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      • KCI등재후보

        Pull-Through Buddy Wire Technique for Endovascular Thrombectomy in Patients with Acute Ischemic Stroke: Technical Note

        Chiang Pin-Yi,Lin Yen-Heng,Huang Yu-Cheng,Lee Chung-Wei 대한신경중재치료의학회 2021 Neurointervention Vol.16 No.1

        Excessive tortuosity is a notable cause of failed endovascular thrombectomy for acute large-vessel occlusion stroke. Transcervical access (TCA) is a commonly proposed solution for overcoming this difficulty. However, the large-bore catheter usually used in TCA increases the risk of serious local complications. This paper presents a modified technique for TCA that uses a pull-through buddy wire (PTBW) to track a large-bore femoral guiding sheath (GS) into the carotid artery via a small carotid puncture site. The carotid puncture site can be easily managed through gentle manual compression. Two illustrative cases using this technique to deal with a large aortic arch and tortuous left common carotid artery are reported. In both cases, recanalization was achieved after successful GS placement. Using a PTBW is feasible in TCA.

      • KCI등재

        Relation between the local structure and solid solubility of the layered material LiMO2 (M=Co, Ni, Fe) in Li2MnO3

        Chen Hou,Xiang Xiao,Yi-Ran Xing,Le-Le Yu,Yong-Heng Si,Han Lu,Yu-Juan Zhao 대한금속·재료학회 2022 ELECTRONIC MATERIALS LETTERS Vol.18 No.1

        Although low solid solubility and activity of LiFeO2in xLi2MnO3·(1–x)LiFeO2 limit its practical application, it still has thepotential to become a new-generation cathode material without cobalt or nickel for Li-ion batteries. In order to understand theeffects of the local structures of different LiMO2(M = Co, Ni, Fe) layered materials on their solid solubility in Li2MnO3,partialdensities of states are calculated to determine the Jahn–Teller distortion in the layered cathode material, and the first-principlescalculation method based on density functional theory is used to optimize and compare the local structures of LiCoO2,LiNiO2,LiFeO2,LiMnO2,and Li2MnO3. The degrees of distortion of the transition metal–oxygen (M–O) and lithium–oxygen (Li–O)octahedra in the crystal structure of the material are evaluated. It is clear that the solid solubility of layered materials is relatedto the bond lengths and degrees of distortion of the M–O and Li–O octahedra. Among them, the similar bond length of LiNiO2and Li2MnO3and the high distortion of NiO6enhance the solid solubility of LiNiO2in Li2MnO3. Owing to the absence ofJahn–Teller distortion in LiFeO2and LiCoO2,the FeO6and CoO6octahedra are slightly distorted, thereby decreasing thesolid solubility of LiMO2(M = Fe, Co) in Li2MnO3. Understanding the relation between intra-octahedral distortion and solidsolubility provides simple and efficient evidence for comparing the solid solubilities of different LiMO2layered materials inthe Li2MnO3of Li-rich cathode materials. This study can be used as a reference for component design in Li-rich materials.

      • KCI등재

        Ovarian cancer risk score predicts chemo-response and outcome in epithelial ovarian carcinoma patients

        Hsiao-Yun Lu,Yi-Jou Tai,Yu-Li Chen,Ying-Cheng Chiang,Heng-Cheng Hsu,Wen-Fang Cheng 대한부인종양학회 2021 Journal of Gynecologic Oncology Vol.32 No.2

        Objective: Cytoreductive surgery followed by adjuvant chemotherapy is a standard frontlinetreatment for epithelial ovarian cancer (EOC). We aimed to develop an ovarian cancer riskscore (OVRS) based on the expression of 10 ovarian-cancer-related genes to predict thechemoresistance, and outcomes of EOC patients. Methods: We designed a case-control study with total 149 EOC women including 75chemosensitives and 74 chemoresistants. Gene expression was measured using thequantitative real-time polymerase chain reaction. We tested for correlation between theOVRS and chemosensitivity or chemoresistance, disease-free survival (DFS), and overallsurvival (OS), and validated the OVRS by analyzing patients from the TCGA database. Results: The chemosensitive group had lower OVRS than the chemoresistant group (5 vs. 15, p≤0.001, Mann-Whitney U test). Patients with disease relapse (13 vs. 5, p<0.001, Mann Whitney U test) or disease-related death (13.5 vs. 6, p<0.001) had higher OVRS than thosewithout. OVRS ≥10 (hazard ratio=3.29; 95% confidence interval=1.94–5.58; p<0.001) was theonly predictor for chemoresistance in multivariate analysis. The median DFS (5 months vs. 24 months) and OS (39 months vs. >60 months) of patients with OVRS ≥10 were significantlyshorter than those of patients with OVRS <9). The high OVRS group also had significantlyshorter median OS than the low OVRS group in 255 patients in the TCGA database (39 vs. 49months, p=0.046). Conclusions: Specific genes panel can be clinically applied in predicting the chemoresistanceand outcome, and decision-making of epithelial ovarian cancer.

