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The Results of Postoperative Radiation Therapy for Perihilar Cholangiocarcinoma (간문부 담도암에서 수술 후 방사선 치료의 결과)

  • Lee, Yu-Sun;Park, Jae-Won;Park, Jin-Hong;Choi, Eun-Kyung;Ahn, Seung-Do;Lee, Sang-Wook;Song, Si-Yeol;Lee, Sung-Gyu;Hwang, Shin;Lee, Young-Joo;Park, Kwang-Min;Kim, Ki-Hun;Ahn, Chul-Soo;Moon, Deok-Bog;Chang, Heung-Moon;Ryu, Min-Hee;Kim, Tae-Won;Lee, Jae-Lyun;Kim, Jong-Hoon
    • Radiation Oncology Journal
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    • v.27 no.4
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    • pp.181-188
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    • 2009
  • Purpose: The aim of this study was to evaluate the results of postoperative radiotherapy in a case of perihilar cholagiocarcinoma by analyzing overall survival rate, patterns of failure, prognostic factors for overall survival, and toxicity. Materials and Methods: Between January 1998 and March 2008, 38 patients with perihilar cholangiocarcinoma underwent a surgical resection and adjuvant radiotherapy. The median patient age was 59 years (range, 28 to 72 years), which included 23 men and 15 women. The extent of surgery was complete resection in 9 patients, microscopically positive margins in 25 patients, and a subtotal resection in 4 patients. The tumor bed and regional lymphatics initially received 45 Gy or 50 Gy, but was subsequently boosted to a total dose of 59.4 Gy or 60 Gy in incompletely resected patients. The median radiotherapy dose was 59.4 Gy. Concurrent chemotherapy was administered in 30 patients. The median follow-up period was 14 months (range, 6 to 45 months). Results: The 3-year overall survival and 3-year progression free survival rates were 30% and 8%, respectively. The median survival time was 28 months. A multivariate analysis showed that differentiation was the only significant factor for overall survival. The 3-year overall survival was 34% in R0 patients and 20% in R1 patients. No statistically significant differences in survival were found between the 2 groups (p=0.3067). The first site of failure was local in 18 patients (47%). No patient experienced grade 3 or higher acute toxicity and duodenal bleeding developed in 2 patients. Conclusion: Our results suggest that adjuvant RT might be a significant factor in patients with a positive margin following a radical resection. However, there was still a high locoregional recurrence rate following surgery and postoperative radiotherapy. Further study is necessary to enhance the effect of the adjuvant radiotherapy.

Breast Conservation Therapy Versus Mastectomy - Preliminary Results of Pattern of Failure and Survival Rate in Early Breast Cancer (조기유방암에서 유방보존치료와 유방전절제술의 치료결과 및 실패양상 비교)

  • Kim Yeon-Sil;Yoon Sei-Chul;Chung Su-Mi;Ryu Mi-Ryeong;Jung Sang-Sul;Choi Ihl-Bohng
    • Radiation Oncology Journal
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    • v.22 no.2
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    • pp.115-123
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    • 2004
  • Purpose : This retrospective study was conducted to compare early preliminary results of breast conservation therapy (BCT) with mastectomy In early breast cancer. Materials and Methods : We evaluated 171 women with AJCC stage I and II breast cancer who had been treated at Kangnam St. Mary's Hospital from March 1989 to August 1996. Eighty-eight patients underwent mastectomy and 85 patients did conservative surgery with breast irradiation. in the BCT group, all patients received whole breast irradiation to a total dose of 45$\~$50 Gy/5$\~$6 wks, followed by a boost to the original tumor site at least 60 Gy. Chemotherapy was administered to 29 (34.1$\%$) patients in BCT and 40 (45.5$\%$) in mastectomy, with various sequencing of surgery and/or radiation. We compared survival rate, patterns of failure in each treatment group and the prognostic factors that had a significant effect on treatment failure. The median follow-up time was 63 months (19$\~$111 months). Log rank test was used to estimate the prognostic factors for treatment failure. Results : Overall survival, disease free survival, locoregional recurrence and distant metastasis rates were not significantly different between the two treatment groups. During the follow-up period, 11 patients (12.5$\%$)in the mastectomy group and 10 patients (11.8%$\%$ in the BCT group were failed. Six local recurrences occurred after mastectomy and 5 after BCT Five patients fatted at distant site in mastectomy and 4 in BCT. Of the local recurrence cases, five of 6 mastectomy patients and 3 of S BCT patients were alive with no evidence of disease after salvage surgery and/or chemoirradiation. Our results indicated that the major influence on survival was distant metastasis. Unfortunately, control of distant metastasisis was not frequently achieved. Even with salvage systemic therapy or radiotherapy, most of distant metastasis patients died or had uncontrolled disease in both treatment groups: only one of 4 BCT patients and none of mastectomy patients were alive without disease. There was no apparent difference in the incidence rate of contralateral breast cancer and non-breast 2$^{nd}$ primary tumor between the two treatment groups. Univariate Log-rank test identified the N stage and the involved axillary LN number as distinct prognostic factors that were highly predictive of treatment failure in both treatment groups. Additionally, marginal status in BCT and histologic nuclear grade In the mastectomy group were risk factors for treatment fallure (p < 0.05). Concousion : Although further careful follow-up is necessary to confirm the trends evident In this serles, it would appear that patterns of failure and survival rate following conservative surgery and radiotherapy in early breast cancer are similar to those following mastectomy. The great majority of patients with local recurrence had an exellent salvage rate in both treatment groups. Therefore, these preliminary short term results support BCT as an equally effective management for early breast cancer as an alternative to mastectomy.

