Feasibility of Intraoperative Radiotherapy Tumor Bed Boost in Patients with Breast Cancer after Neoadjuvant Chemotherapy

조연아,양고운,김준원,이익재,정준,안성귀,배숭준,김지형 연세대학교의과대학 2024 Yonsei medical journal Vol.65 No.3

Purpose: This study aimed to assess the feasibility and safety of administering intraoperative radiotherapy (IORT) as a boost dur ing breast-conserving surgery (BCS) following neoadjuvant chemotherapy for patients at high risk of breast cancer recurrence. Materials and Methods: Patients who underwent neoadjuvant chemotherapy received a single 20-Gy dose of IORT during BCS, followed by external beam radiotherapy 4–6 weeks after surgery. Results: The median follow-up duration was 31.0 months (range, 18.0–59.0 months). Initial tumor sizes had a median of 2.6 cm (range: 0.8–5.3 cm), reducing to 0.3 cm (range: 0–4.0 cm) after neoadjuvant chemotherapy. The most common neoadjuvant che motherapy regimen was doxorubicin and cyclophosphamide, followed by paclitaxel (n=42, 73.7%). Among 57 patients who re ceived neoadjuvant chemotherapy before BCS and IORT, 2 patients (3.5%) required secondary surgery to achieve negative resec tion margins due to initially positive margins. Regional lymph node irradiation was performed in 37 (64.9%) patients. There was no grade 3 or higher adverse events, with 4 patients (7.0%) experiencing grade 2 acute radiation dermatitis and 3 (5.3%) having less than grade 2 breast edema. Binary correlation analysis did not reveal statistically significant associations between applicator size or radiation therapy modality and the risk of treatment-related toxicity. Furthermore, chi-square analysis showed that the grade of treatment-related toxicity was not associated with the fractionated regimen (p=0.375). Conclusion: Most patients successfully received IORT as a tumor bed boost after neoadjuvant chemotherapy. Thus, IORT may be a safe and feasible option for patients with advanced-stage breast cancer receiving neoadjuvant chemotherapy.

Ruthenium-106 Brachytherapy with or without Additional Local Therapy Shows Favorable Outcome for Variable-Sized Choroidal Melanomas in Korean Patients

조연아,장지석,윤진숙,이성철,김용배,김주호,금기창 대한암학회 2018 Cancer Research and Treatment Vol.50 No.1

Purpose The purpose of this study was to report clinical outcomes of ruthenium-106 (106Ru) brachytherapy with or without additional local therapy for choroidal melanomas in Korean patients. Materials and Methods A total of 88 patients diagnosed with choroidal melanomas were treated with 106Ru brachytherapy between 2006 and 2012. Patients were divided into two groups according to their tumor height: a large group (! 6 mm, n=50) and a small group (< 6 mm, n=38). Most patients in the large group received combined therapy with local excision and/or transpupillary thermotherapy. In general, 85-95 Gy was administered to the apex of the tumor, while 100 Gy was administered to the point 2-6 mm from the outer surface of the sclera for patients undergoing combined therapy. Results The median follow-up duration was 30 months. The 3-year local control rate was significantly higher in the small group than in the large group (94% vs. 70%, p=0.047). The free from distant metastasis (FFDM) rate and the overall survival (OS) rate were also higher in patients in the small group (3-year FFDM, 97% vs. 76%; p=0.031 and 3-year OS, 97% vs. 72%; p=0.036). A total of 13 patients underwent enucleation. The eye-preservation rate was also higher in the small group (3-year eye-preservation rate, 94% vs. 70%; p=0.050), and tumor height was a significant prognostic factor for eye-preservation. Conclusion 106Ru brachytherapy showed favorable outcomes in small choroidal melanomas in Korean patients. Although additional local treatment could improve eye-preservation rate for large tumors, other strategies should be considered for disease control.

