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조선시대 노인(老人)의 존재양상 - 연령과 신분을 중심으로 - (A Study on the existence aspect of the elderly in the Joseon Dynasty)

  • 김효경
    • 역사민속학
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    • 제52호
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    • pp.7-46
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    • 2017
  • 조선시대 노인은 육체적 변화와 더불어 10년을 단위로 하는 연령별로 사회적 처우가 달랐다. 우선 유교 이념에서 노인은 군자로서의 완성된 성품을 지닌 자로서 여전히 수신해야 하는 존재였다. 군자로서의 성품을 지녔기에 존로와 경로는 신분과 관품을 초월해서 이루어졌다. 노인은 육체적 쇠약이 시작되는 50세부터로 보았지만 이는 장년과 노인의 변곡점을 언급한 것일 뿐 노인을 규정한 것은 아니다. 노인은 국역이라는 사회적 의무가 해제되는 60세는 모든 사회적 존재에게 해당되는 명실상부한 노인의 하한 연령이다. 그러나 60세는 사회적 의무가 해제될 뿐 여전히 노인은 일반 사회구성원으로 간주되었기에 특별한 혜택이 부여되지는 않았다. 신분제와 관료제 사회에서 노인의 우대는 연령별로 다르게 시행되었다. 70세는 고관에게만 다양한 혜택이 주어졌는데, 복호와 시정을 처음으로 제공했다. 또한 관료의 정년은 특별히 정해지지 않고 스스로 물러나는 치사(致仕)에 의해 존로를 예우하는 방식으로 거행되었다. 고관과 대신에게 주어진 최상의 예우라 하겠다. 80세는 양천 모두에게 노인을 우대하는 조치로 양로연을 베풀었다. 더불어 노인직을 수여함으로써 사회적 가치가 부여된 관품(官品)을 허용했다. 서인과 천인에게조차 허용된 관품은 최상의 존로(尊老)정책이었다고 하겠다. 그러나 노인 관련 존로정책은 신분과 관품에 따라 왕은 60세부터, 정2품 고관, 종친 등은 70세, 일반 서인은 80세, 노비는 90세에 사회적 예우의 대상이 되었다. 노인 봉양은 개인적으로 실시하면 되지만 국가가 이를 주관했기에 사회적 가치를 부여한 것이다. 신분과 관품에 따라 복호와 시정을 배정하고, 사물의 종류를 달리함으로써 당시 사회적 한계가 분명히 드러났다. 존로 사상이라는 이념보다는 신분과 관품이라는 사회적 질서가 우선시 된 것이다. 그러나 연령별, 신분별 존로 행위는 개인적 차원에 그치지 않고 국가가 사회의 구성원인 노인을 존로사상에 입각해 다양한 방법으로 양로했다. 육체적 쇠약으로 인해 활동이 여의치 않은 이들을 사회가 양로코자 했다. 경제적으로는 의자, 쌀, 고기, 얼음 등의 사물(賜物)을 통해, 법적으로는 면죄(免罪)와 감경과 속죄금 등으로, 사회적으로는 가자(加資)라는 노인직 수여를 통해 관료제 사회의 구성원으로 치환함으로써 그 존재 가치를 높였다. 신분과 관품을 초월하여 모든 계층을 대상으로 실시된 양로연과 가자는 80세 이상이 사회적 존로의 대상임을 분명히 한다. 즉 80세에 이르면 노인은 신분을 초월하여 사회적으로 존경받는 노인으로서 경로의 대상이 되었다.

養蠶適地選定에 관한 調査硏究 (Survey Studies on Serviceable Sericultural Communities in Korea)

  • 최병희;권영하;문재유;백현준;이건영;이상풍;이원주;임수호;조동옥;김성호;황홍도;김기석;김수경;고낙용;소병주;이건우;이재옥;임동락;조진구
    • 한국잠사곤충학회지
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    • 제25권1호
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    • pp.34-43
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    • 1983
  • 1. 우리나라 養絲業은 ‘60年代 以後 ’70年代 前半期까지 急伸長하여 ‘76年에는 蠶繭生産量은 年平均 18.5%, 뽕밭面積은 年平均 16.4%가 減少하여, 養蠶生産基盤이 約 1/3로 萎縮되어, 生絲類 供給不足 現狀이 深化되어 養蠶基盤確保問題가 重要課題가 되고 있다. 2. 養蠶基盤 激減의 原因은 70年代 後半期 以後 國際景氣沈帶에서 오는 絲價의 下落, 輸入觀制等의 外部的 要因과 繭價引上率의 鈍化, 養蠶收益性의 相對的 底現狀이 두드러지게 나타났다. 이 現狀은 農業地帶別로 보면 ‘76年 대비 ’80年의 蠶繭生産量이 嶺南의 山間混作地帶가 33%減으로 가장 安定된 反面 江原道를 비롯한 準山間 田作地帶가 70%減으로 가장 크게 變動되었고, 이를 다시 行政單位別로 보면 慶南山淸等 6個郡은 20%未滿減인데 비해, 江原三陟等 16個郡은 80% 以上減이다. 面單位로 細分하여 보면 25個面은 오히려 增産되었고 143個面은 80% 以上이나 減少하는등 地域單位가 적어질수록 그 격차가 크게 나타나고 있음을 알 수 있다. 4. 蠶繭生産量의 增減과 가장 깊은 상관관계가 있는 것은 農家戶當 蠶繭生産量의 減少率로서 各道 다같이 正의 상관관계를 나타내었으며, 10a當 蠶繭生産量의 多寡와 一般耕地面積 및 밭面積中의 뽕밭面積 比率도 主要한 要因으로 作用하였다. 5. 養蠶經營 및 技術實態를 (79年 대비 81年) Computer에 의하여 精密調査하고자 農業地帶別로 17個郡 464里洞을 대상으로 調査한 결과는 다음과 같다. 1) 戶當蠶繭生産量 農業地帶別은 大差 없으나 比較的 安定된 里洞(79대비 81, 20%未滿減)은 戶當生産量이 ‘79年 100.8kg에서 81年이 122kg로 增産, 不安定里洞(40% 以上減)은 102.9.kg에서 82kg로 減産되었다. 2) 10a當 收繭量 山間地 보다 平野地가 많으며 安定里洞은 73.4kg, 不安定里洞은 55kg였다. 3) 가지뽕치기 普及率 山間地 보다 平野地가 높으며 安定里洞은 79年3 養蠶의 普及率.이 24.2%, 秋蠶은 16.7%에서 ‘81年4은 34.3% 10.1%로 各各 擴大된 경향이나, 不安定里洞은 81年이 春蠶 13.3%, 秋蠶 12.6%로 安定里洞에 비하여 크게 떨어지고 있다. 4) 養蠶複合經營의 類型 <養蠶十水稻十特作>이 55%로 가장 많고 <養蠶十水稻十一般作物>과 <養蠶十水稻가 各各 14%를 차지하고 있으며 養蠶所得이 農業所得에서 占하는 比重이 20%未滿 里洞이 81%나 되어 完全複合經營管 形態에는 이르지 못하고 있다. 5) 農業公害와 農藥型態 農業公害는 平野地에서는 主로 水稻에서 오는 것이 많고 그 被害 時期는 秋蠶期가 大部分을 차지하고 撒布農藥은 液劑가 65%, 粒劑가 35%로 粒劑使用 比重이 낮은 것은 價格이 비싼 때문이다.

