국내 자연·기술 복합재난 사례 및 위험관리 개선 시사점

소철환 국토연구원 2017 국토 : planning and policy Vol.430 No.-

Acute viral gastroenteritis in children hospitalized in Iksan, Korea during December 2010–June 2011

소철환,김동섭,유승택,조지현,김종덕 대한소아청소년과학회 2013 Clinical and Experimental Pediatrics (CEP) Vol.56 No.9

Purpose: Viral etiology is common in cases of children with acute diarrhea, and antibiotic therapy is usually not required. Therefore, it is important to determine the distribution of common viruses among children hospitalized with acute diarrhea. Methods: We included 186 children who suffered from acute diarrhea and were hospitalized at the Wonkwang University Hospital Pediatric ward from December 1, 2010 to June 30, 2011 in this study. Stool samples were collected and multiplex reverse transcriptase polymerase chain reaction (multiplex RT-PCR) was used to simultaneously determine the viral etiology such as rotavirus, norovirus,astrovirus, or adenovirus. Results: Causative viruses were detected in 72 of the 186 cases (38.7%). The mean age of the viruspositive cases was 1 year and 9 months (range, 1 month to 11 years). Rotavirus was detected in 50/186 (26.9%); norovirus, in 18/186 (9.7%); and astrovirus, in 3/186 cases (1.6%). Adenovirus was not detected in any of the cases. Proportions of norovirus genogroups I and II were 21.1% and 78.9%,respectively. Four of the 51 rotavirus-positive cases (7.8%) had received rotavirus vaccination at least once. The mean duration of diarrhea was 2.8 days (range, 1 to 10 days) and vomiting occurred in 39 of the 72 cases (54.2%). Conclusion: Viral etiology was confirmed in about one-third of the children with acute diarrhea, and the most common viral agent was rotavirus, followed by norovirus.

Anti-JKa 항체 부적합증에 의한 신생아 용혈성 황달 1례

소철환 ( Cheol Hwan So ),윤세훈 ( Se Hoon Yoon ),김동섭 ( Dong Sup Kim ),유승택 ( Seung Taek Yu ),오연균 ( Yeon Kyun Oh ) 대한주산의학회 2012 Perinatology Vol.23 No.1

The Kidd system of blood group is clinically significant since the anti-Kidd antibody can cause immediate or delayed hemolytic transfusion reactions as well as hemolytic disease of newborn (HDN). In contrast to the hemolytic activity of Kidd antibodies in incompatible transfusion, the severity of HDN varies but usually tends to be a benign clinical course with favorable outcomes. And severe HDN due to anti-JKa incompatibility is a rare, which is still not reported in Korea. We experienced a newborn with severe jaundice to be detected within 24 hours from birth due to anti-JKa incompatibility. The laboratory data on admission indicated hemoglobin 13.2g/dL, reticulocyte 4.08%, total bilirubin 18.7mg/dL, and direct and indirect antiglobulin tests were positive (2+/2+). But, there are no ABO and Rh (D) incompatibilities between the mother and newborn. Maternal serum was found to contain an antibody that recognized JKa, and also seen in neonate. This patient completely recovered with intensive phototherapy without exchange transfusion. We report this case with a brief review of relevant literature.

