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최규혜,김진아,이시원,강영남,장홍석 대한방사선종양학회 2018 Radiation Oncology Journal Vol.36 No.1
Purpose: The objective of this study was to compare dosimetric characteristics of three-dimensional conformal radiotherapy (3D-CRT) and two types of intensity-modulated radiotherapy (IMRT) which are step-and-shoot intensity modulated radiotherapy (s-IMRT) and modulated arc therapy (mARC) for thoracic esophageal cancer and analyze whether IMRT could reduce organ-at-risk (OAR) dose. Materials and Methods: We performed 3D-CRT, s-IMRT, and mARC planning for ten patients with thoracic esophageal cancer. The dose-volume histogram for each plan was extracted and the mean dose and clinically significant parameters were analyzed. Results: Analysis of target coverage showed that the conformity index (CI) and conformation number (CN) in mARC were superior to the other two plans (CI, p = 0.050; CN, p = 0.042). For the comparison of OAR, lung V5 was lowest in s-IMRT, followed by 3D-CRT, and mARC (p = 0.033). s-IMRT and mARC had lower values than 3D-CRT for heart V30 (p = 0.039), V40 (p = 0.040), and V50 (p = 0.032). Conclusion: Effective conservation of the lung and heart in thoracic esophageal cancer could be expected when using s-IMRT. The mARC was lower in lung V10, V20, and V30 than in 3D-CRT, but could not be proven superior in lung V5. In conclusion, low-dose exposure to the lung and heart were expected to be lower in s-IMRT, reducing complications such as radiation pneumonitis or heart-related toxicities.
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최규혜,윤재은 한국공간디자인학회 2015 한국공간디자인학회논문집 Vol.10 No.6
(Research Background and Purpose)The Busan Cinema Center, designed by Coop Himmelb(l)au, is considered a landmark building from the perspective of deconstructive spatial aesthetics. This study examines the spatial characteristics of the Busan Cinema Center with Coop Himmelb(l)au’s spatial philosophy as the research background. (Research methods) This paper starts with a theoretical approach to Coop Himmelb(l)au’s philosophy of deconstruction architecture. The spatial domain has been described in Coop Himmelb(l)au’s unique philosophy of deconstruction architecture. Hence, first, the spatial characteristics of the Busan Cinema Center are analyzed with a theoretical approach to the architectural philosophy of Coop Himme(l)blau. This is followed by a real-scene analysis of the Busan Cinema Center. To this end, this paper uses a field survey to analyze the spatial and expression techniques shown in the Busan Cinema Center representing the architectural philosophy of Coop Himmelb(l)au. (Results) The results of this study reveal five architectural characteristics of the Busan Cinema Center. First, the structure of the space is irregular. The Busan Cinema Center comprises an irregular space characterized by sloppiness, penetration, cleft, and geometrical conflict. Irregular space refers to an open space causing a visual sense of motion and a feeling of tension. Second, the space is non-territorial. The Busan Cinema Center uses spatial elements, which are overlapping and ambiguous, in a complex manner. The blurred space is converted into a non-territorial, open space. Third, the space is transparent. The Busan Cinema Center was formed as a transparent piece of architecture from glass and linear materials. Transparent architecture creates an open space by enabling the mutual intersection of internal and external spaces. Fourth, the architecture is organic. Big Roof and Small Roof, and Bridge in Air illustrate gravity-defying designs, dynamism, and fantastic, imaginary architecture. Lastly, the architecture changes per the users’ needs. The Busan Cinema Center demonstrates new forms and spaces which have user-oriented aesthetic characteristics such that the spaces change and move according to the users’ needs. These results indicate that the architecture of the Busan Cinema Center is characterized by an open space that is valued most highly in Coop Himmelb(l)au’s philosophy. (Conclusion) This study was conducted to help people understand that the Busan Cinema Center is not only a theater dedicated to the Busan International Film Festival (BIFF), but is also a monumental building that was constructed to promote the efficient management of the BIFF. This festival began with the political and economic purposes of initiating the second take-off of Busan and launching the tourism industry, which is its foundation industry, as well as to create an identity of Busan as a city of visual culture. This background knowledge helps us understand that the Busan Cinema Center is an architectural work embodying the architectural philosophy of Coop Himmelb(l)au and the aesthetics of open space.
