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권호별목차 / 소장처보기

H : 소장처정보

T : 목차정보

The Korean journal of internal medicine : KJIM 16건

  1. [국내논문]   Effects of Nitric Oxide (NO) Synthesis Inhibition on Antitumor Responses during Interleukin-2 (IL-2) Treatment of Mice  

    Yim, Chang-Yeol (Department of Nuclear Medicine, Chonbuk National University Medical School, Chonju, Chonbuk 560-182, Korea) , Lee, Chang-Whan , Choi, Soo-Mee , Park, Sang-Suk , Lee, Sung-Joong , Kim, Jae-Hean , Song, Jung-Sun , Yoo, Wan-Hee , Kwak, Jae-Yong , Sohn, Myung-Hee
    The Korean journal of internal medicine : KJIM v.11 no.2 ,pp. 93 - 100 , 1996 , 1226-3303 ,

    초록

    Objectives To evaluate if L-arginine: NO pathway is activated in tumor tissues during IL-2 therapy and to evaluate whether IL-2 induced NO synthesis represents an antitumor effector muchanism or an inhibitory factor against therapeutic effects of IL-2. Methods Four groups[untreated control, N G -monomethyl-L-arginine(MLA) therapy only, IL-2 therapy only, IL-2/MLA therapy groups] of BALB/c mice were injected intraperitoneally with 2×10 6 Meth A tumor cells on day 0. MLA was administered subcutaneously with Alzet continuous infusion pumps on day 2. IL-2 therapy (180,000 IU s.c. every 12h for 5 days) was started on day 3. NO production within ascites tumors was assessed by measuring nitrite concentrations in cultures of ascites cells harvested on day 8. Survival and the rate of body weight increment of the mice were measured to evaluate therapeutic responses. Daily urinary nitrate excretion was monitored to demonstrate the effectiveness of MLA in inhibiting NO synthesis. Results Nitrite production in supernatants of Meth A ascites cell cultures was 63±14 μM in IL-2 treated mice and 3.2±1.5 μM in untreated controls (p Conclusion L-arginine: NO pathway can be activated in malignant ascites, by IL-2 therapy and NO synthesis functions as an inhibitory mechanism against IL-2 induced anti-tumor effects.

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  2. [국내논문]   DNA Ploidy and Proliferative Activity in bcl-2 Expressed Non-small Cell lung Cancer  

    Kim, Young-Chul (Department of Internal Medicine & Pathology, Chonnam National University Hospital, 8 Hakdong, Dongku, 501-757, Kwangju, Korea ) , Park, Kyung-Ok (Department of Internal Medicine & Pathology, Chonnam National University Hospital, 8 Hakdong, Dongku, 501-757, Kwangju, Korea) , Kim, Hyeoung-Joon , Choi, In-Seon , Park, Chang-Soo , Juhng, Sang-Woo
    The Korean journal of internal medicine : KJIM v.11 no.2 ,pp. 101 - 107 , 1996 , 1226-3303 ,

    초록

    Objectives The expressions of bcl-2 have been reported recently in non-small cell lung carcinoma (NSCLC * ). As oncogensis is believed to involve a number of genetic alterations, there can be differences in DNA ploidy or proliferative activity even in bcl-2 positive cases according to the superimposed genetic events. Subjects and Methods On the assumption that we might further discern the biologic behavior of bcl-2 positive NSCLC according to the status of DNA ploidy and proliferative activity, we conducted a study for bcl-2 expression with immunohistochemical staining and DNA analysis on 52 surgical specimens of NSCLC. Results The bcl-2 was positive in 52% (27/52) of specimens, According to the status of bcl-2 expression, there were no significant differences in tumor stages, performance status score and survival time. Among bcl-2 positive NSCLC, aneuploidy and high proliferative activity were noted in 40% and 44%, respectively. In cases with squamous cell carcinoma (SQC ** ), the proportion of aneuploidy was significantly higher in bcl-2 positive group compared to bcl-2 negative group (p Conclusion In bcl-2 expressed NSCLC, proliferative activity and DNA ploidy were not homogeneous, suggesting other genetic alterations. This may explain our results which showed no differences in survival according to the status of the bcl-2 expression.

