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      • SCOPUSKCI등재

        성문상부 상피세포암에서의 근치적 방사선치료의 역할

        원택(Won Taek Kim),동원(Dong Won Kim),권병현(Byung Hyun Kwon),남지호(Ji Ho Nam),원주(Won Joo Hur) 대한방사선종양학회 2000 Radiation Oncology Journal Vol.18 No.4

        목 적 : 본 연구에서는 부산대학교병원 치료방사선과에서 성문상부 편평상피세포암으로 진단받고 근치적 방사선치료를 받은 환자들을 대상으로 방사선치료 성적과 여기에 영향을 미칠 수 있는 여러 인자들을 비교 분석하여 성문상부암에서의 방사선치료의 효율성과 역할, 그리고 앞으로의 치료방침의 결정에 있어서 고려해야 할 부분들을 알아보려 하였다. 대상 및 방법 : 1985년 8월부터 1996년 12월까지 성문상부암으로 진단되어 근치적 방사선치료를 받은 환자 32예를 후향적 분석을 통해 최소 29개월간 추적관찰 하였다. 6MV 광자선을 이용하여 조사영역 축소치료법과 통상적 분할조사 방법으로 원발부위와 주위 경부림프절을 평균 70.2 Gy로 치료하였고, 이 중 13예는 cisplatin과 5- FU로 유도 항암화학요법을 시행받았다. 병기별로는 1기가 5명(15.6%), 2기가 10명(31.3%), 3기가 8명(25%), 4기가 9명(28.1%)이었다. 결 과 : 연구 결과 5년 전체 생존율과 국소제어율, 성문보존율은 각각 51.7%, 65.2%, 65.6%였고, 병기별로의 생존율은, 1기, 2기, 3기, 4기 각각 80%, 66.7%, 42.9%, 25.0%였고, 국소제어율은 각각 100%, 60.0%, 62.5%, 44.4%였으며, 성문보존율은 각각 100%, 70%, 62.5%, 44.4%였다. 유도 화학요법을 실시한 군과 방사선 단독 군에서 생존율, 국소제어율 등에서 유의한 차이를 보이지 못했다. 치료실패를 보인환자 중 7예에서 구제적 수술을 시행했고 이 중 3예에서 성공하였다. 치료 중 화학요법을 병용한 1예에서 중성구감소증으로 입원하였으며, 그 외에는 grade 3 이상의 급성 독성은 관찰되지 않았고, 치료 후 2예에서 심한 후두부종으로 기관절개술을 받았다. 원격전이는 4예에서 보였고(폐 3예, 뇌 1예), 2예에서 이차성 원발암이 발견되었다. T병기와 N병기, 총방사선량, 그리고 종양의 육안적 소견 등이 유의한 예후인자였다. 결 론 : 다른 연구들의 결과와 비교해 보았을 때, 조기 성문상부암인 경우 방사선치료와 보존적 수술이 생존율과 국소제어율에 비슷한 결과를 보이므로 후두기능 보존의 효과가 좋은 방사선치료 단독으로도 그 역할을 충분히 할 수 있다 하겠으며, 진행된 병기의 경우에서는 방사선 단독 치료가 수술과의 병합치료보다 예후가 월등히 좋지 않게 나타나므로 가급적 수술과 방사선치료 병합요법을 시도하는 것이 좋겠으나, 방사선치료를 해야만 하는 경우에서는 성문보존율과 국소제어율을 향상 시킬 수 있는 화학요법과의 병용치료, 특히 동시 화학방사선치료와 다분할 방사선치료, 그리고 방사선 민감제 등을 이용한 보다 더 폭 넓은 연구와 치료계획의 수립이 필요하다고 하겠다. Background : First of all, this study was performed to assess the result of curative radiotherapy and to evaluate different possible prognostic factors for squamous cell carcinoma of the supraglottic larynx treated at the Pusan National University Hospital. The second goal of this study was by comparing our data with those of other study groups, to determine the better treatment policy of supraglottic cancer in future. Methods and Materials :Thirty- two patients with squamous cell carcinoma of the supraglottic larynx were treated with radiotherapy at Pusan National University Hospital, from August 1985 to December 1996. Minimum follow- up period was 29 months. Twenty- seven patients (84.4%) were followed up over 5 years. Radiotherapy was delivered with 6 MV photons to the primary laryngeal tumor and regional