가와사끼병에서의 고용량 정주용 면역글로불린 재치료

심소연,허미영,김혜순,손세정,Shim, So Yun,Heo, Mi Young,Kim, Hae Soon,Sonh, Sejung 대한소아청소년과학회 2002 Clinical and Experimental Pediatrics (CEP) Vol.45 No.10

목 적 : 가와사끼병에서 고용량 정주용 면역글로불린 1회 투여에 반응을 보인 군과 재투여 한 군간에 임상양상, 혈액 검사 및 관상동맥 병변의 차이를 비교하고, 고용량 면역글로불린 재투여의 효과를 규명하고자 했다. 방 법 : 1999년 3월부터 2001년 7월까지 이화의대 목동병월에 가와사끼병으로 입원한 174명의 입원 및 외래기록을 후향적으로 조사하였다. 1회 면역글로불린에 반응을 보인 군을 I군(154명)으로, 재투여를 받은 환아군을 II군(20명)으로 하여 임상양상, 혈액검사 및 관상동맥 병변에 대한 차이를 비교하였다. 결 과 : 1) 고용량 면역글로불린 치료를 받은 174명의 환아 중 20명(11.5%)이 면역글로불린을 재투여 받았고 이 중 2명(1.1%)은 면역글로불린에 저항을 보였다. 2) 두 군간에 성별, 나이 및 임상양상에서는 유의한 차이가 없었다. 3) 면역글로불린 재투여군에서 1회 투여군에 비하여 혈중 albumin은 유의하게 낮았고 (3.7 vs 3.4 g/dl, P<0.05) ALT는 유의하게 높았다(118.2 vs 229.3 U/L, P<0.05). CRP도 재투여군에서 유의하게 높았다(8.9 vs 13.3 mg/dL, P<0.05). 4) 관상동맥병변은 면역글로불린 1회 투여군이 13.6% 재투여군이 45%로 면역글로불린 재투여군에서 유의하게 높았다. 결론 : 고용량 정주용 면역글로불린 투여 후에도 발열이 지속되거나 재발열 되는 가와사끼병의 치료에 면역글로불린 재투여는 안전하고 효과적이었으나, 관상동맥 합병증을 감소시키지는 못하였다. Purpose : To determine clinical features, laboratory findings and cardiac abnormalities of highdose immune globulin(IVIG) retreatment in patients with Kawasaki disease, and to report effectiveness of retreatment. Methods : Retrospective study of 174 children diagnosed with Kawasaki disease at Ewha Mokdong hospital from March, 1999 to July, 2001. Results : Twenty(11.5%) of 174 patients were retreated with high-dose IVIG. After this, only two patients(1.1%) did not respond to IVIG retreatment. Patients with failure to respond to initial IVIG did not differ from the patients who responded to a single course of IVIG in sex, age, days of fever at initial IVIG and clinical characteristics. Compared with responders with single IVIG treatment, the patients who were retreated had significantly lower albumin(3.7 vs 3.4 g/dL, P < 0.05), higher ALT(118.2 vs 229.3 U/L, P < 0.05) and CRP(8.9 vs 13.3 mg/dL, P < 0.05). On echocardiography, patients who recieved IVIG retreatment were significantly more likely to have caronary abnormalities(45.0% vs 13.6%, P < 0.05). Conclusion : Retratment with IVIG for persistent or recurrent fever was safe and effective.

