Lung Abscess and Bacteremia Caused by Neisseria flavescens and Streptococcus sanguis in Patient with Idiopathic Hypereosinophilic Syndrome

공주현,신성현,박수은,박희주,이종윤,김신영,손승국 대한임상미생물학회 2012 Annals of clinical microbiology Vol.15 No.4

Neisseria flavescens has been rarely reported as a pathogen in the literature. We experienced a case of N. flavescens bacteremia and lung abscess co-infected with Streptococcus sanguis in patient with idiopathic hypereosinophilic syndrome. A 15-year-old boy was diagnosed with idiopathic hypereosinophilic syndrome complicated with pulmonary thromboembolism. He was given systemic steroids and thrombolytics. After 8 weeks of therapy, a lung abscess appeared on the plain chest radiograph. We treated him with empirical antibiotics and carried out surgical drainage. Two types of microorganisms were cultured from both blood and pus samples, obtained in the first day of hospitalization. Pus was aspirated from the lung abscess with an aseptic technique. Neisseria species and S. sanguis were identified using traditional methods. To confirm the identity of the Neisseria species, we conducted further testing using 16S ribosomal ribonucleic acid sequencing whereupon N. flavescens was identified. This is the first case report of pulmonary infection caused by N. flavescens. We suggest that N. flavescens may act as a pathogen.

에니어그램 성격유형별 맞춤 독서지도가 청소년의 정서지능과 진로성숙에 미치는 영향 연구

공주현,이명희 한국비블리아학회 2019 한국비블리아학회지 Vol.30 No.4

The purpose of this study was to evaluate the effect of a personalized reading instruction program with customized book selection for adolescents based on their personalities on their emotional intelligence and vocational maturity. The Enneagram personality test was utilized for selecting books based on the students’ personalities and the effect of the reading instruction program was assessed using pre- and post-tests. The findings of the study revealed that the personalized reading instruction program was effective in improving emotional intelligence and vocational maturity for students with Ennneagram personality type 6. In addition, a qualitative analysis was conducted to investigate the participants’ satisfaction level and their personal opinions. For future studies, independent research with a larger population and appropriate reading time based on each Enneagram personality type is suggested. 본 연구는 에니어그램을 이용하여 청소년들의 성격유형별로 맞춤도서를 선정하여 독서지도 프로그램을 실시하였을 때, 정서지능 및 진로성숙도에 긍정적인 영향을 미치는가를 사전-사후 검사를 실시하여 효과를 측정하였다. 에니어그램 성격유형 6번 유형의 학생을 대상으로 맞춤독서 프로그램을 시행하고 정서지능 검사와 진로성숙도 검사를 실시하였을 때, 정서지능과 진로성숙에 긍정적 효과가 있음을 발견하였다. 또한, 피험자들의 만족도 조사와 개인적 의견의 질적분석을 수행하였다. 후속연구에서는 규모의 학생 수를 확보한 프로그램 진행, 프로그램 진행시 적절한 독서시간 확보, 에니어그램 성격유형별 단독연구 실행이 제언되었다.

[P8-95] Allergen에 의해 유도된 기도상피세포의 알레르기성 천식에 대한 kaempferol의 효과

공주현,강영희 한국식품영양과학회 2010 한국식품영양과학회 학술대회발표집 Vol.2010 No.10

뇌전증 소아에서 독립보행 병력의 임상적인 의미

공주현(Ju Hyun Kong),서혜경(Hye Kyung Seo),연규민(Gyu Min Yeon),이윤진(Yun Jin Lee),김영미(Young Mi Kim),남상욱(Sang Ook Nam) 대한소아신경학회 2012 대한소아신경학회지 Vol.20 No.3

