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Purpose : The purpose of this study was to evaluate the utility of the CT cholangiography by using helical CTwith multiplanar reformation in patients with extrahepatic biliary obstruction. Materials and Methods : Helical CTwas performed in 36 patients of extrahepatic biliary obstruction confirmed by operation or invasivecholangiography(percutaneous transhepatic cholangiography or endoscopic retrograde cholagiopancreatography). Thecause of obstructions were 18 benign diseases(11 common bile duct stones, four choledochal cysts, threepancreatitis) and 18 malignant diseases(seven common bile duct carcinomas, seven pancreatic head carcinomas, threeampullary carcinomas, one periampullary duodenal carcinoma). After helical scanning through the extrahepatic bileduct, retrospective reconstruction of the helical data was performed. And then, CT cholagiogram was obtained withmultiplanar reformation. We evaluated the technical success rate and the accuracy in determinating the level andthe cause of the obstruction. We compared findings of the CT cholangiogram with that of operation or invasivecholangiography. Results : In 100%(36/36) of cases, CT cholangiography could be obtained successfully. Theaccuracy of the CT cholangiography in determinating the level of the obstruction was 100%(11 cases ofsuprapancreatic duct, 13 cases of intrapancreatic duct, 13 cases of infrapancreatic duct and ampulla), and theaccuracy in determinating the cause of the obstruction was 91.7%(all cases of 18 benign diseases, and 15 cases of18 malignant diseases). Conclusion : In evaluating the obstruction of extrahepatic bile ducts, the CTcholangiography by using helical CT with multiplanar reformation is an useful noninvasive method in determinatingthe level and the cause of biliary obstruction and therefore could replace the invasive cholangiography.
Purpose: To determine the value of Gd-DTPA enhanced fat-suppression(GEFS) MR imaging in the characterizationand differentiation of benign from malignant ovarian tumors. Materials and Methods: MRI findings of thirty-sevenpatients with surgically proved 44 ovarian tumors (30 benign, 14 malignant) were studied retrospectively. MRimaging with conventional spin echo (CSE ; T1-weighted image TR/TE 450/20, T2-weighted image TR/TE 3500/30, 90) andGEFS were performed with a 1.5T GE signa. MRI findings of tumors including cystic or solid, wall and septalthickness, necrosis, invasion to adjacent organ, ascites and lymphadenopathy were assessed separately by using CSEand GEFS images, and then tumors were characterized as benign or malignant. Results: Comparing with CSE image, GEFS MR image showed better visualization of solid component in 5 malignant lesions, wall thickness in 5 malignantand 1 benign lesions, septal thickness in 3 malignant and 1 benign lesions, necrosis in 1 malignant lesion, andadjacent soft tissue invasion in 5 malignant lesions. Correct characterization of malignant tumors was increasedfrom 71% on CSE image to 93% on GEFS image. However, correct characterization of benign tumors was 93% on bothimages. Conclusion: GEFS MR imaging could be useful for characterization of ovarian tumors, especially inmalignant cases, and employed for differentiation of benign from malignant tumors.
