소아에서 조혈모세포 이식 후 발생한 경련의 임상 양상과 위험인자

정나영(Na Young Chung),이재욱(Jae Wook Lee),이대형(Dae Hyung Lee),조빈(Bin Cho),최병준(Byung Jun Choi),김영훈(Young Hoon Kim),정승연(Seung Yun Chung),이인구(In Goo Lee),김학기(Hack Ki Kim) 대한소아신경학회 2006 대한소아신경학회지 Vol.14 No.2

목 적: 조혈모세포 이식을 받은 환자의 11-70%에서 신경학적 합병증이 발생하며 경련은 가장 흔한 증상으로 소아가 어른에 비해 발생 위험이 높지만 아직까지 조혈모세포 이식 과정에서 경련을 일으킨 소아 환자들만을 대상으로 한 보고를 접하지 못하였다. 이에 저자들은 소아에서 조혈모세포 이식 후 발생한 경련의 임상적인 면과 경련의 발생을 예측할 수 있는 위험인자가 무엇인지, 그리고 경련이 있었던 환자들과 없었던 환자들에서 3년 생존율의 차이 등을 알아보기 위하이 연구를 시행하였다. 방 법: 2001년 8월부터 2005년 8월까지 가톨릭의대 성모병원 소아과 조혈모 이식센터에 등록되어 조혈모세포 이식을 받은 197명(남자 113명, 여자 84명)의 환자들 중 경련 증상을 보인 28명(남자 21명, 여자 7명)을 대상으로 하였다. 대상 환자들에서 경련의 빈도, 경련형, 발생 시기, 뇌 영상 촬영 소견 및 뇌파소견, 경련과 관련이 있을 것으로 추정되는 위험인자(성별, 연령, 방사선 및 투여 약제, 조혈모세포 이식 방법, 급성이식편대 숙주병의 등급, 악성 질환의 유무), 그리고 3년 생존율 등을 통계분석을 통해 알아보았다. 결 과 : 조혈모세포 이식 후 경련 발생의 빈도는 13.8% 이었고, 남자가 여자보다 높았다. 경련을 일으킨 환자를 대상으로 한 경련의 발생 시기나 경련형에서는 차이점을 발견할 수 없었다. 경련 환자에서 시행한 뇌영상 촬영은 76.9%(20명)에서 이상 소견을 보였는데 가역적 후백질 뇌병증이 가장 많았고, 뇌파검사에서는 91.3%(21명)에서 이상소견을 보였는데 뇌피질 기능장애가 가장 많았다. 경련과 관련이 있을 것으로 추정한 여러 인자들 중에서는 연령과 급성 이식편대 숙주병의 등급이 위험인자로서 통계적 유의성을 가지고 있었는데, 환자의 연령이 5세 이상인 경우는 5세 미만인 경우에 비해 4.2배(P=0.025), 그리고 2-4등급의 급성이식편대 숙주병은 0-1등급에 비해 2.77배(P=0.034) 경련 발생의 위험이 더 높았다. 조혈모세포 이식 후 3년 생존률은 경련이 있었던 환자들의 경우는 37±18%인 반면 경련이 없었던 환자들은 67±8%를 보이고 있었다(P<0.001) 결 론 : 조혈모세포 이식 소아환자에서 환자의 연령이 5세 이상이거나 2등급 이상의 급성 이식편대숙주병의 발생은 경련 발생의 위험을 조기에 예측할 수 있는 위험인자들이며, 경련은 환자의 3년 생존율과도 밀접한 관련이 있기 때문에 경련이 발생한 환자에 대해서는 조기에 면밀한 관찰과 집중적 치료가 필요할 것으로 사료된다. Purpose : This study was designed to assess the clinical manifestations and the risk factors of seizures after hematopoietic stem cell transplantation(HSCT) in children. Also we analyzed the 3-year survival rates of those who experienced such seizures and those who did not. Method : The study group consisted of 28 patients(21 males and, 7 females) who experienced seizures out of the 197 patients(113 males and, 84 females) who underwent HSCT at St. Mary's Hospital HSCT Center of the Catholic University of Korea. Results : The overall incidence of seizures developing after HSCT was 13.8%, with boys reporting a higher incidence than girls. No significant difference was found with regards to the onsets and the types of seizures. In terms of the possible risk factors for seizures, the age of the patient and the stage of acute graft versus host disease(aGVHD) were statistically significant. The patients who were 5 years or more showed a 4.2 times greater incidence rate of seizures(P=0.025) than those who were younger. Also, the patients with stage 2-4 aGVHD showed a 2.77 times greater incidence of seizures(P= 0.034) than those with stage 0-1 aGVHD. The 3-year survival rate of the patients experiencing seizures was 37±18%, while the rate increased to 67±8% for those who did not(P<0.001). Conclusion : Among the recipients of HSCT in children, the patients aged 5 years or older and aGVHD of the stage 2 or above showed a greater likelihood of seizures occurring after HSCT. The patients who experienced seizures should undergo a close observation and an intensive care since those patients reported a lower 3-year survival rate than those who did not.

