국궁 사법의 원형에 대한 실태 분석

모창배(Chang Bae Mo),정진명(Jin Myung Jeong) 한국사회체육학회 2007 한국사회체육학회지 Vol.0 No.31

Though Korean Traditional Archery has existed for countless centuries, few, if any, records exist on this subject. The fact that it takes years, indeed decades, of practice to master archery only compounds the difficulty in documenting it. Fortunately, this dearth in documented accounts of Korean Traditional Archery (hereafter referred as KTA) was alleviated with the publication of ``Joseon ui Gungsul``. However, since its original publication over 70 years ago, there have been and continue to be many changes and developments in the field, and it follows that the time has come to review, re-assess, and redefine the nature and form of KTA. Recognizing that a single individual`s account of KTA does not give us a valid picture of what defines it, we decided to collect the accounts of numerous veteran archers since the Liberation of Korea and to specifically look for common pointsin order to get a clearer picture of what KTA really is. The results of our research indicate that those accounts generally correlate with the data found in ``Joseon ui Gungsul``. We also found, however, that the KTA as described by these veteran archers differed from that described in ``Joseon ui Gungsul`` in many significant respects. They agree that there have been many changes in KTA since Korea`s liberation and that for a variety of reasons there appeared a modern form of KTA in the late 1970`s. One of the more significant changes was that modern KTA incorporated the pushing of the ``bow`` hand to generate power(characteristic of Western archery) whereas in classic KTA most of the power was generated by the drawing of the ``arrow`` hand. The documented accounts of post-Liberation veteran archers attest to the fact that KTA has changed and continues to change. There is a common recognition, however, that the traditions that define classic KTA are valuable and must be preserved. And for this reason we note that, for the most part, the accounts of the post-Liberation veteran archers generally match the data found in ``Joseon ui Gungsul``.

냉동보관된 자가골편과 Methyl Methacrylate를 이용한 두개골성형술의 결과 비교

박균철,황수현,김준수,김기정,박인성,김은상,정진명,한종우,Park, Gyeun Chul,Hwang, Soo Hyun,Kim, Joon Soo,Kim, Ki Jeong,Park, In Sung,Kim, Eun-Sang,Jung, Jin-Myung,Han, Jong Woo 대한신경외과학회 2001 Journal of Korean neurosurgical society Vol.30 No.1

Objective : Authors analyzed clinical outcomes of cranioplasty according to the materials used for covering defects of the skulls. Methods : From January 1997 to February 2000, there were forty one patients undergone cranioplasty at our institution. We used refrigerated autogenous bone flaps in 19 cases(group A) and methyl methacrylate(MMA) in 22 cases(group B). The medical records and plain skull radiographs of the patient were reviewed. Results : There were thirty men and eleven women. Mean follow up period was 12 months(From operation to last Outpatient department follow up). The mean operative time of the group A($136.8{\pm}3$ minutes) was shorter than the group B($172.7{\pm}2$ minutes, Mann-Whitney test, p=0.001). In group A, the degree of satisfaction was good in 8 cases, fair in 10, and poor in 1. In the group B, there were fair in 13 and poor in 9. So the cosmetic result was superior in the group A(Chi-square test, p=0.00). The complications were occured in one case of flap infection in the group A and 6 in the group B(one stitch abscess, 4 infected flaps, one subgaleal hematoma). Conclusion : Cranioplasty using refrigerated autogenous bone flap showed shorter operative time, better cosmetic results, and less complication rate than those using MMA.

