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야뇨증 환아들의 심리사회적 특성에 대한 다기관 연구 : 행동 및 정서 문제를 중심으로
조수철,김재원,신민섭,황준원,한상원,박관현,이상돈,김경도,김건석,서홍진,이유식,정재용,김영균,문두건,남궁미경,한창희,조원열,김영식,배기수,이종국,정우영,신의진 大韓神經精神醫學會 2005 신경정신의학 Vol.44 No.6
Objectives : The aim of this study was to examine the behavioral and emotional problems associated with nocturnal enuresis in Korean children. Methods : Three hundred eighteen children with nocturnal enuresis, together with their parents, completed the Child Behavior Checklist (CBCL), Disruptive Behavior Disorder Scale according to DSM-IV (DBDS), Children's Depression Inventory (CDI), State-Trait Anxiety Inventory for Children (STAIC), and Piers-Harris Children's Self-Concept Scale (PHCSC). Ninety-three normal students were selected as the control group. Results : Compared to the normal control group, the mean scores with regard to the withdrawn, social problems, attention problems, delinquent behavior, aggressive behavior, externalizing problems and total problems profiles were significantly higher in the nocturnal enuresis group according to the CBCL results. The nocturnal enuresis group also scored significantly higher in the ADHD and ODD profiles of the DBDS. The nocturnal enuresis group was more depressed and anxious than the control group according to the results of the CDI and STAI. The mean score of the PHCSC was significantly lower in the nocturnal enuresis group when compared to the normal control group. Conclusion : The results of this study suggest that children with nocturnal enuresis in Korea have clinically relevant behavioral and emotional problems. The findings support the link between nocturnal enuresis and psychopathology in Korean children.
비혈연간 골수이식 후 무균실에서 발생한 마이코플라즈마 폐렴 1예
김병주,김효정,배기수,김문규 대한조혈모세포이식학회 2002 대한조혈모세포이식학회지 Vol.7 No.1
마이코플라즈마 폐렴은 학동기에 호발하는 유행성 폐렴으로 골수 이식과 관련되어 보고된 문헌이 거의 없으며 골수 이식과 관련한 호흡기증상 발현 시 대부분의 경우에는 기회감염성 폐렴만을 고려하게 된다. 저자들은 본원에서 연소성 골수단구성 백혈병을 진단 받고 비혈연간 골수이식술을 시행 받은 이후 폐렴증상을 보인 7세된 남자 환아 1예를 경험하였으며, 흉부 X-ray 및 급성기의 혈청 내 마이코플라즈마 특이항체를 검사함으로써 마이코플라즈마 폐렴을 확진할 수 있었고 roxithromycin 투여 후에 증상의 호전을 관찰하였다. 따라서 본 증례를 통하여 골수이식 후 면역억제 중 발생하는 호흡기 감염 시 잘 알려져 있는 CMV peumonitis 및 pneumocystis carinii pneumonia 외에 아직 골수이식과 관련된 정확한 병인은 알려져 있지 않으나 마이코플라즈마 폐렴에 대한 고려도 필요할 것으로 생각한다. Mycoplasma pneumoniae is one of the most common etiological agent causing community acquired interstitial pneumonia. The pathophysiologic mechanism of the disease is based on a unique gliding motility, adhesion to respiratory epithelial cells and the induction of a pathological hyperstimulation of cellular response mechanism of the host in addition to the direct invasion. We reported a 7-year-old child with mycoplasma pneumonia after undergoing unrelated bone marrow transplantation for the treatment of juvenile myelomonocytic leukemia (JMML). He developed severe productive cough and dyspnea about three weeks after UBMT. After serologic study of acute and convalescent phase, mycoplasma pneumonia was confirmed and respiratory symptoms was improved after roxithromycin therapy. Because he was reversibly isolated and had no contact with community, there was a possibility of endogeneous reactivation. This case suggests that when the bone marrow transplant recipient manifests respiratory symptoms such as cough and dyspnea, mycoplasma pneumonia should be included as one of the possible causative disease in addition to CMV pneumonitis or pneumocystis carinii pneumonia.
김향숙,정윤석,조준필,박문성,배기수 대한응급의학회 1999 대한응급의학회지 Vol.10 No.4
Back Ground : Hypothermia is a condition that can lead to serious complications and even to death in newborn. Although the temperature control is essential in neonatal care, it is often neglected during urgent transfer from local private hospitals. The purpose of this study is to evaluate the incidence and clinical outcomes of transfer induced neonatal hypothermia. Subjects and Method : In this retrospective study, subject is limited to transferred outborn babies with age less than 27 hours from June 1996 to May 1999. A total of 3,086 patients were admitted in NICU during the study period and inborn and outborn babies were 1,743(56%) and 1,343(44%) respectively. Among the 1,343 outborn babies, 212 babies were transferred from the private hospital within 24 hours of birth and were eligible for the study. Rectal temperature on arrival, transfer time, birth weight, gestational age, initial arterial gas study, and clinical outcome were compared. Statistical analysis has been done with chi-sqaure test and multiple logistic regression analysis. Results : There were 84 cases(39.6%) hypothermia(<36℃) among the 212 babies and the rate of hypothermia in transfered babies have not decreased over the study period. There were significantly more hypothermia in lower gestational age (less than 28 weeks) and lower birth weight (less than 2,000gm) caused hypothermia significantly more than normal gestational age or normal range of birth weight. And time interval (less than 12 hour) from birth to arrival at emergency department was also significant factor in hypothermia. The mortality rate was three fold higher in hypothermia than normothermic or hyperthermic babies. Conclusion: This study shows that hypothermia during neonate transportation is a major cause of neonatal mortality and morbidity in prehopital care. Body temperature control during transport of neonates under 24 hours of age should be emphasized for the better outcome of treatment.
