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It was in 1910s of the history of Korean modern poetic literature that new contents and forms of poetry had begun to be explored and practiced, though traditional poems and songs had been yet enjoyed in those days. In this history of literature it is enough to be remarkable that Earck Kim had provided the symbolic poetics for a found of the Korean modern poetry in 1910s. Earck Kim's literary activities whose had received and created the symbolic poetics were particularly to be remarkable in the early new-literature. But with these fruits his literature has debated as limits about how he had preponderately received poetry of P. M. Verlaine, and had tended to a senumentality and an musicality. Contrary, his literature also has appraised that he had suggested rules of set-form so called the ‘rhythmical poetics’ in 1930s against a superficial understanding about the receiving symbolism. This study has seen these characters of Earck Kim not as a limit or a fault of the receiving it but as a speciality and a personality of it, and even has illuminated objective and subjective elements which had these characters of him. For this study has laid a comparative literary view by using a framework(or methodology) that those elements have determinated a character of the receiving it according as D. Durisin had suggested the progressive study of the receiving. If the objective elements are to be a whole literary situation of one state receiving it, then the subjective elements are to be personality, individuality, creativity, and like of the literator in the state. By the way theories of Pierre Bourdieu's the ‘literature champ' and the ‘habitus' have been used as scientific epistemology and methodology in order that this study has explained stricter and more dynamic relationships how the subjective elements of literary subjects have been involved in the objective situations, and how they have determinated a character of the receiving it. For it has been to be thought effective how the ‘litterature champ' has been used to explain the objective elements of the receiver contacting them, and how the 'habitus' to explain the subjective elements of the receiver-self. With these methodologies this study has first examine on building up the ‘litterature champ' in 1910s and its characters as the objective elements of the receiving. And this study has concretely inquired Earck Kim’s poetic tendency which had regarded importantly sentimentality and emotion of ones as the subjective elements, his experiences of learning in and out Korea, and contents of learning about symbolism in Japan. Second, this study has tried to rethink a bout Earck Kim's the receiving symbolism based on above results. Anyway, his preponderantly receiving Verlaine could have been issued not from the lack of his power of the receiving symbolism, but from that symbolism had been harmonized with Earck Kim's personal poetic taste. His groping for a modern from of poetry also has been generated in a reflective thought against the utility litterature champ in which had been fixed the literary topical consciousness. And the rhythmic poetics which had tried to seek for rules of our language in 1930s has been turned out to be an inheritance from his inquiry of poetic farms before. Finally, Earck Kim had opened the individuals eyes into their self-consciousness through stimulating their emotions when the utility ideology had been emphasized. Consequently, Earck Kim in 1910s had obviously shown a direction of future lyrics through his reflection on the literature of the day in terms that he had made a fixed directive point toward the excluding thoughts and meanings from his poetry and the seeking for musicality in it, and that he had enlightened new poets on lyricism as their poetic defect.
남북한 문학사에서 김북원에 대한 소개 및 평가는 해방 전 문학성과를 봉인한 채, 한국 전쟁기 이후의 성과에 집중되어 왔다. 이는 해당 작가의 자료를 남한과 북한이 비교 논의하지 않았기 때문이다. 이에 본 연구에서는 김북원의 해방 전 문단 활동이 비교적 일찍부터 시작되었음을 필명을 찾아 밝히고 창작의 영역이나 경향 역시 다양했음을 자료 발굴 및 제시를 통해 논의함으로써 김북원에 관한 전체적 연구의 토대 마련을 시도했다. 그간 남한의 아동문학사에서 『별나라』에 실린 아동소설 및 동시의 작가로 알려진 필명 ‘북원초인’이 김북원임을 북한의 아동문학사와 비교하고, 1930년대 김북원의 농업학교 재직 경험 등을 통해 밝혔다. 그리고 소설로 알려진 「완구」가 꽁트임을 밝혔고, 『삼천리』에 추천된 「유랑민」이라는 소설을 통해 김북원이 당대 노동자로 전락하는 농민의 삶을 핍진하게 그림으로써 이후 북한문단에서 농촌작가라는 평가의 단초를 읽을 수 있었다. 『신인문학』이나 『시인춘추』 등에 발표한 김북원의 시를 최초로 소개했고 1930년대 후반 『맥』과 1940년대 『시현실동인』으로서 초현실주의와 포르말리즘의 작품 창작 및 이론을 고찰함으로써 1930년대 초반 초현실주의 및 모더니즘을 이론적, 지역적으로 확장하여 만주모더니즘을 선도한 작가임을 밝혔다. 1943년까지 초현실주의 시의 창작방법론을 시도했던 김북원은 해방기에는 북한 문단의 정책과 변화하는 현실의 요구에 맞는 작품들을 창작했다. 김일성에 대한 찬양을 기본 골자로 하면서, 농촌의 토지개혁, 빨치산 전투에 참여한 영웅적 주인공, 노동 현장의 변화, 소련과의 친선 등 북한의 중요한 이슈들을 시화했다. 