Dementia and Neurocognitive Disorders 2014; 13: ORIGINAL ARTICLE 초기다계통위축증에대한뇌관류 Single Photon Emissi

Size: px
Start display at page:

Download "Dementia and Neurocognitive Disorders 2014; 13: ORIGINAL ARTICLE 초기다계통위축증에대한뇌관류 Single Photon Emissi"

Transcription

1 Dementia and Neurocognitive Disorders 2014; 13: ORIGINAL ARTICLE 초기다계통위축증에대한뇌관류 Single Photon Emission Computed Tomography 의임상적유용성 이종윤 * 송인욱 * 정성우 * 정용안 양영순 가톨릭대학교의과대학신경과학교실 * 핵의학과학교실, 보훈공단중앙보훈병원신경과 Received: May 16, 2014 Revision received: May 28, 2014 Accepted: May 28, 2014 Address for correspondence In-Uk Song, M.D. Department of Neurology, Incheon St. Mary s Hospital, The Catholic University College of Medicine, 56 Dongsu-ro, Bupyeong-gu, Incheon , Korea Tel: siuy@cmcnu.or.kr Clinical Usefulness of 99mTc-Hexamethyl Propylene Amine Oxime Perfusion Single Photon Emission Computed Tomography for Early Phase Multiple System Atrophy Jong-Yoon Lee, M.D.*, In-Uk Song, M.D.*, Sung-Woo Chung, M.D.*, Yong-An Chung, M.D., YoungSoon Yang, M.D. Departments of Neurology* and Nuclear Medicine, College of Medicine, The Catholic University of Korea, Seoul; Department of Neurology, Veterans Hospital, Seoul Medical Center, Seoul, Korea Background: Clinical diagnosis of multiple system atrophy (MSA) relays on signs and symptoms that are often difficult to identify particularly at early stage. Indeed neuropathological studies have demonstrated that Parkinson variant of MSA (MSA-P) is the first cause of misdiagnosis in a cohort of patients presenting with parkinsonian features. But accurate diagnosis of these disorders is important for deciding on treatment, appropriate advice and prognosis since atypical parkinsonian disorders are characterized by poor response to dopaminergic treatment and more rapid disease progression. Therefore, we conducted this study to investigate difference of perfusion Single Photon Emission Computed Tomography (SPECT) in patients with the early phase of MSA-P using SPM program. Methods: We recruited consecutively 21 patients with MSA-P and 48 age-matched healthy controls. All subjects underwent Tc-99m HMPAO perfusion SPECT and this perfusion images were analyzed. Results: For MSA-P, only hypoperfusion was seen in the middle frontal gyrus of left frontal lobe, superior frontal gyrus of right frontal lobe, precentral gyrus of left frontal lobe, middle frontal gyrus of right frontal lobe and precentral gyrus of right frontal lobe with respect to healthy subjects. Conclusions: We cautiously assume that perfusion SPECT may offer significant advantages compared to other imaging techniques in the assessment of neuronal degeneration in MSA-P and may help the clinician in the diagnostic characterization of patients presenting with atypical parkinsonism. Key Words: Multiple system atrophy, Tc-99m HMPAO perfusion SPECT, Frontal lobe 서론특발파킨슨병과다계통위축증은대표적인파킨슨증을일으키는질환이다 [1]. 다계통위축증은임상적으로파킨슨증상과소뇌증상, 자율신경이상증상과추체외로증상을동반하는질환이다 [2]. 이러한다계통위축증의병리소견은흑질줄무늬체도파민로 (nigrostriatal dopaminergic pathway), 꼬리핵 (caudate) 과조가비핵 (putamen), 창백핵 (globus pallidus), 뇌간 (brain stem), 소뇌그리고척수에서신경퇴행성변화를보여주는질환으로특발파킨슨병과마찬가지로 확진은뇌조직검사뿐이므로다계통위축증도임상증상및신경학적검사를중심으로추정진단을내릴뿐이다 [2, 3]. 다계통위축증의조기진단은특발파킨슨병에비해진행이빠르고약물에반응을하지않아조기의증상조절및예후에대한명확한설명이반드시필요하다. 특발파킨슨병의경우는도파민전달체를이용한뇌기능영상기법과 iodine-123-meta-iodobenzylguanidine (I-123 MIBG) 신티그라피등으로인하여조기진단에많은도움을받고있으나다계통위축증에대해서는이러한영상기법이아직까지나와있지않는실정이다 [4]. 하지만뇌자기공명사진촬영으로다계통위축증을시 2014 Korean Dementia Association This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. 37

2 38 이종윤 송인욱 정성우외 2 인 사하는소견들이보고되고는있으나어느정도진행된단계에서의소견이므로초기다계통위축증에서는적용되기힘들다. 물론이전연구들에의하면 statistical parametric mapping (SPM) 을이용한 fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) 영상으로인해특발파킨슨병과다계통위축증의특징적인소견을보였다고하나이는경제적인문제등으로인하여일반적으로사용하기어려운실정이다 [5, 6]. 이에반해뇌관류 brain perfusion singlephoton emission computed tomography (SPECT) 은일반적으로많이유용되는검사로서뇌혈류를 technetium을붙인 Hexamethyl-prophylene-amine-oxime 또는 ethyl cysteinate dimer를이용하여많이활용되고있으며, 최근신경퇴행성질환에있어서뇌혈류량에따른기능향상을평가하는데많이이용되고있다 [7, 8]. 특발파킨슨병에대해서는두정엽, 후두엽, 기저핵등에서관류저하를보이는특징적인소견이보고되고있으나뇌관류 SPECT의다계통위축증소견에대해서는아직까지확립되지않았을뿐만아니라이에대한연구도미미한실정이다 [6, 7, 9]. 더욱이다계통위축증은파킨슨증의임상증상을동반하기때문에조기에감별진단이더욱어려운실정이다. 하지만다계통위축증은특발파킨슨병에비해진행이빠르고약물에반응을하지않아조기의증상조절및예후에대한명확한설명이반드시필요하다. 따라서다계통위축증의뇌관류 SPECT 소견을객관적인방법인 SPM 프로그램을이용하여정상군과비교분석하여조기진단에도움이되고자본연구를시행한다. 방법본연구는 2012년 1월부터 12월까지본원신경과에내원한파킨슨증양상을주로보이는다계통위축증의파킨슨변형 (Parkinson variant of multiple system atrophy, MSA-P) 환자를대상하였고, 본원임상윤리심의위원회의승인을받고진행하였다. 모든연구대상자들은 Gilman 등 [2] 에의해제안된추정다계통위축증진단기능에맞는환자를선택하였다. 또한초기환자만을선정하기위해 Modified Hoehn-Yahr stage (H-Y stage) 3 미만환자만을선택하였고, 본원 123I-n-fluoropropyl-2b-carbomethoxy-3b-(4-iodophenyl) nortropane positron emission tomography (FP-CIT PET) 상에서도도파민전달체의흡수가저하되지않은환자만을선택하였다. 뇌자기공명사진상에서뇌의구조적병변이나허혈성병변등이있는환자는본연구에서제외하였다. 또한임상적으로의미있는신장, 간장, 심혈관계, 호흡기계, 뇌혈관계, 내분비계질환혹은기타심각한진행형신체질환이있는경우, 우울증이나정신과적장애를가졌거나과거력을가진경우, 2차성파킨슨증을일으킬만한약물및알코올의남용력이있는경우는본연구에서제외하였다. 이들선택된환자군은나이와성별을맞춘정상군과비교분석되었으며, 모든대상군은 뇌관류 SPECT를안정영상으로촬영하였다. 99m Tc-HMPAO SPECT 영상획득뇌영상연구를위해사용한단일광자방출전산화단층촬영 (Single Photon Emission Computed Tomographic, SPECT) 을시행했다. 영상획득은 6 간격으로 360 회전하여저에너지고해상도조준기 (low energy high resolution collimator) 를사용하여 60프레임을얻는다. 안정상태에서의영상을얻기위해 925 MBq의 99m Tc-HMPAO 를정맥주사하고, 주사한후 20분경과후약 20-30분동안스캔하였다. 촬영하는동안피검자는편안한상태를유지하며, 머리의움직임을최소로하였으며촬영실은조용하고조명을어두운상태로유지했다. 영상분석및 SPM SPECT 영상은표준다이콤 (DICOM) 형태로변환되어마이크로소프트윈도우기반의컴퓨터에저장되었다. 각각의파일은분석을위해 Analyze형식으로변환된후모든영상을 SPECT 표준지도위에공간정규화했다. 뇌피질및내부구조의미세한차이는저주파함수들로미리정의된기저함수 (basis function) 들의가중합으로나타내는선형화된비선형적 (linearized nonlinear) 방법을사용하여제거했다. 신호대잡음비를높이고미처보정되지않은뇌피질의차이를극복하기위하여공간정규화가된영상들을 16 mm의 full width at half maximum (FWHM) 을갖는가우시안커널 (Gaussian kernel) 로중첩적분 (convolution) 했다. 이러한전처리과정으로서의편평화 (smoothing) 는통계분석결과에서크기가작은덩어리의생성을줄이므로위양성결과를보정하고고주파의잡음을제거해서예민도를높이는역할을한다. 그리고각복셀이가지는국소계수는뇌피질내의전체계수와개인적인내변이그리고불규칙한잡음의선형결합 ( 일반선형모델 : general linear model) 으로나타내어진다는가정하에선형회귀분석을이용하여각복셀에서의이러한변수들의가중치를찾아낸후국소계수의차이만을추출했다. 양대상군의기본자료에대한통계분석은 SPSS ver (SPSS Inc., Chicago, IL, USA) 을이용하여연속변수는독립 t-test 을시행하였고, 비연속변수에대해서는 Pearson chi-square analysis를사용하였다. 뇌영상사진에대한분석은복셀별로통계분석하였다. 복셀별로각각의 SPECT군사이의국소계수차이에대한귀무가설을검증하고자뇌영역내의모든복셀에대해 t-test를시행하고용이한해석을위해 t값들을표준정규분포로변환하여 Z값으로나타냈다. 이는위에서언급한일반선형모델을기본모델로하고, 각변수의효과가 Student s t 통계를따른다고보아그유의성을검정하는것으로이렇게각복셀에서구해진 t값들은그자체가뇌기능영상

