소아청소년 코로나바이러스감염증-19: 역학과 임상 양상

최수한,김한울,강지만,김동현,조은영,Choi, Soo-Han,Kim, Han Wool,Kang, Ji-Man,Kim, Dong Hyun,Cho, Eun Young 대한소아감염학회 2020 Pediatric Infection and Vaccine Vol.27 No.1

2019년 12월 발견되어 2020년 3월 11일 전 세계 대유행이 선포된 코로나바이러스감염증-2019 (coronavirus disease-2019, COVID-19)는 신종 감염병으로서 수많은 감염사례와 사망을 초래하여 사회 전반적으로 영향을 끼치고 있다. 소아청소년 COVID-19는 발병 환자 중 차지하는 비율이 적으며 성인보다는 경증인 경우가 많으나, 일부에서는 중증으로 진행할 수 있다. 신생아 시기부터 감염될 수 있으며, 지역사회 감염의 전파자로서 역할을 할 수 있을 것으로 보인다. 본 종설에서는 현재까지 소아청소년에서의 COVID-19에 대해 알려진 내용을 정리하여 소아청소년 환자들의 진료에 도움을 주고자 한다.

소아암 환자에서 2009 대유행 인플루엔자 A(H1N1) 감염의 임상적 고찰 및 계절 인플루엔자와의 비교 분석

최수한,유건희,안강모,성기웅,구홍회,김예진,Choi, Soo Han,Yoo, Keon Hee,Ahn, Kangmo,Sung, Ki Woong,Koo, Hong Hoe,Kim, Yae Jean 대한소아감염학회 2012 Pediatric Infection and Vaccine Vol.19 No.2

목적: 본 연구는 단일 기관에서 소아암 환자의 2009 인플루엔자 A(H1N1) [A(H1N1)pdm09] 감염 양상을 조사하고 이전의 계절 인플루엔자 감염과 비교 분석하고자 하였다. 방법: 삼성서울병원에서 2009년 8월부터 2010년 2월까지 A(H1N1)pdm09 감염, 2000년 1월부터 2009년 5월까지 계절 인플루엔자 A 감염이 확진된 소아암 환자의 의무기록을 후향적으로 분석하였다. 결과: 82명의 소아암 환자에서 A(H1N1)pdm09 감염이 확진되었다. 10명(12.2%)의 환자에서 하기도 감염증 또는 호흡기 외 감염이 발생하였다. 3명(3.7%)의 환자가 사망하였고 그 중 2명은 A(H1N1)pdm09 기여 사망이었다. 합병된 감염증과 관련하여 유의성을 가지는 위험인자는 감염의 시점(2009년 44-45주)과 병원 내 감염이었다. 이전의 계절 인플루엔자 A 감염과 비교하였을 때 임상적 특성에는 유의한 차이가 없었으나 A(H1N1) pdm09 감염에서 적극적인 항바이러스제 치료가 시행되었다. 결론: 소아암 환자에서 A(H1N1)pdm 감염은 경증부터 중증까지 다양한 임상 경과를 보였으며 이전의 계절 인플루엔자와 비교했을 때 임상 양상의 유의한 차이는 없었다. Purpose: This study was performed to compare the clinical characteristics of 2009 pandemic influenza A(H1N1) [A(H1N1) pdm09] and seasonal influenza A infection in the pediatric cancer patients. Methods: A retrospective review was performed in the pediatric cancer patients who had confirmed A(H1N1)pdm09 infection at Samsung Medical Center from August 2009 to February 2010. For the comparison, the medical records of pediatric cancer patients with seasonal influenza A from January 2000 to May 2009 were reviewed retrospectively. Results: Eighty-two A(H1N1)pdm09 infections were confirmed in the pediatric cancer patients. Ten patients (12.2%) developed complicated clinical course by lower respiratory infections or extrapulmonary infections; 4 pneumonia, 1 bronchitis, 1 pericarditis with pneumonia, 1 encephalitis with pneumonia, 2 meningitis and 1 pericarditis. Three patients received mechanical ventilator and ICU care. Three pediatric cancer patients (3.7%) died. The risk factors related to complicated A(H1N1)pdm09 infections were date of infection (44-45th week 2009) and nosocomial infection. When comparing with previous seasonal influenza A infections, more prompt and aggressive antiviral therapy was given in A(H1N1)pdm09 infections. Conclusion: The A(H1N1)pdm09 infections caused a various clinical manifestations including fatal cases in pediatric cancer patient during pandemic season. There was no significant difference in clinical course between influenza A(H1N1)pdm09 and seasonal influenza A infections except the antiviral treatment strategy.

