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      • 염산증기 흡입에 의해 발생한 화학성 폐렴 1예

        장재혁,원경준,권세훈,하성일,권용은,이승일,윤성호 朝鮮大學校 附設 醫學硏究所 2007 The Medical Journal of Chosun University Vol.32 No.2

        A 38-year-old man with dyspnea admitted to the emergency department after exposure to hydrochloric acid in pharmaceutical product manufacturer. Crackle was auscultated in both lung fields in initial physical examination. Chest radiograph showed consolidation and diffuse parenchymal infiltration in both lung fields. Arterial blood gas analysis showed severe hypoxia. This patient was treated by mechanical ventilation, corticosteroid, antibiotics and bronchodilators and was improved completely in a week after the admission. The authors report a rare case of chemical pneumonitis caused by hydrochloric acid.

      • SCOPUSSCIEKCI등재

        클로르헥시딘 바니쉬의 적용이 교정용 브라켓의 전단접착강도에 미치는 영향

        임동혁,김태우,장영일,남동석,양원식,백승학 대한치과교정학회 2000 대한치과교정학회지 Vol.30 No.2

        본 연구의 목적은 클로르헥시딘 처리가 교정용 브라켓의 전단접착강도와 탈락 양상에 미치는 영향을 비교하는 것이다. 실험군으로 4주간 4회의 클로르헥시딘 바니쉬를 도포한 22개의 사람 소구치를 선택하였고, 대조군으로 아무 처리도 하지 않은 22개의 사람 소구치를 선택하였다. 모든 치아는 37%의 phosphoric acid gel로 부식시키고 교정용 브라켓을 같은 조건으로 부착시켰다. 전단접착강도의 측정을 위해 Instron universal testing machine(model 4466)을 이용하였고, 법랑질과 브라켓 표면은 SEM으로 관찰하였다. 결과의 분석은 t-test를 이용하였으며 결과는 다음과 같다. 1.클로르헥시딘의 법랑질 처리는 전단접착강도에 영향을 미치지 않았다. 2.클로르헥시딘으로 법랑질을 처리한 경우와 그렇지 않는 경우에 브라켓 탈락 양상에 차이가 없었다. 따라서, 클로르헥시딘으로 법랑질을 처리하여도 브라켓 접착에 유해한 작용이 없었고, 따라서 임상사용에 적합하다고 생각된다. The purpose of this study was to determine whether the application of chlorhexidine varnish affects the shear bond strength and failure pattern of orthodontic brackets or not. The experimental group consisted of 22 human premolars which extracted after chlorhexidine vanish application(4 times for 1 week interval) in vivo, and the control group consisted of 22 human premolars which extracted without any pre-treatment. After all teeth were etched with 37% phosphoric acid gel, metal orthodontic brackets (Q-3002, RMO, USA) were bonded to each tooth using auto-polymerizing orthodontic resin (Ortho-One, Bisco, USA) with the same bonding procedure. The shear bond strength was measured with Instron universal testing machine (model 4466, Instron Ltd., England), and the failure pattern of each bracket was examined with Scanning Electron Microscope (SM 840A, JEOL, Japan). The data were analysed statistically with t-test. The results were as follows : 1.Application of chlorhexidine varnish had no significant effect on the shear bond strength of the orthodontic bracket. 2.There was no significant difference in the failure pattern of orthodontic bracket between the experimental group and the control group.

      • 개에 있어서 심장사상충증을 동반한 창상성 횡격막 허니아의 수술적 치료 1례

        조승혁,임영환,손정민,노경완,박창식,전무형,김명철,송근호,정성목 忠南大學校 獸醫科大學 動物醫科學硏究所 2005 動物醫科學硏究誌 Vol.13 No.-

        A 7-month old, castrated male Shih-tzu dog was referred to the Veterinary Medical Teaching Hospital of Chungnam National University with history of depression, dyspnea, mild scale, tachypnea, exercise intolerance and severe leanness. On physical examination, cardiac arrhythmias was heard and heart worm ELISA test was positive. Microfilaria was found on the direct blood smear. Survey radiographs showed loss of diaphragmatic line and cardiac silhouette, displacement of lung fields and presence of gas filled intestines in the thoracic cavity. Rib fracture and pelvic fracture with callus formation were found incidentally. On the basis of physical examination and radiographic findings, it was diagnosed as traumatic diaphragmatic hernia and heart worm disease. Herniorrhaphy was performed. Postoperatively, it was treated for heart worm disease and scale. There is no evidence of recurrence of diaphragmatic hernia and heart worm disease over 1 year.