3 Perfusion SPECT and early MSA-P 39 이포함된 3차원공간상에서또다른하나의확률변수 (random variable) 로서행동한다고생각하고, 그분포는고정가우시안랜덤영역 (stationary Gaussian random field) 을따른다고가정하였다. 이러한가정하에서각복셀의 t값에대한통계적유의성은그값을 Z값 [Z = (t-m)/sd; m, 평균 ; SD, 표준편차 ] 으로변환하여가우시안랜덤영역의행동과비교함으로써얻을수있다. 통계분석의결과를해석하고유의한관류차이와덩어리크기를갖는영역의 Z값들을 magnetic resonance imaging 표준지도위에표현하여표준지도상에서의좌표와해부학적이름, 브로드만영역등을표시해주었다. 또한각복셀의 Z값에대한통계적매개변수영상 (statistical parametric image) 을구성하고 3차원으로렌더링 (rendering) 한표준지도위에투사하여관류차이를보이는부위를쉽게알아볼수있게한다. 이상의과정은 Matlab, ver. 5.3 (Mathworks Inc., Natick, MA, USA) 상에서구현된 SPM2 소프트웨어 (statistical parametric mapping software, Institute of Neurology, University College of London, London, UK) 를이용하였다. 결과다계통위축증환자중에서파킨슨증상의변형 (MSA-P) 을가진 Table 1. Demographic and clinical characteristics of all subjects 환자 21명과 48명의정상군과의평균연령및성별의의미있는차이는없었다. MSA-P의평균 H-Y stage는 2.14 ± 0.63이고유병기간은 ± 14.64개월을보였다 (Table 1). 뇌관류 SPECT 분석상에서는 MSA-P를가진환자군과정상군을비교했을때좌측전두엽의중간전두이랑 (middle frontal gyrus of left frontal lobe; BA 6), 우측전두엽의상전두이랑 (superior frontal gyrus of right frontal lobe), 좌측전두엽의전중심이랑 (precentral gyrus of left frontal lobe; BA 4), 우측전두엽의중간전두이랑 (middle frontal gyrus of right frontal lobe; BA 6) 그리고우측전두엽의전중심이랑 (precentral gyrus of right frontal lobe) 에서 MSA-P에서관류저하소견을통계적으로의미있게보였다 (Table 2, Fig. 1). 고찰특발파킨슨병과 MSA-P의임상적인특징은파킨슨증양상을중심으로나타나기때문에초기단계에서는감별진단하기가매우어렵다 [7, 9, 10]. 특히 MSA-P가특발파킨슨병에비해약물에반응을보기가어려울뿐만아니라예후도좋지않음에도불구하고도진단및뇌기능에대한연구는특발파킨슨병에만초점이맞추어져있는실정이다. 이전초기단계에서임상적으로 MSA-P와비슷한소견을보이는특발파킨슨병에대한뇌관류를분석한연구에서는정상 MSA-P Healthy control p value Number of subject Age ± ± Gender (male/female) 8/13 11/ Duration after diagnosis ± (months) Duration after symptom ± (months) Hoehn & Yahr stage 2.14±0.63 MMSE ± 0.91 Levodopa dose/day (mg) ± Dopamine agnoists/day (mg)* 1.09±1.42 *All patients have taken only pramipexole. MSA-P, Parkinson variant of multiple system atrophy; MMSE, mini-mental state examination. Table 2. Areas with significantly decreased regional cerebral blood flow in the MSA-P patients compared with the healthy controls ke T Z x, y, z Brain areas , 2, 60 Left Frontal Lobe, Middle Frontal Gyrus, BA , 8, 54 Right Frontal Lobe, Superior Frontal Gyrus , -24, 60 Left Frontal Lobe, Precentral Gyrus, BA , -10, 62 Right Frontal Lobe, Middle Frontal Gyrus, BA , -10, 60 Right Frontal Lobe, Precentral Gyrus Height threshold, T=6.25, corrected p=0.01; Extent threshold, k=50 voxels. ke, Expected voxels per cluster. Left Z value corrected p<0.001 Right Fig. 1. Comparisons of patients with MSA-P compared with the healthy controls show cerebral regions (yellow color) with decreased regional cerebral blood flow in trans-axial MR fused images.

4 40 이종윤 송인욱 정성우외 2 인 군에비해전전두엽 (prefrontal lobe) 과외측전두엽 (lateral frontal lobe) 중심의전두엽과렌즈핵 (lentiform nucleus) 에서주로뇌관류저하를보인다고보고하면서이들영역에비해정도는약하지만측두엽과두정엽, 후두엽에서도약간의관류저하를보고하고있다 [7, 11-13]. 따라서이들보고들은이미잘알려진특발파킨슨병에서의전두엽기능저하를보이는뇌관류소견이라고볼수있겠다. 이에반해 MSA-P는신경병리학연구에의하면올리브교뇌소뇌계 (olivopontocerebellar system) 보다는흑질줄무늬체 (nigrostriatal system) 를주로침범하는양상을보인다고알려져있다 [3, 14]. 하지만 MSA-P 의뇌관류에대한최근연구들에의하면임상적으로소뇌증상은거의보이지않음에도불구하고소뇌에서주로저관류소견을보이면서전두엽, 섬이랑, 조가비핵그리고시상에서저관류소견을보인다고보고하였다 [8, 9, 14]. 하지만본연구에서는전두엽의저관류소견이이전의연구결과와비슷한소견을보였으나소뇌에서는정상군에비해서의미있는저관류소견을보이지않아이전의보고들과다른소견을보였다. 본연구의이러한결과는아마도이전의연구들과는달리본연구는초기단계의 MSA-P 환자의뇌관류소견만을분석하였기에기인되었을것이라고생각된다. 따라서저자들은본연구의결과및이전의연구들을통해서 MSA-P의초기단계의증상발현시기에는전두엽영역의침범으로시작하여증상이진행하면서소뇌를포함한다른뇌영역으로퇴행성변화가퍼져나간다는추정을할수있었다. 또한본연구에서는특발파킨슨병에서저관류를보이는후두엽에서는어떠한비정상적인뇌관류소견을보이지않아특발파킨슨병과 MSA-P의초기단계에서도두질환을감별할수있는뇌관류소견이될수도있을것이라는추정을할수있었다. 하지만이러한추정에대해서는향후두질환을가진환자들간의뇌관류에대한비교분석이반드시필요하다고생각한다. 결론적으로본연구는뇌관류 SPECT을통해서정상군에비해 MSA-P를가진환자군에서의미있는뇌관류변화의소견을알아보기위한연구로서이를통해정상군보다임상적초기단계의 MSA-P라할지라도전두엽중심으로의미있는저관류소견을보인것을알수있었다. 따라서본연구의결과를기초로초기단계의 MSA-P 환자의진단에도움이되는영상기법으로써 perfusion SPECT이유용하게사용될수있을가능성을본저자들은제시할수있었다. 따라서이러한영상검사를통해상기질환의초기감별에도움이될수있다면초기단계에각각질환에맞는적절한치료및예방을가능하게되어향상된삶을영위하는데기여할수있으리라생각된다. 더욱이뇌관류 SPECT은뇌자기공명사진이나, 뇌 PET 사진같이고가의검사가아니므로임상적으로도쉽게사용하여두질환의초기감별진단에적용할수있으리라생각된다. 하지만본연구의결과를좀더명확히하고객관화하기위해서는많은수의환자를통한다기관연구및추적검사를통한뇌관류에대한 연구가향후에반드시진행되어야할필요성이있다고주장하는바이다. 참고문헌 1. Hughes AJ, Daniel SE, Kilford L, Lees AJ. Accuracy of clinical diagnosis of idiopathic parkinson s disease: a clinico-pathological study of 100 cases. J Neurol Neurosurg Psychiatry 1992; 55: Gilman S, Low PA, Quinn N, Albanese A, Ben-Shlomo Y, Fowler CJ, et al. Consensus statement on the diagnosis of multiple system atrophy. J Neurol Sci 1999; 163: Wenning GK, Tison F, Ben Shlomo Y, Daniel SE, Quinn NP. Multiple system atrophy: a review of 203 pathologically proven cases. Mov Disord 1997; 12: Hughes AJ, Ben-Shlomo Y, Daniel SE, Lees AJ. What features improve the accuracy of clinical diagnosis in parkinson s disease: a clinicopathologic study. Neurology 1992; 42: Antonini A, Leenders KL, Vontobel P, Maguire RP, Missimer J, Psylla M, et al. Complementary pet studies of striatal neuronal function in the differential diagnosis between multiple system atrophy and parkinson s disease. Brain 1997; 120(Pt 12): Juh R, Kim J, Moon D, Choe B, Suh T. Different metabolic patterns analysis of parkinsonism on the 18f-fdg pet. Eur J Radiol 2004; 51: Feigin A, Antonini A, Fukuda M, De Notaris R, Benti R, Pezzoli G, et al. Tc-99m ethylene cysteinate dimer spect in the differential diagnosis of parkinsonism. Mov Disord 2002; 17: Cilia R, Marotta G, Benti R, Pezzoli G, Antonini A. Brain spect imaging in multiple system atrophy. J Neural Transm 2005; 112: Matsui H, Udaka F, Miyoshi T, Hara N, Tamura A, Oda M, et al. Brain perfusion differences between parkinson s disease and multiple system atrophy with predominant parkinsonian features. Parkinsonism Relat Disord 2005; 11: Tang CC, Poston KL, Eckert T, Feigin A, Frucht S, Gudesblatt M, et al. Differential diagnosis of parkinsonism: a metabolic imaging study using pattern analysis. Lancet Neurol 2010; 9: Van Laere K, Santens P, Bosman T, De Reuck J, Mortelmans L, Dierckx R. Statistical parametric mapping of (99m)tc-ecd spect in idiopathic parkinson s disease and multiple system atrophy with predominant parkinsonian features: correlation with clinical parameters. J Nucl Med 2004; 45: Paschali A, Messinis L, Lyros E, Constantoyannis C, Kefalopoulou Z, Lakiotis V, et al. Neuropsychological functions and rcbf spect in parkin-

