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내시경역행담췌관조영술에서 조영제 주입 전 담즙 흡인의 임상적 효과
최정식 ( Jung Sik Choi ),강대환 ( Dae Hwan Kang ),김현대 ( Hyun Dae Kim ),엄상화 ( Sang Hwa Urm ),이상헌 ( Sang Heun Lee ),김지현 ( Ji Hyun Kim ),지삼룡 ( Sam Ryong Jae ),정은욱 ( Eun Uk Jung ),박성재 ( Sung Jae Park ),이연재 ( Yo 대한소화기학회 2012 대한소화기학회지 Vol.60 No.6
목적: 내시경역행담췌관조영술 후 담관염, 간기능의 악화, 담낭염, 췌장염 등의 합병증을 경험하게 된다. 이를 예방하기 위한 방법으로 조영제 주입 전 담즙을 일부 흡인함으로써 폐쇄 담관의 감압을 통한 이들 합병증의 빈도가 감소하는지를 알아보기 위하여 이번 연구를 시행하였다. 대상 및 방법: 2008년 12월 1일부터 2010년 6월 30일까지 3차 의료기관에서 내시경역행담췌관조영술을 시행한 988명의 환자 중 담관 조영술 전에 일정량의 담즙 흡인 후 조영제를 주입한 환자 102명과 통상적인 방법인 담즙 흡인 없이 조영제를 주입하여 담관 조영술을 시행한 대조군 115명을 대상으로 하여 시술 후 담관염, 간기능의 악화, 담낭염, 췌장염 등을 전향적으로 비교하였다. 결과: 조영제 주입전 담즙 흡입을 먼저 시행한 102명 중 담관염은 3명(2.9%), 시술 후 간기능 악화 4명(3.9%), 담낭염과 췌장염은 1명도 발생하지 않았다. 시술 후 복통 없이 혈청 아밀라제 증가만 보인 경우가 6명(5.8%)이었다. 대조군 115명 중에서 담관염은 1명(0.4%), 시술 후 간기능 악화소견을 보인 환자는 9명(7.8%), 췌장염은 3명(2.6%), 시술 후 복통 없이 혈청 아밀라제 증가만 보인 경우가 10명(8.6%)이었으며, 담낭염은 1명도 발생하지 않았다. 조영제 주입 전 담즙 흡입군과 대조군에서 시술 후 합병증의 유의한 차이를 보이지 않았다 (p>0.05). 결론: 담관 폐쇄 환자에서 내시경역행담췌관조영술을 시행할때 선택적 담관 삽관 후 일정량의 담즙을 흡인한 후에 조영제를 주입하여 담관조영술을 하는 경우에 시술 후 합병증 예방에 미치는 영향은 미미하였다. Background/Aims: This study was designed to determine whether bile aspiration before contrast injection cholangiogram prevent of post-ERCP cholangitis, liver function worsening, cholecystitis and pancreatitis. Methods: One hundred and two patients in the bile aspiration group before contrast injection from December 1, 2008 to December 30, 2009 and 115 patients in the conventional control group from January 1, 2010 to June 30, 2010 were analyzed. The incidence of post-ERCP cholangitis, liver function worsening, cholecystitis, pancreatitis, and hyperamylasemia only were compared between these two groups. Results: In the 102 patients with the bile aspiration group, post-ERCP cholangitis in 3 patients (2.9%), liver function worsening in 4 patients (3.9%), cholecystitis and pancreatitis in none, and hyperamylasemia only in 6 patients (5.8%) occurred. In the 115 patients with control group, post-ERCP cholangitis in 1 patient (0.4%), liver function worsening in 9 patients (7.8%), cholecystitis in none, pancreatitis in 3 patients (2.6%), hyperamylasemia only in 10 patients (8.6%) developed, The two groups did not significantly differ in terms of the incidence of post-ERCP cholangitis, liver function worsening, pancreatitis, and hyperamylasemia only (p>0.05). Conclusions: Initially bile juice aspiration just before contrast injection into the bile duct rarely prevented post-ERCP cholangitis, liver function worsening, and pancreatitis in patients with the extrahepatic bile duct obstruction.
