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      • KCI등재후보
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      • KCI등재후보

        소아의 방광 요관 역류 진단시 X-ray 배뇨성 방광 요도 조영술(X-ray VCUG)과 방사성 동위원소 배뇨성 방광 요도 조영술(RI VCUG)의 비교

        홍현숙,최득린,김은미,김성준,Hong Hyun-Soook,Choi Deuk-Lin,Kim Eun-Mi,Kim Sung-Jun 대한소아신장학회 1999 Childhood kidney diseases Vol.3 No.2

        목적 : 방광요관역류는 방광에서 요관과 신장으로 소변이 역류하는 현상으로 요로감염증의 약 1/3에서 발견되며 정도는 1도에서 5도까지 나눌수 있다. 소아의 방광요관역류의 진단에 있어 사용되는 RI VCUG(Radioisotope voiding cystourethrography(이하 VCUG)) 와 X-ray VCUG의 결과를 비교하여 방광요관역류의 진단에 어느 방법이 더 유용한지 평가하고자 본 연구를 시행하였다. 방법 : 1991년 1월부터 1998년 7월까지 7년 6개월동안 순천향병원 소아과 외래를 방문한 환아중 잦은 요로감염증이나 초음파 검사상 이상소견을 보인 9개월에서 17세까지 평균 5년 6개월의 남아 19명, 여아 21명을 대상으로 대상환아들에게 X-ray VCUG나 RI VCUG 또는 두가지 방법을 동시에 시행하였으며 요검사와 소변 배양검사를 1개월마다, 신장 초음파 검사를 3개월마다, RI VCUG를 6개월마다 추적검사를 시행하여 방광요관역류의 소실여부를 관찰하며 예후를 평가하였다. 결과 : 대상환아중 24명이 RI VCUG를 시행하여 17명이 방광요관역류소견을 보여 70.1%의 양성률을 보였고 22명이 X-ray VCUG를 시행하여 9명이 방광요관역류소견을 보여 40.1%의 양성률을 보였으며 19명이 두가지 검사를 모두 시행하여 15명이 RI VCUG상 양성소견을 보였고 이중 7명이 X-ray VCUG상 양성소견을 보였고 RI VCUG상 음성소견을 보인 4명은 X-ray VCUG 상에서도 음성소견을 보였다. 방광요관역류환아의 예후는 중복신장을 동반한 1례에서는 수술로 교정되었으며 다낭포신을 동반한 1례에서는 역류가 지속되었고 그외 단순한 역류에서는 자연소실과 반혼의 형성이 각각 8명이었으며 역류가 지속된 경우가 5명, 수술로 교정된 경우는 2명, 신기능이 감소된 경우가1명, 추적관찰이 되지않은 경우가 1명이었다. DMSA(2,3-dimercaptosuccinic acid 이하 DMSA) sacn상 방광요관역류환아 9명중 8명이 반흔을 형성하였고 역류가 없던 8명에서는 반흔을 형성하지 않았다. 요배양검사상 방광요관역류환아가 19명중 17명으로 역류가 없던 환아 21명중 15명이 양성소견을 보인것보다 양성률이 높았으며 원인균으로는 대장균이 가장많았고 방광요관역류환아에서 요로감염이 없던 기간은 14개월로 방광요관역류가 없는 환아에서의 26개월보다 짧았다. 결론 : 소아의 방광요관 역류의 진단에 있어 RI VCUG가 X-ray VCUG보다 양성률이 높음을 확인할수 있었다. 그러므로 초기진단시 방광요관 역류가 의심되나 X-ray VCUG로 발견되지 않은 경우에는 RI VCUG를 꼭 시행하는 것이 방광요관역류의 정확한 진단을 하는데 도움이 된다. Purpose : VUR is state where urine regurge from bladder to ureter and kidney. It is shown in about 1/3 of urinary tract infection patients and it is classified as grade I to V. We compared results from RI VCUG(Radiisotope voiding cystourethrography) and X-ray VCUG which used in diagnosing VUR in children, to evaluate which is better in diagnosing VUR in children. Methods : 41 Patients(19 males, 21 females), who visited Pediatric department, Soonchunhyang university Hospital from peroid of 1991. January to 1998. July for recurrent urinary tract infection or abnormalities in ultrasonogams, were enrolled in the study. The age ranged from 9 months to 17 years and mean age was 5 1/2 years. Both RI VCUG and X-ray VCUG were done and follow-up test of urine culture, renal ultrasonogram and RI VCUG were done every month, every 3 month and every 6 month, respectively to observe the disappearance of VUR and evaluated the prognosis. Results : 24 patients had taken RI VCUG and 17(70.1%) patients showed positive result. 22 patients had taken X-ray VCUG and 9(40.1%) patients showed findings of VUR. 17 patients had taken both tests and 14 patients showed positive result in RI VCUG and 6 of these patients also showed reflux in X-ray VCUG. 3 patients who showed negative in RI VCUG, showed negative also in X-ray VCUG. For prognosis, resolution and scar formation was shown in 8 patients each. Persistent VUR was shown in 6 patients and 2 of these patients VUR was corrected by operation, 1 patient showed decreased renal function, and 1 patient was not follwed up. 8 of 9 patients who showed findings of VUR on DMSA scan formed a scar and 8 patients who showed no findings of VUR didn't form a scar. Urine culture was positive in 17 of 19 patients with VUR. Positive rate in urine culture was higher than that of patients with no VUR who showed positivity in 15 of 21 patients for urine culture. E. coli was most common organism and the period free of UTI was 14 months in VUR patients and it was shorter compared to patients without VUR which was 26 months. Conclusion : In diagnosing VUR in children, the positive rate was higher in RI VCUG than X-ray VCUG. Therefore, in early diagnosis when VUR is suspicious but not shown in X-ray VCUG, RI VCUG should be done and it will help to make accurate diagnosis.

