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      • Kartagener's Syndrome의 1예

        홍순표,정복기,조건국 朝鮮大學校 附設 醫學硏究所 1983 The Medical Journal of Chosun University Vol.8 No.1

        '스콜라' 이용 시 소속기관이 구독 중이 아닌 경우, 오후 4시부터 익일 오전 9시까지 원문보기가 가능합니다.

        Kartagener's syndrome is a rare disease, characterized by situs inversus, sinusitis, dextrocardia and bronchiectasis. This is a report of a rare case of kartagener's syndrome in 20-year-old-male whose chief complaint was purulent sputum, rhinorrhea, & exertional dyspnea. Chest P-A view revealed the dextrocardia and the magenblase in the right subphrenic area, suggesting situs inversus totalis. Multiple small cystic radielu-concies are also seen in lower halves of both thorax, suggesting bronchiectasis. P.N.S view revealed the homogenous increase-d density in all sinuses, tut didn't clear bony destruction. Bronchogram revealed the saccular and tubular dilation of the segmental bronchi in all bronchi, Particularly in the right lower lobe bronchus. EKG finding was alternation of voltage, right atrial hypertrophy and dextrocardia.

      • 지연성으로 발생한 외상성 횡격막 파열의 임상적 고찰

        이정희,서홍주,이석기 朝鮮大學校 附設 醫學硏究所 2006 The Medical Journal of Chosun University Vol.31 No.3

        Background: Diaphragmatic rupture may occur from blunt or penetrating thoracoabdominal trauma, which may be undiagnosed initially in the acute trauma, work-up and may remain unrecognized. Delayed traumatic diaphragmatic rupture is reported with increasing frequency and is associated with high morbidity and mortality. The purpose of this study was to present our experience and found out early diagnostic method, clinical presentation and management. Matehals and Methods: From March 1998 to February 2004, the 6 patients of delayed diaphragmatic rupture in our hospital were operated. We reviewed the diagnostic interval, symptom, diagnostic method, operative method and complication. Resutt: They were 3 men and 3 women. Mean age was 56.8:t15.8 years(range 29-69). Most common symptom was dyspnea. Delayed diaphragmatic rupture was right-sided in 4 patients, left-sided in 2. The average operative interval of delayed diaphragmatic rupture was 18.8 months(range 5-48). The diagnosis was chest x-ray and thoracic CT. Operative approach were only thorax in 4 patients and both thorax and abdomen in 2. Postoperative complication were observed in 4 patients, and the overall mortality was none. Conclusion: The delayed case of traumatic diaphragmatic rupture tends to be overlooked without suspicion, In all patients with thoracoabdominal blunt injury a rupture of the diaphragm must be suspected. With a high suspicion, a thorough physical examination and diagnostic method is recommended in order to avoid early or late complications.

      • 정신분열병 환자의 집-나무-사람 검사 반응과 정신병리

        황걸,박상학,김학렬,김상훈,조용래 조선대학교 부설 의학연구소 2002 The Medical Journal of Chosun University Vol.27 No.1

        Objectives: This study was conducted to compare the characteristics of schizophrenic subjects with those of normal subjects in the H-T-P test. Materials and methods: Fifty-six schizophrenics and 53 normal subjects were examined and scored with the H-T-P test. And their drawings were scored by using 85 objectively scorable items developed by the author. Results: The House : The schizophrenic subjects depicted less frequently, the houses of 2 or more floors, doors, ways or pave stones leading to the doors, door knobs, windows, accessory trees and animals, chimneys, smoke, and fences. The pictures of House drawn by schizophrenic subjects showed slanted houses. The Tree : Contrary to the expectation, keyhole trees and the looping lines of the trees occurred with low frequency in the schizophrenic group. The Person : The most striking differences of the two groups were the sexual depictions, moving objects, smiling face, appendages of clothes (eg. button, pocket, belt, texture etc.), and the constructional acuity of bodies, which occurred less frequently in the scizophrenic group. Another difference is the absence of ears in the pictures of the schizophrenic group. Conclusions: In conclusion the H-T-P test can identify the psychological contents, cognitive functions, and social attitude of the schizophrenic subjects, based on the contents and structures of their drawings.

