군위 대율마을 계회(契會) 방식의 변화와 그 요인

손대원(Sohn Dae-won) 실천민속학회 2010 실천민속학연구 Vol.15 No.-

한 마을의 생활문화를 제대로 이해하려면 마을 공동체 혹은 동계뿐만 아니라 개인들이 특정한 목적을 위해 조직한 자발적 결사체로서의 계의 목적 및 운영원리, 구성원의 성격과 함께 계회 방식의 변화도 면밀히 살펴볼 필요가 있다. 그런 점에서 계회 연구는 한 마을의 생활문화를 연구하는데 매우 중요하다고 하겠다. 이 논문에서는 한 마을의 계회가 어떻게 변했으며, 그 요인 무엇인지를 밝히고자 한다. 먼저 계의 성격에 따라 계회의 변화를 살펴보았다. 혈연계의 경우 계회 장소를 유사집에서 하던 것을 마을 인근의 식당으로 옮겼으며, 계회 날짜도 고정적이던 것을 유동적으로 변하였다. 지연계와 학계는 결성 초기에는 기금을 모으는 것에 중점을 두었지만. 지금은 일년에 한 번 계원들이 모이는 것을 더 중요시한다. 반면 친목계는 식당이나 노래방, 유명 관광지 등에서 계회를 개최하고, 계회 참석자도 부부동반으로 확대되었다. 이런 계회의 변화 원인으로는 먼저, 마을 인구의 감소와 고령화로 인한 계회 개최의 어려움을 들 수 있다. 그 결과 계원들이 차츰 줄어들면서 마을에 있는 계원들과 외지로 간 계원들 간의 소통의 공간이 축소되고 만남의 시간도 줄어들었다. 문중계, 지연계, 학계의 경우에는 계회의 변화를 통해서 계를 유지 존속 시키려고 하지만, 친목계의 경우에는 기존에 모아두었던 계 기금을 소모하기 위해서 계회를 하는 경우가 많다. 원래 계의 가장 큰 기능이자 목적은 바로 공동 가치의 실현과 집단 결속, 공동 사업의 수행, 유교적 의례의 실천 등이었다. 하지만 현대생활에서 계의 주 목적이 친목 도모 및 유희에 더 중점을 두고 있다. 이런 변화는 결국 계회 방식에도 일정부분 영향을 미친 것을 부인할 수 없다. 다음으로 식생활의 풍요로움을 들 수 있다. 명절 제사, 계회는 먹거리가 부족했던 당시 사람들이 음식을 섭취할 수 있는 좋은 기회였다. 그러나 현대에 와서는 일상음식에 갈망이 과거에 비해 현저히 낮아졌다. 그런 가운데 마을에 다양한 메뉴를 가진 식당들의 등장은 계원들의 새로운 먹거리를 찾는 욕구를 충족시킬 수 있었다. 이런 이유로 계희를 굳이 집에서 할 필요가 없다. 마지막으로 교통의 발달로 계회 장소를 마을 밖으로 확대되었다. 특히 친목계는 순수 친목만이 아니라 여가생활이나 다른 목적을 수반하는 경우가 많은데 이러한 현상은 ‘꿩도 먹고 알도 먹으려는’ 바쁜 현대인의 생활양식에서 비롯된 것 같다. 대율마을의 계회는 분명 과거에 비해서 많이 변했다. 계원의 수가 줄고, 계의 규모도 축소되면서 계에 대한 관심이 약해진 것은 사실이다. 하지만 이들은 대율마을의 사회ㆍ문화적 환경이 변하는 것에 발맞추어 계회를 변화시키고 계의 전통을 계승하려는 것이다. One should take a close look into the objectives, operational principles, member characters, and gathering styles of Gye as a voluntarily organized meeting for individuals' special purposes in addition to the community and its Gyes in order to understand its life culture right. In that sense, a study on Gye gatherings claims huge significance in researches on a village's life culture. This study set out to investigate how a village's Gye gatherings changed and what were its causes. First, changes to Gye gatherings were examined according to the nature of Gye. Gyes of blood ties moved the gathering venue from the home of the head official to a restaurant near the village and changed fixed gathering dates flexibly. Both the Gyes of regional relations and academic connections placed an early focus on raising funds but give more emphasis to the gathering of all the members once a year today. And Gyes of friendly relations gather together at a restaurant, karaoke, or famous tourist destination and expand the membership to include couples. Then the causes of those changes were investigated. First, several difficulties emerged with Gye gatherings due to the increasing size of village population and its aging. Consequently, the number of Gye members gradually dropped, the space of communication between the members remaining in the village and those who left to other cities became smaller, and the time of gathering reduced. While Gyes of clans, regional relations, and academic connections try to maintain and preserve their existence through changes, those of friendly relations mostly hold gatherings to consume the funds accumulated so far. The biggest functions and goals of Gye were originally implementing the community values, solidarity of groups, carrying out joint projects, and practicing the Confucian ceremonies. In modern life, however, the main goals of Gye have changed to promoting friendly relationships and having fun. Those changes have made partial influences on gathering styles without a doubt. The next cause can be found in the richness of dietary life. In the past when food was scarce, holidays, religious services for ancestors, and Gyes provided people with a great opportunity to consume food. But people's desire for food has considerably dropped in modern times. Furthermore, there are a huge number of restaurants that provide a wide variety of menus and satisfy the desire of Gye members to search for new dishes in the village. As a result, there is no need to hold a Gye gathering at home any longer. And finally, gathering venues expanded outside the village thanks to the advancement of transportation. Gyes of friendly relations, in particular, pursue additional goals other than the original goal of promoting friendly relationships in many cases, which is seemingly attributed to the busy life style of modern people that want to "kill two birds with one stone." The Gye garherings of Daeyul Village definitely went through many changes compared with the past. It is the reality that both the membership and size have grown smaller, which led to the weakened interest in Gyes. However, those are for changing the Gye gatherings and inherit the traditions of Gye according to the changes to the village's social and cultural environments.

