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      • 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

        정신분열병에 대한 리스페리돈의 효과 및 안정성

        이민수,김용구,김영훈,연병길,오병훈,윤도준,윤진상,이철,정희연,강병조,김광수,김동언,김명정,김상훈,김희철,나철,노승호,민경준,박기창,박두병,백기청,백인호,손봉기,손진욱,양병환,양창국,우행원,이정호,이종범,이홍식,임기영,전태연,정영조,정영철,정인과,정인원,지익성,채정호,한상익,한선호,한진희,서광윤 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

        연구목적 : 본 시험의 목적은 임상시험 시작전에 연구자들을 대상으로 PANSS Workshop을 통하여 PANSS, ESRS에 대한 국내에서의 표준화 작업을 구축하고 새로운 정신병 치료제인 리스페리돈의 효과와 안정성을 재확인하여 리스페리돈 사용에 대한 적정화를 이루는데 있다. 연구방법 : 1996년 4월부터 1996년 9월까지 국내 39개 대학병원 정신과에 입원중인 혹은 증상이 악화되어 입원하는 정신분열병 환자 377명을 대상으로 다시설 개방 연구를 시행하였다. 1주일간의 약물 배설기간을 가진후, 리스페리돈을 8주간 투여하였고, 기준점, 1주, 2주, 4주, 그리고 8주후에 평가되었다. 용량은 제1일에는 리스페리돈 1mg씩 1일 2회, 제2일에는 2mg씩 1일 2회, 제3∼7일에는 3mg씩 1일 2회 투여하였다. 이후 환자의 임상상태에 따라 임의로 증량할 수 있으며, 최대 일일 16mg을 초과하지 않도록 하였다. 추체외로 증상을 조절하기 위한 투약을 허용하였다. 임상증상 및 부작용의 평가는 PANSS(Positive and Negative Syndrome Scale), CGI(Clinical Global Impression) 그리고 ESRS(Extrapyramidal Symptom Rating Scale)을 사용하였다. 연구결과 : 377명중 343명(91%)이 8주간의 연구를 완결하였다. 치료 종결시점인 8주후 PANSS 총점수가 20% 이상 호전된 경우를 약물 반응군으로 정의할때, 약물반응군은 81.3%였다. 리스페리돈에 반응하는 예측인자로는 발병연령, 이전의 입원 횟수, 유병기간이 관련 있었다. 리스페리돈은 1주후부터 PANSS양성, 음성, 및 일반정신병리 점수상에 유의한 호전을 보여 효과가 빨랐다. CGI의 경우도 기준점에 비해 1주후부터 유의한 감소를 나타내었다. ESRS의 경우, 파킨슨 평가점수는 기준점과 비교해 투여 1주, 2주, 4주후 유의하게 증가되었다가 8주후 기준점과 차이가 없었다. Dystonia 평가점수는 1주후만 유의한 증가를 보였으며, dyskinesia 평가점수는 유의한 차이가 없었다. 혈압, 맥박수의 생명징후 및 일반 혈액학 검사, 생화학적 검사, 심전도 검사에서 유의한 변화는 없었다. 결 론 : 이상의 다시설 개방 임상 연구를 통해 리스페리돈은 정신분열병 환자에서 양성증상뿐만 아니라 음성증상 및 전반적인 증상에도 효과적인 것으로 사료된다. 보다 명확한 평가를 위해서는 다른 항정신병약물과의 이중맹검 연구가 필요할 것으로 생각되며, 또한 장기적 치료에 대한 평가도 함께 이루어져야 하겠다. Objective : The purpose of this study was to investigate the efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. Method : This multicenter open study included 377 schizophrenic patients drawn from 39 university hospitals. After a wash-out period of 1 week, the schizophrenic patients were treated with risperidone for 8 weeks and evaluated at 5 points ; at baseline, and 1, 2, 4 and 8 weeks of treatment. The dose was increased from 2mg/day(1mg twice daily) to 6mg/day(3mg twice daily) during the first week and adjusted to a maximum of 16mg/day over the next 7 weeks according to the patient's clinical response. Medication to control extrapyramidal symptoms was permitted. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. Results : 343(91%) of 377 patients completed the 8-week trial period. Clinical improvement, as defined by a 20% or more reduction in total PANSS score at end point, was shown by 81.3% of patients. The predictors of response to risperidone were associated older age, shorter duration of illness, fewer previous hospitalization. Risperidone had rapid onset of action ; a significant decrease of the total PANSS and three PANSS factor(positive, negative, general), and CGI was already noticed at the end of first week. For the ESRS, parkinsonism rating scores were significantly increased until week 4 comparing with baseline. Dystonia rating scores were significantly increased until week 1, and dyskinesia rating scores were not significantly changed during the study. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial. Conclusions : This study suggests that risperidone is generally safe and effective against both the positive and negative symptoms in our group of patients.

