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이세련,양덕환,안재숙,김여경,이제중,최영진,신호진,정주섭,조윤영,김종광,손상균,김형준,채이수 대한의학회 2009 Journal of Korean medical science Vol.24 No.3
A refractory and resistant disease to conventional induction chemotherapy and relapsed disease are considered as the most important adverse prognostic factors for acute myeloid leukemia (AML). Sixty-one patients (median age, 33.6 yr) with relapsed or refractory AML were treated with the FLAG regimen that consisted of fludarabine (30 ㎎/㎡, days 1-5), cytarabine (2.0 g/㎡, days 1-5) and granulocyte colony-stimulating factor. Of the treated patients 29 patients (47.5%) achieved complete remission (CR). Higher CR rates were observed for patients with a first or second relapse as compared to patients with a primary refractory response or relapse after stem cell transplantation (HSCT). There was a significant difference in the response rates according to the duration of leukemia-free survival (pre-LFS) before chemotherapy (P=0.05). The recovery time of both neutrophils (≥500/μL) and platelets (≥20,000/μL) required a median of 21 and 18 days, respectively. Treatmentrelated mortality (TRM) occurred in seven patients (11.4%), of which 71.4% of TRM was caused by an invasive aspergillosis infection. After achieving CR, 18 patients underwent consolidation chemotherapy and six patients underwent allogeneic HSCT. In conclusion, FLAG chemotherapy without idarubicin is a relatively effective and well-tolerated regimen for relapsed or refractory AML and the use of FLAG chemotherapy has allowed intensive post-remission therapy including HSCT.
The International Legal Framework for the Protection of Individuals in the Event of Disasters
이세련 충북대학교 법학연구소 2010 法學硏究 Vol.21 No.1
2010년 1월 10일 아이티에서 발생한 지진참사로 인한 재난 복구와 이재민 구호를 위한 유례없는 대규모의 국제적 원조는 재난발생시 국제협력의 중요성을 교훈으로 남겼다. 현재 아이티는 여전히 국제사회의 협력과 도움이 절실히 필요한 상황이다. 국제재난대응체제는 무력충돌의 상황에서 유래하였지만 20세기에 접어들어 자연재해에 대한 구체적인 국제적 대응으로 그 본질이 변화되었다. 현재 국제재난대응법규는 다양한 양자조약 및 지역적 조약을 통해 발전해오고 있다. 특히 2009년 12월 발효된 ‘재난관리와 비상대응에 관한 ASEAN 협정’은 지역적 차원에서 체결되었음에도 불구하고 협정의 당사자에 비국가적 실체를 포함하였다는 점에 주목할 만하다. 현재까지 국제재난대응에 대한 보편적인 조약은 체결되지 않았지만 이로 인해 재난발생시 실질적으로 적용 가능한 법규가 존재하지 않는다는 것을 의미하지 않는다. 국제재난대응법규는 파편화된 체제로 발전해 오고 있다. 따라서 보다 통일적이고 보편적인 국제적 규율체제를 구축하기 위한 목적으로 유엔 국제법위원회는 2006년 ‘재난발생시 개인의 보호’ 라는 주제 하에 연구를 착수한 이래 두개의 보고서를 통해 심도 있는 연구를 지속해오고 있다. 재난발생시 개인의 보호에 대한 국제법적 검토에 있어 먼저 재난’에 대한 정의를 명백히 규정하는 것은 매우 중요하다. ‘재난’의 정의에 따라 국제적 또는 국내적 인도적 대응수준이 결정되기 때문이다. 최든 발생하는 자연재해의 본질상 유엔 국제법위원회가 재난의 발생 원인을 자연재해와 인위적 재해로 구분하지 않은 점은 타당하다고 생각한다. 그러나 재난은 발생원인 뿐만 아니라 재난의 발생규모, 기간, 급격함에 따라 구분될 수도 있다. 유엔 국제법위원회가 제안한 재난은 소위 지진과 해일 같은 급격한 재해에 국한되어 있지만 가문과 사막화과 같은 장기적인 재난 문제도 결코 간과할 수 없을 것이다. 국제재난대응법규와 관련된 몇 가지 핵심쟁점은 국제법의 가장 근본원칙인 영토주권과 국내문제불간섭의 원칙, 국제협력의 원칙, 국제재난구호과정에 참여하는 주체의 인적 및 물적 관할권 문제 등이 포함되며, 특히 국제인권법과의 관계에 있어 개인의 보호와 균형을 이루는 이슈가 발생하기도 한다. 최근 들어 발생한 자연재해에 대한 국제규율체제는 그 규모와 피해에 있어 국제사회의 협력이 필수적임에도 불구하고 무력충돌상황에 적용되는 국제인도법과는 대조적으로 초기단계에 있다. 국제재난대응법규는 다양한 국제적 및 지역적 조약, 유엔의 결의안을 통해 발전을 거듭나고 있으며, 보다 포괄적이고 다국적인 법적 규제가 필요한 현실을 감안할 때 유엔 국제법위원회가 착수한 “재난발생시 개인의 보호”에 대한 연구는 파편화된 국제재난대응체제를 보편적 차원으로 발전시키는데 매우 중요한 역할을 수행하고 있다.
