Histological and Immunohistochemical Evaluation of Ductal Carcinoma In Situ Co-Existing with Triple-Negative Carcinoma of the Breast

설혜실,고형석,박인애 대한병리학회 2008 Journal of Pathology and Translational Medicine Vol.42 No.6

Background : Triple-negative breast carcinomas (TNBCs) are associated with high-grade histological tumor and a poor clinical outcome. In this study, we evaluated the histology and immunohistochemical features of DCIS co-existing with TNBC to determine the characteristics of the precursor lesions of TNBC. Methods : Among the 1,610 cases of breast carcinoma, we selected the TNBCs with DCIS (n=196), and compared the pathological and immunohistochemical findings of the DCIS with those of the invasive carcinoma areas. Results : Among the 1,610 breast carcinomas, the TNBCs accounted for 330 cases (20.5%) and there were 196 cases with DCIS. The TN-DCIS cases exhibited high nuclear (94.5%) and histological (94.5%) grades, comedo-necrosis (68.9%) and a small extent of the DCIS-involved area. Immunohistochemically, a p53 expression was present in 48.4% of the TN-DCIS cases and a high Ki-67 index was present in 31.5%. The same TN immunohistochemical profiles as the carcinoma were detected in 109 of the 124 (87.9%) cases, but different profiles were observed in 15 of the 124 (12.1%) cases. The 15 discordant cases were associated with a low histological grade (p=0.037), low p53-positivity (p=0.006) and a low Ki-67 index (p=0.026), as compared to the invasive carcinomas. Conclusions : The results of this study suggest that TN DCIS is a highly probable, but not obligate, precursor lesion of TNBC.

역사학과 상상력은 어떻게 만나는가?

설혜심 延世大學校 文科大學 2008 人文科學 Vol.88 No.-

근대 역사학이 과학적 검증성을 통해 합리적 인과관계를 도출하는 것을 본질로 천명한 이래 역사학은 상상력과는 동떨어진 학문으로 인식되는 경향이 있다. 하지만 이미 지나간 과거를 고찰의 대상으로 삼는 역사학에는 상상력이 필수적으로 개입한다. 이 논문은 역사연구에 있어 상상력이 동원되거나 개입되는 다양한 방식을 소개하며 역사학에서의 상상력의 중요성을 되짚어보는 글이다. 상상력은 오랜 학문인 역사학을 지속시켜온 가장 중요한 원동력으로, 상상력으로 인해 역사는 절대적인 '과거'가 아닌, 끊임없이 새로워질 수 있었다. 이제 역사가는 역사적 사건뿐만 아니라 과거 사람들의 꿈과 상상력까지도 고찰의 대상으로 삼게 되었고, 미시사와 감각의 문화사 같은 새로운 접근들이 이 분야를 한층 풍부하게 만들었다. 여기서 한 시대를 온전하게 재구성하고자 하는 '사회적 상상력'은 특히 중요한 요소로 부각된다. 검증적 작업에 있어서도 역사가의 건전한 상상력은 부족한 사료를 메워주는 접착제 역할을 한다. 하지만 역사가는 무의식적으로 역사가라는 동질적 집단을 상정하는가 하면, 기술의 대상으로 관습적인 상상의 공동체를 조형해 내곤 한다는 문제점도 안고 있다. 한편, 역사의 생산자인 역사가뿐만 아니라 소비자인 독자들 역시 상상력을 발휘하며 역사서술을 접하게 되는데, 향후 역사가들은 역사소비에 개입되는 독자들의 상상력에 대해 더 많은 관심을 기울일 필요가 있다. Since modem history proclaimed the rational empirical causal explanation as its true vocation, historical study has often been perceived as a learning without imagination, Imagination, however, is essential to the historical study. With imagination, history has constantly been able to renew itself, and the historical analysis now encompasses, not only the external events and the historical situations, but also the dreams and imaginations of the people who lived the past. Such new historical methods as the micro-history and the cultural history of senses enrich these arenas where the concept of 'social imagination' emerges as a crucial factor. Even in the field of empirical analysis, historian's sound imagination is useful and often desired, because it could fill the gaps appearing on the imperfect historical evidences. Meanwhile, historian must stay vigilant against the abusable application of imaginative concept in his own historical writing, like 'us(historians)' and such other homogeneous groups as 'nation' and 'community.' Now, besides the imagination of the historian who produces history, more attention is required to explain the imagination of the readers who consume history.

