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Recent Trends in Compensation for Mental Anguish of Airline Passengers (항공여객의 정신적 손해배상에 관한 최근 동향 - 미국 연방법원 판례를 중심으로 -)

  • Lee, Chang-Jae
    • The Korean Journal of Air & Space Law and Policy
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    • v.35 no.1
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    • pp.33-62
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    • 2020
  • The current air transportation industry is facing a lot of changes not only in the quantitative growth of the market, but also in the legal aspects. For many years, the Warsaw Convention has contributed to the uniform discipline of civil carriers' legal liabilities arising from international aviation accident and has fulfilled the duties of legal guardians for the development of the air transport industry. In the process, however, the consumer interests of the air transport industry did not have much protection compared to other industries. In response, the Montreal Convention has effected for protecting the interests of aviation consumers, and there are numerous legal changes around the world to protect aviation consumers like passengers. The mental damages of airline passengers arising from the accident can also be understood as part of the protection of air consumers. Considering that the US Federal Court has dealt with the recognition of mental damages for air passengers since the early 1990s. However, Korean judicial precedent still excludes mental anguishes from the scope of damage compensation. From this point of view, it is considered academically meaningful to analyze the latest case of the US federal court. Recently, the United States Court of Appeal for the Sixth Circuit in Doe v Etihad Airways applied a different interpretation against the traditional opinion: passengers could not recover for mental distress unless that mental distress resulted from a bodily injury sustained in an airplane accident. The background of the court's conclusions can be explained in many ways, among other things, unlike the Warsaw Convention the new international rule, Montreal Convention is recognizing the importance of ensuring protection of the interests of consumers in international carriage by air and the need for equitable compensation based on the principle of restitution.

The Clinical Study of Lung Cancer in Patients Younger than 40 Years of Age (약년자 폐암의 임상적 연구)

  • Kim, Geun-Hwa;Park, Hee-Sun;Kim, Myeng-Hoon;Kang, Dong-Won;Lee, Gyu-Seung;Ko, Dong-Seok;Suh, Jae-Chul;Jeong, Seong-Su;Kim, Ju-Ock;Kim, Sun-Young
    • Tuberculosis and Respiratory Diseases
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    • v.48 no.5
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    • pp.748-756
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    • 2000
  • Background : Bronchogenic carcinoma is generally considered as a disease that predominantly affects middleaged and elderly men. A small percentage of patients with lung cancer are diagnosed in the third or fourth decade of life or earlier. The current study was performed to review the clinical characteristics of bronchogenic carcinoma in patients younger than 40 years of age at Chungnam National University Hospital. Method : To determine the clinicopathologic characteristics including survival rates of lung cancer patients younger than 40 years of age and to compare them with those of patients 이der than 40 years of age at diagnosis, data of 905 patients diagnosed as lung cancer from January. 1990 to Marm 1997 were analyzed. Result : Twenty-three of 905 patients(2.5%) belonged to the young age group (less than 40 years). Male to female ratios of young age group and control group were 2.8 : 1 and 5.3 : 1, respectively. The mean duration of symptoms from onset to the definite diagnosis was 3.2 months in the young age group. The most common initial symptoms in the young age group were cough(52.2%) and dyspnea(43.5%). Adenocarcinoma (43.5%) was more frequent in the young age group than in the control group(20.1%). Stage III and IV(70%) tumors were more frequent in the young age group than in the control group(52.3%). Distant metastasis rate of the young age group(56.5%) was higher than that of the control group(22.3%). Conclusion : The predominance of adenocarcinoma, the lower male-female ratio, and the high incidence of advanced stage tumor at diagnosis are the characteristics of lung cancer in patients younger than 40 years of age.

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The Role of Heme Oxygenase-1 in Lung Cancer Cells (폐암세포주에서 Heme Oxygenase-1의 역할)

