소아에서 결핵성 중이염 1례

김은아,함세창,김영균,박용원,강윤경,Kim, Eun Ah,Ham, Se Chang,Kim, Young Kyoun,Park, Yong Won,Kang, Yun Kyung 대한소아감염학회 2002 Pediatric Infection and Vaccine Vol.9 No.1

결핵성 중이염은 매우 드문 질환이나 최근 결핵의 유병률이 증가하는 추세이므로 장기간의 항생제 치료에도 반응하지 않는 만성 중이염의 경우 결핵성 중이염의 가능성을 염두에 두어 감별진단 하여야 한다. 이런 관심은 조기 진단과 이에 따른 적절한 치료를 하게 되어 고막 파열, 청력 소실 및 안면신경마비와 같은 중한 합병증을 줄일 수 있을 것이다. Tuberculous otitis media is a very rare disease in extrapulmonary tuberculosis and in chronic otitis media nowadays. The characteristic signs seem to have altered from the past ones. And the suspicion index is very low that there is often a considerable delay prior to diagnosis. This might result in irreversible complications such as hearing loss, facial nerve paralysis and labyrinthitis. It is difficult to be defined by culture, so many patients with tuberculous otitis media are subjected to have surgery without a correct etiologic diagnosis. Therefore bacteriologic study of secretion and pathologic examinations of biopsied tissue are mandatory. We report one year and 11 months old boy with tuberculous otitis media having painful otorrhea and perforated tympanic membrane diagnosed by histologic finding and polymerase chain reaction(PCR). And we would like to emphasize the fact that tuberculous otitis media must be considered in the differential diagnosis of persistent suppurative otitis media despite appropriate antibiotic therapy considering the increasing tendency in incidence of Tuberculosis in Korea these days.

모체-태아간 아형에 따른 IgG의 이행

안강모 ( Kang Mo Ahn ),남승연 ( Seung Yeon Nam ),함세창 ( Se Chang Ham ),이상일 ( Sang Il Lee ),한만용 ( Man Yong Han ) 대한소아알레르기호흡기학회(구 대한소아알레르기 및 호흡기학회) 1999 소아알레르기 및 호흡기학회지 Vol.9 No.4

아토피피부염 환아에서 난백에 대한 IgG western blotting 분석

신미용(Mi Yong Shin),이광신(Kwang Shin Lee),손대열(Dae Yul Son),남승연(Seung Yeon Nam),함세창(Se Chang Ham),안강모(Kang Mo Ahn),강이석(I Seok Kang),이상일(Sang Il Lee) 대한천식알레르기학회 2000 천식 및 알레르기 Vol.20 No.4

N/A Background: and objective: Specific IgE to food allergen is associated with atopic dermatitis, but it does not always show good clinical correlation. It has been suggested that IgG may be partly involved in allergen-induced reaction. This study was designed to investigate the clinical significance of specific IgG antibody to egg white (EW) in atopic dermatitis patients who showed improvement with egg elimination diet. Method: Eleven atopic dermatitis patients who responded to egg elimination diet were selected. They were classified into two groups group I(n=5) with positive specific IgE to EKV and group II(n=6) with normal levels of serum specific IgE. Two volunteers with no allergic diseases were enrolled in the control group. EW-specific IgG western blotting was performed with patient's serum and purified protein extracted from EW. Results : IgG western blotting to EKV in group I showed bands at 51.8 kD in two patients and bands at 35 kD in the others. In group II. Two showed bands at 51.8 kD, and diffuse bands at 35 kD -51.8 kD were found in four patients. There were no bands in the control group. Conclusion : Regardless of the presence of specific IgE. Specific IgG to EVJ was detected by western blotting in patients with egg-associated atopic dermatitis, suggesting that specific IgG may play a role in the pathogenesis of atopic dermatitis. (J Asthma Allergy Clin Immunol 20: 627-6:32. 2000)

굴곡성 기관지경으로 치료 후 호전된 2개월 영아에서의 흡인성 폐렴

조영재,함세창,김우경,김영균,박용원,이혜경 인제대학교 백병원 2002 仁濟醫學 Vol.23 No.4

The flexible bronchoscopy is not frequently used in children as in adults due to many causes. However the role of bronchoscopy in children is important in respect of diagnosis and treatment. We have done with flexible bronchoscopy for the purpose of diagnosis and treatment in a two-month-old infant with pneumonia and atelectasis. The lipid-laden alveolar macrophage(LLAM) index was 227/400. We thought the aspiration pneumonia of the patient resulted from his mother's abnormal feeding posture. After the bronchoscopy and washing, the radiologic findings and clinical symptoms were improved. We recommended the feeding position to the patient's mother and he has been well-being state afterwards.

