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        다제내성 그람음성균 감염의 항생제 치료

        강철인 ( Cheol In Kang ) 대한내과학회 2015 대한내과학회지 Vol.88 No.5

        The incidence of infections caused by multidrug-resistant (MDR) Gram-negative bacteria has increased over the past decade and extensively drug-resistant (XDR) infections are now on the rise, especially in non-fermenters such as Pseudomonas and Acinetobacter species. Unfortunately, our therapeutic options for these pathogens are extremely limited. Infections due to antimicrobial-resistant bacteria are associated with a greater likelihood of inappropriate antimicrobial therapy, which has adverse effects on the outcomes of patients with serious infections. Physicians who are treating immunocompromised patients should be aware of not only the current epidemiological status of antimicrobial resistance but also appropriate antimicrobial therapy for MDR pathogens. Although carbapenems are considered a mainstay for the treatment of extended-spectrum beta-lactamase (ESBL) or AmpC β-lactamase-producing pathogens, antimicrobial stewardship for the appropriate use of carbapenems should be implemented to preserve these important antimicrobial agents. For carbapenem-resistant XDR infections, colistin and tigecycline could be considered a therapeutic option, based on the in vitro antibacterial spectrum, although the optimum treatment has not been established. This review provides a recent update of the antimicrobial therapeutic strategies for serious infections due to MDR or XDR Gram-negative bacteria, such as ESBL-producers and carbapenem-resistant pathogens. (Korean J Med 2015;88:502-508)

      • 한국민담 "바늘 상자 속에 넣어 둔 눈알"에 대한 분석심리학적 해석

        강철중 ( Cheol Joong Kang ) 한국분석심리학회 2008 心性硏究 Vol.23 No.1

        The Korean fairytale `Eyes in the Sewing Box` is a story about a boy who was abandoned by his mother and searches to find own father. The father was exiled to a distant place and the boy lived with his stepmother. One day, his stepmother told him that his father got a serious disease and he needed fresh human eyes for a cure. The boy took out his eyes and gave them to his mother. But the story was a lie and it was her plan to abandon her son. She put her son`s eyes into her silk pouch and kept them in her sewing box. The boy`s stepmother abandoned the boy and brought him to a riverside very far from their home. Because of his blindness, he could not find where to go. He was completely lost and finally he fell into a river. But fortunately he landed on an island. He found a bamboo grove and heard some beautiful sounds which came from the bamboo. He wanted to find where the sound came from. He grabbed the bamboo one by one, finally he found it. Then he cut the bamboo and made a flute. He sat there and played the bamboo flute every day, all day long. The sound was extremely beautiful and emotional. Everybody who heard the sound was touched by it. One day, a local judge heard the sound and ordered his servant to find the person who played the flute. The servant brought the boy in front of the judge. The judge asked him about his story, how he became blind, and why he played the bamboo flute. The boy told him his entire story. Just then, his father heard the story of the boy in the crowd. Finally the boy and his father met again. They went back to their home and found his eyes. The boy`s vision was restored and he forgave his mother. They lived together happily ever after. This story is about a boy who loses his father and who is reunited with his father again. Immature consciousness cannot stand individually, so it is helpless under the influence of negative mother archetype. Additionally, it takes out the vision of consciousness. The consciousness isolated in the lonely island, and surrounded by unconsciousness. But the island is individual space, though it is very small and lonely. From there, the sound is produced spontaneously. That is the sound of the Self. The consciousness does not ignore the sound from the Self, finally it gets back its` paternity and achieves higher consciousness.

