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서유승,최재웅,송창섭,조용범,양진수,박준섭,정인수 대한내과학회 2003 대한내과학회지 Vol.65 No.2
관상동맥 동정맥루 기형은 매우 드문 질환으로 치료가 불필요한 경우가 대부분이나 coronary steal 현상으로 인해 증상이 발생하거나 합병증이 발생한 환자에 대해선 치료를 요한다. 최근에는 시술에 적합한 누공을 가진 선택된 환자군을 대상으로 카테터를 이용한 중재적 시술이 시행되어 수술적 치료와 유사한 결과를 얻고 있다. 저자들은 젊은 남자에서 관상동맥 동정맥루 기형과 동반된 급성 심근 경색증을 진단하여 비 수술적 방법인 카테타 코일 색전술로 성공적 치료 후 증상 및 심근 재관류에 호전을 보인 증례를 경험하였기에 문헌고찰과 함께 보고하는 바이다. We report a case of coronary fistula between the left anterior descending and main pulmonary artery complicating acute non-Q wave myocardial infarction. A 27-year-old man visited emergency department because of severe chest pain lasting two hours. The electrocardiogram showed ST segment elevation in precordial leads V3~6. Cardiac enzymes were as follows;CK-MB:36.44 IU/L T-T:0.489 ng/mL, CPK:542 IU/L, and LDH:475 IU/L. The thallium-201 dipyridamole stress perfusion scan showed perfusion defect and reversed redistribution in the anteroseptal wall. The coronary angiogram revealed coronary artery fistula between the proximal left anterior descending artery and main pulmonary artery without significant stenoses of coronary arteries. The result of ergonovine test was negative. After micro-coil embolization to the coronary fistula, symptoms were improved. Follow-up thallium-201 scan showed normalized blood flow in the left anteroseptal wall.
혈액투석 유지 환자에서 혈청 인 수치와 동정맥루 기능부전의 상관관계
최유범 ( Yu Bum Choi ),김정현 ( Jung Hyun Kim ),이미정 ( Mi Jung Lee ),최승윤 ( Seungyoon Choi ),김형종 ( Hyung Jong Kim ) 대한내과학회 2020 대한내과학회지 Vol.95 No.1
목적: 혈액투석 환자에서 혈관접근로의 기능 유지는 혈액투석 치료 유지에 매우 중요하다. 따라서 동정맥루의 기능 부전을 일으킬 수 있는 위험인자를 파악하는 것이 중요하며, 이 연구의 목적은 혈청 인이 동정맥루의 혈류량에 미치는 관련성을 알아보고자 하였다. 방법: 본 연구는 2016년 11월부터 2017년 12월까지 차의 과대학교 분당차병원 인공신장실에서 주 3회 4시간 외래 혈 액투석 치료 중인 환자 총 62명의 환자를 대상으로 하였으며, 매달 시행하는 정기 혈액 검사를 통하여 혈청 인을 측정하였으며 시간에 따른 평균값을 계산하였다. 모든 환자는 왼쪽 팔의 동정맥루(단단 문합법)를 사용하여 혈액투석을 받았으며, 동정맥루 혈류량은 Transonic HD 03를 통해 측정하였다. 이때 측정된 600 mL/min보다 작은 값을 혈류량이 감소하였다고 정의하였다. 결과: 62명 중 14명에서 동정맥루 혈류량의 감소가 관찰되었고, 단변량 분석법에서 혈청 인 수치가 높을수록 초음파 희석법으로 측정한 동정맥루 혈류량의 감소와 관련성을 보였으며 나이, 성별, 혈액투석 시 혈류속도나 좌심실 수축기능, 혈청 칼슘 수치 등은 관련성이 없었다. 다변량 분석법에 서도 높은 혈청 인 수치는 자가혈관 동정맥루 혈류량의 감소와 독립적인 연관성의 결과를 보였고 다른 인자들은 통계적으로 유의한 연관이 없었다. 결론: 혈액투석 환자에서 높은 인 수치는 자가혈관 동정맥루 혈류량 감소에 영향을 미칠 수 있는 독립적 인자가 될수 있을 것으로 생각된다. 혈청 인 수치의 정기적인 감시가 동정맥루 기능 장애의 위험도를 예측하는 데 유용할 수 있으며, 적극적인 조절이 자가혈관 동정맥루의 기능을 유지하는데 도움이 될 수 있을 것으로 생각된다. Background/Aims: Maintaining vascular access (VA) is very important in the management of hemodialysis (HD) patients. Therefore, the identification of risk factors for decreased vascular access flow has clinical relevance. The aim of the present study was to investigate the impact of serum phosphorus (P) on autologous arteriovenous fistula flow in HD patients. Methods: Sixty-two maintenance HD patients who visited the dialysis unit of CHA Bundang Medical Center between November 2016 and December 2017 were included in the study. Serum P levels were obtained every month, and time-averaged serum P was calculated. All patients had left arm arteriovenous fistulas (AVF; side-to-side anastomosis). AVF flow was assessed by Transonic HD 03. Decreased AVF flow was defined as < 600 mL/min. Results: Decreased AVF flow was observed in 14 of 62 patients. In univariate analysis and multivariable analysis, higher serum P had a significant independent association with decreased AVF flow. Advanced age, reduced ejection fraction, low blood flow rate in dialysis, and higher serum calcium were not associated with AVF flow. Conclusions: The present study demonstrated that higher serum P was an independent risk factor for decreased autologous AVF flow in maintenance HD patients. Serial monitoring of serum P may be helpful in stratifying patients by risk of AVF dysfunction, and proper management of serum P levels may be helpful in maintaining flow through autologous AVFs. (Korean J Med 2020;95: 36-42)
Human Immunodeficiency Virus Type Ⅰ에 대한 음나무 추출물의 억제활성
