진성 성조숙증 환아에서 Gonadotropin-Releasing Hormone Agonists의 치료가 최종 성인 신장에 미치는 영향 및 이와 관련된 인자들에 관한 연구

안성연,류재호,신충호,양세원 대한소아청소년과학회 2004 Clinical and Experimental Pediatrics (CEP) Vol.47 No.6

Purpose:The aim of this study was to evaluate the effects of treatment with GnRH agonists on final height(FH) and the influencing factors on height gains. Methods:Twenty-five girls and five boys with true precocious puberty, who were treated with GnRH agonists for more than one year and had attained final height, were evaluated retrospectively. We analysed auxological parameters at diagnosis, at the end of treatment, and at the attainment of final height, and calculated height gains. Results:FH SDS was significantly higher than predicted adult height(PAH) SDS at diagnosis (-0.91±1.32, vs. -1.80±1.39, P<0.01). A group of initial PAH below the range of target height(TH) attained significantly more height gains and increments of height SDS than those in a group of initial PAH within the range of TH(8.37±2.56 cm vs. 1.38±6.42 cm, P<0.01; 1.30±0.74 vs. 0.35±1.28, P<0.05). Height gains were positively correlated with bone age advancement at diagnosis and height velocity during the first year of treatment(r=0.528, P<0.01 and r=0.454, P<0.05), while height gains were negatively correlated with initial PAH and bone age increments during treatment(r=-0.485, P< 0.05 and r=-0.613, P<0.01). Conclusion:This study suggests that GnRH agonist therapy for children with true precocious puberty improves the final height, and height gains are positively affected by bone age advancement at diagnosis and growth velocity during the first year of therapy, and negatively affected by PAH at diagnosis and degree of bone maturation during therapy. 목 적 : 성인 신장에 도달한 진성 성조숙증 환아에서 성장 변화와 성인 신장 획득에 영향을 미치는 관련 인자에 대하여 살펴보고자 하였다.방 법 : 1989년부터 2000년까지 성조숙증을 주소로 내원한 환아들 중 진성 성조숙증으로 진단되어 GnRHa를 1년 이상 사용하였으며 최종 성인 신장에 도달한 환자 30명을 대상으로 하여, GnRHa 치료 동안과 이후에 최종 성인 신장에 이르기까지 성장변화 및 이에 영향을 끼치는 인자들에 대하여 후향적인 조사를 시행하였다.

Excess of leptin inhibits hypothalamic KiSS-1 expression in pubertal mice

안성연,Sei Won Yang,이희제,Jong Seon Byun,신충호 대한소아청소년과학회 2012 Clinical and Experimental Pediatrics (CEP) Vol.55 No.9

Purpose: Leptin has been considered a link between metabolic state and reproductive activity. Defective reproductive function can occur in leptin-deficient and leptin-excessive conditions. The aim of this study was to examine the effects of centrally injected leptin on the hypothalamic KiSS-1 system in relation to gonadotropin-releasing hormone (GnRH) action in the initial stage of puberty. Methods: Leptin (1 μg) was injected directly into the ventricle of pubertal female mice. The resultant gene expressions of hypothalamic GnRH and KiSS-1 and pituitary LH, 2 and 4 hours after injection, were compared with those of saline-injected control mice. The changes in the gene expressions after blocking the GnRH action were also analyzed. Results: The basal expression levels of KiSS-1, GnRH, and LH were significantly higher in the pubertal mice than in the prepubertal mice. The 1-μg leptin dose significantly decreased the mRNA expression levels of KiSS-1, GnRH, and LH in the pubertal mice. A GnRH antagonist significantly increased the KiSS-1 and GnRH mRNA expression levels, and the additional leptin injection decreased the gene expression levels compared with those in the control group. Conclusion: The excess leptin might have suppressed the central reproductive axis in the pubertal mice by inhibiting the KiSS-1expression, and this mechanism is independent of the GnRH-LHestradiol feedback loop.