5 Perfusion SPECT and early MSA-P 41 son s disease patients considered candidates for deep brain stimulation. Eur J Nucl Med Mol Imaging 2009; 36: Firbank MJ, Molloy S, McKeith IG, Burn DJ, O Brien JT. Longitudinal change in 99mtchmpao cerebral perfusion spect in parkinson s disease over one year. J Neurol Neurosurg Psychiatry 2005; 76: Kimura N, Hanaki S, Masuda T, Hanaoka T, Hazama Y, Okazaki T, et al. Brain perfusion differences in parkinsonian disorders. Mov Disord 2011; 26:

<30342DB3AABDC2C8F12DBFF8C0FA2DBFCF2E687770>

<30342DB3AABDC2C8F12DBFF8C0FA2DBFCF2E687770> Original Article http://dx.doi.org/10.4235/jkgs.2012.16.4.200 뇌관류 Single Photon Emission Computed Tomography 에서초기알쯔하이머병과파킨슨병치매에서의뇌영역별혈류량의차이 가톨릭대학교의과대학신경과학교실 1, 핵의학과교실 2 나승희 1 송인욱 1 김영도 1 조현지 1 정성우 1 정용안

More information

( )Kju098.hwp

( )Kju098.hwp 건강한젊은남성과중년남성에서성적자극에의한뇌의활성화비교 Difference of Brain Activation by Visual Erotic Stimuli in Young and Middle-aged Healthy Males Dong Wan Sohn, Kang June Cho, Hyo Sin Kim, Choong Bum Lee, Sung Hak Kang, Yong-Hyun

More information

(

( 317 318 319 320 1 3 5 5 5 5 2 321 : 1.,,,,, 06 2. X-ray beam penetration (density) (contrast) 03 3. patch coating, precipitation, flaking 03 4. centering 03 5. Esophagus, cardia, fundus, body, angle, antrum,

More information

012임수진

012임수진 Received : 2012. 11. 27 Reviewed : 2012. 12. 10 Accepted : 2012. 12. 12 A Clinical Study on Effect of Electro-acupuncture Treatment for Low Back Pain and Radicular Pain in Patients Diagnosed with Lumbar

More information

서론 34 2

서론 34 2 34 2 Journal of the Korean Society of Health Information and Health Statistics Volume 34, Number 2, 2009, pp. 165 176 165 진은희 A Study on Health related Action Rates of Dietary Guidelines and Pattern of

More information

Lumbar spine

Lumbar spine Lumbar spine CT 32 111 DOI : 10.3831/KPI.2010.13.2.111 Lumbar Spine CT 32 Received : 10. 05. 23 Revised : 10. 06. 04 Accepted : 10. 06. 11 Key Words: Disc herniation, CT scan, Clinical analysis The Clinical

More information

1..

1.. Volume 12, Number 1, 6~16, Factors influencing consultation time and waiting time of ambulatory patients in a tertiary teaching hospital Jee-In Hwang College of Nursing Science, Kyung Hee University :

More information

<283732372D3733312920B4D9C3CAC1A120BCD2C7C1C6AEC4DCC5C3C6AEB7BBC1EEC0C720B3EBBEC8C0C720BDC3B7C2BAB8C1A4BFA120B4EBC7D120C0AFBFEBBCBA20C6F2B0A1283035292E687770>

<283732372D3733312920B4D9C3CAC1A120BCD2C7C1C6AEC4DCC5C3C6AEB7BBC1EEC0C720B3EBBEC8C0C720BDC3B7C2BAB8C1A4BFA120B4EBC7D120C0AFBFEBBCBA20C6F2B0A1283035292E687770> 대한안과학회지 제 49 권 제 5 호 2008 J Korean Ophthalmol Soc 49(5):727-731, 2008 DOI : 10.3341/jkos.2008.49.5.727 다초점 소프트콘택트렌즈의 노안의 시력보정에 대한 유용성 평가 김현경 1 김효명 2 정성근 1 가톨릭대학교 의과대학 성모병원 안과학교실 1, 고려대학교 의과대학 안암병원 안과학교실

More information

- i - - ii - - iii - - iv - - v - - 1 - - 2 - - 3 - - 4 - - 5 - - 6 - - 7 - - 8 - - 9 - - 10 - - 11 - - 12 - - 13 - - 14 - - 15 - - 16 - - 17 - - 18 - - 19 - α α - 20 - α α α α α α - 21 - - 22 - - 23 -

More information

김범수

김범수 Analysis of Outcomes after Resection of Sarcomatous Hepatocellular Carcinoma Purpose: Sarcomatous hepatocellular carcinoma (HCC) is rare. Therefore, the clinicopathologic characteristics and prognosis

More information

한국성인에서초기황반변성질환과 연관된위험요인연구

한국성인에서초기황반변성질환과 연관된위험요인연구 한국성인에서초기황반변성질환과 연관된위험요인연구 한국성인에서초기황반변성질환과 연관된위험요인연구 - - i - - i - - ii - - iii - - iv - χ - v - - vi - - 1 - - 2 - - 3 - - 4 - 그림 1. 연구대상자선정도표 - 5 - - 6 - - 7 - - 8 - 그림 2. 연구의틀 χ - 9 - - 10 - - 11 -

More information

- i - - ii - - iii - - iv - - v - - vi - - 1 - - 2 - - 3 - 1) 통계청고시제 2010-150 호 (2010.7.6 개정, 2011.1.1 시행 ) - 4 - 요양급여의적용기준및방법에관한세부사항에따른골밀도검사기준 (2007 년 11 월 1 일시행 ) - 5 - - 6 - - 7 - - 8 - - 9 - - 10 -

More information

자기공명영상장치(MRI) 자장세기에 따른 MRI 품질관리 영상검사의 개별항목점수 실태조사 A B Fig. 1. High-contrast spatial resolution in phantom test. A. Slice 1 with three sets of hole arr

