An Evaluation of Nutrition Support for Terminal Cancer Patients at Teaching Hospitals in Korea

Do Yeun Kim,Sang Min Lee,Kyoung Eun Lee,Hye Ran Lee,김지현,Keun-Wook Lee,Jong Seok Lee,Soon Nam Lee 대한암학회 2006 Cancer Research and Treatment Vol.38 No.4

Purpose: We wanted to analyze the use of nutrition support for terminal cancer patients, the effect of discussing withdrawal of nutrition support and do-not- resuscitate (DNR) consent on the use of intravenous nutrition during the patient’s last week of life and at the time of death.Materials and Methods: The study involved 362 patients with terminal cancer from four teaching hospitals, and they all died between January 1 2003 and December 31 2005. The basic demographic data, the use of intravenous nutrition during the patient’s last week of life and at death, discussion of terminal nutrition withdrawal and DNR consent were evaluated.Results:In the week before death, the patients received artificial nutrition such as total parenteral nutrition (31%), intravenous albumin infusion (25%), and feeding tube placements (9%). A discussion concerning withdrawal of nutrition support was limited to 25 (7%) patients. DNR consent was obtained from 294 (81%) patients. None of the patients were directly involved in any of these decisions. The discussion about withdrawal of terminal nutrition and DNR consent with the patient’s surrogates did not have any effect on reducing the use of parenteral nutrition.Conclusion: The majority of patients dying of terminal cancer were still given potentially futile nutritional support. Modern clinical guidelines and ethical education about nutritional support at the end of life care is urgently needed in Korean medical practice to provide proper administration of terminal nutrition for end of life care. (Cancer Res Treat. 2006;38:214-217)

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>

Safety of subtotal or total colectomy with primary anastomosis compared to Hartmann procedure for left-sided colon cancer obstruction or perforation

Eun-Do Kim,Jin-Kwon Lee,Jin-Kyu Cho,Jae-Myung Kim,Ji-Ho Park,Ju-Yeon Kim,Sang-Ho Jeong,Young-Tae Ju,Chi-Young Jeong,Eun-Jung Jung,Young-Joon Lee1,Soon-Chan Hong,곽승진 대한종양외과학회 2019 Korean Journal of Clinical Oncology Vol.15 No.2

Purpose: Whether subtotal or total colectomy with primary anastomosis (PA) is safer than Hartmann procedure (HP) for left-sided colon cancer obstruction or perforation remains controversial. The purpose of this study was to compare postoperative morbidity, mortality, and defecation frequency between PA and HP for left-sided colon cancer obstruction or perforation. Methods: This retrospective study enrolled 54 patients from January 2014 to February 2018 who underwent emergency surgery due to left-sided colon cancer obstruction or perforation. Results: PA was carried out in 20 patients while HP was performed for 34 patients. Thirty-day mortality did not show significant difference between the two groups (15.0% vs. 14.7%, P=1.000). No anastomotic leakage occurred in PA group while three (8.8%) cases of stump leakage occurred in HP group. Stoma repair was performed for 13 cases (44.8%) and stoma reformation was performed for one case in HP group (7.7%). Stoma related complications occurred in five cases (17.24%). For patients after stoma repair, defecation frequency at 3 months after operation was 2.91±2.88 times per day in PA group and 2.86±2.63 times per day in HP group. At 1 year after operation, defecation frequency was changed to 1.40±1.12 times per day in PA group and 1.17±0.39 times per day in HP group. Conclusion: Primary ileosigmoid or ileorectal anastomosis for left-sided colon cancer obstruction or perforation is safe, and shows similar outcome of defecation frequency compared to H