낚시와 인문학 : 아이작 월튼(Izaak Walton)의 『조어대전(釣魚大全)』다시 읽기

설혜심 연세대학교 인문학연구원 2009 人文科學 Vol.90 No.-

Izaak Walton's The Compleat Angler, or the Contemplative Man's Recreation is most frequently reprinted book in English literature. Scholars, however, have not paid serious attention to this book, because it is categorized as a fishing guidebook rather than a authentic literary work. This article examines the reason of sudden acknowledgement of sport fishing and the enormous popularity of Walton's book in 17th century England. Hunting, especially falconry was a popular sport and status symbol among the nobles in medieval Europe. In England, however, from the 17th century Puritanism began to give steady pressure against the atrocities of blood sports. As falconry declined in importance and popularity, fishing or Angling emerged as a desirable alternative. Also, the English began to divide their environment into two distinct categories-- the natural and the artificial, the city and the countryside. Within this dichotomous framework, countryside was perceived as natural and healthy. New sensibilities arose towards animals, plants and landscape, and recreations in countryside were exalted as the morally beneficial activities. In this context, Walton could argue that fishing in quiet waters is a form of contemplative activity. The Compleat Angler is not merely a pastoral discourse on stratagems of fishing, but a humanistic literature on peaceful lifestyle and pleasure of soul. In this book, Walton's style and narratives are extremely lucid refreshed by verses, songs, anecdotes and Biblical analogies. The style and contents also explains why this work appealed to millions of people who have never caught a fish. 653년 아이작 월튼이 출간한 『조어대전』은 ‘낚시의 고전,’ 혹은 ‘낚시의 바이블’이라 불리는 베스트셀러이다. 본 논문은 문학작품이기보다는낚시안내서로 분류되어 학술적 조명이 잘 이루어지지 않았던 『조어대전』을 심층적으로 읽어내어 17세기 영국의 사회상을 이해하는 한편 이책의 폭발적 인기의 원인을 분석한다. 낚시는 매사냥이 쇠퇴하면서 스포츠로서 각광받기 시작했는데, 그 배경에는 탐욕과 유혈스포츠를 경계하는 청교도주의의 영향, 도시에 대비되는 시골의 미덕을 고양하던 시대적 분위기, 명상에 대한 새로운 개념의정립 등의 변화가 놓여있었다. 또한 『조어대전』은 단순한 낚시법 안내서를 넘어서 훌륭한 교양서로서의 미덕을 갖추고 있었기 때문에 많은 독자를 끌어 모았던 것이다. 궁극적으로 이 책은 낚시를 매개로 삶을 반추하는 명상의 중요성을 설파한 인문학서라고 볼 수 있다.

