• 제목/요약/키워드: Critical Care

검색결과 1,900건 처리시간 0.029초

샤르댕의 아동 교육 장르화 - 18세기 프랑스 부르주아의 계몽주의적 아동관 (Chardin's Genre Paintings of Child Education: The Enlightenment Views on Children of the French Bourgeois Class in the 18th Century)

  • 고유경
    • 미술이론과 현장
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    • 제8호
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    • pp.33-58
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    • 2009
  • This paper examines four genre paintings on the subject of child education by Jean-Baptiste-Sim${\'{e}}$on Chardin(1699-1779). The Governess, The Diligent Mother, Saying Grace, and The Morning Toilette garnered critical attention after they were exhibited in the Salon from 1739 to 1741. After the exhibition, the paintings were made into prints and frequently sold to members of the bourgeois class in Paris. The iconographical details of Chardin's genre paintings have, thus far, been compared to Dutch genre pictures of the seventeenth century. Further, most studies conducted on Chardin's paintings focus on formal analysis rather than the historical and social contexts. Through attempting social-contextual readings of Chardin's educational series, this paper argues that the significance of Chardin's painting series of child education lies in his representation of the ideal French bourgeois family and the standard of early childhood education in the eighteenth-century French Enlightenment period. In each of the four child education paintings, Chardin depicted a mother with children in a domestic space. Even though this theme derives from traditional Dutch genre paintings in the seventeenth century, the visual motifs, the pictorial atmosphere and the painting techniques of Chardin all project the social culture of eighteenth century France. Each painting in the child education series exemplifies respectively the attire of a French gentlemen, the social view on womanhood and the education of girls, newly established table manners, and the dressing up culture in a 'toilette' in eighteenth century France. Distinct from other educational scenes in previous genre paintings, Chardin accentuated the naive and innocent characteristics of a child and exemplified the mother's warmth toward that child in her tender facial expressions and gesturing. These kinds of expressions illustrate the newly structured standard of education in the French Enlightenment period. Whereas medieval people viewed children as immature and useless, people in the eighteenth century began to recognize children for their more positive features. They compared children to a blank piece of paper (tabula rasa), which signified children's innocence, and suggested that children possess neither good nor bad virtues. This positive perspective on children slowly transformed the pedagogical methods. Teaching manuals instructed governesses and mothers to respect each child's personality rather than be strict and harsh to them. Children were also allotted more playtimes, which explains the display of various toys in the backgrounds of Chardin's series of four paintings. Concurrently, the interior, where this exemplary education was executed, alludes to the virtue of the bourgeois's moderate and thrifty daily life in eighteenth century France. While other contemporary painters preferred to depict the extravagant living space of a French bourgeoisie, Chardin portrayed a rather modest and cozy home interior. In contrast to the highly decorated living space of aristocrats, he presented the realistic, humble domestic space of a bourgeois, filled with modern household objects. In addition, the mother is exceptionally clad in working clothes instead of fashionable dresses of the moment. Fit to take care of household affairs and children, the mother represents the ideal virtues of a bourgeois family. It can be concluded that the four genre paintings of child education by Chardin articulate the new standards of juvenile education in eighteenth century France as well as the highly recognized social virtues between French bourgeois families. Thus, Chardin's series of child education would have functioned as a demonstration of the ideal living standards of the bourgeois class and their emphasis on early childhood education in the French Enlightenment period.

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미술의 공공성과 키스 해링(Keith Haring)의 사회적 개입에 관한 연구 (A Study on Art's Public Features and Social Intervention by Keith Haring)

