소아에서 소장형 장중첩증; 자연 정복과 수술적 치료의 비교

박미란,임미선,서정기,고재성,장주영,양혜란,임윤정,김우선,Park, Mi-Ran,Lim, Mi-Sun,Seo, Jeong-Kee,Ko, Jae-Sung,Chang, Ju-Young,Yang, Hye-Ran,Lim, Yoon-Joung,Kim, Woo-Sun 대한소아소화기영양학회 2010 Pediatric gastroenterology, hepatology & nutrition Vol.13 No.2

목 적: 장중첩증은 영아기 급성 복통의 흔한 원인 중 하나로 대부분 특발성의 소장-대장형이다. 반면 소장형 장중첩증은 드물며 시작점을 보이는 경우가 있고 수술적 정복을 필요로하는 경우가 흔하다. 본 연구의 목적은 소아에서 소장형 장중첩증의 임상 양상과 경과에 대해 알아보고자 한다. 방 법: 2005년에서 2010년까지 서울대병원에서 소장형 장중첩증으로 진단받은 21명의 환아들의 임상 양상 및 영상 소견을 후향적으로 분석하였다. 결 과: 임상 양상은 복통 및 보챔(85%), 구토(23%), 발열(14%), 혈변(14%) 및 복부 종괴(4%) 등이었다. 여섯 명(28%)의 환아에서 수술적 치료가 필요하였다. 초음파에서 병변의 직경은 1.6${\pm}$0.7 cm였고 가장자리의 두께는 1.7${\pm}$1.8 mm였다. 열한 명에서 병변이 왼쪽 복부 혹은 배꼽 주위였다. 수술적 치료가 필요했던 환아들은 자연 정복된 환아들에 비해 평균 연령이 높았다(109${\pm}$17개월: 51${\pm}$20개월). 병변의 평균 직경 및 가장 자리의 두께는 수술적 치료가 필요했던 환아들에서 더 큰 소견을 보였고 위치는 두 그룹 간에 차이를 보이지 않았다. 결 론: 소장형 장중첩증은 많은 소아에서 자연 정복된다. 그러나 초음파에서 크기가 크고, 나이가 많을수록 또한 병변의 시작점이 있으면 수술적 치료를 고려할 수 있다. Purpose: Intussusception is one of the most common causes of an acute abdomen in infancy. The majority of pediatric cases of intussusception are of the ileocolic type and usually idiopathic. Small bowel intussusception is rarely diagnosed in children, and few cases have been reported. The purpose of this study was to determine the clinical features and causes of small bowel intussusception in children. Methods: We retrospectively reviewed the clinical and radiologic findings of 21 children with small bowel intussusception who were admitted to Seoul National University Children's Hospital between March 2005 and January 2010. Results: The clinical presentation of small bowel intussusception included abdominal pain or irritability (85%), vomiting (23%), fever (14%), bloody stools (14%), and abdominal masses (4%). Six patients required surgical management. Ultrasonography showed that the mean diameter of the lesions and mean thickness of the outer rims were 1.6${\pm}$0.7 and 1.7${\pm}$1.8 mm, respectively. Eleven lesions were located in the left abdominal or paraumbilical regions. Children who underwent surgical management were older than children with transient small bowel intussusception (mean age, 51 vs. 109 months). The mean diameter of the lesions and mean thickness of the outer rims were greater in the surgically-managed group. The location of intussusception was not significantly different between the two groups. Conclusion: Small bowel intussusception was spontaneously reduced in a large number of pediatric patients. However, sonographic demonstration of larger size, older age, and pathologic lead point warrant surgical intervention.

반복되는 복통과 고혈압을 동반한 급성 간헐성 포르피린증 1예

박미란,서정기,고재성,장주영,양혜란,Park, Mi-Ran,Seo, Jeong-Kee,Ko, Jae-Sung,Chang, Ju-Young,Yang, Hye-Ran 대한소아소화기영양학회 2011 Pediatric gastroenterology, hepatology & nutrition Vol.14 No.1