이 시대의 첨병 - 엔지니어

최수한 한국공학기술학회 1995 공학교육동향 Vol.2 No.2

Pediatric and Parents' Attitudes Towards COVID-19 Vaccines and Intention to Vaccinate for Children

최수한,Jo Yoon Hee,Jo Kyo Jin,박수은 대한의학회 2021 Journal of Korean medical science Vol.36 No.31

Background: Coronavirus disease 2019 (COVID-19) vaccination is necessary to reach herd immunity and essential for mitigating the spread of the pandemic. In May 2021, the US FDA and the EU have expanded the emergency use authorization for a COVID-19 vaccine to children aged 12 to 15. The aim of this study was to investigate parental acceptability of COVID-19 vaccination for their children, factors affecting their acceptability, and children's perceptions of COVID-19 vaccines in Republic of Korea. Methods: We conducted a questionnaire survey at two tertiary hospitals from May 25, 2021 to June 3, 2021. Subjects were parents having children under 18 years and children aged 10–18 years. Results: Two hundred twenty-six parents and 117 children aged 10–18 years were included in the final analysis. Overall, 76.5% and 64.2% of parents intended to get vaccinated against COVID-19 and intended to have their children vaccinated, respectively. However, only 49.6% of children responded that they would get COVID-19 vaccination. In the multivariate analysis, high confidence in the safety of COVID-19 vaccines (adjusted odds ratio [AOR], 4.87; 95% confidence interval [CI], 1.32–24.12), parents' willingness to vaccinate themselves (AOR, 19.42; 95% CI, 6.85–64.00), and awareness of the need to vaccinate children against COVID-19 (AOR, 13.15; 95% CI, 4.77–41.27) were associated with positive factors intention to vaccinate their children. Conclusion: This study provides insight into how parents think about the COVID-19 vaccine for their children in South Korea. Our findings could be referenced in establishing a policy for childhood COVID-19 vaccination in the future.

Systemic use of fluoroquinolone in children

최수한,김은영,김예진 대한소아청소년과학회 2013 Clinical and Experimental Pediatrics (CEP) Vol.56 No.5

Fluoroquinolones are an important class of antibiotics that are widely used in adult patients because of their broad spectrum of activity, good tissue penetration, and oral bioavailability. However,fluoroquinolone use in children is limited because juvenile animals developed arthropathy in previous experiments on fluoroquinolone use. Indications for fluoroquinolone use in patients younger than 18 years, as stated by the U.S. Food and Drug Administration, include treatment of complicated urinary tract infections and postexposure treatment for inhalation anthrax. In Korea, the systemic use of fluoroquinolones has not been approved in children younger than 18 years. Although concerns remain regarding the adverse musculoskeletal effects of fluoroquinolones in children, their use in the pediatric population has increased in many circumstances. While pediatricians should be aware of the indications and adverse effects of fluoroquinolones, recent studies have shown that the risk for musculoskeletal complications in children did not significantly increase following fluoroquinolone treatment. In addition, fluoroquinolones may be particularly helpful in treating multidrug-resistant infections that have not responded to standard antibiotic therapy in immunocompromised patients. In the present article, we provide an updated review on the safety and current recommendations for using fluoroquinolones in children.

