뇌암 및 두경부암 체적변조방사선치료시 Jaw-Tracking 기법의 선량학적 유용성 평가

김희성,문재희,김군주,서정민,이정진,최재훈,김성기,장인기,Kim, Hee Sung,Moon, Jae Hee,Kim, Koon Joo,Seo, Jung Min,Lee, Joung Jin,Choi, Jae Hoon,Kim, Sung Ki,Jang, In-Gi 대한방사선치료학회 2018 대한방사선치료학회지 Vol.30 No.1

목 적 : 체적변조회전방사선치료(VMAT)는 종양의 모양에 맞게 균일하면서도 정밀한 방사선 조사를 하면서 동시에 정상조직의 방사선 손상위험을 줄이는 장점이 있어 뇌암, 두경부암 및 전립선암 등의 종양과 정상장기가 가까운 암의 치료에 사용되고 있다. 본 연구의 목적은 뇌암 및 두경부암 환자의 VMAT 방사선 치료 시 Jaw-Tracking technique(JTT)의 선량학적 유용성을 평가하고자 한다. 대상 및 방법 : 본원에서 VMAT 치료기법으로 방사선치료를 받은 뇌암 및 두경부암 환자 8명을 선택하였다. 환자의 종양 및 정상 장기의 윤곽그리기(contouring) 정보를 Velocity(Varian, USA)의 deformable registration을 이용하여 Rando phantom에 fusion하였다. Varian Eclipse(ver 15.5, Varian, USA)를 사용하여 Jaw-Tracking 사용 유무를 제외하고 환자 치료 시 사용한 beam parameter와 동일하게 치료계획을 진행하였다. 평가 지표로써 target과 OAR의 최대선량, 평균선량을 사용하여 비교하였고 치료계획 검증을 위해 Portal dosimetry를 시행하였다. 결 과 : JTT를 사용했을 경우는 Static-Jaw technique(SJT)을 사용하였을 경우보다 OAR의 상대 선량이 각각 평균선량은 5.24 %, 최대선량은 7.05 % 감소한 것으로 나타났다. 다양한 OAR에서 평균선량과 최대선량의 감소의 범위는 각각 0.01~3.16 Gy, 0.12~6.27 Gy로 나타났다. Target의 경우는 JTT의 경우가 SJT보다 GTV, CTV, PTV의 최대선량이 각각 0.17 %, 0.43 %, 0.37 % 감소하였으며, 평균선량은 0.24 %, 0.47 %, 0.47% 감소하였다. 감마분석은 3 %/3 mm, 통과율 95 % 이상을 통과 기준으로 설정하였고 JTT, SJT 통과율은 각각 $98{\pm}1.73%$, $97{\pm}1.83%$이었다. 실험에 적용된 모든 OAR의 선량을 비교해 보았을 때, JTT을 사용하였을 경우가 SJT보다 MLC 외에 추가적인 jaw 차폐로 인하여 선량이 유의미하게 줄어들었다는 것을 알 수 있었다. 결 론 : VMAT 치료계획을 이용한 방사선 치료시 뇌암, 두경부암과 같이 종양과 정상 장기가 인접한 경우와 MLC를 통한 누설선량을 증가시킬 수 있는 넓은 조사야 및 높은 에너지의 사용을 필요로 하는 방사선 치료 시 JTT를 적용함으로써 종양주변 정상조직의 피폭선량을 낮추고 이로 인해 PTV의 target coverage를 높일 수 있을 것이라 판단된다. Purpose : Volumetric Modulated Arc Therapy(VMAT) has the advantage of uniformly and precisely irradiating the tumor to the shape of the tumor while reducing the risk of radiation damage to normal tissues. such as brain cancer, head and neck cancer and prostate cancer, It is being used for treatment. The purpose of this study is to evaluate the usefulness of the Jaw-Tracking technique(JTT) in VMAT for brain and head and neck cancer. Materials and Methods : We selected eight patients with brain and head and neck cancer(4 Brain, 4 head and neck) who were treated with the VMAT treatment technique. Contouring information of the patient's tumor and normal organ was fused to the Rando phantom using the deformable registration of Velocity(Varian, USA). A treatment plan was developed using the Varian Eclipse(ver 15.5, Varian, USA) with the same patient actual beam parameters except for the use of jaw-tracking. As the evaluation index, the maximum dose and mean dose of target and OAR were compared and a portal dosimetry was performed for the treatment plan verification. Results : When using JTT, the relative dose of OAR decreased by 5.24 % and the maximum dose by 7.05 %, respectively, compared with the Static-Jaw technique(SJT). In the various OARs, the mean dose and maximum dose reduction ranges ranged from 0.01 to 3.16 Gy and from 0.12 to 6.27 Gy, respectively. In the case of the target, the maximum dose of GTV, CTV, PTV decreased by 0.17 %, 0.43 %, and 0.37 % in JTT, and the mean dose decreased by 0.24 %, 0.47 % and 0.47 %, respectively. Gamma analysis The JTT and SJT passing rates were $98{\pm}1.73%$ and $97{\pm}1.83%$ on the basis of 3 % / 3 mm, respectively. Comparing the doses of all OARs applied to the experiment, it was found that the use of JTT resulted in a significant decrease in dose due to additional jaw shielding besides MLC than SJT. Conclusion : In radiation therapy using VMAT treatment plan, we can apply JTT in the case of adjacent tumor and normal organs such as brain cancer and head and neck cancer, and in radiotherapy required large field and high energy caused increase leakage dose through MLC. It is considered that the target dose of PTV can be increased by lowering the dose of normal tissue surrounding the tumor.

