새로운 전중추신경 방사선 조사법 ; 방사선속의 발산에 의한 선량의 불균일성을 극복하기 위한 치료 방법

장혜숙,Chang, Hye-Sook The Korean Society for Radiation Oncology 1991 Radiation Oncology Journal Vol.9 No.2

전중추신경 방사선 조사는 수아세포종, 중추신경정상피종, 중추신경임파종, 중추신경백혈병 환자 치료에 시행한다. 뇌부위에는 양면 조사야를 통하고 척추 신경부위는 후면 단일 조사야를 통해 방사선 조사한다. 이때 조사야가 인접한 부위에서 발생하는 방사선조사야의 중첩에 의한 선량의 불균일성은 큰 문제로, 특히 척추신경의 극히 한정된 방사선 인내능력으로 인해 심각한 부작용을 병발할 수 있다. 이 문제를 해결하기위한 많은 연구가 보고되고 있으나 그들이 보고한 방법에 의해서도 불균일성은 최고 $60\%\sim70\%$로 부터 최소 $15\%\sim20\%$에 이른다. 저자는 split beam (central axis beam)과 collimator rotation technique을 이용하거나 collimator/couch rotation technique을 이용하여 3조사야가 접하는 부위의 방사선량의 불균일성을 해결하고자 시도하였다. 저자의 방법으로 시행할 때 3조사야가 접하는 부위에서의 불균일성은 $5\%$정도로 감소시킬 수 있었다. 본 논문에서 저자의 방법의 장단점을 기술하였다. To irradiate the entire neuroaxis, bilateral parallel opposed brain fields and direct posterior spinal field have been utilized and radiation dose at the junction between abutting fields has been extensilvely studied. And several workable methods were reported to achieve uniform dose at a desired depth at the juction between abutting fields whose central axis are coplanar. But the dose distribhution at the juction of orthogonal fields has been a persistent problem in radiation oncology. Author describes a new method to solve the junction problem between abutting fields whose central axis are orthogonal. Author utilized split beam/comllimator rotation or collimator/couch rotation to avoid hot or cold spots that may arise from beam divergence. Author achieved accurate and homogeneous dose distribution by mathching the $50\%$ isodose line at the junction between orthogonal central axis beam fields.

개에서 Tiletamine-zolazepam, Tiletamine-zolazepam-xylazine 및 Ketamine-xylazine의 마취효과

장혜숙,장인호,Chang, Hye-sook,Jang, In-ho 대한수의학회 1998 大韓獸醫學會誌 Vol.38 No.2

This study was conducted to compare the anesthetic effects of intravenous tiletamine-zolazepam(TZ, 7mg/kg TZ), tiletamine-zolazepam-xylazine(TZX, 7mg/kg TZ and 1.1mg/kg X) and ketamine-xylazine(KX, 10mg/kg K and 1.1mg/kg X). Fifteen mixed-breed healthy dogs($3.5{\pm}1.0kg$) were randomly assigned to the three treatment groups(TZ, TZX, KX) with 5 dogs in each group. The mean surgical anesthesia time was $25.6{\pm}4.2$, $62.6{\pm}6.2$ and $21.0{\pm}3.7$ min in TZ-, TZX- and KX-anesthetized dogs, respectively. The duration of the loss of response to toe-web needle prick and to visceral pain was significantly increased in the TZX group with $40.0{\pm}15.8$ min and $44.0{\pm}5.5$ min, respectively(p<0.01). Heart rate decreased significantly below baseline in TZX and KX groups(p<0.05, p<0.01) whereas it increased above baseline in TZ group. Respiratory rate remained unchanged or increased above baseline in TZ group, but decreased significantly from 10 to 30 min in TZX(p<0.01, p<0.05) and at 10 min in KX group(p<0.05). Body temperature decreased significantly below baseline in all three groups(p<0.01, p<0.05). Hematologic(PCV, RBC, WBC) and serum chemistry values(GOT, GPT, BUN, creatinine, total protein, glucose) were monitored before anesthesia, after recovery from anesthesia and 1, 3 and 7 days postanesthesia. All hematologic values remained generally within normal ranges, and GOT, GPT, BUN, creatinine and total protein values were within normal ranges during the period. Glucose values for TZX and KX groups increased greatly after recovery from anesthesia. We conclude that tiletamine-zolazepam-xylazine provides effective surgical anesthesia in dogs and in many cases may be preferable to conventional ketamine-xylazine regimen.

