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      • SCOPUSKCI등재

        An Anatomy of South Korea's "Total Crisis" in the Spring of 1990

        Lee, Kyoung Eun,Rhie, June Hyoung the Center for International Studies, Inha Univers 1990 Pacific Focus Vol.5 No.2

        Most students of Korean affairs would hardly disprove that South Korea's spring of 1990 was characterized as the season of a ''total crisis.'' This terIn was coined by an econoInic lninister at the late March cabinet lneeting, shortly after the cabinet reshuffle on March 18, in order to delineate the then situation into which South Korea was believed to be graduaIly but unwittingly plunging. The terln won overwhehning popularity, alInost in the twinkling of an eye, arnong the Korean politicians and journalists. For instance, even Young-sam Kim (hereafter YS Khn) encouraged the mernbers of the ruling Democratic Liberal Party (hereanter DLP) to help the nation escape the total crisis, even though in a later presidential address, President Tae-woo Roh lightly declined to ternl the situation as a crisis. The term''total crisis,'' despite its alnbiguity and obscurity, con- tinued to retain the status of being the subject of conversation until the historic n1eeting of Roh and Mikhail Gorbachev in early June. In other words, Roh's monlentous meeting with Gorbachev in San Francisco surprisingly evaporated the total crisis, at least apparently hronl the Korean political scene, particularly ftom the voices of politicians and from the tips of journalists'fingers. An ordinary citizen must accept such ephemerality of the crisis even if he was lefL bewildered by its genesis and abscondence. The lnysterious denlection of crisis in the beginning of June only left nlore mysteries and conlplication than satisfaction behind to the naviet6 of the ordinary citizens. So a National Assemblyrnan hrom the Peace Democratic Party (hereafter PDP), the largest opposition party in South Korea, made a cynical renlark concerning such ephemeral crisis in his speech at the late- June Nationa1 Assemlbly interpellation session that the total crisis was a ''total fraud,'' to which no ready reply was appropriately given either by YS Kim or by that econonlic minister. Many questions are allowed to spring fron, but few answers are available for, such ''queer'' transiency of crisis in the current Korean political scene. First, was the situation referred to by the economic minsiter a real crisis at al1? If it had been a real one, how could the Korean governlnent and people have extricated theInseIves ffonl such a mysterious way, perhaps just as we recover from a mild cold by ourselves? `Vhy did not econonhc n1inister and others agree to char- acterize that situation as a total crisis with what sort of facts and data, anyway? VVere they avant-gardes who are able to foresee what the ordinary citizens fail to do? Had the ordinary people agreed to this, or to a lesser degree, had they been weII infornled and thereby weI1 persuaded of the graveness of the situation as much as the eco- nomic minister and other hnportant political nigures perceived the situation? Or, was the characterization of the situation a real hoax or fraud? VVhat was the aim if it had been a po1itically manipulated deception? `Vhy was the opposition's insight was so slow if it were a hoax devised by the ruling power? To answer these questions we rnay need Inany facts and data nlore than we can collect. But even if we could, these facts and data are Ineaningful only within an appropriate frarnework or Inodel of crisis. Hence we will here dea1 wdth a lnodel of a crisis first and then examine the characterization based on that n1odel, with particular attention to political, economic and socio-cultural developments in current Korea.

