톨로사-헌트 증후군에서 속발한 경막동맥해면정맥굴샛길 1예

박아람(A ram Park),김승우(Seung Woo Kim),정승아(Seung Ah Chung) 대한안과학회 2016 대한안과학회지 Vol.57 No.6

목적: 톨로사-헌트 증후군이었던 눈에서 발생한 경막동맥해면정맥굴샛길 증례를 경험하여 이를 보고하고자 한다. 증례요약: 고혈압이 있는 64세 여자 환자가 우안 주변의 통증, 우안 눈꺼풀처짐, 복시를 주소로 내원하였다. 우안 동공산대와 함께, 우안 외사시와 상사시, 그리고 심한 상전, 하전, 내전장애가 있었다. 뇌/뇌혈관자기공명영상에서 뇌혈관 이상은 없었으나 우측 해면정맥굴에 염증 소견이 있어서 경구 스테로이드로 치료하였고 3일 뒤 통증이 소실되어 완전 동안신경마비로 발현한 톨로사-헌트 증후군으로 생각되었다. 2개월 뒤 우안 눈꺼풀처짐은 소실되고 안구운동장애도 호전되었으나, 심한 우안 주변 통증이 다시 발생하였다. 톨로사-헌트 증후군의 재발로 생각되어 고용량 스테로이드 주사치료를 시행하였고, 빠른 호전을 보였다. 3개월 뒤 안구운동장애도 소실되었으나, 우안 결막충혈, 박동성 잡음, 안구돌출이 있어 시행한 뇌혈관조영술에서 우측 경막동맥해면정맥굴샛길이 확인되었다. 경정맥코일 색전술 2개월 후 증상은 소실되었다. 결론: 해면정맥굴에 발생하는 육아종성 염증질환인 톨로사-헌트 증후군에서 경막동맥해면정맥굴샛길이 뒤이어 발생할 수 있으므로 경과관찰 시 주의해야 한다. <대한안과학회지 2016;57(6):977-982> Purpose: To report a case of cavernous sinus dural arteriovenous fistula following Tolosa-Hunt syndrome. Case summary: A 64-year-old female with a history of hypertension, presented with blepharoptosis and periorbital pain in the right eye and diplopia. Her right pupil was dilated. She had right exotropia and right hypertropia with inability to elevate, depress, and adduct the right eye. Magnetic resonance imaging including angiography, revealed hyperintensities in the right cavernous sinus consistent with inflammation and no vascular abnormalities. Three days after oral corticosteroid therapy, the pain disappeared. A presumptive diagnosis was Tolosa-Hunt syndrome presenting as a form of complete oculomotor nerve palsy. Two months later, she experienced severe pain in the right periocular area, even though blepharoptosis was resolved and ocular motility was improved. A rapid response to high-dose intravenous corticosteroids was consistent with recurrence of Tolosa-Hunt syndrome. Three months later, she had normal ocular motility, but developed a conjunctival injection, pulsatile orbital bruits, and exophthalmos in the right eye. Cerebral angiography showed a cavernous sinus dural arteriovenous fistula. She received a transvenous coil embolization and her symptoms markedly improved over 2 months. Conclusions: Tolosa-Hunt syndrome, a granulomatous inflammation in the cavernous sinus may be followed by cavernous sinus dural arteriovenous fistula and should be considered during follow-up. J Korean Ophthalmol Soc 2016;57(6):977-982

서울시 강남구지역 플라워카페 디스플레이의 감성이미지 연구

박아람(A Ram Park),김동찬(Dong Chan Kim),임진강(Jin Kang Lim) 인간식물환경학회 2015 인간식물환경학회지 Vol.18 No.5

