microRNAs, Past, Present and Future

윤신원 ( Sin Weon Yun ) 중앙대학교 의학연구소 2017 中央醫大誌 Vol.42 No.1

가와사끼병에서 Matrix metalloproteinase 9과 Tissue inhibitor of metalloproteinase 1, 2의 임상적 중요성

윤기욱,윤신원,이정주,채수안,임인석,최응상,유병훈,이미경,Yun, Ki-Wook,Yun, Sin-Weon,Lee, Jung-Ju,Chae, Soo-Ahn,Lim, In-Seok,Choi, Eung-Sang,Yoo, Byoung-Hoon,Lee, Mi-Kyung 대한소아청소년과학회 2010 Clinical and Experimental Pediatrics (CEP) Vol.53 No.4

목 적: 가와사끼병은 급성 전신성 미세혈관염으로서, 소아의 후천성 심질환의 가장 흔한 원인이다. 가와사끼병의 관상동맥병변에 대한 조직병리학적 소견은 미만성 혈관염에 의한 관상동맥벽의 파괴를 시사하는데, matrix metalloproteinase (MMP)와 그 내인성 억제인자인 tissue inhibitor of metalloproteinases (TIMP)가 이러한 과정에 주요한 역할을 할 것으로 생각되고 있으며, 그 중에도 MMP-9이 최근 가장 주목을 받고 있다. 따라서 본 연구에서는, 한국의 가와사끼병 환아들에서 MMP-9과 그 억제인자들인 TIMP-1, TIMP-2가 갖는 임상적 중요성을 평가하고자 하였다. 방 법: 가와사끼병 환아 47명을 연구대상으로 하였고, 급성열성 세균감염 환아 14명을 대조군으로 하였다. 혈중 MMP-9, TIMP-1, TIMP-2의 농도를 kit를 통한 효소 면역법을 이용하여 측정하였고, 각 임상 단계 및 관상동맥병변의 유무에 따라 비교분석하였다. 결 과: 급성기에 MMP-9과 TIMP-1은 가와사끼군에서 대조군에 비해 유의하게 높았고, TIMP-2는 오히려 낮았다($P$<0.05). 급성기에 증가한 MMP-9은 아급성기와 회복기에 유의하게 감소하였다($P$<0.05). 관상동맥 확장군과 비확장군의 비교에서는, 확장군에서 급성기 MMP-9과 TIMP-1, MMP-9/TIMP-2가 낮았으며, 아급성기로 가면서 통계적으로 유의하게 증가하였다가 다시 회복기로 가면서 감소하는 양상을 보였다($P$<0.05). MMP-9은 급성기와 아급성기에 TIMP-1과 통계적으로 유의한 양의 상관관계를 보였고, TIMP-2와는 아급성기와 회복기에 음의 상관관계를 보였다($P$<0.05). 결 론: 이러한 결과들은 MMP-9과 TIMP-1의 증가, 그리고 MMP-9과 TIMP-2의 불균형이 가와사끼병, 특히 그 관상동맥병변의 병태생리에 핵심적인 역할을 한다는 사실을 시사한다 하겠다. 더 종합적이고 심도 깊은 연구를 위해서 좀 더 많은 대상자를 포함하는 큰 규모의 연구들이 향후 이루어져야 할 것이다. Purpose : Kawasaki disease (KD) is a systemic vasculitis, a leading cause of pediatric acquired heart disease. Histopathological findings of coronary artery lesion (CAL) in KD indicate destruction of the coronary artery wall with diffuse vasculitis. Matrix metalloproteinases (MMPs) and their endogenous tissue inhibitors (TIMPs) might play central roles in this process. Special attention to MMP-9 has recently been emerging. This study was performed to investigate the clinical significance of MMP-9 and its inhibitors, TIMP-1 and TIMP-2, in KD. Methods : We compared 47 KD patients with 14 febrile controls. Serum MMP-9 and TIMP-1, TIMP-2 were measured by ELISA and compared according to clinical stages and coronary involvement. Results : In acute stage, MMP-9 and TIMP-1 were significantly higher, whereas TIMP-2 was lower, in KD than those in febrile controls ($P$<0.05). The elevated MMP-9 levels in acute phase significantly decreased during the subacute and convalescent phases ($P$<0.05). During acute phase, the MMP-9, TIMP-1, and MMP-9/TIMP-2 levels in the CAL group were lower than those in the non-CAL group, but they increased significantly in the subacute phase ($P$<0.05). MMP-9 has a positive correlation with TIMP-1 in the acute and subacute phases, and negative correlation with TIMP-2 in the subacute and convalescent phases ($P$<0.05). Conclusion : These results suggest that MMP-9, TIMP-1, and the imbalance in MMP-9 and TIMP-2 might play important roles on the pathophysiology of KD and especially on the development of CAL. However, further larger studies are needed.