도시 개발에 따른 기상장 변동의 3차원 수치해석에 관한 연구

이희철,이범주,이도훈,이은태 경희대학교 산학협력기술연구원 1999 산학협력기술연구논문집 Vol.5 No.-

비온의 연구에 나타난 시간성의 정신분석적 의미 : 버지니아 울프의 소설 『등대로』를 중심으로

이은도(Lee, Eun?Do),이준호(Lee, Joon?Ho) 한국현대정신분석학회 2020 현대정신분석 Vol.22 No.1

“시간이 흐른다”는 것은 자연 속에 존재하는 당연한 현상이므로 그 정신분석적 의미는 간과되기 쉽지만 비온은 그 의미에 대해 논한 바 있다. 비온의 연구에서 시간성은 사고의 발달 과정에서 나타난다. 시간의 측정은 좌절을 견딜 수 있는 유아에게 가능하며, 부재하는 젖가슴과 젖가슴 사이의 간격 측정과 “무의식적 깨어 생각하기”의 과정을 거쳐 유아의 내면에 시간의 흐름에 대한 관념이 생겨난다. 본 논문에서는 시간의 흐름에 대한 관념은 사고의 발달이 가능한 표지로서 기능할 수 있다고 보았고, 사고의 방향성이 가진 시간적 측면에 따라 시간을 K시간과 O시간으로 나누었다. 시간에 대한 인식의 실패는 O로의 변형에 필연적으로 수반되는 시간의 분열에서 생겨날 수 있으며, O로의 변형을 시도하였으나 좌절을 견디지 못하여 –K로 도피하였을 경우에도 생겨난다. 이때 K시간을 방어로서 사용할 수 있다. 이러한 시간에 대한 인식의 실패가 있는 경우 시간에 대한 특정한 증상으로 발현될 수 있다. 본 논문에서는 이러한 사례로 버지니아 울프의 작가 일기 「로드멜 1926」을 선정하였다. 「로드멜 1926」은 버지니아 울프의 자전적 소설인 『등대로』를 집필하던 당시의 일기로, 소설 속에는 버지니아 울프의 알파 기능, O에 직면하고 이를 변형하려고 시도하는 모습, 좌절을 견디지 못하여 –K로 도피하는 모습, 그 과정에서 나타난 시간의 분열과 멸절의 양상이 잘 드러나 있다. 「로드멜 1926」에 나타난 시간적 측면의 증상은 버지니아 울프가 소설 속에서 보여준 시간에 대한 인식의 실패가 현실로 발현된 사례로 볼 수 있을 것이다. “Time flows” is a natural phenomenon. But it’s psychoanalytic implications may not be obvious. In Bion’s study, measurement of time becomes possible for infants who can endure frustration, and through the process of “Unconscious wakeful thinking”, the notion on continuity of time is created in the infant’s mind. Time is classified as K time and O time according to the thought’s direction upon the aspect of time in this article. Failure of recognition of time can be generated from the splitting of time that is inevitably accompanied with the transformation of O, and it is generated when one tries to transform into O but cannot endure the frustration so as to escape into –K. In this case, K time can be used as a defense. When failure of recognition of time occurs, it can manifest as a certain symptom related to time. Virginia Woolf’s diary, “Rodmell 1926” would be this case. “Rodmell 1926” is Virginia Woolf’s diary when she wrote her autobiographical novel, To the Lighthouse. In the novel, her alpha function, the confrontation and attempt at transformation of O, the escape to –K due to intolerance of frustration, and splitting of time and annihilation were well illustrated. The symptoms of time that appeared in “Rodmell 1926” can be considered as the case of failure of recognition of time that Virginia Woolf wrote about in her novel, which was expressed in reality.

