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        뇌혈관 협착 환자에서 SPM과 확률뇌지도를 이용한 기저/아세타졸아미드 SPECT의 정량적 분석법의 유용성

        이호영,이동수,팽진철,오창완,조맹제,정준기,이명철 대한핵의학회 2002 핵의학 분자영상 Vol.36 No.6

        목적: 뇌혈관질환에 있어서 뇌혈류와 뇌혈류예비능을 기저/아세타졸아미드 뇌혈류SPECT로 평가 가능하나 재관류 수술효과를 비교 평가하기 위해서는 정량적인 평가가 필요하다. 대상 및 방법: 12명의 환자(51±15세, 남:녀=6:6)의 수술 전후 기저 시와 아세타졸아미드 부하 뇌관류 SPECT를 SPM에서 공간정규화하고 소뇌의 계수를 기준으로 계수정규화한 후 확률뇌지도(statistical probabilistic anatomical map, SPAM)를 이용하여 부위별 혈류를 정량화하였다. 이 결과로부터 수술 전후 및 정상대조군(59±15세, 남:녀=10:11)과의 비교를 McNemar test와Mann-Whiteny test를 이용하여 비교하였다. 혈류예비능은 기저 시와 부하시의 차이를 기저 시 계수를 기준으로 백분율로 표현하였다. 결과: 수술 후 수술 부위의 기저 시와 아세타졸아미드 부하 시 혈류 그리고 혈류예비능 모두가 유의하게 향상되었다(p<0.05). 정상군과의 비교에 있어서는 기저 시 혈류는 정상군과 차이가 없을 정도로 호전되었으나, 아세타졸아미드 부하시 혈류와 혈류예비능은 수술 후에도 유의한 차이를 보였다(p<0.05). 혈류예비능은 주로 수술부위를 중심으로 향상되었다. 결론: SPM 및 SPAM을 이용하여 기저/아세타졸아미드 뇌혈류 SPECT의 수술 전후결과를 정량적, 객관적으로 쉽게 비교 평가할 수 있다. Purpose: While cerebral blood flow and cerebrovascular reserve could be evaluated with basal/acetazolamide Tc-99m-HMPAO SPECT in cerebrovascular disease, objective quantification is necessary to assess the efficacy of the revasculariztion. In this study we adopted the SPM method to quantify basal cerebral blood flow and cerebrovascular reserve on basal/acetazolamide SPECT in assessment of the patients who underwent bypass surgery for linternal carotid artery (ICA) stenosis. Materials and Methods: Twelve patients (51±15 years) with ICA stenosis were enrolled. Tc-99m-HMPAO basal/acetazolamide perfusion SPECT was performed before and after bypass surgery. After spatial and count normalization to cerebellum, basal cerebral blood flow and cerebrovascular reserve were compared with 21 age-matched normal controls and postoperative changes of regional blood flow and reserve were assessed by Statistical Parametric Mapping method. Mean pixel values of each brain region were calculated using probabilistic anatomical map of lobes. Perfusion reserve was defined as the % changes after acetazolamide over basal counts. Results: Preoperative cerebral blood flow and cerebrovascular reserve were significantly decreased in involved ICA territory, comparing with normal control (p<0.05). Postoperative improvement of cerebral blood flow and cerebrovascular reserve was observed in grafted ICA territories, but cerebrovascular reserve remained with significant difference with normal control. Improvement of the cerebrovascular reserve was most prominent in the superior temporal and the angular gyrus, nearest to the anastomosis sites. Conclusion: Using SPM quantification method on basal/acetazolamide Tc-99m-HMPAO SPECT, the cerebral blood flow and cerebrovascular reserve could be assessed before revascularization and so could the efficacy of the bypass surgery. (Korean J Nucl Med 2002;36;357-67)

      • 최대근력부하와 폭발적 근력부하에 의한 신경-근피로와 그 회복과정 비교 분석

        유관호,이무연,이승훈,김민섭,육조영,임정일,임완기,김대경 한국스포츠리서치 2004 한국 스포츠 리서치 Vol.15 No.5

        The result which was gained from this study is as follows. From the conclusion of this study it was confirmed that resistant motion at high level strength brings about rise in density of lactate in blood at the same time decline of muscular power and generates acute fatigue of nerve-muscle accompanied by decline in electrical activity of muscle. On the other hand explosive loading produced fatigue at body center and decline in nervine-muscular activity particularly for men, In case of women explosive load did not produce fatigue in the same level as men and they were also quicker in recovery after exercise. Based on 2 types of loading method used in this study there was clearly difference in the process of restoration from resistant motion. For greater decline in muscular power and electromyogram activity more longer period of recovery was require.

