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Long-term Survival Analysis of Bronchioloalveolar Cell Carcinoma (기관세지폐포암의 장기결과분석)

  • Lee Seung Hyun;Kim Yong Hee;Moon Hye Won;Kim Dong Kwan;Kim Jong Wook;Park Seung Il
    • Journal of Chest Surgery
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    • v.39 no.2 s.259
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    • pp.106-110
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    • 2006
  • Background: Bronchioloalveolar carcinoma (BAC) is an uncommon primary malignancy of the lung, and it accounts for $2{\~}14\%$ of all pulmonary malignancies. According to World Health Organization (WHO) categorisation, BAC is a subtype of adenocarcinoma. The current definition of BAC includes the following: malignant neoplasms of the lung that have no evidence of extrathoracic primary adenocarcinoma, an absence of a central bronchogenic source, a peripheral parenchymal location, and neoplastic cells growing along the alveolar septa. Previous reports had demonstrated a better prognosis following surgery for patients affected by BAC than those affected by other type of non-small cell lung cancer (NSCLC). We aim to analyse Asan Medical Center experiences of BAC. Material and Method: Between 1990 and 2002, 31 patients were received operations for BAC. We analyse retrosepectively sex, age, disease location, preoperative clinical stage, postoperative pathologic stage & complications, survival according to medical record. Result: There were 12 men and 19 women, the average age was 61.09$\pm$10.63 ($31{\~}79$) years. Tumor locations were 7 in RUL, 1 in RML, 4 in RLL, 8 in LUL, 11 in LLL. Operations were 28 lobectomies, 2 pneumonectomies. Postoperative pathologic stage were 12 T1N0M0, 15 T2N0M0, 1 T1N1M0, 1 T1N2M0, 1 T2N2M0, 1 T1N0M1. Mortality were 4 cases ($12.9\%$) and there were no early mortality. Cancer free death was 1 cases, other 3 were cancer related deaths. All of them were affected by distal metastasis and received chemotherapy and each metastatic locations were right rib, brain, and both lung field. The average follow up periods were 50.87$\pm$24.77 months. The overall 3, 5-year survival rate among all patients was $97.1\%,\;83.7\%$, stage I patients overall 2, 5year survival rate was $96.3\%$. The overall disease free 1, 2, 5-year survival rate among all patients was $100\%,\;90\%,\;76\%$ and 2, 5-year survival rate in cases of stage I was $96.4\%,\;90.6\%$. 7 cases ($22.58\%$) were chemotherapies, 1 case ($3.22\%$) was radiation therapy, and 2 cases ($6.45\%$) were chemoradiation therapies. Metastatic locations were 3 cases in lung, 1 case in bone, 1 cases in brain. Conclusion: BAC has a favourable survival and low recurrence rate compare with reported other NSCLC after operative resections.

Postoperative Radiation Therapy in the Soft-tissue Sarcoma (연부 조직 육종의 수술 후 방사선 치료 결과)