State Indicator of Water Quality for Surface Water and Groundwater in Agriculture

Min-Kyeong Kim,Goo-Bok Jung,An-Sung Ro,Seung-Chul Choi,Won-Il Choi,Eun-Jeong Kim,Jong-Eun Lee,Yeo-Uk Yun,Kab-Cheol Kim,Do-Young Ko,Byeong-Ho Kim,Hyeon-Ji Kim,Sang-Jo Park,Seong-Tae Lee,Jae-Young Heo,S 한국토양비료학회 2015 한국토양비료학회지 Vol.48 No.5

Indicators of environmental conditions qualitatively and quantitatively describe the state of the environment and natural resources, and the OECD (Organization for Economic Cooperation and Development) has initiated and suggested AEIs (Agri-Environmental Indicators) to assess trends over time of the effects of agriculture on the environment and the effectiveness and efficiency of agricultural and environmental policy measures since 1990’s. This study aims to develop the state indicators of water quality for agricultural water, surface and groundwater, to evaluate the environmental impacts of agricultural activities and policies by qualifying the environmental levels of a nation. Status indicators were calculated according to the agricultural water quality standards of OECD and Korea, and their trends were analyzed over time. Particularly, nitrate(NO₃<SUP>-</SUP>) status indicators of ground water in 2013 were significantly lower than the ones in 2000. Overall, the water quality indicators of surface water in 2013 were higher than the ones in 2012, except for pH and DO. The groundwater quality indicators in 2013 were lower than those of previous years. The optimal management indicators were calculated to assess agricultural surface water and groundwater quality. The findings of this study indicated that the state indicators could play a significant role to establish policies and procedures for managing and conserving water resources. This study also discussed water pollution caused by agricultural and industrial effluents.

State Indicator of Water Quality for Surface Water and Groundwater in Agriculture

Kim, Min-Kyeong,Jung, Goo-Bok,Ro, An-Sung,Choi, Seung-Chul,Choi, Won-Il,Kim, Eun-Jeong,Lee, Jong-Eun,Yun, Yeo-Uk,Kim, Kab-Cheol,Ko, Do-Young,Kim, Byeong-Ho,Kim, Hyeon-Ji,Park, Sang-Jo,Lee, Seong-Tae,H 한국토양비료학회 2015 한국토양비료학회지 Vol.48 No.5

Indicators of environmental conditions qualitatively and quantitatively describe the state of the environment and natural resources, and the OECD (Organization for Economic Cooperation and Development) has initiated and suggested AEIs (Agri-Environmental Indicators) to assess trends over time of the effects of agriculture on the environment and the effectiveness and efficiency of agricultural and environmental policy measures since 1990's. This study aims to develop the state indicators of water quality for agricultural water, surface and groundwater, to evaluate the environmental impacts of agricultural activities and policies by qualifying the environmental levels of a nation. Status indicators were calculated according to the agricultural water quality standards of OECD and Korea, and their trends were analyzed over time. Particularly, nitrate ($NO_3{^-}$) status indicators of ground water in 2013 were significantly lower than the ones in 2000. Overall, the water quality indicators of surface water in 2013 were higher than the ones in 2012, except for pH and DO. The groundwater quality indicators in 2013 were lower than those of previous years. The optimal management indicators were calculated to assess agricultural surface water and groundwater quality. The findings of this study indicated that the state indicators could play a significant role to establish policies and procedures for managing and conserving water resources. This study also discussed water pollution caused by agricultural and industrial effluents.

재발된 단낭성 법랑아세포종의 증례보고

이병도,이완,김진화,최동훈,팽준영,김은철 대한구강악안면방사선학회 2008 Imaging Science in Dentistry Vol.38 No.2

The unicystic ameloblastoma (UA) is a variant of the solid or multicystic ameloblastoma, a less encountered variant of the ameloblastoma. It appears more frequently in the second or third decade with no sexual or racial predilection. It is almost exclusively encountered asymptomatically in the posterior mandible. We report a case of a 43-year old patient with UA, who had previously undergone a surgical treatment on the same site about 1 year ago, this lesion recurred and presented as an exophytic gingival lesion in the anterior mandibular region.

