Childhood Venous Thromboembolism in Yeungnam Region in Korea: Multicenter Study

이소람,윤종혁,임재영,최희원,이재민,서진경,김지윤,양유진,박경미,임영탁,박지경,최은미,심예지,김흥식,박상규,공섬김,최은진,박은실 대한소아혈액종양학회 2018 Clinical Pediatric Hematology-Oncology Vol.25 No.1

Background: Venous thromboembolism (VTE) is rare in pediatric patients compared to adults, but it’s incidence is gradually increasing. The purpose of this study was to analyze the incidence, risk factors, and prognosis of pediatric patients with VTE in Korea. Methods: Between January 2000 and July 2017, 249,312 medical records of the patients older than 1 year who were hospitalized in the department of pediatrics of 10 university hospitals in Yeungnam region were retrospectively reviewed. Results: The overall incidence of VTE was 4.9 per 10,000 admissions. Of the total 123 patients, 80 (65.0%) were male and the median age was 10.8 years (range, 1.0-23.5 years). Magnetic resonance imaging was performed most frequently to confirm the diagnosis of VTE (43.1%). Thrombosis occurred in the cerebral vessels (46.3%), lower extremities (23.8%), pulmonary (19.5%), abdomen (9.8%), and upper extremities (4.1%). One hundred and six patients had underlying causes such as cancer (27.6%), infection (26.8%), intravenous catheter insertion (17.9%), and surgery (14.6%). Protein C was evaluated in 39 patients (31.7%), protein S in 40 (32.5%), antithrombin (AT) III in 52 (42.3%), and homocysteine in 21 (17.1%). Among them, one patient with a family history of AT III deficiency had SERPINC gene mutation. Seventy-seven patients (62.6%) started anticoagulation treatment. Most (52.0%) were treated for more than 90 days. Conclusion: Healthcare providers must be aware of the potential for VTE development in childhood. In the near future, a nationwide survey should be investigated to determine the incidence rate and the trends in VTE among Korean children.

Clinical Characteristics and Treatment Outcomes of Childhood Acute Promyelocytic Leukemia in Korea: A Nationwide Multicenter Retrospective Study by Korean Pediatric Oncology Study Group

박경미,유건희,김성구,이재욱,정낙균,주희영,구홍회,류철주,한승민,한정우,최정윤,홍경택,강형진,신희영,임호준,고경남,김혜리,국훈,백희주,김보람,양의진,임재영,박은실,최은진,박상규,이재민,심예지,김지윤,박지경,공섬김,최영배,조빈,임영탁 대한암학회 2022 Cancer Research and Treatment Vol.54 No.1

