비타민 D 고용량 주사로 인한 심한 고칼슘혈증 발생 1예

이상아,문재철,Lee, Sang Ah,Moon, Jae Cheol 제주대학교 의과학연구소 2019 The Journal of Medicine and Life Science Vol.16 No.1

Hypercalcemia is often seen in patients, but most of them showed mild to moderate hypercalcemia. The severe hypercalcemia with a blood calcium level of 14.0 mg/dL or more is known to be associated mainly with malignant tumors. Because this is emergency status, most clinicians tried to decrease serum calcium level to near normal range to improve symptoms related to hypercalcemia. A 71-year-old female patient visited the emergency room with dizziness and general weakness. Her serum calcium level was very high (15.6 mg/dL), but serum PTH, 25-OH vitamin D, and PTH related peptide were normal. We can exclude hyperparathyroidism, familial hypocalciuric hypercalcemia, other connective tissue diseases, and hypercalcemia due to malignant tumors as a cause of severe hypercalcemia. Conclusively, we diagnosed as severe hypercalcemia due to high-dose vitamin D injections treated one week ago. High dose vitamin D injections have recently been shown to increase the frequency of prescription as the various causes and the clinicians needed to carefully monitor the serum calcium levels in the patients after treating with high dose vitamin D.

나비굴경유 수술을 통해 완치된 뇌하수체 거대선종에 동반된 쿠싱병 1예

이상아,문재철,Lee, Sang Ah,Moon, Jae Cheol 제주대학교 의과학연구소 2021 The Journal of Medicine and Life Science Vol.18 No.1

Cushing's disease (CD) is a rare illness characterized by chronic hypercortisolism secondary to the overproduction of adrenocorticotropic hormone by a pituitary adenoma, which is associated with a high risk of developing serious complications, such as diabetes mellitus, cardiovascular disease, and emotional disorders. Endoscopic transsphenoidal surgery is performed for the treatment of CD, and was initially preferred over other types of treatments. However, the recurrence after pituitary surgery for CD is a common problem after an initial successful surgery. In microadenomas, the remission rates were higher than those of macroadenoma. This patient had a giant tumor that was greater than 4 cm in length on sella magnetic resonance imaging, and panhypopituitarism was detected using a combined pituitary stimulation test. After transsphenoidal surgery, the patient required temporary hormone replacement for a short period of time. After 1 year, he showed a normal cortisol response on the overnight dexamethasone suppression test and low morning cortisol levels. Therefore, we indicated that the patient was cured of giant macroadenoma with panhypopituitarism before surgery, and thus, reported this case.

미국, 캐나다, 영국의 재입원율 활용 현황

이상아,주영준,신재용,박은철,이후연,Lee, Sang-Ah,Ju, Yeong-Jun,Shin, Jae-Yong,Park, Eun-Cheol,Lee, Hoo-Yeon 한국의료질향상학회 2016 한국의료질향상학회지 Vol.22 No.1

Readmission which reflects capacity to manage patients and general level of medical services has been known for one of the causes of medical expenditure due to inefficient service. Compared to disease-specific readmission, hospital wide readmission (HWR) is relatively easy to understand, and has merit to get over limitation of collateral medical services assessment; therefore, a growing interest in development and usage of readmission indicator as quality of care indicator focusing on all-disease is detected. In this study, we investigate current state of risk standardized readmission rate indicator used in the United States, the United Kingdom, and Canada, and examine the considerations when using readmission rate as quality indicator in Korea. Differences in risk-adjustment methods were showed among countries. The United States do not control race not to hide socio-demographic factors on readmission. Canada shows differentiation compared to other countries about reflecting community factors. All three-countries utilize readmission rate as monitoring quality of care rather than incentives or penalty due to the fact that readmission rate could not represent the whole quality of hospital and has a limitation at controlling socio-economic factors. Therefore, for usage readmission rate as quality indicator in Korea, preparing readmission classification standard for Korean medical environment and additional methods for acquiring information by using discharge summary is need. Moreover, continued discussion with clinical specialists is needed for obtain clinical reliability and validity.

외상성 뇌손상 후두통과 기억장애가 발생한 환자에 서각지황탕가감방(犀角地黃湯加減方)을 투여한 1례 보고

이상아,권태욱,김명호,손한범,안립,장명웅,최동준,Lee, Sang-Ah,Kwon, Tae-Wook,Kim, Myung-Ho,Son, Han-Beom,Ahn, Lib,Jang, Myung-Woong,Choi, Dong-Jun 대한한방내과학회 2013 大韓韓方內科學會誌 Vol.34 No.4

The purpose of this study is to report the clinical effects of modified Seogakjihwang-tang on a patient who had headache and memory disorder after traumatic brain injury, which were considered as the result of blood stasis. The patient had headache and memory disorder after traumatic brain injury and treated with modified Seogakjihwang-tang three times a day for 60days. As a result, the numerical rating scale and pain rating score of headache decreased and the scores of mini-mental state examination-Korea, the Korean version of Montreal cognitive assessment and the mini-memory test increased during treatment with modified Seogakjihwang-tang. Therefore, this case supports a possibility that modified Seogakjihwang-tang might be an effective treatment to patients with headache and memory disorder after traumatic brain injury.

