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        다제내성 결핵의 진단과 치료

        강영애 대한의사협회 2014 대한의사협회지 Vol.57 No.1

        Multidrug-resistant tuberculosis (MDR-TB) is a great public health concern worldwide. MDR-TB denotes bacillary resistance to at least isoniazid and rifampicin. Extensively drug-resistant tuberculosis (XDR-TB) is MDR-TB with additional bacillary resistance to any fluoroquinolone and at least one second-line injectable drug. The treatment of MDR-TB requires prolonged administration of a toxic second line anti-tuberculosis drug and generally has poor outcomes. XDR-TB requires more complex treatment and has higher mortality. MDR- and XDR-TB arise because of inadequate or interrupted administration of first-line treatment and can be transmitted in the community. Thus, prevention of the emergence of resistance is the first principle in the management of MDR/XDR-TB. To prevent the emergence of drug resistance and transmission of MDR/XDR-TB, the adequate prescription of an anti-TB drug by a physician and good adherence of patients are essential. In addition, rapid diagnosis of drug resistance using molecular tests such as a line probe assay and Xpert MTB/RIF and the programmatic management of MDR/XDR-TB by designing an effective regimen using available drugs (a newer generation of fluoroquinolone, second-line injectable drugs, second-line oral drugs, and pyrazinamide) based on a guideline are an important strategy for controlling MDR/XDR TB. Despite the long duration of treatment, the treatment success rate of MDR-TB for patients who started treatment in 2009 has been 48% according to the World Health Organization. Thus, to improve the treatment outcomes of MDR/XDR-TB, new drug development is necessary.

      • KCI등재

        비디오투시조영검사를 통한 침습/흡인에 따른 음성의 음향적 분석

        강영애,지성주,구본석 대한이비인후과학회 2017 대한이비인후과학회지 두경부외과학 Vol.60 No.9

        Background and Objectives The present study aimed to investigate the effects of penetration/aspiration (P/A) on voice acoustic parameters. Subjects and Method Twenty-seven patients were analyzed with the videofluoroscopic swallowing study (VFSS) and then divided into two groups based on the modified Penetration and Aspiration Scale results. Ten patients (5 males and 5 females) were included in the Non-P/A group, and 17 patients (12 males and 5 females) in the P/A group. Stroke was the major cause of swallowing disorders. Three sustained /a/ vowels recorded in pre- and post-VFSS were analyzed. Mann-Whitney U-test was used to compare acoustic values before and after VFSS, and the receiver operating characteristics (ROC) curve with combination of significant parameters was also conducted. Results Among acoustic parameters, the length of analyzed sample (p=0.010), number of segments computed (p=0.018), total number detected pitch periods (p=0.017), and second formant (p=0.013) in pre- and post-VFSS were significantly different between Non-P/A and P/A groups. In the P/A group after VFSS, the means of these significant parameters decreased. According to ROC combined with four significant parameters, the probability of predicting P/A condition was 84% (p=0.005), the sensitivity was 80%, and the specificity was 80%. Conclusion Voice acoustic analysis can reflect voice changes by penetration/aspiration and the combination of significant parameters can also detect swallowing disorders. Therefore, voice analysis can be a reliable screening tool for patients with swallowing disorders. Korean J Otorhinolaryngol-Head Neck Surg 2017;60(9):454-62