Purpose Acute promyelocytic leukemia (APL) is a rare disease in children and there are some different characteristics between children and adult. We aimed to evaluate incidence, clinical characteristics and treatment outcomes of pediatric APL in Korea. Materials and Methods Seventy-nine pediatric APL patients diagnosed from January 2009 to December 2016 in 16 tertiary medical centers in Korea were reviewed retrospectively. Results Of 801 acute myeloid leukemia children, 79 (9.9%) were diagnosed with APL. The median age at diagnosis was 10.6 years (range, 1.3 to 18.0). Male and female ratio was 1:0.93. Thirty patients (38.0%) had white blood cell (WBC) count greater than 10×109/L at diagnosis. All patients received induction therapy consisting of all-trans retinoic acid and chemotherapy. Five patients (6.6%) died during induction chemotherapy and 66 patients (86.8%) achieved complete remission (CR) after induction chemotherapy. The causes of death were three intracranial hemorrhage, one cerebral infarction, and one sepsis. Five patients (7.1%) suffered a relapse during or after maintenance chemotherapy. The estimated 4-year event-free survival and overall survival (OS) rates were 82.1%±4.4%, 89.7%±5.1%, respectively. The 4-year OS was significantly higher in patients with initial WBC < 10×109/L than in those with initial WBC ≥ 10×109/L (p=0.020). Conclusion This study showed that the CR rates and survival outcomes in Korean pediatric APL patients were relatively good. The initial WBC count was the most important prognostic factor and most causes of death were related to serious bleeding in the early stage of treatment. Purpose Acute promyelocytic leukemia (APL) is a rare disease in children and there are some different characteristics between children and adult. We aimed to evaluate incidence, clinical characteristics and treatment outcomes of pediatric APL in Korea.Materials and Methods Seventy-nine pediatric APL patients diagnosed from January 2009 to December 2016 in 16 tertiary medical centers in Korea were reviewed retrospectively.Results Of 801 acute myeloid leukemia children, 79 (9.9%) were diagnosed with APL. The median age at diagnosis was 10.6 years (range, 1.3 to 18.0). Male and female ratio was 1:0.93. Thirty patients (38.0%) had white blood cell (WBC) count greater than 10×109/L at diagnosis. All patients received induction therapy consisting of all-trans retinoic acid and chemotherapy. Five patients (6.6%) died during induction chemotherapy and 66 patients (86.8%) achieved complete remission (CR) after induction chemotherapy. The causes of death were three intracranial hemorrhage, one cerebral infarction, and one sepsis. Five patients (7.1%) suffered a relapse during or after maintenance chemotherapy. The estimated 4-year event-free survival and overall survival (OS) rates were 82.1%±4.4%, 89.7%±5.1%, respectively. The 4-year OS was significantly higher in patients with initial WBC < 10×109/L than in those with initial WBC ≥ 10×109/L (p=0.020).Conclusion This study showed that the CR rates and survival outcomes in Korean pediatric APL patients were relatively good. The initial WBC count was the most important prognostic factor and most causes of death were related to serious bleeding in the early stage of treatment.

빈곤가구의 경제적 안정성에 관한 연구

심 영(Young Shim) 연세대학교 사회복지연구소 2012 한국사회복지조사연구 Vol.31 No.-

빈곤가구의 경제적 안정성 확보는 매우 중요함에도 불구하고, 경제적 적정성 및 경제적 불평등성에 비해 상대적으로 관심이 적었을 뿐 아니라 이에 대한 연구 또한 거의 이루어지지 않았다. 결과적으로, 빈곤가구의 경제적 안정성 확보를 위한 정책적 노력이 다른 정책에 비해 거의 이루어지지 않았다. 따라서 본 연구는 빈곤가구의 경제적 안정성을 파악하고자, 가구유형이 가구의 단기 및 장기 경제적 안정성에 관련이 있는가와 가구유형별 가구의 단기 및 장기 경제적 안정성에 영향을 미치는 요인을 살펴보았다. 이를 위해 2008년도 한국복지패널조사 자료로 실증분석을 실시하였다. 회귀분석 결과, 가구유형은 단기 및 장기 경제적 안정성과 관련이 있는 것으로 나타났다. 그러나 사회보장 체계를 고려하였을 때, 가구유형은 단기 및 장기 경제적 안정성과 통계적으로 유의미한 관련이 없었다. 공공부조는 가구의 단기 및 장기 경제적 안정성에 부적인 영향을 미치는 반면에, 사회보험은 단기 및 장기 경제적 안정성에 정적인 영향을 미치는 것으로 나타났다. 특히, 단기 및 장기 경제적 안정성에 대한 사회보험의 정적 영향은 가구의 경제적 복지에 미치는 사회보험의 중요한 긍정적 기여를 나타내는 것으로, 가구의 단기 및 장기 경제적 안정성 확보를 위한 사회보험의 보다 더 적극적인 활용 가능성을 시사한다. 근로빈곤, 비근로빈곤 및 비빈곤 가구 모두에서, 월세의 주거형태는 단기 및 장기 경제적 안정성에 부적 영향을 미치는 것으로, 가구의 경제적 안정성 확보를 위한 주택정책의 중요성을 시사한다. In spite of the fact that it is important for poor households to achieve economic stability over time, relatively less attention has been paid to their economic stability, and little research has been done on it. As a result, policy efforts to promote economic stability have been less frequently pursued than other policy options such as economic adequacy, economic inequality. Thus, the purpose of this study was to examine economic stability in poor households. In order for this purpose, this study tested whether household type was related to short-term and long-term economic stabilities of households and what factors affected short-term and long-term economic stabilities of households by household type. The 2008 Welfare Panel Survey (KOWEPS) data was used for the empirical analyses. Regression analyses showed that the household type was related to the short-term and the long-term economic stabilities of households. However, household type was not related to the short-term and long-term economic stabilities of households, when the social security system was controlled for. Public assistance was negatively related to the short-term and the long-term economic stabilities of households, but social insurance was positively related to the short-term and the long-term economic stabilities of households. In particular, the positive relation of social insurance with the short-term and the long-term economic stabilities of households implies that social insurance makes important positive contributions to economic well-being, suggesting the possibility of a more proactive usage of social insurance not only for the short-term economic stability but also for the long-term economic stability of households. For the working poor, the non-working poor and the non-poor households, monthly rent in housing affected negatively the short-term and long-term economic stabilities. This result may suggest the importance of housing policy for economic stability of households.

