제 10 차 춘계학술대회 : 일반연제 : 대장 ; 일반 항문직장내압검사와 3차원 방사항문직장내압검사를 이용한 소아항문기능의 평가

배선환,정주영,고재성,박귀원,서정기 대한소화관운동학회 2000 대한소화관운동학회 춘계학술대회 Vol.10 No.-

Long-term safety of PEG 4000 in children with chronic functional constipation: A biochemical perspective

배선환 대한소아청소년과학회 2010 Clinical and Experimental Pediatrics (CEP) Vol.53 No.7

Purpose: To evaluate the long-term safety of polyethylene glycol (PEG) 4000 in children with constipation, particularly the biochemical aspects of safety. Methods: Medical records were evaluated, and 100 children, who had been taking PEG 4000 for more than 6 months, and who had been under clinical and biochemical monitoring, were enrolled. Ages;6.11±3.12 years, Duration of therapy; 16.93±7.02 months, dose of PEG 4000; 0.72±0.21 g/kg/d. Results: None of the children complained of clinical adverse effect. The first biochemical test was performed at 8.05 months after beginning of PEG 4000. Serum phosphate (SP) value was high in 10children, and leucopenia was noted in one child. The second test was performed in 44 children at 7.57 months after the first test. The SP value was high in four children, including the three children whose initial SP value was high and one new child. Six out of 10 children with high initial SP value became normal and one was lost. Hypernatremia was noted in one child. The third test was done in 15 children at 7.5months after the second test. The SP value of the new child from the second test was high, but became normal after finishing treatment. Two out of 3 children with high SP value at the second test became normal and one was lost. The fourth test was done in 2 children few months after the third test. All of the results were normal. There were no relation between duration of therapy and hyperphosphatemia, or between dose of PEG 4000 and hyperphosphatemia. Conclusions: PEG 4000 is safe for long-term therapy in children with constipation with respect to biochemical parameters.

Diets for Constipation

배선환 대한소아소화기영양학회 2014 Pediatric gastroenterology, hepatology & nutrition Vol.17 No.4

Chronic constipation is a very common disease in children. Successful treatment of constipation can be achieved not only with medication but also with lifestyle changes, including a proper diet. Diets including fruits, fluids, and probiotics are good for constipation. Some dietary components are helpful for constipation, and some are harmful. In this study, we present diets related to constipation from the literature, and propose some perspectives regarding diets related to constipation.

소아 변비 치료에서 약물사용

배선환,Bae, Sun Hwan 대한소아소화기영양학회 2009 Pediatric gastroenterology, hepatology & nutrition Vol.12 No.suppl1

Constipation is one of the most common symptoms that a child visits pediatrician. The general approach to the child with functional constipation includes the following steps; disimpaction, maintenance and withdrawal of medication. There are many drugs which can be applied to children; osmotic agents (lactulose, sorbitol, magnesium hydroxide/citrate, polyethylene glycol with/without electrolytes, sodium phosphate, glycerin), stimulants (senna, bisacodyl, caster oil), lubricant (mineral oil), bulking agent (psyllium, cellulose, glucomannan). At each stage of treatment, one or some of these drug can be applied to the purpose. The author tries to summarize recent studies on drugs for constipation in child, and finally introduces new dugs for constipation which is under investigation.

소아에서 소용량 아스피린의 장기간 사용에 의한 위.장관 출혈 위험성에 대한 연구

배선환,손동우,박경희,Bae, Sun-Hwan,Son, Dong-Woo,Park, Kyung-Hee 대한소아소화기영양학회 2003 Pediatric gastroenterology, hepatology & nutrition Vol.6 No.1