Recently, sales attempting of emotion between the flower shop and cafe is increasing by their strategic partnership. The combination of them, however, is at an early stage. So it’s unsystematic and also related research is not entirely satisfactory. Thus, the research tried to contribute to flower cafe’s vitalization by analysing the image characteristics and preference factor of the flower cafe. The subjects of analysis are 6 flower cafe located in Gangnam-gu, Seoul. The research method is as in the following. General public group and professional group, each of them is 100 people, are the research object. They did a survey which is about their sense of the flower cafe, visual preference about display elements, the image characteristics of the cafe and a difference of awareness between the groups. Collected material was analyzed by SPSS statistics 18 program. The result of the research is that they preferred color of all display elements and didn’t prefer POP(Point of Purchase Advertising). Additionally, an average of ‘Modernistic-Traditional’, which is an adjective item of cafe image characteristic, is the highest while the average of ‘Graceful-Unpretentiously’ is the lowest. In the research, the most important variable in visual preference about display elements is display goods, and the most influence elements in image characteristic of cafe is scale feeling. Moreover, there are the difference between a gender about preference and image characteristics. Especially, the general public group has higher perception than the professional group under the statistical significance level. This research shows that the flower cafe makes user easily access to flower and plants, and there is high correlation between the visual preference and image of display and preference of cafe.

뇌과학에 기반한 연령별 학습법과 연령별 한의학적 학습방법론 비교고찰

조아람 ( A Ram Cho ),박소임 ( So Im Park ),강다현 ( Da Hyun Kang ),서주희 ( Joo Hee Sue ) 대한한방신경정신과학회 2014 동의신경정신과학회지 Vol.25 No.4

Objectives: The purpose of this study was to research learning based on brain science and the learning methodology of Korean Medicine according to disparity of age. Through this, the study aimed to provide a guideline to related Korean Medicine treatments as well as the common nurturing/educational institutions. Methods: All journals and dissertations on brain science based learning methods studied in Korea to date that could be found in the National Assembly Library and the RISS were implemented in the analysis. The terminology used for search was as follows: 1st search, ``Brain``; 2nd search, ``Learning``, ``Education``; 3rd search, ‘Baby, ‘Infant``, ``Child``. For the learning methodology of Korean Medicine according to disparity of age, the related contents were extracted from Donguibogam and Liuyi, Sasang constitutional medicine. Results: A total of 30 studies, were collected as data. In the baby stage, the development and myelination of brain neurons are accelerated by experience and learning, highly influenced by social, cognitive and emotional movement. In infancy, the frontal lobe actively develops, so education for development of the prefrontal cortex is suggested. The brain of the infant at this stage can be developed by arts and physical education. In the child stage, the parietal and temporal lobe develop actively. Thus, programs to stimulate brain activity including brain respiration would be helpful in enhancing learning ability, concentration, etc. As evidence for learning and nurturing methodology according to disparity of age from Korean Medicine prospective, the following are listed: Location and time for sexual intercourse before pregnancy, stabilization during pregnancy, baby nurturing methods for nurturing from Donguibogam. Also Liuyi and Sasanag constitutional medicine can be the learning methodology according to disparity of age. And there are acupuncture points on each head section according to age in Donguibogam. Conclusions: Studies on ``brain-science based learning`` are continuously being conducted. Based on these studies, diverse new brain-science based learning will be developed in the future. There is also a need to develop the learning methodology of Korean Medicine according to disparity of age in a more systematic and diverse way.

