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Nineteen patients suffering from post-traumatic intracerebral hematoma, being managed by stereotactic aspiration of hematoma were evaluated. The outcome in this series is quite satisfactory, with 58% of patients having a functional survival. Eight patients died, of which three patients died of brain swelling and 5 died of systemic causes such as respiratory failure, gastrointestinal(GI) bleeding, and renal failure. It is our belief that stereotactic aspiration is helpful in managing patients with traumatic intracerebral hematoma without herniation and severe brain swelling.
Objective : The aim of this study is to biomechanically assess the pullout strength of the dynamic osteosynthesis construct(DOC) cervical plating system to consider the effects of screw triagulation in the cervical spine. Methods : Twelve fresh cadaveric cervical spines(C4-C7) were randomly instumented with DOC cervical system with 20 degree(six specimens) or 30 degree platforms(six specimens). All specimens were tested on an MTS Alliance RT/10 testing machine. Load-displacement data was sampled at a rate of 50Hz. After the biomechanical testing, specimens were cut on sagittal plane and the penetrating depths of screw were measured. Results : Mean insertion torque of 20 degree was 1.025 newton-meters and that of 30 degree was 1.031 newtonmeters( p>0.05). Mean penetration depth of 20 degree was 11.82mm(C4), 12.20mm(C7) and that of 30 degree platforms were 12.22mm(C4), 13.04mm(C7). Mean pullout strength with 20 degree platforms was 642.2 N ; with 30 degree platforms was 537.7N(p>0.05). Conclusion : There is no statistical differences in pullout strength between 20 degree platform and 30 degree platform that were plated in cervical vertebral bodies, even though a literature shows that more increased screw angulation of 30 degree than that of 20 degree would decrease pullout resistance due to less amount of bone purchase against the pullout force in parallelogram shaped cervical vertebral body.
Congenital dermal sinus(CDS) is a rare entity widely known to occur as a result of the of the failure of the neuroectoderm to separate from the cutaneous ectoderm during the process of neurulation at the third to fifth week of gestation. The lesion can occur at any level of the craniospinal axis. but are located predominantly at the lumbosacral and occipital legion CDS of thoracic region and cervical region are rare The patient with CDS presents with meningitis and/or mass effect from the associated inclusion tumor They ars usually dermoid or epidermoid cyst. Teratoma is rarely associated with CDS. We report our experience of CDS in an 11-month old boy associated with an lntramedullary dermoid tumor at the thoracic region and together we report a review of the literature.
Epilepsy affects more than 0.5% of the world population and is known to be associated with a large genetic component eliciting an electrical hyperexcitability in the central nervous system. However, its pathogenic mechanisms remain poorly understood. In order to gain greater molecular incite in the pathogenesis in epilepsy, we analyzed proteomes of human cerebral cortices. Quantitative proteome analysis was used to compare signals corresponding to individual proteins between epileptic cerebral cortices from patients with temporal lobe epilepsy and age-matched non-epileptic subjects. To minimize individual variations, gender and age of the patients were matched. Changes of several spots were consistent among 6 pairs of epileptic patients and nonepileptic subjects. One of the spots was identified as the mitochondrial type Mn-superoxide dismutase (Mn-SOD) confirmed by Western blot analysis with Mn-SOD antibody and enzyme activity assay. Such results were agreeable with chemical and physical parameters given by the 2-dimensional electrophoresis (2-DE) gel. Mn-SOD was consistently down-regulated in epileptic cerebral cortices compared with those of nonepileptic subjects. Our results demonstrate a clear link between pathogenesis of epilepsy and SOD. Additionally, we identified four proteins that were consistently over-expressed in all epileptic temporal neocortices specimens and the other four proteins that were found to be expressed less than non-epileptic control subjects. These proteomic data provide cellular markers in the understanding mechanism of the epilepsy pathogenesis.
Typically electronic resistance type sensors have been used for measurement system of high-speed trains. But due to a large number of measurement quantities, we had difficulties in installing and maintaining the cables that connect sensors and measuring devices. Furthermore, signals obtained from the electronic resistance type sensors are often distorted because the sensors and cables are vulnerable to electro-magnetic interference (EMI). In this paper the characteristic of FBG sensors are compared with those of electronic resistance type sensors in application for the measurement system of high-speed trains. FBG sensors haveadvantages because of their multiplexing characteristic and robustness to EMI environment.