Intraoperative Radiotherapy for Resectable Pancreatic Cancer Using a Low-Energy X-Ray Source: Postoperative Complications and Early Outcomes

조연아,김준원,김형선,박준성,이익재 연세대학교의과대학 2022 Yonsei medical journal Vol.63 No.5

Purpose: We evaluated the safety, feasibility, and early treatment outcomes of intraoperative radiotherapy (IORT) using a lowenergyX-ray source. Materials and Methods: Patients with resectable pancreatic cancer were enrolled in this single-institution, prospective, singlearm,phase II trial. Patients underwent surgery and IORT with 10 Gy prescribed at a 5-mm depth from the tumor bed using a 50 kVX-ray source (Intrabeam, Carl Zeiss). Six cycles of adjuvant gemcitabine-based chemotherapy were administered 8–12 weeks aftersurgery. Results: A total of 41 patients were included. Thirty-one patients (75.6%) underwent wide R0 resection, while 5 (12.2%) underwentR1 resection and 5 (12.2%) underwent narrow R0 resection (retroperitoneal margin <1 mm). Grade 3 postoperative complicationswere reported in only one patient (4.9%) who needed additional surgery due to ulcer perforation. At a median follow-up of 9 months,four patients showed local-only recurrence, nine had distant metastases, and two showed both local and distant recurrence. The1-year local control rate was 76.4%. Conclusion: Our preliminary report suggests that IORT is well-tolerated and feasible in patients with resectable pancreatic cancer. Further follow-up is needed to confirm the clinical benefits of IORT in terms of local control and overall survival. Trial Registration: Clinical trial registration No. (NCT03273374).

배드민턴 동호인의 여가만족에 관한 연구

조연철(Cho Yeon Chui),이종완(Lee Jong Wan) 한국사회체육학회 2000 한국사회체육학회지 Vol.14 No.-

The purpose of this study was to compare and analyze the satisfaction of the leisure and the life with the demographic trait and the degree of participation of the badminton club members, so to make offer useful fundamental source for application and development of exercise program. Subjects of the study were 361 male and female who were badminton club members living in T city. The satisfaction of the leisure and the life was examined by demographic trait and period frequency time of exercise participation degree, so the independent variables so following finding are come out. 1. The analysis of satisfaction of the leisure and the life according to demographic trait variable 1) The satisfactions of the leisure and the life according to sex showed significant differences in facts of the physical satisfaction and the enviranmental satisfaction, and male group archived higher was scores than female group. 2) The satisfactions of the leisure and the life according to age showed significant differences in fact of the rest satisfaction and the life satisfaction, and age group of forties showed higher scores than other age group. 3) The satisfactions of the leisure and the life according to the school career showed significant difference in the facts of the physical satisfaction, the environmental satisfaction and the rest satisfaction, and higher school career group showed higher satisfaction. 4) The satisfaction of the leisure and the life according to the income degrees showed significant differences in facts of the physical satisfaction, the social educational satisfaction, the environmental satisfaction, the rest satisfaction and the life satisfaction, and more income group showed higher satisfaction. 5) The satisfaction of the leisure and the life according to the religion showed significant difference in fact of the life satisfaction only. 2. The analysis of the satisfactions of the leisure and the life according to the degree of participation of badminton club members. 1) Satisfaction of the leisure and the life according to period shows significant difference in the facts of the physical satisfactions, the social educational satisfaction, the environmental satisfaction and the rest satisfaction, and it shows higher level as the period is getting longer. 2) Satisfaction of the leisure and the life according to frequency and time shows significant differences in five facts of the physical satisfaction, the social educational satisfaction, the environmental satisfaction, the rest satisfaction and the life satisfaction, and it shows higher level as it become longer in time and frequency. 3. Correlation of independent variable and dependent variable 1) According to sex there were significant correlation for badminton participation period(r=-14) and the factor of the physical satisfaction(r=-18), the environmental satisfaction(r=-12). 2) According to age there were significant correlation for badminton participation frequency(r=l4), participation time(r=-21) and the factor of the life satisfaction(r=13). 3) According to school career there were significant correlation for badminton participation frequency(r=14) and the factor of the physical satisfaction(r=20), the environmental satisfaction(r=20), the rest satisfaction factor(r=l7). 4) According to income degree there were significant correlation for badminton participation frequency(r=18), and all five factors. 5) According to religion there were significant correlation for badminton participation time(r=14), and the factor of the life satisfaction(r=-13). 4. Satisfaction of the leisure and the life of badminton club members by sex and age. 1) Acconding to age and sex, result of analysis about the physical satisfaction factors and the life satisfaction factors is revealed to have significant difference age and interaction with age and sex have no significant difference. 2) According to sex and age, result of analysis about the social educational satisfaction factors, the enviro

