미만성 범세기관지염 환자들의 임상 경과 고찰

이애라,허은영,이상민,임재준,양석철,유철규,한성구,김영환 대한결핵 및 호흡기학회 2011 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.112 No.-

비결핵항산균 폐질환 환자의 특성

이애라,채경옥,이진우,박영식,이창훈,이상민,유철규,김영환,한성구,임재준 대한결핵 및 호흡기학회 2012 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.114 No.0

목적: 비결핵항산균 폐질환은 최근 빠르게 증가하고 있지만 이 질환에 이환된 환자들에 대한 이해는 아직 부족하다. 이 연구의 목적은 비결핵항산균 폐질환 환자들의 표현형적, 면역학적, 임상적 특징을 확인하는 것이다. 방법: 서울대 병원을 방문한 과거 치료력이 없는 비결핵항산균 폐질환 환자를 2011년 7월 1일부터 모집한 코호트 자료를 분석하였다. 기저검사로 병력 청취 및 신체검사, 류마티스 인자를 포함한 면역학적 검사, 폐 전산화단층촬영 등의 방사선검사, 전혈, 인터페론감마 검사 (Intereron-Gamma Release Assay, IGRA), 폐기능검사, 세인트조지 호흡기설문(St George`s respiratory questionnaire, SGRQ)을 시행하였다. 성적: 모두 108명의 환자가 참여하였다. 진단 당시의 연령의 중앙값은 65세(31-85)이었으며, 여자가 56명(51.8%)였고 비흡연자가 62명(57.4%)였다. 33명의(30.6%) 환자가 과거에 결핵으로 치료받은 적이 있었고, 86명(79.6%)에서 BCG 흉터가 확인되었다. 척추 측만증은 26명 (24.1%)에서 관찰되었다. 부비동염이 35명(32.4%)에서 관찰되었고, 19명(17.6%)의 환자가 역류성 식도염이 있었다. 원인균은 Mycobacterium avium complex가 가장 흔했고(59명, 57.8%), M. abscessus complex가 그 다음이었다(12명, 11.1%). 비결핵항산균 폐질환 환자들은 정상인보다 체질량지수(kg/m2)가 낮았으며(20.7±2.4 vs. 23.6±3.3; p<0.001), 류마티스 인자는 69명(67.6%)에서 확인되었고, 기관지확장증과 공동이 가장 흔한 방사선 소견이었다. 폐쇄성 환기장애는 24명(22.2%)에서 관찰되었고 SGRQ의 중앙값은 21.7점(0-79.1)이었다. IGRA 양성률은 정상인보다 낮았다(43.5% vs. 61.9%, p=0.002). 결론: 비결핵항산균 폐질환 환자들은 다양한 특성을 가지고 있다. 이런 특성들의 비결핵항산균 폐질환 발생과의 연관성 및 예후에 미치는 영향에 대한 후속 연구가 필요하다.