  • 김지영
    • 미술이론과 현장
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    • 제8호
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    • pp.59-87
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    • 2009
  • This thesis started from the attempt to make it clear that 80's American artist Keith Haring(1958-1990) had conducted social intervention of criticism, resistance, and participation through his works, and so pursued public value. Haring of graffiti fame left popular and familiar cartoon style pictures on the street wall, the billboards, the posters and so on. Popular and playful works was explained as his unique characteristics, but Haring's creative way at the field has more value than just being grasped as artist's personal characteristics. Haring's work pieces became everyday art by joining with people's life, and are working as a social speaking place. So I think that these Haring's art works possess characteristics of 'the public sphere'. 'The Public Sphere' means that is independent and free from the government or partisan economic forces, so that is not connected with the interested relations, and that is the sphere of rational argumentation without 'disguise' or 'fabrication', and that is the sphere where general public can participate in and is inspected by them. The public sphere between the sphere of public authority such a nation and a market and the private sphere of free individual, it is mutually connected with them and works as the space forming public opinion. Private individuals communicate with this public sphere and perform a role of direct and indirect check, balance, and social criticism way off from power. Openness that should include the voice of not only leading power but also the socially weak such as citizens, women, homosexuals, minority races, and so on, and alienated class, is an index of the public characteristics. The public sphere is not working just with speech and mass media. Many artists as well as Haring open their mouth and act through an art at the center of society, and create another public sphere by an art. I understood that the real participatory and practical characteristics on the Haring's work is a phenomenon and current of a part of the art world including Haring. Such current started from 1960s is the in-depth effort to be connected with the life more closely, to communicate with people, and to improve problems of life. And it has pursued public value on the different way from the nation or public power. Artists have intervened in the society with strategic and positive ways in order to raise pushed-out value and sinked rights as the public agenda, and labored to accept the value of variety and difference at the society. The aspect of such social intervention is the notable features, findable on the Haring's works and process. Haring's works include art historical meanings and are expressed with familiar and plastic language, so they were able to communicate with various classes. And he secured various customers at the field and the street. This communicative and public approach factor raised the possibility much for his works to work as the public sphere. Haring presented critical and resistant speech toward society with his works based on this factor. He asserted his position and justice of gender identity as a sexual minority. And his such work continued to movement for alienated class and social week over his own rights. His speech and message on the wall painting, poster, T-shirts, billboard of the subway, and so on worked as a spectacle and pressed concern with social issues and consciousness shift. And he's been trying to protect and care people who is injured by HIV and drug and to realize social justice through social week protection. Haring's works planned to meet many people as much as possible performed its role of intervening in society through criticism, resistance, speech, and participation, and controlling and checking social issues. These things considered, Haring's works show his consciousness about public attributes of art, and obviously include public value seeking. And also we can find the meaning of such his work as that an art is working as the public sphere and shows the possibility to discuss and practice public issues.

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독거노인의 사회안전망에 대한 활성화 방안 - 광양시 무선페이징시스템 대상자 중심으로 - (Activation plan of social safety network of the aged living alone - Focused on the aged using wireless paging system in Gwangyang-si -)

