74 research outputs found
Clinical Practice Guidelines for Prenatal Aneuploidy Screening and Diagnostic Testing from Korean Society of Maternal-Fetal Medicine: (2) Invasive Diagnostic Testing for Fetal Chromosomal Abnormalities
The Korean Society of Maternal Fetal Medicine proposed the first Korean guideline on prenatal aneuploidy screening and diagnostic testing, in April 2019. The clinical practice guideline (CPG) was developed for Korean women using an adaptation process based on good-quality practice guidelines, previously developed in other countries, on prenatal screening and invasive diagnostic testing for fetal chromosome abnormalities. We reviewed current guidelines and developed a Korean CPG on invasive diagnostic testing for fetal chromosome abnormalities according to the adaptation process. Recommendations for selected 11 key questions are: 1) Considering the increased risk of fetal loss in invasive prenatal diagnostic testing for fetal genetic disorders, it is not recommended for all pregnant women aged over 35 years. 2) Because early amniocentesis performed before 14 weeks of pregnancy increases the risk of fetal loss and malformation, chorionic villus sampling (CVS) is recommended for pregnant women who will undergo invasive prenatal diagnostic testing for fetal genetic disorders in the first trimester of pregnancy. However, CVS before 9 weeks of pregnancy also increases the risk of fetal loss and deformity. Thus, CVS is recommended after 9 weeks of pregnancy. 3) Amniocentesis is recommended to distinguish true fetal mosaicism from confined placental mosaicism. 4) Anti-immunoglobulin should be administered within 72 hours after the invasive diagnostic testing. 5) Since there is a high risk of vertical transmission, an invasive prenatal diagnostic testing is recommended according to the clinician's discretion with consideration of the condition of the pregnant woman. 6) The use of antibiotics is not recommended before or after an invasive diagnostic testing. 7) The chromosomal microarray test as an alternative to the conventional cytogenetic test is not recommended for all pregnant women who will undergo an invasive diagnostic testing. 8) Amniocentesis before 14 weeks of gestation is not recommended because it increases the risk of fetal loss and malformation. 9) CVS before 9 weeks of gestation is not recommended because it increases the risk of fetal loss and malformation. 10) Although the risk of fetal loss associated with invasive prenatal diagnostic testing (amniocentesis and CVS) may vary based on the proficiency of the operator, the risk of fetal loss due to invasive prenatal diagnostic testing is higher in twin pregnancies than in singleton pregnancies. 11) When a monochorionic twin is identified in early pregnancy and the growth and structure of both fetuses are consistent, an invasive prenatal diagnostic testing can be performed on one fetus alone. However, an invasive prenatal diagnostic testing is recommended for each fetus in cases of pregnancy conceived via in vitro fertilization, or in cases in which the growth of both fetuses differs, or in those in which at least one fetus has a structural abnormality. The guidelines were established and approved by the Korean Academy of Medical Sciences. This guideline is revised and presented every 5 years.ope
μ¬νμ°Έμ¬μ 볡μμ£Όμ μ΄λμ΄ νκ΅ μλ―Όμ΄λμ νμ±μ λΌμΉ μν₯
νμλ
Όλ¬Έ (μμ¬)-- μμΈλνκ΅ λνμ : μ’
κ΅νκ³Ό, 2013. 8. μ μν.λ³Έ λ
Όλ¬Έμ 1987λ
λ―Όμ£Όν μ΄λ μκΈ°μ μ κ°λ μ¬νμ°Έμ¬μ 볡μμ£Όμ μ΄λμ λ°°κ²½μ λ°νκ³ μ΄ μ΄λμ΄ νκ΅ μλ―Όμ΄λμ νμ±μ λΌμΉ μν₯μ λΆμνλ κ²μ λͺ©μ μΌλ‘ νλ€. 1980λ
λ μ€λ°μ λ°μ λΆ μ΄λμ ν΅ν λ―Όμ£Όνμ μ΄κΈ°κ° 무λ₯΄μ΅λ μκΈ°μκ³Ό λμμ λ―Όμ£Όν μ΄ν 본격μ μΌλ‘ λ§κ² λλ μλ―Όμ΄λμ μλλ₯Ό μ€λΉνλ μκΈ°μ΄κΈ°λ νλ€. λ³Έ λ
Όλ¬Έμ μ΄ μκΈ°μ κ°μ κ΅ λ΄μ ν λΆνμΈ λ³΅μμ£Όμ μ΄λμ΄ νλ°ν μ¬νμ°Έμ¬λ₯Ό μμνκ² λ λ°°κ²½κ³Ό κ·Έ μ κ° μμμ μ΄ν΄λ³΄κ³ , νκ΅ μλ―Όμ΄λμ νμ±μ λΌμΉ μν₯μ 보μ¬μ€λ€. μ΄λ λ―Όμ£Όν κ³Όμ μμ μ£Όλμ μΈ μν μ μννλ μμ λ―Όμ€μ΄λ μ§ν₯μ κΈ°λ
κ΅ λΆν μΈμ μλ―Όμ΄λμ λ¨μ΄λ₯Ό νκ³ μλ‘μ΄ μ¬νμ΄λμ μ€λΉνλ κ°μ κ΅ λ³΅μμ£Όμ λΆνμ μμ¬μ μλ―Έλ₯Ό λμ΄λ €λ΄λ μμ
μ΄ λ κ²μ΄λ€.
1980λ
λ νκ΅μμ λ±μ₯ν μ¬νμ°Έμ¬μ 볡μμ£Όμ μ΄λμ 1940λ
λ λ―Έκ΅μμ λλν μ 볡μμ£Όμ μ΄λμ μν₯μΌλ‘ μμλμλ€. λ―Έκ΅ μ 볡μμ£Όμ μ΄λμ μ±κ³Όλ¬ΌμΈ νλλ λλΌμ λν μλ‘μ΄ ν΄μ, λ‘μμΈμ½ κ·Έλ¦¬κ³ κΈ°λ
κ΅μΈκ³κ΄μ΄λμ νκ΅ κ°μ κ΅μΈλ€μ μ¬νμ°Έμ¬λ₯Ό μ νμ Β· μ² νμ μΌλ‘ μ λΉνν΄μ£Όλ ν λλ₯Ό μ 곡νλ€. κ·Έλ¬λ 1980λ
λ νκ΅μ κ°μ κ΅μΈλ€μκ² μ¬νμ°Έμ¬μ μ±
μμ μκ·Ήν κ²μ λΉμ νλ°νκ² μ κ°λμλ λ―Όμ£Όνμ΄λμ΄μλ€. λ―Έκ΅μ μ 볡μμ£Όμ μ΄λμ κ·Όλ³Έμ£Όμ μΈλ ₯κ³Όμ κ°λ±κ³Ό λΆλ¦¬λ₯Ό ν΅ν΄ μ¬νμ°Έμ¬μ μ±κ²©μ νλνμμ§λ§, νκ΅μ μ¬νμ°Έμ¬μ 볡μμ£Όμ μ΄λμ 80λ
λ λ―Όμ€μ΄λ νΉμ κ°μ κ΅μ μνλ©λ컬 μ΄λ μ§μμ νλ°ν λ―Όμ£Όν μ΄λμΌλ‘ μΈν μκ·ΉμΌλ‘λΆν° μ’
κ΅μ μ¬νμ±
μμ μΈμνκ² λμλ€. μ¬νμ°Έμ¬λ₯Ό λλ¬μΌ λ
Όμμ λμμ΄ λ―Έκ΅ λ³΅μμ£Όμμλ€μκ²λ κ·Όλ³Έμ£Όμμλ€μ΄μμ§λ§ νκ΅μ 볡μμ£Όμμλ€μκ²λ λ―Όμ€μ΄λ μ§μμ΄μλ€λ κ²μ΄λ€. μ΄ κ³Όμ μμ νκ΅μ 볡μμ£Όμμλ€μ μ¬νμ λν κ΄μ¬μ λ―Όμ€μ΄λ μ§μκ³Ό 곡μ νλ©΄μλ μ λ¬Όλ‘ μ΄λΌλ μ¬μκ³Ό νλ ₯νλͺ
μ΄λΌλ λ°©λ²λ‘ μλ 거리λ₯Ό λμλ€. νκ΅μ μ¬νμ°Έμ¬μ 볡μμ£Όμ μ΄λμ λ―Όμ£Όν μ΄λμ μ κ·Ήμ 주체μλ λ
Έλμ Β· λλ―Ό λ±μ λ―Όμ€μ΄λ, λ―Όμ€μ΄λμ μ΄λ‘ μ μΌλ‘ λ·λ°μΉ¨νλ λ§λ₯΄ν¬μ€μ£Όμ, λ―Όμ€μ΄λκ³Ό λ§λ₯΄ν¬μ€μ£Όμμ μ νμ μμ©μ κ²°κ³ΌμΈ λ―Όμ€μ ν, λ―Όμ€μ νμ κΈ°λ°μΌλ‘ μ¬νμ΄λμ λ²μλ μνλ©λ컬 μ§μ λͺ¨λμ ꡬλ³λλ μ΄λμΌλ‘μ μ€μ€λ‘μ μ 체μ±μ κ·μ νμλ κ²μ΄λ€.