토끼에서 허혈성 급성 신부전에 대한 베라파밀의 보호효과

김용근,김수영,함세창,유황재 대한신장학회 1998 Kidney Research and Clinical Practice Vol.17 No.4

This study was undertaken to determine whether verapamil protects renal function in rabbits with ischemic acute renal failure. Renal ischemia was induced by clamping bilateral renal arteries for 60 min. One group received intravenously an infusion of verapamil(lmg/kg) for 30 min prior to initiation of renal artery clamping and the other group received equal volume of saline. Renal blood flow was measured with flowmeter before(basal) and 24 hr after ischemia. Serum creatinine level increased 24 hr after ischemia and remained high to 72 hr. When verapamil was pretreated, the level 48 and 72 hr after ischemia was significantly decreased compared with saline insusion. Urine flow was markedly decreased 24 hr after ischemia and remained depressed to 72 hr, but it was significantly increased 72 hr after ischemia in verapamil-pretreatment animals as compared with the saline-infusion animals. GFR were markedly reduced 24 hr after ischemia and remained depressed to 72 hr, which was significantly prevented by verapamil pretreatment. Ischemia caused a significant increase in FE_Na and a reduction in U_osm, and T^c_H2O, indicating impairment in urine concentrating ability of tubules, and the impairment was significantly attenuated by verapamil. The uptake of p-aminohippurate in cortical slices was depressed by ischemia, which was significantly prevented by verapamil pretreatment. In salineinfusion animals, renal blood flow was not significantly different between the basal value and that after 24 hr of reflow. Renal blood flow was not significantly altered by verapamil pretreatment. Anoxia/reoxygenation injury in the control renal slices was not significantly prevented by Ca^2+ channel blockers. These results suggest that verapamil exerts a protective effect in ichemic acute renal failure, and the beneficial effects may be attributed to effects other than vasodilation. These data also indicate that a reduction in GFR following ischemia does not result from change in renal blood flow

미숙아 동맥관 개존증에서 인도메타신 정맥 투여의 치료 성적에 대한 분석

이미경,김영균,함세창,오세욱,박용원 인제대학교 백병원 2001 仁濟醫學 Vol.22 No.2

Objective: The aims of this study were to determine the response of patent ductus arteriosus(PDA) and side effects to intravenous indomethacin therapy. Methods and Materials: From January 1999 to December 2000, 24 preterm infants diagnosed as significant PDA based on clinical and echocardiographic findings in NICU at Seoul Paik Hospital were analysed retrospectively for clinical effects and complications of intravenous indomethacin therapy. Results: The PDA was closed in 12(50%) and constricted in 10(42%) among total patients initially. Only one of 10 constricted infants was reopened. Second courses of indomethacin therapy were repeated in three patients showing poor responses, resulting in 67%(2/3) of PDA closure rate. Eventually, indomethacin therapy was successful in 22(92%) neonates, except 2 patients(8.3%) requiring PDA ligation. The side effects of indomethacin were transient hyponatremia(62.5%) and oliguria(4.2%). Total mortality rate was 12.5%(3/24), and only 1 case with pulmonary hemorrhage seemed to be possibly related to indomethacin therapy. Conclusions: The results of our study confirm that a significantly high PDA closure rate can be achieved by intravenous indomethacin administration. We conclude that intravenous indomethacin therapy can be the first method of treatment in premature infants with PDA, despite the transient renal side effects.

성인에서의 심실중격결손증에 대한 임상적 고찰

정옥자,김영균,함세창,오세욱,박용원,이홍섭 인제대학교 백병원 2001 仁濟醫學 Vol.22 No.2

Objectives: The aims of this study were to establish the natural courses and the pre- and post-operative complications of ventricular septal defect(VSD) in adult life. Materials & Methods: This study showed clinical results of 26 patients aged 20 years or older undergoing surgical repair of isolated VSD at Seoul Paik hospital during the period from Feb. 1989 to Dec. 2000. The data were analyzed retrospectively as to clinical profiles, data of cardiac catheterization, associated cardiac findings, operative methods, postoperative complications and mortalities. Results: The incidences of perimembranous(PM) VSD and subarterial(SA) VSD were 15 cases and 11 cases respectively. Data of preoperative cardiac catheterization showed mean values of Qp/Qs 2.34±1.12 in PM VSD and 1.26±0.09 in SA VSD. Mean pulmonary arterial pressure of PM VSD(49.9±25.5mmHg) was also higher than that of SA VSD(24.0±3.3). Aortic valve prolapses(AVP) and aortic insufficiencies (AI) were observed in 90.9% and 45.5% among SA VSD patients. As operative methods, patch closures were done mainly. We had good operative results without mortalities. Conclusions: The incidence of SA VSD in adult was relatively high compared to that in childhood. Corrective surgery in adult VSDs showed good operative results, so should be done immediately to prevent further damages to heart.

급성 괴사성 뇌증 1례

김성기,오세욱,김영균,함세창,박용원,김상우 대한소아과학회 2001 小兒科 Vol.44 No.8