거대세포 바이러스 간염이 동반된 장성 선단 피부염 1례

김광렬,박재옥,신상만,Kim, Kwang-Yeol,Park, Jae-Ock,Shin, Sang-Mann 대한소아소화기영양학회 1999 Pediatric gastroenterology, hepatology & nutrition Vol.2 No.2

Acrodermatitis enteropethica (AE) is a rare autosomal recessive disorder of zinc absorption leading to chronic diarrhea and characteristic skin lesion. The term is also applied to any acquired zinc deficiency state resulting in the same clinical pictures. We experienced one case of AE in 1 month old male infant who had bacterial enterocolitis. The skin around mouth, anus, eyes, ears, hands and legs became reddish, vesicular and eczematoid. Serum zinc level was decreased to $51.4\;{\mu}g/dL$ (N=70~150). Endoscopic finding revealed pale gastric mucosa and villous atrophy of small intestine. Biopsy finding of small intestine showed no villi due to mucosal atrophy. On 13 day of admission jaundice with DIC were noted and AST & ALT were elevated to 110 & 36.8 IU/L, respectively. Diarrhea was improved but jaundice and liver function were not recovered until discharge from hospital. After discharge when the patient was 4 months of age serum bilirubin and AST/ALT had not been normalized. CMV shell vial culture of urine and CMV Ig G antibody were positive. So intravenous ganciclovir injection of 7.5 mg/kg, two times a day for 2 weeks and then 10 mg/kg/day for 3 months was done from 4 to 6 months of age. No virus was found in the urine and AST & ALT were normalized at 2 months after stopping ganciclovir treatment.

Creosote에 의해 발생한 위궤양 2례

김광렬,박재옥,신상만,Kim, Kwang-Yeol,Park, Jae-Ock,Shin, Sang-Mann 대한소아소화기영양학회 2000 Pediatric gastroenterology, hepatology & nutrition Vol.3 No.1

Secondary peptic ulceration and gastritis have been known to be associated with stress, exogenous agents, drugs or infection. Salicylate (aspirin) ingestion has been known to be associated with increased incidence of gastric ulcer and more frequently as the cause of hemorrhagic gastric erosions and gastritis. Some medications such as tetracyclines and iron preparations have been associated with ulceration of the gastrointestinal tract. Chemotherapeutic agents including cytoxan and methotrexate also have been implicated in the development of mucosal and gastrointestinal ulcers. We have experienced two cases of hemorrhagic gastric ulcers due to creosote ingestion in a 13 month and a 5 year old boys. Creosote is a main component of one of the popular digestives, Jungrohwan in Japan and Korea.

장이상회전이 동반된 십이지장 막양구조(Web) 1례

김진숙,이주택,박재옥,신상만,Kim, Jin-Suk,Lee, Jhoo-Taek,Park, Jae-Ock,Shin, Sang-Mann 대한소아소화기영양학회 1999 Pediatric gastroenterology, hepatology & nutrition Vol.2 No.1

저자들은 출생 후부터 1년에 수 회 반복되는 담즙이 포함된 사출성 구토가 있었던 9세 여아에서 발견된 십이지장 격막과 동반된 장이상회전 1례를 경험하였기에 보고하는 바이며, 장의 완전 폐쇄가 아닌 경우에는 년장아에서도 선천성 장폐쇄의 소견이 나타날 수 있으므로 구토가 심하게 반복되는 경우에는 항상 주의깊게 감별진단해야 한다. Duodenal web is an uncommon lesion that infrequently cause partial or complete intestinal obstruction. If the duonenal web is incomplete and only partially obstructs the duodenal lumen, the onset of symptoms may be delayed for years, and obstructive symptoms will be only minimal and intermittent. Congenital duodenal obstruction is occasionally associated with intestinal malrotation. We experienced a case of duodenal web associated with intestinal malrotation in a 9-year-old girl who had been suffered from intermittent projectile vomiting since birth without failure to thrive. The diagnosis was made by UGI series & abdominal CT. Patient remained asymptomatic after operation.

Shell vial culture로 진단한 선천성 거대 세포 바이러스 감염증 1례

김태호(Tae Ho Kim),박상천(Sang Cheon Park),서은숙(Eun Sook Suh),신상만(Sang Mann Shin) 대한소아신경학회 1995 대한소아신경학회지 Vol.2 No.2

Cytomegalovirus is the leading cause of congenital viral infection. The prevalence rate of congenital infection is 0.2-2.5% of all live births. The infection may be congenital, but it is most often aquired during birth, breast milk, blood transfusions, organ transplantations, perinatal infections. The vast majority of these infections are chronic, subclinical forms, but symptomatic infections are sufficiently prevalent and dangerous to present a major unresolved health problem throughout the world. We experienced one case of congenital cytomegalovirus infection. The case was hospitalized in our hospital because of convulsion. She was characterized by microcephaly, hepatomegaly, convulsion, periventricular calcifications on brain CT. We could confirmed the congenital cytomegalovirus infection by shell vial culture. We report this case with brief rewiew fo literature.