      • 3분 및 4분 상완골근위부 골절에서의 외반형 및 내반형에 따른 임상적 비교

        최창혁,권굉우,김신근,이상욱,신동규,이승진 대한골절학회 2002 대한골절학회지 Vol.15 No.4

        목 적 : 수술적으로 치료한 3분, 4분 상완골 근위부 골절을 외반형과 내반형으로 재분류하여 임상적 결과를 비교하고자 하였다. 대상 및 방법 : Neer 분류상 3분, 4분 상완골근위부 골절로 분류된 21례에 대해 수술적 치료를 시행하고 12개월 이상 추시된 증례를 대상으로, 골절부위의 각형성, 상완골두의 방향성, 그리고 우세 전위결절의 양상에 따라 외반형과 내반형으로 재분류하여 UCLA shoulder rating scale에 따른 기능적 평가를 시행하였다. 결 과 : 단순 방사선 소견을 기준으로 Neer의 3, 4분 상완골 근위부골절을 외반형과 내반형 및 각각의 아형(subtype)으로 분류할 수 있었다. 견관절 반치환술을 시술한 2례를 제외하고 분석한 각 그룹의 UCLA 기능적 평가는 외반형에서 양호 이상의 결과가 9례중 8례(89%), 내반형에서 10례중 4례(40%)로 외반형에서 더 우수한 임상적 경과를 보였다. 결 론 : 상완골 근위부 골절에서 골두의 방향성은 골절의 각형성 및 우세 전위결절의 양상과 높은 상관관계를 가졌으며, 내반형의 경우 혈행과 신경장애가 좀더 빈번하고 예후도 불량한 것으로 나타났고, 이러한 경우 수술시 도달 방법, 연부조직 상태에 대한 평가가 더욱 신중하게 고려되어야 할 것으로 생각되었다. Purpose : We reclassified three-and four-part proximal humerus fracture by Neer's classification into valgus & varus type, and compared the results of these groups. Materials & methods : 21 cases classified as three- and four-part fracture in Neer's classifiation were treated surgically and followed for 12 months. We reclassified the 21 cases vlagus and varus type fractures, according to angulation of fractures, facing of humeral head, and dominant displaced tuberosity. Functional evaluation was done by UCLA shoulder rating scale. Results : Neer's three- and four-part proximal humerus fractures could be reclassified based on angulation, facing of humeral head, and dominant tuberosity displacement. The functional results according to UCLA shoulder rating scale were good or excellent in 8 of 9 cases of valgus type(89%), and at 4 in cases of varus type(40%). The clinical result of the valgus type was better than that of the varus type. Conclusion : Based on reclassification system of proximal humerus fractures, clinical results and radiographic findings including angulation, facing of head and domonant tuberosity displacement showed close relationship. Neurovascular complication were more frequent in the varus type. Therefore, careful evaluation including surgical approach and soft tissue status should be considered in the varus type of complex proximal humerus fracture.