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  3. [국내논문]   Head-up Tilt Test with Isoproterenol Provocation in Syncope of Unknown Origin  

    Ryu, Moon Hee (Division of Cardiology, Department of Internal Medicine, Chonnam University Medical School, Hanam Sungshim Hospital, Kwangju, Korea) , Cho, Jeong Gwan , Bae, Youl , Rhew, Jay Young , Chung, You Jeong , Youn, Sugkee , Jeong, Myung Ho , Park, Jong Chun , Kang, Jung Chaee
    The Korean journal of internal medicine : KJIM v.11 no.2 ,pp. 108 - 112 , 1996 , 1226-3303 ,

    초록

    Objectives Head-up tilt test (HUT) has been reported to be useful in the evaluation of syncope of unknown origin (SUO). However, the sensitivity of HUT with no pharmacologic provocation was relatively low and variable, ranging 32–70%. Therefore, several protocols of HUT with different degrees and durations of the tilt and modes of provocation were proposed. The purpose of this study was to determine the value of the multi-stage head-up tilt test with isoproterenol provocation (HUT-isp) in the evaluation of SUO and drug efficacy. Methods Sixty-seven patients presenting with SUO and 30 control subjects with no history of syncope underwent the HUT-isp. Blood pressure (BP) was measured every 2 min and whenever the patient complained of any symptom, and cardiac rhythm was continuously monitored. The HUT-isp consisted of 3 stages: first for 20 min with no provocation, second and third stages with infusion of isoproterenol for 10 min each at a rate of 2 μg/min and 5 μg/min, respectively. A positive HUT-isp was defined when syncope or presyncope was reproduced, accompanied by hypotension ( Results The HUT-isp was positive in 56 (83.6%) of 67 patients with SUO and 10 (33.3%) of 30 control subjects. The type of positive responses was vasodepressive in 41 (73.2%), cardioinhibitory in 4 (7.1%) and mixed in 11 (19.6%). The sensitivity of the HUT-isp in diagnosing vasovagal syncope was 83.6%, specificity 66.7% and positive predictive value 84.8%. Positive responses were developed most frequently in the 3rd stage: 76.8% in patients, 70% in controls. The effect of 3 drugs (carteolol, aminophylline and disopyramide) was evaluated in 27 patients with a repeat HUT-isp. Carteolol was effective in 12 (85.7%) of 14 patients, disopyramide in 7 (58.3%) of 12 and aminophylline in 1 (14.3%) of 7. During the follow-up period of 175±212 days (26–623 days), none of the 20 patients with a negative repeat HUT-isp developed a recurrent syncope. Conclusion The HUT-isp is thought safe and useful to evaluate syncope of unknown origin and to guide effective drug therapy.

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  4. [국내논문]   Clinical Features of Interstitial Lung Diseases  

    Lim, Gune-il (Division of Allergy and Respiratory Medicine, Department of Medicine, Anatomic Pathology, Soon Chun Hyang University Hospital, Seoul, Korea ) , Lee, Kwang Hee (Division of Allergy and Respiratory Medicine, Department of Medicine, Anatomic Pathology, Soon Chun Hyang University Hospital, Seoul, Korea ) , Jeong, Seong Whan (Diagnostic Radiology, Soon Chun Hyang University Hospital, Seoul, Korea ) , Uh, Soo-taek (Diagnostic Radiology, Soon Chun Hyang University Hospital, Seoul, Korea ) , Jin, So Young (Thoracic Surgery, Soon Chun Hyang University Hospital, Seoul, Korea) , Lee, Dong Hwa , Park, Jai Soung , Choi, Deuk Lin , Kang, Chang Hee , Park, Choon Sik
    The Korean journal of internal medicine : KJIM v.11 no.2 ,pp. 113 - 121 , 1996 , 1226-3303 ,