RSV 감염에 의한 급성 세기관지염에서 리바비린 치료 효과에 대한 연구

김종복(Jong Bock Kim),편복양(Bok Yang Pyun),이동환(Dong Whan Lee),신상만(Sang Mann Shin) 대한소아알레르기호흡기학회(구 대한소아알레르기 및 호흡기학회) 1995 소아알레르기 및 호흡기학회지 Vol.5 No.1

N/A We evaluated the effect of aerosolized ribavirin therapy in infants with acute bronchiolitis who admitted to SoonChunHyang University hospital from december 1992 to february 1994 . Twenty - eight infants were enrolled to this study(RSV antibody in 18 cases were confirmed by indirect immunofluorescent technique and 10 cases were clinically diagnosed as acute bronchiolitis) . Twelve infants received aerosolized ribavirin therapy and 16 infants were treated with only conservative treatment . The mean ages were 4.5+2.5 months in rebavirin group and 4.6 ± 3.1 months in control group. The results were as follows 1) In ribavirin group , the severity of illness improved more rapidly than control group . At admission , the score of severity of illness was 13.9 in the ribavirin group and 12.4 in the control group. 2) Among eight clinical variables, 6 clinical variables (nasal discharge , chest retraction , poor feeding, stridor , rales , cough ) improved more rapidly in the ribavirin group than that in control group significantly , 3) Mean respiration rate decreases more rapidly in ribavirin group than that in control group. 4) Mean heart rate decreases more rapidly in the ribavirin group than that in control group, 5) Capillary oxygen saturation improved after 1st day in the ribavirin group, but that improved after 2nd day in the control group. 6) Mean duration of treatment was 3.5 ± 0.6 days in ribavirin group and that was 5.3 1.2 days in control group, 7) There was no evidence of abnormal hematologic or chemical finding in the ribavirin group , but minor rash on eyelid was noted in 1 case. Other side effects or direct toxicity to the lower respiratory tract were not associated with the aerosol therapy .

Coffin-Siris syndome 1례

신상만 순천향의학연구소 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2

Coffin-Siris syndrome is a syndrome characterized by mental retardation, hyperplasia of fifth finger, toe nails and terminal phalanges of the fifth finger and toes, growth deficiency, joint laxity, coarse facies with full lips, low nasal bridge, vertebral anomaly, short forearm, Dandy-Walker malformation and gastric outlet obstruction. We report a case of Coffin-Siris syndrome in a 2-month-old female who showed hyperplasia second finger nail, Dandy-Walker variants, gastric outlet obstruction, low nasal bridge, coars facies with full lips.

예방 접종의 어제와 오늘

신상만,이상주 순천향대학교 1993 논문집 Vol.16 No.4

Many of the infectious diseases with high mortality have been controlled by vaccination. Advances in the development of the vaccine and improvement of the scocioeconomic status changed the routine immunization practice. And the concept of vaccination switched from the mass protection to the individual protection. A brief history of vaccination for Korean Children and development of new vaccine were reviewed.

학동기 이후의 성장 주기별 신장 및 체중 증가율에 관한 연구

신상만,박경배,박준수,김창휘 순천향의학연구소 1996 Journal of Soonchunhyang Medical Science Vol.2 No.2

This study was carried out to know the growth rate of height and weight in Korean children which was conducted on semi-longitudinal research method. For this study, health records of the sample group that carry information for the period from their first grade of elementary school to the third grade of high school were used, 120 males and 120 females who became third grade of high school in 1994 were selected at random from each of the four cities; Seoul, Chonan, Kumi and Eumsung. Among 917 candidates, 460 males and 457 females born between March 1976 and December 1976 were finally selected as a sample for the purpose of this research. The results are as follows; 1. Measurement of the physique Both male and female samples showed constant growth in height and weight. Male grew from the range of 115.8±4.8㎝ at the age of 6 to 171.5±5.6㎝ at 17 while females grew from the range of 114.6±4.7㎝ to 158.9±5.1㎝. The Weight of males rose from the range of 19.9±2.5Kg at the age of 6 to 62.5 ±8.1Kg at 17 while that of females increased from the range of 19.3±2.4Kg to 54.1±6.9Kg. 2. Growth and Nutritional Indices The study revealed that relative weight of the sample group increased as they grew older. The Kaup index also showed an increase in line with the advancement in their ages, and exceeded 2.0 at the age of 15 for males and at the age of 14 for females. The Rohrer index, on the other hand, showed a declining trend for the first several years but began to increase at the age of 13 for males and at the age of 11 for females. 3. Comparative analysis with similar regardless that were performed using sample groups born in 1965 and 1970 revealed the followings; ① Height - The average height of male samples(born in 1976) under this survey was bigger than that of male samples born in 1965 in their respective age from 6 to 17. - The average height of male samples born in 1970 was bigger than that of male samples born in 1970 from 6 to 14 but showed no difference after 15. - Female samples born in 1976 showed height that was bigger than the other sample groups born in 1965 and 1970 in their respective age from 6 to 17. ② Weight Both male and female samples under this survey weighed more than their counterpart sample groups born in 1965 and 1970 in their respective age. 4. The Maximum Growth Age was 12.3 for males and 10.4 for females. Males grew 5.92±2.77㎝ a year on an average when they were 12 and 13 years old while females grew 5.93±2.69㎝ when they were 11 and 12 years old. In conclusion, the study revealed that like in other countries males and females experienced the second growth spurt during their adolescence and relatively slow growth thereafter. Unlike height which showed constant growth, weight varied; there were incidences where females even experienced weight loss after years of diminishing growth rate in the wake of the adolescence.

