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Glutathione S-transferase 활성부위 잔기들의 역할에 관한 부위특이적 변이법
공광훈,조성희 中央大學校 遺傳工學硏究所 1995 遺傳工學硏究論集 Vol.8 No.1
GST의 활성중심 잔기는 Tyr7이다. Figure 3에 나타낸 바와 같이 Tyr7의 phenol성 수산기가 효소에 결합한 GSH의 thiol에 있는 proton의 해리를 촉진하여 친핵성을 높이는 것이 촉매기구의 가장 중요한 점이다. 또한 Arg13의 side chain들은 GSH의 thiolate anion에 대해 solvent로부터의 노출을 막아(탈수화) 반응성을 강화시킨다고 생각되어 진다. Lys44, Gln51, Gln64, Ser65, Asp98의 잔기들은 GSH의 결합에 중요하다. 특히 Gln64와 Asp98은 GSH의 결합에 필수적인 잔기로 여겨진다. In order to elucidate the roles of residues in the active site of glutathione S-trans-ferase(GST), seven residues in human GST P1-1 were individually replaced with phenylalanine, threonine or alanine by site-directed mutagenesis to obtain mutants Y7F, R13T, K44T, Q51A, Q64A, S65A and D98A. Enzymatic properties of mutants were compared with those of the wild-type enzyme. Tyr7 is considered to be important for catalytic activity in lowering the pKa of the thiol of GSH in the enzyme GSH complex. Arg13 seems to be essential for the enzymatic activity as mainly involved in the construction of a proper structure of the active site. Lys44, Gln51, Gln64, Ser65 and Asp98 were deduced to contribute to the binding of GSH.
NIHSS 활용을 통한 뇌졸중 환자 간호의 질향상 전략
박경현,송경애,공혜성,나화주,유수경,박소영,김상희,최혜림,배희준,한문구,양미화 한국의료QA학회 2009 한국의료질향상학회지 Vol.15 No.2
문제: 뇌졸중 환자를 돌보는 간호현장에서는 급성기 뇌졸중 환자의 증상악화에 대한 조기사정과 적절한 대처가 매우 중요한 문제이다. 그러나 임상현장에서는 이를 객관화하고 수치화하여 모든 의료진이 의사소통할 수 있는 유용한 도구를 사용하고 있지는 못하는 실정이다. 이러한 문제를 해결하기위해 NIHSS(National Institute of Health Stroke Scale)를 신경과 진료의사를 중심으로활용하고 있지만 아직 간호현장에서는보편적으로사용하지 않고있다. 이에 뇌졸중환자간호에 NIHSS를 활용하여 뇌졸중 증상악화의 조기사정과 빠른 대처로 궁극적으로는 뇌졸중환자 간호의 질을보다 향상시키기 위하여 본활동이 시도되었다. 목적: 첫째, 간호사의 NIHSS 측정 신뢰도의 현수준을 점검하고 이를향상시키기 위한 프로그램을 개발·적용한다. 둘째, 간호사가급성기 뇌졸중환자에게 NIHSS 측정을 통하여 뇌졸중악화를 얼마나 예측할 수 있는지 분석하고 이를 향상시킬수있는 방법을 모색한다. 셋째, 궁극적으로 급성기 뇌졸중 환자의 증상악화의 조기 발견과치료를위한의료진의 올바른 대처지침을 마련하여 이를 적용한다. 의료기관: 경기도에 소재한 대학병원의 뇌졸중 집중치료실 질 향상 활동: 첫째, 간호사의 NIHSS 측정 신뢰도 향상을 위해 「NIHSS 간호사 교육 프로그램」을 마련하였다.
