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      • SCIEKCI등재

        Predicting postoperative total calcium requirements after parathyroidectomy in secondary hyperparathyroidism

        ( Byung Heon Kang ),( Soon Young Hwang ),( Jeong Yeop Kim ),( Yu Ah Hong ),( Mi Yeon Jung ),( Eun Ah Lee ),( Ji Eun Lee3 ),( Jae Bok Lee ),( Gang Jee Ko ),( Heui Jung Pyo ),( Young Joo Kwon ) 대한내과학회 2015 The Korean Journal of Internal Medicine Vol.30 No.6

        Background/Aims: To prevent hypocalcemia after parathyroidectomy (PTX), parenteral calcium is required in addition to oral calcitriol and calcium. After switching to oral calcium, patients can be discharged from the hospital. The aim of this study was to analyze the clinical characteristics and outcomes of PTX performed at a single Korean center and to investigate the associated laboratory factors used to analyze the total amount of postoperative calcium required. Methods: We enrolled 91 hemodialysis patients undergoing PTX from November 2003 to December 2011. We collected clinical and laboratory data preoperatively, 12 and 48 hours postoperatively, at discharge, and 3 and 6 months postoperatively. Results: In total, 59 patients underwent PTX with autotransplantation (AT), 6 underwent total PTX without AT, 11 underwent subtotal PTX, and 15 underwent limited PTX. Total PTX without AT showed the lowest recurrence rate. At all postoperative time points, the mean levels of serum calcium, phosphorus, and intact parathyroid hormone (iPTH) decreased significantly, compared with preoperative levels; however, alkaline phosphatase (ALP) increased significantly from 48 hours postoperatively to discharge (p < 0.001). On multiple linear regression analysis, the total amount of injected calcium during hospitalization showed a significant correlation with preoperative ALP (p < 0.001), preoperative iPTH (p = 0.037), and Δphosphorus at 48 hours (p < 0.001). We developed an equation for estimating the total calcium requirement after PTX. Conclusions: Preoperative ALP, preoperative iPTH, and Δphosphorus at 48 hours may be significant factors in estimating the postoperative calcium requirement. The formula for postoperative calcium requirement after PTX may help to predict the duration of postoperative hospitalization.

      • KCI등재후보

        조혈모세포이식 환자에서 침습성 진균 감염에 대한 Micafungin의 예방 효과 및 안전성

        김시현,이동건,최수미,권재철,박선희,최정현,유진홍,이성은,조병식,김유진,이석,김희제,민창기,조석구,김동욱,이종욱,민우성,박종원 대한감염학회 2010 감염과 화학요법 Vol.42 No.3

        Background: Micafungin, a potent inhibitor of 1,3-β-D-glucan synthase, is a novel antifungal agent of the echinocandin class. In vitro study showed that micafungin was effective against Aspergillus species as well as Candida species, but clinical data on the prophylactic efficacy against invasive fungal infections (IFIs) other than candidiasis are still lacking. Materials and Methods: We identified 60 consecutive adult hematopoietic stem cell transplantation (HSCT) recipients who received at least 3 doses of micafungin during neutropenic period. Micafungin was started as an alternative in patients who were intolerant or had adverse events (AEs) to primary prophylactic antifungal agents. We retrospectively reviewed the medical records and analyzed the efficacy and safety of micafungin for prophylaxis against IFIs. Results: The patients either had autologous (n=9) or allogeneic (n=51: 1 syngeneic, 24 sibling, 26 unrelated donor) HSCT. Itraconazole oral solution (n=58) was the most frequently used first line antifungal agent for prophylaxis and was administered for median 11 days. The most frequent cause of switch to micafungin was vomiting (n=42). The duration of neutropenia and micafungin administration was median 13 and 12 days, respectively. A successful outcome was achieved in 45 (75%) patients. Empirical antifungal therapy was initiated in 13 (22%) patients. There were 2 cases (3.3%) of breakthrough fungal infections which comprised a probable invasive pulmonary aspergillosis and a possible invasive fungal sinusitis. There was no case of invasive candidiasis. A total of 53 (88%) patients experienced at least one AE regardless of causality during micafungin administration. The most frequent AEs were hypokalemia, vomiting, diarrhea, and elevated serum aspartate aminotransferase or alanine aminotransferase. Among the aforementioned AEs, only 1 case of diarrhea could be classified as a probable relation with micafungin when causality was assessed. There was no AEs that caused discontinuation of micafungin. Conclusions: Micafungin seems to be a safe and effective agent for prophylaxis of IFIs including aspergillosis as well as candidiasis in HSCT recipients. However, further large, prospective, and randomized comparative studies are warranted for aspergillosis.

