어린이 음료수에 의한 유치 법랑질 침식에 대한 연구

신윤혜,김영재 大韓小兒齒科學會 2009 대한소아치과학회지 Vol.36 No.2

본 연구의 목적은 시중 어린이 음료의 산성도를 조사하고, 수 종 어린이 음료에 의한 유치 법랑질 침식정도를 실험적으로 평가하는 것이었다. 서울 시내 및 경기도 지역에서 판매순위가 비교적 높은 수 종의 어린이 음료를 표집하여 pH를 측정하고, 그 중에서도 pH 3.5 이하의 어린이 음료 7개를 선별하였다. 탈락기의 건전한 법랑질 표면을 가진 유치를, 어린이 음료에 1 분, 5 분, 10 분, 15 분, 30 분 동안 노출시켜 인공적으로 법랑질 침식을 유도하였을 때 나타나는 양상을 표면미세경도측정법으로 분석하여 다음과 같은 결론을 얻었다. 1. 본 연구에서 조사한 시중 어린이 음료의 대부분은 치아 침식을 유발할 수 있는 산성도인 pH 5.5 이하의 산성도를 갖고 있었다. 2. 어린이 음료에 대한 노출 후의 법랑질 표면미세경도는 대조군에 비해 모든 시료에서 낮아졌다(p<0.05). 노출 후 1 분이 경과되었을 때부터 표면미세경도의 유의한 감소 양상을 보였으며, 30 분이 경과되었을 때까지 표면미세경도의 감소가 계속 관찰되었다(p<0.05). 3. 음료의 산성도가 높을수록, 시편을 30 분간 노출시켰을 때의 표면미세경도가 유의하게 감소했다(p<0.05). 그러나 음료의 산성도와 표면미세경도의 감소정도 사이에 유의한 비례관계는 찾을 수 없었다(p>0.05). The purpose of this study is to examine the acidity of beverages that are sold for children in the market and to estimate by experiment the degree of the enamel erosion of deciduous teeth that is attributed to the beverages. The pH value of children beverages among top sale list in Seoul and Gyeonggi province were measured. And 7 beverages with the pH value of 3.5 or lower were selected. The enamel erosion of deciduous teeth by the children beverages for 1, 5, 10, and 30 minutes respectively was examined. The results were as follows: 1. The acidity of most of the children beverges examined in this study was the pH level of 5.5 or lower that can cause the tooth erosion. 2. The microhardness value of the enamel of deciduous teeth was lower as exposing it to children beverages. The reduction of surface microhardness value was significant from 1 minute after the exposure, and the reduction was continuously observed until 30 minutes has passed. 3. The higher the acidity of beverages, the larger the reduction in microhardness value caused after the exposure of 30 minutes to the beverages. There was no significant relation between the acidity of beverages and the reduction rate of surface microhardness value. The other factors such as calcium, phosphorus, and fluorine or buffering of the beverages may affect the enamel erosion.

신증후군에서 의료방임으로 발생한 복부농양 1례

신윤혜,허준,이강균,임현이,배기수,Shin Yun-Hye,Hur Joon,Lee Kang-Gyoon,Yim Hyun-Ee,Pai Ki-Soo 대한소아신장학회 2005 Childhood kidney diseases Vol.9 No.1

Nephrotic syndrome is a common chronic disease in childhood. Patients with nephrotic syndrome are at an increased risk of bacterial Infections due to immunological changes secondary to proteinuria. Primary bacterial peritonitis is one of the most serious and common infectious complications. The rate of peritonitis is, 2-6% and overwhelming infection still carries a mortality rate of 1.5%. We experienced a rare case of nephrotic syndrome complicated with severe peritonitis and Peritoneal empyema in a 10-year old girl after 2 months of medical neglect by parents. Here we emphasize thf: importance of early detection and treatment of peritoneal infection in nephrotic syndrome.