80λ
λμ 90λ
λμ νκ΅ μ¬νμ°Έμ¬μ 볡μμ£Όμ μ΄λμ μ¨κ±΄ν μ¬νμ°Έμ¬μ 볡μμ£Όμ μ΄λκ³Ό κΈμ§μ μΈ μ¬νμ°Έμ¬μ 볡μμ£Όμ μ΄λμΌλ‘ λΆνλμ΄ κ°μμ μ
μ₯μ κ°μ‘°νλ λ
Όμμ λ²μ΄λ©΄μλ 곡쑴νλ λͺ¨μ΅μ 보μλ€. κΈμ§μ μΈ λΆνλ λΉμ λ―Όμ€μ΄λμ μ€μν μ΄λ‘ μ λ°°κ²½μ΄μλ λ§λ₯΄ν¬μ€μ£Όμμ λ―Όμ€μ ν, κ·Έλ¦¬κ³ νλ ₯νλͺ
μ΄λΌλ μ΄λμ λ΅μ μΌμ λΆλΆ μμ©νμκ³ , μ¨κ±΄ν λΆνλ μ΄λ₯Ό λΉννλ©° 볡μμ£Όμ μ μμ ν μμμμ μ¬νμ°Έμ¬ μ΄λμ μ§ν₯νμλ€. μ΄ κ³΅μ‘΄μ μκΈ°λ μ§§κ² λλλ€. κΈμ§μ μΈ μ¬νμ°Έμ¬μ 볡μμ£Όμ λΆνκ° λ³΅μμ£Όμ μ μμ μ μ§νλ©΄μλ λ§λ₯΄ν¬μ€μ£Όμμ λ―Όμ€μ νμ μμ©νλ μ νμ Β· μ€μ²μ ν λλ₯Ό νμμν€μ§ λͺ»νκΈ° λλ¬Έμ΄λ€. κ²°κ³Όμ μΌλ‘ κ·Έλ€ μ€ μΌλΆλ μ μμ λ²λ¦¬κ³ μμ μ΄λκΆμΌλ‘ μλ ΄λκ±°λ λ―Όμ€μ΄λ λ΄ μνλ©λ컬 μ§μμΌλ‘ μ΄μ νμ§λ§, λλΆλΆμ κΈμ§μ μΈ μ¬νμ°Έμ¬μ 볡μμ£Όμμλ€μ μ¨κ±΄ν μ¬νμ°Έμ¬μ 볡μμ£Όμμλ€κ³Ό ν¨κ» μλ―Όμ΄λλ¨μ²΄λ₯Ό κ²°μ±νκ±°λ 볡μμ£Όμ λͺ©νμμ κΈΈμ μ ννμλ€. μ¨κ±΄ν μ¬νμ°Έμ¬μ 볡μμ£Όμμλ€μ λ―Όμ£Όν μ΄ν νμ±λ μλ―Όμ¬νμ κΈ°νμμμ μ‘μ κΈ°μ€μ€μ΄λ κ²½μ€λ ¨ λ±μ μλ‘μ΄ μλ―Όμ΄λλ¨μ²΄λ₯Ό νμ±νλ€. λ°λΌμ λ―Όμ£Όν μ΄ν νκ΅μ μλ―Όμ΄λ νμ±μ μν₯μ μ€ λ³΅μμ£Όμ λΆνλ λ°λ‘ μ΄ μ¨κ±΄ν μ¬νμ°Έμ¬μ 볡μμ£Όμμλ€μ΄λΌκ³ ν μ μλ€.
μ¨κ±΄ν μ¬νμ°Έμ¬μ 볡μμ£Όμ μ΄λμ΄ νκ΅ μλ―Όμ΄λμ νμ±μ λΌμΉ μν₯μ ν¬κ² μλ―Όμ΄λλ¨μ²΄μ κ²°μ±κ³Ό μλ―Όμ΄λμ μ±κ²© κ·μ μ΄λΌλ λ μΈ‘λ©΄μ μ§μ ν μ μλ€. 1980λ
λ μ¨κ±΄ν μ¬νμ°Έμ¬μ 볡μμ£Όμμλ€μ 1987λ
κΈ°μ€μ€κ³Ό 1989λ
κ²½μ€λ ¨μ μ€λ¦½νλ λ± λ³Έκ²©μ μΈ μλ―Όμ΄λλ¨μ²΄λ₯Ό μμν¨μΌλ‘μ¨ νκ΅ μλ―Όμ΄λμ νμ±μ κΈ°μ¬νλ€. μ΄λ€μ μ±κ³΅μΌλ‘ 7,80λ
λ λ―Όμ€μ΄λμ λ²μ£Όμ ν¬ν¨λμ΄ μλ μ΄λλ¨μ²΄λ€μ΄ 80λ
λ λ§λΆν° κ·Έ μ±κ²©μ λ¬λ¦¬νκΈ° μμνμ¬ 90λ
λ μ΄ μμ ν μλ―Όμ΄λμ μ±κ²©κ³Ό λ°©μμ μμ©νκΈ°μ μ΄λ₯Έλ€. μ¨κ±΄ν μ¬νμ°Έμ¬μ 볡μμ£Όμ μ΄λμ΄ μλ―Όμ΄λμ νμ±μ λΌμΉ λ λ²μ§Έ μν₯μ νκ΅ μλ―Όμ΄λμ μ±κ²©μ κ·μ νλ€λ μ μ΄λ€. μ¨κ±΄ν μ¬νμ°Έμ¬μ 볡μμ£Όμ λΆνλ 볡μμ£Όμ λ΄λΆμμμ κΈμ§μ μΈ μ¬νμ°Έμ¬μ 볡μμ£Όμ μ΄λκ³Ό 볡μμ£Όμ μΈλΆμ μλ λ―Όμ€μ΄λκ³Ό λ§λ₯΄ν¬μ€μ£Όμ, λ―Όμ€μ ν, κ·Έλ¦¬κ³ μνλ©λ컬 μ΄λμ λ°λνλ κ²μΌλ‘ μ€μ€λ‘μ μ 체μ±μ κ·μ νλ€. μ΄λ¬ν μ 체μ±μ μ΄λ€μ΄ νμ±ν νκ΅ μλ―Όμ΄λμ μ΄κΈ° μ±κ²©μλ κ·Έλλ‘ μ΄μ΄μ§λ€. μ¨κ±΄ν μ¬νμ°Έμ¬μ 볡μμ£Όμ λΆνλ μ μΉμ λ―Όμ£Όνκ° μ±μ·¨λ μ§ν μ€λ¦½λ κΈ°μ€μ€κ³Ό κ²½μ€λ ¨μ ν΅ν΄μ νκ΅μ μλ―Όμ΄λμ μ μ (ε
ε )ν¨μΌλ‘μ¨ λ―Όμ€μ΄λμ΄ μλ μλ―Όμ΄λ, λ§λ₯΄ν¬μ€μ£Όμκ° λ΄μΈμ°λ κ³κΈ μ μΉμ λ°λνλ μ΄λμΌλ‘μμ μλ―Όμ΄λμ μ±κ²©μ κ·μ νκ² λλ€. μλ―Όμ¬νμ μλ―Όμ΄λμ λλ¬μΌ μ΄λ‘ μ λ
Όμμ΄ νκ³μ μ΄λ μ§μμμ νλ°ν΄μ§κΈ° μμν κ²μ 1990λ
λμ λ€μ΄μμΈλ° νμλ€κ³Ό νλκ°λ€μ κΈ°μ€μ€κ³Ό κ²½μ€λ ¨μ νκ΅ μλ―Όμ΄λμ μ λ²(ε
Έη―)μΌλ‘ μΌμλ€.