실험동물의 발생이상 용어집

김종춘(Jong-Choon Kim),양영수(Young-Su Yang),안태환(Tai-Hwan Ahn),김성호(Sung-Ho Kim),정수연(Soo-Youn Chung),이규식(Gyu-Seek Rhee),정나영(Na-Young Chung),정문구(Moon-Koo Chung) 한국독성학회 2006 Toxicological Research Vol.22 No.3

This paper presents the first version of a Korean glossary of terms for structural developmental abnormalities in common laboratory animals, mainly rats, mice and rabbits. This is a translation of the glossary entitled Terminology and Developmental Abnormalities in Common Laboratory Mammals that was edited by the International Federation of Teratology Societies (IFTS) Committee on International Harmonization of Nomenclature in Developmental Toxicology. The purpose of the Korean glossary is to provide a common vocabulary that will reduce confusion and ambiguity in the description of developmental effects, particularly in submissions to regulatory agencies worldwide. The glossary contains a primary term or phrase, a definition of the abnormality, and notes, where appropriate. Selected synonyms or related terms, which reflect a similar or closely related concept, are noted. Non-preferred terms are indicated where their usage may be incorrect. Modifying terms used repeatedly in the glossary (e.g., absent, branched) are listed in Appendix A, and syndrome names are generally excluded from the glossary, but are listed separately in Appendix B. The glossary is organized into broad sections for external, visceral, and skeletal observations, then subdivided into regions, structures, or organs in a general overall head to tail sequence. Numbering is sequential, and not in any regional or hierarchical order. Uses and misuses of the glossary are discussed. Updates of the Korean glossary are planned based on the comments received.

발생독성 검색을 위한 마우스 전배자배양법의 확립

김종춘(Jong-Choon Kim),신진영(Jin-Young Shin),신동호(Dong-Ho Shin),손우찬(Woo-Chan Son),강성철(Cheng-Zhe Jiang),정나영(Na-Young Jung),백성수(Sung-Soo Baek),정문구(Moon-Koo Chung) 한국실험동물학회 2004 Laboratory Animal Research Vol.20 No.1

The present study was carried out to establish a mouse whole embryo culture technique for detecting developmental toxicity in ICR mice. ICR mouse embryos were explanted on gestational day (GD) 8.5 and cultured for 48 hrs in the bottles containing 2 ㎖ of culture media consisting of 100% immediately centrifuged and heat-inactivated rat serum. The culture bottles with 15 ㎖ capacity were attached to a rotator drum and rotated at 35 rpm, 37.5℃ with a continuous gas flow of 5% O₂, 5% CO₂, 90% N₂ for the first 17 hrs; 20% O₂, 5% CO₂, 75% N₂ for the next 17 hrs; 40% O₂, 5% CO₂, 55% N₂ for the last 24 hrs, After 48 hrs of culture, the growth and differentiation of embryos were compared with those of embryos grown in vivo and each embryo was evaluated for the presence of any malformations. At the begining of the culture, embryos were early somite stage, and the length of whole conceptus including ectoplacental corn was about 1.8 ㎜. At the end of culture, all embryos in culture showed well-developed vascularization in the body and yolk sac. No morphological and histological defects were detected in any embryos examined. The yolk sac diameter, crown-rump length, and head length were 5.1, 4.3, and 2.3 ㎜, respectively. The number of somite pairs and morphological score were 30.0 and 67.7, respectively. The crown-rump length, head length and somite number of embryos grown for 48 hrs in vitro were slightly lower than those of embryos in vivo, respectively, but the morphology and differentiation were similar to those of embryos in vivo. These results indicated that morphology, growth and differentiation of in vitro mouse embryos are almost identical to those of in vivo embryos and suggest that the mouse whole embryo culture technique can be a useful tool for prescreening the developmental toxicity of chemicals.

