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조상현,Youngs Chang,Yoon Kim 대한예방의학회 2019 Journal of Preventive Medicine and Public Health Vol.52 No.1
Objectives: The aim of this study was to investigate cancer patients’ utilization of tertiary hospitals in Seoul before and after the benefit expansion policy implemented in 2013. Methods: This was a before-and-after study using claims data of the Korean National Health Insurance Service from 2011 to 2016. The unit of analysis was inpatient episodes, and inpatient episodes involving a malignant neoplasm (International Classification of Diseases, Tenth Revision codes: C00-C97) were included in this study. The total sample (n=5 565 076) was divided into incident cases and prevalent cases according to medical use due to cancer in prior years. The tertiary hospitals in Seoul were divided into two groups (the five largest hospitals and the other tertiary hospitals in Seoul). Results: The proportions of the incident and prevalent episodes occurring in tertiary hospitals in Seoul were 34.9% and 37.2%, respectively, of which more than 70% occurred in the five largest hospitals in Seoul. Utilization of tertiary hospitals in Seoul was higher for inpatient episodes involving cancer surgery, patients with a higher income, patients living in areas close to Seoul, and patients living in areas without a metropolitan city. The utilization of the five largest hospitals increased by 2 percentage points after the policy went into effect. Conclusions: The utilization of tertiary hospitals in Seoul was concentrated among the five largest hospitals. Future research is necessary to identify the consequences of this utilization pattern.
조상현,이수용,전대근,송원석,공창배,이정동,조완형,Cho, Sang-Hyun,Lee, Soo Yong,Jeon, Dae-Geun,Song, Won-Seok,Kong, Chang-Bae,Lee, Jung-Dong,Cho, Wan-Hyeong 대한근골격종양학회 2012 대한골관절종양학회지 Vol.18 No.2
Purpose: We analyzed treatment result to examine the outcome for patients with sacral chordoma and to determine relevant prognostic factors. Materials and Methods: We retrospectively reviewed 19 patients with sacral chordoma seen at out institution between 1990 and 2010. There were 9 men and 10 women with mean age of 56 years. The average follow up was 63 months (range, 25-144 months). 15 patient received surgical treatment, six of these patient had wide, eight had marginal, one had intralesional margin and 4 patient treated with Radiation therapy only. Results: The disease free and overall survival rate for all 19 patients was 34.7% and 79.7% at 5-years, respectively. Statistical analysis using the log-rank test revealed no significant difference between the surgery and radiation therapy groups in overall survival (p=0.54). Nine of 19 patients had local recurrence at a median of 2.5 years postoperatively. Seven of these 9 patients had distant metastasis at a median of 4.5 years postoperatively. Among the variables, tumor size (p=0.033) and tumor involvement of above S3 (p=0.032) were independent prognostic factor for overall survival. Nine of 15 patients who received surgical treatment had postoperative complication such as voiding difficulty and incontinence. Conclusion: Careful consideration of the patient general condition and predictable complication of the treatment might be the best way to improve patient's survival and quality of life. 목적: 천골에 발생한 척색종의 치료결과 분석을 통해 생존율 및 종양의 국소조절과 연관된 예후인자에 대하여 알아보고자 하였다. 대상 및 방법: 1990년 1월부터 2010년 2월까지 본원에서 치료받은 19예를 대상으로 하였다. 평균연령은 56세였으며 남자9예, 여자 10예였다. 15명의 환자에서 후방접근법을 이용한 절제술을 시행하였으며 4명의 환자는 방사선 치료만을 시행하였다. 종양의 위치가 S3 보다 근위부를 침범한 경우가 6예였으며 이중 4예에서 방사선 치료만을 시행하였다. 광범위 절제 6예, 변연부 절제 8예, 병소내 절제 1예였다. 평균 추시 기간은 63개월(25-144개월)이었다. 결과: 5년 무병 생존율 및 전체 생존율은 각각 34.7%, 79.7%였다. 재발은 9예, 원격전이는 7예에서 발생하였다. 생존율에 관계된 예후 인자는 종양의 제3천추 상방 침범유무(p=0.033), 종양의 크기(p=0.032)였다. 수술 후 합병증으로 배뇨 및 배변 장애가 발생한 경우가 9예였으며 이중 2예에서는 자가도뇨 시행이 필요하거나 중증의 요실금이 발생하였다. 결론: 종양의 절제 가능성 여부와 더불어 전반적인 환자상태와 수술 후 발생 가능한 합병증을 고려한 치료방법의 선택이 생존율과 함께 삶의 질을 높일 수 있는 방법으로 생각된다.
