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정윤선,유정일,박원,최두호 대한암학회 2019 Cancer Research and Treatment Vol.51 No.4
Purpose This first Korean prospective study is to evaluate the feasibility of prone breast radiotherapy after breast conserving surgery for left breast cancer patients who have relatively small breast size and we present dosimetric comparison between prone and supine positions. Materials and Methods Fifty patients underwent two computed tomography (CT) simulations in supine and prone positions. Whole breast, ipsilateral lung, heart, and left-anterior-descending coronary artery were contoured on each simulation CT images. Tangential-fields treatment plan in each position was designed with total 50 Gy in 2-Gy fractions, and then one of the positions was designated for the treatment by comparing target coverage and dose to normal organs. Also, interfractional and intrafractional motion was evaluated using portal images. Results In total 50 patients, 32 cases were decided as prone-position–beneficial group and 18 cases as supine-position–beneficial group based on dosimetric advantage. Target dose homogeneity was comparable, but target conformity in prone position was closer to optimal than in supine position. For both group, prone position significantly increased lung volume. However, heart volume was decreased by prone position for prone-position–beneficial group but was comparable between two positions for supine-position–beneficial group. Lung and heart doses were significantly decreased by prone position for prone-position–beneficial group. However, prone position for supine-position–beneficial group increased heart dose while decreasing lung dose. Prone position showed larger interfractional motion but smaller intra-fractional motion than supine position. Conclusion Prone breast radiotherapy could be beneficial to a subset of small breast patients since it substantially spared normal organs while achieving adequate target coverage.
코다이 음악교육이 음악적 능력과 정의적 행동특성에 미치는 효과
정윤선 한국아동교육학회 1996 아동교육 Vol.5 No.2
This study is find certain difference in musical capability and affective behavior patterns between two groups of students who received traditional music education and Kodaly methodology through empirical analysis. Two hypothesis has been developed to examine certain difference in musiccal capability and affective behavior patterns. Hypothesis I : There is certain difference in musical affective behavior patterns between two groups of students who received traditional music education and Kodaly methodology. Hypothesis II : There is certain difference in musical capability between two groups of students who received traditional music education and Kodaly methodology This study surveyed elementary school students on their perception of affective behavior pattern and musical capability to examine the hypotheses. 120 students of 4th, 5th grade in H elementary school in School were selected as sample. The result of examining the hypotheses is : The examination of the hypotheses shows difference n music education leads to difference in affective behavior pattern about music and musical capability. The results support findings of previous studies, which musical experience of knowledge acquisition or perception development, or developing expression capability, accomponies affective response. The examination shows music education affects affective behavior pattern about music and musical capability. Music education methodology is a decisive factor affecting behavior pattern about music and musical capability. It is very important to choose effective music education metrology to develope positive attitude toward music and musical capability. Kodaly music education me hodology is more effective for facilitating positive attitude toward music and musical capability of elementary school students. The results provide two main points for further studies. First, it is necessary to study relationship among Kodaly music education methodology, musical capability, affective behavior pattern. Second, the provides a clue of how to enhance affective behavior pattern about music and musical capability of elementary school students.
정윤선,신종환,송경준,김한범,홍기정 대한응급의학회 2012 大韓應急醫學會誌 Vol.23 No.4
Purpose: Fitz-Hugh-Curtis syndrome (FHCS) is a perihepatitis associated with pelvic inflammatory disease. Due to difficulty in diagnosis of FHCS on initial evaluation, we developed a reliable scoring system for screening FHCS using clinical variables. Methods: We reviewed the registries of women of childbearing age who presented with upper abdominal pain in an urban emergency department from April 2008 to October 2010. Using multivariate analysis, along with 95%confidence interval (CI), we identified the statistically significant predictor variables that affected the FHCS. Using the results, we developed the scoring system for FHCS. Performances of each score were evaluated using the receiver operating characteristics (ROC) curve. Results: A total of 361 eligible women of childbearing age were enrolled in our study. Fifty patients were diagnosed as FHCS. The significant factors for FHCS were as follows: pain onset for more than two days, history of abortion, unmarried woman, coitus within four weeks, migrating pain, absence of gastrointestinal symptoms, absence of urinary symptoms, and elevation of C-reactive protein. We assigned a score of 1 or 2to each variable using the beta-coefficients. The ROC areas of the scoring system were 0.920. Patients were categorized as low (score 0~4), intermediate (score 5~7), and high (score 8~10) risk groups; 75.0% of high, 18.3% of intermediate, and 1.0% of the low risk group were diagnosed as FHCS. Conclusion: We developed a novel scoring system for screening FHCS of women of child-bearing-age who had presented with upper abdominal pain. Use of this scoring system will allow for easier screening for FHCS in women of child-bearing age.
정윤선,윤홍인,김용배,Seung Kwon Ahn,금기창,서창옥 한국유방암학회 2012 Journal of breast cancer Vol.15 No.3
Purpose: We assessed the risk of radiation pneumonitis (RP) in terms of dosimetric parameters in breast cancer patients, who received radiotherapy using the partially wide tangent technique (PWT), following breast conservation surgery (BCS). Methods: We analyzed the data from 100 breast cancer patients who underwent radiotherapy using PWT. The entire breast, supraclavicular lymph node, and internal mammary lymph node (IMN)were irradiated with 50.4 Gy in 28 fractions. RP was scored on a scale of 0 to 5, based on Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer toxicity criteria. The dosimetric parameters, used in analysis for the ipsilateral lung, were the mean lung dose (MLD), V5 (percentage of lung volume that received a dose of 5 Gy or more)-V50, and normal tissue complication probability (NTCP). Results: Of the 100 patients, three suffered from symptomatic RP (symptom grade ≥2), but were relieved by supportive care. The risk of RP was not correlated with the treatment regimen. RP associated mostly with asymptomatic minimal pulmonary radiologic change or mild dry cough developed more frequently in the group with MLD ≥20.5 Gy or NTCP ≥23% than in the group with MLD <20.5 Gy and NTCP <23% (48.6% vs. 25.4%, p=0.018). Conclusion: Dosimetric parameters of MLD and NTCP were correlated with the incidence of RP, but the clinical impact was minimal. We suggest that PWT is a safe technique for the treatment of IMN for BCS patients with low risk of symptomatic RP.