고혈압을 동반한 당뇨병에서 유병기간에 따른 뇌졸중 위험도

김희성,Kim, Hee Sung 대한임상검사과학회 2020 대한임상검사과학회지(KJCLS) Vol.52 No.3

Stroke is a major cause of death and disorder, and diabetes mellitus (DM) is a significant risk factor of stroke. This study examined the importance of target blood pressure (<140/<90 mmHg) management in patients with DM. Based on the data of the 6th National Health and Nutrition Examination Survey, a total of 16,389 patients aged 18 to under 80 were assessed through regression analysis to estimate the risk of stroke through blood pressure control. The prevalence of stroke according to the presence or absence of DM was higher in the diabetic group, and a longer duration of DM indicated a higher risk of hypertension and stroke. The hazard ratio of stroke was lower in the maintenance group (0.57) of target blood pressure (<140/<90 mmHg) compared to the high blood pressure group(>140/>90 mmHg). Despite the accompanying treatment for DM and hypertension, the frequency of hypertension increased, and the prevalence of stroke increased after five years of DM. Hence, effective blood pressure management at this time is important. The risk of stroke should be reduced by continuously managing blood pressure in DM. 뇌졸중은 사망발생 및 장애를 일으키는 주요 원인 질환이며, 당뇨병은 뇌졸중의 주요 위험인자이다. 당뇨병 환자가운데 뇌졸중을 동반한 환자에서 적정 혈압 관리의 중요성을 알아보고자 한다. 제6기 국민건강영양조사 자료를 바탕으로 18세 이상 80세 미만자 총 16,389명을 대상으로 회귀분석을 통하여 당뇨병 유병기간에 따른 혈압조절을 통한 뇌졸중의 위험도를 산정하였다. 당뇨병 유무에 따른 뇌졸중의 유병률은 당뇨병 환자 군에서 높았고, 당뇨병의 유병기간이 길어질수록 고혈압과 뇌졸중의 위험도는 상승하였으며, 당뇨병과 고혈압에 대한 치료 비율은 높았다. 고혈압군에 비해 적정 혈압 유지군(<140/<90 mmHg)에서 뇌졸중 위험비(HR)는 0.57 낮았다. 당뇨병과 고혈압에 대한 치료가 동반됨에도 불구하고 고혈압의 빈도는 상승하였고, 당뇨병 유병기간 5년 이후 뇌졸중의 유병률이 상승함에 따라 이 시기의 효과적인 혈압관리가 더욱 중요하다. 당뇨병 환자에서 지속적으로 적정 혈압으로 관리함으로써 뇌졸중 위험도를 낮추는 것이 중요하다.

