2009년 새롭게 개편된 국내 급성이완성마비 감시체계

빈중현(Joong Hyun, Bin),김영훈(Young Hoon, Kim) 대한소아신경학회 2009 대한소아신경학회지 Vol.17 No.2

After global eradication of smallpox, the World Health Organization(WHO) launched a campaign to eradicate polio. In 2008 December, Global Polio Eradication Initiative(GPEI) Strategic Plan 2009-2013 was declared, and movements to reorganize the acute flaccid paralysis(AFP) surveillance were also started in South Korea. The Korea Center for Disease Control and Prevention set out to intensify the AFP surveillance by rearranging the centers to hospitals with neurology and pediatric neurology specialists, actively promoting surveillance, and modifying the transportation system of samples. This article provides a comprehensive review of newly reorganized AFP surveillance.

최근 5년간의 신생아 고빌리루빈혈증 및 청각유발 전위검사 결과의 변화

빈중현 ( Joong Hyun Bin ),김소영 ( So Young Kim ) 대한주산의학회 2007 Perinatology Vol.18 No.4

Objective: The purpose of this study was to identify the current trends of the incidence of hyperbilirubinemia and the results of the auditory evoked potential and to evaluate the correlation with early and late evidence of bilirubin-induced brain injury. Methods: We reviewed the medical records of all neonates who were admitted to the Holy family hospital of CUMC exclusively for management of neonatal jaundice from January, 2002 to December, 2006. The gestational age, the age at peak bilirubin level, the peak bilirubin level, feeding method and brainstem auditory-evoked potential (AEP) were reviewed. Results: We investigated 121 term and 101 preterm infants treated for management of neonatal jaundice. The mean peak bilirubin values of term and preterm infants were 22.7±0.5 and 13.7±0.3 mg/dL. The mean age at peak bilirubin level of term and preterm infants were 7.5±0.5 and 4.7±0.2 days. All were breastfed (46.3% vs. 30.7%) or fed a combination of breast and bottle feedings (53.7% vs. 44.5%) in term and preterm infants. Comparison of peak bilirubin levels and age at peak bilirubin level in the serum of term and preterm group with AEP results showed no significant relationship. Trend in peak serum indirect bilirubin level in term infants were significantly increased in the recent 3 years. Trend in AEP abnormality showed no significant changes during the study periods. Only two preterm infant showed abnormal AEP at follow up study. Conclusion: Recently, increased frequency of breast-feeding, shortened hospital stays, and inconsistent follow-up after hospital discharge may cause the increased incidence of severe hyperbilirubinemia in healthy preterm and term newborn infants. But it is not clear such early onset hyperbilirubinemia may cause acute bilirubin encephalopathy or permanent brain injury.

결신 발작에서 이차 약제로서 Valproate와 Lamotrigine의 치료 효과

빈중현(Joong Hyun Bin),박선영(Sun Young Park),한지윤(Ji Yoon Han),엄태훈(Tae Hoon Eom),김성준(Seong Joon Kim),김영훈(Young Hoon Kim),이인구(In Goo Lee),정승연(Seung Yun Chung) 대한소아신경학회 2014 대한소아신경학회지 Vol.22 No.2