자기공명영상장치(MRI) 자장세기에 따른 MRI 품질관리 영상검사의 개별항목점수 실태조사 A B Fig. 1. High-contrast spatial resolution in phantom test. A. Slice 1 with three sets of hole arr Original Article pissn 1738-2637 J Korean Soc Radiol 2012;67(2):129-134 The Survey of Magnetic Resonance Imaging Quality according to in Korea 1 자기공명영상장치(MRI) 자장세기에 따른 MRI 품질관리 영상검사의 개별항목점수 실태조사 1 Hyun-Hae

More information

Kinematic analysis of success strategy of YANG Hak Seon technique Joo-Ho Song 1, Jong-Hoon Park 2, & Jin-Sun Kim 3 * 1 Korea Institute of Sport Scienc

Kinematic analysis of success strategy of YANG Hak Seon technique Joo-Ho Song 1, Jong-Hoon Park 2, & Jin-Sun Kim 3 * 1 Korea Institute of Sport Scienc Kinematic analysis of success strategy of technique JooHo Song 1, JongHoon Park 2, & JinSun Kim 3 * 1 Korea Institute of Sport Science, 2 Catholic Kwandong University, 3 Yonsei University [Purpose] [Methods]

More information

........-55..9.30

........-55..9.30 MYONGJI ST. MARY S HOSPITAL EXCELLENT STROKE TREATMENT CENTER The president of Myongji St. Mary s Hospital M.D. HUH, CHOON WOONG Graduated from Seoul Catholic Medical College. Achived M.D. in Neurosurgeon.

More information

A 617

A 617 Special Issue Diabetic Retinopathy Won Ki Lee, M.D. Department of Ophthalmology The Catholic University of Korea College of Medicine Kangnam St. Mary s Hospital E mail : wklee@catholic.ac.kr Abstract R

More information

Kbcs002.hwp

Kbcs002.hwp Does Real-time Compound Imaging Improve Evaluation of reast Cancer Compared to Conventional Sonography? o Kyoung Seo, M.D., Yu Whan Oh, M.D., Kyu Ran Cho, M.D., Young Hen Lee, M.D., Hyung Joon Noh, M.D.,

More information

DBPIA-NURIMEDIA

DBPIA-NURIMEDIA The e-business Studies Volume 17, Number 4, August, 30, 2016:319~332 Received: 2016/07/28, Accepted: 2016/08/28 Revised: 2016/08/27, Published: 2016/08/30 [ABSTRACT] This paper examined what determina

More information

04조남훈

04조남훈 Received : 2011. 11. 16 Reviewed : 2011. 11. 25 Accpeted : 2011. 12. 5 A Case Report of Prescribing Yanghyeolgeopung-tang(yangxuequfeng-tang) to Two Patients with Cervical Disc Herniation and Headache

More information

09권오설_ok.hwp

09권오설_ok.hwp (JBE Vol. 19, No. 5, September 2014) (Regular Paper) 19 5, 2014 9 (JBE Vol. 19, No. 5, September 2014) http://dx.doi.org/10.5909/jbe.2014.19.5.656 ISSN 2287-9137 (Online) ISSN 1226-7953 (Print) a) Reduction

More information

- iii - - i - - ii - - iii - 국문요약 종합병원남자간호사가지각하는조직공정성 사회정체성과 조직시민행동과의관계 - iv - - v - - 1 - - 2 - - 3 - - 4 - - 5 - - 6 - - 7 - - 8 - - 9 - - 10 - - 11 - - 12 - - 13 - - 14 - α α α α - 15 - α α α α α α

More information

45-51 ¹Ú¼ø¸¸

45-51 ¹Ú¼ø¸¸ A Study on the Automation of Classification of Volume Reconstruction for CT Images S.M. Park 1, I.S. Hong 2, D.S. Kim 1, D.Y. Kim 1 1 Dept. of Biomedical Engineering, Yonsei University, 2 Dept. of Radiology,

More information

09구자용(489~500)

09구자용(489~500) The Study on the Grid Size Regarding Spatial Interpolation for Local Climate Maps* Cha Yong Ku** Young Ho Shin*** Jae-Won Lee**** Hee-Soo Kim*****.,...,,,, Abstract : Recent global warming and abnormal

More information

139~144 ¿À°ø¾àħ

139~144 ¿À°ø¾àħ 2 139 DOI : 10.3831/KPI.2010.13.2.139 2 Received : 10. 04. 08 Revised : 10. 04. 26 Two Case Report on Wrist Ganglion Treated with Scolopendrid Pharmacopuncture Accepted : 10. 05. 04 Key Words: Wrist Ganglion,

More information

Abstract Background : Most hospitalized children will experience physical pain as well as psychological distress. Painful procedure can increase anxie

Abstract Background : Most hospitalized children will experience physical pain as well as psychological distress. Painful procedure can increase anxie Volume 12, Number 1, 92~102, An Intervention Study of Pain Reduction during IV Therapy in Hospitalized Children Myo-Jin Kim 1), Joung-Hae Bak 1), Won-Seok Seo 2) Mi-Young Kim 3), Sun-Kyoung Park 3), Jai-Soung

More information

A Study on Married Female Immigrants Life Style and Marriage Satisfaction in Terms of Preparing Their Old Age in Chungcheongnam-do Department of Gerontology, Hoseo University Doctoral Student : Hi Ran

More information

975_983 특집-한규철, 정원호

975_983 특집-한규철, 정원호 Focused Issue of This Month Gyu Cheol an, MD Department of Otolaryngology ead & Neck Surgery, Gachon University of College Medicine E - mail : han@gilhospital.com Won-o Jung, MD Department of Otolaryngology

More information

( )kju145.hwp

( )kju145.hwp 시각적성자극에의한대뇌활성의국지화 를이용한 분석 Location of Brain Electrical Source Activation according to Visually Stimulated Sexual Arousal: A Cross Spectral Analysis using Low Resolution Brain Electromagnetic Tomography

More information

<30312DC1A4BAB8C5EBBDC5C7E0C1A4B9D7C1A4C3A52DC1A4BFB5C3B62E687770>

<30312DC1A4BAB8C5EBBDC5C7E0C1A4B9D7C1A4C3A52DC1A4BFB5C3B62E687770> Journal of the Korea Institute of Information and Communication Engineering 한국정보통신학회논문지(J. Korea Inst. Inf. Commun. Eng.) Vol. 19, No. 2 : 258~264 Feb. 2015 ID3 알고리즘 기반의 귀납적 추론을 활용한 모바일 OS의 성공과 실패에 대한

More information

Journal of Educational Innovation Research 2017, Vol. 27, No. 2, pp DOI: : Researc

Journal of Educational Innovation Research 2017, Vol. 27, No. 2, pp DOI:   : Researc Journal of Educational Innovation Research 2017, Vol. 27, No. 2, pp.251-273 DOI: http://dx.doi.org/10.21024/pnuedi.27.2.201706.251 : 1997 2005 Research Trend Analysis on the Korean Alternative Education

More information

황지웅

황지웅 Comparison of Laparoscopy and Exploration in the Distal Pancreatectomy BACKGROUND: To determine the benefits of laparoscopic surgery compared with exploration, the clinical outcomes of open and laparoscopic

More information

44-4대지.07이영희532~

44-4대지.07이영희532~ A Spatial Location Analysis of the First Shops of Foodservice Franchise in Seoul Metropolitan City Younghee Lee* 1 1 (R) 0 16 1 15 64 1 Abstract The foodservice franchise is preferred by the founders who

More information

歯1.PDF

歯1.PDF 200176 .,.,.,. 5... 1/2. /. / 2. . 293.33 (54.32%), 65.54(12.13%), / 53.80(9.96%), 25.60(4.74%), 5.22(0.97%). / 3 S (1997)14.59% (1971) 10%, (1977).5%~11.5%, (1986)

More information

09È«¼®¿µ 5~152s

09È«¼®¿µ5~152s Korean Journal of Remote Sensing, Vol.23, No.2, 2007, pp.45~52 Measurement of Backscattering Coefficients of Rice Canopy Using a Ground Polarimetric Scatterometer System Suk-Young Hong*, Jin-Young Hong**,

More information

386-390.hwp

386-390.hwp 386 HANYANG MEDICAL REVIEWS Vol. 29 No. 4, 2009 우리나라 미숙아의 통계와 의료비용 Statistics and Medical Cost of Preterm in Korea 윤혜선 을지대학교 노원을지병원 소아청소년과학교실 Hye Sun Yoon, M.D., Ph.D., Department of Pediatrics, Nowon

More information

ECG & EP CASES Young-Keun On, MD, PhD Division of Cardiology, Department of Medicine Cardiac & Vascular Center, Samsung Medical Center Sungkyunkwan University School of Medicine, Seoul, Korea A case of

