• Title/Summary/Keyword: 소아환자

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Serum interleukin-6, tumor necrosis factor-α and adiponectin levels in Kawasaki disease (가와사키병 환자의 혈청 interleukin-6, tumor necrosis factor-α, Adiponectin 치에 대한 연구)

  • An, Jung;Kim, Han Gyu;Sohn, Sejung;Hong, Young Mi
    • Clinical and Experimental Pediatrics
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    • v.53 no.1
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    • pp.41-47
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    • 2010
  • Purpose : Adiponectin is an endogenous modulator of vascular remodeling that suppresses vascular inflammation. However, the role of adiponectin in Kawasaki disease (KD) has not been elucidated. The purpose of this study is to investigate the correlation between serum adiponectin level and several parameters, such as interleukin (IL)-6, tumor necrosis factor $(TNF)-{\alpha}$, lipid profile, and C reactive protein (CRP), and to clarify the association between adiponectin and cardiac function. Methods : Twenty-two KD patients (22 patients in acute phase and 20 patients in subacute phase) were enrolled in the study group. The control group consisted of 31 subjects (13 febrile patients and 18 healthy children). Both groups underwent blood sampling and tissue Doppler imaging (TDI). Results : CRP was significantly increased in the KD group compared with the control group. There were no significant differences in serum $TNF-{\alpha}$, IL-6, and adiponectin levels between groups. However, a negative correlation was found between adiponectin level and CRP level or platelet count. Systolic myocardial velocity and A myocardial velocity measured by TDI were decreased significantly in the acute KD group compared with the subacute KD group and control group. Positive correlations were found between adiponectin level and systolic myocardial velocity or A myocardial velocity. Conclusion : In acute KD patients, low adiponectin level was related to severe inflammatory reactions and decreased left ventricular functions.

Clinical Outcome and Follow-up of Neonatal Hydronephrosis Diagnosed Antenatally (산전 진찰에서 진단된 신생아 수신증에 대한 추적 관찰)

  • Park, Su-Eun;Kim, Su-Yung
    • Childhood Kidney Diseases
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    • v.2 no.2
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    • pp.161-168
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    • 1998
  • Purpose : Lots of congenital anomalies of urinary tract including hydronephrosis are detected in fetus and neworn by popular use of prenatal ultrasonography. But there are little data available in Korea about natural course of hydronephrosis diagnosed antenatally by ultrasonography. So we intended to help management of these patients by analizing the follow up data of the neonates with hydronephrosis diagnosed antenatally. Methods : We evaluated 22 patients with neonatal hydronephrosis(33 renal units) who were diagnosed prenatally and confirmed postnatally. Especially patients with suspected ureteropelvic junction obstruction were followed regulary with renal ultrasonography and diuretic renography for 8-24 months. Results : 1) The etiologies of neonatal hydronephrosis diagnosed prenatally were suspected ureteropelvic junction obstruction($69.9\%$), vesicoureteral reflux($15.1\%$), primary megaureter($3.0\%$), double ureter with ureterocele($3.0\%$), ureteral stricture($3.0\%$), multicystic dysplastic kidney(3.0$\%$), and ureterovesical junction obstruction(3.0$\%$). 2) The follow up results of 23 renal units of suspected ureteropelvic junction obsruction: Except 4 renal units with palpable abdominal mass, of the remained 19 renal units, 14 units($73.6\%$) were improved spontaneously, 3 units($15.7\%$) remained stable, only2 units($10.5\%$) were aggravated. Conclusion : We concluded that in most cases of hydronephrosis there is no need for immediate surgery, and that nonoperative approach, using serial ultrasonography and diuretic renogram, is safe management of neonatal hydronephrosis diagnosed anteratally.

