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한상아(Sang Ah Han),김새리(Sairhee Kim),강은영(Eunyoung Kang),김정현(Jeong-Hyun Kim),하태현(Tae-Hyeon Ha),양은주(Eun Joo Yang),임재영(Jae-Young Lim),한원식(Wonshik Han),노동영(Dong-Young Noh),김성원(Sung-Won Kim) 대한의학유전학회 2010 대한의학유전학회지 Vol.7 No.1
목적 : 본 연구는 한국인 BRCA 유전자 돌연변이 가계구성원들을 대상으로 암진단 및 돌연변이 보유 여부가 심리 상태와 삶의 질에 미치는 영향을 알아보기 위해 시행되었다. 대상 및 방법 : BRCA 유전자 돌연변이를 가진 13가계에서 암에 이환된 보인자 17명, 이환되지 않은 보인자 16명, 건강한 비보인자 13명이 본 연구의 분석에 포함되었다. 이 세 군을 대상으로 우울, 불안, 낙관, 유전성 유방암관련 지식수준과 삶의 질을 설문을 통하여 평가하였다. 결과 : 설문시기는 유전자 검사 후 평균 21개월(6-35)로 세 군 간의 차이는 없었다(P=0.254). 세 군 간의 우울, 낙관, 육체적 삶의 질은 유사했다. 불안은 세 군 모두에서 일반인보다 상승되어 있었다. 이환된 보인자의 정신적 삶의 질은 암에 이환된 보인자가 다른 두 군에 비해 유의하게 낮았다(P=0.009, P=0.017). 다변량 분석 결과 정신적 삶의 질에 영향을 미친 인자는 암이환여부(P=0.043)와 직업유무(P=0.008) 였다. 결론 : 같은 돌연변이 가계 내에서 돌연변이 유무는 우울, 불안, 낙관에서 심리적반작용을 일으키지 않았으나, 돌연변이 가계 구성원의 불안 수준은 돌연변이 유무에 관계 없이 높았다. 본 연구는 소규모 표본을 대상으로 한 단면적 연구이나, BRCA 유전자 검사에 수반될 수 있는 심리적 스트레스 및 그에 대한 대처법을 수립하는 데 기초연구로 의의를 가진다. Purpose: The aims of this study are to evaluate psychological impact and quality of life according to the cancer diagnosis and mutation status in Korean families with BRCA mutations. Materials and Methods: Seventeen affected carriers (AC), 16 unaffected carriers (UC) and 13 healthy non carriers (NC) from 13 BRCA mutation families were included in the study. Outcomes were compared with regard to depression (Beck Depression Inventory), anxiety (State-Trait Anxiety Inventory, STAI), optimism (Reevaluation of the Life Orientation test, LOT-R), knowledge of hereditary ovarian cancer, and quality of life (QoL) (SF-36v2 Health Survey, physical component score [PCS], mental component score [MCS]) among three groups. Result: Level of depression, optimism, and PCS were similar in AC, UC, and NC. Anxiety score was elevated in all three groups. MCS was significantly low in AC than in UC and NC (P =0.009, P =0.017). Knowledge of hereditary breast and ovarian cancer was high in AC than NC (P =0.001). MCS was significantly related to whether patient was affected by cancer (P =0.043) and has occupation (P =0.008) or not in multivariable analysis. Conclusion: From this cross sectional study, psychological adverse effect was not related to the carrier status of BRCA mutation. Elevated anxiety in BRCA family members was observed but, independent to affection and the type of genetic mutation. AC showed low mental QoL. Further effort to understand psychological impact and QoL of genetic testing in BRCA family members is required for follow-up in clinical aspects.