1세 미만과 1세 이상의 가와사끼병 환아에서 급성기 임상양상 및 관상동맥 변화에 대한 비교

김소영,임성준,윤신원,이동근,최응상,Kim, So Young,Lim, Seong Joon,Yun, Sin Weon,Lee, Dong Keun,Choi, Eung Sang 대한소아청소년과학회 2002 Clinical and Experimental Pediatrics (CEP) Vol.45 No.6

목 적 : 기존의 진단기준을 모두 만족시키지 못하는 비정형적인 가와사끼병이 실제로 1세 미만에서 더 흔히 발생하는지 및 가와사끼병의 심혈관 합병증의 위험인자로 기존에 언급된 바 있는 1세 미만에 발병한 가와사끼병 환아에 있어서 1세 이상 가와사끼병 환아와 비교하여 급성기의 임상양상, 검사실 소견, 관상동맥 병변의 빈도에 차이가 있는지를 알아보고, 이들 비교 분석을 통해 가와사끼병의 발병연령에 따른 좀더 합리적인 진단기준 설정 및 조기치료의 필요성이 있는지에 대하여 알아보고자 하였다. 방 법: 1997년 4월부터 2001년 5월까지 49개월간 중앙대학교 용산병원 및 필동병원 소아과에 가와사끼병으로 입원하였던 환아 70례를 대상으로 발병연령이 1세 미만인 환아 17례와 1세 이상인 53례로 나누어 성별, 급성기 임상양상, 입원시 검사실 소견, 급성기, 아급성기 및 회복기의 심초음파 검사 소견 등에 대해 입원 기록지를 후향적으로 분석하였다. 결 과 : 1) 총 70례의 환아 중 1세 미만 환아는 24.3%를 차지하였고 발병연령은 최소 2개월에서 최대 8세였으며(평균연령 26.5개월) 전체 대상아의 남녀비는 1.3 : 1였고 1세 미만군의 남녀비는 3.3 : 1 및 1세 이상군의 남녀비는 1.0 : 1로 1세 미만 환아에서 통계적으로 유의하게 남아에서 호발하였다(P=0.04). 2) 발열시작부터 IVIG을 투여 받기까지의 총 발열일수($4.6{\pm}1.3$ 대 $6.2{\pm}2.5$일, P=0.004)와 발열시작부터 최초의 심초음파 시행까지의 일수($5.2{\pm}1.6$일 대 $7.1{\pm}2.6$일, P=0.01)는 1세 미만군에서 유의하게 짧았고, 5일 이상의 발열을 보인 경우(70.6% 대 92.5%, P=0.008)는 1세 미만군에서 유의하게 적었다. 경부림프절 비대를 보인 우(35.3% 대 66.0%, P=0.02)는 1세 미만에서 유의하게 적었다. 가와사끼병의 전형적 임상징후 5개를 모두 보인 경우(41.2% 대 75.5%, P=0.006)는 1세 미만군에서 유의하게 적었다. 비정형적 기타 임상증상 중 호흡기 증상의 빈도(23.5% 대 50.9 %, P=0.041)는 1세 이상군에서 유의하게 많았다. 3) 입원시 혈청 알부민($4.3{\pm}0.3g/dL$ 대 $3.8{\pm}0.5g/dL$, P=0.005)은 1세 이상군에서 유의하게 낮았고, 혈청 BUN($11.0{\pm}3.9mg/dL$ 대 $8.5{\pm}2.8mg/dL$, P=0.026)은 1세 미만군에서 유의하게 높았으며, 혈청 칼륨($4.8{\pm}0.4mEq/L$ 대 $4.1{\pm}0.4mEq/L$, P<0.001)은 1세 이상군에서 유의하게 낮았다. 4) 심초음파상 심염의 빈도는 급성기, 아급성기, 회복기 모두 두군간 차이가 없었다. 관상동맥확대 빈도는 급성기, 아급성기, 회복기 모두 1세 미만군에서 더 높았으나 통계적 유의성은 급성기(47.1% 대 17.0%, P=0.01)에만 있었고 가와사끼병으로 진단되어 IVIG를 투여한 후인 아급성기 및 회복기에는 두군간 유의한 차이를 보이지 않았다. 결 론 : 1세 미만에 발병한 가와사끼병 환아에서는 1세 이상군에 비해 전형적인 진단기준을 완전히 만족하지 못하는 경우가 유의하게 많으며 급성 발열기에 관상동맥변화가 나타남을 알 수 있었다. 따라서 1세 미만의 어린 영아에서 뚜렷한 원인이 없이 발열이 지속되는 경우에는 가와사끼병의 가능성을 항상 염두에 두고 심초음파 검사를 시행, 관상동맥 병변 유무를 확인하여 조기진단과 조기의 적절한 IVIG 투여가 필요할 것으로 사료된다. Purpose : To identify the necessity of more reasonable diagnostic criteria and the possibility of early prediction of coronary involvement in the higher risk group, we investigated and compared clinical and laboratory findings in the acute phase and coronary involvements in those younger (n=17) and older(n=53) than one year of age in Kawasaki disease(KD). Methods : Retrospective chart reviews were performed on 70 patients with KD who were admitted to the Chung-Ang University Hospital from April 1997 to May 2001. Results : Male were significantly higher in the younger age group(M : F ratio 3.3 : 1 vs. 1.0 : 1, P=0.004). Fever durations before intravenous immunoglobulin(IVIG) and echocardiography were significantly shorter in the younger group($4.6{\pm}1.3$ vs. $6.2{\pm}2.5$, P=0.004 vs. 0.01, respectively). Cases meeting typical diagnostic criteria were significantly less in the younger group(P=0.006). In the laboratory findings, serum albumin, BUN and $K^+$ levels in the acute febrile phase were significantly higher in the younger group(P=0.002, 0.006, <0.001, respectively) and incidences of coronary artery dilatation in the acute phase were significantly higher in the younger group(P=0.01). Conclusion : Although less met the typical diagnostic criteria of KD, infants younger than one year of age are more susceptible to coronary artery change in the acute febrile phase. Therefore, KD should be entertained as a diagnostic possibility in young infants with prolonged fever without distinct fever focus, and echocardiography should be considered as part of the evaluation of these patients, and then early diagnosis and prompt IVIG should be conducted.