소아 연구균 감염 후 급성 사구체 신염의 예후

신윤혜,이지연,배기수,Shin, Yun-Hye,Lee, Ji-Yeon,Pai, Ki-Soo 대한소아신장학회 2005 Childhood kidney diseases Vol.9 No.2

Purpose : Acute poststreptococcal glomerulonephritis(APSGN) follows infection of group A$\beta$-hemolytic streptococci. The prognosis of APSGN has been reported as favorable. However, several studies have reported that some patients progress to chronic renal failure. In an attempt to clarify this, we analyzed the clinical course of patients with APSGN. Methods : Between January 2000 and December 2004, a total of 48 children who were diagnosed with APSGN according to the presence of hematuria, transient hypocomplementemia and evidence of group A $\beta$-hemolytic streptococcal infection were evaluated. Results : Six(12.5$\%$) patients showed elevation of serum creatinine level but there was no patient with Persistent renal dysfunction. Blood pressure was controlled with ease in all patients and there was no case of persistent hypertension. Renal biopsy was done in 5 patients who showed heavy proteinuria or renal insufficiency and the outcomes showed findings consistent with ordinary APSGN except one with findings of rapidly progressive glomerulonephritis(RPGN). Serum complement levels normalized within 8 weeks(92.9$\%$). Hematuria disappeared within 6 months(79$\%$) and proteinuria within 6 months(100$\%$) from the disease onset. Conclusion : Prolonged renal dysfunction or heavy proteinuria found in five patients(10.4$\%$) led to renal biopsy. All these problems resolved within 6 months. Our data support that the prognosis of childhood APSGN is favorable without any serious sequoia. (J Korean Soc Pediatr Nephrol 2005;9:137-142)

신질환 환아에서 초음파 골량측정법을 이용한 골상태 평가

강주형,신윤혜,조남한,배기수,Kang Ju-Hyung,Shin Yun-Hye,Cho Nam-Han,Pai Ki-Soo 대한소아신장학회 2005 Childhood kidney diseases Vol.9 No.1

Purpose : Metabolic bone diseases have been mai or problems in children with renal diseases and steroid treatment is the main precipitating factor reducing bone mineral density(BMD). This study was performed to assess the prevalence of osteoporosis and to evaluate the clinical factors associated with decreased BMD in children with renal diseases. Methods : Forty-four children with renal diseases who were diagnosed at the Pediatric no phrology division of Ajou University hospital since Oct. 1994 were included. Using a new quantitative ultrasound device, BMD and the prevalence of osteoporosis were evaluated. The clinical and serological data were analyzed in association with decreased BMD. Results : A total of 44 patients were evaluated. The age at initial diagnosis was 6.7$\pm$4.2 years. At the time of evaluation, the chronological and bone age was 9.3$\pm$4.2 years and 8.2 $\pm$ 4.6 years, respectively. The renal diseases included nephrotic syndrome 24(54.5%), Henoch Schonlein purpura nephritis 7(15.9%), IgA nephropathy 6(13.9%), reflux nephropathy(RN) 2 (4.5%), and other renal disease 5(%). The prevalence of osteoporosis was 11%. There was no difference in the clinical factors between the long-term and the short-term treated steroid groups. Conclusion : The prevalence of osteoporosis was 12% in 44 children with renal diseases No significant factor was found in association with decreased BMD and there was no relationship between osteoporosis and steroid usage duration or cumulative dose. A new quantitative ultrasound, which is relatively easy to perform, especially in children, is expected to be in common use and will enable clinicians to evaluate metabolic bone disorders with ease.

형제선별검사로 유아기에 조기 진단된 심한 방광요관역류 1례

이동기,신윤혜,유재은,배기수,Lee Dong-Ki,Shin Yun-Hye,Yu Jey-Un,Pai Ki-Soo 대한소아신장학회 2004 Childhood kidney diseases Vol.8 No.2

We report a case of severe(gradeV) unilateral vesicoureteral reflux(VUR) without any renal damage in a 6-month-old boy through the early sil)ling screening test for VUR, whose old brother had reflux nephropathy. The early detection of VUR aroused us to take special precautions to prevent urinary tract infection in this patient. We believe that this approach was helpful to reduce the risk of renal damage in this patient and are reporting the case with a brief review of related literatures. It is our firm suggestion that screening for vesicoureteral reflux should be carried out in every child who has siblings with refluf nephrouathy.

