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Using the more common conventional chordwise aerodynamic approach, flapping a flat plate wing with zero degree chordwise pitch angle of attack and no relative wind should not produce lift. However, in hover, with no forward relative velocity and zero degree chordwise pitch angle of attack, flapping flat plate wings does in fact produce lift. In the experiments peformed for this paper, the flapping motion is considered pure(downstroke and upstroke) with no flapping stroke plane inclination angle. No changes in chordwise pitch angle are made. The total force is measured using a force transducer and the net aerodynamic force is determined from this measured total force by subtracting the experimentally determined inertial contribution. These experiments were repeated at various flapping frequencies and for various wing planform sizes for flat plate wings. The trends in the aerodynamic lift variation found using a force transducer have nearly identical shape for various flapping frequencies and wing planform sizes.
Objectives : Thyroid nodule is a common clinical problem and it is important to distinguish benign from malignant nodule. Although features found on history taking, physical examnation and imaging studies help the diagnosis, fine needle aspiration(FNA) has been accepted as an accurate and reliable diagnostic procedure of thyroid nodule. This study was aimed to assess the values of FNA and needle biopsy in the diagnosis of thyroid nodules. Methods : We reviewed the medical records of the 405 patients who underwent FNA and needle biopsy for the diagnosis of thyroid nodule form September 1993 to July 1996. Results : The 414 fine needle aspiration cytologic specimens were obtained from 405 patients(male : 26, female : 379). 390 cases(94.2%) were adequate for cytologic diagnosis. And the diagnosis showed benign in 357(91.5%), malignancy in 20(5.1%) and suspicious malignancy in 13(3.3%). Among the 357 benign cases, 104 cases were benign cysts, 163 cases were adenomatous goiter and 45 cases were follicular adenoma. 46 patients underwent thyroidectomy after FNA and 21 patients(45.7%) were diagnosed as having carcinoma. The sensitivity and specificity of FNA in diagnosing malignancy were 65% and 82%, respectively, with an accuracy of 74%. Of 46 patients, needle biopsy was done in 41. The sensitivity and specificity of the needle biopsy were 79% and 73%, respectively. And the accuracy was 76%. Hoarseness was developed in one patient after FNA and needle biopsy, and small amount of hemoptysis was developed in another patient after FNA. Conclusion : Although it had been expected that needle biopsy may increase the diagnostic accuracy, our study didn't show the superiority of needle biopsy as compared with FNA. FNA has limitations in suspicious and nondiagnostic results but it is a safe, simple, reliable and cost-effective means of evaluating thyroid nodules. It is the preferred initial diagnostic method in all patients with thyroid nodule.
Background: Patients with intermediate- or high-grade non-Hodgkin's lymphoma (NHL) who have a relapse or refractoriness after initial standard chemotherapy generally have a poor prognosis. Conventional salvage treatment can induce lengthy remission. It is, however, not generally agreed that long-term survival has been expected in patients receiving salvage chemotherapy. The combination of high dose therapy and autologous stem cell transplantation has been considered promising in refractory or relapsed patients with NHL. Methods: The response rate and survival (disease-free and overall survival) of 15 patients with relapsed or refractory NHL who only received salvage chemotherapy was compared with those of 14 patients who has been assigned to receive high dose therapy and autologous stem cell transplantation. Results: the overall rate of response to salvage chemotherapy was 13% but that of high dose therapy with stem cell support was 58%. Disease free survival (DFS) in the salvage chemotherapy group was very low; only 2 patients survived in remission without a relapse of disease in long duration. On the contrary the rate of DFS in the transplantation group was 48% at 3 years. At 3 years, the rate of overall survival (OS) was 17% in the group receiving salvage chemotherapy and 31% in the transplantation group. Conclusion: As compared with salvage chemotherapy, treatment with high dose therapy and autologous stem cell transplantation increases disease-free and overall survival in relapsed or refractory patients with non-Hodgkin's lymphoma.
Grief is the ordinarily self-limited complex of symptoms and processes that constitute the acute reaction to a significant loss. And it is the reaction of the dying as well as the bereaved. Every culture has had its own ways of grief and mourning. The definition of healthy grief and mourning, in terms of both emotional expression and the length of time it should continue, mostly depend upon the type of culture as well as the type of religion. So the manner of grief and mourning greatly differs from culture to culture. In the most of the Asian countries, influenced by Confucianism, Taoism, and Buddhism, death is traditionally considered the most significant life cycle transition. In Chinese culture, many rituals have evolved to help family members deal with their loss, over the past five thousand years. Confucianism taught the virtues of filial piety and righteousness. These rules and many customs added since the time of Cofucius, have been loyally followed and practiced by many Asian people. However, Buddhists have different ideas. They believe in karma and reincarnation and in predetermination of one's present life by good or bad deeds in the present life and past lives. Display of uncontrollable emotion is not encouraged. Continuity of family relations after death is very important. The ancient practice of the ancestor worship is still followed in many Asian households. Many Buddhist do not practice ancestor worship; family members honor the deceased by placing a memorial plate in the temple for continued chanting purposes. The mourning rituals have been dramatically curtailed in the past 50 years. For example, political, social and economic forces have shaped the current mourning practices of Chinese in different countries. There are many clinical implications in helping Asian to deal better with the emotional strains of the experience of loss. The therapiest must respect the cultural framework through which the client perceives family losses.
Cirrhotic patients may exhibit circulatory derangement and renal dysfunction during the clinical course. Renal dysfunction on cirrhosis can occur without specific causative factors. This functional renal failure in cirrhosis is considered as a consequence of renal vasoconstriction. These alteratons of renal hemodynamics are already present in the early phase of the disease, even in the condition that the conventional kidney function tests are normal. A new method for noninvasive evaluation of arterial tone is duplex Doppler sonography. Among the various sonographic indices proposed, the renal resistive index(RI) is the most widely used for the estimation of intrarenal arteriolar vascular resistence. This study was performed to evaluate the role of Doppler sonography in early detection of renal dysfunction and to assess the clinical significance of RI. In 25 cirrhotic patients without overt kidney failure and ten control subjects, the RI of the acurate artery in both kidneys was measured by Doppler sonography. The mean RI of cirrhotic group was significangly higher than that of control subjects(0,68±0.08 vs -0.62 ±0.05,p<0). Accordiing to Child class, the RI showed increasing tendency from A to C, through witout statistical significance. In this study, the RI was significantly inversely correlated with 24hr urinary sodium amount(r=-0.39, p<0,05)and correlated with serum creatinine(r=6.60,p<0.01). This study indicates that the measurement of RI is a sensitive method to assess intarenal hemodynamics and to detect early changes of the renal dysfunction in cirrhotic patients.