Cowden 증후군 환자에서 발생한 캔디다 식도염 1예

강경지,윤혜정,류성렬,류남희,강유나,황진복,Kang, Kyung-Ji,Yun, Hye-Jung,Ryu, Seong-Yeol,Ryoo, Nam-Hee,Kang, Yu-Na,Hwang, Jin-Bok 대한소아소화기영양학회 2009 Pediatric gastroenterology, hepatology & nutrition Vol.12 No.1

Cowden's syndrome is a harmatomatous polyposis syndrome with characteristic mucocutaneous lesions and among the spectra of clinical disorders that has been attributed to germline mutations in the PTEN gene. Although Cowden's syndrome has rarely been reported, immunologic studies have revealed that patients with this syndrome have humoral and/or cellular immune abnormalities. We recently identified a 21-year-old woman with Cowden's syndrome who was diagnosed with candida esophagitis without a history of diabetes, carcinoma, or steroid therapy. We report the immunologic status of this patient and the relationship with candida esophagitis on the basis of a literature review. Cowden 증후군으로 진단되어 추적 관찰 중인 21세 여자에서 위장관 용종의 정기적 관찰을 위하여 시행한 내시경 검사 중 캔디다 식도염이 발견되어 문헌 고찰과 함께 보고한다. 면역학적 이상, 진균 식도 감염의 선행 질환, 투약의 병력이 없었고, 뚜렷한 식도 감염의 임상 증상도 없었다.

Perianastomotic ulceration presenting with long-term iron deficiency anemia and growth failure: A case report and review of the literature

강경지,김은하,정은영,박우현,강유나,김애숙,황진복 대한소아청소년과학회 2010 Clinical and Experimental Pediatrics (CEP) Vol.53 No.1

Perianastomotic ulceration (PAU) rarely occurs after small bowel resection in infancy. Since the understanding of its pathogenesis is incomplete, an effective method of treatment has not yet been discovered. We report the first case in Korea of a 10-year-old girl with chronic iron deficiency anemia (IDA) and growth failure who was diagnosed with PAU at colonoscopy. Seven years were required to identify the cause of IDA. After surgical resection and revision of anastomosis, a close follow-up is being conducted due to the risk of recurrence. Here, we also review reports on 25 pediatric patients with PAU derived from a search of the English-language literature and describe the clinical features of PAU along with the results of treatment.

임상 ; 신생아 위장관 천공에서 괴사성 장염군과 기타군의 임상양상 및 사망률 비교

강경지 ( Kyung Ji Kang ),송지현 ( Ji Hyeun Song ),김천수 ( Chun Soo Kim ),이상락 ( Sang Lak Lee ),최순옥 ( Soon Ok Choi ),박우현 ( Woo Hyun Park ) 대한주산의학회 2011 Perinatology Vol.22 No.2