사이버나이프를 이용한 무고정틀 두개 방사선 수술 중 발생한 환자의 치료 중 움직임 분석

강기문,채규영,정배권,하인봉,박경범,정진명,임영경,정호진,Kang, Ki Mun,Chai, Gyu Young,Jeong, Bae Gwon,Ha, In-Bong,Park, Kyung Bum,Jung, Jin-Myung,Lim, Young Kyung,Jeong, Hojin 한국의학물리학회 2012 의학물리 Vol.23 No.3

무고정틀 두개 방사선 시술은 두개 고정틀 방식에 비해 환자 친화적이며 다중 분할 치료의 적용이 용이하다는 장점을 가진다. 그러나, 환자의 움직임을 완전히 제어할 수 없기 때문에 치료 중 움직임으로 인해 시술의 정확도가 영향을 받을 수 있다. 본 연구에서는 종양 추적 방식의 무고정틀 방사선 치료를 시행 받은 환자의 실제 치료 기록을 분석하여 무고정틀 방사선 치료 시 발생할 수 있는 치료 중 환자의 움직임을 분석하였다. 사이버나이프(CyberKnife, Accuray Inc, CA)를 이용한 294회의 뇌종양 방사선 수술 기록을 분석하였으며, 이를 토대로 치료시간에 따른 치료 중 움직임의 크기를 통계적으로 제시하였다. 본 연구의 결과는 무고정틀 방사선 수술 시 고려되어야 할 치료 중 움직임에 대한 기본 지표로 활용될 수 있을 것으로 생각된다. Frameless method in brain radiosurgery has advantages relative to rigid head-frame method in terms of patient friendly and flexible application of multi-fractionation. However, it has also disadvantages and the most negative point is that it cannot control the patient motion during treatment as lowly as the level of the frame-based radiosurgery, which could affect to the treatment accuracy. In the present study, we analyzed the geometric uncertainty of the intra-fraction motion using the actual treatment records of 294-CyberKnife treatments for brain tumors. Based on the analysis, we statistically presented the magnitude of intra-fraction motion in frameless radiosurgy. The result could provide the quantitative information to determine the adequate treatment margins to compensate the intra-fraction movements.

경사에코자기공명영상을 이용한 뇌미만성 축삭 손상 환자의 예후 분석

김형종,박인성,김재형,김기정,황수현,김은상,정진명,한종우,Kim, Hyoung Jong,Park, In Sung,Kim, Jae Hyoung,Kim, Ki Jeong,Hwang, Soo Hyun,Kim, Eun-Sang,Jung, Jin-Myung,Han, Jong Woo 대한신경외과학회 2001 Journal of Korean neurosurgical society Vol.30 No.2

Objective : The authors have studied the clinical outcome of patients with diffuse axonal injuries(DAI) to evaluate the prognostic value of gradient-echo MR imaging findings. Materials and Methods : From March 1995 to March 1998, there were nineteen patients with DAI whose initial Glasgow coma scales were eight or less. Authors divided them into two groups according to Glasgow outcome scales ; those patients with GOS 3 or less(group A ; 9) and those with 4 or more(group B ; 10). We subdivided the lesions as superficial and deep lesion, and analyzed the numbers, anatomical loci of the lesions on the gradient echo images of each group. Results : Mean numbers of the lesions were 15 per case in group A(135/9) and 10 in group B(100/10). The common loci involved in DAI were cerebral cortex, brain stem, and corpus callosum. Cortical lesions were 31.1% in group A(42/135) and 47% in group B(47/100). Brain stem lesions were 25.9%(35/135) and 15%(15/100) each. Callosal lesions were 31.1%(26/135) and 13%(13/100) each. The frequency of callosal and brain stem lesions was significantly different between two groups(p<0.05). We divided callosal lesions as genu, body, and splenium and body lesions as anterior, middle, posterior, but no significant topographical difference of lesions was observed between two groups. Deep lesions were observed more frequently in group A(58.5%, 79/135) than group B(36%, 36/100). Conclusion : The poor outcome group showed more numbers of lesion and more frequent involvement of brain stem and corpus callosum than favorable outcome group. Gradient-echo MR imaging seems to have predictive value for clinical outcome in patients with DAI.

