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        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.

      • 순화슬러지와 생슬러지로 본 질산염제거특성

        조순자,정용주,이나은,이정은,손형식,이상준 부산대학교 환경문제연구소 2003 環境硏究報 Vol.21 No.-

        Using acclimated sludge with inorganic nitrogen medium for three months and non-acclimated sludge, raw sludge, under aerobic condition we investigated characteristics biological nitrogen removal. As results, e acclimated sludge under aerobic condition accomplished nitrification efficiently. But the samples from the reactor operated raw sludge had higher ammonium concentration rather than the concentration which was loaded by the medium. This means when we are trying to reorganize existing facilities, we should take high initial ammonium concentration into account.

      • KCI등재

        간세포암과 하대정맥 막성폐쇄의 치료 후 호전된 백혈구파괴혈관염 1예

        이준엽 ( Jun Yeob Lee1 ),이주원 ( Ju Won Lee1 ),이진욱 ( Jin Wook Lee ),박현준 ( Hyun Joon Park ),장국환 ( Gook Hwan Jang ),김다정 ( Da Jung Kim ),김선민 ( Sun Min Kim ),한병훈 ( Byung Hoon Han ),정규식 ( Gyoo Sik Jung ),김근태 ( 대한류마티스학회 2015 대한류마티스학회지 Vol.22 No.5

        저자들은 하지 자색반과 고환 통증으로 내원한 알코올성 간경화증 환자에서 LCV의 원인 감별하는 과정에서 HCC와 하대정맥 막성폐쇄를 진단하고 이에 대한 치료 후 LCV의 호전된 증례를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Vasculitis is a heterogeneous group of diseases that destroy blood vessel walls by inflammation. Approximately half of vasculitis cases are idiopathic, but sometimes associated with genetic factors, medicines, chronic infection, autoimmune diseases, and malignancies. Although the mechanism remains unclear, vasculitis secondary to malignancy, also known as paraneoplastic vasculitis, has been reported. It is generally associated with hematologic malignancies rather than solid malignancies and commonly presents as leukocytoclastic vasculitis or polyarteritis nodosa. We experienced a case of leukocytoclastic vasculitis in a patient with hepatocellular carcinoma and membranous obstruction of the inferior vena cava. Here, we report this case with a brief review of literature. (J Rheum Dis 2015;22:322-326)

      • 철도교통안전진단제도 발전방향 제시

        정연욱(Yeun Wook Jung),이주영(Ju Young Lee),김영선(Young Sun Kim),노남진(Nam Jin Noh),이승열(Seung Yeoul Lee),송병호(Byung Ho Song) 한국철도학회 2015 한국철도학회 학술발표대회논문집 Vol.2015 No.10

        철도실시설계단계에서 이용자 중심의 안전성을 강화하고자 교통안전법 및 교통안전진단 지침이 개정됨으로써 14 년 10 월 13 일 철도교통안전진단제도가 시행되었다. 이후 중앙선, 하남선 등 15 개 철도건설사업 실시설계에 대하여 철도교통안전진단이 시행되었고, 그 결과 이용자 및 열차운행측면에서의 안전위험요인이 도출 및 개선되었다. 본 연구에서는 철도교통안전진단제도가 보다 더 실효성 있게 시행될 수 있도록 진단대상 · 진단시기 등을 명확화 하였고, 진단항목 고도화를 위하여 기존 진단항목 보완 및 신규진단항목을 개발하였다. 이와 함께, 철도교통안전진단에 대한 평가제도 도입의 필요성 및 시행방안을 제시하였다. To enforce safety of passenger at enforcement design stage of rail, Railroad Traffic Safety Diagnosis is introduced at Oct 13, 2014 by revising Traffic Safety Act and Traffic Safety Diagnosis. Railroad Traffic Safety Diagnosis is implemented about enforcement design which is for 15 railroad construction like Jung-Ang Line and Ha-Nam Line, therefore, danger factors about safety are deducted and improved in respect of passenger and train operation. In this study, diagnosis object, diagnosis time and other article are clarified for effectiveness of the Safety Diagnosis and diagnosis articles are supplemented and developed for enhancement. In addition, necessity and execution plan of evaluation system are proposed.

      • KCI등재
      • KCI등재

        Safety of subtotal or total colectomy with primary anastomosis compared to Hartmann procedure for left-sided colon cancer obstruction or perforation

        Eun-Do Kim,Jin-Kwon Lee,Jin-Kyu Cho,Jae-Myung Kim,Ji-Ho Park,Ju-Yeon Kim,Sang-Ho Jeong,Young-Tae Ju,Chi-Young Jeong,Eun-Jung Jung,Young-Joon Lee1,Soon-Chan Hong,곽승진 대한종양외과학회 2019 Korean Journal of Clinical Oncology Vol.15 No.2