    초록

    Objectives Interstitial lung diseases (ILD) are heterogenous groups of disorders that involve the interstitium of the lung. Lung biopsy is mandatory in most cases of ILD for diagnosis. In Korea, a few clinical data about ILD were analyzed on the basis of pathologic proof. Thus, we analysed the clinical profiles of patients with ILD who had lung biopsy in a tertiary university hospital. Methods Clinical and pathologic data concerning 100 patients who had open lung biopsy (OLB) and/or transbronchial lung biopsy (TBLB) were prospectively analysed. Two patients were excluded because one patient was proven to have metastatic cancer and the other to have miliary tuberculosis. One patient had two combined diseases: rheumatoid arthritis and pneumoconiosis. Thus, 99 cases were analysed from 98 patients. Demographic characteristics, pulmonary functions and pathologic findings were analysed according to the disease entities of ILD. Pathologic findings were classified only in patients who had OLB. Clinical courses were also analysed during follow-up. Results OLB was performed on 68 cases with concomittant TBLB in 18 cases and 30 cases had TBLB only. Mediastinal lymph node biopsy has performed on one case. The most common cause of ILD was IPF (51.5%), which was followed by CVD-PF (15.2%) and HP (9.1%). Average age of 51 cases with idiopathic pulmonary fibrosis (IPF) was 60±11 years, that of 15 cases with collagen vascular disease associated pulmonary fibrosis (CVD-PF) was 46±17 years and that of 9 cases with hypersensitivity pneumonitis (HP) was 53±8.1 years. In IPF, CVD-PF AND HP, male to female ratio was equal. But female was dominant in sarcoidosis and male was dominant in pneumoconiosis. Pulmonary function tests (PFT) in IPF, CVD-PF and HP were restrictive patterns in half of the cases. In pneumoconiosis and sarcoidosis, PFT showed normal pattern. Usual interstitial pneumonia (UIP) was the most common pathologic type in IPF and CVD-PF. The most common cause of CVD-PF was rheumatoid arthritis. The overall mortality rate was 12.1%. Conclusion We reported that the ILD had a variety of disease entities and pathologic types even in one tertiary referral hospital. We hope that a multi-center study will be performed on the basis of pathologic proof in the future.

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  5. [국내논문]   Nonspecific Interstitial Pneumonia/Fibrosis: Clinical Manifestations, Histologic and Radiologic Features  

    Park, Choon Sik (Division of Allergy and Respiratory Medicine, Department of Internal Medicine, Radiology, Soon Chun Hyang University Hospital, Seoul, Korea ) , Jeon, Jin Woo (Division of Allergy and Respiratory Medicine, Department of Internal Medicine, Radiology, Soon Chun Hyang University Hospital, Seoul, Korea ) , Park, Sung Woo (Division of Allergy and Respiratory Medicine, Department of Internal Medicine, Pathology, Soon Chun Hyang University Hospital, Seoul, Korea ) , Lim, Gune-Il (Division of Allergy and Respiratory Medicine, Department of Internal Medicine, Thoracic Surgery, Soon Chun Hyang University Hospital, Seoul, Korea) , Jeong, Seong Hwan , Uh, Soo-Taek , Park, Jai Soung , Choi, Deuk Lin , Jin, So Young , Kang, Chang Hee
    The Korean journal of internal medicine : KJIM v.11 no.2 ,pp. 122 - 132 , 1996 , 1226-3303 ,

