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조재원(Jae Won Joh),김성주(Sung Joo Kim),최인석(In Seok Choi),이병붕(Byung Boong Lee),이석구(Suk Koo Lee),박재범(Jae Berm Park),허우성(Woo Seong Huh),오하영(Ha Young Oh),김성민(Sung Min Kim),백경란(Kyung Ran Peck),송재훈(Jae Hoon Son 대한이식학회 1999 Korean Journal of Transplantation Vol.13 No.2
Tuberculosis is a significant opportunistic infection in transplant recipients under the immunosuppressed condition, though not common and also known to have higher incidence among transplant recipients than in general population. The most common form of tuberculosis among transplant recipients is pulmonary, gastrointestinal, bone and genital tract in decreasing order. However tuberculous infection of the transplanted graft is rare and usually associated with disseminated tuberculosis with high mortality. We experienced M.. tuberculosis infection of the renal allograft after chronic rejection. A 28-year-old female received living-related renal transplantation, required high-dose steroid therapy for two episodes of acute rejection (8 and 20 months later). However, she eventually became renal failure due to chronic rejection and immunosuppression therapy was discontinued. Patient was refered back to our institute for the hemodialysis (post-transplant 40 months) when the patient was found to have pulomary tuberculosis of miliary type. Antituberculosis medication (INH, RFP, EMB & PZA) was immediately started on the basis of positive cultures from lung and bone marrow specimen for M. tuberculosis. In spite of full medication, high fever was sustained and subsequently pyonephritis of grafted kidney was detected and infected graft was removed to confirm the tuberculosis is very serious disease among immunosuppressed transplant patient and therefore more aggressive approach is needed including the search for the hidden infection even at the failed graft with cessated function
조재원(Jae Won Joh),김성주(Sung Joo Kim),최인석(In Seok Choi),허진석(Jin Seok Heo),이병붕(Byung Boong Lee),황대준(Dae Jun Hwang),이석구(Suk Koo Lee),김진국(Jin Gook Kim) 대한이식학회 1999 Korean Journal of Transplantation Vol.13 No.2
Aspegillosis is a fatal opportunistic disease using immunosupppresive drugs after liver transplantation. Mortality of aspergillosis after liver transplantation reaches 100% and survival rate pulmonary asper-gillosis is less than 5% using medical treatment only and pneumonectomy and medical treatment revealed better results. We experienced the invasive pulmonary aspergillosis developed a patient who suffered from bacterial pneumonia and had long peroid of mechanical ventillation after liver transplantation. We performed pneumonectomy and antifungal medical treatment for about 50 days and he recovered from invasive aspergillosis.
Malignant sarcomas arising from the wall of blood vessels are extremely rare. It tends to enlarge by intra- or extra-luminal extension rather than infiltration, in some instances the tumor origin from the IVC invaded adjacent vital structures limit the extent of the resection. However, a wide and complete surgical resection ptovided the best chance for prolonged survival in patients. We experienced one case of IVC tumor invaded to right renal vein and liver. In a 52-year-old women suffering right frank pain, right upper retroperitoneal mass was found. In preoperative CT, MRI, Vena Cavogram, the mass was invaded to the right and quadate lobe of the liver, adrenal gland, and right renal vein. We performed the en-block resection including the right hepatic and quadate lobe, IVC and both kidney, and then IVC was reconstructed with graft (PTFE) and uninvolved left kidney was autotransplanted at right peritoneal space. Postoperatively, the patient was recovered satisfactory without complication. Because only way of preventing the development of recurrence is the radical resection of the IVC tumor including adjacent organs, a preoperative accurate staging and aggressive treatment are recommended.
홍재웅 ( Jae Woong Hong ),신밀재 ( Mill Jae Shin ),문형환 ( Hyung Hwan Moon ),이상훈 ( Sang Hoon Lee ),김종만 ( Jong Man Kim ),박재범 ( Jae Berm Park ),권준혁 ( Choon Hyuck Kwon ),조재원 ( Jae Won Joh ),이석구 ( Suk Koo Lee ),김 대한이식학회 2014 Korean Journal of Transplantation Vol.28 No.1
Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea Background: The most effective treatment for end-stage renal disease is kidney transplantation, and the number of kidney transplantations has shown a rapid increase. The aim of this study was to determine graft survival and functional outcome of 1,500 kidney transplant cases in a single center. We also investigated the factors affecting graft failure after kidney transplantation. Methods: We retrospectively reviewed the clinical data of 1,500 pairs of donors and subsequent recipients who underwent kidney transplantation in Samsung Medical Center, from February 1995 to January 2012. Results: The mean follow-up period was 2,241.5±1,609.4 days. There were 851 (56.7%) male recipients; 62 (4.1%) recipients were younger than 19 years old. Eleven (0.7%) cases were ABO blood group incompatible kidney transplant. A total of 531 (35%) deceased and 969 (65%) living donors were included. Among them, 191 (12.7%) recipients were experienced in graft failure. The most common cause of graft loss was chronic allograft nephropathy. One-year, 5-year, 10-year, and 15-year graft survival were 97.3%, 92.8%, 81.6%, and 75.1% (85.2% for living, 75.4% for deceased donor), respectively. Higher incidence of graft failure was observed in recipients who received deceased donor kidneys or experienced a rejection episode. Conclusions: In our experience, overall 10-year graft survival after kidney transplantation was 81.6%. This report demonstrated that the type of donor (living or deceased) and history of allograft rejection are the only significant factors affecting graft survival.
This study was conducted to assess the possibility of the field application of the iceharbor-type precast fishway. When overflow depth of weir is 4.0 cm in model fishway, upper part velocities appear appropriate for upstream migration of fish and the lowest overflow wall (right line) in lower part has shown velocity distribution more or less inadequate for upstream migration. Except that right line, left and middle line revealed that velocities are appropriate for upstream migration of fish. Therefore, we concluded that this fishway owing to be not broad growth width of overflow velocities according to increasing discharges can correspond to variation of water level. Also We consider that various velocities in fishway were effective, because slow velocity line can guide flow for upstream migration. For low flow, the arrangement of different crest level or each overflow part (higher left, middle and lower right, or lower left, middle and higher right) was more effactive than unform crert level. Hole plays an important role as migration pass during drought and flood flow. Therefore, We concluded that this fishway can cope with water depth variation by various overflow wall height change and raise the field applicability with better performance hydraulically and structurally.