한국인 성인 당뇨병환자에서 항 GAD 항체 양성률

이상아 ( Sang Ah Lee ),김의영 ( Eui Young Kim ),김은희 ( Eun Hee Kim ),정지윤 ( Ji Yun Jeong ),정은희 ( Eun Heui Jeong ),김동우 ( Dong Woo Kim ),조은희 ( Eun Hee Cho ),고은희 ( Eun Hee Koh ),김민선 ( Min Seon Kim ),박중열 ( Joong 대한당뇨병학회 2009 Diabetes and Metabolism Journal Vol.33 No.1

국내 박물관 공공성 확대를 위한 분석 및 제안

이상아(Lee, Sang-Ah),김주원(Kim, Ju- Won) 대한건축학회 2016 대한건축학회 학술발표대회 논문집 Vol.36 No.2

The classical meaning of “Meseum” was collection for offering to a god unlike today concept and the meaning and form of museum have been changed from ancient times to the middle ages, modern times and today. In the middle ages, The museum was rarely put on display with the private property of the nobility in catholic church and the independent museum has been appeared in modern times. Through donating a private collection and opening to the public, publicness of museum was improved. In the Europe, the museum has been early improved, on the other hand, the first korean museum has been advanded by ‘Lee Dynasty Museum’ in 1900s. By opening Lee Dynasty Museum, placed in Changdeokgung Palace, opens to the people, it becomes to have public concern and then today it has aspect of the national museum.Unlike the Europe, the korean museum has come from a palace and even if they have been improved as the independent building, it leaves much to be desired at the point of improving publicness. By camparing some cases of Europe museum and the Korean museum have, focused on time period, this study presents plan for expanding the publicness of korean museum.

생태시의 융합적 성격과 창의성

이상아(Lee, Sang-Ah),윤여탁(Yoon, Yeo-Tak) 문학과환경학회 2014 문학과 환경 Vol.13 No.2

This study aims to reveal convergent characteristics and creativity of Eco-poetry. Existing studies on convergence of science and art understand nature as a subject which has an objective truth understandable through scientific methodology. It has been identified that this point of view is opposed to the world-view of art which focused on aesthetic judgement and figuration of nature. There have been some attempts recently to blur such conflictual distinction and communicate across the borderline, but there was a limit to that convergence as it was based on the existing way of thinking of science. This study is about ecological literature as science being integrative, which believes that ecology is an alternative to an inflexible definition of existing science and accordingly has been influenced by ecology. This study gives an example of the convergence of science and art, in particular, mainly with Eco-poetry. Along with that, it gives shape to meaning of convergent aspect of Eco-poetry by deriving creativity of that characteristics.

칼슘알루미네이트시멘트(CAC)와 고로슬래그(GGBS)를 활용한 고내구성 하수암거의 황산염 침식 저항성 평가

이상아(Sang-ah Lee),안기용(Ki-Yong Ann) 한국콘크리트학회 2018 콘크리트학회논문집 Vol.30 No.5

인슐린 투여가 당뇨병 환자의 삶의 질, 우울 요소에 미치는 영향

이상아 ( Sang Ah Lee ),박중열 ( Joong Yeol Park ) 대한내과학회 2009 대한내과학회지 Vol.77 No.1

Insulin is the most effective drug for reducing blood glucose in patients with diabetes commonly. But it has negative aspect for diabetic patients to change from oral hypoglycemic drug to insulin injection. Insulin injection makes patients feel reducing self-esteem and QOL (quality of life). So they complain depressive moods. Multiple insulin injection has an effect on patient`s emotion more negatively than one or two injection of insulin. It is suggested that physicians much more concern about self-esteem and emotional aspect of patients when they prescript insulin. (Korean J Med 77:57-59, 2009)

운율 교육에서 현대시 읽기 방법의 모색

이상아 ( Lee Sang-ah ) 한국독서학회 2017 독서연구 Vol.0 No.42

본고의 목표는 현대시의 운율을 시 교육에서 활용하기 위한 읽기 방법을 모색하는 데 있다. 운율은 개념 자체가 지닌 혼란에 더불어 국내로 수용되면서 서구의 언어 및 시사(詩史)와의 차이로 인해 명확한 합의가 어려운 용어가 되었다. 본고는 운율 교육의 목표가 지식을 `아는 것`이라기보다 이를 활용하여 시를 읽고 해석할 수 있는 능력 함양에 있다는 데 주목하였다. 따라서 운율을 느끼기 위해 학습자의 시 읽기는 음독 상황을 뜻하는 것이어야 하며, 이러한 음독의 과정에서 시의 전체적 의미와 운율 간의 관계를 찾을 수 있어야 한다는 조건 아래 연구를 진행하였다. 길이와 형태 측면에서 자유로운 확대를 꾀한 현대시 텍스트를 음독하며 학습자들은 의도된 호흡의 패턴을 느낌으로써 시의 의미를 추론해 나갈 수 있다. 이러한 경험은 이후 시의 다양한 운율에 대한 주체적 발견과 해석을 하는 데 유용한 도움을 줄 수 있을 것이다. The aim of this paper is to find a reading method to utilize the rhythm of modern poetry in poetry education. The rhythm has become a difficult term to be defined due to the confusion of the concept itself and the difference between western languages and history of poetry. This paper focuses on the fact that the purpose of rhythm education is not to `know` knowledge but rather to develop a set of abilities to read and interpret poetry. Therefore, in order to sense the rhythm, the learner `s poetry reading should be performed by reading aloud. This research was carried out under the condition that the relationship between the poem` s whole meaning and rhythm should be found in the process of reading aloud. Deducing the meaning of poetry could be achieved by reading aloud modern poetry texts that are free to expand in terms of length and form. By doing this activity, learners are able to taste the intended breathing pattern in the poem. This experience should be useful in helping to identify and interpret the various rhythms of poetry later on.