중증도 평가점수를 이용한 급성 세기관지염의 입원 기간 영향 요인 연구

정영상 ( Yeongsang Jeong ),황지현 ( Ji Hyen Hwang ),권지윤 ( Ji Yoon Kwon ),신정희 ( Jeonghee Shin ),권정현 ( Jung Hyun Kwon ),한경도 ( Kyungdo Han ),서원희 ( Won Hee Seo ),정지태 ( Ji Tae Choung ) 대한천식알레르기학회(구 대한알레르기학회) 2016 Allergy Asthma & Respiratory Disease Vol.4 No.6

Purpose: This study aimed to evaluate the clinical factors that could influence the length of hospital stay (LHS) of infants with acute bronchiolitis using the bronchiolitis severity score (BSS). Methods: The medical records of 105 infants aged 0-12 months with acute bronchiolitis who were admitted to a tertiary hospital between December 2014 and May 2015 were reviewed. The BSS was composed 5 factors, namely general condition, wheezing, chest retraction, respiration rate, and peripheral oxygen saturation, which were evaluated at admission. In addition, the age of the infants, LHS, body weight, birth history, familial history, laboratory test result, chest X-ray, and treatment modalities were reviewed. Subjects were classified into 3 groups according to their BSS, and logistic regression analysis was used to identify the association of the BSS with longer LHS. Results: Among subjects, 62 were studied. Their mean LHS and age were 5.5±2.0 days and 3.9±2.7 months, respectively. Twelve infants were classified as mild (20.3%), 43 as moderate (68.8%), and 7 as severe (10.9%). Venous blood gas pH value and white blood cell count were the best predictors of disease severity. The LHS was associated with the BSS, age, body weight and pCO2 by venous blood gas analysis (P<0.05). Conclusion: The LHS was associated with the BSS, age, body weight, and pCO2 by venous blood gas analysis at admission. The BSS could be a useful tool to predict disease severity and decide treatment strategies for infants with acute bronchiolitis who have no known risk factors. (Allergy Asthma Respir Dis 2016:4:429-435)

천식 환아에서 메타콜린 기관지 과민성의 추적 관찰

김건하 ( Gun Ha Kim ),서강진 ( Kang Jin Seo ),변정혜 ( Jung Hye Byeon ),송대진 ( Dae Jin Song ),유영 ( Young Yoo ),정지태 ( Ji Tae Choung ),고영률 ( Young Yull Koh ) 대한소아알레르기 및 호흡기학회 2007 소아알레르기 및 호흡기학회지 Vol.17 No.3

소아 마이코플라스마 폐렴에서 호흡기 바이러스 중복 감염의 임상적 특징

김종현 ( Jong Hyun Kim ),김은지 ( Eunji Kim ),권정현 ( Jung Hyun Kwon ),서원희 ( Won Hee Seo ),유영 ( Young Yoo ),정지태 ( Ji Tae Choung ),송대진 ( Dae Jin Song ) 대한천식알레르기학회(구 대한알레르기학회) 2017 Allergy Asthma & Respiratory Disease Vol.5 No.1

Purpose: Bacterial/viral coinfection is not uncommon in children with community acquired pneumonia. However, the data about viral coinfection in Mycoplasma pneumoniae pneumonia is limited. The aim of this study was to investigate the frequency and clinical characteristics of respiratory viral coinfection in pediatric M. pneumoniae pneumonia. Methods: A retrospective cross sectional study was performed in 432 children hospitalized with M. pneumoniae pneumonia in a tertiary teaching hospital between June 2015 and May 2016. Results: One hundred forty patients (32.4%) were coinfected with M. pneumoniae and respiratory viruses. Among coinfected viruses, rhinovirus (44.4%) was most commonly detected. Viral coinfection was more likely to occur under the age of 5 years in winter and spring. As compared with patients infected with M. pneumoniae monoinfection, patients coinfected with respiratory viruses showed a lower mean age and shorter total febrile days. Although total leukocyte count was higher, relative proportion of neutrophils and C-reactive protein level were significantly lower in these patients. Conclusion: Viral coinfection was common in pediatric M. pneumoniae pneumonia, especially in patients under the age of 5 years, and this was associated with shorter total febrile days and lower level of acute phase response as compared with M. pneumoniae monoinfection. (Allergy Asthma Respir Dis 2017:5:15-20)

