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      • KCI등재후보
      • KCI등재

        광범위 베타 락탐계 항생제 분해 효소를 생성하는 폐렴간균에 의한 균혈증이 발생한 환자에서 감영의 위험 인자 및 치료 결과

        강철인,김성한,방지환,김홍빈,박상원,최영주,오명돈,김의종,최강원 대한감염학회 2003 감염과 화학요법 Vol.35 No.2

        목적 : 본 연구는 ESBL을 생성하는 K. pneumoniae에 의한 균혈증 환자에서 감염의 위험 인자 및 치료 결과를 알아보고자 시행하였다. 방법 : 1998년 1월부터 2002년 4월까지 혈액 배양 검사에서 동정된 K. pneumoniae를 대상으로 NCCLS guidelines과 이중 디스크 확산법(double-disk diffusion test)을 이용하여 ESBL 생성 여부를 확인하였다. ESBL 생성 균주에 의한 균혈증 환자 60명(환자군)에 대해 ESBL을 생성하지 않는 균주에 의한 균혈증 환자들(대조군)을 연령, 성별, 균혈증 발생 시점을 고려하여 1:2 또는 1:3으로 배정하였다. 총 159명의 대조군을 선정하였고 후향적인 환자-대조군 연구를 시행하였다. 결과 : 환자군과 대조군 사이에 연령, 성별, APACHE Ⅱ score, 주된 감염 부위의 유의한 차이는 없었다. ESBL을 생성하는 K. pneumoniae에 의한 균혈증이 발생할 독립적인 위험 인자에는 요관 삽입, 균혈증 발생 이전 72시간 동안 침습적인 시술을 받은 경우, 균혈증 발생 이전 30일 동안 투여받은 항생제 개수가 있었다. 초기 항생제 치료 72시간 후의 반응을 평가하였을 때, 완전 반응(complete response)은 대조군에서 더 많았고(13.3% vs. 40.3%, P<0.001), 치료 실패(treatment failure)는 환자군에서 더 많았다(33.3% vs. 11.9%, P<0.001). 7일 사망률은 환자군에서 20% (12/60), 대조군에서 15.6% (25/159)이었고(P=0.451), 30일 사망률은 환자군에서 30% (18/60), 대조군에서 24.5% (39/159)이었다(P=0.410). ESBL 생성 균주에 의한 균혈증이 있는 환자들에서 최종 항생제 치료가 부적절했던 환자들을 제외하고 30일 사망률을 분석하였을 때 효과적인 항생제 치료의 지연은 사망률을 높이지 않았다(11.1% vs. 9.1%, P=1.000). 결론 : ESBL을 생성하는 K. pneumoniae에 의한 균혈증이 있는 환자에서 초기 항균제 치료 72시간 후의 치료 반응률은 낮지만 사망률은 유의하게 증가하지 않았다. 원인균이 동정된 후 최종 치료 항생제의 선정이 적절하다면 초기에 효과적인 항생제 투여의 지연은 사망률을 유의하게 증가시키지는 않았다. Background : This study was conducted to evaluate risk factors for infection and treatment outcome of bloodstream infection due to extended spectrum β-lactamases(ESBL)-producing K. pneumoniae. Methods: ESBL production was evaluated by NCCLS guidelines and/or double-disk synergy test in K. pneumoniae blood isolates stored from January, 1998 to April, 2002. Sixty patients with bloodstream infection due to ESBL-producing K. pneumoniae (case patients) were compared with 159 matched control patients with bloodstream infection of non-ESBL-producing K. pneumoniae. Retrospective case-control study was performed. Results : There were no significant differences in age, sex, APACHE Ⅱ score, and the primary site of infection between the case and control groups. In multivariate analysis, significant independent risk factors associated with bloodstream infection due to ESBL-producing K. pneumoniae were urinary catheterization, invasive procedure within previous 72 hours, and the number of antibiotics administered within previous 30 days. In clinical response at 72 hours after initial antibiotic treatment, complete response rate was higher in the controls (13.3% vs. 40.3%, respectively, P<0.001), however, treatment failure rate was higher in the cases (33.3% vs. 11.9%, respectively, P<0.001). Overall 7-day mortality rates in the cases and the controls were was 20% (12/60) and 15.7% (25/159) (P=0.451), respectively, and overall 30-day mortality rates were 30% (18/60) and 24.5% (39/159), respectively (P=0.410). When the patients with bloodstream infection of ESBL-producing organism were evaluated and the patients who received inadequate definitive antibiotic treatment were excluded, delayed effective antibiotic treatment was found to be not associated with higher mortality. Conclusion : In patients infected with ESBL-producing K. pneumoniae bacteremia, clinical response rate at 72 hours after antimicrobial therapy was lower, but the increase of mortality rate was not significant. Delayed effective antibiotic treatment was not associated with higher mortality, when definitive appropriate antibiotic treatment was prescribed.

