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.

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.

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.

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>

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.

스마트 전통시장을 위한 화재 감지 시스템 설계

고아라(Ara Ko),이희주(Heeju Lee),조정원(Jungwon Cho) 한국컴퓨터교육학회 2023 한국컴퓨터교육학회 학술발표대회논문집 Vol.27 No.1

시각장애인을 위한 촉각 그래픽에 등장하는 시각 중심적 표현 고찰

고아라(Ara Ko),홍재영(Jaeyoung Hong) 한국시각장애교육재활학회 2024 시각장애연구 Vol.40 No.1

연구 목적: 이 연구는 시각장애인을 위해 제작된 촉각 그래픽에 등장하는 시각 중심적 표현의 유형과 시각장애인이 시각 중심적 표현을 이해하기 어려운 이유를 연구한 문헌 고찰연구이다. 이 연구는 시각장애 학생에게 유의미한 촉각 그래픽을 제작하기 위한 기초 정보를 제공하는 것을 목적으로 한다. 연구 방법: 이를 위해 1990년대 이후 발표된 문헌 중 시각장애인을 위한 촉각 자료 관련 문헌을 연구 대상으로 설정하였으며, 귀납적 내용분석 절차에 따라 문헌을 고찰하였다. 연구 결과: 촉각 그래픽에 등장하는 시각 중심적 표현에는 ‘시점, 원근법, 가려짐, 비일관성, 복잡성, 관용적 표현’ 등이 있었다. 시점, 원근법, 가려짐은 시각으로 대상을 관찰하거나, 시각으로 관찰한 대상을 평면에 옮길 때 발생하였다. 이는 촉각으로 대상을 탐색할 때는 발생하지 않는 시각 중심적 표현이다. 시각으로 대상을 관찰할 때는 어렵게 여겨지지 않는 비일관성, 복잡성, 관용적 표현도 시각적 경험이 없는 시각장애인에게는 자료 탐색에 어려움을 가중하는 요소였다. 결론: 이러한 연구 결과를 바탕으로 시각장애 학생에게 유의미한 촉각 그래픽을 제작하기 위한 방안을 논의하였다. Purpose: This study was a literature review that investigated the types of visually centered expressions found in tactile graphic for the visually impaired and the reasons why visually impaired individuals found it difficult to understand these expressions. The purpose was to provide foundational information for creating meaningful tactile graphic for visually impaired students. Method: The study focused on literature related to tactile materials for the visually impaired published since the 1990s and conducted an inductive content analysis of the selected documents. Results: Visually centered expressions identified in tactile graphic include ‘viewpoint, perspective, occlusion, inconsistency, complexity, and visual graphic habits.’ Viewpoint, perspective and occlusion occur when translating observed objects into tactile graphic, which do not arise when exploring objects through touch. Inconsistencies, complexity and visual graphic habits, typically not challenging when observed visually, exacerbated the difficulty for individuals with congenital blindness. Conclusion: Based on these results, the study discussed strategies for developing meaningful tactile materials for visually impaired students.

BEGAN을 이용한 광각 안저사진 합성 연구

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

인성 함양 지속가능발전교육 융합 모델 개발

고아라(Ara Ko),남영숙(Young-Sook Nam) 학습자중심교과교육학회 2024 학습자중심교과교육연구 Vol.24 No.2

목적 이 연구는 인성 함양 지속가능발전교육 융합 모델을 강구하는 데 목적이 있다. 방법 이를 위해 2022 개정 교육과정 상의 초등학교 5~6학년군 교과 목표, 내용요소와 성취기준과 학습활동을 분석, 인성 요소와 융합한 지속가능발전교육 내용을 분석하는 문헌연구로 진행하였다. 분석한 내용을 토대로 인성 함양 지속가능발전교육 융합 모델 주제를 선정하고, 인성 함양 지속가능발전교육 융합 모델 및 사례를 개발하였다. 타당도 제고를 위해서는 전문가 5인을 대상으로 설문지 조사를 하여 학습 주제 선정, 교육역량 및 목표, 교육내용, 교수·학습방법, 평가, 모델 개발 전반에 대한 의견을 수렴하였다. 결과 연구결과는 다음과 같다. 첫째, 인성 함양 지속가능발전교육 융합 모델 개발의 원칙은 융합된 역량 선정, 융합 성취기준 활용, 삶과 연계한 방식 진행이다. 둘째, 인성 함양 지속가능발전교육 융합 모델 개발을 위한 주제를 선정하기 위해 관련 교과별 성취기준을 추출하고, ESD 성취기준을 개발하며, 융합 목표를 도출한 후, 융합 모델 주제를 선정하였다. 셋째, 인성 함양 지속가능발전교육 융합 모델 및 사례를 개발하기 위해 기획, 준비, 개발, 개선의 단계를 거친다. 2022 개정 5~6학년 교육과정을 대상으로 ‘도시’를 소재로 한 ‘우리 도시를 더 나은 곳으로 만들기 위한 협력과 아이디어’를 주제로한 인성 함양 지속가능발전교육 융합 모델의 프로젝트 10차시를 개발하였다. 결론 지속가능발전교육 내용 요소별 성취기준이 필요하다. 인성 함양 지속가능발전교육을 위한 다양한 융합 모델이 중요하다. Objectives The purpose of this study is to devise a convergence model for character cultivation and education of sustainable development(ESD). Methods To this end, a literature study was conducted to analyze the subject goals, content elements, achieve-ment standards, and learning activities of the 5th to 6th grades of elementary school in the 2022 revised curricu-lum, and to analyze the contents of ESD fused with personality elements. Based on the analysis, the subject of the personality cultivation ESD convergence model was selected, and the personality cultivation ESD convergence model and case were developed. To improve the validity, a questionnaire survey was conducted on five experts to collect opinions on the selection of learning topics, educational competencies and goals, educational content, teaching and learning methods, evaluation, and model development as a whole. Results The results of the study are as follows. First, the principle of developing a convergence model for person-ality cultivation and ESD is to select convergent competencies, use convergence achievement standards, and pro-ceed in a way linked to life. Second, after extracting achievement standards for each related subject, developing ESD achievement standards, and deriving convergence goals, convergence model topics were selected to select topics for the development of a convergence model for personality cultivation and ESD. Third, it goes through the stages of planning, preparation, development, and improvement to develop a convergence model and case for personality cultivation and ESD. For the 2022 revised 5th to 6th grade curriculum, the 10th session of the project of a convergence model for personality cultivation and ESD under the theme of “Cooperation and Ideas to Make Our City a Better Place” was developed. Conclusions Achievement standards for each element of ESD are needed. Various convergence models for per-sonality cultivation and ESD are important.