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유방암 환자의 수술 전 액와림프절 전이 여부 평가를 위한 영상의학적 검사의 효용성
김경덕(Kyeong Deok Kim),인정진(Jeong Jin In),장윤희(Yun Hee Jang),김지선(Zisun Kim),국중철(Jung Cheol Kuk),최규성(Kyu Sung Choi),정재홍(Jaehong Jeong),허성모(Sung Mo Hur),정귀애(Gui Ae Jeong),정준철(Jun Chul Chung),조규석(Gyu Seok Ch 대한종양외과학회 2015 Korean Journal of Clinical Oncology Vol.11 No.2
Purpose: The purpose of this retrospective study was to identify the diagnostic performance of positron emission tomography/computed tomography (PET/CT) compared to conventional modalities, such as ultrasonography (US) and contrast-enhanced computed tomography (CT) in detecting axillary lymph node metastasis (ALNM) in patients with breast cancer. Methods: Two hundred thirty-three consecutive patients diagnosed with primary breast cancer who had not been treated with neoadjuvant chemotherapy and had been examined by US, CT, and PET/CT before surgery were included. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of each imaging modality and combinations of modality according to tumor size were obtained, and were compared with the histopathological results of sentinel lymph node biopsy or axillary lymph node dissection. Results: ALNM was confirmed in 32.6% (76/233) of patients. The sensitivity, specificity, PPV, NPV, and accuracy of US for detecting ALNM were 65.8%, 86.6%, 70.4%, 84.0%, and 79.8%, respectively. The sensitivity, specificity, PPV, NPV, and accuracy of CT were 72.4%, 72.6%, 56.1%, 84.4%, and 72.5%, respectively. The sensitivity, specificity, PPV, NPV, and accuracy of PET/CT were 69.7%, 86.0%, 70.7%, 85.4%, and 80.7%, respectively. The combination of US and PET/CT showed the most accurate results with specificity, PPV and accuracy values of 93.6%, 81.5%, and 82.0%, respectively. Conclusion: The diagnostic performance of PET/CT was comparable to that of US and CT. Combination of US and PET/CT could be a reliable strategy for determining preoperative ALNM in patients with operable breast cancer.
김재광(Kim, Jae-Kwang),김경덕(Kim, Kyeong-Deok) 韓國土地公法學會 2010 土地公法硏究 Vol.50 No.-
일본의 토지계획법제의 제정 상황에 있어서는 국토전체의 이용계획이나 종합계획 등에 있어서 우리나라와 유사한 구조를 가지고 있다. 종래부터의 일본의 토지계획법제에 대한 일본 국내의 일반적인 평가를 보면, 일본의 토지계획법제는 도시개발이나 경제발전을 위한 수단으로 개발에 중점을 둔 국가 주도형의 획일적인 법제 시스템을 유지해 왔으므로 지방특성의 활성화와 실제 주민의 삶과는 동떨어진 계획법제라는 등의 비판을 받고 있다.일본은 경제발전기를 시작으로 개발중심의 이념 속에서 중앙집권적인 색채를 강하게 띤 톱다운 식의, 소위 중앙으로부터 지방으로, 전국토에 걸친 광역적인 계획 하에 각종 시책 들을 진행시켜 왔고 이는 곧 토지이용이나 토지계획을 규율하는 각 개별법의 성격을 결정 짓는 요소로 작용하였다. 즉, 일본의 토지이용.계획 법제의 기본적인 특징은 개발지향형 시스템 및 국가 주도형 시스템에 중점이 놓여져 왔다고 할 수 있다. 하지만 최근의 법개정에 있어서는 도시계획법과 경관법 등에서 종래의 토지이용과 계획 법제를 시정하기 위하여 각종 조치를 도입하고 있다. 이는 물론 법제도의 개정이기도 하지만 토지에 대한 이념의 변화를 나타내는 것이기도 하다. 즉 국가 주도형의 일방적인 계획법제의 한계성을 인식하고 각 지방의 의견수렴과 의견형성을 바탕으로 지방으로부터 계획을 형성.책정하고 이를 바탕으로 국토 전반에 대한 균형을 이루어야 한다는 등의 이념이 그 근저에 있다고 볼 수 있다. 또한 지금까지 문제시 되어 왔던 소유권 절대원칙에 입각한 건축자유의 원칙 혹은 개발자유의 원칙과, 경찰행정적인 최소규제원칙 등에 대한 이념의 변화를 나타내는 것이기도 하다. Japan's structure for land plan or comprehensive plan etc. are similar to our countrys' in enacting land planning laws. According to the Japanese domestic general assessment to Japan's land planning section for a long time, Japan's land planning section was maintained uniform legal system driven by nation to focus land development, as a means for urban development and economic development, therefore, it has been criticized for apart from the actual life of residents, local activation and so on. The Japan has kept carrying out various measures under integrated plan - a strong centralized top-down, so-called from center to province - through the nation in the notion of development from the area of economic development. It has affected nature of each law to govern land use or land plan. In other words, the basic features of Japan's land-use and planning laws seem to be focused on development-oriented and government-led system. However, Japan's government has introduced the various measures into recent law-amendment to correct the problems of conventional land use and planning laws, such as urban planning act, landscape act and so on. Of course, this action means not only the revision of the legal system but also a change in idea of land. That is, the philosophy - after recognizing the limitations of state-driven and unilateral planning laws, and then making and enforcing local planning on the basis of forming opinions and gathering opinions in each province, on this, land development must be balanced with the overall - is lying at the bottom. Furthermore, it represents the change of philosophy on the freedom of architecture or development based on absolute ownership principle questioned so far, and the minimum regulatory principle in police administration.