Additional corticosteroids or alternative antibiotics for the treatment of macrolide-resistant Mycoplasma pneumoniae pneumonia

양은애,이경일 대한소아청소년과학회 2017 Clinical and Experimental Pediatrics (CEP) Vol.60 No.8

Prevention of Recurrent FSGS with Cyclosporine and Plasmapheresis Prior to Renal Transplantation

양은애,박효민,조민현,고철우,김형기,허승,Yang, Eun-Ae,Park, Hyo-Min,Cho, Min-Hyun,Ko, Cheol-Woo,Kim, Hyung-Kee,Huh, Seung Korean Society of Pediatric Nephrology 2010 Childhood kidney diseases Vol.14 No.1

국소 분절성 사구체 경화증은 소아 말기 신부전의 중요한 원인이며, 신이식 후에도 재발되는 특징을 보이는데, 이러한 재발에 대한 치료로는 혈장교환술과 사이클로스포린과 같은 면역억제제의 투여 등이 있다. 이에 저자들은 신이식 전 혈장교환술과 예방적 사이클로스포린을 투여하여 국소 분절성 사구체 경화증의 재발을 효과적으로 예방한 경험 2례를 보고하는 바이다. We report on two children with a high risk of recurrent focal segmental glomerulosclerosis (FSGS) after renal transplantation that could be effectively prevented by prophylactic administration of cyclosporine combined with preemptive plasmapheresis prior to renal transplantation.

소아 대엽성 폐렴에서 마이코플라즈마 폐렴의 임상적 특성

양은애,강미현,유선영,김진환,이재호 대한 소아알레르기 호흡기학회 2012 Allergy Asthma & Respiratory Disease Vol.22 No.3

Purpose:This study was conducted to evaluate the prevalence, clinical characteristics and laboratory findings of lobar pneumonia in children caused by Mycoplasma pneumonia and to find a diagnostic tool for identifying M. pneumoniae infection in children. Methods:We analyzed medical records of 78 children between March 2010 and December 2011, who were admitted to our hospital and diagnosed with lobar pneumonia on the basis of chest X-rays. White blood cells (WBC), C-reactive protein (CRP), procalcitonin (PCT), specific antibodies to M. pneuomoniae, and cold agglutinin (CA) were measured at the time of admission. Children were divided into 2 groups: those with M. pneumoniae infection (group A) and those without infection (group B). Group A children were also subdivided into 2 categories: those with increased CA (group 1) and those without (group 2). Results:The prevalence of lobar pneumonia was higher in the year 2011 than in 2010. M. pneumoniae infection usually occurs in summer and autumn. Group A children accounted for 75.6% (59/78) of all the cases. The onset ages was higher in group A than in group B (P=0.016). WBC counts and PCT values were higher in group B than in group A.(P=0.015 and P=0.011, respectively) Radiologic findings showed that the lower lobe was most commonly involved without predilection for either side and pleural effusion was present in 13.6% of all the cases. The duration of fever before admission was longer in group 1 than in group 2.(P=0.019)Conclusion:It is concluded that lobar pneumonia caused by M. pneumoniae can be more accurately diagnosed using serum PCT values than using CRP values. 목 적:저자들은 흉부 방사선 검사로 진단된 소아의 대엽성 Mycoplasma pneumoniae 감염에 의한 특징적인 임상 증상 및 검사 결과들을 비교 분석하여 M. pneumoniae에 의해 발생하는 대엽성 폐렴을 유용하게 진단할 수 있는 방법을 연구하고자 하였다. 방 법:2010년 3월부터 2011년 12월까지 충남대학교병원 소아청소년과에 입원하여 흉부 방사선 검사에서 대엽성 폐렴(lobar pneumonia)으로 진단 받은 환아 78명을 대상으로 입원 당시 말초 혈액 백혈구 수, 혈청 C-reactive protein (CRP), 혈청 procalcitonin (PCT)을 검사하였고, 혈청학적 진단 방법으로 M. pneumoniae 특이 항체 및 한랭 응집소를 측정하였다. 대상 환아들을 마이코플라즈마 폐렴 군(A군)과 마이코플라즈마 폐렴이 아닌 군(B군)으로 구분한 다음 A 군을 한랭 응집소 양성 군(1군)과 음성 군(2군)으로 분류하였다. 본 연구는 의무기록을 후향적으로 조사하여 실시하였다. 결 과:대엽성 폐렴의 발생 빈도는 2010년보다 2011년에 높았으며, M. pneumoniae에 의한 폐렴이 75.6% (59/ 78)로 여름과 가을에 호발하였다. 발생 연령은 A군에서 B군보다 높았으며,(P=0.016) 말초혈액 백혈구 수 및 혈청 PCT은 B군에서 유의하게 높았다.(P=0.015, P=0.011) 흉부 방사선 검사 결과 좌우에 관계없이 두 군 모두에서 하엽 경화가 많았으며(50%) A군의 13.6%에서 늑막삼출이 동반되었다. A군 중에서 1군은 32명, 2군은 19명이었고, 입원 전 평균 발열 기간은 1군에서 2군보다 길었으나(P= 0.019) 말초혈액 백혈구의 수, 중성구 분율, 혈청 CRP와 PCT은 두 군 사이에 유의한 차이를 보이지 않았다. 결 론:본 연구 결과 M. pneumoniae에 의한 소아의 대엽성 페렴 군에서 M. pneumoniae에 의하지 않은 군보다 혈청 PCT 값이 낮았다. 그러므로 혈청 PCT 검사가 마이코플라즈마 폐렴을 전형적 세균성 폐렴과 감별하는데 CRP보다 유용한 지표로 활용될 수 있을 것이다.

