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      • PE-267 : Tacotsubo Cardiomyopathy Secondary to Pyogenic Liver Abscess

        ( Jeong Ill Suh ) 대한간학회 2020 춘·추계 학술대회 (KASL) Vol.2020 No.1

        Background: Takotsubo cardiomyopathy, also known as stress cardiomyopathy, is a type of non-ischemic cardiomyopathy in which myocardium suddenly weaken temporarily and is caused by emotional or physical stress such as sepsis, bleeding, asthma, or pheochromocytoma. Several infections have also been shown to precipitate Takotsubo cardiomyopathy. However, few cases have demonstrated the association with liver abscess. Reported herein is a rare case of Takotsubo cardiomyopathy precipitated by the liver abscess. Case: A 73-year-old female was admitted due to fever. She has been without any illness. She was acute ill looking appearance. Initial vital signs were: BP 110/60 mmHg, HR 101 beats/min, RR 20 breaths/min, temperature 38.0℃. Laboratory studies revealed WBC 21,550/㎣, hemoglobin 14.7 g/dL, platelet 101,000/㎣, prothrombin time was 15.8 sec (INR of 1.44). AST/ALT 94/87 IU/L, total bilirubin 0.89 mg/dL, albumin 2.9 g/dL, r-GTP 66 U/L, ALP 139 U/L. Viral markers were HBsAg(-), anti-HBs(+), anti-HBc IgM(-), anti-HAV IgM(-), anti-HCV(-). Initial EKG showed sinus tachycardia. Abdominal CT showed about 5x6cm sized cystic mass like lesion with air bubbles in the liver S8. Percutanenous catheter drainage was performed and antibiotic treatment was started. On 2<sup>nd</sup> day after admission, she developed suddenly worsening of dyspnea followed by blood pressure drop. Follow up EKG revealed myocardial ischemic change of lateral wall. CK 602 U/L, CK-MB 105.4 ng/ml, LDH 613 U/L, Troponin-I 18.8 ng/ml. Transthorasic echocardiography showed diffuse myocardial hyokinesia (ejection fraction 26%). But, coronorary angiogram showed completely normal findings. The cultured pus and blood samples were positive for K. pneumoniae. On the 11th day of hospitalization, her cardiac function was restored and EKG showed normal sinus rhythm. Her liver function recovered completely to normal and follow up abdominal CT showed marked decreased size of liver abscess on 38th day of hospitalization. Conclusions: Tacotsubo cardiomyopathy caused by pyogenic liver abscess is rare. The presentation is vary from asymptomatic to chest pain, shortness of breath, nausea, vomiting, palpitations or fainting. It may also show an EKG change and troponin elevation similar to myocardial infarction. Although stress cardiomyopathy is a reversible condition, but it can be serious and fatal.

      • KCI등재

        정신분열병 환자들의 自己灣入에 관한 예비 연구

        박성봉,김영미,전성일,이기철,김영훈,정영조,이영렬,이정호,최영민 大韓神經精神醫學會 1997 신경정신의학 Vol.36 No.6

        '스콜라' 이용 시 소속기관이 구독 중이 아닌 경우, 오후 4시부터 익일 오전 7시까지 원문보기가 가능합니다.