      • KCI등재후보

        위절제술 환자의 표준진료지침 개발 및 적용 효과

        김은희,김철규,이순교,김순덕,이혜옥,권정순,이경미,이민미,심순미,유용만,신종식,강은희,이상일,김병식,오성태,육정환,박수길 한국의료QA학회 2003 한국의료질향상학회지 Vol.10 No.2

        Background : Gastric cancer is the most common malignant tumor in Korea. surgical operation is one of the major treatment modalities for gastric cancer patients. Therefore, gastrectomy is one of the most common procedures in General Surgery. There were variation in length of hospital stay and medical treatment for gastrectomy between three surgeons at Asan Medical Center. Clinical pathways have received considerable attention as a tool for recucing the medical practice variation, increasing the efficiency of care process, and improving the quality of care. The aim of this study was to evaluate the effect of a clinical pathway for gastrectomy in gastric cancer patients. Methods : The clinical pathway for gastrectomy was developed and implemented by a multidisciplinary group in Asan Medical Center. A computerized clinical pathway program was developed and revised after a pilot test. A total of 145 patients underwent gastrectomy by three surgeons at Asan Medical Center. We compared the length of hospital stay, patient satisfaction, and unplanned readmission rate between the pre-pathway group(n=67) and the post-pathway group(n=78). We also investigated the degree of satisfaction among the physicians and nurses who were main end-users of the clinical pathway. Results : The clinical pathway was applied to all target patients. The average length of hospital stay was shortened from 12.7days to 10.6days(p<0.01). The degree of patient satisfaction with the care process changed from 90.3% to 89.2% after the implementation of the clinical pathway, but the difference was of satistically significant(p=0.761). Unplanned readmission rate was 2.9% in the pre-pathway group. More than 90% of physicians and nurses answered that the clinical pathway had been a useful tool in their medical practice. Conclusions : The findings of the study demonstrated that implementation of the clinical pathway for gastrectomy produced substantial reduction in the length of hospital stay while improving the quality of patient outcomes. The computerized clinical pathway program can be used as one of the powerful patient management tools for reducing the practice variations and increasing the efficiency of care process in Korea hospital settings.

      • KCI등재후보

        전통누룩 진균류를 이용한 입국의 제조 및 입국곰팡이의 동정

        김재호 ( Jae Ho Kim ),권영희 ( Young Hee Kwon ),이애란 ( Ae Ran Lee ),김혜련 ( Hye Ryun Kim ),안병학 ( Byung Hak Ahn ) 한국균학회 2012 韓國菌學會誌 Vol.40 No.4

        다양한 향미를 가진 막걸리의 개발을 위해 전통누룩으로부터 분리한 곰팡이로 입국을 제조한 후 품질특성을 분석하여 입국의 규격에 적합하며 이취가 없고 관능이 우수한 9균주를 입국 제조용 우수균주로 최종 선발하였다. 선발된 균주는 Aspergillus oryzae(C1-5-2-2, C20-7-3, CN1.3.1-4, CN16.19.1-1, N152-1, N220-1), Mycocladus corymbiferus (N162-2), Rhizopus oryzae(N20), Lichtheimia corymbifera (N21)로 동정되었으며, 제조한 입국의 산도는 5.0~6.8, 당화력은 128~241sp이었다. Various koji were prepared by fungi isolated from traditional nuruk and their quality characteristics were investigated. Acidity and saccharification power of their koji were ranged in 5.0~6.8 and 128sp~241sp. Nine fungi which were showed good quality and sensory evaluation were identified by analysis of their nucleotide sequences with PCR-amplified 18S rDNA internal transcribed spacer-1(ITS-1) and ITS-4 genes. Among them, six strains were identified as Aspergillus oryzae and the other strains were identified as Mycocladus corymbiferus, Rhizopus oryzae, Lichtheimia corymbifera.

      • 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.