      • KCI등재

        열공형과 비열공형 피질하 혈관성 치매에서 위험인자의 차이에 관한 비교 연구

        배희준,정지향,유경호,나덕렬,김상윤,최경규,양동원,손의주,이상도,김재우,박경원,김응규,이재홍,박미영,한일우,함동석,최문성,하충건,최성혜,이애영,이병철,한설희 대한치매학회 2003 Dementia and Neurocognitive Disorders Vol.2 No.2

        Backgrounds and Objectives: Vascular dementia is a group of dementing disoders arising from various stroke syndrome. Among these. subcortical ischemic vascular dementia (SIVD) is regarded as a relatively distinct clinical entity. However, MRI patterns of SIVD are not homogenous. In some patients, lacunes are dominant, and in others, subcortical white matter changes are. This study was designed to compare risk factor profiles between SIVD with and without multiple lacunes. Methods: We divided 47 subjects (22 males, mean age. 68 years) recruited from VADAPET (Multicenter Trial For Evaluation Of The Changes In the PET Images Of Subcortical Vascular Dementia Patient) study into two groups one with more than 5 lacunes in deep gray matter (lacune group) and the other with 5 or less(non-lacune group) Clinical characteristics and laboratory findings of two groups were compared. Results: Nineteen of 47 patients (40%) belonged to the lacune group. The lacune and non-lacune groups d d not differ in the following variables: age, hypertension, diabetes mellitus, hyperlipidemia heart disease, history of stroke or TIA, history of trauma or major surgery, family history of hypertension stroke, or dementia, age at diagnosis of dementia, body mass index, white blood cell count, ESR, CRP, fibrinogen, hemoglobin A1C, total cholesterol. LDL cholesterol creatinine, proteinuria, glucosuria, and microhematuria. However, male sex, smoking alcohol. hemoglobin, and HDL cholesterol were possibly associated more with lacune group SIVD than with non-lacune group (p<0 1) Multivariate analyses revealed that smoking, hemoglobin, and HDL cholesterol were independent predictors of SIVD with multiple lacunes Conclusion: Our study suggests that SIVD with multiple lacunes may be significantly different in smoking habits hemoglobin, and HDL cholesterol from SIVD without multiple lacunes.

      • SCISCIESCOPUS

        Therapeutic effects of Schisandra chinensis on the hyperprolactinemia in rat

        Hong, So-Hye,Li, Mei,Jeung, Eui-Bae,Lee, Geun-Shik,Hong, Eui-Ju,Choi, Young-Whan,An, Beum-Soo Spandidos Publications 2017 International journal of oncology Vol.50 No.4

        <P>Prolactin (PRL) is secreted from the pituitary gland in response to eating, mating, and ovulation. Increased serum concentration of PRL during pregnancy contributes to enlargement of the mammary glands of the breasts and prepares for production of milk. However, high PRL levels derived from prolactinoma and hyperprolactinemia induce physiological disorders such as infertility and early menopause. Natural compounds isolated from S. chinensis have been known to possess anti-oxidative, anti-inflammatory and anti-diabetic effects. In the present study, we examined the therapeutic effect of S. chinensis and its single compounds on hyperprolactinemia in the pituitary gland. In rat pituitary cells, PRL expression levels were examined using real-time PCR and western blot assay. Crude S. chinensis extract and its single compound, gomisin N, reduced mRNA and protein levels of PRL in GH3 cells. In addition, cell proliferation and PRL target gene expression in cells were modulated by S. chinensis. Similar to the in vitro experiments, crude S. chinensis extract and gomisin N reduced PRL levels in the pituitary and serum of immature female rats. These results show that S. chinensis and its single compound, gomisin N, are regulators of PRL production and may be candidates for treatment of hyperprolactinemia and prolactinoma.</P>

      • SCISCIESCOPUS

        Effects of calcitonin and parathyroid hormone on the regulation of cabindin-D<sub>9k</sub> in the uterus, placenta, and fetal membrane of rats related to blood calcium level during late gestation

        Hong, Eui-Ju,Choi, Kyung-Chul,Hyun, Sang-Hwan,Jeung, Eui-Bae JOHN WILEY & SONS LTD 2007 MOLECULAR REPRODUCTION AND DEVELOPMENT Vol.74 No.9