      • 동종 조혈모세포이식 후 발생한 크립토콕쿠스 척추염 1예

        고윤호,임동준,이성수,조유경,이동건,최정현,김유진,민창기,김동욱,박정미,김춘추,신완식 대한감염학회 2001 감염 Vol.33 No.4

        Skeletal cryptococcosis is an uncommon infection. Cryptococcus is a common cause of meningitis and infects 7∼10% of patients with AIDS. As well as AIDS, the infection may be seen in association with leukemia, lymphoma, Hodgkin's disease, sarcoidosis, tuberculosis and diabetes, also in patients on steroid medication. But there is no case report of skeletal cryptococcosis following allogeneic hematopoietic stem cell transplantation. A 40-year-old woman was admitted to the hospital because of low back pain. She had chronic myelogenous leukemia for 2 years and underwent allogeneic hematopoietic stem cell transplantation 8 months ago. She have been treated with steroid and cyclosporine orally because of chronic graft versus host disease. On examination she was afebrile and had posterior lower lumbar tenderness. But, she had no reduced strength of low extremities. Open biopsy was underwent. Histology demonstrated budding, round-to-oval, refractile yeast-like organisms within debris. The results of a lumbar puncture were unremarkable and cerebrospinal fluid culture failed to grow bacteria and yeast. The patient was treated with amphotericin B (1 gram) and AmBisome□ (2.8 gram) over 6 weeks. Three months after cessation of therapy, the patient was doing well.(Korean J Infect Dis 33:298∼301, 2001)

      • 그람음성 간균의 수술후 상기도 정착에 관한 연구

        석민호,김완식,조양자 한양대학교 의과대학 1987 한양의대 학술지 Vol.7 No.1

        Upper respiratory colonization and subsequent postoperative pneumonia caused by gram-negative bacilli are increased in patients undergoing surgical procedure. The present study was to investigate the effect of surgical procedure on postoperative respiratory colonization and subsequent infection caused by gram-negative bacilli. Among patients undergoing various major and minor operations at Hanyang university hospital during the months of November and December of 1985, 50 patients were chosen to evaluate the changes in upper respirtory colonization by gram-negative bacilli and receptivity of buccal epithelial cells to Pseudomonas aeruginosa, a common respiratory colonizer and pathogen. Upper respiratory colonization by gram-negative bacilli was significantly increased from preoperative 10% (5/50) to postoperative 29% (13/45). Klebisiella pneumoniae was the most frequent postopertative isolate (4 strains). Viability of buccal epithelial cells was decresed postoperaively (P<0.05). Receptivity of buccal epithelial cell to Pseudomonas aeruginosa was increased postoperatively (P<0.001) in mean numbers of attached bacteria per cell and in numbers of cells with minimal numbers of attached bacteria and these two parameters were extremely correlated (=0.999). Upper respiratory colonization rate of gram-negative bacilli and increase in receptivity of buccal epithelial cells to Pseudomonas aeruginosa was significantly greater in patients whose operation took more than 2 hours than in those whose operation lasted less than 2 hours (P<0.001). Data obtained in the present study suggest that changes in surface binding properties of upper respiratory epithelium may be an important factor in predisposing to postoperative respiratory infection by gram-negative bacilli.

      • Java/qmail을 활용한 인터넷 메시지 시스템 설계 및 구현

        이호성,이충세,조완섭 충북대학교 컴퓨터정보통신 연구소 2001 컴퓨터정보통신연구 Vol.9 No.1

        90년대 중반부터 국내에 인터넷 붐이 일어나고 사용이 보편화되면서 전자메일은 개인간의 메시지를 가능하게 해주는 기반기술 중 하나로 자리잡고 있다. 기존의 POP(Post Office Protocol) 프로토콜을 이용하던 전자메일 시스템은 별도의 환경설정 없이 지역, 언어, 시간에 제약이 없는 웹기반의 메시지 시스템으로 발전하고 있다. 현재 웹기반 메시지 시스템에 사용되어지는 MTA(Mail Transfer Agent)로는 sendmail이 사실상의 표준으로 받아 들여지고 있다. 그러나 sendmail은 단일 모듈로 작성되었으며, 사이즈가 매우 크고, 보안상의 문제점도 지적되고 있다. 이에 본 논문에서는 sendmail의 문제점을 효율적으로 해결할 수 있는 qmail의 활용방법을 제시하고, 웹과 qmail을 연계할 수 있도록 자바를 통한 웹기반 인터넷 메시지 시스템을 설계 및 구현한다. The rapid growth of the internet and World-Wide Web(WWW) has allowed more people access to global computer network and network applications. Internet Service Provider profit by offering many kinds of Internet services such as electronic mail, WWW, FTP, and others. Electronic mail service is one of the most popular and essential services in Internet. so, it called "killer application". Mail server is a computer system that sends and receives electronic message for a number of users in a certain management domain. Mail servers are connected to networks and should reliably process incoming and outgoing mail messages. Sending and receiving tasks are actually processed by a special software called mail transfer agent in the mail server(e.g., sendmail or qmail). In this paper, we present the design and implementation of Internet message system. The system integrates two different technologies - the qmail an Java servlet. Our system combines advantages from both technologies so users may remotely manage their mail system easily and effectively.

