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Contribution of Emotional Labor to Burnout and Work Engagement of School Foodservice Employees in Daegu and Gyeongbuk Province (대구·경북 일부지역 학교급식 조리종사자의 감정노동이 직무 소진 및 직무 열의에 미치는 영향)

  • Heo, Chang-Goo;Lee, Kyung-A
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.44 no.4
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    • pp.610-618
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    • 2015
  • The purpose of this study was to analyze differences in emotional labor strategies, burnout, and work engagement according to general characteristics of school foodservice employees as well as verify differential effects of two emotional labor strategies on burnout and work engagement. Our survey was administered to 400 school foodservice employees in Gyeongbuk from March 3 to April 25, 2014. A total of 358 completed questionnaires were returned, and 350 questionnaires were used for final analysis. For verification of mean differences, the mean scores for surface acting, deep acting, burnout, and work engagement were shown to be 2.38/5.00, 3.46, 2.67, and 3.41, respectively. The mean surface acting was significantly different according to cooking certification (P<0.001), turnover number (P<0.001), salary (P<0.001), and school level (P<0.01). The mean deep acting was significantly different according to educational background (P<0.001), cooking certification (P<0.001), employment status (P<0.001), salary (P<0.001), school level (P<0.01), and meal service time (P<0.05). The mean burnout was significantly different according to educational background (P<0.01), cooking certification (P<0.05), employment status (P<0.001), school level (P<0.001), and meal service time (P<0.001). The mean work engagement was significantly different according to cooking certification (P<0.001), employment satus (P<0.001), salary (P<0.001), school level (P<0.01), and meal service time (P<0.05). Verification of causal models found that surface acting and deep acting increased burnout and deep acting, respectively (research model). Additionally, surface acting did not influence work engagement, and deep acting did not influence burnout (alternative models). In other words, we identified that emotional labor strategies have differential influences on burnout and work engagement. Finally, implications and limitations of this study are discussed.

Possibility of Establishing an International Court of Air and Space Law (국제항공우주재판소의 설립 가능성)

  • Kim, Doo-Hwan
    • The Korean Journal of Air & Space Law and Policy
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    • v.24 no.2
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    • pp.139-161
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    • 2009
  • The idea of establishing an International Court of Air and Space Law (hereinafter referred to ICASL) is only my academic and practical opinion as first proposal in the global community. The establishment of the International Court of Air and Space Law can promote the speed and promote fairness of the trial in air and space law cases. The creation of an ICASL would lead to strengthening of the international cooperation deemed essential by the global community towards joint settlement in the transnational air and space cases, claims and would act as a catalyst for the efforts and solution on aircraft, satellite and space shuttle's accidents and cases and all manpower, information, trial and lawsuit to be centrally managed in an independent fashion to the benefit of global community. The aircraft, satellite and spacecraft's accidents attributes to the particular and different features between the road, railway and maritime's accidents. These aircraft, satellite and spacecraft's accidents have incurred many disputes between the victims and the air and space carriers in deciding on the limited or unlimited liability for compensation and the appraisal of damages caused by the aircraft's accidents, terror attack, satellite, space shuttle's accidents and space debris. This International Court of Air and Space Law could hear any claim growing out of both international air and space crash accidents and transnational accidents in which plaintiffs and defendants are from different nations. This alternative would eliminate the lack of uniformity of decisions under the air and space conventions, protocols and agreements. In addition, national courts would no longer have to apply their own choice of law analysis in choosing the applicable liability limits or un-limit for cases that do not fall under the air and space system. Thus, creation of an International Court of Air and Space Law would eliminate any disparity of damage awards among similarly situated passengers and shippers in nonmembers of air and space conventions, protocols, agreements and cases. Furthermore, I would like to explain the main items of the abovementioned Draft for the Convention or Statute of the International Court of Air and Space Law framed in comparison with the Statute of the International Court of Justice, the Statue of the International Tribunal for the Law of the Sea and the Statute of the International Criminal Court. First of all, in order to create the International Court of Air and Space Law, it is necessary for us to legislate a Draft for the Convention on the Establishment of the International Court of Air and Space Law. This Draft for the Convention must include the elected method of judges, term, duty and competence of judge, chambers, jurisdiction, hearing and judgment of the ICASL. The members of the Court shall be elected by the General Assembly and Council of the ICAO and by the General Assembly and Legal Committee of the UNCOPUOS from a list of persons nominated by the national groups in the six continent (the North American, South American, African, Oceania and Asian Continent) and two international organization such as ICAO and UNCOPUOS. The members of the Court shall be elected for nine years and may be re-elected as one time. However, I would like to propose a creation an International Court of Air and Space Law in extending jurisdiction to the International Court of Justice at the Hague to in order to decide the air and space convention‘s cases. My personal opinion is that if an International Court on Air and Space Law will be created in future, it will be settled quickly and reasonably the difficulty and complicated disputes, cases or lawsuit between the wrongdoer and victims and the injured person caused by aircraft, satellite, spacecraft's accidents or hijacker and terrorists etc. on account of deciding the standard of judgment by judges of that’s court. It is indeed a great necessary and desirable for us to make a new Draft for the Convention on a creation of the International Court of Air and Space Law to handle international air and space crash litigation. I shall propose to make a new brief Draft for the Convention on the Creation of an International Court of Air and Space Law in the near future.

