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증예(症例) : 장게실염에 동반된 Klebsiella pneumoniae 균혈증에 의한 문맥염과 그에 합병한 패혈성 색전증에 의한 괴사성 폐렴 1예
백혜리 ( Hae Ri Baek ),이은지 ( Eun Ji Lee ),이찬복 ( Chan Bok Lee ),김성진 ( Sung Jin Kim ),최상명 ( Sang Myung Choi ),채병기 ( Byoung Gy Chae ),김은석 ( Eun Seok Kim ) 전북대학교 의과학연구소 2010 全北醫大論文集 Vol.34 No.2
저자들은 10일의 발열을 주소로 내원한 환자에서 영상검사 및 혈액배양검사로 패혈성 혈전성 문맥염과 그에 병발한 간농양 및 괴사성 폐렴을 진단하고 항생제와 항응고요법으로 치료한 1예를 문헌 고찰과 함께 보고하는 바이다. Pylephlebitis is a thrombophlebitis of the portal venous system. It is a rare but life-threatening complication of intra-abdominal infection. The outcome of this infection has improved duo to recent advances in antibiotics therapy but the mortality rate remains still high. We report a case of pylephlebitis with K. pneumoniae bacteremia secondary to diverticulitis. The patient developed necrotizing pneumonia during hospital stay as a result of septic emboli.
Kang Na Ri,Ahn Yo Han,박유진,Lee Keum Hwa,Baek Hee Sun,Kim Seong Heon,Cho Heeyeon,Cho Min Hyun,Shin Jae Il,Lee Joo Hoon,Cheong Hae Il,Kang Hee Gyung,Park Young Seo,Ha Il-Soo,Moon Duk-Soo,Han Kyoung Hee 대한의학회 2021 Journal of Korean medical science Vol.36 No.20
Background: Chronic kidney disease (CKD) has a negative impact on growth and development in children and is a risk factor for neurocognitive impairment; however, there is limited research on the cognitive function of children and adolescents with CKD. This study therefore aimed to investigate the mean intelligence and risk factors for low intelligence in children and adolescents with CKD. Methods: Eighty-one patients with CKD under 18 years old were included in the KoreaN cohort study for Outcomes in patients With Pediatric Chronic Kidney Disease (KNOW-Ped CKD). Participants completed either the Wechsler Intelligence Scale for Children (6–16 years), or Wechsler Adult Intelligence Scale (> 16 years). Results: The mean full-scale intelligence quotient (IQ) was 91 ± 19; 24.7% of participants scored a full-scale IQ below 80. Participants with a short stature (height Z scores < −1.88), failure to thrive (weight Z scores < −1.65), more severe CKD stage (≥ IIIb), longer duration of CKD (≥ 5 years), and those who were Medicare or Medicaid beneficiaries, had significantly lower mean full-scale IQs. Conclusion: On linear regression analysis, the association between the full-scale IQ, and longer duration of CKD and growth failure, remained significant after controlling for demographic and clinical variables. It is therefore necessary to investigate cognitive impairment in pediatric patients with CKD who exhibit growth failure or for a longer postmorbid period. It is believed that early interventions, such as kidney transplantation, will have a positive effect on IQ in children with CKD, as the disease negatively affects IQ due to poor glomerular filtration rate over time.
