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Purpose:This study compares the prevalence of pubertal menstrual disorders in type 1 diabetes mellitus (DM) patients with that in normal subjects. Methods:A questionnaire was used to obtain data on pubertal development and menstrual history from 43 type 1 DM patients, who were diagnosed at the pediatrics department of Severance Children's Hospital, Yonsei University, and 56 normal control subjects. We evaluated the estrogen levels in all type 1 DM patients. Results:The age at onset of puberty did not significantly differ between the 2 groups. However, the prevalence of oligomenorrhea in type 1 DM patients (21.21%) was significantly higher than that in the control group (2.08%; P˂0.05). In addition, the incidence of amenorrhea in type 1 DM patients (20.59%) was significantly higher than that in the control group (2.08%; P˂0.05 ). Pubertal development in type 1 DM patients was delayed due to elevated levels of glycosylated hemoglobin (HbA1c). The delay (9 months) in pubertal development in the patients diagnosed with type 1 DM at prepubertal ages was shorter than that (14.8 months) in the patients diagnosed with type 1 DM at postpubertal age (P˂0.05). The level of LH, FSH were higher and E2 level was lower in DM patients compared to control group, especially in diabetics with amenorrhea (P˂0.05). Conclusion:We observed a high frequency of delayed pubertal development and menstruation irregularities in patients who were diagnosed with type 1 DM at the prepubertal age or in type 1 DM patients with high levels of HbA1c. This finding can be attributed to the decreased plasma levels of E2 or due to the decreased E2 activity in patients with type 1 DM. Further evaluation of hormonal changes in type 1 DM patients is essential. 목 적:최근 1형 당뇨 여아에게서 사춘기 발달이 늦거나, 생리 이상의 빈도가 높다는 연구 결과가 있었다. 본 연구에서는 한국에서 사춘기 연령의 1형 당뇨 여아에서 정상 사춘기 여아와 비교하였을 때 사춘기 지연 및 생리 이상의 빈도에 차이가 있는지 알아보고, 그 원인을 규명하고자 한다. 방 법:2006년 이후 연세대학교 세브란스 어린이병원 소아청소년과에서, 1형 당뇨병으로 진단받은 만 10세에서 17세 사이의 여아 43명을 대상으로 하였고, 정상 대조군은 같은 연령의 만성 기저 질환이 없는 정상 여아 56명을 선정하였다. 모든 대상자의 신장 및 몸무게를 측정하고, 생리 주기 및 기간, 생리 불순 및 무월경 여부 등에 대해 설문조사를 하였으며, 당뇨 환자에게는 혈당 조절 정도와 에스트로겐의 농도를 측정하였다. 결 과:당뇨환자와 정상 대조군의 평균 연령의 유의한 차이는 없었다. 당뇨 환자와 정상 대조군 사이에 사춘기 발달 시기의 유의한 차이는 없었으나, 희발 생리는 1형 당뇨 환자와 정상 대조군에서 각각 21.21%, 2.08% 로 당뇨 환아에서 더 높았고, 무월경은 1형 당뇨 환자에서 20.59%로 정상 대조군 2.08% 에 비해 높았다. 1형 당뇨 환자 중, 당화혈색소가 높을수록 사춘기가 지연되는 경향을 보였고, 사춘기 시작 이전에 당뇨가 발병한 경우 유방 발달 시기는 사춘기 시작 이후에 발병한 군보다 약 9개월, 초경 시기는 약 14.8개월 가량 늦었다. 당뇨 환자에서 LH 및 FSH의 농도는 정상 사춘기 여아에 비해 증가되었고, 이는 무월경이 있을수록 더욱 높았다. 또한 당뇨 환자에서 혈중 E2의 농도는 정상 사춘기 여아에 비해 의미 있게 낮았고, 무월경이 있을 경우에는 더 낮았다. 결 론:본 연구에서는 사춘기 시기 당뇨 여아에서 사춘기 이전에 당뇨가 발병했을 경우, 당화혈색소가 높을수록 사춘기 발달이 늦어지고 생리 불순이 많았으며, 이는 혈중 E2농도 저하나 작용 기전 저하 때문으로 생각되며, 그 기전에 대해 추후 연구가 필요하다.