목 적 : 발달력은 소아뇌전증 환자의 평가에서 중요한 부분이지만 나이가 든 소아나 청소년에서는 부모의 기억력이 불완전하여 정확한 정보를 얻는 것은 힘든 경우가 많다. 이 연구는 발달력 중 부모가 가장 잘 기억하는 독립보행의 시기에 대한 병력이 뇌전증환자의 임상적 특징과 검사소견 및 치료반응을 예측하는 데 유용한 의미가 있는지 알아보고자 시행하였다. 방 법 : 2000년 1월 1일부터 2007년 12월 31일까지 부산대학병원 소아청소년과에서 뇌전증으로 진단받고 1년 이상 항경련제 치료를 받은 262명의 환자를 대상으로 하였다. 독립보행에 대한 병력청취상에서 생후 18개월 이전에 독립보행을 한 환자는 정상군으로, 18개월 이후에 독립보행을 한 환자는 지연군으로 나누어 임상적 특징과 뇌파검사, 치료에 대한 반응을 비교하였다. 결 과 : 정상군은 241명(92%), 지연군은 21명(8%)이었다. 성별과 발작의 양상, 뇌전증의 가족력은 양 군간에 차이가 없었다. 첫 발작 나이(5.6±2.2세:2.2±1.4세)와 뇌전증으로 진단받은 나이(7.0±3.3세, 3.2±2.2세)는 지연군에서 더 빨랐다( P<0.001). 또한 지연군에서 제왕절개 출생과 재태주수 37주 미만의 미숙아로 태어난 경우가 많았다(25%:52%, P=0.010; 6%:29%, P<0.001). 뇌자기공명영상검사에서 뇌병변이 관찰된 경우도 정상군이 19%, 지연군이 86%로 지연군에서 의미 있게 많았다( P<0.001). 치료 시작시 뇌파에서 간질양파의 출현은 양 군간에 차이가 없었으나(72%:90%), 배경파의 이상은 지연군에서 의미있게 많았다(15%:81%, P<0.001). 반면에 항경련제 치료 1년 후 추적 관찰한 뇌파 검사에서는 간질양파 출현과 배경파 이상이 모두 지연군에서 높게 나타났다(60%:90%, P=0.004, 14%:67%, P<0.001). 발작관해 환자의 비율은 정상군에서 122명(51%), 지연군에서 8명(38%)이었으나 의미 있는 차이는 없었다. 결 론 : 영유아 발달의 항목 중에서 특히 중요한 지표가 되는 독립보행의 시기에 대한 병력청취는 뇌전증 환자의 임상적 특성을 파악하고 뇌파검사와 뇌영상검사의 소견을 예측하는데 적지 않은 도움을 주므로 청소년의 포함한 모든 소아 뇌전증 환자의 병력을 청취할 때 필수적으로 시행하기를 적극 권장하는 바이다. Purpose : The developmental history is an important element in the evaluation of children with epilepsy. However, obtaining accurate information from history is often very difficult especially in older children because of their parents’ incomplete recollection. This study was aimed to investigate if the timing of independent walking has a valuable clinical significance in children with epilepsy. Methods : We classified 262 patients with epilepsy into normal and delayed groups from a history of the timing of independent walking at 18 months as a cutoff point. We compared their clinical and laboratory characteristics between two groups. Results : Out of 262 patients, twenty one (8%) were delayed. There was no difference in seizure types between two groups. The Age of seizure onset and diagnosis of epilepsy was earlier in delayed group (5.6:2.2 years, P<0.001; 7.0:3.2 years, P<0.001). The proportion of Cesarean section and preterm delivery were also higher in delayed group (25%:52%, P= 0.010; 6%:29%, P<0.001). Abnormal MRI findings were more frequent in the delayed group(19%:86%, P<0.001). EEG at diagnosis showed no difference in epileptic form discharges, but background abnormality was more common in the delayed group (15%:81%, P<0.001). EEG at 1 year after the diagnosis showed both epileptic form discharges and background abnormality were more frequent in the delayed group (60%:90%, P=0.004; 14%:67%, P<0.001). Conclusion : Based on the result of this study, we strongly recommended that we should take a history of the timing of independent walking in children and adolescents with epilepsy.