        <P>Calbindin-D<SUB>9k</SUB> (CaBP-9k) gene is expressed in the uterus of pregnant rats, which is regulated by steroid hormones during estrous cycle or gestation. We hypothesized that there is a positive correlation between altered CaBP-9k expression and change in one or more of the hormones to provide a clue to the mechanism responsible for the altered calcium levels in the uterus, placenta, and fetal membrane during late gestation. Thus, in the present study, we investigated the effects of the hormones including estradiol (E2), calcitonin (CT), and parathyroid hormone (PTH) on the regulation of CaBP-9k in these tissues. There was an increase in the level of CaBP-9k in the uterus, placenta, and extra-embryonic membrane at late gestation, as blood calcium level increased. The protein level of CaBP-9k remained lower in the uterus at two-thirds of pregnancy, and then it rebounded abruptly during late pregnancy. During late gestation, E2 is postulated to be a dominant factor in the regulation of uterine CaBP-9k gene expression. Furthermore, we assumed that there is a positive correlation between altered expression of CaBP-9k and blood calcium level during pregnancy. The present study demonstrated the regulation of CaBP-9k mRNA in the uterus, placenta, and fetal membrane of rats, implying a role for CaBP-9k gene in the control of blood calcium in placenta and the calcium passing from maternal blood to fetal circulation. Taken together, these results suggest that major alterations in calcium metabolism caused by maternal thyroparathyroidectomy (TPTX), are sufficient to affect the changes in reproductive tissues during late pregnancy. In addition, an increase of blood calcium level is one of the most significant factors in the regulation of CaBP-9k at the transcriptional and/or translational levels in the reproductive tissues during late pregnancy. Mol. Reprod. Dev. 74: 1188–1197, 2007. © 2007 Wiley-Liss, Inc.</P>

      • KCI등재

        Morphological study of a horsehair worm, Gordius sp. (Nematomorpha: Gordiida), passed in canine feces

        Hong, Eui-Ju,Ha, Na-Ri,Ryu, Si-Yun,Chae, Joon-Seok,Kim, Hyeon-Cheol,Park, Jinho,Choi, Kyoung-Seong,Yu, Do-Hyeon,Park, Bae-Keun The Korean Society of Veterinary Service 2016 韓國家畜衛生學會誌 Vol.39 No.4

        Horsehair or gordian worms (Nematomorpha) were identified with 22 genera (Gordiida) and 5 marine species (Nectonema) until now. During juvenile phase in development, they gain parasitic activity in arthropods. In this study, a gordian worm was detected in the feces of a dog living in Nonsan-si, Chungcheongnam-do, Korea. Using this worm, we evaluated the morphological characteristics by light microscopic analysis. Furthermore, the morphological classification was re-evaluated by scanning and transverse electron microscopes. The worm was determined that it is male adult having a bi-lobed tail and male gonads in cross sections. Based on the morphological characteristics including cross sections of body and areole on the cuticle, the parasite was also identified as Gordius sp. (Nematomorpha: Gordiidae).

      • SCIEKCI등재

        Eucommia ulmoides Extract Stimulates Glucose Uptake through PI 3-kinase Mediated Pathway in L6 Rat Skeletal Muscle Cells

        Hong, Eui-Jae,Hong, Seung-Jae,Jung, Kyung-Hee,Ban, Ju-Yeon,Baek, Yong-Hyeon,Woo, Hyun-Su,Park, Dong-Suk The Korean Society of Toxicogenomics and Toxicopro 2008 Molecular & cellular toxicology Vol.4 No.3

        Eucommia ulmoides (Duchung) is commonly used for treatment of diabetes in Korean traditional medicine. However, the exact mechanism of its anti-diabetic effect has not yet been fully elucidated. In this study, the effect of E. ulmoides extract on glucose uptake was investigated in L6 rat skeletal muscle cells. E. ulmoides extract stimulated the activity of phosphatidylinositol (PI) 3-kinase that is a major regulatory molecule in glucose uptake pathway. Protein kinase B (PKB) and protein kinase C-${\xi}$ (PKC-${\xi}$), downstream mediators of PI 3-kinase, were also activated by E. ulmoides extract. We assessed the activity of AMP-activated protein kinase (AMPK), another regulatory molecule in glucose uptake pathway. Phosphorylation level of AMPK did not change with treatment of E. ulmoides extract. Phosphorylations of p38 mitogen activated protein kinase (p38 MAPK) and acetyl-CoA carboxylase (ACC), downstream mediators of AMPK, were not significantly different. Taken together, our results suggest that E. ulmoides may stimulate glucose uptake through PI 3-kinase but not AMPK in L6 skeletal muscle cells.

      • SCIESCOPUSKCI등재

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