      • 북부 동-정맥루공 전신마취 1례

        정종달 朝鮮大學校 附設 醫學硏究所 1986 The Medical Journal of Chosun University Vol.11 No.1

        '스콜라' 이용 시 소속기관이 구독 중이 아닌 경우, 오후 4시부터 익일 오전 9시까지 원문보기가 가능합니다.

        36 years old male patient admitted for surgical correction of an arteriovenous fistula between right common iliac artery and inferior vena cava. Thiopental sodium and succinylcholine were injected for tracheal intubation and the anesthesia was maintained with nitrous oxide, oxygen and halothane. The EKG, blood pressure, Pulse rate, CVP were monitored continuously. After aorta was cross-clamped, arterial systolic and diastolic pressure rose moderately, CVP was slightly decreased and no significant changes were seen after declamping. This patient was discharged after 1 month in good condition.

      • 광주의 한 이차병원에서 조사한 결핵약제 내성과 관련인자

        조준호,김강,최상철,이경록,정종필,고영춘 朝鮮大學校 附設 醫學硏究所 2008 The Medical Journal of Chosun University Vol.33 No.3

        연구목적: 우리나라의 결핵약제에 대한 내성은 지속적으로 감소되고 있음에도 불구하고 여전히 적지 않은 환자를 보유하고 있는 상황에서 치료 실패의 중요한 요인이 되고 있다. 이에 결핵 내성률에 영향을 미칠 수 있는 인자들을 파악하고 이에 대한 예방 대책을 수립하는 것이 내성률 발생의 예방에 도움이 될 것으로 사료된다. 이에 저자들은 광주 소재의 한 2차 병원에서 결핵 약제 내성률 및 위험인자로 판단되는 요소들과의 상호관계를 조사하였다. 대상 및 방법: 2005년 3월 부터 2006년 2월 까지 광주 기독 병원 내과에서 치료받은 결핵 환자중 객담 결핵균 배양 검사상 양성으로 판명되어 약제 감수성 검사를 확인할 수 있었던 346명을 대상으로 의무기록, 면담 등을 통한 후향적 조사를 시행 하였다 결과: 346명중 한가지 이상의 약제에 내성을 보인 경우는 150명(43.4%)였고, 다제 내성 결핵은 72명(20.8%)였다. 조사 요인의 유무별로 약제 내성률을 조사하였을 때 흉부 사진의 침범 정도에 따른 약제 내성률 및 다제 내성률은 경증에서 36.3%와 6.2%, 중등도에서 36.1%와 22.6%, 중증에서 61.0%와 35.0%였다. 병변의 공동성 병변 유무에 따른 약제 내성률은 공동이 있는 군에서는 49.8%, 공동이 없는 군에서는 34.0%였다. 과거의 치료력 여부에 따른 약 제 내성률은 치료력이 없는 군에서는 19.7%였고, 치료력이 있는 군에서는 81.2%였다. 항 결핵제 복용의 규칙성 여부에 따른 약제 내성률은 규칙적 복용군은 31.7%, 불규칙적 복용군은 59.7%로 나타났다. 결론: 광주 소재의 한 2차 병원에서 조사한 약제 내성률 및 다제 내성률은 전국 평균치를 훨씬 상회하였다. 한편 과거 치료병력 및 약제의 불규칙 복용은 약제 내성률을 높이는 데에 기여하는 인자가 될 것으로 사료된다. 흉부방사선 사진 상의 폐 침범 정도, 공동성 병변의 존재도 약제 내성률 증가와 관련이 있는 것으로 보이나 보다 정확한 선후관계 분석을 위해서는 추가적인 전향적 연구가 필요하다. Background and objectives: Drug resistance is a major obstacle to the treatment of pulmonary tuberculosis (TB). This study was conducted to determine the prevalence of drug-resistant tuberculosis and its associated factors at a secondary hospital in Gwangju. Materials and Methods: A retrospective one-center analysis was conducted, with 346 pulmonarytuberculosis patients who underwent drug susceptibility tests for M. tuberculosis at Gwangju Christian Hospital from March 2005 to February 2006. Results: The following percentages of subjects were found to be resistant to at least one drug and to have multidrug-resistant tuberculosis (MDR-TB), respectively: 43.4% and 20.8% of all the subjects; according to the severity of the chest X-ray findings, 36.3% and 6.2% in the mild group, 36.1% and 22.6% in the moderate group, and 61.0% and 35.0% in the far- advanced group; according to the presence of a cavitary lesion, 49.8% in the cavitary-lesion group and 34.0% in the noncavitary-lesion group and according to the history of previous tuberculosis treatment, 81.2% in the group who have had treatment and 19.7% in the group who have never had treatment. The resistance rate according to the regularity of antituberculosis drug medication was 31.7% in the regular medication group and 59.7% in the irregular medication group. Conclusion: The drug resistance rate was increased by the history of previous tuberculosis treatment and the irregular medication. As to whether the severity of chest X-ray findings and the presence of cavitary lesions have a correlation with drug resistance, prospective studies are needed for more accurate results.