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최규혜,송진호,김연실,김지훈,정우진,남인철,김진호,안희경,전상훈,홍현준,주영훈,은영규,문성호,이정심 대한암학회 2021 Cancer Research and Treatment Vol.53 No.4
Purpose The incidence of human papillomavirus (HPV)-related oropharyngeal cancer (OPC) has increased, and staging and optimal therapeutic approaches are challenging. A questionnaire survey was conducted to investigate the controversial treatment policy of stage T2 OPC according to the N category and determine the opinions of multidisciplinary experts in Korea. Materials and Methods Five OPC scenarios were developed by the Subcommittee on Oropharyngeal Treatment Guidelines of the Korean Society for Head and Neck Oncology and distributed to experts of multidisciplinary treatment hospitals. Results Sixty-five experts from 45 institutions responded. For the HPV-positive T2N0M0 scenario, 67.7% of respondents selected surgery followed by definitive concurrent chemoradiotherapy (CCRT) or radiotherapy alone. For the T2N1M0 HPV-positive scenario, there was a notable difference in the selection of primary treatment by expert specialty; 53.9% of respondents selected surgery and 39.8% selected definitive CCRT as the primary treatment. For the T2N3M0 advanced HPV-positive scenario, 50.0% of respondents selected CCRT and 33.3% considered induction chemotherapy (IC) as the primary treatment. CCRT and IC were significantly more frequently selected for the HPV-related OPC cases (p=0.010). The interdepartmental variability showed that the head and neck surgeons and medical oncologists favored surgery, whereas the radiation oncologists preferably selected definitive CCRT (p < 0.001). Conclusion In this study, surgery was preferred for lymph node-negative OPC, and as lymph node metastasis progressed, CCRT tended to be preferred, and IC was administered. Clinical practice patterns by stage and HPV status showed differences according to expert specialty. Multidisciplinary consensus guidelines will be essential in the future.
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최규혜,송진호,장홍석,김성환,이종훈 대한암학회 2021 Cancer Research and Treatment Vol.53 No.2
Purpose Colorectal cancer (CRC) is increasing in South Korea due to westernized eating habits and regular health check-ups. The Korean Health Insurance Review and Assessment Service (HIRA) has conducted a national quality assessment of the treatment of CRC. This study examined the quality assessment report of the Korean HIRA and analyzed the status of practice pattern and the epidemiology of CRC in South Korea.Materials and Methods The number of subjects was determined based on the number of surgical procedures in each institution during 2012-2017. The institution types were classified according to the number of beds and the composition of oncologic specialists. Twenty-one indicators for diagnosis, chemotherapy, radiotherapy, surgery, pathology, and mortality were analyzed and the interinstitutional variation for each indicator was calculated.Results Among 21 evaluation indices, indicators related to medical records, receipt of chemotherapy with a high coefficient of variation of ≥ 0.1% were improved over 6 years until the survey in 2017. In the analysis of indices affecting surgical mortality, the regional lymph node resection and examination rate (p=0.022) showed a negative correlation with surgical mortality. Hospitalization stay (p < 0.001) and hospitalization cost (p=0.002) were positively correlated with surgical mortality.Conclusion This study showed that the treatment quality and examination status for CRC in South Korea were appropriate for improving relevant medical records, receipt of chemotherapy, maintaining the quality of treatment, and mortality. These analyses could be the basis for developing an improved quality assessment program worldwide.