Glutamate가 유도하는 세포독성으로부터 신경세포를 보호하는 상백피 추출물의 효과
김현정(Hyun-Jung Kim),김지현(Ji-Hyun Kim),손은순(Eun-Soon Son),이정민(Jeung-Min Lee),박해룡(Hae-Ryong Park) 한국생명과학회 2009 생명과학회지 Vol.19 No.7
본 연구에서는 glutamate로 유도된 세포독성으로부터 신경세포를 보호하는 상백피(Morus alba) 추출물의 활성을 확인하기 위하여 N18-RE-105 세포주를 이용하여 MTT reduction assay, LDH release assay 및 광학 현미경을 이용하여 형태학적인 변화를 관찰하였다. 그 결과, 상백피 methanol 추출물에서 농도 의존적으로 신경세포 보호효과가 나타났으며, 50 ㎍/㎖ 농도에서는 80% 이상의 세포생존율을 확인할 수 있었다. 이 결과는 N18-RE-105 세포주의 LDH release assay와 형태학적 변화에서도 일치하는 결과를 확인하였다. 가장 높은 활성을 보인 상백피 methanol 추출물을 hexane, diethyl ether, ethyl acetate, water 층으로 분획하여 각 각 1, 5, 10 ㎍/㎖ 농도로 처리 시 hexane 층에서 48.0%, 65.6%, 71.5%로 가장 높은 신경세포 보호효과를 확인할 수 있었다. 따라서 상백피 추출물은 glutamate에 의한 세포독성으로부터 신경세포 손상을 억제하며 신경세포를 보호하는 효과가 있다는 것을 알 수 있었다. This study evaluated the neuroprotective effect of extracts from the root bark of Morus alba (MA) against glutamate-induced cytotoxicity in neuronal cells. Glutamate-induced cytotoxicity was shown by MTT reduction assay. The neuroprotective effects of methanol, ethanol, and acetone extracts from MA against glutamate-induced cytotoxicity were measured. Among the three extracts, the methanolic extracts showed the highest protective effect, as determined by the results of an morphological assay, a lactate dehydrogenase release assay. Furthermore, the methanol extracts were fractionated sequentially with hexane, diethyl ether, ethyl acetate, and water layer according to degree of polarity. The hexane fractions exhibited a neuroprotective effect against glutamate-stressed N18-RE-105 cells. Therefore, these results suggest that extracts of MA could be a new potential candidate as a protective substance against glutamate-induced cytotoxicity.
침습선암의 조직소견이 동반된 혼합형 증식성 선종성 직장용종 1예
서효림 ( Hyo Rim Seo ),김지현 ( Ji Hyun Kim ),정수진 ( Soo Jin Jung ),최윤정 ( Yun Jung Choi ),류충헌 ( Choong Heon Ryu ),박관식 ( Kwan Sik Park ),하승인 ( Seoung In Ha ),정은욱 ( Eun Uk Jung ),이상헌 ( Sang Heon Lee ),박성재 ( Su 대한장연구학회 2012 Intestinal Research Vol.10 No.3
Epithelial colon polyps are largely divided into hyperplastic and adenomatous polyps. Adenomatous polyps are premalignant lesions, whereas hyperplastic polyps are regarded as benign lesions. However, this histological classification has been blurred, as cases of malignant changes in hyperplastic polyposis, mixed hyperplastic adenomatous polyps (MHAPs), and serrated adenomas in the colon have been reported. Rare cases of MHAP have been reported, and are mainly found at the proximal colon with a relatively large size. MHAPs seem to be an intermediate stage of the hyperplastic polyp-adenoma sequence or a collision tumor. Here, we report on a case of a single polyp in the rectum diagnosed with a MHAP combined with an invasive adenocarcinoma. (Intest Res 2012;10:295-299)
진료를 받는 고혈압 환자의 혈압 조절과 관련된 의사 요인
김소영,조인숙,이재호,김지현,이은정,박종혁,이진석,김윤,Kim, So-Young,Cho, In-Sook,Lee, Jae-Ho,Kim, Ji-Hyun,Lee, Eun-Jung,Park, Jong-Hyock,Lee, Jin-Seok,Kim, Yoon 대한예방의학회 2007 예방의학회지 Vol.40 No.6