이상과 같은 논의를 통해 식민지 시기와 해방기 이후 김북원의 문학 활동의 연속성을 확보함으로써 남북한 문학사에서 김북원에 관한 전체적인 평가의 토대가 구축될 수 있었다. In the history of North and South Korean literature, the introduction and evaluation of Kim Buk-won has focused on the achievements after the Korean War, sealing the literary achievements before liberation. This is because both South Korea and North Korea did not discuss comparative resources of the author. In this study, research on Kim Buk-won was attempted for the first time by unveiling that Kim Buk-won’s preliberation literary activities had started relatively early by finding his pen name, and by discussing that his creative territory or tendency were also diverse through data supplement. This study uncovers that the author of children’s stories and poetry published in The Land of Stars (별나라 Byeolnara) in the history of children’s literature in South Korea, under the pen name “Buk-won-cho-in” was in fact Kim Buk-won by comparing Kim’s identity with the history of children’s literature in North Korea, and through Kim’s experience working in agricultural school in the 1930s. Moreover, I uncover that the work, Toy (Wan-gu) that was known as a novel, was in fact a conte (short story), and was able to read the start of the assessment of Kim Buk-won as an agricultural writer in the North Korean literary circle after depicting the lives of farmers turning into laborers in the novel Nomads (Yurangmin), which was nominated in The Land of Korea (삼천리 Samcheolli).Kim Buk-won’s poetry, which was published in New Face of Literature (신인문학 Sininmunhak) or Spring and Fall of Poets (시인춘추 Siin chunchu), was first introduced and discussed in this study. By reviewing the creation and theories of Maek in the late 1930s and ‘Poetry Reality Coterie’ in the 1940s, it became possible to evaluate that Kim was a writer led Manchurian Modernism, by theoretically and geographically expanding surrealism and modernism in the 1930s. Kim Buk-won, who tried to create surrealistic poetry creative methodology by 1943, created works that fit the policies of North Korean literary circles and the demands of changing reality. With the praise of Kim Il Sung as the basic framework, he has poeticized North Korea’s major issues such as land reform in rural areas, the heroic protagonist who participated in the battle of partizan, changes in the workplace, and goodwill with the Soviet Union. Through these discussions, I believe that securing of the continuity of Kim’s literary activities after the colonial period and the liberation period, and the complete description of the history of literature in North and South Korea became possible.
In the beginning of the Korean modern literature since 1910's, Kim Eok played a crucial role as a translator for foreign literature and theory. During the acceptance of foreign literature, Kim realized the importance of translation and he is considered an intellectual who, as opposed to other contemporary translators, performed a bulk of translations from various countries. He was in the lead of balancing content and form, reforming he literary circles of translation in which there was abundance of arbitrary interpretations and content-concentrated translations. However, Kim Eok's translated works have been devalued by reason of erroneous and liberal translation of original works and inapt understanding. Researchers generally examine original and translated texts in tandem, after which they point out problems of the translations and attribute them to the translators' lack of capacity. The study of this paper presupposes that in-depth understanding of translated texts can be carried out only when the theory and practice of translation go in parallel. It argues that the negative evaluation for Kim's translations can be reconsidered through the study of theory. Kim argued for 'creative liberal translation,' and this paper investigates the formation and characteristics of this standpoint. This paper particularly looks into how symbolism, which Kim embraced, influenced Kim's view on translation. The acceptance of symbolism and the theory of translation are discussed in regard to the theory of translation maintained by Bejamin, a German literary critic who lived around the same time, in his book The Task of the Translator. The paper also examines Kim Eok's theory of translation in the sense that the act of translating foreign languages expands and deepens a mother tongue, which provides an opportunity to form and develop the self-identity. Kim's viewpoint on translation, which searches for the nature of poems, found modern poetic language for the Korean poetry, which was possible due to his exploration into language that represents this nature. Translating the western poems in the initial stage of modern literature implies admission and conveyance of heterogeneous culture, beyond simple written text, and creation of new culture. Kim Eok's translated works shows the creativity of cultural translation that is generated at the intersection of internal and external cultures. The literary world after 1920's, via translations, could realize the identity of modern literature by means of dialogue with others, i.e. dialogue between tradition and the West. Furthermore, it could have a foundation in creation of new culture. Along these lines of modern literature, Kim Eok's theory of translation presented ‘creative liberal translation’ and ‘creative translation’ as the task and direction for those who do the translation, including himself. It was an aspect of cultural action that Kim's theory evidently showed through translation.