소아에서 망막검영법과 자동굴절검사로 시행한 현성굴절검사와 조절마비굴절검사의 비교

박아람(A Ram Park),정승아(Seung Ah Chung) 대한안과학회 2016 대한안과학회지 Vol.57 No.8

목적: 소아에서 현성굴절검사와 조절마비굴절검사를 망막검영법과 자동굴절검사로 시행하여 비교하고, 검사 간 차이와 관련된 인자를 알아보았다. 대상과 방법: 평균 나이 7.4 ± 3.6세인 소아 388명을 대상으로 조절마비 전후 망막검영법과 자동굴절검사(Grand Seiko GR-3500KA)를 시행하여 굴절력을 비교하고, 성별, 나이, 굴절이상 종류, 약시, 사시, 전신질환 동반에 따른 차이가 있는지 조사하였다. 구면도수, 난시도수를 각각 비교하였고, 두 검사 결과가 ±0.50디옵터 이상의 차이를 보이면 의미 있는 측정오차로 정하였다. 결과: 현성자동굴절검사는 망막검영법에 비해 구면도수 47.2%에서 더 근시로 측정되었고, 난시도수 37.1%에서 더 크게 측정되었으며, 이러한 구면도수 차이는 7세 미만, 원시, 약시인 경우에 더 흔하였다(각각 p=0.002, p<0.001, p=0.033). 조절마비자동굴절검사는 구면도수 29.4%, 난시도수 30.7%에서 망막검영법과 차이가 있었으나, 의미 있는 측정오차는 아니었고 임상양상에 따른 차이도 없었다. 조절마비 전후 망막검영법에서 구면도수 차이가 있는 경우의 55.6%는 조절마비 전 망막검영법과 자동굴절검사에서도 차이를 보였으며, 이 두 차이 간에는 의미 있는 상관관계가 있었다. 결론: 조절마비자동굴절검사의 제한적 사용이 가능해 보이나, 여전히 30%의 소아에서 망막검영법과 차이가 있었다. 나이가 어리거나 원시, 약시인 경우, 조절마비 전 망막검영법과 자동굴절검사 간 차이를 보인 경우, 현성굴절검사나 자동굴절검사가 망막검영법에 의한 조절마비굴절검사와 차이가 있을 수 있어 더욱 주의하여야 하겠다. Purpose: To compare the measurements between manifest refraction and cycloplegic refraction using retinoscopy or an autorefractor in children and to investigate factors affecting the difference. Methods: A total of 388 children with a mean age of 7.4 ± 3.6 years were examined using retinoscopy and a Grand Seiko GR-3500KA autorefractor before and after cycloplegia. We compared the difference in spherical and cylindrical components between refractions and analyzed the results according to gender, age, type of refractive error, amblyopia, strabismus, and neuro- developmental disorder. A difference in refractions of ±0.50 D or more was considered as a significant discrepancy. Results: Before cycloplegia, the spherical portion of the refractive error via autorefractor measurement was more myopic than for the retinoscopic measurement in 47.2% of patients, and the cylindrical portion was greater in 37.1%. The spherical discrepancies were more common in children aged < 7 years, with hyperopia, or amblyopia (respectively, p = 0.002, p < 0.001, and p = 0.033). After cycloplegia, the spherical component of the refractive error by auto-refraction differed from retinoscopic measurement in 29.4% of patients, and the cylindrical portion differed in 30.7%. However, the difference was not significant and there was no difference according to clinical features. More than half of the children with discrepancies in the spherical component between retinoscopic refractions before and after cycloplegia had a discrepancy between auto-refraction and retinoscopic refraction before cycloplegia, and the two discrepancies had a significant correlation. Conclusions: Auto-refraction after cycloplegia can estimate retinoscopic values partially. Nevertheless, 30% of the children still showed a discrepancy. The discrepancy of manifest refraction or auto-refraction compared to retinoscopic refraction with cycloplegia should be considered in younger children, cases with hyperopia or amblyopia, and cases with a difference in auto-refraction and retinoscopic refraction before cycloplegia.

북한이탈주민들의 병증발생시기 인식에 대한 질적 연구

조아람 ( A Ram Cho ),유춘길 ( Chun Gil Ryu ),박소임 ( So Im Park ),성우용 ( Woo Yong Seong ),서주희 ( Joo Hee Sue ) 대한한방신경정신과학회 2013 동의신경정신과학회지 Vol.24 No.4

Objectives: The purpose of this study is to understand the cognition of the initiation of diseases of North Korean refugees in South Korea. Methods: 9 North Korean refugees hospitalized in Oriental Neuropsychiatry of National Medical Center participated in the interview. The statements were analyzed by using the phenomenological research methodology and Giorgi`s analytical method, in particular, was applied. Results: A total of 4 categories and 15 sub categories were derived from the participants` descriptions. North Korean refugees who thought their diseases have begun while living in North Korea coming to South Korea, have fire disease because of the strict social system, limitations imposed on their actions, and the violence of their husbands. And who thought during escaping from North Korea, have anxiety about being killed, found and transferred to North Korea. They also suffered from a sense of guilt towards their family who were left behind as well as from depression. Consequently, they thought their skeletal diseases have begun during this period. Who thought during their period in Korea, their diseases like fire disease and depression have been worsen because of unfamiliar circumstances and doctors who said their problems had been caused by psychiatric disorder. Nevertheless, they did their jobs, felt happy and had a will to be cured thingking possibilities of overcoming diseases. Conclusions: These results suggest that various factors during different periods in the life of North Korean refugees could have an effect on their present diseases.