급성신우신염 환아에서 DMSA 스캔상 발견된 신결손의 예후 인자

서영선,권덕근,신윤혜,배기수,Seon, Yeong-Seon,Kwon, Duck-Geun,Shin, Yun-Hyea,Pai, Ki-Soo 대한소아신장학회 2010 Childhood kidney diseases Vol.14 No.2

Purpose : The purpose of this study is to determine if there are prognostic factors leading to permanent parenchymal damages to kidney in children after acute pyelonephritis. Methods : This study was conducted in 160 pediatric patients with acute pyelonephritis admitted to Ajou University Hospital from 2000 to 2005, whose renal cortical defects were confirmed by $^{99m}Tc$-dimercaptosuccinic acid scintigraphy (DMSA scan). Along with the follow-up DMSA scan after 6 months, they were classified into two groups; recovered group (106) and scarred group (54). The clinical characteristics of each group were compared. Results : Among the total of 160 patients, 106 (66.3%) showed recovery of the initial defect (the recovered group), while 54 (33.8%) showed permanent defects on the followup DMSA scan (scarred group). Recovery rate was poor for patients of 1 year and older, or patients with the duration of fever and pyuria longer than 7 days. The recovery rate was poor in the patients with history of frequent febrile episodes and abnormal results of imaging studies, such as voiding cystourethrography (VCUG), ultrasonography. Conclusion : The recovery rate of children with renal defects on DMSA scan with acute pyelonephritis was lower when the patient is older than 1 year, when the duration of fever and pyuria exceeded 7 days, and when the patients had the histories of frequent febrile episodes and had urinary tract abnormalities on imaging studies. These findings suggest that there may be under- or mis-diagnosis of acute pyelonephritis by pediatrician.

Rotavirus-Induced Neonatal Seizures with Cerebral White Matter Abnormalities on Magnetic Resonance Imaging: A Case Report

박지나,박현아,신윤혜,황종희 대한신생아학회 2017 Neonatal medicine Vol.24 No.1

Rotavirus is a major cause of acute gastroenteritis in infancy and early childhood. Febrile seizures can occur in some infants or children exhibiting rotavirus gastroenteritis even without severe electrolyte imbalance, hypoglycemia or abnormal cerebrospinal fluid (CSF) finding. Some reports have described diffuse cerebral white matter lesions on diffusion-weighted magnetic resonance imaging (DW-MRI) in neonates with rotavirus-associated encephalopathy/encephalitis. In this case study, a 6-day-old male neonate was transferred to the neonatal intensive care unit after having a fever lasting 24 hours. On hospital day two, the seventh day after birth, the patient had his first seizure. The pregnancy and delivery were uneventful. The lab findings, including a CSF exam, were normal, but a stool antigen test for rotavirus was positive. The electroencephalography (EEG) examination result was normal. DWMRI of the brain showed bilateral symmetric diffusion restriction in the genu and splenium of the corpus callosum as well as in the periventricular white matter of the lateral ventricles. Multiple scattered high-signal-intensit foci on T1-weighted image/ fluid-attenuated inversion recovery (FLAIR) in the periventricular white matter were also seen bilaterally. He is now 17 months old, and there were no further seizures. He did not show any neurodevelopmental delay. This case reports that the patient with rotavirus-induced neonatal seizures with cerebral white matter abnormalities on magnetic resonance imaging (MRI) showed a normal neurodevelopmental outcome on the follow-up.

근무력증과 왜소증을 동반한 Bartter syndrome 1례

김인성,강주형,신윤혜,이동국,김순남,배기수,Kim In-Sung,Kang Ju-Hyung,Shin Yun-Hei,Lee Dong-Kuk,Kim Soon-Nam,Pai Ki-Soo 대한소아신장학회 2002 Childhood kidney diseases Vol.6 No.2

Bartter syndrome is a rare disorder characterized by the association of hypokalemic hypochloremic metabolic alkalosis, hyperreninemia, hyperaldosteronemia, short stature and nephrocalcinosis. This disorder presents with hyperplasia of juxtaglomerular apparatus on renal biopsy. We experienced a case of late-onset Bartter syndrome with nephrocalcinosis in a 9-year-old boy, whose chief pictures were muscle weakness, short stature, persistent sterile pyuria and microscopic hematuria. We report this case with a brief review of related literatures.

