급성 신부전과 괴사성 근염을 동반한 가와사끼병 1례

안소현,심소연,손세정,이승주,한운섭,Ahn, So Hyun,Shim, So Yun,Sohn, Sejung,Lee, Seung Joo,Han, Un Seop 대한소아청소년과학회 2003 Clinical and Experimental Pediatrics (CEP) Vol.46 No.2

가와사끼병은 주로 심혈관계를 침범하는 전신적인 염증 질환이다. 8세 이상의 나이가 많은 소아에서 가와사끼병은 발생률이 낮고 비정형적인 다양한 임상양상을 보이기 때문에 진단이 늦어질 수 있다. 저자들은 10세 남아에서 급성 신부전과 근염을 비롯하여 여러 가지 비정형적인 증상을 보임으로써 진단이 늦어진 가와사끼병을 경험하였기에 보고하는 바이다. Kawasaki disease is an acute febrile vasculitis affecting primarily infants and young children. In addition to the cardiovascular involvement, it may cause inflammatory changes in various organs and body systems : digestive, respiratory, urinary, nervous and musculoskeletal. A case is reported of atypical Kawasaki disease associated with acute renal failure and necrotizing myositis in the right gastrocnemius in a 10-year-old boy. In older children, uncommon age of onset and additional features less commonly associated with Kawasaki disease may contribute to a delayed diagnosis.

항콜린제(옥시부티닌)가 원발성 방광요관역류의 자연 소실에 미치는 영향

안소현,심소연,이정원,조수진,이승주,Ahn So-Hyun,Shim So-Yun,Lee Jung-Won,Cho Su-Jin,Lee Seung-Joo 대한소아신장학회 2003 Childhood kidney diseases Vol.7 No.2