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최규혜,이시원,유미나,정송미,이정원,이종훈 대한부인종양학회 2019 Journal of Gynecologic Oncology Vol.30 No.1
Objective: There is no definitive guideline for the significance and cut-off value of squamouscell carcinoma antigen (SCC-Ag) in cervical cancer. Thus, we analyzed the significance and optimal cut-off value of SCC-Ag for predicting tumor recurrence and patient survival in squamous-cell carcinoma of uterine cervix. Methods: From January 2010 to October 2016, we enrolled 304 cervical cancer patients with squamous-cell carcinoma staging International Federation of Gynecology and Obstetrics (FIGO) Ib–IVa and treated with definitive chemoradiotherapy (CRT) followed by intracavitary radiotherapy (ICR). The cut-off value of SCC-Ag level for tumor recurrence was calculated using the receiver operating characteristic (ROC) curve. The recurrence-free survival (RFS) and overall survival (OS) were assessed using Kaplan-Meier method to estimate the significance of SCC-Ag level. Results: The optimal cut-off value of SCC-Ag level for predicting tumor recurrence was calculated and set at 4.0 ng/mL in the ROC curve. After a median follow-up period of 36.5 months, the 3-year RFS (56.6% vs. 80.2%, p<0.001) and OS (72.1% vs. 86.8%, p=0.005) were significantly lower in SCC-Ag ≥4 ng/mL arm than in <4 ng/mL arm. The 3-year locoregional recurrence (17.6% vs. 7.0%, p=0.012), distant metastasis (20.4% vs. 6.9%, p=0.002), and para-aortic recurrence (9.4% vs. 2.1%, p=0.012) rates were significantly higher in SCC-Ag ≥4 ng/mL arm than in SCC-Ag <4 ng/mL arm. Conclusion: Pre-treatment SCC-Ag level higher than 4 ng/mL may be a useful predictor of tumor recurrence in patients with squamous-cell carcinoma of uterine cervix treated with definitive CRT and ICR.
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최규혜,성수윤,이시원,전예원,김성환,이종훈 대한암학회 2023 Cancer Research and Treatment Vol.55 No.2
Purpose Quality assessment of breast cancer treatment in South Korea showed the upward standardization of the grade since 2013, but treatment disparities still have existed. This study analyzed the 5-year trend between 2013 and 2017 in the assessment of breast cancer treatment practice using the Korean health insurance data. Materials and Methods All the medical records including surgery, chemotherapy, and radiotherapy for 7,354 patients a year on average were evaluated. Twenty indices consisted of one structural, 17 process-related, and two result-related factors. We calculated the coefficient of variation (CV) annually to determine the variation in adherence rate of evaluation indices according to the type of institution (advanced vs. general hospital vs. clinic). Results Based on the initial assessment in 2013, 10 out of 20 indicators showed significant variation among the types of institutions with a CV of less than 0.1%. Six of them had a CV decline of less than 0.1%. The CV was still 0.1% or higher in the four indicators, including the composition of professional staff, the implementation of target therapy, the average length of hospital stay, and the hospitalization cost. Regarding the first grade of assessment, there was a statistically significant relationship between the institution type (p=0.029) and region (metropolitan vs. province, p < 0.001). Conclusion There were disparities in the structural and systemic treatment factors depending on the institutional type. The quality improvement of the regional institutions and multidisciplinary experts for breast cancer is necessary.