One characteristic of Korean consonants is that there are three distinctive voiceless sounds in the stop category. Since Chinese has two-way contrast stop consonants while Korean has three-way contrast stop consonants, it was anticipated that the Chinese group selected for the experiment would demonstrate particular difficulties in learning a foreign language with a different system of contrast consonants. This paper suggests factors in two aspects as major factors in distinguishing the three-way contrast in the Korean voiceless obstruents. The first aspect is speech production, including VOT (Voice Onset Time) and F0 (fundamental frequency). The second aspect is speech perception, including the factor of the pronunciation of Korean learners. Generalizing from the results of Perception Test 1 and 2, adult learners of a foreign language seem to exhibit a correlation between articulation and auditory perception. Perception Test 3 shows how both Korean and Chinese participants can use F0 and VOT values as the major factors in distinguishing three-way contrast stop consonants in Korean.
Purpose: We observed the frequencies of microvascular complications and their related factors in patients with type 1 diabetes. Methods: Two hundred seventy one patients (111 males and 160 females, mean age 21.9 ± 5.8 years) with type 1 diabetes were included. Subjects were all at least 10 years old and had diabetes for at least two years. Three types of microvascular complications (diabetic nephropathy, retinopathy, and neuropathy) were evaluated, and their frequencies and risk factors were analyzed. Results: The overall prevalence of microvascular disease was 83/271 (30.6%). Microalbuminuria had developed in 39 patients (14.4%), persistent microalbuminuria in 31patients (11.4%), and proteinuria in 12 (4.4%). Diabetic retinopathy had developed in 35patients (12.9%) and neuropathy in 39 patients (13.7%). The mean HbA1c for 10 years was significantly higher in the patients with microvascular complications (10.5 ± 2.8%vs. 8.4 ± 1.4%). The rate of intensive management in the non-complication group was higher than in the microvascular complication group. The incidence of microalbuminuria was greater in males than females, but there were no gender differences in either diabetic retinopathy or neuropathy. Puberty and the duration of diabetes may be associated with microvascular complications. Conclusion: The incidence of microvascular complications in type 1 diabetes is declining. Sex, puberty, and the duration of diabetes as well as prolonged hyperglycemia are all related to microvascular complications. Therefore, intensive insulin management and regular screening for microvascular complications should be performed in patients who have either entered into puberty or have had diabetes for more than 5 years. 목적: 본 연구에서는 1형 당뇨병 환자를 대상으로 미세혈관 합병증의 발생 빈도와 이와 관련된 인자들을 알아보고자한다. 방법: 연세대학교 세브란스 병원에서 1형 당뇨병으로 진단받는 환자들 중, 만 10세가 넘고 당뇨병 유병기간이 적어도2년이 넘는, 총 271명의 1형 당뇨병 환자(남자 111명, 여자 160명, 평균 나이 21.9±5.8세)를 대상으로 당뇨병성 신증, 망막병증, 신경병증의 세가지 미세혈관 합병증을 조사하고, 이와 관련된 인자들을 분석하였다. 결과: 미세혈관 합병증은 전체 271명 중 83명(30.6%)에서 발생하였다. 미세알부민뇨는 39명(14.4%)에서, 지속성 미세알부민뇨는 31명(11.4%)에서 발생하였으며, 단백뇨는 12명(4.4%)에서 발생하였다. 또한, 당뇨병성 망막병증은 35명(12.9%)의 환자에서, 신경병증은 39명(13.7%)의 환자에서 발생하였다. 10년 동안의 평균 당화혈색소는 미세혈관합병증이 있는 군에서 합병증이 없는 군 보다 더 높았다(10.5±2.8% vs. 8.4±1.4%). 또한 인슐린 치료법 중 적극적치료법의 비율은 미세혈관 합병증이 없는 군에서 미세혈관 합병증이 있는 군보다 더 높았다. 미세알부민뇨는 여자보다남자에서 더 많이 발생하였으나, 당뇨병성 망막병증이나 신경병증에서는 성별의 차이를 보이지 않았다. 또한, 사춘기및 당뇨병의 유병기간도 미세혈관 합병증의 위험인자로 생각된다. 결론: 1형 당뇨병 환자에서 미세혈관 합병증의 발생률은 점차적으로 낮아지고 있다. 하지만, 지속적인 고혈당뿐만 아니라 성별, 사춘기, 당뇨병의 유병기간도 미세혈관 합병증 발생과 연관된 위험인자이기 때문에, 적극적 인슐린 치료법을 통해 철저히 혈당을 관리하고, 사춘기 연령이거나 당뇨병의 유병기간이 5년이 넘는 환자에서는 미세혈관 합병증에대한 정기적인 선별검사가 필요하다.
