• 제목/요약/키워드: disease intensity

검색결과 485건 처리시간 0.032초

The Association of Smoking Status and Clustering of Obesity and Depression on the Risk of Early-Onset Cardiovascular Disease in Young Adults: A Nationwide Cohort Study

  • Choon-Young Kim;Cheol Min Lee;Seungwoo Lee;Jung Eun Yoo;Heesun Lee;Hyo Eun Park;Kyungdo Han;Su-Yeon Choi
    • Korean Circulation Journal
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    • 제53권1호
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    • pp.17-30
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    • 2023
  • Background and Objectives: To evaluate the impact of smoking in young adults on the risk of cardiovascular disease (CVD) and the clustering effect of behavioral risk factors such as smoking, obesity, and depression. Methods: A Korean nationwide population-based cohort of a total of 3,280,826 participants aged 20-39 years old who underwent 2 consecutive health examinations were included. They were followed up until the date of CVD (myocardial infarction [MI] or stroke), or December 2018 (median, 6 years). Results: Current smoking, early age of smoking initiation, and smoking intensity were associated with an increased risk of CVD incidence. Even after quitting smoking, the risk of MI was still high in quitters compared with non-smokers. Cigarette smoking, obesity, and depression were independently associated with a 1.3-1.7 times increased risk of CVD, and clustering of 2 or more of these behavioral risk factors was associated with a 2-3 times increased risk of CVD in young adults. Conclusions: In young adults, cigarette smoking was associated with the risk of CVD, and the clustering of 2 or more behavioral risk factors showed an additive risk of CVD.

인삼의 수분생리 1. 자생지관찰.재배 경험.기상요인과 근 및 엽의 특성 (Water Physiology of Panax ginseng. 1. Habitat observation. cultural experience, weather factors and characteristics of root and leaf)

  • 박훈
    • Journal of Ginseng Research
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    • 제4권2호
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    • pp.197-221
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    • 1980
  • Habitat observation, cultural experience of old and present plantation, weather factors in relation to crop stand and water physiology of root and leaf were reviewed. According to habitat observation ginseng plants love water but plate wit talus well grow at drained place with high moisture content in air and soil while ginseng plants were not found in dry or wet place. According to cultivation experience ginseng plants require abundant water in nursery and main field but most old planters believe that ginseng plaints are draught-loving thus require little water. The experience that rain especially in summer i.e unfavorable might be due to mechanical damage of leaves arid leaf disease infection, or severe leaf fall which is caused by high air temperature and coinsided with rain. According to crop stand observation in relation to weather factors abunsant water increased each root weight but decreased total yield indicating tile increase of missing root rate. Rain in summer was unfavorable too. Though rain in June was favorable for high yield general experience that cloudy day and rain were unfavorable might be due to low light intensity under shade. Present leading planters also do loot consider the importance of water in main field. Water content is higher in top than in root and highest in central portion of root and in stem of top. For seedling the heavier the weight of root is tile higher the water content while it reveries from two years old. Water potential of intact root appeared to be -2.89 bar suggesting high sensitivity to water environment. Under water stress water content severly decreased only in leaf. Water content of leaf appeared to be 78% for optimum, below 72% for functional damage and 68% for perm anent wilting. Transpiration or curs Principally through stomata in lower side of leaf thus contribution of upper side transpiration decreased with the increase of intensity. Transpiration is greater in the leaves grown under high light intensity. Thus water content is lower with high light inte nsity under field condition indicating that light is probable cause of water stress in field. Transpiration reached maximum at 10K1ut The decrease of transpiration at higher temperature seems to be due to the decrease of stomata aperture caused by water stress. Severe decrease of photosynthesis under water stress seems to be principally due to functional damage which is not caused by high temperature and Partly due to poor CO2 supply. Water potential of leaf appeared to be -16.8 bar suggesting weakness in draught tolerance. Ginseng leaves absorb water under high humidity. Water free space of leaf disc is %mailer than that of soybean leaf and water uptake appears to be more than two steps.

