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Extended-spectrum β Lactamase (ESBL) 음성과 양성인 Klebsiella pneumoniae 혈류 감염증 환자의 임상적 특성 및 예후 비교
곽희원 외 중앙대학교 의과대학 의과학연구소 2009 中央醫大誌 Vol.34 No.1/2
ESBL-producing Klebsiella pneumoniae are resistant to many antibiotics, and bloodstream infections by ESBL-producing Klebsiella pneumoniae are known to increase the treatment failure and the mortality rate, but further Korean studies are required. We conducted this study to test the hypothesis that the clinical outcomes and prognosis amomg patients with bloodstream infection by ESBL-non-producing Klebsiella pneumoniae and by ESBL-producing Klebsiella pneumoniae are different. One hundred forty two patients with a bloodstream infection by Klebsiella pneumoniae were enrolled in this study from January, 2003 to May, 2007 at Chung-Ang University Hospital. Demographic characteristics, the mortality rate, hospitalization, site of infection, underlying disease and source of infection were assessed and compared between patients with bloodstream infection by ESBL-non-producing Klebsiella pneumoniae and by ESBL-producing Klebsiella pneumoniae by a retrospective analysis. Age, sex, site of infection, underlying disease showed no significant difference between patients with bloodstream infection by ESBL-non-producing Klebsiella pneumoniae and by ESBL-producing Klebsiella pneumoniae. But the infections by ESBL-producing organism more developed among patients with longer hospitalization and longer recovery period than the infections by ESBL-non-producing organism, but the motality rate showed no significant difference. The infections by ESBL-nonroducing organism were mostly community acquired, whereas the infections by ESBL-producing organismswere mostly hospital acquired. In intensive care units, the infections by ESBL-producing organism needed significantly longer Intensive Care Unit hospitalization, but the motality rate showed no significant difference.
시상부위에 발생한 단일성 뇌농양 : 증례 보고 및 문헌고찰 Report of Two Cases and Review of the Literature
곽호신,김동규,이상형,정희원,이현구,김현집,한대희 대한신경외과학회 1992 Journal of Korean neurosurgical society Vol.21 No.12
The authors present two cases of solitary thalamic abscess which were intially diagnosed as malignant thalamic glioma. After treatment with steroids and osmotic agents, the patients' clinical conditions improved after two to three days. However, sudden deterioration of consciousness level developed and the CT scan showed acute hydrocephalus with increment of thalamic low-density lesions. We performed extraventricular drainage and obtained CSF containing numerous inflammatory cells. This suggested the possibility that the lesion was a pyogenic abscess. which progressed to ventriculitis, rather than a malignant glioma. Stereotactic aspiration of the lesion confirmed thalamic abscess. These findings and review of previous reports of thalamic abscess suggested that early diagnosis and stereotactic drainage of the thalamic abscess is of primary importance.
대장균에서 재조합 Rat Guanine deaminase 유전자의 발현, 정제 및 분석
성연선,곽상준,박대성,김향원,이희영 단국대학교 1998 論文集 Vol.33 No.-
Guanine deaminase(EC, 3.5.4.3, ;Guanine aminohydrolase, GAH, GDA) catalyzes the deamination reaction of guanine to xanthine irreversibly. The cDNA encoding rat guanine deaminase had been isolated from a λZAPII rat brain expression library using antibody generated against purified rat guanine deaminase. Toe obtain recombinant GDA and analyze the property of catalytically conserved retion, here we expressed the recombinant GDA in E.coli and showed the retention of its catalytic activity similar to native rat GDA. To make the construct carrying coding region to GDA in pGEX4T prokaryotic expression vector, the region encompassing open reading frame of pBlue-GDA was PCR amplified and subcloned into pGEX4T prokaryotic expression vector with correct reading frame of fusion carrier glutathione S-transferase. After transformation to E.coli DH5a. The bacteria carrying pGEX-GDA was grwon in the condition of IPTG induction. The fusion protein GST-GDA was purified with GSH-sepharose affinity chromatography. The purified GST-GDA was subsequently digested with biotin-conjugated thrombin, and thrombin was removed by streptavidin agarose. Then sample were treated with GSH-sepharose affinity chromatography to remove the contaminant GST and GST-GDA. The purified recombinant GDA showed 70% of specific activity relative to that of purified rat GDA. The recombinant GDA showed identical molecular weight with rat GDA in SDS-PAGE.