Yu Young Beob,Shim Bum Sang,Ahn Kyoo Seok,Choi Seung Hoon,Park Jong Cheol,Miyashiro H.,Hattori M. 대한동의생리학회 2004 동의생리병리학회지 Vol.18 No.4
For the purpose of developing new anti-HIV agents from natural sources, the extracts of Kalopanax pictus were tested for their inhibitory effects on HIV-1 replication and its essential enzymes as the reverse transcriptase (RT). protease and α-glucosidase. In the assay of HIV-1-infected human T-cell line, water extracts of stem and leafstalk inhibited the HIV-1-induced cytopathic effects with Ie (inhibitory concentration) of 25 and 50㎍/㎖, respectively. Moreover water extracts (100㎍/㎖) of stem and leafstalk showed strong activity of 80% and 90% on anti-HIV-1 RT using Enzyme Linked Oligonucleotide Sorbent Assay (ELOSA) method. In the HIV-1 protease inhibition assay, aqueous stem extract inhibited the activity of the enzyme to cleave an oligopeptide, resembling one of the cleavage sites in the viral polyprotein which can only be processed by HIV-1 protease with 58%, but no glucosidase inhibitory activities. We found out this result, for these samples it is possible that the inhibition of the viral replication in vitro is due to the inhibition at least one of RT and protease. It would be of great interest to identify the compounds which are responsible for this inhibition, since all therapeutically useful agent up to date are RT, PR and α-glucosidase inhibitors.
Choi, Yu-Min,Lee, So-Young,Kim, Bum-Joon Baishideng Publishing Group Inc 2018 World journal of gastroenterology Vol.24 No.16
<P>The annual number of deaths caused by hepatitis B virus (HBV)-related disease, including cirrhosis and hepatocellular carcinoma (HCC), is estimated as 887000. The reported prevalence of HBV reverse transcriptase (RT) mutation prior to treatment is varied and the impact of preexisting mutations on the treatment of naïve patients remains controversial, and primarily depends on geographic factors, HBV genotypes, HBeAg serostatus, HBV viral loads, disease progression, intergenotypic recombination and co-infection with HIV. Different sensitivity of detection methodology used could also affect their prevalence results. Several genotype-dependent HBV RT positions that can affect the emergence of drug resistance have also been reported. Eight mutations in RT (rtL80I, rtD134N, rtN139K/T/H, rtY141F, rtM204I/V, rtF221Y, rtI224V, and rtM309K) are significantly associated with HCC progression. HBeAg-negative status, low viral load, and genotype C infection are significantly related to a higher frequency and prevalence of preexisting RT mutations. Preexisting mutations are most frequently found in the A-B interdomain of RT which overlaps with the HBsAg “a” determinant region, mutations of which can lead to simultaneous viral immune escape. In conclusion, the presence of baseline RT mutations can affect drug treatment outcomes and disease progression in HBV-infected populations via modulation of viral fitness and host-immune responses.</P>
한국어판 흡연갈망설문지의 표준화 연구 : 신뢰도와 타당도
최경숙,이창화,유제춘,김세진,최호진,정범석 대한신경정신의학회 2008 신경정신의학 Vol.47 No.2
Objectives : The objective of this study is to assess the reliability and validity of the Korean version of the Tobacco Craving Questionnaire (K-TCQ), a multidimensional, self report instrument evaluating tobacco craving in a population of current smokers. Methods : The Korean version of TCQ was administered to 216 current cigarette smokers. Results : The Cronbach's alpha coefficient of the K-TCQ was high (0.95) which provided the evidence for the internal consistency. The test-retest reliability of K-TCQ was 0.66 (correlation coefficient, P<0.01). The correlation coefficients between the K-TCQ and each five VAS questionnaires were high (0.50-0.59, P<0.01). Inter-correlations of K-TCQ, VAS, FTQ, BDI, STAI-I and STAI-II were significant (p<0.01). Conclusion : The Korean version of TCQ is a valid and reliable scale for evaluating tobacco craving.