  • Jung, Jong-Hoon;Kim, Hak-Ryul;Kim, Eun-Jung;Hwang, Ki-Eun;Kim, So-Young;Park, Jung-Hyun;Kim, Hwi-Jung;Yang, Sei-Hoon;Jeong, Eun-Taek
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.3
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    • pp.304-313
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    • 2006
  • Background : Heme oxygenase-1 (HO-1) is an inducible enzyme that catalyzes the oxidative degradation of heme to form biliverdin, carbon monoxide (CO), and free iron. The current evidence has indicated a critical role of HO-1 in cytoprotection and also in other, more diverse biological functions. It is known that the high expression of HO-1 occurs in various tumors, and that HO-1 has an important role in rapid tumor growth because of its antioxidative and antiapoptotic effects. Therefore, the role of HO-1 was analyzed in human lung cancer cell lines, and especially in the A549 cell line. Material and Methods : Human lung cancer cell lines, i.e., A549, NCI-H23, NCI-H157 and NCI-H460, were used for this study. The expression of HO-1 in the untreated state was defined by Western blotting. ZnPP, which is the specific HO inhibitor we used, and the viability of cells were tested for by conducting MTT assaysy. The HO enzymatic activity, as determined via the bilirubin level, was also indirectly measured. Moreover, the generation of intracellular hydrogen peroxide (H2O2) was monitored fluorimetrically with using a scopoletin-horse radish peroxidase (HRP) assay and 2',7'-dichlorofluorescein diacetate (DCFH-DA). We have also transfected small HO-1 interfering RNA (siRNA) into A549 cells, and the apoptotic effects were evaluated by flow cytometric analysis and Western blotting. Results : The A549 cells had a greater expression of HO-1 than the other cell lines, whereas ZnPP significantly decreased the viability of the A549 cells more than the viability of the other lung cancer cells in a dose-dependant fashion. Consistent with the viability, the HO enzymatic activity also was decreased. Moreover, intracellular H2O2 generation via ZnPP was induced in a dose-dependent manner. Apoptotic events were, then induced in the HO-1 siRNA transfected A549 cells. Conclusion : HO-1 provides new important insights into the possible molecular mechanism of the antitumor therapy in lung cancer.

Survery on Business of the Departments of Radiology in Health Centers (보건소(保健所)의 방사선과(放射線科) 업무(業務)에 관한 조사연구(調査硏究))

  • Choi, Jong-Hak;Jeon, Man-Jin;Huh, Joon;Park, Sung-Ock
    • Journal of radiological science and technology
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    • v.8 no.2
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    • pp.21-28
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    • 1985
  • We serveyed the actual condition of business of the departments of radiology of 45 health conters (except 3) in the area of Seoul, Kyungki and Inchon from March, 1984 to November, 1984. The results are summarized as follows : 1. T.O. of the radiologic technologist is three persons in each health center of Seoul area, and one person in each one of Kyungki and Inchon area. P.O. is 2-5 persons in Seoul area, 1-2 persons in Kyungki or Inchon area. 2. The number of all the radiologic technologists employed now is 75 persons, and among all of them, when analized by position class 7th is 54.7%, class 8th 28.0%, class 9th is 13.3%, and class 6th is 2.7%, and by sex, female is 68.0%, male is 32.0%, by educational background, for the most part, junior college graduates come to 73.3%, by age group 60% of them is in their twenties, 16.0% is in their thirties and forties, 8.0% is in their fifties, and by career after certificate 60% have the career of 1-5 years, 13.3% have the one of 6-7 years or mor than 21 years, and 6.7% have the one of 11-15 years of 16-20 years. 3. All the diagnostic x-ray equipment being kept is 62, and among them flxing equipment is 71.0%, portable equipment is 29.0% and by rating of X-ray equipment, maximum tube current 100 mA is 46.8%, maximum KV 100KVP is 72.6%, the most part. 4. Photofluorographic camera and hood are equipped in every health center. While, as to the radiographic cassettes, $14{\times}14"$ cassetts are equipped in every health center, but cassettes of other sizes are in half of them. 5. Bucky's table is equipped in 11.9% health centers, the automatic processor is in 21.4%, the photofluorographic film changer is 9.5%, the grid is 73.8%, the protective apron is in 88.1%, and the protective glove is in 57.1% health centers. 6. The number of the people who got the x-ray examination for one year (by the year 1989) is the most, 1,000-6,000 in direct radiography of the chest, or 15,0001-45,000 in the health centers of Seoul area, 5,000-20,000 in Kyungki and Inchon area in photofluorography of the chest. Moreover, other radiographies are being taken extremely limitedly in all health centers. 7. In processing types of x-ray film, automatic processing is used in 9 health centers (21.4%), manual tank processing is in 30 (71.4%), and manual tray processing in 3 (7.2%). 8. As for collimation of x-ray exposure field, "continual using restricted by a subject size" has the most part, 78.6% "restricted using at every radiography" has 19%, and the case of "never considered" has 2.4% response. 9. As for the dosimeter used for radiation control, film badge (35.7%) and pocket dosimeter (26.2%) are used, and in 38.1% health centers the dosimeter is not equipped at all. Consideration of the previous radiation exposure is being done in only one health center. 10. Reading of radiographs is mainly depended on the radiologists electively (45.2%) or on the genral practitioners(45.2%).

