• 제목/요약/키워드: Advanced age

검색결과 1,495건 처리시간 0.038초

Present Condition of Fortress of Silla Capital and Research Direction on Landscape Architecture (신라왕경 성곽의 현황과 조경학적 차원의 연구방향)

  • Kim, Hyung-Suk;Sim, Woo-Kyung;Lee, Won-Ho;Ahn, Gye-Bog
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • 제33권1호
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    • pp.1-11
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    • 2015
  • Gyeongju, Silla capital, hasn't paid much attention to a value of fortress as advanced frame of landscape all the while. All have done until now were maintaining lots of fortress including Gyeongju and setting night landscape lighting for them or building a trail in mountain fortress. Hereupon, this study tried to take a look at historical and scenic value of fortress, landscape frame of Gyeongju-Silla capital, based on Wolseong and Myeonghwalseong and find the way to contribute to it on landscape architectural level. As Wolseong(月城) and Myeonghwalseong(明活城) functioned as royal palace in Silla Dynasty, they need some research and study on fortress inside in detail rather than restoring them by simply maintaining the shapes. While Wolseong has overall excavation investigation going on, Myeonghwalseong representing mountain fortress area is losing its value due to unbefitting management to a title of world heritage. If conducting close research and study on these remains, it seems like it could contribute a lot to landscape architectural research of Silla royal palace through tracks, which will be used as royal palace. Here I suggest research direction on landscape architectural level about fortress remains in Gyeongju area as followings. Firstly, away from all research focusing on fortress shape, consecration way, etc, we need to conduct a research comprisable of inner space of fortress. As Wolseong and Myeonghwalseong functioned as royal palace in Silla Dynasty, it'll be possible to research about ponds, Nu-Jeong(樓亭), drainage facilities, oddly shaped stones, moundings, pavements, circulation systems, planting traces, etc. For this, we need to research and study through comparison with cases of China, Japan and Goguryeo of the same age. Secondly, applying garden archaeological way is possible to translate objectively regarding research of ancient garden with low literature record. But attainable achievement and information will be limited if implementing excavation based on archaeology as excavations so far regarding excavation investigation of Wolseong. The alternative to such problem is participation plan of landscaping field through the foundation of garden archaeology. We might be able to attain many results on landscape architectural level from research, if conducting research and study about Silla capital including Wolseong by applying garden archaeology such as collection of environmental sample and discovery and analysis of remains through aerial photograph, archaeological research, analysis of historical building, surface exploration, excavation technique, analysis of soil and flowerpot, etc. For this, many people majored in landscape architecture need to try and acquire archaeological knowledge. Also, we need to call attention to internal garden archaeology through international academic symposium by inviting global experts in garden archaeology field. I've suggested the study of location of Wolseong and Silla fortress in Gyeongju area, plan research on using and treating trees about the space in and out of fortress and landscape architectural research direction of Wolseong fortress.

A Study of Family Cohesion on Self-Regulation Ability of the Elderly (노인의 가족결속력이 자기조절능력에 미치는 영향 연구)

  • Jung, Myung-Hee
    • The Journal of Industrial Distribution & Business
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    • 제8권6호
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    • pp.51-60
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    • 2017
  • Purpose - This study aimed to investigate the correlation between the social activity of the elderly and recognition of family cohesion of the elderly who are exposed to the current aging society. In addition, the study has delved into the method of family cohesion improvement through the differences between groups based on the mediator effect of how the results have effects on the elderly's self-control capabilities. Research design, data, and methodology - This study has targeted the elderly who are attending the elderly university among users in seven community centers located in Seoul and Gyeonggi-do area. The study has also conducted a survey by the format of a half-structured questionnaire. It is aiming to investigate the elderly's family cohesion with children and their self-control capability, and understand their satisfaction of social activity to help successful elderly life. The study has suggested the following as mentioned. First, the study analyzed that the perceptual factor of family cohesion with children would be deducted based on advanced researches. Second, the influencing relationship would be analyzed through the relational analysis between the elderly's family cohesion and social activity. Results - The family cohesion with children has a significant effect on psychological happiness and it showed the influencing relationship with improvement of the elderly's self-control capability. Therefore, creating fellowship through meaningful conversation with children would be needed. In addition, various programs and consultant service would be offered to build healthy relationship between aged parents and their children. Through this, the elderly will be able to have not only better relationships with their family, but also increased psychological health and well-being as well. Conclusions - It is needed that not only supporting policies for children who take care of aged parents but also that the elderly who need long-term care could meet their children whenever they want through increased numbers of sanatoriums operated by cities and countries. In addition, the nation would offer financial and administrative support continuously so that people receive the benefits from sanatoriums located in the locality of children's residence beyond the elderly's residence. Moreover, social infra would be established as well.