Secondary renal amyloidosis in a 13-year-old girl with bronchiectasis

양은애,이동원,현명철,조민현 대한소아청소년과학회 2010 Clinical and Experimental Pediatrics (CEP) Vol.53 No.7

A 13-year-old girl was diagnosed with non-cystic fibrosis (CF)-related multifocal bronchiectasis accompanied by nephrotic-range proteinuria of unknown cause. On renal biopsy, there were many segmental homogeneous deposits of amyloid tissue with positive Congo red staining in the glomeruli and interstitium. On electron microscopy, relatively straight, non-branching, randomly arranged amyloid fibrils were showed in the mesangium of the glomeruli. These fibrils were approximately 10 nm in diameter, compatible with secondary amyloidosis. Her level of serum amyloid A was remarkably elevated. To our knowledge, this girl is the first case of secondary renal amyloidosis induced by bronchiectasis in Korean children.

스크립트를 이용한 몸짓언어 중재가 중도·중복장애 학생의 의사소통기능에 미치는 효과

양은애(Yang Eun-ae),김희규(Kim Hee-gyu) 한국특수교육교과교육학회 2019 특수교육교과교육연구 Vol.12 No.2

본 연구는 스크립트를 이용한 몸짓언어 중재가 중도·중복장애 학생의 의사소통 기능에 미치는 효과를 알아보는 것을 목적으로 하였다. 본 연구의 대상은 충남 C시의 특수학교에 배치된 중도·중복장애 학생 1명을 대상으로 하였으며, 본 연구에서 사용한 연구 도구는 진단 평가 도구로 Communication Matrix(커뮤니케이션 매트릭스)를 사용하였고, 의사소통 기능을 지도하기 위한 중재도구로 보완·대체의사소통 도구의 몸짓언어와 스크립트를 사용하였다. 연구 결과 스크립트를 이용한 몸짓언어 중재는 중도・중복장애 학생의 의사소통 기능인 사물 요구하기와 행동 요구하기의 빈도를 증가시켰다. This study aimed to analyze effects body language intervention based on script activities for the student with severe and multiple disabilities. A student with severe and multiple disabilities participated in the study and body language Intervention was selected based on his needs, functional level, physical condition, and mobility. The result follows that the communication skill of the student with severe and multiple disabilities improved, communication behaviors were increased. and the effect is maintained.

