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한 마을의 생활문화를 제대로 이해하려면 마을 공동체 혹은 동계뿐만 아니라 개인들이 특정한 목적을 위해 조직한 자발적 결사체로서의 계의 목적 및 운영원리, 구성원의 성격과 함께 계회 방식의 변화도 면밀히 살펴볼 필요가 있다. 그런 점에서 계회 연구는 한 마을의 생활문화를 연구하는데 매우 중요하다고 하겠다. 이 논문에서는 한 마을의 계회가 어떻게 변했으며, 그 요인 무엇인지를 밝히고자 한다. 먼저 계의 성격에 따라 계회의 변화를 살펴보았다. 혈연계의 경우 계회 장소를 유사집에서 하던 것을 마을 인근의 식당으로 옮겼으며, 계회 날짜도 고정적이던 것을 유동적으로 변하였다. 지연계와 학계는 결성 초기에는 기금을 모으는 것에 중점을 두었지만. 지금은 일년에 한 번 계원들이 모이는 것을 더 중요시한다. 반면 친목계는 식당이나 노래방, 유명 관광지 등에서 계회를 개최하고, 계회 참석자도 부부동반으로 확대되었다. 이런 계회의 변화 원인으로는 먼저, 마을 인구의 감소와 고령화로 인한 계회 개최의 어려움을 들 수 있다. 그 결과 계원들이 차츰 줄어들면서 마을에 있는 계원들과 외지로 간 계원들 간의 소통의 공간이 축소되고 만남의 시간도 줄어들었다. 문중계, 지연계, 학계의 경우에는 계회의 변화를 통해서 계를 유지 존속 시키려고 하지만, 친목계의 경우에는 기존에 모아두었던 계 기금을 소모하기 위해서 계회를 하는 경우가 많다. 원래 계의 가장 큰 기능이자 목적은 바로 공동 가치의 실현과 집단 결속, 공동 사업의 수행, 유교적 의례의 실천 등이었다. 하지만 현대생활에서 계의 주 목적이 친목 도모 및 유희에 더 중점을 두고 있다. 이런 변화는 결국 계회 방식에도 일정부분 영향을 미친 것을 부인할 수 없다. 다음으로 식생활의 풍요로움을 들 수 있다. 명절 제사, 계회는 먹거리가 부족했던 당시 사람들이 음식을 섭취할 수 있는 좋은 기회였다. 그러나 현대에 와서는 일상음식에 갈망이 과거에 비해 현저히 낮아졌다. 그런 가운데 마을에 다양한 메뉴를 가진 식당들의 등장은 계원들의 새로운 먹거리를 찾는 욕구를 충족시킬 수 있었다. 이런 이유로 계희를 굳이 집에서 할 필요가 없다. 마지막으로 교통의 발달로 계회 장소를 마을 밖으로 확대되었다. 특히 친목계는 순수 친목만이 아니라 여가생활이나 다른 목적을 수반하는 경우가 많은데 이러한 현상은 ‘꿩도 먹고 알도 먹으려는’ 바쁜 현대인의 생활양식에서 비롯된 것 같다. 대율마을의 계회는 분명 과거에 비해서 많이 변했다. 계원의 수가 줄고, 계의 규모도 축소되면서 계에 대한 관심이 약해진 것은 사실이다. 하지만 이들은 대율마을의 사회ㆍ문화적 환경이 변하는 것에 발맞추어 계회를 변화시키고 계의 전통을 계승하려는 것이다. One should take a close look into the objectives, operational principles, member characters, and gathering styles of Gye as a voluntarily organized meeting for individuals' special purposes in addition to the community and its Gyes in order to understand its life culture right. In that sense, a study on Gye gatherings claims huge significance in researches on a village's life culture. This study set out to investigate how a village's Gye gatherings changed and what were its causes. First, changes to Gye gatherings were examined according to the nature of Gye. Gyes of blood ties moved the gathering venue from the home of the head official to a restaurant near the village and changed fixed gathering dates flexibly. Both the Gyes of regional relations and academic connections placed an early focus on raising funds but give more emphasis to the gathering of all the members once a year today. And Gyes of friendly relations gather together at a restaurant, karaoke, or famous tourist destination and expand the membership to include couples. Then the causes of those changes were investigated. First, several difficulties emerged with Gye gatherings due to the increasing size of village population and its aging. Consequently, the number of Gye members gradually dropped, the space of communication between the members remaining in the village and those who left to other cities became smaller, and the time of gathering reduced. While Gyes of clans, regional relations, and academic connections try to maintain and preserve their existence through changes, those of friendly relations mostly hold gatherings to consume the funds accumulated so far. The biggest functions and goals of Gye were originally implementing the community values, solidarity of groups, carrying out joint projects, and practicing the Confucian ceremonies. In modern life, however, the main goals of Gye have changed to promoting friendly relationships and having fun. Those changes have made partial influences on gathering styles without a doubt. The next cause can be found in the richness of dietary life. In the past when food was scarce, holidays, religious services for ancestors, and Gyes provided people