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        장기요양노인병원에서 발생한 보라색 오줌 증후군 또는 Purple Urine Bag Syndrome 16예 보고 및 문헌 리뷰

        최규동(Gyu-Dong Choi),가혁(Hyuk Ga),박기호(Ki-Ho Park),유병익(Byung-Ik Yoo),김성민(Sung-Min Kim),강문철(Moon-Chul Kang),이은자(Eun-Jah Lee),박승태(Seung-Tae Park) 대한임상노인의학회 2007 대한임상노인의학회지 Vol.8 No.2

        연구배경: 1978년 란셋 잡지에 보라색 소변에 대한 보고가 최초로 있은 이래, 이 현상에 대한 생화학적, 미생물학적, 임상적 규명이 있었다. 보라색 소변은 환자나 환자 가족에게 불편하거나 걱정스러운 질병이다. 그러나 대개의 경우 환자의 건강에 실제적인 위험이 되는 경우는 거의 없다. 심지어 보라색 소변은 열심히 치료할 필요가 없다고 주장하는 사람도 있다. 이에 대조군 연구를 통하여 보라색 소변의 위험요인과 임상적인 의미(심각성)에 대하여 평가를 하고자 한다. 방법: 2007년 2월부터 4월 사이에 인천은혜병원에 입원하고 있는 381명의 환자들 중 도뇨관을 삽입하고 있는 65명을 대상으로 하였다. 이 65명은 65세 이하이거나 1개월 이하동안 도뇨관을 갖고있는 환자는 제외한 숫자이다. 대상 환자는 모두 실리콘제의 폴리카테터와 일회용 소변주머니를 사용하였고 카테터의 교환주기는 특별한 경우 외에는 1개월마다 교환하였다. 대상환자 중 16명이 보라색 소변을 보여, 멸균생리식염수로 방광세척을 한 뒤 카테터와 소변 주머니를 소독된 새 것으로 무균적으로 교환한 뒤 소변배양을 실시하였다. 관련 환자와 대조군의 비교항목들을 통계처리하여 통계적인 유의성을 확인하였으며, 변수의 분석은 신뢰도 95%로(P value 0.05) 카이스퀘어 가설검정과 만-휘트니 U검사를 실시하였다. 결과: 보라색 소변을 보였던 환자들의 나이 평균은 80세였고 전원이 와상상태의 할머니였다. 대상환자의 진단명 중 가장 많은 것은 치매였다. 평균 도뇨기간은 22개월 이었다. 보라색소변을 보인환자군은 보이지 않은 환자들 보다 평균 도뇨기간이 길었으며, 변비가 더 심하였고 변비치료용 좌약 사용빈도가 높았다. 대조군에서는 조사기간 전 1개월 이내에 항생제를 사용한 빈도가 약간 더 높았으나 통계적인 의미는 확실하지 않았다. 결론: 보라색소변은 장기요양노인병원에서 흔히 발생하는 문제이다. 이전 연구들에서 없었던 보라색 소변과 항생제사용과의 관련성 및 변비치료제로 bisacodyl 좌약사용과의 관련성, 소변 카테터의 삽입기간 등에 대한 정보를 추가하여 얻을 수 있었다. Background: Since the first report of purple urine bag syndrome (PUBS) by Barlow and Dickson in 1978, many researchers have tried to reveal the clinical and bacteriological background of this phenomenon. To the best of our knowledge, most of them were case or case series reports and only three were case-control studies which compared the clinical, biochemical, or bacteriological background between patients with and without PUBS. It is certain that PUBS is an uncomfortable or troubling issue for some patients and their families. However, most of the patients who presented with PUBS were, largely, asymptomatic and it is apparent that PUBS is not a disease per se, nor does it appear to represent any real danger to patient's health, and some authors go so far as to even advocate that it is unnecessary to treat PUBS-affected patients aggressively. In this case-control study, we reviewed risk factors and clinical significance of PUBS in geriatric wards. Methods: Of the 381 hospitalized patients in a hospital specialized in the long term care of the elderly handicapped (Incheon Eun-Hye Hospital, Incheon, Korea), 65 patients who featured urinary catheterization during the period from February 2007 and April 2007 were enrolled in this study. Subjects who were younger than 65 or catheterized duration was less than one month were excluded. The same types of silicone Foley balloon catheter and disposable plastic urine bag were used for all patients. Routine Foley catheter change interval was one month. For the 16 patients who exhibits PUBS, bladder irrigation with normal saline and immediate change of urine bag and catheter were performed. And urine culture was done. Variables were statistically analyzed by chi square test or Mann-Whitney's U-test. P values less than 0.05 were considered statistically significant. Results: The PUBS patients mean age was 80, and bed ridden female. Most common diagnosis was dementia. Mean duration of the catheterization was 22 months. The PUBS patients were more constipated than non-PUBS control group and used more bisacodyl suppository. Antibiotics usage within one month before this survey in PUBS group is more frequent than control group with borderline statistical significance. Conclusion: PUBS is frequently occurring problem in long-term care geriatric wards. Causative factors are tryptophan putrefaction (decreased intestinal absorption, motility), alkaline urine, oxygen (air, Foley catheterization). All factors are bacterial infection related. Our results were the same as previous results. Relationship with antibiotics usage, bisacodyl suppository and constipation, long term usage of the Foley catheter notified also. Female predomination is related with easy, frequent urinary infection, and more population in old age.