Purpose : Unstable bladder has been known to be one of the reasons for the genesis and persistance of primary vesicoureteral reflux(VUR) in children. And treatment of unstable bladder by anticholinergic agent may contribute to the resolution of primary VUR. We evaluated the effect of an anticholinergic agent(oxybutynin) on the resolution of primary VUR in children with different toilet training and voiding functions. Methods : 152 children with persistant primary VUR after one year of follow up were randomly assigned to the oxybutynin group(n=59, oxybutynin 0.2 mg/kg twice daily) and the control group(n=93, no oxybutynin) at Ewha Womans University Mok-Dong Hospital from October 1996 to April 2002. The resolution rate of the VUR and the difference according to the status of toilet training and voiding dysfunction were analyzed. Statistical analysis was done by the Chi-square test and a P-value of less than 0.05 was considered as significant. Results : VUR was resolved in 49.2%, improved in 20.3% and not changed in 30.5% in the oxybutynin group(n=59) which was not significantly different to 45.2%, 16.1%, 38.7% in the control group(n=93), respectively. In the non-toilet trained young children, VUR was resolved in 50.0%, improved in 23.5% and not changed in 26.5% in the oxybutynin group(n=34) which was not significantly different to 44.2%, 19.2%, 36.6% in the control group(n=52), respectively. In the toilet trained older children, VUR was resolved in 48.0%, improved in 16.0% and not changed in 36.0% in the oxybutynin group(n=25) which was not significantly different to 46.3%, 12.2%, 41.5% in the control group(n=41), respectively. In the toilet trained older children with no voiding dysfunction, VUR was resolved in 33.3%, improved in 11.1% and not changed in 55.5% in the of oxybutynin group(n=9) which was not significantly different to 53.6 %, 10.7%, 35.7% in the control group(n=28), respectively. In the toilet trained older children with voiding dysfunction, VUR was resolved in 56.3%, improved in 18.7% and not changed in 25.0% in the oxybutynin group(n=16), which looked higher than 30.7%, 15.4%, 53.9% in the control group(n=13), respectively, but these were not significantly different either. Conclusion : Oxybutynin was not effective in the resolution of primary VUR in non-toilet trained young children and toilet trained older children. Oxybutynin showed slightly higher tendency of reflux resolution in toilet-trained older children with voiding dysfunction but the difference was not statistically significant. Judicious use of oxybutynin is required in selected older children with VUR and voiding dysfunction. 목적 : 불안정 방광은 소아에서 원발성 방광 요관역류를 생성하고 지속시키는 원인으로 알려져 있다. 따라서 불안정 방광의 치료제인 항콜린제의 사용은 일차성 방광요관역류의 자연 소실율을 증가시킬 수 있으나 논쟁의 여지가 있어왔다. 저자들은 항콜린제인 옥시부티닌이 소변 가리기 훈련과 배뇨 증상이 각기 다른 소아에서 원발성 방광요관역류의 소실에 미치는 영향을 조사하고자 하였다. 방법 : 1996년 10월부터 2002년 4월까지 이화의대 목동병원에 요로 감염으로 입원한 후 방광요관역류가 발견되고 1년 후 추적 검사에서도 소실되지 않은 152명을 대상으로 하였다. 옥시부티닌군(59명)은 옥시부티닌과 trimethoprim-sulfamethoxazole을, 대조군(93명)은 trimethoprim-sulfamethoxazole만을 투약했다. 방광요관역류의 소실율을 나이, 소변 가리기 및 배뇨 장애 유무에 따라 구분하여 분석하였다. 통계 분석은 Chisquare test를 이용하였고 P-값이 0.05 미만을 유의한 것으로 간주하였다. 결과 : 방광요관역류의 변화는 옥시부티닌군(59명)에서 소실 49.2%, 호전 20.3%, 무변화 30.5%로 대조군(93명)의 45.2%, 16.1%, 38.7%와 비교해 유의한 차이는 없었다. 소변을 가리지 못하는 영유아에서 방광요관역류의 변화는 옥시부티닌군(34명)에서 소실 50.0%, 호전 23.5%, 무변화 26.5%로 대조군(52명)의 44.2%, 19.2%, 36.6%와 비교해 유의한 차이는 없었다. 소변을 가리는 소아에서 방광요관역류의 변화는 옥시부티닌군(25명)에서는 소실 48.0%, 호전 16.0%, 무변화 36.0%로 대조군(41명)의 46.3%, 12.2%, 41.5%와 비교해 유의한 차이는 없었다. 소변을 가리고 배뇨 장애도 없는 연장아에서 방광요관역류의 변화는 옥시부티닌군(9명)에서 소실 33.3%, 호전11.1%, 무변화 55.6%로 대조군(28명)의 53.6%, 10.7%, 35.7%와 비교해 유의한 차이는 없었다. 소변을 가리나 배뇨 장애를 보이는 연장아에서 방광요관역류의 변화는 옥시부티닌군(16명)에서는 소실 56.3%, 호전 18.7%, 무변화 25.0%로 대조군(13명)의 30.7%, 15.4%, 53.9%와 비교해 소실되는 경향이나 유의한 차이는 없었다. 결론 : 옥시부티닌은 소변 가리기나 배뇨 장애와 관계없이 모든 소아에서 역류의 소실율에 미치는 치료 효과가 없었다. 배뇨 장애를 보이는 연장아에서는 역류의 소실율이 약간 증가되는 경향이 있었으나 유의하지 않았다. 원발성 방광요관역류에서 옥시부티닌은 배뇨 장애를 보이는 일부 연장아에서 신중하게 사용되어져야 할 것으로 생각된다.

