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      • 비전형적인 세침흡인 세포학적 소견을 보인 후복막강 부신경절종 - 1례 보고 -

        김진아,김영신,강창석,이안희,김병기,심상인,김선무,Kim, Jean-A,Kim, Young-Shin,Kang, Chang-Suk,Lee, An-Hi,Kim, Byung-Kee,Shim, Sang-In,Kim, Sun-Moo 대한세포병리학회 1994 대한세포병리학회지 Vol.5 No.1

        A case of retroperitoneal paraganglioma is presented with fine needle aspiration cytologic features. A 57-year-old woman complained of abdominal discomfort and left flank pain for 2 years. The abdominal CT scan revealed an ovoid mass left to the abdominal aorta. Percutaneous fine needle aspiration was performed from the mass. The smear revealed cellular sheets or groups on hemorrhagic background. The tumor cells were ovoid, round to spindle shaped with mild to moderate cellular pleomorphism. The nuclei were round to ovoid and had evenly dispersed chromatin and small nucleoli. The cytoplasm was amphophilic, finely granular and poorly defined. Cells having large or spindle nuclei were quite frequently observed, however, mitosis was not present The cytologic findings suggested paraganglioma, but the frequent spindle cell pattern and the pleomorphism made it difficult to exclude other endocrine tumors and sarcomas. The clinical, histological and ultrastructural findings as well as cytologic findings contributed to confirmatory diagnosis.

      • 뺨 점막에 발생한 충실성 선양낭성암종의 세침흡인 세포학적 소견 - 1예 보고 -

        김진아,김영실,이안희,심상인,김병기,김경미,Kim, Jean-A,Kim, Young-Sill,Lee, An-Hi,Shim, Sang-In,Kim, Byung-Kee,Kim, Kyoung-Mee 대한세포병리학회 2000 대한세포병리학회지 Vol.11 No.2

        Adenoid cystic carcinoma constitutes 4 percent of ail benign and malignant epithelial salivary gland tumors and is a highly malignant tumor of the salivary glands. The cytologic presentation in aspirates is usually characteristic with spherical clusters(balls) of small tumor cells filled with hyaline material. But in case of the poorly differentiated variety(solid type), it is difficult to differentiate from other tumors because sheets of small, fairly monotonous malignant cells, with somewhat larger and more conspicuous nuclei are only seen. The cytologic findings of fine needle aspiration of solid type adenoid cystic carcinoma of buccal mucosa in a 51-year-old man are presented. On cytologic findings, solid sheets of monotonous tumor cells with focal necrosis was noted on a hemorrhagic background and the characteristic cytologic features of adenoid cystic carcinoma was absent.

      • 폐 과오종의 세침흡인 세포학적 소견 - 2예 보고 -

        김진아,김영실,이안희,심상인,김병기,김경미,Kim, Jean-A,Kim, Young-Sill,Lee, An-Hi,Shim, Sang-In,Kim, Byung-Kee,Kim, Kyoung-Mee 대한세포병리학회 2000 대한세포병리학회지 Vol.11 No.1

        Pulmonary hamartoma is an uncommon benign tumor consisting of a mixture of loose fibromyxoid tissue, cartilage, fat, and cleft-like spaces lined by cuboidal or ciliated epithelium. Cytologically, the presence of a mesenchymal component is essential for the diagnosis of pulmonary hamartoma. We report the fine needle aspiration cytologic findings of two cases of pulmonary hamartoma. Case 1 was a 71-year-old woman with a mass, measuring $1.8{\times}1.5cm$ in the upper lobe of the right lung. Case 2 was a 51-year-old woman with a mass, measuring $2.3{\times}2.0cm$ in the lower lobe of the right lung. Fine needle aspiration cytology of both pulmonary masses revealed several sheets of loose fibromyxoid tissue fragments with focal cartilaginous differentiation and a few clusters of bland cuboidal epithelial cells on the bloody background. The diagnosis was histologically confirmed by needle biopsy.

