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We report on a case of right thalamic hemorrhage resulting from low-voltage electrical injury caused by contact between a wet hand and an electronic scale. The patient was treated with clopidogrel for control of a previous cerebral infarction. The patient complained of numbness of the left upper extremity. On neurological examination, decreased motor power of her left side, grade IV, was observed. Findings on computerized tomography of the brain revealed a right thalamic hemorrhage. To the best of our knowledge, cerebral hemorrhage resulting from lowvoltage electrical injury has not been previously reported in the literature.
Objectives : It has been reported that the presence of a pharmacologically inactive foreign substance, polystyrene latex bead, in subarachnoid space activates a non-specific immunological response and elicits arterial narrowing. Recently the activation of potassium($K^+$) channels may be of benefit in relieving cerebral vasospasm. The present study examined the effects of systemic administration of a ATP-sensitive $K^+$ channel activator, cromakalim, on the polystyrene latex bead-induced cerebral vasospasm. Methods : The spasm models similar to that caused by subarachnoid blood injection were created by injection of bead into rabbit cisterna magna. Intravenous injections of cromakalim were administered twice daily(bid) 30 minutes after induction of vasospasm. Animals were killed by perfusion-fixation 2 days after vasospasm. Basilar arteries were removed and sectioned, and the luminal cross-sectional areas were measured. Results : Injection of bead elicited an arterial constriction, reducing arterial diameter to 33.3% of resting tone. Cromakalim inhibited bead-induced constriction at a dose of 0.3mg/kg(Mann-Whitney test, p<0.01). Conclusion : These results support the concept that the cellular events triggered by inactivation of ATP-sensitive $K^+$ channels are responsible for the pathogenesis of vasospasm. The findings also indicate that cromakalim represents a potential therapeutic agents for the treatment of cerebral vasospasm.
Dapsone은 이전에 주로 나병 치료제로 많이 이용되었으나 최근 피부 질환 뿐 아니라 류마티스 질환 등 여러 질환의 치료에 이용되고 있다. 이에 의한 부작용 중 흔하지 않으나 치명적인 경과를 보이는 dapsone 증후군이 나타날 수 있고 호산구 증가가 동반되면 DRESS 증후군으로 진단할 수 있다. 저자들은 베체트 증후군의 점막 병변의 치료를 위해 dapsone을 사용한 환자에서 약물 사용 3주 후 발생한 고열, 피부발진, 호산구 증가와 늑막액 발생, 간, 비장 종대를 동반한 간 효소 효치의 현저한 상승으로 입원하였다가 전격성 간부전 상태로 판단되어 간이식을 고려중인 상태에서 dapsone에 의한 DRESS 증후군으로 진단하고 고용량의 스테로이드제재를 투여 후 간 이식 없이 호전을 보인 1예를 경험하여 보고하는 바이다. Dapsone has been used for several dermatological conditions such as immunobullous disease and ulticarial vasculitis. Dapsone is very useful drug for treating the mucocutaneous manifestations of Behcet`s disease. The widely recognized side effects of dapsone are headache, methemoglobinemia and hemolysis. The severer, but rarer side effect of dapsone is known as dapsone hypersensitivity syndrome, which consists of exfoliative dermatitis, hepatitis, lymphadenopathy and hemolytic anemia. When this is associated with eosinophilia, we can diagnose and treat this drug reaction with eosinophilia and systemic symptoms (DRESS). DRESS is a syndrome of fever, rash, and internal organ involvement that`s secondary to administering the offending medication. We describe here a 47-year-old woman who was hospitalized with fever, skin rash, hemolytic anemia, lymphadenopathy, eosinophilia, pleural effusion and life threatening hepatitis, which could lead to hepatic failure, within three weeks of starting of dapsone therapy for controlling her oral and genital ulcers. We diagnosed the woman as suffering with DRESS syndrome and we started treatment with corticosteroid. Three weeks after starting therapy, her symptoms almost completely resolved and she was discharged.
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Heme oxygenase-1 (HO-1)은 heme의 분해 대사과정에 관여하는 속도제한효소(rate-limiting enzyme)로 강력한 염증억제작용을 한다고 알려져 있으나 그 작용기전은 잘 알려져 있지 않다. 따라서 본 논문에서는 HO-1이 TNBS 유도 대장염에서 항염증작용이 있는지를 조사하였다. TNBS 유도 대장염을 평가하기 위해 체중변화를 조사하였고 면역조직화학염색법으로 TNF-α, IL-1β 그리고 ICAM-1 등의 염증매개물질의 발현을 조사하였다. HO-1의 발현과 NF-κB의 활성을 조사하기 위하여 IκB-α의 파괴를 Western blot으로 조사하였다. HO-1의 유도제인 CoPPIX 투여군은 TNBS에 의한 체중감소 및 임상 증상, 조직병리학적 변화를 현저히 개선하였으며, 또한 염증의 유지에 중요한 역할을 하는 TNF-α, IL-1β과 ICAM-1의 발현 역시 현저히 억제하였다. 더우기 CoPPIX는 염증의 유도에 매우 중요한 역할을 하는 NF-κB 활성을 현저히 억제하였다. 이러한 CoPPIX의 효과들은 HO-1 활성 억제제인 ZnPPIX에 의해 차단되었다. 이상의 결과로 CoPPIX는 HO-1의 유도를 통하여 NF-κB 활성을 억제함으로써 TNBS에 의해 유도된 만성 대장염의 증상들을 개선시킬 수 있다고 본다. Heme oxygenage-1 (HO-1), rate-limiting enzyme in heme catabolism, has been known to show strong immune-suppressive properties although its mechanisms are not completely understood. In this study, the authors investigated the mechanism whereby HO-1 has anti-inflammatory properties in trinitrobenzene sulfonic acid (TNBS)-induced colitis. Body weight was evaluated and tumor necrosis factor (TNF-α), interleukin (IL)-1β and intercellular adhesion molecule-1 (ICAM-1) were detected by immunohistochemical staining. Heme oxygenase-1 (HO-1) expression was analyzed by Western blot and immunohistochemical staining. In a mouse model, HO-1 inducer, cobalt-protoporphyrin IX (CoPPIX) administration significantly improved the clinical symptoms and histopathologic changes of trinitrobenzene sulfonic acid (TNBS) colitis as well as significantly suppressed the expression of several inflammatory mediators such as TNF-α, IL-1β and ICAM-1 induced by TNBS. Furthermore CoPPIX suppressed NF-κB activation that is an important transcription factor for expression of proinflammatory mediators in TNBS colitis while HO-1 activity inhibitor, zinc protoporphyrin IX (ZnPPIX) reversed the protective effects of CoPPIX in TNBS colitis. Collectively, these results suggest that HO-1 exerts anti-inflammatory effects by down-regulation of NF-κB activity via induction of HO-1 during pathogenesis of TNBS-induced colitis.