필라테스 운동이 비만남성의 신체구성, 콜레스테롤, CRP 및 렙틴에 미치는 영향

심소연(Shim So-Yeon),김윤미(Kim Yun-Mi),고성경(Ko Seong-Kyeong) 한국체육과학회 2011 한국체육과학회지 Vol.20 No.3

The aim of this study was to investigate the effects of a 12 week Pilates exercise program on body composition, cholesterol, hs-CRP and leptin in male obese adults. Subjects were obese 30-42 year old men (BMI=25.0-30.0㎏/㎡). They were classified into a Pilates group (N=7) and control group (N=7). Pilates program consisted of upper abdominal curl, spine stretch forward, roll up, rolling, single leg stretch, criss crosses, double straight leg, single straight leg stretch, single and double kick, side up/down kick in parallel and side band, etc. Training was preformed 3 days/week for 65 min during the 12 weeks. Exercise intensity was monitored using heart rate monitor and peak intensity was reached between 50 and 75% HRR. Data was analyzed by repeated two way ANOVA with group and period, and then post Hoc test(a=.05) with paired and independent t-test were performed. After 12 week of Pilates training, waist, hip and chest circumstance in body composition factors were significantly decreased with a main effect of period and an interaction effect of period and group in Pilates group. In lipoprotein factors, total cholesterol had a main effect of period and LDL-C had an interaction effect of period and group. In inflammatory markers, hs-CRP were significantly decreased with a main effect of period and an interaction effect of period in Pilates group. In conclusion, 12 weeks of Pilates training seemed to be effective to improve cardiovascular disease risk factors in obese adults.

항콜린제(옥시부티닌)가 원발성 방광요관역류의 자연 소실에 미치는 영향

안소현,심소연,이정원,조수진,이승주,Ahn So-Hyun,Shim So-Yun,Lee Jung-Won,Cho Su-Jin,Lee Seung-Joo 대한소아신장학회 2003 Childhood kidney diseases Vol.7 No.2

