• Title/Summary/Keyword: Design change

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A Study of Health Condion and Shift Service of the Nurse in (종합병원 간호사의 교대근무와 건강상태에 관한 연구)

  • Kim, Soon-Ok
    • Journal of Korean Academy of Nursing Administration
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    • v.3 no.1
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    • pp.119-133
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    • 1997
  • Continuing shift service of clinical nurses can be not only the cause of occupational dissatisfaction by being connected with the change of circadian rhythm and the burden of duties to be applicable to such changes. But also of inviting the lowering of nursing quality by being affected to the resignation of the nurses as the threat to the health of the nurses. This study has selected 500 nurses at random under non-probability sampling who have been serving by shift in 7 general hospitals which have over 400 sickbeds for the purpose of cross-sectional survey design from Sep. 7 through 20, 1996. Standardized modification of the CMI has been used which was designed for Koreans with Cornell Medical Index developed by Broadman and his fellow workers as the study device. The structure of the device was composed of 35 questions on physical appeal(Chronbach's ${\alpha}=8507$) and 22 questions of mental appeal(Cronbach's ${\alpha}=.8166$ totalling 57 questions. The collected data has been computerrized by using SPSS. General character, present symptom, perceived symptom and others are sought by practical number and percentage, and the health condition comparison followed by general characters was conducted by t-test and ANOVA. The post test was by Duncan's test by the level of p<.05. 1) The items of the answer that they have the physical symptom presently by 50% or over of the nurses were as "Do you often have spells of severe dizziness", "Are your eyes often red or inflamed", "Does press or pain in the head often make like miserable", "Are your ankles often badly swollen", "Do pains in the back make it hard for you to keep up with your work". 2) The items of the answer by over 50% of the nurses as the mental symptom at present were "do you fell bad when criticized?", "Do you get angry when everything is against your will?", "do you get angry when ordered to do this and that?", "do you feel uneasy by such a trifle thing?", "do you tremble or are you freightened by sudden sound?". The mental and physical symptoms which have appeared presently in connection with the shift service have been agreed with each other. But the physical condition has been worse than the mental one. 3) In the physical health conditions followed by demosociological character, there were the significant differences by sex, religion and place of residence(p<.05), and in the mental health conditions, there were the significant differences by age, marital status, residence place and the required time for attending hospital(p<.05). 4) There was significant difference by the degree of satisfaction about the duty in both the physical and mental health conditions. In short, the higher the degree of duty satisfaction, the better the health conditions. 5) There were the significant difference according to the times of night duty and whether they take the drug or not or the kinds of the drugs in the physical health conditions related with the characters of night shift. Mental health conditions in the night shift case showed significant differences according to their taking drug or not or the kinds of the drugs(p<.05). I can confirm that the nurses have been affected continuously by the shift service mentally and physically. The maintenance of the physical and mental health of the nurses and its promotion are very important problem to guarantee the quality nursing in the performance of the nursing service continuously and effectively, so the hospital should make every effort to improve the duty conditions by finding out the causes affecting to their health. In the nursing management viewpoint, I think that elevating the satisfaction degree about the duty would be a great help to the promotion of physical and mental health conditions. But what is most important is that the nurses themselves should take care of themselves in maintaining the good conditions in their service in the hospital.

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Two stage reconstruction of bilateral alveolar cleft using Y-shaped anterior based tongue flap and iliac bone graft (Y-형 전방 기저 설 피판과 장골 이식을 이용한 양측성 치조열의 이단계 재건술)

