태변 흡인 증후군 신생아에서의 피하지방괴사 1례

홍미애,오경창,안승인,신혜정,장진근,이병두,김병일,최중환,Hong, Mi Ae,Oh, Kyung Chang,Ahn, Seung In,Shin, Hye Jung,Chang, Jin Keun,Lee, Byung Doo,Kim, Beyong Il,Choi, Jung-Hwan 대한소아청소년과학회 2002 Clinical and Experimental Pediatrics (CEP) Vol.45 No.11

저자들은 태아 곤란증 때문에 제왕절개한 과체중아로 저산소성 손상을 받은 태변 흡인 증후군 환아에서 생후 3-4일경에 어깨와 등에 여러 개의 홍반성의 결절과 반이 발생하였고 악화와 완화를 반복했으며 2-3회의 바늘 흡인(needle aspiration)을 시행하였고 합병증 없이 1세경 소실되었던 신생아 피하지방괴사 1례을 경험하였기에 문헌고찰과 함께 보고하는 바이다. Subcutaneous fat necrosis in neonates is a rare disease characterized by skin lesions, which may be single or multiple, poorly circumscribed and often tender erythematous nodules or plaques on cheeks, buttocks, back, arms, and thighs. These symptoms are usually self-limited; resolution occurs over a period of weeks to months. Subcutaneous fat necrosis affects full term and healthy-appearing infants who have experienced perinatal distress such as hypoxic insult, birth trauma and hypothermia. Most skin lesions appear within the first two weeks of life. We experienced a case of subcutaneous fat necrosis in a neonate with hypoxic insult and report the case with a brief review of the literature.

혈액 및 일반 세균배양에서 검출된 균종과 항균제 감수성 추이(1997~2001)

홍미애,오경창,안승인,김봉림,김연호,김성섭,장진근,전경소,차성호,Hong, Mi Ae,Oh, Kyung Chang,Ahn, Seng In,Kim, Bong Rim,Kim, Yun Ho,Kim, Sung Seop,Chang, Jin Keun,Jeun, Kyoung So,Cha, Sung Ho 대한소아감염학회 2003 Pediatric Infection and Vaccine Vol.10 No.2

