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        유리 광배근피판을 이용한 하지의 재건

        이규윤,김용배,이영만,양순재,박종섭 大韓成形外科學會 1991 Archives of Plastic Surgery Vol.18 No.1

        Significant soft-tissue defects in the lower extremity including the tibia and the foot are best managed with free skin-muscle of skin-grafted free muscle transfers. While free flap donor sites useful for lower exremity reconstruction include the latissimus dorsi, the rectus abdominis, the gracilis, and the scapular flaps, the latissimus dorsi seems ideal. This muscle has a reliably long vascular pedicle of wide diameter, making microsurgical anastomosis of the thoracodorsal vessels straightforward. Because it is so large, it can cover virtually and size defect. Furthermore, its flat configuration makes it especially easy to fold on itself to that it can be used to closure wounds with complex three-dimensional geometry and dead space. Although the gracilis and rectus abdominis muscles have their roles, in most cases the latissimus dorsi should serve well. We described technical considerations in each case and the advantages of free latissimus dorsi myocutaneous flap on the reconstruction of the soft tissue defect in the lower extremity.

      • 하지 절단자 보행의 운동역학적 분석

        임규찬,박윤서,배성제,정철수,신인식,김복영 師範大學 體育硏究所 1994 서울大學校 體育硏究所論集 Vol.15 No.2

        This study was conducted to investigate the biomechanical characteristics of the gait pattern in an amputee for the purpose of improving the proper gait posture and designing the prosthetic. The subjects were six males amputees and one normal person. The ground reaction force was measured using AMTI force platform. The conclusions were as follows; 1. In case of amputee group, the ground reaction force was revealed in specific figure according to position in which they used the prosthetic, whereas in case of normal person the ground reaction force was revealed in the figure of two humps in regard of vertical axis. 2. In case of amputee group, the ground reaction force in time between fight foot contact and left foot contact was deviated from a figure of rectangle, whereas in case of normal person the ground reaction force was revealed in the figure of rectangle. 3. In case of amputee group, the ground reaction force referred to both feet angle point of view was revealed in irregular figure, whereas in case of normal person the ground reaction force was revealed about 47。

      • KCI등재후보

        연취급 근로자들의 사회 심리적 스트레스와 연노출 지표들간의 관련성

        김용배,안현철,황보영,리갑수,황규윤,이성수,안규동,이병국 大韓産業醫學會 2000 대한직업환경의학회지 Vol.12 No.1

        목 적 : 연취급 근로자를 대상으로 사회 심리적 스트레스 수준을 알아보고 이를 기초자료로 활용하며 사회 심리적 스트레스와 연노출 지표들간의 관련성을 알아보고자 시도하였다. 방 법 ' 1차 연제련업종의 근로자 234명을 대상으로 일반적 특성, 사회 심리적 스트레스, 직업적 특성과 사회적 지지를 문진과 설문지를 통해 확인했으며 연노출 수준을 알기 위해 혈중 ZPP 농도, 혈중연농도, 요중 δ-ALA 배설량, 혈색소, 혈구용적치등을 측정했다. 결 과 : 단일변량 분석결과 혈중 연농도 수준과 직업적 특성에 따른 사회 심리적 스트레스는 유의한 차이가 있었으며 혈중 연농도가 증가함에 따라 스트레스 수준도 증가되는 경향을 나타냈다. 사회 심리적 스트레스와 연노출 지표 및 다른 변수들간의 관련성을 파악하기 위하여 상관분석을 실시한 결과 혈중 연농도만이 사회 심리적 스트레스와 양의 상관관계를 나타냈으며 유의했다. 결 론 : 고농도 연노출의 가능성이 있는 직종인 경우 기존의 연관련 자각증상에 대한 설문조사와 함께 사회 심리적 스트레스 측정도 병행하여 실시하는 것이 연에 의한 건강장해를 조기에 발견하고 예방하는데 필요하다. Objectives : This study was carried out to assess psychosocial distress of lead workers and to examine the relationship between lead exposure indices and psychosocial distress. Methods The study design was cross-sectional and research subjects were 234 lead workers in primary smelting industry. General characteristics, job characteristics and social support were obtained by self-administered questionnaire and history taking. Psychosocial distress was measured using PWI(Psychosocial Well-being Index), a 45-item self-administered instrument. Blood lead(PbB), zinc protoporphyrin(ZPP), δ-aminolevulinic acid in urine (ALAU) were selected as indicators of lead exposure. Results : There was significant difference in PWI according to lead exposure level and job characteristics. The results of correlation analysis showed that PWI was significantly correlated with PbB (r=0.203, p=0.002). Conclusions : Our results supported the association between lead exposure and psy-chosocial distress. The inclusion of psychosoclal distress measurement as a special health examination for lead workers was highly recommended for the effective health manage-ment.

