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      • KCI등재

        자기공명영상 획득 조건과 적용된 뇌 표준판에 따른 인체 뇌의 백질, 회백질 및 해마 체적 비교 연구

        정원범,손두범,김영주,김영훈,은충기,문치웅 대한자기공명의과학회 2011 Investigative Magnetic Resonance Imaging Vol.15 No.3

        Purpose : The aim of this study was to examine the volume differences of human brain 3-D MR images obtained by automatic segmentation methods depending on brain templates and image acquisition conditions,respectively. Materials and Methods : 3D T1-weighted MR images oriented in coronal and sagittal plane were acquired from eight healthy subjects (29.5±5.66 years) using two identical 3T MR scanners at different sites. Caucasian brain template and Korean elderly brain template were applied for the same subject to segment brain structural region. Volumetric differences and variation of gray matter, white matter and hippocampus depending on scan orientations and brain template types were statistically evaluated. Results : Volumetric measurements have some different results for the same subject images depending on scan orientation in identical MR scanners but not significantly. However, all segmented volumes relied upon brain templates were significantly different (p<0.05). Small variation of the volume in gray matter,white matter (coefficient of variation, CV≤1%) and hippocampus (CV≤3%) were obtained. Comparing the mean CV in all segmented regions, variation of scan orientation was not significantly different with inter scanner variation but variation relied upon brain templates were significantly different (p<0.001). Conclusion : Authors found that brain template regarding the specific properties of the subjects is required to reduce the errors of brain volumetry. 목적: 자기공명영상 뇌 영상으로 인체 뇌 조직의 체적을 측정할 때 영상조건과 적용된 뇌 표준판에 따른 체적의 차이와 그 범위를 통계분석하고 질병에 따른 뇌 조직의 유의한 체적 변화의 추정 가능성을 확인하고자 하였다. 대상 및 방법: 정상인 8명에 대해 두 기관에 설치된 동일한 사양의 장치에서 관상면과 시상면의 두 방향으로 3D T1강조 영상을 얻었다. 서양인과 한국노인을 대상으로 제작된 두 뇌 표준판을 이용해 회백질, 백질, 좌우 해마를 분할하고 체적을 측정하여 그 차이를 비교하고 변화 범위를 평가하였다. 결과: 동일 인의 영상에 대해 영상 조건에 따른 체적의 차이는 있으나 통계적으로 유의하지 않았으며, 적용된 뇌 표준판에 따라 유의한 체적의 차이가 있었다. 회백질과 백질 영역에서 평균 1%, 해마 영역에서 평균 3%의 변화 범위가 측정되었고, 영상 획득 방향에 따른 체적 변화와 동일 사양의 장치에서 획득한 영상에 대한 변화 간의 유의한 차이는 없었으나 뇌 표준판에 따라 유의한 체적 변화가 있었다. 해마의 경우 표준판에 따라 분할의 정확성에서 유의한 차이를 발생시켜 인종 및 연령별 표준판의 필요성을 확인하였다. 결론: 자기공명영상을 이용한 자동 영역 분할 및 체적 분석의 최적화를 위해 분석 대상자의 특성을 고려한 뇌 표준판 개발 및 적용이 필요한 것으로 사료된다.

      • KCI등재

        다 기관의 자기공명영상장치에서 측정된 뇌 조직 체적의 재현성 분석

        정원범,강민재,손두범,김영주,이영민,김영훈,은충기,문치웅 대한자기공명의과학회 2012 Investigative Magnetic Resonance Imaging Vol.16 No.3