목적: ESX로 치료하고 잘 조절되고 있던 소아청소년기 결신 발작환자에서 ESX 치료가 중단되어 VPA와 LTG로 대체하였을 때 치료 효과를 비교하고자 하였다. 방법: 2010년 1월부터 2012년 12월까지 가톨릭대학교 서울성모병원, 인천성모병원, 부천성모병원, 의정부성모병원, 성빈센트병원 소아청소년과를 통해 소아청소년기 결신 발작으로 진단 받고 일차 치료제로 ESX를 사용하였다가 ESX 사용 중단으로 이차 치료제인 VPA와 LTG로 대체한 34명의 환자를 대상으로 하였다. 소아청소년기 결신발작의 임상양상과 특징적인 뇌파 소견을 기준으로 선정하였고 치료약제 변경에 따른 발작 감소율과 약제에 대한 부작용 등을 후향적으로 조사하였다. 결과: 전체 34명의 환자 중 17명(50.0%)이 이차 치료제로 VPA를, 17명(50.0%)이 LTG를 사용하였다. 이차 치료제로 치료 시작 후 3개월 동안 발작이 완전히 조절된 환자는 전체 20명(58.8%)이였고, 이중 VPA로 치료 받은 환자는 13명(76.5%), LTG로 치료 받은 환자는 7명(41.2%)이었다. 이차 치료제를 사용하였으나 발작이 잘 조절되지 않거나 부작용에 의해 다른 약으로 대체한 경우는 이차 치료제로 VPA 치료한 환자는 4명(23.5%), LTG로 치료한 환자는 10명(58.8%)이었다. 이차 치료제로 VPA와 LTG를 사용하여 3개월 동안 발작이 완전히 조절되는 치료 효과를 비교하였을 때 VPA가 LTG에 비해 더 좋은 결과를 보였다(P=0.04). 결론: ESX로 치료하고 잘 조절되고 있던 소아청소년기 결신 발작환자에서 부득이한 이유로 ESX를 사용할 수 없을 때 이차 치료제로 VPA 사용이 추천된다. Purpose: Ethosuximide (ESX) is currently not available due to various reasons in Korea. The aim of this study is to compare the efficacy of valproate (VPA) and lamotrigine (LTG) when ESX monotherapy was replaced by VPA or LTG. Methods: A retrospective study was done for a total of 34 patients treated with ESX in 5 different hospitals affiliated with Catholic University of Korea from January, 2010 to December, 2012. They all were initially treated with ESX, but later switched to VPA or LTG. The subjects were selected based on clinical symptoms and electroencephalography findings. Results: Among 34 patients, VPA was prescribed to 17 patients (50.0%) and LTG to 17 patients (50.0%). Twenty patients (58.8%) achieved the seizure freedom after 3 months of the treatments, 13 patients (76.5%) by VPA and 7 (41.2%) by LTG respectively. Four patients (23.5%) with VPA and 10 (58.8%) with LTG were replaced by other anticonvulsants due to ineffectiveness and/or side effects of medication. When we compare the efficacy of seizure reduction between VPA and LTG after 3 month period of the treatment, the efficacy of VPA was better than that of LTG (P=0.04). Conclusion: The results of this study suggest that the VPA is a better alternative anticonvulsant than LTG for the patients with absence epilepsy who are unable to continue ESX.

소아 일차 두통에서 성별, 나이, 가족력, 어깨 통증의 영향

나현주(Hyun Ju Na),김주현(Joo Hyun Kim),박선영(Sun Young Park),한지윤(Ji Yoon Han),엄태훈(Tae Hoon Eom),빈중현(Joong Hyun Bin),김영훈(Young Hoon Kim),이인구(In Goo Lee),정승연(Seung Yun Chung) 대한소아신경학회 2015 대한소아신경학회지 Vol.23 No.2