강은영(Eunyoung Kang),한상아(Sang Ah Han),이희은(Hee Eun Lee),박소연(So Yeon Park),김선미(Sun Mi Kim),장미정(Mijung Jang),김성원(Sung-Won Kim) 대한외과학회 2009 Annals of Surgical Treatment and Research(ASRT) Vol.77 No.2
Adenoma of the nipple (AN) is an uncommon benign tumor of the breast. This tumor usually arises from the lactiferous ducts of the nipple. The common clinical findings are unilateral serosanguinous discharge with crust and a palpable nodule in the nipple. The symptoms and signs of AN are similar to those of Paget’s disease and this confusion sometimes leads to unnecessary mastectomy. Thus performing careful clinical and histological examinations along with radiologic investigations are very important for the proper management of AN. This tumor is usually treated by total excision of the nipple. We report here on two cases of AN in two women who presented with red swelling, serosanguinous discharge and erosion of the nipple. We successfully managed them with partial excision or total excision along with reconstruction. Although AN is a relatively rare disease, surgeons should keep the diagnosis in mind for the proper management of this disease.
갑상선 결절의 수술 전 세침흡인세포검사 결과에 따라 수술 중 동결절편검사를 생략할 수 있는가?
송정윤(Jeong Yoon Song),한상아(Sang Ah Han),장재훈(Jae Hoon Jang),봉준우(Jun Woo Bong) 대한갑상선-내분비외과학회 2015 The Koreran journal of Endocrine Surgery Vol.15 No.4
Purpose: Fine needle aspiration (FNA) is a useful preoperative diagnostic tool for thyroid nodule because of the high sensitivity and specificity. The aim of this study is to determine the necessity of intraoperative frozen section (IOFS) after fine needle aspiration. Methods: Data of 534 patients with a single thyroid nodule who underwent thyroidectomy from June 2006 to August 2013 were reviewed retrospectively. FNA was performed preoperatively in all patients and IOFS was performed selectively according to the intraoperative findings and FNA results. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of FNA and IOFS for malignant nodules were analyzed. Results: The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of FNA for malignant nodules were 100%, 95.5%, 99.8%, 100%, and 99.8%, respectively. All nodules diagnosed as benign by FNA were reaffirmed as benign nodules by permanent sections. When the result of FNA was suspicious for malignancy, specific features of preoperative ultrasound, including hypoechoic, size<10 mm showed high positive predictive value and accuracy (98%, 86.9%, and 100%, 78.7% respectively). Conclusion: Performance of IOFS was not necessary when the result of FNA was consistent with malignancy or benign. However when the result of FNA was non-diagnostic or atypia, IOFS should be performed for more accurate detection of malignancy. When the result of FNA is suspicious for malignancy, IOFS is restrictively useful for excluding benign nodules using the features of ultrasound. In addition, IOFS is not useful in finding malignant thyroid nodules when the result of FNA is follicular neoplasm.
김현주(Kim, Hyeon Ju),강윤지(Kang, Yun Ji),이설아(Lee, Seol Ah),한상아(Han, Sang Ah),김은영(Kim, Eun Young) 충북대학교 생활과학연구소 2016 생활과학연구논총 Vol.20 No.2
This study is to explore customer channel migration from a smart kiosk in information searching and purchasing fashion products. A self-administered questionnaire was developed based on the literatures, and mainly included usage of retail channels, importance of information contents on a fashion smart kiosk, and intentions of channel migration for purchasing fashion products. A total of 103 responses was obtained from smart phone users who were aged from 19 to 27 years old. The respondents represent more females(n=70) than males(n=33). For data analysis, descriptive analysis, K-means cluster analysis, and ANOVA were conducted via SPSS 18.0 program. Based on the usage of retail channels, consumers were classified into three clusters: store shopper, non-store shopper and cross shopper. For information search, there was significant difference in the importance of information contents(e.g., recommended products and style, special sized products, up-to-date items, special sales) among three groups. Also there were significant differences in the intentions of channel migration from a smart kiosk for purchasing products among three groups. Specifically, cross shoppers were likely to migrate from smart kiosk to offline stores in purchasing products; store shoppers were likely to migrate to offline stores after searching for style and price on the smart kiosk; and non-store shoppers were likely to migrate to mobile apps for purchases after searching for special offers on the smart kiosk. This study provides an insight into developing strategic channel integration by utilizing smart kiosk with unique design and promotional contents in the fashion retail environments.