Clinical Analysis for the Result after Curative Resection of Esophageal Cancer (식도암에서 근치적 절제술 후의 성적에 대한 임상적 고찰)

  • 이재익;노미숙;최필조
    • Journal of Chest Surgery
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    • 제37권4호
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    • pp.356-363
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    • 2004
  • Esophageal cancer is an aggressive disease with a poor prognosis. Recently, every effort has been made to improve the long term survival, but the general prognosis for patients with this disease remains poor. In this study, we reviewed 8 years of experiences with esophageal cancer patients managed in our department at Dong-A University Hospital and evaluated the effectiveness of cervical lymph node dissection performed selectively. Material and Method: From January 1995 to August 2003, 70 patients underwent esophagectomy for esophageal cancer in our department. Among them, 51 patients who underwent curative resection, had no double primary tumors and no neoadjuvant therapy were analyzed retrospectively. In most patients, intrathoracic esophagectomy and cervical esophago-gastrostomy was performed. Since 1997, 3-field lymph node dissection was performed selectively. Result: There were 46 men and 15 women. The median age was 60 years. The tumor was located in the upper third part in 10 patients (19%), middle third in 21 (41%), and lower third in 20 (40%). Majority of the patients (90%) had squamous cell carcinoma. Cervical anastomosis was made in 41 patients, and intrathoracic anastomosis in 10. 2-field lymph node dissection was done in 40 patients, and 3-field lymph node dissection in 11. The pathologic staging were as follows: stage I in 9 patients (17.6%), IIA in 20 (39.2%), IIIB in 7 (13.7%), III in 11 (21.6%), IVA in 2 (3.9%), and IVB in 2 (3.9%). The in-hospital mortality was 3.9% (2 patients) and complications occurred in 24 patients (47%). Overall actuarial 1, 3, and 5-year survival rates were 74.4%, 48.4%, and 48.4% including operative mortality. The 4-year survival rate did not differ significantly between 3-field lymph node dissection group (50.5%) and 2-field lymph node dissection group (48.9%). In 3-field lymph node dissection group, the respiratory complications were more frequent and operative time was significantly longer. Conclusion: We think that curative resection for esophageal cancer can be performed with acceptable mortality, and aggressive surgical approach may improve the long term survival. even for advanced stages. Effectiveness of 3-field lymph node dissection needs further investigations.

The Results of Radiation Therapv for Adenocarcinoma of the Uterine Cervix (자궁경부 선암 환자에 대한 생존율과 실패양상 분석)

