여성권력과 로맨스 쓰기: 제인 오스틴의 『에마』연구

학위논문 (석사)-- 서울대학교 대학원 : 영어영문학과, 2017. 2. 조선정.이 논문은 제인 오스틴의 『에마』의 유례 없이 독특한 여주인공에 주목하여 새로운 형태의 구애소설을 엮어내는 오스틴의 서사 전략을 연구한다. 오스틴은 결혼할 동기가 없으며 결혼을 원치 않는 여주인공의 성취와 실패를 다채롭게 형상화함으로써 전통적인 결혼플롯의 단선적인 전개를 입체적으로 확장시킨다. 그 과정에서 근대적 개인의 주체성이 입체적으로 그려지고, 구애소설이 가질 수 있는 잠재적인 서사적 가능성이 극대화된다. 1장에서는 새로운 형태의 로맨스를 엮어내는 기반으로 작용하는 여주인공의 독특한 면을 살펴본다. 에마가 누리는 권력은 젠더의 이분법으로 규정할 수 없는 에마의 기질과 사회적 위치와 연동한다. 에마의 권력은 여성 억압적인 가부장 이데올로기와 길항하면서 에마의 독특한 면모를 형성한다. 오스틴은 여주인공을 복잡하고 독특한 인물로 그려내면서 새로운 형태의 로맨스를 준비한다. 2장에서는 에마의 결혼 주선이 대리 로맨스로 기능하며 관습적인 결혼플롯에 저항하는 서사적 장치가 되는 과정을 밝힌다. 대리 로맨스는 에마가 남성중심적 로맨스 서사와 자신을 분리하려는 욕망의 결과물이자 관습적인 로맨스가 포착할 수 없는 에로스를 담아내는 매개이다. 대리 로맨스는 여주인공의 로맨스를 대체하는 동시에 소설의 중심을 관통하는 결혼플롯, 즉 나이틀리의 로맨스를 준비하는 서사적 장치이기도 하다. 3장은 에마와 나이틀리의 로맨스가 전개되는 방식을 분석한다. 나이틀리의 청혼을 기점으로 소설이 엮어온 의미구조가 전복되며 일상적이고 사소한 장면에 기입된 에로스가 드러남으로써, 관습적인 결혼플롯이 재구성된다. 특별히 비평가들 사이에서 중요한 대목으로 꼽히는 박스힐 장면을 나이틀리의 자아성찰과 변화라는 관점에서 다시 읽으면서 오스틴이 어떻게 새로운 형태의 로맨스를 구성하는지 조명한다. 오스틴은 『에마』에서 여주인공을 복잡한 인물로 형상화하고 결혼플롯을 독특하게 전개하면서 소설의 의미구조를 여러 겹으로 펼쳐놓는다. 전통적 결혼플롯을 확장시키면서 오스틴은 소설 공간을 다양한 로맨스 플롯을 품어낼 수 있는 깊이 있고 확장된 공간으로 재창조하고, 구애소설의 틀을 다시 쓴다.Ⅰ. 서론 1 Ⅱ. 본론 14 1. 에마의 여성성과 여성권력 14 2. 에마의 결혼 주선과 로맨스 쓰기 36 3. 변화하는 나이틀리와 에마의 로맨스 57 Ⅲ. 결론 77 Works Cited 80 Abstract 84Maste

