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        Direct effectiveness of pneumococcal polysaccharide vaccine against invasive pneumococcal disease and non-bacteremic pneumococcal pneumonia in elderly population in the era of pneumococcal conjugate vaccine: A case-control study

        Kim, Jong Hun,Chun, Byung Chul,Song, Joon Young,Kim, Hyo Youl,Bae, In-Gyu,Kim, Dong-Min,Choi, Young Hwa,Jun, Yoon Hee,Choi, Won Suk,Kang, Seong Hee,Kwon, Hyun Hee,Jeong, Hye Won,Kee, Sae Yoon,Hur, Jia Elsevier Ltd. 2019 Vaccine Vol. No.

        <P><B>Abstract</B></P> <P><B>Background</B></P> <P>While herd effects and serotype replacement by childhood pneumococcal protein conjugated vaccines (PCVs) continues to accumulate worldwide, direct effectiveness of 23-valent pneumococcal polysaccharide vaccine (PPV23) against pneumococcal diseases in the elderly has been challenged. We estimated the direct effectiveness of PPV23 in the elderly population.</P> <P><B>Methods</B></P> <P>For a hospital-based case-control study, cases of invasive pneumococcal disease (IPD) and non-bacteremic pneumococcal pneumonia (NBPP) (adults ≥ 65 years) were identified in 14 hospitals participated in the pneumococcal surveillance program from March 2013 to October 2015, following implementation of PPV23 national immunization program (NIP) for the elderly in the Republic of Korea. Controls matched by age, sex, and hospital were selected at ratios of 1:2 (IPD) or 1:1 (NBPP). Clinical data and vaccination records were collected. Vaccine effectiveness was calculated as (1-adjusted odds ratio) × 100.</P> <P><B>Results</B></P> <P>We enrolled 148 IPD and 557 NBPP cases, and 295 IPD and 557 NBPP controls for analyses. Overall effectiveness of PPV23 against IPD was 28.5% [95% confidence interval (CI) −5.8%–51.6%] and against NBPP was 10.2% (-15.1-30.6) in all patients ≥ 65 years. However, in subgroup analysis of patients aged 65–74 years, PPV23 was protective against IPD [effectiveness 57.4% (19.4–77.5)] and against NBPP [effectiveness 35.0% (2.3–56.7)]. Furthermore, serotype-specific effectiveness of PPV23 against IPD was 90.6% (27.6–98.8) for PPV23-unique serotypes and 81.3% (38.6–94.3) for PPV23 serotypes excluding serotype 3.</P> <P><B>Conclusions</B></P> <P>This study indicates that PPV23 with broad serotype coverage might be beneficial in preventing IPD and NBPP due to non-PCV13 serotypes in the young-elderly, with potentially increasing effectiveness in the setting of childhood PCV NIP.</P> <P><B>Highlights</B></P> <P> <UL> <LI> National immunization program for PPV23 for the elderly was implemented in Korea. </LI> <LI> PPV23 was effective against IPD and NBPP for young elderly patients aged 65–74. </LI> <LI> Effectiveness of PPV23 against IPD was higher for PPV23 unique serotypes. </LI> <LI> PPV23 was non-protective against IPD caused by PCV13 serotypes. </LI> </UL> </P>

      • 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.

      • 충청도 지역 일대 저품위 질석의 팽창 특성에 관해서

        강헌찬,김영훈,김광수,신선명 동아대학교 건설기술연구소 1996 硏究報告 Vol.20 No.1

        The propose of this thesis was to study the usage of the low-grade Vermiculite from the Chung Chong province and also to increase its Value-added. A series of experiments have been done for separation as well as heat-expansion characteristics of the Chung Chong Vermiculite some conclusions can be drawn as follows; 1. Vermiculite from Chung-Yang and Hong-Shung areas wear better than that from Palabora's mine in South Africa in terms of the usefulness for an organic fertilizer. 2. The ratio of the volume expansion of Vermiculite increased along with the temperature. 3. In general, the ratio of volume expansion of the vermiculite from Chung-Yang, Hong-Shung and Palabora's mine in South Africa increased with temperature. But it decreased temporarily in the vicinity of 850℃. The result seems to be due to temporary decrease in the latent heat as the crystal water in the crystals such as Ca_(10)(Mg,Fe)₂A1₄Si_(9)O₃₄(OH)₄, K(Fe,Mg)₃AlSi₃O_(10)(OH)₂and K (Fe,Mg)₃AlSi₃O_(10)(OH)₂evaporated. 4. Above 1050℃, the crystal structure began to change and resulted in partial destruction to produce some dusts. Finally sintering occurred.