13세 여아에서 발생한 총담관낭 I형에서 기원한 담관암 1례

안성연,남상욱,박재홍,임영탁,이준우,이창훈,Ahn, Sung-Ryon,Nam, Sang-Ook,Park, Jae-Hong,Lim, Young-Tak,Lee, Jun-Woo,Lee, Chang-Hun 대한소아소화기영양학회 2002 Pediatric gastroenterology, hepatology & nutrition Vol.5 No.1

저자들은 갑작스럽게 발생한 우상복부 동통을 주소로 내원한 13세 여아에서 간에 다발성으로 전이가 된 I형 총담관낭으로부터 발생한 담관암 1례를 경험하였기에 보고하는 바이다. Choledochal cyst is a rare developmental malformation of the biliary tree and has serious problem of transformation to malignancy. The development of cholangiocarcinoma related to choledochal cyst increases as the age of patient increases and is more common in Orientals with female predominance of 2.5 times. Prevalence rate of cholangiocarcinoma is various from 2.5 to 15.6% in adult with choledochal cyst, but very low in children. We experienced a case of cholangiocarcinoma with multiple liver metastases arising from type I choledochal cyst in a 13-year-old girl who complained of sudden onset of right upper quadrant abdominal pain.

흉벽의 림프관종증에 대한 방사선 치료 후 조절된 유미흉 1례

안성연,최봉석,박희주,김영대,권병현 대한 소아알레르기 호흡기학회 2002 Allergy Asthma & Respiratory Disease Vol.12 No.1

A Case of Chylothorax Controlled by Radiotherapy onLymphangiomatosis of ThoraxSung Ryon Ahn, M.D., Bong Seok Choi, M.D., Hee Ju Park, M.D.Young Dae Kim, M.D.* and Byong Hyon Kwon, M.D.† 저자들은 좌측 액와부와 옆구리 부위의 적색 판상 반점을 주소로 내원하여 흉곽을 전부 차지하고 있는 유미흉과 흉벽의 림프관종증을 발견하고 흉강경을 통한 흉막제거술 및 흉막유착술을 시행하였으나 호전이 없어 2주간의 10회에 걸친 방사선 치료 후 유미흉이 조절된 10세 여아를 경험하였기에 보고하는 바이다.

면역글로불린 A 및 $G_2$, $G_4$ 결핍에 동반된 만성 난치성 설사 1례

안성연,김영미,남상욱,박재홍,이창훈,Ahn, Sung-Ryon,Kim, Young-Mi,Nam, Sang-Ook,Park, Jae-Hong,Lee, Chang-Hoon 대한소아소화기영양학회 2001 Pediatric gastroenterology, hepatology & nutrition Vol.4 No.2

저자들은 생후 2개월부터 지속되는 만성 설사를 주소로 내원한 환아에서 면역글로불린 정량 검사상 IgA의 결핍과 함께 $IgG_2$ 및 $IgG_4$ 결핍이 동반되어 있고 영아기에 빈번한 설사와 감염을 동반한 증례를 경험하였기에 보고하는 바이다. In most cases, acute diarrhea in childhood heals spontaneously, but it may become the form of chronic diarrhea in immunodeficient children and then cause weight loss, dehydration, malabsorption and malnutrition. The immunodeficient diseases associated with chronic diarrhea include severe combined immunodeficiency syndrome, common variable immunodeficiency, acquired immunodeficiency syndrome, agammaglobulinemia or selective IgA deficiency. IgA deficiency is the most common primary immunodeficiency. Because many IgA deficient individuals seem to have compensated for their deficiency with increased IgM production and various nonimmunologic factors, the incidence of gastrointestinal involvement is not prominent. Some of those with IgA deficiency and recurrent infections have been found to also have IgG subclass deficiency. IgA deficiency with $IgG_2$ and $IgG_4$ subclass deficiency have high susceptability to infection and chronic diarrhea. IgG subclass deficiency, when present, is more likely to be found in association with a partial IgA deficiency rather than complete IgA deficiency. We report a 3-month-old male with intractable diarrhea accompanied by IgA, $IgG_2$, and $IgG_4$ deficiency.