청소년기 10대 임신에서 임산부와 신생아의 주산기 문제점

박인호,소철환,조정익,유승택,이승현,홍기연,오연균 대한신생아학회 2012 Neonatal medicine Vol.19 No.3

Purpose: The number of teenage pregnancy is increasing on these days due to changes in sexual awareness, precocious puberty,lack of proper sex education and abortion restrictions. We evaluated the clinical features including the rate and perinatal complications of mother and neonates caused by teenage births. Methods: Subjects were mothers whose ages were below 19 at time of admission in Wonkwang University Hospital from January 2000 to July 2011. We reviewed the medical records of teenage mothers and her neonates retrospectively, and investigated the differences between above and below the age of 16 . Results: The number of neonates of teenaged mothers was 73, which is 10.4 per 1,000 births and it showed an upward trend during the late decade of 2,000’s. 14 (19.2%) of the mothers were multiparous, and 69 (94.5%) unmarried, 25 (34.2%) no prenatal examinations, 11 (15.1%) an abortion history, 47 (64.4%) middle or high school students, and 25 (34.2%) a single parent. Among the maternal complications, premature birth was the most prevalent with 34 cases (46.6%), followed by 11 (4.1%) of premature rupture of membrane. The most common neonatal complication was prematurity in 37 cases (50.7%), followed by 30 (41.1%) low birth weight, 19 (26%) ICU admission. There were no significant differences between above and below the age of 16 in neonatal and obstetrical complications. Conclusion: The number of teenage pregnancy is increasing recently, and they had a high prevalence rate of prematurity, low birth weight and respiratory distress syndrome. And, the grouping by age of above and below 16 was no affect the prognosis. 목적: 성 인식의 개방, 성조숙, 미비한 성교육, 낙태금지 등으로 청소년 임신이 증가하고 있으며, 이러한 어린나이 임신은 태아의 자궁내 성장지연, 태아곤란, 조산, 저출생체중, 영아 사망 등 고위험 신생아 발생의 요인이 된다. 이에 10대의 신생아 분만율을 포함하여 산모와 신생아의 주산기 관련 특성과 합병증을 알아보고자 본 연구를 시행하였다. 방법: 2000년 1월부터 2011년 7월까지 원광대학교 병원 신생아실및 신생아집중치료실에 입원한 신생아 중 산모가 19세 이하인 경우를 대상으로 하였다. 해당 기간 동안 분만한 신생아들의 의무기록을후향적으로 분석하여 산모와 신생아의 특성, 주산기 합병증 등을 조사하였으며, 16세를 기준으로 그 이상군(≥16세 이상)과 미만군(<16세 미만)으로 구분하고 차이점이 있는지도 비교하였다. 결과: 10대 산모에 의한 신생아분만은 총 73명으로 분만율은1,000명의 분만아 당 평균 10.4명이었으며 2000년대 후반기에 증가하는 경향을 보였다. 10대 산모의 산과력 상 경산부 14명(19.2%), 미혼 69명(94.5%), 산전 진찰을 받지 않은 경우 25명(34.2%), 유산 기왕력 11명(15.1%)이었으며, 교육 수준은 중고등학교에 재학 중인 경우가 47명(64.4%)이나 되었고 결손가정은 25명(34.2%)이었다. 산모의 문제점은 조산이 34명(46.6%)으로 가장 높고, 양막조기파수 11명(15.1%), 양수과소증 3명(4.1%), 빈혈 3명(4.1%) 순으로 나타났다. 신생아의 평균 출생체중은 2612.4±764.6g, 평균 재태주령은 35.6±3.5주, Apgar 점수(1,5분) 6.6±2.0, 8.1±1.8이었고, 문제점으로는 미숙37명(50.7%), 저체중출생 30명(41.1%), 집중치료센타 입원 19명(26%), 신생아호흡곤란증후군(>Grade III) 10명(13.7%) 등의 순으로 조사 되었다. 산모 16세를 기준으로 구분한 이상과 미만 두군 간에 산과적, 신생아적 문제점의 차이는 없었으며 사망률의 차이도 없었다. 결론: 청소년기 10대 임신이 최근 증가하고 있으며, 출생한 신생아는 고위험 요소인 미숙, 저체중출생, 신생아 호흡곤란증후군 등에서유병률이 높은 것으로 보이고, 고위험군의 기준으로 구분한 16세의연령 기준은 신생아의 예후에 영향을 미치지 않는 것으로 사료된다.

Prevalence of Pathological Brain Lesions in Girls with Central Precocious Puberty: Possible Overestimation?

윤종서,소철환,이해상,임중섭,황진순 대한의학회 2018 Journal of Korean medical science Vol.33 No.51

Background: Brain magnetic resonance imaging (MRI) is routinely performed to identify brain lesions in girls with central precocious puberty (CPP). We aimed to investigate the prevalence and type of brain lesions among Korean girls with CPP and evaluate the need for routine brain MRI examinations. Methods: This retrospective cross-sectional study evaluated data on 3,528 girls diagnosed with CPP from April 2003 to December 2016, and identified 317 girls who underwent sellar MRI. Exclusion criteria were patients with a known brain tumor or who did not undergo brain MRI due to refusal or the decision of the pediatric endocrinologist. Results: Normal sellar MRI findings were observed in 291 of the 317 girls (91.8%). Incidental findings were observed in 26 girls (8.2%). None of the patients had pathological brain lesions. Conclusion: The prevalence of intracranial lesions among girls who were generally healthy and without neurological symptoms but diagnosed with CPP was lower than that previously reported. Furthermore, none of the identified lesions required treatment. It may be prudent to reconsider the routine use of brain MRI to screen all patients with CPP, especially if they are healthy and neurologically asymptomatic, and are girls aged 6–8 years.