Purpose : To know the trends of antimicrobial susceptibility is critical for antimicrobial treatment. We studied the organisms isolated from blood, urine, stool, and cerebrospinal fluid from 1997 to 2001 to reveal the trends of their antimicrobial susceptibility. Methods : We conducted a retrospective study with isolates obtained from 0~18 year old outpatients and inpatients from 1997 to 2001 at Department of Pediatrics, Hanil general hospital. We gathered the data through the laboratory test files and the origin of microorganisms cultured from blood, urine, stool and cerebrospinal fluid and their antimicrobial susceptibility. Results : Microorganisms were isolated from 226(3.3%) out of 6,974 blood cultures, 365 (8.0%) out of 4,549 urine cultures, 50(1.9%) out of 2,593 stool cultures and 9(1.4%) in 655 cerebrospinal fluid cultures. The most frequently isolated organisms from blood cultures was Staphylococcus epidermidis(33.5%) which was followed by Staphylococcus aureus(19.7%), Escherichia coli(13.8%), and Burkholderia cepacia(9.0%). Among the urine cultures, E. coli was the most common(74.7%) which was followed by Group D Enterococcus(11.3%), Klebsiella pneumoniae(7.1%) and Proteus mirabilis(2.5%). The positive stool cultures all yield Salmonella species. Group D Salmonella was obtained most frequently. Among the positive cerebrospinal fluid cultures, Group B Streptococcus was isolated most frequently. Among the 40 cases of S. aureus in blood cultures, 27 cases were methicillin-resistant. The rates of susceptibility for amikacin, ceftizoxime and ceftriaxone of E. coli isolated from blood cultures were 80%, 100% and 60% in 1997 and 60%, 80% and 60% in 2001. The rates of susceptibility for amikacin, ceftizoxime and ceftriaxone of K. pnumoniae isolated from urine cultures. were 80%, 100% and 80% in 1997 and 50%, 83% and 50% in 2001 Enterococcus was isolated from 6.7% to 15.8% and vancomycin-resistant Enterococcus was observed in 17% of Group D Enterococcus isolated from urine cultures. The rates of susceptibility for amikacin, ceftizoxime and ceftriaxone of Group D Salmonella were 96%, 96% and 92% during the study period. Conclusion : Among the blood cultures S. epidermidis, S. aureus, E. coli and B. cepacia were isolated in order of frequency and among the urine cultures E. coli, Group D Enterococcus, K. pneumoniae and P. mirabilis were isolated in order of frequency. During the study period there was no big difference in major organisms isolated from blood and urine. The methicillin-resistant S. aureus was observed in 67% of S. aureus isolated from blood cultures but vancomycin-reistant S. aureus or vancomycin intermediate resistant S. aureus was not observed. The rates of susceptibility to amikacin and the third generation cephalosporin of E. coli isolated from blood cultures and K. pneumoniae from urine cultures have decreased. The isolation rates of Group D Enterococcus and vancomycin resistant Enterococcus have increased. 목 적 : 연도별 항균제 감수성의 추이를 파악하는 것은 항생제 치료에 대한 정보를 얻는데 매우 중요하다. 이에 저자들은 1997년부터 2001년까지의 혈액, 뇨, 분변 및 뇌척수액에서 분리된 균종 및 그들의 항균제 감수성검사를 분석하였다. 방 법 : 1997년 1월부터 2001년 12월 사이에 신생아에서 18세까지의 한일병원 소아과 외래 및 입원환아로부터 혈액, 요, 분변 및 뇌척수액에서 분리된 검출물을 대상으로 검사대장을 통해서 원인균주와 항균제 감수성 검사를 후향적으로 조사 분석하였다. 결 과 : 6,974검체의 혈액배양에서 226검체(3.3%), 4,549검체의 요배양에서 365검체(8.0%), 2,593검체의 분변 배양에서 50검체(1.9%) 및 655검체의 뇌척수액배양에서 9검체(1.4%)로부터 원인 균주가 분리되었다. 1) 혈액배양에서 Staphylococcus epidermidis(33.5%), Staphylococcus aureus(19.7%), Escherichia coli(13.8%)와 Burkholderia cepacia(9.0%) 순으로 많았고 요배양에서 E. coli(74.7%), GroupD Enterococcus(11.3%), Klebsiella pneumoniae(7.1%)와 Proteus mirabilis(2.5%) 순으로 많았으며 분변배양에서 Group D Salmonella 및 뇌척수액배양에서 Group B Streptococcus가 많이 분리되었다. 연도별 주요 원인균주의 빈도는 큰 변화를 보이지 않았다. 2) 혈액배양에서 40명의 S. aureus 양성 환아 중 27명에서 methicillin에 내성을 갖는 S. aureus가 관찰되었다. 3) 혈액배양에서의 E. coli의 amikacin과 3세대 cephalosporin제제인 ceftizoxime 및 ceftriaxone에 대한 감수성률은 1997년도에 각각 80%, 100%, 80%와 2001년도에 각각 60%, 80%, 60%이었고 요배양에서 K. pneumoniae의 amikacin과 ceftizoxime 및 ceftriaxone에 대한 감수성률은 1997년도에 각각 80%, 100%, 80%와 2001년도에 각각 50%, 83%, 50%이었다. 4) 요배양에서의 Group D Enterococcus 양성률은 1997년도에 6.7%에서 2001년에는 15.8%에서 분리되었으며 다약제 내성을 보였고, 특히 vancomycin에 대해서는 11~33% 정도의 균주가 내성을 보였다. 5) Group D Salmonella의 amikacin과 3세대 cephalosporin계 항생제인 ceftizoxime 및 ceftriaxone에 대한 감수성률은 각각 96%, 96%, 92%이었다. 결 론 : 혈액배양에서 methicillin에 내성을 갖는 S. aureus가 67%에서 관찰되었으나 vancomycin에 내성을 갖는 S. aureus는 관찰되지 않았다. 혈액배양에서의 E. coli와 요배양에서의 K. pneumoniae의 amikacin과 3세대 cephalosporin제제에 대한 내성이 증가하는 경향이었으며 요배양에서의 Group D Enterococcus의 검출율이 증가하였고, vancomycin에 대한 내성이 17%에서 관찰되었다.