목적: 신생아 위장관 천공의 빈도와 사망률이 높은 괴사성 장염을 다른 원인들과 비교를 통해 사망률 증가의 위험인자를 알아보고자 하였다. 방법: 1999년 1월부터 2009년 12월까지 계명대학교 동산의료원에서 위장관 천공으로 수술한 신생아 28명을 후향적의무기록조사를 통해 괴사성 장염군과 기타군으로 분류하여 임상적 특성과 사망률을 비교하였다. 결과: 원인으로 괴사성 장염이 35.7%로 가장 많았고 기타 원인(장관 폐쇄, 장관 회전이상, 태변 복막염 등)이 64.3%였다. 괴사성 장염군에서 유의하게 재태주령이 낮고(32.8±4.6주 vs. 36.8±2.7주, P=0.028), 천공 진단일이 늦었으며(16.3±9.7일 vs. 2.2 ±1.8일, P=0.001) 사망률이 높았다(50.0% vs. 5.6%, P=0.013). 단순 회귀분석에서 재태주령(OR 0.69, 95% CI: 0.51-0.95, P=0.022)과 괴사성 장염(OR 17.00, 95% CI: 1.60-181.36, P=0.019)이 유의한 위험인자였으나 다중로지스틱 회귀분석에서는 괴사성 장염(OR 7.70, 95% CI: 0.55-108.06, P=0.130)과 재태주령(OR 0.79, 95% CI: 0.58-1.09, P=0.151)은 유의성이 없었다. 결론: 괴사성 장염군에서 유의하게 재태주령이 낮고 사망률이 높았으나 다중 회귀분석결과 낮은 재태주령과 괴사성장염 자체는 사망률 증가의 유의한 위험인자는 아니었다. Purpose: This study was conducted to compare the clinical features and outcome of neonatal gastrointestinal perforation due to necrotizing enterocolitis (NEC) and other etiologic diseases (non-NEC). Methods: The medical records of neonates, admitted to the neonatal intensive care unit of Dongsan Medical Center for gastrointestinal perforation between January 1999 and December 2009, were reviewed retrospectively. The admission records for clinical findings and mortality were reviewed and statistically analyzed for both groups. Results: Among 28 neonates, NEC group was 35.7% and the other group (intestinal atresia, malrotation, meconium peritonitis, etc) was 64.3%. The mean gestational age was significantly shorter (32.8±4.6 weeks vs. 36.8±2.7 weeks, P=0.028) and the mean diagnostic day was significantly later (16.3±9.7 days vs. 2.2±1.8 days, P=0.001) in the NEC group than that of the non-NEC group. The mortality rate was markedly higher in the NEC group (50%) than that of the non-NEC group (5.6%)( P=0.013). By simple logistic regression analysis, gestational age (OR 0.69, 95% CI: 0.51-0.95, P=0.022) and NEC (OR 17.00, 95% CI: 1.60-181.36, P=0.019) were the significant risk factors to increase the mortality rate. Multiple logistic regression analysis showed NEC (OR 7.70, 95% CI: 0.55-108.06, P=0.130) and gestational age (OR 0.79, 95% CI: 0.58-1.09, P=0.151) were not the significant independent risk factors. Conclusions: This study found that gestational age was shorter and mortality rate was higher in the NEC group than the non-NEC group. However, after multiple logistic regression analysis, NEC or lower gestational age itself did not increase the mortality rate significantly.

인공근육개발을 위한 소프트 액추에이터 연구

강경지(Gyeongji Kang),송가혜(Kahye Song) 한국로봇학회(논문지) 2021 로봇학회 논문지 Vol.16 No.1

고중량 파지용 소프트 그리퍼를 활용한 스마트 팜 토마토 수확

강경지(Gyeongji Kang),김성훈(Seonghun Kim),박신석(Shinsuk Park),송가혜(Kahye Song) 대한기계학회 2023 대한기계학회 춘추학술대회 Vol.2023 No.11

This paper introduces an innovative technique for the harvesting of tomatoes through the implementation of a soft robotic gripper. The functionality of this gripper is rooted in a woven structural configuration, resembling a spherical morphology. This design enables a gentle interaction with individual tomatoes, significantly reducing the risk of damage. This achievement is facilitated by the strategic integration of flexible materials, endowing the gripper with an exceptional adaptability to a wide spectrum of tomato sizes and shapes. The amalgamation of this soft gripping technology holds immense promise in revolutionizing harvesting efficiency, all while preserving the integrity of the tomato. Notably, this configuration shows a substantial payload capacity(>100㎏) advantage compared to conventional gripper designs, positioning it as a critical technology within the broader domain of harvesting. The assimilation of these advanced soft grippers not only pledges a discernible enhancement in operational efficiency, but also heralds the advent of a transformative framework for multifaceted fruit/vegetable harvesting.

소아 가막성 대장염: 단일 대학병원의 경험

박재현,강경지,강유나,김애숙,황진복 대한소아청소년과학회 2010 Clinical and Experimental Pediatrics (CEP) Vol.53 No.2