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A comparison study of the effects of loratadine-pharmacopuncture and loratadine-oral administration based on traditional Korean medicine theory on anaphylactic reaction in mice

  • Kim, Hyun-Min;Kim, Hyun-Min;Lee, Min-Jung;Cho, Min-Gi;Kang, Deok;Kim, Yu-Kyung;Kim, Changmin;Kang, Do-Hyun;Jeong, Si-Hwa;Ahn, Ik-Gyun;Hwang, Jun-Hyeok;Kim, Jae-Hyun;Lee, Hyun-Jin;Jang, Jun-Yeong;Park, Ho-Jung;Kang, Sin woo;Youm, Jieun;Baek, Seung-won;Kim, Eu Jin;Shin, Moon-Kou;Park, Chan;Son, Chang-Bin;Yim, Tae-Bin;Lim, Jung Hyun;Hong, Sung-eun;Choi, Jun-Hyuk;Kim, Jun-Dong;Yoon, Dong-ju;Lee, Dong-Min;Yu, Soo-Min;Hong, Ye-Im;Lee, Yeong-Seok;Koo, Bon-Cheol;Park, Hyoung-Jun;Uem, Chae-Yoon;Kim, Min-Jeong;Oh, Jayoung;Park, NamGyeong;Kim, Eun-Jong;Cho, Whi-Sung;Lee, Ho-Sung;Kim, Tae-oh;Yoon, Cheol;Kwon, Sung-Keun;Jeong, Dong-Hyeon;Lee, Changwon;Yu, Sang-Yeol;Shon, Chae-won;Jeon, Gyu-Ri;Hong, Yang-Seok;Moon, Phil-Dong
    • CELLMED
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    • v.8 no.1
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    • pp.5.1-5.4
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    • 2018
  • Pharmacopuncture, or herbal acupuncture, is a new form of therapy derived from combinations of two traditional therapeutic methods, herbal medicine and acupuncture therapy. To compare the efficacy between loratadine-pharmacopuncture (LP) and loratadine-oral administration (LO), the effect of loratadine was investigated in murine models. Anti-anaphylactic effects of loratadine treatments were investigated in compound 48/80-induced systemic anaphylactic reaction and passive cutaneous anaphylaxis (PCA). LP treatment significantly inhibited the compound 48/80-induced systemic anaphylactic reaction and PCA. The effect between LP and LO were on a similar level. These results indicate that LP can be used as an alternative method for LO in case of emergency.

Usefulness Evaluation of Open Mouth View when PET/CT scan In Tongue Cancer Patients (Tongue Cancer 환자에서 PET/CT 검사 시 Open Mouth 촬영법의 유용성 평가)

