요로감염이 진단되었거나 의심되는 영아에서 방광요관역류를 예측할 수 있는 임상적, 실험실적 지표들에 대한 연구

조승만,홍성완,홍찬의,정철주,노영일 朝鮮大學校 附設 醫學硏究所 2007 The Medical Journal of Chosun University Vol.32 No.3

Background: Vesicoureteral reflux (VUR) in infants may be the main cause of recurrent urinary tract infection (UTI) and renal scarring. So the early diagnosis of VUR is helpful to prevent recurrence of UTI and to alleviate the grade of VUR. This study is to examine the predictability of clinical and laboratory variables for VUR in infants with confirmed or suspected UTI. Material and Methods: Data of infants younger than 12 months who underwent voiding cystourethrography (VCUG) between 2003 and 2006 were evaluated retrospectively. Among the infants with suspected UTI, infants with VUR (Group 1) vs no VUR (Group 2) were compared. And among the Infants with confirmed UTI, infants with VUR (Group 3) vs no VUR (Group 4) were compared, Variables selected in this study were age at onset, gender, fever, laboratory data and imaging (ultrasonography). Results: Among the variables, the mean of C-reactive protein (CRP) in Group 1 and Group 2 were 5.24±6.82 and 2.46±3.75, respectively, showing that Group 1 had a higher value than Group 2 (P=0.0104). And the number of patients with fever □38.5℃ in Group 1 was higher than in Group 2 (U=0.0004). The mean of C-reactive protein (CRP) in Group 3 and Group 4 were 8.95±6.1 and 5.39±6.0, respectively, showing that Group 3 had a higher value than Group 4 (P=0.0409). Conclusion: Fever≥38.5℃ and CRP≥0.6 ㎎/dL were closely associated with VUR in infants with suspected UTI. And CRP□3.4㎎/dL was closely associated with VUR in infants with confirmed UTI. However, further evaluations and studies for these variables will be needed to use them as predictors for VUR.

중증 천식 환아에서 기계환기 후 발생한 기복 1례

조승만,홍성완,이성훈,정철주,이동진 대한 소아알레르기 호흡기학회 2005 Allergy Asthma & Respiratory Disease Vol.15 No.2

Massive pneumopritoneum developing immediately following initiation of artificial ventilation is an unusual sign of lung barotrauma and must be distinguished from pneumoperitoneum following rupture of a hollow abdominal viscus. Besides, pneumoperitoneum occurring in a mechanically ventilated asthmatic patient can present a diagnostic dilemma as the usual signs of an intestinal perforation may be masked by steroid therapy, sedation or paralysis, or combination of all three. We report a case of massive pneumoperitoneum after initiation of mechanical ventilation in a child with severe asthmatic attack. 기계적 환기 후에 발생하는 기복은 폐 용적 상해나 압력 상해의 흔하지 않은 증상이지만 복강내 장기 천공에 의한 기복과의 감별이 필수적이다. 전형적인 복막염 증상 및 징후가 없고 비외과성 기복일 가능성이 있는 병력이 있을 때 좀 더 정확한 진단방법을 통하여 비외과성 기복임을 입증하고 이 경우 관찰 및 보존적 요법으로 치료하여 불필요한 개복수술을 피해야 할 것이다. 저자들은 폐렴을 동반한 중증 기관지 천식 환아에서 기계환기 후 발생한 기복 및 음낭기종 1례를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

라미부딘 내성 소아 청소년 만성 B형 간염에서 Entecavir 치료 경험

조승만,최병호,추미애,김정미,Cho, Seung-Man,Choe, Byung-Ho,Chu, Mi-Ae,Kim, Jung-Mi 대한소아소화기영양학회 2010 Pediatric gastroenterology, hepatology & nutrition Vol.13 No.1