      • 땅에 투사된 자기의 상징 -명당의 분석심리학적 측면-

        강철중 ( Cheol Joong Kang ) 한국분석심리학회 2011 心性硏究 Vol.26 No.1

        풍수는 음양오행설에 기초를 둔 주거지와 묏자리의 환경에 대한 체계이다. 풍수에서는 땅 속에 존재하는 생기의 흐름이 있다는 믿음을 전제로, 그 흐름을 중요시 하여 가능하면 그 생기를 잘 받을 수 있는 땅에 집터나 묘지를 만들고자 한다. 산 사람은 땅 위에 얹혀 살며 그 기운(생기)을 얻는 반면, 죽은 자는 땅 속에서 그 기운을 직접 받아들이기 때문에 산 사람 보다는 죽은 사람이 얻는 생기가 더 크고 확실하다고 믿는다. 이렇게 죽은 사람이 얻는 생기는 후손에게 그대로 이어진다고 여겼는데 이를 동기감응, 혹은 친자감응이라고 한다. 땅속의 기운이 좋은 곳을 찾아 살거나 혹은 그러한 곳에 조상의 뼈를 묻음으로써 후손들이 그 기운을 이어받아 후손들의 번영을 기원하는 것이다. 풍수에서 땅속의 생기를 잘 받을 수 있는 위치의 땅을 명당이라고 한다. 명당을 선정하는 방법에 대해 과거로부터 많은 경험들을 체계적으로 정리한 것이 풍수의 이론이다. 최고의 자리라고 알려진 명당의 형국을 상징적으로 살펴보면, 사위와 원 등으로 표현되는, 조화와 균형이라는 측면에서 전체성의 상징인 자기(Self)의 상징을 발견할 수 있다. 명당을 찾고자 하는 노력은 서양의 연금술사들이 최고의 물질인 금을 얻기 위해 행해온 것과 유사하다고 볼 수 있다. 그러므로 명당은 우리 마음속의 최고의 가치인 조화와 균형, 완전성 그리고 전일성인 자기의 상이 땅에 투사된 것이다. 우리는 그것을 찾는 과정에서 우리 정신의 전체성을 추구하는 과정과 유사한 모습을 엿볼 수 있다. Pungsu is an ancient logic that systemizes geography based on the Yin-Yang and The Five Elements Principle. It is defined as the unique and highly systemized ancient Eastern art of selecting auspicious sites and arranging harmonious structures such as graves, houses, and cities on them by evaluating the surrounding landscape and cosmological directions. Pungsu helps allegedly one improve life by receiving vital energy(Shengqi, 生氣)-energy flow that flows under the ground. It is traditional belief that the living lead their lives on the ground, indirectly receiving the energy coming out of the ground, whereas the dead are buried under the ground, allowing them to directly absorb energy from the ground, which makes Shengqi the dead receive bigger and more obvious than that the living receive. This energy absorbed by the dead from the ground was believed to be passed on to their descendants. This phenomenon is called “Induction of vital energy between Ancestors and Descendants”. People searched for the sites which were believed to contain rich and positive vital energy flow. They also tried to bury their ancestors under such sites hoping to receive the Shengqi coming from underground which they believed would help them thrive and prosper. The efforts to locate the sites which have the most vital energy, auspicious sites or “Bright Yard(明堂)”, are easily observed in Asia including China and Korea. The ultimate goal of searching for auspicious sites lies in human(whether alive or dead) receiving vital energy from the nature to enjoy happy lives. In choosing a place to live or to bury their dead ancestors, people tried to understand the energy flow of the site considering the factors related with mountain, water, and direction. If we take a closer look into the methods of finding auspicious sites, we can see that people have tried to see the outer conditions of lands, mountains and waters within the perfect harmony if possible. Auspicious site or Bright Yard is the site with those elements in perfect order and harmony, that is, it is the place which derives the most vital energy from the best order and harmony of nature. As this shows, an auspicious site symbolizes totality-the Self, and it seems to be projected to the land. It is believed to be an attempt that the reason why we try to find auspicious sites to internalize the totality that we projected to the outer world. Therefore, this auspicious site is what our foremost values, symbol of the Self, such as harmony, equilibrium, perfection, and uniqueness are reflected to the land. Through the process of finding such a site, we try to gain totality of psyche.

      • 농촌학교 교사의 연수 요구 분석

        강철호(Kang, Cheol Ho) 공주대학교 교육연구소 2012 교육연구 Vol.27 No.1

        농촌 교사에게 필요한 전문성을 알아보고 전반적인 연수 활성화 방안을 제시하는 데 본 연구 목적이 있다. 연구결과 농촌학교에 가장 필요한 전문성을 수업활동 및 생활지도를 들고 있다. 특히 초등학교는 학급운영을 중등학 교는 수업활동 연수를 가장 선호하고 있었다. 이는 초등의 경우 담임위주의 수업이 이루어지기 때문이고 중등의 경우 전공위주의 수업을 소규모 학교가 특성에 맞춰야 하기 때문에 다양한 수업방법에 대하여 전문성을 갖길 원하는 것으로 보인다. 또한, 학생수는 적지만 학생특성에 따른 생활지도의 전문성이 필요한 것으로 보인다. 따라서 농촌학교 교사에게 필요한 차별화된 연수 과정의 개발이 필요하다. 대부분 연수기관에서는 학교급 또는 전공과 교양에 초점을 맞춰 연수과정을 설계하고 개설하고 있는데 도시와 농촌 학교의 특성에 맞는 차별화된 맞춤형 연수의 필요성이 절실히 요구된다. This study is to survey rural teachers’ in-service educational needs. The professional needs for rural teachers are how to teach and guide rural children. Elementary teachers prefer to take a in-service educational program of a class management and secondary teachers do how to teach because elementary teachers manage the classroom mainly and secondary teachers do the subject. Even the rural school has a small number of students it needs the professional knowledge about rural children. The rural children have a different personality from urban children. The current in-service programs consists of liberal and professional programs not for rural teachers, but for all teachers. As rural situations are different from urban the in-service programs should be open for rural teachers.