목 적: 아스피린을 비롯한 NSAID의 사용이 위장관 출혈 등 여러 가지 위 장관합병증의 위험성을 증가시키는 것은 이미 잘 알려진 사실이다. 소아에서 염증성 질환이나 해열제로 사용하는 통상용량의 아스피린보다 10분의 1정도의 소용량을 사용하는 경우가 종종 있으나, 이와 연관된 위 장관 출혈의 위험성에 대한 연구는 거의 없다. 이에 저자들은 Kawasaki병으로 아스피린을 사용한 소아들을 대상으로 소용량 아스피린의 장기적 사용에 의한 위 장관 출혈의 위험성을 평가하고자 하였다. 방 법: 1995년부터 2001년 5월까지 을지병원 소아과에서 Kawasaki병으로 진단받고 입원 치료하였던 소아가운데, 임상 기록을 확인하고 보호자와 전화통화를 하여 위장관 출혈 여부를 확인할 수 있었던 소아 100명을 대상으로 하였다. 위 장관 출혈 여부는 환아의 임상 기록을 확인하고, 보호자와 직접 전화 인터뷰를 하여 소용량 아스피린 투여시 육안적 토혈, 혈변의 유무를 물어서 확인하였다. 결 과: 모두 100명의 환아가 연구 대상에 포함되었으며, 남아 63명, 여아 37명으로 이들이 아스피린 투약을 시작할 때 연령은 4~118개월이었으며, 약 75%의 환아가 3세 미만이었다. 아스피린 투약기간은 0.5~17개월로 나타났으며, 약 70%의 환아가 2~3개월 간의 투약을 시행하였다. 한 명의 환아에서 육안적 혈변이 발생하였는데, 환아는 투약 당시 18개월된 여아로 투약 1개월경 하루 한번 씩 약 1주일간 육안적 혈변을 보았으나, 복통이나 다른 증상은 동반되지 않았다. 혈변은 씨메티딘을 약 1주일간 사용한 후 호전되었으며, 이후 씨메티딘을 사용하지 않으며, 아스피린 투약을 약 3개월 가량 더 지속하였으나 더 이상의 출혈은 없었다. 100명의 환아가 총 341.5개월 동안 아스피린을 투여하였으며, 이 가운데 한 명만이 육안적 장출혈을 보여, 이를 100명의 환아가 일년동안 소용량 아스피린을 먹은 것으로 환산하면 3.5회/100명/1년의 비율로 장출혈이 발생하는 것을 의미하게 된다. 결 론: 소아에서 소용량 아스피린의 장기적 사용은 안전하나, 위 장관 출혈의 위험성을 높일 수 있으므로 해당 환아에 대한 세심한 추적관찰이 필요하며, 위 장관 출혈의 위험성을 감소시켜주기 위한 다양한 노력이 병행되어야 할 것이다. Purpose: To evaluate the risk of gastrointestinal bleeding associated with use of low-dose aspirin in children. Methods: Among about 250 children who received low-dose aspirin (5 mg/kg/day) under the diagnosis of Kawasaki disease, from March 1995 to May 2001, at Eul-Ji general hospital, 100 children were enrolled in this study. We reviewed the medical records and interviewed the children's parents over the phone to confirm the existence of gross gastrointestinal bleeding. Results: The age of the children at the beginning of medication ranged 4~118 months. About 75% of them was younger than 3 years old. The duration of medication ranged 0.5~17 months. About 70% of the children took the medicine for 2~3 months. Only 1 child (1%) had hematochezia during medication without any accompanying gastrointestinal symptom, and cimetidine for 1 week had cleared up the bleeding. The total duration of medication of 100 children was 341.5 months, and only 1 child had gastrointestinal bleeding. This translates into a rate of clinically significant gastrointestinal bleeding of 3.5 episodes/100 children/year. Conclusion: The long-term use of low-dose aspirin is safe, but, is associated with the risk of gastrointestinal bleeding in children. Careful follow-up and efforts to reduce the risk of gastrointestinal bleeding are necessary during long-term low-dose aspirin therapy in children.

수술 후 임상증상이 호전된 간경화를 합병한 2세 여아에서의 총수담관낭 1례

배선환 대한소아청소년과학회 2005 Clinical and Experimental Pediatrics (CEP) Vol.48 No.1

Choledochal cyst is considered to be congenital anomalies of the biliary tract, characterized by varying degrees of cystic dilatation at various segments of the biliary tract. A 20-month-old girl was admitted to Eul-Ji general hospital because of abdominal distension. Physical examination revealed marked splenomegaly and hepatomegaly with nodular surface and hard consistency. Laboratory examination showed elevated transaminase level, alkaline phosphatase level and gamma glutamyltranspeptidase level without evidence of cholestasis. Diagnostic imaging study revealed choledochal cyst with Todani classification type 1. Cholecystectomy and Roux-en-Y choledochojejunostomy was performed, and wedge liver biopsy showed diffuse periportal fibrosis with cirrhotic change and ductular proliferation in the portal area. After operation, hepatosplenomegaly and abnormal laboratory examinations improved rapidly, and in 9 months, the liver and spleen became not palpable. We experienced a case of choledochal cyst complicated by liver cirrhosis on pathology in a 20 month-old girl, and removal of choledochal cyst improved clinical manifestations rapidly. 저자들은 20개월 유아에서 복통이나 담즙정체 등의 특이 증상이 동반되지 않으면서도 간, 비장종대를 동반하고 간 조직검사에서 간경화가 있었으나, 종괴제거 수술 후 간기능검사 뿐 아니라 간, 비장 종대가 급격하게 해결된 총수담관낭을 경험하였다. 총수담관낭을 조기에 발견하여 적절하게 제거하는 것이 간기능검사의 호전 뿐 아니라 조직학적으로 입증된 간경화를 호전시키는 데에도 중요함을 시사한다고 하겠다.