      • KCI등재

        Delay of Surgery for Spinal Metastasis due to the COVID-19 Outbreak Affected Patient Outcomes

        Chia-Jung Hsieh,Chun-Yu Wu,Yen-Heng Lin,Yu-Cheng Huang,Wen-Chi Yang,Tom Wei-Wu Chen,Wei-Li Ma,Wei-Hsin Lin,Feng-Ming Hsu,Furen Xiao,Shih-Hung Yang,Dar-Ming Lai,Chang-Mu Chen,Shin-Yi Chao,Fon-Yih Tsuan 대한척추신경외과학회 2023 Neurospine Vol.20 No.4

        Objective: The present study is to analyze the effects of the coronavirus disease 2019 (COVID 2019) outbreak and the subsequent lockdown on the outcomes of spinal metastasis patients. Methods: The study was a retrospective analysis of data from a prospective cohort study. All patients underwent surgical intervention for spinal metastases between January 2019 and December 2021 and had at least 3 months of postoperative follow-up. The primary outcome was overall mortality during the 4 different stages (pre-COVID-19 era, COVID-19 pandemic except in Taiwan, national lockdown, lifting of the lockdown). The secondary outcomes were the oncological severity scores, medical/surgical accessibility, and patient functional outcome during the 4 periods as well as survival/mortality. Results: A total of 233 patients were included. The overall mortality rate was 41.20%. During the Taiwan lockdown, more patients received palliative surgery than other surgical methods, and no total en bloc spondylectomy was performed. The time from surgeon visit to operation was approximately doubled after the COVID-19 outbreak in Taiwan (75.97, 86.63, 168.79, and 166.91 hours in the 4 periods, respectively). The estimated survival probability was highest after the national lockdown was lifted and lowest during the lockdown. In the multivariate analysis, increased risk of mortality was observed with delay of surgery, with emergency surgery having a higher risk with delays above 33 hours, urgent surgery (below 59 and above 111 hours), and elective surgery (above 332 hours). Conclusion: The COVID-19 pandemic and related policies have altered daily clinical practice and negatively impacted the survival of patients with spinal metastases.

      • KCI등재

        Abrupt Decline in Estimated Glomerular Filtration Rate after Initiating Sodium-Glucose Cotransporter 2 Inhibitors Predicts Clinical Outcomes: A Systematic Review and Meta-Analysis

        Min-Hsiang Chuang,Yu-Shuo Tang,Jui-Yi Chen,Heng-Chih Pan,Hung-Wei Liao,Wen-Kai Chu,Chung-Yi Cheng,Vin-Cent Wu,Michael Heung 대한당뇨병학회 2024 Diabetes and Metabolism Journal Vol.48 No.2