      • KCI등재

        타리비드 정(오플록사신 100㎎)에 대한 파비드 정의 생물학적동등성

        박완수,조성희,이헌우,임호택,홍성제,서성훈,류재환,이경태 한국약제학회 2005 Journal of Pharmaceutical Investigation Vol.35 No.1

        The purpose of the present study was designed to evaluate the bioequivalence of two ofloxacin tablets, Tarivid (Jell Pharm. Co., Ltd.) and Favid (ILHWA Co., Ltd.), according to the guidelines of Korea Food and Drug Administration (KFDA). Twenty-four normal male volunteers, 23.67±3.12 year in age and 68.50±7.23 kg in body weight, were divided into two groups and a randomized 2x2 cross-over study was employed. After four tablets containing 100 mg of ofloxacin were orally administered, blood was taken at predetermined time intervals and concentrations of ofloxacin in plasma were deter mined using HPLC. Pharmacokinetic parameters such as AUC_(t) and T_(max) were calculated and ANOVA test was utilized for the statistical analysis of the parameters using logarithmically transformed AUC_(t), and C_(max) and untransformed T_(max). There were no sequence effects between two formulations in these parameters. The 90% confidence intervals for the log transformed data were acceptance range of log 0.8 to log 1.25 (e.g., log 0.94-log 1.04 and log 0.90-log 1.07 for AUC_(t) and C_(max) respectively). The major parameters. AUC_(t) and C_(max) met the criteria of KDFA for bioequivalence indicating that Favid tablet is bioequivalent to Tarivid tablet.

      • Thermoplasma acidophilum의 20S Proteasome에 의한 ATPase-활성적 단백질분해에 관한 연구

        우기민,장예진,조만희,김창세,김완종,조성호,이상한 순천향의학연구소 1999 Journal of Soonchunhyang Medical Science Vol.5 No.1

        The eukaryotic 26S proteasome is an ATP/ubiquitin-dependent proteolytic complex consisting of the 20S core particle and 19S ATPase complex. However, because of its complexity and unstable properties, this study was carried out to present more simple and stable model for the ATP-activated proteolytic complex in prokaryotes which can take the place of the eukaryotic 26S proteasome. For this purpose, recombinant Thermoplasma 20S proteasome (T20S) and Methanococcus MS4, a sequence homolog of one ATPase subunit in the 19S ATPase complex, were successfully isolated from Escherichia coli (E. coli). The α and β subunits of T20S expressed in E. coli could assemble for themselves, and showed the peptide-hydrolyzing activity. Whereas both T20S and R20S (the 20S complex from rabbit skeletal muscle) had the highest peptidase activity against Suc-LLVY-AMC, a good substrate for chymotrypsin-like peptidase activity, the specific activity of T20S was slightly lower than that of R20S. In addition, several reagents such as KCI, SDS, and ovalbumin were shown to have different effects on the peptidase activities between T20S and R20S. When the ATPase activity of the purified MS4 were assayed , the Km for ATP was about 0.5 mM, and casein could stimulate the activity more than 2 fold without the change in Km. This result implicates that protein-activated ATPase may induce the conformational change of casein, and therefore suggests that MS4 ATPase may activate the proteolytic activity of the 20S proteasome via accelerating the recognition and translocation of the protein substrates.