Measurement of dynamic characteristics are widely used to detect damages in various machines or civil structures. The most common approach is to measure changes in frequency spectrum or mode shapes using accelerometer sensor. Another method, which compares the mode shapes measuring the strain of structures instead of measuring the shape of displacement mode using the accelerometer sensor, is advantageous in inspecting the damages of the structures as the strain mode is sensitive to local damages compared to the displacement mode. In this paper, we compared strain gages and FBG sensors for the measurement of dynamic characteristics of structure.
Paget's disease of the bone is the second-most-common metabolic bone disease. However, it is rarely found in the Far East. Vertebral Paget's disease usually occurs at multiple vertebral levels, with less than 20% of vertebral Paget's disease being monostotic. Here, we present a rare case of monostotic vertebral Paget's disease, which we initially misdiagnosed as a spinal metastasis. A 34-year-old man was admitted with a one-month history of lower back pain. Initially, computed tomography of the lumbar spine showed an osteolytic change of the L4 and mild expansion of the L4 vertebral body. Subsequently, magnetic resonance imaging showed a highly homogenously enhanced L4 vertebral body. We performed positron-emission tomography, bone scan, and tumor marker evaluation. However, we could not detect any likely primary origin of the spinal metastasis. Therefore, we carried out a needle bone biopsy under fluoroscopic guidance, and the bone specimen revealed Paget's disease of the bone.
저자들은 고열, 기면과 경련양 운동을 주소로 내원하여 중증 고나트륨혈증성 탈수와 급성 신부전을 동반한, 면역 기능부전 등의 소견없이 원발성으로 발생한, 생후 15일 남아에서의 뇌국균증을 수술적요법과 항진균제 투여로 치료하였기에 문헌 고찰과 함께 보고하는 바이다. Fungal infection of the central nervous system tends to occur in immunosuppressed patients. In the pediatric population, it is usually seen in severely immunocompromised patients, particulary in children with chronic granulomatous disease, hematopoietic malignancies, and those receiving chemotherapy or corticosteroid therapy. Literature indicates rare survivors from neonatal aspergillosis. We report a case of multiple brain abscess caused by Aspergillus in a 15-day-old male neonate, who had suffered from high fever, generalized seizure, severe dehydration, and azotemia. The patient was immunologically competent and successfully treated with surgical removal and antifungal agents.
Objective : This study is designed to investigate whether early surgery can result in a better outcome for seizure control and brain development in pediatric patients with intractable epilepsy. Methods : Preoperative evaluation methods for surgery included history taking, neurological examination, chronic video-EEG monitoring with surface and subdural grid electrodes, magnetic resonance image(MRI), 3-dimensional surface rendering with MRI, PET and SPECT. The Denver Developmental Screening Test II, and the Full Scale Intelligence Quotient(FSIQ) were evaluated for developmental status before and after surgery. Seizure outcome was classified according to Engel's classification. Surgical procedures included temporal lobectomy in four subjects, extratemporal resection in 14, callosotomy in one and tumor removal in one. Results : Seizure outcomes were class I in 11 patients(55%), class II in three(15%), class III in 4(20%) and class IV in two (10%). Under the age of 6 years, the preoperative average developmental delay was 12.4 months. Postoperatively, two of them caught up to their normal developmental status. Over the age of 6 years, the preoperative average FSIQ was 87.5 and the postoperative average FSIQ was 103.3. Conclusion : In pediatric patients with intractable epilepsy, the early surgical treatment is very helpful in the normalization of their brain function.
A 47-year-old man underwent the surgery of intertransverse discectomy through paramedian muscle splitting due to extraforaminal type of far lateral disc herniation at 4th-5th interspace of lumbar vertebrae. The authors encountered the terminal branch of the segmental artery that traversed the extruded disc around the dorsal root ganglion during the sugery. We coagulated the artery by a bipolar coagulator and cut the artery for the discectomy. There was no active bleeding during the surgery. However, the patient suffered from abdominal, right leg and flank pain at the first postoperative day. The follow-up magnetic resonance imaging revealed a retroperitoneal hematoma at the operation site. The patient underwent removal of the retroperitoneal hematoma. We identified the cause of bleeding as the rupture of coagulated terminal branch of the segmental artery around the dorsal root ganglion. The retroperitoneal hematoma was evacuated completely. The ruptured artery was clipped by a small metal clip, and his symptoms subsequently were resolved.