중국 동북 조기 조선개척민의 역사탐색

최수한 명지사학회 1994 명지사론 Vol.6 No.1

A Korean Case of Infantile Krabbe Disease with a Novel GALC Gene Mutation

최수한,이지훈,이상구,기창석,이문향 대한소아신경학회 2009 대한소아신경학회지 Vol.17 No.2

Krabbe disease is a rare autosomal recessive neurodegenerative disorder caused by mutations in the galactocerebrosidase(GALC) gene. The deficiency of GALC activity leads to the accumulation of psychosine, resulting in apoptosis of myelin-forming cells of the central and peripheral nervous system. The patients with typical infantile onset Krabbe disease have extreme irritability, developmental regression, spasticity, and seizures with an onset prior to six months of age. These children usually die within two years after birth. We report a female infant who showed the characteristic clinical manifestations, disease course, and neuroimaging features of infantile onset Krabbe disease that was confirmed by the identification of a compound heterozygous mutation of the GALC gene.

Nakagami 페이딩 채널하에서 하이브리드 DS / FH 확산대역 시스팀의 성능 ( Performance of Hybrid DS / FH Spread Spectrum systems Over Nakagami Fading Channels )

최수한,조현욱,박상규 한국통신학회 1995 한국통신학회 학술대회논문집 Vol.14 No.2

소아청소년 코로나바이러스감염증-19의 치료: 치료 약제를 중심으로

최수한,최재홍,윤기욱,Choi, Soo-Han,Choi, Jae Hong,Yun, Ki Wook 대한소아감염학회 2022 Pediatric Infection and Vaccine Vol.29 No.1

Coronavirus disease 2019 (COVID-19) presents as a mild-to-moderate respiratory illness in most children. However, a small proportion of children with COVID-19 develop severe or critical illnesses. Although pediatric clinical trials for the treatment of COVID-19 are sparse, some drugs are available for children and adolescents with severe COVID-19. This review summarizes clinical data focusing on antiviral agents and immunomodulators for use in treating COVID-19. In addition, current recommendations for therapeutics for children and adolescents with COVID-19 are discussed.

예정 제왕 절개술시 Cimetidine 마취전투약이 위 내용물의 pH 및 용량에 미치는 영향

최수한,문성호 대한마취과학회 1995 Korean Journal of Anesthesiology Vol.29 No.2

Aspiratian of gastric contents during anesthesia is the most common cause of maternal anesthetic death. Particularly, the parturient is predisposed to the catastrophe of aspiration for many reasons. So, the effect of cimetidine premedication on gastric pH and volume were studied. 120 ASA Class I patients scheduled for elective obstetric and gynecologic surgery were randomly divided into six groups as follows: Class A(n=80) is pregnant women scheduled for elective cesarean section. In the class A, group 1(n=20)(control group) was received no cimetidine premedication, group 2(n=20) was received cimetidine 300 mg p.o. hs. group 3(n=20) was received cimetidine 300 mg p.o. 2hrs before anesthesia, and group 4(n=20) was received cimetidine 200 mg iv 2hrs before anesthesia. Class B (n=40) is 20-40 aged non-pregnant women scheduled for elective surgery. ln the class B, group 5(n=20)(control group) was received no cimetidine premedication and group 6(n=20) was received cimetidine 200 mg iv 2hrs before anesthesia. Immediately following induction of anesthesia, the gastric fluid was obtained by suction on a nasogastric tube and its volume and pH were measured. The results were as follows: 1) When cimetidine is not premedicated, number of patient with a gastric pH less than 2,5 and gastric volume greater than 25 ml was increased in the group 1 compared with group 5. 2) In the class A, there was significant increased gastric pH and decreased gastric volume in the group 2, 3, and 4 compared with group l. 3) In the class B, there was significant increased gastric pH and decreased gastric volume in the group 6 compared with group 5. In conclusion, it would seem that the risk of aspiration pneumonitis can be increased in the pregnant women compared with nonpregnant women. The authors recommend that the incidence of severe aspiration pneumonia can be decreased by cimetidine premedication before general anesthesia even though there is any gastric aspiration. (Korean J Anesthesiol 1995; 29: 198~203)