      • 한국의 태안반도에서 CH₄의 지역적 배경농도에 관한 연구 : 1990 ∼ 1992 년 자료를 중심으로

        이근준,정용승 한국교원대학교 환경과학연구소 1994 환경연구논문집 Vol.- No.2

        Since November 1990, the observations of methane (CH₄) level have been carried out at Tae-ahn Peninsula (TAP) in Korea. Analysis on atmospheric data obtained in the period from November 1990 to August 1992 is carried out and the results are included in this study. We note that CH₄ does not have a clear seasonal cycle with a minor maximum in August-September and with a minimum in June-July. The variations in monthly average level are much larger with 1765.01∼1857.21 ppb (amplitude 92.20 ppb). The occurrence of a minimum in June-July is due to the inflow of the North Pacific air, an increase of OH radical and due to a decrease in CH₄ emission from rice paddy. A maximum in August and September appears to result from an increase in organic materials in agriculture (rice paddy) and forests, inputs of local sources due to weak airflows, stagnation of the warm and moist air and from a decrease in OH radical. The present analysis indicates that according to CH₄ data from Mongolia and from several sites in North Pacific TAP is influenced as much as 31 ppb in average from the inputs of Chinese emission. When the atmospheric CH₄of TAP is compared with data observed at Korea National University of Education (KNU), the values of KNU are higher (127 ppb) than those of TAP. It is clear that air samples taken at KNU are influenced strongly by local sources in central Korea than those at TAP. According to analysis of trajectories and airflows, we find that there are 4 types in classification. Firstly, when an air flow is originated mainly in China values of CH₄ gas are in medium ranges. Secondly, when an airflow is from both local(Korea) and China we find higher values. Thirdly, with an airflow from both local (Korea) and Japan origins medium values are recorded. Fourthly, when an airflow of maritime origin arrives low values of atmospheric CH₄are observed at TAP.

      • 강의 수소취화에 대한 국부영역에서의 수소의 거동(Ⅰ) : 지연파괴의 수소집적에 미치는 응력 및 소성변형의 영향

        이영호,이진우,배명일,고준빈,이규천 충남대학교 산업기술연구소 2001 산업기술연구논문집 Vol.16 No.1

        Hydrogen embrittlement cause decrease of it's mechanical properties during hydrogen dissolved in steels. Many mechanisms of hydrogen concentration researches have done, but it is not clearly known yet. In this study the effect of plastic deformation and external stress on mechanism of hydrogen concentration by high temperature hydro-genation treatment were investigated. The main results are as follow : 1)For short time fracture process, a defect rate of chemical potential energy is an important factor on hydrogen concentration for delayed fracture of steel processed with high temperature hydrogen. 2)For long time fracture process, the important element is long range diffusion of hydrogen due to the rate of effective hydrogen density and plastic deformation. 3)hydrogen concentration as plastic deformation vary in proportion to slope of plastic deformation. 4)Hydrogen concentration due to the effect of external stress, but this effect is limited in short range. 5)External stress is an acceleration element for delayed fracture of steel.

      • 홍요추 이행부 골절에 대한 임상적 연구

        이준규,이호석 충남대학교 의과대학 지역사회의학연구소 1993 충남의대잡지 Vol.20 No.2

        We have treated 38 cases of the injuries of the Thoracolumbar spine (T11 to L2) by short segment pedicular screw fixation using C-D instrumentation during the period from May. 1989 to June, 1993. The results were obtained as follows. 1. The Correction after short segment fixation was satisfying as follows : Ant. wedging angle, 11.3 degrees. Local Kyphosis angle, 11.1 degrees. Ant. vertebral height, 31.7%. Post. vertebral height, 6.6%. 2. The maintaing of correction appeared to be satistying as well, correction loss was follows : Ant. wedging angle, 2.2 degrees. Local kyphosis angle, 1.7 degreees. Ant. vertebral height, 6.2%. Post. vertebral height, 1.8%. 3. The short segment fixation with CD instrumentation was effective in correction, its maintance and no neurologic deterioration