몽골시대 高麗의 王命

沈 永 煥(Sim Young-hwan) 한림대학교 태동고전연구소 2012 泰東古典硏究 Vol.29 No.-

몽골시대 고려는 몽골제국(Mongghol Empire)의 외연에서는 자주적인 사직(社稷)을 가지고 있는 ‘國’이었지만, 내부에서는 공주(公主)의 강가(降嫁)를 통한 대몽골 울루스(Dai Ön Yeke Mongghol Ulus)의 일원인 부마(駙馬, güregen)라는 이중적 지위를 가지고 있었다. 따라서 몽골과 고려의 관계는 기왕의 중국의 왕조와 맺었던 책봉(冊封)과 조공(朝貢)의 형태와는 달랐고, 관제 (官制)를 비롯한 정치구조는 몽골제국을 따를 수밖에 없었다.몽골시대 고려는 몽골의 행정감독관인 다루가치(darughachi, 達魯花赤)의 힐난에 따라 기왕에 사용하던 선지(宣旨)를 왕지(王旨)로 고쳤다. ‘宣旨’란 만당(晩唐)에서 오대(五代)와 북송(北宋)을 거쳐 형성된 추밀원(樞密院)에서 발령하였던 황제의 의지(意志)를 말한다. 고려는 성종 10년(991) 10월에 북송의 추밀원을 참작하여 중추원(中樞院)을 설치하였고, 이를 통해 ‘宣旨’를 도입한 것으로 보인다. 고려는 국왕이 ‘王旨’라는 명령을 국왕의 의지로 채택하자 상왕(上王)이나 심왕(瀋王)은 균지(鈞旨)라는 명령을 사용하였다. 몽골시대 황제의 의지는 ‘ǰarliq’인데 이를 한자어로는 성지(聖旨)라 하고, 한어체로 명령문을 작성할 때는 ‘詔書’라고 하였다. 이에 반해, 황태후의 의지 (懿旨), 황태자의 영지(令旨), 제사(帝師)의 법지(法旨), 재상과 부마의 균지(鈞 旨)는 한자어는 달라도 모두 몽골어 ‘üge(言語)’의 이칭이었다. 그러므로 몽골 시대 고려 국왕의 ‘王旨’와 상왕과 심왕의 ‘鈞旨’는 모두 몽골어 ‘üge’의 이칭 이라는 것을 알 수 있다. 몽골시대 고려국왕의 명령을 살펴볼 수 있는 자료로는 공신문서 3점이 전사본으로 남아 있다. 이들 공신문서는 몽골의 문서양식을 차용하여 작성되었 다. 곧, ‘皇帝福廕裏(황제의 福廕에)’라는 전형적인 몽골 명령문의 기두어(起頭 語)를 차용하고 있다. 그런데 고려는 ‘몽골어 직해체’라는 몽골시대 문체(文 體)를 수용하지 않았다. 따라서 이들 공신문서는 본문은 한어체로 작성되었고, 결사(結辭) 또한 세조 쿠빌라이(Qubilai) 이후 확립된 성지(聖旨, ǰarliq)의 한어식(漢語式) 양식인 ‘詔書’ 양식을 차용하여 작성하였던 것이다. 다시 말하면, 몽골시대 고려국왕의 공신문서는 ‘王旨’의 일종으로 ‘üge(言語)’의 한 종류였던 것이다. 이후, 고려는 다시 공민왕대의 반원정책에 이어서 명(明)나라의 등장과 북원(北元)의 관계 속에서 새로운 문서 양식을 도모하였던 것이다. The Goryeo Dynasty in the era of the Mongol Empire had dual-conceptualized standings especially in terms with the Empire; more specifically, although it was a nation externally having an autonomous ruling power (or sovereignty, 社稷), Goryeo was, in the inner manifestation, a güregen(駙馬) that constituted a part of Dai Ön Yeke Mongghol Ulus, being in a status of imperial son in law through marriage with a princess of the Empire s royal family. Therefore, the relationship between the Goryeo and the Mongol was clearly far from that with the earlier Chinese dynasties being characterized by investiture and tribute, which meant that the Goryeo s political system including its administrative system was mandated to be in accord with that of the Empire. The Goryeo Dynasty in the era of the Mongol Empire replaced Sun-ji(宣旨) used up to then to Wang-ji(王旨), submitting to condemning pressure by Darughachi, executive officials designated by the Empire, where the former indicated an emperor s wishes issued by Chumil-won(樞密院, an advisory board to aid king) existing from the end of Tang Dynasty through