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      • KCI등재

        수지상세포의 방사선 저항성에 대한 연구

        김은실,김종순,이명호,범희승,민정준,정환정,김성민,허영준,송호천,이제중 대한핵의학회 2003 핵의학 분자영상 Vol.37 No.3

        목적 : 림프구와 비교되는 수지상 세포의 방사선 민감성을 보기 위하여 본 연구를 시행하였다. 대상 및 방법 : 말초혈액에서 분리한 T 림프구에 0 Gy, 10 Gy, 30 Gy의 방사선을 조사하고 4시간 후에 유세포 분석기를 이용하여 선량별 세포고사 빈도를 관찰하였다. 또한 조혈모세포에서 미성숙 및 성숙 수지상 세포를 단계적으로 분리 배양하여 각각 0 Gy, 10 Gy, 30 Gy, 100 Gy의 방사선을 조사하고 4시간, 24시간 그리고 48 시간 후에 선량별 세포고사 빈도를 관찰하였다. 사이토스핀(cytospin)슬라이드에 림프구와 미성숙 및 성숙 수지상세포를 3×104개 씩 분주하고 May Grunwald-Giemsa 염색한 후, 광학 현미경 하에서 각각의 세포군 당 100개의 세포에서 세포 면적당 핵의 면적 비를 측정하였다. 결과 : 림프구에서는 방사선조사 선량별로 세포고사 빈도가 유의하게 증가하였으나, 수지상 세포에서는 그 분화정도나 방사선조사 선량에 따른 세포고사의 빈도차이가 없었다. 또한 수지상 세포는 방사선선량과 관계없이 용량에 의존적으로 강력한 T-세포 자극능을 보였다. 림프구의 세포에 대한 핵의 면적 비는 미성숙 및 성숙 수지상세포의 세포에 대한 핵의 면적 비보다 현저히 큰 반면, 두 가지 수지상세포간에 유의한 차이는 없었다. 결론 : 수지상세포는 그 분화도와 상관없이 림프구에 비하여 방사선 저항성을 나타내었고, 이는 세포의 형태적 차이에 따른 표적의 크기와 관련이 있을 것으로 생각되며, 향후 분자 생물학적인 연구의 기초 자료로 활용할 수 있을 것으로 생각된다. Purpose : To evaluate radiation sensitivity of dendritic cells in comparison with lymphocytes. Materials and methods : T lymphocytes captured from peripheral blood were irradiated by 0 Gy, 10 Gy, 30Gy. Apoptosis was measured by flowcytometry for staining of Annexin V 4 hours after irradiation. Immature and mature dendritic cells processed from blood hematopoietic stern cell were irradiated by 0 Gy, 10 Gy, 30 Gy, 100 Gy respectively and apoptosis was measured by flowcytometry with time difference as 4h, 24h and 48h after irradiation. Morphometric analysis by percent nucleus was measured in three cell groups, also. Results : Lymphocytes showed radiation sensitivity by increasing apoptotic fraction according to radiation dose. However, both mature and immature dendritic cells showed consistent fraction of apoptosis in spite of increasing radiation dose. Percent nucleus ratio is significantly higher in lymphocytes than that of mature or immature dendritic cells. Stimulation of T-cell by dendritic cells was not changed after irradiation. Conclusion : Dendritic cells showed radioresistance which was associated with small size of nucleus in comparison with lymphocytes and this result would be used as a basal data of radio-labelling for the cellular trafficking studies in nuclear medicine fields.

      • KCI등재후보

        2003년 국내 중증급성호흡기증후군 진료 현황 및 문제점 분석

        이진수,김은실,정문현,백제중,정선화,안주희,최영화,이선희,고철우,김성범,김민자,박승철,기현균,송재훈,최상호,김양수,이상오,조용균,박영훈,정숙인,김연숙,이흥범,손창희,장성희,정희진,김우주 대한감염학회 2004 감염과 화학요법 Vol.36 No.3

