Mycoplasma pneumoniae 감염의 신속 항원 검사 키트 "Ribotest Mycoplasma^®"의 진단적 평가

양송이,한미선,김선중,이성연,최은화,Yang, Song I,Han, Mi Seon,Kim, Sun Jung,Lee, Seong Yeon,Choi, Eun Hwa 대한소아감염학회 2019 Pediatric Infection and Vaccine Vol.26 No.2

Purpose: Early detection of Mycoplasma pneumoniae is important for appropriate antimicrobial therapy in children with pneumonia. This study aimed to evaluate the diagnostic value of a rapid antigen test kit in detecting M. pneumoniae from respiratory specimens in children with lower respiratory tract infection (LRTI). Methods: A total of 215 nasopharyngeal aspirates (NPAs) were selected from a pool of NPAs that had been obtained from children admitted for LRTI from August 2010 to August 2018. The specimens had been tested for M. pneumoniae by culture and stored at $-70^{\circ}C$ until use. Tests with Ribotest $Mycoplasma^{(R)}$ were performed and interpreted independently by two investigators who were blinded to the culture results. Results: Among the 215 NPAs, 119 were culture positive for M. pneumoniae and 96 were culture negative. Of the culture-positive specimens, 74 (62.2%) were positive for M. pneumoniae by Ribotest $Mycoplasma^{(R)}$, and 92 of the 96 (95.8%) culture-negative specimens were negative for M. pneumoniae by Ribotest $Mycoplasma^{(R)}$. When culture was used as the standard test, the sensitivity and specificity of Ribotest $Mycoplasma^{(R)}$ were 62.2% and 95.8%, respectively. Additionally, the positive predictive value, negative predictive value, and overall agreement rates with Ribotest $Mycoplasma^{(R)}$ were 94.9%, 67.2%, and 77.2%, respectively. Conclusions: A positive test result of Ribotest $Mycoplasma^{(R)}$ suggests a high likelihood of culture-positive M. pneumoniae infection. However, a negative test result should be interpreted with caution because nearly one-third of negative test results reveal culture-positive M. pneumoniae infections.

소아 폐쇄세기관지염에 대한 새로운 관점

양송이 ( Song-i Yang ) 대한천식알레르기학회 2022 Allergy Asthma & Respiratory Disease Vol.10 No.2

한국 소아의 식품 의존성 운동유발 아나필락시스: 단일 기관 후향적 연구

양송이 ( Song I Yang ),이은 ( Eun Lee ),유진호 ( Jin Ho Yu ),조유숙 ( You Sook Cho ),김태범 ( Tae Bum Kim ),홍수종 ( Soo Jong Hong ) 대한천식알레르기학회 2015 Allergy Asthma & Respiratory Disease Vol.3 No.3

Purpose: Food-dependent exercise-induced anaphylaxis (FDEIA) is a specific clinical syndrome requiring both ingestion of an allergenic food and exercise to induce anaphylaxis. It may be underdiagnosed due to insufficient history taking in terms of the causes of anaphylaxis. This study aims to describe clinical characteristics and diagnostic results of FDEIA in children. Methods: We retrospectively reviewed the medical records of patients under 18 years old who were diagnosed with FDEIA at Asan Medical Center between January 2003 and August 2014. Results: Of the 170 children with anaphylaxis, 11 (6.5%) had FDEIA. The mean age at the onset of symptoms was 14.8±1.5 years. The causative foods were: wheat (n=4), meat (n=1), mung beans (n=1), rice (n=1), celery (n=1), cabbage (n=1), fish (n=1), and soy (n=1). The numbers of symptom development were: 7 (n=1), 6 (n=1), 3 (n=4), 2 (n=2), and 1 (n=3). The geometric mean (range of 1 standard deviation) of total serum IgE levels was 131.6 kU/L (53.5.324.2 kU/L). The skin prick test and immununoCAP were positive for causative foods in 3 of 6 patients (50.0%) and 7 of 10 patients (70.0%), respectively. The provocation test was performed in 8 of 11 patients and showed positive results except 1 patient. The interval between exercise and symptoms was 21.6±7.3 minutes. Conclusion: It is important to suspect FDEIA and take a detailed history in children with anaphylaxis. Provocation test should be considered to confirm the diagnosis. Further studies on disease course and long-term prognosis are warranted.(Allergy Asthma Respir Dis 2015;3:194-199)