  • Kim, Jae Hwan;Yun, Jong Jun;Jung, Ji Wook;Kim, Jung Wook;Hwang, Ju Won;Ji, Hye In
    • The Korean Journal of Nuclear Medicine Technology
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    • v.20 no.2
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    • pp.14-20
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    • 2016
  • Purpose Tongue cancer is 1.8% of all cancer tumors occur in the tongue, it is known that the high incidence enough to account for 75% of oral cancer conducted a PET / CT examination for early diagnosis, metastasis, staging, etc. and. Tongue when PET / CT scan of a cancer patient and a Torso taken to close mouth lesions if the condition was caused due to the overlapping or corresponding artifacts are not clearly observed. The purpose of this study is to evaluate the changes that occur during PET / CT scan with open mouth and its usefulness under. Materials and Methods From June 2015 to March 2016 complained of herein by May 21 had received a diagnosis of tongue cancer underwent PET / CT scan patients were treated with a target (16 males, 5 female). The first was taken to close mouth Torso state, it was taken to add 1 bed open mouth condition. Tumor (T), measuring the Normal Tongue (NT), Lymph Node (LN) standard intake coefficient by setting a region of interest in the (standardized uptake value, SUV) SUVmean, the average value was measured SUVmax, drawn to each region of interest 3 times and Background (Carotid artery) was out of the SUV. In Chapter 3 of the slice to the tumor clearly visible by setting the region of interest to measure the change Tumor size was calculated average value. Gross Image resolution assessment were analyzed statistically through were divided into 1-5 points by the Radiation 7 people in 2, more than five years worked in specialized nuclear medicine compare to proceed with the blind test nonparametric test (wilcoxon signed rank test). (SPSS ver.18) Results $SUV_{mean}$ T's were in close mouth $5.01{\pm}2.70$ with open mouth $5.48{\pm}2.88$ (P<0.05), $SUV_{max}$ were respectively $8.78{\pm}5.55$ and $9.70{\pm}5.99$ (P<0.05). $SUV_{mean}$ in the NT were respectively $0.43{\pm}0.30$ and $0.34{\pm}0.24$ (P=0.20), $SUV_{max}$ was $0.56{\pm}0.34$ and $0.45{\pm}0.25$ (P=0.204). LN $SUV_{mean}$ were respectively $1.62{\pm}1.43$ and $1.69{\pm}1.49$ (P=0.161), $SUV_{mean}$ was $2.09{\pm}1.88$ and $1.99{\pm}1.74$ (P=0.131). Tumor size change is close mouth $4.96{\pm}4.66cm^2$ $5.33{\pm}4.64cm^2$ with 7.45% increase was (P<0.05), gross image resolution evaluation is $2.87{\pm}0.73$, $3.77{\pm}0.68$ with open mouth examinations 30.5% increase was (P<0.05). Conclusion Tumor SUV on the changes that had an increase in open mouth during inspection, the normal tongue and lymph node, but there was no significant difference in the change slightly. It is also one open mouth PET / CT scan will provide improved image to all patients with tongue cancer, but it could be confirmed that similar overall through the blind test, or tumor size changes and showing a high resolution image. It can be the perfect alternative method for problems that occur when the close mouth Open mouth PET / CT scan, but is believed to be through the open mouth to observe the boundary of overlapping or tumor of the oral cavity other structures a little more clearly. Tongue cancer patients how to recommend that the shooting further open mouth PET / CT.

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Facters Affecting Recurrence after Video-assisted Thoracic Surgery for the Treatment of Spontaneous Pneumothotax (자연기흉에 대한 비디오흉강경수술후 재발에 영향을 미치는 요인들)

