2 TU와 5 TU 투베르쿨린 검사의 반응성 비교

조대선,이경미,이대열,김정수 대한소아청소년과학회 2000 Clinical and Experimental Pediatrics (CEP) Vol.43 No.5

소아 호산구성 근막염과 근골격계 합병증 - 증례 보고 -

조대선,박성희 대한재활의학회 2009 Annals of Rehabilitation Medicine Vol.33 No.4

Eosinophilic fasciitis (EF) in childhood is a very rare, and it is characterized by diffuse fasciitis and peripheral eosinophilia. It has been reported that EF shows good recovery after systemic steroids. We report a case of 18 months old boy with eosinophilic fasciitis which affected the right lower extremity and flank. The case we present here differs from other published reports, in that the patient with eosinophilic fasciitis presented serious musculoskeletal complications such as muscle atrophy, osteoporosis, fracture, and inequality of limb length that were associated with chronic course of steroids therapy. Interdisciplinary approach is critical in preventing complications in children with eosinophilic fasciitis.

Optimal Time of Flu Shot: Influenza B Is the Problem

조대선 대한의학회 2019 Journal of Korean medical science Vol.34 No.46

A trivalent influenza vaccine (TIV) contains hemagglutinin derived from strains of an A (H3N2)-like virus, an A (H1N1)pdm09-like virus, and a B (either Victoria or Yamagata lineage)-like virus. A quadrivalent influenza vaccine (QIV) contains an additional B strain which is not included in the TIV. On the basis of the experts' review of surveillance data available and their discussion on the candidate vaccine strains, the World Health Organization (WHO) recommends the composition of Northern Hemisphere influenza vaccines, i.e., which strains should be included in the vaccines.1 Although the prediction might make a good hit, as the antibody titer wanes and if it is not protective at the time of the epidemic, all the efforts for the influenza vaccination end in failure.

소아의 전염성 단핵구증에서 사이토카인과 세포자멸사 연관 유전자의 발현의 변화

조대선,한지혜,김선영,김민선,이호근,이대열,황평한 대한소아청소년과학회 2009 Clinical and Experimental Pediatrics (CEP) Vol.52 No.12

목적:소아 전염성 단핵구증 환자의 임상적 특성과 EBV 감염과 관련된 사이토카인과 세포자멸사 연관 유전자의 발현에 대해 알아보고자 본 연구를 시행하였다. 방법:2006년 3월부터 2007년 2월까지 전북대학교병원에 입원한 전형적인 임상 증상을 보이면서 혈청학적 검사로 전염성단핵구증으로 확진된 15명을 대상으로 임상적 특성을 조사하고, 진단 당시, 발병 1주 후, 3주 후에 각각 말초혈액에서의 T세포 세군, 사이토카인, EBV DNA, 세포자멸사 연관 유전자 발현을 측정하여 건강한 대조군 10명과 비교하였다. 결과:환자의 평균 연령은 5.7±3.4세(3-9세)였으며, 남녀비는 1.5:1이었다. 발열(100%)과 인두통(73%), 무기력과 권태감(53%)이 흔한 임상 증상이었고, 인두염 및 편도염(100%), 경부 림프절 비대(87%)와 간비종대(53%)가 흔하게 나타났다. 환자의 말초혈액에서 CD3+ T세포와 CD8+ suppressor T세포, CD56+ NK세포가 대조군에 비하여 증가하였다(P<0.01). 환자의 혈청 IL-2, 6, INF-γ가 증상 초기에 대조군에 비하여 증가하였다(P<0.01). 환자의 말초혈액 단핵구내 EBV DNA 양은 평균 102.38 copies/μg이었으며 진단 당시 최고치를 보이다가 회복기에는 정상화되는 양상이었다. 환자의 말초혈액 단핵구의 세포자멸사 연관 유전자 발현은 Bcl-2는 증상 초기에 증가하다가 감소하였고 Bax는 회복기에 약간 증가하였으며, Fas는 거의 변화가 없었으나 FasL은 발병 1주 후에 현저히 증가하였다가 회복기에 감소하였다. 결론:본 연구를 통해 급성 전염성 단핵구증 소아 환자에서 다양한 임상 증상과 말초혈액에서 T세포 세군의 변화 및 세포자멸사 연관 유전자 발현의 변화를 확인하였다. 앞으로 분자 생물학적 관점에서의 병인 및 치료 방법에 대한 더 많은 연구가 필요할 것으로 사료된다. Purpose:The aims of this study were to identify the clinical characteristics and determine the changes in the expression of cytokines and apoptosis-related genes in children with infectious mononucleosis. Methods:Serological examinations of 15 pediatric patients diagnosed with infectious mononucleosis were performed prospectively. Peripheral blood from the patients was used to compare the composition of T cell subsets, cytokines, Epstein–Barr virus (EBV) DNA, and the expression of apoptosis-related genes with those in 10 healthy children. Results:Mean age of the patient group was 5.7±3.4 (range, 3–9) years, and the male-to-female ratio was 1.5:1. Fever, sore throat, pharyngitis/tonsillitis, and cervical lymph node enlargement were the most common symptoms and signs. The proportions of CD3+ T cells, CD8+ suppressor cells, and CD56+ natural killer (NK) cells were higher in the patient group than in the control group (P<0.01). The IL-2, IL-6, and interferon (IFN)-γ levels were higher in the early symptomatic period (P<0.01). Mean amount of EBV DNA in the patients was 102.38 copies/μg, and the amount was the highest at the beginning of the symptomatic period and normalized during the convalescent phase. Bcl-2 expression increased during the initial phase, while Bax expression increased during the convalescent phase. Further, FasL expression increased 1 week after symptom presentation and decreased during the convalescent phase. There was no significant change in Fas expression. Conclusion:We analyzed the clinical characteristics and changes in the expression ofcytokines and apoptosis-related genes in the patients with infectious mononucleosis.

