MRI Findings of Type II Sacral Agenesis: A Case Report and Literature Review

이상아,김명순,권우철 대한영상의학회 2016 대한영상의학회지 Vol.75 No.1

Sacral agenesis (or caudal regression syndrome) is a rare congenital anomaly involving various levels of coccygeal, sacral, and even lumbar or lower thoracic vertebral dysgenesis, as well as spinal cord abnormalities. A few cases have been previously reported in Korea, especially based upon MRI findings. We describe a case of a 4-year-old girl with partially bilateral agenesis of the sacrum (type II), and clubshaped (chisel-shaped) spinal cord disruption. We also review MRI findings of sacral agenesis, focused on classification and radiological findings.

A New Scoring System for the Differential Diagnosis between Tuberculous Meningitis and Viral Meningitis

이상아,김신우,장현하,정혜진,김윤정,황소윤,김수정,박한기,이종명 대한의학회 2018 Journal of Korean medical science Vol.33 No.31

Background: Tuberculous meningitis (TBM) is associated with high mortality and morbidity despite administering anti-tuberculous chemotherapy to the patients. Differential diagnosis between TBM and viral meningitis (VM) is difficult in some clinical situations. Methods: We reviewed and analyzed records of adult patients who were admitted and diagnosed with TBM or VM at a tertiary hospital in Korea, between January 2006 and December 2015. Diagnostic criteria for TBM were categorized into three groups: definite, probable, and possible TBM. The VM group included patients with no evidence of other meningitis who achieved complete recovery with only conservative treatments. Clinical, laboratory and radiological findings, as well as outcomes, were compared between the TBM and VM groups. Results: Ninety-eight patients were enrolled. Among the study patients, 47 had TBM and 51 had VM. Based on univariate analysis and multivariate logistic regression, sodium < 135 mmol/L in serum (hyponatremia), lactate dehydrogenase > 70 (U/L) in cerebrospinal fluid (CSF), protein > 160 (mg/dL) in CSF, voiding difficulty, and symptoms of cranial nerve palsy were significant predictive factors for TBM in the final model. We constructed a weighted scoring system with predictive factors from multiple regression analyses. Receiver operating characteristic curve analyses and decision tree analyses were plotted to reveal an optimum cutoff point as 4 with this scoring system (range: 0–13). Conclusion: For differential diagnosis between TBM and VM, we created a new weighted scoring system. This scoring system and decision tree analysis are simple and easy to apply in clinical practice to differentiate TBM from VM.

