개에서 분리한 Staphylococcus aureus와 S. intermedius의 항생제 감수성

변정혜,김태중,Byun, Jeong Hye,Kim, Tae Jung 대한수의학회 2007 大韓獸醫學會誌 Vol.47 No.1

Staphylococci are Gram-positive, facultatively anaerobic cocci, normally found on the skin andmucosal surfaces of most warm-blooded animals and often involved in a wide variety of diseases in animals.Staphylococcal infections are treated with antibiotics and, consequently, antibiotic resistance and/or acquiredresistance have developed. Staphylococcus (S.) intermedius and Staphylococcus (S.) aureus are 2 comonveterinary isolates that are frequently associated with suppurative infections. This study was undertaken toexamine antimicrobial susceptibility of S. aureus (23 isolates) and S. intermedius (160 isolates) isolatedfrom dogs in Gwangju, Korea and investigate whether the antibiotic resistance of S. aureus and S.intermedius is efected by the site of isolation, age, and sex of dogs. More isolates were isolated fromadult dogs (71.3%) than juveniles (20.5%). Antimicrobial resistance was commonly found for Penicillin,Tetracycline, Trimethoprim-Sulphamethoxazole in both Staphylococcus species. All of the isolates weresusceptible to Amoxicillin/Clavulanic Acid, Cephalothin, Oxacilin, Neomycin, and Vancomycin. Appropriateprotocol for antibiotic use and strategies to reduce antimicrobial resistance rate will be needed. Periodicsubstitution of antimicrobial agents and limitation of antibiotic use should also be considered.

소아기 전정편두통

변정혜 대한의사협회 2022 대한의사협회지 Vol.65 No.2

Background: Vestibular migraine and benign paroxysmal vertigo are the most common causes of vertigo in children and adolescents. This is a review of vestibular migraine of childhood dizziness. Current Concepts: In children and adolescents, the symptoms of dizziness or vertigo are not well defined. Thus, few studies have investigated the characteristics of dizziness or vertigo in children and adolescents. Vestibular migraine is categorized as episodic syndromes associated with migraine in the International Classification of Headache Disorders, 3rd edition. Despite vertigo’s various clinical features and duration, vestibular migraine can be diagnosed only when a migraine accompanies vertigo from 5 minutes to 72 hours. Benign paroxysmal vertigo is more common in children and adolescents than vestibular migraine. Benign paroxysmal vertigo is considered one of the precursor syndrome of migraine, and the duration of vertigo is short from seconds to minutes. Discussion and Conclusion: Vestibular migraine is common in older children and adults who need a differential diagnosis. This review might be helpful to diagnose, evaluate, and treat children with vestibular migraine and to reassure their parents.

Cognitive Dysfunction and Hippocampal Damage Induced by Hypoxic-Ischemic Brain Injury and Prolonged Febrile Convulsions in Immature Rats

변정혜,Gun-Ha Kim,김주연,선웅,김현,은백린 대한신경외과학회 2015 Journal of Korean neurosurgical society Vol.58 No.1

Objective : Perinatal hypoxic-ischemic encephalopathy (HIE) and prolonged febrile seizures (pFS) are common neurologic problems that occur during childhood. However, there is insufficient evidence from experimental studies to conclude that pFS directly induces hippocampal injury. We studied cognitive function and histological changes in a rat model and investigated which among pFS, HIE, or a dual pathologic effect is most detrimental to the health of children. Methods : A rat model of HIE at postnatal day (PD) 7 and a pFS model at PD10 were used. Behavioral and cognitive functions were investigated by means of weekly open field tests from postnatal week (PW) 3 to PW7, and by daily testing with the Morris water maze test at PW8. Pathological changes in the hippocampus were observed in the control, pFS, HIE, and HIE+pFS groups at PW9. Results : The HIE priming group showed a seizure-prone state. The Morris water maze test revealed a decline in cognitive function in the HIE and HIE+pFS groups compared with the pFS and control groups. Additionally, the HIE and HIE+pFS groups showed significant hippocampal neuronal damage, astrogliosis, and volume loss, after maturation. The pFS alone induced minimal hippocampal neuronal damage without astrogliosis or volume loss. Conclusion : Our findings suggest that pFS alone causes no considerable memory or behavioral impairment, or cellular change. In contrast, HIE results in lasting memory impairment and neuronal damage, gliosis, and tissue loss. These findings may contribute to the understanding of the developing brain concerning conditions caused by HIE or pFS.