  • Lee, Jong-Ho;Kim, Myung-Jin;Kang, Jin-Han;Kang, Na-Ra;Lee, Jong-Hwan;Choi, Won-Jae;Choi, Jin-Young
    • Korean Journal of Cleft Lip And Palate
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    • v.3 no.1
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    • pp.23-31
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    • 2000
  • Objective: When an alveolar cleft is too large to close with adjacent mucobuccal flaps or large secondary fistula following a primary bilateral palatoplasty exists, a one-stage procedure for bone grafting becomes challenging. In such a case, we used the tongue flap to repair the fistula and cleft alveolus in the first stage, and bone grafting to the cleft defect was performed in the second stage several months later. The purpose of this paper is to report our experiences with the use of an anteriorly-based Y-shaped tongue flap to fit the palatal and labial alveolar defects and the ultimate result of the bone graft. Patients: A series of 14 patients underwent surgery of this type from January 1994 to December 1998.The average age of the patients was 15.8 years old (range: 5 to 28 years old). The mean period of follow-up following the 2nd stage bone raft operation was 45.9 months (range: 9 to 68 months). In nine of the 14 cases, the long-fork type of a Yshaped tongue flap was used for extended coverage of the labial side alveolar defects with the palatal fistula in the remaining cases the short-forked design was used. Results: All cases demonstrated a good clinical result after the initial repair of cleft alveolus and palatal fistula. There was no fistula recurrence, although Partial necrosis of distal margin in long-forked tongue flap was occurred in one case. Furthermore, the bone graft, which was performed an average of 8 months after the tongue flap repair, was always successful. Occasionally, the transferred tongue tissue was bulging and interfering with the hygienic care of nearby teeth; however, these problems were able to be solved with proper contour-pasty performed afterwards. No donor site complications such as sensory disturbance, change in taste, limitations in tongue movement, normal speech impairments or tongue disfigurement were encountered. Conclusion: This two-stage reconstruction of a bilateral cleft alveolus using a Y-shaped tongue flap and iliac bone graft was very successful. It may be indicated for a bilateral cleft alveolus patient where the direct closure of the cleft defect with adjacent tissue or the buccal flap is not easy due to scarred fibrotic mucosa and/or accompanied residual palatal fistula.

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Geoscientific land management planning in salt-affected areas* (염기화된 지역에서의 지구과학적 토지 관리 계획)

  • Abbott, Simon;Chadwick, David;Street, Greg
    • Geophysics and Geophysical Exploration
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    • v.10 no.1
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    • pp.98-109
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    • 2007
  • Over the last twenty years, farmers in Western Australia have begun to change land management practices to minimise the effects of salinity to agricultural land. A farm plan is often used as a guide to implement changes. Most plans are based on minimal data and an understanding of only surface water flow. Thus farm plans do not effectively address the processes that lead to land salinisation. A project at Broomehill in the south-west of Western Australia applied an approach using a large suite of geospatial data that measured surface and subsurface characteristics of the regolith. In addition, other data were acquired, such as information about the climate and the agricultural history. Fundamental to the approach was the collection of airborne geophysical data over the study area. This included radiometric data reflecting soils, magnetic data reflecting bedrock geology, and SALTMAP electromagnetic data reflecting regolith thickness and conductivity. When interpreted, these datasets added paddock-scale information of geology and hydrogeology to the other datasets, in order to make on-farm and in-paddock decisions relating directly to the mechanisms driving the salinising process. The location and design of surface-water management structures such as grade banks and seepage interceptor banks was significantly influenced by the information derived from the airborne geophysical data. To evaluate the effectiveness ofthis planning., one whole-farm plan has been monitored by the Department of Agriculture and the farmer since 1996. The implemented plan shows a positive cost-benefit ratio, and the farm is now in the top 5% of farms in its regional productivity benchmarking group. The main influence of the airborne geophysical data on the farm plan was on the location of earthworks and revegetation proposals. There had to be a hydrological or hydrogeological justification, based on the site-specific data, for any infrastructure proposal. This approach reduced the spatial density of proposed works compared to other farm plans not guided by site-specific hydrogeological information.

A Study on the Chemical Index of Alteration of Igneous Rocks (화성암의 화학적 변질지수에 관한 연구)

  • Choi, Eun-Kyeong;Kim, Sung-Wook;Kim, In-Soo;Lee, Kyu-Hwan
    • Journal of the Korean Geotechnical Society
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    • v.28 no.5
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    • pp.41-54
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    • 2012
  • The weathering process of rocks leads to the reduction of geotechnical bearing capacity. The weathering of granite is frequently used to refer to the degradation of geotechnical property in the design and construction of infra-structure. In this study, the range of values of CIA (chemical index of alteration) and the change of mineral compositions by weathering have been analysed with igneous rock, which covers 45.5% in South Korean territory. Several weathering indices were studied for various rocks found in Korea and significant relationships between different indices were delineated via statistical analysis. The applicability of CIA was found to be the most significant among all weathering indicies. The composition of illite, the secondary weathering residual, generally increases for the felsic rock, and swelling clay material is not included. The weathering of felsic rock will follow a sequential process, starting from bed rock, illite, and chlorite to kaoline. The mafic rock will show weathering process, from bed rock, smectite, and chlorite to kaoline. The intermediate rocks such as andesite and tuff will show similar weathering procedure and the composition of kaoline, chlorite, and smectite tends to increase more than that of illite when the mafic rock is dominated. This means the increase of rock material which has high CEC (cation exchange capacity) during secondary weathering process. However, the characteristics of a specific rock cannot be completely analyzed using merely CIA, since it is exclusively based on chemical composition and corresponding alteration. The CIA can be used to quantify the weathering process in a limited range, and further considerations such as rock composition, strength characteristics will be required to configure the comprehensive weathering impact on any specific region.