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부비동 및 비강에 발생한 신경내분비암종의 영상소견: 자기공명영상을 중심으로 2예 보고 (MR Imaging Findings of Sinonasal Neuroendocrine Carcinoma: Two Case Reports)

  • 김정은;김루시아;임명관;박선원
    • Investigative Magnetic Resonance Imaging
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    • 제11권2호
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    • pp.127-132
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    • 2007
  • 비강 및 부비동에 발생하는 신경내분비암종(neuroendocrine carcinoma)은 매우 드물고, 자기공명영상 소견에 대한 보고가 거의 없다. 이에 본 저자들은 비출혈을 주소로 내원한 62세 남자와 74세 남자에서 발생한 신경내분비암종의 2 증례에 대하여 전산화단층촬영과 자기공명영상의 소견을 중심으로 보고하고자 한다. 2예 모두 전산화단층촬영에서 비강과 부비동내에 비교적 크고 경계가 불분명한 종괴가 있었으며, 인접한 골 파괴를 동반하였다. 자기공명영상에서 종괴는 T1강조영상에서 등신호 강도를 보였고, T2강조영상에서는 등신호와 고신호가 섞여있는 양상을 보였으며, 조영 증강시 불균질한 조영 증강을 보였고 내부에는 괴사가 포함되어 있었다. 자기공명영상에서도 종괴에 인접한 골 파괴가 관찰되었다. 2예에서 모두 인접한 접형동내에 T1강조영상에서 고신호 강도를 보이는 점액낭 혹은 종양주변 낭성 부위가 관찰되었다. 2예 모두 전산화단층촬영과 자기공명영상에서 일반적인 비강과 부비동에 발생하는 악성 종양의 비특이적인 소견을 보였으나 종양 주변 낭성 부위의 의미에 대해서는 보다 많은 연구가 필요할 것으로 보인다.

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유산소 운동이 고지방 식이 흰쥐의 지방량, 혈중지질, 혈전용해능 및 산화질소에 미치는 영향 (The Effects of Aerobic Exercise Training on Blood Lipid Profiles, Fibrinolytic Activities, and Nitric Oxide Levels in High-fat-diet induced Rats)

  • 손원목;김도연;성기동;곽이섭;백영호;박송영
    • 생명과학회지
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    • 제25권12호
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    • pp.1432-1438
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    • 2015
  • 본 연구는 생후 3주령 Sprague-Dawley계 수컷 흰쥐를 16마리로 6주간 고지방식이를 통해 비만을 유도 후 운동군(8마리), 대조군(8마리)로 구분하였다. 운동기간 중 운동군과 대조군 모두 고지방식이를 섭취시켰다. 1주차는 14-15 m/min의 속도로 1일 30분, 2, 3주차는 15-16 m/min의 속도로 1일 35분, 4주차는 16-17 m/min의 속도로 1일 40분으로 주 6회 실시한 후 다음과 같은 결론을 얻었다. TC, TG는 운동군이 대조군 보다 유의하게 낮았으며, HDL-C는 운동군이 대조군 보다 유의하게 높았다. 혈전용해능, 산화질소는 운동군이 대조군 보다 유의하게 높았다. 이상을 종합하여 볼 때 유산소 운동이 혈관기능개선에 도움을 주는 것으로 나타났다.

Hypofractionated intensity-modulated radiotherapy in patients with localized prostate cancer: a preliminary study

  • Kang, Hye Jin;Kay, Chul-Seung;Son, Seok Hyun;Kim, Myungsoo;Jo, In Young;Lee, So Jung;Lee, Dong Hwan;Suh, Hong Jin;Choi, Yong Sun
    • Radiation Oncology Journal
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    • 제34권1호
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    • pp.45-51
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    • 2016
  • Purpose: The aim of this work was to assess the efficacy and tolerability of hypofractionated intensity-modulated radiotherapy (IMRT) in patients with localized prostate cancer. Materials and Methods: Thirty-nine patients who received radical hypofractionated IMRT were retrospectively reviewed. Based on a pelvic lymph node involvement risk of 15% as the cutoff value, we decided whether to deliver treatment prostate and seminal vesicle only radiotherapy (PORT) or whole pelvis radiotherapy (WPRT). Sixteen patients (41%) received PORT with prostate receiving 45 Gy in 4.5 Gy per fraction in 2 weeks and the other 23 patients (59%) received WPRT with the prostate receiving 72 Gy in 2.4 Gy per fraction in 6 weeks. The median equivalent dose in 2 Gy fractions to the prostate was 79.9 Gy based on the assumption that the ${\alpha}/{\beta}$ ratio is 1.5 Gy. Results: The median follow-up time was 38 months (range, 4 to 101 months). The 3-year biochemical failure-free survival rate was 88.2%. The 3-year clinical failure-free and overall survival rates were 94.5% and 96.3%, respectively. The rates of grade 2 acute genitourinary (GU) and gastrointestinal (GI) toxicities were 20.5% and 12.8%, respectively. None of the patients experienced grade ${\geq}3$ acute GU and GI toxicities. The grade 2-3 late GU and GI toxicities were found in 8.1% and 5.4% of patients, respectively. No fatal late toxicity was observed. Conclusion: Favorable biochemical control with low rates of toxicity was observed after hypofractionated IMRT, suggesting that our radiotherapy schedule can be an effective treatment option in the treatment of localized prostate cancer.