      • KCI등재후보

        납노출지표와 적혈구내 protein kinase C 활성도의 연관성

        황규윤,황보영,안현철,김용배,리갑수,이성수,안규동,이병국 大韓産業醫學會 2001 대한직업환경의학회지 Vol.13 No.4

        목적 : Protein kinase C는 칼슘-인지질 의존형인산화 효소로 'H VJ'tfO에서 납에 의하여 활성화되지만, 납에 노출된 인체내에서 그 영향을 평가한 경우는 얼다. 본 연구의 목적은 납에 직업적으로 노출되는 근로자를 대상으로 납 노출이 적혈구막의 단백질내에서 PKC 활성에 의한 인산화 수준에 영향을 주는지 알아보고자 하였다. 방법 : 1998년부터 국내 납 근로자를 대상으로 납에 의한 건강 영향조사가 4년간의 코호트 연구로 실행하였다. 1차년도에 630명의 납 근로자와 135명의대조군이 조사되었고 이들중 본 연구에서는 직업적노출이 되는 사업장에 근무하는 212명의 근로자를대상하였다. 156명의 남자와 56명의 여자 근로자를 대상으로 인구학적, 과거병력, 직업력 등을 구조화된 설문과 면접으로 조사되었고 납 노출 평가는 혈중 납농도 및 ZPP, 경골중 납농도를 측정하였다. PKC의 활성도는 적혈구막 단백질내 PKC 의존형인산화 수준으로 평가하였다. 적혈구막 단백질인spectrin과 band 4.9의 후인산화수준을 측정하여각 납 노출지표(혈중 납, ZPP, 경골중 납. 노출기간)와의 관련성은 다중회귀분석을 이용하였다. 결과 : 조사대상자의 평균(SD) 연령은39.1(10.0)세, 근무기간은 8.1(6.5)년 이었으며, 경골중 납농도는 범위가 0.8에서 290.8 trg Pb/gbone mineral로 평근(SD) 34.4(35.2) rig Pb/gbone mineral이었다. 적혈구막 단백질의 후인산화수준은 개인간 변이가 매우 컸으며, spectrin은 평균(SD) 540 7(304.1), band 4.9 SfkDa는198.6(78.2), 48 kDa는 247.7(83.3) PSL이었다.경골중 납농도와 노출 기간은 이들 후인산화 수준과역상관성을 보였으나(p(0.05), 혈중 납 농도와 ZPP는 상관성이 없었다(p)0.05). 가능성 있는 혼란변수를 통제한 상태에서도 경골중 납 농도와 노출기간은 이들 후인산화수준과 유의한 회귀계수를 나타내었다. 결론 : 만성적 납 노출에 의하여 적혈구내 PKC활성도는 영향을 받아 증가되어있는 것으로 평가되어 적혈구막 단백질의 인산화수준은 납의 노출지표로 이용될 수 있을 것이다. 납의 신경독성은 부분적으로 PKC의 활성도왁 관련되어 있을 기전을 배제하기 어렵기 때문에 PfC 활성도와 신경행동학적 기능과의 관련성 평가가 진행되어야 할 것이다. Objectives : Protein kinase C(PKC) , a calcium and phospholipid dependent enzyme, is activated by lead in vitro at picomolar concentrations. However, the effect of lead on PKC has never been studied in a human population. The purpose of the study was to evaluate whether lead exposure was associated with PKC mediated-phosphorylation in erythrocytes among lead workers. Methods : Two hundred and twelve lead workers were studied. To determine the levels of phosphorylation ir vivo, an in vivo back phosphorylation technique was used by adding PKC and γ-32P to preparations of erythrocyte membranes. We measured back phosphorylations of erythrocyte membrane proteins, spectrin, and 52 kDa and 48 kDa, as an indirect measure of PKC activation if vivo. Results : The mean(SD) age and exposure duration was 39.1(10.0) years and 8.1(6.5) years, respectively. Tibial lead ranged from 0.8 to 290.8 μg Pb/g bone mineral with a mean (SD) of 34.4(35.2) μg Pb/g bone mineral. The means(SD) of back phosphorylation levels of the three proteins were 540.7(304.1), 198.6(78.2), and 247.7(83.3) photostimulated luminescence units (PSL), respectively, by phosphoimager. After adjustment for potential confounding factors, tibial lead and exposure duration were significantly and inversely associated with back phosphorylation levels. One unit of increase in tibial lead (1 μg Pb/g bone mineral) is associated with a decline in spectrin, band 4.9 52 kDa, and band 4.9 48 kDa back phosphorylation levels by 1.4(p〈0.05), 0.34(p〈0.05), and 0.47(p〈0.01), respectively However, there were no associations between the back phosphorylation levels and either blood lead or ZPP levels. Conclusions : These findings suggest that the PKC activity in erythrocytes is increased by chronic lead exposure and that erythrocyte membrane protein phosphorylation may be a biomarker of lead exposure.

