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Bronchogenic cysts are rare congenital malformations, most often occurring in the pulmonary parenchyma or posterior mediastinum. But they can develop in the ectopic area, especially in the retroperitoneal space. We report a case of adrenal bronchial cyst treated with laparoscopic excision. A 55-year-old woman was admitted with a left adrenal tumor on computed tomography during a study for dyspnea, cough, and sweats. The function of the adrenal glands was examined, and as a result, the adrenal tumors were determined to be nonfunctional. Magnetic resonance imaging showed about an 8-cm-sized large unilocular cystic lesion with mild and high signal intensities at left suprarenal fossa on T1 and T2 images. Iodine-123 metaiodobenzylguanidine scan showed no scintigraphic evidence of neuroendocrine tumor in the left adrenal gland. We performed laparoscopic adrenalectomy with transperitoneal approach. The round, cystic mass was completely excised saving normal adrenal tissues. The operative time was 75 minutes and there was no definitive bleeding and complication. The pathologic tissue weighed 35 g and measured 88 mm×45 mm×28 mm, and cystic changes were observed on the cut surface. The pathologic examination confirmed an adrenal bronchogenic cyst. We report a very rare disease, adrenal bronchial cyst, which could be easily and safely treated with laparoscopic surgery.
The prevalence of urolithiasis is increasing not only in South Korea but also around the world. Urolithiasis has a high recurrence rate, therefore, reducing it is very important in the quality of life for stone formers. For this purpose, dietary modifications and drug therapy can be performed through stone analysis and 24-hour urine collection. Stone analysis is recommended for all stone formers, and the 24-hour urine collection is usually recommended for recurrent stone formers or high-risk groups. A general dietary modification for all stone formers includes a sufficient fluid intake, low levels of sodium, sugar, and animal protein, a normal calcium diet, as well as a high amount of citrate intake. Drug therapy should be performed in cases such as the recurrence of stones or increase of the existing ones, even after the application of preservation therapy, such as dietary modification. The ideal drug therapy should prevent the occurrence of urolithiasis, have no side effects, and have a suitable patientsʼ compliance. Follow-up should be performed periodically, through 24-hour urine collections and imaging studies. For follow-up imaging studies, a lowdose non-enhanced computed tomography is recommended, and it can be performed once a year if the patient is in a stable state. To control various and complex metabolic abnormalities in recurrent stone formers, multiple approaches may be required through diet modifications, drug therapy, treatment of the metabolic syndrome, and lifestyle modifications.
Chemical mechanical polishing (CMP) has become widely accepted for the planarization of multi-interconnect structures in semiconductor manufacturing. However, perfect planarization is not so easily ahieved because it depends on the pattern sensitivity, the large number of controllable process parameters, and the absence of a reliable process model, etc. In this paper, we realized the planarization of deposited oxide layers followed by metal (W) polishing as a replacement for tungsten etch-back process for via formation. Atomic force microscope (AFM) is used for the evaluation of pattern topography during CMP. As a result, AFM evaluation is very attractive compared to conventional methods for the measurment of planarity. mOreover, it will contribute to analyze planarization characteristics and establish CMP model.
Endoscopic combined intrarenal surgery (ECIRS) with simultaneous retrograde intrarenal surgery (RIRS) and percutaneous nephrolithotomy (PCNL) has been proposed as a new surgical treatment to overcome the disadvantage of RIRS and PCNL monotherapies in the treatment of renal stone. One of advantages of ECIRS is that it can increase stone-free rates in complex renal stone within single-session. Intermediate-supine position in real-time simultaneous ECIRS can prevent an anesthesiologic problem, and patient's burden is small even for long-term operation. Thus, we will share the experience and advantages of real-time simultaneous ECIRS and introduce techniques to increase the stone-free rate.
Purpose: We assessed the accuracy of urinary detection by visualization compared with a method using the urethral channel of a transurethral, three-channel urodynamic catheter. Materials and Methods: This was a case series of 52 patients presenting with stress urinary incontinence over 2 years. Patients underwent video-urodynamic studies in both the supine and the erect positions by use of two techniques for measuring leak point pressure (LPP) by one examiner. LPP was determined as the intravesical pressure simultaneous to the starting point of urethral pressure changes through the urethral channel of a urodynamic catheter (LPP-ure) and then by visualization (LPP-vis) during different events. We also measured the time related to the provocations and the time to mark the leakage on the urodynamic machine by the examiner. Results: The LPP-ure values (cough supine: 42.1±18.7, cough erect: 42.1±21.8, Valsalva supine: 42.2±23.3, Valsalva erect: 41.0±22.6 cmH2O) were significantly lower than the LPP-vis values (89.9±29.4, 97.4±30.4, 70.6±25.2, and 74.4±32.6 cmH2O, respectively, all p<0.001). Whereas the actual leakages happened during the pressure increases, urodynamic recording by visualization was done after those increases had finished. Conclusions: The use of visualization as a urinary detection method entails potential errors that cannot be adjusted for on that time scale. Our results emphasize the need to standardize the methodologies used for urinary leakage detection, because this measurement is closely related to the accuracy of measurement of leak point pressure.
The RP&M (Rapid prototyping and Manufacturing) is the most appropriate technology for the small-lot production system, in which the production cycle is getting shorter owing to various needs from consumers. In this paper, RP&M is applied to a casting process. A casting process has a merit of being able to reflect complicated shapes at one time. But it has not been applied to the precision industry because of bad quality on surface. So we will improve characteristics of aluminum casting process using vacuum sealed casting process and porous ceramic mold which is made by slurry casting process.