전립샘암 환자의 방사선 치료 시 광중성자 선량으로 인한 암 발생률의 연구

이주아,Lee, Joo-Ah 한국방사선학회 2022 한국방사선학회 논문지 Vol.16 No.4

전립샘암의 방사선치료법인 3D CRT와 IMRT 5 portals, IMRT 9 portals에서 정상장기인 대장과 갑상샘의 광중성자 선량 피폭으로 인하여 암이 발생할 확률을 연구하고자 한다. 전립샘암 총 처방선량 6600 cGy로 1회당 220 cGy, 총 횟수는 30회의 분할조사를 적용하였다. 실험에 사용한 의료용 선형가속기의 치료테이블(couch)위에 Rando phantom을 setup 한 후에 phantom의 대장, 갑상샘의 해당부위에 중성자 광자극발광선량계 (Optically stimulated luminescence albedo neutron dosimeter)를 위치시켜 측정하였다. 전립샘암 3D CRT시 정상장기인 대장과 갑상샘의 광중성자 선량으로 인한 2차 암의 발생확률은 10,000명 당 1.8명 이었다. 그리고 IMRT 5 portals은 10,000명 당 8.7명으로, 3D CRT에 비해서 약 5배 컸다. IMRT 9 portals는 1,000명 당 1.2명이 암이 발생할 확률이 있음의 결과를 도출하였다. 본 연구를 바탕으로 방사선 치료 시 발생하는 광중성자 선량으로 인하여 2차 방사선 피폭선량의 위험성을 연구하여, 향후 방사선의 확률적 영향과 방사선 방호에 관련하여 유용한 자료로 활용될 것으로 사료된다. The purpose of this study was to study the probability of cancer occurrence due to photoneutron dose exposure of the colon and thyroid gland, which are normal organs, in 3D CRT, IMRT 5 portals, and IMRT 9 portals, which are radiotherapy methods for prostate cancer. The total prescribed dose for prostate cancer was 6600 cGy, 220 cGy per dose, and 30 divided irradiations were applied for the total number of times. After setting up the Rando phantom on the treatment table (couch) of the medical linear accelerator used in the experiment, an optically stimulated luminescence albedo neutron dosimeter was placed on the corresponding area of the large intestine and thyroid gland of the phantom for measurement. During 3D CRT of prostate cancer, the probability of secondary cancer due to photoneutron dose to the colon and thyroid gland, which are normal organs, was 1.8 per 10,000 people. And IMRT 5 portals were 8.7 per 10,000 people, which was about 5 times larger than 3D CRT. IMRT 9 portals derived the result that there is a probability that 1.2 people per 1,000 people will develop cancer. Based on this study, the risk of secondary radiation exposure due to the dose of photoneutrons generated during radiation therapy is studied, and it is thought that it will be used as useful data for radiation protection in relation to the stochastic effect of radiation in the future.

대중교통 기반시설여건 대비 토지이용강도 분석을 통한 서울시 도시철도 역세권의 개발여건 분석

이주아(Lee, Joo-Ah),박진아(Park, Jin-Ah),구자훈(Koo, Ja-Hoon) 대한국토·도시계획학회 2012 國土計劃 Vol.47 No.6