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부산 영화의 전당에 나타난 쿱 힘멜블라우 건축의 공간적 특성에 관한 연구
최규혜(제1저자) ( Gyuhye Choi ),윤재은(교신저자) ( Jaeeun Yoon ) 한국공간디자인학회 2015 한국공간디자인학회논문집 Vol.10 No.6
(연구배경 및 목적)해체주의 건축가 쿱 힘멜블라우는 60년대 말 아키그램의 영향과 초현실주의적 경향으로 다른 해체주의 건축가들과 차별화된 그들만의 특성을 지닌다. 이러한 쿱 힘멜블라우가 설계한 부산 영화의 전당은 해체주의 공간 미학에 기초한 조형미가 우수한 건축물로 평가 받고 있다. 따라서 본 논문은 해체주의 건축가 쿱 힘멜블라우의 공간 철학에 대한 관점을 연구 배경으로 하여 부산 영화의 전당에 나타난 공간적 특성에 대한 연구를 목적으로 한다. (연구방법)본 논문의 연구 방법은 첫째, 쿱 힘멜블라우의 해체주의 건축 철학에 대한 이론적 접근으로부터 시작한다. 쿱 힘멜블라우의 공간적 특성은 그들 특유의 해체주의 건축 이념에 의해 표현되어 왔다. 그러므로 부산 영화의 전당에 나타난 공간적 특성 역시 우선적으로 쿱 힘멜블라우의 건축 이념에 대한 이론적 접근으로부터 출발해야 할 것이다. 두 번째로는 부산 영화의 전당에 대한 실제적 현장 분석 방법이다. 본 연구자는 이를 위해 부산 영화의 전당에 나타난 쿱 힘멜블라우의 건축 이념의 특징을 잘 보여주는 공간과 표현 기법에 대하여 현장 답사를 기초 자료로 작성하여 본 논문에 제시하고자 한다. (결과)본 논문에서 분석해본 결과 부산 영화의 전당에 나타난 쿱 힘멜블라우의 건축적 특성은 크게 5가지로 볼 수 있다. 첫 번째, 공간의 비정형성이다. 부산 영화의 전당은 기울어짐, 비틀림, 꿰뚫음, 갈라진 틈, 기하학적 충돌에 의해 비정형적인 공간을 구성한다. 비정형적 공간은 불안정감과 불균형을 통해 시각적 운동감과 긴장감을 유발하여 열린 공간을 표현한다. 두 번째, 공간의 비영역성이다. 부산 영화의 전당은 공간요소들이 복합적으로 사용되고 중첩되며 그 개념이 모호해진다. 모호해진 공간은 비영역성을 가지며 개방적이고 열린 공간이 된다. 세 번째, 공간의 투명성이다. 부산 영화의 전당은 유리와 선(line)적인 재료를 사용함으로서 투명한 건축으로 생성되었다. 투명한 건축은 내·외부 공간에 상호 관입을 가능케 하여 내부에서 외부로 공간이 확장되며 열린 공간을 추구하게 된다. 네 번째, 유기적인 건축이다. 빅루프와 스몰루프, 공중의 브리지는 반중력성과 역동성을 보여주며 환상적이고 공상적인 건축을 가능케 하였다. 마지막으로 사용자의 의도에 따라 반응하는 건축이다. 부산 영화의 전당은 새로운 형태와 공간을 창조함으로서 사용자의 목적에 따라 공간이 변하고 움직이는 사용자 중심의 미학적 특징을 가진다. 이러한 분석결과로 본 논문에서는 부산 영화의 전당이 쿱 힘멜블라우의 건축에서 가장 중요시 하는 열린 공간의 성격이 잘 나타나있는 건축이라고 분석하였다. (결론)본 연구를 통해 부산 영화의 전당이 단순히 부산국제영화제 전용관으로서가 아니라 부산의 제2의 도약이자 지역기반산업인 관광산업의 활성화라는 정치적, 경제적 목적을 가지고 시작한 부산국제영화제의 효율적인 운영과 부산의 영상문화도시 이미지창출 및 정체성 획득을 위한 기념비적인 건축물이라는 건립 배경을 바탕으로 쿱 힘멜블라우의 건축철학이 담긴, 열린 공간의 미학이 잘 표현된 건축물로서 이해될 수 있기를 기대한다. (Research Background and Purpose)The Busan Cinema Center, designed by Coop Himmelb(l)au, is considered a landmark building from the perspective of deconstructive spatial aesthetics. This study examines the spatial characteristics of the Busan Cinema Center with Coop Himmelb(l)au`s spatial philosophy as the research background. (Research methods) This paper starts with a theoretical approach to Coop Himmelb(l)au`s philosophy of deconstruction architecture. The spatial domain has been described in Coop Himmelb(l)au`s unique philosophy of deconstruction architecture. Hence, first, the spatial characteristics of the Busan Cinema Center are analyzed with a theoretical approach to the architectural philosophy of Coop Himme(l)blau. This is followed by a real-scene analysis of the Busan Cinema Center. To this end, this paper uses a field survey to analyze the spatial and expression techniques shown in the Busan Cinema Center representing the architectural philosophy of Coop Himmelb(l)au. (Results) The results of this study reveal five architectural characteristics of the Busan Cinema Center. First, the structure of the space is irregular. The Busan Cinema Center comprises an irregular space characterized by sloppiness, penetration, cleft, and geometrical conflict. Irregular space refers to an open space causing a visual sense of motion and a feeling of tension. Second, the space is non-territorial. The Busan Cinema Center uses spatial elements, which are overlapping and ambiguous, in a complex manner. The blurred space is converted into a non-territorial, open space. Third, the space is transparent. The Busan Cinema Center was formed as a