        목적 : 2002년 말 중국에서 SARS가 발생한 이후 국내에서도 2003년 10월까지 총 3명의 추정환자, 17명의 의심환자가 보고되었다. 향후 추가적인 SARS의 유행이 우려되는 상황에서, 그간의 SARS 환자 진료에 있어서의 실질적인 준비사항, 진료 현황 등에 대한 조사를 통해 문제점을 파악하여, 향후 더 나은 대비가 될 수 있도록 개선점을 제시하고자 하였다. 재료 및 방법 : SARS로 의심되는 환자를 진료 경험이 있는 병원의료진을 대상으로 2003년 10월에 설문조사를 실시하였다. 설문에는 SARS 환자 진료 시의 실질적인 조치, 진료 현황, 병실, 응급실 및 외래에서의 격리 시설과 준비사항, 보건당국의 관리와 지원에 관한 사항을 포함하였다. 결과 : 대상이 되는 22개 병원 중 17개(17/22, 77.2%) 병원이 설문에 응하였다. SARS 환자를 위한 격리실은 응급실, 외래, 일반병실 및 중환자실에서 각각 9개(9/17, 52.9%), 5개(5/17, 29.4%), 15개(15/16, 93.7%), 4개(4/16, 25%) 병원에서 음압처리가 되어있지 않은 일인실 혹은 다인실이 사용되었고, 1개(1/16, 6.3%) 병원에서만 일반병실에서 음압격리실이 운영되었다. 입원환자의 진찰 시 개인보호구의 착용은 거의 모든 의료기관에서 이루어졌다. 보건당국에서 SARS지정병원의 시설 등을 사전에 확인한 곳은 1곳(1/12, 8.3%)이였고, 14개 병원(14/15, 93.3%)에서는 보건당국에 의뢰한 검사결과를 통하 받지 못하였다. 결론 : 의료기관에서 SARS 환자용 격리실뿐만 아니라 기존의 격리실 설비 등이 미흡하였으며, 특히 중환자실 및 외래의 준비가 더욱 부족하였다. 보건당국의 의료기관에 대한 종합적인 지원이 부족하였고, 병원과의 원활한 연계가 잘 이루어지지 않았다. SARS 만이 아닌 격리를 필요로 하는 질환의 적절한 진료를 위해 향후 병원 시설의 정비와 정부차원에서의 보다 구체적이고 실질적인 대책마련이 필요하다. Background : There was an worldwide outbreak of the Severe Acute Respiratory Syndrome (SARS) originated from China in late 2002. During that period three cases of suspected SARS and 17 cases of probable SARS were reported in Korea. With the concerns about the reemergence of SARS-coV transmission, it is important to be prepared for any possibility. So, this study is aimed to analysis the past measures in managing SARS and propose the amendatory plans to improve the preparedness. Materials & Methods : Questionnaires were collected among clinicians with any experience in managing the probable or suspected SARS cases in Oct. 2003. 17 out of 22 hospitals responded to the questionnaire. The contents in the questionnaire were practical activities, personal equipments, response plans, isolation facilities in emergency centers, outpatient clinics, general wards and intensive care units, and relationship with the public health department. Results : The dedicated isolation rooms in emergency centers, outpatient clinics, general wards, and intensive care units were prepared in 9 (9/17, 52.9%), 5 (5/17, 29.4%), 15 (15/16, 93.7%), and 4 (4/16, 25.0%) hospitals, respectively. Except for one hospital that newly made negative pressure room for SARS, single or multi-bed rooms without airborne infection control were used in all the other hospitals. The personal precaution principles were kept quite well in general wards. Before the designation of SARS hospital by the public health department prior evalution to see if the hospital was suitable for managing SARS was conducted in only 1 (1/12, 8.3%) hospital. The results of laboratory diagnosis were reported back in 1 (1/15, 6.6%) hospital. Conclusions : The isolation facilities which can control airborne infection were almost deficient not only for SARS but also for other respiratory transmissible diseases. For the infection control of transmissible diseases including SARS, more investment is needed on medical facilities and comprehensive support from the public health department required.