      • SCOPUSKCI등재

        H₂^(15)O PET을 이용한 뇌혈류 파라메트릭 영상 구성을 위한 알고리즘 비교

        이재성,이동수,박광석,정준기,이명철 대한핵의학회 2003 핵의학 분자영상 Vol.37 No.5

        목적: H_(2)^(15)O PET의 정량화를 위하여 1-조직 구획모델이 쓰이며, 뇌혈류와 조직/혈액 분배계수를 구하기 위하여 nonlinear least squares (NLS) 방법이 사용되나 계산 시간이 긴 등의 문제로 파라미터를 각 화소마다 구해야 하는 파라메트릭 영상 구성에는 적합하지 않다. 이 연구에서는 이와 같은 NLS 문제점을 극복하여 파라메트릭 영상을 빠르게 구성하기 위하여 제안된 파라미터 추정 알고리즘들을 구현하고, 이 방법들의 통계적 신뢰도와 계산의 효율성을 비교하였다. 대상 및 방법: 이 연구에서 이용한 방법들은 linear least squares (LLS), linear weighted least squares(LWLS), linear generalized least squares (GLS), linear generalized weighted least squares (GWKS), weighted integration (WI), 그리고 model-based clustering method (CAKS)이다. 노이즈 정도에 따른 각 파라메트릭 영상법의 정확성 및 통계적 신뢰성을 알아보기 위하여 Zubal 뇌모형(brain phantom)으로부터 동적 PET 영상을 모사하고 포아송노이즈를 더한 후 각 파라메트릭 영상 구성 방법을 적용하였다. 또한 정상인 16명에 대하여 얻은 실제 자료에 대하여 이 방법들을 적용하고 결과를 비교하였다. 결과: 뇌혈류와 분배계수에 대한 평균 오차는 방법에 따라 크게 다르지 않았으며 모든 방법이 뇌혈류 및 분배계수 추정에 있어 무시할 만한 바이어스를 보였다. 파라메트릭 영상의 정성적 특성 또한 유사하였으나 CAKS 방법의 계산 속도가 월등하여 NLS 방법의 약 1/500, LLS 방법의 약 1/25의 계산시간을 보였다. 결론: 뇌혈류 파라메트릭 영상 구성을 위한 빠른 파라미터 추정 알고리즘들 중에 보다 개선되어 제아노딘 LWS, GLS, GLWS, CAKS 방법들이 단순하고 빠른 LLS, WI 방법들에 비하여 통계적 신뢰성을 크게 향상시키지는 못하나 CAKS 방법은 계산 시간을 유의하게 단축시키므로 가장 적합한 파라메트릭 영상 구성방법이라 할 수 있을 것이다. Purpose: To obtain regional blood flow and tissue-blood partition coefficient with time-activity curves from H_(2)^(15)O PET, fitting of some parameters in the Kety model is conventionally accomplished by nonlinear least squares (NLS) analysis. However, NLS requires considerable compuation time then is impractical for pixel-by-pixel analysis to generate parametric images of these parameters. In this study, we investigated several fast parameter estimation methods for the parametric image generation and compared their statistical reliability and computational efficiency. Materials and Methods: These methods included linear least squres(LSS), linear weighted least squares (LWLS), linear generalized least squares (GLS), linear generalized weighted least squares (GWLS), weighted integration (WI), and model-based clustering method (CAKS). H_(2)^(15)O dynamic brain PET with Poisson noise component was simulated using numerical Zubal brain phantom. Error and bias in the estimation of rCBF and partition coefficient, and computation time in various noise environments was estimated and compared, In addition, parametric images from H_(2)^(15)O dynamic brain PET data performed on 16 healthy volunteers under various physiological conditions was compared to examine the utility of these methods for real human data. Results: These fast algorithms produced parametric images with similar image quality and statistical reliability. When CAKS and LLS methods were used combinedly, computation tine was significantly reduced and less than 30 seconds for 128×128×46 images on Pentium III processor. Conclusion: Parametric images of rCBF and partition coefficient with good statistical properties can be generated with short computation time which is acceptable in clinical situation.