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      • KCI등재

        지방자치단체간 문화관광축제의 연계유형 평가 - '2001 세계도자기엑스포' 개최 관계자와 방문객의 인식조사를 중심으로 -

        강영애,조중현,김용근 한국조경학회 2002 韓國造景學會誌 Vol.30 No.5

        The Purpose of this study is to suggest the necessity of linking and coordinating Cultural Tourism Festivals among local governments and to propose a plan for maximizing the effects of these festivals. The 'World Ceramic Exposition 2001 Korea' which took place from August 10th to October 28th was selected as a case study for the linkage plan of Cultural Tourism Festivals among local governments. Data were collected from a random sampling of visitors to 'World Ceramic Exposition 2001 Korea' from 24 to 28 October, 2001. 369 samples from a total 375 respondents were used for the final analysis. The contents of the questionnaire consisted of the cognition and satisfaction about the effects of the festival linkage among local governments and the preference of festival linkage types. The results of the analysis showed that not only festival staff but also visitors recognized the necessity of linking festivals among regions. Both visitors and festival staff had a positive attitude about the effects of the linked festival. In addition, they highly rated the 'World Ceramic Exposition 2001 Korea' as a successful festival. Visitors were satisfied with the festival. Furthermore, the number of visitors was more than staff expected. The organizing committee and staff considered the 'World Ceramic Exposition 2001 Korea' as a successful festival. The successful evaluation of the 'World Ceramic Exposition 2001 Korea' was related to the successful linkage of the festival. This study originated in the increased necessity of linking cultural Tourism Festivals among local governments. Since it is a transcendental study, it is not only significant but also limited. However, in the near future, more varied case studies about the linkages of Festivals will be conducted and these will generalize the results of this study and test the effectiveness of the linkage plans through positive analysis. For the effective linking of festivals among regions, it is necessary to study the definition of factors that affect visitors satisfaction, and determine which methods will improve visitors satisfaction.

      • KCI등재

        음성장애환자 대상 음성피로와 음성평가 간 상관 및 음성피로도 설문(Voice Fatigue Index)의 임상적용

        강영애,장재원,구본석 대한이비인후과학회 2017 대한이비인후과학회지 두경부외과학 Vol.60 No.5

        Background and Objectives Vocal fatigue is a symptom and a term that has been frequently used in the clinical study. Although a recently developed vocal fatigue index (VFI), a self-report questionnaire that reliably identifies vocal fatigue patients, provides detailed characteristics of the symptom, there has been no study about the association between VFI and other voice assessment parameters. This study aimed to investigate whether there is a relationship between VFI and the established voice assessment in Korean patients. Subjects and Method Two hundred fifty-seven patients with voice disorders (mean age, 49.48±14.34; 145 male and 112 female) undertook the voice assessment that consisting of perceptual judgment [Grade, Roughness, Breathiness, Asthenia, Strain (GRBAS) Scale], acoustic and aerodynamic analysis, and voice handicap index (VHI) questionnaire. All patients validated using VFI. Correlation analysis between each voice assessment and VFI was conducted. Results There were statistical significances between items of voice assessment and VFI. Among the GRBAS Scale, G, B, A, S and a number of acoustic measures were associated with vocal fatigue. In particular, these features were prominent in men. As the score of VFI increased, the sound pressure level during voicing and the phonation time from aerodynamic measures were decreased while the mean pitch was increased. In addition, VFI was closely correlated with pre-existing self-report questionnaire and VHI in both gender. Conclusion These findings suggest that VFI has a significant association with pre-established voice assessment. Therefore, VFI can be used as a reliable tool for identifying and validating vocal fatigue in Korean. Korean J Otorhinolaryngol-Head Neck Surg 2017;60(5):232-42