본 것, 볼 수 없던 것, 그리고 자랑삼았던 것 -16-17세기 옥스퍼드 대학과 케임브리지 대학의 이미지-

설혜심 ( Hea Sim Sul ) 영국사학회 2006 영국연구 Vol.16 No.-

도벽광(kleptomania) - 소비사회가 낳은 광기와 그 유산 -

설혜심( Haesim Sul ) 영국사학회 2017 영국연구 Vol.37 No.-

19세기 중반부터 영국에서는 중간계급 여성 들치기가 사회적 문제로 제기되었다. 이들은 단순한 절도범이 아니라 도벽광(kleptomania)으로 불렸다. 도벽광은 1816년 의학계에서 최초로 언급된 이래 곧 이론적 토대를 갖추어가며 법정에서 들치기 변론에 적극 이용되었다. 이 글은 도벽광을 19세기 서구사회가 발명해 낸 광기로 규정하며 이 새로운 광증을 만들어낸 사회경제적 동인과 문화적 변화를 추적한다. 중간계급 여성 들치기는 주로 새롭게 등장한 소비의 장에서 발생했다. 엠포리엄, 바자, 백화점과 같은 새로운 쇼핑공간은 큰 인기를 끌었지만 동시에 사회적 불안감과 혼란을 불러일으켰다. 판매여성이 성매매를 할지 모른다는 의혹에 더해 빅토리아 시대 도덕률은 여성이 쇼핑의 주체가 되는 것을 아직 용인할 수 없었기 때문이다. 이런 딜레마는 중간계급 여성 들치기라는 현상에 대처할 새로운 해결책을 요구했다. 그것은 전문의학, 특히 정신병리학과 형법체계의 결합, 즉 도벽광의 발명이었다. 의사들은 범죄행위에 불과했던 도둑질을 병리학적 영역으로 끌어들이며 지적 권위와 특권적 위치를 확보해 갔다. 그런데 도벽광에 대한 정의와 사법적 적용은 여성의 생리학적 특수성을 부각시키는 성차별적 편견과 중간계급 이상에게만 해당되는 계급차별적 모순을 드러낸 것이었다. 오늘날 도벽광은 의학계에서 낡은 개념으로 치부되지만 절도강박은 여전히 월경전증후군 등과 연관된 것으로 회자되며 여성의 생물학적 특질이라는 프레임을 견지하고 있다. From the mid-19th century, shoplifting of middle-class women became the subject of social concern in Britain. They were not simple thieves, but were considered to be affected by `kleptomanias.` Kleptomania first appeared in 1816 in the medical field as one of the new monomanias, and doctors soon started to use the kleptomania diagnosis to widely defend the theft of middle-class women. This article defines kleptomania as the invention of 19th-century western society, tracing the causes of its emergence. Kleptomania could be a convenient solution for dealing with new social dilemma consumer society introduced. With kleptomania defense, the psychiatry was able to penetrate into the court system as an important part of forensic medicine, and those practices overall contributed to constructing the authority and professionalization of medical doctors. Although the kleptomania was a genderless and classless ailment, its medical definition and application to the legal system became particularly female and class biased. Since the mid-20th century kleptomania has been losing its scientific credibility, but the compulsive stealing that often signifies the premenstrual syndrome continues to be perceived within the frame of female malady.

서양의학에서의 인삼활용과 한계, 1660-1900

설혜심(SUL Heasim) 대한의사학회 2017 醫史學 Vol.26 No.3

This article demonstrates the medicinal usage of ginseng in the West from 1660 to 1914. Asian[Korea] ginseng was first introduced into England in the early 17th century, and North American ginseng was found in the early 18th century. Starting from the late 17th century doctors prescribed ginseng to cure many different kinds of ailments and disease such as: fatigue general lethargy, fever, torpidity, trembling in the joints, nervous disorder, laughing and crying hysteria, scurvy, spermatic vessel infection, jaundice, leprosy, dry gripes and constipation, strangury, yellow fever, dysentery, infertility and addictions of alcohol, opium and tobacco, etc. In the mid-18th century Materia Medica began to specify medicinal properties of ginseng and the patent medicines containing ginseng were widely circulated. However, starting in the late 18th century the medicinal properties of ginseng began to be disparaged and major pharmacopoeias removed ginseng from their contents. The reform of the pharmacopoeia, influenced by Linnaeus in botany and Lavoisier in chemistry, introduced nomenclature that emphasized identifying ingredients and active constituents. Western medicine at this period, however, failed to identify and to extract the active constituents of ginseng. Apart from the technical underdevelopment of the period, the medical discourses reveal that the so-called chemical experiment of ginseng were conducted with unqualified materials and without proper differentiation of various species of ginseng.

서구 소비사의 현황과 전망

설혜심(Heasim Sul) 역사비평사 2014 역사비평 Vol.- No.107

From the 1980s, historical studies of consumption have proliferated enormously. On the theoretical guidelines of Veblen, Sombart, Baudrillard and Bourdieu, the history of consumption has developed into two major currents of analyses. One is related to the birth of the consumer society or the “Consumer Revolution” which is considered to have begun in early modern England. The other is concerned with the controversy on the mass consumption society that signifies the ‘affluent society’ in post-World War II United States. Recently, the diffusion model which claims that consumer culture flowed from the U.S. to the rest of the world has been challenged by ‘decentering’ perspectives and case studies of resistance against or negotiation with the diffusion. Scholars have also began to pay more attention to the agency of active consumers and the new, alternative, and transnational networks built around them. Although the history of consumption is confronted with problems of fragmentation, it has great potential for expanding the scope of historical subjects and of enlarging the content of historical research.

