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      • Comparison of trophic factors changes in the hippocampal CA1 region between the young and adult gerbil induced by transient cerebral ischemia.

        Yan, Bing Chun,Park, Joon Ha,Kim, Sung Koo,Choi, Jung Hoon,Lee, Choong Hyun,Yoo, Ki-Yeon,Kwon, Young-Geun,Kim, Young-Myeong,Kim, Jong-Dai,Won, Moo-Ho Kluwer Academic/Plenum Publishers 2012 Cellular and molecular neurobiology Vol.32 No.8

        <P>In the present study, we investigated neuronal death/damage in the gerbil hippocampal CA1 region (CA1) and compared changes in some trophic factors, such as brain-derived neurotrophic factor (BDNF), glial cell line-derived neurotrophic factor (GDNF) and vascular endothelial growth factor (VEGF), in the CA1 between the adult and young gerbils after 5 min of transient cerebral ischemia. Most of pyramidal neurons (89%) were damaged 4 days after ischemia-reperfusion (I-R) in the adult; however, in the young, about 59% of pyramidal neurons were damaged 7 days after I-R. The immunoreactivity and levels of BDNF and VEGF, not GDNF, in the CA1 of the normal young were lower than those in the normal adult. Four days after I-R in the adult group, the immunoreactivity and levels of BDNF and VEGF were distinctively decreased, and the immunoreactivity and level of GDNF were increased. However, in the young group, all of their immunoreactivities and levels were much higher than those in the normal young group. From 7 days after I-R, all the immunoreactivities and levels were apparently decreased compared to those of the normal adult and young. In brief, we confirmed our recent finding: more delayed and less neuronal death occurred in the young following I-R, and we newly found that the immunoreactivities of trophic factors, such as BDNF, GDNF, and VEGF, in the stratum pyramidale of the CA1 in the young gerbil were much higher than those in the adult gerbil 4 days after transient cerebral ischemia.</P>

      • 고빌리루빈혈증을 동반한 자가면역성 간염 1례

        서영범,김성욱,장재식,강혁주,이중현,윤병구,김욱년,이광헌,이구,유석동,양창헌,이정호,이영현,이창우,서정일 동국대학교 의학연구소 2000 東國醫學 Vol.7 No.-

        자가면역성 간염은 대개 만성 경과를 가지며, 혈중 자가면역항체와 혈청 글로불린치의 상승, 그리고 조직학적으로 괴사 염증성 변화를 특징으로 하는 질환으로 아직 정확한 병인이 밝혀져 있지 않은 상태이다. 발병연령은 대개 젊은 영자(15-25세)에서 호발한다. 이 질환은 급성 간염의 임상경과를 보일 수 있으나, 심한 급성 간염이나 전격성 간염으로도 나타날 수 있는데, 이 경우 아주 나쁜 예후를 보인다고 한다. 치료는 자가면역성 간염 임상 경과의 다양성이나 병인, 병리기전의 불확실성에도 불구하고 대개 steroid 치료에 반응하는 것으로 알려져 있으며 대개 80%의 관해율을 나타내며 궁극적으로 간경변으로의 진행을 막을 수 있는 것으로 보인다. 저자들은 58세 남자에서 발생한 급성의 경과를 가지고 심한 황달을 동반한 자가면역성 간염을 경험하였기에 문헌고찰과 함께 보고하는 바이다. Autoimmune hepatitis (AIH) is a chronic necroinflammatory liver disorder of unknown cause associated with circulating autoantibodies and a high serum globulin level. The age of onset of AIH show a peak between the age of 15 and 25 years. AIH can develop and be manifested as acute hepatitis, but severe form of acute hepatitis or fulminant hepatic failure has a poor prognosis. Although AIH is likely to progress from chronic active hepatitis to cirrhosis, steroid therapy can control the disease activity, prolong survival, improve the quality of life , and defer liver transplantation. In the present report we describe a 58-year-old man who admitted because of progressive jaundice and fatigue. He was diagnosed with AIH from laboratory test result showing positivity for antinuclear antibodies, anti-smooth muscle antibodies, and negativity for hepatitis viral markers and from liver biopsy. Steroid therapy, oral administration of prednisolone, was effective in improving the liver function test. Following liver biopsy 6 months after onset shows markedly improved necroinflammatory activity.