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Histological Comparison of Vascular Grafts in a Pig to Goat Xenotransplantation Model (돼지-염소 이종이식모델에서 냉동 및 무세포화 혈관이식편의 조직학적 비교분석)

  • Yang Ji-Hyuk;Sung Ki-Ick;Kim Won-Geon
    • Journal of Chest Surgery
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    • v.39 no.6 s.263
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    • pp.427-433
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    • 2006
  • Background: Current vascular prostheses are considered still inadequate for reconstruction of small-diameter vessels. To evaluate the potential use of xenograft vessels as small diameter arterial grafts, we implanted porcine vessels in goats. The grafts were treated with two different processes, freezing and acellularization, before implantation, and gross inspection as well as microscopic examination followed after a predetermined period. Material and Method: Bilateral porcine carotid arteries were harvested and immediately stored at $-70^{\circ}C$ within tissue preservation solution. One of them was designated as frozen xenograft vessel. The other one was put on acellularization process using NaCl-SDS solution and stored frozen until further use. Grafts were implanted in the place of carotid arteries of the same goat. The grafts have remained implanted for 1, 3, and 6 months in three animals, respectively. Periodic ultrasonographic examinations were performed during the observation period. After explantation, the grafts were analyzed grossly and histologically under light microscope. Result: All animals survived the experimental procedure without problems. Ultrasonographic examinations showed excellent patency of all the grafts during the observation period. Gross examination revealed nonthrombotic, patent lumens with smooth surfaces. Microscopic examinations of the explanted grafts showed cellular reconstruction at the 6-month stage in both grafts. Although more inflammatory responses were observed in the early phase of frozen xenografts, there was no evidence of significant rejection. Conclusion: These findings suggest that porcine xenograft vessels, regardless of pre-implantation processes of acelluarization or freezing, can be acceptably implanted in goats, although short duration of observation in a small number of animals may limit this study.

Analysis of Prognositic Factors and Long-tenn Survival According to the Pattern of Lymph Node Metastasis in Surgically Resected N2 Non-Small Cell Lung Cancer(NSCLC) (N2 병기의 비소세포성 폐암 수술 후 림프절 전이 양태에 따른 생존율 비교 및 예후 인자 분석)

  • Chung, Kyung-Young;Kim, Si-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.4
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    • pp.474-485
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    • 2000
  • Background : Current studies on multimodal strategy for N2 non-small cell lung cancer are being high interest, have drawn much attention. N2 lung cancer, however, is composed of is divided into several sub groups with that have different prognoses. The prognostic factors still remain controversial. Methods : Between January 1990 and June 1999, 180 patients with N2 lung cancer who underwent surgical resection were investigated, excluding 10 of these for surgical mortality. All patients underwent mediastinal lymph node dissection. 20 clinicopathologic factors were investigated by univariable and multivariable analyses to identify significant prognostic factors among resected N2 disease. Results : The overall 5-year survival rate was 20.6%. Multivariable analyses among overall patients revealed 3 significant prognostic factors : Age, Histologic type, Vascular invasion. Based on the result, 49 patients with both age more than 60 and pathologic Non-squamous cell showed a 5-year survival of 5.0%, whereas 37 patients with neither of the factors showed a 5-year survival of 56.6%(p<0.001). And 12 patients with both vascular invasion and pathologic Non-squamous cell showed a 5-year survival of 11.9%, whereas 67 patients with neither of the factors showed a 5-year survival of 33.6%(p=0.01). Conclusion : The prognosis of surgically resected N2 disease varies according to the 3 significant prognosis factors. Tumor size may be an additional influencing factor in the prognosis of N2 disease.