      • KCI등재
      • 얇은 도핑조절 a-Si:H초격자에서 지속 광전기 전도도

        康聖洙,梁承勳,李原鎭,金英鳳,孔維庠,朴相俊,崔時永 慶北大學校 1990 論文集 Vol.49 No.-

        Very large PPC effect(σ_ppc/σ_A=10^5) in doping-modulated npnp a-Si: H superlattices could be obtained. B and P atoms, respectively, diffuse and so some parts compensated. Therefore, annealing activation energy of E_a=0.67eV is larger than one of reference n-type sample of E_a=0.26eV and annealing dark conductivity of σ_A=4×10^-[ohm cm]^-1 is lower than that of n-type reference sample of σ_A=2×10 exp (4)[ohm cm]^-1. From this results, very large PPC relatively have obtained. In this paper, we have observed that PPC effect depends on temperature and exposure time. On the basis of the experimental results, we discuss the existing models.

      • KCI등재

        급성 약물중독 환자의 응급의학적 고찰

        강지훈,이현노,진영호,이재백 大韓應急醫學會 1999 대한응급의학회지 Vol.10 No.3

        Background : Nowadays, acute drug intoxication is a important section of emergency medicine. The purpose of this study was to determine what is the best-way to manage acutely intoxicated patients with drug in emergency department setting. Methods : Clinical assessment were made on 135 cases of drug intoxication visited to emergency center of Hospital during one year from June 1997 to May 1998. Results : 1. The total number of cases of acute drug intoxication was 135 which is 0.5% of total patients presented to emergency center. 2. There was no sexual difference in incidence, but the highest incidence of age group was in 3rd decade(23.7%) and the next was 7th decade(20.0%). 3. High frequency of acute intoxication was observed in autumn. October had the largest portion in monthly distribution. The largest portion of presumed time of poisoning was noon - 4 p. m. and of the time on arrival to emergency center was 8 p. m. - midnight. 4. Suicidal attempt was the most common motive of intoxication (72.6%). 5. The most common drug of intoxication was insecticides (35.7%) and the others were centrally active agents, herbicides in orders. 6. Mental change was observed in 20.7% of patients and the abnormal vital signs were hypertension, tachycardia, and hypotension in order on arrival to emergency center. 7. Mean duration of treatment was 36.1 hours. Mortality rate of the cases was 7.4%. Conclusion : The mortality rate was high in patients who ingested relatively fatal drugs (i.e. herbicides, antimicrovials, insecticides), showed mental change on arrival or received mechanical ventilatory care(p < 0.05).

      • 저가 후막 EL소자 제조 및 신뢰성 평가

        강계원,김대연,이영훈,강봉석,박정현,최병호 금오공과대학교 산업기술개발연구원 2000 産業技術開發硏究 Vol.16 No.-

        AC powder electroluminescence(EL) device consists of seven layers : PET substrate, transparent electrode, phosphor layer, dielectric layer, two layer metal electrodes and protective layer. Etch layer needs to control to improve electrical and optical properties. Both phosphor and dielectric layer among them is more important to increase its properties. For long-time reliability, proper choices of passivation and sealing material are essential. In this paper, influence of phosphor and dielectric layer thickness on EL performance is studied. Type of cellulos is selected as a sealing material to avoid moisture. To add two type of plasticizer to resin improves flexibility and passivation of EL devices. Through this experiments, technologies of fabrication low-cost thick film EL device can be established.

      • KCI등재

        Glufosinate Ammonium을 포함한 제초제(Basta)중독

        강지훈,진영호,이재백 大韓應急醫學會 1998 대한응급의학회지 Vol.9 No.4

        Basta is one of the Phospho-amino acid group herbicide. It consist of glufosinate ammonium (18.5%), alkylether sulfate as surfactant (30%) and some solvents. Although it's WHO classification is grade Ⅲ, the intoxicated patient appears an serious clinical findings and have a 20% mortality rate. Nowadays, in Korea the ingestion of herbicidal agents for suicidal attempts is frequent. The literature for intoxication of bipyridilium (Gramoxon) as herbicide is varied, but the information for Basta is poor even though the use of it tends to increase. Recently, We experienced six cases of Basta intoxication and found that the patient expressed a gradually progressed depression of mentation, recent memory disturbances, convulsions, hypotension, or bradycardia because of CNS or cardiovascular effects of Basta We report these cases with literature review.

      • KCI등재후보

        Gel형 인화성 용제 Compound의 특성

        강영구,김정훈 한국안전학회 2003 한국안전학회지 Vol.18 No.3

        Gel-like compounds containing flammable solvents were prepared to use for cleaning agents in field of innovative industries and general purposes. And experiments were conducted to improve the defects of liquified flammable solvents from the view point of safety and health hazards. Flammable solvents used in this study were several single component flammable solvents(turpentine oil, N-methyl-2- pyrrolidone(NMP), d-limonene) and multi component flammable solvent(gasoline and ethanol). For gelation of flammable solvents, commercially known as Aerosil® 200 fumed silica and triethanolamine(TEA) were used as gelation agent, dispersant. The analyses on properties of gel-like compounds was studied by gelation and viscosity test, pH test, volatility test and differential scanning calorimetry(DSC) measurement. The experimental results indicate that gel-like compounds containing flammable solvents have pH stability, high viscosity, volatile organic compounds(VOC) control by the decrease of volatility and odor component generation, fluidity control etc. From the experimental values, it can be predicted that the safety in the working place is improved by manufacturing flammable solvents into gel-like compounds.

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