김환기의 근대기 작품에 나타난 체험과 감각

김인아(Kim In-ah) 한국근현대미술사학회 2015 한국근현대미술사학 Vol.29 No.-

It is prevalent opinion that Kim Whan?ki from the 1930s to the early 1940s was an abstract artist. As well known, Kim had strong ties with the avant-garde communities of Japan when he was a student there as well as when back to Korea while producing abstract works. Kim later formed a neorealism community with Yoo Youngkuk and Lee KyuSang, where he seeked the ‘Neo-Reality’. He also reflected his interest in korean tradition and antiques in his work while having made an exchange with artists, poets, and writers who had worked through ‘Munjang’ that is literature magazine. That much of the academic literature on Kim’s paintings from this period have been focused on abstract and avant-garde art and orientalism may be a natural consequence of his historical trajectory as the above. As the advanced researches tell, Kim Whan?ki’s interest is not the departure from an object but the way ‘abstractifying’ an object, while pursuing the abstract art. This study also begins from the premise that the key element necessary for interpreting Kim’s abstract art is the way rather than the concept. I would like to go even a step further to argue that the form and content of the abstract in Kim’s work reflect the artist’s personal experiences and emotional sensations. And I’ll argue that such personal experiences-which exist on the outskirts of Kim’s abstract art-are imbued with a kind of romanticism. To illuminate these points, I analyze the abstract features of Kim’s work that appear as geometrical designs in conjunction with the social atmosphere of the era, and also interpret the artist’s personal experiences reflected in the work through references to articles, photographs, and related written works published in the literary magazines of the day. I attempt to show that Kim Whan-ki’s painting which abstractly portrayed the city and machines-symbols of the most cutting-edge elements of civilization- are not simply a matter of style but concrete expressions of the artist’s existential interpretations of nature, life, and modern civilization. It may seem unusual for an artist who interprets the world through the lens of existentialism to pursue such an abstract style. However, at that time, this is not unusual. This is because the avant-garde discourse in those days was developed in each artist’s personal understanding. The experiences of the 1930s that appear in Kim’s work were personal and everyday experiences of modern civilization, and this is why his artwork includes hints at the modernist emotional connection with urban life. Kim’s nostalgia for the modern lifestyle he experienced during his student years in Tokyo occasionally appears as a landscape that is in turn representational or contemplative. These approach is similar to imagism in literature. Kim Gi-rim, a leading Korean modernist poet, defines poetry as the expression of not the mental but the “real” world in writing. Similarly, Kim Whan?ki’s work is an expression of reality as created through the artist’s memories and experiences.

P53 Overexpression and Outcome of Radiation Therapy in Head & Neck Cancers

김인아(In Ah Kim),최일봉(Ihl Bhong Choi),강기문(Ki Mun Kang),장지영(Ji Young Jang),김경미(Kyung Mi Kim),박경신(Kyung Shin Park),김영신(Young Shin Kim),강창석(Chang Suk Kang),조승호(Seung Ho Cho),김형태(Hyung Tae Kim) 대한방사선종양학회 1999 Radiation Oncology Journal Vol.17 No.1

목 적:실험적으로 p53 종양억제유전자는 세포의 방사선에 대한 반응을 조절하는 것으로 알려져 있는데, 임상에서 p53의 변화와 방사선치료 후의 예후와의 상호관련성은 아직 명확하게 규명되지 않은 상태이다. 이에 두경부종양환자에서 흔히 관찰되는 p53의 변화가 방사선치료결과에 어떤 영향을 미칠 수 있는지를 알아보고자 하였다. 재료 및 방법:두경부종양으로 진단되어 근치적 방사선치료를 받은 55명의 환자를 대상으로 임상결과를 후향적으로 분석하였다. 각 환자의 치료전 종양조직의 paraffin section을 human p53단백질에 대한 monoclonal antibody (D-07)로 면역조직화학염색하여 labeling Index (number of labelded nuclei/total number of counted nuclei x100)를 구하여, 임상결과와 연관지어 분석하였다. 결 과:전체환자의 67.2%에서 p53의 기능이상을 시사하는 과발현 소견을 보였다. 원발병소에 따른 과발현 빈도는 oral cavity, larynx, hypopharynx, nasopharynx순으로 각각 100%, 76%, 67%, 67%, 38%로 나타났다. 흡연자가 비흡연자에 비해 유의하게 높은 과발현 빈도를 보였다 (78.6%, 30.8%). 원발병소, 병기 및 Karnofsky performance status가 방사선치료에 대한 반응율과 유의한 연관을 보였으며, p53의 과발현여부는 치료반응율에 유의한 영향을 미치지 못하는 것으로 나타났다. 무병생존율 및 전체생존율에 영향을 미치는 인자는 원발병소와 병기였고, p53의 과발현여부는 유의한 연관을 보이지 못하였다. 결 론:근치적 방사선치료를 받은 두경부종양 환자에서, 면역조직화학염색에 의한 p53의 과발현율은 원발병소, 병기 및 흡연여부와 유관하였으며, 과발현여부가 치료반응율 및 생존율에 유의한 영향을 미치지 못하였다. Purpose:Experimental studies have implicated the wild type p53 in cellular response to radiation. Whether altered p53 function can lead to changes in clinical radiocurability remains an area of ongoing study. This study was performed to investigate whether any correlation between change of p53 and outcome of curative radiation therapy in patients with head and neck cancers. Methods:Immunohistochemical analysis with a mouse monoclonal antibody (D0-7) specific for human p53 was used to detect to overexpression of protein in formalin fixed, paraffin-embedded tumor sample from 55 head and neck cancer patients treated with curative radiation therapy (median dose of 7020 cGy) from February 1988 to March 1996 at St. Mary's Hospital. Overexpression of p53 was correlated with locoregional control and survival using Kaplan-Meier method. A Cox regression multivariate analysis was performed that included all clinical variables and status of p53 expression. Results:Thirty-seven (67.2%) patients showed overexpression of p53 by immunohistochemical staining in their tumor. One hundred percent of oral cavity, 76% of laryngeal, 66.7% of oropharyngeal, 66.7% of hypopharyngeal cancer showed p53 overexpression (P=0.05). The status of p53 had significant relationship with stage of disease (P=0.03) and history of smoking (P=0.001). The overexpression of p53 was not predictive of response rate to radiation therapy. The locoregional control was not significantly affected by p53 status. Overexpression of p53 didn't have any prognostic implication for disease free survival and overall survival. Primary site and stage of disease were significant prognostic factors for survival. Conclusions:The p53 overexpression as detected by immunohistochemical staining had significant correaltion with stage, primary site of disease and smoking habit of patients. The p53 overexpression didn't have any predictive value for outcome of curative radiation therapy in a group of head and neck cancers.

