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>

신경회로망을 이용한 자동 조정 서보제어기

남현도,조일인 단국대학교 1998 論文集 Vol.33 No.-

Conventional PID gain-tunning methods such as a Zigler-Nichols method and the relay feedback method, have many problems, so the optimal controller’s gains should be tuned by using try and error methods. In this paper, modified PID-type controllers which include self-tunning characteristics are pro-posed. Proposed controllers automatically tune the PID gains using neural network, and neural network compensators in proposed controllers have the robust properties against presence of disturbance. A modified learning scheme was also proposed for improving learning speed in neural networks and satisfying the real time condition. Computer simulation were performed to show the usefulness of proposed controllers in case of brushless DC motor control. As shown in result of computer simulations, proposed controllers have good performances and robust properties even though disturbance exists.

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.

하이브리드 적응 필터를 이용한 능동소음제어

남현도 단국대학교 1999 論文集 Vol.34 No.-

Passive noise control techniques is effective at high frequencies (greater than 500 ㎐), but active control control techniques generally work better at low frequencies. An hybrid active noise control (HANC) systems which is based on the combination of feedforward and feedback ANC controllerss is presented in this paper. HANC noise regeneration principle and filtered-X LMS algorithms. HANC systems show better attenuation characteristics and residual spectrum. The order of adaptive filters used in HANC systems is lower than that of conventional feedforward and feedback ANC systems. HANC systems provide broadband noise cancellation, which is a definite asset over feedback ANC systems which cancel only the predictable components of the primary signal. Computer simulations were 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.

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.

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.

능동 소음제어를 위한 적응 필터 설계

南炫道 단국대학교 1995 論文集 Vol.29 No.-

Adaptive algorithms for acctive noise control were considered. Conventional active noise control systems have used LMS(Least Mean Squares) algorithms to design an adaptive filter in spite of slow convergence speed of LMS algorithms. The convergence speed of the LMS algorithm is mainly concerned with the values of the convergence coefficients. In this paper, a fuzzy LMS algorithm, which uses fuzzy logic to select suitable convergence coefficients, is proposed and applied to an active noise control system in a duct. A proposed algorithm shows better convergence property and stability than conventional LMS algorithms. Computer simulations were performed to show effectiveness of a proposed algorithm.

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.

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.