가로의 물리적 여건과 보행량의 영향관계 분석

이주아(Lee, Joo-Ah),구자훈(Koo, Ja-Hoon) 대한국토·도시계획학회 2013 國土計劃 Vol.48 No.4

한국 사회 종교 갈등 축소를 위한 데이터베이스 구축 방안 연구

이주아(Joo-Ah Lee) 연세대학교 신과대학(연합신학대학원) 2014 신학논단 Vol.75 No.-

The purpose of this paper is to draw feasible ways in Christian Education to improve understanding of the inter-religions. Literature research on Narrative Theology, Platform, Big Data, and Christian Education had been conducted and based on this research the exchange of stories is presented as educational methods. Also, platform and database building are suggested as a way of effective exchange of the stories. An extensive social materials and documentary research about platform, big data and social data had been made to support the idea, including studies on the social phenomena and their characteristics such as social impact of platform. To sum up, this researcher proposes the exchange of stories through platform in order to improve understanding of the inter-religions as follows: first, building a database of religious conflicts in Korea; second, proposing a contents of a platform for drawing more early users; third, utilization of Big Data through the platform. This study has a significance in a sense that it engages ‘platform’, one of the most attention-receiving agenda today, to the field of Christian Education, and proposes three specific steps to implement the idea. In addition, this researcher suggests further research needs for establishing religious story platform and it will be helpful for the work of other researchers. The purpose of this paper is to draw feasible ways in Christian Education to improve understanding of the inter-religions. Literature research on Narrative Theology, Platform, Big Data, and Christian Education had been conducted and based on this research the exchange of stories is presented as educational methods. Also, platform and database building are suggested as a way of effective exchange of the stories. An extensive social materials and documentary research about platform, big data and social data had been made to support the idea, including studies on the social phenomena and their characteristics such as social impact of platform. To sum up, this researcher proposes the exchange of stories through platform in order to improve understanding of the inter-religions as follows: first, building a database of religious conflicts in Korea; second, proposing a contents of a platform for drawing more early users; third, utilization of Big Data through the platform. This study has a significance in a sense that it engages ‘platform’, one of the most attention-receiving agenda today, to the field of Christian Education, and proposes three specific steps to implement the idea. In addition, this researcher suggests further research needs for establishing religious story platform and it will be helpful for the work of other researchers.

한국 청소년의 위기에 대한 기독교교육적 대안 모색

이주아(Joo Ah Lee) 한국기독교학회 2012 한국기독교신학논총 Vol.83 No.-

This study began with a critical question about how Christian Education can creatively respond to the present crisis of Korean youth. Christian Education have tasks helping youth to overcome challenges presented to them and develope their own vision for the future. To this end, this research investigates the characteristics of current adolescent problems and Christian Education of Korea through social materials and documentary research, field surveys and suggest practical methods to connect Christian Education field with mobile media what is the main communication media of youth. This study suggests two Christian Education task to be accomplished in adolescence: the formation of the self-identity based on Christian values, the formation of critical and creative reflection about current culture. For the practice of Christian Education with mobile media, recommendations for the configuration of the Korean Church`s mobile web, creating new mobile app for the formation of youth identity and critical reflection and creativity in Christian community are suggested for its specific methods. These are the teaching-learning process that focuses on interactions and relationship of Christian community. One of the most significant demands that current Christian Education face is proactive coping and creative responses to a variety of changes. Christian Education should continue seeking for its new possibilities. It needs to expand new concepts of education and further develop concrete steps of teaching-learning process. And this should be done by fundamental and in-depth study and critical examination on new media as well.

전립선암 방사선치료 시 광자극발광선량계를 이용한 광중성자선량 평가

이주아(Joo Ah Lee),백금문(Geum Mun Back),김연수(Yeon Soo Kim),손순룡(Soon Yong Son),최관우(Kwan Woo Choi),유병규(Beong Gyu Yoo),정회원(Hoi Woun Jeong),정재홍(Jae Hong Jung),김기원(Ki Won Kim),민정환(Jung Whan Min) 대한방사선과학회(구 대한방사선기술학회) 2014 방사선기술과학 Vol.37 No.2

