• Journal of Chest Surgery
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• 제41권5호
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• pp.667-670
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• 2008

성인에서의 잠복 기관지 이물은 소아의 기관지내 이물 흡인과 달리 매우 드물며 아직까지 기관지나 폐의 연관손상 정도와 잠복기간에 따른 치료전략이 정립되어 있지 않은 상태다. 과거력상 반복적인 기침과 객담, 발열을 경험하였으나 30년 전에 사인펜 뚜껑이 기도내로 흡인되었던 사실을 인지하지 못하던 40세 남자 환자가 동일 주소와 영상검사상 우중엽 및 하엽의 허탈과 폐쇄성 폐간질염 소견으로 전원되었다. 처음엔 기관지경 이물 제거와 내과적 치료를 계획하였으나 제거가 불가능하였고 결국 개흉후 양엽 절제를 통해 치료하였다. 저자들은 본 증례가 잠복성 기관지 이물의 다양한 임상상 축적에 중요한 정보를 제공하였다고 생각한다.

• 대한수의학회지
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• 제46권4호
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• pp.381-385
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• 2006

Discospondylitis is an infection of intervertebral discs, associated end plates, and adjacent vertebral bodies causing destruction and proliferation. A 10-year-old intact female Rhodesian Ridgeback dog was referred to the Veterinary Medical Teaching Hospital, Seoul National University with paraparesis and severe pain at T13-L1 region for one week duration. The treatment with PDS for one week by referring veterinarian showed no clinical improvement. At time of presentation, clinical signs of the patient included depression, vaginal discharge, and fever. In T-L spine radiography, osteolytic change was found between caudal endplate of T13 and cranial endplate of L1. The affected vertebral bodies were shortened and intervertebral disc space was widened. In abdominal radiography, a dilated soft tissue opacity tubular structure was found in mid-caudal abdomen. The abdominal ultrasonography revealed the uterus dilated with echogenic fluid. The CT findings showed concentric lysis of T13-L1 endplates. The dog was diagnosed as diskospondylitis at T13-L1 and pyometra. Urine and blood were cultured, and Staphylococcus (S.) intermedius was identified. The patient had surgical treatment for pyometra but died for septicemia.

• 대한한방소아과학회지
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• 제32권3호
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• pp.72-89
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• 2018

Objectives The objective of this study is to investigate the application of Sifeng point (EX-UE 10) in children and to make suggestions for domestic research and clinical application by reviewing relevant randomized controlled trials. Methods Eight electronic databases including English, Chinese, Korean databases were comprehensively searched for randomized controlled trials evaluating the effects of Sifeng point in children up to May 2, 2018. We extracted the year of publication, country, target diseases or symptoms, location of Sifeng, acupuncture method; such as acupuncture tool and depth of insertion, and frequency, number, and duration of the treatment. Results Fifty studies were included for analysis. All the included studies were conducted in China, and studies were published from 1962 to 2017. The most frequent target symptom was anorexia (46%). In addition, Sifeng point was used for digestive diseases or symptoms such as diarrhea, constipation, and mesenteric lymphadenitis, as well as respiratory diseases or symptoms such as cough, cold, acute bronchiolitis, recurrent respiratory tract infections, bronchopneumonia, and asthmatic bronchitis. Also, allergic diseases such as chronic urticaria, and other variety of symptoms such as malnutrition, fever, and iron-deficiency anemia were treated with the Sifeng point. The location of Sifeng points was inconsistent, and the most common location of the Sifeng point was the midpoint of transverse creases of the proximal interphalangeal joints of the index, middle, ring and little fingers (84.2%). The most commonly used acupuncture tool was three-edged needle (40.9%). All included studies have the method of squeezing out blood or mucus from the Sifeng points. The treatment was mostly conducted once per week (35.4%), mostly repeated for 4 times (32.6%). The most common treatment duration was 4 weeks (18.6%). Conclusions We could identify acupuncture method and various indications for the Sifeng points treatment. Based on this study, there is a need for the clinical application and related researches on the Sifeng points in children in Korea. In addition, the treatment location of Sifeng point should be standardized.

• Pediatric Infection and Vaccine
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• 제23권2호
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• pp.87-93
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• 2016