림프절 세침흡인 세포검사의 진단적 유용성과 한계 - 생검으로 확진한 176 예의 분석 -

김희성,김대수,오영륜,고영혜,이회정,Kim, Hee-Sung,Kim, Dae-Soo,Oh, Young-Lyun,Ko, Young-Hyeh,Ree, Howe-J. 대한세포병리학회 1999 대한세포병리학회지 Vol.10 No.1

The accuracy of fine needle aspiration cytology(FNAC) of the lymph node was investigated through a review of 176 FNAC cases and the corresponding biopsies. We chose 157 FNAC cases after the exclusion of 19 inadequate ones. Sensitivity of malignancy was 94.0%, specificity 100%, false negativity 6.0%, and false positivity 0.0%. The overall diagnostic accuracy was 96.8%. Sensitivity of metastatic carcinoma was 98.0% and that of malignant lymphoma was 87.9%. False negative cases included one metastatic carcinoma and four malignant lymphomas. The aspirates of metastatic carcinoma with false negativity exhibited a diffuse smear of keratin debris without viable cells, which led to the difficulty in differentiation from benign epithelial cyst. The cases of malignant lymphoma with false negative diagnosis were two Hodgkin diseases, one Lennert's lymphoma, and one peripheral T cell lymphoma in the histologic sections. On the analysis of 39 cases of tuberculosis, 17 cases(43.6%) were diagnosed as tuberculosis, 4(10.3%) as granulomatous lymphadenitis, 3(7.7%) as necrotizing lymphadenitis, and 15(38.5%) as reactive hyperplasia or pyogenic inflammation. Sensitivity of tuberculosis was 53.9%. In conclusion, lymph node FNAC is an excellent non-invasive diagnostic tool for the diagnosis of metastatic carcinoma. The diagnostic accuracy of malignant lymphoma could be improved with flow cytometry or polymerase chain reaction for antigen receptor genes. For the FNAC diagnosis of tuberculosis, AFB stain, culture, and PCR would be helpful as adjuvant techniques.

구절 동사와 전치사 수반동사의 의미에 따른 음성적 실현

김희성,송지연,김기호,Kim, Hee-Sung,Song, Ji-Yeon,Kim, Kee-Ho 대한음성학회 2007 말소리 Vol.63 No.-

Verb phrase could have two different meanings according to which is followed after verb; adverb or preposition. The meaning of 'verb+adverb' is deduced from a figurative meaning which is idiomatic expression, and 'verb+preposition' is interpreted as the literal meaning. The purpose of this study is to observe how English native speakers and Korean leaners of English distinguish two sentences of the same word strings with acoustic cues like pause and duration. According to the result, as pause was used for meaning distinction, it was likely that the pause length preceding prepositions was longer than that of following adverbs. To distinguish two sentences of the same word strings, all participants seemed to use pause, verb lengthening and adverb/preposition lengthening. Among them, there is a hierarchical significance; in sequence, pause, verb lengthening, adverb/preposition lengthening.

일본인 한국어 학습자의 한국어 모음 포먼트 연구

김희성,송지연,김기호,Kim, Hee-Sung,Song, Ji-Yeon,Kim, Kee-Ho 한국음성학회 2006 음성과학 Vol.13 No.3

The purpose of this experimental study is to investigate formant characteristics of Korean monophthongs spoken by Japanese learners and to compare the characteristics of vowels produced by the Japanese learners with those of the Korean native speakers. The data consisted of three categories: eight vowels in isolation, words including eight vowels in carrier sentences, and words including eight vowels in natural sentences. In this study, formant frequencies of the vowels were measured by Wave Surfer. It was assumed that the formant frequencies of the Korean vowels produced by the Japanese learners could be different from those of the Korean native speakers due to the influence of their own Japanese vowels. Results of this study showed that the Japanese learners had the difficulties to distinguish between the pairs /-/and /ㅜ/, /ㅓ/and /ㅗ/, and /ㅏ/and /ㅔ/. In Japanese vowels, F2 frequency value of /ㅜ/ was similar to that of the Korean /-/. It means that when the Japanese leaners produced Korean /ㅜ/, they might neutralize /-/ and /ㅜ/. Besides, there were not /ㅓ/and /ㅐ/ in Japanese vowels. Therefore, they tended to pronounce /ㅓ/ similar to /ㅗ/ which has the most similar formant frequency value with that of /ㅓ/, and /ㅐ/ was pronounced similar to /ㅔ/ for the same reason.