2011-2015년까지 경남 하동군 악양 집수역의 해발고도 8~1,073m 범위에 설치된 10개 무인기상관측기에서 0600, 1500 기온 관측값을 수집하여 월별 표준편차를 계산하고, 소기후모형으로부터 예측된 기온의 표준편차 결과를 함께 비교하여 미관측 지점의 추정기술에 실효성이 있는지 평가하였다. 소기후모형에 따른 예측값은 월별 0600, 1500 기온의 표준편차를 각각 88%, 86% 정도 설명할 수 있었지만, 전반적으로 과소추정하는 경향이었다. 겨울철과 여름철에 나타나는 낮은 고도 대비 해발고도가 높아질수록 변이가 작아지거나 커지는 방향성에 있어서 관측값과는 반대양상으로 나타나 당초 기대와는 다른 결과를 보였다. 또 다른방법으로 월별 기온 표준편차와 지형간의 관계를 정량화하여 임의지역의 지형특성과 종관규모 수준의 기온자료 만으로 표준편차 분포를 예측할 수 있을지 회귀분석을 수행하였다. 회귀모형은 해발고도편차에 따라 보정된 월별 기온 외에, 경사도와 경사향 등 기본적인 지형인자와 온난대효과와 냉기집적효과, 개방도 등의 기온과 관련된 변수들을 고려하여 월별로 표준편차를 가장 잘 설명할 수 있는 변수를 1~3개까지 선발하여 만들어졌으며, 월별 결정계수는 0.46부터 0.98 범위로 나타났다. 회귀모델을 이용해 기온이 관측되지 않는 임의지역의 표준편차를 지형변수의 최소-최대값 유효범위 내에서 월별로 예측한다면 70% 수준의 추정능력으로 공간변이 분포도를 나타낼 수 있을 것으로 예상된다. The distribution of inter-annual variation in temperature would help evaluate the likelihood of a climatic risk and assess suitable zones of crops under climate change. In this study, we evaluated two methods to estimate the standard deviation of temperature in the areas where weather information is limited. We calculated the monthly standard deviation of temperature by collecting temperature at 0600 and 1500 local standard time from 10 automated weather stations (AWS). These weather stations were installed in the range of 8 to 1,073m above sea level within a mountainous catchment for 2011-2015. The observed values were compared with estimates, which were calculated using a geospatial correction scheme to derive the site-specific temperature. Those estimates explained 88 and 86% of the temperature variations at 0600 and 1500 LST, respectively. However, it often underestimated the temperatures. In the spring and fall, it tended to had different variance (e.g., increasing or decreasing pattern) from lower to higher elevation with the observed values. A regression analysis was also conducted to quantify the relationship between the standard deviation in temperature and the topography. The regression equation explained a relatively large variation of the monthly standard deviation when lapse-rate corrected temperature, basic topographical variables (e.g., slope, and aspect) and topographical variables related to temperature (e.g., thermal belt, cold air drainage, and brightness index) were used. The coefficient of determination for the regression analysis ranged between 0.46 and 0.98. It was expected that the regression model could account for 70% of the spatial variation of the standard deviation when the monthly standard deviation was predicted by using the minimum-maximum effective range of topographical variables for the area.
