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Ultrasonography has been used in clinical fields because of its merits, such as convenience noninvasiveness and abscence of radiation hazard. Author performed 67 cases of cholecystosonography and compared with surgical and pathological findings. The results were as follows: 1. 45 patients (67.1%) were distributed age 40 to 59, and male to female ratio was 1: 1.4 2. The order of frequency of GB disease was gallstone, acalculculcus cholecystitis, GB cancer and clonorchiasis. 3. The most common sonographic findings of GB stone was internal echo with sonic shadowing, and gallstone detection rate was 92.1%. 4. The order of frequency of sonographic findings of calculous cholecystitis were GB wall thickening, GB distension, faint internal echo and wall anechoicity. In cases of acalculous cholicystitis small portion of GB distension was seen. 5. Sonographic findings of GB cancer were irregular echcgenic mass without sonic shadowing and movability by position change.
Background: Two major events occurring in the cerebral hemodynamics after successful resuscitation from cardiac arrest are reactive hyperemia and postischemic hypoperfusion. In this study, we examined the effect of Pentoxifylline(PTX) on the rat brain following cardiac arrest. Methods: Fourteen rats were anesthetized and artificially ventilated. Cardiac arrest was produced by chest compression and clamping of tracheal tube for 3 minutes in ketamine anesthetized rats. Circulation was restored by standard cardiopulmonary resuscitation methods. In 7 rats, PTX 10mg/kg was infused at 10min after cardiac arrest(PTX group). In the other 7 rats, same amount of normal saline was infused(control group). Results: In both groups, hemodynamic variables, neurologic deficit(ND) score and histopathologic findings of hippocampal CA1 neurons were observed. Hemodynamic variables and ND score were not significantly different between two groups. Delayed ischemic neurons of hippocampal CA1 were decreased in PTX group(2.2±2.4%) compared with control group(9.1±1.2%). Conclusions: We conclude that PTX prevented development of delayed ischemic neurons in hippocampal CA1 after cardiac arrest. PTX may be useful in emergency situations following cardiac arrest.
연구배경 : 혈전현상을 특징으로 하는 질환에서는 Plasminogen activator inhibitor-1 (PAI-1) 이 높은 활성도를 보이는데, PAI-1 치는 당뇨병, 심근경색증, 비만 등에서 높다고 밝혀진 바 있다. 또한 당뇨병 환자들의 합병증의 주요한 병인은 죽상경화증으로 혈전현상이 특징인 질환에서 증가하는 PAI-1이 당뇨병 환자에서 높다. 목적 : 정상인에서의 PAI-1 유전자 촉진자의 유전자형의 분포 및 혈액농도를 관찰하고, 당뇨병 및 뇌혈관 질환 환자군에서의 PAI-1 유전자 촉진자 유전자형의 분포 및 혈액농도를 측정하여 정상인과 차이점을 알아본다. 당뇨병 환자군에서의 혈장 PAI-1 치와 인슐린 저항성, 전구 인슐린 등과의 상관관계를 살펴보고, 인슐린저항성과 대혈관질환의 지표로 사용될 수 있는지 알아보았다. 방법 : 대상으로는 정상인 76명, 제2형 당뇨병 환자 56명, 뇌혈관질환이 동반된 제2형 당뇨병 환자 48명, 뇌혈관질환 환자 51명을 선택하여, 환자의 혈액에서 인슐린, 공복시 혈당, 전구인슐린, 중성지방, 총콜레스테롤 및 기타 생화학 검사 및 이학적 검사를 시행하였다. 환자의 DNA를 채취하여 전사개시 -675bp를 포함하는 대립형질 특이 시발체를 사용하여 중합효소 연쇄 반응을 실시하여, 그 유전자형을 판독하였다. 결과 : 정상 대조군 76명 (46.4±11.1세), 2형 당뇨병 환자 56명 (58.3±12.6세), 뇌경색증 환자 51명 (63.1±13.2세) 대상으로 하였다. PAI-1 촉진자 유전자형의 (4G/4G, 4G/5G, 5G/5G)빈도는 정상 대조군이 각각 23.7%, 75.0%, 1.3%, 뇌경색 환자군이 19.6%, 66.7%, 13.7%, 뇌경색이 동반된 당뇨병 환자군이 33.3%, 58.3%, 8.3% 였다. (X2=12.6, p=0.05). 이러한 사실은 서구인에 비해 4G/4G, 5G/5G 동형 유전자형이 낮은 결과였다. 각 군별 혈장 PAI-1 농도는 정상 대조군 13.4, 1.8 ~ 65.2 ng/mL (중앙값 , 범위 ) 2형 당뇨병 환자군 14.4, 2.9 ~ 47.8 ng/mL, 뇌경색 환자군 21.9, 6.2 ~ 154.7 ng/mL , 뇌경색이 동반된 2형 당뇨병 환자군 28.8, 3.2 ~ 139.3 ng/mL 로 차이를 보였다 (p=0.000). 전체 대상에서 PAI-1 촉진자 부위의 유전자형에 따른 PAI-1 활성도와 항원 농도는 차이를 보이지 않았다. 그러나 PAI-1 활성도는 혈중 중성지방, 전구인슐린, 체질량지수와 독립적인 상관관계를 보였다 (p=0.000, p=0.000 and p=0.005). 