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항균제 임상시험 Guideline

  • 우준희
    • Proceedings of the Korean Society of Applied Pharmacology
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    • 1994.11a
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    • pp.27-30
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    • 1994
  • 잠재적으로 항감염 약제로 사용될 가능성이 있는 약제들의 초기 연구과정에서 주된 관심사는 이들이 미생물(세균, 바이러스, 기타 기생충)에 대한 작용들이 있는가 하는 점이다. 이러한 작용들이 실험적으로 충분히 연구가 된 후에야 실험동물에서 그 효과를 연구한다. 항 바이러스 제제의 경우에는 세포배양을 통한 연구가 그 약제의 독성과 효용성을 나타내는데 필수적인 것이 된다. 여러 종류의 동물을 이용한 생체실험에서 약제의 일반적인 흡수와 배설, 분포 등에 관한 정보와 약제 자체와 동물 내에서의 대사적 변화에 대한 정보가 제공된다. 여러 가지 미생물로 감염을 시킨 적합한 동물과 여러 가지 용량으로 치료하는 실험을 통하여 약제의 항 감염 능력이 알려지게 된다. 동물에서의 생체실험과 실험관내에서 실험을 하고 나서야 사람에서의 연구가 이루어지게 된다. 소위 전임상시험에서 대표적 병원성 미생물에 대한 생물학적효과, 약리학적 효과와 독성 그리고 동물실험모델에서의 가능한 효과가 결정된 후에 임상시험에 들어가기 마련이다. 항균제의 임상시험에는 각각의 감염질환에 대한 진단 및 치료기준을 반영하는 것이 기본이다. 새로운 항균제의 임상시험에서는 안전성과 효과가 반드시 밝혀져야 한다. 1상에서는 인체에서의 약리효과, 안전성이 주목적이며, 2상과 3상은 겹쳐지는 점도 있으나 하나 또는 그 이상의 적응증에 대한 항균제의 효과와 단기간의 부작용은 2상에서 관찰하여야하며, 다수의 환자에서 제안된 적응질환의 무작위임상시험과 다수에서의 안전성도 3상에서 관찰하여야 한다. 4상에서는 이상에서의 자료로 시판된 후에도 계속해서 감시하는 것으로 지속적으로 안전성을 관찰하는 것이다. 이러한 기본사항외에도 소아, 임산부, 고령자등에서의 임상시험도 넓은 의미에서 포함되어야 할 것이며 또한 질적인 면에서 조절하는 Quality Assurance도 중요하다.양상은 세 용량군 간 차이가 없었으나, 시험기에서 발열의 발현율이 낮았으며, 발열일 수와 항생제 사용일 수가 짧았다. 결론: 골수억제 조절 효과는 용량에 따른 혈액소견에 미치는 영향, 부작용, 감염의 빈도, 감염발생에 따른 항생제 사용기간 등을 고려하여 그 임상 유효성 평가시, 제 3상 시험에 사용할 권장량 (recommended dose) 은 250 ug/$m^2$/d $\times$ 10d 으로 관찰되었다.5주에 부검한 랫드의 간에서 c-myc 종양단백의 발현은 모든 처리군들이 대조군에 비하여 높게 발현되는. 것이 관찰되었으나 시험개시후 26주에 부검한 랫드의 간에서 c-myc 종양단백의 발현은 대조군에 비하여 차이가 거의 없었다. 따라서 랫드에서 화학적으로 유도한 간암발생 과정에서 NK 세포활성이 현저하게 억제되는 것으로 생각되며, c-myc 종양단백의 발현은 시험개시후 15주에 그 발현이 확실한 것으로 사료되어 진다.에 영향을 주는 성분이 있음을 제시하였다.1과 항우울약들의 항혈소판작용은 PKC-기질인 41-43 kD와 20 kD의 인산화를 억제함에 기인되는 것으로 사료된다.다. 것으로 사료된다.다.바와 같이 MCl에서 작은 Dv 값을 갖는데, 이것은 CdCl$_{4}$$^{2-}$ 착이온을 형성하거나 ZnCl$_{4}$$^{2-}$ , ZnCl$_{3}$$^{-}$같은 이온과 MgCl$^{+}$, MgCl$_{2}$같은 이온종을 형성하기 때문인것 같다. 한편 어떠한 용리액에서던지 NH$_{4}$$^{+}$의 경우 Dv값이 제일 작았다. 바. 본 연구의 목적중의 하나인 인체유