Preliminary Results of Concurrent Chemotherapy and Radiation Therapy using High-dose-rate Brachytherapy for Cervical Cancer (자궁경부암에 항암화학요법과 동시 병용요법으로 외부 방사선조사와 고선량률 강내조사의 예비적 치료 결과)

  • Lee, Kyung-Ja;Lee, Ji-Hye;Lee, Re-Na;Suh, Hyun-Suk
    • Radiation Oncology Journal
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    • v.24 no.3
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    • pp.171-178
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    • 2006
  • [ $\underline{Purpose}$ ]: To determine the efficacy and safety of concurrent chemotherapy and radiation therapy with high-dose-rate brachytherapy for cervical cancer. $\underline{Materials\;and\;Methods}$: From January 2001 to December 2002, 30 patients with cervical cancer were treated with concurrent chemotherapy (cisplatin and 5-FU) and definitive radiation therapy. The median age was 58 (range $34{\sim}74$) year old. The pathology of the biopsy sections was squamous cell carcinoma in 29 patients and one was adenocarcinoma. The distribution to FIGO staging system was as follows: stage IB, 7 (23%); IIA, 3 (10%); IIB, 12 (40%); IIIA, 3 (10%); IIIB, 5 (17%). All patients received pelvic external beam irradiation (EBRT) to a total dose of $45{\sim}50.4\;Gy$ (median: 50.4 Gy) over $5{\sim}5.5$ weeks. Ir-192 HDR intracavitary brachytherapy (ICBT) was given after a total dose of 41.4 Gy. HDR-ICBT was performed twice a week, with a fraction point A dose of 4 Gy and median dose to point A was 28 Gy (range: $16{\sim}32\;Gy$) in 7 fractions. The median cumulative biologic effective dose (BED) at point A (EBRT+ICBT) was $88\;Gy_{10}$ (range: $77{\sim}94\;Gy_{10}$). The median cumulative BED at ICRU 38 reference point (EBRT+ICBT) was $131\;Gy_3$ (range: $122{\sim}140\;Gy_3$) at point A, $109\;Gy_3$ (range: $88{\sim}125\;Gy_3$) at the rectum and $111\;Gy_3$ (range: $91{\sim}123\;Gy_3$) at the urinary bladder. Cisplatin ($60\;mg/m^2$) and 5-FU ($1,000\;mg/m^2$) was administered intravenously at 3 weeks interval from the first day of radiation for median 5 (range: $2{\sim}6$) cycles. The assessment was performed at 1 month after completion of radiation therapy by clinical examination and CT scan. The median follow-up time was 36 months (range: $8{\sim}50$ months). $\underline{: The complete response rate after concurrent chemoradiation therapy was 93.3%. The 3-yr actuarial pelvic control rate was 87% and 3-yr actuarial overall survival and disease-free survival rate was 93% and 87%, respectively. The local failure rate was 13% and distant metastatic rate was 3.3%. The crude rate of minor hematologic complications (RTOG grade 1-2) occurred in 3 patients (10%) and one patient had suffered from severe leukopenia (RTOG grade 4) during concurrent treatment. Acute minor enterocolitis (RTOG grade 1-2) occurred in 11 patients (37%) and one patient (3%) was suffered from colon perforation during radiation therapy. Late colitis of RTOG grade 1 occurred in 5 patients (15%). Acute cystitis of RTOG grade 1 occurred in 12 patients (40%) and late cystitis of RTOG grade 2 occurred in one patient (3%). No treatment related death was seen. $\underline{Conclusion}$: The results of this study suggest that the concurrent chemoradiation therapy with HDR brachytherapy could be accepted as an effective and safe treatment for cervical cancer.

