간질성 발작의 뇌신경 세포 손상에 대한 동물 실험적 증거

차병호,Cha, Byung Ho 대한소아청소년과학회 2003 Clinical and Experimental Pediatrics (CEP) Vol.46 No.2

전반적 발달장애 아동의 교육 효과에 대한 연구

차병호(Byung Ho Cha),이준수(Joon Soo Lee),고창준(Chang Jun Coe),장진섭(Jin Seob Jang) 대한소아신경학회 1995 대한소아신경학회지 Vol.3 No.1

Mentally retarded 86 children with behavioral disorder at the special school have been reaccessed by neurological examination, autistic behavior checklist designed by Krug et al as well as measurement of developmental status by Griffth mental development scale to evaluate the effects of special education. 14 children(16%) of 86 were typical autistic children, 16 children(19%) pervasive develop-mental disorder not otherwise specified (PDD-NOS), 7 children(8%) Asperger's syndrome, and the rest 49 children(57%) were simple mental retardation. The result of the special education for one year as following, the typical autistic children improved by ABC scores except language subitem, PDD-NOS also improved except sensory and relating subitem. and children with Asperger's syndrome improved only in social & self help subitem and otherwise deteriorated in developmental status even the special education. In general, Asperger's syndrome in known to have better prognosis than autism and PDD-NOS. but our result revealed that Asperger's syndrome was more deteriorated. And we concluded that the education for the children of pervasive developmental diserder must be carried out each other by classified autism, PDD-NOS, Asperger's syndrome for better educational effectiveness.

한국 자폐아동의 교육 및 평가에 대한 연구

차병호(Byung Ho Cha),박석원(Seok Woon Park),이준수(Joon Soo Lee),고창준(Chang Jun Coe),장진섭(Jin Seob Jang) 대한소아신경학회 1994 대한소아신경학회지 Vol.2 No.1

200 children studying at the special school under the clinical diagnosis of childhood autism have been evaluated by the criteria of DSM-III-R and autistic behavior check list designed by krug and Arick as well as measurement of developmental status by Griffths mental development scale. There were classified as typical Kanner autism. pervasive developmental disorder not otherwise specified(PDD-NOS). Asperger syndrome and mental retardation. 21% of 200 children was typical autistic children was typical autistic children and most of them were belonged to simple mental retardation. Asperger syndrome and PDD-NOS. We concluded that the diagnosis of autism should be made sincerely by team works consist of neurologist, psychologist, social worker and special educator because each individual has various degree of disable and behavioral characteristics.

분자유전학적 검사로 확진된 MELAS 증후군

차병호(Byung Ho Cha),이준수(Jun Soo Lee),고창준(Chang Jun Coe),이진성(Jin Sung Lee),김태승(Tai Seung Kim),선우 일남(Il Nam Sunwoo) 대한소아신경학회 1995 대한소아신경학회지 Vol.3 No.1

We performed the molecular genetic analysis of mitochodrial DNA(mtDNA) in two MELAS(mitochondrial myopathy, encephalopathy, lactic acidosis, andtroke-like episodes) patients who were clinically defined and as well as their family members, and confirmed the diagnosis of MELAS. two patients had the following features:normal early development, recurrent convulsions, cortical blindness and one patient had deterioration of intellectural ability. Brain imaging studies(brain C-T and MRI) of both patients showed progressive cerebral infarction, especially temporal and occipital area. Biochemical tests showed high levels of lactate and pyruvate in the blood. Muscle biopsy manifested ragged-red fibers in one patient and the other was not. Molecular genetic analysis of both patients and elder brother of one patient revealed substitution of an A-to-G at nucleotide position 3243 of their mtDNA in a heteroplasmic fraction. We conclude that the mitochondrial DNA analysis is essential to diagnosis and differentiate MELAS syndrome from other mitochondrial disorders.

일측성 편마비를 동반한 A군 ${\beta}$-용혈성 사슬알균 수막뇌염 1례

김기원,순유진,차병호,이해용,어영,김선주,전진경,Kim, Ki-Won,Soon, Eu-Gene,Cha, Byung Ho,Lee, Hae Yong,Uh, Young,Kim, Sunjoo,Chun, Jin-Kyong 대한소아감염학회 2009 Pediatric Infection and Vaccine Vol.16 No.2

Group A streptococcus (GAS) rarely causes meningoencephalitis in children without risk factors. A previously healthy 8 year-old child presented with lethargy, high fever, and vomiting. The clinical course was unusual including intractable seizures, disseminated intravascular coagulation (DIC), and left hemiparesis in spite of the appropriate and timely administration of antibiotics and corticosteroids. The microbiologic studies revealed that the pathogen was susceptible to penicillin and GAS M18 strains. This case showed the importance of the GAS vaccine in addition to appropriate antibiotics.