A Study on Laboratory Treatment of Metalworking Wastewater Using Ultrafiltration Membrane System and Its Field Application (한외여과막시스템을 이용한 금속가공폐수의 실험실적 처리 및 현장 적용 연구)

  • Bae, Jae Heum;Hwang, In-Gook;Jeon, Sung Duk
    • Korean Chemical Engineering Research
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    • v.43 no.4
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    • pp.487-494
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    • 2005
  • Nowadays a large amount of wastewater containing metal working fluids and cleaning agents is generated during the cleaning process of parts working in various industries of automobile, machine and metal, and electronics etc. In this study, aqueous or semi-aqueous cleaning wastewater contaminated with soluble or nonsoluble oils was treated using ultrafiltration system. And the membrane permeability flux and performance of oil-water separation (or COD removal efficiency) of the ultrafiltration system employing PAN as its membrane material were measured at various operating conditions with change of membrane pore sizes and soil concentrations of wastewater and examined their suitability for wastewater treatment contaminated with soluble or insoluble oil. As a result, in case of wastewater contaminated with soluble oil and aqueous or semi-aqueous cleaning agent, the membrane permeability increased rapidly even though COD removal efficiency was almost constant as 90 or 95% as the membrane pore size increased from 10 kDa to 100 kDa. However, in case of the wastewater contaminated with nonsoluble oil and aqueous or semi-aqueous cleaning agent, as the membrane pore size increased from 10 kDa to 100 kDa and the soil concentration of wastewater increased, the membrane permeability was reduced rapidly while COD removal efficiency was almost constant. These phenomena explain that since the membrane material is hydrophilic PAN material, it blocks nonsoluble oil and reduces membrane permeability. Thus, it can be concluded that the aqueous or semi-aqueous cleaning solution contaminated with soluble oil can be treated by ultrafiltration system with the membrane of PAN material and its pore size of 100 kDa. Based on these basic experimental results, a pilot plant facility of ultrafiltration system with PAN material and 100 kDa pore size was designed, installed and operated in order to treat and recycle alkaline cleaning solution contaminated with deep drawing oil. As a result of its field application, the ultrafiltration system was able to separate aqueous cleaning solution and soluble oil effectively, and recycle them. Further more, it can increase life span of aqueous cleaning solution 12 times compared with the previous process.

Theoretical Study on Optimal Conditions for Absorbent Regeneration in CO2 Absorption Process (이산화탄소 흡수 공정에서 흡수액 최적 재생 조건에 대한 이론적 고찰)

  • Park, Sungyoul
    • Korean Chemical Engineering Research
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    • v.50 no.6
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    • pp.1002-1007
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    • 2012
  • The considerable portion of energy demand has been satisfied by the combustion of fossil fuel and the consequent $CO_2$ emission was considered as a main cause of global warming. As a technology option for $CO_2$ emission mitigation, absorption process has been used in $CO_2$ capture from large scale emission sources. To set up optimal operating parameters in $CO_2$ absorption and solvent regeneration units are important for the better performance of the whole $CO_2$ absorption plant. Optimal operating parameters are usually selected through a lot of actual operation data. However theoretical approach are also useful because the arbitrary change of process parameters often limited for the stability of process operation. In this paper, a theoretical approach based on vapor-liquid equilibrium was proposed to estimate optimal operating conditions of $CO_2$ absorption process. Two $CO_2$ absorption processes using 12 wt% aqueous $NH_3$ solution and 20 wt% aqueous MEA solution were investigated in this theoretical estimation of optimal operating conditions. The results showed that $CO_2$ loading of rich absorbent should be kept below 0.4 in case of 12 wt% aqueous $NH_3$ solution for $CO_2$ absorption but there was no limitation of $CO_2$ loading in case of 20 wt% aqueous MEA solution for $CO_2$ absorption. The optimal regeneration temperature was determined by theoretical approach based on $CO_2$ loadings of rich and lean absorbent, which determined to satisfy the amount of absorbed $CO_2$. The amount of heating medium at optimal regeneration temperature is also determined to meet the difference of $CO_2$ loading between rich and lean absorbent. It could be confirmed that the theoretical approach, which accurately estimate the optimal regeneration conditions of lab scale $CO_2$ absorption using 12 wt% aqueous $NH_3$ solution could estimate those of 20 wt% aqueous MEA solution and could be used for the design and operation of $CO_2$ absorption process using chemical absorbent.

