Factors associated with seizure and cognitive outcomes after epilepsy surgery for low-grade epilepsy-associated neuroepithelial tumors in children

Ko, Ara,Lee, Joon Soo The Korean Pediatric Society 2020 Clinical and Experimental Pediatrics (CEP) Vol.63 No.5

Low-grade epilepsy-associated neuroepithelial tumors (LEATs) are responsible for drug-resistant chronic focal epilepsy, and are the second-most common reason for epilepsy surgery in children. LEATs are extremely responsive to surgical treatment, and therefore epilepsy surgery should be considered as a treatment option for LEATs. However, the optimal time for surgery remains controversial, and surgeries are often delayed. In this review, we reviewed published article on the factors associated with seizure and cognitive outcomes after epilepsy surgery for LEATs in children to help clinicians in their decision whether to pursue epilepsy surgery for LEATs. The achievement of gross total resection may be the most important prognostic factor for seizure freedom. A shorter duration of epilepsy, a younger age at surgery, and extended resection of temporal lobe tumors have also been suggested as favorable prognostic factors in terms of seizure control. Poor cognitive function in children with LEATs is associated with a longer duration of epilepsy and a younger age at seizure onset.

Potentiation of Th1-Type Immune Responses to Mycobacterium tuberculosis Antigens in Mice by Cationic Liposomes Combined with De-O-Acylated Lipooligosaccharide

( Ara Ko ),( Seo Ri Wui ),( Ji In Ryu ),( Yeon Jeong Lee ),( Do Thi Thu Hien ),( Inmoo Rhee ),( Sung Jae Shin ),( Shin Ae Park ),( Kwang Sung Kim ),( Yang Je Cho ),( Na Gyong Lee ) 한국미생물생명공학회(구 한국산업미생물학회) 2018 Journal of microbiology and biotechnology Vol.28 No.1

Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis. Bacillus Calmette-Guerin (BCG) vaccine is the only TB vaccine currently available, but it is not sufficiently effective in preventing active pulmonary TB or adult infection. With the purpose of developing an improved vaccine against TB that can overcome the limitations of the current BCG vaccine, we investigated whether adjuvant formulations containing de-O-acylated lipooligosaccharide (dLOS) are capable of enhancing the immunogenicity and protective efficacy of TB subunit vaccines. The results revealed that the dLOS/dimethyl dioctadecyl ammonium bromide (DDA) adjuvant formulation significantly increased both humoral and Th1-type cellular responses to TB subunit vaccine that are composed of three antigens, Ag85A, ESAT-6, and HspX. The adjuvanted TB vaccine also effectively induced the Th1-type response in a BCG-primed mouse model, suggesting a potential as a booster vaccine. Finally, the dLOS/DDA-adjuvanted TB vaccine showed protective efficacy against M. tuberculosis infection in vitro and in vivo. These data indicate that the dLOS/DDA adjuvant enhances the Th1-type immunity and protective efficacy of the TB subunit vaccine, suggesting that it would be a promising adjuvant candidate for the development of a booster vaccine.

Impact of monthly arteriovenous fistula flow surveillance on hemodialysis access thrombosis and loss

Ara Ko,Miyeon Kim,Hwa Young Lee,Hyunwoo Kim 제주대학교 의과학연구소 2023 The Journal of Medicine and Life Science Vol.20 No.3

