국제 결혼 외국인 산모에서 태어난 신생아의 주산기 문제 및 예후

송은송,최영륜 한국모자보건학회 2008 한국모자보건학회 학술대회 연제집 Vol.2008 No.2

임신 31주 산모의 복부 자상으로 인해 발생한 태아 두부 손상

송은송 ( Eun Song Song ),김수영 ( Soo Young Kim ),최영륜 ( Young Youn Choi ),김윤하 ( Yoon Ha Kim ),송태복 ( Tae Bok Song ) 대한주산의학회 2009 Perinatology Vol.20 No.3

Penetrating trauma in a fetus is uncommon but may cause potentially life-threatening injuries. We experienced a case of preterm infant who delivered by C-section and showed two deep laceration wounds on face, facial nerve palsy, skull fracture and intracranial hemorrhage due to penetrating injury of an abdominal stab wound in a 31 weeks pregnant woman.

다량의 태아-모체간 수혈로 인한 중증 신생아 빈혈 2예

송은송 ( Eun Song Song ),김기환 ( Ki Hwan Kim ),김소연 ( So Youn Kim ),박천학 ( Chun Hak Park ),최영륜 ( Young Youn Choi ) 대한주산의학회 2004 Perinatology Vol.15 No.2

Feto-maternal hemorrhage, the presence of fetal red blood cells in the maternal circulation, occurs in up to 75% of pregnancies. But its volume is usually very small. Feto-maternal hemorrhage of more than 30 ml of whole blood is relatively rare. The key features that lead to early diagnosis are the maternal history, fetal monitoring, the clinical and laboratory findings of anemia and a negative Coombs` test. Diagnosis is confirmed by Kleihauer-Betke test. Perinatal problems include fetal distress, neonatal anemia, hypovolemic shock, and death. The fetal outcome depends on the amount and rate of bleeding. The initial hemoglobin level was a better predictor than the volume of bleeding. We present two cases of severe neonatal anemia associated with massive feto-maternal hemorrhage, which was confirmed by Kleihauer-Betke test.

The first report of a chromosome 1q44 deletion in Korea

조주현,송은송,김희나,오범석,최영윤 대한소아청소년과학회 2014 Clinical and Experimental Pediatrics (CEP) Vol.57 No.6

The deletion of the distal long arm of chromosome 1 is associated with a characteristic facial appearanceand a pattern of associated malformations. Characteristic manifestations include a round face withprominent ‘cupid's bow’ and downturned corners of the mouth, thin vermilion borders of lips, a longupper lip with a smooth philtrum, a short and broad nose, epicanthal folds, apparently low-set ears,micrognathia, microcephaly, abnormal hands and feet, variable cardiac or genital anomalies, moderateto severe mental retardation, and growth retardation. Using fluorescent in situ hybridization (FISH)analysis to map precisely the deletion, we present a case of chromosome 1q44 deletion with craniofacialcharacteristics, multiple congenital anomalies, and growth and psychomotor retardation. Incomparison with other reported cases of 1q43-44 deletion, the subject does not show hydrocephalus,seizure, syn- or polydactyly of hands, and a urogenital anomaly. However, an arachnoid cyst, pinpointdimple on the midline of the forehead, a right-sided supernumerary nipple and auricular pit, polydactylyof the right foot, adducted thumb, and flexion restriction of the proximal interphalangeal joint with asimian line in both hands were observed additionally.

Lung torsion after tracheoesophageal fistula repair in an infant

양은미,송은송,장해인,정인석,최영윤 대한소아청소년과학회 2013 Clinical and Experimental Pediatrics (CEP) Vol.56 No.4

Lung torsion is a very rare event that has been reported in only 9 cases in the pediatric literature but has not yet been reported in Korean infants. We present a case of lung torsion after tracheoesophageal fistula repair in an infant. Bloody secretion from the endotracheal tube and chest radiographs and computed tomographic scan results indicated lung torsion. Emergency exploration indicated 180°torsion of the right upper lobe (RUL) and right middle lobe (RML). After detorsion of both lobes, some improvement in the RUL color was observed, but the color change in the RML could not be determined. Although viability of the RML could not be proven, pexy was performed for both the lobes. Despite reoperation, clinical signs and symptoms did not improve. The bronchoscopy revealed a patent airway in the RUL but not in the RML. Finally, the RML was surgically removed. The patient was discharged on the 42nd day after birth.

