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>

구개열 아동 언어의 진단 평가

신효근,고승오,홍기환,서정환,고도흥,김현기 大韓顎顔面成形再建外科學會 1998 Maxillofacial Plastic Reconstructive Surgery Vol.20 No.1

무용전공별 최대성 운동후 Endorphine변화 및 회복율에 관한 연구

도정님,조근종 漢陽大學校 體育科學硏究所 1994 體育科學 Vol.14 No.14

The purpose of this study was to investigate the endorphine secretion level of dancer according to operating conditions and the differences of catecholamine changes according to dance majors(korea dance,ballet,modern dance) following all-out running on treadmill to understand the physiological mechanism and emotional natural of dancer. Subjects for this study were total 15 female college students(each group : 5) on dance department of HS univ. in Seoul who were selec-ted by cluster sampling method. Independent variation for study was dance major and 5 conditions(rest, immediatly exercise, and IS, 30, 60min. after exorcise), dependent variation was endorphine. Exercise treatment protocol was Bruce's stress testing protocol. For data analysis used 2 way ANOVA of SPSS and critical level for significance was α 0.05. The result of study can be summarized as follows. 1, On endorphine, there are non significant differences among all groups on all conditions. 2. On endorphine recovery rate, korea dance group show the highest, modern dance group show the lowest significantly. 3. Endorphines according to 5 conditions, all groups showed significantly the lowest level at rest or 1 hour after exercise and the highest level at immediate exorcise. In summary, the results of this study showed that dance majors can't effected on endorphine changes in some conditions, but recovery rate are closely related to dance major. But all results have some problem to generalize because individual differences of subject, small subject, difference of equipment condition. So, in fu- ture research should be consider proper exercise treatment and research design ac- cording to subject's speciality.

Morphology를 이용한 Range 영상의 Edge 검출 및 분류

안도건,박용기,김두영 동아대학교 공과대학 부설 한국자원개발연구소 1995 硏究報告 Vol.19 No.1

Range images provide an explicit encoding of the shape and geometric structure of the objects in the image from the point of view of the sensor. Since morphological methods are inherently geometric in nature, they are ideally suited for the analysis of range images. In this paper we propose the method for edge detection and classification in range images using morphological method and surface normals. Dilation residues and erosion residues of structuring elements at different scales are used to extract edges and surface normals are used to remove noises.

독립 유도발전기의 정상상태 해석

김도진,좌종근 제주대학교 공과대학 첨단기술연구소 2002 尖端技術硏究所論文集 Vol.13 No.2

This Paper describes a method of steady state analysis of isolated self excited induction generator using the loop impedance method. In this method, the complex loop impedance based on the condition of self excitation need not be divided into two parts, the real part and imaginary part. This involves the simplest algebraic calculations, but the accuracy of this is as good as the conventional method. The availability of this method is verified by comparing the results of this method with those of conventional.

불평형 전압이 인가된 유도전동기 동손의 예측

김도진,좌종근 제주대학교 공과대학 첨단기술연구소 2004 尖端技術硏究所論文集 Vol.15 No.2

This paper describes the method of predicting copper loss of an induction motor which is operated by unbalanced voltage, with minimun operation data. The unbalanced current and speed of motor are needed for these data. The current unbalance factor(CUF), symmetrical components of current, and CUF angle are computed by using the definition of symmetrical coordinate method. The equivalent circuit parameters under operating condition are determined using the ratio of symmetrical component of voltage and current, and symmetrical impedances. The copper loss is reasonably predicted by these parameters.

구간계산을 사용한 NEWTON방법에 관한 연구

김근시,김도현 濟州大學校 師範大學 科學敎育硏究所 1992 科學敎育 Vol.9 No.1

In general, interval arithmetic as a number of significant applications in cientific, engineering and statistical computation. In this thesis, we shall consider a method for including zeros of a real function of one real variable X. Among the many methods for root-find-ing. we shall study especially the Newton method which uses derivatives. It can be used to find zeros of the function, indluding non-accuracy coefficients.

승모판 대치술후에 발생한 좌심실유출로 폐색 1예

김도연,조홍근,정익모,박시훈,박성훈,신길자,정병철 대한순환기학회 1998 Korean Circulation Journal Vol.28 No.1

운동 중 지방 대사에 대한 고찰

이근일,백병주,김의영,김도준,조용철,정훈,조재혁 龍仁大學校 體育科學硏究所 2002 體育科學硏究論叢 Vol.12 No.1

Glucose-fatty acid cycle is very important because it explains that fatty acid influences glucose level. Glucose-fatty acid cycle is the key factor to understand how endurance training which aids fat oxidation and carbohydrate stored in skeletal muscle influence mitochondria level. However, it is not certain whether glucose-fatty acid cycle influences exercising skeletal muscle of human being. As an energy resource, training increases use of fatty acid, endurance ability, and oxidation of triglyceride. During high level training, catecholamine secretions and restraint of fatty acid use caused by insulin increases dramatically, this results in reduction of free fat acids and reunification of free fat acids into triglyceride. Training restrains insulin activity and reduces plasma acid density, however, elite athletes have high triglyceride-fatty acid cycle. Although enzyme's activities and mitochondira's density increase after training, it's not certain that enzyme's activities is major factor in restraint of fatty acid oxidation in exercising muscle cells. Stores of fat leads to increases of fat oxidation, performance and reduces use of carbohydrate, however, there is no absolute evidence to support these results.