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      • KCI등재

        관상동맥 시술 도중 발생한 좌주간부 관상동맥 박리에 대한 스텐트 삽입 치료의 단장기 임상 결과 : acute and long-term results

        이세환,이승환,홍명기,김영학,이철환,한기훈,송종민,강덕현,송재관,김재중,박성욱,박승정 대한내과학회 2004 대한내과학회지 Vol.66 No.6

        목적 : 심도자 사용 시술과 관련된 좌주간부 관상동맥박리에 대한 적절한 치료는 아직 확실히 정립되지 않은 상태이다. 이에 본 연구는 좌주간부 관상동맥 박리에 대한 스텐트 삽입술의 단장기 임상결과를 후향적으로 분석하였다. 방법 : 좌주간부 관상동맥 박리에 대한 치료로 즉각적인 스텐트 삽입술을 시행하는 것이 안전하고 효과적인 방법임을 가설하였고, 이러한 즉각적인 스텐트 삽입을 시행한 10명의 환자를 대상으로 단장기적 임상경과를 의무기록 고찰과 전화 면담을 통해서 평가하였다. 결과 : 전체 환자 모두 처음부터 좌주간부 관상동맥에 유의한 협착을 가진 환자는 없었으며, 8명의 환자는 심도자의 조작으로 인한 박리가 발생한 경우였고(진단적 혈관 조영술 중에 3명, 유도 도자 조작 중에 5명), 나머지 2명은 다른 병변에 스텐트 삽입시술을 하는 중에 박리가 발생하였다. 이 10명의 환자에서 모두 즉각적인 스텐트 삽입술이 시행되었고, 4명의 환자에서 시술 도중 혈압 저하로 Intra-aortic Ballon Pump (IABP)를 장착하였다. 모든 환자에서 성공적으로 스텐트가 삽입되었고, 병원내 사망은 1명도 없었다. 6개월 추적 관상동맥 조영술은 8명의 환자에서 시행되었다. 혈관 조영상의 재협착(직경 협착 50% 이상)은 8명 모두에게서 관찰되지 않았으며, 퇴원 후 평균 31±25개월의 추적관찰 결과 주요 심장사건은 1건도 발생하지 않았다. 결론 : 비록 대상 환자가 적은 연구였지만 좌주간부 관상동맥 박리에 대한 스텐트 삽입술은 기술적으로 안전하고 빠르게 시행 할 수 있으며, 훌륭한 단장기적인 치료 효과를 보여준다. Background : The optimal treatment of patients with left main coronary artery (LMCA) dissection during catheter-based procedure remains uncertain. We retrospectively analyzed the acute and long-term results of bail-out stenting for LMCA dissection. Methods : In cases with significant LMCA dissection occurring during catheter-based procedure, prompt stent implantation may be safe and associated with favorable clinical outcome. We evaluated the acute and long-term results of bail-out stenting for LMCA dissection occurring during catheter-bases procedure in 1- patients. Results : Initially, there was significant stenosis of LMCA segment in these patients. Catheter-induced dissection occurred in 8 patients (during diagnostic angiography in 3 patients and guiding catheter manipulation in 5 patients). Two patients suffered dissection in the setting of stent deployment in other vessels. Therefore, bail-out stenting LMCA dissection was performed in a total of 10 patients. In 4 patients, hypotension developed and intra-aortic balloon pump was placed during procedure. Stents were successfully deployed in all patients. There was no in-hospital mortality. Six-month angiographic follow-up was performed in 8 patients. Angiographic restenosis(diameter stenosis 50%) was not observed in all patients at follow-up study. During a mean follow-up of 31±25 months after hospital discharge, there was no major adverse cardiac event (death, myocardial infarction, and target lesion revascularization). Conclusion : Bail-out LMCA stenting is technically feasible, and showed good acute and long-term results in a small series of patients.

      • KCI등재후보

        Expression Profiles of Retinoblastoma Protein and p27Kip1 According to HER2 Amplification Status in Primary Breast Cancer

        신재호,Sung-Jin Park,Hyun-Jin Cho,Geumhee Gwak,Byung-Noe Bae,Ki Whan Kim,Hong-Yong Kim2,Kyeongmee Park,Sehwan Han 한국유방암학회 2009 Journal of breast cancer Vol.12 No.1