신생검에서 급성 사구체신염 양상을 보인 Henoch-$Sch{\ddot{o}}nlein$ 자반증 2례

이상흔,남궁미경,차병호,김종수,Lee Sang Heun,Namgoong Mee Kyung,Cha Byung Ho,Kim Jong Soo 대한소아신장학회 1998 Childhood kidney diseases Vol.2 No.2

[ $\beta$ ]-streptococci have been reported as an etiology of Henoch-$Sch{\ddot{o}}nlein$ purpura(HSP), but the role of $\beta$-streptococci in HSP is not yet confirmed. Our report of two HSP patients is as follows : Although the two patients' clinical symptoms resembled those symptoms of HSP, whereas serum $C_3$ decreased in one case, ASO titer increased in both cases and a histological examination of renal biopsy specimens revealed the fetures commonly described in poststreptococcal glomerulonephritis.

소아 결핵 감염 진단에 있어서 결핵 특이항원 자극 Interferon-${\gamma}$ 분비능 측정의 진단적 유용성

순유진,임백근,김황민,남궁미경,차병호,어영,전진경,Soon, Eu-Gene,Lim, Baek-Keun,Kim, Hwang-Min,NamGoong, Mee-Kyung,Cha, Byung-Ho,Uh, Young,Chun, Jin-Kyong 대한결핵및호흡기학회 2010 Tuberculosis and Respiratory Diseases Vol.68 No.5

Background: $QuantiFERON^{(R)}$-TB Gold In Tube (QFT-G IT) has been used for diagnosing latent tuberculosis infection and active tuberculosis (TB) since 2007. However, there has not been enough data on QFT-G IT for universal use in children. In this study, we evaluated the clinical usefulness of the QFT-G IT in pediatric practice. Methods: We retrospectively reviewed the clinical records of 70 patients younger than 18 years of age who had taken QFT-G IT and had a tuberculin skin test (TST) between July 2007 and July 2009 at Wonju Christian Hospital. The subjects were divided into two groups, asymptomatic TB exposure group and disease group. Four patients who were taking immunosuppressants during the study period were excluded. Results: A total of 66 immunocompetent children were included in this study. Among 27 asymptomatic children who had contact histories of TB, 6 (22.2%) were found to be positive by QFT-G IT. Eleven (40.7%) and 5 (18.5%) children were found to be positive by TST with cutoff values of ${\geq}5mm$ and ${\geq}10mm$, respectively. Agreement was fair to good between QFT-G IT and TST (${\kappa}=0.59$: cutoff value ${\geq}5mm$, ${\kappa}=0.7$: cutoff value ${\geq}10mm$). In disease group, 14 patients (35.9%) were diagnosed with active tuberculosis, 8/14 (57.1%) were positive on TST and 9/14 (64.3%) on QFT-G IT. The positive rate of acid-fast bacilli smear, TB-polymerase chain reaction, and culture for tuberculosis was 11% (1/9), 27.3% (3/11) and 33.3% (3/9), respectively. Conclusion: Our data support that the QFT-G IT can be used as an additional diagnostic tool for latent and active tuberculosis infection in children.

전반적 발달장애(Pervasive Developmental Disorder)

고창준(Chang Jun Coe),차병호(Byung Ho Cha),이준수(Joon Soo Lee),장진섭(Jin Seob jang) 대한소아신경학회 1993 대한소아신경학회지 Vol.1 No.2

Pevasive developmental disorder is consisted of Kanner's autism , pervasive developmental disorder, Asperger syndrome and high intellegence autism. Those symptoms were reviewed as well as their prognosis and many hypothetical research works of their pathogenesis. 100 cases of autistic children, who were studying at the special school were investigated with abnormal behavior check list test and about 30% of them are not thought to be belonged to autism. By this study, we concluded that the diagnosis should be made more sincerely , hopefully the diagnosis better to be made by team work such as child neurology, psychology, psychiatry as well as education. And well planned educational system should be established for their well being in their future life.

뇌량 부분 형성부전 환아의 임상적 고찰

김순남(Soon Nam Kim),차병호(Byung Ho Cha),이준수(Joon Soo Lee),고창준(Chang Jun Coe) 대한소아신경학회 1995 대한소아신경학회지 Vol.2 No.2

59 cases with partial agenesis of corpus callosum visited to Department of pediatrics. College of medicine, Yonsei university, from Jan.1980 to Dec.1993, were reviewed on the basis of clinical characteristics. The results were summarized as follows: the age distribution were 31 cases(52.5%) under 1year, 20 cases(33.8%) from 1 to 5 years, 8 cases(13.7%) from 6 to 15 years. Sex distribution revealed males to females to be 1:1.2. All cases shewed mental retardation, 30 cases(50.8%) with seizure, 8 cases(13.6%) with cerebral palsy, and the most common type of seizure was generalized tonic clonic seizure. 24 of 56 patients had abnormal perinatal history: 22% of them had perinatal asphyxia, 10%. low birth weight, 6.7%. prematurity. 48 patients had associated anomalies. among which craniofacial anomaly was the most common and 8 patients had cardiovascular. 8 patients, skeletal anomalies. We used Griffith developmental scale to assess the developmental status in 31 cases. None of the cases achieved the score above 85 for general intelligence quotient and 24 cases were below 55. EEG revealed most commonly asymmetricity between two hemispheres. some of them showed spikes and slow waves.