소아청소년의 예방접종 시행에 대한 일반적인 권장사항

조대선,최은화 대한의사협회 2009 대한의사협회지 Vol.52 No.3

Immunization is the most cost-effective method of preventing many infectious diseases. Recommendations for immunization practices are based on scientific knowledge of vaccine characteristics, the principles of immunization, the epidemiology of specific diseases, host characteristics, and expert opinion of public health officials and specialists in clinical and preventive medicine on vaccine benefit and safety issues. Therefore, recommendations for vaccination practices balance scientific evidence of benefits and risks of immunization programs. Many of the standards for child and adolescent vaccination programs that have been previously published are universal and are applicable to many countries where different public health concerns may exist. However, several updated changes are added to these standards to maximize the benefits from the vaccination services. This report will provide the most recent technical guidance about common vaccination concerns for clinicians who administer vaccines to infants, children, and adolescents.

급성 중이염 및 급성 부비동염의 치료: 가이드라인을 중심으로

조대선 대한소아감염학회 2008 Pediatric Infection and Vaccine Vol.15 No.2

Acute otitis media and acute sinusitis are some of the most common antibiotic-prescribed diseases in childhood. Usually, with an accurate diagnosis, a 10-14 day course of antibiotics is recommended to cover common causative agents, including pneumococci. Establishment of management guidelines for these infectious diseases based on further study of the epidemiologic profile, antibiotic resistance, and clinical circumstances in Korea is needed. (Korean J Pediatr Infect Dis 2008;15:100-107) Acute otitis media and acute sinusitis are some of the most common antibiotic-prescribed diseases in childhood. Usually, with an accurate diagnosis, a 10-14 day course of antibiotics is recommended to cover common causative agents, including pneumococci. Establishment of management guidelines for these infectious diseases based on further study of the epidemiologic profile, antibiotic resistance, and clinical circumstances in Korea is needed. (Korean J Pediatr Infect Dis 2008;15:100-107)

Innocent Neonate, Resistant Staph, and Embarrassed Staff

조대선 대한감염학회 2013 Infection and Chemotherapy Vol.45 No.2

Wanted: The Best Second Option to Treat Macrolide-Unresponsive Mycoplasmal Pneumonia in Children

조대선 대한의학회 2018 Journal of Korean medical science Vol.33 No.43

Mycoplasma pneumoniae is a major pathogen of community-acquired pneumonia in children and adolescents. Physicians may know the treatment of choice for childhood mycoplasmal pneumonia is macrolides.1 However, recently we have experienced so many beyond-textbook cases, i.e., macrolide-unresponsive mycoplasmal pneumonia.2 There have been many studies explaining why we should encounter these embarrassing patients: the most well-known is that the clever pathogens already acquired resistance by 23S rRNA mutation

A Case of Unusual Visceral Heterotaxy Syndrome with Isolated Levocardia

조대선,정성수,주찬웅 대한심장학회 2013 Korean Circulation Journal Vol.43 No.10

Situs inversus of the abdominal organs in the presence of normally placed heart on the left side of the thorax is known as situs inversus with isolated levocardia. This rare condition is commonly associated with severe congenital defects of the heart. We report a case of situs inversus with levocardia in a 19-year-old asymptomatic male patient with completely normal heart on the left chest. Spiral computed to-mography of the thorax and abdomen and echocardiographic studies revealed situs inversus of abdominal organs, normal heart (levocar-dia), mirrored left lungs, a midline liver, a left-sided inferior vena cava connecting to the right atrium, multiple splenic masses in the ab-dominal right upper quadrant, and aneurysmal dilatation of a splenic artery.

Recommended immunization schedule for children and adolescents: the Korean Pediatric Society, 2013

조대선,김종현,최은화,박수은,김예진,김윤경,이진아,은병욱,이수영,이현주,김기환,김경효 대한소아청소년과학회 2013 Clinical and Experimental Pediatrics (CEP) Vol.56 No.6

This article contains the recommended immunization schedule by the Committee on Infectious Diseases of the Korean Pediatric Society, updated in March 2013, when Haemophilus influenzae type b vaccine is now included in the National Immunization Program in Korea. It also includes catchup immunization schedule for children and adolescents who are behind the recommended schedule. These schedules are a minor revision of the corresponding parts of Immunization Guideline, 7th edition,of the Korean Pediatric Society, released in 2012. Pediatricians should be aware of these schedules to provide adequate immunization to Korean children and adolescents.