Arteriovenous fistula flow dysfunction is the leading cause of vascular access thrombosis and loss in patients undergoing hemodialysis. However, data regarding the influence of access flow rate measurements on the long-term outcomes of access are limited. This study aims to identify accesses at a high risk of thrombosis and loss among patients undergoing hemodialysis by measuring the access flow rate and exploring an optimal threshold value for predicting future access thrombosis. We enrolled 220 patients with arteriovenous fistula undergoing hemodialysis. The primary outcome was the occurrence of access thrombosis. Access flow rates were measured monthly using the ultrasound dilution method and were averaged using all measurements from patients with patent access. In patients experienced access thrombosis, those immediately before the thrombosis were selected. Using these data, we calculated the access flow rate threshold for thrombosis occurrence by analyzing the receiver operating characteristic curve, and the patients were divided into two groups according to whether access flow rates were higher or lower than 400 mL/min. During a median follow-up period of 3.1 years, 4,510 access flows were measured (median measurements per patient, 33 times; interquartile range, 11-54). A total of 65 access thromboses and 19 abandonments were observed. Access thrombosis and loss were higher in the lowflow group than in the high-flow group. This study revealed that low access flow rates are strongly associated with access thrombosis occurrence and subsequent loss of arteriovenous fistulas in patients undergoing hemodialysis.

Significance of Polyspikes on Electroencephalography in Children with Focal Epilepsy

Ara Ko,Juhyun Kong,Furkat Samadov,Akmal Mukhamedov,Young Mi Kim,Yun-Jin Lee,Sang Ook Nam 대한소아신경학회 2022 대한소아신경학회지 Vol.30 No.2

Purpose: Epilepsy is one of the most common neurological disorders in both adults and children. After detailed history-taking, electroencephalography (EEG) is the most important investigation in the evaluation of epilepsy patients. Polyspikes, defined as a sequence of two or more spikes, are among the findings that can be seen on EEGs of epilepsy patients, but the literature on their significance in focal epilepsy patients is scarce. Therefore, in the current study, we investigated the significance of polyspikes on EEG in childhood focal epilepsy. Methods: A retrospective analysis was conducted of data from children who were diagnosed with focal epilepsy and received anti-seizure medications at Pusan National University Children’s Hospital. Results: Among the 1,125 children included in this study, 468 (41.6%) showed interictal polyspikes on their EEGs. In the multivariate analysis, only the presence of brain magnetic resonance imaging (MRI) abnormalities was significantly associated with the presence of interictal polyspikes on EEGs. Among patients with brain MRI abnormalities, localized polyspikes were significantly associated with focal cortical dysplasia, while multifocal polyspikes were significantly associated with perinatal insults (hypoxic-ischemic encephalopathy and destructive encephalomalacia). Conclusion: Focal epilepsy patients with interictal polyspikes were more likely to have a structural etiology. Furthermore, patients with localized polyspikes were more likely to have focal cortical dysplasia as the structural etiology, while patients with multifocal polyspikes were more likely to have perinatal insults as the structural etiology. This study demonstrates that focal polyspikes can be used as markers of the possible presence of a structural etiology in routine practice.

A Fibroma of Tendon Sheath Causing Carpal Tunnel Syndrome: A Case Report of an Atypical Clinical Presentation

Ko Ara,Lee Geun Young,Kim Sujin,Lee Jaesung,Hwang Hye Won 대한영상의학회 2021 대한영상의학회지 Vol.82 No.6

Fibroma of the tendon sheath is a benign slow-growing fibrous tumor. Although rare, cases occurring in the upper extremities usually involve the fingers. It appears as a well-defined, roundor oval-shaped mass originating from the flexor tendon. Abundant fibrous stroma makes fibromas appear as a low intensity mass in all MRI sequences. Most of the fibromas manifest as painless soft tissue masses. Herein, we report a case of fibroma of the tendon sheath with an unusual clinical presentation, triggering carpal tunnel syndrome during wrist movement.