인간 재조합 인터루긴-32 면역조절작용에 대한 유세포 분석

이광수,김영관,채정일,심정현,김은미,강형식,김수현,윤도영,명평근 충남대학교 생물공학연구소 2006 생물공학연구지 Vol.12 No.-

Xenotransplantation of porcine organs has the potential to overcome the severe shortage of human tissues and organ available for human transplantation. however, it remains various hurdles for clinical xenotransplantation. In pig and mouse xenotransplantation, porcine xenograft evoke a strong cellular rejection response in immunocompetent host and grafts are destroyed within a week. This cellular immune response could involved both T cells and NK cells. A number of groups have shown that human NK cells can recognize and damage porcine endothelial cells. In addition, human T cells can respond to porcine endothelial cells through both direct and indirect mechanisms. Cellular rejection of porcine tissues requires T cells, particularly CD4^(+) cells. A new cytokine recombinant human interleukin-32α,β(IL-32α,β) has a role innate and acquired immune system. In order to investigate the role of recombinant mouse IL-18 and recombinant human IL-32α,β in xenograft rejection, we transplanted the PK(15) cells to C57BL/6 mice with or without intraperitoneal injection of recombinant mouse IL-18 or recombinant human IL-32 α,β. It was analyzed the population of NK cell, T cell and B cell in the C57BL/6 mice transplanted with PK(15) cells and recombinant mouse IL-18 or recombinant human IL-32α,β by flow cytometry analysis. As a result, lymph node and thymus of PK15/IL18, PK15/IL32α and PK15/IL32β injected group were increased to T cell activation population than normal injected groups. CD8^(+) T cells were decreased in lymph node of PK15/IL18, PK15/IL32α and PK15/IL32β injected groups. CD4^(+) T cells were increased in lymph node cell of PK15/IL32α and PK15/IL32β injected group and also, B cell population were increased in lymph node cell and spleen of PK15/IL18, PK15/IL32α and PK15/IL32β injected group. Therefore, we suggest that recombinant mouse IL-18 and recombinant human IL-32α,β suppress xenograft rejection in cellular xenotransplantation.

위 MALT 림프종에서 다발성 림프절 전이로 오인된 동시성 림프절 결핵 1예

김성은,김규종,김도현,송준영,문대성,장리라,유찬희,문원,박무인,박선자,김영옥 고신대학교의과대학 2008 고신대학교 의과대학 학술지 Vol.23 No.2

28세 남자가 내시경적 점막절제술을 통해 저등급 위MALT 림프종으로 진단되었다. 병기설정을 위해 18F-FDG PET 검사를 시행하였고 우측 쇄골상부, 우측상/하부 기관주위, AP window 부위에 강한 섭취가 관찰되어 전이성 림프절로 판단하였다. 그러나, 우측 쇄골상부 림프절에서 시행한 절제생검에서 만성육아종성염증소견이 관찰되었고 조직의 결핵 중합효소연쇄반응에서도 양성 반응을 보였다. 2개월간 항결핵제의 사용 후 시행한 추적 컴퓨터단층촬영 검사에서 림프절 크기의 감소를 보여 최종적으로 위 MALT 림프종에서 광범위 림프절 전이로 오인된 동시성 림프절 결핵으로 진단되었다. A 28-year-old man was diagnosed as gastric MALT lymphoma in diagnostic EMR (endoscopic mucosal resection). He subsequently underwent an 18F-FDG PET. 18F-FDG PET showed intense multifocal uptake in right supraclavicular, right upper and lower paratracheal, and AP window areas that was considered radiologically to represent widespread metastatic lymphadenopathy. Excisional biopsy of a supraclavicular lymph node, however, revealed chronic granulomatous lymphadenitis with a positive reaction of Tb-nested PCR. After antituberculosis treatment for 2 months, a follow-up CT scan showed complete resolution of the lesions. Intense 18F-FDG uptake could be due to an infectious process such as synchronous tuberculous lymphadenitis. Therefore, this could mimic a malignant condition such as lymphoma with extensive lymph node metastasis due to a false-positive finding, which may lead to a misdiagnosis.