        목 적 : 정 신분열병 환자의 자기만입 정도에 영향을 미치는 인구학적 변인들 및 질병연관 변인들을 규명해 보고자 하였다. 또한. 환자들의 자기만입과 병식 사이의 연관성. 자기만입과 자존심 사이의 연관성을 알아보고자 하였다. 방 법 : 정신과 의사가 병록지와 면담을 통하여 대상 정신분열병 환자들의 인구학적 변인들 및 질병연관 변인들에 관한 자료를 얻고 환자들의 병식 정도를 평가한 후, 환자들로 하여금 자기보고형의 자기만입 척도와 자존심 척도를 시행하게 하였다. 총 111명의 환자가 연구대상으로 선택되었다. 결과: . 1) 여자가 남자보다 유의하게 높은 자기만입 척도 점수를 나타내었다 2) 질병연관 변인들 중 하위집단 사이에 자기만입 척도 점수의 유의한 차이를 보이는 변은 없었다. 3) 자기만입 척도 점수와 병식 점수 사이에 유의한 상관관계가 없었다. 4) 자기만입 척도 점수와 자존심 척도 점수 사이에 유의한 역상관 관계를 보였다. 결 론 : 본 예비 연구의 결과로 보아 정신분열 병 환자의 병식이 부족한 상태에서도 자기만입이 진행될 수 있으며. 자기만입이 심할수록 환자의 자존심이 저하되는 것으로 생각된다. 또한 여자 환자들이 남자 환자들보다 자기만입에 더 취약한 것으로 생각된다. 따라서 정신분열 병 환자의 이해와 치료를 위하여 자기만입에 관한 지속적인 연구가 필요할 것으로 생각된다. objective : This study was conducted to identify demographic variables and illness related variables which may affect the severity of self-engulfment in the patients with schizophrenia. We also studied the relationship between self-engulfment and insight, and the relationship between self-engulfment and self-esteem. Methods : Data on demographic variables and illness related variables for the subjects were gathered from hospital records and clinical interviews by the psychiatrists. Degree of insight for the subjects was assessed through clinical interviews by the psychiatrists. Degree of self-engulfment and self-esteem for the subjects was assessed from the self-engulfment scale and the self-esteem scale respectively. A total of 111 patients with schizophrenia were selected for statistical analysis. Results 1) The females exhibited significantly higher scores than the males on the self-engulfment scale. 2) There was no illness related variable, which exhibited a significant difference among subgroups on the self-engulfment scale. 3) There was no significant correlation between the self-engulfment scores and the insight 4) There was a significantly inverse correlation between the self-engulfment scores and the self-esteem scores. Conclusion : The results of this preliminary study suggest that self-engulfment may develop despite lack of insight and that there was inverse relationship between self-engulfment and self-esteem in the patients with schizophrenia. It also suggests that females are more subject to self-engulfment than males. So, authors suggest that it is valuable to do further studies of self-engulfment in the patients with schizophrenia.

      • SCOPUSSCIEKCI등재

        가성동맥류의 수술적 가료

        김재홍,임만빈,이창영,김일만,Kim,,Jae,Hong,Yim,,Man,Bin,Lee,,Chang,Young,Kim,,Ill,Man 대한신경외과학회 2001 Journal of Korean neurosurgical society Vol.30 No.3

        Objective : Surgical experiences of pseudoaneurysms such as traumatic, mycotic and ill-defined unknown causes of aneurysms are rare. The authors have studied the results of surgical management from such cases in our series. Patients and Method : In the last 17 years, 1320 patients with cerebrovascular aneurysms were managed surgically. Among these, 16 patients showed the pseudoaneurysms. The authors analyzed retrospectively the clinical characteristics, treatment methods, management outcomes and problems in the managements. Results : There were 6 patients with traumatic aneurysm, 4 mycotic aneurysms and 6 ill-defined unknown causes of aneurysm. The sites of traumatic aneurysms were cavernous portion of the internal carotid artery(n=3), distal portion of the anterior cerebral artery (n=2) and vertebral artery(VA : n=1). Good outcomes in 5 cases could be obtained by extracranial - intracranial bypass followed by parent vessel occlusion or resection of aneurysm followed by re-anastomosis of parent vessel. The sites of mycotic aneurysm were peripheral portions of middle cerebral artery(MCA : n=3) and posterior cerebral artery(PCA : n=1). The outcomes of the patients with a mycotic aneurysm were relatively poor. It was partially due to the development of new aneurysm after treatment in one. The sites of ill-defined unknown causes of aneurysm were extracranial carotid artery(n=3), V2 portion of the VA(n=1), peripheral portion of the PCA (n=1) and MCA(n=1). Good outcome in all cases could be obtained by resection of aneurysm with or without saphenous vein graft. Conclusion : For the treatments of cerebrovascular pseudoaneurysm, combinations of aggressive medical, endovascular and surgical managements seem mandatory. Insertion of stent for a extracranial carotid artery aneurysm and coiling for a peripheral mycotic aneurysm can be option in future.