수평관 표면 활주 비등 기포에 대한 실험적 관측 및 힘 평형 분석

학위논문 (석사)-- 서울대학교 대학원 공과대학 에너지시스템공학부, 2017. 8. 조형규.Boiling on the outer surface of a horizontal tube occurs in various systems including PAFS, which is the passive residual heat removal system of APR +. In order to predict the boiling heat transfer based on a kinematic model such as the heat partitioning model, it is important to understand the behavior of the vapor bubbles. Particularly, in the case of the lower inclined surface such as the lower half of a horizontal tube, the accuracy of the heat transfer prediction depends on the evaluation of the sliding bubble motion. However, previous studies on bubble behavior mainly focused on the horizontal plate or the vertical channels, and the experimental and analytic studies on the sliding bubble behavior on a horizontal tube were insufficient. Therefore, the purpose of this study is as follows. First, measuring the sliding bubble behavior parameters experimentally, required for the improvement of the heat transfer model. Second, analyzing the sliding bubble behavior using the improved force balance model to establish the foundation of the predictable model. In order to observe the sliding bubble behavior on the outer surface of a horizontal tube heater, the experimental facility with a horizontal tube heater was constructed. In addition, the stereoscopic measurement technique using the two synchronized high-speed cameras was established. The experiment was performed using nearly saturated water under atmospheric pressure for various conditionsliquid velocity (11.2 – 27.6 mm/s), wall heat flux (26 – 66 kW/m2), and the location of nucleation site (0 – 180° from the bottom of the heater). A thin film heater with a narrow heating strip proposed in this study generates boiling bubbles in a restricted region on a horizontal heater. Therefore, the quality of the visualization of the sliding bubbles improved significantly. Furthermore, an artificial cavity created on the heating strip could control the location of the nucleation cavity so that it improved the surface condition difference between the polyimide-based heater and the metal heater. The two synchronized high-speed cameras captured the behavior of the bubbles from two perpendicular measurement angles. The configurations of the bubbles were identified by an image processing method based on shadowgraphy from the two images, and the results of the image processing includes various boiling bubble parameters, such as the departure and lift-off of bubble, bubble volume transient, bubble velocity, bubble frequency, etc. In particular, the volume of the non-spherical bubble was calculated by a three-dimensional reconstruction method, which defines a specific cross-section configuration at each elevation using stereoscopic images. The two verification steps confirmed that the reconstruction method has allowable errors and the monoscopic visualization method has a limitation for deformed bubble measurement. Based on the experimental observations, the force balance analysis of the sliding bubble on the horizontal tube was performed. The previous force balance model for the sliding bubble on a horizontal plate was improved for sliding bubble on the horizontal tube by introducing additional forces and representing them in cylindrical coordinates. The circumferential force balance analysis estimated the local liquid velocity, not obtained in experiment. The radial force balance analysis estimated the local liquid velocity gradient and predicted the lift-off point of the sliding bubble. As a result, the dominant forces determining bubble behavior confirmed in this study are the surface tension, contact pressure force, buoyancy and added mass force. Meanwhile, the lift force, buoyancy and added mass force are dominant near the lift-off. Finally, the study based on the experimental observation and analysis results figured out the transients of the bubble behavior parameters. It could be the foundation of developing a prediction model of bubble behavior by simplifying and improving on several parameters.Chapter 1. Introduction 1 1.1 Boiling heat transfer on a horizontal tube 2 1.2 Previous studies on bubble behavior 3 1.3 Objectives of this study 6 Chapter 2. Experimental Facility 9 2.1 Test loop 9 2.2 Horizontal tube heater with a narrow heating strip for bubble visualization 10 2.3 Visualization system 14 Chapter 3. Establishment of Measurement Method 21 3.1 Phase separation technique 21 3.1.1 Axial image 22 3.1.2 Radial image 23 3.2 Measurement of bubble parameters 24 3.3 3 dimensional bubble reconstruction technique 27 3.3.1 Bubble reconstruction procedure 27 3.3.2 Verification of reconstruction technique 28 3.3.2.1 Verification for inclined ellipsoids 28 3.3.2.2 Verification for asymmetric phantom images 30 3.4 Measurement results 32 Chapter 4. Force Balance Analysis 48 4.1 Force balance model for a sliding bubble on the horizontal tube 48 4.2 θ-directional force balance analysis 50 4.3 R-directional force balance analysis 53 4.4 Analysis result 56 Chapter 5. Closure of Force Balance Model 66 5.1 Empirical correlation for bubble behavior parameters 66 5.1.1 Local liquid velocity 66 5.1.2 Bubble deformation coefficient 67 5.1.3 Radius of curvature of the bubble at the heater surface 67 5.1.4 Contact angle 68 5.1.5 Velocity gradient correction factor 68 5.1.6 Limitation in the closure 69 5.2 Prediction result 70 Chapter 6. Conclusion 82 6.1 Summary 82 6.2 Recommendation 83 Reference 85Maste