lymphatics with shrinking field technique. All patients received radiotherapy under conventional fractionated schedule (once a day). Median total tumor dose was 70.2 Gy (range, 55.8 to 75.6 Gy) on prima ry or gross tumor lesion. Thirteen patients had induction chemotherapy with cisplatin and 5- fluorouracil (1- 3 cycles). Patient distribution, according to the different stages, were as follows: stage I, 5/32 (15.6%); stage II, 10/32 (31.3%); stage III, 8/32 (25%); stage IV, 9/32 (28.1%). Results :The 5- year overall survival rate of the whole series (32 patients) was 51.7%. The overall survival rate at 5- years was 80% in stage I, 66.7% in stage II, 42.9% in stage III, 25% in stage IV (p=0.0958). The 5-year local control rates after radiotherapy were as follows: stage I, 100%; stage II, 60%; stage III, 62.5%; stage IV, 44.4% (p=0.233). Overall vocal preservation rates was 65.6%, 100% in stage I, 70% in stage II, 62.5% in stage III, 44.4% in stage IV (p=0.210). There was no statistical significance in survival and local control rate between neoadjuvant chemotherapy followed by radiotherapy group and radiotherapy alone group. Severe laryngeal edema was found in 2 cases after radiotherapy, emergent tracheostomy was done. Four patients were died from distant metastsis, : three in lung, one in brain. Double primary tumor was found in 2 cases, one in lung (metachronous), another in thyroid (synchronous). Ulcerative lesions were revealed as unfavorable prognostic factor (p=0.0215), and radiation dose (more or less than 70.2 Gy) was an important factor on survival (p=0.0302). Conclusions :The role of radiotherapy in the treatment of supraglottic carcinoma is to improve the survival and to preserve the la ryngeal function. Based on our data and other studies, ea rly and moderately advanced supraglottic carcinomas could be successfully treated with either conservative surgery or radiotherapy alone. Both modalities showed similar results in survival and vocal preservation. For the advanced cases, radiotherapy alone is inadequate for curative aim and surgery combined with radiotherapy should be done in operable patients. When patients refuse operation or want to preserve vocal function, or for the patients with inoperable medical conditions, combined chemoradiotherapy (concurrent) or altered fractionated radiotherapy with or without radiosensitizer should be taken into consideration in future.