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Brief Introduction of Research Progresses in Control and Biocontrol of Clubroot Disease in China

  • He, Yueqiu;Wu, Yixin;He, Pengfei;Li, Xinyu
    • 한국균학회소식:학술대회논문집
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    • 한국균학회 2015년도 춘계학술대회 및 임시총회
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    • pp.45-46
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    • 2015
  • Clubroot disease of crucifers has occurred since 1957. It has spread to the whole China, especially in the southwest and nourtheast where it causes 30-80% loss in some fields. The disease has being expanded in the recent years as seeds are imported and the floating seedling system practices. For its effective control, the Ministry of Agriculture of China set up a program in 2010 and a research team led by Dr. Yueqiu HE, Yunnan Agricultural University. The team includes 20 main reseachers of 11 universities and 5 institutions. After 5 years, the team has made a lot of progresses in disease occurrence regulation, resources collection, resistance identification and breeding, biological agent exploration, formulation, chemicals evaluation, and control strategy. About 1200 collections of local and commercial crucifers were identified in the field and by artificiall inoculation in the laboratories, 10 resistant cultivars were breeded including 7 Chinese cabbages and 3 cabbages. More than 800 antagostic strains were isolated including bacteria, stretomyces and fungi. Around 100 chemicals were evaluated in the field and greenhouse based on its control effect, among them, 6 showed high control effect, especially fluazinam and cyazofamid could control about 80% the disease. However, fluzinam has negative effect on soil microbes. Clubroot disease could not be controlled by bioagents and chemicals once when the pathogen Plasmodiophora brassicae infected its hosts and set up the parasitic relationship. We found the earlier the pathogent infected its host, the severer the disease was. Therefore, early control was the most effective. For Chinese cabbage, all controlling measures should be taken in the early 30 days because the new infection could not cause severe symptom after 30 days of seeding. For example, a biocontrol agent, Bacillus subtilis Strain XF-1 could control the disease 70%-85% averagely when it mixed with seedling substrate and was drenching 3 times after transplanting, i.e. immediately, 7 days, 14 days. XF-1 has been deeply researched in control mechanisms, its genome, and development and application of biocontrol formulate. It could produce antagonistic protein, enzyme, antibiotics and IAA, which promoted rhizogenesis and growth. Its The genome was sequenced by Illumina/Solexa Genome Analyzer to assembled into 20 scaffolds then the gaps between scaffolds were filled by long fragment PCR amplification to obtain complet genmone with 4,061,186 bp in size. The whole genome was found to have 43.8% GC, 108 tandem repeats with an average of 2.65 copies and 84 transposons. The CDSs were predicted as 3,853 in which 112 CDSs were predicted to secondary metabolite biosynthesis, transport and catabolism. Among those, five NRPS/PKS giant gene clusters being responsible for the biosynthesis of polyketide (pksABCDEFHJLMNRS in size 72.9 kb), surfactin(srfABCD, 26.148 kb, bacilysin(bacABCDE 5.903 kb), bacillibactin(dhbABCEF, 11.774 kb) and fengycin(ppsABCDE, 37.799 kb) have high homolgous to fuction confirmed biosynthesis gene in other strain. Moreover, there are many of key regulatory genes for secondary metabolites from XF-1, such as comABPQKX Z, degQ, sfp, yczE, degU, ycxABCD and ywfG. were also predicted. Therefore, XF-1 has potential of biosynthesis for secondary metabolites surfactin, fengycin, bacillibactin, bacilysin and Bacillaene. Thirty two compounds were detected from cell extracts of XF-1 by MALDI-TOF-MS, including one Macrolactin (m/z 441.06), two fusaricidin (m/z 850.493 and 968.515), one circulocin (m/z 852.509), nine surfactin (m/z 1044.656~1102.652), five iturin (m/z 1096.631~1150.57) and forty fengycin (m/z 1449.79~1543.805). The top three compositions types (contening 56.67% of total extract) are surfactin, iturin and fengycin, in which the most abundant is the surfactin type composition 30.37% of total extract and in second place is the fengycin with 23.28% content with rich diversity of chemical structure, and the smallest one is the iturin with 3.02% content. Moreover, the same main compositions were detected in Bacillus sp.355 which is also a good effects biocontol bacterial for controlling the clubroot of crucifer. Wherefore those compounds surfactin, iturin and fengycin maybe the main active compositions of XF-1 against P. brassicae. Twenty one fengycin type compounds were evaluate by LC-ESI-MS/MS with antifungal activities, including fengycin A $C_{16{\sim}C19}$, fengycin B $C_{14{\sim}C17}$, fengycin C $C_{15{\sim}C18}$, fengycin D $C_{15{\sim}C18}$ and fengycin S $C_{15{\sim}C18}$. Furthermore, one novel compound was identified as Dehydroxyfengycin $C_{17}$ according its MS, 1D and 2D NMR spectral data, which molecular weight is 1488.8480 Da and formula $C_{75}H_{116}N_{12}O_{19}$. The fengycin type compounds (FTCPs $250{\mu}g/mL$) were used to treat the resting spores of P. brassicae ($10^7/mL$) by detecting leakage of the cytoplasm components and cell destruction. After 12 h treatment, the absorbencies at 260 nm (A260) and at 280 nm (A280) increased gradually to approaching the maximum of absorbance, accompanying the collapse of P. brassicae resting spores, and nearly no complete cells were observed at 24 h treatment. The results suggested that the cells could be lyzed by the FTCPs of XF-1, and the diversity of FTCPs was mainly attributed to a mechanism of clubroot disease biocontrol. In the five selected medium MOLP, PSA, LB, Landy and LD, the most suitable for growth of strain medium is MOLP, and the least for strains longevity is the Landy sucrose medium. However, the lipopeptide highest yield is in Landy sucrose medium. The lipopeptides in five medium were analyzed with HPLC, and the results showed that lipopeptides component were same, while their contents from B. subtilis XF-1 fermented in five medium were different. We found that it is the lipopeptides content but ingredients of XF-1 could be impacted by medium and lacking of nutrition seems promoting lipopeptides secretion from XF-1. The volatile components with inhibition fungal Cylindrocarpon spp. activity which were collect in sealed vesel were detected with metheds of HS-SPME-GC-MS in eight biocontrol Bacillus species and four positive mutant strains of XF-1 mutagenized with chemical mutagens, respectively. They have same main volatile components including pyrazine, aldehydes, oxazolidinone and sulfide which are composed of 91.62% in XF-1, in which, the most abundant is the pyrazine type composition with 47.03%, and in second place is the aldehydes with 23.84%, and the third place is oxazolidinone with 15.68%, and the smallest ones is the sulfide with 5.07%.