Purpose:Pseudomembranous colitis (PMC) occurs rarely in children, but its incidences are increasing due to frequent antibiotic use. We investigated the incidence and clinical characteristics of PMC accompanied by bacterial enteritis-like symptoms in children. Methods:Between November 2003 and July 2007 at the Department of Pediatrics, Dongsan Medical Center, we analyzed the medical records of consecutive patients who received antibiotics in the past 1 month, developed bacterial enteritis-like symptoms, and were diagnosed with PMC based on sigmoidoscopy examination and histological findings. Results:Among 22 patients who underwent sigmoidoscopy and biopsy examinations, 11 (50%) were diagnosed with PMC. These 11 patients were aged 2 months-12 years, among whom 5 patients (45.5%) were less than 1 year old. The clinical symptoms were bloody diarrhea (28.6%), abdominal pain or colic (28.6%), watery or mucoid diarrhea (23.8%), vomiting (9.5%), and fever (9.5%). The antibiotics used were penicillins (55.6%), macrolides (27.8%), cephalosporins (11.1%), and aminoglycosides (5.6%). The period of antibiotic use was 3-14 days. The interval between the initial antibiotic exposure and the onset of symptoms was 5-21 days. The results of stool examination of all patients were negative for Clostridium difficile toxin A. Patient distribution according to the degree of PMC was as follows: grade I, 18.2% (2 cases); grade II, 27.3% (3); grade III, 36.4% (4); and grade IV, 18.2% (2). PMC did not recur in any case. Conclusion:PMC is not a rare disease in children. If pediatric patients receiving antibiotics manifest symptoms like bacterial enteritis, PMC should be suspected. Endoscopy and biopsy should be applied as aggressive diagnostic approaches to detect this condition. 목적:가막성 대장염(pseudomembranous colitis, PMC)은 소아에서는 드문 질환으로 항생제의 사용이 늘어나면서 증가하고 있을 것으로 추정되고 있다. 저자들은 세균성 장염의 소견을 보인 소아 PMC의 발병 빈도와 임상 특성에 관한 단일 대학 병원의 경험을 소개하고자 한다. 방법:2003년 11월부터 2007년 7월까지 동산의료원 소아과에 입원한 환자 중 최근 1개월 이내에 항생제 사용의 병력을 가지면서 세균성 장염 증상을 보인 환자에서 직장 내시경 및 조직 생검을 시행하여 조직학적으로 PMC로 확진된 연속해서 모아진 환자를 대상으로 하였다. 결과:직장 내시경 및 조직 검사를 시행한 22례 중 11례(50.0%)에서 PMC로 진단되었다. 소아 PMC 환자의 연령은 2개월에서 12세로, 1세 이하가 5례(45.5%)를 차지하였다. 혈성 설사 6례(28.6%), 복통 혹은 보챔 6례(28.6%), 수양성 혹은 점액성 설사 5례 (23.8%), 구토 2례(9.5%), 열 2례(9.5%)가 관찰되었다. 항생제는 병합 사용된 경우를 포함하여 총 18건이 관찰되어, 페니실린 계열 10건(55.6%), 마크로라이드 5건(27.8%), 세팔로스포린 2건(11.1%), 아미노글라이코사이드 계열 사용이 1건(5.6%)이었다. 항생제 사용 기간은 3일에서 14일로 다양하였다. 항생제 노출에서 증상 발현까지의 기간은 5일에서 21일이었다. 대변 Clostridium difficile 독소 A 검사는 PMC 환자 전례에서 음성이었다. 가막성을 기준으로 한 가막성 대장염의 내시경 소견은 1단계(18.2%, 2), 2단계(27.3%, 3), 3단계(36.4%, 4), 4단계(18.2%, 2)였다. 추적 관찰 중 전례에서 재발은 관찰되지 않았다. 결론:소아의 가막성 대장염은 드물지 않으며, 영아기에도 호발한다. 특히 항생제를 사용 중이거나 사용 병력을 가진 환자에서 세균성 장염의 소견을 보일 때 직장 내시경 검사 및 조직 생검을 이용한 적극적인 진단적 접근이 필요할 것으로 판단된다.

What is the 'objective' differential factor of diarrhea in infancy?: Normal state versus diarrheal illness in infants with chronic frequent and loose stool

황진복,강경지,이중정,김애숙 대한소아청소년과학회 2010 Clinical and Experimental Pediatrics (CEP) Vol.53 No.12

Purpose: This study aimed to identify 'objective' differential factors for normal frequent loose stool (NFLS) and diarrheal illness with dehydration and nutritional deficiency (DIDN) among infants with chronic frequent loose stool (CFLS). Methods: Data were analyzed from infants under 2 years of age with CFLS who had been transferred from general pediatricians. These 46patients were divided into 2 groups (NFLS versus DIDN). Nocturnal stool was defined as evacuation between 10 pm and 6 am. Maximal stool amount/day (measured using the mother's hand) was specified as the highest score during the period of CFLS obtained by adding up each evacuation's score (range, 0-2 points). Results: There were 36 cases of NFLS and 10 of DIDN. A failure to gain weight (P=0.0001), fever (P=0.0079), colic/abdominal pain (P=0.0014), gross blood in stool (except allergic proctocolitis) (P=0.0113), nocturnal stool (P=0.0001), and the score of stool amount (P =0.0001) were found to significantly differentiate the groups. A failure to gain weight was observed in 39% of even NFLS. The frequency,mucus content, and microbiological findings of stools, as well as diaper dermatitis were not found to significantly differentiate the groups. Conclusion: NFLS was more common than DIDN in infants with CFLS. The most 'objective' differential factors were nocturnal stool and the score of stool amount (≥7 points/day).