분산병렬처리 환경에서 오토매핑 기법을 통한 NoSQL과 RDBMS와의 연동

김희성,이봉환,Kim, Hee Sung,Lee, Bong Hwan 한국정보통신학회 2017 한국정보통신학회논문지 Vol.21 No.11

최근 빅데이터가 주목받게 되면서 빅데이터를 처리하기 위한 시스템들도 중요하게 여겨지고 있다. 빅데이터 처리 시스템으로 분산파일시스템인 Hadoop과 비정형 데이터 처리를 위한 NoSQL 데이터 스토어가 주목받고 있다. 하지만 아직까지 NoSQL을 사용함에 있어 어려움이나 불편함도 존재한다. 저용량 데이터인 경우 NoSQL의 MapReduce는 불필요한 작업시간을 소모하게 되며, RDBMS 보다 상대적으로 많은 데이터 탐색 시간이 소요되기도 한다. 본 논문에서는 이러한 NoSQL의 문제점을 해결하기 위해 NoSQL과 RDBMS 간의 연동 기법을 제안하였다. 개발한 오토매핑 기법은 처리할 데이터의 양에 따라 적합한 데이터베이스를 사용하게 하여 결과적으로 검색시간을 빠르게 할 수 있다. 실험 결과 제안한 데이터베이스 연동 기법은 특정 데이터 셋의 경우 검색시간을 최대 35%까지 줄일 수 있다. Lately big data processing is considered as an emerging issue. As a huge amount of data is generated, data processing capability is getting important. In processing big data, both Hadoop distributed file system and unstructured date processing-based NoSQL data store are getting a lot of attention. However, there still exists problems and inconvenience to use NoSQL. In case of low volume data, MapReduce of NoSQL normally consumes unnecessary processing time and requires relatively much more data retrieval time than RDBMS. In order to address the NoSQL problem, in this paper, an interworking scheme between NoSQL and the conventional RDBMS is proposed. The developed auto-mapping scheme enables to choose an appropriate database (NoSQL or RDBMS) depending on the amount of data, which results in fast search time. The experimental results for a specific data set shows that the database interworking scheme reduces data searching time by 35% at the maximum.

최근 일반 건강인에 대한 매독 혈청 검사 양성율 - 1995년

김희성,이한승,이민걸,이정복 ( Hee Sung Kim,Han Sung Lee,Min Geol Lee,Jung Bock Lee ) 대한피부과학회 1997 大韓皮膚科學會誌 Vol.35 No.3

Background: The VDRL is used as a screening test for syphilis worldwide. In addition, reactive rates of the VDRL test are used to estimate the incidence of syphilis. The prevalence of syphilis reported in Korea varies according to the study population, district and time. Reports on prevalence of syphilis indicate that reactive rates of the serologic test for syphilis showed an increasing tendency in the 1960s and has steadily decreased in the 1990s. We have already reported VDRL positive rates periodically since the late 1970s in similar areas with similar population groups and methods in order to standardize the results for accurate analysis of the prevalence of syphilis in Korea. Objective : This study was performed utilizing the VDRL test in order to find out if the decreasing trend of syphilis prevalence is still continuing. Methods : The ser ologic tests for syphilis were carried out on 13,426 apparently normal adults aged twenty-years-old or over(8,250 blood donors in the Seoul area, 2,461 physical examinees examined at Severance Hospital, Yonsei University and 2,715 pregnant women at delivery at Severance Hospital, Yonsei University ) from January to December 1995. We hve performed the VDRL quantitative test in VDRL-reactive persons among blood donors and pregnant women. Results : The reactive rate of the serum VDRL test was 0.2% in 13,426 healthy adults(blood donors.0.2%, physical examinees:0,2%, pregnant women:0.3%). There was a statistically decreasing tendency compared to 0.4% in 1990(p<0.001). The VDRL quantitative test resulted in levels below the 1:2 titer in 92% of the VDRL-reactive physical exarninees and pregnant women. Conclusion . From the comparison of VDRL reactive rates for syphilis in an apparently normal Korean population obtained by the present author group since 1977, i.e., 2.5% in 1977, 1.1% in 1981, 0.6% in 1986, 0.4% in 1990 and 0.2% in 1995, it is clear that the prevalence of syphilis has been rapidly decreasing since the mid 1970s in Korea. (Kor J Dermatol 1997;35(3): 514-519)

