18윤상 염색체 1례

빈중현,송문영,이인구,이원배,이병철 대한소아청소년과학회 2001 Clinical and Experimental Pediatrics (CEP) Vol.44 No.6

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.

정맥영양 극소저체중출생아의 간담도 기능 이상

이윤희,빈중현,이주영,이현승,이정현,성인경,전정식,김소영 대한신생아학회 2009 Neonatal medicine Vol.16 No.2

Purpose : The objective of this study was to describe the frequency of hepatobiliary dysfunction (HD) at our hospital and determine the possible risk factors and complications associated with the development of HD in very low birth weight infants (VLBWI) treated with parenteral nutrition (PN). Methods : A retrospective study of VLBWI (n=92) that required PN between 2004 and 2008 in the NICU at the Bucheon St. Marys Hospital of Catholic University was performed. HD was defined by a direct bilirubin (DB) >2 mg and a transaminase of 60 IU/L defined cholestasis and liver injury. Groups I, II, and III were limited to cases of cholestasis, liver injury without cholestasis, and no abnormalities, respectively. The VLBWI were compared to each other. Results : Thirty-six subjects (39.1%) had cholestasis and 51 (55.4%) had liver injury. In addition, 36 (39.1%), 19 (20.7%), and 37 (40.2%) subjects were classified as groups I, II, and III, respectively. The three groups showed significant differences in gestational age, 1- and 5-minute Apgar scores, use of surfactant, duration of parenteral nutrition, frequency of RBC transfusions, bronchopulmonary dysplasia (BPD), and patent ductus arteriosus (PDA) (P<0.05). The multiple regression analysis with cholestasis as the dependent variable, showed a significant correlation with gestational age, use of surfactant, frequency of RBC transfusions, and PDA. Conclusion : Various factors, such as birth weight, gestational age, 1- and 5-minute Apgar scores, use of surfactant for respiratory distress syndrome (RDS), frequency of RBC transfusions, BPD, and PDA may be related to hepatobiliary dysfunction in VLBWI treated with PN.

대장창냄술로 치료된 궤양 동반 항문 주위 혈관종 1례

최정윤,빈중현,한승훈,김현희,이원배,이도상,김소영 대한신생아학회 2008 Neonatal medicine Vol.15 No.2

Hemangioma is the most common benign tumor of infancy. Greater than 60% of hemangiomas occur on the head and neck, and have an uncomplicated course. In contrast, most complicated hemangiomas develop in the urogenital or anogenital areas. These lesions are frequently associated with pain, bleeding, recurring infections, and ulcerations. Sometimes, perianal ulcerative hemangiomas are difficult to treat with multiple therapies, such as laser and steroid therapy. We managed a case of a severe perianal ulcerative hemangioma in a male newborn who did not respond to conservative management. He was successfully treated after a colostomy.

비특이 반응성 간염에서 AST와 ALT 수치 상승과 회복

김태성,임선정,빈중현,한승훈,김소영,김현희,이원배 대한소아청소년과학회 2008 Clinical and Experimental Pediatrics (CEP) Vol.51 No.4

Purpose:The study was performed to assess the distribution of the diseases associated with nonspecific reactive hepatitis (NRH) for the past 10 years and to evaluate the change in the level of AST and ALT, and the difference by several variable factors. Methods:From January 1997 to December 2006, 646 patients had elevated liver enzymes among 22,763 patients admitted to the Holy Family Hospital. We analyzed the difference in the age distribution, the period of elevated levels of AST and ALT, the resolution period, the peak value, the daily resolution value of AST and ALT, the sexual differences and the difference in several disease entities. One hundred and ninety-seven patients not confirmed as NRH or lost during follow-up were excluded. Results:The prevalence rate of NRH was 2.84%. When compared to AST, ALT showed longer period of morbidity and resolution and the peak value was also higher in ALT. The male and female ratio showed significant value of 1.63:1. The morbid and resolution periods of AST and ALT between males and females were longer periods in males. The most prevalent disease entities were respiratory and gastrointestinal infections. Between the respiratory and the gastrointestinal diseases, the highest level of AST and ALT was observed in the respiratory disease. Conclusion:NRH is a common disease that occurs in 2.84% of the admitted pediatric patients. However, the pathogenesis and the progress of the disease have not been well known due to the lack of generalized information. Further research is necessary in the future. (Korean J Pediatr 2008;51:396-400) Purpose:The study was performed to assess the distribution of the diseases associated with nonspecific reactive hepatitis (NRH) for the past 10 years and to evaluate the change in the level of AST and ALT, and the difference by several variable factors. Methods:From January 1997 to December 2006, 646 patients had elevated liver enzymes among 22,763 patients admitted to the Holy Family Hospital. We analyzed the difference in the age distribution, the period of elevated levels of AST and ALT, the resolution period, the peak value, the daily resolution value of AST and ALT, the sexual differences and the difference in several disease entities. One hundred and ninety-seven patients not confirmed as NRH or lost during follow-up were excluded. Results:The prevalence rate of NRH was 2.84%. When compared to AST, ALT showed longer period of morbidity and resolution and the peak value was also higher in ALT. The male and female ratio showed significant value of 1.63:1. The morbid and resolution periods of AST and ALT between males and females were longer periods in males. The most prevalent disease entities were respiratory and gastrointestinal infections. Between the respiratory and the gastrointestinal diseases, the highest level of AST and ALT was observed in the respiratory disease. Conclusion:NRH is a common disease that occurs in 2.84% of the admitted pediatric patients. However, the pathogenesis and the progress of the disease have not been well known due to the lack of generalized information. Further research is necessary in the future. (Korean J Pediatr 2008;51:396-400)