광대의상 연구

장혜숙 ( Hye Sook Chang ) 한국연극교육학회 2013 연극교육연구 Vol.22 No.-

Clowns have existed always in any nation or culture and keep our side safe in a variety of ways through long history of the world. They have been grown and adapted to the society of that tin by experiencing vast change of their characters such as burlesque players from ancient Greece and Rome to the medieval wandering clowns and court jesters who were connected to playful characters of Commedia del arte. The clowns therefore have been increasingly evolved and improved professionally through circus, TV, movie and show stage. Clown costumes have also varied from the ordinary outfits of the first stage to extraordinary and grotesque appearance later to represent good, evil, humorous farcical elements and even more to exaggerate their irrational and mysterious appearance of a nonster. Clowns` outlooks have been dramatically changed not only to increase the visibility with exaggerated size, strong colors and infantile details or objects but also to express folly of the power and absurdity of the society to be delved by implying cynical satire and expressing fun and satire at the same time. The world of clowns increased the value of the clown art with their own unique costume and makeup with diversification of Whiteface, Auguste and Character clowns. They shake their reputation as comedy program actors or hosts of a show as well as carnival, party, performance and circus. They appear with various types of specialized organization of the society even in psychotherapy and the field of medicine. In addition to the purpose of commercial profit, the development of a modem clown art and large-scale global entertainment additionally requires visual significance and values resulting from a fusion of cultures and ethnicities across the border of any regions. As laughter is the best treatment, clowns` antics expose human folly utmost and rescue from despair of life. Clowns could also turn people`s painful lives joyful and may serve as a motivation to bring lubricants to their lives. Clowns create unique and haunting characters in popular culture with distorted and exaggerated laugh, and clear or unclear expression of human emotion. Moreover, they create these countenance through their diverse and ever-changing colors, and designs of costume and makeup. Exaggeration, sense of exceptionalism, infant friendliness, disharmony and contradictory discrepancy, evoked from the external characteristic elements of clown costume that represents symbolism, satire, amusingness and estrangement between ordinary audience and the laughter of the clown. As long as human exists, clown character will always exist regardless of the form of a clown costume and design. Playful elements will basically exist and evolve in the area of exaggerated colors, decorations, bright stripes, dots, patterns, oversized ruffles, ribbon tie, flapping shoes and color wig. Perception of tradition should not force the advancement and development of both clowns and clown costumes in order to be tied into human bondage. On the other hand, abandoning the tradition is not also desirable by reason of opposing advancement. Change should be pursued from the application and the extension of tradition Therefore, clown costume would be developed smoothly in a flow of the transition of aesthetic sense to become interesting, playful and bizarre with the expansion of pluralism and personalized aesthetics. From the results, clowns could constantly express and prosecute for aspects of our lives, and will represent the structure of consciousness of their belonging period and its society.

폐암의 방사선 치료

장혜숙 ( Hye Sook Chang ) 대한결핵 및 호흡기학회 1990 Tuberculosis and Respiratory Diseases Vol.37 No.3

사극드라마 의상 연구(1) -TV퓨전사극을 중심으로-

장혜숙 ( Hye Sook Chang ) 한국연극교육학회 2009 연극교육연구 Vol.15 No.-

무대의상의 유희성과 그 접근에 관한 연구

장혜숙 ( Hye Sook Chang ) 한국연극교육학회 2014 연극교육연구 Vol.24 No.-

As the physical and the spiritual activities except for activities are related to the human survival and daily life, play is a non-purpose activity participated voluntarily. Play or amusement would be described by the physical and the spiritual activities irrelevant to the human survival and daily life and therefore it has no purpose. Human develops the variety of creative activities in the world through the play with rich imagination, which provides elasticity to unpack the life and gives an opportunity to overcome a sense of inferiority. In other words, it brings modern people catharsis play with release and free feeling in sterile emotions because of the fact that their essence is based on the fun and enjoyment. Theatre is a genre of art that best represents the type and features of play. Modern audiences are intended to prefer the propensity of comedy works causing laugh to escape from the harsh reality and to give off free emotion. Comedy has very wide range of meaning spectrum and is therefore connected not only to satire, irony and the grotesque black comedy with combination of contradiction and heterogeneity but also humor and wit. The satire and humorous play always gives freedom spiritual pleasure as well as playful fun by showing animosity against absurdity and contradiction scattered in daily life. Comicality in the negation of social reality has always satire and aggressive nature, in this case, also has the character of generosity and reconciliation. Theatre costumes are expected to be valuably and effectively amusing when design elements are added in accordance with various comic devices of the works in the right place for the right costumes. The writer and director produce fun and laugh through comic devices, which express superiority by holding others up to ridicule and derision, physical deformity and distortion of the defect or sexual parts. The devices also include stubborn and unexpected sense of restraint due to incongruity, involuntary and dehumanized movements, the reversal of the expected change, and other ridiculous situations such as mask and transformation or disguise . The playful costumes on the basis of comic devices would therefore let the audience meditate on deep inner meanings as well as laughter and enjoyment. A deep study of amusingness of costume design through various design approaches and understanding comic devices would play a role in pursuing creative value and meaning in the culture and art, and entertainment industry in the future.