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Neonatal Meningoencephalitis caused by Herpes Simplex Virus Type 2 (Herpes simplex virus type 2에 의한 신생아 수막뇌염)

  • Kim, Dae Eun;Pae, Ramee;Bae, E Young;Han, Ji Yoon;Han, Seung Beom;Jeong, Dae Chul;Lee, In Goo;Kang, Jin Han
    • Pediatric Infection and Vaccine
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    • v.21 no.2
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    • pp.150-156
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    • 2014
  • Despite its rare occurrence, early diagnosis and appropriate treatment for neonatal herpes simplex virus infection are mandatory due to its high morbidity and mortality. In Korea, there has been no epidemiologic data on neonatal herpes simplex virus infection, and even case reports are rare. We observed a 16-day-old neonate who presented with fever and seizures. We diagnosed her with meningoencephalitis caused by herpes simplex virus type 2 based on the polymerase chain reaction test, and treated her with intravenous acyclovir and anticonvulsants. The seroprevalence of herpes simplex virus type 2 sharply increases in women in their 30s, and the average age for childbirth has increased to older than 30 years of age in Korea; we therefore expect that the incidence of neonatal herpes simplex virus type 2 infection will rise in Korea, and more attention should be directed to neonatal herpes simplex virus type 2 infection. We report this newborn patient's case along with a literature review.

Surgical Repair of Inferior Sinus Venosus Defect - A Report Four Cases- (하정맥동형 심방중격결손의 외과적처지 -4례 보고-)

  • 최형호;김천석;윤향석;최종범;최순호
    • Journal of Chest Surgery
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    • v.31 no.2
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    • pp.168-172
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    • 1998
  • Inferior sinus venosus defect is a rare lesion in which there is a large interatrial communication adjacent to the atrial connection of the inferior caval vein. The defect is located posteriorly and inferiorly, outside the confines of the true atrial septum, and partial anomalous pulmonary venous connections are the rule. We underwent surgical repair in four patients with inferior sinus venosus defect and partial anomalous pulmonary venous return. There were three males and one female with an age range from four months to 25 years. A cross- sectional echocardiogram and cardiac catheterization had been performed preoperatively in all patients, but the correct diagnosis had been made in only one case. Surgical repair was indicated due to congestive heart failure, and one patient of 4-month-old needed urgent operation. The repair was accomplished by suturing a untreated autologous pericardial patch to the right of the pulmonary veins, so that the defect was closed and all the pulmonary venous blood was directed to the left atrium. The preoperative knowledge of the unusual anatomy allows the surgeon to repair the anomaly without difficulties. For the patients in whom interatrial communication and anomalous pulmonary venous return are suggested, surgeon has to pay careful attention to the anatomical landmarks to avoid incorrect placement of the patch.

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Patient dose in adult and pediatric dental panoramic radiography in Korea (성인과 소아에서 치과 파노라마방사선검사의 환자선량)