컬러푸드 중 쿼세틴 및 쿼세틴 배당체 함량조사

박예지(Ye-ji Park),김기철(Ki-Cheol Kim),조상훈(Sang-Hun Cho),문선애(Sun-Ae Moon),김한택(Han-Taek Kim),정아용(Ah-Yong Jeong),김아람(A-Ram Kim),채경석(Kyung-Suk Chae),김지원(Ji-Won Kim),박명기(Myoung-Ki Park) 한국식품영양과학회 2023 한국식품영양과학회지 Vol.52 No.7

본 연구는 국내에서 주로 소비되고 유통되는 컬러푸드의 쿼세틴 및 배당체 함량을 조사하기 위한 것이다. 이를 위해 QuEChERS kit인 ENK1-SC와 WT186008075를 사용하여 추출 및 정제하는 전처리법을 확립하였고, LC-MS/MS를 이용해 21분 동안 negative 모드로 분석하는 기기 분석법을 확립하였다. 서류 1품목, 과일류 4품목, 채소류 8품목(총 100건)의 쿼세틴 및 배당체 함량을 분석한 결과, 브로콜리를 제외한 12품목에 함유되었음을 확인하였다. 총 쿼세틴 함량은 블루베리, 체리, 오디, 토마토, 양파, 포도, 고추, 파프리카, 애호박, 고구마, 콜리플라워, 양배추 순으로 높게 나타났다. Rutin의 함량이 가장 높은 항목은 체리(135.88±7.27μg/g FW)였고, 블루베리에서 hyperin(74.22±14.69 μg/gFW), isoquercitrin(58.48±12.30 μg/g FW), quercitrin(5.47±0.73 μg/g FW)의 함량이 가장 높게 검출되었다. 쿼세틴 함량은 양파(4.96±0.36 μg/g FW)에서 높게 나타났다. 또한, 품목은 같지만 색이 다른 시료의 함량을 비교한 결과, 포도의 isoquercitrin 함량은 청포도보다 약 9배 높게 검출되었고, 청고추의 quercitrin 함량은 홍고추보다 약 8배 높게 나타났다. 쿼세틴 함량이 가장 높은 양파를 부위별로 나누어 함량을 비교한 결과, 과육, 뿌리, 껍질 순으로 isoquercitrin과 쿼세틴의 함량이 증가하였다. 본 연구 결과는 국내 다소비 컬러푸드의 쿼세틴 및 배당체 함량에 대한 영양학적 기초자료로 활용하고자 한다. This study was undertaken to determine the contents of quercetin and quercetin glycosides in colored foods. We developed a sample extraction and separation method using the quick, easy, cheap, effective, rugged, and safe (QuEChERS) kit, and the analytical method was performed by liquid chromatography coupled to mass spectrometry (LC-MS/MS). Totally, 13 colored foods were analyzed; quercetin and quercetin glycosides were obtained in 12 foods, except broccoli. The total quercetin contents of colored foods were high, in the sequential order blueberry, cherry, mulberry, tomato, onion, grape, pepper, sweet pepper, zucchini, sweet potato, cauliflower, and cabbage. Among the colored foods surveyed, the highest content was obtained for rutin, a quercetin glycoside, in cherries (135.88±7.27 μg/g FW). The highest contents obtained in blueberries were hyperin (74.22±14.69 μg/g FW), isoquercitrin (58.48±12.30μg/g FW), and quercitrin (5.47±0.73 μg/g FW). Quercetin content was the highest in onions (4.96±0.36 μg/g FW). Comparing the contents of quercetin and quercetin glycosides according to color, the isoquercitrin content of purple grapes was determined to be about 9 times higher than in green grapes (P<0.05). Furthermore, the contents of rutin, isoquercitrin, and quercitrin were significantly higher in green pepper than in red pepper (P<0.05).

위혈관종증에 의해 초래된 위-십이지장 중첩증 1례

박아람,김병주,국훈,우영종,최영륜,마재숙,황태주,Park, A-Ram,Kim, Byung-Ju,Kook, Hoon,Woo, Young-Jong,Choi, Young-Youn,Ma, Jae-Sook,Hwang, Tai-Ju 대한소아소화기영양학회 2000 Pediatric gastroenterology, hepatology & nutrition Vol.3 No.2

Gastroduodenal intussusception is an invagination of part of the stomach through the pylorus and into the duodenum for a varying distance. The lead point of the intussusception is usually a benign gastric tumor such as gastric adenoma. We report a case of gastroduodenal intussusception in a 33-month-old boy presented with nonbilious vomiting and abdominal pain. Laparotomy revealed a gastroduodenal intussusception. After reduction and gastrostomy, a mass measuring $15{\times}5\;cm$ in size, was found at the leading point of the intussusceptum. The mass was resected, and pathological diagnosis showed a gastric hemangiomatosis.

