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      • Astromicin sulfate의 약동학 및 안전성 평가

        정숙인,김연숙,오원섭,복혜숙,김명민,최경업,김연화,김성민,백경란,송재훈 대한화학요법학회 2001 대한화학요법학회지 Vol.19 No.3

        목적 : Astromicin은 aminoglycoside계 항생제와 유사한 화학구조와 특성을 지니고, 기존의 aminoglycoside와 유사하거나 향상된 임상효과 및 부작용을 지닌 것으로 알려져 있다. 저자들은 astromicin의 약동학적 특성을 분석하고, astromicin 투여 환자를 대상으로 한국인에서 그 임상적 및 세균학적 효과와 안전성을 평가하고자 하였다. 대상 및 방법 : 약동학적 지표는 정상성인 남자를 대상으로 astromicin 200㎎을 30분간 정주한 후 24시간까지 혈장 및 뇨 검체를 수집하여 one-compartment open model에 따라 분석하였다. 중증으 세균감염이 있는 18세 이상의 환자를 대상으로 병용 또는 단독 투여한 후 임상적 효과와 세균학적 효과를 판정하였고, 치료전과 후의 순음청력검사와 혈청 크레아티닌으로 이독성과 신독성을 평가하였다. 결과 : 정상 성인 남자 12명을 대상으로 약동학적 지표를 평가하였고, 최고혈장농도는 투여 종료시점(C_(0))에서 16.87±1.68㎍/mL였으며, 반감기는 1.86±0.43 시간 이었고, AUC_(0-12h)은 38.12±10.57㎍ㆍhr/mL, Vd는 0.18±0.02L/㎏, CL은 5.25±2.07L/hr였다. 이러한 약동학적 지표는 다른 aminoglycoside와 유사한 결과를 보였다. 59명의 환자를 대상으로 시행한 임상적 효과 분석에서는 단독요법을 시행한 50명 중 임상적 치유율 94%, 세균학적 치유율 100%를 보였고, 순음청력검사를 시행한 48례의 환자중 의미있는 청력감소 소견은 관찰되지 않았으며, 신독성 또한 전혀 나타나지 않았다. 결론 : Astromicin의 약동학적 지표는 다른 aminoglycoside의 약동학적 지표와 비슷한 양상을 보이므로 향후 astromicin의 약물농도 감시에 있어서 다른 aminoglycoside의 치료적 약물 농도 감시 방법과 유사한 방법을 적용할 수 있으리라 기대된다. 또한 임상적 치유율이 우수하면서 신독성이나 이독성이 적어 세균 감염 환자의 치료에 있어서 단독 또는 병합 요법으로 비교적 안전하게 사용할 수 있으리라 생각된다. Astromicin(Fortimicin®) has some characteristics in common with other aminioglycoside antibiotics, although it has a unique chemical structure, which is different from them. This study was performed to elucidate the pharmacokinetic (PK) parameters of astromicin following single-dose intravenous infusion of 200 mg and to evaluate clinical efficacy and safety of astromicin in Korean populations. PK parameters of astromicin were determined in 12 healthy volunteers (65.5±5.2㎏). The plasma and urine samples were collected up to 24hrs. PK variables were calculated by fitting individual concentration-time curves to a one-compartment open model. Plasma level at the end of infusion was 16.87?1.68 ㎍/mL and declined to 1.05±0.35 (㎍/mL 8hr later. The half-life was 1.86±0.43 hr. Apparent volume of distribution was 0.18±0.02 L/㎏g, and total body clearance was 5.25±2.07 L/hr. These values were similar to those of other aminioglycosides. Clinical efficacy and safety were eviuated in 59 patients with moderate to severe bacterial infections who needed parenteral antibiotics. Among 50 patients who recieved astromicin monotherapy, 49 (98%) had favorable clinical reponse and 28 (100%) had favorable bacteriological response. Serial audiograms revealed no change in all of 48 patients. No nephrotoxicity was observed in all patients. Conclusively, our data suggest that therapeutic drug monitoring of astromicin can be conducted in a similar fashion as other aminioglycosides and astromicin is a useful and safe antibiotic in the treatment of severe bacterial infections.