아토피 소아에서 아토피지표 및 기도과민성과 IgE - 매개성 호염기구 히스타민 유리능과의 관련성
이기선(Ki Sun Lee),홍창호(Chang Ho Hong),이수영(Soo Young Lee),전계리(Gye Ree Jeon),배기수(Ki Soo Pai),(Rosemarie . H . Dekruyff),(Dale . T . Umetsu),홍수종(Soo Jong Hong),전진경(Jin Kyong Chun),김봉성(Bong Seong Kim),심정연(Ju 대한소아알레르기호흡기학회(구 대한소아알레르기 및 호흡기학회) 2000 소아알레르기 및 호흡기학회지 Vol.10 No.4
목 적 : 아토피 천식에서 IgE-매개성 호염기구 유리능과 기도과민성, 아토피 지표들간에 상관관계가 있는지 국내 아토피 소아에서 알아보고자 조사하였다. 방 법 : D.f.와 D.p항원에 양성 피부반응을 보이면서 중등도 이상의 천식병력이 있는 아토피 천식환아 12명과 아토피 정상아 4명을 대상으로 하여, 말초혈액내 총호산구 수, 혈청내 총IgE 농도 및 D.p와 D.f-특이 IgE 항체 농도를 측정하고, 폐기능 검사와 메타콜린 유발검사를 시행하여 각 지표사이의 상관관계를 분석하였다. 결 과 : 1) PC_20은 통계적으로 유의하게 항IgE 항체에 의한 호염기구 히스타민 유리능과 상관관계를 보였다(r=-0.50, P<0.05). 2) 항IgE 항체에 의한 호염기구 히스타민 유리능은 혈청내 총IgE 농도와 상관관계가 있었다(r=0.54, P<0.05). 3) 혈청 D.p 특이-IgE 항채 농도와 항IgE 항체에 의한 호염기구 히스타민 유리능과는 통계적으로 유의한 상관관계가 있었다(r=0.66, p<0.05). 4) 기도과민성의 지표인 PC_20과 폐색성 폐질환 지표인 FEF_(25%-75%)간에도 상관관계가 있었으며(r=0.75, P<0.05), 아토피 지표인 총호산구수와 PC_20간에는 서로 역상관관계가 있었다(r=-0.69, P<0.01). 결 론 :아토피 소아에서 IgE-매개성 말초혈액 히스타민 유리능은 기도과민성과 역상관관계가 있고, 혈청 총IgE 농도 및 D.p 특이-IgE 항체 농도와도 상관관계가 있다. 향후 소아의 아토피 질환에 있어서 기도과민성과 특정 항원에 대한 감작 여부 검사, 진단 및 치료에 대한 반응을 관찰하는데 사용될 수 있는 유용한 방법의 하나로 생각한다. Background : Our previous data suggested that IgE-mediated histamine release from basophil was elevated in the atopic asthmatic children. Basophil may play an important role in the development of the IgE-dependent, late phase response in allergen induced airway disease. So the existence of enhanced basophil histamine release in asthma could promote airway reactivity and obstruction. Purpose : The purpose of this study is to determine the relationship between IgE-mediated basophil histamine releasability(BHR) and airway hyperresponsiveness or markers of atopy in atopic children. Methods : Twelve atopic asthmatics and four healthy atopics who were sensitive to D.p and D.f were selected. Their median age was 11.2 years old, their mean serum IgE level was 897±276 IU/mL and mean total eosinophil count was 536±71/㎣. Total eosinophil counts, total IgE, D.p and D.f-specific IgE, pulmonary function test, and methacholine provocation test were performed. IgE-mediated basophil histamine release by D.f allergen and goat-antihuman IgE antibody were measured by automated fluorometric assay. The relationship between histamine release and airway hyperresponsiveness or atopic markers was investigated. Results : PC_20 inversely correlated with anti-IgE antibody-mediated BHR(r=-0.50, P<0.05). Serum total IgE concentration correlated with anti-IgE antibody-mediated BHR(r=0.54, P<0.05). Serum concentrations of specific IgE to D.p correlated with anti-IgE antibody-mediated BHR(r=0.66, P<0.05). PC_20 correlated correlated with FEF_(25-75%)(r=0.75, P<0.05) and inversely with the total eosinophil counts(r=-0.69, P<0.01). Conclusion : IgE-mediated basophil histamine releasability is inversely correlated with airway hyperresponsiveness, and correlated with total or specific-IgE in atopic children. These findings suggest that basophil histamine releasability is easy and useful method of diagnosis and monitoring response to treatment in atopic disease.