좌절 상황에서 정신병질 및 자기애 성격특질이 공격행동에 미치는 영향

이상아,장혜인 한국건강심리학회 2018 한국심리학회지 건강 Vol.23 No.4

The purpose of this study was to determine the associations between personality traits (i.e., psychopathy and narcissism) and aggression in the context of frustraion. The frustration-provoking situations were divided into ego-threatening or achievement-failure, depending on whether or not negative evaluative self-information were involved, and the associations between psychopathy and narcissism levels and types of aggression were examined in each context. A total 192 undergraduate students completed a set of questionnaires psychopathy, narcissism and self-esteem. Subsequently, participants were randomly assigned to either plan failure or ego-threat situation, and were asked to read a scenario that described respective frustration event. Physical and verbal aggression were then measured using the Aggression Questionnaire and the Competitive Reaction Time Task. Results from hierarchical regression models revealed that, higher levels of psychopathy associated with levels of physical and verbal aggression in both plan failure and ego-threat situations. Additionally, high levels of narcissism led to high levels of verbal aggression in the ego-threat situation. Theoretical and clinical implications as well as limitations of the study were also discussed. 본 연구는 공격성이 발현되는 서로 다른 촉발상황(계획실패, 자아위협)에서 정신병질 및 자기애 성격특질이 신체적 및 언어적 공격성의 수준을 예측하는지를 살펴보았다. 구체적으로 공격성이 유발되는 좌절 상황을 개인에 대한 부정적인 평가정보의 포함 여부에 따라 계획실패와 자아위협 상황으로 구분하여, 각 상황에서 정신병질 및 자기애 성향이 높을수록 공격성의 수준 및 유형에 차이가 존재하는지 확인하였다. 이를 위해 서울 소재 4년제 대학에 재학 중인 학부생 192명을 대상으로 정신병질, 자기애 그리고 자존감을 자기보고식 질문지로 평가하였다. 그 후 참여자들을 두 조건에 무선할당 하여 계획실패 또는 자아위협 상황 중 하나를 묘사한 시나리오를 제시하였고, 시나리오를 읽은 후의 각 참여자의 공격성을 측정하였다. 이때 보다 객관적인 공격성 측정치를 얻기 위하여 공격성 질문지와 함께 행동으로 공격성을 평가하는 반응속도 경쟁게임(Competitive Reaction Time Task)을 사용하였다. 위계적 회귀분석 결과, 정신병질 성향이 높을수록 계획실패와 자아위협 상황 모두에서 신체적 및 언어적 공격성이 높게 나타났다. 반면에 자기애가 높을수록 자아위협 상황에서 언어적 공격성만이 높게 나타났다. 본 연구는 정신병질 및 자기애 성향이 높은 개인에게서 공격성이 촉발되는 심리적 기제가 다를 수 있음을 시사한다. 이를 바탕으로 개인의 성격특질 및 촉발맥락을 고려하여 공격성 유형 및 수준을 예측하고, 효과적인 치료 계획을 수립하는 데 기초지식을 제공하고자 하였다.

Gene-Diet Interaction on Cancer Risk in Epidemiological Studies

이상아 대한예방의학회 2009 예방의학회지 Vol.42 No.6

Genetic factors clearly play a role in carcinogenesis, but migrant studies provide unequivocal evidence that environmental factors are critical in defining cancer risk. Therefore, one may expect that the lower availability of substrate for biochemical reactions leads to more genetic changes in enzyme function; for example, most studies have indicated the variant MTHFR genotype 677TT is related to biomarkers, such as homocysteine concentrations or global DNA methylation particularly in a low folate diet. The modification of a phenotype related to a genotype, particularly by dietary habits, could support the notion that some of inconsistencies in findings from molecular epidemiologic studies could be due to differences in the populations studied and unaccounted underlying characteristics mediating the relationship between genetic polymorphisms and the actual phenotypes. Given the evidence that diet can modify cancer risk, gene-diet interactions in cancer etiology would be anticipated. However, much of the evidence in this area comes from observational epidemiology, which limits the causal inference. Thus, the investigation of these interactions is essential to gain a full understanding of the impact of genetic variation on health outcomes. This report reviews current approaches to gene-diet interactions in epidemiological studies. Characteristics of gene and dietary factors are divided into four categories: one carbon metabolism-related gene polymorphisms and dietary factors including folate, vitamin B group and methionines; oxidative stress-related gene polymorphisms and antioxidant nutrients including vegetable and fruit intake; carcinogen-metabolizing gene polymorphisms and meat intake including heterocyclic amins and polycyclic aromatic hydrocarbon; and other gene-diet interactive effect on cancer.