Targeted gene panel and genotype-phenotype correlation in children with developmental and epileptic encephalopathy

Ko, Ara,Youn, Song Ee,Kim, Se Hee,Lee, Joon Soo,Kim, Sangwoo,Choi, Jong Rak,Kim, Heung Dong,Lee, Seung-Tae,Kang, Hoon-Chul Elsevier 2018 Epilepsy research Vol.141 No.-

<P><B>Abstract</B></P> <P><B>Objective</B></P> <P>We performed targeted gene-panel sequencing for children with developmental and epileptic encephalopathy (DEE) and evaluated the clinical implications of genotype–phenotype correlations.</P> <P><B>Methods</B></P> <P>We assessed 278 children with DEE using a customized gene panel that included 172 genes, and extensively reviewed their clinical characteristics, including therapeutic efficacy, according to genotype.</P> <P><B>Results</B></P> <P>In 103 (37.1%) of the 278 patients with DEE, 35 different disease-causing monogenic mutations were identified. The diagnostic yield was higher among patients who were younger at seizure onset, especially those whose seizures started during the neonatal period, and in patients with drug-resistant epilepsy. According to epilepsy syndromes, the diagnostic yield was the highest among patients with West syndrome (WS) with a history of neonatal seizures and mutations in <I>KCNQ2</I> and <I>STXBP1</I> were most frequently identified. On the basis of genotypes, we evaluated the clinical progression and seizure outcomes with specific therapeutic regimens; these were similar to those reported previously. In particular, sodium channel blockers were effective in patients with mutations in <I>KCNQ2</I> and <I>SCN2A</I> in infancy, as well as <I>SCN8A</I>, and interestingly, the ketogenic diet also showed diverse efficacy for patients with <I>SCN1A</I>, <I>CDKL5</I>, <I>KCNQ2</I>, <I>STXBP1,</I> and <I>SCN2A</I> mutations. Unfortunately, quinidine was not effective in 2 patients with migrating focal epilepsy in infancy related to <I>KCNT1</I> mutations.</P> <P><B>Conclusion</B></P> <P>Targeted gene-panel sequencing is a useful diagnostic tool for DEE in children, and genotype–phenotype correlations are helpful in anticipating the clinical progression and treatment efficacy among these patients.</P> <P><B>Highlights</B></P> <P> <UL> <LI> Monogenic mutations constitute substantial etiology for developmental and epileptic encephalopathy (DEE). </LI> <LI> Targeted gene panel study is an effective genetic diagnostic tool for DEE. </LI> <LI> The diagnostic yield increases in patients with earlier seizure onset age, or with drug-resistant epilepsy. </LI> <LI> Despite phenotypic pleiotropy, there is some clinical consistency in patients with the same genotypes. </LI> </UL> </P>

드론 산업 인재 유입 및 양성을 위한 STEAM 드론 캠프 제안

고아라(Ara Ko),배진아(JinAh Bae),조정원(Jungwon Cho) 한국정보과학회 2023 한국정보과학회 학술발표논문집 Vol.2023 No.6

BEGAN을 이용한 광각 안저사진 합성 연구

고아라(Ara Ko),류혜인(Ara Hyein Ryu),조정원(Jungwon Cho) 한국정보과학회 2020 한국정보과학회 학술발표논문집 Vol.2020 No.7

성별에 따른 SW·AI 분야의 진로 선호도 요인 탐색

고아라(Ara Ko),배진아(Jinah Bae),조정원(Jungwon Cho) 한국컴퓨터교육학회 2023 한국컴퓨터교육학회 학술발표대회논문집 Vol.27 No.2