      • KCI등재

        저압 화학기상증착법을 이용한 β-SiC의 증착 및 결정 성장 방위에 따른 기계적 특성 변화

        대종,이종민,김원주,윤순길,박지연,Kim, Daejong,Lee, Jongmin,Kim, Weon-Ju,Yoon, Soon Gil,Park, Ji Yeon 한국세라믹학회 2013 한국세라믹학회지 Vol.50 No.1

        ${\beta}$-SiC was deposited onto a graphite substrate by a LPCVD method and the effect of the crystallographic orientation on mechanical properties of the deposited SiC was investigated. The deposition was performed at $1300^{\circ}C$ in a cylindrical hot-wall LPCVD system by varying the deposition pressure and total flow rate. The texture and crystallographic orientation of the SiC were evaluated by XRD. The deposition rate increased linearly with the gas flow rate from 800 sccm to 1600 sccm. It also increased with the pressure but became saturated above a total pressure of 3.3 kPa. In the range of 3.3 - 10 kPa, the preferred orientation changed from the (220) and (311) planes to the (111) plane. The hardness and elastic modulus showed maximum values when the SiC had the (111) preferred orientation, though it gradually decreased upon a change to the (220) and (311) preferred orientations.

      • 서울시 기후변화대응 성과분석 및 비전수립

        운수 ( Woon Soo Kin ),신성일 ( Seong Il Shin ),김원주 ( Won Joo Kim ),정아 ( Jeong Gah Kim ) 서울시정개발연구원 2009 연구보고서 Vol.2009 No.1

        It is no surprise that all developed countries and many developing ones around the world are in a fiercer green race for responding climate change issues and achieving promised low-carbon societies. Each country`s bid for green leadership is just related with drawing his competitive power in the low-carbon age. In parallel, in light of the urgent need to take climate protection initiative, meet housing demand with low carbon communities, minimize threats to the environment and fulfill public`s aspiration for higher quality of life, designing cities to attain such high expectation standards should be targeted to deal successfully with all these challenges. The purpose of this study is to provide basis of Seoul city`s vision for climate protection initiative in 2030, thereby figuring out what kinds of strategies be adopted to meet pacesetting goal in such an optimized systematic way. In particular, as reborn to be a clean and charming world-leading city, Seoul city needs to act today more for better tomorrow based upon goal-oriented climate protecting guidelines. Thus the Seoul city`s vision for climate protection initiatives in 2030 can serve Seoul in implementing effective and practical greenhouse abatement actions in order to achieve its emission reduction goals by 2030, This study might be used as a ``living guideline`` to assist Seoul prepare actions and obtain the greatest benefits from climate protection activities, The findings of this study is summarized as follows.

      • 서울시 주요산 도시공원화에 따른 주제공원 조성 및 이용증진 방안

        김원주 ( Won Joo Kim ),장남종 ( Nam Jong Jang ),연정민 ( Jeong Min Yeon ) 서울시정개발연구원 2009 연구보고서 Vol.2009 No.23

        More than 20 natural public parks including Mt.Buk-han, Mt.Kwan-ak, shall change into public park or natural public park zone by the Law on urban park and green space. Recent survey of park visitors showed that 23% of users wanted facility addition and liked the concept of theme park. Seoul has a total of 2,464 parks as of January 2009 and 29 parks among them are theme parks. However, the existing theme parks fall short of meeting the need of public expectation and most of them are of a sort that are showy amusement parks. There is nothing unique or with concrete theme but function disorders and restrictions such as difficult access, low awareness, and steep slants. Taking into consideration the institutional change from the existing natural public parks to public parks and leisure demand, this study analyzes 20 potential theme parks out of 82 projected areas regarding to renovation public parks in major mountains, suggests detailed park types and effective using plan on site. 1. Feasibility study on building theme park regarding to renovation public parks in major mountains This study performed physical evaluation and functional evaluation for theme parks. Physical evaluation criteria are size, topography, ecology / environmental value, accessibility of the park while functional evaluation criteria are mainly statuses of theme resources. According to the evaluation result, eco parks, cemetery parks, and amusement parks were influenced by size and in particular, eco parks were greatly influenced by high environmental value. Functional evaluation showed that theme parks, especially history parks were heavily affected by location of theme resources. Super size and large scale parks turned out to be adequate for eco park and parks with high accessibility for culture park. 2. Study on Building Theme Parks and encouraging their use History park is a gateway to a nation`s historical resources thus it can be designed to provide learning, education, experience on historical resources. Its tangible theme resources and intangible cultural resources are critical for cultural activity. Eco park can be designed for 5 functions: to provide Biotope, natural trail, and information/commentary, protect natural habitat, and facilitate research activities and dissemination on nature restoration. Theme parks should have diverse and clear themes to meet user needs providing incentives for visitors to participate such diverse programs. Also, well-trained volunteers from a nearby community center or civic groups can be a brilliant way to utilize applicable support. 3. Policy Directions Before building a new one, you need to understand regional characteristics of the existing park types and projected site. Future demands of the park also need to be predicted to choose an adequate theme for the park and promote use of the park. This facelift will help people in the local community experience varied theme parks and also contribute an improvement to the community. For a medium to large scale park, it is necessary to group varied themes and offer a broad variety of experiences of entertainment, play, and relaxation. When it comes to a park, green belt must come first rather than facilities installation. Most of all tranquil relaxation and dynamic trail with the view of forests and meadow is the base for a park. For this, modification of the relevant laws and regulations is a must since mandatory facilities rate often hinders promotion of theme park in selecting the existing park type.