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Thoracic Nodal Staging in Non-small Cell Lung Cancer by FDG-PET (비소세포폐암의 병기 판정에 있어서 N staging에서의 PET의 역할)

  • Yoo, Ji-Hoon;Kwon, Sung-Youn;Yoo, Chul-Gyu;Lee, Choon-Taek;Kim, Young-Whan;Han, Sung-Koo;Shim, Young-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.3
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    • pp.290-297
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    • 2000
  • Background : Current non-invasive methods for evaluating the mediastinum by computed tomographic (CT) scan have limited sensitivity and specificity. The recently introduced PET was reported to be a more sensitive and specific method for the mediastinal staging of NSCLC (sensitivity : 76-100 %, specificity : 81-100%) than CT or MRI. We assessed the usefulness of PET in the mediastinal staging of NSCLC. Methods : We reviewed the medical records of NSCLC patients that had undertaken staging work-up by both CT and PET before thoracotomy between January 1997 and December 1998. A total of 23 patients were enrolled in the study (14 males and 7 females) with a mean age of 61$\pm$9 years. By comparing the clinical(CT and PET) and pathologic stagings, we evaluated the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of PET in thoracic nodal staging. Results : Sensitivity, specificity, positive predicted value and negative predicted value were 38%, 40%, 25% and 50% respectively for computed tomography, and 50%, 60%, 30% and 69% for PET. The accuracy of FDG-PET in our study was lower than that reported by previous other studies. Conclusion : The addition of FDG-PET to CT scanning has limited benefit for the thoracic nodal staging of NSCLC, but its value in our study was lower than that observed by others.

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Clinical Features of Pulmonary Langerhans Cell Histiocytosis in Korea (국내 폐 랑게르한스세포 조직구증(Pulmonary Langerhans Cell Histiocytosis)의 임상양상)

  • Kim, Chul;Jeong, Sung Hwan;Shim, Jae Jeong;Cha, Seung-Ick;Son, Choonhee;Chung, Man Pyo;Park, Hye Yoon;Kim, Young Whan;Park, Jong Sun;Uh, Soo-Taek;Park, Choon Sik;Kim, Dong Soon;Cho, Kyung Wook;Song, Jin Woo;Jegal, Yang Jin;Park, Moo Suk;Park, Byung Hoon;Lee, Jin Hwa;Hur, Jin Won;Yum, Ho-Kee;Lee, Hong-Lyeol;Park, Yong Bum
    • Tuberculosis and Respiratory Diseases
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    • v.66 no.2
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    • pp.98-103
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    • 2009
  • Background: Pulmonary Langerhans cell histiocytosis (PLCH) is characterized by a proliferation of Langerhans cells and this results in granulomas that involve multiple organs of the body. Because the incidence of PLCH is very low in Korea and worldwide, collecting the clinical data of patients with PLCH nationwide is needed to determine the clinical features of Korean patients with PLCH. Methods: The patients with PLCH confirmed by biopsy at any body site were included and the patients should have lung lesions present. A questionnaire that had items on the symptoms, lung function tests, the roentgenographic findings and the treatment was collected retrospectively at a Korean ILD Research Meeting. Results: A total of 56 cases were collected. The number of males and females was 48 and 8, respectively, and their median age was 43 years (range: 18-67 years). The patients were current or ex-smokers in 79% of the cases. The most frequent symptom was coughing (39%), followed in decreasing order by dyspnea (38%), sputum (20%) and chest pain (20%). Pneumothorax was observed in 16 (29%) patients. Lung function tests showed a normal, restrictive, mixed or obstructive pattern in 26 (61%), 7 (16%), 7 (16%) and 3 patients (7%), respectively. Nodular-cystic lesion was most frequently observed in 59% of the patients on HRCT. The lung lesions were located in the middle and upper lobes in almost the cases. The median follow-up period was 90 months (range: 1-180 months) and only two patients died during this period. Conclusion: This study provides a national survey of the patients with PLCH during a long follow-up period.

Correlation between Expiratory Increase of Lung Attenuation and Age and Smoking in the Subjects with Normal Inspiratory Low Dose CT and Pulmonary Function Test (저선량 흉부전산화단층촬영의 흡기 영상과 폐기능이 정상인 성인에서 호기 말 폐 감쇄도 증가 정도와 연령 및 흡연과의 연관성)