Purpose : Unstable bladder has been known to be one of the reasons for the genesis and persistance of primary vesicoureteral reflux(VUR) in children. And treatment of unstable bladder by anticholinergic agent may contribute to the resolution of primary VUR. We evaluated the effect of an anticholinergic agent(oxybutynin) on the resolution of primary VUR in children with different toilet training and voiding functions. Methods : 152 children with persistant primary VUR after one year of follow up were randomly assigned to the oxybutynin group(n=59, oxybutynin 0.2 mg/kg twice daily) and the control group(n=93, no oxybutynin) at Ewha Womans University Mok-Dong Hospital from October 1996 to April 2002. The resolution rate of the VUR and the difference according to the status of toilet training and voiding dysfunction were analyzed. Statistical analysis was done by the Chi-square test and a P-value of less than 0.05 was considered as significant. Results : VUR was resolved in 49.2%, improved in 20.3% and not changed in 30.5% in the oxybutynin group(n=59) which was not significantly different to 45.2%, 16.1%, 38.7% in the control group(n=93), respectively. In the non-toilet trained young children, VUR was resolved in 50.0%, improved in 23.5% and not changed in 26.5% in the oxybutynin group(n=34) which was not significantly different to 44.2%, 19.2%, 36.6% in the control group(n=52), respectively. In the toilet trained older children, VUR was resolved in 48.0%, improved in 16.0% and not changed in 36.0% in the oxybutynin group(n=25) which was not significantly different to 46.3%, 12.2%, 41.5% in the control group(n=41), respectively. In the toilet trained older children with no voiding dysfunction, VUR was resolved in 33.3%, improved in 11.1% and not changed in 55.5% in the of oxybutynin group(n=9) which was not significantly different to 53.6 %, 10.7%, 35.7% in the control group(n=28), respectively. In the toilet trained older children with voiding dysfunction, VUR was resolved in 56.3%, improved in 18.7% and not changed in 25.0% in the oxybutynin group(n=16), which looked higher than 30.7%, 15.4%, 53.9% in the control group(n=13), respectively, but these were not significantly different either. Conclusion : Oxybutynin was not effective in the resolution of primary VUR in non-toilet trained young children and toilet trained older children. Oxybutynin showed slightly higher tendency of reflux resolution in toilet-trained older children with voiding dysfunction but the difference was not statistically significant. Judicious use of oxybutynin is required in selected older children with VUR and voiding dysfunction. 목적 : 불안정 방광은 소아에서 원발성 방광 요관역류를 생성하고 지속시키는 원인으로 알려져 있다. 따라서 불안정 방광의 치료제인 항콜린제의 사용은 일차성 방광요관역류의 자연 소실율을 증가시킬 수 있으나 논쟁의 여지가 있어왔다. 저자들은 항콜린제인 옥시부티닌이 소변 가리기 훈련과 배뇨 증상이 각기 다른 소아에서 원발성 방광요관역류의 소실에 미치는 영향을 조사하고자 하였다. 방법 : 1996년 10월부터 2002년 4월까지 이화의대 목동병원에 요로 감염으로 입원한 후 방광요관역류가 발견되고 1년 후 추적 검사에서도 소실되지 않은 152명을 대상으로 하였다. 옥시부티닌군(59명)은 옥시부티닌과 trimethoprim-sulfamethoxazole을, 대조군(93명)은 trimethoprim-sulfamethoxazole만을 투약했다. 방광요관역류의 소실율을 나이, 소변 가리기 및 배뇨 장애 유무에 따라 구분하여 분석하였다. 통계 분석은 Chisquare test를 이용하였고 P-값이 0.05 미만을 유의한 것으로 간주하였다. 결과 : 방광요관역류의 변화는 옥시부티닌군(59명)에서 소실 49.2%, 호전 20.3%, 무변화 30.5%로 대조군(93명)의 45.2%, 16.1%, 38.7%와 비교해 유의한 차이는 없었다. 소변을 가리지 못하는 영유아에서 방광요관역류의 변화는 옥시부티닌군(34명)에서 소실 50.0%, 호전 23.5%, 무변화 26.5%로 대조군(52명)의 44.2%, 19.2%, 36.6%와 비교해 유의한 차이는 없었다. 소변을 가리는 소아에서 방광요관역류의 변화는 옥시부티닌군(25명)에서는 소실 48.0%, 호전 16.0%, 무변화 36.0%로 대조군(41명)의 46.3%, 12.2%, 41.5%와 비교해 유의한 차이는 없었다. 소변을 가리고 배뇨 장애도 없는 연장아에서 방광요관역류의 변화는 옥시부티닌군(9명)에서 소실 33.3%, 호전11.1%, 무변화 55.6%로 대조군(28명)의 53.6%, 10.7%, 35.7%와 비교해 유의한 차이는 없었다. 소변을 가리나 배뇨 장애를 보이는 연장아에서 방광요관역류의 변화는 옥시부티닌군(16명)에서는 소실 56.3%, 호전 18.7%, 무변화 25.0%로 대조군(13명)의 30.7%, 15.4%, 53.9%와 비교해 소실되는 경향이나 유의한 차이는 없었다. 결론 : 옥시부티닌은 소변 가리기나 배뇨 장애와 관계없이 모든 소아에서 역류의 소실율에 미치는 치료 효과가 없었다. 배뇨 장애를 보이는 연장아에서는 역류의 소실율이 약간 증가되는 경향이 있었으나 유의하지 않았다. 원발성 방광요관역류에서 옥시부티닌은 배뇨 장애를 보이는 일부 연장아에서 신중하게 사용되어져야 할 것으로 생각된다.

미강 추출 식이섬유 혼합물을 첨가한 돈육 유화물의 품질특성

최윤상,정종연,최지훈,한두정,김학연,이미애,심소연,백현동,김천제,Choi, Yun-Sang,Jeong, Jong-Youn,Choi, Ji-Hun,Han, Doo-Jeong,Kim, Hack-Youn,Lee, Mi-Ai,Shim, So-Yeon,Paik, Hyun-Dong,Kim, Cheon-Jei 한국축산식품학회 2007 한국축산식품학회지 Vol.27 No.2