      • SCOPUSKCI등재

        Quality Bread as Influenced by Sweet Pumpkin Powder

        Yoo, Jung-Sang,Seog, Eun-Ju,Lee, Jun-Ho The Korean Society of Food Science and Nutrition 2006 Preventive Nutrition and Food Science Vol.11 No.4

        Physicochemical properties of bread as influenced by the addition of sweet pumpkin powder (SPP) were investigated. Freeze-dried sweet pumpkin was ground, sieved through a laboratory sieve and a fraction with particles less than $250\;{\mu}m$ was used. Amount of SPP added to the bread was found to affect the bread quality significantly (p<0.05). Loaf volume and weight of the control were significantly higher than others (p<0.05) and decreased significantly (p<0.05) with the addition of SPP. In other words, the enrichment of product with SPP decreased bread volume and weight without significant changes in the moisture content. There were distinctive color changes with the addition of the powder: L- and a-values were reduced but b-value was significantly increased (p<0.05). The hardness, springiness, and gumminess of bread were found to increase with the addition of the powder. Consumer test indicated that bread contained with 3% SPP had the highest overall acceptability score while 1 or 5% addition produced an acceptable quality for the bread.

      • Human epidermal growth factor receptor-2 (HER2) receptor expression and its dynamic change in patients with ovarian cancer

        ( Yoo-na Kim ),( Yun Soo Chung ),( Junsik Park ),( Yong Jae Lee ),( Jung-yun Lee ),( Eun Ji Nam ),( Sang Wun Kim ),( Sunghoon Kim ),( Young Tae Kim ) 대한산부인과학회 2022 대한산부인과학회 학술대회 Vol.108 No.-