      • 요양보호시설 노인의 의치 만족도 조사

        정희선 원광대학교 대학원 2009 論文集 Vol.42 No.-

        Data were gathered through person-to-person interviews with 120 old people that were aged 65 or older, lived at nursing facilities for the elderly in Jeollabuk Province, and had a removable denture from August 1 to December 5, 2007. The subjects' satisfaction with their dentures was examined according to the characteristics related to a denture, general characteristics, and denture characteristics. 1. As for the characteristics related to a denture, the biggest number of the subjects had a full denture at 37.5%, and 62.4% of them used their dentures for three years or longer, which was a relatively long term. 2. The treatment of their dentures was done by a dentist in 79.2% of the entire cases, which was a bigger percentage than a curer with no license. 3. It turned out that 91.7% of the subjects paid constant attention to the state of their dentures and 66.7% said that the denture prices were adequate. 4. As for denture satisfaction according to general characteristics, those who were aged 75 or older had greater denture satisfaction than those who were aged 65~74, and those who graduated from middle school displayed a higher level of denture satisfaction than those who received no formal education or graduated from elementary school. There were statistically significant differences(P=0.011 and P=0.049, respectively). 5. As for leisure activities, those who enjoyed them showed greater denture satisfaction than those who didn't(P=0.01l). 6. As for perceived state of dental health, those who said they had good dental health were more satisfied with their dentures than those who said their dental health was average or poor(P=0.000).

      • KCI등재

        치과기공사들의 호흡기 자각증상 및 관련요인

        정희선,이무식,김남송 대한보건협회 2002 대한보건연구 Vol.28 No.2

        본 연구는 치과기공사들의 호흡기 및 근골격계 자각증상에 관한 호소율과 관련요인을 조사 분석하여 직업성 질병을 예방하고 효율적인 건강관리와 작업 환경 개선을 위한 기초자료를 제공하고자 실시하였다. 연구대상을 전국의 치과기공소(실)에 근무하고있는 치과기공사를 무작위로 추출하여 우편 설문조사에 응답한 265명 이었으며 조사기간은 2000년 12월부터 2001년 3월 까지였다. 수집된 자료는 Spss 8.0프로그램을 사용하여 X2-test와 로지스틱 회기분석을 통하여 다음과 같은 결론을 얻었다. 조사대상자의 성별에 따른 일반적 특성을 분석한 결과 연령, 결혼상태, 흡연여부, 음주여부와 유의성이 있었고 직무특성 분포에서는 치과기공경력, 담당업무, 직위에 따라 유의성이 있었다. 호흡기 장애 호소율을 분석한 결과 평소시침 호소율(55.5%)이 가장 높게 나타났고 다음은 담.가래(52.5%), 숨참.숨헐떡임(42.6%), 콧물.코감기(39.2%), 숨쉴 때 소리(23.4%)순이었다. 로지스틱 회귀분석에서 평소기침 호소율에 유의한 영향을 준 요인으로는 직위였고, 담.가래는 직장소재지였으며, 콧물.코감기는 성별, 연령, 결혼상태, 직위였다. 이상의 결과로 볼 때 치과기공사들의 신체 자각증상 호소율은 비교적 ?? 나타났으며 효율적인 건강 관리와 작업환경 개선을 위해 치과기공과 재학생들에게도 치과기공 재료들의 유해성에 대한 보건관리 교육 실시 및 재료등의 유해성 방지를 위한 전문 연국기관이 요구되며 치과기공사들의 적극적 자기관리와 치과기공소 운영자의 정기적인 작업환경 측정으로 쾌적한 환경유지가 필요하다. 또한 치과기공사들의 직업적 특성을 고려한 건강관리 교육 및 전용의료기관을 지정하고, 정기 건강검진을 실시하여 질병 예방의 제도적 장치가 필요할 것으로 판단된다. The purpose of this study was to serve as a basis for the protection of dental technicians from occupational diseases, more successful health care for them, and the betterment of working environment, by examining their complaints about respiratory subjective symptom and the relevant factors. The study subjects were 265 dental technicians who were randomly selected from dental technology shops nationwide and respondent to a mail survey. The survey was conducted from December 2000 to March 2001. The collected data were analyzed with SPSS 8.0 program, and X^2-test and logistic regression analysis procedures were utilized. Dental technicians suffered coughing in ordinary time(55.5%), phlegm and sputum(52.5%%), shortness of breath(42.6%), nasal discomfort(39.2%). Major predictors to suffer coughing in ordinary time on multiple logistic regression analysis were position in the office, phlegm and sputum were location of work area and nasal discomfort were sex, age, marital status and position in the office. The above-mentioned findings showed that the dental technicians suffered highly from physical subjective symptoms of respiratory system. S0 there are some suggestions about mere efficient health care and better working environment: dental technology students should receive healthcare education to leam the harmfulness of dental technology materials, and a specialized research institution is needed to make a deep study of addressing the harmfulness of the materials. Dental technicians have to pay more attention to their own health care, and dental technology manager should check out working environment on a regular basis to maintain a comfortable environment. In addition, healthcare education should be provided to dental technicians in consideration of their vocational characteristics, and specific medical institutions for dental technicians should be designated. And a regular health examination should be conducted to prevent any possible occupational diseaede.