Concurrent Chemoradiation Therapy in Stage III Non-small Cell Lung Cancer

김인아(In Ah Kim),최일봉(Ihl Bhong Choi),강기문(Ki Mun Kang),장지영(Jie Young Jang),문한림(Han Lim Mun),송정섭(Jung Sub Song),이선희(Sun Hee Lee),곽문섭(Mun Sub Kuak),신경섭(Kyung Sub Shinn) 대한방사선종양학회 1997 Radiation Oncology Journal Vol.15 No.1

목 적 : 국소진행된 III기 비소세포성 폐암에서 방사선감작제로서의 저용량 Cisplatin과 방사선 동시병합요법의 효과를 알아보고자하여, 관해율, 전체생존율, 무병생존율 및 치료에 따른 부작용을 방사선 단독치료군과 후향적으로 비교분석하였다. 대상 및 방법 : 1992년 4월부터 1994년 3월까지 32명의 III기 비소세포성 폐암환자(IIIa 12명, IIIb 20명)가 항암제 및 방사선동시병합요법을 받았다. 방사선치료는 3000cGy/ 10회를 2주간에 걸쳐 시행한 뒤 3주후에 2500cGy/ 10회를 추가하였으며, 방사선감작제로 cis platin 6mg/m2를 매일 방사선치료 전에 정맥주사하였다. 추적관찰기간은 13개월에서 48개월로 중간값은 24개월이었다. 방사선단독치료군 32명(IIIa 13명, IIIb 19명)은 매일 170- 200cGy씩 총 5580- 7000cGy (중간값 5960cGy) 치료받았으며, 추적관찰기간은 36개월에서 105개월로 중간값은 62개월이었다. 결 과 : cis platin- 방사선동시요법군이 방사선 단독치료군에 비해 유의하게 높은완전반응률(18.8% vs . 5.6%)및 낮은 조사야내 재발율(25% vs . 47%)을 나타내었다. 2년 전체생존율은 Cisplatin- 방사선동시요법군이 17%, 방사선단독치료군이 9.4%로 유의한 차이는 보이지 않았다.국소재발 없는 2년 무병생존율(16.5% vs. 5.3%) 및 원격전이 없는 2년 무병생존율(17% vs. 4.6%)도 두군간에 유의한 차이를 보이지 않았다. 그러나 Karnofsky performance scale 80 이상인 환자군만을 대상으로 분석한 결과, cisplatin- 방사선동시요법군이 방사선단독치료군에 비해 유의하게 높은 2년 전체생존율을 보였다(62.5% vs. 15.6%). 전체생존율에 영향을 미치는 예후인자로 cisplatin- 방사선동시요법군에 있어서는 performance status 및 조직학적 진단유형(상피세포암 vs. 비상피세포암)으로 나타났고, 방사선단독치료군에 있어서는 performance status 및 병기(IIIa vs. IIIb)로 나타났다. 치료에 따른 급성부작용으로 RTOG/ECOG grade 2 이상의 오심, 구토는 cisplatin- 방사선동시요법군이 방사선단독치료군 (22% vs. 6%)에 비해 유의하게 높은 빈도를 나타내었다. Gra de 2 이상의 혈액학적 독성은 Cis platin- 방사선동시요법군에서 방사선단독치료군에 비해 높은 빈도를 나타내었다(25% vs. 15.6%). 방사선단독치료군에 비해 cis platin- 방사선동시요법군에서, RTOG/ECOG Grade 2 이상의 폐독성의 빈도(31% vs. 19%)나 WHO Grade 3 이상의 폐섬유화의 빈도(38% vs. 25%)의 유의한 증가는 관찰되지 않았다. 방사선치료부위의 면적이 200cm2 이상이었던 경우, 두군 모두에서 폐독성 빈도의 유의한 증가를 보였다. 결 론 : cisplatin- 방사선동시병합요법이 방사선단독치료군에 비해 높은 국소제어율을 나타내었으나, 전체생존율이나 무병생존율의 유의한 증가는 보이지 않았다. KPS 80이상인 환자군에 있어서는 cisplatin- 방사선동시요법군이 방사선단독군에 비해 높은 전체생존율을 보였다. cisplatin- 방사선동시병합요법군에서 급성부작용이 증가되는 경향을 보였으나, 방사선에 의한 폐독성의 유의한 증가는 관찰되지 않았다. cisplatin- 방사선동시병합요법군이 방사선단독치료군에 비해 1년 이내에 조기사망율이 높은 반면, 2년이상 장기생존율이 높은 경향을 보여, 이러한 환자군에 대한 장기적인 추적조사를 통해 생존율에 대한 본 치료의 영향을 좀더 명확하게 평가할 수 있을것으로 기대되며, 향후 치료효과를 증가시키기위해 large fraction size의 split course RT 대신 continuous course의 conventional RT 혹은 hyperfractionated RT와 Cisplatin의 동시병합요법 등이 고려되어야할 것으로 사료된다. Purpose : This study was tried to evaluate the potential be nefits of concurrent chemoradiation therapy (low dose daily cisplatin combined with split course radiation therapy) compared with conventional radiation thera py alone in stage III non- small cell lung cancer. The end points of analyses were responserate , overalls urvival, survival without locoregional failure , survival without distant metastasis , prognostic factors affecting survival and treatment related toxicities. Materials and Methods : Between April 1992 and March 1994, 32 patients who had stage III non-small cell lung cancer were treated with concurrent chemoradiation therapy. Radiation