        Background: The initiation of sodium-glucose cotransporter-2 inhibitors (SGLT2i) typically leads to a reversible initial dip in estimated glomerular filtration rate (eGFR). The implications of this phenomenon on clinical outcomes are not well-defined.Methods: We searched MEDLINE, Embase, and Cochrane Library from inception to March 23, 2023 to identify randomized controlled trials and cohort studies comparing kidney and cardiovascular outcomes in patients with and without initial eGFR dip after initiating SGLT2i. Pooled estimates were calculated using random-effect meta-analysis.Results: We included seven studies in our analysis, which revealed that an initial eGFR dip following the initiation of SGLT2i was associated with less annual eGFR decline (mean difference, 0.64; 95% confidence interval [CI], 0.437 to 0.843) regardless of baseline eGFR. The risk of major adverse kidney events was similar between the non-dipping and dipping groups but reduced in patients with a ≤10% eGFR dip (hazard ratio [HR], 0.915; 95% CI, 0.865 to 0.967). No significant differences were observed in the composite of hospitalized heart failure and cardiovascular death (HR, 0.824; 95% CI, 0.633 to 1.074), hospitalized heart failure (HR, 1.059; 95% CI, 0.574 to 1.952), or all-cause mortality (HR, 0.83; 95% CI, 0.589 to 1.170). The risk of serious adverse events (AEs), discontinuation of SGLT2i due to AEs, kidney-related AEs, and volume depletion were similar between the two groups. Patients with >10% eGFR dip had increased risk of hyperkalemia compared to the non-dipping group.Conclusion: Initial eGFR dip after initiating SGLT2i might be associated with less annual eGFR decline. There were no significant disparities in the risks of adverse cardiovascular outcomes between the dipping and non-dipping groups.

      • Clinical Application of Endoscopic Inguinal Lymph Node Resection after Lipolysis and Liposuction for Vulvar Cancer

        Wu, Qiang,Zhao, Yi-Bing,Sun, Zhi-Hua,Ni, Jing,Wu, Yu-Zhong,Shao, Heng-Hua,Qu, Jun-Wei,Huang, Xin-En Asian Pacific Journal of Cancer Prevention 2013 Asian Pacific journal of cancer prevention Vol.14 No.12

        Aim: To examine lymph nodes obtained after lipolysis and liposuction of subcutaneous fat of the inguinal region of female vulvar cancer patients to explore the feasibility of clinical application. Methods: The field of operation was on the basis of the range of the conventional resection of inguinal lymph nodes. We injected lipolysis liquid fanwise, started liposuction after 15-20 minutes; then the subcutaneous fatty tissue was sucked out clearly by suction tube. We selected the first puncture holes located on 2-3 cm part below anterior superior spine, the others respectively being located 3cm and 6cm below the first for puncturing into the skin, imbedding a trocar to intorduce $CO_2$ gas and the specular body, and excise the lymph nodes by ultrasonic scalpel. The surgical field chamber was set with negative pressure drainage and was pressured with a soft saline bag after surgery. Results: A lacuna emerged from subcutaneous of the inguinal region after lipolysis and liposuction, with a wide fascia easily exposed at the bottom where lymph nodes could be readily excised. The number of lymph nodes of ten patients excised within the inguinal region on each side was 4-18. The excised average number of lymph nodes was 11 when we had mature technology. Conclusion: Most of adipose tissue was removed after lipolysis and liposuction of subcutaneous tissue of inguinal region, so that the included lymph nodes were exposed and easy to excise by endoscope. This surgery avoided the large incision of regular surgery of inguinal region, the results indicating that this approach is feasible and safe for used as an alternative technology.

      • KCI등재

        A Study on the Scenario Transparency of Civil Intelligent Adjudication in China

        주복용 ( Fu-yong Zhu ),퉁신위 ( Xin-yu Tong ),가오이헝 ( Yi-heng Gao ) 한중사회과학학회 2024 한중사회과학연구 Vol.22 No.1