      • KCI등재

        성폭력 피해여성의 경험에 관한 연구

        정연강,권혜진,지순주,남선영,김경희 韓國學校保健學會 1996 韓國學校保健學會誌 Vol.9 No.1

        This studies designed to work out a theoretical framework on the experience of sexual abuse from the perspective of grounded theory in an effort to provide more practical and efficient nursing intervention for female victims. The subcategories identified were "sexual abuse", "threatening", "absent mindness", "embarrassment", "horripilation", "dizziness", "wondrousness", "filthiness", "sexual curiousity", "violence level", "victim's age", "neighbors response", "victims personality", "common experience", "sexual abuse information", "family relations", "level of familiarity", "hiding", "suppression", "self-torture", "self-protection", 'avoidance", "asking aid", "withdrawal", "hatred", "confusion", "dodging", "remmant", and "pursuing". The 29 subcategories given above were further integrated into 16 categories such as "victimizedness", "being astounded", "filthiness", "degree", "developmental stage", "response pattern", "personality", "rarity", "infromation availability", "family support", "cover-up", "escaping", "informing", "negative internalization", and "positive pursuit of change". The core categories linked to all the other categories turned out to be "being taken aback" and "filthiness" incorporation the relevant subcategories. A total of 23 theoretical hypothesis emerged in the process of analyzing data. 1. the grater sexual curiosity, the weaker the senses of being taken aback and filthiness. 2. The weaker sexual curiosity, the stronger the senses of being taken aback and filthness. 3. The stronger the level of violence, The more violent the senses of being taken aback and filthiness. 4. The lower the level of violence, the weaker the senses of being taken aback and filthiness. 5. The younger the victims, the stronger the senses of being taken aback and filthness. 6. The older the victims, The weaker the senses of being taken aback and filthness. 7. 'Escaping' will transpire regardless of the given circumstances. 8. The weaker the senses of being taken aback and filthness, the more probable 'informing' and 'escaping' transpire. 9. The stronger the senses of being taken aback and filthness, the more probable 'informing' and 'escaping' transpire. 10. The more protective the response from 'informing' and 'escaping' transpire around, the more likely the response to 'being taken aback' and 'filthiness' will be 'informing' and 'escaping'. 11. The more repelling the response from around, the more likely the response to 'being taken aback' and 'filthiness' will be 'covering-up' and 'escaping'. 12. The more open minded the personality of subject, the more likely the response to 'being taken aback' and 'filthiness' will be 'covering-up' and 'escaping'. 13. The more closed the personality of subject, the more likely the response to 'being taken aback' and 'filthiness' will be 'covering-up' and 'escaping'. 14. The more frequent the experience of sexual abuse, the more likely the response to 'being taken aback' and 'filthiness' will be 'covering-up' and 'escaping'. 15. The less frequent the experience of sexual abuse, the more likely the response to 'being taken aback' and 'filthiness' will be 'covering-up' and 'escaping'. 16. The more available information concerning sexual abuse, the more likely the response to 'being taken aback' and 'filthiness' will be 'covering-up' and 'escaping'. 17. The less available information concerning sexual abuse, the more likely the response to 'being taken aback' and 'filthiness' will be 'covering-up' and 'escaping'. 18. The more cohesive the family of the subject, the more likely the response to 'being taken aback' and 'filthiness' will be 'covering-up' and 'escaping'. 19. The less cohesive the family of the subject, the more likely the response to 'being taken aback' and 'filthiness' will be 'covering-up' and 'escaping'. 