Five Dynasties and North Song Dynasty. The Goryeo, taking Chumil-won of the North Song into consideration, established Jungchu-won(中樞院) through which Sun-ji was thought to be introduced. As the term Wang-ji was adopted by a king of the Goryeo Dynasty as mentioned above, orders of precedent kings or kings Shim(瀋王, a king forced to stay in China or Mongolia as a sort of hostage) were called Gyun-ji(鈞旨). The term corresponding to emperor s order or wish in the Mongghol Era was ‘ǰarliq’ in Mongolian, matching with Sung-ji(聖旨) in Chinese character or In-seo(詔書) when written in an imperative statement. Meanwhile, an order or wish commanded by an empress was in Chinese expressed as Eui-ji(懿旨); similarly, Young-ji(令旨) in the case of emperor s son (crown prince), Beop-ji(法旨) in the case of Jesa(帝師) and Gyun-ji(鈞旨) in the case of prime minister and king s son-in-law. Despite being different in terms of Chinese characters, they all equivalently meant ‘üge(言語)’ in Mongolic. In this sense, it can be known that such terminology used in Goryeo as Wang-ji and Gyun-ji be identical to Mongolian ‘üge’. There remains three pieces of scripts documenting the achievements of meritorious retainers from which orders of kings in the Goryeo Dynasty can be paleographically investigated. These documents were made following the Mongghol Empire s documental style. More strictly, they borrowed Gidu words(起頭語) that were typical in ancient Mongolian imperative sentences citing as ‘皇帝福廕裏(in the emperor’s grace)’. Nevertheless, the Goryeo Dynasty did not adopt the writing style of the Mongghol Empire called as Jikhaeche in a Mongolic language. Namely, main texts of the archive containing records about vassals of merit were made up with the use of Chinese characters by particularly conforming to the‘詔書’ style in terms of their Gyeolsa(結 辭), an expression in the Chinese language style for delivering Sung-ji (聖旨, ǰarliq), which had been popular since Qubilai Khan. In other words, it could be concluded that documents with regards to meritorious retainers of the Goryeo Dynasty in the era of the Mongol Empire be written in ‘üge(言語)’ as part of Wang-ji. Since then, the Goryeo Dynasty once again pursued a new writing style for documentation amid the complicatedly developing foreign situations from anti-Won policy by King Gongmin to emergence of the Myung Dynasty and correlation with the North Won Dynasty in China.