The Results of Curative Radiotherapy for the Uterine Cervical Cancer (자궁경부암의 근치적 방사선치료 성적)

  • Kim, Hyoung-Jin;Kim, Jung-Soo;Kwon, Hyoung-Cheol;Kim, Jin-Kee;Oh, Byung-Chan
    • Radiation Oncology Journal
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    • v.14 no.3
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    • pp.191-199
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    • 1996
  • Purpose : To evaluate 5-year survival rate, patterns of failure and complications of cervical cancer treatment, fifty nine patients treated by curative radiotherapy for the uterine cervical cancer were analyzed retrospectively. Materials and Methods : From March 1986 to May 1990, fifty nine patients with histologically proven uterine cervical cancer were analyzed. According to FIGO stage, there were 2 patients ($3.4\%$) in stage Ib, 2 patients ($3.4\%$) in stage IIa, 31 patients ($52.5\%$) in stage IIb, 15 patients ($25.4\%$) in stage IIIb, 9 patients ($15.3\%$) in stage IV. External RT was per formed by 6 MVLINAC with daily 1.8 Gy, 5 times per week and followed by ICR. A point dose of ICR was calculated to 30-43.66 Gy (median: 34.6 Gy). These techniques delivered total A Point dose of 80.4 to 109.8 Gy (median: 85 Gy). Patients had been followed up from 2 to 110 months (median: 61 months) Results : The overall 5-year survival rate & disease free survival rate were $55.9\%$ and $55.0\%$ respectively. According to FIGO stage, the 5-year survival rate for less than IIa, IIb, IIIb, IV were $75.0\%$, $74.8\%$, $26.7\%$, $33.3\%$, respectively. In univariate analysis, the 5-year survival rate for stage IIb and below versus stage IIIa and above revealed $74.8\%$, $29.2\%$ respectively (P<0.005). According to the hemoglobin level during RT, the 5-rear survival rate of was $73.3\%$ for patients with Hg 10 gm/dL or higher, in contrast to $0\%$ for those with lower than 10 gm/dL (p<0.005). In 18 patients with nonbulky tumor (<5cm), the 5-year survival rates were $71.8\%$. The 5-rear survival rates for 18 patients with 5 cm or greater in tumor diameter were $22.2\%$ (p<0.005). The 5-year survival rate for Patient age of above 50 years and below were $65.3\%$ $34.2\%$ respectively (p<0.05). ECOG performance status. pathologic finding, total dose, total treatment time were not statistically significant factors. The significant prognostic factors affecting overall 5-year survival rate by multivariate analysis showed the hemoglobin level during RT (P=0.0001), tumor size (p=0.0390), FIGO stage (p=0.0468). Total recurrence rate was $23.7\%$ local failure $15.2\%$ (9/59), distant metastasis $6.8\%$ (4/59), local and distant metastasis $1.7\%$ (1/59). According to the RTOG/EORTC Soma Scales, the late complication rate was $23.8\%$ (14/59) The late complication rate of colorectum and genitourinary tract were $15.3\%$ (9/59), $8.5\%$ (5/59), respectively: 10 patients ($17.0\%$) were grade 2, 3 Patients ($5.1\%$) were grade 3 and one patient ($1.7\%$) was grade 4. The late complications were radiation proctitis, rectal bleeding, radiation colitis, diarrhea and radiation cystitis in decreasing order. Conclusion : For improvement of therapeutic results, prospective randomized trials are recomended to discover new prognostic factors and more aggressive radiation therapeutic methods are needed for poor prognostic patients. The adjuvant chemotherapy or radiation-sensitizing agents must be considered to inhibit regional and distant metastasis.