      • 越鞠丸合補中益氣湯이 電氣刺戟스트레스를 받은 mouse의 免疫機能에 미치는 影響

        權泰植,李淑慶,具炳壽 동국대학교 한의학연구소 2000 東國韓醫學硏究所論文集 Vol.9 No.-

        본 실험은 越鞠丸合補中益氣湯의 항스트레효과를 조사하기 위하여 시행되었다. 越鞠丸合補中益氣湯이 전기자극으로 스트레스 상황을 유발시킨 mouse에게 끼친 B 임파구 면역계 변화를 mouse 혈청의 綿羊赤血球에 대한 적혈구 응집소가와 비장세포에서 B 세포 및 T 세포가 차지하는 백분율의 변화를 통하여 측정하였으며 이를 대조군과 비교 분석하였다. 혈청 항체가의 측정에서 스트레스 자극하에서 越鞠丸合補中益氣湯을 투여받은 그룹에서 약제를 투여받지 않은 그룹에 비하여 유의성 있는 차이를 보여(p<0.01) 면역 기능을 정상군의 수준으로 유지하는 결과를 얻었다. T 세포와 B 세포의 백분율의 측정에서도 스트레스 자극하에서 越鞠丸合補中益氣湯을 투여 받은 그룹에서 약제를 투여 받지 않은 그룹에 비하여 유의성 있는 차이를 보여(p,0.01) 면역 기능을 정상군의 수준으로 유지하는 결과를 얻었다. 실험결과들로 보아 越鞠丸合補中益氣湯이 체액성 면역 반응과 비장 내 면역 세포의 백분율을 정상의 수준으로 유지하는 효과를 보여 면역 기능의 이상에 응용할 수 있는 가능성을 제시한다고 사료된다. The present experiments were designed to study the influence of Walgookwhanhab-Bojoongikgitang on immune functions of Balb/c mice under stress condition. Walgookwhanhab-Bojoongikgitang was orally administered to the mice for 15 days. On the 10th day the mice were immunized with sheep red blood cells (SRBC) and then subjected to electric footshock for 5 days (2 sessions a day, 11 footshocks a 31 min-session). The immune responses to SRBC were determined by means of hemagglutination and B / T cell populations in the spleen were studied by FACS analysis on the 16th day. The results were as follows. 1. After electric footshock, mice became sluggish and crowded to one side of the cage. Increased antibody titer for SRBC, increased B cell population, and decreased 7 cell population in the spleen were also observed. These results confirm that electric footshock caused stress inducing immunological and behavioral changes in Balb/c mice. 2. Walgookwhanhab-Bojoongikgitang administration significantly antagonized the effect of electric footshock on the antibody titer for SRBC. As a result, antibody titers for SRBC in the mice treated with Walgookwhanga-Bojoongikgitang were maintained at the similar levels as those of control group mice even after the electric footshock. 3. Walgookwhanhab-Bojoongikgitang administration also antagonized the effect of electric footshock on the B / T populations in spleen. As a result, B and T populations in the mice treated with Walgookwhanhab-Bojoongikgitang were maintained at the similar levels as in the control group mice even after the electric footshock. Taken together, M algookwhanhab-Bojoongikgitang seem to help Balb/c mice to maintain their humoral immune response and immune cell populations at a normal range under the stress conditions, suggesting its possible therapeutic use as a immune function modulator.

      • Mokpo-MS를 利用한 F_1用種子 採種方法과 採種能力

        權炳善,文溶植,李鍾一 조선대학교 농업연구소 1982 農業硏究 Vol.1982 No.1

        成分改良된 Mokpo-MS를 利用하여 F_l用種子 採種方法과 採種能力을 究明코자 實驗한바 MS와 花粉親間 의 交互栽植時에 10a 當 F_l採種量은 어느 組合에서나 다 같이 MS 1 畦, 花粉親 1畦 交互畦栽植에서118~127kg의 F_l採種量을 얻었고 MS 2 畦, 花粉親 1 畦 交互畦 栽植에서는 101~ 118Kg, MS 3 畦, 花粉親 1 畦 交互畦 栽植에서는 86~89Kg의 F_l採種量을 얻었다. The F_1 seed production in per l0a has been produced by 118kg to 120kg with the one row planting of pollen parents and one row alternate planting of Mokpo-MS. The other hand, two rows planting of Mokpo-MS and one row alternate planting of pollen parents has been to produced by 101kg to 118kg and three rows planting of Mokpo-MS and one row alter nate planting of pollen parents has been produced by 86 to kg in F-l seed production.

      • 油菜의 人爲突然變異 利用에 의한 M₂世代의 莢長, 一莢結實數 및 一莢胚珠數의 變異體 選拔

        李鍾一,權炳善 順天大學校 1985 論文集 Vol.4 No.1

        本 試驗은 耐寒油菜, 榮山油菜, 木浦5號의 油菜種子에 r-ray 30KR를 照射하여 有用變異體를 選拔하고자 實施하였으며 M₂世代에 出現하는 莢長, 一莢結實數, 一莢胚珠數의 變異體에 대하여 調査한 結果를 要約하면 다음과 같다. 1. r-ray 30KR를 照射하므로서 莢長은 母種에 비하여 97% 程度가 길게 나타났고 一莢結實數는 90%, 一莢胚珠數는 85% 程度가 많은 方向으로 나타났다. 2. 長莢, 多粒의 有用形質을 갖춘 變異體를 耐寒油菜에서 1系統, 榮山油菜에서 1系統, 木浦5號에서 2系統을 各各 選拔하였다. This experiment was conducted to select useful mutants in three rapeseed varieties, Naehan, Yeongsan and Mokpo-59, treated with gamma-ray 30KR. One hundred and ninety seven mutant lines in Naehan, 131 in yeongsan and 256 in Mokpo-59 were evaluated for number of seeds, pod length and ovules per pod compared with their mother varieties in M₂generation. The results obtained are summarized as follows: More than 97%of the mutants longer for the pod length and 90% were more in number of seeds. The mutants in the M₂generation were able to be selected. One mutant line in Naehan and Yeongsan, and two mutant lines in Mokpo-59 were selected for longer pod length, more seed and ovules per pod respectively.

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