목 적: 라미부딘에 내성을 보인 소아 청소년 만성 B형 간염에서 엔테카비어 단독요법의 바이러스 억제효과를 확인하고자 하였다. 방 법: 라미부딘에 내성을 보이는 소아 청소년 만성 B형 간염 환자 23명 중 6명(남 4, 나이 15.1~24.6세, 평균 17.5세)에게 엔테카비어 1 mg으로 치료하였으며 (평균 13.4개월, 1~21.1개월) 아데포비어로 치료한 11명과 비교하였다. 치료 시작 후 HBV DNA 역가가 1 $log_{10}$ 이하, 2 $log_{10}$ 이하, 357 IU/mL 이하로 감소하는데 걸리는 기간을 각각 구하여 서로 비교하였다. 결 과: HBV DNA 역가가 2 $log_{10}$ IU/mL 이상 감소하는데 걸린 기간은 각각 2.4${\pm}$2.3개월, 9.2${\pm}$7.3개월로 (p=0.025) 두 군 간에 유의한 차이가 있었다. HBV DNA 역가가 1 $log_{10}$ IU/mL 이상 감소하는데 걸린 기간 및 357 IU/mL 이하로 감소하는데 걸린 기간은 두 군 간에 유의한 차이가 없었다. 결 론: 라미부딘 내성 소아 청소년 만성 B형 간염에서 엔테카비어 단독요법은 아데포비어 단독요법과 비교해 볼 때 HBV DNA 역가가 2 $log_{10}$ IU/mL 이상 감소하는데 걸린 기간이 유의하게 짧았다. 특별한 부작용은 관찰되지 않았다. 엔테카비어의 치료 효과를 알기 위하여 더 많은 환자를 대상으로 한 장기 치료가 필요하다. Purpose: To estimate the viral suppressive effect of entecavir monotherapy in Korean children and adolescents with lamivudine-resistant chronic hepatitis B (CHB). Methods: One milligram of entecavir was administered once daily to 6 patients (4 boys; mean age, 17.5 years; range, 15.10~24.6 years) with lamivudine-resistant CHB for a mean duration of therapy of 13.4 months (range, 1~21.1 months). The therapeutic results were compared with 11 patients who received adefovir (0.3 mg/kg/day [maximal dose 10 mg]) for at least 12 months (mean, 33.4 months; range, 12.4~58.3 months). The serum HBV DNA level and serologic markers were measured every 2 months. Results: The interval to a HBV DNA titer decrement (>1 $log_{10}$) was 1.2${\pm}$0.2 and 4.4${\pm}$5.2 months (p=0.185) for the entecavir and adefovir groups, respectively. The interval to a HBV DNA titer decrement (>2 $log_{10}$) was 2.4${\pm}$2.3 and 9.2${\pm}$7.3 months (p=0.025), for the entecavir and adefovir groups, respectively. Conclusion: The therapeutic efficacy of entecavir was favorable in children and adolescents, especially in shortening the interval to a >2 $log_{10}$ decrement in the HBV DNA titer. Long-term follow up is needed to determine the therapeutic efficacy of entecavir for lamivudine-resistant CHB in children and adolescents.

Enteric Pathogens in Pediatric Patients with Acute Gastroenteritis in Gyeongju, Korea: A Retrospective Study for 7 Years in a Regional Hospital

조승만,이동석,하경임,손동철,이창일 한국미생물·생명공학회 2019 한국미생물·생명공학회지 Vol.47 No.2

Acute diarrhea is a global health problem that causes high morbidity and mortality in children. Notably, enteric pathogen co-infections have been suggested to play an important role in gastroenteritis. In this study, we analyzed 1150 stool specimens of patients who visited the pediatric ward of Dongguk University Hospital in Gyeongju province from January 2011 to December 2017. The average isolation rate of potential stool pathogens over 7 years was 37.3% (429/1150), and coinfections were observed in 51 patients (51/429; 11.9%). In the 51 co-infection cases, the most frequent type of co-infection was found to be that of virus-bacteria (33/51). The most frequently detected bacterial pathogen among the co-infected cases was Clostridium spp. (22/51), out of which Clostridium perfringens was found to be the main pathogen (16/22; 72.7%). Escherichia coli spp. were the second most common bacterial pathogens found in 12 cases (12/51; 23.5%), with 10 cases of E. coli EPEC. Furthermore, the most frequently implicated viral pathogen among the co-infected cases was norovirus (16/51), followed by rotavirus (12/51).

A Case of COVID-19 in a 45-Day-Old Infant with Persistent Fecal Virus Shedding for More Than 12 Weeks

조승만,하경임 연세대학교의과대학 2020 Yonsei medical journal Vol.61 No.10

In this report, we describe the case of a SARS-CoV-2 infection (COVID-19) in an infant with mild fever and diarrhea in the absence of respiratory distress. A 45-day-old male infant with COVID-19 was transferred to our pediatric department. He had mild fever and diarrhea at admission. Positive-to-negative nasal swab conversion occurred on the 21st day from the onset of symptoms. However, stool swab positivity persisted during the 6-week admission period and for 7 weeks during follow-up at an outpatient clinic after discharge. Negative conversion in a stool specimen occurred on the 142nd day from the onset of symptoms. This case highlights the potential of fecal virus shedding as an important feature of viral transmission in infants and young children.

