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지속성 외래 복막투석 환자에서 발생한 반코마이신 내성 장구균 복막염에 대한 리네졸리드 (Linezolid)치료 경험
유동은 ( Dong Eun Yoo ),김민경 ( Min Kyeung Kim ),허애정 ( Ae Jung Huh ),김영아 ( Young Ah Kim ),강이화 ( Ea Wha Kang ),유태현 ( Tae Hyun Yoo ),신석균 ( Sug Kyun Shin ) 대한신장학회 2007 Kidney Research and Clinical Practice Vol.26 No.2
Peritonitis is one of the major complications of CAPD (continuous ambulatory peritoneal dialysis). Among its causative organisms, vancomycin-resistant enterococcus (VRE) is rare, but serious causative organism, because it is refractory to antibiotics commonly used for CAPD peritonitis. Some drugs such as linezolid and dalfopristin have been introduced for VRE infections nowadays, but reports about usefulness of those drugs in VRE peritonitis are rare. We experienced a case of CAPD peritonitis caused by VRE, which was treated successfully with removal of CAPD catheter and use of linezolid. We report our experience with review of the literature.
유동미,한재진,어은경,Yoo, Dong-Mi,Han, Jae-Jin,Eo, Eun-Kyung 연세대학교 의과대학 2014 의학교육논단 Vol.16 No.1
The purposes of this study were to identify and analyze students' attitudes and satisfaction to the portfolio process and assessment for the Introduction to Clinical Medicine course at Ewha Womans University School of Medicine in Seoul, Korea. The subjects consisted of 64 medical school students. Questionnaires consisting of 20 5-point Likert-type items were developed, including three question domains: 1) orientation, 2) portfolios in general, 3) individualized feedback. The mean and median were found and frequency analysis was performed to identify the common characteristics of the participants. A major finding was that 54.7% of the respondents felt that the self-reflection involved in building the portfolio was a valuable learning experience. Plus, the majority of respondents perceived that the individualized feedback had a positive tone and its contents were specific, practical, and constructive. The students perceived that building and writing portfolios heightened their understanding of exit learning outcomes and enhanced their reflective thinking and self-directed learning skills. Meanwhile, some students perceived that there was too much paperwork in the portfolio process and that the process was time consuming. Furthermore, 32.8% of the respondents said that they had difficulty establishing their learning strategies by themselves and self-directing their learning during the portfolio process. In conclusion, it is expected that building a portfolio can help students not only to enhance their ability to accumulate and use their personal learning resources but also to develop the professional qualities required by doctors, such as self-directed learning, self-reflection, lifelong learning, team work, organizational skills, time management and prioritization, and professional thinking and behavior.
성인 미세변화 질환 환자에서 치료 반응에 따른 병리학적 소견 및 신조직 내 유전자 발현의 차이
박선영 ( Sun Young Park ),한승혁 ( Seung Hyeok Han ),김승준 ( Seung Jun Kim ),유동은 ( Dong Eun Yoo ),오형중 ( Hyung Jung Oh ),이한성 ( Han Sung Lee ),이태희 ( Tae Hee Lee ),문성진 ( Sung Jin Moon ),최훈영 ( Hoon Young Choi ),한 대한신장학회 2007 Kidney Research and Clinical Practice Vol.26 No.1
목적: 성인 미세변화 질환 (minimal change disease, MCD) 환자의 경우 소아에 비하여 약물 치료에 대한 반응이 늦게 나타나는 경향이 있다. 스테로이드 반응성과 관련된 임상 및 검사실 소견에 대한 보고는 종종 있었으나, 스테로이드 반응성과 신조직 내 유전자 발현 사이의 연관성에 대한 연구는 전무한 실정이다. 이에 저자들은 성인 MCD 환자를 대상으로 스테로이드 치료 반응에 따른 병리학적 소견과 신조직내 네프린 및 Glucocorticoid receptor (GCR) 유전자의 발현 차이를 알아보고자 하였다. 방법: 2000년 1월 1일부터 2005년 12월 31일까지 본원에서 신장 조직검사상 MCD로 확진된 성인 신증후군 환자를 대상으로, 스테로이드 치료 반응에 따른 병리학적 소견 및 신조직 내 네프린과 GCR mRNA의 발현을 비교 분석하였다. 대상 환자는 스테로이드 반응에 따라 치료 4주 이내에 Complete remission (CR) 상태에 도달한 경우에 early responder (ER), 4주 이후에 CR이 동반된 경우에는 late responder (LR)로 분류하였다. 