λ³Έ λ
Όλ¬Έμ κ·Έ λμ μ λλ‘ ν¬μ°©λμ§ λͺ»ν 1987λ
λ―Όμ£Όν μ ν κ°μ κ΅ λ³΅μμ£Όμ μ΄λκ³Ό μλ―Όμ΄λμ κ΄κ³μ μ΄μ μ λ§μΆμλ€. κΈ°μ‘΄μ νκ΅ μλ―Όμ΄λ νμ±μ λλ¬μΌ νκ³μ λ΄λ‘ μμλ 볡μμ£Όμ μ΄λμ μν κ³Ό μ€μμ±μ΄ κ°κ³Όλμλ€. νκ΅μ μλ―Όμ΄λμ νμ±νκ³ κ·Έ μ±κ²©μ κ·μ νλ μ¬νμ°Έμ¬μ 볡μμ£Όμ μ΄λμ μμ¬μ νΉμ±μ λ°νμΌλ‘μ¨ μ¬ν λ³λμ λν μ’
κ΅μ λ
립λ³μλ‘μμ μν μ μ£Όλͺ©νλ€λ μ μμ λ³Έ λ
Όλ¬Έμ νλ¬Έμ μμλ₯Ό μ°Ύμ μ μλ€.λͺ© μ°¨
κ΅λ¬Έμ΄λ‘ β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’ β
°
λͺ©μ°¨ β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’ β
΄
β
. μλ‘ β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’ 1
1. λ
Όλ¬Έμ λͺ©μ κ³Ό μμ β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’ 1
2. μ νμ°κ΅¬ κ²ν β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’ 4
3. λ
Όλ¬Έμ κ΅¬μ± β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’ 22
β
‘. νκ΅μ μ¬νμ°Έμ¬μ 볡μμ£Όμμ νμ±κ³Ό λ°°κ²½ β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’ 30
1. λ°°κ²½ : λ―Έκ΅ μ 볡μμ£Όμμ μμ¬ β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’ 31
2. νκ΅μ μ¬νμ°Έμ¬μ 볡μμ£Όμμ νμ± β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’ 37
3. νκ΅μ μ¬νμ°Έμ¬μ 볡μμ£Όμμ μ±κ²© β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’ 45
β
’. νκ΅ μ¬νμ°Έμ¬μ 볡μμ£Όμ μ΄λμ λΆν β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’ 48
1. μ¬νμ°Έμ¬μ 볡μμ£Όμ μ΄λμ λΆν β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’ 48
2. κΈμ§μ μΈ μ¬νμ°Έμ¬μ 볡μμ£Όμ μ΄λμ λ°ν₯κ³Ό μ ν΄ β’β’β’β’β’β’ 61
3. μ¨κ±΄ν μ¬νμ°Έμ¬μ 볡μμ£Όμ μ΄λμ λλ β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’ 70
β
£. νκ΅ μλ―Όμ΄λμ μμκ³Ό 볡μμ£Όμμ μν₯ β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’ 81
1. μλ―Όμ΄λλ¨μ²΄μ κ²°μ± β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’ 82
2. μλ―Όμ΄λμ μ±κ²© κ·μ β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’ 96
β
€. κ²°λ‘ β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’ 121
μ°Έκ³ λ¬Έν β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’ 127
ABSTRACT β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’β’ 137Maste
Synthesis, Characterization, and Applications of Highly Efficient Far-Red to Near Infra-Red Emissive Ξ²-Dicyanodistyrylbenzene Derivatives
νμλ
Όλ¬Έ (μμ¬)-- μμΈλνκ΅ λνμ : μ¬λ£κ³΅νλΆ(νμ΄λΈλ¦¬λ μ¬λ£), 2014. 2. λ°μμ.In the last decades, the immense interest in highly fluorescent Ο-conjugated compounds which emit deep red to near infrared (NIR) in the solid state has been driven by their utilities toward advanced photonic applications such as organic light-emitting diodes, fluorescent chemosensors, organic solid-state lasers. However, most of organic red emitting fluorophores suffer from aggregation-caused quenching due to their characteristics of strong ΟβΟ stacking, dipole-dipole interaction or donor (D)-acceptor (A) charge transfer interaction. Thus, the development of strongly far-red to NIR emitting materials in the solid state is still challenging.
Recently, highly fluorescent solid-state emitters based on 2Z,2'Z-3,3'(or2,2)-(2,5-dimethoxy-1,4-phenylene)bis(2(or3)-phenylacrylonitrile (MODCS) have been explored and contributed to establish the relationship between the molecular arrangement and the corresponding fluorescence features on aggregation-induced enhanced emission (AIEE) depending on the position of the pendant cyano group on the stilbene.
As an extended work for further development of Ξ²-MODCS exhibiting strong deep red-NIR fluorescence, I herein report the synthesis of the D-A-D-A-D type Ξ²-dicyanodistyrylbenzene (Ξ²-DCS) derivatives that have various N-amine moieties (Ξ²-MODEADCS, Ξ²-MODBADCS, Ξ²-MODPADCS, Ξ²-EODEADCS) with emission maximum peaks in the range of 650 nm and 718 nm. Among them, Ξ²-MODEADCS especially exhibits emission in the Near Infra-Red region with quite good quantum efficiency (Π€FL = 0.42). These unique highly emissive properties in the solid-state were thoroughly investigated by UV-Vis spectroscopy, photoluminescence spectroscopy, fluorescence lifetime measurement, electrochemical measurement, and single crystal X-ray analysis. Furthermore, we also present Ξ²-dicyanodistyrylbenzene based highly red fluorescent amphiphilic molecules Ξ²-EODEADCS and Ξ²-wedge DEADCS. Their optical properties and intriguing nanostructures in water were obtained by DLS, SEM, cryo-TEM experiments and UV-Vis spectroscopy. Based on the understanding of their optoelectrical characteristics, we demonstrated p-type single crystal organic field-effect transistors (SC-OFETs) using high crystalline Ξ²-MODEADCS and bio-imaging with self-assembled nanoparticles of Ξ²-EODEADCS.Contents