유아의 거친 신체놀이 참여 정도에 따른 정서지능 및 친사회적 행동 차이

정나영,정계숙 부산대학교 과학교육연구소 2016 교사교육연구 Vol.55 No.1

The purpose of this study was to examine the differences of the rough-and-tumble play among preschoolers according to their emotional intelligence and pro-social behavior. The subjects of this study were 350 preschoolers aged four to five years old. A questionnaire which are rough-and-tumble play, emotion intelligence, pro-social behavior, and a coping checklist was given to the teachers. From the 350 questionnaires returned 300 were finally analyzed based on sufficient data. The collected data was analyzed according to a frequency analysis and t-test using the statistical package SPSS 18.0 program. The results of this study were as follows. First, the preschooler``s rough-and-tumble play most frequently displayed was running and chasing in which boys were more likely to participate in than girls. Second, there were differences among the preschoolers emotion intelligence according to their level of rough-and-tumble play. Preschoolers who participated in more rough-and-tumble play showed more emotion intelligence than those who participated in less rough-and-tumble play. These differences in emotional intelligence included: more appraisal and expression of self emotion, more developed relationship with the teacher, and more developed relationship with their peers. Third, there were differences among the preschooler’s pro-social behavior according to their level of rough-and-tumble play. Preschoolers who participated in more rough-and-tumble play showed better pro-social behavior than those who participated in less rough-and-tumble play. These differences in pro-social behaviors included: a higher likelihood to help others, active communication, a higher willingness to help, higher comfort levels of proximity, more willing to share, and a deeper display of empathy. 본 연구는 유아의 거친 신체놀이 참여 정도에 따라 정서지능과 친사회적 행동에 차이가 있는지 알아보고자 하였다. 이를 위해 경상도와 경기도에 소개하고 있는 유치원 및 어린이집에 재원 중인 만 4, 5세 유아 300명을 최종 연구대상으로 하였다. 유아의 거친 신체놀이, 정서지능, 친사회적 행동의 측정은 거친 신체놀이 11문항, 정서지능 50문항, 친사회적 행동 42문항으로 구성된 교사용 척도를 사용하였다. 연구문제에 따라 분석한 결과는 다음과 같다. 첫째, 유아의 거친 신체놀이 참여 빈도를 알아 본 결과, 유아들은 거친 신체놀이에서 도망가기와 쫓기를 가장 많이 하였고, 몰래 다가가 놀래키기를 가장 적게 하였다. 또한 거친 신체놀이에 따라 대한 유아 성별의 차이를 알아본 결과, 남아가 여아보다 거친 신체놀이를 많이 하는 것으로 나타났다. 둘째, 유아의 거친 신체놀이 참여 정도에 따라 정서지능을 알아본 결과, 거친 신체놀이 참여도가 높은 집단의 정서지능의 점수가 더 높았다. 셋째, 유아의 거친 신체놀이 참여 정도에 따라 친사회적 행동의 차이를 알아본 결과, 거친 신체놀이 참여도가 높은 집단의 친사회적 행동 점수가 더 높게 나타났다.

SRY 양성 46,XX 남성 1례

정나영,인영흠,정민호,서병규,이병철 대한소아내분비학회 2003 Annals of Pediatirc Endocrinology & Metabolism Vol.8 No.2