16세 여아에서 복통, 구토, 고혈압, 경련 및 고지혈증을 보였던 급성 간헐성 포르피린증 1예를 경험하였기에 보고하는 바이다. 소아에서 원인을 알 수 없는 복통에 고혈압, 경련 등 특징적 포르피리아 증상이 동반된 경우에 반드시 급성 간헐성 포르피린증을 고려해야 한다. Acute intermittent porphyria (AIP) is a rare disorder characterized biochemically by the increased excretion of porphyrins and porphyrin precursors, including delta-aminolevulinic acid (ALA) and porphobilinogen (PBG). AIP has variable clinical manifestations, such as acute abdominal pain, vomiting, nausea, constipation, peripheral neuropathy, seizures, tachycardia, and hypertension. A 16-year-old girl presented with recurrent abdominal pain, vomiting, hypertension, seizures, hypercholesterolemia, and red urine. AIP was confirmed by clinical features and increased 24-hour urine ALA and PBG. AIP should be considered in the differential diagnosis of patients who have abdominal pain, hypertension, and seizures when the results of all other tests are normal.

실크섬유를 이용한 팬티스타킹 개발에 관한 연구 -실크필라멘트사와 나일론 텍스쳐사 혼방에 따른 스타킹의 물성 및 착용성능 비교-

박미란,조정숙,조길수,Park, Mi-Ran,Jo, Jeong-Suk,Jo, Gil-Su 한국섬유공학회 1995 한국섬유공학회지 Vol.32 No.5

The objectives of this study were 1) to compare physical and wear performances of panty hoses made with silk 61amen1 and texturized nylon filament yams, 2) to examine these characteristics as a function of the percentage of texturized nylon filament yarn, 3) to evaluate thermal resistances and thermoyaphic assessments of those panty hoses worn on a thermal manikin, and 4) to investigate objective wear performances including microclimate and subjective wear sensations and relationships with their physical performances. Five digrent types of panty hoses made with silk filament yarn(S4), texturized nylon filament(N4), and blending level of the two types of yarn were(SIN3, S2N2, S3Nl) used as test specimens. Warmth retention values and Q-max values were measured using Thermo Labo II, and breaking strengths and elongations were evaluated by Instron Tensile Tester. Thermal manikin and subject wear tests were conducted in the following environmental conditions 21$\pm$1$^{\circ}C$, 60$\pm$ 5% RH., and 0.25m/sec air velocity. Ten healthy female subjects followed the repeated exercises consisting of walking on a treadmill and resting. The results were as follows: 1) In warmth retention values and Q-max values, S4 showed higher values than N4. 2) The wickability and moisture regain of S4 showed higher performance than those of N4 but elongation and breaking strength of S4 was lower than that of N4. 3) As the blending level of silk filament yarn increases, warmth retention value, 0-max values, moisture regain, and wickability were increased but elongation and breaking strength were decreased. 4) Clo values measured using thermal manikin increased in the following order: S4>S2N2>N4. 5) Microclimate temperatures of the subjects who worn S4 were significantly higher than those of subjects who worn S2N2 and N4. But microclimate humidities were not significantly different among the subjects who worn S4, S2N2 and N4. 6) Thermal sensation rating of subjects who worn S2N2 was significantly higher than that of subjects who worn S4 and N4. Humidity, tactile and overall sensation ratings of subjects who worn S4 and S2N2 were lower than those of subjects who worn N4.

전국민의료보험에 대비한 의무기록분야 관리방안

박미란,Park, Mi-Ran 대한병원협회 1989 대한병원협회지 Vol.18 No.3

병원경영 효율화와 의무기록 대처방안

박미란,Park, Mi-Ran 대한병원협회 1997 대한병원협회지 Vol.26 No.4

Drug reaction with eosinophilia and systemic symptoms 증후군의 임상 양상과 혈청 비타민 D 측정치 사이의 연관성

박미란 ( Mi Ran Park ),남영희 ( Young Hee Nam ),정일환 ( Il Hwan Jeong ),이혜원 ( Hye Won Lee ),김용준 ( Yong Jun Kim ),박인철 ( In Chul Park ),조덕송 ( Duk Song Cho ),윤늘봄 ( Neul Bom Yoon ),엄수정 ( Soo Jung Um ),손춘희 ( Choon 대한소아알레르기호흡기학회 2013 Allergy Asthma & Respiratory Disease Vol.1 No.2