      • 태아 피부 에크린한선의 발육에 관한 전자현미경적 연구

        송계용,김숙이,서중석,지제근 중앙대학교 의과대학 의과학연구소 1991 中央醫大誌 Vol.16 No.3

        To observe the developing process of human fetal eccrine sweat gland during the intrauterine life, an electron microscopic study was carried out based on 12 fetuses ranging from 20 to 42 weeks of gestation. These fetuses were the products of induced deliveries found to have not associated disease or congenital anomalies at the autopsy. Following observations were made. The various types of cell consisting coiled portion of eccrine sweat gland were recognized at the 20th weed of gestation and they were clear cells, undifferentiated dard cells, myoepithelial cells. clear cells were located in central central portion and dark or myoepithelial cells were in peripheral portion. While undifferentiated dark cells were randomly distributed in the straight portion of eccrine sweat gland. The differential points between clear cell and undifferentiated dark cell were its round nucleus and glycogen contents. Marked hydropic changes of clear cells were noted at the 30th week of gestation. Secretory granules were noted at the 31st week of gestation. Secretory cells in the coiled portion of eccrine sweat gland was not fully mature until the 42nd week of gestation. Clear cells showed clear cytoplasm, abundant free ribosomes and scanty organelles. Undifferentiated dark cells showed many mitochondria and few glycogen. Secretory granules were rarely seen. Myoepithelial cells showed a few mitochondria, glycogen and microfilaments. Among three portions of eccrine gland, duct lumen in the acral and coiled portion were formed through the intracellular canaliculus and in the straight portion were made through the intercellular canaliculus. The main basic morphological mechanism of the lumen formation were microvesicle formation and pinched off phenomenon.

      • 77K에서 SC(NH₂)₂의 ¹⁴N 핵사중극 공명연구

        최숙자,박영민,박현진,전인,송승기,서용문 명지대학교 자연과학연구소 1997 자연과학논문집 Vol.16 No.-

        강유전체 질소화합물 thiourea [SC(NH₂)₂]분말시료의 ??plused NQR 실험을 77K 에서 실행하여 공명진동수와 핵사중극 결합상수, 비대칭인자, 완화시간등을 측정했으며, 4개의 공명선이 관측되었다. 결정내에는 주위 환경이 다른 두 종류의 질소 N₁,N₂가 존재함을 알 수 있었다. N₁에 관한 공명진동수는 ??(1)=2.6487㎒, ??(1)=2.032㎒, N₂에 대하여는 ??(2)=3.1852㎑, ??(2)=2.0183㎒이고, 공명선폭은 ??(1)=2.6752㎑, ??(1)=3.1852㎑, ??(2)=3.2618㎑, ??(2)=3.5448㎑ 임을 보였다. 한편 e²qQ/h의 값은 ν(1)에서 3.1205㎒, η는 0.3953이었으며, ν(2)에서는 3.0279㎒, 0.3939이었다. 이는 이미 보고된 결과와 일치하였다. 그리고, FID(Free Induction Decay)와 spin-echo실험을 통하여 얻은 스핀-격자 완화시간 T₁은 ??(1)에서 7.143 s, ??(2)에서 5.88 s이었으며, 스핀-스핀 완화시간 T₂는 ??(1)에서 25㎳, ??(2)에서 33.3㎳, ??(2)에서 33.3㎳의 값을 얻었다. We have measured ??N NQR frequencies, nuclear quadroupole coupling constants, asymmetric parameters and relaxation times in ferroelectric nitrogen thiourea [SC(NH2)2] at 77K, and four NQR resonance lines were observed. The results of measurements show that there are two kinds of nitrogen site, N1 and N2, with different environments in the crystal. The resonance frequencies were found to be ν+(l)=2.64 87MHz, ν_(1)=2.032 MHz for N1 and ν+(2)=2.6285MHz, ν_(2) =2.0183MHz for N2 respectively. The corresponding linewidths were ν+(1)= 2.6752kHz, Δν_(l) =3.1852kHz, ν+(2) =3.2618kHz and Δν_(2) =3.5448kHz, respectively. For N1, e2Q/h is 3.1205 MHz and η is 0.3953, and for N2, these are 3.0979MHz and 0.3939. These results are in agreement with those reported previously. The spin-lattice relaxation time (Ti) and the spin-spin relaxation time (T2) by FID and spin-echo experiments are as follows : T1(ν+(1)) is 7.143 s and T1(ν+(2)) is 5.88 s. T2(ν+(1)) is 25 ms, T2(ν_(1)) is 25 ms, T2(ν+(2)) is 33.3 ms and T2(ν_(2)) is 33.3 ms.