      • 피부관리실을 찾는 고객들의 심리적 특성

        나명순,박상학 조선대학교 부설 의학연구소 1998 The Medical Journal of Chosun University Vol.23 No.2

        The purpose of this study was to investigate the relationship between skin-related variables and characteristics of clients to skin care shops. A questionnaire was administered to 300 clients, of those 89 samples were excluded due to missing values and the others, and then the data reported by 211 samples were analyzed The major findings are as follows ; 1. Of several significant predictor variables, self-esteem was the most powerful variable on irritable mood for skins. The number of clients who felt irritable for their skins was more in clients with low self-esteem than in those with highh self-esteem. 2. Of several significant predictor variables, foundation color was the most powerful variable on depressed mood. The frequency of clients who reported depressed was higher in clients using light foundations usually than in the others. 3. Of several significant predictor variables, purpose for skin care was the most powerful variable on stress experience. The number of clients who experienced stress due to their skins was more in clients for skin problems-solving than in those for prevention or relaxation. 4. Of several significant Predictor variables, foundation color was the most powerful variable on interpersonal avoidance. The frequency of clients who avoided interpersonal contact due to their skins was higher in clients using light foundations usually than in the others. 5. The frequency of clients who were satisfied with skin care was higher in clients with high liking for estheticians than in those with low liking. In summary, the number of clients who reported negative psychological reactions was more in clients with skin problems than in the others. Therefore, it is concluded that clients with skin problems require psychosocial intervention for their emotional well-being as well as skin care.

      • 화농성 견관절염의 관절경적 처치

        문영래,유재원,심형준,박준광 조선대학교 부설 의학연구소 2002 The Medical Journal of Chosun University Vol.27 No.1

        Purpose : The purpose of this study is to evaluate the usefulness of arthroscopic drainage in the management of septic arthritis of the shoulder. Materials and methods : The cases of nine septic glenohumeral joints were evaluated. Each patient was treated by arthroscopic irrigation and necrotic synovectomy, combined with parenteral antibiotics. Result In five of nine shoulders in which treatment was begun four weeks or less after symptoms appeared, a satisfactory functional outcome was obtained, while four patients who were treated after a delay of more than four weeks had poor results. Conclusion : The most significant factors leading to poor results of treatment were delay in instituting treatment, virulence of the infecting organism, and a serious process of underlying disease. Arthroscopic drainage is a valuable procedure for the treatment of the septic arthritis of shoulder. Arthroscopic drainage is a method that has proved effective, with minimal morbidity, in attempts to cure septic arthritis of the shoulder.