        과학기술의 발전으로 인하여 민사재판에 있어서도 이른바 ‘스마트 재판’이 등장하였다. 스마트 재판은 과학기술에 재판의 기능을 더한 것으로, 재판절차를 표준화함으로써 재판의 질적 및 효율성을 제고하는데 도움이 된다. 현재 재판과정을 보면, ‘사전회의-공판-판결’을 거치는데, 이때 판결의 편차가 발생하게 된다. 이러한 판결의 편차에 있어 투명성이 보장되지 않기 때문에 스마트 재판에 사용되는 AI의 알고리즘에 대한 분석이 필요하다. 하지만, 알고리즘은 대부분 제조회사의 영업비밀로 보호되고 있다. 이른바 ‘알고리즘 블랙박스’로 인해 민사사건 당사자와 일반대중은 알고리즘의 실제 작동과정과 재판에서의 적용에 관해 알기 어려울 뿐만 아니라, 재판결과에 대한 합리적 의심을 해결할 수 없게 된다. 이로 인해 최근 중국이 스마트 재판을 받아들여 발전시키려는 정책에 걸림돌이 될 수 있다. 이를 위해 스마트 재판의 과정을 시각화함으로써 투명성을 보장할 필요가 있다. 즉, 재판준비과정에서 공판 및 판결에 이르기 까지의 전과정을 AI 알고리즘의 운영이 시각화할 수 있도록 하여야 한다. 기술적으로는 재판과정 간 투명성 보장을 위한 알고리즘을 통해 상호 통합하도록 하여, 실제 재판이라는 물리적 공간과 AI가 제공하는 사이버 공간을 상호 연결하여 융합할 필요가 있다. 또한, 민사재판의 투명성 보장을 통해 ‘기계(프로그램)+인간’이 공생하는 민사재판 모델을 구축하고, 전통적인 ‘현장 정의’ 이론을 ‘디지털 정의’이론으로 전환함으로써 민사사건 해결에 있어 새로운 국면을 열 수 있을 것이다. Technology and civil adjudication of two-way run to write a new chapter of civil intelligent adjudication, intelligent technology for the adjudication of empowerment, help to standardize the adjudication of the operation of the program, enhance the quality of the adjudication of the effectiveness of the adjudication of the realization of the goals of the adjudication of great significance. However, in practice, due to the lack of transparency of pre-trial meetings, court hearings, adjudication and deviation and other scenarios, in particular, the algorithms involved are mostly protected by technology companies as trade secrets. The black box of algorithms makes it difficult for the parties to civil cases and the public to know the actual operation of the algorithms and the logic behind the adjudication actions, and it is impossible to dispel the reasonable doubts of the parties and the public about the adjudication results, which may exacerbate the crisis of the acceptability of civil intelligent adjudication. To this end, we take scene transparency as the perspective, typify the scenes of civil intelligent adjudication, construct intelligent transparency models from different scenes such as pre-trial preparation, trial, adjudication and adjudication deviation, promote the deep integration between technology and adjudication activities, promote the connection, switching and integration of material space and information space through technology, shape the theoretical models of transparency in different scenes, and improve the compatibility between the theoretical models of scene transparency and the development of intelligent adjudication technology. It also improves the adaptability between the theoretical model of scene transparency and the development of intelligent adjudication technology. Based on the justice goal of scene transparency research and development, and in accordance with the principle of human-machine symbiosis, the civil adjudication mode of human-machine symbiosis is constructed to promote the traditional theory of “field justice” to the theory of “digital justice”, improve the digital system of civil case resolution, and promote the realization of the fusion of technology and law. It also promotes the digitalization system of civil case resolution, promotes the integration of technology and law, and promotes the integration of emotion, reason and law in the adjudication results while enhancing the transparency of the intelligent adjudication scenario, so as to continuously improve the acceptability of the civil adjudication results, and to build up an ecological system of trust for civil intelligent adjudication.

      • KCI등재

        H_3PW_12_O40/SiO_2 for sorbitol dehydration to isosorbide: High efficient and reusable solid acid catalyst

        Peng Sun,He Huang,Ding Hua Yu,Yi Hu,Zhen Chen Tang,Jiao Jiao Xia,Heng Li 한국화학공학회 2011 Korean Journal of Chemical Engineering Vol.28 No.1

        Tungstophosphoric acids (PW) supported on various metal oxides (SiO_2, γ_Al_2O_3, TiO_2, ZrO_2 and CeO_2)were synthesized and used as catalysts for sorbitol dehydration to isosorbide for the first time. 30% PW/SiO_2 exhibited the best catalytic performance for sorbitol dehydration, over which 56% isosorbide selectivity could be gained at a 95% sorbitol conversion at 250℃. The catalytic performance of regenerated 30% PW/SiO_2 catalysts by dichloromethane elution showed no loss after recycling five runs. Characterizations with UV-Vis, XRD, NH3-TPD and thermal analysis techniques revealed that PW had a good dispersion, and the primary Keggin structure was preserved after supporting PW on different supports. The interaction between PW and oxides resulted in different acidity of catalysts,which affected conversion of sorbitol and selectivity for isosorbide. The final acidity order of supported PW catalysts was the following: SiO_2>γ_Al_2O_3>TiO_2 ≈ZrO_2>CeO_2.

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