More information

DBPIA-NURIMEDIA

DBPIA-NURIMEDIA 27(2), 2007, 96-121 S ij k i POP j a i SEXR j i AGER j i BEDDAT j ij i j S ij S ij POP j SEXR j AGER j BEDDAT j k i a i i i L ij = S ij - S ij ---------- S ij S ij = k i POP j a i SEXR j i AGER j i BEDDAT

More information

2009;21(1): (1777) 49 (1800 ),.,,.,, ( ) ( ) 1782., ( ). ( ) 1,... 2,3,4,5.,,, ( ), ( ),. 6,,, ( ), ( ),....,.. (, ) (, )

2009;21(1): (1777) 49 (1800 ),.,,.,, ( ) ( ) 1782., ( ). ( ) 1,... 2,3,4,5.,,, ( ), ( ),. 6,,, ( ), ( ),....,.. (, ) (, ) Abstract Kim Dal-Rae, Kim Sun-Hyung* Dept. of Sasang Constitutional Medicine, College of Oriental Medicine, Kyung-Hee Univ. *Dept. of Sasang Constitutional Medicine, East-West Neo Medical Center, Kyung-Hee

More information

untitled

untitled ORIGINAL ARTICLE pissn: 1229-6538 eissn: 2383-5699 Korean J Clin Geri 2019;20(1):26-30 https://doi.org/10.15656/kjcg.2019.20.1.26 혼합치매와알츠하이머병의국소뇌혈류차이 이명아 1, 정현석 2, 송인욱 1 1 가톨릭대학교인천성모병원신경과, 2 가톨릭대학교인천성모병원영상의학과

More information

THE JOURNAL OF KOREAN INSTITUTE OF ELECTROMAGNETIC ENGINEERING AND SCIENCE Nov.; 26(11),

THE JOURNAL OF KOREAN INSTITUTE OF ELECTROMAGNETIC ENGINEERING AND SCIENCE Nov.; 26(11), THE JOURNAL OF KOREAN INSTITUTE OF ELECTROMAGNETIC ENGINEERING AND SCIENCE. 2015 Nov.; 26(11), 985991. http://dx.doi.org/10.5515/kjkiees.2015.26.11.985 ISSN 1226-3133 (Print)ISSN 2288-226X (Online) Analysis

More information

제5회 가톨릭대학교 의과대학 마취통증의학교실 심포지엄 Program 1 ANESTHESIA (Room 2층 대강당) >> Session 4 Updates on PNB Techniques PNB Techniques for shoulder surgery: continuou

제5회 가톨릭대학교 의과대학 마취통증의학교실 심포지엄 Program 1 ANESTHESIA (Room 2층 대강당) >> Session 4 Updates on PNB Techniques PNB Techniques for shoulder surgery: continuou 제5회 가톨릭대학교 의과대학 마취통증의학교실 심포지엄 (Room 2층 대강당) >> Session 4 Updates on PNB Techniques PNB Techniques for shoulder surgery: continuous vs single injection, interscalene vs supraclavicular approach 의정부성모병원

More information

16(1)-3(국문)(p.40-45).fm

16(1)-3(국문)(p.40-45).fm w wz 16«1y Kor. J. Clin. Pharm., Vol. 16, No. 1. 2006 x w$btf3fqpsu'psn û w m w Department of Statistics, Chonnam National University Eunsik Park College of Natural Sciences, Chonnam National University

More information

원위부요척골관절질환에서의초음파 유도하스테로이드주사치료의효과 - 후향적 1 년경과관찰연구 - 연세대학교대학원 의학과 남상현

원위부요척골관절질환에서의초음파 유도하스테로이드주사치료의효과 - 후향적 1 년경과관찰연구 - 연세대학교대학원 의학과 남상현 원위부요척골관절질환에서의초음파 유도하스테로이드주사치료의효과 - 후향적 1 년경과관찰연구 - 연세대학교대학원 의학과 남상현 원위부요척골관절질환에서의초음파 유도하스테로이드주사치료의효과 - 후향적 1 년경과관찰연구 - 연세대학교대학원 의학과 남상현 원위부요척골관절질환에서의초음파 유도하스테로이드주사치료의효과 - 후향적 1 년경과관찰연구 - 지도김석원교수 이논문을석사학위논문으로제출함

More information

( )Jkstro011.hwp

( )Jkstro011.hwp 비인강암의방사선치료결과및생존율에관한예후인자분석 2005 2 1 2005 3 28. :, Tel: 053)250-7665, Fax: 053)250-7984 E-mail: jhkim@dsmc.or.kr 정영연외 2 인 : 비인강암의예후인자분석 정영연외 2 인 : 비인강암의예후인자분석 Carcinoma of the nasopharynx treated by radiotherapy

More information

조사연구 권 호 연구논문 한국노동패널조사자료의분석을위한패널가중치산출및사용방안사례연구 A Case Study on Construction and Use of Longitudinal Weights for Korea Labor Income Panel Survey 2)3) a

조사연구 권 호 연구논문 한국노동패널조사자료의분석을위한패널가중치산출및사용방안사례연구 A Case Study on Construction and Use of Longitudinal Weights for Korea Labor Income Panel Survey 2)3) a 조사연구 권 호 연구논문 한국노동패널조사자료의분석을위한패널가중치산출및사용방안사례연구 A Case Study on Construction and Use of Longitudinal Weights for Korea Labor Income Panel Survey 2)3) a) b) 조사연구 주제어 패널조사 횡단면가중치 종단면가중치 선형혼합모형 일반화선형혼 합모형

More information

(JBE Vol. 21, No. 1, January 2016) (Regular Paper) 21 1, (JBE Vol. 21, No. 1, January 2016) ISSN 228

(JBE Vol. 21, No. 1, January 2016) (Regular Paper) 21 1, (JBE Vol. 21, No. 1, January 2016)   ISSN 228 (JBE Vol. 1, No. 1, January 016) (Regular Paper) 1 1, 016 1 (JBE Vol. 1, No. 1, January 016) http://dx.doi.org/10.5909/jbe.016.1.1.60 ISSN 87-9137 (Online) ISSN 16-7953 (Print) a), a) An Efficient Method

More information

Can032.hwp

Can032.hwp Chromosomal Alterations in Hepatocellular Carcinoma Cell Lines Detected by Comparative Genomic Hybridization Sang Jin Park 1, Mahn Joon Ha, Ph.D. 1, Hugh Chul Kim, M.D. 2 and Hyon Ju Kim, M.D. 1 1 Laboratory

More information

16_이주용_155~163.hwp

16_이주용_155~163.hwp 사상체질의학회지 2008;20(2):155-163 J of Sasang Constitutional Medicine Vol. 20, No. 2, 2008:155-163 http://www.esasang.com 腦 梗 塞 으로 발생한 少 陽 人 半 身 舞 蹈 病 患 者 치험 1례 이주용 이한얼 한경수 안택원 Abstract 대전대학교 한의과대학 사상체질과 A Soyangin

More information

Journal of Educational Innovation Research 2018, Vol. 28, No. 1, pp DOI: * A Analysis of

Journal of Educational Innovation Research 2018, Vol. 28, No. 1, pp DOI: * A Analysis of Journal of Educational Innovation Research 2018, Vol. 28, No. 1, pp.99-117 DOI: http://dx.doi.org/10.21024/pnuedi.28.1.201803.99 2015 * A Analysis of the Characters and Issues about the 2015 Revised Social

More information

( )Kju269.hwp

( )Kju269.hwp 만성세균성전립선염모델흰쥐에서 의항염효과 Anti-inflammatory Effect of Lycopene on Chronic Bacterial Prostatitis Rat Model Cho Hwan Yang, Dong Wan Sohn, Yong-Hyun Cho From the Department of Urology, The Catholic University

More information

(Exposure) Exposure (Exposure Assesment) EMF Unknown to mechanism Health Effect (Effect) Unknown to mechanism Behavior pattern (Micro- Environment) Re

(Exposure) Exposure (Exposure Assesment) EMF Unknown to mechanism Health Effect (Effect) Unknown to mechanism Behavior pattern (Micro- Environment) Re EMF Health Effect 2003 10 20 21-29 2-10 - - ( ) area spot measurement - - 1 (Exposure) Exposure (Exposure Assesment) EMF Unknown to mechanism Health Effect (Effect) Unknown to mechanism Behavior pattern

More information

2-1

2-1 Part Brain, Head & Neck PART Brain, Head & Neck Overview of brain Caudate nucleus Nucleus accumbens Globus pallidus Subthalamic nucleus Putamen Substantia nigra Cerebral corter Thalamus Nucleus subthalamicus

More information

12이문규

12이문규 Review on Conservative Treatment of Spinal Scoliosis Moon-kyu Lee, O.M.D., Gil-jae Lee, O.M.D., Yun-kyung Song, O.M.D., Hyung-ho Lim, O.M.D. Dept. of Oriental Rehabilitation Medicine College of Oriental