  • Kim Yeon Shil;Jang Hong Seok;Yoon Sei Chul;Ryu Mi Ryeong;Kay Chul Seung;Chung Su Mi;Kim Hoon Kyo;Kang Yong Koo
    • Radiation Oncology Journal
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    • v.16 no.4
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    • pp.485-495
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    • 1998
  • Purpose : The major goal of the therapy in the soft tissue sarcoma is to control both local and distant tumor. However, the technique of obtaining local control has changed significantly over the past few decades from more aggressive surgery to combined therapy including conservative surgery and radiation and/or chemotherapy. We retrospectively analyzed the treatment results of the postoperative radiation therapy of soft tissue sarcoma and its prognostic factor. Materials and Methods : Between March 1983 and June 1994, 50 patients with soft tissue sarcoma were treated with surgery and postoperative radiation therapy at Kang-Nam St. Mary's hospital. Complete follow up was possible for all patients with median follow up duration 50 months (range 6-162 months). There were 28 male and 32 female patients. Their age ranged from 6 to 83 with a median of 44 years. Extremity (58$\%$) was the most frequent site of occurrence followed by trunk (20$\%$) and head and neck (12$\%$). Histologically malignant fibrous histiocytoma (23$\%$), liposarcoma (17$\%$), malignant schwannoma (12$\%$) constitute 52$\%$ of the patients. Daily radiation therapy designed to treat all areas at a risk for tumor spread upto dose of 4500-5000 cGy. A shrinking field technique was then used and total 55-65 Gy was delivered to tumor bed. Twenty-five patients (42$\%$) received chemotherapy with various regimen in the postoperative period. Results : Total 41 patients failed either with local recurrence or with distant metastasis. There were 29 patients (48$\%$) of local recurrence. Four patients (7$\%$) developed simultaneous local recurrence and distant metastasis and 8 patients (13$\%$) developed only distant metastasis. Local recurrence rate was rather higher than of other reported series. This study included patients of gross residual, recurrent cases after previous operation, trunk and head and neck Primary This feature is likely explanation for the decreased local control rate. Five of 29 Patients who failed only locally were salvaged by re-excision and/or re-irradiation and remained free of disease. Factors affecting local control include histologic type, grade, stage, extent of operation and surgical margin involvement, lymph node metastasis (p<0.05). All 21 patients who failed distantly are dead with progressive disease at the time of this report. Our overall survival results are similar to those of larger series. Actuarial 5 year overall survival and disease free survival were 60.4 $\%$, 30.6$\%$ respectively. Grade, stage (being close association with grade), residual disease (negative margin, microscopic, gross) were significant as a predictor of survival in our series (p<0.05). Conclusion : Combined surgery and postoperative radiation therapy obtained 5 year survival rate comparable to that of radical surgery.

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Radiotherapy in Incompletely Resected Gastric Cancers (불완전 절제된 위암의 방사선 치료)

  • Kim Jong Hoon;Choi Eun Kyung;Cho Jung Gil;Kim Byung Sik;Oh Sung Tae;Kim Dong Kwan;Chang Hyesook
    • Radiation Oncology Journal
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    • v.16 no.1
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    • pp.17-25
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    • 1998
  • Purpose : Although local recurrence rates of stomach cancer after radiocal surgery have been reported in the range of $30-70\%$, the role of postoperative adjuvant therapy has not been established. We report the result of radiotherapy in resected stomach cancer with positive surgical margin to elucidate the role of postoperative radiotherapy. Materials and Methods : From June 1991 to August 1996, twenty five patients with positive surgical margins after radical gastrectomy were treated with postoperative radiotherapy and chemotherapy. Median dose of radiation was 55.8Gy and the range was 44.6-59.4Gy. Second cycle of chemotherapy was delivered concurrently with radiation and total number of six cycles were delivered. Twenty three had adenocarcinoma and the other two had leiornyosarcoma. The numbers of patients with stage I B, II, III A, III B, and IV were 1, 2, 11, 10 and 1 respectively. Positive margins at distal end of the stomach were in 17 patients and proximal in 5. The other three patients had positive margin at the sites of adjacent organ invasion Minimum and median follow-up periods were 12 months and 18 months, respectively, Results : Twenty-four of 25 patients received prescribed radiation dose and RTOG grade 3 toxicity of UGI tract was observed in 3, all of which were weight loss more than $15\%$ of their pretreatment weight. But hematemesis. melena, intestinal obstruction or grade 4 toxicity were not found. Locoregional failure within the radiation field was observed in 7 patients, and distant metastasis in 10 patients. Sites of locoregional recurrences involve anastomosis/remnant stomach in 3, tumor bed/duodenal stump in 3, regional lymph node in 1 patient Peritoneal seeding occurred in 6, liver metastases months and median disease free survival time was 26 months. Stages andradiation dose were not significant prognostic factors for locoregional in 2, and distant nodes in 2 patients. Four year disease specificsurvival rate was $40\%$ and disease free survival was $48\%$. Median survival was 35 failures. Conculsion : Although all patients in this study had positive surgical margins, locoregional failure rate was $28\%$, and 4 year disease specific survival rate was $40\%$. Considering small number of patients and relatively short follow-up period, it is not certain that postoperative radiotherapy lowered locoregional recurrences. but we could find a Possibility of the role of postoperative radiotherapy in Patients with high risk factors.