      • KCI등재후보

        사례분석을 통한 『상한론(傷寒論)』 변병진단체계(辨病診斷體系)의 서사의학적 가치의 탐색

        김진아,이성준,Kim, Jin-A,Lee, Sung-Jun 대한상한금궤의학회 2014 대한상한금궤의학회지 Vol.6 No.1

        Objective : The purpose of this study is exploring value of Shanghanlun six diagnostic system as Narrative Medicine by analyzing cases. Methods : In the article, we examined the theory of narrative medicine and current studies. And then key elements of narrative medicine was defined. On the basis of these, two medical cases were analyzed by reordering in accordance with time sequences and causality for confirming narrative factors. Results : The narrative approach to analyzing cases shows us that different diseases could be the result of same pathological patterns based on Shanghanlun. This tells us following four aspects. [1] Shanghanlun is the causes-oriented records and the text includes narrative factors. [2] Shanghanlun six diagnostic system is a process of constructing plot of medical case history through the clinical interpretation of contextual meaning of patient's life. [3] In the process of diagnosis, Schemata and script are engaged in assuming and confirming six patterns diseases. [4] The subjective factors of an individual can be applied universally through the provision of Shanghanlun. Conclusions : Narrative factors of Shanghanlun six diagnostic system suggest the possibility and value of Shanghan Medicine as Narrative Medicine in terms of Medical Humanities, essence of medical diagnosis and therapeutic action.

      • KCI등재

        미국 문화, 그 기로에 서서 - NEA(국립예술진흥기금)를 둘러싼 논쟁 중심으로

        김진아,Kim, Jin-A 한국미술이론학회 2006 미술이론과 현장 Vol.4 No.-

        '문화 전쟁(Culture Wars)'은 1980년대 말부터 1990년대 초 미국에서 보수주의자와 진보주의자 사이에 벌어진 문화적 논쟁을 일컫는다. 이 용어는 제임스 헌터(James Hunter)의 책 "문화 전쟁: 미국을 정의하려는 노력(Culture Wars: The Struggle to Define America)"의 출간으로 대중화되었고, 당시 공화당 대통령 후보였던 패트릭 부캐넌(Patrick Buchanan)에 의해 급부상하게 된다. 그는 "이 나라에는 지금 종교 전쟁, 즉 냉전만큼 중요한 '문화 전쟁'이 일어나고 있고, 이것은 미국의 영혼을 위한 전쟁이다." 라고 부르짖으며 급변하는 문화 정체성의 위기 속에서 미국적인 전통을 지키고자 하였다. 이 문화 전쟁은 여러 다양한 논쟁을 함의하고 있었는데, 교목제도의 폐지, 교육기관에서의 다문화주의(multiculturalism) 커리큘럼 도입, 동성애자의 군복무, 낙태, 총기 소지 등의 허용 문제로 당시 미국의 교육계, 문화계뿐만 아니라 정치계, 입법부에서도 첨예한 대립 구도를 형성하였다. 미술계에서 가장 치열했던 문화 전쟁은 안드레 세라노(Andres Serrano)의 작품전과 ${\ll}$로버트 메플소프: 완벽한 순간(Robert Mapplethorpe: The Perfect Moment)전${\gg}$이 공공기금인 국립예술진흥기금(National Endowments for the Arts, NEA)의 지원을 받아 개최되는 것이 타당한 것이냐에 대한 논쟁에서 표출되었다. 이 두 전시를 기점으로 그 뒤로도 여러 미술 전시회와 음악회, 연극 등을 둘러싼 NEA 기금 지원과 관련한 분쟁은 한동안 계속된다. 이 글은 이러한 미술계 문화 전쟁의 발전 과정과 몇몇 논점에 초점을 맞추되, 세라노나 메플소프의 작품 자체를 분석하고 비평하는 글이 아님을 밝혀 둔다. 본 연구는 분쟁의 전개에 대한 상세한 기술적, 연대기적 조사보다는 그 발단과 전개 과정에서 몇 가지 핵심적인 사항들을 기술하고, 이 사항들이 암시하는 정치적, 미학적, 미술사적 시각의 충돌에 대해 지적하는 글이 될 것이다. 더 나아가 당시 이러한 논쟁이 미국 미술계에 의미하던 것, 미국 문화 전체에 의미하던 것은 과연 무엇인가에 대한 비평적 질문으로 글을 맺고자 한다. The cultural debates between conservatives and liberals at the end of the 1980s and in the early 1990s were termed as "culture wars." The "culture wars" involved a diverse range of controversial issues, such as the introduction of multicultural curricula in educational institutions, prayers in schools, whether to allow gays to serve openly in the military, and whether abortion should be permitted. The most heated debates of the "culture wars" regarding art raged over