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      • KCI등재후보

        모야모야병에 있어서 MR에서 뇌경색과 혈관조영술소견간의 연관성: 후방순환의 중요성

        이은자,유원종,정소령,강시원,Lee, Eun-Ja,Yu, Won-Jong,Jeong, So-Ryeong,Gang, Si-Won 대한영상의학회 2002 대한영상의학회지 Vol.46 No.6

        목적:모야모야병을 가진 환자에서 혈관조영술 소견에서 전방 순환과 후방 순환의 변화와 MR영상에서 보이는 뇌경색의 빈도와 분포사이의 관련성에 대하여 알아보았다. 대상과 방법:특발성 모야모야병으로 진단된 34명의 환자의 모두 58예의 대뇌반구(양측성;24예,일측성;10예)를 대상으로 하였고 남녀비는 12:22이었으며,나이는 2세에서52세사이이었다.모든 환자는 고식적인 혈관조영술과 MR영상을 시행하였다.혈관조영술 소견을 분석하기 위해 전방순환과 후방순환 각각에서 혈관의 폐쇄정도를 단계별로 평가하였고 또한 후대뇌동맥의 피질 분지로부터 연막측부순환혈관의 발달정도를 4단계로 나누었다.MR영상에서는 대뇌 피질과 피질하 백질의 경색의 위치를 6개의 영역으로 나누었고,그외 백질 및 기저핵의 경색,뇌실확장,피질위축,그리고 혈종동반유무를 평가하여 MR 영상소견과 혈관조영술 소견간에 관련성에 대해서 카이자승법과 Mantel-Haenszel 경향분석법을 사용하여 통계적 유의성을 평가하였다. 결과:후대뇌동맥의 폐쇄의 진행정도는 내경동맥의 단계의 진행정도와 통계적으로 유의하게 상관관계가 있었다(p<0.0001).후대뇌동맥의 폐쇄정도가 진행할수록 후대 뇌동맥으로 부터의 모야모야혈관의 발달이 감소하였으나(p<0.0001),내경동맥의 진행정도와는 통계적 유의성이 없었다(p>0.05).내경동맥과 후대뇌동맥의 폐쇄의 정도가 심할수록 대뇌피질의 경색의 발생이 통계적으로 유의하게 상관관계가 있었다(p<0.0001).모야모야환자에서 대뇌경색의 정도는 내경동맥의 폐쇄정도보다 후대뇌동맥의 폐쇄정도가 더 의미있게 유의하였다.후대뇌동맥의 병변이 1단계 혹은 2단계일 경우에는 대뇌의 전방영역에 뇌경색이 분포하는 경향이 있고,후대뇌동맥의 병변이 진행될수록 뇌경색은 대뇌의 후방,특히 후방 중대뇌동맥 영역,후방 분수계 영역,후대뇌동맥 영역에 유의하게 뇌경색이 동반되었다(p=0.0007).전대뇌동맥영역과 전방 중대뇌동맥영역의 뇌경색은 내경동맥과 후대뇌동맥의 폐쇄정도와는 통계적 유의성이 없었다. 결론:후대뇌동맥의 폐쇄정도와 내경동맥의 폐쇄정도는 통계적으로 유의하게 상관관계가 있었다.내경동맥과 후대뇌동맥의 폐쇄정도가 진행할수록 보다 광범위한 뇌경색이 동반되었다.모야모야환자에서 뇌경색의 정도는 내경동맥의 폐쇄정도보다 후대뇌동맥의 폐쇄정도와 더욱 의미있게 유의하였다.모야모야환자에서 후대뇌동맥의 폐쇄는 뇌경색의 발생과 밀접한 관련이 있었다. Purpose: To investigate the relationship between changes in the posterior and anterior circulation, as seen at angiography, and the frequency and extent of cerebral infarction revealed by MR imaging in moyamoya disease. Materials and Methods: This study involved 34 patients (22 females and 12 males, aged 2-52years) in whom cerebral angiography revealed the presence of moyamoya disease (bilateral: unilateral=24:10; total hemispheres= 58) and who also underwent brain MR imaging. To evaluate the angiographic findings, we applied each ngiographic staging system to the anterior and posterior circulation. Leptomeningeal collateral circulation from the cortical branches of the posterior cerebral artery (PCA) was also assigned one of four grades. At MR imaging, areas of cerebral cortical or subcortical infarction in the hemisphere were divided into six zones. White matter and basal ganglionic infarction, ventricular dilatation, cortical atrophy, and hemorrhagic lesions were also evaluated. To demonstrate the statistical significance of the relationship between the angiographic and the MR findings, both the Mantel-Haenszel chi-square test for trend and the chi-square test were used. Results: The degree of steno-occlusive PCA change correlated significantly with the internal carotid artery (ICA) stage (p<0.0001). As PCA stages advanced, the degree of leptomeningeal collaterals from the PCA decreased significantly (p<0.0001), but ICA stages were not significant (p>0.05). The prevalence of infarction showed significant correlation with the degree of steno-occlusive change in both the ICA and PCA. The degree of cerebral ischemia in moyamoya patients increased proportionally with the severity of PCA stenosis rather than with that of steno-occlusive lesions of the anterior circulation. Infarctions tended to be distributed in the anterior part of the hemisphere at PCA stage I or II , while in more advanced PCA lesions, they were also found posteriorly, especially in the territories of the posterior middle cerebral artery (MCA), the posterior border zone, and the PCA (p<0.0001). The frequency of infarctions in the territories of the anterior cerebral artery (ACA) and the anterior MCA was unrelated to the degree of steno-occlusive ICA and PCA lesions (p>0.05). Conclusion: The degree of steno-occlusive lesions of the PCA correlated with the ICA stage. Progressive changes in steno-occlusive lesions of the ICA and PCA are associated with the extent and distribution of cerebral infarction. The degree of cerebral ischemia in moyamoya patients increased proportionally with the severity of PCA stenosis rather than with that of steno-occlusive lesions of the anterior circulation. In these patients, the presence of stenotic or occlusive PCA lesions appears to be significantly related to the occurrence of cerebral infarction.