Abstract i
Contents iv
List of Tables vii
List of Schemes viii
List of Figures ix
Chapter 1 Introduction 1
1.1 Highly Efficient Solid-state Emissive Ο-conjugated Organic Materials 1
1.2 Aggregation-induced enhanced emission(AIEE) 4
1.2.1 Organic field-effect transistors (OFETs) 7
1.2.2 Fluorescent optical recording media 10
1.2.3 Biological imaging 12
1.3 Characteristics and Significance of Far-red Fluorophores 14
1.4 Research objective 16
1.5 Bibliography 17
Chapter 2 Synthesis and Characterization of Stimuli-Responsive Ξ²-Dicyanodistyrylbenzene
Derivatives exhibiting Highly Efficient Solid-state Emission in the Far-red to Near Infra-Red Region
20
2.1 Design concept and Target materials 20
2.2 Experimental 25
2.2.1 Synthesis 25
2.2.2 Sample preparation 29
2.2.3 Spectroscopic characterization 30
2.2.4 X-ray and Thermal analysis 31
2.2.5 Quantum chemical calculation 31
2.3 Results and Discussion 32
2.3.1 Optical properties in various phases 32
2.3.2 Single crystal analysis of Ξ²-MODEADCS 41
2.3.3 Luminescence switching by Mechanical and Thermal stimuli 46
2.3.4 Fabrication and Measurement of SC-OFETs 52
2.4 Conclusion 56
2.5 Bibliography 57
Chapter 3 Novel Far-Red Fluorescent Molecules forming Self-assembled Nanostructure in Aqueous Systems: Introducing Ethyleneoxide Groups to the Ξ²-DCS Core 59
3.1 Design concept and Target materials 59
3.2 Experimental 62
3.2.1 Synthesis 62
3.2.2 Spectroscopic characterization 67
3.2.3 Thermal analysis and Morphological analysis 68
3.2.4 Quantum chemical calculation 69
3.3 Results and Discussion 70
3.3.1 Photophysical property 70
3.3.2 Fabrication of self-assembled nanostructures and Morphology
76
3.3.3 In vitro Cell imaging 81
3.4 Conclusion 85
3.5 Bibliography 87
Abstract in Korean 88
List of Presentations 91Maste
μ λ³κ²μ¬ λꡬ κ°λ° κ³Όμ μ μ€μ¬μΌλ‘ μ΄ν΄λ³Έ μ°μΈμ μΈ‘μ νλ μ§μμ νμ±, 1993~2011 νκ΅
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Όλ¬Έμ 1993λ
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μ¬μ΄ νκ΅ μ¬νμμ μ°μΈμ μΈ‘μ νλ μ§μμ΄ νμ±λ κ³Όμ μ λΆμνμλ€. μ΄λ₯Ό μν΄ λ³Έ λ
Όλ¬Έμ λκ·λͺ¨ μ μ μ§ν μνμ‘°μ¬λ₯Ό μν΄ μ°μΈμ¦ μ λ³κ²μ¬ λκ΅¬κ° κ°λ°λ λ°°κ²½κ³Ό μ μ© κ³Όμ μ μ΄ν΄λ΄μΌλ‘μ¨ μΈλ‘ κΈ°μ¬λ₯Ό λΉλ‘―ν΄ λ€μν μ°μΈμ¦ μ°κ΅¬μ μμ£Ό μΈμ©λλ μ°μΈμ¦ μ λ³λ₯ κ°μ νμ± κ³Όμ μ λΉνμ μΌλ‘ λΆμνμλ€.
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μ μ λ³΄κ±΄λ² μ μ μ΄ν νκ΅μ μ μ 보건μ μ±
μ΄ μμ© μ€μ¬μ μ μ±
μμ μ§μμ¬ν μ μ 보건 μ μ±
μΌλ‘ μ ν₯ν κ²μ΄λ€. μ§μμ¬ν μ μ 보건μ μ±
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λ λ²μ§Έ λ§₯λ½μ OECD μμ΄λ₯ 1μ κ΅κ°λΌλ μ€λͺ
κ³Ό ν¨κ» νκ΅ μ¬νμμ μμ΄μ΄ μ¬νμ μ΄μλ‘ λ μ€λ₯΄λ©΄μ 2000λ
λ μ΄ λ μ°¨λ‘μ κ±Έμ³ μ€μλ μμ΄μλ°©μ’
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μ μ€μλ€. μμ΄μλ°©μ’
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μ μμ΄μ μμΈμΌλ‘μ μ°μΈμ¦μ μ§λͺ©νλ©΄μ μμ΄ κ³ μνκ΅°μΌλ‘μ μ μ¬μ μΈ μ°μΈμ¦ νμλ₯Ό μ λ³ν΄λ΄λ μΌμ μ€μν κ³Όμ λ‘ λ§λ€μλ€.
λ³Έ λ
Όλ¬Έμ μ΄λ¬ν μλμ λ°°κ²½μ μΌλμ λλ©΄μ μ°μΈμ¦ μ λ³κ²μ¬ λꡬμ κ°λ° κ³Όμ μ λΆμνμλ€. μ λ³κ²μ¬ λꡬλ μ°μΈμ¦μ μ§λ¨νλ λꡬμ μ°μΈκ°μ μ λλ₯Ό μΈ‘μ νλ λκ΅¬λ‘ λλλ€. λ³Έ λ
Όλ¬Έμ μ°μΈκ°μ μ λλ₯Ό μΈ‘μ νλ λꡬλ μ°μΈμ¦μκ΅°μ κ°λ €λ΄λ κ²μΌλ‘ μμ μ§λ¨κ³Όλ λ€λ¦μλ λΆκ΅¬νκ³ , μ°μΈκ°μ μ λλ₯Ό μΈ‘μ νλ λκ΅¬κ° μ°μΈμ¦μ μ§λ¨νλ λκ΅¬λ³΄λ€ μλμ μΌλ‘ κ°νΈνκ³ λ¨μνμ¬ μνμ‘°μ¬λ₯Ό ν¬ν¨ν΄ μΈλ‘ κΈ°μ¬λ μ§μꡬ μ μ 건κ°μΌν°μ μκ°κ²μ§ ν
μ€νΈ λ¬Έν λ±μμ λ§μΉ μ°μΈμ¦μ μ§λ¨νλ λꡬμ²λΌ νΌλλμ΄ μ°μΈλ€λ μ μ 보μλ€. λν, μ§λ¨ λꡬλΌκ³ νλλΌλ μνμ‘°μ¬μμ μ΄λ£¨μ΄μ§λ μ§λ¨μ μ΄λκΉμ§λ μ μ μ μΈ(tentative) κ²μΌλ‘, μνκ΅°μ κ°λ €λ΄ μΉλ£λ‘ μΈλνκΈ° μν¨μ΄μ§ μμ μμ¬μ μν΄ λ΄λ €μ§λ μ μ μ§λ¨μ΄λΌκ³ λ³Ό μ μλ€.
λλΆμ΄ λ³Έ λ
Όλ¬Έμ μ°μΈμ¦ μ λ³κ²μ¬ λκ΅¬κ° λ²μλλ κ³Όμ μ΄ νκ΅μΈμ΄ κ²½ννλ λ°©μμ μ°μΈμ΄ μΆ©λΆν κ³ λ €λμλ€κΈ°λ³΄λ€λ μμ΄λ‘ μ΄λ£¨μ΄μ§ λ¬Ένμ΄ νκ΅μ΄λ‘ λ²μλλ, μ΄μμ μΈ μ°¨μμ λ²μμ κ·Έμ³€λ€λ μ λ 보μλ€. λ λ²μ μ΄ν μ λ³κ²μ¬ κ²°κ³Ό μ μμμ λͺ μ κΉμ§λ₯Ό μ°μΈμ¦μ΄λΌκ³ λ³Ό κ²μΈμ§μ λ°λΌ, μ¦ μ΅μ μ λ¨μ (cut-off score)μ μ΄λ»κ² λ κ²μΈμ§μ λ°λΌμ μ°μΈμ¦ μ λ³λ₯ μ ν¬κ² λ¬λΌμ§ μ μμΌλ©°, μ΄ κ°μ κ΅κ°λ§λ€ λ¬λΌμ§ μ μκ³ , λ κ°μ κ΅κ° μμμλ μνμ‘°μ¬μ λͺ©μ μ λ°λΌ λ¬λΌμ§ μ μμμ 보μλ€.
μ΄μμ λ
Όμλ₯Ό ν΅ν΄ λ³Έ λ
Όλ¬Έμ λ€μν κΈμ λ¬Έμ μμ΄ μΈμ©λ λ§νΌ μ°μΈμ μΈ‘μ νλ μ§μμ΄ κ°κ΄μ±μ ν보ν λ¨λ¨νκ³ κ³ μ λ μ§μμ΄ μλλ©°, μ°μΈμ¦μ μ§λ¨κ³Ό μ°μΈ μ¦μμ μΈ‘μ μ΄ νΌλλκΈ°λ νκ³ , μ λ³λ₯ μμ²΄κ° λͺ©μ μ λ§κ² μ‘°μ¨λκΈ°λ νλ λ± νΉμ ν μ곡κ°μ λ°°κ²½κ³Ό μ°κ΅¬ λͺ©μ μ λ°λΌ ꡬμ±λλ κ°μ΄λΌλ μ μ 보μλ€.
