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This paper provides a review of some recent issues on the Mixmaster dynamics concerning the features of its stochasticity. After a description of the geometrical structure characterizing the homogeneous cosmological models in the Bianchi classification and the Belinsky-Khalatnikov-Lifshitz piecewise representation of the types VIII and IX oscillatory regime, we face the question regarding the time covariance of the resulting chaos as viewed in terms of continuous Misner-Chitr\'e like variables. Finally, we show how in the statistical mechanics framework the Mixmaster chaos raises as semiclassical limit of the quantum dynamics in the Planckian era.
( Giovanni Barbara ), ( Cesare Cremon ), ( Giovanni Carini ), ( Lara Bellacosa ), ( Lisa Zecchi ), ( Roberto De Giorgio ), ( Roberto Corinaldesi ), ( Vincenzo Stanghellini ) 대한소화기기능성질환·운동학회(구 대한소화관운동학회) 2011 Journal of Neurogastroenterology and Motility (JNM Vol.17 No.4
The potential relevance of systemic and gastrointestinal immune activation in the pathophysiology and symptom generation in the irritable bowel syndrome (IBS) is supported by a number of observations. Infectious gastroenteritis is the strongest risk factor for the development of IBS and increased rates of IBS-like symptoms have been detected in patients with inflammatory bowel disease in remission or in celiac disease patients on a gluten free diet. The number of T cells and mast cells in the small and large intestine of patients with IBS is increased in a large proportion of patients with IBS over healthy controls. Mediators released by immune cells and likely from other non-immune competent cells impact on the function of enteric and sensory afferent nerves as well as on epithelial tight junctions controlling mucosal barrier of recipient animals, isolated human gut tissues or cell culture systems. Antibodies against microbiota antigens (bacterial flagellin), and increased levels of cytokines have been detected systemically in the peripheral blood advocating the existence of abnormal host-microbial interactions and systemic immune responses. Nonetheless, there is wide overlap of data obtained in healthy controls; in addition, the subsets of patients showing immune activation have yet to be clearly identified. Gender, age, geographic differences, genetic predisposition, diet and differences in the intestinal microbiota likely play a role and further research has to be done to clarify their relevance as potential mechanisms in the described immune system dysregulation. Immune activation has stimulated interest for the potential identification of biomarkers useful for clinical and research purposes and the development of novel therapeutic approaches. (J Neurogastroenterol Motil 2011;17:349-359)
Purpose: The purpose of this study was to validate the role of the total malignancy score (TMS)in identifying thyroid nodules suspicious for malignancy through the sum of their ultrasoundfeatures. Methods: The local ethical committee approved this prospective observational study. Weexamined 231 nodules in 231 consecutive patients (164 females and 67 males; age range, 20 to87 years; median age, 59 years; interquartile range, 48 to 70 years) who underwent ultrasoundfollowed by fine-needle aspiration cytology (FNAC). The nodules were further classified usingthe TMS, which considers ultrasound features (number, echogenicity, structure, halo, margins,Doppler signal, calcifications, and growth), and the Bethesda System for Reporting ThyroidCytopathology (TBSRTC), which considers cytological features. Patients with non-negativenodules (TBSRTC categories III to VI) underwent histological analysis, repeated FNAC, or 2years of regular ultrasound follow-up. The associations between the final diagnosis, each of theultrasound features, and the TMS were estimated using the chi-square test, the Mann-WhitneyU test, and multivariate logistic regression. A receiver operating characteristic (ROC) curve wasused to evaluate the diagnostic accuracy of the TMS. Results: On ultrasound, 47% of the nodules (108 of 231) had a TMS <3, 18% (42 of 231) hada TMS of 3, and 35% (81 of 231) had a TMS >3. The FNAC results of 85% of the nodules (196of 231) were benign, while 15% (35 of 231) had non-negative results. Hypoechogenicity, solidstructure, the presence of microcalcifications, and the number of nodules were independentpredictors of the final diagnosis, and the diagnostic accuracy of the TMS was good (area underthe ROC curve, 0.82). Conclusion: The TMS system is simple to use, reliable, easily reproducible, and closely reflectsmalignancy risk. Based on our results, FNAC could be limited to nodules with a TMS ≥3 withoutmissing any cases of carcinoma.
Background: Single-incision laparoscopic right colectomy (SILRC) has been reported in 2008, and since that time an increased number of reports ap-peared in literature. Currently, it remains popular between the centers with achieved experience. Adoption of suprapubic access, instead of umbilical or other access-sites, allows to enhance the final cosmetic outcomes, together with the realization of complete mesocolic excision (CME) and intra-corporeal anastomosis (ICA).Methods: Between January 2016 and August 2018, 20 patients (10 females, 10 males) were submitted to suprapubic single-incision laparoscopic right colectomy (SSILRC) for adenocarcinoma. Mean age was 74 years and mean body mass index was 24 kg/m2. Sixteen patients have already been submitted to open abdominal surgery.Results: Mean total operative time was 233.9 minutes and mean laparoscopic time was 199.4 minutes. Mean time for ICA was 34 minutes. Mean blood loss was 279.5 mL. One additional 5-mm trocar was necessary in 1 patient (5.0%). Mean length scar was 60.5 cm. Mean hospital stay was 7.8 days. A minimal use of pain killers was registered postoperatively. Mean number of lymph nodes retrieved was 24.5. Early complications were one suprapubic abscess and one suprapubic hematoma. No late complications, including suprapubic incisional hernia, were achieved. Conclusion: Since the specimen has to be removed from the abdomen after conventional laparoscopic right colectomy, the suprapubic access can be an option. SSILRC allows to join the surgical procedure, the specimen's removal and the enhanced cosmetic results through the same access. Other advantages are the CME, the ICA, the reduced postoperative pain, and the decreased incisional hernia's rate.