2000-2001년 동안 발생한 홍역 환아의 임상적 고찰

안성연,박수은,Ahn, Sung Ryon,Park, Su En 대한소아청소년과학회 2002 Clinical and Experimental Pediatrics (CEP) Vol.45 No.8

목 적 : 예방접종의 도입이후 발생이 현저히 감소를 보이다가 1989-1990년, 1993-1994년의 유행에 이어 2000년부터 2001년까지 다시 홍역의 대유행이 있었다. MMR 접종이 시행된 후 일정 기간이 경과한 뒤인 최근 유행의 특징은 특히 홍역백신 접종 이전의 어린 영아와 이전에 접종했던 소아에서 발생이 증가하는 양상을 보인다는 것이다. 본 연구에서는 2000-2001년에 발생한 홍역 환자들을 대상으로 임상소견을 조사함으로서 이전 유행과 비교해보고 접종 실패의 원인에 대해 분석해 보고자 이 연구를 시행하였다. 방 법 : 2000년 1월부터 2001년 10월까지 홍역으로 부산대학교병원 소아과에 입원한 환자의 의무기록을 조사하여 이들의 연령, 월별 분포, 예방접종 여부, 합병증 등을 조사하였다. 예방접종 시행여부에 따라 접종군과 비접종군으로 나누어 연령 분포 및 항체양성률의 차이를 비교하였다. 항체가는 발진이 나타난 후 5일 이내에 혈청에서 홍역 특이 IgM과 IgG 항체를 EIA 방법으로 측정하였다. 결 과 : 1) 발병 연령은 2세 이하가 43명(72.9%), 5세 이상이 14명(23.7%)으로 이분화되는 소견을 보였다. 이중12개월 이하의 영아는 28명으로 47.5%에 해당하였다. 2) 예방접종률은 접종력이 있는 환아는 18명(30.5%)이었고 접종력이 없는 환아는 41명(69.5%)이었다. 접종군과 비접종군의 평균 나이는 각각 $9.25{\pm}4.27$세, 0.95{\pm}0.30$세였다. 3) 연령 분포별 예방접종 여부는 2세 이하의 발병에서는 43명 중 41명이 비접종자였으며 2세 이상의 발병에서는 모두에서 MMR의 접종력이 있었다. 4) 혈청검사를 시행한 환아에서 IgM의 양성은 접종군 15명 중에서 13명(86.7%), 비접종군 31명 중에서 28명(90.3%)이었다. 홍역 특이 IgG 항체의 양성은 접종군과 비접종군에서 각각 11명(73.3%), 13명(41.9%)으로 나왔으며 IgG 항체가는 접종군에서는 평균 $3.48{\pm}3.28$, 비접종군에서는 $1.36{\pm}1.32$로 접종군에서 높게 나왔다. 5) 유행기간 동안의 합병증은 호흡기계가 44.0%, 위장관계 15.2%, 경부 임파절 종대 13.5%, 구강내 궤양 3.4% 순으로 나타났으며, 2례(3.4%)가 호흡기 합병증으로 사망하였다. 결 론 : 본 연구에서 홍역에 이환된 환아 중 예방접종군에서 IgM 항체의 양성률이 86.7%로 나온 것은 1차 백신 실패가 임상적으로 중요한 문제임을 의미한다. 1차 백신 실패와 미접종으로 인한 홍역의 이환을 극복하고 국내 홍역 발생의 근절을 위해서는 적극적인 홍보를 통한 소아에서의 1, 2차 홍역백신 접종률을 높게 유지하는 것이 필수적이며, 현재 접종연령(9개월) 미만의 미접종 영아의 경우에 홍역에 감수성이 높기 때문에 환자 발생을 철저히 감시하여 유행기에는 이들의 홍역감염 예방에 특별한 주의를 기울여야할 것이다. Purpose : Although the number of patients with measles have dramatically decreased since the introduction of measles vaccines in 1965, measles outbreaks have occurred periodically every 4-6 years during the 1990s(1989-1990 and 1993-1994). During 2000-2001, measles prevailed all over the country again. A characteristic of current epidemics is that the majority of affected population was infants and school-aged children. This study was designed to analyze the epidemic and clinical features of measles prevalence during 2000-2001 and to find ways to overcome vaccination failure. Methods : We reviewed the records of 59 patients with mealses admitted in the Pediatric Department of Pusan National University Hospital from January 2000 to October 2001 for patient's age, month of admission, history of vaccination, clinical features and complications. Antibody titers of measles-specific IgM and IgG were measured by enzyme immunoassay. Results : The epidemic show two peaks in the age distribution. Forty three patients(72.9%) were under 2-years of age and 14 patients(23.7%) were over 5-years of age. Outbreaks had high incidence in July to August, 2000 and March to April, 2001, then faded away after July, 2001. Vaccinated group comprised 30.5% and unvaccinated group comprised 69.5% and their mean age was $9.25{\pm}4.27$ years old and $0.95{\pm}0.30$ years old respectively. Positive rate of IgM was 86.7% in vaccinated group and 90.3% in unvaccinated group. This means there was primary vaccine failure; 13 cases of 15 vaccinated patients were positive in IgM antibody. During the prevalence, two patients died with mealses complication. One of them was immunocompromised. Conclusion : To prevent another prevalence of measles in the future, we must enhance revaccination at ages 4-6 and check vaccination status when children enter elementary school. These will produce over 95% of herd immunity, with catch-up MMR vaccination which has been completed already.