      • 동일한 환자에서 조혈모세포이식 전후의 호중구감소 기간 중 감염양상에 대한 비교연구 : 중심정맥관 관련 패혈증을 중심으로 Based on Central Venous Catheter Related Septicemia

        류재호,노규태,이영석,이영호,권혁찬,김재석,김효진,이영민,박혜원,박근희 대한조혈모세포이식학회 2002 대한조혈모세포이식학회지 Vol.7 No.1

        연구배경: 동일한 환자를 대상으로 조혈모세포이식 전 일반 병실에서의 관해유도 항암제치료 및 강화요법으로 인한 호중구감소 기간의 감염양상과 고용량 항암제치료 후 무균실에서의 조혈모세포이식 시 호중구감소 기간의 감염양상을 중심정맥관 관련 패혈증을 중심으로 비교 연구함으로써 효율적인 감염관리지침을 마련하고자 하였다. 대상 및 방법: 1999년 1월부터 2001년 7월까지 2년 7개월간 동아대학교병원 일반병실에서 악성혈액질환으로 항암제 치료를 받다가 조혈모세포이식을 시행받았던 22명을 대상으로 중심정맥관 관련 패혈증의 형태를 비교분석하였다. 결과: 대상 환자들의 일반병실과 무균실에서의 입원기간은 각각 32±13일, 33±19일, 호중구 감소기간은 15±12일, 17±18일, 호중구 감소기간의 발열 횟수는 14회, 14회로서 입원병실의 종류에 따른 차이는 없었다. 환자들의 중심정맥관 사용일수는 일반병실에서 29일(7~545일), 무균실에서 100.5일(25~606일)이었으며, 총 사용일수는 각각 1,515일, 3,250일로서 무균실에서의 중심정맥관 사용일수가 의미 있게 길었다(P=0.001). 중심정맥관 사용 일수에 대한 감염률은 각각 5.28/1,000일, 3.08/1,000일로서 일반병실에서 그 빈도가 높았으나 통계적 유의성은 보이지 않았다(P=0.141). 결론: 중심정맥관 삽입 후 일반병실에서 항암제 치료를 받던 환자가 조혈모세포이식을 위하여 무균실에 입원하는 경우, 중심정맥관을 교체하는 것이 감염관리를 위하여 바람직할 것으로 생각된다. Background: We compared the incidence of central venous catheter (CVC) related septicemia during neutropenic period in the same patient, which developed following chemotherapy for remission induction and consolidation, or hematopoietic stem cell transplantation (HSCT). Methods: We retrospectively reviewed the medical records and laboratory data of 22 patients with hematologic malignancies who received anticancer chemotherapy followed by HSCT at Dong-A University Hospital between January, 1999 and July, 2001. We investigated the duration of hospitalization, duration of neutropenic period, duration of catheterization, microbiologically documented organisms and incidence of CVC related septicemia. Results: The data in general ward (before HSCT) and laminar air flow room (after HSCT) were as follows: duration of hospitalization was 32±13 days and 33±19 days, duration of neutropenic period was 15±12 days and 17±18 days, median duration of catheterization was 29 days (7~545 days) and 100.5 days (25~606 days) (P=0.001), and incidence of CVC related septicemia was 5.28/1000 days and 3.08/1000 days, respectively. In the CVC related septicemia, the most common etiologic organism was coagulase negative staphylococcus. Conclusion: We suggest that the exchange of CVC before admission to laminar air flow room could decrease the incidence of CVC related septicemia in HSCT recipients.