목적: 소아 일차 두통에서 성별, 나이, 가족력, 어깨 통증의 영향을 알아보고자 하였다. 방법: 2009년 1월부터 2013년 12월까지 가톨릭대학교 인천성모병원에 두통으로 내원한 319명의 환자를 대상으로 의무기록을 후향적으로 분석하였다. 결과: 두통으로 내원한 환자는 319명이고 이 중 97명이 편두통, 98명이 긴장형 두통으로 진단되었다. 전조 동반 편두통은 35명이였고, 전조 동반하지 않은 편두통은 62명이였다. 두통 환자의 평균 나이는 10.9세였고, 전조 동반한 편두통 환자의 평균 나이는 13.1세(P<0.01)로 다른 두통 환자에 비해 나이가 많았다. 남자 환자는 121명, 여자 환자는 198명으로 남녀 비는 1:1.64였다. 전조 동반한 편두통 환자에서 남녀 비는 1:3.38(P=0.04)로 다른 두통 환자에 비해 여자가 많았다. 어깨 통증 있는 두통 환자는 37.9%였고, 질환에 따른 유의한 차이는 없었다. 두통의 가족력을 가진 환자는 32.3%였고, 질환에 따른 유의한 차이는 없었다. 편두통의 가족력을 가진 환자는 13.2%였고, 전조를 동반하지 않은 편두통 환자는 25.8%(P<0.01)로 다른 두통 환자에 비해 많았다. 엄마의 두통 경력이 있는 환자는 22.6%였고, 전조를 동반하지 않은 편두통 환자는 32.3%(P=0.03)으로 다른 환자에 비해 많았다. 결론: 연령이 많은 환자가 두통에서 차지하는 비중이 높았다. 두통 환자에서 연령이 증가함에 따라 여자가 많아졌다. 전조를 동반한 편두통 환자는 다른 두통 환자에 비해 나이가 많고, 여자가 많았다. 전조를 동반하지 않은 편두통 환자는 다른 두통 환자에 비해 편두통의 가족력이 있는 경우가 많았고, 엄마의 두통 경력이 있는 경우가 많았다. Purpose: Headache is recognized as a common health problem in children and adolescents. We analyzed migraine and tension type headache by sex, age, family history and shoulder pain to find factors influencing each type of headache. Method: This retrospective study was conducted in total 319 patients with headache, who were brought to the Department of Pediatrics of Catholic University Incheon Saint Mary's Hospital from January 2009 to December 2013. Our diagnosis was made using the International Classification of Headache Disorders-II (ICHD-II). Results: In whole study population, 195 patients were identified; 97 were diagnosed with migraine and 98 were diagnosed with tension type headache. Among migraine patients, 35 patients had migraine with aura and 62 had migraine without aura. Mean age of headache patients is 10.9 years old. The type with the oldest mean age was migraine with aura (13.1 years old, P<0.01). Male to female ratio of headache patients is 1:1.64. Female was significantly predisposed to migraine with aura (M:F=1:3.38, P=0.04). Thirty eight percent of patients have shoulder pain. Forty one percent of patients in migraine, 42.9% migraine with aura, 40.3% migraine without aura and 38.8% tension type headache have shoulder pain. Thirty two percent of patients have family history of headache. Thirty seven percent of patients with migraine, 31.4% migraine with aura, 40.3% migraine without aura and 30.6% tension type headache have family history of headache. Conclusion: Although, as many as 32% of headache patients have family history, our study did not reveal the patients with migraine have family history more often than those with tension type headache. Likewise, the incidence of shoulder pain was not significantly different between the patients with migraine and those with tension type headache. Patients having migraine with aura were older age and more female predominant than patients with other types of headache.

Prevalence of Viruses with Diarrhea among Hospitalized Children West Gyeonggi Province

서수영,정인아,김지훈,조경순,빈중현,김현희,이희진,이원배,Seo, Soo Young,Jung, In Ah,Kim, Ji Hoon,Cho, Kyung Soon,Bin, Joong Hyun,Kim, Hyun Hee,Lee, Hee Jin,Lee, Wonbae The Korean Society of Pediatric Infectious Disease 2012 Pediatric Infection and Vaccine Vol.19 No.1