생후 90일 미만 영아의 요로 감염에서 세균성 수막염의 동반 가능성

황준호,김수영,이나미,이대용,윤신원,채수안,임인석,박지영,Hwang, Jun Ho,Kim, Su Yeong,Lee, Na Mi,Yi, Dae Yong,Yun, Sin Weon,Chae, Soo Ahn,Lim, In Seok,Park, Ji Young 대한소아감염학회 2022 Pediatric Infection and Vaccine Vol.29 No.2

Purpose: Urinary tract infections (UTIs) are the most common serious bacterial infections in young infants. Lumbar puncture (LP) has been used to diagnose coexisting meningitis in infants under 90 days of age with suspected UTI in many hospitals. However, the incidence of bacterial meningitis associated with UTIs is low. We aimed to describe the prevalence of concomitant bacterial meningitis in young infants with UTIs. Methods: The medical records of infants with the first episode of UTI admitted to the Chung-Ang University Hospital from January 2010 to December 2019 were retrospectively reviewed. Infants aged < 90 days who underwent LP with initial evaluation were included. Demographic and clinical features, laboratory findings, and imaging findings were collected and analyzed. Results: Eighty-six infants with UTIs were enrolled in the study. The median age was 61.5 days (interquartile range, 42.3-73.8 days) and boys (90.7%) were predominant. Escherichia coli was the most common pathogen (n=80, 93.0%) and followed by Klebsiella species (n=5, 5.8%). Fifteen (18.1%) specimens produced extended spectrum β-lactamase (ESBL). Five (5.8%) infants had positive blood culture results. Seven (8.1%) infants showed pleocytosis in the cerebrospinal fluid, but none had coexisting bacterial meningitis. Twenty-four (30.8%) infants showed renal dilatation or hydronephrosis on ultrasonography. Dimercaptosuccinic acid (DMSA) scans revealed cortical defects in 17 (21.3%) infants while voiding cystourethrography revealed vesicoureteral reflux in 6 (46.2%) infants. Conclusion: Co-existing bacterial meningitis was not observed in young infants with UTIs. LP could not be routinely performed considering the clinical condition of <90 days old UTI patients.