      • KCI등재후보
      • KCI등재후보

        병·의원에서 분리한 메티실린 내성 황색포도알균에서 SCCmec 유형과 Aminoglycoside 변형효소 유전자의 분포

        정영희,김광욱,차정옥,이경민,유재일,유정식,김봉수,노영주,윤혜령,이영선 대한감염학회 2008 감염과 화학요법 Vol.40 No.1

        목적 : 대부분의 AME 효소 유전자는 transposon이나 plasmid 상태로 전달되며 staphylococcal chromosomal cassette mec (SCCmec) 내에도 삽입되어 있다. 최근 MRSA의 SCCmec 유형에 따라 다양한 내성유전자를 가지는 것으로 보고되고 있다. 따라서 1, 2차 의료기관에서 분리된 황색포도알균의 항생제 내성률을 조사하고 MRSA에서 SCCmec type에 따른 AME 효소 유전자의 분포를 확인하였다. 재료 및 방법 : 2004년 1, 2차 의료기관에서 분리된 황색포도알균 640주를 대상으로 methicillin의 내성유전자 mecA와 AME 효소 유전자 aac(6')-aph(2"), aph(3')-IIIa, ant(4')-Ia 등을 multiplex PCR 방법을 이용하여 확인하였다. 항생제 감수성 시험과 MIC 값은 한천배지 희석법으로 확인하였고 SCCmec type도 결정하였다. 결과 : 640주의 황색포도알균 중 MRSA을은 39.7%였으며 MRSA 분리주 모두 mecA 유전자가 검출되었다. Aminoglycoside 중 kanamycin, tobramycin에 대한 내성률은 98.1%이었고, gentamicin 68.7%, amikacin 30.8%, netilomicin 2.8%이었으며 vancomycm에는 모두 감수성이었다. Oxacillin MIC_50과 MIC_90은 각각 128 ug/mL, 256 ug/mL이었으며 254주의 MRSA 중 214주를 선별하여 AME 효소 유전자를 확인한 결과 aph(3')-IIIa 13.1%, aad(6')-aph(2") 77.1%, ant(4)-Ia 53.3%이었으며 SCCmec type에 따라서는 type II, type III, type IV가 각각 50.9%, 16.4%, 32.7%였다. SCCmec type에 따른 AME 효소 유전자의 분포는 SCCmec type II에서는 aac(6')-aph(2")와 aac(6')-aph(2")/ant(4')-Ia가 각각 49.5%, 36.7%에서 검출되었고 type III에서는 aph(3')-IIIa/aac(6')-aph(2")가 60%, aac(6')-aph(2")가 31.4%, type IV에서는 aac(6')-aph(2")/ant(4')-Ia와 ant(4')-Ia가 각각 41.4%, 50%로 나타났다. 결론 : 1, 2차 의료기관에서 분리한 황색포도알균 분리주의 메티실린 내성률은 39.7%이었다. MRSA 분리주 중 SCCmec type II와 III에서는 aac(6')-aph(2")가, SCCmec type IV에서는 ant(4')-Ia가 90% 이상 검출되어 SCCmec type과 AME 효소 유전자 분포와는 연관성이 있는 것으로 나타났다. Background : Many genes encoding aminoglycoside modifying enzymes (AMEs) on transposon or plasmid were transferred from one strain to another strain and inserted into a staphylococcal chromosomal cassette mec (SCCmec). There are very diverse subtypes in SCCmec type to the insertion of resistant genes. Therefore, we researched the resistance rates of antibiotics and distribution of AME genes according to SCCmec type in MRSA strains. Materials and Methods : We isolated 640 Staphylococcus aureus from non-tertiary hospitals in 2004, detected mecA, aac(6')-aph(2"), aph(3')-llla, and ant(4')-la using the multiplex PCR method, tested antibacterial susceptibility disk diffusion and minimal inhibitory concentration, and determined SCCmec type. Results : Of 640 S. aureus isolates, MRSA rate was 39.7% and all MRSA isolates carried mecA gene. Among 214 MRSA selected, aminoglycoside-resistant rates were 98.1% in kanamycin and tobramycin, 68.7% in gentamicin, 30.8% in amikacin, and 2.8% in netilmicin. The detection rates for aac(6')-aph(2"), aph(3')-llla, and ant(4')-la were 77.1%, 13.1%, and 53.3%, respectively. Also, SCCmec type was 50.9% in SCCmec type II, 16.4% in type Ill, and 32.7% in type IV. The genes encoding AMEs were distributed aac(6')-aph(2") (49.5%) and aac(6')-aph(2")/ant(4')-la (36.7%) in SCCmec type II, aph(3')-llla/aaac(6')-aph(2") (60%) and aac(6')-aph(2") (31.4%) in type III, and aac(6')-aph(2")/ant(4')-la (41.4%) and ant(4')-la (50%) in type IV. Conclusion : 39.7% of S. aureus isolated from non-tertiary hospitals was resistant to methicillin. More than 90% of MRSA isolates were detected aac(6')-aph(2") in SCCmec type II and Ill, and ant(4')-la in type IV. With these results, the genes encoding AMEs may be closed related to SCCmec type.