비인강암의 세기조절방사선치료기술을 이용한 동시차등조사가속치료의 예비성적 ('Simultaneous Modulated Accelerated Radiation Therapy' (SMART) Intensity-Modulated Radiotherapy in the Treatment of Nasopharyngeal Carcinoma : the Asan Medical Center)

  • 이상욱;백금문;이병용;최은경;김종훈;안승도;신성수;김상윤;남순열;최승호;김성배;송시열
    • 대한두경부종양학회지
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    • 제19권1호
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    • pp.9-15
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    • 2003
  • Purpose: To introduce our early experience with intensity-modulated radiotherapy (IMRT) in the treatment of nasopharyngeal carcinoma. Methods and Materials: Eight patients who underwent IMRT for no disseminated nasopharyngeal carcinoma at the Asan Medical Center between September 2001 and November 2002 were evaluate by prospective analysis. According to the 1997 American Joint Committee on Cancer staging classification, 5 had Stage III, and 3 had Stage IVB disease. The IMRT plans were designed to be delivered as a 'Simultaneous Modulated Accelerated Radiation Therapy' (SMART) using the 'step and shoot' technique with a MLC (multileaf collimator). Daily fractions of 2.2-2.5Gy and 1.9-2Gy were prescribed and delivered to the GTV and CTV and clinically negative neck node, respectively. The prescribed dose was 70A-79.0Gy to the gross tumor volume (GTV), 60Gy to the clinical target volume (CTV) and metastatic nodal station, and 46Gy to the clinically negative neck. All patients also received weekly cisplatin during radiotherapy. Acute and late normal tissue effects were graded according to the Radiation Therapy Oncology Group (RTOG) radiation morbidity scoring criteria. Results: Follow-up period was ranging from 5 to 18 months. All patients showed complete response and loco-regional control rate was 100% but one patient died of malnutrition due to treatment related toxicity. There were no Grade 3 or 4 xerostomia and all patients had experienced improvement of salivary gland function. Conclusion: 'Simultaneous Modulated Accelerated Radiation Therapy' (SMART) boost intensity-modulated radiotherapy technique allows parotid sparing as evidenced both clinically and by dosimetry. Initial tumor response and loco-regional control was promising. It is clinically feasible. A larger population of patients and a long-term follow-up are needed to evaluate ultimate tumor control and late toxicity.

수면장애 노인의 운동유형별 뇌파와 혈 중 멜라토닌 농도 비교 (A Study of EEG and Melatonin in Plasma According to Exercise Type in Elderly with Sleep Disorder)

