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      • 생체분해성 망막압정을 이용한 망막고정에 대한 실험적 연구

        김용백,민병무,김창식,박근성,김승영,길숙종,조항진,이성복,노승무,송규상,강대영,조준식,양준묵,정경수,최선웅,이진호,김학용,인현빈 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

        Biodegradable retinal fixation devices obtain mechnical fixation of the retina with desirable chorioretinal scarring and with the potential for local, sustained release of antimetabolites and steroids to inhibit proliferative vitreoretinopathy. We manufactured a biodegradable retinal tack with barb that was designed in order to prevent intrusion from implantation of retinal tacks. This study was carried to evaluate the efficacy for retinal fixation and the capability for sustained release of drugs with a newly designed biodegradable retinal tack Biodegradable retinal tacks were made of polymers of glycolic acids and were designed with barbs in a shape to prevent the disinsertion. Biodegradale retinal tacks are divided into 3 parts, a conical portion that is inserted into the sclera, a cylinder portion that remains in the vitreous, and a neck portion between the pin and the cylinder. The tapered conical end was manufactured to allow easy insertion through the retina and choroid into the sclera. A cylinder portion was manufactured with a tapered angle that fixes firmly into the orifice of 19 gauge spinal needle. A neck portion, 0.4 mm in diameter, was designed to prevent disinsertion from following implantation of retinal tack. The applicator was a 19 gauge spinal needle and its orifice was prepared to 15°angle to accept the tapered cylinder portion of the retinal tack. The retinal tacks, secured in the needles, were passed through the formed vitreous and inserted into the retina, choroid, and sclera and were released by pushing the internal needle, usually within 2-3mm of the medullary ray of the posterior rabbit retina A retinal tack was placed in each of 8 pigmented rabbit eyes. Slit-lamp biomicroscopy, indirect ophthalmoscopy and fundus photography were performed periodically from 1 day to 8 weeks after surgery. Eight eyes were enucleated and studied by light microscopy at 8 weeks. Biomicroscopic evaluation of the animals revealed edemas adjacent to the retinal surfaces immediately after insertion of the biodegradable retinal tacks in all the animals. These edemas disappeared after 1 week. The first noticeable change in the size of retinal tacks was shown after 2weeks. The size of the retinal tacks gradually got smaller, decreasing to about one-half at 4 weeks and about one-third at 8 weeks. All retinal tacks remained in inserted places without any movement for an 8 week period. On light microscopy, epiretinal proliferations were seen to extend into the vitreous cavity. Cellular capsules that lined the inner aspect of the scleral defect caused by tack insertion were found. However the adjacent retina had a normal cytologic appearance and architecture in all specimens. We manufactured a biodegradable retinal tack that is designed to prevent intrusion from implantation of retinal tacks. All biodegradable retinal tacks reduce in size with time, but no retinal tacks extruded from the inserted place. The newly designed biodegradable retinal tack can be used for retinal fixation and may be used as a vehicle for the introduction of pharmacologic agents to prevent the cellular events that promote proliferative vitreoretinopathy.

      • KCI등재후보

        8년간(1992~1999) 산업안전보건연구원에 의뢰된 직업병 심의 사례 분석

        강성규,김규상,김양호,최정근,안연순,진영우,최병순,양정선,김은아,채창호,최용휴,김대성,박정선,정호근 대한산업의학회 2000 대한직업환경의학회지 Vol.12 No.2

        Objectives : Pneumoconisis and noise-induced hearing loss (NIHL) have been reported as main occupational diseases by the Special Health Examination. The Industrial Accident Compensation Insurance has reported various work-related diseases, however, these two diseases occupied almost a half of compensated cases. Therefore, it was not well known about the status of occupational diseases other than pneumoconiosis, NIHL, and cardio-cerebrovascular accident (CVA). This study was conducted to analyze claimed cases as an occupational disease, that was requested to the Korea Industrial Safety and Health Agency (KOSHA). Methods : The local office of the Korea Labor Welfare Corporation (KLWC) has asked the KOSHA for confirmation of claimed cases as an occupational disease. We analyzed 379 cases requested from KLWC, the Ministry of Labor, employers, unions and occupational health agencies from 1992 to 1999. Results : Male was 80.7 % of the requested cases. Their mean age was 42 years old and 75.5 % of them were more than 35 years old. The requested cases were increased rapidly from 25 cases in 1992 to 108 cases in 1999 and the accept rate was 50.7 %. The majority of requested cases were respiratory diseases(22.4%), cancers(18.5%), Neuropsychiatric problems(14.5%), and musculoskeletal problems(13.5%). The accept rate was high in reproductive, respiratory, musculoskeletal and digestive disorders and low in neuropsychiatric, renal and otologic problems and occupational cancers. 73.6% of them were caused by chemical agents, especially 28.5 % were by organic solvents. 67% of them were clinically confirmed at university hospitals. A half of the cases were from KyongIn area, even the request came from the whole country. Conclusions : A claim was common in workers whose age was over 35 years old and exposure history was over 10 years. The respiratory diseases and neuropsychiatric disorders were still main problems in occupational health and occupational cancers was increasing even though its accept rate was not high yet.