역수요 모형을 이용한 절화시장의 가격-거래량 관계 분석

학위논문(석사)--서울대학교 대학원 :농업생명과학대학 농경제사회학부(농경제학전공),2019. 8. 김관수.The distribution structure of cut flowers based on the private market is changing into a distribution structure centered on the public market. In the public flower wholesale market, most of the transactions are conducted through auctions. However, there is a lack of domestic studies on the relationship between the price and the quantity formed in the auction. In this study, price-quantity relationships for cut flowers traded at Yangjae flower auctions are analyzed to provide the necessary information to various distribution participants. This study will be more important as the demand for imported cut flowers is increasing and the discussion about handling imported cut flowers in the public market is being done. This study analyzed the price-quantity relationship of the cut flower market by deriving the flexibility of cut flowers using the Linear Approximation Inverse Almost Ideal Demand System (LA-IAIDS). It is appropriate to use the inverse demand model in which the quantity is determined beforehand and the price is determined in the market to liquidate it, due to the characteristics of difficult to store and perishable cut flowers. The data used in this analysis is weekly transaction data from 2000 to 2018. The cut flowers were aggregated into six groups based on total transaction amount; rose, chrysanthemums, lily, carnation, gerbera; and a sixth aggregated category, other cut flowers. Based on the estimation results of the LA-IAIDS model, the results of measuring the price and scale elasticity are as follows. All own price flexibility is negative, i.e. a price of a group of cut flowers is decreased when the supplied quantity of that group is increased. All own price flexibility is less than 1, indicating that the demand for all flower groups is inflexible. The group with the greatest absolute value of own flexibility is chrysanthemum. This implies that chrysanthemum producers are most likely to gain price effects by shipment of commodities at low quantity through adjustment of shipment timing. In addition, if the transaction volume increases due to the handling of imported cut flowers, chrysanthemum is the group that can show the greatest drop in prices. Most cross flexibilities except gerbera are negative, which means most cut flower groups have quantity substitute relationships. Gerbera versus chrysanthemum, lily, and carnation have complementary relationships. This is a result of reflecting the phenomenon that chrysanthemum, lily, and gerbera are used together in wreaths. For rose, chrysanthemum, gerbera and others, each of the cross price flexibilities is numerically smaller than the corresponding own price flexibility, which means an increase in supply of a given flower species mostly affects the price of that flower itself. For lily and carnation, however, each of the own price flexibilities is numerically smaller than the