  • 이재민
    • 한국응급구조학회지
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    • 제13권3호
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    • pp.41-58
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    • 2009
  • Objective : The purpose of this study is to identify actual operations and issues of wireless paging system operation for the aged living alone as the end users of wireless paging system primarily in Gwangyang city, and thereby to explore possible advanced and integrated ways to promote social safety network for the aged. Methods : The survey tool used in this study was a structured questionnaire form consisting of question items. The researcher hereof conducted this survey by means of direct visit and interview during two seasons, i.e. from February to August, 2008 and from December 2008 to March 2009, respectively. Results : 1) For general demographic characteristics, it was found that 90.9% of all respondents were women and 61.2% of all respondents were at age 75 to 84. for health conditions, it was found that more than 90% of all respondents often took medicines due to their unhealthy body, and most of respondents suffered from musculoskeletal diseases 79.3% and circulatory diseases 61.6%. for walking capacity, it was found that 45.5% of all respondents used walking aids, and disable respondents (11.5% of all respondents) were represented primarily by those with physical disability (52.6% of disable respondents). for actual use of medical institutions, it was found 47.3% of all respondents relied on local clinics, since they preferred neighborhood hospitals or clinics they can trust for medical care. for social activities and supports, it was found that 43.6% respondents had 'needs for assistance at times' and 33.9% respondents have 'no need for assistance'. And it was found that the major difficulties in living alone at old age were represented primarily by health problems 37.8% and economic difficulties 33.5%. 2) For characteristics related to wireless paging system, it was found that 90.3% respondents used wireless paging system recommended by firemen, and 28.5% respondents used this system. and it was found that 59.6% respondents used this system once, and 85.2% respondents used it because of acute or chronic diseases. more than 90% respondents thought that they knew about wireless paging system and considered themselves safe, but 83.6% respondents didn't attach a remote control on their upper clothes, and even 49.1% respondents turned off the power of wireless paging system due to their concern about electricity bill and noise. 3) It was found that 83.6% respondents felt it necessary to use wireless paging system, and wireless paging users felt more satisfied with using the system than non-users, and 50.7% showed high satisfaction at certain psychological benefits like 'confidence in coping with critical situations' and 'a sense of relief'. In addition, it was found that some respondents who answered that 'they didn't turn off the paging system as they knew how it works' and those who answered that they knew 'how to use it' showed relatively high satisfaction. And some respondents who kept it well and felt it necessary also showed high satisfaction. 4) It was found that the level of satisfaction our respondents felt with using wireless paging system varied significantly availability($x^{2}$ = 12.759, p = .002), psychological advantages($x^{2}$ = 12.174, p = .002), knowledge about how to use system($x^{2}$ = 7.021, p = .016), power on/off($x^{2}$ = 13.221, p = .001), level of knowledge about system($x^{2}$ = 21.002, p = .000), maintenance($x^{2}$ = 9.871, p = .007) and level of necessity($x^{2}$ = 34.939, p = .000) on the statistical basis.

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Pollen-Food Allergy Syndrome in Korean Pollinosis Patients: A Nationwide Survey

  • Kim, Mi-Ae;Kim, Dong-Kyu;Yang, Hyeon-Jong;Yoo, Young;Ahn, Youngmin;Park, Hae-Sim;Lee, Hyun Jong;Jeong, Yi Yeong;Kim, Bong-Seong;Bae, Woo Yong;Jang, An-Soo;Park, Yang;Koh, Young-Il;Lee, Jaechun;Lim, Dae Hyun;Kim, Jeong Hee;Lee, Sang Min;Kim, Yong Min;Jun, Young Joon;Kim, Hyo Yeol;Kim, Yunsun;Choi, Jeong-Hee;Work Group for Rhinitis, the Korean Academy of Asthma, Allergy and Clinical Immunology
    • Allergy, Asthma & Immunology Research
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    • 제10권6호
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    • pp.648-661
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    • 2018
  • Purpose: Pollen-food allergy syndrome (PFAS) is an immunoglobulin E (IgE)-mediated allergy in pollinosis patients caused by raw fruits and vegetables and is the most common food allergy in adults. However, there has been no nationwide study on PFAS in Korea. In this study, we investigated the prevalence and clinical characteristics of PFAS in Korea. Methods: Twenty-two investigators participated in this study, in which patients with allergic rhinoconjunctivitis and/or bronchial asthma with pollen allergy were enrolled. The questionnaires included demographic characteristics, a list of fruits and vegetables, and clinical manifestations of food allergy. Pollen allergy was diagnosed by skin prick test and/or measurement of the serum level of specific IgE. Results: A total of 648 pollinosis patients were enrolled. The prevalence of PFAS was 41.7% (n = 270). PFAS patients exhibited cutaneous (43.0%), respiratory (20.0%), cardiovascular (3.7%) or neurologic symptoms (4.8%) in addition to oropharyngeal symptoms. Anaphylaxis was noted in 8.9% of the PFAS patients. Seventy types of foods were linked to PFAS; e.g., peach (48.5%), apple (46.7%), kiwi (30.4%), peanut (17.4%), plum (16.3%), chestnut (14.8%), pineapple (13.7%), walnut (14.1%), Korean melon (12.6%), tomato (11.9%), melon (11.5%) and apricot (10.7%). Korean foods such as taro/taro stem (8.9%), ginseong (8.2%), perilla leaf (4.4%), bellflower root (4.4%), crown daisy (3.0%), deodeok (3.3%), kudzu root (3.0%) and lotus root (2.6%) were also linked to PFAS. Conclusions: This was the first nationwide study of PFAS in Korea. The prevalence of PFAS was 41.7%, and 8.9% of the PFAS patients had anaphylaxis. These results will provide clinically useful information to physicians.