with a great opportunity to consume food. But people's desire for food has considerably dropped in modern times. Furthermore, there are a huge number of restaurants that provide a wide variety of menus and satisfy the desire of Gye members to search for new dishes in the village. As a result, there is no need to hold a Gye gathering at home any longer. And finally, gathering venues expanded outside the village thanks to the advancement of transportation. Gyes of friendly relations, in particular, pursue additional goals other than the original goal of promoting friendly relationships in many cases, which is seemingly attributed to the busy life style of modern people that want to "kill two birds with one stone." The Gye garherings of Daeyul Village definitely went through many changes compared with the past. It is the reality that both the membership and size have grown smaller, which led to the weakened interest in Gyes. However, those are for changing the Gye gatherings and inherit the traditions of Gye according to the changes to the village's social and cultural environments.
관상동맥 질환은 점점 증가하고 있으며, 심근경색과 같은 치명적인 질환의 원인이 되고, 심부전을 비롯한 여러 다른 합병증을 일으킬 수 있어 정확한 진단과 치료가 매우 중요하다. 다중열검출기를 이용한 관상동맥 컴퓨터전산화단층촬영술은 비침습적이며, 높은 음성 예측도를 가지고 있어 최근 임상에서의 이용이 급격히 늘고 있으며 앞으로 그 역할의 증대가 더욱 기대되는 검사법이다. 저자들은 이러한 관상동맥 컴퓨터전산화단층촬영술에서 발생할 수 있는 대표적인 위양성 증례와 아직까지 잘 알려지지 않은 짧은 병변에서의 위음성 증례를 보고하여 관상동맥 컴퓨터전산화단층촬영술의 결과 해석시 다른 임상 상황들을 충분히 고려해야 한다는 것을 문헌고찰과 함께 보고하는 바이다. The prevalence of coronary artery disease is gradually increasing. The importance of accurate, early diagnosis and treatment has been emphasized repeatedly, given the possible fatal outcome of coronary artery disease, such as in acute myocardial infarction or heart failure. In order to detect patients at high risk of coronary artery disease, noninvasive multi-detector computed tomographic coronary angiography (CTCAG) has recently been introduced for clinical use. It has become popular thanks to its noninvasiveness and high negative predictive value. Most studies have focused on these advantages, while neglecting a number of flaws in multi-detector CTCAG. We present two cases of multi-detector CTCAG with false positive and false negative results. We would like to emphasize that the interpretation of the findings obtained with multi-detector CTCAG should depend on the clinical findings in the patient, along with other factors, such as the location or length of the lesion. (Korean J Med 76:589-594, 2009)
화학겔로써 대표적인 실리카겔과 아마이드겔의 겔화(gelation)과정을 살펴보고 라텍스 입자를 추적자로 사용하는 광산란 실험을 통해 이들의 구조와 화학적 성질을 고찰하여 보았다. 표준입자(standard particle)로 쓰이는 라텍스 입자를 추적자로 사용하여 입자들의 병진운동(translational diffusion)을 고려함으로서 겔의 내부공간크기를 확인하고 겔과 입자표면과의 화학적 상호작용을 고려하였다. 실리카겔은 아마이드 겔보다 규칙적인 겔구조를 나타내는 것으로 사료되며 표면이 카르복실기를 갖는 입자는 실리카 겔과 엉킴(aggregation)현상을 나타냄을 관측하였다. 불균일(heterogeneity)한 겔의 고조확인을 위한 광산란법을 비에르고딕(non-ergodic)이론에 기초한 통계적인 방법을 통해 접근하였다. Probe diffusion with latex particles in two different types of chemically cross linked gel has been studied. The diffusion of particles in silica gel is decreased by decreasing the gel correlation length but the particles' diffusion in the acrylamide gel still shows the heterogeneity of the gel. By increasing the contents of the gel network the silica gel makes a more homogeneous and compact structure than that of acrylamide gel which has partial heterodyning. Dynamic light scattering study with the probe particles in two different gels reveals the heterogeneity of the gel network. The latex particles trapping in the gel has been investigated by using non-ergodic concepts.