  • Kwon, Sung-Youn;Hwang, Yong-Il;Yoon, Ho-Il;Lee, Jae-Ho;Lee, Choon-Taek;Lee, Kyung Won
    • Tuberculosis and Respiratory Diseases
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    • v.65 no.6
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    • pp.457-463
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    • 2008
  • Background: The attenuation of the lung parenchyma increases on expiration as a consequence of decreased air in the lung. Expiratory CT scans have been used to show air trapping in patients with chronic airway disease and diffuse parenchymal disease and also in asymptomatic smokers. Although there have been several reports investigating the regional air trapping on a expiratory CT scan, there have been only a few reports evaluating the changes of whole lung attenuation with considering its clinical significance, and especially in healthy subjects. The purpose of this study was to evaluate the correlation of an expiratory increase of lung attenuation with age and smoking in healthy subjects. Methods: Asymptomatic subjects who underwent a low dose chest CT scan as part of a routine check-up and who showed normal spirometry and a normal inspiratory CT scan were recruited for this study. We excluded the subjects with significant regional air trapping seen on their expiratory CT scan. Lung attenuation was measured at 24 points of both the inspiratory and expiratory CT scans, respectively, for 100 subjects. The correlations between an expiratory increase of the lung attenuation and the amount of smoking, the patient's age and the results of spirometric test were assessed. Results: There were 87 men and 13 women included in this study. Their median age was 49.0 years old (range:25~71). Sixty current smokers, 24 ex-smokers and 16 non-smokers were included. As age increased, the expiratory increase of lung attenuation was reduced at every measuring points (r=-0.297~-0.487, Pearson correlation). The statistical significance was maintained after controlling for the effect of smoking. Smoking was associated with a reduction of the expiratory increase of lung attenuation. But the significance was reduced after controlling for the patient's age. The $FEV_1$, FVC, $FEV_1/FVC$ and $FEF_{25{\sim}75%}$ were not associated with an expiratory increase of lung attenuation. Conclusion: The expiratory increase of lung attenuation in subjects with a normal inspiratory CT scan was negatively correlated with age. It was also reduced in heavy smokers. It may reflect aging and the smoking related changes.

Association between Socioeconomic Status and Altered Appearance Distress, Body Image, and Quality of Life Among Breast Cancer Patients

  • Chang, Oliver;Choi, Eun-Kyung;Kim, Im-Ryung;Nam, Seok-Jin;Lee, Jeong Eon;Lee, Se Kyung;Im, Young-Hyuck;Park, Yeon Hee;Cho, Juhee
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.20
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    • pp.8607-8612
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    • 2014
  • Background: Breast cancer patients experience a variety of altered appearance - such as loss or disfigurement of breasts, discolored skin, and hair loss - which result in psychological distress that affect their quality of life. This study aims to evaluate the impact of socioeconomic status on the altered appearance distress, body image, and quality of life among Korean breast cancer patients. Materials and Methods: A cross-sectional survey was conducted at advocacy events held at 16 different hospitals in Korea. Subjects were eligible to participate if they were 18 years of age or older, had a histologically confirmed diagnosis of breast cancer, had no evidence of recurrence or metastasis, and had no psychological problems at the time of the survey. Employment status, marital status, education, and income were assessed for patient socioeconomic status. Altered appearance distress was measured using the NCI's cancer treatment side effects scale; body image and quality of life were measured by the EORTC QLC-C30 and BR23. Means and standard deviations of each outcome were compared by socioeconomic status and multivariate linear regression models for evaluating the association between socioeconomic status and altered appearance distress, body image, and quality of life. Results: A total of 126 breast cancer patients participated in the study; the mean age of participants was 47.7 (SD=8.4). Of the total, 83.2% were married, 85.6% received more than high school education, 35.2% were employed, and 41% had more than $3000 in monthly household income. About 46% had mastectomy, and over 30% were receiving either chemotherapy or radiation therapy at the time of the survey. With fully adjusted models, the employed patients had significantly higher altered appearance distress (1.80 vs 1.48; p<0.05) and poorer body image (36.63 vs 51.69; p<0.05) compared to the patients who were unemployed. Higher education (10.58, standard error (SE)=7.63) and family income (12.88, SE=5.08) was positively associated with better body image after adjusting for age, disease stage at diagnosis, current treatment status, and breast surgery type. Similarly, patients who were married and who had higher education had better quality of life were statistically significant in the multivariate models. Conclusions: Socioeconomic status is significantly associated with altered appearance distress, body image, and quality of life in Korean women with breast cancer. Patients who suffer from altered appearance distress or lower body image are much more likely to experience psychosocial, physical, and functional problems than women who do not, therefore health care providers should be aware of the changes and distresses that these breast cancer patients go through and provide specific information and psychosocial support to socioeconomically more vulnerable patients.