영아기에 진단된 Swyer 증후군

유승택 ( Seung Taek Yu ),오일지 ( Il Ji Oh ),최은정 ( Eun Jung Choi ),홍명은 ( Myoung Eun Hong ),김종건 ( Jong Geon Kim ),이창우 ( Chang Woo Lee ),오연균 ( Yeon Kyun Oh ) 대한주산의학회 2005 Perinatology Vol.16 No.2

Swyer syndrome is characterized by a female phenotype, normal to tall stature, sexual infantilism with primary amenorrhea and 46,XY karyotype. The internal genitalia are female with uterus and full vagina, but have no ovaries or testis. Swyer syndrome is often diagnosed when young adults are evaluated for delayed puberty, as menstruation dose not occur naturally. We experienced a case of Swyer syndrome diagnosed incidentally in course of evaluating intrauterine growth retardation and delayed growth in infant. So, we report a case of Swyer syndrome with a brief review of literatures.

미숙아 및 준만삭아에서 출생 후 급격하게 진행한 리스테리아 패혈증 2례

이승현 ( Seung Hyun Lee ),김동섭 ( Dong Sup Kim ),김종덕 ( Jong Duck Kim ),유승택 ( Seung Taek Yu ),이창우 ( Chang Woo Lee ),조정익 ( Jung Ik Cho ),최두영 ( Du Young Choi ),오연균 ( Yeon Kyun Oh ) 대한주산의학회 2013 Perinatology Vol.24 No.1

isteria monocytogenes is a facultative anaerobic, gram-positive bacillus. Listeria is commonly found in processed and prepared foods and listeriosis is associated with high morbidity and mortality. This bacterium is an important cause of severe infection in neonates and pregnant women. Pregnant women are at high risk for listeriosis, but symptoms are non-specific and diagnosis is difficult. Neonatal Listeriosis is generally a severe and fatal disease. There are two forms of the disease in the neonate, early- and late-onset, suggesting different modes of transmission. Generally, early detection and empirical treatment of listeriosis helps to improve survival and prognosis. We explained two cases of L. monocytogenes sepsis with culture-proven in preterm and late preterm newborns from asymptomatic mothers. These neonates had fulminant clinical course even if standard antibiotics treatment were administrated.

원외 출생 후 신생아 중환자실로 전원된 환아들의 감시배양 결과에 대한 임상적 고찰

이승현 ( Seung Hyun Lee ),조성우 ( Sung Woo Cho ),유승택 ( Seung Taek Yu ),오연균 ( Yeon Kyun Oh ) 대한주산의학회 2015 Perinatology Vol.26 No.3

Purpose: To identify trends in bacterial organisms and antimicrobial susceptibilities for transmission by outborn neonates, it is important to perform surveillance cultures. The aim of this study was to investigate major organisms and any other clinical factors through surveillance cultures of out-born neonates who transferred to neonatal intensive care units (NICU). Methods: This study is a retrospective collected data among 189 out-born neonates admitted to NICU from Mar. 2012, to Feb. 2014. Surveillance cultures were obtained routinely from both nasal and axillary region and inoculated CHROM agar™ MRSA immediately. Bacterial culture identification and antibiotic susceptibility were carried out using Vitek II ID-GPI card. Results: The most prevalent organisms isolated from the nasal surveillance cultures were methicillin-resistant Staphylococcus aureus (MRSA) and coagulase negative Staphylococcus (CoNS) (each 17 cases vs. 11 cases); both vancomycin and rifampin were susceptible. Only 1 case of S. epidermidis has same result in blood and surveillance culture. Demographic, clinical and healthcare related parameters according to surveillance culture results were compared, but no obvious association was apparent on above parameters. Nevertheless, positive surveillance culture group showed lower birth weight and longer duration until transferred to NICU. Conclusion: In our surveillance culture study showed that MRSA and CoNS were the most common organisms in out-born neonates; both were penicillin- and oxacillin-resistant on antibiotic susceptibility testing. Although there is no statistical meaning, positive surveillance culture group showed relatively lower birth weight and longer duration from birth to NICU arrival. These findings were contributed to obtain a reliable policy of the transmission in NICU.