Effect of rhPMP-2 coated implants on alveolar ridge augmentation in dogs (성견에서 골형성단백질이 코팅된 임플란트가 치조골 증대에 미치는 영향)

  • Park, Chan-Kyung;Kim, Jong-Eun;Shin, Ju-Hee;Ryu, Jae-Jun;Huh, Jung-Bo;Shin, Sang-Wan
    • The Journal of Korean Academy of Prosthodontics
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    • v.48 no.3
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    • pp.202-208
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    • 2010
  • Purpose: This study was aimed to evaluate the effect of rhPMP-2 coated implants on alveolar ridge augmentation in dogs. Materials and methods: Six Beagle dogs were used in this study. Six 8.0 mm long anodized surface titanium implants were placed 5 mm into the mandibular alveolar ridge following 6 month of healing period after extraction. Each animal received three implants coated with rhBMP-2 and three uncoated control implants using the randomized split-mouth design. Radiographic examinations were undertaken immediately at implant placement (baseline), at weeks 4 and 8 after implant placement. The amount of bone augmentation was evaluated by measuring the distance from the uppermost point of the coverscrew to the marginal bone. Implant Stability Quotient (ISQ) values were measured immediately at implant placement and 8 weeks after implant placement. For the statistical analysis, Man-Whitney ranksum test and Wilcoxon signed rank test of SPSS 12.0 software were used (P=.05). Results: The BMP group exhibited radiographic vertical bone augmentation about $0.6{\pm}0.7$ mm at 8 weeks later while controls showed bone loss about $0.4{\pm}0.6$ mm. There was significant difference among the rhBMP-2 group and controls in bone level change (P<.05). The ISQ values were significantly higher in the BMP-2 group than the control group at 8 weeks later (P<.05), while there was no significant difference at surgery. Conclusion: Within the limitation of this study, the rhBMP-2 coated on anodized implant could stimulate vertical alveolar bone augmentation, which may increase implant stability significantly on completely healed alveolar ridge.

An Analysis of Nursing education Research in China : 1990-1998 (중국 간호교육관련 연구실태 분석)

  • Ko Il-Sun;Li Chun-Yu;Kim Jing-Ai
    • The Journal of Korean Academic Society of Nursing Education
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    • v.5 no.2
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    • pp.177-190
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    • 1999
  • This study has been conducted on the basis of the literature review of Nursing Education Research in China from 1990 through August 1998. Its purpose was to support the basic data of nursing education which is risen as major revolutionary of nursing in China and those for exchange of information between Korea-China nursing education. It is retrospective and descriptive research analyzing one hundred eighty articles published in The Journal of China Nursing. The results of the study were as follows. 1. Only 33.3% of the professors of Technical Nursing School who have played of major role of nursing education in China have carried out the study related to nursing education. Baccalaureate program professors have marked 22.2% of all studies, and diploma program professors have done 12.2% of all. Therefore, the professors of above the diploma program have done total 44.4%. It explains that the professors of baccalaureate and diploma programs have done more studies related to nursing education than those of Technical Nursing School. 2. In terms of the study design, most of the studies(38.8%) were case studies introducing the curriculum contents that were done at education institutions. And then, 28.5% were reviewing the articles, and 15.6% were descriptive studies. 3. In terms of the content of the study, 38.3% were relevant to education of Technical Nursing School, 15.0% were about baccalaureate education, and 10.4% is about diploma. 4. To analyze the specific contents of the studies ; a. In baccalaureate program, human resources (professor or teaching), course extension, lab, classes, teaching method, education philosophy, goal of education, evaluation method, and human resource development were included. b. In diploma program, teaching contents evaluation method, teaching method, and educational system were included c. In the technical school, there were qualification of professors , teaching method, evaluation method, opening the courses, teaching contents, goal of education and so on. d. Beyond these, there were practice guidance and appraisement, teaching method, and opening new courses which were not specially indicated as educational curriculum and score management as continuing education. What is above tell us that the study regarding development of university system has been progressed actively and widely. It has been for the effort of revolution which based on the China government force to reform of nursing education process during last 10 years. On the base of the result, we suggest the following questions and the alternatives. 1) Since most articles are case studies related to teaching methods and the others doesn't propose the research method. the study which is applied more exact research method is needed. 2) No study is regarding social change and health policy. Because University program, founded in 1983 is on the beginning point, the research about curriculum have to be taken as a top priority as well as to reflect social needs which are based on social changes and national health policy 3) Only one review article study tells nursing Human resource. To appear in large numbers in nursing manpower, avoid the present hospital nurses training system. Then, the study for manpower development which is able to accomplish in many fields has to be advanced. 4) Most studies did not have literature review processes, so it was impossible for researcher to know the past study tendency and there is no relation among studies as to same subject, the education about research method is needed.