단일 제대 동맥을 가진 건강한 신생아에서 신장 초음파 검사의 유용성

강주미,송은송,국진화,이형신,김소영,최영륜,Kang, Ju-Mi,Song, Eun-Song,Kuk, Jin-Hwa,Lee, Hyung-Sin,Kim, So-Young,Choi, Young-Youn 대한소아청소년과학회 2003 Clinical and Experimental Pediatrics (CEP) Vol.46 No.9

목 적 : 단일 제대 동맥을 가진 건강한 신생아의 약 1/3에서 위장관 폐색 및 요로 기형을 동반할 수 있으므로 요로 기형을 발견하기 위해 초음파 검사를 관습적으로 시행하고 있지만 실제초음파 검사상 이상이 발견되는 경우는 드물다. 이에 저자는 단일 제대 동맥을 가진 건강한 신생아에서 신장 초음파 검사의 유용성을 알아보고자 본 연구를 실시하였다. 방 법 : 1995년 1월부터 2002년 7월까지 출생 후 이학적 검사상 단일 제대 동맥이 있는 신생아에서 단일 제대 동맥이면서 증후군의 일부이거나 수술적 치료가 필요한 심각한 질환이 동반된 경우는 제외하고 건강한 신생아 총 30명을 대상으로 하였다. 임상적 배경과 출생 72시간 이후 신장 초음파를 실시하였고, 신장초음파상 이상이 있는 경우 지속적 추적관찰과 더불어 배뇨성 방광요도 조영술 및 technetium-99m-mercaptoacetyl-triglycerine(MAG3) 신스캔 검사를 실시하여 수신증의 크기, 폐쇄의 정도 및 신기능 변화를 분석하였다. 결 과 : 총 30명의 남녀비는 1 : 1이었으며 평균 재태 연령은 $38.0{\pm}2.56$주, 평균 출생 체중은 $2,780{\pm}690g$이었다. 단일 제대동맥을 가진 건강한 신생아 30명 중 신장 초음파상 이상이 발견 된 례는 5명으로 16.7%이었고, 의미 있는 요로 기형은 1명으로 3.3%이었다. 이상이 발견된 5명 중 4명은 경도의 수신증으로 추적 검사상 자연 소실되었고, 1명은 심한 수신증으로 배뇨성 방광 요도 조영술상 역류는 없었고 MAG3 검사상 좌측 신장 기능 저하가 보여 외래 추적 관찰 중이다. 결 론 : 단일 제대 동맥을 가진 건강한 신생아에서 신장 초음파 검사상 발견된 신장 이상은 16.7%로 일반인에서 보이는 신장 이상의 빈도와 큰 차이는 없었고 1명을 제외한 4명(80.0%)에서 자연 소실되었으므로, 비용-이익 면에서 볼 때 단일 제대 동맥을 가진 건강한 신생아에서 관습적으로 신장 초음파 검사를 실시하는 것에 대해 고려해 볼 필요가 있다고 사료된다. Purpose : It is known that single umbilical artery is frequently associated with gastrointestinal or urogenital anomaly, however, routine renal sonography has been debated in healthy neonate with isolated single umbilical artery. This study is designed to determine the usefulness of routine renal sonography in apparently healthy infants with an isolated single umbilical artery. Methods : Thirty healthy neonates with a single umbilical artery without a major anomaly from January 1995 to July 2002 were enrolled. The authors investigated the clinical background of babies and their mothers after renal sonography after 72 hours of age. When the abnormalities were found at the first renal sonography, the severity of hydronephrosis and degree of obstruction and renal function were analyzed by follow up renal sonography, voiding cystourethrography(VCUG) and technetium-99m-dimercaptosuccinic acid(DMSA) scan or technetium-99m-mercaptoacetyl-triglycerine (MAG3) scan. Results : Among the 30 healthy patients with isolated single umbilical artery, five patients(16.7%) showed abnormalities on first renal sonography with one major(3.3%) and four(13.4%) minor renal anomaly(minimal or mild hydroneohrosis). One major renal anomaly(severe hydronephrosis) showed severe decreased renal function on MAG3 scan without reflux, and the other four minor regressed spontaneously on follow up study. Conclusion : The value of routine early renal sonograpy for detecting renal anomaly in healthy infants with an isolated single umbilical artery remained unclear because most of the anomalies would regress spontaneously in the follow up study.

A case of vancomycin-induced drug hypersensitivity syndrome

민경선,최우연,송은송,한동균,조영국,마재숙 대한소아청소년과학회 2008 Clinical and Experimental Pediatrics (CEP) Vol.51 No.11

Drug hypersensitivity syndrome (DHS) has rarely been reported in association with vancomycin treatment. Here, we describe an 11-year-old girl who developed fever and a maculopapular rash on day 18 of intravenous vancomycin for treatment of infective endocarditis. The patient presented with fever, a maculopapular skin rash, hepatitis, and acute renal failure caused by vancomycin-induced DHS. The symptoms resolved in less than 24 h after withdrawal of vancomycin and treatment with corticosteroids. We present this case of DHS associated with vancomycin.