목적: 신생아 중환자실(neonatal intensive care unit, NICU)에서 인플루엔자 바이러스 집단 발병의 보고는 흔하지 않으며 그 증상은 다양하다. 저자들은 국내 단일기관 NICU에서 발생한 A형 인플루엔자 바이러스 감염의 집단발병에 대해 보고하고 신생아 특히 미숙아에서의 임상적 특성을 알아보고자 하였다. 방법: 2011-2012년 국내 인플루엔자 바이러스 감염 유행 시기에 고신대학교 복음병원 NICU에 입원한 환자들 중 인플루엔자 바이러스 RT-PCR 검사를 시행한 29명 환자들의 의무기록을 후향적으로 조사하였다. 결과: 대상 환자 중 11명에서 A형 인플루엔자 바이러스 양성이었는데(37.9%), 모두 미숙아였고 이들 중 3명(27%)은 증상이 없었으며 상기도 감염 증상 없이, 발열(18%, 2/11), 호흡곤란(72.7%, 8/11), 소화기 증상(27.3%, 3/11)이 있었다. 증상 소실까지 기간의 중앙값은 5일이었다. 이들은 모두 합병증 없이 생존하여 퇴원하였다. A형 인플루엔자 바이러스 RT-PCR 양성군과 음성군 사이에 검체 채취시 재원기간, CRIB 점수, 기계환기 과거력, 덱사메타손 사용 과거력의 차이가 있었다. 결론: 신생아 특히 미숙아에서 A형 인플루엔자 바이러스 감염의 증상은 비특이적이므로 지역 내 인플루엔자 유행시기에는 NICU 입원 중인 신생아에서 감염질환의 원인 병원체로 인플루엔자 바이러스를 고려해야 한다.

• Childhood Kidney Diseases
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• 제24권2호
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• pp.83-90
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• 2020

Purpose: To investigate the association between urinary neutrophil gelatinase-associated lipocalin (uNGAL) and leukocyte differential count in children with urinary tract infections (UTIs). Methods: A retrospective chart review was performed in children undergoing uNGAL measurements between June 2018 and September 2019. Patients with suspected or diagnosed UTIs were included. The relationship between uNGAL and blood leukocyte differential count was investigated in children. Results: A total of 197 children were included in this study, 119 of whom (60%) had UTIs. The non-UTI patients (n=78) were diagnosed with pneumonia, acute gastroenteritis, viral upper respiratory infection, and others. After adjusting for age, gender, and fever duration, the leukocyte count, monocyte count, and uNGAL levels were higher in the UTI group than in the non-UTI group (P<0.05). uNGAL showed positive correlations with neutrophil counts, monocyte counts, the neutrophil-to-lymphocyte ratio, and the monocyte-to-lymphocyte ratio in the UTI group (P<0.05). uNGAL levels were only associated with the neutrophil-to-lymphocyte ratio in the non-UTI group (P<0.05). In a multivariable logistic regression analysis, only uNGAL was associated with the presence of UTI (P<0.05). The area under the receiver operating characteristic curves for uNGAL and monocyte counts to identify UTI were 0.89 (95% confidence interval (CI): 0.824-0.939; P=0.025) and 0.7 (95% CI: 0.627-0.774; P=0.038), respectively. Conclusions: In children with UTIs, uNGAL levels may be associated with blood leukocyte differential counts. uNGAL measurements and monocyte counts can be helpful in children with suspected UTIs.

• Pediatric Infection and Vaccine
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• 제3권2호
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• pp.145-153
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• 1996

The incidence of Adenovirus(AV) pneumonia in children is estimated at 8%. Long-term complications reported with type 7 include hyperleucent lung syndrome, bronchiolitis obliterans and may require several months to recover. We reviewed 8 case of AV pnemonia confirmed by AV culture and sero-diagnosis among selected 19 AV pneumonia suspicious cases who were admitted to the Sanggye Paik Hospital of Inje University due to clinical pneumonia from May to July 1996. From 19 children, nasal aspirates or trachial aspirates were collected: viral agents were detected by virus isolation and virus antigen was detected by indirect immunofluorescent staining. Serologic diagnosis for type-specific AV antibody was done by neutralisation test. The results are as follows: 1) Age of the patients ranged from 6 months to 47 months with a mean of $24{\pm}9$ months. 6 were male and 2 were female(M:F= 3:1). 2) Monthly distribution showed 4 cases on June, 2 cases on May and July, respectively. 3) The mean duration of admission was 20.4 days and mean duration of fever was 11.3 days 4) Peripheral leukocyte counts were elevated in 4 cases(50%) and findings of shift to left were showed in 4 cases(50%) and serum aminotransferase activities were elevated in 6 case(75%). 5) Radiologic findings include linear and streaky infiltration(1/8 cases), patchy and lobar consolidation (7/8 cases), pleural effusion(2/8 cases) and hyperleucency was seen in 3/8 cases at time of admission and increased to 6/8 cases on hospital discharge. 6) The AV serotypes were type 7, type 3, and type 1. 7) Oxygen supply was done in 4 cases(50%) and all 8 patients include 2 cases of type 7 treated with artificial ventilator were survived. In conclusion, the serotypes of AV pneumonia outbreaks in early summer of 1996 were type 7, 3, 1 and, as showed severe clinical course, continued follow up surveillance is necessary to the long term pulmonary complications.