Korean Food Globalization has been launched as a tool of civil ambassador and the high value-oriented industry. According to department of statistics in 2012, the trend of Korean food globalization from international visitors of Chinese and Japanese has grown. Hence, this study is purposed to identify the level of satisfaction of Chinese and Japanese consumers based on their food-related lifestyle. The survey was conducted by interviewing 403 Chinese and Japanese visitors who have experienced Korean food. The survey questionnaire was composed of 3 parts of demographic information, food-related lifestyle, and satisfaction of Korean restaurant. As factor analysis results, 3 factors were yielded for the food-related lifestyle factors-a eat-out preferred group, a health preferred group, and a taste preferred group, and 3 factors were generated for Korean restaurant satisfaction-hygiene and service, menu, and food quality. For cluster analysis, 3 clusters were identified as follows: high interested in food itself, health interested, and taste interested. Female appears to be significantly different in terms of 3 clusters than male. Nationality shows that Chinese consumers showed a high interest in food itself whereas Japanese consumers were high interested in health. With regard to Korean restaurant satisfaction, service appeared to be important in Chinese consumers while Japanese consumers showed a higher mean value on serving size, price, and nutrition. The findings concluded that by understanding the nature of food-related lifestyle of international visitors, marketing strategies can better meet visitors' expectations and increase their satisfaction with Korean restaurants.
청록파는 한국시문학사에서 '자연'에 관한 전통적인 서정을 구현한 주요한 유파로 평가되어 왔으며,『청록집』역시 자연시의 '정전'으로 인식되어 왔다. 이런 평가는 청록파가 1930년대의 순수문학을 계승하여 한국시의 '순수서정'을 심화, 발전시켰다는 문학사적 평가의 적극적 계승에 의해 지속되었는데, 이는 중심 문단의 문학적 권위와 미학이 문학사적 평가의 중심에 서 있었기 때문이기도 한다. 본 연구는 문학사에서 정전으로 인식되어 온 청록파의 위상을 비판적으로 검토하면서 한국근대시사에서 자연시 장르의 특성과 문학사적 의의를 고찰하고 있다. 청록파와 전통 자연을 관련시켜 최초로 문학사적 평가를 내린 김동리의 해석이 지속적으로 문학사의 권위로 작용하면서 후대 연구자들의 평가에 영향을 주었음을 비판적으로 고찰하고 있다. 또한 나아가 이런 비판적 이해를 바탕으로 실제적으로 어떤 측면에서 청록파가 전통과 관련되고, 당대의 자연시와는 어떤 관련성을 가지면서 자신들의 독자적인 미학을 갖는지 설명하고 있다. 문학적으로 자연에 관한 전통적인 사유란 시에 자연을 중심에 두는 것이다. 그런데 청록파 시인들의 작품을 분석해보면 시적 자아인 '나'의 정서를 투영하고 있다. 그들은 자연 그 자체의 본질을 통해 인간과 관련된 생에 대한 윤리나 삶의 가치를 드러내기보다는 시인 자신의 정서를 투영하기 위한 대상으로 등장시키고 있다는 점에서 근대적이다. 청록파 시인들을 추천한 정지용은 '신'(新)이라는 수식어를 통해 이들의 미학이 기존의 미학과는 다르다는다는 점을 강조했다. 그럼에도 이들의 자연을 전통과 관련시키면서 민족, 향토 등을 환기시키는 것은 정치적, 이념적으로 관념화된 해석과 평가를 무비판적으로 계승한 것이다. 한편 생명의 공간으로 비유되는 자연이 현실이 배제된 초역사, 초현실의 탈역사성을 환기시킨다는 점은 한국 자연시 장르 전반의 탈역사성에 영향을 주고 있다. 또한 현실과 유리된 자연 공간과 여성성이 관습적으로 연결됨으로써 여성성을 탈역사화, 탈정치화 시키고 있을 뿐만 아니라 '자연-여성' 공간을 외세와 근대, 남성의 수탈 공간으로 정당화하고 있다. 때문에 1950년대 이후 시문학사에서 서정-자연시는 역사나 현실사회의 변화와는 유리된 지점에 위치하게 되었으며, 반드시 '순수'의 이름으로 정치, 사회적 현실과는 유리된, 내면화되고, 여성화된 미학적 표현이라는 장르적 특성을 갖게 되었다. 이런 논의들에 대한 비판적 고찰을 토대로 자연과 청록파를 재고할 때 그들의 시는 근대서정시의 리리시즘과 애상성, 그리고 환상성과 여성적인 자연에 대한 그리움의 미학을 보여주고 있다. 이런 특성은 정지용이 지적한 바, 신(新)자연으로 시문학사에서 '자연'의 전통을 창조한 것으로 평가할 수 있을 것이다. The school of Chenglok has been evaluated as a principal school which realized the traditional lyricism on the 'nature' in the history of the Korean poetry, and Chenglokcip (collection of Chenglok poems) has also been recognized as the canon of nature poems. This assessment was made possible by the positive succession to the literary criticism that the school of Chenglok inherited the 'pure literature' of the 1930s and deepened and developed the 'pure lyricism' of the Korean poetry. This can be ascribed to the fact that the literary authority and aesthetics of the central literary world were crucial for historical evaluation of literary schools. The study of this paper examines the genre characteristics of nature poems and their literary implication in the history of modern Korean poetry, while critically reconsidering the status of the Chenglok school which has been canonized in the history of literature. In this light, a critical investigation is made into Donglee Kim's interpretation which initially defined the Chenglok school with regard to the traditional nature, and which in turn continuously serves as such an authority for the literary history that influences on the later