      • KCI등재

        게이트 심근 SPECT를 이용한 좌심실의 국소탄성률 평가방법 개발 및 재현성 평가

        이병일,이동수,이재성,강원준,정준기,이명철,최흥국 대한핵의학회 2003 핵의학 분자영상 Vol.37 No.6

        목적: 게이트 심근 SPECT 영상에서 국소부피변화를 얻으면, 요골동맥 긴장도를 측정하여 얻은 중심 동맥의 압력 곡선으로부터 최대탄성률을 얻을 수 있다. 이 연구에서는 좌심실의 국소탄성률을 평가하기 위한 방법을 개발하고 국소탄성률 측정의 재현성을 평가하였다. 대상 및 방법: 게이트 Tc-99m MIBI 심근 관류 SPECT를 두 번 연속으로 시행한 환자 7명(남:여=5:2, 58±11.9세)을 대상으로 하였다. 국소적 부피변화를 측정하기 위하여 개발한 CSA(Cardiac SPECT Analyzer) 소프트웨어를 이용하여 좌심실의 부피변화를 측정하였으며, 시간-압력 곡선과 국소 시간-부피 곡선을 이용하여 반복연산을 통하여 구한 국소 시간-탄성율 곡선에서 국소탄성률을 얻었다. 같은 SPECT 영상에 대해서 두 번 측정한 국소탄성률의 재현성과, 같은 환자에서 연속하여 두 번 얻은 SPECT 영상에 대해서 측정한 국소탄성률의 재현성을 평가하였다. 결과: 평균 국소탄성률은 15분할모델에서 3.36±3.38 mmHg/mL이었으며, 7분할모델과 5분할모델에서 각각 3.16±2.25 mmHg/mL, 3.11±2.57 mmHg/mL이었다. 국소탄성률의 조화평균은 전체탄성률과 일치하였다. 동일한 데이터에서 두 번 측정한 국소탄성률 값의 상관계수는 모든 모델에서 0.97이상이었고, Bland Altman 도표에서 차이의 2-표준편차는 각각 1.5%, 1.0%, 0.9%였다. 동일 환자에서 두 번 연속 촬영한 SPECT 데이터로부터 측정한 국소탄성률의 상관계수는 모든 모델에서 0.95이상이었으며, Bland Altman 도표에서 차이의 2-표준편차는 각각 2.2%, 1.0%, 1.2%였다. 결론: 게이트 심근 SPECT를 이용한 좌심실의 국소탄성률을 측정하였으며 재현성 있는 결과를 얻었다. 심근 SPECT를 이용하여 얻은 국소탄성률의 평가방법은 향후 임상적인 데이터를 바탕으로 새로운 심기능 분석지표로 활용될 수 있을 것이다. Purpose: Regional contractility can be calculated using the regional volume change of left ventricle measured by gated myocardial SPECT image and curve of central artery pressure obtained from radial artery pressure data. In this study, a program to obtain the regional contractility was developed, and reproducibility of regional contractility measurement was assessed. Materials and Methods: Seven patients )male:female=5:2, 58±11.9 years) with coronary artery diseases underwent gated Tc-99m MIBI myocardial SPECT twice without delay between two scans. Regional volume change of left ventricle was estimated using CSA (Cardiac SPECT Analyzer) software developed in this study. Regional contractility was iteratively estimated from the time-elastance curve obtained using the time-pressure curve and regional time-volume curve. Reproducibility of regional contractility measurement assessed by comparing the contractility values measured twice from the same SPECT data and by comparing those measured from the pair of SPECT data obtained from a same patient. Results: Measured regional contractility was 3.36±3.38 mmHg/mL using 15-segment model, 3.16±2.25 mmHg/mL using 7-segment model, and 3.11±2.57 mmHg/mL using 5-segment model. The harmonic average of regional contractility value was almost identical to the global contractility. Correlation coefficient of regional contractility values measured twice from the same data was greater than 0.97 for all models, and two standard deviations of contractility difference on Bland Altman plot were 1.5%, 1.0%, and 0.9% for 15-, 7-, and 5-segment models, respectively. Correlation coefficient of regional contractility values measured from the pair of SPECT data obtained from a same patient was greater than 0.95 for all models, and two standard deviations on Bland Altman plot were 2.2%, 1.0%, and 1.2%. Conclusion: Regional contractility of left ventricle measured using developed software in this study was reproducible. Regional contractility of left ventricle will be a new useful index for myocardial function after analysis of the clinical data.

