미세 변화형 신증후군과 동반된 급성 무결석 담낭염 1례

신윤호,박지민,신재일,김명준,이재승,Shin Youn-Ho,Park Jee-Min,Shin Jae-Il,Kim Myung-Jun,Lee Jae-Seung 대한소아신장학회 2003 Childhood kidney diseases Vol.7 No.1

저자들은 4세에 신증후군으로 진단받고 스테로이드를 투여하며 재발을 수 회 반복하던 환자가 갑작스런 복통과 구토를 주소로 입원하여 시행한 검사 상 급성 무결석 담낭염으로 진단받고 금식, 비 위관 배액, 충분한 수액 공급, 그리고 항생제치료로 완치된 경우를 경험하였기에 이를 보고하는 바이다. The nephrotic syndrome is characterized by generalized edema, hypoproteinemia(<2 g/dL), proteinuria(>40 $mg/m^2/hr$), and hypercholesterolemia(>200 mg/dL). It is reported that hypoalbuminemia, which is one of the four diagnostic criteria of the nephrotic syndrome, is associated with gallbladder wall thickening. An explanation for the thickened wall in hypoalbuminemic states is the accumulation of fluid in the subserosal layer of the gallbladder wall which contains the most areolar tissue. This report describes a patient who was initially diagnosed with the nephrotic syndrome at the age of 4 and subsequently developed acute acalculous cholecystitis at the age of 5.8 with an albumin level of 1.3 g/dL. The patient responded to fluid therapy, nasogastric suction, and broad spectrum antibiotics.

충북지역 톱다리개미허리노린재의 발생밀도 변동과 이동

신윤호,윤승환,박영욱,안정진,윤창만,윤영남,김길하,Shin, Youn-Ho,Yun, Seung-Hwan,Park, Young-Uk,An, Jeong-Jin,Yoon, Chang-Mann,Youn, Young-Nam,Kim, Gil-Hah 한국응용곤충학회 2012 한국응용곤충학회지 Vol.51 No.2

Seasonal fluctuations of Riptortus pedestris were investigated in four regions including two sites each at Mt. Yangseong (Munui-myeon, Cheongwon-gun), O-chang (Cheongwon-gun), and Jujung-dong (Cheongju) using aggression pheromone traps from April to November in 2010 and 2011. Aggression pheromone and aggression pheromone + soybean traps were set at all investigated sites, and the Mt. Yangseong A and B sites were investigated at a farmland (80 m, asl) and forest (200 and 300 m). The population density of R. pedestris was high in mid June, mid August, and late October in 2010 and in early May, mid June, mid September, and early October in 2011 with trivoltine. O-chang and Jujung-dong populations, which were distinguished in farmlands and forests, were highest from June to August in the farmland and in September in the forest. Similar numbers of R. pedestris were capture in the farmlands and the forest in June-August, September-November, respectively. From the results of the four regions, more R. pedestris adults were captured in the aggression pheromone + soybean trap than that in the pheromone trap. To investigate the migration route by altitude, 500 R. pedestris adults marked with fluorescent paint were released and re-caught insects were counted in traps after 10 and 20 days. The pattern of the re-caught R. pedestris indicated migration from the forest to farmlands during April-June. These results suggest that the insects did not migrate in August because food was plentiful in the forest at 200 m, but they moved to the forest during October due to the scarcity of food and for overwintering. The R. pedestris seasonal fluctuations in 2011 were affected heavily by the environment, particularly rain precipitation. 충북지역 4곳의 농경지 및 산림지를 선정하여 2010년 4월 5일부터 2011년 11월 30일까지 발생밀도를 조사하였다. 농경지(80 m, 산림경계)와 산림지(200 m, 300 m)로 이루어진 양성산 두 지역은 고도별로 집합페로몬트랩과 집합페로몬+대두트랩을 설치하였다. 2010년도에 톱다리개미허리노린재가 6월 중순, 8월 중순, 10월 하순에 높은 발생밀도를 보였고, 2011년도에는 양성산 두 지역에서는 5월 초순, 6월 중순, 9월 중순, 10월 초순에 높은 발생밀도를 보였다. 농경지와 산림지로 구분된 청원군 오창면, 청주시 주중동 두 지역에서는 6월에서 8월까지 농경지에서, 9월에는 산림지에서 많이 포획되었다. 계절별로도 6월부터 8월까지는 농경지 쪽에서, 9월부터 11월까지는 산림지쪽에 존재하였다. 트랩별 유인력의 차이는 4곳의 지역 모두에서 집합페로몬트랩보다 집합페로몬+대두트랩에서 더 많은 수의 성충이 포획되었다. 성충 500마리에 형광페인트를 칠하여 양성산에서 고도별로 방사하고 10일과 20일 후 고도별 이동을 조사한 결과, 4월부터 월동에서 깨어나기 시작하여 6월까지는 산림지에서 농경지로 이동하였다. 8월에는 고도별로 이동하지 않았으나, 9월과 10월에는 다시 농경지에서 산림지로 이동하였다. 톱다리개미허리노린재는 계절별로 적은 수가 이동을 하며 대부분은 주변에서 먹이를 찾는 것으로 보인다. 2011년도의 발생밀도는 환경, 특히 강우량에 영향을 많이 받았다.