  • 김동현;김석범
    • 대한지역사회작업치료학회지
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    • 제8권2호
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    • pp.29-37
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    • 2018
  • 목적 : 수면장애는 노인에게 있어 다양한 이유로 빈발하고 있다. 이러한 노인의 수면장애에서 운동 강도에 따른 지속적인 운동습관이 수면장애의 치료적 효과를 줄 수 있는지를 밝히기 위해서 뇌파와 멜라토닌의 농도를 이용한 과학적인 방법으로 접근하는 것이 본 연구의 목적이다. 연구방법 : 일부지역의 노인시설에 거주하는 65세 이상의 노인 30명을 대상으로 하였다. 수면장애의 판단은 수면시간 6시간 이하의 경우(Kozier et al, 2004)와 PSQI(Pittsburgh Sleep Quality Index)의 점수를 동시에 만족하는 경우로 정하였다. 운동유형별 적용은 저강도의 걷기운동, 중강도의 유산소 운동, 고강도의 저항성 근력운동을 적용하였으며 측정도구는 뇌파에서 파형을 체크하기 위하여 QEEG 8-System(LAXTHA Inc. KOREA) 기기와 수면의 질을 검사하기 위해서 수면다원검사에 사용하는 Polysomnograpy (Compumedics, Australia) 기기를 사용하였다. 그리고 TTC(triphenyltetrazolium chloride) 염색과 H & E(Hematoxylin & Eosin) 염색을 통해 조직학적 양상을 관찰하였다. 결과 : 중강도의 유산소 운동 후에 멜라토닌의 농도와 뇌파로 측정한 수면지수에는 긍정적인 유의미한 변화가 있었다. 중강도의 유산소 운동에서는 SWS가 저강도, 고강도 운동보다 유의한 효과가 있었고 SWS의 관찰지표인 델타파의 유의한 변화가 있었다. 결론 : 인체의 일주기성 리듬의 생화학적, 행동학적 기능에 변화를 가져오는 노인에게서 수면장애에 대한 지속적인 운동은 운동의 유형에 따라 효과가 다름을 알 수 있었고 특히 유산소 운동이 다른 운동보다 노인 수면장애에 효과가 크다는 것을 멜라토닌의 농도와 뇌파를 통하여 알 수 있었다. 노인에게 맞춤형 운동을 제공하여 노인들의 삶의 질에 유용하고 건강한 말년을 제공할 수 있을 것이다.

Effectiveness and patient satisfaction of dental emergencies in Pitié Salpêtrière Hospital, Paris, during the COVID 19 pandemic

  • Rodriguez, Isabelle;Zaluski, Daniel;Jodelet, Pierre Alain;Lescaille, Geraldine;Toledo, Rafael;Boucher, Yves
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제22권4호
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    • pp.255-266
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    • 2022
  • Background: A previous study reported the effectiveness and patient satisfaction in the dental emergency unit (DEU) of the Pitie Salpetrière Hospital in Paris before coronavirus disease 2019 (COVID-19). The same methodology was used during the COVID-19 pandemic to compare pain, anxiety, and patient satisfaction during the two periods. Methods: This prospective study was conducted in 2020 (NCT04354272) on adult patients. Data were collected on day zero (D0) on site and then by phone during the daytime on day one (D1), day three (D3), and day seven (D7). The primary objective was to assess the pain intensity at D1. Secondary objectives were to assess pain intensity at D3 and D7, anxiety intensity at D1, D3, and D7, and patient satisfaction. Patients were evaluated on a 0-10 numeric scale on D1, D3, and D7; mean scores were compared with non-parametric statistics (ANOVA, Dunn's). Results: A total of 445 patients were given the opportunity to participate in the study, and 370 patients consented. Seventy-one were lost during follow-up. Ultimately, 299 patients completed all the questionnaires and were included in the analysis. In the final sample (60% men, 40% women, aged 39 ± 14 years), 94% had health insurance. The mean pain scores were: D0, 6.1 ± 0.14; D1, 3.29 ± 0.16; D3, 2.08 ± 0.16; and D7, 1.07 ± 0.35. This indicates a significant decrease of 46%, 67%, and 82% at D1, D3, and D7, respectively, when compared to D0 (P < 0.0001). The mean anxiety scores were D0, 4.7 ± 0.19; D1, 2.6 ± 0.16; D3, 1.9 ± 0.61; and D7, 1.4 ± 0.15. This decrease was significant between D0 and D7 (ANOVA, P < 0.001). Perception of general health improved between D1 and D7. The overall satisfaction was 9.3 ± 0.06. Conclusion: DEU enabled a significant reduction in pain and anxiety with high overall satisfaction during COVID-19, which was very similar to levels observed pre-COVID-19 pandemic.