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The Results of Hyperfractionated Radiotherapy on Locally Advanced Non-Small Cell Lung Cancer (국소적으로 진행된 비소세포 폐암에 대한 과분할 방사선 치료의 성적)

  • Hur, Won-Joo;Lee, Hyung-Sik;Kim, Jeong-Ki;Choi, Young-Min;Lee, Ho-Jun;Youn-Seon-Min;Kim, Jae-seok;Kim, Hyo-Jin;Woo-Jong-Soo;Choi, Pill-Jo;Lee, Ki-Nam
    • Radiation Oncology Journal
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    • v.16 no.3
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    • pp.275-282
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    • 1998
  • Purpose : The effect of hyperfractionated radiotherapy on locally advanced non-small lung cancer was studied by a retrospective analysis. Materials & Methods : We analyzed sixty one patients of biopsy-confirmed, IIIA and IIIB non-small cell lung cancer. Using the ECOG performance scale, all the patients were scored less than 2. They were treated by curative hyperfractionated radiotherapy alone from Oct. 1992 to Oct. 1995 at the Department of Radiation Oncology. All the patients received 120cGy b.i.d with more than 6 hours interval between each fraction. The total dose of radiation was reached up to 6400-7080 cGy with a mean dose of 6934 cGy. The results were analyzed retrospectively. Results : The overall survival rate was 53 1$\%$ in 1 year, 9.9$\%$ in 2 years with a median survival time (MST) of 13.9 months. The progression free survival (PFS) rate was 37.0$\%$ in 1 year, 8.9$\%$ in 2 years. Twenty two Patients were classified as complete responders to this treatment and their MST was 19.5 months When this was compared with that of partial responders (MST: 11 7months), it was statistically significant (p=0.0003). Twenty nine patients of stage IIIA showed a better overall survival rate (1yr 63.3$\%$, 2yr 16.8$\%$) than IIIB patients (1yr 43.3$\%$, 2yr 3.6$\%$), which was also statistically significant (p=0.003). Patients with adenocarcinoma showed a better survival rate (1yr 64.3$\%$, 2yr 21.4$\%$) than that of squamous cell counterpart (1yr 49.4$\%$, 2yr 7.4$\%$), although this was not significant statistically (p=0.61). Two patients developed fatal radiation-induced pneumonia right after the completion of the treatment which progressed rapidly and they all died within 2 months. One patient developed radiation-induced fibrosis after 13 months. He refused further treatment and died soon after the development of fibrosis. Conclusion : Among locally advanced NSCLC, hyperfractionated radiotherapy was effective on stage IIIA patients by increasing MST with acceptable toxicities. Acute radiation-induced pneumonia should be carefully monitored and must be avoided during or after this treatment.

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Translocation of Tolclofos-methyl from Ginseng Cultivated Soil to Ginseng (Panax ginseng C. A. Meyer) and Residue Analysis of Various Pesticides in Ginseng and Soil (토양 중 잔류된 Tolclofos-methyl의 인삼(Panax ginseng C. A. Meyer)에 대한 이행 및 잔류 특성)

  • Kim, Ji Yoon;Kim, Hea Na;Saravanan, Manoharan;Heo, Seong Jin;Jeong, Haet Nim;Kim, Jang Eok;Kim, Kwan Rae;Hur, Jang Hyun
    • The Korean Journal of Pesticide Science
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    • v.18 no.3
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    • pp.130-140
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    • 2014
  • Recently, some of the previous studies reported that tolclofos-methyl is still exist in ginseng cultivated soil, even though it is has been banned for ginseng. Therefore, the current study was aimed to examine the levels of absorption and translocation of tolclofos-methyl from ginseng cultivated soil to ginseng root and leaf stem for the period of 1 year. For this study, ginseng plants were transplanted in pots and treated with $5.0mg\;kg^{-1}$ of tolclofos-methyl (50% WP). At the end of each interval periods (every three months) the samples (soil, roots and leaf stems) were collected and analyzed the absorption and translocation levels of tolclofos-methyl using gas chromatography and mass spectrometry (GC-MS). The limit of quantitation of tolclofos-methyl was found to be $0.02mg\;kg^{-1}$ and 70.0~120.0% recovery was obtained with coefficient of variation of less than 10% regardless of sample types. In this study, a considerable amount of translocation of tolclofos-methyl residues were found in soil (4.28 to $0.06mg\;kg^{-1}$), root (7.09 to $1.54mg\;kg^{-1}$) and leaf stem (0.79 to $0.69mg\;kg^{-1}$). The results show that the tolclofos-methyl was absorbted and translocated from ginseng cultivated soil to ginseng root and ginseng leaf stem and found to be decreased time-coursely. Secondly, we were also analyzed soil, root and leaf stems samples from Hongcheon, Cheorwon, Punggi and Geumsan by GC-MS/MS (172 pesticides), LC-MS/MS (74 pesticides). In this study, 43 different pesticides were detected ($0.01{\sim}7.56mg\;kg^{-1}$) in soil, root and leaf stem. Further, tolclofos-methyl was detected 4 times separately in root sample alone which is less ($0.01{\sim}0.05mg\;kg^{-1}$) than their maximum residual limit (MRL) in ginseng. Consequently, the results from both studies indicate the residues of tolclofos-methyl found in ginseng cultivated soil and ginseng ensuring their safety level. Moreover, long-term evaluations are needed in order to protect the soil as well as ginseng free from tolclofos-methyl residues.