        Purpose: Whether subtotal or total colectomy with primary anastomosis (PA) is safer than Hartmann procedure (HP) for left-sided colon cancer obstruction or perforation remains controversial. The purpose of this study was to compare postoperative morbidity, mortality, and defecation frequency between PA and HP for left-sided colon cancer obstruction or perforation. Methods: This retrospective study enrolled 54 patients from January 2014 to February 2018 who underwent emergency surgery due to left-sided colon cancer obstruction or perforation. Results: PA was carried out in 20 patients while HP was performed for 34 patients. Thirty-day mortality did not show significant difference between the two groups (15.0% vs. 14.7%, P=1.000). No anastomotic leakage occurred in PA group while three (8.8%) cases of stump leakage occurred in HP group. Stoma repair was performed for 13 cases (44.8%) and stoma reformation was performed for one case in HP group (7.7%). Stoma related complications occurred in five cases (17.24%). For patients after stoma repair, defecation frequency at 3 months after operation was 2.91±2.88 times per day in PA group and 2.86±2.63 times per day in HP group. At 1 year after operation, defecation frequency was changed to 1.40±1.12 times per day in PA group and 1.17±0.39 times per day in HP group. Conclusion: Primary ileosigmoid or ileorectal anastomosis for left-sided colon cancer obstruction or perforation is safe, and shows similar outcome of defecation frequency compared to H

      • 청소년의 스마트폰 중독과 우울 및 불안과의 관계

        김경은,김필송,민주연,박수경,신서인,이지은,정해인,조호정,최정원,최정인 이화여자대학교 간호과학대학 2013 이화간호학회지 Vol.- No.47

        Purpose: The purpose of this study was to investigate the relationships between the degree of smart phone addiction among adolescents and their depression and anxiety levels. Method: In this study, 379 high school students were selected using the convenient sampling method. The instruments used for this study were smart phone addiction measure, the CES-D (Center for Epidemiological Studies-Depression Scale), and the STAI (State-Trait Anxiety Inventory). Data were analyzed using the SPSS 20.0 program with descriptive statistics, t-test, ANOVA with Scheffe test, and Pearson’s correlation coefficient. Result: The mean score for smart phone addiction was 40.45±17.27, depression was 36.56±9.58, state anxiety was 44.00±9.61, and trait anxiety was 45.70±9.75. There were significant differences between the degree of smart phone addiction and the following variables: gender (t=-4.953, p<.001), hours of smart phone use per day (F=12.259, p<.001), types of frequently used features (F=3.485, p=.008), and satisfaction level for smart phone (F=5.18, p<.001). There were statistically significant relationships (p<.001) among degree of smart phone addiction, depression level, and state and trait anxiety levels. Conclusion: The results of this study suggested that there was a significant relationship between smart phone addiction and mental health, specifically, depression and anxiety among adolescents. Further research is needed to develop nursing strategies to provide care for adolescents who frequently utilize smart phones.

      • KCI등재

        The Identification of Aucklandiae Radix, Inulae Radix, Vladimiriae Radix and Aristolochiae Radix, Using Macroscopic, Microscopic and Physicochemical Methods

        Yoon, Jee-Hyun,Park, Ha-Yeong,Kim, Tae-Ju,Lee, Seung-Ho,Kim, Jung-Hoon,Lee, Guem-San,Kim, Hong-Jun,Ju, Young-Sung The Society of Korean Medicine 2014 대한한의학회지 Vol.35 No.4

        Objectives: This study aimed for establishing the discriminative criteria for Aucklandiae Radix, Inulae Radix, Vladimiriae Radix and Aristolochiae Radix, which can be confused as 'Mokhyang', because of similar appearances and synonyms. Methods: Morphological characteristics of dried herbal medicines were compared by macroscopic observation. To examine microscopic features of 'Mokhyang', paraffin embedding and the staining by using Ju's method were conducted. Physicochemical experiments were performed using HPLC analysis and antioxidant assay. Results: The types of stem, phyllotaxy and leaf shape were chosen as macroscopic criteria and the size, oil spots, color and root top as well as phloem and central cylinder were compared using microscopic features. The HPLC results showed different amounts of costunolide and dehydrocostuslactone among Aucklandiae Radix, Inulae Radix and Vladimiriae Radix. However, Aristolochiae Radix only contained aristolochic acid. The antioxidant assays also showed that Vladimiriae Radix exhibited strongest antioxidant activity followed by Aucklandiae Radix, Inulae Radix and Aristolochiae Radix. Conclusions: These results demonstrate that macroscopic, microscopic and physicochemical methods would be useful tools for the discrimination of 4 kinds of 'Mokhyang'.

      • 주사 탐침 현미경을 이용하여 표면 처리한 기판 위의 DNA 관찰

        이남주,손정민,진상협,전동렬,강치중 명지대학교 자연과학연구소 2004 자연과학논문집 Vol.23 No.-

        대장균에서 추출한 plasmid DNA를 운모 기판에 착상시켜 주사 탐침 현미경으로 관찰하였다. plasmid DNA를 운모 기판에 착상시키기 위하여 운모 기판을 염 이온으로 0.01~10mM까지 농도를 변화시켜 표면 처리하였다. 운모 기판 위 염 이온의 농도 차이를 X-선 광전 분광기(XPS)로 표면을 분석하였다. 기판 처리에 사용한 염 이온의 농도에 영향을 받아 착상된 DNA의 밀도 및 모양이 변화하였다. 운모 기판 처리 농도에 따른 AFM 영상 차이와 XPS로 분석한 기판 위의 염 이온의 상태를 제시하고, 이들 사이의 상관관계에 대하여 논의하였다. The plasmid DNA on mica is observed using scanning probe microscopy. The mica surface is treated by 0.01~10mM NiCl_(2) for depositing the plasmid DNA. Concentration difference of NiCl_(2) on mica is analyzed a treated mica surface using XPS. The plasmid DNA on the treated mica has a difference of density and conformation in proportion as Ni^(2+) concentration. We present AFM topology difference and Ni^(2+) states on mica by XPS, discuss interaction between AFM topology difference and Ni^(2+) states on mica

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