More information

Ja Young Kim, et al. Dysarthria and Cognitive Function in Parkinson s Disease 근육긴장이상및미간반사 (glabella reflexes) 등이관찰된다 (Jankovic, 2008). 비운동영역에서는자율신경계기능

Ja Young Kim, et al. Dysarthria and Cognitive Function in Parkinson s Disease 근육긴장이상및미간반사 (glabella reflexes) 등이관찰된다 (Jankovic, 2008). 비운동영역에서는자율신경계기능 ISSN 2288-1328 (Print) ISSN 2288-0917 (Online) Commun Sci Disord 2014;19(4):551-557 Original Article Characteristics of Dysarthria and Cognitive Functions in Patients with Parkinson s Disease and Parkinsonplus

More information

KISEP Case Report 대한간질학회지 2004;8(2):15 8(2): 손을이용한정신활동시유발되는반사성간질 1 예 오영미 서정화 천상명 김상호 Reflex Epilepsy Provoked by Mental Activities Mainly As

KISEP Case Report 대한간질학회지 2004;8(2):15 8(2): 손을이용한정신활동시유발되는반사성간질 1 예 오영미 서정화 천상명 김상호 Reflex Epilepsy Provoked by Mental Activities Mainly As KISEP Case Report 대한간질학회지 2004;8(2):15 8(2):155-15 159 손을이용한정신활동시유발되는반사성간질 1 예 오영미 서정화 천상명 김상호 Reflex Epilepsy Provoked by Mental Activities Mainly Associated with Use of the Hands Young-Mi Oh, M.D., Jeong-Hwa

More information

(01) hwp

(01) hwp Journal of Life Science 2013 Vol. 23. No. 2. 157~166 ISSN (Print) 1225-9918 ISSN (Online) 2287-3406 DOI : http://dx.doi.org/10.5352/jls.2013.23.2.157 α μ δ κ 158 생명과학회지 2013, Vol. 23. No. 2 Journal of

More information

005송영일

005송영일 Received : 2015. 12. 09 Reviewed : 2015. 12. 16 Accepted : 2015. 12. 16 Sternal Fracture occurred after Thai Massage : A Case Report Young-Il Song, K.M.D. 1, Dong-Eun Kim, K.M.D. 1 1 Department of Rehabilitation

More information

04김호걸(39~50)ok

04김호걸(39~50)ok Journal of Environmental Impact Assessment, Vol. 22, No. 1(2013) pp.39~50 Prediction of Landslides Occurrence Probability under Climate Change using MaxEnt Model Kim, Hogul* Lee, Dong-Kun** Mo, Yongwon*

More information

Abstract Musculoskeletal Symptoms and Related Factors for Nurses and Radiological Technologists Wearing a Lead Apron for Radiation Pro t e c t i o n Jung-Im Yoo, Jung-Wan Koo 1 ) Angio Unit, Team of Radiology,

More information

<5B313132385D32303039B3E220C1A634B1C720C1A632C8A320B3EDB9AEC1F628C3D6C1BE292E687770>

<5B313132385D32303039B3E220C1A634B1C720C1A632C8A320B3EDB9AEC1F628C3D6C1BE292E687770> 디지털 영상에서의 자막추출을 이용한 자막 특성 분석에 관한 연구 이세열 * 요약 본 연구는 방송 프로그램 제작에 있어서 중요한 역할을 담당하고 있는 영상 자막의 특성과 영상 커 뮤니케이션 기능적인 관점에서 나타나고 있는 현상을 살펴본다. 다양한 방송 프로그램에서 활용되고 있는 디지털 영상 자막의 기능은 단순하게 간략한 정보를 전달하는 기능적인 역할을 수행하였다.

More information

278 경찰학연구제 12 권제 3 호 ( 통권제 31 호 )

278 경찰학연구제 12 권제 3 호 ( 통권제 31 호 ) 여성경찰관의직업윤리의식결정요인분석 * An Analysis of Determinantal Factors Influencing Professional Ethical Standards of South Korean Police Women 신문희 ** 이영민 *** Ⅰ. 서론 Ⅱ. 이론적배경 Ⅲ. 연구방법 Ⅳ. 연구결과 Ⅴ. 결론 Ⅰ. 서론 278 경찰학연구제 12

More information

<34375FB1E8C0B1C1F82DC1A4BBF320B3FAC7F7B7F920BFB5BBF3BFA1BCAD20C0E7B1B8BCBA20BECBB0EDB8AEC1F22E687770>

<34375FB1E8C0B1C1F82DC1A4BBF320B3FAC7F7B7F920BFB5BBF3BFA1BCAD20C0E7B1B8BCBA20BECBB0EDB8AEC1F22E687770> Journal of the Korea Academia-Industrial cooperation Society Vol. 13, No. 11 pp. 5311-5316, 2012 http://dx.doi.org/10.5762/kais.2012.13.11.5311 정상뇌혈류영상에서재구성알고리즘적용에따른섭취율차이 : 통계적파라미터지도를사용한분석 이효영 1, 김윤진 2*,

More information

2014_........pdf

2014_........pdf 1, 1, 2, 1 (1, 2 ) Jin Suk Suh 1, Jong In Kim 1, Ryeong Jae Park 2, Sang Bum Park 1 (1 Korea Forest Research Institute, 2 Korea Traditional Dye Institute) Introduction (2011-2013), (VOCs)., (7 ),,. Materials

More information

A Study on the Relationships between Self-Differentiation and Adaptability Factors for Senior Dementia Patients Care Givers Department of Social Welfare, Seoul Welfare Graduate University Full-time Lecturer

More information

Àå¾Ö¿Í°í¿ë ³»Áö

Àå¾Ö¿Í°í¿ë ³»Áö Disability & Employment 55 Disability & Employment 56 57 Disability & Employment 58 59 Disability & Employment 60 61 Disability & Employment 62 63 Disability & Employment 64 65 Disability & Employment

More information

기관고유연구사업결과보고

기관고유연구사업결과보고 기관고유연구사업결과보고 작성요령 2001 ~ 2004 2005 ~ 2007 2008 ~ 2010 2001 ~ 2004 2005 ~ 2007 2008 ~ 2010 1 2/3 2 1 0 2 3 52 0 31 83 12 6 3 21 593 404 304 1,301 4 3 1 8 159 191 116 466 6 11 (`1: (1: 16 33 44 106

More information

<30345F283439372D353034295F313135375FC0CCB5BFC8F15FB5B5B7CEC5CDB3CEC0C720B0BBB1B8BACE20B0E6B0FCBCB3B0E8B0A120C5CDB3CE20B3BBBACEC1B6B8ED2E687770>

<30345F283439372D353034295F313135375FC0CCB5BFC8F15FB5B5B7CEC5CDB3CEC0C720B0BBB1B8BACE20B0E6B0FCBCB3B0E8B0A120C5CDB3CE20B3BBBACEC1B6B8ED2E687770> J of Korean Tunn Undergr Sp Assoc 15(5)497-504(2013) eissn: 2287-4747 http://dx.doi.org/10.9711/ktaj.2013.15.5.497 pissn: 2233-8292 도로터널의 갱구부 경관설계가 터널 내부조명에 미치는 영향에 관한 연구 이미애 1 ㆍ이동희 2 * 1 아이라이트 대표이사 2

More information

Journal of Educational Innovation Research 2019, Vol. 29, No. 1, pp DOI: * Suggestions of Ways

Journal of Educational Innovation Research 2019, Vol. 29, No. 1, pp DOI:   * Suggestions of Ways Journal of Educational Innovation Research 2019, Vol. 29, No. 1, pp.65-89 DOI: http://dx.doi.org/10.21024/pnuedi.29.1.201903.65 * Suggestions of Ways to Improve Teaching Practicum Based on the Experiences

More information

DBPIA-NURIMEDIA

DBPIA-NURIMEDIA The e-business Studies Volume 17, Number 6, December, 30, 2016:275~289 Received: 2016/12/02, Accepted: 2016/12/22 Revised: 2016/12/20, Published: 2016/12/30 [ABSTRACT] SNS is used in various fields. Although

More information

달생산이 초산모 분만시간에 미치는 영향 Ⅰ. 서 론 Ⅱ. 연구대상 및 방법 達 은 23) 의 丹 溪 에 최초로 기 재된 처방으로, 에 복용하면 한 다하여 난산의 예방과 및, 등에 널리 활용되어 왔다. 達 은 이 毒 하고 는 甘 苦 하여 氣, 氣 寬,, 結 의 효능이 있