보건소 영양교육 프로그램이 유아의 영양지식, 식습관 부모의 식태도에 미치는 효과

홍미애(Mi Ae Hong),최미숙(Mee Sook Choi),한영희(Young Hee Han),현태선(Tai Sun Hyun) 대한지역사회영양학회 2010 대한지역사회영양학회지 Vol.15 No.5

This study was carried out to examine the effects of nutrition education program developed by Jincheon Public Health Center on preschool children`s nutrition knowledge and dietary habits and the parents` dietary attitudes. The subjects of this study were five- and six-year-old children as well as their parents. A 5-week nutrition education program was implemented to 104 children in five day care centers, and 107 children in three day care centers were investigated as a control group. Activity tools designed for each lesson such as puzzles, food magnets, story, songs, Pierrot costume, and balls were used. Nutrition knowledge and dietary habits of children and dietary attitudes of parents were evaluated before and after education. Mean nutrition knowledge score in the education group was significantly higher than that in the control group after education (p < 0.001). Mean dietary habit score of three questions (three meals a day, eating at fixed time, eating breakfast) in the education group was also significantly higher than that in the control group after education (p < 0.01). In addition, parents in the education group showed significantly higher mean dietary attitude score than those in the control group even though they did not receive education (p < 0.001). Our nutrition education program was found to be effective in improving nutrition knowledge and dietary habits in preschool children as well as improving dietary attitudes in their parents. (Korean J Community Nutr 15(5): 593~602, 2010)

고등학교 교사들의 독서토론 지도 경험을 통한 실천적 지식과 형성 과정 탐구

홍미애(Mi-ae Hong),정옥년(Ok-ryun Jong) 우리말교육현장학회 2022 우리말교육현장연구 Vol.16 No.2

본 연구는 고등학교 교사가 독서교육 프로그램에 참여하여 독서 및 독서토론에 대한 인식이 어떻게 변화했는지, 성찰을 통해 어떻게 실천적 지식을 형성하고 있는지, 그렇게 형성한 실천적 지식은 무엇인지를 탐구하여 교사가 독서교육의 전문성을 형성하는 데 독서토론 실천 경험이 어떠한 역할을 하는지 탐색하는 것을 목적으로 한다. 교사들은 즉각적이고 상황 의존적인 실천 행위를 성찰하면서, 독서교육 전문가로서 실천적 지식을 습득하고 스스로 독자로 성장하는 과정을 보여주었다. 교사들의 성찰은 개별적인 특성과 상황적 맥락에 따라 다양한 양상을 보여주었지만, 전반적으로 교사들은 독서교육의 가치에 대한 신념을 형성하고, 독서지도 교사로서 정체성과 역할을 인식하고 있었다. 이 연구는 학교 독서교육이 특정 교과의 범위를 넘어 범교과적 차원에서 이루어질 수 있다는 것을 실제 프로그램을 통해 확인해보고, 학교 독서교육의 주체로 성장하기 위한 교사의 노력을 보여주었다는 점에서 의의가 있다. This study examines how high school teachers participated in the reading education program and changed their perception of reading and reading discussion, how they formed practical knowledge through reflection, and what practical knowledge was formed in this way. This study aims to explore the role of reading discussion practice experience in forming students’ professionalism. As teachers reflected on immediate and situation-dependent practical actions, they showed the process of acquiring practical knowledge as reading education experts and developing themselves as readers. Their reflection showed various aspects according to individual characteristics and situational contexts; however, overall, teachers formed a belief in the value of reading education and recognized their identity and role as reading instructors. This study is meaningful in that it confirms through the actual program that school reading education can be conducted at a cross-curricular level beyond the scope of a specific subject, and shows the teachers' efforts to grow as the main body of school reading education.