FDM 방식의 3D 프린터로 제작한 유성 기어 감속기의 진동 분석

조연상(Yonsang Cho) 한국트라이볼로지학회 2021 한국트라이볼로지학회 학술대회 Vol.2021 No.10

인터넷상의 청소년이용 성표현물의 법적 규제체계에 관한 전문가 인식 연구 : 음란물법 적용의 타당성을 중심으로

조연하(Cho Younha) 사단법인 언론과 사회 2005 언론과 사회 Vol.13 No.3

이 연구에서는 인터넷상의 청소년이용 성표현물에 대해 ‘청소년의성보호에관한법률’이 아닌 ‘정보통신망이용촉진법및정보보호등에관한법률’의 음란물죄 조항을 적용시키는 현행 법적 규제체계의 배경적 요인과 한계를 파악하려는 목적에서, 법률 전문가를 대상으로 심층인터뷰를 실시하였다. 연구결과, 인터넷 청소년이용 성표현물에 대한 음란물법 적용요인은 청소년 인권보호보다는 유교적 담론에서 출발한 음란성 개념에 대한 광범위한 해석과 인터넷상의 음란물 유통구조의 특성을 고려한 기소편의주의적 정책에서부터 찾아볼 수 있었다. 그리고 이러한 현행 규제체계 또는 입법상 문제점으로는 음란성을 띠지 않은 저속한 청소년이용 성표현물에 대한 포섭 불가능, 청소년이용 성표현물의 단순소지에 대한 처벌 불가능, 그리고 청소년이용 성표현물에 대한 법 적용의 일관성 결여로 나타났다. 이와 같은 연구결과는 청소년이용 성표현물이란 표현물 자체의 성격에 대한 인식의 전환과 함께, 전달매체의 속성보다는 보호법익을 근거로 한 법 적용체계의 개선이 필요하다는 점을 시사한다. Child pornography on the Internet is regulated under the obscenity law, not under the child pornography law called the Minor Protection Against Sexual Exploitation Act, enacted in 2000 to ban child pornography, as of now in Korea. This regulatory system requires that the material be legally obscene in order to prosecute child pornography. The purpose of this paper is to explore the implication of such a regulatory system and the potential loophole on the current child pornography law. <br/> Based on in-depth interviews with legal experts such as judges, prosecutors, lawyers and legal scholars, this paper demonstrates that the characteristic of the current regulatory system against child pornography on the Internet, attributes to the Confucian culture which sees sexual expression as obscene and to the broad definition of the scope of obscenity. The government’s prosecution policy on child pornography, considering the flow structure of obscene material on the Internet, instead of the rights of children, is another factor which forces Internet child pornography to be regulated under the obscenity law. <br/> The limit of such a regulatory system is that it is not possible to prosecute the private possession of child pornography, since the obscenity law can not criminalize the simple possession of obscene material. And the loophole of the Act is that it can not proscribe non-obscene child pornography. It is demonstrated that law enforcements against child pornography in Korea are inconsistent.<br/> This study suggests that the current legislation to ban child pornography needs to be revised, and that the current legal regime should inevitably be improved by applying the Act to the child pornography on the Internet, according to the rationale of the Ferber case of 1982 that child pornography should be prohibited regardless of whether the material is obscene.