본 연구는 전립선암의 방사선치료에 적용되는 치료기법별 세기조절방사선치료의 적절한 조사문수의 선택 및 광중성자 피폭을 고려한 방사선 치료계획 수립을 위한 기초자료를 제공하고자 하였다. 연구대상은 2013년 9월부터 2014년 1월까지 5개월 동안 전립선암으로 방사선치료를 받은 환자 10명을 대상으로 하였다. 그리고 3-dimensional conformal radiotherapy (3D-CRT), volumetric-modulated arc radiotherapy (VMAT), intensity modulated radiation therapy (IMRT) 5, 7, 9 조사문으로 각각 치료계획을 수립하였다. 기술통계와 분산분석으로 광중성자선량의 평균적 차이를 비교하였으며, 상관관계분석과 회귀분석으로 상관성 및 영향을 분석하였다. 연구 결과, 치료기법별로는 3D-CRT가 가장 낮았다. 또한 IMRT가 가장 높게 측정되었으며, 통계적으로 매우 유의하였다 (p<.01). 세기조절방사선치료 조사문수별 광중성자선량은 평균 4.37 ± 1.08 mSv였으며, 조사문수 간에 통계적으로 매우 유의한 차이를 보였다(p<.01). 그리고 조사문수와 광중성자선량은 상관계수가 0.570으로 나타나 통계적으로 매우 유의한 양의 상관관계를 보였다 (p<.01). 조사문수와 광중성자 선량의 선형회귀분석 결과, 조사문수가 1단계 증가할 때마다 평균적으로 광중성자선량이 0.373배로 유의하게 증가하였다. 결론적으로 전립선암의 방사선치료에 빈번히 사용하고 있는 IMRT의 조사문수의 선택 및 광중성자 피폭선량 및 방사선 치료계획의 질적 수준 평가를 고려한 적절한 치료계획 선택에 있어 기초자료로 활용될 수 있으리라 기대된다. This study is to provide basic information regarding photoneutron doses in terms of radiation treatment techniques and the number of portals in intensity-modulated radiation therapy (IMRT) by measuring the photoneutron doses. Subjects of experiment were 10 patients who were diagnosedwithprostate cancer and have received radiation treatment for 5 months from September 2013 to January 2014 in the depart-ment of radiation oncology in S hospital located in Seoul. Thus, radiation treatment plans were created for 3-Dimensional Conformal Radiotherapy (3D-CRT), Volumetric-Modulated Arc Radiotherapy (VMAT), IMRT 5, 7, and 9 portals. The average difference of photoneutron dose was compared through descriptive statistics and variance analysis, and analyzed influence factors through correlation analysis and regression analysis. In summarized results, 3D-CRT showed the lowest average photoneutron dose, while IMRT caused the highest dose with statistically significance (p <.01). The photoneutron dose by number of portals of IMRT was 4.37 ± 1.08 mSv in average and statistically showed very significant difference among the number of portals (p <.01). Number of portals and photoneutron dose are shown that the correlation coefficient is 0.570, highly statistically significant positive correlation (p <.01). As a result of the linear regression analy-sis of number of portals and photoneutron dose, it showed that photoneutron dose significantly increased by 0.373 times in average as the number of portals increased by 1 stage. In conclusion, this study can be expected to be used as a quantitative basic data to select an appropriate IMRT plans regarding photo-neutron dose in radiation treatment for prostate cancer.

방사선관리구역내의 종사자 및 임상실습 학생의 개인피폭선량 분석

이주아(Lee joo-ah),계철승(Kay chul-seung) 한국콘텐츠학회 2017 한국콘텐츠학회 종합학술대회 논문집 Vol.2017 No.5

간 , 간경변과 바이러스 간염 환자의 영양불량 위험도 비교: 단일기관 연구

이주아 ( Joo Ah Lee ),이태희 ( Tae Hee Lee ),김지영 ( Ji Yeong Kim ),석민규 ( Min Gyu Seok ),강민규 ( Min Gyu Kang ),정지현 ( Ji Hyun Jeong ),구훈섭 ( Hoon Sup Koo ),송경호 ( Kyung Ho Song ),김용석 ( Yong Seok Kim ),김선문 ( Sun M 대한소화기학회 2014 대한소화기학회지 Vol.64 No.5