Purpose : This study was conducted to evaluate epidemiological data of the viral pathogens obtained from stool exams and provide information on the regional prevalence of infectious diarrheal disease west in Gyeonggi Province, Korea. Methods : We enrolled a cohort of children <10 years of age admitted for treatment of acute diarrhea at Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea. In total, 310 fecal specimens, documented to be free of common bacterial pathogens, were collected from pediatric patients during a 12-month period from January to December 2009 and were tested for the presence of rotavirus, parechovirus, adenovirus, astrovirus, enterovirus, and norovirus using polymerase chain reaction (PCR) and reverse transcription polymerase chain reaction (RT-PCR) assay. Results : The most common virus was parechovirus (16%), followed by adenovirus (15%), astrovirus (14%), rotavirus (13%), and enterovirus (5%). Interestingly, only one of the specimens was positive for norovirus. Single infection cases were detected in 173 (55.8%) of the 310 children, whereas mixed viral infections were detected in 10 (3.2%) of the same children. Viral gastroenteritis generally showed a double peak of incidence. Parechovirus, rotavirus, and adenovirus shared a similar pattern of peak incidence with overall viruses; however, astrovirus infections occurred more frequently in the spring. Eighty-five percent of the confirmed viral gastroenteritis cases developed in under 24 months. Conclusion : The results support the importance of parechovirus, adenovirus, astrovirus, and enterovirus as causative agents of diarrhea in children, which may be underestimated by current routine diagnostic testing. 목 적 : 이 연구는 경기서부지역의 감염성 설사의 원인 바이러스의 역학 및 지역적 유병율에 대한 정보 제공을 위해 실시되었다. 방 법 : 2009년 1월부터 12월까지 가톨릭대학교 부천성모병원에 급성 설사로 입원한 10세 미만 환아를 대상으로 흔한 세균성 병원체가 없는 310개의 대변 검체에서 rotavirus, parechovirus, adenovirus, astrovirus, enterovirus, norovirus의 유무를 PCR과 RT-PCR을 이용하여 확인하였다. 결 과 : parechovirus (16%)가 가장 흔한 것으로 나타났으며, adenovirus (15%), astrovirus (14%), rotavirus (13%), enterovirus (5%)의 순으로 검출되었다. 단일 감염은 55.8%에서, 중복 감염은 3.2%에서 나타났다. 바이러스성 장염은 전체적으로 두 차례의 유행 시기를 보였으며, 84.6%는 2세 이하에서 발생하였다. 결 론 : parechovirus, adenovirus, astrovirus, enterovirus는 기존에 시행 중인 진단방법으로는 과소평가되어 있으나 소아 설사의 중요한 원인이다.

Congenital Syphilis: An Uncommon Cause of Gross Hematuria, Skin Rash, and Pneumonia

심선희,김주영,이의경,방경원,조경순,이주영,서진순,빈중현,김현희,이원배,Shim, Sun Hee,Kim, Ju Young,Lee, Eu Kyoung,Bang, Kyongwon,Cho, Kyoung Soon,Lee, Juyoung,Suh, Jin-Soon,Bin, Joong Hyun,Kim, Hyun Hee,Lee, Won Bae The Korean Society of Pediatric Infectious Disease 2014 Pediatric Infection and Vaccine Vol.21 No.1

선천성 매독은 산전진찰로 예방할 수 있음에도 불구하고, 여전히 문제가 되고 있다. 최근에는 선천성 매독과 관련된 혈뇨나 폐렴이 보고된 증례가 없었으나 저자들은 적절한 산전치료를 받지 못한 산모에게서 태어난 22일된 남아에게서 발생한 선천성 매독에 동반된 신증후군과 폐렴의 증례를 보고한다. 선천 매독의 진단은 혈청학적 검사로 확진하였고, 환아는 페니실린 G 치료를 받고 회복되었다. 신생아에게서 임상증상은 매우 불확실할 수 있어, 질환에 대한 인식이 지연 될 수 있다. 따라서 선천성 매독의 예방에는 철저한 산전관리가 필수적이다. 만약 산모가 적절한 산전진찰을 받지 않았을 경우에는 신속한 혈청학적 진단이 반드시 시행되어야 할 것이다. Although congenital syphilis can be prevented with prenatal screening, the disease remains problematic. Currently, there are no cases that describe hematuria and pneumonia related to congenital syphilis. We report a case of congenital syphilis that involved nephrotic syndrome and pneumonia alba in a 22-day-old male infant whose mother did not receive adequate prenatal care. The congenital syphilis diagnosis was confirmed with a serologic test and the patient recovered with penicillin treatment. Clinical findings may be subtle in neonates and delayed recognition occurs frequently, thus complete prenatal screening is critical for congenital syphilis prevention. Immediate serologic testing should be performed to obtain a differential diagnosis if an infant is delivered by a mother that has not received appropriate prenatal examinations.

