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

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.

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 Allergy Asthma & Respiratory Disease Vol.15 No.2

HBeAg 음성 만성 B형 간염 소아청소년 환자에서 라미부딘의 적절 치료 기간 결정을 위한 장기 치료 경험

김정미,홍석진,최병호,추미애,조승만,최병호,Kim, Jung-Mi,Hong, Suk-Jin,Choi, Byung-Ho,Chu, Mi-Ae,Cho, Seung-Man,Choe, Byung-Ho 대한소아소화기영양학회 2009 Pediatric gastroenterology, hepatology & nutrition Vol.12 No.1

Purpose: To provide the primary data for reaching a consensus on the adequate duration of treatment of lamivudine in children with HBeAg negative chronic hepatitis B. Methods: Seven of 83 children/adolescents with chronic hepatitis B were diagnosed with HBeAg-negative and HBV DNA-positive chronic hepatitis B and treated with lamivudine. Six children/adolescents were enrolled among 7 patients, who had been treated with lamivudine over 2 years. The primary goal of treatment was HBV DNA clearance and normalization of the serum ALT level; the final goal of treatment was the durability of the complete response after discontinuation of lamivudine. It was planned to continue lamivudine for more than two additional years after HBV DNA negativity and normalization of ALT. Results: The mean duration of lamivudine treatment was 32.2 months (range, 26~40 months) and the mean duration of follow-up was 59.5 months (range, 26~110 months). HBV DNA levels became undetectable (<0.5 pg/mL) in 6 patients within 3 months of treatment. ALT levels were normalized in 3.5 months (range, 2~7 months) in all 6 patients. Biochemical breakthrough developed in 1 patient 18 months after the initiation of lamivudine treatment. No evidence of relapse could be found in 4 patients with a mean follow-up of 23.8 months (range, 4~75 months) after cessation of lamivudine treatment. Conclusion: Suppression of HBV replication and normalization of serum ALT levels were effectively achieved with long-term lamivudine treatment in children/adolescents with HBeAg-negative chronic hepatitis B. Two additional years of lamivudine may be needed after HBV DNA clearance and ALT normalization in HBeAg-negative chronic hepatitis B in order to decrease the relapse rate.

혈청 나트륨 농도가 열성 경련의 발생 및 재발에 미치는 영향

서인애(In Ae Seo),서은영(Eun Young Seo),조승만(Seung Man Cho),이동석(Dong Seok Lee),최성민(Sung Min Choi),김두권(Doo Kwun Kim) 대한소아신경학회 2016 대한소아신경학회지 Vol.24 No.4

목적: 환자-대조군 연구를 통하여 혈청 나트륨 농도가 열성 경련의 발생 및 재발에 미치는 영향에 대하여 연구하고자 하였다. 방법: 2014년 1월 1일부터 2016년 2월 29일까지 동국대학교 경주병원에서 입원치료를 받은 6개월 이상에서 5세 미만의 열성 경련 환자 150명과 경련 없이 발열만 있었던 환자 150명에 대해 후향적으로 의무 기록지를 조사하였다. 환자군 및 대조군의 연령, 성별 및 혈청 나트륨 농도를 비교하였고 환자군을 단순 대 복합 열성 경련군, 비반복성 대 반복성 열성 경련군, 비재발성 대 재발성 열성 경련군으로 나누어 각 그룹의 혈청 나트륨 농도를 통계적으로 분석하였다. 결과: 환자군의 평균 혈청 나트륨 농도(137.46±2.72 mmol/L)는 대조군의 혈청 나트륨 농도(139.34±2.14 mmol/L)에 비해 유의하게 낮았다(P<0.05). 단순 열성 경련군의 혈청 나트륨 농도(137.47±2.53mmol/L)는 복합 열성 경련군의 혈청 나트륨 농도(137.43±3.77mmol/L)와 유의한 차이가 없었다(P=0.998). 반복성 열성 경련군의 혈청 나트륨 농도(136.56±3.2 mmol/L)는 비반복성 열성 경련군의 혈청 나트륨 농도(137.56±2.66 mmol/L)보다 더 낮았으나 통계적으로 유의하지는 않았다(P=0.272). 재발성 열성 경련군의 혈청 나트륨농도(136.6±2.02 mmol/L)는 비재발성 열성 경련군의 혈청 나트륨농도(137.89±2.93 mmol/L)에 비하여 유의하게 낮았다(P=0.006). 환자군의 모든 하위 그룹들의 혈청 나트륨 농도는 대조군에 비해 유의하게 낮았다. 결론: 낮은 혈청 나트륨 농도는 열성 경련의 발생 및 재발의 증가에 영향을 주는 것으로 판단된다. Purpose: The aim of this study is to elucidate the effects of serum sodium concentration on occurrence and recurrence of febrile seizures based on case-control study. Methods: We reviewed retrospectively clinical records of 150 inpatients with febrile seizures and 150 inpatients with febrile illness without seizure aged from 6 months to 5 years in the Pediatric Department of Dongguk University Gyeongju Hospital between January 2014 and February 2016. The age, sex and serum sodium concentration of the patient group were compared with those of control group. Patient group was divided into simple vs complex febrile seizure group, non-repeated vs repeated febrile seizure group, non-recurrent vs recurrent febrile seizure group, and the serum sodium concentration of each group were analysed statistically. Results: The mean serum sodium concentration (137.46±2.72 mmol/L) of patient group was significantly lower (P<0.05) than that of control group (139.34±2.14 mmol/L). The mean serum sodium concentration of simple febrile seizure group (137.47±2.53 mmol/L) was not significantly different (P=0.998) from that of complex febrile seizure group (137.43±3.77 mmol/L). The mean serum sodium concentration of repeated febrile seizure group (136.56±3.2 mmol/L) was lower than that of non-repeated febrile seizure group (137.56±2.66 mmol/L), but not significant (P= 0.272). The mean serum sodium concentration of recurrent febrile seizure group (136.60±2.02 mmol/L) was significantly lower (P=0.006) than that of non-recurrent febrile seizure group (137.89±2.93 mmol/L). The mean serum sodium concentration of all these subgroups were significantly lower than that of control group. Conclusion: Low serum sodium concentration may have an effect on the increase of occurrence and recurrence of febrile seizures.

소아 만성 B형간염에서 라미부딘 치료 후 연령에 따른 B형간염바이러스 표면항원 소실률 비교

김정미 ( Jung Mi Kim ),최병호 ( Byung Ho Choe ),추미애 ( Mi Ae Chu ),조승만 ( Seung Man Cho ) 대한간학회 2009 Clinical and Molecular Hepatology(대한간학회지) Vol.15 No.2

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.