최영진,주상현,신선혜,공옥녀,안준협,김영대,손석만,김인주,김용기 대한내분비학회 2004 Endocrinology and metabolism Vol.19 No.1
저자들은 체중 증가와 전신 부종, 당뇨병을 주소로 내원한 여자 환자에서 폐 우중엽의 ACTH 염색 양성인 유암종이 쿠싱 증후군을 유발한 증례를 진단하여 수술적 제거 후 증상 완화를 경험하였기에 문헌 고찰과 함께 이를 보고하는 바이다. Fifteen percent of patients with Cushing's syndrome could be accompanied with nonpituitary tumors that secrets ACTH-the ectopic ACTH syndrome. Among them, bronchial carcinoid is one of the rare causes of the ectopic ACTH syndrome. We experienced a 60-year-old woman who showed conditions of weight gain, generalized edema, hypokalemia, diabetes mellitus, and right middle lung mass. Histologically, the tumor was diagnosed with bronchial carcinoid and was confirmed as an ectopic ACTH syndrome through immunohistochemical staining of ACTH. After resection of the lung mass, blood sugar, electrolytes, generalized weakness, and blood pressure improved (J Kor Soc Endocrinol 19:76∼81, 2004).
Subclinical Hypothyroidism and Coronary Revascularization After Coronary Artery Bypass Grafting
Kong, Sung Hye,Yoon, Ji Won,Kim, Sang Yoon,Oh, Tae Jung,Park, Kay-Hyun,Choh, Joong Haeng,Park, Young Joo,Lim, Cheong Elsevier 2018 The American journal of cardiology Vol.122 No.11
<P>We aimed to investigate long-term cardiovascular sequelae after coronary artery bypass grafting (CABG) in patients with subclinical hypothyroidism (SCH). All-cause and cardiovascular-related mortality, and cardiovascular events were retrospectively reviewed in 222 euthyroid and 36 SCH patients who underwent CABG. During a mean follow-up period of 8.2 ± 4.1 years, there were 90 incidents of all-cause deaths, 20 cardiovascular-related deaths, 70 major cardiovascular adverse events, 6 myocardial infarctions, 12 unstable anginas, 31 strokes, 23 hospitalizations due to heart failure, 15 atrial fibrillation (AF) events, and 27 coronary revascularizations. The incidence rate of coronary revascularization was significantly higher in patients with SCH (n = 6, 16.6%) than in euthyroid patients (n = 20, 9.0%), with a hazard ratio (HR) of 3.179 (95% confidence interval [CI] 1.174, 8.605; <I>p</I> = 0.023) after adjustment. In subgroup analysis, SCH patients who experienced postoperative AF within 3 months after CABG surgery had a significantly higher risk of coronary revascularization (n = 4, 25.0%) than euthyroid patients without AF (n = 14, 8.9%) after adjustment (HR 11.759, 95% CI 2.747, 50.343, <I>p</I> = 0.001). The frequency of fatal or nonfatal unstable angina was also higher in patients with SCH (n = 2, 12.5%) than in euthyroid patients (n = 4, 2.5%) (HR 16.999, 95% CI 2.242, 128.860, <I>p </I>= 0.006). In conclusion, preoperative SCH is associated with less favorable cardiovascular outcomes, especially coronary revascularization after CABG. Moreover, SCH patients who develop postoperative AF exhibit significantly increased risks of unstable angina and coronary revascularization. Preoperative evaluation of thyroid function may be helpful for predicting long-term outcomes after CABG.</P>
Sung Hye Kong,김정희,Sang Wan Kim,정애진,Song-Hee Lee,Sang-Kyu Ye,Chan Soo Shin 대한골대사학회 2022 대한골대사학회지 Vol.29 No.2
Background: A rapid increase in bone turnover and bone loss has been observed in response to the discontinuation of denosumab. It led to an acute increase in the fracture risk, similar to that observed in the untreated patients. We aimed to investigate the effect of denosumab on osteoclast (OC) precursor cells compared to that of zoledronate. Methods: The study compared the effects of denosumab (60 mg/24-week) and zoledronate (5 mg/48-week) over 48 weeks in postmenopausal women with osteoporosis. From patients’ peripheral mononuclear cells, CD14+/CD11b+/vitronectin receptor (VNR)- and CD14+/CD11b+/VNR+ cells were isolated using fluorescent-activated cell sorting, representing early and late OC precursors, respectively. The primary endpoint was the changes in OC precursors after 48 weeks of treatment. Results: Among the 23 patients, 11 were assigned to the denosumab group and 12 to the zoledronate group (mean age, 69 years). After 48 weeks, the changes in OC precursors were similar between and within the groups. Serum C-terminal telopeptide of type I collagen levels were inversely correlated with OC precursor levels after denosumab treatment (r=-0.72, P<0.001). Lumbar spine, femur neck, and total hip bone mineral density (BMD) increased in both groups. Lumbar spine BMD increased more significantly in the denosumab group than in the zoledronate group. Conclusions: Denosumab and zoledronate treatments induced similar changes in OC precursors. During denosumab treatment, old age and suppressed bone turnover were associated with increased OC precursor cell populations. Further validation studies with prospective designs are required.