결론 : 결론적으로 PAI-1 촉진자 부위의 유전자형은 뇌경색증의 지표는 아니며, PAI-1 활성도를 결정짓는 인자는 유전적 요인보다는 혈중 중성지방, 전구 인슐린, 체질량지수와 같은 대사적 요인으로 생각된다. Plasminogen activator inhibitor-1 (PAI-1) is known be related to insulin resistance and several components of the large vascular disease. Notably, the high frequencies of diseases such as coronary heart disease or stroke are related to type 2 diabetes complications. We studied to find out whether the PAI-1 promother genotype could be a marker for cerebral infarction in type 2 patients. Subject patients were; 56 type 2 diabetics (age 58.3±12.6), 51 patients with cerebral infarction (age 63.1±13.2), 48 type 2 diabetics with cerebral infarction (age 64.8±9.3) , and 76 healthy control (age 46.4±11.1). The 4G/5G genotype of PAI-1 promoter was evaluated by polymerase chain reaction and endonuclease digestion. PAI-1 promoter genotype frequency (4G/4G, 4G/5G, 5G/5G) was 23.7%, 75.0% and 1.3% in healthy control, 17.9%, 67.9% and 14.3% in type 2 diabetes patients, 19.6%, 66.7% and 13.7% in cerebral infarction patients, 33.3%, 58.3% and 8.3% in type 2 diabetics with cerebral infarction (X^2=12.6, p=0.05). This finding is lower in frequency of 5G/5G homozygote than that reported in Caucasians. The plasma PAI-1 concentrations according to the disease were 13.4, 1.8 ~ 65.2 ng/mL (median, range) for healthy control, 14.4, 2.9 ~ 47.8 ng/mL for type 2 diabetes, 21.9 6.2 ~ 154.7 ng/mL for cerebral infarction , and 28.8, 3.2 ~ 139.3 ng/mL, for cerebral infarction with type 2 diabetes (p=0.000). In the all subjects, PAI-1 concentration and activity of PAI-1 promoter genotype did not show any significant difference. However, the PAI-1 activity was independently associated with serum triglyceride level, plasma proinsulin and BMI (p=0.000, p=0.000 and p=0.005 respectively). We concluded that PAI-1 genotype is not a marker for the cerebral infarction ; however, the genotype is related to PAI-1 concentration , and therefore it seems to be that metabolic factors such as triglyceride level or plasma proinsulin or BMI are more in relations with determining the PAI-1 concentration than the genotype.
위장관 천공은 내시경적 점막절제술 후 발생할 수 있는 중대한 합병증으로 현재까지 이에 대한 치료 방법은 정립되지 않은 상태이다. 본 증례는 점막층에 국한된 위선암에 대한 내시경적 점막절제술 후 위천공이 발생한 경우로서 아주 작은 미세천공(microperforation)이었고, 최근 시도되고 있는 내시경적 클립 시술의 적응이 되지 못했다. 하지만 임상적인 복막염 발생 및 진행의 징후가 보이지 않아 금식, 광범위 항생제 투여 등의 보존적 요법으로 치료를 시행하였고, 시술 일주일 후 복막염의 발생이나 진행 없이 호전되어 퇴원하였다. 본 증례는 내시경적 점막절제술 후 발생한 미세 천공의 제한적인 경우에 한하여 수술이나 내시경적 치료를 하지 않고 보존적 요법만으로 성공적인 치료를 시행한 예로 문헌고찰과 함께 보고하는 바이다. The serious complication after endoscopic mucosal resection (EMR) was bleeding and perforation. Most of bleedings could be controlled by endoscopic procedure. However, the strategy of treatment for perforation was not established. A 60- year-old man was admitted to our center for EMR of gastric adenomatous lesion. After EMR, perforation in stomach was detected by peumoperitoneum on plain upright chest X-ray. We treated with conservative management such as withholding of oral intake, adminstration of broad-spectrum antibiotics, parenteral nutrition and close monitoring. There were no worsening clinical sings of peritoneal inflammation except mild leukocytosis during the in-hospital course. On the third hospital day after EMR, the patient resumed oral intake. The seventh hospital day, he was discharged. Our experience showed that selected small microperforation in stomach after EMR could be treated by not endoscopic procedures or surgical interventions but conservative management.
PLT and PLZT feroelectric thin films were fabricated on ITO substrate by rf magnetron sputtering. Pressure was 30mTorr, rf power was 180W and substrate temperature was varied from room temperature to 500℃. In this case, PLT had the highest dielectric constant of 120 at 500 ℃, oppositly PLZT had the highest dielectric constant of 312 at room temperature. I-V characteristics of PLZT film were shown that leakage current of PLZT film deposited at room temperature was below 3μA at 100V.