결과: 대상 환자는 총 28명으로, ER군이 20명, LR군이 8명이었다. CR까지의 기간은 ER군에서 LR군에 비하여 의의있게 짧았다 (16.5±0.9일 vs. 52.0±4.9일, p<0.005). 신조직검사 소견상 메산지움 내 미약한 IgM 침착이 동반되었던 환자는 LR군에서 ER군에 비하여 유의하게 많았으며 (75.0% vs. 30.0%, p<0.05), 스테로이드 치료 기간별 완전 관해율도 IgM 침착이 동반되었던 환자에서 의의있게 낮았다 (p<0.05). 신조직 내 네프린과 GCR의 mRNA 발현을 실시간-중합효소 연쇄반응 (real time-PCR)을 이용하여 분석한 결과, 네프린 mRNA의 발현은 양 군 사이에 의미있는 차이가 없었으나, GCR mRNA의 발현은 ER군에 비하여 LR군에서 유의하게 감소되어 있었다 (p<0.005). 결론: 성인 MCD 환자에서 사구체 내 IgM 침착 유무와 신조직 내 GCR mRNA의 발현 정도가 스테로이드 반응성 예측에 도움이 될 수 있을 것으로 생각된다. Purpose: Compared to children, adult MCD patients tend to have a slower response to steroids, however, little is known about the relationships between pathologic findings or the expression of certain gene and the response to steroid treatment in adult-onset MCD. This study was undertaken to investigate the differences in pathologic findings and the mRNA expression of nephrin and glucocorticoid receptor (GCR) in renal tissue according to steroid responsiveness in adult-onset MCD. Methods: Twenty-eight adult patients who presented with idiopathic nephrotic syndrome at our institution and fulfilled the criteria for MCD clinically and pathologically were chosen for this study. Based on the response to steroid treatment, patients were divided into two groups: early responders (ER) in whom CR was achieved within 4 weeks of steroid treatment; late responders (LR) in whom CR was achieved after 4 weeks of steroid treatment. Results: Of the 28 patients, ER consisted of 20 patients. Time to CR was significantly shorter in ER compared to LR (16.5±0.9 vs. 52.0±4.9 days, p<0.01). The proportion of patients with minimal IgM deposition on immunofluorescence was significantly higher in LR compared to ER (75.0% vs. 30.0%, p<0.01). On the other hands, the mRNA expression of GCR, assessed by real time-PCR, was significantly lower in LR than that in ER (p<0.005), whereas nephrin mRNA expression was not different between the two groups. Conclusion: The presence of glomerular IgM deposition and the amount of GCR in renal tissue may be useful predictors of steroid responsiveness in adult MCD patients.
투석을 시행 받고 있는 말기 신부전증 환자에서 위장관 출혈의 위험인자
오형중 ( Hyung Jung Oh ),김승준 ( Seung Jun Kim ),박선영 ( Sun Young Park ),유동은 ( Dong Eun Yoo ),이한성 ( Han Sung Lee ),구남수 ( Nam Su Ku ),문지애 ( Ji Ae Moon ),김동기 ( Dong Ki Kim ),이태희 ( Tae Hee Lee ),문성진 ( Sung Jin 대한내과학회 2007 대한내과학회지 Vol.72 No.6
목적: 말기 신부전증 환자에서 전체 사망 중 3~7%는 상부 위장관 출혈과 연관되어 있는 것으로 알려져 있다. 그러나 말기 신부전증 환자에서 위장관 출혈이 호발하는 이유 및 위험인자에 대한 국외 종종 있었으나 이에 대한 국내 보고는 전무한 실정이다. 이에 저자들은 투석을 시행 받고 있는 말기 신부전증 환자에서 위장관 출혈의 임상상 및 위험인자를 알아보고자 하였다. 방법: 2000년 1월부터 2005년 12월까지 연세대학교 의과대학 부속 세브란스 병원에서 위장관 출혈이 발생하였던 말기 신부전증 환자 65명(환자군)과 연령, 성별 그리고 투석 방법이 대응되는 위장관 출혈이 없었던 말기 신부전증 환자 65명(대조군)을 대상으로 위장관 출혈의 임상상 및 독립적 위험인자를 분석하였다. 결과: 심부전증(40.0% vs. 21.5%, p<0.05), 관상동맥 질환(32.3% vs. 4.6%, p<0.005) 그리고 비스테로이드성 소염제 복용력(18.4% vs. 1.5%, p<0.01) 모두 위장관 출혈 환자군에서 의미있게 많았다. 반면에 혈청 알부민 농도는 환자군에서 대조군에 비하여 통계학적으로 의의있게 낮았다(2.53±0.67 g/dL vs. 3.56±0.63 g/dL, p<0.005). 다변량 분석상 관상동맥 질환, 비스테로이드성 소염제, 그리고 혈 알부민 수치가 위장관 출혈의 독립적 위험인자로 나타났으며, odds ratio는 각각 23.0, 12.5, 2.9이었다. 결론: 말기 신부전증 환자에서 관상동맥 질환 동반시 위장관 출혈 발생에 대한 세심한 관찰이 필요하겠으며, 출혈의 예방적 차원에서 비스테로이드성 소염제 사용에 특별한 주의가 필요할 것으로 생각된다. 또한 영양상태의 유지 및 관리도 중요할 것으로 사료된다. Background: Gastrointestinal bleeding (GIB) is not a rare complication in end stage renal disease (ESRD) patients on dialysis and the occurrence of GIB has also been associated with higher morbidity and mortality rates. However, reasons for the high incidence of GIB are not clear. This retrospective study was undertaken not only to analyze the clinical features of GIB but also to elucidate the independent risk factors for GIB in Korean ESRD patients. Methods: One hundred thirty ESRD patients on dialysis at the Severance Hospital of Yonsei University College of Medicine from January 