강도수준을 고려한 원주형 공시체에 대한 콘크리트 압축강도의 크기효과

김희성,진치섭,어석홍,Kim, Hee-Sung,Jin, Chi-Sub,Eo, Seok-Hong 한국콘크리트학회 1999 콘크리트학회지 Vol.11 No.2

콘크리트 원주형 공시체의 크기에 따른 압축강도의 감소현상은 많은 관심을 받아 왔으나, 지금까지도 이에 대해 제시된 모델식이 드문 실정이다. 기존의 연구결과에 의하면 콘크리트의 강도는 부재의 크기가 증가할수록 감소하며 그 파괴거동을 규명하기 위해서는 비선형 파괴역학 이론을 적용해야 함을 알 수 있다. 표준형 및 비표준형 공시체의 크기에 따른 압축강도의 변화를 파괴역학 이론에 따라 연구하고 실용적인 예측 모델식이 제시된 바 있지만 콘크리트의 강도수준에 따른 파괴메카니즘의 차이를 고려한 관계식은 전무한 상황이다. 따라서, 본 논문에서는 공시체의 크기와 h/d의 영향 및 콘크리트 압축강도수준을 고려하여 보다 일반화된 압축강도 예측 모델식을 제시한다. The reduction phenomena of concrete compressive strength with the size of specimens have been extensively investigated, but till now the adequate analysis technique is not fixed. The existing research results show that the bigger the member size, the smaller the strength. This means the nonlinear fracture mechanics theory is needed in order to analyze the fracture behaviors of concrete and the size effect. There is a few model equations that is to predict the size effect of compressive strength of standard and non-standard cylindrical specimen. However, theses equations did not considered the difference of fracturing mechanism which depends on the strength level. In this paper, model equations to predict compressive strength of concrete considering the size effect and strength level are suggested. The size effect model suggested in this paper shows good prediction compared with the existing test data of various concrete size and strength level.

현대 미술디자인 세계 - 군산대학교 현대미술연구소 작품을 중심으로 -

김희성,Kim, Hee-Sung 한국패션뷰티학회 2008 한국패션뷰티학회지 Vol.6 No.2

The Institute of Contemporary Art has gathered, arranged and exchanged historical data and a variety of information of art. It also aims at Helping revitalize artistic activities and develop diverse areas of art among regions. This scheme for revitalization of art includes holding seminars, international exhibitions or regional exchange exhibitions, publishing papers, and enhancing art education. This paper provides a view of what the Institute of Contemporary Art at Kunsan University has done so far, pursues better ways for revitalization of artistic activities, and suggests a future-oriented approach for making the institute a place for regional exchange of modem art and design.

초급 영어 학습자의 약강구조 영어 단어에서의 강약음절 산출

김희성,서미선,신지영,김기호,Kim, Hee-Sung,Seo, Mi-Sun,Shin, Ji-Young,Kim, Kee-Ho 한국음성학회 2005 음성과학 Vol.12 No.3

In this study, realization of strong and weak syllables in English by Korean leaners with low English proficiency was examined through experiment. The aspects of three acoustic characteristics-duration, pitch, amplitude-were measured and compared with native speakers of English. It was assumed that production of duration, pitch and amplitude of strong and weak syllable by Korean learners would be different from that of English native speakers. According to the production experiments, English native speakers produced strong syllable longer, higher and louder than weak syllable. However, Korean leaners produced strong syllable higher and louder than weak syllable, but not longer enough. Specifically, weak syllable by Korean leaners was longer and strong syllable shorter than native speakers. Furthermore, the difference in duration of syllables between Korean leaners and English native speakers is more significant than pitch and amplitude. As a result, the duration was more important cue for the realization of stress than pitch and amplitude. However, Korean leaners did not produce duration of stressed syllables as English native speakers did, even though they produce the pitch and amplitude of stressed syllable in a similar way to native speakers. The reasons for those were considered, too.