the NEA and the question of whether Andres Serrano's works should have been publicly funded, in addition to the exhibition "Robert Mapplethorpe: The Perfect Moment" which were charged as projecting "obscene" or "blasphemous" images. This paper examines the development of culture wars in art and focuses on several issues invoked by the NEA debates. However, it is not a detailed chronological investigation. Rather it pays attention to the several phases of the debates, analyzing and criticizing the clashes of the political and esthetical points of views between conservatives and liberals. How could NEA funding, a mere fraction of the federal budget, have become so critical for both sides(conservative and liberal), for politicians and artists' groups, and for academics and the general public? The art community was astounded by this chain of events; artists personally reviled, exhibitions withdrawn and under attack, the NEA budget threatened, all because of a few images. For conservative politicians, the NEA debate was not only a battle over the public funding of art, but a war over a larger social agenda, a war for "American values and cultures"based on the family, Christianity, the English language, and patriarchy. Conservative politicians argued the question was not one of "censorship" but of "sponsorship," since the NEA charter committed it to "helping museums better serve the citizens of the United States."Liberals and art communities argued that the attempt to restrict NEA funding violated the First Amendment rights of artists, namely "free speeches." "No matter how divided individuals are on matters of taste," Arthur C. Danto wrote, "freedom is in the interest of every citizen." The interesting phase is that both sides are actually borrowing one another's point of view when they are accompanied by art criticism. Kramer, representative of conservative art critic, objected the invasion of political contents or values in art, and struggled to keep art's own realm by promoting pure aesthetic values such as quality and beauty. But, when he talked about Mapplethorpe's works, he advocated political and ethical values. By contrast, art experts who argued for Mapplethorpe's works in the Cincinnati trial defended his work, ironically by ignoring its manifest sexual metaphor or content although they believed that the issues of AIDS and homosexuality in his work were to be freely expressed in the art form. They adopted a formalistic approach, for example, by comparing a child nude with putti, a traditional child-angel icon. For a while, NEA debates made art institutions, whether consciously or unconsciously, exert self-censorship, yet at the same time they were also producing positive aspects. To the majority of people, art was still regarded as belonging to the pure aesthetic realm away from political, economical, and social ones. These debates, however, were expanding the very perspective on the notion of what is art and of how art is produced, raising questions on art appreciation, representation, and power. The interesting fact remains: had the works not been swiped in NEA debates, could the Serrano's or Mapplethorpe's images gain the extent of power and acceptance that it has today?