      • KCI등재

        수술실 손 소독제의 종류에 따른 균주 수의 변화

        홍성윤,김정민,김소영,이수정,오은실,양서인,김화실,김남초 병원간호사회 2006 임상간호연구 Vol.11 No.2

        Purpose: The present study purposed to compare the hand washing effect of 7.5% powidone-iodine, which is used in the operation room of C university hospital in Seoul, with that of Ethyl alcohol-CHG mixture recommended by the US Association of Operating Room Nurses (2002) and to adopt a more effective hand disinfectant. Method: In a quasi-experimental design, 48 medical staff who participated in operations during the period from November 2004 to February 2005 had hand washing using the two kinds of hand disinfectants: 7.5% povidone-iodine and the ethyl alcohol-CHG mixture. Their palms were swabbed and cultured just after hand washing and again after taking dff sterile gloves after the operation. The number of colonies from the two occasions were counted and compared. Result: The number of general bacillus increased significantly in the group using 7.5% povidone-iodine compared to that in the group using the ethyl alcohol-CHG mixture. The number of general bacillus increased signficantly in doctors compared to that in nurses. The factors affecting the increase of the number of general bacillus were disinfectants and medical personnel. The number of general bacillus was expected to increase 9.41 times with 7.5% povidone-iodine than with the ethyl alcohol-CHG mixture and 14.87 times in doctors than in nurses. Conclusion: This study shows that the ethyl alcogol-CHG mixture has a stronger hand disinfection effect than 7.5% povidone iodine. Thus we need to change the hand disinfectant used in operating rooms as soon as possible in order to minimize the infection of wounds resulting from operations.

      • KCI등재후보

        전경대원에서 발생한 결핵의 임상 양상

        문창기,박상준,조민구,김영중,김소연,김윤권,정준오,안석진,김은실,서승오,김지훈,최원제,이윤영,박형기,최규영,김현근 대한감염학회 2006 감염과 화학요법 Vol.38 No.6

        Background: The purpose of this study was to document the incidence and clinical characteristics of patients with tuberculosis (TB) in combat and auxiliary police, living in a group, in Korea where the incidence rate of active TB in a general population is higher than in Western countries. Materials and Methods:We retrospectively reviewed the medical records of all tuberculosis patients diagnosed at National Police Hospital from January 2002 through December 2004. Results:In 2002-2004, a total of 156 cases of tuberculosis were identified with the mean (Standard deviation) age of 20.6 (±1.0) years. Of these, 134 (85.9%) patients were registered as new cases, 11 (7.1%) as relapse, 2 (1.3%) as failure, 5 (3.1%) as treatment-after-default cases whereas 4 (2.6 %) patients were not included in any categories. Average annual new TB rate and smear-positive TB rate were 86.5/10^(5) and 17.4/10^(5) person-years, respectively. In 12 of 31 smear-positive cases, time from onset of symptoms to diagnosis was more than 30 days. Two multidrug-resistance TB cases were identified and two suspected outbreak episodes of TB had occurred during 3 years. Conclusion:There was no statistically significant difference in the incidence rate of new cases of TB between the general population aged 20 to 29 years and combat and auxiliary police in Korea. 배경 : 국내 결핵의 발생은 감소 추세에 있으나 여전히 후진국형 발생양상을 보이고 있다. 특히 집단생활을 하는 젊은이들에서 발생하는 결핵의 유행이 간헐적으로 알려지고 있어 우려를 낳고 있다. 이에 저자들은 최근 전경대원의 결핵 발병 양상에 대해 알아보고자 본 연구를 시행하였다. 재료 및 방법 : 2002년 1월부터 2004년 12월까지 3년간 경찰병원에서 결핵 진료를 받은 전경대원의 의무기록을 후향적으로 분석하여 연도별 결핵 신환발생률, 도말양성결핵 신환율, 진단 지연, 집단발병, 다제내성결핵을 조사하였다. 결과 : 연도별 결핵 신환자 수(10만명당 발생추정치)는 2002년 50명(83.6명), 2003년 42명(83.7명), 2004년 42명(93.5명)이었고 도말양성 폐결핵 신환자 수는 2002년 10명(16.7명), 2003년 11명(21.9명), 2004년 6명(13.4명)이었다. 3년간 도말양성 폐결핵 환자는 31명이 있었고 그 중 12명은 호흡기 증상 발생 30일이 지나서 진단을 받았다. 다제내성 결핵은 2명이 있었으며 결핵의 집단발병이 의심되는 사례는 2차례 있었다. 결론 : 전경대원과 20-29세 연령군 일반인의 결핵 신환발생률, 도말양성 폐결핵 발생률의 통계적으로 유의한 차이는 없었다.