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The Conceptual Intersection between the Old and the New and the Transformation of the Traditional Knowledge System (신구(新舊) 관념의 교차와 전통 지식 체계의 변용)

  • Lee, Haenghoon
    • The Journal of Korean Philosophical History
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    • no.32
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    • pp.215-249
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    • 2011
  • This essay reflects on the modernity of Korea by examining the transformation of the traditional knowledge system from a historico-semantic perspective with its focus on the opposition and collision of the old and the new conception occurred in the early period(1890~1910) of the acceptance of the Western modern civilization. With scientific success, trick of reason, Christianity and evolutionary view of history, the Western modernity regarded itself as a peak of civilization and forced the non-Western societies into the world system in which they came to be considered as 'barbarism(野蠻)' or 'half-enlightened(半開).' The East Asian civilization, which had its own history for several centuries, became degraded as kind of delusion and old-fashioned customs from which it ought to free itself. The Western civilization presented itself as exemplary future which East Asian people should achieve, while East Asian past traditions came to be conceived as just unnecessary vestiges which it was better to wipe out. It can be said that East Asian modernization was established through the propagation and acceptance of the modern products of the Western civilization rather than through the preservation of its past experience and pursuit of the new at the same time. Accordingly, it is difficult to apply directly to East Asian societies Koselleck's hypothesis; while mapping out his Basic Concept of History, he assumed that, in the so-called 'age of saddle,' semantic struggle over concepts becomes active between the past experience and the horizon of expectation on the future, and concepts undergoes 'temporalization', 'democratization', 'ideologization', 'politicization.'The struggle over the old and new conceptions in Korea was most noticeable in the opposition of the Neo-Confucian scholars of Hwangseongsinmun and the theorists of civilization of Doknipsinmun. The opposition and struggle demanded the change of understanding in every field, but there was difference of opinion over the conception of the past traditional knowledge system. For the theorists of civilization, 'the old(舊)' was not just 'past' and 'old-fashioned' things, but rather an obstacle to the building of new civilization. On the other hand, it contained the possibility of regeneration(新) for the Neo-Confucian scholars; that is, they suggested finding a guide into tomorrow by taking lessons from the past. The traditional knowledge system lost their holy status of learning(聖學) in the process of its change into a 'new learning(新學),' and religion and religious tradition also weakened. The traditional knowledge system could change itself into modern learning by accepting scientific methodology which pursues objectivity and rationality. This transformation of the traditional knowledge system and 'the formation of the new learning from the old learning' was accompanied by the intersection between the old and new conceptions. It is necessary to pay attention to the role played by the concept of Sil(hak)(實學) or Practical Learning in the intersection of the old and new conceptions. Various modern media published before and after the 20th century show clearly the multi-layered development of the old and new conceptions, and it is noticeable that 'Sil(hak)' as conceptual frame of reference contributed to the transformation of the traditional knowledge system into the new learning. Although Silhak often designated, or was even considered equivalent to, the Western learning, Neo-Confucian scholars reinterpreted the concept of 'Silhak' which the theorists of civilization had monopolized until then, and opened the way to change the traditional knowledge system into the new learning. They re-appropriated the concept of Silhak, and enabled it to be invested with values, which were losing their own status due to the overwhelming scientific technology. With Japanese occupation of Korea by force, the attempt to transform the traditional knowledge system independently was obliged to reach its own limit, but its theory of 'making new learning from old one' can be considered to get over both the contradiction of Dondoseogi(東道西器: principle of preserving Eastern philosophy while accepting Western technology) and the de-subjectivity of the theory of civilization. While developing its own logic, the theory of Dongdoseogi was compelled to bring in the contradiction of considering the indivisible(道and 器) as divisible, though it tried to cope with the reality where the principle of morality and that of competition were opposed each other and the ideologies of 'evolution' and 'progress' prevailed. On the other hand, the theory of civilization was not free from the criticism that it brought about a crack in subjectivity due to its internalization of the West, cutting itself off from the traditional knowledge system.