Purpose: Vitamin D deficiency (VDD) is widely spread and on the increase throughout the world. Although vitamin D is essential for skeletal mineralization, VDD or vitamin D insufficiency (VDI) has been associated with nonskeletal disorders including cardiovascular disease, cancer, allergic disease and skin disease. However, a few reports showed the association of vitamin D and drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome. Thereafter, we evaluated the association between vitamin D and DRESS syndrome. Methods: We conducted a retrospective study on 45 patients with DRESS syndrome. Four hundred and ninty-eight healthy people who visited the health screening center were enrolled in the study as a control group. We investigated the clinical characteristics, the causative drugs and treatments in the patients with DRESS syndrome, and also analyzed the associations with serum 25-hydroxyvitamin D (25(OH)D3). Results: Forty-four patients (97.8%) had low serum vitamin D levels; 21 patients were VDD (serum 25(OH)D3 <10 ng/mL), and 23 patients were VDI (serum 25(OH)D3 10 to 30 ng/mL). There were no significant differences in clinical parameters between two groups. Serum 25(OH)D3 level of the study patients was significantly lower that of the controls (12.3±9.6 ng/mL vs. 17.3±5.5 ng/mL, P<0.001). Serum 25(OH)D3 level showed a significant negative correlation with admission days (r=-0.377, P=0.011). Conclusion: The majority of the patients with DRESS syndrome showed low vitamin D levels. Serum 25(OH)D3 was inversely correlated with admission days. (Allergy Asthma Respir Dis 2013;1:144-150)

김의경의 초기작에 드러난 서사극 실험 연구

박미란(Park, Mi-ran) 영남대학교 인문과학연구소 2021 人文硏究 Vol.- No.95

이 논문은 김의경의 1960년대 작품에 나타난 서사극적 기법의 활용에 주목함으로써 김의경의 초기 극작 세계에 대한 이해를 더하고, 1960년대 연극계에서 이루어지고 있었던 연극 실험과 현대극 모색의 실천 양상을 밝혀내고자 한다. 김의경은 가상의 시공간이나 추상적 시공간을 배경으로 설정하여 당대 현실을 우의적으로 드러내고, 인물들이 어떤 결과를 맞게 되는가를 관객들이 관찰할 수 있게 함으로써 무대가 하나의 시험대가 될 수 있도록 한다. 이때 시험의 대상이 되는 것은 1960년대 근대화 담론에서 긍정적으로 인정되는 가치이다. 〈신병후보생〉, 〈애욕의 우화〉, 〈무익조〉에서는 목표를 향한 강한 의지를 지니고 있는 인물이 만들어내는 부정적인 결과를 통해, 〈갈대의 노래〉는 근면함과 동정심을 지닌 인물이 겪는 비극적 사건을 통해 1960년대의 지배적 가치에 대한 관객의 비판적 인식을 이끌어낸다. 김의경은 서사극적 기법을 활용하면서 무대의 이동성을 강화하여 현실의 유동성과 모순을 드러내고, 무용과 노래, 가면, 슬라이드 등 다양한 요소를 무대에 활용함으로써 연극적 감각을 확장하고 논평적 기능을 수행하도록 한다. 이러한 연극적 양식에 대한 실험과 함께 무대의 전문화를 꾀함으로써 1960년대 연극계의 과제를 풀어나가려는 시도를 보여준다. This study would add an understanding of the world of Kim Eui-Kyung’s early play writing by paying attention to the use of epic theater techniques and reveal the practical aspects of theatrical experiments in the 1960s. Kim Eui-Kyung allegorically reveals the realities of the times by setting virtual space-time as a background and lets the stage become a testing stand by allowing the audience to observe what consequences the characters come to see. The subject of the test at this time is the value recognized as positive in the discourse on modernization in the 1960s. 〈Recruit Cadet〉, 〈Fable of Passion〉, and 〈Bird without Wings〉 draw out critical perceptions of the audience through negative consequences created by characters who have a strong will toward the goal, and 〈Song of Reeds〉, through tragic incidents experienced by characters with diligence and compassion, dominant values in the 1960s. Kim Eui-Kyung reveals the contradictions of reality, improving the mobility of the stage while utilizing epic theater techniques and expands the theatrical senses and lets them perform critical functions by utilizing various elements such as dance, song, mask, slide on the stage. By attempting the specialization of the stage he shows an attempt to resolve the tasks of the theatrical circles in the 1960s.