저자들은 심장침범을 동반한 원발성 아밀로이드증이 생긴 52세 남자 환자에서 thalidomide 치료 후 임상적 증상, 심초음파 소견, 검사실 소견이 큰 부작용 없이 현저히 좋아진 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Patients with primary amyloidosis (AL) have poor prognosis with a median survival of one to two years. In patients with symptomatic cardiac involvement, prognosis is even worse with the reported median survival of 6 months. One patient, diagnosed as AL amyloidosis with cardiac involvement, was treated with thalidomide and showed remarkable improvement in functional capacity, cardiac function, and various laboratory parameters without any significant adverse effect and, therefore, we report the case with the review of literatures.(Korean J Med 69:S910-S914, 2005)
손경수(Kyeong Soo Sohn),구성회(Seong Hoe Koo),성지동(Ji Dong Seong),송종민(Jong Min Song),여정석(Jeong Seok Yeo),김동운(Dong Woon Kim),조성욱(Seong Wook Cho),현민수(Min Su Hyon),손대원(Dae Won Sohn),오병희(Byung Hee Oh),이명묵(Myoung 대한내과학회 1995 대한내과학회지 Vol.49 No.1
N/A Atrioventricular(AV) nodal reentry is a common cause of supraventricular tachycardia. For the treatment of atrioventricular nodal reentrant tachycardia (AVNRT), antiarrhythmic drug therapy requires long-term use of drugs and surgical ablation may be curative therapy but has problems of open heart surgery. Radiofrequency catheter ablation(RFCA) is reported to be safe and effective treatment modality for the frequently recurrent and severely symptomatic AVNRT. The results of treatment of AVNRT by RFCA of slow pathway is as follows. 1) The study consisted of 32 participants and the sex ratio (M: F) waw 8:24, the mean age was 40.9±15.8 yrs(19-72yrs). 2) At the electrophysiological study before RFCA, the type of reentry was common in 29 cases, uncommon in 1 case and in 2 cases were both common and uncommon type. 3) The applied modes of RFCA were constant power mode in 2 cases and temperature mode in 30 cases. 4) The number of radiofrequency current application till successful ablation was 12.1±9.1(3-39)and the mean power of applicated radiofequency current was 28.7±10.8W(8.2-41.3W). 5) Effective refractory period of antegrade fast pathwy (ERPfa) after ablation (220.0±43.3msec), in comparison with that before ablation(253.3±55. 8msec), has no statistical significance but has reducing tendency. The other parameters such as AH interval of antegrade fast pathway (AHfa), antegrade Wenckebach block cycle length (AWBCL), effective refractory period period of ventriculoatrial conduction system (ERPvacs) and ventriculoatrial block cycle length (VABCL) have no significant differences. 6) Complete AV block developed in only 1 patient who had underlying sinus dysfunction. 7) The follow-up duration was 7±3 months(1-13 months)and there was no AVNRT recurrence during this period. We conclude that the selective RFCA of slow pathway is a safe and effective treatment of AVNRT.