Prevalence, Incidence, and Recurrence of Febrile Seizures in Korean Children Based on National Registry Data

변정혜,김건하,은백린 대한신경과학회 2018 Journal of Clinical Neurology Vol.14 No.1

Background and Purpose Febrile seizures (FS) are the most common type of seizure during childhood, reportedly occurring in 2–5% of children aged 6 months to 5 years. However, there are no national data on the prevalence of FS in Korea. This study determined the prevalence, incidence, and recurrence rates of FS in Korean children using national registry data. Methods The data were collected from the Korea National Health Insurance Review and Assessment Service for 2009–2013. Patients with febrile convulsion as their main diagnosis were enrolled. The overall prevalence of FS in more than 2 million children younger than 5 years was estimated, and the incidence and recurrence rates of FS were determined for children born in 2009. Results The average prevalence of FS in children younger than 5 years based on hospital visit rates in Korea was 6.92% (7.67% for boys and 6.12% for girls). The prevalence peaked in the second to third years of life, at 27.51%. The incidence of FS in children younger than 5 years (mean 4.5 years) was 5.49% (5.89% for boys and 5.06% for girls). The risk of first FS was highest in the second year of life. The overall recurrence rate was 13.04% (13.81% for boys and 12.09% for girls), and a third episode of FS occurred in 3.35%. Conclusions Our study determined the overall prevalence of FS using data for the total population in Korea. The prevalence was comparable to that reported for other countries. Patients with three episodes of FS need to be monitored carefully.

Three cases of pulmonary and/or intestinal tuberculosis in adolescents

변정혜,이윤,이진철,유영,이기형,이광철,정지태,함수연,김철환 대한소아청소년과학회 2007 Clinical and Experimental Pediatrics (CEP) Vol.50 No.11

Since the tuberculosis (TB) in adolescents has unique clinical characteristics, special attention should be paid to this age group. Adolescents are more susceptible to developing TB disease and more likely to have cavitary pulmonary disease. Also, adolescent patients with TB more frequently present with extrapulmonary disease. We report three adolescents with active pulmonary and/or intestinal TB: one had pulmonary and intestinal TB, another had a pulmonary TB, and the third exclusively had an intestinal TB. Diagnosis was confirmed by pathologic examination of the lung and/or intestines. All three patients were treated successfully without complication. A brief review of the literature has been included. 최근 결핵 유병률이 청소년기에 다시 증가하고 있으며, 이 시기의 결핵은 성인이나 어린 소아와는 다른 임상적 특징을 가지고 있다. 결핵 감염에서 질병으로 쉽게 발전되거나, 폐외 결핵의 발생 빈도가 높고, 폐결핵에서 공동이 잘 생기며, 항결핵제에 내성이 있는 경우가 많아 치료실패율이 높기 때문에 조기 진단과 치료를 위해 의료진의 보다 적극적인 관심과 노력이 필요하다. 저자들은 최근 청소년에서 조직검사로 확진된 폐 및 폐외 결핵 3례를 경험하였기에 보고하는 바이다.

Application of Array-Based Comparative Genomic Hybridization to Pediatric Neurologic Diseases

변정혜,은백린,신은심,김건하,이경옥,홍영숙,이주원 연세대학교의과대학 2014 Yonsei medical journal Vol.55 No.1

Purpose: Array comparative genomic hybridization (array-CGH) is a technique used to analyze quantitative increase or decrease of chromosomes by competitive DNA hybridization of patients and controls. This study aimed to evaluate the benefits and yield of array-CGH in comparison with conventional karyotyping in pediatric neurology patients. Materials and Methods: We included 87 patients from the pediatric neurology clinic with at least one of the following features: developmental delay, mental retardation, dysmorphic face, or epilepsy. DNA extracted from patients and controls was hybridized on the Roche NimbleGen 135K oligonucleotide array and compared with G-band karyotyping. The results were analyzed with findings reported in recent publications and internet databases. Results: Chromosome imbalances, including 9 cases detected also by G-band karyotyping, were found in 28 patients (32.2%), and at least 19 of them seemed to be causally related to the abnormal phenotypes. Regarding each clinical symptom, 26.2% of 42 developmental delay patients, 44.4% of 18 mental retardation patients, 42.9% of 28 dysmorphic face patients, and 34.6% of 26 epilepsy patients showed abnormal array results. Conclusion: Although there were relatively small number of tests in patients with pediatric neurologic disease, this study demonstrated that array-CGH is a very useful tool for clinical diagnosis of unknown genome abnormalities performed in pediatric neurology clinics.