Design of Client-Server Model For Effective Processing and Utilization of Bigdata (빅데이터의 효과적인 처리 및 활용을 위한 클라이언트-서버 모델 설계)

  • Park, Dae Seo;Kim, Hwa Jong
    • Journal of Intelligence and Information Systems
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    • v.22 no.4
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    • pp.109-122
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    • 2016
  • Recently, big data analysis has developed into a field of interest to individuals and non-experts as well as companies and professionals. Accordingly, it is utilized for marketing and social problem solving by analyzing the data currently opened or collected directly. In Korea, various companies and individuals are challenging big data analysis, but it is difficult from the initial stage of analysis due to limitation of big data disclosure and collection difficulties. Nowadays, the system improvement for big data activation and big data disclosure services are variously carried out in Korea and abroad, and services for opening public data such as domestic government 3.0 (data.go.kr) are mainly implemented. In addition to the efforts made by the government, services that share data held by corporations or individuals are running, but it is difficult to find useful data because of the lack of shared data. In addition, big data traffic problems can occur because it is necessary to download and examine the entire data in order to grasp the attributes and simple information about the shared data. Therefore, We need for a new system for big data processing and utilization. First, big data pre-analysis technology is needed as a way to solve big data sharing problem. Pre-analysis is a concept proposed in this paper in order to solve the problem of sharing big data, and it means to provide users with the results generated by pre-analyzing the data in advance. Through preliminary analysis, it is possible to improve the usability of big data by providing information that can grasp the properties and characteristics of big data when the data user searches for big data. In addition, by sharing the summary data or sample data generated through the pre-analysis, it is possible to solve the security problem that may occur when the original data is disclosed, thereby enabling the big data sharing between the data provider and the data user. Second, it is necessary to quickly generate appropriate preprocessing results according to the level of disclosure or network status of raw data and to provide the results to users through big data distribution processing using spark. Third, in order to solve the problem of big traffic, the system monitors the traffic of the network in real time. When preprocessing the data requested by the user, preprocessing to a size available in the current network and transmitting it to the user is required so that no big traffic occurs. In this paper, we present various data sizes according to the level of disclosure through pre - analysis. This method is expected to show a low traffic volume when compared with the conventional method of sharing only raw data in a large number of systems. In this paper, we describe how to solve problems that occur when big data is released and used, and to help facilitate sharing and analysis. The client-server model uses SPARK for fast analysis and processing of user requests. Server Agent and a Client Agent, each of which is deployed on the Server and Client side. The Server Agent is a necessary agent for the data provider and performs preliminary analysis of big data to generate Data Descriptor with information of Sample Data, Summary Data, and Raw Data. In addition, it performs fast and efficient big data preprocessing through big data distribution processing and continuously monitors network traffic. The Client Agent is an agent placed on the data user side. It can search the big data through the Data Descriptor which is the result of the pre-analysis and can quickly search the data. The desired data can be requested from the server to download the big data according to the level of disclosure. It separates the Server Agent and the client agent when the data provider publishes the data for data to be used by the user. In particular, we focus on the Big Data Sharing, Distributed Big Data Processing, Big Traffic problem, and construct the detailed module of the client - server model and present the design method of each module. The system designed on the basis of the proposed model, the user who acquires the data analyzes the data in the desired direction or preprocesses the new data. By analyzing the newly processed data through the server agent, the data user changes its role as the data provider. The data provider can also obtain useful statistical information from the Data Descriptor of the data it discloses and become a data user to perform new analysis using the sample data. In this way, raw data is processed and processed big data is utilized by the user, thereby forming a natural shared environment. The role of data provider and data user is not distinguished, and provides an ideal shared service that enables everyone to be a provider and a user. The client-server model solves the problem of sharing big data and provides a free sharing environment to securely big data disclosure and provides an ideal shared service to easily find big data.

