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빈호흡을 보이는 폐렴이 동반된 신종 인플루엔자 감염 소아의 임상 양상
최보금 ( Bo Geum Choi ),이동원 ( Dong Won Lee ),김여향 ( Yeo Hyang Kim ),현명철 ( Myung Chul Hyun ),이희정 ( Hee Jung Lee ) 대한소아알레르기호흡기학회(구 대한소아알레르기 및 호흡기학회) 2010 소아알레르기 및 호흡기학회지 Vol.20 No.2
목적: 신종 인플루엔자로 확진 받고 동반된 폐렴으로 입원 치료한 소아 환자들의 임상 양상, 검사 소견, 경과 과정을 조사 하였다. 방법: 모두 101명의 환자가 연구에 포함되었는데 환자군을 빈호흡이 있으면 1군(66)명, 없으면 2군 (35명)으로 나누고 환자 자료 수집을 위해 의무기록을 후향적으로 재검토하였다. 결과: 1군에서는 2군보다 환자군의 나이가 많았고 (중간값 7세: 4세, P<0.001) 59.0%가 6-8세였다. 1군환자16명(24.2%)이 기저 질환을 가지고 있었고 대부분이 천식이었다. 하지만 나머지 50명은 과거력에서 특이소견 없이 건강했다 입원 당시 대기중 산소 포화도는 1군이 평균92%로 2군(98%)보다 의미있게 낮았고 (P<0.001) 그 중 42명(63.6%) 이 산소 포화도 이하의 저산소증을 동반했다 혈액 검사에서는 2군 (11명)에 비해 1군(59명)이 의미있게 높은 림프구 감소증 빈도를 보였다.(P<0.001)치료 방법에서는 1군이 스테로이드 사용 28명 주사용 면역글로블린 투여 16명 및 산소 치료 48명으로 스테로이드 사용과 산소 치료의 빈도가 2군보다 의미있게 높았다. (P<0.001, P=0.055, P<0.001) 결론: 결론적으로 신종 인플루엔자는 6세 이상의 소아와 관리가 잘 되지 않은 기저질환을 가진 환자군에서 폐렴을 동반한 심각한 수준의 호흡기 문제를 일으킬 수 있었다. 향후 다기관 공동으로 2009년에 유행한 신종 인플루엔자감염 양상에 대한 조사 연구가 필요할 것으로 생각된다. Purpose: We evaluated the clinical/laboratory characteristics and progress of pediatric patients hospitalized for pneumonia and laboratory-confirmed H1N1 influenza infection. Methods: A total of 101 patients were enrolled. They were divided into 2 groups: group 1 with a fast respiration rate for age (n=66) and group 2 with an appropriate respiration rate for age (n=35). We retrospectively reviewed the medical charts to collect data on the hospitalized patients. Results: Patients were significantly older in group 1 than in group 2 (median age, 7 vs. 4 years, P<0.001) and 59.0% were between 6 and 8 years of age. Sixteen patients (24.2%) in group 1 had underlying medical conditions, most of whom had asthma, and 50 were previously healthy. Oxygen saturation on admission day was significantly lower in group 1 than in group 2 (92% vs. 98%, P<0.001) and 42 patients (63.6%) in group 1 had hypoxia (oxygen saturation 92%). The ≤ frequency of lymphopenia was significantly higher in group 1 than in group 2 (n=59 vs. 11, P <0.001). Some patients in group 1 received systemic corticosteroid therapy, intravenous immunoglobulin infusion and oxygen supplement (n=28, n=16, n=48, respectively). The frequency of systemic corticosteroid therapy and oxygen supplement was higher in group 1 than in group 2 ( P<0.001 for each).Conclusion : H1N1 influenza infection complicated by pneumonia can cause severe illness in previously healthy children more than 6 years old and in children with uncontrolled allergic disease. Multi-center studies are needed to evaluate the clinical and epidemiologic characteristics of pediatric patients with 2009 H1N1 influenza.