1개 한방병원 한방내과에 입원한 북한이탈주민 환자에 대한 임상적 분석

박소임,조아람,강다현,김진원,Park, So-Im,Cho, A-Ram,Kang, Da-Hyun,Kim, Jin-Won 대한한방내과학회 2014 大韓韓方內科學會誌 Vol.35 No.4

Objectives: The purpose of this study was to investigate the health status of hospitalized North Korean refugees in a department of Korean internal medicine. Methods: From March 1st, 2011 to June 30th, 2014, 57 North Korean refugee patients were hospitalized 96 times in a department of Korean internal medicine. Their demographic and medical information was approached retrospectively. Results: Among the 57 North Korean refugees, 46 (80.7%) were women, 11 (19.3%) were men and their average age was 49.7. Except for 3 people, the other 54 (94.7%) have been to an outpatient hospital of Department of Western Medicine, National Medical Center. Orthopedics, Neurology and Gastroenterology were most frequently visited and hospitalized. Among the total 96 times of hospitalization in a Department of Korean internal medicine, low back pain was the majority chief complaint. Among the 96, 78 (80.4%) took herbal medicine and tonifying and replenishing formula (補益劑) was most frequently prescribed. As western medication, 32 (33.0%) took ones related to the musculo-skeletal system and 30 (31.0%) took ones related to the nervous system. Qi stasis was highest among 8 types of pattern identification and Deficiency pattern (虛症) was more frequent than Excess pattern (實證). Conclusions: There are several factors that have aggravated the health status of North Korean refugees, and Korean medicine can perform a proper role to improve their health.

침수식 초음파 검사와 부분결합간섭 검사를 이용한 공식의 정확성 비교

윤일석(Il Suk Yun),박아람(A ram Park),최신영(Shin Young Choi),양홍석(Hong Seok Yang) 대한안과학회 2016 대한안과학회지 Vol.57 No.6

목적: 침수성 초음파 장치와 수동 각막곡률계를 이용한 인공수정체 계산공식과 IOL MasterⓇ를 이용한 계산공식의 예측오차를 비교하여 안축장과 전방 깊이, 각막곡률에 따른 침수성 초음파 검사와 수동각막곡률계를 이용한 인공수정체 검사의 정확성에 대해 보고하고자 하였다. 대상과 방법: 단일 술자에 의해 백내장수술을 받은 환자 65명 82안의 의무기록을 후향적으로 검토하였다. 생체계측은 IOL MasterⓇ, 수동각막곡률계, 침수식 방식의 초음파 검사를 순서대로 시행하여 측정하였다. 초음파 방식과 수동각막곡률계로 구한 생체계측 값을 SRK-T, Holladay 1 공식에 대입하였고 IOL MasterⓇ를 이용한 생체계측 값을 장비에 내장되어 있는 SRK-T, Holladay 2 공식에 대입하여 백내장 수술 후 굴절력을 예측하였다. 백내장 수술 후 7주 이상 지난 시점에 현성 굴절 검사를 시행하여 최종 굴절력을 구하였고, 각 공식들의 예측치와 이를 비교하였다. 결과: 평균 안축장과 평균 각막곡률값은 계측기기 간에 의미 있는 차이를 보였다. 그러나 평균절대오차는 두 계측방식 간에, 그리고 공식들 간에 안축장과 전방 깊이, 각막곡률에 따라서 의미 있는 차이가 관찰되지 않았다. 그러나 안축장과 전방 깊이, 각막곡률에 따라서 예측오차가 ±0.5디옵터 이내에 속하는 백분율은 4가지 공식들 간에 차이를 보였다. 결론: 침수식 초음파와 수동 각막곡률계를 이용한 생체계측 방식은 IOL MasterⓇ 방식과 비교하여 그 정확성이 떨어지지 않는 것으로 보인다. 그러나 더 정확한 인공수정체의 선택을 위해서는 안축장, 전방 깊이, 각막곡률에 따라서 더 적절한 인공수정체 공식을 선택하는 것이 필요할 것으로 생각된다. <대한안과학회지 2016;57(6):905-916> Purpose: To report the accuracy of intraocular lens (IOL) formulas according to axial length, anterior chamber depth, and mean corneal curvature when performing biometry with an immersion type A-scan with mannual keratomery and an IOL Master??. Methods: Retrospective medical chart reviews were carried out for 82 eyes of 65 patients who underwent cataract surgery performed by a single surgeon. Biometry was performed using IOL Master??, mannual keratometry, and immersion type A-scan ultrasound in sequence. Prediction diopter was obtained using Sanders-Retzlaff-Kraff/Theoretical (SRK-T) and Holladay 1 formulas calculated with the biometric value measured by mannual keratomery and A-scan, and using SRK-T and, Holladay 2 formulas with IOL Master??. The final refractive outcome was determined as manifested refraction at least 7 weeks after the surgery, and it was compared with the preoperative prediction dipoter (D) of the IOL formulas. Results: Mean axial length and mean keratomtric measurements as determined by A-scan with mannual keratomery showed significant statistical differences from those of IOL Master??. However, there was no difference in postoperative mean absolute error between biometric measurements, or among formulas according to axial length, anterior chamber depth, or mean corneal curvature. However, the percentage of actual refraction within ±0.50 D of the intended refraction was dirrerent among the four formalas according to axial length, anterior chamber dept, mean corneal curvature. Conclusions: Biometry measurement using the immersion-type A-scan with mannual keratomery is as accurate as that using IOL Master?? for predicting the postoperative refractive state of cataract surgery. However, it is suggested that the best IOL formula be chosen according to axial length, anterior chamber depth, and mean corneal curvature. J Korean Ophthalmol Soc 2016;57(6):905-916