흰쥐 흑질내 수산화도파민 주입으로 유도된 파킨슨병 모델에서 흑질과 선조체의 신경교세포 반응 (Neuroglial Reaction in the Substantia Nigra and Striatum of 6-Hydroxydopamine Induced Parkinson's Disease Rat Model)

  • 양경원;성재훈;김문찬;이문용;이상원;최승진;박춘근;강준기
    • Journal of Korean Neurosurgical Society
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    • 제30권6호
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    • pp.688-698
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    • 2001
  • Objectives : Parkinson's disease is a well-known neurodegenerative disease characterized by dopaminergic cell death in the substantia nigra. The reactive gliosis by activated astrocytes and microglias is no more regarded as a simple sequel of neuronal cell death. Microglial activation takes place in a stereotypic pattern with graded morphologic and functional(resting, activated and phagocytic) changes. In Parkinson's disease animal model, the degree of microglial activation along the nigro-striatal dopaminergic tract has not been studied intensively. The purpose of this study was to elucidate the characteristics of microglial reaction and to grade its degree of activation at substantia nigra and corpus striatum using 6-hydroxydopamine induced rat model of Parkinson's disease. Methods : Using Sprague-Dawley rat, parkinsonian model was made by 6-hydroxydopamine(OHDA) induced destruction of medial and lateral substantia nigra(SN). The rat was sacrificed 3-, 5-, 7-, 14- and 21-day-after operation. For control group, we injected saline with same manner and sacrificed 3-day after operation. With immunohistochemistry, we examined dopaminergic neuronal cells and microglial expression using tyrosine hydroxylase (TH) and OX-42 antibodies, respectively. Also we performed in situ hybridization for osteopontin, a possible marker of subset in activated microglia. Results : 1) In lesioned side of substantia nigra and corpus striatum, the TH immunoreactivity was markedly decreased in whole experimental groups. 2) Using optical densitometry, microglia induced immunoreactivity of OX-42 was counted at SN and corpus striatum. At SN, it was increased significantly on the lesioned side in control and all time-dependent experimental groups. At striatum, it was increased significantly in post lesion 3-day group only(p <0.05). Compared to control group, immunoreactivity of OX-42 on lesioned side was increased in groups, except post lesion 21-day group, at SN. Only post lesion 3-day group showed significance at striatum(p <0.05). Compared to SN region, immunoreactivity of OX-42 was much weaker in striatum. 3) Microscopically, the microglias showed typically different activation pattern. At SN, numerous phagocytic microglias were found at pars compacta and reticularis of lesion side. At striatum, no phagocytic form was found and the intensity of staining was much weaker. 4) At SN, the immunoreactivity of osteopontin showed definite laterality and it was markedly increased at pars compacta of lesion side with relatively short duration time. At striatum, however, it was not detected by in situ hybridization technique. Conclusion : The nigral 6-OHDA induced rat model of Parkinson's disease revealed several characteristic patterns of microglial reaction. At SN, microglias was activated shortly after direct neuronal damage and maintained for about three weeks. In contrast, despite of sufficient dopaminergic insufficiency at striatum, activation of microglias was trivial, and distinguished 3 day later. Antegrade slow neuronal degeneration is major pathophysiology in striatal dopaminergic deficiency. So, the acuteness of neuronal damage and consequential degree of neuronal degeneration may be important factor for microglial activation in neurodegenerative diseases such as Parkinson's disease. Additionally, osteopontin may be a possible marker for several subsets of activated microglia, possibly the phagocytic form.

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이차원방사선치료를 시행한 코인두암 환자의 장기 추적 결과 및 예후인자 분석 (Long-Term Results of 2-Dimensional Radiation Therapy in Patients with Nasopharyngeal Cancer)