Kaempferol을 활용한 항알레르기 육제품의 제조 방안

신대근,공주현,정이형,Shin, Daekeun,Gong, Ju-Hyun,Chung, Yi Hyung 한국축산식품학회 2013 축산식품과학과 산업 Vol.2 No.2

산화스트레스에 의한 알레르기성 천식을 완화시킬 수 있는 아스 트라갈린(Astragalin: kaempferol-3-O-glucopyranoside)의 분자영양학적 기전연구

조인희,공주현,강영희 한국식품영양과학회 2012 한국식품영양과학회 학술대회발표집 Vol.2012 No.10

엉겅퀴 추출물과 silibinin이 난소절제 쥐의 골밀도에 미치는 효과

김윤호,공주현,강영희 한국식품영양과학회 2012 한국식품영양과학회 학술대회발표집 Vol.2012 No.10

Herpes Zoster with Aseptic Meningitis in Immunocompetent Children: A Case Series

장현지,유혜원,윤리라,공주현,이윤진,남상욱,김영미 대한소아신경학회 2017 대한소아신경학회지 Vol.25 No.4

Primary clinical features of rash and neurological complications due to varicella zoster virus (VZV) reactivation are rare in a healthy population, especially in immunocompetent children. Early diagnosis and prompt treatment are delayed often due to their rarity. We present four immunocompetent children with VZV reactivation resulting in aseptic meningitis and herpes zoster affecting multiple cranial and spinal nerves. We reviewed the clinical manifestations, laboratory findings, treatment options and outcome of aseptic meningitis associated VZV reactivation. All patients presented with the typical skin lesion of VZV reactivation and definitive laboratory findings of central nervous system infection, without systemic inflammation. Initial manifestations of VZV reactivation included Ramsay Hunt syndrome, herpes zoster ophthalmicus, and herpes zoster affecting the left thoracic dermatomes 4-5. Intravenous acyclovir was administered and all patients recovered fully without any significant sequelae. VZV reactivation can lead to various neurological complications in immunocompetent children. Early recognition and treatment with acyclovir are important for improving the outcome of neurologic complications of VZV reactivation.

소아뇌전증에서 Levetiracetam 부가요법에 따른 경련 증가: 단일 기관 경험

김영미(Young Mi Kim),윤리라(Lira Yoon),공주현(Ju Hyun Kong),연규민(Gyu Min Yeon),이윤진(Yunjin Lee),남상욱(Sang Ook Nam) 대한소아신경학회 2017 대한소아신경학회지 Vol.25 No.3

Purpose: The aim of this study is to evaluate the prevalence and risk factors of seizure aggravation of adjunctive levetiracetam therapy in children with epilepsy. Methods: We retrospectively identified 125 children (0.3-18 years) with epilepsy who were newly treated with adjunctive levetiracetam therapy from November 2008 to July 2014 in Pusan National University Hospital, and 44 patients were excluded according to the exclusion criteria. Aggravation was diagnosed if the seizure frequency increased by more than 50% of baseline or there were new types of seizures after 1 month of adjunctive levetiracetam therapy. Results: Eighty-one patients (male:female, 44:37) were enrolled, including 27 (33.5%) with generalized seizures and 54 (66.7%) with focal seizures. Twelve patients (14.8%) exhibited seizure aggravation and 69 patients (85.2%) had improvement or no change after 1 month of levetiracetam therapy. Eleven patients (91.7%) in seizure aggravation group and 16 patients (23.2%) in non-seizure aggravation group had generalized seizures, with aggravation significantly more frequent in patients with generalized seizures (P < 0.001). Other factors such as age at diagnosis, age at adding levetiracetam, sex, baseline seizure frequency, etiology, electroencephalography and magnetic resonance imaging abnormalities, and concomitant drug use were not identified as risk factors. Conclusion: Although levetiracetam is an effective antiepileptic drug in children with epilepsy, adjunctive levetiracetam therapy was associated with worsening of seizures in 14.8 % of included patients, especially those with generalized seizures. Careful monitoring for increased seizure frequency or the onset of a new type of seizures is advised for patients prescribed levetiracetam add-on treatment.