공항 탑승교용 높낮이 조절 로툰다의 스크류 및 구조물 개발

조연상(Y. S. Cho),박흥식(H. S. Park) 한국트라이볼로지학회 2014 한국트라이볼로지학회 학술대회 Vol.2014 No.10

행정소송법상 소의 변경과 제소기간 - 일본의 법제ㆍ학설 및 판례의 분석과 시사점을 중심으로 -

조연팔 ( Yeon-pal Cho ) 이화여자대학교 법학연구소 2022 法學論集 Vol.26 No.4

일본의 「행정사건소송법」은 취소소송의 제소기간에 대하여서 2004년의 「행정사건소송법」의 개정에 의해 처분 등이 있었던 것을 안 날을 기준으로 하여 3개월로부터 6개월로 연장함과 동시에 ‘정당한 이유가 있을 때’에는 이마저도 연장해주는 취지의 규정이 신설되었다(제14조 제1항). 이 규정을 근거로 정당한 이유를 인정하여, 제소기간 경과 후에 추가적으로 소를 병합하여 제기된 소의 변경신청에 대하여 제소기간 내에 제기된 것으로 인정한 판결도 나와 있다. 여기에 대하여 우리의 「행정소송법」은 제소기간에 대하여 취소소송은 처분 등이 있음을 안 날부터 90일 이내에 제기하여야 한다고 하여 일본에 비하여 짧은 기간을 설정하고 있으면서도, 이를 불변기간으로 규정하고 있어서 국민의 권리구제에 미흡하다는 비판을 받을 수 있다. 이와 관련하여 소의 변경이 빈번하게 발생하는 것은 주로 취소소송 간의 소 변경인데, 일본의 「행정사건소송법」은 ‘처분 취소소송을 그 처분에 관한 심사청구를 기각한 재결 취소소송에 병합해서 제기할 경우’라는 한정적인 사항에 관한 것이긴 하지만, 취소소송 간의 소 변경에 있어서도 신소의 제소기간에 대하여 구소를 제기했을 때에 제기된 것으로 간주한다(제20조)라는 규정을 두고 있는데, 이것을 처분 취소소송에 재결 취소소송을 병합해서 제기한 사안에도 유추적용하고 있는 판결도 보인다. 하지만 우리의 경우에는 처분변경에 의한 소 변경의 경우를 제외하고서는 취소소송 간의 소 변경을 할 수 있다는 규정이 없는데, 이마저도 원래의 제소기간인 90일보더도 단축된 기간인 60일이라는 기간을 설정하여 국민의 권리구제의 기회를 박탈하고 있다는 생각을 지울 수 없다. 게다가 일본 「행정사건소송법」 제19조 제2항에서는 우리 「행정소송법」상의 소 변경 내지 병합 조문과는 달리ㆍ“소의 추가적 병합의 경우에는 「민사소송법」상의 소의 변경([「일본 민사소송법」 제143조)에 관한 규정에 의할 수도 있다”라는 규정을 두어, 「민사소송법」에서 요구되는 요건을 구비하는 경우에는 「민사소송법」에 의한 소의 변경을 허용할 수 있도록 하는 등으로 원고에게 선택의 여지를 주고 있다. 한편 일본의 최고재판소는 「행정사건소송법」 제20조를 유추적용하지 않더라도 구소가 제소기간을 준수하고 있다면, 신소가 제소기간을 도과하였다 하더라도 ‘제소기간의 준수에 있어서 흠결이 없다고 보아야 할 특별의 사정이 있을 때 등의 경우에는 예외를 인정하여 제소기간 준수의 위법은 없다고 한 판결도 다수 내보이고 있다. 하지만 우리 대법원은 대법원 2003두12257판결에서 보이는 것처럼 “소 제기기간의 준수 여부는 각 청구 취지의 추가ㆍ변경신청이 있은 때를 기준으로 개별적으로 판단하여야 한다”라고 하면서 처분이 있음을 안 날로부터 90일이 지난 소의 변경이나 병합청구는 부적법한 청구라고 하고 있다. 따라서 이러한 일본 판례의 경향은 앞으로 우리의 소 변경에 대한 제소기간 제도의 운용에 있어서 어떠한 시사를 줄 수 있다고 생각한다. Japan’s “Administrative Litigation Act” extended from 3 months to 6 months based on the day when it was learned that there was a disposition due to the revision of the “Administrative Litigation Act” in 2004 for the proceeding period of the revocation proceedings. At the same time, a new provision was established to extend even this when there is a justifiable reason(Article 14, Paragraph 1). There is also a judgment that recognized justifiable reasons based on this provision, and recognized that the request for change of the lawsuit filed by merging additional lawsuits after the litigation period had elapsed was recognized as being filed within the litigation period. In response, the Administrative Litigation Act of South Korea states that a revocation proceeding must be filed within 90 days from the day when it is learned that there is a disposition. Although they set a shorter period than Japan, they can be criticized for being inadequate for the relief of the rights of the people because they define this as an invariant period. By the way, the frequent change of lawsuit in connection with this are mainly the change of lawsuit between the revocation lawsuit In this regard, on the other hand, the Administrative Litigation Act of Japan is related to limited matters, but it has a provision considered that the change of the lawsuit filed between the revocation proceedings is also considered to have been filed when the old proceedings were filed for the the new proceedings(Article 20). In the case of South Korea, there is no provision that the proceedings can be changed between the revocation cancellation lawsuit except in the case of the change of lawsuit due to the change in the disposition. In case of change of litigation due to change of disposition, so it has set a period of 60 days, which is shorter than the original filing period of 90 days. In response to this, the idea of depriving the people of the opportunity to relieve their rights cannot be erased. In addition, Article 19 (2) of the Administrative Litigation Act of Japan stipulates that in the case of additional consolidation of claims, the provisions for changing claims under the Code of Civil Procedure may be applied. Therefore, if the requirements required by the Code of Civil Procedure are met, the people have a choice by allowing changes in the lawsuit under the Code of Civil Procedure. Furthermore, if the old lawsuit complies with the filing period even if Article 20 of the Administrative Litigation Act is not applied by analogy in Japanese case law, even if the new lawsuit has passed the filing period of litigation. There are many judgments that it is no defect of comply of the filing period of litigation, when there are special circumstances that must be seen as having no defects. However, as seen in the Supreme Court of Korea’s decision on December 10, 2004, The Supreme Court ruled that in other words, “However, the Supreme Court of Korea, 2003du12257(December 10, 2004), said, “The compliance with the period for filing litigation shall be judged individually based on the time when an application for addition or change of the purpose of each claim is made. In the case of this case Since it is a request to change a lawsuit after 90 days have passed, it is judged that it should be regarded as an illegal lawsuit.” Therefore, I think that the trend of Japanese precedents examined in this study can give some implications in relation to the operation of the filing period of litigation system in our change of litigation in the future.