항경련제 투여 종료 후 경련 재발의 위험인자에 대한 분석

이영은(Young Eun Lee),차병호(Byung Ho Cha),김황민(Whang Min Kim),양재승(Jae seung Yang),김종수(Jong Soo Kim) 대한소아신경학회 1997 대한소아신경학회지 Vol.5 No.1

목적 : 항경련제의 투여 후 상당 기간 경련 조절이 된 환아에서 투여 종료에 대한 기준은 보고자마다 다르다. 저자들은 항경련제의 투여 종료 수 경련 발작의 재발 양상과 재발 위험인자 등을 알아 보고자 본 연구를 시행하였다. 방법 : 1990년 1월 1일부터 1994년 6월 30일까지 원주의대 부속 원주 기독병원 소아과에 방문하여 간질로 진단받고 항경련제 투여 후 2년 이상 발작이 없었던 환아에서 투여 종료 후 1년 이상 외래 추적이 가능하였던 59명을 대상으로 재발 양상과 재발이 없었던 군(43명)과 재발군(16명)으로 분류 하여 두 군간의 위험인자(발병 연령, 투여 전까지의 발작 횟수, 발병 후 투여 시작까지의 기간, 투여 후 경련이 조절되기까지의 기간, 경련없이 경련이 조절되었던 기간, 동반된 신경학적 이상 유무, 투여 종료 직전에 시행한 뇌파 소견) 등을 비교하였다. 결과 : 1) 총 59명의 환아 중 16명(27.1%)에서 재발하였으며 재발 환아 16명 2명은 감량 기간 중, 6명은 투여 종료 후 6개월 이내, 6명은 6개월에서 12개월 사이에 재발하여 87.5%에서 1년 이내 재발하였다. Kaplan-Meier curve에 의하여 투약 종료 후 시간에 따른 경련 발작의 빈도는 투약 종료 후 12개월에는 23.7%, 24개월에는 33.6%로 재발 가능성을 예측할 수 있다. 2) 재발이 없었던 군(43명)과 재발군(16명)은 각각 투여 전 10회 이상 발작 횟수(9.3% vs. 37.5%), 투여 후 경련이 조절되기까지의 평균 기간(9.5개월 vs. 31.1개월), 동반된 신경학적 이상(11.6% vs 56.2%)에서 의의있는 차이를 나타냈다(P<0.05). 3) 두 군간의 평균 발병 연령(70.6개월 vs. 58.5개월), 발병 후 투여 시간까지의 평균 기간(9.5개월 vs. 6.6개월), 평균 경련 조절 기간(49.7개월 vs. 39.3개월), 투여 종료 직전의 뇌파 이상(23.2% vs. 25.0%)은 통계학적으로 유의한 차이는 없었다. 결론 : 총 59명 중 27.1%에서 재발하였으며 재발 환아의 대부분(87.5%)은 감량 기간 및 1명 이내 재발하였다. 투여 전 발작 횟수가 많고, 경련이 조절되기까지의 기간이 길수록, 동반된 신경학적 질환이 있을수록 재발이 잘 되는 것으로 사료된다. 59 children seen from Jan. 1990 to Jun. 1994 with epilepsy were retrospectively reviewed to evaluate the tendency of recurrence and the risk factors after the antiepileptic drug discontinuation. The population consisted of 59 children who were seizure free for more than 2 years and followed up for more than 1 year after the discontinuation via department of pediatrics, Yonsei University, Wonju College of Medicine. We analyzed risk factors of recurrence(age of seizure onset, seizure frequency before treatment, interval from seizure onset to start of treatment, duration from neurologic disorders, and EEG done just before discontinuation) between non-recurrent group(43 patients) and recurrent group(16 patients). The results were as follows: 1) In 59 patients with epilepsy, 16(27.1%) patients showed recurrence after the discontinuation and 14(87.5%) patients of those were developed during tapering and within less than 1 year. The probability of recurrent seizure by Kaplan-Meier curve at 12 and 24 months after discontinuation are 23.7% and 33.6% respectively. 2) There were significant differences on seizure frequency before treatement, duration from start of treatment to control (9.5months vs. 31.1months), and associated neurologic disorders(11.6% vs. 56.2%) between non-recurrent and recurrent group. 3) There were no significant differences on age at seizure onset(70.6 months vs. 58.5months), interval from seizure onset to start of treatment(9.5months vs. 6.6months), length of seizure free(49.7months vs. 39.3months), abnormal EEG finding done just before withdrawal(23.2% vs. 25.0%) between non-recurrent and recurrent group.