지역별 수도권으로의 인구유출에 영향을 미치는 요인 연구: 부산시 사례를 중심으로 (The Factors Affecting the Population Outflow from Busan to the Seoul Metropolitan Area)

  • 임재빈;정기성
    • 토지주택연구
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    • 제12권2호
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    • pp.47-59
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    • 2021
  • 본 연구에서는 부산시 지역들의 수도권으로 인구유출 현황을 파악하고, 인구·사회, 고용, 주택, 문화, 안전, 의료, 복지, 녹지, 교육 및 보육 등 전통적 인구이동 변수와 삶의 질 변수들을 포괄하여 수도권으로의 인구이동에 영향을 미치는 요인과 인과관계를 규명하고자 한다. 연구의 데이터 구축을 위하여 통계청 마이크로데이터통합서비스(MDIS)에서 제공하는 '국내 인구이동 데이터'를 사용하였으며, 시간적 범위에 맞는 인구이동 데이터(2012-2017년) 총 5,700만 건 가운데 부산시 지역별 유출량 중 수도권 이동량을 추출하였다. 각 독립변수들은 연구의 시간적 공간적 범위에 맞춰 공공데이터에서 추출하였다. 구축한 데이터 세트(Data Set)을 기반으로 선형 다중 회귀분석(Multiple Linear Regression Analysis) 모형을 사용하였으며, 수정 결정계수(Adjusted R2), Durbin-Watson분석, 검정통계량(F-statstics)의 p-value값으로 모형의 적합도를 측정하였다. 분석결과, 부산시에서 수도권으로 인구이동에 유의미한 영향을 미치는 변수는 1인가구 증가율, 고령인구 증가율, 고령자수 비율, 합계출산율, 사업체수 증가율과 종사자수 증가율, 주택매매가지수 증가율, 문화시설 증가율, 교원 1인당 학생수 증가율 변수로 나타났다. 1인가구가 증가하는 지역일수록, 지역의 고령자 비율이 낮을수록, 고령자 비율이 감소할수록, 사업체수가 감소할수록, 종사자수가 증가할수록, 주택매매가지수가 증가할수록, 문화시설수가 감소할수록, 학생수가 감소할수록 수도권 인구이동 비율에 정(+)의 영향을 미치는 것으로 나타났다. 분석 결과를 바탕으로 한 정책적 시사점으로 청년 계층을 부산시에 정착시키고 유인할 수 있는 양질의 일자리, 문화, 복지 등의 제반환경을 제공해야 할 것이다. 일자리와 삶의 질을 높이는 것이 부산시 인구를 수도권으로 유출시키는 현상을 완화할 수 있는 핵심 요인이라고 할 수 있다.

"증언자료의 비판적 활용 - 6.25전쟁 시기 유격대의 경우" ("Critical Application of Witness Commentaries: The Case of Guerrilla Warfare in the Korean War")