헬스클럽의 서비스 품질이 재구매 의도에 미치는 영향

조연철,최호철 啓明大學校 生活科學硏究所 2007 科學論集 Vol.33 No.-

Purpose of this study was to identify difference of service qualities depend on person and identify affection of service qualities to repurchase intention on health center. To reach the purpose, 408 persons who are participating health center at least one month in Daegu area were sampled as subjects. Results of the analysis could be summarized as following First, Service qualities depends on personalities presents difference. Especially, man above woman and aged man above less aged man considers service as high degree. Second, Main facility, Program and contribution to community of the center were important factors to decide repurchase intention health center. Third, Service qualities to affect oral communication such as instructor, staff, program, contribution to community were important factors.

상업 스포츠시설 이용자의 소비행도 특성과 이용 만족도에 관한 연구

조연철(Youn Chul Jo),김동우(Dong Woo Kim) 한국사회체육학회 2001 한국사회체육학회지 Vol.16 No.-

The purpose of this paper is to search difference of consumer behavior and satisfaction of commercial sports facility based on personality. Questionaries are responded by commercial sports facility user in Busan, Daegu, Ulsan, Gyeongju and received effective 400 response through random sampling. Correspondence questionaries are extracted from "Facility choice factors of adult in sports for all"(Kim, Jang-Hwan, 1999) and "Development of preference model for the sports facility and analysis of optional information of consumer"(Kim, Yong-Man, 1996). Reliability and validity are verified and improper responses are ignored. Frequency analysis, one way anova, and duncan method are used for effective data analysis. Based on analysis, the research concludes next; First, consumers prefer the forenoon, exercise 3-4 time a week, 30-120min for one time exercise. They use own car for visiting sports center and less than 5-20km, or 10-30min distance. They consider friend as most easy colleague for the sports center visiting. They spend \50,000-150,000 for the a month training and have information for the sports center from surroundings. Second, characteristics of consumer behavior and satisfaction of commercial sports facility shows difference in sex, scholarly, occupation, income. However, there is no difference in marital status. Third, satisfaction based on usage time indicates differences. Fourth, satisfaction based on usage frequency indicates differences. Fifth, satisfaction based on usage type indicates difference.