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      • KCI등재

        lymphREVIEW ARTICLE : The Feasibility and Future Prospects of Robot-Assisted Surgery in Gastric Cancer: Consensus Comments from the National Evidence-based Collaborating Agency Round-Table Conference

        ( Eunhee Shin ),( Jieun Choi ),( Seongwoo Seo ),( Seonheui Lee ) 한국보건행정학회 2015 보건행정학회지 Vol.25 No.2

        To establish an appropriate policy for robotic surgery in Korea, the National Evidence-based Collaborating Agency (NECA) and the Korean Society of Health Policy and Administration held a round-table conference (RTC) to gather opinions through a comprehensive discussion of scientific information in gastric cancer. The NECA RTC is a public discussion forum wherein experts from diverse fields and members of the lay public conduct in-depth discussions on a selected social issue in the health and medical field. For this study, representatives from the medical field, patient groups, industry, the press, and policy makers participated in a discussion focused on the medical and scientific evidence for the use of robotic surgery in gastric cancer. According to the RTC results, robotic surgery showed more favorable results in safety and efficacy than open surgery and it is similar to laparoscopy. When the cost-effectiveness of robotic surgery and laparoscopy is compared, robotic surgery costs are higher but there was no difference between the two of them in terms of effectiveness (pain, quality of life, complications, etc.). In order to resolve the high cost issue of the robotic surgery, a proper policy should be implemented to facilitate the development of a cost-effective model of the robotic surgery equipment. The higher cost of robotic surgery require more evidence of its safety and efficacy as well as the cost-effectiveness issues of this method. Discussions on the national insurance coverage of robotic surgery seems to be necessary in the near future.