      • 위암세포에 의한 종양침윤 림프구의 면역반응 억제기전에 관한 연구

        박정규,송규상,서광선,최정목,배진선,장일성,윤완희,노승무,조은경,백태현 大韓免疫學會 1995 大韓免疫學會誌 Vol.17 No.3

        Tumor-infiltrating lymphocytes ('1°ILs) interact most closely with tumor cells and thus are more likely to reflect tumor host interactions accurately. But it is unknown whether such T cells are nonspecific inflammatory cells or a subset of specific host immune responses. In this study, there was no clear correlation between the infiltration of T lymphocytes in stomach cancer and the overexpression of c-ErbB-2 or increasing class I MHC expression on tumor cells. A positive correlation was seen between the presence of TILs in the tumor and tumors with diploidy by flow cytometric DNA analysis. The proliferative responses of Ills stimulated with IL-2, anti-CD3 mAb, or both were examined. When compared to normal mucosal-associated lymphoid tissue lymphocytes, the proliferative response of TILs to high dose IL-2 was minimal. A similarly poor response to anti-CD3 mAb plus IL-2 was also observed. The freshly isolated TILs exhibit reduced ability to proliferate in response to IL-2, anti-CD3 mAb or both. The microenvironment of the tumor suppresses the proliferative capacity of the TILs. The mechanism of this suppression remains unknown. It could be mediated by suppressor cells, by soluble substances within the tumor, or both. To examine this question, supernatants of stomach cancer cells (SNSNU-1) were tested for the presence of immunosuppressive factors. Human peripheral blood T-cells and tumor-draining lymph node lymphocytes (TDLNL) were incubated for 3 days with SNSNU-1 and then assessed for proliferative responses to PMA, anti-CD28 mAb, or both and for the inducibility to express IFN- r or IL-4 mRNA to PMA. Peripheral blood T-cells pretreated with SNSNU-1 were unable to proliferate in response to PMA, anti-CD28 mAb or both. SNSNU-1 also produces inhibitory activities of TDLNL proliferative response to PMA or anti-CD28 mAb and PMA (49%, 52%, respectively). In contrast, culture supernatants obtained from HEp-2, K562 or Daudi showed normal proliferative responsiveness of peripheral blood T-cells and TDLNL by PMA, anti-CD28 mAb or both.