Objectives : Little is known about the physician-related factors that are associated with the management of Hypertension. The purpose of this study was to determine the physician-related factors associated with blood pressure control in hypertensive patients. Methods : We surveyed 154 physicians at 117 public health (subhealth) centers in Gyeonggi-do, Forty-one physicians completed the survey (response rates : 26.6%) and 31 physicians were finally included as the study subjects. Using the information obtained from the self-reported survey, we measured the physician-related factors associated with hypertension control, including their perception of hypertension, prescription patterns (combination prescription rates, specific antihypertensives prescription rates among patients with diabetes mellitus), and sociodemographic factors. We then collected data on blood pressure and medication use in patients seen by these physicians from the health center#s information system. We compared the physicians# perceived hypertension control rates with the actual rates, and then evaluated the rate of high overestimation (overestimation by more than 25% of the median degree of hypertension control rate overestimation) among the physicians. The physicians# antihypertensive prescription patterns were also evaluated. Multiple logistic regression analysis was used to evaluate the independent association between hypertension control and physician-related factors. Results : The physicians tended to overestimate the proportion of their patients with controlled blood pressure (79.5% perceived vs. 57.8% actual). The percentage of physicians with high overestimation was 35.5% (11 physicians). The physicians with lower control rates were more likely to highly overestimate their patients# control rates. Physicians with below-median actual control rates tended to prescribe fewer combination treatments for patients with uncontrolled blood pressure and angiotensin-converting enzyme inhibitors or fewer angiotensin receptor blockers for patients with diabetes mellitus. The rate of high overestimation by physicians was 1.31 times higher in patients with uncontrolled blood pressure than in patients with other conditions (OR=1.31, 95% CI : 1.17-1.48). Conclusions : Physicians have a tendency to overestimate the rates of hypertension control in their patients. Because physicians have a direct role in treatment outcomes, physicians# overestimation about hypertension management contributes to inadequate blood pressure control. Thus, interventions for improving physician# awareness regarding the management of patients with hypertension are needed.
Mayer-Rokitansky-Kuster-Hauser syndrome 환자에서 발병된 난소암
김성주 ( Sung Joo Kim ),김지현 ( Ji Hyun KIM ),박영한 ( Young Han Park ),강정배 ( Jung Bae Kang ),임채춘 ( Chae Chun Rhim ),전영은 ( Young Eun Jeon ),고아라 ( A Ra Ko ),박수예 ( Sue Ye Park ) 대한산부인과학회 2012 Obstetrics & Gynecology Science Vol.55 No.12
Vaginal aplasia is an unusual congenital anomaly of the genital tract with an incidence of 1 in 4,000 female births. The vast majority of the cases are part of Mayer-Rokitansky-Kuster-Hauser syndrome (MRKHs). In this syndrome, while the vagina is absent and the uterus is missing or extremely rudimentary, the ovarian function is normal and the secondary sexual characteristics are normally developed. The aim of the study is to present a case of ovarian cancer that developed on the ovary of a woman with MRKH syndrome.