A Study on the Function of Oral Medicine as the Secondary Clinic Based on Analysis on Admissive Channel and Case Features (내원경위 분석과 환자 특성 평가에 따른 2차 진료기관으로서 구강내과 역할에 대한 연구)

  • Lee, You-Mee;Lee, Jung-Hyun;Lim, Hyun-Dae
    • Journal of Oral Medicine and Pain
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    • v.31 no.3
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    • pp.199-210
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    • 2006
  • The epidemiological researches on the inpatients hospitalized at the oral medicine ward have been continuously carried out since 1970, and most researches have been performed by centering around the oral medicine wards of college hospitals. Numerous specialists have been produced after the establishment of oral medicine, and they have been active in various fields. As dental clinics have gotten bigger, the function of oral medicine in the secondary clinics is being brought out. As admissive channel, case features, case composition and otherwise have not been researched for a long time, the related researches should be carried out from now on. Hereupon, this study was carried out by targeting the 100 inpatients hospitalized at the oral medicine ward of Sun Hospital located in Daejeon Korea, through questionnaire. As the result, the following results were derived. 1. The ages of the inpatients in Sun Hospital were $29.21{\pm}11.31$ on the average; 71 females' mean average was $29.63{\pm}11.29$ and 29 males' mean average was $28.17{\pm}11.48$. In regard of school career, the patients who finished high-school course or higher accounted for 78%; the patients' school career seemed to be relatively high. The patients who complained of temporomandibular pain accounted for the highest proportion with 65%. In motivation to visit this hospital, internet surfing was 11%, mass media was 10%, acquaintance's introduction was 38%. The patients, who were hospitalized at another hospital due to the same symptom, accounted for 56%. The dental clinics, which made the patients visit this hospital, accounted for 20%. The patients, who were previously aware that the present symptom should be treated by oral medicine, accounted for 38%. The patients, who were not aware of the fact in advance, were 62%. The respondents of 51% answered that they were aware of the fact one month or below before hospitalization. 2. The patients, who complained of craniocervical ache, accounted for 58%; the patients, whose ache aches affect dailylife, were 22%. Continuous ache was 14% and intermittent ache was 68%, and dull pain was 23%. 3. Life variations were compared with each other by using SRRS (Social Readjustment Rating Scale). In consequence, the variation within 3 years indicated a significant difference in the both groups but the variation within 6 months did not indicate any differences. 4. In regard of the questionnaire on the incidents happened for a week, the ache-group was compared with the group free from the ache. As the result, the number of strain arisen for a week, the decrease of favorite works and sudden fear indicated a significant difference. Pleasant feeling and the decrease of interests in looks did not indicate a significant difference, but came close to the significance. 5. In the questionnaire on impatience, the ache-group indicated higher value but there was not a significant difference. 6. In the questionnaire on the symptoms caused by stress, the two groups indicated significant differences in the item of 'the teethridge itches and feels a tooth rising' and 'the occiput or the nape is stiff.' In the item 'the inside of the cheek or the teethridge are widely peeled off, accompanied with ache and hemorrhage', 'the face has acne or pimple' and 'headache frequently attacks', a significant difference was not observed but the two groups came close to the significance.

A Study of Guidelines for Genetic Counseling in Preimplantation Genetic Diagnosis (PGD) (착상전 유전진단을 위한 유전상담 현황과 지침개발을 위한 기초 연구)