수신반 동작상황 실시간 모니터링 시스템 개발

김동현,소철환,유영광,나용선,옹성수 한국화재소방학회 2017 한국화재소방학회 학술대회 논문집 Vol.2017 No.추계

The Impact of Perioperative Use of a Statin–Magnesium Combination on Opioid Consumption in Patients Who Underwent Cardiac Surgery: A Retrospective Study with Propensity-Score Matching

이철,소철환 전남대학교 의과학연구소 2020 전남의대학술지 Vol.56 No.2

Both statins and magnesium are associated with NMDA receptors and anti-inflammatory effect. Peripheral NMDA receptors are known to be involved in inflammation- induced pain. This study aimed to investigate the impact of perioperative use of a statin–magnesium combination on opioid consumption in patients who underwent cardiac surgery. This was a retrospective study of 542 patients who underwent cardiac surgery. The patients were divided into two groups according to statin use: the statin–magnesium group (n=375) and the magnesium-only group (n=167). Patients in the magnesium-only group received only perioperative magnesium, but no statins, to prevent atrial fibrillation following cardiac surgery. After propensity-score matching, 228 patients (n=114 in each group) were analyzed to investigate opioid consumption, visual analogue scale (VAS) pain scores over a 72-h period, and pain outcomes according to the duration of statin treatment (<1 or ≥1 yr). The consumed opioid volume was significantly smaller in statin–magnesium group than the magnesium-only group, both before (p=0.010) and after matching (p=0.017). The statin–magnesium combination did not significantly reduce the VAS pain scores compared with magnesium alone. Although the statin–magnesium combination did not significantly reduce the pain intensity compared with magnesium alone, the combination therapy was effective in reducing opioid consumption after surgery.

부계의 균형전좌에 의해 발생한 과잉 염색체 22 증후군 1례

전윤수,소철환,유승택,박도심,조은해,오연균 대한신생아학회 2010 Neonatal medicine Vol.17 No.1

Supernumerary derivative (22) syndrome is a rare genomic syndrome. It is characterized by severe mental retardation, microcephaly, failure to thrive, preauricular tag or sinus, ear abnormalities, cleft and/or high-arched palate, micrognathia, kidney abnormalities, congenital heart defects, and genital abnormalities in males. In 99% of the cases, one of the parents is a balanced carrier of a translocation between chromosome 11 and chromosome 22. To date, there have been about 100 case reports of supernumerary derivative (22) syndrome. In most of the cases, supernumerary derivative (22) syndrome was the result of 3:1 meiotic segregation in the maternal 11;22 translocation carrier. We now report a case of 47,XX, + der(22)t(11;22)(q23;q11.2) resulting from 3:1 meiotic segregation of the paternal translocation carrier. 저자들은 저긴장증과 다발성 선천성 기형을 보인 신생아에서 염색체 검사 및 FISH로 확인된, 부계의 균형적 전좌에 의한 Emanuel 증후군 1례를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

기업 관점에서의 제조물 배상책임(PL) 리스크에 대한 손실분석방법 소고

하각천,소철환,박성진,Hwang Jong Chul,Park Dae Won 한국화재조사학회 2013 한국화재조사학회 학술대회 Vol.2013 No.1

Intellectual development in preschool children with early treated congenital hypothyroidism

서민경,윤종서,소철환,이혜상,황진순 대한소아내분비학회 2017 Annals of Pediatirc Endocrinology & Metabolism Vol.22 No.2

Purpose: Delayed treatment of congenital hypothyroidism (CH) is a common cause of mental retardation. The aim of the present study was to evaluate intellectual outcomes in preschool children with treated CH. Methods: We retrospectively reviewed the clinical records of 43 children (age range: 13 to 60 days of life; 22 girls and 21 boys) diagnosed with CH. Children aged 5 to 7 years were examined using the Korean Wechsler Intelligence Scale for Children or the Korean Wechsler Preschool and Primary Scale of Intelligence. Results: The patients started treatment between 13 and 60 days of age. The mean intelligence quotient (IQ) of patients tested at age 5 to 7 years was 103.14±11.68 (IQ range: 76–126). None had intellectual disability (defined as an IQ <70). Twenty-one subjects were treated with a low dose (6.0–9.9 µg/kg/day) and 22 with a high dose of levothyroxine (10.0–16.0 µg/kg/day). There was no significant difference in the mean full-scale IQ (FSIQ), verbal IQ (VIQ), and performance IQ (PIQ) scores between the 2 groups. FSIQ, PIQ, and VIQ scores were not significantly correlated with initial dose of L-T4, initial fT4, age at treatment in multivariate analysis. Conclusion: IQ scores of subjects with early treated CH diagnosed through a neonatal screening test were within normal range, regardless of etiology, thyroid function, initial dose of levothyroxine, and age at start of treatment.