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조영일 ( Young Il Jo ),윤선웅 ( Seon Ung Yun ),최혜진 ( Hae Jin Choi ),김소영 ( So Young Kim ),최혜진 ( Hye Jin Choi ),박현식 ( Hyun Sik Park ),배병주 ( Byeong Ju Bae ),기현균 ( Hyun Kyun Ki ) 대한신장학회 2010 Kidney Research and Clinical Practice Vol.29 No.6
Purpose: Arteriovenous vascular access infection associated with S. aureus bacteremia may cause metastatic complications, which relate to a poor outcome especially if proper diagnosis and treatment are delayed. We report a case of a 61-year-old male patient on maintenance hemodialysis who developed multiple metastatic infections associated with arteriovenous graft infection caused by methicillin-resistant Staphylococcus aureus (MRSA). At 7th hospital day, multiple metastatic infections, including osteomyelitis of clavicle, vertebral osteomyelitis, and tendinitis of the 5th finger proximal interphalangeal joint, were diagnosed by CT of chest, ultrasonography of hands, and whole body bone scan. Infected arteriovenous graft was removed and antibiotics was administrated for 18 weeks. Thereafter, MRSA bacteremia and clinical symptoms and signs related to metastatic infections were improved.
오유진 ( O Yu Jin ),이대남 ( Lee Dae Nam ),경영수 ( Gyeong Yeong Su ),윤선웅 ( Yun Seon Ung ),최중섭 ( Choe Jung Seob ),김계현 ( Kim Gye Hyeon ),이교원 ( Lee Gyo Won ),한종설 ( Han Jong Seol ),김성도 ( Kim Seong Do ) 대한산부인과학회 2003 Obstetrics & Gynecology Science Vol.46 No.12
The incidence of rectal endometriosis is relatively rare. We have experienced one case of rectal endometriosis. Endometriosis is defined as abnormal growth of endometrial tissue outside the uterus and it occurs in approximately 5 to 15% of women. Endometr
투석전 만성신부전 환자에서 Epoetin-α와 Darbepoetin-α의 2주 1회 요법의 조혈효과 비교
김소영 ( So Young Kim ),최혜진 ( Hae Jin Choi ),최혜진 ( Hye Jin Choi ),이초이 ( Cho Ee Lee ),윤선웅 ( Seon Ung Yun ),박정환 ( Jung Hwan Park ),이종호 ( Jong Ho Lee ),송종오 ( Jong Oh Song ),조영일 ( Young Il Jo ) 대한신장학회 2010 Kidney Research and Clinical Practice Vol.29 No.5
Purpose: It is very important to correct renal anemia by erythropoiesis stimulating agents (ESA) be-cause anemia is associated with poor outcomes in chronic kidney disease (CKD) patients. We investigated whether once-biweekly (Q2W) treatment with epoetin- (EPO-) is as effective as Q2W darbe-poetin- (DA-α) in CKD patients who are not on dialysis. Methods: Fifteen CKD patients not receiving dialysis with renal anemia (M:F 6:9, age 60.1±7.2 years, eGFR-MDRD 15.7±6.4 mL/min/1.73m2, DM 46.7%) were enrolled. All patients received Q2W subcutaneous DA-α(40μg) for 10 weeks. After 6 weeks of wash-out period, patients were switched to Q2W subcutaneous EPO- (10,000 IU) for 10 weeks. Results: There were no significant differences in baseline parameters, such as hemoglobin (Hb), serum ferritin, and transferrin saturation, between before DA- therapy and before EPO-α therapy. Hb levels significantly increased after completion of ESA therapy (DA-α, 9.8±0.4 vs. 10.4±0.6 g/dL, p=0.001; EPO-α, 9.6±0.7 vs. 10.2±0.4 g/dL, p=0.003). After completion of ESA therapy, Hb levels did not reveal significant differences between two groups (p=0.123). Erythropoietin resistance index (8.2±1.6 vs. 8.4±1.5 IU/kg weight/g hemoglobin/week, p=0.136) and % increase of Hb (106.7±5.5 vs. 106.8±6.4%, p= 0.776) were not significantly different between DA-α therapy and EPO-α therapy. There were no signi-ficant adverse effects observed during study periods. Conclusion: These findings indicate that Q2W high dose (10,000 IU) of EPO-α therapy in CKD patients who are not on dialysis may be effective in maintaining Hb levels as Q2W DA-α therapy.
중등증의 혈우병 B 보인자 환자에서의 반복 제왕절개술 시행
이대남 ( Lee Dae Nam ),오유진 ( O Yu Jin ),경영수 ( Gyeong Yeong Su ),이다연 ( Lee Da Yeon ),윤선웅 ( Yun Seon Ung ),최중섭 ( Choe Jung Seob ),김계현 ( Kim Gye Hyeon ),이교원 ( Lee Gyo Won ),김성도 ( Kim Seong Do ),한종설 ( Han Jo 대한산부인과학회 2003 Obstetrics & Gynecology Science Vol.46 No.11
Hemophilia is a hemorrhagic disease caused by the defect or abnormal activities of the coagulation factor. The proper dosage and interval of factor replacement therapy are not defined. So the dosage and interval can be different in each case. We have expe
복막투석 중인 말기신부전 환자에서 지속적인 midazolam 정주에 의한 진정 상태의 지연 회복
조영일 ( Young Il Jo ),최혜진 ( Hye Jin Choi ),김소영 ( So Young Kim ),최혜진 ( Hae Jin Choi ),박현식 ( Hyun Sik Park ),윤선웅 ( Seon Ung Yun ),배병주 ( Byeong Joo Bae ),박정환 ( Jung Hwan Park ),이종호 ( Jong Ho Lee ) 대한신장학회 2010 Kidney Research and Clinical Practice Vol.29 No.6
Purpose: Midazolam, a benzodiazepine derivatives, is widely used in intensive care unit for sedation of patients who require mechanical ventilation. Although midazolam has a short acting time, it might cause a prolonged sedation, especially in patients with renal failure. We report the case of a 76-year-old man who received peritoneal dialysis and showed prolonged sedation after stopping continuous infusion of midazolam. The patient who has received maintenance hemodialysis for five months admitted in intensive care unit to manage pneumonia and severe congestive heart failure. In ICU, hemodialysis was transferred to peritoneal dialysis due to severe cardiac dysfunction. He was treated with mechanical ventilation under sedation with midazolam. However, even though stopping midazolam, deep sedation by midazolam was not restored. The patient completely recovered from sedation after 280 hours.