A case of severe transient hyperammonemia in a newborn

황민우,유승택,오연균,Hwang, Min-Woo,Yu, Seung-Taek,Oh, Yeon-Kyun The Korean Pediatric Society 2010 Clinical and Experimental Pediatrics (CEP) Vol.53 No.4

신생아 일과성 고암모니아혈증은 고암모니아혈증을 특징으로 하며 대부분 호흡곤란 치료를 받는 미숙아에서 발생한다. 발생원인은 정확히 알려져 있지 않으나 생후 2-3일에 호흡 곤란, 기면, 경련, 혼수 등의 임상 증상을 보이고, 생화학적 검사 상 혈중암모니아 농도가 현저히 증가하며 요소회로 효소 치는 정상을 보인다. 치료가 늦으면 사망에 이르는 응급을 요하는 질환이나 즉각적이고 적절한 치료 시 신경학적 손상을 남기지 않고 호전 가능하다. 저자들은 호흡곤란을 보여 호흡기 치료를 받던 35주 미숙아에서 48시간 내에 경련과 함께 혼수상태에 빠지고 검사상 고암모니아혈증을 보여 신투석 등의 치료 후 회복되었으며 2년 추적관찰에서 정상을 보인 환아를 보고하는 바이다. Transient hyperammonemia in a newborn is an overwhelming disease manifested by hyperammonemic coma. The majority of affected newborns are premature and have mild respiratory syndrome. The diagnosis may be difficult to determine. This metabolic disorder is primarily characterized by severe hyperammonemia in the postnatal period, coma, absence of abnormal organic aciduria and normal activity of the enzymes of the urea cycle. Hyperammonemic coma may develop within 2-3 days of life, although its etiology is unknown. Laboratory studies reveal marked hyperammonemia (>$4,000{\mu}mol/L$). The degree of neurologic impairment and developmental delay in this disorder depends on the duration of hyperammonemic coma. Moreover, the infant may succumb to the disease if treatment is not started immediately and continued vigorously. Hyperammonemic coma as a medical emergency requires dialysis therapy. Here, we report a case of severe transient hyperammonemia in a preterm infant (35 week of gestation) presented with respiratory distress, seizure, and deep coma within 48 hours and required ventilatory assistance and marked elevated plasma ammonia levels. He survived with aggressive therapy including peritoneal dialysis, and was followed 2 years later without sequelae.

학령기 아동에서 어머니-아동 기질 관계와 양육스트레스 연구

유경,김락형,유승택,Yu, Gyung,Kim, Lak Hyung,Yu, Seung Taek 대한한방소아과학회 2015 대한한방소아과학회지 Vol.29 No.3

Objectives : The purpose of this study was to investigate the relationships between mother's and child's temper and parenting stress. Methods : One hundred twenty healthy mothers (above 20 yrs old) who has a school-aged child (7-11 yrs old) participated after informed consent. The temperament of the children was analyzed by the Junior Temperament and Character Inventory 7-11 (JTCI 7-11) by their mothers. The temperament of the mothers was analyzed by the Temperament and Character Inventory-Revised Short (TCI-RS) and the mother's parenting stress was analyzed by the Korean Parenting Stress Index (K-PSI). The relationships between mothers' and child's temperament and parenting stress were assessed using the Pearson correlation coefficient and multiple regression test. Results : There were significant correlations between maternal temperaments and child's temperaments and maternal parenting stress. There was a positive correlation between mother's harm avoidance characteristic, child's novelty seeking degree and parenting stress. On the other hand, there was a negative correlation between child's persistence and parenting stress. In addition, interactions between child and mother temperament dimensions predicted higher levels of parenting stress. Parenting stress was higher in the group of high mother's harm avoidance with child's high novelty seeking and high mother's harm avoidance with low child's persistence. Conclusions : These results are showing that there are significant relationships between mother and child temperament and parenting stress in mothers with school-aged children.

소아에서 벨 마비의 발생빈도, 임상적 특징 및 예후에 대한 연구

원유종,문경희,이완수,금승운,유승택,오경재,이창우,Won, Yoo Jong,Moon, Kyung Hee,Lee, Wan Soo,Keum, Seung Woon,Yu, Seung Taek,Oh, Gyung Jae,Lee, Chang Woo 대한소아청소년과학회 2007 Clinical and Experimental Pediatrics (CEP) Vol.50 No.3