      • KCI등재

        CaO/SiO<sub>2</sub>비 및 W/B 변화에 따른 오토클레이브 양생 경화체의 특성에 관한 실험적 연구

        강철,강기웅,김진만,Kang, Cheol,Kang, Ki-Woong,Kim, Jin-Man 한국콘크리트학회 2009 콘크리트학회논문집 Vol.21 No.5

        이 연구는 수열합성반응을 통해 규사분을 사용한 무기질 다공성 규산칼슘 재료의 특성에 관한 것으로, 다양한 제조과정에 의해 발생하는 규산질 부산물을 사용한 소음 저감용 다공성 경화체 개발을 위한 기초적 자료로 사용하고자 하였다. 오토클레이브 양생 시편의 제조를 위해 다양한 칼슘질 재료를 사용하였고 규산질 재료는 규사분을 사용하였다. 이 연구에서, W/B와 C/S비에 따라 밀도와 강도 특성, 공극의 형태를 위한 현미경, 오토클레이브양생 후의 수화물 검사를 위해 주사전자현미경과 엑스선회절분석을 각각 수행하였다. 측정 결과로 굳지 않은 상태에서 W/B가 증가할 수록 슬러리 밀도는 점점 감소하고 이러한 경향은 굳은 상태에서도 유사하게 나타났다. 압축강도는 C/S비 0.85 시편이 가장 높게 나타났다. 토버모라이트는 C/S비와는 상관없이 모든 시편에서 생성되었다. 공극구조를 확인하기 위해, 기존에 사용되고 있는 다공질 규산칼슘 제품(ALC, 무기질 흡음재)을 비교했다. 관찰 결과, 기존의 무기질 흡음형 다공성 경화체 기공과 유사한 형상을 보였다. 따라서 이러한 결과를 바탕으로 소음저감형 다공성 경화체의 개발 가능성을 확인 할 수 있었다. This study is on the properties of inorganic porous calcium silicate material made from silica powder through the autoclaving curing, the results of this study should be utilized fundamental data for the development of noise reduction porous solid material using siliceous byproduct generated by various manufacture process. For the manufacture of autoclave curing specimen, various calcareous materials used and siliceous materials used silica powder. In this study, properties in density and compressive strength according to the change of W/B and C/S ratio, microscopy for the shape of pore, SEM and XRD for the examination of hydrate after autoclave curing are carried out respectively. The test results shown that the more slurry density decrease, the more W/B increase at the fresh state, this tendency shown similar to in hardened state. Among the specimens of C/S ratio, the compressive strength of C/S ratio of 0.85 gave the highest the compressive strength. In the results of XRD, tobermorite generated by autoclaving curing was created all of specimens regardless of C/S ratio. To ascertain pore structure, we compared with existing porous calcium silicate product(ALC, organic sound absorbing porous material). The results of microscope observation, pore structure of specimen of this study was similar to that of existing inorganic sound absorbing foam concrete. therefore, we could conformed a possibility of sound absorbing porous solid material on the basis of the results.

      • KCI등재후보

        노인 감염성 질환 ; 노인 환자의 항생제 치료 원칙

        강철인 ( Cheol In Kang ) 대한내과학회 2010 대한내과학회지 Vol.79 No.4

        Older persons generally have greater susceptibility to infections than younger adults, probably because of the increased frequency of comorbidities and physiologic changes. There are many factors, both patient-related and treatment-related, which contribute to unique aspects of antimicrobial use in elderly persons that make prescribing complicated. Physiologic and pharmacokinetic changes associated with aging results in a higher risk of an adverse drug event and a harmful drug interaction, making antimicrobial dosing difficult. The risk of polypharmacy and more frequent adverse drug reactions in the elderly population justify a thorough consideration of the patient`s true need for antimicrobial therapy. Given the increase in the elderly population and in the incidence of adverse drug reaction among elderly persons, further efforts should be made to optimize approach to management of infectious diseases in elderly persons. (Korean J Med 79:362-365, 2010)

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