        Objective: HER2 targeted drugs are increasingly introduced in non-breast cancers, yet studies on HER2 expression in ovarian cancer patients is lacking. Therefore, we studied HER2 receptor status and its dynamic change in ovarian cancer patients, a subset of whom also underwent next-generation sequencing (NGS). Methods: Ovarian cancer patients who underwent HER2 testing between January 2015 and May 2021 at Yonsei Cancer Hospital were identified. Clinical information, including histology, germline BRCA status, and immunohistochemistry (IHC) profile were noted. For patients receiving multiple time-lagged biopsies, each anatomical location, timing, and HER2 expression were counted. Results: A total of 200 patients with ovarian cancer, mostly advanced stage and high-grade serious histology, were identified. HER2 expressions of 2+ and 3+ were found in 28% and 6% respectively. A total of 33 patients (16.5%) received targeted therapy including Herceptin in 16 patients. With respect to histology, HER2 3+ rate was 23% in mucinous, 11% in endometrioid, 9% in clear cell, and 5% in high-grade serous type. HER2 3+ was exclusively identified in BRCA wildtype, mismatch repair proficient, or PD-L1 low expressing patients. Genomic analysis showed that in HER2 2+ or 3+ patients the TP53 mutation rate was lower and other mutations such as ARID1A, KRAS, PIK3CA were relatively more common, compared to HER2 0 or 1+ patients. CNV analysis showed that 4 out of 5 patients with HER2 3+ showed ERBB2 amplification on NGS. With respect to anatomical distribution, HER2+ and 3+ were frequently identified in ovary and breast biopsy specimen. Out of 20 patients with multiple time-lagged biopsy, 9 patients showed an increase in HER2 expression in the later biopsy sample. Conclusion: Ovarian cancer patients with HER2 overexpression show a distinct histological, IHC, and genomic profile. HER2 targeting agent may serve as a potential option for BRCA wildtype patients, especially in the later lines of treatment.

      • SCOPUSKCI등재

        Clinical outcome of proton therapy for patients with chordomas

        Sang Hee Youn,Kwan Ho Cho,Joo-Young Kim,Boram Ha,Young Kyung Lim,Jong Hwi Jeong,Sang Hyun Lee,Heon Yoo,Ho-Shin Gwak,Sang Hoon Shin,Eun Kyung Hong,Han Kyu Kim,Je Beom Hong 대한방사선종양학회 2018 Radiation Oncology Journal Vol.36 No.3

        Purpose: To investigate the clinical outcome of proton therapy (PT) in patients with chordoma. Materials and Methods: Fifty-eight patients with chordoma treated with PT between June 2007 and December 2015 at the National Cancer Center, Korea, were retrospectively analyzed. The median total dose was 69.6 cobalt gray equivalent (CGE; range, 64.8 to 79.2 CGE). Local progression-free survival (LPFS), distant metastasis-free survival (DMFS), overall survival (OS), and diseasespecific survival (DSS) rates were calculated by the Kaplan - Meier method. Results: With the median follow-up of 42.8 months (range, 4 to 174 months), the 5-year LPFS, DMFS, OS, and DSS rates were 87.9%, 86.7%, 88.3%, and 92.9%, respectively. The tumor location was associated with the patterns of failure: the LPFS rates were lower for cervical tumors (57.1%) than for non-cervical tumors (93.1%) (p = 0.02), and the DMFS rates were lower for sacral tumors (53.5%) than for non-sacral tumors (100%) (p = 0.001). The total dose was associated with both the LPFS rate and DMFS rate. The initial tumor size was associated with the DMFS rate, but was not associated with the LPFS rate. Three patients had grade 3 late toxicity with none ≥grade 4. Conclusion: PT is an effective and safe treatment in patients with chordomas. The tumor location was associated with the patterns of failure: local failure was common in cervical tumors, and distant failure was common in sacral tumors. Further refinement of PT, such as the utilization of intensity modulated PT for cervical tumors, is warranted to improve the outcome.

      • Poster Session : PS 0646 ; Respiratory Medicine ; Growth Promoting Effect of BCG Originated Supplement for Culture of Mycobacterium Tuberculosis

        ( Eun Hee Lee ),( Hye Jin Kim ),( Hyun Ju Jung ),( Haeun Kim ),( Jung Il Choi ),( Jung Heon Yoo ),( Kyung Ock Park ),( Yong Gyun Jung ),( Sung Weon Ryoo ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

