• Radiation Oncology Journal
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• 제36권2호
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• pp.163-170
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• 2018

Merkel cell carcinoma (MCC) is a rare neuroendocrine tumor of the skin initially believed to arise from the Merkel cells. In the community setting a general radiation oncologist may only encounter this pathology in a handful of cases over the course of their career. Due to the low incidence of this malignancy, few prospective randomized controlled trials have ever been conducted and therefore guidelines are based on relatively lower levels of evidence upon which the clinical recommendations are made. We discuss the case of a female in her 90s presenting with a classic MCC primary lesion, as well as satellite lesions proximal to both the primary and the draining regional lymph nodes with no evidence of nodal involvement. Here we discuss the presentation, management, treatment planning, underlying pathology, results and sequelae of treatment. We also review new treatment modalities, and the most current staging systems and guidelines.

• Tuberculosis and Respiratory Diseases
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• 제87권1호
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• pp.31-39
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• 2024

After the successful development of targeted therapy and immunotherapy for the treatment of advanced-stage non-small cell lung cancer (NSCLC), these innovative treatment options are rapidly being applied in the adjuvant setting for early-stage NSCLC. Some adjuvants that have recently been approved include osimertinib for epidermal growth factor receptor-mutated tumors and atezolizumab and pembrolizumab for selected patients with resectable NSCLC. Numerous studies on various targeted therapies and immunotherapy with or without chemotherapy are currently ongoing in the adjuvant setting. However, several questions regarding optimal strategies for adjuvant treatment remain unanswered. The present review summarizes the available literature, focusing on recent advances and ongoing trials with targeted therapy and immunotherapy in the adjuvant treatment of early-stage NSCLC.

• 의료법학
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• 제9권1호
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• pp.461-503
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• 2008

The right to live is the most valuable benefit and protection of the law. And Medical science is the study considering value of life as the top priority. As modern medical science has progressed and expanding lifespan skills have developed, the number of symptom, called a human vegetable, has been also increased. As a result, people concerns whether euthanasia should be permitted. (1) Active euthanasia is prohibited and a doctor who conduct it is punished. (2) Indirect euthanasia can be permitted unless it is against a patient's intention. (3) Permission of passive euthanasia depends on intention of a patient. In other words, when a patient accepts, a doctor respects the right of self determination of patient and irreversible situation such as brain death happens, treatment stop is permitted. Even a patient who is in the last stage of cancer has a right to die in the dignity and elegance. Solutions for ceasing medical treatment are as follows; First, establishment of 'Bioethics Committee'. Second, setting procedures to empower a court a right to decide whether medical treatment is ceased. Third, setting procedure a government to assist treatment fees. In this paper, direction for social agreement of legal policy regarding the ceasing treatment is provided.

• 보건행정학회지
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• 제30권2호
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• pp.164-177
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• 2020

This study aims to compare the experience of selected countries in operating separate payment system for new healthcare technology and to find implications for price setting in Korea. We analyzed the related reports, papers, laws, regulations, and related agencies' online materials from five selected countries including the United States, Japan, Taiwan, Germany, and France. Each country has its own additional payment system for new technologies: transitional pass-through payment and new technology ambulatory payment classification for outpatient care and new technology add-on payment for inpatient care (USA), an extra payment for materials with new functions or new treatment (C1, C2; Japan), an additional payment system for new special treatment materials (Taiwan), a short-term extra funding for new diagnosis and treatment (NUB; Germany), and list of additional payments for new medical devices (France). The technology should be proven safe and effective in order to get approval for an additional payment. The price is determined by considering the actual cost of providing the technology and the cost of existing similar technologies listed in the benefits package. The revision cycle of the additional payment is 1 to 4 years. The cost or usage is monitored during that period and then integrated into the existing fee schedule or removed from the list. We conclude that it is important to set the explicit criteria to select services eligible for additional payment, to collect and analyze data to assess eligibility and to set the payment, to monitor the usage or cost, and to make follow-up measures in price setting for new health technologies in Korea.

• 한국물환경학회지
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• 제28권1호
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• pp.121-128
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• 2012

The purpose of this study is to solve the problem of nutrient removal due to rapid hydraulic retention time (HRT) variation in small size private sewage treatment facility and to have better effluent quality by using natural zeolite as a coagulant aid. The experiments were conducted by applying different conditions of HRT, coagulant, and zeolite dosages. As an experimental result, $TBOD_{5}$, TSS, and TP removal efficiencies were 64.9%, 94.5%, and 98.8% at co-injection with zeolite. Overall removal efficiencies of $TBOD_{5}$, TSS, and TP have improved 15.7, 28.7, 6.1%, respectively. This result shows that zeolite addition could improve flocculation, increase setting velocity, and thus have better treatment. Therefore the use of zeolite as a coagulant aid can be useful in small size private sewage treatment facility, where especially extra nutrient removal is required to meet the legal standard for discharge.