corresponding cross price flexibility with other species except gerbera, implying that they seems to be the case that increased supply affects the prices of the other groups more that it affects its own price. It is the others that the change of the quantity of roses has the greatest effect on the price change of other species. On the other hand, the change in the quantity of others has the greatest effect on price changes of roses. The change in the quantity of lilies, carnations and gerbera has the greatest effect on price changes of others, and the change in the quantity of chrysanthemums has the greatest effect on price changes of roses. Finally, all scale flexibilities are negative, which means that the price of all groups decreases when the quantity of the whole cut flower increases. Chrysanthemum with a scale flexibility of less than 1 have an character of essential goods, while the other groups with scale flexibility of greater than 1 have an character of luxury goods.민영시장 중심의 절화 유통구조가 공영시장 중심의 유통구조로 변화하고 있다. 화훼 공영 도매시장에서는 대부분 경매를 통한 거래가 이루어지는데 경매에서 형성되는 가격과 거래량의 관계에 관한 국내 연구는 부족한 실정이다. 이에 본 연구에서는 양재동 화훼공판장 경매실적 자료를 이용해 절화시장의 가격과 거래량 간의 관계를 분석함으로써 각종 유통 참가자들에게 필요한 정보를 제공하고자 하였다. 절화의 가격-거래량 관계에 관한 연구는 수입산 절화에 대한 수요가 늘어나면서 공영시장에서 수입산 절화를 취급하는 것에 대한 논의가 이루어지고 있는 시점에서 더 욱 중요하다고 볼 수 있다. 본 연구에서는 선형근사 역준이상수요체계(LA-IAIDS) 모형을 이용하여 절화의 신축성을 도출함으로써 절화시장의 가격-거래량 관계를 분석하였다. 저장이 어렵고 부패하기 쉬운 절화의 특성상 상품의 수량이 사전적으로 결정되고 시장에서 이를 청산하는 방향으로 가격이 결정되는 역수요 모형을 이용하는 것이 적합하다. 분석대상은 2000년부터 2018년까지의 총 거래금액을 기준으로 장미, 국화, 백합, 카네이션, 거베라로 선정하였고, 그 외의 절화 품목을 기타로 묶어 여섯 품목의 주간 거래실적을 분석하였다. LA-IAIDS 모형의 추정결과를 바탕으로 가격 및 규모 신축성을 계측한 결과는 다음과 같다. 여섯 품목 모두 자기가격 신축성이 음(-)의 부호로, 거래량이 증가할 때 자기가격이 감소하는 것으로 나타났다. 자기가격 신축성이 가장 큰 품목은 국화로, 생산자 측면에서는 출하 시기 조정을 통해 거래량이 적은 시기에 상품을 출하함으로써 가격효과를 얻을 가능성이 가장 높은 품목으로 볼 수 있다. 또한 수입 절화 취급으로 인해 거래량이 증가할 경우 가격이 가장 크게 하락할 수 있는 품목이 국화인 것으로 해석할 수 있다. 교차가격 신축성은 대체적으로 음(-)의 부호로 품목 간에 대체관계가 존재하는 것으로 나타났는데, 거베라와 국화, 백합, 카네이션, 국화와 카네이션은 서로 보완관계에 있는 것으로 나타났다. 이는 국화, 백합, 거베라가 화환에 함께 주로 쓰이는 현상을 반영한 결과로 해석된다. 장미와 기타, 국화와 거베라의 경우에는 자기가격 신축성이 다른 품목과의 교차가격 신축성보다 큰 것으로 나타났는데, 이는 각 품목의 거래량 증가가 다른 품목의 가격 보다 자기 가격의 하락에 더 큰 영향을 미치는 것을 의미한다. 이와 반대로 백합과 카네이션은 자기가격 신축성이 거베라를 제외한 다른 품목들의 교차가격 신축성보다 작게 나타났는데, 이는 백합과 카네이션의 거래량 변화는 자기 가격보다 다른 품목의 가격 변화에 더 큰 영향을 미치는 것을 의미한다. 장미의 거래량 변화가 다른 품목의 가격 변화에 가장 큰 영향을 미치는 것은 기타이고, 기타의 거래량 변화는 장미의 가격 변화에 가장 큰 영향을 미친다. 백합, 카네이션, 거베라의 거래량 변화가 다른 품목의 가격 변화에 가장 큰 영향을 미치는 것은 기타이고, 국화의 거래량 변화는 장미의 가격 변화에 가장 큰 영향을 미치는 것으로 나타났다. 마지막으로 규모 신축성은 모두 음(-)의 값으로 절화 전체의 거래량이 증가할 때 모든 품목의 가격이 감소하는 것을 의미한다. 그 중에서 국화의 규모신축성 절댓값은 1보다 큰 값으로 필수재의 성격을 가지는 것으로 나타났고, 나머지 품목들은 1보다 작은 값으로 사치재의 성격을 가지는 것으로 나타났다.제 1 장 서론 1 제 1 절 연구 배경 및 필요성 1 제 2 절 연구 목적 및 방법 3 제 3 절 선행연구 검토 4 제 4 절 논문의 구성 8 제 2 장 절화 시장 현황 9 제 1 절 절화의 생산 9 제 2 절 절화 수출입 현황 13 제 3 절 우리나라의 절화 소비 특징 16 제 4 절 절화의 유통 현황 18 제 3 장 분석 방법 및 자료 21 제 1 절 분석 방법 21 제 2 절 분석 자료 27 제 4 장 분석 결과 37 제 1 절 역준이상수요체계(LA-IAIDS) 추정 결과 37 제 2 절 가격 및 규모신축성 추정 결과 42 제 5 장 요약 및 결론 47 참고문헌 49 Abstract 52Maste