• 대한한방소아과학회지
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• 제12권1호
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• pp.133-143
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• 1998

Myofascial pain syndrome is one of the pain syndrome resulted from myofascia which covered muscles and clinically characteristic feature by sensitive trigger point in skeletal muscles and referred pain reactivated by stimulating each trigger point. The origin of headache are local lesion such as head, chest, abdominal organ, systemic lesion with fever or in toxic state. the other factors are consciousness, personality, anxiety, depression, which cause muscle strain in physiological environment. The Oriental Medical therapy for headache has herb medication and acupuncture. especially acupuncture therapy has not only classical systemic acupuncture(體鍼) but also neo-acupuncture(新鍼) such as commonly using auricular acupuncture(耳鍼) and manual acupuncture (手鍼), recently trigger point acupuncture is used. The author analyzed 27 cases of patient with headache treated by trigger point acupuncture therapy in Dong-yu Oriental Medical Hospital from March 1st 1997 to February 28th 1998. The following results were obtained. 1. The sex ratio of the female was 59.26%(16 cases) and male was 40.74%(11 cases), the ratio of high school student was 62.96%(17cases) as first. 2. The headache duration ratio of 2-3 years was 37.04%(10 cases) as first, 1-2 years was 25.93%(7 cases) as second. 3. The portion ratio of whole headache was 33.33%(9 cases) as first, lateral headache was 29.63%(8 cases) as second 4. The combined symptoms ratio of anorexia was 40.74%(11 cases) as first, fatigue was 33.33%(9 cases) as second, neck stiffness and dizziness was each 25.93%(7 cases) as third. 5. The therapeutic duration ratio of below 1 week was 29.63%(8 cases) as first, 2-3 weeks was 22.22%(6 cases) as second, 1-2 weeks and 3-4 weeks was each 18.52%(5 cases) as third. 6. The ratio of family history was 11 cases(40.74%). mother with headache was 6 cases, father was 3 cases, and brothers & sisters was 2 cases. 7. The herb medication ratio of Chungsanggyuntongtang(淸上?痛湯) was 37.04%(10 cases), Kamiondamtang(加味溫膽湯) was 22.22%(6 cases), Hyangsapyunguisan(香砂平胃散) was 18.25%(5 cases) etc. 8. The remedial effect ratio of good was 25.93%(7 cases), fair was 48.15%(13 cases), not improved was 7.41%(2 cases), side effect was 3.70%(1 cases), and unknown was 14.81%(4 cases).

• Journal of Chest Surgery
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• 제32권3호
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• pp.276-280
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• 1999

배경: 전폐절제술후 발생한 농흉은 흔하지는 않지만 심각한 합병증을 유발할 수 있다. 그리고 치료는 아직 흉부외과 의사에게 문제로 남아있다. 대상과 방법: 1990년 1월부터 1996년 12월 까지 전폐절제술후 발생한 농흉환자 20례를 분석하였다. 결과: 성별비는 남자가 15명, 여자가 5명 이였으며, 평균 연령은 41.5$\pm$21.5세였다. 좌우비는 8:12였고, 선행질환으로는 폐결핵이 가장 많았다. 폐절제후 농흉이 발생하기 까지의 기간은 1개월에서 6년까지 다양하였다. 가장 흔한 증상은 발열이였고, 포도상구균이 가장 흔한 원인균이였다. 13례에서 기관지 늑막루를 동반하였으며 4명의 환자는 전경심막을 통하여 기관지 절주를 봉합한 후 Clagett 술식을 시행하였고, 그 중 한명은 재발하여 후에 대망과 근육을 이용하여 흉곽 성형술을 받았다. 나머지 9명의 환자에게는 대망과 근육을 이용한 흉곽 성형술을 실시하였다. 기관지 늑막루를 동반하지 않은 7례에서는 모두 흉곽성형술을 실시하였고 이중 2례에서는 근육 충진법을 같이 시행하였다. 평균 추적 기간은 40$\pm$32.3개월 이였다. 사망과 재발은 발생하지 않았다. 결론: 전폐절제술후 발생한 농흉 환자에 있어서 조기 진단과 적절한 배농이 일차적 처치로서 중요하며, 흉곽 성형술과 더불어 대망이나 근육 충진법으로 완전한 치료가 가능하다.