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Field Studios of In-situ Aerobic Cometabolism of Chlorinated Aliphatic Hydrocarbons

  • Semprini, Lewts
    • 한국지하수토양환경학회:학술대회논문집
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    • 한국지하수토양환경학회 2004년도 총회 및 춘계학술발표회
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    • pp.3-4
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    • 2004
  • Results will be presented from two field studies that evaluated the in-situ treatment of chlorinated aliphatic hydrocarbons (CAHs) using aerobic cometabolism. In the first study, a cometabolic air sparging (CAS) demonstration was conducted at McClellan Air Force Base (AFB), California, to treat chlorinated aliphatic hydrocarbons (CAHs) in groundwater using propane as the cometabolic substrate. A propane-biostimulated zone was sparged with a propane/air mixture and a control zone was sparged with air alone. Propane-utilizers were effectively stimulated in the saturated zone with repeated intermediate sparging of propane and air. Propane delivery, however, was not uniform, with propane mainly observed in down-gradient observation wells. Trichloroethene (TCE), cis-1, 2-dichloroethene (c-DCE), and dissolved oxygen (DO) concentration levels decreased in proportion with propane usage, with c-DCE decreasing more rapidly than TCE. The more rapid removal of c-DCE indicated biotransformation and not just physical removal by stripping. Propane utilization rates and rates of CAH removal slowed after three to four months of repeated propane additions, which coincided with tile depletion of nitrogen (as nitrate). Ammonia was then added to the propane/air mixture as a nitrogen source. After a six-month period between propane additions, rapid propane-utilization was observed. Nitrate was present due to groundwater flow into the treatment zone and/or by the oxidation of tile previously injected ammonia. In the propane-stimulated zone, c-DCE concentrations decreased below tile detection limit (1 $\mu$g/L), and TCE concentrations ranged from less than 5 $\mu$g/L to 30 $\mu$g/L, representing removals of 90 to 97%. In the air sparged control zone, TCE was removed at only two monitoring locations nearest the sparge-well, to concentrations of 15 $\mu$g/L and 60 $\mu$g/L. The responses indicate that stripping as well as biological treatment were responsible for the removal of contaminants in the biostimulated zone, with biostimulation enhancing removals to lower contaminant levels. As part of that study bacterial population shifts that occurred in the groundwater during CAS and air sparging control were evaluated by length heterogeneity polymerase chain reaction (LH-PCR) fragment analysis. The results showed that an organism(5) that had a fragment size of 385 base pairs (385 bp) was positively correlated with propane removal rates. The 385 bp fragment consisted of up to 83% of the total fragments in the analysis when propane removal rates peaked. A 16S rRNA clone library made from the bacteria sampled in propane sparged groundwater included clones of a TM7 division bacterium that had a 385bp LH-PCR fragment; no other bacterial species with this fragment size were detected. Both propane removal rates and the 385bp LH-PCR fragment decreased as nitrate levels in the groundwater decreased. In the second study the potential for bioaugmentation of a butane culture was evaluated in a series of field tests conducted at the Moffett Field Air Station in California. A butane-utilizing mixed culture that was effective in transforming 1, 1-dichloroethene (1, 1-DCE), 1, 1, 1-trichloroethane (1, 1, 1-TCA), and 1, 1-dichloroethane (1, 1-DCA) was added to the saturated zone at the test site. This mixture of contaminants was evaluated since they are often present as together as the result of 1, 1, 1-TCA contamination and the abiotic and biotic transformation of 1, 1, 1-TCA to 1, 1-DCE and 1, 1-DCA. Model simulations were performed prior to the initiation of the field study. The simulations were performed with a transport code that included processes for in-situ cometabolism, including microbial growth and decay, substrate and oxygen utilization, and the cometabolism of dual contaminants (1, 1-DCE and 1, 1, 1-TCA). Based on the results of detailed kinetic studies with the culture, cometabolic transformation kinetics were incorporated that butane mixed-inhibition on 1, 1-DCE and 1, 1, 1-TCA transformation, and competitive inhibition of 1, 1-DCE and 1, 1, 1-TCA on butane utilization. A transformation capacity term was also included in the model formation that results in cell loss due to contaminant transformation. Parameters for the model simulations were determined independently in kinetic studies with the butane-utilizing culture and through batch microcosm tests with groundwater and aquifer solids from the field test zone with the butane-utilizing culture added. In microcosm tests, the model simulated well the repetitive utilization of butane and cometabolism of 1.1, 1-TCA and 1, 1-DCE, as well as the transformation of 1, 1-DCE as it was repeatedly transformed at increased aqueous concentrations. Model simulations were then performed under the transport conditions of the field test to explore the effects of the bioaugmentation dose and the response of the system to tile biostimulation with alternating pulses of dissolved butane and oxygen in the presence of 1, 1-DCE (50 $\mu$g/L) and 1, 1, 1-TCA (250 $\mu$g/L). A uniform aquifer bioaugmentation dose of 0.5 mg/L of cells resulted in complete utilization of the butane 2-meters downgradient of the injection well within 200-hrs of bioaugmentation and butane addition. 1, 1-DCE was much more rapidly transformed than 1, 1, 1-TCA, and efficient 1, 1, 1-TCA removal occurred only after 1, 1-DCE and butane were decreased in concentration. The simulations demonstrated the strong inhibition of both 1, 1-DCE and butane on 1, 1, 1-TCA transformation, and the more rapid 1, 1-DCE transformation kinetics. Results of tile field demonstration indicated that bioaugmentation was successfully implemented; however it was difficult to maintain effective treatment for long periods of time (50 days or more). The demonstration showed that the bioaugmented experimental leg effectively transformed 1, 1-DCE and 1, 1-DCA, and was somewhat effective in transforming 1, 1, 1-TCA. The indigenous experimental leg treated in the same way as the bioaugmented leg was much less effective in treating the contaminant mixture. The best operating performance was achieved in the bioaugmented leg with about over 90%, 80%, 60 % removal for 1, 1-DCE, 1, 1-DCA, and 1, 1, 1-TCA, respectively. Molecular methods were used to track and enumerate the bioaugmented culture in the test zone. Real Time PCR analysis was used to on enumerate the bioaugmented culture. The results show higher numbers of the bioaugmented microorganisms were present in the treatment zone groundwater when the contaminants were being effective transformed. A decrease in these numbers was associated with a reduction in treatment performance. The results of the field tests indicated that although bioaugmentation can be successfully implemented, competition for the growth substrate (butane) by the indigenous microorganisms likely lead to the decrease in long-term performance.