경인지역에서 조사한 소아의 연령별 antistreptolysin O 역가

이지헌,김유정,빈중현,황자영,한승훈,김소영,김현희,이원배 대한소아청소년과학회 2007 Clinical and Experimental Pediatrics (CEP) Vol.50 No.10

Purpose : Measurement of antistreptolysin O (ASO) is often necessary to confirm a clinical diagnosis of recent streptococcal infection, especially in patients suspected of rheumatic fever and acute glomerulonephritis. Standard normal ranges for ASO should be established locally for each age group. We analyzed ASO to determine the upper limit of normal (ULN) ASO in children in the Gyeonggi-Incheon area. Methods : ASO in normal individual concentrations were measured quantitatively by nephelometry on sera from 753 children (Male : 381, Female : 372). ULN were determined by separating the upper 20% from the lower 80% of the group (80 percentile). Results : The mean ASO concentration calculated in a total cases was 149.9±7.2 IU/mL. The ASO concentration in neonates was 83.4±10.7 IU/mL, and lowest in the 1 year of age group, 26.7±6.6 IU/ mL, and increased to 318.0±33.2 IU/mL gradually in the 9 years of age group. Thereafter, ASO concentration decreased. The ULN for neonates was 122 IU/mL, for 0-3 years, 40 IU/mL; for 4-6 years, 113 IU/ mL; for 7-9 years, 489 IU/mL; for 10-19 years, 433 IU/mL; for 20-29 years, 122 IU/mL. Conclusion : The age-specific ULN for children in the Gyeonggi-Incheon area were determined. The distribution of ASO concentration according to age groups was different from previous reports. These results should be of clinical value to physicians to interprete the ASO results of their patients. 목 적 : Antistreptolysin O(ASO)는 인종, 지역, 역학적 요소에 따라 정상치가 다르므로 시기별, 지역마다 각 연령별 정상치가 필요하다. 경인지역에서 신생아부터 29세까지를 대상으로 연령별 ASO치의 분포를 분석하여 이 지역에서 사용할 수 있는 ASO의 소아 정상치를 확립하고자 하였다. 방 법 : 경인지역에서 2002년 1월에서 2003년 2월 사이의 신생아부터 29세까지 753명(남자 381명, 여자 372명)의 혈청을 이용하여 혈청 내 ASO치를 측정하였다. 전체를 각각 연령별로 분석하고 다시 신생아 군, 0-3세 군, 4-6세 군, 7-9세 군, 10-19세 군과 20-29세 군으로 나누어 ULN를 구하였다. 결 과 : 전체 대상의 ASO치는 149.9±197.0 IU/mL였으며, 신생아 군에서 83.4±78.7 IU/mL이었고, 이후 점차 떨어져 1세 군에서는 26.7±43.0 IU/mL로 가장 낮았다. 이후 점차 증가하여 9세 군에서 318.0±250.8 IU/mL로 최고값에 도달한 후 다시 감소하였다. ASO 상한값(upper Limit of Normal: ULN)은 0-3세 군에서 40 IU/mL, 신생아 군에서 122 IU/mL, 4-6세 군에서 113 IU/mL, 7-9세 군에서 489 IU/mL, 10-19 세 군에서 433 IU/mL, 20-29 세 군에서 122 IU/mL 였다. 결 론 : 이상으로 경인지역에서 2002년 1월에서 2003년 2월 사이의 신생아부터 29세까지의 연령별 ASO치의 ULN을 설정하였으며, ASO 값의 판정은 소아와 성인간에 다른 ULN을 적용하여야 함은 물론 소아에서도 여러 연령별로 나누어서 ASO ULN치를 적용하여야 함을 알 수 있었다. 이 결과는 향후 환자들의 ASO 결과를 임상적으로 해석하는데 도움이 될 것으로 사료된다.

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.

Comparison of Group A, B and C Rotaviral Gastroenteritis among Children in Korea: Prevalence and Clinical Features

배길성,배우리,김지훈,빈중현,김현희,이희진,이원배 대한소아감염학회 2014 Pediatric Infection and Vaccine Vol.21 No.2

Purpose: The aim of this study is that the prevalence of rotavirus infection was evaluated by each group and clinical featuresof group A, B and C rotaviruses infections were described respectively to compare one with another. Methods: Between January 2010 and December 2010, we enrolled a group of children below 10 years of age admittedfor management of acute diarrhea at the Catholic University of Korea Bucheon St. Mary's Hospital. A total of 310 stoolsamples documented to be free of common bacterial pathogens were collected from children with diarrhea. The presenceof group A, B or C rotavirus is indicated by amplification of DNA segments of the expected lengths after the first andsecond PCRsResults: In a total of 310 stool specimens, 40 (12.9%) specimens were positive for rotaviruses. These included 23 (7.4%)positive for group A, 5 (1.6%) for group B and 12 (3.9%) for group C rotaviruses. Group B rotavirus infected patients hadsignificantly less diarrheas per day (group A: P =0.01, group C: P =0.01) and shorter duration of vomiting days (group A:P =0.03, group C: P =0.03) than those with group A and C rotaviruses infection respectively. All the group B rotaviruseshad been isolated in March and October. Group C rotavirus infections were prevalent during late summer and early winterand peaked in October. Conclusion: These findings indicate that group B and C rotaviruses are notable causes or the contributing causes of diarrheaamong infants and children in Korea.