The Recurrence and Survival after Complete Resection of Esophageal Cancer (완전 절제된 식도암의 재발과 생존에 대한 임상적 고찰)

  • 김형수;유정우;김관민;심영목
    • Journal of Chest Surgery
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    • v.36 no.6
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    • pp.411-417
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    • 2003
  • Esophageal cancer is an aggressive disease with a poor prognosis. Recently, neoadjuvant therapy been used in an attempt to increase the long term survival but has not been shown as a clear advantage. We reviewed the recurrence and survival after complete resection of esophageal cancer without neoadjuvant therapy. Material and Method: From December 1994 to December 2001, 182 consecutive patients who underwent intrathoracic esophagectomy, transthoracic esophagogastrostomy and two-field lymph node dissection for esophageal canter without neoadjuvant therapy were studied retrospectively. Result: There were 167 men and 15 women. The median age was 65 years (range, 40 to 90 years). The tumor was located in the upper third part of the esophagus in 7 patients (3.8%), middle third in 86 (47.3%), and lower third in 89 (48.9%). The postsurgical stage were as follows: stage 0 in 2 patients (1.1%), stage I in 32 (17.6%), stageIIA in 47 (25.8%), stage IIB in 25 (13.7%), stage III in 54 (29.7%), stage IVA in 10 (5.5%), and stage IVB in 12 (6.6%). The in-hospital mortality rate was 3.8% (7 patients) and complications occurred in 65 patients (35%), Follow-up was complete in 95.6%. The recurrence occurred in 56 patients (30.8%) and the overall 5-year disease free rate was 55%. The overall 5-year survival rate was 57%; it was 80% for patients in stage I, 65% in stage IIA, 58% in stage IIB, 48% in stage III, and 40% in stage IVB. The overall 5-year survival rate of patients with postoperative adjuvant therapy was 59% compared to 34% in patients without postoperative adjuvant therapy (p<0.05). Conclusion: The most effective therapy for esophageal cancer may be complete resection. More aggressive surgical therapy and adjuvant therapy may improve the long-term survival, even for advanced stage esophageal cancer.

A Comparative Study between Space Law and the Law of the Sea (우주법과 해양법의 비교 연구)