( Giovanni Di Nardo ), ( Federica Viscogliosi ), ( Francesco Esposito ), ( Vincenzo Stanghellini ), ( Maria Pia Villa ), ( Pasquale Parisi ), ( Alessia Morlando ), ( Girolamo Cal ), ( Roberto De Giorgio ) 대한소화기기능성질환·운동학회(구 대한소화관운동학회) 2019 Journal of Neurogastroenterology and Motility (JNM Vol.25 No.4
Pediatric chronic intestinal pseudo-obstruction is a rare disorder characterized by a severe impairment of gastrointestinal motility leading to intestinal obstruction symptoms in the absence of mechanical causes. The diagnosis is usually clinical and diagnostic work is usually aimed to rule out mechanical obstruction and to identify any underlying diseases. Treatment is challenging and requires a multidisciplinary effort. In this manuscript we describe the youngest child successfully treated with the orally administrable, longacting, reversible anti-cholinesterase drug, pyridostigmine. Like other drugs belonging to cholinesterase inhibitors, pyridostigmine enhances gut motility by increasing acetylcholine availability in the enteric nervous system and neuro-muscular junctions. Based on the direct evidence from the reported case, we reviewed the current literature on the use of pyridostigmine in severe pediatric dysmotility focusing on intestinal pseudo-obstruction. The overall data emerged from the few published studies suggest that pyridostigmine is an effective and usually well tolerated therapeutic options for patients with intestinal pseudo-obstruction. More specifically, the main results obtained by pyridostigmine included marked reduction of abdominal distension, reduced need of parenteral nutrition, and improvement of oral feeding. The present case and review on pyridostigmine pave the way for eagerly awaited future randomized controlled studies testing the efficacy of cholinesterase inhibitors in pediatric severe gut dysmotility. (J Neurogastroenterol Motil 2019;25:508-514)
In this paper, we propose an indoor positioning system that makes use of the attenuation model for IEEE 802.11 Channel State Information (CSI) in order to determine its distance from an Access Point (AP) at a fixed position. With the use of CSI, we can mitigate the problems present in the use of Received Signal Strength Indicator (RSSI) data and increase the accuracy of the estimated mobile device's location. For the experiments we performed, we made use of the Intel 5300 Series Network Interface Card (NIC) in order to receive the channel frequency response. The Intel 5300 NIC differs from its counterparts in that it can obtain not only the RSSI but also the CSI between an access point and a mobile device. We can obtain the signal strengths and phases from subcarriers of a system which in turn means making use of this data in the estimation of a mobile device's position.
This paper studies an absorption machine driven by the heat recovered from a Solid Oxide Fuel Cell (SOFC). The absorption unit was first evaluated by a cycle analysis determining the sensitivity to the main boundary conditions and to the internal parameters. Then a specific simulation code of all the different devices of the absorption machine was developed to evaluate the performance and size of the unit together with its operating condition limits.
The aim of this study was to evaluate the effect of two diets different in crude fibre content and ingredients on performance and on caecal characteristics of rabbits around weaning. Thirty litters from thirty New Zealand White does were divided at Day 18 in two groups fed, respectively, a low fibre concentrate (LFC, consisting mainly of soybean meal, delactated whey, barley) from Day 18-28 followed by a creep feed (CF, consisting mainly in alfalfa meal, barley and wheat bran) from Day 29-32, and a CF from Day 18-32. After weaning (32 days) both groups were fed the CF ad libitum for two weeks. During the pre-weaning period, mortality, milk intake and solid feed intake (from Day 20) were recorded daily, while the live weight of kits was recorded twice, at 18 and 32 days. At day 28, one rabbit/litter was slaughtered in order to obtain data on caecal content characteristics. After weaning, the rabbits were located in collective cages, feeding ad libitum CF; feed intake, live weight and mortality were recorded weekly for two weeks. During the preweaning period, there were no differences between the groups in milk and solid feed intake and, by consequence, in live weight at weaning; instead, the mortality was higher (12.5 vs 4.5%) for the group (A) that changed diet at 28 days. Group A showed also a higher caecal pH (6.12 vs. 5.72), propionate to butyrate ratio (0.73 vs. 0.46), ammonia content (9.3 vs. 7.1 mmol/l), but a lower total volatile fatty acid content (66.8 vs. 82.1 mmol/l) than B Group, probably due to the dried milk whey in the concentrate. After weaning, there were no significant differences between the two groups. The authors concluded that the use of a low fibre concentrate for suckling rabbits is not recommended.