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Study for Clinical Characteristics of Nontuberculous Mycobacterial Pulmonary Diseases (폐 비결핵향산균종의 임상적 특징에 관한 연구)

  • Pae, H.H.;Lee, J.H.;Yoo, C.G.;Lee, C.T.;Chung, H.S.;Kim, Y.W.;Shim, Y.S.;Han, S.K.
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.6
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    • pp.735-746
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    • 1999
  • Background: As the prevalence of nontuberculous mycobacteriosis has been increasing rapidly, there has been recent advance in diagnostic methods and drug therapies for disease. Although the incidence of pulmonary disease caused by nontuberculous mycobacteria(NTM) has been increasing in Korea since 1990, detailed clinical description about the disease were very few. In this study we described the clinical manifestations, radiologic findings, and therapeutic outcomes of nontuberculous mycobacterial pulmonary disease. Methods: Medical records and radiologic findings were retrospectively reviewed in 27 patients who were fulfilled the diagnostic criteria of ATS guideline for NTM pulmonary disease between January of 1990 and August of 1998 in Seoul National University Hospital(SNUH). Results: Of the 27 patients, 15 were male. The mean age was 51.5 yr($\pm$11.9). Twenty patients(74.1%) had preexisting pulmonary diseases. Among them, 19 patients had previous pulmonary tuberculosis. Sixteen patients(59.2%) had cavitary lesions and the majority showed slow progression over 1 yr during follow up period on radiography. Susceptibility test to standard antituberculous drugs showed 100% resistance to INH, 72.2% to RMP, 81.5% to EMB, 92.6% to PZA. The average resistance rate to 2nd-line antituberculous drugs was 66.1%. Among twenty-one patients(77.8%) who received drug therapy over 6 months, 11 subjects were improved and 10 subjects were aggravated. Of six subjects(22.2%) without therapy, 5 patients were aggravated. Presence of cavity and less than 3 sensitive drugs in the regimen were indicators for adverse outcome. Conclusion : The nontuberculous mycobacterial pulmonary diseases in our hospital developed predominantly in older patients with preexistent pulmonary disease. The results of antituberculous drug therapy has been frustrating and disappointing. To improve treatment response, different susceptibility tests and drug regimens for different species of NTM should be performed. Also, diagnostic and therapeutic guidelines of Korea should be made in the recent future.

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Improved Preservation Methods for Big and Old Tress in South Korea (우리 나라의 노거수자원(老巨樹資源) 보호관리실태(保護管理室態) 및 개선방안(改善方案))

  • Park, Chong-Min;Seo, Byun-Soo;Lee, Cheong-Taek
    • Journal of Korean Society of Forest Science
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    • v.89 no.3
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    • pp.440-451
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    • 2000
  • This study was conducted in order to provide essential data and relevant management proposal to conserve and maintain big and old trees in a rational way. For the field survey, 77 big and old trees preserved by the laws in Chollabuk-do, Korea were investigated. The study results are summarized as follows : 1. To conserve and manage big and old trees, the valuable trees have been designated as natural monument trees and protection-needed trees. There are 141 individuals of 37 species designated as natural monuments and 10,049 individuals of 102 species designated as protection-needed trees. 2. Management budget for natural monument trees was devoted at 70% from the national expenditure, but that for protection-needed trees was devoted at 98% from the local expenditure. 3. Standardized sign boards and sign stones for natural monument trees were well placed and other protection facilities such as fences, branch supports and branch holdings were established. On the other hand, management of protection-needed trees was deficient overall. 4. Problems for designation process and management of protection-needed trees could include items such as insufficient management budget, various development activities, land ownership, misjudgement of tree age and species identification, unsatisfaction of sign board placement, insufficient surgery for damaged trees, pavement around tree root system and environmental pollution around the trees. 5. In order to improve the existing management methods of big and old trees, the following schemes were suggested : the development of practical criteria for natural monument and protection-needed trees, nationwide surveys of big and old tree resources, the security of national budget, securing sufficient spaces for the tree growth, specialization of management systems, extended practices of tree form management, establishment of permanent standard signs and consideration of opinions of village residents.