      • KCI우수등재
      • KCI등재후보

        중국 근대사 서술에 대한 두 가지 시각 -중국 역사교과서와 대만 역사교과서의 비교 분석을 중심으로

        이은자 역사학연구회 2008 사총 Vol.66 No.-

        This study examines two views on the description of modern Chinese history by comparing and analyzing the most recent Chinese and Taiwanese history textbooks. This study, first of all, addresses basic viewpoints on modern Chinese history in the two countries’worlds of historical science. For the Chinese world of historical science, the modern times of China, opened by the Opium War, is the starting point of the semi-colonial and semi-feudal society. From this perspective, the contents of the description of modern Chinese history consist of presentation of the process in which the semi-colonial and semi-feudal society was deepened, the anti-imperial and anti-feudal struggle was accelerated, and the realization of modernization was tried. The Taiwanese world of historical science also defines the Opium War as the starting point of modern Chinese history. It is said that China had opportunities to drive the self-strengthening movement in the whirlpool of troubles though it had difficulty due to Western impacts. In this respect, the contents of the description of modern Chinese history consist of the emphases upon Western impacts and the self- strengthening movement. Next, this study investigates the contents of the description of the Opium War, which can be said to be the starting point of modern Chinese history. In Chinese history textbooks, the First and Second Opium Wars were processes where the semi-colonialism and semi-feudalism were deepened in China. Contrastively, ‘Western Impacts’called the First and Second Opium Wars in Taiwanese history textbooks are described as a momentum by which (non- equal) treaty relationships, different from the existing tributary ones, were made on one hand, and the self-strengthening movement occurred within China on the other. Lastly, this study takes a look at the descriptive contents regarding the Sino-Japanese War in the two countries’ history textbooks. Chinese history textbooks basically recognize the Sino-Japanese War as a war of invasion vs. anti-invasion between Ching and Japan, and interpret it in tandem with the relationship between China and Japan. Here, the problem of Chosun serves as a dependent variable. Taiwanese history textbooks, on the other hand, explain the causes of the Sino-Japanese War in relation with the Chosun problem, and mention the content of Item 1 of the Simonoseki Treaty “China admits Chosun’s independence.” In Taiwanese history textbooks, the descriptive contents about the ideology of Cheonjo(天朝), loss of subordinate countries, and the Sino-Japanese War are mutually connected. They say that though China had Chosun as its subordinate country, the former lost the latter as its subordinate country. Accordingly, we can find out that the reason why Taiwanese history textbooks deal with the Chosun problem in the Sino-Japanese War is just for more specifically accounting for the viewpoint of the loss of a subordinate country.

      • 실존주의 논의 일고찰 : 1950년대를 중심으로

        李銀子 숙명여자대학교 대학원원우회 1992 원우논총 Vol.10 No.-

        In this paper, I have stated the aspect of accepted existentialism which had been favoured in post-Korean War literature in 1950s and criticism on it. Even though it has been said that existentialism has been favoured in post-war literature, it has already been imported with the western culture since Independence. The withdrawal of ideology is characteristic of the importance of existentialism, which is irrelevant to the discussion on the separation of ideology into Right and Left. Existentialism is placed on the third position through the realistic restriction concerned with anti-communism, and the reflection and skepticism left by the ideological confrontation after independence. It is accepted with critigue based on the marxian socialism. Also, it governs prominently the 1950s' literature with the outbreak of the Korean War, as if the only thought of Korea. The great characteristic of postwar existentialism is that it is concerned with the linkage of generaliations. Expectation to the new generation to fill literary gaps after the establishment of government was acutely needed with the need of a new way of literature after Korean War. The appearance of the new generation, as on method of groping for a new way, was in an opposite position to the old generation, i. e., repelling and criticism which were the most distinguished characteristic of the postwar new generation,. The postwar new generation's critigue, as the resistance to the old generation, showed the strong modernistic inclination, through existentialism which could be in a comparatively profitable position in the 1950s realistic limitation. The typical example is Lee O^-Lyeng's existential analysis and criticism. However, the dispute on existentialism ended as a guarred, not as an argument in the late 1950s. The discussion on existentialism was abstract and superficial because it had been developed without the basic understanding of thought. This is its limitation. The internal division of the literary world made it be trifing theory. As a result, the discussion on the 1950s existentialism was assessed as the internaliation of confict between the new generation and the old one, and its revelation. I think that the study on existentialism accepted in literary works with the 1950s criticism is the important work for the explication of the 1950s literature, and that the study concerned with it must be processed broadly and deeply.