      • 정신질환자 인권증진을 위한 제도분석(1) : 강제 및 응급입원 제도

        홍현숙 국립서울병원 정신보건교육·연구센터 2007 정신건강정책포럼 Vol.1 No.1

        본 연구는 우리나라 정신질환자 인권증진을 위한 제도개선 및 방안을 마련하고자 수행되었으며, 인권 증진을 위한 국제적 흐름과 각국의 제도를 파악하며 우리나라 정신질환자 인권증진을 위한 제도개선에 대한 시사점을 찾고자 한다. 이에 본 고에서는 제도분석을 위한 첫 번째 단계로 각국의 강제 및 응급입원 제도를 소개하고자 한다.

      • KCI등재

        자기공명 영상에서의 치과 재료에 의한 인공물에 관한 연구

        홍현숙 대한영상의학회 1992 대한영상의학회지 Vol.28 No.3

        Magnetic resonance imaging(MRI) has proved to ve a valuable method for evaluation of the head and neck. Un-fortunately, metallic devices associated with certain dental fillings and applicances often cause variable artifacts that can obscure normal or pathologic conditions on MR and computed tomography. In this work, we assessed the MR appearance of dental prosthetic materials in vitro and in vivo including precious alloys, nonprecions alloys, resin, amalgam and titanium alloy. For in vivo studies, thess materials were placed in healthy volunteer's mouths and then images were assesed. Analyis of the appearance of shape and extent of artifact, and observed influence of these artifacts on the image interpretation at 0.2 Tesla permanent type MR scanner were valuated. Material used as temporary or permanent filling of crowns such as amalgam, precious alloy and, microfilled resin did not cause artifact on the image. The size of the artifact produced by the nonprecious alloys was inf uenced by the ferromagnetism of the object and the volume prosthesis, and was related to the scanning sequence. Nonprecious alloys produced minimal local signal distortions, where precious alloys, and dental resin had no effect on the MR image in vivo. These results were mainly from a low field strength MR scanner used in this study.

      • KCI등재후보

        MRI Findings to Predict Neurodevelopmental Outcomes in Preterm Infants Near Term-Equivalent Age

        홍현숙,김성신,박가영 대한자기공명의과학회 2020 Investigative Magnetic Resonance Imaging Vol.24 No.1

        Purpose: Preterm infants are at high risk for adverse neurodevelopmental outcomes. Magnetic resonance imaging (MRI) has been proposed as a means of predicting neurodevelopmental outcomes in this population. It is controversial whether diffuse excessive high signal intensity (DEHSI) represents damage to the white matter or delayed myelination in preterm infants. This study investigated MRI findings for predicting the severity of neurodevelopmental outcomes and assessing whether preterm infants with DEHSI near term-equivalent age have abnormal neurodevelopmental outcomes. Materials and Methods: Preterm infants (n = 64, gestational age at birth < 35 weeks) undergoing brain MRI near term-equivalent age and subsequent neurodevelopmental outcomes were evaluated between 18 and 24 months of age. The associations of MRI findings and the risk of severe cognitive delay, severe psychomotor delay, cerebral palsy (CP), and neurosensory impairment were analyzed. The associations of DEHSI with risks of severe cognitive delay, severe psychomotor delay, CP, and neurosensory impairment (hearing or visual impairment) were analyzed. Outcome data were evaluated by logistic regression and the Fisher’s exact test. Results: There were significant associations between abnormal white matter findings and delayed mental development, delayed psychomotor development, neurosensory impairment, and presence of CP. The presence of DEHSI was not correlated with delayed neurodevelopmental outcomes or presence of CP. In multivariate logistic regression analyses, cystic encephalomalacia, punctate lesion, loss of white matter volume and ventricular dilation were significantly associated with CP. Conclusion: Abnormal MRI findings near term-equivalent age in preterm infants predict adverse neurodevelopmental outcomes. No significant association between DEHSI and adverse neurodevelopmental outcomes was demonstrated.