요실금 환자에서 체외 자기장 신경치료 전후의 요실금 증상과 성기능 개선에 대한 전향적 연구
이정훈 ( Lee Jeong Hun ),김형문 ( Kim Hyeong Mun ),신인환 ( Sin In Hwan ),김진경 ( Kim Jin Gyeong ),김계현 ( Kim Gye Hyeon ),윤선웅 ( Yun Seon Ung ),최중섭 ( Choe Jung Seob ),이교원 ( Lee Gyo Won ),김성도 ( Kim Seong Do ),한종설 ( 대한산부인과학회 2004 Obstetrics & Gynecology Science Vol.47 No.2
목적 : 염색체 이상의 대다수 (95%)를 차지하는 다운증후군은 정신박약, 선천성 심질환 및 위장관 질환등의 심각한 문제를 초래한다. 기존의 산전 진단법인 양수천자 (amniocentesis), 융모막 채취 (chorionic villus sampling) 및 태아 제대 천자 (cordocentesis) 등의 방법은 세포 배양 등의 장시간이 소요와 고가의 비용이 요구되어 이를 대체할 만한 다른 방법들에 대한 필요성이 대두하게 되었다. 본 연구는 실시간 정량 PCR (real-time quantitative PCR) 기법을 이용하여 다운증후군 등의 혈액과 양수를 분석함으로서 이 질환의 산전 진단 기법의 개발과 이의 임상적 유용성을 보기 위해서 본 연구를 시행하였다. 연구 방법 : 2001년 11월부터 2002년 10월까지 연세대학교 세브란스병원 산부인과 외래를 방문한 임신부중 유전학 검사 및 유전 상담의 적응증이 되는 임심 8주에서 41주 사이의 임신부와 다운증후군 환아를 대상으로 하여 양수와 혈액의 D21S167과 S100B 유전자를 이용하여 실시간 정량 PCR분석을 통하여 정상과 다운증후군의 차이를 비교하였다. 결과 : 다운증후군 환아의 혈액에서는 정상에 비해 D21S167과 S100B 유전자의 상대 정량치가 각각 2.6배와 2.4배로 높게 나타났고, P-values는 0.0012와 0.0016으로 통계학적으로 의미가 있었으며, 다운증후군 태아를 가진 산모의 양수에서는 D21S167과 S100B 유전자의 상대 정량치가 정상에 비해 각각 2.1배, 2.7배이며 (P-value=0.0397) 통계학적으로 유의하게 높게 나타났다. 결론 : 실시간 정량적 PCR 기법을 통한 다운증후군의 산전 유전 진단법은 빠르고 정확한 혁신적 방법으로서 임상적으로 유용하며, trisomy 13, trisomy 18 등의 이수 배수성 염색체 질환의 산전 진단에도 응용될 수 있을 것이다. 더 나아가, 임신부 혈액을 이용한 비침습적 태아 염색체 진단에도 기여할 것으로 사료된다. Objective : Trisomy 21 (Down syndrome) is the most common chromosomal anomaly which occurs 1 out of 700-1000 birth. Current techniques such as amniocentesis, chorionic villi sampling (CVS), require lengthy laboratory culture procedures and high costs. This study was undertaken to establish a rapid prenatal diagnosis of trisomy 21 using real-time quantitative polymerase chain reaction of fetal DNA from amniotic fluid. Methods : Real-time quantitative PCR was performed with DNA template obatined from 14 normal serum, 10 normal anniotic fluid samples, 14 Down syndrome serum, and 7 Down syndrome amniotic fluid samples. Primers for D21S167 and S100B of chromosome 21 were used. Primers that direct amplification of 165-bp fragment of the IGFI (Insulin-like growth factor-1) gene on chromosome 12 are included to generate an internal standard for quantitation. Results : The relative levels of D21S167 and S100B were 2.6 and 2.4 times higher in the serum of Down syndrome patients compared to the control group. The difference between these two groups was statistically significant (P-value: 0.0012 and 0.0016). The relative levels of D21S167 and S100B were 2.1 and 2.7 times higher in the annoiotic fluid of Down syndrome fetuses compared to control group. The difference between these two groups was statistically significant (P-value 0.0379 respectively). Conclusion : Prenatal diagnosis of trisomy 21 by real-time quantitative PCR-associated STR (small tandem repeats) analysis of D21S167 and S100B is useful, accurate and rapid diagnostic method and also can be employed in diagnosis of trisomy 13, 18. Furthermore, it may also be useful for prenatal diagnosis with fetal DNA from maternal blood and for preimplantation genetic diagnosis.