      • 소아 흉통의 원인질환에 따른 임상양상

        장국찬,김은영,노영일,양은석,문경래,박영봉 朝鮮大學校 附設 醫學硏究所 2008 The Medical Journal of Chosun University Vol.33 No.2

        목적: 소아에서의 흉통은 흔히 접하게 되며 일반적으로 좋은 경과를 보인다. 가장 흔한 원인으로 특발성, 골격계이상, 위장관계 질환 등이 다양하게 언급되고 있으며 감별진단이 쉽지 않아 여러 검사를 시행하게 된다. 자세한 병력청취와 진찰이 진단에 가장 중요하다고 하지만 통계적 의의를 보고한 바는 드물다. 이에 흉통 원인을 분류하고 각각의 임상양상을 파악하여, 병력 청취와 진찰소견의 감별진단에 대한 유용성과 시행 검사들의 의의를 알아보고자 하였다. 방법: 2004년 3월 부터 2007년 8월 까지 조선대학교 병원 소아청소년과에 흉통을 주소로 방문한 환아 77명을 대상으로 하였다. 연령, 성별, 흉통의 위치, 지속시간, 양상, 빈도, 방문까지 걸린 시간, 동반증상, 유발인자의 각 항목과 원인 질환과의 관련성을 분석하였다. 흉부방사선, 심전도, 심초음파, 24시간 Holter, 운동부하 심전도, 상부 위장관 조영술, 24시간 pH 검사, 위내시경, 심근효소를 검사 하였다. 결과: 평균 나이는 10.2±2.8세로 6세에서 11세까지가 48명(62.3%)으로 가장 많은 분포를 보였고 남아 42명(54.5%), 여아 35명(45.5%)이었다. 흉통의 위치는 좌측이 32명(41.6%), 양상은 콕콕 찌르는 것이 27명(35.1%)으로 가장 많았고 지속시간은 1분미만이 36명(46.8%), 1-5분 사이가 28명(36.4%)으로 대부분 5분 미만이었다. 흉통 원인은 특발성이 27례(35.1%)로 가장 많았고, 위장관 질환 23례(29.9%), 늑골 연골염 12례(15.6%), 심혈관 질환 7례(9.1%), 정신신체화 질환 6례(7.8%), 폐질환 2례(2.6%)였다. 여아에서 연령이 높을수록 정신신체화 질환의 빈도가 높았다(P= 0.046). 흉골 하부 통증을 호소한 17명 중 13명(76.5%)이 위장관 질환으로 통계적으로 유의하였다(P= 0.023). 정신 신체화 질환은 6명에서, 위장관 질환도 20명(86.9%)에서 흉통지속시간이 5분 미만이었으나 통계적 의의는 없었다. 흉통 양상 중 타는 듯한 양상을 호소한 7명중 6명에서 위장관 질환이 원인이었으나 통계적 의의는 없었다. 선택 시행 검사 중 심초음파는 32명중 3례(9.4%), 24시간 Holter 검사는 13명중 5례(35.7%), 24시간 pH 검사는 28명 중 16례(57.1%)에서 이상소견을 보였다. 결론: 소아 흉통 환자 중 연령이 높은 여아에서는 정신 신체화 장애를, 흉골 하부 통증을 호소한 경우는 위장관 질환을 먼저 생각하는 것이 좋다고 판단된다. 흉통원인으로 위장관 질환의 빈도가 높고 시행검사들의 진단율을 볼때, 소아 흉통 환아 에서는 상부 위장관 조영술 등 위장관 질환의 검사를 기본적으로 시행하는 것이 좋을 것으로 생각된다. Purpose: Chest pain in children is usually benign. Chest pain in children results from a wide variety of causes. Differential diagnosis of causes is not easy and then many diagnostic approach is trying. Careful history and physical exams must guide the assessment of children with chest pain. The purpose of this study intends to evaluate children with chest pain and usefulness of careful history, physical examination and several diagnostic examinations. Methods: From March 2004 to August 2007, 77 patients presented with chest pain were enrolled. we evaluated age, sex, characteristics of chest pain (location, duration, description, frequency), accompanying symptoms, increasing reasons and relationship with cause of chest pain. Chest x-ray and ECG were checked in all patients. Cardiologic and gastrointestinal evaluations were checked when considered necessary. Results: The male and female ratio was 0.55:0.45, mean age 10.2 ± 2.8 year. Common ages of chest pain were 10 to 12 years old (38case, 49.3%). The location was on the left precordium in 32cases (41.6%) of the patients. The most common diagnostic findings of chest pain were idiopathic(27cases, 35.1%), gastrointestinal disorder (23cases, 29.9%), costo chondritis (12cases, 15.6%), cardiovascular disorder (7cases, 9.1%), psychosomatic disorder(6cases, 7.8%) and pulmonary disorder (2cases, 2.6%). Older children in female were more likely to have a psychosomatic cause (P= 0.046). The patients complained chest pain on substernal area were 17cases and 13cases (76.5%) were diagnosed as gastrointestinal disorder (P= 0.023). Positive findings of echocardio graphy, 24hr Holter ECG and 24hr pH monitoring were present in 3 (9.4%), 5 (35.7%) and 16 (57.1%) of the patients respectively. Conclusion: Gastrointestinal disorders are common causes and positive diagnostic rate of gastrointestinal evaluation is relatively high in children with chest pain. Old girls are more likely to have a psychosomatic disorder and substernal pain is the reliable sign to be considered as a gastrointestinal disease in children with chest pain. Hence, Diagnostic approach of gastrointestinal disease such as upper GI should be performed basically in mostly children with chest pain.