      • KCI등재후보
      • KCI등재

        양주 회암사지 출토 龍文ㆍ鳳凰紋 막새의 계통과 전개

        신은희(Shin Eunhee) 백산학회 2021 白山學報 Vol.- No.120

        양주 회암사지에서 출토된 용문ㆍ봉황문 막새를 대상으로 제작 시기와 특징을 파악하여 그 계통과 전개양상을 정리해보았다. 유적의 중심 시기인 고려후기~조선전기는 고려에서 조선으로의 왕조 교체기이자 대외적으로는 元에서 明으로의 교체기이다. 그런 의미에서 회암사지는 전환기의 양상과 元과 明의 영향, 중앙과 지방의 양상을 모두 확인할 수 있는 중요한 유적이며 그것을 명확하게 보여주는 것이 왕실 문양인 용문과 봉황문이라고 생각된다. 회암사지에서는 봉황문 수막새 3종, 용문 수막새 2종, 용문 암막새 9종이 확인되었고 시간성을 반영하는 속성인 드림새 뒷면 흔적(갈퀴흔→布痕), 주연 형태와 침선 유무(평면ㆍ針線→돌출ㆍ凹線→돌출ㆍ無線)를 기준으로 유형을 분류하고 제작시기를 검토하였다. 그 결과를 중창기록과 타 유적 출토품과의 비교를 통해 제작시기는 1기(~14세기 말), 2기(15세기 초~15세기 말), 3기(16세기 중반)로 설정하였다. 1기는 태조 연간에 해당하는 시기로 원의 영향을 받은 고려시대 후기(제주 법화사지, 개성 고려궁성)의 제작적 특징이 조선 초(경복궁, 양주 회암사지)까지 이어진다. 용문과 봉황문은 왕권을 상징하는 문양으로 사용처에 제약이 있었고 元順帝가 제주도에 離宮을 짓기 위해 장인을 파견한 기록, 그 장인이 고려궁성 중건에 참여하는 기록, 조선 건국 이후 한양도성 건설에 고려시대부터 건축술을 가지고 있던 공역승들이 투입된 문헌기록으로 보아 용문ㆍ봉황문 막새 등 왕실기와의 제작 시스템이 고려 후기에서 조선 전기까지 이어지고 있음을 확인하였다. 2기는 세종~성종대로 회암사에 20~30년 간격으로 크고 작은 불사가 빈번했던 시기이다. 다양한 종류의 용문ㆍ봉황문 막새와 磨硏痕, 明의 영향으로 보이는 봉황문 수막새 등으로 보아 회암사의 높은 위계와 대외적 교류를 확인할 수 있는 시기이다. 한편, 막새의 제작기법에 있어서 경복궁을 비롯한 도성 소재 왕실 관련 유적과 다른 지역적 양상이 확인된다. 3기는 명종대로 회암사에서는 여전히 왕실과의 관계 속에서 문정왕후에 의한 불사가 이루어지지만 막새의 문양과 종류가 단순화되어 대대적인 중창은 이루어지지 않은 것으로 보인다. 왕실과의 관계가 약화되면서 왕실 사찰로서의 성격을 보여주는 용문ㆍ봉황문 막새는 더 이상 제작되지 않았던 것으로 생각된다. This study is to examine roof-end tiles with dragon and phoenix patterns excavated at the site of Hoeam Temple in Yangju in terms of time of manufacture and characteristics, and to analyze their genealogy and development of patterns. The relics are mainly between the latter part of Goryeo and the former part of Joseon, which witnessed a transition from Goryeo to Joseon on the Korean Peninsula and another transition from Yuan to Ming in China. In this sense, the site of Hoeam Temple is an important place to locate the patterns of the transition period, the influences of Yuan and Ming, and the patterns of central and local districts. Dragon and phoenix patterns as royal patterns are considered to clearly reflect such phenomena. Excavated at the site were three types of round roof-end tiles with a phoenix pattern, two types of round roof-end tiles with a dragon pattern, and nine types of flat roof-end tiles with a dragon pattern. These types are categorized into several patterns and manufacturing periods, according to their attributes such as trimming traces on the back(rake trace → cloth trace), forms of circumference section and dividing lines(plane → projection → no line). Being analyzed together with the temple s rebuilding records and relics excavated at other places, the manufacturing time of the roof-end tiles could be divided into Period 1(~the end of the 14th century), Period 2(early 15th century~end of the 15th century), and Period 3 (middle 16th century). Period 1 fell to the reign of King Taejo. The manufacturing characteristics of latter part of Goryeo which was under the influence of Yuan(site of Beophwa Temple in Jeju and the palace of Goryeo in Gaeseong) continued to the former part of Joseon(Gyeongbok Palace and the site of Hoeam Temple in Yangju). There were limits to the use of dragon and phoenix patterns that represented the royal power. It was confirmed that the manufacture system of royal roof tiles including roof-end tiles with dragon and phoenix patterns was inherited from the latter part of Goryeo to the former part of Joseon, based on records about the dispatch of roof tile artisans by Emperor Shun of Yuan to build a royal villa on Jeju Island, the participation of the artisans in rebuilding the royal palace of Goryeo, and commitment of public service monks of Goryeo with the architecture skill to the construction of Hanyang capital city after the foundation of Joseon. Period 2 encompassed the reign of King Sejong~King Seongjong, when there were frequent big and small rebuilding projects for the Hoeam Temple every 20~30 years. It is confirmed that during this period, the Hoeam Temple enjoyed high hierarchy and international exchanges, which are demonstrated by the various types of roof-end tiles with dragon and phoenix patterns, traces of polishing for surface treatment, and flat roof-end tiles with phoenix patterns under the influence of Ming. The manufacture technique of roof-end tiles at the temple showed local patterns different from royal relics in the capital city including Gyeongbok Palace. Period 3 fell to the reign of King Myeongjong. The temple continued to receive Buddhist service commissioned by Queen Munjeong. While keeping its relations with the royal family, the patterns and types of its roof-end tiles became simple which implies there were no large-scale rebuilding projects. As its relations with the royal family weakened, roof-end tiles with dragon and phoenix patterns, representing as a royal Buddhist temple, were no more made.