  • 이남권;박영제;양대식;윤원섭;이석;김철용
    • Radiation Oncology Journal
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    • 제28권4호
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    • pp.193-204
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    • 2010
  • 목적: 방사선치료 단독요법 또는 동시항암화학방사선치료(concurrent chemoradiation therapy, CCRT)를 시행한 코인두암 환자들의 장기 추적결과를 바탕으로 생존율 재발양상 부작용 및 예후인자를 분석하였다. 대상 및 방법: 1981년 12월부터 2006년 12월까지 코인두암으로 진단받고 고려대학교의료원 방사선종양학과에서 방사선치료를 시행한 190명의 환자를 대상으로 분석하였다. 연령은 8세부터 78세(중앙값 49세) 이었으며, 성별은 남자가 141명, 여자가 49명이었다. 조직학적 분류는 각질화암이 10명 비각질화암이 166명, 기저양평편상피암이 1명이었다. American Joint Committee on Cancer 병기 I이 7명(3.6%), IIA 8명 (4.2%), IIB 33명(17.4%), III 82명(43.2%), IVA 31명(16.3%), IVB 29명 (15.3%)이었으며, 방사선치료 단독요법으로 치료한 환자는 103명이었고, CCRT를 시행한 환자는 87명이었다. 원발병소에 조사된 방사선량은 일일 선량 1.8~2.0 Gy, 총선량 66.6~87 Gy, 중앙값 72 Gi 였다. 생존율, 예후인자 및 부작용에 대하여 후향적으로 분석하였고 급, 만성 부작용 평가는 Radiation Therapy Oncology Group 분류법을 이용하였다. 결과: 190명 중 184명(96.8%)이 계획된 치료를 마쳤으며 방사선치료 기간은 19~88일(중앙값 63일)이었다. 전체 환자의 추적관찰기간은 2~2787개월로 평균 73개월 중앙값 52개월 이었다. 93명(48.9%)의 환자에서 재발이 발생하였는데 국소재발이 44명(23.2%), 림프절재발 13명(6.8%), 원격전이가 49명(25.8%)이었고 원격전이 부위는 뼈, 폐, 간 전이가 각각 23, 18, 12명이었다. 5년 및 10년 전체 생존율(overall survival rate, OS)은 각각 55.6%, 44.5%이었고, 중앙값 52개월이었다. 무병생존율 (disease-free survival rate, DFS)은 5년, 10년이 각각 54.8%, 51.3%이었고, 질병특이생존율(disease-specific survival rate, DSS)은 5년, 10년이 각각 65.3%, 57.4%이었다. 단변량분석에서 CCRT를 받은 환자, 젊은 연령, 여성이 OS, DFS 및 DSS가 유의하게 높았고, CCRT를 시행한 환자와 기간이 짧았던 환자에서 유의하게 원격전이가 적었다. 다변량분석에서는 CCRT를 받은 환자, 여성에서 OS, DFS 및 DSS가 통계적으로 유의하게 높았고, 국소재발에는 성별, 원격전이에는 CCRT시행여부가 영향을 미친 요인으로 나타났다. 방사선치료 도중 발생한 부작용으로 3등급 이상의 점막염 혈액학적 부작용은 각각 42명(22.1%), 18명(9.5%)이었고, 치료기간이 연장된 환자가 59명이었다. 항암화학치료를 병용한 환자에서 통계적으로 의미 있게 부작용 발생빈도가 높았으나 치료기간의 연장에는 통계적으로 유의한 차이를 보이지 않았다. 추적관찰 기간 동안 3등급 이상의 청력장애, 턱관절장애가 각각 9, 6예가 있었다. 결론: 본 연구의 결과, CCRT를 시행한 환자, 여성, T-병기, N-병기 및 연령이 낮은 환자에서 생존율의 향상이 있음을 확인하였다. CCRT를 했을 때 생존율 향상과 원격전이율 감소를 보여 항암화학치료의 역할을 확인할 수 있었으나 항암화학치료의 동시병용이 반드시 국소 및 영역제어율의 향상을 가져오는 것은 아니었다. 따라서 CCRT의 부작용을 감안할 때 세기조절방사선치료(intensity modulated radiation therapy)와 같은 치료에서 각 치료 방법의 역할과 기여도에 대한 비교 연구가 향후 시행되어야 할 것이다.차이를 보이지 않았다. 추적관찰 기간 동안 3등급 이상의 청력장애, 턱관절장애가 각각 9, 6예가 있었다. 결론: 본 연구의 결과, CCRT를 시행한 환자, 여성, T-병기, N-병기 및 연령이 낮은 환자에서 생존율의 향상이 있음을 확인하였다. CCRT를 했을 때 생존율 향상과 원격전이율 감소를 보여 항암화학치료의 역할을 확인할 수 있었으나 항암화학치료의 동시병용이 반드시 국소 및 영역제어율의 향상을 가져오는 것은 아니었다. 따라서 CCRT의 부작용을 감안할 때 세기조절방사선치료(intensity modulated radiation therapy)와 같은 치료에서 각 치료 방법의 역할과 기여도에 대한 비교 연구가 향후 시행되어야 할 것이다