      • KCI등재

        뇌혈관 협착 환자에서 SPM과 확률뇌지도를 이용한 기저/아세타졸아미드 SPECT의 정량적 분석법의 유용성

        이호영,이동수,팽진철,오창완,조맹제,정준기,이명철 대한핵의학회 2002 핵의학 분자영상 Vol.36 No.6

        목적: 뇌혈관질환에 있어서 뇌혈류와 뇌혈류예비능을 기저/아세타졸아미드 뇌혈류SPECT로 평가 가능하나 재관류 수술효과를 비교 평가하기 위해서는 정량적인 평가가 필요하다. 대상 및 방법: 12명의 환자(51±15세, 남:녀=6:6)의 수술 전후 기저 시와 아세타졸아미드 부하 뇌관류 SPECT를 SPM에서 공간정규화하고 소뇌의 계수를 기준으로 계수정규화한 후 확률뇌지도(statistical probabilistic anatomical map, SPAM)를 이용하여 부위별 혈류를 정량화하였다. 이 결과로부터 수술 전후 및 정상대조군(59±15세, 남:녀=10:11)과의 비교를 McNemar test와Mann-Whiteny test를 이용하여 비교하였다. 혈류예비능은 기저 시와 부하시의 차이를 기저 시 계수를 기준으로 백분율로 표현하였다. 결과: 수술 후 수술 부위의 기저 시와 아세타졸아미드 부하 시 혈류 그리고 혈류예비능 모두가 유의하게 향상되었다(p<0.05). 정상군과의 비교에 있어서는 기저 시 혈류는 정상군과 차이가 없을 정도로 호전되었으나, 아세타졸아미드 부하시 혈류와 혈류예비능은 수술 후에도 유의한 차이를 보였다(p<0.05). 혈류예비능은 주로 수술부위를 중심으로 향상되었다. 결론: SPM 및 SPAM을 이용하여 기저/아세타졸아미드 뇌혈류 SPECT의 수술 전후결과를 정량적, 객관적으로 쉽게 비교 평가할 수 있다. Purpose: While cerebral blood flow and cerebrovascular reserve could be evaluated with basal/acetazolamide Tc-99m-HMPAO SPECT in cerebrovascular disease, objective quantification is necessary to assess the efficacy of the revasculariztion. In this study we adopted the SPM method to quantify basal cerebral blood flow and cerebrovascular reserve on basal/acetazolamide SPECT in assessment of the patients who underwent bypass surgery for linternal carotid artery (ICA) stenosis. Materials and Methods: Twelve patients (51±15 years) with ICA stenosis were enrolled. Tc-99m-HMPAO basal/acetazolamide perfusion SPECT was performed before and after bypass surgery. After spatial and count normalization to cerebellum, basal cerebral blood flow and cerebrovascular reserve were compared with 21 age-matched normal controls and postoperative changes of regional blood flow and reserve were assessed by Statistical Parametric Mapping method. Mean pixel values of each brain region were calculated using probabilistic anatomical map of lobes. Perfusion reserve was defined as the % changes after acetazolamide over basal counts. Results: Preoperative cerebral blood flow and cerebrovascular reserve were significantly decreased in involved ICA territory, comparing with normal control (p<0.05). Postoperative improvement of cerebral blood flow and cerebrovascular reserve was observed in grafted ICA territories, but cerebrovascular reserve remained with significant difference with normal control. Improvement of the cerebrovascular reserve was most prominent in the superior temporal and the angular gyrus, nearest to the anastomosis sites. Conclusion: Using SPM quantification method on basal/acetazolamide Tc-99m-HMPAO SPECT, the cerebral blood flow and cerebrovascular reserve could be assessed before revascularization and so could the efficacy of the bypass surgery. (Korean J Nucl Med 2002;36;357-67)

