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      • KCI등재

        연부조직 선천성 혈관기형의 색전술을 이용한 비 수술적 치료

        박재형 대한영상의학회 1994 대한영상의학회지 Vol.30 No.1

        목 적: 연부조직 선천성혈관기형의 치료에 있어 색전술의 효과와 임상적 유용성을 알아보고자 하였다. 대상 및 방법: 사지와 등에 생긴 연부조직 선천성 혈관기형으로 색전술을 시행한 10예를 대상으로 후향적으로 분석하였다. 동정맥기형이 8예, 혈관종과 정맥기형이 각 1예였다. 9예에서는 다양한 종류의 색전물(Gelfoam,lvalon, IBCA, 무수에타놀, Lipiodol, micro-coil)을 단일 EH는 복합적으로 사용하여 경동맥색전술을 시행하였고, 정맥기형을 가지고 있었던 나머지 1예에서는 병변에 대한 직접 천자를 통해 무수에타놀과 Lipiodol 혼합핵으로 색전하였다. 결 과: 4예에서는 색전술직후 수술을 시행하였고, 수술전 색전술을 통해 병변혈관을 줄이고 이상동정맥루를 폐색함으로써 수술시의 출혈등의 위험요소를 감소시킬 수 있었다. 수술이 불가능했던 나머지 6예에서는 1회 이상의 색전술을 시행하였고, 그중 5예에서 추적기간 동안 증상이 호전이 있었다. 결 론: 연부조직 선천성혈관기형의 치료에 있어 색전술은 수술전 수단으로 시행하여 수술시 위험요소를 줄이거나, 수술이 불가능한 환자에 있어 1차적인 치료 수단으로 시행하여 증상의 완화에 상당한 효과가 있을 것으로 사료된다. Purpose : We evaluated the effectiveness of embolization in the management of congenital vascular malformations(CVMs).Materials and Methods: A retrospective analysis was performed in 10 patients who underwent embolotherapy for their soft tissue CVMs(eight arteriovenous malformations, one hemangioma, one venous malformation) involving the extremity or back. In nine patients, intraarterial embolization was performed with multiple embolic agents including Gelfoam, Ivalon, IBCA, ethanol mixed with Lipiodol, and micro-coils. In one patient with venous malformation, direct puncture and embolization of the lesion were performed with absolute ethanol mixed with Lipiodol.Results : In four patients, who subsequently underwent surgery, preoperative embolization decreased operative morbidity and facilitated a thorough extirpation. Five of six patients with inoperable CVMs experienced dramatic reduction of symptoms by single or repeated embolization, with a mean follow-up period of four months.Conclusion: We believe that preoperative embolization may decrease operative morbidity and facilitate a thorough extirpation in the patients with extensive but resectable CVMs and repeated embolizations are effective for symptom control in the patients with inoperable CVMs.

      • KCI등재
      • KCI등재

        금속성 혈관 스텐트를 이용한 장골동맥 협착의 치료

        박재형 대한영상의학회 1993 대한영상의학회지 Vol.29 No.4

        In order to study the clinical efficacy of the metallic stent of the treatment of iliac arterial stenosis, the clinical and arteriographic findings of the 8 patients were retrospectively reviewed. All 8 patients were males with an age of 51 to 79 The Fontaine class for the functional status of lower extremities was II in 4 patients, III in 3 patients and IV in 1 patient. Self expandable Gianturco stent was inserted in 7 iliac arteries and balloon expandable palmaz stent was inserted in 2 iliac arteries in the 8 patients. The indications for the metallic stent application were localized dissection with significant residual stenosis in 6 sites, recoiling due to calcification in one case and eccentricity of the stenotic lesion in 2 sites. The deployment of the metallic stent was successful in all the cases to maintain the patency of iliac arteries with residual stenosis less than 30%. The Fontaine class was improved to I in 6 patients, IIa in 1 patient and IIb in another one. During the follow-up period of 3 to 14 months, none except one developed recurrence of the treatment of iliac arterial stenosis. However, we think that it is a complementary measure to the percutaneous transluminal angioplasty. The comparative study between different types of metallic stent and the long-term effect should be investigated further.

      • KCI등재

        간세포암의 화학색전요법:장기생존율과 예후인자

        박재형 대한영상의학회 1996 대한영상의학회지 Vol.35 No.3

        Purpose : To analyse the long-term survival rate after transcatheter arterial chemoembolization (TACE) ofhepatocellular carcinoma and to determine prognostic factors. Materials and Methods : In 1067 hepatocellularcarcinoma patients who had undergone TACE, of long-term survival rate and prognostic factors were retrospecfivelyanalysed. Chemoembolization was accomplished by hepatic arterial infusion of a mixture of Lipiodol andAdriamycin(51%) or by Gelfoam embolization after infusion of the Lipiodol mixture(49%). The survival rate wascalculated by the Kaplan-Meier method and multivariate analysis using the weibull model was applied to determinewhich prognostic factors were statistically significant. Results : Among the 1067 patients, survival rates were asfollows : one-year, 60.6% ; two-year 42.3% ; three-year, 29.1% ; four-year, 23.7% ; and five-year, 14.7 %. The oneyear survival rate and median survival period of 432 patients with tumors 5cm in diameter or smaller were 77.7%and 33 months respectively, significantly higher than those of patients with larger tumors for whom thecorresponding figures were 44.8% and 11 months. Other significant prognostic factors(p<0.0001) shown bymultivariate analysis included type of tumor, portal vein invasion and child-pugh classification. Conclusion : Theone-year survival rate agter chemoembolization in 1067 patients with hepatocellular carcinoma was 60.6%. Thesignificant prognostic factors were size and type of the tumor, portal vein invasion, and Child-Pughclassification.

