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        사지의 주요 동맥손상의 처치: 23증례에 대한 분석

        원형섭,김상은,배성만,박철완,이 근,조상훈,김상일,우병완 大韓應急醫學會 1996 대한응급의학회지 Vol.7 No.1

        Extremity vascular trauma is common in most emergency centers, and controversy remains about the optimal management of arterial injuries. Retrospectively we reviewed the records of 23 patients who had upper or lower extremity arterial trauma from July 1994 to December 1995. The purpose of this study was to evaluate our department`s management policy to major arterial injuries. The leading cause of major arterial injuries was penetrating trauma. We found that there were clinical findings such as absence of or decreased strength of pulsation(82.6%), cool ischemic extremity(69.6%), large expanding hematoma(43.5%), major bleeding(17.4%) and bruit or thill(8.7%). We gave the priority to management of life-threatening injuries and applied the pressure dressing to wounds as early as possible. There were 18 men(78.3%) and 5 women(21.7%); the mean age was 35(range 20-56 years old) years. There were 12 arterial injuries(52.2%) in the upper extremity and 11 arterial injuries(47.8%) in the lower exteremity. The most commonly injured artery was the brachial artery in the upper(34.8%) and the femoral artery in the lower(30.4%) extremity. The etiology included knife stabbing in 10 patients(43.5%), motor vehicle accidents in 6(26.1%), industrial accidents in 4(17.4%), falls in 2(8.7%) and a farm equipment accident in 1 patient(4.3%). The associated injuries were muscle injuries(78.3%), fracture(56.5%), nerve injuries(52.2%), vein injuries(43.5%), shock(17.4%) and dislocation(13.0%). All patients with arterial injuries were given a preoperative prophylactic antibiotic and TIG(tetanus immunoglobulin). We used Doppler technique as a means of detecting the blood flow. Fourteen patients(60.9%) underwent preoperative arteriography in the radiology department. We performed surgical exploration as soon as major arterial injuries were suspected. The most common methods of treating major arterial injuries were interposition vein graft(69.6%) and end to end anastomosis(21.7%). Systemic or locally infused heparin was used for all vascular repairs. In many of our patients(56.5%), fasciotomy was performed before the vascular repair, as a part of the exploration of the distal arteries. There were 2 amputations(8.7%) but no death. The reason for secondary amputation were wound infection in one and failure to achieve sufficient arterial flow to the involved extremity with resulting gangrene in the other. As the time factor is vitally important in the management of arterial injuries, we advocate prompt and early surgical treatment within 6 hours of the trauma. In conclusion, we believe that the crucial factorsin successful management of major arterial injuries of the extremities are early diagnosis, prompt treatment, complete debridement, fasciotomy when indicated, and simultaneous treatment of concomitant injuries.

      • 근원 불명 전이암의 예후인자와 생존율

        원종호,박성규,홍대식,박희숙,김은석,최두호 순천향의학연구소 1999 Journal of Soonchunhyang Medical Science Vol.5 No.1

        Purpose : Patients with cancer of unknown primary site represent 5% to 10% of all cancer patients. This study was to evaluate survival and prognostic factors of patients with malignancy of unknown origin. Materials and Methods : A retrospective analysis was done for one hundred and two patients with malignancy of unknown origin who were treated from January 1989 to December 1998. There were 52 male and 50 female patients. Age of patients ranged from 20 to 94 years (mean 58 years). Clinical presentation depended on the site of metastases. In cases of multiple metastatic sites, we selected the first apparent metastasis or the symptomatic one for which the patient was first seen. The three most frequent initial metastatic sites were peritoneum, lymph node, and liver. Median follow up period was 4 months(0-100 months) and survival rate measured form the time of diagnosis. Results : The two years survival rate was 13.6% with a median survival time of 4 months. The factors associated with the overall survival rate were the tumor marker CEA(p=0.0061), smoking history(p=0.0039), and histologic type(squamous cell carcinoma versus non-squamous cell carcinoma, p=0.0295). Marginal statistical difference was found according to performance status. No statistical differences were found according to sex, weight loss, initial metastatic site and numbers, primary lesion site, and treatment modality. Conclusion : Squamous cell carcinoma was associated with survival rate. In squamous cell carcinoma of unknown origin with good prognostic factor, especially cervical lymph node metastasis, we suggest an approach of extensive initial workup for staging and aggressive treatment.

