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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.
Background : Malignant melanoma in Korea has been increasing as in other countries, but there is no nationwide survey of malignant melanoma in Korea. Objective : The aim of this study was to document the clinical and histopathological features of cutaneous melanoma in Korea. Methods : The Dermatopathology Research Group conducted a review of nationwide collection of109 primary cutaneous melanomas, diagnosed at 23 institutes over a recent 3-year period. Clinical records and pathology slides of the patients were reviewed retrospectively. Results and Conclusion : 1. The peak age was the 7th decade with the mean age of 58.1 years. Korea has a higher rate of acral melanoma and much lower rate of lentigo maligna melanoma. 2. Major component tumor cell was spindle cell type. 3. Clark level of tumor was Ⅲ or more and Breslow depth was 2 ㎜ or more at the time of the first diagnosis in many cases (62%). 4. Pre-existing melanocytic nevus was present in a few cases (3 cases). 5. All these features suggest that the racial difference between the Korean and the Caucasian is evident. We also suggest that an early detection program is very important to cure this malignant tumor. (Korean J Dermatol 2003;41(1) 43∼47)
Background : The relative frequency and clinicopathologic characteristics of lymphomas vary according to geography and race. Data on the features of cutaneous lymphoma in Korea we limited. Objective : The aim of this study was to document the relative occurrence, the clinical and histopathological features of cutaneous lymphomas in Korea. Methods : The Korean Dermatopathology Research Group conducted a review of nationwide collection of 80 cutaneous lymphomas, diagnosed at 23 institutes over recent 3-year period. Clinical records and pathology slides of the patients were reviewed retrospectively. Results and Conclusion : 1. Korea has a higher rate of T-cell lymphoma and NK/T cell lymphoma and a much lower rate of cutaneous B cell lymphoma. 2. The relative frequency of the major diagnostic group according to WHO classification was as follows mycosis fungoides/Sezary syndrome, 42.5%; anaplastic large cell lymphoma, 19%; nasal and nasal type NK/T cell lymphoma, 15%; subcutaneous panniculitis-like T cell lymphoma, 11%; peripheral T cell lymphoma, unspecified, 7.5%; follicular lymphoma, 3%; marginal zone Iymphorna, 1%; angioimmunoblastic lymphadenopathy, 1%. 3. Compared with Western countries, the rate of nasal and nasal-type NK/T cell lymphoma and subcutaneous panniculitis-like T cell lymphoma were much higher. Therefore, The EORTC classification is not effective in dealing with Korean cases of cutaneous lymphoma. We consider the principles of the WHO classification are applicable to the Korean cases of cutaneous lymphoma. (Korean J Dermatol 2003;41(1) : 48∼57)
D. K. LEE, J. S. LEE, B. J. LEE, H. S. LEE, Y. J. KIM, S. B. PARK, J. P. JOO. PIantar foot pressure analysis during golf swing motion using plantar foot pressure measurement system. Korean Journal of Sport Biomechanics, Vol. 15, No. 1, pp. 75-89, 2005. In this study, weight carrying pattern analysis and comparison method of four foot region were suggested. We used three types of club(driver, iron7, pitching wedge). This analysis method can compare between top class golfer and beginner. And the comparison data can be used to correct the swing pose of trainee. If motion analysis system, which can measure the swing speed and instantaneous acceleration at the point of hitting a ball, is combined with this plantar foot force analysis method, new design development of golf shoes to increase comfort and ball flight distance will be available. 1. Address acting, forces concentrated in rare foot regions and lateral foot of right foot. Back swing top acting, relatively high force occurred in medial forefoot region of left foot and forefoot region of right foot. Impact acting, high force value observed in the lateral rarefoot region of left foot and medial forefoot region of right foot. Finish acting, force concentration observed on the lateral region and rarefoot region of left foot. 2. Forces were increased in address of right foot with clubs length increased. All clubs, back swing top acting, high force value observed in the lateral forefoot region of right foot. All clubs, in impact, high force value observed in the lateral rarefoot region of left foot and medial forefoot region of right foot. Finish acting, force concentration observed on the rarefoot region in driver and lateral foot region in iron on left foot. 3. Right foot forces distribution were increased in address, back swing top and left foot force distribution were increased in impact, finnish