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헤파린 표면처리된 국산화 혈관우회도관의 개발 (Development of Korean Version of Heparin-Coated Shunt)

  • 선경;박기동;백광제;이혜원;최종원;김승철;김택진;이승열;김광택;김형묵;이인성
    • Journal of Chest Surgery
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    • 제32권2호
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    • pp.97-107
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    • 1999
  • 배경: 흉부대동맥 수술에 사용하는 헤파린 우회도관의 국산화를 위해, 헤파린 표면처리기법 중 물리분산법을 이용하여 제작한 우회도관의 동물실험을 통해 혈전저항성 및 안정성을 증명하고자 하였다. 대상 및 방법: 성견 21마리(17.5∼25 kg)를 대상으로 하행흉부대동맥 우회모델을 만들었다. 사용한 우회도관의 종류에 따라 무처리 우회도관군(CONTROL; n=3), 무처리 우회도관 및 전신 헤파린 처치군(HEPARIN; n=6), Gott 헤파린 우회도관군(GOTT; n=6), 국산 헤파린 우회도관군(KIST; n=6)로 분류하였다. 관찰지표는 말초혈액검사, 혈액응고검사, 신장 및 간기능검사, 표면전자현미경 소견 등이었다. 각 지표는 우회도관의 원위부 대동맥 혈액에서 검사하여 우회 전과 우회 후 2시간 째의 군내 변화와군간 차이를 비교하였다. 결과: 모든 관찰지표의 우회 전 기초치는 군간에 차이가 없었다. 말초혈액검사 중 혈소판치는 HEPARIN군과 GOTT군에서 유의하게 높아졌으나(p<0.05) 군간 차이는 유의하지 않았다. 기타 혈구세포의 변화는 각 군에서 군내변화와 군간차이가 유의하지 않았다. Activated clotting time, activated partial thromboplastin time, thrombin time은 HEPARIN군에서 현저히 증가하였고(p<0.05) 군간차이도 유의하였다(p<0.005). Prothrombin time은 GOTT군에서 유의하게 증가하였으나(p<0.05) 군간차이는 없었다. Fibrinogen은 각 군에서 군내변화와 군간차이가 유의하지 않았다. Antithrombin III는 HEPARIN군과 KIST군에서 유의하게 감소하였고(p<0.05) 군간차이도 유의하였다(p<0.05). Protein C는 HEPARIN군에서 유의하게 감소하였으나(p<0.05) 군간차이는 없었다. Blood urea nitrogen은 HEPARIN군과 KIST군에서 유의하게 증가하였으나(p<0.05) 군간차이는 없었다. Creatinine, aspartate aminotransferase, alanine aminotransferase는 각 군에서 군내변화와 군간차이가 유의하지 않았다. 표면전자현미경 소견에서 혈소판 및 혈구세포 응집정도는 CONTROL군이 가장 심했고, HEPARIN군은 GOTT군이나 KIST군에 비해 많았다. 결론: 이상의 결과에서 전신 헤파린 처치(HEPARIN)는 출혈경향을 증가시키면서 이물질 표면의 응고반응을 효과적으로 차단하지 못하는 반면, 헤파린 표면처리된 우회도관(GOTT & KIST)의 경우는 출혈경향 없이 표면의 응고반응을 충분히 억제하였다. 또한 국산(KIST) 헤파린 우회도관은 상용화된 외국산(GOTT)과 동등한 항혈전 성능을 보였다.

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성문상부암의 방사선치료 -국소종양 제어율과 생존율을 중심으로- (Radiotherapy in Supraglottic Carcinoma - With Respect to Locoregional Control and Survival -)