      • 건설 예정의 Coil Center 운영에 대한 Simulation 분석

        성덕현,윤원영,옥영석 釜山大學校生産技術硏究所 1997 生産技術硏究所論文集 Vol.52 No.-

        본 논문은 건설예정인 coil center의 처리능력과 물류를 평가하기위한 시뮬레이션모델을 개발하는 연구이다. 경험적인 추정에 의한 야드에서의 수량, 저장시간의 분포를 구하고 3가지 운영대안이 제안되어 SLAMII를 이용한 시뮬레이션을 실시하며 최종적인 대안은 설비(Slitter)의 추가가 추천되어 이 것에 대한 시뮬레이션 결과를 분석한다. 그 결과 Slitter와 저장야드의 병목현상이 나타나므로 향후 이부분에 대한 기술적인 고려가 필요한 것으로 나타났다. In this paper, the simulation model is developed to evaluate the capacity and the material flow of the planned coil center. By the empirical estimation, the distributions of the quantity and the elapse time in the yard are obtained, and three alternatives are proposed. Based on the primitive simulation using SLAMII, the final alternative is prepared which includes one more facility (slitter), and the simulation is also performed. The result shows that the slitter and the storage yard are the bottleneck points throughout the slitting process. And the problem should be solved technically in managerial decision making related to construct the new coil center.

      • 개에서 발생한 이버멕틴 중독증 1례

        여동원,윤기영,박정호,이왕희,송근호,박성준 忠南大學校 獸醫科大學 附設 動物醫科學硏究所 2011 動物醫科學硏究誌 Vol.18 No.1

        A 1-year old, intact male Jin-do dog with ataxia, hypersalivation and anorexia was referred to the Veterinary Medical Teaching Hospital of Chungnam National University. Ivermectin toxicosis was diagnosed by the history taking, clinical signs, physical examination and neurological examination. After therapy with intravenous fluid and lipid emulsion administration, the clinical signs were found to have significantly improved.

      • 노인장기요양보험제도의 안정적 운영에 대한 소고

        원성구 원광대학교 대학원 2008 論文集 Vol.41 No.-

        It is expected that Elderly Long term Care Insurance(ELCI) has an effect on environment of old people's welfare in Korean aging society. In the concrete, ELCI enormously influences on the formation of the whole infrastructure on old people's welfare and brings to a focus on sharing with a country and a local community as well as their family about not only nursing their disease like dementia or palsy but also caring them who need long term, by the principle of social solidarity. The aim of this study is sharing the interest and the comprehension about old people's welfare, examining of the present condition on ELCI, and suggesting some problems and remedies of ELCI for the stable management. Besides, this study examines the system and the characteristics of ELCI that will be carried out from July 1, 2008, and its details were national and public social insurance. Because ELCI is a national policy, however, there must be various preparations to carry out its stable management. To manage stably ELCI, therefore, this study searched for the many-sided financial resources raising, the investigation of a universal service, the construction of its establishments and infrastructure, and the participation of a whole nation based on the public confidence. To manage successful ELCI, first, there must be a constant interest in some countries concerning with ours through dispatch of specialists, second, there must be the construction of the network of both a local establishment and a home and of the system for both the harmonious communication and the information exchange, third, there must be an approachment of both the prevention and the rehabilitation in order not to waste of the cost, and forth, there must be the feedback about its problem.

      • 文理科大學 國語國文學科 : 現行 韓國語文法에 따라 쓰이는 글자를 對象으로 On the syllables due to current grammar

        成元慶 建國大學校 人文科學硏究所 1978 인문과학논총 Vol.11 No.-

        There have been various approaches and discussions concerning syllables used in our Korean language. If we combinate 21 vowel, 19 consonant, and 27 Badchim (syllable-final consonant or consonant cluser), we are to use 10773 syllables. In the end I find the fact that only 1863 syllables are now being used in the Korean language dictionary. The 1863 syllables mark 17.2%.

      • SCOPUSKCI등재
      • 『字類註釋』 硏究

        成元慶 건국대학교 인문과학연구소 1996 인문과학논총 Vol.28 No.-

        The JARYUJUSOK is a book that was edited and compiled by Jeong, Youn-young at the end of the Yi dynasty. He was 65 years old, when it was completed in 1856 A.D. It is a dictionary of Chinese characters. It is similar to the HUNMONGJAHOE which classified Chinese characters into many items, added a sound, a meaning and a interpretation. Using this book is useful for studing Korean etmology, because you can see the actual condition of Korean used back then. For example, '祖' meas 'haraboji: 할아버지: grandfather.' However, then, they used 'hanaboji: 한아버지: the same ancestor who is whole family's father.' So you can see 'hanaboji' who was changed into 'haraboji : 할아버지: grandfather.' Also, the made the classification of meaning clear. For example, '天' is 'hanul: 하늘: sky,' '昊' is 'yorumhanul: 여름 하늘: summer sky,' '旻' is 'gaulhanul: 가을 하늘: autumn sky.'