      • Polyethylene glycol 용액(Colyte^(R))을 복용한 후 발생한 Boerhaave 증후군 1예

        이관행,기승석,김인숙,김민정,박인호,장세중,하지수,김응수 朝鮮大學校 附設 醫學硏究所 2006 The Medical Journal of Chosun University Vol.31 No.3

        Spontaneous esophageal rupture (Boerhaave's syndrome) is a rare case that require early diagnosis and treatment because of its high mortality. The oral administration of osmotically balanced polyethylene-glycol-based electrolyte preparation is a commonly prescribed preparation for cleansing in patients undergoing colonoscopy. Nausea, vomiting and abdominal pain are frequently seen, but serious adverse reactions are rare. Esophageal rupture secondary to severe vomiting, which occurred during colonoscopy preparation using polyethylene gIycoI(PEG) electrolyte solution is extremely rare and only few cases have been published in the literature. We report a case of spontaneous esophageal rupture after routine administration of the PEG before colonoscopy. 대장 정결을목적으로 PEG 사용 후 아주 드물게 발생하는 Boerhaave 증후군 1예를 경험하였기에 보고하는 바이다.

      • 생쥐모델에서의 망막모세포종 안구 자기공명분광법과 병리소견 : 초기경험

        김동훈,김일중,양재한,김정훈,유영석,이봉재 朝鮮大學校 附設 醫學硏究所 2007 The Medical Journal of Chosun University Vol.32 No.1

        Purpose: To show various MR spectroscopy and correlated pathologic images of retinoblastoma in nude mouse with a new human retinoblastom cell line (SNUOT-Rbl) which innoculated into intravitreous cavity. Materials and Methods: The established cell line was innoculated into mtravitreous cavity of 14 eyeballs of 7 mice and a transplanted retinoblastoma was examed for 1 month. Tl-weighted image (T1WI), T2-weihgted image (T2WI), and MR spectroscopy were obtained with 1.5 Tesla MRI (Magnetom Vision, Siemens, Erlangen, Germany) and 4.7 Tesla MRI (Bruker, Medizintechnik GmbH, Karlsruhe-Ettlingen, Germany). After scanning, eyeballs were extracted and hematoxylin & eosin stained specimens were examined with the microscope. We compared MR spectroscopy with pathologic findings and evaluated characters of tumors. Results: Innoculated cells into eyeball of mice grew retinoblastoma (8/14, 57%). Eyeball with retinoblastoma protruded externally and showed focal hemorrhage. Tumors showed low (n=3), iso (n=4), high (n=1) signal intensity on TIWI, low (n=5), iso (n=1), high (n=2) signal intensity on T2WI, and well enhancement (n=8) with contrast, Involvement of optic nerve was suspected by MRI and confirmed by pathology (n=1). Conclusion: We could demonstrate MR spectroscopy of transplanted retinoblastoma by new tumor cell line in vivo. This imaging technique facilitate molecular imaging investigation of retinoblastoma.

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