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To evaluate the clinical significance of anomalous pancreaticobiliary ductal union(PBDU), we analysed 11 cases(0.19%) of anomalous PBDU among 5675 cases performed ERCP from Jan. 1973 to Aug. 1992. According to the classification of Kimura et al., 4 cases were type 1(P-C union) and 7 cases type 2(C-P union). The length of common channel ranged from 1.5 cm to 3.1 cm(mean 1.9 cm). The common associated disease were choledochal cyst(7 cases), carcinoma of the gallbladder(5 cases) and biliary stone(3 cases). Four cases of carcinoma of the gallbladder were type 1. The incidence of anomalous PBDU was significantly higher in cases with carcinoma of the gallbladder(5 cases among 49 cases) than in case without carcinoma of the gallbladder(6 cases among 5626 cases). And the incidence of gallbladder carcinoma(45%) among the 11 cases of anomalous PBDU was significantly higher than that(0.78%) among those who did not have anomalous PBDU. In conclusion, the common associated diseases with the anomalous PBDU were choledochal cyst, carcinoma of the gallbladder and stone, and the anomalous PBDU may be risk factor in the development of carcinoma of the gllbladder.
We present an innovative Li?S battery concept for the potential realization of low-cost wearable batteries. A novel Li?S battery is constructed by employing a sulfur-free carbon cathode and a sulfur-layered separator fabricated by thermal evaporation at a temperature as low as 120°C. The cell exhibits superior performances compared with a control cell with a sulfur-containing cathode, as all sulfur on the separator takes part in the electrochemical reactions. We reveal that all electrically isolated sulfur from the carbon cathode is successfully converted to polysulfides via the electrode reactions of sulfur molecules at the interface of the carbon surface and the electrolyte solution. Our new concept brings a paradigm shift in the rechargeable battery community.
In a lithium-ion battery, the organic solvent in the electrolyte simply acts as a medium that facilitates ionic charge transfer, whereas for the lithium-sulfur (Li?S) battery, the choice of the electrolyte is critical as it influences the chemical nature of the soluble polysulfides and the cycling stability of the lithium metal anode. Li-S batteries currently use ether-based electrolytes with high polysulfide solubility. Until now, however, the necessary requirements and the roles of the electrolytes have been inconclusive. This work elucidates the essential features and functions of the electrolyte based on an intensive investigation into 17 variants of solvents. Furthermore, examples of electrolytes for high performance, rechargeable Li?S batteries are suggested. The three major study procedures are (1) analyzing the chemical stability of reactive polysulfide species and lithium metal in the solvents of choice, (2) inspecting the chemical reactivity of lithium metal in a polysulfide solution, and (3) evaluating the influences of the solvent on the performance of Li?S cells. Based on the chemical and electrochemical test results, we suggest that the stability of the active materials (i.e., lithium metal and lithium polysulfides) should be ensured in an electrolyte for the proper operation of Li?S cells, that chemical reactions between the polysulfide species and lithium metal should be negligible during the charge?discharge process. In addition, we have confirmed that the high polysulfide solubility is essential for high rate performance.
Mentally retarded children (MRC) are easily predispose to hepatitis B infection due to their special problems, especiaIly in case of institutionalization. So in these children, vaccination against hepatitis B infection is very important. The aim of the present study is to compare the immune response to hepatitis B vaccine between MRC and normal children and to investigate the presence of any difference of immune response according to various factors in MRC. The vaccination was done 0, 1, 2 method with Hepaccine on the deltoid area intramuscularly. Anti HBs titer was cheked one month after each vacinations with radioimmunoassay. The vaccine responder was defined as vaccine recipient whose level of anti HBs over 10 RU after vaccination. At 1month after 1st vaccination, the frequency of responder was lower in group II(31.3%) than in group I (62.5%) and group III(63.3%). But the difference was abscent after 3rd vaccination in each group. The anti-HBs titer shows no difference in each group after 1st and 3rd vaccination. The cause of mental retardation had no effect on frequency of respoder and titer of anti-HBs. Also the sex, age and duration of institutionalization did not influence the immune response in MRC. This results suggest that the immune response of MRC was not so different with healthy children.
Hepatic cysts are often encountered on ahdominal ultrasonography or computed tomography and are usually asymptomatic. However, huge cyst bothers the patients either by compression or complicaticns such as intracystic infections or hemorrhagel. Various modalitles of treatments such as alcohol instillation or other sclerosing agents instillation have been reported. However, two or more sessions of treatment are usually required to ablate cyst We report, here, one-shot instillation of minocyclin chloride to treat a large hepatic cyst causing compression symptom with improvement.
Background/Aims: Endoscopic stent placement has become accepted palliative therapy for malignant biliary tract obstruction (MBTO). The main problem of plastic stent are the clogging or migration. The new self expandable super-elastic metallic coil stent (Endo-coilTM, Instent Inc.) is claimed to allow large lumen and prolong biliary-stent patency. In a prospective randomised trial, we compared the efficacy and frequency of stent dysfunction of EndocoilTMand plastic stent (PercuflexR, Microvasive Co.). Method: Bet-ween Aug. 1994 and Mar. 1995, we assigned 29 patients (21 males and 8 females, mean age 63 years) with unresectable MBTO due to cancer of bile duct (17), pancreas (6) periampullary (3), gallbladder (2) and perichoedochal LN (1). Thirteen of patients underwent EndocoilTMstents (24 Fr) and other 16 patients underwent plastic stents (12 Fr) insertion via transpapillary route. Successful insertion of stents was attained all cases and no serious complication occured. Results: All patients with EndocoilTM stents and 11 (68%) patients with plastic stents were relieved completely from jaundice (T. bilirubon <3.0 mg/dl). There was no differences in decreasement of bilirubin between two groups after 7 days and 30 days after stents insertion. Median patency of the stents was significantly prolonged in patients with EndocoilTM stents compared with those with plastic stents(205 days vs 92 days). The stent dysfunction was noted 2 cases (15%) in EndocoilTM due to tumor ingrowth. In contrast, stent dysfunction was occured in 10 cases (62%) of plastic stents due to clogging (7 cases) and migration (3 cases). The patients' overall median survival was not different significantly between two groups (EndocoilTM250 days vs plastic 196 days). Conclusions: Both ndocoilTMand plastic stents offer effective bile drainage in MBTO. However EndocoilTM stents may be more effective for providing longer periods of drainage due to lower frequency of stent dysfuction than plastic stents.