      • KCI등재

        노인 우울증의 심각도 미치는 요인

        이민수,남종원,차지현,곽동일 大韓神經精神醫學會 1999 신경정신의학 Vol.38 No.5

        '스콜라' 이용 시 소속기관이 구독 중이 아닌 경우, 오후 4시부터 익일 오전 7시까지 원문보기가 가능합니다.

        연구목적 : 우울 증상은 노인 인구에서 흔하고도 중요한 정신 증상이다. 그러나 국내의 경우, 노인 인구의 우울 증상에 영향을 주는 요인에 대한 연구는 많지 않은 실정이다. 본 연구는 도시 노인 인구를 대상으로 노인 우울 증상의 심각도에 영향을 미치는 요인을 연구하였다. 방 법 : 본 연구는 1997년 5월부터 12월까지 성북구 관내에 거주하는 65세 이상 노인 490명을 대상으로 하였다. 대상군에게는 인구통계학적 자료의 평가와 내과적 병력청취, 정신과적 병력청취, 주관적 기억력저하의 보고가 시행되었고, 간이정신상태검사(Mini-Mental Status Exam ; MMSE), 노인우울척도(Geriatric Depression Scale ; GDS), 한국형 우울척도(Korean Depression Scale ; KDS) 등이 시행되었다. 결 과 : 총 490명의 노인 인구 중 남성은 84명, 여성은 406명이었고, 대상군의 평균연령은 72.36±6.76세(남성 72.89±7.42세 ; 여성 72.35±6.62세)였으며, GDS 평균 점수는 14.28±7.52, KDS 평균 점수는 162.01±32.23이었다. KDS 척도와 GDS 척도에 따른 인구통계학적 차이는 발견되지 않았다. 그러나 배우자의 사망, 가족의 죽음, 자신의 건강문제, 가족간의 불화, 그리고 경제적 문제 등을 가지고 있는 경우가 그렇지 않은 경우보다 GDS 점수와 KDS 점수 모두에서 유의한 증가를 보였다. 또한 GDS, KDS 모두에서 한가지 이상의 신체질환을 가진 노인군이 신체질환이 없는 군보다 유의하게 높은 점수를 보였다(GDS 신체질환군 15.28±7.56 신체건강군 12.37±7.32, P<0.001 ; KDS 신체질환군 164.57±33.26, 신체건강군 151.84±29.46, P<0.001). 주관적으로 기억력 장애를 호소하는 군도 비호소군보다 유의하게 높은 GDS, KDS 점수를 보였다(GDS 기억장애호소군 14.99±7.41 기억장애비호소군 12.91±7.84, P=0.006 ; KDS 기억장애호소군 163.29±31.77, 기억장애비호소군 153.98±33.63, P=0.004). 정상 대조군에 비해 우울증 집단에서 유의한 수준에서 더 많은 빈도로 관찰되는 것은 배우자 사망, 가족의 죽음, 경제적 문제, 신체적 질환 등이었다. 이러한 변인들과 우울증과의 관련성 정도를 보기 위해 로짓 회귀분석을 하였을 때, 우울증과 관련성이 있는 변인들은 1) 배우자의 사망(Wald=7.31, df=1, p=.01, odds ratio=5.06, 95% confidence interval=3.887-6.239), 2) 경제적 문제(Wald=6.42, df=1, p=.01, odds ratio=2.94, 95% confidence interval=2.107-3.776), 그리고 3) 신체적 질환(Wald=5.0734, df=1, p=.02, odds ratio=2.0735, 95% confidence interval=1.439-2.708) 등이었다. 결 론 : 배우자의 사망, 경제적 문제, 신체적 질환 등은 도시 노인 인구의 우울 증상의 심각도에 영향을 주는 요인으로 판단된다. The depressive symptoms are frequent and important ones in the elderly population. we studied the various factors affecting the severity of depressive symptoms in the elderly population. The Korean elderly(more than 65 years old ; n=490) in Seoul area(city) were studied on the identifying data and medical and psychiatric history, Mini-Mental State Examination(MMSE), Geriatric Depression Scale(GDS), Korean Depression Scale(KDS : under development) were also administered. In our study, the significant effect of sex, age, education, marital status, and the status of medical security on the severity of depressive symptoms were not found. Significantly higher GDS and KDS scores were found in the elderly who have more than one physical illness, subjective memory complaints, and seven life events. To examine the strength of association of these variables of depression, we conducted logistic regression. Depressive symptoms were associated with 1) the loss of spouse, 2) a current physical illness, and 3) low socioeconomic status. These results showed that depression in the elderly may be correlated with the loss of spouse, a current physical illness, and low socioeconomic status.