禪師의 威風과 그 詩的 구현 — 朝鮮 時代 禪詩를 중심으로 —
조상현 한국선학회 2010 한국선학 Vol.26 No.-
본고는 모순과 결핍의 세계에서 당당히 진리를 체현한 선사들의 위풍을 구체적으로 살펴보고, 또한 그러한 위풍이 조선 시대 선시에서 어떻게 구현 되었는지를 시기별로 검토해 보았다. 특히 조선 시대를 초기, 중·후기, 말기로 나누고, 각 시대별로 대표적인 선사의 시에서 진리 체현자의 위풍이 어떻게 구현되고 있는지 구체적으로 알아보았다. 즉 당대의 대 禪師이자 최고의 문인인 涵虛 得通(1376~1433), 淸虛 休靜(1520~1604), 震黙 一玉(1562~1633), 草衣 意恂(1786~1866), 鏡虛 惺牛(1846~1912) 선사의 시에서 그 시적 구현을 고찰하였다. 한편 그에 앞서 선사들의 위풍에 대한 개념을 선불교 문헌에서 종합적으로 고찰하여 논증하였다. I looked at the dignity of Seon-master who has presented their truth in the world of contradiction and deficiency in detail and how the dignity was realized in Chseon(朝鮮) Dynasty according to time period. Especially, I looked at the realization of the dignity from typical poem from each period as according to early, middle and last stages. Therefore, I looked at poems from each period’s most respected literary man such as Hamheo Deutong(涵虛 得通,1376~1433), Cheongheo Hyujeong(淸虛 休靜,1520~1604), Jinmug Il-og(震黙 一玉,1562~1633), Cho-ui Uisun(草衣 意恂,1786~1866), Gyeongheo Seong u(鏡虛 惺牛,1849~1912). Also, before this, I looked the concept of dignity of Seon-Master through Seon-Buddhism literatures in detail.
Cardiovascular Protective Effects and Clinical Applications of Resveratrol
조상현,남궁경,신민지,박주은,양은영,임진수,부티투,김형규,한진 한국식품영양과학회 2017 Journal of medicinal food Vol.20 No.4
Resveratrol is a naturally occurring phenol that is generated by plant species following injury or attack by bacterial and fungal pathogens. This compound was first described as the French Paradox in 1992. Later in 2003, resveratrol was reported to activate sirtuins in yeast cells. Recent experimental studies have found that resveratrol offers a variety of benefits that include both anticarcinogenic and anti-inflammatory effects in addition to the ability to reverse obesity, attenuate hyperglycemia and hyperinsulinemia, protect heart and endothelial function, and increase the life span. Multiple molecular targets are associated with the cardioprotective capabilities of resveratrol, and therefore, resveratrol has potential for a wide range of new therapeutic strategies for atherosclerosis, ischemia/reperfusion, metabolic syndrome, cardiac failure, and inflammatory alterations during aging. Expectations for application in human patients, however, suffer from a lack of sufficient clinical evidence in support of these beneficial effects. This article reviews recently reported basic research results that describe the beneficial effects of resveratrol in an attempt to condense the evidence observed in clinical trials and provide support for the future development of novel clinical therapeutics in patients with cardiovascular diseases.