20. The more familiar the subject is with the abuser, the more likely the response to 'being taken aback' and 'filthiness' will be 'covering-up' and 'escaping'. 21.The less familiar the subjec is with the abuser, the more likely the response to 'being taken aback' and 'filthiness' will be 'covering-up' and 'escaping'. 22. The more likely the response to 'being taken aback' and 'filthines' is 'informing' and 'escaping', the more positive changes the subject will pursue. 23. The more likely the response to 'being taken aback' and 'filthiness' is 'covering-up' and 'escaping', the more negative changes the subject will pursue. The following four hypothneses were conformed in the process of data analysis. 1) In case the level of violence is strong but 'being taken aback' and 'filthiness' in weak because of strong sexual curiosity and also if information concerning sexual abuse is not readily available and the frequency is low, negative internationalization marked by 'covering-up' and 'escaping' will take place despite the fact the subject is open-minded, the family is cohesive and the abuser is unfamiliar. 2) In case the level of violence is weak but 'being taken aback' and 'filthiness' is weak combined wit weak sexual curiosty and also if information concerning sexual abuse is readily available and the response from around is protective and the frequency is high, the subject will pursue positive changes to 'being taken aback' and 'filthiness' , further aided by the fact that the subject is open-minded, the family is cohesive and the abuser is unfamilar. 3) In case the level of violence is strong but 'being taken aback' and 'filthiness' is strong because of weak sexual curiosity and also if information concerning sexual abuse is reading available and the response from around is readily available and the response from around is protecvice and the frequency is low, the subject will persue positive changes marked by 'informing' and 'escaping' despit the fact that the family cohesion is weak and the abuser is familiar. 4) In case the level of violence is strong but 'being taken aback' and 'filthiness' is strong because of weak sexual curiosity and also if information concerning sexual abuse is not readily available and the response from around is respelling and the frequnecy is low negative internalization like 'covering-up' and 'escaping' will take place, further aggravated by the fact that the subject's personality is closed, family cohension is weak, and subject is familiar. On the basis of the above finding, it is recommended that nursing intervention should focus on promoting the milieu conductive to the victims pursuing positive changes along with the adequate aids from protection facilities as well as from the people around them.

      • KCI등재

        골프장의 잔디 토양에서 살균제 Tolclofosmethyl의 분해

        정근욱,우선희,김흥태,사동민,김영기,홍순달,김재정,이재구 한국환경농학회 2004 한국환경농학회지 Vol.23 No.3

        Tolclofosmethyl (TCFM) is heavily and annually applied to the turf soils of most golf courses in Gyeongju to control the fungi known to cause the disease brown patch. The soil samples used for the experiment was collected three weeks after the annual application at the end of May in the year 2002. The preliminary results obtained from this study demonstrated that the repeated field annual applications of TCFM to the turf soils of a golf course located in Gyeongju city in the southern area of Korea showed the enhanced degradation of the parent compound TCFM, especially in the surface (0~15 cm) soil rather than the shallow subsurface (15~30 cm) and deep subsurface (30~45 cm) soils, compared to the corresponding surface (0~15 cm) and shallow and deep subsurface (15~30 cm and 30~45 cm) soils of the untreated plot. It appears that microorganisms in the soil may be involved in the enhanced degradation of TCFM.

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