  • 이송암;김광택;이일현;백만종;최영호;이인성;김형묵;김학제
    • Journal of Chest Surgery
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    • v.32 no.5
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    • pp.448-455
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    • 1999
  • Background: Recent developments in techniques of video-assisted thoracic surgery(VATS) and endoscopic equipment has expanded the application of video-assisted surgical procedures in the field of thoracic surgery. Especially, it will probably become the treatment of choice of spontaneous pneumothorax(SP). There is, however, a high recurrence rate, high cost, and paucity of long-term results. We report the results of postoperative follow-up and analyze perioperative parameters affected to recurrence, retrospectively. Material and Method: From march 1992 to march 1997, 276 patients with spontaneous pneumothorax underwent 292 VATS procedures. Conversion to open thoracotomy was necessitated in eight patients, and this patients excluded from the study. Result: The sex distribution was 249 males and 31 females. The mean age was 28.1 12.2 years(range, 15 to 69 years). Primary SP was 237cases(83.5%) and secondary SP was 47cases(16.5%). The major underlying lung diseases associated with secondary SP were tuberculosis 27cases(57.4%) and emphysema 8cases (38.3%). Operative indications included Ipsilateral recurrence 123(43.9%), persistent air-leak 53(18.9%), x-ray visible bleb 40(14.3%), tension 30(10.7%), contralateral recurrence 21(7.5%), uncomplicated first episode 8(2.9%), bilateral 3(1.1%), complicated episode 2(0.7%). Blebs were visualized in 247cases(87%) and 244cases(85.9%) performed stapled blebectomy. Early postoperative complications occurred in 33 cases(11.6%): 16 prolonged air-leak more than 5 days(four of them were required a second operation and found missed blebs); 5 bleeding; 5 empyema; 2 atelectasis; 1 wound infection. No deaths occured. The mean operative time was 52.8 23.1 minutes(range, 20 to 165 minutes). The mean d ration of chest tube drainage was 5.0 4.5 days(range, 2 to 37 days). The mean duration ofhospital stay was 8.2 5.5 days (range, 3 to 43days). At a mean follow-up 22.3 18.4 months(range, 1 to 65 months), 12 patients(4.2%) were lost to follow-up. There were 24 recurrences and seven patients underwent second operation and 6 patients(85.7%) were found the missed blebs. 12 perioperative parameters(age, sex, site, underlying disease, extent of collapse, operative indication, size of bleb, number of bleb, location of bleb, bleb management, pleural procedure, prolonged postoperative air-leak) were analyzed statistically to identify significant predictors of recurrence. The significant predictors of recurrence was the underlying disease[17.0%(8/47): 6.8%(16/237), p=0.038], prolonged postoperative air-leakage[37.5%(6/16): 6.7%(18/268), p=0.001], and pleural procedure [11.4%(19/167): 4.3%(5/117), p=0.034]. Blebectomy has less recurrence rate then non-blebectomy [8.2%(20/244) : 10.0%(4/40), p>0. 5]. However, this difference was not statistically significant(p=0.758). Conclusion: We conclude that it is important that we shoud careful finding of bleb during VATS due to reducing of recurrnece, and cases of no bleb identified and secondary spontaneous pneumothorax were indicated of pleurodectomy. VATS is a valid alternative to open procedure for the treatment of spontaneous pneumothorax with less pain, shorter hospital stay, more rapid return to work, high patient acceptance, less scar and exellent cosmetics. But, there is high recurrence rate and high cost, and than it is necessary to evaluate of long-term results for recurrence and to observate carefully during VATS.

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A Study on Commodity Asset Investment Model Based on Machine Learning Technique (기계학습을 활용한 상품자산 투자모델에 관한 연구)

  • Song, Jin Ho;Choi, Heung Sik;Kim, Sun Woong
    • Journal of Intelligence and Information Systems
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    • v.23 no.4
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    • pp.127-146
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    • 2017
  • Services using artificial intelligence have begun to emerge in daily life. Artificial intelligence is applied to products in consumer electronics and communications such as artificial intelligence refrigerators and speakers. In the financial sector, using Kensho's artificial intelligence technology, the process of the stock trading system in Goldman Sachs was improved. For example, two stock traders could handle the work of 600 stock traders and the analytical work for 15 people for 4weeks could be processed in 5 minutes. Especially, big data analysis through machine learning among artificial intelligence fields is actively applied throughout the financial industry. The stock market analysis and investment modeling through machine learning theory are also actively studied. The limits of linearity problem existing in financial time series studies are overcome by using machine learning theory such as artificial intelligence prediction model. The study of quantitative financial data based on the past stock market-related numerical data is widely performed using artificial intelligence to forecast future movements of stock price or indices. Various other studies have been conducted to predict the future direction of the market or the stock price of companies by learning based on a large amount of text data such as various news and comments related to the stock market. Investing on commodity asset, one of alternative assets, is usually used for enhancing the stability and safety of traditional stock and bond asset portfolio. There are relatively few researches on the investment model about commodity asset than mainstream assets like equity and bond. Recently machine learning techniques are widely applied on financial world, especially on stock and bond investment model and it makes better trading model on this field and makes the change on the whole financial area. In this study we made investment model using Support Vector Machine among the machine learning models. There are some researches on commodity asset focusing on the price prediction of the specific commodity but it is hard to find the researches about investment model of commodity as asset allocation using machine learning model. We propose a method of forecasting four major commodity indices, portfolio made of commodity futures, and individual commodity futures, using SVM model. The four major commodity indices are Goldman Sachs Commodity Index(GSCI), Dow Jones UBS Commodity Index(DJUI), Thomson Reuters/Core Commodity CRB Index(TRCI), and Rogers International Commodity Index(RI). We selected each two individual futures among three sectors as energy, agriculture, and metals that are actively traded on CME market and have enough liquidity. They are Crude Oil, Natural Gas, Corn, Wheat, Gold and Silver Futures. We made the equally weighted portfolio with six commodity futures for comparing with other commodity indices. We set the 19 macroeconomic indicators including stock market indices, exports & imports trade data, labor market data, and composite leading indicators as the input data of the model because commodity asset is very closely related with the macroeconomic activities. They are 14 US economic indicators, two Chinese economic indicators and two Korean economic indicators. Data period is from January 1990 to May 2017. We set the former 195 monthly data as training data and the latter 125 monthly data as test data. In this study, we verified that the performance of the equally weighted commodity futures portfolio rebalanced by the SVM model is better than that of other commodity indices. The prediction accuracy of the model for the commodity indices does not exceed 50% regardless of the SVM kernel function. On the other hand, the prediction accuracy of equally weighted commodity futures portfolio is 53%. The prediction accuracy of the individual commodity futures model is better than that of commodity indices model especially in agriculture and metal sectors. The individual commodity futures portfolio excluding the energy sector has outperformed the three sectors covered by individual commodity futures portfolio. In order to verify the validity of the model, it is judged that the analysis results should be similar despite variations in data period. So we also examined the odd numbered year data as training data and the even numbered year data as test data and we confirmed that the analysis results are similar. As a result, when we allocate commodity assets to traditional portfolio composed of stock, bond, and cash, we can get more effective investment performance not by investing commodity indices but by investing commodity futures. Especially we can get better performance by rebalanced commodity futures portfolio designed by SVM model.