  • Kim, Eun-Kyung;Han, Won-Jeong;Kim, Kyoung-A;Lee, Wan;Yoon, Suk-Ja;Hwang, Eui-Hwan;Kim, Gyu-Tae;Heo, Min-Suk;An, Chang-Hyeon;An, Seo-Young;Han, Jin-Woo;Jung, Yun-Hoa
    • The Journal of the Korean dental association
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    • v.55 no.8
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    • pp.516-526
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    • 2017
  • Objective: To suggest diagnostic reference levels (DRLs) for dental panoramic radiography in adults and children through the nationwide survey in Korea. Materials and Methods: Two hundred twelve dental institutions on a national basis were visited. The radiographic examination protocols were surveyed and their patient doses at the clinical exposure setting for adult and children (5- and 10-year old) were measured at 244 panoramic radiographic equipment. The measured DAP were analyzed and compared according to age group, the size of hospital, the type of radiographic system, the installation duration of equipment. Results: The mean exposure parameters were 70.1 kV, 9.2 mA, 14.4 second for adult and 66.6 kV, 7.9 mA, 13.8 second for 10-year old child and 65.5 kV, 7.3 mA, 13.7 second for 5-year old child. The mean and third quartile patient DAPs were $138.3mGy\;cm^2$ and $151.0mGy\;cm^2$ for adult, $99.5mGy\;cm^2$ and $104.8mGy\;cm^2$ for 10-year old child and $89.5mGy\;cm^2$ and $95.5mGy\;cm^2$ for 5-year old child. The mean patient dose at the university dental hospital was lower than that at the dental clinic (p<0.05). The mean patient dose of direct digital radiography type was higher than that of film-based type. However, the difference did not show statistically significance. Conclusion: DRLs for dental panoramic radiography in adult, 10- and 5-year old child were suggested to be $151mGy\;cm^2$, $105mGy\;cm^2$, and $96mGy\;cm^2$ in Korea based on this nationwide survey.

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Development of A-ABR System Using a Microprocessor (마이크로프로세서를 이용한 자동청력검사 시스템 개발)

  • Noh, Hyung-Wook;Lee, Tak-Hyung;Kim, Nam-Hyun;Kim, Soo-Chan;Cha, Eun-Jong;Kim, Deok-Won
    • Journal of the Institute of Electronics Engineers of Korea SC
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    • v.46 no.2
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    • pp.15-21
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    • 2009
  • Hearing loss is one of the most common birth defects among infants. Most of hearing-impaired children are not diagnosed until 1 to 3 years of age - which is too late for the critical period (6 month) for normal speech and language development. If a hearing impairment is identified and treated in its early stage, child's speech and language skills could be comparable to his or her normal-hearing peers. For these reasons, hearing screening at birth and throughout childhood is extremely important. ABR (Auditory brain-stem response) is nowadays one of the most reliable diagnostic tools in the early detection of hearing impairment. In this study, we have developed the system that automatically detects if there is hearing impairment or not for infants or children. For future studies, it will be developed as a portable system to be able to take a measurement not only in sound proof room but also in nursery for neonates.

Clinical Usefulness of 99mTc-DMSA Renal SPECT Using High Sensitivity-All Purpose Collimator for Pediatric Patients (고감도 범용성 콜리메이터를 이용한 소아 환자 99mTc-DMSA 신장 SPECT의 유용성)

  • Kim, Jin-Eui;Kim, Jung-Soo;Han, Jae-Bok;Choi, Nam-Gil
    • The Journal of the Korea Contents Association
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    • v.16 no.3
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    • pp.219-231
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    • 2016
  • $^{99m}Tc$-DMSA planar scan that can analyze the functions of kidney quantitatively provides less information on a lesion than tomography scanning. Therefore, this study applied a high sensitivity all-purpose collimator that is sensitive to photonic signals to $^{99m}Tc$-DMSA and carried out a clinical scan with single photon emission computed tomography (SPECT). And diagnostic accuracy and time requirement of were analyzed to know the clinical usefulness of the applied scanning method. 10 subjects were intravenously injected with radiopharmaceutical product (1.0-1.2 MBq/kg) and scanned by a gamma camera with planar scanner (high resolution (HR)-mode, $256{\times}256$, 50 kcts/view, 4 image) and SPECT (HR / high sensitive (HS)-mode, $128{\times}128$, step and shoot, $180^{\circ}$, variable sec/angle, total 64 frame, OSEM reconstruction), respectively. The collected data was compared with an analysis program. The results showed that HS-mode SPECT detected total counts 1.8-5.6 times more than planar scan. Relative renal function evaluated based on the counts was not significantly different by two scanning methods (p=0.96) and it turned out that test time was shortened by 39% when HS-mode SPECT was used. Therefore, SPECT using HR, HS-mode collimator could analyze renal function more quantitatively than using planar scan and the former could diagnose the location information of a lesion more accurately than the latter as well as shortened test time requirement, which demonstrated the clinical usefulness of $^{99m}Tc$-DMSA renal SPECT using high sensitivity all purpose collimator.