μ°μΈμ¦ μ λ³λ₯ κ°μ΄ νκ΅ μ¬νμμ μ΄λ€ μλ―ΈμΈμ§ ν΄μνκΈ° μ΄μ μ ν΄λΉ μμΉκ° μμ°λ κ³Όμ μ λ€μ¬λ€λ³΄λ κ²μ κΈ°μ‘΄μ νκΈ° μ΄λ €μ λ λ¬Έμ (μ°μΈμ¦ μΉλ£ νμλ λμ΄λλλ° μ΄μ§Έμ μμ΄λ₯ μ μ€μ΄λ€μ§ μλκ°? μ¬μ±μ΄ λ¨μ±λ³΄λ€ μ°μΈμ¦μ μ·¨μ½νλ° μ λ¨μ±μ΄ λ λ§μ΄ μμ΄νλκ°? λ±)μ μ€λ§λ¦¬λ₯Ό μ°μΈμ¦ μ§μμ μμ° κ·Έ μ체μμ μ°Ύμ μλ μλ€λ μ μμ μμκ° μλ€κ³ λ³Έλ€. μ΄λ₯Ό ν΅ν΄ κ·Έλμ μ°λ¦¬κ° λꡬμκ² λ μ£Όλͺ©ν΄μλμ§, λ λꡬλ₯Ό μμλμ§λ₯Ό μ±μ°°νκ³ μ΄λμ κ°μ
ν μ μμμ§λ₯Ό ꡬ체μ μΌλ‘ κ²°μ ν μ μλ€λ μ μμ μλ―Έκ° μλ€.This paper examines how the knowledge of measuring depression and depressive symptoms was formed in South Korea between 1993 and 2011. This paper critically analyzes the formation process of the value of depression prevalence rate, which is often cited in various depression studies and media articles. To this end, this thesis examines how the depression and depressive symptoms screening tool for large-scale mental disorders epidemiologic study was developed and how this tool was applied in actual studies.
Two contexts played a significant role in the development of depression and depressive symptoms screening tool in South Korea. First, since the enactment of the Mental Health Act in 1995, the national mental heath policy put more emphasis on community-based mental health services than institutionalization-based psychiatric services. Community-based mental health policies with deinstitutionalization aim to detect mental disorders in the early phase to help people utilize mental health services. This transformation called for the need to survey mental disorder status in a national scale. The screening tool for depression was the first to be developed for this large-scale investigation.
Second, in the early 2000s, South Korea was infamous for the highest suicide rate among the OECD countries. Against this backdrop, the government implemented the the National Suicide Prevention Strategies twice. The National Suicide Prevention Strategies made the task to screen potential depression patients as a high-risk suicide group crucial, pointing to depression as the cause of suicide.
Screening tools are divided into two kinds, one for diagnosing depression and the other for measuring the degree of depressive symptoms. Although the tools to measure the degree of depressive symptoms cannot make clinical diagnosis by itself, its simplicity leads people to use the tool to diagnose depression online and offline in forms of media articles, epidemiologic surveys, and self-examination questions. It is worth noting that the diagnosis in epidemiologic study is tentatively held only to identify risk groups and guide them to be given appropriate treatment. The diagnosis is not a formal diagnosis made by a clinical physician.
This paper also examines the process of translating depression screening tool. In result, this paper shows that depression experienced by Koreans was not fully considered nor translated, but rather the questions in English were translated into Korean only on a linguistic level. After translation, the prevalence of depression can vary significantly depending on how the cut-off score is placed. The cut-off score may vary from country to country, and even within the same country, it may also vary depending on the purpose of the epidemiologic study.
Combining the discussion above, this paper argues that the knowledge of measuring depression is not solid. The diagnosis of depression and the measurement of depressive symptoms often confused, and the prevalence rate itself can be coordinated contingently on a specific temporal, social, and disciplinary context.
"Why doesn't the suicide rate decrease as the number of patients treated for depression increases?" "Why do men commit suicide more than women, when women are more vulnerable to depression than men?" These questions are hard to answer. I believe that looking into the process of how these figures were produced will give us clues to solve these difficult problems before fully understanding what the value of depression prevalence means in Korean society. It is because the cause of these problems may be linked to the production of depression knowledge itself. In this regard, a critical analysis on the process of producing knowledge of depression is meaningful in that one can reflect on who we have been paying more attention to and who we have forgotten, and decide where to intervene.1. μλ‘ 1
