 for maternal serum and 7 for cfDNA screening) were defined. The main recommendations are: 1) Pregnant women should be informed of common fetal aneuploidy that can be detected, risks for chromosomal abnormality according to the maternal age, detection rate and false positive rate for common fetal aneuploidy with each screening test, limitations, as well as the benefits and risks of invasive diagnostic testing, 2) It is ideal to give counseling about prenatal aneuploidy screening and diagnostic testing at the first prenatal visit, and counseling is recommended to be given early in pregnancy, 3) All pregnant women should be informed about maternal serum screening regardless of their age, 4) cfDNA screening can be used for the screening of trisomy 21, 18, 13 and sex-chromosome aneuploidy. It is not recommended for the screening of microdeletion, 5) The optimal timing of cfDNA screening is 10 weeks of gestation and beyond, and 6) cfDNA screening is not recommended for women with multiple gestations. The guideline was reviewed and approved by the Korean Academy of Medical Sciences.
Recent Trend and Associated Factors of Harmful Alcohol Use Based on Age and Gender in Korea
Choe, Seung-Ah,Yoo, Seunghyun,JeKarl, Jung,Kim, Kwang Kee KOREAN ACADEMY OF MEDICAL SCIENCE 2018 JOURNAL OF KOREAN MEDICAL SCIENCE Vol.33 No.4
<P><B>Background</B></P><P>Previous studies suggest that the impact of social factors on harmful alcohol use between men and women may be different. We aimed to explore the gender-based difference in temporal trend and social risk factors associated with harmful alcohol use.</P><P><B>Methods</B></P><P>The Korea National Health and Nutrition Examination Survey (2007–2014) was used to explore the recent trend of harmful alcohol use in the general population. Among all current alcohol drinkers aged 20–64 years, the frequencies of harmful alcohol use in each age group, year of birth, marriage, income, education, and occupation were analyzed based on gender.</P><P><B>Results</B></P><P>A total of 34,478 people (14,544 men and 19,834 women) who reported drinking alcohol in the last month at the time of interview were included in the analysis. The proportion of harmful alcohol use in men decreased (<I>P</I> for trend = 0.002) during the study period, whereas significant change was not observed in women (<I>P</I> for trend = 0.173). The prevalence of harmful alcohol use was highest in men aged 35–49 years and women aged 20–34 years. For both men and women, lower level of education and service occupation were the common risk factors of harmful alcohol use. Additionally, low income was a risk factor of harmful alcohol use in women but not in men. Marriage increased the risk of harmful alcohol use in women but decreased in men.</P><P><B>Conclusion</B></P><P>Public health interventions in reducing harmful alcohol use should consider the different high-risk groups between men and women.</P>
최승아(Seung-Ah Choe),김새롬(Saerom Kim),김현주(Hyun Joo Kim),류지아(Jia Ryu),민혜숙(Hye Sook Min),오정원(Jeong-Won Oh),윤정원(Jung-Won Yoon),김규원(Kyuwon Kim),정연택(Yun Tag Chung) 충남대학교 사회과학연구소 2024 사회과학연구 Vol.35 No.2
Due to a Supreme Court ruling in April 2020, the Korean Industrial Accident Insurance Act (KIAIA) was revised, and starting in January 2023, industrial accident insurance compensation for a live-born child with health issues due to its mother’s work during pregnancy has been provided. Based on this, a bill to amend the Public Officials’ Accident Compensation Act (POACA) was announced to provide similar compensation to the children of public officials with health issues. This study began with the purpose of presenting problems and alternatives to the currently announced POACA. As a methodology, literature reviews and case studies are used. The proposed recommendations can be largely divided into a plan to expand only services and a plan to expand beyond services to cash compensation. By setting the time of disability determination at the time of discovery of disability, nursing benefits, vocational rehabilitation benefits, and two kinds of paid care leaves could be immediately provided. In addition, disability benefits could be provided at a lower amount to minors in order to cover additional costs due to disabilities. The proposed measures do not significantly modify the current legal framework, but are appropriate for satisfying the principles and needs of compensation.
최승아 ( Choe Seung-ah ) 한국보건사회연구원 2023 보건복지포럼 Vol.321 No.-
한국 여성들이 적시에 필요한 부인과 의료서비스를 받을 수 있도록 하기 위해서는 현재 여성들이 갖고 있는 부인과 건강 문제를 확인하고 부인과 의료 이용 현황과 함께 여성들이 부인과 진료에 어려움을 겪는 원인을 파악하는 것이 중요하다. 지난 2022년 수행된 ‘한국 여성의 생애주기별 성·생식 건강조사’의 의료 이용 설문 결과 여성의 생애주기에 따라 주요 부인과 건강 문제와 미충족 의료 경험률에 차이가 있었다. 초기 성인과 청소년에서 노인보다 대체로 부인과 건강 문제가 흔했다. 중장년층에서는 10명 중 1명꼴로 자궁근종 제거 시술을 받았다. 부인과 진료가 필요한데도 받지 못한 주된 이유는 시간이 없는 것과 산부인과 검진이 불편한 것이었다. 한국 여성들의 삶의 질을 높이고 기대수명 대비 건강수명의 분율을 높이려면 부인과 진료의 장애물을 줄일 수 있는 정책과 프로그램이 필요하다. Ensuring that women in Korea receive the gynecologic care they need in a timely manner requires identifying the current gynecologic health problems that women have, their utilization of gynecologic care, and the reasons why women have difficulty accessing gynecologic care. The healthcare utilization survey, conducted in 2022 as part of the Korean Women's Sexual and Reproductive Health Survey, found that the prevalence of major gynecologic health problems and unmet healthcare needs varied across the life cycle. In early adulthood and adolescence, gynecologic health problems were generally more common than in the elderly. Among middle-aged women, only 1 in 10 had a procedure to remove fibroids. The main reasons for not seeking gynecologic care were lack of time and discomfort with gynecologic exams. Policies and programs are needed to reduce barriers to gynecological care, improve the quality of life of Korean women, and increase the ratio of healthy years to life expectancy.