Yu, Kyung-Rok,Yang, Se-Ran,Jung, Ji-Won,Kim, Hyongbum,Ko, Kinarm,Han, Dong Wook,Park, Sang-Bum,Choi, Soon Won,Kang, Soo-Kyung,Schö,ler, Hans,Kang, Kyung-Sun Wiley (John WileySons) 2012 Stem Cells Vol.30 No.5
<P>CD49f (integrin subunit α6) regulates signaling pathways in a variety of cellular activities. However, the role of CD49f in regulating the differentiation and pluripotency of stem cells has not been fully investigated. Therefore, in this study, human mesenchymal stem cells (hMSCs) were induced to form spheres under nonadherent culture conditions, and we found that the CD49f-positive population was enriched in MSC spheres compared with MSCs in a monolayer. The expression of CD49f regulated the ability of hMSCs to form spheres and was associated with an activation of the phosphatidylinositol 3-kinase (PI3K)/AKT signaling pathway. Furthermore, the forced expression of CD49f modulated the proliferation and differentiation potentials of hMSCs through prolonged activation of PI3K/AKT and suppressed the level of p53. We showed that the pluripotency factors OCT4 and SOX2 were recruited to the putative promoter region of CD49f, indicating that OCT4 and SOX2 play positive roles in the expression of CD49f. Indeed, CD49f expression was upregulated in human embryonic stem cells (hESCs) compared with hMSCs. The elevated level of CD49f expression was significantly decreased upon embryoid body formation in hESCs. In hESCs, the knockdown of CD49f downregulated PI3K/AKT signaling and upregulated the level of p53, inducing differentiation into three germ layers. Taken together, our data suggest that the cell-surface protein CD49f has novel and dynamic roles in regulating the differentiation potential of hMSCs and maintaining pluripotency.</P>
Choi, Yu-Min,Lee, So-Young,Kim, Bum-Joon MDPI 2019 INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES Vol.20 No.3
<P>Hepatitis B virus (HBV) infection is a global health problem that causes a wide range of pathological outcomes, including cirrhosis and hepatocellular carcinoma (HCC). Endoplasmic reticulum (ER) stress induction by HBV infection has been implicated in liver carcinogenesis and disease progression with chronic inflammation via enhanced inflammation, oxidative stress-mediated DNA damage, and hepatocyte proliferation. In the natural course of HBV infection, the accumulation of naturally occurring mutations in the HBV genome can generate several mutant types of HBV-encoded proteins, including three different proteins in the S ORF (SHBs, MHBs, and LHBs) and HBcAg in the C ORF, which could contribute to enhanced ER stress in infected hepatocytes mainly via increased ER accumulation of mutant proteins. However, it seems that there may be distinct capacity and pathway in ER stress-induction and distinct resulting clinical outcomes between HBV variants. In addition, the role of HBxAg mutations in ER stress remains unknown. However, it has been reported that HBxAg itself could exert ER stress in infected cells, resulting in HCC generation in chronic HBV patients. To date, review papers regarding ER stress-mediated HBV mutation have been limited into a specific mutation type: preS2 deletion. So, in this review, we will discuss details about various mutation types in all four regions of the HBV genome (preS1, preS2, S, and C) related to ER stress and their distinct ER stress mechanisms and clinical outcomes in terms of mutation types.</P>