마이코플라즈마 폐렴에서 중합 효소 연쇄반응과 효소면역측정법의 진단적 유용성

신윤호 ( Youn Ho Shin ),이병철 ( Byung Chul Lee ),송태원 ( Tae Won Song ),김경원 ( Kyung Won Kim ),이경은 ( Kyung Eun Lee ),김은수 ( Eun Soo Kim ),박미연 ( Mi Yeoun Park ),류정우 ( Jung Woo Leu ),장욱 ( Wook Chang ),손명현 ( Myun 대한소아알레르기호흡기학회(구 대한소아알레르기 및 호흡기학회) 2006 소아알레르기 및 호흡기학회지 Vol.16 No.1

목 적 : Mycoplasma pneumoniae 폐렴은 소아 및 청소년기에 주로 호흡기 질환을 일으키는 주요 원인이다. M. pneumoniae 폐렴을 진단하기 위해서는 한랭응집소 검출반응, 마이코플라즈마 특이 항체 측정법, 배양 검사 등의 방법이 이용되고 있으나 초기 진단에는 효용성이 떨어진다. 본 연구는 중합 효소 연쇄반응과 효소면역측정법을 이용한 M. pneumoniae 폐렴의 진단적 유용성에 대해 평가하고자 하였다. 방 법 : 연세대학교 의과대학 부속 세브란스병원 및 영동세브란스병원 소아과에 입원한 환자 중 입원 당시 시행한 흉부 X-선 검사 및 흉부 청진상 폐렴 소견을 보인 환아 111명의 임상 검체를 대상으로 M. pneumoniae를 분리, 동정하였다. 마이코플라즈마 특이항체가 1 : 320 이상이거나 추적 관찰 시 4배 이상 역가가 증가하는 경우를 M. pneumoniae 폐렴으로 진단하였고 이를 기준으로 중합 효소 연쇄반응과 효소면역측정법을 수행하였다. 결 과 : 중합 효소 연쇄반응의 민감도는 40.6 %, 특이도 63.3%, 위양성률 69.1%, 위음성률 27.5%로 나타났고, 효소면역측정법에서 M. pneumoniae 특이 IgM은 민감도 9.4%, 특이도 100%, 위양성률 0%, 위음성률 26.9%를 나타내었다. 중합 효소 연쇄반응과 효소면역측정법을 조합한 결과는 민감도 46.9%, 특이도 63.3%, 위양성률 65.9%, 위음성률 25.4%로 나타났다. 결 론 : M. pneumoniae 폐렴의 진단에 있어서 미세입자 응집법을 이용한 특이항체 검사와 더불어 중합 효소 연쇄반응과 효소면역측정법을 시행함으로써 보다 정확한 진단을 할 수 있을 것으로 사료된다. Purpose: Mycoplasma pneumoniae is a common respiratory pathogen responsible for acute respiratory infections in young children. The standard laboratory methods for the specific diagnosis of M. pneumoniae infection have been isolation in culture and serological methods. The objective of this study was to compare the performance of enzyme-linked immunosorbent assays (ELISA) for the detection of M. pneumoniae specific IgG and IgM antibodies and polymerase chain reaction (PCR) in diagnosis of M. pneumoniae pneumonia. Methods : For a 1-year period, 111 patients admitted to Severance Hospital and Yong-dong Severance Hospital with clinical features of pneumonia and radiographically defined pneumonia were included. Serum specimens and throat swab specimens were obtained at the time of admission. Patients who showed M. pneumoniae antibody titer 1 : 320 or greater or a fourfold increase in M. pneumoniae antibody titer between acute and convalescent sera obtained 5 days to 3 weeks after the onset of illness were diagnosed as having M. pneumoniae pneumonia. PCR and ELISA were also performed. Results :The sensitivity, specificity, false positivity, and false negativity of PCR were 40.6 percent, 63.3 percent, 69.1 percent, and 27.5 percent, respectively. The sensitivity, specificity, false positivity, and false negativity of ELISA IgM were 9.4 percent, 100 percent, 0 percent, and 26.9 percent, respectively. The sensitivity, specificity, false positivity, and false negativity of the use of PCR and ELISA in combination were 46.9 percent, 63.3 percent, 65.9 percent, and 25.4 percent, respectively. Conclusion : These observations suggest that the use of PCR and ELISA in addition to the detection of serum antibody to Mycoplasma pneumoniae using microparticle agglutination would allow the maximal number of diagnoses to be made at a very early phase of infection. [Pediatr Allergy Respir Dis(Korea) 2006;16:47-56]