A Study on the Expression of CD44s and CD44v6 in Non-Small Cell Lung Carcinomas (비소세포성 폐암종의 CD44s 및 CD44v6의 발현에 대한 연구 -CD44의 발현에 대한 연구-)

  • Chang, Woon-Ha;Oh, Tae-Yun;Kim, Jung-Tae
    • Journal of Chest Surgery
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    • v.39 no.1 s.258
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    • pp.1-11
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    • 2006
  • Background: CD44 is a glycoprotein on the cell surface which is involved in the cell-to-cell and cell-to-matrix interaction. The standard form, CD44s and multiple isoforms are determined by alternative splicing of 10 exons. Recent studies have suggested that CD44 may help invasion and metastasis of various epithelial tumors as well as activation of Iymphocytes and monocytes. The expression pattern of CD44 can be different according to tumor types. The author studied the expression pattern of CD44s and one of its variants, CD44v6 in non-small cell lung carcinomas (NSCLC) to find their implications on clinicopathologic aspects, including the survival of the patients. Material and Method: A total of 89 primary NSCLSs (48 squamous cell carcinomas, 33 adenocarcinomas, and 8 undifferentiated large cell carcinomas) were retrieved during the years between 1985 to 1994. The immunohisto chemistry was done by using monoclonal antibodies and the CD44 expression for angiogenesis was evaluated by counting the number of tumor microvessels. Result: Seventy-one (79.8$\%$) and 64 (71 .9$\%$) among 89 NSCLSs revealed the expression of CD44s and CD44v6, respectively. The expression of CD44s was well correlated with that of CD44v6 (r=0.710, p < 0.0001). The expression of CD44s and CD44v6 was associated with the histopathologic type of the NSCLCs, and squamous cell carcinoma was the type that showed the highest expression of CD44s and CD44v6 (p < 0.0001). Microvessel count was the highest in adenocarcinomas (113.6$\pm$69.7 on 200-fold magnification and 54.8$\pm$41.1 on 400-fold magnification) and correlated with the tumor size of TNM system (r=0.217, p=0.043) and CD44s expression (r=0.218, p=0.040). In adenocarcinoma, the patients with higher CD44s expression survived shorter than those with lower CD44s expression (p=0.0194) but there was no statistical significance on multivariate analysis(p=0.3298). Conclusion: The expression of both CD44s and CD44v6 may be associated with the squamous differentiation in non-small cell lung carcinomas. The relationship of CD44s expression with micro-vessel density of the tumor suggests an involvement of CD44s in tumor angiogenesis, which in turn would help tumor growth.