증례 : 순환기 ; 비침습적 관상동맥 컴퓨터단층촬영술의 위음성 및 위양성 증례

이원재 ( Won Jae Lee ),김지현 ( Ji Hyun Kim ),박효은 ( Hyo Eun Park ),조영진 ( Young Jin Cho ),김형관 ( Hyung Kwan Kim ),김용진 ( Yong Jin Kim ),손대원 ( Dae Won Sohn ) 대한내과학회 2009 대한내과학회지 Vol.76 No.5

관상동맥 질환은 점점 증가하고 있으며, 심근경색과 같은 치명적인 질환의 원인이 되고, 심부전을 비롯한 여러 다른 합병증을 일으킬 수 있어 정확한 진단과 치료가 매우 중요하다. 다중열검출기를 이용한 관상동맥 컴퓨터전산화단층촬영술은 비침습적이며, 높은 음성 예측도를 가지고 있어 최근 임상에서의 이용이 급격히 늘고 있으며 앞으로 그 역할의 증대가 더욱 기대되는 검사법이다. 저자들은 이러한 관상동맥 컴퓨터전산화단층촬영술에서 발생할 수 있는 대표적인 위양성 증례와 아직까지 잘 알려지지 않은 짧은 병변에서의 위음성 증례를 보고하여 관상동맥 컴퓨터전산화단층촬영술의 결과 해석시 다른 임상 상황들을 충분히 고려해야 한다는 것을 문헌고찰과 함께 보고하는 바이다. The prevalence of coronary artery disease is gradually increasing. The importance of accurate, early diagnosis and treatment has been emphasized repeatedly, given the possible fatal outcome of coronary artery disease, such as in acute myocardial infarction or heart failure. In order to detect patients at high risk of coronary artery disease, noninvasive multi-detector computed tomographic coronary angiography (CTCAG) has recently been introduced for clinical use. It has become popular thanks to its noninvasiveness and high negative predictive value. Most studies have focused on these advantages, while neglecting a number of flaws in multi-detector CTCAG. We present two cases of multi-detector CTCAG with false positive and false negative results. We would like to emphasize that the interpretation of the findings obtained with multi-detector CTCAG should depend on the clinical findings in the patient, along with other factors, such as the location or length of the lesion. (Korean J Med 76:589-594, 2009)

