Do-Not-Resuscitate Orders for Terminal Patients with Cancer in Teaching Hospitals of Korea

Kim, Do Yeun,Lee, Kyoung Eun,Nam, Eun Mi,Lee, Hye Ran,Lee, Keun-Wook,Kim, Jee Hyun,Lee, Jong Seok,Lee, Soon Nam Mary Ann Liebert 2007 Journal of palliative medicine Vol.10 No.5

<P>OBJECTIVES: To examine the current practices relating to do-not-resuscitate (DNR) orders for terminal patients with cancer at teaching hospitals in Korea. METHODS: The records of 387 deaths from January 1 to December 31, 2005 at four cancer centers were identified and reviewed to assess the DNR delineation. Basic demographics, circumstances surrounding the establishment of the DNR directive, the percentage of orders for identified populations, and the time interval between DNR consent and death were evaluated. RESULTS: An order of DNR consent was obtained from 296 patients (76%) of a total of 387 patients. All DNR consents were made between the physician and family, without involving the patient. Written preprinted DNR consent forms were used in 169 (57%) cases and 127 patients (43%) had verbal DNR permission. DNR consent was interpreted in two ways: one forbade resuscitation in two hospitals and the other implied limited care in two other hospitals. A unilateral physician decision to withhold cardiopulmonary resuscitation (CPR) was decided for 62 (16%) patients. Terminal CPR was performed on 29 (7%) patients. DNR discussion was made within 7 days of the day of death on 228 (77%) patient among the 296 DNR consenting patients. CONCLUSION: From our teaching-hospital-based analysis of terminal cancer patients in Korea, consent for a DNR order was common. However, DNR order forms were not standardized and lacked room to document patient involvement in the decision. Usually the DNR decision was made within last days of the patient's life. Our results reflect the need for the improvement of end-of-life care decisions in Korea.</P>

멀티미디어 제작을 통한 초등 정보영재교육에 관한 연구

남승현,배영권,김도윤,구덕회,이태욱 한국컴퓨터교육학회 2005 컴퓨터교육학회 논문지 Vol.8 No.2

PSTN을 이용한 화상 전화시스템의 음성 보코더

남현도,남일룡 단국대학교 1999 산업기술연구 Vol.1 No.-

This paper presents real-time implementation of a speech vocoder for ITU(International Telecommunications Union) H324 video telephony on the PSTN(Public Switched Telephone Network) using ITU G.723 16Kbps ADPCM(Adaptive Differential Pulse Code Modulation) algorithm. ITU H.324 is a new standard for low bit-rate multimedia communication that provides a foundation for interoperability and high quality video, voice and data based phone calls. The encoder using proposed algorithm accepts 8-bit PCM(Pulse Code Modulation) compressed sign민 and expends them to a 14-bit-per-sample for processing. The predicted values are subtracted from these 14-bit values to produced difference signals that are fed to the quantizer. Adaptive quantization is performed on the difference signals to produce a 2-bit output for transmission over the channel. At the decoder, the 2-bit transmitted values are used to update the inverse adaptive quantizer, whose output is a dequantized version of the difference signals. These dequantized values are added to the values generated by the adaptive predictor to produced the reconstructed speech signals. Computer simulations were performed to evaluate the performance of the speech vocoder that implemented by proposed algorithm.

다중채널 LMS 알고리즘을 이용한 자동차 내부 소음의 능동제어

남현도,서성대 단국대학교 2001 산업기술연구 Vol.2 No.-

In this paper, Multi-channel Active Noise Control(ANC) technique is proposed to cancel the noise from the inside of vehicle using engine. The algorithm used in the ANC system has better features for cancelling narrow and broad-band noise than conventional multi-channel ANC system. The broad-band ANC technique is especially applied in this study. The evaluation of the results through fft data processing after computer simulation about a closing space for experimentation is considered to verify the feasibility of the technique. The results shows that the noises measured from the engine inside of a vehicle were converged to low frequency band. Multi-channel LMS algorithm is used to remove the noises of the low frequency band. The results of the computer simulation show that the low frequency noises are reduced.

ARMAX프로세스를 위한 최적기구변수법

南炫道,崔龍雲 단국대학교 1988 論文集 Vol.22 No.-

In this paper, the recursive optinal instrumental vairable method, which estimates noise dynamics as well as system dynamics using pre-filtered data, was propsed. In case of no pre-filtering, the computational burden of this algorithm is equal to that of extended least squares(ELS) methods and less than that of the rescursive maximum likelihood(RML) method. But in case of prefiltering the computational burden of this algorithm is equal to that of the RML, but this algorithm shows faster convergence than ELS and RML algoorithms. Also, vaeious instrumental variables were proposed, and various types of prefilters were prposed to improve the performance of the proposed algorithms. Computer simulations were performed to illustrate the efficiency of the proposed methods.