진성 성조숙증 환아에서 Gonadotropin-Releasing Hormone Agonists의 치료가 최종 성인 신장에 미치는 영향 및 이와 관련된 인자들에 관한 연구

안성연,류재호,신충호,양세원 대한소아과학회 2004 小兒科 Vol.47 No.6

단순 비만아에서 인슐린 감수성 지표에 대한 연구

안성연,신충호,양세원 대한소아내분비학회 2004 Annals of Pediatirc Endocrinology & Metabolism Vol.9 No.1

우리나라 증권시장에서 주가수익률의 이상현상에 관한 연구 - 1 월효과를 중심으로 -

안성연,조정원 한국기업경영학회 1997 기업경영연구 Vol.4 No.1

Recently, many market anomalies such as the size effect, the P/E effect and the January effect have been reported in the stock market. The January effect represents a strong evidence against the efficient market hypothesis. If investors are rational and the market is efficient, there can be no reason that returns in some specific months are higher than returns in other months. Nevertheless, many empirical evidences on stock return anomalies have been found in major stock markets in the world. Using Korean stock market data, Kim(1990), Jang(1991), Koh and Rho(1993) reported the January effect However, these reports have certain limitations due to the lack of both time periods and data used for the research. To get more persuasive and comprehensive evidence, this work attempts; 1. to test the existence of stock return data using monthly stock return series from January 1980 to December 1995. Both of parametric test and non-parametric test are applied. 2. to test the weekly stock return data. Therefore the number of observations has been increased. 3. to test the relationship between the stock price index by the sizes; small, middle, large and overall. The test results in this work are summarized as follows; 1. Using monthly data, the monthly effect was found in middle sized firms, while, no January effect was found. 2. Using weekly data, the monthly effect was found in middle and small sized firms and the January effect was found in small sized firms. 3. The turn-of-the year effect was not found.

음악요법이 초산부의 경막하 무통 분만 중 분만통증, 분만경험, 자아존중감에 미치는 효과: 유사실험 연구

안성연,박은지,문유리,이보영,이은별,김동연,정성희,김진경 한국여성건강간호학회 2023 여성건강간호학회지 Vol.29 No.2

Purpose This non-randomized study was performed to evaluate the effects of music therapy on labor pain, the childbirth experience, and self-esteem in women during vaginal delivery. Methods In total, 136 primiparous women over 37 weeks of gestation receiving epidural analgesia during vaginal delivery were recruited via convenience sampling. To minimize diffusion effects, data from the control group (n=71) were collected first (April 2020 to March 2021), followed by data from the music group (n=65; April 2021 to May 2022). Participants in the music group listened to classical music during labor, while the control group was offered usual care (no music). Labor pain was measured using a numeric rating scale (NRS), and self-esteem and childbirth experience were collected using self-report questionnaires. Data were analyzed using the independent t-test, chi-square test and Cronbach’s α coefficients. Results The overall pain level (NRS) at baseline was 0 in both groups. Mothers in the music therapy group had lower levels of latent pain (t=1.95, p=.005), active pain (t=3.69, p<.001) and transition-phase pain (t=7.07, p<.001) than the control group. A significant difference was observed between the two groups, and the music therapy group expressed more positive perceptions of the childbirth experience (t=-1.36, p=.018). For self-esteem, the experimental group’s score was slightly higher, but without a statistically significant difference from the control group. Conclusion Using music therapy during labor decreased labor pain and improved the childbirth experience. Music therapy can be clinically recommended as a non-pharmacological, safe, and easy method for nursing care in labor.