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The Study of Pain and Pain Management of Cancer Patients (악성종양 환자의 통증 및 통증관리에 관한 연구)

  • Yoon Gwi-Ok;Park Hung-Sook
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.3 no.2
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    • pp.299-316
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    • 1996
  • This study is the descriptive survey to provide basic data for nursing intervention to pain management of cancer patients by finding more effective way to manage pain with recognize pain level and pain characteristics. To achieve the purpose of this study, the subjects of this study are 110 male or female gastro intestinal tract patients who are older than twenty, are hospitalized in Pusan University Hospital from 1995. 5. 28 to 1995. 9. 25 and have had medical treatment. The modified pain assessment of cancer patients of Cornne, H. Rosermary, M. was used as the tool of study with 16 questionaries. The pain score consists of sensory intensity score and distress score. The data was analyzed by the SPSS statistical program number, percentage, mean, standard deviation, t-test, One Way Anova and Duncan's Multiple Range Test were utilized for analysis. The results were summarized as follows : 1. In population-sociological characteristics : in the age-range of subject, the sixties are most as 32.7% and the subjects after the forties are 89.5%, in sex of subjects, male patients are 66.4% and female 33.6%, in the number of family, the subjects who has 4 or above families are 70% and the subjects who live with their spouse, sons and daughters are 54.5% 2. In the disease characteristics : stomach cancer patients were most as 39.1%. And the most of patient who had never been operated before. In time of pain, the most of subjects were intermittent. In the type of pain, the most of subjects were 'dully pain' as 31.8%. Metastatic subjects were 30.0%. In the origin of pain, nervous pressure was 50.8%. The number of complication was 46 and most of complication are obstruction as 6%. 3. In the pain level, 91subjects complained pain. And mean pain score was $287.1{\pm}116.1$ The mean pain score of female subjects was higher than that of male subjects. 4. In the pain characteristics, the pain began usually at meal time as 40.7%. The duration of pain was mostly from 1 month to 3 months as 57.1%. The appetite was mainly concerned with the pain as 31.8%. The etiology of pain was usually tumor as 69.3%. The meaning of pain was incurable disease as 14.5%, anxiety, death and suffering. 5. The 56(61%) of 91subjects were treated with Analgesic pain management. The kinds of Analgesic is usually valentac as 46.4%. The medication was usually intramuscle as 66.1% at whenever necessary, Response of Analgesic after Medication was usually 'moderate release'. The side effects of medication were nausea as 26.8%. The average amount of morphine dosage hospitalized to cancer patients with pain was 80mg in a day and metastatic cancer patients with pain was 101.9mg in a day. 6. In the relation between the disease characteristics and pain level, there is a significant statistical difference : whether subjects had been operated or not : (t=2.88, p=0.005), time of pain is(t=3.34, p=0.005), stage of metastatic(F=9.323, P=0.0002), and type of pain(F=4.013, p=0.0008). In the pain level of diagnosis, Colon cancer was $353.3{\pm}81.7$(F=2.34, p=0.049), the origin of pain, nerve pressure $316.3{\pm}98.5$(F=2.44, P=0.045), In the complication, ascites and obstruction $324.9{\pm}96.8$(T=2.60, P=0.04).

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Comparison of Single vs Combined Modality Treatment in Locally Advanced Non-Small Cell Lung Cancer (국소 진행된 비소세포 폐암에서 복합요법과 단일요법의 비교)

  • Kim, Ae-Kyoung;Jeong, Seong-Su;Shin, Kyoung-Sang;Park, Sang-Gee;Jo, Hai-Jeong;Lee, Jong-Jin;Seo, Jee-Won;Kim, Ju-Ock;Kim, Sun-Young
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.4
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    • pp.502-512
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    • 1995
  • Background: One quarter to one third of patients with NSCLC present with primary tumors that although confined to the thorax are too extensive for surgical resection. Until resently standard treatment for these patients had been thoracic radiation, which produces tumor regression in most patients but few cures and dismal 5-year survival rate. The fact that death for most patients with stage III tumors is caused by distant metastases has promped a reevaluation of combined modality treatment approaches that include systemic chemotherapy. Therefore, we report the results observed in a study to evaluate the effect of multimodality treatment in locally advanced non-small cell lung cancer from 1/91 to 8/93 in CNUH. Method: We grouped the patients according to the treatment modalities and evaluated response rate, median survival and the effect of prognostic variables. Among 67 patients evaluated, twenty seven patients classified with group A, received cisplatin and etoposide containing combination chemotherapy alone, eighteen patients, classified with group B, received chemotherapy and radiotherapy, fifteen patients, group C, received neoadjuvant or adjuvant chemotherapy and surgery with/without radiation therapy, seven patients, group D, received only supportive care. Result: The major response rate for group A and B was 37% and 61% respectively. There was no statistically significant difference in response rate between A and B groups(p=0.97). The analysis of prognostic factors showed that differences of age, sex, pathology, blood type, smoking year, stage and ECOG performance did not related to improvement in survival. Median survival time was 8.6 months for group A, 13.4 months for group B, 19.2 months for group C, and 5.4 months for group D, respectively and there was statistically significant difference(p=0.003), suggesting that multimodality therapy was associated with signigicant improvement in survival. Subset survival analysis showed a significant therapeutic effect for earlier stage and good performance state(p=0.007, 0.009, respectively). A possible survival advantages were observed for major response groups. Conclusion: It was suggested that multimodality therapy for the management of patients who had stage III disease, has yielded good median survival and long survival for seleted patients. But, it is necessory to validate above result with further investigation in large scale and in prospective randomized trials.

