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This study aimed to investigate the prescription of antibiotics in clinics, and evaluate their usage appropriateness after the 2000 Korean separation of dispensary from medical practice. A retrospective study was performed on the antibiotic use for 4 years from August 2000 to July 2004 in three clinics (general, internal medicine and ear-nose-and-throat (ENT) clinics). Moreover, prescription of antibiotics for acute upper respiratory infection (AURI), concomitant drugs, duplicate antibiotics and patient adherence were assessed for 260 patients experienced AURI in a pharmacy. The prescription rates of antibiotics amongst the whole prescription decreased annually during the study period, but those in ENT clinic still constituted more than 90%. The usage of penicillins declined, but that of broad spectrum antibiotics such as amoxicillin/clavulanic acid and 1st/2nd generation cephalosporins increased. Moreover, the categories of antibiotics for the same indication were different among the clinics. For patients with AURI, the more antibiotics were prescribed as its missing days and days under its therapeutic dose increased. The drug interactions with concomitant drugs decreased annually, but the use of duplicate antibiotics was similar across the period. Potential inappropriate antibiotic use was common after the Korean policy, so the observation of pharmacists needs in addition to the patients and practitioners' attention.
송윤경,진선경,한의식,안미령,정주연,이이다,조일영,김동섭,지은희,박효영,오정미,신원,이선희,김인규,Song,,Yun-Kyoung,Jin,,Sun-Kyung,Han,,Eui-Sik,Ahn,,Mee-Ryung,Jung,,Ju-Yeon,Lee,,Rhee-Da,Cho,,Il-Yong,Kim,,Dong-Sub,Ji,,Eun-Hee,Park,,Hyo-Young,Oh, 대한약학회 2011 약학회지 Vol.55 No.4
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Gastritis is the most common disease among Korean. The demand for the development of gastritis drugs has been increasing. Currently, however, there is no guideline available for the clinical evaluation of gastritis drugs worldwide. As a consequence, domestic and international pharmaceutical companies make errors in the drug development processes, and it becomes difficult for them to establish the scientific validity and objectivity of newly developed drugs. The objective of this study was to develop the Guideline for Clinical Trials Evaluation of Gastritis which can be used in improving the quality and consistency of clinical trials. First, we collected and reviewed the clinical trials on gastritis drugs that were available from Japan Pharmaceuticals and Medical Devices Agency and Korea Food and Drug Administration (KFDA), and investigated the recent research trends on clinical trials of gastritis drugs. Reviewers from KFDA and National Institute of Food and Drug Safety Evaluation and scientific experts from the pharmaceutical industries developed the guidelines through regularly scheduled meetings. Opinions and consultation from academic fields and industry experts were also obtained. This project will provide the clinical trial practitioners, investigator and reviewers the scientific and rational guidelines for performance and evaluation of clinical trials for gastritis drugs. Furthermore, we hope this guideline contributes to establishing the national competitiveness, improving the quality of clinical trial, and encouraging researches on drug development for gastritis.
This study attempted to reveal the physiologic etiology or related factors associated with speech processing by comparing the ability of speech motor programming of children group with functional articulation disorders with that of children group without articulation disorders. For the purpose, subjects were 35 children with articulation disorder and 35 children without articulation disorder whose age ranged from 5 to 6 years. They were asked to repeat each words and nonwords rapidly. Task words were consisted of 2 syllable or 3 syllables and were familiar to 5 to 6 year old children. Nonwords were formed from previously selected words by vowel modification maintaining the phonetically balance. Required time in each repetition with words and nonwords was measured by using spectrograph and number of articulation error also were measured. To compare the group performance, independent t - test was used. The results showed that children with articulation disorder revealed significantly greater differences in required time of repeating words and nonwords in both 2 syllables and 3 syllables. And children with articulation disorder showed larger difference in the number of articulation error of repeating words and nonwords as compared to the children without articulation disorder. But, the correlation between the percentage of consonants correct and the two parameters in the articulation disorder group was irrelevant. These results point out to the fact that children with articulation disorder have a poor ability of speech motor programming compared to the children without articulation disorder. On the other hand, the poor ability does not have any relation with the severity of articulation disorder. These results suggest either general or individual characteristics of children with articulation disorder. 본 연구는 말처리 과정에서 나타날 수 있는 조음장애의 원인 또는 관련 요소를 파악하기 위하여 연령과 성별을 통제한 조음장애아동 35명과 정상아동 35명을 대상으로 말운동 프로그래밍 능력을 비교하고 그 특성을 파악 하였다. 이를 위하여 피험자에게 2음절과 3음절의 단어와 비단어를 제시하고 빠르게 반복하는 과제를 수행하게 하였다. 그 결과, 정상아동에 비하여 조음장애아동이 더 큰 단어와 비단어의 반복 소요시간 변화를 보였으며, 더 많은 조음오류수 변화를 보였다. 그러나 조음장애아동은 자음정확도와 소요시간 변화 및 조음오류수 변화에서 유의미한 상관을 보이지 않았다. 이러한 연구결과는 조음장애아동이 정상아동에 비하여 말운동 프로그래밍 능력에서 취약성을 보였지만, 자음정확도의 정도에 따라서 그 취약성이 어떤 경향을 보이는 것이 아님을 시사한다.