상복부 통증이나 압통을 동반한 일차성 두통 환아들의 임상 양상

황희승(Hui Sung Hwang),최혜선(Hye Sun Choi),빈중현(Joong Hyun Bin),김영훈(Young Hoon Kim),이인구(In Goo Lee),정승연(Seung Yun Chung) 대한소아신경학회 2008 대한소아신경학회지 Vol.16 No.2

목 적 : 편두통 또는 두통과 위장관 증상과의 관련성이 보고되고 있다. 일차성 두통 환아들에 있어서 상복부 통증이나 압통을 동반하는 경우와 동반하지 않는 경우에서의 두통의 임상 양상과 치료에 대한 반응을 알아보고자 하였다. 방 법 : 2006년 1월 1일부터 2007년 12월 31일 사이에 1달 이상의 반복되는 두통을 주소로 인천성모병원에 내원한 환아들 중 ICHD-II(2004) 분류에 의해 일차성 두통으로 진단된 58례를 대상으로 하여 두통과 위장관 증상의 동반 유무에 따른 두통의 임상양상과 치료에 대한 반응에 대해 의무기록을 통한 후향적 조사를 하였다. 결 과: 일차성 두통은 편두통 22례, 긴장형 두통 34례, 분류되지 않는 두통 2례 중 상복부 통증이나 압통을 동반한 경우는 편두통 8례(36%), 긴장형 두통 17례(50%), 분류되지 않는 두통 2례(100%) 였다. 상복부 통증이나 압통을 동반한 편두통이나 긴장형 두통 군에서 동반하지 않는 각각의 군에 비해 여아의 비율이 현저하게 높았다. 두통의 정도는 상복부 통증이나 압통을 동반한 편두통과 긴장형 두통 군이 동반하지 않는 각각의 군보다 두통의 정도가 심한 양상을 보였다. 치료에 대한 반응으로는 상복부 통증이나 압통을 동반하지 않는 편두통과 긴장형 두통 군은 생활습관, 수면 습관, 식이 조절과 간헐적인 진통제만으로 두통이 호전을 보인 예가 각각 71 %, 94 %로 높았으나, 상복부 통증과 압통을 동반한 편두통과 긴장형 두통 군은 12%, 18%만이 호전되었으며, 규칙적인 제산제를 추가한 후 두통이 소실되는 경향을 보였다(64%, 53%). 분류되지 않는 두통의 경우 중증의 두통을 호소하였으며, 모두 상복부 압통을 동반하였으며, 규칙적인 제산제를 복용한 후 두통이 소실되었다. 결 론 : 일차성 두통을 가진 환아들 중 상복부 통증이나 압통을 가진 환아들에게서 생활 습관과 식이 조절 개선과 규칙적인 제산제 투여로 두통이 호전되었으며, 이는 두통을 유발하는 스트레스 요인과 관련된 위장관 증상의 조절에 의한 것으로 생각되며, 향후 스트레스 요인 분석과 적극적인 위장관계 검사를 통하여 두통과의 연관성을 확인하는 것이 필요할 것이다. Purpose : Population-based studies have shown positive associations between migraine and irritable bowel syndrome, colitis and peptic ulcer and migraine prevalence was higher among patients with dysmotility-like dyspepsia or nausea/vomiting. The aim of this study was to investigate clinical manifestation between primary headache with epigastric pain or tenderness(EPT) and primary headache without EPT. Methods : We retrospectively reviewed the medical records of 58 patients who were diagnosed primary headache[by ICHD-II(2004)] at Incheon St. Mary Hospital from January, 2006 to December, 2007. Their clinical characteristics such as age, sex, frequency & severity of headache and associated symptoms & signs were analysed. Results : The rate of headache associated with EPT were 36% of migraine cases, 50% of tension-type headache cases, and 100% of unclassified headache cases. Headache with EPT were at a high rate in female. Headache with EPT were more severe than one without EPT. Regulation of behavior, diet and sleep pattern had improved severity of headache in 71% of migraine without EPT and 94% of tension-type headache without EPT, but in 12% of migraine with EPT and 18% of tension-type headache with EPT. Headache disappeared in 64% of migraine with EPT and 53% of tension-type headache by additional regular antiacid medication. Conclusion : Our study supports any specific correlation between headache and EPT, but further studies are needed.