        Purpose : The aim of this study was to evaluate the variations of brain volumetry between the different MR scanners or the different institutes. Materials and Methods: Ten normal subjects were scanned at four different MR scanners, two of them were the same models, to measure inter-MR scanner variations using intraclass correlation coefficient (ICC), coefficient of variation (CV) and percent volume difference (PVD) and to calculate minimal thresholds to detect the significant volumetric changes in gray matter and subcortical regions. Results: Averaged statistical reliability (ICC = 0.837) and volumetric variation (CV = 4.310%) in all segmented regions were observed on overall MR scanners. Comparing the segmented volumes with PVD between two MR scanners, volumetric differences on same models were the lowest (PVD = 3.611%) and volume thresholds were calculated with 7.168%. PVD results and thresholds values on systemically different MR scanners were evaluated with 5.785% and 11.340% respectively. Conclusion: Authors conclude that the reliability of brain volumetry is not so high. Calibration studies of MRI system and image processing are essential to reduce the volumetric variability. Additionally, frameworks comprised of database and algorithms with high-speed image processing are also required for the efficient image data management. 목적 : 뇌 자기공명영상 기반의 다 기관 연구 구축을 위해 장치 차이에 따른 동일인의 자기공명영상에서 측정한 뇌 조직의 체적 차이를 확인함으로써 체적 변화에 따른 뇌 질환의 임상적 진단에 대한 유의성 평가 자료를 마련하고자 하였다. 대상 및 방법 : 정상 남녀 10명에 대해 시스템 사양이 같은 장치 2대를 포함한 전체 4대의 자기공명장치에서 3D T1 강조 영상을 획득하여, 자동화 분할 S/W를 통해 회백질 및 하부 구조를 분할하였으며, 급내상관계수와 변이계수를 통해 체적의 일치성 및 차이를 확인하고, 통계적 유효성을 확인하기 위한 시스템간 체적 차 오프셋을 측정하였다. 결과 : 모든 영역에 대해 MRI 장치간 평균 0.837의 체적 일치성과 평균 4.310%의 체적 변화 범위가 측정되었고, 같은MRI 장치 간 전체 영역에서 평균 3.611%의 체적 차이가 발생하였으며, 평균 7.079%의 오프셋이 요구되었다. 또한 시스템 사양 및 영상 획득 인자가 다른 MRI 장치 간 전체 영역에 대해 약 5.785%의 체적 차이가 발생하였으며, 이에 대한 오프셋은 약 11.340%로 확인되었다. 결론 : 다 기관 뇌 연구의 기반을 구축하기 위해서는 MRI 장치 간에 발생되는 체적 측정 결과의 변동을 최소화하는 하드웨어와 소프트웨어의 최적화가 필요하며, 데이터 관리 및 고속 영상처리 방법 또한 필요한 것으로 판단된다.