      • 생체분해성 고분자를 이용한 사시수술용 제형개발 및 효용성에 대한 연구

        민병무,김용백,김승영,김창식,박근성,길숙종,조항진,이성복,노승무,송규상,강대영,조준식,양준묵,정경수,최선웅,이진호,김학용,인현빈 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.1

        A new device, muscle clamping system was developed to facilitate exact quatifying technique A strabismus surgery, and reduce the risk of complications. The device is composed of a lower fixing body with three jaws and an upper supporting body. They are used to clip an extraocular muscle and fix it to the sclera with a single bite. Superior rectus recession on 16 rabbit eyes were performed with this new device. Conjunctival injection, muscle adhesion strength, and light microscopic findings were examined at 1, 2, 4 and 8 weeks postoperatively. The Conjunctival injection were minimal, adhesion power ranged from 420 to 600 gram gravity, which is sufficient in withstand the normal pull of human extraocular muscle. In microscopic exam, some Inflammatory cells and fibrosis were found. The new device was technically easy, fast, and accurate, so it may be useful in stabismus surgery.

      • 뇌 수막종의 Volume Rendering 영상과 고식적 혈관 조영술의 영상 비교

        김영근,이성길 광주보건대학 2002 論文集 Vol.27 No.-

        This study showed following results. The time interval for maximal enhancement of meningioma was 120∼180 sec after injection of contrast material. All 12 cases showed good relationship between the tumor and surrounding vessels. A case of aneurysm associated with tumor was also well visualized. Three-dimensional volume rendering imaging of meningiomas obtained by using double contrast-enhancement technique was effective in the evaluation of relationship between the tumor and adjacent vascular structure. This technique was considered to be useful in making the preoperative plan.

      • 6차 교육 과정에 따른 고등학교 공통 과학 (화학 부분) 교과서의 탐구 활동 분석

        김윤희,정경규,문경근,문성배 부산대학교 사범대학 과학교육연구소 1998 科學敎育硏究報 Vol.25 No.-

        In order to obtain the fundamental data for developing an ideal chemistry curriculum in the common science, four kind of common science textbooks were analyzed. Particularly, inquiry activities part was analyzed by the three dimension framework which consists of inquiry content dimension, inquiry process dimension and inquiry context dimension. The average volume of chemistry part in the common science text books was 13% (56 page). In the analysis of the inquiry content dimension of inquiry activities, the total number of themes in four kinds of textbook had similar inquiry activities. For the analysis of inquiry process dimension, 'interpreting data and formulating generalizations' category(39.1%) was most emphasized and the categories of 'observation and measuring'(30.8%), and 'building, testing and revising the theoretical model'(16.5%), 'seeing a problem and seeking ways to solve it'(13.5%) follow in order. As for the analysis of the inquiry context dimension, the scientific context was 82%, the individual context 1.8%, the social context 7.8% and the technical context 7.8%. It showed that the proportion of STS related contents in inquiry activities was 18%. For the purpose of common science text book in the 6th curriculum, it is expected to increase the proportion of the high level inquiry process and the proportion of STS related contents.