      • 중독한 추체로 증상을 보인 cyclosporine에 의한 뇌증 1예

        강정현,곽승근,신현영,김성은,이정호,이정찬,곽상혁,윤환중,조덕연,김삼용,김제,송창준 충남대학교 의과대학 지역사회의학연구소 2000 충남의대잡지 Vol.27 No.1

        The use of cyclosporine(CsA), a potent immunosuppressive agent, is associated with numerous side effects. Neurotoxicity was earlier less well known, but with growing experience central nervous system side effects are now reported up to 40% of patients. Among various CsA-induced neurotoxicities, tremor is most common and posterior leukoencephalopathy is well characterized. An encephalopathy presenting with pyramidal weakness, however, seems to be rare and poorly documented. We report here a case of encephalopathy presenting with multiple generalized seizures followed by fluctuating quadriparesis developed a few days after starting CsA and resolved spontaneously after withdrawal of the drug . A 48-year-old woman with aplastic anemia was placed upon immmunosuppressive treatment consisting of antithymocyte globulin(ATG), CsA, and methylprednisolone. Two days after starting the therapy, she developed a generalized seizure. The next day she developed 2 more episodes of seizure and the therapy was stopped. Computed tomogram of the brain was normal. Six days after starting therapy, she developed mild motor weakness and paresthesia of both lower extremities, which progressed to a definite quariparesis confining her to a bed in 3 days. Magnetic resonance imaging(MRI) of the brain revealed asymmetric, bilateral high-signal abnormalites in the subcortical white matter of fronto-temporal areas. After reaching to a maximum with some fluactuation(14 days after starting the therapy) the motor weakness started to be resolved. She was discharged with a almost complete resolution of the weakness 45 days after starting the therapy. Five months later she did well and brain MRI was negative.

      • KCI등재
      • 코일로 치료한 다발성 폐동정맥 기형 1예

        김영훈,장재현,권세훈,장재혁,윤성호,이승일 朝鮮大學校 附設 醫學硏究所 2006 The Medical Journal of Chosun University Vol.31 No.3

        A 29 year old female patient came with grade NYHA Fc IV dyspnea of 1 month. No abnormality was heard during auscultation. Arterial blood gas analysis done due to shortness of breath showed a decreased PO_(2) of 64.6 mmHg. Computerized tomography(CT) was checked due to multiple nodules seen in both lower lung fields of the chest X-ray. CT revealed multiple pulmonary arteriovenous malformations in both the mid and lower lung fields. Dyspnea was uncorrected by the application of oxygen. Coil embolization showed improvement of PO2 and dyspnea. The CT follow up at 9 months after the procedure showed no progression of the arteriovenous malformation without any additional symptoms nor dyspnea.

      • 소아 만성 부비동염에서 단순촬영상과 OMU CT상의 비교

        이병돈,박상호,김장묵,이승균,장혁순,강주원,김장욱 순천향의학연구소 1998 Journal of Soonchunhyang Medical Science Vol.4 No.1

        Most commonly and widely used diagnostic tool for chronic paranasal sinusitis in children is plain X-ray check not only because of small radiation dose and easy performance, but because of low cost. However ostiomeatal unit computed tomography(OMU CT) was known to be more accurate and recommended recently by many physicians. The author have studied for both OMU CT and plain X-ray of paranasal sinuses and compaird their findings in 90 chidren(180 sides of sinus) aged from 4 to 14 years who suspected having sinusitis. OMU CT was taken after plain X-ray examination (Caldwell's view, water's view, lateral view), and the time interval betweeen these two examination was O to 14 days (average 4.7 days). The following results were obtained. Considering that OMU CT was accurate, the rate of correspondence in diagnosis of sinus pathology between plain X-ray and OMU CT was 48.3% in the ethmoid sinus, 51.1% in the maxillary sinus, 41.9% in the sphenoid sinus, 43.4% in the frontal sinus. If all OMU CT findings had been accurate, the incidence of false positives according to plain X-ray was 25.5% in the ethmoid sinus, 28.3% in the maxillary sinus, 70.8% in the spenoid sinus and 77.8% in the frontal sinus. While, the incidence of false negatives according to plain X-ray was 85.9% in the ethmoid sinus, 70.5% in the maxillary sinus, 50.0% in sphenoid sinus and 37.5% in the frontal sinus. A routine preoperative OMU CT is recommended, which allows a detailed evaluation of pathologic changes and anatomical relations of the paranasal sinuses before surgical interventiaon for the paranasal sinuses. Considering the above facts, diagnosis of pediatric sinusitis only by plain X-ray was inadequate and OMU CT was necessary.

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