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      • KCI등재후보

        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.

      • KCI등재

        Clinical Characteristics and Outcomes of Children With SARS-CoV-2 Infection During the Delta and Omicron Variant-Dominant Periods in Korea

        최수한,최재홍,이준기,은병욱,Song Seung Ha,Ahn Bin,Kim Ye Kyung,Yun Ki Wook 대한의학회 2023 Journal of Korean medical science Vol.38 No.9

        Background: Data on the clinical characteristics of pediatric patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variant infection are limited. We aimed to evaluate the clinical features and outcomes of children with SARS-CoV-2 infection before and after omicron variant dominance in Korea. Methods: A multicenter retrospective cohort study was conducted in hospitalized patients aged ≤ 18 years with laboratory-confirmed SARS-CoV-2 infection at five university hospitals in South Korea. The study periods were divided into the delta (from August 23, 2021 to January 2, 2022) and omicron (from January 30 to March 31, 2022). Results: In total, 612 hospitalized patients were identified (211, delta; 401, omicron). During the omicron and delta periods, the proportions of individuals with serious illness (moderate, severe, and critical severity) were 21.2% and 11.8%, respectively (P = 0.034). Compared with the delta period, the proportions of patients with moderate illness increased significantly in the age groups of 0–4 years (14.2% vs. 3.4%) and 5–11 years (18.6% vs. 4.2%) during the omicron period. During the two periods, the proportions of patients with complex chronic diseases (delta, 16.0% vs. 4.3%, P = 0.040; omicron, 27.1% vs. 12.7%; P = 0.002), respiratory diseases except for asthma (delta, 8.0% vs. 0.0%, P = 0.013; omicron, 9.4% vs. 1.6%; P = 0.001), and neurologic diseases (delta, 28.0% vs. 3.2%, P < 0.001; omicron, 40.0% vs. 5.1%, P < 0.001) were significantly higher in patients with serious illness than in those with nonserious illness. During the delta period, the risk for serious illness was higher among patients with obesity (adjusted odds ratio [aOR], 8.18; 95% confidence interval [CI], 2.80–27.36) and neurologic diseases (aOR, 39.43; 95% CI, 6.90–268.3) and aged 12–18 years (aOR, 3.92; 95% CI, 1.46–10.85). However, the presence of neurologic disease (aOR, 9.80; 95% CI, 4.50–22.57) was the only risk factor for serious illness during the omicron period. During the omicron period, the proportions of patients with croup (11.0% vs. 0.5%) and seizures (13.2% vs. 2.8%) increased significantly compared with the delta period. Conclusion: Compared with the delta period, the proportions of young children and patients with complex comorbidities were higher during the omicron period in Korea. Patients with complex chronic diseases, especially neurologic diseases, had a high risk of severe coronavirus disease 2019 in the two distinct variant-dominant periods.

      • KCI등재

        International travel of Korean children and Dengue fever: A single institutional analysis

        최수한,신지헌,유건희,성기웅,구홍회,김예진 대한소아청소년과학회 2010 Clinical and Experimental Pediatrics (CEP) Vol.53 No.6

        Purpose: Dengue fever occurs in many popular tourist destinations and is increasingly imported by returning travelers in Korea. Since Korea is not an endemic country for dengue fever, pediatricians do not usually suspect dengue fever in febrile children even with typical presentation and exposure history. This study was performed to describe the international travel experiences and dengue fever in Korean children. Methods: Travel histories were collected based on questionnaires completed by all patients’ guardians who visited the pediatric infectious diseases clinic at Samsung Medical Center from January 2008 to December 2008. For patients who were suspected of dengue fever, a serological test was performed. Results: Five hundred and seventeen children visited the pediatric infectious diseases clinic for the first time during this period. About 30% of patients who responded to the questionnaire (101/339) had experienced international travel within the last 2 years. Four patients were diagnosed with dengue fever by serological test. Conclusion: Increasing numbers of Korean children visit dengue endemic areas and they may return home with dengue fever. Dengue fever should be suspected in patients who have a travel history to endemic areas.

      • KCI등재후보

        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.

      • KCI등재

        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.

      • KCI등재

        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.

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