단일항원 감작군과 다항원 감작군의 임상 양상 및 알레르기 지표의 차이: 단일 기관 연구

이종호 ( Jong Ho Lee ),김지현 ( Ji Hyun Kim ),윤신원 ( Sin Weon Yun ),한영신 ( Young Shin Han ),안강모 ( Kang Mo Ahn ),채수안 ( Soo Ahn Chae ),임인석 ( In Seok Lim ),최응상 ( Eung Sang Choi ),유병훈 ( Byung Hoon Yoo ) 대한소아알레르기호흡기학회(구 대한소아알레르기 및 호흡기학회) 2011 소아알레르기 및 호흡기학회지 Vol.21 No.4

Purpose: The objective of this study was to identify differences in the clinical manifestations and allergic indices between monosensitized and polysensitized children. Methods: We reviewed retrospective data from the medical records of patients who had chronic or recurrent respiratory symptoms and visited the pediatric clinic at Chung-Ang University Hospital for an evaluation of allergic diseases from January 2003 to January 2011. The patients were categorized into nonsensitized (n=111), monosensitized (n=149), and polysensitized (n=205) groups according to skin prick tests (as classified by five allergen groups). We compared gender, age, family history, admission history, food sensitization, total immunoglobulin E (IgE), peripheral eosinophil counts, eosinophil cationic protein (ECP) levels, forced expiratory volume in 1 second (FEV1), and methacholine provocation tests among the three groups. Results: The frequency of food sensitivity was highest in the polysensitized group (n=101, 49.3%), followed by the monosensitized (n=8, 5.4%) and nonsensitized groups (n=0) (P<0.001). The FEV1 was significantly lower in the polysensitized group than that in the monosensitized and nonsensitized groups (79.4 ± 20.2% vs. 87.2 ±16.0% vs. 87.6 ± 17.1%, respectively) (P=0.013). The total IgE and ECP levels were significantly higher in the polysensitized patients than those in the other patients (P<0.001 and <0.001, respectively). Differences in gender, age, peripheral eosinophil count, and bronchial hyper-responsiveness were not identified between the monosensitized and polysensitized groups. Conclusion: The polysensitized group showed more frequent food hypersensitivity, lower FEV1 values, and higher allergic indices such as total IgE and ECP, suggesting a different atopic phenotype compared with those in the monosensitized group. (Pediatr Allergy Respir Dis(Korea) 2011;21: 277-284)

Comparison of the Head-up Tilt Test in the Children and Adult

류나리 ( Na Li Yu ),이나미 ( Na Mi Lee ),이대용 ( Dae Yong Yi ),윤신원 ( Sin Weon Yun ),채수안 ( Soo Ahn Chae ),임인석 ( In Seok Lim ) 중앙대학교 의학연구소 2017 中央醫大誌 Vol.42 No.1

Objective: To compare the difference of children (under 18 year-old) and adult (over 40 year-old) in head-up tilt test (HUTT) positive patients. Methods: All patients diagnosed as vasovagal syncope in HUTT from January 2005 to December 2015 in Chung-Ang university hospital. Any patients with underline disease excluded. Results: The mean age was 13.5 years (from 7 to 17 years) and 59.3 years (from 40 to 85 years) in children and adult respectively in HUTT positive patients. There was no sex differences in children and adult [male: 57 (35.4%) vs 65 (43%) (p =0.167)]. The positive rate of passive test was statistically different in two groups [54 patients (33.5%) vs 23 patients (15.2%) (p <0.001)]. The highest heart rate (HR) and delta HR in Type I positive in passive test was statistically different in two groups [highest HR: 107.8 bpm vs 91.0 bpm (p <0.05); increase delta HR: 35.8 bpm vs 22.5 bpm (p <0.001); decrease delta HR 38.0bpm vs 25.6 bpm (p <0.05)]. The HR values except at baseline in Type I positive in provocation test were statistically different in two group [highest HR: 138.4 bpm vs 113.5 bpm (p <0.001); lowest HR: 88.7 bpm vs 77.3 bpm (p <0.05); increase delta HR: 64.5 bpm vs 44.4 bpm (p <0.001), decrease delta HR: 49.7 bpm vs 36.1 bpm (p <0.001)]. Conclusion: The positive rate of passive test and HR differences in HUTT were statically different in two groups. Chung-Ang J Med 2017; 42(1): 17-23

9∼12개월 영아에서 철 결핍성 빈혈의 조기 검진 필요성

조양환 ( Yang Hwan Cho ),김수영 ( Su Yeong Kim ),이대용 ( Dae Yong Yi ),윤신원 ( Sin Weon Yun ),채수안 ( Soo Ahn Chae ),임인석 ( In Seok Lim ),이나미 ( Na Mi Lee ) 한국정맥경장영양학회 2019 한국정맥경장영양학회지 Vol.11 No.2