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표적세포의 Nitric oxide 합성이 LAK 세포의 세포독성에 대한 예민도에 미치는 영향
박성일,박주형,이치국,김신재,최보금,곽재용,임창열,Park, Sung Il,Park, Ju Hyung,Lee, Chi Kug,Kim, Shin Chae,Choi, Bo Geum,Kwak, Jae Yong,Yim, Chang Yeol 대한면역학회 2001 Immune Network Vol.1 No.2
Background: Nitric oxide (NO), a cytotoxic molecule is produced in various tissues including tumor cells during interleukin-2 (IL-2) therapy . Lymphokine-activated killer (LAK) cells are induced during IL-2 therapy, and have cytotoxic activity against tumor cells. The current study investigated the effects of NO synthesized in target cells or exposure of target cells to NO on the sensitivity of target cells to LAK cell cytotoxicity. Methods: Cytotoxicity was measured using 4 h chromium release assays. LAK cells which were induced by a 4 day incubation of BALB/c mouse splenocytes with IL-2 (6,000 IU/mL) were employed as effector cells. RD-995 skin tumor cells originated from a C3H/HeN mouse were employed as target cells. NO synthesis in target cells was induced by a 24 h incubation of RD-995 cells with $IFN{\gamma}$ (25 U/mL), TNF (50 U/mL) and IL-1 (20 U/mL). S-nitrosyl acetylpenicillamine (SNAP), an NO donor, was used to expose target cells to NO. $N^G$-monomethyl-L-arginine (MLA) and carboxy-PTIO were added during cytotoxicity assays to inhibit NO synthesis, and to scavenge NO produced by target cells, respectively. Results: Sensitivity of NO-producing RD-995 cells to LAK cell cytotoxicity was decreased by addition of MLA and carboxy-PTIO during cytotoxicity assays. However, the two reagents had no effect on the sensitivity of non-NO-producing RD-995 cells. Pretreatment of RD-995 target cells with SNAP increased the sensitivity in comparison with untreated cells. Conclusions: Sensitivity of target cells to LAK cell cytotoxicity is increased by target cell NO synthesis or exposure to NO. Further studies are needed to evaluate whether these in vitro results have relevance to in vivo phenomena.
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소아 크룹 환자들의 원인 바이러스에 따른 임상 양상과 입원 경과 비교
김가은 ( Ga Eun Kim ),신석원 ( Suk Won Shin ),최희정 ( Hee Joung Choi ),최보금 ( Bo Geum Choi ) 대한천식알레르기학회(구 대한알레르기학회) 2018 Allergy Asthma & Respiratory Disease Vol.6 No.6
Purpose: We evaluated the clinical features of croup in children according to viral etiology. Methods: This study enrolled pediatric patients with croup, who showed positive results on respiratory virus reverse transcriptase polymerase chain reaction performed between January 2012 and December 2017. We retrospectively reviewed the medical re cords. Results: A total of 179 patients (119 boys and 60 girls) were enrolled with the mean age of 18.9±14.7 months. The viruses com monly identified were parainfluenza, respiratory syncytial virus, rhinovirus, and influenza. Among these 4 viruses, patients with rhi novirus infection showed significantly shorter fever and admission durations. Patients with parainfluenza infection showed signifi cantly lower incidences of epinephrine nebulization and patients with influenza infections showed significantly higher incidences of steroid treatment. Conclusion: Clinical manifestations of croup differ according to causative viruses. Further studies should be conducted to evaluate the severity and prognosis of croup according to viral etiology. (Allergy Asthma Respir Dis 2018;6:290-294)
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장애아동 어머니의 자기지각과 사회적 지지가 스트레스에 따른 우울에 미치는 영향
최보금,홍상욱,배옥현 영남대학교 자원문제연구소 1996 資源問題硏究 Vol.15 No.-
The purpose of this study was to explore the relationship between self perception, social support, stress and depression of mothers of handicapped children. This study was conducted by questionnaire of 152 care for mothers of handicapped children which located in Seoul province. The data were analyed with the SAS package using frequency, correlation, path anaiysis. As a result of this study, self perception and social support of mothers of handicapped children are important factors affecting the level of stress and depression of mothers of handicapped children.
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골수의 이형성 변화를 동반한 연소성 류마티스 관절염 1예
박태선,박지현,류완희,김종화,라방주,김현각,최보금,백홍선 대한내과학회 2000 대한내과학회지 Vol.59 No.5
Juvenile rheumatoid arthritis (JRA), an autoimmune disease, was characterized by chronic synovitis and associated with various extra-articular manifestations. Abnormal hematologic findings have been reported in all form of JRA, especially anemia due to chronic disease or iron deficiency. Dysplastic changes were rarely noted in the peripheral blood and bone marrow. We experienced a 15-year-old female patient with pauciarticular JRA who have pancytopenia in peripheral blood and a number of dysplastic changes in bone marrow, and present the case here with brief review of literatures.(Korean J Med 59:587-590, 2000)
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