      • 류마티스성 승모판 협착증의 치료를 위한 경피적 승모판 성형술의 치료성적

        김성은,조흥근,박성훈,박시훈 梨花女子大學校 醫科大學 醫科學硏究所 1999 EMJ (Ewha medical journal) Vol.22 No.4

        연구목적 : 류마티스성 승모판 협착증에 대한 유용한 치료법인 경피적 승모판 성형술의 본원의 단기 치료 성적을 알아보고자 하였다. 방법: 1993년 10월에서 1999년 4월까지의 이대목동병원에 내원한 류마티스성 승모판 협착증 환자 21명에서 투시조명 하에 경피적 승모판 성형술을 시행하였다. 시술전에 경흥부심초음파와 경식도초음파가 시행되었고, 시술후에는 경흉부초음파를 사용하여 혈역학적, 임상학적 변화를 비교하였다. 연구대상의 거의 모두가 NYHA class Ⅱ에 속했고, 5명이 심방세동을 가지고 있었으며, 모두 심초음파점수가 8이하였다. 좌심방에 혈전이 있는 경우로 혈전을 용해시킨 후 시술한 경우가 2예였다. 결과 : 경피적 승모판 성형술 이후의 평균 승모판구면적은 시술전의 1.16±0.36㎠에서 2.06±0.33㎠로 증가되었다. 경승모판 이완기 평균 압력차는 시술전 11.60±5.54mmHg에서 시술 후 4.93±2.53mmHg(p<0.001). 좌심방 크기는 46.41±14.66mm에서 42.03±15.01mm로(p=0.042), 그리고 심박출량은 4.21±1.25L/min에서 6.88±9.57L/min로(p<0.0001) 의미있는 호전을 보였다. 3도 이상의 심한 승모관폐쇄부전이나 심각한 시술후 합병증은 없었다. 결론 : 본원에서 약 6년간 시행된 경피적 승모판 성형술는 그 사례가 적고 시술전 예상되는 난이도 면에서 특이한 것은 없었지만, 시술후 합병증이 거의 발견되지 않았으며 혈역학적 측정상에서도 성공적인 시술을 보여주었다. 승모판구면적에 따른 시술후 단기내 호전의 정도는 거의 예측할 수 없었으나, 심초음파점수는 모두가 8점이하로 높은 성공율의 조건을 제공하였다. Objective : Percutaneous mitral valvuloplasty(PMV) became a treatment modality or mitral stenosis because of its low morbidity, short hospital stay, and low cost. We reviewed clinical and hemodynamic results after PMV for the patients with mitral stenosis in Ewha Womans University Mokdong hospital. Methods : We compared the results of echocardiographic, hemodynamic, and clinical parameters before and after PMV. PMV was performed under fluoroscopic guidance in 21 patients(M:4, F:17, mean age 43±12 years) with mitral stenosis from October 1993 to April 1999. Transesophageal echocardiography(TEE) and Transthoracic echocardiography(TTE) were performed for the evaluation of mitral valve, chamber size, and the presence of left atrial thrombus before procedures. TIE was also used for follow-up evaluation. On presentation, all patients showed at least NYHA class Ⅱ. Five patients had atrial fibrillation. Two patients with thrombus in the left atrium were included to study group after thrombolytic treatment with coumadin. Echo-score of our patients was not greater than 8. Results : Mean mitral valve area(MVA) by 2 dimensional or Doppler echocardiography was increased from 1.16±0.36㎠ before PMV to 2.06±0.33㎠ after PMV. There were marked improvements in transmitral gradients(11.60±5.54mmHg before PMV vs 4.93±2.53mmHg after PMV, p<0.001), left atrial dimension(46.41±14.66mm vs 42.03±15.01mm, p=0.042), and cardiac output(4.21±1.25L/min vs 6.88±9.57L/min, p<0.0001) following PMV, Severe(≥GⅢ) mitral insufficiency or severe postprocedural complications were not noted. This suggested that all procedure was successful. Conclusion : The Procedural success rate of PMV in Ewha Womans University Mokdong hospital was 100%. Low echo score of our patients might explain this high procedural success rate. Long-term-follow-up is warranted in the near future.