극지유래 저온활성 Chitinase 생산균주의 스크리닝과 Chitinase 유전자 클로닝
박유경,김정은,이형석,김지현,박하주,김덕규,박미라,임정한,김일찬,Park, Yu Kyung,Kim, Jung Eun,Lee, Hyoungseok,Kim, Ji Hyun,Park, Ha Ju,Kim, Dockyu,Park, Mira,Yim, Joung Han,Kim, Il-Chan 한국미생물학회 2012 미생물학회지 Vol.48 No.4
극지의 다양한 환경으로부터 분리되어 극지연구소 PAMC(Polar and Alpine Microbial Collection)에 보관중인 169개 균주들을 0.4% colloidal chitin이 첨가된 ZoBell 고체배지에서 배양하여 chitinase 활성을 균주 27개를 선별하였다. 그 중 PAMC 21693 균주는 저온에서 pNP-$(GlcNAc)_1$를 기질로 사용했을 때 가장 큰 활성을 보였고, $4-37^{\circ}C$의 온도 범위 중 $4^{\circ}C$에서 가장 높은 개체수 증가율을 보였다. PAMC 21693의 chitinase 유전자를 클로닝한 결과 2,619 bp의 ORF를 포함하는 총 2,857 bp의 염기서열을 확보하였다. 대장균에서 chitinase 유전자의 재조합 단백질을 발현한 결과 분자량 96 kDa의 재조합 단백질을 확인할 수 있었다. 본 논문에서는 극지 미생물 유래 저온활성 chitinase들의 생물공학 분야에서의 이용가능성을 제시하였다. Of the 169 strains of microorganisms stored in Polar and Alpine Microbial Collection of Korea Polar Research Institute, 27 strains were selected for their chitinase activity on ZoBell plates supplemented with 0.4% colloidal chitin. Among them, PAMC 21693 strain have shown the highest chitinolytic enzyme activity toward pNP-$(GlcNAc)_1$ at low temperature and the highest growth rate at $4^{\circ}C$. We cloned a full-length chitinase gene of 2,857 bp which contains an open reading frame of 2,169 bp encoding 872-amino acid polypeptide. Recombinant chitinase protein was expressed in E. coli and its molecular weight was confirmed 96 kDa. In this paper, we suggest the potential use of cold-active chitinase from polar microorganisms in the field of biotechnology.
한국인 헬리코박터 파일로리 감염 치료 근거 기반 임상 진료 지침 개정안 2020
정혜경 ( Hye-kyung Jung ),강승주 ( Seung Joo Kang ),이용찬 ( Yong Chan Lee ),양효준 ( Hyo-joon Yang ),박선영 ( Seon-young Park ),신철민 ( Cheol Min Shin ),김성은 ( Sung Eun Kim ),임현철 ( Hyun Chul Lim ),김지현 ( Jie-hyun Kim ) 대한내과학회 2021 대한내과학회지 Vol.96 No.3
Helicobacter pylori (H. pylori) infection is one of the most common infectious diseases worldwide. Although its incidence is gradually decreasing, about half of the world's population still get infected. H. pylori infection is responsible for substantial gastrointestinal morbidity worldwide. It is the most common cause of gastric and duodenal ulcers as well as gastric cancer. Since the revision of the H. pylori Clinical Practice Guidelines in 2013, the eradication rate of H. pylori has gradually decreased with the use of classical triple therapy, wherein amoxicillin, clarithromycin, and proton pump inhibitors are administered, for 7 days. According to a nationwide randomized controlled study conducted by the Korean College of Helicobacter and Upper Gastrointestinal Research released in 2018, the intention-to-treat eradication rate was only 63.9%, which was due to increased antimicrobial resistance induced by the use of antibiotics, especially clarithromycin. The update of clinical practice guideline for treatment of H. pylori was developed based on evidence-based medicine by conducting a meta-analysis. The draft recommendations were finalized after expert consensus on three recommendations regarding the indication for treatment and eight recommendations on the treatment itself. These guidelines are designed to provide patients, nurses, medical school students, policymakers, and clinicians with clinical evidence to guide primary care and treatment of H. pylori infection. These may differ from current medical insurance standards and will be revised further, if necessary, based on research-based evidence. (Korean J Med 2021;96:160-189)