Tumor necrosis factor-α (TNF-α) is a major proinflammatory cytokine involved in the pathophysiology of juvenile rheumatoid arthritis. Etanercept is an effective inhibitor of TNF-α and has shown a beneficial effect in patients with JRA. However, the most important cause of concern related to etanercept administration is infection. We report a case of encephalitis in a JRA patient receiving long-term treatment with etanercept. The patient was a 4-year-old boy with refractory JRA, and he received etanercept subcutaneously at a dose of 0.4 mg kg-1 day-1 twice a week for 14 months, along with non-steroidal anti-inflammatory drugs, methotrexate, oral steroids, and sulfasalazine. The patient presented with sudden fever, headache, vomiting, a generalized tonic seizure, and changes in mental status. We suspected a central nervous system infection, and simultaneously administered antibiotics, an antiviral agent, and steroids. After 2 days of hospitalization, his mental function returned to normal, and he showed no further seizure-like movements. Brain magnetic resonance imaging scan of the patient showed a multifocal cortical lesion on both sides of the temporoparietooccipital lobe, which indicated encephalitis. Although we were unable to identify the causative organism of encephalitis, we think that the encephalitis may be attributed to infection, and the use of etanercept may have increased the risk of severe infection. Therefore, etanercept was discontinued and the patient recovered shortly after. To the best of our knowledge, this is the first case of encephalitis in a juvenile rheumatoid arthritis patient treated with etanercept.
Background : Rehmannia glutinosa L. that is a perennial plant belonging to the family Scrophulariaceae is one of the most popular local income crops. Recently, the cultivation area of Chungnam (2017) accounts for 50.5% (106 ha) of the whole country. In July and August, which is the off-season at the highest price of R, glutinosa L. This experiment was carried out to develop early harvest cultivation technology for the improve farm income. Methods and Results : In order to investigate the growth characteristic and yield of R, glutinosa L. by using the rhizome of 'Tokang' were transplanted four times at intervals of 10 days from mid-March to mid-April 2017 and 2018. Growth characteristics of the above and under ground part were investigated by 3 repetitions for 10 ea harvested in mid-July. Regression analysis was performed on the relationship between the planting time and fresh root weight. The highest emergence rate was 88.7% in the mid-March, and the highest above ground part growth was observed in the plant height, leaf number, leaf length, leaf width, and fresh leaves weight. The number of days to flowering tended to be shortened to 60, 53, 52, and 49 days from the mid-March to the mid-April. The growth of underground part was also highest in mid-March and the total root weight per 10 a was also 1,127.4 ㎏ in mid-March. The faster the planting time, the higher the yield. The results of the linear regression on the roots weight according to the planting time showed that there was a negative correlation relation between the planting time, the marketable roots weight, rhizome weight and total roots weight. Conclusion : The total roots weight improved by 80% in the mid-March than mid-April. Therefore, mid-March is considered optimal planting time for off-season production of R. glutinosa L.
Background: Sophora flavescens AIT root is used as a herbal medicine in Asian culture. This study was aimed at selecting the best cultivars, by comparing growth characteristics, active ingredients, and antioxidant activities. Methods and Results: A total twenty nine accessions of S. flavescens were collected from five different regions in Korea. Plant height, leaf length, peduncle length, fresh root weight, and seed weight were the growth characteristics selected. Antioxidant activity was determined by measuring the total polyphenol (TPC) and total flavonoid contents (TFC) as well as the radical scavenging activity of DPPH, ABTS and FRAP. Oxymatrine and matrine, active ingredients in S. flavescens were analyzed by HPLC. Results indicated that accession YS-11 had the highest plant height (152.5 ㎝) and peduncle length (54.0 ㎝). The fresh root weight was highest in JA-01 at 4.9 kg, while the highest total seed weight was recorded in accession BH-04 at 77.7 g. The YS-03 accession contained the highest oxymatrine and matrine total contents (0.9616% and 0.9638%, respectively). Accessions BH-02, YS-11, YS-05, and MJ-03 had the highest levels of antioxidant activity (p < 0.05). Oxymatrine showed a high correlation with TPC and FRAP. TPC showed high correlations with TFC, DPPH, ABTS and FRAP. TFC showed a high correlation with DPPH. Conclusions: The superior lines can be selected for use as standard variety breeding material by comparing the growth characteristics of the accessions.