Policy Direction for The Farmland Sizing Suitable to Regional Trait (지역특성을 반영한 영농규모화사업의 발전방향-충남지역을 중심으로-)

  • Shim, Jae-Sung
    • The Journal of Natural Sciences
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    • v.14 no.1
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    • pp.83-121
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    • 2004
  • This study was carried out to examine how solid the production foundation of rice in Chung-Nam Province is, and, if not, to probe alternative measures through the size of farms specializing in rice, of which direction would be a pivot of rice industry-oriented policy. The results obtained can be summarized as follows : 1. The amount of rice production in Chung-Nam Province is highest in Korea and the size of paddy field area is the second largest : This implying that the probability that rice production in Chung-Nam Province would be severely influenced by a global trend of market conditions. The number of farms specializing in rice becoming the core group of rice farming account for 7.7 percent of the total number of farm household in Korea. Average field area financial support which had been input to farm household by Government had a noticeable effect on the improvement of the policy of farm-size program. 2. Farm-size program in Chung-Nam Province established from 1980 to 2002 in creased the cultivation size of paddy field to 19,484 hectares, and this program enhanced the buying and selling of farmland and the number of farmland bargain reached 6,431 household and 16,517 hectares, respectively, in 1995-2002. Meanwhile, long-term letting and hiring of farmland appeared so active that the bargain acreage reached 6,970 hectares, and farm involved was 7,059 households, however, the farm-exchange-and-unity program did not satisfy our expectation, because the retirement farm operators reluctantly participated to sell their farms. Another reason that had delayed the bargain of farms rested on the general category of social complication attendant upon the exchange and unity operation for scattered farm. Such difficulties would work negative effects out to carry on the target of farm-size work in general. 3. The following measures were presented to propel the farm-size promotion program : a. Occupation shift project, followed by the social security program for retirement and elderly farm operators, should be promptly established and also a number of types of incentives for promoting the letting and hiring work and farm-exchange-and-unity program would also be set up. b. To establish the effective key system of rice production, all the farm operators should increase the unit area yield of rice and lower the production cost. To do so, a great deal of production teams of rice equipped with managerial techniques and capabilities need to be organized. And, also, there should be appropriate arrays of facilities including information system. This plan is desirable to be in line with a diversity of the structural implement of regional integration based on farm system building. c. To extend the size of farm and to improve farm management, we have to devise the enlargement of individual size of farm for maximized management and the utilization of farm-size grouping method. In conclusion, it can be said that the farm-size project in Chung-Nam Province which has continued since the 1980s was satisfactorily achieved. However, we still have a lot of problems to be solved to break down the barrier for attainment of the desirable farm-size operation work.. Farm-size project has fairly close relation with farm specialization in rice and, thus, the positive support for farm household including the integrated program for both retirement farmers and off-farm operators should be considered to pursue the progressive development of the farm-size program, which is key means to successful achievement of rice farming enforcement in Chung-Nam Province.

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Long Term Results of Bronchial Sleeve Resection for Primary Lung Cancer (원발성 폐암 환자에서의 기관지 소매 절제술의 장기 성적)

