• Title/Summary/Keyword: 환아

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Diabetes Guide - 당뇨병과 간

  • 사단법인한국당뇨협회
    • The Monthly Diabetes
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    • s.239
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    • pp.56-58
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    • 2009
  • 당뇨병환자는 일반인에 비해 간질환에 걸릴 위험이 2배에도 불구하고 간 합병증에 대한 위험성은 잘 알려져 있지 않다. 당교병의 합병증으로 발생하는 간질환은 대개 심각한 질환으로 이어지는 경우는 드문 편이다. 간혹 다른 이유의 검진을 통해서 우연찮게 간의 이상을 발견하기도 하는데, 이는 대부분의 간질환이 특별한 증상이 없기 때문이다. 간질환을 제대로 치료하지 않고 방치한다면 간염, 간경변증 및 간암에 까지 이어져 치명적인 결과를 낳는다. 당뇨병과 간은 어떤 관계가 있는지 살펴보자.

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Changes in Mean Platelet Volume and Platelet Distribution Width after Therapy in Childhood Idiopathic Thrombocytopenic Purpura (소아 특발성 혈소판 감소성 자반증 환아에서 치료경과에 따른 평균 혈소판용적과 혈소판용적 분포폭의 변동)

  • Kim, Jong Tai;Lee, Kyung Won;Kim, Soon Nam;Kim, Moon Kyu
    • Clinical and Experimental Pediatrics
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    • v.45 no.4
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    • pp.505-511
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    • 2002
  • Purpose : Mean platelet volume(MPV) and platelet distribution width(PDW) are useful parameters in evaluating disorders of platelets. In cases with idiopathic thrombocytopenic purpura(ITP), they change as platelet count increases. In this study, we compared the values of MPV and PDW in ITP patients at diagnosis with those of normal children. We also studied whether the early changes in MPV may predict the clinical course. Methods : From December 1995 to May 2001, 71 patients with ITP were admitted to Ajou University Hospital. They were treated with IVIg 400 mg/kg for five days and MPV, PDW, platelet count were analysed. Normal control group(n=38) was compared. The study group was divided into acute and chronic forms, and also divided into group A, good early responders whose platelets increased more than $100,000/{\mu}L$ within 5 days and group B who did not. Results : Mean value of MPV at diagnosis in ITP patients was lower than the normal control group(P<0.05). In group A, MPV was abruptly increased on the first day after IVIg and then started to decrease. But in group B, MPV was steadily increased until the fourth day after IVIg. In the normal control group, there were inverse correlations between platelet count and MPV(r=-0.415, P<0.05), but in ITP patients, there were positive relationships between platelet count and MPV(r=0.646, P<0.05) at diagnosis. Conclusions : MPV at diagnosis of ITP was lower than the normal control. MPV and PDW could not predict the course of ITP patients, but MPV could distinguish good early responders. More research is needed to find out the reasons of decreased MPV at diagnosis of ITP.

Asthma predictive index in children with recurrent wheezing (반복성 천명을 가진 소아에서 천식 발생 예측 지표의 적용)

  • Jang, Joo Young;Kim, Hyo Bin;Lee, So Yeon;Kim, Ja Hyung;Kim, Bong Seong;Seo, Hee Jung;Hong, Soo-Jong
    • Clinical and Experimental Pediatrics
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    • v.49 no.3
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    • pp.298-304
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    • 2006
  • Purpose : We compared the asthma predictive index(API) and the modified asthma predictive index (mAPI) of the Tuscon Children's Respiratory Study Group in Korean children with recurrent wheezing. We investigated the atopic profiles and presence of allergen sensitization of each risk group, and ascertained the significant clinical risk factors. Methods : Two hundred and sixty two children, who visited for recurrent wheezing from 1998 to 2005, were enrolled and divided into groups by API and mAPI. We investigated the history of the patients and their families, atopic profiles, and sensitization to aeroallergen and food allergens. Twenty nine children were followed up to 6 years of age and we evaluated the sensitivity, specificity and positive and negative predictive value of both indices. Results : The high risk group of API were of older age, were more likely to be sensitized to aeroallergen(P=0.001) and food allergen(P=0.034) and had higher levels of total eosinophil count, eosinophil percent, serum ECP, total IgE, and D.p-, D.f-specific IgE. High risk group of mAPI showed higher levels of atopic markers such as egg-, milk-, D.p- and D.f-specific IgE. Even though API did not include allergen sensitization, the high risk group was more significantly sensitized to common allergens than the low risk group. Twenty nine children were followed up until 6 years of age; therefore 15 children were diagnosed as asthma, clinically. The sensitivity, specificity, positive and negative predictive values of mAPI were higher than API. Conclusion : Both high risk groups of API and mAPI had higher levels of atopic markers and were more sensitized to common allergens. These findings suggest that sensitization to aeroallergens and food allergens are more objective markers as asthma predictive indices. In addition, mAPI is a more reliable index in predicting asthma in Korean children with recurrent wheezing than is API. But only 29 patients were followed until the age of 6, so we need to include more children with long term follow up for future study.