달생산이 초산모 분만시간에 미치는 영향 Ⅰ. 서 론 Ⅱ. 연구대상 및 방법 達 은 23) 의 丹 溪 에 최초로 기 재된 처방으로, 에 복용하면 한 다하여 난산의 예방과 및, 등에 널리 활용되어 왔다. 達 은 이 毒 하고 는 甘 苦 하여 氣, 氣 寬,, 結 의 효능이 있 대한한방부인과학회지 THE JOURNAL OF ORIENTAL OBSTETRICS & GYNECOLOGY VOL.17, NO.2 : 115-122 (2004) 달생산이 초산모 분만시간에 미치는 영향 * 북경한의원, ** 윤산부인과의원, *** 최은림산부인과의원, 상지대학교 한의과대학 부인과학교실 ****, 경희대학교 동서의학대학원 김성준 *****, 윤왕준

More information

Journal of Educational Innovation Research 2017, Vol. 27, No. 1, pp DOI: * The

Journal of Educational Innovation Research 2017, Vol. 27, No. 1, pp DOI:   * The Journal of Educational Innovation Research 2017, Vol. 27, No. 1, pp.243-268 DOI: http://dx.doi.org/10.21024/pnuedi.27.1.201703.243 * - 2001 2015 - The Research Trends on Peer Counseling in Elementary and

More information

590호(01-11)

590호(01-11) T H E K O R E A N D O C T O R S W E E K L Y www.docdocdoc.co.kr I N S I D E 38 3 5 6 7 10 13 28 29 30 31 38 41 42 2 Advertisement Government & Medicine 3 Government & Medicine 4 Government & Medicine Government

More information

Kor. J. Aesthet. Cosmetol., 라이프스타일은 개인 생활에 있어 심리적 문화적 사회적 모든 측면의 생활방식과 차이 전체를 말한다. 이러한 라이프스 타일은 사람의 내재된 가치관이나 욕구, 행동 변화를 파악하여 소비행동과 심리를 추측할 수 있고, 개인의

Kor. J. Aesthet. Cosmetol., 라이프스타일은 개인 생활에 있어 심리적 문화적 사회적 모든 측면의 생활방식과 차이 전체를 말한다. 이러한 라이프스 타일은 사람의 내재된 가치관이나 욕구, 행동 변화를 파악하여 소비행동과 심리를 추측할 수 있고, 개인의 RESEARCH ARTICLE Kor. J. Aesthet. Cosmetol., 한국 중년 여성의 라이프스타일이 메이크업 추구이미지와 화장품 구매행동에 미치는 영향 주영주 1 *, 이순희 2 1 서경대학교대학원미용예술학과, 2 신성대학교 미용예술계열 The Effects of The Life Style for Korean Middle Aged Women on

More information

KIM Sook Young : Lee Jungsook, a Korean Independence Activist and a Nurse during the 이며 나름 의식이 깨어있던 지식인들이라 할 수 있을 것이다. 교육을 받은 간 호부들은 환자를 돌보는 그들의 직업적 소

KIM Sook Young : Lee Jungsook, a Korean Independence Activist and a Nurse during the 이며 나름 의식이 깨어있던 지식인들이라 할 수 있을 것이다. 교육을 받은 간 호부들은 환자를 돌보는 그들의 직업적 소 1 의사학 제24권 제1호(통권 제49호) 2015년 4월 Korean J Med Hist 24 ː1-34 Apr 2015 c대한의사학회 http://dx.doi.org/10.13081/kjmh.2015.24.1 pissn 1225-505X, eissn 2093-5609 간호부 이정숙의 독립운동 김숙영* 1. 서론 2. 본론 1) 출생에서 정신여학교 수학시절까지

More information

DBPIA-NURIMEDIA

DBPIA-NURIMEDIA e- 비즈니스연구 (The e-business Studies) Volume 17, Number 1, February, 28, 2016:pp. 293~316 ISSN 1229-9936 (Print), ISSN 2466-1716 (Online) 원고접수일심사 ( 수정 ) 게재확정일 2015. 12. 04 2015. 12. 24 2016. 02. 25 ABSTRACT

More information

,,,.,,,, (, 2013).,.,, (,, 2011). (, 2007;, 2008), (, 2005;,, 2007).,, (,, 2010;, 2010), (2012),,,.. (, 2011:,, 2012). (2007) 26%., (,,, 2011;, 2006;

,,,.,,,, (, 2013).,.,, (,, 2011). (, 2007;, 2008), (, 2005;,, 2007).,, (,, 2010;, 2010), (2012),,,.. (, 2011:,, 2012). (2007) 26%., (,,, 2011;, 2006; ,,.. 400,,,,,,.,,, -, -, -., 3.. :, Tel : 010-9540-0640, E-mail : sunney05@hanmail.net ,,,.,,,, (, 2013).,.,, (,, 2011). (, 2007;, 2008), (, 2005;,, 2007).,, (,, 2010;, 2010), (2012),,,.. (, 2011:,, 2012).

More information

Journal of Educational Innovation Research 2018, Vol. 28, No. 1, pp DOI: A study on Characte

Journal of Educational Innovation Research 2018, Vol. 28, No. 1, pp DOI:   A study on Characte Journal of Educational Innovation Research 2018, Vol. 28, No. 1, pp.381-404 DOI: http://dx.doi.org/10.21024/pnuedi.28.1.201803.381 A study on Characteristics of Action Learning by Analyzing Learners Experiences

More information

63-69±è´ë¿µ

63-69±è´ë¿µ Study on the Shadow Effect of 3D Visualization for Medical Images ased on the Texture Mapping D.Y. Kim, D.S. Kim, D.K. Shin, D.Y. Kim 1 Dept. of iomedical Engineering, Yonsei University = bstract = The

More information

歯제7권1호(최종편집).PDF

歯제7권1호(최종편집).PDF ********* (*, **, *** ).., 2002, 7, 1, 1-12. 2-5 80.,.,..,,... :,,. (naming).., (word finding), (lexical look- up), (lexical retrieval), (word recall) (Fried- Oken, 1987). (pause),,, (naming error) (Snyder

More information

( )Kju225.hwp

( )Kju225.hwp 비임균성비뇨생식기감염에서 의진단적효용성 Usefulness of the Mycofast Test (MYCOFAST Evolution 2) for the Diagnosis of Nongonococcal Genitourinary Infections Hang Ro Park, Yang Hyun Kim, Ho Jae Lee, Jea Sang Oh, Hyoung Jin

More information

歯14.양돈규.hwp

歯14.양돈규.hwp : The Korean Journal of Counseling and Psychotherapy 2003. Vol. 15, No. 3, 615-631. 1 2 3 1,410.,, ( ),., ( 69%),.,, ( ), ( ).,,.., ( ).,. :,,. :, (390-711) 21-1, : 043-649-1362 E-mail : ydk9498@hanmail.net

More information

02이용배(239~253)ok

02이용배(239~253)ok A study on the characteristic of land use in subcenter of Seoul. - Cases of Yeongdeungpo and Kangnam Ok Kyung Yuh* Yong-Bae Lee**,. 2010,,..,.,,,,.,,.,,.,,,, Abstract : This study analyzed the land use

More information

대한한의학원전학회지24권6호-전체최종.hwp

대한한의학원전학회지24권6호-전체최종.hwp 小兒藥證直訣 의 五臟辨證에 대한 小考 - 病證과 處方을 중심으로 1 2 慶熙大學校大學校 韓醫學科大學 原典學敎室 ㆍ 韓醫學古典硏究所 白裕相1,2*1)2) A study on The Diagnosis and Treatment Using The Theory of Five Organs in Soayakjeungjikgyeol(小兒藥證直訣) 1 Dept. of Oriental

More information

충북의대학술지 Chungbuk Med. J. Vol. 27. No. 1. 1~ Charcot-Marie-Tooth Disease 환자의마취 : 증례보고 신일동 1, 이진희 1, 박상희 1,2 * 책임저자 : 박상희, 충북청주시서원구충대로 1 번지, 충북대학교

충북의대학술지 Chungbuk Med. J. Vol. 27. No. 1. 1~ Charcot-Marie-Tooth Disease 환자의마취 : 증례보고 신일동 1, 이진희 1, 박상희 1,2 * 책임저자 : 박상희, 충북청주시서원구충대로 1 번지, 충북대학교 충북의대학술지 Chungbuk Med. J. Vol. 27. No. 1. 1~5 2017 Charcot-Marie-Tooth Disease 환자의마취 : 증례보고 신일동 1, 이진희 1, 박상희 1,2 * 책임저자 : 박상희, 충북청주시서원구충대로 1 번지, 충북대학교의과대학마취통증의학교실, 의학연구소 (28644), happycat19@hanmail.net

More information

2 1896 2 26 ( ) 2 7-20 2) 1897 1898 ( )3) 6 1902 8 1904 10 10 (19 05-1914 ) ( ) ( ) 4) 1915 ( ) ( ) 1917 2) 3) 4) 285