2019 개정 누리과정 변화를 경험하는 유아교사가 지각하는 자기효능감과 사회적지지가 변화몰입에 미치는 영향

이애라,김고은 한국교원대학교 유아교육연구소 2022 한국유아교육연구 Vol.24 No.2

This study examined the effects of early childhood teachers’ self-efficacy and social support on their commitment to change, analyzing the relationships among the three factors. A survey was conducted with 375 teachers experiencing institutional-level changes in accordance with the 2019 revised Nuri curriculum, and the collected data was evaluated through descriptive statistical analysis, Pearson correlation analysis, and multiple regression analysis using SPSS 27.0. The research findings were as follows. First, all three factors of self-efficacy, social support, and commitment to change were generally perceived by early childhood teachers to be higher than normal. Second, self-efficacy was positively correlated with their affective commitment to change, but negatively correlated with continuance commitment to change; furthermore, social support was positively correlated with both affective and normative commitment to change, but negatively correlated with continuance commitment to change. Third, teachers’ self-efficacy and social support had a positive effect on affective commitment to change, but a negative effect on continuance commitment to change. Additionally, sub-factors in self-efficacy and social support had a significant effect on the sub-factors of commitment to change. Overall, this study suggests that the successful implementation of the changes required by the 2019 revised Nuri curriculum need measures to promote and improve teachers’ self-efficacy and social support so that teachers can proactively engage in the change. 본 연구는 2019 개정 누리과정에 따른 기관차원의 변화를 경험하는 교사를 대상으로 유아교사가지각하는 자기효능감, 사회적지지, 변화몰입 수준 및 관계를 알아보고, 자기효능감과 사회적지지가 변화몰입에 미치는 영향을 알아보는 것을 목적으로 하였다. 서울 및 경기 지역 유아교사 375명을 대상으로 설문조사를실시하였으며, SPSS 27.0을 사용하여 기술통계분석, Pearson 상관관계분석, 단계적 중다회귀분석을 실시하였다. 연구결과, 첫째, 유아교사가 지각하는 자기효능감과 사회적지지, 변화몰입 수준은 전반적으로 보통보다 높은 것으로 나타났다. 둘째, 유아교사가 지각하는 자기효능감은 정서적 변화몰입과는 정적 상관관계, 지속적 변화몰입과는 부적 상관관계가 나타났으며, 유아교사가 지각하는 사회적지지는 정서적 변화몰입 및 규범적 변화몰입과 정적 상관관계, 지속적 변화몰입과는 부적 상관관계가 나타났다. 셋째, 유아교사가 지각하는자기효능감과 사회적지지는 정서적 변화몰입에 정적 영향, 지속적 변화몰입에 부적 영향을 미치며, 자기효능감과 사회적지지의 하위요인은 변화몰입의 하위요인에 유의미한 영향을 미치는 것으로 나타났다. 본 연구는 2019 개정 누리과정의 성공적인 현장 안착을 위해 교사들이 자발적인 변화 의지를 갖고 참여할 수 있도록자기효능감을 증진하고 구성원 간 사회적지지를 강화하는 방안을 마련할 필요가 있음을 시사한다.

F-47 : Free Paper Presentation ; Adequacy Criteria of Rapid On-Site Evaluation in Endobronchial Ultrasound-guided Transbronchial Needle Aspiration

이애라,( Ji Young Choe ),( Soo Jeong Nam ),( Doo Hyun Chung ),( Sun Mi Choi ),( Jin Woo Lee ),( Chang Hoon Lee ),( Sang Min Lee ),( Jae Joon Yim ),( Chul Gyu Yoo ),( Young Whan Kim ),( Sung Koo Han ),( Y 대한결핵 및 호흡기학회 2013 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.116 No.-

Introduction: Rapid on-site evaluation (ROSE) during Endobronchial Ultrasound-guided Transbronchial Needle Aspiration (EBUS-TBNA) has been advocated for qualitative diagnosis of biopsy samples. But the adequacy criteria of ROSE in EBUS-TBNA is unclear. The aim of this study is to elucidate on-site adequacy criteria for EBUS-TBNA samples and suggest an algorithm to define adequacy. Methods: Patients, who were underwent EBUS-TBNA for nodal evaluation between March and July, 2013 in Seoul National University Hospital, were included in this prospective study. The archived ROSE slides were reviewed by the independent pathologist. Results: EBUS-TBNA was performed in 133 patients on 300 lymph nodes. The frequency of non-diagnostic samples in the cytologic, histologic, and overall pathologic results were 7.7%, 6.3%, and 1.7%, respectively. Large tissue core size (≥2 cm), presence of microscopic anthracotic pigment (MAP), and increased lymphocyte density (LD, ≥40/×40) in ROSE slides were significantly associated with adequacy in the cytological or histological results. Although malignant cells were not associated with adequacy, presence of malignant cell was itself a diagnostic predictor. According to the following sequential four steps: tissue core size, malignant cell, MAP, and LD, the sensitivity and accuracy rate of ROSE were increased from 64.4% to 98.6% and from 64.7% to 97.3%, respectively. Conclusions: The high adequacy rate of ROSE in EBUS-TBNA can be achieved by sequential application of the criteria including tissue core size, malignant cell, MAP, and LD.Introduction: Rapid on-site evaluation (ROSE) during Endobronchial Ultrasound-guided Transbronchial Needle Aspiration (EBUS-TBNA) has been advocated for qualitative diagnosis of biopsy samples. But the adequacy criteria of ROSE in EBUS-TBNA is unclear. The aim of this study is to elucidate on-site adequacy criteria for EBUS-TBNA samples and suggest an algorithm to define adequacy. Methods: Patients, who were underwent EBUS-TBNA for nodal evaluation between March and July, 2013 in Seoul National University Hospital, were included in this prospective study. The archived ROSE slides were reviewed by the independent pathologist. Results: EBUS-TBNA was performed in 133 patients on 300 lymph nodes. The frequency of non-diagnostic samples in the cytologic, histologic, and overall pathologic results were 7.7%, 6.3%, and 1.7%, respectively. Large tissue core size (≥2 cm), presence of microscopic anthracotic pigment (MAP), and increased lymphocyte density (LD, ≥40/×40) in ROSE slides were significantly associated with adequacy in the cytological or histological results. Although malignant cells were not associated with adequacy, presence of malignant cell was itself a diagnostic predictor. According to the following sequential four steps: tissue core size, malignant cell, MAP, and LD, the sensitivity and accuracy rate of ROSE were increased from 64.4% to 98.6% and from 64.7% to 97.3%, respectively. Conclusions: The high adequacy rate of ROSE in EBUS-TBNA can be achieved by sequential application of the criteria including tissue core size, malignant cell, MAP, and LD.