아토피피부염을 가진 24개월 미만의 소아에서 집먼지진드기 특이 IgE 항체의 양전

박미란 ( Mi Ran Park ),이현영 ( Hyun Young Lee ),이상일 ( Sang Il Lee ),김지현 ( Ji Hyun Kim ),안강모 ( Kang Mo Ahn ) 대한소아알레르기호흡기학회 1991 소아알레르기 및 호흡기학회지 Vol.1 No.4

Purpose: A considerable number of children with atopic dermatitis (AD) is known to be sensitized with respiratory allergen and developed to respiratory allergic disease. We aimed to determine the time of sensitization to house dust mite (HDM) allergen and identify the risk factors of sensitization in children with AD. Methods: Data from 159 children with AD aged less than 24 months and with no sensitization to HDM were analyzed retrospectively. Disease severity, total IgE, specific IgE levels to HDM and food allergens were assessed. They were followed to monitor positive conversion of specific IgE against HDM and development of allergic respiratory diseases. The specific IgE was considered as positive when its level was over 0.69 kU/L. Results: The 44.7% of children with AD were sensitized to HDM. The 50% of sensitization to HDM occurred at the median age of 52 months using survival analysis. The severity of atopic dermatitis (six area, six sign in atopic dermatitis score>15; hazard ratio, 2.62) and high peak total IgE in 2 years old (hazard ratio, 1.58) was associated with an increased risk of sensitization to HDM. Sensitization to food allergen, family history of allergic disease and total IgE of 1st visit of hospital were not associated with early sensitization to HDM. Conclusion: The sensitization of HDM of children with AD occurred at the median age of 52 months. The risk factors of sensitization to HDM were AD severity and total IgE level. Children with severe AD need to control the indoor environment before 24 months of age. (Allergy Asthma Respir Dis 2013;1:350-356)

Drug reaction with eosinophilia and systemic symptoms 증후군의 임상 양상과 혈청 비타민 D 측정치 사이의 연관성

박미란 ( Mi Ran Park ),남영희 ( Young Hee Nam ),정일환 ( Il Hwan Jeong ),이혜원 ( Hye Won Lee ),김용준 ( Yong Jun Kim ),박인철 ( In Chul Park ),조덕송 ( Duk Song Cho ),윤늘봄 ( Neul Bom Yoon ),엄수정 ( Soo Jung Um ),손춘희 ( Choon 대한소아알레르기호흡기학회 1991 소아알레르기 및 호흡기학회지 Vol.1 No.2

Purpose: Vitamin D deficiency (VDD) is widely spread and on the increase throughout the world. Although vitamin D is essential for skeletal mineralization, VDD or vitamin D insufficiency (VDI) has been associated with nonskeletal disorders including cardiovascular disease, cancer, allergic disease and skin disease. However, a few reports showed the association of vitamin D and drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome. Thereafter, we evaluated the association between vitamin D and DRESS syndrome. Methods: We conducted a retrospective study on 45 patients with DRESS syndrome. Four hundred and ninty-eight healthy people who visited the health screening center were enrolled in the study as a control group. We investigated the clinical characteristics, the causative drugs and treatments in the patients with DRESS syndrome, and also analyzed the associations with serum 25-hydroxyvitamin D (25(OH)D3). Results: Forty-four patients (97.8%) had low serum vitamin D levels; 21 patients were VDD (serum 25(OH)D3 <10 ng/mL), and 23 patients were VDI (serum 25(OH)D3 10 to 30 ng/mL). There were no significant differences in clinical parameters between two groups. Serum 25(OH)D3 level of the study patients was significantly lower that of the controls (12.3±9.6 ng/mL vs. 17.3±5.5 ng/mL, P<0.001). Serum 25(OH)D3 level showed a significant negative correlation with admission days (r=-0.377, P=0.011). Conclusion: The majority of the patients with DRESS syndrome showed low vitamin D levels. Serum 25(OH)D3 was inversely correlated with admission days. (Allergy Asthma Respir Dis 2013;1:144-150)

유산된 산모 혈액에서 분리한 Listeria Monocytogenes 1례

박미란 ( Mi Ran Park ),김성일 ( Sung Ii Kim ),유희종 ( Hee Jong Yoo ) 대한임상검사과학회 1988 대한임상검사과학회지(KJCLS) Vol.20 No.1