천식 교육을 위한 가족용 보드 게임의 개발 및 교육 효과

최익선 ( Ic Sun Choi ),유병근 ( Byung Keun Yu ),변정혜 ( Jung Hye Byeon ),라경숙 ( Kyong Suk La ),송대진 ( Dae Jin Song ),유영 ( Young Yoo ),정지태 ( Ji Tae Choung ),이영미 ( Young Mee Lee ) 대한소아알레르기호흡기학회(구 대한소아알레르기 및 호흡기학회) 2009 소아알레르기 및 호흡기학회지 Vol.19 No.2

목적: 소아 천식의 효과적인 치료를 위해서는 천식에 대한 정확한 질병 인식을 통해 일상 생활에서 적절한 치료와 관리를 수행하는 것이 필요하다. 연구자들은 소아 천식의 관리와 치료 수준을 향상시키는 방법으로서 가족용 천식 게임을 개발하여 천식에 관한 인식도를 높이고자 하였다. 방 법: 2007년 4월부터 2008년 11월까지의 기간 동안 고려대학교병원 소아알레르기호흡기 세부전문의 3명, 소아과 전문의 1명, 소아과 전공의 3명 및 고려대학교 의과대학생 15명이 게임의 개발에 참여하였다. ADDIE 모델을 통한 체계적인 개발 과정을 적용하였고 19명의 천식 환아 보호자로부터 천식 교육 요구도를 심층 면담을 통해 조사하여 게임 내용에 반영하였다. 개발된 게임의 교육효과를 평가하기 위해 게임을 경험해본 환아군(n=20)과 경험해 보지 않은 환아군(n=22) 사이의 천식 인식도를 설문 조사 방식으로 조사하였다. 결 과: 개발된 게임은 보드 게임 형식으로 천식의 유발 및 악화 인자에 대한 인식과 회피 방법, 천식 증상, 유지 치료의 필요성 등을 내용을 포함하였다. 게임을 진행해 본 결과 초등학생 이상의 환자가 게임 방식과 내용을 쉽게 이해하고 진행할 수있었으며, 약 2시간 정도의 비교적 긴 게임 시간에도 집중력을 유지하며 참여였다. 천식 인식도 점수는 게임을 경험해 본 환아군에서 평균 74.0±17.6점으로 경험해 보지 않은 환아군의 평균 55.0±17.1점에 비해 높은 수준을 보였다.(P=0.006)결 론: 저자들은 체계적인 과정을 통해 천식 교육을 위한 가족용 보드 게임을 개발하였다. 개발된천식 교육용 보드 게임은 천식 인식도를 유의하게 향상시켰고 따라서 이를 통해 천식 관리 수준이 향상될 수 있을 것으로 기대된다. Purpose: The education for self-management of asthma is considered as an essential component to control asthma and improve outcomes. This study aimed to develope an educational game for increasing knowledge of asthma management among children and their caregivers. Methods: Three subspecialists of pediatric allergy and respirology, 1 pediatrician, 3 pediatric residents and 15 medical students conducted this study. An instructional systemic design using analysis, design, development, implementation and evaluation (ADDIE) model was applied in the entire process of game production. We surveyed the demands of asthma education in 19 caregivers of children who were in the treatment of asthma in Korea University Anam Hospital and reflected its results on the construction of game. For the evaluation of the objective effects of developed game, the comparison study was performed between the patients who had experienced the game (n=20) and those who had not (n=22) by using questionnaire about the knowledge of asthma. Results: The game was developed as a form of board game and had contents including precipitating factors, symptoms and treatment of asthma. The patients older than elementary student easily understood the mode and substances of game, and participated with their concentrations throughout approximately 2 hours` operating time. In analysis of the knowledge level of asthma, the patients who had experienced board game showed significantly higher knowledge level than those who had not (74.0±17.6 vs. 55.0±17.1, P=0.006). Conclusion: We developed a family board game for the asthma education through the systematic production process. The board game may increase the knowledge level in asthmatic children, which would improve the ability of self-management. [Pediatr Allergy Respir Dis (Korea) 2009;19:115-124]