고삼(苦蔘)이 RIN-m5F세포의 인슐린 분비와 $\alpha$-glucosidase 활성 억제에 미치는 영향

안소현,조충식,김철중,An, So-Hyun,Cho, Chung-Sik,Kim, Cheol-Jung 대한한방내과학회 2009 大韓韓方內科學會誌 Vol.30 No.3

Background : Radix Sophora Flavescentis (SF) is used for the treatment of diabetes mellitus in Traditional Korean Medicine. However, little is known about the effects of Radix Sophora Flavescentis extract (SFE) on the hypoglycemic mechanism. Objective : We performed a series of experiments to verify the effects of SFE on the proliferation of RIN-m5F, the secretion and synthetic processes of insulin with glucose stimulation and inhibition of $\alpha$-glucosidase. Methods : Various amounts of SFE were added to the RIN-m5F cell culture to identify the effects on the cell proliferation, total amounts of insulin secretion, and related gene expression at the molecular level. Also to identify the inhibitory effect on the $\alpha$-glucosidase activities, ${\rho}NPG$ assay was done with various SFE concentrations followed by comparison with control. Results : SFE did not show considerable effects on RIN-m5F cells proliferation, insulin secretion or insulin mRNA expression, whichever phenomena did not depend on the glucose concentration. However, SFE significantly inhibited $\alpha$-glucosidase activity in a dose dependent manner compared to control. Conclusions : This study showed that SFE has potent $\alpha$-glucosidase inhibitory activity. Thus, SF may by used for the improvement of overall glycemic control. Further mechanism studies on the lipid toxicity and oxidation stress of SF seem to be necessary.

모야모야병 환자의 뼈목동맥관 직경과 임상표현과의 관계

안소현,송홍기,김철호,손종희,장민욱,최휘철,Ahn, So Hyun,Song, Hong-ki,Kim, Cheol Ho,Jang, Min Uk,Sohn, Jong-Hee,Choi, Hui Chul 대한임상신경생리학회 2016 Annals of Clinical Neurophysiology Vol.18 No.1

Background: Moyamoya disease is characterized by a progressive stenosis or occlusion of the intracranial internal carotid artery and/or the proximal portion of the anterior cerebral artery and middle cerebral artery. Whether the onset time was childhood or adulthood, the bony carotid canal diameter might be different, but reflects the size of internal carotid artery passing through the bony carotid canal. In this study, we aimed to identify the relationship between bony carotid canal diameter and clinical manifestation. Methods: 146 consecutive patients diagnosed with moyamoya disease by brain imaging studies were included. We measured the diameter of a transverse portion of bony carotid canal on bone window of a brain computed tomography(CT) image. Patients were divided into two groups, ischemic or hemorrhagic stroke according to clinical manifestation. As a result, 115 patients were included. The Suzuki stage was used as criteria for disease progression. Results: Bony carotid canal diameter was $3.6{\pm}0.5$ (right) and $3.6{\pm}0.4$ (left) in the hemorrhagic stroke group, and $3.7{\pm}0.4$ (right) and $3.6{\pm}0.4$ (left) in the ischemic stroke group. The bony carotid canal diameter of the moyamoya vessels (3.6 mm) was smaller than the diameter of non-moyamoya vessels (3.8 mm), significantly (p = 0.042). However, there was no difference in the collateral patterns and clinical manifestation in a comparison of both groups. Conclusions: In our study, there was no significant difference of clinical manifestations and collateral patterns depend on the bony carotid canal diameter in patients with moyamoya disease. These findings suggest that the clinical presentations of moyamoya disease are not related to the onset time of the disease.

기훈(氣暈) 환자 8례에 대한 임상보고

안소현,박상우,조충식,김철중,An, So-Hyun,Park, Sang-Woo,Cho, Chung-Sik,Kim, Cheol-Jung 대한한방내과학회 2010 大韓韓方內科學會誌 Vol.31 No.3

The aim of this study was to report eight patients with dizziness, diagnosed as Qi-dizziness. The cause of Qi-dizziness is seven emotions(七情), and seven emotions induce liver qi depression(肝氣鬱結), spleen deficiency(肝脾不和) and dual deficiency of the heart-spleen(心脾兩虛). Guibisoyo-san($Gu\={i}p\'{\i}xi\={a}oy\'{a}o-s\`{a}n$) modified formula, which can treat the above diagnosis, was given to patients three times a day. To evaluate the therapeutic effect, visual analog scale(VAS) and inconvenience degree (ICD) were examined. After treatment, the VAS score decreased 7.37 points on average and ICD score decreased 1.62 points on average in patients with both peripheral vestibular dizziness and nonvestibular dizziness. This study shows that herbal therapy by traditional Korean medicine has considerable effects on dizziness, regardless of the etiological cause.

