현대영미소설 : 들릴로의 『코스모폴리스』에 나타난 코스모폴리스적 이상의 아이러니

정희원 ( Hee Won Chun ) 한국현대영미소설학회 2015 현대영미소설 Vol.22 No.1

This paper explores various ironical facets of the idea, or the ideal, of a cosmopolis in Don DeLillo``s Cosmopolis. This essay also offers a critical reflection upon cosmopolitan irony as cosmopolitan virtue. Having been reviewed as DeLillo``s first post-9/ll novel, Cosmopolis has been much acclaimed as describing the collapse of homo technologicus through its analogy between the novel``s protagonist Eric Packer and the World Trade Center. This article relocates the focus of reading from the aftermath of 9111 to its titular ironic embodiment of cosmopolis in New York City, the center of global capitalism. This approach presupposes that the diachronic point of view that originates from eighteenth-century Enlightenment Cosmopolitanism is more helpful in tracing the complicated ironical aspects of (anti-) cosmopolitan practices in DeLillo``s novel. This paper traces the history of cosmopolitanism and the meaning of the term cosmopolitan, especially from Kant``s "Toward Perpetual Peace" through Marx and Engels``s Communist Manifesto and finally to cosmopolitanisms of the present. Then it interprets Cosmopolis as the product of a contemporary cosmopolitanism as part of the project of capitalism, a cosmopolitanism also known as neoliberalism.

천막상부 역형성 성상세포종과 다형성 교모세포종 환자에서 수술적 종양제거 범위가 생존에 미치는 효과 : 휴향적 다변량 분석법에 의한 연구 A Retrospective Multivariate Analysis

정희원,심기범,정천기 대한신경외과학회 1992 Journal of Korean neurosurgical society Vol.21 No.12

A retrospective analysis was performed to evaluate the prognostic factors affecting the length of survival of 86 adults(age>15 years) with newly diagnosed biopsy-proven supratentorial anaplastic astrocytomas and glioblasmas treated at the Seoul National University Hospital and Korea Cancer Center Hospital between June, 1980 and June, 1990. Of the 86 patients, 44 patients (51%) had anaplastic astrocytoma, and 42 patients(49%) had glioblastoma multiforme. The mean age was 40 years, and mean initial Karnofsky performance score(KPS) was 70. The duration of follow up ranged from 3 months to 85 months. Survival curves were generated using the Kaplan-Meier curves. Median survival times were compared using the log-rank test. Additionally, for a study of the prognostic importance of multiple factors acting simultaneously, the proportional hazards regression model of Cox was used in which survival times were modeled as a function of the important independent variables identified in the univariate analysis. Categories included biopsy, partial resection, and gross total resection. Seventeen patient(20%) who underwent a gross total resection of their tumors had median survival time and 6-, 12-, 24- month survival rates of approximately 33 months, 94%, 80% and 57% respectively, when compared to 13 months, 74%, 53%, 34% for fifty patients(60%) who had partial resection. Multivariate analysis demonstrated that the age(p=0.010), the initial KPSP(p<0.001), the histology(p<0.001) and the extent of resection (p=0.016) were significant and independent variables influencing survival. These results suggest that gross total resection of supratentorial anapalstic astrocytomas and glioblastomas is directly associated with longer survival when compared to partial resection or biopsy.

초기태아 뇌조직의 기관형 구상체의 형성에 관한 연구

정희원,한종우,김종수,정천기,전상룡,최길수 대한신경외과학회 1996 Journal of Korean neurosurgical society Vol.25 No.12

The present study investigated whether organotypic spheroids derived from human fetal brain tissue, cultured at agarose-overlay media may serve as an optimal in vitro model for multidisciplinary studies in human neurobiology, particularly in the fields of tumor invasiveness and its biochemical mechanism, using light microscopy. electron microscopy and immunohistochemical staining Eight fetal brain tissues of 8-9 weeks of gestation were minced and explanted into agarose-coated culture wells. After three to five days these human fetal brain tissue fragments emerged as spheroids and could be maintained as organotypic spheroids for up to seven weeks. Light and electron microscopic studies of spheroids demonstrated that most cells were poorly differentiated and there were no definite mature neurons or glial cells after enough culture time, but some cells showed certain evidence suggestive of differentiation to neurons or glial cells immunohistochemical staining for glial fibrillary acidic protein(GFAP) and neuron specific enolase(NSE) demonstrated that NSE-positive cells were oval or spherical cells containing abundant cytoplasm and GFAP-positive cells were fibrillary cytoplasma-containing cells which showed some evidence suggestive of differentiation to glial cells by light microscopy. In future, adding some modifications in culture, this organotypic spheroids derived from the human fetal brain may serve as an optimal in vitro model for neurobiology, especially in the field of studies on tumor invasiveness through co-culture with microtumor spheroids.