빌딩 시뮬레이션 문제 기반 학습과 교훈

김덕우(Kim Deuk-Woo),서원준(Suh Won-Jun),정지태(Jung Ji-Tae),윤성환(Yoon Sung-Hwan),박철수(Park Cheol-Soo) 대한건축학회 2011 대한건축학회논문집 Vol.27 No.7

This paper describes the experiences and lessons learned from one of the PBL (Problem-based Learning) projects, a simple test-bed for building simulation study from modeling to control. A problem about how to enhance the understanding of building simulation skills and expertise, and hands-on experience from modeling to advanced control by using a simple test-bed is raised by a group of four graduate students. The aim of the project is to reduce the gap between textbook knowledge and real application. As the course progresses (offered with a weekly three hours), a simple prototype (rectangular EPS box) has been developed with a halogen lamp inside to emulate a convective/radiative heating system. The PBL case study consists of five steps: (1) mathematical modeling of the EPS box with lamps, (2) development of a state-space simulation model for the given EPS box in LabVIEW, (3) calibration of the simulation model if a significant gap between the simulation and measurement exists, (4) application of an advanced control to the box, (5) realization of web-based user control interface (either by a standard web browser or smart phone). In the paper, the aforementioned five steps are addressed with the lessons of modeling, simulation and control which are learned from this PBL case study.

새로운 기관지폐 이형성증 부검 1례

이진철 ( Jin Chul Lee ),고광민 ( Kwang Min Ko ),변정혜 ( Jung Hye Byeon ),유영 ( Young Yoo ),손창성 ( Chang Sung Son ),정지태 ( Ji Tae Choung ),함수연 ( Soo Youn Ham ),채양석 ( Yang Seok Chae ) 대한소아알레르기 및 호흡기학회 2008 소아알레르기 및 호흡기학회지 Vol.18 No.1

반복적인 천음과 호흡곤란을 보인 영아에서 진단된 선천성 심, 폐기형 3례

남효경 ( Hyo Kyoung Nam ),라경숙 ( Kyong Suk La ),변정혜 ( Jung Hye Byeon ),최익선 ( Ic Sun Choi ),장기영 ( Gi Young Jang ),유영 ( Young Yoo ),정지태 ( Ji Tae Choung ),손창성 ( Chang Sung Son ),함수연 ( Soo Youn Ham ) 대한소아알레르기호흡기학회 2009 소아알레르기 및 호흡기학회지 Vol.19 No.2

Although laryngomalacia is the most common cause of congenital stridor in infancy, it is a benign, self-limited disease which usually resolves by the age of 18 months with no long-term sequelae. Nevertheless, infants who suffered from recurrent stridor and respiratory distress should be evaluated for other causes of stridor such as cardiopulmonary anomalies. We report 3 cases of infants who had recurrent stridor and respiratory distress from their early infancy. Case 1 had a double aortic arch and a tracheomalacia, case 2 had a hypoplasia of the right lung, and case 3 had a horseshoe lung as well as scimitar syndrome. Physicians should be alert for the possibility of the congenital cardiopulmonary abnormalities in infants with recurrent stridor and/or respiratory distress. [Pediatr Allergy Respir Dis(Korea) 2009; 19:183-190]