충북 지역의 소비문화 연구

심 영 西原大學校湖西文化硏究所 2001 湖西文化論叢 Vol.15 No.-

한강의 『채식주의자』와 제임스 조이스의 『율리시스』에 나타난 서술 초점 변화 양상 비교

이 영 심 세계문학비교학회 2019 世界文學比較硏究 Vol.69 No.-

모더니즘 이후, 서사이론은 서사의 내용 그 자체보다 서사기법, 즉, 누가, 어떤 관점과어떤 시점에서, 그리고 어떤 방식으로 서술을 진행하는가의 문제에 초점을 맞춘다. 본 논문에서는 서술 기법에 지대한 관심을 드러내는 『채식주의자』와 『율리시스』를 비교분석해보고자 한다. 흥미롭게도 한강의 『채식주의자』와 제임스 조이스의 『율리시스』는 공통적으로 세 명의 각기 다른 초점화자를 내세울 뿐만 아니라, 1인칭에서 3인칭(혹은 3인칭에서 1 인칭)으로 서술 인칭을 변화시킨다. 먼저 『채식주의자』에서는 영혜의 남편과, 형부인 인혜남편, 그리고 언니인 인혜가 각각 초점화자로 등장하여 각기 다른 관점에서 영혜와 그녀의 극단적 채식주의에 대해 서술을 진행한다. 한편으로 『율리시스』에서는 『채식주의자』와마찬가지로 두 명의 남성인 스티븐과 블룸이 초점화자로 먼저 등장하고, 여성인 몰리 블룸이 최종 초점화자로서 등장하여 서술을 진행한다. 본 논문에서는 두 텍스트에서 공통적으로 활용된 초점화자의 변화 양상과 서술 인칭의 변화의 효과를 비교 분석하고자 한다. Both The Vegetarian and Ulysses make use of multi-focal narrators, which results in refusing to fix narrative meaning of the prior focal narrators and allows to re-state it from a new perspective by the later focal narrators. This emphasizes the fact that the meaning of the narration can be changed depending on who the focal narrator is. In the case of The Vegetarian, the three focus narrators such as Yeong-hye’s husband, In-hye’s husband, and In-hye, show different perspectives regarding Yeong-hye and her extreme vegetarianism. And in Ulysses, the three focal speakers like Stephen, Bloom and Molly Bloom, also reveal the different points of view from each one’s social positions. Especially both texts set the married woman(In-hye or Molly Bloom) as the final focus narrator, who has the privilege of making the final judgment on the prior focal narrators’ narration. In-hye or Molly Bloom as the final focal narrator shows strong resistance to patriarchal male-centeredness revealed by the two prior male focus narrators, which overturns their powerless social position in the contemporary society. Both texts also show that the issue of patriarchal masculinity can be extend to a more fundamental issue of violence exerted by the powerful. In the respect, the “vegetarian” motif, which combines “plant” and “food” is a keyword to analyze Han Gang’s novel, for that motif implies a denial of “violence” inherent in “meat eating” and “animalism”. Thus, both The Vegetarian and Ulysses which are multi-layered texts make the narrative of the text more entangled by making use of the multi-focal narrators and the change of narrative person.

리콜제도에 대한 소비자 인지와 소비자 정보 및 교육의 필요성

이혜임,심 영 한국소비자학회 1999 소비자학연구 Vol.10 No.2