      • KCI등재

        한국교회의 공공성 위기와 기독교의 사회선교

        정원범 한국기독교사회윤리학회 2013 기독교사회윤리 Vol.27 No.-

        이 논문의 목적은 한국교회의 공공성 위기를 분석하고, 공공성 회복의 대안으로서 사회선교를 제시하며 그 사회선교의 내용으로서 생명선교, 정의선교, 평화선교를 제시하는 것이다. 한국교회의 신뢰성 위기는 한국교회의 공공성 상실에 기인한 것이라는 전제를 가지고 본 논문은 2장에서 삼위일체론, 창조론, 인간론, 신국론, 교회론 등에 근거하여 기독교는 본래 공적인 종교라는 사실을 제시하였고, 3장에서는 그러나 어떻게 한국교회가 공공성을 상실하게 되었는가 하는 문제에 대해 그 원인으로 구원에 대한 개인주의적 이해, 이분법적 사고, 근본주의, 샤머니즘과의 결탁, 유교문화와의 결탁, 경제주의와의 결탁, 국가와의 결탁을 제시하였다. 4장에서는 기독교의 공공성은 사회선교를 통해 가장 잘 드러날 수 있다는 사실에 근거하여 공공성 회복의 대안으로서 사회선교를 제시하였고 그 내용으로 생명선교, 정의선교, 평화선교를 제시하였다. The purpose of this study is to investigate the crisis of publicness of the Korean Church, to suggest social mission as an alternative for recovering publicness of christianity and to suggest life mission, justice mission and peace mission as christian social mission. All statistics show that the Korean Church is the most distrusted religion among representative religions in Korea. This crisis of public confidence of the Korean Church results from the loss of publicness of christianity. But originally christianity is not a private religion but a public religion. The reason is as follows: ① God of christianity is not a lonely being but public being in community. God is a social, participatory being. ② The world created by God is not a private domain for a certain group or nation but a symbiotic domain for all creatures. ③ All humans were created not as lonely beings but as beings in relationship with God and other creatures. ④ Kingdom of God is not a private character of kingdom which a certain group or nation can monopolize but public character of kingdom which all humans enjoy justice, peace and joy in Holy Spirit. ⑤ Church is not a private being for itself but a public being for common good of society and the world. On the ground of the above statements, christianity is a public religion in which publicness is a key element. The Korean Church lost publicness. What are the reasons of it? The reasons are as follows: ① Individualistic understanding of salvation ② Dualistic thought which separate soul and body, individual and society, the world beyond and this world and think body, society and this world less importantly than soul, individual and this world ③ fundamentalism ④ collision with shamanism ⑤ collision with confucianism ⑥ collision with economism ⑦ collision with a nation What is an alternative for recovering of publicness of the Korean Church? First, it is to recover the identity of christianity as a public religion Second, it is to perform the task of social mission. Here social mission means all activities which churches and christians perform in relation to social responsibility. What are the contents of social mission? Those are life mission, justice mission and peace mission. First, the task of life mission is to build culture of life and ecological community which affirm and respect life, and to resist powers which drive the socially weak and ecosystem to death. Second, the task of justice mission is to criticize all forms of concentration of power by minority, to resist unilateral dominion of a few vested interests and to change unjust political, economical social system into just political, economical social system. Third, the task of peace mission is to oppose violence, war, war weapons and nuclear weapons, to try to solve conflict relations and hostile relations, to curtail aggressive elements which become the cause of war, to get rid of structural violence such as poverty, oppression, discrimination and alienation. and to build culture of peace in which every people and every nations respect each other. As Moltmann said, the Korean Church today face double crises. One is the crisis of identity, the other the crisis of relevance. The former is the crisis of recognition, the latter is the crisis of praxis. In terms of these double dimensions, the Korean Church face the loss of publicness. If it is the cause of loss of public confidence of the Korean Church, recovering publicness of the Korean Church is a urgent task in order to recover credibility of the Korean Church. In conclusion, the Korean Church has to perform life mission, justice mission and peace mission as social mission in order to recover publicness of christianity. Because a public character of christianity is most clearly revealed through social mission as a christian response of contemporary political, economical, social problems.

      • KCI등재

        Clinical Characteristics and Adequate Treatment of Familial Adenomatous Polyposis Combined with Desmoid Tumors

        정원범,김찬욱,김진천 대한암학회 2014 Cancer Research and Treatment Vol.46 No.4

        PurposeThe objective of this study was to examine the clincopathologic characteristics andoutcomes of familial adenomatous polyposis (FAP) patients with and without desmoidtumors (DTs), including the risk factors for progression of FAP-related DTs. Materials and MethodsWe reviewed the medical records and database of all patients with FAP who were treatedbetween January 1993 and December 2011. ResultsOf 75 FAP patients, 18 (24%) were FAP with DTs. Seventeen of these had intra-abdominalDTs and one had intra- and extra-abdominal DTs. We divided the patients into two groupsaccording to type of resection; the R0 or R1 resection group, referred to as the curativeresection group (eight patients), and the R2 resection/palliative operation/medicaltreatment group, referred to as the palliative resection group (10 patients). Two patients inthe curative resection group and two patients in the palliative group had progressed totumor growth by the follow-up (p=0.800). In univariate analysis, DT diagnosis before orsimultaneously with FAP diagnosis (DTs unrelated to surgical trauma) was a significant riskfactor for tumor progression at final follow-up. ConclusionA multidisciplinary approach to DT treatment is needed, including nonsteroidal antiinflammatorydrugs, anti-estrogens, cytotoxic agents, and surgery. However, the role ofsurgery in resectable and complicated tumors may be limited. DT unrelated to surgicaltrauma has a relatively poor prognosis.

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