      • 운동이 심도자 검사 환자의 불안에 미치는 영향에 관한 연구

        이은자 京畿專門大學 2000 京畿專門大學 論文集 Vol.- No.28

        Cardiac catheterization has become a routine diagnostic procedure indicated for evaluation of a wide variety of cardiac conditions. Patients are admitted to the coronary care unit after cardiac catheterization. These conscious patients used to report anxiety in the CCU, but no studies have been done to reduce anxiety induced by bed rest, sand bag on the femoral puncture site and restricted mobility for 20 hours postprocedure. The main objective of thesis is to provide basic data to nursing on interventions which decrease anxiety perceived by patients in the CCU following cardiac catheterization. The study subjects were a convenience sample of 48 patients following cardiac catheterization who were admitted to the CCU of a general hospital in Inchon. These patients were divided into a exercise-applied group and a control group. Questionnaire was composed of state anxiety by Spielberger, and tested for reliebility by item analysis ; Cronbach's α for the instrument measuring anxiety was .59. The data were collected from January 25, to May 15, 1996. Analysis of data was done by paired t-test, t-test, ANOVA, Chi-square test. The results of the study are summarized as follows: 1. There were no significant differences between a experimental group and a control group according to general information except religion. 2. There were found no significant differences between the two groups in the results of pre-test.(The score of the former : 38.7, the later : 36.5) 3. In the degree of anxiety according to general characteristics were found some significant differences for sex and educational status. But there were no significant differences for age, occupation, marital status, number of family, religion and admission period. 4. There was no reducing effect on anxiety level with exercise after cardiac catheterization.

      • KCI등재

        법륜의 <즉문즉설>의 대중성 연구

        이은자 한국문학과종교학회 2016 문학과종교 Vol.21 No.2

        법륜의 <즉문즉설>은 어디든 직접 찾아가 즉설을 펼치는 법륜의 구도적 행 보가 대중성의 기반을 형성하고 있다. 묻고 대답하는 강연 방식이 대중의 적극 적인 참여를 유도함으로써 힐링의 효과를 주고, 다매체의 적극적 활용은 대중성 을 확산시키는 결정적 역할을 한다. ‘정토회’의 조직적이고 체계적인 지원은 <즉문즉설>의 대중성을 현실 가능한 것으로 만드는 외적 요인이다. <즉문즉설> 이 대중에게 흡입되는 내적 요인은 법륜이 구사하는 언어의 수사적 설득력이 크게 작용한다. 법륜이 제시하는 유머나 스토리텔링, 그리고 비유의 아포리즘이 종교적 담론이 대중과의 소통을 유연하게 만든다. 또한 <즉문즉설>의 궁극적 메시지 코드가 탈종교적 보편 진리인 ‘행복’이라는 점이 대중의 인기를 얻는 중 요한 요인이다. 법륜의 즉설은 ‘지금 여기’에서 대중이 행복한 삶의 주체가 되 는 방법을 구체적으로 제시하고 있다. 그것은 삶에 내재한 고통의 원인이 욕망 과 집착에서 비롯됨을 깨닫고 주인된 삶을 내 안에서 찾아야 한다는 것으로 요 약된다. <즉문즉설>의 대중성은 오랜 시간에 걸쳐 탄력적으로 변화해 온 결과 여서 매우 견고해 보인다. 이제 <즉문즉설>의 과제는 대중성의 방향이 사회의 변화를 이끄는 힘으로 작동할 수 있는가이다. This paper aims to seek the reasons behind how Monk Pomnyun’s ‘Dharma Q&A’ is gaining popularity amongst the public. Its popular appeal is acquired by the following reasons. First of all, Pomnyun visits the audience himself for the lecture, wherever that may be. Secondly, ‘Dharma Q&A’ allows the audience to participate and has a healing effect. Thirdly, it satisfies a wide range of public’s preference by proactive application of the multi-media. Fourth, it’s humorous which entertains the audience. Fifth, he delivers the message of enlightenment in a clear way, through illustrations and metaphors. Finally, it’s main theme ‘happiness’ is non-religious and universal. ‘Dharma Q&A’ seems to have succeeded on gaining popularity due to interactions of these factors. ‘Dharma Q&A’’s task is on the direction of outcome on the popular appeal. It is whether this direction can act as a driving force for creating happiness amongst the public, and function as a power to lead the changes in society.

      • KCI등재

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