      • KCI등재

        국내기업 에너지효율 투자 의사결정 단계별 주요 동인의 상대적 중요도 분석 : 퍼지계층분석을 활용하여

        박재형,우종률,박지용 한국기후변화학회 2022 한국기후변화학회지 Vol.13 No.4

        Energy efficiency is considered a priority because it is not only a management target for companies, but also an effective means for the government of Korea to reduce greenhouse gas emissions and implement carbon neutrality. For this, it is necessary to identify in detail drivers that have a positive impact on energy efficiency-related investments by companies and shift to the development of sophisticated policies that can promote these drivers. Under these circumstances, this study contributes to providing basic data that the government can use as reference data for developing policies to improve corporate energy efficiency by determining drivers that can lead to investments for improving energy efficiency at each stage of corporate decision-making. To this end, we first assumed the company’s decision-making process leading to energy efficiency investments and then selected drivers that have a positive effect on each stage following a literature review. Further, since the government is paying considerable attention to energy efficiency as a means of implementing carbon neutrality, we divided the responding companies on the survey into large emitters of GHGs and small emitters and analyzed the results. Additionally, to improve the reliability of the results, we calculated the relative importance of each driver by applying a fuzzy analytic hierarchy process. We found that an energy price-related driver is more important for large emitters of GHGs. By contrast, we found that small emitters of GHGs placed increased importance on energy audit-related driver, energy efficiency policy-related driver, and technology identification driver. This study provides a framework for the government to take more sophisticated approaches toward developing policies for corporate energy efficiency improvement by identifying drivers that have a positive impact on the implementation of energy efficiency investments at each stage of the corporate decision-making process.

      • KCI등재

        심장판막질환의 영환자기공명영상

        박재형 대한영상의학회 1989 대한영상의학회지 Vol.25 No.2

        Cine-MR Imaging was done in 2 normal persons and 9 patients of valvular heart disease with 20 T superconducting MR system (Spectro-20000 ; GoldStar Korea). The MRI was undertaken using gradient echo technique with small flip angle. Repetition time(TR) was 34 msec and echo time(TE) 18 msec In most cases 20 to 30 frames could be obtained during one cardiac cycle. With normal heart high signal intensity was identified in the blood filled cardiac chambers, transient signal void was observed near tricuspid mitral and aortic valves cardiac chambers. Transient signal void was observed near tricuspid mitral and aortic valves due to the tubulences induced by valve opening or closure. In 6 cases of mitral valvular disease mitral valve was identified in all cases. The valvular motion was limited revealing doming toward cardiac apex during diastole. Signal void was evident in pansystolic phase of left ventricle in all cases. Evidences of combined aortic or tricuspid valve disease were also demonstrted revealing signal void in the corresponding cardiac chambers. Cine-MRI seemed to be not only a good non-invasive diagnostic modality for the valvular heart disease but also an accurate modality for cardiac functional evaluation.

      • KCI등재

        전방십자인대 재건술의 조직학적 연구

        박재형,정재윤,송은규 대한슬관절학회 1994 대한슬관절학회지 Vol.6 No.2

        Macroscopic and microscopic examination were conducted after endoscopic anterior cruciate ligament (ACL) reconstruction to observe a histological findings of reconstructed ACL in accordance with periods of follow-up. 2nd look arthroscopy and biopsy from the reconstructed ACL was performed from 12 cases out of 82 endoscopic ACL reconstructions using central 1/3 bone-patellar tendon-bone autografts, which were followed up for from 4 months to 2 years and 2 months after reconstruction. At 4 months after reconstruction, spindle or ovoid shaped fibroblast with hypercellularity, crimp patterns of collagen fiber, parallel arrangement of fibroblast to collagen fiber were noted. And the cellularity of fibroblast decreased in according to periods of follow up. At 12 months follow up, spindle or ovoid fibmblast, it's cellularity arrangement pattern and crimp pattern of collagen fiber were almost similar to those of normal ACL and continued until up to 2 years and 2 months after reconstruction.

      • SCOPUSKCI등재

        경동맥 색전술에 초기 반응을 보인 간세포암 환자의 생존율 및 예후인자

        박재형,이효석,김정룡,이준성,신경한,우광훈,정진욱,장동경 대한간학회 1998 Clinical and Molecular Hepatology(대한간학회지) Vol.4 No.3

        Focal nodular hyperplasia (FNH) is a benig nepithelial tumor of the liver. The etiology of FNH is unknown, but recent evidence suggests that FNH may represent a localized, hyperplastic response to a pre-existing vascular malformat ion. There is a high probability of as sociat edlesions , most commonly hepatic hemangiomas , meningioma, as trocytoma, and arterial dysplasia in various organs . In the present report we describe a FNH with aberrant lymphatics in a 24-year-old woman. In operation field, lymphatics were located on the site of falciform ligament . Histologically, aberrant lymphatics were composed of well vas cularized complex lymphatic channels and the mass were typical FNH. In this case, the role of aberrant lymphatics in the development of FNH was unclear . But as the FNH frequently as sociated with ot her anomalies , we think the aberrant lymphatic as such anomaly that have not been reported. (Korean J Hepa tol 1998;4:278 282)

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