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Congenital cystic adenomatoid malfmation of the lung(CCAML) is a rare abnormality of embryonic diffaentiation characterized by the replacement of narmal pulmonary tissue with cysts in variable size and number. We experienced a case of bilateral Type III CCAML in neonates of 23 years old pregnant woman, which was detected sonographically at 22weeks of gestation.
Background: Hypertensive patients have an increased risk profile for cardiovascular disease even in the absence of diabetes mellitus. Much evidence exist to show that insulin resistance plays a key role in eliciting several metabolic. and fibrinolytic abnormalities in patients with hypertension. In patients with type 2 diabetes, the onset of hypertension is associated with obesity, advancing age, and the coexistence of essential hypertension. Much less is known about specific vascular abnormalities. leading to thrombosis and the relationship between the hyperinsulinemia and thrombosis in diabetics. Therefore, we want to compare the fibrinolytic and metabolic profile between the type 2 diabetic patients with and without hypertension to investigate whether coexisting hypertension and diabetes act as additive risk factors to accelerate vascular complication. We also want to assess the relationship between levels of the regulators of fibrinolysis, serum lipid profiles including lipoprotein(a) (Lp(a)) and plasma insulin levels. Methods: In thirty-four type 2 diabetic patients with hypertension and 32 type 2 diabetic patients without hypertension, we measured the levels of tissue plasminogen activator (t-PA) and plasminogen activator inhibitor type 1 (PAI-1), the regulators of the fibrinolysis, lipoprotein profile including serum Lp(a) level and the serum c-peptide concentration, as the degree of insulin resistance. Results: Type 2 diabetic patients with hypertension have increased levels of t-PA (p$lt;0.05), PAI-1 (p$lt;0.05), total cholesterol (p$lt;0.05), and plasma Lp(a) (p$lt;0.05) as compared with those without hypertension. A significant correlation between PAI-1 levels and body mass index (BMI) (r=0.3, p$lt;0,05), fasting C-peptide levels (r =0.54, p$lt;0.01) and serum triglyceride levels (r=0.28, p$lt;0.05) was observed in the diabetic patients. But we could not find a significant association between either t-PA or PAI-1 levels and Lp(a) levels in them. Stepwise forward regression analyses using BMI, fasting C-peptide level, age, systolic blood pressure, HbAlc, triglyceride, t-PA and PAI-1 level as independent variables showed that only the fasting C-peptide levels correlated with PAI-1 levels (F=5,61; p$lt;0.05), Conclusion: These results suggest that the type 2 diabetic patients with hypertension seem to have lower fibrinolysis or higher Lp(a) levels than the normotensive diabetics. It might be possible that coexisting hypertension and diabetes act as additive risk factors to accelerate vascular complication by way of aggravating the level of insulin resistance, when we consider the strong association between the level of hypofibrinolysis and dyslipidemia and the hyperinsulinemia, a measure of insulin resistance in the diabetic patients.
We evaluated the diagnostic usefulness of latexagglutination test for elevated serum myoglobin as a screening test in the early phase of acute myocardial infarction and 21 patients with chest pain mimicking acute myocardial infarction were included in this study. Result was compared with serum myoglobin level measured by radioimmunoassay (RIA) in every case. The Following results were obtained: 1) When serum myoglobin levels measured by RIA below 85ng/㎖ were regarded as normal, this test showed sensitivity of 82%, specificity of 95%. 2) In latex-agglutionation test for elevated serum myoglobin, test results were interpreted as negative, weakly positive and positive. If we regard weakly positive tests as positive, sensitivity was 93% and specificity was 62%. In contrast, if we regard weakly positive tests as negative specificity rose to 100% while sensitivity reduced to 75%. 3) Agreement rate of both test was k=0.59. It is suggested that latex-agglutination test for elevated serum myoglobin is helpful in ruling out acute myocardial infarction when test result is negative, and that it can be used as a screening test in the early phase of acute myocardial infarction because of its rapidity and simplicity in performing the procedure.