      • KCI등재

        유동층 화학기상증착법을 이용하여 제조된 열분해 탄화규소의 특성에 미치는 증착온도의 영향

        연구,김원주,여승환,조문성,Kim, Yeon-Ku,Kim, Weon-Ju,Yeo, SungHwan,Cho, Moon-Sung 한국분말야금학회 2014 한국분말재료학회지 (KPMI) Vol.21 No.6

        Silicon carbide(SiC) layer is particularly important tri-isotropic (TRISO) coating layers because it acts as a miniature pressure vessel and a diffusion barrier to gaseous and metallic fission products in the TRISO coated particle. The high temperature deposition of SiC layer normally performed at $1500-1650^{\circ}C$ has a negative effect on the property of IPyC layer by increasing its anisotropy. To investigate the feasibility of lower temperature SiC deposition, the influence of deposition temperature on the property of SiC layer are examined in this study. While the SiC layer coated at $1500^{\circ}C$ obtains nearly stoichiometric composition, the composition of the SiC layer coated at $1300-1400^{\circ}C$ shows discrepancy from stoichiometric ratio(1:1). $3-7{\mu}m$ grain size of SiC layer coated at $1500^{\circ}C$ is decreased to sub-micrometer (< $1{\mu}m$) $-2{\mu}m$ grain size when coated at $1400^{\circ}C$, and further decreased to nano grain size when coated at $1300-1350^{\circ}C$. Moreover, the high density of SiC layer (${\geq}3.19g/cm^3$) which is easily obtained at $1500^{\circ}C$ coating is difficult to achieve at lower temperature owing to nano size pores. the density is remarkably decreased with decreasing SiC deposition temperature.

      • KCI등재

        퍼지관계를 이용한 지속가능경영 평가

        김원주(Won-Ju Kim),황승국(Seung-Gook Hwang) 한국지능시스템학회 2015 한국지능시스템학회논문지 Vol.25 No.3

        본 논문은 기업의 지속가능경영을 평가하기 위하여 기업의 재난관리평가행렬과 지속가능경영평가행렬을 사용한다. 재난관리평가행렬의 구성요소는 4개, 지속가능경영평가행렬의 구성요소는 6개로 구성되어 있다. 이들 두 행렬의 구성요소간의 관계를 필연성과 가능성의 면이 혼합되어 있는 퍼지관계행렬을 구하고 이를 이용하여 새로운 데이터가 주어졌을 때 기업의 지속가능경영 구성요소의 값을 추정하는 방법을 제시하고자 한다. 본 논문에서 사용하고 있는 재난관리와 지속가능경영의 구성요소 데이터를 100개의 중소기업을 대상으로 구한 것이나, 이를 100개의 중소기업의 자료 중 80개는 지속가능경영의 모델링을 위한 트레이닝데이터로 사용하고, 나머지 20개는 평가모델을 검토하기 이한 체킹데이터로 사용하여 모델의 유효성을 보였다. The aim of this study was to provide a method to assume the value of the continuous and possible management part to investigate the relationship between component of evaluation of Disaster Management and Sustainability Management in enterprise by obtaining Fuzzy Relation Matrix in view of necessity and possibility when there are new data. The index of Disaster Management was yielded from 100 small and medium-sized enterprises for 4 component of evaluations of based on ISO standard, and that of Sustainability Management was obtained from same enterprises for 6 component of evaluations in GRI G4 version of Sustainability Management guideline. The above results suggest that this model is significant by using 80 data as a training data and 20 data as a checking data from the 100 data obtained in this study.

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