    초록

    Objectives Customarily used classification of IPF did not satisfy a sizable group of patients with IPF that in the past had been lumped with UIP and now currently has begun to be recognized as nonspecific interstitial pneumonia/fibrosis (NIP). There are few reports about the clinical features of NIP. Methods The pathologic slides of 66 patients having open lung biopsy (OLB) for the differential diagnosis of interstitial lung diseases (ILD) from 1984 to 1995 were reviewed. Seven cases were confirmed as NIP. The clinical record, pulmonay function tests (PFT), chest PA and HRCT were reviewed and analysed retrospectively. Results Six patients with NIP were female. The median age was 56 years. Mean duration of symptoms was 4 months. Five patients had systemic flu-like symptoms. the most common respiratory symptom was gradual dyspnea Two patients revealed a mild degree of anemia Four cases had leukocytois of more than 10,000/mm 3 . ESR and CRP O.K. elevated in all measured cases. Anti-nuclear antibody (ANA) was positive in three of six patients and ds-DNA antibody was positive in one of six patients Restrictive pattern of PFT was predominant. Diffusion capacity of carbonmonoxide (DLCO) decreased markedly. In bronchoalveolar lavage (BAL), total cell counts elevated about three times of normal value. On differntial counts of BAL cells, lymphocytes, neutrophils and eosinophils were higher than those of normal controls. The prominent finding of chest radiology was bilaterally patchy opacifications in parenchyme of lower lung zones. On HRCT, bilaterally patchy areas of ground-glass attenuation and/or areas of alveolar consolidation were commonly shown. The number of pathologic type was one case of group I, four cases of group II and two cases of group III. The average period from diagnosis to the last follow-up was 24.8 months. Five patients were clinically recovered to the previously well-being state. Conclusion Patients with NIP had different clinical features from UIP, AIP and DIP. They also had characteristic findings of radiology and their prognosis seems to be better than UIP.

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  6. [국내논문]   Relationships between Angiotensin I Converting Enzyme Gene Polymorphism and Renal Complications in Korean IDDM Patients *  

    Oh, Tae Geun (Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea ) , Shin, Chan Soo (Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea ) , Park, Kyoung Soo (Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea ) , Kim, Seong Yeon (Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea ) , Cho, Bo Youn (Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea ) , Lee, Hong Kyu (Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea ) , Koh, Chang-Soon (Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea)
    The Korean journal of internal medicine : KJIM v.11 no.2 ,pp. 133 - 137 , 1996 , 1226-3303 ,

    초록

    Objectives The prognosis of IDDM is mainly dependent on complicated diabetic nephropathy which is probably determined by both metabolic abnormalities and genetic predisposition. Angiotensin I converting enzyme (ACE) regulates systemic and renal circulations through angiotensin II formation and kinins metabolism. The insertion(I)/deletion(D) polymorphism in intron 16 of ACE gene is strongly associated with ACE levels, and subjects homozygote for deletion (genotype DD) have the highest plasma values. Recently, it was reported that I/D polymorphism of ACE gene is associated with diabetic nephropathy in Caucasian IDDM patients. We studied the relationship between the ACE gene polymorphism and diabetic nephropathy in Korean IDDM patients. Methods The study population consisted of 59 IDDM patients (duration> 5yrs) and 107 control subjects. IDDM subjects were divided into 2 groups according to the presence or absence of diabetic nephropathy (with nephropathy: n=31, without nephropathy: n=28). After extraction of genomic DNA from peripheral blood leukocytes, PCR was performed using the sense primer (5′-GCC CTG CAG GTG TCT GCA GC-3′) and anti-sense primer (3′-TGC CCA TAA CAG TGC TTC ATA-5′), respectively. The PCR products were electrophoresed in 2% agarose gels, and DNA was visualized directly with ethidium bromide staining. Results Frequencies for II, ID and DD genotypes were similar in IDDM subjects and controls (23:19:17 vs 49:41:17, p=0.142) and derived allele frequencies for I and D alleles were similar in both groups (0.551:0.449 vs 0.649:0.351, p=0.098). The ACE genotype distributions were not different in diabetic subjects with or without nephropathy (12:9:10 vs 11:10:7, p=0.78) and derived allele frequencies were also similar (0.532:0.468 vs 0.571:0.429, p=0.81). Conclusion The I and D allele frequency in our controls was different compared to ACE allele frequencies of Caucasian populations, but very similar compared to those of Chinese or Japanese subjects. We found that I/D polymorphism of ACE gene is not implicated in the diabetic nephropathy of Korean IDDM patients and may be explained by ethnic differences.