연구 논문 : 키스 토머스(Keith Thomas)의 역사세계

설혜심 ( Hea Sim Sul ) 영국사학회 2010 영국연구 Vol.23 No.-

영국사에 대한 새 전망 : 연구논문 ; 17세기 후반 "영국성(Character of Englishness)"의 형성과정 -외국인 여행기와 영국인의 대응 사례-

설혜심 ( Hea Sim Sul ) 영국사학회 2005 영국연구 Vol.14 No.-

My previous work, "England as Seen by Foreigners: the Travel Accounts of Tudor-Stuart period" challenged the 18th century absolutism that Englishness/Britishness is a modern invention, appearing mainly after the 18th century. The travel accounts written by 22 foreign visitors to England showed that the image of Englishman was already well established before the 18th Century. What I could not cover in the article, however, was the dialogical relations between English people and foreigners in the making of English character. To approach this subject, this article focuses on Samuel Sorbiere`s A Voyage to England(1664). Apart from Sorbiere admiration of the scientific development and Royal Academy in England, he mainly criticized English religion, politics, custom and people. Although it was published in French in France, Thomas Sprat, a reputed English scholar, wrote a fierce response which attracted lots of attention among English readers. Reputing most of Sorbiere`s arguments, Sprat`s Observations on Mons. de Sorbiere`s Voyage into England(1665) tried to undermine Sorbiere`s qualification as a scientist, a diplomat, and a royal subject of French King. The textual dissection of these two texts, however, reveals an interesting twist. Many parts of Sorbiere`s A Voyage to England was based on anonymously published pamphlet A Character of England(1659). This satiric pamphlet was full of criticism that attacked the religion, politics, and custom and manners of Englishmen before the Restoration. Although its author was disguised as a frenchman, it was written by John Evelyn, a close friend of Sprat. Interestingly, Sorbiere knew that the author was Englishman. Sorbiere, a Frenchman, appropriated Evelyn`s text to attack Englishness and Sprat criticized Sorbiere for his biased motive of appropriation. The character of Englishness was revealed and sometimes formulated in this process, and Sprat emphasized and even propagandized his version of Englishness in this dialogical relations. This article suggests that the Englishness that foreigners observed might have been a mere product coated over what Englishmen prepared for groundwork. Also, since England produced many informative raw materials about its own country, such as Camden` Britannia already in the 16th century, it was in a superior position in making of National Character.

품격이 필요해: 엘리아스의 『문명화 과정』과 18세기 영국의 매너

설혜심 영국사학회 2022 영국연구 Vol.48 No.-

This article analyses three courtesy books of the 18th century — the propriety text for young gentlemen and ladies, The Polite Academy; Erasmus Jones’s conduct manual for social upstart, The Man of Manners, or Plebeian Polish’d; Samuel Richardson’s letter-writing manual, Letters Written to and for Particular Friends. These sources prove the existence of a variety of new manners for the middle class in 18th century Britain, challenging Norbert Elias’s argument that French courtly manners of the 17th century were spread down to all over Europe without any notable resistance. Although British manners contained some French influences, the manners of the middle class despised the superficiality of French manners, and accentuated the simplicity, sincerity and concern for others. While these texts reveal the awareness of commercial society and social mobility, they also emphasize the idea that polite manners were the important means to unite and ameliorate the commonwealth. That is where manners, which prompted the politeness debate in the political thought of the 18th century, are associated with the British character and patriotic discourses. 이 글은 18세기 예법서 세 권—소년 소녀를 위한 예절 교본인 『품격 있는 아카데미』; 에라스무스 존스가 벼락출세한 사람을 위해 쓴 『매너 있는 사람』; 사무엘 리처드슨의 서간문범(書簡文範) 『특별한 친구에게 쓰는 편지들』—을 분석한 것이다. 17세기부터 프랑스 궁정 매너가 유럽 전역으로 별다른 저항 없이 사회 저변부로 퍼져나갔다는 노르베르트 엘리어스의 도식과 달리, 이 사료들은 18세기 영국에서 중간계급을 위한 새롭고 다양한 형태의 매너가 생겨났음을 증명한다. 프랑스의 영향을 받은 예법도 일부 존재했지만, 전반적으로 영국 중간계급의 매너는 겉치레를 경계하며 단순성과 진정성, 타인에 대한 배려를 강조하는 것이었다. 이들 예법서는 상업 사회와 사회적 이동성에 대한 분명한 자각을 드러내는 한편, 품격 있는 매너가 공동체의 화합과 발전을 가져올 중요한 수단임을 강조한다. 그것이 바로 18세기 정치담론 폴라이트니스 논쟁을 촉발한 매너가 영국성 및 애국 담론과 연결되는 지점이다.