비염을 가진 소아 및 청소년 환자에서 비호산구와 흡입항원 감작의 상관성

양은애 ( Eun Ae Yang ),박유미 ( Yu Mi Park ),김경훈 ( Kyung Hoon Kim ),이혜진 ( Hye Jin Lee ),김환수 ( Hwan Soo Kim ),전윤홍 ( Yoon Hong Chun ),윤종서 ( Jong-seo Yoon ),김현희 ( Hyun Hee Kim ),김진택 ( Jin Tack Kim ) 대한천식알레르기학회(구 대한알레르기학회) 2018 Allergy Asthma & Respiratory Disease Vol.6 No.3

Purpose: To identify the correlation between nasal eosinophilia and aeroallergen sensitization in children and adolescents. Methods: This is a retrospective study of patients below 18 years of age who had a history of rhinitis that lasted more than 2 weeks or had been repeated more than once a year, received nasal eosinophil examinations, and had serum specific IgE to aeroallergens measured at an Allergy Clinic in a single tertiary teaching hospital in Seoul, Korea. The percentage of nasal eosinophils was calculated by the number of eosinophils per total leukocytes in a high-power field of 1,000×. Data was analyzed to determine the association between nasal eosinophilia and 18 aeroallergens. Results: Of the 245 patients included, 156 (63.7%) were male and the mean age (±standard deviation) was 7.9 years (±3.8). In total, 175 patients (71.4%) were sensitized to at least 1 of the 18 aeroallergens tested, and sensitization to house dust mite was most common. In addition, 118 (48.2%) and 69 patients (28.2%) had nasal eosinophilia of at least 1% and 5%, respectively. There were no significant correlations between serum total IgE or age and the percentage of nasal eosinophils. However, the percentage of nasal eosinophils in the group sensitized to any aeroallergens was significantly increased compared to the nonsensitized group (P=0.002). The percentage of nasal eosinophils was significantly higher in patients who were sensitized to Birch-Alder Mix, oak white, Bermuda grass, orchard grass, timothy grass, sweet vernal grass, rye, mugwort, short ragweed, Alternaria alternata, cats, dogs or Dermatophagoides farinae compared to those nonsensitized. Conclusion: Nasal eosinophilia was significantly associated with sensitization to aeroallergens. (Allergy Asthma Respir Dis 2018;6:161-167)

소아 대엽성 폐렴에서 마이코플라즈마 폐렴의 임상적 특성

양은애 ( Eun Ae Yang ),강미현 ( Mi Hyeon Gang ),유선영 ( Sun Young You ),김진환 ( Jin Hwan Kim ),이재호 ( Jae Ho Lee ) 대한소아알레르기호흡기학회(구 대한소아알레르기 및 호흡기학회) 2012 소아알레르기 및 호흡기학회지 Vol.22 No.3

Purpose: This study was conducted to evaluate the prevalence, clinical characteristics and laboratory findings of lobar pneumonia in children caused by Mycoplasma pneumonia and to find a diagnostic tool for identifying M. pneumoniae infection in children. Methods : We analyzed medical records of 78 children between March 2010 and December 2011, who were admitted to our hospital and diagnosed with lobar pneumonia on the basis of chest X-rays. White blood cells (WBC), C-reactive protein (CRP), procalcitonin (PCT), specific antibodies to M. pneuomoniae, and cold agglutinin (CA) were measured at the time of admission. Children were divided into 2 groups: those with M. pneumoniae infection (group A) and those without infection (group B). Group A children were also subdivided into 2 categories: those with increased CA (group 1) and those without (group 2). Results: The prevalence of lobar pneumonia was higher in the year 2011 than in 2010. M. pneumonia infection usually occurs in summer and autumn. Group A children accounted for 75.6% (59/78) of all the cases. The onset ages was higher in group A than in group B (P =0.016). WBC counts and PCT values were higher in group B than in group A.(P =0.015 and P =0.011, respectively) Radiologic findings showed that the lower lobe was most commonly involved without predilection for either side and pleural effusion was present in 13.6% of all the cases. The duration of fever before admission was longer in group 1 than in group 2.(P =0.019) Conclusion : It is concluded that lobar pneumonia caused by M. pneumoniae can be more accurately diagnosed using serum PCT values than using CRP values.