After discontinuation of bisphosphonate therapy, an antiresorptive effect and antifrac-ture protection persist for an undefined period. Patients are encouraged to continue cal-cium and vitamin D supplementation, during a bisphosphonate drug holiday. However,assessment of adequate calcium intake during the bisphosphonate drug holiday is diffi-cult. Therefore, we measured the serum intact parathyroid hormone (PTH) level as a sur-rogate marker. A premenopausal woman discontinued bisphosphonate therapy, after7.5 years of treatment. Two months later, blood calcium and phosphorus levels werenormal, serum 25-hydroxyvitamin D level was 31.3 ng/mL, but serum PTH level had in-creased to 94.9 pg/mL. The elemental calcium supplement dose was increased to 600mg/day, with no change in the cholecalciferol dose (400 IU). Her serum PTH levels de-creased to 49.1 after 4 months and 32.9 pg/mL after 5 months. The serum PTH level maybe helpful in assessing adequate calcium intake during a bisphosphonate drug holiday.
The current study aimed to establish rationales for using three different voice therapies (resonant voice, accent method, and tongue-tip trills) by comparing the aerodynamic, and vocal fold closure characteristics under three therapies. A total of 8 male under/graduate students(tenors) participated as subjects. In order to compare aerodynamic characteristics, air flow rates and subglottal pressures were measured using Phonatory function analyzer under three therapy conditions. The characteristics of vocal fold closure patterns also were examined by comparing closed quotients(CQ) measured by Electroglottograph(EGG) under three therapy conditions. However, maximum phonation time (MPT) was measured under only resonant voice and tongue-tip trills using Aerophone II. The results are summarized as follows : 1) CQ, subglottal pressure and MPT decreased significantly under resonant voice as compared with throat voice, but the air flow rate increased significantly under resonant voice. 2) CQ decreased significantly under accent method as compared with throat voice, but both air flow rate and subglottal pressure increased significantly under accent method. 3) Both CQ and MPT decreased significantly under tongue tip trills as compared with throat voice, but air flow rate and subglottal pressure increased significantly under tongue-tip trills. Clinical implications of results were discussed in light of differential effects of three voice therapies.
The purpose of this study is to identify undergraduate students' emotional response and characteristics of receptiveness as a lecture voice to hoarse and normal reading voice. A hoarse voice sample was collected from a 30 year-old female with functional voice disorder and normal voice sample was collected from a female with same age without voice problems. After listening the voice samples, undergraduate students filled out the adjective checklist and responded to the questionnaire about their feelings as a lecture voice. The results showed that the students had negative emotions to hoarse voice and preferred normal voice to a hoarse voice as a lecture voice. Also, these results pointed out that professors' voice quality in class is important and prevention and care of voice problem(s) are necessary.
Spasmodic dysphonia is a focal dystonia of the larynx and breathy voice is a typical sign of abductor spasmodic dysphonia. A group of patients with abductor spasmodic dysphonia have a number of acoustic characteristics including abnormal fundamental frequency fluctuations and abnormally long word duration. We report a abductor spasmodic dysphonia case have enlongated voice onset time voiceless consonants and breathy voice in wide band spectrogram. The patient have the acoustic characteristics only in telephone speaking at work time. We treated the patient with anticholinergic and anticonvulsant drug and supplementary voice therapy. The breathy voice and enlongated VOT were disappeared after those treatment.
본 연구는 구개편도와 아데노이드 비대가 있는 아동이 구호흡을 하게 되면 만성적인 성대 건조를 유발하게 되고, 이러한 조건이 음질을 저하시킬 수 있을 것이라는 가설을 검증하기 위하여, 만 5세-8세의 정상 아동 68명과 구개편도와 아데노이드 비대아동 50명을 대상으로 MDVP 음성분석을 시행하였다. 연구 결과 정상 아동에 비하여 구개편도와 아데노이드 비대 아동은 Jitt, RAP, PPQ, Shim, APQ 파라미터에서 모두 통계적으로 유의미하게 높은 수치를 나타내어 낮은 음질을 보이고 있음을 알 수 있었다. 따라서 언어치료사나 이비인후과 전문의 등은 구개편도와 아데노이드 비대 아동의 음성문제 가능성을 인식하고, 이들의 음성위생법 교육에 관심을 가져야 할 것으로 여겨진다. This study evaluated the voice of 68 normal children and 50 children with palatine tonsil and adenoid hypertrophy with MDVP to examine the hypothesis that their mouth breathing makes the vocal folds dry and this condition contributes to lower the level of voice quality. The results showed that children with palatine tonsil and adenoid hypertrophy had statistically significant elevations in Jitt, RAP, PPQ, Shim and APQ parameters, and had the lower level of voice quality. Therefore, the children with palatine tonsil and adenoid hypertrophy need vocal hygiene education.