2. μ νμ°κ΅¬ κ²ν λ° μ΄λ‘ μ μμ 12
2.1. μ νμ°κ΅¬ κ²ν 12
2.2. μ΄λ‘ μ μμ 18
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4. μ°μΈμ¦ μΈ‘μ λꡬμ κ°λ°κ³Ό μ μ© 34
4.1. μΈ‘μ λμμΌλ‘μμ μ°μΈ, λꡬλ‘μμ μ λ³κ²μ¬ 40
4.2. κ΅κ°κ° λΉκ΅λ₯Ό μν μ΅μ μ λ¨μ μ€μ 58
5. κ²°λ‘ 72
μ°Έκ³ λ¬Έν 81
Abstract 100Maste
λ² κ²λμ λλ₯μ΄λμ€ μ¬λ‘μμ λλ¬λ κ³Όν νλμμμ μ΄λ‘ μ ν κ³Όμ μ°κ΅¬
κ³ λ±νκ΅μμ μ²μ μ§κ΅¬κ³Όνμ 곡λΆνκ² λλ©΄μ κ°μ₯ μ€μνκ² λ°°μ°λ κ² μ€ νλλ νκ΅¬μ‘°λ‘ μ΄λ€. μ΄ λ νμλ€μ νκ΅¬μ‘°λ‘ μ λͺ¨νκ° λ λ² κ²λμ λλ₯μ΄λμ€ μμ ν¨κ» λ°°μ°κ² λλ€. μ΄μ λν΄ νν λ£λ μ€λͺ
μ, λ² κ²λμ λλ₯μ΄λμ€μ λΉμ λλ₯μ΄λμ μλλ ₯μ μ μνμ§ λͺ»ν΄ λ°μλ€μ¬μ§μ§ λͺ»νλ€λ κ²μ΄λ€. μ΄ κΈμ μ΄λ¬ν μ€λͺ
μ μλ¬Έμ μ κΈ°νκ³ κ·Έμ λ§λ λ΅μ μ€μ€λ‘ μ°Ύμλκ°κΈ° μν μλλΌκ³ ν μ μλ€. λλ₯μ΄λμ€μμ μμνμ¬ 40λ
ν νκ΅¬μ‘°λ‘ μ μ±λ¦½μ μ΄λ₯΄κΈ°κΉμ§ μ§μ§ν νλͺ
κ³Όμ μ λ€λ₯Έ κ³Όννλͺ
λ§νΌμ μλμ§λ§ κ·Έλλ μ μ§ μμ μμ νμμ μν΄ λΆμλμ΄ μλ€. μ§μ§ν νλͺ
κ³Όμ μμ κ³Όνμ μ¬νκ° λ³΄μ¬μ€ κ²©λ ¬ν μ κ°μ¬κ³Ό λ κ·Έμ λλΉλλ νκ΅¬μ‘°λ‘ μ μμν μμ©μ λ§μ κ³Όνμ² νμλ€κ³Ό κ³Όνμ¬νμλ€μκ² ν₯λ―Έλ‘μ΄ λͺ¨μ΅μ΄μμΌλ¦¬λΌ μ§μνλ€. κ·Έλ€μ΄ ν μ°κ΅¬μ μ£Όλ μμ
μ ν¬κ² λ κ°μ§λ‘ λλλ€. 첫째λ μ§μ§ν νλͺ
μ΄ μ΄λ ν νΉμ±μ κ°μ§κ³ μλμ§ κΈ°μ‘΄ κ³Όνμ² νμλ€μ΄ μ μν λ°©λ²λ‘ μ νμ μ μ©νμ¬ μ΄ν΄λ³΄λ κ²μ΄κ³ , λμ§Έλ μ΄λ¬ν κ³Όμ μμ κ΄μ°°λλ κ³Όν νλμμμ ν©λ¦¬μ±μ λν΄ νꡬν΄λ³΄λ κ²μ΄λ€. λ μμ μ§μ§ν νλͺ
κ³Όμ μ΄ κ³Όν νλμμ μ΄λ‘ μ νμ κ³Όμ μ΄ μ΄λ»κ² μ΄λ£¨μ΄μ§λμ§λ₯Ό λΆμνκΈ°μ μ’μ μ¬λ‘κ° λ μ μμΌλ¦¬λΌ νλ¨νλ€
λ°©μ¬λ₯ μνμ λν μΈμ§κ° μμ°λ¬Ό κ°κ²© λ° μλΉμ λ―ΈμΉλ μν₯ λΆμ
νμλ
Όλ¬Έ (λ°μ¬)-- μμΈλνκ΅ λνμ : λμ
μλͺ
κ³Όνλν λκ²½μ μ¬ννλΆ, 2018. 2. λ
Έμ¬μ .μλΉμλ€μ 2011λ
3μμ λ°μν λμΌλ³Έ λμ§μ§κ³Ό νμΏ μλ§ μμ μ λ°©μ¬λ₯ μ μΆ μ¬κ³ λ‘ λ°©μ¬λ₯ μ€μΌλ λμμ°λ¬Ό μλΉμ λν λΆμκ°μ λκΌλ€. μλΉμλ€μ λ°©μ¬μ± λ¬Όμ§ λ
ΈμΆλ‘ μΈν΄ 건κ°μ μ΄μμ΄ μκΈ΄λ€κ³ μΈμνλ©°, μ΄λ¬ν μ¬νμ Β·μ¬λ¦¬μ μΈμμ μνμ§κ° μμ©μ ν΅μ¬ μμΈμ΄ λλ€. λν, λ°©μ¬μ± λ¬Όμ§ λ
ΈμΆκ³Ό μ΄λ‘ μΈν κ±΄κ° μν΄μ κ΄ν μΈλ‘ μ 보λ λ±μ μν νμμ λν λΆμκ°μ κ°μ€μν¨λ€. μ΄μ²λΌ, λ°©μ¬λ₯ μ μΆ μ¬κ³ λ μ€μ μνλ³΄λ€ μλΉμκ° λλΌλ λΆμκ°μ΄ ν¬λ©°, μ΄λ¬ν μν© λ³νλ μλΉμ μ€μ€λ‘ μμ μ 보νΈνλ €λ μ±ν₯μ 보μ΄κ² λλ€.
λ°©μ¬λ₯ μν μΈμ§μ λ°λ₯Έ κ±΄κ° λ³΄νΈ μ±ν₯ λ° κ΅¬λ§€ννμ λν μλ¬Έμμ μΆλ°ν λ³Έ μ°κ΅¬λ λ°©μ¬λ₯ μνμ 보 μ¦κ°μ λ°λΌ λ―Έμ κ°κ²©, μ 체 μμ°λ¬Ό λ° λͺ
ν μλΉμ μ΄λ€ μν₯μ μ£Όμλμ§ λΆμνλ€. μλΉμλ μν λ°μ μν©μμ λΆμκ° μν λ° κ±΄κ° λ³΄νΈλ₯Ό μν΄ μμ μλΉλ₯Ό νλ€. νΉν, λ°©μ¬λ₯ μ μΆ μ¬κ³ λ°μ μν©μμ λ°©μ¬λ₯μ μμ μλΉμ ν΄λΉνλ λ―Έμμ΄ μ΄λ¬ν μλΉ νμμ λ°λΌ μ΄λ€ κ°κ²©λ³λμ κ°μ Έμλμ§ μ€μ¦μ μΌλ‘ λΆμνλ€. λν, λ°©μ¬λ₯μ λν λΆμκ°μ΄ μ§μ μ μΌλ‘ μν₯μ μ£Όλ μμ°λ¬Όκ³Ό νΉν μΌλ³Έμμ μμ
μ΄ λ§μ λͺ
ν μλΉκ° μ΄λ€ λ³νλ₯Ό 보μλμ§ μ΄ν΄λ³Έλ€.
λ³Έ μ°κ΅¬λ λ€μκ³Ό κ°μ λͺ©μ μ κ°μ§κ³ μλ€. 첫째, λ°©μ¬λ₯μ μνμ΄ λμμ‘μ λ λ°©μ¬λ₯μ μμ μλΉ λμμΈ λ―Έμμ μ΄λ€ μν₯μ μ£Όμλμ§ λΆμνκ³ μ νλ€. μμ μλΉλ μν νμμ΄ λ°μνμμ λ μλΉλ₯Ό ν΅ν΄ μμμ μ»λ νλ μμμΌλ‘ λ°©μ¬λ₯ μνμ λ³΄λ‘ μΈν΄ λ―Έμκ°κ²© λ³νμ μν₯μ μ£Όμλμ§ μ€μ¦μ μΌλ‘ μ΄ν΄λ³Έλ€. λμ§Έ, λ°©μ¬λ₯ μνμ λ³΄κ° κ΅λ΄ μλΉμλ€μ μμ°λ¬Ό μλΉ λ° μΌλ³Έμμ μμ
μ΄ λ§μ νλͺ©μΈ λͺ
ν μ§μΆμ‘μ λ―ΈμΉ μν₯μ λΆμνμ¬ κ΅λ΄ μλΉμλ€μ μμ°λ¬Ό λ° λͺ
ν μλΉμ λ°©μ¬λ₯ μν₯μ΄ μμλμ§ μ€μ¦λΆμνλ€.
μ΄λ¬ν λͺ©μ μμ λ³Έ μ°κ΅¬λ λ κ°μ μλ
Όλ¬ΈμΌλ‘ ꡬμ±νμλ€. 첫 λ²μ§Έ λ
Όλ¬Έμ λ―Έμ μμ°λ, λ―Έμ μμ
Β·μμΆλ, λ―Έμ μ맀κ°κ²©, λ―Έμ μλΉ μ§μΆμ‘, λ°©μ¬λ₯ μνμ 보μ μλ£λ₯Ό μ΄μ©ν΄ μμ μλΉ νμμ΄ λ°©μ¬λ₯ μ μΆ μ¬κ³ λ°μμλ λνλ¬λμ§λ₯Ό VAR λΆμμ ν΅ν΄ νμΈνμλ€. VAR λΆμ κ²°κ³Όλ₯Ό 보면 λ°©μ¬λ₯ μν μ 보λ λ―Έμ μ맀κ°κ²©κ³Ό μ(+)μ κ΄κ³λ‘ λνλ¬λ€. μ΄λ λ°©μ¬λ₯ μνμ λ³΄κ° λ§μμ§λ©΄ λ°©μ¬λ₯ μνμ λν λΆμκ°μ΄ λμμ§κ³ μμ μλΉμ νλλ‘ λ―Έμ μλΉκ° λ§μμ§λ©΄μ μ맀κ°κ²©μ΄ μ¦κ°ν κ²μΌλ‘ νλ¨λλ€. λν, λ―Έμ μ§μΆμ‘κ³Όλ μ(+)μ κ΄κ³λ₯Ό 보μλλ° μ΄ μμ λ―Έμμ λν μ§μΆμ λλ¦ΌμΌλ‘μ¨ μ΄λ₯Ό ν΅ν΄ μμμ μ»λ νμλ₯Ό νλ€κ³ λ³Ό μ μλ€. λνμ μΉμλΆμ κ²°κ³Όλ₯Ό μ΄ν΄λ³΄λ©΄, λ°©μ¬λ₯ μνμ 보μ 좩격μ λ―Έμκ°κ²©μ μμ μν₯μ λ―ΈμΉλ κ²μΌλ‘ λνλ¬λ€. κ²°λ‘ μ μΌλ‘ λ―Έμ μ맀κ°κ²©κ³Ό λ°©μ¬λ₯ μνμ 보 κ°μ μ μ κ΄κ³κ° μμμ 보μκ³ , μ΄λ λ°©μ¬λ₯ μνμ 보μ λ°λ₯Έ μλΉμμ μμ μλΉ νμμ΄ λ―Έμ μ맀κ°κ²©μ μν₯μ μ£Όμλ€κ³ μ μΆν΄λ³Ό μ μλ€.