Recent Achievements in Stem Cell Therapy for Pediatric Gastrointestinal Tract Disease

배선환 대한소아소화기영양학회 2013 Pediatric gastroenterology, hepatology & nutrition Vol.16 No.1

The field of stem cell research has been rapidly expanding. Although the clinical usefulness of research remainsto be ascertained through human trials, the use of stem cells as a therapeutic option for currently disabling diseasesholds fascinating potential. Many pediatric gastrointestinal tract diseases have defect in enterocytes, enteric nervoussystem cells, smooth muscles, and interstitial cells of Cajal. Various kinds of therapeutic trials using stem cells couldbe applied to these diseases. This review article focuses on the recent achievements in stem cell applications forpediatric gastrointestinal tract diseases. (Pediatr Gastroenterol Hepatol Nutr 2013; 16: 10∼16)

리튬전지 제거 후 합병된 식도궤양과 가성식도게실 1례

배선환 대한소아소화기영양학회 2003 Pediatric gastroenterology, hepatology & nutrition Vol.6 No.1

Omega-3 Polyunsaturated Fatty Acid for Cholestasis due to BileDuct Paucity

배선환,박희선,한혜승,윤익진 대한소아소화기영양학회 2014 Pediatric gastroenterology, hepatology & nutrition Vol.17 No.2

Omega (ω)-3 polyunsaturated fatty acids appear to be effective in preventing and treating parenteral nu-trition-associated liver disease, and several mechanisms were proposed for this observation. An 8-week-old male infant with cholestasis and acholic stool was diagnosed non-syndromic intrahepatic interlobular bile duct paucity by open-wedge liver biopsy. Initially he was treated with usual supportive medical therapy, including ursodeoxycholic acid. However, the clinical status and laboratory tests did not improve. Omega (ω)-3 polyunsaturated fatty acids (initially intravenous administration and oral administration later), were started and his liver function, including amino-transferase level and bilirubin levels normalized, and the ivory stool color turned green. We report the possible effec-tiveness of ω-3 polyunsaturated fatty acids as a potent choleretic agent for non-syndromic intrahepatic interlobular bile duct paucity, a very rare structural pediatric hepatic disease.

釜山地域 草本植物 調査報告

洪淳馨,裵先煥 부산대학교 환경문제 연구소 1987 環境硏究報 Vol.5 No.-

1985. 7∼1987. 1까지 4次에 걸쳐 釜山一帶의 草本植物을 調査하였으며 그 結果는 다음과 같다. 1. 釜山地域 草本植物은 125科 876種이었으며 그 中에 762種, 5亞種, 97變種, 12品種을 包含하여 自生種은 647種, 植栽種은 218種, 歸化種은 11種이었다. 2. 多大浦 海岸砂丘에 갯메꽃(Calystegia soldanella), 갯완두(Lathyrus davidii)가 群落를 이루고 있었고, 影島, 太宗臺 海岸 숲속에도 맥문동(Liriope muscari BAIL var. communis NAKAI) 群落이 良好하게 保存되고 있었다. 3. 釜山地域은 最寒月(1月)도 平均零上의 氣溫을 나타내어 溫暖하며, 雨量이 많아 草本植物 生育에 좋은 條件을 갖추고 있었고, 他地域에 比較하여 海岸性 草本植物이 豊富하였다. The herbaceous plants extended Pusan Area were investigated for four times from July 1985 January 1987 periodically and the results can be summarized as follow; 1. The herbaceous plants invstigated in Pusan Area were found to be 125 families. 876 Kinds(762 species, 5 subspecies, 97 varieties and 12 forms). There were 647 natives, 218 planting and 11 naturalized among 876 kinds. 2. Calysegia soldanella and Lathyrus davidii formed the communities in Ta Dae Po sand dune and the community of Liriope muscari has been preserved well at Tae Jong Dae Forest. 3. The temperature of Pusan Area was warm and above 0℃ even in the coldest month(Jan.). The annual precipitation was abundant, so it had a comfortable condition for growing the herbaceous plants. Pusan Area, compared with other area, was a region dominant in the coastal herbaceous plants.