소아와 성인 $Henoch-Sch\"{o}nlein$ Purpura(HSP) 신염의 임상적 비교

김기은,신윤호,신재일,박지민,정현주,이재승,Kim Ki-Eun,Shin Youn-Ho,Shin Jae-Il,Park Jee-Min,Jeong Hyeon-Joo,Lee Jae-Seung 대한소아신장학회 2003 Childhood kidney diseases Vol.7 No.2

Purpose : $Henoch-Sch\"{o}nlein$ purpura(HSP) is a systemic vasculitis that involves multiple organs, especially the kidney, which is the most important organ in determining the prognosis of the disease. The morbidity of HSP nephritis in adults is low and there have been little research done on its clinical course so far. Therefore, we have compared the clinical course of HSP nephritis in children and adults in Korea. Methods : We retrospectively analyzed 81 cases of HSP nephritis in children younger than 15 years of age, and 25 cases of adults older than 15 years of age who were admitted to Yonsei University Medical College Severance Hospital from Jan. 1986 to May 2003. Results : The male to female ratio was 1.5 : 1 in children and 1.3 : 1 in adults. The incidence of HSP nephritis for both age groups was found to be increased during the autumn and winter. Infection was the predisposing factor in 39 cases(48.1%) of children, 16 cases(64.0%) of adults, and drugs were the predisposing factor in 8 cases(9.9%) of children and 4 cases (16.0%) of adults. All patients initially presented with microscopic hematuria. Thirteen cases (16.0%) of children and 7 cases(28.0%) of adults initially showed proteinuria of nephrotic range. Thirty four cases(42.0%) of children and 4 cases(16.0%) of adults showed normal urinalysis after treatment. Asymptomatic urinary abnormalities were found in 41 cases(50.6%) of children and 18 cases(72.0%) of adults. Complications such as nephrotic syndrome and hypertension were found in 3 cases(3.7%) of children and 2 cases(8.0%) of adults. Three children(3.7%) and 1(4.0%) adult required dialysis or renal transplantation. Follow-up renal biopsies were performed on 21 children, of whom 10 cases(47.6%) did not show any histologic change, 9 cases(42.9%) showed low grade changes, and 2 cases(9.5%) showed high grade changes. Prognosis was gloomy when proteinuria of nephrotic range and high grade of abnormal histology were present at diagnosis, and there was no significant difference between the two groups(P<0.05) Conclusion : This study showed that there was no difference in terms of the clinical features and courses between the children and adults with HSP nephritis. Proteinuria of nephrotic range and the severity of abnormal histologic changes at diagnosis were found to be associated with a bad prognosis, therefore we recommend that patients with these features require long term follow-up and management. 목적 : $Henoch-Sch\"{o}nlein$ purpura(HSP)는 여러 장기를 침범하는 전신성 혈관염으로 신장손상이 예후를 좌우하는 중요한 원인이 된다. 성인 HSP 신염은 빈도가 낮고 임상 경과에 대한 연구가 부족한 편이다. 소아와 성인 HSP 신염의 임상 및 경과를 전반적으로 비교함으로서 각각의 예후에 영향을 주는 인자를 알아보고자 하였다. 방법 : 1986년 1월부터 2003년 5월까지 17년 4개월간 연세대학교 세브란스병원에 내원한 15세 미만의 소아 81명과 15세 이상의 성인 25례를 대상으로 후향적으로 고찰하였다. 결과 : 남녀비는 소아 1.5:1, 성인 1.3:1이었고, 발병 계절은 두 군 모두 가을과 겨울에 발병 빈도가 증가하였다. 감염이 선행한 경우가 소아 39례(48.1%), 성인 16례(64.0%)였고, 약물을 복용한 경우는 소아 8례(9.9%), 성인 4례(16.0%)였다. 모든 환자에서 현미경적 혈뇨가 있었고 신증 범위의 단백뇨를 보인 예는 소아 13례(16.0%), 성인 7례(28.0%)있었다(Table 3). 추적 관찰에서 요검사가 정상화된 경우는 소아 34례(42.0%), 성인 4례(16.0%)였고, 무증상 요검사 이상의 예는 소아 41례(50.6%), 성인 18례(72.0%)이었다. 신증후군 또는 고혈압의 합병증이 초래된 경우는 소아 3례(3.7%), 성인 2례(8.0%)이었고, 투석 또는 이식을 받은 경우는 소아 3례(3.7%), 성인 1례(4.0%)였다(Table 4). 소아 21례에서 추적 신생검을 시행하였고 이 중 10례는 조직학적 등급의 변화를 보이지 않았고, 낮은 등급으로 호전된 경우가 9례, 높은 등급으로 악화된 경우가 2례있었다. 진단 당시 신증 범위의 단백뇨가 있었던 경우와 조직학적 등급이 높았던 경우에 나쁜 예후를 보였고(P<0.05) 이는 두 연령군에서 통계학적 차이가 없었다(Table 5). 결론 : 본 연구에서는 소아와 성인에서 임상 양상 및 경과가 두 군에서 다르지 않음을 확인하였고, 소아와 성인 두 군 모두 진단 당시 신증 범위의 단백뇨가 있거나 조직학적 등급이 높을수록 나쁜 예후를 보이므로 그에 따른 장기적인 계획과 치료가 필요할 것으로 생각된다.