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Results of Application of Video-Assisted Thoracoscopic Surgery for the Treatment of Empyema Thoracis (흉강경을 이용한 농흉 치료의 결과)

  • Choi, Gi Hoon;Choi, Goang Min;Kim, Hyoung Soo;Cho, Seong Joon;Ryu, Se Min;Ahn, Hee Cheol;Seo, Jeong Yeol
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.5
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    • pp.463-472
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    • 2006
  • Background: Since video-assisted thoracoscopic surgery (VATS) was introduced as a new treatment modality for empyema thoracis, numerous reports have suggested that VATS is a more effective treatment method than the traditional methods that mainly use antibiotics and drainage apparatus. However, no confirmative evidence of the superiority of VATS over the traditional method has been provided yet. Methods: We attempted to evaluate the efficacy of VATS for the treatment of empyema thoracis by reviewing past medical records and simple chest films. First, we divided the patients into two groups based on the treatment method: group A of 15 patients who were treated with the traditional method between January 2001 and December 2003, and group B of 9 patients who were treated with VATS between December 2003 and August 2006. The final outcomes used in this study were the number of days of hospital stay, chest tube duration, leukocytosis duration, febrile duration, and intravenous antibiotics usage duration. In addition, radiological improvements were compared. Results: The mean age(${\pm}$standard deviation) of 11 men and 4 women in group A was $58.2{\pm}15.7$ years, and of 9 men and 2 women in group B was $51.6{\pm}9.5$ years. Group B had a significantly shorter hospital stay ($16.6{\pm}7.4$ vs. $33.7{\pm}22.6$ days; p=0.014), shorter chest tube duration ($10.5{\pm}5.7$ vs. $19.5{\pm}14.4$ days; p=0.039), shorter leukocytosis duration ($6.7{\pm}6.5$ vs. $18.8{\pm}13.2$ days; p=0.008), shorter febrile duration ($0.8{\pm}1.8$ vs. $9.4{\pm}9.2$ days; p=0.004), and shorter duration of intravenous antibiotics usage ($14.9{\pm}6.4$ vs. $25.4{\pm}13.9$ days; p=0.018). However, radiological improvements did not show any statistical differences. Conclusion: Early application of VATS for empyema thoracis treatment reduced hospital stay, thoracostomy tube duration, leukocytosis duration, febrile duration, and antibiotics usage duration in comparison with the traditional methods. The early performing of VATS might be an effective treatment modality for empyema thoracis.

Developing Food List for Risk Assessment of Contaminants in Korean Foods (식품으로부터의 오염물질 섭취량 및 위해도 평가를 위한 대표식품 선정)

  • Lee, Haeng-Shin;Kim, Bok-Hee;Jang, Young-Ai;Park, Seon-Oh;Oh, Chang-Hwan;Kim, Ji-Young;Kim, Hee-Yun;Chung, So-Young;Sho, Yoo-Sub;Suh, Jung-Hyuck;Lee, Eun-Ju;Kim, Cho-Il
    • Korean Journal of Food Science and Technology
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    • v.37 no.4
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    • pp.660-670
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    • 2005
  • Standard procedure for development of food list was established based on food intake data of 2001 National Health and Nutrition Survey and 2002 Seasonal Nutrition Survey for Total Diet Study. Foods were sorted in descending order of mean intake, and 54 items within cumulative percentage of 80 were selected, followed by selection of 16 additional items with consumption frequency of 10% or higher. Based on higher consumption in certain seasons, regions, sexes, and age classes, 14 additional items were added. Additional 17 items with probable high contents of heavy metals or 23 items with probable high pesticide residues were added. Altogether, 101 and 107 individual food items were included for heavy metal and pesticide residue lists, accounting for 84.9 and 83.3% mean energy intakes of Korean population, respectively.