researchers' evaluations. Based on this critical understanding, an account is presented as to how the Chenglok school could hold its own unique aesthetics while having substantial relevance to the tradition and the contemporary nature poems in one way or another. In terms of literature, thoughts on the nature is traditionally defined as putting the nature in the center of poem. However, the works by the Chenglok school reflect the sentiment of the poetic ego, 'I.' Rather than revealing the ethics or values of human life via the essence of the nature itself, they exploit the nature as an object on which the poet himself can reflect his feelings. In this sense, they can be called modernistic. Jiyong Jung, who recommended the Chenglok poets, emphasized that their aesthetics is different from the existing one by using a modifier, 'new.' Albeit that, their reminding of the nation and native land by virtue of associating the nature with tradition is uncritical inheritance of the politically, ideologically ideated interpretation and evaluation. On the other hand, their poems influence on the de-historicization of the Korean nature poetry in general in that the nature, which is likened to the space of life, is reminiscent of de-historicization, i.e. sur-historicism and surrealism to the exclusion of reality. In addition, the space of nature, which is isolated from reality, and femininity are conventionally connected to the extent that it made femininity de-historicized and de-politicized, not only did it justify the space of 'nature-woman' as the space to plunder for outside power, modernism, and manhood. Therefore, the lyric nature poetry has been viewed as alienated from history and reality since 1950s in the history of poetic literature. It came to have the genre characteristics of internalized and feminized aesthetic expression which, necessarily in the name of 'purity,' is removed from political, social reality. Based on critical investigation of these discussions, reconsideration of the nature and Chenglok school reaches a conclusion that their poems show the aesthetics which includes the lyricism and lamentation of modern lyric poems, fantasy, and yearning for the feminine nature. This characteristic, as Jiyong Jung pointed out, can be evaluated as having established a tradition of 'nature' as new nature, in the history of poetry.
김진희,함명일,박은철,박재현,박종혁,김성은,김성경,Kim, Jin-Hee,Hahm, Myung-Il,Park, Eun-Cheol,Park, Jae-Hyun,Park, Jong-Hyock,Kim, Sung-Eun,Kim, Sung-Gyeong 대한예방의학회 2009 Journal of Preventive Medicine and Public Health Vol.42 No.3
Objectives : The objective of this study is to estimate the economic costs of cancer on society. Methods : We estimated the economic burden of people with cancer in South Korea. To perform the analysis, we reviewed the records of people who were cancer patients and those who were newly diagnosed with cancer. The data was compiled from the National Health Insurance Corporation, which included the insurance claims database, a list of cancer patients, a database that records the cancer rates, the Korea Central Cancer Registry Center s cancer patient registry database and the Korea National Statistical Office s causes of death database. We classified the costs as related to cancer into direct costs and indirect costs, and we estimated each cost. Direct costs included both medical and non-medical care expenses and the indirect costs consisted of morbidity, mortality and the caregiver's time costs. Results : The total economic costs of cancer in South Korea stood at 14.1 trillion won in 2005. The largest amount of the cost 7.4 trillion won, was the mortality costs. Following this were the morbidity costs (3.2 trillion won), the medical care costs (2.2 trillion won), the non-medical care costs (1.1 trillion won) and the costs related to the caregiver's time (100 billion won). As a result, the economic cost of cancer to South Korea is estimated to be between 11.6 trillion won to 14.1 trillion won for the year 2005. Conclusions : We need to reduce the cancer burden through encouraging people to undergo early screening for cancer and curing it in the early stage of cancer, as well as implementing policies to actively prevent cancer.