  • Kim, Han-Taek
    • The Korean Journal of Air & Space Law and Policy
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    • v.24 no.2
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    • pp.187-210
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    • 2009
  • Space law(or outer space law) and the law of the sea are branches of international law dealing with activities in geographical ares which do not or do only in part come under national sovereignty. Legal rules pertaining to the outer space and sea began to develop once activities emerged in those areas: amongst others, activities dealing with transportation, research, exploration, defense and exploitation. Naturally the law of the sea developed first, followed, early in the twentieth century, by air law, and later in the century by space law. Obviously the law of the sea, of the air and of outer space influence each other. Ideas have been borrowed from one field and applied to another. This article examines some analogies and differences between the outer space law and the law of the sea, especially from the perspective of the legal status, the exploration and exploitation of the natural resources and environment. As far as the comparisons of the legal status between the outer space and high seas are concerned the two areas are res extra commercium. The latter is res extra commercium based on both the customary international law and treaty, however, the former is different respectively according to the customary law and treaty. Under international customary law, whilst outer space constitutes res extra commercium, celestial bodies are res nullius. However as among contracting States of the 1967 Outer Space Treaty, both outer space and celestial bodies are declared res extra commercium. As for the comparisons of the exploration and exploitation of natural resources between the Moon including other celestial bodies in 1979 Moon Agreement and the deep sea bed in the 1982 United Nations Convention on the Law of the Sea, the both areas are the common heritage of mankind. The latter gives us very systematic models such as International Sea-bed Authority, however, the international regime for the former will be established as the exploitation of the natural resources of the celestial bodies other than the Earth is about to become feasible. Thus Moon Agreement could not impose a moratorium, but would merely permit orderly attempts to establish that such exploitation was in fact feasible and practicable, by allowing experimental beginnings and thereafter pilot operations. As Professor Carl Christol said until the parties of the Moon Agreement were able to put into operation the legal regime for the equitable sharing of benefits, they would remain free to disregard the Common Heritage of Mankind principle. Parties to one or both of the agreements would retain jurisdiction over national space activities. In so far as the comparisons of the protection of the environment between the outer space and sea is concerned the legal instruments for the latter are more systematically developed than the former. In the case of the former there are growing tendencies of concerning the environmental threats arising from space activities these days. There is no separate legal instrument to deal with those problems.

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Role of Music in Therapist - Client Relationship (치료사-내담자 관계에서 음악의 역할에 대한 사례 연구)

  • Rhee, Hye Joo
    • Journal of Music and Human Behavior
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    • v.3 no.2
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    • pp.29-44
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    • 2006
  • Trust and understanding relationship promoted between a therapist and a client is the basic building block to successful recovery. Its importance is not only pertaining to the music therapy but also to counseling and psychological therapy. Because of its gnificance, broad spectrum of research has been conducted for quite a long time. Historically, researches have been focused on therapists or client's chological variables rather than emotional effects on each other that occur during the therapy session. Recently researchers turned their attention to emotional relationship between a therapist and a client. With recent advances in the field of music and psychological therapy, subsequent study has been conducted to investigate the role that music plays in the therapeutic relationship. For this research, eleven music therapy sessions were conducted for the adult females who are alcoholics. The first three sessions were of group therapy. Fourth to eleventh therapy session was done individually. Throughout the research case-by-case study has been conducted on the basis of the analysis of video and audio taped materials. Analysis depends heavily on its reference from the Amir's music research of 1990, which used Ferrara's seven phases of phenomenological study. Especially, verbal and nonverbal communications were closely analyzed in musical perspective. Research revealed that music and musical instruments act as a mediator between a therapist and a client. By doing so, it protects a therapist from unnecessary negative emotional displacements of a client and creates mutual reliability between a therapist and a client. Here, research suggests that music and musical instrument play a central role in building relationship between a therapist and a client, and it indicates that it has positive effect on treatment.

Status and needs of nutrition education for children's sugars intake reduction in elementary school (초등학교 기반 당류 섭취 저감화 영양교육 실태 및 요구도)

  • Kim, Mi-Hyun;Yeon, Jee-Young
    • Journal of Nutrition and Health
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    • v.51 no.5
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    • pp.433-444
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    • 2018
  • Purpose: This study examined the status and needs of school-based nutritional education programs for reducing sugars intake in elementary schools. Methods: A total of 230 elementary nutrition teachers participated in this study through an online survey in July 2017. Results: Approximately one-third of the schools conducted nutrition education on reducing sugars intake as a main topic. The most frequent educated grade and education period were $4^{th}$ and $3^{rd}$ grade, and once a year. Most of the nutrition teachers answered that nutrition education related to reducing sugars intake for children was necessary. The nutrition teachers answered that first graders were the recipients in most need of nutrition education for reducing sugars but, realistically, third graders were the most suitable for nutrition education. The appropriate education topics were limited to the lower grades, such as sugars consumption related health problems, foods containing high sugars, and behaviors to reduce sugars intake; however, a wider variety of topics were selected for the upper grades. The experiment was considered to be an effective educational method for both the lower and upper grades. The most appropriate nutrition education media appeared to be a mock-up in the lower grades, and an experiment kit in the upper grades. Games and videos were highly considered to be effective media to educate students in reducing sugars consumption by voluntary participation in free time in the classroom in both the lower and upper grades. Conclusion: Nutrition education programs focusing on sugars intake reduction were conducted in some elementary schools, but the training time was short and the types of activities were limited. The perception and demand for nutrition education was very high. Therefore, the development and dissemination of elementary school-based nutritional education programs for sugars intake reduction is urgently needed. Moreover, to develop an effective nutrition education program, the education environment and demand in the field should be fully considered.