그래핀 양자점을 이용한 하이드로겔

학위논문 (석사)-- 서울대학교 대학원 : 화학부 물리화학 전공, 2016. 8. 홍병희.하이드로겔은 매우 높은 수분 함유량을 갖고 산소 투과성이 높은 물질로서 치료 목적, 조직세포 재생과 같은 생물학적 응용부터 로보틱스, 센서, 전도도를 활용한 응용까지 그 활용범위가 넓어 많은 분야의 연구자들에게 실험되어지고 있고 사용범위 역시 증가하고 있다. 본 실험은 그래핀 양자점을 하이드로겔의 광촉매로 사용하여 그에 따른 하이드로겔 분석 및 신체사용에도 무해한 나노물질 하이드로겔을 소개한다. 폴리아크릴아마이드 하이드로겔는 라디컬에 의한 중합과정을 갖는데, 일반적인 광황산염 라디칼 의유도 촉매인 APS 가 아닌 그래핀 양자점을 광촉매로 사용한 새로운 방법의 고분자 중합과정을 분석하였다. 그래핀 양자점은 그래핀의 다양한 형태 중에서도 유일한 광화학의 특성을 지니며 빛의 조사에 의해서 하이드록시기 라디칼을 생성하는 산화과정을 지니게 된다. 발광에 의해 생성된 라디컬이 아크릴아마이드 단위체 결합에 적극적으로 참여하여 고분자의 중합을 유도하게 되는 것이다. 제조한 나노복합체는 TEM, SEM, DLS, UV-vis 분광기를 이용하여 그 형태, 다공성, 사이즈 분포 및 광학적 특성을 분석하였고, 인장, 응착력, 응압힘에 의한 하이드로겔의 기기적 하이드로겔의 기기적 특성을 분석하였다. 이러한 합성기법은 하이드로겔의 향상된 기기적 특성과 안정적이고 접근에 용이한 중합 방법을 제시하며 다양한 응용에도 적합하여 유용하게 사용될 수 있다.Introduction 1 1.1 Introduction 1 Experimental Section 3 2.1 Hydrogel preparation 3 2.2 Graphene Quantum Dots (GQDs) synthesis 4 Results 7 3.1 Mechanical strength 7 3.1.1 Tensile test 7 3.1.2 Surface adhesion energy 8 3.1.3 Compression test 9 3.2 Hydrogel Structure 10 Discussion 12 4.1 Dynamic Light Scattering 12 4.2 Swelling 14 Methods 16 Conclusion 20 6.1 Conclusion 20 Bibliography 21 Figure 26 국문 초록 36Maste

뇌환경 모방 지질이중층 기반 나노입자를 이용한 단백질 응집현상 및 응집체 구조 조절

학위논문 (박사)-- 서울대학교 대학원 자연과학대학 화학부, 2017. 8. 남좌민.Cells in our body have several tens of microns in size and they respond to their microenvironment. Abnormal symptoms or extraordinary signs in the body are usually obtained by misleading cell-cell communication and signal transductions. More specifically, cell-cell communication and cell-extracellular matrix (ECM) interactions are generated at the cell membrane which makes physical barrier to shield intracellular components from the outside. Cell membranes provide a basic platform to investigate many biological processes including material transport, trafficking, and pathogenic pathways. In this regard, it is needed to develop bio-mimicking platforms and materials to understand the mechanism and progress of diseases perfectly. Microscale features could affect the whole-cell guidance and their responses, but nanoscale stimuli also have emerged as fascinating features for several decades. Subcellular structures such as lysosomes, lipids, transmembrane proteins, ion channels are of nanometer scales, so that nanomaterial could be one of attractive candidates to manipulate intra-and extracellular signals. Therefore, supported lipid bilayers (SLBs) have been used as the cell membrane model and hybridized with various membrane-associated molecules to mimic living cells and envision molecular reactions on the membrane surface. For more precise investigation of complex biological processes, nanomaterials would be hybridized with the bio-mimicking system and have boosted the development of new platforms and methodologies. Therefore, Chapter 1 will explain manipulation of protein assemblies and aggregation process with a variety of nanomaterials and detection of biomolecular interactions on the cell membrane using SLB and nanomaterials. In chapter 2, we studied the formation of various Aβ aggregate structures with gold nanoparticles (AuNPs) and brain total lipid extract-based supported lipid bilayer (brain SLB). Understanding and manipulating amyloid-β (Aβ) aggregation provide key knowledge and means for the diagnosis and cure of Alzheimers disease (AD) and the applications of Aβ-based aggregation systems. The roles of AuNPs and brain SLB in forming Aβ aggregates were studied in real time, and the structural details of Aβ aggregates were monitored and analyzed with the dark-field imaging of plasmonic AuNPs that allows for long-term in situ imaging of Aβ aggregates with great structural details without further labeling. It was shown that the fluid brain SLB platform provides the binding sites for Aβ and drives the fast and efficient formation of Aβ aggregate structures and, importantly, large Aβ plaque structures (>15 μm in diameter), a hallmark for AD, were formed without going through fibril structures when Aβ peptides were co-incubated with AuNPs on the brain SLB. The dark-field scattering and circular dichroism-correlation data suggest that AuNPs were heavily involved with Aβ aggregation on the brain SLB and less α-helix, less β-sheet and more random coil structures were found in large plaque-like Aβ aggregates. In chapter 3, we studied the effect of the size, shape, and surface charge of Au nanoparticles (AuNPs) on amyloid beta (Aβ) aggregation on a total brain lipid-based supported lipid bilayer (brain SLB), a fluid platform that facilitates Aβ-AuNP aggregation process. We found that larger AuNPs induce large and amorphous aggregates on the brain SLB, whereas smaller AuNPs induce protofibrillar Aβ structures. Positively charged AuNPs were more strongly attracted to Aβ than negatively charged AuNPs, and the stronger interactions between AuNPs and Aβ resulted in fewer β-sheets and more random coil structures. We also compared spherical AuNPs, gold nanorods (AuNRs), and gold nanocubes (AuNCs) to study the effect of nanoparticle shape on Aβ aggregation on the brain SLB. Aβ was preferentially bound to the long axis of AuNRs and fewer fibrils were formed whereas all the facets of AuNCs interacted with Aβ to produce the fibril networks. Finally, it was revealed that different nanostructures induce different cytotoxicity on neuroblastoma cells, and, overall, smaller Aβ aggregates induce higher cytotoxicity. The results offer insight into the roles of NPs and brain SLB in Aβ aggregation on the cell membrane and can facilitate the understanding of Aβ-nanostructure co-aggregation mechanism and tuning Aβ aggregate structures.Chapter 1 : Introduction 1 1.1. Introduction 1 1.2. Manipulation of Biomolecule Aggregation and Structures Using Nanoparticles 2 1.3. Controlling Biomolecular Interactions on SLB 7 1.4. References 12 Chapter 2. Amyloid β Aggregation with Gold Nanoparticles on Brain Lipid Bilayers 22 2.1. Introduction 22 2.2. Experimental Section 24 2.3. Results and Discussion 29 2.4. Conclusion 38 2.5. References 39 Chapter 3. How Do the Size, Charge and Shape of Nanoparticles Affect Amyloid β Aggregation on Brain Lipid Bilayer? 50 3.1. Introduction 50 3.2. Experimental Section 51 3.3. Results and Discussion 54 3.4. Conclusion 67 3.5. References 68Docto

