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)

심혈관계 질환으로 관상질환 집중치료실에 입원한 환자들의 혜후 측정을 위한 APACHEⅢ점수 체계의 임상적 유용성

이공섭,이창선,최현주,홍종서,강지향,김도형,이민영,오인균,김병엽,김상억,김학찬,한승혜,이재용,지영우,안경주 대한순환기학회 2000 Korean Circulation Journal Vol.30 No.8

iTECH 바닥 슬래브의 시공단계별 진동특성에 관한 연구

이윤경,주영규,윤성원,김도현,김상대 대한건축학회 2005 大韓建築學會論文集 : 構造系 Vol.21 No.3

The story height of the tall buildings is the significant factor due to the limited construction area within the central city such as Seoul. Therefore we developed iTECH(Innovative Technical Economical & Convenient Hybrid) system to reduce story height. Since the top flange of the proposed beam is within the slab, the vibrational characteristics have to be verified by the test. The purpose of this paper is to study on vibration characteristics of floor with iTECH composite system and to evaluate the serviceability. In this research, natural frequency, damping ratio and peak acceleration were measured at experiments for each construction step such as steel erection stage, concrete casting stage and finishing stage. The test results are compared with that of the code. As a result, the proposed composite slab showed enough vibrational characteristics.

충남대학교 학술림 산책로 훼손실태 및 관리방안에 관한 연구

이준우,김명준,최윤호,전용준,오도교,김민호,이소연,이경형 충남대학교 농업과학연구소 2004 농업과학연구 Vol.31 No.2

This study concentrates an the trail of the CNU(Chungnam National University) forest. The amount of use and the pattern of damage are considered, as well as the extent of environmental damage. Finally, some managerial strategies are proposed in connection with sustainable maintenance. The trail of the university forest is composed of three sections; one is the neighborhood park and the Institute of Information Technology/Communications, the second is the Institute of Information Technology/Communications and the Dormitory, and the third section is the Dormitory and the Foreign prof's Apt. The total length of the trail is 2.6km. The daily amount of use is 1,269 visitors per day. The amount of using increased three times the amount of that in 1998. This study shows the pattern of damage of the trail in the order of root-exposure, widening, rock-exposure, deepening and the divergence in the frequency of occurrence of all these factors. Environmental damage is also graded thus: grade 3 is 27.4m, grade 4 is 0.8m, grade 5 is 1.5m, and grade 6 is 0.2m. Accordingly, some managerial strategies were proposed in connection with the sustainable trail maintenance.

대학생의 단극성 우울중 치료를 위한 프로그램의 평가

金道煥,張赫杓,李京任 釜山大學校 學生生活硏究所 1985 硏究報 Vol.21 No.1

The present study was to evaluate the treatment efficacy in a Coping With Depression Curse (psychoeducational group treatment) for unipolar depression among college students. The Coping with Depression Course constructed by Lewinsohn (1979) is based on the social learning theory analyzing depression. It is assumed to be associated with a decrease in pleasant and an increase in unpleasant person-environment interactions. Following these theoretical notions, the goal of treatment (CWD) is to Set the new self-changing skills : relaxation, Pleasant activities, constructive thinking, and social skills. In order to get the changes of the six participants, there were given pre- and post- tests which were consisted of MMPI-D, SCL-D, and BDI tests. According to the results of these tests, there were significant changes between scores on the pre- and post- test. Generally, those results were supported that CWD was an effective program to treat unipolar depression among college students.

Shield Disk 상의 Ag-Cu 공정계 합금 도금기술 개발

윤경도,차동관,심기종,민봉기,최순돈,이상기 嶺南大學校 工業技術硏究所 2003 工業技術硏究所論文集 Vol.31 No.1

The composition and the microstructure of the Ag-Cu alloy electrodeposits electroplated in Succinimide bath were investigated varying the electrolysis conditions such as bath composition, current density and additive agents etc. The cathode overpotential increased with the increase of Succinimide concentration and current density ratio in the bath. The Ag content of the alloy deposits decreased with the increase of current density and pH and temperature in the bath. The optimum condition for 78wt.%Ag-22wt.%Cu code position alloy is an follows : pH10(adjusted by NH_4OH), 0.03M AgNO_3, 0.27M Cu(NO_3)_2 3H_2O, 0.5M Succinimide in bath and 3.5A/dm^2∼5.5A/dm^2 current density.

온톨로지 매핑 정보를 이용한 웹 서비스 자동발견

송재경,김도현,변영철,이상준 제주대학교 공과대학 첨단기술연구소 2004 尖端技術硏究所論文集 Vol.15 No.2

Web Service is a new model based on web to offer dynamic information for a user's request. Currently, the web service discovery mechanism is not efficient because it does not support automatic discovery based on the semantics or capabilities of a web service. The language for semantic web service, such as OWL-S, is being developed to express the capability of a web service semantically. Such semantics can support the more flexible discovery of web services. Web service discovery occurs when the provider's description matches to that of requester. But the matching can fail when the ontologies of service description differ from that of the requester although the requester wants that Web Service. In distributed environment service providers develope their semantic web services independently and tend to use their ontologies to describe web services. So a new approach must be required to avoid service discovery failure. In this paper, a method of annotating the query of requester and discovering semantic web services without service discovery failure is proposed.

한센병 환자의 족저궤양과 최대 족저압력과의 관계

정도영,박경희,이강성 한국전문물리치료학회 2002 한국전문물리치료학회지 Vol.9 No.1

Foot ulceration results in substantial morbidity in patients with peripheral neuropathy. The purpose of this study was to find the relationship of plantar foot pressures during walking to plantar ulceration in patients with Hansen's disease. The subjects were recuruited from two Welfare Clinic for Hansen's disease in Wonju and Uiwang city. Ten subjects (5 females, 5 males) with plantar ulceration and a mean age of 63 years were evaluated in this study. The mean duration of Hansen's disease in these subjects was 30 years. Plantar pressures were measured during self-selected comfortable walking speed by using MatScan system. Three subjects had plantar ulceration under the first metatarsal head. Five subjects had plantar ulceration under the second and third metatarsal head. Two subjects had plantar ulcers under the fifth metatarsal head. Eight of 10 subjects had plantar ulceration at highest pressure point that measured during walking. This result suggests that the abnormal high plantar pressure could be related factor to plantar ulceration in patients with Hansen's disease. Also the foot pressure measurement may be useful to evaluate the risk of plantar ulceration in patients with Hansen's disease.

탄성반력의 영향에 따른 직교 이방성 복합판의 고유 진동 해석

정영화,심도식,김경진,이세진 江原大學校 産業技術硏究所 1997 産業技術硏究 Vol.17 No.-

In this paper, the result of application of vibration method to the orthotropic plates with free edges supported on elastic foundation and with a pair of opposite edges under axial forces is presented. Such plates represent the concrete highway slab and hybrid composite pavement of bridges. The reinforced concrete slab can be assumed as a special orthotropic plate, as a close approximation. The highway slab is supported on elastic foundation, with free boundaries. Sometimes, the pair of edges perpendicular to the traffic direction amy be subject to the axial forces. The plate is subject to the concentrated load/loads, in the form of traffic loads, or the test equipments. Finite difference method is used to obtain the deflection influence surfaces needed for vibration analysis. The influence of the modulus of the foundation, the aspect ration of the plate, and the magnitudes of the axial forces and the concentrated attached mass on the plate, under the natural frequency is thoroughly studied.