      • SCIEKCI등재

        Weight change and microvascular outcomes in patients with new-onset diabetes: a nationwide cohort study

        ( Eun Sil Koh ),( Kyung Do Han ),( Mee Kyoung Kim ),( Eun Sook Kim ),( Min-kyung Lee ),( Ga Eun Nam ),( Hyuk-sang Kwon ) 대한내과학회 2021 The Korean Journal of Internal Medicine Vol.36 No.4

        Background/Aims: Because weight control is important in treatment of type 2 diabetes, it is essential to understand the associations between weight change and the risk of microvascular complications among patients with type 2 diabetes. We examined whether weight changes early after new-onset diabetes have an impact on the clinical outcomes of diabetic nephropathy and retinopathy. Methods: Using the Korean National Health Insurance Service-National Health Screening Cohort database, 181,872 patients newly diagnosed with type 2 diabetes who were free of end-stage renal disease (ESRD) and proliferative diabetic retinopathy (PDR) during 2007 to 2012 were followed to the end of 2016. Weight change was defined as the difference in body weight from the time of diabetes diagnosis to 2 years later. Results: We identified 180 cases of ESRD and 780 cases of PDR followed up for a median of 5.5 years from the index year at 2 years after diagnosis. Those with 5% to 10% weight gain showed a significantly higher hazard ratio (HR) for ESRD, compared with those with ≤ 5% weight change after adjusting for several confounding factors, including the baseline estimated glomerular filtration rate (HR, 1.75; 95% confidence interval [CI], 1.14 to 2.70). Those with ≥ 10% weight loss showed the lowest HR for PDR (HR, 0.52; 95% CI, 0.33 to 0.83), whereas those with ≥ 10% weight gain showed the highest HR for PDR (HR, 3.20; 95% CI, 2.51 to 4.08). Conclusions: Weight gain after new-onset diabetes was associated with increased risk of ESRD and PDR whereas weight loss with decreased risk of PDR, but not ESRD.

      • KCI등재

        알레르기질환을 가진 소아청소년의 수면 장애 연구

        오은민 ( Eun Min Oh ),은소희 ( So Hee Eun ),박수화 ( Su Hwa Park ),서영실 ( Yeong Sil Seo ),김지현 ( Ji Hyun Kim ),서원희 ( Won Hee Seo ),안강모 ( Kang Mo Ahn ),정지태 ( Ji Tae Choung ) 대한천식알레르기학회 2015 Allergy Asthma & Respiratory Disease Vol.3 No.1

        Purpose: Although allergic disease has been recognized as a common chronic disease related to the sleep disturbance of children, studies on sleep disturbance in children with allergic disease are scanty in Korea. The aim of this study was to evaluate the sleep disturbance of children with allergic disease. Methods: Children aged 2 to 12 years were assessed using the sleep questionnaires. From July 2011 to June 2012, surveys were conducted on patients who were diagnosed with allergies in 3 general hospitals and in an elementary school in Seoul and the capital area. The analysis was done in 3 groups according to age. Results: The sleep questionnaires of 1,174 children were evaluated. Children with allergic disease were 341 (209 males and 132 females) and those in the control group were 833 (428 males and 405 females). Parasomnia symptoms were common in young children (ages 2 to 5 years) than in the control group (P<0.05). Symptoms of sleep-disordered breathing were more common in early adolescent children (ages 11 to 12 years) than in the control group (P<0.05). The presence of allergic rhinitis, gender, and body mass index did not correlate with a sleep disturbance in children with allergic disease. Conclusion: To our knowledge, this study was the first report of sleep disturbance in children with allergic disease in Korea. This study suggests that children with allergic disease from early children may have poor sleep quality than those without. Therefore, proper treatment of and great interest in sleep disturbance are required for children with allergic disease.