  • Lee, Ho-Jun;Kim, Jin-Hee;Kim, Ok-Bae
    • Radiation Oncology Journal
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    • 제17권1호
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    • pp.16-22
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    • 1999
  • Purpose : This study was done to analyze prognostic factors and patterns of failure of patients with histologically confirmed adenocarcinoma of the uterine cervix. Materials and Methods : From June 1988 to December 1990, a retrospective analysis was undertaken for 45 patients who were treated with curative radiation therapy for adenocarcinoma of the uterine cervix at the department of Therapeutic Radiology of Keimyung University Hospital. According to FIGO staging classification, f2 patients were stage Ib, 9 patients were lla, 19 patients were IIB, and 5 patients were lIIb. Median age of the patients was 54 years. The radiation therapy consisted of a combination of external and intracavitary irradiation. Only the pelvis was treated for external irradiation, but 6 patients were treated with extended field irradiation including paraaortic nodes. Intracavitary irradiation was performed with high dose rate sources (Co-60). Neoadiuvant chemotherapy was undertaken for 10 patients. Median and maximum follow-up duration was 64 and 116 months, respectively. Results : The overall 5-year survival rate was 55.2$\%$, and the 5-year survival rates for stage Ib, IIa, IIb, and IIIb were 100$\%$, 50.8$\%$, 46.8$\%$, and 40$\%$ (3-year survival rate), respectively. Of the many clinicopathologic variables evaluated for prognosis, only the stage and the tumor size were significant prognostic factors. Statistically, pelvic failure rates for stage Ib, IIa, IIb, and IIIb were 0$\%$, 33.3$\%$, 57.9$\%$, and 60$\%$, respectively. Distant metastasis rates were 0$\%$, 33.3$\%$, 21.1$\%$, and 40$\%$ for stage Ib, IIa, IIb, and IIIb, respectively. Especially the 6 patients who were irradiated with extended field to treat the paraaortic nodes were free of distant metastasis all. But, 9 patients (23.1$\%$) of the 39 patients who were not irradiated the paraaortic nodes were suffered and expired from uncontrolled distant metastasis. Conclusions : As compared with other studies, the survival rates were similar, but distant metastasis rates including paraaortic nodes metastasis were likely somewhat higher than expected, especially for patients with stage II. So, we think that the effect of prophylactic paraaortic nodes irradiation should be studied prospectively, especially for patients with pelvic nodes involvement or advanced stage of disease.

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Results of Breast Conserving Surgery and Subsequent Postoperative Radiotherapy for Cases of Breast Cancer (유방암에서 유방보존수술 및 수술 후 방사선치료의 결과)

  • Chie, Eui-Kyu;Kim, Kyu-Bo;Choi, Jin-Hwa;Jang, Na-Young;Han, Won-Shik;Noh, Dong-Young;Im, Seock-Ah;Kim, Tae-You;Bang, Yung-Jue;Ha, Sung-Whan
    • Radiation Oncology Journal
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    • 제26권3호
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    • pp.142-148
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    • 2008
  • Purpose: We analyzed the treatment outcomes and prognostic factors of breast conserving surgery, followed by postoperative radiotherapy.Materials and Methods: A total of 424 breast cancer patients treated with breast conserving surgery and postoperative radiotherapy between February 1992 and January 2001 were retrospectively analyzed. A quadrantectomy and axillary lymph node dissection was performed in 396 patients. A total of 302 patients had T1 disease, and 122 patients had T2 disease. Lymph node involvement was confirmed in 107 patients. Whole breast irradiation was administered at up to 50.4 Gy in 28 fractions, followed by a 10 Gy boost in 5 fractions to the tumor bed. In addition, 57 patients underwent regional lymph node irradiation. Moreover, chemotherapy was administered in 231 patients. A regimen consisting of cyclophosphamide, methotrexate, and 5-fluorouracil was most frequently used with 170 patients. The median follow-up time was 64 months. Results: The 5-year local control rate was 95.6%. During the follow-up period, local tumor recurrence was observed in 15 patients. The 5-year overall and disease-free survival rates were 93.1% and 88.7%, respectively. The 5-year overall survival rates, by stage, were 94.8% for stage I, 95.0% for stage IIA, 91.1% for stage IIB, 75.9% for stage IIIA, and 57.1% for stage IIIC. As for disease-free survival, the corresponding figures, by stage (in the same order), were 93.1%, 89.4%, 82.8%, 62.0%, and 28.6%, respectively. The advanced N stage (p=0.0483) was found to be a significant prognostic factor in predicting poor overall survival, while the N stage (p=0.0284) and age at diagnosis (p=0.0001) were associated with disease-free survival. Conclusion: This study has shown that breast conserving surgery and postoperative radiotherapy for early breast cancer results was excellent for local control and survival.