기후변화에 따른 국제관광산업 경쟁력 강화를 위한 관광지 선택속성에 대한 중요도 차이 연구 - 컨조인트 분석 활용을 통해 -

안성식 ( Sung-sik Ahn ),박효정 ( Hyo-jung Park ),조아람 ( A-ram Jo ) 한국통상정보학회 2018 통상정보연구 Vol.20 No.3

관광지 환경을 변화시키는 기후변화의 주요 요인으로 꼽히는 이산화탄소의 배출 감소를 위한 노력은 수요자 측면인 관광객 역시 자발적으로 이산화탄소 배출을 감소시키려는 노력이 중요하다. 그래서 본 연구는 이산화탄소 배출을 감소하는 관광행동을 유도하기 위해 관광객들의 기후변화에 대한 인식의 정도를 파악 후 관광객의 성향을 분석하였다. 이에 본 연구에서는 기후변화에 대한 인식수준에 따른 관광지 선택속성에 대한 중요도를 파악하기 위한 방법으로 컨조인트 분석을 사용하였다. 연구를 진행한 결과, 기후변화에 대한 인식수준이 가장 큰 경우에는 접근성(1위), 동행자유형(2위) 순으로, 기후변화에 대한 인식수준이 중간정도일 경우에는 동행자유형(1위), 관광유형(2위) 순으로, 기후변화에 대한 인식이 가장 낮은 경우에는 동행자유형(1위), 접근성(2위) 순으로 나타났다. 따라서 본 연구 결과는 기후변화 인식에 따라 관광객 선택 속성에 차이가 있음을 확인, 향후 관광프로그램이나 상품개발에 있어 이러한 선택속성을 고려해야 함을 시사하고 있다. The effort to reduce CO2 emissions, which is considered to be a major factor in climate change, is also important for tourists. This study analyzed the tendency of tourists after grasping the degree of recognition on climate change by tourists in order to induce the tourist action to reduce CO2 emission. Using Conjoint Analysis Method. A study on the degree of recognition on climate changes : When the recognition level is the highest accessibility (first place), cooperative freestyle (second place), When the level of recognition is medium, cooperative freestyle (first place), tourism type (second place), When the recognition level is the lowest, cooperative freestyle (first place), accessibility (second place). Therefore, the results of this study confirm that there is a difference in tourism destination selection attributes according to degree of recognition on climate changes. Suggesting that these optional attributes should be considered in future tourism programs and product development.