본 연구는 미강 추출 식이섬유 혼합물을 첨가하였을 경우 돈육 유화물의 이화학적 품질 특성을 조사하여 미강을 이용한 기능성 육제품의 활용성에 대한 연구를 실시하였다. 돈육 유화물의 일반성분은 첨가되는 미강 추출 식이섬유 함량이 높을수록 수분함량이 낮아지고 단백질, 지방, 회분함량은 증가하였으며, 식이섬유 첨가량이 적정 수준 이상 되면 수분함량이 낮아지고, 단백질과 회분함량이 높아졌다. pH는 가열 전과 가열 후 모두 처리구들이 대조구와 비교하여 높은 pH를 나타내었고, 가열 후 pH가 가열 전 pH보다 높게 나타났다. 색도는 가열 전 돈육 유화물의 명도와 적색도는 대조구와 비교하여 미강 추출 식이섬유를 첨가한 처리구들이 유의적으로 낮았으며, 황색도는 대조구가 처리구들보다 낮은 값을 나타내었다. 가열 후 돈육 유화물의 명도는 대조구가 미강 추출 식이섬유를 첨가한 처리구들과 비교하여 높은 값을 나타내었고, 황색도는 대조구가 처리구들보다 낮은 값을 나타내었다. 가열감량과 유화안정성도 수분리와 유분리 모두 대조구와 비교하여 모든 처리구에서 유의적으로 낮았으며, 점도도 미강 추출 식이섬유 6% 첨가구가 유의적으로 높은 것으로 나타났다. 경도, 응집성, 검성, 씹음성은 대조구와 비교하여 미강 추출 식이섬유 첨가구가 유의적으로 높게 나타났다. 따라서, 미강 추출 식이섬유 혼합물을 첨가하였을 때 이화학적 품질 특성이 우수한 결과를 보여, 최근 건강에 대한 높은 관심을 반영한 웰빙 식품에 활용한다면 현대인들이 선호할 것으로 기대된다. The purpose of this study was to investigate quality characteristics of the meat batter containing dietary fiber extracted rice bran. The formulations of meat batters were manufactured in a model system with 2% raw rice bran and 2, 4, 6% levels of dietary fiber extracted rice bran, respectively. The proximate compositions of dietary fiber extracted rice bran were 53.27% dietary fiber, 6.10% crude fat, 22.99% crude protein, 12.78% crude moisture, and 7.41% crude ash. Compared with control of uncooked meat batter, the pH value of all treatments were significantly different(p<0.05). The pH of cooked meat batter were similar to uncooked meat batter. $CIE\;L^*-\;and\;CIE\;b^*-value$ of uncooked meat batter containing dietary fiber extracted rice bran were lower than control, but CIE $a^*-value$ of treatment was higher than those in control(p<0.05). All treatments had significantly lower cooking loss and emulsion stability than control(p<0.05). Compared with control, viscosity of the treatments containing dietary fiber extracted rice bran were observed significantly higher than those in control (p<0.05). And then hardness, cohesiveness, gumminess, and chewiness of treatments were higher than in control(p<0.05). Conclusively, the results of this study showed that addition of dietary fiber extracted rice bran affected the high quality properties of meat batter.

급성 신부전과 괴사성 근염을 동반한 가와사끼병 1례

안소현,심소연,손세정,이승주,한운섭,Ahn, So Hyun,Shim, So Yun,Sohn, Sejung,Lee, Seung Joo,Han, Un Seop 대한소아청소년과학회 2003 Clinical and Experimental Pediatrics (CEP) Vol.46 No.2

가와사끼병은 주로 심혈관계를 침범하는 전신적인 염증 질환이다. 8세 이상의 나이가 많은 소아에서 가와사끼병은 발생률이 낮고 비정형적인 다양한 임상양상을 보이기 때문에 진단이 늦어질 수 있다. 저자들은 10세 남아에서 급성 신부전과 근염을 비롯하여 여러 가지 비정형적인 증상을 보임으로써 진단이 늦어진 가와사끼병을 경험하였기에 보고하는 바이다. Kawasaki disease is an acute febrile vasculitis affecting primarily infants and young children. In addition to the cardiovascular involvement, it may cause inflammatory changes in various organs and body systems : digestive, respiratory, urinary, nervous and musculoskeletal. A case is reported of atypical Kawasaki disease associated with acute renal failure and necrotizing myositis in the right gastrocnemius in a 10-year-old boy. In older children, uncommon age of onset and additional features less commonly associated with Kawasaki disease may contribute to a delayed diagnosis.

