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소아에서 Shigella dysenteri에 의한 신우신염 1례
오경일,김성진,장주희,오윤정,강성길,홍영진,손병관,이지은,Oh, Kyung-Il,Kim, Sung-Jin,Zhang, Joo-Hee,Oh, Yun-Jung,Kang, Sung-Kil,Hong, Young-Jin,Son, Byong-Kwan,Lee, Ji-Eun 대한소아신장학회 2006 Childhood kidney diseases Vol.10 No.2
Shigella infection usually produces gastrointestinal symptoms but rarely causes urinary tract infection. A 7-year-old girl was admitted for fever, chills, right flank pain, and dysuria. She had no vomiting or diarrhea. There was mild tenderness in her right lower abdomen, and right CVA tenderness was also noted. Acute pyelonephritis was diagnosed by abdominal CT. She showed improvement with intravenous administration of antibiotics. The first urine culture grew $1{\times}10^5$ CFU/mL Shigella dysenteri. Although urinary tract infections due to Shigella species are extremely rare, Shigella species should be considered as a possible cause of pediatric urinary tract infection. We report the first case of urinary tract infection caused by S. dysenteri, which presented as acute pyelonephritis without gastrointestinal symptoms in a child.
오경일,김정희,이지은,임대현,손병관 대한소아청소년과학회 2007 Clinical and Experimental Pediatrics (CEP) Vol.50 No.2
Acrodermatitis enteropathica (AE) is a rare autosomal recessive disorder of early infancy, and is characterized by periorificial dermatitis, alopecia, and intractable diarrhea. Serum zinc levels are usually low in untreated patients and the oral administration of zinc sulfate can clear skin lesions and other symptoms. Although premature and cow`s milk-fed infants are at particular risk of developing AE, there have been a few reports about AE in term and breast-fed infants. We report a case of transient AE in a 4-month-old breast-fed infant. This patient suffered from diarrhea and dermatitis for more than a month. Her skin lesions were erythematous, scaly, crusted, psoriasiform, eczematous, with an eruption at the chin, and a periorificial disposition with involvement of the flexural areas of lower extremities. Her serum zinc level was almost normal at 129 g/dL (reference range: 60-121 g/dL), but the zinc level in her hair was low: 8 mg percent (reference range: 10-21 mg percent). Skin biopsy findings were consistent with AE. Seven days after zinc supplementation, the skin lesions and diarrhea improved. The authors recommend that a clinical trial of zinc supplementation be considered in cases where there are suspicious of AE, even when the serum zinc level is normal. 장병성 선단 피부염은 위장관에서 아연 흡수가 제대로 되지 않아 발생하는 질환으로서 주로 이유기의 영·유아에 호발하고 상염색체 열성 유전하는 질환이다. 홍반, 인설, 가피, 건선양 피부와 습진의 특징적인 피부 병변이 개구부와 사지 말단 부위에 대칭적으로 나타나고, 만성 설사, 탈모증, 조갑 주위염, 그리고 성장 장애가 나타나는 드문 질환이다. 혈중 아연 농도가 대부분에서 떨어져 있지만 정상 혈중 농도에서도 말초 조직 내의 아연 농도가 떨어지면 증상이 나타난다. 다른 원인 질환이 없고 만삭으로 정상 분만한 모유 수유 영아에서 조직학적으로 일치하며, 혈중 아연 농도는 정상이지만 모발에서 아연 농도가 떨어진 장병성 선단 피부염 증례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.
한희연,오경일,이경화,김정희,김재원,손병관,임대현 대한 소아알레르기 호흡기학회 2006 Allergy Asthma & Respiratory Disease Vol.16 No.3
Subglottic hemangioma is a rare condition which has the potential to cause life-threatening complications during the pediatric period. The most common presenting symptom is inspiratory and expiratory stridor, which is often exacerbated by crying and upper respiratory tract infection. The natural history of subglottic hemangioma is characterized by progressive airway obstruction during the proliferative phase for the first year, but after 1 year of age, the symptoms resolve spontaneously as the lesion regresses. We report a 50-day-old infant with subglottic hemangioma who suffered from episodes of cyanosis and persistent stridor with viral pneumonia. In addition, she had cutaneous hemangioma on her right cheek. The hemangioma was successfully controlled with just systemic steroids, because the lesion occupied 40% of total subglottic space. We concluded that if an infant with cutaneous hemangioma displays biphasic then stridor subglottic hemangioma should be included in differential diagnosis. 성문하 혈관종은 소아에게서 선천적인 천음을 일으키는 원인 중 흔한 원인은 아니지만, 성문하 혈관종으로 인한 기도폐쇄가 심할 경우 응급으로 기관절개를 하거나 기도 삽관을 해야 하는 상황을 초래할 수도 있다. 얼굴에 피하 혈관종을 가진 2개월 환아에서 성문하 혈관종을 조기 진단하여, 스테로이드 단독 치료로 증상의 호전을 보였다. 안면부에 피하 혈관종을 가진 환아에서 천음이 발생하면 성문하 혈관종을 감별하기 위한 진단적 검사가 필요할 것으로 사료된다.