면역효소측정법(ELISA)와 Praziquantel 약물요법이 중추신경계 낭미충증의 진단과 치료에 미치는 영향

왕규창,정천기,정희원,김동규,조병규,한대희,최길수,심보성 대한신경외과학회 1986 Journal of Korean neurosurgical society Vol.15 No.4

The diagnosis and management of neurocysticercosis have changed after the recent introduction of Enzyme Linked Immuno-sorbent Assay(ELISA) and praziquantel. Authors reviewed 11 cases of surgically proved neurocysticercosis in which these new diagnostic and therapeutic methods were applied. Age was widely distributed(range 16-59, mean 40 years old). Male preponderance was noted as in other reports. EUSA was tested in all cases and 10 out of 11 cases were strongly positive, while I case of degenerated cysticercosis was negative. Praziquantel was tried but failed in 5 cases before surgical intervention. Removed cysticerci were located in the fourth ventricle(5 cases), the parenchyme(3 cases), the lateral ventricle(l case), the cistern -parenchyme(1 case), and the cisterna magna(l case). Conclusions were as followings: ELISA was reliable in the diagnosis, but was deceitful as a quantitative base during follow-up. If progressive hydrocephalus was detected on the follow-up brain CT( computerized tomography) and no improvement was found clinically after praziquantel therapy in the case of positive ELISA and hydrocephalus, authors recommend ventriculography in the case of suspicious intraventricular lesion, or recommend shunting procedure in simple hydrocephalus. If the apparent mass disappeared after praziquantel or surgical intervention in the case of positive ELISA, but no improvement occurred clinically, then authors recommend considering of mixed type cysticercosis and performing the diagnostic work-up.

삼차신경통과 반측 안면 경련에 대한 미세혈관 감압술의 단기성적

곽호신,정천기,김현집,오창환,정영섭,김동규,정희원,최길수,한대희 대한신경외과학회 1994 Journal of Korean neurosurgical society Vol.23 No.4

The result of microvascular decompression (MVD) in 105 consecutive cases is presented. The symptomatic vasculoneural compressions including tumor, vascular malformation, or aneurysm are excluded in this study group. The 41 patients with trigeminal neuralgia (TN) were all treated by posterior fossa exploration (PFE). Eighteen of them were treated with MVD only, another 14 with partial sensory rhizotomy (PSR) only, and in the other 9 patients, MVD and PSR were performed together. Sixty-two of 64 hemifacial spasm (HFS) cases were treated succesfully with MVD via PFE. However in one case of which the offending vessel was not identified, neurolysis was camed out. The other case who had both TN and HFS, died due to intraoperative cardiac arrest The result of operation was evaluated at one month after the operation. In TN, among thirty-nine (98%) patients who resulted in pain-improvement, 32 (82%) experienced complete resohition of the pain.,The rate of complete pain-relief was higher in the 'MVD only group' than in 'group with PSR': Amomg 62 (94%) cases of HFS, 29 (47%) patients obtained 'complete cure' and 'improvement-only' respectively only 4 (6%) patients had no change of the spasm. The preoperative clinical characteristics, intraoperative surgical fingdings and postoperative outcomes were itemized and analyzed to find out the prognostic factors. The our results are compared with others in the literature.