유두상 갑상선암의 수술 시 감시림프절 검사의 유용성

조승만,이영돈,Seung Man Jo,M,D,and Young Don Lee,M,D 대한갑상선-내분비외과학회 2007 The Koreran journal of Endocrine Surgery Vol.7 No.2

Purpose: Sentinel lymph node (SLN) biopsy (SLNB) for patients with melanoma and breast carcinoma has been validated as an accurate method for assessing the status of lymph nodes. Although prophylactic modified radical neck dissection for patients with papillary thyroidcarcinoma is not performed routinely, central neck node dissection is currently considered to be part of the standard initial operation. Therefore, this study was conductedto determine the feasibility of SLNB for the evaluation of central neck lymph node status in patients with papillary thyroid carcinoma. Methods: 116 patients (108 women, 8 men) preoperatively diagnosed with papillary thyroid carcinoma between 2004 and 2006 were prospectively studied. After 0.1 to 0.3 ml of 1.0% methylene blue dye was injected into the tumor, SLNB was performed, followed by total thyroidectomy and central neck node dissection. Results: Preoperatively, in cases of papillary thyroid carcinoma without evidence of cervical lymph node metastasis, the identification rate of SLN in level 6 compartments was 93.1%. In addition, the overall accuracy of SLN at predicting the nodal status was 91.7%. Furthermore, the sensitivity, specificity, positive predictive value and negative predictive values were 85.7%, 100%, 100% and 83.3% respectively. Conclusion: The SLNB in the central compartment for papillary thyroid carcinoma is an acceptable and feasible technique for estimating the central neck lymph node status, therefore, it may be helpful in diagnosing metastases and avoiding unnecessary lymph node dissection in cases of papillary thyroid cancer. However further studies are necessary to improve the diagnostic accuracy prior to routine clinical use. (Korean J Endocrine Surg 2007;7:98-102)

중증 천식 환아에서 기계환기 후 발생한 기복 1례

조승만 ( Seung Man Cho ),홍성완 ( Sung Wan Hong ),이성훈 ( Seong Hun Lee ),정철주 ( Cheol Ju Jung ),이동진 ( Dong Jin Lee ) 대한소아알레르기호흡기학회 2005 소아알레르기 및 호흡기학회지 Vol.15 No.2

요로감염이 진단되었거나 의심되는 영아에서 방광요관역류를 예측할 수 있는 임상적, 실험실적 지표들에 대한 연구

조승만 · 홍성완 · 홍찬의 · 정철주 · 노영일 조선대학교 의학연구원 2007 The Medical Journal of Chosun University Vol.32 No.3

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전력계통에서 분산전원의 위치와 용량에 따른 효과해석

조승만(Seung-Man Jo),강인화(In-Hwa Gang),박재민(Jae-Min Park),김인수(In-Su Kim) 대한전기학회 2020 대한전기학회 학술대회 논문집 Vol.2020 No.10

Clinical Study of Prevalence of Antibiotic Resistance of Escherichia coli in Urinary Tract Infection in Children: A 9-year Retrospective, Single Center Experience

서은영,조승만,이동석,최성민,김두권 대한소아신장학회 2017 Childhood kidney diseases Vol.21 No.2

Purpose: The aim of this study was to determine the prevalence of antibiotic susceptibility and resistance of Escherichia coli in urinary tract infections (UTIs) in children. Methods: We retrospectively reviewed the clinical records of 212 inpatients aged 18 years or younger with UTIs treated at the Pediatric Department of Dongguk University Gyeongju Hospital between January 2008 and December 2016. For comparison, patients were divided into three groups according to age as follows: group 1, ≤1 month; group 2, >1 month to ≤12 months; and group 3, ≥13 months. The antibiotic resistance rates from January 2008 to December 2012 (study period 1) and from January 2013 to December 2016 (study period 2) were analyzed statistically by group. Results: As the patient age increased, the antibiotic resistance rate to ampicillin (P =0.013), levofloxacin (P =0.050), piperacillin/tazobactam (TZP) (P <0.001), and trimethoprim/sulfamethoxazole (P =0.002) increased. The frequency of extended spectrum beta-lactamase producing E. coli showed a significant difference from 5 cases (4.6%) in study period 1 and 16 cases (15.8%) in study period 2 (P =0.007). The antibiotic resistance rate of E. coli was compared between the two time periods and we found that the antibiotic resistance rate to cefotaxime was significantly increased from 5.4% to 16.8% (P =0.008) and that to TZP was significantly decreased from 40.5% to 7.9% (P <0.001). Conclusion: Over the past 9 years, the resistance rate to cefotaxime has increased but the resistance rate to TZP has decreased. Thus, it is important to continue to investigate the antibiotic resistance rates of bacteria in the community.