과학기술의 발전과 정보화와의 급진전을 토대로 기술적 지식이 가치창출의 핵심요소로 대두됨으로써 기업환경이 급속한 변화하고 있다. 이러한 환경 하에서 생존하고 성장하고 있는 혁신 형 중소기업에 대하여 관심을 갖고 이들의 생존과 성공비결을 연구하는 것은 중요한 연구과제가 아닐 수 없다. 본 연구는 이러한 혁신 형 중소기업의 성공요인에 대한 선행 연구를 고찰하면서 많은 선행 연구들의 이론적 고찰을 경험하였다. 이러한 선행연구를 바탕으로 사례연구를 위한 이론적 모형을 설정하고, 이를 바탕으로 실제 사례를 통해 검증해 봄으로써 혁신 형 중소기업의 성공요인에 대해 보다 깊이 있게 접근할 수 있었다. 본 연구에서는 선행연구의 검토결과와 연구 과제를 토대로 도출된 주요 성공요인들인 기업가의 특성, 환경특성, 전략특성 조직의 자원과 역량특성 등을 중심으로, 재경부산하 신용보증기관에서 신용보증 받은 기업 중 안정된 성장세를 시현하고 있는 세 개 기업의 사례조사를 통해 검증함으로써 혁신 형 중소기업의 경영성과에 미치는 요인들을 탐색적으로 규명함으로써 혁신 형 중소기업 창업자 및 정책지원업무 관련자에게 시사점을 제공하고자 하였다. To achieve the age of 30,000 dollars GNP, The business with speed will hold a more crucial point than the business with scale, and the mass consumption market will be transformed and changed into the niche market. Moreover, it will not be easy for the company without the peculiar and creative technology to survive in the severe competition. Under these circumstances, The innovative company which knows how to use this new paradigm will select the better position in the changing market. Innovation type SMEs are contributing in maintaining the international competitiveness of domestic economy by serving high-tech and the promotion of employment. Also, Innovation type SMEs have the most important economic leverage in our domestic economy. It's a source of the growth in domestic economy. Therefore, A lot of countries have been trying to support innovation type SMEs (with a small capital and high-tech). And many countries also try to protect and promote the innovation type SMEs. Especially the Korean government is also promoting innovation type SMEs in many ways, because the future of innovation type SMEs are not bright. This study explored the three innovative SEMs and studied 1) entrepreneur characteristics, 2) the industry environment, 3) competitive strategies, and 4) resources and capabilities of organization, which have been considered as the success factors for entrepreneurial firms. This study also holds that the characteristics of entrepreneurs is one of the most important factor to impact the success of innovative SMEs. Most of entrepreneurs have started their business with high education career and field experiences and have high intentions in developing new/high techonologies, challenging spirits, and clear vision and goals. The innovative SMEs with small kinds of products and services, narrow market, and small resources are more sensitively impacted by the environment especially. But the SMEs which entered into market early could have the comparative excellencies in their market to survive and grow in the future. They also have competitive advantages in the market using differentiation strategies by technology innovation. Technology innovation and differention strategies are one of the success factors in SMEs, They entered into the niche market using this weapons. The capabilities of changing organization to their changing environment, the open orgarnization culture, the continuous employment education, and the building the organic organization are also success factors of innovative SMEs. The SMEs with the simple organization structure can make fast decisions and operate with the autonomous and flexible ways. These only three cases will not shown successful factors of over 12,000 Innovation type SMEs in Korea and this study of Innovation type SMEs is insufficient from all aspects. But this study have many implications for the future research and the entrepreneurs ready for their business.