Methylprednisolone 충격요법을 시행한 국소성 분절성 사구체 경화증 환아들의 임상경과

양은애 ( Eun Ae Yang ),박효정 ( Hyo Jung Park ),조민현 ( Min Hyun Cho ),고철우 ( Cheol Woo Ko ) 대한신장학회 2011 Kidney Research and Clinical Practice Vol.30 No.1

Purpose: The clinical characteristics and pathological findings of patients with focal segmental glomerulosclerosis (FSGS) receiving methylprednisolone pulse therapy (MP pulse therapy) according to the Mendoza protocol were studied to evaluate its therapeutic efficacy. Methods: The clinical course and pathological findings of 12 patients that were diagnosed with FSGS and treated according to the Mendoza protocol from 2001 to 2006 were reviewed retrospectively. Results: Only three patients among the total twelve patients finished MP pulse therapy, who were diagnosed with minimal change nephrotic syndrome on the first renal biopsy and have preserved renal function at the recent follow-up. Among them, one patient (8%) achieved complete remission, but relapsed 28-months after the end of therapy, and one patient (8%) had a partial remission. Eight patients progressed to end-stage renal disease (ESRD) and four regressed during therapy. All eight patients that were diagnosed with FSGS, on the first renal biopsy, progressed to ESRD and required hemodialysis or kidney transplantation. The frequency of ESRD in this group was statistically significant. Conclusion: MP pulse therapy according to the Mendoza protocol showed low therapeutic efficacy; it appeared effective in only 17% and most of the patients (67%) progressed to ESRD. There may be close correlation between the severity of glomerular sclerosis at biopsy and ESRD. These results suggest that the indications for MP pulse therapy according to the Mendoza protocol in nephrotic patients with FSGS requires further clarification.

소아 알레르기질환에서 감작 패턴에 따른 혈중 호산구와 총 IgE의 비교

이혜진,양은애,전윤홍,김현희,김환수 대한 소아알레르기 호흡기학회 2024 Allergy Asthma & Respiratory Disease Vol.12 No.1

. Purpose: Eosinophils and total immunoglobulin (IgE) have served as a histologic hallmark of allergic conditions. Many investigators have used total eosinophil count (TEC) and total IgE for evaluating allergic diseases. We examined differences in TEC and total IgE in allergic diseases and whether it differs according to sensitization. Methods: In this retrospective study, we enrolled 551 patients who visited Uijeongbu St. Mary’s Hospital from January 1, 2009 through December 31, 2012 for allergic diseases. We included patients with a diagnosis of atopic dermatitis (AD), allergic rhinitis (AR), asthma (AS), or urticaria (UC). We compared the TEC and total IgE level according to sensitization patterns. Results: There were 235 cases of AD, 179 cases of AS, 112 cases of AR, and 82 cases of UC. Regarding sensitization, 106 were not sensitized to any allergens, 206 were sensitized to inhalants, 109 were sensitized to food allergens, and 49 were sensitized to both food and inhalant allergens. TEC was significantly higher in the AD and AR group than in the UC group. TEC was significantly higher in those sensitized to both inhalant and food than those not sensitized. The total IgE levels were significantly higher in those sensitized to both inhalant and food than those not sensitized or sensitized to food. Total IgE levels were significantly higher in those sensitized to inhalant than those not sensitized or sensitized to food. Conclusion: Eosinophils appear to play differential roles in the expression of different types of allergic diseases. Total IgE level may play a significant role in sensitization.