  • 남택근;정웅기;조재식;안성자;나병식;오윤경
    • Radiation Oncology Journal
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    • 제20권2호
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    • pp.108-115
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    • 2002
  • 목적 : 성문상부암에서 방사선 단독치료 또는 수술 후 방사선치료를 받은 환자를 대상으로 방사선치료의 역할을 국소종양제어율과 생존율을 중심으로 후향적으로 분석하고자 하였다. 대상 및 방법 : 1986년 1월부터 1995년 10월까지 134명이 성문상부암으로 진단되어 방사선단독 또는 수술 후 방사선치료가 시행되었고 이 중 계획된 방사선량을 조사 받은 117명의 환자를 대상으로 하였다. 1997년의 AJCC 병기 분류체계에 의하여 재분류하였고 병기 I, II, III, IVA, IVB의 환자 수는 각각 $6\;(5\%),\;16\;(14\%),\;53\;(45\%),\;32\;(27\%),\;10\;(9\%)$이었다. 전체 환자 중 80명은 근치적 목적의 방사선치료로 원발병소에 $61.2\~79.2\;Gy$ (평균 : 69.2 Gy), 경부림프절에 $45.0\~93.6\;Gy$ (평균:54.0 Gy)를 조사하였다. 전체 환자 중 병기 I과 IVB 환자는 모두 방사선 단독치료를 시행하였다. 37명의 환자에서 수술 후 방사선치료를 받았고 원발병소 절제부위에 $45.0\~68.4\;Gy$ (평균:56.1 Gy), 경부림프절에 $45.0\~59.4\;Gy$ (평균:47.2 Gy)를 조사하였다. 수술방법으로서 33명은 전후두적출술(${\pm}$경부림프절 청소술), 3명은 부분후두적출술(${\pm}$경부림프절 청소술), 나머지 1명은 원발병소만의 절제술이었다. 결과 : 전체환자의 5년 생존율은 $43\%$이었다. 병기 I+II와 III+IV의 5년 생존율은 $49.9\%,\;41.2\%$이었으나(p=0.27), 병기 I (n=6) 환자의 종양특성생존율은 $100\%$이었다. 수술 후 방사선치료군(S+RT)과 방사선단독 치료군(RT)의 5년 생존율은 병기 II에서 $100\%$$43\%$, 병기 III에서 $62\%$$52\%$이었으나 유의한 차이는 없었고(u=0.17, p=0.32), 병기 IVA에서 $58\%$$6\%$로 S+RT군의 생존율이 유의한 차이로 양호하였다(p<0.001). 전체 환자의 국소종양 제어율은 $57\%$이었다. 병기별 국소종양제어율은 병기 I, II, III, IVA, IVB에서 각각 100, 74, 60, 44, $30\%$이었다(p=0.008). S+RT 군과 RT군의 국소종양제어율은 병기 II에서 $100\%$$68\%$, 병기 III에서 $67\%$$55\%$로 유의한 차이는 없었으나(p=0.29, p=0.23), 병기 IVA에서는 $81\%$$20\%$로 유의한 차이가 있었다(p<0.001). 방사선 단독치료를 받은 80명의 환자 중 방사선치료반응에 따른 국소종양제어율은 완전관해, 부분관해, 부분관해미만 군에서 각각 76, 20, $0\%$이었다. (p<0.001). 전체환자에서 생존율에 영향을 미치는 예후인자는 다변량 분석을 시행한 결과 N 병기, 수술 여부, 나이였고 국소종양 제어율에 영향을 미치는 유의한 인자는 N 병기, 수술 여부, ECOG 활동도였다. 방사선 단독치료군에서 다변량 분석결과 생존율과 국소종양제어율 모두에 유의한 인자는 방사선치료 후 종양반응과 N 병기였다. 결론 : 조기 병기의 성문상부암에서는 통상적인 방사선단독치료로 후두기능을 보존하면서 수술군과 대등한 종양제어율을 보여주었다. 그러나 진행된 병기의 경우에는 수술과 방사선치료의 병용요법 또는 후두기능의 보존적 측면에서의 동시적 항암화학방사선요법이 고려되어야 할 것으로 생각된다. 특히 진행된 림프절 병소에 대해서는 가능한 한 방사선치료 전 또는 유도화학요법 후 계획된 경부림프절 청소술을 고려해야 할 것으로 생각된다.

도서관조직의 기술혁신 및 행정혁신에 관한 조직상황론적 연구 (A Study on the Technical and Administrative Innovation of Library Organization in the Perspective of the Contingency Theory)

  • 홍현진
    • 한국문헌정보학회지
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    • 제25권
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    • pp.343-388
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    • 1993
  • The ability of any organization to innovate itself in a rapid change of environment means the existence of the organization. Innovative activity is achieved in different ways according to the objectives of organization. the characteristics of external environmental factors. and various attributes in organization. In the present study. all the existing approaches to the innovative nature of organization were synthetically compared to each other and evaluated: then. for a more rational approach. a research model was built and suggested by establishing the inclusive variables of the innovative nature of library organization and categorizing the types of such nature. Additionally. an empirical. analytical study on such a model was done. That is. paying regard to the fact that innovation has basically a close relation with the circumstantial factors of organization. synthetic, circumstantial relations were clarified. considering the external environmental factors and internal characteristics of organization. In the study. the innovation of library organization was seen in two parts i.e .. the feasible degree of technical innovation and the feasible degree of administrative innovation. Regarding the types of innovative implementation. according to the feasible degree of innovation, four types such as a stationary type. technic-oriented type, organization-oriented type. and technical-socio systematic type were classified. There were nine independent variables-i.e., the scale of organization. available resources of the organization, formalization, differentiation, specialization. decentralization, recognizant degree of the technical attribute. degree of response to the change of technical environment, and professional activities. There were three subordinate variables - i.e., technical innovation, administrative innovation. and the performance of organization. Through establishment of such variables, the factors which might influence the innovation of library organization were understood, and with the types of the innovative implementation of library organization being classified according to the feasible degree of innovation. the characteristics of library organization were reviewed in the light of each type. Also. the performance of library organization according to the types of the innovative implementation of library organization was analyzed. and the relations between the types of innovative implementation according to circumstantial variables and the performance of library organization were clarified. In order to clarify the adequacy of the research model in the methodology of empirical study, data were collected from 72 university libraries and 38 special libraries. and for a hypothetical test of the research model. an analysis of correlations, a stepwise regression analysis. and One Way ANOVA were utilized. The following are the major results or findings from the study 1) It appeared there is a trend that the bigger the scale of organization and available resources are, the more active the professional activity of the managerial class is, and the higher the recognizant degree of technical environment (recognizant degree of technical attributes and the degree of response t9 the change of technical environment) is, the higher the feasible degree of innovation becomes. 2) It appeared that among the variables influencing the feasible degree of technical innovation, the order from the variable influencing most was first, the recognizant degree of technical innovation: second, the available resources of organization: and third, professional activity. Regarding the variables influencing the feasible degree of administrative innovation from the most influential variable, it appeared they were the available resources of organization, the differentiation of organization. and the degree of response to the change of technical environment. 3) It appeared that the higher the educational level of the managerial class is, the more active the professional activity becomes. It seemed there is a trend that the group of library managers whose experience as a librarian was at the middle level(three years to six years of experience) was more active in research activity than the group of library managers whose experience as a librarian was at a higher level(more than ten years). Also, it appeared there is a trend that the lower the age of library managers is, the higher the recognizant degree of technical attributes becomes. and the group of library managers whose experience as a librarian was at the middle level (three years to six years of experience) recognized more affirmatively the technical aspect than the group of library managers whose experience as a librarian was at a higher level(more than 10 years). Also, it appeared that, when the activity of the professional association and research activity are active, the recognizant degree of technology becomes higher, and as a result. it influences the innovative nature of organization(the feasible degree of technical innovation and the feasible degree of administrative innovation). 4) As a result of the comparison and analysis of the characteristics of library organization according to the types of innovative implementation of library organization. it was indicated there is a trend that the larger the available resources of library organization, the higher the organic nature of organization such as differentiation. decentralization, etc., and the higher the level of the operation of system development, the more the type of the innovative implementation of library organization becomes the technical-socio systematic type which is higher both in the practical degrees of technical innovation and administrative innovation. 5) As a result of the comparison and analysis of the relations between the types of innovative implementation and the performance of organization, it appeared that the order from the highest performance of organization is the technical-socio systematic type, then the technic-oriented type, the organization­oriented type, and finally the stationary type which is lowest in such performance. That is, it demonstrated that, since the performance of library organization is highest in the library of the technical-socio systematic type while it is lowest in the library whose practical degrees in both technical innovation and administrative innovation are low, the performance of library organization differs significantly according to the types of innovative implementation of library organization. The present study has extracted the factors influencing innovation, classified systematically the types of innovative implementation, and inferred the synthetical, circumstantial correlations between the types and the performance of organization, and empirically inspected those factors. However, due to the present study's restrictive matters and the limit of the research design, results from the study should be more prudently interpreted. Also, the present study, as an investigative study of the types of innovative implementation, with few preceding studies, requires more complete hypothetical inference based on the results of the present study. In other words, if more systematical studies are given to understanding the relations, it will devote the suggestion and demonstration of a more useful theory.