Overcrowding of emergency department is a serious and growing problem at St. Mary's Hospital. This has motivated the development of short-stay unit(SSU) as an alternative ward to routine hospital admission and ED discharge. In our hospital a SSU begun to admit patients in January 6, 1997. The SSU received 247 patients from the ED during the eight month interval(January 6, 1997 to August 31, 1997). To examine the utilization of the SSU in ED, we retrospectively analyzed 247 patients admitted in SSU from the ED, and compared the average hours per patient with acute gastroenteritis spent in the ED during the 2-month intervals before(July-August 1996) and after(July-August 1997) the establishment of the SSU. The following results were obtained; 1. The total patients consist of EM 92(37.2%), GS 48(19.4%), IM 24(9.7%), PS 21(8.5%), OS 20(8.1%), OBGY 14(5.7%) and others 28(11.3%) 2. The results of EM patients admitted in SSU from ED 1) Sex ratio of male to female was 1:1.1 and the mean age was 37.3±16years 2) In diagnosis, acute gastroenteritis was 29 cases(31.5%), multiple contusion 14 cases(15.2%), drug intoxication 12 cases(13%), limb laceration 6 cases(6.5%), tendon rupture of hand 6 cases(6.5%), and others 19 cases(20.6). 3) Mean length of stay in ED was 9.18 hours. 4) Among 92 patients to the SSU, 79 patients(85.9%) were discharged, 11 patients(11.9%) formally admitted to hospital and 2 patients(2.2%) transferred to otherhospital. The mean hospital stay time of the patients admitted to SSU was 2.6 days. 3. There was a significant reduction in the average stay time spent in the ED by treat-and-releasing patients with acute gastroenteritis after the establishment of the SSU(from 14.65±9.6 to 7.52±5.4 hr/patient, p<0.001). Conclusively, the establishment of the SSU can shorten the average stay time that treat-and-releasing patients spend in the ED, and reduce the number of admitted patients waiting in the ED.
생활중심 수학보고서 쓰기 활동이 현재 학생들이 가지고 있는 수학의 가치에 대한 인식 변화와 수학적 태도, 그리고 수학학업성취도에 어떠한 영향을 주는지 알아보기 위하여 생활중심 수학보고서 양식을 구안하고, 생활중심 수학보고서 쓰기 활동이 수학학업성취에 미치는 효과를 분석하며, 이 활동이 학생의 수학적 성향에 미치는 효과를 분석하였다. 연구 결과 생활중심 수학보고서 쓰기 활동이 학생들의 수학학업성취도 향상과 수학의 가치에 대한 인식 및 태도에 긍정적인 변화를 준다는 것을 알 수 있었다. The purpose of this study is to investigate what effect life-focused mathematical journal writing activity has on the change of recognition which children have about the value of mathematics at present, mathematical attitude, and the degree of mathematics learning achievement. For the purpose of this study, we design a journal writing form of life-focused mathematics. And we analyze the effect of life-focused mathematical journal writing activity on mathematics learning achievement and children's mathematical disposition. We used nonequivalent control group pretest-posttest design to investigate the effect of life-focused mathematical journal writing activity on mathematics learning achievement and mathematical disposition, used SPSS 10.1 program to arrange the results of the pretest-posttest on mathematics learning achievement and of the pretest-posttest on the mathematical disposition to verify the effect of life-focused mathematical journal writing, and analyzed what difference there is between the experimental group and the control group by performing t-test. As a result, we have come to know that life-focused mathematical journal writing activity has a positive effect on the children's mathematics learning achievement, the recognition on the value of mathematics, and mathematical attitude.
Background: The end-tidal carbon dioxide tension(ETCO₂) is defined as a partial pressure of carbon dioxide at the end of an exhaled breath. The purpose of this study is to determine the correlation between ETCO₂and arterial carbon dioxide tension(PaO₂) in nonintubated patients with respiratory distress in emergency department(ED). Methods: A prospective non-blind study was performed in ED of our university hospitals. Participants included all nonintubated adult patients with respiratory distress requiring arterial blood gas analysis. ETCO₂was measured with a capnography monitor during tidal volume breathing. ETCO₂were recoreded at the time of arterial blood gas sampling. The correlation between ETCO₂and PaCO₂was analyzed in all patients and in subgroups by simple linear regression. Results: Sixty patients were enrolled. In all patients, ETCO₂was 5.72mmHg lower than PaCO₂and correlated well with PaCO₂(r²=0.716). ETCO₂correlated best with PaCO₂in patients who were either acidotic or non-smoking. Conclusion: ETCO₂correlate well with PaCO₂in nonintubated patients with respiratory distress in ED. ETCO₂may be sufficient to reflect PaCO₂in selected patients and obviate the need for repeat arterial blood gas determination.
In this work, the characterization of adsorption of Cu, Zn and Cd on granular activated carbon in water has been studied. The factors that affect adsorption in boundary between activated carbon and wastewater are concentration, temperature, contact time, pH and so on. As the result of this study, the maximum adsorption amount of Cu occurred near pH 7, while that of Zn and Cd was near pH 9.6 and 10, respectively. As contact time and temperature are transformed, such factors as optimum contact time and temperature are taken into consideration in an adsorptive process of heavy metal because an adsorption and a reducing process occur. In isotherm of Freundlich, 1/n values of Cu, Cd capacity were between 0.16 and 0.5.