황경국(Kyung Kuk Hwang),박대균(Dae Gyun Park),연태진(Tae Jin Yeun),조영석(Young Seok Cho),손대원(Dae Won Sohn),김효수(Hyo Soo Kim),김철호(Cheol Ho Kim),오병희(Byung Hee Oh),이명묵(Myoung Mook Lee),박영배(Young Bae Park),최윤식(Yun Sh 대한내과학회 1998 대한내과학회지 Vol.54 No.1
N/A Objectives: This study was performed to verify the incidence and prognosis of aortic dissection without intimal tear (aortic intramural hemorrhage, IMH) who took only medical treatment in special referrence to Stanford type A. Methods: We analysed the patients of IMH confirmed by TEE, CT, MRI, angiography or CT-angiography in Seoul National University Hospital between 1987 and l9%, retrospectively. Results: The diagnosis of IMH was estabilished in 20 of 143 patients(14%). Nine patients were Stanford type A, 11 patients were type B. The longitudinal extent varied between 8 and 30cm, and IMH size varied between 10 and 3mm. Surgery was performed in two of type A patients because of persistent chest pain and one of type B patients because of progressive aortic dilatation despite of medical treatment. Follow-up imaging studies (mean follow-up period of 20.0±22.0 months) were done in 10/17 patients who were treated medicaliy. Complete resolution of IMH was observed in seven cases, four of them were Stanford type A, and the mean size of IMH was 12mm(10-17mm). Partial resolution was observed in one case, Stanford type A, with the IMH size of 15mm. There was no significant change in the size of IMH in two cases. Initial mean size of IMH was 25mm. In no case, aortic rupture or death was observed during the follow up period. Conclusion: In the management of the patient with MH, same surgical indications as classic aortic dissection have been advocated based on similar prognosis. However our study showed better prognosis in IMH patients treated medically compared to the previous publications. Therefore, even in cases of proximal IMH. medical treatment should be seriously considered.
N/A Objectives: Percutaneous mitral commissurotomy (PMC) has been known as an effective palliative therapeutic modality for moderate to severe mitral stenosis, however, long-term changes of the mitral valve area and possible predictors affecting the long-term results after PMC has to be elucidated. Methods: 168 patients who were followed up at least 3 months (mean 18.7±13.9 months, range: 3-60 months) after PMC (double balloon technique) at Seoul National University Hospital between August 1988 and April 1993 (total 265 cases), were enrolled in the study. Mitral valve area (MVA) by pressure half-time method and the grade of mitral regurgitation (0-4) were evaluated by Doppler echo- cardiography at 1 day, 3, 6, 12, 24, 36, 48, and 60 months after PMC. The criteria of successful PMC were defined as mitral valve area ≥1.5cm² and mitral regurgitation with grade 2 or less. Results: Pre-PLIC mean MVA was 0.84±0.25 cm², immediate post-PMC MVA 1.64±0.49 cm², and mean MVA at the last follow-up was 1.54±0.43 cm. Relative MVA comparing to immediate post- PMC MVA at each follow-up time were 97.84±22.0, 96.5±24.9, 98.0±28.7, and 99.0±21.9% at 3, 6, 12, and 24 months after VMC, respectively. There were no significant differences between the groups with and without reduced MVA during follow-up period (defined as 15% or more reduction compared to that of immediate post-PMC). PMC resulted in increased grade of mitral regurgitation compared to that of pre-PMC (p=0.001), however, the severity of mitral regurgitation remained stationary in most patients during follow-up period. 86 patients (51.2%) remained in the criterior of successful results at long-term follow-up evaluation. Univariate analysis demonstrated that long-term successful PMC was related to sinus rhythm (p=0.002), low echocardio-graphic score (p=0.031, especially calcification, p=0.024), pre-PMC MVA (p<0.001), and immediate post-PMC MVA (p<0.001), but immediate post- PMC MVA was the only independent predictor of long-term successful PMC by multivariate analysis. Conclusion: Percutaneous mitral commissurotomy results in long-term relief of moderate to severe mitral stenosis in most patients, and the mitral valve area and the extent of mitral regurgitation remains stationary during long-term follow-up period.