스포츠센터 마케팅 활성화를 위한 지리정보시스템(GIS)의 활용방안

천영일(Young Il Chun),신윤호(Youn Ho Shin) 한국사회체육학회 2002 한국사회체육학회지 Vol.18 No.1

This study aims to present the effectiveness of using Geographic Information System(GIS) in the marketing for sports centers and find out the utilization methods by analyzing the requirements needed for sports-related marketing on GIS and comprehend the problems on spatial data. Through the precedent researches on the location of sports facilities and the analysis of service zones, and case studies of marketing application utilizing GIS, this study implemented visualization of distribution of sports facilities, service zones and their competition states. Also, this study proved the fact that sports facilities can be properly distributed, in order to induce active utilization of GIS to sports marketing strategies. As a result of this study, following utilization methods of GIS were suggested. First, mapping the current location of sports center customers through collecting customer data and coordinate transformation of address; Second, identifying the boundary of primary, secondary and tatiery service zones by the application of spatial mutual working model; Third, grasping approach to the sports centers through range; Fourth, grasping the location having potential customers using population geographic data; Fifth, specifying goal market of sports center using data of each stage. However, in order to reflect requirements for spatial decision making of a company, it is required to set up and distribute socioeconomic data considering data aspects required for GIS application in business field. For the purpose, further researches should be made as well.

권연벌레와 어리쌀바구미에 대한 26종 살충제의 접촉독성 및 잔효성

조선란(Sun-Ran Cho),신윤호(Youn-Ho Shin),윤창만(Changmann Yoon),김길하(Gil-Ha Kim) 한국농약과학회 2011 농약과학회지 Vol.15 No.3

소아에서 폐기능검사

지혜미 ( Hye Mi Jee ),신윤호 ( Youn Ho Shin ),한만용 ( Man Yong Han ) 대한천식알레르기학회(구 대한알레르기학회) 2014 Allergy Asthma & Respiratory Disease Vol.2 No.1

Pulmonary function testing (PFT) is an important and fundamental method in the evaluation and treatment of respiratory diseases. Airway responsiveness assessed using histamine or methacholine by PFT is meaningful for the diagnosis of asthma. Spirometry is simple, and has been the most commonly used technique. However, in younger or uncooperative children, other commercially available tools such as impulse oscillometry (IOS), gas dilution, and plethysmography have been used. IOS is a noninvasive method that allows the measurement of airway mechanics (resistance [R] and reactance [X]) with minimal patient cooperation. Functional residual capacity (FRC) is one of the most important measurements obtained by gas dilution. Plethysmography is a gold standard to measure airway resistance and useful for lung function testing in infants. The purpose of this review is to help pediatric physicians being familiar with PFT techniques used in young children by discussing their principles, clinical applications, limitations, and current accessibility in Korea. (Allergy Asthma Respir Dis 2014;2:3-7)

