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황지현 ( Ji Hyen Hwang ),제보경 ( Bo-kyung Je ),김윤경 ( Yun-kyung Kim ) 대한소아감염학회 2017 Pediatric Infection and Vaccine Vol.24 No.2
영아에서의 결핵은 소아나 성인의 결핵에 비해 더 심한 증상과 합병증을 초래할 수 있다. 하지만 증상이 전형적이지 않거나 균 검출이 잘 되지 않는 경우가 많아 진단에 어려움이 있다. 본 증례는 폐결핵으로 진단된 3개월 환아에 대한 보고이다. 환아는 광범위한 양측 폐의 병변에도 불구하고 발열이나 호흡곤란, 기침 등의 증상을 보이지 않았으며 항결핵제 투약 6개월째 폐병변이 호전되었다. 일부 영아 결핵에서 증상이 나타나지 않는 것은 면역반응의 미성숙으로 부분적으로 설명될 수 있을 것이다. 따라서 영아에서 결핵 접촉자 검진의 중요성이 강조된다. A 3-month-old asymptomatic infant presented with bilateral extensive consolidation of the lungs, which was diagnosed as pulmonary tuberculosis. Evaluation of the baby for tuberculosis was initiated because of a history of contact with a known tuberculosis patient. This case is interesting because the baby rarely showed symptoms during the whole course of the disease.
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뇌전증을 가진 소아청소년의 복용 순응도에 영향을 미치는 요인
방용현(Yong Hyun Bang),황지현(Ji Hyen Hwang),변정혜(Jung Hye Byeon),김건하(Gun Ha Kim),은백린(Baik Lin Eun),은소희(So Hee Eun) 대한소아신경학회 2016 대한소아신경학회지 Vol.24 No.4
목적: 뇌전증의 발작 조절에 항경련제에 대한 순응도가 중요하다. 소아청소년 뇌전증 환자의 항경련제에 대한 복용 순응도와 이에 영향을 주는 임상 인자에 대해 알아보고자 하였다. 방법: 2015년 2월 1일부터 2월 28일 동안 고려대학교 안산 및 안암병원 소아신경 클리닉을 방문한 소아청소년 뇌전증 환자들을 대상으로 최근 1개월, 6개월의 약물 복용에 대해 파악하고, 약물 순응도와 임상인자와의 연관을 분석하였다. 결과: 총 191명의 대상 환자 중 129명(67.5%)이 최근 1개월 동안 항경련제를 빠짐없이 복용하였다. 정기적으로 환자가 직접 병원에 방문하여 진료 받은 횟수가 순응도와 관련되었고(adjusted odds ratio[AOR]: 5.78, P=0.000), 항경련제 단일요법 복용 환자들이 복합요법에 비해 순응도가 좋았다(AOR: 3.14, P=0.006). 복약 누락 횟수가 많을수록 발작 빈도가 높았다(r=0.374, P=0.000). 결론: 소아청소년 연령에서 환자가 직접 방문하지 않고 보호자가 대신 진료를 받는 환자들과 항경련제 복합요법을 시행하는 환자들에 대한 보다 면밀한 약물 순응도 파악과 관리가 필요하다. Purpose: Medication compliance is crucial for optimizing seizure control. The aim of this study was to evaluate the relationship between antiepileptic drug (AED) compliance and clinical factors in pediatric population. Methods: We interviewed all epileptic patients who visited the epilepsy clinic at Korea University Ansan and Anam Hospitals during a period of one month and reviewed their medical charts. Drug compliance was evaluated in terms of the number of missed AEDs during the recent 1 and 6 month in this study and the relationship between drug compliance and clinical factors was analyzed. Results: The study included 191 patients. Of these, 129 (67.5%) patients reported taking each AED regularly, without missing a dose for recent 1 month. A history of patient’s regular clinic visits was associated with good compliance (adjusted odds ratio [AOR]: 5.78, P=0.000). And, patients who received AED monotherapy had better compliance than those who received AED polytherapy (AOR: 3.14, P=0.006). Spearman correlation was detected for seizure frequency and the number of missed doses (r=0.374, P=0.000). Conclusion: More careful monitoring the patients who skipped their clinic visits and prescribing the possible minimum number of AEDs would be helpful to increase the drug compliance in children and adolescents with epilepsy.
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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 in fants 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)
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