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이 연구는 직업교육 환경의 변화에 부응하고 고등학교 단계의 직업교육을 다양화하고 특성화하는 방안으로 도입된 직업교육 분야 특성화 고등학교 정책이 성공적으로 정착되고 있는지를 평가하기 위하여 수행되었다. 이를 위하여 특성화 고등학교 정책을 평가하기 위한 모형을 개발하였으며, 이 모형을 특성화 고등학교 정책에 적용한 결과 각 영역별로 의미있는 결과를 도출하였다. 평가 모형은 평가 단계, 평가 영역, 평가 항목, 평가 기준의 네 가지 요소로 구성하였다. 특성화 고등학교 정책 평가 결과 목표 달성도에 있어 특성화 고등학교로 개편한 후 입학률은 높아졌고, 중도 탈락률과 취업률은 낮아졌으며, 반면에 대학 진학률은 상당히 높아졌다. 정책 대상자의 만족도에 있어서는 학생, 학부모, 교사들의 만족도는 보통 이상이었으나, 산업체서의 만족도는 낮았다. The primary purpose of this study was to evaluate the policy for specialized vocational high schools which were developed as an alternative system to traditional vocational high schools. The research methods used in this study were literature review and qualitative and quantitative methods. The qualitative method was used in the analysis of the materials of the policy, in-depth interviews, and telephone interviews. The questionnaire was also administerd to students, their teachers and their parents according to the types of the specialized vocational high schools. The major conclusions of this study are as follows: First, the model to evaluate the policy for specialized vocational high schools consists of four elements: evaluation stage, evaluation areas, evaluation items, and evaluation criteria. Each stage was classified into three courses. Second, the application of the evaluation model for specialized vocational high schools showed that the policy adequately responded to international and national environment, social and economic changes, based on relevant diagnosis of the environmental contexts. The policy for specialized vocational high schools did not reflect the demand of industries. As for policy performance evaluation, specialized vocational high school students enrollment rate and admittance rate to university increased, whereas the rate of the drop out students and employment decreases. Satisfaction of such policy target groups as the students, teachers, their parents was relatively high but the satisfaction rate of the industries which employed graduates from the specialized vocational high schools was low. Finally, specialized vocational high schools need to be promoted in the view of national human resources development, school choice model for life long learning, expanding school autonomy, and long term administration and financial support.
Wound healing proceeds, fibroblasts play a major role in controlling the composition and amount of extracellular matrix and collagen metabolism. As the amount of collagen product is increased, the scar becomes more thicker and harder. Firmness of the scar can significantly influence the outcome of scar revision depending on the amount of collagen. This study aimed to classify the results of surgical scar revision according to the hardness of the scar and to compare histological differences and effectiveness in scar revision surgery between each classification. We selected subjects who had undergone scar revision and examined their scar pathology and surveyed the satisfaction levels of patients and Vancouver scar scale in each group. As the scar hardness increased from soft to hard, more collagen fiber bundle and elastic fiber tangling were noted. On the other hand, the satisfaction of patients was increased as the scar hardness was decreased from hard to soft. In this study, therefore, we concluded that as the scar becomes harder, the tangling of elastic fibers and the amount of collagen fiber bundles increase. Such patients revealed a robust collagen metabolism, and showed worse results of scar revision.
Twenty-five patients with 47 cases of herniated cervical disks underwent CT scans before and after intravenous contrast enhancement and also after intrathecal administration of contrast medium, in order to evaluate the relative efficacy of intravenously enhanced CT among the three method in the detection of corvical HNP findings. Intravenously enhanced CT showed marginal ring enhancement along the posterior margin of the herniated disk and thickened linear blush, and so provided a better delination of HNP findings in 4 cases with focal disk herniation and 3 cases with a far lateral type of disk herniation than did simple CT and myelographic CT. The authors conclude that intravenous contrast enhancement really improves the CT diagnosis of herniated cervical disk, particularly in cases with doubtful focal herniation and far lateral type of disk herniation, and can make preoperative myelography and myelographic CT unnecessary.