화학겔 안에서의 라텍스 입자의 거동에 관한 연구

장경호,손대원,Jang, Kyung Ho,Sohn, Dae Won 대한화학회 1998 대한화학회지 Vol.42 No.2

화학겔로써 대표적인 실리카겔과 아마이드겔의 겔화(gelation)과정을 살펴보고 라텍스 입자를 추적자로 사용하는 광산란 실험을 통해 이들의 구조와 화학적 성질을 고찰하여 보았다. 표준입자(standard particle)로 쓰이는 라텍스 입자를 추적자로 사용하여 입자들의 병진운동(translational diffusion)을 고려함으로서 겔의 내부공간크기를 확인하고 겔과 입자표면과의 화학적 상호작용을 고려하였다. 실리카겔은 아마이드 겔보다 규칙적인 겔구조를 나타내는 것으로 사료되며 표면이 카르복실기를 갖는 입자는 실리카 겔과 엉킴(aggregation)현상을 나타냄을 관측하였다. 불균일(heterogeneity)한 겔의 고조확인을 위한 광산란법을 비에르고딕(non-ergodic)이론에 기초한 통계적인 방법을 통해 접근하였다. Probe diffusion with latex particles in two different types of chemically cross linked gel has been studied. The diffusion of particles in silica gel is decreased by decreasing the gel correlation length but the particles' diffusion in the acrylamide gel still shows the heterogeneity of the gel. By increasing the contents of the gel network the silica gel makes a more homogeneous and compact structure than that of acrylamide gel which has partial heterodyning. Dynamic light scattering study with the probe particles in two different gels reveals the heterogeneity of the gel network. The latex particles trapping in the gel has been investigated by using non-ergodic concepts.

증례 : Thalidomide 치료 후 호전된 심장 침범을 동반한 원발성 아밀로이드증 1예

오일영 ( Il Young Oh ),손대원 ( Dae Won Sohn ),서정주 ( Jung Ju Sir ),홍용상 ( Yong Sang Hong ),윤성수 ( Sung Soo Yoon ),박영배 ( Young Bae Park ),최윤식 ( Yun Shik Choi ) 대한내과학회 2005 대한내과학회지 Vol.69 No.-

저자들은 심장침범을 동반한 원발성 아밀로이드증이 생긴 52세 남자 환자에서 thalidomide 치료 후 임상적 증상, 심초음파 소견, 검사실 소견이 큰 부작용 없이 현저히 좋아진 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Patients with primary amyloidosis (AL) have poor prognosis with a median survival of one to two years. In patients with symptomatic cardiac involvement, prognosis is even worse with the reported median survival of 6 months. One patient, diagnosed as AL amyloidosis with cardiac involvement, was treated with thalidomide and showed remarkable improvement in functional capacity, cardiac function, and various laboratory parameters without any significant adverse effect and, therefore, we report the case with the review of literatures.(Korean J Med 69:S910-S914, 2005)

방실결절회귀빈맥의 치료에서 Slow Pathway 의 Radiofrequency Catheter Ablation 에 관한 연구

손경수(Kyeong Soo Sohn),구성회(Seong Hoe Koo),성지동(Ji Dong Seong),송종민(Jong Min Song),여정석(Jeong Seok Yeo),김동운(Dong Woon Kim),조성욱(Seong Wook Cho),현민수(Min Su Hyon),손대원(Dae Won Sohn),오병희(Byung Hee Oh),이명묵(Myoung 대한내과학회 1995 대한내과학회지 Vol.49 No.1