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자궁경부암에 항암화학요법과 동시 병용요법으로 외부 방사선조사와 고선량률 강내조사의 예비적 치료 결과 (Preliminary Results of Concurrent Chemotherapy and Radiation Therapy using High-dose-rate Brachytherapy for Cervical Cancer)

  • 이경자;이지혜;이레나;서현숙
    • Radiation Oncology Journal
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    • 제24권3호
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    • pp.171-178
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    • 2006
  • 목 적: 자궁경부암 환자에 항암화학요법과 동시에 외부 방사선조사와 고선량률의 강내조사를 시행하여 국소제어율, 생존율 및 독성을 후향적으로 분석하여 그 효과와 안전성을 알아보기 위한 연구이다. 대상 및 방법: 2001년 1월부터 2002년 12월까지 자궁경부암으로 진단받고 완치목적의 방사선치료가 필요한 30명의 환자를 대상으로 항암화학요법과 방사선조사를 동시에 시행하였다. 환자 나이의 중앙값은 58세($34{\sim}74$세)였다. 병리조직학적 소견은 29명이 편평상피세포암이고 1명은 선암이었다. FIGO 병기에 따라 IB 7명(23%), IIA 3명(10%), IIB 12명(40%), IIIA 3명(10%), IIIB 5명(17%)이었다. 외부 방사선조사는 골반강에 1회 180 cGy로 총 선량 $45{\sim}50.4\;Gy$ (중앙값: 50.4 Gy)를 시행하였다. 강내조사는 외부 방사선조사 41.4 Gy 조사 후 Ir-192를 이용한 고선량률로 point A에 1회 4 Gy를 주 2회 시행하여 총 $4{\sim}8$회 조사하여 $16{\sim}32\;Gy$ (중앙값 28 Gy) 조사하였다. Point A에 외부조사와 강내조사의 합산 선량의 생물학적 동등선량(biological effective dose, BED)은 $77{\sim}94\;GY_{10}$ (중앙값 $88\;Gy_{10}$)이었다. ICRU 38에 따른 직장의 선량은 $88{\sim}125\;Gy_3$ (중앙값 $109\;Gy_3$), 방광의 선량은 $91{\sim}123\;Gy_3$ (중앙값 $111\;Gy_3$)이였다. 항암제는 cisplatin ($60\;mg/m^2$)과 5-FU ($1,000\;mg/m^2$)를 외부 방사선조사와 동시에 시작하여 3주 간격으로 정맥 주입하였으며 총 $2{\sim}6$회(중앙값 5회) 시행하였다. 방사선조사 완료 후 4주에 진찰소견과 복부-골반 전산화단층촬영을 시행하여 관해정도를 관찰하였다. 추적기간은 $8{\sim}50$개월(중앙값 36개월)이었으며 국소제어율, 3년 생존율, 직장과 방광의 급성 및 만성 합병증을 관찰하였다. 결 과: 방사선조사와 항암화학요법을 동시에 시행하여 완전관해는 30명 중 28명으로 완전관해율은 93%였다. 3년 국소제어율은 87%, 전체환자의 3년 생존율은 93%, 무병생존율은 87%였다. 4명(13%)에서 국소실패를 보였고 1명(3%)에서 원격전이를 보였다. 치료 중 급성 합병증으로 11명(37%)에서 RTOG grade 1-2의 장염을 보였으며 1명은 대장의 천공이 발생하여 수술로 치유되었다. 12명(40%)에서 RTOG grade 1-2의 급성 방광염을 보였다. 3명(10%)에서 RTOG grade 1-2의 백혈구 감소증이 보였으며 1명에서 심한 백혈구 감소증(RTOG grade 4)이 나타났으나 회복되어 치료를 완료하였다. 만성 합병증으로 5명(15%)에서 RTOG grade 1-2의 만성 장염을 보였으며 별다른 치료 없이 지내고 있으며 1명(3%)에서 RTOG grade 2의 만성 방광염을 보였다. 그러나 치료에 의해 사망한 환자는 없었다. 결 론: 자궁경부암 환자에 항암화학요법과 동시에 외부 방사선조사와 고선량률의 강내조사를 시행한 결과 독성이 심하지 않고 국소제어율과 단기 생존율이 양호하여 안전하고 효율적인 치료방법으로 생각된다. 그러나 장기 생존율과 만성 합병증을 파악하기 위해서는 더 많은 환자를 대상으로 장기 추적관찰이 요구된다.