A군 연쇄구균성 인두편도염 진단을 위한 두 종류 신속항원검사법의 비교

송승규,홍미애,오경창,안승인,태미현,신혜정,장진근,차성호,Song, Seung Kyu,Hong, Mi Ae,Oh, Kyung Chang,Ahn, Seung In,Tae, Mi Hyon,Shin, Hye Jung,Chang, Jin Keun,Cha, Sung Ho 대한소아청소년과학회 2002 Clinical and Experimental Pediatrics (CEP) Vol.45 No.8

목 적: A군 베타용혈성 연쇄구균은 급성 인두편도염의 원인이 되는 세균으로 류마티스성 열 및 사구체 신염과 같은 심각한 합병증을 유발할 수 있어 정확한 진단과 치료를 해야 하는 질병이다. A군 연쇄구균성 인두편도염은 증상만으로는 진단하기 어렵고, 가장 좋은 검사방법인 인두배양검사는 시간을 요하는 단점이 있다. 최근에 비교적 검사과정이 간단한 신속항원검사법을 이용할 수 있게 되었다. 이에 저자들은 두 종류의 신속항원검사법의 민감도와 특이도를 알아보고, 일치도를 평가하기 위해 본 연구를 시행하였다. 방 법: 2001년 11월부터 2002년 2월까지 한일병원 소아과 외래를 방문한 환자 중 인두의 발적과 부종, 인두의 삼출물, 인두의 점상 출혈이 있는 61명의 환자를 대상으로 인두배양검사와 신속항원검사를 시행하였다. 신속항원검사법은 BD $LINK2^{TM}$ Strep A(Becton, Dickinson & Company, U.S.A.)와 $QuickVue^{(R)}$ $In-LINK^{TM}$(Quidel Corporation, U.S.A.)를 사용하였다. 결 과 : 1) 61례의 검체 중 22례(36.1%)에서 인두배양검사상 A군 베타용혈성 연쇄구균이 배양되었다. 2) 집락수 1+는 2례(9.1%), 집락수 2+는 1례(4.5%), 집락수 3+는 10례(45.5%), 집락수 4+는 9례(40.9 %)로 배양되었다. 3) 인두배양검사에서 양성으로 나온 환자 중 3세에서 5세 사이가 14례(63.6%)로 본 연구에서 A군 연쇄구균성 인두편도염의 가장 흔한 연령층이었다. 4) 인두배양검사상 양성으로 나온 환자의 임상 증상 및 징후는 발열과 림프절 종대가 각각 18례(81.8%)에서 나타났고, 인두통 16례(72.7%), 구토 11례(50.0%), 성홍열양 피부발진 8례(36.4%), 두통 7례(31.8%), 복통 7례(31.8%), 딸기모양의 혀는 6례(27.7%)에서 관찰되었다. 5) 민감도는 BD $LINK2^{TM}$ Strep A가 81.8%(18례/22례), $QuickVue^{(R)}$ $In-LINK^{TM}$이 77.3%(17례/22례)이었다. 특이도는 BD $LINK2^{TM}$ Strep A가 89.7%(35례/39례), $QuickVue^{(R)}$ $In-LINK^{TM}$이 100%(39례/39례)이었다. 6) 양성 예측도는 BD $LINK2^{TM}$ Strep A가 81.8%, $QuickVue^{(R)}$ $In-Line^{TM}$이 100%이었다. 음성 예측도는 BD $LINK2^{TM}$ Strep A가 89.7%, $QuickVue^{(R)}$ In-Line$^{TM}$이 88.6%이었다. 7) 인두배양검사에 대한 BD $LINK2^{TM}$ Strep A의 k값은 0.72로 일치도 좋음을 보였고, $QuickVue^{(R)}$ $In-Line^{TM}$의 k값은 0.81로 일치도 아주 좋음을 나타냈다. 결 론 : 신속항원검사법인 BD $LINK2^{TM}$ Strep A와 $QuickVue^{(R)}$ $In-LINK^{TM}$은 민감도와 특이도, 일치도가 높을 뿐 아니라 신속하고 간편하게 결과를 알 수 있어서 인두배양검사와 병행하여 급성 인두편도염을 진단하고 치료하는데 많은 도움이 될 수 있을 것으로 사료된다. Purpose : Recently, a number of rapid antigen detection tests have been available to diagnose group A streptococcal pharyngotonsillitis. The purpose of this study was to determine the sensitivity, specificity and consistency of the two rapid antigen detection tests. Methods : Among the patients who visited our clinic from November 2001 to February 2002, 61 patients who had clinical findings of pharyngeal erythema or edema, pharyngeal exudates and soft palatine petechiae were enrolled in our study. A total of 61 patients were tested with rapid antigen detection tests and throat culture. BD $LINK2^{TM}$ Strep A(Becton, Dickinson & Company, U.S.A.) and $QuickVue^{(R)}$ $In-Line^{TM}$(Quidel Corporation, U.S.A.) were selected for rapid antigen detection tests. Results : Of the 61 patients tested, 22 patients were confirmed as group A streptococcal pharyngotonsillitis by throat culture. The BD $LINK2^{TM}$ Strep A had a sensitivity of 81.8% and a specificity 89.7%. The positive and negative predictive values were 81.8% and 89.7%, respectively. The $QuickVue^{(R)}$ $In-Line^{TM}$ had a sensitivity of 77.3% and a specificity of 100%. The positive and negative predictive values were 100% and 88.6%, respectively. The kappa values of BD $LINK2^{TM}$ Strep A and $QuickVue^{(R)}$ $In-Line^{TM}$ were 0.72 and 0.81, respectively. Conclusion : In addition to high sensitivity, specificity and consistency, both kits are easy to use and simple to interpret, and therefore have the potential to be used with backup throat culture for diagnosis of acute pharyngotonsillitis.