therapy for 2 weeks (300cGy given 10 times up to 3000cGy) followed by a 3 weeks rest period and then radiation therapy for 2 more weeks (250cGy given 10 times up to 2500cGy) was combined with 6mg/M2 of cisplatin. Follow-up period ranged from 13 months to 48 months with median of 24 months . Historical control group consisted of 32 patients who had stage III non-small cell lung cancer were received conventionally fractionated (daily 170- 200cGy) radiation therapy a lone. Total radiation dose ranged from 5580cGy to 7000cGy with median of 5940cGy. Follow-up period ranged from 36 months to 105 months with median of 62 months . Results : Complete reponse rate was higher in chemoradiation therapy (CRT) group than radiation therapy (RT) group (18.8% vs. 6.3%). CRT group showed lower in-field failure rate compared with RT group(25% vs. 47%). The overall survival rate had no significant differences in between CRT group and RT group(17.5% vs. 9.4% at 2 years). The survival without locoregional failure (16.5% vs. 5.3% at 2 years) and survival without distant metastas is (17% vs. 4.6% at 2 years) also had no significant differences . In subgroup analyses for patients with good performance status (Karnofsky performance scale 80), CRT group showed significantly higher overall survival rate compared with RT group (62.5% vs. 15.6% at 2 years). The prognostic factors affecting survival rate were performance status and pathologic subtype (squamous cell cancer vs. nonsquamous cell cancer) in CRT group. In RT alone group, performance status and stage (IIIa vs IIIb) were identified as a prognostic factors . RTOG/EORTC grade 2-3 nausea and vomiting(22% vs. 6%) and bone marrow toxicities (25% vs. 15.6%) were significantly higher in CRT group compared with RT alone group. The incidence of RTOG/EORTC grade 3-4 pulmona ry toxicity had no significant differences in between CRT group and RT group (16% vs. 6%). The incidence of WHO grade 3-4 pulmonary fibrosis also had no significant differences in both group(38% vs . 25%). In analyses for relationship of field size and pulmonary toxicity, the patients who treated with field size beyond 200cm2 had s ignificantly higher rates of pulmonary toxicities. Conclusion : The CRT group showed significantly higher local control rate than RT group. There were no significant differences of survival rate in between two groups. The subgroup of patients who had good performa nce status showed higher overall survival rate in CRT group than RT group. In spite of higher incidence of acute toxicities with concurrent chemoradiation therapy, the survival gain in subgroup of patients with good pe rformance status were encouraging. CRT group showed higher rate of early death within 1 year, higher 2 year survival rate compared with RT group. The refore, to evaluate the accurate effect on survival of concurrent chemoradiation therapy, systematic follow-up for long term survivors are needed.