사극 속 갑주에 관한 연구

장혜숙 ( Hye Sook Chang ) 한국연극교육학회 2015 연극교육연구 Vol.27 No.-

Historical drama has more meaning and value to the public than simply enjoying. It could be fun and easily accessible visual history textbook to most of the people. It also looks back to the past and illuminates the future as a mirror of the times and life and eventually reminds us a sense of pride for our people and culture. Under the oppression inside the border of the history, the width of imagination and freedom of expression of historical drama has been relatively limited by comparing with other genres and media. Drama is, however, drama, not a documentary. It is, therefore, impossible to fully coincide with the historical facts. Creative imagination is a necessary element to achieve dramatic structure because it is essential artistic working conditions to some extent in the reconstructed, reinterpreted, and re-creation process. This process could solve viewers yearning for the history of communication. For the successful process, however, it should be given a rationale for anyone to admit and represented in creative ways under the boundary of such a permissible logic. The war has emerged as an essential element in the drama hanging between the past and the present, and dream and reality. Wearing armor during the war, therefore, became an important yardstick in determining the success of the drama. Due to the limitations of remaining historical data, the armor is difficult to be verified with historical research during construction, leaving to the imagination which becomes essential process for the completeness and genre characteristics of the historical drama. It has been unfortunately true and unsatisfactory in representing higher level of armor by the lackness of historical research and limitation of budget and time, Armor recycling and random mixing of style, therefore, would be a frequent happening in historical dramas. In addition, we were so generous to excessive design transformation and fusionism drama having unknown nationality in the flow of modernization for the popularity ratings. Recently, however, China``s Northeast Project, distortion of history in Japan and Korean history textbooks in compulsory subjects specified and controversial, such as confusion and identity issues of history, become a center of attention aspiring to ``correct history`` requiring historical facts and materials based on meticulous historical research. People now requires a high level of drama having such a fundamental research. Accordingly, expression of the armor in drama also raised gradually the level of construction and expression area and increased the completeness of the historical drama with more advanced, decorated and refined skills by focusing on the factual representations and visuals with the development of technology. This study shows costumes and the relations between historical research and imagination through the gaps of history and historical drama, The historical research and the problems of the modern transformation of ancient armor were discussed through the drama producted in recent years by focusing on the evolved face of the armor in the drama of TV and film. Especially the armor with investigation through the historical research of <Geunchogowang> has been analyzed with an attention to the development of the lightweight and durable material from Gyeongbeongab of <Jeongdojeon>, and the evolution of appropriate design transformation for a film through <Myungryang>. Finally, higher level of historical drama could be expected from the desirable costume study based on understanding that the relationship between correct history with historical drama is to be the one with the fact and imagination, and historical research and media transformation, not truth and lies. It is very notable that the creative balancing of the underlined gap would lead to the historical drama remaining significant arts and meaningful records in our history.

직장 감각능이 저하된 변비 환자에 있어서 전기자극 치료의 효과

장혜숙 ( Hye Sook Chang ),명승재 ( Seung Jae Myung ),양석균 ( Suk Kyun Yang ),정훈용 ( Hwoon Yong Jung ),김태훈 ( Tae Hoon Kim ),윤인자 ( In Ja Yoon ),권오련 ( Oh Ryoun Kwon ),홍원선 ( Weon Seon Hong ),김진호 ( Jin Ho Kim ),민영일 대한소화기기능성질환·운동학회 2002 Journal of Neurogastroenterology and Motility (JNM Vol.8 No.2

N/A Among constipated patients, there is a subgroup of patients who complain about an absent or diminished sense of desire to defecate, suggesting that one of the causes of functional constipation may be impaired rectal sensation. Recently, electrical stimulation therapy (EST) has been used for the treatment of patients with urinary/fecal incontinence. The aim of this study was to evaluate the efficacy of EST for a subgroup of constipated patients with impaired rectal sensation. Methods: Of the 130 patients with functional constipation as defined by Rome II criteria, 22 patients who had impaired rectal sensation (rectal desire threshold volume = 90 ml) were selected. Twelve patients were treated with EST and 10 patients with biofeedback therapy (BFT). Results: The overall symptoms of the patients significantly improved after therapy in both groups (p<0.05). Interestingly, the sense of desire to defecate improved only after EST (p<0.05). Moreover, there was significant improvement in anal residual pressure after BFT solely (p<0.05). On the other hand, rectal sensory threshold volumes improved significantly after EST exclusively (p<0.05). Conclusions: This study has revealed that the efficacy of EST can be comparable to BFT in a subgroup of constipated patients, especially with impaired rectal sensation. EST could be considered an adjunctive therapeutic modality for the management of functional constipation with impaired rectal sensation.(Kor ean J our nal of Gastrointestinal Motility 2002;8:160-166)