목적 : 초기 유방암 (병기 I, II)에서는 유방 보존 수술과 방사선치료가 선호 받고 있는 치료법이다. 본원에서는 1992년부터 이러한 방법을 시행 중이며 실패양상과 미용효과 및 생존률을 알아보고자 하였다. 대상 및 방법 : 1992년 1월부터 1997년 12월까지 계명대학교 동산의료원에서 유방 보존 수술과 방사선치료를 받은 초기 유방암환자 72명을 대상으로 하였다. 연령분포는 $25\~77$세(중앙값 43세)이었고 TNM 병기는 0기 5명, I기 33명, IIa기 25명, IIb기 9명이었다. 모든 환자는 유방의 부분절제술과 동측 액와림프절 곽청술을 시행하고 방사선치료를 하였다. 유방의 방사선치료는 동측 전체 유방에 6 MV 광자선으로 $50\~54\;Gy$를 5주에서 6주간에 조사하였고 원발병소에 추가 방사선은 전자선으로 $10\~16\;Gy$를 1주에서 2주간 조사하였다. 항암화학요법은 41명에서 방사선치료 전후에 시행하였다. 미용효과는 환자의 만족도를 매우좋음, 좋음, 만족할만함, 불만족의 4단계로 설문조사를 시행하였다. 추적관찰기간은 22개월에서 91개월로 중앙값이 40개월이었다. 결과 : 전체환자의 5년 무병생존률은 $95.8\%$ 이었다. 병기별로는 0기에는 $100\%$, I기에는 $96.9\%$, IIa기에는 $96\%$, IIb기에는 $88.9\%$이었다. 2명에서 원격전이가 있었으며 1명에서 동시재발이 있었다. 원격전이 환자 중 1명에서는 방사선 치료 후 14개월에 골, 간에 있었고 1명에서는 21개월에 폐와 양측 쇄골상 림프절에 전이되었다. 동시재발환자는 14개월에 동측 유방의 다른 사분역에 재발하여 유방전절제술과 항암화학요법을 시행하고 44개월에 뇌전이로 방사선치료와 항암화학요법을 시행하였으나 55개월 째 사망하였다. 부작용으로는 4명에서 무증상의 폐렴양 음영이 흉부 X선 촬영에서 보였고 1명에서 증상을 동반한 방사선폐렴이 있었고 4명$(5\%)$에서 경미한 정도의 손부종이나 팔 부종이 있었다. 미용결과는 설문에 응답한 59명중 51명$(86\%)$에서 좋음에서 매우 좋음으로 나타났다. 결론 : 이상의 결과로 초기 유방암에서 유방보존수술과 방사선치료는 안전한 치료방법이며 우수한 생존률과 미용 결과를 보인다고 생각되며 향후 장기추적관찰을 통해 예후 인자의 분석이 필요 할 것으로 사료된다. Purpose : To evaluate interim results in terms of failure, cosmetic results and survival after breast conserving operation and radiation therapy in early breast cancer. Material and Methods : From January 1992 through December 1997, seventy two patients with early stage 0, I and II breast cancer were treated with conservative surgery plus radiotherapy at Keimyung University Dongsan Medical Center. Age distribution was 25 to 77 years old with median age of 43. According to TNM stage, five patients had stage 0, thirty three were stage I, twenty five were IIa, and nine were IIb. Most patients underwent excision of all gross tumor and ipsilateral axillary dissection. Breast was irradiated through medial and lateral tangential fields of 6 MV photons to 50.4 Gy in 28 fractions over 5.5 weeks. We delivered a boost irradiation dose of 10 to 16 Gy in 1 to 2 weeks to excision site. Adjuvant chemotherapy was administered in forty one patients with CMF (cyclophosphamide, methotrexate, 5-fluorouracil) regimens of 6 cycles concurrently or before radiation. Cosmetic results were assessed by questionnaire to patients grading of excellent, good, fair, poor. Follow-up periods were 22 to 91 months with median 40 months. Results : Five year disease free survival rate (5YDFS) was $95.8\%$. According to stage, 5YDFS was $100\%,\;96.9\%,\;96\%\;and\;88.9\%$ in stage 0, I, IIa and IIb, respectively. Two patients had distant metastasis and one had local and distant failure. One patient with distant failure had bone and liver metastasis at 14 months after treatment and the other had lung and both supraclavicular metastasis at 21 months after treatment. Patient with local and distant failure had local recurrence on other quadrant in same breast and then salvaged with total mastectomy and chemotherapy but she died due to brain metastasis at 55 months. Complications were radiation pneumonitis in five patients (four patients of asymptomatic, one patients of symptomatic) and hand or arm edema(4 patients). Fifty nine patients answered our cosmetic result questionnaire and cosmetic results were good to excellent in fifty one patients $(86\%)$. Conclusion : We considered that conservative surgery and radiation for the treatment of early stage invasive breast cancer was safe and had excellent survival and cosmetic results. We need to assess about prognostic factors with longer follow up and with large number of patients.