양평 벽계리에 설정된 곡중경(曲中景)의 지향성과 화서(華西) 이항로(李恒老)의 벽원(蘗園) 경영 (Studies on the Directivity of Gokjungkyeong(Kyung Overlapped with Gok) which was specified in Byeokgye-ri, Yangpyeong-gun and the Hwaseo Lee, Hang-ro's Management in Byeokwon Garden)

  • 정우진;노재현
    • 한국전통조경학회지
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    • 제34권3호
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    • pp.78-97
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    • 2016
  • 본 연구는 문헌 및 현장조사를 바탕으로 양평군 서종면 벽계천에 형성된 수회구곡과 벽계구곡 그리고 노산팔경의 설정 경위를 검토하고, 화서 당대에 향유되고 경영된 명승 벽계의 경관실체를 구명하는 것을 목적으로 한다. 연구의 결과는 다음과 같다. 첫째, 화서 이항로 이후에 설정된 벽계구곡과 노산팔경은 화서의 행적과 관련된 주요 경처를 모은 '현대기(現代期)'의 집경으로 판명되었다. 벽계구곡이 수회구곡의 집경요소와 많은 부분 중복되는 점이나, 수회구곡의 종점부터 노산팔경의 영역이 시작되는 작위적 구성은 수입리 벽계와 노문리 벽계 사이의 장소대립 및 장소패권의 양상을 엿보게 한다. 이는 화서 이전 벽계 향유집단의 오랜 역사성과 화서의 이미지로 밀착된 영역성이 상충되어 나타난 결과로 판단된다. 둘째, 벽계구곡은 노산팔경의 영역을 확대함과 동시에 수입리의 경승을 선별해 재구성한 2차적 공간체계였다. 벽계구곡의 설정 이후 벽계천 전체 권역에 대한 장소 정체성이 효과적으로 확보되었는데, '청서구장(淸西舊莊)'과 '수회구곡(水回九曲)' 바위글씨 등 화서 이전의 명소가 철저히 배제되는 등 '화서 지향적' 공간 성격을 갖고 있었다. 그 결과 노문리뿐만 아니라 수입리에 이르는 벽계천 전체 영역은 화서의 문화경관으로 재편되었다. 셋째, '주자-율곡-우암-화서'로 이어지는 도통 강화의 일환으로 설정된 화서학파의 구곡 설정은 벽계구곡 탄생의 계기이자 외적 동인이 되었다. 즉, 벽계구곡과 노산팔경은 화서학의 중심이 옥계동으로 건너간 것에 대한 반동, 무이구곡 고산구곡과 옥계구곡의 사이의 결손된 도체공간의 창출 그리고 후손과 지역민에 의한 화서 선양작업 등 일련의 전략적 지향성과 흐름을 같이 한다. 넷째, 화서의 주리론적 관점에서 살펴보면, 그가 경영한 벽원(蘗園)의 모든 경역은 '실제로 존재하는 산수경치의 물상[氣]'을 통해 리(理)의 내재함과 심미적 자아의 허령(虛靈)한 경계를 체험하는 공간작법으로 존재했음을 알 수 있다. 이러한 점은 벽계구곡이나 노산팔경을 화서와 연관된 영역으로 조명하기 이전에, 벽원 고유의 경관성을 규정짓고 나아가 어떤 방식으로 접근하고 향유해야 하는지를 일깨워 준다. 다섯째, 노산팔경은 벽계구곡 중 노문리 벽계 일원 중에서도, 화서가 강학하고 소요하던 여덟 곳의 경승을 담는 곡중경(曲中景)의 문화경관으로 구성되었으나 화서가 남긴 바위글씨와 시문에 의존해 집경됨으로써 벽계구곡에 비해 내적 충일성은 확보되지만 집경에 따른 개념적 타당성에는 다소의 의문이 남는다.

농촌(農村) 주민(住民)들의 의료필요도(醫療必要度)에 관(關)한 연구(硏究) (A Study Concerning Health Needs in Rural Korea)