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15세기 후반은 국가적 법제와 문물이 완비되면서도 세조의 즉위와 이에 편승한 훈구공신의 권력독점과 전횡으로 조선왕조의 이상이 심각하게 훼손된 시기였다. 이때 ｢弔義帝文｣은 세조의 즉위에 따른 역사의 상흔을 치유하고자 한 정치세력에게 있어서 자신들의 의리명분론을 대변하는 의미를 지녔다. 그러나 정작 ｢조의제문｣을 지은 金宗直의 사환은 평탄하고 일상은 안온하였다. 당대 일급 문사로서 세조와 그의 공신을 적극 찬양하기도 하였으며 지방관으로서 庶政을 쇄신하고 많은 제자를 양성하는 등의 치적을 올렸다. 그러나 내면의 심리적 울분과 정체성 갈등은 심각하였다. 김종직이 적극적 현실참여의 길로 선회한 것은 모친상을 지낸 다음이었다. 이 과정에서 金宏弼등의 일부 제자와 出處論문제로 갈등이 있었고, 정치쇄신과는 거리를 두었던 때문에 후진의 비판을 받기도 하였다. 그러나 김종직은 국가 학술 및 편찬사업을 통하여 훈구파 일색의 學文權力을 해체하는 역할을 자임하였다. 사림파의 정치적, 학술적 위상의 강화에 기여한 것이다. 金馹孫등이 세조의 치세를 재평가하는 역사운동에 적극 나설 수 있었던 것도 사림파의 위상 제고를 바탕으로 한 것이었는데, 이때 ｢조의제문｣을 한 시대의 역사적 상흔을 웅변한 불멸의 서사로 재평가되었다. 이러한 점에서 김종직은 세조의 즉위와 그에 따른 공신의 체제에 머물렀음에도 그들의 두터운 장벽을 허물기 위한 도전의 단초를 제공하였다는 점에서 시대의 변화와 사림의 의식전환을 이끌었던 경계인으로 평가될 수 있을 것이다. In the late 15th century, legal and institutional systems were completely organized, but the ideals of Joseon dynasty were seriously damaged because of King Sejo(世祖)'s enthronement and political monopoly of Hungu meritorious retainers. At this time, new political forces suggested the damage caused by king's enthronement to be managed and the ｢Joeuijemun(弔義帝文)｣was a model of such change in consciousness. However, Kim, Jong-Jik who wrote the ｢Joeuijemun｣could not but take a job in the royal court and admire the regime by King Sejo. Internal conflicts were serious. Poetry in its early period such as ｢Kaheungcham(可興站)｣and ｢Sabangji(舍方知)｣was representation of such conflicts. And though he attempted to reform officialdom as a local officer while teaching a number of students, his psychological conflicts and resentment were not resolved. Kim, Jong-Jik turned his attention to practical things after he lost his mother in spite of Kim, Gweng-Pil's appeasement. However, though some of his students criticized him, he stayed away from a political reform. Instead, he participated in national academic projects to permeate into academic power of Hungu-group(勳舊派) and greatly contributed to reinforcement of political and academic positions of Sarim-group(士林派). Based on reinforced academic capability, Sarim fiercely confronted against Hungu and led a campaign of history to reevaluate the regime of King Sejo. At this time, the ｢Joeuijemun｣was reevaluated as an everlasting narrative that speaks for historical damage of one period. In this aspect, this study suggests that Kim, Jong-Jik's life was a challenge to break a thick barrier of Hungu meritorious retainers though he belonged to them.
The most important boundary between Hungu(勳舊) and Sarim(士林) in the late 15th century was an issue of past history. Hungu respected King Sejo as a king of rare restoration while Salim revealed historical defects in the process that King Sejo used to usurp the throne and attempted to correct them. Such conflicts caused Muosahwa(戊午士禍) when Kim Il-Son's historical record, where 'Joeijemun(弔義帝文)' are inserted, was disclosed. However, 'Joeijemun' was not published in the historical record because Kim, Il-Son was one of Kim Jong-Jik's students. It was because vivid memories and record by Kim, Si-Seup and Nam, Hyo-On who spent their whole lives wandering and traveling were transferred to Kim, Il-Son. Kim, Il-Son also visited hermits who resisted against King Sejo's usurpation of the throne and reign from his teens until his mid-twenties. In this respect, traveling and pilgrimage was not avoidance of the time, but a choice beyond the boundary of the time and place to remember and treat historical scars. Therefore, the road to Kim, Si-Seup, Nam, Hyo-On and Kim, Il-Son who led the memory campaign was a memory space. However, the memory campaign was not intended to deny and liquidate King Sejo's reign wholly. It was an attempt of historic reconciliation for record of the past truth and future. It gives a useful suggestion on historical campaign today.