2000 to December 2005 were included in the study. The patients were divided into two groups: 65 patients with GIB (the GIB group) and 65 age-, sex-, and dialysis modality-matched patients without GIB (the C group). Clinical characteristics, medications, and laboratory findings were compared between the two groups. Results: Compared to the C group, congestive heart failure (40.0% vs. 21.5%, p<0.05), coronary arterial occlusive disease (CAOD) (32.3% vs. 4.6%, p<0.005), and nonsteroidal anti-inflammatory drug (NSAID) use (18.4% vs. 1.5%, p<0.01) were significantly more common in the GIB group. The baseline serum albumin levels were significantly lower in the GIB group than in the C group (2.53±0.67 g/dL vs. 3.56±0.63 g/dL, p<0.005). Using logistic regression analysis, CAOD (OR=23.0), NSAID use (OR=12.5), and lower serum albumin levels (OR=2.9) were identified as independent risk factors for GIB (p<0.05). Conclusions: Careful attention must be paid to ESRD patients with CAOD, taking NSAIDs, or with low serum albumin levels in view of GIB. (Korean J Med 72:616 624, 2007)
다중 레이다 시스템의 고속표적 인계 시점 결정기법 연구
박순서(Soon-Seo Park),장대성(Dae-Sung Jang),최한림(Han-Lim Choi),김은희(Eun-Hee Kim),선웅(Woong Sun),이종현(Jong-Hyun Lee),유동길(Dong-Gil Yoo) 한국전자파학회 2016 한국전자파학회논문지 Vol.27 No.3
다층 방어 시스템은 표적의 장거리 조기탐지를 위해 조기 경보 레이다를 활용하고, 정밀 요격 통제를 위해 대공 레이다를 활용하는 방식을 취한다. 그러므로 레이다들 사이에 표적 인계 과정을 필요로 하게 되는데, 추적의 안정화 및 교전통제를 고려하여 적절한 시점에 표적 인계가 이루어져야 한다. 본 논문에서는 다층 레이다 시스템의 운용 특성을 분석하고, 고속표적에 효과적으로 대응하기 위한 추적 성능 예측 기반의 표적 인계 시점 결정기법을 제안하였다. 또한, 탄도탄 방어 시나리오를 포함하는 통합 시뮬레이터 환경에서 제안 기법을 검증하였다. A multiple radar system is comprised of early warning radar for fast detection of a target and air defense radar for precision intercept. For this reason, target take-over process is required between the two radars. The target take-over should be performed at an appropriate time by consideration of stable tracking and effective fire control. In this paper, operation characteristics of multiple radar system are analyzed and target take-over time determination method using estimation of target tracking performance is proposed for high-velocity targets. The proposed method is validated with ballistic target defense scenarios in the developed integrated simulator.
슬러리 코팅 공정으로 제조된 Fe 폼의 기공 특성에 미치는 Fe 및 Fe<sub>2</sub>O<sub>3</sub> 분말의 혼합 비율의 영향
최진호,정은미,박다희,양상선,한유동,윤중열,Choi, Jin Ho,Jeong, Eun-Mi,Park, Dahee,Yang, Sangsun,Hahn, Yoo-Dong,Yun, Jung-Yeul 한국분말야금학회 2014 한국분말재료학회지 (KPMI) Vol.21 No.4
Metal foams have a cellular structure consisting of a solid metal containing a large volume fraction of pores. In particular, open, penetrating pores are necessary for industrial applications such as in high temperature filters and as a support for catalysts. In this study, Fe foam with above 90% porosity and 2 millimeter pore size was successfully fabricated by a slurry coating process and the pore properties were characterized. The Fe and $Fe_2O_3$ powder mixing ratios were controlled to produce Fe foams with different pore size and porosity. First, the slurry was prepared by uniform mixing with powders, distilled water and polyvinyl alcohol(PVA). After slurry coating on the polyurethane(PU) foam, the sample was dried at $80^{\circ}C$. The PVA and PU foams were then removed by heating at $700^{\circ}C$ for 3 hours. The debinded samples were subsequently sintered at $1250^{\circ}C$ with a holding time of 3 hours under hydrogen atmosphere. The three dimensional geometries of the obtained Fe foams with an open cell structure were investigated using X-ray micro CT(computed tomography) as well as the pore morphology, size and phase. The coated amount of slurry on the PU foam were increased with $Fe_2O_3$ mixing powder ratio but the shrinkage and porosity of Fe foams were decreased with $Fe_2O_3$ mixing powder ratio.