신생아기에 진단된 Citrullinemia 1례

송승규,오경창,홍미애,김희택,신혜정,김순영,장진근,조희승,김병일,양세원,최중환,Song, Seung Kyu,Oh, Kyung Chang,Hong, Mi Ae,Kim, Hee Taeg,Shin, Hye Jung,Kim, Soon Young,Chang, Jin Keun,Jo, Heui Seung,Kim, Beyong Il,Yang, Sei Won,Choi, J 대한소아청소년과학회 2002 Clinical and Experimental Pediatrics (CEP) Vol.45 No.4

Citrullinemia는 유전성 대사 질환 중 하나로서 argininosuccinic acid synthetase 결손에 의해 발생하는 질병이다. 구토, 기면 또는 보챔, 경련, 의식장애와 같은 증상이 고암모니아혈증에 의해 초래되고 고암모니아혈증을 신속히 치료해야만 비가역적인 뇌손상을 줄일 수 있다. 저자들은 소변 유기산 분석과 혈중 및 요중 아미노산 분석에 의해 citrullinemia 1례를 경험했기에 이에 문헌 고찰과 함께 보고하는 바이다. Citrullinemia is a rare inborn error of metabolism of the urea cycle, and was first reported by McMurray, et al. in 1962. It is inherited as an autosomal recessive trait. The normal synthesis of argininosuccinic acid is blocked in this disease due to a deficiency of argininosuccinic acid synthetase(AS), which has been demonstrated in liver cells and fibroblasts. The clinical symptoms are vomiting, lethargy or irritability, convulsion and mental retardation. The diagnosis is made by the finding of an increased plasma citrulline level. Every effort should be made to reduce the blood ammonia level as rapidly as possible before irreversible brain damage occurs. This report describes a case of citrullinemia that was diagnosed through organic acid analysis and amino acid analysis, and reviews the related literatures.