      • KCI등재

        만성정신병환자의 재활치료를 위한 주간보호 모델

        이규항,김한오,이후경,윤성철,성상경,함웅,윤배중 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.5

        목 적 : 본 연구는 전문병원 위탁형 정신보건센터에서 실시한 주간보호의 전체적인 체계, 운영, 프로그램에 관한 모델을 소개하고, 이 모델을 주간보호에서 시행한 후 그 결과와 시행과정에서 나타난 특징을 분석하여, 우리 실정에 맞는 주간보호 모델을 발전시켜 만성정신병환자의 생활유지와 재활을 촉진시키기 위한 목적으로 실시되었다. 방 법 : 본 주간보호 모델(이하 본 모델이라 함)을 1997년 3월부터 1998년 2월까지 의왕시 정신보건센터에서 총 23명의 환자를 대상으로 실시하였다. PANSS, Quality of Life, 삶의 만족 척도를 주간보호 전과 주간보호 실시 3개월 이후에 조사하였다. 프로그램 유익성 척도, 13가지 치료요인 척도를 주간보호 1개월째와 주간보호 실시 3개월 이후에 조사하였다. 결 과 : 1) 본 모델은 만성정신병환자의 증상을 감소시키고 삶의 질을 향상시켜, 환자의 생활유지 및 재활에 도움을 주었다. 2) 본 모델은 다양한 형태의 집단치료들을 사용하여 만성정신병환자에게 유익을 주었으며, 특히 예술치료와 활동치료가 환자의 신체적, 심리적, 사회적 기능회복을 위해 중요한 역할을 하였다. 3) 본 모델에 작용하는 치료요인의 특징을 보면 주간보호 초기와 후기에 모두 중시된 치료요인은 치료자와의 동일시, 치료자의 조언, 일차가족집단의 교정적 감정경험이었다. 주간보호 초기에 중시된 치료요인은 집단응집력, 이타심이었으며, 주간보호 후기에는 희망의 고취가 중시되었다. 4) 본 모델은 여러 분야의 치료자들과 다양한 치료방법들을 전체적으로 통합하여 사용하는데 유용하였다. 결 론 : 본 모델은 만성정신병환자의 생활유지와 재활을 위해 우리 나라에서 효과적이면서 효율적으로 적용될 수 있을 것으로 생각된다. Objectives : The purpose of this study was to present general system, operation, and program of a day care model managed by a psychiatrist, to evaluate the results of performing this model, and thus to develop a day care model applied to Korean situation appropriately for promoting maintenance and rehabilitation of chronic psychotic patients. Methods : We performed this day care model(hereinafter called as this model) from March 1997 to February 1998. The subjects were composed of 23 psychotic patients. PANSS, Quality of Life Scale, Life Satisfaction Self-Rating Scale were used before beginning this model and after three months of performing this model. Program Helpfulness Scale, 13 Therapeutic Factors Scale were used at one months of day care and after three months of day care. Results : 1) This model helped maintenance and rehabilitation of chronic psychotic patients through reducing their symptoms and increasing quality of life. 2) This model used the various group therapy, especially creative art therapy and activity therapy, played an important role for recovering physical, psychological, and social functions. 3) Important therapeutic factors at early and late period of this model were identification with therapists, guidance of therapists, and the corrective recapitulation of the primary family group. Important therapeutic factors at early period were group cohesiveness and altruism, and at late period instillation of hope. 4) This model was useful for integrating the multidisciplinary therapeutic team and the various therapeutic methods. Conclusion : This model would be applied to day care in this country effectively and efficiently for maintenance and rehabilitation of chronic psychotic patients.

      • KCI등재후보

        상악 전치부에 발생한 낭종성 치아종의 치험례

        김효언,윤규호,전인성,신재명,한광홍,배정호 大韓顎顔面成形再建外科學會 2003 Maxillofacial Plastic Reconstructive Surgery Vol.25 No.1

        Odontomas are odontogenic harmatomas which are composed of hard dental tissue. This lesion is composed of more than one type of tissue and, for this reason, has been called a composite odontoma. Odontogenic cysts are derived from epithelium associated with the development of the dental apparatus. Dentigerous cyst originated after the crown has been completely formed by accumulation of fluid between the reduced enamel epithelium and the crown. It also associated with crown of impacted tooth. Cystic odontomas are closely similar to dentigerous cysts clinically and radiologically. Treatment of choice is total removal(enucleation) or decompression(marsupialization). We represent two cases of Cystic odontomas with literature review in 69-year old male and 55-year old female occured in anterior maxilla. The leisions were successfully treated by marsupializaion.