  • 이성관;김두희;정종학;정극수;박상빈;최정헌;홍순호;라진훈
    • Journal of Preventive Medicine and Public Health
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    • 제7권1호
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    • pp.29-94
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    • 1974
  • Today most developed countries provide modern medical care for most of the population. The rural area is the more neglected area in the medical and health field. In public health, the philosophy is that medical care for in maintenance of health is a basic right of man; it should not be discriminated against racial, environmental or financial situations. The deficiency of the medical care system, cultural bias, economic development, and ignorance of the residents about health care brought about the shortage of medical personnel and facilities on the rural areas. Moreover, medical students and physicians have been taught less about rural health care than about urban health care. Medical care, therefore, is insufficient in terms of health care personnel/and facilities in rural areas. Under such a situation, there is growing concern about the health problems among the rural population. The findings presented in this report are useful measures of the major health problems and even more important, as a guide to planning for improved medical care systems. It is hoped that findings from this study will be useful to those responsible for improving the delivery of health service for the rural population. Objectives: -to determine the health status of the residents in the rural areas. -to assess the rural population's needs in terms of health and medical care. -to make recommendations concerning improvement in the delivery of health and medical care for the rural population. Procedures: For the sampling design, the ideal would be to sample according to the proportion of the composition age-groups. As the health problems would be different by group, the sample was divided into 10 different age-groups. If the sample were allocated by proportion of composition of each age group, some age groups would be too small to estimate the health problem. The sample size of each age-group population was 100 people/age-groups. Personal interviews were conducted by specially trained medical students. The interviews dealt at length with current health status, medical care problems, utilization of medical services, medical cost paid for medical care and attitudes toward health. In addition, more information was gained from the public health field, including environmental sanitation, maternal and child health, family planning, tuberculosis control, and dental health. The sample Sample size was one fourth of total population: 1,438 The aged 10-14 years showed the largest number of 254 and the aged under one year was the smallest number of 81. Participation in examination Examination sessions usually were held in the morning every Tuesday, Wenesday, and Thursday for 3 hours at each session at the Namchun Health station. In general, the rate of participation in medical examination was low especially in ages between 10-19 years old. The highest rate of participation among are groups was the under one year age-group by 100 percent. The lowest use rate as low as 3% of those in the age-groups 10-19 years who are attending junior and senior high school in Taegu city so the time was not convenient for them to recieve examinations. Among the over 20 years old group, the rate of participation of female was higher than that of males. The results are as follows: A. Publie health problems Population: The number of pre-school age group who required child health was 724, among them infants numbered 96. Number of eligible women aged 15-44 years was 1,279, and women with husband who need maternal health numbered 700. The age-group of 65 years or older was 201 needed more health care and 65 of them had disabilities. (Table 2). Environmental sanitation: Seventy-nine percent of the residents relied upon well water as a primary source of dringking water. Ninety-three percent of the drinking water supply was rated as unfited quality for drinking. More than 90% of latrines were unhygienic, in structure design and sanitation (Table 15). Maternal and child health: Maternal health Average number of pregnancies of eligible women was 4 times. There was almost no pre- and post-natal care. Pregnancy wastage Still births was 33 per 1,000 live births. Spontaneous abortion was 156 per 1,000 live births. Induced abortion was 137 per 1,000 live births. Delivery condition More than 90 percent of deliveries were conducted at home. Attendants at last delivery were laymen by 76% and delivery without attendants was 14%. The rate of non-sterilized scissors as an instrument used to cut the umbilical cord was as high as 54% and of sickles was 14%. The rate of difficult delivery counted for 3%. Maternal death rate estimates about 35 per 10,000 live births. Child health Consultation rate for child health was almost non existant. In general, vaccination rate of children was low; vaccination rates for children aged 0-5 years with BCG and small pox were 34 and 28 percent respectively. The rate of vaccination with DPT and Polio were 23 and 25% respectively but the rate of the complete three injections were as low as 5 and 3% respectively. The number of dead children was 280 per 1,000 living children. Infants death rate was 45 per 1,000 live births (Table 16), Family planning: Approval rate of married women for family planning was as high as 86%. The rate of experiences of contraception in the past was 51%. The current rate of contraception was 37%. Willingness to use contraception in the future was as high as 86% (Table 17). Tuberculosis control: Number of registration patients at the health center currently was 25. The number indicates one eighth of estimate number of tuberculosis in the area. Number of discharged cases in the past accounted for 79 which showed 50% of active cases when discharged time. Rate of complete treatment among reasons of discharge in the past as low as 28%. There needs to be a follow up observation of the discharged cases (Table 18). Dental problems: More than 50% of the total population have at least one or more dental problems. (Table 19) B. Medical care problems Incidence rate: 1. In one month Incidence rate of medical care problems during one month was 19.6 percent. Among these health problems which required rest at home were 11.8 percent. The estimated number of patients in the total population is 1,206. The health problems reported most frequently in interviews during one month are: GI trouble, respiratory disease, neuralgia, skin disease, and communicable disease-in that order, The rate of health problems by age groups was highest in the 1-4 age group and in the 60 years or over age group, the lowest rate was the 10-14 year age group. In general, 0-29 year age group except the 1-4 year age group was low incidence rate. After 30 years old the rate of health problems increases gradually with aging. Eighty-three percent of health problems that occured during one month were solved by primary medical care procedures. Seventeen percent of health problems needed secondary care. Days rested at home because of illness during one month were 0.7 days per interviewee and 8days per patient and it accounts for 2,161 days for the total productive population in the area. (Table 20) 2. In a year The incidence rate of medical care problems during a year was 74.8%, among them health problems which required rest at home was 37 percent. Estimated number of patients in the total population during a year was 4,600. The health problems that occured most frequently among the interviewees during a year were: Cold (30%), GI trouble (18), respiratory disease (11), anemia (10), diarrhea (10), neuralgia (10), parasite disease (9), ENT (7), skin (7), headache (7), trauma (4), communicable disease (3), and circulatory disease (3) -in that order. The rate of health problems by age groups was highest in the infants group, thereafter the rate decreased gradually until the age 15-19 year age group which showed the lowest, and then the rate increased gradually with aging. Eighty-seven percent of health problems during a year were solved by primary medical care. Thirteen percent of them needed secondary medical care procedures. Days rested at home because of illness during a year were 16 days per interviewee and 44 days per patient and it accounted for 57,335 days lost among productive age group in the area (Table 21). Among those given medical examination, the conditions observed most frequently were respiratory disease, GI trouble, parasite disease, neuralgia, skin disease, trauma, tuberculosis, anemia, chronic obstructive lung disease, eye disorders-in that order (Table 22). The main health problems required secondary medical care are as fellows: (previous page). Utilization of medical care (treatment) The rate of treatment by various medical facilities for all health problems during one month was 73 percent. The rate of receiving of medical care of those who have health problems which required rest at home was 52% while the rate of those who have health problems which did not required rest was 61 percent (Table 23). The rate of receiving of medical care for all health problems during a year was 67 percent. The rate of receiving of medical care of those who have health problems which required rest at home was 82 percent while the rate of those who have health problems which did not required rest was as low as 53 percent (Table 24). Types of medical facilitied used were as follows: Hospital and clinics: 32-35% Herb clinics: 9-10% Drugstore: 53-58% Hospitalization Rate of hospitalization was 1.7% and the estimate number of hospitalizations among the total population during a year will be 107 persons (Table 25). Medical cost: Average medical cost per person during one month and a year were 171 and 2,800 won respectively. Average medical cost per patient during one month and a year were 1,109 and 3,740 won respectively. Average cost per household during a year was 15,800 won (Table 26, 27). Solution measures for health and medical care problems in rural area: A. Health problems which could be solved by paramedical workers such as nurses, midwives and aid nurses etc. are as follows: 1. Improvement of environmental sanitation 2. MCH except medical care problems 3. Family planning except surgical intervention 4. Tuberculosis control except diagnosis and prescription 5. Dental care except operational intervention 6. Health education for residents for improvement of utilization of medical facilities and early diagnosis etc. B. Medical care problems 1. Eighty-five percent of health problems could be solved by primary care procedures by general practitioners. 2. Fifteen percent of health problems need secondary medical procedures by a specialist. C. Medical cost Concidering the economic situation in rural area the amount of 2,062 won per residents during a year will be burdensome, so financial assistance is needed gorvernment to solve health and medical care problems for rural people.

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