      • KCI등재

        니트로글리세린 투여 Tc-99m-MIBI 정량 게이트 심근SPECT를 이용한 관상동맥우회로술 후 심근 기능 회복 예측

        이동수,김유경,천기정,팽진철,이명묵,김기봉,정준기,이명철 대한핵의학회 2003 핵의학 분자영상 Vol.37 No.5

        목적: 생존심근 진단에 있어 니트로글리세린 투여 Tc-99m-MIBI 게이트 심근SPECT의 진단성능을 휴식/지연재분포 Tl-201 심근SPECT와 비교하였다. 대상 및 방법: 22명의 관상동맥질환에서 Tl-201휴식/디피리다몰 부하 Tc-99m-MIBi 게이트/ 지연재분포 Tl-201 심근SPECT를 시행하였다. 이 때 게이트SPECT 시행 후 니트로글리세린 0.6mg을 설하 투여하고 연이어 그 자리에서 게이트 SPECT를 1회 더 반복 시행하였다. 환자들에서 관상동맥우회로술을 시행하고 3개월 후 게이트 심근SPECT를 추적검사로 시행하였다. 20 분절 모델을 이용하여 각 분절에서 휴식, 지연재분포, 기저상태와 니트로글리세린 투여 후의 심벽운동 및 수축기비후화 등을 정량하였다. 정량화된 생존심근 예측지표들 중, (1) 휴식기 Tl-201 섭취, (2) Tl-201 지연재분포, (3) 기저상태의 수축기비후화, (4) 니트로글리세린 투여 후의 수축기비후화, 네 가지의 예측성능을 평가하고 비교하였다. 결과: 총 100개의 분절이 분석에 포함되었으며, 이 중 66개(66%)의 분절이 재관류 후 기능 회복을 보였다. 최적 기준점인 50%를 기준으로 하였을 때, ROC 곡선 분석에서 휴식기 Tl-201 섭취와 Tl-201 지연재분포의 민감도, 특이도는 각각 79%와 44%, 그리고 82%와 44%였다. 또한 15%를 기준으로 하여, 기저상태 수축기비후화와 니트로글리세린 투여후 수축기비후화의 민감도, 특이도는, 각각 49%, 50%와 64%, 65%였다. ROC 곡선의 AUC는 니트로글리세린 투여 후 수축기비후화가 기저시 수축기비후화에 비하여 유의하게 높았다(p=0.004). 결론: 니트로글리세린 투여 Tc-99m-MIBI 정량적 게이트 심근SPECT는 기능이상 심근에서 기능 회복을 예측하는데 유용한 검사이다. The performance of nitroglycerin-challenged Tc-99m-MIBI quantitative gated SPECT for the detection of viable myocardium was compared with rest/ 24-hour redistribution TI-201 SPECT. Materials and Methods: In 22 patients with coronary artery disease, rest Tl-201/ dipyridamole stress Tc-99m-MIBI gated/ 24-hour redistribution TI-201 SPECT were performed, and gated SPECT was repeated on-site after sublingual administration of nitroglycerin (0.6 mg). Follow-up gated SPECT was done 3 months after coronary artery bypass graft surgery. For 20 segments per patient, perfusion at rest and 24-hour redistribution, and wall motion and thickening at baseline and nitroglycerin-challenged state were quantified. Quantitative viability markers were evaluated and compared;(1) rest thallium uptake, (2) thallium uptake on 24-hour redistribution SPECT, (3) systolic wall thickening at baseline, and (4) systolic wall thickening with nitroglycerin-challenge. Results: Among 100 revascularized dysfunctional segments, wall motion improved in 66 segments (66%) on follow-up gated myocardial SPECT after bypass surgery. On receiver operating characteristic (ROC) curve analysis, the sensitivity and specificity of rest and 24-hour delayed redistribution TI-201 SPECT were 79%, 44% and 82%, 44%, respectively, at the optimal cutoff value of 50% of Tl-201 uptake. The sensitivity and specificity of systolic wall thickening at baseline and nitroglycerin-challenge were 49%, 50% and 64%, 65% at the optimal cutoff value of 15% of systolic wall thickening. Area under the ROC curve of nitroglycerin-challenged systolic wall thickening was significantly larger than that of baseline systolic wall thickening (p=0.004). Conclusion: Nitroglycerin-challenged quantitative gated Tc-99m-MIBI SPECT was a useful method for predicting functional recovery of dysfunctional myocardium.