목적 : 진행된 자궁경부암에서 방사선치료 단독과 비교하여 항암화학요법과 방사선 병용치료의 성적을 후향적으로 분석하였다. 재료 및 방법 : 계명대학교 동산의료원 치료방사선과에서 1988년 6월부터 1993년 12월까지 FIGO병기 IIb, III, IV자궁경부암으로 근치적 방사선치료를 받은 76명의 환자를 대상으로 하였다. 모든 환자는 외부방사선치료와 강내방사선치료를 시행받았다. 방사선 단독으로 치료한 환자는 36명이었고 Cisplatin을 포함한 항암화학요법후 방사선치료를 시행한 환자는 40명이었다. 병기는 FIGO 분류상 IIb가 48명. IIIa가 3명, IIIb가 23명, IVa가 2명이었고 환자의 평균 연령은 53세이었고 환자의 추적기간은 7개월에서 95개월로 중앙추적기간은 58개월이었다. 결과 :완전관해는 방사선치료 단독군은 31명$(86.1\%)$, 병용치료군은 32명$(80\%)$로 통계적으로 유의한 차이가 없었다. 전체 환자의 5년생존률은 $67.3\%$이었고 병기별 5년 생존률은 IIb가 $74\%$, IIIa는 $66.7\%$, IIIb는 $49.8\%$, IVa는 $50\%$이었다. 치료방법에 따른 5년생존률은 방사선치료단독군은 $74.1\%$, 병용치료군은 $61.4\%$(P=0.4)로 통계적으로 유의한 차이가 없었다. 5년 무병생존률은 방사선치료 단독군은 $65.8\%$, 병용치료군은 $57.5\%$(P=0.27)이었고 5년 국소제어률은 방사선치료 단독군은 $71.5\%$, 병용치료군은 $60\%$(P=0.17)이었으며 5년 원격제어률은 방사선치료 단독군은 $80.7\%$, 병용치료군은 $89.9\%$(P=0.42)이었다. 치료에 따른 골수억제는 방사선치료 단독군에서 4명 $(11.1\%)$, 병용치료군에서는 9명$(22.5\%)$가 관찰되었다. Grade 11 방광염이 방사선치료 단독군에서 2명에서 관찰 되었고 grade II 직장염이 방사선치료 단독군에서 2명, 병행치료군에서 2명, 외과적 수술이 필요했던 직장천공 1명과 보존적으로 치료된 장폐쇄 1명이 방사선치료 단독군에서 관찰되었다. 치료에 따른 부작용은 양군간에 유의한 차이가 없었다. 결 론:진행된 자궁경부암에서 방사선치료 단독군과 비교하여 항암화학요법과 방사선 병용요법이 생존률, 치료실패, 부작용 등에 영향을 미치지 않았다. Purpose : This is retrospective study to compare the results of radiation therapy alone and neoadjuvant chemotherapy and radiation in advanced stage of uterine cervical cancer. Materials and Methods : Seventy-six Patients who were treated with definitive radiation therapy for locally advanced cervical cacinoma between June 1988 and December 1993 at the department of radiation oncology, Keimyung University Dong-san Hospital. Thirty six patients were treated with radiation therapy alone and forty patients were treated with cisplatin based neoadjuvant chemotherapy and radiation therapy. According to FIGO staging system. there were 48 patients in stage IIb, 3 patients in stage IIIa, 23 patients in stage lIIb and two patients in stage IVa with median age of 53 years old. Follow-up periods ranged from 7 to 95 months with median 58 months. Results : Complete response (CR) rate were $86.1\%$ in radiation alone group and $80\%$ in chemoradiation group. There was no statistical difference in CR rate between the two groups. Overall five-year survival rate was $67.3\%$. According to stage, overall five-rear survival rates were $74\%$ in stage IIb, $66.7\%$ in stage IIIa, $49.8\%$ in stage IIb, $50\%$ in stage IVa. According to treatment modality overall five year survival rates were $74.1\%$ in radiation alone and $61.4\%$ in chemoradiation group (P=0.4) Five rear local failure free survival rates were $71.5\%$ in radiation alone group and $60\%$ in chemoradiation group (P=0.17). Five year distant metastasis free survival rates were $80.7\%$ in radiation aione group and $89.9\%$ in chemoradiation group (P=0.42). Bone marrow suppression (more than noted in 3 cases of radiaion alone group and 1 case of chemoradiation group. Grade II retal complication was noted in 5 patients of radiation group and 4 patients In chemoradiation group. Bowel obstruction treated with conservative treatment (1 patient) and bowel perforation treated with surgery (1 patient) were noted in radiation alone group. There was no statistical difference in complication between two groups. Conclusion : There was no statistical difference in survival, failure and complication between neoadjuvant chemotherapy and radiation versus radiation alone in locally advanced uterine cervical carcinoma.