      • KCI등재

        천주가사 <십자풀이가>에서 나타나는 <각설이타령>과의 혼종성

        강영애 한국국악학회 2014 한국음악연구 Vol.55 No.-

        <십자풀이가>는 음악부분에서 연구된 40곡의 천주가사 중 20%가 넘는 비중을 차지하는 중요한 곡이다. 많은 사람들에 의해 애창된 이 곡의 노랫말에는 <각설이타령(장타령)>에서 보이는 “일자나 한자 들고바”가 지속적으로 등장한다. <각설이타령>은 각설이패가 부르던 타령으로 <장타령>이라고도 한다. 본고에서는 이러한 각설이타령과 천주가사의 융합과정에서 빚어진 <십자풀이가>의 배경과 특징을 파악하는 데 주안점을 두었다. <각설이타령>은 19세기에 광대, 각설이패, 풍각쟁이, 초란이 같은 떠돌이 예인들에 의해 각 지역의 <장타령>으로 시작되었다. 그 후 일제강점기와 혼탁한 현실이었던 20세기 초에 숫자풀이 부분과 후렴이 추가되었고, ‘허절시고나 들어간다’는 도입부분도 추가되었다. 경상도에서 가장 많이 불렸으며, 메나리토리의 특징을 지닌다. <십자풀이가>는 <각설이타령>의 도입부나 종결부를 제외하고 숫자풀이 부분만을 따르고 있다. 저작시기는 노랫말과 사회적인 분위기를 토대로 1920~30년대로 추정되며, 저작자는 의식있는 사제나 신앙심이 두터운 신자로 보인다. 사설내용은 천당진복, 예수탄생, 치명복자 등 천주교 교리의 내용이 일부터 십까지의 숫자인 ‘일자나 한자 들고봐, 이자나 한자 들고봐’로 전개되었다. 채록된 노랫말은 가창자별로 약간씩 차이가 나지만, 내용이 바뀌는 정도는 아니다. 음악적으로는 구성음에서 민요 중 경토리와 메나리토리의 특징이 반영되기도 했지만, 선율진행에서는 대부분 정악의 스타일이 나타났다. Sol La do re mi의 5음음계 평조인 곡이 6곡으로 가장 많고, 계면조가 2곡, 메나리토리가 1곡이다. 천주가사 <십자풀이가>의 특징은 단순 반복, 순차진행, 여러 종지음의 출현으로, <각설이타령>의 특징과는 차별화된다. 이는 천주가사가 한국에 정착하는 과정에서 나타나는 혼종성으로 보인다. Sipjapuriga is an important tune (melody) that accounts for more than 20% of the 40 Catholic Verses which has been studied in the music sector. The lyrics, which have been sung by many people, contain the repetitive chorus, “Pick up the number one (일자나 한자 들고봐)” which is also found in Gakseoritaryeong (JangTaryeong). Gakseoritaryeong, a Taryeong sung by beggars, is also known as Jangtaryeong. This study focused on the background and characteristics of Sipjapuriga which was created in the course of the fusion between such Gakseoritaryeong and Catholic Verse. Gakseoritaryeong was started as Jangtaryeong of each region by the wandering entertainers such as clowns, beggars, Pungakjaengi, Chorani, etc., in the 19th century. Later, the number signing part and the refrain part were added in the early 20th century which was the period of Japanese forcible occupation and a period of murky reality. The introductory part, “Hey, let’s start... (허절시고나 들어간다)”, was also added. It was sung most commonly in Gyeongsang province and is characterized by the menaritori. Sipjapuriga follows only the number signing part, except for the introductory or ending part of Gakseoritaryeong. This Sipjapuriga is considered to have been created in 1920s and 1930s based on the lyrics and social atmosphere, and the author of Sipjapuriga is presumed to be a priest or devout faithful person. The lyrical contents were structured primarily around the phrase, “Pick up the number one, and number two (일자나 한자 들고봐, 이자나 한자 들고봐)”, which means the number 1 to 10 of the catholic doctrine, including the heavenly bliss, birth of Jesus, Martyr, etc. The lyrics which were recorded showed some difference, depending on the singers, but such difference was not too significant to change the context of the lyrics. Although the characteristics of gyeongtori and menaritori were reflected in terms of the component sound among the folk songs from the musical perspective, the melody exhibited primarily the Jeongak style. 6 tunes were structured with pyeongjo scale of Sol La do re mi, which accounted for the largest proportion, followed by gyemyeonjo scale with 2 tunes and menaritori with 1 tune. The Catholic Verse Sipjapuriga is characterized by the simple repetitions, consecutive progression, and several ending sound in contrast to the characteristics of Gakseoritaryeong. That is considered to represent the hybridity that emerges from the process by which that the Catholic Verse took root in Korea.

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