Hand, Foot, and Mouth Disease Neurologic Complications: Clinical Features and Parameters

김지수(Ji Soo Kim),엄태훈(Tae Hoon Eom),김성준(Seong Joon Kim),빈중현(Joong Hyun Bin),김영훈(Young Hoon Kim) 대한소아신경학회 2014 대한소아신경학회지 Vol.22 No.3

Purpose: Hand, foot, and mouth disease (HFMD) is a common childhood illness. Enterovirus 71 (EV71) epidemics have recently been associated with HFMD-based neurologic complications in the Asia-Pacific region. This study described HFMD clinical features, and investigated clinical parameters in patients presenting with acute neurologic complications associated with HFMD. Methods: We retrospectively reviewed medical records from 235 hospitalized patients who developed HFMD with or without neurologic complications (22 and 213 cases, respectively) in Uijengbu, Korea between 2010 and 2013. Clinical manifestations, radiologic findings, cerebrospinal fluid (CSF) analyses, virological analyses, and treatment regimens were summarized. Additionally, routinely collected baseline data from 235 patients were retrospectively analyzed to identify clinical parameters associated with neurologic complications. Results: Brainstem encephalitis was the most frequent neurologic complication (11 cases), followed by aseptic meningitis (seven cases). We also found acute disseminated encephalomyelitis and meningitis retention syndrome. Both have rarely been reported in EV71-associated HFMD. Virological analyses were performed for 15 cases, and 14 demonstrated EV71 infection, while one patient demonstrated Coxsackievirus B3 infection. Multivariate logistic regression analysis indicated patients were more likely to develop neurologic complications if they experienced nausea/vomiting (OR= 13.65, P<0.001) and lethargy (OR=10.68, P=0.003). Males were more likely to develop neurologic complications compared to females (OR=2.12, P=0.005). In addition, neurologic complications were associated with a higher peak heart rate (OR=1.13, P=0.001). Conclusion: This study revealed usual and unusual findings of HFMD-associated neurologic complications. Male gender, nausea/vomiting, lethargy, and peak heart rate parameters predicted HFMD-associated neurologic complications. However, laboratory findings did not reliably predict HFMD-associated neurologic complications.

주의력 결핍 과잉 행동장애가 중복된 뇌전증 소아의 특성

최혜윤(Hye-Yoon Choi),한지윤(Ji-Yoon Han),김성준(Seong-Joon Kim),엄태훈(Tae-Hoon Eom),빈중현(Joong-Hyun Bin),김영훈(Young-Hoon Kim),정승연(Seung-Yun Chung),이인구(In Goo Lee) 대한소아신경학회 2013 대한소아신경학회지 Vol.21 No.3