현민수(Min Su Hyon),강덕현(Duk Hyun Kang),고광곤(Kwang Kon Koh),손대원(Dae Won Sohn),오병희(Byung Hee Oh),이명묵(Myoung Mook Lee),박영배(Young Bae Park),최윤식(Yun Sik Choi),서정돈(Jung Don Seo),이영우(Young Woo Lee) 대한내과학회 1989 대한내과학회지 Vol.37 No.5
N/A We reviewed the patients who were diagnosed as infective endocarditis from January 1984 to September 1988, The total number of patients was one hundred and sixteen. Seventy-six were male and forty were female. The mean age was 37.5 years. Rheumatic heart disease was the most common predisposing heart disease with fifty-five cases l47.4%), followed by congenitai heart disease with eighteen cases (15.5%), prosthetic valve endocarditis with sixteen (18.8%) and cardiac pacemaker with one case. Culture was positive in sixty-eight cases (58.6%). Alpha hemolytic streptococci were the most commonly isolated micrroorganisms (51.5%), followed by S. aureus (16.2%). Fungus was also isolated (1case). Vegetations were found in seventy-nine cases an echocardiographic examination (68.1%). These were found more frequently on the aortic valve (48.1%) than on the mitral valve (32.9%). Fifty-nine cases (50.8%) developed congestive heart failure and twenty-seven cases (23.3%) had embolic complications. Out of 116 patients, 27 died and the overall mortality was 23.3%. Main causes of death were congestive heart failure and embolic complications. Surgical traeatment was performed in thirty-nine patients (33.6%). Operation was indicated more frequently in patients with prosthetic valve endocarditis ar in patients with vegetation.
유경훈(Kyong Hoon You),김석연(Seok Yeon Kim),김효수(Hyo Soo Kim),손대원(Dae Won Sohn),오병희(Byung Hee Oh),이명묵(Myoung Mook Lee),박영배(Young Bae Park),최윤식(Yun Shik Choi),이영우(Young Woo Lee) 대한내과학회 1998 대한내과학회지 Vol.55 No.6
N/A Objectives: Paraoxonase is a high density lipoprotein (HDL)-associated enzyme, which has been implicated in preventing low density lipoprotein-cholesterol (LDL-C) from oxidation. The human paraoxonase gene is codominantly expressed as allele A and B. The A allele codes for glutamine(A subtype) and the B allele for arginine(B subtype) at codon 192 of the paraoxonase enzyme. This genetic polymorphism divides the enzyme into high and low activity form It has been believed that this difference of specific activity might change the metabolism of cholesterol and the prevalence of coronary artery disease. The present study investigated the association among the paraoxonase gene polymorphism and the level of plasma lipoprotein and coronary artery disease. Methods: The 416 subjects who have undergone coronary angiography in SNUH were recruited. 7he patients(n=251) had >50% stenosis of at least one of the major coronary arteries. To identify the genotype of paraoxonase, we amplified the target region in the paraoxonase gene by PCR(polymerase chain reaction) and electrophoresed the products. Results: There was no difference between the two groups in the allele frequency (A: B = 0.41: 0.59 in patients, A: B = 0.37: 0.63 in controls; p=0.21) or in the genotype frequency (AA:AB:HB= 45:116:90 in patients, AA:AB:BB=22:77:66 in controls; p=0.41). There was no association of the paraoxonase genotype with serum lipoprotein level and acute coronary syndrome in this study. The B allele was not an independent risk factor for coronary artery disease in this study. Conclusion: The paraoxonase gene 192 polymorphism was not an independent risk factor for coronary artery disease in this study.