소아 하기도 호흡기 감염에서 항생제 치료 가이드라인으로서의 혈청 procalcitonin의 임상적 유용성

임한혁,강혜진,양은애,이재호 대한 소아알레르기 호흡기학회 2012 Allergy Asthma & Respiratory Disease Vol.22 No.1

Purpose:Procalcitonin (PCT), a precursor of calcitonin, has been described as a biomarker of bacterial infection and inflammation. This study was performed to evaluate the clinical usefulness of PCT levels and to reduce the unnecessary usage of antibiotics in children with lower respiratory tract infection (RTI). Methods:Eighty-eight children, with lower RTI, under the age of 5 years, who were admitted to Chungnam National University Hospital, between May 2010 and December 2010, were enrolled. White blood cell counts, erythrocyte sedimentation rate, C-reactive protein, and PCT were measured. Blood and sputum cultures were performed to identify the causative bacteria and reverse transcription-polymerase chain reaction for the viruses. Clinical features were reviewed, retrospectively. Results:The mean participant age was 1.9±1.5 years. The cut-off value for serum PCT levels, which was derived from the receiver-operator characteristic curve, was 0.11 ng/mL. In 29 patients (33.0%) with low PCT levels (<0.11 ng/mL), antibiotic therapy showed no benefit for clinical and laboratory findings. However, in 59 patients (67.1%) with high PCT levels (≥0.11 ng/mL), hospitalization (P=0.005) and fever (P=0.054) exhibited a shorter duration, after antibiotic therapy. Conclusion:A single initial serum PCT levels (≥0.11 ng/mL) may be clinically useful to give a guideline for antibiotic treatment in children with lower respiratory tract infection and to reduce the unnecessary usage of antibiotics. 목 적:칼시토닌의 전구 물질인 혈청 procalcitonin (PCT)은 세균성 감염 및 염증 반응의 새로운 표지자로 제안되어 이에 본 연구는 항생제의 불필요한 사용을 예방하기 위해 소아의 하기도 호흡기 감염에서 혈청 PCT의 임상적 유용성을 알아보고자 한다. 방 법:2010년 3월부터 2010년 12월까지 충남대학교 병원 소아청소년과에 입원하여 하기도 호흡기 감염으로 치료받은 5세 미만의 환아 88명을 대상으로 하였다. 입원 당시 말초혈액 백혈구 수, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), PCT을 측정하였고, 원인균 확인을 위해 입원 당시 혈액배양 검사 및 바이러스 다중 역전사 중합효소 연쇄반응(reverse transcription- polymerase chain reaction) 검사를 시행하였다. 임상 양상은 후향적으로 조사하였다. 결 과:대상 환아의 평균 나이는 1.9±1.5세였다. Receiver operating characteristic 곡선에서 PCT 값의 cut-off값은 0.11 ng/mL이었다. 혈청 PCT 값이 0.11 ng/mL 미만으로서 혈청 PCT 값이 낮은 군으로 분류된 29명 환아에서 항생제 사용 유무에 따른 임상 증상, 말초혈액 백혈구 수, ESR 및 CRP 값은 유의한 차이를 보이지 않았다. 반면, 혈청 PCT 값이 높은 군(PCT≥0.11 ng/mL)에서 항생제 사용이 환자들의 입원 기간(P=0.005)과 입원 후 발열 기간(P= 0.054)을 호전시키는데 도움이 되었다. 결 론:소아 하기도 호흡기 감염에서 혈청 PCT 측정값(0.11 ng/mL)이 항생제 치료 여부를 결정하는데 필요한 요소로 활용되고, 불필요한 항생제 사용을 감소시키는데 기여할 것으로 기대된다.