수두-대상포진 바이러스에 노출된 소아 환자의 예방 조치

양송이 ( Song I Yang ),임지희 ( Ji Hee Lim ),김은진 ( Eun Jin Kim ),박지영 ( Ji Young Park ),윤기욱 ( Ki Wook Yun ),이환종 ( Hoan Jong Lee ),최은화 ( Eun Hwa Choi ) 대한소아감염학회 2016 Pediatric Infection and Vaccine Vol.23 No.3

목적: 본 연구는 병원 내에서 의도치 않게 수두-대상포진 바이러스(varicella zoster virus [VZV]) 감 염 환자에 노출된 의료진과 소아 입원 환자의 사례를 대상으로 노출 후 예방 조치와 그에 따른 2차 수 두 감염 발생 여부를 분석하고자 하였다. 방법: 2010년 1월부터 2015년 12월까지 서울대학교 어린이병원에 입원한 수두 혹은 대상포진 환자 중 초기에 적절한 격리 조치가 이루어지지 않았던 사례와 노출자를 대상으로 하였다. 노출자의 VZV에 대한 면역력과 면역 저하 상태의 유무에 따라 노출 후 예방 조치를 시행하였다. 의무기록을 통하여 사례 환자와 노출자들의 임상 정보 및 2차 감염 발생 여부를 조사하였다. 결과: 2010년부터 2015년까지 147명의 VZV 감염 환자가 입원하였고 이 중 의도치 않게 노출되었던 환자는 13명이었다. 이 중 5명(38.5%)의 사례 환자는 수두 백신 접종력이 확인되었다. 총 86명의 환자 가 다인용 병실에서 사례 환자에 노출되었고, 62.8% (54/86)에서 VZV에 대한 면역력이 있었다. 27명 의 노출 환자에게 노출 후 예방 조치를 시행하였으며, VZIG를 투약받은 환자는 23명이었고 수두 백신을 접종받은 환자는 4명이었다. 2차 수두가 발병한 환자는 4명으로, 예방 조치를 받지 않은 소아 1명과 예 방 조치를 받은 27명 중 3명에서 감염이 확인되었다. 이들은 모두 한 명의 사례 환자에게 노출되었다. 2차 수두 감염률은 4.7% (4/85)이었고, 노출 후 예방 조치를 받은 환자 중 2차 감염률은 11.1% (3/27) 이었다. 면역 기능이 정상인 환자에서 2차 수두 감염률은 1.9%, 면역 저하 환자에서는 9.7%이었다. 결론: 수두의 진단이 지연되면 병원에서 VZV에 노출되는 사례가 발생할 수 있으며 이로 인하여 감수성 이 있는 소아나 면역 저하자에게 수두가 2차적으로 발생할 수 있다. VZV에 대한 면역력 여부를 기반으로 노출 후 예방 조치 여부를 결정하는 국내 기준의 적정성을 재고할 필요가 있다. Purpose: This study described the post-exposure prophylaxis (PEP) and secondary varicella infection in children inadvertently exposed to varicella zoster virus (VZV) in the hospital. Methods: We retrospectively analyzed data from patients with VZV infection who were initially not properly isolated, as well as children exposed to VZV at the Seoul National University Children`s Hospital between January 2010 and December 2015. The PEP measures were determined by the presence of immunity to VZV and immunocompromising conditions. Patient clinical information was reviewed via medical records. Results: Among 147 children hospitalized between 2010 and 2015, 13 inadvertent exposures were notified due to VZV infection. Five index children had a history of VZV vaccination. Eighty-six children were exposed in multi-occupancy rooms and 62.8% (54/86) were immune to VZV. The PEP measures administered to 27 exposed patients included varicella zoster immunoglobulin and VZV vaccination. Four children developed secondary varicella, which was linked to a single index patient, including one child who did not receive PEP and three of the 27 children who received PEP. The rates of secondary varicella and prophylaxis failure were 4.7% (4/85) and 11.1% (3/27), respectively. The secondary varicella rates were 1.9% (1/54) and 9.7% (3/31) among immunocompetent and immunocompromised children, respectively. Conclusions: Delayed diagnosis of VZV infection can lead to unexpected exposure and place susceptible children and immunocompromised patients at risk for developing varicella. The appropriateness of the current PEP strategy based on VZV immunity may require re-evaluation.

