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Infantile hemangiomas (IH) is the most common vascular tumor of infancy. Topical or systemic nonselective beta-blocker have been used for IH in proliferative phase as a safe and effective management option. However, efficacy of pharmacotherapy and laser therapy for involuting or involuted IH after proliferative phase is limited. Herein we report 5 cases of non-proliferating IHs treated by surgery. These patients had previously been treated by topical timolol, a nonselective beta-blocker and laser therapy during proliferative phase of IH but residual lesion including loose surface and fibrofatty core tissue had not responded to the treatments. Eccentric partial excision (relevant to 'drawer handle') to tense loose tumor surface and fibrofatty core excision (relevant to 'drawer content') to reduce residual tumor volume were performed because the remaining lesions had been or were predicted to be cosmetically unfavorable even if the lesions fully involuted. Four patients showed satisfactory cosmetic results with general postoperative management for at least 3 months and one patient showed successful result with laser treatment for remnant telangiectasia. Therefore, ‘Drawer-opening' method could be considered as a useful surgical option for contour deformities in non-proliferating IH.
( Jong Wook Kim ), ( Dae Lyong Ha ), ( Jin Hwa Son ), ( Jung Soo Lee ), ( Kihyuk Shin ), ( Hoon Soo Kim ), ( Hyun Chang Ko ), ( Byung Soo Kim ), ( Moon Bum Kim ) 대한피부과학회 2020 대한피부과학회 학술발표대회집 Vol.72 No.2
Background: Linear lichen planus (LLP) seems to be not common disorder and its clinical data have been limited. Objectives: This study aimed to investigate the clinical characteristics of LLP. Methods: We retrospectively reviewed medical records and clinical photos of 30 patients diagnosed with LLP by skin biopsy in the Pusan National University Hospital (Busan and Yangsan) for 17 years (2004-2020). Results: The mean age at initial visit was 35.7 (2.4-70) years and the mean age at onset was 35.1 (2.0-70) years, respectively. The male to female ratio was 1:1.7. Frequently involved areas were leg (60%, 20/30), trunk (27%, 8/30), and arm (23%, 7/30) and bilateral lesions were noted in 1 patient (4%). 6 patients (20%) have comorbidity such as diabetes (2/30), dyslipidemia (2/30), hypertension (1/30), and thyroid cancer (1/30). 17 patients (57%) were treated with topical tacrolimus and 13 patients (43%) were treated with topical steroid. There was no difference on cure rate, however topical steroid reduced pruritus better than topical tacrolimus. 15 patients showed hyperpigmented patches as LLP resolves. 3 patients had recurrent LLP on the different areas from the previous lesions. Conclusion: This study identified the clinical characteristics of LLP and could be useful for the dermatologists who encounters LLP.
A reactor pressure vessel is a very important structure which maintains the function at high temperature and under high pressure. Thus, it is designed and manufactured according to strict code requirements in order to assure the structural integrity. The objective of this study is to evaluate the structural integrity of the reactor pressure vessel during the pressurized thermal shock by applying the deterministic fracture mechanics. The deterministic fracture mechanics analysis was performed using the three-dimensional finite element models. The crack configurations, the crack aspect ratio and the cladding properties were considered in the parametric study. Also, maximum allowable transition temperatures are investigated.
The effect of interfaces on thermal conductivity is studied with Y₂O₃ thin films deposited on an Al₂O₃ substrate. Y₂O₃ thin films with the thickness between 100 and 500 ㎚ are prepared by RF magnetron sputtering and thermal conductivity of the films is measured by the 3 omega method. The strong film thickness-dependent thermal conductivity is observed due to the interfacial thermal resistance. The relationship between the interfacial thermal resistance and film thickness-dependent thermal conductivity is derived from a temperature profile across a thin film having an interface with a substrate.