Purpose: Growth and development of infants can be periodically assessed through health screening, but iron deficiency anemia, which is common in infants, is difficult to detect by conducting only infant health screening. This study evaluated the prevalence of iron deficiency anemia in infants who visited Chung-Ang university hospital between 9 and 12 months of age. The study also determined the difference of anemia between term and preterm infants. Methods: The subjects of this study were infants aged 9 to 12 months who visited outpatient clinics of Chung-Ang University Hospital from January 2006 to August 2018 for the purpose of infant health screening and immunizations. We divided the subjects as the term group and the preterm group, and their medical records were retrospectively analyzed. Results: One hundred and fifty-two infants were included in the study. There were 51 in the preterm infant group and 101 in the term infant group. Thirteen infants were diagnosed with iron deficiency anemia, and 12 infants of these infants were in the term group and one infant was in the preterm group, which was statistically significant (P<0.001). There are significant differences in the hemoglobin (12.0±1.1 g/dL, 12.6±1.2 g/dL), hematocrit (35.8%±2.7%, 36.7%±3.2%), serum iron (60.8±25.4 μg/dL, 73.5±40.9 μg/dL), and unsaturated iron binding capacity (279.1±67.7 μg/dL, 252.0±47.5 μg/dL) between the term infant group and the preterm infant group, respectively (P<0.05). Conclusion: Iron deficiency anemia was significantly more often diagnosed in term infants than that in preterm infants. Preterm infants may have a lower prevalence of iron deficiency anemia than do term infants because the preterm infants are taking iron supplements prophylactically. Therefore, iron deficiency anemia should be prevented in term infants, and it is important to confirm the presence of iron deficiency anemia by conducting blood tests during the first 9 to 12 months of life.

급성 결핵성수막염의 양상을 보이는 속립성 결핵에 동반된 신경 베쳇증후군

은성훈(Seonghoon Eun),김영덕(Young Duck Kim),이대용(Dae Yong Yi),이나미(Na Mi Lee),윤신원(Sin Weon Yun),채수안(Soo Ahn Chae),임인석(InSeok Lim ),최응상(Eung Sang Choi) 대한소아신경학회 2016 대한소아신경학회지 Vol.24 No.1

A 14-year-old girl diagnosed with Behçet's disease 15 months previously presented at the emergency department with severe headache, fever, and vomiting. Chest radiographic and computed tomography findings were consistent with miliary tuberculosis, and pleocytosis and increased protein levels were found on examination of cerebrospinal fluid (CSF). Tuberculous meningitis associated with miliary pulmonary tuberculosis was suspected, and a four-drug regimen for tuberculosis plus intravenous dexamethasone was initiated. However, negative results of real-time polymerase chain reaction and CSF cultures led us to reconsider our initial diagnosis. On brain magnetic resonance imaging, the results supported neuro-Behçet's syndrome rather than tuberculous meningitis. However, it is unclear how miliary tuberculosis complicated neuro-Behçet's syndrome because the patient had no history of tuberculosis or contact with patients with tuberculosis, and had not used any immunosuppressive agents such as anti-tumor necrosis factor-alpha drugs. This is a very rare case of neuro-Behçet's syndrome associated with miliary tuberculosis. More commonly, cases of neuro-Behçet's syndrome presenting with features mimicking acute tuberculous meningitis have been reported. Neuro- Behçet's syndrome should be considered in patients with a history of Behçet's disease presenting with signs of meningeal irritation.

임상 ; 우리나라 저체중출생아와 이에 관계된 인자의 변화양상, 1995-2007

김상원 ( Sang Won Kim ),이정주 ( Jung Ju Lee ),김지현 ( Ji Hyun Kim ),이재희 ( Jae Hee Lee ),윤신원 ( Sin Weon Yun ),채수안 ( Soo Ahn Chae ),임인석 ( In Seok Lim ),최응상 ( Eung Sang Choi ),유병훈 ( Byung Hoon Yoo ) 대한주산의학회 2010 Perinatology Vol.21 No.3