원발성 중추신경계 임파종 : 치료 및 생존율 Treatment and Survival Rate

남도현,이상형,김동규,정희원,지제근,왕규창,김현집,최길수,한대희 대한신경외과학회 1993 Journal of Korean neurosurgical society Vol.22 No.3

The authors report on 17 patients having primary central nervous system(CNS) lymphomas between January, 1981 and August, 1992. All patients were treated at Seoul National University Hospital. Only three cases underwent surgery only and fourteen cases underwent surgery and radiation therapy with or without chemotherapy. There were no immunosuppressive patients. Sixteen patients were analyzed for survival studies, because one case was lost during follow-up. The median survival time(MST) was 26 months and one- and two-year survival rates for the 16 patients were 87.5% and 65.6% respectively. The rate of survival was analyzed according to possible prognostic factors ; age and sex, multiplicity and location of tumors, preoperative Karnofsky performance score(KPS), pathological subclassification, type of surgery, preoperative steroid therapy, postoperative adjuvant therapy, extent of radiation, chemotherapy and the degree of response to treatment at three months follow-up. Postoperative adjuvant therapy and the degree of response to the treatment correlated with survival. Fourteen patients who underwent postoperative adjuvant therapy had a median survival time of 63 months. The one- and two-year survival rates were 100% and 75% respectively compared to the MST of 1.5 months with survival rates of 0% and 0% retrospectively for the two patients who did not. A higher long term survival rate was observed in the group with better immediate responses. In nine of 16 patients with complete responses, the MST, one-, and two-year survival rates were 63 months, 100%, and 83% respectively. The authors suggest that preoperative application of steroids may be considered in case of clinically suspected primary CNS lymphomas. It is concluded that after obtaining the tissue diagnosis of primary CNS lymphomas, radiotherapy with or without chemotherapy should be performed until the complete response.

양전자 소멸 분광학에 대한 플라스틱 섬광검출기의 시간 분해능 측정

남기용;김도현;김종국;주관식 명지대학교 자연과학연구소 2004 자연과학논문집 Vol.23 No.-

We have measured the time resolution of the system for Positron Annihilation Spectroscopy(PAS). Time resolution means a measure to response to time intervals between start and stop signals. We used ^(22)Na positron source to obtain start and stop signals, that is, 1.27 MeV γ-ray is as a start signal, and 511 keV γ-ray as a stop signals resulted from annihilation with electron in material. The system composed of two plastic scintillation detertors with a size of diameter 2". After calibrating TAC, We obtained that the time resolution of PAS system has about 300 ps for ^(60)Co window. In addition to that, we recognized that the resolution was dependent of the length of delay line on the CFD panel, except of the size of scintillators and the geometry of Photo Multiplier Tube. 본 연구에서는 양전사 소멸 분광학(PSA)의 시스템의 시간 분해능을 측정하였다. 시간 분해능은 시작과 정지신호 사이의 시간 차이의 반응 정도를 측정하는 것이다. ^(22)Na 양전자 동위원소를 사용하여 금속안에서 전자의 소멸로 인한 1.27 MeV의 감마선 시작 신호와, 511 keV의 정지신호를 얻을 수 있었다. 측정장비는 지름이 2인치인 두 개의 플라스틱 섬광검출기로 구성하였다. TAC를 보정한 후에 ^(60)Co 창에서 PAS 시스템의 시간 분해능은 300ps임을 얻을 수 있었다. 이번 연구에서 분해능은 CFD 패널의 시간 지연선의 길이에 의존적임을 알 수가 있었으며, 섬광체의 크기와 광전자증배판(PM Tube)의 구조와는 연관이 없음을 알 수 있다.

주사 전자현미경을 통하여 확인된 단락관내 소집락 형성 : 증례보고 Case Report

남도현,왕규창,이현구,조병규 대한신경외과학회 1992 Journal of Korean neurosurgical society Vol.21 No.10

Two patients who had bacterial colonies in shunt catheter confirmed by scanning electron microscopy(SEM) are described Coagulase negative staphylococcus had been cultured persistently from ventricular cerebrospinal fluid in spite of adequate medical treatment for shunt infection and the normalized profile of the cerebrospinal fluid. The authors controlled the shunt infection by removal of shunt catheters. Based on these SEM findings, it is mandatory to remove an infected shunt and replace it with a new one after proper antimicrobial therapy in cases with persistently positive culture.

서브밴드 제어 기법을 이용한 공조 덕트에서의 능동 소음 제어

남현도 단국대학교 1998 論文集 Vol.32 No.-

In this paper, a new active noise control technique which combines a hybrid active noise control technique and a subband active noise control technique is presented. Since this algorithm shares the advantages of both techniques, the computational burden of this algorithm could be reduced than conventional active noise control system and the stability of the proposed algorithm could be improved especially when the acoustic feedback exists. To reduce the computational burden the active noise control system, a weighted hybrid control technique, which has weighting factor which control the weights of feedforward control filters and feedback control filters, is applied. This algorithm shows higher stability and good noise attenuation property in either broad hand or narrow band active noise control systems in HVAC ducts. Computer simulations ware performed to show the effectiveness of the proposed algorithm.

확장 기구 변수법의 특성 해석 및 전치 윈도우형 격자구조 실현

南炫道 단국대학교 1989 論文集 Vol.23 No.-

The extended instrumental variable(EIV) method for ARMA spectral estimation was presented for improving the convergence property of ELS and RML which have slow convergence in MA parameters. In this paper, analysis of numerical properties and lattice implementation of EIV for high resolution spectral analysis has been researched as follows (1) Improve performance of EIV using he prefilter, (2) Prove the convergence of EIV using ordinary differential equations, (3) Prove the unbiasness of EIV using the whiteness property of residual processes, (4) Derive prewindowed type lattice algorithms which are computationally efficient (o(p) operations required) and profitable in VLSI circuit implementation.