      • 신체상, 건강신념 및 환자역할행위와의 관계분석

        김인숙,서희숙,김송자 朝鮮大學校 附設 醫學硏究所 1987 The Medical Journal of Chosun University Vol.12 No.1

        Data collection was done from August 18th to August 30th, 1986. The subjects in this study were 70 upper or lower limb fractured patients admitted to the Orthopedic Surgery units of 3general hospitals located in Gwang-Ju city and 70 normal persons. There were aims at increasing the compliance level of sick role behavior by finding the degree of compliance and analysing the relationship between the body image and health belief. The instruments used for this study were Body Cathexis Scale developed by Secord and Jourard, Body Mesning Scale developed by osgood, and the instrument measuring patients haalth belief which was developed by the researcher who utilized information available from the several references. Analysis of data was done by using t-test, ANOVA, Pearson-Correlation Coefficients. The results of this study were as follows: 1. The first hypothesis, "there would be a difference in the body image between the patients with upper or lower limb fractured and normal persons," was supported (t = 58.99, p <. 05) 2. The second hypothesis, "the more positive the body image, the higher the health belief," was not significant. 3. The third hypothesis, "the more positive the body image, the higher the compliance level," was supported (r =: 0.3581, p < . 05) 4. The forth hypothesis, "the higher the health belief, the higher the compliance level." was not significant.

      • KCI등재후보

        국내에서 발생하고 있는 사람 브루셀라증의 임상적 특성

        김연숙,최영실,오원섭,권기태,이혁,이선희,손준성,김신우,장현하,정숙인,고관수,박미연,백경란,송재훈 대한감염학회 2006 감염과 화학요법 Vol.38 No.6

