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임성희,Jong-Mu Sun,Joohyun Hong,Dongryul Oh,Yong Chan Ahn,Man Ki Chung,Han-Sin Jeong,Young-Ik Son,Myung-Ju Ahn,Chung-Hwan Baek,Keunchil Park 대한내과학회 2021 The Korean Journal of Internal Medicine Vol.36 No.0
Background/Aims: Clinical trials have not consistently supported the use of induction chemotherapy (IC) for locally advanced head and neck squamous cell cancer. Hypopharynx and base of tongue (BOT) cancer has shown relatively poor survival. We investigated the role of IC in improving outcome over current chemoradiotherapy (CRT) in patients with hypopharynx and BOT cancer. Methods: Treatment-naïve patients with stage III/IV (M0) hypopharynx or BOT cancer were randomly assigned to receive CRT alone (CRT arm: cisplatin 100 mg/m2 on D1 3-weekly, two times plus radiotherapy 68.4 Gy/30 fractions on weekdays) versus two 21-day cycles of IC with TPF (docetaxel & cisplatin 75 mg/m2 on D1, and fluorouracil 75 mg/m2 on D1-4) followed by the same CRT regimen (IC arm). The primary endpoint was progression-free survival (PFS). Results: This study closed early after enrollment of 36 patients (19 in the CRT arm, 17 in the IC arm). After a median follow-up of 47.2 months, there was no significant difference in PFS: the median PFS was 26.8 months for the CRT arm and was not reached for the IC arm (p = 0.13). However, the survival curves were widely separated with a plateau after 3 years, suggesting a potential survival benefit from IC: 3-year PFS rates were 45% and 68%, and 3-year overall survival rates were 56% and 86%, in the CRT and IC arms, respectively. Conclusions: This study failed to demonstrate that induction TPF chemotherapy improves survival in patients with BOT and hypopharynx cancer. However, it suggested a favorable outcome with IC to this population.
최근 공교육은 많은 도전과 과제를 요구받고 있다. 급격한 사회 변화로 인해 학교 교 육이 과거와는 다른 교육문제를 야기함과 동시에 새로운 교육수요를 낳고 있는 것이다. 가족의 해체, 사회불평등 심화와 빈곤가정의 증가, 아동·청소년 돌봄 소외 현상의 증가 등은 공교육의 방향 전환을 요구하고 있다. 특히 평생학습사회의 도래 및 지식의 생성주 기 단축은 학습의 장으로서 학교가 누렸던 교육기관으로서의 독보적 위상을 흔들고, 학 교로부터 구체적 변화를 일으킬 것을 촉구하고 있다.
This study explores how non-native English teachers in South Korea empower one another through an online community. A growing number of English as a Foreign Language (EFL) teacher in Korea have begun to implement a recently introduced pedagogical approach, Flipped Classroom, in their classes. For learning to teach Flipped Classroom, ninety-five Korean EFL teachers built their online (SNS-based) community on NAVER BAND to share their classroom materials, knowledge, experience related to Flipped Classroom. This study investigates how an online community of the Korean EFL teachers participate and engage in professional development using collaborate web 2.0 technologies. With a qualitative, netnographic approach, data includes over seven months of online participant observation, and computer-mediated activities from the virtual community. Findings describe the characteristics of the community of practice (CoP) of Flipped EFL Classroom teacher’s NAVER BAND in terms of domain, community and practice. Furthermore, the study links the changes of the teachers from their engagement in the community with the characteristics of the CoP in relation to the effectiveness of online teacher community as a means of sustained and significant teacher learning. This study concludes with suggestion of online (SNS)-based community as a workable alternative to current in-service teacher training.
