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.

논문 : 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.

논문 : 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.

논문 : 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.

폐암의 방사선 치료

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

가면을 통한 캐릭터의 시각 표현성 확대에 관한 연구

장혜숙 ( Chang Hye-sook ) 한국연극교육학회 2016 연극교육연구 Vol.29 No.-

Mask used first in an ancient ritual ceremony was an important tool for a variety of social roles and communication with multiple functions such as ritual, playfulness, transformation, symbolism, sense of healing and decorativeness. Especially the religious function of the mask has been lost in modern times and while its artistic view has been emphasized as a symbolic and experimental expression medium. Moreover, its meaning has been recently interpreted newly in theater, opera, dance and musical etc. Through organic and harmonious relationship between the actors and the audience, mask could lead to a variety of emotional meaning and expression. It also stimulates the emotion with a visual language connected with something that is not expressed colloquially. As a metaphor in the text and as an excellent tool on the stage, mask has new relationship constantly with costumes, props and the stage and exert a direct or indirect impact on the acting of the characters. This study is for maximization of visual expression for characters using the mask through the work of Julie Tamer doing vigorous activities on costume, puppet and mask design in a variety of areas such as theaters, operas, musicals and movies. Her unique masks show new aesthetics distinctly different structural forms from those of the previous masks and even raised the price of the work through the expansion of the visual representation scopes of the characters. She had broken stereotypes like a mask on face and was seeking to free the structural changes such as creating a mask on head, moving mask and holding mask for acting. This made a great welcome enlargement creation and powerful existence of character than a real person and made it possible to expand the variety of facial expressions and movements through a mechanical and structural changes in the mask. Expressionless and neutral masks caused a subtle conflict with moving body and expanded mystery of the characters leading to unconsciousness and fictional world away from the daily in combination with symbolic objects. In addition, it enables the transition to other beings by introducing symbolic icon representing the works and characters. It was also possible to ridicule, criticize and satire by focusing on playful expression through highlighting the modified feature, grotesqueness and distortion of character. The reason why mask occupies an important position in the performing arts including theater, is due to the active commitment from audience and because it has versatility and aesthetic attraction as well as valuable as a medium of communication and interaction with people. It should be continued to attempt steady expansion of visual representation through the imagination for the development of performing aesthetics through the mask. Masks in contact with attributes of humans, already wearing various social masks, will continue to exist so far as human desire is wriggling despite of a different time and place.

논문 : 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.

무증상 한국인에서 대장 종양의 유병률 및 대장암 선별검사로서 대장내시경 검사의 역할

장혜숙 ( Hye Sook Chang ),최재원 ( Jae Won Choe ),양석균 ( Suk Kyun Yang ),명승재 ( Seung Jae Myung ),정훈용 ( Hwoon Yong Jung ),이진혁 ( Gin Hyug Lee ),홍원선 ( Weon Seon Hong ),김진호 ( Jin Ho Kim ),민영일 ( Young Il Min ) 대한장연구학회 2003 Intestinal Research Vol.1 No.2

목적: 최근 대장암의 선별검사로서 대장내시경 검사의 중요성이 강조되고 있으나, 이에 대한 국내 연구는 미비하다. 저자들은 무증상 한국인에서 대장 종양의 유병률을 알아보고, 대장암의 선별검사로서 대장내시경 검사의 역할에 대해 알아보고자 하였다. 대상 및 방법: 1998년 3월부터 2002년 7월까지 서울아산병원 건강증진센터에서 대장내시경 검사를 시행받은 3,325명의 검진자 중 직장 출혈, 최근 배변 습관의 변화, 대장암 또는 용종의 가족력이나 과거력, 염증성 장질환이나 대장 수술의 과거력 및 지난 10년 이내에 대장 내시경 검사나 대장조영술을 시행받은 적이 있는 환자 1,106명 및 대장내시경 검사가 불완전하게 시행된 11명을 제외한 2,208명을 대상으로 대장 종양의 빈도와 특성을 분석하였다. 결과: 대상군의 평균 나이는 49.2±10.1세였으며, 남자가 1,564명(70.8%)이었다. 대장 종양의 유병률은 선종 18.3%, 진행성 선종 2.0%, 대장암 0.3%이었으며, 50세 이상의 경우에는 각각 25.8%, 3.0%, 0.5%이었다. 남녀 모두 연령이 증가할수록 대장 선종, 진행성 선종 및 대장암의 빈도가 증가하였으며(p for trend<0.05), 여자보다 남자에서 대장 선종의 유병률이 유의하게 높았다(21.0% vs 12.0%, p<0.001). 한편 근위부 대장에서 종양이 발견될 확률은 원위부 대장에 종양이 있는 경우 26.0% (53/2004)로서 원위부 대장에 종양이 없는 경우의 10.3% (207/2004)보다 유의하게 높았다(p<0.001). 그러나 근위부 대장에서 관찰되는 진행성 종양의 69.2% (18/26)가 원위부 대장에 이상이 없이 고립성으로 존재한 경우였다. 결론: 무증상 한국인에서 대장 종양의 유병률은 서양에 비해 다소 낮은 경향이 있으며 또한 남녀 사이에 차이를 보인다. 따라서 한국에서의 대장암 선별검사의 지침을 마련하는데 있어 이러한 점들이 고려되어야 할 것이다. 한편 원위부 대장에 종양이 있는 경우에는 그렇지 않은 경우에 비해 근위부 대장에서 종양이 발견될 확률이 높아지지만, 원위부 대장에 종양이 있는 경우에만 대장내시경 검사를 할 경우 근위부 진행성 종양의 약 2/3를 놓치게 된다. 따라서 대장암 선별 검사로서 대장내시경 검사는 매우 유용한 것으로 생각된다. Background/Aims: Recent studies have reported the importance of screening colonoscopy for colorectal cancer. However, the prevalence of colorectal neoplasms in asymptomatic Korean population has not been determined until now. The purpose of this study was to evaluate the prevalence of colorectal neoplasms in asymptomatic Korean population and to assess the role of colonoscopy in colorectal cancer screening. Methods: We reviewed the endoscopic and pathologic reports of 3,325 patients who underwent colonoscopy at the Health Promotion Center, Asan Medical Center, from 1998 to 2002. Of them, 2,208 asymptomatic patients who underwent colonoscopy for the purpose of colorectal cancer screening were enrolled. Results: The mean age was 49.2 years and 70.8% were men. The overall prevalence of colorectal neoplasms was 18.6% and the prevalence among patients 50 years of age or older was 26.3%. The prevalence of neoplasms increased with age and was higher in the male. Patients with distal neoplasms were more likely to have proximal neoplasms than those without distal neoplasms. However, 69.2% of the patients with advanced proximal neolplasms had no synchronous distal neoplasms. Conclusions: The prevalence of colorectal neoplasms in asymptomatic average-risk Koreans seems to be lower than that in corresponding Westerns and shows a gender-difference. These results should be considered when establishing a guideline for colorectal cancer screening in Korea. Over half of the patients with advanced proximal neoplasms will not be detected if only those with distal neoplasms undergo colonoscopic screening. Therefore, colonoscopy may be useful as a screening test for colorectal cancer. (Intestinal Research 2003;2:179-185)

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)