        Purpose: Human epidermal growth factor receptor-2 (HER-2)/neu amplification affects the cell proliferation through the modulation of multiple G1 cell cycle regulators in breast tumor cells. We performed this study to investigate whether retinoblastoma protein (pRB) and p27Kip1 were differently expressed according to the HER2 amplification status in human breast cancer. Methods: HER2 amplification was assayed by fluorescence in situ hybridization and the expression of cell cycle regulators were assayed by immunohistochemistry on 153 consecutive invasive breast cancers. The proliferative activity of breast cancer was analyzed according to the HER2 amplification and cell cycle protein expression status. Results: HER2 amplification was observed in 39 (25.5%) of 153 breast cancers. In the HER2 amplified breast cancers, the pRB expression was significantly increased (p=0.011) whereas there was no significant relationship between HER2 amplification and p27Kip1 expression. There was an inverse correlation between pRB expression and Ki-67 labeling index in the HER2 amplified breast cancers (p=0.036). In contrast, Ki67 labeling index was significantly decreased as p27Kip1 expression increased in HER2 non-amplified breast cancers (p=0.028). In HER2 non-amplified breast cancers, we could not observe any association between the pRB expression and Ki67 labeling index. Conclusion: The proliferation of the breast cancers was associated with pRB expression in HER2 amplified tumors whereas it was associated with p27Kip1 expression in HER2 non-amplified tumors. The results of the current study indicate that the cell proliferative activity of the breast cancer is under different growth signal pathways according to HER2 amplification status.

      • 준 열원의 강도분포에 관한 연구

        도시홍,정세민,배세환,성상기,박흥준 釜山水産大學校 1985 釜山水産大學 硏究報告 Vol.25 No.1

        실험결과 다음과 같은 결론을 얻을 수 있었다. q=3,q=30일때 최대치의 확율은 각각 0.08, 및 0.029이었다. 이것은 Pearl과 Troup의 결과 (q=1.9106, q=5.6904 및 q=34.7657 일때 최대치의 확율은 각각 0.09, 0.06 및 0.02)와 아주 유사했으며, 관측시간의 증가에 따라 분포의 천이경향도 이론적 결과와 잘 일치 되었다. 또한 준열원에서 방출된 광자들이 공간내의 유한한 영역에서 고르게 분포되어 있을때 그 광원을 coherence time보다도 더 긴 시간동안 관찰한다면 그 관원을 gaussian으로 취급할 수 있으며, 광자에 대한 Bose-Einstein 통계의 적용이 타당함과 Mandel의 근사공식(q>>1, q<<1인 경우)이 잘 성립될 것임을 실험으로 예상할 수 있었다. Light emitted from a source fluctuates both spatially and temporally. The spatial fluctuations are due to the finite size of the source and the spatial incoherence of the photons emitted from various parts of the source. Temporal fluctuation are due to the wide blackbody spectrum emitted by such a source. It is a direct result of the Bose-Einstein statistics obeyed by photons. Actual measurements on the statistical behavior of thermal light are conducted by pseudothermal light source. In the experiment, we examined the probability density f(I) that the intensity I associated with one or pore coherence volumes is between I and I+dI and the deviation for q<1, which is given by G. Bedad et al. The derivation of f(1) for the case of more than one coherence volume has been given in an approximate form by Mandel and by Troup. As a result, we obtain p(n,T)=0.08 at q=3 and p(n,T)=0.029 at q=30. These are very similar to pearl and Troup's [p(n,T)=0.09 at q=1.9106, p(n,T)=0.06 at q=5. 690, p(n,T)=0.02 at q=34.7657]. So we can conclude that when we observerse pseudo-thermal source for a long time (compared with its coherent time), the source can be treated as a gaussian light source and Mandel's approximation is good fit for photon counting.

      • 서울의 Penicillinase Producing Neisseria Gonorrhoeae 발생빈도(1996)

        김재홍,황동규,전재홍,김윤석,김중환,김용준,이창균,임동진,김현수,조창근,김경문,박상훈,전우형,김희성,이호정,차명수,김갑형,김형석,김석우,황지환,박병순,권오상,이민수,송기훈,성소영,이인섭,부태성 대한화학요법학회 1999 대한화학요법학회지 Vol.17 No.2

        Background : In recent years, gonorrhea has been panedemic and remains one of the most commom STDs in the world, especially in developing countries. Objective & Methods: For the detection of a more effective therapeutic regimen and assessing the prevalence of PPNG, we have been trying to study the patients who have visited the VD Clinic of Choong-Ku Public Health Center in Seoul since 1980 by means of the chromogenic cephalosporin method. Results: In 1996, 139 strains of N. gonorrhoeae were isolated, among which 53(39.0%) were PPNG. Conclusion: Our results suggests that after a peak of 74.3% in 1993, the prevalence of PPNG in Seoul is gradually declining.

      • Burkhoderia sp. AK-17에 의한 잎들깨 재배의 생물학적 조절

        김근기,김용균,손홍주,최영환,강규영 Plant molecular biology and biotechnology research 2005 Plant molecular biology and biotechnology research Vol.2005 No.