Sodium Valproate(Depakine^(�)) 정맥주사의 임상적 효능에 관한 연구 : 신경외과 수술후 1주일간의 간질억제효과와 안전성 Antiepileptic Effect and Safety Assessment During the Postoperative Seven Days in Neurosurgical Patients

백선하,왕규창,오창완,정천기,김동규,정희원,김현집,조병규,최길수,한대희 대한신경외과학회 1996 Journal of Korean neurosurgical society Vol.25 No.7

Diphenylhydantoin(DPH) has been used intravenously as a drug of choice in conditions which seizure patients are incapable of oral Teeding or in a state of status epilepticus However, its clinical use has limitations because of its serious side effects o# cardiac depression or systemic hypotension In Western countries. the recently do- veloped intravenous sodium valproate has been reported as safe and e#Tective for seizure control in such patients To assess the safety and effectiveness in seizure control we investigated the serum levels of the drug at f4 hours 48 hours and 7 days after intravenous administration of sodium valproate(Depakine른. occurrence of seizures in the perioperative period and the side eT#ects of the drugs in 30 neurosurgical patients older than 3 years of age The mean serum concentrations of valproic acid after bolus injection To IS mg/kg followed by continuous infusion with the rate To OSmg/kg/hour, were over 450 rg/ml . 좌S 0± IS 3 ff/ml at 운4 hours, 504±fl 0 f(g/ml at 좌』 hours and 58 9±tO 7 賠,/1 at 7 days aTter the sta「t of the adinistration All the Patients whose se「u vaIProic acid levelwas witHin the therapeutic range(40-100 rr/ml). had never experienced an episode of seizure attack during the perioperative days There was no evidence of elevated liver enzyme activity, but there were evidence of some tendencyof decreased platelet count in the peripheral blood at f days a#ter the administration of intravenous Yalproic acid Four patients experienced episodes of mild nausea and/or vomiting in conclusion per'ioperat'ive intravenous administration of valproic acids in neurosurgical patients was safe and effective in seizure control However it must be used precauciously in the patients with compromized coagulation system

Phase Ⅲ Randomized Trial of ACNU in Addition to Surgery and Radiotherapy for Patients with Malignant Glioma of the Brain : A Preliminary Report 초기 보고

Jung, Hee-Won,Chung, Chun Kee,Chi, Je G.,Bang, Yung Jue,Heo, Dae Seog,Ahn, Yoon-Ok,Kim, Il Han,Kim, Noe Kyeong,Choi, Kil Soo,Han, Dae Hee 대한신경외과학회 1992 Journal of Korean neurosurgical society Vol.21 No.9

악성 뇌교종환자에서 수술후 방사선 치료와 함께 시작하여 최소 2주기이상 시행한 ACNU 화학요법이 방사선치료만 시행하였을때보다 관해유지에 부가되는 치료효과가 있는지를 결정하기 위하여 전향성 무작위 임상시험을 시행하였다. 수술후 악성 뇌교종으로 확진된 환자들을 연령, 성별, 수술적출 정도 및 병리 소견으로 충화한 다음, 무작위로 방사선치료 단독군(단독군)(11명) 또는 방사선 및 화학요법 병용군(병용군)(11명)으로 할당하였다. 연령 분포상 50세 이상이 45% 이었고 남녀비는 1 : 1이었다. 전적출은 단독군에서 2례, 병용군에서 5례 시행하였으며 악성 성상세포종이 27%, 다형성교모세포종이 73%이었다. 이러한 연령, 성별, 수술적출의 정도 및 병리소견의 분포는 단독군과 병용군간에 차이가 없었다. 총관해율(완전 및 부분)은 단독군에서 36.4%, 병용군에서 27.3%였다. 환자의 생존기간 및 병의 진행기간을 카프란-마이어법으로 분석하였고 단독군과 병용군 간의 차이는 로그-순위법으로 비교하였다. 일년 누적생존율은 단독군에서 60.6%, 병용군에서 46.7%로 두군간의 차이는 관찰되지 않았다(0.25<p<0.50). 그러나 70주이상의 장기 누적 비진행율은 단독군(22.7%)에서보다 병용군(46.7%)에서 더 높았다. 병용군의 64%에서 부작용(주로 골수억제)이 관찰되었고, 단독군의 36%에서 오심이 관찰되었다. 화학요법제의 용량조절이 필요한 경우가 병용군의 64%에서 관찰되었으나, 골수억제기간이 일시적이었으므로 이로인하여 화학요법의 중단이 필요한 경우는 없었다. 본 초기보고상에서는 ACNU가 종양관해유도 및 관해유지에 통계학적으로 유의한 부가적 효과가 있다고 하기는 어렵다. 그러나, 장기적인 종양관해의 유지에 미치는 부가적 효과에 대한 판정은 환자수가 더 축적되고 추적관찰의 기간이 연장되면 가능할 것으로 판단되었다.