Sentinel lymph node biopsy in high-risk endometrial cancer: performance, outcomes, and future avenues

Endometrial cancer is the second most common gynecological malignancy worldwide, with an overall favorable prognosis. However, a subgroup of patients has a high risk of recurrence and poor prognosis. This review summarizes recently published articles that examined sentinel lymph node (SLN) biopsy in patients with high-risk endometrial cancer. We focused on the performance and outcomes of SLN biopsy, and examined potential methods for improving the management of this high-risk subset. Few studies have examined the long-term outcomes of SLN in patients with high-risk endometrial cancer. Thus, we reviewed recently published retrospective studies that have adopted statistical techniques, such as inverse probability weighting or propensity score matching, to examine the outcome of SLN biopsy compared to conventional lymphadenectomy. Potential avenues for future research to fine-tune decision making for this patient subgroup were also discussed.ope

Predicting labor induction success by cervical funneling in uncomplicated pregnancies

Aim: Predictive accuracy of cervical funneling for successful vaginal delivery prior to labor induction was compared to that of conventional methods such as Bishop score and cervical length. Methods: Prospective observational study was conducted on nulliparous women at 38 gestational weeks or more with intact membranes who delivered vaginally following labor induction. Transvaginal ultrasound was performed prior to labor induction to evaluate the cervix, to determine the cervical length and to check for the presence of funneling. Following pelvic examinations, the Bishop score was calculated. Predictive accuracy of the three different methods, namely cervical funneling, cervical length and Bishop, were compared. Results: A total of 235 nulliparous women with intact membranes were recruited. Of these, 194 women (82.6%) had successful vaginal deliveries following induction. Cervical funneling was observed in 105 women (44.7%). The rate of successful vaginal delivery was significantly higher in women with cervical funneling than in those without funneling (90.5% vs 76.2%, P < 0.004). Multivariable analysis showed that cervical funneling, similar to traditional measures such as the Bishop score and cervical length, was an independent predictor of successful vaginal delivery following labor induction (odds ratio = 2.95; 95% confidence interval: 1.38-6.47; P = 0.007). Conclusions: Similar to the conventional methods of cervical evaluation, such as the Bishop score and cervical length, cervical funneling may serve as a useful and valid predictor of successful vaginal deliveries prior to labor induction.ope

