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        Malignant Skin Tumor Misdiagnosed as a Benign Skin Lesion

        황소민,Hao-Ching Pan,황민규,김민욱,이종서 대한두개안면성형외과학회 2016 Archives of Craniofacial Surgery Vol.17 No.2

        Despite the fact that benign skin lesions can undergo malignant transformation, the necessity and timing of the surgical resection have yet to be established. In this study, we analyse three cases of benign-appearing skin lesions, which were found to be carcinomatous on histologic examination and review the literature regarding the importance of prophylactic removal of benign-appearing skin lesion. The first and second cases were female patients wishing for cosmetic surgery. The first patient had a benign-appearing lesion on dorsum nasi, and the second patient had an inconspicuous lesion right along the right nasolabial fold. The third patient was a middle-aged male with a pigmented lesion on the left cheek, who presented to the clinic only after having met the operating surgeon through an acquaintance outside the hospital setting. All of the lesions were suspected to be of benign nature and were excised for cosmesis only. However, histologic examination of these lesions showed that the first two tumors were basal cell carcinoma with the last tumor being squamouse cell carcinoma. Thus, it is considered that removal of benign like skin lesion will result in good prognosis of patients scheduled to undergo other surgery.

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        Reduction of Nasal Bone Fracture using Ultrasound Imaging during Surgery

        황소민,Hao-Ching Pan,김홍일,김형도,황민규,김민욱,이종서 대한두개안면성형외과학회 2016 Archives of Craniofacial Surgery Vol.17 No.1

        Background: Most nasal bone fractures are corrected using non-invasive methods. Often, patients are dissatisfied with surgical outcomes following such closed approach. In this study, we compare surgical outcomes following blind closed reduction to that of ultrasound-guided reduction. Methods: A single-institutional prospective study was performed for all nasal fracture patients (n=28) presenting between May 2013 and November 2013. Upon research consent, patients were randomly assigned to either the control group (n=14, blind reduction) or the experimental group (n=14, ultrasound-guided reduction). Surgical outcomes were evaluated using preoperative and 3-month postoperative X-ray images by two independent surgeons. Patient satisfaction was evaluated using a questionnaire survey. Results: The experimental group consisted of 4 patients with Plane I fracture and 10 patients with Plane II fracture. The control group consisted of 3 patients with Plane I fracture and 11 patients with Plane II fracture. The mean surgical outcomes score and the mean patient dissatisfaction score were found not to differ between the experimental and the control group in Plane I fracture (p=0.755, 0.578, respectively). In a subgroup analysis consisting of Plane II fractures only, surgeons graded outcomes for ultrasoundguided reduction higher than that for the control group (p=0.007). Likewise, among the Plane II fracture patients, those who underwent ultrasound-guided reduction were less dissatisfied than those who underwent blind reduction (p=0.043). Conclusion: Our study result suggests that ultrasound-guided closed reduction is superior to blind closed reduction in those patients with Plane II nasal fractures.

      • Anatomical Variation of the Lesser Saphenous Vein

        Hwang, So-Min,Pan, Hao-Ching,Kim, Hong-Il,Jung, Yong-Hui,Kim, Hyung-Do 대한미세수술학회 2013 Archives of reconstructive microsurgery Vol.22 No.2

        Purpose: The lessor saphenous vein is an anatomical index in various surgical methods involving an approach to the popliteal fossa. However, occasionally, there have been some cases where the surgical process was difficult because the lessor saphenous vein was not found in the popliteal fossa during the operation process. The aim of this study is to determine the frequency of the anatomical variation of lessor saphenous vein not found in the popliteal fossa with a review of the literature. Materials and Methods: This study was conducted on 83 cases of selective neurectomy for hypertrophic calf performed in our clinic from March 1997 to June 2013. There were 42 patients, with a mean age of 32.8 years old. We confirmed the existence of the lessor saphenous vein in the popliteal fossa during the operation process. Results: Among 83 cases during this study period, the lesser saphenous vein was not found in four cases. In one patient, no lesser saphenous vein was found on either side of the popliteal fossa, and in two patients, no lesser saphenous vein was found on the left side of the popliteal fossa. As a result, the frequency of variation was found to be 4.8%. Conclusion: Due to the anatomical variation of the lessor saphenous vein, it may not be found in the midline of the popliteal fossa. Based on the literature review, several possibilities for failure to observe the lesser saphenous vein could be suggested. If surgeons are well aware of these possibilities, the steadier operation could be performed.

      • Evolution of Multi-temporal Landslides at Luhu, Miaoli County, Taiwan

        ( Che-ming Yang ),( Keng-hao Kang ),( Kuo-wei Li ),( Hui-jung Wang ),( Ching-ping Hsiao ),( Jyh-jong Liao ),( Yii-wen Pan ) 대한지질공학회 2019 대한지질공학회 학술발표회논문집 Vol.2019 No.2

        A deep-seated landslide took place in Luhu, Miao-Li, Taiwan during intermittent rainfall in April 2018; initially, there were successive rock falls and gully erosion then leaded to a deep-seated landslide failure eventually. This study aims to understand the failure mechanism and the process of deep-seated failure. The study site is a steep anaclinal slope consisting of the Miocence Shihti Formation with thick sandstone, interbedded of sandstone and shale. We collected multi-temporal ortho-images and digital elevation (surface) models from 1980 to 2019 for geological investigation, geomorphological interpretation and numerical simulation. The images reveal several slope failures at 1998, 2003, 2005, 2009, 2015, 2017 and 2018 with various volume and failure types. The study area contains three sub-regions: the north, the northwest and the southwest slopes. The slope failure occurred repeatedly inside the north and the northwest slopes in the early stage. Gully erosion in the southwest slope progressed to a landslide on April 5, 2018 first and expanded to cover the deep-seated landslide failure in the northwest slope eventually; the slope failure resulted in a natural dam. After the landslide, several open cracks appeared near to the crown. The estimated maximum thickness, area and volume of the deep-seated landslide are ~60 m, 65,000 m2 and ~2 Mm3, respectively. Based on these results, we also performed a series of numerical simulation using the software RAMMS to interpret the run out and the deposition of this landslide case.

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