예술작품의 의미와 전시

안소현 ( So-Hyun Ahn ) 한국미학회 2010 美學 Vol.64 No.-

L`exposition constitue un contexte institutionnel pour les oeuvres d`art. Se faisant elle-meme une interpretation, elle n`est plus seulement un bapteme, mais un processus complexe de transformation. Etant donne qu`aucune exposition n`est pas reellement neutre, il faudra reconsiderer les dipositifs museographiques a legard du sens de l`oeuvre d`art. Les expositions interviennent au sens de l`oeuvre d`art par leur action symbolique, mais aussi indicielle selon la terminologie de Charles Sanders Peirce, dont la deuxieme occupe une place particuliere a cause de son caractere physique et corporelle. Certaines expositions des avant-gardes montrent comment l`environnement museographique creent des sens, parfois d`une maniere physique. En formant une condition perceptible, l`exposition peut permettre une interpretation non verbale, par son caractere physique.

알레르기비염의 사회 환경 위험 요인

안소현 ( So Hyun Ahn ),이희영 ( Hee Young Lee ),송영은 ( Young Eun Song ),박신영 ( Sin Young Park ),임대현 ( Dae Hyun Lim ),김정희 ( Jeong Hee Kim ),손병관 ( Byong Kwan Son ) 대한소아알레르기호흡기학회(구 대한소아알레르기 및 호흡기학회) 2012 소아알레르기 및 호흡기학회지 Vol.22 No.1

Purpose: We investigated the risk factors related to the development and aggravation of allergic rhinitis, which is associated with residential environment and lifestyle habits of children residing in Incheon. Methods: A total of 182 children diagnosed with moderate to severe allergic rhinitis and 67 healthy children were enrolled. A detailed questionnaire of the environmental characteristics and the dietary habits were completed by the parents. Further, skin prick tests with 14 common allergens were performed. Results: The mean age of the children with allergic rhinitis and healthy control was 8.2±2.8 and 9.4±2.0 years, respectively. The presence of indoor mold was associated with an increased risk of development of allergic rhinitis, (adjusted odds ratio [aOR], 4.26; 95% confidence interval [CI], 1.96-9.27) Among the food groups, there was no significant difference of the daily intake of milk and yogurt between the patients and the controls. However, daily intake of vegetables, except Kimchi, and daily intake of fruits or fruit juice were associated with a decreased risk of allergic rhinitis. (aOR, 0.43; 95% CI, 0.20-0.92 / aOR, 0.43; 95% CI, 0.13-0.90, respectively) Conclusion: The results indicate that an indoor dampness is one of the risk factors of development and aggravation of allergic rhinitis. Control of indoor humidity and daily intake of fruits and vegetables can prevent the development and control symptoms of allergic rhinitis.

생후 6개월 이하의 중등증 및 중증 아토피피부염 환자에서 위험요인 분석

안소현 ( So Hyun Ahn ),서원희 ( Won Hee Seo ),김수정 ( Su Jung Kim ),황수정 ( Su Jung Hwang ),박화영 ( Hwa Young Park ),한영신 ( Young Shin Han ),정상진 ( Sang Jin Chung ),이희철 ( Hee Chul Lee ),안강모 ( Kang Mo Ahn ),이상일 ( Sa 대한소아알레르기호흡기학회(구 대한소아알레르기 및 호흡기학회) 2005 소아알레르기 및 호흡기학회지 Vol.15 No.3