Background/Aims: It is well-known that patients with chronic liver disease commonly have nutritional deficiency. In the present study, we investigated the differences in malnutrition risk between patients with liver cirrhosis and viral hepatitis carrier. Methods: Patients with chronic liver disease who have been hospitalized at Konyang University Hospital from May 2012 to April 2013 were analyzed retrospectively. The malnutrition risk was divided into three categories (low, intermediate, and high) according to Konyang University Hospital Malnutrition Screening, which include BMI, serum albumin, total lymphocyte count (TLC), hemoglobin, weight change, appetite, and dysphagia, within 24 hours of hospitalization. Results: Among a total of 460 patients, 313 had liver cirrhosis (LC), and 147 were viral hepatitis carriers. Age (p<0.001), serum albumin level (p<0.001), TLC (p=0.011), hemoglobin (p<0.001) and serum cholesterol level (p=0.005) were significant different between the two groups. However, there were no difference in height, weight, and BMI. The malnutrition risk of the patients with viral hepatitis carrier was significantly lower than that of the patients with LC (p<0.001). In addition, among 313 patients with LC, malnutrition risk of the patients with Child-Pugh class A (n=150) was significantly lower than that of the patients with class B (n=90) or C (n=73) (p<0.001). Conclusions: Viral hepatitis carrier group had significantly lower malnutrition risk than LC group. The risk of malnutrition in Child-Pugh class A group was significantly lower than that in class B or C group. (Korean J Gastroenterol 2014,64:284-289)

의료기관 방사선작업종사자와 임상실습 학생의 피폭선량 분석

이주아(Joo-Ah Lee),최관우(Kwan-Woo Choi),민정환(Jung-Whan Min),임종천(Jong-Cheon Lim),손순룡(Soon-Yong Son) 한국산학기술학회 2016 한국산학기술학회논문지 Vol.17 No.8

연구목적은 의료용 방사선 장비를 운용하는 병원의 근무지별 종사자와 동일한 구역에서 임상실습을 수행한 학생과의 피폭선량을 비교하여 실습학생의 체계적인 피폭관리의 당위성을 제시하고자 하였다. 연구대상은 2014년 7월부터 8월까지 C대학병원 방사선구역에서 임상실습을 이수한 121명의 학생과 동 의료기관에 재직중인 종사자 62명(영상의학과 47명, 방사 선종양학과 8명, 핵의학과 7명)을 대상으로 연구하였다. 연구방법은 측정을 위해 임상실습 기간인 8주간의 피폭선량을 측정 하였으며, 종사자는 영상의학, 방사선종양학, 핵의학분야 종사자의 4개 그룹으로 구분하여 8주간의 심부선량과 표층선량을 비교하였다. 선량측정은 OSLD를 이용하였으며, 각 그룹의 평균의 차이는 분산분석(ANOVA)을 수행하였고 사후검정으로는 Duncan의 중다검정방법(muliple range test)을 이용하여 유의성을 분석하였다. 연구결과 심부선량은 영상의학과 0.127±0.331 mSv, 방사선종양학과 0.01±0.003 mSv, 핵의학과 0.431±0.205 mSv, 실습생 0.143±0.136 mSv로 나타났다. 표층선량은 영상의 학과 0.131±0.331 mSv, 방사선종양학과 0.009±0.003 mSv, 핵의학과 0.445±0.198 mSv, 실습생 0.151±0.14 mSv로 나타났으며, 두 선량에서 모두 통계적으로 매우 유의한 차이를 보였다(p<.01). 연구결과를 통하여 실습생의 평균선량이 핵의학 종사자를 제외한 나머지 그룹보다 높게 나타났으므로 향후 방사선방어 측면에서 관리 대상자에 포함하여 체계적인 개인피폭 관리가 이루어지도록 개선이 필요할 것으로 사료된다. This study was conducted to determine the appropriateness of systemic radiation exposure control for students in clinical practice by comparing radiation exposure in radiography employees at different stations of a hospital with that of students conducting clinical practice using identical stations. Overall, 121 students who conducted clinical practice in the department of radiology area of C university hospital from July 2014 to August 2014 and 62 workers working in the same medical facility (47 in the department of radiology, 8 in the department of radiation oncology, 7 in the department of nuclear medicine) were investigated. The radiation exposure experienced by students was measured for 8 weeks, which is the duration of the clinical practice. Additionally, radiation exposure of workers were classified into 4 groups, department of radiology, department of radiation oncology, and department of nuclear medicine was compared. Dose was measured with OSLD and differences among groups were identified by ANOVA followed by Duncan's multiple range test. Among employees, those in the department of radiology, oncology and nuclear medicine were exposed depth doses of 0.127±0.331 mSv, 0.01±0.003 mSv, and 0.431±0.205 mSv, respectively, while students were exposed to 0.143±0.136 mSv. Additionally, workers in the department of radiology, oncology and nuclear medicine were exposed to surface doses of 0.131±0.331 mSv, 0.009±0.003 mSv, and 0.445±0.198 mSv, respectively, while students were exposed to 0.151±0.14 mSv, which was significantly different in both doses (p < 0.01). The average dose that students received is higher than that of the other groups (except for nuclear medicine workers), indicating that further improvements must be made in systemic controls for individual radiation exposure by including the students as subjects of management for protection from radiation.