Association Between Sensitization to Mold and Impaired Pulmonary Function in Children With Asthma

변정혜,이수현,Oyuntulga Amarsaikhan,김은지,안소현,최익선,김형진,서성철,윤원석,유영 대한천식알레르기학회 2017 Allergy, Asthma & Immunology Research Vol.9 No.6

Purpose: Recent data indicate that sensitization to mold contributes to the severity and persistence of asthma. In this study, we investigated the relationships between sensitization to mold and lung function parameters in children with asthma. Methods: We retrospectively reviewed clinical data from 551 asthmatic subjects. We selected subjects who met clinical diagnostic criteria of asthma. Their spirometry, methacholine challenge tests, and measurements of blood eosinophils, serum IgE, eosinophil cationic protein (ECP) and fractional exhaled nitric oxide (FeNO) results were included. Skin prick testing (SPT) results with 13 common aeroallergens in Korea including house dust mites, animal dander, pollen, cockroach and mold were reviewed. Subjects were divided into 3 groups according to their SPT results. Subjects who showed no positive result to any aeroallergen were designated as group 1 (non-sensitized). Group 2 represented subjects who were sensitized to aeroallergens other than mold (other allergen-sensitized) and group 3 included subjects who were sensitized to mold allergens (mold-sensitized). Results: Among the 551 asthmatic subjects, 67 (12.2%) were sensitized to mold and 366 (66.4%) were sensitized to other aeroallergens. The log mean IgE levels were higher in groups 2 (5.96±1.14 IU/mL) and 3 (5.81±0.97 IU/mL) compared to group 1 (3.88±1.68 IU/mL). Blood eosinophils, ECP and FeNO concentrations were significantly higher in groups 2 and 3, but no significant difference was found between the 2 groups. The mean FEV1 value was significantly lower in group 3 (86.9±12.1%pred) than in groups 2 (92.0±14.8%pred) and 1 (93.4±15.4%pred). The log mean methacholine PC20 was significantly lower in group 3 (0.08±1.91 mg/mL) than in groups 2 (1.31±1.69 mg/mL) and 1 (2.29±1.66 mg/mL). Conclusions: We observed a differential association between mold and other aeroallergen sensitization, and severity of asthma. Sensitization to mold is associated with lower lung function and increased airway hyper-responsiveness in children with asthma. Mold sensitization could be an important factor determining asthma severity particularly airflow limitation in children.

반복적인 천음과 호흡곤란을 보인 영아에서 진단된 선천성 심, 폐기형 3례

남효경,변정혜,장기영,정지태,손창성,함수연,라경숙,최익선,유영 대한 소아알레르기 호흡기학회 2009 Allergy Asthma & Respiratory Disease Vol.19 No.2

천음은 상기도 폐쇄를 시사하는 것으로, 영아기 비감염성 천음의 가장 흔한 원인은 후두연화증이며 이는 증상이 경미하고 대부분 특별한 치료 없이 호전된다. 그러나 천음이 출생 직후부터 나타나거나 지속적이며 호흡곤란이 동반되는 경우에는 심, 폐기형 등 상기도 협착을 일으킬 수 있는 다른 질환의 동반 가능성을 고려하여야 한다. 이러한 심혈관계, 호흡기계의 기형이 있는 경우 천음, 호흡곤란 등의 증상이 호전되지 않고 심한 호흡곤란과 인공호흡기 이탈장애, 사망에까지 이를 수 있어 조기 진단과 치료에 대한 적극적인 노력이 필요하다. Although laryngomalacia is the most common cause of congenital stridor in infancy, it is a benign, self-limited disease which usually resolves by the age of 18 months with no long- term sequelae. Nevertheless, infants who suffered from recurrent stridor and respiratory distress should be evaluated for other causes of stridor such as cardiopulmonary anomalies. We report 3 cases of infants who had recurrent stridor and respiratory distress from their early infancy. Case 1 had a double aortic arch and a tracheomalacia, case 2 had a hypoplasia of the right lung, and case 3 had a horseshoe lung as well as scimitar syndrome. Physicians should be alert for the possibility of the congenital cardiopulmonary abnormalities in infants with recurrent stridor and/or respiratory distress.

천식 환아에서 흡입용 스테로이드의 사용이 골밀도와 골대사에 미치는 영향

최익선,변정혜,이승민,라경숙,오연정,이기형,정지태,유영 대한소아청소년과학회 2009 Clinical and Experimental Pediatrics (CEP) Vol.52 No.7