Occurrences and Physicochemical Properties of Japanese Bentonite Deposits (일본 벤토나이트 광상의 부존특성 및 광석의 물리화학적 특성)

  • Song Min-Sub;Koh Sang-Mo;Takagi Tetsuichi
    • Journal of the Mineralogical Society of Korea
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    • 제17권3호
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    • pp.245-265
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    • 2004
  • This study was to compare the geological occurrences and geneses of the Myogi, Tsukinuno, Dobuyama and Kawasaki bentonite deposits distributed in the Tertiary sedimentary basins of NE Japan, and to compare the mineralogical and physicochemical properties of their bentonites. The Japanese bentonite deposits are mainly distributed in the Green-tuff region which was formed in Neogene. The shape of ore body of the Myogi, Tsukinuno and Kawasaki deposits formed by the diagenesis are layered and stratiform. In contrast to this, the Dobuyama deposit formed by hydrothermal alteration shows the cone shape. The mineralization age of four deposits are 1.8 ~ 21 Ha from Early Miocene to Pliocene. The Dobuyama bentonite with the highest montmorillonite content shows the highest surface area, CEC, MB adsorption, and strengths. The Tsukinuno bentonite with a little high montmorillonite content is characterized by strong alkalinity, high viscosity and swelling. The Kawasaki bentonite, the Na-Ca mixed type, shows higher viscosity and swelling than the Ca-type Dobuyama bentonite. The Myogi bentonite with the lowest montmorillonite content shows the properties of low viscosity, In adsorption, strengths and a little high CEC and surface area. The high CEC and surface area of this deposit is due to the sufficient occurrence of zeolite. A strong dispersion in the Na-type bentonite and a strong flocculation in the Ca-type bentonite took place, and both the types show a slow flocculation with time. The physicochemical properties of the bentonite are mainly controlled by the montmorillonite content, interlayer cations, and impurity minerals such as zeolite. But bentonites inconsistent to this factors are sometimes occurred. This is maybe due to the crystal chemistry such as layer charge of montmorillonite and crystal morphology of montmorillonite such as aspect ratio.

Clinical and Bacteriologic Characteristics of Retreated Tuberculosis Patients (재치료 폐결핵환자의 임상적 세균학적 특성)

  • Oh, Seoung-Joon;Yoon, Ki-Heon;Yoo, Jee-Hong;Kang, Hong-Mo
    • Tuberculosis and Respiratory Diseases
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    • 제42권1호
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    • pp.19-24
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    • 1995
  • Background: Although pulmonary tuberculosis is effectively controlled with 6 months or 9 months short course standard regimens, comparable numbers of treatment failures ensued because of inadequate treatment mainly due to patient's poor compliance. Indequate treatment with standard regimens during initial treatment may cause emergence of drug resistance and prolong the duration of chemotherapy. Also it may make the patient lesser compliant and finally increase the morbidity and the mortality. Methods: A clinical study was done to evaluate clinical and bacteriological characteristics of 94 patients who were retreated for pulmonary tuberculosis. Results: 1) 62 of the 94 patients were male and 32 patients were female. Mean age is 51 years old in male and 45 years old in female. 2) The extent of the disease on the chest radiograph was minimal in 10(11.1%) patients, moderate in 31(33.3%) patients, and far advanced in 52(55.6%) patients. 3) On sputum bacteriologic examination, 73(77.7%) patients were positive in sputum AFB smear and/or culture for Mycobacterium tuberculosis. 4) Results of drug sensitivity test performed in 42 patients showed that the resistance to one drug is in 9(20.5%) patients, two drugs in 18(40.8%) patients, and more than three drugs in 14(31.8%) patients. 5) Poor patient's compliance was the leading cause of the retreatment of pulmonary tuberculosis(43.6%) 6) Only 24(25.5%) patients of the 94 retreatment patients were successfully treated and 39(41.6%) patients were dropped out during follow-up. Conclusion: We concluded that poor patient's compliance was the most important cause of treatment failure not only in primary treatment patients but also in retreatment patients. Primary treatment of pulmonary tuberculosis should be completed under strict monitoring of the patient because significant number of retreatment patients had multiple drug resistance and poor outcome.

