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황치관,이건수,안인철 충남대학교 의과대학 지역사회의학연구소 2000 충남의대잡지 Vol.27 No.1
Routine liver function test is done in epileptic children receiving antiepileptic drugs to prevent hepatotoxicity induced by these drugs. The abnormalities of liver function test are rarely seen, but these abnormalities accompanied by the clinical manifestation of hepatotoxicity are seldomly seen. This study carried out in order to assess the efficacy of routine liver function test in epileptic children. We examed the changes of the serum level of aspartate transferase(AST), alanine aminotransferase(ALT), total bilirubin, total protein, albumine, alkaline phosphatase(ALP) before and after antiepileptic drug medication in 60 epileptic children who had been receiving valproic acid(n=25명), ethosuximide(n=6명), carbamazepine(n=4명), valproic acid and carbamazepine(n= 14명), and other polytherapy(n=11명) for 3months or more. Results are as follows ; 1) The difference in each groups according to age, duration of treatment, and drug plasma concentration was not found. 2) AST was within normal range in any group, but decreased after valproic acid, ethosuximide, carbamazepine, and other polytherapy treatment. 3) ALT was within normal range in any group, but decreased after valproic acid treatment. 4) Total bilirubin, total protein, albumin, and ALP were within normal range in any groups. 5) Y-GT was within normal range, but the values were increasing tendency in polytherapy groups. 6) No clinical significant menifestations had developed during study period in any groups. The result suggest that the routine liver function test itself can not be the indicator of hepatotoxicity, and that the liver function test exammed when the clinical symptoms appear is more effective than the routine liver function test.
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임상적으로 ITP로 진단받은 환아에게 골수검사의 필요성 유무
조일영,황치관,류혜영,신정원,박경덕 충남대학교 의과대학 지역사회의학연구소 2001 충남의대잡지 Vol.28 No.1
Objective : Bone marrow examination is controversial in childhood idiopathic thrombocyropenic purpura(ITP). The purpose of this study is whether bone marrow examination is needed or not in pediatirc patients clinically diagnosed ITP. Method : To asses the need for bone marrow examination, we followed up 64 patients with presumed ITP. In this patients, Bone marrow examinations were performed in 37 patients at initial diagnosis of ITP and 27 patients are not preformed bone marrow examination at initial diagnosis of ITP. In all 64 patients, the onsets of the disease were abrupt and congenital anomalies were not combined. Physical examination most often reveals mucocutaneous pethechiae and bruise, but lymph node, liver, and spleen were not enlarged. in addition, the complete blood cell count were normal, except for the thrombocytopenia. Results : 1. When clinical ITP was diagnosed initially, bone marrow examinations were preformed in 37 patients. Among these patients, the results of bone marrow examination were not consistent with ITP in 4 patients. In 4 patients, one patient is diagnosed as transient erythroid hypoplasia, another was diagnosed as decreased megakaryocyte, the others were diagnosed as hypocelluar marrow. During following up 37 patients, none had leukemia, aplastic anemia, and other diagnosis. 2. When clinical ITP is diagnosed initially, bone marrow examinations were not performed in 27 patients. these patients were treated with intravenous globulin(IV-G). 5 patients did not response with IV-G. In these 5 patients, only 2 patients progressed to chronic ITP, but were not diagnosed as other disease. Conclusion : Proper history and physical examination as well as a complete blood cell count are reliable means of diagnosing ITP. Bone marrow examination must be considered carefully to ITP patients who are clinically diagnosed.
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Survival Motor Neuron 유전자 Exon 7과 8 부위가 결실된 제1형 척수성 근위축증 1례
김영득(Young Deuk Kim),김재철(Jae Chul Kim),황치관(Chi Kwan Hwang),이건수(Kun Su Lee) 대한소아신경학회 2003 대한소아신경학회지 Vol.11 No.1
Spinal muscular atrophy(SMA) is a genetic disorder of the motor neurons that cause muscular weakness and muscular atrophy due to anterior horn cell degeneration. Classic spinal muscular atrophy patient is caused by mutation in the chromosome 5(q11.2-q13.3), and the majority of the patient shows homozygous deletion of the telomeric survival motor neuron(SMN) gene in the chromosome 5. Deletion of exon 7 and 8 of the SMN gene and deletion of exon 4 and 5 of the neuronal apoptosis inhibitory protein(NAIP) are typically observed in SMA patients. The SMN protein plays a role in an essential cell metabolism process, the splicing of pre mRNA in the spliceosomes. We report a 7 month old male with SMA. He showed rapidly aggrdvatial muscular weakness and died at 7 months. His DNA analysis proved deletion of exon 7 and 8 of the telomeric copy of the SMN gene. 저자들은 survival motor neuron 유전자의 exon 7, 8 부위가 결실된 척수성 근위축증 환아 1례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.
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