Purpose : Inhaled corticosteroids (ICS) are used as first-line agents for the treatment of persistent asthma; however, their use is accompanied by apprehension of potential systemic adverse effects. This study aimed to assess the effects of ICS on bone mineral density (BMD) and bone metabolism in children with asthma. Methods : From February 2008 to September 2008, 26 asthmatic children treated with ICS (ICS group), 15 asthmatic children treated with leukotriene receptor antagonist (LTRA) (LTRA group), and 30 healthy children (Control group) were selected from the Korea University Anam Hospital. BMD and serum bone-specific alkaline phosphatase (BALP) levels were measured. The asthmatic children underwent spirometry and methacholine bronchial challenge test. Results : There were no significant differences in BMD in the lumbar spine (P=0.254) and proximal femur (P=0.297) among the 3 groups. The serum BALP levels were significantly higher in both the ICS (P=0.017) and LTRA (P=0.025) groups than in the Control group. None of the parameters pertaining to ICS use, such as the mean daily dose during the last 6 months, the total cumulative dose, duration of use, and age of commencement of use, showed significant correlations with BMD (P>0.05 for all parameters). Conclusions : We demonstrated that a low dose of ICS does not exert any significant adverse effect on bone metabolism in asthmatic children. These findings support the current recommendations with regard to the use of ICS for asthmatic children. 목 적 : 소아 천식에서 흡입용 스테로이드의 장기간 사용이 골밀도와 골대사에 미치는 영향에 대해 알아보고자 하였다. 방 법 : 고려대학교 안암병원 소아청소년과에서 천식으로 진단되어 최소 6개월 이상 ICS를 사용 중인 만 6세에서 12세 사이의 환아(ICS군: 26명)를 대상으로 하였다. 대조군으로 연령 및 성별이 일치하면서 LTRA만을 사용한 천식 환아(LTRA군: 15명)와 골밀도에 영향을 미칠 만한 기저 질환이 없는 정상 소아(정상군: 30명)를 선정하여 이중 에너지 X-선 흡수법으로 요추와 대퇴골 상부에서 골밀도를 측정하고, 골대사에 대한 영향은 혈청 골-특이 알칼리인산효소(BALP)를 측정하여 평가하였다. 결 과 : ICS군의 요추 골밀도는 0.57±0.07 g/cm2으로 LTRA군(0.55±0.06 g/cm2) 및 정상군(0.58±0.07 g/cm2)과 유의한 차이를 보이지 않았고(P=0.254), 대퇴골 상부의 골밀도도 ICS군에서 0.70±0.07 g/cm2로 LTRA군(0.66±0.06 g/cm2)및 정상군(0.70±0.07 g/cm2)과 유의한 차이가 없었다(P=0.297). 골밀도 Z-점수 또한 세 군에서 유의한 차이를 보이지 않았다(요추: ICS군 -0.22±0.78 vs. LTRA군 -0.16±0.47 vs. 정상군 -0.19±0.83, P=0.963; 대퇴골 상부: ICS 군 -0.12±0.93 vs. LTRA군 0.16±0.59 vs. 정상군 -0.04±0.67, P=0.560). 혈청 BALP 농도는 ICS군과 LTRA군에서 정상군에 비해 유의하게 높은 소견을 보였다(P=0.021). ICS군에서 ICS의 최근 6개월간 사용량, 총 축적 용량, 사용 기간, 투여 시작 연령과 골밀도 Z-점수는 유의한 상관관계를 보이지 않았다(모두 P>0.05). 결 론 : 천식 환아에서 저용량의 ICS 사용은 골밀도에 유의한 영향을 미치지 않음을 확인하여, ICS의 부작용에 대한 과도한 우려를 막고 치료 순응도를 높이는데 도움이 될 것으로 생각한다.

Neuroprotective Effect of Lacosamide on Hypoxic-Ischemic Brain Injury in Neonatal Rats

김건하,변정혜,은백린 대한신경과학회 2017 Journal of Clinical Neurology Vol.13 No.2

Background and Purpose Lacosamide (LCM) is an antiepileptic drug that enhances the slow inactivation of sodium channels and modulates collapsin response mediator protein-2. LCM was recently demonstrated to exert a neuroprotective effect in a murine model of trau¬matic brain injury and status epilepticus. Assuming the same underlying excitotoxicity-related brain injury mechanism, we hypothesized that LCM would have a neuroprotective effect in hypoxic-ischemic brain injury. Methods We divided rats into three groups at each testing session: pre- or postfed with LCM, fed with normal saline, and sham. A hypoxic-ischemic brain injury was induced by subjecting 7-day-old rats to right carotid artery coagulation followed by 2.5 h of exposure to 8% oxygen. The animals were killed on postnatal day 12 to evaluate the severity of brain damage. Open field testing was also performed between week 2 and week 6, and the Morris water maze test was performed in week 7 after hypoxia-ischemia. Results The incidence of liquefactive cerebral infarction was lower in rats prefed with LCM at 100 mg/kg/dose, with the mortality rate being higher at higher doses (200 and 300 mg/kg/dose). The infarct areas were smaller in LCM-prefed rats in several brain regions including the hemisphere, hippocampus, cortex, and striatum. Spatial learning and memory function were better in LCM-prefed rats (p<0.05). No effect was observed in postfed rats. Conclusions This study suggests that LCM pretreatment exerts a neuroprotective effect on hypoxia-ischemia in neonatal rats. The obtained results suggest that LCM pretreatment could be used as an effective neuroprotective method for neonates under hypoxic-ischemic condi¬tions including heart surgery.