N/A Atrioventricular(AV) nodal reentry is a common cause of supraventricular tachycardia. For the treatment of atrioventricular nodal reentrant tachycardia (AVNRT), antiarrhythmic drug therapy requires long-term use of drugs and surgical ablation may be curative therapy but has problems of open heart surgery. Radiofrequency catheter ablation(RFCA) is reported to be safe and effective treatment modality for the frequently recurrent and severely symptomatic AVNRT. The results of treatment of AVNRT by RFCA of slow pathway is as follows. 1) The study consisted of 32 participants and the sex ratio (M: F) waw 8:24, the mean age was 40.9±15.8 yrs(19-72yrs). 2) At the electrophysiological study before RFCA, the type of reentry was common in 29 cases, uncommon in 1 case and in 2 cases were both common and uncommon type. 3) The applied modes of RFCA were constant power mode in 2 cases and temperature mode in 30 cases. 4) The number of radiofrequency current application till successful ablation was 12.1±9.1(3-39)and the mean power of applicated radiofequency current was 28.7±10.8W(8.2-41.3W). 5) Effective refractory period of antegrade fast pathwy (ERPfa) after ablation (220.0±43.3msec), in comparison with that before ablation(253.3±55. 8msec), has no statistical significance but has reducing tendency. The other parameters such as AH interval of antegrade fast pathway (AHfa), antegrade Wenckebach block cycle length (AWBCL), effective refractory period period of ventriculoatrial conduction system (ERPvacs) and ventriculoatrial block cycle length (VABCL) have no significant differences. 6) Complete AV block developed in only 1 patient who had underlying sinus dysfunction. 7) The follow-up duration was 7±3 months(1-13 months)and there was no AVNRT recurrence during this period. We conclude that the selective RFCA of slow pathway is a safe and effective treatment of AVNRT.

화학겔 안에서의 라텍스 입자의 거동에 관한 연구

장경호(Kyung Ho Jang),손대원(Dae Won Sohn) 대한화학회 1998 대한화학회지 Vol.42 No.2

내막파열을 동반하지 않은 대동맥 박리 ( 대동맥 벽내출혈 ) 에 대한 임상적 고찰

황경국(Kyung Kuk Hwang),박대균(Dae Gyun Park),연태진(Tae Jin Yeun),조영석(Young Seok Cho),손대원(Dae Won Sohn),김효수(Hyo Soo Kim),김철호(Cheol Ho Kim),오병희(Byung Hee Oh),이명묵(Myoung Mook Lee),박영배(Young Bae Park),최윤식(Yun Sh 대한내과학회 1998 대한내과학회지 Vol.54 No.1

N/A Objectives: This study was performed to verify the incidence and prognosis of aortic dissection without intimal tear (aortic intramural hemorrhage, IMH) who took only medical treatment in special referrence to Stanford type A. Methods: We analysed the patients of IMH confirmed by TEE, CT, MRI, angiography or CT-angiography in Seoul National University Hospital between 1987 and l9%, retrospectively. Results: The diagnosis of IMH was estabilished in 20 of 143 patients(14%). Nine patients were Stanford type A, 11 patients were type B. The longitudinal extent varied between 8 and 30cm, and IMH size varied between 10 and 3mm. Surgery was performed in two of type A patients because of persistent chest pain and one of type B patients because of progressive aortic dilatation despite of medical treatment. Follow-up imaging studies (mean follow-up period of 20.0±22.0 months) were done in 10/17 patients who were treated medicaliy. Complete resolution of IMH was observed in seven cases, four of them were Stanford type A, and the mean size of IMH was 12mm(10-17mm). Partial resolution was observed in one case, Stanford type A, with the IMH size of 15mm. There was no significant change in the size of IMH in two cases. Initial mean size of IMH was 25mm. In no case, aortic rupture or death was observed during the follow up period. Conclusion: In the management of the patient with MH, same surgical indications as classic aortic dissection have been advocated based on similar prognosis. However our study showed better prognosis in IMH patients treated medically compared to the previous publications. Therefore, even in cases of proximal IMH. medical treatment should be seriously considered.