      • KCI등재SCOPUS

        New control strategy for interleaved PFC rectifiers using Lyapunov function

        Ill‑Uk,Kim,Byung‑Kwan,Bae,Jong‑Woo,Choi 전력전자학회 2021 JOURNAL OF POWER ELECTRONICS Vol.21 No.2

        The conventional current and voltage control methods of AC/DC power factor correction (PFC) rectifiers have been applied using proportional-integral (PI) or proportional-resonant controls. However, these approaches do not guarantee global stability at various operating points and are sensitive to disturbances, such as parameter or load variations. In this paper, a new control method is proposed based on the Lyapunov function that provides global stability and a fast response at various operating points. Experiments are conducted using an air conditioner with a 3 kW capacity. Experimental results are obtained and thoroughly analyzed.

      • KCI등재
      • Environmental Control for Greenhouse Management

        Sul,,Ill-Whan,Shin,,Dong-Ill 대구효성가톨릭대학교 응용과학연구소 1998 응용과학연구논문집 Vol.6 No.2

        온실재배는 겨울이 긴 우리나라의 기후특성과 보다 높은 소득의 창출, 그리고 식물의 생리 등 학문적 연구목적을 위해 많이 이용되고 있다. 그러나 자본집약적이고 높은 관리기술이 요구되는 이러한 시설재배를 위해서는 시설의 표준화, 시설내의 환경관리와 재배방법의 체계화가 필요하다. 시설내의 재배환경관리에 있어 가장 중요한 요인인 heating,과 cooling은 지역의 기후특성, 온실의 형태 및 크기 등을 고려하여 최소의 경비로써 효율이 높은 최적의 system,을 찾는 것이 중요하다. 본 총설에서는 현재 이용되고 있는 heating 과 cooling system에 대한 장,단점을 기술하고자 한다.

      • PE-266 : Empyema Comlicated by Pyogenic Liver Abscess

        ( Jeong Ill Suh ) 대한간학회 2020 춘·추계 학술대회 (KASL) Vol.2020 No.1

        Background: Empyema complicated by transdiaphragmatic extension of pyogenic liver abscess is a very rare complication of liver abscess. Effective drainage with proper antibiotic use is essential for treatment. Reported herein is a rare case of empyema complicated by pyogenic liver abscess. Case: A 58-year-old male was admitted due to fever with RUQ pain. He has been inactive HBV carrier state since 20 years ago. He was acute ill looking appearance. Initial vital signs were: BP 150/90 mmHg, HR 116 beats/min, RR 20 breaths/min, temperature 38.0oC. Laboratory studies revealed WBC 12,590/㎣, hemoglobin 13.5 g/dL, platelet 128,000/㎣, prothrombin time was 17.0 sec (INR of 1.55). CRP 25.6 mg/dl, AST/ALT 84/113 IU/L, total bilirubin 1.85 mg/dL, albumin 2.6 g/dL, r-GTP 53 U/L, ALP 102 U/L. Viral markers were HBsAg(+), anti-HBs(-), anti-HCV(-). Abdominal CT showed about 7x9cm sized septated cystic and low attenuation mass with mild rim enhancement in right heatic lobe posteror aspect. Percutanenous catheter drainage was performed and antibiotic treatment was started. On 6th day of hospitalization, he developed dyspnea. Follow up CT showed newly developed empyema of right lower lung. Chest tube drainage was performed. The cultured pus in liver abacess, empyema and blood samples were positive for K. pneumoniae. On the 20th day of hospitalization, liver function recovered completely to normal and follow up abdominal CT showed marked improved state of liver abscess and disappearance of empyema. Conclusions: It is very rare for pyogenic liver abscesses to expand into the diaphragm and cause empyema. Effective drainage with appropriate antibiotics is essential for successful treatment.

      • SCOPUSKCI등재
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