2 1896 2 26 ( ) 2 7-20 2) 1897 1898 ( )3) 6 1902 8 1904 10 10 (19 05-1914 ) ( ) ( ) 4) 1915 ( ) ( ) 1917 2) 3) 4) 285 13 2 ( 25 ) 2004 12 Korean J Med Hist 13 284 296 Dec 2004 ISSN 1225 505X 1) * ** ** 1 1920 1930 40 ( 1896-1973) 80 * ** 1) 2003 284 2 1896 2 26 ( ) 2 7-20 2) 1897 1898 ( )3) 6 1902 8 1904 10 10 (19 05-1914

More information

Microsoft PowerPoint - analogic_kimys_ch10.ppt

Microsoft PowerPoint - analogic_kimys_ch10.ppt Stability and Frequency Compensation (Ch. 10) 김영석충북대학교전자정보대학 2010.3.1 Email: kimys@cbu.ac.kr 전자정보대학김영석 1 Basic Stability 10.1 General Considerations Y X (s) = H(s) 1+ βh(s) May oscillate at ω if βh(jω)

More information

Dementia and Neurocognitive Disorders 2007; 6: 7-11 원발성정상압수두증환자의국소뇌혈류변화 : Statistical Parametric Mapping을이용한 SPECT 분석 윤보라 양동원 심용수 김범생손영민 정성우 정용안 * 손형선

Dementia and Neurocognitive Disorders 2007; 6: 7-11 원발성정상압수두증환자의국소뇌혈류변화 : Statistical Parametric Mapping을이용한 SPECT 분석 윤보라 양동원 심용수 김범생손영민 정성우 정용안 * 손형선 Dementia and Neurocognitive Disorders 2007; 6: 7-11 원발성정상압수두증환자의국소뇌혈류변화 : Statistical Parametric Mapping을이용한 SPECT 분석 윤보라 양동원 심용수 김범생손영민 정성우 정용안 * 손형선 * 가톨릭대학교의과대학신경과학교실핵의학교실 * Analysis of Regional Cerebral

More information

<C7A5C1F620BEE7BDC4>

<C7A5C1F620BEE7BDC4> 연세대학교 상경대학 경제연구소 Economic Research Institute Yonsei Universit 서울시 서대문구 연세로 50 50 Yonsei-ro, Seodaemun-gS gu, Seoul, Korea TEL: (+82-2) 2123-4065 FAX: (+82- -2) 364-9149 E-mail: yeri4065@yonsei.ac. kr http://yeri.yonsei.ac.kr/new

More information

Jkbcs016(92-97).hwp

Jkbcs016(92-97).hwp Expression of bcl-2 and Apoptosis and Its Relationship to Clinicopathological Prognostic Factors in Breast Cancer - A Study with Long Term Follow-up correlated with the survival rate.(journal of Korean

More information

Pharmacotherapeutics Application of New Pathogenesis on the Drug Treatment of Diabetes Young Seol Kim, M.D. Department of Endocrinology Kyung Hee Univ

Pharmacotherapeutics Application of New Pathogenesis on the Drug Treatment of Diabetes Young Seol Kim, M.D. Department of Endocrinology Kyung Hee Univ Application of New Pathogenesis on the Drug Treatment of Diabetes Young Seol Kim, M.D. Department of Endocrinology Kyung Hee University College of Medicine & Hospital E mail : ycell2@yahoo.co.kr Abstract

More information

Contents 치매의종류 신경퇴행성질환 알츠하이머병에의한치매 전두측두치매 루이체치매 혈관성치매 MID (Multi-infarct dementia: 다발성경색성치매 ) SVD (Subcortical vascular dementia: 피질하혈관성치매 ) SID (Stra

Contents 치매의종류 신경퇴행성질환 알츠하이머병에의한치매 전두측두치매 루이체치매 혈관성치매 MID (Multi-infarct dementia: 다발성경색성치매 ) SVD (Subcortical vascular dementia: 피질하혈관성치매 ) SID (Stra 치매의종류와병태생리 - 간호협회치매인력양성교육 울산의대, 서울아산병원 정신과김성윤 1 Contents 치매의종류 신경퇴행성질환 알츠하이머병에의한치매 전두측두치매 루이체치매 혈관성치매 MID (Multi-infarct dementia: 다발성경색성치매 ) SVD (Subcortical vascular dementia: 피질하혈관성치매 ) SID (Strategic

More information

Journal of Educational Innovation Research 2018, Vol. 28, No. 4, pp DOI: 3 * The Effect of H

Journal of Educational Innovation Research 2018, Vol. 28, No. 4, pp DOI:   3 * The Effect of H Journal of Educational Innovation Research 2018, Vol. 28, No. 4, pp.577-601 DOI: http://dx.doi.org/10.21024/pnuedi.28.4.201812.577 3 * The Effect of Home-based Activities Using Traditional Fairy Tales

More information

7 1 ( 12 ) 1998. 1913 ( 1912 ) 4. 3) 1916 3 1918 4 1919. ( ) 1 3 1, 3 1. 1.. 1919 1920. 4) ( ), ( ),. 5) 1924 4 ( ) 1. 1925 1. 2). ( ). 6). ( ). ( ).

7 1 ( 12 ) 1998. 1913 ( 1912 ) 4. 3) 1916 3 1918 4 1919. ( ) 1 3 1, 3 1. 1.. 1919 1920. 4) ( ), ( ),. 5) 1924 4 ( ) 1. 1925 1. 2). ( ). 6). ( ). ( ). 7 1 ( 12 ) : 1-11, 1998 K orean J M ed H ist 7 : 1-11, 1998 ISSN 1225-505X * **.,.., 1960.... 1) ( ) 1896 3 2 ( ) ( ) ( ) ( ) 2. 1), 14 1909 1,. 14 17 1913. 2)..,. ( ) ( ),. * 1998 (1998. 5. 7). ** 1).

More information

< DBDC5C8F1BFB52E687770>

< DBDC5C8F1BFB52E687770> Journal of Movement Disorders ORIGINAL ARTICLE Journal of Movement Disorders Vol. 1, No. 1, April 2008 Received November 13, 2007 Accepted April 3, 2008 파킨슨병환자에서보이는인지기능저하의양상과설문지를통한병식에관한연구 고려대학교의과대학신경과학교실,

More information

ÀÇÇа�ÁÂc00Ì»óÀÏ˘

ÀÇÇа�ÁÂc00Ì»óÀÏ˘ Common Allergic Diseases in Children Sang - Il Lee, M.D. Department of pediatrics Sungkyunkwan University School of Medicine, Samsung Medical Center E - mail : silee@smc.samsung.co.kr Abstract Allergy

More information

???? 1

???? 1 The Korean Journal of Applied Statistics (2014) 27(1), 13 20 DOI: http://dx.doi.org/10.5351/kjas.2014.27.1.013 Maximum Tolerated Dose Estimation by Stopping Rule and SM3 Design in a Phase I Clinical Trial

More information

Dementia2

Dementia2 Today s Topics Memory Impairment & Dementia Age Associated Memory Impairment Dementia Definition of dementia Depression Schizophrenia Mental retardation Delirium : Not final diagnosis term, but symptomatologic

More information

( )Jksc057.hwp

( )Jksc057.hwp 직장암환자의전직장간막절제술의 예측인자분석 : 불완전절제와절제시간에영향을미치는인자에관한연구 Analysis of Factors Affecting the Degree of Difficulty in Total Mesorectal Excision for Rectal Cancer: Investigation of the Factors Affecting Incomplete

More information

54 한국교육문제연구제 27 권 2 호, I. 1.,,,,,,, (, 1998). 14.2% 16.2% (, ), OECD (, ) % (, )., 2, 3. 3

54 한국교육문제연구제 27 권 2 호, I. 1.,,,,,,, (, 1998). 14.2% 16.2% (, ), OECD (, ) % (, )., 2, 3. 3 27 2, 53-70, 2009. (Nursing Home) * ** (Nursing Home). 5 50 5 2 1,,,,, SPSS t.,,,,,,,. :,, : 2009/08/27 : 2009/09/24 : 2009/09/30 * ** (: hjkim@daelim.ac.kr) 54 한국교육문제연구제 27 권 2 호, 2009. I. 1.,,,,,,, (,

More information

<B3EDB9AEC1FD5F3235C1FD2E687770>

<B3EDB9AEC1FD5F3235C1FD2E687770> 오용록의 작품세계 윤 혜 진 1) * 이 논문은 생전( 生 前 )에 학자로 주로 활동하였던 오용록(1955~2012)이 작곡한 작품들을 살펴보고 그의 작품세계를 파악하고자 하는 것이다. 한국음악이론이 원 래 작곡과 이론을 포함하였던 초기 작곡이론전공의 형태를 염두에 둔다면 그의 연 구에서 기존연구의 방법론을 넘어서 창의적인 분석 개념과 체계를 적용하려는

More information