Maternal age and risk of early neonatal mortality: a national cohort study

Advanced maternal age (AMA) is a growing trend world-wide and is traditionally defined as childbearing in women over 35 years of age. The purpose of our study was to determine the maternal age group within the Korean population, in which the risk of early neonatal mortality is increased. Korean birth and mortality data from 2011 to 2015 were used to estimate the influence of maternal age on the risk of early neonatal mortality. A Poisson regression was used for the analysis of multiple clinical variables such as year of delivery, maternal age, gestational age, infant gender, birth weight, multiple birth, parity, and socioeconomic variables. Furthermore, a generalized additive model was used to determine the maternal age at which the risk for neonatal mortality increases. We included 2,161,908 participants and found that 49.4% of mothers were 30-34 years of age at delivery. The proportion of mothers aged 35 and above increased over the 5-year analysis period. A maternal age lower than 29 years or higher than 40 years was associated with a relatively higher risk of early neonatal mortality. The trend and magnitude of the age-related risk on early neonatal mortality were independent of maternal socioeconomic factors such as living in an obstetrically underserved area, education level, and employment status. Furthermore, we showed that the risk for early neonatal mortality was higher until the maternal age of 28. However, there were no significant changes in the risk between the age of 35 and 40 years. According to recent national-wide data, age-related risk for early neonatal mortality is only apparent for mothers ≥ 40 years old whereas, age between 35 and 39 are not at increased risk for early neonatal mortality, despite being classified as AMA.ope

Identification of Lynch Syndrome in Patients with Endometrial Cancer Based on a Germline Next Generation Sequencing Multigene Panel Test

We aimed to investigate the prevalence and relative contributions of LS and non-LS mutations in patients with endometrial cancer in Korea. We retrospectively reviewed the medical records of 204 patients diagnosed with endometrial cancer who underwent a germline next generation sequencing multigene panel test covering MLH1, MSH2, MSH6, PMS2, and EPCAM at three tertiary centers. Thirty patients (14.7%) with pathogenic mutations (12 MLH1; 6 MSH2; 10 MSH6; 2 PMS2) and 20 patients (9.8%) with 22 unclassified variants (8 MLH1; 8 MSH2; 2 MSH6; 3 PMS2; 1 EPCAM) were identified. After excluding four close relatives of a proband, the prevalence of LS was 13.0% (26/200). Patients with LS were more likely than those with sporadic cancer to be younger at diagnosis (48 vs. 53 years, p = 0.045) and meet the Amsterdam II criteria (66.7 vs. 3.5%, p < 0.001). Non-endometrioid histology was more prevalent in patients with MSH6 or PMS2 mutations (41.7%) than those with MLH1 or MSH2 mutations (5.6%, p = 0.026). In this pre-selected cohort of endometrial cancer patients who underwent next generation sequencing, the prevalence of LS was 13%, thus supporting the use of gene panel testing for endometrial cancer patients.ope

An Integrative Review of Cognitive Behavioral Therapy for Patients with Alcohol Use Disorder

Purpose: The present study aimed to review the characteristics of cognitive behavioral therapy (CBT) programs for alcohol use disorders and to examine the outcomes of such programs. Methods: We searched for domestic and foreign studies that implemented a CBT program for alcohol use disorders, published from 2006 to 2017. Studies that met inclusion/exclusion criteria were selected and a quality assessment was performed using the Risk of Bias (RoB) and Risk of Bias Assessment Tool for Nonrandomized Studies (RoBANS) instruments. We utilized a five-stage analysis process, through which nine experimental studies were selected. Results: Of these nine studies, four were randomized controlled trials, four used a quasi-experimental design, and one used a qualitative design. The CBT involved the three domains of cognitive reconstruction, problem solving, and coping. Coping with drinking situations and communication constituted most of the sessions. The outcomes of such interventions showed that CBT had a positive effect on alcohol use and self-evaluation. Conclusion: CBT is an effective way to change alcohol use behaviors, motivation, interpersonal relationships, emotional control, and self-efficacy among patients with alcohol use disorders. This study provides evidence for the effectiveness of CBT-based programs for the treatment of alcohol use disorders