      • KCI등재

        가능성 소화장애증 환자의 정신사회적 요인과 위장 생리활동성의 연관성에 관한 연구 -위 배출능 검사를 이용하여-

        김진아,임승한,문성근,이상열,Kim, Jin-A,Lim, Seung-Han,Moon, Seong-Keun,Lee, Sang-Yeol 한국정신신체의학회 2001 정신신체의학 Vol.9 No.1

        연구목적 : 기능성 소화장애증 환자에서 실제적인 위장 운동 기능의 이상을 알아볼 수 있는 위 배출능 검사를 시행하여 위장 운동 기능 이상의 유무 및 위장 운동 기능과 정신병리(특히 불안과 우울), 지각된 스트레스, 스트레스의 매개변인인 대처방식, 사회적 지지와의 연관성을 알아보고자 하였다. 방법 : 원광의대 소화기 내과에 가능성 소화장애증을 주소로 내원히여 방사선 검사 및 심전도 검사 제반 내시경 및 생화학적 검사에서 이상소견을 보이지 않고 식도운동검사 및 24 시간 위-식도 역류검사를 실시하여 이상 소견을 보이지 않는 환자 30명으 대상으로 지각한 스트레스의 양 및 SCL-90-R, BDI, STAI, 대처방식, 사회적 지지와 위 배출능 검사를 시행하여 상관관계를 분석하였다. 결과 : 1) 위 배출 반감시간은 $118.50{\pm}23.64$분이었으며, 위 배출능 검사에서 정상 범위를 벗어난 환자는 없었다. 2) 위 배출 반감시간은 우울 및 상태 불안과 유의한 정적인 상관이 있었다. 3) 위 배출 반감시간은 지각된 스트레스, 대처방식, 사회적 지지와 유의한 상관이 없었다. 결론 : 이상의 결과로 보아 기능성 소화장애증 환자의 생리적 기능인 위 배출반감시간은 우울 빛 불안과 유의한 상관이 있으며 스트레스 매개변인과는 연관이 없었다. 이는 스트레스 인자와 반응사이의 매개변인보다는 그 결과로 생각되는 정신병리가 위장 생리 활성과 연관이 있고 이런 측면이 신경정신과적 중재 및 치료에 고려 될 수 있음을 시사하고 있다. Objectives : This study was designed to investigate the relationship between gastric emptying, psychopathology(especially anxiety and depression), and various factors that can mediate stress and response, such as coping style, social support and level of perceived stress. Methods : A total 30 patients who complained of the non-ulcer dyspepsia and did not have any abnormal finding on the gastroduodenal endoscopic examination, 24 hour ambulatory esophageal manometry and conventional gastroesophageal manometry were tested with gastric emptying that would be a functional examination of stomach. The correlations between the gastric emptying and psychological vaiable such as quantity of perceived stress, Symptom Checklist-90-Revision(SCL-90-R), Beck Depression Inventory(BDI), Spielberger Stait-Trait Anxiety Inventory(STAI), Ways of Coping Checklist and Interpersonal Support Evaluation List were evaluated. Results : 1) The mean and standard deviation of the time for half of the meal to empty(T50%) was $118.50{\pm}23.64$ minute which showed no gastric stasis in terms of gastric emptying test. 2) There were significant positive correlations between T50% and the state anxiety, T50% and thedepression. 3) There was no significant correlation between T50% and the quantity of perceived stress, T50% and mediating factors(coping style and social support). Conclusion : These results suggested that psychopathology, especially emotional components such as depression and anxiety, could affect on the current physiological functional gastric activity(gastric emptying), but quantity of perceive stress and mediating factors of stress and response such as coping style and social support could not affected on the functional gastric activity. These results showed that psychological interventions should considered in management of the patients with functional dyspepia.

      • KCI등재

        서울시내 수계시설에서 분리된 Legionella spp.의 병원성에 대한 분자역학적 연관성

        김진아,정지헌,김수진,진영희,오영희,한기영,Kim, Jin-Ah,Jung, Ji-Hun,Kim, Soo-Jin,Jin, Young-Hee,Oh, Young-Hee,Han, Gi-Young 한국미생물학회 2009 미생물학회지 Vol.45 No.2

        Legionella spp. is the causative agent of Legionellosis, which induces a potentially fatal form of pneumonia. With a concentrated performance during the summer of 2008, we secured 73 isolates from the water systems of 25 wards in Seoul. We analysed serotypes, pathogenic genes (Dot/Icm), and patterns of pulsed-field gel electrophoresis (PFGE) in an attempt to confirm relationships among them. Different from the previous year's pattern (2007), among the isolates, 69 were Legionella pneumophila and 4 were Legionella spp. The serotype distribution of Legionella pneumophila was sg1 43, sg6 9, sg5 8, sg3 8, and sg2 1. The serotype for the 4 Legionella spp. was Legionella nautarum. Most of the Legionella pneumophila had several pathogenic genes. On the other hand, the 4 Legionella spp. were defective in pathogenicity in genomic terms. The PFGE patterns of the serotypes showed a tendency for diversity of Legionella pneumophila and a close correlation with genetic pathogenicity. 레지오넬라균은 치명적인 폐렴을 일으킬 수 있는 균으로서, 기후 온난화와 함께 노출의 수위가 높아지고 있는 병원성균이다. 본 연구는 2008년 6월부터 8월까지 서울시내 25개구 소재 수계시설에서 분리한 레지오넬라균 73개 주에 대해 혈청형, Dot/Icm라 일컬어지는 병원성 유전자 분석 그리고 Pulsed field gel electrophoresis (PFGE)를 실시하여 유전자형과 그들 사이의 상관관계를 파악하였다. 73개주 중 69주는 Legionella pneumophila로 혈청형의 분포는 sg1 43주, sg6 9주, sg5 8주, sg3 8주, sg2 1주로 파악되었으며, Legionella spp. 4개주는 Legionella nautarum였다. 분리된 Legionella pneumophila 대부분이 여러 개의 병원성 유전자를 보유하고 있었으며, 반면에 Legionella nautarum은 병원성 유전자가 많이 결핍되어있었다. PFGE pattern을 분석해 볼 때, Legionella pneumophila가 동일한 혈청형안에서 다양하게 분화되어감을 볼 수 있었으며, 병원성 유전자의 분포와 깊은 상관관계를 보였다.

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