일차 항결핵제 모두에 과민반응을 보인 환자의 성공적 탈감작 결핵 치료 1예

이애라 ( Ae Ra Lee ),김수정 ( Soo Jung Kim ),김정현 ( Jung Hyun Kim ),박주희 ( Ju Hee Park ),이정규 ( Jung Kyu Lee ),김주영 ( Ju Young Kim ),이서영 ( Suh Young Lee ),강혜련 ( Hye Ryun Kang ) 대한소아알레르기호흡기학회(구 대한소아알레르기 및 호흡기학회) 1991 소아알레르기 및 호흡기학회지 Vol.1 No.4

Tuberculosis is an infectious disease that can be treated using a combination of antitubercular drugs. First-line antitubercular agents such as isoniazid and rifampin are considered pivotal to successful treatment. However, they are also known to have relatively high rates of adverse events including hypersensitivity reactions. Discontinuing the first-line agents in the event of hypersensitivity may significantly compromise the cure rate of tuberculosis. Drug desensitization can be an effective method allowing continued use of the first-line agents and achieving successful cure of tuberculosis. A 70-year-old man was diagnosed with culture proven pulmonary tuberculosis and treated with first-line antitubercular agents (isoniazid, 300 mg; rifampin, 600 mg; pyrazinamide, 1,500 mg; and ethambutol, 800 mg). After 2 weeks of treatment, generalized erythematous papular rash and fever developed, for which all drugs were discontinued. Since he had hypersensitivity to all 4 first-line antitubercular agents, we tried desensitization for all 4 drugs one by one to resume antituberculosis treatment. After successful desensitization of all 4 first-line antituberculosis drugs, 6 months-antitubercular therapy was completed without any complications. We report here a case of multiple desensitization in a pulmonary tuberculosis patient having hypersensitivity to all of the 4 first-line antitubercular drugs, successfully completing 6-month antitubercular therapy without any complications. (Allergy Asthma Respir Dis 2013;1:395-399)

일차 항결핵제 모두에 과민반응을 보인 환자의 성공적 탈감작 결핵 치료 1예

이애라 ( Ae Ra Lee ),김수정 ( Soo Jung Kim ),김정현 ( Jung Hyun Kim ),박주희 ( Ju Hee Park ),이정규 ( Jung Kyu Lee ),김주영 ( Ju Young Kim ),이서영 ( Suh Young Lee ),강혜련 ( Hye Ryun Kang ) 대한천식알레르기학회(구 대한알레르기학회) 2013 Allergy Asthma & Respiratory Disease Vol.1 No.4

Tuberculosis is an infectious disease that can be treated using a combination of antitubercular drugs. First-line antitubercular agents such as isoniazid and rifampin are considered pivotal to successful treatment. However, they are also known to have relatively high rates of adverse events including hypersensitivity reactions. Discontinuing the first-line agents in the event of hypersensitivity may significantly compromise the cure rate of tuberculosis. Drug desensitization can be an effective method allowing continued use of the first-line agents and achieving successful cure of tuberculosis. A 70-year-old man was diagnosed with culture proven pulmonary tuberculosis and treated with first-line antitubercular agents (isoniazid, 300 mg; rifampin, 600 mg; pyrazinamide, 1,500 mg; and ethambutol, 800 mg). After 2 weeks of treatment, generalized erythematous papular rash and fever developed, for which all drugs were discontinued. Since he had hypersensitivity to all 4 first-line antitubercular agents, we tried desensitization for all 4 drugs one by one to resume antituberculosis treatment. After successful desensitization of all 4 first-line antituberculosis drugs, 6 months-antitubercular therapy was completed without any complications. We report here a case of multiple desensitization in a pulmonary tuberculosis patient having hypersensitivity to all of the 4 first-line antitubercular drugs, successfully completing 6-month antitubercular therapy without any complications.