        Background: M. tuberculosis culture is major technique for diagnosis of tuberculosis. Owing to the slow growth of M. tuberculosis, development of optimized culture media to enhance Mycobacteria growth rate have been required. Our preliminary data suggested that supplements originated BCG may be suffi cient to improve growth of Mycobacteria. Methods: BCG-Tokyo strains, widely administrated BCG Vaccines, were used as sources to develop the growth promoting supplement. Two species of supplement were prepared in a 4L culture of BCG-Tokyo strains with sauton media. To harvest autolysis portion, BCG-Tokyo extracts were allowed to proceed at 52℃ for 72 hrs in a rotary shakers at 140 rpm with pH 5.4 deionized water contained tween 80. We examined the growth promotion test with different Mycobacterial species, M. tuberculsosis H37Rv and M. Avium. Supplements were evaluated growth rate on the 7H9 broth media and 7H11 agar plate cultures. Results: The enhancing effect of supplements to stimulate culture of M. tuberculosis was represented by liquid medium and solid agar culture systems. Both of supplements showed signifi cant growth promoting effect in the 96well plate with 7H9 broth media calculated at OD 600. As the mycobacteria were plated on the supplements contained 7H11 agar plate, the observed colonies diameter showed larger than control plate. Moreover, when we tested various mixed conditions with routine used growth supplement such as OADC, ADC-tween80 0.5% and FBS, the supplements were represented the effects of advanced TB growth both broth and agar culture systems. Conclusions: According to our results, supplements originated BCG-Tokyo extracts showed an enhancing effect of bacterial growth. These culture supplements should be able to reduce the detection time for diagnosis of Mycobacterium tuberculosis infection.

      • SCIESCOPUSKCI등재

        Reduced Mitochondrial Properties in Putative Progenitor/Stem Cells of Human Keratinocytes

        ( Sung Eun Chang ),( Young Mi Kim Pak ),( Hae Woong Lee ),( Jee Ho Choi ),( Eun Jeong Jeong ),( Seung Ho Choi ),( Hyo Won Chang ),( Yoo Sam Chung ),( Sang Yoon Kim ) 대한피부과학회 2009 Annals of Dermatology Vol.21 No.4

        Background: The characterization of progenitor/keratinocyte stem cells (KSC) remains an unachieved goal. A previous study showed that rapid adhering cells to collagen IV had the characteristics of putative progenitor/KSCs. Objective: The purpose of this study was to investigate the genetic expression of rapid adhering cells compared to non adhering cells to determine the characteristic of KSCs. Methods: We isolated rapid adhering cells representative of KSCs from non adhering cells representative of transient amplifying cells. In addition, we differentiated cells from human tonsilar keratinocytes utilizing the adhering capability of the KSCs to collagen IV. Annealing control primer based differentially displayed polymerase chain reaction (PCR) was performed as well as Western blot analysis. Results: The levels of mitochondria- related gene expression were low in the rapid adhering cells compared to the non adhering cells. Mitochondrial complex I, COX IV, peroxiredoxins (I, II and IV) and mitochondrial membrane potential were all low in the rapid adhering cells compared to the non adhering cells. Conclusion: Using an adhesion method on human collagen IV-coated plates, our results suggest that reduced mitochondrial function may be an important characteristic of KSCs. (Ann Dermatol 21(4) 364~368, 2009)

      • Epithelial Cells: Involvement of p38 and Extracellular Signal-Regulated Kinase Signaling Pathways

        ( Eun Young Choi ),( Hyun Mee Oh ),( Hyun Ju Lee ),( Sang Wook Kim ),( Geom Seog Seo ),( Young Woo Sohn ),( Kyo Sang Yoo ),( Tae Hyeon Kim ),( Suck Chei Choi ),( Chang Duk Jun ),( Yong Ho Nah ) 대한소화기학회 2003 대한소화기학회 추계학술대회 Vol.2003 No.-

        <Purpose/Aims> Competition for cellular iron (Fe) is a vital component of the interaction between host and pathogen. Most bacteria have an obligate requirement for Fe to sustain infection, growth and survival in host. To obtain iron required for growth, m

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