Cox-Maze III 술식의 변형

김기봉,허재학,장지민,이정상,안혁,손대원,Kim, Ki-Bong,Huh, Jae-Hak,Chang, Ji-Min,Lee, Jeong-Sang,Ahn, Hyuk,Sohn, Dae-Won 대한흉부심장혈관외과학회 2000 Journal of Chest Surgery (J Chest Surg) Vol.33 No.11

배경: Cox-Maze III (CM-III) 술식은 복잡한 심방 절개로 인한 긴 수술시간 때문에 다른 개심 수술과 병행하여 시행하기 어려운 단점이 있다. 대상 및 방법: 저자들은 CM-III 술직을 다음과 같이 변형하여 시행하고 그 임상성적을 분석하였다. \circled1 좌심방이를 절제하는 대신 좌심방이를 외부에서 결찰하고, \circled2 폐정맥 분리 절개선과 좌심방이 사이에 냉동절제술을 시행하며, \circled3 우심방이를 절제하는 대신에 우심방 외측 절개선을 우심방이까지 연장하고, \circled4 후종 우심방 절개 하부에서 우심방 외측을 지나 삼첨판막륜으로 향하는 T-자 절개선을 생략하였다. 저자들이 시행한 변형 술식의 용이성과 효율성을 평가하기 위하여, 우리나라에서도 빈도가 높은 류마치스성 승모판막 질환에서, 전통적인 Cox-III 술식(그룹 I)의 임상결과와, 변형된 CM-III 술식(그룹 II)의 임상결과를 비교하였다. 결과: 그룹 I(n=18)에서 동반된 수술은 승모판막 치환술 10례, 승모판막 성형술3례, 승모판막 치환술과 삼첨판막륜 성형술3례, 승모판막 재치환술 2례 등이었다. 그룹II(n=23)에서 동반된 수술은 승모판막 치환술 7례, 승모판막 성형술 5례, 승모판막 치환술과 삼첨판막륜 성형술 1례, 승모판막 재치환술 10례 등이었다. 그룹 I과 그룹 II에서 평균 대동맥 차단 시간(ACC)은 각각 135$\pm$29분과 104$\pm$18 분, 심패바이패스(CPB) 시간은 각각 240$\pm$33분과 185$\pm$42분이었다. 그룹 I과 그룹 II의 평균 추적 관찰 기간은 각각 47$\pm$14 개월과 29$\pm$4 개월이었다. 그룹 I에서는 16례(88.9%)에서 정상 동율동으로 회복되었고 1례에서 심방세동이 남아 있었으며, 다른 1례는 서맥증후군(sick sinus syndrome)으로 인공 심박조율기를 삽입하였다. 그룹 II에서는 21례(91.3%)에서 정상 동율동으로 회복되었고 2례는 심방세동이 지속되었다. 그룹 I에서 정상동율동으로 회복된 16례는 100%(16/16)에서 우심방의 수축을 심장 초음파검사에서 확인할 수 있었으며, 좌심방의 수축은 75%(12/16)에서 확인할 수 있었다. 그룹 II에서는 정상 동율동으로 회복된 21례 중 100%(21/21)에서 우심방의 수축을 확인할 수 있었으며, 좌심방의 수축은 76.2%(16/21)에서 확인할 수 있었다. 결론: 변형 CM-III 술식은 전통 CM-III 술식에 비하여 ACC time(p<0.005)과 CPB time(p<0.001)을 의미있게 줄이면서도 필적할 만 한 정상 동율동 전환율과 심방 수축력의 회복을 보여주었다.

경피적승모판교련술후의 장기추적 관찰성적

오세일(Se Il Oh),김효수(Hyo Soo Kim),손대원(Dae Won Sohn),오병희(Byung Hee Oh),이명묵(Myoung Mook Lee),박영배(Young Bae Park),최윤식(Yun Shik Choi),서정돈(Jung Don Seo),이영우(Young Woo Lee) 대한내과학회 1995 대한내과학회지 Vol.49 No.4

