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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>
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)
Insert type 총형공구 여유각 영향에 따른 베어링 Rubber Seal 금형의 가공성 평가
Li, Li-Hai,김연술,김도형,양균의,문상돈 한국공작기계학회 2004 한국공작기계학회 춘계학술대회논문집 Vol.2004 No.-
Formed insert type tool satisfy both the surface roughness and geometric accuracy, so that cutting edge of formed tool can duplicate final feature. For experiment, the formed tools with various clearance angles are machined. And the tools are evaluated with respect cutting force, flank wear and surface roughness to optimistic condition.
김동연,권도하,전겸구,조인수,윤치연 大邱大學校 障碍人綜合硏究所 1998 再活科學硏究 Vol.14 No.1
본 연구에서는 장애아 부모들이 경험하는 스트레스와 대처를 보다 명확하게 규명하기 위하여 장애아 부모(62명)와 정상아 부모(135명)를 비교하였다. 그 결과, 정서적 스트레스와 관련해서는 장애아 부모가 정상아 부모에 비하여 상태 분노, 특성 분노, 분노 표출, 및 우울에서 유의하게 높게 나타났다. 또한 대처 방식과 관련해서는 장애아 부모가 정상아 부모에 비하여 소극적 철수, 고집, 체념 및 자기 비판에서 유의하게 높게 나타났다. 끝으로, 신체증상과 관련해서는 장애아 무모가 정신아 부모에 비하여 불면증과 심장 질환 증상에서 유의하게 높게 나타났다. An attempt was made to compare the parents of children with disabilities and those of normal children in terms of their emotional stress and coping styles. The scales utilized in the present study were Korean adaptation of STAXI, the multidimensional coping scale, and Korean adaptation of CES-D. The major findings revealed that (1) the parents of children with disabilities compared to those of normal children showed higher levels of state anger, trait anger, and depression. (2) The parents of children with disabilities compared to those of normal children employed more frequently 'passive withdrawal,' 'perseverance,' 'fatalism,' and 'self-criticism', suggesting that they are more frequently employing ineffective coping styles. (3) The parents of children with disabilities compared to those of normal children were suffering from insomnia and cardiac symptoms. Finally, the present findings were discussed and implications for future studies are suggested.
p-Methoxystyrylphenylsulfone의 가수분해 반응메카니즘에 대한 반응속도론적 연구
權奇星,高東成,朴文奎,金演斗,成洛道 충남대학교 기초과학연구소 1981 연구논문집 Vol.2 No.-
The rate constants for the hydrolysis of p-methoxystyrylphenylsulfone were determined at wide pH ranges by means of UV spectrophotometer and the rate equations which could be applied to the experimental results were obtained. Form the facts, reaction mechanism was proposed : above pH 11.5, the rate is only dependent on the concentration of hydroxide ion and below pH 9.5, the reaction is initiated by the attack of a water molecule on the activated carbon-carbon double bond. In the range of pH from 9.5 to 11.5, these two reactions occur competitively.
Kim Do Yeun,Ha Hyerim,Bae SeungJin,Kang Jin-Hyoung 대한의학회 2021 Journal of Korean medical science Vol.36 No.29
Background: As the role of immunotherapies and personalized medicine grow, cancer patients have faced many choices in treatments and have suffered financial toxicity. These challenges brought the need for the value framework (VF) to guide treatment decision making. Methods: A survey was taken to 102 oncologists about perception for VF. They were asked about priorities among several considerations when they prescribe cancer drugs. Their views on the need for development and potential implications of VF in Korea were assessed, also. Results: The survey shows that 90% of the respondents choose clinical efficacy as the most important value in cancer drugs selection, and the cost of drug was more weighted value in immune checkpoint inhibitors (13.7%). Approximately half (53.9%) answered that they were aware of the existing VFs. Over 90% of respondents agreed with the need for development of a VF for cancer drugs based on Korean healthcare system and further usefulness for decisions about reimbursement issues. Seventy-one percent answered that two representative VFs (American Society Clinical Oncology-VF and European Society for Medical OncologyMagnitude of Clinical Benefit Scale) should be reflected in value measurement of cancer drugs in Korea. Conclusion: The Korean oncologists recognized the necessity for the clinical application of VF. Further discussion between the stakeholders should be followed to alleviate the financial burden through the value-based decision making of cancer drugs.
Charge-Spin Correlation in van der Waals Antiferromagnet NiPS3
Kim, So Yeun,Kim, Tae Yun,Sandilands, Luke J.,Sinn, Soobin,Lee, Min-Cheol,Son, Jaeseok,Lee, Sungmin,Choi, Ki-Young,Kim, Wondong,Park, Byeong-Gyu,Jeon, C.,Kim, Hyeong-Do,Park, Cheol-Hwan,Park, Je-Geun American Physical Society 2018 Physical Review Letters Vol.120 No.13