        There are various crop diseases in green houses that are caused by the cultural environments, especially high temperature and moisture. To solve the forementioned problems, farmers are overusing agricultural chemicals, causing other damages by the chemical residue. In this study, antagonistic bacteria as biological control agents were isolated to produce the environmentally-friendly crops for use in green houses. Eighteen species of antagonistic bacteria were totally isolated from the soil and plants in the Perilla fields, and AK-17 showed the highest activity among the isolates. According to the results of anti-fungal spectrum against several pathogens by AK-17, the antagonism effect of the isolates was remarkable against grey mold rot by Botrytis cinerea, sclerotinia rot by Sclerotnia sclerotiorum, and stem rot by Rhizoctonia solini. To evaluate the biological control effects of the isolates against the major diseases of Perilla, studies were carried out to evaluate the preventive and the curative effects of the diseases throughout the pot experiments. According to the forementioned experiments, the preventive and the curative effects by the isolates against sclerotinia rot were respectively showed as 55% and 92%. For the grey mold rot, those were 40% and 78%, respectively. As to the evaluation of the growth-promoting effect by AK-17, the length and the biomass of the tested plants were increased to 120% and to 164%, respectively. For the leaf numbers and area were respectively increased to 120% and 220%. Furthermore, AK-17 was identified as Burkhoderia sp. according to the results of physiological properties and genetic methods. 시설원예단지의 재배환경은 고온다습으로 많은 병해가 발생하며, 이를 방제하기위해 과다한 농약을 사용하므로 농약 잔류성에 대한 피해가 심각한 우려를 낳고 있다. 미생물을 이용한 생물학적 방제법 개발로 청정 시설원예작물을 생산할 목적으로 길항균을 분리하였다. 잎들깨 재배토양과 식물체로부터 길항세균 18종을 분리하였으며 분리한 길항세균 중에 AK-17이 가장 활성이 뛰어나 이를 이용하여 주요 식물병원균에 대한 항균스펙트럼을 조사하였다. 그 결과 잿빛곰팡이병원균의 Botrytis cinerea와 균핵병원균의 Sclerotinia sclerotiorum 및 줄기썩음병원균인 Rhizoctonia solant에 대한 항균효과가 뛰어났다. 잎들깨의 주요 병에 대한 생물학적 방제실험은 병발생 억제효과와 병방제효과를 pot 실험으로 실시했다. 그 결과 균핵병은 55%의 병발생 억제효과와 92%의 방제효과가 있었고, 잿빛곰팡이병은 40%의 병발생 억제효과와 78%의 방제효과를 확인할 수 있었다. AK-17의 식물 생육촉진효과는 신장이 120%, 생체중이 164% 증가되었으며, 엽수와 엽면적은 각각 120%와 220%의 증가효과를 보였다. 그리고 AK-17을 생리·생화학적방법과 유전학적 방법으로 동정한 결과, Burkhoderia sp.로 확인되었다.

      • KCI우수등재

        성인에서 비만에 대한 자가 평가

        황재경,김홍규,공희상,윤효중,황용하,이기영,정연실,이성광,박혜영,김갑환,최원철,강문호 대한비만학회 2002 The Korean journal of obesity Vol.11 No.4