Bone homeostasis is regulated by the balance between bone-resorbing osteoclasts and bone-forming osteoblasts. Osteoporosis, rheumatoid arthritis and periodontal disease are related with up-regulated osteoclast formation and its activity. Gol-Swae-Bo(Drynariae Rhizoma) is widely used on skeletal disease. In this study, we sought to examine the effect of Drynariae Rhizoma in RANKL-induced osteoclast differentiation. The extract of Drynariae Rhizoma inhibited RANKL-induced osteoclast differentiation in a dose dependent manner without cytotoxicity. receptor activator of nuclear factor-kB ligand(RANKL) mediated IkB degradation in bone marrow macrophages(BMMs). However, the extract of Drynariae Rhizoma inhibited RANKL induced IkB degradation in BMMs. And mRNA expression of OSCAR, TRAP, c-Fos and NFATc1 was suppressed by the extract of Drynariae Rhizoma. Moreover, the extract of Drynariae Rhizoma inhibited the protein expression of NFATc1 and c-Fos induced by RANKL. After all the analysis, these results suggest that Drynariae Rhizoma may be good candidate of medicine in the treatment of bone-related disease.
Osteoclasts are bone-resorbing giant cells that differentiate from hematopoietic cells of the monocyte/macrophages. Excessive osteoclast differentiation leads to gradual loss of bone mass causing fracture of the skeleton. The aim of this study was to develop a drug candidates for the treatment of osteoporosis. RANKL-induced osteoclast differentiation was dose-dependently inhibited by myricetin. Myricetin inhibited the expression of c-Fos, NFATc1, and TRAP in BMMs treated with RANKL. Myricetin disrupted the structure of actin ring and suppressed osteoclastic bone resorption. Also, myricetin induced apoptosis in mature osteoclasts. Myricetin inhibited the phosphorylation of ERK in mature osteoclasts treated with M-CSF. The activation of caspase-9 and caspase-3 was increased by myricetin treatment. Our results suggest that myricetin may be an effective agent to prevent bone diseases such as osteoporosis.
Bone maintains its homeostasis through balance between bone resorbing osteoclasts and bone forming osteoblasts. Thus, unusual balance between osteoclasts and osteoblasts leads to pathological bone diseases, such as osteoporosis, rheumatoid arthritis, autoimmune arthritis, periodontitis. Schisandra chinensis well known traditional herbal has been used for treatment of diseases in China, Korea, Japan, andothers. Recently, research studies have demonstrated that the lignans found in Schisandra chinensis stimulate osteoblasts and suggest that it may be helpful against osteoporosis. However, the inhibitory effect of water extract of Schisandra chinensis on osteoclast differentiation remains largely unknown. In this study, Water extract of Schisandra chinensis markedly suppressed RANKL-induced osteoclast differentiation in cultures of BMMs without cytotoxicity. The mRNA expression of c-Fos, NFATc1, and TRAP induced by RANKL was inhibited by water extract of Schisandra chinensis. It also suppressed c-Fos and NFATc1 protein expression. Taken together, these results suggest that water extract of Schisandra chinensis has the potential to serve as a treatment of bone disease such as osteoporosis.
Churg-Strauss 증후군에서 위장관 천공은 드물지만 천공 발생시 사망률이 높고 응급 수술이 필요하므로 급성 복통이 있을 경우 반드시 염두에 두고 조기에 치료해야 한다. 또한 적절한 스테로이드의 투여 및 면역억제제 사용을 통해 천공의 위험성을 줄여야 한다. 본 저자들은 Churg-Strauss 증후군 환자에서 동일 부위에 발생한 재발성 소장 천공을 복강경을 통한 봉합과 스테로이드로 치료한 경험이 있어 문헌고찰과 함께 보고하는 바이다. Churg-Strauss syndrome is a rare systemic disorder characterized by asthma, eosionphilia and necrotizing vasculitis affecting small-to-medium-sized vessels. Although it is frequently associated with gastrointestinal mucosal lesions, recurrent bowel perforation is rare and potentially life threatening. We report a case of a 66-year-old man with Churg-Strauss syndrome, who presented with recurrent small bowel perforation. He was admitted with abdominal pain developed previous night, who had a previous small bowel perforation history treated with laparoscopic closure 5 months ago. Laboratory data showed remarkable eosinophilia. Physical examination indicated positive signs of peritoneal irritation in the entire abdomen, and abdominal computed tomography scanning showed edematous small bowel with intra-abdominal free air, suggesting intestinal perforation. He underwent laparoscopic small bowel closure and was treated with steroid.