목적: 저체중출생아는 신생아의 유병률과 사망률을 높일 뿐 아니라 성인에서 만성질환을 야기할 수 있다. 우리나라의 경우 최근 저체중출생아의 출생률이 급격히 상승하고 있다. 이에 본 저자들은 우리나라의 저체중출생아의 출생률의 변화 및 이에 영향을 미치는 인자들의 변화양상을 알아보고자 이 연구를 시행하였다. 방법: 본 연구는 우리나라 통계청 인구동태 자료 중 1995년에서 2007년까지 13년간의 출생기록의 원시자료를 이용하여 연도별 평균 재태연령, 평균 출생체중, 평균 산모연령, 미숙아, 저체중출생아, 다태아, 첫째 아이의 출생률, 성별, 미혼모, 저연령산모(<20세), 고령산모(>35세), 저학력산모(고등학교 졸업 미만)의 빈도의 변화에 대해 조사하였고, 어떤 인자들이 우리나라의 저체중출생아의 출생률에 영향을 미치는지 알아보았다. 결과: 1995년에서 2007년까지 대상 신생아 수는 7,294,237명이었다. 이 기간 동안 평균 재태연령은 1995년에 39.5±0.9주에서 2007년에 38.6±1.1주로 줄어들었고, 평균 출생체중은 1995년에 3,289±443 g에서 2007년에 3,239±458 g 으로 줄어들었으며, 평균 산모나이는 27.4±3.8세에서 30.1±4.0세로 증가하였다. 저체중출생아의 출생률은 2.99%에서 4.66%로 증가하였고, 미숙아는 2.51%에서 5.17%, 남아에 대한 여아의 성비는 0.88에서 0.94, 다태아는 1.31%에서 2.74%, 첫째 아이는 48.17%에서 53.52%, 미혼모는 0.83%에서 1.51%, 고령산모는 4.53%에서 13.13%로 증가하였다. 이 중 미숙아, 다태아, 여아, 미혼모, 고연령산모 등은 저체중출생아의 출생률 관계가 있었다. 결론: 우리나라의 경우 최근 13년간 평균출생체중은 줄어들고 저체중출생아의 출생률은 증가하였다. 저체중출생아의 출생률이 증가한 원인으로 미숙아, 다태아, 여아, 미혼모, 고연령산모와 관련이 있으며 이는 사회적 변화와 관련이 있다. Objective: Low birth weight (LBW) infants are known to be at the risk of increased morbidity and mortality, and also of developing adult or metabolic diseases later in their life. Recently, the number of LBW infants has increased in Korea. Therefore, we examined the changing patterns of LBW infants and associated risk factors. Methods: Data from the Korean National Statistical Office during 13 years (1995-2007) were used. We analyzed the changing mean gestational age, mean birth weight, mean maternal age, and the changing incidence of premature infant, LBW infant, multiple births, the proportion of first baby, and sex of the baby. Also, we analyzed the incidence of unmarried mother, old aged mother (>35 years), young aged mother (<20 years), high school graduated mother. In addition, we analyzed the relationship between LBW infants and risk factors. Results: The incidence of LBW infants was 2.99% in 1995, and 4.66% in 2007. The proportion of premature infant, multiple birth, first baby, unmarried mother, old aged mother, female baby increased. The increase in premature infant, multiple birth, old aged mother, unmarried mother, and female infant were found to be the important factors regarding increase in LBW infants in Korea. Conclusion: In Korea, an increase in the prevalence of LBW infants and prematurity from 1995 to 2007 was observed. The increase in premature infants, multiple birth, old aged mother, unmarried mother, and female infant are associated with the increase in LBW infants.

태변장폐색증으로 인한 자궁 내 중장 염전으로 장천공 및 장괴사 상태로 출생한 미숙아 1례

박귀옥 ( Gwi Ok Park ),김지현 ( Ji Hyun Kim ),이재희 ( Jae Hee Lee ),이정주 ( Jung Ju Lee ),윤신원 ( Sin Weon Yun ),채수안 ( Soo Ahn Chae ),임인석 ( In Seok Lim ),이동근 ( Dong Keun Lee ),최웅상 ( Eung Sang Choi ),유병훈 ( Byoung 대한주산의학회 2008 Perinatology Vol.19 No.3

Midgut volvulus is commonly complicated with malrotation, and develops mainly in infants before 1 year old, especially in neonate. Intrauterine midgut volvulus is an extremely rare disease therefore is difficult to diagnose. Furthermore unless the fetus has malrotation, symptoms and results of tests suspicious of fetal midgut volvulus are nonspecific. There are some reports that meconium ileus could be a cause of intrauterine midgut volvulus from foreign countries, however has never been reported in Korea. So we report a case of prematurity born with bowel perforation and gangrene due to intrauterine midgut volvulus caused by meconium ileus.