The Feasibility of Reforming the UN Security Council: Too Much Talk, Too Little Action?
이세련 (사) 이준국제법연구원 2011 Journal of East Asia and International Law Vol.4 No.2
While a broad consensus exists over the necessity of reforming the Security Council,the disagreement among the different groups of member States prevails in great partdue to the enlargement and category of membership and the working methods. Suchdivergence in views attributed to the stalemate in the debate over the SecurityCouncil’s reform. However, the recent discussion has gained momentum since thelaunch of the intergovernmental negotiation at the UN level. The key issuessurrounding the UN Security Reform include the size of an enlarged Council,categories of membership with proper regional representation, the veto, workingmethods and relations with the General Assembly. It is essential not only to properlyassess the content of the different proposals to bring out the most‘ sensible’solution,but the attitude of the five permanent members should also be closely examined. Inany case, the potential changes in the structure of the Security Council wouldultimately require a unanimous decision of the 5P States. This article aims to reviewthe historical development of the Security Council’s reform debate and concentrateon the most contentious questions by analyzing the content of the relevant proposalsto test the feasibility of each option.
오락성을 향한 여정: 챕북과 탄생기 아동문학의 발달 과정과 상호성
이세련 한국18세기영문학회 2020 18세기영문학 Vol.17 No.2
This paper explores the complex relations between the emergence of the middle class, commercial market and children’s literature as entertainment takes its place firmly alongside instruction. It is widely accepted that children’s literature as a separate genre of writing began in the eighteenth century as part of the modern idea of the child and childhood that emerged in the same period. John Newbury stands at the very beginning of this new development with the publication of his Little Pretty Pocket Book (1744), in which he states the two purposes of his book: instruction and amusement. The tradition of didacticism has always been strong in books that children were encouraged to read, and in the eighteenth century increasingly it served through education to meet the goal of the new middle class. But at the same time, popular literature that included fairy tales, medieval romances and fables, provided mainly through chapbooks, had been steady reading materials for children although they were considered dangerous as providing merely pleasure and amusement. However in the eighteenth century, pleasure/entertainment found a legitimate way into children’s literature as popular tales assimilated some didactic elements to become more respectable. Behind this change in favour of entertainment is the emergence of the commercial market in which children’s books became a highly valued commodity.
이세련,최호준,이병현,강가원,유은상,김대식,박용,최철원,김병수,성화정 대한내과학회 2019 The Korean Journal of Internal Medicine Vol.34 No.6
Background/Aims: Bortezomib plus melphalan-prednisone (VMP) is a standard treatment for multiple myeloma, particularly for patients who are ineligible for high-dose therapy. However, early discontinuation or treatment modification is often needed owing to adverse events. The aim of this study was to investigate the clinical outcomes of modifying the dose of melphalan-prednisone (MP) in patients receiving VMP. Methods: We examined 67 patients who received a modified dose of MP, and 38 patients who received the regularly planned dose of MP. We then analyzed clinical differences between the groups. Results: Although there was no difference in the proportion of discontinuation due to adverse events between dose groups, more patients in the planned-dose group experienced earlier discontinuation in general. The overall response rate (ORR) was 81.0% and complete response (CR) rate was 30.5%. After a median 15.7 months of follow-up, the median progression-free survival (PFS) and overall survival (OS) were 25.0 and 47.8 months, respectively. There was no significant difference in the ORR, CR, PFS, and OS of the two dose groups. A median of four cycles were delivered, and the median cumulative bortezomib dose was 41.6 mg/m2. The median PFS in patients with doses ≥ 41.6 mg/m2 was longer than that in patients with doses < 41.6 mg/m2 (35.1 months vs. 9.6 months). However, when MP was < 50% of the planned dose, PFS and OS were poor. Conclusions: Modifying the dose of MP might be a feasible and effective therapeutic approach for multiple myeloma patients receiving VMP treatment.