두개강내로 진출한 접형동 점액종의 진단과 치료

정천기,왕규창,이선호,김동규,정희원,김종현,조병규,지제근,최길수 대한신경외과학회 1986 Journal of Korean neurosurgical society Vol.15 No.4

Sphenoid sinus mucocele with the intracranial extension is a rare disease but should be included in the differential diagnosis of destructive changes of the sella turcica, since a seemingly harmful intracranial procedure may be attempted. With the use of CT scan and MRI, it can be diagnosed preoperatively with a much better accuracy. Three histologically - verified cases of sphenoid mucocele with intracranial extension developing headache, visual disturbance and/or amenorrhea are described with a review of the literatures. All cases were successfully operated upon by the intranasal procedures.

지주막하 출혈시 급성기에서 Nizofenone의 치료효과

한대희,정천기,정희원 대한신경외과학회 1992 Journal of Korean neurosurgical society Vol.21 No.1

We administered new imidazole dervative, nizofenone, to 15 cases in the acute stage following subarachnoid hemorrhage between December, 1990 and March, 1991 to determine its therapeutic value of ischemic protection. The appearance of delayed ischemic deficit was not prevented, but its prognostic adverse effect was ameliorated. The ability to perform the normal activity was 67% in the group which did not show the delayed ischemic deficit. And the ability to perform the normal activity was also 67% in the group which showed the delayed ischemic deficit. No significant side effect was seen in the end of its administration. But in 6 cases, the administration was stopped because of deterioration of patient's consciousness level despite its administration. No therapeutic value was observed in the poor grade(Hunt and Hess grade Ⅲ-Ⅳ) patients. The ability to perform the normal activity was still 29% in the poor grade group. The mortality was 13% despite nizofenone. In this clinical trial, we concluded that nizofenone had the ameliorating effect to the adverse effect of the delayed ischemic deficit in the good grade(Hunt and Hess grade Ⅰ-Ⅱ) patients. But the effect to the poor grade patients was not observed. So large scaled controlled study would be necessary to verify its good therapeutic effect to the whole population of subarachnoid hemorrhage patients.

악성 신경교종에서 기관형적 배양후 형성된 미세종양 구상체의 초미세구조적연구

신형진,정천기,박인성,정영섭,정희원,한대희 대한신경외과학회 1993 Journal of Korean neurosurgical society Vol.22 No.3

The present study investigated not only the feasibility of organotypic spheroid culture system taken from human malignant gliomas but also the similarities and differences between surgical specimens and cultured spheroids using light microscopy electron microscopy, and flow cytometric examination. Surgically resected tumor specimens from eighteen human malignant gliomas were minced and explanted into agarose-coated culture wells. After three to five days these microtumor fragments emerged as spheroids and could be maintained as organotypic spheroids for more than eight weeks. Measurements of the spheroids showed that they decreased during the initial two to three weeks and afterwards remained unaltered over a specific period of time. This growth pattern of the spheroids was consistent with the condition of tumors in vivo suggesting the linkage of cell proliferation and loss. Light microscopic and electron microscopic studies of the spheroids demonstrated that morphological structures were similar to those of the original tumor tissue in vivo and histopathologic characteristics of the original tumor were maintained over a long culture period. The spheroids contained connective tissues, blood vessels, macrophages and neutrophils maintaining a three-dimensional architectural resemblance to the original tumors. Of three pairs of the surgical and spheroid specimen examined by the flow cytometry, one showed a change of ploidy pattern and two contained increased fictions of proliferating cells. It is concluded that this microtumor spheroid system can maintain the characteristics of the original tumors and may serve as an alternative to the in vivo xenograft model for the research of brain tumor biology, invasion and immunology while providing a valuable technique for the evaluation of new therapies such as biological response modifiers.