50세 이상 고소득층 성인 및 노인의 고혈압 관련건강 및 영양 요인에 관한 연구 : 2005년 국민건강영양조사 결과에 근거하여

안소현 ( So Hyun Ahn ),손숙미 ( Sook Mee Son ),박진경 ( Jin Kyung Park ) 대한영양사협회 2009 대한영양사협회 학술지 Vol.15 No.3

This study was performed to determine the health and nutritional risk factors associated with hypertension in Koreans over the age of 50 in a high-income class (more than twice as much family income as the 2005 Korean minimum cost of living, 668,540 Won). A total of 505 subjects aged over 50 from the 2005 Korean National Health and Nutrition Examination Survey (KNHANES) were divided into two groups: A hypertension group (HG) (N=151, Systolic Blood Pressure ≥140 mmHg or Diastolic Blood Pressure ≥90 mmHg) and normal group (NG) (N=354). Subjects who took hypertension medicines or underwent diet therapy were excluded. In HG, mean daily alcohol intake and the amount of alcohol consumption per one occasion were significantly higher than in NG, respectively. A greater number of hypertension subjects answered that they drank alcohol to reduce stress as compared to normal subjects. HG also took fewer dietary supplements than NG. Mean body mass index (BMI), waist circumference, fasting blood sugar level, and 2 hour postprandial blood sugar following a glucose load were significantly higher in HG than in NG, respectively. Also, iron, thiamin, and niacin intakes and the consumption frequency of seaweeds were significantly lower in HG than in NG, respectively. Finally, obesity (BMI ≥25 kg/m2), abdominal obesity (waist circumference ≥90 cm for males, ≥80 cm for females), high blood sugar level 2 hours after an oral glucose load (≥140∼200 mg/dl), and hypertriglyceridemia (serum TG ≥200 mg/dl) were related to a significantly higher risk of hypertension in the subjects (odds ratio: 1.884∼3.040). In conclusion, dietary factors such as higher alcohol consumption; lower intakes of iron, thiamin, and niacin; lower consumption frequency of seaweeds; and metabolic syndrome were associated with hypertension in the study subjects.

경피경간담즙배액 도관의 복강내 이동으로 발생한 복막염

안소현 ( So Hyun Ahn ),기성호 ( Sung Ho Ki ),오창렬 ( Chang Yul Oh ),조우현 ( Woo Hyun Cho ),이종훈 ( Jong Hun Lee ),이용석 ( Yong Seok Lee ),이희주 ( Hee Joo Lee ) 대한췌담도학회 2016 대한췌담도학회지 Vol.21 No.2

경피경간담즙배액술은 담석, 양성협착, 악성종양 등에 의한 폐쇄성 황달을 감압시키기 위한 방사선학적 방법이다. 담관을 통한 담즙의 내부배액이 회복되면 경피경간담즙배액 도관은 경피적으로 제거할 수 있다. 본례에서는 병상에서 경피경간담즙배액 도관을 제거할 때, 도관이 복강으로 이동하여 복막염이 발생하였고 경구내시경으로 도관을 제거하였다. 경피경간담즙배액 도관을 제거할 때는 도관이 복강으로 이동하지 않도록 주의하여야 하며, 부주의로 인하여 도관이 복강으로 이동하였을 경우에는 경구내시경으로 도관을 제거할 후 있다. Percutaneous transhepatic biliary drainage (PTBD) is a modality that is used to decompress obstructive jaundice due to impacted stones, benign stricture or cancer. The PTBD catheter is removed percutaneously after the restoration of internal biliary drainage. We experienced a case of a 62-year-old man with peritonitis due to the migration of the PTBD catheter into the peritoneal cavity; we successfully removed it using peroral endoscopy. Although rare, the PTBD catheter may migrate into the peritoneal cavity during the removal of it. In these cases, clinicians should consider the peroral endoscopic removal of the PTBD catheter.