transparent piece of architecture from glass and linear materials. Transparent architecture creates an open space by enabling the mutual intersection of internal and external spaces. Fourth, the architecture is organic. Big Roof and Small Roof, and Bridge in Air illustrate gravity-defying designs, dynamism, and fantastic, imaginary architecture. Lastly, the architecture changes per the users` needs. The Busan Cinema Center demonstrates new forms and spaces which have user-oriented aesthetic characteristics such that the spaces change and move according to the users` needs. These results indicate that the architecture of the Busan Cinema Center is characterized by an open space that is valued most highly in Coop Himmelb(l)au`s philosophy. (Conclusion) This study was conducted to help people understand that the Busan Cinema Center is not only a theater dedicated to the Busan International Film Festival (BIFF), but is also a monumental building that was constructed to promote the efficient management of the BIFF. This festival began with the political and economic purposes of initiating the second take-off of Busan and launching the tourism industry, which is its foundation industry, as well as to create an identity of Busan as a city of visual culture. This background knowledge helps us understand that the Busan Cinema Center is an architectural work embodying the architectural philosophy of Coop Himmelb(l)au and the aesthetics of open space.
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곽유강,박희현,최규혜,박은영,성수윤,이시원,홍지현,이효춘,유이령,김연실 대한암학회 2020 Cancer Research and Treatment Vol.52 No.1
Purpose Fluorodeoxyglucose positron emission tomography–computed tomography (PET-CT) is gaining evidence as a predictive factor in non-small cell lung cancer (NSCLC). Stereotactic ablative radiotherapy (SABR) is the standard treatment in early-stage NSCLC when a patient is unsuitable for surgery. We performed a study to assess the prognostic clinical significance of PET-CT after SABR in early-stage NSCLC. Materials and Methods Seventy-six patients with stage I NSCLC treated with SABR were investigated. Total radiation dose ranged from 36 to 63 Gy in three to eight fractions depending on tumor location and size. Respiratory motion control was implemented at simulation and during treatment. PETCT prior to SABR was performed in 66 patients (86.8%). Results Median follow-up time was 32 months (range, 5 to 142 months). Local control rate at 1, 2, and 5 years were 95.9%, 92.8%, and 86.7%, respectively. Overall survival (OS) at 1, 2, and 5 years were 91.0%, 71.3%, and 52.1% respectively. Cause-specific survival at 1, 2, and 5 years were 98.6%, 93.1%, and 84.3% respectively. Tumor size and pre-SABR maximal standardized uptake value (SUVmax) demonstrated statistical significance in the Kaplan-Meier survival analyses with log-rank test. In multivariate analyses pre-SABR SUVmax remained statistically significant in correlation to OS (p=0.024; hazard ratio [HR], 3.2; 95% confidence interval [CI], 1.2 to 8.8) and with marginal significance in regards to regional progressionfree survival (p=0.059; HR, 32.5; 95% CI, 2.6 to 402.5). Conclusion Pre-SABR SUVmax demonstrated a predictive power in statistical analyses. Tumors with SUVmax above 6 at diagnosis were associated with inferior outcomes.
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