한희연 ( Hee Youn Han ),오경일 ( Kyung Il Oh ),이경화 ( Kyung Hwa Lee ),김정희 ( Jeong Hee Kim ),김재원 ( Jae Won Kim ),손병관 ( Byong Kwan Son ),임대현 ( Dae Hyun Lim ) 대한소아알레르기호흡기학회 2006 소아알레르기 및 호흡기학회지 Vol.16 No.3
Subglottic hemangioma is a rare condition which has the potential to cause life-threatening complications during the pediatric period. The most common presenting symptom is in-spiratory and expiratory stridor, which is often exacerbated by crying and upper respiratory tract infection. The natural history of subglottic hemangioma is characterized by progressive airway obstruction during the proliferative phase for the first year, but after 1 year of age, the symptoms resolve spontaneously as the lesion regresses. We report a 50-day-old infant with subglottic hemangioma who suffered from episodes of cyanosis and persistent stridor with viral pneumonia. In addition, she had cutaneous hemangioma on her right cheek. The hemangioma was successfully controlled with just systemic steroids, because the lesion occupied 40% of total subglottic space. We concluded that if an infant with cutaneous hemangioma displays biphasic then stridor subglottic hemangioma should be included in differential diagnosis. [Pediatr Allergy Respir Dis(Korea) 2006;16:243-247]
양측 제 1,4 단중족증의 자가골을 이용한 일단계 골연장술(1예 보고)
김동희,정덕환,한정수,이재훈,박재용,오경일,탁대현,Kim, Dong-Hee,Chung, Duke-Whan,Han, Chung-Soo,Lee, Jae-Hoon,Park, Jae-Yong,Oh, Kyung-Il,Tak, Dae-Hyun 대한족부족관절학회 2010 대한족부족관절학회지 Vol.14 No.2
19 years old girl presented with bilateral 1, 4th brachymetatarsia. We have used an autograft interposition technique to lengthen the brachymetatarsia involving first and fourth metatarsal. The technique was to graft the bone fragment from the relatively long second and third metatarsal bone to be used as an autograft to the short first and fourth metatarsal bone. The method is superior in not having the necessity of a long term external fixator which is needed using callotasis method and in also avoiding the inconvenience of performing an allograft. Absence of donor site complication during autograft from iliac bone is also an advantage to be mentioned. Our technique can therefore be ascertained as a successful method in both cosmetic results and improvement of symptoms including reduction in length of recovery.
Pentobarbital로 치료된 저산소성 뇌손상 후 발생한 난치성 근간대성 경련 간질 중첩증(란스-아담스 증후군) 1례
김동현(Dong Hyun Kim),김성진(Sung Jin Kim),오경일(Kyung Il Oh),권영세(Young Se Kwon),손병관(Byong Kwan Son) 대한소아신경학회 2006 대한소아신경학회지 Vol.14 No.2
저자들은 란스-아담스 증후군을 보이는 15개월 남아에서 일차 항경련제 투여에도 불구하고 1시간 이상 지속된 난치성 간질 중첩증이 발생하였을 때 pentobarbital 투여로 경련이 조절된 1례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다. Lance-Adams syndrome is a rare complications of cardiorespiratory arrest. We report a 15-month-old child with Lance-Adams syndrome who fell into a refractory status epilepticus after a successful resuscitation after the cardiopulmonary arrest from upper airway obstruction due to the croup. On the day of the admission, he went through a generalized tonic-clonic seizure with poor mental status. His condition became aggravated on 18th day of admission when he developed focal myoclonus in his left arm and leg. The EEG findings before the pentobarbital treatment show partial electrical seizure. The seizures were intractable despite the administration of midazolam, phenobarbital, phenytoin, and valproic acid. Therefore, a pentobarbital(PTB) therapy was required. PTB administered by a continuous infusion pump at a loading dose of 5 mg/kg was sufficient to produce a burst suppression pattern and a seizure control, followed by a maintenance infusion of 0.5-1.5 mg/kg/hour. At that time, the brain MRI showed a diffuse distribution of high signal intensity and swelling in both basal ganglia, thalamus and the temporo-occipital area. The therapy continued for 10 days. Thereafter, PTB was gradually tapered after a minimum 48-hours of a seizure-free status. So we report a case with a brief review of related literature.