  • 조성훈
    • 기록학연구
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    • 제12호
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    • pp.137-178
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    • 2005
  • The anticommunist guerrillas' activities that aretheconcern of this article took place largely in North Korea or behind the enemy-held lines. Verifying their history is accordingly difficult and requires careful attention, but despite their active operations the military as well as the scholarly community have been lax in studying them. The Korean War came to be perceived as a traditional, limited war with regular battles, so that the studies addressed mostly the regular operations, and guerrilla warfare is remembered as an almost 'exclusive property' of the communist invaders; a small wonder that the anticommunist guerrillas have not been studied much and the collection of materials neglected. Therefore, in contrast with the witness accounts concerning regular battles, witness resources were of a small volume about these "patriots without the service numbers." For the above reasons the guerrilla participants and their later-organized fellowships took to the task of leaving records and compiling the histories of their units. They became active preservers of history in order to inform later generations of their works and also to secure deserved benefits from the government, in a world where none recognized their achievements. For instance, 4th Donkey Unit published witness accounts in addition to a unit history, and left video-recordings of guerrilla witnesses before any institute systematized the oral history of the guerrillas. In the case of Kyulsa ("Resolved to Die") Guerrilla Unit, the unit history was 10 times revised and expanded upon for publication, contributing substantially to the recovery of anticommunist guerrilla history which had almost totally lacked documented resources. Now because the guerrilla-related witness accounts were produced through fellowship societies and not individually, it often took the form of 'collective memory.' As a result, though thousands of former guerrillas remain surviving, the scarcity of numerous versions of, or perspectives upon, an event renders difficult an objective approach to the historical truth. Even requests to verify the service of a guerrilla member or to apply for decoration or government benefits for those killed in action, the process is taken care of not at the hands of the first party but the veteran society, so that a variety of opinions are not available for consideration. Moreover, some accounts were taken by American military personnel, and since some historians, unaware of official documents or evaluation of achievements, tended to center the records around their own units and especially to exaggerate the units' performances, they often featured factual errors. Thefollowing is the means to utilize positively the aforementioned type of witness accounts in military history research. It involves the active use of military historical detachments (MHD). As in the examples of those dispatched by the American forces during the Korean War, experts should be dispatched during, and not just after, wartimes. By considering and investigating the differences among various perspectives on the same historical event, even without extra documented resources it is possibleto arrive at theerrors or questionable points of the oral accounts, supplementing the additional accounts. Therefore any time lapses between witness accounts must be kept in consideration. Moreover when the oral accounts come from a group such as participants in the same guerrilla unit or operation, a standardized list of items ought to be put to use. Education in oral history is necessary not just for the training of experts. In America wherethefield sees much activity, it is used not only in college or graduate programs but also in elementary and lifetime educational processes. In comparison in our nation, and especially in historical disciplines, methodological insistence upon documented evidences prevails in the main, and in the fields of nationalist movement or modern history, oral accounts do not receive adequate attention. Like ancient documents and monuments, oral history also needs to be made a regular part of diverse resource materials at our academic institutes for history. Courses in memory and history, such as those in American colleges, are available possibilities.

비자나무 추출물의 항당뇨 활성물질의 특성 연구 (Characterization of Antidiabetic Compounds from Extract of Torreya nucifera)

  • 김지원;김동섭;이화신;박보배;유선녕;황유림;김상헌;안순철
    • 생명과학회지
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    • 제32권1호
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    • pp.1-10
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    • 2022
  • 비자나무는 한반도 남부지역과 제주도에 자생하고 있으며 식용으로 이용이 가능하며, 전통적으로 구충 빛 변비 예방의 목적으로 사용되어 왔었다. 그러나 항산화 활성에 대한 연구는 보고되어 왔지만 항당뇨 활성에 대한 연구는 제대로 이루어지지 않고 있다. 새로운 당뇨 치료제로서 천연물은 독성의 염려가 낮고 매우 오랫동안 사용되어 왔기 때문에 약물에 대한 안전성의 장점이 있다. 식용 및 한방 재료로 사용되고 있는 비자나무는 지금까지 살충 및 항균성에 대해 보고되어 왔으나 항당뇨에 관한 연구는 이루어진 바가 없다. 따라서 본 연구에서는 비자나무 추출물의 항당뇨 효과를 조사하고 그 특성을 조사하였다. 먼저, 비자나무의 과육과 종자를 메탄올로 각각 추출한 후, 항당뇨 활성과 관련된 α-glucosidase와 protein tyrosine phosphatase 1B (PTP1B)에 대한 저해활성을 포함한 다양한 생리활성을 조사하였다. 그 결과, 비자나무의 종자 추출물에서 항당뇨활성을 나타내는 α-glucosidase와 PTP1B 효소에 대한 억제 효능이 높게 나타났으며, 특히 과육에 비해 종자 추출물이 각각 14.5배, 4.3배 높은 저해활성을 보였다. 또한 비자나무의 과육 추출물의 pH와 열 안정성 테스트를 수행한 결과로, 활성 물질은 산, 알카리 조건과 고온의 조건에서 안정한 저해활성을 보였다. 비자 과육의 메탄올 추출물을 한외 여과(ultrafiltration)한 결과, 항당뇨 활성물질은 분자량이 300 kDa 이상에 해당하였고 Diaion HP-20 수지에 대한 흡착능을 조사한 결과, 50-100% 메탄올 조건에서 항당뇨 활성물질이 용출되었다. 따라서 비자나무 종자의 메탄올 추출물로부터 buthanol 추출, 한외 여과, Diaion HP-20 컬럼 크로마토그래피를 통해 비자나무의 항당뇨 활성 물질의 분리, 정제를 시도하였다. 따라서 비자나무 종자 추출물의 인슐린 저항성에 대한 개선 효과에 대한 추가 연구를 통해 천연물 유래 당뇨병 예방 및 치료용 조성물로서의 가능성을 보여주었다.

