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The purpose of this paper is service system development which enables to carry out the mission of preserving worldwide Korean cultural relics, internationally to contact the informations about our country's cultural relics on the Cyber space, to make atmosphere that makes it possible to appreciate them, and to provide information service by performing mutimedia service which is related to Soon-sin Lee using Virual Reality. For that, creating Virtual Reality information and Video Informaion which is related to Soon-sin Lee, especially Gubooksun by using Virtual Reality technique, 3-Degree image manufacture technique, animation manufacture technique, video manufacture and service technique and Internet/Web technique, and then manufacturing and storing them in the digital data type, and carry out Information Service through connecting the system of serving these informations with the Information SuperHighway
Acinar cell carcinoma is a rare tumor that represents 1~2% of al1 pancreatic cancers. Clinical and radiologic findings are inconclusive in this disease Acinar cell carcinoma is characterized by rapid progression and early metastasis, which lead to its poor prognosis. A 41-year-o1d man was admitted to our hospital for abdominal pain. Abdominal computed tomography (CT) and positron emission tomography-computed tomography (PET-CT) showed a splenic mass, which was being invaded by a pancreatic tail mass and which had increased ^(18)F-fluorodeoxyglucose (FDG) uptake Primary radical distal pancreatectomy and splenectomy were performed. Pathologic findings revealed an acinar cell carcinoma of the Pancreas The patient underwent a total gastrectomy three months later because of gastric recurrence Four months later, multiple hepatic metastases were discovered, and the patient underwent a left hepatectomy During treatment with capecitabine, there was no evidence of tumor progression for 14 months. We report a case of metastatic pancreatic acinar cell carcinoma, which did not progress for an extended period while the patient was being treated with capecitabme.
연구배경: 현재까지의 당뇨병 교육에 대한 노력은 제한되었으며, 연구 결과를 보면 식사 조절 교육과 체중 조절 프로그램을 수행한 환자들 중 적극적이고 기간이 긴 교육을 받은 경우, 성공적 결과가 나타남을 알 수 있었다. 자가관리나 체중감량 등의 당뇨병 치료의 중요한 목표는 적극적이고 긴 기간의 교육 없이는 시행되기 어렵다. 본 연구에서는 외래에서 당뇨병 환자를 대상으로 시행할 수 있는 행동 및 식사 교육 등의 적극적 교육 프로그램을 개발하여 제2형 당뇨병 환자들을 대상으로 이들에게 식사 조절 방법에 대한 목표설정과 문제에 직면하였을 때의 해결 방법 등을 교육해서 궁극적으로는 적극적 자아관리에 연결될 수 있도록 도와주는 것을 목적으로 기존의 통상적 교육과 보다 적극적인 교육이 당뇨병 환자의 혈당 조절에 어떠한 영향을 미치는지에 대해 알아보기 위해 다음과 같은 연구를 시행하였다. 방법: 본 연구는 아주대학교 병원 내분비 대사 내과를 처음으로 방문하여 치료받았던 58명의 제2형 당뇨병 환자를 대상으로 하였다. 내원 환자들을 무작위하게 추출하여 진찰권 번호 끝자리에 따라 홀수는 통상적 교육군(conventional education group, CE)과 짝수는 적극적 교육군(intensive education group, IE)으로 나누어 교육하고, 3개월후에 교육의 효과를 평가하였다. 결과: 1) 연구 대상자들의 교육 전과 후의 공복혈당, 식후2시간 혈당 및 HbA_lc 치는 IE군과 CE군 모두 각 그룹 내에서, 유의적으로 감소하였다(p<0.05). IE군에서는 공복혈당이 12.4nmol/L에서 7.7nmol/L로, 식후2시간 혈당이 20.3nmol/L에서 10.9nmol/L으로, HbA_lc치가 9.4%에서 7.0%로 모두 교육 전에 비하여, 교육 후에 감소(p<0.05)하였고, CE군도 공복혈당은 10.9nmol/L에서 9.4nmol/L로, 식후2시간 혈당은 17.1nmol/L에서 14.6nmol/L으로 HbA_lc가 8.5%에서 7.3%으로 모두 교육 후에 감소하였다(p<0.05). 또한, 교육 전에 비하여 교육 후에 공복 혈당 및 HbA_lc치가 감소하는 정도는 IE군에서의 감소가 CE군에 비해 더 현저하였다Op<0.05). 2) 식사에 대한 태도는 3부분으로 나누어 식사에 대한 규칙성, 식사 내용의 균형성, 식사에 대한 태도 등으로 나누어 각각의 점수 및 총점을 비교하였으며 교육 전에 비해 교육 후에 연구 대상자들의 식태도가 향상되었음을 알 수 있었다. 두 그룹간의 차이를 분석한 결과 식사의 균형성 항목에서와 총점에서 유의적으로 두 그룹의 차이를 보여서 IE군에 CE군에 비해 식사의 균형성 측면이 향상되었고, 전체적인 식태도가 좋아졌음을 알 수 있었다(p<0.05). 