The Origin and Geochemical Behavior of Fluoride in Bedrock Groundwater: A Case Study in Samseung Area (Boeun, Chungbuk) (화강암 지역 암반 지하수 내 불소 이온의 기원 및 거동: 충북 보은 삼승면 일대의 현장 조사와 실내 실험 연구)

  • Chae, Gi-Tak;Koh, Dong-Chan;Choi, Byoung-Young
    • The Journal of Engineering Geology
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    • v.18 no.4
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    • pp.555-566
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    • 2008
  • Hydrogeochemical study in Samseung area (Boeun, Chungbuk) and waterrock interaction experiment using rock samples from the area were performed to elucidate the fluoride source in groundwater and explaining geochemical behavior of fluoride ion. Fluoride concentration of public water supply mostly using groundwater in Boeun area was significantly higher in South Korea. The maximum fluoride concentration of the study area was 3.9 mg/L, and 23% of samples exceeded the Korean Drinking Water Standard of fluoride (1.5 mg/L). The average concentration of fluoride was 1.0 mg/L and median was 0.5 mg/L. Because of high skewness (1.3), median value is more appropriate to represent fluoride level of this area. The relationships between fluoride ion and geochemical parameters ($Na^+$, $HCO_3$, pH, etc.) indicated that the degree of waterrock interaction was not significant. However, high fluoride samples were observed in $NaHCO_3$ type on Piper's diagram. The negative relationship between fluoride and $NO_3$ ion which might originate from surface contaminants was obvious. These results indicate that fluoride ion in groundwater is geogenic origin. The source of fluoride was proved by waterrock interaction batch test. Fluoride concentration increased up to 1.2 mg/L after 96 hours of reaction between water and biotite granite. However, the relationship between well depth and fluoride ion, and groundwater age and fluoride ion was not clear. This indicates that fluoride ion is not correlated with degree of waterrock interaction in this area but local heterogeneity of fluoriderich minerals in granite terrain. High fluoride concentration in Boeun area seems to be correlated with distribution of permeable structures in hard rocks such as lineaments and faults of this area. This entails that the deep bedrock groundwater discharges through the permeable structures and mixed with shallow groundwater.

Effects of Different Nitrogen Levels and Planting Densities on the Quality and Yield of the Black Rice Cultivar 'Shinnongheugchal' (재식밀도 및 시비량 차이가 신농흑찰 품질 및 수량에 미치는 영향)

  • Lee, In-Sok;Lee, Deok-Ryeol;Cho, Seung-Hyun;Lee, Song-Yi;Kim, Kab-Cheol;Lee, Ki-Kwon;Song, Young-Ju
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.61 no.2
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    • pp.79-86
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    • 2016
  • The late-maturing black rice cultivar Shinnongheugchal from Jeollabuk-do Agricultural Research and Extension Service was used as the plant material for estimating growth characters, quality and yield from the vegetation period to harvest age. This study was performed to select an optimum combination of nitrogen level and planting density for the maximum yield of Shinnongheugchal. The plant height, number of tillers, and SPAD index were higher when the combination of 70 hills per $3.3m^2$ and 13 kg/10 a nitrogen level was used at 30 days after transplanting. The heading date for the combination of 70 hills per $3.3m^2$ and 15 kg/10 a nitrogen level, and 80 hills per $3.3m^2$ and 15 kg/10 a nitrogen level was August 22. The heading date for the other combinations was August 21. The combination of 70 hills per $3.3m^2$ and 13 kg/10 a nitrogen level yielded the highest number of tillers at 40 days after flowering. Even though the lodging index was increased with increasing nitrogen levels, field lodging did not occur until harvest time. Seed nitrogen concentration in the combination of 70 hills per $3.3m^2$ and 13 kg/10 a nitrogen level showed a significant difference when compared with the other combinations. The black rice yield varied significantly, and the highest yield was observed in the combination of 70 hills per $3.3m^2$ and 13 kg/10 a nitrogen level. The yield was significantly correlated with seed nitrogen concentration. The maximum yield was estimated to be 14.67 kg/10 a nitrogen level by using the regression equation. On average, the coloring degree of the black rice was higher at planting density of 70 hills per $3.3m^2$ than at 80 hills per $3.3m^2$. The highest yield of perfect black rice was obtained using the combination of 70 hills per $3.3m^2$ and 13 kg/10 a nitrogen level. Our findings demonstrate that a nitrogen level of 13-14 kg/10 a can be used to obtain the maximum yield from Shinnongheugchal with yield, cyanidin 3-glucoside content, and perfect black rice yield as the standard.