Kong, Taeyoung,Park, Jong Eun,Park, Yoo Seok,Lee, Hye Sun,You, Je Sung,Chung, Hyun Soo,Park, Incheol,Chung, Sung Phil Elsevier 2017 The American journal of emergency medicine Vol.35 No.12
<P><B>Abstract</B></P> <P><B>Background</B></P> <P>This is the first study to evaluate the association between the serially measured RDW values and clinical severity in patients surviving >24 h after sustaining trauma. We evaluated the serial measurement and cut-off values of RDW to determine its significance as a prognostic marker of early mortality in patients with suspected severe trauma.</P> <P><B>Methods</B></P> <P>This study retrospectively analyzed prospective data of eligible adult patients who were admitted to the ED with suspected severe trauma. The RDW was determined on each day of hospitalization. The primary outcome was all-cause mortality within 28-days of ED admission.</P> <P><B>Results</B></P> <P>We included 305 patients who met our inclusion criteria. The multivariate Cox regression model demonstrated that higher RDW values on day 1 (hazard ratio [HR], 1.558; 95% confidence interval [CI], 1.09–2.227; <I>p</I> =0.015) and day 2 (HR, 1.549; 95% CI, 1.046–2.294; <I>p</I> =0.029) were strong independent predictors of short-term mortality among patients with suspected severe trauma. Considering the clinical course of severe trauma patients, the RDW is an important ancillary test for determining severity. Specifically, we found that RDW values >14.4% on day 1 (HR, 4.227; 95% CI: 1.672–10.942; <I>p</I> <0.001) and >14.7% on day 2 (HR, 6.041; 95% CI: 2.361–15.458; <I>p</I> <0.001) increased the hazard 28-day all-cause mortality.</P> <P><B>Conclusion</B></P> <P>An increased RDW value is an independent predictor of 28-day mortality in patients with suspected severe trauma. The RDW, routinely obtained as part of the complete blood count without added cost or time, can be serially measured as indicator of severity after trauma.</P>
Kong, Kyoung Hye,Kim, Hyun Kyu,Song, Kwan Sung,Woo, Young Sik,Choi, Won Suk,Park, Hee Ra,Park, Mikyung,Kim, Mi Eun,Kim, Min-Sun,Ryu, Jeong Sim,Kim, Hyung Sik,Lee, Jaewon Taylor Francis 2010 Journal of toxicology and environmental health. Pa Vol.73 No.21
<P>Capsaicin (N-vanillyl-8-methyl-1-nonenamide) is a major pungent ingredient in hot peppers and induces apoptosis in malignant carcinoma cell lines. However, the adverse effects of capsaicin on neuronal development have not been fully explored. The aim of this study was to determine whether capsaicin affected murine-derived cerebellar multi-potent neural progenitor cells (NPC) or adult hippocampal neurogenesis in vivo. Capsaicin dose-dependently suppressed NPC proliferation, and higher concentrations were cytotoxic. Capsaicin decreased the activation of extracellular signal-regulated kinases (ERK) without markedly affecting p38 kinases. Capsaicin reduced the number of newly generated cells in the dentate gyrus of the hippocampus but did not significantly alter learning and memory performance in young adult mice. Interestingly, capsaicin decreased ERK activation in the hippocampus, suggesting that reduced ERK signaling may be involved in the capsaicin-mediated regulation of hippocampal neurogenesis.</P>