      • SCOPUSKCI등재
      • 우리나라 연 작업자들의 연폭로 수준에 관한 연구

        조인숙,김용배,리갑수,김화성,황규윤,장봉기,이성수,안규동,이병국 순천향대학교 산업의학연구소 1999 순천향산업의학 Vol.5 No.1

        To assess lead exposure in Korean lead workers, 2047 male lead workers in 17 lead using industries were studied. Study population were divided into 4 occupation categories such as storage battery industry(type 1), secondary smelting and litharge making industries(type 2), PVC stabilizer making industries(type 3) and primary smelting and related industries (type 4). Blood lead and zinc protoporphyrin in whole blood (ZPP) were selected as an index of lead exposure. Hemoglobin and hematocrit were also checked. Fifteen questionnaires of lead related symptoms were provided to all lead workers and filled up by themselves and confirmed by medical doctors. Personal variables such as age, work duration, smoking and drinking habits were also collected. the results were as follows. 1) The mean blood lead, ZPP and hemoglobin of all lead workers were 29.7+12.6㎍/100㎖, 56.5+38.6㎍/100㎖ and 14.6+1.3 gm/100㎖ respectively. 2) While the mean blood lead of lead workers in type 1, 2, 3 and 4 were 28.6+11.6㎍/100㎖, 46.2+15.3 ㎍/100㎖, 46.8+12.1 ㎍/100㎖ and 26.2+10.2 ㎍/100㎖, the mean value of blood ZPP of those workers were 53.6+32.6 ㎍/100㎖, 108.1+87.1 ㎍/100㎖, 98.9 +54.9 ㎍/100㎖ and 45.8+19.5 ㎍/100㎖ respectively. 3) The percents of lead workers whose blood lead were 40-59.9 ㎍/100㎖ and over 60.0 ㎍/100㎖ were 17.6% and 2.1% respectively. Those whose blood lead were 40-59.9 ㎍/100㎖ and over 60.0 ㎍/100㎖ were 15.18% and 0.96% for type 1, 43.59% and 21.79% for type 2, 58.89% and 12.22% for type 3 and 11.82% and 0% for type 4 respectively. 4) The percents of lead workers whose blood ZPP were 100-149 ㎍/100㎖ and over 150 ㎍/100㎖ were 5.17% and 3.17% respectively. Those whose blood ZPP were 100-149 ㎍/100㎖ and over 150 ㎍/100㎖ were 4.66% and 2.04% for type 1, 10.26% and 25.64% for type 2, 23.33 and 13.33% for type 3 and 1.28% and 0.32% for type 4 respectively. 5) The prevalence rate of smoking and drinking of male lead workers in all lead industries were 70.8% and 71.0% respectively. While the mean blood lead of smoker, non-smoker, drinker and non-drinker were 30.24+12.58 ㎍/100㎖, 28.35+12.7 ㎍/100㎖, 30.24 ㎍/100㎖ and 28.74 ㎍/100㎖ respectively, the mean blood ZPP of those were 55.7+37.1 ㎍/100㎖, 58.4+41.9 ㎍/100㎖, 55.7+36.5 ㎍/100㎖ and 58.4+43.3 ㎍/100㎖ respectively. 6) While the correlation of hematocrit corrected blood lead with other lead exposure variables were higher than non-corrected blood lead, the correlation of log-transformed ZPP with other lead exposure variables were higher than non-corrected blood ZPP. 7) The most frequent symptom among 15 lead related symptom questionnaires was 'general fatigue' and the next one was 'feeling irritated with disturbance' and least one was 'acute abdominal pain around the umbilicus' in all lead workers. The overall prevalence of lead workers in storage battery industry and primary lead smelting industry were higher than secondary lead smelting and PVC stabilizer making industries. 8) The prevalence of lead related symptoms was a little higher in 13 symptoms in smokers than non-smokers and in 14 symptoms in drinker than non-drinkers, but they were not statistically significant. 9) Stepwise multiple regression analysis, using overall symptom prevalence as a dependent variable blood lead, blood ZPP, hemoglobin, age, work duration, drinking and smoking habits as independent variables, indicated that smoking habit, drinking habit and age were significantly contributed to the dependent variable. 10) The slopes of simple linear regression of blood lead (independent variable) with blood ZPP and log-transformed ZPP as dependent variable were different among 4 types of lead industries. The slope of lead industries with low mean blood lead were less steeper than those with high mean blood lead.

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