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  7. [국내논문]   Identification of Glucocorticoid Response Element of the Rat TRH gene  

    Lee, Gyu-Chun (Department of Internal Medicine, College of Medicine, KyungHee University, Seoul, Korea ) , Yang, In-Myung (Department of Internal Medicine, College of Medicine, KyungHee University, Seoul, Korea ) , Kim, Byoung-Joon (Department of Internal Medicine, College of Medicine, KyungHee University, Seoul, Korea ) , Woo, Jeong-Taek (Department of Internal Medicine, College of Medicine, KyungHee University, Seoul, Korea ) , Kim, Sung-Woon (Department of Internal Medicine, College of Medicine, KyungHee University, Seoul, Korea ) , Kim, Jin-Woo (Department of Internal Medicine, College of Medicine, KyungHee University, Seoul, Korea ) , Kim, Young-Seol (Department of Internal Medicine, College of Medicine, KyungHee University, Seoul, Korea ) , Choi, Young-kil (Department of Internal Medicine, College of Medicine, KyungHee University, Seoul, Korea)
    The Korean journal of internal medicine : KJIM v.11 no.2 ,pp. 138 - 144 , 1996 , 1226-3303 ,

    초록

    Objectives It was suggested that glucocorticoid exerts cell-specific effects on thyrotropin-releasing hormone (TRH) gene expression at the transcriptional level. Althought there is no typical palindromic glucocorticoid response element (GRE) on the rat TRH gene promoter, a perfect GRE half-site is found between −205 bp and −211 bp. We investigated whether the segment between −242 bp and −200 bp of the rat TRH gene promoter is responsible for glucocorticoid response. Methods For the 5′ deletion study of the TRH gene, four differnt plasmid constructs, pTRH(−554/84), pTRH(−242/84), pTRH(−200/6), pTRH(−113/84) were used for transient transfection study. The plasmid pMAMneo-LUC was used as a positive control and pRSV-GR expression vector, as a co-transfection study. Transfection was performed by the modified calcium precipitation method with 2 μg of each lasmid on the HeLa cells. Results Dexamethasone (DEX) stimulated the transcriptional activity of pTRH(−554/84)-LUC and pTRH(−242/84)-LUC by approximately 3.2 fold at 10 −8 M and 5.4 fold at 10 −6 M. On the contrary, deletion of the region between −242 to −200 bp reduced the basal transcriptional activity by 90% and also completely abolished the DEX-induced transcriptional activation of the luciferase gene. The DEX-induced transcriptional activation of pTRH(−242/84)-LUC was in dose-dependent manner. While the co-transfection of glucocorticoid receptor expression vector (pRSV-GR) did not increase the basal transcriptional activity of pMAMneo-LUC, it increased the basal transcription of pTRH(−242/84)-LUC by 1.8 fold. The pRSV-GR co-transfection and DEX tratment further increased the transcription of pTRH(−242/84)-LUC by 2–4 fold at the concentration of 10 −8 M. Conclusion These findings suggest that a cis-acting element(s) which is important for the basal transcriptional activation and glucocorticoid response of the rat TRH gene is located between −242 bp and −200 bp. The gene has a weak GRE glucocorticoid response and seems to be mediated by an interaction between glucocorticoid receptor and other transcriptional factor (s).

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  8. [국내논문]   Effect of Deamino-8-D-Arginine Desmopressin in Uremic Bleeding  

    Hong, Sae-Yong (Department of Internal Medicine, Soonchunhyang Hospital, Chunan, Korea ) , Yang, Dong-Ho (Department of Internal Medicine, Soonchunhyang Hospital, Chunan, Korea)
    The Korean journal of internal medicine : KJIM v.11 no.2 ,pp. 145 - 150 , 1996 , 1226-3303 ,