Lee, Jae Hyup,Baek, Hae-Ri,Lee, Kyung-Mee,Zheng, Guang Bin,Shin, Sung Joon,Shim, Hee-Jong Mary Ann Liebert 2015 Tissue engineering. Part A Vol.21 No.15
<P>This study used the segmental long-bone defect model to assess the effects of osteoporosis on the formation of new bones and the osteoinductivity of recombinant human bone morphogenetic protein-2 (rhBMP-2). Seventy-two female Sprague-Dawley rats were divided into two groups: an osteoporosis group with ovariectomies and dexamathasone intramuscular injections and a sham group. When they reached 22 weeks in age, each group was further divided into two groups and a 5-mm defect was made in both fibular mid-shafts of each rat. One fibula in each rat was picked randomly and was injected with 0.05?mL of hydrogel carrier; the opposite fibula was injected with the same carrier mixed with rhBMP-2 (10?μg). After rearing for a further 5 and 9 weeks, the ratios of the lengths of the newly formed bones in the fibular defects were determined using micro-CT and undecalcified histology. The sham rhBMP-2-injected group-in all of the 5- and 9-week-kept groups-showed a significantly higher bridging bone formation ratio than the other three groups. The osteoporosis rhBMP-2-injected group showed a significantly higher ratio than both the non-rhBMP-2-injected sham hydrogel and the osteoporosis hydrogel groups. The comparison of the micro-CT parameters of the newly formed bones showed that the sham rhBMP-2 group at both 5 and 9 weeks compared with the osteoporosis rhBMP-2 group had significantly higher percentage bone volumes, trabecular thicknesses, and trabecular numbers, in addition to significantly lower specific surfaces, trabecular pattern factors, and structural model indices. The histology results showed that the sham-rhBMP-2 group began forming bridging bones in the defect areas at 5 weeks, and at 9 weeks, trabeculae and marrow spaces were observed. However, the osteoporosis rhBMP-2 group exhibited a relatively minor level of new bone and trabecula formation. Consequently, the rhBMP-2 group showed significantly increased bone formation in the osteoporosis rat fibular defect model compared with the hydrogel group, whereas the new bone quantities, qualities, and remodeling in the osteoporosis rhBMP-2 group were less effective than those in the sham-rhBMP-2 group, signaling that ovariectomy and corticosteroid-induced osteoporosis significantly undermines rhBMP-2 osteoinductivity.</P>
( Jae Hyup Lee ),( Hae Ri Baek ),( Eui Nam Lee ),( Kyung Mee Lee ),( Hyun Kyung Lee ) 한국조직공학·재생의학회 2013 조직공학과 재생의학 Vol.10 No.5
Porous hydroxyapatite (HA) has great osteoconductivity, which allows it to be used as a bone graft extender. Porous HA enables bone formation by binding with recombinant human bone morphogenetic protein-2 (rhBMP-2). This research is to assess the capability of porous HA granules as a carrier of E.coli-derived rhBMP-2 (E.BMP-2). We compared the release of E.BMP-2 from porous HA of both block and granular forms for 120 min by using an ELISA. Using alkaline phosphatase (ALP) activity assay of human mesenchymal stem cells (hMSC), and the rat abdominal ectopic bone formation model, we also examined the osteogenic capacity of granular HA containing E.BMP-2.The result has shown that the rate of E.BMP-2 released from porous HA for 120 min indicated 42% of HA granules and 27.9% of HA block; the amount of HA granules was larger than HA block. At each set time interval of 10 min, 20 min, 40 min, 80 min, and 120 min, the amount of E.BMP-2 released from HA granules were significantly higher than those from HA block. The ALP activity on the third day of porous HA granules treated with 100 μg E.BMP-2 was significantly higher than that of pure HA granules. In addition, in the rat in vivo model, bony tissue was confirmed in the all of the cases in the E.BMP-HA group but not in the pure HA group, according to the micro-CT and the histology 8 weeks after the surgery. Moreover, in contrast to the pure HA group, the E.BMPHA group showed a higher level of bone volume, percent bone volume, structure model index, trabecular thickness, and trabecular number in the micro-CT scan. In conclusion, porous HA granules can be bound with E.BMP-2 and can properly release E.BMP-2, so that it can increase the osteoblastic differentiation of hMSC and induce the ectopic bone formation, consequently qualifying as a carrier of E.BMP-2.
Lee, Jae Hyup,Baek, Hae-Ri,Lee, Kyung Mee,Zheng, Guang Bin,Shin, Sung Joon,Jin, Yuan Zhe Harwood Academic Publishers 2015 Growth factors Vol.33 No.3
<P>This study evaluated the effect of the combined treatment of intravenous zoledronic acid (ZA, 0.08?mg/kg) and rhBMP-2 (5??g) on osteogenesis in a calvarial defect model of ovariectomized SD rats. New bone formation was evaluated 4 or 8 weeks after calvarial defect implantation using micro-CT and histology. Micro-CT results revealed that the rhBMP-2 group showed significantly higher calvarial defect coverage ratio compared with the ZA?+?rhBMP-2 group at 4 weeks. In addition, bone formation indices were significantly lower in ZA?+?rhBMP-2 group when compared with the rhBMP-2 group after 4 weeks, which indicates a negative effect of ZA on the initial bone formation and the bone quality. At 8 weeks, the negative effect induced by ZA treatment was alleviated as time passed. Histological examination showed similar results to the micro-CT measurements. In conclusion, although ZA treatment lowered the new bone formation induced by rhBMP-2 initially, as time passed, the negative effect was decreased.</P>