      • SCOPUSSCIEKCI등재

        골격성 Ⅲ급 부정교합자에서 전진이부성형술을 동반한 하악 후퇴술 후 연조직 외형의 변화

        김근령,김성식,손우성,박수병 대한치과교정학회 2008 대한치과교정학회지 Vol.38 No.2

        본 연구는 전진이부성형술을 동반한 하악지 시상분할골절단술을 시행한 하악 전돌증을 가진 환자에서 하안면부, 특히 이부의 경조직과 연조직의 변화를 예측하는 데 있어서, 전후관계와 수직적 계측치를 통하여, 경조직의 변화에 따른 연조직의 상대적 변화량에 대해 비교, 분석하여 한국인의 골격성 III급 부정교합자의 악교정 수술시 전진이부성형술이 연조직 외형에 미치는 영향을 알아보고자 시행하였다. 교정치료와 악교정수술을 시행한 골격성 III급 부정교합자 40명을 전진이부성형술을 시행하지 않고 하악지 시상분할골절단술만 시행한 환자 20명(BSSO group, 남자 10명, 여자 10명)과 하악지 시상분할골절단술과 동시에 전진이부성형술을 시행한 환자 20명(Genio group, 남자 10명, 여자 10명)으로 분류하여 수술 직전(T1)과 수술 직후(T2), 수술 최소 6개월 후(T3)의 측모 두부 방사선계측사진을 채득하여 계측 항목의 변화량을 분석하였다. BSSO군에서는 수술 후 경조직 B점, Pogonion, Menton에 대하여 연조직 B점, Pogonion, Menton이 각각 수평적으로 0.997, 0.965, 1.022의 변화율을 보였으며, Genio군에서는 각각 0.824, 0.602, 0.887의 수평적 변화율을 보여서, Genio군에서 연조직 B점, 연조직 Pogonion의 연조직 두께의 감소량이 더 크게 나타났다. 경조직 Pogonion(Pg)의 악교정수술 전과 후의 수평적 변화에 따른 하순의 하방점(Li), 연조직 B점(B')의 변화간의 상관관계계수는 BSSO군에서는 각각 0.833, 0.922인 반면에, Genio군에서는 각각 0.775, 0.799로 BSSO군에 비해서 상관관계가 다소 작은 것으로 나타났다. 이상의 결과에서 하악지 시상분할골절단술을 시행하는 환자에서 전진이부성형술을 동반할 경우에는 골격의 변화에 대해서 연조직의 두께 변화가 다소 적게 나타나므로 수술 시에 이를 고려하여 전진이부성형술을 시행하여야 할 것이다. Purpose: The purpose of this study was to assess the hard and soft tissue changes associated with mandibular bilateral sagittal split osteotomy and genioplasty. Methods: This is a retrospective study of 40 patients who underwent either bilateral sagittal split osteotomy for mandibular setback (BSSO group, n = 20) or in combination with advancement genioplasty (Genio group, n = 20). Lateral radiographs, were taken before and immediately after surgery, and at least 6 months after surgery. Results: Comparing hard and soft tissue changes between the BSSO group and Genio group, there were significant differences in the lower incisor, soft tissue B point (B'), and soft tissue Pogonion (Pg') (P < 0.5). The mean ratio of hard and soft tissue changes for B/B', Pg/Pg', and Menton/soft tissue Menton after surgery in the BSSO group was 0.997, 0.965, and 1.022 respectively, and 0.824, 0.602, and 0.887 respectively in the genio group. Significant differences were found between the two groups. There were significant differences in lip thickness (B-B', Pg-Pg') in the Genioplasty group between pre and postsurgery, but not in the BSSO group. Pogonion to Labrale inferior and B' had a correlation coefficient of 0.833, 0.922, respectively for the BSSO group, and 0.775, 0.799 for the Genio group. Conclusions: The results indicate that there is a significant difference between bilateral sagittal split osteotomy with or without genioplasty in the lower facial esthetics values. The combination of mandibular setback and genioplasty had a smaller change in soft tissue thickness of the symphysis area after surgery than that of mandibular setback only.

      • 부분적 수면박탈이 주간 졸리움, 피로감과 반응시간에 미치는 영향

        김상국,왕성근 충남대학교 의과대학 지역사회의학연구소 1998 충남의대잡지 Vol.25 No.2

        The purpose of this study was to investigate the effects of early partial sleep deprivation on daytime sleepiness, fatigue and reaction time, measured by the multiple sleep latency test(MSLT), visual analogue scale(VAS) and reaction timer. The subjects were 10 healthy young male college students aged from 19 to 25 years, who had no histories of significant medical or psychiatric illness as well as sleep related problems. Subjects undergown experiment 4 nights and days in the laboratory. The data of the first night and day were baseline. The remaining experiment in the laboratory consisted of 1 hour, 3 hours, 5 hours sleep restriction night and day. Each experiment had intervals more than 3 days to eliminate possible cumulative effects of repetitive partial sleep deprivation. Subjects applied MSLT to investigate their objective daytime sleepiness, VAS to rate subjective feeling of sleepiness and fatigue, and reaction time to investigate visuo-motor performance. MSLT data scored according to the criteria of Rechtschaffen and Kales every 30 seconds, and applied paired-t-test. Sleep restrictions result in the increment of sleepiness index, VAS score, stage 2 sleep. However, sleep latency on MSLT and reaction times were shortened. One hour sleep restriction affects sleep latency on MSLT and visual analogue scale scores mostly. The results suggested that nocturnal sleep restriction may induce daytime sleepiness and fatigue as expected, and shortened reaction time was out of our expectation.

      • SCIESCOPUSKCI등재

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