결론: 비교적 긴 기간은 아니지만 적극적 교육을 받은 당뇨병 환자들이 통상적 교육을 받은 군보다 혈당 및 HbA_lc, 식태도 점수등의 수치의 호전뿐만 아니라 당뇨병 환자의 삶에서 중요한 부분을 차지하는 식사요법 관리 부분에 있어 향상됨을 알 수 있었다. Background: To this date, efforts to develop effective methods for the education of diabetic patients have been limited. The important goal of self-management and weight control for diabetic treatment can not be attained without long and intensive period of education. This study was undertaken to assess the effectiveness of an intensive educational program, of behavior and diet control, which was carried out on subjects with type 2 diabetes, on and out-patient basis. we compared the effectiveness of an intensive education programme with that of a conventional education programme for the self-management of type 2 diabetic patients. Methods: Subjects with type 2 diabetes were randomly selected, and allocated to one of two groups. One group received a conventional education programme of self-management(the CE group), and the second group received an intensive education progammes for three months, after which the effectiveness of the programmes were evaluate. Results: 1) The levels of fasting blood sugar(FBS), postprandial 2 hour blood sugar(PP2h) and HbA1c were significantly lowered in both groups following the intervention(p<0.05). In the IE group, the FBS declined from 12.4nmol/L to 7.7nmol/L, PP2h declined from 20.3nmol/L to 10.9nmol/L, and the HbA_lc showed a similar decline from 9.4 to 7.0% after intervention(p<0.05). In the Ce group, the FBS declined from 10.9 to 9.4nmol/l, the PP2h decreased from 17.1 to 14.6nmol/l, and the HbA_lc also decreased from 8.5 to 7.3% after intervention(p<0.05). The decrease in the FBS and HbA_lc following the educational intervention was more pronounced in the IE group than the CE group(p<0.05). 2) The effectiveness of the education programmes in promoting appropriate dietary behavior in the diabetic subjects was assessed by a scoring system in three parts: a regularity score, a balance score and an attitude score. From a comparative study of the three scores, the patients attitudes were observed to be much improved in both the groups following the intervention compared to before the programmes, but the balance and total scores were significantly higher in the IE group than the CE group(p<0.05). Conclusion: We can conclude that the intensive diabetic education programme is more effective than a conventional programme, not only in improving the patients' levels of glucose, HbA_lc, and dietary score, but also the diabetic patients self-control abilities, promoting behavioral change, and prompting problem solving capabilities in respect to the everyday problems that they have to face throughout their lives(J Kor Soc Endocrinol 18:63∼72, 2003).
This study was designed to exam the aged's needs for spiritual nursing care. The purpose was to serve as a basis for the development of spiritual nursing practice. The major findings are as follows : 1. The degree of needs for spiritual nursing care as area was that needs of love and relationship mean 22.0, needs of meaning and object mean 28.2, needs of forgiving mean 13.5. Total needs for spiritual nursing care mean 63.7, which was on the upper middle level. The needs of meaning and object was rated highest. 2. Among the general characteristics of the subjects, needs of love and relatiohship wasn't significanlty different. 3. Among the general characteristics of the subjects, needs of meaning and object was significantly different according to two factors : age(F=7.260, p=0.001), religion(F=5.275, p=0.001). Higher needs of meaning and object was possessed by the older than the younger, by the one who have religion than the other. 4. Among the general characteristics of the subjects, four factors made a significantly difference to needs of forgiving : sex(t=-2.851, p=0.006), age(F=8.201, p=0.001), religion(F=6.928, p=0.000), disease(t=2.327, p=0.024). Higher needs of forgiving was possessed by man than woman, by the older than the younger, by the one who have religion than the other, by the one who have disease than the other.