    초록

    Objectives This study is designed to evaluate the clinical outcome of uremic bleeding treated with DDAVP. DDAVP was given intravenously in nine ESRD patients who had undergone A/V fistula surgery and showed oozing of the operation site for more than one hour. Methods Hemostasis was observed by removing the blood from the wound site with a piece of filter paper for 3 hours after DDAVP administration. vWF, t-PA antigen, t-PA activity, total fibrinolytic activity in euglobulin fraction, fibrinopeptide A and FDP were measured before and after DDAVP administration. Results Cessation of the oozing did not occur within 3 hours after DDAVP administration in all of the cases. vWF levels and t-PA antigen were significantly increased after DDAVP administration peaked at 30 min for vWF and 60 min for t-PA antigen. t-PA activity increased in 6 cases and euglobulin fibrinolytic activity increased in 7 cases, respectively. These values fell towards pre-administration levels 120 min after the administration. There was no difference in fibrinopeptide A levels before and after DDAVP administration. FDP became positive in 4 cases after DDAVP administration. Conclusion DDAVP increased both vWF and t-PA levels and cessation of the oozing from post-operative AV-fistula wounds did not occur within 3 hours after DDAVP administration in all of the cases. These results suggest that the effect of DDAVP should be reassessed in the treatment of uremic bleeding.

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  9. [국내논문]   Cisapride in Chronic Idiopathic Constipation: Clinical Response and Effect on Colonic Transit Time  

    Bak, Young-Tae (Division of Gastroenterology, Korea University Guro Hospital, Seoul, Korea ) , Kim, Jin Ho (Division of Gastroenterology, Korea University Guro Hospital, Seoul, Korea ) , Lee, Chang Hong (Division of Gastroenterology, Korea University Guro Hospital, Seoul, Korea)
    The Korean journal of internal medicine : KJIM v.11 no.2 ,pp. 151 - 156 , 1996 , 1226-3303 ,

    초록

    Objectives To evaluate the effect of cisapride on the total and segmental colonic transit times (CTT's) and on the clinical symptoms in patients with chronic idiopathic constipation, and to elucidate whether the correction of the CTT parallels the symptomatic improvement. Methods An open prospective trial of cisapride, 10 mg t.i.d. orally for 8 weeks, was done in 25 adult patients (M: F 6: 19) with chronic idiopathic constipation of 1 year or longer duration. CTT was measured at baseline and after 8 weeks of cisapride therapy. Frequency, consistency and difficulty in passage of bowel movements were evaluated at baseline and after 2, 4 and 8 weeks of cisapride therapy. Results 19 cases continued to participate until the end of 4 weeks of therapy and 15 cases completed the entire 8 weeks' trial. No serious side effect was experienced during the study period. Total and right segmental CTT's shortened with 8 weeks of cisapride treatment. Defecation frequency increased and difficulty in stool passage improved with 2 to 8 weeks of treatment. Stool consistency had a tendency toward normal after 8 weeks of treatment (p=0.06). The global response was excellent in 7 cases (46.7%), good in 5 (33.3%) and poor in 3 (20.0%). If all dropped-out cases were assumed to be poor responders, the good or excellent responders after 8 weeks of cisapride might be 48.0% of all recruited patients. The response to cisapride could not be predicted by the various clinical parameters of the patients. Conclusion Cisapride is an effective drug in at least half of the patients with chronic idiopathic constipation.

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  10. [국내논문]   Complete Resolution of Airway Hyperresponsiveness in Aspirin-sensitive Asthmatic Patients  

    Park, Hae-Sim (Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, Korea)
    The Korean journal of internal medicine : KJIM v.11 no.2 ,pp. 157 - 160 , 1996 , 1226-3303 ,

    초록

    Appreciable numbers of aspirin-sensitive asthmatic patients have chronic steroid-dependent severe asthmatic symptoms. We report four cases of aspirin-sensitive asthmatics who had mild to severe asthmatic symptoms, whose methacholine PC20 level ranged from 0.6 to 22 mg/ml at the first visit. The aspirin sensitivity was confirmed by lysine-aspirin bronchoprovocation. After anti-asthmatic medications and avoidance of salicylate-containing agents, airway hyperresponsiveness and respiratory symptoms disappeared for two to 30 months. These results suggest that early detection and careful avoidance of salicylate-containing agents may have a beneficial effect resulting in the resolution of airway hyperresponsiveness in aspirin-sensitive asthmatic patients.

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