In order to evaluate the feasibility of the noninvasive continuous wave Doppler (CWD) echocardiographic technique in evaluating transmitral pressure gradient and the effective mitral valve area, the 17 patients with pure or dominant mitral stenosis were examined by CWD echocardiography and by cardiac catheterization technique. By CWD technique mean and peak transmitral pressure gradient were measured as 9.5±4.0 mmHg, 13.9±4.9mrnHg respectively, and the effective mitral valve area was calculated as 0.62±0.16 cm², while by standard fluid filled catheter system the mean diastolic pressure gradient between the pulmonary capillary wedge position and the left ventricle was measured as 12.2±4.1mmHg, and effective mitral valve area by Gorlin and Gorlin formula was calculated as 0.66±0,39 cm. Each of the mean and peak diastolic pressure gradient by CWD was significantly correlated with the pressure gradient measured by cardiac catheterization technique (r=0.61, r=0,55, p$lt;0.05, p$lt;0.05, repectively). Effective mitral orifice areas measured by either of the technique were well correlated (r=0.73, p$lt;0.02). We concluded that noninvasive CWD technique could be an alternative method to the cardiac catheterization in quantitating the severity of mitral stenosis.
In order to observe the aspects of prosthetic cardiac valve failure, we analyzed 26 cases of Redo operation among 1081 cases of valve replacemant performed from Jan. 1961. to July 1986. The results are as follows; 1) Crude Redo operation rate was 2.4%. 2) The most common cause or prosthetic cardiac valve failure was the primary tissue failure (73%) 8r the PVE was the 2nd (15.4%). 3) Mean valve implantation time was 47.7 months. Implantation time in the child group was shorter than in adult by 6.8 months, In the primary tissue failure group (19 cases) implantation time in the child was 42.8 months 8z in adult, 66.8 months. (P$lt;0.05) In conclusion, the durability of tissue valves was significantly decreased in the child age group because of increased propensity for calcification, so the preference of tissue valves especially in this age group should be reconsidered.
Objective : To evaluate the effectiveness of evidence-based teratogenic risk counseling by relevant medical literature concerning pregnant women exposed to medication or diagnostic radiation during the first trimester. Methods : Between January 2001 and April 2001, 67 pregnant women exposed to medication or diagnostic radiation visited our clinic for teratogenic risk counseling. We counseld the teratogenic risk of their fetus by relevant medical literature.Also, We measured the score to terminate pregnancy and the perceptive risk on their fetus with major congenital anomaly using 10cm visual analogue scale. Results : None of them were exposed to any known teratogenic drugs or radiation in any teratogenic doses. Other physicians had already recommended, to about a third of patients, pregnancy termination. Their perceptive estimation on the risk of major congenital malformation in the general population was 4.6±1.1%. The perceptive risk on their fetus with major congenital anomaly decreased from 39.5±3.1% before consultation to 10.8±1.6% thereafter (P$lt;0.05). Also, their score on the visual analogue scale to terminate pregnancy was 6.4±2.7 before consultation and 9.1±1.6 thereafter. Their tendency to terminate pregnancy significantly decreased after consultation (P$lt;0.05). Conclusion : Evidence-based counseling for pregnant women exposed to medication or diagnostic radiation during the first trimester may prevent unnecessary pregnancy terminations as well as reduce anxiety.