2009-2011년 신종 인플루엔자 A (H1N1)와 계절 인플루엔자 감염으로 입원한 소아 환자들의 임상 양상과 경과 비교

양송이 ( Song I Yang ),노정희 ( Jung Hee Rho ),선용한 ( Yong Han Sun ),조강호 ( Kang Ho Cho ),심소연 ( So Yeon Shim ),은병욱 ( Byung Wook Eun ),김지은 ( Jee Eun Kim ),손동우 ( Dong Woo Son ),차한 ( Hann Tchah ) 대한소아알레르기호흡기학회(구 대한소아알레르기 및 호흡기학회) 2012 소아알레르기 및 호흡기학회지 Vol.22 No.3

Purpose: Pandemic influenza viruses have caused significant morbidity and mortality. Pandemic influenza A (H1N1) was detected in April 2009 and caused worldwide outbreak. We investigated the differences in clinical characteristics and courses between pandemic and seasonal influenzas. Methods: We reviewed the medical records of pediatric patients, (≤18 years) with influenza hospitalized to Gachon University Gil Medical Center from the 1 April 2009 to the 31 August 2011. Results: Two hundred twenty-six patients with pandemic influenza and 118 patients with seasonal influenza were included. Age, sex, and proportion of underlying diseases were similar between the two groups. Hypoxemia, shortness of breath, and tachypnea were more common in pandemic influenza.(P <0.05) Oxygen supplementation and radiologically confirmed pneumonia were more common in pandemic influenza.(P <0.005) However, there were no significant differences in the mean duration of hospitalization, proportion of patients admitted to the intensive care unit, need for mechanical ventilation, and death. Conclusion: Pandemic influenza caused more frequently lower respiratory tract infection and pneumonia. However, the courses of pandemic influenza were not different from those of seasonal influenza; probably, due to the effects of several factors, including antiviral therapy.

패션 전시 공간에 적용된 오브제 연출방법에 관한 사례 연구

양송이 ( Song I Yang ),이정교 ( Jung Kyo Lee ) 한국공간디자인학회 2013 한국공간디자인학회논문집 Vol.8 No.4

(연구배경 및 목적)현대 패션 전시 공간은 각 브랜드의 이미지를 향상시키기 위하여 다양한 오브제들을 사용한다. 특히, 오브제를 활용한 다양한 연출방법들은 패션 전시 공간의 완성도를 높여주고 좀 더 대중적인 측면에서 주목을 받게 함으로써 가치와 인지도를 높여주는 역할을 한다. 예술적이며 유행을 반영한 패션 전시 공간에서의 오브제 연출기법을 연구하는데 목적이 있다. (연구방법)이에 본 연구에서는 패션 전시 공간과 오브제 요소, 오브제 연출기법에 관한 이론적 고찰과 해외 우수 패션 전시 공간의 연출사례 6곳을 중심으로 각 사례별 오브제 요소에 따른 연출기법을 분석함으로써 전시공간의 특성을 분석하고자 한다. (결과)분석결과, 패션 전시 공간에서는 다양한 연출방법이 도입되고 있으며 공간의 신비롭고 특별한 느낌을 주기 위해 데페이즈망 기법을 가장 많이 사용하고 있는 것으로 나타났고 여러 가지 오브제 연출기법이 함께 적용되었을 때 새롭고 신비로운 체험의 장소가 된다는 결론을 추출할 수 있었다. 결국, 패션 전시는 새로운 공간의 경험을 통해 소비자의 감성 욕구를 충족시켜 줌으로써 기업 및 브랜드의 이미지를 향상시키기 때문에, 오브제 연출 방식은 보다 적극적이고 차별화된 다양한 방법을 제시할 것이다. (Background and Purpose) Using various objects in modern fashion exhibition spaces is helpful for building beloved brands. The purpose of this study is to observe the various kinds of objects, as well as their various uses, in fashion exhibitions where artistic and trend-leading brands succeed in boosting brand values. (Method) In this study, theoretical studies and case analyses regarding exhibition spaces of fashion brands and objects are included. Six successful exhibition spaces by top global brands have been examined to identify the reasons for their success in drawing attention and building brand values using objects. (Result) In summary, various display methods are used in fashion exhibition spaces. D?paysement: is used most often, and it is the most popular among the various methods, for creating a unique and detached sense of place. It may be concluded that placing two or more objects in one place at the same time and place is particularly useful for creating a sense of disconnection or dislocation.