Lee, Jae Hyup,Baek, Hae-Ri,Lee, Kyung Mee,Lee, Dong-Yeon,Lee, A-Young Informa UK Ltd. 2015 Growth factors Vol.33 No.1
<P>This study aims to explore the effect of recombinant human bone morphogenetic protein-2 (rhBMP-2) on bone formation when treated with epidermal growth factor (EGF) using human mesenchymal stem cells (hMSCs) and a rabbit tibial defect model. The rhBMP-2 (250 ng/ml)+EGF (10 ng/ml) group showed higher alkaline phosphatase (ALP) activity, ALP expression, increased calcium amount than rhBMP-2 group. In micro-CT and histology results of animal experiments, the rhBMP-2+EGF group showed more amount of bone bridging compared to the rhBMP-2 group. Among the 8-week groups, the rhBMP-2+EGF group showed significantly higher percent bone volume and trabecular number compared to the rhBMP-2 group. The combined treatment with EGF and rhBMP-2 induced significantly higher bone formation compared to that of rhBMP-2 only in both hMSCs and a rabbit tibial defect model. Therefore, EGF is expected to facilitate bone formation effect of rhBMP-2 when both factors are treated in combination.</P>
Lee, Jae Hyup,Kim, Jungju,Baek, Hae-Ri,Lee, Kyung Mee,Seo, Jun-Hyuk,Lee, Hyun-Kyung,Lee, A-Young,Zheng, Guang Bin,Chang, Bong-Soon,Lee, Choon-Ki Springer US 2014 Journal of materials science, Materials in medicin Vol.25 No.9
<P>Methods to improve osseointegration that include implantation of rhBMP-2 with various kinds of carriers are currently of considerable interest. The present study was conducted to evaluate if the rhBMP-2 loaded β-TCP microsphere-hyaluronic acid-based powder-like hydrogel composite (powder gel) can act as an effective rhBMP-2 carrier for implantation in host bone with a bone defect or poor bone quality. The release pattern for rhBMP-2 was then evaluated against an rhBMP-2-loaded collagen sponge as a control group. Dental implants were also inserted into the tibias of three groups of rabbits: an rhBMP-2 (200 µg) loaded powder gel composite implanted group, an implant only group, and a powder gel implanted group. Micro-CT and histology of the implanted areas were carried out four weeks later. The rhBMP-2 powder gel released less rhBMP-2 than the collagen sponge, but it continued a slow release for more than 7 days. The rhBMP-2 powder gel composite improved osseointegration of the dental implant by increasing the amount of new bone formation in the implant pitch and it improved the bone quality and bone quantity of new bone. The histology results indicated that the rhBMP-2 powder gel composite improved the osseointegration in the cortical bone as well as the marrow space along the fixture. The bone-to-implant contact ratio of the rhBMP-2 (200 µg) loaded powder gel composite implanted group was significantly higher than those of the implant only group and the powder gel implanted group. The powder gel appeared to be a good carrier and could release rhBMP-2 slowly to promote the formation of new bone following implantation in a bone defect, thereby improving implant osseointegration.</P>
( Jae Hyup Lee ),( Kyung Mee Lee ),( Soo Jeong Jang ),( Hye Soo Lee ),( Hae Ri Baek ) 한국조직공학·재생의학회 2011 조직공학과 재생의학 Vol.8 No.1
Bisphosphonates have been reported to accelerate osteoblastic differentiation of human mesenchymal stem cells, and bioactive glass-ceramics have been used as bone graft extender due to high osteoconductivity. The purpose of this study is to find out what effects CaO-SiO2-P2O5-B2O3 glass-ceramics (BGS-7) treated with alendr-onate have on the osteoblastic differentiation of human mesenchymal stem cells. Human bone marrow mesenchymal stem cells cultured on BGS-7, hydroxyapatite and cell plate are treated with different concentrations of alendronate and analyzed by MTS assay, ALP assay, RT-PCR, western blot analysis and SEM. The result of the MTS assay shows that the OD value was highest in BGS-7, followed by HA and the plate, and the ALP assay shows that the OD value was higher in the BGS-7 group than the plate group when treated with 10-7 M alendronate. According to the RT-PCR analysis, osteopontin had higher expression in the alendronate-treated group than the non-treated group upon one-week differentiation, showing a clear increase in BGS-7, and osteocalcin and runx-2 showed enhanced expression in the BGS-7 group treated with 10-7M alendronate during week 3 of differentiation. Also, in the western blot analysis, the expression of osteocalcin and runx-2 was increased in the BGS-7 group compared to the plate group in terms of protein expression. The SEM assay shows that the presence of osteoblasts was more evident and the mineral content was higher in the alendronate-treated BGS-7 group than in the alendronate-non treated BGS-7 and alendronate-treated HA. When treated with alendronate, BGS-7, HA and cell plate all accelerated the osteoblastic differentiation of human bone marrow mesenchymal stem cells and especially, the osteoblastic differentiation was accelerated even more in CaO-SiO2-P2O5-B2O3 glass-ceramics (BGS-7) than hydroxyapatite.