Polymorphisms of tumor necrosis factor-alpha promotor gene in Kawasaki disease and relation to the risk of coronary artery lesion (가와사키병에서의 TNF-alpha 유전자의 다형성 및 관상동맥 합병증과의 연관성)

  • Kim, Se-hwa;Yun, Jang-won;Lee, Young-hyuk;Cheon, Eun-jung
    • Clinical and Experimental Pediatrics
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    • v.52 no.4
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    • pp.476-480
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    • 2009
  • Purpose : The purpose of this study was to investigate the polymorphisms of the TNF-alpha promotor gene, its susceptibility to Kawasaki disease (KD) and to assess whether the TNF-alpha promotor gene polymorphism was related the risk of coronary artery lesions (CALs). Methods : From January 2003 to January 2007, 51 children (30 boys and 21 girls) with KD and 48 children forming an age-matched control group were studied. DNA from the peripheral blood of all the children was sampled, and the DNA polymorphisms of the 5' flanking regions of the TNF-alpha promoter gene at position -308 [guanine (G) to adenine (A)] were determined by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Then, the relationship between KD and the TNF-alpha promotor gene polymorphisms was evaluated. Results : The A allele frequency of the -308 site of the TNF-alpha promotor gene was 17.6% (9/51) for children with KD and 6.8% (3/48) for the control group children, but this result was not statistically significant. Twenty-four patients experienced CALs within 60 days after the onset of symptoms. KD children with TNF-alpha -308 A allele had lower frequencies of CALs (12.5% versus 22.2%, P>0.05). Conclusion : The DNA polymorphism of the -308 site TNF-alpha gene was not associated with susceptibility to KD and a risk of CALs. Multicenter, large-scale randomized controlled trials are needed for further study.

Clinical significance of cerebrospinal fluid pleocytosis in pediatric refractory status epilepticus (소아 난치성 간질 중첩증에서 뇌척수액 백혈구 증가증의 임상적 의의)

  • Kim, Jung Mi;Kim, Young Mi;Kwon, Soon Hak
    • Clinical and Experimental Pediatrics
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    • v.49 no.10
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    • pp.1086-1092
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    • 2006
  • Purpose : Refractory status epilepticus(RSE) is a serious neurological emergency in children. The mortality is high and the neurological outcome is not good. This study aimed to evaluate the clinical significance of cerebrospinal fluid(CSF) pleocytosis in refractory status epilepticus in children. Methods : From January 1999 to January 2006, 25 out of 37 children with refractory status epilepticus had spinal tapping. We retrospectively analyzed the data from these children's medical records. We compared the results between groups with and without CSF pleocytosis, and between a group with first seizure and a group with epilepsy. Result : Six out of 25 children had CSF pleocytosis. The group without CSF pleocytosis had a higher mortality rate and required higher doses of antiepileptic drugs as compared with the group with CSF pleocytosis. The group with CSF pleocytosis had much worse neurologic segualae. However, except for the children with CNS infection, the overall prognosis between the group with and without CSF pleocytosis was not significantly different. All children with CSF pleocytosis came in with first seizures. Conclusion : In children with RSE, a CSF study must be perfomed as soon as possible to exclude the possibility of CNS infection. A CSF study is even more important in cases of first seizure or CNS infection suspected. Mild CSF pleocytosis without evidence of infection does not seem to affect the prognosis, so physicians should therefore be more cautious in selecting antibacterial or antiviral agents for it.