Y. J. MOON, S. H. LEE, J. H. BACK, J. K, LEE, K. B. LEE. The development of posture evaluation and Range of Motion(ROM) system by using digital vision analysis method. Korean Journal of Sport Biomechanics, Vol. 14, No. 3, pp. 49-65, 2004. The purpose of this study is development of posture evaluation and Range of Motion(ROM) system by using digital vision analysis method. The results of this study are as follows. First, Scoliosis evaluation through this research measurement system represent 3mm error in 7 cervical point and deepest lumbar point, 0.7mm error in other point. This mean this research measurement system have a reliability for scoliosis evaluation. Second, for spine line evaluation on high fat subject, we need reconstrection spine line after mesurement for fat thickness in 7 cervical point and deepest lumbar point. Third, In pedioscope error test, it present 0.01848cm in X axis and 0.01757cm in Y axis. This results mean pedioscope have a reliability foot evaluation. Forth, Posture evaluation and Range of Motion measurement system by using digital vision analysis method can fast measure in range of motion and foot evaluation and posture. therefore we can expect this system application in young people posture clinic center and hospital and so on.
With a view to examining the habit and method in which old people maintain and improve their health, we consulted 551 men and 444 women who were over 65 years old, and concluded as follows: 1. Habit of eating It's been revealed that most of the old people keep a regular eating hour, control the quantity of meal or eat a little food, and prefer vegetables to meat. 2. Mental health Old people feel the necessity for mental health and most of them (about 80%) keep good mental health without becoming pessimistic. Their chief concenrs have turned out to be about their sons and daughters and their own health and finance. 3. Managing Good Health It has been revelaed that old people do not possess any special kind of secret to keep good health but taking plenty of rest, regular meal, and proper exercise, and many of them (about 60%) have been shown to eat invigorant food that they can easily get around their living area. 4. Physical Functions It has been revealed that many old people are conscious of some symptoms about their parts of body and about to percent of them suffers from neuralgia. Some measures like medical aid especially for old people need to be taken as soon as possible. As we have found that the health-keeping method of old people consists plenty of rest, proper exercise, and appropriate nutrition, we can conclude that the recreatonal and culture facilities and programs for keeping old people in good health should be developed. It is also necessary to study food that contribute to their health and develop ways to get rid of the stresses to which they are exposed in their daily life. Presides, it is natural that government found an administrative department to deal with these matters effectively.
이 연구의 목적은 중·장기복무를 마치고 제대하여 재취업하고자 하는 제대군인들의 원활한 전직을 돕기 위한 제대군인 취업지원 프로그램의 개발방향과 개발안을 제시하는 데 있다. 이를 위해 국내·외에서 이루어지고 있는 제대군인 취업지원 프로그램의 실태를 분석하였고, 제대군인 취업지원 프로그램에 대한제대예정군인 및 제대군인과 기업체의 요구를 분석하여 시사점을 도출하였다. 그리고 이를 기초로 제대군인 취업지원 프로그램의 기본방향과 전체 흐름도, 세부 프로그램 개발안을 제시하였다. 이를 위해서 활용된 연구의 방법은 문헌연구, 조사연구, 전문가협의회 등이다. 이 연구를 통해서 제시된 제대군인 취업지원 프로그램의 개발방향과 개발안을 토대로, 일관되고 지속적인 수요자 중심의 제대군인 취업지원 프로그램의 개발이 가능할 것이다. The purpose of this study is to suggest plans and directions for developing. job-seeking support program for military veterans. The study is conducted through literature review, survey and interview. The results of this study are as follows: ⒧ basic development directions and flowchart of job-seeking support program for military veterans are suggested; and ⑵ development plans for sub-programs are suggested.
The diagnostic requirements were suggested and explained regarding the systems of differentiation of symptoms and signs in the third year study of standardization and unification of the terms and conditions used for diagnosis in oriental medicine. The systems were as follows : - analyzing and differentiating of epidemic febrile disease - analyzing and differentiating in accordance with the Sasang constitution medicine based on four-type recognition - differentiation of disease according to pathological changes of Chong and Ren channels - standards for diagnosis of women's disease - standards for diagnosis of children's disease - standards for diagnosis of motor and sensor disturbance (-muscle. born, joint, etc.) - standards for diagnosis of neuropsychiatric disease - standards for diagnosis of five sense organ disease - standards for diagnosis of external disease The indivisual diagnosis pattern was arranged by the diagnostic requirements in the following order : another name, notion of diagnosis pattern, index of differentiation of symptoms and signs, the main point of diagnosis, analysis of diagnosis pattern, discrimination of diagnosis pattern, prognosis, a way of curing a disease, prescription, herbs in common use, disease appearing the diagnosis pattern, documents. The standards for diagnosis of each disease was arranged by the diagnostic requirements in the following order : another name, notion of disease, the main point of diagnosis, analyzing and differentiating of disease, analysis of disease, discrimination of disease, prognosis, a way of curing and prescription of disease, disease in western medicine appearing the disease in oriental medicine, documents.