Clinical disease characteristics according to karyotype in Turner syndrome (터너증후군에서 핵형에 따른 임상질환의 발병양상)

  • Yeo, Chae Young;Kim, Chan Jong;Woo, Young Jong;Lee, Dae Yeol;Kim, Min Sun;Kim, Eun Young;Kim, Jong Duck
    • Clinical and Experimental Pediatrics
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    • v.53 no.2
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    • pp.158-162
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    • 2010
  • Purpose : Turner syndrome (TS) is a disorder in which various anomalies can be accompanied, especially cardiovascular, renal, thyroid and auditory problems. The aim of this study is to identify the incidence of these disorders in patients with TS according to karyotype. Methods : We reviewed medical records of 90 patients with TS diagnosed by chromosomal analysis in 4 hospitals from Jan 1998 to Dec 2007. We evaluated these cases by prepared protocol of 4 medical problems.Results : The distribution of karyotype was 45,X (47.8%), mosaic pattern (34.4%) and structural aberration group (17.8%). Renal anomalies, cardiovascular anomalies, thyroid disorders and auditory problems are accompanied in 4.4%, 10.0 %, 11.1% and 5.6%, respectively. 45,X group had renal anomalies (7.0%), cardiovascular anomalies (18.6%), thyroid disorders (9.3%) and auditory problems (11.6%). Mosaic group had renal anomalies (3.2%), thyroid disorders (12.9%), no cardiovascular anomalies and auditory problems. Structural aberration group had cardiovascular anomalies (6.3%), thyroid disorders (12.5%) and no other 2 problems. Patients with 45,X group had a significant higher incidence of cardiovascular anomalies (P =0.025). Conclusion : Our results indicate that there are differences clinically according to karyotype of TS, especially in incidence of cardiovascular anomalies.

Ocular manifestations in Leigh syndrome (Leigh 증후군 환아에서의 안과적 이상 소견)

  • Kim, Kyo Ryung;Byeon, Suk Ho;Lee, Young Mock;Kang, Hoon Chul;Lee, Joon Soo;Kim, Heung Dong
    • Clinical and Experimental Pediatrics
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    • v.53 no.2
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    • pp.163-166
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    • 2010
  • Purpose : Leigh syndrome is a typical type of mitochondrial disease. This study was conducted to analyze the types of ophthalmologic symptoms and results of funduscopy conducted in the ophthalmologic examination of patients with Leigh syndrome. Methods : Funduscopy was conducted on 24 subjects, who were chosen among those diagnosed as having mitochondrial respiratory chain complex defect and who were clinically suitable for the criteria of Leigh syndrome. Their clinical features, ophthalmologic symptoms, and ophthalmologic examination results were retrospectively analyzed. Results : Of the 24 patients with Leigh syndrome, 11 developed ophthalmologic symptoms and no abnormal finding was observed in 13. The most frequent abnormal finding was visual disturbance in 5 patients. Funduscopy revealed abnormal findings in 17 patients; retinal pigmentation was the most frequent abnormality and was seen in 9 patients. Conclusion : Funduscopy can be an important screening test to find ophthalmologic abnormalities among patients with mitochondrial disease (MD), including those patients whose ophthalmologic symptoms are inconspicuous. It is predicted that an improved screening test can be made in the future that will identify risk factors related to ophthalmologic symptoms.