Leptomycin B Increases Radiosensitization by Trichostain A in HeLa Cells

In Ah Kim(김인아),Jin Ho Kim(김진호),Jin Hee Shin(신진희),Il Han Kim(김일한),Jae Sung Kim(김재성),Hong Gyun Wu(우홍균),Eui Kyu Chie(지의규),Yong Ho Kim(김용호),Bo Kyung Kim(김보경),Semie Hong(홍세미),Sung Whan Ha(하성환),Chan Il Park 대한방사선종양학회 2005 Radiation Oncology Journal Vol.23 No.2

목 적: 히스톤탈아세틸화효소 억제제는 그 자체의 항암효과뿐만 아니라 방사선 감작제로서의 효과가 점차 분명해져가고 있다. 최근 Class I 특이적인 히스톤탈아세틸화효소 억제제의 개발로 계층 특이적인(class specific) 연구가 가능해짐에 따라, 본 연구에서는 서로 다른 히스톤탈아세틸화효소억제제의 방사선감작효과를 비교함과 동시에 p53 발현도의 차이가 히스톤탈아세틸화효소억제제의 방사선 감수성에 미치는 영향을 알아보고자 하였다. 대상 및 방법: 이를 위해 p53 발현도가 매우 낮은 HeLa 세포에 p53의 핵 외 수송을 억제하여 세포질 내 분해를 차단하는 Leptomycin B를 처리하여 p53의 발현도를 현저하게 높인 후, Trichostatin와 SK7041의 방사선 민감도를 비교 관찰하였다. 결 과: 세포생존곡선, SER 및 SF2를 비교 분석 시, p53의 발현이 높은 Leptomycin B 처리군에서 TrichostatinA가 Class I HDAC만을 억제하는 SK7041에 비해 유의하게 높은 방사선 감작효과를 나타내었다. 이는 p53이 Class I 특이적 억제제인 SK7041과 Class I과 II를 모두 억제하는 TSA의 방사선감작효과에 미치는 영향의 차이에 기전적으로 관여함을 시사한다. 결 론: Leptomycin B에 의해 유도된 p53의 발현증가는 Class I과 Class I과 II를 모두 억제하는 TSA의 방사선 감작효과를 증강시킨다. Purpose: Histone deacetylase inhibitors (HDIs) are emerging as potentially useful components of anticancer therapy and their radiosensitizing effects have become evident. Specific HDIs are now available that preferentially inhibit specific HDAC classes; TSA inhibits Class I and II HDACs, and SK7041 inhibits Class I HDACs. Materials and Methods: We tested the differential radiosensitization induced by two different classes of HDIs in HeLa cells. We next tested the hypothesis that p53 expression in cancer cells may influence the susceptibility to HDIs by using pharmacologic modification of the p53 status under an isogenic background. Results: It is interesting that p53 expression in the HeLa cells clearly increased the degree of radiosensitization by TSA compared to that of the class I specific inhibitor SK7041. This suggests that p53 may, in part, be responsible for the mechanistic role for the greater radiosensitization induced by Class I & II inhibitors compared to that of the class I specific inhibitors. Thus, these studies are useful in distinguishing between events mediated solely by the Class I HDACs versus those events involving the other classes of HDACs as well. Conclusion: The anticancer efficacy of targeting Class I and II HDACs, in conjunction with radiation therapy, may be further enhanced by the restoration of p53 expression.

조기 위암의 위벽단축:상부 위장관 조영술과 병리 소견의 비교

김인재,최철순,김은아,김규선,윤구섭,김호철,배상훈,강구,신형식,Kim, In-Jae,Choi, Chul-Soon,Kim, Eun-Ah,Kim, Kyu-Sun,Yun, Ku-Sub,Kim, Ho-Chul,Bae, Sang-Hun,Kang, Gu,Shin, Hyung-Sik 대한영상의학회 1995 대한영상의학회지 Vol.32 No.1

Purpose : To investigate the causes of gastric wall shortening in ealy gastric cancer, upper gastrointestinalstudy was correlated with pathologic findings. Materials and Methods : We evaluated 41 cases (m:F=1.7:1, averageage=49) of early gastric cancer, retrospectively. The gastric wall shortening were classified as Grade I;none,Grade II;intermediate, and Grade III; prominent. Pathologic findings such as size of lesions, depth of tumorinvasion, degree of the submucosal fibrosis, degree of thickness of the submucosa and muscularis propria, andmorphologic patterns of lesions including conversing mucosal folds were correlated with the degree of gastric wallshortening on upper gastrointestinal series. Results : Submucosal fibrosis was present in 4 cases in Grade I(n=21), 4 cases in Grade II (n=6) and 8 cases in Grade III (n=10), Positive conversing mucosal folds were seen in 5cases in Grade I (n=17), 0 case in Grade II (n=2) and 9 cases in Grade III (n=9), Gastric wall shortening wassignificantly associated with submucosal fibrosis and conversing mucosal folds of early gastric cancer. (p=.0001and p=.002, respectively) Conclusion : Upper gastrointestinal finding of gastric wall protrusion in patients withearly gastric cancer should not misinterprete as advanced gastric cancer sine the finding could be a result ofsubmucosal fibrosis.