  • Kim, Min-Jee;Lee, Hyoung-Song;Kang, Inn-Soo;Jeong, Seon-Yong;Kim, Hyon-J.
    • Journal of Genetic Medicine
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    • v.7 no.2
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    • pp.125-132
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    • 2010
  • Purpose: Preimplantation genetic diagnosis (PGD), also known as embryo screening, is a pre-pregnancy technique used to identify genetic defects in embryos created through in vitro fertilization. PGD is considered a means of prenatal diagnosis of genetic abnormalities. PGD is used when one or both genetic parents has a known genetic abnormality; testing is performed on an embryo to determine if it also carries the genetic abnormality. The main advantage of PGD is the avoidance of selective pregnancy termination as it imparts a high likelihood that the baby will be free of the disease under consideration. The application of PGD to genetic practices, reproductive medicine, and genetic counseling is becoming the key component of fertility practice because of the need to develop a custom PGD design for each couple. Materials and Methods: In this study, a survey on the contents of genetic counseling in PGD was carried out via direct contact or e-mail with the patients and specialists who had experienced PGD during the three months from February to April 2010. Results: A total of 91 persons including 60 patients, 49 of whom had a chromosomal disorder and 11 of whom had a single gene disorder, and 31 PGD specialists responded to the survey. Analysis of the survey results revealed that all respondents were well aware of the importance of genetic counseling in all steps of PGD including planning, operation, and follow-up. The patient group responded that the possibility of unexpected results (51.7%), genetic risk assessment and recurrence risk (46.7%), the reproduction options (46.7%), the procedure and limitation of PGD (43.3%) and the information of PGD technology (35.0%) should be included as a genetic counseling information. In detail, 51.7% of patients wanted to be counseled for the possibility of unexpected results and the recurrence risk, while 46.7% wanted to know their reproduction options (46.7%). Approximately 96.7% of specialists replied that a non-M.D. genetic counselor is necessary for effective and systematic genetic counseling in PGD because it is difficult for physicians to offer satisfying information to patients due to lack of counseling time and specific knowledge of the disorders. Conclusions: The information from the survey provides important insight into the overall present situation of genetic counseling for PGD in Korea. The survey results demonstrated that there is a general awareness that genetic counseling is essential for PGD, suggesting that appropriate genetic counseling may play a important role in the success of PGD. The establishment of genetic counseling guidelines for PGD may contribute to better planning and management strategies for PGD.

A Study on the Improvement of Flexible Working Hours (탄력적 근로시간제 개선에 대한 연구)

  • Kwon, Yong-man
    • Journal of Venture Innovation
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    • v.5 no.3
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    • pp.57-70
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    • 2022
  • In modern industrial capitalism, the relationship between the provision of work and the receipt of wages has become an important principle governing society. According to the labor contract, the wages provided by entrusting the right to dispose of one's labor to the employer are directly compensated, and human life should be guaranteed and reproduced with proper rest. The establishment of labor relations under free contracts represents a problem in protecting workers, and accordingly, the maximum of working hours is set as a minimum right for workers, and the standard for minimum rest is set and assigned. The reduction of working hours is very important in terms of the quality of life of workers, but it is also an important issue in efficient corporate activities. As of 2020, Korea has 1,908 hours of annual working hours, the third lowest among OECD 37 countries in the happiness index surveyed by the Sustainable Development Solution Network(SDSN), an agency under the United Nations. Accordingly, the necessity of reducing working hours has been recognized, and the maximum working hours per week has been limited to 52 hours since 2018. In this situation, various working hours are legally excluded as a way to maintain the company's value-added creation and meet the diverse needs of workers, and Korea's Labor Standards Act restricts flexible working hours within three months, flexible working hours exceeding three months, selective working hours, and extended working hours. However, in the discussion on the application of the revised flexible working hours system in 2021 and the expansion of the settlement unit period recently discussed, there is a problem with the flexible working hours system, which needs to be improved. Therefore, this paper aims to examine the problems of the flexible working hours system and improvement measures. The flexible working hours system is a system that does not violate working hours even if the legal working hours are exceeded on a specific day or week according to a predetermined standard, and does not have to pay additional wages for excessive overtime work. It is mainly useful as a form of shift work in manufacturing, sales service, continuous business or electricity, gas, water, and transportation for long-term operations. It is also used as a way to shorten working hours, such as expanding holidays through short working days. However, if the settlement unit period is expanded, it is disadvantageous to workers as the additional wages that workers can receive will not be received. Therefore, First, in order to expand the settlement unit period currently under discussion, additional wages should be paid for the period expanded from the current standard. Second, it is necessary to improve the application of the flexible working hours system to individual workers to have sufficient consultation with individual workers in a written agreement with the worker representative, Third, clarify the allowable time for extended work during the settlement unit period, and Fourth, limit the daily working hours or apply to continuous rest. In addition, since the written agreement of the worker representative is an important issue in the application of the flexible working hours system, it is necessary to secure the representation of the worker representative.