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Concentration of E-cadherin Correlated with Pathologic Features in Gastric Cancer (위암에서 조직학적 특징에 따른 혈청 E-cadherin의 농도)

  • Hur, Hoon;Song-Gyo-Young;Kim, Jin-Jo;Chin-Hyung-Min;Kim, Wook;Park, Cho-Hyun;Park, Seung-Man;Lim-Keun-Woo;Park, Woo-Bae;Kim, Seung-Nam;Jeon, Hae-Myoung
    • Journal of Gastric Cancer
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    • 제4권3호
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    • pp.156-163
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    • 2004
  • Purpose: While E-cadherin in normal cells induces calciumdependent cell-cell adhesion, in malignant cell, it plays a role in invasion and metastasis with a reduction of adhesion. Serum soluble E-cadherin is a result of the reduction of the cellular E-cadherin molecule and is found in the circulation of normal individuals, but it is particularly known to be increased in patients with malignancies. Accordingly, through checking the level of serum soluble E-cadherin in patients with gastric cancer and analyzing it in the view of clinicopathology, we investigated whether serum soluble E-cadherin could be translated into a clinicopathologic esult and used as a tumor marker. Materials and Methods: The investigation targeted 88 patients who had been diagnosed as having gastric cancer by the Department of Surgery, St. Mary's Hospital, from October 1, 2002, to July 30, 2003, and who had under gone performed surgery. We measured the level of preoperative serum E-cadherin in the 88 patients by unsing ELISA. Among them, we collected gastric cancer tissues from 54 patients and executed immunohistochemistry for E-cadherin. The samples were compared with normal tissues in terms of both serum E-cadherin level and immunohistochemistry level, as well as with other clinicopathologic factors. Result: The mean serum E-cadherin level of the 88 patients was 4368.7 ng/ml and was significantly higher than the level in 12 normal control patients, 3335.5 ng/ml (P=0.016). In terms of clinicopathology, the serum level of E-cadherin was significantly correlated with increasing age (P=0.0006) and was higher in positive venous invasion patients (P=0.0005). When the E-cadherin immunohistochemical stain was compared with the serum E-cadherin level in 54 patients, no significant statistically meaningful result was obtained (P=0.2881). However, 4 patients with serum E-cadherin levels about 6000 ng/ml were classified into the lower expression group ($<80\%$ of E-cadherin immunohistochemicals stain. In the analysis for 36 patients who were early gastric cancer patients, the serum E-cadherin level in lymph-node-metastatic patients was higher than it was in the other patients (P=0.0442). Conclusion: The serum E-cadherin level in gastric cancer patients was higher than the level in normal control patients. In advanced gastric cancer patients, that the difference was increased. Also, since the E-cadherin level correlated with the serum E-cadherin level with venous invasion, it can be used as an effective tumor marker for gastric cancer. Particularly, in that the serum E-cadherin level correlated with lymph node metastasis in early gastic cancer, it can be used when a therapeutic method for early gastric cancer is selected.