초등학교 통합학급에서의 지적장애학생에 대한 일반학생의 태도

김인아(In-Ah Kim),김정연(Jeongyoun Kim) 조선대학교 교과교육연구소 2015 敎科敎育硏究 Vol.36 No.1

이 연구의 목적은 일반학교 통합학급 수업 경험이 초등학생의 장애학생에 대한 수용태도 및 인식에 미치는 영향을 밝히는데 있다. 이를 위해 학년별, 성별, 통합 경험 유무별로 통합학급과 비 합 학급의 일반 초등학생을 대상으로 장애학생 수용태도를 조사하였다. 이 연구의 대상은 전라북도 전주시에 소재한 초등학교 4, 5, 6학년 400명의 학생이다. 본 연구를 통해 도출된 결과는 다음과 같다. 첫째, 일반학생의 지적장애학생에 대한 수용 태도는 통합학급 경험 유무에 따라 유의한 차이가 있는 것으로 나타났다. 통합학급의 경험이 있는 학생들이 통합경험이 없는 학생들에 비해 장애학생에 대한 태도와 인식이 전반적으로 더 긍정적인 것으로 나타났다. 둘째, 일반학생의 지적장애학생에 대한 수용 태도는 성별 요인에 따라 유의한 차이가 나타나지 않았다. 셋째, 일반학생의 지적장애학생에 대한 수용 태도는 학년별 요인에 따라 유의한 차이가 나타났다. 일반학생의 장애 수용 태도는 저학년일수록 더 긍정적인 것으로 나타났다. 논의에서는 연구 결과를 바탕으로 성공적인 통합교육 환경을 만들고 장애학생에 대한 일반학생들의 태도를 증진시키기 위한 방안을 제안하였다. The purpose of this study was to examine the effects of inclusive education and the receptive attitudes and perceptions of elementary school students toward intellectual disabilities. Therefore, this study was conducted to see whether grade levels, gender and the presence of inclusive education experience affects the acceptance of students with disabilities in inclusive and non-inclusive classrooms. This study examined four hundred 4th, 5th and 6th grade elementary school students in Jeonju, Jeollabuk-do. The results were as follows. First, there was a statistically significant difference in the receptive attitudes toward the intellectual disabilities according to the experience of participating in an integrated education class. The study found that inclusive classroom students were shown to have a more positive perceptions and attitude toward disabilities than non-inclusive classroom students in overall acceptance. Second, there was no statistically significant difference in receptive attitudes toward the intellectual disabilities according to gender. Third, there was a statistically significant difference in receptive attitudes toward the intellectual disabilities according to grade. The lower grade students have more positive recognition than that of the higher grades. Based on these results, the researcher suggested some ideas about how to improve students attitude toward disabilities and develop the better inclusive environment.

국소재발된 두경부종양의 무고정틀 정위적 분할방사선치료

김인아(In Ah Kim),최일봉(Ihl Bhong Choi),장지영(Ji Young Jang),강기문(Ki Mun Kang),조승호(Seung Ho Jho),김형태(Hyung Tae Kim),이경진(Kyung Jin Lee),최창락(Chang Rak Choi) 대한두경부종양학회 1998 대한두경부 종양학회지 Vol.14 No.2

Background & Objectives: Frameless fractionated stereotactic radiotherapy(FFSRT) is a modification of stereotactic radiosurgery(SRS) with radiobiologic advantage of fractionation without losing mechanical accuracy of SRS. Local recurrence of head and neck cancer at or near skull base benefit from reirradiation. Main barrier to successful palliation is dose limitation secondary to normal tissue tolerance. We try to evaluate the efficacy and safety of FFSRT as a new modality of reirradaton in these challenging patients. Materials & Methods: Seven patients with recurrent head & neck cancer involving at or near skull base received FFSRT from September 1995 to November 1997. Six patients with nasopharyngeal cancer had received induction chemotherapy and curative radiation therapy. One patient with maxillary sinus cancer had received total maxillectomy and postoperative radiation therapy as a initial treatment. Follow-up ranged from 11 to 32 months with median of 24 months. Three of 7 patients received hyperfractionated radiation therapy(1.1-1.2Gy/fraction, bid, total 19.8-24Gy) just before FFSRT. All patients received FFSRT(3-5Gy/fraction, total 15-30Gy/5-10fractions). Chemotherapy(cis-platin 100mg/m(2)) were given concurrently with FFSRT in four patients. Second course of FFSRT were given in 4 patients with progression or recurrence after initial FFSRT. Because IF(irregularity factor; ratio of surface area of target to the surface area of sphere with same volume as a target) is too big to use conventional stereotactic RT using multiple arc method for protection of radiation damage to critical normal tissue, all patients received FFSRT with conformal method using irregular static ports. Results: Five of 7 patients showed complete remission in follow-up CT &/or MRI. Three of these five patients who developed marginal, in-field, and out-field recurrences, respectively. Another one of complete responders has been dead of G-I bleeding without evidence of local recurrence. One partial responder who showed progressive disease 15 months after initial FFSRT has received additional FFSRT, and then he is well-being with symptomatic improvement. One minmal responder who showed progression of locoregional disease 9 months after 1st FFSRT has received 2nd FFSRT, and then he is alive with stable disease. Five of 7 case had showed direct invasion to skull base and had complaint headache and various symptoms of cranial nerve involvement. Four of these five case showed improvement of neurologic symptoms after FFSRT. No significant neurologic complicaltion related to FFSRT was observed during follow-up periods. Tumor volumes were ranged from 3.9 to 50.7 cc and surface area ranged from 16.1 to 114.9cm(2). IF ranged from 1.21 to 1.74. The average ratio of volume of prescription isodose shell to target volume was 1.02 that indicated the improvement of target coverage and dose distribution with FFSRT with conformal method compared to target coverage with FFSRT with multiple arc method. Conclusion: Our initial experience suggests that FFSRT with conformal method was relatively effective and safe modality in the treatment of recurrent head and neck cancer involving at or near skull base. Treatment benefit included good palliation of symptoms and reasonable radiographic response. However, more experience and additional follow-up are needed to better assess its ultimate role in treating these challenging patients.