목 적 : 뇌전증으로 치료 받고 있는 환자에서 ADHD 유병률을 알아보고, 두 질환이 중복되어 있는 환자를 ADHD가 없는 환자와 비교 분석하여 특징을 알아보아 두 질환이 중복되어 있는 환자들의 치료에 도움을 주고자 한다. 방 법: 2009년 3월부터 2012년 5월까지 서울성모병원 소아신경과에 등록되어 뇌전증 진단 하에 항경련제 치료를 받았던 6세에서 18세까지 환자 중에 1년 이상 추적관찰이 가능하였던 184명을 대상으로 의무기록을 분석하였다. 결 과: 1) 대상아 184명중 ADHD가 중복된 환아는 69명으로 37.5%를 차지하고 있었다. 2) ADHD가 중복되지 않은 뇌전증 환아군에서의 남녀 비율은 49:51로 거의 비슷하였으나, ADHD가 중복된 뇌전증 환아군에서는 67:33으로 남자에서의 발생 비율이 여자에 비해 2배 이상 높았다(P=0.022). 3) 뇌파검사에서 ADHD가 중복된 뇌전증 환아들의 병변부위로는 중심부가 39%로 가장 많았다(P=0.014). 4) ADHD가 중복되지 않은 환아들에서는 한 가지 약제로 경련 조절이 가능했던 경우가 56%인 반면 ADHD가 중복된 경우는 36% 이었다(P=0.001). 따라서 뇌전증 환아에서 ADHD의 유무는 항경련제 치료 반응과 관계를 가지고 있으며, 조기에 치료 반응을 예측할 수 있는 유용한 인자 중 하나라고 생각할 수 있다. 결 론:뇌전증 환아에서 ADHD가 중복되는 경우는 ADHD가 중복되지 않은 경우에 비해 여러 특성이 다를 뿐 아니라 뇌전증의 치료 반응도 나쁘기 때문에 ADHD를 조기에 발견하여 대책을 수립하는 것이 필요하다. Purpose : To investigate the prevalence of ADHD (attention-deficit hyperactivity disorder) in children with epilepsy and to determine the difference of characteristics in patients with epilepsy and concomitant ADHD as opposed to the patients without ADHD for better management. Methods : We retrospectively reviewed 184 patients diagnosed as epilepsy and treated with antiepileptic drugs in pediatric neurology department of Seoul St. Mary's hospital from March, 2009 to May, 2012. Their ages ranged from 6 to 18 years. The subjects were included in the study those who made a regular visit for more than a year. Results : 1) Out of 184 patients, 69 patients (37.5%) had both ADHD and epilepsy. 2) In epilepsy children with ADHD, male outnumbered female by almost two fold (male 67: female 33) (P=0.022). 3) In epilepsy children with ADHD, epileptiform discharges on EEG was focused in central regions in 39% of them (P=0.014). 4) In 56% of patients without ADHD, their seizures remained under the control with single anticonvulsant, as opposed to 36% of patients with both ADHD and epilepsy (P=0.001). Therefore, the presence of ADHD in patients with epilepsy might be related to the therapeutic response to anticonvulsants, and be a useful predictive factor for the response to early treatment. Conclusion : Patients with epilepsy and concomitant ADHD showed a significant difference and poor response to epilepsy treatment, as opposed to patients without ADHD. Therefore, early detection and establishment of countermeasures for ADHD is necessary.

인플루엔자 B 바이러스와 연관된 근염의 임상적 고찰

정인아 ( In Ah Jung ),서수영 ( Soo Young Seo ),김지훈 ( Ji Hoon Kim ),조경순 ( Kyoung Soon Cho ),빈중현 ( Joong Hyun Bin ),이원배 ( Won Bae Lee ),강지민 ( Ji Min Kahng ),김현희 ( Hyun Hee Kim ) 대한소아알레르기호흡기학회(구 대한소아알레르기 및 호흡기학회) 2011 소아알레르기 및 호흡기학회지 Vol.21 No.2

Purpose: Influenza B-associated myositis is an infrequent and poorly known complication of influenza B virus infection in children. The aim of this study was to describe the clinical and laboratory manifestations, diagnosis, and outcomes of influenza B-associated myositis in Korean children. Methods: A retrospective analysis was conducted in patients aged <16 years who had been diagnosed with influenza B-associated myositis at the Catholic University Bucheon Saint Mary`s Hospital between April 2010 and May 2010. Results: Overall, 16 cases were analyzed. Influenza B-associated myositis typically occurred in preschool-aged children with a 3:1 male predominance. The mean age was 4.6 years (range, 3 to 7 years). The median interval between onset of influenza infection and onset of influenza B-associated myositis was 3 days (range, 1 to 7 days). Only the calf muscles were involved in all patients. Blood creatine phosphokinase concentration was elevated in most patients. Median duration to clinical recovery was 3 days (range, 1 to 4 days). No patient had rhabdomyolysis, renal failure, or related sequelae. All patients had a favorable outcome without administration of antiviral drugs. Conclusion: Clinical and laboratory findings of influenza B-associated myositis are very characteristic and allow a rapid diagnosis during the influenza season. Outcomes of influenza B-associated myositis are good with only proper supportive treatment. [Pediatr Allergy Respir Dis(Korea) 2011;21:86-90]