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Analysis of Diagnostic Performance of CT and EUS for Clinical TN Staging of Gastric Cancer (위암의 임상적 병기 설정을 위한 전산화단층촬영 및 초음파 내시경의 진단력 평가)

  • Shin, Ru-Mi;Lee, Ju-Hee;Lee, Moon-Soo;Park, Do-Joong;Kim, Hyung-Ho;Yang, Han-Kwang;Lee, Kuhn-Uk
    • Journal of Gastric Cancer
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    • 제9권4호
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    • pp.177-185
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    • 2009
  • Purpose: Preoperative clinical staging of gastric cancer is very important for determining the treatment plans and predicting the prognosis. The previous reports regarding the accuracy of computed tomography or endoscopic ultrasound for the preoperative staging of gastric cancer have shown various outcomes. We analyzed the diagnostic performance of CT and EUS, which are important staging tools for the staging of TN gastric cancer. Materials and Methods: We retrospectively analyzed 1,174 patients who underwent gastrectomy for gastric cancer at Seoul National University Bundang Hostpital from May, 2003 to December, 2007. We derived the Kappa value to examine the agreement of the preoperative staging obtained from CT and EUS with the pathological staging. Results: The mean age of the 1,174 patients was $59.31{\pm}11.98$ years. Six hundred thirty seven patients had early gastric cancer and 536 had advanced gastric cancer. The diagnostic performance between CT and EUS for the T staging showed no significant difference between CT and EUS for the kappa values. The kappa values showed moderate agreement at 0.4039 (P=0.021) and 0.4201 (P=0.026), respectively. This suggests that there is no difference between the two examinations for the overall T staging. Analysis of the discrimination of mucosal and submucosal lesions with EUS showed an accuracy of 58.92% and a Kappa value of 0.206 (P<0.001), suggesting fair agreement and a lower diagnostic performance than expected. To differentiate lesions with stages higher than or equal to T2 or T3 from the lesion with stages lower than T2 or T3, respectively, adoption of the higher stage from the CT staging or the EUS staging showed a larger AUC of 0.84 than that from either stage alone. The CT-derived node stage had the higher diagnostic performance (68.55%) than that of the EUS-derived node stage (60.82%) for the node staging. Conclusion: The CT-derived stage and EUS-derived stage showed comparable results for determining the T stage of gastric cancer. Yet the higher stage of the two stages from CT and EUS most accurately discriminated between those lesions with stages higher than T2 and those lesions with stages lower than T2.

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Docetaxel as Second-line Monotherapy for Advanced Non-small Cell Lung Cancer (진행성 비소세포폐암의 이차항암화학요법으로서 Docetaxel 단독요법의 성적)

  • Kang, Hyun Mo;Lee, Jeong Eun;Jang, Pil Soon;Lee, Yun Sun;Kwon, Sun Jung;An, Jin Young;Jung, Sung Soo;Kim, Ju Ock;Kim, Sun Young
    • Tuberculosis and Respiratory Diseases
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    • 제58권5호
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    • pp.465-472
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    • 2005
  • Background : The survival benefit associated with first-line chemotherapy in lung cancer has led to the need for second-line chemotherapy, for which Docetaxel ($Taxotere^{(R)}$) has proven efficacy in both settings. This study evaluated the safety and efficacy of docetaxel in patients with non-small cell lung cancer who had failed first-line platinum-based chemotherapy. Methods : Thirty one patients with non-small-cell lung cancer, who had failed first-line platinum-based chemotherapy, between March 1999 and August 2003, were enrolled in this study. Patients received intravenous docetaxel, either $75mg/m^2$ or $100mg/m^2$, with routine premedication every three weeks. Results : Fourteen patients (45.2%) had a partial response. The median survival and progression-free survival times were 12.5 months (95% CI 7.3-17.6) and 3.0 months (95% CI 1.6-4.5), respectively. This study showed 2 factors gave different survival benefits; the age (< 60 years: 20.1 months vs. ${\geq}60years$: 6.6 months, p = 0.0105) and the histological type (adenocarcinoma: 25.6 months vs. others: 7.9 months, p=0.0055). The predominant toxicity was neutropenia, which occurred as WHO grade 3 or 4 in 38.7 % of patients. One treatment-related death was also reported. Non-hematological toxicity was minor and easily controlled. There were no significant statistical differences in the survival benefit and toxicity between the two doses. Conclusion : Docetaxel, as second-line monotherapy, was well tolerated and effective in patients with non-small-cell lung cancer who failed first-line platinum-based chemotherapy.