Effects of Adjuvant Radiation Therapy and Chemotherapy Following Curative Surgery in Locally Advanced Rectal Cancer

강기문,최일봉,김인아,장지영,신경섭,장석균,이재학,김영하,원종만,최동환,김진승,박신희,Kang, Ki-Mun,Choi, Ihl-Bohng,Kim, In-Ah,Jang, Jee-Young,Shin, Kyung-Sub,Jang, Suck-Kyun,Lee, Jae-Hak,Kim, Young-Ha,Won, Chong-Man,Choi, Dong-Hwan,Kim, J The Korean Society for Radiation Oncology 1997 Radiation Oncology Journal Vol.15 No.2

목적 : 국소 진행된 직장암 환자에서 근치적 절제술후 방사선치료와 항암화학요법과의 병용치료를 시항하여 치료에 따른 합병증, 국소재발 그리고 생존율에 대한 그 효과를 알아보고자 하였다. 방법 : 1992년 9월부터 1995년 9월까지 직장암으로 진단받고 근치적 절제술후 방사선치료와 항암화학요법과의 병용치료를 받은 28명의 환자를 대상으로 하였다. 방사선치료는 근치적 절제술 후 4주에서 6주이내에 시행하였으며 선형가속기 6MV와 15MV X-ray를 이용하여 주 5회, 1회 180cGy로 5-6주간 총조사선량은 5040cGy-5580cGy까지 조사하였다. 항암화학요법은 방사선치료 시작 1주와 5주째 처음 제1일부터 제4일까지 4일간 5-FU는 체표면적 $m^2$당 400mg씩 그리고 Leucovorin은 체표면적 $m^2$당 20mg씩을 정맥주사로 4주간격으로 2회 시행하였다. 추적관찰기관은 2개월에서 42개월이었으며 중앙값은 24개월이었다. 결과 : 전체환자의 2년 생존율과 무병생존율은 각각 $78.6\%,\;70.8\%$였다. 병기에 있어 2년 생존율과 무병생존율은 $B_{2+3}$에서는 $93.0\%$와 $79.4\%,\;C_{2+3}$에서는 $76.2\%$와 $69.2\%$였다. 치료실패 양상은 국소재발이 $10.7\%$(3128), 원격전이가 $3.6\%$(1/28), 국소재발과 원격전이가 동시에 발생한 경우는 $7.1\%$(2/28)로 궁극적인 국소재발율이 $17.9\%$(5/28)였다. 병기에 따른 국소재발율은 $B_{2+3}$와 $C_{2+3}$의 각각 $13.3\%$(2/15)와 $23.1\%$(3/13)였다. 치료에 따른 합병증으로는 방사선 피부염은 $28.6\%$(8/28)로 가장 많이 발생하였고 혈액학적 부작용으로 백혈구감소증이 $21.4\%$(6/28)에서 발생하였으나 보조적인 치료후 모두 회복되었고 치료와 관련되어 사망한 경우도 없었다. 생존율, 무병 생존과 국소재발율은,.영향을 미치는 단변수분석에서는 조직학적 분화도에 있어 잘 분화된 선암이 분화도가 나쁜 선암보다 통계학적 유의성이 있었고(p=0.04, 0.05, 0.04) 그외에서는 초기병기일수록, 종양의 크기가 5cm 이하에서 좋은 결과를 보였지만 통계학적 유의성은 없었다. 결론 : 국소적으로 진행된 직장암의 경우 근치적 절제술후 방사선치료와 항암화학요법과의 병용치료가 비교적 안전하고 효과적인 방법이였다. 그러나 본 연구에서는 직장암이 국소적으로 진행된 대상환자의 수효가 적어 향후 좀 더 환자를 모으고 장기적인 추적 결과를 살펴보아야 근치적 절제술후 방사선치료와 항암화학요법과의 병용치료의 효율성을 보다 명확히 확인할 수 있으리라 생각된다. Purpose : To evaluate the effect of postoperative adjuvant radiation therapy and chemotherapy on the survival, pattern of failure and complication for locally advanced rectal carcinoma Materials and Methods : From October 1992 to September 1995, twenty eight patients with rectal carcinoma were treated by postoperative adjuvant radiation therapy and chemotherapy Radiation therapy was delivered with 6MV and 15MV linear accelerator, 180c0y fractions 5 day per week. Total radiation doses were 5040cGy in $B_{2+3}$ and 5580cGy in $C_{2+3}$. Within 4 weeks after radical surgery. 5-FU$(400mg/m^2/day)\;and\;Leucovorin(20mg/m^2/day)$ were administered by intravenous injection for 4 days during the first and fifth week of radiation therapy. The median follow up was 19 months with a range 2 to 47 months. Results : The 2 year overall survival and disease free survival rates were $78.6\%\;and\;70.8\%$, respectively. The 2 year overall survival was $93.0\%\;in\;B_{2+3}$ and $76.2\%\;in\;C_{2+3}$(p=0.11) The 2 year disease free survival was $79.4\%\;in\;B_{2+3}\;and\;69.2\%\;in\;C_{2+3}(p=0.13)$. The overall failure rate was $21.42\%$(6/28) including $10.72\%$(3/28) locoregional recurrence, $3.62\%$(1/28) distant metastasis and $7.12\%$(2/28) locoregional recurrence with distant metastasis. The overall locoregional recurrence rate was $17.92\%$(5/28). The 2 year locoregional recurrence rates were $13.32\%(2/15)\;and\;23.12\%$(3/13) for respectively for $B_{2+3}\;and\;C_{2+3}$ The difference between the locoregional recurrence of $B_{2+3}\;and\;C_{2+3}$ patients was not significant(p=0.07). Complications developed in 13 patients$(46.42\%)$, including 8 dermatitis, 7 loose stool, 6 leukopenia, 4 tenesmus, 2 diarrhea. In Univariate analysis, there was no statistically significant factor except for tumor grade in locoregional recurrence, disease free survival and overall survival rate(p=0.04, 0.05, 0.04). Conclusion : This study sugges1s that postoperative adjuvant radiation therapy and chemotherapy is effective in patients with locally advanced rectal cancer. Therefore these results need to be confirmed with a long term follow-up and larger number of patients with the further clinical trials including prospective controlled studies.