모유 수유에 대한 일반인들의 인식에 관한 설문조사

반성환,이동환,박재옥,신상만 순천향의학연구소 1997 Journal of Soonchunhyang Medical Science Vol.3 No.1

OBJECT : From the late in 1970, the incidence of breast-feeding have been increased in the developed countries. But, there is a marked contrast in Korea, inspite of the campaign of breast-feeding. We researched the general opinions of general populations on breast feeding to find out a better way on successful breast-feeding and helping people's understanding. METHODS : To find out the factors influencing the incidence of breast-feeding, we made on ingury study in 234 women and their family member including their husbands during the period of April, 1995 to August, 1995. We analysed the results according to sex, age, and the status of education and marriage. RESULT People in the inquiry answered as follows : - breast feeding is to be taken for granted.(93-94%) - the reason of breast feeding is for protecting baby from disease.(81-83%) - feeding breast milk is much better than cow's milk.(82-83%) - breast feeding is good for hepling the bonding between mother and her baby.(89%) - most of them would like to follow the spouse's opinion to keep on breast feeding.(73-75%) - breast feeding could cause some inconveniences in sexual-life/(74-78%) - breast feeding woman are regarded more admiarable when compared with non-breast feeding woman.(80-84%) - breast feeding woman is less attactive.(22-23%) - the purpose of creating breast is to feed baby.(14-17%) - breast feeding in public place is permissible.(43%) - breast feeding can make breast shapeless.(22%) CONCLUSIONS : Every effort should be made so as to increase the recognition of the value of breast feeding, not only for pregnant women but also for their husbands. Both of them have to attend the breast feeding education classes given before and after childbirth. Students have to be taught about the merit and the way of breast feeding through school education. Doctors are expected to encourage people to realize the advantages of breast-feeding, participate in the campaign and never advise to give up breast feeding.

한국 신생아의 혈소판수, 평균혈소판용적, 혈소판용적비 및 혈소판분포폭에 관한 연구

이상주,신상만 순천향대학교 1991 논문집 Vol.14 No.2

Platelet count and platelet indices represent a balance between production and consumption, and this dynamic equilibrium has been the subject of intensive study in recent years, but normal reference range for platelet indices have not been firmly established in Korean neonate. Blood samples from frmoral vein collected in K₂EDTA bottle of 219 neonates(190 full term, 19 preterm, 10 post term) were analyzed with Coulter Hematology Analyzer Model STKS. The following results were obtained ; 1. Normal reference range(Mean ±2SD) for platelet count, mean platelet volume, plateletcrit, platelet distribution width was 300.13±134.16 ×10³/μ1, 7.58±1.36fl, 0.225±0.096%, 16.60±1.02, respectively. 2. Platelet count did not correlate with both gestational age and birth weight. Mean platelet volume showed negative correlation with gestational age(r=-0.287) and birth weight(r=-0.199). Plateletcrit correlated negatively with gestational age(r=-0.195) and birth weight(r=-0.153). Platelet distribution width did not correlate with both gestational age and birth weight. 3. Small group of high risk infant such as preterm, post term, SGA, LGA and LBW infant showed values out of normal range, but significant difference was revealed only in preterm, post term and LBW infant. Preterm infant showed significantly higher value for mean platelet volume(p< 0.016) and platelet distribution width(p=0.002) than those value in term infant. Post term infant showed significantly lower value for mean platelet volume than the value in term infant(p=0.007). Low birth weight infant showed significantly higher value for mean platelet volume(p<0.05) than normal value of all neonate. 4. correlation coefficient(r) between platelet count and mean platelet volume, plateletcrit, platelet distribution width was -0.352, 0.866, -0.418, respectively. Correlation coefficient(r) between plateletcrit and platelet distribution width was -0.394. Mean platelet volume did not correlate with both platelectcrit and platelet distribution width. These data represent normal reference range for healthy Korean neonate, demonstrate more significant variation with gestational age than birth weight and show some correlation between platelet count and platelet indices.