호흡기 바이러스의 연령별, 성별, 계절별에 따른 유병률 변화: 단일기관에서 10년 동안 호흡기 질환으로 입원한 소아 환자를 중심으로

이승진 ( Seung Jin Lee ),이신혜 ( Shin Hae Lee ),하은교 ( Eun Kyo Ha ),신윤호 ( Youn Ho Sheen ),성명순 ( Myong Soon Sung ),정영호 ( Young-ho Jung ),이경석 ( Kyung Suk Lee ),지혜미 ( Hye Mi Jee ),한만용 ( Man Yong Han ) 대한천식알레르기학회(구 대한알레르기학회) 2017 Allergy Asthma & Respiratory Disease Vol.5 No.6

Purpose: It is well known that respiratory viral infection has epidemiological characteristics, including season. This study aimed to investigate the patterns of the prevalence of common respiratory viruses during a period of 10 years with regard to age, sex, and season in Korean children. Methods: From June 2006 to November 2016, we obtained 11,798 specimens from patients aged less than 18 years who were admitted with lower respiratory infections. Ten respiratory viruses were detected using multiplex reverse transcription-polymerase chain reaction. Results: Of 11,798 specimens, at least 1 virus was detected in 4,845 (41.1%). Respiratory syncytial virus (RSV, 18.9%) was the most common virus detected, followed by human rhinovirus (HRV, 14.8%), adenovirus (9.5%), and human bocavirus (HBoV, 7.4%). The detection rate of HRV was higher in male subjects (male 60.0% vs. female 40.0%, P=0.004), but the other viruses had no significant differences with regard to sex. The subjects who were positive for RSV test were youngest (median, 10.5 months; interquartile range, 3.0-25.0 months), followed by human coronavirus (median, 13.0 months), HRV (median, 14 months), and parainfluenza (median, 14 months). HBoV was most commonly detected in spring (29.3%), enterovirus in summer (25.8%), HRV in fall (22.6%), and RSV in October and winter (22.6%). Conclusion: We found that the prevalence of respiratory viruses in Korean children during a period of 10 years was associated with age, sex, and season when the infection occurred. Further nationwide data is warranted to infer clinical implication of our results. (Allergy Asthma Respir Dis 2017;5:320-325)

Insecticidal Activities of Polymers and Surfactants Against Sweet Potato Whitefly, Bemisia tabaci (Hemiptera: Aleyrodidae)

Changmann Yoon(윤창만),Sun-Ran Cho(조선란),Sang-Rae Moon(문상래),Youn-Ho Shin(신윤호),Gil-Hah Kim(김길하) 한국농약과학회 2011 농약과학회지 Vol.15 No.2

소아 아토피피부염 환자에서 혈장 내독소 농도가 질환의 중증도에 미치는 영향

김주영 ( Joo Young Kim ),김은경 ( Eun Kyung Kim ),이혜진 ( Hye Jin Lee ),신윤호 ( Youn Ho Shin ),이혜경 ( Hye Kyung Lee ),김진택 ( Jintack Kim ) 대한천식알레르기학회 2014 Allergy Asthma & Respiratory Disease Vol.2 No.1

Purpose: Endotoxin exposure is associated with the development and pathogenesis of allergic diseases. The present study aimed to determine whether plasma endotoxins are elevated in children with atopic dermatitis (AD) and whether the plasma endotoxins are associated with the AD severity. Methods: This study included 42 children with AD and 16 controls. The AD severity was assessed and skin prick tests were performed along with serum total IgE, total eosinophil count, and ImmunoCAP analyses for common allergens. For plasma endotoxin levels, kinetic turbidimetric assay and limulus amebocyte lysate reagent were used. Results: The endotoxin levels were significantly higher in children with AD than in controls (0.039 [interquartile range {IQR}, 0.031 to 0.046] EU/mL vs. 0.031 [IQR, 0.019 to 0.035] EU/mL, P<0.05). The endotoxin levels showed a significantly inverse correlation with the disease severity in the extrinsic AD (r=.0.414, P=0.017) but not in the intrinsic AD (r=0.222, P=0.426). No significant correlation was observed between plasma endotoxin levels, serum total eosinophil count, and serum total IgE. Conclusion: Our results suggest that plasma endotoxin level is increased in the AD subjects than in the normal controls and affects the disease severity only in the extrinsic AD subjects. Further studies with larger sample sizes are warranted to investigate whether plasma endotoxin levels have a different effect on the AD severity depending on the presence of atopy. (Allergy Asthma Respir Dis 2014;2:59-63)