        연구배경 : 일반인들의 비만에 대한 자가평가는 객관적인 기준에 의하기보다는 주관적인 것으로, 이는 체중조절에 대한 부적절한 노력을 이끌 가능성이 있다. 본 연구는 우리나라 성인을 대항으로 비만에 대한 자가평가와 체질량지수를 기준으로 정의한 객관적인 비만도 사이의 차이를 알아보고, 비만에 대한 인식에 영향을 주는 사회환경적 요인을 규명해 보고자 하였다. 방법 : 가천의대 길병원의 건강증진 센터에 내원하여, 건강검진을 받은 561명 (남 341 : 여 220) 의 성인을 대상으로 하였다. 체질량지수 20미만, 20 ~ 24.9, 25 ~ 29.9, 30이상 (kg/㎡)에 따라 네 군으로 분류하였고, 설문조사 상 자신의 체형에 대한 인식 (마른 편, 적당, 비만, 매우비만)과의 일치도를 살펴보았다. 결과 : 대상자의 연령은 37±13세, 남녀 비는 1.5:1, 체질량지수는 22.7±3.2 kg/㎡, 복부-둔부 둘레비는 0.85±0.07이었다. 체질량지수 (20미만, 20 ~ 24.9, 25 ~29.9. 30이상 (kg/㎡))를 기준으로 한 경우와 자가평가 (마른편, 적당, 비만, 매우 비만)에 대한 일치도는 각각 56%, 52%, 49% 그리고 89% (kappa=0.26)이었다. 그리고 , 체질량수 25 kg/㎡ 이상인 비만인 남성의 44%가 자신을 비만하지 않다고 평가하고 있었으며, 체질량지수 25 kg/㎡ 미만인 여성의 43%가 자신을 비만하다고 인식하였다. 비만에 대한 자가 평가가 적절한 군과 그렇지 않은 군 사이에 연령, 교육 수준, 거주지역 등에 의미 있는 차이는 관찰되지 않았다. 결론 : 우리 나라 성인에서 객관적인 비만도와 일반인의 자가 평가 사이에는 상당한 차이가 있다는 것을 알 수 있었다. 남성의 경우에는 자신의 비만에 대한 인식이 부족하였고, 여성의 경우에는 비만하지 않은 경우에도 자신을 비만하다고 과평가하는 비율이 높았다. 따라서, 일반인들을 객관적으로 비만 기준으로 정확히 평가하고, 올바른 신체이미지를 가질 수 있도록 교육하는 것이 필요함을 알 수 있었다. Background : Obesity has become a matter of great public concern in Korea with its increasing prevalence in recent years. People should properly recognize themselves whether to be obese or not before seeking medical attention. However self assessment of obesity may be erroneously subjective and misleading. This study is to investigate the possible discrepancy between self-assessment of obesity and obesity defined by BMI in Korean adults. Materials And Methods : Five hundred sixty one adult subjects (341 men and 220 women) who took a routine health examination in Gachon Health Center were included in this study. We analyzed the data obtained from health examination and a questionnaire including self-assessment of obesity categorized as underweight, normal, obese and severely obese. Body mass index (BMI) ≥ 25 kg/㎡ is defined as obese, BMI ≥ 30 kg/㎡ as very obese and BMI <20 kg/㎡ as underweight. Results : The age of the subjects was 37±13 years, male to female ratio 1.5:1, the BMI 22.7±3.2 kg/㎡, and the WHR 0.85±0.07. The concordance rates between self-assessment of obesity and obesity defined by BMI were 56%, 52%, 49% and 89% (kappa=0.26) respectively in underweight, normal, obese and very obese. 44% of men with obesity (BMI ≥25 kg/㎡) assessed themselves to be non-obese, whereas 43% of non-obese women (BMI ≥25 kg/㎡) assessed themselves to be obese. There were no differences in age, education level, and residential area between the groups who correctly assessed their obesity and did not. Conclusions : There were significant discrepancies between self-assessment of obesity and obesity defined by BMI in Korean adults. Significant proportion of men with obesity underestimated their obesity, while significant proportion of non-obese women overestimated their fatness. These results suggest that public education be required to provide the proper definition of obesity and avoid the misleading in its management.

      • SCISCIESCOPUS

        Late target lesion revascularization after implantation of sirolimus-eluting stent

        Hong, Myeong-Ki,Mintz, Gary S.,Lee, Cheol Whan,Park, Duk-Woo,Lee, Seung-Whan,Kim, Young-Hak,Jung, In-Hyun,Kim, Sang-Hyun,Cheong, Sang-Sig,Kim, Jae-Joong,Park, Seong-Wook,Park, Seung-Jung Wiley Subscription Services, Inc., A Wiley Company 2008 CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS Vol.71 No.3

        <P>Objectives: We evaluated the incidence, clinical presentation, and angiographic in-stent restenosis (ISR) pattern of late target lesion revascularization (TLR) after sirolimus-eluting stent (SES) implantation. Background: Late TLR is an unusual finding beyond 6–9 months after bare-metal stent implantation. However, late TLR after SES implantation has not been sufficiently evaluated. Methods: The study population consisted of 804 patients with 1,020 native lesions that were patent at 6-month follow-up angiogram after SES implantation. Results: Late TLR was performed in 18 patients with 18 lesions (1.8%) at 24.1 ± 2.6 months (range; 18–30 months) after SES implantation. Clinical presentation of late TLR patients was silent ischemia in eight patients and recurrent angina in 10 patients, but none had an acute coronary syndrome. Angiographic ISR pattern of late TLR lesions were focal ISR in 12 lesions (67%) and diffuse ISR in six lesions (33%). Serial quantitative coronary angiographic analysis of these lesions showed a minimal lumen diameter of 2.6 ± 0.5 mm immediately after SES implantation, 2.4 ± 0.4 mm at 6-month follow-up and 0.7 ± 0.6 mm at 24-month follow-up (ANOVA P < 0.001). By stepwise multiple logistic regression analysis, the only independent predictor of late TLR was stent length (P < 0.001, OR = 1.040, 95% CI = 1.019–1.061). Conclusions: Late TLR was performed in 1.8% of 1,020 native lesions that were patent at 6-month follow-up angiogram. Clinical presentations of late TLR was either silent ischemia or recurrent angina, but not acute coronary syndrome. Two-thirds of late TLR lesions had a focal angiographic ISR pattern. © 2007 Wiley-Liss, Inc.</P>

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