• 임상간호연구
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• 제28권3호
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• pp.289-298
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• 2022

Purpose: Nursing stress on life-sustaining treatment of nurses is a significant contributing factor to nursing care performance and patient care outcomes. We need to investigate the factors associated with nursing stress on life-sustaining treatment in hospital settings. The purpose of this descriptive study was to examine the relationship of role perception of life-sustaining treatment and good death perception with nursing stress on life-sustaining treatment among nurses in hospital settings. Methods: Using a cross-sectional study design, we recruited nurses at a hospital located in a metropolitan city in Korea. The nurses completed structured questionnaire questions which were composed of well-validated questionnaires. Descriptive statistics and hierarchical multiple regression model were utilized for data analysis. Results: A total of 205 nurses participated in the study (female 93.2%; aged 20~29 years 63.0%; single status 78.5%). In the hierarchical multiple regression model, there was a significant positive relationship between role perception of life-sustaining treatment and nursing stress on life-sustaining treatment (β=.27, p<.001). Higher education level and working at a ward setting were also significantly related to nursing stress on life-sustaining treatment (β=.13, p<.046 for education level; β=.22, p=.001 for work setting). However, there was no relationship between good death perception and nursing stress on life-sustaining treatment. Conclusion: Education programs to reduce nursing stress on life-sustaining treatment are needed to develop for nurses who have higher role perception of life-sustaining treatment with higher education level working at ward settings in hospitals.

• 한국염색가공학회지
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• 제2권2호
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• pp.14-19
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• 1990

The setting behavior of disulfide-enriched wool and disulfide-crosslinked silk obtained by treatment with a disulfide-containing crosslinking agent, bis $(\beta-isocyanatoethyl)$ dissulfide was compared with that of untreated wool and silk under the absence and the presence of a reducing agent. Rearrangment of secondary bonds facilitated by cleavage of crosslinks as well as rearrangement of crosslinks itself seems to play an important role in the set stability.

• 한국의류학회지
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• 제3권2호
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• pp.15-22
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• 1979

The heat setting of sewing thread is known to have some puckering. In this experiment, the P/C fabrec and polyester thread were heat setted at temperatures ranging from $70^{\circ}C$ to $150^{\circ}C$ at the interval of every $^20{\circ}C$ for the period of 1, 5, 10, 20 and 40 minutes resoectivly. The results obtained are as follows: 1) In general, the pre-laundering sewing shrinkage related negatively to time but related positively to temperature. And it showed the lowest rate at $110^{\circ}C$. 2) In case of slack treatment, the post-laundering sewing sewing shrinkage marked the lowest rate at $130^{\circ}C$ while that of stretch treatment showed the lowest rate at $90^{\circ}C$. 3) The rates of post-laundering sewing shrinkage were higher than those of pre-laundering shrinkage, the difference between them reached the bottom when applied the slack treatment at $130^{\circ}C$ and the streched treatment at $110^{\circ}C$.

• 환경영향평가
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• 제23권4호
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• pp.296-314
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• 2014

우리나라의 공공하수처리시설 방류수 수질기준을 마련하는데 있어 기준설정 근거를 명확히 하는 것과 하수처리시설의 운영조사를 근거로 적정성 여부를 검토할 수 있는 종합적인 기준설정 체계를 마련할 필요가 있다. 미국은 연방정부가 POTW에 대한 최소한의 항목과 기준의 가이드라인을 제시하며, 지방정부는 국가 가이드라인과 동일하거나 주별 특성을 반영하여 보다 엄격한 가이드라인을 제시하도록 하고 있다. 일본의 경우 하수도법상 방류수 수질기준에서 하수처리시설 구조 기술상의 기준을 만족하여야 하고 방류수 수질기준과 공공수역으로의 배수기준을 동시에 적용하도록 하고 있으며 이에 대한 세부항목 및 기준은 지자체 조례로 규정하고 있다. 유럽의 경우 하수처리시설 방류수 수질기준은 공공수역에 대한 부영양화의 민감성에 따라 수질기준 항목을 차등하여 적용하고, 수계로 배출되는 오염물질 부하량에 따라 수질기준을 차등하여 적용하고 있다. 우리나라도 공공하수처리시설 방류수 수질기준 설정 시 미국 국가오염물질배출삭감제도 또는 유럽 통합환경관리제도에서와 같이 통계적 평균값 및 처리효율 또는 최적처리기술을 적용한 방류수 수질기준을 설정하는 체계를 도입하는 것이 필요하다.

• Journal of Trauma and Injury
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• 제33권3호
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• pp.181-185
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• 2020

Damage control surgery (DCS) is an abbreviated laparotomy procedure that focuses on controlling bleeding to limit the surgical insult. It has become the primary treatment modality for patients with exsanguinating truncal trauma. Herein, we present the case of a 47-year-old woman with liver, kidney, and superior mesenteric vein (SMV) injuries caused by a motor vehicle collision. The patient underwent DCS following resuscitative endovascular balloon occlusion of the aorta (REBOA). In this case report, we discuss the importance of priority setting in DCS for the treatment of multisystem damage of several abdominal organs, particularly when the patient has incurred a combination of major vascular injuries. We also discuss the implications of damage control of the SMV, perihepatic packing, and right-sided medial visceral rotation. Further understanding of DCS, along with REBOA as a novel resuscitation strategy, can facilitate the conversion of uniformly lethal abdominal injuries into rescuable injuries.