      • 만성 B형 간염 환자의 급성 악화 후 발생한 피부 결절 다발동맥염과 류마티스관절염

        이주현,김민,이준성,장선희,윤보영,이윤우 인제대학교 2009 仁濟醫學 Vol.30 No.-

        Cutaneous polyarteritis nodosa(CPAN) is a rare vascular disorder that affects small and medium-sized arteries in the reticular dermis and subcutaneous tissue. It has been described as a distinct clinical entity with benign and a chronic prolonged course without systemic involvement. Hepatitis B virus-related polyarteritis nodosa (HBV-related PAN) is typical form of classic PAN. Its pathogenesis is not well known, but considered an immune complex-mediated disease. The patients with HBV-related PAN often present with malignant hypertension, orchitis, and vascular nephropathy. But, HBV-related CPAN has been rarely reported. Rheumatoid vasculitis is a complication of rheumatoid arthritis that can be lead to variety of clinically significant skin and systemic conditions, It has been reported before or at the time of rheumatoid arthritis diagnosis but is usually seen an average of 10 to 14 years after arthritis onset. The histological features of cutaneous vasculitis in rheumatoid arthritis overlapped both the characteristics of cutaneous necrotizing venulitis and cutaneous polyarteritis nodosa. But polyarteritis nodosa-like rheumatoid vasculitis has rarely been reported. We report a case of rheumatoid arthritis and cutaneous polyarteritis nodosa in a chronic hepatitis B with acute exacerbation.

      • SCOPUSKCI등재

        측두엽 간질에서 F-18-FDG PET에 나타난 측두엽 내외측 부위별 대사의 차이

        이명철,이동수,정준기,김현집,송호천,이상건,여정석 대한핵의학회 1999 핵의학 분자영상 Vol.33 No.1

        Purpose: We investigated the difference of glucose metabolism of medial and lateral temporal lobes of patients with temporal lobe epilepsy (TLE) utilizing quantitative comparison of regional metabolic activities using asymmetric index. Materials and Methods: We studied 19 pathologically proven mesial TLE and 25 lateral TLE patients. Lateral TLE patients were either normal on magnetic resonance imaging (cryptogenic: n=14) or had structural lesions (lesional: n=11). Asymmetric index (ASI) was calculated as [(ipsilateral-contralateral)/(ipsilateral+ contralateral)]×200. Results: ASI of medial and lateral lobes of mesial TLE was decreased (-16.4±8.3 and -12.7±5.5, respectively). In cryptogenic lateral TLE, ASI of lateral temporal lobe was decreased (-11.8±4.7), whereas that of medial temporal lobe was not decreased (-4.6±6.3). ASI of medial lobe of lesional lateral TLE was -7.3±9.1, which was significantly different from that of mesial TLE (p<0.05). Patients with lesional lateral TLE had evident metabolic d or decrease (ASI: -22±10.5) in lateral temporal lobe. While we could not find the difference of metabolic activity in lateral temporal lobes between cryptogenic lateral TLE and mesial TLE patients, the difference of metabolic activity was significant in medial temporal lobes which was revealed by ASI quantitation. Conclusion: Asymmetric decrease of metabolic activity in both medial and lateral temporal lobes indicates medial temporal epilepsy. Symmetry of metabolic activity in medial temporal lobe combined with asymmetry of that in lateral temporal lobe may give hints that the epileptogenic zone is lateral.

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