신경 인터페이스 기반 초감각 디바이스 기술 동향

김혜진,변춘원,김성은,이정익,Kim, H.J.,Byun, C.W.,Kim, S.E.,Lee, J.I. 한국전자통신연구원 2018 전자통신동향분석 Vol.33 No.6

Sensory devices have been developed to help people with disabled or weakened sensory functions. Such devices play a role in collecting and transferring data for the five senses (vision, sound, smell, taste, and tactility) and also stimulating nerves. To provide brain or prosthesis devices with more sophisticated senses, hyper sensory devices with a high resolution comparable to or even better than the human system based on individual neuron cells are essential. As for data collecting components, technologies for sensors with higher resolution and sensitivity, and the conversion of algorithms from physical sensing data to human neuron signals, are needed. Converted data can be transferred to neurons that are responsible for human senses through communication with high security, and neural interfaces with high resolution. When communication deals with human data, security is the most important consideration, and intra-body communication is expected to be a candidate with high priority. To generate sophisticated human senses by modulating neurons, neural interfaces should modulate individual neurons, and therefore a high resolution compared to human neurons (~ several tens of um) with a large area covering neuron cells for human senses (~ several tens of mm) should be developed. The technological challenges for developing sensory devices with human and even beyond-human capabilities have been tackled by various research groups, the details of which are described in this paper.

절제 가능한 직장암에서 수술전 방사선 치료의 효과 -병리 조직학적인 연구를 중심으로-

최일봉,장지영,김인아,신경섭,이종서,장석균,최규용,김영하,김준기,전정수,계철승,Choi, Ihl-Bong,Jang-Ji-Young,Kim, In-Ah,Shinn-Kyung-Sub,Lee, Jong-Suh,Chang-Suk-Kyun,Choi, Kyu-Young,Kim, Young-Ha,Kim, Jun-Gi,Chun-Chung-Soo,Kay-Chul-Seung 대한방사선종양학회 1997 Radiation Oncology Journal Vol.15 No.1