영유아 보육시설과 응급실에서의 식품 알레르기 관리 현황

서원희 ( Won Hee Seo ),장은영 ( Eun Young Jang ),한영신 ( Young Shin Han ),안강모 ( Kang Mo Ahn ),정지태 ( Ji Tae Jung ) 대한소아알레르기호흡기학회(구 대한소아알레르기 및 호흡기학회) 2011 소아알레르기 및 호흡기학회지 Vol.21 No.1

목적: 영유아 보육시설에서의 식품 알레르기를 가진 소아의 관리 현황과 식품에 의한 심한 알레르기 반응으로 응급실에 내원한 영유아의 진단 및 추후 관리에 대해 조사하였다. 방법: 1) 2010년 4월 서울 소재 어린이집 345개소의 보육 교사를 대상으로 식품 알레르기에 연관된 증상들과 관리 사항에 대해 우편으로 설문 조사하였다. 2) 2002년 1월부터 2010년 8월까지 고려대학교 안암병원과 안산병원 응급실에 내원한 0-5세 소아 중 혈관 부종 또는 아나필락시스로 진단받은 환아의 의무기록을 후향적으로 연구하였다. 결과: 1) 서울지역 어린이집 345개소의 보육교사들이 참여하였다. 보육시설이 보호자에게 등록된 소아의 식품 알레르기 질환 여부를 조사하는 곳은 243개소였고, 식품에 알레르기가 있는 소아는 492명이었다. 어린이집에서 제한식이가 필요한 소아는 207개소에 있는 461명으로 제한식이를 하는 경우 동일한 영양 성분과 양의 대체식만으로 제공하는 곳은 21개소였다. 급식과 관련하여 식품 알레르기에대한 교육을 받은 보육 교사는 145명이었다. 2)고려대 안 암병원과 안산병원에 2002년 1월부터 2008년 8월까지 혈관 부종과 아나필락시스로 진단받은 환자 중 식품 섭취 후 증상을 보인 환자는 105명 중 30명이었고, 증상 호전 후 알레르기 진문의의 진료를 시행하고 진단을 받은 경우는 7명 이었다. 결론: 이 연구는 일반 영유아 보육시설과 응급실을 대상으로 식품 알레르기 관리 및 현황에 대한 첫 번째 연구로서 집단 급식에서의 식품 알레르기 발생 위험성에 대해 보육시설 교사와 보호자인 부모가 충분히 인지하지 못하고 있음을 알 수 있었다. 보육시설과 보호자는 식품 알레르기의 심각성에 대한 인식이 필요하며, 알레르기 반응을 예방하기 위한 체계적인 교육과 대책이 필요하다고 생각된다. Purpose: We studied the management of young children with histories of food allergies at child care centers, along with the diagnosis and follow-up management after a visit to a hospital emergency department (ED). Methods: 1) The survey was conducted in April 2010 in Seoul, Korea. Three hundred forty-five child care centers caring for children between the ages of 0 and 5 years were contacted by mail. The questionnaire was designed to identify symptoms and management of children in child care centers with histories of food allergies. 2) We studied children who were diagnosed with angioedema or anaphylaxis between January 2002 and August 2010 in the ED of Korea University. Results: 1) According to the 345 collected questionnaires, 243 child care centers asked parents about their children`s allergic diseases and 492 children had food allergies. A reported 461 children from 207 child care centers had food restrictions. Only 21 child care centers supplied substitute foods with the same amounts and types of nutrients. One hundred forty-five teachers had received education about food allergies. 2) Thirty children were diagnosed with anaphylaxis or angioedema after food ingestion. Only seven children visited a physician after being discharged from the ED. Conclusion: This study identified a lack of food allergy education at child care centers and in homes. Child care centers need to be equipped with knowledge to prevent severe allergic reactions. Also, parents should know more about the importance of food allergies in their children. [Pediatr Allergy Respir Dis(Korea) 2011;21:32-38]