인삼조직에서 Catalase Activity 측정에 관한 새로운 Method ( A New Method on the Measurement of Catalase Activity of Panax ginseng C. A. Meyer Tissues )

양덕조,채쾌,윤재준,이성종,이애라 고려인삼학회 1985 Journal of Ginseng Research Vol.9 No.2

Adjuvant Treatment of Proper Endobronchial Management in Leiomyosarcoma

김수정,김정현,박주희,이애라,이정규,김태민,박영식 대한결핵및호흡기학회 2013 Tuberculosis and Respiratory Diseases Vol.75 No.6

Endobronchial metastasis of leiomyosarcoma is rare, but it can cause life-threatening complications, such as massive hemoptysis, respiratory failure or even death. The development of new endoscopic modalities allows for effective endobronchial management. We report three patients with endobronchial metastases from advanced leiomyosarcomas which caused bronchial obstruction. The bronchoscopic examinations revealed masses obstructing the left main bronchus in all three patients. After removing the endobronchial tumor via interventional bronchoscopy, there was symptomatic and radiologic improvement. Moreover, the patients were able to undergo additional palliative chemotherapy. Therefore, endobronchial management of endobronchial tumors should be considered in the treatment of endobronchial metastasis, even in patients with advanced malignancies.

Diagnostic Yield of Bronchial Washing Fluid Analysis for Hemoptysis in Patients with Bronchiectasis

박주희,이세원,김수정,이애라,이중규,김정현,임효정,조영재,박종선,윤호일,이재호,이춘택 연세대학교의과대학 2014 Yonsei medical journal Vol.55 No.3

Purpose: Bronchiectasis is the main cause of hemoptysis. When patients with bronchiectasis develop hemoptysis, clinicians often perform bronchoscopy and bronchial washing to obtain samples for microbiological and cytological examinations. Bronchial washing fluids were analyzed from patients with bronchiectasis who developed hemoptysis, and the clinical impacts of these analyses were examined. Materials and Methods: A retrospective observational study of patients who underwent fiberoptic bronchoscopy for hemoptysis in Seoul National University Bundang Hospital, a university affiliated tertiary referral hospital, between January 2006 and December 2010 were reviewed. Among them, patients who had bronchiectasisconfirmed by computed tomography and had no definite cause of hemoptysisother than bronchiectasis were reviewed. The demographic characteristics, bronchoscopy findings, microbiological data, pathology results and clinical coursesof these patients were retrospectively reviewed. Results: A total of 130 patients were reviewed. Bacteria, non-tuberculous mycobacteria (NTM), and Mycobacteriumtuberculosis were isolated from bronchial washing fluids of 29.5%, 21.3%, and 0.8% patients, respectively. Suspected causal bacteria were isolated only from bronchial washing fluid in 19 patients, but this analysis led to antibiotics change in only one patient. Of the 27 patients in whom NTM were isolated from bronchial washing fluid, none of these patients took anti-NTM medication during the medianfollow-up period of 505 days. Malignant cells were not identified in none of the patients. Conclusion: Bronchial washing is a useful method to identify microorganismswhen patients with bronchiectasis develop hemoptysis. However, these results only minimally affect clinical decisions.

Embolization of Multiple Systemic Artery to Pulmonary Artery Fistula with Recurrent Hemoptysis

이정규,박주희,김중현,이애라,이창훈,소영호,김수정 대한결핵및호흡기학회 2013 Tuberculosis and Respiratory Diseases Vol.75 No.3

Herein, we report a case of multiple systemic arteries to pulmonary artery fistulas without any underlying causes, presenting recurrent hemoptysis. Transcatheter embolization was successfully performed several times on multiple systemic feeding arteries. Multiple systemic arteries to pulmonary fistulas can be a source of uncontrolled bleeding, and embolization may be a reasonable therapeutic option to control the bleeding.