( Seungmo Kim ), ( Ryeun Heo ), ( Hee Joo Lee ), ( Cheon-tae Kim ), ( Hee-jin Kim ), ( Jong-wook Hong ), ( Soul-hee Kim ), ( Tae-Shik Park ), ( Dea-seon Han ), ( Hyeon-su Kim ), ( Jong-myun Song ), ( Mi-so Kim ) 대한결핵 및 호흡기학회 2020 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.128 No.-
Background Fluoroquinolones have been recognized as important anti-TB agents based on new tuberculosis treatment guidelines. In this study we have evaluated gyrA and gyrB how to relate with MIC based on 7H9 and phenotypic DST Results based on Löwenstein-Jensen (L-J) medium. Method Since 13th July 2020, 108 cases have analyzed gyrA and gyrB genes for fluoroquinolones. We have tested bedaquiline (0.03125~4 μg/mL), delamanid (0.00625~0.8 μg/mL), moxifloxacin (0.0625~8.0 μg/mL), levofloxacin (0.0625~8.0 μg/mL), linezolid (0.0625~8.0 μg/mL) using 7H9 broth. In Löwenstein-Jensen (L-J)medium, low concentration of moxifloxacin was 1.0 μg/mL and high concentration of moxifloxacin was 2.0 μg/mL, And that of levofloxacin and linezolid was 2.0μg/mL. Results All of mono-INH resistant cases analyzed wild type in gyrA and gyrB genes. There were 7 mutant type analyzed in gyrA and 1 mutant type in gyrB gene among 54 RIF resistant and MDR cases. All of 8 cases what we analyzed mutant type in gyrA and gyrB genes was interpreted resistant in phenotypic DST using L-J medium. Additionally all of 52 cases interpreted susceptible in phenotypic DST using L-J medium was wild type in gyrA and gyrB genes. The distribution of MICs for moxifloxacin what analyzed mutant type in gyrA gene was middle and high level (1.0 ~ 4.0 μg/mL). And The MIC for moxifloxacin what analyzed mutant type in gyrB gene was middle level (0.5 μg/mL). The distribution of MICs for levofloxacin what analyzed mutant type in gyrA gene was high level (4.0 ~ 8.0 μg/mL). And The MIC for levofloxacin what analyzed mutant type in gyrB gene was middle level (1.0 μg/mL). Conclusions We found 8 mutant type cases in gyrA and gyrB genes. Most of mutant type (75%) was gyrA_D94G(GAC/GGC). We observed gyrA and gyrB genes were associated with MICs based on 7H9 and phenotypic DST Results based on L-J medium.
Graft-versus-host disease (GVHD) is a frequent complication after bone marrow transplantation. Infectious complications are common in GVHD patients due to defect in cell-mediated immunity. A rare case of S. pneumoniae meningoencephalitis occured in a patient with extensive form of chronic GVHD after allogeneic bone marrow transplantation. He was immediately treated with full dosage of ceftriaxone and ampicillin. He suffered from various complications such as sepsis, acute renal failure, atelectasis, and seizure. Despite of aggressive treatment, he died probably due to renal shutdown and massive subacute cerebral infarction of left cerebral hemisphere. This report showed two unusual and rare features. First, the infection site was CNS rather than respiratory system. Second, the causative organism was S. pneumoniae, which is rare cause of CNS infection in immunocompromised patients.
Whilst it is clear that increasing temperatures from global environmental change will impact the positions of alpine treelines, it is likely that a range of regional and local scaled factors will mediate the overall impact of global scale climate drivers. We summarized 12 categories of abiotic and biotic factors as 4 groups determining treeline positions. First, there are global factors related to climate-induced growth limitation and carbon limitation. Second, there are seven regional and local factors related to treeline dynamics including frost stress, topography, water stress, snow, wind, fire and non-fire disturbance. Third, species-specific factors can control treeline dynamics through their influence on reproduction and life history traits. Fourth, there are positive feedbacks in structuring the dynamics of treelines. Globally, the commonly accepted growth limitation hypothesis is that growth at a treeline is limited by temperature. Meanwhile, positive feedbacks between canopy cover and tree establishment are likely to control the spatial pattern and temporal dynamics of many treelines. The presence of non-linear dynamics at treelines has implications for the use of treelines as barometers of climate change because the lagged responses and abrupt shifts inherent in non-equilibrium systems may combine to mask the overall climate trend.
Although half of the cases of acute lymphocytic leukemia (ALL) in children have been cured by chemotherapy alone, a dilemma still remains as to the choice of the appropriate therapeutic regimens for childhood ALL in relapse and adult ALL. Recently, 10 patients with ALL were given a supralethal dose of cytoreductive chemoradiotherapy followed by HLA-identical bone marrow transplantation. Among them, only one patient who had been refractory to conventional intensive chemotherapy died of acute renal failure, possibly due to toxicities of the drugs, including long term use of amphotericin-B as well as cyclosporin-A before complete recovery of pancytopenia. Nine patients are enjoying complete remission ranging from 3 to 68 months (median 12 months). Even if the observation period seems to be limited, there were no deaths due to venoocclusive, disease, graft failure, graft versus host reaction, interstitial pneumonia and/or relapse. The actuarial two year disease free survival is 90%. There is still controversy as to determination of the correct 'Timing' for allogeneic bone marrow transplantation in ALL. But we would like to recommend allogeneic bone marrow transplantation for patients with childhood ALL in the advanced state as well as for even minimal residual disease among poor risk groups.