The Study for Breast Lymphoscintigraphy of Sentinal Lymph Node in breast cancer (유방암환자 전초림프절의 유방 림프신티그라피에 관한 연구)

  • Kim, Hwa-Gon;Kim, Chang-Soo;Kim, Myung-Jun
    • Journal of radiological science and technology
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    • v.29 no.2
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    • pp.75-81
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    • 2006
  • In the past, most patient of breast cancer suffered side effects due to the useless removement of Axillary Lymph Node, but there is no need to remove it because of the result in this study. The purpose of this study is to save surgery time and side effects after surgical operation for patients with breast cancer by making decisions of operation range for metastasis in first Stenosis Lymph Node using the $^{99m}Tc-Tincolloid$ Scintigraphy and the Micro Probe for radioisotope. As a result of this study, 15 among 20 patients became objects of this study could reduced side effects for operation because there were no axillary lymph node operations. However there is no standard for method of this treatment. It should be standardize where inject point is, how much $^{99m}Tc-Tincolloid$ should be injected(radioactivity value), and the need of massage and Lymph Scintigraphy. Nevertheless I think that this result of study is useful to reduce suffering and side effects from breast cancer and also we should try to do that continuously. The objects for this study were 20 patients diagnosed as breast cancer by Ultrasonography, Mammography & Biopsy. The average of patient age was 45.4 years and its range was between 31 and 71 years. In case of clinical period there were 9 patients of Period I and II patients of Period III. The equipment for this study were $^{99m}Tc-Tincolloid$ describing the Stenosis Lymph Node as a tracer, Micro Probe : Neoprobe 2000(the rest is Gamma Probe) tracing the location, and MS-II Gamma Camera : SIEMENS(the rest is MS-II Gamma Camera) describing the images. There were 3 methods for this study, after selecting one of those methods all 20 patients were performed Stenosis Lymph Node diagnosis & Gamma Probe in operation room. The result was that I imaged all the 20 patients, and seek the Stenosis Lymph Node by using Gamma Probe. Metastasis in Stenosis Lymph Node was 5 and Metastasis in Axillary Lymph Node was 3 between Metastasis in Stenosis Lymph Node cases. Finally 15 patients were also proved that Axillary Lymph Node was Positive and that means there was no Metastasis in Axillary Lymph Node.

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Cause-specific Analysis of Risk Factors in Completely Resected Pathologic Stage Ia Non-small Cell Lung Cancer (병리학적 병기 Ia기 비소세포폐암 환자에서 완전절제술 후 사망의 원인에 따른 위험인자 분석)

  • Park, Seong-Yong;Park, In-Kyu;Byun, Chun-Sung;Lee, Chang-Young;Bae, Mi-Kyung;Kim, Dae-Joon;Chung, Kyung-Young
    • Journal of Chest Surgery
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    • v.42 no.6
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    • pp.725-731
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    • 2009
  • Background: Lobectomy and more extended anatomic resection are regarded as standard treatment for stage Ia non-small cell lung cancer, but approximately 15~40% of patients suffer from treatment failures such as cancer recurrence or death. The authors analyzed types and causes of treatment failures in surgically treated cases of stage Ia non small cell lung cancer. Material and Method: We retrospectively reviewed the medical records of 156 patients who had undergone complete resection for stage Ia NSCLC between Jan 1992 and Aug 2005. Patients were divided into two different treatment failure groups: cancer-related deaths and non-cancer-related deaths. Risk factors were analyzed in each group by the Kaplan-Meyer survival method and the Cox proportional hazard model. Result: Among the 156 patients, 93 were males; the mean age was 61. The median follow-up period was 33.8 months. The 5 year survival rate was 87.6%. Microscopic lympho-vascular permeation was reported in 10 patients. Recurrence was reported in 19 patients and 12 patients died due to recurrent lung cancer. Noncancer related deaths occurred in 16 patients. Risk factors for cancer recurrence and cancer related death were microscopic lympho-vascular permeation (HR=6.81, p=0.007, HR=7.81, p<0.001); for non-cancer related death, risk factors were pneumonectomy (HR=25.92, p=0.001) and postoperative cardiopulmonary complications (HR=29.67, p=0.002). Conclusion: After complete resection of stage Ia non small cell lung cancer patients, mortality includes not only cancer related deaths but also cancer unrelated deaths. Adjuvant chemotherapy is advised for patients who show microscopic lympho-vascular permeation, which is a risk factor for recurrence and for cancer related death. Patients who had pneumonectomy or who suffered from cardiac or respiratory complications need meticulous care in order to reduce comorbidity-induced death.