Mycoplasma pneumoniae 감염의 신속 항원 검사 키트 “Ribotest Mycoplasma^®”의 진단적 평가

양송이 ( Song I Yang ),한미선 ( Mi Seon Han ),김선중 ( Sun Jung Kim ),이성연 ( Seong Yeon Lee ),최은화 ( Eun Hwa Choi ) 대한소아감염학회 2019 Pediatric Infection and Vaccine Vol.26 No.2

목적: Mycoplasma pneumoniae 폐렴은 학동기 소아와 청소년의 지역사회 획득 폐렴 중 가장 흔한 원인으로, 조기에 원인 진단이 가능하다면 적절한 항균 요법을 결정하는데 도움이 된다. 본 연구는 하기도 감염 소아의 호흡기 검체에서 M. pneumoniae를 검출하기 위한 신속 항원 검사 방법의 진단적 가치를 평가하고자 하였다. 방법: 2010년 8월부터 2018년 8월까지 하기도 감염으로 서울대학교 어린이병원에서 응급실 또는 입원 치료를 받은 소아로부터 채취한 비인두 흡인물 중 M. pneumoniae 배양 검사를 시행한 후 -70°C 초저온냉동고에 보관되어 있는 검체 215개를 선정하였다. 비인두 흡인물 검체를 실온에서 해동하고 면역크로마토그래피를 이용한 Ribotest Mycoplasma^®를 시행한 후 두 명의 검사자가 결과를 판독하였다. 검사를 시행하는 자와 판독하는 자는 배양 검사 결과를 모르는 상태에서 검사를 진행하였다. 결과: 총 215개의 비인두 흡인물 검체 중 M. pneumoniae가 배양 양성인 검체는 119개, 배양 음성인 검체는 96개였다. M. pneumoniae가 배양 양성인 119개 중 74개(62.2%)가 Ribotest Mycoplasma^® 검사 결과 양성이었고, 배양 음성인 96개 중 92개(95.8%)가 Ribotest Mycoplasma^® 검사 결과 음성이었다. 배양 검사 결과를 기준으로 평가한 Ribotest Mycoplasma^®의 민감도는 62.2% (74/119, 95% 신뢰구간, 53.5-70.9%)이었으며, 특이도는 95.8% (92/96, 95% 신뢰구간, 91.8-99.8%)이었다. 또, 양성 예측도는 94.9% (74/78, 95% 신뢰구간, 90.0-99.8%)이었으며, 음성 예측도는 67.2% (92/137, 95% 신뢰구간, 59.3-75.0%), 그리고 일치도 77.21% (166/215, 95% 신뢰구간, 71.6-82.8%)를 보였다. 결론: 본 연구 결과, 신속 항원 검출법인 Ribotest Mycoplasma^® 검사결과가 양성인 경우는 M. pneumoniae 배양 양성과의 일치도가 매우 높아서 M. pneumoniae 감염의 진단에 유용하였다. 그러나, Ribotest Mycoplasma^® 검사결과가 음성인 경우의 약 1/3은 M. pneumoniae 배양 양성인 검체이었으므로, 음성 검사 결과에 대한 해석은 주의하여야 한다. Purpose: Early detection of Mycoplasma pneumoniae is important for appropriate antimicrobial therapy in children with pneumonia. This study aimed to evaluate the diagnostic value of a rapid antigen test kit in detecting M. pneumoniae from respiratory specimens in children with lower respiratory tract infection (LRTI). Methods: A total of 215 nasopharyngeal aspirates (NPAs) were selected from a pool of NPAs that had been obtained from children admitted for LRTI from August 2010 to August 2018. The specimens had been tested for M. pneumoniae by culture and stored at -70°C until use. Tests with Ribotest Mycoplasma^® were performed and interpreted independently by two investigators who were blinded to the culture results. Results: Among the 215 NPAs, 119 were culture positive for M. pneumoniae and 96 were culture negative. Of the culture-positive specimens, 74 (62.2%) were positive for M. pneumoniae by Ribotest Mycoplasma®, and 92 of the 96 (95.8%) culture-negative specimens were negative for M. pneumoniae by Ribotest Mycoplasma^®. When culture was used as the standard test, the sensitivity and specificity of Ribotest Mycoplasma^® were 62.2% and 95.8%, respectively. Additionally, the positive predictive value, negative predictive value, and overall agreement rates with Ribotest Mycoplasma^® were 94.9%, 67.2%, and 77.2%, respectively. Conclusions: A positive test result of Ribotest Mycoplasma^® suggests a high likelihood of culture-positive M. pneumoniae infection. However, a negative test result should be interpreted with caution because nearly one-third of negative test results reveal culture-positive M. pneumoniae infections.