조건우,김희원,권석근,곽은호,문석형 대한방사선 방어학회 1985 방사선방어학회지 Vol.10 No.2
KSC-1 핵연료 수송용기에 대한 방사선차폐해석을 QAD-CG, ANISN-KA, DOT 3.5등의 전산코드와 DLC-23/CASK의 핵단면적 자료를 사용하여 수행하였다. 운반물인 사용후 핵연료집합체로부터 방출되는 중성자 및 감마선의 방사선원항은 ORIGEN-79전산코드를 이용하여 평가하였다. 방사선차폐해석 결과, 1개의 가압경수로 사용후 핵연료집합체를 운반할 수 있는 KSC-1핵연료 수송용기는 정상적인 수송조건에서 뿐만 아니라 가상적인 사고수송조건하에서도 관련 법령에서 정하는 기준을 만족하고 있어 방사선차폐해석의 관점에서 볼 때, 그 안전성이 입증된다. Radiation shield design for a shipping cask, KSC-1, was evaluated to verify that the cask can be used in the transportation of a spent fuel assembly discharged from KNU 5 & 6. Radiation source term of the spent fuel assembly was calculated with the computer program ORIGEN-79, QAD-CG, ANISN-KA and DOT 3.5 codes were used in the shielding calculations and the nuclear cross section data needed was extracted from the DLC-23/CASK library. It is concluded that KSC-1 shipping cask satisfies the requirements specified in the relevant regulations under normal conditions of transport and under accident conditions in transport.
한국인에 있어서 상부식도의 이소성 위점막의 빈도 및 임상적 양상
이동욱(Dong Wook Lee),김은영(Eun Young Kim),박정모(Jung Mo Park),이원석(Won Suk Lee),곽동협(Dong Hyup Kwak),김정희(Jung Hee Kim) 대한내과학회 1998 대한내과학회지 Vol.54 No.1
N/A Objectives: This study was performed to investigate the incidence and the clinical significance of inlet patch of heterotopic gastric mucosa in Koreans. This lesion can be found by close observation around the upper esophageal sphincter during upper gastrointestinal endoscopy. Methods: From March 1, 1996 to July 8, 1996, at Kwak's hospital, randomly selected 271 patients undergoing routine diagnostic upper gastrointestinal endoscopy were included in this study. Patients with the inlet patch were confirmed by histology. Clinical symptoms observed through medical history were recorded. Results: Twenty-six cases(9.6%) of the 271 patients studied had heterotopic gastric mucosa which was found at or just below the upper esophageal sphincter, varing from 3 to 30mm in diameter. It was velvety red in color and distinct from the surrounding normal squamous esophageal mucosa, resembling the Z-line at the esophagogastric junction. Parietal cells were identified in all 18 cases in which biopsy specimen contained deep glands, and chief cells were found in 14 eases. Histologically, fundic gland type was most frequent. The symptoms were relatively mild, 5 out of 6 patients who complained of throat discomfort were relieved by H2 antagonists. Conclusion: In Koreans the incidence of heterotopic gastric mucosa in the upper esophagus was similar to the reports from western countries unlike Barrett's esophagus, The etiology of these patches appeared to be congenital rather than acquired from reflux of gastric acid. This was supported by its location in the proximal esophagus and lack of correlation with reflux esophagitis. It must be considered as one of the differential diagnosis of a patient who complains of throat discomfort during diagnostic upper gastrointestinal endoscopy. Attention needs to be paid to find possible development of complications such as stricture and adenocarcinoma in patients with the inlet patch of heterotopic gastric mucosa.