목적 : 절제 가능한 직장암 환자에서 수술전 방사선 치료를 시행한 예들(대상군)과 동일한 임상병기에서 수술만을 시행했던 예들(대조군)사이의 수술후 병리 조직학적 소견들을 비교하여 수술전 방사선 치료의 효과에 대하여 알아보고자 하였다. 대상 및 방법 :1995년 7월부터 1996년 4월까지 가톨릭대학교 의과대학 성모병원 방사선종양 학과에서 수술전방사선치료를 받았던 19명의 환자중 수술을 시행받은 16명을 대상으로 하였으며, 이를 과거에 수술만을 시행했던 31명과 후향적분석을 통해 비교하였다. 진단 당시 이들의 임상병기 분류는 Thomas Jefferson(TJ) system을 이용하였다. 수술전 방사선 치료는 매일 180-200 cGy로 주 5회, 총 방사선 조사량 4500-5000cGy까지 시행하였으며, 방사선 치료가 끝나고 평균 4주후에 수술을 시행하였다. 수술후 병기 결정은 Modified Astler-Coiler(MAC) system을 이용하였다. 방사선 치료후 임상 병기에 따른 수술후 병리학적 병기와 소견을 관찰하고, 이 결과를 수술전 동일한 임상 병기를 지녔던 대조군의 병리학적 소견과 비교하였다 병리학적 소견으로는 종양세포의 혈관 침범, 림프관 침범및 신경조직주위 침범여부 등을 관찰하였다. 통계학적 방법으로는 chi-square test를 사용하였다. 결과 : 대상이 되었던 19명중 16명에서 종양의 위치에 관계없이 방사선 치료후 항문보존적 근치수술을 시행할수 있었으며, 방사선 치료후 1명$(6.3\%)$의 환자가 병리조직학적으로 완전반응을 보였다. 방사선 치료후에 항문보존적 근치수술을 시행했던 대상군과 수술만을 시행했던 대조군사 이의 임상적 병기와 수술후 병기를 비교해 보면 TJ stage III였던 경우, 9명의 대상군중에서는 완전반응을 보인 1명을 제외하고는, 8명 모두가 MAC stage B로 나타났으며$(88.9\%)$, 17명의 대조관에서는 B인 경우가 11명$(64.7\%)$, C인 경우가 6명$(35.3\%)$이었으며, TJ stage III였던 경우, 7명의 대상군에서는 MAC stage상 B인 경우가 4명$(57.1\%)$, C인 경우가 3명 $(42.9\%)$이었고, 14명의 대조관에서는 B인 경우가 4명$(28.6\%)$, C인 경우가 10명$(71.4\%)$이었다. 따라서 수술전 방사선 치료를 시행했던 예들에서 병리학적 병기가 낮은 경향을 보였으며, 특히 방사선 치료후 MAC stage C 소견의 급격한 감소가 보였다(p=0.049). 병리학적인 소견으로 종양세포의 혈관 침범, 림프관 침범과 신경조직 주위 침범등이 대상군에서 대조군에 비하여 모두가 감소하는 것으로 나타났다. 결론 : 동일한 임상 병기에서 수술전 방사선 치료를 시행한 군과 수술만을 시행한 군 사이의 수술후 병기는 수술전 방사선 치료를 시행한 경우에 비하여 병기가 감소되는 경향을 보였다. 특히 병리학적으로 종양세포의 림프관 침범 소견이 감소된 것은 방사선 치료군에서 수술후 MAC Stage C 소견이 감소된 것과 일치되는 소견을 보였다 이러한 결과를 통해 절제 가능한 직장암 환자에서 수술전 방사선 치료를 하는 것이 효과적일수 있다고 사료된다. 그러나, 좀 더 명확한 결론을 얻기 위해서는 더 많은 수의 환자들을 대상으로 장기적인 추적관찰을 하는 연구가 함께 이루어져야 할 것이라고 생각된다. Purpose : To evaluate the pathologic effects of preoperative radiotherapy o the resectable distal rectal cancer, we analyzed the results of postoperative pathologic findings for the patients with preoperative radiotherapy ant surgery Materials and Methods: From July 1995 to April 1996, we treated sixteen patients of resectable rectal cancer with preoperative radiation therapy and curative surgery At diagnosis, Thomas Jefferson (TJ) system was used for the clinical stage of the Patients. We treated the patients with conventional radiation therapy of 4500~5000cGy before surgery. The surgery was carried out 4 weeks after completion of radiation therapy. Modified Astler Coller (MAC) system was used for the postoperative pathologic stage. We analyzed the pathologic stages and findings according to preoperative clinical stage and compared with those of the control group in similar clinical stages. Result : All patients were treated with sphincter preservation surgery after Preoperative radiation therapy. Pathoiogic complete response (CR) was shown in 1 case $(6.3\%)$. We compared the results between preoperative radiation therapy group (Preop.RT group) and surgery only group (control group). In TJ stage II, among nine patients of Preop.RT group, 8 patients $(88.9\%)$ were in MAC stage 8 except 1 CR patient, but among 17 patients of control group. 11 patients$(64.7\%)$ were in MAC stage B and 6 Patients $(35.3\%)$ in MAC stage C. In TJ stage III, among 7 patients of Preop.RT group, 4 patients $(57.1\%)$ were in MAC stage B and 3 patients$(42.9\%)$ in MAC stage C. Among 14 Patients of control group, 4 patients $(28.6\%)$ were in MAC stage B and 10 Patients $(71.4\%)$ in MAC stage C. Above results showed that postoperative Pathologic stage was decreased in Preop.RT group with statistical significance (P=0.049). The postoperative Pathologic findings (blood vessel invasion. Iymphatic vessel invasion, perineural invasion) were decreased in the Preop.RT group compared with those of control group. But statistical significance was found only in Iymphatic vessel invasion (p=0.019). Conclusion : The Postoperative pathologic stages and adverse Prognostic pathologic findings were decreased in preoperative radiation therapy group. The Iymphatic vessel invasion and MAC stage C findings were abruptly decreased in Preoperative radiation therapy group. The preoperative radiation therapy was found to be effective in resectable rectal cancer. The patients group in our study was very small and long term follow up was not done. Therefore, further study about this issues is needed.