  • Cho, Suk-Ki;Sung, Ki-Ick;Lee, Cheul;Lee, Jae-Ik;Kim, Joo-Hyun;Kim, Young-Tae;Sung, Sook-Whan
    • Journal of Chest Surgery
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    • v.34 no.12
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    • pp.917-923
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    • 2001
  • Background : Bronchial sleeve resection for centrally located primary lung cancer is a lung-parenchyma-sparing operation in patients whose predicted postoperative lung function is expected to diminished markedly. Because of its potential bronchial anastomotic complications, it is considered to be an alternative to pneumonectomy. However, since sleeve lobectomy yielded survival results equal to at least those of pneumonectomy, as well as better functional results, it became and accepted standard procedure for patients with lung cancer who have anatomically suitable tumors, regardless of lung function. In this study, from analyzing of occurrence rate of postoperative complication and survival rate, we wish to investigate the validity of sleeve resection for primary lung cancer. Material and Method : From January 1989 to December 1998, 45 bronchial sleeve resections were carried out in the Department of Thoracic Surgery of Seoul National University Hospital. We included 40 men and 5 women, whose ages ranged from 23 to 72 years with mean age of 57 years. Histologic type was squamous cell carcinoma in 35 patients, adenocarcinoma in 7, and adenosquamous cell carcinoma in 1 patients. Right upper lobectomy was peformed in 24 patients, left upper lobectomy in 11, left lower lobectomy in 3, right lower lobectomy in 1, right middle lobecomy and right lower lobectomy in 3, right upper lobectomy and right middle lobecomy in 2, and left pneumonectomy in 1 patient. Postoperative stage was Ib in 11, IIa in 3, IIb in 16, IIIa in 13, and IIIb in 2 patients. Result: Postoperative complications were as follows; atelectasis in 9, persistent air leakage for more than 7 days was in 7 patients, prolonged pleural effusion for more than 2 weeks in 7, pneumonia in 2, chylothorax in 1, and disruption of anastomosis in 1. Hospital mortality was in 3 patients. During follow-up period, bronchial stricture at anastomotic site were found in 7 patients under bronchoscopy, Average follow-up duration of survivals(n=42) was 35.5$\pm$29 months. All of stage I patients were survived, and 3 year survival rate of stage II and III patients were 63%, 21%, respectively. According to Nstage, all of N0 patients were survived and 3 year survival rates of Nl and N2 were 63% and 28% respectively. Conclusion: We suggest that this sleeve resection, which is technically demanding, should be considered in patients with centrally located lung cancer, because ttlis lung-saving operation is safer than pneumonectomy and is equally curative.

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High-Dose-Rate Brachytherapy for Uterine Cervical Cancer : The Results of Different Fractionation Regimen (자궁경부암의 고선량률 근접치료 : 분할선량에 따른 결과 비교)

  • Yoon, Won-Sup;Kim, Tae-Hyun;Yang, Dae-Sik;Choi, Myung-Sun;Kim, Chul-Yong
    • Radiation Oncology Journal
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    • v.20 no.3
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    • pp.228-236
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    • 2002
  • Purpose : Although high-dose-rate (HDR) brachytherapy regimens have been practiced with a variety of modalities and various degrees of success, few studies on the subject have been conducted. The purpose of this study was to compare the results of local control and late complication rate according to different HDR brachytherapy fractionation regimens in uterine cervical cancer patients. Methods and Materials : From November 1992 to March 1998, 224 patients with uterine conical cancer were treated with external beam irradiation and HDR brachytherapy. In external pelvic radiation therapy, the radiation dose was $45\~54\;Gy$ (median dose 54 Gy) with daily fraction size 1.8 Gy, five times per week. In HDR brachytherapy, 122 patients (Group A) were treated with three times weekly with 3 Gy to line-A (isodose line of 2 cm radius from source) and 102 patients (Group B) underwent the HDR brachytherapy twice weekly with 4 or 4.5 Gy to line-A after external beam irradiation. Iridium-192 was used as the source of HDR brachytherapy. Late complication was assessed from grade 1 to 5 using the RTOG morbidity grading system. Results : The local control rate (LCR) at 5 years was $80\%$ in group A and $84\%$ in group B (p=0.4523). In the patients treated with radiation therapy alone, LCR at 5 years was $60.9\%$ in group A and $76.9\%$ in group B (p=0.2557). In post-operative radiation therapy patients, LCR at 5 years was $92.6\%$ In group A and $91.6\%$ in group B (p=0.8867). The incidence of late complication was $18\%$ (22 patients) and $29.4\%$ (30 patients), of bladder complication was $9.8\%$ (12 patients) and $14.7\%$ (15 patients), and of rectal complication was $9.8\%$ (12 patients) and $21.6\%$ (22 patients), in group A and B, respectively. Lower fraction sized HDR brachytherapy was associated with decrease in late complication (p=0.0405) (rectal complication, p=0.0147; bladder complication, p=0.115). The same result was observed in postoperative radiation therapy patients (p=0.0860) and radiation only treated patients (0=0.0370). Conclusion : For radiation only treated patients, a greater number of itemized studies on the proper fraction size of HDR brachytherapy, with consideration for stages and prognostic factors, are required. In postoperative radiation therapy, the fraction size of HDR brachytherapy did not have much effect on local control, yet the incidence of late complication increased with the elevation in fraction size. We suggest that HDR brachytherapy three times weekly with 3 Gy could be an alternative method of therapy.