소아 연구균 감염후 급성 사구체신염에서 단백뇨의 발생과 그 예후

정우철,이효성,신윤혜,배기수,Jeoung, Woo-Chul,Lee, Hyo-Sung,Shin, Yun-Hye,Pai, Ki-Soo 대한소아신장학회 2006 Childhood kidney diseases Vol.10 No.2

Purpose : The prognosis of acute poststreptococcal glomerulonephritis(APSGN) has been reported to be favorable. However, several studies have reported that patients with nephrotic range proteinuria in the acute phase or persistent proteinuria may progress to chronic renal failure. To elucidate this further, we analyzed the features of proteinuria and its prognosis in pediatric patients with APSGN. Methods : A total of 48 children with APSGN admitted to our hospital between Jan. 2000 and Dec. 2004 were included. After discharge from the hospital, patients were regularly followed up every month by clinical evaluations and laboratory tests including routine urinalysis and quantification of proteinuria. Results : Age of the patients ranged from 3 to 15 years(median 5.8 years) at the time of disease onset. Proteinuria was present in 34(70.8%) patients and 5 of them showed heavy proteinuria. Proteinuria normalized within one month in most patients(82.3%) and there was no one with proteinuria after 6 months. Cyclosporine A(5 mg/kg/day in two divided doses) was given to 3 patients with massive proteinuria that lasted longer than 2 months and the result was complete remission within 4 months. Conclusions : Our data indicated that the prognosis of APSGN during childhood is excellent. Children with severe proteinuria or subnormal renal function in poststreptococcal glomerulonephritis had favorable prognosis without chronic renal failure, and children with crescentic formation also had favorable prognosis. Three patients who continued to have heavy proteinuria for more than 2 months received cyclosporine A and remission of proteinuria was achieved within a couple of months.

소아 급성 세균성 신엽염의 임상상 및 신장 예후

이동기,권덕근,임윤주,신윤혜,윤석남,배기수,Lee Dong-Ki,Kwon Duck-Geun,Lim Yun-Ju,Shin Yun-Hye,Yun Suk-Nam,Pai Ki-Soo 대한소아신장학회 2004 Childhood kidney diseases Vol.8 No.2

Purpose: This study was perfonned to elucidate the clinical pictures of acute focal bacterial nephritis(nephronia) in children. Methods: We reviewed 9 children with nephronia diagnosed by ultrasonography or computed tomography of kidneys from September 1994 to August 2004. Results: The overall male to female ratio was 2:1, and the age distribution ranged from 0.1 to 6 years(mean $2.8{\pm}2.2$). The cardinal symptoms were fever, chills, abdominal pain and dysuria/frequency. The initial leukocyte count was $21,000{\pm}5,600/uL$, ESR $60{\pm}23mm/hr$, CRP $17{\pm}10\;mg/dl$. Pyuria was noted in every patient and persisted for $10.5{\pm}7.8$ days after antimicrobial treatment. Abdominal sonography demonstrated focal lesion of ill-defined margin and low echogenicity in 5 of 9 patients(55.6%), while computed tomography revealed nonenhancing low density area in all patients(100%). Three of 9 patients(33.3%) had vesicoureteral reflux, greater than grade III. The initial $^{99m}Tc-DMSA$ scan showed one or multiple cortical defects in every patient, and improvements were noted in 2(33.3%) of 6 patients who received follow up scan after 4 months. Intravenous antibiotics was given in every patient under admission. Total febrile period was $11.8{\pm}6.3$ days(pre-admission, $4.0{\pm}3.0;$ post-admission, $7.8{\pm}5.5$ days) and the patients needed hospitalization for $17.2{\pm}8.1$ days. Conclusion: For the early diagnosis of 'acute focal bacterial nephritis' we should perform renal computed tomography first rather than ultrasonography, when the child has toxic symptoms and severe inflammatory responses in blood and urine.