부모의 정서적 자녀가치, 양육행동, 유아의 학습준비도 및 학업능력 간의 구조적 관계: 자기-상대방효과를 중심으로

이주아 ( Lee Joo Ah ),박지은 ( Park Ji Eun ),정혜민 ( Chung Hye Min ),이순형 ( Yi Soon Hyung ) 한국유아교육학회 2017 유아교육연구 Vol.37 No.4

이 연구는 자기-상대방 상호의존모형(Actor-Partner Interdependence Model, APIM)을 적용하여 유아기 자녀를 둔 아버지와 어머니의 정서적 자녀가치와 양육행동 간의 자기효과와 상대방효과를 검증하고, 부모의 정서적 자녀가치가 양육행동을 매개로 자녀의 학습준비도와 학업능력에 미치는 영향을 확인하였다. 유아교육기관에서 초등학교로의 전이과정에서 부모의 정서적 자녀가치와 양육행동, 유아의 학습준비도와 학업능력 간의 관계를 살펴보고, 초등학교에서의 안정적인 적응을 위한 전이 준비의 중요성을 확인하는데 목적이 있다. 그 결과, 첫째, 어머니와 아버지의 정서적 자녀가치가 온정적 및 통제적 양육행동에 미치는 유의한 자기효과가 나타났다. 둘째, 어머니의 정서적 자녀가치가 아버지의 온정적 양육행동에 미치는 유의한 상대방효과가 나타났다. 셋째, 어머니와 아버지의 정서적 자녀가치가 유아의 학습준비도 및 학업능력에 미치는 영향은 부모의 양육행동에 의해 완전 매개하는 것으로 나타났다. 부모 자녀가치와 양육행동의 상호작용이 유아의 학습준비도와 학업능력에 영향을 주는 것을 구체적으로 살펴보아 초등학교로의 적응을 위한 전이 준비의 중요성을 확인할 수 있었다. 본 연구는 이러한 결과를 바탕으로 부모의 정서적 자녀가치 증진과 양육행동이 유아의 학습준비도와 학업능력을 발달시키기 위한 부모교육의 기초정보를 제공하는데 도움을 주고자 한다. This study examined the dyadic relationship between mothers and fathers in their emotional value of children and parenting behavior and their effects on preschoolers school readiness and scholastic competence. This research made use of 6th and 7th year data from Panel Study of Korean Children(PSKC). Participants numbered 1,041 parents and their children. Data were analyzed upon the Actor-Partner Interdependence Model(APIM) using SPSS 21.0 and Amos 21.0. The results can be summarized as follows. First, both mothers and fathers emotional value of children had a significant positive actor effect on their own warm and controlled parenting behavior. Second, only mothers emotional value of children showed a significant positive partner effect on fathers warm parenting behavior, but no partner effect of fathers was found. Third, parenting behavior completely mediated the effects between both parents emotional value of children and preschoolers school readiness and scholastic competence. These results suggested that the widespread parenting programs would be necessary for acknowledging their values of children and proper parenting, which would eventually affect child s school life.