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A Comparative Case Study on the Adaptation Process of Advanced Information Technology: A Grounded Theory Approach for the Appropriation Process (신기술 사용 과정에 관한 비교 사례 연구: 기술 전유 과정의 근거이론적 접근)

  • Choi, Hee-Jae;Lee, Zoon-Ky
    • Asia pacific journal of information systems
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    • v.19 no.3
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    • pp.99-124
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    • 2009
  • Many firms in Korea have adopted and used advanced information technology in an effort to boost efficiency. The process of adapting to the new technology, at the same time, can vary from one firm to another. As such, this research focuses on several relevant factors, especially the roles of social interaction as a key variable that influences the technology adaptation process and the outcomes. Thus far, how a firm goes through the adaptation process to the new technology has not been yet fully explored. Previous studies on changes undergone by a firm or an organization due to information technology have been pursued from various theoretical points of views, evolved from technological and institutional views to an integrated social technology views. The technology adaptation process has been understood to be something that evolves over time and has been regarded as cycles between misalignments and alignments, gradually approaching the stable aligned state. The adaptation process of the new technology was defined as "appropriation" process according to Poole and DeSanctis (1994). They suggested that this process is not automatically determined by the technology design itself. Rather, people actively select how technology structures should be used; accordingly, adoption practices vary. But concepts of the appropriation process in these studies are not accurate while suggested propositions are not clear enough to apply in practice. Furthermore, these studies do not substantially suggest which factors are changed during the appropriation process and what should be done to bring about effective outcomes. Therefore, research objectives of this study lie in finding causes for the difference in ways in which advanced information technology has been used and adopted among organizations. The study also aims to explore how a firm's interaction with social as well as technological factors affects differently in resulting organizational changes. Detail objectives of this study are as follows. First, this paper primarily focuses on the appropriation process of advanced information technology in the long run, and we look into reasons for the diverse types of the usage. Second, this study is to categorize each phases in the appropriation process and make clear what changes occur and how they are evolved during each phase. Third, this study is to suggest the guidelines to determine which strategies are needed in an individual, group and organizational level. For this, a substantially grounded theory that can be applied to organizational practice has been developed from a longitudinal comparative case study. For these objectives, the technology appropriation process was explored based on Structuration Theory by Giddens (1984), Orlikoski and Robey (1991) and Adaptive Structuration Theory by Poole and DeSanctis (1994), which are examples of social technology views on organizational change by technology. Data have been obtained from interviews, observations of medical treatment task, and questionnaires administered to group members who use the technology. Data coding was executed in three steps following the grounded theory approach. First of all, concepts and categories were developed from interviews and observation data in open coding. Next, in axial coding, we related categories to subcategorize along the lines of their properties and dimensions through the paradigm model. Finally, the grounded theory about the appropriation process was developed through the conditional/consequential matrix in selective coding. In this study eight hypotheses about the adaptation process have been clearly articulated. Also, we found that the appropriation process involves through three phases, namely, "direct appropriation," "cooperate with related structures," and "interpret and make judgments." The higher phases of appropriation move, the more users represent various types of instrumental use and attitude. Moreover, the previous structures like "knowledge and experience," "belief that other members know and accept the use of technology," "horizontal communication," and "embodiment of opinion collection process" are evolved to higher degrees in their dimensions of property. Furthermore, users continuously create new spirits and structures, while removing some of the previous ones at the same time. Thus, from longitudinal view, faithful and unfaithful appropriation methods appear recursively, but gradually faithful appropriation takes over the other. In other words, the concept of spirits and structures has been changed in the adaptation process over time for the purpose of alignment between the task and other structures. These findings call for a revised or extended model of structural adaptation in IS (Information Systems) literature now that the vague adaptation process in previous studies has been clarified through the in-depth qualitative study, identifying each phrase with accuracy. In addition, based on these results some guidelines can be set up to help determine which strategies are needed in an individual, group, and organizational level for the purpose of effective technology appropriation. In practice, managers can focus on the changes of spirits and elevation of the structural dimension to achieve effective technology use.

GnRH Agonist Stimulation Test (GAST) for Prediction of Ovarian Response in Controlled Ovarian Stimulation (COH) (난소기능평가를 위한 Gonadotropin Releasing Hormone Agonist Stimulation Test (GAST)의 효용성에 관한 연구)

  • 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
    • Clinical and Experimental Reproductive Medicine
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    • v.26 no.2
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    • pp.163-170
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    • 1999
  • 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.

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