공공부문 데이터 관리직무의 전문성에 대한 탐색적 연구 - 문헌정보학 관점에서 - (An Exploratory Study of Professionalism on Data Management Jobs in the Public Sector: From the Perspective of Library and Information Science)

  • 박희진;김지성
    • 한국문헌정보학회지
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    • 제56권4호
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    • pp.491-514
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    • 2022
  • 신공공관리론 기반의 정부개혁 패러다임에 따라 공공부문이 전문화되어 행정의 역할이 확대되고 그 기능이 세분화하면서 고도의 전문성과 자격을 요구하는 직무 수요가 증가하고 있다. 한편 정보통신기술의 급속한 발달에 따라 공공행정업무를 통해 생산되는 데이터도 큰 폭으로 증가하여 공공부문 데이터 관리 분야가 확장되고 그 중요성 또한 커지고 있다. 하지만 데이터 관리직무에 대한 개념화 및 체계적 연구가 매우 부족한 현실이며 관련 법령에서도 직무의 구체적 정의나 담당 인력에 대한 구체적 자격 요건을 찾아보기 어렵다. 본 연구는 공공부문의 전문화와 이에 따라 요구되는 직무의 전문성에 대한 선행연구 검토를 통해 전문성의 개념적 차원을 확인하고 이를 토대로 공공부문 데이터 관리 직무의 유형과 자격 요건을 분석하였다. 공직 전문화에 토대를 둔 전문성의 하위 차원 중 전문직 기반 인사관리와 통제에 초점을 두고 관련 법령 및 업무 지침, 채용 공고에 나타난 직무의 내용을 분석한 결과 첫째, 공공부문 데이터 관리직무에 대한 책임자 및 실무담당자의 직무 역할 및 책임의 한계 구분이 모호한 것으로 나타났다. 둘째, 업무 지침 및 실무 매뉴얼에 데이터 생애주기의 각 단계별 직무 내용이 균등하게 반영되지 않고 사후 품질관리단계에만 중점을 두고 있었다. 셋째, 공공부문 데이터 관리직무 및 담당 인력에 대한 자격 요건의 구체적 정의가 확립되지 않았다. 따라서 법령 및 지침에 직무와 담당자의 역할 및 책임 수준과 데이터 생애주기의 단계별 내용을 구체적으로 반영하고 장기적 관점에서 직무 전문성 제고를 위한 직무분석 및 평가가 선행되어야 할 것이다.

온라인 구전과 영화 매출 간 상호영향에 관한 연구: 한국 영화 산업을 중심으로 (Simultaneous Effect between eWOM and Revenues: Korea Movie Industry)