프로골프선수의 슬관절 등속성 근력에 관한 굴곡근과 신전근의 비교연구. 운동과학, 제 9권 제 1호. (201)-(209), 2000. 본 연구는 장기간의 골프운동이 슬관절의 단축성 굴근력과 신근력의 발달에 미치는 영향을 규명하여 경기력 향상을 위한 트레이닝 방법의 기초자료를 제공하고자 수행 되었다. 연구의 대상은 24명의 프로골프선수들(29.60±3.8세)로 골프경력은 12±1.7년으로 대상자 전원이 오른손을 주로 사용(우타)하였다. 측정은 등속성근력계(Cybex 770)를 이용하여 각속도 60°/sec와 180°/sec에서 3회씩 좌·우 교대로 측정하였다. 측정변인은 peak torque, peak torque 발현각, 평균파워, 총운동량 등이었다. 자료분석은 SPSS통계프로그램을 이용하여 실시하였으며 다음과 같은 결론을 얻었다.; 슬관절 굴곡근과 신장근의 좌·우 근력 비교에서 각속도 180°/sec로 굴곡성 운동시 총 운동량(total work)에서 좌·우측간에 유의한 차이가 있는 것으로 나타났으나(p<.05), 나머지 측정변인에서는 굴곡근과 신전근 모두 부하각속도에서 통계적으로 유의하지 않았다. 굴곡력의 경우 우측하지가 좌측하지에 비하여 높았으나 신전력의 경우 좌측하지가 다소 높은 경향을 보였다. 각 변인의 평균치에 대한 60°/sec와 180°/sec간의 비교에서는 모든 변인에서 통계적으로 유의한 차이를 나타내었다(p<.05). 슬관절 굴곡근의 신전근에 대한 비율(Flexor/Extensor Ratio)은 60°/sec에서 60%보다 낮게 나타났으나 좌·우측간 유의하지는 않았다. 결론적으로 다년간의 골프운동은 하지의 슬관절 근기능을 발달시키며 우측하지에 비해 좌측하지의 신전근에 더 많은 발달을 가져온다고 할 수 있다. A study on isokinetic concentric torque of kee extensor and flexor in golf players. Exercise Science, 9(1): 201-209, 2000. The purpose of this stydy was to investigate the effect of long therm golf exercise on isokinetic concentric torque of kee extensor and flexor. The subjects of this study were 24 men progolf players(29.60±3.8yrs) who have experience of 12±1.7yrs golf exercise and use mainly a right hand. The measurement was performed by use of Cybex 770 in angular velocity 60˚ /sec, 180˚ /sec and 3 repetitions. The variable of measure were peak torque, angle of peak torque, average power, total work and so on. The result of this study were as follow: There only was statistical difference between both low limb in Total work of knee flexor in angular velocity 180°/sec(p<.05) but not in other variables in both angular valocity. Right low limb was little stronger than reft low limb in flexor but there was opposite result in extensors. There was statistical difference between 60°/sec and 180°/sec in all varible. Knee flexors and extensors ratio was lower than 60% in angular velocity 60°/sec but there was no statistical difference between right and left low limb. It might be concluded from the test that long term golf exercise strengthen muscle function of knee flexors and extensor and left knee extensors more strengthen than right knee extensors.
Scopolia Rhizoma is Rhizoma of Scopolia parviflora Nakai and Contains hyoscyamine, atropine (dl-hyo-scyamine), norhyoscyamine, noratropine, Scopolamine(Hyoscine), Scopolin etc. We experienced 4 patients who mistook scopolia Rhizoma as Discorea batatas Decaisne and suffered from acute poisoning after ingestion of this compound. The main clinical features were delayed appearance of the stimulative CNS signs & symptoms(restlessness, irritability, disorientation, hallucination, delirium, convulsion), followed by the appearance of the depressive CNS signs and symptoms(respiratory depression, Coma).
aObjective: IDDM is an autoimmune disease, which occurs among genetically susceptible individuals. In the Asian populations, it is not uncommon for adult patients with NIDDM to eventually lose beta cell function and develop IDDM. These individuals may be characterized by autoantibodies to GAD and high risk HLA-DQ alleles, which are unlikely to be prevalent among $quot;true$quot; NIDDM cases or in the general population. The objective of the present study was to evaluate and compare the prevalence of these immunogenetic markers in NIDDM patients and healthy non-diabetic individuals from Korea. Methods: The prevalence of anti-GAD antibodies and HLA-DQA1 and DQB1 alleles among 121 newly diagnosed NIDDM cases identified from a population-based study in Yonchon, Korea and 100 matohed healthy control subjects were evaluated and compared. Results: The overall prevalence of anti-GAD antibodies was 1.7% (2 of 121) in patients with previously undiagnosed NIDDM, whereas 1 of 100 controls had positive antibodies. Among those who were positive, their titer of antibodies to GAD were not high. No statistically significant differences in the distributions of either mean levels of anti-GAD or DQA1 and DQB1 alleles were found comparing NIDDM patients to controls. Conclusion: The low prevalence of anti-GAD antibodies and HLA-DQA1 and DQB1 susceptibility alleles among recent-onset NIDDM patients, which was similar to observations in controls, suggests that diabetes in Korean adults is unlikely to have an autoimmune component to its pathogenesis.