      • KCI등재후보

        국내 의료기관의 항생제 사용 실태와 규제 시스템 조사

        방지환,송경호,박완범,김성한,조재현,김홍빈,김남중,오명돈,최강원 대한감염학회 2006 감염과 화학요법 Vol.38 No.6

        목적 : 이전 연구들에 따르면 아직까지 국내에서 불필요한 항생제 사용은 무시할 수 없는 수준이며, 특히, 수술환자들에 대한 예방적 항생제 투여가 문제로 지적되고 있다. 많은 병원에서 불필요한 항생제 처방을 제한하려는 노력을 하고 있지만 구체적인 현황에 대한 자료는 적은 실정이다. 이에 본 연구자 등은 국내 의료기관의 항생제 규제 시스템의 현황과 수술시 예방적 항생제 사용의 적정성을 알아보고자 한다. 재료 및 방법 : 전임 감염내과 전문의가 근무하는 의료기관 55곳에 대해 설문조사를 시행하였다. 설문의 내용은 적정한 항생제 사용을 유도하기 위한 정책 및 규제 프로그램, 실제 각 의료기관의 예방적 항생제 사용 현황 등으로 이루어져 있다. 결과 : 55개의 의료기관에 보낸 설문 중 44개가 회수되었다. 회신한 의료기관에서 항생제 처방 관리는 제한항생제 시스템을 가장 많이 이용하고 있었고(95.5%), 항생제에 대한 교육(79.5%), 전산시스템에서 관리(59.1%), 감염내과에 의뢰(54.5%), 항생제 사용 실적 검토(52.3%) 등의 순이었다. 대개의 병원에서 glycopeptides (100.0%), carbapenems (93.0%), quinupristin/dalfopristin 또는 linezolid(93.0%), 4세대 cephalosporin (74.4%), caspofungin 또는 voriconazole (62.8%), liposomal amphotericin B (60.5%) 등을 제한항생제로 분류하여 관리하고 있었다. 모든 의료기관에서 위절제술 및 유방절제술시에 불필요하게 예방적 항생제를 사용하고 있었다. 슬관절치환술의 경우 2세대 cephalosporin을 예방적으로 사용하는 경우가 가장 많았으며(30.2%), 관상동맥우회술의 경우 3세대 cephalosporin을 예방적으로 사용하는 경우가 가장 많았다(47.2%). 예방적 항생제의 투여 기간을 살펴보면 위절제술시 70.5%에서 4일을 초과하여 사용하고 있었고, 유방절제술시에는 63.6%에서, 슬관절치환술시에는 81.8%에서, 관동맥우회술시에는 81.1%에서 4일을 초과하여 장기간 예방적 항생제를 투여하고 있었다. 한편, 예방적 항생제 투여시 aminoglycoside계 항생제를 병용하는 경우도 많았다. 결론 : 아직까지 국내 의료기관에서 항생제 오남용을 막기 위한 노력이 더 필요할 것으로 생각되며, 특히 수술시 예방적 항생제의 올바른 투여에 많은 관심이 필요하다. Background : Previous studies in Korea showed that unnecessary antibiotic use could not be neglected, especially in prophylactic use. Currently many hospitals employ diverse antibiotic stewardship programs, but there are few studies on surveillance of such programs. So, we planned this study to evaluate current status of antimicrobial stewardship and adequacy of antimicrobial prophylaxis in surgery. Materials and Methods : We sent questionnaires about policy on antibiotic usage, control program for adequate antibiotic prescription, and actual status of prophylactic antibiotic usage to 55 infectious disease physicians in each hospital. Results : Of 55 contacted infectious diseases clinicians, 44 answered the questionnaire. Majority of hospitals employed restricted antimicrobial system (95.5%), education (79.5%), control by order communicating system (59.1%), consult to infectious disease physicians (59.1%), and review of cumulative antimicrobial usage (52.3%) to prevent inadequate antibiotic use. Glycopeptides were designated as a restricted antimicrobial agent in 100.0% of hospitals; carbapenems, 93.0%; quinupristin/ dalfopristin or linezolid, 93.0%; the 4th generation cephalosporins, 74.4%; caspofungin or voriconazole, 62.8%; liposomal amphotericin B, 60.5%, and so on. Unnecessary perioperative prophylactic antimicrobial agents were prescribed in gastrectomy and mastectomy in all the hospitals. The second generation cephalosporins and the third generation cephalosporins were the most commonly prescribed prophylactic antimicrobial agents in total knee replacement arthroplasty (TKRA) and coronary artery bypass graft surgery (CABG) respectively. In 70.5% of institutes they use prophylactic antimicrobial agents more than four days in gastrectomy; 63.6% in mastectomy; 81.8% in TKRA; 81.1% in CABG. Unnecessary combination of aminoglycosides with other antimicrobial agents for prophylactic use was another common problem. Conclusion : This study shows that more effort is required to diminish antimicrobial misuse or overuse, especially in prophylactic use for surgical patients.

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