      • 네트워크 응답시간을 고려한 웹 캐시 교체 정책

        신은희(Eunhee Shin),서진모(Jinmo Seo),신승훈(Seunghun Sihn),박승규(Seungkyu Park) 한국정보과학회 2003 한국정보과학회 학술발표논문집 Vol.30 No.1A

        최근 인터넷 기반 서비스 환경의 질적개선과 이에 따른 이용자 증가에 따라, 오디오나 동영상과 같은 규모가 크고 동적 특성을 가진 웹 컨텐츠의 수가 증가하는 추세이다. 이에 따라 ‘hit ratio’ 뿐만 아니라 오브젝트의 크기를 기반으로 하는 ‘byte hit ratio’ 또한 캐시 성능을 평가하는 중요한 측정 요소가 되었다. 이러한 측정기준을 대상으로 할 때, 기존의 웹 캐시 교체 정책중 HP연구소의 GDSF(Greedy-Dual-Size with Frequency)알고리즘과 LFU-DA(LFU with Dynamic Aging)알고리즘이 우수한 성능을 보이는 것으로 알려져있는데, 이러한 기존의 웹 캐시 교체 정책은 서버와의 네트워크 상태를 고려하지 않은 정책이고, 이에 따라 네트워크 상태에 따른 전송비용의 차이를 반영하지 못하고 있다. 따라서 본 논문에서는 서버와 웹 캐시 간의 네트워크 상태를 반영할 수 있는 캐시 교체 정책을 제안하고, 이에 대한 실험을 수행하였으며, 그 결과 사용자의 요구에 대한 응답시간의 감소 효과를 얻을 수 있었다.

      • KCI등재

        Maternal Serum Levels of VCAM-1, ICAM-1 and E-selectin in Preeclampsia

        Kim Shin Young,류현미,Yang Jae Hyug,김문영,Ahn Hyun Kyong,Lim Ha Jung,Shin Joong Sik,Woo Hyuk Jun,박소연,Kim Young Mi,Kim Jin Woo,Cho EunHee 대한의학회 2004 Journal of Korean medical science Vol.19 No.5

        Endothelial dysfunction is thought to be a central pathogenic feature in preeclampsia on the basis of elevated adhesion molecules. The aim of the present study was to compare the levels of soluble vascular cell adhesion molecule-1 (sVCAM-1), inter-cellular adhesion molecule-1 (sICAM-1) and E-selectin (sE-selectin) in sera of normal and preeclamptic pregnancies. We studied the serum levels of sVCAM-1, sICAM-1 and sE-selectin in normal pregnant women (n=63), mild preeclampsia (n=33) and severe preeclampsia (n=82). Concentrations of soluble adhesion molecules were determined with enzyme-linked immunoassay (ELISA). Serum concentrations of sVCAM-1 were significantly higher in both mild (p=0.004) and severe preeclampsia (p=0.000) than normal pregnancy. There were also significant differences in sVCAM-1 levels between mild and severe preeclampsia (p=0.002). sICAM-1 levels of severe preeclampsia were statistically different from those of normal pregnancy (p=0.038). Levels of sE-selectin were elevated in both mild (p=0.011) and severe preeclamp-sia (p=0.000) compared to normal pregnancy, but no statistical difference between the mild and severe preeclampsia (p=0.345). These results suggest that all three soluble adhesion molecules are increased in severe preeclampsia, and sVCAM-1 among them may be useful in predicting the severity of preeclampsia.

      • KCI등재
      • SCOPUSKCI등재
      • KCI등재

        The Effects of Clinical Practice Stress and Resilience on Nursing Students' Academic Burnout

        Shin, Sujin,Hwang, Eunhee Yonsei university college of medicine 2020 의학교육논단 Vol.22 No.2

        The high degree of academic burnout experienced during academic life indicates that job skill levels during the first year following graduation are low, and the correlation with turnover intention is high. We investigated the effects of clinical practice stress and resilience on nursing students' burnout, and searched for factors that can prevent or control burnout. We recruited a convenience sample of 202 nursing students. Academic burnout, general characteristics, clinical practice stress, and resilience were assessed via self-reported questionnaires. The mean total score of academic burnout was 44.0 points; exhaustion was the highest at 18.5 points, inefficacy was 15.9 points, and cynicism was 9.6 points. High levels of clinical practice stress affected academic burnout (β=0.194, p=0.003), while high resilience was a factor that lowered the degree of academic burnout (β=-0.449, p<0.001). Based on our results, factors affecting students' experiences of academic burnout were clinical practice stress and resilience. We therefore propose the implementation of a new curriculum aimed at increasing satisfaction with the major, reducing clinical practice stress, and increasing resilience, including an efficient peer mentoring program for clinical practice.

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