목적: 대장암 환자에서 나선식 CT 검사시 횡단면 영상뿐만 아니라 바륨 대장조영영상과 유사한 삼차원 영상의 CT 대장조영영상(colonogram)을 얻을 수 있는데, 이때 사용되는 장관내 조영제로 공기를 이용하고 있다. 이에 대장암 환자에서 공기주입 나선식 CT의 유용성을 알아보고자 하였다. 대상과 방법: 공기주입 나선식 CT 검사를 한 후 수술로 확진된 대장암 33예를 대상으로 하였다. 모든 예에서 검사직전 항문을 통하여 적당량의 공기를 주입하여 횡단면으로 나선식 CT 영상을 얻었다. 이중 CT 검사 전 바륨 대장조영술을 시행한 11예에서 CT 대장조영영상을 함께얻었다. 두 명의 방사선과 의사가 합의하에 횡단면 CT 영상에서 병변의 위치와 발견율을 결정하고 변형Dukes(Astler-Coller)분류를 기초로 병기 결정을 하여 병리조직학적 소견과 비교하였다. 또한 CT 대장조영영상에서 병변의 발견율을 알아보았다. 결과: 횡단면 CT 영상에서 대장암의 병변의 발견은 33예중 32예로 97%에서 가능하였다. 전체적인 병기결정의 정확도는 23예에서 병리학적 소견과 일치하여 70%의 정확도를 보였다. 병기결정에서 CT와 병리학적 장막 침윤정도에서 일치하였던 예는 30예, 과대 평가되었던 예는 3예, 과소 평가 되었던 예는 없어, 예민도 100%, 특이도 50%, 정확도 91%를 보였다. 림프절침범은 CT와 병리학적 병기가 일치하였던 예는 25예, 과대 평가 되었던 예는 4예, 과소 평가되었던 예는 4예로 예민도 69%,특이도 80%,정확도 76%였다. CT 대장조영술 영상에서 병변의 발견은 11예 모두 (100%)에서 가능하였고, 병변의 위치도 바륨 대장조영술과 비교하여 모든 예 (100%)에서 일치하였으나 병변의 모양은 1예를 제외한 91%에서 일치하였다. 결론: 공기주입 나선식 CT는 양성조영제를 사용하는 것 보다 대장암을 발견하고 병기 결정하는데 우수하였고, 바륨 대장조영영상과 유사한 CT 대장조영영상을 얻을 수 있어 대장암의 위치에 관한 정보를 삼차원적으로 제공하므로 대장암의 성상을 정확히 알 수 있는데 도움을 주었다. Purpose: In patients with colorectal carcinoma, helical CT using air as a contrast agent provides axial images and a three-dimensional CT colonogram similar to that provided by barium enema. The purpose of this study was to assess the usefulness of air insufflation helical CT in colorectal cancer patients. Materials and Methods: Thirty-three patients with colorectal carcinoma confirmed by surgery underwent air insufflation helical CT scanning after the infusion of air through the anus. In eleven who underwent barium studies, CT colonograms were also obtained. Two radiologists, who reached a consensus, analysed the detection rate, location and staging of the tumors; staging was based on the modified Dukes (Astler-Coller) classification. Results: Using axial helical CT, the detection rate was 97%; staging was correct in 23 of the 33 patients, with an overall accuracy of 70%. Pathologic correlation was correct in 30 of the 33 cases (three were overestimated), and sensitivity, specificity and accuracy were 100%, 50%, and 91%, respectively. With regard to the involvement of lymph nodes, pathologic correlation was correct in 25 of the 33 patients; four were overestimated and four were underestimated. Sensitivity, specificity and accuracy were 69%, 80%, and 76%, respectively. The detection rate of CT colonography was 100%, but because in one case there was a discrepancy between CT colonography and barium enema as to the shape of the carcinoma, the agreement rate was 91%. Conclusion: Air insufflation helical CT, which provides a higher detection rate and more precise staging of colorectal carcinoma than the use of positive contrast materials and three dimensional depiction of tumor location, is helpful for the evaluation of colorectal carcinoma.
콘빔형 소동물용 CT 장치는 바이오-의료분야의 기초 실험에 활발히 응용되고 있다. 10μm의 직경을 가진 텅스텐 와이어(wire)와 물 팬텀을 이용하여 비교적 간단한 방법으로 소동물용 CT 장치를 평가할 수 있는 방법을 제시하였다. X선 튜브가 안정적으로 장시간 운전 가능한 조건에서 1° 간격으로 360개의 투영영상을 획득하고, 영상재구성을 통하 여 슬라이스 영상 및 3차원 영상을 얻었다. 콘빔형 소동물용 CT 장치는 배율 1.07배 위치에서 13.78lp/mm(공간해상 도 36.2μm)를 나타내었고, 80kV의 관전압에서 CNR 10.33 및 S/N 5.87을 보였다. A cone-beam computed tomography (CT) system for a small animal has been widely used in the bio-medical application. This paper introduced simple methods for evaluating a cone-beam CT system using a simple tungsten wire phantom of 10 μm diameter and a water phantom. Slice images and three-dimensional tomography images were obtained through 360 projection views per one sample rotation under stable X-ray tube conditions for a long running time. The cone-beam CT system at a position of a 1.07 magnification showed a spatial frequency of 13.78 lp/mm (36.2 μm spatial resolution) and gave a CNR of 10.33 and a S/N of 5.87 under a tube voltage of 80kV.