Effects of Sowing Date on Grain Filling and Related Traits in Winter Barley (파종기 차이가 보리의 등숙과 등숙관련 형질에 미치는 영향)

  • 류용환;이창덕;하용웅
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.37 no.1
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    • pp.93-103
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    • 1992
  • Experiments were conducted in the research field of the Wheat and Barley Research Institute with three barley cultivars, Olbori, Kangbori and Suwon 18, which showed different growth characteristics. The highest rates of daily dry matter accumulation in grains were 1.03 1.94 mg / grain / day in early and optimum sowings and 0.88 1.88 mg / grain / day in late sowings, which occurred around 20~30 days after heading in early and optimum sowings and 15~20 days after heading in late sowings. Grains reached their maximum weight by 40 days after heading in early and optimum sowings and 35 days after heading in late sowings. Total sugar content in grains followed a pattern of linear increase immediately after heading, but it started to decrease around 20 days after heading. On the other hand, starch content continued to increase until maturity. The contents of both components were high in the order of &apos;Olbori&apos; &gt; &apos;Kangbori&apos; &gt; &apos;Suwon 18&apos;, but they did not respond in a regular pattern to different sowings. 1,000 grain weight showed highly significant positive correlation(r=0.767$^{**}$) with the duration of grain growth, but it had negative correlations with the average (r=-0.548$^{**}$) or the sum (r=-0.595$^{**}$) of post-anthesis daily mean temperature.ature.

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Effect of seeding date on growth , dry matter accumulation and chemical composition of sorghum , sudangrass and sorghum-sudangrass Hybrid (파종기 이동이 수수 , 수단그라스 및 수수$\times$수단그라스 교잡종의 생육 , 건물축적 및 성분 함량에 미치는 영향)

  • 한흥전;안수봉
    • Journal of The Korean Society of Grassland and Forage Science
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    • v.5 no.1
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    • pp.62-72
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    • 1985
  • In order to find out the effects of seeding time on growth, dry matter production and nutritive content of Pioneer 931, Pioneer 988 and Piper, this study was carried out on the experimental field of Livestock Experiment Station in 1981-83. Seeding time were 7 with 14-day interval from April 16 to July 9. The results are summarized as follows: 1. It tool about 12 to 13 days from seeding to emergence in case of Mid-April seeding and 7 to 8 days in Late-June. Earlier seeding, more longer growth period from emergence to heading they required. 2. Plant height of Pioneer 931 seeded lately was longer than 4.5 meters in primary growth and Sudangrass was about 2.0 to 2.5 meters. Leaf area was the greatest in Mid-August by early seeding but it was increased until Early-October by late seeding. 3. Sorghum gas brought the highest yield in dry mater and Sudangrass the lowest. In general dry matter yield reduced gradually in response to later seeding but Pioneer 931 has brought more than 10 tons per hecter until Late-June. 4. Relative Growth Rate, Leaf Area Ratio and Leaf Weight of all varieties decreased in accordance with growth development. 5. Crude protein content of leaf was higher than stem and the younger the plants, the more protein they contain. Nitrogen Free Extract was just opposite to crude protein.

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