정부는 여성과학기술인 육성·지원을 위해 ‘여성과학기술인 육성·지원 기본계획’을 기반으로 다양한 노력을 기울이고 있다. 그러나 이런 노력에도 불구하고 이공계 분야의 성별 불균형은 여전히 존재한다. 프로그램의 효과성을 향상시키기 위해서는 여학생들이 이공계열 전공 및 직업 선택에 영향을 미치는 요인을 분석하고, 데이터 기반의 프로그램 기획과 운영이 필요하다. 따라서 본 연구에서는 기대-가치 이론을 바탕으로 성별에 따른 진로 선호도에 영향을 미치는 요인을 분석하고자 한다. 본 연구에서는 SW·AI 캠프에 참여한 일부 학생들을 대상으로 설문 조사를 실시하였으며, 기대는 자기효능감, 가치는 내적 가치와 유용 가치로 구분하여 진로 선호도에 미치는 영향을 분석하였다. 분석은 구조방정식 모형을 활용하였고, 결과적으로 내적 가치와 유용 가치가 진로 선호도에 영향을 미치는 것을 확인하였다. 성별에 따른 분석 결과, 남학생들은 전체 데이터와 유사한 경향을 보였으며, 유용 가치의 영향이 더 큰 것으로 나타났다. 그러나 여학생들은 내적 가치만이 진로 선호도에 영향을 미치는 것으로 나타났다. 이렇듯 성별에 따라 진로 선호도에 영향을 주는 요인이 달라서 여학생들의 이공계열 유입을 위해서는 해당 분야에 흥미를 느낄 수 있는 프로그램 설계가 필요하다.

잔류농약의 식이노출량 평가를 위한 국민건강영양조사 미산출 식품 섭취량 산출 연구

고아라 ( Ara Ko ),주효정 ( Hyojung Ju ),이헌주 ( Hunjoo Lee ),이중근 ( Joong Keun Lee ),김문숙 ( Moon Sook Kim ),정해랑 ( Hae Rang Chung ) 한국환경농학회 2017 한국환경농학회 학술대회집 Vol.2017 No.-

농산물에 적용되는 농약의 잔류허용기준 설정을 위해서는 우리나라 국민의 섭취량에 대한 정확 한 이해가 매우 중요한 데 현재 국민건강영양조사 (이하 국건영) 섭취량 자료이나 본 조사의 식품 코드 체계로는, 혼합식품에 사용된 원재료별 섭취량을 산출하기 어렵다. 이에 본 연구는 식품 중 잔류농약 위해평가에 필요한 식품 원재료 섭취량 DB와 이를 이용한 원재료 섭취량 산출 시스템을 구축하는데 그 목적이 있다. 이를 위해 잔류농약 위해평가를 위한 주요국의 식품 섭취량 산출 방법을 조사하고, 국건영 자료를 식약처의 “유해물질 모니터링 자료관리·평가 시스템(MIMS/MAP)”과 연계하여, 제5기(2010- 2012년) 및 제6기(2013-2015년) 총 6개년의 연차별 내지는 전체 통합 섭취량 산출을 위한 DB 및 알고리즘을 개발하였다. 산출한 국건영 자료 품목 중 다른 품목 레시피의 구성 성분으로 속한 품 목의 경우, 기존 식약처 보유 국제특허인 “식품원재료 섭취량 산출 시스템”의 데이터베이스 및 알고리즘을 분석, 적용하였다. 또한 기존 데이터베이스의 오류를 보정하고 정확성과 신속성을 강화하기 위하여 B+Tree 알고리즘을 적용하였다. 그 결과, 섭취량 산출이 필요한 대상 총 653 품목 중국건영에서 섭취한 것으로 조사된 품목은 총 448 종이었다. 현재까지 224 품목에 대한 섭취량을 산출하였으며, 이 중 50여 품목에 대하여는 레시피를 반영하여 정교한 섭취량을 산출하고 있다. 국건영에서 조사되지 않은 품목은 총 205 종으로, 이는 주로 국건영에서 섭취량 파악이 어려운 소규모 면적의 재배작물이거나 최근 수입이 급증한 품목이다. 본 품목에 대해서는, 생산량, 수입량 및 재배면적 등을 고려한 추정 방법을 검토 중에 있다. 본 시스템이 구축되면 국건영 섭취량 자료의 식품코드 만으로도 완결성을 가진 식품에 대한 섭취량을 산출하고, 가공식품 등 혼합식품에 사용된 양을 포함하여 개별 원재료의 섭취량을 산출하며 소규모 면적 재배 작물 등 국건영에 포함되지 않은 식품 원재료의 섭취량도 산출할 수 있게 될 것이다.