N/A Objectives: Percutaneous mitral commissurotomy (PMC) has been known as an effective palliative therapeutic modality for moderate to severe mitral stenosis, however, long-term changes of the mitral valve area and possible predictors affecting the long-term results after PMC has to be elucidated. Methods: 168 patients who were followed up at least 3 months (mean 18.7±13.9 months, range: 3-60 months) after PMC (double balloon technique) at Seoul National University Hospital between August 1988 and April 1993 (total 265 cases), were enrolled in the study. Mitral valve area (MVA) by pressure half-time method and the grade of mitral regurgitation (0-4) were evaluated by Doppler echo- cardiography at 1 day, 3, 6, 12, 24, 36, 48, and 60 months after PMC. The criteria of successful PMC were defined as mitral valve area ≥1.5cm² and mitral regurgitation with grade 2 or less. Results: Pre-PLIC mean MVA was 0.84±0.25 cm², immediate post-PMC MVA 1.64±0.49 cm², and mean MVA at the last follow-up was 1.54±0.43 cm. Relative MVA comparing to immediate post- PMC MVA at each follow-up time were 97.84±22.0, 96.5±24.9, 98.0±28.7, and 99.0±21.9% at 3, 6, 12, and 24 months after VMC, respectively. There were no significant differences between the groups with and without reduced MVA during follow-up period (defined as 15% or more reduction compared to that of immediate post-PMC). PMC resulted in increased grade of mitral regurgitation compared to that of pre-PMC (p=0.001), however, the severity of mitral regurgitation remained stationary in most patients during follow-up period. 86 patients (51.2%) remained in the criterior of successful results at long-term follow-up evaluation. Univariate analysis demonstrated that long-term successful PMC was related to sinus rhythm (p=0.002), low echocardio-graphic score (p=0.031, especially calcification, p=0.024), pre-PMC MVA (p<0.001), and immediate post-PMC MVA (p<0.001), but immediate post- PMC MVA was the only independent predictor of long-term successful PMC by multivariate analysis. Conclusion: Percutaneous mitral commissurotomy results in long-term relief of moderate to severe mitral stenosis in most patients, and the mitral valve area and the extent of mitral regurgitation remains stationary during long-term follow-up period.

한국인에서의 Paraoxonase Gene Polymorphism 과 관동맥 질환과의 관계

유경훈(Kyong Hoon You),김석연(Seok Yeon Kim),김효수(Hyo Soo Kim),손대원(Dae Won Sohn),오병희(Byung Hee Oh),이명묵(Myoung Mook Lee),박영배(Young Bae Park),최윤식(Yun Shik Choi),이영우(Young Woo Lee) 대한내과학회 1998 대한내과학회지 Vol.55 No.6

N/A Objectives: Paraoxonase is a high density lipoprotein (HDL)-associated enzyme, which has been implicated in preventing low density lipoprotein-cholesterol (LDL-C) from oxidation. The human paraoxonase gene is codominantly expressed as allele A and B. The A allele codes for glutamine(A subtype) and the B allele for arginine(B subtype) at codon 192 of the paraoxonase enzyme. This genetic polymorphism divides the enzyme into high and low activity form It has been believed that this difference of specific activity might change the metabolism of cholesterol and the prevalence of coronary artery disease. The present study investigated the association among the paraoxonase gene polymorphism and the level of plasma lipoprotein and coronary artery disease. Methods: The 416 subjects who have undergone coronary angiography in SNUH were recruited. 7he patients(n=251) had >50% stenosis of at least one of the major coronary arteries. To identify the genotype of paraoxonase, we amplified the target region in the paraoxonase gene by PCR(polymerase chain reaction) and electrophoresed the products. Results: There was no difference between the two groups in the allele frequency (A: B = 0.41: 0.59 in patients, A: B = 0.37: 0.63 in controls; p=0.21) or in the genotype frequency (AA:AB:HB= 45:116:90 in patients, AA:AB:BB=22:77:66 in controls; p=0.41). There was no association of the paraoxonase genotype with serum lipoprotein level and acute coronary syndrome in this study. The B allele was not an independent risk factor for coronary artery disease in this study. Conclusion: The paraoxonase gene 192 polymorphism was not an independent risk factor for coronary artery disease in this study.