중증 열대열 말라리아에 합병한 흑수열 소아 1예

양송이 ( Song I Yang ),최영준 ( Young June Choe ),이환종 ( Hoan Jong Lee ),최은화 ( Eun Hwa Choi ) 대한소아감염학회 2017 Pediatric Infection and Vaccine Vol.24 No.2

흑수열은 급성 혈관 내 용혈, 발열과 검붉은색 소변 등의 증상을 보이는 증후군으로, 말라리아 및 불규칙적인 키닌의 투약과 관련 있는 것으로 알려져 있다. 국내에서는 삼일열 말라리아만 발생하고 있으나, 최근 말라리아 유행지역을 여행한 해외여행객들로부터 열대열 말라리아의 해외 유입 보고가 증가하고 있다. 따라서 의료진들은 열대열 말라리아와 그 합병증에 대해 알 필요가 있다. 본 증례는 쇼크를 동반한 중증 열대열 말라리아 이후에 흑수열이 합병한 14세 여자에 대해 보고하는 바이다. Blackwater fever is a serious clinical syndrome manifested by acute intravascular hemolysis, fever, and the passage of black or red urine, which is classically associated with falciparum malaria and irregular administration of quinine. In Korea, Plasmodium vivax is the only endemic malaria circulating; a number of imported cases of falciparum malaria have been reported in patients following return from international travel to a malaria endemic area. Therefore, it is important for health care professionals including pediatricians to be aware of the falciparum malaria and its clinical courses. Herein, we report a case of a 14-year-old girl with severe falciparum malaria that was complicated by blackwater fever.

10학년 과학교과서와 차세대 과학교과서의 지구 영역 비교 분석

조규성 ( Kyu Seong Cho ),양송이 ( Song I Yang ),김재영 ( Jae Young Kim ),정주상 ( Ju Sang Jeong ) 전북대학교 과학교육연구소 2012 科學敎育論叢 Vol.37 No.-

본 연구의 목적은 차세대 과학교과서와 10학년 과학교과서의 지구과학 영역을 비교 분석해 보고 개선방향을 연구하는데 있다. 연구 결과는 다음과 같다. 전체 단원에 대한 지구 단원의 비중을 분석한 결과 차세대 과학교과서가 26.93%로 나타나 기존 교과서에 비해 높은 값을 보였다. 지구 영역의 전체 면수에 대한 그림, 표, 보충자료의 비율을 조사한 결과, 차세대 과학교과서가 기존 교과서에 비해 그림과 표의 비율은 적고 보충자료의 비율은 늘어난 것으로 나타났다. 또한 차세대 교과서는 기존 교과서에 비해 크고 선명한 사진자료와 다양한 용어가 제시되어 있다. The purpose of this research is to compare and analyze the earth science domain of a next-generation science textbook with that of a 10th grade science textbook in order to study possible improvements that can be made. The results of this research are as follows: According to the results of analyzing the load of chapters on Earth out of all the chapters the ratio was 26.93% with the new-generation science textbooks which showed a high value relative to previous textbooks. And the results of studying the ratio of diagrams tables and supplementary documents regarding the total number of pages on the Earth domain the ratios of diagrams and tables have decreased for the next-generation science textbook while the ratio of supplementary data has increased. Furthermore the next-generation textbooks provide clearer photographs and more diverse terms in comparison to the existing textbooks.

호흡기바이러스감염과 알레르겐 감작에 의한 소아 천식 악화의 계절적 변동

김유진 ( Yoo Jin Kim ),양송이 ( Song-i Yang ) 대한천식알레르기학회 2021 Allergy Asthma & Respiratory Disease Vol.9 No.4

Purpose: Acute asthma exacerbations in children have seasonal variations and occur frequently in fall. Respiratory viral infections and environmental allergens are associated with asthma exacerbation. This study aimed to identify seasonal trends of asthma exac-erbation and the effects of respiratory viral infection and allergen sensitization on the seasonality of asthma exacerbation in children. Methods: Children under the age of 18 years who visited to the Emergency Department or hospitalized for acute asthma exacerba-tions from 2011 to 2019 were included. We reviewed medical records, including demographics, date of asthma exacerbation, results of respiratory virus and allergen sensitization, and they were analyzed to identify the seasonal trends of asthma exacerbation. Results: A total of 320 asthma exacerbations were included, with the highest frequency in fall. Human rhinovirus was positive in 64.7% and 60.0% in fall and spring exacerbations, respectively. House dust mite sensitization was highest in fall at 78.5%, while food sensitization was highest in spring at 76.9%. In patients who were sensitized to house dust mites or food allergens, respiratory viral infections further increased asthma exacerbation in fall and spring, respectively. Conclusion: Respiratory virus may be associated with asthma exacerbation in fall and spring. House dust mite and food sensitiza-tions may be associated with fall and spring asthma exacerbations by worsening the severity of asthma symptoms caused by respi-ratory viral infections. In childhood asthmatic patients with allergen sensitization, avoidance of sensitized allergens, prevention of viral infection, and more active treatment of viral infection may help prevent acute asthma exacerbations. (Allergy Asthma Respir Dis 2021;9:238-244)