제주해녀와 함께 흘러가다 : 제주대학교사범대학부설고등학교 진로학술동아리 테왁이 둥둥

홍지희,강경지,김은희,김온유,이유빈,고준혁,강민재,양현정,양연재,심유림,김민지,금나현,김금별,허정인 제주학회 2016 제주학회 학술발표논문집 Vol.2016 No.2

우주물체 포획을 위한 전개형 그리퍼 설계

이성진(Sung-Jin Lee),강경지(Gyeongji Kang),송가혜(Kahye Song),이대영(Dae-Young Lee) 한국항공우주학회 2023 한국항공우주학회 학술발표회 논문집 Vol.2023 No.6

임상 ; 미숙아에서 태변 장폐색의 임상적 특징 및 예후

김천수 ( Chun Soo Kim ),김은하 ( Eun Ha Kim ),이상락 ( Sang Lak Lee ),강경지 ( Kyung Ji Kang ),이금채원 ( Geum Chae Won Yi ) 대한주산의학회 2012 Perinatology Vol.23 No.4

목적 : 태변 장폐색은 점착성의 농축된 태변이 회장 말단과 대장에 축적되어 발생하는 일시적 장폐색으로 알려져 있다. 이 연구는 미숙아에서 발생하는 태변 장폐색의 임상소견과 예후를 알아보고자 시행하였다. 방법 : 2009년 1월부터 2011년 12월까지 일개 대학병원 신생아 집중치료실에 입원했던 미숙아를 대상으로 의무기록과 방사선 영상소견을 통하여 후향적으로 연구하였다. 태변 장폐색의 진단은 임상증상과 gastrografin 관장 검사의 이상 소견 둘 다 있는 경우로 하였다. 대조군은 출생연도와 재태연령을 동일한 조건으로 맞춘 미숙아 중에서 2배수 무작위 추출하였다. 결과 : 연구 대상으로 합당한 태변 장폐색군 환아는 43명이었다. 주산기 임상소견 중 산모의 고혈압증과 황산마그네슘 사용 빈도는 장폐색군에서 더 높았으나 통계적 유의성은 없었고, 부당 경량아의 빈도는 장폐색군이 대조군보다 더 높았 다(14% 대 3.5%; P<0.05). 수유장애의 동반율도 장폐색군이 대조군보다 더 높았다(86% 대 24.4%; P<0.001). 1례를 제외 한 모든 환아에서 gastrografin 관장은 1회 시행하였고, 영상소견상 소결장은 7예(16.3%)에서 동반되었다. 전례에서 관 장의 합병증 발생은 없었다. 태변 장폐색을 가진 환아에서 조영관장 후 폐색의 호전은 방사선 영상소견상 6.5±10.0일에 이루어졌고, 이는 임상증상의 호전 시기인 7.5±9.4일보다 더 빨랐다(P<0.05). 완전 장관영양의 도달 시기는 장폐색군이 25.4±14.3일로 대조군(16.4±9.3일)보다 더 느렸고, 재원기간도 장폐색군에서 더 길었다(P<0.001). 결론 : 미숙아에서 수유장애는 태변 장폐색을 시사하는 소견이 된다. 태변 장폐색은 완전 장관영양의 도달 시기를 지연 하거나 재원기간을 연장하는 요인이 된다. Purpose : This study was undertaken to investigate the clinical features and outcomes of meconium intestinal obstruction (MIO) in preterm infants. Methods : A retrospective analysis of medical records and radiologic images was conducted in a neonatal intensive care unit over a 3-year period (2009-2011). In addition, birth year- and gestational age-matched babies were selected by random sampling with twice the number as the control group. Results : There were 43 infants with MIO who were appropriate as subjects. In perinatal factors, a maternal history of hypertension and the use of magnesium sulfate were more frequent in patients with MIO, but not significant. Feeding intolerance was more common in the MIO group than the control (86% vs. 24.4%; P < 0.001). The frequency of gastrografin enema was once in all but one of the patients, and the microcolon was detected in 7 cases (16.3%). Radiographic change after enema was seen earlier than clinical improvement (P < 0.05).The patients with MIO took longer to achieve full enteral feeding, and had a more prolonged hospital stay (P <0.001). Conclusion : Feeding intolerance in preterm infants may be an early clinical finding of MIO. Meconium obstruction causes a delay of full enteral feeding and extension of hospital stay.