        배경 : 2002년 내국인에서의 첫 사람 브루셀라증의 증례 보고 이후 국내에서 사람 브루셀라증이 빠른 증가를 보이고 있다. 이에 연구자들은 국내에서 발생하는 브루셀라증의 임상적 특성을 연구하고자 하였다. 방법 : 2003년부터 2006년 7월까지 7개 대학병원에 내원한 환자들을 대상으로 WHO의 진단기준에 의하여 확진된 브루셀라증 환자들의 의무기록을 후향적으로 조사분석 하였다. 배양된 균은 삼성서울병원에 의뢰하여 16S rRNA 유전자 분석방법을 이용하여 종을 확인하였고, 표준시험관응집검사는 국립보건원에 의뢰하여 시행하였다. 결과 : 34예의 환자들이 브루셀라증으로 확진되었고, 31명이 남자였다. 혈액에서 B. abortus가 증명된 경우가 8예, 표준시험관 응집검사상 의미 있는 항체가 상승을 보인경우가 26예이었다. 환자들은 대부분 축산업관련 종사자였고, 추후 브루셀라증으로 확진된 소와의 직접 접촉을 통해 감염된 것으로 여겨진다. 국내 사람 브루셀라증의 가장 흔한 증상은 발열이었고, 위장관계 합병증이 가장 흔히 동반되었다. 치료로는 doxycycline/rifampicin이 24예의 환자에서 doxycycline/aminoglycoside (streptomycin 혹은 gentamicin)이 10예의 환자에서 6주 이상의 기간 동안 투여되었다. 치료에 반응을 보이지 않는 환자는 없었고, 재발이 1예 있었다. 결론 : 국내에서 발생하는 사람 브루셀라증의 원인균으로 현재까지 분리 동정된 것은 B. abortus이며, 소 브루셀라증의 증가로 인해 인체감염사례가 함께 증가하는 것으로 사료된다. 위험 직업군 종사자들에서 감염된 소와의 직접 접촉을 통해 주로 발생하고 있는 브루셀라증의 임상종상은 국외에서 발생하는 경우와 유사한 양상을 보이고 있으며 치료에 대한 반응은 비교적 좋은 편이긴 하나, 추후 보다 많은 환자들을 대상으로 한 연구가 필요하리라 사료된다. 사람 브루셀라증의 조절을 위해서는 소 브루셀라증의 조절이 필수적이며, 브루셀라증의 조절에 성공한 선진국의 사례를 적극적으로 도입해야 할 것으로 생각된다. Background : Since the first Korean case of human brucellosis was reported in 2002, the incidence of human brucellosis has been rapidly increasing. We performed this study to evaluate the clinical characteristics of human brucellosis occurring in South Korea. Materials and Methods : Demographic features, clinical manifestations, and therapeutic outcomes of cases confirmed as brucellosis according to WHO diagnostic criteria were evaluated. Species of Brucella isolates were identified with 16S rRNA gene sequencing method. Serologic diagnosis was performed with standard tube agglutination test (STA). Results : A total of 34 cases were enrolled from 2003 to 2006 in six hospitals. Eight cases were confirmed with the isolation of Brucella from blood and 26 cases were confirmed with titer of antibodies ≥1:160 by STA. Male (31) was predominant and most of the patients were cattle farmers. The most common transmission route was direct contact with infected or their cattle byproducts. Fever was the most prominent symptom and fatigue followed. Gastrointestinal and musculoskeletal systems were commonly complicated. Patients were treated with doxycycline and rifampin or aminoglycosides for more than 6 weeks. All patients responded well to the therapeutic regimens, but one patient relapsed 10 months after treatment. Conclusion : Brucellosis occurring in Korea has been caused by B. abortus, whose preferred natural host animals are cattle. Korean patients were infected through direct contact with bovine brucellosis. Clinical manifestations of brucellosis were similar to those occurring worldwide. Therapeutic outcomes were good among patients with brucellosis in Korea. In order to prevent human brucellosis, measures to eradicate bovine brucellosis should precede.

      • 당뇨병의 임상적 관찰

        김송자,김인숙 조선대학교 1981 The Medical Journal of Chosun University Vol.6 No.-

        A total of 217 cases of diabetes mellitus who were admitted to Chosun university during three years and eight months from January, 1977 to August, 1980. The results were summerized as following : 1. Of 217 cases of diabetes mellitus, male and female ratio of the patients was 1.4:1 and the highest incidence of diabetes mellitus was in fifth decade of age in both sex. 2. Common symptoms were polydipsia(42.9%), Polyuria(32.7%), general weakness(30.3%), fatigability(28.6%), and polyphagia(23.0%). 3. Frequent complications were infection(25.3%), retinopathy(14.7%), hypertension(12.9%), neuropathy(8.8%), and liver cirrhosis(8.3%). 4. The fasting blood sugar levels before treatment were developed high in 150-200㎎%(26.8%). 5. Hypercholesterolemia(over200㎎%) was seen in 36.0% of diabetes mellitus. 6. Blood pressure of diabetes mellitus was higher than that of normal persons. 7. The result of therapy had fair control to the treatment with diet and insulin.

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