표준화된 간호진단 및 문제와 NANDA-I 교차분석: 4개 상급종합병원 사례를 중심으로

송미라 ( Song Mi Ra ),심소연 ( Shim So Yun ),김대성 ( Kim Dae Sung ),이경순 ( Lee Kyung Soon ),이유나 ( Lee Yu Na ),원미숙 ( Won Mi Suk ) 병원간호사회 2020 임상간호연구 Vol.26 No.3

Purpose: To explore the scope and method of applying standardized nursing terminologies to nursing diagnosis and problems used in nursing practice. Methods: A descriptive study was done with a retrospective analysis of the nursing records of 141,420 patients that were hospitalized in 4 tertiary hospitals. The nursing diagnosis and problems collected from the records were standardized, and the standardized nursing diagnosis and problems cross mapped with NANDA-I, confirmed in a nursing focus group. Results: 65 (67.7%) of the 96 standardized nursing diagnosis and problems were equal with NANDA-I and included in the 10 domains of NANDA-I. Among 86 nursing diagnosis and problems excluded from the cross mapping with NANDA-I, the 63 terms (73.3%) related to surgery/procedure were the most common. Conclusion: It is meaningful that multi-tertiary hospital nursing diagnosis and problems were standardized and cross mapping with standard nursing terminologies was performed. As for the method of applying standardized nursing terminologies in nursing practice, it is appropriate to use several standardized nursing terminologies complementarily.

밀 식이섬유와 분리대두단백의 첨가가 프랑크푸르터의 품질특성에 미치는 영향

김현욱,최지훈,최윤상,한두정,김학연,이미애,심소연,김천제,Kim, Hyun-Wook,Choi, Ji-Hun,Choi, Yun-Sang,Han, Doo-Jeong,Kim, Hack-Youn,Lee, Mi-Ai,Shim, So-Yeon,Kim, Cheon-Jei 한국축산식품학회 2009 한국축산식품학회지 Vol.29 No.4

The effects of wheat fiber (WF) and isolated soy protein (ISP) on the physicochemical and sensory properties of frankfurter-type sausages were evaluated. The frankfurters were formulated with 2% WF (T1), 2% ISP (T2), and 1% WF plus 1% ISP (T3). The pH of all the samples ranged from 5.90 to 5.94 (p>0.05), and the CIE $L^{\ast}$ values of the WF and ISP treatments were higher than those of the control, but the CIEs of $a^{\ast}$ and $b^{\ast}$ were lower than those of the control (p<0.05). The cooking losses with the treatments were lower than the cooking loss with the control, but there were no significant differences among all the treatments. The treated frankfurters showed better emulsion stability than the control, and T1 had the greatest hardness, cohesiveness, and viscosity (p<0.05). All the frankfurters scored the same for sensory color (p>0.05), and the sensory properties of flavor, juiciness, and overall acceptability of T1 resulted in satisfactory sensory scores. The best results were conclusively obtained with the frankfurters that contained 2% WF. This study showed the potential of WF to be used in frankfurters as a substitute for ISP.

32주 미만 미숙아에서 조기 Dexamethasone 치료의 만성 페질환 예방 효과

심소연,조수진,박은애 대한소아과학회 2004 小兒科 Vol.47 No.5

가와사끼병에서의 고용량 정주용 면역글로불린 재치료

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