냉각 유체의 유량변동을 고려한 고압터빈 노즐 압력면 막냉각 홀 배열의 강건 최적설계

이상아,이동호,이관중 한국항공우주학회 2015 한국항공우주학회 학술발표회 논문집 Vol.2015 No.11

본 연구에서는 항공기용 가스터빈엔진의 고압터빈 냉각성능 향상을 위한 막냉각 홀 배열 강건 최적화를 수행하였다. 이를 위해 2개의 막냉각 홀 열을 9개의 변수로 정의하였고 냉각 유체의 유량변동에도 강건한 형상을 얻기 위해 각각의 내부유로로 공급되는 냉각유체의 유량을 확률변수로 정의하였다. 3차원 유동 및 열전달 해석은 정상 압축성 RANS 방정식을 이용하였으며, 확률 평가 및 최적화 기법으로는 크리깅 근사모델과 몬테카를로 시뮬레이션 및 유전 알고리즘을 사용하였다. 노즐 압력면의 온도의 평균과 변동을 최소화하는 다목적 최적화 문제로 수행되었으며, 그 결과 온도의 평균은 최대 약 7.9%, 온도 변동의 편차는 최대 약 88.2%까지 줄일 수 있는 냉각유량변동에 강건하면서도 향상된 성능의 막냉각 홀 배열 형상을 도출하였다. In the present work, robust design optimization of film-cooling hole array at the pressure side of high pressure turbine nozzle was conducted. To do this, 2 rows of film cooling holes were parameterized by 9 design variables and mass flow rate of cooling air supplied to each internal cooling passage were defined as uncertainties. 3-dimensional compressible RANS equations were used for flow analysis and measuring heat transfer at the nozzle surface. For probabilistic approach and optimization, Monte Carlo Simulation with Kriging surrogate model, and Genetic algorithm were used. as a result, average wall temperature was decreased about 7.9% and variance of the wall temperature was decreases about 88.2%.

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.

지역고용정책과 청년, 노인 고용활성화와의 관계 : 고용의 양과 질 측면을 중심으로

이상아 비판과 대안을 위한 사회복지학회 2020 비판과 대안을 위한 사회복지학회 학술대회 발표논문집 Vol.2020 No.6

본 연구의 목적은 지역고용정책 유형들이 고용 활성화(Activation), 그리고 청년과 고령자 활성화에 어떻게 영향을 미치는지 분석하는 것이다. 이를 위해 한국의 지역고용정책을 이론적 틀에 기반하여 유형을 확인하고, 지역고용정책의 대상 포괄성, 정책내용의 적극성, 정책재원의 독립성 이 세 가지 요소와 세 가지 요소를 기반으로 한 지역고용정책 유형을 모두 고려하는 정책 통합적 접근을 통해 고용 활성화 효과를 측정하였다. 본 연구는 2014-2019년 시기의 전국 225개 각 시도에 속한 시군구를 대상으로 하여 지역고용정책 유형별 활성화 관계를 밝혔다. 분석 결과, 빈약한 지역고용정책 유형보다 한 요소라도 발전된 지역고용정책에서 지역 전반과 노인 질적 활성화가 높아지는 것을 확인하였다. 특히 포괄적인 적극적고용정책형에서는 양적 활성화와 질적 활성화가 모두 빈약한 지역고용정책형에 비해 높은 것으로 분석되었다. 이러한 결과는 지역고용정책이 기존 연구들에서 다루어졌던 고용률과 실업률 등과 같은 양적 활성화에 영향을 미칠 뿐만 아니라, 질적 활성화에도 긍정적 영향을 미칠 수 있음을 확인한다. 즉, 지역고용정책은 지역의 특수성을 반영하여 지역고용정책의 3가지 요소 중 한가지만이라도 갖추어졌을 때 소극적 상태에 놓여진 대상이 진입가능한 일을 확대하고, 지역고용정책을 통한 장기고용가능성을 향상 시킬 수 있음을 보여준다.

MRI Findings of Spinal Angiomyolipoma: A Case Report and Literature Review

이상아,전영욱,김명순,정순희 대한영상의학회 2017 대한영상의학회지 Vol.76 No.1

Spinal angiomyolipoma (AML) is a rare disease. It is often reviewed with spinal angiolipoma. Both are composed of vascular and mature adipose elements. However, only AML contains broader array of mesenchymal component. They are accounting for 0.14% to 1.2% of spinal tumors. They appear as fat containing hypervascular tumor located at epidural space of thoracic spine. Spinal AML is more frequently infiltrative and ofted occurs more ventrally than angiolipoma. Previous studies have employed conventional radiograph, myelogram, and CT scan for spinal AML studies. Recently, MRI has been used for spinal AML in a few studies. Here, we describe a case of typical thoracic spinal AML with a review of its MRI findings and other differential diagnosis for epidural spinal mass with similar characteristics.

리차드 3세(Richard III) 공연 리뷰: 리차드의 죄에 대한 물음

이상아 한국셰익스피어학회 2022 셰익스피어 비평 Vol.58 No.1

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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.