λ λ²μ§Έ λ
Όλ¬Έμ κ°κ³λν₯μ‘°μ¬(2006λ
~2013λ
)μ μμ°λ¬Ό λ° λͺ
ν μ§μΆμ‘μ κ°κ°μ μ’
μλ³μλ‘ μ€μ νκ³ λ°©μ¬λ₯ μν₯μ λνλ΄λ λ³μλ₯Ό μ¬μ©νμ¬ λ°©μ¬λ₯ μν₯μ΄ μ 체 μμ°λ¬Ό μ§μΆμ‘μ λ―ΈμΉ μν₯μ λΆμνμλ€. κ·Έ κ²°κ³Ό, λ°©μ¬λ₯ μ¬κ³ μ΄μ λ³΄λ€ μ΄ν μμ°λ¬Ό μ§μΆμ‘μ μ(-)μ κ΄κ³λ‘ λνλ¬λ€.
λ€μμΌλ‘, λ°©μ¬λ₯ μν₯μ΄ λͺ
ν μ§μΆμ‘μ μ€ μν₯μ λΆμν κ²°κ³Ό, λ°©μ¬λ₯ μνμ 보μ μ¦κ°λ λͺ
ν μ§μΆμ‘μ μ(-)μ μν₯μ μ£ΌμμΌλ©°, λ§μ°¬κ°μ§λ‘ λ°©μ¬λ₯ μ¬κ³ μ΄νμλ λͺ
ν μ§μΆμ‘μ΄ κ°μν κ²μΌλ‘ λΆμλμλ€. μμ°λ¬Ό μ§μΆμ‘κ³Ό λ¬λ¦¬ λ°©μ¬λ₯ μνμ 보λ³μμ λ°©μ¬λ₯ μ¬κ³ λλ―Έ λ³μ λͺ¨λκ° λͺ
ν μ§μΆμ‘μ μ(-)μ μν₯μ μ€ κ²μΌλ‘ λΆμλμλ€. μ΄λ μλΉμλ€μκ² λ°©μ¬λ₯ μ¬κ³ κ° μΌλ³Έμ° μμ
μ΄ λ§μ λͺ
ν μλΉμ μ§κ°μ μ μΈ μν₯μ μ€ κ²μΌλ‘ λ³Ό μ μλ€. μ¦, λ³Έ μ°κ΅¬μ λΆμκ²°κ³Όλ₯Ό ν λλ‘ μΌλ³Έμ λ°©μ¬λ₯ μ μΆ μ¬κ³ κ° μ°λ¦¬λλΌμμ μμ°νλ μμ°λ¬Όμλ λ°©μ¬λ₯ μ€μΌμ μ λ¬νμ§λ μμμ§λ§, μΌλ³Έμμ μμ
ν μμ°λ¬Όμ λν κ±°λΆκ°μ μ‘΄μ¬νμ κ²μΌλ‘ 보μΈλ€.
μν μνμ 보μ μμ μλΉ νμμ λ°λ₯Έ κ΅λ΄ μμ°λ¬Ό κ°κ²©μ κ΄ν λΆμκ³Ό μμ°λ¬Ό μλΉλ³νμ λν μ΄μμ μ°κ΅¬κ²°κ³Όλ ν₯ν μ΄μ λμνλ μ ν΅, ν맀, μ λΆμ μ μ ν μμ°λ¬Ό μ μ±
λΏλ§ μλλΌ μ¬λ λ° μ¬κ³ μν©μμ μ μ±
μ μννλλ° μ μ©ν μ 보 μ 곡μ νμ©λ κ²μ κΈ°λνλ€.
μ£Όμμ΄ : λ°©μ¬λ₯μνμ 보, μμ μλΉ, VAR λͺ¨ν, μμ°λ¬Ό μλΉ, λͺ
ν μλΉ
ν λ² : 2011-30332 λ°©μ¬λ₯ μνμ λ³΄κ° λ―Έμκ°κ²© λ³νμ λ―ΈμΉλ μν₯ 1
1.1. μλ‘ 1
1.2. μ΄λ‘ μ κ³ μ°° 5
1.2.1. μμ μλΉ νμμ μ΄λ‘ μ κ³ μ°° 5
1.2.2. λ°©μ¬λ₯ μ μΆ μ¬κ³ μ μμ μλΉ νμ 6
1.3. μ°κ΅¬λ°©λ² 10
1.3.1. μκ³μ΄μλ£μ λ¨μκ·Ό κ²μ 10
1.3.2. λ²‘ν° μκΈ°νκ·λͺ¨ν(Vector Autoregression) 11
1.3.3. Granger μΈκ³Όκ²μ (Granger Casuality Test) 13
1.3.4. λν μΉμ ν¨μ(Dynamic-multiplier function) 14
1.4. μλ£ λ° λ³μ 15
1.5. λΆμκ²°κ³Ό 22
1.5.1. μκ³μ΄μλ£μ λ¨μκ·Ό κ²μ κ²°κ³Ό 22
1.5.2. μμ°¨κ²°μ 24
1.5.3. λ²‘ν° μκΈ°νκ·λͺ¨ν(Vector Autoregression) 25
1.5.4. Granger μΈκ³Όκ²μ κ²°κ³Ό 29
1.5.5. λν μΉμ ν¨μ(Dynamic-multiplier function) 31
1.6. μμ½ λ° κ²°λ‘ 35
λ°©μ¬λ₯ μν μ λ³΄κ° μ 체 μμ°λ¬Ό λ° λͺ
νμ μλΉ μ§μΆμ‘μ λ―ΈμΉλ μν₯ λΆμ 37
2.1. μλ‘ 37
2.2. μ°κ΅¬λ°©λ² 41
2.3. λΆμμλ£ λ° λ³μ 44
2.4. λΆμκ²°κ³Ό 49
2.5. μμ½ λ° κ²°λ‘ 59
μ°Έκ³ λ¬Έν 62
[1]λ
Όλ¬Έ 62
[2]λ
Όλ¬Έ 68
λΆλ‘ 2 71Docto
Mismatch Negativityλ₯Ό μ΄μ©ν μ μ μ¦ μμμ κ³ μνκ΅°μ κ΄ν΄ μμΈ‘ μ°κ΅¬
νμλ
Όλ¬Έ (λ°μ¬)-- μμΈλνκ΅ λνμ : μκ³Όλν μνκ³Ό, 2018. 8. κΆμ€μ.μλ‘ : μ‘°νλ³μ μ‘°κΈ°μ λ°κ²¬νκ³ λ°λ³μ μλ°© λ° μ§μ°μν€κΈ° μνμ¬ μ‘°νλ³ μ ꡬ기 μ¦μμ 보μ΄λ μ μ μ¦ μμμ κ³ μνκ΅°μ λν μ°κ΅¬κ° νλ°ν μ΄λ£¨μ΄μ Έ μλ€. κ·Έλ¬λ μ μ μ¦ μμμ κ³ μνκ΅°μμ μ€μ λ‘ μ μ λ³μ΄ λ°μνλ μ¬λμ λΉμ¨μ΄ μ€μ΄λ€κ³ , μ μ λ³μ΄ λ°μνμ§ μλλΌλ λμ μνλ₯Ό 보μ΄λ μ¬λμ΄ λ§μμ΄ μλ €μ§λ©΄μ, μ μ λ³ λ°μκ³Ό μκ΄ μμ΄ μ μ μ¦ μμμ κ³ μνκ΅° μνμμ κ΄ν΄λ₯Ό μμΈ‘νκΈ° μν μλ¬Όνμ νμ§μ λ°κ΅΄μ νμμ±μ΄ λλλκ³ μλ€. λ³Έ μ°κ΅¬λ μ‘°νλ³ μμμ κ³ μνκ΅°μμ Mismatch Negativity (MMN) λ₯Ό μ΄μ©νμ¬ 6λ
μ μΆμ κ΄μ°° κΈ°κ° λμμ μνλ₯Ό μμΈ‘νκ³ μ νλ λͺ©μ μΌλ‘ μνλμλ€.