Endoscopic Findings of Children with Henoch-Schonlein Purpura (소아 알레르기성 자반증의 위장관 내시경 소견)

  • Lee, Dong Hoon;Park, Chul Han;Park, Ji Min;Park, Geun Soo;Kim, Heung Sik;Kang, Chin Moo
    • Clinical and Experimental Pediatrics
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    • v.46 no.6
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    • pp.572-575
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    • 2003
  • Purpose : This study was performed to analyze the endoscopic findings in Henoch-Schonlein purpura patients, and to compare the differences in endoscopic findings according to age and gastrointestinal symptoms. Methods : We examined children with Henoch-Schonlein purpura aged 3 to 15 years between September 1996 and October 2002. The total number studied was 65, consisting of 41 boys and 24 girls. Endoscopy was performed and the results were analysed. Results : Among 65 cases, 12 cases of duodenitis, nine cases of gastritis and duodenitis, six cases of duodenal erosion, five cases of gastritis, five cases of duodenal ulcer, two cases of gastric ulcer and one case of colonic erosion were noted. Endoscopic abnormality was found in 38 of 53 who had gastrointestinal symptoms, and in two of 12 who didn't have gastrointestinal symptoms. Conclusion : Most of the gastrointestinal symptoms in Henoch-Schonlein purpura patients were relieved without complication. But in some cases severe symptoms such as hematemesis, melena, and abdominal pain localized to epigastric area were developed when diagnosis was delayed. Prompt endoscopy will be helpful for diagnosis and therapy of Henoch-Schonlein purpura with gastrointestinal involvement.

Brain wave results in children with attention deficit hyperactivity disorder and treatment result with central nervous system stimulants (주의력결핍 과잉행동장애 환아에서 시행한 뇌파 결과 및 중추신경자극제 치료에 따른 결과)

  • Lim, Young Su;Sim, Ji Yun;Son, Jung-Woo;Kim, Won Seop
    • Clinical and Experimental Pediatrics
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    • v.51 no.12
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    • pp.1324-1328
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    • 2008
  • Purpose : Attention deficit hyperactivity disorder (ADHD) is a syndrome characterized by inattention, impulsive disruptive behavior, impaired concentration, and motor restlessness. This study examined the relationships among electroencephalographic (EEG) findings, stimulant use, and seizure occurrence in children with ADHD. Methods : We retrospectively studied 308 children with ADHD who visited the neuropsychiatric clinic of our hospital from January 2001 to December 2005. We retrospectively analyzed age distribution, etiology, abnormal EEG findings, and use of CNS stimulants. Among these children, brain waves was recorded in 84 patients. Results : Eighty-four children (72 males, 85.7%, 9.3 years mean age; 12 females, 14.3%, 8.0 years mean age) with ADHD had electroencephalograms (EEGs) performed at our institute. Nineteen patients (22.6%) demonstrated epileptiform abnormalities, and 65 (77.4%) demonstrated normal EEGs. Stimulant therapy was applied to 59 of 84 patients (70.2%). Seizures occurred in 1 of 65 patients with a normal EEG (incidence, 1.5%) and 3 of 19 treated patients with epileptiform EEGs (incidence, 15.7%). Conclusion : These data suggest that patients with normal EEGs have minor risk for seizure. In contrast, patients with epileptiform EEGs have higher risk for seizure than patients with normal EEGs.

Superexchange Interaction and Anisotropic Superexchange (Dzyaloshinskii-Moriya) Interaction (초교환 상호작용과 비등방성 초교환(Dzyaloshinskii-Moriya) 상호작용)

  • Yang, Il-Kyu;Bang, Kil-Hyun;Kim, Bum-Hyun;Min, Byung-Il
    • Journal of the Korean Magnetics Society
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    • v.17 no.5
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    • pp.215-220
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    • 2007
  • The superexchange interaction is introduced to explain antiferromagnetic ordering in transition metal compounds such as MnO and $MnF_2$. The anisotropic superexchange (Dzyaloshinskii-Moriya: DM) interaction can be derived by incorporating the spin-orbit interaction into the superexchange interaction. The anisotropic superexchange DM can account for the weak ferromagnetism observed in transition metal compounds such as ${\alpha}-Fe_2O_3$, $MnCO_3$, $CrF_3$.