사극드라마 의상 연구(2) -매체 전환된 작품을 중심으로-

장혜숙 ( Hye Sook Chang ) 한국연극교육학회 2011 연극교육연구 Vol.18 No.-

Current historical drama shows very active media conversion inside to generate higher profits with one content source to be used for performance, film, TV production, cartoon and game. This is due to the combined results of the producer`s commercial pursuit to ensure a box office hit through the text which has already proven to the public and also to alleviate the difficulties of creation of the new text according to the increasing demand for cultural content. In this study, the status and problems of costume design have been examined for not only play 《Yi》, film 「King and the Clown」, musical 《Gonggiljeon》 that led to successful outcomes through media conversion but also the cartoon 《The Land of Wind》, the game 《Kingdom of the Winds》, and the TV drama 《Kingdom of the Winds》 that showed a lot of different costume expressions. Plays and films, TV dramas and musicals have many similarities from the respect of structure, materials and style. The methods of expression and delivery of message of the works are however, quite different due to the specialty of each media even though they came from the same original works. Costumes, therefore should be designed and produced appropriately based on each medium selected. The cartoons and the games are an important media to lead future market of the cultural contents. It is true that our cultural contents have lack of their souls in our history. The cartoons and the games having our historical background do not ascertain in detail historical evidence of the costume in reference to the character of a period. It is strongly recommended to put our heart and soul properly into the concept of costume design for the works. Because of the importance of the educational aspects for historical drama, the relation between creation and historical evidence has become a big issue. Many creative costumes having implicit of designer`s intend appears in drama recently by the popularity of the fused historical drama. It is however too obvious to maintain a balanced view of history in the design and to avoid an unidentified westernization and modernization in designing process. It is because historically based costume design is very noble creativity for the future generation and it gives a sense of national consciousness and identity to the future generations. It is very noticeable that the real power of art and culture comes from the creation with love, attention and responsibility for one`s historical background. Despite of the different genre and media, diversity of contents could be found in the works to show not only costumes but also emotion, symbol, story and culture. It is therefore very urgent to train and educate professionals to develop and converge the various types of contents. Large scale of musical and opera producers heavily depend on foreign workforces for not only composition and directing but also choreography and scenography. It is our situation that the well-educated professionals in costume parts especially could not participate in the work of cartoons and games. It is due to the lack of awareness of producers and short linkage and exchange between different genres and media. In addition to convergence and integration of manpower as well as genre and media of the works, systematic and professional education is very imperative for both academia and industry.

단독 전기자극치료로 임상적 호전을 보인 직장 감각능 저하를 동반한 변비 환자 1 예

장혜숙(Hye Sook Chang),명승재(Seung Jae Myung),윤인자(In Ja Yoon),양석균(Suk Kyun Yang),정훈용(Hwoon Yong Jung),홍원선(Weon Seon Hong),김진호(Jin Ho Kim),민영일(Young Il MIn),유창식(Chang Sik Yu) 대한소화기기능성질환·운동학회 2001 Journal of Neurogastroenterology and Motility (JNM Vol.7 No.2

Patients with intractable constipation often complain of social, physical and psychological stress. Recently, biofeedback therapy is widely used in the management of intractable constipation and improve the defecation act, particularly in cases of constipation associated with pelvic floor dyssynergia. However, some of constipated patients show only decreased rectal sensation and increased rectal compliance on the anorectal function tests. It is unclear whether the decreased rectal sensation is a cause or outcome of constipation and not known how to treat such cases. We recently experienced a 25-year-old female patient who complained of constipation. She had intractable constipation, which made her attempt a suicide. Colon transit time study and defecogram showed nonspecific findings. Her anorectal manometric findings were within normal ranges except rectal sensation and compliance. Rectal volume for desire and urge to defecate, and maximal tolerable volume were markedly increased and compliance was impossible to measure. She was treated by electrical stimulation therapy. After electrical stimulation therapy, her constipation symptoms improved dramatically. Furthermore, the desire and urge volume were decreased and the compliance became calculated. We report this constipation case with decreased rectal sensation and increased rectal compliance possibly treated by electrical stimulation therapy. (Korean Journal of Gastrointestinal Motility 2001;7:245-250)