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Background: The authors conducted a retrospective study to evaluate the mechanism of injury, the surgical techniques, the clinical features, the combined injuries, the treatment results, and the surgical complications in patients with atlantoaxial fracture/subluxations. Methods: The authors reviewed 71 cervical fracture/dislocations during a four-year period from September 2002 to August 2006. Among them, there were twenty one C1,2 fracture/subluxations. There were thirteen men (mean age : 43.5 years) and eight women (mean age : 50 years). Their follow-up period was at least 6 months, and the mean follow-up period was 9.6 months. Gardner-Wells tongs traction was used in all patients immediately on presentation. Surgical treatment was performed, depending on the pathologic conditions. Results: Of all 21 cases, 14 cases were injured in motor vehicle accidents, 5 were falls, and 2 were miscellaneous. There were four C1 fracture (5.6%), fourteen C2 fracture (66.7%), one C1 and 2 combined fracture (4.8%), and one C1-2 subluxation (4.8%). The C1 fractures in our series were classified as two Jefferson`s fractures and two C1 lateral mass fracture. The C2 fractures were classified as one odontoid type I fracture, two odontoid type II fractures, five odontoid type III fractures, one hangman`s fracture, and four C2 body tear-drop fractures. Atlantoaxial fractures were associated with six (28.6%) head injuries, four (19.0%) other spinal injuries, two (9.5%) chest injuries, and three (14.3%) spinal cord injuries. Surgical treatment was performed in nine cases, which included anterior odontoid screw fixation in two cases, transarticular screw fixation with iliac bone graft in one case, posterior fixation by using C2 pedicle screw and C3 lateral mass screw in three cases, lateral mass screw fixation C1-2 with iliac bone graft in one case, O(occipito)-C1-3-4 screw fixation in one case, posterior C2-3 wiring with allograft in one case, and halo vest in six cases. Conservative management was used in the rest of the patients in our trials. Bone fusion was complete in all cases. There were no operation-related complication, except one pin site infection in the case of halo vest. Conclusion: In this study, the choice of appropriate treatment according to the fracture types resulted in safe and effective management of unique atlantoaxial fracture/subluxations. (J Korean Soc Traumatol 2006;19:164-172)
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본 연구는 국내에서 개봉된 <다크 나이트, 2008>과 <조커, 2019>의 극중 배우인 조커를 대상으로 그가 등장하는 장면에서 표현되는 상징, 특히 얼굴 분장, 조명, 의상 등에 대한 색감을 기호학적 관점에서 분석하였다. 그동안 영화 주인공에 대한 다양한 색감 등 스타일에 대한 연구가 활발히 이루어져 왔으나, 연구 대부분이 패션 스타일에 한정되고 기호학을 접목한 연구는 전무하다시피 했다. 특히 본 연구는 조커의 심리 상태를 중심으로 다양한 색감이 어떠한 의미를 지니고 있는지에 대해 분석하였다. 색채가 갖는 의미는 다양한 사회적, 문화적 차이에 따라 달라지기도 하지만 결국 문화적 의미화를 지시한다. 영화감독은 자신의 담론을 펼치기 위해 다양한 표현 기법을 스크린에 펼치고 있지만, 관객이 그 신호를 아주 쉽게 알아챌 수 있는 것은 색감일 것이다. 연구 결과, 두 영화에 등장한 조커를 상징하는 색은 노란색이었고, 그 색은 희망의 색이었다. 하지만 그 색이 파괴되는 순간 그는 악당이 되었다. 그리고 조커의 기쁨과 희망찬 상황에서는 초록색이 작동했다. 하얀색은 꼭 순수나 선을 대변하지 않았고, 색감은 때로 텍스트를 대신하기도 했다. 그동안 우리는 색에 대해 고정관념을 지니고 있었으나, 이번 연구를 통해 그것이 전복된다면 더한 감동 또는 충격을 줄 수 있음을 알게 되었다. 아직은 보완해야 할 점이 많은 연구이지만 앞으로는 기호학적인 관점에서 영화 주인공에 대한 색감을 분석한 연구들이 더욱 활발하게 이루어지길 기대해본다. This study analyzed feeling of color in facial makeup, lighting and costuming used to highlight the Joker from the Dark Knight (2008) and JOKER (2019) from the perspective of semiology. To date, there have been a lot of studies on the styles of main characters in films such as the use of diverse colors. However, these mostly have focused on fashion styles and it has been difficult to find a study which adopted semiology. This study has analyzed the meaning of diverse colors, focusing on the Joker's mental state. The meaning of colors can differ depending on social and cultural differences. However, it ultimately refers to cultural signification. Movie directors use diverse techniques to express their discourse, but it would be color images through which the audience can easily recognize this. The results found the following: The color symbolizing the Joker was yellow, the color of hope. As soon as the color was destroyed, he turned into a ruthless villain. When he was joyful and full of hope, the color green appeared. The color white did not always represent good. Sometimes, such colors would substitute for text. People have held stereotypes regarding colors over a long period of time. It could be very meaningful if such conventional conceptions can be overcome through this study. This study still needs to be improved in many aspects, but it is anticipated that there would be further studies on feeling of color from the viewpoint of semiology.
Neuroblastoma is the one of the most common solid tumors in pediatric oncology. The long-term survival of patients with advanced stage neuroblastoma has remarkably improved secondary to aggressive treatment protocols including autologous bone marrow transplantation(BMT). The central nervous system(CNS), once a rare site of disease, is becoming involved with increasing frequency. However, here we present an unusual case of acute intracerebral hemorrhage in a child with stage IV neuroblastoma, in which follow-up radiological imaging had not revealed involvement of the brain parenchyma or leptomeninge. A 27 month-old boy, who had been diagnosed with stage IV neuroblastoma, developed right hemiparesis and decreased consciousness abruptly ten months after diagnosis. Brain computed tomography revealed left temporal intracerebral hemorrhage(ICH) which had to be removed by emergency operation as soon as possible. Previous follow-up studies had not shown parenchymal or leptomeningeal involvement. Emergency craniotomy of the left temporal lesion demonstrated no dura invasion with an underlying massive cortical hemorrhage that did not involve a definite tumor mass. Even so, the hemorrhage was biopsied for the confirmation of brain metastasis. Metastatic neuroblastoma was histologically confirmed.
Objective: Lateral ventricular tumors are rare lesions of the central nervous system. Since most tumors are benign or low grade, good outcomes can be achieved with complete removal. However, optimal surgical management in lateral ventricle tumors remains controversial. We review six cases of patients with these lesions treated with a surgical approach on the basis of the tumor location. Methods: Six patients underwent surgery for lateral ventricle tumors. The transcortical approach was used in five patients, and the transcallosal approach was used in one patient. Transcortical approaches are frontal transcortical, middle temporal gyrus, and posterior parietal transcortical approaches. And we operated one patient with atypical meningioma of frontal horn and body by anterior interhemispheric transcallosal approach. Results: Gross total resection was performed in five patients. There was the only surgical morbidity that the tumor bed operated was bled, and the outcome of the patient remained poor. Two visual field deficits were developed transiently, however they were recovered during follow-up period. Conclusions: Lateral ventricle tumors can be treated best by careful selection of the approach according to the specific location, size, and vascularization of these tumors.