Lithium is commonly employed in the treatment of bipolar disorders. The commonly reported nephrotoxic effects of lithium therapy are nephrogenic diabetes insipidus and chronic tubulointerstitial nephropathy with little or no proteinuria. Mild proteinuria is a common manifestation of most renal injuries including nephrotoxicity by lithium. But nephrotic syndrome related with lithium therapy is very rare and only one case of membranous glomenilonephritis has been reported in Korea by this time. We report a lithium toxicity case manifested by nephrotic syndrome, nephrogenic diabetes inspidus and chronic renal insufficiency in a 4-year-old man who had been taking lithium for 13 years for bipolar disorder. Kidney pathology showed minimal change disease and chronic tubulointerstitial nephritis which can be seen in chronic lithium toxicity. Polyuria and massive proteinuria disappeared with the withdrawal of lithium. Renal function was gradually improved but not to norma range. Careful and regular monitoring an the renal function in all patients on lithium treatment will be needed. (Korean J Nephrol 2004;23(3) :500-504)
Effect of Epidural Morphine, Morphine with Droperidol and Morphine with Nalbuphine after a Cesarean Section Tong0Il Kim, M.D., Hye-Ja Kim, M.D., and Jung-Un Lee, M.D. Department of Anesthesiology, College of Medicine, Chungnam National University, Daejon, Korea Background: A number of recent reoprts have described the usefullness of the epidural injection of narcotics for the relief of postoperative pain. Morphine, an ??-receptor agonist, produces strong analgesic effects with side effects. Nalbupine, a ??-antagonist and ??-agonis, has an analgesic effect comparable to morphine with little side effects. The comparison of side effects and analgesic effects of epidural morphine with little side effects. The comparison of side effects and analgesic effects of epidural morphine alone and a combination of nalbuphine and droperidol respectively to morphine were sutudied in cesarean section patients. Methods: We divided 45 patients into 3 groups utilizing a two-day Boxter infusor in normal saline 100 ml at 2.0 ml/hr: Group M (n = 15) initially a 1 mg bolus + 2 mg/day of maintenance morphine. Group M + D (n = 15): initially received a 1 mg bolus + 2 mg/day of maintenance morphine + 1.25 mg/day of maintenance droperidol. Group M + N (n = 15): initially received a 1mg morphine bolus + 2 mg/day of maintenance morphine + 5 mg/day of maintenance nalbupine. The Analgesic effect was evaluated by a visual analogue scale (0-10) at 30 min, 4 hr, 12hr and 24 hr postoperatively and the incidence of side effects was observed too. Results: The average VAS scores are below 3 in all groups. In addition, there are no significant changes between groups. There are no significant differences in side effects between groups except sedation of patients is significantly (P < 0.05) high in group M + D. Conclusion: We concluded that the analgesic effect of epidural morphine, morphine with nalbuphine and morphine with droperidol are good in all patients and there is no significant difference even though there is a belief that a combination of nalbuphine or droperidol increases analgesic effects of morphine. Comparing the incidence of side effects in the three groups, the sedative effect of morphine with droperidol is increased significantly over the other two groups.intubation. (Korean J Anesthesiol 2001; 41: 324~329)
Primary retroperitoneal mucinous cystadenocarcinoma is a very rare malignancy, and little is known concerning its Pathogenesis, optimal treatment, and prognosis. A 29-year-o1d pregnant woman (21 weeks) Presented with abdominal discomfort CA 19-9, CA 125, and CEA were normal Abdominal CT scanning revealed a 19x15x13 cm retropentoneal tumor Exploratory laparotomy and tumor excision were performed. Mucinous retropentoneal implants were removed as completely as possible Histologically, the tumor showed focal areas of capsular invasion, but free resection margins The uterus and both ovaries were normal in appearance No adjuvant therapy was pursued. Six months later, Peritoneal and bilateral ovarian metastases were discovered. Hence, we report the details of this case of primary retroperitoneal mucinous Cystadeno-carcinoma and present a review of the literature.