뇌경막 동정맥루를 동반한 장기간 지속된 외상성 경동맥-해면정맥동루 - 증례보고 -

박경범,박인성,김준수,김기정,황수현,김은상,정진명,한종우,김재형,Park, Kyung Bum,Park, In Sung,Kim, Joon Soo,Kim, Ki Jeong,Hwang, Soo Hyun,Kim, Eun-Sang,Jung, Jin-Myung,Han, Jong Woo,Kim, Jae Hyung 대한신경외과학회 2001 Journal of Korean neurosurgical society Vol.30 No.1

Traumatic carotid-cavernous fistula is a rare complication of moderate to severe head injury. For the treatment of carotid-cavernous fistula, detachable balloon occlusion is the best method of choice. A 26 year old male patient was hurt with a left periorbital penetrating injury 20 years ago, and then left side exophthalmos, bruit and right hemiparesis developed 10 years later. We experienced the very rare case of direct carotidcavernous fistula with cavernous dural arteriovenous fistula. Brain MRIs and cerebral angiograms revealed that direct carotid-cavernous fistula was accompanied by cavernous dural arteriovenous fistula due to longstanding venous hypertension and development of collateral circulation. Detachable balloon occlusion and surgical internal carotid artery ligation were not enough to occlude fistular flow, so cavernous dural arteriovenous fistula embolization was necessary. The authors present a case of long-standing traumatic carotid-cavernous fistula with cavernous dural arteriovenous fistula, with review of the literature.

폐전이를 보인 경-흉추 이행부 악성 신경초종 1례 - 증 례 보 고 -

박경범,황수현,김준수,김기정,박인성,김은상,정진명,한종우,Park, Kyung Bum,Hwang, Soo Hyun,Kim, Joon Soo,Kim, Ki Jeong,Park, In Sung,Kim, Eun-Sang,Jung, Jin-Myung,Han, Jong Woo 대한신경외과학회 2001 Journal of Korean neurosurgical society Vol.30 No.11

Acase of malignant schwannoma in the cervico-thoracic region with lung metastasis is presented. The patient was 55-year-old man presented with right arm weakness. Magnetic resonance image demonstrated lobulated enhancing soft tissue masses in spinal canal, neural foramen and right paraspinal space at C7-T1 level compressing the dural sac and spinal cord. Subtotal removal was performed and histological diagnosis of malignant schwannoma was made. Reoperation due to recurrence was done but subsequent metastasis to lung was observed.

폐암환자의 종양추적 정위방사선치료를 위한 삼차원 및 사차원 방사선치료계획의 비교

채규영(Gyu Young Chai),임영경(Young Kyung Lim),강기문(Ki Mun Kang),정배권(Bae Gwon Jeong),하인봉(In-Bong Ha),박경범(Kyung Bum Park),정진명(Jin-Myung Jung),김동욱(Dongwook Kim) 대한방사선종양학회 2010 Radiation Oncology Journal Vol.28 No.4