소아 중추 및 말초신경계의 급성 병합 탈수초질환

변정희(Joung-Hee Byun),송지연(Ji-Yeon Song),공주현(Juhyun Kong),남상욱(Sang-Ook Nam),김영미(Young Mi Kim),연규민(Gyu Min Yeon),이윤진(Yun-Jin Lee) 대한소아신경학회 2017 대한소아신경학회지 Vol.25 No.2

목적: 본 연구는 소아 중추 및 말초신경계의 급성 병합 탈수초 질환의 발병률과 임상적 특징을 조사하고, 중추 혹은 말초신경계의 단독 탈수초질환과의 비교 분석을 하고자 하였다. 방법: 부산대어린이병원에서 2010년부터 2015년 사이에 급성 탈수 초질환 소아들의 의무기록을 후향적으로 조사하였다. 임상증상, 자기 공명영상 및 신경전도검사 소견을 바탕으로 진단 기준에 합당한 96명을 선정하였다. 이들을 중추신경계 단독 탈수초질환군(A군, 60명), 말 초신경계 단독 탈수초질환군(B군, 30명), 그리고 병합 탈수초질환군 (C군, 6명)으로 분류하였다. 결과: 세 군 사이 비교분석을 하였고, 2013­2015년 동안의 발병율 (A군, 45.0%; B군, 43.3%; C군, 83.3%; P =0.024), 중환자실 입실 비율 (A군, 8.3%; B군, 26.7%; C군, 50.0%; P =0.027), 전체 입원 기간(A군, 9.7±11.2일; B군, 12.3±18.7일; C군, 48.3±51.2일; P =0.75), 스테로이 드 치료(A군, 88.3%; B군, 10.0%; C군, 100.0%; P =0.003), 면역글로불 린 투여(A군, 13.3%; B군, 100.0%; C군, 100.0%; P =0.002), 혈장교환술 시행(A군, 0.0%; B군, 3.3%; C군, 50.0%; P =0.037; P =0.037) 그리고 퇴원시 심각한 활동 장애 비율(A군, 3.3%; B군, 16.7%; C군, 33.3%; P =0.012)에서 의미 있는 차이가 있었다. 결론: 급성 탈수초질환 추정되는 경우에, 병합 탈수초질환군이 단독 탈수초질환군에 비해 불량한 경과를 보일 수 있으므로, 신경영상 및 신경전도검사 등의 광범위한 검사를 통해 병합 탈수초질환에 대한 정확한 진단과 신속한 치료를 함으로써, 비가역적인 신경학적 후유증 을 방지할 수 있겠다. Purpose: This study aimed to describe the clinical characteristics and outcomes of children with acute combined central and peripheral nervous system demyelination (CCPD); and compare with the children of isolated acute central or peripheral nervous system demyelination. Methods: A retrospective chart review of 145 children with acute demyelinating disease between 2010 and 2015 was undertaken in children with younger than 18 years old. Among these, 96 fulfilled criteria (clinical features and positive neuroimaging or electromyography/nerve conduction studies) for either acute central (group A, n=60, 62.5%) or peripheral (group B, n=30, 31.3%) nervous system demyelination, or a CCPD (group C, n=6, 6.3%). Results: Significant differences among the groups (A vs B vs C) were evident for occurrence of disease between 2013-2015 (45.0% vs 43.3% vs 83.3%; P=0.024), admission to intensive care unit (8.3% vs 26.7% vs 50.0%; P=0.027), length of hospitalization (median, 9.7 vs 12.3 vs 48.3 days; P<0.001), treatment with steroids (88.3% vs 10.0 vs 100.0%; P=0.003), immunoglobulins (13.3% vs 100.0% vs 100.0%; P=0.002) and plasmapheresis (0.0% vs 3.3% vs 50.0%; P=0.037) and severe disability at discharge (3.3% vs 16.7% vs 33.3%; P=0.012). Children of group C showed good response to simultaneous use of immunoglobulin and high-dose corticosteroids and earlier try of plasmapheresis, however, two patients had moderate degree of neurological disability. Conclusion: Systemic studies using neuroimaing and electromyography/nerve conduction studies in all patients with demyelinating disease will be necessary to verify the combined or isolated disease, because CCPD might have the poorer outcome than isolated disease.