      • KCI등재

        팀 기반 시뮬레이션 실습교육이 간호대학생의 문제해결적극성, 의사소통능력, 문제해결과정에 미치는 영향

        민은실(Min, Eun-Sil) 학습자중심교과교육학회 2019 학습자중심교과교육연구 Vol.19 No.14

        본 연구는 팀 기반 시뮬레이션 실습교육이 간호대학생의 문제해결적극성, 의사소 통능력, 문제해결과정에 미치는 영향을 파악하고자 실시되었다. 연구대상자는 간호대 학생 97명이었으며, 시뮬레이션 교육 및 자료수집기간은 2017년 11월 4일부터 12월 10일까지이었다. 연구결과 팀 기반 시뮬레이션 실습교육 후 간호대학생의 문제해결 적극성은 5점 만점에 4.0점, 의사소통능력 4.0, 문제해결과정 3.9점으로 유의한 차이가 있었다. 시뮬레이션 실습 교육 후 문제해결적극성, 의사소통능력, 문제해결과정간의 상관관계를 분석한 결과 문제해결과정은 문제해결적극성, 의사소통능력과 강한 정적 상관관계가 있는 것으로 나타났으며, 문제해결적극성은 의사소통능력과 강한 정적 상관관계가 있는 것으로 나타났다. 본 연구 결과는 팀기반 시뮬레이션 실습교육이 문제해결적극성, 의사소통능력, 문제해결과정을 향상시키는 프로그램을 개발하는 기초 자료로 활용할 수 있을 것으로 생각한다. The purpose of this study was to identify the effects of simulation practice education using team-based on proactivity of problem-solving, communication ability, and problem solving process of nursing students. The study used a one group, pre-post test design. The subjects of this study were 97 nursing college students.and self-reported questionnaires were collected between November 4 and December 10, The data were analyzed by frequencies, paired t-test, and Pearson s correlation using SPSS Win 20.0. As a result, there were significant differences in the proactivity of problem solving 4.0 out of 5, communication ability 4.0, and problem solving 3.9. After analyzing the correlation between proactivity of problem-solving, communication ability and problem solving process after simulation training, it was found that problem solving process had strong positive correlation with proactivity of problem-solving and communication ability. proactivity of problem-solving was a strong positive correlation with communication ability. The results of this study suggest that simulation practice education using team-based can be used as a basic data to develop programs to improve proactivity of problem-solving, communication ability and problem solving process.

      • KCI등재

        고혈압 환자의 치료지시 이행에 영향을 미치는 예측요인

        민은실(Min, Eun Sil),허명행(Hur, Myung-Haeng) 기본간호학회 2012 기본간호학회지 Vol.19 No.4

        Purpose: The purposes of this study were to identify knowledge, health belief and compliance in patients with hypertension and to identify the most important predictors for compliance of hypertensive patient. Method: The participants in this study were 117 patients who were receiving treatment for hypertension at E. university hospital or one of three local clinics in D-city. Data were collected using a knowledge measurement instrument, health belief scale, and an instrument on compliance. Collected data were analyzed using X2 test, ANOVA, multiple linear regression with PASW statistics 18.0 program. Results: There were statistically significantly positive correlations between knowledge of hypertension and health belief, health belief and compliance. But there was no correlation between knowledge of hypertension and compliance. In the multiple regression analysis, perceived barriers, perceived severity, perceived benefits were significant predictors to explain compliance and accounted for 54.1% of the variance in compliance. Conclusion: The results of the study indicate that health belief and compliance are significantly strongly correlated. Thus it is suggested that nursing interventions to improve compliance should include nursing care plans to increase health belief, perceived severity, perceived benefit and to decrease perceived barrier.

      • 강의실을 스마트하게 빌리기 위한 어플리케이션

        문은실 ( Eun-sil Mun ),김민주 ( Min-ju Kim ),김민희 ( Min-hee Kim ),강승석 ( Seung-seok Kang ) 한국정보처리학회 2019 한국정보처리학회 학술대회논문집 Vol.26 No.1

        시간과 장소에 관계없이 휴대폰으로 강의실을 대여할 수 있는 시스템을 개발한다. 또한 예약조회와 승인이 가능하도록 Django 웹 프레임 워크를 이용하여 웹 서버를 구축하고 웹페이지와 어플 간의 API 통신을 IOS 에서 구현한다.

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