목적: 최근 Lactobacillus rhamnosus GG (LGG)가 급성설사에 효과가 있는 약제로 주목받고 있으나 만성 장염의 치료 및 재발 예방 효과에 대해서는 잘 알려져 있지 않다. 본 연구에서는 생쥐에서 dextran sulfate sodium (DSS) 유발 장염을 재발시킨 후 LGG의 장염 예방 효과를 관찰하고cytokine 분비의 변화와 mucin gene 발현의 변화를 알아보았다. 대상 및 방법: 국내에서 생산된 생후 8주의 생쥐(n=64)에 5% DSS를 7일간 경구 투여하여 장염을 유발시켰다. 이후 10일간의 회복기에 생쥐를 두 군으로 나누어 LGG(n=25, 치료군)와 PBS (n=26, 비치료군)를 각각 경구 투여한 후 다시 DSS를 4일간 경구 투여하여 장염을 재발시킨후 질환 활성도, 조직학 점수, 장 길이를 관찰하고 장 조직내의 TNF-α와 IL-10, 그리고 mucin gene 발현 양상을 관찰하였다. 결과: 급성 장염기의 장 길이는 평균 6.34 cm로정상 대조군 8.60 cm에 비해 짧았고(p=0.014), 장 조직의TNF-α와 IL-10은 각각 46.09±148.38 pg/mL와 50.45±87.07 pg/mL였으며 IL-10은 대조군에 비해 유의하게 높았다(p<0.05). 조직학 점수는 근위부에 비해 원위부에서 더 높았다(8.6 vs 15.4, p=0.01). 회복기 질환 활성도는 치료군과 비치료군에서 차이가 없었으나 장염 재발기에는 치료군에서 비치료군에 비해 유의하게 낮았다(1.16 vs. 3.80,p<0.05). 또한 장 길이는 치료군에서 유의하게 길었다(5.62cm vs. 4.60 cm, p<0.05). 장 조직 내 TNF-α는 치료군과 비치료군에서 차이를 보이지 않았으나 IL-10은 치료군에서는 정상대조군에 가까운 낮은 수치를 보인 반면 비치료군에서는 61.78 pg/mL로 유의한 차이를 보였다(p=0.02). 또한 치료군의 IL-10의 재발시 생성량은 급성 장염기의 생성량에 비해 유의하게 낮았다(p<0.05). 그러나 mucin gene의 발현에는 치료군과 비치료군 간에 유의한 차이를 보이지 않았다. 결론: LGG는 만성 장염의 재발을 줄이는 효과가 있을 것으로 생각되며 이러한 효과의 기전은 cytokine 발현의 변화와 세균총의 변화와 관련이 있는 것으로 생각되며mucin gene과의 관련성은 없는 것으로 생각된다. Background/Aims: Lactobacillus rhamnosus GG (LGG) has been used in acute colitis treatment. However, it is unclear whether the LGG prevents chronic colitis. The aim of this study was to examine the prophylactic effect of LGG on animal colitis, cytokine secretion, and mucin gene expression. Methods: BALB/c mice (n=64) were exposed to 5% dextran sulfate sodium (DSS) for 7 days followed by 10 days recovery period and repeatedly exposed for 4 days. Then, the mice were devided into three group; group of oral LGG adminstration throughout the recovery and repeated colitis period; PBS group of PBS administration; control group. Colon length, histologic score, tumor necrosis factor-α (TNF-α), interleukin-10 (IL-10) levels, mucin gene expressions were determined at each period. Results: In acute colitis period, the LGG group showed higher levels of disease activity index (DAI), histologic score, TNF-α, IL-10, but shorter colon length, lower levels of mucin gene expressions than the control group. However, in repeated colitis period, the LGG group showed markedly lower levels of DAI and IL-10 but significantly longer colon length than PBS group (p<0.05). There was no difference in the mucin gene expression. Conclusions: These results suggest that LGG prevents chronic murine colitis. It may be associated with cytokine modulation and competitive inhibition of pathogenic bacteria. However, it may not be related with gene expression. (Korean J Gastroenterol 2004;43:234-245)