      • 원발성 위장관 악성 림프종의 임상적 고찰 : 치료 결과를 중심으로

        원종호,백승호,홍대식,오도연,박희숙 순천향대학교 1994 논문집 Vol.17 No.4

        저자들은 1984년 3월부터 1992년 12월까지 순천향 대학교 부속병원에서 원발성 위장관 악성 림프종으로 진단되었던 23명을 대상으로 다음과 같은 결론을 얻었다. 1. 대상 환자의 나이의 중앙치는 44(23-75)세로 남녀비가 2.8 : 1이었다. 2. 원발병소는 위 10예(43.5%), 소장 8예(34.8%) 및 회맹장 이행부위 5예(21.7%)였고, 병기 Ⅰ??기 8예(34.8%), Ⅱ??기 12예(52.2%), Ⅲ기 2예(8.7%), Ⅳ기 1예(4.3%)였다. 동반된 다른 장기는 주로 복부 임파절이었으며 폐 임파절 침범이 1예 있었고, 간을 침범한 경우가 1예, 위장과 소장에 병발한 경우가 1예 있었다. 조직학적 분류로는 중등도 19예(82.6%) 및 고도 4예(17.4%)였고 10예(43.5%)에서 B 증후가 있었다. 3. 치료를 시행한 20예중 Ⅰ??기 7예는 수술적 치료후 보조항암화학요법을 시행하였으며, Ⅱ??기 13예중 진단적 개복술후 완전절제가 확인된 3예는 보조항암화학요법을, 불완전절제로 확인된 7예는 관해유도 항암화학요법을 시행하였고, 3예는 항암화학요법만을 시행하였다. 4. 치료를 시행한 20예의 생존기간은 중앙치 43(4-100??개월이었으며, 3년 생존율 60.9%, 5년 생존율 40.6%였다. 5. Ⅰ??기 7예의 생존기간은 중앙치 42(11-100??개월이었으며, Ⅱ??, Ⅲ기 13예에서 치료에 대한 완전 관해가 9례(70%), 부분관해(15%), 무반응이 2례(15%)로 관해율은 85%였으며, 생존기간은 중앙치 44(4-52??개월이었다. 6. 완전관해자가 진행시까지의 관해지속기간은 중앙치 43(10-56??개월이었으며, 3년 무병생존율 79.1%, 5년 무병생존율 36.2%였다. Over a 8-year period(March 1984 through December 1992), 23 patients with primary gastrointestinal non-Hodgkin's lymphoma treated at Soonchunhyang University Hospital were analyzed with the following results; 1. The mean age of the patients was 43(23-75) years with male to female ratio of 2.8 : 1. 2. The primary sites of lymphoma were stomach in 10(43.5%), small intestine in 8(34.8%), and ileocecal area in 5(21.7%) and by modified Ann Arbor system, stage Ⅰ?? was 8(34.8%), stage Ⅱ?? was 12(52.2%), stage Ⅲ was 2(8.7%), and stage Ⅳ was 1(4.3%). Histologic classification by Working formulation revealed 19 cases(82.6%) of intermediate grade and 4 cases(17.4%) of high grade. B symptoms were observed in 10 cases(43.5%). 3. Treatments were performed in 20 cases as follows : In 7 cases with stage Ⅰ, complete surgical resection with systemic combined chemotherapy was performed. In 13 cases with stage ⅡE and Ⅲ, complete resection with systemic combined chemotherapy in 3 cases, incomplete resection with combined chemotherapy in 7 cases, and combined chemotherapy only in 3 cases. 4. Median survival duration of 20 treated patients was 43(4-100?? months and 3-year survival rate and 5-year survival rate were 60.9% and 40.6%, respectively. 5. Median survival duration of 7 cases with stage Ⅰ?? was 42 months(11-100??. In 13 cases with stage Ⅱ??, Ⅲ, response to treatment was complete remission in 9(70%), partial remission in 2(15%), and no response in 2(15%) resulting 85% of response rate and median survival duration was 44(4-52?? months. 6. Disease free survival rate of achieving a complete remission was 43(10-56?? months and 3-year disease-free survival rate and 5-year disease-free survival rate were 79.1% and 39.2%, respectively.

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