      • KCI등재

        Perspectives on Mesenchymal Stem Cells: Tissue Repair, Immune Modulation, and Tumor Homing

        홍현숙,Youngsook Son,김영훈 대한약학회 2012 Archives of Pharmacal Research Vol.35 No.2

        Mesenchymal stem cells (MSCs) or MSC-like cells have been identified in a variety of different tissues that share molecular expression profiles and biological functions but also retain a unique differentiation preference depending on their tissue origins. MSCs play beneficial roles in the healing of damaged tissue by directly differentiating to many different resident cell types and/or by secreting several trophic factors that aid tissue repair. Aside from MSCs’ reparative stem cell function, they drive immune responses toward immunosuppression and anti-inflammation. This novel function of MSCs opens up new avenues for clinical development of MSC immune-therapeutics to treat uncontrollable, life threatening, severe, chronic inflammation and autoimmune disease. Unexpectedly high rates of MSCs’ tumor homing capacity and their tumor supporting capability have also been noted in tumor-bearing animal models. In this review, we will discuss MSCs’ basic cell biology and perspectives on MSCs in terms of tissue repair, immune modulation, and tumor homing.

      • KCI등재

        Anomalous Binder Cumulant and Lack of Self-Averageness in Systems with Quenched Disorder

        홍현숙,Hyunggyu Park,Lei-Han Tang 한국물리학회 2006 THE JOURNAL OF THE KOREAN PHYSICAL SOCIETY Vol.49 No.5I

        The Binder cumulant (BC) has been widely used for locating the phase transition point accurately in systems with thermal noise. In systems with quenched disorder, the BC may show subtle .nite- size eects due to large sample-to-sample °uctuations. We study the globally coupled Kuramoto model of interacting limit-cycle oscillators with random natural frequencies and .nd an anomalous dip in the BC near the transition. We show that the dip is related to non-self-averageness of the order parameter at the transition. Alternative de.nitions of the BC, which do not show any anomalous behavior regardless of the existence of non-self-averageness, are proposed.

      • KCI등재

        페닐케톤뇨증에서의 골 변화

        홍현숙 대한영상의학회 1998 대한영상의학회지 Vol.38 No.2

        Purpose : While treating 14 phenylketonuria(PKU) patients, we evaluated bone density, changes in bone age, andbony changes such as spiculation or metaphyseal widening. Materials and Methods: A total of 14 PKU patients agedbetween 1 month and 14 years(mean, 6.4 years) were under dietary treatment. Eight and eleven patients underwentradiography of the left hand and wrist and bone densitometry(BMD) of the lumbar spine, respectively. The resultswere reviewed with regard to abnormal bony changes, delayed bone age, and osteopenia. Patients were assigned toeither the early or late treatment group, depending on whether or not dietary therapy was started before 3 monthsof age. Those in whom a blood phenylalanine level of under 10 mg/dl was maintained were assigned to the ‘goodcontrol’ group; others were classified as 'variable control'. The findings of radiographs of the left hand andlumbar BMD were evaluated in relation to the time of dietary therapy, and adequacy of treatment. Results: Onlumbar BMD, four of 11 patients (36%) showed reduced bone density of more than 1 S.D. None of the 11 who underwentradiography of the left hand showed bony abnormalities such as spiculation or metaphyseal widening. In four of the11, bone age was less than chronological age by at least one year. According to Fisher's exact test there was norelation between delayed bone age , osteoporosis and the time and adequacy of dietary therapy (p >0.05).Conclusion: None of the 14 PKU patients who underwent dietary therapy had bony abnormalities such as spiculationor metaphyseal widening. In four of the 11, bone age was at least one year less than chronological age, and onlumbar BMD, osteoporosis was seen. For the evaluation of bone change in PKU patients, plain radiography and BMDare thus complementary.

      • KCI등재

        스터지 웨버 증후군의 MR 영상 소견 :1예 보고

        홍현숙 대한영상의학회 1990 대한영상의학회지 Vol.26 No.5

        One 6-month-old patient of Sturge-Weber syndrome examined with MR imaging and CT scan was reported. Both techniques well demonstrated unilateral cortical atrophy. In the region of parenchymal volume loss, MR better demonstrated thickened cortex and abnormal white matter, and prominent ependymal vein. after Gd-DTPA enhancement, intense enhancement of pial angiomatosis along brain surface was noted. However, CT scan better demonstrated the calcification. MR and CT scan appear to be complementary in the evaluation of Sturge-Weber syndrome.

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