  • 배정호;심범준;김병도
    • Asia Marketing Journal
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    • 제12권2호
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    • pp.1-25
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    • 2010
  • 기존 영화 산업에서 구전의 크기는 매출에 영향을 주지만 방향성은 영향을 주지 못하는 것으로 연구되었다(Liu 2006). 하지만, 이러한 분석 방법을 국내 영화 데이터에 동일하게 적용시켜 본 결과, 구전의 방향성도 영화의 매출에 영향을 주는 것으로 밝혀졌다. 이는 아시아 지역의 소비자들에게서 나타나는 독립적 자아관점과 북미 지역의 소비자들에게서 나타나는 상호의존적 자아관점의 차이로 인해 나타난 결과로 보인다. 즉, 국내 소비자의 경우는 영화를 선택/관람함에 있어 타인의 평가가 영향력을 주기 때문에 구전의 방향성도 유의한 양(+)의 값을 가진다. 기존의 연구에서는 구전의 크기가 일방적으로 매출에 영향을 미친다는 가정을 통해 영화 산업의 구전효과를 분석했으나, 이는 발생된 매출이 구전의 크기에 미치는 영향을 간과한 것이다. 따라서 매출이 구전에 미치는 효과까지 고려하여 연립방정식(Simultaneous Equation)을 통해 구전의 크기와 매출 간 상호 관계를 추정한 결과, 구전의 방향성은 위의 분석과 동일하게 영화 개봉 후 지속적으로 매출에 양(+)의 영향력을 미치는 것으로 나타났다. 하지만, 구전의 크기는 매출의 원인이 되는 것이 아니라, 오히려 매출이 증가하여 구전의 크기가 증가하는 것이라는 결과를 보여주었다. 즉, 개봉 후 1주차에는 소비자들이 영화를 선택할 때 구전의 크기와 방향성이 동시에 고려되지만, 2주차 이후로는 구전의 크기는 매출에 영향을 미치는 변수가 아니라, 매출의 증가에 따른 결과라는 사실이 밝혀졌다.

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폐암을 동반한 특발성 폐섬유증 환자에서 폐섬유증의 급성 악화: 폐암 비동반군과의 발병률, 생존율 및 전산화단층촬영 소견의 비교 (Acute Exacerbation of Idiopathic Pulmonary Fibrosis with Lung Cancer: A Comparative Analysis of the Incidence, Survival Rate, and CT Findings with the Patients without Lung Cancer)

  • 조범상;강희;김제훈;박정구;박세경;윤종혁
    • 대한영상의학회지
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    • 제81권3호
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    • pp.688-700
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    • 2020
  • 목적 폐암이 동반된 특발성 폐섬유증 환자와 폐암 비동반 특발성 폐섬유증 환자에서 폐섬유증 급성 악화의 발병률, 생존율 및 전산화단층촬영 소견을 비교하고자 하였다. 대상과 방법 2004년 6월부터 2018년 7월까지, 특발성 폐섬유증으로 진단받은 89명의 환자를 대상으로 하였으며 26명의 폐암 동반 특별 폐섬유증 환자군과 63명의 폐암 비동반 특발 폐섬유증 환자군으로 구성되었다. 이들의 폐섬유증, 폐암, 급성 악화와 관련된 임상 검사 소견과 CT 소견을 검토하였다. 폐암 환자들은 1차 또는 2차 치료로 수술(n = 6), 항암치료(n = 23) 등을 받았다. 두 군 간에 생존율, 급성 악화의 CT 소견, 무병 기간과 급성 악화 발병 이후 사망까지의 시간을 비교하였다. 결과 급성 악화의 발병률은 폐암 동반군에서는 61.5%, 비동반군에서는 58.7%였다(p = 0.806). 폐암 동반군과 비동반군의 평균 생존 기간은 각각 16.8개월과 83.0개월이었다(p < 0.001). 치료 시작부터 급성 악화까지의 기간은 수술과 항암치료에서 각각 16.0개월과 4.6개월이었다. 급성 악화에 의한 사망을 비교하였을 때, 생존율은 폐암 동반군이 비동반군보다 유의하게 낮았다(p = 0.008). 급성 악화의 CT 소견은 폐암 동반군에서 기관지 주위 분포(p < 0.001)와 비대칭 분포(p = 0.016)를 보이는 경우가 많았다. 결론 폐암을 동반한 특발성 폐섬유증 환자에서, 급성 악화에 의한 사망률이 폐암 비동반 특발 폐섬유증 환자들보다 높았다. 또한, 기관지 주위 또는 비대칭 분포의 CT 소견을 보이는 경향이 있다.