• Pediatric Infection and Vaccine
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• 제27권1호
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• pp.45-52
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• 2020

목적: Carbapenem-resistant Acinetobacter baumannii (CRAB)에 의한 인공호흡기연관 폐렴(ventilator-associated pneumonia, VAP)의 치료에 있어 고용량 ampicillin-sulbactam과 colistin의 병합요법 치료효과를 살펴보기 위한 예비 연구이다. 방법: 2017년도 6월부터 2018년도 8월까지 17명의 CRAB VAP 환자를 후향적으로 분석하였다. 10명(58.8%)의 환자는 고용량 ampicillin-sulbactam과 colistin 병합요법(병합치료군)으로 치료받았으며, 나머지 7명은 colistin 단독치료를 하였거나 colistin을 포함 또는 미포함하는 다양한 항균제의 병합치료(기타치료군)를 하였다. 본 연구는 두 그룹간의 임상 및 세균학적 결과를 비교하였다. 결과: 병합치료군에서 항균제 사용 후 발열기간은 1.30±1.70일이었고, 기타치료군에서는 1.71±1.49일이었다. 기관내관 흡인물 검체에서 균이 음전 될 때까지의 평균 기간은 병합치료군에서 3.40±1.71일 기타치료군에서 11.80±8.86일이었다(P=0.030). 항균제 치료 30일 이내 사망률은 병합치료균에서 1/10 (10%)이고 기타치료군에서 3/7 (42.9%)이었다. 결론: 소아의 CRAB에 의한 인공호흡기연관 폐렴 환자에서 고용량 ampicillin-sulbactam과 colistin의 병합요법이 임상적 예후를 개선시킬 수 있을 것으로 기대된다.

• 한방안이비인후피부과학회지
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• 제15권2호
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• pp.169-182
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• 2002

Background: Allergic rhinitis(AR) is a heterogeneous disorder that despite its high prevalence is often undiagnosed. It is characterized by one or more symptoms including sneezing, itching, nasal congestion, and rhinorrhea. And it is frequently accompanied by symptoms involving the eyes, ears, and throat, including postnasal drainage. There are many different causes of rhinitis in children and adults. Approximately 50$\%$ of all cases of rhinitis are caused by allergy. In the case of rhinitis caused by allergens, symptoms arise as a result of inflammation induced by a gamma globulin E-mediated immune response to specific allergens such as pollens, molds, animal dander, and dust mites. The immune response involves the release of inflammatory mediators and the activation and recruitment of cells to the nasal mucosa. AR is similar to 鼻？, hypersensitive rhinitis in Oriental Medicine. I think hypersensitive rhinitis is including of AR, vasomotor rhinitis and non-allergic rhinitis related with eosinophil increased and so on. Purpose: To perform a clinical analysis of hypersensitive rhinitis including allergic rhinitis and estimate the efficacy of Oriental Medical treatment. Objective: We studied 96 patients who had visited our hospital with complaints of nasal symptoms from March 2000 to February 2002; they had the signs more than 2 - nasal obstruction, watery discharge, sneezing and eye or nasal itching. Parameters Observed & Methods: We treated them with acupuncture & herb-medication. Sometime they used aroma oil or external medicine. 1) the distribution of sex & age groups 2) the clinical type based on duration & the severity of symptom 3) the breakdown of complication & pasl history of Otolaryngologic or allergic disease 4) the clinical assessment and classification of rhinitis(sneezers and runners & blockers) 5) the associated symptoms and signs 6) the classification of Byeonjeung 7) the classification of prescriptions and 8) the efficacy of treatment. Result: 1. In the clinical type of based on duration, the intermittent type was 42.7$\%$ and the persistent was 57.3$\%$. 2. We observed the severity of symptoms based on the quality of life. The mild type was 24.0$\%$ and the moderate-severe was 76.0$\%$. 3. In the clinical assessment and classification of rhinitis, the sneezers and runners type was 69.8$\%$ and the blockers was 30.2$\%$. 4. The most common family history with otolaryngologic or allergic disease were allergic rhinitis(17.7$\%$), urticaria, paranasal sinusitis and T.B.(3.1$\%$). 5. The most common past history with otolaryngologic or allergic disease were paranasal sinusitis(14.6$\%$), atopic dermatitis and asthma(8.3$\%$). It was 31.3$\%$ they had a family history and 44.8$\%$, past history. 6. The most common complication was paranasal sinusitis(15.6$\%$). In decreasing order the others were otitis media with effusion(9.4$\%$), GERD and headache(6.3$\%$), asthma, bronchitis, nasal bleeding and allergic dermatitis(5.2$\%$). 7. Classification through Byeonjeung : ⅰ) 39 cases(34.9$\%$) were classified as showing Deficiency syndrome. The insuffficiency of Qi was 17.7$\%$, deficiency of Kidney-Yang, 12.5$\%$ and Lung-Cold, 10.4$\%$. ⅱ) 57 cases(59.4$\%$) were classified as showing Excess syndrome. The Fever of YangMing-meridian was 35.4$\%$, Lung-Fever, 24.0$\%$. 8. The efficacy of treatments showed: an improvement in 22cases(22.9$\%$); an improvement partly in 24 cases(25.0$\%$); no real improvement or changes in 16 cases(16.7$\%$); and couldn't check the results 18cases(18.6$\%$). Conclusion: We suggest that this study could be utilized as a standard of clinical Oriental Medical treatment when we treat hypersensitive rhinitis including allergic rhinitis.