목 적: 폐암환자의 종양추적 정위방사선치료에서 삼차원 및 사차원치료계획의 선량분포 차이를 비교하였고 선량계산 알고리즘에 따른 폐의 비균질성 보정 결과에 커다란 차이가 있음을 확인하고자 하였다. 대상 및 방법: 7명의 폐암환자를 대상으로 전향적 호흡동조된 사차원 컴퓨터단층촬영 영상을 얻었다. 획득한 영상은 환자의 호흡에 대응하는 10개의 삼차원단층촬영 영상이며 이를 바탕으로 사차원치료계획이 수립되었다. 사차원 치료계획에서는 종양과 주변장기의 움직임을 고려하여 X선의 방향과 선량분포를 최적화한다. 사차원치료계획에서 최적화된 빔을 호흡의 50% 위상에 해당하는 한 개의 삼차원단층촬영 영상에 동일하게 적용하여 삼차원치료계획을 만들었다. 삼차원 및 사차원 치료계획에서 선량계산을 위하여 각각 Ray-tracing과 몬테칼로 알고리즘을 사용하였다. 수립된 4개의 치료계획에서 처방선량의 종양체적 포함률, 종양체적의 95%를 포함하는 선량인 D95, 종양의 최대선량, 그리고 척수의 최대선량을 비교하였고 종양의 위치에 대한 연관성도 함께 고찰하였다. 결 과: 몬테칼로 알고리즘을 사용한 삼차원 및 사차원 치료계획에서 종양이 폐의 하엽에 위치해 있는 경우에는 사차원치료계획에서 종양 포함률이 평균 4.4% 높았던 반면에 종양이 폐의 중엽이나 상엽에 위치해 있는 경우에는 반대로 평균 4.6% 낮았다. 또한, D95도 종양이 폐의 하엽에 위치해 있는 경우에는 사차원치료계획에서 평균 4.8% 높았던 반면에 종양이 폐의 중엽이나 상엽에 위치해 있는 경우에는 반대로 평균 1.7% 낮았다. 척수의 최대선량에 대한 비교에서도 종양과 유사한 경향이 나타났다. 치료계획의 차원과 무관하게 Ray-tracing과 몬테칼로 알고리즘 사이의 선량계산 차이는 평균 30% 정도로 몬테칼로 알고리즘을 사용하였을 때 처방선량이 포함하는 종양의 부피는 크게 줄어들었다. 결 론: 폐 종양의 삼차원 및 사차원 치료계획 사이의 차이를 종양과 척수의 선량분포를 통해 비교하였다. 두 치료계획 사이에서 planning target volume (PTV) 포함률이나 D95와 같이 종양과 관련된 선량학적 인자들의 차이 또는 척수의 최대선량 차이는 종양의 이동크기와 형태변화의 정도에 밀접하게 연관되어 있는 것으로 나타났다. 또한, 치료계획의 차원과 무관하게 몬테칼로 알고리즘을 사용하면 처방선량이 포함하는 PTV 포함률이나 D95가 크게 줄어드는 것을 확인하였다. Purpose: To compare the dose distributions between three-dimensional (3D) and four-dimensional (4D) radiation treatment plans calculated by Ray-tracing or the Monte Carlo algorithm, and to highlight the difference of dose calculation between two algorithms for lung heterogeneity correction in lung cancers. Materials and Methods: Prospectively gated 4D CTs in seven patients were obtained with a Brilliance CT64-Channel scanner along with a respiratory bellows gating device. After 4D treatment planning with the Ray Tracing algorithm in Multiplan 3.5.1, a CyberKnife stereotactic radiotherapy planning system, 3D Ray Tracing, 3D and 4D Monte Carlo dose calculations were performed under the same beam conditions (same number, directions, monitor units of beams). The 3D plan was performed in a primary CT image setting corresponding to middle phase expiration (50%). Relative dose coverage, D95 of gross tumor volume and planning target volume, maximum doses of tumor, and the spinal cord were compared for each plan, taking into consideration the tumor location. Results: According to the Monte Carlo calculations, mean tumor volume coverage of the 4D plans was 4.4% higher than the 3D plans when tumors were located in the lower lobes of the lung, but were 4.6% lower when tumors were located in the upper lobes of the lung. Similarly, the D95 of 4D plans was 4.8% higher than 3D plans when tumors were located in the lower lobes of lung, but was 1.7% lower when tumors were located in the upper lobes of lung. This tendency was also observed at the maximum dose of the spinal cord. Lastly, a 30% reduction in the PTV volume coverage was observed for the Monte Carlo calculation compared with the Ray-tracing calculation. Conclusion: 3D and 4D robotic radiotherapy treatment plans for lung cancers were compared according to a dosimetric viewpoint for a tumor and the spinal cord. The difference of tumor dose distributions between 3D and 4D treatment plans was only significant when large tumor movement and deformation was suspected. Therefore, 4D treatment planning is only necessary for large tumor motion and deformation. However, a Monte Carlo calculation is always necessary, independent of tumor motion in the lung.

노인성 골다공증성 추체 압박골절 환자에 대한 경피적 척추성형술 후 치료 결과 및 합병증 : Treatment Efficacy and Complications

강동호,김기정,이철희,황수현,김은상,정진명 대한노인병학회 2002 대한노인병학회지 Vol.6 No.3