Management and 2 Years Follow-Up of Newborns in the Neonatal Intensive Care Unit Exposed to Congenital Tuberculosis

양재혁,이지선,송은송 대한주산의학회 2022 Perinatology Vol.33 No.3

Objective: We report the management and 2 years follow-up of newborns in the neonatal intensive care unit (NICU) exposed to congenital tuberculosis (Tb). Methods: Preterm twins born to a mother diagnosed with Tb 2 months after delivery were diagnosed with congenital Tb in other hospital where they were transferred. An epidemiological investigation and management plans were conducted for contacts. Medical staff classified as contacts perform an interferon-gamma release assay (IGRA) and chest X-ray. A physical examination, history taking, and chest X-ray were performed on newborns classified as contacts to check for active Tb infection. Tuberculin skin test (TST) was performed 3 months after the last exposure or 3 months of corrective age, whichever is later. Until then, they took isoniazid (INH) prophylactically. Chest X-ray and symptom follow-up were performed every 6 months for 2 years. Results: Of the total 78 neonates, 8 were classified as contacts. No one was suspected of having active Tb. While taking INH, there were no significant side effects. A TST was positive in one newborn. During follow-up, no one showed any signs of active Tb. The chest X-ray and IGRA test of 4 patients admitted to the same room with the mother were all negative. All the medical staff’s chest X-ray was normal. But 4 medical staff were diagnosed with latent Tb by IGRA. Conclusion: Tb management guidelines in NICU have not been standardized and clear. This research will help manage Tb in NICU, as most of the contacts were premature.

미숙아에서 혈소판 감소증에 의해 발견된 장 혈관종 (Kasabach-Meritt 증후군) 1례

이영진,배설희,송은송,최수진나,김윤하,최영륜 대한신생아학회 2010 Neonatal medicine Vol.17 No.1

Kasabach-Merritt syndrome is a rare thrombocytopenic consumptive coagulopathy associated with a giant hemangioma. We experienced a case of unexplained ascites with thrombocytopenia in a 32 week premature infant. An exploratory laparotomy was performed to determine the cause of the refractory ascites and thrombocytopenia. An intestinal hemangioma was found, but, surgical removal was not performed due to the extensive involvement. Hemangioma was confirmed by SPECT (single-photon emission computed tomography) and the thrombocytopenia was treated with steroid therapy. It is recommended that hemangioma of the visceral organs should be suspected when unexplained thrombocytopenia and disseminated intravascular coagulopathy persist. Kasabach-Merritt 증후군은 거대한 혈관종에 의해 혈소판이 소모되어 감소되는 드문 질환이다. 저자들은 재태주령 32주 미숙아에서 설명되지 않은 복수와 혈소판 감소증의 원인을 찾기 위해 시험적 개복술을 시행하여 장 혈관종을 발견하였으나 광범위하여 수술적 제거를 하지 못하고, SPECT로 확인 후 스테로이드 치료로 혈소판 감소증이 호전된 1례를 경험하였다. 따라서 다른 원인에 의해 설명되지 않는 혈소판 감소증과 파종성 혈관내 응고병증이 있으면 내부 장기의 혈관종을 의심해 볼 필요가 있다고 사료되었다.

후기 조산아와 산모의 임상적 특징: 단일기관 자료

이수향,오하진,송은송,최영륜 한국모자보건학회 2018 한국모자보건학회지 Vol.22 No.1

Department of Pediatrics, Chonnam University Medical School, Gwangju, Korea2 Purpose: Recently, the number of late preterm infants are increasing, and they are prone to have many clinical problems. The purpose of this study is to emphasize the importance of perinatal care for the late preterm infants and their mothers. Methods: Total admitted numbers of late preterm infants were 547 (from 464 mothers) and of term infants were 1,514 (from 1,470 mothers) in NICU, at Chonnam National University Hospital January 2014~December 2015. Maternal and neonatal mortality rate were calculated in the total admitted numbers. Exclusion criteria were death or transfer during admission, congenital anomaly, and etc. The enrolled numbers of late preterm infants were 493 (from 418 mothers) and of term infants were 1,167 (from 1,123 mothers). Retrospective chart review was conducted. In mothers, demographics, underlying illness, and obstetric complication, and in newborns, demographics, hospital days and morbidity were compared between late preterm group and term group. Results: Maternal mortality rate was not different. However, neonatal mortality rate was higher in late preterm infants. In mothers of late preterm group, there was no difference in demographic characteristics, but the rates of autoimmune disease and obstetric complication were higher. In infants of late preterm group, body size was smaller, artificial conception and C-section rate were higher, and one and five-minute Apgar scores were lower, and hospital duration was longer. And the incidence of respiratory distress, transient tachypena of newborn, intraventricular hemorrhage and metabolic abnormalities were higher, but the incidence of meconium aspiration syndrome was lower compare to the term infant group. Conclusion: Maternal mortality was not different. However, neonatal mortality was higher in late preterm infants. In late preterm group, the mothers had higher rate of autoimmune disease and obstetric complication, and the infants had higher morbidity compare to the term group. When the obstetrician decides on delivery time in high risk pregnancy, maternal medical condition and neonatal outcome should be considered.