목 적 : 벨 마비(Bell's palsy)는 특별한 원인이나 외상없이 얼굴 근육의 움직임을 지배하는 제7번 뇌신경에 이상이 생겨 안면운동이 마비되는 질환으로, 70-80%는 수일 또는 수 주일에 걸쳐 완전히 회복되나 일부는 후유증을 남긴다. 우리나라에서 소아의 벨 마비의 임상적 고찰에 대한 보고서가 부족한 상황이다. 이에 본원에서는 소아에서 나타난 벨 마비의 임상 양상과 나이에 따른 예후를 알아보고자 본 연구를 시행하였다. 방 법 : 1998년 1월부터 2006년 7월까지 원광대학병원에 안면마비를 주소로 내원한 15세 이하의 소아 61명을 대상으로 남녀 비율, 좌우 비율, 계절별 발생빈도, 치료 기간, 나이에 따른 완치율 등을 후향 적으로 분석하였다. 결 과 : 총 61명 중 남아는 31명, 여아는 30명으로 차이는 없었으며 좌우 병변 부위의 비율은 1:1.44 로 우측이 우세하였다. 월별에 따른 발병 빈도는 3개월(12월, 1월, 2월)에 22(36.0%)명으로 다른 월보다 높은 발병률을 보였다. 스테로이드 치료에 따른 완치 정도 및 완전 회복기간에 있어 유의한 차이는 없었다. 하지만 6세 미만에서 6세 이상에 비하여 완전 회복 기간이 4주 미만인 경우가 유의하게 많았다. 결 론 : 본 연구에서 소아 벨 마비의 발병빈도는 겨울에 높았고 예후는 나이가 어릴수록 좋았다. Purpose : Bell's palsy is defined as an idiopathic facial nerve paralysis of sudden onset. In spite of intensive clinical and experimental investigation, there is still uncertainty in the incidence, etiology, and preferred mode of treatment in children. The objective of this study was to analyze clinical outcome and prognosis of children with Bell' palsy. Methods : We analyzed 61 cases of Bell's palsy diagnosed at the Department of Wonkwang University Hospital from January 1998 to July 2006. The inclusion criteria were any children with acute isolated unilateral lower motor neuron type of facial nerve palsy. The clinical findings and investigations were reviewed including age, sex, affected site, seasonal incidence and result of steroid treatment. Chi-square and Fisher's exact test was used to compare clinical outcome between duration of complete recovery and age. Results : There was no difference in incidence according to sex or age. Incidence was higher in summer and winter. There was no difference in complete recovery rate and duration between steroid treated group and control group. In the group of children younger than 6 years, duration of complete recovery was shorter than older children. Conclusion : We found increasing the incidence of Bell's palsy in summer and winter. Children younger than 6 years had shorter duration in complete recovery.

건강한 소아에서 살모넬라 장염의 합병증으로 발생한 독성거대결장

전성배 ( Sung Bae Jeon ),소철환 ( Cheol Hwan So ),조영민 ( Young Min Jo ),유승택 ( Seung Taek Yu ) 대한소아감염학회 2021 Pediatric Infection and Vaccine Vol.28 No.2

독성거대결장은 염증성 장질환, 감염성 대장염 등에 의해 발생하는 치명적인 합병증이다. 중증도에 따라 장절제부터 사망까지 예후가 나빠 조기 진단과 적절한 치료가 매우 중요한 질환이다. 하지만, 소아에서 그 유병률은 매우 낮으며 염증성 장질환과 같은 기저질환이 없이 발생할 경우 조기진단이 늦어질 수 있다. 기저질환이 없는 12세 남자가 하복부 통증과 발열, 그리고 혈변을 주소로 병원을 방문했다. 항생제 치료에도 불구하고 환자의 증상은 악화되었다. 3병일째 복부 컴퓨터단층촬영에서 횡행결장의 심각한 팽창이 관찰되었고 이를 통해 독성거대결장으로 진단할 수 있었다. 광범위항생제와 함께 정맥 스테로이드 치료를 시행하였으며, 환자의 증상은 호전되었다. 이후 대변 배양 검사에서 Salmonella enteritidis group D가 배양 되었으며, 직장 내시경 검사를 통해 염증성 장질환을 배제할 수 있었다. 저자는 독성거대결장을 적절한 영상 검사를 통해 조기 진단하였고, 내과적으로 성공적인 치료를 하여 이에 대한 경험을 공유하고자 한다. Toxic megacolon is a fatal complication of inflammatory or infectious bowel disease. Prognosis depends on the severity of the disease. In cases of poor prognosis, clinical outcomes range from intestinal resection to death, so early diagnosis and appropriate treatment are very important. However, the prevalence of toxic megacolon in children is very low, and in those without underlying diseases such as inflammatory bowel disease, early diagnosis may be delayed. A previously healthy 12-year-old boy presented to our hospital with lower abdomen pain, fever, and hematochezia. Despite antibiotic therapy, the symptoms worsened. On the third day, abdominal computed tomography revealed severe dilatation of the transverse colon, which indicated toxic megacolon. Stool culture was positive for Salmonella enteritidis group D, and rectal endoscopy showed no signs of inflammatory bowel disease. Ceftriaxone and intravenous methylprednisolone were administered, and the patient's condition improved without any complications. We report a case of toxic megacolon as a complication of infectious colitis caused by S. enteritidis group D, which was diagnosed using early imaging and successfully treated without surgical intervention.

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.

재발성 가와사끼병의 임상양상과 검사소견

유승택,최은정,이창우,오연균,박승택,윤향석 圓光大學校 醫科學硏究所 2003 圓光醫科學 Vol.18 No.2

9개월 영아에서 발생한 Henoch-Schonlein 자반증 1례

김옥란,유승택,최두영 圓光大學校 醫科學硏究所 2006 圓光醫科學 Vol.21 No.2