      • 국내 상급종합병원과 종합병원 간호사의 정맥주입간호실무지침의 확산정도

        은영(Young Eun),구미옥(Mee Ok Gu),조용애(Young Ae Cho),정재심(Jae Shim Jeong),권정순(Jeong Soon Kwon),유정숙(Cheong Suk Yoo5),정영선(Young Sun Jeong),정인숙(In Sook Jung),김경숙(Kyeong Sug Kim),이선희(Seon Heui Lee),서현주(Hyun Ju S 한국근거기반간호학회 2015 근거와 간호 Vol.3 No.1

        Purpose: This study was conducted to investigate the extent of diffusion of Intravenous infusion nursing practice guideline among nurses in advanced general hospitals and general hospitals in Korea. Methods: The subjects were 234 nurses who practice the intravenous infusion in 24 advanced general hospitals and general hospitals. Data were collected between October 5 and November 2, 2015 by mail (return rates: 97.5 %). Data were analyzed using descriptive statistics, t-test, and ANOVA with SPSS/ WIN 21. Results: The average guideline diffusion score and levels of diffusion was 3.39±0.58 (level of “use sometimes”). 44 recommendations (46%) were in level of “use always” and 50 recommendations (53%) were in “use sometimes”. Extent of diffusion were significantly different according to present status (F=2.81, p=.040) and education (F=4.35, p=.014). The facilitating factors to use the guideline were education by department of nursing service, convenient composition of guideline and barrier factors were “no time to use the guideline”, “don’t know the guideline” and “there is no guideline at ward”. Conclusion: Extent of diffusion of Intravenous infusion nursing practice guideline among nurses was moderate level. The strategies for promoting the implementation of guideline in clinical practice is needed. Further study of outcome evaluation of guideline implementation will be needed.

      • KCI등재후보

        하시모트 갑상선염과 동반된 갑상선 MALT 림프종(MALToma) 1 예

        김영선,이태영,한찬희,유명희,김철희,변동원,진소영,남일송,류은상,홍기영,윤석기,서교일 대한내과학회 2001 대한내과학회지 Vol.61 No.3

        Primary thyroid lymphomas constitute of up to 5% of all thyroid malignancies. Recently, mucosa-associated lymphoid tissue (MALT) lymphoma are relatively recognized as a B cell subset of non-Hodgkin's lymphoma. MALT-lymphomas are thought to develop from acquired lymphocytic tissue during the course of a chronic inflammatory or autoimmune process. In the thyroid , which is normally devoid of lymphocytic tissue, chronic autoimmune thyroiditis (Hashimoto's disease) has been associated with an increased risk of lymphoma, including MALT type. The clinical presentations include the enlarging of the neck mass, dysphagia, hoarsenes and choking or cold thyroid nodule. We report a case of MALToma of the thyroid accompanied by Hashimoto's thyroiditis with a review of the literature.(Korean J Med 61:281-285, 2001)

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