This study focuses on the practical cases of ‘Educational Integration Model’ operated by Wanju-gun Education Integration Support Center (just ‘center’ hereinafter), and intends to examine how the model was conceived and how the model project was developed, and present its characteristics. Also, this study goes further to look into how the project has been applied and practiced in the school field, and analyse the effectiveness of the model that has surfaced during the process of practicing. For this purpose, we studied practical cases of three school types: ‘independent urban-country multi type’, ‘quasi-independent country type’, and ‘dependent small school type’, based on the level of dependency on community’s educational support, from many cases of Educational Integration Model that the center has been operating since 2013. Of the three types, we studied the practical case of `dependent small school type’and intended to lay the foundation for the other cases. The Educational Integration Model of the center has been operating in order to help students solve difficulties they have, with the participation of the persons concerned of the center and ‘mediators’(school parents trained at the center). Through the practice, we could find the following effects. First, it is apparent that the children who have low motivation actively participated in the process. Second, the students listen and gradually narrow the difference in views. Third, the students concentrate on the relationship in which they listen to one another. Fourth, these three effects are the results of the joint response of the school, center, and community to the school problems. From the study results above, Educational Integration Model has a potential to be the practical alternative model for the local communities in Wan-ju gun as well as in the whole country. 본 연구는 전국 유일의 교육전담중간지원조직인 완주군교육통합지원센터(이하 ‘센터’로 약칭) 가 운영하는 ‘교육통합모델’ 실천사례를 중심으로 센터가 운영하는 교육통합모델을 어떻게 구상하게 되었는지, 학교 유형에 따른 교육통합모델 프로젝트를 어떤 과정을 통해 개발하였고, 그 특성이 무엇인지를 밝히고자 한다. 그리고 이를 학교현장에 어떻게 적용ㆍ실천하였으며, 그 실천과정에서 드러난 효과가 무엇인지를 분석하고자 한다. 본 연구를 위해 2013년 이후 현재까지 완주군교육통합지원센터가 운영해오고 있는 교육통합모델의 여러 사례들 가운데, 지역사회의 교육자원에 대한 의존 여부를 기준으로 ‘독립적인 도농복합형’, ‘준 독립적인 농촌형’, ‘의존적인 작은 학교형’으로 구분하였다. 세 유형 중 의존적인 작은학교형인 소망분교 실천 사례를 연구하여 나머지 사례로 확장하기 위한 기초를 마련하고자 하였다. 완주군교육통합지원센터의 교육통합모델은 센터의 관계자 및‘매개자’(센터에서 양성된 학부모 등)가 참여하여 학교의 정규교과 또는 방과후 프로그램에 참여, 다양한 프로젝트 학습을 적용함으로써 학생들이 겪고 있는 어려움을 해결할 수 있도록 돕는 방식으로 진행되었다. 이를 통해 다음과 같은 효과가 확인되었다. 첫째, 무기력한 아이들의 적극적 참여가 또렷해졌다. 둘째, 차이를 좁혀가며 듣게 되었다. 셋째, 서로 들어 주는 관계 속에 집중하게 되었다. 넷째, 참여가 또렷해지고, 차이를 좁혀 듣게 되며, 서로 들어 주는 관계 속에 집중하는 현상은 학교, 센터, 지역사회가 학교 문제에 공동 대응한 결과이다. 이상의 연구결과를 통해 볼 때, 교육전담중간지원조직체가 운영하는 교육통합모델은 완주군뿐만 아니라 전국지역 단위에서 지역공동체의 실천적 대안모델로 성장할 가능성을 가지고 있음을 확인할 수 있었다.
Purpose The optimal perioperative treatment for resectable esophageal squamous cell carcinoma (ESCC) remains controversial. We evaluated the efficacy and safety of leucovorin and 5-fluorouracil (LV5FU2) and LV5FU2 plus oxaliplatin (FOLFOX) combination chemotherapies administered adjuvantly for curatively-resected, node-positive ESCC. Materials and Methods Patients with pathologically node-positive esophageal cancer after curative R0 resection were enrolled and randomly assigned to receive LV5FU2 or FOLFOX biweekly for up to eight cycles. The primary endpoint was disease-free survival (DFS). Results Between 2011 and 2015, 62 patients were randomized into the two treatment groups (32 in the LV5FU2 arm and 30 in the FOLFOX arm). The median age was 60 years and both groups had similar pathologic characteristics in tumor, nodal status, and location. Treatment completion rates were similarly high in both groups. The DFS rate at 12 months was 67% in the LV5FU2 group and 63% in the FOLFOX group with a hazard ratio of 1.3 (95% confidence interval [CI], 0.66 to 2.62). After a median follow-up period of 27 months, the median DFS was 29.6 months (95% CI, 4.9 to 54.2) in the LV5FU2 arm and 16.8 months (95% CI, 7.5 to 26.1) in the FOLFOX arm (p=0.428), respectively, while the median overall survival was not reached in either arm. Grade 3 or 4 neutropenia was more frequent in patients in the FOLFOX arm than the LV5FU2 arm (20.0% vs. 3.1%). Conclusion The addition of oxaliplatin (FOLFOX) did not lead to better efficacy compared to LV5FU2 chemotherapy in an adjuvant setting in node-positive ESCC patients.
Background: The purposes of this study were (1) to investigate the abilities of word definition in patients with Alzheimer’s disease (AD) according to the severity, and (2) to examine the error patterns in patients with Alzheimer’s disease. Methods: Eight individuals with MCI (CDR=0.5) and 16 patients with AD (eight for probable AD mild group of CDR=1 and eight for probable AD moderate group of CDR=2) participated in the study. Eight normal age-, gender-, and education-matched elderly adults served as a control group for the MCI and AD groups. As stimuli for the word definition, eleven semantic categories were used, and two concrete words were selected from each category, resulting in a total of 22 items. Prior to the task, four definition categories were provided: 1) functional, 2) relational, 3) perceptual, and 4) categorical. Statistical analyses were performed using Kruskal-Wallis test, and Bonferroni analyses were used as a post-hoc comparison for any significant results. Results: There were significant differences in word definition scores among four groups. The probable AD moderate group showed the lower definition score than the probable AD mild group. And the probable AD moderate group showed the lower definition score than MCI group. Each group defined words in different ways. While the control group employed four definition different categories equally, the probable AD moderate group used a functional definition category mainly. However, relational and categorical definition categories were rarely observed in the probable AD moderate group. The analysis of error pattern showed that inadequate definition was frequently observed in all groups. Conclusions: The results from this study suggest that word definition task could be a sensitive indicator of the impairment of semantic knowledge in patients with AD.