작업치료과 학생들이 지각한 작업치료사의 이미지의 대한 연구

송민옥 ( Min Ok Song ),장아람 ( A Ram Jang ),정명진 ( Myeong Jin Jung ),홍미애 ( Mi Ae Hong ),장철 ( Chel Jang ) 대한통합의학회 2013 대한통합의학회지 Vol.1 No.3

Purpose : The purpose of this study work for the therapy and how students perceive the occupational therapist was to find out how. Method : The subjects in Busan and Kyungnam located in three two-year colleges and four-year clinical experience of two college students completed work therapeutics were expressed any research to understand the purpose of those who agreed to participate in the survey responded to the 175 people working Therapeutics two, three, four grades were included in the study. Result : 1. Education according to the image of the occupational therapist in grades four -year professional, the value and worth, the patient understand the position was higher in order. 3 -year sophomore highly skilled in, the patient understand the position, sincerity was higher in order. 2. Gender occupational therapist who specializes in images for men, the value and worth, high practician was higher in women who were professional, the value and worth, helfer as high. 3. Theory of motivation based on the value of occupational therapists and rewarding images aptitude and interest, high practician, attractive, intellectual was in order. Entrance examination scores as a professional party, value & worth, abuse of authority ceremony was in order. 4. Image by Place of Practice Rehabilitation Hospital occupational therapist who specializes in, high practician, intellectual was in order. Care in the hospital and rewarding value, the professional character, high practician was in order. Hospital and rewarding the value, who specializes in, hepfer was in order. University Hospital who specializes in, the value and worth, Attractive was in order. Conclusion : It had revealed that occupational image perception of occupational therapy student was positive.

Haemophilus influenzae Type b 에 대한 급성 후두염의 치료 경험 2 례

이수영(Soo Young Lee),유상호(Sang Ho Yoo),이기선(Ki Sun Lee),홍미애(Mi Ae Hong),김순남(Soon Nam Kim) 대한소아알레르기호흡기학회 1998 소아알레르기 및 호흡기학회지 Vol.8 No.1

Epiglottitis is an uncommon but potentially life threatening infectious disease in young children. And it is rapidly progressing cellulitis of the epiglottis and adjacent structures that has the potential for causing abrupt, complete airway obstruction. The most common cause of acute epiglottitis is Haemophilius influenzae type b (Hib), therefore in USA, the acute epiglottitis is seen less commonly since the wide spread use of immunization against Hib. In Korea, there has been no report of acute epiglottitis caused by known bacterial organism, and a little investigation of the effects of the immunization against Hib, or Hib related respiratory diseases. In this report, we describe two cases of acute epiglottitis caused by Hib, occurred in non-immunized young-male children admitted to Ajou University Hospital. They had visited to the emergency center of Ajou University hospital with the complaints of acute fever, drooling, dysphagia and severe respiratory difficulties. In both cases, we observed the cherry-red colored, severely swollen epiglottis by the direct laryngoscopic examination. Hib was cultured in blood samples from both two cases, and the patients treated successfully by the 3 days of endotracheal intubation and proper antibiotics therapy without any complications such as pneumonia, meningitis, osteomyelitis, or pericarditis.

진흙 심토 지대에서의 국내 육성 온주밀감 ‘하례조생’의 과실품질

강상훈(Sang Hun Kang),양철준(Chul Jun Yang),홍미애(Mi Ae Hong),이복실(Bok Sil Lee),주정숙(Jung Suk Ju),강종훈(Jong Hoon Kang),좌창숙(Chang Suk Jwa) 한국원예학회 2019 한국원예학회 학술발표요지 Vol.2019 No.5