λ°©λ²: μ΄ 48λͺ
μ μ μ μ¦ μμμ κ³ μνκ΅°μμ μ°κ΅¬ μ°Έμ¬ μμ μ μμ νκ°λ₯Ό μννμκ³ , μ΄ν μΆμ μμ νκ°λ₯Ό μ΅λ 6λ
κΉμ§ μΌμ ν κ°κ²©μΌλ‘ μννμλ€. μμ νκ° κ²°κ³Όλ₯Ό λ°νμΌλ‘ μ μ μ¦ μμμ κ³ μνκ΅°μ κ΄ν΄κ΅°κ³Ό λΉκ΄ν΄κ΅°μΌλ‘ λλκ³ , μ°κ΅¬ μ°Έμ¬ μμ μ μΈ‘μ λMMN μ§νκ³Ό μ λλ λ°κ΅¬μ μλΆμΈ‘λμ΄λκ³Ό νλΆμ λμ΄λμ μ¬κ΅¬μ±λ MMN μμ± λΆμ μ λ₯ ν¬κΈ°λ₯Ό μ§λ¨ λΉκ΅νμλ€. μ μ μ¦ κ³ μνκ΅° μνλ‘λΆν°μ κ΄ν΄, μ½νλ μμ± μ¦μ, μ λ°μ κΈ°λ₯ μνμ ν볡μ μμΈ‘νλ μΈμλ₯Ό μ°Ύμλ΄κΈ° μνμ¬ νκ· λΆμμ μννμλ€.
κ²°κ³Ό: μ μ μ¦ μμμ κ³ μνκ΅°μμ κ΄ν΄κ΅°κ³Ό λΉκ΅νμ¬ λΉκ΄ν΄κ΅°μ μ°κ΅¬ μ°Έμ¬ μμ μμ λ μμ MMN μ§νμ 보μλ€. λ‘μ§μ€ν± νκ·λΆμμμ μ λ λΆμ μ κ·Ήμμ μΈ‘μ ν MMN μ§νμ΄ κ΄ν΄λ₯Ό μμΈ‘ν μ μλ μ μΌν μΈμλ‘ λμΆλμλ€. λ€μ€ νκ· λΆμμμ MMN μ§νκ³Ό νμ μ λ³μ μ μ¬μ©, κ΅μ‘ μ° μκ° μ½νλ μ μ λ³μ μ¦μμ νΈμ μ μμΈ‘νμλ€. μ°μΈ‘ μλΆμΈ‘λμ΄λκ³Ό νλΆμ λμ΄λμ MMN μμ± λΆμ μ λ₯ ν¬κΈ°, λμ΄, νμ°μΈμ μ μ¬μ©μ΄ κΈ°λ₯μ ν볡μ μμΈ‘νμλ€.
κ²°λ‘ : λ³Έ μ°κ΅¬μ κ²°κ³Όλ MMNμ΄ μ μ μ¦ μμμ κ³ μνκ΅°μμ μ μ λ³ λ°λ³κ³Ό μκ΄ μμ΄ μν μ체λ₯Ό μμΈ‘νλλ° μ λ§ν μμΈ‘ μΈμκ° λ μ μμμ μμ¬νλ€. μ μ μ¦ μμμ κ³ μνκ΅° μ΄κΈ° λ¨κ³μμλΆν° MMNμ μ΄μ©νμ¬ μ‘°κΈ°μ μνλ₯Ό μμΈ‘νκ³ μ μ ν μΉλ£λ₯Ό μ 곡νλ λ° λμμ λ°μ μ μμ κ²μ΄λ€.Abstract i
Contents iii
List of Tables iv
List of Figures v
List of Abbreviations vii
I. Introduction 1
II. Methods 4
III. Results 8
IV. Discussion 24
V. Conclusion 27
VI. References 28
Abstract in Korean 33Docto
Prediction of small-for-gestational age by fetal growth rate according to gestational age
BACKGROUND: Small-for-gestational age (SGA) infants should be identified before birth because of an increased risk of adverse perinatal outcomes. The objective of this study was to assess the impact of fetal growth rate by gestational age on the prediction of SGA and to identify the optimal time to initiate intensive fetal monitoring to detect SGA in low-risk women. We also sought to determine which the ultrasonographic parameters that contribute substantially to the birthweight determination.
METHODS: This was a retrospective study of 442 healthy pregnant women with singleton pregnancies. There were 328 adequate-for-gestational age (AGA) neonates and 114 SGA infants delivered between 37+0 and 41+6 weeks of gestation. We compared the biparietal diameters (BPD), head circumferences (HC), abdominal circumferences (AC), femur lengths (FL), and estimated fetal weights (EFW) obtained on each ultrasound to determine which of these parameters was the best indicator of SGA. We created receiver operating characteristic curves, calculated the areas under the curves (AUCs), and analyzed the data using multivariable logistic regressions to assess the ultrasound screening performances and identify the best predictive factor.
RESULTS: Among the four ultrasonographic parameters, the AC measurement between 24+0~28+6 weeks achieved a sensitivity of 79.5% and a specificity of 71.7%, with an AUC of 0.806 in the prediction of SGA. AC showed consistently higher AUCs above 0.8 with 64~80% sensitivities as gestational age progressed. EFW measurements from 33+0~35+6 gestational weeks achieved a sensitivity of 60.6% and a specificity of 87.6%, with an AUC of 0.826. In a conditional growth model developed from the linear mixed regression, the value differences between AC and EFW in the SGA and AGA groups became even more pronounced after 33+0~35+6 weeks.
CONCLUSION: Healthy low-risk women with a low fetal AC after 24 weeks' gestation need to be monitored carefully for fetal growth to identify SGA infants with a risk for adverse perinatal outcomes.ope
Clinical Practice Guidelines for Prenatal Aneuploidy Screening and Diagnostic Testing from Korean Society of Maternal-Fetal Medicine: (1) Prenatal Aneuploidy Screening
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.ope
Assessment of predictive markers for placental inflammatory response in preterm births
Placental inflammatory response (PIR) is associated with adverse neonatal outcomes such as sepsis, cerebral palsy, low birth weight, preterm birth, and neonatal mortality. However, there is an urgent need for noninvasive and sensitive biomarkers for prediction of PIR. In this study, we evaluated the clinical usefulness of maternal serum inflammatory markers for prediction of PIR in women with impending preterm birth. We conducted a retrospective cohort study of 483 patients who delivered preterm neonates. Serum levels of leukocyte differential counts, C-reactive protein (CRP), and neutrophil to lymphocyte ratio (NLR) were compared between women with no placental inflammation and women with PIR. The mean neutrophil counts, CRP levels, and NLR in both the patients with histologic chorioamnionitis (HCA) alone and those with HCA with funisitis were significantly higher than those in women with no placental inflammation. Compared to leukocyte subset or CRP, NLR in women with funisitis was significantly higher than in women with HCA alone and showed higher predictive accuracy, along with 71.4% sensitivity, 77.9% specificity, 80.7% positive predictive value, and 67.8% negative predictive value for prediction of PIR. On Kaplan-Meier survival analysis, women with both an elevated level of CRP and a high NLR had a shorter admission-to-delivery interval compared to women with either an elevated level of CRP or a high NLR alone. NLR may be a predictive marker of PIR and could be used as a cost-effective parameter for identifying women at risk of PIR.ope
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